Senate Bill sb2616

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    Florida Senate - 2005                                  SB 2616

    By Senator Clary





    4-1609-05                                               See HB

  1                      A bill to be entitled

  2         An act relating to emergency management;

  3         amending s. 252.355, F.S.; providing that the

  4         Department of Community Affairs shall be the

  5         designated lead agency responsible for

  6         community education and outreach to the general

  7         public, including special needs clients,

  8         regarding registration as a person with special

  9         needs, special needs shelters, and general

10         information regarding shelter stays; requiring

11         the department to disseminate educational and

12         outreach information through local emergency

13         management offices; amending s. 381.0303, F.S.;

14         removing a condition of specified funding as a

15         prerequisite to the assumption of lead

16         responsibility by the Department of Health for

17         specified coordination with respect to the

18         development of a plan for the staffing and

19         medical management of special needs shelters;

20         providing that the local Children's Medical

21         Services offices shall assume lead

22         responsibility for specified coordination with

23         respect to the development of a plan for the

24         staffing and medical management of pediatric

25         special needs shelters; requiring such plans to

26         be in conformance with the local comprehensive

27         emergency management plan; requiring county

28         governments to assist in the process of

29         coordinating the recruitment of health care

30         practitioners to staff local special needs

31         shelters; providing that the appropriate county

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1         health department, Children's Medical Services,

 2         and local emergency management agency shall

 3         jointly determine the responsibility for

 4         medical supervision in a special needs shelter;

 5         providing that the Department of Elderly

 6         Affairs shall be the lead agency responsible

 7         for ensuring the placement of special needs

 8         residents rendered homeless due to a disaster

 9         event and for appropriate and necessary

10         discharge planning for special needs shelter

11         residents; providing that the Department of

12         Children and Family Services shall be the lead

13         agency responsible for ensuring the placement

14         of developmentally disabled persons, mental

15         health special needs residents, and Alzheimer

16         adult special needs residents rendered homeless

17         due to a disaster event and for the appropriate

18         and necessary discharge planning for special

19         needs shelter residents; providing that state

20         employees with a preestablished role in

21         disaster response may be called upon to serve

22         in times of disaster in specified capacities;

23         requiring hospitals that are used to shelter

24         special needs persons during and after an

25         evacuation to submit invoices for reimbursement

26         from the state for expenses incurred for

27         medical care provided at the request of the

28         Department of Health in special needs shelters

29         or at other locations during times of emergency

30         or major disaster; revising the role of the

31         special needs shelter interagency committee

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1         with respect to the planning and operation of

 2         special needs shelters; providing required

 3         functions of the committee; providing for the

 4         inclusion of specified rules with respect to

 5         health practitioner recruitment for special

 6         needs shelters; providing that the requirement

 7         for submission of emergency management plans by

 8         home health agencies, nurse registries, and

 9         hospice programs to local emergency management

10         agencies for review and approval remains in

11         effect; providing requirements with respect to

12         such plans; removing a condition of specified

13         funding as a prerequisite to the submission of

14         such plans; amending s. 252.385, F.S.;

15         requiring the Department of Management Services

16         to annually review the registry of persons with

17         special needs to ensure that the construction

18         of special needs shelters is sufficient and

19         suitable to house such persons during and after

20         an evacuation; amending s. 400.492, F.S.;

21         providing that home health, hospice, and

22         durable medical equipment provider agencies

23         shall not be required to continue to provide

24         care to patients in emergency situations that

25         are beyond their control and that make it

26         impossible to provide services; authorizing

27         home health agencies and durable medical

28         equipment providers to establish links to local

29         emergency operations centers to determine a

30         mechanism to approach areas within a disaster

31         area in order for the agency to reach its

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1         clients; providing that the presentation of

 2         home care clients to the special needs shelter

 3         without the home health agency making a good

 4         faith effort to provide services in the shelter

 5         setting constitutes abandonment of the client;

 6         requiring regulatory review in such cases;

 7         amending s. 408.831, F.S.; providing that

 8         entities regulated or licensed by the Agency

 9         for Health Care Administration may exceed their

10         licensed capacity to act as a receiving

11         facility under specified circumstances;

12         providing requirements while such entities are

13         in an overcapacity status; providing for

14         issuance of an inactive license to such

15         licensees under specified conditions; providing

16         requirements and procedures with respect to the

17         issuance and reactivation of an inactive

18         license; providing fees; providing an effective

19         date.

