Bill Text: FL S0248 | 2013 | Regular Session | Enrolled
Bill Title: Treatment Programs for Impaired Licensees and Applicants
Spectrum: Bipartisan Bill
Status: (Passed) 2013-06-17 - Chapter No. 2013-166 [S0248 Detail]
Download: Florida-2013-S0248-Enrolled.html
ENROLLED 2013 Legislature CS for SB 248 2013248er 1 2 An act relating to treatment programs for impaired 3 licensees and applicants; amending s. 456.076, F.S.; 4 exempting an entity retained by the Department of 5 Health as an impaired practitioner consultant from 6 certain licensure requirements; authorizing impaired 7 practitioner consultants to contract with schools or 8 programs to provide services to impaired students who 9 are enrolled for the purpose of preparing for 10 licensure as a specified health care practitioner or 11 as a veterinarian; limiting the liability of those 12 schools or programs when they refer a student to an 13 impaired practitioner consultant; authorizing each 14 board and profession within the division to delegate 15 to its chair or other designee the authority to 16 determine that an applicant for licensure under its 17 jurisdiction may be impaired before certifying or 18 declining to certify an application for licensure; 19 authorizing the chair or other designee to refer the 20 applicant to the consultant for an evaluation before 21 the board certifies or declines to certify the 22 applicant’s application to the department; tolling the 23 department’s deadline for approving or denying the 24 application until the evaluation is completed and the 25 result of the evaluation and recommendation by the 26 consultant is communicated to the board by the 27 consultant if the applicant agrees to be evaluated by 28 the consultant; requiring the board to certify or 29 decline to certify the applicant’s application to the 30 department notwithstanding the lack of an evaluation 31 and recommendation by the consultant if the applicant 32 declines to be evaluated by the consultant; providing 33 that the impaired practitioner consultant is the 34 official custodian of records relating to the referral 35 of the licensee or applicant to the consultant and any 36 other interaction between them; clarifying the 37 circumstances under which an impaired practitioner 38 consultant may disclose certain information concerning 39 an impaired licensee or applicant; authorizing the 40 Department of Health and others that contract with an 41 impaired practitioner consultant to have 42 administrative control over the consultant to the 43 extent necessary to receive disclosures allowed under 44 federal law; authorizing an impaired licensee to 45 obtain confidential information from the department 46 regarding a pending disciplinary proceeding; amending 47 ss. 458.331 and 459.015, F.S.; conforming cross 48 references; creating s. 468.315, F.S.; providing that 49 radiological personnel are subject to a treatment 50 program for impaired licensees; providing an effective 51 date. 52 53 Be It Enacted by the Legislature of the State of Florida: 54 55 Section 1. Section 456.076, Florida Statutes, is amended to 56 read: 57 456.076 Treatment programs for impaired practitioners.— 58 (1) For professions that do not have impaired practitioner 59 programs provided for in their practice acts, the department 60 shall, by rule, designate approved impaired practitioner 61 programs under this section. The department may adopt rules 62 setting forth appropriate criteria for approval of treatment 63 providers. The rules may specify the manner in which the 64 consultant, retained as set forth in subsection (2), works with 65 the department in intervention, requirements for evaluating and 66 treating a professional, requirements for continued care of 67 impaired professionals by approved treatment providers, 68 continued monitoring by the consultant of the care provided by 69 approved treatment providers regarding the professionals under 70 their care, and requirements related to the consultant’s 71 expulsion of professionals from the program. 72 (2)(a) The department shall retain one or more impaired 73 practitioner consultants who are each licensees. The consultant74shall be a licenseeunder the jurisdiction of the Division of 75 Medical Quality Assurance within the department and who must be: 76 1. A practitioner or recovered practitioner licensed under 77 chapter 458, chapter 459, or part I of chapter 464;,or 78 2. An entity that employs:employing79 a. A medical director who must be a practitioner or 80 recovered practitioner licensed under chapter 458 or,chapter 81 459;,or 82 b. An executive director who must be a registered nurse or 83 a recovered registered nurse licensed under part I of chapter 84 464. 85 (b) An entity retained as an impaired practitioner 86 consultant under this section which employs a medical director 87 or an executive director is not required to be licensed as a 88 substance abuse provider or mental health treatment provider 89 under chapter 394, chapter 395, or chapter 397 for purposes of 90 providing services under this program. 91 (c)1. The consultant shall assist the probable cause panel 92 and the department in carrying out the responsibilities of this 93 section. This includesshall includeworking with department 94 investigators to determine whether a practitioner is, in fact, 95 impaired. 