Florida Senate - 2005 COMMITTEE AMENDMENT
Bill No. SB 2616
Barcode 164460
CHAMBER ACTION
Senate House
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11 The Committee on Domestic Security (Wise) recommended the
12 following amendment:
13
14 Senate Amendment (with title amendment)
15 Delete everything after the enacting clause
16
17 and insert:
18 Section 1. Section 252.355, Florida Statutes, is
19 amended to read:
20 252.355 Registry of persons with special needs;
21 notice.--
22 (1) In order to meet the special needs of persons who
23 would need assistance during evacuations and sheltering
24 because of physical, mental, or sensory disabilities, each
25 local emergency management agency in the state shall maintain
26 a registry of persons with special needs located within the
27 jurisdiction of the local agency. The registration shall
28 identify those persons in need of assistance and plan for
29 resource allocation to meet those identified needs. To assist
30 the local emergency management agency in identifying such
31 persons, the Department of Children and Family Services,
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1 Department of Health, Agency for Health Care Administration,
2 Department of Labor and Employment Security, and Department of
3 Elderly Affairs shall provide registration information to all
4 of their special needs clients and to all incoming clients as
5 a part of the intake process. The registry shall be updated
6 annually. The registration program shall give persons with
7 special needs the option of preauthorizing emergency response
8 personnel to enter their homes during search and rescue
9 operations if necessary to assure their safety and welfare
10 following disasters.
11 (2) The Department of Community Affairs shall be the
12 designated lead agency responsible for community education and
13 outreach to the general public, including special needs
14 clients, regarding registration and special needs shelters and
15 general information regarding shelter stays. The Department of
16 Community Affairs shall disseminate such educational and
17 outreach information through the local emergency management
18 offices.
19 (3)(2) On or before May 1 of each year each electric
20 utility in the state shall annually notify residential
21 customers in its service area of the availability of the
22 registration program available through their local emergency
23 management agency.
24 (4)(3) All records, data, information, correspondence,
25 and communications relating to the registration of persons
26 with special needs as provided in subsection (1) are
27 confidential and exempt from the provisions of s. 119.07(1),
28 except that such information shall be available to other
29 emergency response agencies, as determined by the local
30 emergency management director.
31 (5)(4) All appropriate agencies and community-based
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1 service providers, including home health care providers, and
2 hospices shall assist emergency management agencies by
3 collecting registration information for persons with special
4 needs as part of program intake processes, establishing
5 programs to increase the awareness of the registration
6 process, and educating clients about the procedures that may
7 be necessary for their safety during disasters. Clients of
8 state or federally funded service programs with physical,
9 mental, or sensory disabilities who need assistance in
10 evacuating, or when in shelters, must register as persons with
11 special needs.
12 Section 2. Section 381.0303, Florida Statutes, is
13 amended to read:
14 381.0303 Health practitioner recruitment for special
15 needs shelters.--
16 (1) PURPOSE.--The purpose of this section is to
17 designate the Department of Health, through its county health
18 departments, as the lead agency for coordination of the
19 recruitment of health care practitioners, as defined in s.
20 456.001(4), to staff special needs shelters in times of
21 emergency or disaster and to provide resources to the
22 department to carry out this responsibility. However, nothing
23 in this section prohibits a county health department from
24 entering into an agreement with a local emergency management
25 agency to assume the lead responsibility for recruiting health
26 care practitioners.
27 (2) SPECIAL NEEDS SHELTER PLAN AND STAFFING.--Provided
28 funds have been appropriated to support medical services
29 disaster coordinator positions in county health departments,
30 The department shall assume lead responsibility for the local
31 coordination of local medical and health care providers, the
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1 American Red Cross, and other interested parties in developing
2 a plan for the staffing and medical management of special
3 needs shelters. The local Children's Medical Services offices
4 shall assume lead responsibility for the local coordination of
5 local medical and health care providers, the American Red
6 Cross, and other interested parties in developing a plan for
7 the staffing and medical management of pediatric special needs
8 shelters. Plans The plan shall be in conformance with the
9 local comprehensive emergency management plan.
