MASSAGE THERAPY LAWS AND are licensure, enforcement and information. Administrative Code, and the third reviews RULES - LEGAL UPDATE 2011 The Florida Board of Massage Therapy, recent announcements and frequently asked created within the Florida Department of questions regarding massage therapy in (10 CE Hours) Health, consists of seven members appointed Florida. by the Governor and confi rmed by the Objectives Notes pertaining to the development of the Florida Senate. Board members administer  List the organizations responsible for law in specifi c subject areas are detailed in and enforce the law regulating massage regulating massage therapy in Florida. the History sections, referred to at points therapy, encompassed primarily in Chapter  Name the two primary legal documents throughout the text. Each corresponds to 480, Florida Statutes (FS). The Board is also regulating massage therapy in Florida. a section of the Florida Statutes or Florida empowered to pass rules that enable it to  Discuss the qualifi cations and Administrative Code, with citations to the implement its statutorily authorized duties and responsibilities of the Board of Massage section and chapter number of the creating act responsibilities. These rules are contained in Therapy. and each subsequent amendatory act in the Chapter 64B7, Florida Administrative Code  List changes to electronic health records Laws of Florida. (FAC). These two documents are the primary associated with 2009-172. regulating instruments for massage therapy in This chapter fulfi lls ten continuing education  List the incentives and disincentives Florida: hours addressing recent legal updates for prohibiting Medicaid fraud in the health  Chapter 480, Florida Statutes: Massage Massage Therapy professionals. The chapter care professions. Therapy http://www.leg.state.fl .us/ will also provide links to review legislative  Explain the requirements of 2010-211 statutes/index.cfm?App_mode=Display_ changes in more detail, and direct you to regarding medical record releases. Statute&URL=0400-0499/0480/0480.html a variety of massage therapy resources for  Describe the responsibilities of apprentices  Rules: Chapter 64B7, Florida further information. and sponsors in an approved apprenticeship Administrative Code https://www. training program. fl rules.org/gateway/Organization. PART I: Florida Statues – Laws  Describe the requirements for instructors asp?OrgNo=64b7 The Florida Statutes (found at http://www. and massage therapy students training in leg.state.fl .us/STATUTES/) are a permanent colonics irrigation. While most of the legal requirements collection of state laws organized by subject  List the laws and guidelines governing associated with massage therapy are addressed area into a code made up of titles, chapters, establishments of massage therapy and in these documents, other laws regulating its parts, and sections. The Florida Statutes are requirements for the premises. practice are found in these, and other, statute updated annually by laws that create, amend,  List the changes in Chapter 64B7 FAC that chapters. or repeal statutory material. Legislative became effective in 2010.  Chapter 112, Florida Statutes: Public changes to the Florida Statutes effective up Offi cers and Employees: General to and including January 1, 2012, are treated Introduction Provisions as current for publication of the 2011 Florida This chapter discusses recent legislative  Chapter 119, Florida Statutes: Public Statutes. This means that some material in the changes that affect practitioners of massage Records 2011 edition may not take effect up to or until therapy. As this is an ongoing process,  Chapter 120, Florida Statutes: January 1, 2012. All information presented it is a good idea to get acquainted with a Administrative Procedure Act here is currently in effect unless otherwise number of web sites that provide up-to-date  Chapter 408, Florida Statutes: Health Care noted. information about your legal responsibilities Administration as a professional in the fi eld. Most of the  Chapter 456, Florida Statutes: Health information in this chapter is drawn from the The sections below highlight legislative Professions and Occupations: General following governmental web sites, which revisions of primary relevance to massage Provisions provide current and historical information therapists from the Florida Statutes for the regarding the legislative process and results: Because Chapter 480 Florida Statutes and 2009, 2010, and 2011 legislative sessions, but  Florida Senate web site: http://www. Chapter 64B7 FAC are so central to massage it is not a complete list of all changes. For fl senate.gov practice, they are reproduced here in their example, many revisions to Chapter 112 and  Florida House web site: http://www. entirety. The other chapters are excerpted in Chapter 119 FS are of a technical nature, myfl oridahouse.gov part, as necessary, to emphasize legislative for the purposes of revising laws to delete  Florida Department of State: http:// changes, which are summarized. While this expired or obsolete language and correct election.dos.state.fl .us chapter highlights many of the legislative cross-references and grammatical errors, changes in massage therapy in recent years, among other functions. While these laws You will also fi nd it valuable to check the it does not address all changes. Please alter existing massage therapy regulations, Florida Department of Health Massage refer directly to the Statutes and Florida they do not require any action on the part of Therapy Web Page to learn about professional Administrative Code for the complete and practitioners, so have not been included. For updates and alerts in the fi eld of massage current version of the laws and rules. further information or detail regarding recent therapy, at: legislative changes, refer to the links and web  http://www.doh.state.fl .us/mqa/massage/ Statutory changes affecting massage therapy sites noted in the chapter. index.html law occur regularly, with minor changes occurring some years, and sweeping changes New laws are listed fi rst by their new number Massage therapy regulation in others. This chapter will review select (the year the legislation was passed – 2009, The Florida Department of Health (FDH), legislative changes affecting Massage Therapy 2010, or 2011), then a dash, then the next through its Division of Medical Quality practice, focusing on the past three years, number in a the sequence, beginning with “1” Assurance (MQA), oversees licensure beginning with the most recent legislative at the start of the session, then by their title, requirements for practitioners of massage session, in 2011. The fi rst part of the chapter then by their previous bill number (HB for therapy. MQA’s three key business processes addresses changes in the Florida Statutes, House, and SB for Senate). The title and links the second discusses changes in the Florida are followed by summaries of the amended Elite CME - www.EliteCME.com Page 1 statutes, and selected portions of the revised is appropriate when a health care provider care providers will enable providers to text of the statute, which will be printed with exchanges the health record upon receipt of have cost-effective access to the medical strikethroughs and underscores to show recent a valid authorization form. The law states information needed to make sound changes in the wording (CODING: Words that the provider in such a circumstance decisions about health care, and stricken are deletions; words underlined are does not violate a right of confi dentiality, WHEREAS, maintaining the privacy and additions). For the complete text of the new is immune from civil liability for releasing security of identifi able health records is law, use the chapter number link. or accessing the patient’s health records, essential to the adoption of procedures and is deemed to not have violated or for sharing of electronic health records TITLE XXIX Public health waived any privilege protected under among health care providers involved Chapter 408 F.S. – Health care statutory or common law. The law also in the treatment of patients, NOW, administration states that anyone who forges a signature THEREFORE, See complete text at http://www.fl senate. on an authorization form or obtains an gov/Laws/Statutes/2010/Chapter408 authorization form or health record of Be It Enacted by the Legislature of the State another person under false pretenses may of Florida: Section 1. Subsection (4) of section 2009-172 Electronic health records (SB be liable for compensatory damages plus 395.3025, Florida Statutes, is amended to read: 162) attorney’s fees and costs. This law makes revisions to a number of 395.3025 Patient and personnel records; See complete revised text at Ch_2009-172.pdf provisions in Florida law regarding patient copies; examination. or http://laws.fl rules.org/2009/172 medical records and health information 4. Patient records are confi dential and must  An act relating to electronic health records; technology. not be disclosed without the consent of the amending s. 395.3025, F.S.; expanding  The law clarifi es that a patient’s records patient or his or her legal representative, access to a patient’s health records in order held by a hospital may be disclosed but appropriate disclosure may be made to facilitate the exchange of data between without the consent of the patient, or without such consent to: certain health care facility personnel, his or her legal representative, to health a. Licensed facility personnel, attending practitioners, and providers and attending care practitioners and providers currently physicians, or other health care physicians; deleting the exemption that involved in the care or treatment of the practitioners and providers currently allows long-term ombudsman councils to patient. The law also authorizes a clinical involved in the care or treatment of the have access to certain nursing home patient laboratory to provide laboratory results patient for use only in connection with records; without patient consent to other health the treatment of the patient.  Creating s.408.051, F.S.; creating the care practitioners and providers involved b. Licensed facility personnel only “Florida Electronic Health Records in the care or treatment of the patient for for administrative purposes or risk Exchange Act”; providing defi nitions; use in connection with the treatment of the management and quality assurance authorizing the release of certain health patient. functions. records under emergency medical  The law repeals the authority of the State c. The agency, for purposes of health care conditions without the consent of the Long-Term Care Ombudsman Council and cost containment. patient or the patient representative; local long-term care ombudsman councils d. In any civil or criminal action, unless providing for immunity from civil liability; to access patient records held by a hospital otherwise prohibited by law, upon the providing duties of the Agency for Health without patient consent. The state and issuance of a subpoena from a court Care Administration with regard to the local councils will continue to have access of competent jurisdiction and proper availability of specifi ed information on to patient records held by long-term care notice by the party seeking such the agency’s Internet website; requiring facilities and hospital records by obtaining records to the patient or his or her legal the agency to develop and implement patient consent. representative. a universal patient authorization form  The law creates the Florida Electronic e. The agency upon subpoena issued in paper and electronic formats for Health Records Exchange Act and defi nes pursuant to s. 456.071, but the records the release of certain health records; several common health information obtained thereby must be used solely providing procedures for use of the form; technology terms such as “electronic health for the purpose of the agency and providing penalties; providing for certain record,” “certifi ed electronic health record the appropriate professional board compensation and attorney’s fees and technology,” and “identifi able health in its investigation, prosecution, and costs; record.” The law provides civil immunity appeal of disciplinary proceedings.  Creating s. 408.0512, F.S.; requiring the for a health care provider who, in good If the agency requests copies of the Agency for Health Care Administration faith, releases or accesses a patient’s health records, the facility shall charge no to operate an electronic health record record without the patient’s consent for more than its actual copying costs, technology loan fund, subject to a specifi c the treatment of an emergency medical including reasonable staff time. The appropriation; requiring the agency to condition when the provider is unable records must be sealed and must not adopt rules related to standard terms and to obtain the patient’s consent due to be available to the public pursuant conditions for the loan program; the patient’s condition. In addition, the to s. 119.07(1) or any other statute law requires the Agency for Health Care WHEREAS, the use of electronic health providing access to records, nor may Administration (agency) to create, by July information technology has been proven to they be available to the public as part 1, 2010, a universal patient authorization benefi t consumers by increasing the quality of the record of investigation for and form that may be used by a health care and effi ciency of health care delivery prosecution in disciplinary proceedings provider for the release of a patient’s health throughout the state, and made available to the public by the records. agency or the appropriate regulatory  The law creates a rebuttable presumption WHEREAS, clear and concise standards board. However, the agency must make that the release of a patient’s health record for sharing privacy-protected medical available, upon written request by a information among authorized health practitioner against whom probable Page 2 Elite CME - www.EliteCME.com cause has been found, any such records interoperable and accessible digital surviving spouse, parent, or adult that form the basis of the determination format. child; or the attorney for the parent or of probable cause. b. “Qualifi ed electronic health record” guardian of a surviving minor child. f. The Department of Health or its agent, means an electronic record of health- 3. EMERGENCY RELEASE OF for the purpose of establishing and related information concerning an IDENTIFIABLE HEALTH RECORD. – A maintaining a trauma registry and for individual which includes patient health care provider may release or access the purpose of ensuring that hospitals demographic and clinical health an identifi able health record of a patient and trauma centers are in compliance information, such as medical history without the patient’s consent for use in the with the standards and rules established and problem lists, and which has the treatment of the patient for an emergency under ss. 395.401, 395.4015, 395.4025, capacity to provide clinical decision medical condition, as defi ned in s. 395.404, 395.4045, and 395.405, and support, to support physician order 395.002(8), when the health care provider for the purpose of monitoring patient entry, to capture and query information is unable to obtain the patient’s consent or outcome at hospitals and trauma relevant to health care quality, and to the consent of the patient representative centers that provide trauma care exchange electronic health information due to the patient’s condition or the nature services. with, and integrate such information of the situation requiring immediate g. The Department of Children and from, other sources. medical attention. A health care provider Family Services or its agent, for the c. “Certifi ed electronic health record who in good faith releases or accesses an purpose of investigations of cases technology” means a qualifi ed identifi able health record of a patient in of abuse, neglect, or exploitation of electronic health record that is certifi ed any form or medium under this subsection children or vulnerable adults. pursuant to s. 3001(c)(5) of the is immune from civil liability for accessing h. A local trauma agency or a regional Public Health Service Act as meeting or releasing an identifi able health record. trauma agency that performs quality standards adopted under s. 3004 of 4. UNIVERSAL PATIENT assurance activities, or a panel or such act which are applicable to the AUTHORIZATION FORM. – committee assembled to assist a local type of record involved, such as an a. By July 1, 2010, the agency shall trauma agency, or a regional trauma ambulatory electronic health record for develop forms in both paper and agency in performing quality assurance offi ce-based physicians or an inpatient electronic formats which may be used activities. Patient records obtained hospital electronic health record for by a health care provider to document under this paragraph are confi dential hospitals. patient authorization for the use or and exempt from s. 119.07(1) and s. d. “Health record” means any release, in any form or medium, of an 24(a), Art. I of the State Constitution. information, recorded in any form identifi able health record. i. Organ procurement organizations, or medium, which relates to the b. The agency shall adopt by rule the tissue banks, and eye banks required to past, present, or future health of an authorization form and accompanying conduct death records reviews pursuant individual for the primary purpose of instructions and make the authorization to s. 395.2050. providing health care and health-related form available on the agency’s website, j. The Medicaid Fraud Control Unit services. pursuant to s. 408.05. in the Department of Legal Affairs e. “Identifi able health record” means c. A health care provider receiving an pursuant to s. 409.920. any health record that identifi es the authorization form containing a request k. The Department of Financial Services, patient or with respect to which there for the release of an identifi able health or an agent, employee, or independent is a reasonable basis to believe the record shall accept the form as a valid contractor of the department who information can be used to identify the authorization to release an identifi able is auditing for unclaimed property patient. health record. A health care provider pursuant to chapter 717. f. “Patient” means an individual who has may elect to accept the authorization l. A regional poison control center for sought, is seeking, is undergoing, or form in either electronic or paper purposes of treating a poison episode has undergone care or treatment in a format or both. The individual or entity under evaluation, case management of health care facility or by a health care that submits the authorization form poison cases, or compliance with data provider. containing a request for the release collection and reporting requirements g. “Patient representative” means a parent of an identifi able health record shall of s. 395.1027 and the professional of a minor patient, a court-appointed determine which format is accepted organization that certifi es poison guardian for the patient, a health by the health care provider prior to control centers in accordance with care surrogate, or a person holding submitting the form. federal law. a power of attorney or notarized d. An individual or entity that submits a consent appropriately executed by the request for an identifi able health record Section 2. Section 408.051, Florida patient granting permission to a health is not required under this section to Statutes, is created to read: care facility or health care provider use the authorization form adopted and 408.051 Florida Electronic Health Records to disclose the patient’s health care distributed by the agency. Exchange Act. – information to that person. In the case e. The exchange by a health care provider 1. SHORT TITLE. – This section may be of a deceased patient, the term also of an identifi able health record upon cited as the “Florida Electronic Health means the personal representative of receipt of an authorization form Records Exchange Act.” the estate of the deceased patient; the completed and submitted in accordance 2. DEFINITIONS. – As used in this section, deceased patient’s surviving spouse, with agency instructions creates a the term: surviving parent, or surviving adult rebuttable presumption that the release a. “Electronic health record” means a child; the parent or guardian of a of the identifi able health record was record of a person’s medical treatment surviving minor child of the deceased appropriate. A health care provider that which is created by a licensed patient; the attorney for the patient’s releases an identifi able health record in health care provider and stored in an Elite CME - www.EliteCME.com Page 3 reliance on the information provided to Section 2. Section 408.815, Florida ended more than 15 years before prior the health care provider on a properly Statutes, is amended to read: to the date of the application; or completed authorization form does b. Termination for cause from the not violate any right of confi dentiality 408.815 License or application denial; Medicare program or a state Medicaid and is immune from civil liability for revocation. program, unless the applicant has been accessing or releasing an identifi able 1. In addition to the grounds provided in in good standing with the Medicare health record under this subsection. authorizing statutes, grounds that may program or a state Medicaid program f. A health care provider that exchanges be used by the agency for denying and for the most recent 5 years and the an identifi able health record upon revoking a license or change of ownership termination occurred at least 20 years receipt of an authorization form shall application include any of the following before the date of the application.; or not be deemed to have violated or actions by a controlling interest: c. Terminated for cause, pursuant to the waived any privilege protected under a. False representation of a material appeals procedures established by the the statutory or common law of this fact in the license application or state or Federal Government, from the state. omission of any material fact from the federal Medicare program or from any 5. PENALTIES. – A person who does any of application. other state Medicaid program, unless the following may be liable to the patient b. An intentional or negligent act the applicant has been in good standing or a health care provider that has released materially affecting the health or safety with a state Medicaid program or the an identifi able health record in reliance of a client of the provider. federal Medicare program for the most on an authorization form presented to c. A violation of this part, authorizing recent 5 years and the termination the health care provider by the person statutes, or applicable rules. occurred at least 20 years prior to the for compensatory damages caused by d. A demonstrated pattern of defi cient date of the application. an unauthorized release, plus reasonable performance. 5. For any application subject to denial under attorney’s fees and costs: e. The applicant, licensee, or controlling subsection (4), the agency may consider a. Forges a signature on an authorization interest has been or is currently mitigating circumstances as applicable, form or materially alters the excluded, suspended, or terminated including, but not limited to: authorization form of another person from participation in the state Medicaid a. Completion or lawful release from without the person’s authorization; or program, the Medicaid program of any confi nement, supervision, or sanction, b. Obtains an authorization form or an other state, or the Medicare program. including the terms of probation, and identifi able health record of another 2. If a licensee lawfully continues to operate full restitution; person under false pretenses. while a denial or revocation is pending b. Execution of a compliance plan with in litigation, the licensee must continue the agency; 2011-61 Medicaid (SB 2144) to meet all other requirements of this c. Compliance with an integrity This is primarily a law associated with the part, authorizing statutes, and applicable agreement or compliance plan with General Appropriations Act (GAA) for the rules and must fi le subsequent renewal another government agency; 2011-12 fi scal year and contains various applications for licensure and pay all d. Determination by any state Medicaid statutory revisions to conform to budget licensure fees. The provisions of ss. program or the Medicare program that adjustments in the area of health care. 120.60(1) and 408.806(3)(c) do shall not the controlling interest or entity in Among its changes, it amends 408.815, F.S., apply to renewal applications fi led during which the controlling interest was an modifying the requirements for the denial of the time period in which the litigation of owner or offi cer is currently allowed an application for a license or license renewal the denial or revocation is pending until to participate in the state Medicaid requests; provides mitigating circumstances that litigation is fi nal. program or the Medicare program, for consideration for any application subject to 3. An action under s. 408.814 or denial of the directly as a provider or indirectly as an denial; and provides criteria for the extension license of the transferor may be grounds owner or offi cer of a provider entity; of a license that has been denied, revoked or for denial of a change of ownership e. Continuation of licensure by the set to terminate. application of the transferee. controlling interest or entity in which See complete revised text at http://laws.fl rules. 4. Unless an applicant is determined by the controlling interest was an owner org/2011/61 the agency to satisfy the provisions of or offi cer, directly as a licensee or  Amends 408.815, F.S.; requiring that the subsection (5) for the action in question, indirectly as an owner or offi cer of a Agency for Health Care Administration the agency shall deny an application for a licensed entity in the state where the deny an application for a license or license license or license renewal based upon any action occurred; renewal of an applicant, a controlling of the following actions of an applicant, a f. Overall impact upon the public health, interest of the applicant, or any entity in controlling interest of the applicant, or any safety, or welfare; or which a controlling interest of the applicant entity in which a controlling interest of the g. Determination that a license denial was an owner or offi cer during the applicant was an owner or offi cer when the is not commensurate with the prior occurrence of certain actions; authorizing following actions occurred. action taken by the Medicare or state the agency to consider certain mitigating a. A conviction or enters a plea of guilty Medicaid program. After considering circumstances; authorizing the agency or nolo contendere to, regardless of the circumstances set forth in this to extend a license expiration date under adjudication, a felony under chapter subsection, the agency shall grant the certain circumstances; 409, chapter 817, chapter 893, 21 license, with or without conditions, U.S.C. ss. 801-970, or 42 U.S.C. ss. grant a provisional license for a period 1395-1396, Medicaid fraud, Medicare of no more than the licensure cycle, fraud, or insurance fraud, unless the with or without conditions, or deny the sentence and any subsequent period of license. probation for such convictions or plea

