Senate Bill sb1058c1

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    Florida Senate - 2006                           CS for SB 1058

    By the Committee on Domestic Security; and Senators Diaz de la
    Portilla and Wise




    583-1711-06

  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 - 2006                           CS for SB 1058
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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         providing that state employees with a

22         preestablished role in disaster response may be

23         called upon to serve in times of disaster in

24         specified capacities; requiring the Secretary

25         of Elderly Affairs to convene a multiagency

26         emergency special needs shelter response team

27         or teams to assist local areas that are

28         severely impacted by a natural or manmade

29         disaster that requires the use of special needs

30         shelters; providing duties and responsibilities

31         of multiagency response teams; authorizing

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    Florida Senate - 2006                           CS for SB 1058
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 1         local emergency management agencies to request

 2         the assistance of a multiagency response team;

 3         providing for the inclusion of specified state

 4         agency representatives on each multiagency

 5         response team; authorizing hospitals and

 6         nursing homes that are used to shelter special

 7         needs persons during or after an evacuation to

 8         submit invoices for reimbursement to the

 9         Department of Health; requiring the department

10         to specify by rule expenses that are

11         reimbursable and the rate of reimbursement for

12         services; prescribing means of and procedures

13         for reimbursement; providing eligibility for

14         reimbursement of health care facilities to

15         which special needs shelter clients have been

16         discharged by a multiagency response team upon

17         closure of a special needs shelter; providing

18         requirements with respect to such

19         reimbursement; prescribing means of and

20         procedures for reimbursement; disallowing

21         specified reimbursements; revising the role of

22         the special needs shelter interagency committee

23         with respect to the planning and operation of

24         special needs shelters; providing required

25         functions of the committee; providing that the

26         committee shall recommend guidelines to

27         establish a statewide database to collect and

28         disseminate special needs registration

29         information; revising the composition of the

30         special needs shelter interagency committee;

31         requiring the inclusion of specified rules with

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    Florida Senate - 2006                           CS for SB 1058
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 1         respect to special needs shelters and specified

 2         minimum standards therefor; providing

 3         requirements with respect to emergency

 4         management plans submitted by a home health

 5         agency, nurse registry, or hospice to a county

 6         health department for review; removing a

 7         condition of specified funding as a

 8         prerequisite to the submission of such plans;

 9         amending s. 252.385, F.S.; requiring the

10         Division of Emergency Management of the

11         Department of Community Affairs to prepare and

12         submit a statewide emergency shelter plan to

13         the Governor and the Cabinet for approval;

14         providing plan requirements; requiring the

15         Department of Health to assist the division in

16         determining the estimated need for special

17         needs shelter space; requiring inspection of

18         public hurricane evacuation shelter facilities

19         by local emergency management agencies prior to

20         activation of such facilities; amending s.

21         400.492, F.S.; providing that nurse registries,

22         hospices, and durable medical equipment

23         providers shall prepare and maintain a

24         comprehensive emergency management plan;

25         providing that home health, hospice, and

26         durable medical equipment provider agencies

27         shall not be required to continue to provide

28         care to patients in emergency situations that

29         are beyond their control and that make it

30         impossible to provide services; authorizing

31         home health agencies, nurse registries,

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    Florida Senate - 2006                           CS for SB 1058
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 1         hospices, and durable medical equipment

 2         providers to establish links to local emergency

 3         operations centers to determine a mechanism to

 4         approach areas within a disaster area in order

 5         for the agency to reach its clients; providing

 6         that the presentation of home care or hospice

 7         clients to the special needs shelter without

 8         the home health agency or hospice making a good

 9         faith effort to provide services in the shelter

10         setting constitutes abandonment of the client;

11         requiring regulatory review in such cases;

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

13         entities regulated or licensed by the Agency

14         for Health Care Administration may exceed their

15         licensed capacity to act as a receiving

16         facility under specified circumstances;

17         providing requirements while such entities are

18         in an overcapacity status; providing for

19         issuance of an inactive license to such

20         licensees under specified conditions; providing

21         requirements and procedures with respect to the

22         issuance and reactivation of an inactive

23         license; providing fees; creating s. 252.357,

24         F.S.; requiring the Florida Comprehensive

25         Emergency Management Plan to permit the Agency

26         for Health Care Administration to initially

27         contact nursing homes in disaster areas for

28         specified monitoring purposes; requiring the

29         agency to publish an emergency telephone number

30         for use by nursing homes; providing an

31         effective date.

