Senate Bill sb2214c1

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    Florida Senate - 2006                           CS for SB 2214

    By the Committee on Children and Families; and Senator
    Saunders




    586-2311-06

  1                      A bill to be entitled

  2         An act relating to the licensure of health care

  3         providers; amending s. 383.335, F.S.; exempting

  4         certain facilities from a provision prohibiting

  5         a birth center from providing conduction

  6         anesthesia; requiring that the Agency for

  7         Health Care Administration review patient

  8         safety data for purposes of determining the

  9         viability of statewide application of the

10         exemption; creating parts I, II, III, and IV of

11         ch. 408, F.S.; amending s. 408.036, F.S.;

12         exempting a nursing home that is created by

13         combining certain licensed beds from

14         requirements for obtaining a certificate of

15         need from the Agency for Health Care

16         Administration; providing for future repeal;

17         creating s. 408.801, F.S.; designating part II

18         of ch. 408, F.S., consisting of ss.

19         408.801-408.820, F.S., as the "Health Care

20         Licensing Procedures Act"; providing

21         legislative findings and purpose; creating s.

22         408.802, F.S.; providing applicability;

23         creating s. 408.803, F.S.; providing

24         definitions; creating s. 408.804, F.S.;

25         requiring providers to have and display a

26         license from the Agency for Health Care

27         Administration; providing limitations; creating

28         s. 408.805, F.S.; establishing license fees;

29         providing a method for calculating annual

30         adjustment of fees; creating s. 408.806, F.S.;

31         providing a license application process;

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 1         requiring specified information to be included

 2         on the application; requiring payment of late

 3         fees under certain circumstances; requiring

 4         inspections; providing an exception;

 5         authorizing the Agency for Health Care

 6         Administration to establish procedures and

 7         rules for the electronic transmission of

 8         required information; creating s. 408.807,

 9         F.S.; providing procedures for a change of

10         ownership by a licensee; requiring the

11         transferor to notify the agency in writing

12         within a specified period; providing for duties

13         and liability of the transferor; providing for

14         maintenance of records; creating s. 408.808,

15         F.S.; providing license categories and

16         requirements therefor; creating s. 408.809,

17         F.S.; requiring background screening of

18         specified employees; providing for submission

19         of proof of compliance, under certain

20         circumstances; providing conditions for

21         granting provisional and standard licenses;

22         providing an exception to screening

23         requirements; creating s. 408.810, F.S.;

24         providing minimum licensure requirements;

25         providing procedures for discontinuance of

26         operation and surrender of a license; requiring

27         forwarding of client records; requiring

28         publication of a notice of discontinuance of

29         operation by a provider; providing penalties;

30         providing for statewide toll-free telephone

31         numbers for reporting complaints and abusive,

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 1         neglectful, or exploitative practices;

 2         requiring that a provider provide proof of a

 3         legal right to occupy property, proof of

 4         insurance, and proof of financial viability,

 5         under certain circumstances; requiring

 6         disclosure of information relating to financial

 7         instability; providing a penalty; prohibiting

 8         the agency from licensing a health care

 9         provider that does not have a certificate of

10         need or an exemption; creating s. 408.811,

11         F.S.; providing for inspections and

12         investigations by the agency to determine

13         compliance; providing that inspection reports

14         are public records; requiring retention of

15         records for a specified period; creating s.

16         408.812, F.S.; prohibiting certain unlicensed

17         activity by a provider; requiring unlicensed

18         providers to cease activity; providing

19         penalties; requiring the reporting of

20         unlicensed providers; creating s. 408.813,

21         F.S.; authorizing the agency to impose

22         administrative fines; creating s. 408.814,

23         F.S.; providing conditions for the agency to

24         impose a moratorium or emergency suspension

25         against a provider; requiring notice; creating

26         s. 408.815, F.S.; providing grounds for denial

27         or revocation of a license or

28         change-of-ownership application; providing

29         conditions for continuing operation; exempting

30         renewal applications from provisions requiring

31         the agency to approve or deny an application

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 1         within a specified period, under certain

 2         circumstances; creating s. 408.816, F.S.;

 3         authorizing the agency to institute injunction

 4         proceedings, under certain circumstances;

