HB 1551

1
A bill to be entitled
2An act relating to emergency management; amending s.
3252.355, F.S.; providing that the Department of Community
4Affairs shall be the designated lead agency responsible
5for community education and outreach to the general
6public, including special needs clients, regarding
7registration as a person with special needs, special needs
8shelters, and general information regarding shelter stays;
9requiring the department to disseminate educational and
10outreach information through local emergency management
11offices; amending s. 381.0303, F.S.; removing a condition
12of specified funding as a prerequisite to the assumption
13of lead responsibility by the Department of Health for
14specified coordination with respect to the development of
15a plan for the staffing and medical management of special
16needs shelters; providing that the local Children's
17Medical Services offices shall assume lead responsibility
18for specified coordination with respect to the development
19of a plan for the staffing and medical management of
20pediatric special needs shelters; requiring such plans to
21be in conformance with the local comprehensive emergency
22management plan; requiring county governments to assist in
23the process of coordinating the recruitment of health care
24practitioners to staff local special needs shelters;
25providing that the appropriate county health department,
26Children's Medical Services, and local emergency
27management agency shall jointly determine the
28responsibility for medical supervision in a special needs
29shelter; providing that the Department of Elderly Affairs
30shall be the lead agency responsible for ensuring the
31placement of special needs residents rendered homeless due
32to a disaster event and for appropriate and necessary
33discharge planning for special needs shelter residents;
34providing that the Department of Children and Family
35Services shall be the lead agency responsible for ensuring
36the placement of developmentally disabled persons, mental
37health special needs residents, and Alzheimer adult
38special needs residents rendered homeless due to a
39disaster event and for the appropriate and necessary
40discharge planning for special needs shelter residents;
41providing that state employees with a preestablished role
42in disaster response may be called upon to serve in times
43of disaster in specified capacities; requiring hospitals
44that are used to shelter special needs persons during and
45after an evacuation to submit invoices for reimbursement
46from the state for expenses incurred for medical care
47provided at the request of the Department of Health in
48special needs shelters or at other locations during times
49of emergency or major disaster; revising the role of the
50special needs shelter interagency committee with respect
51to the planning and operation of special needs shelters;
52providing required functions of the committee; providing
53for the inclusion of specified rules with respect to
54health practitioner recruitment for special needs
55shelters; providing that the requirement for submission of
56emergency management plans by home health agencies, nurse
57registries, and hospice programs to local emergency
58management agencies for review and approval remains in
59effect; providing requirements with respect to such plans;
60removing a condition of specified funding as a
61prerequisite to the submission of such plans; amending s.
62252.385, F.S.; requiring the Department of Management
63Services to annually review the registry of persons with
64special needs to ensure that the construction of special
65needs shelters is sufficient and suitable to house such
66persons during and after an evacuation; amending s.
67400.492, F.S.; providing that home health, hospice, and
68durable medical equipment provider agencies shall not be
69required to continue to provide care to patients in
70emergency situations that are beyond their control and
71that make it impossible to provide services; authorizing
72home health agencies and durable medical equipment
73providers to establish links to local emergency operations
74centers to determine a mechanism to approach areas within
75a disaster area in order for the agency to reach its
76clients; providing that the presentation of home care
77clients to the special needs shelter without the home
78health agency making a good faith effort to provide
79services in the shelter setting constitutes abandonment of
80the client; requiring regulatory review in such cases;
81amending s. 408.831, F.S.; providing that entities
82regulated or licensed by the Agency for Health Care
83Administration may exceed their licensed capacity to act
84as a receiving facility under specified circumstances;
85providing requirements while such entities are in an
86overcapacity status; providing for issuance of an inactive
87license to such licensees under specified conditions;
88providing requirements and procedures with respect to the
89issuance and reactivation of an inactive license;
90providing fees; providing an effective date.
