Professions & Public Health Subcommittee Meeting Packet, February 2, 2022
Summary
The meeting packet for the Professions & Public Health Subcommittee of the House of Representatives on Wednesday, February 2, 2022, 11:30 AM to 2:00 PM in Webster Hall (212 Knott), with Chris Sprowls as Speaker and Will Robinson as Chair. Bills listed include HB 593 Telecommunicator Cardiopulmonary Resuscitation, HB 1073 Newborn Screenings, HB 1101 Anesthesiologist Assistants, HB 1209 Administration of Vaccines and HB 1521 Professional Counselors Licensure Compact, with a proposed committee substitute for HB 937, Nonemergent Patient Care. The packet reproduces the bills and staff analyses.
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
Wednesday, February 2, 2022
11:30 AM – 2:00 PM
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: Wednesday, February 02, 2022 11:30 am
End Date and Time: Wednesday, February 02, 2022 02:00 pm
Location: Webster Hall (212 Knott)
Duration: 2.50 hrs
Consideration of the following bill(s):
HB 593 Telecommunicator Cardiopulmonary Resuscitation by Trabulsy, McClure
HB 1073 Newborn Screenings by Aloupis
HB 1101 Anesthesiologist Assistants by Altman
HB 1209 Administration of Vaccines by Tuck
HB 1521 Professional Counselors Licensure Compact by Koster
HB 1523 Pub. Rec. and Meetings/Professional Counselors Licensure Compact by Koster
Consideration of the following proposed committee substitute(s):
PCS for HB 937 -- Nonemergent Patient Care
For information about attending or testifying at a committee meeting, please see the “Visiting the House”
tab at www.myfloridahouse.gov.
NOTICE FINALIZED on 01/31/2022 4:04PM by Osborne.Erin
01/31/2022 04:04:23PM Leagis ® Page 1 of 1
HB 593
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 593 Telecommunicator Cardiopulmonary Resuscitation
SPONSOR(S): Trabulsy
TIED BILLS: IDEN./SIM. BILLS: SB 890
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Guzzo McElroy
2) Health & Human Services Committee
SUMMARY ANALYSIS
A heart attack occurs when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes
blocked. If blood flow is not restored quickly, the section of heart muscle begins to die. Heart attack treatment
is most effective if provided when symptoms first occur. Emergency assistance to a person having a heart
attack is usually provided by emergency medical technicians (EMTs), paramedics, or a bystander who
attempts to administer cardiopulmonary resuscitation (CPR).
The Department of Health (DOH) is responsible for certifying 911 public safety telecommunicators (911 PSTs).
To become certified as a 911 PST an applicant is required to receive 232 hours of training, which must include
successful completion of a CPR certification class. A 911 PST must renew their certification every two years
and must receive 20 hours of continuing education prior to renewal. Current law does not require the 20-hours
of continuing education to include CPR training. Current law also does not require 911 PSTs to complete
biennial telecommunicator CPR training.
The bill requires a 911 PST to complete biennial telecommunicator CPR training in order to have their
certification renewed.
The bill also authorizes certain public safety agencies to enter into a reciprocal agreement with another public
safety agency to provide telephonic assistance in administering CPR, including a fire department, law
enforcement department, or other emergency medical service that receives or dispatches calls for emergency
medical conditions.
The bill has no fiscal impact on state or local government.
The bill provides 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.
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FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Heart Attacks
A heart attack occurs when the flow of oxygen-rich blood to a section of heart muscle suddenly
becomes blocked. 1 If blood flow is not restored quickly, the section of heart muscle begins to die. Heart
attacks most often occur as a result of ischemic heart disease – also known as coronary heart disease
or coronary artery disease, which is caused by plaque build-up inside the coronary arteries. Eventually,
an area of plaque can rupture inside of an artery causing a blood clot to form on the plaque’s surface. If
the blood clot becomes large enough, it can mostly or completely block blood flow through a coronary
artery. If the blockage isn’t treated quickly, the portion of heart muscle fed by the artery begins to die.
Heart attack treatment is most effective if provided when symptoms first occur. 2
911 Public Safety Telecommunicators
Out-of-hospital cardiac arrest describes the sudden, unexpected loss of heart function, breathing, and
consciousness. 3 Every year an estimated 350,000 people have cardiac arrest in the United States in
an out-of-hospital environment and only one out of 10 victims survive. 4 911 public safety
telecommunicators 5 (911 PSTs) along with the 911-caller are often the first responders and it is the 911
PST’s job to transform the caller into a lay rescuer by instructing them how to perform cardiopulmonary
resuscitation (CPR). 6 This is known as telephone CPR. 7 Studies have shown the efficacy of telephone
CPR in increasing the survival rate of sudden cardiac arrest. 8
The Department of Health (DOH) is responsible for certifying 911 PSTs. 9 Certification as a 911 PST is
required for any person employed as a 911 PST at a public safety answering point—the public safety
agency that receives incoming 911 requests for assistance and dispatches appropriate public safety
agencies to respond to the requests. 10 A public safety agency 11 may employ a 911 PST for up to 12
months if the trainee works under the direct supervision of a certified 911 public safety
telecommunicator and is enrolled in a 911 PST training program. 12
DOH is responsible for approving 911 PST training programs, which must be equivalent to the public
safety telecommunication program curriculum framework developed by the Department of Education
1 U.S. Department of Health & Human Services, National Heart, Lung, and Blood Institute, Heart Attack, available at
https://www.nhlbi.nih.gov/health-topics/heart-attack (last visited Jan 26. 20, 2022).
2 Id.
3 Michael Christopher, Telecommunicator Cardiopulmonary Resuscitation – A Policy Statement from the American Heart Association,
AHA Journals, Mar. 24, 2020, available at https://www.ahajournals.org/doi/10.1161/CIR.0000000000000744 (last visited Jan. 26, 2022).
4 Id.
5 A 911 PST is a public safety dispatcher or 911 operator whose duties and responsibilities include the answering, receiving,
transferring, and dispatching functions related to 911 calls; dispatching law enforcement officers, fire rescue services, emergency
medical services, and other public safety services to the scene of an emergency; providing real-time information from federal, state, and
local crime databases; or supervising or serving as the command officer to a person or persons having such duties and responsibilities.
6 Rea TD, Eisenberg MS, Culley LL, Becker L. Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest.
Circulation. 2001 Nov 20;104(21):2513-6. doi: 10.1161/hc4601.099468. PMID: 11714643.
7 Id.
8 Id., see also Eisenberg MS, Hallstrom AP, Carter WB, Cummins RO, Bergner L, Pierce J. Emergency CPR instruction via telephone.
Am J Public Health. 1985 Jan;75(1):47-50. doi: 10.2105/ajph.75.1.47. PMID: 3966598; PMCID: PMC1646147.
9 Section 401.465(2), F.S.
10 Section 401.465(2)(a), F.S.
11 Public safety agency means a functional division of a public agency which provides firefighting, law enforcement, medical, or other
emergency services.
12 Section 401.465(2)(b), F.S.
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(DOE) and consist of at least 232 hours. 13 The curriculum framework developed by DOE requires
students to successfully complete a CPR certification class. 14
A 911 PST must renew their certification every two years and must receive 20 hours of continuing
education prior to renewal, which does not currently include CPR training. 15 Current law also does not
require 911 PSTs to complete biennial telecommunicator CPR training.
Effect of the Bill
The bill requires a 911 PST to complete biennial telecommunicator CPR training in order to have their
certification renewed.
The bill also authorizes certain public safety agencies to enter into a reciprocal agreement with another
public safety agency to provide telephonic assistance in administering CPR, including a fire
department, law enforcement department, or other emergency medical service that receives or
dispatches calls for emergency medical conditions.
The bill provides an effective date of July 1, 2022.
B. SECTION DIRECTORY:
Section 1: Amends s. 401.465, F.S., relating to 911 public safety telecommunicator certification.
Section 2: 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.
D. FISCAL COMMENTS:
None.
III. COMMENTS
13 Section 401.465(1)(c), F.S.
14 Florida Department of Education Curriculum Framework, p. 13 (Jun. 8, 2010), incorporated by reference in rule 64J-3.002, F.A.C.,
available at https://www.flrules.org/Gateway/reference.asp?No=Ref-01490 (last visited Jan. 26, 2022).
15 Rule 64J-3.003, F.A.C.
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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:
DOH has sufficient rule-making authority to implement the provisions of 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 593 2022
1 A bill to be entitled
2 An act relating to telecommunicator cardiopulmonary
3 resuscitation; amending s. 401.465, F.S.; providing
4 definitions; requiring certain 911 public safety
5 telecommunicators to complete biennial
6 telecommunicator cardiopulmonary resuscitation
7 training; authorizing certain agencies to enter into
8 reciprocal agreements with certain entities to provide
9 telephonic assistance in administering cardiopulmonary
10 resuscitation under certain circumstances; requiring
11 certain employees of such agencies to directly provide
12 telephonic assistance in administering cardiopulmonary
13 resuscitation, when appropriate, or transfer telephone
14 calls for emergency medical conditions to certain
15 entities; providing an effective date.
16
17 Be It Enacted by the Legislature of the State of Florida:
18
19 Section 1. Paragraph (c) of subsection (1) of section
20 401.465, Florida Statutes, is redesignated as paragraph (d),
21 subsections (3) and (4) are renumbered as subsections (4) and
22 (5), respectively, paragraphs (b), (d), (i), and (j) of
23 subsection (2) of that section are amended, new paragraphs (c)
24 and (e) are added to subsection (1) of that section, and a new
25 subsection (3) is added to that section, to read:
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hb0593-00
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 593 2022
26 401.465 911 public safety telecommunicator certification. —
27 (1) DEFINITIONS.—As used in this section, the term:
28 (c) "Public safety agency" has the same meaning as in s.
29 365.171(3)(d).
30 (e) "Telecommunicator cardiopulmonary resuscitation
31 training" means specific training, including continuous
32 education, that is evidence based and contains nationally
33 accepted guidelines for high-quality telecommunicator
34 cardiopulmonary resuscitation with the recognition of out-of-
35 hospital cardiac arrest over the telephone and the delivery of
36 telephonic instructions for treating cardiac arrest and
37 performing compression-only cardiopulmonary resuscitation.
38 (2) PERSONNEL; STANDARDS AND CERTIFICATION.—
39 (b) A public safety agency, as defined in s.
40 365.171(3)(d), may employ a 911 public safety telecommunicator
41 trainee for a period not to exceed 12 months if the trainee
42 works under the direct supervision of a certified 911 public
43 safety telecommunicator, as determined by rule of the
44 department, and is enrolled in a public safety telecommunication
45 training program.
46 (d) The department shall determine whether the applicant
47 meets the requirements specified in this section and in rules of
48 the department and shall issue a certificate to any person who
49 meets such requirements. Such requirements must include all of
50 the following:
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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 593 2022
51 1. Completion of an appropriate 911 public safety
52 telecommunication training program.;
53 2. Certification under oath that the applicant is not
54 addicted to alcohol or any controlled substance.;
55 3. Certification under oath that the applicant is free
56 from any physical or mental defect or disease that might impair
57 the applicant's ability to perform his or her duties.;
58 4. Submission of the application fee prescribed in
59 subsection (4). (3);
60 5. Submission of a completed application to the department
61 which indicates compliance with subparagraphs 1., 2., and 3. ;
62 and
63 6. Effective October 1, 2012, passage of an examination
64 approved by the department which measures the applicant's
65 competency and proficiency in the subject material of the public
66 safety telecommunication training program.
67 (i) If a person was employed as a 911 public safety
68 telecommunicator or a state-certified firefighter before April
69 1, 2012, he or she must pass the examination approved by the
70 department which measures the competency and proficiency in the
71 subject material of the public safety telecommunication program ,
72 as defined in paragraph (1)(c). Upon passage of the examination,
73 the completion of the public safety telecommunication training
74 program is waived.
75 (j)1. The requirement for certification as a 911 public
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HB 593 2022
76 safety telecommunicator is waived for a person employed as a
77 sworn state-certified law enforcement officer, if provided the
78 officer:
79 a. Is selected by his or her chief executive to perform as
80 a 911 public safety telecommunicator;
81 b. Performs as a 911 public safety telecommunicator on an
82 occasional or limited basis; and
83 c. Passes the department-approved examination that
84 measures the competency and proficiency of an applicant in the
85 subject material comprising the public safety telecommunication
86 program.
87 2. A sworn state-certified law enforcement officer who
88 fails an examination taken under subparagraph 1. must take a
89 department-approved public safety telecommunication training
90 program before prior to retaking the examination.
91 3. The testing required under this paragraph is exempt
92 from the examination fee required under subsection (4) (3).
93 (3) TELECOMMUNICATOR CARDIOPULMONARY RESUSCITATION.—
94 (a) In addition to the certification and recertification
95 requirements in this section, 911 public safety
96 telecommunicators who answer telephone calls and provide
97 dispatch functions for emergency medical conditions must
98 complete telecommunicator cardiopulmonary resuscitation training
99 every 2 years.
100 (b)1. A public safety agency or any agency that receives
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HB 593 2022
101 or dispatches telephone calls for emergency medical conditions
102 may enter into a reciprocal agreement with another public safety
103 agency or agency that receives or dispatches such telephone
104 calls, a dedicated phone line, or a call center to provide
105 telephonic assistance in administering cardiopulmonary
106 resuscitation, if the applicable agency, dedicated phone line,
107 or call center that will be accepting the telephone calls
108 employs 911 public safety telecommunicators who have completed
109 telecommunicator cardiopulmonary resuscitation training pursuant
110 to paragraph (a).
111 2. Any employee of a public safety agency or agency
112 receiving or dispatching telephone calls for emergency m edical
113 conditions who answers such telephone calls must directly
114 provide telephonic assistance in administering cardiopulmonary
115 resuscitation, when appropriate, or transfer such calls to the
116 applicable agency, dedicated phone line, or call center with
117 which the transferring agency has a reciprocal agreement as
118 provided in subparagraph 1.
119 Section 2. This act shall take effect July 1, 2022.
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hb0593-00
PCS for HB 937
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: PCS for HB 937 Nonemergent Patient Care
SPONSOR(S): Professions & Public Health Subcommittee
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
Orig. Comm.: Professions & Public Health Morris McElroy
Subcommittee
SUMMARY ANALYSIS
In November 2020, as a response to the COVID-19 pandemic, the federal Centers for Medicare and Medicaid
Services began issuing waivers to eligible hospitals authorizing the practice of acute hospital care at home.
The Acute Hospital Care at Home program (Program) allows eligible hospitals to treat eligible patients in their
homes for more than 60 acute conditions, such as asthma, congestive heart failure, pneumonia, and chronic
obstructive pulmonary disease. The Program treats patients who require acute inpatient admission to a
hospital and at least daily checks by a physician and a medical team monitoring the patient’s care needs on an
ongoing basis. Patient participation in the Program is voluntary.
Participating hospitals must have screening protocols which assess both medical and non-medical factors,
including working utilities, assessment of physical barriers, and screenings for domestic violence concerns.
Eligible patients are admitted only from emergency departments and inpatient hospital beds. An in-person
evaluation is required prior to starting care at home. Registered nurses must evaluate each patient once per
day, either in person or remotely, and two in-person visits must occur daily by either a registered nurse or a
paramedic.
Paramedics are regulated by the Department of Health (DOH) and are certified to provide basic life support
(BLS) and advanced life support services (ALS). Paramedics are not authorized under current law to provide
non-emergent BLS and ALS in a home care setting.
PCS for HB 937 authorizes paramedics to provide BLS and ALS services to acute hospital care at home
patients as specified by a physician. A physician who supervises or provides medical direction to a paramedic
for acute hospital care at home is liable for any act or omission of the paramedic when performing ALS or BLS
services in such setting.
An institutional pharmacy is a pharmacy located within a hospital, clinic, nursing home, dispensary, sanitarium,
extended care facility, or other facility locations where medicinal drugs are compounded, dispensed, stored, or
sold. Class III institutional pharmacies are institutional pharmacies affiliated with a hospital which employ a
registered pharmacist who consults with and dispenses medicinal drugs to patients on the premises of the
hospital, for use on hospital premises. Class III institutional pharmacies also dispense, distribute, compound,
and fill prescriptions for medicinal drugs for inpatient treatment only. It is unclear whether such a pharmacy is
authorized to dispense to a patient receiving care under an acute care at home program.
The bill authorizes Class III institutional pharmacies to dispense, distribute, compound, and fill prescriptions for
medicinal drugs for inpatient treatment and for acute hospital care at home program patients.
The bill has a significant, negative fiscal impact on DOH and no fiscal impact on local governments.
The bill provides 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.
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FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Emergency Medical Services
The Department of Health (DOH) regulates paramedics under part III of ch. 401, F.S. A paramedic is a
person who is certified by DOH to perform basic life support (BLS) and advanced life support (ALS)
services. 1
BLS service refers to any emergency medical service that uses only basic life support techniques. 2
BLS includes basic non-invasive interventions to reduce morbidity and mortality associated with out-of-
hospital medical and traumatic emergencies. 3 The services provided may include stabilization and
maintenance of airway and breathing, pharmacological interventions, trauma care, and transportation
to an appropriate medical facility. 4
ALS service refers to any emergency medical or non-transport service that uses advanced life support
techniques. 5 ALS includes the assessment or treatment of a person by a qualified individual, such as a
paramedic, who is trained in the use of techniques such as the administration of drugs or intravenous
fluid, endotracheal intubation, telemetry, cardiac monitoring, and cardiac defibrillation. 6
Paramedics are not authorized under current law to provide non-emergent BLS and ALS in a home
care setting.
Acute Hospital Care at Home
Hospitals are licensed and regulated pursuant to ch. 395, F.S., by the Agency for Health Care
Administration (AHCA) in this state.
In November, 2020, as a response to the COVID-19 pandemic, the federal Centers for Medicare and
Medicaid Services (CMS) began issuing waivers to eligible hospitals authorizing the practice of acute
hospital care at home. 7 The Acute Hospital Care at Home program (Program) allows eligible hospitals
to treat eligible patients in their homes. A patient’s home is his or her permanent residence, which
includes assisted living, but does not include nursing homes. 8
Treatment for more than 60 acute conditions, such as asthma, congestive heart failure, pneumonia,
and chronic obstructive pulmonary disease, may be provided through the Program. 9 The Program
treats patients who require acute inpatient admission to a hospital and at least daily rounding by a
physician and a medical team monitoring the patient’s care needs on an ongoing basis. 10 Patient
participation in the program is voluntary. 11
1 S. 401.23(17), F.S.
2 S. 401.23(8), F.S.
3 S. 401.23(7), F.S., and U.S. Department of Transportation, National Highway Safety Administration, National EMS Scope of Practice
Model 23-24, available at www.nhtsa.gov/people/injury/ems/pub/emtbnsc.pdf (last visited Jan. 29, 2022).
4 Id.
5 S. 401.23(2), F.S.
6 S. 401.23(1), F.S.
7 Centers for Medicare and Medicaid Services, Press Release – CMS Announces Comprehensive Strategy to Enhance Hospital
Capacity Amid COVID-19 Surge, https://www.cms.gov/newsroom/press-releases/cms-announces-comprehensive-strategy-enhance-
hospital-capacity-amid-covid-19-surge (last visited Jan. 29, 2022).
8 Centers for Medicare and Medicaid Services, Acute Hospital Care at Home Frequently Asked Questions,
https://qualitynet.cms.gov/acute-hospital-care-at-home/resources#tab2 (last visited Jan. 29, 2022).
9 Supra, note 7.
10 Id.
11 Supra, note 8.
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Participating hospitals are required to have screening protocols which assess both medical and non-
medical factors, including working utilities, assessment of physical barriers, and screenings for
domestic violence concerns. Eligible patients are admitted only from emergency departments and
inpatient hospital beds. An in-person evaluation is required prior to starting care at home. Registered
nurses must evaluate each patient once per day, either in person or remotely, and two in-person visits
must occur daily by either a registered nurse or a paramedic. 12 Programs must obtain a waiver from
AHCA rule requiring only registered nurses to conduct evaluations in order for paramedics to conduct
such in-person visits. 13
As of January, 2022, 90 hospital systems and 197 hospitals across 37 states are approved to
participate in the Program. 14 Participants in Florida include Mayo Clinic, Cleveland Clinic, Health First
hospitals, 15 Keralty Hospital, 16 and Tampa General Hospital. 17
Pharmacy Regulation
A person must obtain a DOH-issued permit to operate one of five types of pharmacies:
• Community pharmacy – Where medicinal drugs are compounded, dispensed, stored, or sold
or where prescriptions are filled or dispensed on an outpatient basis. 18
• Institutional pharmacy – Hospital, clinic, nursing home, dispensary, sanitarium, extended care
facility, or other facility locations where medicinal drugs are compounded, dispensed, stored, or
sold. 19
• Nuclear pharmacy – Where radioactive drugs and chemicals within the classification of
medicinal drugs are compounded, dispensed, stored, or sold, other than hospitals. 20
• Special pharmacy - Locations where medicinal drugs are compounded, dispensed, stored, or
sold if these locations do not otherwise meet an applicable pharmacy definition in s. 465.003,
F.S. 21
• Internet pharmacy – Locations not otherwise licensed or issued a pharmacy permit within or
outside this state, which use the Internet to communicate with or obtain information from
consumers in this state to fill or refill prescriptions or to dispense, distribute, or otherwise
practice pharmacy in this state. 22
All permitted pharmacies must pass an on-site inspection before DOH will issue an initial permit and
any time a pharmacy changes its ownership or address. 23
Institutional Pharmacies
An institutional pharmacy is a pharmacy within a healthcare institution, such as a hospital, nursing
home, or clinic (as opposed to a community pharmacy, which dispenses drugs to the general public on
an outpatient basis). 24 There are four types of institutional pharmacies: 25
• Class I Institutional permits are issued to institutional pharmacies in which all medicinal drugs
are administered from individual prescription containers to individual patients and in which
12 Supra, note 8
13 Programs must obtain an AHCA waiver for Rule 59A-3.243(4)(c) and (6), F.A.C., relating to nursing services.
14 Centers for Medicare and Medicaid Services, Approved Facilities/Systems for Acute Hospital Care at Home,
https://qualitynet.cms.gov/acute-hospital-care-at-home/resources#tab1 (last visited Jan. 29, 2022).
15 Palm Bay Hospital, Holmes Regional Medical Center, Viera Hospital, and Cape Canaveral Hospital.
16 Formerly Westchester Hospital.
17 Id.
18 Ss. 465.003(11)(a)1. and 465.018, F.S.
19 Ss. 465.003(11)(a)2. and 465.019, F.S.
20 Ss. 465.003(11)(a)3. and 465.0193, F.S.
21 Ss. 465.003(11)(a)4. and 465.0196, F.S.
22 Ss. 465.003(11)(a)5. and 465.0197, F.S.
23 Rule 64B16-28(1)(d), F.A.C.
24 S. 465.003(11), F.S.
25 S. 465.019, F.S.
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medicinal drugs are not dispensed on the premises, except that licensed nursing homes 26 may
purchase medical oxygen for administration to residents.
• Class II Institutional permits are issued to institutional pharmacies that employ a registered
pharmacist who consults with and dispenses medicinal drugs to patients on the premises of the
institution, for use on the premises of the institution.
• Modified Class II Institutional permits are issued to institutional pharmacies in a short-term,
primary care treatment center that meet all the requirements for a Class II permit, except space
and equipment requirements.
• Class III Institutional permits are issued to institutional pharmacies, including central distribution
facilities, affiliated with a hospital that provide the same services that are authorized by a Class
II institutional pharmacy permit. Additionally, an Class III Institutional pharmacy may:
o Dispense, distribute, compound, and fill prescriptions for medicinal drugs;
o Prepare prepackaged drug products;
o Conduct other pharmaceutical services for the affiliated hospital and for entities under
common control that are appropriately permitted;
o Provide the above-listed services to an entity under common control which holds an
active health care clinic establishment permit. 27
Class III Institutional pharmacies must also maintain policies and procedures which address: 28
• Safe practices for the preparation, dispensing, prepackaging, distribution, and transportation of
medicinal drugs and prepackaged drug products;
• Recordkeeping to monitor the movement, distribution, and transportation of medicinal drugs and
prepackaged drug products;
• Recordkeeping of pharmacy staff responsible for each step in the preparation, dispensing,
prepackaging, transportation, and distribution of medicinal drugs and prepackaged drug
products; and
• Medicinal drugs and prepackaged drug products that may not be safely distributed among Class
III institutional pharmacies.
All institutional pharmacies must designate a consultant pharmacist of record. 29 The consultant
pharmacist’s responsibilities include: 30
• Maintaining all drug records required by law;
• Ordering and evaluating laboratory or clinical testing when necessary for the proper
performance of the consultant pharmacist’s responsibilities; 31
• Conducting drug regimen reviews as required by state or federal law; and
• Inspecting the facility and preparing a written report to be filed at the permitted facility monthly.
Dispensing by Institutional Pharmacies
An institutional pharmacy must hold a community pharmacy permit to dispense medicinal drugs to
outpatients. 32 However, hospitals that operate Class II or Class III institutional pharmacies may
dispense a limited supply of medicinal drugs to emergency department patients and inpatients upon
discharge when the prescriber determines the medicinal drug is warranted and community pharmacy
services are unavailable. An authorized prescriber may prescribe and a hospital pharmacy may
26 Nursing homes are licensed under part II, ch. 400, F.S.
27 A health care clinic establishment permit is required for the purchase of a prescription drug by a place of business at one general
physical location that provides health care or veterinary services, which is owned or operated by a business entity. See s. 499.01(2)(r),
F.S.
28 S. 465.019(1)(d), F.S.
29 S. 465.019(5), F.S., and r. 64B16-28.501, F.A.C.
30 S. 465.0125, F.S., and r. 64B16-28.501, F.A.C.
31 A consultant pharmacist may only order these tests for patients under the care of a licensed home health agency and when
authorized by a licensed allopathic physician, osteopathic physician, podiatric physician, or dentist. The consultant pharmacist must
complete additional training and meet additional qualifications in the practice of institutional pharmacy, as required by the board. See s.
465.0125.
32 S. 465.019(4), F.S.
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dispense the greater of a 48-hour supply of a medicinal drug or a supply sufficient to last until the end
of the next business day. 33 An authorized prescriber may prescribe a medicinal drug beyond the initial
prescription period if the prescriber determines the medicinal drug is warranted. 34 Additionally, a
hospital pharmacy may dispense a supply of a medicinal drug that will last up to 72 hours if the patient
is located in an area of the state in which a state of emergency is declared. 35 Such dispensing must be
in accordance with the hospital’s procedures.
It is unclear whether a Class III institutional pharmacy is authorized to dispense to a patient receiving
care under an acute care at home program.
Effect of the Bill
Acute Hospital Care at Home
HB 937 authorizes paramedics to provide BLS and ALS to acute hospital care at home patients as
specified in a paramedic’s supervisory relationship with a physician or a physician’s standing orders. A
physician who supervises or provides medical direction to a paramedic for acute hospital care at home
is liable for any act or omission of the paramedic when performing ALS or BLS services in such setting.
Acute hospital care at home is acute and post-acute health care services provided in a qualified
patient’s permanent residence through a program approved by CMS and AHCA.
Institutional Pharmacies
The bill authorizes Class III institutional pharmacies to dispense, distribute, compound, and fill
prescriptions for medicinal drugs for inpatient treatment and acute care at home patients.
The bill makes technical and conforming changes.
The bill provides an effective date of July 1, 2022.
B. SECTION DIRECTORY:
Section 1: Amends s. 401.23, F.S., relating to definitions.
Section 2: Amends s. 401.272, F.S., relating to emergency medical services community health
care.
Section 3: Amends s. 465.003, F.S., relating to definitions.
Section 4: Amends s. 465.019, F.S., relating to institutional pharmacies.
Section 5: Amends s. 14.33, F.S., relating to Medal of Heroism.
Section 6: Amends s. 252.515, F.S., relating to Post Disaster Relief Assistance Act; immunity from
civil liability.
Section 7: Amends s. 395.1027, F.S., relating to regional poison control centers.
Section 8: Amends s. 401.245, F.S., relating to Emergency Medical Services Advisory Council.
Section 9: 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:
33 Id.
34 Id.
35 Id.
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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:
The bill and current law provide sufficient rulemaking authority to implement the provisions of 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
PCS for HB 937 2022
1 A bill to be entitled
2 An act relating to acute hospital care at home;
3 amending s. 401.23, F.S.; defining the term "acute
4 hospital care at home"; amending s. 401.272, F.S.;
5 authorizing paramedics to perform basic life support
6 services and advanced life support services to acute
7 hospital care at home patients under certain
8 circumstances; providing that a physician or medical
9 director who supervises or directs the provision of
10 such services by a paramedic is liable for any act or
11 omission during the provision of such services;
12 authorizing the Department of Health to adopt rules;
13 amending s. 465.003, F.S.; defining the term "acute
14 hospital care at home"; amending s. 465.019, F.S.;
15 specifying that Class III institutional pharmacies may
16 dispense, distribute, compound, and fill prescriptions
17 for medicinal drugs for inpatient treatment and acute
18 care at home patients; amending ss. 14.33, 252.515,
19 395.1027, and 401.245, F.S.; conforming cross-
20 references; providing an effective date.