 5         creating s. 408.817, F.S.; providing a basis

 6         for review of administrative proceedings

 7         challenging licensure enforcement action by the

 8         agency; creating s. 408.818, F.S.; requiring

 9         fees and fines related to health care licensing

10         to be deposited into the Health Care Trust

11         Fund; creating s. 408.819, F.S.; authorizing

12         the agency to adopt rules; providing a

13         timeframe for compliance; creating s. 408.820,

14         F.S.; providing exemptions from specified

15         requirements of part II of ch. 408, F.S.;

16         amending s. 400.801, F.S.; providing that the

17         definition of the term "homes for special

18         services" applies to sites licensed by the

19         agency after a certain date; amending s.

20         400.9905, F.S.; providing that the term

21         "clinic" does not include certain employee

22         stock ownership plans for purposes of the

23         Health Care Clinic Act; revising the types of

24         entities providing oncology or radiation

25         therapy services which are included within the

26         definition of the word "entities" for purposes

27         of the Health Care Clinic Act; excluding

28         certain entities providing emergency department

29         staff or anesthesia services in facilities

30         licensed under ch. 395, F.S., from the

31         definition of "clinic"; amending s. 408.831,

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 1         F.S.; revising provisions relating to agency

 2         action to deny, suspend, or revoke a license,

 3         registration, certificate, or application;

 4         conforming cross-references; amending s.

 5         400.991, F.S.; prohibiting licensure of health

 6         care clinics when owned by specified entities

 7         licensed under the insurance code; providing

 8         for priority of application in case of

 9         conflict; authorizing the agency to adjust

10         annual licensure fees to provide biennial

11         licensure fees; requiring the Division of

12         Statutory Revision to assist in preparing

13         conforming legislation; authorizing the agency

14         to issue licenses for less than a specified

15         time period and providing conditions therefor;

16         providing an effective date.

17  

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

19  

20         Section 1.  Subsection (3) is added to section 383.335,

21  Florida Statutes, to read:

22         383.335  Partial exemptions.--

23         (3)  Any facility that is located in trauma district

24  17, owned and operated by a board-eligible obstetrician as of

25  June 15, 2006, and subject to licensure under ss.

26  383.30-383.335 is exempt from the prohibition against

27  providing conduction anesthesia contained in s. 383.313(3) for

28  3 years. The facility must be located within 1 mile of a

29  hospital that has a neonatal intensive care unit and must have

30  a written transfer agreement with such hospital. Within the

31  first 24 months of operation, the agency shall review the

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 1  safety and outcome data for patients served in order to

 2  determine the viability of statewide application of the

 3  exemption.

 4         Section 2.  Part I of chapter 408, Florida Statutes,

 5  consisting of sections 408.031, 408.032, 408.033, 408.034,

 6  408.035, 408.036, 408.0361, 408.037, 408.038, 408.039,

 7  408.040, 408.041, 408.042, 408.043, 408.044, 408.045,

 8  408.0455, 408.05, 408.061, 408.062, 408.063, 408.07, 408.08,

 9  408.09, 408.10, 408.15, 408.16, 408.18, 408.185, 408.20,

10  408.301, 408.302, 408.40, 408.50, 408.70, 408.7056, 408.7057,

11  and 408.7071, Florida Statutes, is created and entitled

12  "Health Facility and Services Planning."

13         Section 3.  Part II of chapter 408, Florida Statutes,

14  consisting of sections 408.801, 408.802, 408.803, 408.804,

15  408.805, 408.806, 408.807, 408.808, 408.809, 408.810, 408.811,

16  408.812, 408.813, 408.814, 408.815, 408.816, 408.817, 408.818,

17  408.819, 408.820, and 408.831, Florida Statutes, is created

18  and entitled "Health Care Licensing: General Provisions."