91
92Be It Enacted by the Legislature of the State of Florida:
93
94     Section 1.  Section 252.355, Florida Statutes, is amended
95to read:
96     252.355  Registry of persons with special needs; notice.--
97     (1)  In order to meet the special needs of persons who
98would need assistance during evacuations and sheltering because
99of physical, mental, or sensory disabilities, each local
100emergency management agency in the state shall maintain a
101registry of persons with special needs located within the
102jurisdiction of the local agency. The registration shall
103identify those persons in need of assistance and plan for
104resource allocation to meet those identified needs. To assist
105the local emergency management agency in identifying such
106persons, the Department of Children and Family Services,
107Department of Health, Agency for Health Care Administration,
108Department of Labor and Employment Security, and Department of
109Elderly Affairs shall provide registration information to all of
110their special needs clients and to all incoming clients as a
111part of the intake process. The registry shall be updated
112annually. The registration program shall give persons with
113special needs the option of preauthorizing emergency response
114personnel to enter their homes during search and rescue
115operations if necessary to assure their safety and welfare
116following disasters.
117(2)  The Department of Community Affairs shall be the
118designated lead agency responsible for community education and
119outreach to the general public, including special needs clients,
120regarding registration and special needs shelters and general
121information regarding shelter stays. The Department of Community
122Affairs shall disseminate such educational and outreach
123information through the local emergency management offices.
124     (3)(2)  On or before May 1 of each year each electric
125utility in the state shall annually notify residential customers
126in its service area of the availability of the registration
127program available through their local emergency management
128agency.
129     (4)(3)  All records, data, information, correspondence, and
130communications relating to the registration of persons with
131special needs as provided in subsection (1) are confidential and
132exempt from the provisions of s. 119.07(1), except that such
133information shall be available to other emergency response
134agencies, as determined by the local emergency management
135director.
136     (5)(4)  All appropriate agencies and community-based
137service providers, including home health care providers, shall
138assist emergency management agencies by collecting registration
139information for persons with special needs as part of program
140intake processes, establishing programs to increase the
141awareness of the registration process, and educating clients
142about the procedures that may be necessary for their safety
143during disasters. Clients of state or federally funded service
144programs with physical, mental, or sensory disabilities who need
145assistance in evacuating, or when in shelters, must register as
146persons with special needs.
147     Section 2.  Section 381.0303, Florida Statutes, is amended
148to read:
149     381.0303  Health practitioner recruitment for special needs
150shelters.--
151     (1)  PURPOSE.--The purpose of this section is to designate
152the Department of Health, through its county health departments,
153as the lead agency for coordination of the recruitment of health
154care practitioners, as defined in s. 456.001(4), to staff
155special needs shelters in times of emergency or disaster and to
156provide resources to the department to carry out this
157responsibility. However, nothing in this section prohibits a
158county health department from entering into an agreement with a
159local emergency management agency to assume the lead
160responsibility for recruiting health care practitioners.
161     (2)  SPECIAL NEEDS SHELTER PLAN AND STAFFING.--Provided
162funds have been appropriated to support medical services
163disaster coordinator positions in county health departments, The
164department shall assume lead responsibility for the local
165coordination of local medical and health care providers, the
166American Red Cross, and other interested parties in developing a
167plan for the staffing and medical management of special needs
168shelters. The local Children's Medical Services offices shall
169assume lead responsibility for the local coordination of local
170medical and health care providers, the American Red Cross, and
171other interested parties in developing a plan for the staffing
172and medical management of pediatric special needs shelters.
173Plans The plan shall be in conformance with the local
174comprehensive emergency management plan.
175     (a)  County health departments shall, in conjunction with
176the local emergency management agencies, have the lead
177responsibility for coordination of the recruitment of health
178care practitioners to staff local special needs shelters. County
179health departments shall assign their employees to work in
180special needs shelters when needed to protect the health of
181patients. County governments shall assist in this process.
182     (b)  The appropriate county health department, Children's
183Medical Services, and local emergency management agency shall
184jointly determine who has responsibility for medical supervision
185in a special needs shelter.
186     (c)  The Department of Elderly Affairs shall be the lead
187agency responsible for ensuring the placement of special needs
188residents rendered homeless due to a disaster event and for
189appropriate and necessary discharge planning for special needs
190shelter residents. Other elder service agencies and
191organizations shall assist Department of Elderly Affairs in this
192effort.
