CODING: Words stricken are deletions; words underlined are additions.

Senate Bill 0294

Florida Senate - 1998 SB 294 By Senators Brown-Waite and Forman 10-130A-98 See HB 1 A bill to be entitled 2 An act relating to home medical equipment 3 providers; creating part IX of chapter 400, 4 F.S.; providing for regulation of home medical 5 equipment providers by the Agency for Health 6 Care Administration; providing legislative 7 intent; providing definitions; providing for 8 licensure and exemptions; providing unlawful 9 acts; providing penalties; providing for 10 license applications; providing for fees; 11 providing for background screening; providing 12 for provisional licenses and temporary permits; 13 providing for administrative penalties; 14 providing for injunctions, emergency orders, 15 and moratoriums; providing for licensure 16 inspections and investigations; providing 17 minimum standards; providing for agency rules; 18 providing for patient records; providing for 19 notice of toll-free telephone number for the 20 central abuse registry; providing for 21 background screening of home medical equipment 22 provider personnel; providing penalties; 23 providing screening procedures; providing for 24 agency injunctions; prohibiting patient 25 referrals and rebates; providing for 26 application of the act to existing providers; 27 providing an appropriation; providing an 28 effective date. 29 30 Be It Enacted by the Legislature of the State of Florida: 31 1 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 Section 1. Part IX of chapter 400, Florida Statutes, 2 consisting of sections 400.81, 400.815, 400.82, 400.821, 3 400.822, 400.823, 400.824, 400.825, 400.83, 400.84, 400.843, 4 400.845, 400.85, and 400.86, is created to read: 5 400.81 Legislative intent.--It is the intent of the 6 Legislature to provide for the licensure of every home medical 7 equipment provider and to provide for the development, 8 establishment, and enforcement of basic standards that will 9 ensure quality services to persons receiving home medical 10 equipment. 11 400.815 Definitions.--As used in this chapter, the 12 term: 13 (1) "Accrediting organizations" means the Joint 14 Commission on Accreditation of Healthcare Organizations or 15 other national accreditation agencies whose standards for 16 accreditation are comparable to those required by this part 17 for licensure. 18 (2) "Affiliated person" means any person who directly 19 or indirectly manages, controls, or oversees the operation of 20 a corporation or other business entity that is a licensee, 21 regardless of whether such person is a partner, shareholder, 22 owner, officer, director, agent, or employee of the entity. 23 (3) "Agency" means the Agency for Health Care 24 Administration. 25 (4) "Applicant" means an individual applicant in the 26 case of a sole proprietorship, or any officer, director, 27 agent, managing employee, general manager, or affiliated 28 person, or any partner or shareholder having an ownership 29 interest equal to 5 percent or greater in the corporation, 30 partnership, or other business entity. 31 2 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (5) "Consumer" or "patient" means any person who uses 2 home medical equipment in his or her place of residence. 3 (6) "Department" means the Department of Children and 4 Family Services. 5 (7) "General manager" means the individual who has the 6 general administrative charge of the premises of a licensed 7 home medical equipment provider. 8 (8) "Home medical equipment" includes any product as 9 defined by the Federal Drug Administration's Drugs, Devices 10 and Cosmetics Act, any products reimbursed under the Medicare 11 Part B Durable Medical Equipment benefits, or any products 12 reimbursed under the Florida Medicaid durable medical 13 equipment program. Home medical equipment includes, but is not 14 limited to, oxygen and related respiratory equipment. Home 15 medical equipment includes customized wheelchairs and related 16 seating and positioning, but does not include prosthetics or 17 orthotics or any splints, braces, or aids custom fabricated by 18 a licensed health care practitioner. 19 (9) "Home medical equipment provider" means any person 20 or entity that sells or rents or offers to sell or rent to or 21 for a consumer: 22 (a) Any home medical equipment and services; or 23 (b) Home medical equipment that requires any home 24 medical equipment services. 25 (10) "Home medical equipment provider personnel" means 26 persons who are employed by or under contract with a home 27 medical equipment provider. 28 (11) "Home medical equipment services" means equipment 29 management and consumer instruction, including selection, 30 delivery, setup, and maintenance of equipment, and other 31 3 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 related services for the use of home medical equipment in the 2 consumer's regular or temporary place of residence. 3 (12) "Licensee" means the person or entity to whom a 4 license to operate as a home medical equipment provider is 5 issued by the agency. 