Senate Bill 1036c1

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    Florida Senate - 1998                           CS for SB 1036

    By the Committee on Health Care and Senators Brown-Waite and
    Latvala




    317-1994A-98

  1                      A bill to be entitled

  2         An act relating to emergency management

  3         planning; amending s. 20.43, F.S.; defining

  4         responsibilities of the county health

  5         departments in providing assistance to local

  6         special needs units or shelters; authorizing

  7         the Department of Health to adopt rules;

  8         amending s. 252.355, F.S.; revising provisions

  9         relating to registration of persons requiring

10         special needs assistance in emergencies;

11         amending ss. 400.497 and 400.610, F.S.;

12         providing minimum requirements for home health

13         agency and hospice comprehensive emergency

14         management plans; providing for plan review by

15         the local emergency management agency and other

16         specified entities; requiring the adoption of

17         rules establishing plan components and

18         standards for care and services to be provided

19         in emergency evacuation and sheltering;

20         providing for certain exemptions; amending s.

21         408.15, F.S.; authorizing the Agency for Health

22         Care Administration to establish certain

23         standards of care; creating a special needs

24         shelter interagency committee within the

25         Department of Community Affairs; providing

26         committee tasks; requiring reports; providing

27         an effective date.

28

29  Be It Enacted by the Legislature of the State of Florida:

30

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1         Section 1.  Subsection (5) of section 20.43, Florida

  2  Statutes, is amended to read:

  3         20.43  Department of Health.--There is created a

  4  Department of Health.

  5         (5)(a)  The department shall plan and administer its

  6  public health programs through its county health departments

  7  and may, for administrative purposes and efficient service

  8  delivery, establish up to 15 service areas to carry out such

  9  duties as may be prescribed by the secretary. The boundaries

10  of the service areas shall be the same as, or combinations of,

11  the districts of the health and human services boards

12  established in s. 20.19 and, to the extent practicable, shall

13  take into consideration the boundaries of the jobs and

14  education regional boards.

15         (b)  The county health department shall coordinate with

16  local medical and health care providers, the American Red

17  Cross, and other interested parties in developing and

18  implementing the plan for the management, operation,

19  logistics, and staffing of special needs units or shelters.

20  The county health department shall, in conjunction with the

21  local emergency management agency, coordinate recruitment of

22  medical personnel to staff local special needs units or

23  shelters. During times of emergency or major disaster, the

24  county health department shall assist the local emergency

25  management agency in the operation of the special needs units

26  or shelters. The Department of Health may promulgate, adopt,

27  and enforce all rules necessary to implement this paragraph.

28         Section 2.  Subsections (1) and (3) of section 252.355,

29  Florida Statutes, are amended to read:

30         252.355  Registry of disabled persons with special

31  needs; notice.--

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1         (1)  In order to meet the special needs of persons who

  2  would need assistance during evacuations and sheltering

  3  because of physical, mental, or sensory disabilities or mental

  4  handicaps, each local emergency management agency in the state

  5  shall maintain a registry of disabled persons with special

  6  needs located within the jurisdiction of the local agency.

  7  The registration shall identify those persons in need of

  8  assistance and plan for resource allocation to meet those

  9  identified needs. To assist the local emergency management

10  agency in identifying such persons, the Department of Children

11  and Family Services, Department of Health, and Department of

12  Elderly Affairs Health and Rehabilitative Services shall

13  provide registration information to all of their its special

14  needs clients and to all incoming clients as a part of the

15  intake process.  The registry shall be updated annually.  The

16  registration program shall give disabled persons with special

17  needs the option of preauthorizing emergency response

18  personnel to enter their homes during search and rescue

19  operations if necessary to assure their safety and welfare

20  following disasters.

21         (3)  All records, data, information, correspondence,

22  and communications relating to the registration of disabled

23  persons with special needs as provided in subsection (1) are

24  confidential and exempt from the provisions of s. 119.07(1),

25  except that such information shall be available to other

26  emergency response agencies, as determined by the local

27  emergency management director.

