Bill Amendment: FL S0876 | 2017 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Health Care Practitioners
Status: 2017-05-02 - Laid on Table, companion bill(s) passed, see CS/CS/HB 229 (Ch. 2017-41) [S0876 Detail]
Download: Florida-2017-S0876-Senate_Committee_Amendment_420676.html
Bill Title: Health Care Practitioners
Status: 2017-05-02 - Laid on Table, companion bill(s) passed, see CS/CS/HB 229 (Ch. 2017-41) [S0876 Detail]
Download: Florida-2017-S0876-Senate_Committee_Amendment_420676.html
Florida Senate - 2017 COMMITTEE AMENDMENT Bill No. SB 876 Ì420676<Î420676 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Young) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 88 - 492 4 and insert: 5 (e) “Impairment” means an impairing health condition that 6 is the result of the misuse or abuse of alcohol, drugs, or both, 7 or a mental or physical condition that could affect a 8 practitioner’s ability to practice with skill and safety. 9 (f) “Inability to progress” means a determination by a 10 consultant based on a participant’s response to treatment and 11 prognosis that the participant is unable to safely practice 12 despite compliance with treatment requirements and his or her 13 participant contract. 14 (g) “Material noncompliance” means an act or omission by a 15 participant in violation of his or her participant contract as 16 determined by the department or consultant. 17 (h) “Participant” means a practitioner who is participating 18 in the impaired practitioner program by having entered into a 19 participant contract. A practitioner ceases to be a participant 20 when the participant contract is successfully completed or is 21 terminated for any reason. 22 (i) “Participant contract” means a formal written document 23 outlining the requirements established by a consultant for a 24 participant to successfully complete the impaired practitioner 25 program, including the participant’s monitoring plan. 26 (j) “Practitioner” means a person licensed, registered, 27 certified, or regulated by the department under part III of 28 chapter 401; chapter 457; chapter 458; chapter 459; chapter 460; 29 chapter 461; chapter 462; chapter 463; chapter 464; chapter 465; 30 chapter 466; chapter 467; part I, part II, part III, part V, 31 part X, part XIII, or part XIV of chapter 468; chapter 478; 32 chapter 480; part III or part IV of chapter 483; chapter 484; 33 chapter 486; chapter 490; or chapter 491; or an applicant for a 34 license, registration, or certification under the same laws. 35 (k) “Referral” means a practitioner who has been referred, 36 either as a self-referral or otherwise, or reported to a 37 consultant for impaired practitioner program services, but who 38 is not under a participant contract. 39 (l) “Treatment program” means a department- or consultant 40 approved residential, intensive outpatient, partial 41 hospitalization or other program through which an impaired 42 practitioner is treated based on the impaired practitioner’s 43 diagnosis and the treatment plan approved by the consultant. 44 (m) “Treatment provider” means a department- or consultant 45 approved state-licensed or nationally certified individual who 46 provides treatment to an impaired practitioner based on the 47 practitioner’s individual diagnosis and a treatment plan 48 approved by the consultantFor professions that do not have49impaired practitioner programs provided for in their practice50acts, the department shall, by rule, designate approved impaired51practitioner programs under this section. The department may52adopt rules setting forth appropriate criteria for approval of53treatment providers. The rules may specify the manner in which54the consultant, retained as set forth in subsection (2), works55with the department in intervention, requirements for evaluating56and treating a professional, requirements for continued care of57impaired professionals by approved treatment providers,58continued monitoring by the consultant of the care provided by59approved treatment providers regarding the professionals under60their care, and requirements related to the consultant’s61expulsion of professionals from the program. 62 (2)(a)The department mayshallretain one or moreimpaired63practitionerconsultants to operate its impaired practitioner 64 program. Each consultantwho are each licensees under the65jurisdiction of the Division of Medical Quality Assurance within66the department and whomust be: 67 (a)1.A practitioneror recovered practitionerlicensed 68 under chapter 458, chapter 459, or part I of chapter 464; or 69 (b)2.An entity that employs: 70 1.a.A medical director who ismust be a practitioner or71recovered practitionerlicensed under chapter 458 or chapter 72 459; or 73 2.b.An executive director who ismust be a registered74nurse or a recovered registered nurselicensed under part I of 75 chapter 464. 