21
22 Be It Enacted by the Legislature of the State of Florida:
23
24 Section 1. Present subsections (1) through (22) of section
25 401.23, Florida Statutes, are redesignated as subsections (2)
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26 through (23), respectively, a new subsection (1) is added to
27 that section, and present subsection (19) of that section is
28 amended, to read:
29 401.23 Definitions.—As used in this part, the term:
30 (1) "Acute hospital care at home" means acute and post-
31 acute health care services provided in a clinically qualified
32 patient’s permanent residence, as defined in s. 196.012, through
33 a program approved by the Centers for Medicare and Medicaid
34 Services and the Agency for Health Care Administration.
35 (20)(19) "Physician" means a practitioner who is licensed
36 under the provisions of chapter 458 or chapter 459. For the
37 purpose of providing "medical direction" as defined in this
38 section subsection (14) for the treatment of patients
39 immediately before prior to or during transportation to a United
40 States Department of Veterans Affairs medical facility,
41 "physician" also means a practitioner employed by the United
42 States Department of Veterans Affairs.
43 Section 2. Paragraph (c) is added to subsection (2) of
44 section 401.272, Florida Statutes, to read:
45 401.272 Emergency medical services community health care.—
46 (2) Notwithstanding any other provision of law to the
47 contrary:
48 (c) Paramedics may provide basic life support services and
49 advanced life support services to acute hospital care at home
50 patients as specified in the paramedic’s supervisory
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51 relationship with a physician or standing orders as described in
52 s. 401.265, s. 458.348, or s. 459.025. Each physician who
53 supervises or provides medical direction to a paramedic who
54 administers basic life support services or advanced life support
55 services to acute care at home patients pursuant to a formal
56 supervisory relationship or standing orders is liable for any
57 act or omission of the paramedic acting under the physician’s
58 supervision or medical direction when performing such services.
59 The department may adopt and enforce rules necessary to enforce
60 this paragraph.
61 Section 3. Subsections (1) through (22) of section
62 465.003, Florida Statutes, are renumbered as subsections (2)
63 through (23), respectively, and subsection (1) is added to that
64 section, to read:
65 465.003 Definitions.—As used in this chapter, the term:
66 (1) "Acute hospital care at home" means acute and post-
67 acute health care services provided in a clinically qualified
68 patient’s permanent residence, as defined in s. 196.012, through
69 a program approved by the Centers for Medicare and Medicaid
70 Services and the Agency for Health Care Administration.
71 Section 4. Paragraph (d) of subsection (2) and paragraph
72 (a) of subsection (4) of section 465.019, Florida Statutes, are
73 amended to read:
74 465.019 Institutional pharmacies; permits.—
75 (2) The following classes of institutional pharmacies are
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76 established:
77 (d)1. "Class III institutional pharmacies" are those
78 institutional pharmacies, including central distribution
79 facilities, affiliated with a hospital which that provide the
80 same services that are authorized by a Class II institutional
81 pharmacy permit. Class III institutional pharmacies may also:
82 a. Dispense, distribute, compound, and fill prescriptions
83 for medicinal drugs for inpatient treatment or for acute
84 hospital care at home program patients.
85 b. Prepare prepackaged drug products.
86 c. Conduct other pharmaceutical services for the
87 affiliated hospital and for entities under common control that
88 are each permitted under this chapter to possess medicinal
89 drugs.
90 d. Provide the services in sub-subparagraphs a.-c. to an
91 entity under common control which holds an active health care
92 clinic establishment permit as required under s. 499.01(2)(r).
93 2. A Class III institutional pharmacy shall maintain
94 policies and procedures addressing:
95 a. The consultant pharmacist responsible for
96 pharmaceutical services.
97 b. Safe practices for the preparation, dispensing,
98 prepackaging, distribution, and transportation of medicinal
99 drugs and prepackaged drug products.
100 c. Recordkeeping to monitor the movement, distribution,
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101 and transportation of medicinal drugs and prepackaged drug
102 products.
103 d. Recordkeeping of pharmacy staff responsible for each
104 step in the preparation, dispensing, prepackaging,
105 transportation, and distribution of medicinal drugs and
106 prepackaged drug products.
107 e. Medicinal drugs and prepackaged drug products that may
108 not be safely distributed among Class III institutional
109 pharmacies.
110 (4)(a) Medicinal drugs shall be dispensed by in an
111 institutional pharmacy to outpatients only when that institution
112 has secured a community pharmacy permit from the department.
113 However, medicinal drugs may be dispensed by a hospital that
114 operates a Class II or Class III institutional pharmacy to a
115 patient of the hospital's emergency department or a hospital
116 inpatient upon discharge if a prescriber, as defined in s.
117 465.025(1), treating the patient in such hospital determines
118 that the medicinal drug is warranted and that community pharmacy
119 services are not readily accessible, geographically or
120 otherwise, to the patient. Such prescribing and dispensing must
121 be for a supply of the drug that will last for the greater of
122 the following:
123 1. Up to 48 hours; or
124 2. Through the end of the next business day.
125 Section 5. Subsection (1) of section 14.33, Florida
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126 Statutes, is amended to read:
127 14.33 Medal of Heroism.—
128 (1) The Governor may award a Medal of Heroism of
129 appropriate design, with ribbons and appurtenances, to a law
130 enforcement, correctional, or correctional probation officer, as
131 defined in s. 943.10(14); a firefighter, as defined in s.
132 112.191(1)(b); an emergency medical technician, as defined in s.
133 401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s.
134 401.23(17). A recipient must have distinguished himself or
135 herself conspicuously by gallantry and intrepidity, must have
136 risked his or her life deliberately above and beyond the call of
137 duty while performing duty in his or her respective position,
138 and must have engaged in hazardous or perilous activities to
139 preserve lives with the knowledge that such activities might
140 result in great personal harm.
141 Section 6. Paragraph (a) of subsection (3) of section
142 252.515, Florida Statutes, is amended to read:
143 252.515 Postdisaster Relief Assistance Act; immunity from
144 civil liability.—
145 (3) As used in this section, the term:
146 (a) "Emergency first responder" means:
147 1. A physician licensed under chapter 458.
148 2. An osteopathic physician licensed under chapter 459.
149 3. A chiropractic physician licensed under chapter 460.
150 4. A podiatric physician licensed under chapter 461.
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151 5. A dentist licensed under chapter 466.
152 6. An advanced practice registered nurse licensed under s.
153 464.012.
154 7. A physician assistant licensed under s. 458.347 or s.
155 459.022.
156 8. A worker employed by a public or private hospital in
157 the state.
158 9. A paramedic as defined in s. 401.23 s. 401.23(17).
159 10. An emergency medical technician as defined in s.
160 401.23 s. 401.23(11).
161 11. A firefighter as defined in s. 633.102.
162 12. A law enforcement officer as defined in s. 943.10.
163 13. A member of the Florida National Guard.
164 14. Any other personnel designated as emergency personnel
165 by the Governor pursuant to a declared emergency.
166 Section 7. Subsection (5) of section 395.1027, Florida
167 Statutes, is amended to read:
168 395.1027 Regional poison control centers.—
169 (5) By October 1, 1999, each regional poison control
170 center shall develop a prehospital emergency dispatch protocol
171 with each licensee as defined in s. 401.23 by s. 401.23(13) in
172 the geographic area covered by the regional poison control
173 center. The prehospital emergency dispatch protocol shall be
174 developed by each licensee's medical director in conjunction
175 with the designated regional poison control center responsible
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176 for the geographic area in which the licensee operates. The
177 protocol shall define toxic substances and describe the
178 procedure by which the designated regional poison control center
179 may be consulted by the licensee. If a call is transferred to
180 the designated regional poison control center in accordance with
181 the protocol established under this section and s. 401.268, the
182 designated regional poison control center shall assume
183 responsibility and liability for the call.
184 Section 8. Paragraph (b) of subsection (2) of section
185 401.245, Florida Statutes, is amended to read:
186 401.245 Emergency Medical Services Advisory Council.—
187 (2)
188 (b) Representation on the Emergency Medical Services
189 Advisory Council shall include: two licensed physicians who are
190 "medical directors" as defined in s. 401.23 s. 401.23(15) or
191 whose medical practice is closely related to emergency medical
192 services; two emergency medical service administrators, one of
193 whom is employed by a fire service; two certified paramedics,
194 one of whom is employed by a fire service; two certified
195 emergency medical technicians, one of whom is employed by a fire
196 service; one emergency medical services educator; one emergency
197 nurse; one hospital administrator; one representative of air
198 ambulance services; one representative of a commercial ambulance
199 operator; and two laypersons who are in no way connected with
200 emergency medical services, one of whom is a representative of
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201 the elderly. Ex officio members of the advisory council from
202 state agencies shall include, but are shall not be limited to,
203 representatives from the Department of Education, the Department
204 of Management Services, the State Fire Marshal, the Department
205 of Highway Safety and Motor Vehicles, the Department of
206 Transportation, and the Division of Emergency Management.
207 Section 9. This act shall take effect July 1, 2022.
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HB 1073
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1073 Newborn Screenings
SPONSOR(S): Aloupis
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Morris McElroy
2) Health Care Appropriations Subcommittee
3) Health & Human Services Committee
SUMMARY ANALYSIS
Cytomegalovirus (CMV) is a common virus that infects people of all ages. Over half of adults are infected with CMV by
age 40. Most people infected with CMV show no signs or symptoms. Pregnant women infected with CMV may pass the
virus on to their baby. Approximately one of every 200 babies is born with congenital CMV. About one in five babies with
congenital CMV have long-term health problems, including hearing loss. Current law requires that a newborn hearing
screening must be conducted on all newborns in hospitals in this state on birth admission. Screening for congenital CMV
is not required under current law.
HB 1073 requires a hospital or other state-licensed birthing facility to administer a test approved by the U.S. Food and
Drug Administration (FDA) on a newborn to screen for congenital CMV should the newborn fail his or her screening for
hearing loss. The congenital CMV test must be administered before the newborn becomes 21 days of age or before
discharge, whichever occurs earlier.
The bill also requires primary care providers to ensure that newborns in their care are screened for hearing loss within 21
days after birth. If a newborn fails the hearing screening the bill requires primary care providers to administer a FDA-
approved test to screen for congenital CMV before the newborn becomes 21 days old.
Current law requires birth centers to refer newborns to a licensed audiologist, physician, or hospital for screening for
detection of hearing loss before the newborn is discharged. If the birth is a home birth, the health care provider in
attendance must provide a referral to a licensed audiologist, hospital, or other newborn hearing screening provider. The
bill adds physicians to the list of facilities and practitioners to whom a parent may be referred to obtain the required
newborn hearing screening after a home birth.
Currently, all newborns delivered in a hospital or other state-licensed birthing facility must have a hearing screen
performed prior to being discharged. However, if the screening is not completed before discharge due to scheduling or
temporary staffing limitations, the screening must be completed within 30 days after birth. The bill requires screenings in
these cases to be completed within 21 days after birth.
Current law requires that health care providers in attendance of a home birth to coordinate and refer newborns to a
licensed audiologist, a hospital, or another newborn hearing screening provider within 30 days after birth. The bill reduces
the amount of days such referral is required from 30 days after birth to 7 days after birth, and adds physicians to the list of
practitioners to whom a parent may be referred to for obtaining the required newborn hearing screening after a home
birth.
The bill requires the results of a newborn hearing screening and congenital CMV and any related diagnostic testing to be
reported to DOH within 7 days after receipt of such results.
The bill has a significant, negative fiscal impact on the Department of Health and no fiscal impact on local governments.
The bill provides an effective date of January 1, 2023.
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
Florida Newborn Screening Program
The Legislature created the Florida Newborn Screening Program (NSP) within the Department of
Health (DOH), to promote the screening of all newborns for metabolic, hereditary, and congenital
disorders known to result in significant impairment of health or intellect. 1 The NSP also promotes the
identification and screening of all newborns in this state and their families for environmental risk factors
such as low income, poor education, maternal and family stress, emotional instability, substance
abuse, and other high-risk conditions associated with increased risk of infant mortality and morbidity to
provide early intervention, remediation, and prevention services. 2
The NSP involves coordination among several entities, including the Bureau of Public Health
Laboratories Newborn Screening Laboratory in Jacksonville (state laboratory), DOH Children’s Medical
Services (CMS) Newborn Screening Follow-up Program in Tallahassee, and referral centers, birthing
centers, and physicians throughout the state. 3 Health care providers in hospitals, birthing centers,
perinatal centers, county health departments, and school health programs provide screening as part of
the multilevel NSP screening process. 4 This includes a risk assessment for prenatal women, and risk
factor analysis and screening for postnatal women and newborns as well as laboratory screening for
selected disorders in newborns. 5 The NSP attempts to screen all newborns for hearing impairment and
to identify, diagnose, and manage newborns at risk for selected disorders that, without detection and
treatment, can lead to permanent developmental and physical damage or death. 6 While the NSP
attempts to screen all prenatal women and newborns, parents and guardians may decline the
screening. 7
Health care providers perform non-laboratory NSP screening, such as hearing and risk factor analysis,
and report the results to the Office of Vital Statistics. If necessary, health care providers refer patients
to the appropriate health, education, and social services. 8 Health care providers in hospitals and
birthing centers perform specimen collection for laboratory NSP screening by collecting a few drops of
blood from the newborn’s heel on a standardized specimen collection card. 9 The specimen card is then
sent to the state laboratory for testing. 10 The results of the laboratory test are released to the newborn’s
health care provider. In the event that a newborn screen has an abnormal result, the baby’s health care
provider, or a nurse or specialist from NSP’s Follow-up Program provides follow-up services and
referrals for the child and his or her family. 11
To administer the NSP, DOH is authorized to charge and collect a fee not to exceed $15 per live birth
occurring in a hospital or birth center. 12 DOH must calculate the annual assessment for each hospital
and birth center, and then quarterly generate and mail each hospital and birth center a statement of the
1 S. 383.14(1), F.S.
2 Id.
3 S. 383.14, F.S.
4 Supra, note 1.
5 Id.
6 Florida Department of Health, Florida Newborn Screening Guidelines, 2012, http://floridanewbornscreening.com/wp-
content/uploads/guidelines-final-05-24-2012small-1.pdf (last visited Jan. 29, 2022).
7 S. 383.14(4), F.S.; Rule 64C-7.008, F.A.C.; The health care provider must attempt to get a written statement of objection to be placed
in the medical record.
8 Id.
9 Florida Newborn Screening, What is Newborn Screening?, https://floridanewbornscreening.com/parents/what-is-newborn-screening/
(last visited Jan. 29, 2022). See also Specimen Collection Card, http://floridanewbornscreening.com/wp-content/uploads/Order-
Form.png (last visited Jan. 29, 2022).
10 Id.
11 Id.
12 S. 383.14(3)(g)1., F.S.
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amount due. 13 DOH bills hospitals and birth centers quarterly using vital statistics data to determine the
amount to be billed. 14 DOH is authorized to bill third-party payers for the NSP tests and bills insurers
directly for the cost of the screening. 15 DOH does not bill families that do not have insurance
coverage. 16
The Legislature established the Florida Genetics and Newborn Screening Advisory Council to advise
DOH about which disorders to include in the NSP panel of screened disorders and the procedures for
collecting and transmitting specimens. 17 Florida’s NSP currently screens for 57 conditions, 53 of which
are disorders recommended by the RUSP, including 35 core conditions and 22 secondary conditions. 18
Florida does not currently screen for congenital cytomegalovirus (CMV).
Newborn and Infant Hearing Screening
Section 383.145, F.S., requires that a newborn hearing screening must be conducted on all newborns
in hospitals in this state on birth admission. When a newborn is delivered in a facility other than a
hospital, the parents must be instructed on the importance of having the hearing screening performed
and must be given information to assist them in having the screening performed within three months
after the child's birth. 19
Before a newborn is discharged from a hospital or other state-licensed birthing facility that provides
maternity and newborn care services, and unless objected to by the parent or legal guardian, 20 the
newborn must be screened for the detection of hearing loss to prevent the consequences of
unidentified disorders. 21 However, if the screening is not completed before discharge due to scheduling
or temporary staffing limitations, the screening must be completed within 30 days after the birth. 22
Before a newborn is discharged from a licensed birth center, such facility must refer the newborn to a
licensed audiologist, physician, or hospital for screening for detection of hearing loss and referral for
appointment must be made within 30 days after discharge. 23 If the birth is a home birth, the health care
provider in attendance must provide a referral to a licensed audiologist, hospital, or other newborn
hearing screening provider and the referral for appointment must be made within 30 days after the
birth. 24
All screenings must be conducted by a licensed audiologist, a licensed physician, or appropriately
supervised individual who has completed documented training specifically for newborn hearing
screening. 25 When ordered by the treating physician, screening of a newborn's hearing must include
auditory brainstem responses, or evoked otoacoustic emissions, or appropriate technology as approved
by the United States Food and Drug Administration (FDA). 26
A child who is diagnosed as having a permanent hearing impairment must be referred by the licensee
or individual who conducted the screening to the primary care physician for medical management,
treatment, and follow-up services. Furthermore, any child from birth to 36 months of age who is
diagnosed as having a hearing impairment that requires ongoing special hearing services must be
referred to the Children's Medical Services Early Intervention Program by the licensee or individual who
conducted the screening serving the geographical area in which the child resides. 27 Any person who is
13 Id.
14 S. 383.14(3)(g), F.S.
15 S. 383.14(3)(h), F.S.
16 Supra, note 3.
17 S. 383.14(5), F.S.
18 Florida Newborn Screening, What is Screened, https://floridanewbornscreening.com/conditions/core-secondary-conditions/ (last
visited Jan. 22, 2022).
19 S. 383.145(3)(i), F.S.
20 S. 383.145(3)(c), F.S.
21 S. 383.145(3)(a), F.S.
22 S. 383.145(3)(g), F.S.
23 S. 383.145(3)(b), F.S.
24 S. 383.145(3)(d), F.S.
25 S. 383.145(3)(e), F.S.
26 S. 383.145(3)(h), F.S.
27 S. 383.145(3)(k), F.S.
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not covered through insurance and cannot afford the costs for testing must be given a list of newborn
hearing screening providers who provide the necessary testing free of charge. 28
Cytomegalovirus
Cytomegalovirus is a common virus for people of all ages; however, a healthy person’s immune system
usually keeps the virus from causing illness. 29 In the United States, nearly one in three children are
already infected with CMV by age five. Over half of adults have been infected with CMV by age 40.
Once CMV is in a person’s body, it stays there for life and can reactivate. A person can also be re-
infected with a different strain of the virus. Most people with CMV infection have no symptoms and
aren’t aware that they have been infected. 30
A pregnant woman can pass CMV to her unborn baby. The virus in the woman’s blood can cross
through the placenta and infect the infant. This can happen when a pregnant woman is infected with
CMV for the first time or is infected with CMV again during pregnancy. 31 Some infants with congenital
CMV infection have health problems that are apparent at birth or that develop later during infancy or
childhood. In the most severe cases, CMV can cause the death of an unborn child (pregnancy loss).
Infants with congenital CMV infection may have signs at birth, which include: 32
• Rash;
• Jaundice (yellowing of the skin or whites of the eyes);
• Microcephaly (small head);
• Low birth weight;
• Hepatosplenomegaly (enlarged liver and spleen);
• Seizures; and
• Retinitis (damaged eye retina).
Infants with signs of congenital CMV infection at birth may have long-term health problems, such as: 33
• Hearing loss;
• Developmental and motor delay;
• Vision loss;
• Microcephaly (small head); and
• Seizures.
Some infants without signs of congenital CMV infection at birth may have hearing loss. Hearing loss
may be present at birth or may develop later, even in infants who passed the newborn hearing test. 34
CMV is the most common infectious cause of birth defects in the United States. About one out of 200
children are born with congenital CMV. One out of five infants with congenital CMV will have symptoms
or long-term health problems, such as hearing loss. Hearing loss may progress from mild to severe
during the first two years of life, which is a critical period for language learning. Over time, hearing loss
can affect a child’s ability to develop communication, language, and social skills. 35
28 S. 383.145(3)(l), F.S.
29 About Cytomegalovirus (CMV), Centers for Disease Control and Prevention, https://www.cdc.gov/cmv/overview.html (last visited Jan.
29, 2022).
30 Id.
31 Babies Born with Congenital Cytomegalovirus (CMV), Centers for Disease Control and Prevention,
https://www.cdc.gov/cmv/congenital-infection.html, (last visited Jan. 29, 2022).
32 Id.
33 Id.
34 Id.
35 CMV Fact Sheet for Healthcare Providers, Centers for Disease Control and Prevention, https://www.cdc.gov/cmv/fact-
sheets/healthcare-providers.html#:~:text=Cytomegalovirus%20(CMV)%20is%20the%20most,Hearing%20loss (last visited Jan. 29,
2022).
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Infants may have hearing loss that may or may not be detected by newborn hearing test. Congenital
CMV infection is diagnosed by detection of CMV DNA in the urine, saliva (preferred specimens), or
blood, within three weeks after birth. Infection cannot be diagnosed using tests that detect antibodies to
CMV. Congenital CMV infection cannot be diagnosed using samples collected more than three weeks
after birth because testing after this time cannot distinguish between congenital infection and an
infection acquired during or after delivery. 36
Infants who show signs of congenital CMV disease can be treated with medicines called antivirals.
Antivirals may decrease the severity of hearing loss. Infants who get treated with antivirals should be
closely monitored by their doctor because of possible side effects. 37
Florida’s Newborn Screening Program, hospitals, birthing centers and health care practitioners are not
currently required to screen for congenital CMV.
Effect of the Bill
HB 1073 requires a hospital or other state-licensed birthing facility to administer a FDA approved test,
or other diagnostically equivalent test, on a newborn to screen for congenital cytomegalovirus should
the newborn fail his or her screening for hearing loss. The congenital cytomegalovirus test must be
administered before the newborn becomes 21 days of age or before discharge, whichever occurs
earlier. There will be costs associated with the administration of this test. The bill does not address
whether such costs are to be borne by the parents of the newborn, insurers or the hospital or birthing
center.
The bill also requires licensed health care providers practicing in the primary care setting to ensure that
newborns in their care are screened for hearing loss within 21 days after birth. If a newborn fails the
hearing screening the bill requires licensed health care provider to administer a FDA approved test to
screen for congenital cytomegalovirus before the newborn becomes 21 days of age. There will be costs
associated with the administration of this test. The bill does not address whether such costs are to be
borne by the parents of the newborn, insurers or the licensed health care provider. Additionally, health
care providers who fail to ensure that a CMV test is timely conducted could be subject to regulatory
discipline under their respective practice acts.
Current law requires that all newborns delivered in a hospital or other state-licensed birthing facility
must have a hearing screen performed prior to being discharged. However, if the screening is not
completed before discharge due to scheduling or temporary staffing limitations, the screening must be
completed within 30 days after birth. The bill requires screenings in these cases to be completed within
21 days after birth.
Current law requires that health care providers in attendance of a home birth are responsible for
coordination and referral to a licensed audiologist, a hospital, or another newborn hearing screening
provider within 30 days after birth. The bill requires that the referral for appointment be made within 7
days after birth and adds physicians to the list of facilities and practitioners to whom a parent may be
referred to for obtaining the required newborn hearing screening after a home birth.
The bill requires that the results of a newborn hearing screening and congenital cytomegalovirus and
any related diagnostic testing to be reported to DOH within 7 days after receipt of such results.
The bill makes technical and conforming changes.
The bill provides an effective date of January 1, 2023.
36 About Cytomegalovirus (CMV), Centers for Disease Control and Prevention, available at https://www.cdc.gov/cmv/overview.html (last
visited Jan. 29, 2022).
37 Congenital CMV and Hearing Loss, Centers for Disease Control and Prevention, available at https://www.cdc.gov/cmv/hearing-
loss.html, (last visited Jan. 29, 2022).
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B. SECTION DIRECTORY:
Section 1: Amends s. 383.145, F.S., relating to newborn and infant hearing screening.
Section 2: Provides an effective date of January 1, 2023.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
The bill has a significant, negative fiscal impact on DOH. DOH estimates a potential general
revenue impact of $440,749 to create a CMV follow-up program, which includes: 38
• $372,153 in recurring expenses for four FTE (salary, benefits, and expenses); and
• $68,596 in non-recurring expenses for data system updates and technology integration.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
The number of infants that may be effected by this bill is unknown; however, in 2021, 9,500 infants
failed the newborn hearing screening. 39 The bill would require each of these infants to undergo CMV
testing. Staff estimates the costs for CMV tests to be between $45-$70 per tests. This equates to
$427,500-$665,000 in testing costs.
The bill does not address whether costs associated with the administration of these tests are to be
borne by the parents of the newborn, insurers, licensed health care providers, hospitals or birthing
centers.
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.
38 Department of Health Agency Analysis of 2022 House Bill 1073 (Jan. 26, 2022).
39 Id.
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B. RULE-MAKING AUTHORITY:
Current law provides sufficient rulemaking authority to implement the provisions of 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 1073 2022
1 A bill to be entitled
2 An act relating to newborn screenings; amending s.
3 383.145, F.S.; providing and revising definitions;
4 requiring hospitals and other state-licensed birthing
5 facilities to test for congenital cytomegalovirus in
6 newborns within a specified timeframe under certain
7 circumstances; revising the timeframe within which
8 health care providers attending home births must make
9 certain referrals; requiring certain health care
10 providers practicing in the primary care setting to
11 screen newborns in their care for hearing loss within
12 a specified timeframe; requiring such providers to
13 test such newborns for congenital cytomegalovirus
14 within a specified timeframe under certain
15 circumstances; revising the timeframe within which
16 hospitals must complete newborn hearing screenings
17 that were not completed before discharge due to
18 scheduling or temporary staffing limitations;
19 requiring that certain test results be reported to the
20 Department of Health within a specified timeframe;
21 removing a requirement that the parents of certain
22 newborns be instructed on and provided specified
23 information; removing obsolete language; removing a
24 requirement that certain uninsured persons be provided
25 a list of specified providers; providing an effective
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26 date.
27
28 Be It Enacted by the Legislature of the State of Florida:
29
30 Section 1. Section 383.145, Florida Statutes, is amended
31 to read:
32 383.145 Newborn and infant hearing screening.—
33 (1) LEGISLATIVE INTENT.—It is the intent of the
34 Legislature this section is to provide a statewide comprehensive
35 and coordinated interdisciplinary program of early hearing loss
36 impairment screening, identification, and follow-up followup
37 care for newborns. The goal is to screen all newborns for
38 hearing loss impairment in order to alleviate the adverse
39 effects of hearing loss on speech and language development,
40 academic performance, and cognitive development. It is further
41 the intent of the Legislature that the provisions of this
42 section act only be implemented to the extent that funds are
43 specifically included in the General Appropriations Act for
44 carrying out the purposes of this section.
45 (2) DEFINITIONS.—As used in this section, the term:
46 (a) "Audiologist" means a person licensed under part I of
47 chapter 468 to practice audiology.
48 (a) "Agency" means the Agency for Health Care
49 Administration.
50 (b) "Department" means the Department of Health.
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51 (c) "Hearing loss impairment" means a hearing loss of 30
52 dB HL or greater in the frequency region important for speech
53 recognition and comprehension in one or both ears, approximately
54 500 through 4,000 hertz.
55 (d) "Hospital" means a facility as defined in s.
56 395.002(13) and licensed under chapter 395 and part II of
57 chapter 408.
58 (e)(d) "Infant" means an age range from 30 days through 12
59 months.
60 (f)(e) "Licensed health care provider" means a physician
61 or physician assistant licensed under pursuant to chapter 458;
62 an osteopathic physician or physician assistant licensed under
63 or chapter 459; an advanced practice registered nurse, a
64 registered nurse, or a licensed practical nurse licensed under
65 part I of pursuant to chapter 464; a midwife licensed under
66 chapter 467; or a speech-language pathologist, or an audiologist
67 licensed under part I of pursuant to chapter 468, rendering
68 services within the scope of his or her license.
69 (g)(f) "Management" means the habilitation of the hearing-
70 impaired child with hearing loss.
71 (h)(g) "Newborn" means an age range from birth through 29
72 days.
73 (i) "Physician" means a person licensed under chapter 458
74 to practice medicine or chapter 459 to practice osteopathic
75 medicine.
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76 (j)(h) "Screening" means a test or battery of tests
77 administered to determine the need for an in-depth hearing
78 diagnostic evaluation.
79 (3) REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE
80 COVERAGE; REFERRAL FOR ONGOING SERVICES.—
81 (a) Each licensed hospital or other state-licensed
82 birthing facility that provides maternity and newborn care
83 services shall ensure provide that all newborns are, before
84 prior to discharge, screened for the detection of hearing loss,
85 to prevent the consequences of unidentified disorders. If a
86 newborn fails the screening for the detection of hearing loss,
87 the hospital or other state-licensed birthing facility must
88 administer a test approved by the United States Food and Drug
89 Administration or another diagnostically equivalent test on the
90 newborn to screen for congenital cytomegalovirus before the
91 newborn becomes 21 days of age or before discharge, whic hever
92 occurs earlier.
