SENATE AMENDMENT
    Bill No. CS for CS for SB 2170
    Amendment No. ___   Barcode 911996
                            CHAMBER ACTION
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11  Senator Peaden moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On page 134, between lines 21 and 22,
15  
16  insert:  
17         Section 102.  Sections 102-114 of this act may be cited
18  as the "Clara Ramsey Care of the Elderly Act."
19         Section 103.  Certified Geriatric Specialist
20  Preparation Pilot Program.--
21         (1)  The Agency for Workforce Innovation shall
22  establish a pilot program for delivery of geriatric nursing
23  education to certified nursing assistants who wish to become
24  certified geriatric specialists. The agency shall select two
25  pilot sites in nursing homes that have received the Gold Seal
26  designation under section 400.235, Florida Statutes; have been
27  designated as a teaching nursing home under section 430.80,
28  Florida Statutes; or have not received a class I or class II
29  deficiency within the 30 months preceding application for this
30  program.
31         (2)  To be eligible to receive geriatric nursing
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SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 education, a certified nursing assistant must have been 2 employed by a participating nursing home for at least 1 year 3 and must have received a high school diploma or its 4 equivalent. 5 (3) The education shall be provided at the worksite 6 and in coordination with the certified nursing assistant's 7 work schedule. 8 (4) Faculty shall provide the instruction under an 9 approved nursing program pursuant to section 464.019, Florida 10 Statutes. 11 (5) The education must be designed to prepare the 12 certified nursing assistant to meet the requirements for 13 certification as a geriatric specialist. The didactic and 14 clinical education must include all portions of the practical 15 nursing curriculum pursuant to section 464.019, Florida 16 Statutes, except for pediatric and obstetric/maternal-child 17 education, and must include additional education in the care 18 of ill, injured, or infirm geriatric patients and the 19 maintenance of health, the prevention of injury, and the 20 provision of palliative care for geriatric patients. 21 Section 104. Certified Geriatric Specialty Nursing 22 Initiative Steering Committee.-- 23 (1) In order to guide the implementation of the 24 Certified Geriatric Specialist Preparation Pilot Program, 25 there is created a Certified Geriatric Specialty Nursing 26 Initiative Steering Committee. The steering committee shall be 27 composed of the following members: 28 (a) The chair of the Board of Nursing or his or her 29 designee; 30 (b) A representative of the Agency for Workforce 31 Innovation, appointed by the Director of Workforce Innovation; 2 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 (c) A representative of Workforce Florida, Inc., 2 appointed by the chair of the Board of Directors of Workforce 3 Florida, Inc.; 4 (d) A representative of the Department of Education, 5 appointed by the Commissioner of Education; 6 (e) A representative of the Department of Health, 7 appointed by the Secretary of Health; 8 (f) A representative of the Agency for Health Care 9 Administration, appointed by the Secretary of Health Care 10 Administration; 11 (g) The Director of the Florida Center for Nursing; 12 (h) A representative of the Department of Elderly 13 Affairs, appointed by the Secretary of Elderly Affairs; and 14 (i) A representative of a Gold Seal nursing home that 15 is not one of the pilot program sites, appointed by the 16 Secretary of Health Care Administration. 17 (2) The steering committee shall: 18 (a) Provide consultation and guidance to the Agency 19 for Workforce Innovation on matters of policy during the 20 implementation of the pilot program; and 21 (b) Provide oversight to the evaluation of the pilot 22 program. 23 (3) Members of the steering committee are entitled to 24 reimbursement for per diem and travel expenses under section 25 112.061, Florida Statutes. 26 (4) The steering committee shall complete its 27 activities by June 30, 2007, and the authorization for the 28 steering committee ends on that date. 29 Section 105. Evaluation of the Certified Geriatric 30 Specialist Preparation Pilot Program.--The Agency for 31 Workforce Innovation, in consultation with the Certified 3 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 Geriatric Specialty Nursing Initiative Steering Committee, 2 shall conduct or contract for an evaluation of the pilot 3 program. The agency shall ensure that an evaluation report is 4 submitted to the Governor, the President of the Senate, and 5 the Speaker of the House of Representatives by January 1, 6 2007. The evaluation must address the experience and success 7 of the certified nursing assistants in the pilot program and 8 must contain recommendations regarding the expansion of the 9 delivery of geriatric nursing education in nursing homes. 