HB 1551CS

CHAMBER ACTION



1The Health & Families Council recommends the following:
2
3     Council/Committee Substitute
4     Remove the entire bill and insert:
5
6
A bill to be entitled
7An act relating to emergency management; amending s.
8252.355, F.S.; specifying additional agencies that are
9required to provide registration information to special
10needs clients and persons with disabilities or special
11needs who receive services from such agencies for purposes
12of inclusion within the registry of persons with special
13needs maintained by local emergency management agencies;
14providing that the Department of Community Affairs shall
15be the designated lead agency responsible for community
16education and outreach to the general public, including
17special needs clients, regarding registration as a person
18with special needs, special needs shelters, and general
19information regarding shelter stays; requiring the
20department to disseminate educational and outreach
21information through local emergency management offices;
22requiring the department to coordinate community education
23and outreach related to special needs shelters with
24specified agencies and entities; providing that specified
25confidential and exempt information relating to
26registration of persons with special needs be provided to
27the Department of Health; amending s. 381.0303, F.S.;
28providing for the operation, maintenance, and closure of
29special needs shelters; removing a condition of specified
30funding as a prerequisite to the assumption of lead
31responsibility by the Department of Health for specified
32coordination with respect to the development of a plan for
33the staffing and medical management of special needs
34shelters; providing that the local Children's Medical
35Services offices shall assume lead responsibility for
36specified coordination with respect to the development of
37a plan for the staffing and medical management of
38pediatric special needs shelters; requiring such plans to
39conform to the local comprehensive emergency management
40plan; requiring county governments to assist in the
41process of coordinating the recruitment of health care
42practitioners to staff local special needs shelters;
43providing that the appropriate county health department,
44Children's Medical Services office, and local emergency
45management agency shall jointly determine the
46responsibility for medical supervision in a special needs
47shelter; providing that state employees with a
48preestablished role in disaster response may be called
49upon to serve in times of disaster in specified
50capacities; requiring the Secretary of Elderly Affairs to
51convene a multiagency emergency special needs shelter
52response team or teams to assist local areas that are
53severely impacted by a natural or manmade disaster that
54required the use of special needs shelters; providing
55duties and responsibilities of multiagency response teams;
56authorizing local emergency management agencies to request
57the assistance of a multiagency response team; providing
58for the inclusion of specified state agency
59representatives on each multiagency response team;
60authorizing hospitals and nursing homes that are used to
61shelter special needs persons during or after an
62evacuation to submit invoices for reimbursement to the
63Department of Health; requiring the department to specify
64by rule expenses that are reimbursable and the rate of
65reimbursement for services; prescribing means of and
66procedures for reimbursement; providing eligibility for
67reimbursement of health care facilities to whom special
68needs shelter clients have been discharged by a
69multiagency response team upon closure of a special needs
70shelter; providing requirements with respect to such
71reimbursement; prescribing means of and procedures for
72reimbursement; disallowing specified reimbursements;
73revising the role of the special needs shelter interagency
74committee with respect to the planning and operation of
75special needs shelters; providing required functions of
76the committee; providing that the committee shall
77recommend guidelines to establish a statewide database to
78collect and disseminate special needs registration
79information; revising the composition of the special needs
80shelter interagency committee; requiring the inclusion of
81specified rules with respect to special needs shelters and
82specified minimum standards therefor; providing
83requirements with respect to emergency management plans
84submitted by a home health agency, nurse registry, or
85hospice to a county health department for review; removing
86a condition of specified funding as a prerequisite to the
87submission of such plans; amending s. 252.385, F.S.;
88requiring the Division of Emergency Management of the
89Department of Community Affairs to prepare and submit a
90statewide emergency shelter plan to the Governor and the
91Cabinet for approval; providing plan requirements;
92requiring the Department of Health to assist the division
93in determining the estimated need for special needs
94shelter space; requiring inspection of public hurricane
95evacuation shelter facilities by local emergency
96management agencies prior to activation of such
97facilities; amending s. 400.492, F.S.; providing that
98nurse registries, hospices, and durable medical equipment
99providers shall prepare and maintain a comprehensive
100emergency management plan; providing that home health,
101hospice, and durable medical equipment provider agencies
102shall not be required to continue to provide care to
103patients in emergency situations that are beyond their
104control and that make it impossible to provide services;
105authorizing home health agencies, nurse registries,
106hospices, and durable medical equipment providers to
107establish links to local emergency operations centers to
108determine a mechanism to approach areas within a disaster
109area in order for the agency to reach its clients;
110providing that the presentation of home care or hospice
111clients to the special needs shelter without the home
112health agency or hospice making a good faith effort to
113provide services in the shelter setting constitutes
114abandonment of the client; requiring regulatory review in
115such cases; amending s. 408.831, F.S.; providing that
116entities regulated or licensed by the Agency for Health
117Care Administration may exceed their licensed capacity to
118act as a receiving facility under specified circumstances;
119providing requirements while such entities are in an
120overcapacity status; providing for issuance of an inactive
121license to such licensees under specified conditions;
122providing requirements and procedures with respect to the
123issuance and reactivation of an inactive license;
124providing fees; creating s. 252.357, F.S., requiring the
125Florida Comprehensive Emergency Management Plan to permit
126the Agency for Health Care Administration to initially
127contact nursing homes in disaster areas for specified
128monitoring purposes; requiring the agency to publish an
129emergency telephone number for use by nursing homes;
130providing an effective date.
