Senate Bill sb1058c4

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    Florida Senate - 2006      CS for CS for CS for CS for SB 1058

    By the Committees on Transportation and Economic Development
    Appropriations; Health Care; Community Affairs; Domestic
    Security; and Senators Diaz de la Portilla and Wise



    606-2157-06

  1                      A bill to be entitled

  2         An act relating to emergency management;

  3         amending s. 252.355, F.S.; specifying

  4         additional entities and agencies that are

  5         required to provide registration information to

  6         persons with disabilities or special needs for

  7         purposes of inclusion within the registry of

  8         persons with special needs maintained by local

  9         emergency management agencies; providing that

10         the Department of Community Affairs shall be

11         the designated lead agency responsible for

12         community education and outreach to the general

13         public, including persons with special needs,

14         regarding registration as a person with special

15         needs, special needs shelters, and general

16         information regarding shelter stays; requiring

17         the department to disseminate educational and

18         outreach information through local emergency

19         management offices; requiring the department to

20         coordinate community education and outreach

21         related to special needs shelters with

22         specified agencies and entities; providing that

23         special needs shelters must allow persons with

24         special needs to bring service animals into

25         special needs shelters; revising provisions

26         with respect to the required notification of

27         residential utility customers of the

28         availability of the special needs registration

29         program; providing that specified confidential

30         and exempt information relating to registration

31         of persons with special needs be provided to

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 1         the Department of Health and local law

 2         enforcement agencies; creating s. 252.3568,

 3         F.S.; requiring the Division of Emergency

 4         Management to address evacuation of persons

 5         with pets in the shelter component of the state

 6         comprehensive emergency management plan;

 7         creating s. 252.357, F.S., requiring the

 8         Florida Comprehensive Emergency Management Plan

 9         to permit the Agency for Health Care

10         Administration to make initial contact with

11         each nursing home and assisted living facility

12         in a disaster area; requiring the agency to

13         annually publish an emergency telephone number

14         that may be used by nursing homes and assisted

15         living facilities to contact the agency;

16         amending s. 252.385, F.S., relating to public

17         shelter space; requiring the Division of

18         Emergency Management of the Department of

19         Community Affairs to biennially prepare and

20         submit a statewide emergency shelter plan to

21         the Governor and the Cabinet for approval;

22         providing plan requirements; requiring the

23         Department of Health to provide specified

24         assistance to the division; revising those

25         facilities which are excluded as being suitable

26         for use as public hurricane evacuation

27         shelters; requiring local emergency management

28         agencies to inspect a designated facility prior

29         to activation to determine its readiness;

30         amending s. 381.0303, F.S.; providing for the

31         operation, maintenance, and closure of special

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 1         needs shelters; providing that local Children's

 2         Medical Services offices shall assume lead

 3         responsibility for specified coordination with

 4         respect to the development of a plan for the

 5         staffing and medical management of pediatric

 6         special needs shelters; requiring such plans to

 7         conform to the local comprehensive emergency

 8         management plan; requiring county governments

 9         to assist the Department of Health with

10         nonmedical staffing and operation of special

11         needs shelters; requiring local health

12         departments and emergency management agencies

13         to coordinate such efforts to ensure

14         appropriate staffing; providing that the

15         appropriate county health department,

16         Children's Medical Services office, and local

17         emergency management agency shall jointly

18         determine the responsibility for medical

19         supervision in a special needs shelter;

20         providing notification requirements; requiring

21         local emergency management agencies to be

22         responsible for the infrastructure and closure

23         of special needs shelters; requiring the

24         emergency management agency and the local

25         health department to coordinate efforts to

26         ensure appropriate designation, operation, and

27         infrastructure in special needs shelters;

28         providing that a county health department is

29         not prohibited from entering into an

30         alternative agreement with a local emergency

31         management agency to assume the lead

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 1         responsibility for special needs shelter

 2         supplies and equipment; providing that state

 3         employees with a preestablished role in

 4         disaster response are subject to serve in times

 5         of disaster in specified capacities; requiring

 6         the Secretary of Elderly Affairs to convene

 7         multiagency special needs shelter discharge

 8         planning teams to assist local areas that are

 9         severely impacted by a natural or manmade

10         disaster that requires the use of special needs

11         shelters; providing duties and responsibilities

12         of such discharge planning teams; providing for

13         the inclusion of specified state agency

14         representatives on each discharge planning

15         team; revising provisions relating to

16         reimbursement of health care practitioners;

17         providing for eligibility of specified health

18         care facilities for reimbursement when a

19         multiagency special needs shelter discharge

20         planning team discharges persons with special

21         needs to such receiving facilities; providing

22         procedures and requirements with respect to

23         such reimbursement; requiring the department to

24         specify by rule expenses that are reimbursable

25         and the rate of reimbursement for services;

26         revising provisions which prescribe means of

27         and procedures for reimbursement; disallowing

28         specified reimbursements; revising provisions

29         with respect to the organization, role, duties,

30         and composition of the special needs shelter

31         interagency committee; requiring the department

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 1         to adopt specified rules with respect to

 2         special needs shelters; providing requirements

 3         with respect to emergency management plans

 4         submitted to a county health department by a

 5         home health agency, nurse registry, hospice, or

 6         home medical equipment provider; amending ss.