96 2. The consultant may contract with a school or program to 97 provideforservices to a studentbe provided, for appropriate98compensation, if requested by the school, for studentsenrolled 99 for the purpose of preparingin schoolsfor licensure as a 100 health care practitioner as defined in this chapter or as a 101 veterinarian under chapter 474 if the student is allegedly 102allopathic physicians or physician assistants under chapter 458,103osteopathic physicians or physician assistants under chapter104459, nurses under chapter 464, or pharmacists under chapter 465105who are alleged to beimpaired as a result of the misuse or 106 abuse of alcohol or drugs, or both, or due to a mental or 107 physical condition. The department is not responsibleunder any108circumstancesfor paying for thecosts ofcare provided by 109 approved treatment providers or a consultant, and the department110is not responsible for paying the costs of consultants’ services111provided for students. 112 (d) A medical school accredited by the Liaison Committee on 113 Medical Education orofthe Commission on Osteopathic College 114 Accreditation, or anotherotherschool providing for the 115 education of students enrolled in preparation for licensure as a 116 health care practitioner as defined in this chapter or a 117 veterinarian under chapter 474allopathic physicians under118chapter 458 or osteopathic physicians under chapter 459,which 119 is governed by accreditation standards requiring notice and the 120 provision of due process procedures to students, is not liable 121 in any civil action for referring a student to the consultant 122 retained by the department or for disciplinary actions that 123 adversely affect the status of a student when the disciplinary 124 actions are instituted in reasonable reliance on the 125 recommendations, reports, or conclusions provided by such 126 consultant, if the school, in referring the student or taking 127 disciplinary action, adheres to the due process procedures 128 adopted by the applicable accreditation entities and if the 129 school committed no intentional fraud in carrying out the 130 provisions of this section. 131 (3) Each board and profession within the Division of 132 Medical Quality Assurance may delegate to its chair or other 133 designee its authority to determine, before certifying or 134 declining to certify an application for licensure to the 135 department, that an applicant for licensure under its 136 jurisdiction may be impaired as a result of the misuse or abuse 137 of alcohol or drugs, or both, or due to a mental or physical 138 condition that could affect the applicant’s ability to practice 139 with skill and safety. Upon such determination, the chair or 140 other designee may refer the applicant to the consultant for an 141 evaluation before the board certifies or declines to certify his 142 or her application to the department. If the applicant agrees to 143 be evaluated by the consultant, the department’s deadline for 144 approving or denying the application pursuant to s. 120.60(1) is 145 tolled until the evaluation is completed and the result of the 146 evaluation and recommendation by the consultant is communicated 147 to the board by the consultant. If the applicant declines to be 148 evaluated by the consultant, the board shall certify or decline 149 to certify the applicant’s application to the department 150 notwithstanding the lack of an evaluation and recommendation by 151 the consultant. 152 (4)(3)(a) Whenever the department receives a written or 153 oral legally sufficient complaint alleging that a licensee under 154 the jurisdiction of the Division of Medical Quality Assurance 155 within the department is impaired as a result of the misuse or 156 abuse of alcohol or drugs, or both, or due to a mental or 157 physical condition which could affect the licensee’s ability to 158 practice with skill and safety, and no complaint against the 159 licensee other than impairment exists, the reporting of such 160 information shall not constitute grounds for discipline pursuant 161 to s. 456.072 or the corresponding grounds for discipline within 162 the applicable practice act if the probable cause panel of the 163 appropriate board, or the department when there is no board, 164 finds: 165 1. The licensee has acknowledged the impairment problem. 166 2. The licensee has voluntarily enrolled in an appropriate, 167 approved treatment program. 168 3. The licensee has voluntarily withdrawn from practice or 169 limited the scope of practice as required by the consultant, in 170 each case, until such time as the panel, or the department when 171 there is no board, is satisfied the licensee has successfully 172 completed an approved treatment program. 173 4. The licensee has executed releases for medical records, 174 authorizing the release of all records of evaluations, 175 diagnoses, and treatment of the licensee, including records of 176 treatment for emotional or mental conditions, to the consultant. 177 The consultant shall make no copies or reports of records that 178 do not regard the issue of the licensee’s impairment and his or 179 her participation in a treatment program. 