76 (3) The terms and conditions of the impaired practitioner 77 program must be established by the department by contract with a 78 consultant for the protection of the health, safety, and welfare 79 of the public and must provide, at a minimum, that the 80 consultant: 81 (a) Accepts referrals; 82 (b) Arranges for the evaluation and treatment of impaired 83 practitioners by a treatment provider, when the consultant deems 84 the evaluation and treatment necessary; 85 (c) Monitors the recovery progress and status of impaired 86 practitioners to ensure that such practitioners are able to 87 practice their profession with skill and safety. Such monitoring 88 must continue until the consultant or department concludes that 89 monitoring by the consultant is no longer required for the 90 protection of the public or until the practitioner’s 91 participation in the program is terminated for material 92 noncompliance or inability to progress; and 93 (d) Does not directly evaluate, treat, or otherwise provide 94 patient care to a practitioner in the operation of the impaired 95 practitioner program. 96 (4) The department shall specify, in its contract with each 97 consultant, the types of licenses, registrations, or 98 certifications of the practitioners to be served by that 99 consultant. 100 (5) A consultant shall enter into a participant contract 101 with an impaired practitioner and shall establish the terms of 102 monitoring and shall include the terms in a participant 103 contract. In establishing the terms of monitoring, the 104 consultant may consider the recommendations of one or more 105 approved evaluators, treatment programs, or treatment providers. 106 A consultant may modify the terms of monitoring if the 107 consultant concludes, through the course of monitoring, that 108 extended, additional, or amended terms of monitoring are 109 required for the protection of the health, safety, and welfare 110 of the public. 111 (6)(b)AAn entity retained as an impaired practitioner112 consultantunder this section which employs a medical director113or an executive directoris not required to be licensed as a 114 substance abuse provider or mental health treatment provider 115 under chapter 394, chapter 395, or chapter 397 for purposes of 116 providing services under this program. 117 (7)(c)1.EachTheconsultant shall assist the department 118 and licensure boards on matters of impaired practitioners, 119 including the determination ofprobable cause panel and the120department in carrying out the responsibilities of this section.121This includes working with department investigators to determine122 whether a practitioner is, in fact, impaired, as specified in 123 the consultant’s contract with the department. 1242.The consultant may contract with a school or program to125provide services to a student enrolled for the purpose of126preparing for licensure as a health care practitioner as defined127in this chapter or as a veterinarian under chapter 474 if the128student is allegedly impaired as a result of the misuse or abuse129of alcohol or drugs, or both, or due to a mental or physical130condition. The department is not responsible for paying for the131care provided by approved treatment providers or a consultant.132(d)A medical school accredited by the Liaison Committee on133Medical Education or the Commission on Osteopathic College134Accreditation, or another school providing for the education of135students enrolled in preparation for licensure as a health care136practitioner as defined in this chapter or a veterinarian under137chapter 474 which is governed by accreditation standards138requiring notice and the provision of due process procedures to139students, is not liable in any civil action for referring a140student to the consultant retained by the department or for141disciplinary actions that adversely affect the status of a142student when the disciplinary actions are instituted in143reasonable reliance on the recommendations, reports, or144conclusions provided by such consultant, if the school, in145referring the student or taking disciplinary action, adheres to146the due process procedures adopted by the applicable147accreditation entities and if the school committed no148intentional fraud in carrying out the provisions of this149section.150 (8)(3)Before issuing an approval of, or intent to deny, an 151 application for licensure, each board and profession within the 152 Division of Medical Quality Assurance may delegate to its chair 153 or other designee its authority to determine, before certifying154or declining to certify an application for licensure to the155department,that an applicant for licensure under its 156 jurisdiction may have an impairmentbe impaired as a result of157the misuse or abuse of alcohol or drugs, or both, or due to a158mental or physical condition that could affect the applicant’s159ability to practice with skill and safety. Upon such 160 determination, the chair or other designee may refer the 161 applicant to the consultant to facilitateforan evaluation 162 before the board issues an approval of,certifiesor intent to 163 deny,declines to certifyhis or her applicationto the164department. If the applicant agrees to be evaluatedby the165consultant, the department’s deadline for approving or denying 166 the application pursuant to s. 120.60(1) is tolled until the 167 evaluation is completed and the result of the evaluation and 168 recommendationby the consultantis communicated to the board by 169 the consultant. If the applicant declines to be evaluatedby the170consultant, the board shall issue an approval of, or intent to 171 deny,certify or decline to certifythe applicant’s application 172to the departmentnotwithstanding the lack of an evaluation and 173 recommendation by the consultant. 