10 Section 106. Reports.--The Agency for Workforce 11 Innovation shall submit status reports and recommendations 12 regarding legislation necessary to further the implementation 13 of the pilot program to the Governor, the President of the 14 Senate, and the Speaker of the House of Representatives on 15 January 1, 2005, January 1, 2006, and January 1, 2007. 16 Section 107. Section 464.0125, Florida Statutes, is 17 created to read: 18 464.0125 Certified geriatric specialists; 19 certification requirements.-- 20 (1) DEFINITIONS; RESPONSIBILITIES.-- 21 (a) As used in this section, the term: 22 1. "Certified geriatric specialist" means a person who 23 meets the qualifications specified in this section and who is 24 certified by the board to practice as a certified geriatric 25 specialist. 26 2. "Geriatric patient" means any patient who is 60 27 years of age or older. 28 3. "Practice of certified geriatric specialty nursing" 29 means the performance of selected acts in facilities licensed 30 under part II or part III of chapter 400, including the 31 administration of treatments and medications, in the care of 4 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 ill, injured, or infirm geriatric patients and the promotion 2 of wellness, maintenance of health, and prevention of illness 3 of geriatric patients under the direction of a registered 4 nurse, a licensed physician, a licensed osteopathic physician, 5 a licensed podiatric physician, or a licensed dentist. The 6 scope of practice of a certified geriatric specialist includes 7 the practice of practical nursing as defined in s. 464.003 for 8 geriatric patients only, except for any act in which 9 instruction and clinical knowledge of pediatric nursing or 10 obstetric/maternal-child nursing is required. A certified 11 geriatric specialist, while providing nursing services in 12 facilities licensed under part II or part III of chapter 400, 13 may supervise the activities of certified nursing assistants 14 and other unlicensed personnel providing services in such 15 facilities in accordance with rules adopted by the board. 16 (b) The certified geriatric specialist shall be 17 responsible and accountable for making decisions that are 18 based upon the individual's educational preparation and 19 experience in performing certified geriatric specialty 20 nursing. 21 (2) CERTIFICATION.-- 22 (a) Any certified nursing assistant desiring to be 23 certified as a certified geriatric specialist must apply to 24 the department and submit proof that he or she holds a current 25 certificate as a certified nursing assistant under part II of 26 this chapter and has satisfactorily completed the following 27 requirements: 28 1. Is in good mental and physical health, is a 29 recipient of a high school diploma or its equivalent; has 30 completed the requirements for graduation from an approved 31 program for nursing or its equivalent, as determined by the 5 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 board, for the preparation of licensed practical nurses, 2 except for instruction and clinical knowledge of pediatric 3 nursing or obstetric/maternal-child nursing; and has completed 4 additional education in the care of ill, injured, or infirm 5 geriatric patients, the maintenance of health, the prevention 6 of injury, and the provision of palliative care for geriatric 7 patients. By September 1, 2004, the Board of Nursing shall 8 adopt rules establishing the core competencies for the 9 additional education in geriatric care. Any program that is 10 approved on July 1, 2004, by the board for the preparation of 11 registered nurses or licensed practical nurses may provide 12 education for the preparation of certified geriatric 13 specialists without further board approval. 14 2. Has the ability to communicate in the English 15 language, which may be determined by an examination given by 16 the department. 17 3. Has provided sufficient information, which must be 18 submitted by the department for a statewide criminal records 19 correspondence check through the Department of Law 20 Enforcement. 21 (b) Each applicant who meets the requirements of this 22 subsection is, unless denied pursuant to s. 464.018, entitled 23 to certification as a certified geriatric specialist. The 24 board must certify, and the department must issue a 25 certificate to practice as a certified geriatric specialist 26 to, any certified nursing assistant who meets the 27 qualifications set forth in this section. The board shall 28 establish an application fee not to exceed $100 and a biennial 29 renewal fee not to exceed $50. The board may adopt rules to 30 administer this section. 