93 (b) Each licensed birth center that provides maternity and
94 newborn care services shall ensure provide that all newborns
95 are, before prior to discharge, referred to an a licensed
96 audiologist, a physician licensed under chapter 458 or chapter
97 459, or a hospital, or another other newborn hearing screening
98 provider, for screening for the detection of hearing loss, to
99 prevent the consequences of unidentified disorders. The referral
100 for appointment shall be made within 30 days after discharge.
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101 Written documentation of the referral must be placed in the
102 newborn's medical chart.
103 (c) If the parent or legal guardian of the newborn objects
104 to the screening, the screening must not be completed. In such
105 case, the physician, midwife, or other person who is attending
106 the newborn shall maintain a record that the screening has not
107 been performed and attach a written objection that must be
108 signed by the parent or guardian.
109 (d) For home births, the health care provider in
110 attendance is responsible for coordination and referral to an a
111 licensed audiologist, a physician, a hospital, or another other
112 newborn hearing screening provider. The referral for appointment
113 must shall be made within 7 30 days after the birth. In cases in
114 which the home birth is not attended by a primary health care
115 provider, a referral to a licensed audiologist, physician
116 licensed pursuant to chapter 458 or chapter 459, hospital, or
117 other newborn hearing screening provider must be made by the
118 health care provider within the first 3 months after the child's
119 birth.
120 (e) Licensed health care providers practicing in the
121 primary care setting must ensure that newborns in their care are
122 screened for hearing loss within 21 days after the birth. If a
123 newborn fails the screening for the detection of hearing loss,
124 the licensed health care provider must administer a test
125 approved by the United States Food and Drug Administration or
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126 another diagnostically equivalent test on the newborn to screen
127 for congenital cytomegalovirus before the newborn becomes 21
128 days of age.
129 (f)(e) All newborn and infant hearing screenings must
130 shall be conducted by an a licensed audiologist, a physician
131 licensed under chapter 458 or chapter 459, or an appropriately
132 supervised individual who has completed documented training
133 specifically for newborn hearing screening. Every licensed
134 hospital that provides maternity or newborn care services shall
135 obtain the services of an a licensed audiologist, a physician
136 licensed pursuant to chapter 458 or chapter 459, or another
137 other newborn hearing screening provider, through employment or
138 contract or written memorandum of understanding, for the
139 purposes of appropriate staff training, screening program
140 supervision, monitoring the scoring and interpretation of test
141 results, rendering of appropriate recommendations, and
142 coordination of appropriate follow-up followup services.
143 Appropriate documentation of the screening completion, results,
144 interpretation, and recommendations must be placed in the
145 medical record within 24 hours after completion of the screening
146 procedure.
147 (g)(f) The screening of a newborn's hearing must should be
148 completed before the newborn is discharged from the hospital.
149 However, if the screening is not completed before discharge due
150 to scheduling or temporary staffing limitations, the screening
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151 must be completed within 21 30 days after the birth discharge.
152 Screenings completed after discharge or performed because of
153 initial screening failure must be completed by an audiologist
154 licensed in the state, a physician licensed under chapter 458 or
155 chapter 459, or a hospital, or another other newborn hearing
156 screening provider.
157 (h)(g) Each hospital shall formally designate a lead
158 physician responsible for programmatic oversight for newborn
159 hearing screening. Each birth center shall designate a licensed
160 health care provider to provide such programmatic oversight and
161 to ensure that the appropriate referrals are being completed.
162 (i)(h) When ordered by the treating physician, screening
163 of a newborn's hearing must include auditory brainstem
164 responses, or evoked otoacoustic otacoustic emissions, or
165 appropriate technology as approved by the United States Food and
166 Drug Administration.
167 (j) The results of any test conducted pursuant to this
168 section, including, but not limited to, newborn hearing loss
169 screening, congenital cytomegalovirus testing, and any related
170 diagnostic testing, must be reported to the department within 7
171 days after receipt of such results.
172 (i) Newborn hearing screening must be conducted on all
173 newborns in hospitals in this state on birth admission. When a
174 newborn is delivered in a facility other than a hospital, the
175 parents must be instructed on the importance of having the
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176 hearing screening performed and must be given information to
177 assist them in having the screening performed within 3 months
178 after the child's birth.
179 (k)(j) The initial procedure for screening the hearing of
180 the newborn or infant and any medically necessary follow-up
181 followup reevaluations leading to diagnosis shall be a covered
182 benefit for, reimbursable under Medicaid as an expense
183 compensated supplemental to the per diem rate for Medicaid
184 patients enrolled in MediPass or Medicaid patients covered by a
185 fee-for-service fee for service program. For Medicaid patients
186 enrolled in HMOs, providers shall be reimbursed directly by the
187 Medicaid Program Office at the Medicaid rate. This service may
188 not be considered a covered service for the purposes of
189 establishing the payment rate for Medicaid HMOs. All health
190 insurance policies and health maintenance organizations as
191 provided under ss. 627.6416, 627.6579, and 641.31(30), except
192 for supplemental policies that only provide coverage for
193 specific diseases, hospital indemnity, or Medicare supplement,
194 or to the supplemental polices, shall compensate providers for
195 the covered benefit at the contracted rate. Nonhospital -based
196 providers are shall be eligible to bill Medicaid for the
197 professional and technical component of each procedure code.
198 (l)(k) A child who is diagnosed as having a permanent
199 hearing loss must impairment shall be referred to the primary
200 care physician for medical management, treatment, and follow-up
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201 followup services. Furthermore, in accordance with Part C of the
202 Individuals with Disabilities Education Act, Pub. L. No. 108 -
203 446, Infants and Toddlers with Disabilities, any child from
204 birth to 36 months of age who is diagnosed as having a hearing
205 loss impairment that requires ongoing special hearing services
206 must be referred to the Children's Medical Services Early
207 Intervention Program serving the geographical area in which the
208 child resides.
209 (l) Any person who is not covered through insurance and
210 cannot afford the costs for testing shall be given a list of
211 newborn hearing screening providers who provide the necess ary
212 testing free of charge.
213 Section 2. This act shall take effect January 1, 2023.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1073 (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 Aloupis offered the following:
4
5 Amendment (with title amendment)
6 Remove lines 96-128 and insert:
7 audiologist, a physician licensed under chapter 458 or chapter
8 459, or a hospital, or another other newborn hearing screening
9 provider, for screening for the detection of hearing loss, to
10 prevent the consequences of unidentified disorders. The referral
11 for appointment must shall be made within 7 30 days after
12 discharge. Written documentation of the referral must be placed
13 in the newborn's medical chart.
14 (c) If the parent or legal guardian of the newborn objects
15 to the screening, the screening must not be completed. In such
16 case, the physician, midwife, or other person who is attending
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1073 (2022)
Amendment No. 1
17 the newborn shall maintain a record that the screening has not
18 been performed and attach a written objection that must be
19 signed by the parent or guardian.
20 (d) For home births, the health care provider in
21 attendance is responsible for coordination and referral to an a
22 licensed audiologist, a hospital, or another other newborn
23 hearing screening provider. The health care provider in
24 attendance must make the referral for appointment shall be made
25 within 7 30 days after the birth. In cases in which the home
26 birth is not attended by a primary health care provider, the
27 newborn’s primary health care provider is responsible for
28 coordinating the a referral to a licensed audiologist, physician
29 licensed pursuant to chapter 458 or chapter 459, hospital, or
30 other newborn hearing screening provider must be made by the
31 health care provider within the first 3 months after the child's
32 birth.
33 (e) For home births and births in a licensed birth center,
34 if a newborn is referred to a newborn hearing screening provider
35 and the newborn fails the screening for the detection of hearing
36 loss, the newborn’s primary health care provider must refer the
37 newborn for administration of a test approved by the United
38 States Food and Drug Administration or another diagnostically
39 equivalent test on the newborn to screen for congenital
40 cytomegalovirus.
41
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1073 (2022)
Amendment No. 1
42 -----------------------------------------------------
43 T I T L E A M E N D M E N T
44 Remove lines 9-15 and insert:
45 referrals; providing that a newborn’s primary health care
46 provider is responsible for coordinating such referrals under
47 certain circumstances; requiring a newborn’s primary health care
48 provider to refer the newborn for testing for congenital
49 cytomegalovirus under certain circumstances; revising the
50 timeframe within which
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HB 1101
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1101 Anesthesiologist Assistants
SPONSOR(S): Altman
TIED BILLS: IDEN./SIM. BILLS: SB 1366
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Morris McElroy
2) Health & Human Services Committee
SUMMARY ANALYSIS
An anesthesiologist assistant assists an anesthesiologist with developing and implementing an anesthesia
care plan for patients. Anesthesiologist assistants are regulated under chs. 458 and 459, F.S., and by the
Boards of Medicine (BOM) and Osteopathic Medicine (BOOM) within the Department of Health (DOH).
Anesthesiologist assistants perform duties under a protocol with an anesthesiologist. Current law limits the
duties that an anesthesiologist assistant may perform to those that are expressly listed in statute and
established by BOM or BOOM rule. An anesthesiologist or a group of anesthesiologists must file a written
protocol with the BOM and BOOM upon establishment of a supervisory relationship with an anesthesiologist
assistant, which must be signed by the anesthesiologist assistant and all supervising physicians.
Anesthesiologist assistants work under the direct supervision of an anesthesiologist. An anesthesiologist must
be onsite and physically present in the office or surgical suite when a procedure is performed to supervise an
anesthesiologist assistant. The supervising anesthesiologist must also be immediately available to provide
assistance to the anesthesiologist assistant while services are delivered to a patient.
HB 1101 expands the scope of the practice of an anesthesiologist assistant by allowing an anesthesiologist
assistant to perform any duty, in addition to statutory and the BOM and BOOM established duties, contained
within their protocol.
The bill requires the protocol to be signed by either a single supervising anesthesiologist or a supervising
anesthesiologist designated by a group practice rather than all supervising anesthesiologists. The bill also
authorizes anesthesiologist assistants to personally administer prescribed anesthetic under the direct
supervision of an anesthesiologist.
The bill revises the direct supervision requirements by requiring supervising anesthesiologists to be reasonably
physically available to an anesthesiologist assistant, as needed.
Current law authorizes hospitals to establish criteria for granting privileges to health care practitioners to render
patient care. The bill prohibits hospitals from denying clinical privileges to anesthesiologist assistants, except
for cause, so long as the supervising anesthesiologist is a staff member in good standing at the hospital.
Anesthesiologist assistants must submit sworn statements of any prior felony convictions and any prior
discipline or denial of licensure or certification in any state in an application for licensure in this state. The bill
removes the requirement such statements be sworn, allowing applications for licensure to be completed
electronically.
The bill has no fiscal impact on DOH and local governments.
The bill provides 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.
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FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Anesthesiologist Assistants
Licensure
An anesthesiologist assistant assists an anesthesiologist 1 with developing and implementing an
anesthesia care plan for patients.
To become licensed as an anesthesiologist assistant in this state, an applicant must:
• Complete a training program accredited by the Commission on Accreditation of Allied Health
Education Programs; 2
• Pass an examination established by the National Commission on Certification of
Anesthesiologist Assistants;
• Be certified in advanced cardiac life support; and
• Submit an application fee, as set by the BOM or the BOOM and completed an application,
which must include:
o A certificate of completion of an approved graduate level program;
o A sworn statement of any prior felony convictions;
o A sworn statement of any prior discipline or denial of licensure or certification in any
state; and
o Two letters of recommendation from anesthesiologists.
Anesthesiologist assistants must hold a current certificate issued by the National Commission on
Certification of Anesthesiologist Assistants or complete 40 hours of continuing education every two
years. 3
Practice Protocol
Anesthesiologist assistants may perform duties established by BOM or BOOM rule and included in a
protocol with an anesthesiologist. Such duties include: 4
• Obtaining a comprehensive patient history and present the history to the supervising
anesthesiologist;
• Pretesting and calibrating anesthesia delivery systems and monitoring, obtaining, and
interpreting information from the systems and monitors;
• Assisting the supervising anesthesiologist with the implementation of medically accepted
monitoring techniques;
• Establishing basic and advanced airway interventions, including intubation of the trachea and
performing ventilatory support;
• Administering intermittent vasoactive drugs and starting and adjusting vasoactive infusions;
• Administering anesthetic drugs, adjuvant drugs, and accessory drugs;
1 An anesthesiologist is an allopathic or osteopathic physician regulated under chs. 458 and 459, F.S., respectively, and
the Board of Medicine (BOM) and the Board of Osteopathic Medicine (BOOM) within the Department of Health (DOH),
who has completed an anesthesiology training program approved by the Accreditation Council for Graduate Medical
Education and is certified by the American Board of Anesthesiology.
2 Rules 64B8-31.004 and 64B15-7.004, F.A.C.
3 S. 458.3475(5) and 459.023(5), F.S.
4 S. 458.3475(3) and 459.023(3), F.S.
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• Assisting the supervising anesthesiologist with the performance of epidural anesthetic
procedures and spinal anesthetic procedures;
• Administering blood, blood products, and supportive fluids;
• Supporting life functions during anesthesia health care, including induction and intubation
procedures, the use of appropriate mechanical supportive devices, and the management of
fluid, electrolyte, and blood component balances;
• Recognizing and taking appropriate corrective action for abnormal patient responses to
anesthesia, adjunctive medication, or other forms of therapy;
• Participating in management of the patient while in the post-anesthesia recovery area, including
the administration of any supporting fluids or drugs; and
• Placing special peripheral and central venous and arterial lines for blood sampling and
monitoring, as appropriate.
An anesthesiologist or a group of anesthesiologists must file a written protocol with the BOM and
BOOM upon establishment of a supervisory relationship with an anesthesiologist assistant. Such
protocol must be updated biennially, include the signatures of the anesthesiologist assistant, all
supervising physicians, and the: 5
• Name, address, and license number of the anesthesiologist assistant;
• Name, address, license number, and federal Drug Enforcement Administration number of each
physician who will be supervising the anesthesiologist assistant;
• Address of the anesthesiologist assistant’s primary practice location and the address of any
other locations where the anesthesiologist assistant may practice;
• Date the protocol was developed and the dates of all revision;
• Duties and functions of the anesthesiologist assistant;
• Conditions or procedures that require the personal provision of care by an anesthesiologist; and
• Procedures to be followed in the event of an anesthetic emergency.
Duties Under Direct Supervision
An anesthesiology assistant may only provide services under the direct supervision of an
anesthesiologist. 6 Direct supervision means onsite, personal supervision by an anesthesiologist who is
present in the office or surgical suite when the procedure is being performed and is immediately
available to provide assistance to the anesthesiologist assistant while services are being delivered. 7
Clinical Privileges
Clinical privileges are privileges granted to licensed health care practitioners by a hospital to render
patient care, but does not include admitting patients. 8 Each facility licensed under ch. 395, F.S., which
includes hospitals, establishes its own rules and procedures for consideration of applications for clinical
privileges. 9 Current statute prohibits hospitals from denying clinical privileges to physician assistants,
except for cause, so long as the supervising physician is a staff member in good standing at the
hospital. 10 Current law is silent on denial of hospital clinical privileges for anesthesiologist assistants.
Effect of the Bill
Practice Protocol
5 S 458.3475(2)(b) and 459.023(2)(b), F.S.
6 S. 458.3475(3)(a) and 459.023(3)(a), F.S. The practice of anesthesiology includes pain relief during and after surgery
and childbirth, during chronic disease processes, and during resuscitation and critical care of patients in the operating
room and intensive care.
7 S. 458.3475(1)(g) and 459.023(1)(g), F.S.
8 S. 395.002, F.S.
9 S. 395.0191, F.S.
10 S. 458.347(3) and 459.022(3), F.S.
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HB 1101 expands the scope of the practice an anesthesiologist assistant. Current law limits the duties
that an anesthesiology assistant may perform duties to those that are expressly listed in statute and
established by BOM or BOOM rule. The bill removes this limitation by allowing an anesthesiology
assistant to perform any task, including the BOM and BOOM established duties, contained within their
protocol.
The bill revises the signatory requirement for supervisory protocols. The bill requires the signature of a
single supervising anesthesiologist or a supervising anesthesiologist designated by the practice group
instead of the signature of all supervising physicians. This means one anesthesiologist in a practice
group is the signatory authority for every other anesthesiologist in a practice group, regardless of
whether other anesthesiologists in such practice group have expressly agreed to the protocol in
question.
Duties Under Direct Supervision
The bill revises requirements for direct supervision of an anesthesiologist assistant by an
anesthesiologist by requiring the supervising anesthesiologist to be reasonably physically available as
needed instead of immediately available to provide assistance and physically present in the room when
an anesthesiologist is performing procedures.
The bill also authorizes anesthesiologist assistants to personally administer prescribed anesthetic and
perform tasks and services specified in a written protocol under the revised direct supervision of an
anesthesiologist.
Clinical Privileges
The bill prohibits hospitals from denying clinical privileges to anesthesiologist assistants, except for
cause, so long as the supervising anesthesiologist is a staff member in good standing at the hospital.
The bill makes the above changes in both the allopathic physician practice act, ch. 458, F.S., and the
osteopathic physician practice act, ch. 459, F.S.
Licensure
The bill removes the requirement that anesthesiologist assistant licensure applications contain sworn
statements of any prior felony convictions and any prior discipline or denial of licensure or certification
in any state. This allows applications for licensure to be completed electronically.
The bill provides and effective date of July 1, 2022.
B. SECTION DIRECTORY:
Section 1: Amends s. 458.3475, F.S., relating to anesthesiologist assistants.
Section 2: Amends s. 459.023, F.S., relating to anesthesiologist assistants.
Section 3: Provides an effective date of July 1, 2022.
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DATE: 2/1/2022
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:
None. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
Current law provides sufficient rulemaking authority to implement the provisions of the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
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DATE: 2/1/2022
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 1101 2022
1 A bill to be entitled
2 An act relating to anesthesiologist assistants;
3 amending ss. 458.3475 and 459.023, F.S.; revising the
4 definitions of the terms "anesthesiologist" and
5 "direct supervision"; revising requirements for the
6 written protocol between an anesthesiologist assistant
7 and a supervising anesthesiologist; revising
8 provisions related to duties and functions
9 anesthesiologist assistants may perform; providing
10 that a certain applicant for clinical hospital
11 privileges may not be denied such privileges if the
12 applicant's supervising anesthesiologist is a staff
13 member in good standing at that hospital, with an
14 exception; revising licensure requirements for
15 anesthesiologist assistants; providing an effective
16 date.
17
18 Be It Enacted by the Legislature of the State of Florida:
19
20 Section 1. Paragraphs (a) and (g) of subsection (1),
21 paragraph (b) of subsection (2), subsection (3), and paragraphs
22 (a) and (b) of subsection (6) of section 458.3475, Florida
23 Statutes, are amended to read:
24 458.3475 Anesthesiologist assistants.—
25 (1) DEFINITIONS.—As used in this section, the term:
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26 (a) "Anesthesiologist" means an allopathic or osteopathic
27 physician who holds an active, unrestricted license; who has
28 successfully completed an anesthesiology training program
29 approved by the Accreditation Council on Graduate Medical
30 Education or its equivalent; and who is certified by the
31 American Board of Anesthesiology, is eligible to take that
32 board's examination, or is certified by the Board of
33 Certification in Anesthesiology affiliated with the American
34 Association of Physician Specialists.
35 (g) "Direct supervision" means the physical presence of a
36 supervising anesthesiologist on the premises such that the
37 supervising anesthesiologist is reasonably available as needed
38 onsite, personal supervision by an anesthesiologist who is
39 present in the office when the procedure is being performed in
40 that office, or is present in the surgical or obstetrical sui te
41 when the procedure is being performed in that surgical or
42 obstetrical suite and who is in all instances immediately
43 available to provide assistance and direction to the
44 anesthesiologist assistant while anesthesia services are being
45 performed.
46 (2) PERFORMANCE OF SUPERVISING ANESTHESIOLOGIST.—
47 (b) An anesthesiologist or group of anesthesiologists
48 must, upon establishing a supervisory relationship with an
49 anesthesiologist assistant, file with the board a written
50 protocol that includes, at a minimum:
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51 1. The name, address, and license number of the
52 anesthesiologist assistant.
53 2. The name, address, license number, and federal Drug
54 Enforcement Administration number of each physician who will be
55 supervising the anesthesiologist assistant.
56 3. The address of the anesthesiologist assistant's primary
57 practice location and the address of any other locations where
58 the anesthesiologist assistant may practice.
59 4. The date the protocol was developed and the dates of
60 all revisions.
61 5. The signatures of the anesthesiologist assistant and
62 either the single supervising anesthesiologist or a supervising
63 anesthesiologist designated by the group, as applicable all
64 supervising physicians.
65 6. The duties and functions of the anesthesiologist
66 assistant.
67 7. The conditions or procedures that require the personal
68 provision of care by an anesthesiologist.
69 8. The procedures to be followed in the event of an
70 anesthetic emergency.
71
72 The protocol must be on file with the board before the
73 anesthesiologist assistant may practice with the
74 anesthesiologist or group. An anesthesiologist assistant may not
75 practice unless a written protocol has been filed for that
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76 anesthesiologist assistant in accordance with this paragraph,
77 and the anesthesiologist assistant may only practice under the
78 direct supervision of an anesthesiologist who is identified in
79 the has signed the protocol. The protocol must be updated
80 biennially.
81 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS.—
82 (a) An anesthesiologist assistant may assist an
83 anesthesiologist in developing and implementing an anesthesia
84 care plan for a patient, may personally administer the
85 prescribed anesthetic under the direct supervision of an
86 anesthesiologist, and may perform tasks and services as
87 specified in a written protocol approved by the supervising
88 anesthesiologist, including, but not limited to, any of the
89 following. In providing assistance to an anesthesiologist, an
90 anesthesiologist assistant may perform duties established by
91 rule by the board in any of the following functions that are
92 included in the anesthesiologist assistant's protocol while
93 under the direct supervision of an anesthesiologist :
94 1. Obtain a comprehensive patient history and present the
95 history to the supervising anesthesiologist.
96 2. Pretest and calibrate anesthesia delivery systems and
97 monitor, obtain, and interpret information from the systems and
98 monitors.
99 3. Assist the supervising anesthesiologist with the
100 implementation of medically accepted monitoring techniques.
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101 4. Establish basic and advanced airway interventions,
102 including intubation of the trachea and performing ventilatory
103 support.
104 5. Administer intermittent vasoactive drugs and start and
105 adjust vasoactive infusions.
106 6. Administer anesthetic drugs, adjuvant drugs, and
107 accessory drugs.
108 7. Assist the supervising anesthesiologist with the
109 performance of epidural anesthetic procedures and spinal
110 anesthetic procedures.
111 8. Administer blood, blood products, and supportive
112 fluids.
113 9. Support life functions during anesthesia health car e,
114 including induction and intubation procedures, the use of
115 appropriate mechanical supportive devices, and the management of
116 fluid, electrolyte, and blood component balances.
117 10. Recognize and take appropriate corrective action for
118 abnormal patient responses to anesthesia, adjunctive medication,
119 or other forms of therapy.
120 11. Participate in management of the patient while in the
121 postanesthesia recovery area, including the administration of
122 any supporting fluids or drugs.
123 12. Place special peripheral and central venous and
124 arterial lines for blood sampling and monitoring as appropriate.
125 (b) Nothing in this section or chapter prevents third-
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126 party payors from reimbursing employers of anesthesiologist
127 assistants for covered services rendered by such
128 anesthesiologist assistants.
129 (c) After 90 days following the submission of a completed
130 application for clinical privileges at a hospital, an
131 anesthesiologist assistant may not be denied clinical hospital
132 privileges, except for cause, if the supervising
133 anesthesiologist is a staff member in good standing at that
134 hospital.
135 (d) An anesthesiologist assistant must clearly convey to
136 the patient that he or she is an anesthesiologist assistant.
137 (e)(d) An anesthesiologist assistant may perform
138 anesthesia tasks and services within the framework of a written
139 practice protocol developed between the supervising
140 anesthesiologist and the anesthesiologist assistant.
141 (f)(e) An anesthesiologist assistant may not prescribe,
142 order, or compound any controlled substance, legend drug, or
143 medical device, nor may an anesthesiologist assistant dispense
144 sample drugs to patients. Nothing in this paragraph prohibits an
145 anesthesiologist assistant from administering legend drugs or
146 controlled substances; intravenous drugs, fluids, or blood
147 products; or inhalation or other anesthetic agents to patients
148 which are ordered by the supervising anesthesiologist and
149 administered while under the direct supervision of the
150 supervising anesthesiologist.
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151 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE.—
152 (a) Any person desiring to be licensed as an
153 anesthesiologist assistant must apply to the department. The
154 department shall issue a license to any person certified by the
155 board to:
156 1. Be at least 18 years of age.
157 2. Have satisfactorily passed a proficiency examination
158 with a score established by the National Commission on
159 Certification of Anesthesiologist Assistants.
160 3. Be certified in advanced cardiac life support.
161 4. Have completed the application form and remitted an
162 application fee, not to exceed $1,000, as set by the boards. An
163 application must include:
164 a. A certificate of completion of an approved graduate
165 level program.
166 b. An acknowledgment A sworn statement of any prior felony
167 convictions.
168 c. An acknowledgment A sworn statement of any prior
169 discipline or denial of licensure or certification in any state.
170 d. Two letters of recommendation from anesthesiologists.
171 (b) A license must be renewed biennially. Each renewal
172 must include:
173 1. A renewal fee, not to exceed $1,000, as set by the
174 boards.
175 2. An acknowledgment A sworn statement of no felony
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176 convictions in the immediately preceding 2 years.
177 Section 2. Paragraphs (a) and (g) of subsection (1),
178 paragraph (b) of subsection (2), subsection (3), and parag raphs
179 (a) and (b) of subsection (6) of section 459.023, Florida
180 Statutes, are amended to read:
181 459.023 Anesthesiologist assistants.—
182 (1) DEFINITIONS.—As used in this section, the term:
183 (a) "Anesthesiologist" means an osteopathic or allopathic
184 physician who holds an active, unrestricted license; who has
185 successfully completed an anesthesiology training program
186 approved by the Accreditation Council on Graduate Medical
187 Education, or its equivalent, or the American Osteopathic
188 Association; and who is certified by the American Osteopathic
189 Board of Anesthesiology or is eligible to take that board's
190 examination, is certified by the American Board of
191 Anesthesiology or is eligible to take that board's examination,
192 or is certified by the Board of Certification in Anesthesiology
193 affiliated with the American Association of Physician
194 Specialists.
195 (g) "Direct supervision" means the physical presence of a
196 supervising anesthesiologist on the premises such that the
197 supervising anesthesiologist is reasonably available as needed
198 onsite, personal supervision by an anesthesiologist who is
199 present in the office when the procedure is being performed in
200 that office, or is present in the surgical or obstetrical suite
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201 when the procedure is being performed in that surgical or
202 obstetrical suite and who is in all instances immediately
203 available to provide assistance and direction to the
204 anesthesiologist assistant while anesthesia services are being
205 performed.
206 (2) PERFORMANCE OF SUPERVISING ANESTHESIOLOGIST.—
207 (b) An anesthesiologist or group of anesthesiologists
208 must, upon establishing a supervisory relationship with an
209 anesthesiologist assistant, file with the board a written
210 protocol that includes, at a minimum:
211 1. The name, address, and license number of the
212 anesthesiologist assistant.
213 2. The name, address, license number, and federal Drug
214 Enforcement Administration number of each physician who will be
215 supervising the anesthesiologist assistant.
216 3. The address of the anesthesiologist assistant's primary
217 practice location and the address of any other locations where
218 the anesthesiologist assistant may practice.
219 4. The date the protocol was developed and the dates of
220 all revisions.
221 5. The signatures of the anesthesiologist assistant and
222 either the single supervising anesthesiologist or a supervising
223 anesthesiologist designated by the group, as applicable all
224 supervising physicians.
225 6. The duties and functions of the anesthesiologist
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226 assistant.
227 7. The conditions or procedures that require the personal
228 provision of care by an anesthesiologist.
229 8. The procedures to be followed in the event of an
230 anesthetic emergency.
231
232 The protocol must be on file with the board before the
233 anesthesiologist assistant may practice with the
234 anesthesiologist or group. An anesthesiologist assi stant may not
235 practice unless a written protocol has been filed for that
236 anesthesiologist assistant in accordance with this paragraph,
237 and the anesthesiologist assistant may only practice under the
238 direct supervision of an anesthesiologist who is identified in
239 the has signed the protocol. The protocol must be updated
240 biennially.
241 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS.—
242 (a) An anesthesiologist assistant may assist an
243 anesthesiologist in developing and implementing an anesthesia
244 care plan for a patient, may personally administer the
245 prescribed anesthetic under the direct supervision of an
246 anesthesiologist, and may perform tasks and services as
247 specified in a written protocol approved by the supervising
248 anesthesiologist, including, but not limited to, any of the
249 following. In providing assistance to an anesthesiologist, an
250 anesthesiologist assistant may perform duties established by
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251 rule by the board in any of the following functions that are
252 included in the anesthesiologist assistant's protocol whil e
253 under the direct supervision of an anesthesiologist :
254 1. Obtain a comprehensive patient history and present the
255 history to the supervising anesthesiologist.
256 2. Pretest and calibrate anesthesia delivery systems and
257 monitor, obtain, and interpret information from the systems and
258 monitors.
