Bill Amendment: FL H0977 | 2016 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Behavioral Health Workforce
Status: 2016-04-14 - Chapter No. 2016-231, companion bill(s) passed, see HB 423 (Ch. 2016-224) [H0977 Detail]
Download: Florida-2016-H0977-Senate_Floor_Amendment_Delete_All_848478.html
Bill Title: Behavioral Health Workforce
Status: 2016-04-14 - Chapter No. 2016-231, companion bill(s) passed, see HB 423 (Ch. 2016-224) [H0977 Detail]
Download: Florida-2016-H0977-Senate_Floor_Amendment_Delete_All_848478.html
Florida Senate - 2016 SENATOR AMENDMENT Bill No. CS for HB 977 Ì848478`Î848478 LEGISLATIVE ACTION Senate . House . . . Floor: 1/AE/2R . 03/09/2016 07:24 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Grimsley moved the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 394.453, Florida Statutes, is amended to 6 read: 7 394.453 Legislative intent.—It is the intent of the 8 Legislature to authorize and direct the Department of Children 9 and Families to evaluate, research, plan, and recommend to the 10 Governor and the Legislature programs designed to reduce the 11 occurrence, severity, duration, and disabling aspects of mental, 12 emotional, and behavioral disorders. It is the intent of the 13 Legislature that treatment programs for such disorders shall 14 include, but not be limited to, comprehensive health, social, 15 educational, and rehabilitative services to persons requiring 16 intensive short-term and continued treatment in order to 17 encourage them to assume responsibility for their treatment and 18 recovery. It is intended that such persons be provided with 19 emergency service and temporary detention for evaluation when 20 required; that they be admitted to treatment facilities on a 21 voluntary basis when extended or continuing care is needed and 22 unavailable in the community; that involuntary placement be 23 provided only when expert evaluation determines that it is 24 necessary; that any involuntary treatment or examination be 25 accomplished in a setting which is clinically appropriate and 26 most likely to facilitate the person’s return to the community 27 as soon as possible; and that individual dignity and human 28 rights be guaranteed to all persons who are admitted to mental 29 health facilities or who are being held under s. 394.463. It is 30 the further intent of the Legislature that the least restrictive 31 means of intervention be employed based on the individual needs 32 of each person, within the scope of available services. It is 33 the policy of this state that the use of restraint and seclusion 34 on clients is justified only as an emergency safety measure to 35 be used in response to imminent danger to the client or others. 36 It is, therefore, the intent of the Legislature to achieve an 37 ongoing reduction in the use of restraint and seclusion in 38 programs and facilities serving persons with mental illness. The 39 Legislature further finds the need for additional psychiatrists 40 to be of critical state concern and recommends the establishment 41 of an additional psychiatry program to be offered by one of 42 Florida’s schools of medicine currently not offering psychiatry. 43 The program shall seek to integrate primary care and psychiatry 44 and other evolving models of care for persons with mental health 45 and substance use disorders. Additionally, the Legislature finds 46 that the use of telemedicine for patient evaluation, case 47 management, and ongoing care will improve management of patient 48 care and reduce costs of transportation. 49 Section 2. Subsection (2) of section 394.467, Florida 50 Statutes, is amended to read: 51 394.467 Involuntary inpatient placement.— 52 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be 53 retained by a receiving facility or involuntarily placed in a 54 treatment facility upon the recommendation of the administrator 55 of the receiving facility where the patient has been examined 56 and after adherence to the notice and hearing procedures 57 provided in s. 394.4599. The recommendation must be supported by 58 the opinion of a psychiatrist and the second opinion of a 59 clinical psychologist or another psychiatrist, both of whom have 60 personally examined the patient within the preceding 72 hours, 61 that the criteria for involuntary inpatient placement are met. 62 However,in a county that has a population of fewer than 50,000,63 if the administrator certifies that a psychiatrist or clinical 64 psychologist is not available to provide the second opinion, the 65 second opinion may be provided by a licensed physician who has 66 postgraduate training and experience in diagnosis and treatment 67 of mental and nervous disorders or by a psychiatric nurse. Any 68secondopinion authorized in this subsection may be conducted 69 through a face-to-face examination, in person or by electronic 70 means. Such recommendation shall be entered on an involuntary 71 inpatient placement certificate that authorizes the receiving 72 facility to retain the patient pending transfer to a treatment 73 facility or completion of a hearing. 