HB 1551

CS

CHAMBER ACTION

1	The Transportation & Economic Development Appropriations
2	Committee recommends the following:
3
4	Council/Committee Substitute
5	Remove the entire bill and insert:
6
7	A bill to be entitled
8	An act relating to emergency management; amending s.
9	252.355, F.S.; specifying additional agencies that are
10	required to provide registration information to special
11	needs clients and persons with disabilities or special
12	needs who receive services from such agencies for purposes
13	of inclusion within the registry of persons with special
14	needs maintained by local emergency management agencies;
15	providing that the Department of Community Affairs shall
16	be the designated lead agency responsible for community
17	education and outreach to the general public, including
18	special needs clients, regarding registration as a person
19	with special needs, special needs shelters, and general
20	information regarding shelter stays; requiring the
21	department to disseminate educational and outreach
22	information through local emergency management offices;
23	requiring the department to coordinate community education
24	and outreach related to special needs shelters with
25	specified agencies and entities; providing that specified
26	confidential and exempt information relating to
27	registration of persons with special needs be provided to
28	the Department of Health; amending s. 381.0303, F.S.;
29	providing for the operation, maintenance, and closure of
30	special needs shelters; removing a condition of specified
31	funding as a prerequisite to the assumption of lead
32	responsibility by the Department of Health for specified
33	coordination with respect to the development of a plan for
34	the staffing and medical management of special needs
35	shelters; providing that the local Children's Medical
36	Services offices shall assume lead responsibility for
37	specified coordination with respect to the development of
38	a plan for the staffing and medical management of
39	pediatric special needs shelters; requiring such plans to
40	conform to the local comprehensive emergency management
41	plan; requiring county governments to assist in the
42	process of coordinating the recruitment of health care
43	practitioners to staff local special needs shelters;
44	providing that the appropriate county health department,
45	Children's Medical Services office, and local emergency
46	management agency shall jointly determine the
47	responsibility for medical supervision in a special needs
48	shelter; providing that state employees with a
49	preestablished role in disaster response may be called
50	upon to serve in times of disaster in specified
51	capacities; requiring the Secretary of Elderly Affairs to
52	convene a multiagency emergency special needs shelter
53	response team or teams to assist local areas that are
54	severely impacted by a natural or manmade disaster that
55	required the use of special needs shelters; providing
56	duties and responsibilities of multiagency response teams;
57	authorizing local emergency management agencies to request
58	the assistance of a multiagency response team; providing
59	for the inclusion of specified state agency
60	representatives on each multiagency response team;
61	authorizing hospitals that are used to shelter special
62	needs persons during or after an evacuation to submit
63	invoices for reimbursement to the Department of Health;
64	requiring the department to specify by rule expenses that
65	are reimbursable and the rate of reimbursement for
66	services; prescribing means of and procedures for
67	reimbursement; providing eligibility for reimbursement of
68	health care facilities to whom special needs shelter
69	clients have been discharged by a multiagency response
70	team upon closure of a special needs shelter; providing
71	requirements with respect to such reimbursement;
72	prescribing means of and procedures for reimbursement;
73	disallowing specified reimbursements; revising the role of
74	the special needs shelter interagency committee with
75	respect to the planning and operation of special needs
76	shelters; providing required functions of the committee;
77	providing that the committee shall recommend guidelines to
78	establish a statewide database to collect and disseminate
79	special needs registration information; revising the
80	composition of the special needs shelter interagency
81	committee; requiring the inclusion of specified rules with
82	respect to special needs shelters and specified minimum
83	standards therefor; providing requirements with respect to
84	emergency management plans submitted by a home health
85	agency, nurse registry, or hospice to a county health
86	department for review; removing a condition of specified
87	funding as a prerequisite to the submission of such plans;
88	amending s. 252.385, F.S.; requiring the Division of
89	Emergency Management of the Department of Community
90	Affairs to prepare and submit a statewide emergency
91	shelter plan to the Governor and the Cabinet for approval;
92	providing plan requirements; requiring the Department of
