August 03, 2020
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       Florida Senate - 2010                      CS for CS for SB 1256
       
       
       
       By the Committees on Health and Human Services Appropriations;
       and Health Regulation; and Senator Peaden
       
       
       
       603-04264-10                                          20101256c2
    1                        A bill to be entitled                      
    2         An act relating to the physician workforce; repealing
    3         s. 381.0403(4) and (9), F.S., relating to the program
    4         for graduate medical education innovations and the
    5         graduate medical education committee and report;
    6         amending s. 381.4018, F.S.; providing definitions;
    7         requiring the Department of Health to coordinate and
    8         enhance activities regarding the reentry of retired
    9         military and other physicians into the physician
   10         workforce; revising the list of governmental
   11         stakeholders that the Department of Health is required
   12         to work with regarding the state strategic plan and in
   13         assessing the state’s physician workforce; creating
   14         the Physician Workforce Advisory Council; providing
   15         membership of the council; providing for appointments
   16         to the council; providing terms of membership;
   17         providing for removal of a council member; providing
   18         for the chair and vice chair of the council; providing
   19         that council members are not entitled to receive
   20         compensation or reimbursement for per diem or travel
   21         expenses; providing the duties of the council;
   22         establishing the physician workforce graduate medical
   23         education innovation pilot projects under the
   24         department; providing the purposes of the pilot
   25         projects; providing for the appropriation of state
   26         funds for the pilot projects; requiring the pilot
   27         projects to meet certain policy needs of the physician
   28         workforce in this state; providing criteria for
   29         prioritizing proposals for pilot projects; requiring
   30         the department to adopt by rule appropriate
   31         performance measures; requiring participating pilot
   32         projects to submit an annual report to the department;
   33         requiring state funds to be used to supplement funds
   34         from other sources; requiring the department to adopt
   35         rules; amending ss. 458.3192 and 459.0082, F.S.;
   36         requiring the department to determine by geographic
   37         area and specialty the number of physicians and
   38         osteopathic physicians who plan to relocate outside
   39         the state, practice medicine in this state, and reduce
   40         or modify the scope of their practice; authorizing the
   41         department to report additional information in its
   42         findings to the Governor and the Legislature; amending
   43         s. 458.315, F.S.; revising the standards for the Board
   44         of Medicine to issue a temporary certificate to a
   45         certain physicians to practice medicine in areas of
   46         critical need; authorizing the State Surgeon General
   47         to designate areas of critical need; creating s.
   48         459.0076, F.S.; authorizing the Board of Osteopathic
   49         Medicine to issue temporary certificates to
   50         osteopathic physicians who meet certain requirements
   51         to practice osteopathic medicine in areas of critical
   52         need; providing restrictions for issuance of a
   53         temporary certificate; authorizing the State Surgeon
   54         General to designate areas of critical need;
   55         authorizing the Board of Osteopathic Medicine to waive
   56         the application fee and licensure fees for obtaining
   57         temporary certificates for certain purposes; providing
   58         an effective date.
   59  
   60  Be It Enacted by the Legislature of the State of Florida:
   61  
   62         Section 1. Subsections (4) and (9) of section 381.0403,
   63  Florida Statutes, are repealed.
   64         Section 2. Section 381.4018, Florida Statutes, is amended
   65  to read:
   66         381.4018 Physician workforce assessment and development.—
   67         (1) DEFINITIONS.—As used in this section, the term:
   68         (a) “Consortium” or “consortia” means a combination of
   69  statutory teaching hospitals, statutory rural hospitals, other
   70  hospitals, accredited medical schools, clinics operated by the
   71  Department of Health, clinics operated by the Department of
   72  Veterans’ Affairs, area health education centers, community
   73  health centers, federally qualified health centers, prison
   74  clinics, local community clinics, or other programs. At least
   75  one member of the consortium shall be a sponsoring institution
   76  accredited or currently seeking accreditation by the
   77  Accreditation Council for Graduate Medical Education or the
   78  American Osteopathic Association.
   79         (b) “Council” means the Physician Workforce Advisory
   80  Council.
   81         (c) “Department” means the Department of Health.