131
132Be It Enacted by the Legislature of the State of Florida:
133
134     Section 1.  Section 252.355, Florida Statutes, is amended
135to read:
136     252.355  Registry of persons with special needs; notice.--
137     (1)  In order to meet the special needs of clients persons
138who would need assistance during evacuations and sheltering
139because of physical, mental, cognitive impairment, or sensory
140disabilities, each local emergency management agency in the
141state shall maintain a registry of persons with special needs
142located within the jurisdiction of the local agency. The
143registration shall identify those persons in need of assistance
144and plan for resource allocation to meet those identified needs.
145To assist the local emergency management agency in identifying
146such persons, the Department of Children and Family Services,
147Department of Health, Agency for Health Care Administration,
148Department of Education, Agency for Persons with Disabilities,
149Department of Labor and Employment Security, and Department of
150Elderly Affairs shall provide registration information to all of
151their special needs clients and to all people with disabilities
152or special needs who receive services incoming clients as a part
153of the intake process. The registry shall be updated annually.
154The registration program shall give persons with special needs
155the option of preauthorizing emergency response personnel to
156enter their homes during search and rescue operations if
157necessary to assure their safety and welfare following
158disasters.
159     (2)  The Department of Community Affairs shall be the
160designated lead agency responsible for community education and
161outreach to the general public, including special needs clients,
162regarding registration and special needs shelters and general
163information regarding shelter stays. The Department of Community
164Affairs shall disseminate such educational and outreach
165information through the local emergency management offices. The
166department shall coordinate the development of curriculum and
167dissemination of all community education and outreach related to
168special needs shelters with the Clearinghouse on Disability
169Information of the Governor's Working Group on the Americans
170with Disabilities Act, the Department of Children and Family
171Services, the Department of Health, the Agency for Health Care
172Administration, the Department of Education, the Agency for
173Persons with Disabilities, and the Department of Elderly
174Affairs.
175     (3)(2)  On or before May 1 of each year each electric
176utility in the state shall annually notify residential customers
177in its service area of the availability of the registration
178program available through their local emergency management
179agency.
180     (4)(3)  All records, data, information, correspondence, and
181communications relating to the registration of persons with
182special needs as provided in subsection (1) are confidential and
183exempt from the provisions of s. 119.07(1), except that such
184information shall be available to other emergency response
185agencies, as determined by the local emergency management
186director, and shall be provided to the Department of Health in
187the furtherance of their duties and responsibilities.
188     (5)(4)  All appropriate agencies and community-based
189service providers, including home health care providers, and
190hospices shall assist emergency management agencies by
191collecting registration information for persons with special
192needs as part of program intake processes, establishing programs
193to increase the awareness of the registration process, and
194educating clients about the procedures that may be necessary for
195their safety during disasters. Clients of state or federally
196funded service programs with physical, mental, cognitive
197impairment, or sensory disabilities who need assistance in
198evacuating, or when in shelters, must register as persons with
199special needs.
