The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Fiscal Policy
BILL: CS/SB 1600
INTRODUCER: Fiscal Policy Committee; and Senator Collins
SUBJECT: Interstate Mobility
DATE: February 29, 2024 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Rossitto-Van
Brown HP Favorable
Winkle
2. Kraemer Imhof RI Favorable
3. Rossitto-Van
Yeatman FP Fav/CS
Winkle
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 1600 creates s. 455.2135, F.S., to require the regulatory boards in the Department of
Professional Regulation (DBPR), or the DBPR itself when there is no regulatory board for a
profession, and when endorsement based on years of licensure is not otherwise provided by law
in the practice act for a profession, to allow licensure by endorsement for any individual who
applies for licensure by endorsement if the applicant meets certain specified criteria. The bill
does not apply to harbor pilots.
The bill also creates s. 456.0145, F.S., which requires the Department of Health (DOH) to issue a
license by endorsement to a qualified applicant within seven days of receipt of all required
documents for specified health care professions1 regulated by the DOH when the applicant meets
specific criteria. The DOH boards, or the DOH when there is no board, may continue processing
applications for licensure by endorsement as authorized under the Florida Statutes (2023) until
rules adopted by the boards, or the DOH, to implement the changes made by the bill take effect
or until six months after the bill’s effective date, whichever occurs first.
The bill provides an effective date of July 1, 2024.
1
Office of Program Analysis and Government Accountability, Department of Health, Medical Quality Assurance, Who
Regulates practitioners? available at
https://oppaga.fl.gov/ProgramSummary/ProgramDetail?programNumber=5041#:~:text=Currently%2C%20the%20program%
2C%20in%20conjunction%20with%2022%20boards,pharmacies%2C%20and%20resident%20and%20nonresident%20steril
e%20compounding%20pharmacies.%29 (last visited Jan. 24, 2024).
BILL: CS/CS/SB 1600 Page 2
II. Present Situation:
Department of Business and Professional Regulation
Chapter 455, F.S., applies to the regulation of professions by the DBPR.2 The chapter also
provides the procedural and administrative framework for its divisions and the professional
boards within the DBPR.3 In this context, the term “profession” means any activity, occupation,
profession, or vocation regulated by the DBPR in the Divisions of Certified Public Accounting,
Professions, Real Estate, and Regulation.4 When a person is authorized to engage in a pertinent
profession or occupation in Florida, the DBPR issues a “permit, registration, certificate, or
license” to the licensee.
Organizational Structure of the DBPR
Section 20.165, F.S., establishes the organizational structure of the DBPR, which has the
following 11 divisions:
 Administration;
 Alcoholic Beverages and Tobacco;
 Certified Public Accounting;
 Drugs, Devices, and Cosmetics;
 Florida Condominiums, Timeshares, and Mobile Homes;
 Hotels and Restaurants;
 Professions;
 Real Estate;
 Regulation;
 Technology; and
 Service Operations.
Permits, Registrations, Certificates, and Licenses Issued by the DBPR
The following boards and programs are established within the Division of Professions:
 Board of Architecture and Interior Design;5
 Florida Board of Auctioneers;6
 Barbers’ Board;7
 Florida Building Code Administrators and Inspectors Board;8
 Board of Construction Industry Licensing;9
 Board of Cosmetology;10
2
Section 455.01(6), F.S.
3
See s. 455.203, F.S. The DBPR must also provide legal counsel for boards within the DBPR by contracting with the
Department of Legal Affairs, by retaining private counsel, or by staff counsel of the DBPR. See s. 455.221(1), F.S.
4
Section 455.01(6), F.S.
5
See part I, ch. 481, F.S.
6
See part VI, ch. 468, F.S.
7
See ch. 476, F.S.
8
See part XII, ch. 468, F.S.
9
See part I, ch. 489, F.S.
10
See ch. 477, F.S.
BILL: CS/CS/SB 1600 Page 3
 Electrical Contractors’ Licensing Board;11
 Board of Employee Leasing Companies;12
 Board of Landscape Architecture;13
 Board of Pilot Commissioners;14
 Florida Board of Professional Engineers;15
 Board of Professional Geologists;16
 Board of Veterinary Medicine;17
 Home inspection services licensing program;18 and
 Mold-related services licensing program.19
The following board and commission are established within the Division of Real Estate:
 Florida Real Estate Appraisal Board; 20and
 Florida Real Estate Commission.21
The board of Accountancy is established within the Division of Certified Public Accounting.22
The following additional professions are licensed and regulated within the DBPR, in various
other divisions, for a total of 2223 regulated professions throughout the DBPR:24
 Asbestos contractors and consultants;
 Athletic agent;25
 Community association managers;26 and
 Talent agencies.27
11
See part II, ch. 489, F.S.
