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FAPA Legislative Updates

2019 Updates

 

 

Understanding new laws that affect your practice

Prepared by Corinne Mixon, FAPA Lobbyist

 

Governor DeSantis has acted on all of the bills that passed during the 2019 Florida Legislation. As a result, several new laws have just taken effect beginning July of 2019. Although FAPA originally reported about these bills after the legislative session, we wanted to make this overview available online now that the bills have become law. Please do not hesitate to reach out to FAPA with questions regarding these new laws.


Mental Health

Senate Bill 1418 adds additional circumstances when information from the confidential clinical record may be released to ensure that communication of a specific threat to cause bodily injury or death is timely reported to law enforcement. It further requires that when a patient communicates a specific threat against an identifiable individual to a mental health service provider, including a psychiatrist, the provider must notify law enforcement of the potential threat. The language provides that the disclosure of the threatening confidential communications may not be the basis of civil and criminal legal action. To assist with understanding the changes in law, words stricken are deletions; words underlined are additions. The law is effective July 1, 2019.

 

394.4615 Clinical records; confidentiality.— (3) Information from the clinical record may be released in the following circumstances:
    (a) When a patient has communicated to a service provider a specific threat to cause serious bodily injury or death to an identified or a readily available person, if the service provider reasonably believes, or should reasonably believe according to the standards of his or her profession, that the patient has the apparent intent and ability to imminently or immediately carry out such threat declared an intention to harm other persons. When such communication declaration has been made, the administrator may authorize the release of sufficient information to provide adequate warning to the person threatened with harm by the patient.

For the purpose of determining whether a person meets the criteria for involuntary outpatient placement or for preparing the proposed treatment plan pursuant to s. 394.4655, the clinical record may be released to the state attorney, the public defender or the patient’s private legal counsel, the court, and to the appropriate mental health professionals, including the service provider identified in s.394.4655(7)(b)2., in accordance with state and federal law.
    (4) Information from the clinical record must be released when a patient has communicated to a service provider a specific threat to cause serious bodily injury or death to an identified or a readily available person, if the service provider reasonably believes, or should reasonably believe according to the standards of his or her profession, that the patient has the apparent intent and ability to imminently or immediately carry out such threat. When such communication has been made, the administrator must authorize the release of sufficient information to communicate the threat to law enforcement. A law enforcement agency that receives notification of a specific threat under this subsection must take appropriate action to prevent the risk of harm, including, but not limited to, notifying the intended victim of such threat or initiating a risk protection order. A service provider’s authorization to release information from a clinical record when communicating a threat pursuant to this section may not be the basis of any legal action or criminal or civil liability against the service provider.


Non-Opioid Alternatives Legislation

This must-read policy relates to the suggested use of non-opioid alternatives for the treatment of pain. This bill requires that health care providers, prior to ordering anesthesia or prescribing a Schedule II opioid drug, inform the patient of available non-opioid alternatives for treatment of pain, discuss the advantages and disadvantages of non-opioid alternatives and provide the patient with an informational pamphlet developed by the Department of Health.

Over the past three years, the Florida Legislature has demonstrated its willingness to take aggressive steps toward curbing opioid-related deaths among Floridians. Early versions of HB 451 would have created burdensome requirements for prescribers and made them subject to significant disciplinary action; however, the bill was substantially amended to reflect the concerns of the various medical associations, FAPA and other professional associations. This final version of the legislation ultimately did not receive push-back due to the sensitive nature of the opioid crisis and the legislature’s willingness to amend the bill.

 

Detailed overview:

The law which took effect this month provides that, before a prescriber prescribes, orders, dispenses or administers a Schedule II medication for the treatment of pain, he or she is required to do the following:

1.       Tell the patient that non-opioid treatments may be beneficial for the treatment of pain. Non-opioid alternatives may include, but are not limited to, the following: non-opioid medications, interventional procedures or treatments, acupuncture, chiropractic treatments, massage therapy, physical therapy and occupational therapy. The prescribing clinician is in charge of determining which alternative solution(s) may be effective. Should the prescriber, in his/her clinical judgement, feel that an opioid-alternative would not be useful, he/she is not required to discuss alternatives to opioids.

2.       Discuss the risks and history of controlled substance abuse.

3.       Give the patient the educational pamphlet developed by the Department of Health.

4.       Record the suggested non-opioid alternatives in the patient’s record (if none are recommended, this isn’t necessary).

Key exceptions:

1.       If the clinician is prescribing, ordering, administering or dispensing a Schedule II opioid for reasons other than the treatment of pain, the requirements above do not apply.  

2.       If he/she is prescribing, ordering, administering or dispensing a Schedule III-V opioid, for any reason, the above requirements do not apply.

3.       If the practitioner is prescribing, ordering, administering or dispensing a non-opioid, regardless of the schedule, the above requirements do not apply.


Telehealth

Florida has broadened its regulation of telehealth providers through passage of HB 23. The bill creates a definition of telehealth which specifically excludes audio-only telephone calls, e-mail messages or facsimile transmission.

Furthermore, the bill establishes standards of practice for telehealth providers by:

1.       Creating a registration process and requirements for out-of-state telehealth providers

a.       The new registration process for out-of-state providers will make specific information regarding those providers available to the public, including out-of-state license numbers, malpractice insurance coverage and disciplinary history.

b.       The law creates a framework for disciplining out-of-state providers.

2.       Establishing record-keeping requirements for telehealth providers

3.       Authorizing the prescription of controlled substances, in certain situations via telehealth, which was previously prohibited.

Prior to 2019, out-of-state practitioners could not provide telehealth services in Florida. The medical community remains concerned that we will not be able to adequately discipline these providers. The state boards will oversee rulemaking and FAPA will be actively involved in that process.

 

Keep an eye on these policies which will become law in January – FAPA will send an update when these take effect.


Electronic Prescribing

Also effective January 1, 2020, practitioners who maintain or who own an electronic health records (EHR) system, are employed by or under contract with, a health care facility or practice that maintains such a system, will be required to electronically transmit prescriptions for drugs by either the renewal of the practitioner’s license or by July 1, 2021, whichever is earlier. There are a number of exceptions, but they are relatively narrow.

Again, even though the law will go into effect this January, each prescriber has until either their renewal of licensure or July 1, 2021, to adjust to only e-prescribing.


Office Surgery

Physician offices will be required to register with the Department of Health by January 1, 2020, if they perform a liposuction procedure where more than 1,000 cc. of fat is removed, a Level II office surgery or a Level III office surgery. The new law will authorize the Department to regulate these physician offices, which will include annual site visits, financial responsibility requirements and the designation of a physician to be responsible for the office’s compliance with health and safety requirements.

 

2018 Updates

Two bills FAPA may fight in the 2018 Florida Legislative Session

  

2017 Updates

Legislative Victory

Over the past few years, the Florida Academy of Physician Assistants (FAPA) has battled misinformation being spread concerning how PAs are integrated within the healthcare team throughout the State of Florida. This misinformation sometimes leads to burdensome opposition to FAPA’s ideas about policy making. It’s paramount that FAPA garners any information possible to bolster great decision-making by state policymakers on behalf of Florida’s nearly 8,000 PAs....Read More.


2016 Updates

 

FAPA Knocks Down Even More Barriers to PA Practice


2014 Updates

  • Dr. Nobo and Rick Morales supporting Physician Assistants

more Upcoming Events

10/5/2019
West Central Region CME Day

10/6/2019 » 10/12/2019
PA Week 2019

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FAPA Mission Statement: Empower, represent, and advocate for Florida PAs

 

FAPA Vision: Fully integrate PAs into every aspect of health care in Florida.


 

 

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