31 (c) A person receiving certification under this 6 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 section shall: 2 1. Work only within the confines of a facility 3 licensed under part II or part III of chapter 400. 4 2. Care for geriatric patients only. 5 3. Comply with the minimum standards of practice for 6 nurses and be subject to disciplinary action for violations of 7 s. 464.018. 8 (3) ARTICULATION.--Any certified geriatric specialist 9 who completes the additional instruction and coursework in an 10 approved nursing program pursuant to s. 464.019 for the 11 preparation of practical nursing in the areas of pediatric 12 nursing and obstetric/maternal-child nursing is, unless denied 13 pursuant to s. 464.018, entitled to licensure as a licensed 14 practical nurse if the applicant otherwise meets the 15 requirements of s. 464.008. 16 (4) TITLES AND ABBREVIATIONS; RESTRICTIONS; 17 PENALTIES.-- 18 (a) Only persons who hold certificates to practice as 19 certified geriatric specialists in this state or who are 20 performing services within the practice of certified geriatric 21 specialty nursing pursuant to the exception set forth in s. 22 464.022(8) may use the title "Certified Geriatric Specialist" 23 and the abbreviation "C.G.S." 24 (b) A person may not practice or advertise as, or 25 assume the title of, certified geriatric specialist or use the 26 abbreviation "C.G.S." or take any other action that would lead 27 the public to believe that person is certified as such or is 28 performing services within the practice of certified geriatric 29 specialty nursing pursuant to the exception set forth in s. 30 464.022(8), unless that person is certified to practice as 31 such. 7 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 (c) A violation of this subsection is a misdemeanor of 2 the first degree, punishable as provided in s. 775.082 or s. 3 775.083. 4 (5) VIOLATIONS AND PENALTIES.--Practicing certified 5 geriatric specialty nursing, as defined in this section, 6 without holding an active certificate to do so constitutes a 7 felony of the third degree, punishable as provided in s. 8 775.082, s. 775.083, or s. 775.084. 9 Section 108. Paragraph (b) of subsection (1) of 10 section 381.00315, Florida Statutes, is amended to read: 11 381.00315 Public health advisories; public health 12 emergencies.--The State Health Officer is responsible for 13 declaring public health emergencies and issuing public health 14 advisories. 15 (1) As used in this section, the term: 16 (b) "Public health emergency" means any occurrence, or 17 threat thereof, whether natural or man made, which results or 18 may result in substantial injury or harm to the public health 19 from infectious disease, chemical agents, nuclear agents, 20 biological toxins, or situations involving mass casualties or 21 natural disasters. Prior to declaring a public health 22 emergency, the State Health Officer shall, to the extent 23 possible, consult with the Governor and shall notify the Chief 24 of Domestic Security Initiatives as created in s. 943.03. The 25 declaration of a public health emergency shall continue until 26 the State Health Officer finds that the threat or danger has 27 been dealt with to the extent that the emergency conditions no 28 longer exist and he or she terminates the declaration. 29 However, a declaration of a public health emergency may not 30 continue for longer than 60 days unless the Governor concurs 31 in the renewal of the declaration. The State Health Officer, 8 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 upon declaration of a public health emergency, may take 2 actions that are necessary to protect the public health. Such 3 actions include, but are not limited to: 4 1. Directing manufacturers of prescription drugs or 5 over-the-counter drugs who are permitted under chapter 499 and 6 wholesalers of prescription drugs located in this state who 7 are permitted under chapter 499 to give priority to the 8 shipping of specified drugs to pharmacies and health care 9 providers within geographic areas that have been identified by 10 the State Health Officer. The State Health Officer must 11 identify the drugs to be shipped. Manufacturers and 12 wholesalers located in the state must respond to the State 13 Health Officer's priority shipping directive before shipping 14 the specified drugs. 15 2. Notwithstanding chapters 465 and 499 and rules 16 adopted thereunder, directing pharmacists employed by the 17 department to compound bulk prescription drugs and provide 18 these bulk prescription drugs to physicians and nurses of 19 county health departments or any qualified person authorized 20 by the State Health Officer for administration to persons as 21 part of a prophylactic or treatment regimen. 