| 1 | The Elder & Long-Term Care Committee recommends the following: |
| 2 |
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| 3 | Council/Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to hospices; amending s. 400.601, F.S.; |
| 7 | revising the definition of the term "hospice"; amending s. |
| 8 | 400.602, F.S.; requiring that a hospice state the year of |
| 9 | initial licensure in the state; prescribing the manner and |
| 10 | placement of such notification; requiring a hospice to |
| 11 | serve a specified area, provide certain services, and |
| 12 | employ staff and trained volunteers within a specified |
| 13 | time period; deleting provisions authorizing the transfer |
| 14 | of certain hospices and the acquisition of additional |
| 15 | licenses; amending s. 400.606, F.S.; requiring the Agency |
| 16 | for Health Care Administration to deny a license or |
| 17 | renewal of a license to hospices that fail to meet certain |
| 18 | conditions; amending s. 400.6105, F.S.; requiring a |
| 19 | hospice to use trained volunteers and to document and |
| 20 | report certain volunteer information; requiring the Office |
| 21 | of Program Policy Analysis and Government Accountability |
| 22 | to submit a report to the Legislature; providing |
| 23 | legislative intent; providing that the Department of |
| 24 | Elderly Affairs, in conjunction with the agency and all |
| 25 | hospices licensed in the state, develop certain outcome |
| 26 | measures; providing for adoption of national initiatives; |
| 27 | requiring an annual report; providing for severability; |
| 28 | providing an effective date. |
| 29 |
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| 30 | Be It Enacted by the Legislature of the State of Florida: |
| 31 |
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| 32 | Section 1. Subsection (3) of section 400.601, Florida |
| 33 | Statutes, is amended to read: |
| 34 | 400.601 Definitions.--As used in this part, the term: |
| 35 | (3) "Hospice" means a centrally administered corporation |
| 36 | not for profit, as defined in chapter 617, providing a continuum |
| 37 | of palliative and supportive care for the terminally ill patient |
| 38 | and his or her family. |
| 39 | Section 2. Section 400.602, Florida Statutes, is amended |
| 40 | to read: |
| 41 | 400.602 Licensure required; prohibited acts; exemptions; |
| 42 | display, transferability of license.-- |
| 43 | (1)(a) It is unlawful to operate or maintain a hospice |
| 44 | without first obtaining a license from the agency. |
| 45 | (b) It is unlawful for any person or legal entity not |
| 46 | licensed as a hospice under this part to use the word "hospice" |
| 47 | in its name, or to offer or advertise hospice services or |
| 48 | hospice-like services in such a way as to mislead a person to |
| 49 | believe that the offeror is a hospice licensed under this part. |
| 50 | (c) It is unlawful for any person or legal entity |
| 51 | offering, describing, or advertising hospice services or |
| 52 | hospice-like services or otherwise holding itself out as a |
| 53 | hospice to do so without stating the year of initial licensure |
| 54 | as a hospice in the state or the year of initial licensure of |
| 55 | the hospice entity or affiliate based in the state that owns the |
| 56 | hospice. At a minimum, the year of initial licensure shall be |
| 57 | stated directly beneath the name of the licensed entity in a |
| 58 | type no less than 25 percent of the size of the type used for |
| 59 | the name or other indication of hospice services or hospice-like |
| 60 | services and must be prominently stated at least one time on any |
| 61 | document, item, or other medium offering, describing, or |
| 62 | advertising hospice services or hospice-like services. |
| 63 | (2) Services provided by a hospital, nursing home, or |
| 64 | other health care facility, health care provider, or caregiver, |
| 65 | or under the Community Care for the Elderly Act, do not |
| 66 | constitute a hospice unless the facility, provider, or caregiver |
| 67 | establishes a separate and distinct administrative program to |
| 68 | provide home, residential, and homelike inpatient hospice |
| 69 | services. |
| 70 | (3)(a) A separately licensed hospice may not use a name |
| 71 | which is substantially the same as the name of another hospice |
| 72 | licensed under this part. |
| 73 | (b) A licensed hospice which intends to change its name or |
| 74 | address must notify the agency at least 60 days before making |
| 75 | the change. |
| 76 | (4) The license shall be displayed in a conspicuous place |
| 77 | inside the hospice program office; shall be valid only in the |
| 78 | possession of the person or public agency to which it is issued; |
| 79 | shall not be subject to sale, assignment, or other transfer, |
| 80 | voluntary or involuntary; and shall not be valid for any hospice |
| 81 | other than the hospice for which originally issued. |
| 82 | (5) A hospice must serve the entire service area for which |
| 83 | it is licensed. For any county or counties in the service area |
| 84 | with a population of 50,000 or less, the hospice must have a |