 7         400.492, 400.497, 400.506, 400.610, and

 8         400.934, F.S.; revising requirements with

 9         respect to the comprehensive emergency

10         management plans of home health agencies, nurse

11         registries, and hospices, and providing such

12         requirements with respect to home medical

13         equipment providers, to include the means by

14         which continuing services will be provided to

15         patients who evacuate to special needs

16         shelters; authorizing the establishment of

17         links to local emergency operations centers for

18         specified purposes; providing actions that

19         constitute abandonment of a patient; providing

20         sanctions for abandonment; revising

21         requirements of a county health department with

22         respect to review of a comprehensive emergency

23         management plan submitted by a home health

24         agency, nurse registry, or hospice, and

25         providing such requirements with respect to a

26         home medical equipment provider; providing

27         requirements upon failure to submit a plan or

28         requested information to the department;

29         providing for imposition of a fine; revising

30         requirements of the Department of Health with

31         respect to review of the plan of a home health

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 1         agency, nurse registry, or hospice that

 2         operates in more than one county, and providing

 3         such requirements with respect to a home

 4         medical equipment provider that operates in

 5         more than one county; providing that the

 6         preparation and maintenance of a comprehensive

 7         emergency management plan by a home medical

 8         equipment provider is a requirement for

 9         licensure and must meet minimum criteria

10         established by the Agency for Health Care

11         Administration; providing plan requirements;

12         providing that the plan is subject to review

13         and approval by the county health department;

14         requiring each home medical equipment provider

15         to maintain a current prioritized list of

16         patients who need continued services during an

17         emergency; amending s. 400.925, F.S.; defining

18         "life-supporting or life-sustaining equipment"

19         for purposes of pt. X of ch. 400, F.S.,

20         relating to home medical equipment providers;

21         amending s. 400.935, F.S.; requiring the Agency

22         for Health Care Administration to adopt rules

23         with respect to the comprehensive emergency

24         management plan prepared by a home medical

25         equipment services provider; amending s.

26         408.831, F.S.; providing that entities

27         regulated or licensed by the Agency for Health

28         Care Administration may exceed their licensed

29         capacity to act as a receiving facility under

30         specified circumstances; providing requirements

31         while such entities are in an overcapacity

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 1         status; providing for issuance of an inactive

 2         license to such licensees under specified

 3         conditions; providing requirements and

 4         procedures with respect to the issuance and

 5         reactivation of an inactive license; providing

 6         fees; providing an effective date.

 7  

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

 9  

10         Section 1.  Section 252.355, Florida Statutes, is

11  amended to read:

12         252.355  Registry of persons with special needs;

13  notice.--

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

15  would need assistance during evacuations and sheltering

16  because of physical, mental, cognitive impairment, or sensory

17  disabilities, each local emergency management agency in the

18  state shall maintain a registry of persons with special needs

19  located within the jurisdiction of the local agency. The

20  registration shall identify those persons in need of

21  assistance and plan for resource allocation to meet those

22  identified needs. To assist the local emergency management

23  agency in identifying such persons, home health agencies,

24  hospices, nurse registries, home medical equipment providers,

25  the Department of Children and Family Services, the Department

26  of Health, the Agency for Health Care Administration, the

27  Department of Education, the Agency for Persons with

28  Disabilities, Department of Labor and Employment Security, and

29  the Department of Elderly Affairs shall provide registration

30  information to all of their special needs clients and to all

31  people with disabilities or special needs who receive services

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 1  incoming clients as a part of the intake process. The registry

 2  shall be continuously maintained updated annually. The

 3  registration program shall give persons with special needs the

 4  option of preauthorizing emergency response personnel to enter

 5  their homes during search and rescue operations if necessary

 6  to assure their safety and welfare following disasters.

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

 8  designated lead agency responsible for community education and

 9  outreach to the general public, including special needs

10  clients, regarding registration and special needs shelters and

11  general information regarding shelter stays. The Department of

12  Community Affairs shall disseminate such educational and

13  outreach information through the local emergency management

14  offices. The department shall coordinate the development of

15  curriculum and dissemination of all community education and

16  outreach related to special needs shelters with the

17  Clearinghouse on Disability Information of the Governor's

18  Working Group on the Americans with Disabilities Act, the

19  Department of Children and Family Services, the Department of

20  Health, the Agency for Health Care Administration, the

21  Department of Education, the Agency for Persons with

22  Disabilities, and the Department of Elderly Affairs.

23         (3)  A person with special needs shall be allowed to

24  bring his or her service animal into a special needs shelter

25  in compliance with the Americans with Disabilities Act of

26  1990, Pub. L. No. 101-336. Because a special needs shelter is

27  considered a public facility when it is activated for a

28  disaster, persons with disabilities must be allowed access to

29  special needs shelters when accompanied by a service animal in

30  compliance with the Americans with Disabilities Act, which

31  provides that businesses and organizations that serve the

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 1  public must allow people with disabilities to bring their

 2  service animals into all areas of a facility where customers

 3  are normally allowed to go.

 4         (4)(2)  On or before May 1 of each year Each electric

 5  utility in the state shall annually notify residential

 6  customers in its service area of the availability of the

 7  registration program available through their local emergency

 8  management agency with either:.

 9         (a)  An initial notification upon the activation of new

10  residential service with the electric utility followed by one

11  annual notification between January 1 and May 31; or

12         (b)  Two separate annual notifications between January

13  1 and May 31.

14  

15  The notification required under this subsection may be made by

16  any available means, including, but not limited to, written,

17  electronic, or verbal notification, and may be made

18  concurrently with any other notification to residential

19  customers required by law or rule.

20         (5)(3)  All records, data, information, correspondence,

21  and communications relating to the registration of persons

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

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

24  except that such information shall be available to other

25  emergency response agencies, as determined by the local

26  emergency management director, and to the Department of Health

27  in the furtherance of its duties and responsibilities. Local

28  law enforcement agencies shall be provided complete shelter

29  registration information upon request.