174 (9)(a)(4)(a)WhenWheneverthe department receives a 175written or orallegally sufficient complaint alleging that a 176 practitioner has an impairmentlicensee under the jurisdiction177of the Division of Medical Quality Assurance within the178department is impaired as a result of the misuse or abuse of179alcohol or drugs, or both, or due to a mental or physical180condition which could affect the licensee’s ability to practice181with skill and safety,and no complaint exists against the 182 practitionerlicenseeother than impairmentexists, the 183 department shall refer the practitioner to the consultant, along 184 with all information in the department’s possession relating to 185 the impairment. The impairment doesreporting of such186information shallnot constitute grounds for discipline pursuant 187 to s. 456.072 orthe corresponding grounds for discipline within188 the applicable practice act ifthe probable cause panel of the189appropriate board, or the department when there is no board,190finds: 191 1. The practitionerlicenseehas acknowledged the 192 impairment;problem.193 2. The practitioner becomes a participantlicensee has194voluntarily enrolledin an impaired practitioner program and 195 successfully completes a participant contract under terms 196 established by the consultant;appropriate, approved treatment197program.198 3. The practitionerlicenseehas voluntarily withdrawn from 199 practice or has limited the scope of his or her practice ifas200 required by the consultant;, in each case, until such time as201the panel, or the department when there is no board, is202satisfied the licensee has successfully completed an approved203treatment program.204 4. The practitionerlicenseehas provided to the 205 consultant, or has authorized the consultant to obtain, all 206 records and information relating to the impairment from any 207 source and all other medical records of the practitioner 208 requested by the consultant; andexecuted releases for medical209records, authorizing the release of all records of evaluations,210diagnoses, and treatment of the licensee, including records of211treatment for emotional or mental conditions, to the consultant.212The consultant shall make no copies or reports of records that213do not regard the issue of the licensee’s impairment and his or214her participation in a treatment program.215 5. The practitioner has authorized the consultant, in the 216 event of the practitioner’s termination from the impaired 217 practitioner program, to report the termination to the 218 department and provide the department with copies of all 219 information in the consultant’s possession relating to the 220 practitioner. 221 (b) To encourage practitioners who are or may be impaired 222 to voluntarily self-refer to a consultant, the consultant may 223 not provide information to the department relating to a self 224 referring participant if the consultant has no knowledge of a 225 pending department investigation, complaint, or disciplinary 226 action against the participant and if the participant is in 227 compliance with the terms of the impaired practitioner program 228 and any participant contract, unless authorized by the 229 participantIf, however, the department has not received a230legally sufficient complaint and the licensee agrees to withdraw231from practice until such time as the consultant determines the232licensee has satisfactorily completed an approved treatment233program or evaluation, the probable cause panel, or the234department when there is no board, shall not become involved in235the licensee’s case. 236(c)Inquiries related to impairment treatment programs237designed to provide information to the licensee and others and238which do not indicate that the licensee presents a danger to the239public shall not constitute a complaint within the meaning of s.240456.073 and shall be exempt from the provisions of this241subsection.242(d)Whenever the department receives a legally sufficient243complaint alleging that a licensee is impaired as described in244paragraph (a) and no complaint against the licensee other than245impairment exists, the department shall forward all information246in its possession regarding the impaired licensee to the247consultant. For the purposes of this section, a suspension from248hospital staff privileges due to the impairment does not249constitute a complaint.250(e)The probable cause panel, or the department when there251is no board, shall work directly