Senate Bill sb1658c1
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Florida Senate - 2004 CS for SB 1658
By the Committee on Finance and Taxation; and Senator Diaz de
la Portilla
314-2343-04
1 A bill to be entitled
2 An act relating to public health services;
3 requiring the Agency for Health Care
4 Administration to conduct a pilot program1 for
5 a subacute pediatric transitional care center;
6 requiring background screening of center
7 personnel; requiring the agency to apply for a
8 waiver extension or to amend the Medicaid state
9 plan and seek federal waivers as necessary;
10 requiring the center to have an advisory board;
11 providing for membership on the advisory board;
12 providing requirements for the admission,
13 transfer, and discharge of a child to the
14 center; requiring the agency to submit certain
15 reports to the Legislature; providing an
16 effective date.
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18 Be It Enacted by the Legislature of the State of Florida:
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20 Section 1. (1) Within 30 days after the effective
21 date of this act, the Agency for Health Care Administration
22 must establish minimum staffing standards and quality
23 requirements for a subacute pediatric transitional care center
24 to be operated as a 2-year pilot program in Miami-Dade County.
25 The pilot program must operate under the license of a facility
26 licensed under chapter 395 or chapter 400, Florida Statutes. A
27 child's placement in the subacute pediatric transitional care
28 center may not exceed 90 days. The pilot program shall support
29 the transition of a pediatric patient from an acute care
30 hospital setting to the child's home and train parents to
31 provide the child's daily care, with the goal of reducing
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Florida Senate - 2004 CS for SB 1658
314-2343-04
1 return hospital visits. The center shall arrange for an
2 alternative placement at the end of a child's stay and a
3 transitional plan for children expected to remain in the
4 facility for the maximum allowed stay.
5 (2) Within 60 days after the effective date of this
6 act, the agency must apply for a 2-year extension of the
7 waiver granted to Florida for a Subacute Pediatric
8 Transitional Care Center Pilot Program and, if that extension
9 is not granted, must amend the state Medicaid plan and request
10 any federal waivers necessary to implement and fund the pilot
11 program.
12 (3) The subacute pediatric transitional care center
13 must require level 1 background screening as provided in
14 chapter 435, Florida Statutes, for all employees or
15 prospective employees of the center who are expected to, or
16 whose responsibilities may require them to, provide personal
17 care or services to children, who have access to children's
18 living areas, or who have access to children's funds or
19 personal property.
20 (4) The subacute pediatric transitional care center
21 must have an advisory board. Membership on the advisory board
22 must include, but need not be limited to:
23 (a) A physician and an advanced registered nurse
24 practitioner who are familiar with services for children who
25 are medically fragile or dependent on medical technology.
26 (b) A registered nurse who has experience in the care
27 of children who are medically fragile or dependent on medical
28 technology.
29 (c) A child development specialist who has experience
30 in the care of children who are medically fragile or dependent
31 on medical technology and the families of those children.
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Florida Senate - 2004 CS for SB 1658
314-2343-04
1 (d) A social worker who has experience in the care of
2 children who are medically fragile or dependent on medical
3 technology and the families of those children.
4 (e) A consumer representative who is a parent or
5 guardian of a child placed in the center.
6 (5) The advisory board shall:
7 (a) Review the policy and procedure components of the
8 center to ensure conformance with applicable standards
9 developed by the agency.
10 (b) Provide consultation with respect to the
11 operational and programmatic components of the center.
12 (6) The subacute pediatric transitional care center
13 must have written policies and procedures governing the
14 admission, transfer, and discharge of children. The admission
15 of each child to the center must be under the supervision of
16 the center nursing administrator or his or her designee and
17 must be in accordance with the center's policies and
18 procedures. Each Medicaid admission must be approved as
19 appropriate for placement in the facility by the Children's
20 Medical Services Multidisciplinary Assessment Team of the
21 Department of Health, in conjunction with the agency.
22 (7) Each child admitted to the center shall be
23 admitted upon prescription of the medical director of the
24 center, licensed pursuant to chapter 458 or chapter 459,
25 Florida Statutes, and the child shall remain under the care of
26 the medical director and the advanced registered nurse
27 practitioner for the duration of his or her stay in the
28 center.
29 (8) Each child admitted to the center must meet at
30 least the following criteria:
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Florida Senate - 2004 CS for SB 1658
314-2343-04
1 (a) The child must be medically fragile or dependent
2 on medical technology.
3 (b) The child may not, prior to admission, present
4 significant risk of infection to other children or personnel.
5 The medical and nursing directors shall review, on a
6 case-by-case basis, the condition of any child who is
7 suspected of having an infectious disease to determine whether
8 admission is appropriate.
9 (c) The child must be medically stabilized and require
10 skilled nursing care or other interventions.
11 (9) If the child meets the criteria specified in
12 paragraphs (8)(a), (b), and (c), the medical director or
13 nursing director of the center shall implement a preadmission
14 plan that delineates services to be provided and appropriate
15 sources for such services.
16 (a) If the child is hospitalized at the time of
17 referral, preadmission planning must include the participation
18 of the child's parent or guardian and relevant medical,
19 nursing, social services, and developmental staff to ensure
20 that the hospital's discharge plans will be implemented
21 following the child's placement in the center.
22 (b) A consent form outlining the purpose of the
23 center, family responsibilities, authorized treatment,
24 appropriate release of liability, and emergency disposition
25 plans must be signed by the parent or guardian and witnessed
26 before the child is admitted to the center. The parent or
27 guardian shall be provided a copy of the consent form.
28 Section 2. By January 1, 2006, the Agency for Health
29 Care Administration shall report to the Legislature concerning
30 the progress of the pilot program.
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Florida Senate - 2004 CS for SB 1658
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1 Section 3. By January 1, 2007, the Agency for Health
2 Care Administration shall submit to the Legislature a report
3 on the success of the pilot program.
4 Section 4. This act shall take effect upon becoming a
5 law.
6
7 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
8 SB 1658
9
10 The committee substitute removed the provisions in SB 1658 for
statewide licensure for sub-acute pediatric transitional care
11 centers and instead requires a 2-year pilot program in
Miami-Dade County to provide 90 days of transitional care
12 between a hospital and the child's home. The sub-acute
pediatric transitional care pilot program will support the
13 patient's transition from hospital to home and provide parent
training with the goal of reducing return hospital visits.
14
AHCA received a Medicaid waiver to operate that pilot program
15 which expires in December 2004. The waiver can be extended if
the agency requests an extension 90 days before the waiver
16 expires. The bill requires AHCA to apply for an extension of
that waiver, or to amend the Medicaid state plan and seek
17 federal waivers, to implement the pilot program.
18 AHCA must report to the Legislature concerning the progress of
the pilot program by January 1, 2006, and must report on the
19 success of the program by January 1, 2007.
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