27305129, 64B8ER23-7 - Florida Administrative Rules, Law, Code, Register

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Notice: 27305129

Notice of Emergency Rule

Department:

DEPARTMENT OF HEALTH

Division:

Board of Medicine

Overview

RULE:

64B8ER23-7

Sex-reassignment Standards of Practice in Minors

SPECIFIC REASONS FOR FINDING AN IMMEDIATE DANGER TO THE PUBLIC HEALTH, SAFETY OR WELFARE:

On May 17, 2023, Florida Governor, Ronald DeSantis, signed CSSB 254 into law creating Ch. 2023-90, Laws of Florida and section 456.52, Florida Statutes. Pursuant to section 456.52(1), F.S., sex-reassignment prescriptions are prohibited for patients younger than 18 years of age upon the effective date of the act; however, pursuant to section 456.52(1)(a), F.S., the Board of Medicine shall within 60 days after the effective date of the act, adopt emergency rules pertaining to standards of practice by which minors may continue to be treated if such treatment was commenced before, and is still active on, the effective date of the act. Section 456.52(1)(b), F.S., also provides a minor patient meeting the criteria outlined in section 456.52(1)(a), F.S., may continue to be treated by a physician with such prescriptions according to rules adopted pursuant to paragraph (1)(a).
	Further, pursuant to section 456.52(2), F.S., if sex reassignment prescriptions or procedures are prescribed for or administered to patients 18 years of age or older, consent must be voluntary, informed, and in writing on forms adopted in rule by the Board of Medicine. Pursuant to section 456.52(4), F.S., the consent required for sex-reassignment prescriptions does not apply to renewals of sex-reassignment prescriptions if a physician and his or her patient have met the requirements for consent for the initial prescription. Section 456.52(6)(a), F.S., states “[t]he Board of Medicine and the Board of Osteopathic Medicine shall adopt emergency rules to implement this section.”
Accordingly, the Board of Medicine, by emergency rule, hereby adopts the incorporated standards of practice and mandated consent forms for the treatment of gender dysphoria with puberty blockers and hormone replacement therapy in minors.  
*** This emergency rule does not apply to Susan Doe, Gavin Goe, or Lisa Loe, or their parents or healthcare providers  (see Jane Doe et al., v. Joseph A. Ladapo, et al, Preliminary Injunction, Filed June 6, 2023, Case No. 4:23cv114-RH-MAF, United States District Court for the Northern District of Florida). ***

REASON FOR CONCLUDING THAT THE PROCEDURE IS FAIR UNDER THE CIRCUMSTANCES:

The procedure used for the promulgation of this emergency rule is fair under the circumstances. CSSB 254 was signed into law on May 17, 2023. The Board of Medicine was contacted by multiple licensed physicians and physician groups seeking clarification regarding the exception contained in section 465.52(4), F.S., and a timeframe for the required emergency rules shortly thereafter. In response, the Board of Medicine and the Board of Osteopathic Medicine held a Joint Rules/Legislative Committee (Joint Committee) meeting on June 1, 2023, to discuss the emergency rule.  On May 19, 2023, the Board of Medicine published notice of the Joint Committee’s June meeting both on its website and in the Florida Administrative Register.  On June 2, 2023, the Board of Medicine discussed the report of the Joint Committee and voted upon emergency rule language that would allow for the renewal of previous prescriptions while the Board worked on consent forms.  The Board of Medicine published notice of its June 2, 2023, meeting in the Florida Administrative Register on May 5, 2023, and on its website on May 12, 2023.
The Joint Committee held another meeting on June 23, 2023, to discuss an emergency rule adopting draft consent forms that were under consideration. On June 6, 2023, the Board of Medicine published notice of the Joint Committee’s June 23, 2023, meeting to its website and in the Florida Administrative Register. On June 30, 2023, the Boards of Medicine and Osteopathic Medicine held a Joint Board meeting (Joint Board Meeting) to discuss the draft consent forms that were approved by the Joint Committee on June 23, 2023. Prior to conclusion of the Joint Board Meeting, the Boards each separately voted to approve the draft consent forms via emergency rule. The Joint Board Meeting was held via Microsoft Teams and notice of the same was published to the Board of Medicine’s website and in the Florida Administrative Register on June 22, 2023. 
Each Joint Committee meeting was held in person in a public forum and was able to be attended by any interested persons. The Joint Board Meeting was held via Microsoft Teams and also was able to be attended by any interested persons. Public comment was accepted at all of the aforementioned meetings. Further, the Boards accepted written public comment on the proposed rules up and until 24 hours prior to the Joint Board Meeting. Accordingly, all notice requirements contained in Rule 28-102.001, F.A.C., were properly complied with and interested persons were given ample opportunity to participate in this rulemaking process.

SUMMARY:

The proposed emergency rule formally adopts the required consent forms that must be executed for a minor patient who was already receiving sex-reassignment prescriptions to continue to receive said prescriptions per section 456.52(1), Florida Statutes.

THE PERSON TO BE CONTACTED REGARDING THE EMERGENCY RULE IS:

Paul Vazquez, Executive Director, Board of Medicine, 4052 Bald Cypress Way, Bin # C-03, Tallahassee, Florida 32399-3253,  Paul.Vazquez@flhealth.gov

PRINT PUBLISH DATE:

7/7/2023 Vol. 49/131

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=64B8ER23-7&PDate=7/7/2023&Section=4

REFERENCE MATERIALS:

No reference(s).

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