HB 0653

1	A bill to be entitled
2	An act relating to health care; amending s. 400.487, F.S.;
3	revising home health agency service agreements and
4	treatment orders; amending s. 400.506, F.S.; requiring
5	nurse registries to advise patients, their families, or
6	persons action on behalf of patients of the availability
7	of registered nurses to make visits at an additional cost;
8	removing the requirement for registered nurses to make
9	monthly visits to patients under the care of certified
10	nursing assistants or home health aides; revising
11	requirements for private residence plans of treatment;
12	amending s. 464.009, F.S.; saving a certain requirement
13	for licensure by endorsement from repeal; providing an
14	effective date.
15
16	Be It Enacted by the Legislature of the State of Florida:
17
18	Section 1.  Subsections (1) and (2) of section 400.487,
19	Florida Statutes, are amended to read:
20	400.487  Home health service agreements; physician's,
21	physician's assistant's, and advanced registered nurse
22	practitioner's treatment orders; patient assessment;
23	establishment and review of plan of care; provision of services;
24	orders not to resuscitate.--
25	(1)  Services provided by a home health agency must be
26	covered by an agreement between the home health agency and the
27	patient or the patient's legal representative specifying the
28	home health services to be provided, the rates or charges for
29	services paid with private funds, and the sources method of
30	payment, which may include Medicare, Medicaid, private
31	insurance, personal funds, or a combination thereof. A home
32	health agency providing skilled care must make an assessment of
33	the patient's needs within 48 hours after the start of services.
34	(2)  When required by the provisions of chapter 464; part
35	I, part III, or part V of chapter 468; or chapter 486, the
36	attending physician, physician's assistant, or advanced
37	registered nurse practitioner, acting within his or her
38	respective scope of practice, shall for a patient who is to
39	receive skilled care must establish treatment orders for a
40	patient who is to receive skilled care. The treatment orders
41	must be signed by the physician, physician's assistant, or
42	advanced registered nurse practitioner before a claim for
43	payment for the skilled services is submitted by the home health
44	agency. If the claim is submitted to a managed care
45	organization, the treatment order must be signed in the time
46	allowed under the provider agreement. The treatment orders shall
47	within 30 days after the start of care and must be reviewed, as
48	frequently as the patient's illness requires, by the physician,
49	physician's assistant, or advanced registered nurse practitioner
50	in consultation with the home health agency personnel that
51	provide services to the patient.
52	Section 2.  Paragraph (c) of subsection (10) and paragraph
53	(a) of subsection (17) of section 400.506, Florida Statutes, are
54	amended to read:
55	400.506  Licensure of nurse registries; requirements;
56	penalties.--
57	(10)
58	(c)  A nurse registry shall advise the patient, the
59	patient's family, or a person acting on behalf of a patient at
60	the time of contracting for services through the nurse registry
61	of the availability of registered nurses to make visits to the
62	patient's home at an additional cost A registered nurse shall
63	make monthly visits to the patient's home to assess the
64	patient's condition and quality of care being provided by the
65	certified nursing assistant or home health aide. Any condition
66	which in the professional judgment of the nurse requires further
67	medical attention shall be reported to the attending physician
68	and the nurse registry. The assessment shall become a part of
69	the patient's file with the nurse registry and may be reviewed
70	by the agency during their survey procedure.
71	(17)  All persons referred for contract in private
72	residences by a nurse registry must comply with the following
73	requirements for a plan of treatment:
74	(a)  When, in accordance with the privileges and
75	restrictions imposed upon a nurse under part I of chapter 464,
76	the delivery of care to a patient is under the direction or
77	supervision of a physician or when a physician is responsible
78	for the medical care of the patient, a medical plan of treatment
79	must be established for each patient receiving care or treatment
80	provided by a licensed nurse in the home. The original medical
81	plan of treatment must be timely signed by the physician,
82	physician's assistant, or advanced registered nurse
83	practitioner, acting within his or her respective scope of
84	practice, and reviewed by him or her in consultation with the
85	licensed nurse at least every 2 months. Any additional order or
86	change in orders must be obtained from the physician,
87	physician's assistant, or advanced registered nurse practitioner
88	and reduced to writing and timely signed by the physician,
89	physician's assistant, or advanced registered nurse
90	practitioner. The delivery of care under a medical plan of
91	treatment must be substantiated by the appropriate nursing notes
92	or documentation made by the nurse in compliance with nursing
93	practices established under part I of chapter 464.
94	Section 3.  Paragraph (c) of subsection (1) of section
95	464.009, Florida Statutes, is amended to read:
96	464.009  Licensure by endorsement.--
97	(1)  The department shall issue the appropriate license by
98	endorsement to practice professional or practical nursing to an
99	applicant who, upon applying to the department and remitting a
100	fee set by the board not to exceed $100, demonstrates to the
101	board that he or she:
102	(c)  Has actively practiced nursing in another state,
103	jurisdiction, or territory of the United States for 2 of the
104	preceding 3 years without having his or her license acted
105	against by the licensing authority of any jurisdiction.
106	Applicants who become licensed pursuant to this paragraph must
107	complete within 6 months after licensure a Florida laws and
108	rules course that is approved by the board. Once the department
109	has received the results of the national criminal history check
110	and has determined that the applicant has no criminal history,
111	the appropriate license by endorsement shall be issued to the
112	applicant. This paragraph is repealed July 1, 2004, unless
113	reenacted by the Legislature.
114	Section 4.  This act shall take effect upon becoming a law.

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