Page 4 Elite CME - www.EliteCME.com 6. In order to ensure the health, safety, and 1. Laboratories authorized to perform testing 30. Organ, tissue, and eye procurement welfare of clients when a license has been under the Drug-Free Workplace Act, as organizations, as provided under part V of denied, revoked, or is set to terminate, provided under ss. 112.0455 and 440.102. chapter 765. the agency may extend the license 2. Birth centers, as provided under chapter expiration date for up to 30 days for the 383. 408.803 – Defi nitions. As used in this part, the term: sole purpose of allowing the safe and 3. Abortion clinics, as provided under chapter 1. “Agency” means the Agency for Health orderly discharge of clients. The agency 390. Care Administration, which is the licensing may impose conditions on the extension, 4. Crisis stabilization units, as provided under agency under this part. including, but not limited to, prohibiting or parts I and IV of chapter 394. 2. “Applicant” means an individual, limiting admissions, expedited discharge 5. Short-term residential treatment facilities, corporation, partnership, fi rm, association, planning, required status reports, and as provided under parts I and IV of chapter or governmental entity that submits an mandatory monitoring by the agency 394. application for a license to the agency. or third parties. When imposing these 6. Residential treatment facilities, as provided 3. “Authorizing statute” means the statute conditions, the agency shall consider under part IV of chapter 394. authorizing the licensed operation of a the nature and number of clients, the 7. Residential treatment centers for children provider listed in s. 408.802 and includes availability and location of acceptable and adolescents, as provided under part IV chapters 112, 383, 390, 394, 395, 400, 429, alternative placements, and the ability of of chapter 394. 440, 483, and 765. the licensee to continue providing care to 8. Hospitals, as provided under part I of 4. “Certifi cation” means certifi cation as the clients. The agency may terminate the chapter 395. a Medicare or Medicaid provider of extension or modify the conditions at any 9. Ambulatory surgical centers, as provided the services that require licensure, or time. This authority is in addition to any under part I of chapter 395. certifi cation pursuant to the federal Clinical other authority granted to the agency under 10. Mobile surgical facilities, as provided Laboratory Improvement Amendment chapter 120, this part, and authorizing under part I of chapter 395. (CLIA). statutes but creates no right or entitlement 11. Private review agents, as provided under 5. “Change of ownership” means: to an extension of a license expiration date. part I of chapter 395. a. An event in which the licensee sells 12. Health care risk managers, as provided or otherwise transfers its ownership Chapter 408: Part II: Health care under part I of chapter 395. to a different individual or entity as licensing: General provisions (ss. 408.801- 13. Nursing homes, as provided under part II evidenced by a change in federal 408.832) of chapter 400. employer identifi cation number or Massage Therapists should especially be 14. Assisted living facilities, as provided under taxpayer identifi cation number; or acquainted with Part II of Chapter 408, which part I of chapter 429. b. An event in which 51 percent or more regulates health care licensing. Known as 15. Home health agencies, as provided under of the ownership, shares, membership, the “Health Care Licensing Procedures Act,” part III of chapter 400. or controlling interest of a licensee is it was created to standardize basic licensing 16. Nurse registries, as provided under part III in any manner transferred or otherwise requirements across a number of professions of chapter 400. assigned. This paragraph does not and health providers. There have been 17. Companion services or homemaker apply to a licensee that is publicly substantial changes to the Act in the past three services providers, as provided under part traded on a recognized stock exchange. years. The section is reproduced below, with III of chapter 400. A change solely in the management recent revisions relevant to Massage Therapists 18. Adult day care centers, as provided under company or board of directors is not a highlighted in bold: part III of chapter 429. change of ownership. 19. Hospices, as provided under part IV of Part II – Health care licensing: General 6. “Client” means any person receiving chapter 400. provisions services from a provider listed in s. 20. Adult family-care homes, as provided 408.802. 408.801 – Short title; purpose. under part II of chapter 429. 7. “Controlling interest” means: 1. This part may be cited as the “Health Care 21. Homes for special services, as provided a. The applicant or licensee; Licensing Procedures Act.” under part V of chapter 400. b. A person or entity that serves as an 2. The Legislature fi nds that there is 22. Transitional living facilities, as provided offi cer of, is on the board of directors unnecessary duplication and variation under part V of chapter 400. of, or has a 5-percent or greater in the requirements for licensure by the 23. Prescribed pediatric extended care centers, ownership interest in the applicant or agency. It is the intent of the Legislature to as provided under part VI of chapter 400. licensee; or provide a streamlined and consistent set of 24. Home medical equipment providers, as c. A person or entity that serves as an basic licensing requirements for all such provided under part VII of chapter 400. offi cer of, is on the board of directors providers in order to minimize confusion, 25. Intermediate care facilities for persons with of, or has a 5-percent or greater standardize terminology, and include issues developmental disabilities, as provided ownership interest in the management that are otherwise not adequately addressed under part VIII of chapter 400. company or other entity, related or in the Florida Statutes pertaining to specifi c 26. Health care services pools, as provided unrelated, with which the applicant providers. under part IX of chapter 400. or licensee contracts to manage the 27. Health care clinics, as provided under part 1408.802 Applicability. provider. X of chapter 400. The provisions of this part apply to the The term does not include a voluntary 28. Clinical laboratories, as provided under provision of services that require licensure as board member. part I of chapter 483. defi ned in this part and to the following entities 8. “License” means any permit, registration, 29. Multiphasic health testing centers, as licensed, registered, or certifi ed by the agency, certifi cate, or license issued by the agency. provided under part II of chapter 483. as described in chapters 112, 383, 390, 394, 9. “Licensee” means an individual, 395, 400, 429, 440, 483, and 765: corporation, partnership, fi rm, association, Elite CME - www.EliteCME.com Page 5 governmental entity, or other entity that actual cost of processing and issuing the 2. a. The applicant for a renewal license is issued a permit, registration, certifi cate, license. must submit an application that must or license by the agency. The licensee is 6. A fee may be charged to a licensee be received by the agency at least 60 legally responsible for all aspects of the requesting a duplicate license. The fee may days but no more than 120 days before provider operation. not exceed the actual cost of duplication the expiration of the current license. 10. “Moratorium” means a prohibition on the and postage. An application received more than acceptance of new clients. 7. Total fees collected may not exceed the 120 days before the expiration of the 11. “Provider” means any activity, service, cost of administering this part, authorizing current license shall be returned to the agency, or facility regulated by the agency statutes, and applicable rules. applicant. If the renewal application and listed in s. 408.802. and fee are received prior to the license 12. “Services that require licensure” means 408.806 – License application process. expiration date, the license shall not 1. An application for licensure must be those services, including residential be deemed to have expired if the made to the agency on forms furnished services, that require a valid license license expiration date occurs during by the agency, submitted under oath, and before those services may be provided in the agency’s review of the renewal accompanied by the appropriate fee in accordance with authorizing statutes and application. order to be accepted and considered timely. agency rules. b. The applicant for initial licensure due The application must contain information 13. “Voluntary board member” means a board to a change of ownership must submit required by authorizing statutes and member or offi cer of a not-for-profi t an application that must be received by applicable rules and must include: corporation or organization who serves the agency at least 60 days prior to the a. The name, address, and social security solely in a voluntary capacity, does not date of change of ownership. number of: receive any remuneration for his or her c. For any other application or request, 1. The applicant; services on the board of directors, and has the applicant must submit an 2. The administrator or a similarly no fi nancial interest in the corporation or application or request that must be titled person who is responsible organization. received by the agency at least 60 for the day-to-day operation of the days but no more than 120 days before provider; 408.804 – License required; display. the requested effective date, unless 1. It is unlawful to provide services that 3. The fi nancial offi cer or similarly otherwise specifi ed in authorizing require licensure, or operate or maintain titled person who is responsible statutes or applicable rules. An a provider that offers or provides for the fi nancial operation of the application received more than 120 services that require licensure, without licensee or provider; and days before the requested effective date fi rst obtaining from the agency a license 4. Each controlling interest if the shall be returned to the applicant. authorizing the provision of such services applicant or controlling interest is d. The agency shall notify the licensee or the operation or maintenance of such an individual. by mail or electronically at least 90 provider. b. The name, address, and federal days before the expiration of a license 2. A license must be displayed in a employer identifi cation number or that a renewal license is necessary conspicuous place readily visible to clients taxpayer identifi cation number of the to continue operation. The failure to who enter at the address that appears on the applicant and each controlling interest timely submit a renewal application license and is valid only in the hands of the if the applicant or controlling interest is and license fee shall result in a $50 per licensee to whom it is issued and may not not an individual. day late fee charged to the licensee by be sold, assigned, or otherwise transferred, c. The name by which the provider is to the agency; however, the aggregate voluntarily or involuntarily. The license is be known. amount of the late fee may not exceed valid only for the licensee, provider, and d. The total number of beds or capacity 50 percent of the licensure fee or $500, location for which the license is issued. requested, as applicable. whichever is less. If an application is e. The name of the person or persons received after the required fi ling date 408.805 – Fees required; adjustments. under whose management or Unless otherwise limited by authorizing and exhibits a hand-canceled postmark supervision the provider will operate statutes, license fees must be reasonably obtained from a United States post and the name of the administrator, if calculated by the agency to cover its costs offi ce dated on or before the required required. in carrying out its responsibilities under this fi ling date, no fi ne will be levied. f. If the applicant offers continuing part, authorizing statutes, and applicable rules, 3. a. Upon receipt of an application for a care agreements as defi ned in chapter including the cost of licensure, inspection, and license, the agency shall examine the 651, proof shall be furnished that the regulation of providers. application and, within 30 days after applicant has obtained a certifi cate 1. Licensure fees shall be adjusted to provide receipt, notify the applicant in writing of authority as required for operation for biennial licensure under agency rules. of any apparent errors or omissions under chapter 651. 2. The agency shall annually adjust licensure and request any additional information g. Other information, including fees, including fees paid per bed, by not required. satisfactory inspection results, that the more than the change in the Consumer b. Requested information omitted from agency fi nds necessary to determine Price Index based on the 12 months an application for licensure, license the ability of the applicant to carry immediately preceding the increase. renewal, or change of ownership, out its responsibilities under this part, 3. An inspection fee must be paid as required other than an inspection, must be authorizing statutes, and applicable in authorizing statutes. fi led with the agency within 21 days rules. 4. Fees are nonrefundable. after the agency’s request for omitted h. An affi davit, under penalty of perjury, 5. When a change is reported that requires information or the application shall as required in s. 435.05(3), stating issuance of a license, a fee may be be deemed incomplete and shall be compliance with the provisions of this assessed. The fee must be based on the section and chapter 435. Page 6 Elite CME - www.EliteCME.com withdrawn from further consideration c. Payment of fees. 2. For initial, renewal, or change of and the fees shall be forfeited. d. Notarization of applications. ownership licenses for a home health c. Within 60 days after the receipt of a agency, a home medical equipment Requirements for electronic submission of any complete application, the agency shall provider, or a health care clinic, documents required by this part or authorizing approve or deny the application. applicants and controlling interests who statutes may be established by rule. As an 4. a. Licensees subject to the provisions of are nonimmigrant aliens, as described alternative to sending documents as required this part shall be issued biennial in 8 U.S.C. s. 1101, must fi le a surety by authorizing statutes, the agency may licenses unless conditions of the license bond of at least $500,000, payable to the provide electronic access to information or category specify a shorter license agency, which guarantees that the home documents. period. health agency, home medical equipment b. Each license issued shall indicate 408.8065 – Additional licensure provider, or health care clinic will act in the name of the licensee, the type of requirements for home health agencies, full conformity with all legal requirements provider or service that the licensee home medical equipment providers, and for operation. is required or authorized to operate or health care clinics. 3. In addition to the requirements of s. offer, the date the license is effective, 1. An applicant for initial licensure, or initial 408.812, any person who offers services the expiration date of the license, the licensure due to a change of ownership, that require licensure under part VII or part maximum capacity of the licensed as a home health agency, home medical X of chapter 400, or who offers skilled premises, if applicable, and any other equipment provider, or health care clinic services that require licensure under part information required or deemed shall: III of chapter 400, without obtaining a necessary by the agency. a. Demonstrate fi nancial ability to valid license; any person who knowingly 5. In accordance with authorizing statutes operate, as required under s. 408.810(8) fi les a false or misleading license or license and applicable rules, proof of compliance and this section. If the applicant’s renewal application or who submits false with s. assets, credit, and projected revenues or misleading information related to such application, and any person who violates or 408.810 must be submitted with an meet or exceed projected liabilities and conspires to violate this section, commits application for licensure. expenses, and the applicant provides a felony of the third degree, punishable as 6. The agency may not issue an initial license independent evidence that the funds provided in s. 775.082, s. 775.083, or s. to a health care provider subject to the necessary for startup costs, working 775.084. certifi cate-of-need provisions in part I of capital, and contingency fi nancing this chapter if the licensee has not been exist and will be available as needed, 408.807 – Change of ownership. issued a certifi cate of need or certifi cate-of- the applicant has demonstrated the Whenever a change of ownership occurs: need exemption, when applicable. Failure fi nancial ability to operate. 1. The transferor shall notify the agency to apply for the renewal of a license prior b. Submit pro forma fi nancial statements, in writing at least 60 days before to the expiration date renders the license including a balance sheet, income and the anticipated date of the change of void. expense statement, and a statement ownership. 7. a. An applicant must demonstrate of cash fl ows for the fi rst 2 years of 2. The transferee shall make application compliance with the requirements operation which provide evidence to the agency for a license within the in this part, authorizing statutes, and that the applicant has suffi cient assets, timeframes required in s. 408.806. applicable rules during an inspection credit, and projected revenues to cover 3. The transferor shall be responsible and pursuant to s. 408.811, as required by liabilities and expenses. liable for: authorizing statutes. c. Submit a statement of the applicant’s a. The lawful operation of the provider b. An initial inspection is not required estimated startup costs and sources and the welfare of the clients served for companion services or homemaker of funds through the break-even until the date the transferee is licensed services providers, as provided under point in operations demonstrating by the agency. part III of chapter 400, or for health that the applicant has the ability to b. Any and all penalties imposed against care services pools, as provided under fund all startup costs, working capital the transferor for violations occurring part IX of chapter 400. 1costs, and contingency fi nancing before the date of change of ownership. 2requirements. The statement 4. Any restriction on licensure, including a c. If an inspection is required by the must show that the applicant has conditional license existing at the time of authorizing statute for a license at a minimum 3 months of average a change of ownership, shall remain in application other than an initial projected expenses to cover startup effect until the agency determines that the application, the inspection must be costs, working capital 1costs, and grounds for the restriction are corrected. unannounced. This paragraph does not contingency fi nancing 2requirements. 5. The transferee shall maintain records apply to inspections required pursuant The minimum amount for contingency of the transferor as required in this part, to ss. 383.324, 395.0161(4), 429.67(6), funding may not be less than 1 month authorizing statutes, and applicable rules, and 483.061(2). of average projected expenses. including: d. If a provider is not available when an All documents required under this a. All client records. inspection is attempted, the application subsection must be prepared in b. Inspection reports. shall be denied. accordance with generally accepted c. All records required to be maintained 8. The agency may establish procedures for accounting principles and may be pursuant to s. 409.913, if applicable. the electronic notifi cation and submission in a compilation form. The fi nancial of required information, including, but not 408.808 – License categories. statements must be signed by a certifi ed 1. STANDARD LICENSE. – A standard limited to: public accountant. license may be issued to an applicant at the a. Licensure applications. time of initial licensure, license renewal, b. Required signatures. Elite CME - www.EliteCME.com Page 7 or change of ownership. A standard license clients of closure or suspension of service, him or her to provide personal care or shall be issued when the applicant is in unless the action is a result of a disaster at personal services directly to clients. compliance with all statutory requirements the licensed premises. For the purposes of Evidence of contractor screening and agency rules. Unless sooner revoked, this section, the term “disaster” means a may be retained by the contractor’s a standard license expires 2 years after the sudden emergency occurrence beyond the employer or the licensee. date of issue. control of the licensee, whether natural, 2. Every 5 years following his or her 2. PROVISIONAL LICENSE. – An applicant technological, or manmade, which renders licensure, employment, or entry into a against whom a proceeding denying the provider inoperable at the premises. contract in a capacity that under subsection or revoking a license is pending at the Upon agency approval, the provider shall (1) would require level 2 background time of license renewal may be issued a notify clients of any necessary discharge screening under chapter 435, each such provisional license effective until fi nal or transfer as required by authorizing person must submit to level 2 background action not subject to further appeal. A statutes or applicable rules. The beginning rescreening as a condition of retaining provisional license may also be issued of the inactive license period is the date such license or continuing in such to an applicant applying for a change of the provider ceases operations. The end of employment or contractual status. For any ownership. A provisional license must be the inactive license period shall become such rescreening, the agency shall request limited in duration to a specifi c period of the license expiration date. All licensure the Department of Law Enforcement to time, up to 12 months, as determined by fees must be current, must be paid in full, forward the person’s fi ngerprints to the the agency. and may be prorated. Reactivation of an Federal Bureau of Investigation for a 3. INACTIVE LICENSE. – An inactive inactive license requires the approval national criminal history record check. license may be issued to a health care of a renewal application, including If the fi ngerprints of such a person provider subject to the certifi cate-of-need payment of licensure fees and agency are not retained by the Department of provisions in part I of this chapter when inspections indicating compliance with Law Enforcement under s. 943.05(2) the provider is currently licensed, does all requirements of this part, authorizing (g), the person must fi le a complete set not have a provisional license, and will be statutes, and applicable rules. of fi ngerprints with the agency and the temporarily unable to provide services but 4. OTHER LICENSES. – Other types of agency shall forward the fi ngerprints to the is reasonably expected to resume services license categories may be issued pursuant Department of Law Enforcement for state within 12 months. Such designation to authorizing statutes or applicable rules. processing, and the Department of Law may be made for a period not to exceed Enforcement shall forward the fi ngerprints 12 months but may be renewed by the 408.809 – Background screening; to the Federal Bureau of Investigation for agency for up to 12 additional months prohibited offenses. a national criminal history record check. upon demonstration by the licensee of the 1. Level 2 background screening pursuant to The fi ngerprints may be retained by the provider’s progress toward reopening. chapter 435 must be conducted through the Department of Law Enforcement under However, if after 20 months in an inactive agency on each of the following persons, s. 943.05(2)(g). The cost of the state and license status, a statutory rural hospital, as who are considered employees for the national criminal history records checks defi ned in s. 395.602, has demonstrated purposes of conducting screening under required by level 2 screening may be borne progress toward reopening, but may not be chapter 435: by the licensee or the person fi ngerprinted. able to reopen prior to the inactive license a. The licensee, if an individual. Proof of compliance with level 2 screening expiration date, the inactive designation b. The administrator or a similarly titled standards submitted within the previous 5 may be renewed again by the agency for person who is responsible for the day- years to meet any provider or professional up to 12 additional months. For purposes to-day operation of the provider. licensure requirements of the agency, the of such a second renewal, if construction c. The fi nancial offi cer or similarly titled Department of Health, the Agency for or renovation is required, the licensee individual who is responsible for the Persons with Disabilities, the Department must have had plans approved by the fi nancial operation of the licensee or of Children and Family Services, or the agency and construction must have already provider. Department of Financial Services for an commenced pursuant to s. 408.032(4); d. Any person who is a controlling applicant for a certifi cate of authority however, if construction or renovation is interest if the agency has reason to or provisional certifi cate of authority not required, the licensee must provide believe that such person has been to operate a continuing care retirement proof of having made an enforceable convicted of any offense prohibited by community under chapter 651 satisfi es capital expenditure greater than 25 percent s. 435.04. For each controlling interest the requirements of this section if the of the total costs associated with the hiring who has been convicted of any such person subject to screening has not been of staff and the purchase of equipment and offense, the licensee shall submit to the unemployed for more than 90 days and supplies needed to operate the facility upon agency a description and explanation such proof is accompanied, under penalty opening. A request by a licensee for an of the conviction at the time of license of perjury, by an affi davit of compliance inactive license or to extend the previously application. with the provisions of chapter 435 and approved inactive period must be e. Any person, as required by authorizing this section using forms provided by the submitted to the agency and must include statutes, seeking employment with a agency. a written justifi cation for the inactive licensee or provider who is expected 3. All fi ngerprints must be provided in license with the beginning and ending to, or whose responsibilities may electronic format. Screening results shall dates of inactivity specifi ed, a plan for the require him or her to, provide personal be reviewed by the agency with respect to transfer of any clients to other providers, care or services directly to clients or the offenses specifi ed in s. 435.04 and this and the appropriate licensure fees. The have access to client funds, personal section, and the qualifying or disqualifying agency may not accept a request that is property, or living areas; and any status of the person named in the request submitted after initiating closure, after any person, as required by authorizing shall be maintained in a database. The suspension of service, or after notifying statutes, contracting with a licensee or qualifying or disqualifying status of the provider whose responsibilities require Page 8 Elite CME - www.EliteCME.com person named in the request shall be must be rescreened by July 31, to retaining fi ngerprints pursuant to s. posted on a secure website for retrieval 2015. The agency may adopt rules 943.05(2). by the licensee or designated agent on the to establish a schedule to stagger 8. There is no unemployment compensation licensee’s behalf. the implementation of the required or other monetary liability on the part of, 4. In addition to the offenses listed in s. rescreening over the 5-year period, and no cause of action for damages arising 435.04, all persons required to undergo beginning July 31, 2010, through July against, an employer that, upon notice background screening pursuant to this part 31, 2015. If, upon rescreening, such of a disqualifying offense listed under or authorizing statutes must not have an person has a disqualifying offense chapter 435 or this section, terminates the arrest awaiting fi nal disposition for, must that was not a disqualifying offense at person against whom the report was issued, not have been found guilty of, regardless the time of the last screening, but is a whether or not that person has fi led for an of adjudication, or entered a plea of nolo current disqualifying offense and was exemption with the Department of Health contendere or guilty to, and must not have committed before the last screening, or the agency. been adjudicated delinquent and the record he or she may apply for an exemption not have been sealed or expunged for any from the appropriate licensing agency 408.810 – Minimum licensure of the following offenses or any similar and, if agreed to by the employer, requirements. offense of another jurisdiction: may continue to perform his or her In addition to the licensure requirements a. Any authorizing statutes, if the offense duties until the licensing agency specifi ed in this part, authorizing statutes, and was a felony. renders a decision on the application applicable rules, each applicant and licensee b. This chapter, if the offense was a for exemption if the person is eligible must comply with the requirements of this felony. to apply for an exemption and the section in order to obtain and maintain a c. Section 409.920, relating to Medicaid exemption request is received by the license. provider fraud. agency within 30 days after receipt of 1. An applicant for licensure must d. Section 409.9201, relating to Medicaid the rescreening results by the person. comply with the background screening fraud. 5. The costs associated with obtaining the requirements of s. 408.809. e. Section 741.28, relating to domestic required screening must be borne by the 2. An applicant for licensure must provide violence. licensee or the person subject to screening. a description and explanation of any f. Section 817.034, relating to fraudulent Licensees may reimburse persons for exclusions, suspensions, or terminations acts through mail, wire, radio, these costs. The Department of Law of the applicant from the Medicare, electromagnetic, photoelectronic, or Enforcement shall charge the agency for Medicaid, or federal Clinical Laboratory photooptical systems. screening pursuant to s. 943.053(3). The Improvement Amendment (CLIA) g. Section 817.234, relating to false and agency shall establish a schedule of fees to programs. fraudulent insurance claims. cover the costs of screening. 3. Unless otherwise specifi ed in this part, h. Section 817.505, relating to patient 6. a. As provided in chapter 435, the authorizing statutes, or applicable rules, brokering. agency may grant an exemption from any information required to be reported i. Section 817.568, relating to criminal disqualifi cation to a person who is to the agency must be submitted within use of personal identifi cation subject to this section and who: 21 calendar days after the report period information. 1. Does not have an active or effective date of the information, j. Section 817.60, relating to obtaining a professional license or certifi cation whichever is earlier, including, but not credit card through fraudulent means. from the Department of Health; or limited to, any change of: k. Section 817.61, relating to fraudulent 2. Has an active professional a. Information contained in the most use of credit cards, if the offense was license or certifi cation from the recent application for licensure. a felony. Department of Health but is b. Required insurance or bonds. l. Section 831.01, relating to forgery. not providing a service within 4. Whenever a licensee discontinues m. Section 831.02, relating to uttering the scope of that license or operation of a provider: forged instruments. certifi cation. a. The licensee must inform the agency n. Section 831.07, relating to forging bank b. As provided in chapter 435, the not less than 30 days prior to the bills, checks, drafts, or promissory appropriate regulatory board within discontinuance of operation and notes. the Department of Health, or the inform clients of such discontinuance o. Section 831.09, relating to uttering department itself if there is no as required by authorizing statutes. forged bank bills, checks, drafts, or board, may grant an exemption from Immediately upon discontinuance promissory notes. disqualifi cation to a person who is of operation by a provider, the p. Section 831.30, relating to fraud in subject to this section and who has licensee shall surrender the license obtaining medicinal drugs. received a professional license or to the agency and the license shall be q. Section 831.31, relating to the sale, certifi cation from the Department of canceled. manufacture, delivery, or possession Health or a regulatory board within that b. The licensee shall remain responsible with the intent to sell, manufacture, department and that person is providing for retaining and appropriately or deliver any counterfeit controlled a service within the scope of his or her distributing all records within the substance, if the offense was a felony. licensed or certifi ed practice. timeframes prescribed in authorizing 7. The agency and the Department of Health statutes and applicable rules. In A person who serves as a controlling may adopt rules pursuant to ss. 120.536(1) addition, the licensee or, in the event of interest of, is employed by, or and 120.54 to implement this section, death or dissolution of a licensee, the contracts with a licensee on July chapter 435, and authorizing statutes estate or agent of the licensee shall: 31, 2010, who has been screened requiring background screening and to 1. Make arrangements to forward and qualifi ed according to standards implement and adopt criteria relating records for each client to one of the specifi ed in s. 435.03 or s. 435.04 following, based upon the client’s Elite CME - www.EliteCME.com Page 9 choice: the client or the client’s need not be limited to, copies of warranty 408.811 – Right of inspection; copies; legal representative, the client’s deeds, lease or rental agreements, contracts inspection reports; plan for correction of attending physician, or the health for deeds, quitclaim deeds, or other such defi ciencies. care provider where the client documentation. 1. An authorized offi cer or employee of the currently receives services; or 7. If proof of insurance is required by the agency may make or cause to be made 2. Cause a notice to be published authorizing statute, that insurance must be any inspection or investigation deemed in the newspaper of greatest in compliance with chapter 624, chapter necessary by the agency to determine general circulation in the county 626, chapter 627, or chapter 628 and with the state of compliance with this part, in which the provider was agency rules. authorizing statutes, and applicable rules. located that advises clients of the 8. Upon application for initial licensure The right of inspection extends to any discontinuance of the provider or change of ownership licensure, the business that the agency has reason to operation. The notice must inform applicant shall furnish satisfactory proof of believe is being operated as a provider clients that they may obtain copies the applicant’s fi nancial ability to operate without a license, but inspection of any of their records and specify the in accordance with the requirements business suspected of being operated name, address, and telephone of this part, authorizing statutes, and without the appropriate license may number of the person from whom applicable rules. The agency shall establish not be made without the permission of the copies of records may be standards for this purpose, including the owner or person in charge unless a obtained. The notice must appear at information concerning the applicant’s warrant is fi rst obtained from a circuit least once a week for 4 consecutive controlling interests. The agency shall also court. Any application for a license issued weeks. establish documentation requirements, under this part, authorizing statutes, or 5. a. On or before the fi rst day services are to be completed by each applicant, that applicable rules constitutes permission provided to a client, a licensee must show anticipated provider revenues and for an appropriate inspection to verify the inform the client and his or her expenditures, the basis for fi nancing the information submitted on or in connection immediate family or representative, if anticipated cash-fl ow requirements of with the application. appropriate, of the right to report: the provider, and an applicant’s access to a. All inspections shall be unannounced, 1. Complaints. The statewide toll-free contingency fi nancing. A current certifi cate except as specifi ed in s. 408.806. telephone number for reporting of authority, pursuant to chapter 651, may b. Inspections for relicensure shall be complaints to the agency must be be provided as proof of fi nancial ability to conducted biennially unless otherwise provided to clients in a manner that operate. The agency may require a licensee specifi ed by authorizing statutes or is clearly legible and must include to provide proof of fi nancial ability to applicable rules. the words: “To report a complaint operate at any time if there is evidence 2. Inspections conducted in conjunction regarding the services you receive, of fi nancial instability, including, but not with certifi cation, comparable licensure please call toll-free (phone limited to, unpaid expenses necessary for requirements, or a recognized or approved number).” the basic operations of the provider. accreditation organization may be accepted 2. Abusive, neglectful, or exploitative 9. A controlling interest may not withhold in lieu of a complete licensure inspection. practices. The statewide toll-free from the agency any evidence of fi nancial However, a licensure inspection may also telephone number for the central instability, including, but not limited to, be conducted to review any licensure abuse hotline must be provided to checks returned due to insuffi cient funds, requirements that are not also requirements clients in a manner that is clearly delinquent accounts, nonpayment of for certifi cation. legible and must include the withholding taxes, unpaid utility expenses, 3. The agency shall have access to and the words: “To report abuse, neglect, nonpayment for essential services, or licensee shall provide, or if requested send, or exploitation, please call toll-free adverse court action concerning the copies of all provider records required (phone number).” fi nancial viability of the provider or any during an inspection or other review at 3. Medicaid fraud. An agency-written other provider licensed under this part no cost to the agency, including records description of Medicaid fraud and that is under the control of the controlling requested during an offsite review. the statewide toll-free telephone interest. Any person who violates this 4. A defi ciency must be corrected within 30 number for the central Medicaid subsection commits a misdemeanor of the calendar days after the provider is notifi ed fraud hotline must be provided to second degree, punishable as provided of inspection results unless an alternative clients in a manner that is clearly in s. 775.082 or s. 775.083. Each day of timeframe is required or approved by the legible and must include the words: continuing violation is a separate offense. agency. “To report suspected Medicaid 10. The agency may not issue a license to 5. The agency may require an applicant or fraud, please call toll-free (phone a health care provider subject to the licensee to submit a plan of correction number).” certifi cate-of-need provisions in part I of for defi ciencies. If required, the plan of this chapter if the health care provider The agency shall publish a correction must be fi led with the agency has not been issued a certifi cate of need minimum of a 90-day advance within 10 calendar days after notifi cation or an exemption. Upon initial licensure notice of a change in the toll-free unless an alternative timeframe is required. of any such provider, the authorization telephone numbers. 6. a. Each licensee shall maintain as public contained in the certifi cate of need shall be b. Each licensee shall establish information, available upon request, considered fully implemented and merged appropriate policies and procedures for records of all inspection reports into the license and shall have no force and providing such notice to clients. pertaining to that provider that have effect upon termination of the license for 6. An applicant must provide the agency been fi led by the agency unless those any reason. with proof of the applicant’s legal right reports are exempt from or contain to occupy the property before a license information that is exempt from s. may be issued. Proof may include, but 119.07(1) and s. 24(a), Art. I of the Page 10 Elite CME - www.EliteCME.com State Constitution or is otherwise and fails to license a provider rendering which the problems causing the defi ciency made confi dential by law. Effective services that require licensure, the agency are pervasive in the provider or represent October 1, 2006, copies of such reports may revoke all licenses and impose actions systemic failure that has affected or has shall be retained in the records of the under s. 408.814 and a fi ne of $1,000 the potential to affect a large portion of the provider for at least 3 years following per day, unless otherwise specifi ed by provider’s clients. This subsection does the date the reports are fi led and issued, authorizing statutes, against each licensee not affect the legislative determination regardless of a change of ownership. until such time as the appropriate license is of the amount of a fi ne imposed under b. A licensee shall, upon the request obtained for the unlicensed operation. authorizing statutes. Violations shall be of any person who has completed a 6. In addition to granting injunctive relief classifi ed on the written notice as follows: written application with intent to be pursuant to subsection (2), if the agency a. Class “I” violations are those admitted by such provider, any person determines that a person or entity is conditions or occurrences related to who is a client of such provider, or any operating or maintaining a provider the operation and maintenance of relative, spouse, or guardian of any without obtaining a license and determines a provider or to the care of clients such person, furnish to the requester that a condition exists that poses a threat to which the agency determines present a copy of the last inspection report the health, safety, or welfare of a client of an imminent danger to the clients pertaining to the licensed provider the provider, the person or entity is subject of the provider or a substantial that was issued by the agency or by an to the same actions and fi nes imposed probability that death or serious accrediting organization if such report against a licensee as specifi ed in this part, physical or emotional harm would is used in lieu of a licensure inspection. authorizing statutes, and agency rules. result therefrom. The condition or 7. Any person aware of the operation of practice constituting a class I violation 408.812 – Unlicensed activity. an unlicensed provider must report that shall be abated or eliminated within 1. A person or entity may not offer or provider to the agency. 24 hours, unless a fi xed period, as advertise services that require licensure as determined by the agency, is required defi ned by this part, authorizing statutes, 408.813 – Administrative fi nes; violations. for correction. The agency shall impose or applicable rules to the public without As a penalty for any violation of this part, an administrative fi ne as provided by obtaining a valid license from the agency. authorizing statutes, or applicable rules, the law for a cited class I violation. A fi ne A licenseholder may not advertise or hold agency may impose an administrative fi ne. shall be levied notwithstanding the out to the public that he or she holds a 1. Unless the amount or aggregate limitation correction of the violation. license for other than that for which he or of the fi ne is prescribed by authorizing b. Class “II” violations are those she actually holds the license. statutes or applicable rules, the agency may conditions or occurrences related to 2. The operation or maintenance of an establish criteria by rule for the amount the operation and maintenance of a unlicensed provider or the performance or aggregate limitation of administrative provider or to the care of clients which of any services that require licensure fi nes applicable to this part, authorizing the agency determines directly threaten without proper licensure is a violation statutes, and applicable rules. Each day of the physical or emotional health, of this part and authorizing statutes. violation constitutes a separate violation safety, or security of the clients, other Unlicensed activity constitutes harm that and is subject to a separate fi ne. For fi nes than class I violations. The agency materially affects the health, safety, and imposed by fi nal order of the agency and shall impose an administrative fi ne welfare of clients. The agency or any not subject to further appeal, the violator as provided by law for a cited class state attorney may, in addition to other shall pay the fi ne plus interest at the rate II violation. A fi ne shall be levied remedies provided in this part, bring an specifi ed in s. 55.03 for each day beyond notwithstanding the correction of the action for an injunction to restrain such the date set by the agency for payment of violation. violation, or to enjoin the future operation the fi ne. c. Class “III” violations are those or maintenance of the unlicensed provider 2. Violations of this part, authorizing statutes, conditions or occurrences related to or the performance of any services in or applicable rules shall be classifi ed the operation and maintenance of a violation of this part and authorizing according to the nature of the violation and provider or to the care of clients which statutes, until compliance with this part, the gravity of its probable effect on clients. the agency determines indirectly or authorizing statutes, and agency rules has The scope of a violation may be cited potentially threaten the physical or been demonstrated to the satisfaction of the as an isolated, patterned, or widespread emotional health, safety, or security agency. defi ciency. An isolated defi ciency is a of clients, other than class I or class II 3. It is unlawful for any person or entity to defi ciency affecting one or a very limited violations. The agency shall impose an own, operate, or maintain an unlicensed number of clients, or involving one administrative fi ne as provided in this provider. If after receiving notifi cation or a very limited number of staff, or a section for a cited class III violation. from the agency, such person or entity fails situation that occurred only occasionally A citation for a class III violation must to cease operation and apply for a license or in a very limited number of locations. specify the time within which the under this part and authorizing statutes, A patterned defi ciency is a defi ciency in violation is required to be corrected. If the person or entity shall be subject to which more than a very limited number a class III violation is corrected within penalties as prescribed by authorizing of clients are affected, or more than a the time specifi ed, a fi ne may not be statutes and applicable rules. Each day of very limited number of staff are involved, imposed. continued operation is a separate offense. or the situation has occurred in several d. Class “IV” violations are those 4. Any person or entity that fails to cease locations, or the same client or clients have conditions or occurrences related operation after agency notifi cation been affected by repeated occurrences of to the operation and maintenance may be fi ned $1,000 for each day of the same defi cient practice but the effect of a provider or to required reports, noncompliance. of the defi cient practice is not found to forms, or documents that do not have 5. When a controlling interest or licensee be pervasive throughout the provider. A the potential of negatively affecting has an interest in more than one provider widespread defi ciency is a defi ciency in Elite CME - www.EliteCME.com Page 11 clients. These violations are of a type program, the Medicaid program of any proceedings in a court of competent that the agency determines do not other state, or the Medicare program. jurisdiction when a violation of this threaten the health, safety, or security 2. If a licensee lawfully continues to operate part, authorizing statutes, or applicable of clients. The agency shall impose an while a denial or revocation is pending rules constitutes an emergency administrative fi ne as provided in this in litigation, the licensee must continue affecting the immediate health and section for a cited class IV violation. to meet all other requirements of this safety of a client. A citation for a class IV violation must part, authorizing statutes, and applicable b. Enforce the provisions of this part, specify the time within which the rules and must fi le subsequent renewal authorizing statutes, or any minimum violation is required to be corrected. If applications for licensure and pay all standard, rule, or order issued or a class IV violation is corrected within licensure fees. The provisions of ss. entered into pursuant thereto when the time specifi ed, a fi ne may not be 120.60(1) and 408.806(3)I shall not apply the attempt by the agency to correct imposed. to renewal applications fi led during the a violation through administrative time period in which the litigation of the sanctions has failed or when the 408.814 – Moratorium; emergency denial or revocation is pending until that violation materially affects the health, suspension. litigation is fi nal. safety, or welfare of clients or involves 1. The agency may impose an immediate 3. An action under s. 408.814 or denial of the any operation of an unlicensed moratorium or emergency suspension as license of the transferor may be grounds provider. defi ned in s. 120.60 on any provider if for denial of a change of ownership c. Terminate the operation of a provider the agency determines that any condition application of the transferee. when a violation of any provision of related to the provider or licensee presents 4. In addition to the grounds provided in this part, authorizing statutes, or any a threat to the health, safety, or welfare of authorizing statutes, the agency shall deny standard or rule adopted pursuant a client. an application for a license or license thereto exists that materially affects the 2. A provider or licensee, the license of which renewal if the applicant or a person having health, safety, or welfare of a client. is denied or revoked, may be subject to a controlling interest in an applicant has Such injunctive relief may be immediate imposition of a moratorium or been: temporary or permanent. emergency suspension to run concurrently a. Convicted of, or enters a plea of guilty 2. If action is necessary to protect clients with licensure denial, revocation, or or nolo contendere to, regardless of of providers from immediate, life- injunction. adjudication, a felony under chapter threatening situations, the court may 3. A moratorium or emergency suspension 409, chapter 817, chapter 893, 21 allow a temporary injunction without remains in effect after a change of U.S.C. ss. 801-970, or 42 U.S.C. ss. bond upon proper proofs being made. If it ownership, unless the agency has 1395-1396, unless the sentence and appears by competent evidence or a sworn, determined that the conditions that created any subsequent period of probation for substantiated affi davit that a temporary the moratorium, emergency suspension, or such convictions or plea ended more injunction should be issued, the court, denial of licensure have been corrected. than 15 years prior to the date of the pending the determination on fi nal hearing, 4. When a moratorium or emergency application; shall enjoin the operation of the provider. suspension is placed on a provider or b. Terminated for cause from the Florida licensee, notice of the action shall be Medicaid program pursuant to s. 408.817 – Administrative proceedings. posted and visible to the public at the 409.913, unless the applicant has been Administrative proceedings challenging location of the provider until the action is in good standing with the Florida agency licensure enforcement action shall lifted. Medicaid program for the most recent be reviewed on the basis of the facts and 408.815 – License or application denial; 5 years; or conditions that resulted in the agency action. c. Terminated for cause, pursuant to the revocation. 408.818 – Health care trust fund. 1. In addition to the grounds provided in appeals procedures established by the Unless otherwise prescribed by authorizing authorizing statutes, grounds that may state or Federal Government, from the statutes, all fees and fi nes collected under this be used by the agency for denying and federal Medicare program or from any part, authorizing statutes, and applicable rules revoking a license or change of ownership other state Medicaid program, unless shall be deposited into the Health Care Trust application include any of the following the applicant has been in good standing Fund, created in s. 408.16, and used to pay actions by a controlling interest: with a state Medicaid program or the the costs of the agency in administering the a. False representation of a material federal Medicare program for the most provider program paying the fees or fi nes. fact in the license application or recent 5 years and the termination omission of any material fact from the occurred at least 20 years prior to the 408.819 – Rules. application. date of the application. The agency is authorized to adopt rules b. An intentional or negligent act 408.816 – Injunctions. as necessary to administer this part. Any materially affecting the health or safety 1. In addition to the other powers provided licensed provider that is in operation at the of a client of the provider. by this part, authorizing statutes, and time of adoption of any applicable rule under c. A violation of this part, authorizing applicable rules, the agency may institute this part or authorizing statutes shall be statutes, or applicable rules. injunction proceedings in a court of given a reasonable time under the particular d. A demonstrated pattern of defi cient competent jurisdiction to: circumstances, not to exceed 6 months after performance. a. Restrain or prevent the establishment the date of such adoption, within which to e. The applicant, licensee, or controlling or operation of a provider that does comply with such rule, unless otherwise interest has been or is currently not have a license or is in violation of specifi ed by rule. excluded, suspended, or terminated any provision of this part, authorizing from participation in the state Medicaid statutes, or applicable rules. The agency may also institute injunction Page 12 Elite CME - www.EliteCME.com 408.820 – Exemptions. 20. Transitional living facilities, as provided b. An inactive license may be issued Except as prescribed in authorizing statutes, under part V of chapter 400, are exempt for a period not to exceed 12 months the following exemptions shall apply to from s. 408.810(10). but may be renewed by the agency specifi ed requirements of this part: 21. Prescribed pediatric extended care centers, for up to 12 additional months upon 1. Laboratories authorized to perform testing as provided under part VI of chapter 400, demonstration to the agency of under the Drug-Free Workplace Act, as are exempt from s. 408.810(10). progress toward reopening. A request provided under ss. 112.0455 and 440.102, 22. Home medical equipment providers, as by a licensee for an inactive license are exempt from s. 408.810(5)-(10). provided under part VII of chapter 400, are or to extend the previously approved 2. Birth centers, as provided under chapter exempt from s. 408.810(10). inactive period must be submitted in 383, are exempt from s. 408.810(7)-(10). 23. Intermediate care facilities for persons with writing to the agency, accompanied 3. Abortion clinics, as provided under chapter developmental disabilities, as provided by written justifi cation for the inactive 390, are exempt from s. 408.810(7)-(10). under part VIII of chapter 400, are exempt license, which states the beginning and 4. Crisis stabilization units, as provided under from s. 408.810(7). ending dates of inactivity and includes parts I and IV of chapter 394, are exempt 24. Health care services pools, as provided a plan for the transfer of any clients from s. 408.810(8)-(10). under part IX of chapter 400, are exempt to other providers and appropriate 5. Short-term residential treatment facilities, from s. 408.810(6)-(10). licensure fees. Upon agency approval, as provided under parts I and IV of chapter 25. Health care clinics, as provided under the licensee shall notify clients of 394, are exempt from s. 408.810(8)-(10). part X of chapter 400, are exempt from s. any necessary discharge or transfer 6. Residential treatment facilities, as provided 408.810(6), (7), and (10). as required by authorizing statutes or under part IV of chapter 394, are exempt 26. Clinical laboratories, as provided under applicable rules. The beginning of the from s. 408.810(8)-(10). part I of chapter 483, are exempt from s. inactive licensure period shall be the 7. Residential treatment centers for children 408.810(5)-(10). date the provider ceases operations. and adolescents, as provided under part 27. Multiphasic health testing centers, as The end of the inactive period shall IV of chapter 394, are exempt from s. provided under part II of chapter 483, are become the license expiration date, 408.810(8)-(10). exempt from s. 408.810(5)-(10). and all licensure fees must be current, 8. Hospitals, as provided under part I 28. Organ, tissue, and eye procurement must be paid in full, and may be of chapter 395, are exempt from s. organizations, as provided under part prorated. Reactivation of an inactive 408.810(7)-(9). V of chapter 765, are exempt from s. license requires the prior approval by 9. Ambulatory surgical centers, as provided 408.810(5)-(10). the agency of a renewal application, under part I of chapter 395, are exempt including payment of licensure fees from s. 408.810(7)-(10). 408.821 – Emergency management and agency inspections indicating 10. Mobile surgical facilities, as provided planning; emergency operations; inactive compliance with all requirements under part I of chapter 395, are exempt license. of this part and applicable rules and from s. 408.810(7)-(10). 1. A licensee required by authorizing statutes statutes. 11. Health care risk managers, as provided to have an emergency operations plan must 4. The agency may adopt rules relating under part I of chapter 395, are exempt designate a safety liaison to serve as the to emergency management planning, from ss. 408.806(7), 408.810(4)-(10), and primary contact for emergency operations. communications, and operations. Licensees 408.811. 2. An entity subject to this part may providing residential or inpatient services 12. Nursing homes, as provided under part temporarily exceed its licensed capacity to must utilize an online database approved II of chapter 400, are exempt from ss. act as a receiving provider in accordance by the agency to report information to the 408.810(7) and 408.813(2). with an approved emergency operations agency regarding the provider’s emergency 13. Assisted living facilities, as provided under plan for up to 15 days. While in an status, planning, or operations. part I of chapter 429, are exempt from s. overcapacity status, each provider must 408.810(10). furnish or arrange for appropriate care 408.831 – Denial, suspension, or 14. Home health agencies, as provided under and services to all clients. In addition, revocation of a license, registration, part III of chapter 400, are exempt from s. the agency may approve requests for certifi cate, or application. 408.810(10). overcapacity in excess of 15 days, which 1. In addition to any other remedies 15. Nurse registries, as provided under part approvals may be based upon satisfactory provided by law, the agency may deny III of chapter 400, are exempt from s. justifi cation and need as provided by the each application or suspend or revoke 408.810(6) and (10). receiving and sending providers. each license, registration, or certifi cate of 16. Companion services or homemaker 3. a. An inactive license may be issued to a entities regulated or licensed by it: services providers, as provided under part licensee subject to this section when a. If the applicant, licensee, or a III of chapter 400, are exempt from s. the provider is located in a geographic licensee subject to this part which 408.810(6)-(10). area in which a state of emergency shares a common controlling interest 17. Adult day care centers, as provided under was declared by the Governor if the with the applicant has failed to part III of chapter 429, are exempt from s. provider: pay all outstanding fi nes, liens, or 408.810(10). 1. Suffered damage to its operation overpayments assessed by fi nal order 18. Adult family-care homes, as provided during the state of emergency. of the agency or fi nal order of the under part II of chapter 429, are exempt 2. Is currently licensed. Centers for Medicare and Medicaid from s. 408.810(7)-(10). 3. Does not have a provisional Services, not subject to further appeal, 19. Homes for special services, as provided license. unless a repayment plan is approved by under part V of chapter 400, are exempt 4. Will be temporarily unable to the agency; or from s. 408.810(7)-(10). provide services but is reasonably b. For failure to comply with any expected to resume services within repayment plan. 12 months. Elite CME - www.EliteCME.com Page 13 2. In reviewing any application requesting  Creating additional criminal felonies required by the Offi ce of Insurance a change of ownership or change of the and increasing the criminal penalties Regulation for commercial plans; and licensee, registrant, or certifi cateholder, the for existing offenses.  Allows prepaid plans owned by transferor shall, prior to agency approval  The law creates incentives for persons to federally qualifi ed health clinics to of the change, repay or make arrangements report Medicaid fraud with the following provide behavioral health services to to repay any amounts owed to the agency. provisions: Medicaid recipients. Should the transferor fail to repay or make  Offering monetary rewards for persons arrangements to repay the amounts owed who report Medicaid fraud to the Is this relevant to you? According to Section 456.0635, enacted July to the agency, the issuance of a license, authorities; 1, 2009, health care boards or the department registration, or certifi cate to the transferee  Removing a disincentive to pursue an shall refuse to issue a license, certifi cate shall be delayed until repayment or until action under the Florida False Claims or registration and shall refuse to admit a arrangements for repayment are made. Act; and candidate for examination if the applicant has 3. This section provides standards of  Providing civil immunity for persons been: enforcement applicable to all entities who report suspected Medicaid fraud. 1. Convicted or plead guilty or nolo licensed or regulated by the Agency for  The law makes fi ndings and designates contendre to a felony violation of: chapters Health Care Administration. This section Miami-Dade County as a “health care 409, 817, or 893, Florida Statutes; or controls over any confl icting provisions fraud crisis area” related to home health 21 U.S.C. ss. 801-970 or 42 U.S.C. ss of chapters 39, 383, 390, 391, 394, 395, agencies, home medical equipment 1395-1396, unless the sentence and any 400, 408, 429, 468, 483, and 765 or rules providers and health care clinics. It probation or pleas ended more than 15 adopted pursuant to those chapters. requires additional proof of fi nancial ability years prior to the application. Chapter 893 to operate, and surety bonds under certain F.S. encompasses all drug charges in the 408.832 – Confl icts. circumstances, to obtain a license as one In case of confl ict between the provisions of state, meaning that a license will be denied of these providers. The law imposes a one- this part and the authorizing statutes governing for a felony conviction associated with a year moratorium on initial and change of the licensure of health care providers by the drug charge. ownership home health agency licenses in Agency for Health Care Administration found 2. Terminated for cause from Florida Miami-Dade and Broward Counties, with in s. 112.0455 and chapters 383, 390, 394, 395, Medicaid Program (unless the applicant an exception. The law also prohibits AHCA 400, 429, 440, 483, and 765, the provisions of has been in good standing for the most from renewing a home health agency this part shall prevail. recent fi ve years). license in Miami-Dade County if AHCA 3. Terminated for cause by any other State has administratively sanctioned the agency TITLE XXXII REGULATION OF PROFESSIONS Medicaid Program or the Medicare in the last two years for specifi ed activity. AND OCCUPATIONS Program (unless the termination was The law creates new criminal penalties, by at least 20 years prior to the date of the Chapter 456 – Health professions and making the following offenses third degree application and the applicant has been in occupations: General provisions felonies: good standing with the program for the See complete text at http://www.fl senate.gov/  Offering services requiring licensure most recent fi ve years). Laws/Statutes/2010/Chapter456 as a home medical equipment provider, 2009-223 Health care – Human services or health care clinic, or offering skilled For more information, see the full text of the services requiring licensure as a home appropriations(SB 1986) law and the following links referenced in the health agency, without a license; The law amends multiple sections of law law:  Knowingly submitting false or  to establish a plan for a medical home pilot 21 United States Code, Chapter 13 misleading licensure information to project, address health care fraud and abuse, (ss. 801-970) pertaining to controlled AHCA; and and decrease and streamline regulation of substances under federal law http://fsmta.  Conspiracy to violate the provisions of health care entities. Among its amendments: org/fsmta.org/wp-content/uploads/2009/10/ the enhanced licensure requirements in  The law requires Agency for Health Care usc-title21-chpt13.pdf s. 408.8065, F.S.  Administration (AHCA) to develop a 42 United States Code, Chapter 42 (ss.  The law gives law enforcement and the plan for a new pilot Medicaid services 1395-1396) pertaining to public health Medicaid program additional authority to delivery system based on a medical home and welfare http://fsmta.org/fsmta.org/ prevent and penalize fraud and abusive concept. A medical home is a patient- wp-content/uploads/2009/10/usc-title42- billing, including the following provisions: centered model of care that provides a subchpt18.pdf  Requiring prior authorization and  personal health care professional, usually a Florida Statutes, Chapter 409 Social increased documentation for certain physician, who coordinates and facilitates and Economic Assistance http://www. home health services; access to medical care. leg.state.fl .us/Statutes/index.cfm?App_  Making sanctions and ‘for cause’  The law creates disincentives to commit mode=Display_Statute&URL=0400- contract termination mandatory for Medicaid fraud or abuse, including the 0499/0409/0409ContentsIndex. certain provider activity; following provisions: html&StatuteYear=2010&Title=-  Requiring Medicaid to eliminate  Increasing the administrative penalties %3E2010-%3EChapter%20409 medically unnecessary billing; and  for committing Medicaid fraud; Florida Statutes, Chapter 817  Requiring two pilot projects to monitor  Establishing additional licensure Fraudulent Practices http://www.leg. and manage home health services. penalties for providers who improperly state.fl .us/Statutes/index.cfm?App_  In addition, the law makes other changes law Medicaid; mode=Display_Statute&URL=0800- to the Medicaid program, including the  Adding fraud-related criminal offenses 0899/0817/0817ContentsIndex. following provisions: which disqualify an applicant from html&StatuteYear=2010&Title=-  Reduces the surplus requirements of health care licensure; %3E2010-%3EChapter%2081 Medicaid prepaid plans to match those