6 (13) "Moratorium" means a mandated temporary cessation 7 or suspension of the sale, rental, or offering of equipment 8 after the imposition of the moratorium. Services related to 9 equipment sold or rented prior to the moratorium must be 10 continued without interruption, unless deemed otherwise by the 11 agency. 12 (14) "Person" means any individual, firm, partnership, 13 corporation, or association. 14 (15) "Premises" means those buildings and equipment 15 which are located at the address of the licensed home medical 16 equipment provider for the provision of home medical equipment 17 services, which are in such reasonable proximity as to appear 18 to the public to be a single provider location, and which 19 comply with zoning ordinances. 20 (16) "Residence" means the consumer's home or place of 21 residence, which may include nursing homes, assisted living 22 facilities, transitional living facilities, adult family-care 23 homes, or other congregate residential facilities. 24 400.82 Home medical equipment providers to be 25 licensed; expiration of license; exemptions; unlawful acts; 26 penalties.-- 27 (1) Any person or entity that holds itself out to the 28 public as providing home medical equipment and services or 29 accepts physician orders for home medical equipment and 30 services is subject to licensure under this part. 31 4 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (2) Any person or entity that holds itself out to the 2 public as providing home medical equipment that typically 3 requires home medical services is subject to licensure under 4 this part. 5 (3) A home medical equipment provider must be licensed 6 by the agency to operate in this state or to provide home 7 medical equipment and services to consumers in this state. A 8 standard license issued to a home medical equipment provider, 9 unless sooner suspended or revoked, expires 2 years after its 10 effective date. 11 (4) A separate license is required of all home medical 12 equipment providers operating on separate premises, even if 13 the providers are operated under the same management. 14 (5) The following are exempt from home medical 15 equipment provider licensure, unless they have a separate 16 company, corporation, or division that is in the business of 17 providing home medical equipment and services for sale or rent 18 to consumers at their regular or temporary place of residence 19 pursuant to the provisions of this part: 20 (a) Providers operated by the Federal Government. 21 (b) Nursing homes licensed under part II. 22 (c) Home health agencies licensed under part IV. 23 (d) Hospices licensed under part VI. 24 (e) Intermediate care facilities, homes for special 25 services, and transitional living facilities licensed under 26 part VIII. 27 (f) Hospitals and ambulatory surgical centers licensed 28 under chapter 395. 29 (g) Manufacturers and wholesale distributors when not 30 selling directly to consumers. 31 5 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (h) Licensed health care practitioners who utilize 2 home medical equipment in the course of their practice, but do 3 not sell or rent home medical equipment to their patients. 4 (i) Pharmacies licensed under chapter 465. 5 (6)(a) It is unlawful for any person to offer or 6 advertise home medical equipment and services to the public 7 unless he or she has a valid license under this part. It is 8 unlawful for any holder of a license issued under this part to 9 advertise or indicate to the public that it holds a home 10 medical equipment provider license other than the one it has 11 been issued. 12 (b) A person who violates paragraph (a) is subject to 13 an injunctive proceeding under s. 400.85. A violation of 14 paragraph (a) is a deceptive and unfair trade practice and 15 constitutes a violation of the Florida Deceptive and Unfair 16 Trade Practices Act. 17 (c) A person who violates paragraph (a) commits a 18 misdemeanor of the second degree, punishable as provided in s. 19 775.082 or s. 775.083. A person who commits a second or 20 subsequent violation commits a misdemeanor of the first 21 degree, punishable as provided in s. 775.082 or s. 775.083. 22 Each day of continuing violation constitutes a separate 23 offense. 24 (d) The following penalties shall be imposed for 25 operating an unlicensed home medical equipment provider: 26 1. Any person or entity who operates an unlicensed 27 provider commits a felony of the third degree. 28 2. For any person or entity who has received 29 government reimbursement for services provided by an 30 unlicensed provider, the agency shall make a fraud referral to 31 the appropriate government reimbursement program. 6 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 3. For any licensee found to be concurrently operating 2 licensed and unlicensed provider premises, the agency may 3 impose a fine or moratorium, or revoke existing licenses of 4 any or all of the licensee's licensed provider locations until 5 such time as the unlicensed provider premises is licensed. 6 (e) A provider found to be operating without a license 7 may apply for licensure, and must cease operations until a 8 license is awarded by the agency. 9 400.821 Application for license; fee; provisional 10 license; temporary permit.