30         (6)(4)  All appropriate agencies and community-based

31  service providers, including home health care providers,

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 1  hospices, nurse registries, and home medical equipment

 2  providers, shall assist emergency management agencies by

 3  collecting registration information for persons with special

 4  needs as part of program intake processes, establishing

 5  programs to increase the awareness of the registration

 6  process, and educating clients about the procedures that may

 7  be necessary for their safety during disasters. Clients of

 8  state or federally funded service programs with physical,

 9  mental, cognitive impairment, or sensory disabilities who need

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

11  as persons with special needs.

12         Section 2.  Section 252.3568, Florida Statutes, is

13  created to read:

14         252.3568  Emergency sheltering of persons with

15  pets.--In accordance with the provisions of s. 252.35, the

16  division shall address the evacuation of persons with pets in

17  the shelter component of the state comprehensive emergency

18  management plan. The Department of Agriculture and Consumer

19  Services shall assist the division in determining strategies

20  regarding this activity.

21         Section 3.  Section 252.357, Florida Statutes, is

22  created to read:

23         252.357  Monitoring of nursing homes and assisted

24  living facilities during disaster.--The Florida Comprehensive

25  Emergency Management Plan shall permit the Agency for Health

26  Care Administration, working from the agency's offices or in

27  the Emergency Operations Center, ESF-8, to make initial

28  contact with each nursing home and assisted living facility in

29  the disaster area. The agency, by July 15, 2006, and annually

30  thereafter, shall publish on the Internet an emergency

31  telephone number that may be used by nursing homes and

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 1  assisted living facilities to contact the agency on a schedule

 2  established by the agency to report requests for assistance.

 3  The agency may also provide the telephone number to each

 4  facility when it makes the initial facility call.

 5         Section 4.  Subsection (2) and paragraphs (a) and (b)

 6  of subsection (4) of section 252.385, Florida Statutes, are

 7  amended to read:

 8         252.385  Public shelter space.--

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

10  survey existing schools, universities, community colleges, and

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

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

13  agrees to provide for use as a public hurricane evacuation

14  shelter to identify those that are appropriately designed and

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

16  facilities must be given the opportunity to participate in the

17  surveys. The Board of Governors Regents, district school

18  boards, community college boards of trustees, and the

19  Department of Education are responsible for coordinating and

20  implementing the survey of public schools, universities, and

21  community colleges with the division or the local emergency

22  management agency.

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

24  division shall prepare and submit a statewide emergency

25  shelter plan to the Governor and the Cabinet for approval,

26  subject to the requirements for approval provided in s.

27  1013.37(2). The plan shall identify the general location and

28  square footage of special needs shelters, by regional planning

29  council region, during the next 5 years. The plan shall also

30  include information on the availability of shelters that

31  accept pets. The Department of Health shall assist the

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 1  division in determining the estimated need for special needs

 2  shelter space and the adequacy of facilities to meet the needs

 3  of persons with special needs based on information from the

 4  registries of persons with special needs and other

 5  information.

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

 7  postsecondary education facilities, and other facilities owned

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

 9  hospitals, hospice care facilities, assisted living

10  facilities, or nursing homes, which are suitable for use as

11  public hurricane evacuation shelters shall be made available

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

13  local emergency management agency shall inspect a designated

14  facility to determine its readiness prior to activating the

15  facility for a specific hurricane or disaster. Such agencies

16  shall coordinate with the appropriate school board,

17  university, community college, or local governing board when

18  requesting the use of such facilities as public hurricane

19  evacuation shelters.

20         (b)  The Department of Management Services shall

21  incorporate provisions for the use of suitable leased public

22  facilities as public hurricane evacuation shelters into lease

23  agreements for state agencies. Suitable leased public

24  facilities include leased public facilities that are solely

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

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

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

28  net square footage of floor area shall must be determined by

29  subtracting from the gross square footage the square footage

30  of spaces such as mechanical and electrical rooms, storage

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

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 1  computer laboratories, shop or mechanical areas,

 2  administrative offices, records vaults, and crawl spaces.

 3         Section 5.  Section 381.0303, Florida Statutes, is

 4  amended to read:

 5         381.0303  Health practitioner recruitment for Special

 6  needs shelters.--

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

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

 9  needs shelters and to designate the Department of Health,

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

11  coordination of the recruitment of health care practitioners,

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

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

14  the department to carry out this responsibility. However,

15  nothing in this section prohibits a county health department

16  from entering into an agreement with a local emergency

17  management agency to assume the lead responsibility for

18  recruiting health care practitioners.

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

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

21  been appropriated to support medical services disaster

22  coordinator positions in county health departments:,

23         (a)  The department shall assume lead responsibility

24  for the local coordination of local medical and health care

25  providers, the American Red Cross, and other interested

26  parties in developing a plan for the staffing and medical

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

28  Medical Services offices shall assume lead responsibility for

29  the coordination of local medical and health care providers,

30  the American Red Cross, and other interested parties in

31  developing a plan for the staffing and medical management of

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 1  pediatric special needs shelters. Plans shall conform to The

 2  plan shall be in conformance with the local comprehensive

 3  emergency management plan.

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

 5  with the local emergency management agencies, have the lead

 6  responsibility for coordination of the recruitment of health

 7  care practitioners to staff local special needs shelters.

 8  County health departments shall assign their employees to work

 9  in special needs shelters when those employees are needed to

10  protect the health and safety of persons with special needs of

11  patients. County governments shall assist the Department of

12  Health with nonmedical staffing and the operation of special

13  needs shelters. The local health department and emergency

14  management agency shall coordinate these efforts to ensure

15  appropriate staffing in special needs shelters.

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

17  Children's Medical Services office, and local emergency

18  management agency shall jointly decide determine who has

19  responsibility for medical supervision in each a special needs

20  shelter and shall notify the Division of Emergency Management

21  and the Department of Health of their decision.