28         Section 3.  Subsection (1) of section 400.497, Florida

29  Statutes, is amended, and subsection (11) is added to said

30  section, to read:

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1         400.497  Rules establishing minimum standards.--The

  2  Agency for Health Care Administration shall adopt, publish,

  3  and enforce rules to implement this part, including, as

  4  applicable, ss. 400.506 and 400.509, which must provide

  5  reasonable and fair minimum standards relating to:

  6         (1)  Scope of home health services to be provided,

  7  which shall include services to be provided during emergency

  8  evacuation and sheltering.

  9         (11)(a)  The preparation and annual update of a

10  comprehensive emergency management plan. Home health agencies

11  must plan to continue to provide skilled nursing services

12  during times of emergency or major disaster. To accomplish

13  this, each home health agency must prepare a comprehensive

14  emergency management plan. The Agency for Health Care

15  Administration shall adopt rules establishing minimum criteria

16  for the plan after consultation with the Department of

17  Community Affairs. This requirement does not apply to:

18         1.  A facility that is certified under chapter 651 and

19  has a licensed home health agency used exclusively by the

20  residents of the facility; or

21         2.  A retirement community that consists of residential

22  units for independent living and either a licensed nursing

23  home or an assisted living facility, and has a licensed home

24  health agency used exclusively by the residents of the

25  retirement community;

26

27  provided the comprehensive emergency management plan for the

28  facility or retirement community provides for continuous care

29  of all residents with special needs during an emergency.

30         (b)  At a minimum, the rules must provide for plan

31  components that address client education on personal disaster

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1  preparedness; client awareness of the special needs

  2  registration, evacuation, and shelter process; registration of

  3  clients requiring public assistance; preparation of the agency

  4  offices and staff; plans for coordinating with other agencies

  5  to provide continuity of skilled nursing care to clients

  6  during disaster impact; provisions for continuing skilled

  7  nursing services for home health clients evacuated to special

  8  needs units or shelters, to include providing home health care

  9  staff to special needs units or shelters, to the extent

10  reasonably possible; transfer of medical records or

11  information on home health clients evacuated to special needs

12  units or shelters, if the location is known to the home health

13  agency; and postimpact delivery of services, to include

14  resumption of care and, to the extent possible, expansion of

15  services to accept new client referrals as a result of the

16  disaster.

17         (c)  The plan is subject to review and approval by the

18  local emergency management agency. During its review, the

19  local emergency management agency shall ensure that the

20  following agencies, at a minimum, are given the opportunity to

21  review the plan:

22         1.  Department of Elderly Affairs.

23         2.  County health department.

24         3.  Agency for Health Care Administration.

25         4.  Local chapter of the American Red Cross or other

26  lead sheltering agency.

27         5.  Department of Children and Family Services.

28

29  The local emergency management agency shall complete its

30  review within 60 days after receipt of the plan and shall

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1  either approve the plan or advise the home health agency of

  2  necessary revisions.

  3         Section 4.  Paragraph (b) of subsection (1) of section

  4  400.610, Florida Statutes, is amended to read:

  5         400.610  Administration and management of a hospice.--

  6         (1)  A hospice shall have a clearly defined organized

  7  governing body, consisting of a minimum of seven persons who

  8  are representative of the general population of the community

  9  served. The governing body shall have autonomous authority and

10  responsibility for the operation of the hospice and shall meet

11  at least quarterly.  The governing body shall:

12         (b)  Prepare and annually update a comprehensive

13  emergency management plan which ensures that the hospice will

14  continue to provide an acceptable level of care during times

15  of emergency or major disaster. The department shall adopt

16  rules establishing minimum criteria for the plan after

17  consultation with the Department of Community Affairs. Prepare

18  a disaster preparedness plan.

19         1.  At a minimum, the rules must provide for plan

20  components that address client education on personal disaster

21  preparedness; client awareness of the special needs

22  registration, evacuation, and shelter process; registration of

23  clients requiring public assistance; preparation of the agency

24  offices and staff; plans for providing continuity of care to

25  clients during disaster impact; provisions for caring for

26  hospice clients evacuated to special needs units or shelters,

27  to include providing hospice staff to special needs units or

28  shelters; identification and tracking of clients, to include

29  the transfer of medical records; responding to family

30  inquiries; and postimpact delivery of services, to include

31  resumption of care, facilitating the clients' return to the

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1  home environment, facilitating referral to residential care

  2  facilities for clients unable to return home, and expansion of

  3  services to accept new client referrals as a result of the

  4  disaster.