10 (a) County health departments shall, in conjunction
11 with the local emergency management agencies, have the lead
12 responsibility for coordination of the recruitment of health
13 care practitioners to staff local special needs shelters.
14 County health departments shall assign their employees to work
15 in special needs shelters when needed to protect the health of
16 patients. County governments shall assist in this process.
17 (b) The appropriate county health department,
18 Children's Medical Services, and local emergency management
19 agency shall jointly determine who has responsibility for
20 medical supervision in a special needs shelter.
21 (c) The Department of Elderly Affairs shall be the
22 lead agency responsible for ensuring the placement of special
23 needs residents rendered homeless due to a disaster event and
24 for appropriate and necessary discharge planning for special
25 needs shelter residents. Other elder service agencies and
26 organizations shall assist Department of Elderly Affairs in
27 this effort.
28 (d)1. The Agency for Persons with Disabilities shall
29 be the lead agency responsible for ensuring the placement of
30 developmentally disabled special needs residents.
31 2. The Department of Elderly Affairs shall be the lead
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1 agency responsible for ensuring the placement of elderly
2 residents in programs, Alzheimer's patients, and adult special
3 needs residents rendered homeless due to a disaster event.
4 3. The Department of Children and Family Services
5 shall be the lead agency responsible for ensuring the
6 placement of children within the welfare system and
7 individuals receiving mental health services from the
8 department.
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10 In all cases, the appropriate agency shall provide the
11 appropriate and necessary discharge planning for their
12 respective clients. Other social service agencies or
13 organizations shall assist the aforementioned agencies in this
14 effort.
15 (e) State employees with a preestablished role in
16 disaster response may be called upon to serve in times of
17 disaster commensurate with their knowledge, skills, and
18 abilities and any needed activities related to the situation.
19 (f)(c) Local emergency management agencies shall be
20 responsible for the designation and operation of special needs
21 shelters during times of emergency or disaster. County health
22 departments shall assist the local emergency management agency
23 with regard to the management of medical services in special
24 needs shelters.
25 (3) REIMBURSEMENT TO HEALTH CARE PRACTITIONERS.--The
26 Department of Health shall reimburse, subject to the
27 availability of funds for this purpose, health care
28 practitioners, as defined in s. 456.001, provided the
29 practitioner is not providing care to a patient under an
30 existing contract, and emergency medical technicians and
31 paramedics licensed pursuant to chapter 401 for medical care
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1 provided at the request of the department in special needs
2 shelters or at other locations during times of emergency or
3 major disaster. Reimbursement for health care practitioners,
4 except for physicians licensed pursuant to chapter 458 or
5 chapter 459, shall be based on the average hourly rate that
6 such practitioners were paid according to the most recent
7 survey of Florida hospitals conducted by the Florida Hospital
8 Association. Reimbursement shall be requested on forms
9 prepared by the Department of Health. If a Presidential
10 Disaster Declaration has been made, and the Federal Government
11 makes funds available, the department shall use such funds for
12 reimbursement of eligible expenditures. In other situations,
13 or if federal funds do not fully compensate the department for
14 reimbursement made pursuant to this section, the department
15 shall submit to the Cabinet or Legislature, as appropriate, a
16 budget amendment to obtain reimbursement from the working
17 capital fund. Hospitals that are used to shelter special needs
18 persons during and after an evacuation shall submit invoices
19 for reimbursement from the state for expenses incurred in this
20 effort. Travel expense and per diem costs shall be reimbursed
21 pursuant to s. 112.061.
22 (4) HEALTH CARE PRACTITIONER REGISTRY.--The department
23 may use the registries established in ss. 401.273 and 456.38
24 when health care practitioners are needed to staff special
25 needs shelters or to staff disaster medical assistance teams.