22 3. Notwithstanding s. 456.036, temporarily 23 reactivating the inactive license of the following health care 24 practitioners, when such practitioners are needed to respond 25 to the public health emergency: physicians licensed under 26 chapter 458 or chapter 459; physician assistants licensed 27 under chapter 458 or chapter 459; certified geriatric 28 specialists certified under part I of chapter 464; licensed 29 practical nurses, registered nurses, and advanced registered 30 nurse practitioners licensed under part I of chapter 464; 31 respiratory therapists licensed under part V of chapter 468; 9 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 and emergency medical technicians and paramedics certified 2 under part III of chapter 401. Only those health care 3 practitioners specified in this paragraph who possess an 4 unencumbered inactive license and who request that such 5 license be reactivated are eligible for reactivation. An 6 inactive license that is reactivated under this paragraph 7 shall return to inactive status when the public health 8 emergency ends or prior to the end of the public health 9 emergency if the State Health Officer determines that the 10 health care practitioner is no longer needed to provide 11 services during the public health emergency. Such licenses may 12 only be reactivated for a period not to exceed 90 days without 13 meeting the requirements of s. 456.036 or chapter 401, as 14 applicable. 15 4. Ordering an individual to be examined, tested, 16 vaccinated, treated, or quarantined for communicable diseases 17 that have significant morbidity or mortality and present a 18 severe danger to public health. Individuals who are unable or 19 unwilling to be examined, tested, vaccinated, or treated for 20 reasons of health, religion, or conscience may be subjected to 21 quarantine. 22 a. Examination, testing, vaccination, or treatment may 23 be performed by any qualified person authorized by the State 24 Health Officer. 25 b. If the individual poses a danger to the public 26 health, the State Health Officer may subject the individual to 27 quarantine. If there is no practical method to quarantine the 28 individual, the State Health Officer may use any means 29 necessary to vaccinate or treat the individual. 30 31 Any order of the State Health Officer given to effectuate this 10 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 paragraph shall be immediately enforceable by a law 2 enforcement officer under s. 381.0012. 3 Section 109. Subsection (14) of section 400.021, 4 Florida Statutes, is amended to read: 5 400.021 Definitions.--When used in this part, unless 6 the context otherwise requires, the term: 7 (14) "Nursing service" means such services or acts as 8 may be rendered, directly or indirectly, to and in behalf of a 9 person by individuals as defined in ss. s. 464.003 and 10 464.0125. 11 Section 110. Paragraphs (a) and (c) of subsection (3) 12 of section 400.23, Florida Statutes, are amended to read: 13 400.23 Rules; evaluation and deficiencies; licensure 14 status.-- 15 (3)(a) The agency shall adopt rules providing for the 16 minimum staffing requirements for nursing homes. These 17 requirements shall include, for each nursing home facility, a 18 minimum certified nursing assistant staffing of 2.3 hours of 19 direct care per resident per day beginning January 1, 2002, 20 increasing to 2.6 hours of direct care per resident per day 21 beginning January 1, 2003, and increasing to 2.9 hours of 22 direct care per resident per day beginning May 1, 2004. 23 Beginning January 1, 2002, no facility shall staff below one 24 certified nursing assistant per 20 residents, and a minimum 25 licensed nursing staffing of 1.0 hour of direct resident care 26 per resident per day but never below one licensed nurse per 40 27 residents. For purposes of computing nursing staffing minimums 28 and ratios, certified geriatric specialists shall be 29 considered licensed nursing staff. Nursing assistants employed 30 never below one licensed nurse per 40 residents. Nursing 31 assistants employed under s. 400.211(2) may be included in 11 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 computing the staffing ratio for certified nursing assistants 2 only if they provide nursing assistance services to residents 3 on a full-time basis. Each nursing home must document 4 compliance with staffing standards as required under this 5 paragraph and post daily the names of staff on duty for the 6 benefit of facility residents and the public. The agency shall 7 recognize the use of licensed nurses for compliance with 8 minimum staffing requirements for certified nursing 9 assistants, provided that the facility otherwise meets the 10 minimum staffing requirements for licensed nurses and that the 11 licensed nurses so recognized are performing the duties of a 12 certified nursing assistant. Unless otherwise approved by the 13 agency, licensed nurses counted towards the minimum staffing 14 requirements for certified nursing assistants must exclusively 15 perform the duties of a certified nursing assistant for the 16 entire shift and shall not also be counted towards the minimum 17 staffing requirements for licensed nurses. If the agency 18 approved a facility's request to use a licensed nurse to 19 perform both licensed nursing and certified nursing assistant 20 duties, the facility must allocate the amount of staff time 21 specifically spent on certified nursing assistant duties for 22 the purpose of documenting compliance with minimum staffing 23 requirements for certified and licensed nursing staff. In no 24 event may the hours of a licensed nurse with dual job 25 responsibilities be counted twice. 