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1063 Zoning and Land Use MoratoriumORDINANCE NO. 1063 AN ORDINANCE OF THE CITY OF OKEECHOBEE, FLORIDA ENACTING A ONE YEAR MORATORIUM UPON THE ACCEPTANCE OF ZONING OR LAND USE AMENDMENTS, IN THE LAND DEVELOPMENT CODE, ORDINANCE 716, AND THE ISSUANCE OF BUSINESS TAX LICENSE UNDER CH. 50 CODE OF ORDINANCES, AND APPLICABLE REQUESTS FOR APPROVAL OF PAIN MANAGEMENT CLINICS, OR DRUG MANAGEMENT CLINICS, AS DEFINED HEREIN; WITHIN THE CITY OF OKEECHOBEE, FLORIDA; FURTHER PROVIDING FOR APPEAL AND REVIEW PROCESS; PROVIDING FOR CONFLICTS, SEVERABILITY; PROVIDING AN EFFECTIVE DATE. WHEREAS, it is commonly known in South Florida via news media; televised and newspaper reports; court records, and studies conducted in other Florida jurisdictions that pain management clinics, drug management clinics, or by whatever label is employed to conduct such business, that such businesses carry the reputation of being nothing more than "pill mills," or a means by which persons are able to fill multiple prescriptions for controlled substances and prescription pain medications from a licensed physician, without doctor patient interaction, examination or diagnosis; and WHEREAS, such clinics dispense thousands of pills to persons, including multiple dispensing of the same prescription by the patients' use of "doctor shopping," which is a felony offense in the State of Florida, and that the person often sells the pills to obtain money to again refill their own prescription, which attracts purchasers who travel from out of state; and WHEREAS, such clinics cause or have been associated with drug dependance by their "patients," including the death of patients who overdose by their drug dependency and the sheer volume of pills that are dispensed; and that criminal activity increases in areas where such clinics are located; and WHEREAS, in Chapter 2009 -198, Laws of Florida, the Legislature recognized that pharmaceutical drug diversion hurts this state significantly, in terms of lost lives, increased crime, human misery from addiction, increased medical costs and medicaid fraud; and WHEREAS, neighboring counties and municipalities are enacting moratoriums or ordinances strictly controlling and limiting such clinics, causing them to relocate to more rural locations, such as Okeechobee County, in search of venues with lax licensing and regulation, and; WHEREAS, the adoption of this moratorium will provide the City of Okeechobee an opportunity to develop strict regulations that address these secondary effects of Pain Management Clinics, and their impact on our community, and to protect the health and welfare of its citizens; NOW, THEREFORE, it is ordained before the City Council for the City of Okeechobee, Florida; presented at a duly advertised public meeting; and passed by majority vote of the City Council; and properly executed by the Mayor or designee, as Chief Presiding Officer for the City, as follows: THAT, the terms herein or referenced in this ordinance shall have the following meanings: Ordinance No. 1063 Page 1 of 3 1. MEDICAL OR DENTAL OFFICE. An establishment where patients, who are not lodged overnight, are admitted for examination or treatment by persons practicing any form of healing, or health related services, whether such persons be medical doctors, chiropractors, osteopaths, chiropodists, naturopaths, optometrist, dentists, or any such professions; who adopt and perform a standard of practice similar to that described herein; the practice of which is lawful in the State of Florida, and who are licensed under F.S. Chapter 395, 400, 458, or applicable statutes. A Pain Management Clinic, or drug management clinic, or such other clinic that does not qualify under this section, shall not be considered a medical or dental office. 2. PAIN MANAGEMENT CLINIC. All privately owned Pain Management Clinics, facilities, or offices, which advertise in any medium for any type of pain management services, or employ a physician who is primarily engaged in the treatment of pain by prescribing or dispensing controlled substances as defined under F.S. Chapter 893 or elsewhere, and are required to register with the Florida Department of Health pursuant to F.S. 458 or 459. A physician is primarily engaged in the treatment of pain by prescribing or dispensing controlled substance medications when the majority of the patients seen are prescribed or dispensed controlled substances for the treatment of chronic nonmalignant pain, without significant doctor patient interaction, examination and diagnosis, and which clinics do not adopt a standard of practice similar to that defined herein. Chronic nonmalignant pain is pain unrelated to cancer, which persists (1) beyond the usual course of the disease or the injury that is the cause of the pain, or (2) more than 90 days after surgery. 