93	Health to assist the division in determining the estimated
94	need for special needs shelter space; requiring inspection
95	of public hurricane evacuation shelter facilities by local
96	emergency management agencies prior to activation of such
97	facilities; amending s. 400.492, F.S.; providing that
98	nurse registries, hospices, and durable medical equipment
99	providers shall prepare and maintain a comprehensive
100	emergency management plan; providing that home health,
101	hospice, and durable medical equipment provider agencies
102	shall not be required to continue to provide care to
103	patients in emergency situations that are beyond their
104	control and that make it impossible to provide services;
105	authorizing home health agencies, nurse registries,
106	hospices, and durable medical equipment providers to
107	establish links to local emergency operations centers to
108	determine a mechanism to approach areas within a disaster
109	area in order for the agency to reach its clients;
110	providing that the presentation of home care or hospice
111	clients to the special needs shelter without the home
112	health agency or hospice making a good faith effort to
113	provide services in the shelter setting constitutes
114	abandonment of the client; requiring regulatory review in
115	such cases; amending s. 408.831, F.S.; providing that
116	entities regulated or licensed by the Agency for Health
117	Care Administration may exceed their licensed capacity to
118	act as a receiving facility under specified circumstances;
119	providing requirements while such entities are in an
120	overcapacity status; providing for issuance of an inactive
121	license to such licensees under specified conditions;
122	providing requirements and procedures with respect to the
123	issuance and reactivation of an inactive license;
124	providing fees; creating s. 252.357, F.S., requiring the
125	Florida Comprehensive Emergency Management Plan to permit
126	the Agency for Health Care Administration to initially
127	contact nursing homes in disaster areas for specified
128	monitoring purposes; requiring the agency to publish an
129	emergency telephone number for use by nursing homes;
130	providing an effective date.
131
132	Be It Enacted by the Legislature of the State of Florida:
133
134	Section 1.  Section 252.355, Florida Statutes, is amended
135	to read:
136	252.355  Registry of persons with special needs; notice.--
137	(1)  In order to meet the special needs of clients persons
138	who would need assistance during evacuations and sheltering
139	because of physical, mental, cognitive impairment, or sensory
140	disabilities, each local emergency management agency in the
141	state shall maintain a registry of persons with special needs
142	located within the jurisdiction of the local agency. The
143	registration shall identify those persons in need of assistance
144	and plan for resource allocation to meet those identified needs.
145	To assist the local emergency management agency in identifying
146	such persons, the Department of Children and Family Services,
147	Department of Health, Agency for Health Care Administration,
148	Department of Education, Agency for Persons with Disabilities,
149	Department of Labor and Employment Security, and Department of
150	Elderly Affairs shall provide registration information to all of
151	their special needs clients and to all people with disabilities
152	or special needs who receive services incoming clients as a part
153	of the intake process. The registry shall be updated annually.
154	The registration program shall give persons with special needs
155	the option of preauthorizing emergency response personnel to
156	enter their homes during search and rescue operations if
157	necessary to assure their safety and welfare following
158	disasters.
159	(2)  The Department of Community Affairs shall be the
160	designated lead agency responsible for community education and
161	outreach to the general public, including special needs clients,
162	regarding registration and special needs shelters and general
163	information regarding shelter stays. The Department of Community
164	Affairs shall disseminate such educational and outreach
165	information through the local emergency management offices. The
166	department shall coordinate the development of curriculum and
167	dissemination of all community education and outreach related to
168	special needs shelters with the Clearinghouse on Disability
169	Information of the Governor's Working Group on the Americans
170	with Disabilities Act, the Department of Children and Family
171	Services, the Department of Health, the Agency for Health Care
172	Administration, the Department of Education, the Agency for
173	Persons with Disabilities, and the Department of Elderly
174	Affairs.
175	(3)(2)  On or before May 1 of each year each electric
176	utility in the state shall annually notify residential customers
177	in its service area of the availability of the registration
178	program available through their local emergency management
179	agency.