26 (c) Licensed practical nurses licensed under chapter 27 464 who are providing nursing services in nursing home 28 facilities under this part may supervise the activities of 29 other licensed practical nurses, certified geriatric 30 specialists, certified nursing assistants, and other 31 unlicensed personnel providing services in such facilities in 12 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 accordance with rules adopted by the Board of Nursing. 2 Section 111. Paragraph (b) of subsection (2) of 3 section 409.908, Florida Statutes, is amended to read: 4 409.908 Reimbursement of Medicaid providers.--Subject 5 to specific appropriations, the agency shall reimburse 6 Medicaid providers, in accordance with state and federal law, 7 according to methodologies set forth in the rules of the 8 agency and in policy manuals and handbooks incorporated by 9 reference therein. These methodologies may include fee 10 schedules, reimbursement methods based on cost reporting, 11 negotiated fees, competitive bidding pursuant to s. 287.057, 12 and other mechanisms the agency considers efficient and 13 effective for purchasing services or goods on behalf of 14 recipients. If a provider is reimbursed based on cost 15 reporting and submits a cost report late and that cost report 16 would have been used to set a lower reimbursement rate for a 17 rate semester, then the provider's rate for that semester 18 shall be retroactively calculated using the new cost report, 19 and full payment at the recalculated rate shall be affected 20 retroactively. Medicare-granted extensions for filing cost 21 reports, if applicable, shall also apply to Medicaid cost 22 reports. Payment for Medicaid compensable services made on 23 behalf of Medicaid eligible persons is subject to the 24 availability of moneys and any limitations or directions 25 provided for in the General Appropriations Act or chapter 216. 26 Further, nothing in this section shall be construed to prevent 27 or limit the agency from adjusting fees, reimbursement rates, 28 lengths of stay, number of visits, or number of services, or 29 making any other adjustments necessary to comply with the 30 availability of moneys and any limitations or directions 31 provided for in the General Appropriations Act, provided the 13 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 adjustment is consistent with legislative intent. 2 (2) 3 (b) Subject to any limitations or directions provided 4 for in the General Appropriations Act, the agency shall 5 establish and implement a Florida Title XIX Long-Term Care 6 Reimbursement Plan (Medicaid) for nursing home care in order 7 to provide care and services in conformance with the 8 applicable state and federal laws, rules, regulations, and 9 quality and safety standards and to ensure that individuals 10 eligible for medical assistance have reasonable geographic 11 access to such care. 12 1. Changes of ownership or of licensed operator do not 13 qualify for increases in reimbursement rates associated with 14 the change of ownership or of licensed operator. The agency 15 shall amend the Title XIX Long Term Care Reimbursement Plan to 16 provide that the initial nursing home reimbursement rates, for 17 the operating, patient care, and MAR components, associated 18 with related and unrelated party changes of ownership or 19 licensed operator filed on or after September 1, 2001, are 20 equivalent to the previous owner's reimbursement rate. 21 2. The agency shall amend the long-term care 22 reimbursement plan and cost reporting system to create direct 23 care and indirect care subcomponents of the patient care 24 component of the per diem rate. These two subcomponents 25 together shall equal the patient care component of the per 26 diem rate. Separate cost-based ceilings shall be calculated 27 for each patient care subcomponent. The direct care 28 subcomponent of the per diem rate shall be limited by the 29 cost-based class ceiling, and the indirect care subcomponent 30 shall be limited by the lower of the cost-based class ceiling, 31 by the target rate class ceiling, or by the individual 14 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 provider target. The agency shall adjust the patient care 2 component effective January 1, 2002. The cost to adjust the 3 direct care subcomponent shall be net of the total funds 4 previously allocated for the case mix add-on. The agency shall 5 make the required changes to the nursing home cost reporting 6 forms to implement this requirement effective January 1, 2002. 