20  

21  Be It Enacted by the Legislature of the State of Florida:

22  

23         Section 1.  Section 252.355, Florida Statutes, is

24  amended to read:

25         252.355  Registry of persons with special needs;

26  notice.--

27         (1)  In order to meet the special needs of persons who

28  would need assistance during evacuations and sheltering

29  because of physical, mental, or sensory disabilities, each

30  local emergency management agency in the state shall maintain

31  a registry of persons with special needs located within the

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  jurisdiction of the local agency. The registration shall

 2  identify those persons in need of assistance and plan for

 3  resource allocation to meet those identified needs. To assist

 4  the local emergency management agency in identifying such

 5  persons, the Department of Children and Family Services,

 6  Department of Health, Agency for Health Care Administration,

 7  Department of Labor and Employment Security, and Department of

 8  Elderly Affairs shall provide registration information to all

 9  of their special needs clients and to all incoming clients as

10  a part of the intake process. The registry shall be updated

11  annually. The registration program shall give persons with

12  special needs the option of preauthorizing emergency response

13  personnel to enter their homes during search and rescue

14  operations if necessary to assure their safety and welfare

15  following disasters.

16         (2)  The Department of Community Affairs shall be the

17  designated lead agency responsible for community education and

18  outreach to the general public, including special needs

19  clients, regarding registration and special needs shelters and

20  general information regarding shelter stays. The Department of

21  Community Affairs shall disseminate such educational and

22  outreach information through the local emergency management

23  offices.

24         (3)(2)  On or before May 1 of each year each electric

25  utility in the state shall annually notify residential

26  customers in its service area of the availability of the

27  registration program available through their local emergency

28  management agency.

29         (4)(3)  All records, data, information, correspondence,

30  and communications relating to the registration of persons

31  with special needs as provided in subsection (1) are

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  confidential and exempt from the provisions of s. 119.07(1),

 2  except that such information shall be available to other

 3  emergency response agencies, as determined by the local

 4  emergency management director.

 5         (5)(4)  All appropriate agencies and community-based

 6  service providers, including home health care providers, shall

 7  assist emergency management agencies by collecting

 8  registration information for persons with special needs as

 9  part of program intake processes, establishing programs to

10  increase the awareness of the registration process, and

11  educating clients about the procedures that may be necessary

12  for their safety during disasters. Clients of state or

13  federally funded service programs with physical, mental, or

14  sensory disabilities who need assistance in evacuating, or

15  when in shelters, must register as persons with special needs.

16         Section 2.  Section 381.0303, Florida Statutes, is

17  amended to read:

18         381.0303  Health practitioner recruitment for special

19  needs shelters.--

20         (1)  PURPOSE.--The purpose of this section is to

21  designate the Department of Health, through its county health

22  departments, as the lead agency for coordination of the

23  recruitment of health care practitioners, as defined in s.

24  456.001(4), to staff special needs shelters in times of

25  emergency or disaster and to provide resources to the

26  department to carry out this responsibility. However, nothing

27  in this section prohibits a county health department from

28  entering into an agreement with a local emergency management

29  agency to assume the lead responsibility for recruiting health

30  care practitioners.

31  

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1         (2)  SPECIAL NEEDS SHELTER PLAN AND STAFFING.--Provided

 2  funds have been appropriated to support medical services

 3  disaster coordinator positions in county health departments,

 4  The department shall assume lead responsibility for the local

 5  coordination of local medical and health care providers, the

 6  American Red Cross, and other interested parties in developing

 7  a plan for the staffing and medical management of special

 8  needs shelters. The local Children's Medical Services offices

 9  shall assume lead responsibility for the local coordination of

10  local medical and health care providers, the American Red

11  Cross, and other interested parties in developing a plan for

12  the staffing and medical management of pediatric special needs

13  shelters. Plans The plan shall be in conformance with the

14  local comprehensive emergency management plan.

15         (a)  County health departments shall, in conjunction

16  with the local emergency management agencies, have the lead

17  responsibility for coordination of the recruitment of health

18  care practitioners to staff local special needs shelters.

19  County health departments shall assign their employees to work

20  in special needs shelters when needed to protect the health of

21  patients. County governments shall assist in this process.

22         (b)  The appropriate county health department,

23  Children's Medical Services, and local emergency management

24  agency shall jointly determine who has responsibility for

25  medical supervision in a special needs shelter.

