PCS/CS/SB 700:

HB 803 incentivizes physicians to provide pro bono health care services to certain low-income individuals and provides an opportunity for physicians from other jurisdictions and retired physicians to provide health services to low-income and medically underserved individuals in this state. The bill requires Department of Health (DOH) to waive the renewal fee of a physician who demonstrates the provision of at least 160 hours of pro bono medical services to certain populations within the biennial licensure renewal period. Demonstration of 120 hours gains an exemption from the 40 hours of continuing medical education required for license renewal.

The bill authorizes both the Board of Osteopathic Medicine to issue a limited number of restricted licenses to physicians not licensed in Florida who contract to practice for 36 months solely in the employ of the state, a federally funded community health center, a migrant health center, a free clinic, or a health provider in a health professional shortage area or medically underserved area, which mirrors the current authorization by the Board of Medicine. An applicant for a restricted license must hold an active, unencumbered license to practice medicine in another jurisdiction of the U.S. or Canada and pass a background screening. Prior to the end of the 36-month contract, the physician must take and pass the appropriate licensing exam to become fully licensed in this state. Breach of contract precludes full licensure. Such authorization and requirements mirror current law for the Board of Medicine; however, the bill increases the current authorized contracted practice period for restricted licenses issued by the Board of Medicine from 24 months to 36 months.

The bill also creates a registration process for retired physicians to provide volunteer health care services if the physician held an active license status to practice and maintained such license in good standing in this state or in another jurisdiction of the United States or Canada for at least 20 years and contracts with a health care provider to provide free, volunteer health care services to indigent persons or medically underserved populations in a health professional shortage area or medically underserved area. Such a physician must work under the supervision of a non-retired physician who holds an active, unencumbered license, provide only medical services of the type and within the specialty performed by the physician prior to retirement, and not perform surgery or prescribe controlled substances. These physicians are exempt from any application, licensure, unlicensed activity, and renewal fees. Registration must be renewed biennially to demonstrate compliance with registration requirements.

The “Access to Health Care Act” was enacted in 1992 to encourage health care providers to provide care to low-income persons. The bill redefines low-income persons to include individuals that do not have health insurance and have a family inco

CS/CS/SB 582 requires a parent’s permission before a health care practitioner may provide services, prescribe medicine to the child, or perform a medical procedure, unless otherwise provided by law. Current law does provide an exception for written consent for EMS and Emergency Care, and the bill was amended to also include an exemption for side-line urgent care provided by volunteer team physicians.

CS/CS/SB 2006 amends the State Emergency Management Act to better address the threat posed by a pandemic or other public health emergency. The bill:

The Department of Health Office of Minority Health and Health Equity administers multiple health promotion programs including the “Closing the Gap” (CTG) grant program. The grant program was created by the Legislature in 2000 to improve health outcomes and eliminate racial and ethnic health disparities in Florida by providing grants to increase community-based health and disease prevention activities. Grants are awarded for one year through a proposal process, and may be renewed annually subject to the availability of funds and the grantee’s achievement of quality standards, objectives, and outcomes.

Projects funded through the CTG grant program must address racial and ethnic disparities associated with one or more of the following priority areas:

CS/HB 1381 allows the CTG grant program to fund projects directed at decreasing racial and ethnic disparities in severe maternal morbidity and other maternal outcomes. The bill also adds maternal health programs to existing community-based programs the DOH is required to coordinate. The bill creates telehealth minority maternity care pilot programs in Duval and Orange Counties to expand the capacity for positive maternal health outcomes in racial and ethnic minority populations. The pilot programs are required to use telehealth or coordinate with prenatal home visiting programs to provide services and education to eligible pregnant women and provide training to participating health care practitioners and other perinatal professionals. The bill requires that legislative appropriated funds for the CTG grant program be used to fund the pilot programs. The bill also requires that the DOH’s Division of Community Health Promotion and Office of Minority Health an

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).

Current law requires the medical director of an emergency medical services (EMS) provider to issue standing orders and protocols to its EMTs and paramedics to ensure that patients are transported to facilities that offer a type and level of care appropriate to the patient’s medical condition.

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.

CS/HB 397 requires DOH to annually send a list of providers of adult cardiovascular services to the medical director of each licensed EMS provider. It further requires DOH to develop a sample heart attack triage assessment tool to be posted on its website and distributed to each licensed EMS provider. In addition, the bill requires EMS providers to use a substantially similar assessment tool and requires EMS medical directors to develop and implement assessment, treatment, and transport protocols to ensure heart attack patients are transported to the most appropriate hospital. The bill also requires a 911 PST to complete biennial telecommunicator CPR training in order to have their certification renewed. 