200     Section 2.  Section 381.0303, Florida Statutes, is amended
201to read:
202     381.0303  Health practitioner recruitment for Special needs
203shelters.--
204     (1)  PURPOSE.--The purpose of this section is to provide
205for the operation, maintenance, and closure of special needs
206shelters and to designate the Department of Health, through its
207county health departments, as the lead agency for coordination
208of the recruitment of health care practitioners, as defined in
209s. 456.001(4), to staff special needs shelters in times of
210emergency or disaster and to provide resources to the department
211to carry out this responsibility. However, nothing in this
212section prohibits a county health department from entering into
213an agreement with a local emergency management agency to assume
214the lead responsibility for recruiting health care
215practitioners.
216     (2)  SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE; STATE
217AGENCY ASSISTANCE AND STAFFING.--Provided funds have been
218appropriated to support medical services disaster coordinator
219positions in county health departments,
220     (a)  The department shall assume lead responsibility for
221the local coordination of local medical and health care
222providers, the American Red Cross, and other interested parties
223in developing a plan for the staffing and medical management of
224special needs shelters. The local Children's Medical Services
225offices shall assume lead responsibility for the local
226coordination of local medical and health care providers, the
227American Red Cross, and other interested parties in developing a
228plan for the staffing and medical management of pediatric
229special needs shelters. Plans shall conform to The plan shall be
230in conformance with the local comprehensive emergency management
231plan.
232     (b)(a)  County health departments shall, in conjunction
233with the local emergency management agencies, have the lead
234responsibility for coordination of the recruitment of health
235care practitioners to staff local special needs shelters. County
236health departments shall assign their employees to work in
237special needs shelters when those employees are needed to
238protect the health and safety of special needs clients of
239patients. County governments shall assist in this process.
240     (c)(b)  The appropriate county health department,
241Children's Medical Services office, and local emergency
242management agency shall jointly decide determine who has
243responsibility for medical supervision in each a special needs
244shelter and shall notify the department of their decision.
245     (d)(c)  Local emergency management agencies shall be
246responsible for the designation and operation of special needs
247shelters during times of emergency or disaster and the closure
248of the facilities following an emergency or disaster. County
249health departments shall assist the local emergency management
250agency with regard to the management of medical services in
251special needs shelters.
252     (e)  State employees with a preestablished role in disaster
253response may be called upon to serve in times of disaster
254commensurate with their knowledge, skills, and abilities and any
255needed activities related to the situation.
256     (f)  The Secretary of Elderly Affairs, or his or her
257designee, shall convene, at any time that he or she deems
258appropriate and necessary, a multiagency emergency special needs
259shelter response team or teams to assist local areas that are
260severely impacted by a natural or manmade disaster that requires
261the use of special needs shelters. Multiagency response teams
262shall provide assistance to local emergency management agencies
263with the continued operation or closure of the shelters, as well
264as with the discharge of special needs clients to alternate
265facilities if necessary. Local emergency management agencies may
266request the assistance of a multiagency response team by
267alerting statewide emergency management officials of the
268necessity for additional assistance in their area. The Secretary
269of Elderly Affairs is encouraged to proactively work with other
270state agencies prior to any natural disasters for which warnings
271are provided to ensure that multiagency response teams are ready
272to assemble and deploy rapidly upon a determination by state
273emergency management officials that a disaster area requires
274additional assistance. The Secretary of Elderly Affairs may call
275upon any state agency or office to provide staff to assist a
276multiagency response team or teams. Unless the secretary
277determines that the nature or circumstances surrounding the
278disaster do not warrant participation from a particular agency's
279staff, each multiagency response team shall include at least one
280representative from each of the following state agencies:
281     1.  Department of Elderly Affairs.
282     2.  Department of Health.
283     3.  Department of Children and Family Services.
284     4.  Department of Veterans' Affairs.
285     5.  Department of Community Affairs.
286     6.  Agency for Health Care Administration.
287     7.  Agency for Persons with Disabilities.
288     (3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
289FACILITIES.--
290     (a)  The Department of Health shall upon request reimburse,
291subject to the availability of funds for this purpose, health
292care practitioners, as defined in s. 456.001, provided the
293practitioner is not providing care to a patient under an
294existing contract, and emergency medical technicians and
295paramedics licensed under pursuant to chapter 401, for medical
296care provided at the request of the department in special needs
297shelters or at other locations during times of emergency or a
298declared major disaster. Reimbursement for health care
299practitioners, except for physicians licensed under pursuant to
300chapter 458 or chapter 459, shall be based on the average hourly
301rate that such practitioners were paid according to the most
302recent survey of Florida hospitals conducted by the Florida
303Hospital Association. Reimbursement shall be requested on forms
304prepared by the Department of Health and shall be paid as
305specified in paragraph (d).