   82         (d) “Graduate medical education program” means a program
   83  accredited by the Accreditation Council for Graduate Medical
   84  Education or the American Osteopathic Association.
   85         (e) “Primary care specialty” means emergency medicine,
   86  family practice, internal medicine, pediatrics, psychiatry,
   87  geriatrics, general surgery, obstetrics and gynecology, and
   88  combined pediatrics and internal medicine and other specialties
   89  as determined by the Physician Workforce Advisory Council or the
   90  Department of Health.
   91         (2)(1) LEGISLATIVE INTENT.—The Legislature recognizes that
   92  physician workforce planning is an essential component of
   93  ensuring that there is an adequate and appropriate supply of
   94  well-trained physicians to meet this state’s future health care
   95  service needs as the general population and elderly population
   96  of the state increase. The Legislature finds that items to
   97  consider relative to assessing the physician workforce may
   98  include physician practice status; specialty mix; geographic
   99  distribution; demographic information, including, but not
  100  limited to, age, gender, race, and cultural considerations; and
  101  needs of current or projected medically underserved areas in the
  102  state. Long-term strategic planning is essential as the period
  103  from the time a medical student enters medical school to
  104  completion of graduate medical education may range from 7 to 10
  105  years or longer. The Legislature recognizes that strategies to
  106  provide for a well-trained supply of physicians must include
  107  ensuring the availability and capacity of quality graduate
  108  medical schools and graduate medical education programs in this
  109  state, as well as using new or existing state and federal
  110  programs providing incentives for physicians to practice in
  111  needed specialties and in underserved areas in a manner that
  112  addresses projected needs for physician manpower.
  113         (3)(2) PURPOSE.—The department of Health shall serve as a
  114  coordinating and strategic planning body to actively assess the
  115  state’s current and future physician workforce needs and work
  116  with multiple stakeholders to develop strategies and
  117  alternatives to address current and projected physician
  118  workforce needs.
  119         (4)(3) GENERAL FUNCTIONS.—The department shall maximize the
  120  use of existing programs under the jurisdiction of the
  121  department and other state agencies and coordinate governmental
  122  and nongovernmental stakeholders and resources in order to
  123  develop a state strategic plan and assess the implementation of
  124  such strategic plan. In developing the state strategic plan, the
  125  department shall:
  126         (a) Monitor, evaluate, and report on the supply and
  127  distribution of physicians licensed under chapter 458 or chapter
  128  459. The department shall maintain a database to serve as a
  129  statewide source of data concerning the physician workforce.
  130         (b) Develop a model and quantify, on an ongoing basis, the
  131  adequacy of the state’s current and future physician workforce
  132  as reliable data becomes available. Such model must take into
  133  account demographics, physician practice status, place of
  134  education and training, generational changes, population growth,
  135  economic indicators, and issues concerning the “pipeline” into
  136  medical education.
  137         (c) Develop and recommend strategies to determine whether
  138  the number of qualified medical school applicants who might
  139  become competent, practicing physicians in this state will be
  140  sufficient to meet the capacity of the state’s medical schools.
  141  If appropriate, the department shall, working with
  142  representatives of appropriate governmental and nongovernmental
  143  entities, develop strategies and recommendations and identify
  144  best practice programs that introduce health care as a
  145  profession and strengthen skills needed for medical school
  146  admission for elementary, middle, and high school students, and
  147  improve premedical education at the precollege and college level
  148  in order to increase this state’s potential pool of medical
  149  students.
  150         (d) Develop strategies to ensure that the number of
  151  graduates from the state’s public and private allopathic and
  152  osteopathic medical schools is are adequate to meet physician
  153  workforce needs, based on the analysis of the physician
  154  workforce data, so as to provide a high-quality medical
  155  education to students in a manner that recognizes the uniqueness
  156  of each new and existing medical school in this state.