74 Section 3. Paragraphs (e) and (f) of subsection (1) and 75 paragraph (b) of subsection (4) of section 397.451, Florida 76 Statutes, are amended to read: 77 397.451 Background checks of service provider personnel.— 78 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND 79 EXCEPTIONS.— 80 (e) Personnel employed directly or under contract with the 81 Department of Corrections in an inmate substance abuse program 82who have direct contact with unmarried inmates under the age of8318 or with inmates who are developmentally disabledare exempt 84 from the fingerprinting and background check requirements of 85 this section unless they have direct contact with unmarried 86 inmates under the age of 18 or with inmates who are 87 developmentally disabled. 88 (f) Service provider personnel who request an exemption 89 from disqualification must submit the request within 30 days 90 after being notified of the disqualification. If 5 years or more 91 have elapsed since the most recent disqualifying offense, 92 service provider personnel may work with adults with substance 93 use disorders under the supervision of a qualified professional 94 licensed under chapter 490 or chapter 491 or a master’s level 95 certified addiction professional until the agency makes a final 96 determination regarding the request for an exemption from 97 disqualificationUpon notification of the disqualification, the98service provider shall comply with requirements regarding99exclusion from employment in s. 435.06. 100 (4) EXEMPTIONS FROM DISQUALIFICATION.— 101 (b) Since rehabilitated substance abuse impaired persons 102 are effective in the successful treatment and rehabilitation of 103 individuals with substance use disorderssubstance abuse104impaired adolescents, for service providers which treat 105 adolescents 13 years of age and older, service provider 106 personnel whose background checks indicate crimes under s. 107 817.563, s. 893.13, or s. 893.147 may be exempted from 108 disqualification from employment pursuant to this paragraph. 109 Section 4. Paragraph (g) is added to subsection (1) of 110 section 456.44, Florida Statutes, and subsections (2) and (3) of 111 that section are amended, to read: 112 456.44 Controlled substance prescribing.— 113 (1) DEFINITIONS.—As used in this section, the term: 114 (g) “Registrant” means a physician who meets the 115 requirements of subsection (2). 116 (2) REGISTRATION.—Effective January 1, 2012,A physician 117 licensed under chapter 458, chapter 459, chapter 461, or chapter 118 466 who prescribes any controlled substance, listed in Schedule 119 II, Schedule III, or Schedule IV as defined in s. 893.03, for 120 the treatment of chronic nonmalignant pain, must: 121 (a) Designate himself or herself as a controlled substance 122 prescribing practitioner on his or herthe physician’s123 practitioner profile. 124 (b) Comply with the requirements of this section and 125 applicable board rules. 126 (3) STANDARDS OF PRACTICE.—The standards of practice in 127 this section do not supersede the level of care, skill, and 128 treatment recognized in general law related to health care 129 licensure. 130 (a) A complete medical history and a physical examination 131 must be conducted before beginning any treatment and must be 132 documented in the medical record. The exact components of the 133 physical examination shall be left to the judgment of the 134 registrantclinicianwho is expected to perform a physical 135 examination proportionate to the diagnosis that justifies a 136 treatment. The medical record must, at a minimum, document the 137 nature and intensity of the pain, current and past treatments 138 for pain, underlying or coexisting diseases or conditions, the 139 effect of the pain on physical and psychological function, a 140 review of previous medical records, previous diagnostic studies, 141 and history of alcohol and substance abuse. The medical record 142 shall also document the presence of one or more recognized 143 medical indications for the use of a controlled substance. Each 