HB 1551

1
A bill to be entitled
2An act relating to emergency management; amending s.
3252.355, F.S.; specifying additional agencies that are
4required to provide registration information to special
5needs clients and persons with disabilities or special
6needs who receive services from such agencies for purposes
7of inclusion within the registry of persons with special
8needs maintained by local emergency management agencies;
9providing that the Department of Community Affairs shall
10be the designated lead agency responsible for community
11education and outreach to the general public, including
12special needs clients, regarding registration as a person
13with special needs, special needs shelters, and general
14information regarding shelter stays; requiring the
15department to disseminate educational and outreach
16information through local emergency management offices;
17requiring the department to coordinate community education
18and outreach related to special needs shelters with
19specified agencies and entities; providing that specified
20confidential and exempt information relating to
21registration of persons with special needs be provided to
22the Department of Health; amending s. 381.0303, F.S.;
23providing for the operation, maintenance, and closure of
24special needs shelters; removing a condition of specified
25funding as a prerequisite to the assumption of lead
26responsibility by the Department of Health for specified
27coordination with respect to the development of a plan for
28the staffing and medical management of special needs
29shelters; providing that the local Children's Medical
30Services offices shall assume lead responsibility for
31specified coordination with respect to the development of
32a plan for the staffing and medical management of
33pediatric special needs shelters; requiring such plans to
34conform to the local comprehensive emergency management
35plan; requiring county governments to assist in the
36process of coordinating the recruitment of health care
37practitioners to staff local special needs shelters;
38providing that the appropriate county health department,
39Children's Medical Services office, and local emergency
40management agency shall jointly determine the
41responsibility for medical supervision in a special needs
42shelter; providing that state employees with a
43preestablished role in disaster response may be called
44upon to serve in times of disaster in specified
45capacities; requiring the Secretary of Elderly Affairs to
46convene a multiagency emergency special needs shelter
47response team or teams to assist local areas that are
48severely impacted by a natural or manmade disaster that
49required the use of special needs shelters; providing
50duties and responsibilities of multiagency response teams;
51authorizing local emergency management agencies to request
52the assistance of a multiagency response team; providing
53for the inclusion of specified state agency
54representatives on each multiagency response team;
55authorizing hospitals and nursing homes that are used to
56shelter special needs persons during or after an
57evacuation to submit invoices for reimbursement to the
58Department of Health; requiring the department to specify
59by rule expenses that are reimbursable and the rate of
60reimbursement for services; prescribing means of and
61procedures for reimbursement; providing eligibility for
62reimbursement of health care facilities to whom special
63needs shelter clients have been discharged by a
64multiagency response team upon closure of a special needs
65shelter; providing requirements with respect to such
66reimbursement; prescribing means of and procedures for
67reimbursement; disallowing specified reimbursements;
68revising the role of the special needs shelter interagency
69committee with respect to the planning and operation of
70special needs shelters; providing required functions of
71the committee; providing that the committee shall
72recommend guidelines to establish a statewide database to
73collect and disseminate special needs registration
74information; revising the composition of the special needs
75shelter interagency committee; requiring the inclusion of
76specified rules with respect to special needs shelters and
77specified minimum standards therefor; providing
78requirements with respect to emergency management plans
79submitted by a home health agency, nurse registry, or
80hospice to a county health department for review; removing
81a condition of specified funding as a prerequisite to the
82submission of such plans; amending s. 252.385, F.S.;
83requiring the Division of Emergency Management of the
84Department of Community Affairs to prepare and submit a
85statewide emergency shelter plan to the Governor and the
86Cabinet for approval; providing plan requirements;
87requiring the Department of Health to assist the division
88in determining the estimated need for special needs
89shelter space; requiring inspection of public hurricane
90evacuation shelter facilities by local emergency
91management agencies prior to activation of such
92facilities; amending s. 400.492, F.S.; providing that
93nurse registries, hospices, and durable medical equipment
94providers shall prepare and maintain a comprehensive
95emergency management plan; providing that home health,
96hospice, and durable medical equipment provider agencies
97shall not be required to continue to provide care to
98patients in emergency situations that are beyond their
99control and that make it impossible to provide services;
100authorizing home health agencies, nurse registries,
101hospices, and durable medical equipment providers to
102establish links to local emergency operations centers to
103determine a mechanism to approach areas within a disaster
104area in order for the agency to reach its clients;
105providing that the presentation of home care or hospice
106clients to the special needs shelter without the home
107health agency or hospice making a good faith effort to
108provide services in the shelter setting constitutes
109abandonment of the client; requiring regulatory review in
110such cases; amending s. 408.831, F.S.; providing that
111entities regulated or licensed by the Agency for Health
112Care Administration may exceed their licensed capacity to
113act as a receiving facility under specified circumstances;
114providing requirements while such entities are in an
115overcapacity status; providing for issuance of an inactive
116license to such licensees under specified conditions;
117providing requirements and procedures with respect to the
118issuance and reactivation of an inactive license;
119providing fees; creating s. 252.357, F.S., requiring the
120Florida Comprehensive Emergency Management Plan to permit
121the Agency for Health Care Administration to initially
122contact nursing homes in disaster areas for specified
123monitoring purposes; requiring the agency to publish an
124emergency telephone number for use by nursing homes;
125providing an effective date.