Page 14 Elite CME - www.EliteCME.com  Florida Statutes, Chapter 893 Drug Abuse Medicaid program for the most recent 456.074 Certain health care practitioners; Prevention And Control http://www. fi ve years; immediate suspension of license. leg.state.fl .us/Statutes/index.cfm?App_ c. Terminated for cause, pursuant to the 1. The department shall issue an emergency mode=Display_Statute&URL=0800- appeals procedures established by the order suspending the license of any person 0899/0893/0893ContentsIndex. state or Federal Government, from any licensed under chapter 458, chapter 459, html&StatuteYear=2010&Title=- other state Medicaid program or the chapter 460, chapter 461, chapter 462, %3E2010-%3EChapter%20893 federal Medicare program, unless the chapter 463, chapter 464, chapter 465, applicant has been in good standing chapter 466, or chapter 484 who pleads See complete revised text at Ch_2009-223.pdf with a state Medicaid program or the guilty to, is convicted or found guilty of, or http://laws.fl rules.org/2009/223 federal Medicare program for the most or who enters a plea of nolo contendere to,  Creating s.456.0635, F.S.; prohibiting recent fi ve years and the termination regardless of adjudication, to: Medicaid fraud in the practice of health occurred at least 20 years prior to the a. A felony under chapter 409, chapter care professions; requiring the Department date of the application. 817, or chapter 893 or under 21 U.S.C. of Health or boards within the department 3. Licensed health care practitioners shall ss. 801-970 or under 42 U.S.C. ss. to refuse to admit to exams and to deny report allegations of Medicaid fraud to 1395-1396; or. licenses, permits, or certifi cates to certain the department, regardless of the practice b. A misdemeanor or felony under 18 persons who have engaged in certain acts; setting in which the alleged Medicaid fraud U.S.C. s. 669, ss. 285-287, s. 371, requiring health care practitioners to report occurred. s. 1001, s. 1035, s. 1341, s. 1343, s. allegations of Medicaid fraud; specifying 4. The acceptance by a licensing authority 1347, s. 1349, or s. 1518 or 42 U.S.C. that acceptance of the relinquishment of a of a candidate’s relinquishment of a ss. 1320a-7b, relating to the Medicaid license in anticipation of charges relating license which is offered in response to or program. to Medicaid fraud constitutes permanent anticipation of the fi ling of administrative revocation of a license; charges alleging Medicaid fraud or 2010-211 Controlled substances (SB  Amending s. 456.072, F.S.; creating similar charges constitutes the permanent 2272) additional grounds for the Department revocation of the license. 2010-211 increases the regulation of pain of Health to take disciplinary action management clinics, and physicians who against certain applicants or licensees for Section 25. Paragraphs (ii), (jj), (kk), and (ll) practice in them, by the Department of Health misconduct relating to a Medicaid program are added to subsection (1) of section 456.072, (Department). It requires the prescription or to health care fraud; Florida Statutes, to read: drug monitoring program to report additional  Amending s. 456.074, F.S.; requiring information to law enforcement. the Department of Health to issue an 456.072 Grounds for discipline; penalties; emergency order suspending the license of enforcement. The department may obtain patient records a person who engages in certain criminal 1. The following acts shall constitute grounds from massage establishments without conduct relating to the Medicaid program; for which the disciplinary actions specifi ed written authorization from the patient in in subsection (2) may be taken: certain circumstances if the department fi nds Section 24. Section 456.0635, Florida Statutes, ii. Being convicted of, or entering a plea reasonable cause to believe that a health care is created to read: of guilty or nolo contendere to, any practitioner has practiced his or her profession misdemeanor or felony, regardless of 456.0635 Medicaid fraud; disqualifi cation below that level of care, skill, and treatment adjudication, under 18 U.S.C. s. 669, required as defi ned by this chapter or any for license, certifi cate, or registration. ss. 285-287, s. 371, s. 1001, s. 1035, professional practice act. 1. Medicaid fraud in the practice of a health s. 1341, s. 1343, s. 1347, s. 1349, or care profession is prohibited. s. 1518, or 42 U.S.C. ss. 1320a-7b, Revised text at Ch_2010-211.pdf or 2. Each board within the jurisdiction of the relating to the Medicaid program. http://laws.fl rules.org/2010/211 department, or the department if there is  jj. Failing to remit the sum owed to amending s. 456.057, F.S.; providing no board, shall refuse to admit a candidate the state for an overpayment from that the Department of Health is not to any examination and refuse to issue or the Medicaid program pursuant to a required to attempt to obtain authorization renew a license, certifi cate, or registration fi nal order, judgment, or stipulation or from a patient for the release of the to any applicant if the candidate or settlement. patient’s medical records under certain applicant or any principle, offi cer, agent, kk. Being terminated from the state circumstances; authorizing the department managing employee, or affi liated person of Medicaid program pursuant to s. to obtain patient records without the applicant, has been: 409.913, any other state Medicaid authorization or subpoena if the department a. Convicted of, or entered a plea of program, or the federal Medicare has probable cause to believe that certain guilty or nolo contendere to, regardless program, unless eligibility to violations have occurred or are occurring; of adjudication, a felony under chapter participate in the program from which 409, chapter 817, chapter 893, 21 456.037 Business establishments; the practitioner was terminated has U.S.C. ss. 801-970, or 42 U.S.C. ss. requirements for active status licenses; been restored. 1395-1396, unless the sentence and any delinquency; discipline; applicability. ll. Being convicted of, or entering a subsequent period of probation for such This section applies to any business plea of guilty or nolo contendere to, conviction or pleas ended more than establishment registered, permitted, or any misdemeanor or felony, regardless fi fteen years prior to the date of the licensed by the department to do business. of adjudication, a crime in any application; Business establishments include, but are not jurisdiction which relates to health care b. Terminated for cause from the Florida limited to, dental laboratories, electrology fraud. Medicaid program pursuant to s. facilities, massage establishments, and 409.913, unless the applicant has been Section 26. Subsection (1) of section 456.074, pharmacies, and pain-management clinics in good standing with the Florida Florida Statutes, is amended to read: required to be registered under s. 458.3265 or s. 459.0137. Elite CME - www.EliteCME.com Page 15 Section 2. Paragraph (a) of subsection (9) of reasonable attempts were made to practice, the complete chapter is reproduced section 456.057, Florida Statutes, is amended obtain a patient release. here. to read: 3. The department may obtain patient records, billing records, insurance The Massage Practice Act 456.057 Ownership and control of patient information, provider contracts, and 480.031 – Short title. records; report or copies of records to be all attachments thereto pursuant This act shall be known and may be cited as furnished. to a subpoena without written the “Massage Practice Act.” 9. a. 1. The department may obtain patient authorization from the patient 480.032 – Purpose. records pursuant to a subpoena if the department and probable The Legislature recognizes that the practice without written authorization cause panel of the appropriate of massage is potentially dangerous to the from the patient if the department board, if any, fi nd reasonable public in that massage therapists must have and the probable cause panel cause to believe that a health care a knowledge of anatomy and physiology of the appropriate board, if any, practitioner has submitted a claim, and an understanding of the relationship fi nd reasonable cause to believe statement, or bill using a billing between the structure and the function of the that a health care practitioner has code that would result in payment tissues being treated and the total function excessively or inappropriately greater in amount than would of the body. Massage is therapeutic, and prescribed any controlled substance be paid using a billing code that regulations are necessary to protect the public specifi ed in chapter 893 in violation accurately describes the services from unqualifi ed practitioners. It is therefore of this chapter or any professional performed, requested payment for deemed necessary in the interest of public practice act or that a health care services that were not performed health, safety, and welfare to regulate the practitioner has practiced his or by that health care practitioner, practice of massage in this state; however, her profession below that level of used information derived from a restrictions shall be imposed to the extent care, skill, and treatment required written report of an automobile necessary to protect the public from signifi cant as defi ned by this chapter or any accident generated pursuant to and discernible danger to health and yet not in professional practice act and also chapter 316 to solicit or obtain such a manner which will unreasonably affect fi nd that appropriate, reasonable patients personally or through an the competitive market. Further, consumer attempts were made to obtain a agent regardless of whether the protection for both health and economic patient release. Notwithstanding information is derived directly matters shall be afforded the public through the foregoing, the department need from the report or a summary of legal remedies provided for in this act. not attempt to obtain a patient that report or from another person, release when investigating an solicited patients fraudulently, 480.033 – Defi nitions. offense involving the inappropriate received a kickback as defi ned in As used in this act: prescribing, overprescribing, or s. 456.054, violated the patient 1. “Board” means the Board of Massage diversion of controlled substances brokering provisions of s. 817.505, Therapy. and the offense involves a pain- or presented or caused to be 2. “Department” means the Department of management clinic. The department presented a false or fraudulent Health. may obtain patient records without insurance claim within the meaning 3. “Massage” means the manipulation of patient authorization or subpoena of s. 817.234(1)(a), and also fi nd the soft tissues of the human body with from any pain-management clinic that, within the meaning of s. the hand, foot, arm, or elbow, whether required to be licensed if the 817.234(1)(a), patient authorization or not such manipulation is aided by department has probable cause cannot be obtained because the hydrotherapy, including colonic irrigation, to believe that a violation of patient cannot be located or or thermal therapy; any electrical or any provision of s. 458.3265 or is deceased, incapacitated, or mechanical device; or the application to s. 459.0137 is occurring or has suspected of being a participant the human body of a chemical or herbal occurred and reasonably believes in the fraud or scheme, and if the preparation. that obtaining such authorization subpoena is issued for specifi c and 4. “Massage therapist” means a person is not feasible due to the volume relevant records. licensed as required by this act, who of the dispensing and prescribing 4. Notwithstanding subparagraphs administers massage for compensation. activity involving controlled 1.-3., when the department 5. “Apprentice” means a person approved substances and that obtaining investigates a professional liability by the board to study massage under the patient authorization or the issuance claim or undertakes action pursuant instruction of a licensed massage therapist. of a subpoena would jeopardize the to s. 456.049 or s. 627.912, the 6. “Colonic irrigation” means a method of investigation. department may obtain patient hydrotherapy used to cleanse the colon 2. The department may obtain patient records pursuant to a subpoena with the aid of a mechanical device and records and insurance information without written authorization from water. pursuant to a subpoena without the patient if the patient refuses 7. “Establishment” means a site or premises, written authorization from the to cooperate or if the department or portion thereof, wherein a massage patient if the department and attempts to obtain a patient release therapist practices massage. the probable cause panel of the and the failure to obtain the patient 8. “Licensure” means the procedure by appropriate board, if any, fi nd records would be detrimental to the which a person, hereinafter referred to as reasonable cause to believe that investigation. a “practitioner,” applies to the board for a health care practitioner has approval to practice massage or to operate provided inadequate medical care Chapter 480 F.S. - Massage practice an establishment. based on termination of insurance No changes were made to Chapter 480 in and also fi nd that appropriate, 2009-2011. Because of its relevance to your Page 16 Elite CME - www.EliteCME.com 9. “Board-approved massage school” means or his discretion. A quorum of the board b. Providing for educational standards, a facility which meets minimum standards shall consist of not less than four members. examination, and certifi cation for the for training and curriculum as determined 6. Board members shall receive per diem and practice of colonic irrigation, as defi ned by rule of the board and which is licensed mileage as provided in s. 112.061 from the in s. 480.033(6), by massage therapists. by the Department of Education pursuant place of residence to the place of meeting c. Specifying licensing procedures for to chapter 1005 or the equivalent licensing and return. practitioners desiring to be licensed in authority of another state or is within the 7. The board has authority to adopt rules this state who hold an active license public school system of this state. pursuant to ss. 120.536(1) and 120.54 to and have practiced in any other implement the provisions of this chapter. state, territory, or jurisdiction of the 480.034 – Exemptions. United States or any foreign national 1. Nothing in this act shall modify or repeal 480.036 – Accountability of board jurisdiction which has licensing any provision of chapters 458-464, members. standards substantially similar to, inclusive, or of chapter 476, chapter 477, Each board member shall be held accountable equivalent to, or more stringent than or chapter 486. to the Governor for the proper performance the standards of this state. 2. Athletic trainers employed by or on behalf of all duties and obligations of such board of a professional athletic team performing member’s offi ce. The Governor shall cause to 480.0415 – License renewal. or training within this state shall be exempt be investigated any complaints or unfavorable The board shall prescribe by rule the method from the provisions of this act. reports received concerning the actions of the for renewal of biennial licensure which shall 3. The state and its political subdivisions are board or its individual members and shall take include continuing education requirements not exempt from the registration requirements appropriate action thereon, which may include to exceed 25 classroom hours per biennium. of this act. removal of any board member for malfeasance, The board shall by rule establish criteria for 4. An exemption granted is effective to the misfeasance, neglect of duty, commission of a the approval of continuing education programs extent that an exempted person’s practice felony, incompetency, or permanent inability to or courses. The programs or courses approved or profession overlaps with the practice of perform offi cial duties. by the board may include correspondence massage. courses that meet the criteria for continuing 480.039 – Investigative services. education courses held in a classroom setting. 480.035 – Board of Massage Therapy. The department shall provide all investigative 1. The Board of Massage Therapy is created services required in carrying out the provisions 480.042 – Examinations. within the department. The board shall of this act. 1. The board shall specify by rule the general consist of seven members, who shall be areas of competency to be covered by appointed by the Governor and whose 480.041 – Massage therapists; examinations for licensure. These rules function it shall be to carry out the qualifi cations; licensure; endorsement. shall include the relative weight assigned provisions of this act. 1. Any person is qualifi ed for licensure as a in grading each area, the grading criteria 2. Five members of the board shall be massage therapist under this act who: to be used by the examiner, and the score licensed massage therapists and shall a. Is at least 18 years of age or has necessary to achieve a passing grade. have been engaged in the practice of received a high school diploma or The board shall ensure that examinations massage for not less than 5 consecutive graduate equivalency diploma; adequately measure an applicant’s years prior to the date of appointment to b. Has completed a course of study at a competency. Professional testing the board. The Governor shall appoint board-approved massage school or has services may be utilized to formulate the each member for a term of 4 years. Two completed an apprenticeship program examinations. members of the board shall be laypersons. that meets standards adopted by the 2. The board shall ensure that examinations Each board member shall be a high school board; and comply with state and federal equal graduate or shall have received a graduate c. Has received a passing grade on an employment opportunity guidelines. equivalency diploma. Each board member examination administered by the 3. The department shall, in accordance with shall be a citizen of the United States and department. rules established by the board, examine a resident of this state for not less than 5 2. Every person desiring to be examined for persons who fi le applications for licensure years. The appointments will be subject to licensure as a massage therapist shall apply under this act in all matters pertaining confi rmation by the Senate. to the department in writing upon forms to the practice of massage. A written 3. The Governor may at any time fi ll prepared and furnished by the department. examination shall be offered at least once vacancies on the board for the remainder Such applicants shall be subject to the yearly and at such other times as the of unexpired terms. Each member of the provisions of s. 480.046(1). Applicants department shall deem necessary. board shall hold over after the expiration may take an examination administered 4. The board shall adopt rules providing for of her or his term until her or his successor by the department only upon meeting the reexamination of applicants who have has been duly appointed and qualifi ed. No requirements of this section as determined failed the examination. board member shall serve more than two by the board. 5. All licensing examinations shall be terms, whether full or partial. 3. Upon an applicant’s passing the conducted in such manner that the 4. The board shall, in the month of January, examination and paying the initial applicant shall be known to the department elect from its number a chair and a vice licensure fee, the department shall issue by number until her or his examination chair. to the applicant a license, valid until the is completed and the proper grade 5. The board shall hold such meetings next scheduled renewal date, to practice determined. An accurate record of each during the year as it may determine to be massage. examination shall be made; and that record, necessary, one of which shall be the annual 4. The board shall adopt rules: together with all examination papers, shall meeting. The chair of the board shall have a. Establishing a minimum training be fi led with the State Surgeon General and the authority to call other meetings at her program for apprentices. shall be kept for reference and inspection

