SENATE AMENDMENT
    Bill No. CS for SB 2750
    Amendment No. ___   Barcode 091780
                            CHAMBER ACTION
              Senate                               House
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       04/30/2003 06:34 PM         .                    
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11  Senator Peaden moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On page 9, line 27, through
15            page 12, line 15, delete those lines
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17  and insert:  
18         Section 3.  Paragraphs (a) and (e) of subsection (4)
19  and paragraph (b) of subsection (7) of section 395.3025,
20  Florida Statutes, are amended, and a new paragraph (l) is
21  added to subsection (4) of that section, to read:
22         395.3025  Patient and personnel records; copies;
23  examination.--
24         (4)  Patient records are confidential and must not be
25  disclosed without the consent of the person to whom they
26  pertain, but appropriate disclosure may be made without such
27  consent to:
28         (a)  Licensed Facility personnel and all licensed
29  health care practitioners attending physicians for use in
30  connection with the treatment of the patient.
31         (e)  The Department of Health agency upon subpoena
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    1:59 PM   04/27/03                              s2750c1c-02j04

SENATE AMENDMENT Bill No. CS for SB 2750 Amendment No. ___ Barcode 091780 1 issued pursuant to s. 456.071, but the records obtained 2 thereby must be used solely for the purpose of the department 3 agency and the appropriate professional board in its 4 investigation, prosecution, and appeal of disciplinary 5 proceedings. The administrator or records custodian in a 6 facility licensed under this chapter shall certify that a true 7 and complete copy of the records requested pursuant to a 8 subpoena or patient release have been provided to the 9 department or otherwise identify those documents that have not 10 been provided. If the department agency requests copies of the 11 records, the facility shall charge no more than its actual 12 copying costs, including reasonable staff time. The records 13 must be sealed and must not be available to the public 14 pursuant to s. 119.07(1) or any other statute providing access 15 to records, nor may they be available to the public as part of 16 the record of investigation for and prosecution in 17 disciplinary proceedings made available to the public by the 18 department agency or the appropriate regulatory board. 19 However, the department agency must make available, upon 20 written request by a practitioner against whom probable cause 21 has been found, any such records that form the basis of the 22 determination of probable cause. 23 (l) Researchers or facility personnel for research 24 purposes, provided that the researchers or facility personnel 25 demonstrate compliance with the requirements of 45 C.F.R. s. 26 164.512(i). 27 (7) 28 (b) Absent a specific written release or authorization 29 permitting utilization of patient information for solicitation 30 or marketing the sale of goods or services, any use of such 31 that information for that purpose those purposes is 2 1:59 PM 04/27/03 s2750c1c-02j04
SENATE AMENDMENT Bill No. CS for SB 2750 Amendment No. ___ Barcode 091780 1 prohibited. For purposes of this paragraph, the term 2 "marketing" is defined as set forth in 45 C.F.R. s. 164.501. 3 Section 4. Paragraph (b) of subsection (2) of section 4 395.7015, Florida Statutes, is amended to read: 5 395.7015 Annual assessment on health care entities.-- 6 (2) There is imposed an annual assessment against 7 certain health care entities as described in this section: 8 (b) For the purpose of this section, "health care 9 entities" include the following: 10 1. Ambulatory surgical centers and mobile surgical 11 facilities licensed under s. 395.003. This subsection shall 12 only apply to mobile surgical facilities operating under 13 contracts entered into on or after July 1, 1998. 14 2. Clinical laboratories licensed under s. 483.091, 15 excluding any hospital laboratory defined under s. 483.041(6), 16 any clinical laboratory operated by the state or a political 17 subdivision of the state, any clinical laboratory which 18 qualifies as an exempt organization under s. 501(c)(3) of the 19 Internal Revenue Code of 1986, as amended, and which receives 20 70 percent or more of its gross revenues from services to 21 charity patients or Medicaid patients, and any blood, plasma, 22 or tissue bank procuring, storing, or distributing blood, 23 plasma, or tissue either for future manufacture or research or 24 distributed on a nonprofit basis, and further excluding any 25 clinical laboratory which is wholly owned and operated by 6 or 26 fewer physicians who are licensed pursuant to chapter 458 or 27 chapter 459 and who practice in the same group practice, and 28 at which no clinical laboratory work is performed for patients 29 referred by any health care provider who is not a member of 30 the same group. 31 3. Diagnostic-imaging centers that are freestanding 3 1:59 PM 04/27/03 s2750c1c-02j04
