Ron DeSantis GOVERNOR Joseph A. Ladapo, MD, PhD STATE SURGEON GENERAL April 1 - June 30, 2024 Quarterly Performance ReportQ4 Florida Department of Health A Medical Quality Assurance Publication
TABLE OF CONTENTS 2 | EXECUTIVE SUMMARY 3 | AROUND MQA 8 | PERFORMANCE STATISTICS 13 | ENFORCEMENT AT A GLANCE 15 | UNLICENSED ACTIVITY INVESTIGATIVE SPOTLIGHT 19 | FINANCIAL SUMMARY 20 | GLOSSARY 21 | CONTACT US MISSION To protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts. VALUES INNOVATION We search for creative solutions and manage resources wisely. COLLABORATION We use teamwork to achieve common goals and solve problems. ACCOUNTABILITY We perform with integrity and respect. RESPONSIVENESS We achieve our mission by serving our customers. EXCELLENCE We promote quality outcomes through learning and continuous performance improvement. VISION TO BE THE HEALTHIEST STATE IN THE NATION How We Work LICENSE ENFORCE INFORM
Jennifer L. Wenhold, MSW, CPM I’m proud to highlight MQA’s journey through the final quarter of FY 2023-24 by presenting another outstanding progress report. This report not only marks the conclusion of the fiscal year, but showcases the tenacity of MQA’s workforce as significant milestones and achievements paved the way for continued success in Florida’s health care sector. This quarter, MQA leveraged cutting-edge technology by substantially improving the management of nurse applicant educational records through the Nurse Program Portal (NPP). Over 3,200 records have been automatically uploaded through MQA’s licensing database, allowing for a much faster and more reliable update of applicant data compared to the manual process used in the past. In three months, the NPP has saved 392 hours of work for application processors, totaling $6,056 in cost savings. This update enhances the customer experience of nurse applicants by reducing wait times and ensuring greater accuracy when processing applications. We are excited about the positive impact our upcoming initiatives will have on Florida’s health care community, including enhancements to our digital infrastructure and expansion of our outreach programs to better serve health care applicants, practitioners, and consumers. With your continued support and dedication to our mission, we will continue making significant strides in protecting, promoting, and improving the health of all people in Florida. LETTER FROM THE DIRECTOR EXECUTIVE SUMMARY In Florida’s complex regulatory framework, section 456.025(9), Florida Statutes, serves as a guiding light for the Division of Medical Quality Assurance (MQA). This mandate requires MQA to provide quarterly reports on its performance, financial status, and effectiveness in regulating health care professions and practitioners. Join MQA to review the culmination of a successful fiscal year. LICENSING = 2,000 ENFORCEMENT 2,003 Online Complaints Received 315 Unlicensed Activity Complaints Received 134 Cease and Desist Orders Issued FINANCES Overall Cash Balance at the close of Quarter Four $40 MILLION License 48,539 Initial Applications Received 34,166 New Licenses Issued MQA conducted inspections for massage establishments, optical establishments, dental laboratories, and electrolysis facilities (M.O.D.E.) within five days, which showcases a 6% decrease from last quarter. A total of 288 new M.O.D.E. inspections were completed this quarter. Q4 • Quarterly Performance Report • FY 2023-24 2
Introducing Agenda 2.0: A New Way for Regulatory Boards and Councils to Conduct Business MQA developed new board agenda technology in FY 2023-24 to merge the board member and board staff software, effectively creating a new experience through which the boards can conduct business. Originally established in 1999, the iBuilder and iViewer Agenda systems are utilized by 22 boards and four councils to support their respective missions. The iBuilder system is locally installed on board support staff computers and used to develop, refine, and publish official board meeting content. The iViewer system is web-based and used by board members to view the published official board meeting content. Rollout to boards and councils is expected to begin in November 2024 and will continue through FY 2024-25. INNOVATION - We search for creative solutions and manage resources wisely. COLLABORATION - We use teamwork to achieve common goals and solve problems. Board of Nursing Collaborates with Investigative Services Unit and the University of Miami Health System for Nursing Month In May, the Board of Nursing (the Board) leadership conducted an on-site visit to the Investigative Services Unit (ISU) in Miami. The Board aims to strengthen ties with ISU investigators by addressing questions about the