Elite CME - www.EliteCME.com Page 17 for a period of not less than 2 years rules governing delinquent renewal of a. Attempting to procure a license immediately following the examination. licenses and may impose penalty fees for to practice massage by bribery or delinquent renewal. fraudulent misrepresentation. 480.043 – Massage establishments; 9. The board is authorized to adopt rules b. Having a license to practice massage requisites; licensure; inspection. governing the periodic inspection of revoked, suspended, or otherwise 1. No massage establishment shall be allowed massage establishments licensed under this acted against, including the denial of to operate without a license granted by act. licensure, by the licensing authority of the department in accordance with rules another state, territory, or country. adopted by the board. 480.044 – Fees; disposition. c. Being convicted or found guilty, 1. The board shall set fees according to the 2. The board shall adopt rules governing regardless of adjudication, of a crime in following schedule: the operation of establishments and their any jurisdiction which directly relates a. Massage therapist application and facilities, personnel, safety and sanitary to the practice of massage or to the examination fee: not to exceed $250. requirements, fi nancial responsibility, ability to practice massage. Any plea of b. Massage therapist initial licensure fee: insurance coverage, and the license nolo contendere shall be considered a not to exceed $150. application and granting process. conviction for purposes of this chapter. c. Establishment application fee: not to 3. Any person, fi rm, or corporation desiring d. False, deceptive, or misleading exceed $200. to operate a massage establishment in advertising. d. Establishment licensure fee: not to the state shall submit to the department e. Aiding, assisting, procuring, or exceed $150. an application, upon forms provided by advising any unlicensed person to e. Biennial establishment renewal fee: not the department, accompanied by any practice massage contrary to the to exceed $150. information requested by the department provisions of this chapter or to a rule of f. Biennial massage therapist licensure and an application fee. the department or the board. renewal fee: not to exceed $200. 4. Upon receiving the application, the f. Making deceptive, untrue, or fraudulent g. Massage therapist reexamination fee: department may cause an investigation representations in the practice of not to exceed $250. to be made of the proposed massage massage. h. Fee for apprentice: not to exceed $100. establishment. g. Being unable to practice massage with i. Colonics examination fee: not to 5. If, based upon the application and any reasonable skill and safety by reason exceed $100. necessary investigation, the department of illness or use of alcohol, drugs, j. Colonics reexamination fee: not to determines that the proposed establishment narcotics, chemicals, or any other type exceed $100. would fail to meet the standards adopted of material or as a result of any mental k. Application and reactivation for by the board under subsection (2), the or physical condition. In enforcing inactive status of a massage therapist department shall deny the application for this paragraph, the department shall license fee: not to exceed $250. license. Such denial shall be in writing have, upon probable cause, authority to l. Renewal fee for inactive status: not to and shall list the reasons for denial. Upon compel a massage therapist to submit exceed $250. correction of any defi ciencies, an applicant to a mental or physical examination 2. The department shall impose a late fee not previously denied permission to operate by physicians designated by the to exceed $150 on a delinquent renewal of a massage establishment may reapply for department. Failure of a massage a massage establishment license. licensure. therapist to submit to such examination 3. The board may establish by rule an 6. If, based upon the application and any when so directed, unless the failure was application fee not to exceed $100 for necessary investigation, the department due to circumstances beyond her or his anyone seeking approval to provide determines that the proposed massage control, shall constitute an admission continuing education courses and may establishment may reasonably be expected of the allegations against her or him, provide by rule for a fee not to exceed $50 to meet the standards adopted by the consequent upon which a default and for renewal of providership. department under subsection (2), the fi nal order may be entered without the 4. The department is authorized to charge the department shall grant the license under taking of testimony or presentation of cost of any original license or permit, as such restrictions as it shall deem proper as evidence. A massage therapist affected set forth in this chapter, for the issuance of soon as the original licensing fee is paid. under this paragraph shall at reasonable any duplicate licenses or permits requested 7. a. Once issued, no license for operation intervals be afforded an opportunity to by any massage therapist or massage of a massage establishment may be demonstrate that she or he can resume establishment. transferred from one owner to another. the competent practice of massage with 5. All moneys collected by the department b. A license may be transferred from reasonable skill and safety to clients. from fees authorized by this act shall be one location to another only after h. Gross or repeated malpractice or the paid into the Medical Quality Assurance inspection and approval by the board failure to practice massage with that Trust Fund in the department and shall be and receipt of an application and level of care, skill, and treatment applied in accordance with the provisions inspection fee set by rule of the board, which is recognized by a reasonably of s. 456.025. The Legislature may not to exceed $125. prudent massage therapist as being appropriate any excess moneys from this c. A license may be transferred from acceptable under similar conditions and fund to the General Revenue Fund. one business name to another after circumstances. approval by the board and receipt of an 480.046 – Grounds for disciplinary action i. Practicing or offering to practice application fee set by rule of the board, beyond the scope permitted by law or not to exceed $25. by the board. 1. The following acts constitute grounds for accepting and performing professional 8. Renewal of license registration for massage denial of a license or disciplinary action, as responsibilities which the licensee establishments shall be accomplished specifi ed in s. 456.072(2): knows or has reason to know that she pursuant to rules adopted by the board. or he is not competent to perform. The board is further authorized to adopt Page 18 Elite CME - www.EliteCME.com j. Delegating professional responsibilities owner or principal offi cer of the establishment 480.052 – Power of county or to a person when the licensee may be used in lieu of the license number for municipality to regulate massage. delegating such responsibilities knows the establishment. A county or municipality, within its or has reason to know that such person jurisdiction, may regulate persons and 480.047 – Penalties. is not qualifi ed by training, experience, establishments licensed under this chapter. 1. It is unlawful for any person to: or licensure to perform. Such regulation shall not exceed the powers a. Hold himself or herself out as a k. Violating a lawful order of the board of the state under this act or be inconsistent massage therapist or to practice or department previously entered with this act. This section shall not be massage unless duly licensed under this in a disciplinary hearing, or failing construed to prohibit a county or municipality chapter or unless otherwise specifi cally to comply with a lawfully issued from enacting any regulation of persons or exempted from licensure under this subpoena of the department. establishments not licensed pursuant to this chapter. l. Refusing to permit the department to act. b. Operate any massage establishment inspect the business premises of the unless it has been duly licensed as licensee during regular business hours. PART II: Florida administrative code (FAC) provided herein, except that nothing m. Failing to keep the equipment and – Rules herein shall be construed to prevent the premises of the massage establishment The Florida Administrative Code is the offi cial teaching of massage in this state at a in a clean and sanitary condition. compilation of administrative rules for the board-approved massage school. n. Practicing massage at a site, location, state of Florida. The Department of State c. Permit an employed person to practice or place which is not duly licensed as oversees the publishing of the FAC and the massage unless duly licensed as a massage establishment, except that a monthly supplements. The online, unoffi cial provided herein. massage therapist, as provided by rules version of the FAC is updated weekly on the d. Present as his or her own the license of adopted by the board, may provide department’s e-rulemaking website. You can another. massage services, excluding colonic fi nd that information at the following Web Site. e. Allow the use of his or her license by  irrigation, at the residence of a client, Florida Administrative Weekly and Florida an unlicensed person. at the offi ce of the client, at a sports Administrative Code (FAC): https://www. f. Give false or forged evidence to the event, at a convention, or at a trade fl rules.org department in obtaining any license show. provided for herein. What is a Rule? According to Chapter 120, o. Violating any provision of this chapter g. Falsely impersonate any other license- Florida Statutes, Administrative Procedure or chapter 456, or any rules adopted holder of like or different name. Act (A.P.A.): Rule means each agency pursuant thereto. h. Use or attempt to use a license that has statement of general applicability that 2. The board may enter an order denying been revoked. implements, interprets, or prescribes law or licensure or imposing any of the penalties i. Otherwise violate any of the provisions policy or describes the procedure or practice in s. 456.072(2) against any applicant for of this act. requirements of an agency and includes licensure or licensee who is found guilty 2. Any person violating the provisions of this any form which imposes any requirement of violating any provision of subsection section is guilty of a misdemeanor of the or solicits any information not specifi cally (1) of this section or who is found guilty of fi rst degree, punishable as provided in s. required by statute or by an existing rule. The violating any provision of s. 456.072(1). 775.082 or s. 775.083. term also includes the amendment or repeal of 3. The board shall have the power to revoke a rule. or suspend the license of a massage 480.0485 – Sexual misconduct in the establishment licensed under this act, or practice of massage therapy. Chapter 64B7: Board of Massage to deny subsequent licensure of such an The massage therapist-patient relationship is Signifi cant changes were made to the Florida establishment, in either of the following founded on mutual trust. Sexual misconduct Administrative Code in recent years, with the cases: in the practice of massage therapy means bulk of changes affecting massage therapy a. Upon proof that a license has been violation of the massage therapist-patient enacted in 2010. obtained by fraud or misrepresentation. relationship through which the massage b. Upon proof that the holder of a therapist uses that relationship to induce or 64B7-24: Organization license is guilty of fraud or deceit or attempt to induce the patient to engage, or to https://www.fl rules.org/gateway/RuleNo.asp?ti of gross negligence, incompetency, engage or attempt to engage the patient, in tle=ORGANIZATION&ID=64B7-24.008 or misconduct in the operation of the sexual activity outside the scope of practice or establishment so licensed. the scope of generally accepted examination or 64B7-24.008 Probable cause 4. Disciplinary proceedings shall be treatment of the patient. Sexual misconduct in determination; Probable cause panel. conducted pursuant to the provisions of the practice of massage therapy is prohibited. 1. The determination as to whether probable chapter 120. cause exists to believe that a violation of 480.049 – Civil proceedings. the provisions of Chapter 456 or 480, F.S., 480.0465 – Advertisement. As cumulative to any other remedy or or of the rules promulgated thereunder, has Each massage therapist or massage criminal prosecution, the department may fi le occurred shall be made by a probable cause establishment licensed under the provisions a proceeding in the name of the state seeking panel of two members to be selected by the of this act shall include the number of the issuance of a restraining order, injunction, or chairman of the Board. license in any advertisement of massage writ of mandamus against any person who is 2. The Chairman shall be permitted to appoint services appearing in any newspaper, airwave or has been violating any of the provisions one former Board member to serve on the transmission, telephone directory, or other of this act or the lawful rules or orders of the Board’s probable cause panel. advertising medium. Pending licensure of a department. new massage establishment pursuant to the provisions of s. 480.043(6), the license number of a licensed massage therapist who is an Elite CME - www.EliteCME.com Page 19 64B7-24.0091 Attendance of meetings by F.A.C.; or completes an approved 64B7-25.004 Endorsements. board members. apprenticeship program in accordance 1. The Department shall issue a license by Unexcused absences of a board member are with Rule Chapter 64B7-29, F.A.C.; endorsement to a person who: absences not due to the following situations: d. Completes the HIV/AIDS course a. Pays to the Department the initial 1. Medical problems of a board member or a requirement in Rule 64B7-25.0012, licensure fee set forth in subsection board member’s family including but not F.A.C.; 64B7-27.008(2), F.A.C.; and limited to illness, surgery, emergency care e. Passes a national examination approved b. Submits a completed application on and/or hospitalization; by the Board; form DH-MQA 1115, “Application 2. Death of a family member and/or f. Completes a course relating to the For Licensure,” (Rev. 10/09), adopted attendance at the family member’s funeral; prevention of medical errors as and incorporated by reference in Rule 3. Any confl ict, extraordinary circumstance, required by subsection 456.013(7), F.S. 64B7-25.001, F.A.C.; and or event approved by the chairman of the 2. The Board approves the following c. Is currently licensed and has practiced board. examinations: massage under the laws of another a. National Certifi cation Board for state, and was required, in order to 64B7-24.016 Time for payment of civil Therapeutic Massage and Bodywork be so licensed to meet standards of penalties. Examination; education or apprenticeship training In cases where the Board imposes a civil b. National Certifi cation Examination for substantially similar to, equivalent to, penalty for violation of Chapter 456 or 480, Therapeutic Massage; or more stringent than those required F.S., or the rules promulgated thereunder, the c. National Exam for State Licensure for licensure by Florida law and these penalty shall be paid within thirty (30) days option administered by the National rules; and of its imposition by order of the Board, or as Certifi cation Board for Therapeutic d. Demonstrates that his out-of-state otherwise directed by the Board. Massage and Bodywork; license was issued upon the satisfactory 64B7-24.017 Board business. d. The Massage and Bodywork Licensing completion of an examination 1. For the purposes of Section 456.011(4), Examination administered by the comparable to the examination F.S., the Board defi nes “other business Federation of State Massage Therapy approved by the Board; and involving the Board” as, Boards. e. Has no outstanding or unresolved a. All regularly scheduled meetings of 3. Any Board-approved examination may be complaints fi led against him or her in Board committees, and offered in the Spanish language. the jurisdiction of licensure. b. Whenever a board member has been f. Completes a current curriculum course 64B7-25.0011 Colonic iIrrigation from a Board approved school covering requested by the State Surgeon General application deadline. or the Department staff to participate the Florida Statutes and rules related to An applicant for the colonic irrigation massage therapy. in a meeting or in the preparation, examination or for re-examination must fi le administration, or grading of the g. Completes the HIV/AIDS course in the Board offi ce a completed application requirement in Rule 64B7-25.0012, examination. (incorporated herein by reference and entitled c. Meetings or business at the direction or F.A.C. State of Florida Application for Licensure h. Completes a course relating to the request of the Board. Massage Therapy, form # BMT2, (revised 2. Meetings or participation by telephone do prevention of medical errors as 7/2000), instructions attached and available required by Section 456.013(7), F.S. not constitute other board business. at the Board offi ce), including proof of 3. Documentation of requests, authorizations, 2. The Department may interview an completion of an approved course of study applicant for licensure by endorsement to or notices for meetings under the terms of or an apprenticeship, at least 45 days prior this rule shall be kept at the Board offi ce. determine whether he qualifi es for such to the examination date. The examination endorsement. 64B7-25 Examination or re-examination fee must accompany the https://www.fl rules.org/gateway/ChapterHome. application. 64B7-25.006 Expiration of incomplete asp?Chapter=64B7-25 applications. 64B7-25.0012 HIV/AIDS course required If an applicant fails to submit all items 64B7-25.001 Examination Requirements. for initial licensure. necessary for his/her application to be 1. The Department shall issue a license to a As a condition to granting an initial license, considered complete within one year from the person who: the applicant is required to complete a 3-hour date the application is fi rst received by the a. Pays to the Department the fee set out educational course approved by the Board Department, the application shall expire and in subsection 64B7-27.002(1), F.A.C.; on human immunodefi ciency virus (HIV) the applicant’s fi le shall be closed. b. Submits a completed application on and acquired immune defi ciency syndrome (AIDS). Courses that have received Board form DH-MQA 1115, “Application 64B7-26 Massage establishments approval are sponsored by: the Department of For Licensure,” (Rev. 10/09). The https://www.fl rules.org/gateway/ChapterHome. Health, Division of Health Quality Assurance, form and the attached instructions are asp?Chapter=64B7-26 incorporated herein by reference and the American Red Cross, or directly by the may be obtained from the Board Offi ce Board approved massage schools. 64B7-26.001 Defi nitions. 1. The term “owner” means the sole at 4052 Bald Cypress Way, Bin C-06, 64B7-25.0025 Security and monitoring Tallahassee, Florida 32399 or from proprietor, partnership, limited partnership procedures for licensure examination. the website located at http://www.doh. or corporation that operates the massage The Board adopts by reference Department state.fl .us/mqa/massage/ma_lic_req. establishment. of Health, Rule 64B-1.010, F.A.C., as its html; 2. The term “establishment” means a site rule governing examination security and c. Completes a course of study at a or premises, or portion thereof, wherein monitoring. massage school approved by the Board a licensed massage therapist practices pursuant to Rule Chapter 64B7-32, massage for compensation. Page 20 Elite CME - www.EliteCME.com 3. The term “business name” means the name one roof such as arcades, shopping g. Maintain all bathroom and shower under which the owner applies for the malls, terminals, hotels, etc., may facilities and fi xtures in good repair, establishment license to provide massage substitute centralized toilet facilities. well-lighted and ventilated. therapy, if different from the name of the Such central facilities shall be within 4. Financial responsibility and insurance owner. three hundred (300) feet of the massage coverage. Each establishment shall establishment. maintain property damage and bodily 64B7-26.002 Licensure of massage d. If equipped with a whirlpool bath, injury liability insurance coverage. The establishments. sauna, steam cabinet and/or steam original or a copy of such policy shall 1. Each establishment, shall obtain a license room, maintain clean shower facilities be available on the premises of the from the Department as required by on the premises. establishment. Section 480.043(1), F.S., by submitting 2. Personnel. A licensed massage therapist a completed form BMT3 (Rev. 4/08), must be on the premises of the 64B7-26.004 Inspection upon application Massage Establishment Licensure establishment if a client is in a treatment for license. Application, incorporated herein by room for the purpose of receiving massage Upon receipt of an application for a massage reference, together with the fee set forth therapy. establishment license, employees of the in Rule 64B7-27.003, F.A.C. The form 3. Safety and sanitary requirements. Each Department shall cause an inspection to be and the attached instructions may be establishment shall: made of the site. Such inspection shall be obtained from the Board offi ce at 4052 a. Provide for safe and unobstructed to confi rm that the site is to be utilized for Bald Cypress Way, Bin C-06, Tallahassee, human passage in the public areas of “massage” as defi ned by Section 480.033(4), Florida 32399 or from the website located the premises; provide for removal of Florida Statutes, and that the criteria at http://www.doh.state.fl .us/mqa/massage/ garbage and refuse; and provide for enunciated in Rule 64B7-26.003, F.A.C., are ap_business.pdf. safe storage or removal of fl ammable satisfi ed. 2. The application for licensure shall be materials. submitted in the name of the owner or 64B7-26.005 Periodic inspections. b. Maintain a fi re extinguisher in good The Department shall make periodic owners of the establishment. If the owner working condition on the premises. As inspections of all massage establishments is a corporation, the application shall be used herein “good working condition” licensed in this state no less than once each submitted in the name of the corporation means meeting the standards for year. Such inspection shall include, but not and shall be signed by an authorized approval by the State Fire Marshal. be limited to, whether the establishment corporate representative. Such standards are presently contained is in compliance with Rule 64B7-26.003, 3. An owner may operate an establishment in Chapter 69A 21, F.A.C. F.A.C., governing the establishment’s under a name other than the name of the c. Exterminate all vermin, insects, operation facilities, personnel, safety, sanitary owner, provided such name is submitted to termites, and rodents on the premises. requirements, and a review of existing the Board on the application for licensure. d. Maintain all equipment used to perform insurance coverage. Any advertisement by the establishment of massage services on the premises in a massage therapy must include the business safe and sanitary condition, including 64B7-26.007 Transfer of massage name, and must comply with Rule 64B7- the regular application of cleansers establishment license. 33.001, F.A.C. and bactericidal agents to the massage 1. When there is no change of ownership 4. The applicant shall submit proof table. Unless clean sheets, towels, or or location, the owner may change the confi rming property damage and bodily other coverings are used to cover the business name of the establishment. injury liability insurance coverage massage table for each client, “regular The owner shall apply for a change of for the proposed establishment. If the application,” as used herein, means business name by submitting a completed establishment is operated under a business after the massage of each client. If Application for Licensure-Massage name, the proof of insurance shall include clean coverings are used for each Establishment, Form BMT3, effective both the name of the owner and the client, then “regular application” shall 1/98, incorporated herein by reference, business name. mean at least one time a day and also accompanied by the application fee 64B7 26.003 Massage establishment whenever oils or other substances provided in subsection 64B7-27.003(2), operations. visibly accumulate on the massage F.A.C. When a massage establishment business name is changed, without a 1. Facilities, Each establishment shall meet table surface. change in ownership or location, a new the following facility requirements: e. Maintain a suffi cient supply of clean establishment inspection is not required. a. Comply with all local building code drapes for the purpose of draping 2. When there is no change of ownership, requirements. each client while the client is being the owner of a massage establishment b. Provide for the use of clients a massaged, and launder before reuse all may transfer the license from one location bathroom with at least one toilet and materials furnished for the personal use to another. The owner shall apply for one sink with running water. Such of the client, such as drapes, towels and a change of location by submitting a facilities shall be equipped with toilet linens. As used herein “drapes” means completed Application for Licensure- tissue, soap dispenser with soap or towels, gowns, or sheets. Massage Establishment, accompanied other hand cleaning materials, sanitary f. Maintain lavatories for hand cleansing by the application fee provided in towels or other hand drying device and/or a chemical germicidal designed subsection 64B7-27.003(3), F.A.C. A such as a wall mounted electric blow to disinfect and cleanse hands without massage establishment license may not be dryer, and waste receptacle. the use of a lavatory in the treatment transferred from one location to another c. Maintain toilet facilities in a room itself or within 20 feet of the until after inspection by the department. common area of the establishment. treatment area. Establishments located in buildings housing multiple businesses under