144 registrant must develop a written plan for assessing each 145 patient’s risk of aberrant drug-related behavior, which may 146 include patient drug testing. Registrants must assess each 147 patient’s risk for aberrant drug-related behavior and monitor 148 that risk on an ongoing basis in accordance with the plan. 149 (b) Each registrant must develop a written individualized 150 treatment plan for each patient. The treatment plan shall state 151 objectives that will be used to determine treatment success, 152 such as pain relief and improved physical and psychosocial 153 function, and shall indicate if any further diagnostic 154 evaluations or other treatments are planned. After treatment 155 begins, the registrantphysicianshall adjust drug therapy to 156 the individual medical needs of each patient. Other treatment 157 modalities, including a rehabilitation program, shall be 158 considered depending on the etiology of the pain and the extent 159 to which the pain is associated with physical and psychosocial 160 impairment. The interdisciplinary nature of the treatment plan 161 shall be documented. 162 (c) The registrantphysicianshall discuss the risks and 163 benefits of the use of controlled substances, including the 164 risks of abuse and addiction, as well as physical dependence and 165 its consequences, with the patient, persons designated by the 166 patient, or the patient’s surrogate or guardian if the patient 167 is incompetent. The registrantphysicianshall use a written 168 controlled substance agreement between the registrantphysician169 and the patient outlining the patient’s responsibilities, 170 including, but not limited to: 171 1. Number and frequency of controlled substance 172 prescriptions and refills. 173 2. Patient compliance and reasons for which drug therapy 174 may be discontinued, such as a violation of the agreement. 175 3. An agreement that controlled substances for the 176 treatment of chronic nonmalignant pain shall be prescribed by a 177 single treating registrantphysicianunless otherwise authorized 178 by the treating registrantphysicianand documented in the 179 medical record. 180 (d) The patient shall be seen by the registrantphysician181 at regular intervals, not to exceed 3 months, to assess the 182 efficacy of treatment, ensure that controlled substance therapy 183 remains indicated, evaluate the patient’s progress toward 184 treatment objectives, consider adverse drug effects, and review 185 the etiology of the pain. Continuation or modification of 186 therapy shall depend on the registrant’sphysician’sevaluation 187 of the patient’s progress. If treatment goals are not being 188 achieved, despite medication adjustments, the registrant 189physicianshall reevaluate the appropriateness of continued 190 treatment. The registrantphysicianshall monitor patient 191 compliance in medication usage, related treatment plans, 192 controlled substance agreements, and indications of substance 193 abuse or diversion at a minimum of 3-month intervals. 194 (e) The registrantphysicianshall refer the patient as 195 necessary for additional evaluation and treatment in order to 196 achieve treatment objectives. Special attention shall be given 197 to those patients who are at risk for misusing their medications 198 and those whose living arrangements pose a risk for medication 199 misuse or diversion. The management of pain in patients with a 200 history of substance abuse or with a comorbid psychiatric 201 disorder requires extra care, monitoring, and documentation and 202 requires consultation with or referral to an addiction medicine 203 specialist or a psychiatrist. 204 (f) A registrantphysician registered under this section205 must maintain accurate, current, and complete records that are 206 accessible and readily available for review and comply with the 207 requirements of this section, the applicable practice act, and 208 applicable board rules. The medical records must include, but 209 are not limited to: 210 1. The complete medical history and a physical examination, 211 including history of drug abuse or dependence. 212 2. Diagnostic, therapeutic, and laboratory results. 213 3. Evaluations and consultations. 214 4. Treatment objectives. 215 5. Discussion of risks and benefits. 216 6. Treatments. 217 7. Medications, including date, type, dosage, and quantity 218 prescribed. 219 8. Instructions and agreements. 220 9. Periodic reviews. 221 10. Results of any drug testing. 222 11. A photocopy of the patient’s government-issued photo 223 identification. 