  157         (e) Pursue strategies and policies to create, expand, and
  158  maintain graduate medical education positions in the state based
  159  on the analysis of the physician workforce data. Such strategies
  160  and policies must take into account the effect of federal
  161  funding limitations on the expansion and creation of positions
  162  in graduate medical education. The department shall develop
  163  options to address such federal funding limitations. The
  164  department shall consider options to provide direct state
  165  funding for graduate medical education positions in a manner
  166  that addresses requirements and needs relative to accreditation
  167  of graduate medical education programs. The department shall
  168  consider funding residency positions as a means of addressing
  169  needed physician specialty areas, rural areas having a shortage
  170  of physicians, and areas of ongoing critical need, and as a
  171  means of addressing the state’s physician workforce needs based
  172  on an ongoing analysis of physician workforce data.
  173         (f) Develop strategies to maximize federal and state
  174  programs that provide for the use of incentives to attract
  175  physicians to this state or retain physicians within the state.
  176  Such strategies should explore and maximize federal-state
  177  partnerships that provide incentives for physicians to practice
  178  in federally designated shortage areas. Strategies shall also
  179  consider the use of state programs, such as the Florida Health
  180  Service Corps established pursuant to s. 381.0302 and the
  181  Medical Education Reimbursement and Loan Repayment Program
  182  pursuant to s. 1009.65, which provide for education loan
  183  repayment or loan forgiveness and provide monetary incentives
  184  for physicians to relocate to underserved areas of the state.
  185         (g) Coordinate and enhance activities relative to physician
  186  workforce needs, undergraduate medical education, and graduate
  187  medical education, and reentry of retired military and other
  188  physicians into the physician workforce provided by the Division
  189  of Medical Quality Assurance, the Community Hospital Education
  190  Program and the Graduate Medical Education Committee established
  191  pursuant to s. 381.0403, area health education center networks
  192  established pursuant to s. 381.0402, and other offices and
  193  programs within the department of Health as designated by the
  194  State Surgeon General.
  195         (h) Work in conjunction with and act as a coordinating body
  196  for governmental and nongovernmental stakeholders to address
  197  matters relating to the state’s physician workforce assessment
  198  and development for the purpose of ensuring an adequate supply
  199  of well-trained physicians to meet the state’s future needs.
  200  Such governmental stakeholders shall include, but need not be
  201  limited to, the State Surgeon General or his or her designee,
  202  the Commissioner of Education or his or her designee, the
  203  Secretary of Health Care Administration or his or her designee,
  204  and the Chancellor of the State University System or his or her
  205  designee from the Board of Governors of the State University
  206  System, and, at the discretion of the department, other
  207  representatives of state and local agencies that are involved in
  208  assessing, educating, or training the state’s current or future
  209  physicians. Other stakeholders shall include, but need not be
  210  limited to, organizations representing the state’s public and
  211  private allopathic and osteopathic medical schools;
  212  organizations representing hospitals and other institutions
  213  providing health care, particularly those that currently provide
  214  or have an interest in providing accredited medical education
  215  and graduate medical education to medical students and medical
  216  residents; organizations representing allopathic and osteopathic
  217  practicing physicians; and, at the discretion of the department,
  218  representatives of other organizations or entities involved in
  219  assessing, educating, or training the state’s current or future
  220  physicians.
  221         (i) Serve as a liaison with other states and federal
  222  agencies and programs in order to enhance resources available to
  223  the state’s physician workforce and medical education continuum.
  224         (j) Act as a clearinghouse for collecting and disseminating
  225  information concerning the physician workforce and medical
  226  education continuum in this state.
  227         (5) PHYSICIAN WORKFORCE ADVISORY COUNCIL.—There is created
  228  in the department the Physician Workforce Advisory Council, an
  229  advisory council as defined in s. 20.03. The council shall
  230  comply with the requirements of s. 20.052, except as otherwise
  231  provided in this section.
  232         (a)The council shall consist of 19 members. Members
  233  appointed by the State Surgeon General shall include:
  234         1.A designee from the department who is a physician
  235  licensed under chapter 458 or chapter 459 and recommended by the
  236  State Surgeon General.
  237         2.An individual who is affiliated with the Science
  238  Students Together Reaching Instructional Diversity and
  239  Excellence program and recommended by the area health education
  240  center network.