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

23  responsible for the designation, and operation, and

24  infrastructure of special needs shelters during times of

25  emergency or disaster and the closure of the facilities

26  following an emergency or disaster. The emergency management

27  agency and the local health department shall coordinate these

28  efforts to ensure appropriate designation, operation, and

29  infrastructure in special needs shelters. County health

30  departments shall assist the local emergency management agency

31  with regard to the management of medical services in special

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 1  needs shelters. However, nothing in this section prohibits a

 2  county health department from entering into an alternative

 3  agreement with a local emergency management agency to assume

 4  the lead responsibility for special needs shelter supplies and

 5  equipment.

 6         (e)  Any state employee with a preestablished role in

 7  disaster response that has been designated by the employing

 8  agency is subject to serve in times of disaster in a capacity

 9  that is commensurate with the employee's knowledge, skills,

10  and abilities and to participate in any needed activities

11  related to the disaster unless the employee has other mandated

12  response activities that preclude participation.

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

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

15  appropriate and necessary, a multiagency special needs shelter

16  discharge planning team or teams to assist local areas that

17  are severely impacted by a natural or manmade disaster that

18  requires the use of special needs shelters. Multiagency

19  special needs shelter discharge planning teams shall provide

20  assistance to local emergency management agencies with the

21  continued operation or closure of the shelters, as well as

22  with the discharge of special needs clients to alternate

23  facilities if necessary. Local emergency management agencies

24  may request the assistance of a multiagency special needs

25  shelter discharge planning team by alerting statewide

26  emergency management officials of the necessity for additional

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

28  encouraged to proactively work with other state agencies prior

29  to any natural disasters for which warnings are provided to

30  ensure that multiagency special needs shelter discharge

31  planning teams are ready to assemble and deploy rapidly upon a

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 1  determination by state emergency management officials that a

 2  disaster area requires additional assistance. The Secretary of

 3  Elderly Affairs may call upon any state agency or office to

 4  provide staff to assist a multiagency special needs shelter

 5  discharge planning team or teams. Unless the secretary

 6  determines that the nature or circumstances surrounding the

 7  disaster do not warrant participation from a particular

 8  agency's staff, each multiagency special needs shelter

 9  discharge planning team shall include at least one

10  representative from each of the following state agencies:

11         1.  Department of Elderly Affairs.

12         2.  Department of Health.

13         3.  Department of Children and Family Services.

14         4.  Department of Veterans' Affairs.

15         5.  Department of Community Affairs.

16         6.  Agency for Health Care Administration.

17         7.  Agency for Persons with Disabilities.

18         (3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND

19  FACILITIES.--

20         (a)  The Department of Health shall upon request

21  reimburse, subject to the availability of funds for this

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

23  provided the practitioner is not providing care to a patient

24  under an existing contract, and emergency medical technicians

25  and paramedics licensed under pursuant to chapter 401 for

26  medical care provided at the request of the department in

27  special needs shelters or at other locations during times of

28  emergency or a declared major disaster. Reimbursement for

29  health care practitioners, except for physicians licensed

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

31  on the average hourly rate that such practitioners were paid

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 1  according to the most recent survey of Florida hospitals

 2  conducted by the Florida Hospital Association or other

 3  nationally or state recognized data source. Reimbursement

 4  shall be requested on forms prepared by the Department of

 5  Health and shall be paid as specified in paragraph (c).

 6         (b)  If, upon closure of a special needs shelter, a

 7  multiagency special needs shelter discharge planning team

 8  determines that it is necessary to discharge persons with

 9  special needs to other facilities, such as hospitals, nursing

10  homes, assisted living facilities, and community residential

11  homes, the receiving facilities shall be eligible for

12  reimbursement for services provided to the individuals for up

13  to 90 days. Any facility eligible for reimbursement under this

14  paragraph shall submit invoices for reimbursement on forms

15  developed by the department. A facility must show proof of a

16  written request from a representative of an agency serving on

17  the multiagency special needs shelter discharge planning team

18  that the individual for whom the facility is seeking

19  reimbursement for services rendered was referred to that

20  facility from a special needs shelter. The department shall

21  specify by rule which expenses are reimbursable and the rate

22  of reimbursement for each service. Reimbursement for the

23  services described in this paragraph shall be paid as

24  specified in paragraph (c).

25         (c)  If a Presidential Disaster Declaration has been

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

27  the department shall request federal use such funds for

28  reimbursement of eligible expenditures. In other situations,

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

30  reimbursements permissible under reimbursement made pursuant

31  to this section, the department shall process a budget

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 1  amendment to obtain reimbursement from unobligated,

 2  unappropriated moneys in the General Revenue Fund. The

 3  department shall not provide reimbursement to facilities under

 4  this subsection for services provided to a person with special

 5  needs if, during the period of time in which the services were

 6  provided, the individual was enrolled in another state-funded

 7  program, such as Medicaid or another similar program, was

 8  covered under a policy of health insurance as defined in s.

 9  624.603, or was a member of a health maintenance organization

10  or prepaid health clinic as defined in chapter 641, which

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

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

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

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

15  when health care practitioners are needed to staff special

16  needs shelters or to assist with other disaster-related

17  activities staff disaster medical assistance teams.

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

19  Secretary Department of Health may establish a special needs

20  shelter interagency committee and serve as or appoint a

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

22  shall provide any necessary staff and resources to support the

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

24  staffed by the department. The committee shall address and

25  resolve problems related to special needs shelters not

26  addressed in the state comprehensive emergency medical plan

27  and shall consult on serve as an oversight committee to

28  monitor the planning and operation of special needs shelters.

29         (a)  The committee shall may:

30         1.  Develop, and negotiate, and regularly review any

31  necessary interagency agreements.