180	(4)(3)  All records, data, information, correspondence, and
181	communications relating to the registration of persons with
182	special needs as provided in subsection (1) are confidential and
183	exempt from the provisions of s. 119.07(1), except that such
184	information shall be available to other emergency response
185	agencies, as determined by the local emergency management
186	director, and shall be provided to the Department of Health in
187	the furtherance of their duties and responsibilities.
188	(5)(4)  All appropriate agencies and community-based
189	service providers, including home health care providers, and
190	hospices shall assist emergency management agencies by
191	collecting registration information for persons with special
192	needs as part of program intake processes, establishing programs
193	to increase the awareness of the registration process, and
194	educating clients about the procedures that may be necessary for
195	their safety during disasters. Clients of state or federally
196	funded service programs with physical, mental, cognitive
197	impairment, or sensory disabilities who need assistance in
198	evacuating, or when in shelters, must register as persons with
199	special needs.
200	Section 2.  Section 381.0303, Florida Statutes, is amended
201	to read:
202	381.0303  Health practitioner recruitment for Special needs
203	shelters.--
204	(1)  PURPOSE.--The purpose of this section is to provide
205	for the operation, maintenance, and closure of special needs
206	shelters and to designate the Department of Health, through its
207	county health departments, as the lead agency for coordination
208	of the recruitment of health care practitioners, as defined in
209	s. 456.001(4), to staff special needs shelters in times of
210	emergency or disaster and to provide resources to the department
211	to carry out this responsibility. However, nothing in this
212	section prohibits a county health department from entering into
213	an agreement with a local emergency management agency to assume
214	the lead responsibility for recruiting health care
215	practitioners.
216	(2)  SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE; STATE
217	AGENCY ASSISTANCE AND STAFFING.--Provided funds have been
218	appropriated to support medical services disaster coordinator
219	positions in county health departments,
220	(a)  The department shall assume lead responsibility for
221	the local coordination of local medical and health care
222	providers, the American Red Cross, and other interested parties
223	in developing a plan for the staffing and medical management of
224	special needs shelters. The local Children's Medical Services
225	offices shall assume lead responsibility for the local
226	coordination of local medical and health care providers, the
227	American Red Cross, and other interested parties in developing a
228	plan for the staffing and medical management of pediatric
229	special needs shelters. Plans shall conform to The plan shall be
230	in conformance with the local comprehensive emergency management
231	plan.
232	(b)(a)  County health departments shall, in conjunction
233	with the local emergency management agencies, have the lead
234	responsibility for coordination of the recruitment of health
235	care practitioners to staff local special needs shelters. County
236	health departments shall assign their employees to work in
237	special needs shelters when those employees are needed to
238	protect the health and safety of special needs clients of
239	patients. County governments shall assist in this process.
240	(c)(b)  The appropriate county health department,
241	Children's Medical Services office, and local emergency
242	management agency shall jointly decide determine who has
243	responsibility for medical supervision in each a special needs
244	shelter and shall notify the department of their decision.
245	(d)(c)  Local emergency management agencies shall be
246	responsible for the designation and operation of special needs
247	shelters during times of emergency or disaster. County health
248	departments shall assist the local emergency management agency
249	with regard to the management of medical services in special
250	needs shelters.
251	(e)  State employees with a preestablished role in disaster
252	response may be called upon to serve in times of disaster
253	commensurate with their knowledge, skills, and abilities and any
254	needed activities related to the situation.
