Senate Bill sb2616c2
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By the Committees on Community Affairs; Domestic Security; and
Senator Clary
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1 A bill to be entitled
2 An act relating to emergency management;
3 amending s. 252.355, F.S.; specifying
4 additional agencies that are required to
5 provide registration information to special
6 needs clients and persons with disabilities or
7 special needs who receive services from such
8 agencies for purposes of inclusion within the
9 registry of persons with special needs
10 maintained by local emergency management
11 agencies; providing that the Department of
12 Community Affairs shall be the designated lead
13 agency responsible for community education and
14 outreach to the general public, including
15 special needs clients, regarding registration
16 as a person with special needs, special needs
17 shelters, and general information regarding
18 shelter stays; requiring the department to
19 disseminate educational and outreach
20 information through local emergency management
21 offices; requiring the department to coordinate
22 community education and outreach related to
23 special needs shelters with specified agencies
24 and entities; providing that specified
25 confidential and exempt information relating to
26 registration of persons with special needs be
27 provided to the Department of Health; amending
28 s. 381.0303, F.S.; providing for the operation,
29 maintenance, and closure of special needs
30 shelters; removing a condition of specified
31 funding as a prerequisite to the assumption of
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1 lead responsibility by the Department of Health
2 for specified coordination with respect to the
3 development of a plan for the staffing and
4 medical management of special needs shelters;
5 providing that the local Children's Medical
6 Services offices shall assume lead
7 responsibility for specified coordination with
8 respect to the development of a plan for the
9 staffing and medical management of pediatric
10 special needs shelters; requiring such plans to
11 conform to the local comprehensive emergency
12 management plan; requiring county governments
13 to assist in the process of coordinating the
14 recruitment of health care practitioners to
15 staff local special needs shelters; providing
16 that the appropriate county health department,
17 Children's Medical Services office, and local
18 emergency management agency shall jointly
19 determine the responsibility for medical
20 supervision in a special needs shelter;
21 requiring local emergency management agencies
22 to be responsible for the closure of special
23 needs shelters following an emergency;
24 providing that state employees with a
25 preestablished role in disaster response may be
26 called upon to serve in times of disaster in
27 specified capacities; requiring the Secretary
28 of Elderly Affairs to convene a multiagency
29 emergency special needs shelter response team
30 or teams to assist local areas that are
31 severely impacted by a natural or manmade
2
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1 disaster that required the use of special needs
2 shelters; providing duties and responsibilities
3 of multiagency response teams; authorizing
4 local emergency management agencies to request
5 the assistance of a multiagency response team;
6 providing for the inclusion of specified state
7 agency representatives on each multiagency
8 response team; authorizing hospitals and
9 nursing homes that are used to shelter special
10 needs persons during or after an evacuation to
11 submit invoices for reimbursement to the
12 Department of Health; requiring the department
13 to specify by rule expenses that are
14 reimbursable and the rate of reimbursement for
15 services; prescribing means of and procedures
16 for reimbursement; providing eligibility for
17 reimbursement of health care facilities to whom
18 special needs shelter clients have been
19 discharged by a multiagency response team upon
20 closure of a special needs shelter; providing
21 requirements with respect to such
22 reimbursement; prescribing means of and
23 procedures for reimbursement; disallowing
24 specified reimbursements; revising the role of
25 the special needs shelter interagency committee
26 with respect to the planning and operation of
27 special needs shelters; providing required
28 functions of the committee; providing that the
29 committee shall recommend guidelines to
30 establish a statewide database to collect and
31 disseminate special needs registration
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1 information; revising the composition of the
2 special needs shelter interagency committee;
3 requiring the inclusion of specified rules with
4 respect to special needs shelters and specified
5 minimum standards therefor; providing
6 requirements with respect to emergency
7 management plans submitted by a home health
8 agency, nurse registry, or hospice to a county
9 health department for review; removing a
10 condition of specified funding as a
11 prerequisite to the submission of such plans;
12 amending s. 252.385, F.S.; requiring the
13 Division of Emergency Management of the
14 Department of Community Affairs to prepare and
15 submit a statewide emergency shelter plan to
16 the Governor and the Cabinet for approval;
17 providing plan requirements; requiring the
18 Department of Health to assist the division in
19 determining the estimated need for special
20 needs shelter space; requiring inspection of
21 public hurricane evacuation shelter facilities
22 by local emergency management agencies prior to
23 activation of such facilities; amending s.