306     (b)  Hospitals and nursing homes that are used to shelter
307special needs clients during or after an evacuation may submit
308invoices for reimbursement to the department. The department
309shall develop a form for reimbursement and shall specify by rule
310which expenses are reimbursable and the rate of reimbursement
311for each service. Reimbursement for the services described in
312this paragraph shall be paid as specified in paragraph (d).
313     (c)  If, upon closure of a special needs shelter, a
314multiagency response team determines that it is necessary to
315discharge special needs shelter clients to other health care
316facilities, such as nursing homes, assisted living facilities,
317and community residential group homes, the receiving facilities
318shall be eligible for reimbursement for services provided to the
319clients for up to 90 days. Any facility eligible for
320reimbursement under this paragraph shall submit invoices for
321reimbursement on forms developed by the department. A facility
322must show proof of a written request from a representative of an
323agency serving on the multiagency response team that the client
324for whom the facility is seeking reimbursement for services
325rendered was referred to that facility from a special needs
326shelter. Reimbursement for the services described in this
327paragraph shall be paid as specified in paragraph (d).
328     (d)  If a Presidential Disaster Declaration has been issued
329made, and the Federal Government makes funds available, the
330department shall use those such funds for reimbursement of
331eligible expenditures. In other situations, or if federal funds
332do not fully compensate the department for reimbursements
333permissible under reimbursement made pursuant to this section,
334the department shall submit to the Cabinet or the Legislature,
335as appropriate, a budget amendment to obtain reimbursement from
336the working capital fund. The department shall not provide
337reimbursement to facilities under this subsection for services
338provided to a special needs client if, during the period of time
339in which the services were provided, the client was enrolled in
340another state-funded program, such as Medicaid or another
341similar program, which would otherwise pay for the same
342services. Travel expense and per diem costs shall be reimbursed
343pursuant to s. 112.061.
344     (4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may
345use the registries established in ss. 401.273 and 456.38 when
346health care practitioners are needed to staff special needs
347shelters or to staff disaster medical assistance teams.
348     (5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
349Secretary Department of Health may establish a special needs
350shelter interagency committee and serve as or appoint a designee
351to serve as the committee's chair. The department shall provide
352any necessary staff and resources to support the committee in
353the performance of its duties, to be chaired and staffed by the
354department. The committee shall resolve problems related to
355special needs shelters not addressed in the state comprehensive
356emergency medical plan and shall consult on serve as an
357oversight committee to monitor the planning and operation of
358special needs shelters.
359     (a)  The committee shall may:
360     1.  Develop and negotiate any necessary interagency
361agreements.
362     2.  Undertake other such activities as the department deems
363necessary to facilitate the implementation of this section.
364     3.  Submit recommendations to the Legislature as necessary.
365Such recommendations shall include, but not be limited to, the
366following:
367     a.  Defining "special needs shelter."
368     b.  Defining "special needs client."
369     c.  Development of a uniform registration form for special
370needs clients.
371     d.  Improving public awareness regarding the registration
372process.
373     e.  Improving overall communications with special needs
374clients both before and after a disaster.
375     f.  Recommending the construction or designation of
376additional special needs shelters in underserved areas of the
377state and the necessity of upgrading, modifying, or retrofitting
378existing special needs shelters.
379     g.  Recommending guidelines to establish a statewide
380database designed to collect and disseminate timely and
381appropriate special needs registration information.
382     (b)  The special needs shelter interagency committee shall
383be composed of representatives of emergency management, health,
384medical, and social services organizations. Membership shall
385include, but shall not be limited to, representatives of the
386Departments of Health, Community Affairs, Children and Family
387Services, Elderly Affairs, Labor and Employment Security, and
388Education; the Agency for Health Care Administration; the
389Florida Medical Association; the Florida Osteopathic Medical
390Association; Associated Home Health Industries of Florida, Inc.;
391the Florida Nurses Association; the Florida Health Care
392Association; the Florida Assisted Living Affiliation
393Association; the Florida Hospital Association; the Florida
394Statutory Teaching Hospital Council; the Florida Association of
395Homes for the Aging; the Florida Emergency Preparedness
396Association; the American Red Cross; Florida Hospices and
397Palliative Care, Inc.; the Association of Community Hospitals
398and Health Systems; the Florida Association of Health
399Maintenance Organizations; the Florida League of Health Systems;
400Private Care Association; and the Salvation Army; the Florida
401Association of Aging Services Providers; and the AARP.