-- 11 (1) Application for an initial license or for renewal 12 of an existing license must be made under oath to the agency 13 on forms furnished by it and must be accompanied by the 14 appropriate license fee as provided in subsection (12). 15 (2) The applicant must file with the application 16 satisfactory proof that the home medical equipment provider is 17 in compliance with this part and applicable rules, including: 18 (a) A report, by category, of the equipment to be 19 provided, indicating those offered either directly by the 20 applicant or through contractual arrangements with existing 21 providers. Categories of equipment include: 22 1. Respiratory modalities. 23 2. Ambulation aids. 24 3. Mobility aids. 25 4. Sickroom setup. 26 5. Disposables. 27 (b) A report, by category, of the services to be 28 provided, indicating those offered either directly by the 29 applicant or through contractual arrangements with existing 30 providers. Categories of services include: 31 1. Intake. 7 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 2. Equipment selection. 2 3. Delivery. 3 4. Setup and installation. 4 5. Patient training. 5 6. Ongoing service and maintenance. 6 7. Retrieval. 7 (c) A listing of those with whom the applicant 8 contracts, both the providers the applicant uses to provide 9 equipment or services to its consumers and the providers for 10 whom the applicant provides services or equipment. 11 (3) The applicant for initial licensure must 12 demonstrate financial ability to operate, which may be 13 accomplished by the submission of a $50,000 surety bond to the 14 agency. 15 (4) An applicant for renewal who has demonstrated 16 financial inability to operate must demonstrate financial 17 ability to operate. 18 (5) Each applicant for licensure must comply with the 19 following requirements: 20 (a) Upon receipt of a completed, signed, and dated 21 application, the agency shall require background screening of 22 the applicant, in accordance with the level 2 standards for 23 screening set forth in chapter 435. As used in this 24 subsection, the term "applicant" means the general manager and 25 the financial officer or similarly titled individual who is 26 responsible for the financial operation of the licensed 27 facility. 28 (b) The agency may require background screening for a 29 member of the board of directors of the licensee or an officer 30 or an individual owning 5 percent or more of the licensee if 31 the agency reasonably suspects that such individual has been 8 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 convicted of an offense prohibited under the level 2 standards 2 for screening set forth in chapter 435. 3 (c) Proof of compliance with the level 2 background 4 screening requirements of chapter 435 which has been submitted 5 within the previous 5 years in compliance with any other 6 health care licensure requirements of this state is acceptable 7 in fulfillment of paragraph (a). 8 (d) Each applicant must submit to the agency, with its 9 application, a description and explanation of any exclusions, 10 permanent suspensions, or terminations of the applicant from 11 the Medicare or Medicaid programs. Proof of compliance with 12 disclosure of ownership and control interest requirements of 13 the Medicaid or Medicare programs shall be accepted in lieu of 14 this submission. 15 (e) Each applicant must submit to the agency a 16 description and explanation of any conviction of an offense 17 prohibited under the level 2 standards of chapter 435 by a 18 member of the board of directors of the applicant, its 19 officers, or any individual owning 5 percent or more of the 20 applicant. This requirement does not apply to a director of a 21 not-for-profit corporation or organization if the director 22 serves solely in a voluntary capacity for the corporation or 23 organization, does not regularly take part in the day-to-day 24 operational decisions of the corporation or organization, 25 receives no remuneration for his or her services on the 26 corporation's or organization's board of directors, and has no 27 financial interest and has no family members with a financial 28 interest in the corporation or organization, provided that the 29 director and the not-for-profit corporation or organization 30 include in the application a statement affirming that the 31 9 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 director's relationship to the corporation satisfies the 2 requirements of this provision. 3 (f) A license may not be granted to any potential 4 licensee if any applicant, administrator, or financial officer 5 has been found guilty of, regardless of adjudication, or has 6 entered a plea of nolo contendere or guilty to, any offense 7 prohibited under the level 2 standards for screening set forth 8 in chapter 435, unless an exemption from disqualification has 9 been granted by the agency as set forth in chapter 435. 10 (g) The agency may deny or revoke licensure to any 11 potential licensee if any applicant: 12 1. Has falsely represented a material fact in the 13 application required by paragraphs (d) and (e), or has omitted 14 any material fact from the application required by paragraphs 15 (d) and (e); or 16 2. Has had prior Medicaid or Medicare action taken 17 against the applicant as set forth in paragraph (d). 