Elite CME - www.EliteCME.com Page 21 64B7-26.010 Sexual activity prohibited. 64B7-27.005 Apprentice. 64B7-28.001 Biennial renewal of massage 1. Sexual activity by any person or persons The apprentice application fee shall be one therapist’s license. in any massage establishment is absolutely hundred dollars ($100.00). 1. All license renewals for massage therapists prohibited. shall meet the requirements as set forth in 64B7-27.006 Biennial renewal fee for 2. No massage establishment owner shall Chapters 456 and 480, F.S., these rules, engage in or permit any person or persons massage therapist. and the rules of the Department of Health. The fee for biennial renewal of a massage to engage in sexual activity in such All massage therapists shall renew their therapist’s license shall be $100.00. owner’s massage establishment or use licenses on or before August 31, of each such establishment to make arrangements 64B7-27.007 Biennial renewal fee for biennial year, according to the fee schedule to engage in sexual activity in any other massage establishments. as set forth in Chapter 64B7-27, F.A.C. place. The fee for biennial renewal of a massage 2. No license shall be renewed unless 3. No licensed massage therapist shall use the establishment license shall be $100.00. the licensee submits confi rmation on a therapist-client relationship to engage in department form that the licensee has sexual activity with any client or to make 64B7-27.008 Initial fee for licensure. completed an education course on HIV/ arrangements to engage in sexual activity 1. Any person who is initially licensed AIDS which meets the requirements of with any client. pursuant to Rule 64B7-25.001, F.A.C., Section 456.034, F.S. If the licensee has 4. As used in this rule, “sexual activity” shall pay a fee of $100.00. not submitted confi rmation which has been means any direct or indirect physical 2. Any person who is initially licensed received and recorded by the Board, the contact by any person or between persons pursuant to Rule 64B7-25.004, F.A.C., department shall not renew the license. which is intended to erotically stimulate shall pay a fee of $100.00. The Board approves courses that have been either person or both or which is likely 64B7-27.010 Renewal fee for inactive approved by regulatory Boards or Councils to cause such stimulation and includes license. under the Division of Medical Quality sexual intercourse, fellatio, cunnilingus, Assurance, the Agency for Health Care The fee for renewal of an inactive license shall masturbation, or anal intercourse. For Administration, the Department of Health, be $100.00. purposes of this subsection, masturbation the American Red Cross, or directly by the means the manipulation of any body tissue 64B7-27.012 Licensure of establishment Board, and courses sponsored or presented with the intent to cause sexual arousal. As fee. by Board-approved Massage Schools. used herein, sexual activity can involve The fee for licensure of an establishment shall 3. No license shall be renewed unless the the use of any device or object and is not be $100.00. licensee submits confi rmation in writing to dependent on whether penetration, orgasm, the Florida Board of Massage Therapy that or ejaculation has occurred. Nothing herein 64B7-27.014 Duplicate license fees. the licensee has completed an education shall be interpreted to prohibit a licensed The fee for the issuance of a duplicate course of at least 2 hours relating to massage therapist, duly qualifi ed under massage therapist license shall be twenty-fi ve prevention of medical errors as part of Rule 64B7-31.001, F.A.C, from practicing dollars ($25.00). The fee for the issuance of a the licensure and renewal process. The colonic irrigation. duplicate massage establishment license shall course must include a study of root-cause be twenty-fi ve dollars ($25.00). analysis, error reduction and prevention, 64B7-27 Fee schedule and patient safety. The 2-hour course https://www.fl rules.org/gateway/ChapterHome. 64B7-27.015 Delinquency fee. shall count toward the total number of asp?Chapter=64B7-27 The delinquency fee shall be $150.00. continuing education hours required for 64B7-27.002 Application for licensure; 64B7-27.016 Change in status fee. renewal. The change in status fee shall be $50.00. fees. 64B7-28.0015 Place of practice defi ned. The application fee for licensure shall be a $50 64B7-27.017 Unlicensed activity fee. 1. The reporting requirements of Section nonrefundable application fee. In addition to the initial license fee and in 456.035, F.S., require each licensee to 64B7-27.003 Massage establishment. addition to the license renewal fee, a fee of provide to the Board a current mailing 1. The application fee for licensure of an $5.00 shall be collected from each applicant or address and a “place of practice.” The establishment shall be $150.00. licensee as applicable to fund efforts to combat current mailing address and place of 2. The application fee for change of the unlicensed activity. practice may be one and the same, or may business name of an establishment is 64B7-27.018 Fee for retired status be two different addresses if the licensee $25.00. license. does not receive mail at his or her place of practice. 3. The application and inspection fee for The fee for placing a license in retired status 2. “Place of practice” shall mean: transfer of an establishment from one shall be $50.00. location to another shall be $125.00. a. A massage establishment maintained 64B7-27.019 Fee for reactivation of by the licensed massage therapist; or 64B7-27.004 Re-examination. retired status license. b. The massage establishment at which The re-examination fees shall be: The fee for reactivation of a retired status the licensed massage therapist provides 1. The fee to retake the Board approved license shall be the same renewal fee that massage therapy; or national examination shall be the same fee would be imposed on an active status licensee c. The medical offi ce at which the as the original examination. for all biennial licensure periods during which licensed massage therapist provides 2. The fee to retake the colonics examination the licensee was on retired status. massage therapy; or shall be the same fee as the original d. If the licensed massage therapist colonics examination. 64B7-28 Biennial license renewal practices at more than one location, https://www.fl rules.org/gateway/ChapterHome. one such location as selected by the asp?Chapter=64B7-28 licensed massage therapist;

Page 22 Elite CME - www.EliteCME.com e. If the licensed massage therapist F.A.C., and has complied with the following b. Pay to the Board either the license provides massage therapy only at the requirements: renewal fee as set forth in Rule 64B7- location of clients, the place of practice 1. As a condition to the reactivation of an 27.006, F.A.C., or the inactive status is the residence address of the therapist. inactive license, a massage therapist fee as set forth in Rule 64B7-27.010, must submit proof of having completed F.A.C.; the delinquency fee as set forth 64B7-28.002 Biennial renewal of massage the appropriate continuing education in Rule 64B7-27.015, F.A.C., and the establishment license. requirements as set forth in Rule 64B7- change of status fee as set forth in Rule All license renewals for massage 28.009, F.A.C. 64B7-27.016, F.A.C., if applicable; and establishments shall meet the requirements 2. However, any licensee whose license c. If renewal is elected, demonstrate as set forth in Chapter 480, F.S., and these has been inactive for more than two compliance with the continuing rules. All massage establishments shall renew consecutive biennial licensure cycles and education requirements found in Rule their licenses on or before August 31 of each who has not practiced for two out of the 64B7-28.009, F.A.C. biennial year, according to the fee schedule previous four years in another jurisdiction as set forth in Rule 64B7-27.007, F.A.C., shall be required to appear before the 64B7-28.0044 Retired status and and the insurance coverage requirements Board and establish the ability to practice reactivation of retired status license. of subsection 64B7-26.002(4), F.A.C. If, with the care and skill suffi cient to protect 1. A licensee may place an active or inactive however, the massage establishment does the health, safety, and welfare of the license in retired status at any time. If the not renew its license timely, the license public. At the time of such appearance, the license is placed in retired status at the time shall be considered delinquent. If a massage licensee must: of renewal the licensee shall pay the retired establishment is operating with a delinquent a. Show compliance with subsection (1) status fee set forth in Rule 64B7-27.018, license, said establishment is in violation of above; F.A.C. If the licensee chooses to place Section 480.047(1)(b), F.S., and is subject b. Account for any activities related to the license in retired status at any time to the criminal penalties as provided for in the practice of massage therapy in this other than at the time of license renewal Section 480.047(2), F.S. In order to renew a or any other jurisdiction during the the licensee shall pay a change of status delinquent license, the massage establishment period that the license was inactive and processing fee of $50.00 and the retired shall pay the late fee for delinquent renewal in establish an absence of malpractice status fee. the amount of seventy-fi ve dollars ($75.00) as or disciplinary actions pending in any 2. A licensee may reactivate a retired status set forth in Section 480.044(2), F.S., and the jurisdiction; license at any time, subject to meeting the biennial renewal fee as specifi ed in Rule 64B7- c. Prove compliance with Section following requirements: 27.007, F.A.C. 456.065, F.S., and subsection 64B7- a. Paying the reactivation fee described at 28.001(2), F.A.C. Rule 64B7-27.019, F.A.C.; 64B7-28.003 Biennial period, year b. Demonstrating satisfaction of the defi ned. 3. The Department shall not reactivate the license of any massage therapist who has: continuing education requirements that Biennial period shall mean September 1 of would have been imposed on an active each odd-numbered year and ending August 31 a. Committed any act or offense in this or any other jurisdiction which would status licensee under this title for each of each odd-numbered year. Biennial year shall licensure biennial period in which the mean every odd-numbered year. constitute the basis for disciplining a licensee pursuant to Section 480.046, licensee was on retired status. 64B7-28.0041 Inactive status and renewal F.S. 64B7-28.007 Exemption of spouses of of inactive status. b. Failed to comply with the provisions of members of Armed Forces from licensure 1. Any licensee may elect at the time of Section 456.034, F.S., and subsections renewal provisions. biennial license renewal to place the 64B7-28.001(2) and (3), F.A.C. A licensee who is the spouse of a member license into inactive status by fi ling with of the Armed Forces and was caused to be the Department a completed application 64B7-28.0043 Delinquent status license. absent from Florida for a period of at least six for inactive status as set forth in Section 1. The failure of any license holder to either consecutive months because of the spouse’s 456.036, F.S., and the appropriate fee renew the license or elect inactive status duties with the armed forces and who at the required by Rule 64B7-27.010, F.A.C. before the license expires shall cause the time the absence became necessary was in 2. Inactive licenses must be renewed license to become delinquent. good standing with the Board of Massage biennially including payment of the 2. The delinquent status licensee must and entitled to practice massage in Florida renewal fee set forth in Rule 64B7-27.010, affi rmatively apply for active or inactive shall be exempt from all licensure renewal F.A.C. status during the licensure cycle in which provisions under these rules. The licensee must 3. An inactive license can be reactivated the license becomes delinquent. The failure show satisfactory proof of the absence and the at any time provided the licensee meets by the delinquent status licensee to cause spouse’s military status. the requirements of Rule 64B7-28.0042, the license to be renewed or made inactive F.A.C. before the expiration of the licensure cycle 64B7-28.008 Display of licenses. 4. An inactive licensee who elects to change in which the license became delinquent 1. Each licensed practitioner shall to active status shall not be permitted to shall render the license null and void conspicuously display a current license return to inactive status until the next without further action by the Board or the issued by the Department, or photo copy biennial renewal period. Department. thereof, at each location at which he or she 3. The delinquent status licensee who applies practices. 64B7-28.0042 Requirements for for license renewal or inactive status shall: 2. Each apprentice shall conspicuously reactivation of an inactive license. a. Apply to the department for either display his or her apprentice certifi cate An inactive license shall be reactivated upon license renewal as required by Section issued by the Board offi ce, in the demonstration that the licensee has paid the 480.0415, F.S., or inactive status as establishment for which it has been issued. reactivation fee set forth in Rule 64B7-27.011, required by Section 456.036, F.S.