255	(f)  The Secretary of Elderly Affairs, or his or her
256	designee, shall convene, at any time that he or she deems
257	appropriate and necessary, a multiagency emergency special needs
258	shelter response team or teams to assist local areas that are
259	severely impacted by a natural or manmade disaster that requires
260	the use of special needs shelters. Multiagency response teams
261	shall provide assistance to local emergency management agencies
262	with the continued operation or closure of the shelters, as well
263	as with the discharge of special needs clients to alternate
264	facilities if necessary. Local emergency management agencies may
265	request the assistance of a multiagency response team by
266	alerting statewide emergency management officials of the
267	necessity for additional assistance in their area. The Secretary
268	of Elderly Affairs is encouraged to proactively work with other
269	state agencies prior to any natural disasters for which warnings
270	are provided to ensure that multiagency response teams are ready
271	to assemble and deploy rapidly upon a determination by state
272	emergency management officials that a disaster area requires
273	additional assistance. The Secretary of Elderly Affairs may call
274	upon any state agency or office to provide staff to assist a
275	multiagency response team or teams. Unless the secretary
276	determines that the nature or circumstances surrounding the
277	disaster do not warrant participation from a particular agency's
278	staff, each multiagency response team shall include at least one
279	representative from each of the following state agencies:
280	1.  Department of Elderly Affairs.
281	3.  Department of Children and Family Services.
282	4.  Department of Veterans' Affairs.
283	5.  Department of Community Affairs.
284	6.  Agency for Health Care Administration.
285	7.  Agency for Persons with Disabilities.
286	(3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
287	FACILITIES.--
288	(a)  The Department of Health shall upon request reimburse,
289	subject to the availability of funds for this purpose, health
290	care practitioners, as defined in s. 456.001, provided the
291	practitioner is not providing care to a patient under an
292	existing contract, and emergency medical technicians and
293	paramedics licensed under pursuant to chapter 401, for medical
294	care provided at the request of the department in special needs
295	shelters or at other locations during times of emergency or a
296	declared major disaster. Reimbursement for health care
297	practitioners, except for physicians licensed under pursuant to
298	chapter 458 or chapter 459, shall be based on the average hourly
299	rate that such practitioners were paid according to the most
300	recent survey of Florida hospitals conducted by the Florida
301	Hospital Association. Reimbursement shall be requested on forms
302	prepared by the Department of Health and shall be paid as
303	specified in paragraph (d).
304	(b)  Hospitals that are used to shelter special needs
305	clients during or after an evacuation may submit invoices for
306	reimbursement to the department. The department shall develop a
307	form for reimbursement and shall specify by rule which expenses
308	are reimbursable and the rate of reimbursement for each service.
309	Reimbursement for the services described in this paragraph shall
310	be paid as specified in paragraph (d).
311	(c)  If, upon closure of a special needs shelter, a
312	multiagency response team determines that it is necessary to
313	discharge special needs shelter clients to other health care
314	facilities, such as nursing homes, assisted living facilities,
315	and community residential group homes, the receiving facilities
316	shall be eligible for reimbursement for services provided to the
317	clients for up to 90 days. Any facility eligible for
318	reimbursement under this paragraph shall submit invoices for
319	reimbursement on forms developed by the department. A facility
320	must show proof of a written request from a representative of an
321	agency serving on the multiagency response team that the client
322	for whom the facility is seeking reimbursement for services
323	rendered was referred to that facility from a special needs
324	shelter. Reimbursement for the services described in this
325	paragraph shall be paid as specified in paragraph (d).
326	(d)  If a Presidential Disaster Declaration has been issued
327	made, and the Federal Government makes funds available, the
328	department shall use those such funds for reimbursement of
329	eligible expenditures. In other situations, or if federal funds
330	do not fully compensate the department for reimbursements
331	permissible under reimbursement made pursuant to this section,
332	the department shall submit to the Cabinet or the Legislature,
333	as appropriate, a budget amendment to obtain reimbursement from
334	the working capital fund. The department shall not provide
335	reimbursement to facilities under this subsection for services
336	provided to a special needs client if, during the period of time
337	in which the services were provided, the client was enrolled in
338	another state-funded program, such as Medicaid or another
339	similar program, which would otherwise pay for the same
340	services. Travel expense and per diem costs shall be reimbursed
341	pursuant to s. 112.061.
342	(4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may
343	use the registries established in ss. 401.273 and 456.38 when
344	health care practitioners are needed to staff special needs
345	shelters or to staff disaster medical assistance teams.