18 (h) Upon licensure renewal, each applicant must submit 19 to the agency, under penalty of perjury, an affidavit of 20 compliance with the background screening provisions of this 21 section. 22 (6) The home medical equipment provider must also 23 obtain and maintain professional and commercial liability 24 insurance. Proof of liability insurance, as defined in s. 25 624.605, must be submitted with the application. The agency 26 shall set the required amounts of liability insurance by rule, 27 but the required amount must not be less than $250,000 per 28 claim. In the case of contracted services, it is required that 29 the contractor have liability insurance not less than $250,000 30 per claim. 31 10 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (7) A provisional license shall be issued to an 2 approved applicant for initial licensure for a period of 90 3 days, during which time a survey must be conducted 4 demonstrating substantial compliance with this section. A 5 provisional license shall also be issued pending the results 6 of an applicant's Federal Bureau of Investigation report of 7 background screening confirming that all standards have been 8 met. If substantial compliance is demonstrated, a standard 9 license shall be issued to expire 2 years after the effective 10 date of the provisional license. 11 (8) Ninety days before the expiration date, an 12 application for license renewal must be submitted to the 13 agency under oath on forms furnished by the agency, and a 14 license shall be renewed if the applicant has met the 15 requirements established under this part and applicable rules. 16 The home medical equipment provider must file with the 17 application satisfactory proof that it is in compliance with 18 this part and applicable rules. The home medical equipment 19 provider must submit satisfactory proof of its financial 20 ability to comply with the requirements of this part. 21 (9) When a change of ownership of a home medical 22 equipment provider occurs, the prospective owner must submit 23 an initial application for a license at least 15 days before 24 the effective date of the change of ownership. An application 25 for change of ownership of a license is required when 26 ownership, a majority of the ownership, or controlling 27 interest of a licensed home medical equipment provider is 28 transferred or assigned and when a licensee agrees to 29 undertake or provide services to the extent that legal 30 liability for operation of the home medical equipment provider 31 rests with the licensee. A provisional license shall be issued 11 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 to the new owner for a period of 90 days, during which time 2 all required documentation must be submitted and a survey must 3 be conducted demonstrating substantial compliance with this 4 section. If substantial compliance is demonstrated, a standard 5 license shall be issued to expire 2 years after the issuance 6 of the provisional license. 7 (10) When a change of the general manager of a home 8 medical equipment provider occurs, the licensee must notify 9 the agency of the change within 45 days thereof and must 10 provide evidence of compliance with the background screening 11 requirements in subsection (5); except that a general manager 12 who has met the standards for the abuse registry background 13 check and the Department of Law Enforcement background check, 14 but for whom background screening results from the Federal 15 Bureau of Investigation have not yet been received, may be 16 employed pending receipt of the Federal Bureau of 17 Investigation background screening report. An individual may 18 not continue to serve as general manager if the Federal Bureau 19 of Investigation background screening report indicates any 20 violation of background screening standards. 21 (11) All licensure fees required of a home medical 22 equipment provider are nonrefundable. The agency shall set the 23 fees in an amount that is sufficient to cover its costs in 24 carrying out its responsibilities under this part. However, 25 state, county, or municipal governments applying for licenses 26 under this part are exempt from the payment of license fees. 27 All fees collected under this part must be deposited in the 28 Health Care Trust Fund for the administration of this part. 29 (12) An applicant for initial licensure, renewal, or 30 change of ownership shall pay a license processing fee not to 31 exceed $300, to be paid by all applicants, and an inspection 12 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 fee not to exceed $400, to be paid by all applicants except 2 those not subject to licensure inspection by the agency as 3 described in s. 400.823(2). 4 (13) When a change is reported which requires issuance 5 of a license, a fee must be assessed. The fee must be based on 6 the actual cost of processing and issuing the license. 7 (14) When a duplicate license is issued, a fee must be 8 assessed, not to exceed the actual cost of duplicating and 9 mailing. 