224 12. If a written prescription for a controlled substance is 225 given to the patient, a duplicate of the prescription. 226 13. The registrant’sphysician’sfull name presented in a 227 legible manner. 228 (g) A registrant shall immediately refer patients with 229 signs or symptoms of substance abuseshall be immediately230referredto a board-certified pain management physician, an 231 addiction medicine specialist, or a mental health addiction 232 facility as it pertains to drug abuse or addiction unless the 233 registrant is a physician who is board-certified or board- 234 eligible in pain management. Throughout the period of time 235 before receiving the consultant’s report, a prescribing 236 registrantphysicianshall clearly and completely document 237 medical justification for continued treatment with controlled 238 substances and those steps taken to ensure medically appropriate 239 use of controlled substances by the patient. Upon receipt of the 240 consultant’s written report, the prescribing registrant 241physicianshall incorporate the consultant’s recommendations for 242 continuing, modifying, or discontinuing controlled substance 243 therapy. The resulting changes in treatment shall be 244 specifically documented in the patient’s medical record. 245 Evidence or behavioral indications of diversion shall be 246 followed by discontinuation of controlled substance therapy, and 247 the patient shall be discharged, and all results of testing and 248 actions taken by the registrantphysicianshall be documented in 249 the patient’s medical record. 250 251 This subsection does not apply to a board-eligible or board 252 certified anesthesiologist, physiatrist, rheumatologist, or 253 neurologist, or to a board-certified physician who has surgical 254 privileges at a hospital or ambulatory surgery center and 255 primarily provides surgical services. This subsection does not 256 apply to a board-eligible or board-certified medical specialist 257 who has also completed a fellowship in pain medicine approved by 258 the Accreditation Council for Graduate Medical Education or the 259 American Osteopathic Association, or who is board eligible or 260 board certified in pain medicine by the American Board of Pain 261 Medicine, the American Board of Interventional Pain Physicians, 262 the American Association of Physician Specialists, or a board 263 approved by the American Board of Medical Specialties or the 264 American Osteopathic Association and performs interventional 265 pain procedures of the type routinely billed using surgical 266 codes. This subsection does not apply to a registrantphysician267 who prescribes medically necessary controlled substances for a 268 patient during an inpatient stay in a hospital licensed under 269 chapter 395. 270 Section 5. Paragraph (b) of subsection (2) of section 271 458.3265, Florida Statutes, is amended to read: 272 458.3265 Pain-management clinics.— 273 (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities 274 apply to any physician who provides professional services in a 275 pain-management clinic that is required to be registered in 276 subsection (1). 277 (b) Onlya person may not dispense any medication on the278premises of a registered pain-management clinic unless he or she279isa physician licensed under this chapter or chapter 459 may 280 dispense medication or prescribe a controlled substance 281 regulated under chapter 893 on the premises of a registered 282 pain-management clinic. 283 Section 6. Paragraph (b) of subsection (2) of section 284 459.0137, Florida Statutes, is amended to read: 285 459.0137 Pain-management clinics.— 286 (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities 287 apply to any osteopathic physician who provides professional 288 services in a pain-management clinic that is required to be 289 registered in subsection (1). 290 (b) Onlya person may not dispense any medication on the291premises of a registered pain-management clinic unless he or she292isa physician licensed under this chapter or chapter 458 may 293 dispense medication or prescribe a controlled substance 294 regulated under chapter 893 on the premises of a registered 295 pain-management clinic. 296 Section 7. Section 464.012, Florida Statutes, is amended to 297 read: 298 464.012 Certification of advanced registered nurse 299 practitioners; fees.