Bill Text: FL S0188 | 2019 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Department of Health

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Failed) 2019-05-03 - Died in returning Messages, companion bill(s) passed, see CS/CS/CS/HB 851 (Ch. 2019-152) [S0188 Detail]

Download: Florida-2019-S0188-Introduced.html
       Florida Senate - 2019                                     SB 188
       
       
        
       By Senator Harrell
       
       
       
       
       
       25-00662A-19                                           2019188__
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health; amending
    3         s. 381.4018, F.S.; authorizing the Department of
    4         Health to adopt certain rules; amending s. 456.013,
    5         F.S.; revising health care practitioner licensure
    6         application requirements; amending s. 458.3312, F.S.;
    7         removing a provision prohibiting a physician from
    8         representing himself or herself as a board-certified
    9         specialist in dermatology unless the recognizing
   10         agency is reviewed and reauthorized on a specified
   11         basis by the Board of Medicine; amending s. 458.347,
   12         F.S.; requiring a licensed physician assistant to
   13         report any changes in his or her supervising physician
   14         or designated supervising physician within a specified
   15         timeframe; authorizing a licensed physician assistant
   16         to practice under the supervision of a physician other
   17         than the designated physician, under specified
   18         circumstances; amending s. 459.0055, F.S.; revising
   19         licensure requirements for a person seeking licensure
   20         or certification as an osteopathic physician; amending
   21         s. 459.022, F.S.; requiring a licensed physician
   22         assistant to report any changes in his or her
   23         supervising physician or designated supervising
   24         physician within a specified timeframe; authorizing a
   25         physician assistant to practice under the supervision
   26         of a physician other than the designated physician,
   27         under specified circumstances; amending s. 460.408,
   28         F.S.; defining the term “contact classroom hour”;
   29         revising provisions relating to continuing
   30         chiropractic education requirements; repealing s.
   31         460.4166, F.S., relating to registered chiropractic
   32         assistants; amending s. 464.202, F.S.; requiring the
   33         Board of Nursing to adopt rules that include
   34         disciplinary procedures and standards of practice for
   35         certified nursing assistants; amending s. 464.203,
   36         F.S.; revising certification requirements for nursing
   37         assistants; amending s. 464.204, F.S.; revising
   38         grounds for board-imposed disciplinary sanctions;
   39         amending s. 466.006, F.S.; revising certain
   40         requirements for examinations to be completed by
   41         applicants seeking dental licensure; amending s.
   42         466.007, F.S.; revising requirements for examinations
   43         of dental hygienists; amending s. 466.017, F.S.;
   44         providing adverse incident reporting requirements;
   45         providing for disciplinary action by the Board of
   46         Dentistry; defining the term “adverse incident”;
   47         authorizing the board to adopt rules; amending s.
   48         466.031, F.S.; expanding the definition of the term
   49         “dental laboratory” to include any person, firm, or
   50         corporation that performs an onsite consultation
   51         during dental procedures; amending s. 466.036, F.S.;
   52         revising inspection frequency of dental laboratories
   53         during a specified period; amending s. 468.701, F.S.;
   54         revising the definition of the term “athletic trainer”
   55         for the purpose of relocating an existing requirement;
   56         amending s. 468.707, F.S.; revising athletic trainer
   57         licensure requirements; amending s. 468.711, F.S.;
   58         requiring certain licensees to maintain certification
   59         in good standing without lapse to renew their athletic
   60         trainer license; amending s. 468.713, F.S.; requiring
   61         that an athletic trainer work within a specified scope
   62         of practice; relocating an existing requirement;
   63         amending s. 468.723, F.S.; requiring the direct
   64         supervision of an athletic training student to be in
   65         accordance with rules adopted by the Board of Athletic
   66         Training; amending s. 468.803, F.S.; revising
   67         orthotic, prosthetic, and pedorthic licensure,
   68         registration, and examination requirements; amending
   69         s. 480.033, F.S.; revising the definition of the term
   70         “apprentice”; amending s. 480.041, F.S.; revising
   71         qualifications for licensure as a massage therapist;
   72         specifying that a massage apprentice who was licensed
   73         before a specified date may continue to perform
   74         massage therapy as authorized under his or her
   75         license; authorizing a massage apprentice to apply for
   76         full licensure upon completion of the apprenticeship
   77         under certain conditions; repealing s. 480.042, F.S.,
   78         relating to examinations for licensure as a massage
   79         therapist; amending s. 480.046, F.S.; revising
   80         instances under which disciplinary action may be taken
   81         against massage establishments; prohibiting certain
   82         massage establishments from applying for relicensure;
   83         providing an exception; amending s. 490.003, F.S.;
   84         revising the definition of the terms “doctoral-level
   85         psychological education” and “doctoral degree in
   86         psychology”; amending s. 490.005, F.S.; revising
   87         requirements for licensure by examination of
   88         psychologists and school psychologists; amending s.
   89         490.006, F.S.; revising requirements for licensure by
   90         endorsement of psychologists and school psychologists;
   91         amending s. 491.0045, F.S.; providing an exemption for
   92         registration requirements for clinical social worker
   93         interns, marriage and family therapist interns, and
   94         mental health counselor interns under certain
   95         circumstances; amending s. 491.005, F.S.; revising
   96         requirements for the licensure by examination of
   97         marriage and family therapists; revising examination
   98         requirements for the licensure by examination of
   99         mental health counselors; amending s. 491.006, F.S.;
  100         revising requirements for licensure by endorsement or
  101         certification for specified professions; amending s.
  102         491.007, F.S.; removing a biennial intern registration
  103         fee; amending s. 491.009, F.S.; authorizing the Board
  104         of Clinical Social Work, Marriage and Family Therapy,
  105         and Mental Health Counseling or, under certain
  106         circumstances, the department to enter an order
  107         denying licensure or imposing penalties against an
  108         applicant for licensure under certain circumstances;
  109         amending ss. 491.0046 and 945.42, F.S.; conforming
  110         cross-references; providing an effective date.
  111          
  112  Be It Enacted by the Legislature of the State of Florida:
  113  
  114         Section 1. Subsection (3) of section 381.4018, Florida
  115  Statutes, is amended to read:
  116         381.4018 Physician workforce assessment and development.—
  117         (3) GENERAL FUNCTIONS.—The department shall maximize the
  118  use of existing programs under the jurisdiction of the
  119  department and other state agencies and coordinate governmental
  120  and nongovernmental stakeholders and resources in order to
  121  develop a state strategic plan and assess the implementation of
  122  such strategic plan. In developing the state strategic plan, the
  123  department shall:
  124         (a) Monitor, evaluate, and report on the supply and
  125  distribution of physicians licensed under chapter 458 or chapter
  126  459. The department shall maintain a database to serve as a
  127  statewide source of data concerning the physician workforce.
  128         (b) Develop a model and quantify, on an ongoing basis, the
  129  adequacy of the state’s current and future physician workforce
  130  as reliable data becomes available. Such model must take into
  131  account demographics, physician practice status, place of
  132  education and training, generational changes, population growth,
  133  economic indicators, and issues concerning the “pipeline” into
  134  medical education.
  135         (c) Develop and recommend strategies to determine whether
  136  the number of qualified medical school applicants who might
  137  become competent, practicing physicians in this state will be
  138  sufficient to meet the capacity of the state’s medical schools.
  139  If appropriate, the department shall, working with
  140  representatives of appropriate governmental and nongovernmental
  141  entities, develop strategies and recommendations and identify
  142  best practice programs that introduce health care as a
  143  profession and strengthen skills needed for medical school
  144  admission for elementary, middle, and high school students, and
  145  improve premedical education at the precollege and college level
  146  in order to increase this state’s potential pool of medical
  147  students.
  148         (d) Develop strategies to ensure that the number of
  149  graduates from the state’s public and private allopathic and
  150  osteopathic medical schools is adequate to meet physician
  151  workforce needs, based on the analysis of the physician
  152  workforce data, so as to provide a high-quality medical
  153  education to students in a manner that recognizes the uniqueness
  154  of each new and existing medical school in this state.
  155         (e) Pursue strategies and policies to create, expand, and
  156  maintain graduate medical education positions in the state based
  157  on the analysis of the physician workforce data. Such strategies
  158  and policies must take into account the effect of federal
  159  funding limitations on the expansion and creation of positions
  160  in graduate medical education. The department shall develop
  161  options to address such federal funding limitations. The
  162  department shall consider options to provide direct state
  163  funding for graduate medical education positions in a manner
  164  that addresses requirements and needs relative to accreditation
  165  of graduate medical education programs. The department shall
  166  consider funding residency positions as a means of addressing
  167  needed physician specialty areas, rural areas having a shortage
  168  of physicians, and areas of ongoing critical need, and as a
  169  means of addressing the state’s physician workforce needs based
  170  on an ongoing analysis of physician workforce data.
  171         (f) Develop strategies to maximize federal and state
  172  programs that provide for the use of incentives to attract
  173  physicians to this state or retain physicians within the state.
  174  Such strategies should explore and maximize federal-state
  175  partnerships that provide incentives for physicians to practice
  176  in federally designated shortage areas. Strategies shall also
  177  consider the use of state programs, such as the Medical
  178  Education Reimbursement and Loan Repayment Program pursuant to
  179  s. 1009.65, which provide for education loan repayment or loan
  180  forgiveness and provide monetary incentives for physicians to
  181  relocate to underserved areas of the state.