10 (15) When applications are mailed out upon request, a 11 fee must be assessed, not to exceed the cost of the printing, 12 preparation, and mailing. 13 (16) The license must be displayed in a conspicuous 14 place in the administrative office of the home medical 15 equipment provider and is valid only while in the possession 16 of the person or entity to which it is issued. The license may 17 not be sold, assigned, or otherwise transferred, voluntarily 18 or involuntarily, and is valid only for the home medical 19 equipment provider and location for which originally issued. 20 (17) A home medical equipment provider against whom a 21 proceeding for revocation or suspension, or for denial of a 22 renewal application, is pending at the time of license renewal 23 may be issued a provisional license effective until final 24 disposition by the agency of such proceedings. If judicial 25 relief is sought from the final disposition, the court that 26 has jurisdiction may issue a temporary permit for the duration 27 of the judicial proceeding. 28 400.822 Administrative penalties; injunctions; 29 emergency orders; moratoriums.-- 30 (1) The agency may deny, revoke, or suspend a license, 31 or impose an administrative fine not to exceed $5,000 per 13 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 violation, per day, or initiate injunctive proceedings under 2 s. 400.85. 3 (2) Any of the following actions by a home medical 4 equipment provider or any of its employees is grounds for 5 administrative action or penalties by the agency: 6 (a) Violation of this part or of applicable rules. 7 (b) An intentional, reckless, or negligent act that 8 materially affects the health or safety of a patient. 9 (3) The agency may deny or revoke the license of any 10 applicant that: 11 (a) Made a false representation or omission of any 12 material fact in making the application, including the 13 submission of an application that conceals the controlling or 14 ownership interest or any officer, director, agent, managing 15 employee, affiliated person, partner, or shareholder who may 16 not be eligible to participate; 17 (b) Has been previously found by any professional 18 licensing, certifying, or standards board or agency to have 19 violated the standards or conditions relating to licensure or 20 certification or the quality of services provided. 21 "Professional licensing, certifying, or standards board or 22 agency" shall include, but is not limited to, practitioners, 23 health care facilities, programs, or services, or residential 24 care, treatment programs, or other human services; or 25 (c) Has been or is currently excluded, suspended, or 26 terminated from, or has involuntarily withdrawn from, 27 participation in Florida's Medicaid program or any other 28 state's Medicaid program, or participation in the Medicare 29 program or any other governmental or private health care or 30 health insurance program. 31 14 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (4) The agency may issue an emergency order 2 immediately suspending or revoking a license when it 3 determines that any condition within the responsibility of the 4 home medical equipment provider presents a clear and present 5 danger to public health and safety. 6 (5) The agency may impose an immediate moratorium on 7 any licensed home medical equipment provider when the agency 8 determines that any condition within the responsibility of the 9 home medical equipment provider presents a threat to public 10 health or safety. 11 400.823 Licensure inspections and investigations.-- 12 (1) The agency shall make or cause to be made such 13 inspections and investigations as it considers necessary, 14 including: 15 (a) Licensure inspections. 16 (b) Inspections directed by the federal Health Care 17 Financing Administration. 18 (c) Licensure complaint investigations, including full 19 licensure investigations with a review of all licensure 20 standards as outlined in the administrative rules. Complaints 21 received by the agency from individuals, organizations, or 22 other sources are subject to review and investigation by the 23 agency. 24 (2) The agency shall accept, in lieu of its own 25 periodic inspections for licensure, submission of the 26 following: 27 (a) The survey or inspection of an accrediting 28 organization, provided the accreditation of the licensed home 29 medical equipment provider is not provisional and provided the 30 licensed home medical equipment provider authorizes release 31 15 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 of, and the agency receives the report of, the accrediting 2 organization; or 3 (b) A copy of a valid medical oxygen retail 4 establishment permit issued by the Department of Health, 5 pursuant to chapter 499. 6 400.824 Minimum standards.--As a requirement of 7 licensure, home medical equipment providers shall: 8 (1) Offer and provide home medical equipment and 9 services, as necessary, to consumers who purchase or rent 10 equipment that requires such services. 11 (2) Provide at least one category of equipment 12 directly, filling orders from its own inventory. 