259 3. Assist the supervising anesthesiologist with the
260 implementation of medically accepted monitoring techniques.
261 4. Establish basic and advanced airway interventions,
262 including intubation of the trachea and performing ventilatory
263 support.
264 5. Administer intermittent vasoactive drugs and start and
265 adjust vasoactive infusions.
266 6. Administer anesthetic drugs, adjuvant drugs, and
267 accessory drugs.
268 7. Assist the supervising anesthesiologist with the
269 performance of epidural anesthetic procedures and spinal
270 anesthetic procedures.
271 8. Administer blood, blood products, and supportive
272 fluids.
273 9. Support life functions during anesthesia health care,
274 including induction and intubation procedures, the use of
275 appropriate mechanical supportive devices, and the management of
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276 fluid, electrolyte, and blood component balances.
277 10. Recognize and take appropriate corrective action for
278 abnormal patient responses to anesthesia, adjunctive medication,
279 or other forms of therapy.
280 11. Participate in management of the patient while in the
281 postanesthesia recovery area, including the administration of
282 any supporting fluids or drugs.
283 12. Place special peripheral and central venous and
284 arterial lines for blood sampling and monitoring as appropriate.
285 (b) Nothing in this section or chapter prevents third-
286 party payors from reimbursing employers of anesthesiologist
287 assistants for covered services rendered by such
288 anesthesiologist assistants.
289 (c) After 90 days following the submission of a completed
290 application for clinical privileges at a hospital, an
291 anesthesiologist assistant may not be denied clinical hospital
292 privileges, except for cause, if the supervising
293 anesthesiologist is a staff member in good standing at that
294 hospital.
295 (d) An anesthesiologist assistant must clearly convey to
296 the patient that she or he is an anesthesiologist assistant.
297 (e)(d) An anesthesiologist assistant may perform
298 anesthesia tasks and services within the framework of a written
299 practice protocol developed between the supervising
300 anesthesiologist and the anesthesiologist assistant.
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301 (f)(e) An anesthesiologist assistant may not prescribe,
302 order, or compound any controlled substance, legend drug, or
303 medical device, nor may an anesthesiologist assistant dispense
304 sample drugs to patients. Nothing in this paragraph prohibits an
305 anesthesiologist assistant from administering legend drugs or
306 controlled substances; intravenous drugs, fluids, or blood
307 products; or inhalation or other anesthetic agents to patients
308 which are ordered by the supervising anesthesiologist and
309 administered while under the direct supervision of the
310 supervising anesthesiologist.
311 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE.—
312 (a) Any person desiring to be licensed as an
313 anesthesiologist assistant must apply to the department. The
314 department shall issue a license to any person certified by the
315 board to:
316 1. Be at least 18 years of age.
317 2. Have satisfactorily passed a proficiency examination
318 with a score established by the National Commission on
319 Certification of Anesthesiologist Assistants.
320 3. Be certified in advanced cardiac life support.
321 4. Have completed the application form and remitted an
322 application fee, not to exceed $1,000, as set by the bo ards. An
323 application must include:
324 a. A certificate of completion of an approved graduate
325 level program.
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326 b. An acknowledgment A sworn statement of any prior felony
327 convictions.
328 c. An acknowledgment A sworn statement of any prior
329 discipline or denial of licensure or certification in any state.
330 d. Two letters of recommendation from anesthesiologists.
331 (b) A license must be renewed biennially. Each renewal
332 must include:
333 1. A renewal fee, not to exceed $1,000, as set by the
334 boards.
335 2. An acknowledgment A sworn statement of no felony
336 convictions in the immediately preceding 2 years.
337 Section 3. This act shall take effect July 1, 2022.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1101 (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 Altman offered the following:
4
5 Amendment (with title amendment)
6 Remove everything after the enacting clause and insert:
7 Section 1. Paragraphs (a) and (g) of subsection (1),
8 paragraph (a) of subsection (3), and paragraphs (a) and (b) of
9 subsection (6) of section 458.3475, Florida Statutes, are
10 amended to read:
11 458.3475 Anesthesiologist assistants.—
12 (1) DEFINITIONS.—As used in this section, the term:
13 (a) "Anesthesiologist" means an allopathic or osteopathic
14 physician who holds an active, unrestricted license; who has
15 successfully completed an anesthesiology training program
16 approved by the Accreditation Council on Graduate Medical
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1101 (2022)
Amendment No.1
17 Education or its equivalent; and who is certified by the
18 American Board of Anesthesiology, is eligible to take that
19 board's examination, or is certified by the Board of
20 Certification in Anesthesiology affiliated with the American
21 Association of Physician Specialists.
22 (g) "Direct supervision" means the physical presence of a
23 supervising anesthesiologist on the premises such that the
24 supervising anesthesiologist is immediately available as needed
25 onsite, personal supervision by an anesthesiologist who is
26 present in the office when the procedure is being performed in
27 that office, or is present in the surgical or obstetrical suite
28 when the procedure is being performed in that surgical or
29 obstetrical suite and who is in all instances immediately
30 available to provide assistance and direction to the
31 anesthesiologist assistant while anesthesia services are being
32 performed.
33 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS.—
34 (a) An anesthesiologist assistant may assist an
35 anesthesiologist in developing and implementing an anesthesia
36 care plan for a patient, may personally administer the
37 prescribed anesthetic under the direct supervision of an
38 anesthesiologist, and may perform tasks and services as
39 specified in a written protocol approved by the supervising
40 anesthesiologist which may include any of the following
41 functions. In providing assistance to an anesthesiologist, an
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Amendment No.1
42 anesthesiologist assistant may perform duties established by
43 rule by the board in any of the following functions that are
44 included in the anesthesiologist assistant's protocol while
45 under the direct supervision of an anesthesiologist:
46 1. Obtain a comprehensive patient history and present the
47 history to the supervising anesthesiologist.
48 2. Pretest and calibrate anesthesia delivery systems and
49 monitor, obtain, and interpret information from the systems and
50 monitors.
51 3. Assist the supervising anesthesiologist with the
52 implementation of medically accepted monitoring techniques.
53 4. Establish basic and advanced airway interventions,
54 including intubation of the trachea and performing ventilatory
55 support.
56 5. Administer intermittent vasoactive drugs and start and
57 adjust vasoactive infusions.
58 6. Administer anesthetic drugs, adjuvant drugs, and
59 accessory drugs.
60 7. Assist the supervising anesthesiologist with the
61 performance of epidural anesthetic procedures and spinal
62 anesthetic procedures.
63 8. Administer blood, blood products, and supportive
64 fluids.
65 9. Support life functions during anesthesia health care,
66 including induction and intubation procedures, the use of
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Bill No. HB 1101 (2022)
Amendment No.1
67 appropriate mechanical supportive devices, and the management of
68 fluid, electrolyte, and blood component balances.
69 10. Recognize and take appropriate corrective action for
70 abnormal patient responses to anesthesia, adjunctive medication,
71 or other forms of therapy.
72 11. Participate in management of the patient while in the
73 postanesthesia recovery area, including the administration of
74 any supporting fluids or drugs.
75 12. Place special peripheral and central venous and
76 arterial lines for blood sampling and monitoring as appropriate.
77 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE.—
78 (a) Any person desiring to be licensed as an
79 anesthesiologist assistant must apply to the department. The
80 department shall issue a license to any person certified by the
81 board to:
82 1. Be at least 18 years of age.
83 2. Have satisfactorily passed a proficiency examination
84 with a score established by the National Commission on
85 Certification of Anesthesiologist Assistants.
86 3. Be certified in advanced cardiac life support.
87 4. Have completed the application form and remitted an
88 application fee, not to exceed $1,000, as set by the boards. An
89 application must include:
90 a. A certificate of completion of an approved graduate
91 level program.
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Amendment No.1
92 b. An acknowledgment A sworn statement of any prior felony
93 convictions.
94 c. An acknowledgment A sworn statement of any prior
95 discipline or denial of licensure or certification in any state.
96 d. Two letters of recommendation from anesthesiologists.
97 (b) A license must be renewed biennially. Each renewal
98 must include:
99 1. A renewal fee, not to exceed $1,000, as set by the
100 boards.
101 2. An acknowledgment A sworn statement of no felony
102 convictions in the immediately preceding 2 years.
103 Section 2. Paragraphs (a) and (g) of subsection (1),
104 paragraph (a) of subsection (3), and paragraphs (a) and (b) of
105 subsection (6) of section 459.023, Florida Statutes, are amended
106 to read:
107 459.023 Anesthesiologist assistants.—
108 (1) DEFINITIONS.—As used in this section, the term:
109 (a) "Anesthesiologist" means an osteopathic or allopathic
110 physician who holds an active, unrestricted license; who has
111 successfully completed an anesthesiology training program
112 approved by the Accreditation Council on Graduate Medical
113 Education, or its equivalent, or the American Osteopathic
114 Association; and who is certified by the American Osteopathic
115 Board of Anesthesiology or is eligible to take that board's
116 examination, is certified by the American Board of
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1101 (2022)
Amendment No.1
117 Anesthesiology or is eligible to take that board's examination,
118 or is certified by the Board of Certification in Anesthesiology
119 affiliated with the American Association of Physician
120 Specialists.
121 (g) "Direct supervision" means the physical presence of a
122 supervising anesthesiologist on the premises such that the
123 supervising anesthesiologist is immediately available as needed
124 onsite, personal supervision by an anesthesiologist who is
125 present in the office when the procedure is being performed in
126 that office, or is present in the surgical or obstetrical suite
127 when the procedure is being performed in that surgical or
128 obstetrical suite and who is in all instances immediately
129 available to provide assistance and direction to the
130 anesthesiologist assistant while anesthesia services are being
131 performed.
132 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS.—
133 (a) An anesthesiologist assistant may assist an
134 anesthesiologist in developing and implementing an anesthesia
135 care plan for a patient, may personally administer the
136 prescribed anesthetic under the direct supervision of an
137 anesthesiologist, and may perform tasks and services as
138 specified in a written protocol approved by the supervising
139 anesthesiologist which may include any of the following
140 functions. In providing assistance to an anesthesiologist, an
141 anesthesiologist assistant may perform duties established by
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1101 (2022)
Amendment No.1
142 rule by the board in any of the following functions that are
143 included in the anesthesiologist assistant's protocol while
144 under the direct supervision of an anesthesiologist:
145 1. Obtain a comprehensive patient history and present the
146 history to the supervising anesthesiologist.
147 2. Pretest and calibrate anesthesia delivery systems and
148 monitor, obtain, and interpret information from the systems and
149 monitors.
150 3. Assist the supervising anesthesiologist with the
151 implementation of medically accepted monitoring techniques.
152 4. Establish basic and advanced airway interventions,
153 including intubation of the trachea and performing ventilatory
154 support.
155 5. Administer intermittent vasoactive drugs and start and
156 adjust vasoactive infusions.
157 6. Administer anesthetic drugs, adjuvant drugs, and
158 accessory drugs.
159 7. Assist the supervising anesthesiologist with the
160 performance of epidural anesthetic procedures and spinal
161 anesthetic procedures.
162 8. Administer blood, blood products, and supportive
163 fluids.
164 9. Support life functions during anesthesia health care,
165 including induction and intubation procedures, the use of
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1101 (2022)
Amendment No.1
166 appropriate mechanical supportive devices, and the management of
167 fluid, electrolyte, and blood component balances.
168 10. Recognize and take appropriate corrective action for
169 abnormal patient responses to anesthesia, adjunctive medication,
170 or other forms of therapy.
171 11. Participate in management of the patient while in the
172 postanesthesia recovery area, including the administration of
173 any supporting fluids or drugs.
174 12. Place special peripheral and central venous and
175 arterial lines for blood sampling and monitoring as appropriate.
176 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE.—
177 (a) Any person desiring to be licensed as an
178 anesthesiologist assistant must apply to the department. The
179 department shall issue a license to any person certified by the
180 board to:
181 1. Be at least 18 years of age.
182 2. Have satisfactorily passed a proficiency examination
183 with a score established by the National Commission on
184 Certification of Anesthesiologist Assistants.
185 3. Be certified in advanced cardiac life support.
186 4. Have completed the application form and remitted an
187 application fee, not to exceed $1,000, as set by the boards. An
188 application must include:
189 a. A certificate of completion of an approved graduate
190 level program.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1101 (2022)
Amendment No.1
191 b. An acknowledgment A sworn statement of any prior felony
192 convictions.
193 c. An acknowledgment A sworn statement of any prior
194 discipline or denial of licensure or certification in any state.
195 d. Two letters of recommendation from anesthesiologists.
196 (b) A license must be renewed biennially. Each renewal
197 must include:
198 1. A renewal fee, not to exceed $1,000, as set by the
199 boards.
200 2. An acknowledgment A sworn statement of no felony
201 convictions in the immediately preceding 2 years.
202 Section 3. This act shall take effect July 1, 2022.
203
204 -----------------------------------------------------
205 T I T L E A M E N D M E N T
206 Remove everything before the enacting clause and insert:
207 An act relating to anesthesiologist assistants; amending ss.
208 458.3475 and 459.023, F.S.; revising the definitions of the
209 terms "anesthesiologist" and "direct supervision"; revising
210 requirements for the written protocol between an
211 anesthesiologist assistant and a supervising anesthesiologist;
212 revising provisions relating to duties and functions
213 anesthesiologist assistants may perform; revising licensure
214 requirements for anesthesiologist assistants; providing an
215 effective date.
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HB 1209
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1209 Administration of Vaccines
SPONSOR(S): Tuck and others
TIED BILLS: IDEN./SIM. BILLS: SB 1892
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Morris McElroy
2) Health & Human Services Committee
SUMMARY ANALYSIS
Current law authorizes pharmacists and registered interns who meet certain educational requirements to
administer vaccines to adults within an established protocol with a supervising physician. A pharmacist or a
pharmacy intern may administer:
• Immunizations or vaccines listed on the U.S. Centers for Disease Control and Prevention (CDC) Adult
Immunization Schedule as of April 20, 2021;
• Vaccines recommended by the CDC for international travel as of April 30, 2021;
• Immunizations or vaccines licensed for use in the United States by the U.S. Food and Drug
Administration (FDA) as of April 30, 2021;
• Immunizations or vaccines authorized for emergency use by the FDA as of April 30, 2021;
• Immunizations or vaccines approved by the Board of Pharmacy (Board) in rule; and
• Immunizations or vaccines approved by the Board of Pharmacy in response to a state of emergency
declared by the Governor.
Pharmacy technicians are not currently authorized by law to administer immunizations or vaccines.
HB 1209 authorizes qualified Florida-registered pharmacy technicians to administer to adults the above-
referenced immunizations or vaccines under the supervision of a certified pharmacist.
The bill requires pharmacy technicians to become certified to administer such immunizations and vaccines. To
become certified, a registered pharmacy technician must complete at least six hours of immunization-related
training. The training curriculum must, at a minimum, include instruction on the safe and effective
administration of vaccines and potential allergic reactions to such vaccines. Upon registration renewal,
pharmacy technicians must have completed at least two hours of additional continuing education.
The bill updates the authorized immunizations or vaccines that may be administered from those listed in the
CDC Recommended Immunization Schedule for adults, the CDC’s Health Information for International Travel,
and those licensed or authorized for emergency use by the FDA as of April 30, 2021 to those listed or
approved as of March 31, 2022.
The bill has an insignificant, negative fiscal impact on the Department of Health. The bill has no fiscal impact
on local governments.
The bill provides 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: h1209.PPH
DATE: 2/1/2022
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Vaccinations
CDC Immunization Recommendations
The Advisory Committee on Immunization Practices (ACIP) develops recommendations on the use of
vaccines in the United States. 1 The ACIP is comprised of medical and public health experts, and works
with professional organizations, such as the American Academy of Pediatrics, the American Academy
of Family Physicians, the American College of Obstetricians and Gynecologists, and the American
College of Physicians to develop annual childhood and adult immunization schedules. 2 The Centers for
Disease Control and Prevention (CDC) reviews the ACIP’s recommendations; once approved by the
CDC Director and the U.S. Department of Health and Human Services, they are published as the
CDC’s official recommendations for immunizations of the U.S. population. 3
The current recommended immunization schedule for adults includes: 4
• Influenza (annually) • Varicella (if born in 1980 or later)
• Measles, mumps, rubella (if born in 1957 or • Tetanus, diphtheria, pertussis (booster
later) every 10 years)
• Zoster • Human papillomavirus
• Pneumococcal polysaccharide • Pneumococcal conjugate
• Haemophilus influenza type b • Hepatitis A
• Hepatitis B • Meningococcal A, C, W, Y
• Meningococcal B
New vaccines are considered for addition to the schedule after licensure by the United States Food and
Drug Administration. 5 Not all newly licensed vaccines are added to the schedule. Some licensed
vaccines are only recommended for people who are traveling to areas where other vaccine preventable
diseases occur, such as yellow fever, cholera, dengue, Japanese encephalitis, plague, rabies,
smallpox, and typhoid. 6
The CDC’s Health Information for International Travel, commonly called the Yellow Book (Book), is
published biannually by the CDC as a reference for those who advise international travelers about
1 Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices (ACIP), General Committee-Related
Information, available at https://www.cdc.gov/vaccines/acip/committee/index.html (last visited Jan. 28, 2022). Established under Title 42
U.S.C. § 217a, ACIP members are appointed by the Secretary of the Department of Health and Human Services and consist of a mix of
medical and public health experts from private industry and the public sector. There are 15 voting members (14 are industry experts
and one consumer member), 6 non-voting, ex-officio members consisting of specific federal government employees, and 30 non-voting
representatives from professional health care organizations.
2 Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices (ACIP), ACIP Recommendations,
available at https://www.cdc.gov/vaccines/acip/recommendations.html (last visited Jan. 28, 2022).
3 Id.
4 Centers for Disease Control and Prevention, Recommended Adult Immunization Schedule for Ages 19 Years or Older, United States,
2021, available at https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html (last visited Jan. 28, 2022). The schedule provides the
recommended age, as well as the administration intervals for vaccines that require multiple doses. Some vaccines are recommended
only for populations with special situations that put these individuals at higher risk.
5 College of Physicians of Philadelphia, The History of Vaccines: The Development of the Immunization Schedule, available at
http://www.historyofvaccines.org/content/articles/development-immunization-schedule (last visited Jan. 28, 2022).
6 Id. For a complete list of FDA-licensed vaccines, see U.S. Food & Drug Administration, Vaccines Licensed for Use in the United
States, (as of Dec. 1, 2021), available at https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states
(last visited Jan. 28, 2022).
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health risks. 7 The Book includes the CDC’s most current travel health guidelines, including pre-travel
vaccine recommendations and destination-specific health advice. The Book is authored by subject-
matter experts both within and outside the CDC and the guidelines in the Book are evidence-based and
supported by best practices. 8
Vaccinations are recommended by the CDC to protect international travelers from illness and prevent
the importation of infectious diseases across international borders. The Book recommends that persons
traveling internationally should be up to date on all CDC-recommended vaccines. 9 Additionally, the
Book may recommend additional vaccinations based on traveler’s destination and other factors.
Examples of additional vaccines required for travelers based on the country of entry is yellow fever,
meningococcal, and polio. 10 An example of a vaccine the CDC recommends travelers obtain to protect
their health, even if they are not required for entry into the country, is the typhoid vaccine. 11
FDA Licensure and Emergency Use Authorization
The United States Food and Drug Administration (FDA) oversees the safety, effectiveness, and quality
of vaccines used in the United States. Once a vaccine is developed, the pre-clinical phase begins,
which consists of laboratory research and testing on animals. If the pre-clinical phase shows the
vaccine is likely to be safe and work well in humans, it is tested on humans through clinical trials. While
clinical trials are underway, the FDA assesses the manufacturing process to ensure that the vaccine
can be produced reliably and consistently. Once a manufacturing process is developed and pre-clinical
and clinical trials are successfully completed, developers submit a Biologics License Application to the
FDA, which includes details on the manufacturing process and data from pre-clinical and clinical trials.
The FDA evaluates the application and decides whether to license the vaccine for use in the United
States. The FDA continues to monitor and regulate vaccines and manufacturers after licensing. 12
All vaccines must be licensed (approved) by the FDA in order to be marketed in the United States. 13
However, during public health emergencies, the FDA may authorize vaccines for emergency use,
which speeds up the process of bringing a vaccine to market. 14
Emergency use authorization (EUA) allows the FDA to help strengthen the nation’s public health
protections against chemical, biological, radiological, and nuclear threats including infectious diseases,
by facilitating the availability and use of medical countermeasures need during public health
emergencies. 15 Under section 564 of the Federal Food, Drug, and Cosmetic Act, 16 when the Secretary
of the United States Department of Health and Human Services (HHS) declares that an emergency use
authorization is appropriate, the FDA may authorize unapproved medical products or unapproved uses
of approved medical products to be used in an emergency to diagnose, treat, or prevent serious life-
threatening diseases or conditions caused by chemical, biological, radiological, and nuclear threats. 17
Vaccine manufacturers seeking EUA must follow the same processes as a license applicant, but
instead of submitting a license application, the manufacturer files for EUA. 18 The FDA expects all
manufacturers who receive an EUA to pursue licensure. 19
7 Centers for Disease Control and Prevention. CDC Yellow Book 2020: Health Information for International Travel, available at
https://wwwnc.cdc.gov/travel/page/yellowbook-home (last visited Jan. 28, 2022).
8 Id.
9 Id.
10 Centers for Disease Control and Prevention, Travelers’ Health Most Frequently Asked Questions, available at
https://wwwnc.cdc.gov/travel/page/faq (last visited Jan. 28, 2022).
11 Id.
12 U.S. Food and Drug Administration, Vaccine Development – 101, https://www.fda.gov/vaccines-blood-biologics/development-
approval-process-cber/vaccine-development-101 (last visited Jan. 28, 2022).
13 U.S. Food and Drug Administration, Ensuring the Safety of Vaccines in the United States,
https://www.fda.gov/files/vaccines,%20blood%20&%20biologics/published/Ensuring-the-Safety-of-Vaccines-in-the-United-States.pdf
(last visited Jan. 28, 2022).
14 Food and Drug Administration, Emergency Use Authorization, https://www.fda.gov/emergency-preparedness-and-response/mcm-
legal-regulatory-and-policy-framework/emergency-use-authorization (last visited Jan. 28, 2022). Medical countermeasures are FDA-
regulated products (biologics, drugs, and devices) that may be used in the event of a public health emergency.
15 Id.
16 21 U.S.C. § 360bbb-3.
17 Supra, note 14. A determination that a public health emergency exists does not enable the FDA to issue EUAs.
18 Id.
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Practice of Pharmacy
Licensure
Pharmacy is the third largest health profession behind nursing and medicine. 20 The Board of Pharmacy
(Board), in conjunction with the Department of Health (DOH), regulates the practice of pharmacists
pursuant to ch. 465, F.S. 21 To be licensed as a pharmacist, a person must: 22
• Complete an application and remit an examination fee;
• Be at least 18 years of age;
• Hold a degree from an accredited and approved school or college of pharmacy; 23
• Have completed a Board-approved internship; and
• Successfully complete the Board-approved examination.
A pharmacist must complete at least 30 hours of Board-approved continuing education during each
biennial renewal period. 24 Pharmacists who are certified to administer vaccines or epinephrine
autoinjections must complete a 3-hour continuing education course on the safe and effective
administration of vaccines and epinephrine injections as a part of the biennial licensure renewal. 25
Pharmacists who administer long-acting antipsychotic medications must complete an approved 8-hour
continuing education course as a part of the continuing education for biennial licensure renewal. 26
Scope of Practice
In Florida, the practice of the profession of pharmacy includes: 27
• Compounding, dispensing, and consulting concerning contents, therapeutic values, and uses of
a medicinal drug;
• Consulting concerning therapeutic values and interactions of patent or proprietary preparations;
• Monitoring a patient’s drug therapy and assisting the patient in the management of his or her
drug therapy, including the review of the patient’s drug therapy and communication with the
patient’s prescribing health care provider or other persons specifically authorized by the patient,
regarding the drug therapy;
• Transmitting information from prescribers to their patients;
• Administering vaccines to adults; 28
• Administering epinephrine injections; 29 and
• Administering antipsychotic medications by injection. 30
19 U.S. Food and Drug Administration, Emergency Use Authorization for Vaccines Explained, https://www.fda.gov/vaccines-blood-
biologics/vaccines/emergency-use-authorization-vaccines-explained (last visited Jan. 28, 2022).
20 American Association of Colleges of Pharmacy, About AACP, available at https://www.aacp.org/about-aacp (last visited Jan. 28,
2022).
21 Sections 465.004 and 465.005, F.S.
22 Section 465.007, F.S. DOH may also issue a license by endorsement to a pharmacist who is licensed in another state upon meeting
the applicable requirements set forth in law and rule. See s. 465.0075, F.S.
23 If the applicant has graduated from a 4-year undergraduate pharmacy program of a school or college of pharmacy located outside
the United States, the applicant must demonstrate proficiency in English, pass the board-approved Foreign Pharmacy Graduate
Equivalency Examination, and complete a minimum of 500 hours in a supervised work activity program within Florida under the
supervision of a DOH-licensed pharmacist
24 Section 465.009, F.S.
25 Section 465.009(6), F.S.
26 Section 465.1893, F.S.
27 Section 465.003(13), F.S.
28 See s. 465.189, F.S.
29 Id.
30 Section 465.1893, F.S.
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Pharmacy Interns
A pharmacy intern is a person enrolled in a college of pharmacy and actively pursuing a pharmacy
degree. To become a pharmacy intern, a person must be certified by the Board as enrolled in an intern
program at an accredited school or college of pharmacy or as a graduate of an accredited school or
college of pharmacy and not yet licensed as a pharmacist in Florida. 31 The Board’s rules outline the
registration process for pharmacy interns and the internship program requirements for U.S. pharmacy
students or graduates and foreign pharmacy graduates. 32
A pharmacist is responsible for any delegated act performed by a registered pharmacy intern employed
or supervised by the pharmacist. 33
Pharmacy Technicians
Pharmacy technicians assist, and work under the supervision of, licensed pharmacists. Section
465.014, F.S., authorizes a licensed pharmacist to delegate to registered pharmacy technicians those
duties, tasks, and functions that do not fall within the definition of the practice of the profession of
pharmacy. Registered pharmacy technicians’ responsibilities include delegable tasks assigned by a
pharmacist which do not require the technician to exercise independent professional judgment relating
to the practice of pharmacy. 34 Examples include: retrieval of prescription files; data entry; counting,
weighing, measuring, pouring, and mixing prescription medication; and acceptance of authorization for
prescription renewals.
A pharmacist is responsible for acts performed by persons under his or her supervision. 35
Pharmacy technicians must be over the age of 17, registered with the Board, and complete a Board-
approved training program to practice in this state. 36 The training program includes classroom study
and clinical instruction on: 37
• Introduction to pharmacy and health care system;
• Pharmacy law;
• Pharmaceutical-medical terminology, abbreviations, and symbols;
• Records management and inventory control;
• Interpersonal relations, communications, and ethics; and
• Pharmaceutical calculations.
Registered pharmacy technicians must complete 20 hours of biennial continuing education upon
registration renewal. 38 Such continuing education must include subject matter on: 39
• Pharmacy technician practice areas and special health care problems;
• Biological, physical, behavioral and social sciences;
• The legal aspects of health care;
• Management and administration of health care personnel and patient care; and
• Teaching and learning processes of health care personnel and patient care.
The Board specifies by rule certain acts that pharmacy technicians are prohibited from performing,
which includes: 40
31 Section 465.013, F.S.
32 Rule 64B16-26.2032, F.A.C. (U.S. pharmacy students/graduates); Rule 64B16-26.2033, F.A.C. (foreign pharmacy graduates).
33 Rule 64B16-27.4001, F.A.C.
34 Rule, 64B16-27.420, F.A.C.
35 Rule 64B16-27.1001(7), F.A.C.
36 Section 465.014(2), F.S., and Rule 64B16-26.350, F.A.C.
37 Rule 64B16-26.351, F.A.C.
38 Section 465.014(6), F.S.
39 Rule 65B16-26.355, F.A.C.
40 Supra, note 34.
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• Receiving new verbal prescriptions or any change in the medication, strength, or directions;
• Interpreting a prescription or medication order for therapeutic acceptability and
appropriateness;
• Conducting a final verification of dosage and directions;
• Engaging in prospective drug review;
• Providing patient counseling;
• Transfer a prescription;
• Preparing copies of prescriptions or reading a prescription to any patient for the purpose of
providing reference to the treatment of the patient;
• Receiving therapy or blood product procedures permitted in a nuclear pharmacy;
• Monitoring prescription drug usage;
• Overriding clinical alerts without first notifying the pharmacist; and
• Engaging in any other act which requires a pharmacist’s professional judgment.
Pharmacy technicians are not currently authorized by law to administer immunizations or vaccines.