Elite CME - www.EliteCME.com Page 23 3. The owner of each massage establishment as pro bono services pursuant to Rule 64B7-28.0095 Continuing education for shall conspicuously display a current 64B7-28.0095, F.A.C. pro bono services. establishment license issued by the b. Except as provided in subsection 1. Up to 6 hours of continuing education Department on the premises. 64B7-28.009(1), F.A.C., two hours per biennium in satisfaction of paragraph must be obtained in a course relating 64B7-28.009(3)(a), F.A.C., may be 64B7-28.009 Continuing education. to the prevention of medical errors, awarded for the performance of pro bono 1. Every massage practitioner licensed two hours must cover instruction in services to the indigent, underserved pursuant to Chapter 480, F.S., shall be professional ethics and two hours populations or in areas of critical need required for renewal to complete one must cover instruction in the laws and within the state where the licensee continuing education hour for each month rules of massage therapy, including practices. The standard for determining or part of a month that shall have elapsed Chapters 480 and 456, F.S., and Rule indigence shall be that recognized by since the issuance of the license for which Chapter 64B7, F.A.C. Up to 4 hours the Federal Poverty income guidelines renewal is sought, up to a maximum of continuing education credit for produced by the United States Department requirement of 24 hours for the renewal professional ethics and laws and rules of Health and Human Services. period. Such courses shall have been may be earned on an hour for hour 2. In order to receive credit under this rule, approved for continuing education credit basis by physically attending Board the licensee must receive prior approval pursuant to Rule 64B7-28.010, F.A.C., meetings, provided that: from the Board by submitting a formal and shall have been completed within the 1. The licensee signs in with the request for approval, which must include renewal period preceding the date renewal Executive Director of the Board the following information: is due. Every massage practitioner must prior to the beginning of the a. The type, nature and extent of services obtain the continuing education required meeting; to be rendered; for biennial renewal of the massage 2. The licensee remains in continuous b. The location where the services will be therapist’s license as set forth in Rule attendance at the meeting; rendered; 64B7-28.001, F.A.C. Graduates of a Board 3. The licensee signs out of the c. The number of patients expected to be approved massage school who received meeting with the Executive served; and two hours of education in Chapters 480 Director of the Board in a pre- d. A statement indicating that the patients and 456, F.S., and Rule Chapter 64B7, arranged time and manner. to be served are indigent, underserved F.A.C., and two (2) hours of professional 4. The licensee does not have a related or in an area of critical need. ethics prior to initial licensure shall not be discipline or licensure matter on the 3. Credit shall be given on an hour per hour required to complete additional continuing agenda for the same meeting day. basis. education in the same subject matter for c. The remaining hours may include 4. Approval for pro bono services is only initial renewal of the license. courses on communications with granted for the biennium for which it is 2. All continuing education requirements clients and other professionals, sought. The licensee must request approval may be met by correspondence/home study insurance relating to third party for each biennium they wish to receive courses, tape and/or video cassette courses, payment or reimbursement for credit for pro bono services. provided the course requires passing a services, psychological dynamics of test to be graded by the provider and the the client-therapist relationship, risk 64B7-28.010 Requirements for board passing score is verifi ed by the provider of management, including charting, approval of continuing education the course. Video cassette courses shall not documentation, record keeping, or programs. exceed 5 hours per subject and must meet infection control (other than the HIV/ 1. For the purpose of renewing or reactivating the requirements of Rule 64B7-28.010, AIDS course required by Section a license credit will be approved for F.A.C. The vendor and the licensee shall 456.034, F.S.), or massage practice programs which are offered by providers verify in writing that all requirements management. The remaining hours may whose programs are approved by the of paragraph 64B7-28.010(2)(c) or (d), also include up to 4 hours credit for Board. In order to receive Board approval F.A.C., have been met. Such verifi cation/ adult cardio-pulmonary resuscitation to provide one or more programs, an validation shall clearly indicate the course (CPR), provided the course is applicant shall: is a “correspondence/home study course/ sponsored by the American Red Cross, a. Submit a completed Massage tape or videocassette course” and that the the American Heart Association or the Continuing Education Programs licensee passed the course in order to be American Safety and Health Institute, Provider Registration Application, accepted as proof of attendance. or is instructed by persons certifi ed to BMT-B, and Supplemental Program/ 3. Effective for the biennium beginning instruct courses for those organizations. Instructor Information, BMT-C, September 1, 2001, the continuing 4. The licensee shall retain, for not less than incorporated herein by reference, and education contact hours shall be in the four years, such receipts, vouchers or a non-refundable application fee of following areas: certifi cates as are necessary to document $250.00. The forms will be effective a. At least 12 continuing education completion of the continuing education 12-13-05, copies of which may be hours shall be relevant to and focus stated on the renewal application. obtained from the Board offi ce at: on massage therapy techniques, which 5. At the end of each biennium, the Board 4052 Bald Cypress Way, BIN #C06, may include history of massage will audit a number of randomly selected Tallahassee, Florida 32399-3256. therapy, human anatomy, physiology, licensees to assure that the continuing b. Sign and abide by written agreement kinesiology, and/or pathology. As of education requirements have been met. to: September 1, 2007, the 12 continuing Within 21 days of a request from the Board 1. Provide an identifi able person to education hours shall be taken via live or Department, the licensee must provide be responsible for ensuring that classroom instruction which includes written documentation that the continuing each program presented under hands-on instruction or demonstration, education requirements have been met. their Board of Massage Therapy 6 hours of which may be performed provider registration number meets Page 24 Elite CME - www.EliteCME.com program requirements set forth in c. Has completed specialized 1. Holds a minimum of a subsection (2) below. training in the subject matter bachelor’s degree from a 2. Retain a “sign-in-sheet” with the and has a minimum of two college or university which signature of participants and copies years of practical experience in is accredited by a regional of any promotional materials for at the subject, or accrediting body recognized least 4 years following the course. 3. Is licensed as a massage therapist by the U.S. Department of 3. Provide each participant with a in another state or foreign Education or a substantially certifi cate of attendance verifying sovereign state having standards equivalent accrediting body the program has been completed. of education or apprenticeship of a foreign sovereign state, The certifi cate shall not be issued training substantially similar to or with a major in a subject until completion of the program more stringent than those required directly related to the and shall contain the provider’s for licensure in Florida and has content of the program to be name and registration number, title practiced massage therapy for a offered, or of program and program number, minimum of 10 years, and 2. Has, within the last instructor, date, number of contact a. Has, within the last fi ve years fi ve years of practical hours of credit, the licensee’s name of practical experience, had a experience, had a minimum and license number. minimum of two years teaching of two years teaching 4. Notify the Board of any signifi cant experience in the subject matter experience in the subject changes relative to the maintenance to be offered, or matter to be offered, or of standards as set forth in these b. Has taught the same courses 3. Has taught the same courses rules. on this approved subject a on this approved subject 2. Each continuing education program minimum of 3 times in the past a minimum of 3 times in presented for license renewal credit or to 2 years before a professional the past 2 years before a satisfy initial licensure requirements shall: convention, professional group professional convention, a. Meet the standards of subsection 64B7- or at a massage therapy school, professional group, or at a 28.009(2), paragraph (3)(a), (b) or (c), or massage therapy school, or F.A.C.; c. Has completed specialized 4. Has completed specialized b. Have stated learning objectives; training in the subject matter training in the subject c. Be instructed by a person who meets at and has a minimum of two matter and has a minimum least one of the following criteria: years of practical experience in of two years of practical 1. Holds a minimum of a bachelor’s the subject, or experience in the subject. degree from a college or university 4. Has taught at a school of massage 3. The Board retains the right and authority which is accredited by a regional which has a curriculum equivalent to audit and/or monitor programs given accrediting body recognized by the to requirements in this state and by any provider. The Board will reject U.S. Department of Education or a was approved by a state licensing individual programs given by a provider if substantially equivalent accrediting authority, a nationally recognized the provider has disseminated any false or body of a foreign sovereign state, massage therapy association, or a misleading information in connection with with a major in a subject directly substantially equivalent accrediting the continuing education program, or if the related to the content of the body, or the Board for a minimum program provider has failed to conform program to be offered, or of two years, and to and abide by the written agreement and 2. Has graduated from a school of a. Has, within the last fi ve years rules of the Board. massage or an apprenticeship of practical experience, had a 4. One hour of continuing education is program which has a curriculum minimum of two years teaching defi ned as no less than 50 uninterrupted equivalent to requirements in this experience in the subject matter minutes of learning. state and was approved by a state to be offered, or 5. Presenters/moderators/instructors of licensing authority, a nationally b. Has taught the same courses courses shall not receive credit for courses recognized massage therapy on this approved subject a they present. association, or a substantially minimum of 3 times in the past 6. A provider of Board approved programs equivalent accrediting body, or the 2 years before a professional must submit a completed application for Board, and has completed three convention, professional group supplemental courses, form # BMT-B and years of professional experience in or at a massage therapy school, C, to the Board offi ce prior to offering the practice of massage, and or such courses for credit. The submitted a. Has, within the last fi ve years c. Has completed specialized information must also identify any new of practical experience, had a training in the subject matter continuing education instructor and show minimum of two years teaching and has a minimum of two that such instructor meets the criteria set experience in the subject matter years of practical experience in forth in this rule. Whenever an instructor to be offered, or the subject. and his/her course have obtained approval b. Has taught the same courses d. Provided, however, that by the Board, the instructor may teach the on this approved subject a approved courses in areas course at any time, in whole or in part, minimum of 3 times in the past other than massage theory, so long as the materials being taught do 2 years before a professional history, and techniques may not deviate from the course materials convention, professional group be instructed by a person originally approved, there is no change or at a massage therapy school, who meets at least one of the of instructor, and the documentation of or following criteria: attendance clearly indicates the original

Elite CME - www.EliteCME.com Page 25 course approval number and the hours of F.A.C., studying massage under the “direct 64B7-29.003 Apprenticeship training credit given for this version of the course. supervision” of a “sponsoring massage program. Therefore, the number of continuing therapist”. 1. All apprenticeship training shall be education hours awarded for the course 2. “Sponsoring massage therapist” means a conducted by the licensed sponsoring may be the original number of hours licensed massage therapist whose record massage therapist, in a qualifi ed massage approved, or less. An increase of the with the Department indicates compliance establishment licensed pursuant to Section number of continuing education hours with Chapters 456 and 480, F.S., and the 480.043, F.S. awarded will require submission of form # rules promulgated thereunder. Further, a 2. Apprenticeship training shall be 12 BMT-B for approval of a course. “sponsoring massage therapist” must have months in duration and shall be completed 7. A provider of Board approved programs been engaged in the actual practice of within 24 months of commencement. must revise and update all course materials massage for at least three (3) years prior to The apprentice shall complete within the that are affected by changes occurring his “sponsorship”. fi rst quarter of the apprenticeship training during the biennial renewal period. 3. “Sponsorship” means the willingness program: The Board will rescind approval of any of a “sponsoring massage therapist” to a. 100 hours of study in Physiology, program that is found to be obsolete, assume the responsibility for the “direct b. 100 hours of study in Anatomy, and erroneous, and/or outside the scope of supervision” of only one apprentice by c. 15 hours of study in Statutes and Rules practice, or if the Board determines the execution of the Sponsor’s Apprentice of Massage Practice. program provider has violated the Board’s Application. 3. Course of Study for Apprentices, which rules or Chapter 456 or 480, F.S. The 4. “Direct supervision” means the control, incorporates that required in (2)(a), shall be revised course materials must be submitted direction, instruction, and regulation of as follows: with the biennial renewal form and renewal an apprentice at a “qualifi ed massage a. 300 hours of Physiology. fee. establishment” during the working hours of b. 300 hours of Anatomy. 8. Provider registration numbers must be the establishment. c. 20 hours of Theory and History of renewed biennially on or before August 5. “Qualifi ed massage establishment” means Massage. 31 of the biennial renewal year. The a licensed massage establishment which, d. 50 hours of Theory and Practice of provider must return the renewal form in addition to meeting the requirements of Hydro-Therapy. provided by the department together with Chapter 64B7-26, F.A.C., is equipped with e. 5 hours of Hygiene. a renewal fee of $250.00. If the renewal the following: f. 25 hours of Statutes and Rules of form and renewal fee are not received by a. Tables. Massage Practice. the department on or before August 31 b. Linen and storage areas. g. 50 hours of Introduction to Allied of the biennial year, the provider must c. Colonic equipment (required if colonic Modalities. submit a new application for approval of irrigation is taught). h. 700 hours of Practical Massage. any continuing education programs offered d. Sterilization equipment if non- i. 3 hours of Board-approved HIV/AIDS for license renewal or initial licensure disposable colonic attachments are instruction. requirements, and, if any programs utilized. 4. The sponsoring massage therapist shall are approved, receive a new provider e. Hydro-therapy equipment, which must maintain at the establishment a daily record registration number. include cold packs and hot packs. of hours completed by the apprentice in 9. The following courses, that meet the Such equipment shall be that which is each of the areas listed in subsection (3) criteria for approval under this section, are generally acceptable in the massage above. This record shall be available for approved by the Board: profession. inspection during regular business hours a. Organized and accepted courses of f. Textbooks and teaching materials on and shall be inspected by a representative study offered by providers approved the following subjects: of the Department at least once within 12 by the National Certifi cation Board for 1. Physiology, months from the commencement of the Therapeutic Massage and Bodywork; 2. Anatomy, apprenticeship. b. Organized courses offered by a Board 3. Theory of Massage, 5. The sponsoring massage therapist shall Approved Massage School; 4. Hydro-therapy, submit to the Department, quarterly, on c. Continuing education courses offered 5. Statutes and Rules on Massage a form furnished by the Department, the by or sponsored by the Florida Board Practice, number of hours of each subject listed of Massage Therapy; 6. Colonic Irrigation (if colonic above taught to his apprentice. A copy of d. Continuing education courses equipment is present). the Massage Apprenticeship Quarterly sponsored by the Florida State Massage Report Hours of Training Completed 64B7-29.002 Qualifi cation. Therapy Association; and Form prepared and furnished by the Persons seeking to be apprentices shall meet e. Continuing education courses Department of Health can be obtained by the following requirements: sponsored by the American Massage writing to: Department of Health, Board 1. The applicant must have secured the Therapy Association or the American of Massage, 4052 Bald Cypress Way, Bin sponsorship of a sponsoring massage Massage Therapy Association Florida C06, Tallahassee, Florida 32399-3256. If therapist. Chapter. quarterly reports are not submitted to the 2. The applicant must complete the Department as required herein, the Board 64B7-29 Apprenticeship application furnished by the Department will review the apprenticeship and the https://www.fl rules.org/gateway/ChapterHome. and pay the fee set forth in Rule 64B7- apprenticeship shall be terminated. asp?Chapter=64B7-29 27.005, F.A.C. 6. A graduate of a board-approved massage 3. The applicant may not be enrolled school who enters the apprenticeship 64B7-29.001 Defi nitions. simultaneously as a student in a Board- 1. “Apprentice” means a person meeting the training program, at any time after he has approved massage school. qualifi cations stated in Rule 64B7-29.002, taken the initial licensure examination or

Page 26 Elite CME - www.EliteCME.com subsequent re-examinations thereafter, shall so notify the Department, on a form The form BOM-1 is hereby incorporated must complete the entire program as furnished by the Department, within ten (10) by reference and will be effective 7-3-97, required above prior to taking subsequent days. If the apprentice desires to remain in the copies of which may be obtained from re-examinations. Any applicant who enters apprenticeship program he or she must secure the Board offi ce at the 4052 Bald Cypress the apprenticeship training program and the sponsorship of another sponsoring massage Way, Tallahassee, Florida 32399-3256. terminates the program is prohibited from therapist. The apprentice shall receive credit taking the licensure examination for 1 year for training received from the prior sponsoring 64B7-30 Discipline https://www.fl rules.org/gateway/ChapterHome. from the date of termination. An individual massage therapist. asp?Chapter=64B7-30 may be exempted from this provision if 64B7-29.007 Colonics training through he terminates the apprenticeship training 64B7-30.001 Misconduct and negligence program and subsequently completes a apprenticeship. A massage practitioner shall instruct another in the practice of massage therapy. program at a board-approved massage The following acts shall constitute the failure individual in colonics only under the following school. to practice massage therapy with that level of conditions: care, skill, and treatment which is recognized 64B7-29.004 Termination. 1. The trainee must be either: by a reasonably prudent similar massage 1. If an apprentice terminates his a. Licensed to practice massage under therapist as being acceptable under similar apprenticeship, the sponsoring massage Chapter 480, F.S., conditions and circumstances: therapist shall so notify the Department, on b. Approved as an apprentice under 1. Administering treatment in a negligent a form furnished by the Department, within Chapter 64B7-29, F.A.C., or manner. ten (10) days. c. A student in a Board-approved massage 2. Violating the confi dentiality of information 2. If any violation of Chapter 480 or 456, school. or knowledge concerning a client. F.S., or rules set forth in Chapter 64B7, 2. The instructor, hereafter called sponsor, 3. Offering massage therapy at a sports F.A.C., is found subsequent to Department must be currently licensed under Chapter event, convention or trade show without inspection of the “qualifi ed massage 480, F.S., and authorized to practice obtaining the written approval of the owner establishment” as defi ned under Rule colonics under Chapter 64B7-31, F.A.C. or property manager of the site at which 64B7-29.001, F.A.C., the apprenticeship The sponsor must have been actively the sports event, convention or trade show shall be tolled until such time as the engaged in the practice of colonics for a is held. violation(s) is corrected or disposition minimum of 3 years. 4. Failure to explain expected draping in the case is made. If the disposition of 3. The training shall take place in a massage techniques to a client. As used in this rule, the case resulted in disciplinary action establishment licensed under Chapter draping means towels, gowns, sheets or by the Board, the Board will require 480, F.S., which contains the following clothing. that the “sponsor” and the “apprentice” equipment: 5. Failure to appropriately drape a client. appear before the Board for the purpose a. Colonic equipment. Appropriate draping of a client shall of determining compliance with the b. Disposable colonic attachments or include draping of the buttocks and apprenticeship training program sterilization equipment for non- genitalia of all clients, and breasts of requirements of Rule 64B7-29.003, F.A.C. disposable attachments. female clients, unless the client gives 4. The licensee or apprentice who will 64B7-29.005 Extension of apprenticeship. specifi c informed consent to be undraped. receive colonics instruction must receive An apprenticeship may be extended under the advance approval for such instruction from following conditions: 64B7-30.002 Disciplinary guidelines. the Department. Such approval may be 1. Apprenticeships completed prior to an 1. When the Board fi nds that an applicant, obtained in the following manner: examination date may, upon notifi cation apprentice, or licensee whom it regulates a. If the applicant is a currently licensed by the sponsoring massage therapist to the under Chapter 480, F.S., has committed massage practitioner or a student at Department, automatically be extended any of the acts set forth in Sections a Board-approved massage school, until the date examination results are 480.0485, 480.046, 480.047 and 456.072, application for “colonics only” released. F.S., it shall issue a fi nal order imposing apprenticeship on forms provided by 2. If an applicant fails the fi rst examination appropriate penalties within the ranges the Department must be submitted. The after his apprenticeship is completed, the recommended in the following disciplinary applicant will be required to submit Department may grant an extension of the guidelines after consideration of the the apprentice fee as set forth in Rule apprenticeship with the concurrence of the aggravating and mitigating factors set forth 64B7-27.005, F.A.C. sponsoring massage therapist. in subsection (3) of this rule: b. An unlicensed applicant for a. The apprentice must appear at the next apprenticeship training may apply for scheduled examination for licensure. colonics training approval, in addition b. The extension of the apprenticeship to course work required under Rule shall expire upon written notifi cation 64B7-29.003, F.A.C. by the Department that the apprentice 5. The apprentice shall complete colonics has failed the re-examination or on training within 24 months of approval by the date of the scheduled examination, the Department. should the applicant fail to appear. 6. The sponsor shall certify training is 64B7-29.006 Change of sponsoring complete on a Colonics Apprenticeship massage therapist. Report form provided by the Department If for any reason the sponsoring massage when the apprentice has completed 100 therapist is no longer able to sponsor an hours of training in the subject, including apprentice, the sponsoring massage therapist 45 hours of clinical practicum as required by subsection 64B7-31.001(2), F.A.C. Elite CME - www.EliteCME.com Page 27 (a) 480.046(1)(a) First offense: Suspension and $250.00 fi ne. Subsequent offense: $1,000.00 fi ne and revocation. If Licensee the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne; second offense: $10,000.00 fi ne and suspension of license; subsequent offense: $10,000.00 fi ne and revocation of the license. Applicant Denial of licensure. If the offense is for fraud or making a false or fraudulent representation, denial of licensure and a $10,000.00 fi ne. 456.072(1)(h) Revocation through error of Department or Board. (b) 480.046(1)(b) or 456.072(1)(f) Licensee: Impose discipline consistent with penalty or actions imposed in other jurisdiction. Applicant: Deny licensure. (c) 480.046(1)(c) or 456.072(1)(c) First offense: $250.00 fi ne; second offense: $500.00 fi ne and probation; third offense: $500.00 fi ne and Misdemeanors suspension. Felonies First offense: $500.00 fi ne and probation; second offense: $500.00 fi ne and suspension; third offense: $1,000.00 fi ne and suspension. Crimes relating to assault, battery, $1,000.00 fi ne and revocation. abuse or which otherwise cause bodily harm, prostitution or solicitation for prostitution (d) 480.046(1)(d) First offense: $500.00 fi ne and reprimand; second offense: $750.00 fi ne and probation; third offense: $1,000.00 fi ne and suspension. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and reprimand; second offense: $10,000.00 fi ne and probation; third offense: $10,000.00 fi ne and suspension. (e) 480.046(1)(e) or 456.072(1)(j) First offense: $1,000.00 fi ne and suspension; second offense: $1,000.00 fi ne and revocation for a minimum of two (2) years; third offense: permanent revocation. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and suspension; second offense: $10,000.00 fi ne and revocation for a minimum of two (2) years; third offense: $10,000.00 fi ne and permanent revocation. (f) 480.046(1)(f) or 456.072(1)(a) or First offense: $500.00 fi ne and reprimand; second offense: $500.00 fi ne and probation; third offense: (m) $1,000.00 fi ne and suspension. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne; subsequent offense: $10,000.00 fi ne and revocation. F(g) 480.046(1)(g) First offense: probation; second offense: suspension; third offense: revocation. (h) 480.046(1)(h) First offense: $1,000.00 fi ne and probation; Second offense: $1,000.00 fi ne and suspension; Third offense: $1,000.00 fi ne and revocation. (i) 480.046(1)(i) or 456.072(1)(o) First offense: $1,000.00 fi ne and probation; second offense: $1,000.00 fi ne and suspension; third offense: $1,000.00 fi ne and revocation. (j) 480.046(1)(j) or 456.072(1)(p) First offense: $250.00 fi ne and probation; second offense: $500.00 fi ne and suspension; third offense: $1,000.00 fi ne and revocation. (k) 480.046(1)(o) or 456.072(1)(cc) Unless an offense specifi cally set forth below, fi rst offense: $250.00 fi ne; subsequent offense: $250.00 fi ne and probation. 1. 480.0485 $1,000.00 fi ne and revocation. 2. 480.047(1)(a) – violator’s license $100.00 fi ne for fi rst month and $50.00 for each succeeding month or part thereof and reprimand. If delinquent the offense is for fraud or making a false or fraudulent representation, the fi ne is $10,000.00 and a reprimand. 3. 480.047(1)(a) – violator’s license Revocation. If the offense is for fraud or making a false or fraudulent representation, the fi ne is suspended or inactive $10,000.00 and revocation of license. 4. 480.047(1)(b) – violator’s license $100.00 fi ne for fi rst month and $50.00 for each succeeding month or part thereof and reprimand. If delinquent the offense is for fraud or making a false or fraudulent representation, the fi ne is $10,000.00 and a reprimand. 5. 480.047(1)(b) – violator’s license Revocation. If the offense is for fraud or making a false or fraudulent representation, the fi ne is suspended or inactive $10,000.00 and revocation. 6. 480.047(1)(c) First offense: $1,000.00 fi ne and revocation; subsequent offense: $1000.00 fi ne and revocation for minimum of two (2) years. 7. 480.047(1)(d) First offense: $1,000.00 fi ne; second offense:$1,000.00 fi ne and revocation. If the offense is for Licensee fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne; second offense: $10,000.00 fi ne and revocation.