Nurse Licensure Compact (NLC) and commends ISU's efforts in handling the high volume of nursing cases in South Florida. Additionally, the Board was invited to speak at the University of Miami Health System (UHealth) to culminate the celebration of Nursing Month. During the visit, the Board led various discussions on topics including the NLC, Advanced Practice Registered Nurse AROUND MQA MQA is driven by its core values of innovation, collaboration, accountability, responsiveness, and excellence (ICARE). The following quarterly accomplishments reflect the hard work and dedication of MQA teams, who consistently strive to enhance public protection and deliver high-quality health care services across Florida. ACCOMPLISHMENTS 3 Q4 • Quarterly Performance Report • FY 2023-24
ACCOUNTABILITY - We perform with integrity. (APRN) protocols, the complaint and investigative process, autonomous practice, and declaratory statements. The Board provided an overview of nursing regulation in Florida, insights into its relationship with the National Council of State Boards of Nursing (NCSBN), and recent legislative and rulemaking efforts. Cross-Departmental Modernization Efforts The Bureau of Emergency Medical Oversight (BEMO) is responsible for certifying 911 public safety telecommunicators and overseeing the licensure of more than 81,800 emergency medical technicians and paramedics, over 331 advanced and basic life support agencies, and more than 8,000 emergency medical services (EMS) vehicles. To further the mission of the Florida Department of Health (Department), MQA applied its licensure experience and best practices to collaborate with BEMO to centralize and streamline their EMS application process through the MQA Online Services Portal (the Portal). Previously, applications and associated payment were mailed, processed manually, and returned for review. Now, with the use of the Portal, BEMO-regulated licensees can apply, upload documents, renew licenses, pay fees, and view licensure documents online. This modernization significantly improves application turnaround time and reduces application deficiencies, offering a more efficient and reliable service for practitioners. Enhancing Accessibility: MQA's Commitment to Inclusive Design and Americans with Disabilities Act Compliance Accessibility goes beyond legal requirements; it's a transformative element that enhances everyone's experience, particularly in design. MQA recently conducted a thorough threemonth review of MQA’s 22 regulatory board websites to ensure compliance with the Americans with Disabilities Act (ADA), reflecting its dedication to the ICARE values. As expressed by the MQA Web and Graphic Manager, “[This project] updates our compliance, which is crucial for a government organization. We prioritize our visitors, the public, Floridians, and anyone accessing our websites. Our goal is to ensure a positive experience and demonstrate that we value their input." Q4 • Quarterly Performance Report • FY 2023-24 4
Expanding MQA’s Virtual Agent: ELI’s Growing Impact on Customer Service in Health Care Regulation In Quarter Four, MQA expanded its Virtual Agent, ELI, to serve voice customers interacting with the Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling. The total number of chat queues managed through ELI is now up to 31. As such, ELI fielded a record-breaking 213,453 voice calls and nearly 67,450 web chats from health care practitioners, applicants, and consumers. By broadening ELI’s interaction to more offices, MQA is enhancing the licensure process for a wider array of health care practitioners and applicants. MQA leverages this cuttingedge technology to provide immediate, personal, and actionable information at times best for customers, not only increasing overall satisfaction but also reinforcing trust in MQA’s commitment to efficiently meeting the changing needs of practitioners. To learn more or access ELI, visit FLHealthSource.gov/eli or find ELI at the bottom of any respective board website. RESPONSIVENESS - We achieve our mission by serving our customers and engaging our partners. EXCELLENCE - We promote quality outcomes through learning and continuous performance improvement. Streamlining Nursing Licensure: The Impact of the Nursing Program Portal MQA collaborated with the Florida Board of Nursing to revolutionize the nursing licensure process with the development of the Nursing Program Portal (NPP). This innovative solution addresses the challenges of manual processing during peak graduation periods, where hundreds of school lists and transcripts required meticulous review, often leading to delays in applicant approvals. By enabling Florida nursing programs to submit graduation information