Legislative Update For June 15, 2019

Non-Opioid Alternatives - HB 451 (Plakon) - PASSED

HB 451 requires the Department of Health to create and publish on its website an educational pamphlet regarding the use of non-opioid alternatives to treat pain.  Health care providers, except in the provision of emergency care, must inform patients of non-opioid alternatives for the treatment of pain before providing anesthesia or prescribing, ordering, dispensing or administering an opioid drug and document the non-opioid alternatives considered in the patient’s record.

APRN Practice Modernization - HB 821 (Pigman)/SB 972 (Brandes) - DIED

HB 821 and SB 972 are the advanced practice nursing coalition-backed bills that would achieve independent practice for all Florida APRNS and Physician’s Assistants.  Under the bills, an APRN or PA who holds an active unencumbered license and has completed 2,000 clinical practice or clinical instructional hours as an APRN or PA may register to practice independently.  As an alternative to the 2,000 hour requirement, the House Bill provides that an APRN or PA who has completed a graduate level course in pharmacology is also eligible to practice independently.      

HB 821 passed the House.  Unfortunately, the Senate did not hear SB 972 in any committees, which killed the bill for this session. The robust debate in the House certainly helped to elevate awareness on the issue and will set the stage for us to continue the fight next year.

Office Surgery - SB 732 (Flores) - PASSED

As originally filed, SB 732 and its companion, HB 933, required an anesthesiologist be “present and available” for certain office surgery procedures.  The language was then changed to require a CRNA practicing in an office surgery setting to have a protocol with an anesthesiologist.  We were successful in having amendments adopted to remove any restrictions on CRNA practice from SB 732 and the House companion, HB 933. 

Ambulatory Surgical Centers/Recovery Care Centers -HB 843 (Rodriguez, A.M) - PASSED

While there was no concern regarding the underlying idea behind ambulatory surgical centers, SB 434 referenced a report on pediatric surgical standards that would have required CRNAs to be supervised on-site by an anesthesiologist.   This language was not included in the House bill, and we were successful in removing the problematic language from the bill that ultimately passed.  

Electronic Prescribing – HB 831 (Mariano) - PASSED

HB 831 requires prescribers to generate and transmit all prescriptions electronically by 2021.  An amendment was filed to the Senate companion, SB 1192, which required the Department of Health to adopt rules to implement the law and to consult with the Board of Medicine and Board of Osteopathic Medicine in its rulemaking activities. 

We pointed out to the bill and amendment sponsor, Sen. Bean, that other providers such as APRNs, podiatrists, dentists and optometrists, all prescribe medications and the boards regulating those practices should also be consulted.  The sponsor agreed and filed an amendment to require FDOH to consult with all of those boards in its rulemaking.  The amendment was adopted and language requiring the Department to consult with the Board of Nursing and other boards was included in the bill that passed the legislature.

Advanced Birth Centers - SB 448 (Harrell) /HB 383 (Burton) - DIED

These bills authorized a new type of facility called an “advanced birth center,” which is a specialized ambulatory surgical center for patients with low-risk pregnancies.  The bills contained language that required an anesthesiologist to be one of the medical directors for the center.  In addition, under the bills advanced birth centers would be subject to the same “on-site medical direction” requirement for CRNAs as hospitals and ambulatory surgical centers. 

We were successful in convincing the House to remove the requirement that an anesthesiologist be a medical director when it amended the substance of HB 383 onto HB 25, an unrelated health care bill.  Ultimately, no language relating to advance birth centers passed the Legislature this year.


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