  241         3.Two individuals recommended by the Council of Florida
  242  Medical School Deans, one representing a college of allopathic
  243  medicine and one representing a college of osteopathic medicine.
  244         4.One individual recommended by the Florida Hospital
  245  Association, representing a hospital that is licensed under
  246  chapter 395, has an accredited graduate medical education
  247  program, and is not a statutory teaching hospital.
  248         5.One individual representing a statutory teaching
  249  hospital as defined in s. 408.07 and recommended by the Safety
  250  Net Hospital Alliance.
  251         6.One individual representing a family practice teaching
  252  hospital as defined in s. 395.805 and recommended by the Council
  253  of Family Medicine and Community Teaching Hospitals.
  254         7.Two individuals recommended by the Florida Medical
  255  Association, one representing a primary care specialty and one
  256  representing a nonprimary care specialty.
  257         8.Two individuals recommended by the Florida Osteopathic
  258  Medical Association, one representing a primary care specialty
  259  and one representing a nonprimary care specialty.
  260         9.Two individuals who are program directors of accredited
  261  graduate medical education programs, one representing a program
  262  that is accredited by the Accreditation Council for Graduate
  263  Medical Education and one representing a program that is
  264  accredited by the American Osteopathic Association.
  265         10.An individual recommended by the Florida Association of
  266  Community Health Centers representing a federally qualified
  267  health center located in a rural area as defined in s.
  268  381.0406(2)(a).
  269         11.An individual recommended by the Florida Academy of
  270  Family Physicians.
  271         12. An individual recommended by the Florida Alliance for
  272  Health Professions Diversity.
  273         13.The Chancellor of the State University System or his or
  274  her designee.
  275         14. A layperson member as determined by the State Surgeon
  276  General.
  277  
  278  Appointments to the council shall be made by the State Surgeon
  279  General. Each entity authorized to make recommendations under
  280  this subsection shall make at least two recommendations to the
  281  State Surgeon General for each appointment to the council. The
  282  State Surgeon General shall name one appointee for each position
  283  from the recommendations made by each authorized entity.
  284         (b) Each council member shall be appointed to a 4-year
  285  term. An individual may not serve more than two terms. Any
  286  council member may be removed from office for malfeasance;
  287  misfeasance; neglect of duty; incompetence; permanent inability
  288  to perform official duties; or pleading guilty or nolo
  289  contendere to, or being found guilty of, a felony. Any council
  290  member who meets the criteria for removal, or who is otherwise
  291  unwilling or unable to properly fulfill the duties of the
  292  office, shall be succeeded by an individual chosen by the State
  293  Surgeon General to serve out the remainder of the council
  294  member’s term. If the remainder of the replaced council member’s
  295  term is less than 18 months, notwithstanding the provisions of
  296  this paragraph, the succeeding council member may be reappointed
  297  twice by the State Surgeon General.
  298         (c) The chair of the council is the State Surgeon General,
  299  who shall designate a vice chair from the membership of the
  300  council to serve in the absence of the State Surgeon General. A
  301  vacancy shall be filled for the remainder of the unexpired term
  302  in the same manner as the original appointment.
  303         (d) Council members are not entitled to receive
  304  compensation or reimbursement for per diem or travel expenses.
  305         (e) The council shall meet at least twice a year in person
  306  or by teleconference.
  307         (f) The council shall:
  308         1. Advise the State Surgeon General and the department on
  309  matters concerning current and future physician workforce needs
  310  in this state;
  311         2. Review survey materials and the compilation of survey
  312  information;
  313         3.Annually review the number, location, cost, and
  314  reimbursement of graduate medical education programs and
  315  positions;
  316         4. Provide recommendations to the department regarding the
  317  survey completed by physicians licensed under chapter 458 or
  318  chapter 459;
  319         5. Assist the department in preparing the annual report to
  320  the Legislature pursuant to ss. 458.3192 and 459.0082;
  321         6. Assist the department in preparing an initial strategic
  322  plan, conduct ongoing strategic planning in accordance with this
  323  section, and provide ongoing advice on implementing the
  324  recommendations;
  325         7. Monitor and provide recommendations regarding the need
  326  for an increased number of primary care or other physician
  327  specialties to provide the necessary current and projected
  328  health and medical services for the state; and
  329         8. Monitor and make recommendations regarding the status of
  330  the needs relating to graduate medical education in this state.