electronically, the NPP can automate the data upload and verification process within two business days, drastically reducing wait times and ensuring that applicant files are accurately and swiftly updated. The NPP not only streamlines the licensure process but also accelerates nursing graduates' entry into the workforce. Each day there is a delay in licensing a new health care practitioner results in less money to the economy and less access to care for Floridians and visitors; the average annual wages in Florida for a registered nurse, for example, reflects a salary of $79,910. In three months, the NPP has saved MQA 392 hours of work for application processors, totaling $6,056 in cost savings and demonstrating MQA’s commitment to leveraging technology for improved service delivery and strengthening Florida’s health care system. 5 Q4 • Quarterly Performance Report • FY 2023-24
A Legacy of Prescription Drug Monitoring Program Innovation Continues with New Leadership Since its inception in 2010, Rebecca Poston has been at the forefront of innovation in Florida’s Prescription Drug Monitoring Program Foundation (PDMP), also known as E-FORCSE®. Under her leadership, the foundation has raised over $3 million in supplemental restricted funds and federal grants for outreach and education programs to promote E-FORCSE® to health care practitioners and law enforcement officials. Notably in FY 2020-2021, the foundation contracted within the Department to implement sections of the Centers for Disease Control and Prevention’s (CDC) Overdose to Action Grant (OD2A). Under this grant, a peer-to-peer course on best practices was developed for the use of E-FORCSE®, directed at prescribers and dispensers of controlled substances. As MQA bids her farewell, MQA welcomes John Felton as the new PDMP Program Manager. Mr. Felton brings with him over 13 years of experience, including three years as the PDMP Database Administrator and 10 years as a Client Manager with the nation's largest PDMP vendor. With his extensive background, MQA is confident that Mr. Felton will continue to enhance the program’s effectiveness in combating prescription drug abuse and ensuring the safety and well-being of Floridians. AROUND MQA SPOTLIGHT 6 Q4 • Quarterly Performance Report • FY 2023-24 Honoring Excellence: Alfredo P. Kiernan and Family Award at Florida State University College of Medicine MQA proudly announces that the Board of Medicine recognized Alfredo P. Kiernan and his family with the prestigious Chair’s Recognition Award from Florida State University College of Medicine. This honor recognizes those who embody the highest standards of professionalism, moral character, compassion, and intellectual excellence. Mr. Kiernan and his family have shown outstanding leadership and commitment to their community, setting an inspiring example for future medical practitioners and reflecting core values essential to medicine.
STORM-READY: ESSENTIAL PREPAREDNESS TIPS FOR HEALTH CARE PRACTITIONERS IN CRITICAL AREAS The Division of Emergency Preparedness and Community Support offers resources for personal, family, and community readiness, health care system preparation, and environmental health. These essential preparedness tips for health care practitioners in critical areas include: • Personal and Family Preparedness: Ensure personal readiness to maintain focus on professional duties during emergencies. • Health Care System Preparation: Develop and implement emergency plans for health care facilities to ensure continuity of care. • Community Resilience: Collaborate with local organizations to strengthen communitywide disaster response efforts. • Training and Evaluation: Participate in regular training and drills to stay updated on emergency response protocols. • Environmental Health Preparedness: Address environmental hazards that may impact health during disasters. • Regulatory Compliance: Adhere to state regulations and guidelines for emergency preparedness and response. For detailed information, visit FloridaHealth.gov/programs-and-services/emergency-preparednessand-response/index.html. 7 Q4 • Quarterly Performance Report • FY 2023-24