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    Florida Senate - 2006                           CS for SB 1058
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 1  Be It Enacted by the Legislature of the State of Florida:

 2  

 3         Section 1.  Section 252.355, Florida Statutes, is

 4  amended to read:

 5         252.355  Registry of persons with special needs;

 6  notice.--

 7         (1)  In order to meet the special needs of clients

 8  persons who would need assistance during evacuations and

 9  sheltering because of physical, mental, cognitive impairment,

10  or sensory disabilities, each local emergency management

11  agency in the state shall maintain a registry of persons with

12  special needs located within the jurisdiction of the local

13  agency. The registration shall identify those persons in need

14  of assistance and plan for resource allocation to meet those

15  identified needs. To assist the local emergency management

16  agency in identifying such persons, the Department of Children

17  and Family Services, Department of Health, Agency for Health

18  Care Administration, Department of Education, Agency for

19  Persons with Disabilities, Department of Labor and Employment

20  Security, and Department of Elderly Affairs shall provide

21  registration information to all of their special needs clients

22  and to all people with disabilities or special needs who

23  receive services incoming clients as a part of the intake

24  process. The registry shall be updated annually. The

25  registration program shall give persons with special needs the

26  option of preauthorizing emergency response personnel to enter

27  their homes during search and rescue operations if necessary

28  to assure their safety and welfare following disasters.

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

30  designated lead agency responsible for community education and

31  outreach to the general public, including special needs

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    Florida Senate - 2006                           CS for SB 1058
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 1  clients, regarding registration and special needs shelters and

 2  general information regarding shelter stays. The Department of

 3  Community Affairs shall disseminate such educational and

 4  outreach information through the local emergency management

 5  offices. The department shall coordinate the development of

 6  curriculum and dissemination of all community education and

 7  outreach related to special needs shelters with the

 8  Clearinghouse on Disability Information of the Governor's

 9  Working Group on the Americans with Disabilities Act, the

10  Department of Children and Family Services, the Department of

11  Health, the Agency for Health Care Administration, the

12  Department of Education, the Agency for Persons with

13  Disabilities, and the Department of Elderly Affairs.

14         (3)(2)  On or before May 1 of each year each electric

15  utility in the state shall annually notify residential

16  customers in its service area of the availability of the

17  registration program available through their local emergency

18  management agency.

19         (4)(3)  All records, data, information, correspondence,

20  and communications relating to the registration of persons

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

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

23  except that such information shall be available to other

24  emergency response agencies, as determined by the local

25  emergency management director, and shall be provided to the

26  Department of Health in the furtherance of their duties and

27  responsibilities.

28         (5)(4)  All appropriate agencies and community-based

29  service providers, including home health care providers, and

30  hospices, shall assist emergency management agencies by

31  collecting registration information for persons with special

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    Florida Senate - 2006                           CS for SB 1058
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 1  needs as part of program intake processes, establishing

 2  programs to increase the awareness of the registration

 3  process, and educating clients about the procedures that may

 4  be necessary for their safety during disasters. Clients of

 5  state or federally funded service programs with physical,

 6  mental, cognitive impairment, or sensory disabilities who need

 7  assistance in evacuating, or when in shelters, must register

 8  as persons with special needs.

 9         Section 2.  Section 381.0303, Florida Statutes, is

10  amended to read:

11         381.0303  Health practitioner recruitment for Special

12  needs shelters.--

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

14  provide for the operation, maintenance, and closure of special

15  needs shelters and to designate the Department of Health,

16  through its county health departments, as the lead agency for

17  coordination of the recruitment of health care practitioners,

18  as defined in s. 456.001(4), to staff special needs shelters

19  in times of emergency or disaster and to provide resources to

20  the department to carry out this responsibility. However,

21  nothing in this section prohibits a county health department

22  from entering into an agreement with a local emergency

23  management agency to assume the lead responsibility for

24  recruiting health care practitioners.