126
127Be It Enacted by the Legislature of the State of Florida:
128
129     Section 1.  Section 252.355, Florida Statutes, is amended
130to read:
131     252.355  Registry of persons with special needs; notice.--
132     (1)  In order to meet the special needs of clients persons
133who would need assistance during evacuations and sheltering
134because of physical, mental, cognitive impairment, or sensory
135disabilities, each local emergency management agency in the
136state shall maintain a registry of persons with special needs
137located within the jurisdiction of the local agency. The
138registration shall identify those persons in need of assistance
139and plan for resource allocation to meet those identified needs.
140To assist the local emergency management agency in identifying
141such persons, the Department of Children and Family Services,
142Department of Health, Agency for Health Care Administration,
143Department of Education, Agency for Persons with Disabilities,
144Department of Labor and Employment Security, and Department of
145Elderly Affairs shall provide registration information to all of
146their special needs clients and to all people with disabilities
147or special needs who receive services incoming clients as a part
148of the intake process. The registry shall be updated annually.
149The registration program shall give persons with special needs
150the option of preauthorizing emergency response personnel to
151enter their homes during search and rescue operations if
152necessary to assure their safety and welfare following
153disasters.
154     (2)  The Department of Community Affairs shall be the
155designated lead agency responsible for community education and
156outreach to the general public, including special needs clients,
157regarding registration and special needs shelters and general
158information regarding shelter stays. The Department of Community
159Affairs shall disseminate such educational and outreach
160information through the local emergency management offices. The
161department shall coordinate the development of curriculum and
162dissemination of all community education and outreach related to
163special needs shelters with the Clearinghouse on Disability
164Information of the Governor's Working Group on the Americans
165with Disabilities Act, the Department of Children and Family
166Services, the Department of Health, the Agency for Health Care
167Administration, the Department of Education, the Agency for
168Persons with Disabilities, and the Department of Elderly
169Affairs.
170     (3)(2)  On or before May 1 of each year each electric
171utility in the state shall annually notify residential customers
172in its service area of the availability of the registration
173program available through their local emergency management
174agency.
175     (4)(3)  All records, data, information, correspondence, and
176communications relating to the registration of persons with
177special needs as provided in subsection (1) are confidential and
178exempt from the provisions of s. 119.07(1), except that such
179information shall be available to other emergency response
180agencies, as determined by the local emergency management
181director, and shall be provided to the Department of Health in
182the furtherance of their duties and responsibilities.
183     (5)(4)  All appropriate agencies and community-based
184service providers, including home health care providers, and
185hospices shall assist emergency management agencies by
186collecting registration information for persons with special
187needs as part of program intake processes, establishing programs
188to increase the awareness of the registration process, and
189educating clients about the procedures that may be necessary for
190their safety during disasters. Clients of state or federally
191funded service programs with physical, mental, cognitive
192impairment, or sensory disabilities who need assistance in
193evacuating, or when in shelters, must register as persons with
194special needs.
195     Section 2.  Section 381.0303, Florida Statutes, is amended
196to read:
197     381.0303  Health practitioner recruitment for Special needs
198shelters.--
199     (1)  PURPOSE.--The purpose of this section is to provide
200for the operation, maintenance, and closure of special needs
201shelters and to designate the Department of Health, through its
202county health departments, as the lead agency for coordination
203of the recruitment of health care practitioners, as defined in
204s. 456.001(4), to staff special needs shelters in times of
205emergency or disaster and to provide resources to the department
206to carry out this responsibility. However, nothing in this
207section prohibits a county health department from entering into
208an agreement with a local emergency management agency to assume
209the lead responsibility for recruiting health care
210practitioners.