PERFORMANCE STATISTICS 1. INITIAL APPLICATIONS In Quarter Four, MQA received over 48,500 applications from prospective practitioners seeking initial licensure, representing a 15% increase from Quarter Three. In addition, MQA issued nearly 34,200 licenses to new practitioners, which is a 15% increase from the previous quarter. MQA processed initial applications within 1.5 days on average for qualified applicants in Quarter Four. Measure: The average time taken to issue an initial license to qualified applicants. Definition: The average duration from when an application is deemed qualified to the issuance of the license. Goal: One day. MQA consistently tracks four key performance metrics that indicate its success in meeting its mission to improve the health and well-being of Floridians through critical health care licensure and enforcement activities. This strategic focus includes the timely approval of both initial and renewal licensure applications, along with diligent inspections of pharmacies and M.O.D.E. establishments. Figure 1: Initial Applications Received DID YOU KNOW? The licensure process can be delayed by several factors, mainly stemming from the wait for crucial documents from applicants. These include background screening results, records of criminal and disciplinary history, license verifications, transcripts, and continuing education certificates. Exam results can also cause delays, as some professions permit applicants up to one year to complete exams. Seasonal trends also affect processing times; the busiest periods for applications, typically due to graduation seasons, occur during the fall and spring semesters, while renewal peaks occur in even-numbered years. 8 Q4 • Quarterly Performance Report • FY 2023-24
2. LICENSE RENEWALS MQA processed nearly 175,550 renewal applications in Quarter Four. The majority of renewal applications processed were completed online (98%), and MQA processed completed applications for qualified applicants in under one day on average, reflecting a 75% decrease in processing time overall compared to Quarter One. Measure: The average number of days to process a renewal application for a qualified applicant. Definition: The average number of days to renew a license for health care practitioners and facilities from receipt of the completed application through approval. Goal: One day. Figure 2: Average Time to Process a Renewal Application for a Qualified Applicant Even-Year Renewals: • Radiologic Technicians: Renew based on their birth month. • Physician Assistants and certain physician groups: Renew by January 31. • Acupuncture: Renew by February 28. • Dental Practitioners, including Dental Hygienists and Nuclear Pharmacists: Renew by February 28. • Osteopathy, Podiatry, and Chiropractic Medicine: Renew by March 31. • Nurses (Registered Nurse and Advanced Practitioner Registered Nurse): Renew by April 30 or July 31. • Psychology, Electrologist, Electrologist Facility, and a group of Certified Nursing Assistants: Renew by May 31. • Clinical Laboratories: Renew by August 31. • Athletic Trainers and Nursing Home Administrators: Renew by September 30. • Emergency Medical Technicians and Paramedics: Renew by December 1. • Opticians, Consultant Pharmacists, and Pharmacy Technicians: Renew by December 31. Odd-Year Renewals: • Radiologic Technicians: Renew based on their birth month. • Medical Physicists and another group of Medical Doctors: Renew by January 31. • Occupational Therapists, Optometrists, Pharmacy Establishments, and Hearing Aid Specialists: Renew by February 28. • Social Workers, Marriage and Family Therapists, and Mental Health Counselors: Renew by March 31. • Nurses (Group 3): Renew by April 30. • Respiratory Therapists, another group of Certified Nursing Assistants, and Dietitians and Nutritionists: Renew by May 31. • Licensed Practical Nurses: Renew by July 31. • Massage Therapists and Massage Establishments: Renew by August 31. • Pharmacists: Renew by September 30. • Physical Therapists, School Psychologists, and Orthotists and Prosthetists: Renew by November 30. • Midwifery, Genetic Counselors, and Speech-Language Pathologists and Audiologists: Renew by December 31. DID YOU KNOW? Health care practitioners renew their licenses in either even or odd years, depending on their profession: Q4 • Quarterly Performance Report • FY 2023-24 9
Measure: Average number of days to complete a M.O.D.E. inspection. Definition: The average number of days from the date the facility requests inspection to the date the inspection is completed. This measure does not include those facilities that request a delay in inspections. Goal: 10 days. 5Days Inspection Average Figure 3: Average Days to Complete a M.O.D.E. Inspection 3. M.O.D.E. INSPECTIONS Imagine walking into a health care facility where every corner sparkles with cleanliness, every instrument is impeccably sterilized, and every practitioner is confidently following strict safety protocols. This serene environment isn't a mere coincidence—it is the result of careful facility inspections and compliant facility owners. Facility inspectors are the unsung heroes of health care, ensuring that safety and sterility standards are consistently met for the benefit of both practitioners and the public. This quarter, MQA completed M.O.D.E. inspections