  182         (g) Coordinate and enhance activities relative to physician
  183  workforce needs, undergraduate medical education, graduate
  184  medical education, and reentry of retired military and other
  185  physicians into the physician workforce provided by the Division
  186  of Medical Quality Assurance, area health education center
  187  networks established pursuant to s. 381.0402, and other offices
  188  and programs within the department as designated by the State
  189  Surgeon General.
  190         (h) Work in conjunction with and act as a coordinating body
  191  for governmental and nongovernmental stakeholders to address
  192  matters relating to the state’s physician workforce assessment
  193  and development for the purpose of ensuring an adequate supply
  194  of well-trained physicians to meet the state’s future needs.
  195  Such governmental stakeholders shall include, but need not be
  196  limited to, the State Surgeon General or his or her designee,
  197  the Commissioner of Education or his or her designee, the
  198  Secretary of Health Care Administration or his or her designee,
  199  and the Chancellor of the State University System or his or her
  200  designee, and, at the discretion of the department, other
  201  representatives of state and local agencies that are involved in
  202  assessing, educating, or training the state’s current or future
  203  physicians. Other stakeholders shall include, but need not be
  204  limited to, organizations representing the state’s public and
  205  private allopathic and osteopathic medical schools;
  206  organizations representing hospitals and other institutions
  207  providing health care, particularly those that currently provide
  208  or have an interest in providing accredited medical education
  209  and graduate medical education to medical students and medical
  210  residents; organizations representing allopathic and osteopathic
  211  practicing physicians; and, at the discretion of the department,
  212  representatives of other organizations or entities involved in
  213  assessing, educating, or training the state’s current or future
  214  physicians.
  215         (i) Serve as a liaison with other states and federal
  216  agencies and programs in order to enhance resources available to
  217  the state’s physician workforce and medical education continuum.
  218         (j) Act as a clearinghouse for collecting and disseminating
  219  information concerning the physician workforce and medical
  220  education continuum in this state.
  221  
  222  The department may adopt rules to implement this subsection.
  223         Section 2. Paragraph (a) of subsection (1) of section
  224  456.013, Florida Statutes, is amended to read:
  225         456.013 Department; general licensing provisions.—
  226         (1)(a) Any person desiring to be licensed in a profession
  227  within the jurisdiction of the department shall apply to the
  228  department in writing to take the licensure examination. The
  229  application shall be made on a form prepared and furnished by
  230  the department. The application form must be available on the
  231  Internet, World Wide Web and the department may accept
  232  electronically submitted applications. The application shall
  233  require the social security number and date of birth of the
  234  applicant, except as provided in paragraphs (b) and (c). The
  235  form shall be supplemented as needed to reflect any material
  236  change in any circumstance or condition stated in the
  237  application which takes place between the initial filing of the
  238  application and the final grant or denial of the license and
  239  which might affect the decision of the department. If an
  240  application is submitted electronically, the department may
  241  require supplemental materials, including an original signature
  242  of the applicant and verification of credentials, to be
  243  submitted in a nonelectronic format. An incomplete application
  244  shall expire 1 year after initial filing. In order to further
  245  the economic development goals of the state, and notwithstanding
  246  any law to the contrary, the department may enter into an
  247  agreement with the county tax collector for the purpose of
  248  appointing the county tax collector as the department’s agent to
  249  accept applications for licenses and applications for renewals
  250  of licenses. The agreement must specify the time within which
  251  the tax collector must forward any applications and accompanying
  252  application fees to the department.
  253         Section 3. Section 458.3312, Florida Statutes, is amended
  254  to read:
  255         458.3312 Specialties.—A physician licensed under this
  256  chapter may not hold himself or herself out as a board-certified
  257  specialist unless the physician has received formal recognition
  258  as a specialist from a specialty board of the American Board of
  259  Medical Specialties or other recognizing agency that has been
  260  approved by the board. However, a physician may indicate the
  261  services offered and may state that his or her practice is
  262  limited to one or more types of services when this accurately
  263  reflects the scope of practice of the physician. A physician may
  264  not hold himself or herself out as a board-certified specialist
  265  in dermatology unless the recognizing agency, whether authorized
  266  in statute or by rule, is triennially reviewed and reauthorized
  267  by the Board of Medicine.
  268         Section 4. Paragraph (d) of subsection (7) of section
  269  458.347, Florida Statutes, is amended to read:
  270         458.347 Physician assistants.—
  271         (7) PHYSICIAN ASSISTANT LICENSURE.—
  272         (d) Upon employment as a physician assistant, a licensed
  273  physician assistant must notify the department in writing within
  274  30 days after such employment and provide or after any
  275  subsequent changes in the supervising physician. The
  276  notification must include the full name, Florida medical license
  277  number, specialty, and address of a supervising physician or a
  278  designated the supervising physician. The licensed physician
  279  assistant must report any subsequent change in the supervising
  280  physician or designated supervising physician to the department
  281  within 30 days after the change. Assignment of a designated
  282  physician does not preclude a physician assistant from
  283  practicing under the supervision of a physician other than the
  284  designated supervising physician if:
  285         1.The designated supervising physician is designated as
  286  the primary contact by the facility or physician practice group
  287  that employs the physician assistant and the physician assistant
  288  is subject to supervision by more than one supervising
  289  physician; and
  290         2.The designated supervising physician maintains a current
  291  list of all approved supervising physicians at the facility or
  292  physician group practice which includes the name of each
  293  supervising physician and his or her area of practice, and
  294  provides the list to the department or board upon written
  295  request.
  296         Section 5. Subsection (1) of section 459.0055, Florida
  297  Statutes, is amended to read:
  298         459.0055 General licensure requirements.—
  299         (1) Except as otherwise provided herein, any person
  300  desiring to be licensed or certified as an osteopathic physician
  301  pursuant to this chapter shall:
  302         (a) Complete an application form and submit the appropriate
  303  fee to the department;
  304         (b) Be at least 21 years of age;
  305         (c) Be of good moral character;
  306         (d) Have completed at least 3 years of preprofessional
  307  postsecondary education;
  308         (e) Have not previously committed any act that would
  309  constitute a violation of this chapter, unless the board
  310  determines that such act does not adversely affect the
  311  applicant’s present ability and fitness to practice osteopathic
  312  medicine;
  313         (f) Not be under investigation in any jurisdiction for an
  314  act that would constitute a violation of this chapter. If, upon
  315  completion of such investigation, it is determined that the
  316  applicant has committed an act that would constitute a violation
  317  of this chapter, the applicant is ineligible for licensure
  318  unless the board determines that such act does not adversely
  319  affect the applicant’s present ability and fitness to practice
  320  osteopathic medicine;
  321         (g) Have not had an application for a license to practice
  322  osteopathic medicine denied or a license to practice osteopathic
  323  medicine revoked, suspended, or otherwise acted against by the
  324  licensing authority of any jurisdiction unless the board
  325  determines that the grounds on which such action was taken do
  326  not adversely affect the applicant’s present ability and fitness
  327  to practice osteopathic medicine. A licensing authority’s
  328  acceptance of a physician’s relinquishment of license,
  329  stipulation, consent order, or other settlement, offered in
  330  response to or in anticipation of the filing of administrative
  331  charges against the osteopathic physician, shall be considered
  332  action against the osteopathic physician’s license;
  333         (h) Not have received less than a satisfactory evaluation
  334  from an internship, residency, or fellowship training program,
  335  unless the board determines that such act does not adversely
  336  affect the applicant’s present ability and fitness to practice
  337  osteopathic medicine. Such evaluation shall be provided by the
  338  director of medical education from the medical training
  339  facility;
  340         (i) Have met the criteria set forth in s. 459.0075, s.
  341  459.0077, or s. 459.021, whichever is applicable;
  342         (j) Submit to the department a set of fingerprints on a
  343  form and under procedures specified by the department, along
  344  with a payment in an amount equal to the costs incurred by the
  345  Department of Health for the criminal background check of the
  346  applicant;
  347         (k) Demonstrate that he or she is a graduate of a medical
  348  college recognized and approved by the American Osteopathic
  349  Association;
  350         (l) Demonstrate that she or he has successfully completed
  351  an internship or residency a resident internship of not less
  352  than 12 months in a program accredited hospital approved for
  353  this purpose by the Board of Trustees of the American
  354  Osteopathic Association or the Accreditation Council for
  355  Graduate Medical Education any other internship program approved
  356  by the board upon a showing of good cause by the applicant. This
  357  requirement may be waived for an applicant who matriculated in a
  358  college of osteopathic medicine during or before 1948; and
  359         (m) Demonstrate that she or he has obtained a passing
  360  score, as established by rule of the board, on all parts of the
  361  examination conducted by the National Board of Osteopathic
  362  Medical Examiners or other examination approved by the board no
  363  more than 5 years before making application in this state or, if
  364  holding a valid active license in another state, that the
  365  initial licensure in the other state occurred no more than 5
  366  years after the applicant obtained a passing score on the
  367  examination conducted by the National Board of Osteopathic
  368  Medical Examiners or other substantially similar examination
  369  approved by the board.