Pharmacist Vaccine Administration
Current law authorizes a pharmacist, or a registered pharmacy intern under the supervision of a
certified pharmacist at a ratio of 1:1, to administer immunizations and vaccines to adults within an
established protocol under a licensed supervising physician. 41 The protocol between the pharmacist
and the supervising physician dictates which types of patients to whom the pharmacist may administer
allowable vaccines. 42 The terms, scope, and conditions set forth in the protocol must be appropriate to
the pharmacist’s training and certification. A supervising physician must review the administration of
vaccines by the pharmacist. 43
To be certified to administer vaccines, a pharmacist or registered pharmacy intern must successfully
complete a Board-approved vaccine administration certification program. The certification program
requires a pharmacist or registered intern to complete 20 hours of Board-approved continuing
education that addresses: 44
• Mechanisms of action for vaccines, contraindications, drug interactions, and monitoring after
vaccine administration;
• Immunization schedules;
• Immunization screening questions, provision of risk/benefit information, informed consent,
recordkeeping, and electronic reporting into the state immunization registry;
• Vaccine storage and handling;
• Bio-hazardous waste disposal and sterile technique;
• Entering, negotiating, and performing pursuant to physician oversight protocols;
• Community immunization resources and programs;
• Identifying, managing and responding to adverse incidents including but not limited to potential
allergic reactions associated with vaccine administration;
• Procedures and policies for reporting to the Vaccine Adverse Event Reporting System;
• Reimbursement procedures and vaccine coverage by federal, state, and local governmental
jurisdictions and private third party payers;
• Administration techniques;
• Administration of epinephrine using an autoinjector delivery system;
• The April 30, 2021 CDC Recommended Adult Immunization Schedule;
• The immunizations or vaccines recommended for international travel as of April 30, 2021 found
in the CDC Health Information for International Travel (2020 Edition);
41 Section 468.189(1), F.S.
42 Section 465.189(7), F.S.
43 Id.
44 Rule 64B16-26.1031, F.A.C.
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• State of emergency administration of immunizations or vaccines;
• Current law permitting a pharmacist to administer vaccinations and epinephrine; and
• CPR training.
A pharmacist must also pass an examination and demonstrate vaccine administration technique. 45
Pharmacists who are certified to administer vaccines must maintain at least $200,000 of professional
liability insurance. 46 A pharmacist is permitted to administer epinephrine to treat any allergic reaction
resulting from a vaccine.
Current law restricts the vaccines a pharmacist may administer to adults to those vaccines listed in the
April 30, 2021, CDC Recommended Adult Immunization Schedule. No additional vaccines have been
added to such list since April 30, 2021.
However, current law authorizes the Board to add additional vaccines a pharmacist may administer by
rule. 47 The Board added the Meningococcal B vaccine in 2016 and the Zoster vaccine in 2018. 48 The
Board may authorize pharmacists to administer vaccines in response to a declared state of
emergency. 49
Currently, 15,091 pharmacists and 3,802 pharmacy interns are certified to administer vaccines. 50
Effect of Proposed Changes
HB 1209 authorizes certified registered pharmacy technicians to administer vaccines to adults. To
become certified, a registered pharmacy technician must have at least six hours of Board-approved or
Accredited Council for Pharmacy Education-approved (ACPE) immunization-related training. The
training curriculum must, at a minimum, include instruction on the safe and effective administration of
vaccines and potential allergic reactions to such vaccines. Upon registration renewal, registered
pharmacy technicians must have at least two hours of additional continuing education approved by the
Board or ACPE.
The bill requires registered pharmacy interns and registered pharmacy technicians who administer
vaccines to adults to do so under the supervision of a certified pharmacist who has an established
protocol with a supervising physician.
The bill updates the authorized immunizations or vaccines that may be administered from those listed
in the CDC Recommended Immunization Schedule for adults, the CDC’s Health Information for
International Travel, and those licensed or authorized for emergency use by the FDA as of April 30,
2021 to those listed or approved as of March 31, 2022. Such CDC-recommended vaccines, and
vaccines licensed or authorized for emergency use by the FDA have not changed since April 30, 2021.
However, vaccines may be added to the CDC-recommend lists for adults or authorized for emergency
use by the FDA on or before March 31, 2022.
The bill authorizes the Board to determine the number of technicians a pharmacist may supervise
related to the administration of vaccines, but specifies the ratio must be one pharmacist to no more
than six pharmacy technicians.
The bill provides an effective date of July 1, 2022.
B. SECTION DIRECTORY:
Section 1: Amends s. 465.014, F.S., relating to pharmacy technician.
45 Id.
46 Section 465.189(3), F.S.
47 Section 465.189, F.S.
48 Rule 64B16-27.630, F.A.C.
49 Section 465.189(1)(c), F.S.
50 E-mail from Gangul Gabadage, Legislative Planning Coordinator, Department of Health, Pharmacist Administered Vaccines dated
Jan. 28, 2022.
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Section 2: Amends s. 465.189, F.S., relating to administration of vaccines and epinephrine
autoinfection.
Section 3: 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:
DOH estimates 3 full-time equivalent (FTE) position will be needed to implement the provisions of
the bill at a total cost of $170,674 ($156,727 recurring and $13,947 nonrecurring). 51
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:
Current law and the bill provide sufficient rulemaking authority to implement the bill’s provisions.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
51 Department of Health Agency Analysis of 2022 House Bill 1209 (Jan. 28, 2022).
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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 1209 2022
1 A bill to be entitled
2 An act relating to administration of vaccines;
3 amending s. 465.014, F.S.; authorizing registered
4 pharmacy technicians to administer specified vaccines
5 under certain circumstances; providing requirements
6 for registration renewal; amending s. 465.189, F.S.;
7 authorizing certified pharmacists to administer
8 specified vaccines under certain circumstances;
9 revising the immunizations or vaccines that certified
10 pharmacists, registered interns, and registered
11 pharmacy technicians may administer; revising and
12 providing continuing education requirements for
13 registered pharmacy technicians; providing that the
14 Board of Pharmacy may authorize by rule a staffing
15 ratio for a registered pharmacy technician to
16 administer certain immunizations or vaccines;
17 providing an effective date.
18
19 Be It Enacted by the Legislature of the State of Florida:
20
21 Section 1. Subsections (7) and (8) of section 465.014,
22 Florida Statutes, are renumbered as subsections (8) and (9),
23 respectively, and a new subsection (7) is added to that section,
24 to read:
25 465.014 Pharmacy technician.—
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HB 1209 2022
26 (7) A registered pharmacy technician seeking to administer
27 vaccines under s. 465.189 must have at least 6 hours of
28 immunization-related training approved by the board or the
29 Accreditation Council for Pharmacy Education that shall, at a
30 minimum, have curriculum of instruction concerning the safe and
31 effective administration of such vaccines, including, but not
32 limited to, potential allergic reactions to such vaccines. As a
33 condition of registration renewal, a registered pharmacy
34 technician seeking to administer vaccines under s. 465.189 must
35 have at least 2 hours of continuing education approved by the
36 board or the Accreditation Council for Pharmacy Education in
37 addition to the biennial continuing education required in
38 subsection (6).
39 Section 2. Subsections (1), (4), (5), and (7) of section
40 465.189, Florida Statutes, are amended to read:
41 465.189 Administration of vaccines and epinephrine
42 autoinjection.—
43 (1) In accordance with guidelines of the Centers for
44 Disease Control and Prevention for each recommended immunization
45 or vaccine, a pharmacist who is certified under subsection (7)
46 may administer the following vaccines to an adult within the
47 framework of an established protocol under a supervising
48 physician licensed under chapter 458 or chapter 459. or A
49 registered intern or a registered pharmacy technician under the
50 supervision of a pharmacist who is certified under subsection
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HB 1209 2022
51 (7) may administer the following immunizations or vaccines to an
52 adult within the framework of an established protocol under a
53 supervising physician licensed under chapter 458 or chapter 459:
54 (a) Immunizations or vaccines listed in the Adult
55 Immunization Schedule as of March 31, 2022 April 30, 2021, by
56 the United States Centers for Disease Control and Prevention.
57 The board may authorize by rule additional immunizations or
58 vaccines as they are added to the Adult Immunization Schedule.
59 (b) Immunizations or vaccines recommended by the United
60 States Centers for Disease Control and Prevention for
61 international travel as of March 31, 2022 April 30, 2021. The
62 board may authorize by rule additional immunizations or vaccines
63 as they are recommended by the United States Centers for Disease
64 Control and Prevention for international travel.
65 (c) Immunizations or vaccines licensed for use in the
66 United States, or which have been authorized for emergency use,
67 by the United States Food and Drug Administration as of March
68 31, 2022 April 30, 2021. The board may authorize by rule
69 additional immunizations or vaccines as they are so licensed or
70 authorized.
71 (d) Immunizations or vaccines approved by the board in
72 response to a state of emergency declared by the Governor
73 pursuant to s. 252.36.
74
75 A registered intern who administers an immunization or vaccine
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HB 1209 2022
76 under this subsection must be supervised by a certified
77 pharmacist at a ratio of one pharmacist to one registered
78 intern. The board may authorize by rule the ratio of one
79 certified pharmacist to no more than six registered pharmacy
80 technicians, specific to the administration of vaccines.
81 (4) A pharmacist may not enter into a protocol under a
82 supervising physician licensed under chapter 458 or chapter 459
83 or administer an immunization or vaccine under this section
84 unless he or she maintains at least $200,000 of professional
85 liability insurance and has completed training in administering
86 vaccines authorized under this section.
87 (5) A pharmacist administering immunizations or vaccines
88 under this section shall maintain and make available patient
89 records using the same standards for confidentiality and
90 maintenance of such records as those that are imposed on health
91 care practitioners under s. 456.057. These records shall be
92 maintained for a minimum of 5 years.
93 (7) Any pharmacist, or registered intern, or registered
94 pharmacy technician seeking to administer vaccines under this
95 section must be certified to administer such vaccines pursuant
96 to a certification program approved by the board of Pharmacy in
97 consultation with the Board of Medicine and the Board of
98 Osteopathic Medicine. The certification program shall, at a
99 minimum, require that the pharmacist attend at least 20 hours of
100 continuing education classes approved by the board and the
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101 registered intern complete at least 20 hours of coursework
102 approved by the board. The registered pharmacy technician shall
103 have immunization-related training and continuing education as
104 provided in s. 465.014. The certification programs program
105 shall, at a minimum, have a curriculum of instruction concerning
106 the safe and effective administration of such vaccines,
107 including, but not limited to, potential allergic reactions to
108 such vaccines.
109 Section 3. This act shall take effect July 1, 2022.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1209 (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 Tuck offered the following:
4
5 Amendment (with title amendment)
6 Remove everything after the enacting clause and insert:
7 Section 1. Subsections (7) and (8) of section 465.014,
8 Florida Statutes, are renumbered as subsections (8) and (9),
9 respectively, and a new subsection (7) is added to that section,
10 to read:
11 465.014 Pharmacy technician.—
12 (7) A registered pharmacy technician seeking to administer
13 vaccines under s. 465.189 must be certified to administer such
14 vaccines pursuant to a certification program approved by the
15 Board of Pharmacy in consultation with the Board of Medicine and
16 the Board of Osteopathic Medicine. The certification program
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1209 (2022)
Amendment No. 1
17 must have at least 6 hours of immunization-related training
18 approved by the board that shall, at a minimum, have curriculum
19 of instruction concerning the safe and effective administration
20 of such vaccines, including, but not limited to, potential
21 allergic reactions to such vaccines. As a condition of
22 registration renewal, a registered pharmacy technician seeking
23 to administer vaccines under s. 465.189 must have at least 2
24 hours of continuing education approved by the board in addition
25 to the biennial continuing education required in subsection (6).
26 Section 2. Subsections (1), (4), (5), and (7) of section
27 465.189, Florida Statutes, are amended to read:
28 465.189 Administration of vaccines and epinephrine
29 autoinjection.—
30 (1) In accordance with guidelines of the Centers for
31 Disease Control and Prevention for each recommended immunization
32 or vaccine, a pharmacist who is certified under subsection (7),
33 or a registered intern or pharmacy technician under the
34 supervision of such a pharmacist, who is certified under
35 subsection (7) may administer the following immunizations or
36 vaccines to an adult within the framework of an established
37 protocol under a supervising physician licensed under chapter
38 458 or chapter 459:
39 (a) Immunizations or vaccines listed in the Adult
40 Immunization Schedule as of March 31, 2022 April 30, 2021, by
41 the United States Centers for Disease Control and Prevention.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1209 (2022)
Amendment No. 1
42 The board may authorize by rule additional immunizations or
43 vaccines as they are added to the Adult Immunization Schedule.
44 (b) Immunizations or vaccines recommended by the United
45 States Centers for Disease Control and Prevention for
46 international travel as of March 31, 2022 April 30, 2021. The
47 board may authorize by rule additional immunizations or vaccines
48 as they are recommended by the United States Centers for Disease
49 Control and Prevention for international travel.
50 (c) Immunizations or vaccines licensed for use in the
51 United States, or which have been authorized for emergency use,
52 by the United States Food and Drug Administration as of March
53 31, 2022 April 30, 2021. The board may authorize by rule
54 additional immunizations or vaccines as they are so licensed or
55 authorized.
56 (d) Immunizations or vaccines approved by the board in
57 response to a state of emergency declared by the Governor
58 pursuant to s. 252.36.
59
60 A registered intern who administers an immunization or vaccine
61 under this subsection must be supervised by a certified
62 pharmacist at a ratio of one pharmacist to one registered
63 intern.
64 (4) A pharmacist may not enter into a protocol under a
65 supervising physician licensed under chapter 458 or chapter 459
66 or administer an immunization or vaccine under this section
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1209 (2022)
Amendment No. 1
67 unless he or she maintains at least $200,000 of professional
68 liability insurance and has completed training in administering
69 vaccines authorized under this section.
70 (5) A pharmacist administering immunizations or vaccines
71 under this section shall maintain and make available patient
72 records using the same standards for confidentiality and
73 maintenance of such records as those that are imposed on health
74 care practitioners under s. 456.057. These records shall be
75 maintained for a minimum of 5 years.
76 (7) Any pharmacist, or registered intern, or registered
77 pharmacy technician seeking to administer vaccines under this
78 section must be certified to administer such vaccines pursuant
79 to a certification program approved by the board of Pharmacy in
80 consultation with the Board of Medicine and the Board of
81 Osteopathic Medicine. The certification program shall, at a
82 minimum, require that the pharmacist attend at least 20 hours of
83 continuing education classes approved by the board and the
84 registered intern complete at least 20 hours of coursework
85 approved by the board. The registered pharmacy technician shall
86 have immunization-related training and continuing education as
87 provided in s. 465.014. The certification programs program
88 shall, at a minimum, have a curriculum of instruction concerning
89 the safe and effective administration of such vaccines,
90 including, but not limited to, potential allergic reactions to
91 such vaccines.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1209 (2022)
Amendment No. 1
92 Section 3. This act shall take effect July 1, 2022.
93
94 -----------------------------------------------------
95 T I T L E A M E N D M E N T
96 Remove everything before the enacting clause and insert:
97 An act relating to administration of vaccines; amending s.
98 456.014, F.S.; authorizing registered pharmacy technicians to
99 administer specified vaccines under certain circumstances;
100 providing requirements for registration renewal; amending s.
101 465.189, F.S.; authorizing certified pharmacists to administer
102 specified vaccines under certain circumstances; revising the
103 immunizations or vaccines that certified pharmacists, registered
104 interns, and registered pharmacy technicians may administer;
105 revising and providing continuing education requirements for
106 registered pharmacy technicians; providing an effective date.
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HB 1521
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1521 Professional Counselors Licensure Compact
SPONSOR(S): Koster
TIED BILLS: HB 1523 IDEN./SIM. BILLS: CS/SB 358
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Morris McElroy
2) Government Operations Subcommittee
3) Health Care Appropriations Subcommittee
4) Health & Human Services Committee
SUMMARY ANALYSIS
Current law allows a Florida-licensed health care practitioner, a practitioner licensed under a multistate health
care licensure compact of which Florida is a member, or a registered out-of-state-health care provider to
provide health care services to Florida patients via telehealth. It does not allow health care practitioners,
including Florida licensed clinical social workers, marriage and family therapists, and mental health counselors,
to use telehealth to provide services to out-of-state patients.
The Professional Counselors Licensure Compact (PCLC) is an interstate compact, which is an agreement
between states to enact legislation and enter into a contract for a specific, limited purpose. In 2020, the
National Center for Interstate Compacts adopted model legislation for the compact which authorizes both
telehealth and in-person practice across state lines in compact states.
The compact establishes the Psychology Interjurisdictional Compact Commission (commission), made up of
each party state’s representative of the state licensing board. The commission is responsible for administering
the compact. The compact becomes effective on the date of enactment by the tenth state and currently has
two member states. HB 1521 enacts the PCLC and authorizes Florida to enter into the compact. The
Department of Health must notify the Division of Law Revision when the compact is enacted into law by ten
states.
Professional counselors licensed in compact states may apply to other compact states for the privilege to
practice through either telehealth or in-person. Thus, under the compact a Florida licensed clinical social
worker, marriage and family therapist, or mental health counselor is eligible to provide services to out-of-state
patients through either telehealth or in-person. It also allows out-of-state licensed professional counselors in
compact states to provide services to Florida patients through telehealth and in-person.
The compact requires all participating states to report certain licensure information to a data system, including
identifying information, licensure data, and adverse actions taken against a professional counselor’s license or
practice privileges in a compact state. Such information is public under the compact unless a compact state
designates the information it contributes to the data system as confidential, prohibiting disclosure to the public
without express permission of the reporting state.
The bill has a significant, negative fiscal impact on DOH and no fiscal impact on local governments.
The bill is effective upon enactment of the Professional Counselors Licensure Compact into law by ten states.
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
Health Care Professional Shortage
There is currently a health care provider shortage in the U.S. 1 This shortage is predicted to continue
into the foreseeable future and will likely worsen with the aging and growth of the U.S. population 2 and
the passage of the Patient Protection and Affordable Care Act. 3 Aging populations create a
disproportionately higher health care demand. 4 Additionally, as more individuals qualify for health care
benefits, there will necessarily be a greater demand for more health care professionals to provide these
services.
According to the U.S. Health Resources and Services Administration (HRSA), the U.S. will experience
a 7% increase in demand for mental health counselors by 2030, producing a shortage of approximately
6,870 mental health counselors nationwide. 5 In Florida, HRSA estimates a shortage of 3,400 mental
health counselors by 2030. 6 Exacerbated by the COVID-19 pandemic, the American Academy of
Pediatrics declared a national state of emergency in children’s mental health, creating a need for more
mental health professionals and increased access to such. 7
Mental Health Counselor Licensure in Florida
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
1 For example, as of December 31, 2021, the U.S. Department of Health and Human Services has designated 7,613 Primary Care
Health Professional Shortage Area (HPSA) (requiring 15,184 additional primary care physicians to eliminate the shortage), 6,803
Dental HPSAs (requiring 11,181 additional dentists to eliminate the shortage), and 6,078 Mental Health HPSAs (requiring 6,851
additional mental health providers to eliminate the shortage). U.S. Department of Health and Human Services, Designated Health
Professional Shortage Areas Statistics (Jan. 1, 2022), https://data.hrsa.gov/Default/GenerateHPSAQuarterlyReport (last visited Jan. 30,
2022).
2 According to the U.S. Census Bureau, the U.S population is expected to increase by almost 100 million between 2014 and 2060, and
by 2030, one in five Americans is projected to be 65 and over. Sandra L. Colby & Jennifer M. Ortman, U.S. Census Bureau, Projections
of the Size and Composition of the U.S.Population: 2014 to 2060 (March 2015),
https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf (last visited Jan. 30, 2022).
3 U.S. Dep’t of Health and Human Services, Department of Health and Human Services Strategic Plan: Goal 1: Strengthen Health
Care, available at http://www.hhs.gov/secretary/about/goal5.html (last visited on Jan. 22, 2022).
4 One analysis measured current primary care utilization (office visits) and projected the impact of population increases, aging, and
insured status changes. The study found that the total number of office visits to primary care physicians will increase from 462 million in
2008 to 565 million in 2025, and (because of aging) the average number of visits will increase from 1.60 to 1.66. The study concluded
that the U.S. will require 51,880 additional primary care physicians by 2025. (Petterson, Stephen M., et al., “Projecting U.S. Primary
Care Physician Workforce Needs: 2010-2025,” Annals of Family Medicine, vol. 10, No. 6 (November/December 2012), available at
http://www.annfammed.org/content/10/6/503.full.pdf+html (last visited on Jan. 30, 2022).
5 Health Resources Services Administration, Behavioral Health Workforce Projections, 2016-2030: Clinical, Counseling and School
Psychologists, https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/psychologists-2018.pdf (last visited Jan.
30, 2022).
6 Health Resources Services Administration, State-Level Projections of Supply and Demand for Behavioral Health Occupations: 2016-
2030 (September 2018), https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/state-level-estimates-report-
2018.pdf (last visited Jan. 30, 2022).
7 American Academy of Pediatrics, AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health,
https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-
emergency-in-child-and-adolescent-mental-health/ (last visited Jan. 22, 2022).
8 Sections 491.003(6) and (9), F.S.
9 Section 491.005(4), F.S.
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• 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
Telehealth
A Florida-licensed health care practitioner, a practitioner licensed under a multistate health care
licensure compact of which Florida is a member, 11 or a registered out-of-state-health care provider to
provide health care services to Florida patients via telehealth. 12 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 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. 13
Under current law, in-state and out-of-state licensed or registered health care practitioners may use
telehealth to provide health care services to patients physically located in Florida. The law does not
allow health care practitioners, including Florida licensed mental health counselors, to use telehealth to
provide services to out-of-state patients.
Sovereign Immunity
Sovereign immunity generally bars lawsuits against the state or its political subdivisions for torts
committed by an officer, employee, or agent of such governments unless the immunity is expressly
waived. The Florida Constitution recognizes that the concept of sovereign immunity applies to the state,
although the state may waive its immunity through an enactment of general law. 14
In 1973, the Legislature enacted s. 768.28, F.S., a partial waiver of sovereign immunity, allowing
individuals to sue state government and its subdivisions. 15 According to subsection (1), individuals may
sue the government under circumstances where a private person "would be liable to the claimant, in
accordance with the general laws of [the] state . . . . " Section 768.28(5), F.S., imposes a $200,000 limit
on the government's liability to a single person, and a $300,000 total limit on liability for claims arising
out of a single incident.
10 Section 491.005(4), F.S., and r. 64B4-3.0035, F.A.C.
11 Florida is a member of the Nurse Licensure Compact. See s. 464.0095, F.S.
12 S. 456.47(4), F.S.
13 S. 456.47(2), F.S.
14 Fla. Const. art. X, s. 13.
15 Chapter 73-313, L.O.F., codified at s. 768.28, F.S.
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Impaired Practitioner Program
The impaired practitioner treatment program was created to provide resources to assist health care
practitioners who are impaired as a result of the misuse or abuse of alcohol or drugs, or both, or a
mental or physical condition which could affect the practitioners’ ability to practice with skill and
safety. 16 For a profession that does not have a program established within its individual practice act,
DOH is required to designate an approved program by rule. 17 By rule, DOH designates the approved
program by contract with a consultant to initiate intervention, recommend evaluation, refer impaired
practitioners to treatment providers, and monitor the progress of impaired practitioners. The impaired
practitioner program may not provide medical services. 18
Interstate Compacts
An interstate compact is an agreement between two or more states to address common problems or
issues, create an independent, multistate governmental authority, or establish uniform guidelines,
standards or procedures for the compact’s member states. 19 Article 1, Section 10, Clause 3 (Compact
Clause) of the U.S. Constitution authorizes states to enter into agreements with each other, without the
consent of Congress. However, the case law has provided that not all interstate agreements are subject
to congressional approval, but only those that may encroach on the federal government’s power. 20
Florida is a party to multiple interstate compacts, including the Nurse Licensure Compact, 21 Driver’s
License Compact, 22 Compact on Adoption and Medical Assistance, 23 and the Interstate Compact on
Educational Opportunity for Military Children. 24
Professional Counselors Licensure Compact
The Professional Counselors Licensure Compact (PCLC) was created by the National Center for
Interstate Compacts as an interstate compact which authorizes professional counselors to practice via
telehealth and in-person across state lines in compact states. 25 The compact establishes the
Counseling Compact Commission (Commission) made up of member states which is responsible for
creating and finalizing rules and enforcing the compact. Licensed professional counselors must obtain
the privilege to practice from other compact states in order to provide services to clients in such
states. 26 Nothing in the compact is to be construed as a waiver of sovereign immunity. The PCLC
currently has two member states (Georgia and Maryland). 27
16 Section 456.076, F.S. The provisions of s. 456.076, also apply to veterinarians under s. 474.221, F.S. and radiological personnel
under s. 486.315, F.S.
17 Section 456.076(1), F.S.
18 Rule 64B31-10.001(1)(a), F.A.C.
19 National Center for Interstate Compacts, What Are Interstate Compacts?, https://compacts.csg.org/compacts/ (last visited Jan. 30,
2022).
20 For example, see Virginia v. Tennessee, 148 U.S. 503 (1893), New Hampshire v. Maine, 426 U.S. 363 (1976)
21 Section 464.0095, F.S.
22 Section 322.44, F.S.
23 Section 409.406, F.S.
24 Section 1000.36, F.S.
25 Counseling Compact, Counseling Compact Finalized, https://counselingcompact.org/first-post/ (last visited Jan. 30, 2022).
26 Counseling Compact, Counseling Compact Model Legislation (Dec. 2020), https://counselingcompact.org/wp-
content/uploads/2021/06/Final_Counseling_Compact_With_Cover.pdf (last visited Jan. 30, 2022).
27 Counseling Compact, Map, https://counselingcompact.org/map/ (last visited Jan. 30, 2022).
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The compact is arranged in 15 sections and addresses the following issues: 28
Purpose (Section 1)
The primary purposes of the PCLC are:
• Provide for the mutual recognition of other compact state licenses;
• Enhance states’ abilities to protect the public’s health and safety;
• Encourage the cooperation of member states in regulating multistate practice for licensed
professional counselors;
• Support active duty military personnel and their spouses;
• Enhance the exchange of licensure, investigative, and disciplinary information among member
states;
• Allow for the use of telehealth to increase access to counseling services;
• Support the uniformity of professional counseling licensure requirements throughout states;
• Eliminate the necessity for licenses in multiple states; and
• Facilitate interstate practice by licensed professional counselors who meet uniform
requirements.
Definitions (Section 2)
The compact provides definitions for terms used in the model legislation.
28 Supra, note 26.
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State Participation in the Compact (Section 3)
To participate in the compact, a state must:
• License and regulate professional counselors;
• Require passage of a commission-approved, nationally recognized exam;
• Require licensees to meet specified educational and post graduate professional experience
standards;
• Have a mechanism in place for receiving and investigating complaints;
• Participate in the Commission’s data system;
• Notify the commission of any adverse action or the availability of investigative information
regarding a licensee;
• Implement a process for considering the criminal history of applicants;
• Comply with the rules of the Commission;
• Require applicants to obtain or retain a license in his or her home state and meet the home
state’s qualifications for licensure or renewal of licensure; and
• Provide for the state’s representative to the commission to attend the commission meetings.
Additionally, compact states are authorized to charge a fee for granting the privilege to practice.
Licensed professional counselors may only utilize the compact if their home state joins the compact.
Obtaining a New Home State License Based on a Privilege to Practice (Section 5)
The PCLC requires a professional counselor to hold a home state license in only one compact state at
a time. A licensee who moves from one compact state to another compact state may obtain a new,
expedited home state license in the new state of residence if he or she holds a privilege to practice in
the new state. A licensee must complete a new background screening, any required state-level
background check, and any other requirements to obtain licensure in the new home state.
If a professional counselor moves from a non-compact state to a compact state, or from a compact
state to a non-compact state, he or she must apply for licensure in the new state under such state’s
requirements. Licensees may hold more multiple state licenses, but only the license tied to his or her
primary state of residence serves as the home state license under the compact.
Active Duty Military Personnel or Their Spouses (Section 6)
The PCLC allows an active duty service member or his or her spouse to designate a home state where
he or she has a current license in good standing, which serves as the home state for the duration of the
service member’s active duty.
Compact Privilege to Practice Telehealth (Section 7)
The PCLC establishes providing telehealth services to patients in remote states as a privilege to
practice. Professional counselors practicing via telehealth in a remote state must follow the laws and
regulations of the remote state.
Adverse Actions (Section 8)
Only the home state has the power to take adverse action against a professional counselor’s home
state license. The compact authorizes remote states to take adverse actions against a licensed
professional counselor’s privilege to practice within that compact state and issue subpoenas for
witnesses and evidence from other compact states. Under the compact, compact states are authorized
to initiate joint investigations of licensees and must share investigative materials in furtherance of a joint
investigation initiated under the compact. Adverse actions must be reported to the data system which
alerts the home state of such action. Compact states are authorized to take adverse actions based on
the factual findings of a remote state.
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If a licensee changes his or her home state while under active investigation of the former home state,
the former home state must complete the investigation, take appropriate action under its laws, and
report its findings to the data system.
Nothing in the compact overrides a compact state’s decision to require a licensee to participate in an
alternative program in lieu of adverse action.