in five days, which is a 6% decrease from last quarter. Overall, the average time to complete a new M.O.D.E. inspection this fiscal year has consistently been under six days, with 288 inspections completed for new business inspections this quarter. DID YOU KNOW? Inspections do more than just ensure compliance; they build an environment of trust and care. Each visit reinforces the Department’s mission, safeguarding the well-being of everyone involved. M.O.D.E. inspections are vital for public protection and cover a broad spectrum of health care settings: • Massage establishment inspections ensure that sanitation standards are upheld, and client documentation is carefully maintained. • Optical establishments undergo periodic inspections to verify adherence to health and safety regulations, ensuring a clear vision of care. • Dental laboratories are inspected for infection control protocols and proper waste disposal practices, maintaining the clean environment necessary to deliver oral health services. • Electrolysis facilities are inspected to guarantee quality hygiene standards and the sterilization of equipment, ensuring each procedure is as safe as possible. 10 Q4 • Quarterly Performance Report • FY 2023-24
DID YOU KNOW? As a result of the 2024 legislative session, House Bill 197 Health Care Practitioners and Massage Therapy, amends quorum requirements for the Board of Massage Therapy to a majority of current members and mandates the Department to include specific data on massage therapists and establishments in its annual report. It authorizes the Department to issue an emergency suspension of licenses for massage therapists and establishments if they are involved in certain crimes. Additionally, the bill establishes new grounds for emergency suspension across all health care practitioners, requiring the Department to suspend a license if there is probable cause for sexual misconduct. To view all 2024 bills impacting health care professions, including brief summaries and effective dates, visit FLHealthSource.gov/2024-bills. DID YOU KNOW? A massage establishment owner, designated establishment manager (DEM), and practitioner all have different obligations when running an establishment. • In Florida, a massage establishment owner must obtain and maintain a state license, ensure compliance with health and safety regulations, verify that all staff are licensed, undergo background checks, and maintain proper records. • The DEM must be a licensed massage therapist, physician, or chiropractic physician who oversees daily operations, ensures compliance with state standards, assists with health department inspections, and implements corrective actions based on inspection results. • Practitioners, or massage therapists, must hold a valid Florida license, complete continuing education requirements, maintain professional and ethical standards, follow sanitation protocols, keep accurate client records, adhere to the scope of practice defined by Florida law, and ensure client safety during treatments. Q4 • Quarterly Performance Report • FY 2023-24 11
4. PHARMACY INSPECTIONS Pharmacy facility inspections are designed to ensure that pharmacies adhere to established operational and practice standards, particularly in areas such as record-keeping, inventory management, and the control of substances. During Quarter Four, these inspections were completed in an average of seven days, which is a 19% decrease from the previous quarter. Overall, MQA has consistently completed pharmacy inspections well below the threshold of 14 days. Measure: Average days to complete a new pharmacy inspection. Definition: The average number of days from the date an applicant is ready for opening inspection to the date the inspection is completed. Goal: 14 days. Figure 4: Average Days to Complete a New Pharmacy Inspection DID YOU KNOW? As a result of the 2024 legislative session, House Bill 159 HIV Infection Prevention Drugs passed, which authorizes certified pharmacists to screen adults for HIV exposure and to order and dispense HIV postexposure prophylaxis drugs under a written collaborative practice agreement with a licensed physician. The bill requires participating pharmacies to submit an annual access-to-care plan to the Board of Pharmacy and the Department which ensures patients have access to primary care, specifies requirements for access-to-care plans, and authorizes penalties for non-compliance. For more information pertaining to this bill, visit FLHealthSource. gov/2024-bills. 7Days Inspection Average Q4 • Quarterly Performance Report • FY 2023-24 12