  370         Section 6. Paragraph (d) of subsection (7) of section
  371  459.022, Florida Statutes, is amended to read:
  372         459.022 Physician assistants.—
  373         (7) PHYSICIAN ASSISTANT LICENSURE.—
  374         (d) Upon employment as a physician assistant, a licensed
  375  physician assistant must notify the department in writing within
  376  30 days after such employment and provide or after any
  377  subsequent changes in the supervising physician. The
  378  notification must include the full name, Florida medical license
  379  number, specialty, and address of a supervising physician or a
  380  designated the supervising physician. The licensed physician
  381  assistant must report any subsequent change in the supervising
  382  physician or designated supervising physician to the department
  383  within 30 days after the change. Assignment of a designated
  384  physician does not preclude a physician assistant from
  385  practicing under the supervision of a physician other than the
  386  designated supervising physician if:
  387         1.The designated supervising physician is designated as
  388  the primary contact by the facility or physician practice group
  389  that employs the physician assistant and the physician assistant
  390  is subject to supervision by more than one supervising
  391  physician; and
  392         2.The designated supervising physician maintains a current
  393  list of all approved supervising physicians at the facility or
  394  physician group practice which includes the name of each
  395  supervising physician and his or her area of practice, and
  396  provides the list to the department or board upon written
  397  request.
  398         Section 7. Subsection (1) of section 460.408, Florida
  399  Statutes, is amended to read:
  400         460.408 Continuing chiropractic education.—
  401         (1) The board shall require licensees to periodically
  402  demonstrate their professional competence as a condition of
  403  renewal of a license by completing up to 40 contact classroom
  404  hours of continuing education. For purposes of this subsection,
  405  the term “contact classroom hour” means a presentation in which
  406  the persons presenting and the persons attending the course are
  407  present on site. Up to 10 general credit continuing education
  408  hours may be completed online in place of contact classroom
  409  hours, as determined by board rule. Online continuing education
  410  courses must be competency-based and must use the Shareable
  411  Content Objective Reference Model standard or more stringent
  412  standards, as determined by the board.
  413         (a) Continuing education courses sponsored by chiropractic
  414  colleges whose graduates are eligible for examination under any
  415  provision of this chapter may be approved upon review by the
  416  board if all other requirements of board rules setting forth
  417  criteria for course approval are met.
  418         (b) The board shall approve those courses that build upon
  419  the basic courses required for the practice of chiropractic
  420  medicine, and the board may also approve courses in adjunctive
  421  modalities. Courses that consist of instruction in the use,
  422  application, prescription, recommendation, or administration of
  423  a specific company’s brand of products or services are not
  424  eligible for approval.
  425         Section 8. Section 460.4166, Florida Statutes, is repealed.
  426         Section 9. Section 464.202, Florida Statutes, is amended to
  427  read:
  428         464.202 Duties and powers of the board.—The board shall
  429  maintain, or contract with or approve another entity to
  430  maintain, a state registry of certified nursing assistants. The
  431  registry must consist of the name of each certified nursing
  432  assistant in this state; other identifying information defined
  433  by board rule; certification status; the effective date of
  434  certification; other information required by state or federal
  435  law; information regarding any crime or any abuse, neglect, or
  436  exploitation as provided under chapter 435; and any disciplinary
  437  action taken against the certified nursing assistant. The
  438  registry shall be accessible to the public, the
  439  certificateholder, employers, and other state agencies. The
  440  board shall adopt by rule testing procedures for use in
  441  certifying nursing assistants and shall adopt rules regulating
  442  the practice of certified nursing assistants, including
  443  disciplinary procedures and standards of practice, and
  444  specifying the scope of practice authorized and the level of
  445  supervision required for the practice of certified nursing
  446  assistants. The board may contract with or approve another
  447  entity or organization to provide the examination services,
  448  including the development and administration of examinations.
  449  The board shall require that the contract provider offer
  450  certified nursing assistant applications via the Internet, and
  451  may require the contract provider to accept certified nursing
  452  assistant applications for processing via the Internet. The
  453  board shall require the contract provider to provide the
  454  preliminary results of the certified nursing examination on the
  455  date the test is administered. The provider shall pay all
  456  reasonable costs and expenses incurred by the board in
  457  evaluating the provider’s application and performance during the
  458  delivery of services, including examination services and
  459  procedures for maintaining the certified nursing assistant
  460  registry.
  461         Section 10. Paragraph (c) of subsection (1) of section
  462  464.203, Florida Statutes, is amended to read:
  463         464.203 Certified nursing assistants; certification
  464  requirement.—
  465         (1) The board shall issue a certificate to practice as a
  466  certified nursing assistant to any person who demonstrates a
  467  minimum competency to read and write and successfully passes the
  468  required background screening pursuant to s. 400.215. If the
  469  person has successfully passed the required background screening
  470  pursuant to s. 400.215 or s. 408.809 within 90 days before
  471  applying for a certificate to practice and the person’s
  472  background screening results are not retained in the
  473  clearinghouse created under s. 435.12, the board shall waive the
  474  requirement that the applicant successfully pass an additional
  475  background screening pursuant to s. 400.215. The person must
  476  also meet one of the following requirements:
  477         (c) Is currently certified in another state or territory of
  478  the United States or in the District of Columbia; is listed on
  479  that jurisdiction’s state’s certified nursing assistant
  480  registry; and has not been found to have committed abuse,
  481  neglect, or exploitation in that jurisdiction state.
  482         Section 11. Paragraph (b) of subsection (1) of section
  483  464.204, Florida Statutes, is amended to read:
  484         464.204 Denial, suspension, or revocation of certification;
  485  disciplinary actions.—
  486         (1) The following acts constitute grounds for which the
  487  board may impose disciplinary sanctions as specified in
  488  subsection (2):
  489         (b) Intentionally Violating any provision of this chapter,
  490  chapter 456, or the rules adopted by the board.
  491         Section 12. Paragraph (b) of subsection (3) and subsection
  492  (4) of section 466.006, Florida Statutes, are amended to read:
  493         466.006 Examination of dentists.—
  494         (3) If an applicant is a graduate of a dental college or
  495  school not accredited in accordance with paragraph (2)(b) or of
  496  a dental college or school not approved by the board, the
  497  applicant is not entitled to take the examinations required in
  498  this section to practice dentistry until she or he satisfies one
  499  of the following:
  500         (b) Submits proof of having successfully completed at least
  501  2 consecutive academic years at a full-time supplemental general
  502  dentistry program accredited by the American Dental Association
  503  Commission on Dental Accreditation. This program must provide
  504  didactic and clinical education at the level of a D.D.S. or
  505  D.M.D. program accredited by the American Dental Association
  506  Commission on Dental Accreditation. For purposes of this
  507  paragraph, a supplemental general dentistry program does not
  508  include an advanced education program in a dental specialty.
  509         (4) Notwithstanding any other provision of law in chapter
  510  456 pertaining to the clinical dental licensure examination or
  511  national examinations, to be licensed as a dentist in this
  512  state, an applicant must successfully complete both of the
  513  following:
  514         (a) A written examination on the laws and rules of the
  515  state regulating the practice of dentistry.;
  516         (b)1. A practical or clinical examination, which must shall
  517  be the American Dental Licensing Examination produced by the
  518  American Board of Dental Examiners, Inc., or its successor
  519  entity, if any, that is administered in this state and graded by
  520  dentists licensed in this state and employed by the department
  521  for just such purpose, provided that the board has attained, and
  522  continues to maintain thereafter, representation on the board of
  523  directors of the American Board of Dental Examiners, the
  524  examination development committee of the American Board of
  525  Dental Examiners, and such other committees of the American
  526  Board of Dental Examiners as the board deems appropriate by rule
  527  to assure that the standards established herein are maintained
  528  organizationally. A passing score on the American Dental
  529  Licensing Examination administered in this state and graded by
  530  dentists who are licensed in this state is valid for 365 days
  531  after the date the official examination results are published.
  532         1.2.a. As an alternative to such practical or clinical
  533  examination the requirements of subparagraph 1., an applicant
  534  may submit scores from an American Dental Licensing Examination
  535  previously administered in a jurisdiction other than this state
  536  after October 1, 2011, and such examination results shall be
  537  recognized as valid for the purpose of licensure in this state.
  538  A passing score on the American Dental Licensing Examination
  539  administered out-of-state shall be the same as the passing score
  540  for the American Dental Licensing Examination administered in
  541  this state and graded by dentists who are licensed in this
  542  state. The examination results are valid for 365 days after the
  543  date the official examination results are published. The
  544  applicant must have completed the examination after October 1,
  545  2011.
  546         b. This subparagraph may not be given retroactive
  547  application.
