CODING: Words stricken are deletions; words underlined are additions.
HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
CHAMBER ACTION
Senate House
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11 Representative(s) Green offered the following:
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13 Amendment to Amendment (805735) (with title amendment)
14 On page 33, between lines 4 and 5,
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16 insert:
17 Section 21. By July 1, 2002, the Agency for Health
18 Care Administration shall solicit two private nursing homes,
19 one for-profit and one not-for-profit, in two different
20 geographic areas of the state to participate in a 1-year pilot
21 project to demonstrate the use of electronic monitoring
22 equipment in nursing homes licensed under part II of chapter
23 400, Florida Statutes. If no nursing homes volunteer, the
24 agency shall select the two facilities with the lowest rank in
25 quality-of-care performance under s. 400.191, Florida
26 Statutes, and applicable rules. This selection shall not be
27 subject to review or challenge. If more than two nursing homes
28 apply, the Agency for Health Care Administration shall select
29 two nursing homes, the one with the highest ranking and the
30 one with the lowest ranking in quality-of-care performance
31 under s. 400.191, Florida Statutes, and applicable rules.
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 (1) The nursing homes that participate in the pilot
2 project shall develop policies and procedures that permit each
3 resident or, if appropriate, the resident's legal
4 representative, to request electronic monitoring of the
5 resident's room. The nursing homes that participate in the
6 pilot project shall also install equipment to electronically
7 monitor and shall monitor activities in common areas of the
8 facility. The policies and procedures must include steps to
9 address the privacy and dignity of residents, roommates, and
10 visitors.
11 (2) The request for electronic monitoring of a
12 resident's room must be in writing and signed by the resident
13 or the resident's representative.
14 (a) If a resident has the capacity to request
15 electronic monitoring and has not been judicially declared to
16 lack the required capacity, only the resident may request the
17 electronic monitoring, notwithstanding the terms of any
18 durable power of attorney or similar instrument.
19 (b) If a resident has been judicially declared to lack
20 the capacity required to request electronic monitoring, only
21 the guardian of the resident may request electronic
22 monitoring.
23 (c) If a resident does not have the capacity to
24 request electronic monitoring and has not been judicially
25 declared to lack the required capacity, the resident's
26 physician may make the determination regarding the capacity of
27 the resident to request electronic monitoring and must
28 document the determination in the resident's clinical record.
29 In that case, only the legal representative of the resident
30 may request the electronic monitoring. A person from the
31 following list, in order of priority, may act as the
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 resident's legal representative for the limited purpose of
2 requesting electronic monitoring of the resident's room.
3 1. A person named in the resident's medical power of
4 attorney or other advance directive.
5 2. The resident's spouse.
6 3. An adult child of the resident who has the waiver
7 and consent of all other qualified adult children of the
8 resident to act as the sole decision-maker.
9 4. A majority of the resident's reasonably available
10 adult children.
11 5. The resident's parents.
12 6. The individual clearly identified as suitable to
13 act for the resident by the resident before the resident
14 became incapacitated or the resident's nearest living
15 relative.
16 (3) A resident, or resident's legal representative,
17 who wishes to conduct electronic monitoring must obtain the
18 written, signed consent of other residents in the room. The
19 written consent must be submitted to the administrator of the
20 nursing home or his or her designee.
21 (a) Consent of other residents may be given only by:
22 1. The other resident or residents in the room;
23 2. The guardian of the other resident, if the resident
24 has been judicially declared to lack the required capacity; or
25 3. The legal representative of the other resident,
26 determined by following the same procedure established under
27 (2)(c).
28 (b) Another resident in the room may condition consent
29 on:
30 1. Pointing the camera away from the consenting
31 resident, when the proposed electronic monitoring device is a
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 video surveillance camera; and
2 2. Limiting or prohibiting the use of an audio
3 electronic monitoring device.
4 (c) Electronic monitoring must be conducted in
5 accordance with any limitations placed on the monitoring as a
6 condition of the consent given by or on behalf of another
7 resident of the room.
8 (4) When the request for electronic monitoring and all
9 required consents have been given to the nursing home
10 administrator or his or her designee, electronic monitoring
11 may begin. If electronic monitoring is being conducted in a
12 resident's room, and another resident is moved into the room
13 who has not yet consented to electronic monitoring, the
14 monitoring must cease until the new resident, or the
15 resident's legal representative, consents.
16 (5) Anyone conducting electronic monitoring must post
17 and maintain a conspicuous notice at the entrance to the
18 resident's room stating that the room is being monitored by an
19 electronic monitoring device. The nursing homes participating
20 in the pilot project must post a notice in a prominent
21 location in common areas that the areas are being
22 electronically monitored.
23 (6) The resident or resident's legal representative
24 who requests the electronic monitoring of the resident's room
25 is responsible for the costs associated with conducting
26 electronic monitoring in the resident's room, including the
27 equipment and tapes and the installation, maintenance, or
28 removal of the equipment, other than the costs of electricity.
29 The electronic monitoring equipment and tapes must be the
30 property of the resident. The nursing home must make
31 reasonable physical accommodation for electronic monitoring
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 which includes:
2 (a) A reasonably secure place to mount the video
3 surveillance camera or other electronic monitoring device; and
4 (b) Access to power sources for the video surveillance
5 camera or other electronic monitoring device.