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 1         2.  Undertake other such activities as the department

 2  deems necessary to facilitate the implementation of this

 3  section.

 4         3.  Submit recommendations to the Legislature as

 5  necessary.

 6         (b)  The special needs shelter interagency committee

 7  shall be composed of representatives of emergency management,

 8  health, medical, and social services organizations. Membership

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

10  the Departments of Health, Community Affairs, Children and

11  Family Services, Elderly Affairs, Labor and Employment

12  Security, and Education; the Agency for Health Care

13  Administration; the Florida Medical Association; the Florida

14  Osteopathic Medical Association; Associated Home Health

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

16  the Florida Health Care Association; the Florida Assisted

17  Living Affiliation Association; the Florida Hospital

18  Association; the Florida Statutory Teaching Hospital Council;

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

20  Emergency Preparedness Association; the American Red Cross;

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

22  Community Hospitals and Health Systems; the Florida

23  Association of Health Maintenance Organizations; the Florida

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

25  Salvation Army; the Florida Association of Aging Services

26  Providers; AARP; the Florida Area Health Education Center

27  Network; and the Florida Renal Coalition.

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

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

30  expense of the agencies or organizations they represent. The

31  committee shall make every effort to use teleconference or

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 1  video conference capabilities in order to ensure statewide

 2  input and participation.

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

 4  rules necessary to implement this section. Rules shall may

 5  include:

 6         (a)  The a definition of a "person with special needs,"

 7  including eligibility criteria for individuals with physical,

 8  mental, cognitive impairment, or sensory disabilities and the

 9  services a person with special needs can expect to receive in

10  a special needs shelter patient, specify physician

11  reimbursement, and designate which county health departments

12  will have responsibility for implementation of subsections (2)

13  and (3).

14         (b)  The process for special needs shelter health care

15  practitioners and facility reimbursement for services provided

16  in a disaster.

17         (c)  Guidelines for special needs shelter staffing

18  levels to provide services.

19         (d)  The definition of and standards for special needs

20  shelter supplies and equipment, including durable medical

21  equipment.

22         (e)  Compliance with applicable laws relating to

23  service animals.

24         (f)  Standards for the special needs shelter

25  registration process, including guidelines for addressing the

26  needs of unregistered persons in need of a special needs

27  shelter.

28         (g)  Standards for addressing the needs of families

29  where only one dependent is eligible for admission to a

30  special needs shelter and the needs of adults with special

31  

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 1  needs who are caregivers for individuals without special

 2  needs.

 3         (h)  The requirement of the county health departments

 4  to seek the participation of hospitals, nursing homes,

 5  assisted living facilities, home health agencies, hospice

 6  providers, nurse registries, home medical equipment providers,

 7  dialysis centers, and other health and medical emergency

 8  preparedness stakeholders in preevent planning activities.

 9         (7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY

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

11  health department by a home health agency under s. 400.492, by

12  a nurse registry pursuant to s. 400.506(16)(e), by a hospice

13  pursuant to s. 400.610(1)(b), or by a home medical equipment

14  provider pursuant to s. 400.934(20)(a) shall specify the means

15  by which the home health agency, nurse registry, hospice, or

16  home medical equipment provider will continue to provide staff

17  and equipment to perform the same type and quantity of

18  services for their patients who evacuate to special needs

19  shelters that were being provided to those patients prior to

20  evacuation. The submission of emergency management plans to

21  county health departments by home health agencies, pursuant to

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

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

24  400.610(1)(b) and home medical equipment providers is

25  conditional upon the receipt of an appropriation by the

26  department to establish medical services disaster coordinator

27  positions in county health departments unless the secretary of

28  the department and a local county commission jointly determine

29  to require such plans to be submitted based on a determination

30  that there is a special need to protect public health in the

31  local area during an emergency.

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 1         Section 6.  Section 400.492, Florida Statutes, is

 2  amended to read:

 3         400.492  Provision of services during an

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

 5  a comprehensive emergency management plan that is consistent

 6  with the standards adopted by national or state accreditation

 7  organizations and consistent with the local special needs

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

 9  continuing home health services during an emergency that

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

11  plan shall include the means by which the home health agency

12  will continue to provide staff to perform the same type and

13  quantity of services to their patients who evacuate to special

14  needs shelters that were being provided to those patients

15  prior to evacuation. The plan shall describe how the home

16  health agency establishes and maintains an effective response

17  to emergencies and disasters, including: notifying staff when

18  emergency response measures are initiated; providing for

19  communication between staff members, county health

20  departments, and local emergency management agencies,

21  including a backup system; identifying resources necessary to

22  continue essential care or services or referrals to other

23  organizations subject to written agreement; and prioritizing

24  and contacting patients who need continued care or services.

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

26  the registry established pursuant to s. 252.355 shall include

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

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

29  shall discuss the emergency provisions with the patient and

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

31  is to evacuate, procedures for notifying the home health

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

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

 3  list of medications and equipment which must either accompany

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

 5  an evacuation.

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

 7  prioritized list of patients who need continued services

 8  during an emergency. The list shall indicate how services

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

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

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

12  receiving skilled nursing services and the patient's

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

14  county health departments and to local emergency management

15  agencies, upon request.

16         (3)  Home health agencies shall not be required to

17  continue to provide care to patients in emergency situations

18  that are beyond their control and that make it impossible to

19  provide services, such as when roads are impassable or when

20  patients do not go to the location specified in their patient

21  records. Home health agencies may establish links to local

22  emergency operations centers to determine a mechanism to

23  approach specific areas within a disaster area in order for

24  the agency to reach its clients. The presentation of a home

25  health agency client to a special needs shelter without the

26  home health agency making a good faith effort to provide

27  services in the shelter setting shall be considered

28  abandonment of the client and constitutes a class II

29  deficiency, subject to sanctions provided in s. 400.484(2)(b).

