February 24, 2020
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       Florida Senate - 2010                                     SB 652
       By Senator Rich
       34-00522-10                                            2010652__
    1                        A bill to be entitled                      
    2         An act relating to reproductive health services and
    3         family planning; creating the “Prevention First Act”;
    4         providing definitions; providing duties of licensed
    5         health care practitioners and facilities relating to
    6         the treatment of rape survivors; requiring the
    7         Department of Health to provide certain information;
    8         requiring the Agency for Health Care Administration to
    9         provide for enforcement and impose penalties;
   10         requiring the agency to adopt rules; amending s.
   11         390.011, F.S.; defining the term “contraception”;
   12         creating s. 390.027, F.S.; specifying that the
   13         provision of contraception is not subject to ch. 390,
   14         F.S., relating to the termination of pregnancies;
   15         creating s. 465.191, F.S.; providing definitions;
   16         requiring licensed pharmacies to dispense certain
   17         forms of contraception without delay; specifying
   18         conditions under which a pharmacy may refuse to
   19         provide a contraceptive; providing for a person to
   20         file a complaint with the Department of Health if he
   21         or she believes that a violation of such provisions
   22         has occurred; providing for the Attorney General to
   23         bring a civil action; amending ss. 465.016 and
   24         465.023, F.S.; providing that a violation of
   25         requirements for dispensing contraception constitutes
   26         grounds for the Department of Health or the Board of
   27         Pharmacy to impose disciplinary action or suspend or
   28         revoke a pharmacist’s license or permit; providing for
   29         severability; providing an effective date.
   31         WHEREAS, although the Centers for Disease Control and
   32  Prevention included family planning in its published list of Ten
   33  Great Public Health Achievements in the 20th Century, the United
   34  States still has one of the highest rates of unintended
   35  pregnancies among industrialized nations, and
   36         WHEREAS, the Legislature finds that family planning is
   37  basic health care for women and that access to contraception
   38  helps women prevent unintended pregnancy and control the timing
   39  and spacing of planned births, and
   40         WHEREAS, 46.3 percent of pregnancies among women in this
   41  state are unintended according to the Florida Pregnancy Risk
   42  Assessment Monitoring System initiated by the United States
   43  Centers for Disease Control and Prevention and the Florida
   44  Department of Health, and
   45         WHEREAS, 98 percent of all women will use contraception at
   46  some point in their lifetime according to the Guttmacher
   47  Institute, and
   48         WHEREAS, currently more than 1.9 million women in Florida
   49  are in need of contraceptive services and supplies, and
   50         WHEREAS, the Legislature finds that the victimization of
   51  women through rape is compounded by the possibility that the
   52  rape survivors may suffer unintended pregnancies, and half of
   53  such pregnancies end in abortion, and
   54         WHEREAS, women rely on prescription contraceptives for a
   55  range of medical purposes in addition to birth control, such as
   56  regulation of menstrual cycles and the treatment of
   57  endometriosis, and
   58         WHEREAS, the Legislature further finds that providing
   59  access to family planning information, family planning services,
   60  and birth control will prevent abortions and unintended
   61  pregnancies, thereby significantly reducing the number of women
   62  and teens who need medical assistance, Medicaid, Kidcare, and
   63  other social services, and
   64         WHEREAS, the Legislature recognizes that the most recent
   65  study of women in need of family planning services by the
   66  Florida State University Center for Prevention and Early
   67  Intervention Policy found that only 26 percent of women in this
   68  state who are in need of such services are currently receiving
   69  them, and
   70         WHEREAS, according to the Department of Health’s Family
   71  Planning Program, for every dollar spent on family planning
   72  services, up to $24 is saved as a result of averting
   73  expenditures for public programs that support women who have
   74  unintended pregnancies and their infants, NOW, THEREFORE,
   76  Be It Enacted by the Legislature of the State of Florida:
   78         Section 1. This act may be cited as the “Prevention First
   79  Act.”
   80         Section 2. Treatment for survivors of rape.—
   81         (1) DEFINITIONS.—As used in this section, the term:
   82         (a) “Agency” means the Agency for Health Care
   83  Administration.
   84         (b) “Care to a rape survivor” means medical examinations,
   85  procedures, and services provided to a rape survivor.
   86         (c) “Department” means the Department of Health.
   87         (d) “Emergency contraception” means one or more
   88  prescription or over-the-counter drugs used separately or in
   89  combination to be administered to or self-administered by a
   90  patient to prevent pregnancy within a medically recommended
   91  amount of time after sexual intercourse and dispensed for that
   92  purpose, in accordance with professional standards of practice,
   93  and determined to be safe by the United States Food and Drug
   94  Administration.
   95         (e) “Health care facility” means a facility licensed under
   96  chapter 395, Florida Statutes.
   97         (f) “Incest” means a sexual offense described in s. 826.04,
   98  Florida Statutes.
   99         (g) “Medically and factually accurate” means information
  100  that is supported by the weight of research conducted in
  101  compliance with accepted scientific methods and that is
  102  recognized as accurate and objective by leading professional
  103  organizations and agencies having relevant expertise in the
  104  field.