19         Section 4.  Part III of chapter 408, Florida Statutes,

20  consisting of sections 408.90, 408.901, 408.902, 408.903,

21  408.904, 408.905, 408.906, 408.907, 408.908, and 408.909,

22  Florida Statutes, is created and entitled "Health Insurance

23  Access."

24         Section 5.  Part IV of chapter 408, Florida Statutes,

25  consisting of sections 408.911, 408.913, 408.914, 408.915,

26  408.916, 408.917, and 408.918, Florida Statutes, is created

27  and entitled "Health and Human Services Eligibility Access

28  System."

29         Section 6.  Present paragraphs (f) through (s) of

30  subsection (3) of section 408.036, Florida Statutes, are

31  

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    Florida Senate - 2006                           CS for SB 2214
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 1  redesignated as paragraphs (g) through (t), respectively, and

 2  a new paragraph (f) is added to that subsection, to read:

 3         408.036  Projects subject to review; exemptions.--

 4         (3)  EXEMPTIONS.--Upon request, the following projects

 5  are subject to exemption from the provisions of subsection

 6  (1):

 7         (f)  For the creation of a single nursing home within a

 8  district by combining licensed beds from two or more licensed

 9  nursing homes within such district, regardless of subdistrict

10  boundaries, if 50 percent of the beds in the created nursing

11  home are transferred from the only nursing home in a county

12  and its utilization data demonstrate that it had an occupancy

13  rate of less than 75 percent for the 12-month period ending 90

14  days before the request for the exemption. This paragraph

15  shall be repealed upon the expiration of the moratorium

16  established in s. 651.1185(1).

17         Section 7.  Sections 408.801, 408.802, 408.803,

18  408.804, 408.805, 408.806, 408.807, 408.808, 408.809, 408.810,

19  408.811, 408.812, 408.813, 408.814, 408.815, 408.816, 408.817,

20  408.818, 408.819, and 408.820, Florida Statutes, are created

21  to read:

22         408.801  Short title; purpose.--

23         (1)  This part may be cited as the "Health Care

24  Licensing Procedures Act."

25         (2)  The Legislature finds that there is unnecessary

26  duplication and variation in the requirements for licensure by

27  the Agency for Health Care Administration. It is the intent of

28  the Legislature to provide a streamlined and consistent set of

29  basic licensing requirements for all such providers in order

30  to minimize confusion, standardize terminology, and include

31  

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 1  issues that are not otherwise adequately addressed in the

 2  Florida Statutes pertaining to specific providers.

 3         408.802  Applicability.--The provisions of this part

 4  apply to the provision of services that require licensure as

 5  defined in this part and to the following entities licensed,

 6  registered, or certified by the Agency for Health Care

 7  Administration, as described in chapters 112, 383, 390, 394,

 8  395, 400, 440, 483, and 765:

 9         (1)  Laboratories authorized to perform testing under

10  the Drug-Free Workplace Act, as provided under ss. 112.0455

11  and 440.102.

12         (2)  Birth centers, as provided under chapter 383.

13         (3)  Abortion clinics, as provided under chapter 390.

14         (4)  Crisis-stabilization units, as provided under

15  parts I and IV of chapter 394.

16         (5)  Short-term residential treatment facilities, as

17  provided under parts I and IV of chapter 394.

18         (6)  Residential treatment facilities, as provided

19  under part IV of chapter 394.

20         (7)  Residential treatment centers for children and

21  adolescents, as provided under part IV of chapter 394.

22         (8)  Hospitals, as provided under part I of chapter

23  395.

24         (9)  Ambulatory surgical centers, as provided under

25  part I of chapter 395.

26         (10)  Mobile surgical facilities, as provided under

27  part I of chapter 395.

28         (11)  Private review agents, as provided under part I

29  of chapter 395.

30         (12)  Health care risk managers, as provided under part

31  I of chapter 395.

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 1         (13)  Nursing homes, as provided under part II of

 2  chapter 400.

 3         (14)  Assisted living facilities, as provided under

 4  part III of chapter 400.

 5         (15)  Home health agencies, as provided under part IV

 6  of chapter 400.

 7         (16)  Nurse registries, as provided under part IV of

 8  chapter 400.

 9         (17)  Companion services or homemaker services

10  providers, as provided under part IV of chapter 400.

11         (18)  Adult day care centers, as provided under part V

12  of chapter 400.

13         (19)  Hospices, as provided under part VI of chapter

14  400.