211     (2)  SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE; STATE
212AGENCY ASSISTANCE AND STAFFING.--Provided funds have been
213appropriated to support medical services disaster coordinator
214positions in county health departments,
215     (a)  The department shall assume lead responsibility for
216the local coordination of local medical and health care
217providers, the American Red Cross, and other interested parties
218in developing a plan for the staffing and medical management of
219special needs shelters. The local Children's Medical Services
220offices shall assume lead responsibility for the local
221coordination of local medical and health care providers, the
222American Red Cross, and other interested parties in developing a
223plan for the staffing and medical management of pediatric
224special needs shelters. Plans shall conform to The plan shall be
225in conformance with the local comprehensive emergency management
226plan.
227     (b)(a)  County health departments shall, in conjunction
228with the local emergency management agencies, have the lead
229responsibility for coordination of the recruitment of health
230care practitioners to staff local special needs shelters. County
231health departments shall assign their employees to work in
232special needs shelters when those employees are needed to
233protect the health and safety of special needs clients of
234patients. County governments shall assist in this process.
235     (c)(b)  The appropriate county health department,
236Children's Medical Services office, and local emergency
237management agency shall jointly decide determine who has
238responsibility for medical supervision in each a special needs
239shelter and shall notify the department of their decision.
240     (d)(c)  Local emergency management agencies shall be
241responsible for the designation and operation of special needs
242shelters during times of emergency or disaster and the closure
243of the facilities following an emergency or disaster. County
244health departments shall assist the local emergency management
245agency with regard to the management of medical services in
246special needs shelters.
247     (e)  State employees with a preestablished role in disaster
248response may be called upon to serve in times of disaster
249commensurate with their knowledge, skills, and abilities and any
250needed activities related to the situation.
251     (f)  The Secretary of Elderly Affairs, or his or her
252designee, shall convene, at any time that he or she deems
253appropriate and necessary, a multiagency emergency special needs
254shelter response team or teams to assist local areas that are
255severely impacted by a natural or manmade disaster that requires
256the use of special needs shelters. Multiagency response teams
257shall provide assistance to local emergency management agencies
258with the continued operation or closure of the shelters, as well
259as with the discharge of special needs clients to alternate
260facilities if necessary. Local emergency management agencies may
261request the assistance of a multiagency response team by
262alerting statewide emergency management officials of the
263necessity for additional assistance in their area. The Secretary
264of Elderly Affairs is encouraged to proactively work with other
265state agencies prior to any natural disasters for which warnings
266are provided to ensure that multiagency response teams are ready
267to assemble and deploy rapidly upon a determination by state
268emergency management officials that a disaster area requires
269additional assistance. The Secretary of Elderly Affairs may call
270upon any state agency or office to provide staff to assist a
271multiagency response team or teams. Unless the secretary
272determines that the nature or circumstances surrounding the
273disaster do not warrant participation from a particular agency's
274staff, each multiagency response team shall include at least one
275representative from each of the following state agencies:
276     1.  Department of Elderly Affairs.
277     2.  Department of Health.
278     3.  Department of Children and Family Services.
279     4.  Department of Veterans' Affairs.
280     5.  Department of Community Affairs.
281     6.  Agency for Health Care Administration.
282     7.  Agency for Persons with Disabilities.
283     (3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
284FACILITIES.--
285     (a)  The Department of Health shall upon request reimburse,
286subject to the availability of funds for this purpose, health
287care practitioners, as defined in s. 456.001, provided the
288practitioner is not providing care to a patient under an
289existing contract, and emergency medical technicians and
290paramedics licensed under pursuant to chapter 401, for medical
291care provided at the request of the department in special needs
292shelters or at other locations during times of emergency or a
293declared major disaster. Reimbursement for health care
294practitioners, except for physicians licensed under pursuant to
295chapter 458 or chapter 459, shall be based on the average hourly
296rate that such practitioners were paid according to the most
297recent survey of Florida hospitals conducted by the Florida
298Hospital Association. Reimbursement shall be requested on forms
299prepared by the Department of Health and shall be paid as
300specified in paragraph (d).
