Senate Bill sb1658c1

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

17  

18  Be It Enacted by the Legislature of the State of Florida:

19  

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:

31  

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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.

31  

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    Florida Senate - 2004                           CS for SB 1658
    314-2343-04




 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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