  331         (6) PHYSICIAN WORKFORCE GRADUATE MEDICAL EDUCATION
  332  INNOVATION PILOT PROJECTS.—
  333         (a) The Legislature finds that:
  334         1. In order to ensure a physician workforce that is
  335  adequate to meet the needs of this state’s residents and its
  336  health care system, policymakers must consider the education and
  337  training of future generations of well-trained health care
  338  providers.
  339         2. Physicians are likely to practice in the state where
  340  they complete their graduate medical education.
  341         3. It can directly affect the makeup of the physician
  342  workforce by selectively funding graduate medical education
  343  programs to provide needed specialists in geographic areas of
  344  the state which have a deficient number of such specialists.
  345         4. Developing additional positions in graduate medical
  346  education programs is essential to the future of this state’s
  347  health care system.
  348         5. It was necessary in 2007 to pass legislation that
  349  provided for an assessment of the status of this state’s current
  350  and future physician workforce. The department is collecting and
  351  analyzing information on an ongoing basis to assess this state’s
  352  physician workforce needs, and such assessment may facilitate
  353  the determination of graduate medical education needs and
  354  strategies for the state.
  355         (b) There is established under the department a program to
  356  foster innovative graduate medical education pilot projects that
  357  are designed to promote the expansion of graduate medical
  358  education programs or positions to prepare physicians to
  359  practice in needed specialties and underserved areas or settings
  360  and to provide demographic and cultural representation in a
  361  manner that addresses current and projected needs for this
  362  state’s physician workforce. Funds appropriated annually by the
  363  Legislature for this purpose shall be distributed to
  364  participating hospitals, medical schools, other sponsors of
  365  graduate medical education programs, consortia engaged in
  366  developing new graduate medical education programs or positions
  367  in those programs, or pilot projects providing innovative
  368  graduate medical education in community-based clinical settings.
  369  Pilot projects shall be selected on a competitive grant basis,
  370  subject to available funds.
  371         (c) Pilot projects shall be designed to meet one or more of
  372  this state’s physician workforce needs, as determined pursuant
  373  to this section, including, but not limited to:
  374         1. Increasing the number of residencies or fellowships in
  375  primary care or other needed specialties.
  376         2. Enhancing the retention of primary care physicians or
  377  other needed specialties in this state.
  378         3. Promoting practice in rural or medically underserved
  379  areas of the state.
  380         4. Encouraging racial and ethnic diversity within the
  381  state’s physician workforce.
  382         5. Encouraging practice in community health care or other
  383  ambulatory care settings.
  384         6. Encouraging practice in clinics operated by the
  385  department, including, but not limited to, county health
  386  departments, clinics operated by the Department of Veterans’
  387  Affairs, prison clinics, or similar settings of need.
  388         7. Encouraging the increased production of geriatricians.
  389         (d) Priority shall be given to a proposal for a pilot
  390  project that:
  391         1. Demonstrates a collaboration of federal, state, and
  392  local entities that are public or private.
  393         2. Obtains funding from multiple sources.
  394         3. Focuses on enhancing graduate medical education in rural
  395  or underserved areas.
  396         4. Focuses on enhancing graduate medical education in
  397  ambulatory or community-based settings other than a hospital
  398  environment.
  399         5. Includes the use of technology, such as electronic
  400  medical records, distance consultation, and telemedicine, to
  401  ensure that residents are better prepared to care for patients
  402  in this state, regardless of the community in which the
  403  residents practice.
  404         6. Is designed to meet multiple policy needs as enumerated
  405  in subsection (3).
  406         7. Uses a consortium to provide for graduate medical
  407  education experiences.
  408         (e) The department shall adopt by rule appropriate
  409  performance measures to use in order to consistently evaluate
  410  the effectiveness, safety, and quality of the programs, as well
  411  as the impact of each program on meeting this state’s physician
  412  workforce needs.