| 85 | plan for providing hospice care, meeting the needs for hospice |
| 86 | care, and reporting access and utilization of hospice care by |
| 87 | county residents; must locate an office in the county; and must |
| 88 | employ local hospice staff or trained volunteers within 6 months |
| 89 | after initial licensure. |
| 90 | (5) Notwithstanding s. 400.601(3), any hospice operating |
| 91 | in corporate form exclusively as a hospice, incorporated on or |
| 92 | before July 1, 1978, may be transferred to a for-profit or not- |
| 93 | for-profit entity, and may transfer the license to that entity. |
| 94 | (6) Notwithstanding s. 400.601(3), at any time after July |
| 95 | 1, 1995, any entity entitled to licensure under subsection (5) |
| 96 | may obtain a license for up to two additional hospices in |
| 97 | accordance with the other requirements of this part and upon |
| 98 | receipt of any certificate of need that may be required under |
| 99 | the provisions of ss. 408.031-408.045. |
| 100 | Section 3. Subsection (7) is added to section 400.606, |
| 101 | Florida Statutes, to read: |
| 102 | 400.606 License; application; renewal; conditional license |
| 103 | or permit; certificate of need.-- |
| 104 | (7) The agency shall deny a license or renewal of a |
| 105 | license to any hospice that fails to meet any commitment for the |
| 106 | provision of hospice care or services made in the application |
| 107 | for a certificate of need or any condition for the provision of |
| 108 | hospice care or services specified in the certificate of need, |
| 109 | unless the hospice can demonstrate that meeting a commitment or |
| 110 | condition is premature to the initial issuance of a license. |
| 111 | Section 4. Subsection (4) of section 400.6105, Florida |
| 112 | Statutes, is amended to read: |
| 113 | 400.6105 Staffing and personnel.-- |
| 114 | (4) A hospice must maintain a trained volunteer staff for |
| 115 | the purpose of providing both administrative support and direct |
| 116 | patient care. A hospice must use trained volunteers who work in |
| 117 | defined roles and under the supervision of a designated hospice |
| 118 | employee for an amount of time that equals at least 5 percent of |
| 119 | the total patient care hours provided by all paid hospice |
| 120 | employees and contract staff in the aggregate. The hospice shall |
| 121 | document and report the use of volunteers, including maintaining |
| 122 | a record of the number of volunteers, the number of hours worked |
| 123 | by each volunteer, and the tasks performed by each volunteer. |
| 124 | Section 5. No later than January 1, 2010, the Office of |
| 125 | Program Policy Analysis and Government Accountability shall |
| 126 | submit to the President of the Senate and the Speaker of the |
| 127 | House of Representatives a report analyzing the impact of for- |
| 128 | profit hospices on the delivery of care to terminally ill |
| 129 | patients and include in the report a review of the quality of |
| 130 | care offered by for-profit hospices, changes in the competitive |
| 131 | marketplace in hospice service areas, and any other information |
| 132 | deemed pertinent. |
| 133 | Section 6. In order to protect the citizens of the state, |
| 134 | it is the intent of the Legislature that no change in law or in |
| 135 | administrative rule be made to the hospice licensure and |
| 136 | certificate-of-need provisions until the year 2012 in order to |
| 137 | correctly analyze and evaluate the impact of this act on the |
| 138 | quality of hospice care in the state. |
| 139 | Section 7. (1) No later than December 31, 2007, the |
| 140 | Department of Elderly Affairs, in conjunction with the Agency |
| 141 | for Health Care Administration and all hospices licensed in the |
| 142 | state, shall develop outcome measures to determine the quality |
| 143 | and effectiveness of hospice care in the state. At a minimum, |
| 144 | these outcome measures shall include a requirement that 50 |
| 145 | percent of patients who report severe pain on a 0-to-10 scale |
| 146 | must report a reduction to 5 or less by the end of the 4th day |
| 147 | of care on the hospice program. |
| 148 | (2) The Department of Elderly Affairs, in conjunction with |
| 149 | the Agency for Health Care Administration and all hospices |
| 150 | licensed in the state, shall: |
| 151 | (a) Consider and adopt national initiatives, such as those |
| 152 | developed by the National Hospice and Palliative Care |
| 153 | Organization, to set benchmarks for measuring the quality of |
| 154 | hospice care provided in the state. |
| 155 | (b) Develop an annual report that analyzes and evaluates |
| 156 | the information collected under this act and any other data |
| 157 | collection or reporting provisions of law. |
| 158 | Section 8. If any provision of this act or its application |
| 159 | to any person or circumstance is held invalid, the invalidity |
| 160 | does not affect other provisions or applications of this act |
| 161 | which can be given effect without the invalid provision or |
| 162 | application, and to this end the provisions of this act are |
| 163 | severable. |
| 164 | Section 9. This act shall take effect July 1, 2006. |