24 400.492, F.S.; providing that nurse registries,
25 hospices, and durable medical equipment
26 providers shall prepare and maintain a
27 comprehensive emergency management plan;
28 providing that home health, hospice, and
29 durable medical equipment provider agencies
30 shall not be required to continue to provide
31 care to patients in emergency situations that
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1 are beyond their control and that make it
2 impossible to provide services; authorizing
3 home health agencies, nurse registries,
4 hospices, and durable medical equipment
5 providers to establish links to local emergency
6 operations centers to determine a mechanism to
7 approach areas within a disaster area in order
8 for the agency to reach its clients; providing
9 that the presentation of home care or hospice
10 clients to the special needs shelter without
11 the home health agency or hospice 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; creating s. 252.357,
27 F.S., requiring the Florida Comprehensive
28 Emergency Management Plan to permit the Agency
29 for Health Care Administration to initially
30 contact nursing homes in disaster areas for
31 specified monitoring purposes; requiring the
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1 agency to publish an emergency telephone number
2 for use by nursing homes; providing an
3 effective date.
4
5 Be It Enacted by the Legislature of the State of Florida:
6
7 Section 1. Section 252.355, Florida Statutes, is
8 amended to read:
9 252.355 Registry of persons with special needs;
10 notice.--
11 (1) In order to meet the special needs of clients
12 persons who would need assistance during evacuations and
13 sheltering because of physical, mental, cognitive impairment,
14 or sensory disabilities, each local emergency management
15 agency in the state shall maintain a registry of persons with
16 special needs located within the jurisdiction of the local
17 agency. The registration shall identify those persons in need
18 of assistance and plan for resource allocation to meet those
19 identified needs. To assist the local emergency management
20 agency in identifying such persons, the Department of Children
21 and Family Services, Department of Health, Agency for Health
22 Care Administration, Department of Education, Agency for
23 Persons with Disabilities, Department of Labor and Employment
24 Security, and Department of Elderly Affairs shall provide
25 registration information to all of their special needs clients
26 and to all people with disabilities or special needs who
27 receive services incoming clients as a part of the intake
28 process. The registry shall be updated annually. The
29 registration program shall give persons with special needs the
30 option of preauthorizing emergency response personnel to enter
31
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1 their homes during search and rescue operations if necessary
2 to assure their safety and welfare following disasters.
3 (2) The Department of Community Affairs shall be the
4 designated lead agency responsible for community education and
5 outreach to the general public, including special needs
6 clients, regarding registration and special needs shelters and
7 general information regarding shelter stays. The Department of
8 Community Affairs shall disseminate such educational and
9 outreach information through the local emergency management
10 offices. The department shall coordinate the development of
11 curriculum and dissemination of all community education and
12 outreach related to special needs shelters with the
13 Clearinghouse on Disability Information of the Governor's
14 Working Group on the Americans with Disabilities Act, the
15 Department of Children and Family Services, the Department of
16 Health, the Agency for Health Care Administration, the
17 Department of Education, the Agency for Persons with
18 Disabilities, and the Department of Elderly Affairs.
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, and shall be provided to the
31
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1 Department of Health in the furtherance of their duties and
2 responsibilities.
3 (5)(4) All appropriate agencies and community-based
4 service providers, including home health care providers, and
5 hospices shall assist emergency management agencies by
6 collecting registration information for persons with special
7 needs as part of program intake processes, establishing
8 programs to increase the awareness of the registration
9 process, and educating clients about the procedures that may
10 be necessary for their safety during disasters. Clients of
11 state or federally funded service programs with physical,
12 mental, cognitive impairment, or sensory disabilities who need
13 assistance in evacuating, or when in shelters, must register
14 as persons with special needs.