  413         (f) Participating pilot projects shall submit to the
  414  department an annual report on the project in a manner required
  415  by the department.
  416         (g) Funding provided to a pilot project may be used only
  417  for the direct costs of providing graduate medical education.
  418  Accounting of such costs and expenditures shall be documented in
  419  the annual report.
  420         (h) State funds shall be used to supplement funds from any
  421  local government, community, or private source. The state may
  422  provide up to 50 percent of the funds, and local governmental
  423  grants or community or private sources shall provide the
  424  remainder of the funds.
  425         (7) RULEMAKING.—The department shall adopt rules as
  426  necessary to administer this section.
  427         Section 3. Section 458.3192, Florida Statutes, is amended
  428  to read:
  429         458.3192 Analysis of survey results; report.—
  430         (1) Each year, the Department of Health shall analyze the
  431  results of the physician survey required by s. 458.3191 and
  432  determine by geographic area and specialty the number of
  433  physicians who:
  434         (a) Perform deliveries of children in this state Florida.
  435         (b) Read mammograms and perform breast-imaging-guided
  436  procedures in this state Florida.
  437         (c) Perform emergency care on an on-call basis for a
  438  hospital emergency department.
  439         (d) Plan to reduce or increase emergency on-call hours in a
  440  hospital emergency department.
  441         (e) Plan to relocate their allopathic or osteopathic
  442  practice outside the state.
  443         (f) Practice medicine in this state.
  444         (g) Plan to reduce or modify the scope of their practice.
  445         (2) The Department of Health must report its findings to
  446  the Governor, the President of the Senate, and the Speaker of
  447  the House of Representatives by November 1 each year. The
  448  department shall also include in its report findings,
  449  recommendations, and strategic planning activities as provided
  450  in s. 381.4018. The department may also include other
  451  information requested by the Physician Workforce Advisory
  452  Council.
  453         Section 4. Section 459.0082, Florida Statutes, is amended
  454  to read:
  455         459.0082 Analysis of survey results; report.—
  456         (1) Each year, the Department of Health shall analyze the
  457  results of the physician survey required by s. 459.0081 and
  458  determine by geographic area and specialty the number of
  459  physicians who:
  460         (a) Perform deliveries of children in this state Florida.
  461         (b) Read mammograms and perform breast-imaging-guided
  462  procedures in this state Florida.
  463         (c) Perform emergency care on an on-call basis for a
  464  hospital emergency department.
  465         (d) Plan to reduce or increase emergency on-call hours in a
  466  hospital emergency department.
  467         (e) Plan to relocate their allopathic or osteopathic
  468  practice outside the state.
  469         (f) Practice medicine in this state.
  470         (g)Plan to reduce or modify the scope of their practice.
  471         (2) The Department of Health must report its findings to
  472  the Governor, the President of the Senate, and the Speaker of
  473  the House of Representatives by November 1 each year. The
  474  department shall also include in its report findings,
  475  recommendations, and strategic planning activities as provided
  476  in s. 381.4018. The department may also include other
  477  information requested by the Physician Workforce Advisory
  478  Council.
  479         Section 5. Section 458.315, Florida Statutes, is amended to
  480  read:
  481         458.315 Temporary certificate for practice in areas of
  482  critical need.—
  483         (1) Any physician who:
  484         (a) Is licensed to practice in any jurisdiction in the
  485  United States and other state, whose license is currently valid;
  486  or,
  487         (b) Has served as a physician in the United States Armed
  488  Forces for at least 10 years and received an honorable discharge
  489  from the military;
  490  
  491  and who pays an application fee of $300 may be issued a
  492  temporary certificate for to practice in areas of communities of
  493  Florida where there is a critical need for physicians.
  494         (2) A certificate may be issued to a physician who:
  495         (a) Practices in an area of critical need;
  496         (b) Will be employed by or practice in a county health
  497  department, correctional facility, Department of Veterans’
  498  Affairs clinic, community health center funded by s. 329, s.
  499  330, or s. 340 of the United States Public Health Services Act,
  500  or other agency or institution that is approved by the State
  501  Surgeon General and provides health care to meet the needs of
  502  underserved populations in this state; or
  503         (c) Will practice for a limited time to address critical
  504  physician-specialty, demographic, or geographic needs for this
  505  state’s physician workforce as determined by the State Surgeon
  506  General entity that provides health care to indigents and that
  507  is approved by the State Health Officer.