25         (2)  SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE;

26  STATE AGENCY ASSISTANCE AND STAFFING.--Provided funds have

27  been appropriated to support medical services disaster

28  coordinator positions in county health departments,

29         (a)  The department shall assume lead responsibility

30  for the local coordination of local medical and health care

31  providers, the American Red Cross, and other interested

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    Florida Senate - 2006                           CS for SB 1058
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 1  parties in developing a plan for the staffing and medical

 2  management of special needs shelters. The local Children's

 3  Medical Services offices shall assume lead responsibility for

 4  the local coordination of local medical and health care

 5  providers, the American Red Cross, and other interested

 6  parties in developing a plan for the staffing and medical

 7  management of pediatric special needs shelters. Plans shall

 8  conform to The plan shall be in conformance with the local

 9  comprehensive emergency management plan.

10         (b)(a)  County health departments shall, in conjunction

11  with the local emergency management agencies, have the lead

12  responsibility for coordination of the recruitment of health

13  care practitioners to staff local special needs shelters.

14  County health departments shall assign their employees to work

15  in special needs shelters when those employees are needed to

16  protect the health and safety of special needs clients of

17  patients. County governments shall assist in this process.

18         (c)(b)  The appropriate county health department,

19  Children's Medical Services office, and local emergency

20  management agency shall jointly decide determine who has

21  responsibility for medical supervision in each a special needs

22  shelter and shall notify the department of their decision.

23         (d)(c)  Local emergency management agencies shall be

24  responsible for the designation and operation of special needs

25  shelters during times of emergency or disaster and the closure

26  of the facilities following an emergency or disaster. County

27  health departments shall assist the local emergency management

28  agency with regard to the management of medical services in

29  special needs shelters.

30         (e)  State employees having a preestablished role in

31  disaster response, unless they have other mandated response

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    Florida Senate - 2006                           CS for SB 1058
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 1  activities that preclude participation, may be called upon to

 2  serve in times of disaster commensurate with their knowledge,

 3  skills, and abilities and any needed activities related to the

 4  situation.

 5         (f)  The Secretary of Elderly Affairs, or his or her

 6  designee, shall convene, at any time that he or she deems

 7  appropriate and necessary, a multiagency emergency special

 8  needs shelter response team or teams to assist local areas

 9  that are severely impacted by a natural or manmade disaster

10  that requires the use of special needs shelters. Multiagency

11  response teams shall provide assistance to local emergency

12  management agencies with the continued operation or closure of

13  the shelters, as well as with the discharge of special needs

14  clients to alternate facilities if necessary. Local emergency

15  management agencies may request the assistance of a

16  multiagency response team by alerting statewide emergency

17  management officials of the necessity for additional

18  assistance in their area. The Secretary of Elderly Affairs is

19  encouraged to proactively work with other state agencies prior

20  to any natural disasters for which warnings are provided to

21  ensure that multiagency response teams are ready to assemble

22  and deploy rapidly upon a determination by state emergency

23  management officials that a disaster area requires additional

24  assistance. The Secretary of Elderly Affairs may call upon any

25  state agency or office to provide staff to assist a

26  multiagency response team or teams. Unless the secretary

27  determines that the nature of or circumstances surrounding the

28  disaster do not warrant participation from a particular

29  agency's staff, each multiagency response team shall include

30  at least one representative from each of the following state

31  agencies:

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    Florida Senate - 2006                           CS for SB 1058
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 1         1.  Department of Elderly Affairs.

 2         2.  Department of Health.

 3         3.  Department of Children and Family Services.

 4         4.  Department of Veterans' Affairs.

 5         5.  Department of Community Affairs.

 6         6.  Agency for Health Care Administration.

 7         7.  Agency for Persons with Disabilities.

 8         (3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND

 9  FACILITIES.--

10         (a)  The Department of Health shall upon request

11  reimburse, subject to the availability of funds for this

12  purpose, health care practitioners, as defined in s. 456.001,

13  provided the practitioner is not providing care to a patient

14  under an existing contract, and emergency medical technicians

15  and paramedics licensed under pursuant to chapter 401, for

16  medical care provided at the request of the department in

17  special needs shelters or at other locations during times of

18  emergency or a declared major disaster. Reimbursement for

19  health care practitioners, except for physicians licensed

20  under pursuant to chapter 458 or chapter 459, shall be based

21  on the average hourly rate that such practitioners were paid

22  according to the most recent survey of Florida hospitals

23  conducted by the Florida Hospital Association. Reimbursement

24  shall be requested on forms prepared by the Department of

25  Health and shall be paid as specified in paragraph (d).

26         (b)  Hospitals and nursing homes that are used to

27  shelter special needs clients during or after an evacuation

28  may submit invoices for reimbursement to the department. The

29  department shall develop a form for reimbursement and shall

30  specify by rule which expenses are reimbursable and the rate

31  of reimbursement for each service. Reimbursement for the

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    Florida Senate - 2006                           CS for SB 1058
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 1  services described in this paragraph shall be paid as

 2  specified in paragraph (d).