CS/HB 157 requires school districts to provide basic training in first aid, including one hour of cardiopulmonary resuscitation (CPR) instruction, for public school students in grades 9 and 11. Basic CPR instruction for students is currently encouraged but not required by state law. The bill provides that the CPR training must be based on a nationally recognized program that uses the most current evidence-based emergency cardiovascular care guidelines. The instruction must allow students to practice the psychomotor skills associated with performing CPR. If a school district has the necessary equipment, students must also be provided instruction in the use of an automated external defibrillator. The bill encourages school districts to provide basic first aid training, including CPR instruction, to students in grades 6 and 8. 

In Florida, minority populations experience higher rates of illness and death from health conditions such as heart disease, stroke, specific cancers, diabetes, HIV/AIDS, mental health, asthma, and obesity. The Office of Minority Health and Health Equity (Office), housed within the Department of Health (DOH), is responsible for helping to improve health and healthcare outcomes for racial and ethnic minority communities by developing or advancing policies, programs, and practices that address health, social, economic, environmental, and other factors which impact health. Under current law, the Office is required to be headed by a Senior Health Equity Officer. The responsibilities of the Senior Health Equity Officer include, but are not limited to, administering the Closing the Gap grant program in a manner that maximizes the impact of the grants in achieving health equity.

CS/HB 183 requires the Office to develop and promote the statewide implementation of policies, programs, and practices that increase health equity for racial and ethnic minority populations in Florida. The bill requires the Office to work with other state agencies, organizations, and providers to improve the health of racial and ethnic minority populations through data analysis and the development of health policies and programs that will help eliminate health disparities. The bill requires one representative from each county health department to serve as a minority health liaison (MHL) and requires MHLs to assist the Office in the implementation of the bill. The bill also authorizes the Office to serve as a liaison to and assist the federal Offices of Minority Health and Regional Health Operations, as appropriate. 

CS/HB 1447 creates a 19-member Commission on Mental Health and Substance Abuse (Commission), adjunct to DCF, to examine the current methods of providing mental health and substance abuse services in the state. The bill requires DCF to provide administrative staff and support services for the commission. Commission members are appointed by the Governor, President of the Senate, and Speaker of the House of Representatives and must convene by September 1, 2021. The bill requires state departments and agencies to provide assistance in a timely manner if requested by the Commission. The Commission must submit an initial report by September 1, 2022, and a final report by September 1, 2023, to the Governor, President of the Senate, and Speaker of the House of Representatives on its findings and recommendations on how to best provide and facilitate mental health and substance abuse services in this state. The Commission is repealed on September 1, 2023, unless it is reenacted by the Legislature. The Commission includes an emergency physician.

HB 627 requires DOH, in partnership with DOEA and the Alzheimer’s Association, to provide information to educate physicians and nursing professionals about Alzheimer’s disease and dementia-related disorders. This effort will occur through existing public health and community outreach programs and include education on:  The importance of early detection and timely diagnosis of cognitive impairment;  Utilization of a validated cognitive assessment tool;  The value of Medicare annual wellness visits for cognitive health;  The use of the Medicare billing code for care planning for individuals with cognitive impairment;  Methods to detect early warning signs of Alzheimer’s disease and other types of dementia; and,  Methods to reduce the risk of cognitive decline, particularly among individuals in diverse communities

During the 1970s and 1980s, medical liability insurance in Florida had become so expensive that, although technically available, it was functionally unavailable. The Florida Legislature determined that obstetrician gynecologists (ob-gyns) disproportionately accounted for medical liability claims, both in number of claims and amount of payout. Some patients became nearly disenfranchised as physicians resisted treating high-risk patients and practicing in certain high-risk specialties altogether. Moreover, in 1985, ob-gyns in Florida paid an average medical malpractice liability premium of $185,460, compared to a national average of $23,300. The Florida Birth-Related Neurological Injury Compensation Plan (Plan) was part of the Legislature's efforts to manage both spiraling medical malpractice costs and diminishing liability insurance availability by creating a hybrid no-fault and tort medical liability system. The Plan pays for the care of infants born with certain neurological injuries and is available to eligible families without litigation. By eliminating costly legal proceedings, the Plan ensures that birth-injured infants receive the care they need while reducing the financial burden on both medical providers and families.

CS/HB 1165 increases the maximum amount that may be awarded to parents or legal guardians of an infant who has sustained a birth-related neurological injury from $100,000 to $250,000 for pending petitions or claims filed under the Plan seeking compensation on or after January 1, 2021. The bill requires the maximum award amount to increase by 3 percent each year on January 1. The bill also increases the death benefit for an infant who sustained a birth-related neurological injury from $10,000 to $50,000.

