Bill Amendment: FL H0573 | 2014 | Regular Session

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: Health of Residents

Status: 2014-05-02 - Died on Calendar [H0573 Detail]

Download: Florida-2014-H0573-Senate_Floor_Amendment_764744.html

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       Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS/CS/CS/HB 573, 2nd Eng.
       
       
       
       
       
       
                                Ì764744<Î764744                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       Senator Hays moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 2694 and 2695
    4  insert:
    5         Section 48. Subsection (3), paragraph (e) of subsection
    6  (4), and paragraphs (a), (c), and (e) of subsection (7) of
    7  section 458.347, Florida Statutes, are amended to read:
    8         458.347 Physician assistants.—
    9         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
   10  group of physicians supervising a licensed physician assistant
   11  must be qualified in the medical areas in which the physician
   12  assistant is to perform and shall be individually or
   13  collectively responsible and liable for the performance and the
   14  acts and omissions of the physician assistant. A physician may
   15  not supervise more than six four currently licensed physician
   16  assistants at any one time. A physician supervising a physician
   17  assistant pursuant to this section may not be required to review
   18  and cosign charts or medical records prepared by such physician
   19  assistant. Notwithstanding this subsection, a physician may only
   20  supervise up to four physician assistants in medical offices
   21  other than the physician’s primary practice location pursuant to
   22  s. 458.348(4)(c).
   23         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   24         (e) A supervisory physician may delegate to a fully
   25  licensed physician assistant the authority to prescribe or
   26  dispense any medication used in the supervisory physician’s
   27  practice unless such medication is listed on the formulary
   28  created pursuant to paragraph (f). A fully licensed physician
   29  assistant may only prescribe or dispense such medication under
   30  the following circumstances:
   31         1. A physician assistant must clearly identify to the
   32  patient that he or she is a physician assistant. Furthermore,
   33  the physician assistant must inform the patient that the patient
   34  has the right to see the physician prior to any prescription
   35  being prescribed or dispensed by the physician assistant.
   36         2. The supervisory physician must notify the department of
   37  his or her intent to delegate, on a department-approved form,
   38  before delegating such authority and notify the department of
   39  any change in prescriptive privileges of the physician
   40  assistant. Authority to dispense may be delegated only by a
   41  supervising physician who is registered as a dispensing
   42  practitioner in compliance with s. 465.0276.
   43         3. The physician assistant must certify to file with the
   44  department a signed affidavit that he or she has completed a
   45  minimum of 10 continuing medical education hours in the
   46  specialty practice in which the physician assistant has
   47  prescriptive privileges with each licensure renewal application.
   48         4. The department may issue a prescriber number to the
   49  physician assistant granting authority for the prescribing of
   50  medicinal drugs authorized within this paragraph upon completion
   51  of the foregoing requirements. The physician assistant shall not
   52  be required to independently register pursuant to s. 465.0276.
   53         5. The prescription may must be written or electronic, but
   54  must be in a form that complies with ss. 456.0392(1) and
   55  456.42(1) chapter 499 and must contain, in addition to the
   56  supervisory physician’s name, address, and telephone number, the
   57  physician assistant’s prescriber number. Unless it is a drug or
   58  drug sample dispensed by the physician assistant, the
   59  prescription must be filled in a pharmacy permitted under
   60  chapter 465 and must be dispensed in that pharmacy by a
   61  pharmacist licensed under chapter 465. The appearance of the
   62  prescriber number creates a presumption that the physician
   63  assistant is authorized to prescribe the medicinal drug and the
   64  prescription is valid.
   65         6. The physician assistant must note the prescription or
   66  dispensing of medication in the appropriate medical record.
   67         (7) PHYSICIAN ASSISTANT LICENSURE.—
   68         (a) Any person desiring to be licensed as a physician
   69  assistant must apply to the department. The department shall
   70  issue a license to any person certified by the council as having
   71  met the following requirements:
   72         1. Is at least 18 years of age.
   73         2. Has satisfactorily passed a proficiency examination by
   74  an acceptable score established by the National Commission on
   75  Certification of Physician Assistants. If an applicant does not
   76  hold a current certificate issued by the National Commission on
   77  Certification of Physician Assistants and has not actively
   78  practiced as a physician assistant within the immediately
   79  preceding 4 years, the applicant must retake and successfully
   80  complete the entry-level examination of the National Commission
   81  on Certification of Physician Assistants to be eligible for
   82  licensure.
   83         3. Has completed the application form and remitted an
   84  application fee not to exceed $300 as set by the boards. An
   85  application for licensure made by a physician assistant must
   86  include:
   87         a. A certificate of completion of a physician assistant
   88  training program specified in subsection (6).
   89         b. A sworn statement of any prior felony convictions.
   90         c. A sworn statement of any previous revocation or denial
   91  of licensure or certification in any state.
   92         d. Two letters of recommendation.
   93         d.e. A copy of course transcripts and a copy of the course
   94  description from a physician assistant training program
   95  describing course content in pharmacotherapy, if the applicant
   96  wishes to apply for prescribing authority. These documents must
   97  meet the evidence requirements for prescribing authority.
   98         e. For physician assistants seeking initial licensure on or
   99  after January 1, 2015, fingerprints pursuant to s. 456.0135.
  100         (c) The license must be renewed biennially. Each renewal
  101  must include:
  102         1. A renewal fee not to exceed $500 as set by the boards.
  103         2. A sworn statement of no felony convictions in the
  104  previous 2 years.
  105         (e) Upon employment as a physician assistant, a licensed
  106  physician assistant must notify the department in writing within
  107  30 days after such employment and provide or after any