 3         (c)  If, upon closure of a special needs shelter, a

 4  multiagency response team determines that it is necessary to

 5  discharge special needs shelter clients to other health care

 6  facilities, such as nursing homes, assisted living facilities,

 7  and community residential group homes, the receiving

 8  facilities shall be eligible for reimbursement for services

 9  provided to the clients for up to 90 days. Any facility

10  eligible for reimbursement under this paragraph shall submit

11  invoices for reimbursement on forms developed by the

12  department. A facility must show proof of a written request

13  from a representative of an agency serving on the multiagency

14  response team that the client for whom the facility is seeking

15  reimbursement for services rendered was referred to that

16  facility from a special needs shelter. Reimbursement for the

17  services described in this paragraph shall be paid as

18  specified in paragraph (d).

19         (d)  If a Presidential Disaster Declaration has been

20  issued made, and the Federal Government makes funds available,

21  the department shall use those such funds for reimbursement of

22  eligible expenditures. In other situations, or if federal

23  funds do not fully compensate the department for

24  reimbursements permissible under reimbursement made pursuant

25  to this section, the department shall process a budget

26  amendment to obtain reimbursement from unobligated,

27  unappropriated moneys in the General Revenue Fund. The

28  department shall not provide reimbursement to facilities under

29  this subsection for services provided to a special needs

30  client if, during the period of time in which the services

31  were provided, the client was enrolled in another state-funded

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    Florida Senate - 2006                           CS for SB 1058
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 1  program, such as Medicaid or another similar program, which

 2  would otherwise pay for the same services. Travel expense and

 3  per diem costs shall be reimbursed pursuant to s. 112.061.

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

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

 6  when health care practitioners are needed to staff special

 7  needs shelters or to staff disaster medical assistance teams.

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

 9  Secretary Department of Health may establish a special needs

10  shelter interagency committee and serve as or appoint a

11  designee to serve as the committee's chair. The department

12  shall provide any necessary staff and resources to support the

13  committee in the performance of its duties, to be chaired and

14  staffed by the department. The committee shall resolve

15  problems related to special needs shelters not addressed in

16  the state comprehensive emergency medical plan and shall

17  consult on serve as an oversight committee to monitor the

18  planning and operation of special needs shelters.

19         (a)  The committee shall may:

20         1.  Develop and negotiate any necessary interagency

21  agreements.

22         2.  Undertake other such activities as the department

23  deems necessary to facilitate the implementation of this

24  section.

25         3.  Submit recommendations to the Legislature as

26  necessary. Such recommendations shall include, but not be

27  limited to, the following:

28         a.  Defining "special needs shelter."

29         b.  Defining "special needs client."

30         c.  Development of a uniform registration form for

31  special needs clients.

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    Florida Senate - 2006                           CS for SB 1058
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 1         d.  Improving public awareness regarding the

 2  registration process.

 3         e.  Improving overall communications with special needs

 4  clients both before and after a disaster.

 5         f.  Recommending the construction or designation of

 6  additional special needs shelters in underserved areas of the

 7  state and the necessity of upgrading, modifying, or

 8  retrofitting existing special needs shelters.

 9         g.  Recommending guidelines to establish a statewide

10  database designed to collect and disseminate timely and

11  appropriate special needs registration information.

