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House Bill 0759c1

Florida House of Representatives - 1997 CS/HB 759 By the Committee on Health Care Standards & Regulatory Reform and Representative Geller 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 House of Representatives - 1997 CS/HB 759 601-113-97 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 are 16 comparable to those required by this licensure. 17 (2) "Affiliated person" means any person who directly 18 or indirectly manages, controls, or oversees the operation of 19 a corporation or other business entity that is a licensee, 20 regardless of whether such person is a partner, shareholder, 21 owner, officer, director, agent, or employee of the entity. 22 (3) "Agency" means the Agency for Health Care 23 Administration. 24 (4) "Applicant" means an individual applicant in the 25 case of sole proprietorships, or any officer, director, agent, 26 managing employee, general manager or affiliated person, or 27 any partner or shareholder having an ownership interest equal 28 to 5 percent or greater in the corporation, partnership, or 29 other business entity. 30 31 2 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 (5) "Consumer or patient" means any person who uses 2 home medical equipment in his or her home or place of 3 residence. 4 (6) "Department" means the Department of Children and 5 Family Services. 6 (7) "General manager" means the individual who has the 7 general administrative charge of a licensed home medical 8 equipment provider premises. 9 (8) "Home medical equipment" includes any product as 10 defined by the Federal Drug Administration's Drugs, Devices 11 and Cosmetics Act, any products reimbursed under the Medicare 12 Part B Durable Medical Equipment benefits, or any products 13 reimbursed under the Florida Medicaid durable medical 14 equipment program. Home medical equipment includes, but is not 15 limited to, oxygen and related respiratory equipment. Home 16 medical equipment includes customized wheelchairs and related 17 seating and positioning, but does not include prosthetics or 18 orthotics. 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, set-up, and maintenance of equipment, and other 31 3 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 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 House of Representatives - 1997 CS/HB 759 601-113-97 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 House of Representatives - 1997 CS/HB 759 601-113-97 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 House of Representatives - 1997 CS/HB 759 601-113-97 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 delinquent 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 set-up. 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 House of Representatives - 1997 CS/HB 759 601-113-97 1 2. Equipment selection. 2 3. Delivery. 3 4. Set-up 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 providers the applicant uses to provide 9 equipment or services to its consumers, and providers for whom 10 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) The applicant must file with the application 19 satisfactory proof of compliance with background screening 20 requirements as follows: 21 (a) Upon receipt of a completed, signed, and dated 22 application, the agency shall require background screening, 23 using the level 2 standards for screening set forth in chapter 24 435, for the applicant. 25 (b) Such background screening shall require each 26 applicant to submit to the Department of Law Enforcement the 27 information necessary, including a full set of fingerprints, 28 to enable a criminal background investigation to be conducted 29 for a state criminal and juvenile history record check. The 30 Department of Law Enforcement shall forward the fingerprints 31 to the Federal Bureau of Investigation for a national criminal 8 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 history records check. Upon completion of the state and 2 national criminal history records checks, the Department of 3 Law Enforcement shall report the findings to the agency. The 4 actual cost of such state and national criminal history 5 records checks shall be borne by the applicant. 6 (c) Such background screening shall also require each 7 applicant to submit to the Department of Children and Family 8 Services a complete set of information necessary to conduct a 9 records check through the central abuse registry. The actual 10 costs of searching the department's central abuse registry 11 shall be borne by the applicant. 12 (d) A license shall not be granted to any applicant 13 who has been found guilty of, regardless of adjudication, or 14 who has entered a plea of nolo contendere or guilty to, any 15 offense prohibited under the level 2 standards of chapter 435. 16 A license shall not be granted to any applicant having a 17 confirmed report of abuse, neglect, or exploitation as defined 18 in s. 415.102 which has been uncontested or upheld under 19 chapter 415, or having a proposed confirmed report that 20 remains unserved and is maintained in the central abuse 21 registry and tracking system pursuant to s. 415.1065(2)(c). 22 (e) The agency shall also require every applicant, as 23 a condition of license application, to submit information 24 concerning any prior violation, fine, suspension, termination, 25 or other administrative action taken under the laws, rules, or 26 regulations of any regulatory body of this state or of any 27 other state or the Federal Government; and any prior violation 28 of the laws, rules, or regulations relating to the Medicaid or 29 Medicare programs. 30 (f) Upon licensure renewal, each applicant must submit 31 to the agency, under penalty of perjury, an affidavit of 9 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 compliance with the background screening provisions of this 2 section. 