12
See Part XI, ch. 468, F.S.
13
See Part II, ch. 481, F.S.
14
See ch. 310, F.S.
15
See ch. 471, F.S.
16
See ch. 492, F.S.
17
See ch. 474, F.S.
18
See part XV, ch. 468, F.S.
19
See part XVI, ch. 468, F.S.
20
See part II, ch. 475, F.S.
21
See part I, ch. 475. F.S.
22
See ch. 473, F.S.
23
See Department of Business and Professional Regulation, Annual Report, Fiscal Year 2022-2023, at pp. 18 and 87,
available at http://www.myfloridalicense.com/DBPR/os/documents/Division%20Annual%20Report%20FY%2022-23.pdf
(last visited Jan. 23, 2024).
24
The Florida Athletic Commission is assigned to the DBPR for administrative and fiscal accountability purposes only; and
The DBPR also administers the Child Labor Law and Farm Labor Contractor Registration Law. See s. 548.003(1), F.S., and
parts I and III, ch. 450, F.S., respectively.
25
See part IX, ch., 468 F.S.
26
See s. 468.432, F.S.
27
See part VII, ch. 468, F.S.
BILL: CS/CS/SB 1600 Page 4
DBPR Licensure by Endorsement
Of the 22 professions that fall under ch. 455, F.S., sixteen of the professions currently have one
or more licensure by endorsement provisions in their practice act. The following six professions
do not have provisions for licensure by endorsement:
 Harbor pilots;
 Talent agents;
 Community association managers;
 Athletic agents;
 Employee leasing companies; and
 Real estate appraisers.
The following DBPR-regulated professions have endorsement provisions but do not specify the
number of years of licensure that are required for endorsement:
 Auctioneers;
 Architecture and interior design;
 Real estate brokers, sales associates, and schools; and
 Cosmetology specialists.
Department of Health
One of the many enumerated missions of the DOH is to regulate health practitioners for the
preservation of the health, safety, and welfare of the public.28 The Division of Medical Quality
Assurance (MQA), within the DOH, has general regulatory authority over health care
practitioners.29 The MQA works in conjunction with 22 regulatory boards and four councils to
license and regulate 364 health care professions.30 Each profession is regulated by an individual
practice act and by ch. 456, F.S., which provides general regulatory and licensure authority for
the MQA.
Regulation of Health Care Practitioners
The MQA is statutorily responsible for assisting the following boards and professions in the
regulation of their health care practitioner members:31
 The Board of Acupuncture;32
 The Board of Medicine;33
28
Section 20.43, F.S.
29
Pursuant to s. 456.001(4), F.S., health care practitioners are defined to include acupuncturists, physicians, physician
assistants, chiropractors, podiatrists, naturopaths, dentists, dental hygienists, optometrists, nurses, nursing assistants,
pharmacists, midwives, speech language pathologists, nursing home administrators, occupational therapists, respiratory
therapists, dieticians, athletic trainers, orthotists, prosthetists, electrologists, massage therapists, clinical laboratory personnel,
medical physicists, genic counselors, dispensers of optical devices or hearing aids, physical therapists, psychologists, social
workers, counselors, and psychotherapists, among others.
30
Florida Department of Health, Division of Medical Quality Assurance, Annual Report and Long-Range Plan, Fiscal Year
2022-2023, at pg. 4, available at https://www.floridahealth.gov/licensing-and-regulation/reports-and-publications/annual-
reports.html (last visited Jan. 23, 2024).
31
Section 456.001(4), F.S.
32
See ch. 457, F.S.
33
See ch. 458, F.S.
BILL: CS/CS/SB 1600 Page 5
 The Board of Osteopathic Medicine;34
 The Board of Chiropractic Medicine;35
 The Board of Podiatric Medicine;36
 Naturopathy;37
 The Board of Optometry;38
 The Board of Nursing;39
 Nursing assistants;40
 The Board of Pharmacy;41
 The Board of Dentistry; 42
 Midwifery; 43
 The Board of Speech-Language Pathology and Audiology; 44
 The Board of Nursing Home Administrators; 45
 The Board of Occupational Therapy;46
 Respiratory therapy, practices under the Board of Respiratory Care;47
 Dietetics and nutritionists practice under the Board of Medicine;48
 The Board of Athletic Training;49
 The Board of Orthotists and Prosthetists;50
 Electrolysis practices under the Board of Medicine;51
 The Board of Massage Therapy;52
 The Board of Clinical Laboratory Personnel;53
 Medical physicists;54
 Genetic counselors;55
 The Board of Opticianry;56
 The Board of Hearing Aid Specialists;57
34
See ch. 459, F.S.