  108  subsequent changes in the supervising physician. The
  109  notification must include the full name, Florida medical license
  110  number, specialty, and address of a designated the supervising
  111  physician. Any subsequent change in the designated supervising
  112  physician shall be reported to the department within 30 days
  113  after the change. Assignment of a designated supervising
  114  physician does not preclude a physician assistant from
  115  practicing under multiple supervising physicians.
  116         Section 49. Paragraph (c) of subsection (4) of section
  117  458.348, Florida Statutes, is amended to read:
  118         458.348 Formal supervisory relationships, standing orders,
  119  and established protocols; notice; standards.—
  120         (4) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.—A
  121  physician who supervises an advanced registered nurse
  122  practitioner or physician assistant at a medical office other
  123  than the physician’s primary practice location, where the
  124  advanced registered nurse practitioner or physician assistant is
  125  not under the onsite supervision of a supervising physician,
  126  must comply with the standards set forth in this subsection. For
  127  the purpose of this subsection, a physician’s “primary practice
  128  location” means the address reflected on the physician’s profile
  129  published pursuant to s. 456.041.
  130         (c) A physician who supervises an advanced registered nurse
  131  practitioner or physician assistant at a medical office other
  132  than the physician’s primary practice location, where the
  133  advanced registered nurse practitioner or physician assistant is
  134  not under the onsite supervision of a supervising physician and
  135  the services offered at the office are primarily dermatologic or
  136  skin care services, which include aesthetic skin care services
  137  other than plastic surgery, must comply with the standards
  138  listed in subparagraphs 1.-4. Notwithstanding s.
  139  458.347(4)(e)6., a physician supervising a physician assistant
  140  pursuant to this paragraph may not be required to review and
  141  cosign charts or medical records prepared by such physician
  142  assistant.
  143         1. The physician shall submit to the board the addresses of
  144  all offices where he or she is supervising an advanced
  145  registered nurse practitioner or a physician’s assistant which
  146  are not the physician’s primary practice location.
  147         2. The physician must be board certified or board eligible
  148  in dermatology or plastic surgery as recognized by the board
  149  pursuant to s. 458.3312.
  150         3. All such offices that are not the physician’s primary
  151  place of practice must be within 25 miles of the physician’s
  152  primary place of practice or in a county that is contiguous to
  153  the county of the physician’s primary place of practice.
  154  However, the distance between any of the offices may not exceed
  155  75 miles.
  156         4. The physician may supervise only one office other than
  157  the physician’s primary place of practice except that until July
  158  1, 2011, the physician may supervise up to two medical offices
  159  other than the physician’s primary place of practice if the
  160  addresses of the offices are submitted to the board before July
  161  1, 2006. Effective July 1, 2011, the physician may supervise
  162  only one office other than the physician’s primary place of
  163  practice, regardless of when the addresses of the offices were
  164  submitted to the board.
  165         5. As used in this subparagraph, the term “nonablative
  166  aesthetic skin care services” includes, but is not limited to,
  167  services provided using intense pulsed light, lasers, radio
  168  frequency, ultrasound, injectables, and fillers.
  169         a. Subparagraph 2. does not apply to offices at which
  170  nonablative aesthetic skin care services are performed by a
  171  physician assistant under the supervision of a physician if the
  172  physician assistant has successfully completed at least:
  173         (I) Forty hours of postlicensure education and clinical
  174  training on physiology of the skin, skin conditions, skin
  175  disorders, skin diseases, preprocedure and postprocedure skin
  176  care, and infection control, or has worked under the supervision
  177  of a board-certified dermatologist within the preceding 12
  178  months.
  179         (II) Forty hours of postlicensure education and clinical
  180  training on laser and light technologies and skin applications,
  181  or has 6 months of clinical experience working under the
  182  supervision of a board-certified dermatologist who is authorized
  183  to perform nonablative aesthetic skin care services.
  184         (III) Thirty-two hours of postlicensure education and
  185  clinical training on injectables and fillers, or has 6 months of
  186  clinical experience working under the supervision of a board
  187  certified dermatologist who is authorized to perform nonablative
  188  aesthetic skin care services.
  189         b. The physician assistant shall submit to the board
  190  documentation evidencing successful completion of the education
  191  and training required under this subparagraph.
  192         c. For purposes of compliance with s. 458.347(3), a
  193  physician who has completed 24 hours of education and clinical
  194  training on nonablative aesthetic skin care services, the
  195  curriculum of which has been preapproved by the Board of
  196  Medicine, is qualified to supervise a physician assistant
  197  performing nonablative aesthetic skin care services pursuant to
  198  this subparagraph.
  199  
  200  ================= T I T L E  A M E N D M E N T ================
  201  And the title is amended as follows:
  202         Delete line 292
  203  and insert:
  204         home health agencies; amending s. 458.347, F.S.;
  205         increasing the number of licensed physician assistants
  206         that a physician may supervise at any one time;
  207         providing an exception; revising circumstances under
  208         which a physician assistant is authorized to prescribe
  209         or dispense medication; revising requirements for
  210         medications prescribed or dispensed by physician
  211         assistants; revising application requirements for
  212         licensure as a physician assistant and license
  213         renewal; amending s. 458.348, F.S.; defining the term
  214         “nonablative aesthetic skin care services”;
  215         authorizing a physician assistant who has completed
  216         specified education and clinical training
  217         requirements, or who has specified work or clinical
  218         experience, to perform nonablative aesthetic skin care
  219         services under the supervision of a physician;
  220         providing that a physician must complete a specified
  221         number of education and clinical training hours to be
  222         qualified to supervise physician assistants performing
  223         certain services; providing effective dates.