26         (c)  The Department of Elderly Affairs shall be the

27  lead agency responsible for ensuring the placement of special

28  needs residents rendered homeless due to a disaster event and

29  for appropriate and necessary discharge planning for special

30  needs shelter residents. Other elder service agencies and

31  

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  organizations shall assist Department of Elderly Affairs in

 2  this effort.

 3         (d)  The Department of Children and Family Services

 4  shall be the lead agency responsible for ensuring the

 5  placement of developmentally disabled special needs residents,

 6  mental health special needs residents, and Alzheimer adult

 7  special needs residents rendered homeless due to a disaster

 8  event and the appropriate and necessary discharge planning for

 9  special needs shelter residents. Other social service agencies

10  or organizations shall assist the Department of Children and

11  Family Services in this effort.

12         (e)  State employees with a preestablished role in

13  disaster response may be called upon to serve in times of

14  disaster commensurate with their knowledge, skills, and

15  abilities and any needed activities related to the situation.

16         (f)(c)  Local emergency management agencies shall be

17  responsible for the designation and operation of special needs

18  shelters during times of emergency or disaster. County health

19  departments shall assist the local emergency management agency

20  with regard to the management of medical services in special

21  needs shelters.

22         (3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS.--The

23  Department of Health shall reimburse, subject to the

24  availability of funds for this purpose, health care

25  practitioners, as defined in s. 456.001, provided the

26  practitioner is not providing care to a patient under an

27  existing contract, and emergency medical technicians and

28  paramedics licensed pursuant to chapter 401 for medical care

29  provided at the request of the department in special needs

30  shelters or at other locations during times of emergency or

31  major disaster. Reimbursement for health care practitioners,

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  except for physicians licensed pursuant to chapter 458 or

 2  chapter 459, shall be based on the average hourly rate that

 3  such practitioners were paid according to the most recent

 4  survey of Florida hospitals conducted by the Florida Hospital

 5  Association. Reimbursement shall be requested on forms

 6  prepared by the Department of Health. If a Presidential

 7  Disaster Declaration has been made, and the Federal Government

 8  makes funds available, the department shall use such funds for

 9  reimbursement of eligible expenditures. In other situations,

10  or if federal funds do not fully compensate the department for

11  reimbursement made pursuant to this section, the department

12  shall submit to the Cabinet or Legislature, as appropriate, a

13  budget amendment to obtain reimbursement from the working

14  capital fund. Hospitals that are used to shelter special needs

15  persons during and after an evacuation shall submit invoices

16  for reimbursement from the state for expenses incurred in this

17  effort. Travel expense and per diem costs shall be reimbursed

18  pursuant to s. 112.061.

19         (4)  HEALTH CARE PRACTITIONER REGISTRY.--The department

20  may use the registries established in ss. 401.273 and 456.38

21  when health care practitioners are needed to staff special

22  needs shelters or to staff disaster medical assistance teams.

23         (5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The

24  Department of Health may establish a special needs shelter

25  interagency committee, to be chaired and staffed by the

26  department. The committee shall resolve problems related to

27  special needs shelters not addressed in the state

28  comprehensive emergency medical plan and shall serve in a

29  consultative role in as an oversight committee to monitor the

30  planning and operation of special needs shelters.

31         (a)  The committee shall may:

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1         1.  Develop and negotiate any necessary interagency

 2  agreements.

 3         2.  Undertake other such activities as the department

 4  deems necessary to facilitate the implementation of this

 5  section.

 6         3.  Submit recommendations to the Legislature as

 7  necessary.

 8         (b)  The special needs shelter interagency committee

 9  shall be composed of representatives of emergency management,

10  health, medical, and social services organizations. Membership

11  shall include, but shall not be limited to, the Departments of

12  Community Affairs, Children and Family Services, Elderly

13  Affairs, Labor and Employment Security, and Education; the

14  Agency for Health Care Administration; the Florida Medical

15  Association; the Florida Osteopathic Medical Association;

16  Associated Home Health Industries of Florida, Inc.; the

17  Florida Nurses Association; the Florida Health Care

18  Association; the Florida Assisted Living Association; the

19  Florida Hospital Association; the Florida Statutory Teaching

20  Hospital Council; the Florida Association of Homes for the

21  Aging; the Florida Emergency Preparedness Association; the

22  American Red Cross; Florida Hospices, Inc.; the Association of

23  Community Hospitals and Health Systems; the Florida

24  Association of Health Maintenance Organizations; the Florida

25  League of Health Systems; Private Care Association; and the

26  Salvation Army.

27         (c)  Meetings of the committee shall be held in

28  Tallahassee, and members of the committee shall serve at the

29  expense of the agencies or organizations they represent.