402     (c)  Meetings of the committee shall be held in
403Tallahassee, and members of the committee shall serve at the
404expense of the agencies or organizations they represent. The
405committee shall make every effort to use teleconference or video
406conference capabilities in order to ensure statewide input and
407participation.
408     (6)  RULES.--The department has the authority to adopt
409rules necessary to implement this section. Rules shall may
410include a definition of a special needs client patient, specify
411physician reimbursement, and the designation of designate which
412county health departments which will have responsibility for the
413implementation of subsections (2) and (3). Standards for special
414needs shelters adopted by rule shall include minimum standards
415relating to:
416     (a)  The provision of electricity.
417     (b)  Staffing levels for provision of services to assist
418individuals with activities of daily living.
419     (c)  Provision of transportation services.
420     (d)  Compliance with applicable service animal laws.
421     (e)  Eligibility criteria that includes individuals with
422physical, cognitive, and psychiatric disabilities.
423     (f)  Provision of support and services for individuals with
424physical, cognitive, and psychiatric disabilities.
425     (g)  Standardized applications that include specific
426eligibility criteria and the services an individual with special
427needs can expect to receive.
428     (h)  Procedures for addressing the needs of unregistered
429individuals in need of shelter.
430     (i)  Requirements that the special needs shelter location
431meets the Florida Accessibility Code for Building Construction.
432If the location fails to meet the standards, a plan must be
433provided describing how compliance will be achieved.
434     (j)  Procedures for addressing the needs of families that
435are eligible for special needs shelter services. Specific
436procedures shall be developed to address the needs of families
437with multiple dependents where only one dependent is eligible
438for the special needs shelter. Specific procedures shall be
439developed to address the needs of adults with special needs who
440are caregivers for individuals without special needs.
441     (k)  Standards for special needs shelters, including
442staffing, emergency power, transportation services, supplies,
443including durable medical equipment, and any other
444recommendations for minimum standards as determined by the
445committee.
446     (7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY OF
447CARE.--Each emergency management plan submitted to a county
448health department by a home health agency pursuant to s.
449400.497, by a nurse registry pursuant to s. 400.506, or by a
450hospice pursuant to s. 400.610, shall specify the organization's
451functional staffing plan for special needs shelters to ensure
452continuity of care and services to its clients during and after
453the disaster or emergency situation. The submission of Emergency
454management plans to county health departments by home health
455agencies pursuant to s. 400.497(8)(c) and (d) and by nurse
456registries pursuant to s. 400.506(16)(e) and by hospice programs
457pursuant to s. 400.610(1)(b) is conditional upon the receipt of
458an appropriation by the department to establish medical services
459disaster coordinator positions in county health departments
460unless the secretary of the department and a local county
461commission jointly determine to require such plans to be
462submitted based on a determination that there is a special need
463to protect public health in the local area during an emergency.
464     Section 3.  Subsections (2) and (4) of section 252.385,
465Florida Statutes, are amended to read:
466     252.385  Public shelter space.--
467     (2)(a)  The division shall administer a program to survey
468existing schools, universities, community colleges, and other
469state-owned, municipally owned, and county-owned public
470buildings and any private facility that the owner, in writing,
471agrees to provide for use as a public hurricane evacuation
472shelter to identify those that are appropriately designed and
473located to serve as such shelters. The owners of the facilities
474must be given the opportunity to participate in the surveys. The
475Board of Regents, district school boards, community college
476boards of trustees, and the Department of Education are
477responsible for coordinating and implementing the survey of
478public schools, universities, and community colleges with the
479division or the local emergency management agency.
480     (b)  By January 31 of each even-numbered year, the Division
481of Emergency Management of the Department of Community Affairs
482shall prepare and submit a statewide emergency shelter plan to
483the Governor and the Cabinet for approval, subject to the
484requirements for approval provided in s. 1013.37(2). The plan
485must also identify the general location and square footage of
486special needs shelters, by regional planning council region,
487during the next 5 years. The Department of Health shall assist
488the division in determining the estimated need for special needs
489shelter space based on information from the special needs
490registration database and other factors.