26 (5) SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
27 Department of Health may establish a special needs shelter
28 interagency committee, to be chaired and staffed by the
29 department. The committee shall resolve problems related to
30 special needs shelters not addressed in the state
31 comprehensive emergency medical plan and shall serve in a
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1 consultative role in as an oversight committee to monitor the
2 planning and operation of special needs shelters.
3 (a) The committee shall may:
4 1. Develop and negotiate any necessary interagency
5 agreements.
6 2. Undertake other such activities as the department
7 deems necessary to facilitate the implementation of this
8 section.
9 3. Submit recommendations to the Legislature as
10 necessary. Such recommendations shall include, but not be
11 limited to, the following:
12 a. Defining "special needs shelter."
13 b. Defining "special needs person."
14 c. Development of a uniform registration form.
15 d. The improvement of public awareness regarding the
16 registration process.
17 e. The improvement of overall communications with
18 special needs persons both before and after a disaster.
19 f. The establishment of special needs shelter
20 guidelines for staffing, supplies, including durable medical,
21 emergency power, and transportation.
22
23 The Department of Health shall establish a statewide database
24 designed to collect and disseminate timely and appropriate
25 special needs registration information.
26 (b) The special needs shelter interagency committee
27 shall be composed of representatives of emergency management,
28 health, medical, and social services organizations. Membership
29 shall include, but shall not be limited to, the Departments of
30 Community Affairs, Children and Family Services, Elderly
31 Affairs, Labor and Employment Security, and Education; the
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1 Agency for Health Care Administration; the Agency for
2 Workforce Innovation; the Florida Medical Association; the
3 Florida Osteopathic Medical Association; Associated Home
4 Health Industries of Florida, Inc.; the Florida Nurses
5 Association; the Florida Health Care Association; the Florida
6 Assisted Living Association; the Florida Hospital Association;
7 the Florida Statutory Teaching Hospital Council; the Florida
8 Association of Homes for the Aging; the Florida Emergency
9 Preparedness Association; the American Red Cross; Florida
10 Hospices, Inc.; the Association of Community Hospitals and
11 Health Systems; the Florida Association of Health Maintenance
12 Organizations; the Florida League of Health Systems; Private
13 Care Association; and the Salvation Army; the Florida
14 Association of Aging Services Providers; and the American
15 Association of Retired Persons.
16 (c) Meetings of the committee shall be held in
17 Tallahassee, and members of the committee shall serve at the
18 expense of the agencies or organizations they represent. The
19 committee shall make every effort to use teleconference or
20 video conference capabilities in order to ensure widespread
21 input and to accommodate persons from other areas of the
22 state.
23 (6) RULES.--The department has the authority to adopt
24 rules necessary to implement this section. Rules shall may
25 include a definition of a special needs patient, specification
26 with respect to specify physician reimbursement, and the
27 designation of designate which county health departments which
28 will have responsibility for the implementation of subsections
29 (2) and (3).
30 (7) REVIEW OF EMERGENCY MANAGEMENT PLANS.--The
31 submission of Emergency management plans submitted to county
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1 health departments by home health agencies pursuant to s.
2 400.497(8)(c) and (d) and by nurse registries pursuant to s.
3 400.506(16)(e) and by hospice programs pursuant to s.
4 400.610(1)(b) shall specifically address an agency's
5 functional staffing plan for the shelters to ensure continuity
6 of care and services for clients is conditional upon the
7 receipt of an appropriation by the department to establish
8 medical services disaster coordinator positions in county
9 health departments unless the secretary of the department and
10 a local county commission jointly determine to require such
11 plans to be submitted based on a determination that there is a
12 special need to protect public health in the local area during
13 an emergency.
14 Section 3. Subsection (4) of section 252.385, Florida
15 Statutes, is amended to read:
16 252.385 Public shelter space.--
17 (4)(a) Public facilities, including schools,
18 postsecondary education facilities, and other facilities owned
19 or leased by the state or local governments, but excluding
20 hospitals or nursing homes, which are suitable for use as
21 public hurricane evacuation shelters shall be made available
22 at the request of the local emergency management agencies. The
23 local emergency management agency shall inspect a facility
24 prior to activating such facility for a specific hurricane or
25 disaster. Such agencies shall coordinate with the appropriate
26 school board, university, community college, or local
27 governing board when requesting the use of such facilities as
28 public hurricane evacuation shelters.