— 300 (1) Any nurse desiring to be certified as an advanced 301 registered nurse practitioner shall apply to the department and 302 submit proof that he or she holds a current license to practice 303 professional nursing and that he or she meets one or more of the 304 following requirements as determined by the board: 305 (a) Satisfactory completion of a formal postbasic 306 educational program of at least one academic year, the primary 307 purpose of which is to prepare nurses for advanced or 308 specialized practice. 309 (b) Certification by an appropriate specialty board. Such 310 certification shall be required for initial state certification 311 and any recertification as a registered nurse anesthetist, 312 psychiatric nurse, or nurse midwife. The board may by rule 313 provide for provisional state certification of graduate nurse 314 anesthetists, psychiatric nurses, and nurse midwives for a 315 period of time determined to be appropriate for preparing for 316 and passing the national certification examination. 317 (c) Graduation from a program leading to a master’s degree 318 in a nursing clinical specialty area with preparation in 319 specialized practitioner skills. For applicants graduating on or 320 after October 1, 1998, graduation from a master’s degree program 321 shall be required for initial certification as a nurse 322 practitioner under paragraph (4)(c). For applicants graduating 323 on or after October 1, 2001, graduation from a master’s degree 324 program shall be required for initial certification as a 325 registered nurse anesthetist under paragraph (4)(a). 326 (2) The board shall provide by rule the appropriate 327 requirements for advanced registered nurse practitioners in the 328 categories of certified registered nurse anesthetist, certified 329 nurse midwife, and nurse practitioner. 330 (3) An advanced registered nurse practitioner shall perform 331 those functions authorized in this section within the framework 332 of an established protocol that is filed with the board upon 333 biennial license renewal and within 30 days after entering into 334 a supervisory relationship with a physician or changes to the 335 protocol. The board shall review the protocol to ensure 336 compliance with applicable regulatory standards for protocols. 337 The board shall refer to the department licensees submitting 338 protocols that are not compliant with the regulatory standards 339 for protocols. A practitioner currently licensed under chapter 340 458, chapter 459, or chapter 466 shall maintain supervision for 341 directing the specific course of medical treatment. Within the 342 established framework, an advanced registered nurse practitioner 343 may: 344 (a) Monitor and alter drug therapies. 345 (b) Initiate appropriate therapies for certain conditions. 346 (c) Perform additional functions as may be determined by 347 rule in accordance with s. 464.003(2). 348 (d) Order diagnostic tests and physical and occupational 349 therapy. 350 (4) In addition to the general functions specified in 351 subsection (3), an advanced registered nurse practitioner may 352 perform the following acts within his or her specialty: 353 (a) The certified registered nurse anesthetist may, to the 354 extent authorized by established protocol approved by the 355 medical staff of the facility in which the anesthetic service is 356 performed, perform any or all of the following: 357 1. Determine the health status of the patient as it relates 358 to the risk factors and to the anesthetic management of the 359 patient through the performance of the general functions. 360 2. Based on history, physical assessment, and supplemental 361 laboratory results, determine, with the consent of the 362 responsible physician, the appropriate type of anesthesia within 363 the framework of the protocol. 364 3. Order under the protocol preanesthetic medication. 365 4. Perform under the protocol procedures commonly used to 366 render the patient insensible to pain during the performance of 367 surgical, obstetrical, therapeutic, or diagnostic clinical 368 procedures. These procedures include ordering and administering 369 regional, spinal, and general anesthesia; inhalation agents and 370 techniques; intravenous agents and techniques; and techniques of 371 hypnosis. 372 5. Order or perform monitoring procedures indicated as 373 pertinent to the anesthetic health care management of the 374 patient. 375 6. Support life functions during anesthesia health care, 376 including induction and intubation procedures, the use of 377 appropriate mechanical supportive devices, and the management of 378 fluid, electrolyte, and blood component balances. 379 7. Recognize and take appropriate corrective action for 380 abnormal patient responses to anesthesia, adjunctive medication, 381 or other forms of therapy. 