30         (6)  RULES.--The department has the authority to adopt

31  rules necessary to implement this section. Rules shall may

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  include a definition of a special needs patient, specification

 2  with respect to specify physician reimbursement, and the

 3  designation of designate which county health departments which

 4  will have responsibility for the implementation of subsections

 5  (2) and (3).

 6         (7)  REVIEW OF EMERGENCY MANAGEMENT PLANS.--The

 7  requirement for submission of emergency management plans to

 8  county health departments by home health agencies pursuant to

 9  s. 400.497(8)(c) and (d) and by nurse registries pursuant to

10  s. 400.506(16)(e) and by hospice programs pursuant to s.

11  400.610(1)(b) to local emergency management agencies for

12  review and approval remains in effect. These plans shall

13  specifically address an agency's functional staffing plan for

14  the shelters to ensure continuity of care and services for

15  clients is conditional upon the receipt of an appropriation by

16  the department to establish medical services disaster

17  coordinator positions in county health departments unless the

18  secretary of the department and a local county commission

19  jointly determine to require such plans to be submitted based

20  on a determination that there is a special need to protect

21  public health in the local area during an emergency.

22         Section 3.  Subsection (4) of section 252.385, Florida

23  Statutes, is amended to read:

24         252.385  Public shelter space.--

25         (4)(a)  Public facilities, including schools,

26  postsecondary education facilities, and other facilities owned

27  or leased by the state or local governments, but excluding

28  hospitals or nursing homes, which are suitable for use as

29  public hurricane evacuation shelters shall be made available

30  at the request of the local emergency management agencies.

31  Such agencies shall coordinate with the appropriate school

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  board, university, community college, or local governing board

 2  when requesting the use of such facilities as public hurricane

 3  evacuation shelters.

 4         (b)  The Department of Management Services shall

 5  incorporate provisions for the use of suitable leased public

 6  facilities as public hurricane evacuation shelters into lease

 7  agreements for state agencies. Suitable leased public

 8  facilities include leased public facilities that are solely

 9  occupied by state agencies and have at least 2,000 square feet

10  of net floor area in a single room or in a combination of

11  rooms having a minimum of 400 square feet in each room. The

12  net square footage of floor area must be determined by

13  subtracting from the gross square footage the square footage

14  of spaces such as mechanical and electrical rooms, storage

15  rooms, open corridors, restrooms, kitchens, science or

16  computer laboratories, shop or mechanical areas,

17  administrative offices, records vaults, and crawl spaces.

18         (c)  The Department of Management Services shall

19  annually review the registry of persons with special needs to

20  ensure that the construction of special needs shelters is

21  sufficient and suitable to house such persons during and after

22  an evacuation.

23         (d)(c)  The Department of Management Services shall, in

24  consultation with local and state emergency management

25  agencies, assess Department of Management Services facilities

26  to identify the extent to which each facility has public

27  hurricane evacuation shelter space. The Department of

28  Management Services shall submit proposed facility retrofit

29  projects that incorporate hurricane protection enhancements to

30  the department for assessment and inclusion in the annual

31  report prepared in accordance with subsection (3).

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1         Section 4.  Subsection (3) of section 400.492, Florida

 2  Statutes, is amended to read:

 3         400.492  Provision of services during an

 4  emergency.--Each home health agency shall prepare and maintain

 5  a comprehensive emergency management plan that is consistent

 6  with the standards adopted by national accreditation

 7  organizations and consistent with the local special needs

 8  plan. The plan shall be updated annually and shall provide for

 9  continuing home health services during an emergency that

10  interrupts patient care or services in the patient's home. The

11  plan shall describe how the home health agency establishes and

12  maintains an effective response to emergencies and disasters,

13  including: notifying staff when emergency response measures

14  are initiated; providing for communication between staff

15  members, county health departments, and local emergency

16  management agencies, including a backup system; identifying

17  resources necessary to continue essential care or services or

18  referrals to other organizations subject to written agreement;

19  and prioritizing and contacting patients who need continued

20  care or services.

21         (3)  Home health, hospice, and durable medical

22  equipment provider agencies shall not be required to continue

23  to provide care to patients in emergency situations that are

24  beyond their control and that make it impossible to provide

25  services, such as when roads are impassable or when patients

26  do not go to the location specified in their patient records.