301     (b)  Hospitals and nursing homes that are used to shelter
302special needs clients during or after an evacuation may submit
303invoices for reimbursement to the department. The department
304shall develop a form for reimbursement and shall specify by rule
305which expenses are reimbursable and the rate of reimbursement
306for each service. Reimbursement for the services described in
307this paragraph shall be paid as specified in paragraph (d).
308     (c)  If, upon closure of a special needs shelter, a
309multiagency response team determines that it is necessary to
310discharge special needs shelter clients to other health care
311facilities, such as nursing homes, assisted living facilities,
312and community residential group homes, the receiving facilities
313shall be eligible for reimbursement for services provided to the
314clients for up to 90 days. Any facility eligible for
315reimbursement under this paragraph shall submit invoices for
316reimbursement on forms developed by the department. A facility
317must show proof of a written request from a representative of an
318agency serving on the multiagency response team that the client
319for whom the facility is seeking reimbursement for services
320rendered was referred to that facility from a special needs
321shelter. Reimbursement for the services described in this
322paragraph shall be paid as specified in paragraph (d).
323     (d)  If a Presidential Disaster Declaration has been issued
324made, and the Federal Government makes funds available, the
325department shall use those such funds for reimbursement of
326eligible expenditures. In other situations, or if federal funds
327do not fully compensate the department for reimbursements
328permissible under reimbursement made pursuant to this section,
329the department shall submit to the Cabinet or the Legislature,
330as appropriate, a budget amendment to obtain reimbursement from
331the working capital fund. The department shall not provide
332reimbursement to facilities under this subsection for services
333provided to a special needs client if, during the period of time
334in which the services were provided, the client was enrolled in
335another state-funded program, such as Medicaid or another
336similar program, which would otherwise pay for the same
337services. Travel expense and per diem costs shall be reimbursed
338pursuant to s. 112.061.
339     (4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may
340use the registries established in ss. 401.273 and 456.38 when
341health care practitioners are needed to staff special needs
342shelters or to staff disaster medical assistance teams.
343     (5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
344Secretary Department of Health may establish a special needs
345shelter interagency committee and serve as or appoint a designee
346to serve as the committee's chair. The department shall provide
347any necessary staff and resources to support the committee in
348the performance of its duties, to be chaired and staffed by the
349department. The committee shall resolve problems related to
350special needs shelters not addressed in the state comprehensive
351emergency medical plan and shall consult on serve as an
352oversight committee to monitor the planning and operation of
353special needs shelters.
354     (a)  The committee shall may:
355     1.  Develop and negotiate any necessary interagency
356agreements.
357     2.  Undertake other such activities as the department deems
358necessary to facilitate the implementation of this section.
359     3.  Submit recommendations to the Legislature as necessary.
360Such recommendations shall include, but not be limited to, the
361following:
362     a.  Defining "special needs shelter."
363     b.  Defining "special needs client."
364     c.  Development of a uniform registration form for special
365needs clients.
366     d.  Improving public awareness regarding the registration
367process.
368     e.  Improving overall communications with special needs
369clients both before and after a disaster.
370     f.  Recommending the construction or designation of
371additional special needs shelters in underserved areas of the
372state and the necessity of upgrading, modifying, or retrofitting
373existing special needs shelters.
374     g.  Recommending guidelines to establish a statewide
375database designed to collect and disseminate timely and
376appropriate special needs registration information.
377     (b)  The special needs shelter interagency committee shall
378be composed of representatives of emergency management, health,
379medical, and social services organizations. Membership shall
380include, but shall not be limited to, representatives of the
381Departments of Health, Community Affairs, Children and Family
382Services, Elderly Affairs, Labor and Employment Security, and
383Education; the Agency for Health Care Administration; the
384Florida Medical Association; the Florida Osteopathic Medical
385Association; Associated Home Health Industries of Florida, Inc.;
386the Florida Nurses Association; the Florida Health Care
387Association; the Florida Assisted Living Affiliation
388Association; the Florida Hospital Association; the Florida
389Statutory Teaching Hospital Council; the Florida Association of
390Homes for the Aging; the Florida Emergency Preparedness
391Association; the American Red Cross; Florida Hospices and
392Palliative Care, Inc.; the Association of Community Hospitals
393and Health Systems; the Florida Association of Health
394Maintenance Organizations; the Florida League of Health Systems;
395Private Care Association; and the Salvation Army; the Florida
396Association of Aging Services Providers; and the AARP.