15 Section 2. Section 381.0303, Florida Statutes, is
16 amended to read:
17 381.0303 Health practitioner recruitment for Special
18 needs shelters.--
19 (1) PURPOSE.--The purpose of this section is to
20 provide for the operation, maintenance, and closure of special
21 needs shelters and to designate the Department of Health,
22 through its county health departments, as the lead agency for
23 coordination of the recruitment of health care practitioners,
24 as defined in s. 456.001(4), to staff special needs shelters
25 in times of emergency or disaster and to provide resources to
26 the department to carry out this responsibility. However,
27 nothing in this section prohibits a county health department
28 from entering into an agreement with a local emergency
29 management agency to assume the lead responsibility for
30 recruiting health care practitioners.
31
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1 (2) SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE;
2 STATE AGENCY ASSISTANCE AND STAFFING.--Provided funds have
3 been appropriated to support medical services disaster
4 coordinator positions in county health departments,
5 (a) The department shall assume lead responsibility
6 for the local coordination of local medical and health care
7 providers, the American Red Cross, and other interested
8 parties in developing a plan for the staffing and medical
9 management of special needs shelters. The local Children's
10 Medical Services offices shall assume lead responsibility for
11 the local coordination of local medical and health care
12 providers, the American Red Cross, and other interested
13 parties in developing a plan for the staffing and medical
14 management of pediatric special needs shelters. Plans shall
15 conform to The plan shall be in conformance with the local
16 comprehensive emergency management plan.
17 (b)(a) County health departments shall, in conjunction
18 with the local emergency management agencies, have the lead
19 responsibility for coordination of the recruitment of health
20 care practitioners to staff local special needs shelters.
21 County health departments shall assign their employees to work
22 in special needs shelters when those employees are needed to
23 protect the health and safety of special needs clients of
24 patients. County governments shall assist in this process.
25 (c)(b) The appropriate county health department,
26 Children's Medical Services office, and local emergency
27 management agency shall jointly decide determine who has
28 responsibility for medical supervision in each a special needs
29 shelter and shall notify the department of their decision.
30 (d)(c) Local emergency management agencies shall be
31 responsible for the designation and operation of special needs
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1 shelters during times of emergency or disaster and the closure
2 of the facilities following an emergency or disaster. County
3 health departments shall assist the local emergency management
4 agency with regard to the management of medical services in
5 special needs shelters.
6 (e) State employees with a preestablished role in
7 disaster response may be called upon to serve in times of
8 disaster commensurate with their knowledge, skills, and
9 abilities and any needed activities related to the situation.
10 (f) The Secretary of Elderly Affairs, or his or her
11 designee, shall convene, at any time that he or she deems
12 appropriate and necessary, a multiagency emergency special
13 needs shelter response team or teams to assist local areas
14 that are severely impacted by a natural or manmade disaster
15 that requires the use of special needs shelters. Multiagency
16 response teams shall provide assistance to local emergency
17 management agencies with the continued operation or closure of
18 the shelters, as well as with the discharge of special needs
19 clients to alternate facilities if necessary. Local emergency
20 management agencies may request the assistance of a
21 multiagency response team by alerting statewide emergency
22 management officials of the necessity for additional
23 assistance in their area. The Secretary of Elderly Affairs is
24 encouraged to proactively work with other state agencies prior
25 to any natural disasters for which warnings are provided to
26 ensure that multiagency response teams are ready to assemble
27 and deploy rapidly upon a determination by state emergency
28 management officials that a disaster area requires additional
29 assistance. The Secretary of Elderly Affairs may call upon any
30 state agency or office to provide staff to assist a
31 multiagency response team or teams. Unless the secretary
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1 determines that the nature or circumstances surrounding the
2 disaster do not warrant participation from a particular
3 agency's staff, each multiagency response team shall include
4 at least one representative from each of the following state
5 agencies:
6 1. Department of Elderly Affairs.
7 2. Department of Health.
8 3. Department of Children and Family Services.
9 4. Department of Veterans' Affairs.