30  For purposes of this section, "good faith effort" may be

31  demonstrated by documented attempts of staff to follow

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 1  procedures as outlined in the home health agency's

 2  comprehensive emergency management plan, and by the patient's

 3  record, which support a finding that continuing care has been

 4  provided for those patients who have been identified as

 5  needing care by the home health agency in the event of an

 6  emergency or disaster under subsection (1).

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

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

 9  agency may provide services in a special needs shelter located

10  in any county.

11         Section 7.  Paragraphs (c) and (d) of subsection (8) of

12  section 400.497, Florida Statutes, are amended to read:

13         400.497  Rules establishing minimum standards.--The

14  agency shall adopt, publish, and enforce rules to implement

15  this part, including, as applicable, ss. 400.506 and 400.509,

16  which must provide reasonable and fair minimum standards

17  relating to:

18         (8)  Preparation of a comprehensive emergency

19  management plan pursuant to s. 400.492.

20         (c)  The plan is subject to review and approval by the

21  county health department. During its review, the county health

22  department shall contact state and local health and medical

23  stakeholders during its review when necessary. ensure that the

24  following agencies, at a minimum, are given the opportunity to

25  review the plan:

26         1.  The local emergency management agency.

27         2.  The Agency for Health Care Administration.

28         3.  The local chapter of the American Red Cross or

29  other lead sheltering agency.

30         4.  The district office of the Department of Children

31  and Family Services.

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 1  

 2  The county health department shall complete its review to

 3  ensure that the plan is in accordance with the criteria set

 4  forth in the rules of the Agency for Health Care

 5  Administration within 90 60 days after receipt of the plan and

 6  shall either approve the plan or advise the home health agency

 7  of necessary revisions. If the home health agency fails to

 8  submit a plan or fails to submit the requested information or

 9  revisions to the county health department within 30 days after

10  written notification from the county health department, the

11  county health department shall notify the Agency for Health

12  Care Administration. The agency shall notify the home health

13  agency that such failure constitutes a deficiency, subject to

14  a fine of $5,000 per occurrence. If the plan is not submitted,

15  information is not provided, or revisions are not made as

16  requested, the agency may impose the fine.

17         (d)  For any home health agency that operates in more

18  than one county, the Department of Health shall review the

19  plan, after consulting with state and local health and medical

20  stakeholders, when necessary all of the county health

21  departments, the agency, and all the local chapters of the

22  American Red Cross or other lead sheltering agencies in the

23  areas of operation for that particular home health agency. The

24  department of Health shall complete its review within 90 days

25  after receipt of the plan and shall either approve the plan or

26  advise the home health agency of necessary revisions. The

27  department of Health shall make every effort to avoid imposing

28  differing requirements on a home health agency that operates

29  in more than one county as a result of differing or

30  conflicting comprehensive plan requirements of the based on

31  

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 1  differences between counties in which on the home health

 2  agency operates.

 3         Section 8.  Subsection (16) of section 400.506, Florida

 4  Statutes, is amended to read:

 5         400.506  Licensure of nurse registries; requirements;

 6  penalties.--

 7         (16)  Each nurse registry shall prepare and maintain a

 8  comprehensive emergency management plan that is consistent

 9  with the criteria in this subsection and with the local

10  special needs plan. The plan shall be updated annually. The

11  plan shall include the means by which the nurse registry will

12  continue to provide staff to perform the same type and

13  quantity of services to their patients who evacuate to special

14  needs shelters that were being provided to those patients

15  prior to evacuation. The plan shall specify how the nurse

16  registry shall facilitate the provision of continuous care by

17  persons referred for contract to persons who are registered

18  pursuant to s. 252.355 during an emergency that interrupts the

19  provision of care or services in private residencies. Nurse

20  registries may establish links to local emergency operations

21  centers to determine a mechanism to approach specific areas

22  within a disaster area in order for a provider to reach its

23  clients. The presentation of nurse registry clients to a

24  special needs shelter without the nurse registry provider

25  making a good faith effort to provide services in the shelter

26  setting shall be considered abandonment of the patient and

27  constitutes a class II deficiency, subject to sanctions

28  provided in s. 400.484(2)(b). For purposes of this section,

29  "good faith effort" may be demonstrated by documented attempts

30  of staff to follow procedures as outlined in the nurse

31  registry's comprehensive emergency management plan which

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 1  support a finding that continuing care has been provided for

 2  those patients who have been identified as needing care by the

 3  nurse registry in the event of an emergency under s.

 4  400.506(1).

 5         (a)  All persons referred for contract who care for

 6  persons registered pursuant to s. 252.355 must include in the

 7  patient record a description of how care will be continued

 8  during a disaster or emergency that interrupts the provision

 9  of care in the patient's home. It shall be the responsibility

10  of the person referred for contract to ensure that continuous

11  care is provided.

12         (b)  Each nurse registry shall maintain a current

13  prioritized list of patients in private residences who are

14  registered pursuant to s. 252.355 and are under the care of

15  persons referred for contract and who need continued services

16  during an emergency. This list shall indicate, for each

17  patient, if the client is to be transported to a special needs

18  shelter and if the patient is receiving skilled nursing

19  services. Nurse registries shall make this list available to

20  county health departments and to local emergency management

21  agencies upon request.

22         (c)  Each person referred for contract who is caring

23  for a patient who is registered pursuant to s. 252.355 shall

24  provide a list of the patient's medication and equipment needs

25  to the nurse registry. Each person referred for contract shall

26  make this information available to county health departments

27  and to local emergency management agencies upon request.