346	(5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
347	Secretary Department of Health may establish a special needs
348	shelter interagency committee and serve as or appoint a designee
349	to serve as the committee's chair. The department shall provide
350	any necessary staff and resources to support the committee in
351	the performance of its duties, to be chaired and staffed by the
352	department. The committee shall resolve problems related to
353	special needs shelters not addressed in the state comprehensive
354	emergency medical plan and shall consult on serve as an
355	oversight committee to monitor the planning and operation of
356	special needs shelters.
357	(a)  The committee shall may:
358	1.  Develop and negotiate any necessary interagency
359	agreements.
360	2.  Undertake other such activities as the department deems
361	necessary to facilitate the implementation of this section.
362	3.  Submit recommendations to the Legislature as necessary.
363	Such recommendations shall include, but not be limited to, the
364	following:
365	a.  Defining "special needs shelter."
366	b.  Defining "special needs client."
367	c.  Development of a uniform registration form for special
368	needs clients.
369	d.  Improving public awareness regarding the registration
370	process.
371	e.  Improving overall communications with special needs
372	clients both before and after a disaster.
373	f.  Recommending the construction or designation of
374	additional special needs shelters in underserved areas of the
375	state and the necessity of upgrading, modifying, or retrofitting
376	existing special needs shelters.
377	g.  Recommending guidelines to establish a statewide
378	database designed to collect and disseminate timely and
379	appropriate special needs registration information.
380	(b)  The special needs shelter interagency committee shall
381	be composed of representatives of emergency management, health,
382	medical, and social services organizations. Membership shall
383	include, but shall not be limited to, representatives of the
384	Departments of Health, Community Affairs, Children and Family
385	Services, Elderly Affairs, Labor and Employment Security, and
386	Education; the Agency for Health Care Administration; the
387	Florida Medical Association; the Florida Osteopathic Medical
388	Association; Associated Home Health Industries of Florida, Inc.;
389	the Florida Nurses Association; the Florida Health Care
390	Association; the Florida Assisted Living Affiliation
391	Association; the Florida Hospital Association; the Florida
392	Statutory Teaching Hospital Council; the Florida Association of
393	Homes for the Aging; the Florida Emergency Preparedness
394	Association; the American Red Cross; Florida Hospices and
395	Palliative Care, Inc.; the Association of Community Hospitals
396	and Health Systems; the Florida Association of Health
397	Maintenance Organizations; the Florida League of Health Systems;
398	Private Care Association; and the Salvation Army; the Florida
399	Association of Aging Services Providers; and the AARP.
400	(c)  Meetings of the committee shall be held in
401	Tallahassee, and members of the committee shall serve at the
402	expense of the agencies or organizations they represent. The
403	committee shall make every effort to use teleconference or video
404	conference capabilities in order to ensure statewide input and
405	participation.
406	(6)  RULES.--The department has the authority to adopt
407	rules necessary to implement this section. Rules shall may
408	include a definition of a special needs client patient, specify
409	physician reimbursement, and the designation of designate which
410	county health departments which will have responsibility for the
411	implementation of subsections (2) and (3). Standards for special
412	needs shelters adopted by rule shall include minimum standards
413	relating to:
414	(a)  The provision of electricity.
415	(b)  Staffing levels for provision of services to assist
416	individuals with activities of daily living.
417	(c)  Provision of transportation services.
418	(d)  Compliance with applicable service animal laws.
419	(e)  Eligibility criteria that includes individuals with
420	physical, cognitive, and psychiatric disabilities.
421	(f)  Provision of support and services for individuals with
422	physical, cognitive, and psychiatric disabilities.
423	(g)  Standardized applications that include specific
424	eligibility criteria and the services an individual with special
425	needs can expect to receive.
426	(h)  Procedures for addressing the needs of unregistered
427	individuals in need of shelter.
428	(i)  Requirements that the special needs shelter location
429	meets the Florida Accessibility Code for Building Construction.
430	If the location fails to meet the standards, a plan must be
431	provided describing how compliance will be achieved.