27  Home health agencies and durable medical equipment providers

28  may establish links to local emergency operations centers to

29  determine a mechanism to approach areas within the disaster

30  area in order for the agency to reach its clients. The

31  presentation of home care clients to a special needs shelter

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  without the home health agency making a good faith effort to

 2  provide services in the shelter setting will constitute

 3  abandonment of the client and will result in regulatory

 4  review.

 5         Section 5.  Section 408.831, Florida Statutes, is

 6  amended to read:

 7         408.831  Denial, suspension, or revocation of a

 8  license, registration, certificate, or application.--

 9         (1)  In addition to any other remedies provided by law,

10  the agency may deny each application or suspend or revoke each

11  license, registration, or certificate of entities regulated or

12  licensed by it:

13         (a)  If the applicant, licensee, registrant, or

14  certificateholder, or, in the case of a corporation,

15  partnership, or other business entity, if any officer,

16  director, agent, or managing employee of that business entity

17  or any affiliated person, partner, or shareholder having an

18  ownership interest equal to 5 percent or greater in that

19  business entity, has failed to pay all outstanding fines,

20  liens, or overpayments assessed by final order of the agency

21  or final order of the Centers for Medicare and Medicaid

22  Services, not subject to further appeal, unless a repayment

23  plan is approved by the agency; or

24         (b)  For failure to comply with any repayment plan.

25         (2)  In reviewing any application requesting a change

26  of ownership or change of the licensee, registrant, or

27  certificateholder, the transferor shall, prior to agency

28  approval of the change, repay or make arrangements to repay

29  any amounts owed to the agency. Should the transferor fail to

30  repay or make arrangements to repay the amounts owed to the

31  agency, the issuance of a license, registration, or

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  certificate to the transferee shall be delayed until repayment

 2  or until arrangements for repayment are made.

 3         (3)  Entities subject to this section may exceed their

 4  licensed capacity to act as a receiving facility in accordance

 5  with an emergency operations plan for clients of evacuating

 6  providers from a geographic area where an evacuation order has

 7  been issued by a local authority having jurisdiction. While in

 8  an overcapacity status, each provider must furnish or arrange

 9  for appropriate care and services to all clients and comply

10  with all firesafety requirements of state and local

11  authorities.  Overcapacity status in excess of 30 days

12  requires written prior approval by the agency, which shall be

13  based upon satisfactory justification and need.

14         (4)  An inactive license may be issued to a licensee

15  subject to this section when the provider is located in a

16  geographic area where a state of emergency was declared by the

17  Governor of Florida if the provider:

18         (a)  Suffered damage to the provider's operation during

19  that state of emergency;

20         (b)  Is currently licensed;

21         (c)  Does not have a provisional license; and

22         (d)  Will be temporarily unable to provide services but

23  is reasonably expected to resume services within 12 months.

24  

25  An inactive license may be issued for a period not to exceed

26  12 months but may be renewed by the agency for up to 6

27  additional months upon demonstration to the agency of progress

28  toward reopening. A request by a licensee for an inactive

29  license or to extend the previously approved inactive period

30  must be submitted in writing to the agency, accompanied by

31  written justification for the inactive license which states

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    Florida Senate - 2005                                  SB 2616
    4-1609-05                                               See HB




 1  the beginning and ending dates of inactivity, and including a

 2  plan for the transfer of any clients to other providers and

 3  appropriate licensure fees. Upon agency approval, the licensee

 4  shall notify clients of any necessary discharge or transfer as

 5  required by authorizing statutes or applicable rules. The

 6  beginning of the inactive licensure period shall be the date

 7  the provider ceases operations. The end of the inactive period

 8  shall become the licensee expiration date and all licensure

 9  fees must be current, paid in full, and may be prorated.

10  Reactivation of an inactive license requires the prior

11  approval by the agency of a renewal application, including

12  payment of licensure fees and agency inspections indicating

13  compliance with all requirements of this part and applicable

14  rules and statutes.

15         (5)(3)  This section provides standards of enforcement

16  applicable to all entities licensed or regulated by the Agency

17  for Health Care Administration. This section controls over any

18  conflicting provisions of chapters 39, 381, 383, 390, 391,

19  393, 394, 395, 400, 408, 468, 483, and 641 or rules adopted

20  pursuant to those chapters.

21         Section 6.  This act shall take effect July 1, 2005.

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