ENFORCEMENT AT A GLANCE MQA stands at the heart of Florida’s health care system as a vigilant guardian, upholding the regulations defined in section 20.43 and Chapter 456, Florida Statutes. MQA’s Bureau of Enforcement operates with a mission centered on public health, safety, and welfare, comprising the Consumer Services Unit (CSU), Investigative Services Unit (ISU), and Compliance Management Unit (CMU). These units work together to receive, investigate, and resolve complaints filed against health care practitioners and facility owners. In Quarter Four, MQA received a total of 11,651 complaints, completed 1,435 investigations, and inspected 4,463 health care facilities. MQA also identified 1,403 cases deemed legally sufficient for potential prosecution and found 431 cases of probable cause. The count of open enforcement cases decreased 2% from 35,605 cases in Quarter Three to 34,932 cases at the end of Quarter Four. CSU managed the majority of cases (23,573) compared to CMU, which managed 5,566 open cases, Prosecution Services Unit (PSU) which managed 4,958, and ISU which managed 835. Section 456.074, Florida Statutes, grants PSU the authority to order an immediate stop to activities deemed an imminent threat to the public. These directives, referred to as Emergency Orders, are issued by the State Surgeon General. Whereas Emergency Restriction Orders (EROs) establish limits on a practitioner's professional activities under suspicion, Emergency Suspension Orders (ESOs) temporarily revoke the practitioner's license according to the order's terms. CMU CSU PSU ISU 35,605 OPEN CASES 23,373 5,566 4,958 835 Figure 5: Complaints Received In Thousands Q4 • Quarterly Performance Report • FY 2023-24 13
During Quarter Four, PSU issued 70 Emergency Orders. Among these, 33% were EROs (23), while 67% were ESOs (47). 47 ESOs EROs 23 70 EMERGENCY ORDERS ISSUED THE PATH OF A COMPLAINT Figure 6: Orders to Cease and Desist Q4 • Quarterly Performance Report • FY 2023-24 14
UNLICENSED ACTIVITY INVESTIGATIVE SPOTLIGHT MQA's Unlicensed Activity (ULA) Program informs the public about the risks associated with receiving health care services from unlicensed practitioners. Per section 456.065, Florida Statutes, delivering medical care without a license may lead to fines, civil penalties, and potential imprisonment. Through collaboration with law enforcement agencies and state attorneys, the ULA Program actively investigates and pursues legal action against unlicensed practitioners, which is critical in safeguarding public interest and maintaining the integrity of professional standards. In response to violations, the Department issued 134 cease and desist orders this quarter. ULA OUTREACH Outreach is a crucial element of the ULA Program, designed to educate the community about the serious risks associated with unlicensed health care practices. While traditionally capturing widespread community attention by prioritizing large-scale events to effectively communicate its importance to residents and visitors, the ULA Program shifted its focus toward building meaningful relationships with local community leaders, advisors, and public health sectors. This new goal emphasizes smaller, localized events throughout Florida’s communities. Through these targeted outreach efforts, MQA investigators aim to highlight not only the physical consequences but also the mental and financial burdens of engaging in unlicensed health care activities. In doing so, investigators address topics such as penalty fines for violations, potential criminal charges, and correct procedures for reporting unlicensed health care practices to ensure that critical information reaches the heart of each community. 25% 25% 25% 25% Educational Seminars Health Expos Town Hall Meeting Community Fairs Figure 7: ULA Outreach Q4 • Quarterly Performance Report • FY 2023-24 15
Round 'Em Up This year's ULA Annual Training embraced the theme, "Round 'Em Up," reflecting its concerted efforts to address individuals involved in unlicensed health care activities. This highly anticipated three-day program featured special guests from the U.S. Food and Drug Administration, the Florida Department of Law Enforcement, and the Federal Bureau of Investigation. Investigators also participated in one-on-one sessions with MQA staff members to discuss field challenges and gain valuable insights on specific concerns. Hurricane Expo In May, Alachua ISU participated in the Family Fun and Hurricane Expo in Levy County, which emphasized the importance of maintaining proper supplies for hurricane season. Alachua ISU distributed items beneficial for hurricane preparedness, including small flashlights, hand sanitizers, and first aid kits. Given the potential for significant damage during hurricane season, it is crucial for ISU to partner with local organizations that share the Department's mission of keeping residents safe. Pensacola Gainesville Jacksonville Orlando Jupiter Ft. Myers Q4 • Quarterly Performance Report • FY 2023-24 16