  548         2.3. If the date of an applicant’s passing American Dental
  549  Licensing Examination scores from an examination previously
  550  administered in a jurisdiction other than this state under
  551  subparagraph 1. subparagraph 2. is older than 365 days, then
  552  such scores are shall nevertheless be recognized as valid for
  553  the purpose of licensure in this state, but only if the
  554  applicant demonstrates that all of the following additional
  555  standards have been met:
  556         a.(I) The applicant completed the American Dental Licensing
  557  Examination after October 1, 2011.
  558         (II) This sub-subparagraph may not be given retroactive
  559  application;
  560         b. The applicant graduated from a dental school accredited
  561  by the American Dental Association Commission on Dental
  562  Accreditation or its successor entity, if any, or any other
  563  dental accrediting organization recognized by the United States
  564  Department of Education. Provided, however, if the applicant did
  565  not graduate from such a dental school, the applicant may submit
  566  proof of having successfully completed a full-time supplemental
  567  general dentistry program accredited by the American Dental
  568  Association Commission on Dental Accreditation of at least 2
  569  consecutive academic years at such accredited sponsoring
  570  institution. Such program must provide didactic and clinical
  571  education at the level of a D.D.S. or D.M.D. program accredited
  572  by the American Dental Association Commission on Dental
  573  Accreditation. For purposes of this paragraph, a supplemental
  574  general dentistry program does not include an advanced education
  575  program in a dental specialty;
  576         c. The applicant currently possesses a valid and active
  577  dental license in good standing, with no restriction, which has
  578  never been revoked, suspended, restricted, or otherwise
  579  disciplined, from another state or territory of the United
  580  States, the District of Columbia, or the Commonwealth of Puerto
  581  Rico;
  582         d. The applicant submits proof that he or she has never
  583  been reported to the National Practitioner Data Bank, the
  584  Healthcare Integrity and Protection Data Bank, or the American
  585  Association of Dental Boards Clearinghouse. This sub
  586  subparagraph does not apply if the applicant successfully
  587  appealed to have his or her name removed from the data banks of
  588  these agencies;
  589         e.(I)(A)In the 5 years immediately preceding the date of
  590  application for licensure in this state, The applicant submits
  591  must submit proof of having been consecutively engaged in the
  592  full-time practice of dentistry in another state or territory of
  593  the United States, the District of Columbia, or the Commonwealth
  594  of Puerto Rico in the 5 years immediately preceding the date of
  595  application for licensure in this state;, or,
  596         (B) If the applicant has been licensed in another state or
  597  territory of the United States, the District of Columbia, or the
  598  Commonwealth of Puerto Rico for less than 5 years, the applicant
  599  submits must submit proof of having been engaged in the full
  600  time practice of dentistry since the date of his or her initial
  601  licensure.
  602         (II) As used in this section, “full-time practice” is
  603  defined as a minimum of 1,200 hours per year for each and every
  604  year in the consecutive 5-year period or, where applicable, the
  605  period since initial licensure, and must include any combination
  606  of the following:
  607         (A) Active clinical practice of dentistry providing direct
  608  patient care.
  609         (B) Full-time practice as a faculty member employed by a
  610  dental or dental hygiene school approved by the board or
  611  accredited by the American Dental Association Commission on
  612  Dental Accreditation.
  613         (C) Full-time practice as a student at a postgraduate
  614  dental education program approved by the board or accredited by
  615  the American Dental Association Commission on Dental
  616  Accreditation.
  617         (III) The board shall develop rules to determine what type
  618  of proof of full-time practice is required and to recoup the
  619  cost to the board of verifying full-time practice under this
  620  section. Such proof must, at a minimum, be:
  621         (A) Admissible as evidence in an administrative proceeding;
  622         (B) Submitted in writing;
  623         (C) Submitted by the applicant under oath with penalties of
  624  perjury attached;
  625         (D) Further documented by an affidavit of someone unrelated
  626  to the applicant who is familiar with the applicant’s practice
  627  and testifies with particularity that the applicant has been
  628  engaged in full-time practice; and
  629         (E) Specifically found by the board to be both credible and
  630  admissible.
  631         (IV) An affidavit of only the applicant is not acceptable
  632  proof of full-time practice unless it is further attested to by
  633  someone unrelated to the applicant who has personal knowledge of
  634  the applicant’s practice. If the board deems it necessary to
  635  assess credibility or accuracy, the board may require the
  636  applicant or the applicant’s witnesses to appear before the
  637  board and give oral testimony under oath;
  638         f. The applicant submits must submit documentation that he
  639  or she has completed, or will complete, prior to licensure in
  640  this state, continuing education equivalent to this state’s
  641  requirements for the last full reporting biennium;
  642         g. The applicant proves must prove that he or she has never
  643  been convicted of, or pled nolo contendere to, regardless of
  644  adjudication, any felony or misdemeanor related to the practice
  645  of a health care profession in any jurisdiction;
  646         h. The applicant has must successfully passed pass a
  647  written examination on the laws and rules of this state
  648  regulating the practice of dentistry and must successfully pass
  649  the computer-based diagnostic skills examination; and
  650         i. The applicant submits must submit documentation that he
  651  or she has successfully completed the applicable examination
  652  administered by the Joint Commission on National Dental
  653  Examinations or its successor organization National Board of
  654  Dental Examiners dental examination.
  655         Section 13. Paragraph (b) of subsection (4) and paragraph
  656  (a) of subsection (6) of section 466.007, Florida Statutes, are
  657  amended to read:
  658         466.007 Examination of dental hygienists.—
  659         (4) Effective July 1, 2012, to be licensed as a dental
  660  hygienist in this state, an applicant must successfully complete
  661  the following:
  662         (b) A practical or clinical examination approved by the
  663  board. The examination shall be the Dental Hygiene Examination
  664  produced by the American Board of Dental Examiners, Inc. (ADEX)
  665  or its successor entity, if any, if the board finds that the
  666  successor entity’s clinical examination meets or exceeds the
  667  provisions of this section. The board shall approve the ADEX
  668  Dental Hygiene Examination if the board has attained and
  669  continues to maintain representation on the ADEX House of
  670  Representatives, the ADEX Dental Hygiene Examination Development
  671  Committee, and such other ADEX Dental Hygiene committees as the
  672  board deems appropriate through rulemaking to ensure that the
  673  standards established in this section are maintained
  674  organizationally. The ADEX Dental Hygiene Examination or the
  675  examination produced by its successor entity is a comprehensive
  676  examination in which an applicant must demonstrate skills within
  677  the dental hygiene scope of practice on a live patient and any
  678  other components that the board deems necessary for the
  679  applicant to successfully demonstrate competency for the purpose
  680  of licensure. The ADEX Dental Hygiene Examination or the
  681  examination by the successor entity administered in this state
  682  shall be graded by dentists and dental hygienists licensed in
  683  this state who are employed by the department for this purpose.
  684         (6)(a) A passing score on the ADEX Dental Hygiene
  685  Examination administered out of state must shall be considered
  686  the same as a passing score for the ADEX Dental Hygiene
  687  Examination administered in this state and graded by licensed
  688  dentists and dental hygienists.
  689         Section 14. Subsections (9) through (15) are added to
  690  section 466.017, Florida Statutes, to read:
  691         466.017 Prescription of drugs; anesthesia.—
  692         (9)Any adverse incident that occurs in an office
  693  maintained by a dentist must be reported to the department. The
  694  required notification to the department must be submitted in
  695  writing by certified mail and postmarked within 48 hours after
  696  the incident occurs.
  697         (10)A dentist practicing in this state must notify the
  698  board in writing by certified mail within 48 hours after any
  699  adverse incident that occurs in the dentist’s outpatient
  700  facility. A complete written report must be filed with the board
  701  within 30 days after the incident occurs.
  702         (11)Any certified registered dental hygienist
  703  administering local anesthesia must notify the board in writing
  704  by registered mail within 48 hours of any adverse incident that
  705  was related to or the result of the administration of local
  706  anesthesia. A complete written report must be filed with the
  707  board within 30 days after the mortality or other adverse
  708  incident.
  709         (12)A failure by the dentist or dental hygienist to timely
  710  and completely comply with all the reporting requirements in
  711  this section is the basis for disciplinary action by the board
  712  pursuant to s. 466.028(1).
  713         (13)The department shall review each adverse incident and
  714  determine whether it involved conduct by a health care
  715  professional subject to disciplinary action, in which case s.
  716  456.073 applies. Disciplinary action, if any, shall be taken by
  717  the board under which the health care professional is licensed.
  718         (14)As used in subsections (9)-(13), the term “adverse
  719  incident” means any mortality that occurs during or as the
  720  result of a dental procedure, or an incident that results in a
  721  temporary or permanent physical or mental injury that requires
  722  hospitalization or emergency room treatment of a dental patient
  723  which occurs during or as a direct result of the use of general
  724  anesthesia, deep sedation, moderate sedation, pediatric moderate
  725  sedation, oral sedation, minimal sedation (anxiolysis), nitrous
  726  oxide, or local anesthesia.
  727         (15)The board may adopt rules to administer this section.
  728         Section 15. Section 466.031, Florida Statutes, is amended
  729  to read:
  730         466.031 “Dental laboratory” defined.—As used in this
  731  chapter, the term “dental laboratory” as used in this chapter:
  732         (1) includes any person, firm, or corporation that who
  733  performs for a fee of any kind, gratuitously, or otherwise,
  734  directly or through an agent or an employee, by any means or
  735  method, or who in any way supplies or manufactures artificial
  736  substitutes for the natural teeth;, or who furnishes, supplies,
  737  constructs, or reproduces or repairs any prosthetic denture,
  738  bridge, or appliance to be worn in the human mouth; provides
  739  onsite consultation during dental procedures; or who in any way
  740  represents holds itself out as a dental laboratory.
  741         (2)The term does not include a Excludes any dental
  742  laboratory technician who constructs or repairs dental
  743  prosthetic appliances in the office of a licensed dentist
  744  exclusively for that such dentist only and under her or his
  745  supervision and work order.
  746         Section 16. Section 466.036, Florida Statutes, is amended
  747  to read:
  748         466.036 Information; periodic inspections; equipment and
  749  supplies.—The department may require from the applicant for a
  750  registration certificate to operate a dental laboratory any
  751  information necessary to carry out the purpose of this chapter,
  752  including proof that the applicant has the equipment and
  753  supplies necessary to operate as determined by rule of the
  754  department, and shall require periodic inspection of all dental
  755  laboratories operating in this state at least once each biennial
  756  registration period. Such inspections must shall include, but
  757  need not be limited to, inspection of sanitary conditions,
  758  equipment, supplies, and facilities on the premises. The
  759  department shall specify dental equipment and supplies that are
  760  not allowed permitted in a registered dental laboratory.