28         (d)  Each person referred for contract shall not be

29  required to continue to provide care to patients in emergency

30  situations that are beyond the person's control and that make

31  it impossible to provide services, such as when roads are

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 1  impassable or when patients do not go to the location

 2  specified in their patient records.

 3         (e)  The comprehensive emergency management plan

 4  required by this subsection is subject to review and approval

 5  by the county health department. During its review, the county

 6  health department shall contact state and local health and

 7  medical stakeholders, when necessary ensure that, at a

 8  minimum, the local emergency management agency, the Agency for

 9  Health Care Administration, and the local chapter of the

10  American Red Cross or other lead sheltering agency are given

11  the opportunity to review the plan. The county health

12  department shall complete its review to ensure that the plan

13  is in accordance with the criteria set forth in the rules of

14  the Agency for Health Care Administration within 90 60 days

15  after receipt of the plan and shall either approve the plan or

16  advise the nurse registry of necessary revisions. If a nurse

17  registry fails to submit a plan or fails to submit requested

18  information or revisions to the county health department

19  within 30 days after written notification from the county

20  health department, the county health department shall notify

21  the Agency for Health Care Administration. The agency shall

22  notify the nurse registry that such failure constitutes a

23  deficiency, subject to a fine of $5,000 per occurrence. If the

24  plan is not submitted, information is not provided, or

25  revisions are not made as requested, the agency may impose the

26  fine.

27         (f)  The Department of Health shall review the

28  comprehensive emergency management plan of any nurse registry

29  that operates in more than one county. The department shall

30  complete its review within 90 days after receipt of the plan

31  and shall either approve the plan or advise the nurse registry

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 1  of necessary revisions. The department shall make every effort

 2  to avoid imposing differing requirements on nurse registries

 3  that operate in more than one county as a result of differing

 4  or conflicting comprehensive plan requirements of the counties

 5  in which the nurse registry operates.

 6         (g)(f)  The Agency for Health Care Administration shall

 7  adopt rules establishing minimum criteria for the

 8  comprehensive emergency management plan and plan updates

 9  required by this subsection, with the concurrence of the

10  Department of Health and in consultation with the Department

11  of Community Affairs.

12         Section 9.  Paragraph (b) of subsection (1) of section

13  400.610, Florida Statutes, is amended to read:

14         400.610  Administration and management of a hospice.--

15         (1)  A hospice shall have a clearly defined organized

16  governing body, consisting of a minimum of seven persons who

17  are representative of the general population of the community

18  served. The governing body shall have autonomous authority and

19  responsibility for the operation of the hospice and shall meet

20  at least quarterly. The governing body shall:

21         (b)1.  Prepare and maintain a comprehensive emergency

22  management plan that provides for continuing hospice services

23  in the event of an emergency that is consistent with local

24  special needs plans. The plan shall include provisions for

25  ensuring continuing care to hospice patients who go to special

26  needs shelters. The plan shall include the means by which the

27  hospice provider will continue to provide staff to perform the

28  same type and quantity of services to their patients who

29  evacuate to special needs shelters that were being provided to

30  those patients prior to evacuation. The plan is subject to

31  review and approval by the county health department, except as

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 1  provided in subparagraph 2. During its review, the county

 2  health department shall contact state and local health and

 3  medical stakeholders, when necessary ensure that the

 4  department, the agency, and the local chapter of the American

 5  Red Cross or other lead sheltering agency have an opportunity

 6  to review and comment on the plan. The county health

 7  department shall complete its review to ensure that the plan

 8  is in accordance with the criteria set forth in the rules of

 9  the Department of Elderly Affairs within 90 60 days after

10  receipt of the plan and shall either approve the plan or

11  advise the hospice of necessary revisions. Hospice providers

12  may establish links to local emergency operations centers to

13  determine a mechanism to approach specific areas within a

14  disaster area in order for the provider to reach its clients.

15  The presentation of hospice clients to a special needs shelter

16  without the hospice provider making a good faith effort to

17  provide services in the shelter setting shall be considered

18  abandonment of the client subject to sanction as provided by

19  law or rule. For the purposes of this section, "good faith

20  effort" may be demonstrated by documented attempts of staff to

21  follow procedures as outlined in the hospice's comprehensive

22  emergency management plan and to provide continuing care for

23  those hospice clients who have been identified as needing

24  alternative caregiver services in the event of an emergency.

25         2.  For any hospice that operates in more than one

26  county, the Department of Health during its review shall

27  contact state and local health and medical stakeholders, when

28  necessary review the plan, after consulting with all of the

29  county health departments, the agency, and all the local

30  chapters of the American Red Cross or other lead sheltering

31  agency in the areas of operation for that particular hospice.

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 1  The Department of Health shall complete its review to ensure

 2  that the plan is in accordance with the criteria set forth in

 3  the rules of the Department of Elderly Affairs within 90 days

 4  after receipt of the plan and shall either approve the plan or

 5  advise the hospice of necessary revisions. The Department of

 6  Health shall make every effort to avoid imposing on the

 7  hospice differing requirements on a hospice that operates in

 8  more than one county as a result of differing or conflicting

 9  comprehensive plan requirements of the based on differences

10  between counties in which the hospice operates.

11         Section 10.  Subsections (13) through (16) of section

12  400.925, Florida Statutes, are renumbered as subsections (14)

13  through (17), respectively, and a new subsection (13) is added

14  to that section to read:

15         400.925  Definitions.--As used in this part, the term:

16         (13)  "Life-supporting or life-sustaining equipment"

17  means a device that is essential to, or that yields

18  information that is essential to, the restoration or

19  continuation of a bodily function important to the

20  continuation of human life. Life-supporting or life-sustaining

21  equipment includes apnea monitors, enteral feeding pumps,

22  infusion pumps, portable home dialysis equipment, and

23  ventilator equipment and supplies for all related equipment,

24  including oxygen equipment and related respiratory equipment.