with the consultant, and all252information concerning a practitioner obtained from the253consultant by the panel, or the department when there is no254board, shall remain confidential and exempt from the provisions255of s. 119.07(1), subject to the provisions of subsections (6)256and (7).257(f)A finding of probable cause shall not be made as long258as the panel, or the department when there is no board, is259satisfied, based upon information it receives from the260consultant and the department, that the licensee is progressing261satisfactorily in an approved impaired practitioner program and262no other complaint against the licensee exists.263 (10)(5)In any disciplinary action for a violation other 264 than impairment in which a practitionerlicenseeestablishes the 265 violation for which the practitionerlicenseeis being 266 prosecuted was due to or connected with impairment and further 267 establishes the practitionerlicenseeis satisfactorily 268 progressing through or has successfully completed an impaired 269 practitioner programapproved treatment programpursuant to this 270 section, such information may be considered by the board, or the 271 department when there is no board, as a mitigating factor in 272 determining the appropriate penalty. This subsection does not 273 limit mitigating factors the board may consider. 274 (11)(a)(6)(a)Upon request by the consultant, and with the 275 authorization of the practitioner when required by law, an 276 approved evaluator, treatment program, or treatment provider 277 shall, upon request,disclose to the consultant all information 278 in its possession regarding a referral or participantthe issue279of a licensee’s impairment and participation in the treatment280program. All information obtained by the consultant and281department pursuant to this section is confidential and exempt282from the provisions of s. 119.07(1), subject to the provisions283of this subsection and subsection (7). Failure to provide such 284 information to the consultant is grounds for withdrawal of 285 approval of such evaluator, treatment program, or treatment 286 provider. 287 (b) When a referral or participant is terminated from the 288 impaired practitioner program for material noncompliance with a 289 participant contract, inability to progress, or any other 290 reason, the consultant shall discloseIf in the opinion of the291consultant, after consultation with the treatment provider, an292impaired licensee has not progressed satisfactorily in a293treatment program,all informationregarding the issue of a294licensee’s impairment and participation in a treatment program295 in the consultant’s possession relating to the practitioner 296shall be disclosedto the department. Such disclosure shall 297 constitute a complaint pursuant to the general provisions of s. 298 456.073. In addition, whenever the consultant concludes that 299 impairment affects a practitioner’slicensee’spractice and 300 constitutes an immediate, serious danger to the public health, 301 safety, or welfare, the consultant shall immediately communicate 302 suchthatconclusionshall be communicatedto the department and 303 disclose all information in the consultant’s possession relating 304 to the practitioner to the departmentState Surgeon General. 305 (12) All information obtained by the consultant pursuant to 306 this section is confidential and exempt from s. 119.07(1) and s. 307 24(a), Art. I of the State Constitution. 308 (13)(7)A consultant, or a director, officer, employee, or 309 agent of a consultant, may not be held liable financially or may 310 not have a cause of action for damages brought against him or 311 her for making a disclosure pursuant to this section, for any 312 other action or omission relating to the impaired practitioner 313 program, or for the consequences of such disclosure or action or 314 omission, including, without limitation, action by the 315 department against a license, registration, or certification 316licensee, or approved treatment provider who makes a disclosure317pursuant to this section is not subject to civil liability for318such disclosure or its consequences. 319 (14) The provisions of s. 766.101 apply to any consultant 320 and the consultant’s directors, officers, employees, or agents 321 in regards to providing information relating to a participant to 322 a medical review committee if the participant authorizes such 323 disclosureofficer, employee, or agent of the department or the324board and to any officer, employee, or agent of any entity with325which the department has contracted pursuant to this section. 