3 (g) Proof of compliance with the level 2 background 4 screening requirements of chapter 435 submitted within the 5 previous 5 years for any other Florida health care licensure 6 requirements shall be accepted to fulfill the Department of 7 Law Enforcement and Department of Children and Family Services 8 background check, provided that such proof of compliance is 9 accompanied, under penalty of perjury, by an affidavit of 10 compliance with these background screening provisions. 11 (h) Notwithstanding paragraph (d), a provisional 12 license may be granted to an applicant who has met the 13 standards for the abuse registry background check and the 14 Department of Law Enforcement background check, but for whom 15 background screening results from the Federal Bureau of 16 Investigation have not yet been received by the agency. A 17 standard license may be issued upon receipt of the Federal 18 Bureau of Investigation report of background screening 19 confirming that all standards have been met. 20 (6) The home medical equipment provider must also 21 obtain and maintain professional and commercial liability 22 insurance. Proof of liability insurance, as defined in s. 23 624.605, must be submitted with the application. The agency 24 shall set the required amounts of liability insurance by rule, 25 but the required amount must not be less than $250,000 per 26 claim. In the case of contracted services, it is required that 27 the contractor have liability insurance not less than $250,000 28 per claim. 29 (7) A provisional license shall be issued to an 30 approved applicant for initial licensure for a period of 90 31 days, during which time a survey must be conducted 10 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 demonstrating substantial compliance with this section. A 2 provisional license shall also be issued pending the results 3 of an applicant's Federal Bureau of Investigation report of 4 background screening confirming that all standards have been 5 met. If substantial compliance is demonstrated, a standard 6 license shall be issued to expire 2 years after the effective 7 date of the provisional license. 8 (8) Ninety days before the expiration date, an 9 application for license renewal must be submitted to the 10 agency under oath on forms furnished by the agency, and a 11 license shall be renewed if the applicant has met the 12 requirements established under this part and applicable rules. 13 The home medical equipment provider must file with the 14 application satisfactory proof that it is in compliance with 15 this part and applicable rules. The home medical equipment 16 provider must submit satisfactory proof of its financial 17 ability to comply with the requirements of this part. 18 (9) When a change of ownership of a home medical 19 equipment provider occurs, the prospective owner must submit 20 an initial application for a license at least 15 days before 21 the effective date of the change of ownership. An application 22 for change of ownership of a license is required when 23 ownership, a majority of the ownership, or controlling 24 interest of a licensed home medical equipment provider is 25 transferred or assigned and when a licensee agrees to 26 undertake or provide services to the extent that legal 27 liability for operation of the home medical equipment provider 28 rests with the licensee. A provisional license shall be issued 29 to the new owner for a period of 90 days, during which time 30 all required documentation must be submitted and a survey must 31 be conducted demonstrating substantial compliance with this 11 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 section. If substantial compliance is demonstrated, a standard 2 license shall be issued to expire 2 years after the issuance 3 of the provisional license. 4 (10) When a change of the general manager of a home 5 medical equipment provider occurs, the licensee must notify 6 the agency of the change within 45 days thereof and must 7 provide evidence of compliance with the background screening 8 requirements in subsection (5); except that a general manager 9 who has met the standards for the abuse registry background 10 check and the Department of Law Enforcement background check, 11 but for whom background screening results from the Federal 12 Bureau of Investigation have not yet been received, may be 13 employed pending receipt of the Federal Bureau of 14 Investigation background screening report. An individual may 15 not continue to serve as general manager if the Federal Bureau 16 of Investigation background screening report indicates any 17 violation of background screening standards. 18 (11) All licensure fees required of a home medical 19 equipment provider are nonrefundable. The agency shall set the 20 fees in an amount that is sufficient to cover its costs in 21 carrying out its responsibilities under this part. However, 22 state, county, or municipal governments applying for licenses 23 under this part are exempt from the payment of license fees. 24 All fees collected under this part must be deposited in the 25 Health Care Trust Fund for the administration of this part. 26 (12) Initial licensure fees, renewal fees, and change 27 of ownership shall consist of a license processing fee not to 28 exceed $300, to be paid by all applicants, and an inspection 29 fee not to exceed $400, to be paid by all applicants except 30 those not subject to licensure inspection by the agency as 31 described in s. 400.823(2). 12 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 (13) When a change is reported that requires issuance 2 of a license, a fee shall be assessed. The fee shall be based 3 on the actual cost of processing and issuing the license. 4 (14) When a duplicate license must be issued, a fee 5 shall be assessed, not to exceed the actual cost of 6 duplicating and mailing. 