  105         (h) “Rape” means sexual battery as described in ss. 794.011
  106  and 827.071, Florida Statutes.
  107         (i) “Rape survivor” means a person who alleges or is
  108  alleged to have been raped or who is the victim of alleged
  109  incest and because of the alleged offense seeks treatment as a
  110  patient.
  112         (a) A health care practitioner licensed under chapter 458,
  113  chapter 459, or chapter 464, Florida Statutes, or a health care
  114  facility licensed under chapter 395, Florida Statutes, providing
  115  care to a rape survivor shall:
  116         1. Provide each female rape survivor with medically and
  117  factually accurate, clear, and concise information concerning
  118  emergency contraception, including its indications and
  119  contraindications and the risks associated with its use.
  120         2. Inform each female rape survivor of her medical option
  121  to receive emergency contraception.
  122         (b) If emergency contraception is requested, the health
  123  care practitioner or health care facility shall immediately
  124  provide the female rape survivor with the complete regimen of
  125  emergency contraception, unless contraindicated as determined by
  126  a pregnancy test approved by the United States Food and Drug
  127  Administration.
  128         (c) The Agency for Health Care Administration, with input
  129  from the Florida Hospital Association and the Florida Council
  130  Against Sexual Violence, shall adopt a protocol to implement the
  131  requirements of this subsection.
  132         (3) PATIENT INFORMATION.—
  133         (a) The department shall:
  134         1. Develop, prepare, and produce informational materials
  135  relating to emergency contraception for the prevention of
  136  pregnancy for distribution to and use in all health care
  137  facilities in the state which provide care to rape survivors, in
  138  quantities sufficient to comply with the requirements of this
  139  section, to the extent that funds are available.
  140         2. Develop, prepare, and post information on the
  141  department’s Internet website relating to the duty of licensed
  142  health care practitioners and health care facilities to provide
  143  emergency contraception to female rape survivors.
  144         (b) Information provided to female rape survivors or female
  145  victims of sexual assault must:
  146         1. Be medically and factually accurate;
  147         2. Be clearly written, readily comprehensible, and
  148  culturally appropriate as determined by the department, in
  149  collaboration with community sexual assault programs and other
  150  relevant stakeholders; and
  151         3. Explain the nature of emergency contraception, including
  152  its use, safety, efficacy, and availability.
  154         (a) In addition to any other remedies provided by law, the
  155  agency shall respond to complaints, using all available
  156  investigative tools, and shall periodically review whether a
  157  health care facility is in compliance with this section. If the
  158  agency finds that a health care facility is not in compliance
  159  with this section, the agency shall:
  160         1. Impose a fine of $5,000 per woman who is:
  161         a. Denied medically and factually accurate and objective
  162  information about emergency contraception;
  163         b. Not informed of her medical option to receive emergency
  164  contraception; or
  165         c. Not provided the complete regimen of emergency
  166  contraception, if emergency contraception is requested.
  167         2. Impose a fine of $5,000 for failure to comply with this
  168  section. For every 30 days that a health care facility is not in
  169  compliance with this section, an additional fine of $5,000 shall
  170  be imposed.
  171         (b) The agency shall adopt rules as necessary to administer
  172  the provisions of this section.
  173         Section 3. Present subsections (4) through (8) of section
  174  390.011, Florida Statutes, are redesignated as subsections (5)
  175  through (9), respectively, and a new subsection (4) is added to
  176  that section, to read:
  177         390.011 Definitions.—As used in this chapter, the term:
  178         (4) “Contraception” means any drug or device approved by
  179  the United States Food and Drug Administration to prevent
  180  pregnancy.
  181         Section 4. Section 390.027, Florida Statutes, is created to
  182  read:
  183         390.027 Access to contraception.—The provision of
  184  contraception is not subject to or governed by this chapter.
  185         Section 5. Section 465.191, Florida Statutes, is created to
  186  read:
  187         465.191 Patient contraceptive protection.—
  188         (1) DEFINITIONS.—As used in this section, the term:
  189         (a) “Contraception” or “contraceptive” means any
  190  prescription drug or over-the-counter oral contraceptive
  191  approved by the United States Food and Drug Administration to
  192  prevent pregnancy.
  193         (b) “Employee” means a person hired, by contract or any
  194  other form of agreement, by a pharmacy.
  195         (c) “Product” means a drug or device approved by the United
  196  States Food and Drug Administration.
  197         (d) “Professional clinical judgment” means the use of
  198  professional knowledge and skills to form a clinical judgment in
  199  accordance with prevailing medical standards.
  200         (e) “Without delay,” with respect to a pharmacy dispensing
  201  a prescription for contraception, means within the pharmacy’s
  202  customary timeframe for dispensing the prescription for other
  203  products.
  205         (a) If a patient requests a contraceptive that is in stock,
  206  the pharmacy shall ensure that the contraceptive is provided to
  207  the patient or patient representative without delay.