Pensacola Meet and Greet Meet and greets are essential for spreading awareness among community partners. Pensacola ISU connected with representatives from the Office of the Attorney General, the Department of Financial Services, and the Bureau of Insurance Fraud. This event significantly enhanced departmental collaboration and improved community support through shared expertise and knowledge. Fighting ULA Jacksonville ISU is actively combating unlicensed health care activities with the support of students. In May, the team visited the Parisian Spa Institute, a school offering career training programs in massage therapy and cosmetology. Raising awareness among students is crucial in this fight, as they can recognize unethical practices. During the visit, students learned how to identify signs of unlicensed health care activity, verify licenses, and report suspicious behavior. Orlando Promotes Community Engagement In April, Orlando ISU partnered with Clarita’s House Ministry to support a food bank dedicated to helping the homeless and disadvantaged. Orlando ISU saw this as a valuable opportunity to both serve the community and provide promotional items such as cups, beach balls, pens, and other giveaways, thereby increasing the Department’s visibility and fostering a sense of goodwill and support within the community. Jupiter Police Family Autism Day In April, Jupiter ISU participated in the Jupiter Police Family Autism Day, which featured various activities, including sensory play, story time, first aid sessions, petting zoo interactions, and food. This event was a valuable opportunity to engage with the community, foster connections, and build trust with local families. If unlicensed activity is suspected, individuals can submit information through MQA’s Online Complaint Portal or call 1-877-HALT-ULT to speak directly with an investigator. Q4 • Quarterly Performance Report • FY 2023-24 17
Fort Myers Annual Meet and Greet Fort Myers hosted its annual meet and greet in June by welcoming several key agencies, including Collier County Code Enforcement, Fort Myers Police Department, Lee County Sheriff’s Office, Department of Children and Families – Adult Protective Services Program, Department of Elder Affairs, Lee County Emergency Medical Services, Lee Memorial Hospital, Agency for Health Care Administration, Office of the Attorney General, Cape Coral Police Department, Physician’s Regional, Naples Police Department, Department of Business and Professional Regulation, and Charlotte County Public Safety Department. Nearly 50 participants attended and engaged in meaningful discussions on their areas of expertise. Florida Crime Intelligence Analysts Association In June, MQA staff participated in the Florida Crime Intelligence Analysts Association Annual Training. MQA staff contributed to the association's vision by creating a robust network for sharing critical information on crime trends, intelligence data, education, and training. This involvement not only promoted the ULA Program but also strengthened collaborative efforts and knowledge exchange within the crime intelligence community. Events like this are paramount to the Department's mission: to protect, promote, and improve the health of all people in Florida. " " Q4 • Quarterly Performance Report • FY 2023-24 18
MQA funds its operations through the collection of licensing fees and fines from health care practitioners, as well as enforcement actions, per section 456.025(9), Florida Statutes. These revenues are allocated across the 22 regulatory boards and four councils responsible for overseeing daily licensing and enforcement tasks. By the end of Quarter Four, regulatory fines and fees totaled $891,205.25, with $414,405.48 successfully collected within the quarter. A portion of each practitioner's application fee, specifically $5, is allocated to support enforcement activities. Additional funding is generated through fines imposed for disciplinary actions. These financial resources are pooled into the MQA Trust Fund, which underpins the regulation of health care practitioners and facilities. Quarterly financial statements provide transparency and measure MQA's regulatory performance. In Quarter Four, MQA reported an overall cash balance of $40,876,335, earmarked for various initiatives including licensing, program administration, and promotional activities. This balance includes the opening amount for FY 2023-24, along with all revenue and expenditure details, culminating in the quarter's closing balance. FINANCIAL SUMMARY Q4 • Quarterly Performance Report • FY 2023-24 19