382 8. Recognize and treat a cardiac arrhythmia while the 383 patient is under anesthetic care. 384 9. Participate in management of the patient while in the 385 postanesthesia recovery area, including ordering the 386 administration of fluids and drugs. 387 10. Place special peripheral and central venous and 388 arterial lines for blood sampling and monitoring as appropriate. 389 (b) The certified nurse midwife may, to the extent 390 authorized by an established protocol which has been approved by 391 the medical staff of the health care facility in which the 392 midwifery services are performed, or approved by the nurse 393 midwife’s physician backup when the delivery is performed in a 394 patient’s home, perform any or all of the following: 395 1. Perform superficial minor surgical procedures. 396 2. Manage the patient during labor and delivery to include 397 amniotomy, episiotomy, and repair. 398 3. Order, initiate, and perform appropriate anesthetic 399 procedures. 400 4. Perform postpartum examination. 401 5. Order appropriate medications. 402 6. Provide family-planning services and well-woman care. 403 7. Manage the medical care of the normal obstetrical 404 patient and the initial care of a newborn patient. 405 (c) The nurse practitioner may perform any or all of the 406 following acts within the framework of established protocol: 407 1. Manage selected medical problems. 408 2. Order physical and occupational therapy. 409 3. Initiate, monitor, or alter therapies for certain 410 uncomplicated acute illnesses. 411 4. Monitor and manage patients with stable chronic 412 diseases. 413 5. Establish behavioral problems and diagnosis and make 414 treatment recommendations. 415 (5) A psychiatric nurse, as defined in s. 394.455, within 416 the framework of an established protocol with a psychiatrist, 417 may prescribe psychotropic controlled substances for the 418 treatment of mental disorders. 419 (6) The board shall certify, and the department shall issue 420 a certificate to, any nurse meeting the qualifications in this 421 section. The board shall establish an application fee not to 422 exceed $100 and a biennial renewal fee not to exceed $50. The 423 board is authorized to adopt such other rules as are necessary 424 to implement the provisions of this section. 425 Section 8. Paragraph (p) is added to subsection (1) of 426 section 464.018, Florida Statutes, and subsection (2) of that 427 section is republished, to read: 428 464.018 Disciplinary actions.— 429 (1) The following acts constitute grounds for denial of a 430 license or disciplinary action, as specified in s. 456.072(2): 431 (p) For a psychiatric nurse: 432 1. Presigning blank prescription forms. 433 2. Prescribing for office use any medicinal drug appearing 434 in Schedule II of s. 893.03. 435 3. Prescribing, ordering, dispensing, administering, 436 supplying, selling, or giving a drug that is an amphetamine, a 437 sympathomimetic amine drug, or a compound designated in s. 438 893.03(2) as a Schedule II controlled substance, to or for any 439 person except for: 440 a. The treatment of narcolepsy; hyperkinesis; behavioral 441 syndrome in children characterized by the developmentally 442 inappropriate symptoms of moderate to severe distractibility, 443 short attention span, hyperactivity, emotional lability, and 444 impulsivity; or drug-induced brain dysfunction. 445 b. The differential diagnostic psychiatric evaluation of 446 depression or the treatment of depression shown to be refractory 447 to other therapeutic modalities. 448 c. The clinical investigation of the effects of such drugs 449 or compounds when an investigative protocol is submitted to, 450 reviewed by, and approved by the department before such 451 investigation is begun. 452 4. Prescribing, ordering, dispensing, administering, 453 supplying, selling, or giving growth hormones, testosterone or 454 its analogs, human chorionic gonadotropin (HCG), or other 455 hormones for the purpose of muscle building or to enhance 456 athletic performance. As used in this subparagraph, the term 457 “muscle building” does not include the treatment of injured 458 muscle. A prescription written for the drug products identified 459 in this subparagraph may be dispensed by a pharmacist with the 460 presumption that the prescription is for legitimate medical use. 461 5. Promoting or advertising on any prescription form a 462 community pharmacy unless the form also states: “This 463 prescription may be filled at any pharmacy of your choice.” 