12         (b)  The special needs shelter interagency committee

13  shall be composed of representatives of emergency management,

14  health, medical, and social services organizations. Membership

15  shall include, but shall not be limited to, representatives of

16  the Departments of Health, Community Affairs, Children and

17  Family Services, Elderly Affairs, Labor and Employment

18  Security, and Education; the Agency for Health Care

19  Administration; the Florida Medical Association; the Florida

20  Osteopathic Medical Association; Associated Home Health

21  Industries of Florida, Inc.; the Florida Nurses Association;

22  the Florida Health Care Association; the Florida Assisted

23  Living Affiliation Association; the Florida Hospital

24  Association; the Florida Statutory Teaching Hospital Council;

25  the Florida Association of Homes for the Aging; the Florida

26  Emergency Preparedness Association; the American Red Cross;

27  Florida Hospices and Palliative Care, Inc.; the Association of

28  Community Hospitals and Health Systems; the Florida

29  Association of Health Maintenance Organizations; the Florida

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

31  

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 1  Salvation Army; the Florida Association of Aging Services

 2  Providers; the Florida Renal Coalition; and the AARP.

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

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

 5  expense of the agencies or organizations they represent. The

 6  committee shall make every effort to use teleconference or

 7  video conference capabilities in order to ensure statewide

 8  input and participation.

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

10  rules necessary to implement this section. Rules shall may

11  include a definition of a special needs client patient,

12  specify physician reimbursement, and the designation of

13  designate which county health departments that will have

14  responsibility for the implementation of subsections (2) and

15  (3). Standards for special needs shelters adopted by rule

16  shall include minimum standards relating to:

17         (a)  Staffing levels for provision of services to

18  assist individuals with activities of daily living.

19         (b)  Provision of transportation services.

20         (c)  Compliance with applicable service animal laws.

21         (d)  Eligibility criteria that include individuals with

22  physical, cognitive, and psychiatric disabilities.

23         (e)  Provision of support and services for individuals

24  with physical, cognitive, and psychiatric disabilities,

25  including persons receiving dialysis.

26         (f)  Standardized applications that include specific

27  eligibility criteria and the services an individual with

28  special needs can expect to receive.

29         (g)  Procedures for addressing the needs of

30  unregistered individuals in need of shelter.

31  

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 1         (h)  Requirements that the special needs shelter

 2  location meets the Florida Accessibility Code for Building

 3  Construction. If the location fails to meet the standards, a

 4  plan must be provided describing how compliance will be

 5  achieved.

 6         (i)  Procedures for addressing the needs of families

 7  that are eligible for special needs shelter services. Specific

 8  procedures shall be developed to address the needs of families

 9  with multiple dependents where only one dependent is eligible

10  for the special needs shelter. Specific procedures shall be

11  developed to address the needs of adults with special needs

12  who are caregivers for individuals without special needs.

13         (j)  Standards for special needs shelters, including

14  staffing, onsite emergency power, transportation services,

15  supplies, including durable medical equipment, and any other

16  recommendations for minimum standards as determined by the

17  committee.

18         (7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY

19  OF CARE.--Each emergency management plan submitted to a county

20  health department by a home health agency pursuant to s.

21  400.497, by a nurse registry pursuant to s. 400.506, or by a

22  hospice pursuant to s. 400.610 shall specify the

23  organization's functional staffing plan for special needs

24  shelters to ensure continuity of care and services to its

25  clients during and after the disaster or emergency situation.

26  The submission of Emergency management plans to county health

27  departments by home health agencies pursuant to s.

28  400.497(8)(c) and (d) and by nurse registries pursuant to s.

29  400.506(16)(e) and by hospice programs pursuant to s.

30  400.610(1)(b) is conditional upon the receipt of an

31  appropriation by the department to establish medical services

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 1  disaster coordinator positions in county health departments

 2  unless the secretary of the department and a local county

 3  commission jointly determine to require such plans to be

 4  submitted based on a determination that there is a special

 5  need to protect public health in the local area during an

 6  emergency.

 7         Section 3.  Subsections (2) and (4) of section 252.385,

 8  Florida Statutes, are amended to read:

 9         252.385  Public shelter space.--

10         (2)(a)  The division shall administer a program to

11  survey existing schools, universities, community colleges, and

12  other state-owned, municipally owned, and county-owned public

13  buildings and any private facility that the owner, in writing,

14  agrees to provide for use as a public hurricane evacuation

15  shelter to identify those that are appropriately designed and

16  located to serve as such shelters. The owners of the

17  facilities must be given the opportunity to participate in the

18  surveys. The Board of Regents, district school boards,

19  community college boards of trustees, and the Department of

20  Education are responsible for coordinating and implementing

21  the survey of public schools, universities, and community

22  colleges with the division or the local emergency management

23  agency.