432	(j)  Procedures for addressing the needs of families that
433	are eligible for special needs shelter services. Specific
434	procedures shall be developed to address the needs of families
435	with multiple dependents where only one dependent is eligible
436	for the special needs shelter. Specific procedures shall be
437	developed to address the needs of adults with special needs who
438	are caregivers for individuals without special needs.
439	(k)  Standards for special needs shelters, including
440	staffing, emergency power, transportation services, supplies,
441	including durable medical equipment, and any other
442	recommendations for minimum standards as determined by the
443	committee.
444	(7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY OF
445	CARE.--Each emergency management plan submitted to a county
446	health department by a home health agency pursuant to s.
447	400.497, by a nurse registry pursuant to s. 400.506, or by a
448	hospice pursuant to s. 400.610, shall specify the organization's
449	functional staffing plan for special needs shelters to ensure
450	continuity of care and services to its clients during and after
451	the disaster or emergency situation. The submission of Emergency
452	management plans to county health departments by home health
453	agencies pursuant to s. 400.497(8)(c) and (d) and by nurse
454	registries pursuant to s. 400.506(16)(e) and by hospice programs
455	pursuant to s. 400.610(1)(b) is conditional upon the receipt of
456	an appropriation by the department to establish medical services
457	disaster coordinator positions in county health departments
458	unless the secretary of the department and a local county
459	commission jointly determine to require such plans to be
460	submitted based on a determination that there is a special need
461	to protect public health in the local area during an emergency.
462	Section 3.  Subsections (2) and (4) of section 252.385,
463	Florida Statutes, are amended to read:
464	252.385  Public shelter space.--
465	(2)(a)  The division shall administer a program to survey
466	existing schools, universities, community colleges, and other
467	state-owned, municipally owned, and county-owned public
468	buildings and any private facility that the owner, in writing,
469	agrees to provide for use as a public hurricane evacuation
470	shelter to identify those that are appropriately designed and
471	located to serve as such shelters. The owners of the facilities
472	must be given the opportunity to participate in the surveys. The
473	Board of Regents, district school boards, community college
474	boards of trustees, and the Department of Education are
475	responsible for coordinating and implementing the survey of
476	public schools, universities, and community colleges with the
477	division or the local emergency management agency.
478	(b)  By January 31 of each even-numbered year, the Division
479	of Emergency Management of the Department of Community Affairs
480	shall prepare and submit a statewide emergency shelter plan to
481	the Governor and the Cabinet for approval, subject to the
482	requirements for approval provided in s. 1013.37(2). The plan
483	must also identify the general location and square footage of
484	special needs shelters, by regional planning council region,
485	during the next 5 years. The Department of Health shall assist
486	the division in determining the estimated need for special needs
487	shelter space based on information from the special needs
488	registration database and other factors.
489	(4)(a)  Public facilities, including schools, postsecondary
490	education facilities, and other facilities owned or leased by
491	the state or local governments, but excluding hospitals or
492	nursing homes, which are suitable for use as public hurricane
493	evacuation shelters shall be made available at the request of
494	the local emergency management agencies. The local emergency
495	management agency shall inspect a designated facility to
496	determine its readiness prior to activating such facility for a
497	specific hurricane or disaster. Such agencies shall coordinate
498	with the appropriate school board, university, community
499	college, or local governing board when requesting the use of
500	such facilities as public hurricane evacuation shelters.
501	(b)  The Department of Management Services shall
502	incorporate provisions for the use of suitable leased public
503	facilities as public hurricane evacuation shelters into lease
504	agreements for state agencies. Suitable leased public facilities
505	include leased public facilities that are solely occupied by
506	state agencies and have at least 2,000 square feet of net floor
507	area in a single room or in a combination of rooms having a
508	minimum of 400 square feet in each room. The net square footage
509	of floor area must be determined by subtracting from the gross
510	square footage the square footage of spaces such as mechanical
511	and electrical rooms, storage rooms, open corridors, restrooms,
512	kitchens, science or computer laboratories, shop or mechanical
513	areas, administrative offices, records vaults, and crawl spaces.