464 6. Prescribing, dispensing, administering, mixing, or 465 otherwise preparing a legend drug, including a controlled 466 substance, other than in the course of his or her professional 467 practice. For the purposes of this subparagraph, it is legally 468 presumed that prescribing, dispensing, administering, mixing, or 469 otherwise preparing legend drugs, including all controlled 470 substances, inappropriately or in excessive or inappropriate 471 quantities is not in the best interest of the patient and is not 472 in the course of the advanced registered nurse practitioner’s 473 professional practice, without regard to his or her intent. 474 7. Prescribing, dispensing, or administering a medicinal 475 drug appearing on any schedule set forth in chapter 893 to 476 himself or herself, except a drug prescribed, dispensed, or 477 administered to the psychiatric nurse by another practitioner 478 authorized to prescribe, dispense, or administer medicinal 479 drugs. 480 8. Prescribing, ordering, dispensing, administering, 481 supplying, selling, or giving amygdalin (laetrile) to any 482 person. 483 9. Dispensing a substance designated in s. 893.03(2) or (3) 484 as a substance controlled in Schedule II or Schedule III, 485 respectively, in violation of s. 465.0276. 486 10. Promoting or advertising through any communication 487 medium the use, sale, or dispensing of a substance designated in 488 s. 893.03 as a controlled substance. 489 (2) The board may enter an order denying licensure or 490 imposing any of the penalties in s. 456.072(2) against any 491 applicant for licensure or licensee who is found guilty of 492 violating any provision of subsection (1) of this section or who 493 is found guilty of violating any provision of s. 456.072(1). 494 Section 9. Subsection (21) of section 893.02, Florida 495 Statutes, is amended to read: 496 893.02 Definitions.—The following words and phrases as used 497 in this chapter shall have the following meanings, unless the 498 context otherwise requires: 499 (21) “Practitioner” means a physician licensed pursuant to 500 chapter 458, a dentist licensed pursuant to chapter 466, a 501 veterinarian licensed pursuant to chapter 474, an osteopathic 502 physician licensed pursuant to chapter 459, a naturopath 503 licensed pursuant to chapter 462, a certified optometrist 504 licensed pursuant to chapter 463, a psychiatric nurse as defined 505 in s. 394.455, or a podiatric physician licensed pursuant to 506 chapter 461, provided such practitioner holds a valid federal 507 controlled substance registry number. 508 Section 10. This act shall take effect upon becoming a law. 509 ================= T I T L E A M E N D M E N T ================ 510 And the title is amended as follows: 511 Delete everything before the enacting clause 512 and insert: 513 A bill to be entitled 514 An act relating to behavioral health workforce; 515 amending s. 394.453, F.S.; revising legislative 516 intent; amending s. 394.467, F.S.; authorizing a 517 second opinion for admission to a treatment facility 518 to be provided by certain licensed physicians in all 519 counties, rather than counties with a specified 520 population size; revising procedures for recommending 521 admission of a patient to a treatment facility; 522 amending s. 397.451, F.S.; revising provisions 523 relating to personnel background checks and exemptions 524 from disqualification for certain service provider 525 personnel; amending s. 456.44, F.S.; defining the term 526 “registrant”; requiring psychiatric nurses to make 527 certain designations and comply with certain 528 requirements under specified circumstances; amending 529 s. 458.3265, F.S.; restricting to physicians the 530 authorization to dispense certain medications or 531 prescribe certain controlled substances on the 532 premises of a registered pain-management clinic; 533 amending s. 459.0137, F.S.; restricting to osteopathic 534 physicians the authorization to dispense certain 535 medications or prescribe certain controlled substances 536 on the premises of a registered pain-management 537 clinic; amending s. 464.012, F.S.; providing 538 certification criteria for psychiatric nurses; 539 authorizing psychiatric nurses to prescribe certain 540 psychotropic controlled substances under certain 541 circumstances; amending s. 464.018, F.S.; providing 542 that certain acts by a psychiatric nurse constitute 543 grounds for denial of a license or disciplinary 544 action; amending s. 893.02, F.S.; revising the 545 definition of the term “practitioner”; providing an 546 effective date.