SENATE AMENDMENT Bill No. CS for SB 2750 Amendment No. ___ Barcode 091780 1 outpatient facilities that provide specialized services for 2 the identification or determination of a disease through 3 examination and also provide sophisticated radiological 4 services, and in which services are rendered by a physician 5 licensed by the Board of Medicine under s. 458.311, s. 6 458.313, or s. 458.315 458.317, or by an osteopathic physician 7 licensed by the Board of Osteopathic Medicine under s. 8 459.006, s. 459.007, or s. 459.0075. For purposes of this 9 paragraph, "sophisticated radiological services" means the 10 following: magnetic resonance imaging; nuclear medicine; 11 angiography; arteriography; computed tomography; positron 12 emission tomography; digital vascular imaging; bronchography; 13 lymphangiography; splenography; ultrasound, excluding 14 ultrasound providers that are part of a private physician's 15 office practice or when ultrasound is provided by two or more 16 physicians licensed under chapter 458 or chapter 459 who are 17 members of the same professional association and who practice 18 in the same medical specialties; and such other sophisticated 19 radiological services, excluding mammography, as adopted in 20 rule by the board. 21 Section 5. Subsection (10) of section 400.141, Florida 22 Statutes, is amended to read: 23 400.141 Administration and management of nursing home 24 facilities.--Every licensed facility shall comply with all 25 applicable standards and rules of the agency and shall: 26 (10) Keep full records of resident admissions and 27 discharges; medical and general health status, including 28 medical records, personal and social history, and identity and 29 address of next of kin or other persons who may have 30 responsibility for the affairs of the residents; and 31 individual resident care plans including, but not limited to, 4 1:59 PM 04/27/03 s2750c1c-02j04
SENATE AMENDMENT Bill No. CS for SB 2750 Amendment No. ___ Barcode 091780 1 prescribed services, service frequency and duration, and 2 service goals. The records shall be open to inspection by the 3 agency. A certified complete copy of the records shall be 4 provided to the Department of Health upon subpoena issued 5 pursuant to ss. 456.057 and 456.071. The provisions of chapter 6 456 apply to records obtained pursuant to this section. 7 8 Facilities that have been awarded a Gold Seal under the 9 program established in s. 400.235 may develop a plan to 10 provide certified nursing assistant training as prescribed by 11 federal regulations and state rules and may apply to the 12 agency for approval of their program. 13 Section 6. Subsection (3) is added to section 400.145, 14 Florida Statutes, to read: 15 400.145 Records of care and treatment of resident; 16 copies to be furnished.-- 17 (3) The administrator or records custodian in a 18 facility licensed under this part shall certify that a true 19 and complete copy of the records requested pursuant to a 20 subpoena or patient release has been provided to the 21 department or otherwise identify those documents that have not 22 been provided. 23 Section 7. Subsection (4) of section 400.211, Florida 24 Statutes, is amended to read: 25 400.211 Persons employed as nursing assistants; 26 certification requirement.-- 27 (4) When employed by a nursing home facility for a 28 12-month period or longer, a nursing assistant, to maintain 29 certification, shall submit to a performance review every 12 30 months and must receive regular inservice education based on 31 the outcome of such reviews. The inservice training must: 5 1:59 PM 04/27/03 s2750c1c-02j04
SENATE AMENDMENT Bill No. CS for SB 2750 Amendment No. ___ Barcode 091780 1 (a) Be sufficient to ensure the continuing competence 2 of nursing assistants, must be at least 12 18 hours per year, 3 and may include hours accrued under s. 464.203(7)(8); 4 (b) Include, at a minimum: 5 1. Techniques for assisting with eating and proper 6 feeding; 7 2. Principles of adequate nutrition and hydration; 8 3. Techniques for assisting and responding to the 9 cognitively impaired resident or the resident with difficult 10 behaviors; 11 4. Techniques for caring for the resident at the 12 end-of-life; and 13 5. Recognizing changes that place a resident at risk 14 for pressure ulcers and falls; and 15 (c) Address areas of weakness as determined in nursing 16 assistant performance reviews and may address the special 17 needs of residents as determined by the nursing home facility 18 staff. 19 20 Costs associated with this training may not be reimbursed from 21 additional Medicaid funding through interim rate adjustments. 22 23 (Redesignate subsequent sections.) 24 25 26 ================ T I T L E A M E N D M E N T =============== 27 And the title is amended as follows: 28 On page 1, lines 9-22, delete those lines 29 30 and insert: 31 clinical records may be restricted; amending s. 6 1:59 PM 04/27/03 s2750c1c-02j04
SENATE AMENDMENT Bill No. CS for SB 2750 Amendment No. ___ Barcode 091780 1 395.3025, F.S.; authorizing the release of 2 patient records to a health care practitioner, 3 the Department of Health, or a researcher or 4 facility personnel under certain circumstances; 5 revising a restriction on the use of patient 6 information for certain purposes; amending s. 7 395.7015, F.S.; conforming cross-references; 8 amending s. 400.141, F.S.; providing for the 9 release of certain nursing home resident 10 records to the Department of Health pursuant to 11 subpoena; amending s. 400.145, F.S., and 12 creating s. 400.455, F.S.; requiring 13 certification of certain records by the nursing 14 home administrator or records custodian; 15 amending s. 400.211, F.S.; reducing required 16 inservice training hours for nursing 17 assistants; amending s. 18 19 20 21 22 23 24 25 26 27 28 29 30 31 7 1:59 PM 04/27/03 s2750c1c-02j04