10 5. Department of Community Affairs.
11 6. Agency for Health Care Administration.
12 7. Agency for Persons with Disabilities.
13 (3) REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
14 FACILITIES.--
15 (a) The Department of Health shall upon request
16 reimburse, subject to the availability of funds for this
17 purpose, health care practitioners, as defined in s. 456.001,
18 provided the practitioner is not providing care to a patient
19 under an existing contract, and emergency medical technicians
20 and paramedics licensed under pursuant to chapter 401, for
21 medical care provided at the request of the department in
22 special needs shelters or at other locations during times of
23 emergency or a declared major disaster. Reimbursement for
24 health care practitioners, except for physicians licensed
25 under pursuant to chapter 458 or chapter 459, shall be based
26 on the average hourly rate that such practitioners were paid
27 according to the most recent survey of Florida hospitals
28 conducted by the Florida Hospital Association. Reimbursement
29 shall be requested on forms prepared by the Department of
30 Health and shall be paid as specified in paragraph (d).
31
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1 (b) Hospitals and nursing homes that are used to
2 shelter special needs clients during or after an evacuation
3 may submit invoices for reimbursement to the department. The
4 department shall develop a form for reimbursement and shall
5 specify by rule which expenses are reimbursable and the rate
6 of reimbursement for each service. Reimbursement for the
7 services described in this paragraph shall be paid as
8 specified in paragraph (d).
9 (c) If, upon closure of a special needs shelter, a
10 multiagency response team determines that it is necessary to
11 discharge special needs shelter clients to other health care
12 facilities, such as nursing homes, assisted living facilities,
13 and community residential group homes, the receiving
14 facilities shall be eligible for reimbursement for services
15 provided to the clients for up to 90 days. Any facility
16 eligible for reimbursement under this paragraph shall submit
17 invoices for reimbursement on forms developed by the
18 department. A facility shall show proof of a written request
19 from a representative of an agency serving on the multiagency
20 response team that the client for whom the facility is seeking
21 reimbursement for services rendered was referred to that
22 facility from a special needs shelter. Reimbursement for the
23 services described in this paragraph shall be paid as
24 specified in paragraph (d).
25 (d) If a Presidential Disaster Declaration has been
26 issued made, and the Federal Government makes funds available,
27 the department shall use those such funds for reimbursement of
28 eligible expenditures. In other situations, or if federal
29 funds do not fully compensate the department for
30 reimbursements permissible under reimbursement made pursuant
31 to this section, the department shall submit to the Cabinet or
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1 the Legislature, as appropriate, a budget amendment to obtain
2 reimbursement from the working capital fund. The department
3 may not provide reimbursement to facilities under this
4 subsection for services provided to a special needs client if,
5 during the period of time in which the services were provided,
6 the client was enrolled in another state-funded program, such
7 as Medicaid or another similar program, which would otherwise
8 pay for the same services. Travel expense and per diem costs
9 shall be reimbursed pursuant to s. 112.061.
10 (4) HEALTH CARE PRACTITIONER REGISTRY.--The department
11 may use the registries established in ss. 401.273 and 456.38
12 when health care practitioners are needed to staff special
13 needs shelters or to staff disaster medical assistance teams.
14 (5) SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
15 Secretary Department of Health may establish a special needs
16 shelter interagency committee and serve as or appoint a
17 designee to serve as the committee's chair. The department
18 shall provide any necessary staff and resources to support the
19 committee in the performance of its duties, to be chaired and
20 staffed by the department. The committee shall resolve
21 problems related to special needs shelters not addressed in
22 the state comprehensive emergency medical plan and shall
23 consult on serve as an oversight committee to monitor the
24 planning and operation of special needs shelters.
25 (a) The committee shall may:
26 1. Develop and negotiate any necessary interagency
27 agreements.
28 2. Undertake other such activities as the department
29 deems necessary to facilitate the implementation of this
30 section.
31
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1 3. Submit recommendations to the Legislature as
2 necessary. Such recommendations shall include, but not be
3 limited to, the following:
4 a. Defining "special needs shelter."