29 (b) The Department of Management Services shall
30 incorporate provisions for the use of suitable leased public
31 facilities as public hurricane evacuation shelters into lease
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1 agreements for state agencies. Suitable leased public
2 facilities include leased public facilities that are solely
3 occupied by state agencies and have at least 2,000 square feet
4 of net floor area in a single room or in a combination of
5 rooms having a minimum of 400 square feet in each room. The
6 net square footage of floor area must be determined by
7 subtracting from the gross square footage the square footage
8 of spaces such as mechanical and electrical rooms, storage
9 rooms, open corridors, restrooms, kitchens, science or
10 computer laboratories, shop or mechanical areas,
11 administrative offices, records vaults, and crawl spaces.
12 (c) The Department of Management Services shall
13 annually review the registry of persons with special needs to
14 ensure that the construction of special needs shelters is
15 sufficient and suitable to house such persons during and after
16 an evacuation.
17 (d)(c) The Department of Management Services shall, in
18 consultation with local and state emergency management
19 agencies, assess Department of Management Services facilities
20 to identify the extent to which each facility has public
21 hurricane evacuation shelter space. The Department of
22 Management Services shall submit proposed facility retrofit
23 projects that incorporate hurricane protection enhancements to
24 the department for assessment and inclusion in the annual
25 report prepared in accordance with subsection (3).
26 Section 4. Subsection (3) of section 400.492, Florida
27 Statutes, is amended to read:
28 400.492 Provision of services during an
29 emergency.--Each home health agency shall prepare and maintain
30 a comprehensive emergency management plan that is consistent
31 with the standards adopted by national accreditation
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1 organizations and consistent with the local special needs
2 plan. The plan shall be updated annually and shall provide for
3 continuing home health services during an emergency that
4 interrupts patient care or services in the patient's home. The
5 plan shall describe how the home health agency establishes and
6 maintains an effective response to emergencies and disasters,
7 including: notifying staff when emergency response measures
8 are initiated; providing for communication between staff
9 members, county health departments, and local emergency
10 management agencies, including a backup system; identifying
11 resources necessary to continue essential care or services or
12 referrals to other organizations subject to written agreement;
13 and prioritizing and contacting patients who need continued
14 care or services.
15 (3) Home health, hospice, and durable medical
16 equipment provider agencies shall not be required to continue
17 to provide care to patients in emergency situations that are
18 beyond their control and that make it impossible to provide
19 services, such as when roads are impassable or when patients
20 do not go to the location specified in their patient records.
21 Home health agencies and durable medical equipment providers
22 may establish links to local emergency operations centers to
23 determine a mechanism to approach areas within the disaster
24 area in order for the agency to reach its clients. The
25 presentation of home care clients to a special needs shelter
26 without the home health agency making a good-faith effort to
27 provide the home health services in the shelter setting, which
28 the agency is currently providing in the client's home, will
29 constitute abandonment of the client and will result in
30 regulatory review.
31 Section 5. Section 408.831, Florida Statutes, is
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1 amended to read:
2 408.831 Denial, suspension, or revocation of a
3 license, registration, certificate, or application.--
4 (1) In addition to any other remedies provided by law,
5 the agency may deny each application or suspend or revoke each
6 license, registration, or certificate of entities regulated or
7 licensed by it:
8 (a) If the applicant, licensee, registrant, or
9 certificateholder, or, in the case of a corporation,
10 partnership, or other business entity, if any officer,
11 director, agent, or managing employee of that business entity
12 or any affiliated person, partner, or shareholder having an
13 ownership interest equal to 5 percent or greater in that
14 business entity, has failed to pay all outstanding fines,
15 liens, or overpayments assessed by final order of the agency
16 or final order of the Centers for Medicare and Medicaid
17 Services, not subject to further appeal, unless a repayment
18 plan is approved by the agency; or
19 (b) For failure to comply with any repayment plan.