326 (15)(a)(8)(a)A consultant retained pursuant to this 327 section andsubsection (2),a consultant’s directors, officers, 328andemployees, or agentsand those acting at the direction of329the consultant for the limited purpose of an emergency330intervention on behalf of a licensee or student as described in331subsection (2) when the consultant is unable to perform such332interventionshall be considered agents of the department for 333 purposes of s. 768.28 while acting within the scope of the 334 consultant’s duties under the contract with the departmentif335the contract complies with the requirements of this section.The336contract must require that:3371.The consultant indemnify the state for any liabilities338incurred up to the limits set out in chapter 768.3392.The consultant establish a quality assurance program to340monitor services delivered under the contract.3413.The consultant’s quality assurance program, treatment,342and monitoring records be evaluated quarterly.3434.The consultant’s quality assurance program be subject to344review and approval by the department.3455.The consultant operate under policies and procedures346approved by the department.3476.The consultant provide to the department for approval a348policy and procedure manual that comports with all statutes,349rules, and contract provisions approved by the department.3507.The department be entitled to review the records351relating to the consultant’s performance under the contract for352the purpose of management audits, financial audits, or program353evaluation.3548.All performance measures and standards be subject to355verification and approval by the department.3569.The department be entitled to terminate the contract357with the consultant for noncompliance with the contract.358 (b) In accordance with s. 284.385, the Department of 359 Financial Services shall defend any claim, suit, action, or 360 proceeding, including a claim, suit, action, or proceeding for 361 injunctive, affirmative, or declaratory relief, against the 362 consultant, or the consultant’s directors, officers,or363 employees, and agents brought as the result of any action or 364 omission relating to the impaired practitioner programor those365acting at the direction of the consultant for the limited366purpose of an emergency intervention on behalf of a licensee or367student as described in subsection (2) when the consultant is368unable to perform such intervention, which claim, suit, action,369or proceeding is brought as a result of an act or omission by370any of the consultant’s officers and employees and those acting371under the direction of the consultant for the limited purpose of372an emergency intervention on behalf of the licensee or student373when the consultant is unable to perform such intervention, if374the act or omission arises out of and is in the scope of the375consultant’s duties under its contract with the department. 376 (16)(c)If atheconsultant retained by the department 377 pursuant to this sectionsubsection (2)is also retained by 378 anotherany otherstate agency to operate an impaired 379 practitioner program for that agency, this section also applies 380 to the consultant’s operation of an impaired practitioner 381 program for that agency, and if the contract between such state382agency and the consultant complies with the requirements of this383section, the consultant, the consultant’s officers and384employees, and those acting under the direction of the385consultant for the limited purpose of an emergency intervention386on behalf of a licensee or student as described in subsection387(2) when the consultant is unable to perform such intervention388shall be considered agents of the state for the purposes of this389section while acting within the scope of and pursuant to390guidelines established in the contract between such state agency391and the consultant. 392 (17)(9)AAn impaired practitioner consultant is the393official custodian of records relating to the referral of an394impaired licensee or applicant to that consultant and any other395interaction between the licensee or applicant and the396consultant. Theconsultant may disclose to a referral or 397 participant documents, records, or other information from the 398 consultant’s file on the referral or participantthe impaired399licensee or applicant or his or her designee any information400that is disclosed to or obtained by the consultant or that is401confidential under paragraph (6)(a), but onlyto the extent that 402 it is necessary to do so to carry out the consultant’s duties 403 under the impaired practitioner program and this section, or as 404 otherwise required by law.The department, and any other entity405that enters into a contract with the consultant to receive the406services of the consultant, has direct administrative control407over the consultant to the extent necessary to receive408disclosures from the consultant as allowed by federal law.If a 409 disciplinary proceeding is pending, a referral or participant 410 may obtain a complete copy of the consultant’s file from the 411 department as provided byan impaired licensee may obtain such412information from the department unders. 456.073. 413 (18)(a) The consultant may contract with a school or 414 415 ================= T I T L E A M E N D M E N T ================ 416 And the title is amended as follows: 417 Delete line 26 418 and insert: 419 practitioners; making technical changes; requiring the 420 department to refer