5 b. Defining "special needs client."
6 c. Development of a uniform registration form for
7 special needs clients.
8 d. Improving public awareness regarding the
9 registration process.
10 e. Improving overall communications with special needs
11 clients both before and after a disaster.
12 f. Recommending the construction or designation of
13 additional special needs shelters in underserved areas of the
14 state and the necessity of upgrading, modifying, or
15 retrofitting existing special needs shelters.
16 g. Recommending guidelines to establish a statewide
17 database designed to collect and disseminate timely and
18 appropriate special needs registration information.
19 (b) The special needs shelter interagency committee
20 shall be composed of representatives of emergency management,
21 health, medical, and social services organizations. Membership
22 shall include, but shall not be limited to, representatives of
23 the Departments of Health, Community Affairs, Children and
24 Family Services, Elderly Affairs, Labor and Employment
25 Security, and Education; the Agency for Health Care
26 Administration; the Florida Medical Association; the Florida
27 Osteopathic Medical Association; Associated Home Health
28 Industries of Florida, Inc.; the Florida Nurses Association;
29 the Florida Health Care Association; the Florida Assisted
30 Living Affiliation Association; the Florida Hospital
31 Association; the Florida Statutory Teaching Hospital Council;
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1 the Florida Association of Homes for the Aging; the Florida
2 Emergency Preparedness Association; the American Red Cross;
3 Florida Hospices and Palliative Care, Inc.; the Association of
4 Community Hospitals and Health Systems; the Florida
5 Association of Health Maintenance Organizations; the Florida
6 League of Health Systems; Private Care Association; and the
7 Salvation Army; the Florida Association of Aging Services
8 Providers; and the AARP.
9 (c) Meetings of the committee shall be held in
10 Tallahassee, and members of the committee shall serve at the
11 expense of the agencies or organizations they represent. The
12 committee shall make every effort to use teleconference or
13 video conference capabilities in order to ensure statewide
14 input and participation.
15 (6) RULES.--The department has the authority to adopt
16 rules necessary to implement this section. Rules shall may
17 include a definition of a special needs client patient,
18 specify physician reimbursement, and the designation of
19 designate which county health departments which will have
20 responsibility for the implementation of subsections (2) and
21 (3). Standards for special needs shelters adopted by rule
22 shall include minimum standards relating to:
23 (a) The provision of electricity.
24 (b) Staffing levels for provision of services to
25 assist individuals with activities of daily living.
26 (c) Provision of transportation services.
27 (d) Compliance with applicable service animal laws.
28 (e) Eligibility criteria that includes individuals
29 with physical, cognitive, and psychiatric disabilities.
30 (f) Provision of support and services for individuals
31 with physical, cognitive, and psychiatric disabilities.
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1 (g) Standardized applications that include specific
2 eligibility criteria and the services an individual with
3 special needs can expect to receive.
4 (h) Procedures for addressing the needs of
5 unregistered individuals in need of shelter.
6 (i) Requirements that the special needs shelter
7 location meets the Florida Accessibility Code for Building
8 Construction. If the location fails to meet the standards, a
9 plan must be provided describing how compliance will be
10 achieved.
11 (j) Procedures for addressing the needs of families
12 that are eligible for special needs shelter services. Specific
13 procedures shall be developed to address the needs of families
14 with multiple dependents where only one dependent is eligible
15 for the special needs shelter. Specific procedures shall be
16 developed to address the needs of adults with special needs
17 who are caregivers for individuals without special needs.
18 (k) Standards for special needs shelters, including
19 staffing, emergency power, transportation services, supplies,
20 including durable medical equipment, and any other
21 recommendations for minimum standards as determined by the
22 committee.
23 (7) REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY
24 OF CARE.--Each emergency management plan submitted to a county
25 health department by a home health agency pursuant to s.
26 400.497, by a nurse registry pursuant to s. 400.506, or by a
27 hospice pursuant to s. 400.610, shall specify the
28 organization's functional staffing plan for special needs
29 shelters to ensure continuity of care and services to its
30 clients during and after the disaster or emergency situation.