20 (2) In reviewing any application requesting a change
21 of ownership or change of the licensee, registrant, or
22 certificateholder, the transferor shall, prior to agency
23 approval of the change, repay or make arrangements to repay
24 any amounts owed to the agency. Should the transferor fail to
25 repay or make arrangements to repay the amounts owed to the
26 agency, the issuance of a license, registration, or
27 certificate to the transferee shall be delayed until repayment
28 or until arrangements for repayment are made.
29 (3) Entities subject to this section may exceed their
30 licensed capacity to act as a receiving facility in accordance
31 with an emergency operations plan for clients of evacuating
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1 providers from a geographic area where an evacuation order has
2 been issued by a local authority having jurisdiction. While in
3 an overcapacity status, each provider must furnish or arrange
4 for appropriate care and services to all clients and comply
5 with all firesafety requirements of state and local
6 authorities. Overcapacity status in excess of 30 days requires
7 prior written approval by the agency, which shall be based
8 upon satisfactory justification and need.
9 (4) An inactive license may be issued to a licensee
10 subject to this section when the provider is located in a
11 geographic area where a state of emergency was declared by the
12 Governor of Florida if the provider:
13 (a) Suffered damage to the provider's operation during
14 that state of emergency.
15 (b) Is currently licensed.
16 (c) Does not have a provisional license.
17 (d) Will be temporarily unable to provide services but
18 is reasonably expected to resume services within 12 months.
19
20 An inactive license may be issued for a period not to exceed
21 12 months but may be renewed by the agency for up to 6
22 additional months upon demonstration to the agency of progress
23 toward reopening. A request by a licensee for an inactive
24 license or to extend the previously approved inactive period
25 must be submitted in writing to the agency, accompanied by
26 written justification for the inactive license which states
27 the beginning and ending dates of inactivity and includes a
28 plan for the transfer of any clients to other providers and
29 appropriate licensure fees. Upon agency approval, the licensee
30 shall notify clients of any necessary discharge or transfer as
31 required by authorizing statutes or applicable rules. The
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1 beginning of the inactive licensure period shall be the date
2 the provider ceases operations. The end of the inactive period
3 shall become the licensee expiration date and all licensure
4 fees must be current, paid in full, and may be prorated.
5 Reactivation of an inactive license requires the prior
6 approval by the agency of a renewal application, including
7 payment of licensure fees and agency inspections indicating
8 compliance with all requirements of this part and applicable
9 rules and statutes.
10 (5)(3) This section provides standards of enforcement
11 applicable to all entities licensed or regulated by the Agency
12 for Health Care Administration. This section controls over any
13 conflicting provisions of chapters 39, 381, 383, 390, 391,
14 393, 394, 395, 400, 408, 468, 483, and 641 or rules adopted
15 pursuant to those chapters.