Establishment of Counseling Compact Commission (Section 9)
The compact establishes the Counseling Compact Commission. Each compact state has one delegate
selected by that state’s licensing board. The delegate must be a current member or an administrator of
the licensing board. The Commission must establish term limits, a code of ethics, bylaws, rules, and a
budget in order to carry out the compact. The Commission must elect an executive committee of up to
11 members, at least seven of which must be from the Commission and up to four must be ex-officio,
nonvoting members from recognized national professional counselor organizations. All Commission
meetings must be open to the public except for when the Commission must discuss:
• Noncompliance of a compact state with its obligations under the compact;
• The employment, compensation, discipline, or other personnel matters, practices, or procedures
related to specific employees or other matters related to the Commission’s internal personnel
practices and procedure;
• Current, threatened, or reasonably anticipated litigation;
• Contract negotiations for the purchase or sale of goods, services, or real estate;
• Accusing a person of a crime or formally censuring a person;
• Disclosure of trade secrets or commercial or financial information that is privileged or
confidential;
• Disclosure of information of a personal nature where disclosure would constitute a clearly
unwarranted invasion of personal privacy if disclosed to the public;
• Disclosure of active investigatory records compiled for law enforcement purposes;
• Disclosure of information related to any reports prepared by or on behalf of the commission for
the purpose of investigation for compliance with the compact; and
• Matters specifically exempted from disclosure by federal law or the laws of any party state.
Commission members are immune from liability related to their positions except in cases of wanton
misconduct.
Data System (Section 10)
The compact requires all compact states to share licensee information. Compact states must submit a
uniform dataset to the data system on all counselors to whom the compact applies, as required by the
rules of the Commission. The data system allows for expedited sharing of adverse action or significant
investigative information against professional counselors with privilege to practice under the compact.
Data system information must be expunged according to the laws of the reporting compact state.
Rulemaking (Section 11)
The PCLC provides rulemaking authority to the Commission. Rules and amendments to the rules
passed by the Commission are binding on the party states as of the effective date specified in each rule
or amendment.
Prior to the promulgation and adoption of a rule, and at least 30 days in advance, the Commission must
provide notice of the meeting at which the rule is to be considered and voted upon. The notice must be
posted on the Commission’s website and the website of the licensing board of each member state, or
the publication in which each state would otherwise publish proposed rules, and include:
• The time, date, and location of the meeting;
• The text of the proposed rule or amendment,
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• A request for comment from interested persons; and
• The manner in which interested persons may submit comments.
The public may submit written comments, which must be made publicly available, prior to the adoption
of the proposed rule. The Commission must hold a public hearing before it adopts a rule if requested
by:
• At least 25 people;
• A state or federal governmental entity; or
• An association having at least 25 members.
If a hearing is held, the Commission must publish the place, time, and date of the scheduled public
hearing. Anyone wishing to speak at the hearing must notify the Executive Director of the Commission,
or another designated member, within five business days before the hearing. Hearings must be
conducted in a manner that provides fair and reasonable opportunity for the public to comment orally or
in writing. Transcripts of hearings are not required unless a written request is made. All hearings must
be recorded and a copy of the recording must be made available upon request. Rules may be grouped
together in the same hearing for convenience of the Commission.
Following the hearing, the Commission must consider all comments received from the public. A majority
vote of the Commission is required for adoption of rules and the Commission may decide the effective
date of the rule.
The commission has the authority to consider and adopt emergency rules, without prior notice, if there
is an imminent threat to public health, safety, or welfare; to prevent a loss of funds of the commission or
a party state; or to meet a deadline for the promulgation of an administrative rule that is required by
federal law.
Oversight, Dispute Resolution, and Enforcement (Section 12)
The executive, legislative, and judicial branches of state government in each compact state is charged
with enforcing the compact and must take any necessary action to effectuate its purpose and intent.
The Commission is entitled to receive service of process relating to its powers, responsibilities, or
actions, and may intervene in any proceeding affecting such.
If a party state defaults in the performance of its duties or responsibilities under the compact, the
Commission must notify the defaulting state, as well as other party states, in writing of the nature of the
default and proposed cure of the default. The Commission will also provide remedial training and
technical assistance related to the default. If the defaulting state fails to cure the default, the
Commission may terminate its membership in the compact, upon majority affirmative vote of the
majority of the administrators. The Commission must notify the governor and the majority and minority
leaders of the defaulting state’s legislature, as well as all compact states, of its intent to suspend or
terminate the state’s membership in the compact. However, termination of membership is to only be
imposed after all other means of compliance have been exhausted.
A termination of membership in the compact may be appealed by petitioning the U.S. District Court for
the District of Columbia or the federal district in which the compact’s principal office is located. The
compact’s principal office is located in Lexington, Kentucky. The Commission may also bring an action
in federal court against a defaulting state to enforce compliance with the provisions of the compact. The
Commission may seek injunctive relief, damages, or any other remedies available under state or
federal law. A prevailing party in either action is entitled to court costs and reasonable attorneys’ fees.
In the event that a dispute arises between party states, the Commission will attempt to resolve such
disputes.
Date of Implementation of the Counseling Compact Commission and Associated Rules,
Withdrawal, and Amendment (Section 13)
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The compact takes effect on the date of enactment by the tenth state. States that join after such date
are subject to the rules of the Commission as they exist on the date when the compact becomes law in
that state.
To withdraw from the PCLC, a state must enact a statute repealing the compact. Such withdrawal does
not take effect until six months after the enactment of the repealing legislation. Any adverse actions or
investigations that occur prior to the effective date of a withdrawal must be reported as required under
the compact.
The compact may be amended by the party states; however, an amendment will not be effective until it
is enacted into the laws of all compact states.
Construction and Severability (Section 14)
This compact is to be liberally construed to effectuate its purposes. The PCLC contains a severability
clause that provides that if the entire compact is found to be held contrary to the constitution of any
state member thereto, the compact shall remain in full force and effect as to the remaining compact
states.
Binding Effect of Compact and Other Laws (Section 15)
This section reiterates that licensees must adhere to the laws and regulations, including scope of
practice, of the state in which they are practicing. The compact requires that all rules and bylaws of the
Commission are binding on compact states. In the event of a conflict between a law of a compact state
and the compact, the state law is superseded to the extent of the conflict.
Effect of the Bill
Professional Counselors Licensure Compact
HB 1521 enacts the Professional Counselors Licensure Compact (see description of compact
provisions in the Background section) and authorizes Florida to enter into the compact with all other
jurisdictions that have legally joined the compact. This allows an eligible Florida licensed clinical social
workers, marriage and family therapists, and mental health counselors to provide services to out-of-
state patients through either telehealth or in-person across compact states. It also allows out-of-state
licensed professional counselors in compact states to provide services to Florida patients through
telehealth and in-person.
The bill amends current law to allow compact implementation. It requires DOH to report any significant
investigation information relating to a professional counselor’s practicing under the compact to the data
system. It requires counselors practicing under the compact to withdraw from all practice under the
compact if the psychologist in an impaired practitioner program. It requires the Board of Clinical Social
Work, Marriage and Family Therapy, and Mental Health Counseling (Board) to appoint an individual to
serve on the Commission and exempts out-of-state licensed clinical social workers, marriage and
family therapists, and mental health counselors who practice under the compact from licensure
requirements in this state. The bill authorizes the Board to take adverse action against a mental health
counselor’s authority to practice under the compact and impose disciplinary actions for violation of
prohibited acts.
The bill makes conforming changes to statute to reference the compact and the requirements under the
compact. The bill does not require changes to Florida’s licensure and license renewal requirements.
Sovereign Immunity
The bill provides that an individual of the Board, when serving as the state administrator of the
compact, and any administrator, officer, executive director, employee, or representative of the
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commission, when acting within the scope of their employment, duties, or responsibilities in this state, is
considered an agent of the state. The bill also requires the Commission to pay any claims or judgments
up to the statutory waived amount of sovereign immunity and authorizes it to maintain insurance
coverage to pay any such claims or judgements.
The bill is effective upon enactment of the Professional Counselors Licensure Compact into law by ten
states
B. SECTION DIRECTORY:
Section 1: Creates s. 491.017, F.S., relating to Professional Counselors Licensure Compact.
Section 2: Amends s. 456.073, F.S., relating to disciplinary proceedings.
Section 3: Amends s. 456.076, F.S., relating to impaired practitioner programs.
Section 4: Amends s. 491.004, F.S., relating to Board of Clinical Social Work, Marriage and Family
Therapy, and Mental Health Counseling.
Section 5: Amends s. 491.005, F.S., relating to licensure by examination.
Section 6: Amends s. 491.006, F.S., relating to licensure by endorsement.
Section 7: Amends s. 491.009, F.S., relating to discipline.
Section 8: Amends s. 768.28, F.S., relating to waiver of sovereign immunity in tort actions; recovery
limits; civil liberty for damages caused during a riot; limitation on attorney fees; statute of
limitation; exclusions; indemnification; risk management programs.
Section 9: Requires DOH to notify the Division of Law Revision upon enactment of the Professional
Counselors Licensure Compact into law by 10 states.
Section 10: Provides the bill shall take effect upon enactment of the Professional Counselors
Licensure Compact into law by 10 states.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
The compact allows states to collect fees for granting privilege to practice under the compact. If
DOH chooses to collects such fees, a fee bill is needed.
2. Expenditures:
DOH estimates 1 full-time equivalent (FTE) position will be needed to implement the provisions of
the bill at a total cost of $56,892 ($44,314/Salary, $12,272/Expense, and $306/Human
Resources). 29
DOH may also experience an increase in cost related to annual membership with the PCLC,
additional complaints and investigations, rulemaking, and updating licensure systems, which can be
absorbed within current resources. 30
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
29 Department of Health Agency Analysis of 2022 House Bill 1521 (Jan. 25, 2022).
30 Id.
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Applicants for the Florida Interstate Licensed Professional Counselors compact will be required to pay
a fee to participate in the compact, as well as incurring cost for a background check. 31
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:
As discussed below in the section entitled, “RULE-MAKING AUTHORITY,” the bill delegates
authority to the commission to adopt rules that facilitate and coordinate the implementation and
administration of the Psychology Interjurisdictional Compact.
If enacted into law, the state will effectively bind itself to rules not yet adopted by the commission.
The Florida Supreme Court has held that while it is within the province of the Legislature to adopt
federal statutes enacted by Congress and rules promulgated by federal administrative bodies that
are in existence at the time the Legislature acts, it is an unconstitutional delegation of legislative
power to prospectively adopt federal statutes not yet enacted by Congress and rules not yet
promulgated by federal administrative bodies. 3233 Under this holding, the constitutionality of the bill’s
adoption of prospective rules might be questioned, and there does not appear to be binding Florida
case law that squarely address this issue in the context of interstate compacts.
The most recent opportunity Florida courts have had to address this issue appears to be in
Department of Children and Family Services v. L.G., involving the Interstate Compact for the
Placement of Children (ICPC). 34 The First District Court of Appeal considered an argument that the
regulations adopted by the Association of Administrators of the Interstate Compact were binding and
that the lower court’s order permitting a mother and child to relocate to another state was in violation
of the ICPC. The court denied the appeal and held that the Association’s regulations did not apply as
they conflicted with the ICPC and the regulations did not apply to the facts of the case.
The court also references language in the ICPC that confers to its compact administrators the “power
to promulgate rules and regulations to carry out more effectively the terms and provisions of this
compact.” 35 The court states that “the precise legal effect of the ICPC compact administrators’
regulations in Florida is unclear,” but noted that it did not need to address the question to decide the
case. 36 However, in a footnote, the court provided:
Any regulations promulgated before Florida adopted the ICPC did not, of course, reflect
the vote of a Florida compact administrator, and no such regulations were ever
themselves enacted into law in Florida. When the Legislature did adopt the ICPC, it did
not (and could not) enact as the law of Florida or adopt prospectively regulations then
yet to be promulgated by an entity not even covered by the Florida Administrative
Procedure Act. See Freimuth v. State, 272 So.2d 473, 476 (Fla.1972); Fla. Indus.
31 Id.
32 Freimuth v. State, 272 So.2d 473, 476 (Fla. 1972) (quoting Fla. Ind. Comm’n v. State ex rel. Orange State Oil Co., 155 Fla. 772
(1945).
33 This prohibition is based on the separation of powers doctrine, set forth in Article II, Section 3 of the Florida Constitution, which has
been construed in Florida to require the Legislature, when delegating the administration of legislative programs, to establish the
minimum standards and guidelines ascertainable by reference to the enactment creating the program. See Avatar Development Corp.
v. State, 723 So.2d 199 (Fla. 1998).
34 801 So.2d 1047 (Fla. 1st DCA 2001).
35 Id at 1052.
36 Id.
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Comm'n v. State ex rel. Orange State Oil Co., 155 Fla. 772, 21 So.2d 599, 603 (1945)
(“[I]t is within the province of the legislature to approve and adopt the provisions of
federal statutes, and all of the administrative rules made by a federal administrative
body, that are in existence and in effect at the time the legislature acts, but it would be
an unconstitutional delegation of legislative power for the legislature to adopt in advance
any federal act or the ruling of any federal administrative body that Congress or such
administrative body might see fit to adopt in the future.”); Brazil v. Div. of Admin., 347
So.2d 755, 757–58 (Fla. 1st DCA 1977), disapproved on other grounds by LaPointe
Outdoor Adver. v. Fla. Dep't of Transp., 398 So.2d 1370, 1370 (Fla.1981). The ICPC
compact administrators stand on the same footing as federal government administrators
in this regard. 37
In accordance with the discussion provided by the court in this above-cited footnote, it may be
argued that the bill’s delegation of rule-making authority to the commission is similar to the
delegation to the ICPC compact administrators, and thus, could constitute an unlawful delegation of
legislative authority. This case, however, does not appear to be binding as precedent as the court’s
footnote discussion is dicta. 38
B. RULE-MAKING AUTHORITY:
The bill authorizes the Commission to adopt rules to facilitate and coordinate the implementation and
administration of the compact. The compact specifies that the rules have the force and effect of law and
are binding in all compact states. If a compact state fails to meet its obligations under the compact or
the promulgated rules, the state may be subject to remedial training, alternative dispute resolution,
suspension, termination, or legal action.
C. DRAFTING ISSUES OR OTHER COMMENTS:
The bill includes mental health counselors licensed under ch. 491, F.S., as licensed professional
counselors. The model compact legislation does not contain this language and the compact requires
states to adopt the model langue in its entirety in order to utilize the compact. Additionally, this
language excludes clinical social workers and marriage and family therapists, who are also licensed
under ch. 491, F.S., from the privilege to practice under the compact.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
37 Id.
38 Dicta are statements of a court that are not essential to the determination of the case before it and are not a part of the law of the
case. Dicta has no biding legal effect and is without force as judicial precedent. 12A FLA JUR. 2D Courts and Judges s. 191 (2015).
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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 1521 2022
1 A bill to be entitled
2 An act relating to Professional Counselors Licensure
3 Compact; creating s. 491.017, F.S.; creating the
4 Professional Counselors Licensure Compact; providing
5 purposes and objectives; defining terms; specifying
6 requirements for state participation in the compact;
7 specifying duties of member states; specifying that
8 the compact does not affect an individual's ability to
9 apply for, and a member state's ability to grant, a
10 single state license pursuant to the laws of that
11 state; providing construction; providing for
12 recognition of the privilege to practice licensed
13 professional counseling in member states; specifying
14 criteria a licensed professional counselor must meet
15 for the privilege to practice under the compact;
16 providing for the expiration and renewal of the
17 privilege to practice; providing construction;
18 specifying that a licensee with a privilege to
19 practice in a remote state must adhere to the laws and
20 rules of that state; authorizing member states to act
21 on a licensee's privilege to practice under certain
22 circumstances; specifying the consequences and
23 parameters of practice for a licensee whose privilege
24 to practice has been acted on or whose home state
25 license is encumbered; specifying that a licensed
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26 professional counselor may hold a home state license
27 in only one member state at a time; specifying
28 requirements and procedures for changing a home state
29 license designation; providing construction;
30 authorizing active duty military personnel or their
31 spouses to keep their home state designation during
32 active duty; specifying how such individuals may
33 subsequently change their home state license
34 designation; providing for the recognition of the
35 practice of professional counseling through telehealth
36 in member states; specifying that licensees must
37 adhere to the laws and rules of the remote state in
38 which they provide professional counseling through
39 telehealth; authorizing member states to take adverse
40 actions against licensees and issue subpoenas for
41 hearings and investigations under certain
42 circumstances; providing requirements and procedures
43 for adverse action; authorizing member states to
44 engage in joint investigations under certain
45 circumstances; providing that a licensee's privilege
46 to practice must be deactivated in all member states
47 for the duration of an encumbrance imposed by the
48 licensee's home state; providing for notice to the
49 data system and the licensee's home state of any
50 adverse action taken against a licensee; providing
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51 construction; establishing the Counseling Compact
52 Commission; providing for the jurisdiction and venue
53 for court proceedings; providing construction;
54 providing for membership, meetings, and powers of the
55 commission; specifying powers and duties of the
56 commission's executive committee; providing for the
57 financing of the commission; providing commission
58 members, officers, executive directors, employees, and
59 representatives immunity from civil liability under
60 certain circumstances; providing exceptions; requiring
61 the commission to defend the commission's members,
62 officers, executive directors, employees, and
63 representative in civil actions under certain
64 circumstances; providing construction; requiring the
65 commission to indemnify and hold harmless such
66 individuals for any settlement or judgment obtained in
67 such actions under certain circumstances; providing
68 for the development of the data system, reporting
69 procedures, and the exchange of specified information
70 between member states; requiring the commission to
71 notify member states of any adverse action taken
72 against a licensee or applicant for licensure;
73 authorizing member states to designate as confidential
74 information provided to the data system; requiring the
75 commission to remove information from the data system
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76 under certain circumstances; providing rulemaking
77 procedures for the commission; providing for member
78 state enforcement of the compact; specifying that the
79 compact and commission rules have standing as
80 statutory law in member states; specifying that the
81 commission is entitled to receive notice of process,
82 and has standing to intervene, in certain judicial and
83 administrative proceedings; rendering certain
84 judgments and orders void as to the commission, the
85 compact, or commission rules under certain
86 circumstances; providing for defaults and termination
87 of compact membership; providing procedures for the
88 resolution of certain disputes; providing for
89 commission enforcement of the compact; providing for
90 remedies; providing construction; providing for
91 implementation of, withdrawal from, and amendment to
92 the compact; providing construction; specifying that
93 licensees practicing in a remote state under the
94 compact must adhere to the laws and rules of the
95 remote state; providing construction; specifying that
96 the compact, commission rules, and commission actions
97 are binding on member states; providing construction
98 and severability; amending s. 456.073, F.S.; requiring
99 the Department of Health to report certain
100 investigative information to the data system; amending
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101 s. 456.076, F.S.; requiring monitoring contracts for
102 impaired practitioners participating in treatment
103 programs to contain certain terms; amending s.
104 491.004, F.S.; requiring the Board of Clinical Social
105 Work, Marriage and Family Therapy, and Mental Health
106 Counseling to appoint an individual to serve as the
107 state's delegate on the commission; amending ss.
108 491.005 and 491.006, F.S.; exempting certain persons
109 from licensure requirements; amending s. 491.009,
110 F.S.; authorizing certain disciplinary action under
111 the compact for specified prohibited acts; amending s.
112 768.28, F.S.; designating the state delegate and other
113 members or employees of the commission as state agents
114 for the purpose of applying waivers of sovereign
115 immunity; requiring the commission to pay certain
116 claims or judgments; authorizing the commission to
117 maintain insurance coverage to pay such claims or
118 judgments; requiring the department to notify the
119 Division of Law Revision upon enactment of the compact
120 into law by 10 states; providing a contingent
121 effective date.
122
123 Be It Enacted by the Legislature of the State of Florida:
124
125 Section 1. Section 491.017, Florida Statutes, is created
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126 to read:
127 491.017 Professional Counselors Licensure Compact. —The
128 Professional Counselors Licensure Compact is hereby enacted and
129 entered into by this state with all other jurisdictions legally
130 joining therein in the form substantially as follows:
131
132 ARTICLE I
133 PURPOSE
134 The compact is designed to achieve the following purposes
135 and objectives:
136 (1) Facilitate interstate practice of licensed
137 professional counseling to increase public access to
138 professional counseling services by providing for the mutual
139 recognition of other member state licenses.
140 (2) Enhance the member states' ability to protect the
141 public's health and safety.
142 (3) Encourage the cooperation of member states in
143 regulating multistate practice of licensed professional
144 counselors.
145 (4) Support spouses of relocating active duty military
146 personnel.
147 (5) Facilitate the exchange of information between member
148 states regarding licensure, investigations, adverse actions, and
149 disciplinary history of licensed professional counselors.
150 (6) Allow for the use of telehealth technology to
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151 facilitate increased access to professional counseling services.
152 (7) Support the uniformity of professional counseling
153 licensure requirements throughout member states to promote
154 public safety and public health benefits.
155 (8) Provide member states with the authority to hold a
156 licensed professional counselor accountable for meeting all
157 state practice laws in the state in which the client is located
158 at the time care is rendered through the mutual recognition of
159 member state licenses.
160 (9) Eliminate the necessity for licensed professional
161 counselors to hold licenses in multiple states and provide
162 opportunities for interstate practice by licensed professional
163 counselors who meet uniform licensure requirements.
164
165 ARTICLE II
166 DEFINITIONS
167 As used in this compact, the term:
168 (1) "Active duty military" means full-time duty status in
169 the active uniformed service of the United States, including,
170 but not limited to, members of the National Guard and Reserve on
171 active duty orders pursuant to 10 U.S.C. chapters 1209 and 1211.
172 (2) "Adverse action" means any administrative, civil, or
173 criminal action authorized by a state's laws which is imposed by
174 a licensing board or other authority against a licensed
175 professional counselor, including actions against an
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176 individual's license or privilege to practice, such as
177 revocation, suspension, probation, monitoring of the licensee,
178 limitation on the licensee's practice, issuance of a cease a nd
179 desist action, or any other encumbrance on licensure affecting a
180 licensed professional counselor's authorization to practice.
181 (3) "Alternative program" means a nondisciplinary
182 monitoring or practice remediation process approved by a
183 professional counseling licensing board to address impaired
184 practitioners.
185 (4) "Continuing education" means a requirement, as a
186 condition of license renewal, to participate in or complete
187 educational and professional activities relevant to the
188 licensee's practice or area of work.
189 (5) "Counseling Compact Commission" or "commission" means
190 the national administrative body whose membership consists of
191 all states that have enacted the compact.
192 (6) "Current significant investigative information" means:
193 (a) Investigative information that a licensing board,
194 after a preliminary inquiry that includes notification and an
195 opportunity for the licensed professional counselor to respond,
196 if required by state law, has reason to believe is not
197 groundless and, if proved true, would indicate more than a minor
198 infraction; or
199 (b) Investigative information that indicates that the
200 licensed professional counselor represents an immediate threat
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201 to public health and safety, regardless of whether the licensed
202 professional counselor has been notified and had an opportunity
203 to respond.
204 (7) "Data system" means a repository of information about
205 licensees, including, but not limited to, information relating
206 to continuing education, examinations, licensure statuses,
207 investigations, the privilege to practice, and adverse actions.
208 (8) "Encumbered license" means a license in which an
209 adverse action restricts the practice of licensed professional
210 counseling by the licensee and said adverse action has been
211 reported to the National Practitioner Data Bank.
212 (9) "Encumbrance" means a revocation or suspension of, or
213 any limitation on, the full and unrestricted practice of
214 licensed professional counseling by a licensing board.
215 (10) "Executive committee" means a group of directors
216 elected or appointed to act on behalf of, and within the powers
217 granted to them by, the commission.
218 (11) "Home state" means the member state that is the
219 licensee's primary state of residence.
220 (12) "Impaired practitioner" means an individual who has a
221 condition that may impair his or her ability to safely practice
222 as a licensed professional counselor without intervention. Such
223 impairment may include, but is not limited to, alcohol or drug
224 dependence, mental health conditions, and neurological or
225 physical conditions.
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226 (13) "Investigative information" means information,
227 records, or documents received or generated by a professional
228 counseling licensing board pursuant to an investigation.
229 (14) "Jurisprudence requirement," if required by a member
230 state, means the assessment of an individual's knowledge of the
231 laws and rules governing the practice of professional counseling
232 in a state.
233 (15) "Licensed professional counselor" means a mental
234 health counselor licensed under chapter 491 or a counselor
235 licensed by a member state, regardless of the title used by that
236 state, to independently assess, diagnose, and treat behavioral
237 health conditions.
238 (16) "Licensee" means an individual who currently holds an
239 authorization from the state to practice as a licensed
240 professional counselor.
241 (17) "Licensing board" means the agency of a state, or
242 equivalent, that is responsible for the licensing and regulation
243 of licensed professional counselors.
244 (18) "Member state" means a state that has enacted the
245 compact.
246 (19) "Privilege to practice" means a legal authorization,
247 which is equivalent to a license, authorizing the practice of
248 professional counseling in a remote state.
249 (20) "Professional counseling" means the assessment,
250 diagnosis, and treatment of behavioral health conditions by a
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251 licensed professional counselor.
252 (21) "Remote state" means a member state, other than the
253 home state, where a licensee is exercising or seeking to
254 exercise the privilege to practice.
255 (22) "Rule" means a regulation adopted by the commission
256 which has the force of law.
257 (23) "Single state license" means a licensed professional
258 counselor license issued by a member state which authorizes
259 practice only within the issuing state and does not include a
260 privilege to practice in any other member state.
261 (24) "State" means any state, commonwealth, district, or
262 territory of the United States of America which regulates the
263 practice of professional counseling.
264 (25) "Telehealth" means the application of
265 telecommunication technology to deliver professional counseling
266 services remotely to assess, diagnose, and treat behavioral
267 health conditions.
268 (26) "Unencumbered license" means a license that
269 authorizes a licensed professional counselor to engage in the
270 full and unrestricted practice of professional counseling.
271
272 ARTICLE III
273 STATE PARTICIPATION
274 (1) To participate in the compact, a state must currently
275 do all of the following:
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276 (a) License and regulate licensed professional counselors.
277 (b) Require licensees to pass a nationally recognized exam
278 approved by the commission.
279 (c) Require licensees to have a 60 semester hour, or 90
280 quarter hour, master's degree in counseling or 60 semester
281 hours, or 90 quarter hours, of graduate coursework including all
282 of the following topic areas:
283 1. Professional counseling orientation and ethical
284 practice.
285 2. Social and cultural diversity.
286 3. Human growth and development.
287 4. Career development.
288 5. Counseling and helping relationships.
289 6. Group counseling and group work.
290 7. Diagnosis, assessment, testing, and treatment.
291 8. Research and program evaluation.
292 9. Other areas as determined by the commission.
293 (d) Require licensees to complete a supervised
294 postgraduate professional experience as defined by the
295 commission.
296 (e) Have a mechanism in place for receiving and
297 investigating complaints about licensees.
298 (2) A member state shall do all of the following:
299 (a) Participate fully in the commission's data system,
300 including using the commission's unique identifier as defined in
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301 rules adopted by the commission.
302 (b) Notify the commission, in compliance with the terms of
303 the compact and rules adopted by the commission, of any adverse
304 action or the availability of investigative information
305 regarding a licensee.
306 (c) Implement or utilize procedures for considering the
307 criminal history records of applicants for an initial privilege
308 to practice. These procedures must include the submission of
309 fingerprints or other biometric-based information by applicants
310 for the purpose of obtaining an applicant's criminal history
311 record information from the Federal Bureau of Investigation and
312 the agency responsible for retaining that state's criminal
313 records.
314 1. A member state must fully implement a criminal
315 background check requirement, within a timeframe established by
316 rule, by receiving the results of the Federal Bureau of
317 Investigation record search and shall use the results in making
318 licensure decisions.
319 2. Communication between a member state and the commission
320 and among member states regarding the verification of
321 eligibility for licensure through the compact may not include
322 any information received from the Federal Bureau of
323 Investigation relating to a federal criminal records check
324 performed by a member state under Public Law 92-544.
325 (d) Comply with the rules adopted by the commission.
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326 (e) Require an applicant to obtain or retain a license in
327 the home state and meet the home state's qualifications for
328 licensure or renewal of licensure, as well as all other
329 applicable state laws.
330 (f) Grant the privilege to practice to a licensee holding
331 a valid unencumbered license in another member state in
332 accordance with the terms of the compact and rules adopted by
333 the commission.
334 (g) Provide for the attendance of the state's commissioner
335 at the commission meetings.
336 (3) Individuals not residing in a member state may
337 continue to apply for a member state's single state license as
338 provided under the laws of each member state. However, the
339 single state license granted to these individuals may not be
340 recognized as granting a privilege to practice professional
341 counseling under the compact in any other member state.
342 (4) Nothing in this compact affects the requirements
343 established by a member state for the issuance of a single state
344 license.
345 (5) A professional counselor license issued by a home
346 state to a resident of that state must be recognized by each
347 member state as authorizing that licensed professional counselor
348 to practice professional counseling, under a privilege to
349 practice, in each member state.
350
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351 ARTICLE IV
352 PRIVILEGE TO PRACTICE
353 (1) To exercise the privilege to practice under the terms
354 and provisions of the compact, the licensee must meet all of the
355 following criteria:
356 (a) Hold a license in the home state.
357 (b) Have a valid United States Social Security Number or
358 national provider identifier.