3. AUTHORIZED STANDARD OF PRACTICE. It is recognized that there exists a need for legitimate pain management for patients with chronic nonmalignant pain, and at such time as the City adopts an ordinance regulating Pain Management Clinics, for such legitimate Pain Management Clinics, the standards of practice would include, but are not limited to, a complete medical history and physical examination be conducted and documented in the medical records prior to commencement of any treatment. The medical record would document the nature and intensity of the pain, current and past treatments for pain, underlying or coexisting diseases or conditions, the effect of the pain on physical and psychological function, a review of prior medical records, previous diagnostic studies, and history of alcohol and substance abuse. The medical record would also document the presence of one or more recognized medical indications for the use of a controlled substance. Prior to prescribing or dispensing controlled substances, the patients' records must include a diagnosis made within 60 days prior to the presentation of the patient at the office of the clinic, by a licensed physician not practicing, or having any financial or ownership interest in the Pain Management Clinic, or there exists a written referral for treatment by a Florida Licensed Physician not practicing, or having any financial or ownership interest in the clinic, which was provided within 60 days prior to presentation of the patient at the clinic. 4. THAT, the intent of this ordinance is to prohibit the establishment of Pain Management Clinics within the City of Okeechobee for a period of one year from adoption, to protect the public against illegitimate and dangerous practices in the prescribing and dispensing of controlled substances, but not to prohibit the legal prescribing and dispensing of controlled substances by legitimate offices of medical providers licensed under Florida law, or pharmacies. Ordinance No. 1063 Page 2 of 3 5. THAT, for any such applicant who hereafter applies for a land use or zoning change, and application for business tax license to locate and establish a licensed medical facility that seeks to dispenses controlled substances, such application shall include not only the general information necessary for purposes of the Building Department and Department of General Services, but include proposed standards of practice for its patients as defined herein, in order for the City to determine if the proposed business is indeed a legitimate entity and not a Pain Management Clinic. 6. THAT, if during the period of this moratorium, the City denies issuance of a Land use or Zoning change, and Business Tax License for a facility that it considers a Pain Management Clinic, such applicant may appeal the decision to the City Administrator. The administrator shall review the applicants' information, including standards of practice, to determine the nature of the proposed business, provide the applicant a meeting to discuss the issues, and render a decision as to whether the City has properly denied the application as a prohibited Pain Management Clinic. 7. THAT, all laws or ordinances in conflict with any provisions of this ordinance are hereby repealed to the extent of such conflict. 8. THAT, if any section, paragraph, sentence, clause, phrase, word, definition, or any other item contained in this ordinance is for any reason held by the court to be unconstitutional, inoperative, void or otherwise invalid, the balance shall remain in effect and such holding shall not affect the remainder of this ordinance. 9. THAT, the City of Okeechobee reserves the right, upon public notice, to extend, modify, or otherwise amend this moratorium from time to time in its sole discretion, to serve a municipal purpose. 10. THAT, this Ordinance shall become effective upon adoption. INTRODUCED for first reading and set for final 2010. ATTEST: Lane Gamiote. CMC, City Clerk ATTEST: PASSED AND ADOPTED after Second and Fin. Lane` Gamiotea, CMC, City Clerk REVIEWED FO EGA SUF ICIENCY: John R. Cook, City Attorney Ordinance No. 1063 Page 3 of 3 hearing on this 20 day of April, 9 James E. Kirk, Mayor lic Hearing this 4th day of May, 2010. James E. Kirk, Mayor