7 3. The direct care subcomponent shall include salaries 8 and benefits of direct care staff providing nursing services 9 including registered nurses, licensed practical nurses, 10 certified geriatric specialists certified under part I of 11 chapter 464, and certified nursing assistants who deliver care 12 directly to residents in the nursing home facility. This 13 excludes nursing administration, MDS, and care plan 14 coordinators, staff development, and staffing coordinator. 15 4. All other patient care costs shall be included in 16 the indirect care cost subcomponent of the patient care per 17 diem rate. There shall be no costs directly or indirectly 18 allocated to the direct care subcomponent from a home office 19 or management company. 20 5. On July 1 of each year, the agency shall report to 21 the Legislature direct and indirect care costs, including 22 average direct and indirect care costs per resident per 23 facility and direct care and indirect care salaries and 24 benefits per category of staff member per facility. 25 6. In order to offset the cost of general and 26 professional liability insurance, the agency shall amend the 27 plan to allow for interim rate adjustments to reflect 28 increases in the cost of general or professional liability 29 insurance for nursing homes. This provision shall be 30 implemented to the extent existing appropriations are 31 available. 15 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 2 It is the intent of the Legislature that the reimbursement 3 plan achieve the goal of providing access to health care for 4 nursing home residents who require large amounts of care while 5 encouraging diversion services as an alternative to nursing 6 home care for residents who can be served within the 7 community. The agency shall base the establishment of any 8 maximum rate of payment, whether overall or component, on the 9 available moneys as provided for in the General Appropriations 10 Act. The agency may base the maximum rate of payment on the 11 results of scientifically valid analysis and conclusions 12 derived from objective statistical data pertinent to the 13 particular maximum rate of payment. 14 Section 112. Subsection (1) and paragraph (a) of 15 subsection (2) of section 1009.65, Florida Statutes, are 16 amended to read: 17 1009.65 Medical Education Reimbursement and Loan 18 Repayment Program.-- 19 (1) To encourage qualified medical professionals to 20 practice in underserved locations where there are shortages of 21 such personnel, there is established the Medical Education 22 Reimbursement and Loan Repayment Program. The function of the 23 program is to make payments that offset loans and educational 24 expenses incurred by students for studies leading to a medical 25 or nursing degree, medical or nursing licensure, or advanced 26 registered nurse practitioner certification or physician 27 assistant licensure. The following licensed or certified 28 health care professionals are eligible to participate in this 29 program: medical doctors with primary care specialties, 30 doctors of osteopathic medicine with primary care specialties, 31 physician's assistants, certified geriatric specialists 16 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 certified under part I of chapter 464, licensed practical 2 nurses and registered nurses, and advanced registered nurse 3 practitioners with primary care specialties such as certified 4 nurse midwives. Primary care medical specialties for 5 physicians include obstetrics, gynecology, general and family 6 practice, internal medicine, pediatrics, and other specialties 7 which may be identified by the Department of Health. 8 (2) From the funds available, the Department of Health 9 shall make payments to selected medical professionals as 10 follows: 11 (a) Up to $4,000 per year for certified geriatric 12 specialists certified under part I of chapter 464, licensed 13 practical nurses, and registered nurses, up to $10,000 per 14 year for advanced registered nurse practitioners and 15 physician's assistants, and up to $20,000 per year for 16 physicians. Penalties for noncompliance shall be the same as 17 those in the National Health Services Corps Loan Repayment 18 Program. Educational expenses include costs for tuition, 19 matriculation, registration, books, laboratory and other fees, 20 other educational costs, and reasonable living expenses as 21 determined by the Department of Health. 22 Section 113. Subsection (2) of section 1009.66, 23 Florida Statutes, is amended to read: 24 1009.66 Nursing Student Loan Forgiveness Program.