  761         Section 17. Subsection (1) of section 468.701, Florida
  762  Statutes, is amended to read:
  763         468.701 Definitions.—As used in this part, the term:
  764         (1) “Athletic trainer” means a person licensed under this
  765  part who has met the requirements of under this part, including
  766  the education requirements established as set forth by the
  767  Commission on Accreditation of Athletic Training Education or
  768  its successor organization and necessary credentials from the
  769  Board of Certification. An individual who is licensed as an
  770  athletic trainer may not provide, offer to provide, or represent
  771  that he or she is qualified to provide any care or services that
  772  he or she lacks the education, training, or experience to
  773  provide, or that he or she is otherwise prohibited by law from
  774  providing.
  775         Section 18. Section 468.707, Florida Statutes, is amended
  776  to read:
  777         468.707 Licensure requirements.—Any person desiring to be
  778  licensed as an athletic trainer shall apply to the department on
  779  a form approved by the department. An applicant shall also
  780  provide records or other evidence, as determined by the board,
  781  to prove he or she has met the requirements of this section. The
  782  department shall license each applicant who:
  783         (1) Has completed the application form and remitted the
  784  required fees.
  785         (2) For a person who applies on or after July 1, 2016, Has
  786  submitted to background screening pursuant to s. 456.0135. The
  787  board may require a background screening for an applicant whose
  788  license has expired or who is undergoing disciplinary action.
  789         (3)(a) Has obtained, at a minimum, a baccalaureate or
  790  higher degree from a college or university professional athletic
  791  training degree program accredited by the Commission on
  792  Accreditation of Athletic Training Education or its successor
  793  organization recognized and approved by the United States
  794  Department of Education or the Commission on Recognition of
  795  Postsecondary Accreditation, approved by the board, or
  796  recognized by the Board of Certification, and has passed the
  797  national examination to be certified by the Board of
  798  Certification; or.
  799         (b)(4)Has obtained, at a minimum, a bachelor’s degree, has
  800  completed the Board of Certification internship requirements,
  801  and If graduated before 2004, has a current certification from
  802  the Board of Certification.
  803         (4)(5) Has current certification in both cardiopulmonary
  804  resuscitation and the use of an automated external defibrillator
  805  set forth in the continuing education requirements as determined
  806  by the board pursuant to s. 468.711.
  807         (5)(6) Has completed any other requirements as determined
  808  by the department and approved by the board.
  809         Section 19. Subsection (3) of section 468.711, Florida
  810  Statutes, is amended to read:
  811         468.711 Renewal of license; continuing education.—
  812         (3) If initially licensed after January 1, 1998, the
  813  licensee must be currently certified by the Board of
  814  Certification or its successor agency and maintain that
  815  certification in good standing without lapse.
  816         Section 20. Section 468.713, Florida Statutes, is amended
  817  to read:
  818         468.713 Responsibilities of athletic trainers.—
  819         (1) An athletic trainer shall practice under the direction
  820  of a physician licensed under chapter 458, chapter 459, chapter
  821  460, or otherwise authorized by Florida law to practice
  822  medicine. The physician shall communicate his or her direction
  823  through oral or written prescriptions or protocols as deemed
  824  appropriate by the physician for the provision of services and
  825  care by the athletic trainer. An athletic trainer shall provide
  826  service or care in the manner dictated by the physician.
  827         (2) An athletic trainer shall work within his or her
  828  allowable scope of practice as specified in board rule under s.
  829  468.705. An athletic trainer may not provide, offer to provide,
  830  or represent that he or she is qualified to provide any care or
  831  services that he or she lacks the education, training, or
  832  experience to provide, or that he or she is otherwise prohibited
  833  by law from providing.
  834         Section 21. Subsection (2) of section 468.723, Florida
  835  Statutes, is amended to read:
  836         468.723 Exemptions.—This part does not prohibit prevent or
  837  restrict:
  838         (2) An athletic training student acting under the direct
  839  supervision of a licensed athletic trainer. For purposes of this
  840  subsection, “direct supervision” means the physical presence of
  841  an athletic trainer so that the athletic trainer is immediately
  842  available to the athletic training student and able to intervene
  843  on behalf of the athletic training student. The supervision must
  844  comply with board rule in accordance with the standards set
  845  forth by the Commission on Accreditation of Athletic Training
  846  Education or its successor.
  847         Section 22. Subsections (1), (3), and (4) of section
  848  468.803, Florida Statutes, are amended to read:
  849         468.803 License, registration, and examination
  850  requirements.—
  851         (1) The department shall issue a license to practice
  852  orthotics, prosthetics, or pedorthics, or a registration for a
  853  resident to practice orthotics or prosthetics, to qualified
  854  applicants. Licenses to practice shall be granted independently
  855  in orthotics, prosthetics, or pedorthics shall be granted
  856  independently, but a person may be licensed in more than one
  857  such discipline, and a prosthetist-orthotist license may be
  858  granted to persons meeting the requirements for licensure both
  859  as a prosthetist and as an orthotist license. Registrations to
  860  practice shall be granted independently in orthotics or
  861  prosthetics shall be granted independently, and a person may be
  862  registered in both disciplines fields at the same time or
  863  jointly in orthotics and prosthetics as a dual registration.
  864         (3) A person seeking to attain the required orthotics or
  865  prosthetics experience required for licensure in this state must
  866  be approved by the board and registered as a resident by the
  867  department. Although a registration may be held in both
  868  disciplines practice fields, for independent registrations the
  869  board may shall not approve a second registration for until at
  870  least 1 year after the issuance of the first registration.
  871  Notwithstanding subsection (2), a person an applicant who has
  872  been approved by the board and registered by the department in
  873  one discipline practice field may apply for registration in the
  874  second discipline practice field without an additional state or
  875  national criminal history check during the period in which the
  876  first registration is valid. Each independent registration or
  877  dual registration is valid for 2 years after from the date of
  878  issuance unless otherwise revoked by the department upon
  879  recommendation of the board. The board shall set a registration
  880  fee not to exceed $500 to be paid by the applicant. A
  881  registration may be renewed once by the department upon
  882  recommendation of the board for a period no longer than 1 year,
  883  as such renewal is defined by the board by rule. The
  884  registration renewal fee may shall not exceed one-half the
  885  current registration fee. To be considered by the board for
  886  approval of registration as a resident, the applicant must have
  887  one of the following:
  888         (a) A Bachelor of Science or higher-level postgraduate
  889  degree in Orthotics and Prosthetics from a regionally accredited
  890  college or university recognized by the Commission on
  891  Accreditation of Allied Health Education Programs. or, at
  892         (b) A minimum, of a bachelor’s degree from a regionally
  893  accredited college or university and a certificate in orthotics
  894  or prosthetics from a program recognized by the Commission on
  895  Accreditation of Allied Health Education Programs, or its
  896  equivalent, as determined by the board.; or
  897         (c)A minimum of a bachelor’s degree from a regionally
  898  accredited college or university and a dual certificate in both
  899  orthotics and prosthetics from programs recognized by the
  900  Commission on Accreditation of Allied Health Education Programs,
  901  or its equivalent, as determined by the board.
  902         (b)A Bachelor of Science or higher-level postgraduate
  903  degree in Orthotics and Prosthetics from a regionally accredited
  904  college or university recognized by the Commission on
  905  Accreditation of Allied Health Education Programs or, at a
  906  minimum, a bachelor’s degree from a regionally accredited
  907  college or university and a certificate in prosthetics from a
  908  program recognized by the Commission on Accreditation of Allied
  909  Health Education Programs, or its equivalent, as determined by
  910  the board.
  911         (4) The department may develop and administer a state
  912  examination for an orthotist or a prosthetist license, or the
  913  board may approve the existing examination of a national
  914  standards organization. The examination must be predicated on a
  915  minimum of a baccalaureate-level education and formalized
  916  specialized training in the appropriate field. Each examination
  917  must demonstrate a minimum level of competence in basic
  918  scientific knowledge, written problem solving, and practical
  919  clinical patient management. The board shall require an
  920  examination fee not to exceed the actual cost to the board in
  921  developing, administering, and approving the examination, which
  922  fee must be paid by the applicant. To be considered by the board
  923  for examination, the applicant must have:
  924         (a) For an examination in orthotics:
  925         1. A Bachelor of Science or higher-level postgraduate
  926  degree in Orthotics and Prosthetics from a regionally accredited
  927  college or university recognized by the Commission on
  928  Accreditation of Allied Health Education Programs or, at a
  929  minimum, a bachelor’s degree from a regionally accredited
  930  college or university and a certificate in orthotics from a
  931  program recognized by the Commission on Accreditation of Allied
  932  Health Education Programs, or its equivalent, as determined by
  933  the board; and
  934         2. An approved orthotics internship of 1 year of qualified
  935  experience, as determined by the board, or an orthotic residency
  936  or dual residency program recognized by the board.
  937         (b) For an examination in prosthetics:
  938         1. A Bachelor of Science or higher-level postgraduate
  939  degree in Orthotics and Prosthetics from a regionally accredited
  940  college or university recognized by the Commission on
  941  Accreditation of Allied Health Education Programs or, at a
  942  minimum, a bachelor’s degree from a regionally accredited
  943  college or university and a certificate in prosthetics from a
  944  program recognized by the Commission on Accreditation of Allied
  945  Health Education Programs, or its equivalent, as determined by
  946  the board; and
  947         2. An approved prosthetics internship of 1 year of
  948  qualified experience, as determined by the board, or a
  949  prosthetic residency or dual residency program recognized by the
  950  board.