Page 28 Elite CME - www.EliteCME.com Applicant First offense: denial of licensure; subsequent offense: denial of licensure and prohibition on reapplication for 2-5 years. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and denial of licensure; subsequent offense: $10,000.00 fi ne and denial of licensure and prohibition on reapplication for 2-5 years. 8. 480.047(1)(e) 1,000.00 fi ne and revocation. If the offense is for fraud or making a false or fraudulent representation, the fi ne is $10,000.00 and revocation of license. $9. 480.047(1)(f) First offense: $1,000.00 fi ne and probation; second offense: $1,000.00 fi ne and suspension; third Licensee offense: $1,000.00 fi ne and revocation. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and probation; second offense: $10,000.00 fi ne and suspension; third offense: $10,000.00 fi ne and revocation. Applicant First offense: denial of licensure; subsequent offense: denial of licensure and prohibition on reapplication for 2-5 years. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and denial of licensure; subsequent offense: $10,000.00 fi ne, denial of licensure and prohibition on reapplication for 2-5 years. 10. 480.047(1)(g) First offense: $1,000.00 fi ne and probation; subsequent offense: $1,000.00 fi ne and revocation. If the Licensee offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and probation; subsequent offense: $10,000.00 fi ne and revocation. Applicant First offense: denial of licensure; subsequent offense: denial of licensure and prohibition on reapplication for 2-5 years. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne, denial of licensure and prohibition on reapplication for 2-5 years. 11. Failure to respond to continuing First offense: $500.00 fi ne and suspension; subsequent offense: $500.00 fi ne and revocation. education audit 12. Any violation of Rule 64B7- First Offense: $1000.00 fi ne and probation to $2,500.00 fi ne and revocation. Second offense: $5,000.00 26.010, F.A.C. fi ne and revocation. (l) 480.046(1)(1) First offense: $500 fi ne and suspension; second offense: $1,000.00 fi ne and suspension; suspension; third offense: $1,000.00 fi ne and revocation. (m) 480.046(1)(m) First offense: $250.00 fi ne and reprimand; second offense: $500.00 fi ne and suspension; third offense: $1,000.00 fi ne and revocation. (n) 480.046(1)(n) $100.00 fi ne for the fi rst month and $50.00 for each succeeding month or part thereof and reprimand. 1. Establishment license delinquent If the offense is for raud or making a false or fraudulent representation, the penalty is $10,000.00 fi ne and reprimand. 2. Establishment license suspended – First offense: Suspension of owner’s massage therapy license; subsequent offense: revocation of site owned by massage therapist licensed owner’s massage therapy license. If the offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and suspension of owner’s massage therapy license; subsequent offense: $10,000.00 fi ne and revocation of the owner’s massage therapy license. (o) 456.072(1)(g) false report to fi rst offense: $500.00 fi ne and suspension; subsequent offense: $1,000.00 fi ne and revocation. If the Department regarding violation offense is for fraud or making a false or fraudulent representation: fi rst offense: $10,000.00 fi ne and suspension; subsequent offense: $10,000.00 fi ne and revocation. F(p) 456.072(1)(i) – failure to report First offense: $500.00 fi ne and reprimand; subsequent offense: $1,000.00 fi ne and suspension. If the violator offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and reprimand; subsequent offense: $10,000.00 fi ne and suspension. (q) 456.072(1)(l) – fi ling a false report First offense: $500.00 fi ne and probation; subsequent offense: $1,000.00 fi ne and revocation. If the required by law offense is for fraud or making a false or fraudulent representation, fi rst offense: $10,000.00 fi ne and probation; subsequent offense: $10,000.00 fi ne and revocation. (r) 456.072(1)(n) – infl uencing client First offense: $500.00 fi ne and probation; subsequent offense $1,000.00 fi ne and revocation. for fi nancial gain (s) 456.072(1)(r) – interfering with an First offense: $500.00 fi ne and probation; subsequent offense: $1,000.00 fi ne and revocation. investigation or inspection (t) 456.072(1)(b) – intentionally First offense: $1,000.00 fi ne and suspension; subsequent offense: $1,000.00 fi ne and revocation. violating a rule of the Board or intentionally violating a rule of the Board or Department (u) 456.072(1)(k) – failure to perform First offense; $250.00 fi ne; second offense: $500.00 fi ne; subsequent offense: $1,000.00 fi ne. any legal obligation placed on licensee

Elite CME - www.EliteCME.com Page 29 (v)1. 456.072(1)(q) or 480.046(1)(k) First offense: $250.00 fi ne and probation; Second offense: $500.00 fi ne and probation; Third offense: – violating any Board or Department $1,000.00 fi ne and suspension. order or failure to comply with a lawfully issued subpoena of the Department. 2. Violation of a Board order entered $1000.00 fi ne and suspension until compliant with previous order. If the offense is for fraud or making in a previous disciplinary case, a false or fraudulent representation, the fi ne is $10,000.00 and suspension until compliant with the including citation fi nal orders. previous fi nal order. (w) 456.072(1)(u) engaging or Verbal fi rst offense: $1,000.00 fi ne and probation; subsequent offense: verbal or physical, $1,000.00 attempting to engage a patient or client fi ne and revocation. Physical: $1,000.00 fi ne and revocation. in verbal or physical sexual activity. (x) 456.072(1)(w) failing to report to First offense: $500.00 fi ne if non-violent, non-sexual and non-felony; second offense: $5,000.00 fi ne the Board within thirty (30) days after and suspension; third offense: $1,000.00 fi ne and revocation. If a crime of violence, sexual crime or the licensee has been found guilty of, felony, fi rst offense: $1,000.00 fi ne and suspension; subsequent offense: $1,000.00 fi ne and revocation. or entered a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction (y) 456.072(1)(w) failing to report If the crime is non-violent, non-sexual and non-felony: $500.00 fi ne. If a crime of violence, sexual to the Board in writing on or before crime, or felony: $1,000.00 fi ne and revocation. October 1, 2001, any convictions, fi ndings of guilt or pleas of nolo contendere that occurred prior to July 1, 1999, and not previously reported to the Board (z) 456.072(1)(x) using information First offense: $500.00 fi ne and probation; second offense: $500.00 fi ne and suspension; about people involved in motor third offense: $500.00 fi ne and revocation vehicle accidents which has been derived from accident reports made by law enforcement offi cers or persons involved in accidents, or using information published in a newspaper or other news publication or through a radio or television broadcast that has used information gained from such reports for the purpose of commercial or any other solicitation whatsoever of the people involved in such accidents. (aa) 456.072(1)(gg), F.S. First offense: Suspension until compliant up to suspension until compliant with program followed by up to 5 years probation with conditions. Second or subsequent offense: suspension until compliant with program and up to fi ve years probation with conditions, or revocation, and up to $2,000.00 fi ne.

Page 30 Elite CME - www.EliteCME.com 2. If an establishment licensed pursuant f. Placement of the licensee on probation b. “Subject” means the licensee, to Chapter 480, F.S., is found to have for a period of time and subject to applicant, person, partnership, obtained such license by fraud or such conditions as the Board may corporation, or other entity alleged to misrepresentation, the usual action of the specify. Those conditions shall include have committed a violation designated Board shall be revocation of the license requiring the licensee to undergo in this rule. and prohibition of reapplication by the treatment, attend continuing education 2. In lieu of the disciplinary procedures holder of the license for a period of two courses, submit to be reexamined, contained in Section 456.072, F.S., the years. work under the supervision of another Department is hereby authorized to dispose 3. Based upon consideration of aggravating or licensee, or satisfy any terms which are of any violation designated herein by mitigating factors, present in an individual reasonably tailored to the violations issuing a citation to the subject within six case, the Board may deviate from the found. months after the fi ling of the complaint penalties for the violations charged. The g. Corrective action. which is the basis for the citation. Board shall consider as aggravating or 5. The provisions of subsections (1) through 3. The Board hereby designates the following mitigating factors the following: (4) above are not intended and shall not as citation violations, which shall result in a. The danger to the public; be construed to limit the ability of the a penalty as specifi ed below: b. The length of time since the violation; Board to informally dispose of disciplinary a. Refusing to allow the department to c. The number of times the licensee has actions by stipulation, agreed settlement, inspect the business premises of the been previously disciplined by the or consent order pursuant to Section licensee during regular business hours Board; 120.57(4), F.S. as required by Section 480.046(1) d. The length of time licensee has 6. The provisions of subsections (1) through (l), F.S., shall result in a penalty of practiced; (4) above are not intended and shall not be $500.00. e. The actual damage, physical or construed to limit the ability of the Board b. Failing to display a license or otherwise, caused by the violation; to pursue or recommend the Department certifi cate as required by Rule 64B7- f. The deterrent effect of the penalty pursue collateral, civil or criminal actions 28.008, F.A.C., shall result in a penalty imposed; when appropriate. of $250.00. g. The effect of the penalty upon the 7. In any proceeding where the Board is c. Failing to keep the equipment and licensees livelihood; authorized to take disciplinary action, premises of a massage establishment h. Any effort of rehabilitation by the the Board will also impose costs of in a clean and sanitary condition licensee; investigation and prosecution as authorized as required by Section 480.046(1) i. The actual knowledge of the licensee by Section 456.072(4), F.S. (m), F.S., shall result in a penalty of pertaining to the violation; 8. Whenever the Board, in accordance $250.00. j. Attempts by licensee to correct or with this rule, imposes a monetary fi ne d. Failing to maintain property damage stop violation or refusal by licensee to against a respondent in an Administrative and bodily injury liability insurance correct or stop violation; Complaint, it shall also impose a coverage as required by subsection k. Related violations against licensee in suspension of the respondent’s license 64B7-26.003(4), F.A.C., shall result in another state including fi ndings of guilt until the fi ne is paid. However, to enable a penalty of $250.00. or innocence, penalties imposed and the respondent to pay the monies fi ne, e. Failure to include the license number penalties served; the Board shall stay the imposition of the of either the massage therapist l. Actual negligence of the licensee suspension for the same time period as or the massage establishment in pertaining to any violation; specifi ed, in accordance with Rule 64B7- advertisements as required by Section m. Penalties imposed for related offenses 24.016, F.A.C., for payment of the monies 480.0465, F.S., shall result in a penalty under subsections (1) and (2) above; fi ne. If the fi ne is paid within the specifi ed of $250.00. n. Any other mitigating or aggravating time, then the order of suspension shall not f. Practicing with a delinquent license circumstances. take effect; if the fi ne is paid after the order in violation of Section 480.047(1)(a), 4. When the Board fi nds any person guilty of of suspension has taken effect, then the F.S., when the license, has become the grounds set forth in subsection (1) or suspension shall be lifted. delinquent automatically for failure of any grounds set forth in the applicable 9. For the purposes of Sections 480.033(4) to renew, so long as the license is practice act, including conduct constituting and 480.047(1)(a), F.S., “Compensation” reactivated within 30 days of becoming a substantial violation of subsection (1) or is defi ned as the payment of money or delinquent, shall result in a penalty a violation of the applicable practice act its equivalent; the receipt or delivery of of $250.00. Practice for more than which occurred prior to obtaining a license, property; the performance of a service; or 30 days after a license has become it shall enter an order imposing one or the receipt or delivery of anything of value, delinquent shall not be a citation more of the following penalties: to the person giving a massage in exchange violation. a. Refusal to certify, or to certify with for massage services. g. Violations of Rule 64B7-28.009, restrictions, an application for a F.A.C., by licensees provided that the license. 64B7-30.004 Citations. violation did not involve bribery or 1. Defi nitions. As used in this rule: b. Suspension or permanent revocation of fraudulent misrepresentation, shall a. “Citation” means an instrument which a license. result in a penalty of $25.00 per meets the requirements set forth in c. Restriction of practice. hour for each hour of defi cit of the Section 456.077, F.S., and which is d. Imposition of an administrative fi ne not continuing education hour requirement, served upon a subject in the manner to exceed $10,000 for each count or and completion of the required provided in Section 456.077, F.S., for separate offense. continuing education. the purpose of assessing a penalty in an e. Issuance of a reprimand. h. First-time failure of the licensee amount established by this rule; to satisfy continuing education

Elite CME - www.EliteCME.com Page 31 requirements established by the Board; 1. Failure to provide written notice of Board, and the respondent shall cease Fine of $250.00, and one hour of licensee’s current mailing address and practice until a temporary supervisor/ continuing education for each hour not place of practice in violation of Rule 64B7- monitor is approved. The Chairman of completed or completed late. These 28.015, F.A.C. the Board shall approve a temporary continuing education hours are to be 2. Failure to obtain continuing education in supervisor/monitor who shall serve completed within 90 days of the date of HIV/AIDS in violation of Section 456.034, in that capacity until the next meeting citation issuance. F.S. of the Board, at which time the Board i. Failure of a massage therapist to notify 3. Failure to have proof of insurance available shall accept or reject a new proposed the Board of a change of address as at an establishment as required by supervisor/monitor. If the Board rejects required by Section 456.035(1), F.S., subsection 64B7-26.003(4), F.A.C. the proposed supervisor, the respondent shall result in a penalty of $250.00. 4. Failure to include license number or shall cease practice until the Board j. False, misleading or deceptive numbers in any advertisement as required approves a new supervisor/monitor. advertising by advertising massage by Section 480.0465, F.S. d. The supervisor/monitor must be a therapy services under a name under licensee under Chapter 480, F.S., in which a license has not been issued 64B7-30.007 Probable cause panel. good standing and without restriction The determination of probable cause shall be in violation of Section 480.046(1) or limitation on his license. In addition, made by the probable cause panel of the board. (d), F.S., shall result in a penalty of the Board shall reject any proposed The probable cause panel shall consist of two $250.00. supervisor/monitor on the basis that he members, and may include a former board k. Violating Section 456.072(1)(h), F.S., or she has previously been subject to member. The chair of the board shall appoint by tendering a check that is dishonored any disciplinary action against his/her the panel members. by the institution upon which it is license. The supervisor/monitor must drawn shall result in a penalty of 64B7-30.008 Probationary conditions and be actively engaged in the same or $250.00. defi nitions. similar specialty area unless otherwise l. First time failure to comply with the 1. Indirect Supervision. Whenever a license provided by the Board. The Board will HIV/AIDS continuing education is placed on probation or otherwise also reject any proposed supervisor/ requirements of Section 456.034, restricted in such a manner as to require monitor whom the Board fi nds has F.S., or the medical errors continuing the respondent to practice under indirect violated the Board’s rules or Chapter education requirements of Section supervision, the term indirect supervision 456 or 480, F.S. 456.013(7), F.S., shall result in a does not require that the monitoring 4. For purpose of determining the dates when penalty of $250.00 for each defi cient practitioner practice on the same premises reports are due, the date the Final Order is course requirement, in addition to the as the respondent; however, the monitor fi led shall constitute the beginning of the requirement to make up the coursework shall practice within a reasonable quarter. within 90 days of the date the citation geographic proximity to the respondent, a. All quarterly reports shall be provided is fi led. which shall be within 20 miles unless to the Board offi ce no later than three m. Failing to identify to a patient verbally otherwise authorized by the Board, and months from the fi ling date of the Final or in writing, which may include shall be readily available for consultation. Order. wearing of a name tag, that a licensee 2. Direct Supervision. Whenever a license b. All semiannual reports shall be is practicing as a licensed massage is placed on probation or otherwise provided to the Board offi ce no later therapist, in violation of Section restricted in such a manner as to require than six months from the fi ling date of 456.072(1)(t), F.S., shall result in a the respondent to practice under direct the Final Order. penalty of $100.00. supervision, the term direct supervision c. All annual reports shall be provided to 4. In addition to the fi nes imposed herein, requires that the respondent practice only if the Board offi ce no later than twelve the costs of investigation and prosecution the supervisor is on the premises. months from the fi ling date of the Final for each offense shall be assessed in the 3. Provisions governing all supervised or Order. citation. monitored practitioners. 5. All fi nes and costs imposed in a citation 64B7-31Coloni irrigation a. The supervisor/monitor shall https://www.fl rules.org/gateway/ChapterHome. shall be paid within 90 days of the date the be furnished with copies of the asp?Chapter=64B7-31 citation is fi led. Administrative Complaint, Final Order, 64B7-30.005 Mediation. Stipulation (if applicable), and other 64B7-31.001 Colon hydrotherapy. 1. Intent. Pursuant to Section 456.078, F.S., the Board relevant orders. a. The Board of Massage fi nds that the designates fi rst time violations of the following b. The respondent shall not practice colon hydrotherapy procedures, while as appropriate for mediation: without a supervisor/monitor unless falling directly within the scope of 1. Violation of Section 480.047(1)(a), F.S., by otherwise ordered. The respondent Chapter 480, F.S., presents a substantial practicing on a delinquent license. shall appear at the next meeting of the danger to the public if performed by 2. Failure to timely respond to a continuing Board with his proposed supervisor/ incompetent practitioners. education audit in violation of subsection monitor unless otherwise ordered. b. The Board of Massage further fi nds 64B7-28.009(5), F.A.C. c. After the next meeting of the Board, the respondent shall only practice that a signifi cant proportion of 64B7-30.006 Notice of noncompliance. under the supervision of the supervisor/ licensees do not perform the colonic Pursuant to Sections 120.695 and 456.073(3), monitor. If for any reason the approved procedure and further that a signifi cant F.S., the Board designates the following supervisor/monitor is unwilling or proportion of those desiring to enter the as minor violations for which a notice of unable to serve, the respondent and the profession do not intend to engage in noncompliance may be issued for the fi rst supervisor/monitor shall immediately the practice of colonic irrigation. violation thereof: notify the Executive Director of the