  208         (b) A pharmacy shall ensure that its employees do not:
  209         1. Intimidate, threaten, or harass a patient in the
  210  delivery of services relating to a request for contraception;
  211         2. Interfere with or obstruct the delivery of services
  212  relating to a request for contraception;
  213         3. Intentionally misrepresent or deceive a patient about
  214  the availability of contraception or its mechanism of action;
  215         4. Breach medical confidentiality with respect to a request
  216  for contraception or threaten to breach such confidentiality; or
  217         5. Refuse to return a valid, lawful prescription for
  218  contraception upon a patient’s or patient representative’s
  219  request.
  220         (c) This section does not prohibit a pharmacy from refusing
  221  to provide a contraceptive to a patient if:
  222         1. It is unlawful to dispense the contraceptive to the
  223  patient without a valid, lawful prescription and such
  224  prescription is not presented;
  225         2. The patient or patient representative is unable to pay
  226  for the contraceptive; or
  227         3. The employee of the pharmacy refuses to provide the
  228  contraceptive on the basis of a professional clinical judgment.
  229         (d) This section does not prevent a pharmacist or other
  230  person from refusing to furnish any in-stock contraceptive for
  231  religious reasons so long as the pharmacy reasonably
  232  accommodates the patient or patient representative without delay
  233  and in compliance with this section.
  234         (e) This section does not alter any standard established
  235  under the Florida Civil Rights Act of 1992.
  236         (f) Any person who believes that a violation of this
  237  section has occurred may file a complaint with the Department of
  238  Health.
  239         (g) If the Attorney General has reasonable cause to believe
  240  that any person or group of persons is being, has been, or may
  241  be injured by conduct constituting a violation of this section,
  242  the Attorney General may bring a civil action in the name of the
  243  state, as parens patriae on behalf of natural persons residing
  244  in the state.
  245         Section 6. Paragraph (t) is added to subsection (1) of
  246  section 465.016, Florida Statutes, to read:
  247         465.016 Disciplinary actions.—
  248         (1) The following acts constitute grounds for denial of a
  249  license or disciplinary action, as specified in s. 456.072(2):
  250         (t) Violating the provisions of s. 465.191.
  251         Section 7. Subsection (1) of section 465.023, Florida
  252  Statutes, is amended to read:
  253         465.023 Pharmacy permittee; disciplinary action.—
  254         (1) The department or the board may revoke or suspend the
  255  permit of any pharmacy permittee, and may fine, place on
  256  probation, or otherwise discipline any pharmacy permittee if the
  257  permittee, or any affiliated person, partner, officer, director,
  258  or agent of the permittee, including a person fingerprinted
  259  under s. 465.022(3), has:
  260         (a) Obtained a permit by misrepresentation or fraud or
  261  through an error of the department or the board;
  262         (b) Attempted to procure, or has procured, a permit for any
  263  other person by making, or causing to be made, any false
  264  representation;
  265         (c) Violated any of the requirements of this chapter or any
  266  of the rules of the Board of Pharmacy; of chapter 499, known as
  267  the “Florida Drug and Cosmetic Act”; of 21 U.S.C. ss. 301-392,
  268  known as the “Federal Food, Drug, and Cosmetic Act”; of 21
  269  U.S.C. ss. 821 et seq., known as the Comprehensive Drug Abuse
  270  Prevention and Control Act; or of chapter 893;
  271         (d) Been convicted or found guilty, regardless of
  272  adjudication, of a felony or any other crime involving moral
  273  turpitude in any of the courts of this state, of any other
  274  state, or of the United States;
  275         (e) Been convicted or disciplined by a regulatory agency of
  276  the Federal Government or a regulatory agency of another state
  277  for any offense that would constitute a violation of this
  278  chapter;
  279         (f) Been convicted of, or entered a plea of guilty or nolo
  280  contendere to, regardless of adjudication, a crime in any
  281  jurisdiction which relates to the practice of, or the ability to
  282  practice, the profession of pharmacy;
  283         (g) Been convicted of, or entered a plea of guilty or nolo
  284  contendere to, regardless of adjudication, a crime in any
  285  jurisdiction which relates to health care fraud; or
  286         (h) Dispensed any medicinal drug based upon a communication
  287  that purports to be a prescription as defined by s. 465.003(14)
  288  or s. 893.02 when the pharmacist knows or has reason to believe
  289  that the purported prescription is not based upon a valid
  290  practitioner-patient relationship that includes a documented
  291  patient evaluation, including history and a physical examination
  292  adequate to establish the diagnosis for which any drug is
  293  prescribed and any other requirement established by board rule
  294  under chapter 458, chapter 459, chapter 461, chapter 463,
  295  chapter 464, or chapter 466; or.
  296         (i) Violated the provisions of s. 465.191.
  297         Section 8. If any provision of this act or the application
  298  thereof to any person or circumstance is held invalid, the
  299  invalidity does not affect other provisions or applications of
  300  the act which can be given effect without the invalid provision
  301  or application, and to this end the provisions of this act are
  302  severable.
  303         Section 9. This act shall take effect July 1, 2010.

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