31 The submission of Emergency management plans to county health
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1 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) is conditional upon the receipt of an
5 appropriation by the department to establish medical services
6 disaster coordinator positions in county health departments
7 unless the secretary of the department and a local county
8 commission jointly determine to require such plans to be
9 submitted based on a determination that there is a special
10 need to protect public health in the local area during an
11 emergency.
12 Section 3. Subsections (2) and (4) of section 252.385,
13 Florida Statutes, are amended to read:
14 252.385 Public shelter space.--
15 (2)(a) The division shall administer a program to
16 survey existing schools, universities, community colleges, and
17 other state-owned, municipally owned, and county-owned public
18 buildings and any private facility that the owner, in writing,
19 agrees to provide for use as a public hurricane evacuation
20 shelter to identify those that are appropriately designed and
21 located to serve as such shelters. The owners of the
22 facilities must be given the opportunity to participate in the
23 surveys. The Board of Regents, district school boards,
24 community college boards of trustees, and the Department of
25 Education are responsible for coordinating and implementing
26 the survey of public schools, universities, and community
27 colleges with the division or the local emergency management
28 agency.
29 (b) By January 31 of each even-numbered year, the
30 Division of Emergency Management within the Department of
31 Community Affairs shall prepare and submit a statewide
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1 emergency shelter plan to the Governor and the Cabinet for
2 approval, subject to the requirements for approval provided in
3 s. 1013.37(2). The plan must also identify the general
4 location and square footage of special needs shelters, by
5 regional planning council region, during the next 5 years. The
6 Department of Health shall assist the division in determining
7 the estimated need for special needs shelter space based on
8 information from the special needs registration database and
9 other factors.
10 (4)(a) Public facilities, including schools,
11 postsecondary education facilities, and other facilities owned
12 or leased by the state or local governments, but excluding
13 hospitals or nursing homes, which are suitable for use as
14 public hurricane evacuation shelters shall be made available
15 at the request of the local emergency management agencies. The
16 local emergency management agency shall inspect a designated
17 facility to determine its readiness prior to activating such
18 facility for a specific hurricane or disaster. Such agencies
19 shall coordinate with the appropriate school board,
20 university, community college, or local governing board when
21 requesting the use of such facilities as public hurricane
22 evacuation shelters.
23 (b) The Department of Management Services shall
24 incorporate provisions for the use of suitable leased public
25 facilities as public hurricane evacuation shelters into lease
26 agreements for state agencies. Suitable leased public
27 facilities include leased public facilities that are solely
28 occupied by state agencies and have at least 2,000 square feet
29 of net floor area in a single room or in a combination of
30 rooms having a minimum of 400 square feet in each room. The
31 net square footage of floor area must be determined by
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1 subtracting from the gross square footage the square footage
2 of spaces such as mechanical and electrical rooms, storage
3 rooms, open corridors, restrooms, kitchens, science or
4 computer laboratories, shop or mechanical areas,
5 administrative offices, records vaults, and crawl spaces.
6 (c) The Department of Management Services shall, in
7 consultation with local and state emergency management
8 agencies, assess Department of Management Services facilities
9 to identify the extent to which each facility has public
10 hurricane evacuation shelter space. The Department of
11 Management Services shall submit proposed facility retrofit
12 projects that incorporate hurricane protection enhancements to
13 the department for assessment and inclusion in the annual
14 report prepared in accordance with subsection (3).
15 Section 4. Section 400.492, Florida Statutes, is
16 amended to read:
17 400.492 Provision of services during an
18 emergency.--Each home health agency, nurse registry, hospice,
19 or durable medical equipment provider shall prepare and
20 maintain a comprehensive emergency management plan that is
21 consistent with the standards adopted by national
22 accreditation organizations and consistent with the local
23 special needs plan. The plan shall be updated annually and
24 shall provide for continuing home health, nurse registry,
25 hospice, or durable medical equipment services during an
26 emergency that interrupts patient care or services in the
27 patient's home. The plan shall describe how the home health
28 agency, nurse registry, hospice, or durable medical equipment
29 provider establishes and maintains an effective response to
30 emergencies and disasters, including: notifying staff when
31 emergency response measures are initiated; providing for
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1 communication between staff members, county health
2 departments, and local emergency management agencies,
3 including a backup system; identifying resources necessary to
4 continue essential care or services or referrals to other
5 organizations subject to written agreement; and prioritizing
6 and contacting patients who need continued care or services.