6 (7) The nursing home may:
7 (a) Require an electronic monitoring device to be
8 installed in a manner that is safe for residents, employees,
9 or visitors who may be moving about the room and that meets
10 all local and state regulations;
11 (b) Require the electronic monitoring to be conducted
12 in plain view; and
13 (c) Place a resident in a different room to
14 accommodate a request for electronic monitoring.
15 (8) A participating nursing home may not refuse to
16 admit an individual and may not discharge a resident solely
17 because of a request to conduct electronic monitoring.
18 (9) Any questionable activity discovered as a result
19 of viewing a tape produced by the electronic monitoring
20 equipment shall be reported to the nursing home's
21 administrator and the Agency for Health Care Administration
22 within 24 hours after discovery of the questionable activity.
23 (a) When a questionable activity that occurred in a
24 resident's room has been reported to the nursing home
25 administrator and the Agency for Health Care Administration,
26 the nursing home administrator shall arrange a meeting for
27 viewing or listening to the recording of the activity as soon
28 as is practicable. The following persons must be at the
29 meeting:
30 1. The resident or the resident's legal
31 representative;
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 2. A long-term care ombudsman, if requested by the
2 resident or the resident's legal representative;
3 3. A quality-of-care monitor from the Agency for
4 Health Care Administration;
5 4. The nursing home's designated risk manager; and
6 5. The nursing home administrator.
7 (b) When a questionable activity that has purportedly
8 occurred in a common area of the nursing home is reported to
9 the nursing home administrator and the Agency for Health Care
10 Administration, the nursing home administrator shall arrange a
11 meeting for viewing or listening to the recording of the
12 activity as soon as is practicable. The following persons must
13 be at the meeting:
14 1. The resident or residents involved in the
15 questionable activity, or the resident's or residents' legal
16 representatives;
17 2. A long-term care ombudsman, if requested by the
18 resident or the resident's legal representative;
19 3. A representative of the nursing home's resident
20 council;
21 4. A quality-of-care monitor from the Agency for
22 Health Care Administration;
23 5. The nursing home's designated risk manager; and
24 6. The nursing home administrator.
25 (c) The purpose of such a meeting is to facilitate
26 discussion of the quality of care being provided to the
27 resident and, if necessary, how to improve the quality of care
28 being provided.
29 (d) The Agency for Health Care Administration may take
30 any regulatory action authorized under part II of chapter 400,
31 Florida Statutes, in response to a questionable activity
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 documented through electronic monitoring and reported to the
2 agency.
3 (10) Because of the nature of the pilot project, any
4 activity or information recorded on tape shall be used to
5 improve care and is not admissible as evidence in civil
6 litigation against the nursing home, a licensed health care
7 practitioner, or staff of the nursing home.
8 (11) Each nursing home that participates in the pilot
9 project shall receive the sum of $10,000 to:
10 (a) Research and purchase an electronic monitoring
11 system for common areas which would tape activities in the
12 common areas so as to minimize security risks; and
13 (b) Submit 6-month progress reports to the Agency for
14 Health Care Administration on the status of the pilot project.
15 The reports must describe efforts by the nursing home to
16 inform residents and their legal representatives of the
17 circumstances under which electronic monitoring equipment will
18 be installed in residents' rooms; must provide an evaluation
19 of resident, family, and staff response to the availability
20 and use of electronic monitoring equipment; and must document
21 staff turnover and changes in liability insurance premiums and
22 deductibles attributed to the use of electronic monitoring
23 equipment.
24 (12) The nursing homes that participate in the pilot
25 project are entitled to a one-time rebasing of operating costs
26 under the Medicaid program to cover any increased costs in
27 liability insurance because of the installation of the
28 electronic monitoring equipment during the 12 months that the
29 pilot project is in effect and for 6 months thereafter.
30 (13) The Agency for Health Care Administration shall
31 convene a panel to advise the agency as it reviews the outcome
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 of the pilot project and produces a report. The panel shall be
2 comprised of a representative of the American Association of
3 Retired Persons, a member of the clergy, a registered nurse, a
4 physician licensed under chapter 458 or chapter 459, Florida
5 Statutes, a long-term care ombudsman, a representative of the
6 Agency for Health Care Administration, and a representative of
7 the Office of the Attorney General. The Agency for Health Care
8 Administration shall submit to the Governor, the President of
9 the Senate, and the Speaker of the House of Representatives,
10 by October 1, 2003, a report on the outcome of the pilot
11 project.
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15 And the title is amended as follows:
16 On page 36, line 22, of the amendment
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18 after the semicolon, insert:
19 requiring the Agency for Health Care
20 Administration to conduct a pilot project to
21 demonstrate the use of electronic monitoring
22 equipment in nursing homes; establishing
23 requirements for nursing homes participating in
24 the pilot project; establishing procedures for
25 the use of electronic monitoring equipment;
26 specifying who may request electronic
27 monitoring; providing for conditional consent
28 to electronic monitoring; providing for review
29 of tapes documenting questionable activity;
30 prohibiting the admission of tapes as evidence
31 in civil litigation against a nursing home, a
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HOUSE AMENDMENT
hbd-08 Bill No. HB 703
Amendment No. ___ (for drafter's use only)
1 licensed health care practitioner, or staff of
2 a nursing home; providing for rebasing of
3 Medicaid costs; requiring the Agency for Health
4 Care Administration to convene an advisory
5 panel; requiring a report;
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