Senate Bill sb2616c2

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    Florida Senate - 2005                    CS for CS for SB 2616

    By the Committees on Community Affairs; Domestic Security; and
    Senator Clary




    578-2284-05

  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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    Florida Senate - 2005                    CS for CS for SB 2616
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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

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    Florida Senate - 2005                    CS for CS for SB 2616
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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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    Florida Senate - 2005                    CS for CS for SB 2616
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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

31  

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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.

 9  

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.

31  

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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.

22  

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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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