35
See ch. 460, F.S.
36
See ch. 461, F.S.
37
See ch. 462, F.S.
38
See ch. 463, F.S.
39
See part I, ch. 464, F.S.
40
See part II, Ch. 464, F.S.
41
See ch. 465, F.S.
42
See ch. 466, F.S.
43
See ch. 467, F.S.
44
See part I, ch. 468, F.S.
45
See part II, ch. 468, F.S.
46
See part III, ch. 468, F.S.
47
See part V, ch. 468, F.S.
48
See part X, ch. 468, F.S.
49
See part XIII, ch. 468, F.S.
50
See part XIV, ch. 468, F.S.
51
See ch. 478, F.S.
52
See ch. 480, F.S.
53
See part I, ch. 483, F.S.
54
See part II, ch. 483, F.S.
55
See part III, ch. 483, F.S.
56
See part I, ch. 484, F.S.
57
See part II, ch. 484, F.S.
BILL: CS/CS/SB 1600 Page 6
 The Board of Physical Therapy;58
 The Board of Psychology;59
 School psychologists;60
 The Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health
Counseling;61
 Radiation technologists;62
 Emergency medical technicians;63 and
 Paramedics.64
The DOH and the health care practitioner boards have different roles in the regulatory system.
Boards establish practice standards by rule, pursuant to specific legislative grants of statutory
authority and directives. The DOH receives and investigates complaints about health care
practitioners and prosecutes cases for disciplinary action against practitioners. The boards
determine the course of action and any disciplinary action to be taken against a practitioner under
the applicable practice act.65 The DOH is then responsible for ensuring that the licensee complies
with the terms and penalties imposed by the board. If a case is appealed, the DOH’s attorneys
defend the final actions of the boards before the appropriate appellate court.
For professions for which there is no board, the DOH determines the action and discipline to be
taken against a health care practitioner and issues the final orders. Those professions include the
following:
 Emergency medical technicians (EMTs);
 Paramedics;
 Genetic counselors ;
 Radiation technologists;
 Naturopathy; and
 Medical physicists.
The DOH rules and board rules apply to all statutory grounds for discipline against a health care
practitioner. Under current law, the DOH has disciplinary authority for violations of a practice
act only for practitioners that are not regulated by a board. The DOH does not have final
disciplinary authority over practitioners for which there is a board.
58
See ch. 486, F.S.
59
See ch. 490, F.S.
60
Id.
61
See ch. 491, F.S.
62
See part III, ch. 468, F.S.
63
See part III, ch. 401, F.S.
64
Id.
65
Section 456.072(2), F.S.
BILL: CS/CS/SB 1600 Page 7
Licensure of Health Care Practitioners
Licensure by examination is the most common pathway for individuals seeking initial licensure,
particularly among health care professionals educated and trained in Florida. The requirements to
qualify for licensure by examination are legislatively specified in each profession’s respective
practice act and vary widely based on the profession. However, licensure by examination has
some common elements for most health care professions, and those include the following:
 Completion of an approved or legislatively mandated educational training program;
 Completion of an approved or legislatively mandated licensure or certification examination
with a passing score; and
 Submission of a legislatively mandated application, approved by the DOH, fingerprints for a
criminal background check, and an application fee.
Licensure by Endorsement of Health Care Professionals
Licensure by endorsement is the most common alternative to licensure by examination in
Florida. Licensure by endorsement is an expedited licensure process which allows a health care
professional to become licensed in Florida based upon holding a substantially equivalent or
similar health care professional license from another state. Currently, 20 health care
professionals regulated by the DOH and the boards are legislatively authorize to offer licensure
by endorsement. Seventeen are not. See lists below.
Health Care Professions with Health Care Professions without
Licensure by Endorsement Licensure by Endorsement
Acupuncturist Anesthesiologist Assistant
Allopathic Physician (MD) Athletic Trainer
Audiologist Chiropractor
Certified Nursing Assistant (CNA) Clinical Laboratory Personnel
Mental Health Professions Dental Hygienist
Dietitian Dentist
Electrologist EMT/Paramedic
Licensed Practical Nurse (LPN) Genetic Counselor
Massage Therapist Hearing Aid Specialist
Midwifery Medical Physicist
Nursing Home Administrator Optometrist
Occupational Therapist Optician
Pharmacist Orthotist and Prosthetist
Physical Therapist/Physical Therapy Assist. Osteopathic Physician (DO)
Physica