7 (15) When applications are mailed out upon request, a 8 fee shall be assessed, not to exceed the cost of the printing, 9 preparation, and mailing. 10 (16) The license must be displayed in a conspicuous 11 place in the administrative office of the home medical 12 equipment provider and is valid only while in the possession 13 of the person or entity to which it is issued. The license may 14 not be sold, assigned, or otherwise transferred, voluntarily 15 or involuntarily, and is valid only for the home medical 16 equipment provider and location for which originally issued. 17 (17) A home medical equipment provider against whom a 18 proceeding for revocation or suspension, or for denial of a 19 renewal application, is pending at the time of license renewal 20 may be issued a provisional license effective until final 21 disposition by the agency of such proceedings. If judicial 22 relief is sought from the final disposition, the court that 23 has jurisdiction may issue a temporary permit for the duration 24 of the judicial proceeding. 25 400.822 Administrative penalties; injunctions; 26 emergency orders; moratoriums.-- 27 (1) The agency may deny, revoke, or suspend a license, 28 or impose an administrative fine not to exceed $5,000 per 29 violation, per day, or initiate injunctive proceedings under 30 s. 400.85. 31 13 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 (2) Any of the following actions by a home medical 2 equipment provider or any of its employees is grounds for 3 administrative action or penalties by the agency: 4 (a) Violation of this part or of applicable rules. 5 (b) An intentional, reckless, or negligent act that 6 materially affects the health or safety of a patient. 7 (3) The agency may deny or revoke the license of any 8 applicant that: 9 (a) Made a false representation or omission of any 10 material fact in making the application, including the 11 submission of an application that conceals the controlling or 12 ownership interest or any officer, director, agent, managing 13 employee, affiliated person, partner, or shareholder who may 14 not be eligible to participate; 15 (b) Has been previously found by any professional 16 licensing, certifying, or standards board or agency to have 17 violated the standards or conditions relating to licensure or 18 certification or the quality of services provided. 19 "Professional licensing, certifying, or standards board or 20 agency" shall include, but is not limited to, practitioners, 21 health care facilities, programs, or services, residential 22 care, treatment programs, or other human services; or 23 (c) Has been or is currently excluded, suspended, or 24 terminated from, or has involuntarily withdrawn from, 25 participation in Florida's Medicaid program or any other 26 state's Medicaid program, or participation in the Medicare 27 program or any other governmental or private health care or 28 health insurance program. 29 (4) The agency may issue an emergency order 30 immediately suspending or revoking a license when it 31 determines that any condition within the responsibility of the 14 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 home medical equipment provider presents a clear and present 2 danger to public health and safety. 3 (5) The agency may impose an immediate moratorium on 4 any licensed home medical equipment provider when the agency 5 determines that any condition within the responsibility of the 6 home medical equipment provider presents a threat to public 7 health or safety. 8 400.823 Licensure inspections and investigations.-- 9 (1) The agency shall make or cause to be made such 10 inspections and investigations as it deems necessary, 11 including: 12 (a) Licensure inspections. 13 (b) Inspections directed by the federal Health Care 14 Financing Administration. 15 (c) Licensure complaint investigations, including full 16 licensure investigations with a review of all licensure 17 standards as outlined in the administrative rules. Complaints 18 received by the agency from individuals, organizations, or 19 other sources are subject to review and investigation by the 20 agency. 21 (2) The agency shall accept, in lieu of its own 22 periodic inspections for licensure, submission of the 23 following: 24 (a) The survey or inspection of an accrediting 25 organization, provided the accreditation of the licensed home 26 medical equipment provider is not provisional and provided the 27 licensed home medical equipment provider authorizes release 28 of, and the agency receives the report of, the accrediting 29 organization; or 30 31 15 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 (b) A copy of a valid medical oxygen retail 2 establishment permit issued by the Department of Health, 3 pursuant to chapter 499. 4 400.824 Minimum standards.--As a requirement of 5 licensure, home medical equipment providers shall: 6 (1) Offer and provide home medical equipment and 7 services, as necessary, to consumers who purchase or rent 8 equipment that requires such services. 9 (2) Provide at least one category of equipment 10 directly, filling orders from its own inventory. 11 (3) Respond to orders received for other equipment by 12 filling those orders from its own inventory or inventory from 13 other companies with which it has contracted to fill such 14 orders; or customizing or fitting items for sale from supplies 15 purchased under contract. 16 (4) Maintain trained personnel to coordinate order 17 fulfillment and schedule timely equipment and service 18 delivery. 19 (5) As necessary in relation to the sophistication of 20 the equipment and services being provided, ensure that 21 delivery personnel are appropriately trained to conduct an 22 environment and equipment compatibility assessment; 23 appropriately and safely set up the equipment; instruct 24 patients and caregivers in the safe operation and client 25 maintenance of the equipment; and recognize when additional 26 education or followup patient compliance monitoring is 27 appropriate. 