180 (b) If, however, the department has not received a legally 181 sufficient complaint and the licensee agrees to withdraw from 182 practice until such time as the consultant determines the 183 licensee has satisfactorily completed an approved treatment 184 program or evaluation, the probable cause panel, or the 185 department when there is no board, shall not become involved in 186 the licensee’s case. 187 (c) Inquiries related to impairment treatment programs 188 designed to provide information to the licensee and others and 189 which do not indicate that the licensee presents a danger to the 190 public shall not constitute a complaint within the meaning of s. 191 456.073 and shall be exempt from the provisions of this 192 subsection. 193 (d) Whenever the department receives a legally sufficient 194 complaint alleging that a licensee is impaired as described in 195 paragraph (a) and no complaint against the licensee other than 196 impairment exists, the department shall forward all information 197 in its possession regarding the impaired licensee to the 198 consultant. For the purposes of this section, a suspension from 199 hospital staff privileges due to the impairment does not 200 constitute a complaint. 201 (e) The probable cause panel, or the department when there 202 is no board, shall work directly with the consultant, and all 203 information concerning a practitioner obtained from the 204 consultant by the panel, or the department when there is no 205 board, shall remain confidential and exempt from the provisions 206 of s. 119.07(1), subject to the provisions of subsections(5)207and(6) and (7). 208 (f) A finding of probable cause shall not be made as long 209 as the panel, or the department when there is no board, is 210 satisfied, based upon information it receives from the 211 consultant and the department, that the licensee is progressing 212 satisfactorily in an approved impaired practitioner program and 213 no other complaint against the licensee exists. 214 (5)(4)In any disciplinary action for a violation other 215 than impairment in which a licensee establishes the violation 216 for which the licensee is being prosecuted was due to or 217 connected with impairment and further establishes the licensee 218 is satisfactorily progressing through or has successfully 219 completed an approved treatment program pursuant to this 220 section, such information may be considered by the board, or the 221 department when there is no board, as a mitigating factor in 222 determining the appropriate penalty. This subsection does not 223 limit mitigating factors the board may consider. 224 (6)(5)(a) An approved treatment provider shall, upon 225 request, disclose to the consultant all information in its 226 possession regarding the issue of a licensee’s impairment and 227 participation in the treatment program. All information obtained 228 by the consultant and department pursuant to this section is 229 confidential and exempt from the provisions of s. 119.07(1), 230 subject to the provisions of this subsection and subsection 231 (7)(6). Failure to provide such information to the consultant is 232 grounds for withdrawal of approval of such program or provider. 233 (b) If in the opinion of the consultant, after consultation 234 with the treatment provider, an impaired licensee has not 235 progressed satisfactorily in a treatment program, all 236 information regarding the issue of a licensee’s impairment and 237 participation in a treatment program in the consultant’s 238 possession shall be disclosed to the department. Such disclosure 239 shall constitute a complaint pursuant to the general provisions 240 of s. 456.073. Whenever the consultant concludes that impairment 241 affects a licensee’s practice and constitutes an immediate, 242 serious danger to the public health, safety, or welfare, that 243 conclusion shall be communicated to the State Surgeon General. 244 (7)(6)A consultant, licensee, or approved treatment 245 provider who makes a disclosure pursuant to this section is not 246 subject to civil liability for such disclosure or its 247 consequences. The provisions of s. 766.101 apply to any officer, 248 employee, or agent of the department or the board and to any 249 officer, employee, or agent of any entity with which the 250 department has contracted pursuant to this section. 251 (8)(7)(a) A consultant retained pursuant to subsection (2), 252 a consultant’s officers and employees, and those acting at the 253 direction of the consultant for the limited purpose of an 254 emergency intervention on behalf of a licensee or student as 255 described in subsection (2) when the consultant is unable to 256 perform such intervention shall be considered agents of the 257 department for purposes of s. 768.28 while acting within the 258 scope of the consultant’s duties under the contract with the 259 department if the contract complies with the requirements of 260 this section. The contract must require that: 261 1. The consultant indemnify the state for any liabilities 262 incurred up to the limits set out in chapter 768. 263 2. The consultant establish a quality assurance program to 264 monitor services delivered under the contract. 265 3. The consultant’s quality assurance program, treatment, 266 and monitoring records be evaluated quarterly. 267 4. The consultant’s quality assurance program be subject to 268 review and approval by the department. 