16 Section 6. This act shall take effect July 1, 2005.
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19 ================ T I T L E A M E N D M E N T ===============
20 And the title is amended as follows:
21 Delete everything before the enacting clause
22
23 and insert:
24 A bill to be entitled
25 An act relating to emergency management;
26 amending s. 252.355, F.S.; providing that the
27 Department of Community Affairs shall be the
28 designated lead agency responsible for
29 community education and outreach to the general
30 public, including special needs clients,
31 regarding registration as a person with special
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1 needs, special needs shelters, and general
2 information regarding shelter stays; requiring
3 the department to disseminate educational and
4 outreach information through local emergency
5 management offices; amending s. 381.0303, F.S.;
6 removing a condition of specified funding as a
7 prerequisite to the assumption of lead
8 responsibility by the Department of Health for
9 specified coordination with respect to the
10 development of a plan for the staffing and
11 medical management of special needs shelters;
12 providing that the local Children's Medical
13 Services offices shall assume lead
14 responsibility for specified coordination with
15 respect to the development of a plan for the
16 staffing and medical management of pediatric
17 special needs shelters; requiring such plans to
18 be in conformance with the local comprehensive
19 emergency management plan; requiring county
20 governments to assist in the process of
21 coordinating the recruitment of health care
22 practitioners to staff local special needs
23 shelters; providing that the appropriate county
24 health department, Children's Medical Services,
25 and local emergency management agency shall
26 jointly determine the responsibility for
27 medical supervision in a special needs shelter;
28 providing that the Department of Elderly
29 Affairs shall be the lead agency responsible
30 for ensuring the placement of special needs
31 residents rendered homeless due to a disaster
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1 event and for appropriate discharge planning;
2 providing that the Agency for Persons with
3 Disabilities shall be the lead agency
4 responsible for ensuring the placement of
5 developmentally disabled special needs
6 residents; providing that the Department of
7 Elderly Affairs shall be the lead agency
8 responsible for ensuring the placement of
9 elderly residents in programs, Alzheimer's
10 patients, and adult special needs residents
11 rendered homeless due to a disaster event;
12 providing that the Department of Children and
13 Family Services shall be the lead agency
14 responsible for ensuring the placement of
15 children within the welfare system and
16 individuals receiving mental health services
17 from the department; providing that the
18 appropriate agency shall provide necessary
19 discharge planning for their respective
20 clients; providing that state employees with a
21 preestablished role in disaster response may be
22 called upon to serve in times of disaster in
23 specified capacities; requiring hospitals that
24 are used to shelter special needs persons
25 during and after an evacuation to submit
26 invoices for reimbursement from the state for
27 expenses incurred for medical care provided at
28 the request of the Department of Health in
29 special needs shelters or at other locations
30 during times of emergency or major disaster;
31 revising the role of the special needs shelter
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1 interagency committee with respect to the
2 planning and operation of special needs
3 shelters; providing required functions of the
4 committee; providing that the Department of
5 Health shall establish a statewide database to
6 capture and disseminate special needs
7 registration information; revising the
8 composition of the special needs shelter
9 interagency committee; providing for the
10 inclusion of specified rules with respect to
11 health practitioner recruitment for special
12 needs shelters; providing requirements with
13 respect to emergency management plans submitted
14 by home health agencies, nurse registries, and
15 hospice programs to county health departments
16 for review; removing a condition of specified
17 funding as a prerequisite to the submission of
18 such plans; amending s. 252.385, F.S.;
19 requiring inspection of public hurricane
20 evacuation shelter facilities by local
21 emergency management agencies prior to
22 activation of such facilities; requiring the
23 Department of Management Services to annually
24 review the registry of persons with special
25 needs to ensure that the construction of
26 special needs shelters is sufficient and
27 suitable to house such persons during and after
28 an evacuation; amending s. 400.492, F.S.;
29 providing that home health, hospice, and
30 durable medical equipment provider agencies
31 shall not be required to continue to provide
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1 care to patients in emergency situations that
2 are beyond their control and that make it
3 impossible to provide services; authorizing
4 home health agencies and durable medical
5 equipment providers to establish links to local
6 emergency operations centers to determine a
7 mechanism to approach areas within a disaster
8 area in order for the agency to reach its
9 clients; providing that the presentation of
10 home care clients to the special needs shelter
11 without the home health agency making a good
12 faith effort to provide services in the shelter
13 setting constitutes abandonment of the client;
14 requiring regulatory review in such cases;
15 amending s. 408.831, F.S.; providing that
16 entities regulated or licensed by the Agency
17 for Health Care Administration may exceed their
18 licensed capacity to act as a receiving
19 facility under specified circumstances;
20 providing requirements while such entities are
21 in an overcapacity status; providing for
22 issuance of an inactive license to such
23 licensees under specified conditions; providing
24 requirements and procedures with respect to the
25 issuance and reactivation of an inactive
26 license; providing fees; providing an effective
27 date.
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