  951         Section 23. Subsection (5) of section 480.033, Florida
  952  Statutes, is amended to read:
  953         480.033 Definitions.—As used in this act:
  954         (5) “Apprentice” means a person approved by the board to
  955  study colonic irrigation massage under the instruction of a
  956  licensed massage therapist practicing colonic irrigation.
  957         Section 24. Subsections (1) and (2) of section 480.041,
  958  Florida Statutes, are amended, and subsection (8) is added to
  959  that section, to read:
  960         480.041 Massage therapists; qualifications; licensure;
  961  endorsement.—
  962         (1) Any person is qualified for licensure as a massage
  963  therapist under this act who:
  964         (a) Is at least 18 years of age or has received a high
  965  school diploma or high school equivalency diploma;
  966         (b) Has completed a course of study at a board-approved
  967  massage school or has completed an apprenticeship program that
  968  meets standards adopted by the board; and
  969         (c) Has received a passing grade on a national an
  970  examination designated administered by the board department.
  971         (2) Every person desiring to be examined for licensure as a
  972  massage therapist shall apply to the department in writing upon
  973  forms prepared and furnished by the department. Such applicants
  974  are shall be subject to the provisions of s. 480.046(1).
  975  Applicants may take an examination administered by the
  976  department only upon meeting the requirements of this section as
  977  determined by the board.
  978         (8)A person issued a license as a massage apprentice
  979  before July 1, 2019, may continue that apprenticeship and
  980  perform massage therapy as permitted under that license until it
  981  expires. Upon completion of the apprenticeship, which must occur
  982  before July 1, 2022, a massage apprentice may apply to the board
  983  for full licensure and be granted a license if all other
  984  applicable licensure requirements are met.
  985         Section 25. Section 480.042, Florida Statutes, is repealed.
  986         Section 26. Subsection (3) of section 480.046, Florida
  987  Statutes, is amended, and subsection (5) is added to that
  988  section, to read:
  989         480.046 Grounds for disciplinary action by the board.—
  990         (3) The board may shall have the power to revoke or suspend
  991  the license of a massage establishment licensed under this act,
  992  or to deny subsequent licensure of such an establishment, if the
  993  establishment is owned by an individual or entity that owned
  994  another establishment whose license was revoked, upon a showing
  995  of proof that, in either of the following cases:
  996         (a) The current Upon proof that a license has been obtained
  997  by fraud or misrepresentation.
  998         (b) Upon proof that The holder of the a license is guilty
  999  of fraud or deceit or of gross negligence, incompetency, or
 1000  misconduct in the operation of the currently licensed
 1001  establishment so licensed.
 1002         (c)The owner of the massage establishment or any
 1003  individual or individuals providing massage therapy services
 1004  within the establishment, in the aggregate or individually, have
 1005  had three convictions of, or pleas of guilty or nolo contendere
 1006  to, or dismissals of a criminal action after a successful
 1007  completion of a pretrial intervention, diversion, or substance
 1008  abuse program for any misdemeanor or felony, regardless of
 1009  adjudication, a crime in any jurisdiction related to
 1010  prostitution and related acts as defined in s. 796.07, which
 1011  occurred at or within the currently licensed establishment.
 1012         (5)An establishment that has been the subject of
 1013  disciplinary action under this section may not apply for
 1014  relicensure unless there is a change in ownership.
 1015         Section 27. Subsection (3) of section 490.003, Florida
 1016  Statutes, is amended to read:
 1017         490.003 Definitions.—As used in this chapter:
 1018         (3)(a)Prior to July 1, 1999, “doctoral-level psychological
 1019  education” and “doctoral degree in psychology” mean a Psy.D., an
 1020  Ed.D. in psychology, or a Ph.D. in psychology from:
 1021         1.An educational institution which, at the time the
 1022  applicant was enrolled and graduated, had institutional
 1023  accreditation from an agency recognized and approved by the
 1024  United States Department of Education or was recognized as a
 1025  member in good standing with the Association of Universities and
 1026  Colleges of Canada; and
 1027         2.A psychology program within that educational institution
 1028  which, at the time the applicant was enrolled and graduated, had
 1029  programmatic accreditation from an accrediting agency recognized
 1030  and approved by the United States Department of Education or was
 1031  comparable to such programs.
 1032         (b) Effective July 1, 1999, “doctoral-level psychological
 1033  education” and “doctoral degree in psychology” mean a Psy.D., an
 1034  Ed.D. in psychology, or a Ph.D. in psychology from:
 1035         1.a psychology program within an educational institution
 1036  that which, at the time the applicant was enrolled and
 1037  graduated, had institutional accreditation from an agency
 1038  recognized and approved by the United States Department of
 1039  Education or was recognized as a member in good standing with
 1040  the Association of Universities and Colleges of Canada. The
 1041  psychology program must have had; and
 1042         2.A psychology program within that educational institution
 1043  which, at the time the applicant was enrolled and graduated, had
 1044  programmatic accreditation from the American Psychological
 1045  Association an agency recognized and approved by the United
 1046  States Department of Education.
 1047         Section 28. Paragraph (b) of subsection (1) and paragraph
 1048  (b) of subsection (2) of section 490.005, Florida Statutes, are
 1049  amended to read:
 1050         490.005 Licensure by examination.—
 1051         (1) Any person desiring to be licensed as a psychologist
 1052  shall apply to the department to take the licensure examination.
 1053  The department shall license each applicant who the board
 1054  certifies has:
 1055         (b) Submitted proof satisfactory to the board that the
 1056  applicant has:
 1057         1. Received doctoral-level psychological education, as
 1058  defined in s. 490.003(3); or
 1059         2. Received the equivalent of a doctoral-level
 1060  psychological education, as defined in s. 490.003(3), from a
 1061  program at a school or university located outside the United
 1062  States of America and Canada, which was officially recognized by
 1063  the government of the country in which it is located as an
 1064  institution or program to train students to practice
 1065  professional psychology. The applicant has the burden of
 1066  establishing that this requirement has the requirements of this
 1067  provision have been met shall be upon the applicant;
 1068         3.Received and submitted to the board, prior to July 1,
 1069  1999, certification of an augmented doctoral-level psychological
 1070  education from the program director of a doctoral-level
 1071  psychology program accredited by a programmatic agency
 1072  recognized and approved by the United States Department of
 1073  Education; or
 1074         4.Received and submitted to the board, prior to August 31,
 1075  2001, certification of a doctoral-level program that at the time
 1076  the applicant was enrolled and graduated maintained a standard
 1077  of education and training comparable to the standard of training
 1078  of programs accredited by a programmatic agency recognized and
 1079  approved by the United States Department of Education. Such
 1080  certification of comparability shall be provided by the program
 1081  director of a doctoral-level psychology program accredited by a
 1082  programmatic agency recognized and approved by the United States
 1083  Department of Education.
 1084         (2) Any person desiring to be licensed as a school
 1085  psychologist shall apply to the department to take the licensure
 1086  examination. The department shall license each applicant who the
 1087  department certifies has:
 1088         (b) Submitted satisfactory proof to the department that the
 1089  applicant:
 1090         1. Has received a doctorate, specialist, or equivalent
 1091  degree from a program primarily psychological in nature and has
 1092  completed 60 semester hours or 90 quarter hours of graduate
 1093  study, in areas related to school psychology as defined by rule
 1094  of the department, from a college or university which at the
 1095  time the applicant was enrolled and graduated was accredited by
 1096  an accrediting agency recognized and approved by the Council for
 1097  Higher Education Accreditation or its successor organization
 1098  Commission on Recognition of Postsecondary Accreditation or from
 1099  an institution that which is publicly recognized as a member in
 1100  good standing with the Association of Universities and Colleges
 1101  of Canada.
 1102         2. Has had a minimum of 3 years of experience in school
 1103  psychology, 2 years of which must be supervised by an individual
 1104  who is a licensed school psychologist or who has otherwise
 1105  qualified as a school psychologist supervisor, by education and
 1106  experience, as set forth by rule of the department. A doctoral
 1107  internship may be applied toward the supervision requirement.
 1108         3. Has passed an examination provided by the department.
 1109         Section 29. Subsection (1) of section 490.006, Florida
 1110  Statutes, is amended to read:
 1111         490.006 Licensure by endorsement.—
 1112         (1) The department shall license a person as a psychologist
 1113  or school psychologist who, upon applying to the department and
 1114  remitting the appropriate fee, demonstrates to the department
 1115  or, in the case of psychologists, to the board that the
 1116  applicant:
 1117         (a)Holds a valid license or certificate in another state
 1118  to practice psychology or school psychology, as applicable,
 1119  provided that, when the applicant secured such license or
 1120  certificate, the requirements were substantially equivalent to
 1121  or more stringent than those set forth in this chapter at that
 1122  time; and, if no Florida law existed at that time, then the
 1123  requirements in the other state must have been substantially
 1124  equivalent to or more stringent than those set forth in this
 1125  chapter at the present time;
 1126         (a)(b) Is a diplomate in good standing with the American
 1127  Board of Professional Psychology, Inc.; or
 1128         (b)(c) Possesses a doctoral degree in psychology as
 1129  described in s. 490.003 and has at least 10 20 years of
 1130  experience as a licensed psychologist in any jurisdiction or
 1131  territory of the United States within the 25 years preceding the
 1132  date of application.