EMERGENCY ACTION An action taken by the State Surgeon General to suspend or restrict the ability to practice when a licensed health care practitioner poses an immediate and serious threat to the health, safety, and welfare of the public. EMERGENCY SUSPENSION ORDER (ESO) An order issued by the Department suspending the license of a practitioner. A practitioner may not practice in the state of Florida while under an emergency suspension order. EMERGENCY RESTRICTION ORDER (ERO) An order issued by the Department restricting the practice of a practitioner in the state of Florida under conditions specified by the Department. FINAL ORDER An order of a regulatory board or the Department outlining the finding of facts, and penalties in a disciplinary case against a licensee. The administrative complaint outlining the charges against the licensee is attached and becomes part of the final order when filed with the agency clerk. INVESTIGATIONS COMPLETED Investigations are initiated when a complaint is considered legally sufficient. All completed investigations are presented to the PSU with an Investigative Report and all documents related to the complaint. LEGALLY SUFFICIENT A complaint that contains ultimate facts that show that a violation of chapter 456.073(1), Florida Statutes, of any of the practice acts relating to the professions regulated by the department, or of any rule adopted by the department or a regulatory board in the department has occurred. MQA TRUST FUND UNLICENSED ACTIVITY FEE A $5 fee collected at initial and renewal licensing that funds the investigation and enforcement of unlicensed activities, according to Florida law. PROBABLE CAUSE A determination that there is a reasonable basis to suspect that a person has violated or is violating the law. QUALIFIED APPLICANT A qualified applicant has met all requirements to become licensed and may be licensed on the day an application has concluded processing. This is different from an approved applicant who may still have to pass an examination or meet an additional requirement outside of having an application approved. UNLICENSED ACTIVITY (ULA) Unauthorized practice of a health care profession or delivery of health care or medical services by an individual not in possession of a valid or active license to practice that could cause injury, disease, or death. GLOSSARY Q4 • Quarterly Performance Report • FY 2023-24 20
Allen Hall Dietetics and Nutrition, Electrolysis, Occupational Therapy, Physical Therapy, Psychology, Respiratory Care, and School Psychology 850-245-4374 Allen.Hall@flhealth.gov Traci Zeh Dentistry and Pharmacy 850-245-4507 Traci.Zeh@flhealth.gov Ashleigh Irving Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling, Athletic Training, Hearing Aid Specialists, Opticianry, Podiatric Medicine, Orthotists and Prosthetists, and Genetic Counseling 850-245-4462 Ashleigh.Irving@flhealth.gov Dayle Mooney Chiropractic Medicine, Clinical Laboratory Personnel, Nursing Home Administrators, Medical Physicists, Optometry, Radiologic Technologists, Emergency Medical Technicians and Paramedics 850-901-6830 Dayle.Mooney@flhealth.gov Joe Baker and Amanda Gray Nursing and Certified Nursing Assistants Joe Baker – 850-245-4158 Joe.Baker@flhealth.gov Amanda Gray – 850-245-4170 Amanda.Gray@flhealth.gov Paul Vazquez, JD Medical Doctors, Physician Assistants, Anesthesiologist Assistants, Office Surgery Registration, and Pain Management Clinic Registrations 850-245-4130 Paul.Vazquez@flhealth.gov Chase Wells Office of Veteran Licensure Services 850-245-4235 Chase.Wells@flhealth.gov Stephanie Webster Acupuncture, Massage Therapy, Midwifery, Osteopathic Medicine, and Speech-Language Pathology and Audiology 850-245-4162 Stephanie.Webster@flhealth.gov EXECUTIVE DIRECTORS MQA EXECUTIVE MANAGEMENT TEAM DIVISION DIRECTOR Jennifer L. Wenhold, MSW, CPM 850-245-4460 Jennifer.Wenhold@flhealth.gov CONTACT US For more information or to contact us, please visit MQA’s Virtual Agent, ELI, on the board and council websites. ELI uses artificial intelligence to improve the experience for health care applicants and practitioners by providing immediate information and suggestions and fielding inquiries outside of normal business hours through voice and online chat options. CHAT NOW Emily Roach, Chief Bureau of Operations 850-245-4064 Emily.Roach@flhealth.gov VACANT, Chief Bureau of Enforcement Jessica Nijem, Chief Bureau of Health Care Practitioner Regulation 850-245-4463 Jessica.Nijem@flhealth.gov Q4 • Quarterly Performance Report • FY 2023-24 21
4052 Bald Cypress Way, Bin C-00, Tallahassee, FL 32399-3250 www.FLHealthSource.gov MedicalQualityAssurance@flhealth.gov
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