24         (b)  By January 31 of each even-numbered year, the

25  Division of Emergency Management of the Department of

26  Community Affairs shall prepare and submit a statewide

27  emergency shelter plan to the Governor and the Cabinet for

28  approval, subject to the requirements for approval provided in

29  s. 1013.37(2). The plan must also identify the general

30  location and square footage of special needs shelters, by

31  regional planning council region, during the next 5 years. The

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 1  Department of Health shall assist the division in determining

 2  the estimated need for special needs shelter space based on

 3  information from the special needs registration database and

 4  other factors.

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

 6  postsecondary education facilities, and other facilities owned

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

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

 9  public hurricane evacuation shelters shall be made available

10  at the request of the local emergency management agencies. The

11  local emergency management agency shall inspect a designated

12  facility to determine its readiness prior to activating such

13  facility for a specific hurricane or disaster. Such agencies

14  shall coordinate with the appropriate school board,

15  university, community college, or local governing board when

16  requesting the use of such facilities as public hurricane

17  evacuation shelters.

18         (b)  The Department of Management Services shall

19  incorporate provisions for the use of suitable leased public

20  facilities as public hurricane evacuation shelters into lease

21  agreements for state agencies. Suitable leased public

22  facilities include leased public facilities that are solely

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

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

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

26  net square footage of floor area must be determined by

27  subtracting from the gross square footage the square footage

28  of spaces such as mechanical and electrical rooms, storage

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

30  computer laboratories, shop or mechanical areas,

31  administrative offices, records vaults, and crawl spaces.

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 1         (c)  The Department of Management Services shall, in

 2  consultation with local and state emergency management

 3  agencies, assess Department of Management Services facilities

 4  to identify the extent to which each facility has public

 5  hurricane evacuation shelter space. The Department of

 6  Management Services shall submit proposed facility retrofit

 7  projects that incorporate hurricane protection enhancements to

 8  the department for assessment and inclusion in the annual

 9  report prepared in accordance with subsection (3).

10         Section 4.  Section 400.492, Florida Statutes, is

11  amended to read:

12         400.492  Provision of services during an

13  emergency.--Each home health agency, nurse registry, hospice,

14  or durable medical equipment provider shall prepare and

15  maintain a comprehensive emergency management plan that is

16  consistent with the standards adopted by national

17  accreditation organizations and consistent with the local

18  special needs plan. The plan shall be updated annually and

19  shall provide for continuing home health, nurse registry,

20  hospice, or durable medical equipment services during an

21  emergency that interrupts patient care or services in the

22  patient's home. The plan shall describe how the home health

23  agency, nurse registry, hospice, or durable medical equipment

24  provider establishes and maintains an effective response to

25  emergencies and disasters, including: notifying staff when

26  emergency response measures are initiated; providing for

27  communication between staff members, county health

28  departments, and local emergency management agencies,

29  including a backup system; identifying resources necessary to

30  continue essential care or services or referrals to other

31  

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    Florida Senate - 2006                           CS for SB 1058
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 1  organizations subject to written agreement; and prioritizing

 2  and contacting patients who need continued care or services.

 3         (1)  Each patient record for patients who are listed in

 4  the registry established pursuant to s. 252.355 shall include

 5  a description of how care or services will be continued in the

 6  event of an emergency or disaster. The home health agency

 7  shall discuss the emergency provisions with the patient and

 8  the patient's caregivers, including where and how the patient

 9  is to evacuate, procedures for notifying the home health

10  agency in the event that the patient evacuates to a location

11  other than the shelter identified in the patient record, and a

12  list of medications and equipment which must either accompany

13  the patient or will be needed by the patient in the event of

14  an evacuation.

15         (2)  Each home health agency shall maintain a current

16  prioritized list of patients who need continued services

17  during an emergency. The list shall indicate how services

18  shall be continued in the event of an emergency or disaster

19  for each patient and if the patient is to be transported to a

20  special needs shelter, and shall indicate if the patient is

21  receiving skilled nursing services and the patient's

22  medication and equipment needs. The list shall be furnished to

23  county health departments and to local emergency management

24  agencies, upon request.