397     (c)  Meetings of the committee shall be held in
398Tallahassee, and members of the committee shall serve at the
399expense of the agencies or organizations they represent. The
400committee shall make every effort to use teleconference or video
401conference capabilities in order to ensure statewide input and
402participation.
403     (6)  RULES.--The department has the authority to adopt
404rules necessary to implement this section. Rules shall may
405include a definition of a special needs client patient, specify
406physician reimbursement, and the designation of designate which
407county health departments which will have responsibility for the
408implementation of subsections (2) and (3). Standards for special
409needs shelters adopted by rule shall include minimum standards
410relating to:
411     (a)  Staffing levels for provision of services to assist
412individuals with activities of daily living.
413     (b)  Provision of transportation services.
414     (c)  Compliance with applicable service animal laws.
415     (d)  Eligibility criteria that includes individuals with
416physical, cognitive, and psychiatric disabilities.
417     (e)  Provision of support and services for individuals with
418physical, cognitive, and psychiatric disabilities.
419     (f)  Standardized applications that include specific
420eligibility criteria and the services an individual with special
421needs can expect to receive.
422     (g)  Procedures for addressing the needs of unregistered
423individuals in need of shelter.
424     (h)  Requirements that the special needs shelter location
425meets the Florida Accessibility Code for Building Construction.
426If the location fails to meet the standards, a plan must be
427provided describing how compliance will be achieved.
428     (i)  Procedures for addressing the needs of families that
429are eligible for special needs shelter services. Specific
430procedures shall be developed to address the needs of families
431with multiple dependents where only one dependent is eligible
432for the special needs shelter. Specific procedures shall be
433developed to address the needs of adults with special needs who
434are caregivers for individuals without special needs.
435     (j)  Standards for special needs shelters, including
436staffing, onsite emergency power, transportation services,
437supplies, including durable medical equipment, and any other
438recommendations for minimum standards as determined by the
439committee.
440     (7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY OF
441CARE.--Each emergency management plan submitted to a county
442health department by a home health agency pursuant to s.
443400.497, by a nurse registry pursuant to s. 400.506, or by a
444hospice pursuant to s. 400.610, shall specify the organization's
445functional staffing plan for special needs shelters to ensure
446continuity of care and services to its clients during and after
447the disaster or emergency situation. The submission of Emergency
448management plans to county health departments by home health
449agencies pursuant to s. 400.497(8)(c) and (d) and by nurse
450registries pursuant to s. 400.506(16)(e) and by hospice programs
451pursuant to s. 400.610(1)(b) is conditional upon the receipt of
452an appropriation by the department to establish medical services
453disaster coordinator positions in county health departments
454unless the secretary of the department and a local county
455commission jointly determine to require such plans to be
456submitted based on a determination that there is a special need
457to protect public health in the local area during an emergency.
458     Section 3.  Subsections (2) and (4) of section 252.385,
459Florida Statutes, are amended to read:
460     252.385  Public shelter space.--
461     (2)(a)  The division shall administer a program to survey
462existing schools, universities, community colleges, and other
463state-owned, municipally owned, and county-owned public
464buildings and any private facility that the owner, in writing,
465agrees to provide for use as a public hurricane evacuation
466shelter to identify those that are appropriately designed and
467located to serve as such shelters. The owners of the facilities
468must be given the opportunity to participate in the surveys. The
469Board of Regents, district school boards, community college
470boards of trustees, and the Department of Education are
471responsible for coordinating and implementing the survey of
472public schools, universities, and community colleges with the
473division or the local emergency management agency.
474     (b)  By January 31 of each even-numbered year, the Division
475of Emergency Management of the Department of Community Affairs
476shall prepare and submit a statewide emergency shelter plan to
477the Governor and the Cabinet for approval, subject to the
478requirements for approval provided in s. 1013.37(2). The plan
479must also identify the general location and square footage of
480special needs shelters, by regional planning council region,
481during the next 5 years. The Department of Health shall assist
482the division in determining the estimated need for special needs
483shelter space based on information from the special needs
484registration database and other factors.