7 (1) Each patient record for patients who are listed in
8 the registry established pursuant to s. 252.355 shall include
9 a description of how care or services will be continued in the
10 event of an emergency or disaster. The home health agency
11 shall discuss the emergency provisions with the patient and
12 the patient's caregivers, including where and how the patient
13 is to evacuate, procedures for notifying the home health
14 agency in the event that the patient evacuates to a location
15 other than the shelter identified in the patient record, and a
16 list of medications and equipment which must either accompany
17 the patient or will be needed by the patient in the event of
18 an evacuation.
19 (2) Each home health agency shall maintain a current
20 prioritized list of patients who need continued services
21 during an emergency. The list shall indicate how services
22 shall be continued in the event of an emergency or disaster
23 for each patient and if the patient is to be transported to a
24 special needs shelter, and shall indicate if the patient is
25 receiving skilled nursing services and the patient's
26 medication and equipment needs. The list shall be furnished to
27 county health departments and to local emergency management
28 agencies, upon request.
29 (3) Home health, hospice, and durable medical
30 equipment provider agencies shall not be required to continue
31 to provide care to patients in emergency situations that are
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1 beyond their control and that make it impossible to provide
2 services, such as when roads are impassable or when patients
3 do not go to the location specified in their patient records.
4 Home health agencies, nurse registries, hospices, and durable
5 medical equipment providers may establish links to local
6 emergency operations centers to determine a mechanism to
7 approach areas within the disaster area in order for the
8 agency to reach its clients. The presentation of home care or
9 hospice clients to a special needs shelter without the home
10 health agency or hospice making a good-faith effort to provide
11 services in the shelter setting will constitute abandonment of
12 the client and will result in regulatory review.
13 (4) Notwithstanding the provisions of s. 400.464(2) or
14 any other provision of law to the contrary, a home health
15 agency may provide services in a special needs shelter located
16 in any county.
17 Section 5. Section 408.831, Florida Statutes, is
18 amended to read:
19 408.831 Denial, suspension, or revocation of a
20 license, registration, certificate, or application.--
21 (1) In addition to any other remedies provided by law,
22 the agency may deny each application or suspend or revoke each
23 license, registration, or certificate of entities regulated or
24 licensed by it:
25 (a) If the applicant, licensee, registrant, or
26 certificateholder, or, in the case of a corporation,
27 partnership, or other business entity, if any officer,
28 director, agent, or managing employee of that business entity
29 or any affiliated person, partner, or shareholder having an
30 ownership interest equal to 5 percent or greater in that
31 business entity, has failed to pay all outstanding fines,
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1 liens, or overpayments assessed by final order of the agency
2 or final order of the Centers for Medicare and Medicaid
3 Services, not subject to further appeal, unless a repayment
4 plan is approved by the agency; or
5 (b) For failure to comply with any repayment plan.
6 (2) In reviewing any application requesting a change
7 of ownership or change of the licensee, registrant, or
8 certificateholder, the transferor shall, prior to agency
9 approval of the change, repay or make arrangements to repay
10 any amounts owed to the agency. Should the transferor fail to
11 repay or make arrangements to repay the amounts owed to the
12 agency, the issuance of a license, registration, or
13 certificate to the transferee shall be delayed until repayment
14 or until arrangements for repayment are made.