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

26  equipment provider agencies shall not be required to continue

27  to provide care to patients in emergency situations that are

28  beyond their control and that make it impossible to provide

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

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

31  Home health agencies, nurse registries, hospices, and durable

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    Florida Senate - 2006                           CS for SB 1058
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 1  medical equipment providers may establish links to local

 2  emergency operations centers to determine a mechanism to

 3  approach areas within the disaster area in order for the

 4  agency to reach its clients. The presentation of home care or

 5  hospice clients to a special needs shelter without the home

 6  health agency or hospice making a good faith effort to provide

 7  services in the shelter setting will constitute abandonment of

 8  the client and will result in regulatory review.

 9         (4)  Notwithstanding the provisions of s. 400.464(2) or

10  any other provision of law to the contrary, a home health

11  agency may provide services in a special needs shelter located

12  in any county.

13         Section 5.  Section 408.831, Florida Statutes, is

14  amended to read:

15         408.831  Denial, suspension, or revocation of a

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

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

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

19  license, registration, or certificate of entities regulated or

20  licensed by it:

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

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

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

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

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

26  ownership interest equal to 5 percent or greater in that

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

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

29  or final order of the Centers for Medicare and Medicaid

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

31  plan is approved by the agency; or

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    Florida Senate - 2006                           CS for SB 1058
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 1         (b)  For failure to comply with any repayment plan.

 2         (2)  In reviewing any application requesting a change

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

 4  certificateholder, the transferor shall, prior to agency

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

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

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

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

 9  certificate to the transferee shall be delayed until repayment

10  or until arrangements for repayment are made.

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

12  licensed capacity to act as a receiving facility in accordance

13  with an emergency operations plan for clients of evacuating

14  providers from a geographic area where an evacuation order has

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

16  an overcapacity status, each provider must furnish or arrange

17  for appropriate care and services to all clients. Overcapacity

18  status in excess of 15 days shall require compliance with all

19  firesafety requirements or their equivalency as approved by

20  state and local authorities, whichever is applicable. In

21  addition, the agency shall approve requests for overcapacity

22  beyond 15 days, which approvals shall be based upon

23  satisfactory justification and need as provided by the

24  receiving and sending facility.

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

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

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

28  Governor of Florida if the provider:

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

30  that state of emergency.

31         (b)  Is currently licensed.

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    Florida Senate - 2006                           CS for SB 1058
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 1         (c)  Does not have a provisional license.

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

 3  is reasonably expected to resume services within 12 months.

 4  

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

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

 7  additional months upon demonstration to the agency of progress

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

 9  license or to extend the previously approved inactive period

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

11  written justification for the inactive license which states

12  the beginning and ending dates of inactivity and includes a

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

14  appropriate licensure fees. Upon agency approval, the licensee

15  shall notify clients of any necessary discharge or transfer as

16  required by authorizing statutes or applicable rules. The

17  beginning of the inactive licensure period shall be the date

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

19  shall become the licensee expiration date, and all licensure

20  fees must be current or paid in full and may be prorated.

21  Reactivation of an inactive license requires the prior

22  approval by the agency of a renewal application, including

23  payment of licensure fees and agency inspections indicating

24  compliance with all requirements of this part and applicable

25  rules and statutes.

26         (5)(3)  This section provides standards of enforcement

27  applicable to all entities licensed or regulated by the Agency

28  for Health Care Administration. This section controls over any

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

30  393, 394, 395, 400, 408, 468, 483, and 641 or rules adopted

31  pursuant to those chapters.

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 1         Section 6.  Section 252.357, Florida Statutes, is

 2  created to read:

 3         252.357  Monitoring of nursing homes during

 4  disaster.--The Florida Comprehensive Emergency Management Plan

 5  shall permit the Agency for Health Care Administration,

 6  working from the agency's offices or in the Emergency

 7  Operations Center, ESF-8, to make initial contact with each

 8  nursing home in the disaster area. The agency, by July 15,

 9  2005, and annually thereafter, shall publish on the Internet

10  an emergency telephone number that can be used by nursing

11  homes to contact the agency on a schedule established by the

12  agency to report requests for assistance. The agency may also

13  provide the telephone number to each facility when it makes

14  the initial facility call.

15         Section 7.  This act shall take effect July 1, 2006.

16  

17          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
18                         Senate Bill 1058

19                                 

20  The committee substitute exempts state employees with a
    pre-established disaster response role from serving in times
21  of disaster if they have other mandated response activities
    that preclude participation.
22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

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