193     (d)  The Department of Children and Family Services shall
194be the lead agency responsible for ensuring the placement of
195developmentally disabled special needs residents, mental health
196special needs residents, and Alzheimer adult special needs
197residents rendered homeless due to a disaster event and the
198appropriate and necessary discharge planning for special needs
199shelter residents. Other social service agencies or
200organizations shall assist the Department of Children and Family
201Services in this effort.
202     (e)  State employees with a preestablished role in disaster
203response may be called upon to serve in times of disaster
204commensurate with their knowledge, skills, and abilities and any
205needed activities related to the situation.
206     (f)(c)  Local emergency management agencies shall be
207responsible for the designation and operation of special needs
208shelters during times of emergency or disaster. County health
209departments shall assist the local emergency management agency
210with regard to the management of medical services in special
211needs shelters.
212     (3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS.--The
213Department of Health shall reimburse, subject to the
214availability of funds for this purpose, health care
215practitioners, as defined in s. 456.001, provided the
216practitioner is not providing care to a patient under an
217existing contract, and emergency medical technicians and
218paramedics licensed pursuant to chapter 401 for medical care
219provided at the request of the department in special needs
220shelters or at other locations during times of emergency or
221major disaster. Reimbursement for health care practitioners,
222except for physicians licensed pursuant to chapter 458 or
223chapter 459, shall be based on the average hourly rate that such
224practitioners were paid according to the most recent survey of
225Florida hospitals conducted by the Florida Hospital Association.
226Reimbursement shall be requested on forms prepared by the
227Department of Health. If a Presidential Disaster Declaration has
228been made, and the Federal Government makes funds available, the
229department shall use such funds for reimbursement of eligible
230expenditures. In other situations, or if federal funds do not
231fully compensate the department for reimbursement made pursuant
232to this section, the department shall submit to the Cabinet or
233Legislature, as appropriate, a budget amendment to obtain
234reimbursement from the working capital fund. Hospitals that are
235used to shelter special needs persons during and after an
236evacuation shall submit invoices for reimbursement from the
237state for expenses incurred in this effort. Travel expense and
238per diem costs shall be reimbursed pursuant to s. 112.061.
239     (4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may
240use the registries established in ss. 401.273 and 456.38 when
241health care practitioners are needed to staff special needs
242shelters or to staff disaster medical assistance teams.
243     (5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
244Department of Health may establish a special needs shelter
245interagency committee, to be chaired and staffed by the
246department. The committee shall resolve problems related to
247special needs shelters not addressed in the state comprehensive
248emergency medical plan and shall serve in a consultative role in
249as an oversight committee to monitor the planning and operation
250of special needs shelters.
251     (a)  The committee shall may:
252     1.  Develop and negotiate any necessary interagency
253agreements.
254     2.  Undertake other such activities as the department deems
255necessary to facilitate the implementation of this section.
256     3.  Submit recommendations to the Legislature as necessary.
257     (b)  The special needs shelter interagency committee shall
258be composed of representatives of emergency management, health,
259medical, and social services organizations. Membership shall
260include, but shall not be limited to, the Departments of
261Community Affairs, Children and Family Services, Elderly
262Affairs, Labor and Employment Security, and Education; the
263Agency for Health Care Administration; the Florida Medical
264Association; the Florida Osteopathic Medical Association;
265Associated Home Health Industries of Florida, Inc.; the Florida
266Nurses Association; the Florida Health Care Association; the
267Florida Assisted Living Association; the Florida Hospital
268Association; the Florida Statutory Teaching Hospital Council;
269the Florida Association of Homes for the Aging; the Florida
270Emergency Preparedness Association; the American Red Cross;
271Florida Hospices, Inc.; the Association of Community Hospitals
272and Health Systems; the Florida Association of Health
273Maintenance Organizations; the Florida League of Health Systems;
274Private Care Association; and the Salvation Army.