485     (4)(a)  Public facilities, including schools, postsecondary
486education facilities, and other facilities owned or leased by
487the state or local governments, but excluding hospitals or
488nursing homes, which are suitable for use as public hurricane
489evacuation shelters shall be made available at the request of
490the local emergency management agencies. The local emergency
491management agency shall inspect a designated facility to
492determine its readiness prior to activating such facility for a
493specific hurricane or disaster. Such agencies shall coordinate
494with the appropriate school board, university, community
495college, or local governing board when requesting the use of
496such facilities as public hurricane evacuation shelters.
497     (b)  The Department of Management Services shall
498incorporate provisions for the use of suitable leased public
499facilities as public hurricane evacuation shelters into lease
500agreements for state agencies. Suitable leased public facilities
501include leased public facilities that are solely occupied by
502state agencies and have at least 2,000 square feet of net floor
503area in a single room or in a combination of rooms having a
504minimum of 400 square feet in each room. The net square footage
505of floor area must be determined by subtracting from the gross
506square footage the square footage of spaces such as mechanical
507and electrical rooms, storage rooms, open corridors, restrooms,
508kitchens, science or computer laboratories, shop or mechanical
509areas, administrative offices, records vaults, and crawl spaces.
510     (c)  The Department of Management Services shall, in
511consultation with local and state emergency management agencies,
512assess Department of Management Services facilities to identify
513the extent to which each facility has public hurricane
514evacuation shelter space. The Department of Management Services
515shall submit proposed facility retrofit projects that
516incorporate hurricane protection enhancements to the department
517for assessment and inclusion in the annual report prepared in
518accordance with subsection (3).
519     Section 4.  Section 400.492, Florida Statutes, is amended
520to read:
521     400.492  Provision of services during an emergency.--Each
522home health agency, nurse registry, hospice, or durable medical
523equipment provider shall prepare and maintain a comprehensive
524emergency management plan that is consistent with the standards
525adopted by national accreditation organizations and consistent
526with the local special needs plan. The plan shall be updated
527annually and shall provide for continuing home health, nurse
528registry, hospice, or durable medical equipment services during
529an emergency that interrupts patient care or services in the
530patient's home. The plan shall describe how the home health
531agency, nurse registry, hospice, or durable medical equipment
532provider establishes and maintains an effective response to
533emergencies and disasters, including: notifying staff when
534emergency response measures are initiated; providing for
535communication between staff members, county health departments,
536and local emergency management agencies, including a backup
537system; identifying resources necessary to continue essential
538care or services or referrals to other organizations subject to
539written agreement; and prioritizing and contacting patients who
540need continued care or services.
541     (1)  Each patient record for patients who are listed in the
542registry established pursuant to s. 252.355 shall include a
543description of how care or services will be continued in the
544event of an emergency or disaster. The home health agency shall
545discuss the emergency provisions with the patient and the
546patient's caregivers, including where and how the patient is to
547evacuate, procedures for notifying the home health agency in the
548event that the patient evacuates to a location other than the
549shelter identified in the patient record, and a list of
550medications and equipment which must either accompany the
551patient or will be needed by the patient in the event of an
552evacuation.
553     (2)  Each home health agency shall maintain a current
554prioritized list of patients who need continued services during
555an emergency. The list shall indicate how services shall be
556continued in the event of an emergency or disaster for each
557patient and if the patient is to be transported to a special
558needs shelter, and shall indicate if the patient is receiving
559skilled nursing services and the patient's medication and
560equipment needs. The list shall be furnished to county health
561departments and to local emergency management agencies, upon
562request.
563     (3)  Home health, hospice, and durable medical equipment
564provider agencies shall not be required to continue to provide
565care to patients in emergency situations that are beyond their
566control and that make it impossible to provide services, such as
567when roads are impassable or when patients do not go to the
568location specified in their patient records. Home health
569agencies, nurse registries, hospices, and durable medical
570equipment providers may establish links to local emergency
571operations centers to determine a mechanism to approach areas
572within the disaster area in order for the agency to reach its
573clients. The presentation of home care or hospice clients to a
574special needs shelter without the home health agency or hospice
575making a good faith effort to provide services in the shelter
576setting will constitute abandonment of the client and will
577result in regulatory review.
578     (4)  Notwithstanding the provisions of s. 400.464(2) or any
579other provision of law to the contrary, a home health agency may
580provide services in a special needs shelter located in any
581county.