  508         (3) The Board of Medicine may issue this temporary
  509  certificate with the following restrictions:
  510         (a)(1) The State Surgeon General board shall determine the
  511  areas of critical need, and the physician so certified may
  512  practice in any of those areas for a time to be determined by
  513  the board. Such areas shall include, but are not be limited to,
  514  health professional shortage areas designated by the United
  515  States Department of Health and Human Services.
  516         1.(a) A recipient of a temporary certificate for practice
  517  in areas of critical need may use the certificate license to
  518  work for any approved entity employer in any area of critical
  519  need or as authorized by the State Surgeon General approved by
  520  the board.
  521         2.(b) The recipient of a temporary certificate for practice
  522  in areas of critical need shall, within 30 days after accepting
  523  employment, notify the board of all approved institutions in
  524  which the licensee practices and of all approved institutions
  525  where practice privileges have been denied.
  526         (b)(2) The board may administer an abbreviated oral
  527  examination to determine the physician’s competency, but a no
  528  written regular examination is not required necessary. Within 60
  529  days after receipt of an application for a temporary
  530  certificate, the board shall review the application and issue
  531  the temporary certificate, or notify the applicant of denial, or
  532  notify the applicant that the board recommends additional
  533  assessment, training, education, or other requirements as a
  534  condition of certification. If the applicant has not actively
  535  practiced during the prior 3 years and the board determines that
  536  the applicant may lack clinical competency, possess diminished
  537  or inadequate skills, lack necessary medical knowledge, or
  538  exhibit patterns of deficits in clinical decisionmaking, the
  539  board may:
  540         1.Deny the application;
  541         2.Issue a temporary certificate having reasonable
  542  restrictions that may include, but are not limited to, a
  543  requirement for the applicant to practice under the supervision
  544  of a physician approved by the board; or
  545         3.Issue a temporary certificate upon receipt of
  546  documentation confirming that the applicant has met any
  547  reasonable conditions of the board which may include, but are
  548  not limited to, completing continuing education or undergoing an
  549  assessment of skills and training.
  550         (c)(3) Any certificate issued under this section is shall
  551  be valid only so long as the State Surgeon General determines
  552  that the reason area for which it was is issued remains a an
  553  area of critical need to the state. The Board of Medicine shall
  554  review each temporary certificateholder not the service within
  555  said area not less than annually to ascertain that the minimum
  556  requirements of the Medical Practice Act and its adopted the
  557  rules and regulations promulgated thereunder are being complied
  558  with. If it is determined that such minimum requirements are not
  559  being met, the board shall forthwith revoke such certificate or
  560  shall impose restrictions or conditions, or both, as a condition
  561  of continued practice under the certificate.
  562         (d)(4) The board may shall not issue a temporary
  563  certificate for practice in an area of critical need to any
  564  physician who is under investigation in any jurisdiction in the
  565  United States another state for an act that which would
  566  constitute a violation of this chapter until such time as the
  567  investigation is complete, at which time the provisions of s.
  568  458.331 shall apply.
  569         (4)(5) The application fee and all licensure fees,
  570  including neurological injury compensation assessments, shall be
  571  waived for those persons obtaining a temporary certificate to
  572  practice in areas of critical need for the purpose of providing
  573  volunteer, uncompensated care for low-income residents
  574  Floridians. The applicant must submit an affidavit from the
  575  employing agency or institution stating that the physician will
  576  not receive any compensation for any service involving the
  577  practice of medicine.
  578         Section 6. Section 459.0076, Florida Statutes, is created
  579  to read:
  580         459.0076Temporary certificate for practice in areas of
  581  critical need.—
  582         (1) Any physician who:
  583         (a) Is licensed to practice in any jurisdiction in the
  584  United States and whose license is currently valid; or
  585         (b) Has served as a physician in the United States Armed
  586  Forces for at least 10 years and received an honorable discharge
  587  from the military;
  588  
  589  and who pays an application fee of $300 may be issued a
  590  temporary certificate for practice in areas of critical need.