13 (3) Respond to orders received for other equipment by 14 filling those orders from its own inventory or inventory from 15 other companies with which it has contracted to fill such 16 orders; or customizing or fitting items for sale from supplies 17 purchased under contract. 18 (4) Maintain trained personnel to coordinate order 19 fulfillment and schedule timely equipment and service 20 delivery. 21 (5) As necessary in relation to the sophistication of 22 the equipment and services being provided, ensure that 23 delivery personnel are appropriately trained to conduct an 24 environment and equipment compatibility assessment; 25 appropriately and safely set up the equipment; instruct 26 patients and caregivers in the safe operation and client 27 maintenance of the equipment; and recognize when additional 28 education or followup patient compliance monitoring is 29 appropriate. 30 (6) Ensure that patients are made aware of service 31 hours and emergency service procedures. 16 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (7) At the time of the initial delivery, set up an 2 appropriate followup home medical equipment service schedule 3 as needed for such times as, but not limited to, periodic 4 maintenance, supply delivery, and other related activities. 5 (8) Arrange for emergency service after normal 6 business hours; provide refresher and review training for 7 appropriate personnel; establish a system for resolution of 8 complaints and service problems; and provide for timely 9 replacement or delivery of disposable or consumable equipment 10 supplies. 11 (9) Honor all warranties expressed and implied under 12 applicable state law. 13 (10) Answer any questions or complaints a consumer has 14 about an item or the use of an item that the consumer 15 purchases or rents. 16 (11) Maintain and repair directly, or through a 17 service contract with another company, items rented to 18 consumers. 19 (12) Accept returns of substandard or unsuitable items 20 from consumers. As used in this subsection, the term 21 "substandard" means less than full quality for the particular 22 item and the term "unsuitable" means inappropriate for the 23 consumer at the time it was fitted or sold. 24 (13) Disclose consumer information to each consumer 25 who rents or purchases items, including all applicable 26 warranty information. This information consists of the 27 provider standards to which the item must conform. 28 (14) Maintain patient payment and service records in 29 accordance with the requirements of this part. 30 (15)(a) Designate appropriate staff as intake 31 coordinators, and ensure that order intake personnel are 17 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 appropriately trained in the types of equipment and products, 2 commonly occurring medical conditions, service procedures, 3 third-party billing, and insurance requirements and coverage. 4 (b) Train intake coordinators in a basic understanding 5 of the following areas: dealing with patient and caregiver 6 needs; other, nonhome medical equipment provider services as 7 they relate to home medical equipment services and home care 8 patient crisis management. 9 (16) Establish procedures for maintaining a record of 10 the employment history, including background screening as 11 required by s. 400.843, of all home medical equipment provider 12 personnel. A home medical equipment provider must require its 13 personnel to submit an employment history to the home medical 14 equipment provider and must verify the employment history for 15 at least the previous 5 years, unless through diligent efforts 16 such verification is not possible. There is no monetary 17 liability on the part of, and no cause of action for damages 18 arising against a former employer, a prospective employee, or 19 a prospective independent contractor with a licensed home 20 medical equipment provider, who reasonably and in good faith 21 communicates his or her honest opinions about a former 22 employee's job performance. This subsection does not affect 23 the official immunity of an officer or employee of a public 24 corporation. 25 (17) Upon request by the consumer or as otherwise 26 required by state or federal laws, rules, and regulations, 27 assist consumers with meeting the necessary filing 28 requirements to obtain third-party payment to which a consumer 29 may be entitled. 30 (18) Maintain safe premises. 31 (19) Comply with all other state and federal laws. 18 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 400.825 Rules establishing minimum standards.--The 2 agency shall adopt, publish, and enforce rules to implement 3 this part, which must provide reasonable and fair minimum 4 standards relating to: 5 (1) The qualifications and minimum training 6 requirements of all home medical equipment provider personnel. 7 (2) License application and renewal. 8 (3) License and inspection fees. 9 (4) Financial ability to operate. 10 (5) The administration of the home medical equipment 11 provider. 12 (6) Procedures for maintaining patient records. 13 (7) Ensuring that the home medical equipment and 14 services provided by a home medical equipment provider are in 15 accordance with the plan of treatment established for each 16 patient, when provided as a part of a plan of treatment. 