359 (c) Be eligible for a privilege to practice in any member
360 state in accordance with subsections (4), (7), and (8).
361 (d) Have not had any encumbrance or restriction against
362 any license or privilege to practice within the preceding 2
363 years.
364 (e) Notify the commission that the licensee is seeking the
365 privilege to practice within a remote state.
366 (f) Meet any continuing education requirements established
367 by the home state.
368 (g) Meet any jurisprudence requirements established by the
369 remote state in which the licensee is seeking a privilege to
370 practice.
371 (h) Report to the commission any adverse action,
372 encumbrance, or restriction on a license taken by any nonmember
373 state within 30 days after the action is taken.
374 (2) The privilege to practice is valid until the
375 expiration date of the home state license. The licensee must
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376 continue to meet the criteria specified in subsection (1) to
377 renew the privilege to practice in the remote state.
378 (3) For purposes of the compact, the practice of
379 professional counseling occurs in the state where the client is
380 located at the time of the counseling services. The compact does
381 not affect the regulatory authority of states to protect public
382 health and safety through their own system of state licensure.
383 (4) A licensee providing professional counseling in a
384 remote state under the privilege to practice must adhere to the
385 laws and regulations of the remote state.
386 (5) A licensee providing professional counseling services
387 in a remote state is subject to that state's regulatory
388 authority. A remote state may, in accordance with due process
389 and that state's laws, remove a licensee's privilege to practice
390 in the remote state for a specified period of time, impose
391 fines, or take any other action necessary to protect the health
392 and safety of its residents. The licensee may be ineligible for
393 a privilege to practice in any member state until the specific
394 time for removal has passed and all fines are paid.
395 (6) If a home state license is encumbered, a licensee
396 loses the privilege to practice in any remote state until both
397 of the following conditions are met:
398 (a) The home state license is no longer encumbered.
399 (b) The licensee has not had any encumbrance or
400 restriction against any license or privilege to practice within
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401 the preceding 2 years.
402 (7) Once an encumbered license in the licensee's home
403 state is restored to good standing, the licensee may obtain a
404 privilege to practice in any remote state if he or she meets the
405 requirements of subsection (1).
406 (8) If a licensee's privilege to practice in any remote
407 state is removed, the individual may lose the privilege to
408 practice in all other remote states until all of the following
409 conditions are met:
410 (a) The specified period of time for which the privilege
411 to practice was removed has ended.
412 (b) The licensee has paid all fines imposed.
413 (c) The licensee has not had any encumbrance or
414 restriction against any license or privilege to practice within
415 the preceding 2 years.
416 (9) Once the requirements of subsection (8) have been met,
417 the licensee may obtain a privilege to practice in a remote
418 state if he or she meets the requirements in subsection (1).
419
420 ARTICLE V
421 OBTAINING A NEW HOME STATE LICENSE BASED ON A
422 PRIVILEGE TO PRACTICE
423 (1) A licensed professional counselor may hold a home
424 state license, which allows for a privilege to practice in other
425 member states, in only one member state at a time.
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426 (2) If a licensed professional counselor changes his or
427 her primary state of residence by moving between two member
428 states, then the licensed professional counselor must file an
429 application for obtaining a new home state license based on a
430 privilege to practice and notify the current and new home state
431 in accordance with applicable rules adopted by the commission.
432 (3) Upon receipt of an application for obtaining a new
433 home state license based on a privilege to practice, the new
434 home state must verify that the licensed professional counselor
435 meets the criteria outlined in article IV through the data
436 system. The new home state does not need to seek primary source
437 verification for information obtained from the data system,
438 except for the following:
439 (a) A Federal Bureau of Investigation fingerprint -based
440 criminal background check, if not previously performed or
441 updated pursuant to applicable rules adopted by the commission
442 in accordance with Public Law 92-544;
443 (b) Any other criminal background check as required by the
444 new home state; and
445 (c) Proof of completion of any requisite jurisprudence
446 requirements of the new home state.
447 (4) The former home state shall convert the former home
448 state license into a privilege to practice once the new home
449 state has activated the new home state license in accordance
450 with applicable rules adopted by the commission.
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451 (5) Notwithstanding any other provision of the compact, if
452 the licensed professional counselor does not meet the criteria
453 in article IV, the new home state may apply its own requirements
454 for issuing a new single state license.
455 (6) If a licensed professional counselor changes his or
456 her primary state of residence by moving from a member state to
457 a nonmember state or from a nonmember state to a member state,
458 the new state's own criteria apply for issuance of a single
459 state license in the new state.
460 (7) The compact does not interfere with a licensee's
461 ability to hold a single state license in multiple states.
462 However, for the purposes of the compact, a licensee may have
463 only one home state license.
464 (8) The compact does not affect the requirements
465 established by a member state for the issuance of a single state
466 license.
467
468 ARTICLE VI
469 ACTIVE DUTY MILITARY PERSONNEL AND THEIR SPOUSES
470 Active duty military personnel, or their spouse, shall
471 designate a home state where the individual has a current
472 license in good standing. The individual may retain the home
473 state license designation during the period the service member
474 is on active duty. Subsequent to designating a home state, the
475 individual may change his or her home state only through
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476 application for licensure in the new state or through the
477 process outlined in article V.
478
479 ARTICLE VII
480 COMPACT PRIVILEGE TO PRACTICE TELEHEALTH
481 (1) Member states shall recognize the right of a licensed
482 professional counselor, licensed by a home state in accordance
483 with article III and under rules adopted by the commission, to
484 practice professional counseling in any member state through
485 telehealth under a privilege to practice as provided in the
486 compact and rules adopted by the commission.
487 (2) A licensee providing professional counseling services
488 in a remote state through telehealth under the privilege to
489 practice must adhere to the laws and rules of the remote state.
490
491 ARTICLE VIII
492 ADVERSE ACTIONS
493 (1) In addition to the other powers conferred by state
494 law, a remote state has the authority, in accordance with
495 existing state due process law, to do any of the following:
496 (a) Take adverse action against a licensed professional
497 counselor's privilege to practice within that member state.
498 (b) Issue subpoenas for both hearings and investigations
499 that require the attendance and testimony of witnesses or the
500 production of evidence. Subpoenas issued by a licensing board in
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501 a member state for the attendance and testimony of witnesses or
502 the production of evidence from another member state must be
503 enforced in the latter state by any court of competent
504 jurisdiction, according to the practice and procedure of that
505 court applicable to subpoenas issued in proceedings pending
506 before it. The issuing authority shall pay any witness fees,
507 travel expenses, mileage, and other fees required by the service
508 statutes of the state in which the witnesses or evidence is
509 located.
510 (2) Only the home state has the power to take adverse
511 action against a licensed professional counselor's license
512 issued by the home state.
513 (3) For purposes of taking adverse action, the home state
514 shall give the same priority and effect to reported conduct
515 received from a member state as it would if the conduct had
516 occurred within the home state. The home state shall apply its
517 own state laws to determine appropriate action in such cases.
518 (4) The home state shall complete any pending
519 investigations of a licensed professional counselor who changes
520 primary state of residence during the course of the
521 investigations. The home state may also take appropriate action
522 and shall promptly report the conclusions of the investigations
523 to the administrator of the data system. The administrator of
524 the data system shall promptly notify the new home state of any
525 adverse actions.
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526 (5) A member state, if authorized by state law, ma y
527 recover from the affected licensed professional counselor the
528 costs of investigations and dispositions of any cases resulting
529 from adverse action taken against that licensed professional
530 counselor.
531 (6) A member state may take adverse action against a
532 licensed professional counselor based on the factual findings of
533 a remote state, provided that the member state follows its own
534 statutory procedures for taking adverse action.
535 (7)(a) In addition to the authority granted to a member
536 state by its respective professional counseling practice act or
537 other applicable state law, any member state may participate
538 with other member states in joint investigations of licensees.
539 (b) Member states shall share any investigative,
540 litigation, or compliance materials in furtherance of any joint
541 or individual investigation initiated under the compact.
542 (8) If adverse action is taken by the home state against
543 the license of a professional counselor, the licensed
544 professional counselor's privilege to practice in all other
545 member states must be deactivated until all encumbrances have
546 been removed from the home state license. All home state
547 disciplinary orders that impose adverse action against the
548 license of a professional counselor must include a statement
549 that the licensed professional counselor's privilege to practice
550 is deactivated in all member states while the order is in
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551 effect.
552 (9) If a member state takes adverse action, it must
553 promptly notify the administrator of the data system. The
554 administrator shall promptly notify the licensee's home state of
555 any adverse actions by remote states.
556 (10) Nothing in the compact overrides a member state's
557 decision to allow a licensed professional counselor to
558 participate in an alternative program in lieu of adverse action.
559
560 ARTICLE IX
561 ESTABLISHMENT OF COUNSELING COMPACT COMMISSION
562 (1) COMMISSION CREATED.—The compact member states hereby
563 create and establish a joint public agency known as the
564 Counseling Compact Commission.
565 (a) The commission is an instrumentality of the compact
566 states.
567 (b) Venue is proper, and judicial proceedings by or
568 against the commission shall be brought solely and exclusively
569 in a court of competent jurisdiction where the principal office
570 of the commission is located. The commission may waive venue and
571 jurisdictional defenses to the extent that it adopts or consents
572 to participate in alternative dispute resolution proceedings.
573 (c) Nothing in the compact may be construed to be a waiver
574 of sovereign immunity.
575 (2) MEMBERSHIP.—
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576 (a) The commission shall consist of one voting delegate,
577 appointed by each member state's licensing board. The
578 commission, by rule, shall establish a term of office for
579 delegates and may establish term limits.
580 (b) The delegate must be either:
581 1. A current member of the licensing board at the time of
582 appointment, who is a licensed professional counselor or public
583 member; or
584 2. An administrator of the licensing board.
585 (c) A delegate may be removed or suspended from office as
586 provided by the law of the state from which the delegate is
587 appointed.
588 (d) The member state licensing board must fill any vacancy
589 occurring on the commission within 60 days.
590 (e) Each delegate is entitled to one vote with regard to
591 the adoption of rules and creation of bylaws and shall otherwise
592 participate in the business and affairs of the commission.
593 (f) A delegate shall vote in person or by such other means
594 as provided in the bylaws. The bylaws may provide for delegates'
595 participation in meetings by telephone or other means of
596 communication.
597 (3) MEETINGS OF THE COMMISSION.—
598 (a) The commission shall meet at least once during each
599 calendar year. Additional meetings must be held as set forth in
600 the bylaws.
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601 (b) All meetings must be open to the public, and public
602 notice of meetings must be given in the same manner as required
603 under the rulemaking provisions in article XI.
604 (c) The commission or the executive committee or other
605 committees of the commission may convene in a closed, nonpublic
606 meeting if the commission or executive committee or other
607 committees of the commission must discuss any of the following:
608 1. Noncompliance of a member state with its obligations
609 under the compact.
610 2. The employment, compensation, discipline, or other
611 matters, practices, or procedures related to specific employees,
612 or other matters related to the commission's internal personnel
613 practices and procedures.
614 3. Current, threatened, or reasonably anticipated
615 litigation.
616 4. Negotiation of contracts for the purchase, lease, or
617 sale of goods, services, or real estate.
618 5. Accusing any person of a crime or formally censuring
619 any person.
620 6. Disclosure of trade secrets or commercial or financial
621 information that is privileged or confidential.
622 7. Disclosure of information of a personal nature if
623 disclosure would constitute a clearly unwarranted invasion of
624 personal privacy.
625 8. Disclosure of investigative records compiled for law
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626 enforcement purposes.
627 9. Disclosure of information related to any investigative
628 reports prepared by or on behalf of or for use of the commission
629 or other committee charged with responsibility of investigation
630 or determination of compliance issues pursuant to the compact.
631 10. Matters specifically exempted from disclosure by
632 federal or member state law.
633 (d) If a meeting, or portion of a meeting, is closed under
634 this subsection, the commission's legal counsel or designee must
635 certify that the meeting may be closed and must reference each
636 relevant exempting provision.
637 (e) The commission shall keep minutes that fully and
638 clearly describe all matters discussed in a meeting and shall
639 provide a full and accurate summary of actions taken, and the
640 reasons therefore, including a description of the views
641 expressed. All documents considered in connection with an action
642 must be identified in such minutes. All minutes and documents of
643 a closed meeting must remain under seal, subject to release by a
644 majority vote of the commission or order of a court of competent
645 jurisdiction.
646 (4) POWERS.—The commission may do any of the following:
647 (a) Establish the fiscal year of the commission.
648 (b) Establish bylaws.
649 (c) Maintain its financial records in accordance with the
650 bylaws.
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651 (d) Meet and take actions that are consistent with the
652 compact and bylaws.
653 (e) Adopt rules that are binding to the extent and in the
654 manner provided for in the compact.
655 (f) Initiate and prosecute legal proceedings or actions in
656 the name of the commission, provided that the standing of any
657 state licensing board to sue or be sued under applicable law is
658 not affected.
659 (g) Purchase and maintain insurance and bonds.
660 (h) Borrow, accept, or contract for services of personnel,
661 including, but not limited to, employees of a member state.
662 (i) Hire employees and elect or appoint officers; fix
663 compensation for, define duties of, and grant appropriate
664 authority to such employees and officers to carry out the
665 purposes of the compact; and establish the commission's
666 personnel policies and programs relating to conflicts of
667 interest, qualifications of personnel, and other related
668 personnel matters.
669 (j) Accept any and all appropriate donations and grants of
670 money, equipment, supplies, materials, and services, and
671 receive, utilize, and dispose of the same, provided that at all
672 times the commission avoids any appearance of impropriety or
673 conflict of interest.
674 (k) Lease, purchase, accept appropriate gifts or donations
675 of, or otherwise own, hold, improve, or use, any property, real,
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676 personal, or mixed, provided that at all times the commission
677 avoids any appearance of impropriety or conflict of interest.
678 (l) Sell, convey, mortgage, pledge, lease, exchange,
679 abandon, or otherwise dispose of any property, real, personal,
680 or mixed.
681 (m) Establish a budget and make expenditures.
682 (n) Borrow money.
683 (o) Appoint committees, including standing committees
684 consisting of commission members, state regulators, state
685 legislators or their representatives, and consumer
686 representatives, and such other interested persons as may be
687 designated in the compact and bylaws.
688 (p) Provide information to, receive information from, and
689 cooperate with law enforcement agencies.
690 (q) Establish and elect an executive committee.
691 (r) Perform any other function that may be necessary or
692 appropriate to achieve the purposes of the compact and is
693 consistent with the state regulation of professional counseling
694 licensure and practice.
695 (5) THE EXECUTIVE COMMITTEE.—
696 (a) The executive committee may act on behalf of the
697 commission according to the terms of the compact and shall
698 consist of up to 11 members, as follows:
699 1. Seven voting members who are elected by the commission
700 from the current membership of the commission.
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701 2. Up to four ex officio, nonvoting members from four
702 recognized national professional counselor organizations. The ex
703 officio members shall be selected by their respective
704 organizations.
705 (b) The commission may remove any member of the executive
706 committee as provided in its bylaws.
707 (c) The executive committee shall meet at least annually.
708 (d) The executive committee shall do all of the following:
709 1. Make recommendations to the commission for any changes
710 to the rules, bylaws, or compact legislation.
711 2. Ensure compact administration services are
712 appropriately provided, contractually or otherwise.
713 3. Prepare and recommend the budget.
714 4. Maintain financial records on behalf of the commission.
715 5. Monitor compact compliance of member states and provide
716 compliance reports to the commission.
717 6. Establish additional committees as necessary.
718 7. Perform any other duties provided for in the rules or
719 bylaws.
720 (6) FINANCING OF THE COMMISSION.—
721 (a) The commission shall pay, or provide for the payment
722 of, the reasonable expenses of its establishment, organization,
723 and ongoing activities.
724 (b) The commission may accept any appropriate revenue
725 sources, donations, or grants of money, equipment, supplies,
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726 materials, or services.
727 (c) The commission may not incur obligations of any kind
728 before securing the funds adequate to meet the same; nor may the
729 commission pledge the credit of any of the member states, except
730 by and with the authority of the member state.
731 (d) The commission shall keep accurate accounts of all
732 receipts and disbursements. The receipts and disbursements of
733 the commission are subject to the audit and accounting
734 procedures established under its bylaws. However, all receipts
735 and disbursements of funds handled by the commission must be
736 audited annually by a certified or licensed public accountant,
737 and the report of the audit must be included in and become part
738 of the annual report of the commission.
739 (7) QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION.—
740 (a) The members, officers, executive director, employees,
741 and representatives of the commission are immune from suit and
742 liability, either personally or in their official capacity, for
743 any claim for damage to or loss of property or personal injury
744 or other civil liability caused by or arising out of any actual
745 or alleged act, error, or omission that occurred, or that the
746 person against whom the claim is made had a reasonable basis for
747 believing occurred, within the scope of commission employment,
748 duties, or responsibilities. This paragraph may not be construed
749 to protect any such person from suit or liability for any
750 damage, loss, injury, or liability caused by the intentional or
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751 willful or wanton misconduct of that person.
752 (b) The commission shall defend any member, officer,
753 executive director, employee, or representative of the
754 commission in any civil action seeking to impose liability
755 arising out of any actual or alleged act, error, or omission
756 that occurred, or that the person against whom the claim is made
757 had a reasonable basis for believing occurred, within the scope
758 of commission employment, duties, or responsibilities, provided
759 that the actual or alleged act, error, or omission did not
760 result from that person's intentional or willful or wanton
761 misconduct. This paragraph may not be construed to prohibit that
762 person from retaining his or her own counsel.
763 (c) The commission shall indemnify and hold harmless any
764 member, officer, executive director, employee, or representative
765 of the commission for the amount of any settlement or judgment
766 obtained against that person arising out of any actual or
767 alleged act, error, or omission that occurred, or that such
768 person had a reasonable basis for believing occurred, within the
769 scope of commission employment, duties, or responsibilities,
770 provided that the actual or alleged act, error, or omission did
771 not result from the intentional or willful or wanton misconduct
772 of that person.
773
774 ARTICLE X
775 DATA SYSTEM
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776 (1) The commission shall provide for the development,
777 operation, and maintenance of a coordinated database and
778 reporting system containing licensure, adverse action, and
779 investigative information on all licensed professional
780 counselors in member states.
781 (2) Notwithstanding any other provision of state law to
782 the contrary, a member state shall submit a uniform data set to
783 the data system on all licensees to whom the compact is
784 applicable, as required by the rules of the commission,
785 including all of the following:
786 (a) Identifying information.
787 (b) Licensure data.
788 (c) Adverse actions against a license or privilege to
789 practice.
790 (d) Nonconfidential information related to alternative
791 program participation.
792 (e) Any denial of application for licensure and the reason
793 for such denial.
794 (f) Current significant investigative information.
795 (g) Other information that may facilitate the
796 administration of the compact, as determined by the rule s of the
797 commission.
798 (3) Investigative information pertaining to a licensee in
799 any member state may be made available only to other member
800 states.
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801 (4) The commission shall promptly notify all member states
802 of any adverse action taken against a licensee or an individual
803 applying for a license. Adverse action information pertaining to
804 a licensee in any member state must be made available to any
805 other member state.
806 (5) Member states reporting information to the data system
807 may designate information that may not be shared with the public
808 without the express permission of the reporting state.
809 (6) Any information submitted to the data system which is
810 subsequently required to be expunged by the laws of the member
811 state reporting the information must be removed from the data
812 system.
813
814 ARTICLE XI
815 RULEMAKING
816 (1) The commission shall adopt reasonable rules to
817 effectively and efficiently achieve the purposes of the compact.
818 If, however, the commission exercises its rulemaking authority
819 in a manner that is beyond the scope of the purposes of the
820 compact, or the powers granted hereunder, then such an action by
821 the commission is invalid and has no force or effect.
822 (2) The commission shall exercise its rulemaking powers
823 pursuant to the criteria set forth in this article and the rules
824 adopted thereunder. Rules and amendments become binding as of
825 the date specified in each rule or amendment.
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826 (3) If a majority of the legislatures of the member states
827 rejects a rule by enactment of a statute or resolution in the
828 same manner used to adopt the compact within 4 years after the
829 date of adoption of the rule, such rule does not have further
830 force and effect in any member state.
831 (4) Rules or amendments to the rules must be adopted at a
832 regular or special meeting of the commission.
833 (5) Before adoption of a final rule by the commission, and
834 at least 30 days in advance of the meeting at which the rule
835 will be considered and voted upon, the commission shall file a
836 notice of proposed rulemaking:
837 (a) On the website of the commission or other publicly
838 accessible platform; and
839 (b) On the website of each member state's professional
840 counseling licensing board or other publicly accessible platform
841 or in the publication in which each state would otherwise
842 publish proposed rules.
843 (6) The notice of proposed rulemaking must include:
844 (a) The proposed time, date, and location of the meeting
845 in which the rule will be considered and voted upon;
846 (b) The text of the proposed rule or amendment and the
847 reason for the proposed rule;
848 (c) A request for comments on the proposed rule from any
849 interested person; and
850 (d) The manner in which interested persons may submit
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851 notice to the commission of their intention to attend the public
852 hearing and any written comments.
853 (7) Before adoption of a proposed rule, the commission
854 must allow persons to submit written data, facts, opinions, and
855 arguments, which must be made available to the public.
856 (8) The commission shall grant an opportunity for a public
857 hearing before it adopts a rule or an amendment if a hearing is
858 requested by:
859 (a) At least 25 persons who submit comments independently
860 of each other;
861 (b) A state or federal governmental subdivision or agency;
862 or
863 (c) An association that has at least 25 members.
864 (9) If a hearing is held on the proposed rule or
865 amendment, the commission must publish the place, time, and date
866 of the scheduled public hearing. If the hearing is held through
867 electronic means, the commission must publish the mechanism for
868 access to the electronic hearing.
869 (a) All persons wishing to be heard at the hearing must
870 notify the executive director of the commission or other
871 designated member in writing of their desire to appear and
872 testify at the hearing at least 5 business days before the
873 scheduled date of the hearing.
874 (b) Hearings must be conducted in a manner providing each
875 person who wishes to comment a fair and reasonable opportunity
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876 to comment orally or in writing.
877 (c) All hearings must be recorded. A copy of the recording
878 must be made available on request.
879 (d) This section may not be construed to require a
880 separate hearing on each rule. Rules may be grouped at hearings
881 required by this section for the convenience of the commission.
882 (10) If the commission does not receive a written notice
883 of intent to attend the public hearing by interested parties,
884 the commission may proceed with adoption of the proposed rule
885 without a public hearing.
886 (11) Following the scheduled hearing date, or by the close
887 of business on the scheduled hearing date if the hearing was not
888 held, the commission shall consider all written and oral
889 comments received.
890 (12) The commission, by majority vote of all members,
891 shall take final action on the proposed rule and shall determine
892 the effective date of the rule based on the rulemaking record
893 and the full text of the rule.
894 (13) Upon determination that an emergency exists, the
895 commission may consider and adopt an emergency rule without
896 prior notice, opportunity for comment, or hearing, provided that
897 the usual rulemaking procedures provided in the compact and in
898 this section are retroactively applied to the rule as soon as
899 reasonably possible, but no later than 90 days after the
900 effective date of the rule. For purposes of this subsection, an
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901 emergency rule is one that must be adopted immediat ely in order
902 to:
903 (a) Meet an imminent threat to public health, safety, or
904 welfare;
905 (b) Prevent a loss of commission or member state funds;
906 (c) Meet a deadline for the adoption of an administrative
907 rule established by federal law or rule; or
908 (d) Protect public health and safety.
909 (14) The commission or an authorized committee of the
910 commission may direct revisions to a previously adopted rule or
911 amendment for purposes of correcting typographical errors,
912 errors in format, errors in consistency, or grammatical errors.
913 Public notice of any revision must be posted on the website of
914 the commission. Revisions are subject to challenge by any person
915 for a period of 30 days after posting. A revision may be
916 challenged only on grounds that the revision results in a
917 material change to a rule. A challenge must be made in writing
918 and delivered to the chair of the commission before the end of
919 the notice period. If a challenge is not made, the revision
920 takes effect without further action. If a revision is
921 challenged, the revision may not take effect without the
922 approval of the commission.
923
924 ARTICLE XII
925 OVERSIGHT; DEFAULT, TECHNICAL ASSISTANCE, AND TERMINATION;
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926 DISPUTE RESOLUTION; AND ENFORCEMENT
927 (1) OVERSIGHT.—
928 (a) The executive, legislative, and judicial branches of
929 state government in each member state shall enforce the compact
930 and take all actions necessary and appropriate to effectuate the
931 compact's purposes and intent. The compact and the rules adopted
932 thereunder have standing as statutory law.
933 (b) All courts shall take judicial notice of the compact
934 and the rules in any judicial or administrative proceeding in a
935 member state pertaining to the subject matter of the compact
936 which may affect the powers, responsibilities, or actions of the
937 commission.
938 (c) The commission is entitled to receive service of
939 process in any judicial or administrative proceeding specified
940 in paragraph (b) and has standing to intervene in such a
941 proceeding for all purposes. Failure to provide service of
942 process to the commission renders a judgment or an order void as
943 to the commission, the compact, or adopted rules.
944 (2) DEFAULT, TECHNICAL ASSISTANCE, AND TERMINATION.—
945 (a) If the commission determines that a member state has
946 defaulted in the performance of its obligations or
947 responsibilities under the compact or adopted rules, the
948 commission must:
949 1. Provide written notice to the defaulting state and
950 other member states of the nature of the default, the proposed
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951 means of curing the default, and any other action to be taken by
952 the commission; and
953 2. Provide remedial training and specific technical
954 assistance regarding the default.
955 (b) If a state in default fails to cure the default, the
956 defaulting state may be terminated from the compact upon an
957 affirmative vote of a majority of the member states, and all
958 rights, privileges, and benefits conferred by the compact are
959 terminated on the effective date of termination. A cure of the
960 default does not relieve the offending state of obligations or
961 liabilities incurred during the period of default.
962 (c) Termination of membership in the compact may be
963 imposed only after all other means of securing compliance have
964 been exhausted. The commission shall submit a notice of intent
965 to suspend or terminate a defaulting member state to that
966 state's governor, to the majority and minority leaders of that
967 state's legislature, and to each member state.
968 (d) A member state that has been terminated is responsible
969 for all assessments, obligations, and liabilities incurred
970 through the effective date of termination, including obligations
971 that extend beyond the effective date of termination.
972 (e) The commission may not bear any costs related to a
973 member state that is found to be in default or that has been
974 terminated from the compact, unless agreed upon in writ ing
975 between the commission and the defaulting member state.
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976 (f) The defaulting member state may appeal the action of
977 the commission by petitioning the United States District Court
978 for the District of Columbia or the federal district where the
979 commission has its principal offices. The prevailing party must
980 be awarded all costs of such litigation, including reasonable
981 attorney fees.
982 (3) DISPUTE RESOLUTION.—
983 (a) Upon request by a member state, the commission shall
984 attempt to resolve disputes related to the compact which arise
985 among member states and between member and nonmember states.
986 (b) The commission shall adopt rules providing for both
987 mediation and binding dispute resolution for disputes as
988 appropriate.
989 (4) ENFORCEMENT.—
990 (a) The commission, in the reasonable exercise of its
991 discretion, shall enforce the provisions and rules of the
992 compact.
993 (b) By majority vote, the commission may initiate legal
994 action in the United States District Court for the District of
995 Columbia or the federal district where the commission has its
996 principal offices against a member state in default to enforce
997 compliance with the compact and its adopted rules and bylaws.
998 The relief sought may include both injunctive relief and
999 damages. If judicial enforcement is necessary, the prevailing
1000 party must be awarded all costs of such litigation, including
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1001 reasonable attorney fees.
1002 (c) The remedies under this article are not the exclusive
1003 remedies to the commission. The commission may pursue any other
1004 remedies available under federal or state law.
1005
1006 ARTICLE XIII
1007 DATE OF IMPLEMENTATION OF THE COUNSELING COMPACT COMMISSION AND
1008 ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT
1009 (1) The compact becomes effective on the date on which the
1010 compact is enacted into law in the 10th member state. The
1011 provisions that become effective at that time are limited to the
1012 powers granted to the commission relating to assembly and the
1013 adoption of rules. Thereafter, the commission shall meet and
1014 exercise rulemaking powers necessary for implementation and
1015 administration of the compact.
1016 (2) Any state that joins the compact subsequent to the
1017 commission's initial adoption of the rules is subject to the
1018 rules as they exist on the date on which the compact becomes law
1019 in that state. Any rule that has been previously adopted by the
1020 commission has the full force and effect of law on the day the
1021 compact becomes law in that state.
1022 (3) Any member state may withdraw from the compact by
1023 enacting a statute repealing the compact.
1024 (a) A member state's withdrawal does not take effect until
1025 6 months after enactment of the repealing statute.
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1026 (b) Withdrawal does not affect the continuing requirement
1027 of the withdrawing state's professional counseling licensing
1028 board to comply with the investigative and adverse action
1029 reporting requirements of the compact before the effective date
1030 of withdrawal.
1031 (4) The compact may not be construed to invalidate or
1032 prevent any professional counseling licensure agreement or other
1033 cooperative arrangement between a member state and a nonmember
1034 state which does not conflict with the compact.