269 5. The consultant operate under policies and procedures 270 approved by the department. 271 6. The consultant provide to the department for approval a 272 policy and procedure manual that comports with all statutes, 273 rules, and contract provisions approved by the department. 274 7. The department be entitled to review the records 275 relating to the consultant’s performance under the contract for 276 the purpose of management audits, financial audits, or program 277 evaluation. 278 8. All performance measures and standards be subject to 279 verification and approval by the department. 280 9. The department be entitled to terminate the contract 281 with the consultant for noncompliance with the contract. 282 (b) In accordance with s. 284.385, the Department of 283 Financial Services shall defend any claim, suit, action, or 284 proceeding against the consultant, the consultant’s officers or 285 employees, or those acting at the direction of the consultant 286 for the limited purpose of an emergency intervention on behalf 287 of a licensee or student as described in subsection (2) when the 288 consultant is unable to perform such intervention which is 289 brought as a result of any act or omission by any of the 290 consultant’s officers and employees and those acting under the 291 direction of the consultant for the limited purpose of an 292 emergency intervention on behalf of a licensee or student as 293 described in subsection (2) when the consultant is unable to 294 perform such intervention when such act or omission arises out 295 of and in the scope of the consultant’s duties under its 296 contract with the department. 297 (c) If the consultant retained pursuant to subsection (2) 298 is retained by any other state agency, and if the contract 299 between such state agency and the consultant complies with the 300 requirements of this section, the consultant, the consultant’s 301 officers and employees, and those acting under the direction of 302 the consultant for the limited purpose of an emergency 303 intervention on behalf of a licensee or student as described in 304 subsection (2) when the consultant is unable to perform such 305 intervention shall be considered agents of the state for the 306 purposes of this section while acting within the scope of and 307 pursuant to guidelines established in the contract between such 308 state agency and the consultant. 309 (9) An impaired practitioner consultant is the official 310 custodian of records relating to the referral of an impaired 311 licensee or applicant to that consultant and any other 312 interaction between the licensee or applicant and the 313 consultant. The consultant may disclose to the impaired licensee 314 or applicant or his or her designee any information that is 315 disclosed to or obtained by the consultant or that is 316 confidential under paragraph (6)(a), but only to the extent that 317 it is necessary to do so to carry out the consultant’s duties 318 under this section. The department, and any other entity that 319 enters into a contract with the consultant to receive the 320 services of the consultant, has direct administrative control 321 over the consultant to the extent necessary to receive 322 disclosures from the consultant as allowed by federal law. If a 323 disciplinary proceeding is pending, an impaired licensee may 324 obtain such information from the department under s. 456.073. 325 Section 2. Paragraph (e) of subsection (1) of section 326 458.331, Florida Statutes, is amended to read: 327 458.331 Grounds for disciplinary action; action by the 328 board and department.— 329 (1) The following acts constitute grounds for denial of a 330 license or disciplinary action, as specified in s. 456.072(2): 331 (e) Failing to report to the department any person who the 332 licensee knows is in violation of this chapter or of the rules 333 of the department or the board. A treatment provider approved 334 pursuant to s. 456.076 shall provide the department or 335 consultant with information in accordance with the requirements 336 of s. 456.076(4), (5), (6), (7), and (9)s.456.076(3), (4),337(5), and (6). 338 Section 3. Paragraph (e) of subsection (1) of section 339 459.015, Florida Statutes, is amended to read: 340 459.015 Grounds for disciplinary action; action by the 341 board and department.— 342 (1) The following acts constitute grounds for denial of a 343 license or disciplinary action, as specified in s. 456.072(2): 344 (e) Failing to report to the department or the department’s 345 impaired professional consultant any person who the licensee or 346 certificateholder knows is in violation of this chapter or of 347 the rules of the department or the board. A treatment provider, 348 approved pursuant to s. 456.076, shall provide the department or 349 consultant with information in accordance with the requirements 350 of s. 456.076(4), (5), (6), (7), and (9)s.456.076(3), (4),351(5), and (6). 352 Section 4. Section 468.315, Florida Statutes, is created to 353 read: 354 468.315 Treatment program for impaired radiological 355 personnel.—Radiological personnel who are subject to 356 certification under this part are governed by s. 456.076 as if 357 they were under the jurisdiction of the Division of Medical 358 Quality Assurance. 359 Section 5. This act shall take effect July 1, 2013.