17 (8) Contractual arrangements for the provision of home 18 medical equipment and services by providers not employed by 19 the home medical equipment provider providing for the 20 consumer's needs. 21 (9) Physical location and zoning requirements. 22 (10) Home medical equipment requiring home medical 23 equipment services. 24 400.83 Patient records.-- 25 (1) The home medical equipment provider must maintain, 26 for each patient, a patient record that includes the home 27 medical equipment and services the home medical equipment 28 provider has provided. Such records must contain: 29 (a) Any physician's order or certificate of medical 30 necessity, if the equipment was ordered by a physician. 31 19 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (b) Signed and dated delivery slips verifying 2 delivery. 3 (c) Notes reflecting all services and maintenance 4 performed, and any equipment exchanges. 5 (d) The date on which rental equipment was retrieved. 6 (e) Such other information as is appropriate to 7 specific patients in light of the particular equipment 8 provided to them. 9 (2) Such records are considered patient records under 10 s. 455.667, and must be maintained by the home medical 11 equipment provider for 5 years following termination of 12 services. If a patient transfers to another home medical 13 equipment provider, a copy of his or her record must be 14 provided to the other home medical equipment provider, upon 15 request. 16 400.84 Notice of toll-free telephone number for 17 central abuse registry.--On or before the first day home 18 medical equipment is delivered to the patient's home, any home 19 medical equipment provider licensed under this part must 20 inform the consumer and his or her immediate family, if 21 appropriate, of the right to report abusive, neglectful, or 22 exploitative practices. The statewide toll-free telephone 23 number for the central abuse registry must be provided to 24 consumers in a manner that is clearly legible and must include 25 the words: "To report abuse, neglect, or exploitation, please 26 call toll-free 1-800-962-2873." Home medical equipment 27 providers shall establish appropriate policies and procedures 28 for providing such notice to consumers. 29 400.843 Background screening of home medical equipment 30 provider personnel.--The agency shall require employment 31 screening as provided in chapter 435, using the level 1 20 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 standards for screening set forth in that chapter, for home 2 medical equipment provider personnel. 3 (1) The agency may grant exemptions from 4 disqualification from employment under this section as 5 provided in s. 435.07. 6 (2) The general manager of each home medical equipment 7 provider must sign an affidavit annually, under penalty of 8 perjury, stating that all home medical equipment provider 9 personnel hired on or after July 1, 1998, who enter the home 10 of a patient in the capacity of their employment have been 11 screened and that its remaining personnel have worked for the 12 home medical equipment provider continuously since before July 13 1, 1998. 14 (3) Proof of compliance with the screening 15 requirements of s. 110.1127, s. 393.0655, s. 394.457, s. 16 397.451, s. 402.305, s. 402.313, s. 409.175, s. 464.008, or s. 17 985.407 or this part must be accepted in lieu of the 18 requirements of this section if the person has been 19 continuously employed in the same type of occupation for which 20 he or she is seeking employment without a breach in service 21 that exceeds 180 days, the proof of compliance is not more 22 than 2 years old, and the person has been screened through the 23 central abuse registry and tracking system of the department 24 and by the Department of Law Enforcement. An employer or 25 contractor shall directly provide proof of compliance to 26 another employer or contractor, and a potential employer or 27 contractor may not accept any proof of compliance directly 28 from the person requiring screening. Proof of compliance with 29 the screening requirements of this section shall be provided, 30 upon request, to the person screened by the home medical 31 equipment provider. 21 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (4) There is no monetary liability on the part of, and 2 no cause of action for damages arising against, a licensed 3 home medical equipment provider that, upon notice of a 4 confirmed report of adult abuse, neglect, or exploitation 5 under chapter 415, terminates the employee against whom the 6 report was issued, whether or not the employee has filed for 7 an exemption with the agency and whether or not the time for 8 filing has expired. 9 (5) The costs of processing the statewide 10 correspondence criminal records checks and the search of the 11 department's central abuse registry must be borne by the home 12 medical equipment provider or by the person being screened, at 13 the discretion of the home medical equipment provider. 