491     (4)(a)  Public facilities, including schools, postsecondary
492education facilities, and other facilities owned or leased by
493the state or local governments, but excluding hospitals or
494nursing homes, which are suitable for use as public hurricane
495evacuation shelters shall be made available at the request of
496the local emergency management agencies. The local emergency
497management agency shall inspect a designated facility to
498determine its readiness prior to activating such facility for a
499specific hurricane or disaster. Such agencies shall coordinate
500with the appropriate school board, university, community
501college, or local governing board when requesting the use of
502such facilities as public hurricane evacuation shelters.
503     (b)  The Department of Management Services shall
504incorporate provisions for the use of suitable leased public
505facilities as public hurricane evacuation shelters into lease
506agreements for state agencies. Suitable leased public facilities
507include leased public facilities that are solely occupied by
508state agencies and have at least 2,000 square feet of net floor
509area in a single room or in a combination of rooms having a
510minimum of 400 square feet in each room. The net square footage
511of floor area must be determined by subtracting from the gross
512square footage the square footage of spaces such as mechanical
513and electrical rooms, storage rooms, open corridors, restrooms,
514kitchens, science or computer laboratories, shop or mechanical
515areas, administrative offices, records vaults, and crawl spaces.
516     (c)  The Department of Management Services shall, in
517consultation with local and state emergency management agencies,
518assess Department of Management Services facilities to identify
519the extent to which each facility has public hurricane
520evacuation shelter space. The Department of Management Services
521shall submit proposed facility retrofit projects that
522incorporate hurricane protection enhancements to the department
523for assessment and inclusion in the annual report prepared in
524accordance with subsection (3).
525     Section 4.  Section 400.492, Florida Statutes, is amended
526to read:
527     400.492  Provision of services during an emergency.--Each
528home health agency, nurse registry, hospice, or durable medical
529equipment provider shall prepare and maintain a comprehensive
530emergency management plan that is consistent with the standards
531adopted by national accreditation organizations and consistent
532with the local special needs plan. The plan shall be updated
533annually and shall provide for continuing home health, nurse
534registry, hospice, or durable medical equipment services during
535an emergency that interrupts patient care or services in the
536patient's home. The plan shall describe how the home health
537agency, nurse registry, hospice, or durable medical equipment
538provider establishes and maintains an effective response to
539emergencies and disasters, including: notifying staff when
540emergency response measures are initiated; providing for
541communication between staff members, county health departments,
542and local emergency management agencies, including a backup
543system; identifying resources necessary to continue essential
544care or services or referrals to other organizations subject to
545written agreement; and prioritizing and contacting patients who
546need continued care or services.
547     (1)  Each patient record for patients who are listed in the
548registry established pursuant to s. 252.355 shall include a
549description of how care or services will be continued in the
550event of an emergency or disaster. The home health agency shall
551discuss the emergency provisions with the patient and the
552patient's caregivers, including where and how the patient is to
553evacuate, procedures for notifying the home health agency in the
554event that the patient evacuates to a location other than the
555shelter identified in the patient record, and a list of
556medications and equipment which must either accompany the
557patient or will be needed by the patient in the event of an
558evacuation.
559     (2)  Each home health agency shall maintain a current
560prioritized list of patients who need continued services during
561an emergency. The list shall indicate how services shall be
562continued in the event of an emergency or disaster for each
563patient and if the patient is to be transported to a special
564needs shelter, and shall indicate if the patient is receiving
565skilled nursing services and the patient's medication and
566equipment needs. The list shall be furnished to county health
567departments and to local emergency management agencies, upon
568request.
569     (3)  Home health, hospice, and durable medical equipment
570provider agencies shall not be required to continue to provide
571care to patients in emergency situations that are beyond their
572control and that make it impossible to provide services, such as
573when roads are impassable or when patients do not go to the
574location specified in their patient records. Home health
575agencies, nurse registries, hospices, and durable medical
576equipment providers may establish links to local emergency
577operations centers to determine a mechanism to approach areas
578within the disaster area in order for the agency to reach its
579clients. The presentation of home care or hospice clients to a
580special needs shelter without the home health agency or hospice
581making a good faith effort to provide services in the shelter
582setting will constitute abandonment of the client and will
583result in regulatory review.
584     (4)  Notwithstanding the provisions of s. 400.464(2) or any
585other provision of law to the contrary, a home health agency may
586provide services in a special needs shelter located in any
587county.