15 (3) Entities subject to this section may exceed their
16 licensed capacity to act as a receiving facility in accordance
17 with an emergency operations plan for clients of evacuating
18 providers from a geographic area where an evacuation order has
19 been issued by a local authority having jurisdiction. While in
20 an overcapacity status, each provider must furnish or arrange
21 for appropriate care and services to all clients. Overcapacity
22 status in excess of 15 days shall require compliance with all
23 fire safety requirements or their equivalency as approved by
24 state and local authorities, whichever is applicable. In
25 addition, the agency shall approve requests for overcapacity
26 beyond 15 days, which approvals shall be based upon
27 satisfactory justification and need as provided by the
28 receiving and sending facility.
29 (4) An inactive license may be issued to a licensee
30 subject to this section when the provider is located in a
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1 geographic area where a state of emergency was declared by the
2 Governor of Florida if the provider:
3 (a) Suffered damage to the provider's operation during
4 that state of emergency.
5 (b) Is currently licensed.
6 (c) Does not have a provisional license.
7 (d) Will be temporarily unable to provide services but
8 is reasonably expected to resume services within 12 months.
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10 An inactive license may be issued for a period not to exceed
11 12 months but may be renewed by the agency for up to 6
12 additional months upon demonstration to the agency of progress
13 toward reopening. A request by a licensee for an inactive
14 license or to extend the previously approved inactive period
15 must be submitted in writing to the agency, accompanied by
16 written justification for the inactive license which states
17 the beginning and ending dates of inactivity and includes a
18 plan for the transfer of any clients to other providers and
19 appropriate licensure fees. Upon agency approval, the licensee
20 shall notify clients of any necessary discharge or transfer as
21 required by authorizing statutes or applicable rules. The
22 beginning of the inactive licensure period shall be the date
23 the provider ceases operations. The end of the inactive period
24 shall become the licensee expiration date and all licensure
25 fees must be current, paid in full, and may be prorated.
26 Reactivation of an inactive license requires the prior
27 approval by the agency of a renewal application, including
28 payment of licensure fees and agency inspections indicating
29 compliance with all requirements of this part and applicable
30 rules and statutes.
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1 (5)(3) This section provides standards of enforcement
2 applicable to all entities licensed or regulated by the Agency
3 for Health Care Administration. This section controls over any
4 conflicting provisions of chapters 39, 381, 383, 390, 391,
5 393, 394, 395, 400, 408, 468, 483, and 641 or rules adopted
6 pursuant to those chapters.
7 Section 6. Section 252.357, Florida Statutes, is
8 created to read:
9 252.357 Monitoring of nursing homes during
10 disaster.--The Florida Comprehensive Emergency Management Plan
11 shall permit the Agency for Health Care Administration,
12 working from the agency's offices or in the Emergency
13 Operations Center, ESF-8, to make initial contact with each
14 nursing home in the disaster area. The agency, by July 15,
15 2005, and annually thereafter, shall publish on the Internet
16 an emergency telephone number that can be used by nursing
17 homes to contact the agency on a schedule established by the
18 agency to report requests for assistance. The agency may also
19 provide the telephone number to each facility when it makes
20 the initial facility call.
21 Section 7. This act shall take effect July 1, 2005.
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1 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
2 CS/SB 2616
3
4 The committee substitute for committee substitute (CS) deletes
language requiring the Agency for Workforce Innovation to
5 provide certain registration information. It deletes language
that specified which agency would assume lead responsibility
6 for certain clients in the event of a disaster. Instead, it
designates the Department of Elderly Affairs as the lead
7 agency responsible for convening a multiagency emergency
special needs response team to assist local areas severely
8 impacted by a natural or manmade disaster. Other agencies are
required to assist the department in this effort. The CS also
9 provides for the reimbursement of health care facilities, such
as a nursing home, assisted living facility, or a community
10 residential group home, for caring for special needs shelter
clients that have been discharged from a special needs
11 shelter.
12 This CS requires a special needs shelter interagency
committee, if established by the Department of Health, to make
13 additional recommendations to the Legislature. It deletes
language requiring the Department of Health to establish a
14 statewide database for special needs registration information.
Finally, the CS requires the Agency for Health Care
15 Administration to make initial contact with nursing homes in a
disaster area and provide a schedule for the nursing homes to
16 contact the agency thereafter to report requests for
assistance.
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