  591         (2) A certificate may be issued to a physician who:
  592         (a) Will practice in an area of critical need;
  593         (b) Will be employed by or practice in a county health
  594  department, correctional facility, Department of Veterans’
  595  Affairs clinic, community health center funded by s. 329, s.
  596  330, or s. 340 of the United States Public Health Services Act,
  597  or other agency or institution that is approved by the State
  598  Surgeon General and provides health care to meet the needs of
  599  underserved populations in this state; or
  600         (c) Will practice for a limited time to address critical
  601  physician-specialty, demographic, or geographic needs for this
  602  state’s physician workforce as determined by the State Surgeon
  603  General.
  604         (3) The Board of Osteopathic Medicine may issue this
  605  temporary certificate with the following restrictions:
  606         (a) The State Surgeon General shall determine the areas of
  607  critical need. Such areas include, but are not limited to,
  608  health professional shortage areas designated by the United
  609  States Department of Health and Human Services.
  610         1. A recipient of a temporary certificate for practice in
  611  areas of critical need may use the certificate to work for any
  612  approved entity in any area of critical need or as authorized by
  613  the State Surgeon General.
  614         2. The recipient of a temporary certificate for practice in
  615  areas of critical need shall, within 30 days after accepting
  616  employment, notify the board of all approved institutions in
  617  which the licensee practices and of all approved institutions
  618  where practice privileges have been denied.
  619         (b) The board may administer an abbreviated oral
  620  examination to determine the physician’s competency, but a
  621  written regular examination is not required. Within 60 days
  622  after receipt of an application for a temporary certificate, the
  623  board shall review the application and issue the temporary
  624  certificate, notify the applicant of denial, or notify the
  625  applicant that the board recommends additional assessment,
  626  training, education, or other requirements as a condition of
  627  certification. If the applicant has not actively practiced
  628  during the prior 3 years and the board determines that the
  629  applicant may lack clinical competency, possess diminished or
  630  inadequate skills, lack necessary medical knowledge, or exhibit
  631  patterns of deficits in clinical decisionmaking, the board may:
  632         1.Deny the application;
  633         2.Issue a temporary certificate having reasonable
  634  restrictions that may include, but are not limited to, a
  635  requirement for the applicant to practice under the supervision
  636  of a physician approved by the board; or
  637         3.Issue a temporary certificate upon receipt of
  638  documentation confirming that the applicant has met any
  639  reasonable conditions of the board which may include, but are
  640  not limited to, completing continuing education or undergoing an
  641  assessment of skills and training.
  642         (c) Any certificate issued under this section is valid only
  643  so long as the State Surgeon General determines that the reason
  644  for which it was issued remains a critical need to the state.
  645  The Board of Osteopathic Medicine shall review each temporary
  646  certificateholder not less than annually to ascertain that the
  647  minimum requirements of the Osteopathic Medical Practice Act and
  648  its adopted rules are being complied with. If it is determined
  649  that such minimum requirements are not being met, the board
  650  shall revoke such certificate or shall impose restrictions or
  651  conditions, or both, as a condition of continued practice under
  652  the certificate.
  653         (d) The board may not issue a temporary certificate for
  654  practice in an area of critical need to any physician who is
  655  under investigation in any jurisdiction in the United States for
  656  an act that would constitute a violation of this chapter until
  657  such time as the investigation is complete, at which time the
  658  provisions of s. 459.015 apply.
  659         (4) The application fee and all licensure fees, including
  660  neurological injury compensation assessments, shall be waived
  661  for those persons obtaining a temporary certificate to practice
  662  in areas of critical need for the purpose of providing
  663  volunteer, uncompensated care for low-income residents. The
  664  applicant must submit an affidavit from the employing agency or
  665  institution stating that the physician will not receive any
  666  compensation for any service involving the practice of medicine.
  667         Section 7. This act shall take effect July 1, 2010.

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