25         Section 11.  Subsections (20), (21), and (22) are added

26  to section 400.934, Florida Statutes, to read:

27         400.934  Minimum standards.--As a requirement of

28  licensure, home medical equipment providers shall:

29         (20)(a)  Prepare and maintain a comprehensive emergency

30  management plan that meets minimum criteria established by the

31  agency in rule under s. 400.935. The plan shall be updated

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 1  annually and shall provide for continuing home medical

 2  equipment services for life-supporting or life-sustaining

 3  equipment, as defined in 400.925, during an emergency that

 4  interrupts home medical equipment services in a patient's

 5  home. The plan shall include:

 6         1.  The means by which the home medical equipment

 7  provider will continue to provide equipment to perform the

 8  same type and quantity of services to its patients who

 9  evacuate to special needs shelters that were being provided to

10  those patients prior to evacuation.

11         2.  The means by which the home medical equipment

12  provider establishes and maintains an effective response to

13  emergencies and disasters, including plans for:

14         a.  Notification of staff when emergency response

15  measures are initiated.

16         b.  Communication between staff members, county health

17  departments, and local emergency management agencies, which

18  shall include provisions for a backup communications system.

19         c.  Identification of resources necessary to continue

20  essential care or services or referrals to other organizations

21  subject to written agreement.

22         d.  Contacting and prioritizing patients in need of

23  continued medical equipment services and supplies.

24         (b)  The plan is subject to review and approval by the

25  county health department. During its review, the county health

26  department shall contact state and local health and medical

27  stakeholders, when necessary. The county health department

28  shall complete its review to ensure that the plan is in

29  accordance with the criteria set forth in the rules of the

30  Agency for Health Care Administration within 90 days after

31  receipt of the plan. If a home medical equipment provider

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 1  fails to submit a plan or fails to submit requested

 2  information or revisions to the county health department

 3  within 30 days after written notification from the county

 4  health department, the county health department shall notify

 5  the Agency for Health Care Administration. The agency shall

 6  notify the home medical equipment provider that such failure

 7  constitutes a deficiency, subject to a fine of $5,000 per

 8  occurrence. If the plan is not submitted, information is not

 9  provided, or revisions are not made as requested, the agency

10  may impose the fine.

11         (c)  The Department of Health shall review the

12  comprehensive emergency management plan of any home medical

13  equipment provider that operates in more than one county. The

14  department shall complete its review within 90 days after

15  receipt of the plan and shall either approve the plan or

16  advise the home medical equipment provider of necessary

17  revisions. The department shall make every effort to avoid

18  imposing differing requirements on home medical equipment

19  providers that operate in more than one county as a result of

20  differing or conflicting comprehensive plan requirements of

21  the counties in which the home medical equipment provider

22  operates.

23         (21)  Each home medical equipment provider shall

24  maintain a current prioritized list of patients who need

25  continued services during an emergency. The list shall

26  indicate the means by which services shall be continued for

27  each patient in the event of an emergency or disaster, whether

28  the patient is to be transported to a special needs shelter,

29  and whether the patient has life-supporting or life-sustaining

30  equipment, including the specific type of equipment and

31  related supplies. The list shall be furnished to county health

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 1  departments and local emergency management agencies, upon

 2  request.

 3         (22)  Home medical equipment providers may establish

 4  links to local emergency operations centers to determine a

 5  mechanism to approach specific areas within a disaster area in

 6  order for the provider to reach its patients.

 7         Section 12.  Subsection (11) is added to section

 8  400.935, Florida Statutes, to read:

 9         400.935  Rules establishing minimum standards.--The

10  agency shall adopt, publish, and enforce rules to implement

11  this part, which must provide reasonable and fair minimum

12  standards relating to:

13         (11)  Preparation of the comprehensive emergency

14  management plan under s. 400.934 and the establishment of

15  minimum criteria for the plan, including the maintenance of

16  patient equipment and supply lists that can accompany patients

17  who are transported from their homes. Such rules shall be

18  formulated in consultation with the Department of Health and

19  the Department of Community Affairs.

20         Section 13.  Section 408.831, Florida Statutes, is

21  amended to read:

22         408.831  Denial, suspension, or revocation of a

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

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

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

26  license, registration, or certificate of entities regulated or

27  licensed by it:

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

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

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

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

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

 2  ownership interest equal to 5 percent or greater in that

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

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

 5  or final order of the Centers for Medicare and Medicaid

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

 7  plan is approved by the agency; or

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

 9         (2)  In reviewing any application requesting a change

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

11  certificateholder, the transferor shall, prior to agency

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

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

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

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

16  certificate to the transferee shall be delayed until repayment

17  or until arrangements for repayment are made.

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

19  licensed capacity to act as a receiving facility in accordance

20  with an emergency operations plan for clients of evacuating

21  providers from a geographic area where an evacuation order has

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

23  an overcapacity status, each provider must furnish or arrange

24  for appropriate care and services to all clients. In addition,

25  the agency may approve requests for overcapacity beyond 15

26  days, which approvals may be based upon satisfactory

27  justification and need as provided by the receiving and

28  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 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 12

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 license 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 14.  This act shall take effect July 1, 2006.

 8  

 9          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
10                    CS/CS/CS Senate Bill 1058

11                                 

12  The committee substitute for Senate Bill 1058 revises s.
    252.357, F.S., to include assisted living facilities, in
13  addition to nursing homes, as facilities within a disaster
    area that will receive initial contact from the Agency for
14  Health Care Administration along with a process for requesting
    assistance.
15  

16  

17  

18  

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

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