  5         2.  The plan is subject to review and approval by the

  6  local emergency management agency. During its review, the

  7  local emergency management agency shall ensure that the

  8  following agencies, at a minimum, are given the opportunity to

  9  review the plan:

10         a.  Department of Elderly Affairs.

11         b.  County health department.

12         c.  Agency for Health Care Administration.

13         d.  Local chapter of the American Red Cross or other

14  lead sheltering agency.

15         e.  Department of Children and Family Services.

16

17  The local emergency management agency shall complete its

18  review within 60 days after receipt of the plan and shall

19  either approve the plan or advise the hospice of necessary

20  revisions.

21         Section 5.  Subsection (12) is added to section 408.15,

22  Florida Statutes, to read:

23         408.15  Powers of the agency.--In addition to the

24  powers granted to the agency elsewhere in this chapter, the

25  agency is authorized to:

26         (12)  Establish, in coordination with the Department of

27  Health, uniform standards of care to be provided in special

28  needs units or shelters during times of emergency or major

29  disaster.

30         Section 6.  (1)  There is created within the Department

31  of Community Affairs a special needs shelter interagency

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1  committee, to be chaired and staffed by the department.  The

  2  committee is directed to resolve those special needs

  3  sheltering problems and issues not addressed in the state

  4  comprehensive emergency management plan, and to serve as an

  5  oversight committee to monitor the effectiveness of an

  6  implemented special needs sheltering program.  The specific

  7  tasks for the committee are to:

  8         (a)  Establish clear roles and responsibilities of

  9  state agencies and other organizations necessary to implement

10  the program on or before January 1, 1999.

11         (b)  Identify those issues requiring additional

12  legislation and funding on or before January 1, 1999.

13         (c)  Determine the need for local or county advisory

14  committees to work with the appropriate local agencies and

15  staff.

16         (d)  Propose and negotiate any necessary interagency

17  agreements.

18         (e)  Provide ongoing evaluation, recommendations, and

19  monitoring to the program administrator and submit a 6-month

20  report to the Legislature. Thereafter, reports shall be

21  submitted to the Legislature annually.

22         (2)  The special needs shelter interagency committee

23  shall be composed of representatives of emergency management,

24  health, medical, and social services organizations. Membership

25  shall include at least one representative from the following

26  agencies and entities:  Department of Community Affairs,

27  Department of Health, Department of Children and Family

28  Services, Agency for Health Care Administration, Department of

29  Elderly Affairs, Department of Education, Department of Labor

30  and Employment Security, Associated Home Health Industries of

31  Florida, Inc., Florida Nurses Association, Florida Health Care

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    Florida Senate - 1998                           CS for SB 1036
    317-1994A-98




  1  Association, Florida Hospital Association, Florida Homes for

  2  the Aging, Association of Community Hospitals and Health

  3  Systems, Florida League of Health Systems, and the Salvation

  4  Army.

  5         (3)  Headquarters for committee meetings shall be in

  6  Tallahassee, with the Division of Emergency Management of the

  7  Department of Community Affairs determining the exact meeting

  8  locations. Members of the committee shall serve at the expense

  9  of the agencies or organizations they represent.

10         Section 7.  This act shall take effect October 1, 1998.

11

12          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
13                         Senate Bill 1036

14

15  Revises the responsibilities of county health departments with
    regard to special needs units or shelters specific to: overall
16  coordination, coordination of staffing, and Department of
    Health rulemaking.
17
    Provides an exception to home health agency emergency
18  management planning requirements for continuing care
    retirement communities licensed under ch. 651, F.S., and for
19  independent living retirement communities.

20  Revises emergency management plan requirements for home health
    agencies specific to coordination with other agencies and the
21  provision of continuing services.

22  Revises emergency management plan requirements for hospices
    specific to expansion of services to accept new client
23  referrals as a result of the disaster.

24  Amends s. 408.15, F.S., rather than 408.034, F.S., to require
    the Agency for Health Care Administration to coordinate with
25  the Department of Health in establishing uniform standards of
    care.
26
    Creates within the Department of Community Affairs a special
27  needs shelter interagency committee, with specific tasks,
    duties, and membership.
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