1035 (5) The compact may be amended by the member states. An
1036 amendment to the compact is not effective and binding upon any
1037 member state until it is enacted into the laws of all member
1038 states.
1039
1040 ARTICLE XIV
1041 BINDING EFFECT OF COMPACT AND OTHER LAWS
1042 (1) A licensee providing professional counseling services
1043 in a remote state under the privilege to practice shall adhere
1044 to the laws and regulations, including scope of practice, of the
1045 remote state.
1046 (2) The compact does not prevent the enforcement of any
1047 other law of a member state which is not inconsistent with the
1048 compact.
1049 (3) Any laws in a member state which conflict with the
1050 compact are superseded to the extent of the conflict.
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1051 (4) Any lawful actions of the commission, including all
1052 rules and bylaws properly adopted by the commission, are binding
1053 on the member states.
1054 (5) All permissible agreements between the commission and
1055 the member states are binding in accordance with their terms.
1056 (6) If any provision of the compact exceeds the
1057 constitutional limits imposed on the legislature of any member
1058 state, the provision shall be ineffective to the extent of the
1059 conflict with the constitutional provision in question in that
1060 member state.
1061
1062 ARTICLE XV
1063 CONSTRUCTION AND SEVERABILITY
1064 The compact must be liberally construed so as to effectuate
1065 the purposes thereof. The provisions of the compact are
1066 severable, and if any phrase, clause, sentence, or provision of
1067 the compact is declared to be contrary to the constitution of
1068 any member state or of the United States or the applicability
1069 thereof to any government, agency, person, or circumstance is
1070 held invalid, the validity of the remainder of the compact and
1071 the applicability thereof to any government, agency, person, or
1072 circumstance is not affected thereby. If the compact is held
1073 contrary to the constitution of any member state, the compact
1074 remains in full force and effect as to the remaining member
1075 states and in full force and effect as to the member state
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1076 affected as to all severable matters.
1077 Section 2. Subsection (10) of section 456.073, Florida
1078 Statutes, is amended to read:
1079 456.073 Disciplinary proceedings.—Disciplinary proceedings
1080 for each board shall be within the jurisdiction of the
1081 department.
1082 (10) The complaint and all information obtained pursuant
1083 to the investigation by the department are confidential and
1084 exempt from s. 119.07(1) until 10 days after probable cause has
1085 been found to exist by the probable cause panel or by the
1086 department, or until the regulated professional or subject of
1087 the investigation waives his or her privilege of
1088 confidentiality, whichever occurs first. The department shall
1089 report any significant investigation information relating to a
1090 nurse holding a multistate license to the coordinat ed licensure
1091 information system pursuant to s. 464.0095, and any significant
1092 investigatory information relating to a health care practitioner
1093 practicing under the Professional Counselors Licensure Compact
1094 to the data system pursuant to s. 491.017. Upon completion of
1095 the investigation and a recommendation by the department to find
1096 probable cause, and pursuant to a written request by the subject
1097 or the subject's attorney, the department shall provide the
1098 subject an opportunity to inspect the investigative fil e or, at
1099 the subject's expense, forward to the subject a copy of the
1100 investigative file. Notwithstanding s. 456.057, the subject may
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1101 inspect or receive a copy of any expert witness report or
1102 patient record connected with the investigation if the subject
1103 agrees in writing to maintain the confidentiality of any
1104 information received under this subsection until 10 days after
1105 probable cause is found and to maintain the confidentiality of
1106 patient records pursuant to s. 456.057. The subject may file a
1107 written response to the information contained in the
1108 investigative file. Such response must be filed within 20 days
1109 of mailing by the department, unless an extension of time has
1110 been granted by the department. This subsection does not
1111 prohibit the department from providing such information to any
1112 law enforcement agency or to any other regulatory agency.
1113 Section 3. Subsection (5) of section 456.076, Florida
1114 Statutes, is amended to read:
1115 456.076 Impaired practitioner programs.—
1116 (5) A consultant shall enter into a participant contract
1117 with an impaired practitioner and shall establish the terms of
1118 monitoring and shall include the terms in a participant
1119 contract. In establishing the terms of monitoring, the
1120 consultant may consider the recommendations of one or more
1121 approved evaluators, treatment programs, or treatment providers.
1122 A consultant may modify the terms of monitoring if the
1123 consultant concludes, through the course of monitoring, that
1124 extended, additional, or amended terms of monitoring are
1125 required for the protection of the health, safety, and welfare
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1126 of the public. If the impaired practitioner is a health care
1127 practitioner practicing under the Professional Counselors
1128 Licensure Compact pursuant to s. 491.017, the terms of the
1129 monitoring contract must include the impaired practitioner's
1130 withdrawal from all practice under the compact.
1131 Section 4. Subsection (8) is added to section 491.004,
1132 Florida Statutes, to read:
1133 491.004 Board of Clinical Social Work, Marriage and Family
1134 Therapy, and Mental Health Counseling.—
1135 (8) The board shall appoint an individual to serve as the
1136 state's delegate on the Counseling Compact Commission, as
1137 required under s. 491.017.
1138 Section 5. Subsection (6) is added to section 491.005,
1139 Florida Statutes, to read:
1140 491.005 Licensure by examination.—
1141 (6) EXEMPTION.—A person licensed as a clinical social
1142 worker, marriage and family therapist, or mental health
1143 counselor in another state who is practicing under the
1144 Professional Counselors Licensure Compact pursuant to s.
1145 491.017, and only within the scope provided therein, is exempt
1146 from the licensure requirements of this section, as applicable.
1147 Section 6. Subsection (3) is added to section 491.006,
1148 Florida Statutes, to read:
1149 491.006 Licensure or certification by endorsement. —
1150 (3) A person licensed as a clinical social worker,
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1151 marriage and family therapist, or mental health counselor in
1152 another state who is practicing under the Professional
1153 Counselors Licensure Compact pursuant to s. 491.017, and only
1154 within the scope provided therein, is exempt from the licensure
1155 requirements of this section, as applicable.
1156 Section 7. Section 491.009, Florida Statutes, is amended
1157 to read:
1158 491.009 Discipline.—
1159 (1) The following acts constitute grounds for denial of a
1160 license or disciplinary action, as specified in s. 456.072(2) or
1161 s. 491.017:
1162 (a) Attempting to obtain, obtaining, or renewing a
1163 license, registration, or certificate under this chapter by
1164 bribery or fraudulent misrepresentation or through an error of
1165 the board or the department.
1166 (b) Having a license, registration, or certificate to
1167 practice a comparable profession revoked, suspended, or
1168 otherwise acted against, including the denial of certification
1169 or licensure by another state, territory, or country.
1170 (c) Being convicted or found guilty of, regardless of
1171 adjudication, or having entered a plea of nolo contendere to, a
1172 crime in any jurisdiction which directly relates to the practice
1173 of his or her profession or the ability to practice his or her
1174 profession. However, in the case of a plea of nolo contendere,
1175 the board shall allow the person who is the subject of the
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1176 disciplinary proceeding to present evidence in mitigation
1177 relevant to the underlying charges and circumstances surrounding
1178 the plea.
1179 (d) False, deceptive, or misleading advertising or
1180 obtaining a fee or other thing of value on the representation
1181 that beneficial results from any treatment will be guaranteed.
1182 (e) Advertising, practicing, or attempting to practice
1183 under a name other than one's own.
1184 (f) Maintaining a professional association with any person
1185 who the applicant, licensee, registered intern, or
1186 certificateholder knows, or has reason to believe, is in
1187 violation of this chapter or of a rule of the department or the
1188 board.
1189 (g) Knowingly aiding, assisting, procuring, or advising
1190 any nonlicensed, nonregistered, or noncertified person to hold
1191 himself or herself out as licensed, registered, or certified
1192 under this chapter.
1193 (h) Failing to perform any statutory or legal obligation
1194 placed upon a person licensed, registered, or certified under
1195 this chapter.
1196 (i) Willfully making or filing a false report or record;
1197 failing to file a report or record required by state or federal
1198 law; willfully impeding or obstructing the filing of a report or
1199 record; or inducing another person to make or file a false
1200 report or record or to impede or obstruct the filing of a report
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1201 or record. Such report or record includes only a report or
1202 record which requires the signature of a person licensed,
1203 registered, or certified under this chapter.
1204 (j) Paying a kickback, rebate, bonus, or other
1205 remuneration for receiving a patient or client, or receiving a
1206 kickback, rebate, bonus, or other remuneration for referring a
1207 patient or client to another provider of mental health care
1208 services or to a provider of health care services or goods;
1209 referring a patient or client to oneself for services on a fee-
1210 paid basis when those services are already being paid for by
1211 some other public or private entity; or entering into a
1212 reciprocal referral agreement.
1213 (k) Committing any act upon a patient or client which
1214 would constitute sexual battery or which would constitute sexual
1215 misconduct as defined pursuant to s. 491.0111.
1216 (l) Making misleading, deceptive, untrue, or fraudulent
1217 representations in the practice of any profession licensed,
1218 registered, or certified under this chapter.
1219 (m) Soliciting patients or clients personally, or through
1220 an agent, through the use of fraud, intimidation, undue
1221 influence, or a form of overreaching or vexatious conduct.
1222 (n) Failing to make available to a patient or client, upon
1223 written request, copies of tests, reports, or documents in the
1224 possession or under the control of the licensee, registered
1225 intern, or certificateholder which have been prepared for and
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1226 paid for by the patient or client.
1227 (o) Failing to respond within 30 days to a written
1228 communication from the department or the board concerning any
1229 investigation by the department or the board, or failing to make
1230 available any relevant records with respect to any investigation
1231 about the licensee's, registered intern's, or
1232 certificateholder's conduct or background.
1233 (p) Being unable to practice the profession for which he
1234 or she is licensed, registered, or certified under this chapter
1235 with reasonable skill or competence as a result of any mental or
1236 physical condition or by reason of illness; drunkenness; or
1237 excessive use of drugs, narcotics, chemicals, or any other
1238 substance. In enforcing this paragraph, upon a finding by the
1239 State Surgeon General, the State Surgeon General's designee, or
1240 the board that probable cause exists to believe that the
1241 licensee, registered intern, or certificateholder is unable to
1242 practice the profession because of the reasons stated in this
1243 paragraph, the department shall have the authority to compel a
1244 licensee, registered intern, or certificateholder to submit to a
1245 mental or physical examination by psychologists, physicians, or
1246 other licensees under this chapter, designated by the department
1247 or board. If the licensee, registered intern, or
1248 certificateholder refuses to comply with such order, the
1249 department's order directing the examination may be enforced by
1250 filing a petition for enforcement in the circuit court in the
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1251 circuit in which the licensee, registered intern, or
1252 certificateholder resides or does business. The licensee,
1253 registered intern, or certificateholder against whom the
1254 petition is filed may shall not be named or identified by
1255 initials in any public court records or documents, and the
1256 proceedings shall be closed to the public. The department shall
1257 be entitled to the summary procedure provided in s. 51.011. A
1258 licensee, registered intern, or certificateholder affected under
1259 this paragraph shall at reasonable intervals be afforded an
1260 opportunity to demonstrate that he or she can resume the
1261 competent practice for which he or she is licensed, registered,
1262 or certified with reasonable skill and safety to patients.
1263 (q) Performing any treatment or prescribing any therapy
1264 which, by the prevailing standards of the mental health
1265 professions in the community, would constitute experimentation
1266 on human subjects, without first obtaining full, informed, and
1267 written consent.
1268 (r) Failing to meet the minimum standards of performance
1269 in professional activities when measured against generally
1270 prevailing peer performance, including the undertaking of
1271 activities for which the licensee, registered intern, or
1272 certificateholder is not qualified by training or experience.
1273 (s) Delegating professional responsibilities to a person
1274 whom the licensee, registered intern, or certificateholder knows
1275 or has reason to know is not qualified by training or experience
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1276 to perform such responsibilities.
1277 (t) Violating a rule relating to the regulation of the
1278 profession or a lawful order of the department or the board
1279 previously entered in a disciplinary hearing.
1280 (u) Failure of the licensee, registered intern, or
1281 certificateholder to maintain in confidence a communication made
1282 by a patient or client in the context of such services, except
1283 as provided in s. 491.0147.
1284 (v) Making public statements which are derived from test
1285 data, client contacts, or behavioral research and which identify
1286 or damage research subjects or clients.
1287 (w) Violating any provision of this chapter or chapter
1288 456, or any rules adopted pursuant thereto.
1289 (2)(a) The board or, in the case of certified master
1290 social workers, the department may enter an order denying
1291 licensure or imposing any of the penalties authorized in s.
1292 456.072(2) against any applicant for licensure or any licensee
1293 who violates subsection (1) or s. 456.072(1).
1294 (b) The board may take adverse action against a clinical
1295 social worker's, a marriage and family therapist's, or a mental
1296 health counselor's privilege to practice under the Professional
1297 Counselors Licensure Compact pursuant to s. 491.017 and may
1298 impose any of the penalties in s. 456.072(2) if the clinical
1299 social worker, marriage and family therapist, or mental health
1300 counselor commits an act specified in subsection (1) or s.
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1301 456.072(1).
1302 Section 8. Paragraph (h) is added to subsection (10) of
1303 section 768.28, Florida Statutes, to read:
1304 768.28 Waiver of sovereign immunity in tort actions;
1305 recovery limits; civil liability for damages caused during a
1306 riot; limitation on attorney fees; statute of limitations;
1307 exclusions; indemnification; risk management programs.—
1308 (10)
1309 (h) For purposes of this section, the individual appointed
1310 under s. 491.004(8) as the state's delegate on the Counseling
1311 Compact Commission, when serving in that capacity pursuant to s.
1312 491.017, and any administrator, officer, executive director,
1313 employee, or representative of the commission, when acting
1314 within the scope of his or her employment, duties, or
1315 responsibilities in this state, is considered an agent of the
1316 state. The commission shall pay any claims or judgments pursuant
1317 to this section and may maintain insurance coverage to pay any
1318 such claims or judgments.
1319 Section 9. The Department of Health shall notify the
1320 Division of Law Revision upon enactment of the Professional
1321 Counselors Licensure Compact into law by 10 states.
1322 Section 10. This act shall take effect upon enactment of
1323 the Professional Counselors Licensure Compact into law by 10
1324 states.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1521 (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 Between lines 124 and 125, insert:
7 Section 1. Subsections (5) through (17) of section
8 491.003, Florida Statutes, are renumbered as subsections (6)
9 though (18), respectively, and subsection (5) is added to that
10 section, to read:
11 491.003 Definitions.—As used in this chapter:
12 (5) "Licensed professional counselor" means a clinical
13 social worker, marriage and family therapist, or mental health
14 counselor authorized to provide services under the Professional
15 Counselors Licensure Compact.
16
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Page 1 of 2
COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1521 (2022)
Amendment No. 1
17
18 -----------------------------------------------------
19 T I T L E A M E N D M E N T
20 Remove line 3 and insert:
21 Compact; amending s. 491.003, F.S.; defining "licensed
22 professional counselor"; creating s. 491.017, F.S.; creating
23 the
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 1521 (2022)
Amendment No. 2
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
6 Remove lines 233-235 and insert:
7 (15) "Licensed professional counselor" means a counselor
8 licensed by a member state, regardless of the title used by that
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HB 1523
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1523 Pub. Rec. and Meetings/Professional Counselors Licensure Compact
SPONSOR(S): Koster
TIED BILLS: HB 1521 IDEN./SIM. BILLS: CS/SB 590
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Morris McElroy
2) Government Operations Subcommittee
3) Health & Human Services Committee
SUMMARY ANALYSIS
HB 1521 authorizes Florida to enter into the Professional Counselors Licensure Compact (PCLC) enacting its
provisions into the laws of the state. The PCLC is an interstate compact that facilitates the interstate practice of
licensed professional counseling in person and through telehealth. In Florida, licensed clinical social workers,
marriage and family therapists, and mental health counselors (counselors, collectively) are able to apply for
privileges to practice under the PCLC. The PCLC requires compact states to submit counselor’s licensure and
regulation records, including any actions taken against a counselor’s ability to practice, to a coordinated
licensure information system (CLIS). The compact creates the Counseling Compact Commission
(Commission) to oversee and administer the provisions of the PCLC and a licensure information data system
(data system).
This bill, which is linked to the passage of HB 1521, creates public records and public meetings exemptions for
certain records and meetings relating to the compact.
The bill creates a public records exemption for a counselor’s personal identifying information, other than his or
her name, licensure status, or licensure number, obtained from the data system and held by the Department of
Health or the Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counselors,
unless the laws of the state that originally reported the information authorizes its disclosure.
The bill also creates a public meeting exemption for Commission meetings, or portions of such meetings, in
which a matter discussed is specifically exempted from disclosure by federal or state statute. The bill provides
that any recordings, minutes, and records generated from such a meeting are also exempt from public records
requirements.
The bill provides that the public record exemption is subject to the Open Government Sunset Review Act and
will repeal on October 2, 2027, unless reviewed and saved from repeal by the Legislature. It also provides a
statement of public necessity as required by the Florida Constitution.
The bill has an insignificant, negative fiscal impact on the Department of Health and no fiscal impact on local
governments.
The bill will become effective on the same date that HB 1521 or similar legislation takes effect, if such
legislation is adopted in the same legislative session or an extension thereof and becomes law.
Article I, s. 24(c) of the Florida Constitution requires a two-thirds vote of the members present and
voting for final passage of a newly created or expanded public record or public meeting exemption.
The bill creates a public record exemption; thus, it requires a two-thirds vote for final passage.
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
Public Records
Article I, s. 24(a) of the Florida Constitution sets forth the state’s public policy regarding access to
government records. This section guarantees every person a right to inspect or copy any public record
of the legislative, executive, and judicial branches of government. The Legislature, however, may
provide by general law for the exemption of records from the requirements of art. I, s. 24(a) of the
Florida Constitution. 1 The general law must state with specificity the public necessity justifying the
exemption 2 and must be no broader than necessary to accomplish its purpose. 3
Public policy regarding access to government records is addressed further in s. 119.07(1), F.S., which
guarantees every person a right to inspect and copy any state, county, or municipal record, unless the
record is exempt. Furthermore, the Open Government Sunset Review Act 4 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 necessary to meet one of the following purposes: 5
• 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.
The Open Government Sunset Review Act requires the automatic repeal of a newly created public
record exemption on October 2nd of the fifth year after creation or substantial amendment, unless the
Legislature reenacts the exemption. 6
Professional Counselors Licensure Compact
HB 1521 authorizes Florida to enter into the Professional Counselors Licensure Compact (PCLC or
compact) by enacting its provisions into Florida law. The PCLC was created by the National Center for
Interstate Compacts and is an interstate compact that facilitates the interstate practice of licensed
professional counseling in person and through telehealth. Florida-licensed clinical social workers,
marriage and family therapists, and mental health counselors (counselors, collectively) are eligible to
apply for privileges to practice under the PCLC.
Under the compact, a counselor who is licensed in a compact state is permitted to practice in another
compact state after obtaining a privilege to practice in that compact state. A counselor practicing under
the compact practice privileges must comply with the practice laws of the state in which he or she is
practicing or where the patient is located.
Under the PCLC, compact states are required to report a counselor’s identifying information; licensure
data; significant investigatory information; adverse actions 7 against a counselor’s license;
1 Article I, s. 24(c), Fla. Const.
2 This portion of a public record exemption is commonly referred to as a “public necessity statement.”
3 Article I, s. 24(c), FLA. CONST.
4 Section 119.15, F.S.
5 Section 119.15(6)(b), F.S.
6 Section 119.15(3), F.S.
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nonconfidential information related to participation in alternative programs; denials of applications and
reasons for such denials; and other information, determined by Commission rule, which may facilitate
the administration of the compact to a coordinated licensure information system. A compact state may
designate information it reports as confidential and therefore, cannot be shared with noncompact states
or other entities without the express permission of the reporting state.
Coordinated Licensure Information System
The PCLC requires all compact states to share licensee information. 8 Compact states must submit a
uniform dataset to a coordinated licensure information system on all counselors to whom the compact
is applicable. The database allows for expedited sharing of information, which is not currently exempt
from disclosure requirements under s. 119.07(1), F.S. and s. 24(a), Art. 1 of the Florida Constitution,
including: 9
• Identifying information;
• Licensure data;
• Significant investigatory information;
• Adverse actions against a counselor’s license;
• Nonconfidential information related to participation in alternative programs;
• Any licensure application denials and reasons for such denial; and
• Other information, determined by Commission rule, which may facilitate the administration of
the compact.
The data system information must be expunged according to laws of the reporting compact state. 10
Commission Meetings
The compact establishes the Counseling Compact Commission (Commission). Each compact state has
one delegate selected by that state’s licensing board. All Commission meetings must be open to the
public except for when the Commission must discuss: 11
• Noncompliance of a compact state with its obligations under the compact;
• The employment, compensation, discipline, or other personnel matters, practices, or procedures
related to specific employees or other matters related to the Commission’s internal personnel
practices and procedure;
• Current, threatened, or reasonably anticipated litigation;
• Contract negotiations for the purchase or sale of goods, services, or real estate;
• Accusing a person of a crime or formally censuring a person;
• Disclosure of trade secrets or commercial or financial information that is privileged or
confidential;
• Disclosure of information of a personal nature where disclosure would constitute a clearly
unwarranted invasion of personal privacy if disclosed to the public;
• Disclosure of active investigatory records compiled for law enforcement purposes;
• Disclosure of information related to any reports prepared by or on behalf of the commission for
the purpose of investigation for compliance with the compact; and
• Matters specifically exempted from disclosure by federal law or the laws of any party state.
Effect of the Bill
7 Adverse action is any disciplinary action that is a matter of public record which is taken by a state’s counselor regulatory authority
against a counselor’s license to practice in that state.
8 Counseling Compact Model Legislation (Dec. 4, 2020), https://counselingcompact.org/wp-
content/uploads/2021/06/Final_Counseling_Compact_With_Cover.pdf (last visited Jan. 29, 2022).
9 Id.
10 Id.
11 Id.
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The bill creates public record and public meeting exemptions related to the PCLC.
Specifically, the bill provides that personal identifying information of a counselor, other than the
counselor’s name, licensure status, or licensure number, obtained from the data system and held by
the Department of Health or the Board of Clinical Social Work, Marriage and Family Therapy, and
Mental Health Counselors is exempt from public records requirements, unless the laws of the state that
originally reported the information authorizes its disclosure. Disclosure under such circumstance is
limited to the extent permitted under the laws of the reporting state.
The bill also creates a public meeting exemption for Commission meetings, or portions of such
meetings, at which the Commission discusses matters specifically exempt from disclosure by state or
federal law. Recordings, minutes, and records generated during an exempt portion of a Commission
meeting are also exempt from public disclosure.
The bill provides a public necessity statement for the public records exemption, as required by the State
Constitution, and states that the protection of such information is required under the compact, which the
state must adopt in order to become a party state to the compact. Without the public records
exemption, the state would be unable to effectively and efficiently implement and administer the
compact.
Additionally, the bill provides a statement of public necessity for the public meeting exemption, as
required by the State Constitution, and states that the PCLC requires any meeting in which matters that
are exempt from disclosure by federal or state statute are discussed to be closed to the public. Without
the public meeting exemption, the state will be prohibited from becoming a party to the compact and
would be unable to effectively and efficiently administer the compact. The bill further provides that
without the public records exemption for the recordings, minutes, and records generated during an
exempt meeting, the release of such information would negate the public meeting exemption.
The bill provides that the public records and public meeting exemptions are subject to the Open
Government Sunset Review Act and will stand repealed on October 2, 2027, unless saved from repeal
by reenactment by the Legislature.
The effective date of this bill is the same date that HB 1521 or similar legislation takes effect, if such
legislation is adopted in the same legislative session or an extension thereof becomes law.
B. SECTION DIRECTORY:
Section 1: Creates s. 491.018, F.S., relating to Professional Counselors Licensure Compact; public
records and meeting exemptions.
Section 2: Provides that the bill is effective on the same date that HB 1521 (2022) or similar
legislation takes effect.
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:
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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:
Vote Requirement
Article I, s. 24(c) of the Florida Constitution requires a two-thirds vote of the members present and
voting for final passage of a newly created or expanded public record or public meeting exemption.
The bill creates a public record exemption; thus, it requires a two-thirds vote for final passage.
Public Necessity Statement
Article I, s. 24(c) of the Florida Constitution requires a public necessity statement for a newly created
or expanded public record or public meeting exemption. The bill creates a public record exemption;
thus, it includes a public necessity statement.
Breadth of Exemption
Article I, s. 24(c) of the State Constitution provides that an exemption must be created by general law
and the law must contain only exemptions from public record or public meeting requirements. The
exemption does not appear to be in conflict with the constitutional requirement.
B. RULE-MAKING AUTHORITY:
Current law provides sufficient rulemaking authority to implement the provisions of 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 1523 2022
1 A bill to be entitled
2 An act relating to public records and meetings;
3 creating s. 491.018, F.S.; providing an exemption from
4 public records requirements for certain information
5 held by the Department of Health or the Board of
6 Clinical Social Work, Marriage and Family Therapy, and
7 Mental Health Counseling pursuant to the Professional
8 Counselors Licensure Compact; authorizing the
9 disclosure of such information under certain
10 circumstances; providing an exemption from public
11 meetings requirements for certain meetings or portions
12 of certain meetings of the Counseling Compact
13 Commission or committees of the commission; providing
14 an exemption from public records requirements for
15 recordings, minutes, and records generated during the
16 closed portions of such meetings; providing for future
17 legislative review and repeal of the exemptions;
18 providing statements of public necessity; providing a
19 contingent effective date.
20
21 Be It Enacted by the Legislature of the State of Florida:
22
23 Section 1. Section 491.018, Florida Statutes, is created
24 to read:
25 491.018 Professional Counselors Licensure Compact; public
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26 records and meetings exemptions.—
27 (1) A counselor's personal identifying information, other
28 than the counselor's name, licensure status, or licensure
29 number, obtained from the data system, as described in article X
30 of s. 491.017, and held by the department or the Board of
31 Clinical Social Work, Marriage and Family Therapy, and Mental
32 Health Counseling is exempt from s. 119.07(1) and s. 24(a), Art.
33 I of the State Constitution unless the state that originally
34 reported the information to the data system authorizes the
35 disclosure of such information by law. If disclosure is so
36 authorized, information may be disclosed only to the extent
37 authorized by law by the reporting state.
38 (2)(a) A meeting or a portion of a meeting of the
39 Counseling Compact Commission, established in article IX of s.
40 491.017, or the executive committee or other committees of the
41 commission, at which matters specifically exempted from
42 disclosure by federal or state statute are discussed is exempt
43 from s. 286.011 and s. 24(b), Art. I of the State Constitution.
44 (b) Recordings, minutes, and records generated during an
45 exempt meeting are exempt from s. 119.07(1) and s. 24(a), Art. I
46 of the State Constitution.
47 (3) This section is subject to the Open Government Sunset
48 Review Act in accordance with s. 119.15 and shall stand repealed
49 on October 2, 2027, unless reviewed and saved from repeal
50 through reenactment by the Legislature.
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51 Section 2. (1) The Legislature finds that it is a public
52 necessity that a counselor's personal identifying information,
53 other than the counselor's name, licensure status, or licensure
54 number, obtained from the data system, as described in article X
55 of s. 491.017, Florida Statutes, and held by the Department of
56 Health or the Board of Clinical Social Work, Marriage and Family
57 Therapy, and Mental Health Counseling be made exempt from s.
58 119.07(1), Florida Statutes, and s. 24(a), Art. I of the State
59 Constitution. Protection of such information is required under
60 the Professional Counselors Licensure Compact, which the state
61 must adopt in order to become a member state of the compact.
62 Without the public records exemption, this state will be unable
63 to effectively and efficiently implement and administer the
64 compact.
65 (2)(a) The Legislature finds that it is a public necessity
66 that any meeting of the Counseling Compact Commission or the
67 executive committee or other committees of the commission held
68 as provided in article IX of s. 491.017, Florida Statutes, at
69 which matters specifically exempted from disclosure by federal
70 or state law are discussed be made exempt from s. 286.011,
71 Florida Statutes, and s. 24(b), Art. I of the State
72 Constitution.
73 (b) The Professional Counselors Licensure Compact requires
74 the closure of any meeting, or any portion of a meeting, in
75 which the substance of paragraph (a) is discussed to be closed
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76 to the public. In the absence of a public meeting exemption,
77 this state would be prohibited from becoming a member state of
78 the compact. Thus, this state will be unable to effectively and
79 efficiently administer the compact.
80 (3) The Legislature also finds that it is a public
81 necessity that the recordings, minutes, and records generated
82 during a meeting that is exempt pursuant to article IX of s.
83 491.017, Florida Statutes, be made exempt from s. 119.07(1),
84 Florida Statutes, and s. 24(a), Art. I of the State
85 Constitution. Release of such information would negate the
86 public meetings exemption. As such, the Legislature finds that
87 the public records exemption is a public necessity.
88 Section 3. This act shall take effect on the same date
89 that HB 1521 or similar legislation takes effect, if such
90 legislation is adopted in the same legislative session or an
91 extension thereof and becomes a law.
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