514	(c)  The Department of Management Services shall, in
515	consultation with local and state emergency management agencies,
516	assess Department of Management Services facilities to identify
517	the extent to which each facility has public hurricane
518	evacuation shelter space. The Department of Management Services
519	shall submit proposed facility retrofit projects that
520	incorporate hurricane protection enhancements to the department
521	for assessment and inclusion in the annual report prepared in
522	accordance with subsection (3).
523	Section 4.  Section 400.492, Florida Statutes, is amended
524	to read:
525	400.492  Provision of services during an emergency.--Each
526	home health agency, nurse registry, hospice, or durable medical
527	equipment provider shall prepare and maintain a comprehensive
528	emergency management plan that is consistent with the standards
529	adopted by national accreditation organizations and consistent
530	with the local special needs plan. The plan shall be updated
531	annually and shall provide for continuing home health, nurse
532	registry, hospice, or durable medical equipment services during
533	an emergency that interrupts patient care or services in the
534	patient's home. The plan shall describe how the home health
535	agency, nurse registry, hospice, or durable medical equipment
536	provider establishes and maintains an effective response to
537	emergencies and disasters, including: notifying staff when
538	emergency response measures are initiated; providing for
539	communication between staff members, county health departments,
540	and local emergency management agencies, including a backup
541	system; identifying resources necessary to continue essential
542	care or services or referrals to other organizations subject to
543	written agreement; and prioritizing and contacting patients who
544	need continued care or services.
545	(1)  Each patient record for patients who are listed in the
546	registry established pursuant to s. 252.355 shall include a
547	description of how care or services will be continued in the
548	event of an emergency or disaster. The home health agency shall
549	discuss the emergency provisions with the patient and the
550	patient's caregivers, including where and how the patient is to
551	evacuate, procedures for notifying the home health agency in the
552	event that the patient evacuates to a location other than the
553	shelter identified in the patient record, and a list of
554	medications and equipment which must either accompany the
555	patient or will be needed by the patient in the event of an
556	evacuation.
557	(2)  Each home health agency shall maintain a current
558	prioritized list of patients who need continued services during
559	an emergency. The list shall indicate how services shall be
560	continued in the event of an emergency or disaster for each
561	patient and if the patient is to be transported to a special
562	needs shelter, and shall indicate if the patient is receiving
563	skilled nursing services and the patient's medication and
564	equipment needs. The list shall be furnished to county health
565	departments and to local emergency management agencies, upon
566	request.
567	(3)  Home health, hospice, and durable medical equipment
568	provider agencies shall not be required to continue to provide
569	care to patients in emergency situations that are beyond their
570	control and that make it impossible to provide services, such as
571	when roads are impassable or when patients do not go to the
572	location specified in their patient records. Home health
573	agencies, nurse registries, hospices, and durable medical
574	equipment providers may establish links to local emergency
575	operations centers to determine a mechanism to approach areas
576	within the disaster area in order for the agency to reach its
577	clients. The presentation of home care or hospice clients to a
578	special needs shelter without the home health agency or hospice
579	making a good faith effort to provide services in the shelter
580	setting will constitute abandonment of the client and will
581	result in regulatory review.
582	(4)  Notwithstanding the provisions of s. 400.464(2) or any
583	other provision of law to the contrary, a home health agency may
584	provide services in a special needs shelter located in any
585	county.
586	Section 5.  Section 408.831, Florida Statutes, is amended
587	to read:
588	408.831  Denial, suspension, or revocation of a license,
589	registration, certificate, or application.--
590	(1)  In addition to any other remedies provided by law, the
591	agency may deny each application or suspend or revoke each
592	license, registration, or certificate of entities regulated or
593	licensed by it:
594	(a)  If the applicant, licensee, registrant, or
595	certificateholder, or, in the case of a corporation,
596	partnership, or other business entity, if any officer, director,
597	agent, or managing employee of that business entity or any
598	affiliated person, partner, or shareholder having an ownership
599	interest equal to 5 percent or greater in that business entity,
600	has failed to pay all outstanding fines, liens, or overpayments
601	assessed by final order of the agency or final order of the
602	Centers for Medicare and Medicaid Services, not subject to
603	further appeal, unless a repayment plan is approved by the
604	agency; or
605	(b)  For failure to comply with any repayment plan.