14 (6) Neither the agency nor the home medical equipment 15 provider may use the criminal records, juvenile records, or 16 central abuse registry information of a person for any purpose 17 other than determining whether that person meets minimum 18 standards of good moral character for home medical equipment 19 provider personnel. 20 (7)(a) It is a misdemeanor of the first degree, 21 punishable as provided in s. 775.082 or s. 775.083, for any 22 person willfully, knowingly, or intentionally to: 23 1. Fail, by false statement, misrepresentation, 24 impersonation, or other fraudulent means, to disclose in any 25 application for voluntary or paid employment a material fact 26 used in making a determination as to the person's 27 qualifications to be an employee under this section; 28 2. Operate or attempt to operate an entity licensed 29 under this part with persons who do not meet the minimum 30 standards for good moral character as contained in this 31 section; or 22 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 3. Use information from the criminal records or 2 central abuse registry obtained under this section for any 3 purpose other than screening that person for employment as 4 specified in this section, or release such information to any 5 other person for any purpose other than screening for 6 employment under this section. 7 (b) It is a felony of the third degree, punishable as 8 provided in s. 775.082, s. 775.083, or s. 775.084, for any 9 person willfully, knowingly, or intentionally to use 10 information from the juvenile records of a person obtained 11 under this section for any purpose other than screening for 12 employment under this section. 13 400.845 Procedures for screening of home medical 14 equipment provider personnel.-- 15 (1) A person employed by a home medical equipment 16 provider shall, within 5 working days after starting to work, 17 submit to the home medical equipment provider or registrant a 18 complete set of information necessary to conduct a screening 19 under this section. The person must sign an affidavit stating 20 whether the person meets the minimum standards for good moral 21 character under this section. The home medical equipment 22 provider shall submit the information to the Department of Law 23 Enforcement and to the department's central abuse registry and 24 tracking system for processing. If disposition information is 25 missing on a criminal record, it is the responsibility of the 26 person being screened to obtain and supply the missing 27 information within 30 days. Failure to supply the missing 28 information or to show reasonable efforts to obtain such 29 information will result in automatic disqualification for 30 employment. 31 23 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 (2) Home medical equipment provider personnel hired on 2 or after July 1, 1998, must be placed on probationary status 3 pending a determination of compliance with minimum standards 4 for good moral character. 5 (3) The home medical equipment provider must 6 automatically terminate the employment of any of its personnel 7 found to be in noncompliance with the minimum standards for 8 good moral character under this section, unless such person 9 has obtained an exemption under s. 400.843(1). 10 (4) The general manager of each home medical equipment 11 provider must sign an affidavit annually, under penalty of 12 perjury, stating that all personnel hired on or after July 1, 13 1998, have been screened and that its remaining personnel have 14 worked for the home medical equipment provider continuously 15 since before July 1, 1998. 16 400.85 Injunction proceedings.--The agency may 17 institute injunction proceedings in a court of competent 18 jurisdiction when violation of this part or of applicable 19 rules constitutes an emergency affecting the immediate health 20 and safety of a patient or consumer. 21 400.86 Prohibited acts.--Compliance with state and 22 federal laws regarding prohibited patient referrals and 23 rebates shall be a condition of licensure. 24 Section 2. Existing home medical equipment providers 25 subject to licensure under part IX of chapter 400, Florida 26 Statutes, as created in this act, shall submit an application 27 and applicable fees for licensure by December 31, 1998. Those 28 existing providers that submit applications and fees prior to 29 December 31, 1998, shall be deemed to meet licensure 30 requirements until the agency acts to deny or grant the 31 initial licensure application. After December 31, 1998, 24 CODING: Words stricken are deletions; words underlined are additions. Florida Senate - 1998 SB 294 10-130A-98 See HB 1 applicants for licensure may not operate until they are 2 approved and obtain a license. 3 Section 3. There is hereby appropriated from the 4 Health Care Trust Fund to the Agency for Health Care 5 Administration 13 full-time-equivalent staff positions and 6 $634,845 to implement the provisions of this act. 7 Section 4. This act shall take effect July 1 of the 8 year in which enacted. 9 10 ***************************************** 11 SENATE SUMMARY 12 Provides for the licensure of home medical equipment providers and for background screening of employees of 13 such providers. (See bill for details.) 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 25