15         (20)  Adult family-care homes, as provided under part

16  VII of chapter 400.

17         (21)  Homes for special services, as provided under

18  part VIII of chapter 400.

19         (22)  Transitional living facilities, as provided under

20  part VIII of chapter 400.

21         (23)  Prescribed pediatric extended care centers, as

22  provided under part IX of chapter 400.

23         (24)  Home medical equipment providers, as provided

24  under part X of chapter 400.

25         (25)  Intermediate care facilities for persons with

26  developmental disabilities, as provided under part XI of

27  chapter 400.

28         (26)  Health care services pools, as provided under

29  part XII of chapter 400.

30         (27)  Health care clinics, as provided under part XIII

31  of chapter 400.

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 1         (28)  Clinical laboratories, as provided under part I

 2  of chapter 483.

 3         (29)  Multiphasic health testing centers, as provided

 4  under part II of chapter 483.

 5         (30)  Organ and tissue procurement agencies, as

 6  provided under chapter 765.

 7         408.803  Definitions.--As used in this part, the term:

 8         (1)  "Agency" means the Agency for Health Care

 9  Administration, which is the licensing agency under this part.

10         (2)  "Applicant" means an individual, corporation,

11  partnership, firm, association, or governmental entity that

12  submits an application to the agency for a license.

13         (3)  "Authorizing statute" means the statute

14  authorizing the licensed operation of a provider listed in s.

15  408.802, including chapters 112, 383, 390, 394, 395, 400, 440,

16  483, and 765.

17         (4)  "Certification" means certification as a Medicare

18  or Medicaid provider of the services that require licensure or

19  certification pursuant to the federal Clinical Laboratory

20  Improvement Amendment (CLIA).

21         (5)  "Change of ownership" means an event in which the

22  licensee changes to a different legal entity or in which 45

23  percent or more of the ownership, voting shares, or

24  controlling interest in a corporation whose shares are not

25  publicly traded on a recognized stock exchange is transferred

26  or assigned, including the final transfer or assignment of

27  multiple transfers or assignments over a 2-year period which

28  cumulatively total 45 percent or greater. A change solely in

29  the management company or the board of directors is not a

30  change of ownership.

31  

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 1         (6)  "Client" means any person receiving services from

 2  a provider listed in s. 408.802.

 3         (7)  "Controlling interest" means:

 4         (a)  The applicant or licensee;

 5         (b)  A person or entity that serves as an officer of,

 6  is on the board of directors of, or has a 5 percent or greater

 7  ownership interest in the applicant or licensee; or

 8         (c)  A person or entity that serves as an officer of,

 9  is on the board of directors of, or has a 5 percent or greater

10  ownership interest in the management company or other entity,

11  related or unrelated, with which the applicant or licensee

12  contracts to manage the provider.

13  

14  The term does not include a voluntary board member.

15         (8)  "License" means any permit, registration,

16  certificate, or license issued by the agency.

17         (9)  "Licensee" means an individual, corporation,

18  partnership, firm, association, or governmental entity that is

19  issued a permit, registration, certificate, or license by the

20  agency. The licensee is legally responsible for all aspects of

21  the operations of the provider.

22         (10)  "Moratorium" means a prohibition on the

23  acceptance of new clients.

24         (11)  "Provider" means any activity, service, agency,

25  or facility regulated by the agency and listed in s. 408.802.

26         (12)  "Services that require licensure" means those

27  services, including residential services, that require a valid

28  license before those services may be provided in accordance

29  with authorizing statutes and agency rules.

30         (13)  "Voluntary board member" means a board member of

31  a not-for-profit corporation or organization who serves solely

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 1  in a voluntary capacity, does not receive any remuneration for

 2  his or her services on the board of directors, and has no

 3  financial interest in the corporation or organization. The

 4  agency shall recognize a person as a voluntary board member

 5  following submission of a statement to the agency by the board

 6  member and the not-for-profit corporation or organization that

 7  affirms that the board member conforms to this definition. The

 8  statement affirming the status of the board member must be

 9  submitted to the agency on a form provided by the agency.

10         408.804  License required; display.--

11         (1)  It is unlawful to provide services that require

12  licensure, or operate or maintain a provider that offers or

13  provides services that require licensure, without first

14  obtaining from the agency a license authorizing the provision

15  of such services or the operation or maintenance of such

16  provider.