CS/CS/HB 673 creates “Gail’s Law” to require FDLE, subject to an appropriation and no later than July 1, 2023, to create and maintain a statewide database tracking the location, processing status, and storage of each Sexual Assault Kit (or Rape Kit) collected after the database is implemented. The database must be accessible by law enforcement, alleged victims, and alleged victims’ parents, guardians, or other representatives. The database must track the status of a SAK from its collection throughout the criminal justice process all the way through the kit’s destruction. The bill requires FDLE to adopt rules and that specified entities must participate in the database in accordance with those rules. The bill also requires FDLE to ensure that every victim or victim’s representative is notified that the database exists and is provided with instructions on how to use it. Under the bill, a victim must be notified when the analysis of his or her SAK results in a DNA match, but such notification must not release any identifying information of the match. Such notification may only be delayed up to 180 days if notifying the required persons would negatively affect an investigation. The bill authorizes FDLE to phase in participation according to region, volume of kits, and other criteria, but requires all entities in the chain of custody to fully participate in the statewide database no later than one year after it is created. The bill also requires FDLE to apply for any available grant funds to assist in implementing the database.

CS/CS/HB 523 creates a human trafficking victim advocate-victim privilege which mirrors the privilege provided for sexual assault and domestic violence victim advocates. The bill authorizes a human trafficking victim to seek expunction in multiple jurisdictions at the same time for any offense committed while he or she was a victim of human trafficking and prohibits a clerk of court from charging any fees for a human trafficking victim’s petition for expunction. The bill also clarifies that a human trafficking victim may seek expunction for an arrest or charges filed for specified offenses, but retains current law prohibiting expunction for a conviction of such an offense. The bill amends s. 787.06, F.S., by:

Under the bill, a person convicted of sexually related acts of human trafficking must complete sex offender probation.

CS/CS/SB 1826 creates s. 90.5034, F.S., establishing a privilege for communication between human trafficking victims and human trafficking advocates or trained volunteers. The bill provides that communication between a human trafficking victim advocate or trained volunteer and a human trafficking victim is “confidential,” if it is not intended to be disclosed to third persons, except to specified persons. A human trafficking victim has a privilege to refuse to disclose, and prevent any other person from disclosing such confidential communication or record made in the course of advising, counseling, or providing services to the victim. Additionally, the bill defines the terms “anti-human trafficking organization,” “human trafficking victim advocate,” “trained volunteer,” and “human trafficking victim,” and provides training requirements for human trafficking victim advocates and trained volunteers. The bill amends s. 787.06, F.S., to expand the definition of “human trafficking,” to include the “purchasing, patronizing, [or] procuring” another person for the purpose of exploitation of that person. Additionally, the definition of “obtain,” is amended to mean “in relation to labor, commercial sexual activity, or services, to receive, take possession of, or take custody of another person or secure performance thereof.” The bill expands the scope of specified human trafficking offenses relating to children under 18 years of age to include an adult believed to be under 18 years of age. The bill provides that the Legislature encourages each state attorney to adopt a proprosecution policy for human trafficking offenses, and requires the state attorney to determine whether to file, nonfile, or divert criminal charges even when there is no cooperation from a victim or over the objection of the victim, if necessary. 

The bill also expands the list of offenses in which a court must impose special conditions on probationers or community controllees who are placed under supervision or on community control or sex offender probation for committing a specified human trafficking offense on or after a certain date.

A podiatric physician diagnoses or provides medical, surgical, palliative, and mechanical treatment of ailments affecting the human foot and leg. Podiatric medicine also includes the amputation of toes and other parts of the foot, but does not include amputation of the entire leg or foot. Medical assistants are non-licensed personnel that may assist a physician in all aspects of a medical practice under the direct supervision and responsibility of a physician. Current law does not specifically authorize podiatric physicians to utilize medical assistants in their practices. HB 17 authorizes podiatric physicians to use medical assistants in the same manner and under the same conditions as an allopathic physician. Section 456.0301, F.S., requires health care practitioners with authority to prescribe controlled substances to take a board-approved 2-hour continuing education course on safe and effective prescribing of controlled substances biennially offered by certain statewide professional organizations of physicians. However, if a licensee’s practice act requires the licensee to complete a 2-hour course on safe and effective prescribing of controlled substances, the licensee is exempt from the requirements of s. 456.0301, F.S. Podiatric physicians are required to complete 40 hours of continuing professional education biennially, but their practice act does not specifically require continuing education on controlled substances. The bill requires podiatric physicians to complete a 2-hour continuing education course on safe and effective prescribing of controlled substances as a part of the 40 hours of continuing professional education required for biennial licensure renewal. Podiatric physicians will no longer be subject to the requirements of s. 456.0301, F.S., including the requirement that the course be offered only by certain physician organizations. Currently, patients may enter into direct health care agreements with allopathic physicians, osteopathic physicians, chiropractic physicians, nurses, or dentists, or a health care group practice for the provision of health care services. The bill adds podiatric physicians to the list of health care providers who may offer such agreements.