Page 32 Elite CME - www.EliteCME.com c. This rule is promulgated to ensure that massage which met the minimum standards requirements of the Department of only those who have been determined for training and curriculum as delineated Education. duly qualifi ed to practice colon in this rule chapter. A transcript indicating 3. Board of Massage Therapy approval shall hydrotherapy may do so in an effort to passing grades in all courses, and including be withdrawn if the massage school: protect the health, safety and welfare of dates of attendance, and stating the date of a. Modifi es its curriculum to fall below the public. successful completion of the entire course of the minimum standards set out in this 2. Prior to the practice of colon hydrotherapy, study, is evidence of successful completion. rule, or fails to require its students to any licensed massage therapist, or If the transcript does not specifi cally state complete the minimum standards in apprentice shall be required to present that the student successfully completed the order to graduate; certifi cation to the Board of successful entire course of study, the transcript must be b. Submits to the Board of Massage completion of examination by a Board accompanied by a diploma or certifi cate of Therapy on behalf of an applicant approved massage school after completion completion indicating the dates of attendance for licensure documents containing of a supervised classroom course of study and completion. information the school, through its in colonic irrigation or in the case of a owner, manager, instructors, or other duly authorized apprenticeship training 64B7-32.003 Minimum requirements for employees or agents, knows to be false; program, evidence of having completed board approved massage schools. c. Violates any standard applicable to 100 hours of colonic irrigation training, 1. In order to receive and maintain Board the school pursuant to licensure by the including a minimum of 45 hours of of Massage Therapy approval, a massage Department of Education; clinical practicum with a minimum of 20 school, and any satellite location of a d. Violates any applicable rule herein. treatments given. previously approved school, must: 4. A Board of Massage Therapy-approved 3. Prior to the practice of colonic irrigation, a. Meet the requirements of and be school must notify the Board of Massage any licensed massage therapist, or licensed by the Department of Therapy within 90 days of: apprentice shall be required to successfully Education pursuant to Chapter 1005, a. Changes in curriculum; complete and pass the National Board F.S., or the equivalent licensing b. Changes in faculty or staff, including for Colon Hydrotherapy Examination authority of another state or county, or submission of the credentials of new (NBCHT) which is approved by the Board. be within the public school system of faculty; and 4. Any licensed massage therapist whose the State of Florida; and c. Changes in address. license has been in an inactive or retired b. Offer a course of study that includes, at 5. Any change in ownership of a Board of status for more than two consecutive a minimum, the 500 classroom hours Massage Therapy approved school must biennial licensure cycles shall be required listed below, completed at the rate of be approved by the Board of Massage to successfully complete and pass the no more than 6 classroom hours per Therapy. NBCHT, prior to resuming the practice of day and no more than 30 classroom colonic irrigation. hours per calendar week: 64B7-32.004 Standards for transfer of 5. Any applicant for massage therapist credit. Course of study Classroom hours licensure or licensed massage therapist, Hours credited through transfer credit will who in conjunction with previous Anatomy and 150 not be recognized by the Board unless the massage therapist licensure was certifi ed Physiology following transfer standards are met: to practice colonic irrigation, shall be Basic Massage Theory 100 1. The school shall be provided with a required to successfully complete and and History certifi ed transcript from a school licensed by the Department of Education pursuant pass the NBCHT prior to practicing colon Clinical Practicum 125 hydrotherapy. to Chapter 1005, F.S., or the equivalent Allied Modalities 15 licensing authority for another county, 64B7-32 Board approved massage school Theory and Practice of 15 state, or country, or be within the public https://www.fl rules.org/gateway/ChapterHome. Hydrotherapy school system of the State of Florida. asp?Chapter=64B7-32 2. Courses for which credit is granted shall Florida Laws and 10 parallel in content and intensity to the 64B7-32.001 Defi nitions. Rules courses presently offered by the school. For the purposes of this rule chapter a (Chapters 456 and 480, 3. Documentation of previous training shall “classroom hour” shall be defi ned as no less F.S. and Chapter 64B7, be included in each student’s permanent than 50 minutes of any one clock hour during F.A.C.) fi le. which the student participates in a learning Professional Ethics 4 activity in the physical presence of a member 64B7-32.005 Minimum standards for of the faculty of the school. HIV/AIDS Education 3 colonics training. Medical Errors 2 4. Any course of study in colonics shall be 64B7-32.002 Documentation of in addition to the minimum 500 classroom graduation from a board approved c. Apply directly to the Board of Massage hours provided in Rule 64B7-32.003, Therapy and provide the following massage school. F.A.C., above. The course must include In order to be acknowledged as a graduate information: a minimum of 100 classroom hours of of a Board approved massage school as 1. Sample transcript and diploma; colonics training and may only follow referred to in subsection 480.033(9), F.S., the 2. Copy of curriculum, catalog or completion of the 500 hour requirement Board’s administrative offi ce must receive an other course descriptions; except that Board approved massage offi cial transcript documenting the applicant’s 3. Faculty credentials; and schools may include the additional 100 training. Such transcript must document to the 4. Proof of licensure by the hours of colonic training at any time during satisfaction of the Board that the applicant has Department of Education. the basic course curriculum. successfully completed a course of study in 2. All faculty members of the massage therapy school must meet the minimum Elite CME - www.EliteCME.com Page 33 2. No course of study in colonics shall be PART III: Announcements and frequently Tallahassee, Florida 32399 or from offered except by a Board approved asked questions the website located at http://www.doh. massage school, or an independent Licensing and renewal state.fl .us/mqa/massage/ma_lic_req. provider approved by the Board for A notice for renewal is mailed to each licensee html; colonics training only. at the last address provided to the Board. c. Completes a course of study at a 3. Applicants for licensure as a colonics Failure to receive this notifi cation does not massage school approved by the Board provider shall meet the criteria established relieve the licensee of the responsibility of pursuant to Rule Chapter 64B7-32, by Rule 64B7-28.010, F.A.C. meeting the renewal or continuing education F.A.C.; or completes an approved 4. Prior to licensure as a colonics provider requirements. apprenticeship program in accordance applicants shall submit a proposed with Rule Chapter 64B7-29, F.A.C.; curriculum to the Board for approval. Such By renewing and submitting the appropriate d. Completes the HIV/AIDS course curriculum shall include but not be limited renewal fees, you are acknowledging requirement in Rule 64B7-25.0012, to: compliance with all requirements for renewal. F.A.C.; a. 50 hours of classroom theory, anatomy, You are responsible for retaining proof of e. Passes a national examination approved physiology, pathology of the colon all earned continuing education hours for a by the Board; and digestive system and principles of period of four (4) years. All massage therapists f. Completes a course relating to the colon hygiene. renewing active licenses are subject to audit prevention of medical errors as b. 45 hours of practical experience, and may be asked to show proof of appropriate required by subsection 456.013(7), F.S. including procedure, history, clinical continuing education. 2. The Board approves the following records and contra-indication. You should renew as soon as possible when examinations: c. 5 hours of sterilization techniques your receive the renewal notice. All renewal a. National Certifi cation Board for and familiarization with the types and applications, with the appropriate fees, must be Therapeutic Massage and Bodywork makes of colonic irrigation equipment postmarked on or before the expiration date of Examination; commonly used in the trade. the license in order to be considered timely. b. National Certifi cation Examination for 5. Colonics training shall be conducted only Therapeutic Massage; at a licensed massage establishment or Massage therapists are not permitted to c. National Exam for State Licensure Board approved school. practice without proof of current licensure. option administered by the National 6. Providers approved by the Board for If you do not have your new license by the Certifi cation Board for Therapeutic colonics training only shall meet the expiration date your employer may verify your Massage and Bodywork; criteria established by paragraph 64B7- license at the Health Licensee and Continuing d. The Massage and Bodywork Licensing 32.003(1)(a), F.A.C. Education Providers Information website. If Examination administered by the your license renewal is in progress the status Federation of State Massage Therapy 64B7-33 Advertisement will not be available on the website. You will Boards. https://www.fl rules.org/gateway/ChapterHome. need to contact the Board at (850) 488-0595 to 3. Any Board-approved examination may be asp?Chapter=64B7-33 verify that your renewal application, with the offered in the Spanish language. proper fee, has been received and validated. 64B7-33.001 Advertisement. However, you should be allowed to continue Q: Can I fax my change of address to you 1. Each massage therapist or massage working. or may I leave my change of address on establishment licensed under the provisions your voice mail or can you take a change of this act shall include the number of the If there have been any changes in either of address over the telephone? license in any advertisement of massage the location or the ownership of a massage A: Because of recent changes in Florida law, services. establishment, you may download the you now have the option of submitting your 2. Any advertisement of massage services application and submit when completed, along change of address you may write a letter in any advertising medium as defi ned with the appropriate fees to the Board offi ce. requesting the change that includes the type herein shall include the license number of Any deletion or addition of an owners’ name to of address to be changed and faxing it to each licensed massage therapist and each or from a massage establishment is considered (850) 487-9626. You will need your current licensed massage establishment whose a change of ownership. (You can not indicate a license number and the control number from name appears in the advertisement. change of ownership or location of a massage the license for security reasons. Remember a 3. For purposes of this rule, “advertising establishment on a renewal notice). change of location for a massage establishment medium” means: any newspaper, airwave requires the completion of an application and or computer transmission, telephone Effective 6/2/10, any Board of Massage submission of the appropriate fees. directory listing other than an in-column Therapy approved exam may be offered listing consisting only of a name, address, in the Spanish language [from 64B7- and telephone number, business card, 25.001 Examination Requirements, FAC]. Q: Is a massage establishment license handbill, fl yer, sign other than a building 1. The Department shall issue a license to a needed for a licensed massage therapist directory listing all building tenants and person who: to perform massage therapy in a their room or suite numbers, or other form a. Pays to the Department the fee set out acupuncturist, chiropractor, dentist, of written advertising. in subsection 64B7-27.002(1), F.A.C.; physical therapist or podiatrist’s offi ce? 4. No provision herein shall be construed to b. Submits a completed application on A: Yes. form DH-MQA 1115, “Application prohibit the use of a properly registered Q: May I indicate a change of business corporate or fi ctitious name, if registered For Licensure,” (Rev. 10/09). The location on my renewal notice? according to Florida Law. form and the attached instructions are incorporated herein by reference and A: No, you must submit a complete application may be obtained from the Board Offi ce to the Board in order to change the location of at 4052 Bald Cypress Way, Bin C-06, your business. Any address change refl ected

Page 34 Elite CME - www.EliteCME.com on your renewal notice will be considered a liability insurance coverage for the proposed client while the client is being massaged, change in mailing address only. establishment. Only the licensed massage and launder before reuse all materials therapist who is the owner of the establishment furnished for the personal use of the client, Q: I am ready to renew my license may use insurance from a professional such as drapes, towels and linens. As used however, the co-owner of this association to satisfy this requirement for herein “drapes” means towels, gowns, or establishment is no longer affi liated with massage establishment licensure. sheets. [64B7-26.003(3) (e), F.A.C.] the business, may I refl ect this change on 15. Provide for the use of clients a bathroom my renewal notice? Q: When will my massage establishment with at least one toilet and one sink with A: No, any addition to or deletion of owners’ be inspected? Will the inspector call fi rst? running water. Such facilities shall be name to or from a massage establishment is A: The inspector may visit the facility at equipped with toilet tissue, soap dispenser considered a change in the ownership of that anytime during this period unannounced as the with soap or other hand cleaning materials, establishment and you must submit a complete Board of Massage has no control over when sanitary towels or other hand-drying device application to the Board for a new license inspections occur. such as a wall-mounted electric blow dryer, number to be issued. Q: I have received a notice for renewal and waste receptacle. [64B7-26.003(1) (b), Massage establishments of my massage establishment license, F.A.C.] IMPORTANT INFORMATION FROM THE however I am no longer in business. How 16. Toilet facility fi xtures/components clean, in BOARD: do I notify the Board? good repair. [64B7-26.003(3) (g), F.A.C.] 1. If you plan on opening a massage A: Write out of business across your license or 17. Maintain all bathroom and shower establishment or move a current your renewal notice and mail it to the Board facilities and fi xtures in good repair, well- establishment you must apply for a license. offi ce. lighted and ventilated. [64B7-26.003(3) 2. You may not offer massages in an (g), F.A.C.] establishment until it has been inspected Massage establishment inspection 18. Toilet facility on premises or in same AND the new license has been issued. authority is outlined in CHAPTER building within 300 feet of establishment. 3. It takes approximately 45 days to process 480.043, F.S., AND 64 B 7–26.004 & [64B7-26.003(1) (c), F.A.C.] non-problematic applications, complete 26.005 F.A.C. The inspection process 19. Lavatory in treatment room or within the inspection and issue the new license. requires satisfactory validation of the 20 feet for cleansing hands or chemical Please plan accordingly. following items: germicidal designed for use without 4. If your establishment fails the inspection 1. Current establishment license. [480.043(1), lavatory. [64B7-26.003(3) (f), F.A.C.] your license will be denied by the F.S.] 20. Proof of current property damage and Department of Health and you will have to 2. Establishment license conspicuously bodily injury liability coverage maintained re-apply. displayed. [64B7-28.008(3), F.A.C.] on premises. [64B7-26.003(4), F.A.C.] 5. Licensure of a massage establishment 3. Employed person(s) duly licensed. 21. Clean/adequate shower facilities if cannot be transferred to a different owner. [480.047(1) (c), F.S.] whirlpool bath/sauna/steam cabinet and/or The new owner must apply for a new 4. Each Massage Therapist’s license steam room on premise. [64B7-26.003(1) license and the old owner should request conspicuously displayed. [64B7-28.008(1), (d), F.A.C.] an administrative voluntary relinquishment F.A.C.] 22. Massage therapist not supervising more of the current license in writing to the 5. If advertisement is visible at this than one apprentice. [64B7-29.001(3), Board of Massage Therapy offi ce at: 4052 establishment, must meet requirements of F.A.C.] Bald Cypress Way, Bin C06, Tallahassee, 480.0465, F.S. Colonic irrigation FL 32399-3252. 6. Establishment complies with local building 23. Licensed massage therapist or apprentice 6. You must submit proof of property damage code requirements. [64B7-26.003(1) (a), licensee properly certifi ed to perform and bodily injury liability insurance F.A.C.] colonic irrigation. [64B7-31.001(2), coverage. 7. Public premise areas provided with safe F.A.C.] 7. Section 480.052, F.S. Power of county and unobstructed human passages. [64B7- 24. Colonic irrigation equipment maintained or municipality to regulate massage. 26.003(3) (a), F.A.C.] in sanitary and safe working condition. A county or municipality, within its 8. Garbage and refuse removal provided. [64B7-26.003(3) (d), F.A.C.] jurisdiction, may regulate persons and [64B7-26.003(3) (a), F.A.C.] establishments licensed under this chapter. 9. Safe storage/removal of fl ammable Apprentice program (inspection if Such regulation shall not exceed the materials provided. [64B7-26.003(3) (a), appropriate) powers of the state under this act or be F.A.C.] 25. Apprentice certifi cate or provisional inconsistent with this act. This section shall 10. Premise fi re extinguisher maintained in license conspicuously displayed. [64B7- not be construed to prohibit a county or good working condition. (Sprinkler system 28.008(2), F.A.C.]* municipality from enacting any regulation not acceptable substitute.) [64B7-26.003(3) 26. Apprentice under supervision of licensed of persons or establishments not licensed (b),F.A.C] sponsoring massage therapist. [64B7- pursuant to this act. 11. Exterminate all vermin, insects, termites 29.003(1), F.A.C.] and rodents on premises. [64B7-26.003(3) 27. Record of apprentice hours maintained and To apply for a massage establishment or (c), F.A.C.] available for inspection. [64B7-29.003(4), to move existing establishments please 12. Safe/sanitary massage equipment F.A.C.] see the application at the Florida Board of maintained. [64B7-26.003(3) (d), F.A.C.] Massage Therapy Web Site. 13. Regular use of cleaners and bacterial Establishment equipment required in agents or clean table covering utilized for addition to 64B7-26 for apprentice Q: Is insurance coverage necessary for a program* massage establishment? each client. [64B7-26.003(3) (d), F.A.C.] 14. Maintain a suffi cient supply of clean 28. Tables for massages. [64B7-29.001(5) (a), A: Yes, the applicant must submit proof F.A.C.] confi rming property damage and bodily injury drapes for the purpose of draping each Elite CME - www.EliteCME.com Page 35 29. Linen and storage area. [64B7-29.001(5) are not required to complete this course for directly on the body. Unlike licensed massage (b), F.A.C.] renewal. therapists who are able to use their bare hands 30. Colonic equipment if colonic irrigation  Two (2) hours must cover instruction in the when applying oils and creams on their clients. taught. [64B7-29.001(5) (c), F.A.C.] prevention of medical errors. 31. Sterilization equipment if non-disposable  Two (2) hours must cover instruction in Q: Is a massage therapy license required colonic attachments are utilized. [64B7- Florida Laws and Rules (Chapter 480 and to perform refl exology and reiki? 29.001(5)(d),F.A.C] 456, Florida Statutes, and Rule Chapter A: Yes. 32. Hydrotherapy equipment including hot/ 64B7, Florida Administrative Code. Note: Minimum requirements for certifi cation cold packs. [64B729.001(5)(e),F.A.C] If you are a new licensee and this is your in colonic irrigation (colonics): 33. Appropriate textbooks and teaching fi rst renewal, you are not required to In order to become eligible for certifi cation materials. [64B7-29.001(5)(f)(1-6),F.A.C] complete this course for renewal. in colonic irrigation (Colonics) you must  In addition to the hours required above, a Continuing education either hold a valid Florida Massage Therapist course in HIV/AIDS is also required for License or have submitted an application for Q: I have completed more hours for this renewal. It can be for any number of hours. biennium than was necessary. May I carry licensure as a massage therapist. (Please note that the colonics certifi cation will not be issued the balance over to the next renewal The remaining hours may include courses unless a license to practice massage therapy period? on: has been approved.) A: No, all hours must be earned within your  Communications with clients and other renewal period and cannot be carried over to professionals; If currently licensed to practice massage the next biennium.  Insurance relating to third party payment or therapy in Florida, the following is required: reimbursement for services;  Successful completion of a course of study Q: I have received my renewal notice  Psychological dynamics of the client- in colonics at a Florida Board Approved and have not completed my required therapist relationship; Massage Therapy School, which is continuing education hours. May I mail  Risk management, including charting, approved to offer colonics, or completion in my renewal and complete my hours documentation, record keeping, or of a Board approved apprenticeship later? infection control (other than the HIV/AIDS program in the area of colonics; A: No, you must complete all contact hours course required by section 456.034, F.S.),  Must submit an application to the board before you renew your license. You may face or massage practice management and fee for certifi cation in colonics; and disciplinary action for not completing the  Four (4) hours credit for adult cardio-  Must pass the National Board for Colon mandatory continuing education requirement. pulmonary resuscitation (CPR) provided Hydrotherapy (NBCHT) examination. the course is sponsored by the American Q: Will I have to show proof that I have Red Cross, the American Heart Association If not currently licensed to practice massage earned all of my contact hours, if I have or the American Safety and Health therapy in Florida, the following is required:  an active license? Institute, or is instructed by persons Must be at least 18 years of age or have A: All massage therapists licenses are subject certifi ed to instruct courses for those received a high school diploma or graduate to random audit. If audited, you must submit organizations. equivalency diploma (GED); copies of certifi cates of attendance to the  Completed a course of study at a Florida Board as proof of completion of an approved All courses must be obtained through a Board of Massage Therapy Approved continuing education courses. Board of Massage Therapy Approved School (pdf - 78kb) which has an approved Provider. course of study in colonics or completed a Q: What are current continuing education Board meetings board approved apprenticeship program in requirements? the area of colonics; A: Every massage therapist is required to Q: How can I become a Board member?  Must pass the National Board for Colon complete: A: Board members are appointed by the Hydrotherapy (NBCHT) (pdf - 1.5mb)  One (1) hour of continuing education Governor and confi rmed by the Senate. You examination; for each month or partial month that has may apply by contacting the Governor’s  Must have completed a 2-hour course on elapsed since the issuance of the license for Appointment Offi ce at (850) 488-2183. the prevention of medical errors. which renewal is sought, up to a maximum Q: Who can attend Board meetings? of 24 hours for the renewal period. NOTE - If this was not a part of the curriculum A: All Board meetings are open to the public  Twelve (12) of the continuing education at the Board of Massage Therapy Approved and you are encouraged to attend. hours shall be taken via live classroom School, it can be obtained through a Board instruction which includes hands-on Services approved Continuing Education Provider; and instruction or demonstration, six (6) hours Q: Can massage therapists provide body  Must submit an application and fee for of which may be performed as pro bono wrapping services? licensure as a massage therapist and services pursuant to rule 64B7-28.0095, A: Yes, a licensee under Chapter 480, F.S., certifi cation in Colonic Irrigation. F.A.C. These continuing education hours has always been able to provide the skin shall be relevant to and focus on massage beautifi cation and body wrapping services. therapy techniques, which may include New legislation was passed that a person does history of massage therapy, human not have to be a licensed massage therapist anatomy & physiology, kinesiology, and/or to perform body wraps. But it is required pathology. to take a twelve (12) hour course and then  Two (2) hours must cover instruction in register as a body wrapper under the Board of professional ethics. Note: If you are a new Cosmetology. A registered person will only licensee and this is your fi rst renewal, you be able to use pre-soaked wrap material and will not be allowed to apply oils or creams

Page 36 Elite CME - www.EliteCME.com MASSAGE THERAPY LAWS AND 4. Chapter 408, Part II, Section 408.811, 8. 2009-223 gives the Medicaid program specifi es all the following about inspections, additional authority, including all the RULES - LEGAL UPDATE 2011 except: following provisions, except: (10 CE HOURS) a. All inspections shall be unannounced, a. Requiring prior authorization and Select the best answer for each question and except as specifi ed in s. 408.806. increased documentation for certain complete your test online at b. The right of inspection extends to any home health services www.elitecme.com. business that the agency has reason to b. Requiring four pilot projects to monitor believe is being operated as a provider and manage home health care services 1. All of the following agencies are without a license c. Requiring Medicaid to eliminate responsible for massage therapy regulation c. The agency shall have access to and the medically unnecessarily billing in Florida, except: licensee shall provide, or if requested d. Making sanctions and “for cause” send, copies of all provider records contract termination mandatory for a. Florida Department of Health required during an inspection or other certain provider activity b. American Massage Therapy review at no cost to the agency Association d. Inspections for relicensure shall be c. Division of Medical Quality Assurance conducted annually unless otherwise 9. Which of the following is not one of the d. Florida Board of Massage Therapy specifi ed by authorizing statutes or requirements for licensure as a massage applicable rules therapist?

2. In Chapter 408, Part II, Section 408.803, a. Being at least 21 years of age “Defi nitions,” the term “Controlling interest” 5. Unless an alternative timeframe is required or b. Completing a course of study at a means all the following, except: approved by the agency, a defi ciency found board-approved massage school or during an inspection must be corrected within completing an apprenticeship program a. The applicant or licensee what period of time after the provider is that meets standards adopted by the b. A voluntary board member notifi ed of inspection results? board c. A person or entity that serves as an c. Receiving a passing grade on an offi cer of, is on the board of directors a. 10 calendar days examination administered by the of, or has a 5-percent or greater b. 30 calendar days department ownership interest in the management c. 1 year d. Paying the initial licensure fees company or other entity, related or d. None of the above unrelated, with which the applicant or licensee contracts to manage the 10. According to 480.044, Fees, the massage provider 6. Which of the following is not listed as a therapist initial licensure fee will not exceed: d. A person or entity that serves as an disincentive to commit Medicaid fraud offi cer of, is on the board of directors mentioned in 2009-223? a. $100 of, or has a 5-percent or greater b. $125 ownership interest in the applicant or a. Decreasing the administrative penalties c. $150 licensee b. Establishing additional licensure d. $175 penalties c. Adding fraud-related criminal offenses 3. In Chapter 408, Part II, Section 408.808, a d. None of the above 11. According to 480.044, Fees, the colonics Provisional License is limited to a period of examination fee will not exceed: what length of time? 7. 2009-223 creates new criminal penalties a. $100 a. Up to 6 months by making all the following third degree b. $125 b. Up to 12 months felonies, except: c. $150 c. Up to 16 months d. $175 d. Up to 24 months a. Offering services requiring licensure as a home medical provider without a license 12. According to 64B7-25.0012, as a condition to b. Knowingly submitting false or granting an initial licensure, the applicant is misleading information to AHCA required to complete a course on HIV/AIDS c. Fraudulent or abusive billing of how many hours? d. Conspiracy to violate the provisions of the enhanced licensure requirement in a. 1 s. 408.8065 b. 2 c. 3 d. 4

Elite CME - www.EliteCME.com Page 37 13. Which of the following is not a requirement 17. According to 64B7-29, Apprentice, a for licensure by endorsement, according to “qualifi ed massage establishment” must be 64B7-25.004? equipped with all the following, except:

a. The individual must submit a a. Tables completed application, form #BMT2 b. Changing rooms b. The individual must pay the initial c. Colonic equipment if colonic irrigation licensure fee is taught c. The individual must complete a course d. Textbooks and teaching materials on relating to the prevention of medical anatomy errors d. The individual must demonstrate that the out-of-state licensure was issued 18. According to 64B7-30.004, refusing to upon the satisfactory completion of allow the department to inspect the business an examination comparable to the premises of the licensee during regular examination provided by the Board business hours will result in a penalty of what amount?

14. In 2010, the biennial renewal fee for massage a. $175 therapists and massage establishments was b. $250 reduced to: c. $350 d. $500 a. $75 b. $100 c. $125 19. According to 64B7-30.004, failure to include d. $150 the license number of either the massage therapist or the massage establishment in advertisements will result in a penalty of 15. According to 64B7-28.001, no license shall what amount? be renewed unless the licensee has completed at least two hours relating to the prevention a. $175 of medical errors, including a study of all the b. $250 following, except: c. $350 d. $500 a. Root-cause analysis b. Error reduction and prevention c. Patient safety 20. A notice of noncompliance may be issued for d. Vaccinations all the following, except:

a. Failure to timely respond to a 16. According to 64B7-28.0015, “Place of continuing education audit practice” means all the following except: b. Failure to provide written notice of licensee’s current mailing address and a. A massage establishment maintained place of practice by the licensed massage therapist c. Failure to obtain continuing education b. The massage establishment at which in HIV/AIDS the licensed massage therapist provides d. Failure to have proof of insurance massage therapy available at an establishment c. The client’s address, if the massage therapist provides therapy at the client’s location d. The medical offi ce at which the licensed massage therapist provides massage therapy

Page 38 Elite CME - www.EliteCME.com