606	(2)  In reviewing any application requesting a change of
607	ownership or change of the licensee, registrant, or
608	certificateholder, the transferor shall, prior to agency
609	approval of the change, repay or make arrangements to repay any
610	amounts owed to the agency. Should the transferor fail to repay
611	or make arrangements to repay the amounts owed to the agency,
612	the issuance of a license, registration, or certificate to the
613	transferee shall be delayed until repayment or until
614	arrangements for repayment are made.
615	(3)  Entities subject to this section may exceed their
616	licensed capacity to act as a receiving facility in accordance
617	with an emergency operations plan for clients of evacuating
618	providers from a geographic area where an evacuation order has
619	been issued by a local authority having jurisdiction. While in
620	an overcapacity status, each provider must furnish or arrange
621	for appropriate care and services to all clients. Overcapacity
622	status in excess of 15 days shall require compliance with all
623	fire safety requirements or their equivalency as approved by
624	state and local authorities, whichever is applicable. In
625	addition, the agency shall approve requests for overcapacity
626	beyond 15 days, which approvals shall be based upon satisfactory
627	justification and need as provided by the receiving and sending
628	facility.
629	(4)  An inactive license may be issued to a licensee
630	subject to this section when the provider is located in a
631	geographic area where a state of emergency was declared by the
632	Governor of Florida if the provider:
633	(a)  Suffered damage to the provider's operation during
634	that state of emergency.
635	(b)  Is currently licensed.
636	(c)  Does not have a provisional license.
637	(d)  Will be temporarily unable to provide services but is
638	reasonably expected to resume services within 12 months.
639
640	An inactive license may be issued for a period not to exceed 12
641	months but may be renewed by the agency for up to 6 additional
642	months upon demonstration to the agency of progress toward
643	reopening. A request by a licensee for an inactive license or to
644	extend the previously approved inactive period must be submitted
645	in writing to the agency, accompanied by written justification
646	for the inactive license which states the beginning and ending
647	dates of inactivity and includes a plan for the transfer of any
648	clients to other providers and appropriate licensure fees. Upon
649	agency approval, the licensee shall notify clients of any
650	necessary discharge or transfer as required by authorizing
651	statutes or applicable rules. The beginning of the inactive
652	licensure period shall be the date the provider ceases
653	operations. The end of the inactive period shall become the
654	licensee expiration date and all licensure fees must be current,
655	paid in full, and may be prorated. Reactivation of an inactive
656	license requires the prior approval by the agency of a renewal
657	application, including payment of licensure fees and agency
658	inspections indicating compliance with all requirements of this
659	part and applicable rules and statutes.
660	(5)(3)  This section provides standards of enforcement
661	applicable to all entities licensed or regulated by the Agency
662	for Health Care Administration. This section controls over any
663	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
664	394, 395, 400, 408, 468, 483, and 641 or rules adopted pursuant
665	to those chapters.
666	Section 6.  Section 252.357, Florida Statutes, is created
667	to read:
668	252.357  Monitoring of nursing homes during disaster.--The
669	Florida Comprehensive Emergency Management Plan shall permit the
670	Agency for Health Care Administration, working from the agency's
671	offices or in the Emergency Operations Center, ESF-8, to make
672	initial contact with each nursing home in the disaster area. The
673	agency, by July 15, 2005, and annually thereafter, shall publish
674	on the Internet an emergency telephone number that can be used
675	by nursing homes to contact the agency on a schedule established
676	by the agency to report requests for assistance. The agency may
677	also provide the telephone number to each facility when it makes
678	the initial facility call.
679	Section 7.  This act shall take effect July 1, 2005.

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