588     Section 5.  Section 408.831, Florida Statutes, is amended
589to read:
590     408.831  Denial, suspension, or revocation of a license,
591registration, certificate, or application.--
592     (1)  In addition to any other remedies provided by law, the
593agency may deny each application or suspend or revoke each
594license, registration, or certificate of entities regulated or
595licensed by it:
596     (a)  If the applicant, licensee, registrant, or
597certificateholder, or, in the case of a corporation,
598partnership, or other business entity, if any officer, director,
599agent, or managing employee of that business entity or any
600affiliated person, partner, or shareholder having an ownership
601interest equal to 5 percent or greater in that business entity,
602has failed to pay all outstanding fines, liens, or overpayments
603assessed by final order of the agency or final order of the
604Centers for Medicare and Medicaid Services, not subject to
605further appeal, unless a repayment plan is approved by the
606agency; or
607     (b)  For failure to comply with any repayment plan.
608     (2)  In reviewing any application requesting a change of
609ownership or change of the licensee, registrant, or
610certificateholder, the transferor shall, prior to agency
611approval of the change, repay or make arrangements to repay any
612amounts owed to the agency. Should the transferor fail to repay
613or make arrangements to repay the amounts owed to the agency,
614the issuance of a license, registration, or certificate to the
615transferee shall be delayed until repayment or until
616arrangements for repayment are made.
617     (3)  Entities subject to this section may exceed their
618licensed capacity to act as a receiving facility in accordance
619with an emergency operations plan for clients of evacuating
620providers from a geographic area where an evacuation order has
621been issued by a local authority having jurisdiction. While in
622an overcapacity status, each provider must furnish or arrange
623for appropriate care and services to all clients. Overcapacity
624status in excess of 15 days shall require compliance with all
625fire safety requirements or their equivalency as approved by
626state and local authorities, whichever is applicable. In
627addition, the agency shall approve requests for overcapacity
628beyond 15 days, which approvals shall be based upon satisfactory
629justification and need as provided by the receiving and sending
630facility.
631     (4)  An inactive license may be issued to a licensee
632subject to this section when the provider is located in a
633geographic area where a state of emergency was declared by the
634Governor of Florida if the provider:
635     (a)  Suffered damage to the provider's operation during
636that state of emergency.
637     (b)  Is currently licensed.
638     (c)  Does not have a provisional license.
639     (d)  Will be temporarily unable to provide services but is
640reasonably expected to resume services within 12 months.
641
642An inactive license may be issued for a period not to exceed 12
643months but may be renewed by the agency for up to 6 additional
644months upon demonstration to the agency of progress toward
645reopening. A request by a licensee for an inactive license or to
646extend the previously approved inactive period must be submitted
647in writing to the agency, accompanied by written justification
648for the inactive license which states the beginning and ending
649dates of inactivity and includes a plan for the transfer of any
650clients to other providers and appropriate licensure fees. Upon
651agency approval, the licensee shall notify clients of any
652necessary discharge or transfer as required by authorizing
653statutes or applicable rules. The beginning of the inactive
654licensure period shall be the date the provider ceases
655operations. The end of the inactive period shall become the
656licensee expiration date and all licensure fees must be current,
657paid in full, and may be prorated. Reactivation of an inactive
658license requires the prior approval by the agency of a renewal
659application, including payment of licensure fees and agency
660inspections indicating compliance with all requirements of this
661part and applicable rules and statutes.
662     (5)(3)  This section provides standards of enforcement
663applicable to all entities licensed or regulated by the Agency
664for Health Care Administration. This section controls over any
665conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
666394, 395, 400, 408, 468, 483, and 641 or rules adopted pursuant
667to those chapters.
668     Section 6.  Section 252.357, Florida Statutes, is created
669to read:
670     252.357  Monitoring of nursing homes during disaster.--The
671Florida Comprehensive Emergency Management Plan shall permit the
672Agency for Health Care Administration, working from the agency's
673offices or in the Emergency Operations Center, ESF-8, to make
674initial contact with each nursing home in the disaster area. The
675agency, by July 15, 2005, and annually thereafter, shall publish
676on the Internet an emergency telephone number that can be used
677by nursing homes to contact the agency on a schedule established
678by the agency to report requests for assistance. The agency may
679also provide the telephone number to each facility when it makes
680the initial facility call.
681     Section 7.  This act shall take effect July 1, 2005.


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