275     (c)  Meetings of the committee shall be held in
276Tallahassee, and members of the committee shall serve at the
277expense of the agencies or organizations they represent.
278     (6)  RULES.--The department has the authority to adopt
279rules necessary to implement this section. Rules shall may
280include a definition of a special needs patient, specification
281with respect to specify physician reimbursement, and the
282designation of designate which county health departments which
283will have responsibility for the implementation of subsections
284(2) and (3).
285     (7)  REVIEW OF EMERGENCY MANAGEMENT PLANS.--The requirement
286for submission of emergency management plans to county health
287departments by home health agencies pursuant to s. 400.497(8)(c)
288and (d) and by nurse registries pursuant to s. 400.506(16)(e)
289and by hospice programs pursuant to s. 400.610(1)(b) to local
290emergency management agencies for review and approval remains in
291effect. These plans shall specifically address an agency's
292functional staffing plan for the shelters to ensure continuity
293of care and services for clients is conditional upon the receipt
294of an appropriation by the department to establish medical
295services disaster coordinator positions in county health
296departments unless the secretary of the department and a local
297county commission jointly determine to require such plans to be
298submitted based on a determination that there is a special need
299to protect public health in the local area during an emergency.
300     Section 3.  Subsection (4) of section 252.385, Florida
301Statutes, is amended to read:
302     252.385  Public shelter space.--
303     (4)(a)  Public facilities, including schools, postsecondary
304education facilities, and other facilities owned or leased by
305the state or local governments, but excluding hospitals or
306nursing homes, which are suitable for use as public hurricane
307evacuation shelters shall be made available at the request of
308the local emergency management agencies. Such agencies shall
309coordinate with the appropriate school board, university,
310community college, or local governing board when requesting the
311use of such facilities as public hurricane evacuation shelters.
312     (b)  The Department of Management Services shall
313incorporate provisions for the use of suitable leased public
314facilities as public hurricane evacuation shelters into lease
315agreements for state agencies. Suitable leased public facilities
316include leased public facilities that are solely occupied by
317state agencies and have at least 2,000 square feet of net floor
318area in a single room or in a combination of rooms having a
319minimum of 400 square feet in each room. The net square footage
320of floor area must be determined by subtracting from the gross
321square footage the square footage of spaces such as mechanical
322and electrical rooms, storage rooms, open corridors, restrooms,
323kitchens, science or computer laboratories, shop or mechanical
324areas, administrative offices, records vaults, and crawl spaces.
325     (c)  The Department of Management Services shall annually
326review the registry of persons with special needs to ensure that
327the construction of special needs shelters is sufficient and
328suitable to house such persons during and after an evacuation.
329     (d)(c)  The Department of Management Services shall, in
330consultation with local and state emergency management agencies,
331assess Department of Management Services facilities to identify
332the extent to which each facility has public hurricane
333evacuation shelter space. The Department of Management Services
334shall submit proposed facility retrofit projects that
335incorporate hurricane protection enhancements to the department
336for assessment and inclusion in the annual report prepared in
337accordance with subsection (3).
338     Section 4.  Subsection (3) of section 400.492, Florida
339Statutes, is amended to read:
340     400.492  Provision of services during an emergency.--Each
341home health agency shall prepare and maintain a comprehensive
342emergency management plan that is consistent with the standards
343adopted by national accreditation organizations and consistent
344with the local special needs plan. The plan shall be updated
345annually and shall provide for continuing home health services
346during an emergency that interrupts patient care or services in
347the patient's home. The plan shall describe how the home health
348agency establishes and maintains an effective response to
349emergencies and disasters, including: notifying staff when
350emergency response measures are initiated; providing for
351communication between staff members, county health departments,
352and local emergency management agencies, including a backup
353system; identifying resources necessary to continue essential
354care or services or referrals to other organizations subject to
355written agreement; and prioritizing and contacting patients who
356need continued care or services.
