§ 86-133. Application.

(a)

Application required. Any high prescribing health clinic operating in Pinellas County shall file a sworn application created by the department, which shall contain at least the following information:

(1)

Applicants that are registered with the state department of health as of the effective date of the ordinance from which this article derives as required by F.S. § 458.309 or § 459.005, or any successor state law, shall provide proof of current registration, including copy of the applicant's state application form, including all information required for the state department of health registration.

(2)

A sworn statement by the clinic owner and medical director attesting to the veracity and accuracy of the information provided in the application.

(3)

A typewritten, signed and notarized application that shall include the post office address of the applicant and the property owner. The application shall not be signed by an authorized agent.

(4)

A statement including the following information:

i.

The professional license numbers of the medical director, including DEA number;

ii.

A list of all persons associated with the management or operation of the high prescribing health clinic whether paid or unpaid, part time or full time. The list must include, but is not limited to, all owners, operators, physicians, physicians' assistants, employees or authorized agents;

iii.

For persons listed, the following information must be provided: title; current home address; telephone numbers and date of birth; all criminal convictions whether misdemeanor or felony; photocopy of current Florida driver's license; and

iv.

For physicians, physicians assistants, medical director, office managers, and owners, a fingerprint card completed at the Pinellas County Sheriff's Office must be included.

(5)

Information provided in the application shall be updated within ten days of any changes to the application associated with the high prescribing health clinic.

(6)

That no employees of the facility have been convicted of a drug-related felony within the five-year period to the date of application.

(7)

That the high prescribing health clinic will not knowingly employ any such convicted felons.

(8)

A floor plan of the high prescribing health clinic showing the location and size of the waiting area, location of and size of the patient rooms and location and type of diagnostic equipment.

(b)

Incomplete application. If the application for a high prescribing health clinic permit is not properly completed, the department shall notify in writing the person designated for service in the application. This notification shall explain the reason the department has determined the application to be incomplete. The applicant shall have 15 days from the date of such notification to properly complete the application. Failure to respond within 15 days to a request for information necessary to complete the application shall result in a denial of the application.

(c)

Any person with multiple physical business locations shall submit a separate registration for each business location.

(d)

Time period for granting or denying.

(1)

The department shall grant a new or renewal high prescribing health clinic permit within 30 days from the date of its proper filing provided the applicant is registered with the state department of health pursuant to F.S. § 458.309 or § 459.005, or any successor state law, as of the effective date of the ordinance from which this article derives unless there exists a basis for denial of the permit.

(2)

The director or his or her designee shall mail a notice of intent to deny a high prescribing health clinic permit within 15 days from the date of its filing.

(3)

The director shall send a notice of denial based on any of the grounds set forth herein.

(4)

Any applicant who received a notice of denial of a high prescribing health clinic permit may request a hearing before the director of the department within 15 days of the date of the mailing of the notice of denial. The director shall set a date for the requested hearing and decide whether to maintain the denial within 15 days of receipt of the request for hearing.

(e)

Granting of permit. If there is no basis for denial of a high prescribing health clinic permit pursuant to the criteria set forth herein, the department shall grant the permit, notify the applicant and issue the permit to the applicant.

(f)

Denial of permit. The department shall deny a high prescribing health clinic permit on the basis of any one of the following grounds:

(1)

An applicant has submitted an application which contains material false information.

(2)

An applicant has had a registration issued under either F.S. § 458.309 or § 459.005 suspended or revoked.

(3)

An applicant has submitted an incomplete application.

(4)

The owner or physician has been convicted of violating a pain management ordinance in any city, county or state.

(5)

The facility is owned by or has any contractual or employment relationship with a physician:

i.

Whose drug enforcement administration number has ever been revoked.

ii.

Whose application for a license to prescribe, dispense or administer a controlled substance has been denied, revoked, voluntarily relinquished, or otherwise encumbered due to final disciplinary actions of the state or by any jurisdiction.

iii.

Who has been convicted of or plead guilty within the last five years to an offense that constitutes a felony for receipt of illicit and diverted drugs, including any controlled substance listed in Schedule I, Schedule II, Schedule III, Schedule IV or Schedule V of F.S. § 893.03, or any other state, or the United States. Physicians shall not be subject to this provision if their conviction or plea occurred more than five years prior to the application.

(g)

Application fee. Each application for a high prescribing health clinic permit shall be accompanied by a nonrefundable $250.00 application fee to offset the cost of processing the application. Any changes to the application fees authorized by this article shall be accomplished by resolution of the county commissioners.

(h)

Tolling of time. The time allotted for obtaining a high prescribing health clinic permit shall be tolled during the pendency of any final determination by the director based on a denial of a permit application.

(Ord. No. 10-26, § 9, 5-4-10; Ord. No. 10-45, §§ 2—5, 9-28-10; Ord. No. 11-44, § 6, 11-8-11; Ord. No. 12-19, § 6, 5-8-12; Ord. No. 14-37, § 2, 9-23-14)