§ 2-18-4. Definitions.

(a)

Acute pain is the normal, predicted physiological response to an adverse chemical, thermal or mechanical stimulus and is associated with surgery, trauma, or illness. It is generally short-lived. Acute pain responses may vary between patients and between pain episodes within an individual patient. Acute pain episodes may be present in patients with chronic pain.

(b)

Chronic pain means pain which includes one or more of the following characteristics: (a) the pain persists beyond the usual course of a disease that is the cause of the pain; (b) the pain persists beyond the expected time for healing from an injury or trauma that is the cause of the pain; or (c) the pain is associated with long-term incurable or intractable medical illness or disease. It is not amenable to routine pain control methods. Patients with chronic pain may have either continuous or intermittent pain, including episodes of acute pain related to disease progression or reoccurrence.

(c)

Code enforcement officer means any designated employee or agent of Manatee County whose duty it is to enforce codes and ordinances enacted by Manatee County, or designated employee or agent of the municipalities whose duty is to enforce codes and ordinances enacted by Manatee County. Employees or agents who may be code enforcement officers for purposes of this article may include, but are not limited to, code inspectors, nuisance abatement coordinators, law enforcement officers, animal control officers, building inspectors, or fire safety inspectors. Code enforcement officers shall be immune from prosecution, civil or criminal, for trespass upon real property while in the discharge of said duties.

(d)

Controlled substance means a controlled substance listed in Schedule II, Schedule III, or Schedule IV in Section 893.03, Florida Statutes, recognized as effective for pain relief such as, but not limited to, Buprenophine, Butorphenol, Codeine, Hydrocodone, Hydromorphone, Levorphanol, Methadone, Morphine, Oxycodone, Propoxyphene, and Fentanyl.

(e)

Department shall mean the department designated by the county administrator to administer the temporary mandate of this ordinance, or whatever regulatory scheme is subsequently enacted by a future ordinance.

(f)

Health care physician or physician means any practitioner who is subject to licensure or regulation by the Florida Department of Health under Chapter 458 (physician) or Chapter 459 (osteopathic physician), Florida Statutes.

(g)

Licensed medical professional means an individual who has successfully completed a prescribed program of study in a variety of health fields and who has obtained a license or certificate indicating his or her competence to practice in that field.

(i)

Operator means any person on the premises of a pain management clinic who puts or keeps the business in operation or who is authorized to manage the business or exercise overall operational control of the business premises. A person may be found to be an operator of a pain management clinic regardless of whether that person is an owner, part owner, or licensee of the business.

(j)

Opioids are any morphine-like synthetic narcotic that produces the same effects as drugs derived from the opium poppy (opiates), such as pain relief, sedation, constipation and respiratory depression.

(k)

Pain means an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Categories of pain include acute pain or chronic pain.

(l)

Pain management means the use of pharmacological and nonpharmacological interventions to control the patient's identified pain. Pain management often extends beyond pain relief, encompassing the patient's quality of life, ability to work productively, to enjoy recreation, and to function normally in family and society.

(m)

Pain management clinic and/or pain clinic means a privately owned pain management clinic, facility, or office, whatever its title, including, but not limited to, a "wellness center," "urgent care facility", or "detox center," which engages in pain management and holds itself out as providing, or advertises in any medium as providing, any type of pain management services and that the primary business purpose of such clinic, medical office, or practitioner's office is to prescribe or dispense pain medication including, but not limited to, opioids, including Fentanyl, Hydrocodone, Morphine, and Oxycodone, to individuals for payment by cash, check or charge; and includes an entity that employs a physician who is primarily engaged in the treatment of pain by prescribing or dispensing controlled substance medications, and is required to register with the Florida Department of Health pursuant to Section 458.309(4) or 459.005(3), Florida Statutes (2009), or any successor state law.

In determining whether a clinic, medical facility, practitioner's office, or pharmacy is a pain clinic or pain management clinic, the county administrator may also consider the following: whether it employs one or more physicians licensed under Chapter 458 or 459, Florida Statutes, who, in a single day, issues in excess of twenty-five (25) prescriptions for controlled substances for the treatment of pain; whether major medical insurance is accepted; whether the owner/operator is a physician; whether the medical director is board certified in pain medicine and; whether the owner/operator has been convicted of or has pled guilty or nolo contendere to, an offense that constitutes a felony or a misdemeanor which was related to, or included the distribution or illegal sale or prescription of a narcotic; and the percentage of patients of the pain management clinic residing out of state.

(n)

Permit shall mean a certificate issued by Manatee County acknowledging the submission and accurate completion of the pain management clinic registration forms required in order to conduct business in Manatee County as a pain management clinic.

(o)

Person means any individual, firm, partnership, joint venture, syndicate, or other group or combination acting as a unit, association, corporation, estate, trust, business trust, trustee, executor, administrator, receiver, or other fiduciary, and includes the plural as well as the singular.

(p)

Pharmacy shall mean the same as that term is defined in Section 465.003, Florida Statutes, as may be amended from time to time, and includes "community pharmacy," "internet pharmacy," and "special pharmacy," but does not include "institutional pharmacy" or "nuclear pharmacy," as each of those terms are used in that section.

(q)

Pill mill is an entity employing a doctor, a doctor, a clinic, or pharmacy that is prescribing or dispensing controlled substances inappropriately, unlawfully, or for nonmedical reasons and whose operations and practices do not comply with the requirements of federal law, Florida Statutes and regulations, or this article.

(r)

Probation means that the permittee may receive additional supervision by the department for a specific period of time as determined by the department but not exceeding the two-year term of the permit. Such supervision may include:

(1)

Shortening the reporting period of the permittee;

(2)

Increasing the information to be provided in each monthly report;

(3)

Restricting the days and hours of operation;

(4)

Making additional unannounced inspections of the premises.

(s)

Revocation means that the permit is terminated for the remainder of its term and the applicant may reapply at the conclusion of the revocation period.

(t)

Surgical services shall mean the practice that deals with the diagnosis and treatment of oral health, injury, deformity, and disease in which part of the body is entered by puncture or incision and treatment takes place through manual and instrumental means. This includes interventional pain management procedures such as spinal injections, spinal cord stimulators, intrathecal pumps, and similar medical procedures.

(u)

Suspension means that the permit may be suspended by the department for a period not to exceed three (3) months. After the suspension concludes, the permit is automatically reinstated for the remainder of its term but the permitted organization is still subject to any and all enforcement remedies e.g., probation, suspension, revocation on the occasion of any subsequent violation(s) of the terms of this article.

(Ord. No. 12-14, § 1, 3-27-12)