 1133         Section 30. Subsection (6) of section 491.0045, Florida
 1134  Statutes, as amended by chapter 2016-80 and chapter 2016-241,
 1135  Laws of Florida, is amended to read:
 1136         491.0045 Intern registration; requirements.—
 1137         (6) A registration issued on or before March 31, 2017,
 1138  expires March 31, 2022, and may not be renewed or reissued. Any
 1139  registration issued after March 31, 2017, expires 60 months
 1140  after the date it is issued. The board may make a one-time
 1141  exception from the requirements of this subsection in emergency
 1142  or hardship cases, as defined by board rule, if A subsequent
 1143  intern registration may not be issued unless the candidate has
 1144  passed the theory and practice examination described in s.
 1145  491.005(1)(d), (3)(d), and (4)(d).
 1146         Section 31. Subsections (3) and (4) of section 491.005,
 1147  Florida Statutes, are amended to read:
 1148         491.005 Licensure by examination.—
 1149         (3) MARRIAGE AND FAMILY THERAPY.—Upon verification of
 1150  documentation and payment of a fee not to exceed $200, as set by
 1151  board rule, plus the actual cost of to the department for the
 1152  purchase of the examination from the Association of Marital and
 1153  Family Therapy Regulatory Board, or similar national
 1154  organization, the department shall issue a license as a marriage
 1155  and family therapist to an applicant who the board certifies:
 1156         (a) Has submitted an application and paid the appropriate
 1157  fee.
 1158         (b)1. Has a minimum of a master’s degree with major
 1159  emphasis in marriage and family therapy, or a closely related
 1160  field from a program accredited by the Commission on
 1161  Accreditation for Marriage and Family Therapy Education or from
 1162  a Florida university program accredited by the Council for
 1163  Accreditation of Counseling and Related Educational Programs,
 1164  and graduate courses approved by the Board of Clinical Social
 1165  Work, Marriage and Family Therapy, and Mental Health Counseling
 1166  has completed all of the following requirements:
 1167         a.Thirty-six semester hours or 48 quarter hours of
 1168  graduate coursework, which must include a minimum of 3 semester
 1169  hours or 4 quarter hours of graduate-level course credits in
 1170  each of the following nine areas: dynamics of marriage and
 1171  family systems; marriage therapy and counseling theory and
 1172  techniques; family therapy and counseling theory and techniques;
 1173  individual human development theories throughout the life cycle;
 1174  personality theory or general counseling theory and techniques;
 1175  psychopathology; human sexuality theory and counseling
 1176  techniques; psychosocial theory; and substance abuse theory and
 1177  counseling techniques. Courses in research, evaluation,
 1178  appraisal, assessment, or testing theories and procedures;
 1179  thesis or dissertation work; or practicums, internships, or
 1180  fieldwork may not be applied toward this requirement.
 1181         b.A minimum of one graduate-level course of 3 semester
 1182  hours or 4 quarter hours in legal, ethical, and professional
 1183  standards issues in the practice of marriage and family therapy
 1184  or a course determined by the board to be equivalent.
 1185         c.A minimum of one graduate-level course of 3 semester
 1186  hours or 4 quarter hours in diagnosis, appraisal, assessment,
 1187  and testing for individual or interpersonal disorder or
 1188  dysfunction; and a minimum of one 3-semester-hour or 4-quarter
 1189  hour graduate-level course in behavioral research which focuses
 1190  on the interpretation and application of research data as it
 1191  applies to clinical practice. Credit for thesis or dissertation
 1192  work, practicums, internships, or fieldwork may not be applied
 1193  toward this requirement.
 1194         d.A minimum of one supervised clinical practicum,
 1195  internship, or field experience in a marriage and family
 1196  counseling setting, during which the student provided 180 direct
 1197  client contact hours of marriage and family therapy services
 1198  under the supervision of an individual who met the requirements
 1199  for supervision under paragraph (c). This requirement may be met
 1200  by a supervised practice experience which took place outside the
 1201  academic arena, but which is certified as equivalent to a
 1202  graduate-level practicum or internship program which required a
 1203  minimum of 180 direct client contact hours of marriage and
 1204  family therapy services currently offered within an academic
 1205  program of a college or university accredited by an accrediting
 1206  agency approved by the United States Department of Education, or
 1207  an institution which is publicly recognized as a member in good
 1208  standing with the Association of Universities and Colleges of
 1209  Canada or a training institution accredited by the Commission on
 1210  Accreditation for Marriage and Family Therapy Education
 1211  recognized by the United States Department of Education.
 1212  Certification shall be required from an official of such
 1213  college, university, or training institution.
 1214         2. If the course title that which appears on the
 1215  applicant’s transcript does not clearly identify the content of
 1216  the coursework, the applicant shall be required to provide
 1217  additional documentation, including, but not limited to, a
 1218  syllabus or catalog description published for the course.
 1219  
 1220  The required master’s degree must have been received in an
 1221  institution of higher education which, at the time the applicant
 1222  graduated, was: fully accredited by a regional accrediting body
 1223  recognized by the Commission on Recognition of Postsecondary
 1224  Accreditation or; publicly recognized as a member in good
 1225  standing with the Association of Universities and Colleges of
 1226  Canada,; or an institution of higher education located outside
 1227  the United States and Canada, which, at the time the applicant
 1228  was enrolled and at the time the applicant graduated, maintained
 1229  a standard of training substantially equivalent to the standards
 1230  of training of those institutions in the United States which are
 1231  accredited by a regional accrediting body recognized by the
 1232  Commission on Recognition of Postsecondary Accreditation. Such
 1233  foreign education and training must have been received in an
 1234  institution or program of higher education officially recognized
 1235  by the government of the country in which it is located as an
 1236  institution or program to train students to practice as
 1237  professional marriage and family therapists or psychotherapists.
 1238  The applicant has the burden of establishing that the
 1239  requirements of this provision have been met shall be upon the
 1240  applicant, and the board shall require documentation, such as,
 1241  but not limited to, an evaluation by a foreign equivalency
 1242  determination service, as evidence that the applicant’s graduate
 1243  degree program and education were equivalent to an accredited
 1244  program in this country. An applicant with a master’s degree
 1245  from a program that which did not emphasize marriage and family
 1246  therapy may complete the coursework requirement in a training
 1247  institution fully accredited by the Commission on Accreditation
 1248  for Marriage and Family Therapy Education recognized by the
 1249  United States Department of Education.
 1250         (c) Has had at least 2 years of clinical experience during
 1251  which 50 percent of the applicant’s clients were receiving
 1252  marriage and family therapy services, which must be at the post
 1253  master’s level under the supervision of a licensed marriage and
 1254  family therapist with at least 5 years of experience, or the
 1255  equivalent, who is a qualified supervisor as determined by the
 1256  board. An individual who intends to practice in Florida to
 1257  satisfy the clinical experience requirements must register
 1258  pursuant to s. 491.0045 before commencing practice. If a
 1259  graduate has a master’s degree with a major emphasis in marriage
 1260  and family therapy or a closely related field which that did not
 1261  include all of the coursework required by subparagraph (b)1.
 1262  under sub-subparagraphs (b)1.a.-c., credit for the post-master’s
 1263  level clinical experience may shall not commence until the
 1264  applicant has completed a minimum of 10 of the courses required
 1265  by subparagraph (b)1. under sub-subparagraphs (b)1.a.-c., as
 1266  determined by the board, and at least 6 semester hours or 9
 1267  quarter hours of the course credits must have been completed in
 1268  the area of marriage and family systems, theories, or
 1269  techniques. Within the 2 3 years of required experience, the
 1270  applicant shall provide direct individual, group, or family
 1271  therapy and counseling, to include the following categories of
 1272  cases including those involving: unmarried dyads, married
 1273  couples, separating and divorcing couples, and family groups
 1274  that include including children. A doctoral internship may be
 1275  applied toward the clinical experience requirement. A licensed
 1276  mental health professional must be on the premises when clinical
 1277  services are provided by a registered intern in a private
 1278  practice setting.
 1279         (d) Has passed a theory and practice examination provided
 1280  by the department for this purpose.
 1281         (e) Has demonstrated, in a manner designated by board rule
 1282  of the board, knowledge of the laws and rules governing the
 1283  practice of clinical social work, marriage and family therapy,
 1284  and mental health counseling.
 1285         (f)
 1286  
 1287  For the purposes of dual licensure, the department shall license
 1288  as a marriage and family therapist any person who meets the
 1289  requirements of s. 491.0057. Fees for dual licensure may shall
 1290  not exceed those stated in this subsection.
 1291         (4) MENTAL HEALTH COUNSELING.—Upon verification of
 1292  documentation and payment of a fee not to exceed $200, as set by
 1293  board rule, plus the actual per applicant cost of to the
 1294  department for purchase of the examination from the National
 1295  Board for Certified Counselors or its successor Professional
 1296  Examination Service for the National Academy of Certified
 1297  Clinical Mental Health Counselors or a similar national
 1298  organization, the department shall issue a license as a mental
 1299  health counselor to an applicant who the board certifies:
 1300         (a) Has submitted an application and paid the appropriate
 1301  fee.