357     (3)  Home health, hospice, and durable medical equipment
358provider agencies shall not be required to continue to provide
359care to patients in emergency situations that are beyond their
360control and that make it impossible to provide services, such as
361when roads are impassable or when patients do not go to the
362location specified in their patient records. Home health
363agencies and durable medical equipment providers may establish
364links to local emergency operations centers to determine a
365mechanism to approach areas within the disaster area in order
366for the agency to reach its clients. The presentation of home
367care clients to a special needs shelter without the home health
368agency making a good faith effort to provide services in the
369shelter setting will constitute abandonment of the client and
370will result in regulatory review.
371     Section 5.  Section 408.831, Florida Statutes, is amended
372to read:
373     408.831  Denial, suspension, or revocation of a license,
374registration, certificate, or application.--
375     (1)  In addition to any other remedies provided by law, the
376agency may deny each application or suspend or revoke each
377license, registration, or certificate of entities regulated or
378licensed by it:
379     (a)  If the applicant, licensee, registrant, or
380certificateholder, or, in the case of a corporation,
381partnership, or other business entity, if any officer, director,
382agent, or managing employee of that business entity or any
383affiliated person, partner, or shareholder having an ownership
384interest equal to 5 percent or greater in that business entity,
385has failed to pay all outstanding fines, liens, or overpayments
386assessed by final order of the agency or final order of the
387Centers for Medicare and Medicaid Services, not subject to
388further appeal, unless a repayment plan is approved by the
389agency; or
390     (b)  For failure to comply with any repayment plan.
391     (2)  In reviewing any application requesting a change of
392ownership or change of the licensee, registrant, or
393certificateholder, the transferor shall, prior to agency
394approval of the change, repay or make arrangements to repay any
395amounts owed to the agency. Should the transferor fail to repay
396or make arrangements to repay the amounts owed to the agency,
397the issuance of a license, registration, or certificate to the
398transferee shall be delayed until repayment or until
399arrangements for repayment are made.
400     (3)  Entities subject to this section may exceed their
401licensed capacity to act as a receiving facility in accordance
402with an emergency operations plan for clients of evacuating
403providers from a geographic area where an evacuation order has
404been issued by a local authority having jurisdiction. While in
405an overcapacity status, each provider must furnish or arrange
406for appropriate care and services to all clients and comply with
407all firesafety requirements of state and local authorities.
408Overcapacity status in excess of 30 days requires written prior
409approval by the agency, which shall be based upon satisfactory
410justification and need.
411     (4)  An inactive license may be issued to a licensee
412subject to this section when the provider is located in a
413geographic area where a state of emergency was declared by the
414Governor of Florida if the provider:
415     (a)  Suffered damage to the provider's operation during
416that state of emergency;
417     (b)  Is currently licensed;
418     (c)  Does not have a provisional license; and
419     (d)  Will be temporarily unable to provide services but is
420reasonably expected to resume services within 12 months.
421
422An inactive license may be issued for a period not to
423exceed 12 months but may be renewed by the agency for up to 6
424additional months upon demonstration to the agency of progress
425toward reopening. A request by a licensee for an inactive
426license or to extend the previously approved inactive period
427must be submitted in writing to the agency, accompanied by
428written justification for the inactive license which states the
429beginning and ending dates of inactivity, and including a plan
430for the transfer of any clients to other providers and
431appropriate licensure fees. Upon agency approval, the licensee
432shall notify clients of any necessary discharge or transfer as
433required by authorizing statutes or applicable rules. The
434beginning of the inactive licensure period shall be the date the
435provider ceases operations. The end of the inactive period shall
436become the licensee expiration date and all licensure fees must
437be current, paid in full, and may be prorated. Reactivation of
438an inactive license requires the prior approval by the agency of
439a renewal application, including payment of licensure fees and
440agency inspections indicating compliance with all requirements
441of this part and applicable rules and statutes.
442     (5)(3)  This section provides standards of enforcement
443applicable to all entities licensed or regulated by the Agency
444for Health Care Administration. This section controls over any
445conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
446394, 395, 400, 408, 468, 483, and 641 or rules adopted pursuant
447to those chapters.
448     Section 6.  This act shall take effect July 1, 2005.


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