Scope of Practice and Reproductive Health Changes Coming to Florida
Many new laws passed by the Florida Legislature during the 2020 session go into effect on July 1. Two bills that are among those that will have an impact on medical practices are highlighted below.
Expansion of Nurse Practitioners' Scope
Senate Bill 607 significantly expands the scope of nurse practitioners in Florida by authorizing Advanced Practice Registered Nurses (APRNs) to engage in autonomous practice of primary care. Primary care includes family medicine, general pediatrics and general internal medicine. An APRN can also practice autonomously if he or she is certified by the American College of Nurse Midwives to engage in midwifery. In order to practice autonomously, an APRN must document to the Board of Nursing (BON) that he or she has an unencumbered license under s. 464.012, F.S.; no disciplinary action against his or her license in the past five years; 3,000 clinical hours supervised by a physician in the past five years; completion of six college semester hours within the last five years (three in pharmacology and three in a differential diagnosis); financial responsibility to pay claims and costs arising out of the rendering of or failure to render nursing care, treatment or services in an amount not less than $100,000 per claim with a minimum annual aggregate of not less than $300,000; and any additional requirements imposed by BON rule. SB 607 also creates a nine-member Council on Advanced Practice Registered Nurse Autonomous Practice, establishes requirements for continuing education requirements through the BON, requires disclosures to new patients, creates additional grounds for discipline and provides $5 million in state funds for the Health Care Education Reimbursement and Loan Repayment Program for APRNs registered under s. 464.0123. Nursing home facilities are authorized to use paid feeding assistants who have completed a 12-hour program developed by American Health Care Association (AHCA). A registered nurse (RN) can delegate tasks to a certified nursing assistant (CNA) or home health aide (HHA), except the administration of controlled substances.
Written Consent for Reproductive Health
Senate Bill 698 will require a significant change for some physician practices. It requires a healthcare practitioner, medical student or any other student who is receiving training as a healthcare practitioner to obtain the written consent of a patient or a patient's representative before performing a pelvic exam (exception for court-ordered collection of evidence or to avert a serious health risk). This includes pelvic exams of both males and females. Other provisions of the new law include:
- disciplinary action against a healthcare practitioner's license if he or she intentionally transfers an embryo or reproductive material without the recipient's consent
- crime of reproductive battery (third-degree felony to implant or transfer embryo or reproductive material without consent of the recipient; penalty increased to second-degree felony if the donor is the healthcare practitioner)
- statute of limitations does not begin until the date the violation is discovered and reported to law enforcement or other government agency; it is not a defense to the crime that the recipient consented to the use of an anonymous donor