-- 25 (2) To be eligible, a candidate must have graduated 26 from an accredited or approved nursing program and have 27 received a Florida license as a licensed practical nurse, a 28 certified geriatric specialist certified under part I of 29 chapter 464, or a registered nurse or a Florida certificate as 30 an advanced registered nurse practitioner. 31 Section 114. The sum of $157,017 is appropriated from 17 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 the General Revenue Fund to the Agency for Workforce 2 Innovation to support the work of the Certified Geriatric 3 Specialty Nursing Initiative Steering Committee, to administer 4 the pilot sites, to contract for an evaluation, and to the 5 extent that funds are available, and if necessary, to provide 6 nursing faculty, substitute certified nursing assistants for 7 those who are in clinical education, and technical support to 8 the pilot sites during the 2004-2005 fiscal year. 9 10 (Redesignate subsequent sections.) 11 12 13 ================ T I T L E A M E N D M E N T =============== 14 And the title is amended as follows: 15 On page 10, line 28, following the semicolon 16 17 insert: 18 providing a short title; requiring the Agency 19 for Workforce Innovation to establish a pilot 20 program for delivery of certified geriatric 21 specialty nursing education; specifying 22 eligibility requirements for certified nursing 23 assistants to obtain certified geriatric 24 specialty nursing education; specifying 25 requirements for the education of certified 26 nursing assistants to prepare for certification 27 as a certified geriatric specialist; creating a 28 Certified Geriatric Specialty Nursing 29 Initiative Steering Committee; providing for 30 the composition of and manner of appointment to 31 the Certified Geriatric Specialty Nursing 18 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 Initiative Steering Committee; providing 2 responsibilities of the steering committee; 3 providing for reimbursement for per diem and 4 travel expenses; requiring the Agency for 5 Workforce Innovation to conduct or contract for 6 an evaluation of the pilot program for delivery 7 of certified geriatric specialty nursing 8 education; requiring the evaluation to include 9 recommendations regarding the expansion of the 10 delivery of certified geriatric specialty 11 nursing education in nursing homes; requiring 12 the Agency for Workforce Innovation to report 13 to the Governor and Legislature regarding the 14 status and evaluation of the pilot program; 15 creating s. 464.0125, F.S.; providing 16 definitions; providing requirements for persons 17 to become certified geriatric specialists; 18 specifying fees; providing for articulation of 19 geriatric specialty nursing coursework and 20 practical nursing coursework; providing 21 practice standards and grounds for which 22 certified geriatric specialists may be subject 23 to discipline by the Board of Nursing; creating 24 restrictions on the use of professional nursing 25 titles; prohibiting the use of certain 26 professional titles; providing penalties; 27 authorizing approved nursing programs to 28 provide education for the preparation of 29 certified geriatric specialists without further 30 board approval; authorizing certified geriatric 31 specialists to supervise the activities of 19 9:31 AM 04/23/04 s2170c2c-02bz2
SENATE AMENDMENT Bill No. CS for CS for SB 2170 Amendment No. ___ Barcode 911996 1 others in nursing home facilities according to 2 rules by the Board of Nursing; revising 3 terminology relating to nursing to conform to 4 the certification of geriatric specialists; 5 amending s. 381.00315, F.S.; revising 6 requirements for the reactivation of the 7 licenses of specified health care practitioners 8 in the event of a public health emergency to 9 include certified geriatric specialists; 10 amending s. 400.021, F.S.; including services 11 provided by a certified geriatric specialist 12 within the definition of nursing service; 13 amending s. 400.23, F.S.; specifying that 14 certified geriatric specialists shall be 15 considered licensed nursing staff; authorizing 16 licensed practical nurses to supervise the 17 activities of certified geriatric specialists 18 in nursing home facilities according to rules 19 adopted by the Board of Nursing; amending s. 20 409.908, F.S.; revising the methodology for 21 reimbursement of Medicaid program providers to 22 include services of certified geriatric 23 specialists; amending s. 1009.65, F.S.; 24 revising eligibility for the Medical Education 25 Reimbursement and Loan Repayment Program to 26 include certified geriatric specialists; 27 amending s. 1009.66, F.S.; revising eligibility 28 requirements for the Nursing Student Loan 29 Forgiveness Program to include certified 30 geriatric specialists; providing an 31 appropriation; 20 9:31 AM 04/23/04 s2170c2c-02bz2