 1302         (b)1. Has a minimum of an earned master’s degree from a
 1303  mental health counseling program accredited by the Council for
 1304  the Accreditation of Counseling and Related Educational Programs
 1305  that consists of at least 60 semester hours or 80 quarter hours
 1306  of clinical and didactic instruction, including a course in
 1307  human sexuality and a course in substance abuse. If the master’s
 1308  degree is earned from a program related to the practice of
 1309  mental health counseling that is not accredited by the Council
 1310  for the Accreditation of Counseling and Related Educational
 1311  Programs, then the coursework and practicum, internship, or
 1312  fieldwork must consist of at least 60 semester hours or 80
 1313  quarter hours and meet all of the following requirements:
 1314         a. Thirty-three semester hours or 44 quarter hours of
 1315  graduate coursework, which must include a minimum of 3 semester
 1316  hours or 4 quarter hours of graduate-level coursework in each of
 1317  the following 11 content areas: counseling theories and
 1318  practice; human growth and development; diagnosis and treatment
 1319  of psychopathology; human sexuality; group theories and
 1320  practice; individual evaluation and assessment; career and
 1321  lifestyle assessment; research and program evaluation; social
 1322  and cultural foundations; substance abuse; and legal, ethical,
 1323  and professional standards issues in the practice of mental
 1324  health counseling in community settings; and substance abuse.
 1325  Courses in research, thesis or dissertation work, practicums,
 1326  internships, or fieldwork may not be applied toward this
 1327  requirement.
 1328         b. A minimum of 3 semester hours or 4 quarter hours of
 1329  graduate-level coursework addressing diagnostic processes,
 1330  including differential diagnosis and the use of the current
 1331  diagnostic tools, such as the current edition of the American
 1332  Psychiatric Association’s Diagnostic and Statistical Manual of
 1333  Mental Disorders. The graduate program must have emphasized the
 1334  common core curricular experience in legal, ethical, and
 1335  professional standards issues in the practice of mental health
 1336  counseling, which includes goals, objectives, and practices of
 1337  professional counseling organizations, codes of ethics, legal
 1338  considerations, standards of preparation, certifications and
 1339  licensing, and the role identity and professional obligations of
 1340  mental health counselors. Courses in research, thesis or
 1341  dissertation work, practicums, internships, or fieldwork may not
 1342  be applied toward this requirement.
 1343         c. The equivalent, as determined by the board, of at least
 1344  700 1,000 hours of university-sponsored supervised clinical
 1345  practicum, internship, or field experience that includes at
 1346  least 280 hours of direct client services, as required in the
 1347  accrediting standards of the Council for Accreditation of
 1348  Counseling and Related Educational Programs for mental health
 1349  counseling programs. This experience may not be used to satisfy
 1350  the post-master’s clinical experience requirement.
 1351         2. Has provided additional documentation if a the course
 1352  title that which appears on the applicant’s transcript does not
 1353  clearly identify the content of the coursework., The applicant
 1354  shall be required to provide additional documentation must
 1355  include, including, but is not limited to, a syllabus or catalog
 1356  description published for the course.
 1357  
 1358  Education and training in mental health counseling must have
 1359  been received in an institution of higher education that, which
 1360  at the time the applicant graduated, was: fully accredited by a
 1361  regional accrediting body recognized by the Council for Higher
 1362  Education Accreditation or its successor organization or
 1363  Commission on Recognition of Postsecondary Accreditation;
 1364  publicly recognized as a member in good standing with the
 1365  Association of Universities and Colleges of Canada,; or an
 1366  institution of higher education located outside the United
 1367  States and Canada, which, at the time the applicant was enrolled
 1368  and at the time the applicant graduated, maintained a standard
 1369  of training substantially equivalent to the standards of
 1370  training of those institutions in the United States which are
 1371  accredited by a regional accrediting body recognized by the
 1372  Council for Higher Education Accreditation or its successor
 1373  organization Commission on Recognition of Postsecondary
 1374  Accreditation. Such foreign education and training must have
 1375  been received in an institution or program of higher education
 1376  officially recognized by the government of the country in which
 1377  it is located as an institution or program to train students to
 1378  practice as mental health counselors. The applicant has the
 1379  burden of establishing that the requirements of this provision
 1380  have been met shall be upon the applicant, and the board shall
 1381  require documentation, such as, but not limited to, an
 1382  evaluation by a foreign equivalency determination service, as
 1383  evidence that the applicant’s graduate degree program and
 1384  education were equivalent to an accredited program in this
 1385  country. Beginning July 1, 2024, an applicant must have a
 1386  master’s degree from a program that is accredited by the Council
 1387  for Accreditation of Counseling and Related Educational Programs
 1388  which consists of at least 60 semester hours or 80 quarter hours
 1389  to apply for licensure under this paragraph.
 1390         (c) Has had at least 2 years of clinical experience in
 1391  mental health counseling, which must be at the post-master’s
 1392  level under the supervision of a licensed mental health
 1393  counselor or the equivalent who is a qualified supervisor as
 1394  determined by the board. An individual who intends to practice
 1395  in Florida to satisfy the clinical experience requirements must
 1396  register pursuant to s. 491.0045 before commencing practice. If
 1397  a graduate has a master’s degree with a major related to the
 1398  practice of mental health counseling which that did not include
 1399  all the coursework required under sub-subparagraphs (b)1.a. and
 1400  b. (b)1.a.-b., credit for the post-master’s level clinical
 1401  experience may shall not commence until the applicant has
 1402  completed a minimum of seven of the courses required under sub
 1403  subparagraphs (b)1.a. and b. (b)1.a.-b., as determined by the
 1404  board, one of which must be a course in psychopathology or
 1405  abnormal psychology. A doctoral internship may be applied toward
 1406  the clinical experience requirement. A licensed mental health
 1407  professional must be on the premises when clinical services are
 1408  provided by a registered intern in a private practice setting.
 1409         (d) Has passed a theory and practice examination provided
 1410  by the department for this purpose.
 1411         (e) Has demonstrated, in a manner designated by board rule
 1412  of the board, knowledge of the laws and rules governing the
 1413  practice of clinical social work, marriage and family therapy,
 1414  and mental health counseling.
 1415         Section 32. Paragraph (b) of subsection (1) of section
 1416  491.006, Florida Statutes, is amended to read:
 1417         491.006 Licensure or certification by endorsement.—
 1418         (1) The department shall license or grant a certificate to
 1419  a person in a profession regulated by this chapter who, upon
 1420  applying to the department and remitting the appropriate fee,
 1421  demonstrates to the board that he or she:
 1422         (b)1. Holds an active valid license to practice and has
 1423  actively practiced the licensed profession for which licensure
 1424  is applied in another state for 3 of the last 5 years
 1425  immediately preceding licensure;.
 1426         2.Meets the education requirements of this chapter for the
 1427  profession for which licensure is applied.
 1428         2.3. Has passed a substantially equivalent licensing
 1429  examination in another state or has passed the licensure
 1430  examination in this state in the profession for which the
 1431  applicant seeks licensure; and.
 1432         3.4. Holds a license in good standing, is not under
 1433  investigation for an act that would constitute a violation of
 1434  this chapter, and has not been found to have committed any act
 1435  that would constitute a violation of this chapter.
 1436  
 1437  The fees paid by any applicant for certification as a master
 1438  social worker under this section are nonrefundable.
 1439         Section 33. Subsection (3) of section 491.007, Florida
 1440  Statutes, is amended to read:
 1441         491.007 Renewal of license, registration, or certificate.—
 1442         (3)The board or department shall prescribe by rule a
 1443  method for the biennial renewal of an intern registration at a
 1444  fee set by rule, not to exceed $100.
 1445         Section 34. Subsection (2) of section 491.009, Florida
 1446  Statutes, is amended to read:
 1447         491.009 Discipline.—
 1448         (2) The board department, or, in the case of certified
 1449  master social workers psychologists, the department board, may
 1450  enter an order denying licensure or imposing any of the
 1451  penalties authorized in s. 456.072(2) against any applicant for
 1452  licensure or licensee who is found guilty of violating any
 1453  provision of subsection (1) of this section or who is found
 1454  guilty of violating any provision of s. 456.072(1).
 1455         Section 35. Paragraph (c) of subsection (2) of section
 1456  491.0046, Florida Statutes, is amended to read:
 1457         491.0046 Provisional license; requirements.—
 1458         (2) The department shall issue a provisional clinical
 1459  social worker license, provisional marriage and family therapist
 1460  license, or provisional mental health counselor license to each
 1461  applicant who the board certifies has:
 1462         (c) Has Met the following minimum coursework requirements:
 1463         1. For clinical social work, a minimum of 15 semester hours
 1464  or 22 quarter hours of the coursework required by s.
 1465  491.005(1)(b)2.b.
 1466         2. For marriage and family therapy, 10 of the courses
 1467  required by s. 491.005(3)(b)1. s. 491.005(3)(b)1.a.-c., as
 1468  determined by the board, and at least 6 semester hours or 9
 1469  quarter hours of the course credits must have been completed in
 1470  the area of marriage and family systems, theories, or
 1471  techniques.
 1472         3. For mental health counseling, a minimum of seven of the
 1473  courses required under s. 491.005(4)(b)1.a.-c.
 1474         Section 36. Subsection (11) of section 945.42, Florida
 1475  Statutes, is amended to read:
 1476         945.42 Definitions; ss. 945.40-945.49.—As used in ss.
 1477  945.40-945.49, the following terms shall have the meanings
 1478  ascribed to them, unless the context shall clearly indicate
 1479  otherwise:
 1480         (11) “Psychological professional” means a behavioral
 1481  practitioner who has an approved doctoral degree in psychology
 1482  as defined in s. 490.003(3) s. 490.003(3)(b) and is employed by
 1483  the department or who is licensed as a psychologist pursuant to
 1484  chapter 490.
 1485         Section 37. This act shall take effect July 1, 2019.

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