28 (6) Ensure that patients are made aware of service 29 hours and emergency service procedures. 30 (7) At the time of the initial delivery, set up an 31 appropriate followup home medical equipment service schedule 16 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 as needed for such times as, but not limited to, periodic 2 maintenance, supply delivery, and other related activities. 3 (8) Arrange for emergency service after normal 4 business hours; provide refresher and review training for 5 appropriate personnel; establish a system for resolution of 6 complaints and service problems; and provide for timely 7 replacement or delivery of disposable or consumable equipment 8 supplies. 9 (9) Honor all warranties expressed and implied under 10 applicable state law. 11 (10) Answer any questions or complaints a consumer has 12 about an item or the use of an item that the consumer 13 purchases or rents. 14 (11) Maintain and repair directly, or through a 15 service contract with another company, items rented to 16 consumers. 17 (12) Accept returns of substandard or unsuitable items 18 from consumers. For the purposes of this subsection, 19 "substandard" means less than full quality for the particular 20 item and "unsuitable" means inappropriate for the consumer at 21 the time it was fitted or sold. 22 (13) Disclose consumer information to each consumer 23 who rents or purchases items, including all applicable 24 warranty information. This information consists of the 25 provider standards to which the item must conform. 26 (14) Maintain patient payment and service records in 27 accordance with the requirements of this part. 28 (15)(a) Designate appropriate staff as intake 29 coordinators, and ensure that order intake personnel are 30 appropriately trained in the types of equipment and products, 31 17 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 1 commonly occurring medical conditions, service procedures, 2 third-party billing, and insurance requirements and coverage. 3 (b) Train intake coordinators in a basic understanding 4 of the following areas: dealing with patient and caregiver 5 needs; other, nonhome medical equipment provider services as 6 they relate to home medical equipment services and home care 7 patient crisis management. 8 (16) Establish procedures for maintaining a record of 9 the employment history, including background screening as 10 required by s. 400.843, of all home medical equipment provider 11 personnel. A home medical equipment provider must require its 12 personnel to submit an employment history to the home medical 13 equipment provider and must verify the employment history for 14 at least the previous 5 years, unless through diligent efforts 15 such verification is not possible. There is no monetary 16 liability on the part of, and no cause of action for damages 17 arising against a former employer, a prospective employee, or 18 a prospective independent contractor with a licensed home 19 medical equipment provider, who reasonably and in good faith 20 communicates his or her honest opinions about the former 21 employee's job performance. This subsection does not affect 22 the official immunity of an officer or employee of a public 23 corporation. 24 (17) Upon request by the consumer or as otherwise 25 required by state or federal laws, rules, and regulations, 26 assist consumers with meeting the necessary filing 27 requirements to obtain third-party payment to which a consumer 28 may be entitled. 29 (18) Maintain safe premises. 30 (19) Comply with all other state and federal laws. 31 18 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 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) Standards for contractual arrangements for the 18 provision of home medical equipment and services by providers 19 not employed by the home medical equipment provider providing 20 for the 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 House of Representatives - 1997 CS/HB 759 601-113-97 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. 455.241, 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 House of Representatives - 1997 CS/HB 759 601-113-97 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, 1997, 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, 1997. 14 (3) Proof of compliance with the screening 15 requirements of s. 39.076, s. 110.1127, s. 393.0655, s. 16 394.457, s. 397.451, s. 402.305, s. 402.313, s. 409.175, or s. 17 464.008 or this part shall 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 House of Representatives - 1997 CS/HB 759 601-113-97 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 such 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 House of Representatives - 1997 CS/HB 759 601-113-97 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 House of Representatives - 1997 CS/HB 759 601-113-97 1 (2) Home medical equipment provider personnel hired on 2 or after July 1, 1997, 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 1997, have been screened and that its remaining personnel have 14 worked for the home medical equipment provider continuously 15 since before July 1, 1997. 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, 1997. Those 28 existing providers that submit applications and fees prior to 29 December 31, 1997, shall be deemed to meet licensure 30 requirements until the agency acts to deny or grant the 31 initial licensure application. After December 31, 1997, 24 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 CS/HB 759 601-113-97 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 $596,350 to implement the provisions of this act. 7 Section 4. This act shall take effect July 1, 1997. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 25