582     Section 5.  Section 408.831, Florida Statutes, is amended
583to read:
584     408.831  Denial, suspension, or revocation of a license,
585registration, certificate, or application.--
586     (1)  In addition to any other remedies provided by law, the
587agency may deny each application or suspend or revoke each
588license, registration, or certificate of entities regulated or
589licensed by it:
590     (a)  If the applicant, licensee, registrant, or
591certificateholder, or, in the case of a corporation,
592partnership, or other business entity, if any officer, director,
593agent, or managing employee of that business entity or any
594affiliated person, partner, or shareholder having an ownership
595interest equal to 5 percent or greater in that business entity,
596has failed to pay all outstanding fines, liens, or overpayments
597assessed by final order of the agency or final order of the
598Centers for Medicare and Medicaid Services, not subject to
599further appeal, unless a repayment plan is approved by the
600agency; or
601     (b)  For failure to comply with any repayment plan.
602     (2)  In reviewing any application requesting a change of
603ownership or change of the licensee, registrant, or
604certificateholder, the transferor shall, prior to agency
605approval of the change, repay or make arrangements to repay any
606amounts owed to the agency. Should the transferor fail to repay
607or make arrangements to repay the amounts owed to the agency,
608the issuance of a license, registration, or certificate to the
609transferee shall be delayed until repayment or until
610arrangements for repayment are made.
611     (3)  Entities subject to this section may exceed their
612licensed capacity to act as a receiving facility in accordance
613with an emergency operations plan for clients of evacuating
614providers from a geographic area where an evacuation order has
615been issued by a local authority having jurisdiction. While in
616an overcapacity status, each provider must furnish or arrange
617for appropriate care and services to all clients. Overcapacity
618status in excess of 15 days shall require compliance with all
619fire safety requirements or their equivalency as approved by
620state and local authorities, whichever is applicable. In
621addition, the agency shall approve requests for overcapacity
622beyond 15 days, which approvals shall be based upon satisfactory
623justification and need as provided by the receiving and sending
624facility.
625     (4)  An inactive license may be issued to a licensee
626subject to this section when the provider is located in a
627geographic area where a state of emergency was declared by the
628Governor of Florida if the provider:
629     (a)  Suffered damage to the provider's operation during
630that state of emergency.
631     (b)  Is currently licensed.
632     (c)  Does not have a provisional license.
633     (d)  Will be temporarily unable to provide services but is
634reasonably expected to resume services within 12 months.
635
636An inactive license may be issued for a period not to exceed 12
637months but may be renewed by the agency for up to 6 additional
638months upon demonstration to the agency of progress toward
639reopening. A request by a licensee for an inactive license or to
640extend the previously approved inactive period must be submitted
641in writing to the agency, accompanied by written justification
642for the inactive license which states the beginning and ending
643dates of inactivity and includes a plan for the transfer of any
644clients to other providers and appropriate licensure fees. Upon
645agency approval, the licensee shall notify clients of any
646necessary discharge or transfer as required by authorizing
647statutes or applicable rules. The beginning of the inactive
648licensure period shall be the date the provider ceases
649operations. The end of the inactive period shall become the
650licensee expiration date and all licensure fees must be current,
651paid in full, and may be prorated. Reactivation of an inactive
652license requires the prior approval by the agency of a renewal
653application, including payment of licensure fees and agency
654inspections indicating compliance with all requirements of this
655part and applicable rules and statutes.
656     (5)(3)  This section provides standards of enforcement
657applicable to all entities licensed or regulated by the Agency
658for Health Care Administration. This section controls over any
659conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
660394, 395, 400, 408, 468, 483, and 641 or rules adopted pursuant
661to those chapters.
662     Section 6.  Section 252.357, Florida Statutes, is created
663to read:
664     252.357  Monitoring of nursing homes during disaster.--The
665Florida Comprehensive Emergency Management Plan shall permit the
666Agency for Health Care Administration, working from the agency's
667offices or in the Emergency Operations Center, ESF-8, to make
668initial contact with each nursing home in the disaster area. The
669agency, by July 15, 2005, and annually thereafter, shall publish
670on the Internet an emergency telephone number that can be used
671by nursing homes to contact the agency on a schedule established
672by the agency to report requests for assistance. The agency may
673also provide the telephone number to each facility when it makes
674the initial facility call.
675     Section 7.  This act shall take effect July 1, 2005.


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