17         (2)  A license must be displayed in a conspicuous place

18  readily visible to clients who enter at the address that

19  appears on the license and is valid only in the hands of the

20  licensee to whom it is issued and may not be sold, assigned,

21  or otherwise transferred, voluntarily or involuntarily. The

22  license is valid only for the licensee, provider, and location

23  for which the license is issued.

24         408.805  Fees required; adjustments.--Unless otherwise

25  limited by authorizing statutes, license fees must be

26  reasonably calculated by the agency to cover its costs in

27  carrying out its responsibilities under this part, authorizing

28  statutes, and applicable rules, including the cost of

29  licensure, inspection, and the regulation of providers.

30         (1)  Licensure fees shall be adjusted to provide for

31  biennial licensure under agency rules.

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 1         (2)  The agency shall annually adjust licensure fees,

 2  including fees paid per bed, by not more than the change in

 3  the Consumer Price Index based on the 12 months immediately

 4  preceding the increase.

 5         (3)  An inspection fee must be paid as required in

 6  authorizing statutes.

 7         (4)  Fees are nonrefundable.

 8         (5)  When a change is reported that requires issuance

 9  of a license, a fee may be assessed. The fee must be based on

10  the actual cost of processing and issuing the license.

11         (6)  A fee may be charged to a licensee requesting a

12  duplicate license. The fee may not exceed the actual cost of

13  duplication and postage.

14         (7)  Total fees collected may not exceed the cost of

15  administering this part, authorizing statutes, and applicable

16  rules.

17         408.806  License application process.--

18         (1)  An application for licensure must be made to the

19  agency on forms furnished by the agency, submitted under oath,

20  and accompanied by the appropriate fee in order to be accepted

21  and considered timely. The application must contain

22  information required by authorizing statutes and applicable

23  rules and must include:

24         (a)  The name, address, and social security number of

25  the applicant and each controlling interest if the applicant

26  or controlling interest is an individual.

27         (b)  The name, address, and federal employer

28  identification number or taxpayer identification number of the

29  applicant and each controlling interest if the applicant or

30  controlling interest is not an individual.

31         (c)  The name by which the provider is to be known.

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 1         (d)  The total number of beds or capacity requested, as

 2  applicable.

 3         (e)  The name of the person or persons under whose

 4  management or supervision the provider will be operated and

 5  the name of the administrator, if required.

 6         (f)  If the applicant offers continuing care agreements

 7  as defined in chapter 651, proof that the applicant has

 8  obtained a certificate of authority as required for operation

 9  under chapter 651.

10         (g)  Other information, including satisfactory

11  inspection results, which the agency finds necessary to

12  determine the ability of the applicant to carry out its

13  responsibilities under this part, authorizing statutes, and

14  applicable rules.

15         (2)(a)  The applicant for a renewal license must submit

16  an application that must be received by the agency at least 60

17  days before the expiration of the current license. If the

18  renewal application and fee are received before the license

19  expiration date, the license shall not be deemed to have

20  expired if the license expiration date occurs during the

21  agency's review of the renewal application.

22         (b)  The applicant for initial licensure due to a

23  change of ownership must submit an application that must be

24  received by the agency at least 60 days before the date of

25  change of ownership.

26         (c)  For any other application or request, the

27  applicant must submit an application or request that must be

28  received by the agency at least 60 days before the requested

29  effective date, unless otherwise specified in authorizing

30  statutes or rules.

31  

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 1         (d)  The agency shall notify the licensee by mail or

 2  electronically at least 90 days before the expiration of a

 3  license that a renewal license is necessary to continue

 4  operation. The failure to timely submit a renewal application

 5  and license fee shall result in a late fee of $50 per day

 6  charged to the licensee by the agency; however, the aggregate

 7  amount of the late fee may not exceed 50 percent of the

 8  licensure fee or $500, whichever is less. If a renewal

 9  application is received after the required filing date and

10  exhibits a hand-canceled postmark obtained from a United

11  States Post Office dated on or before the required filing

12  date, a fine may not be levied.

13         (3)(a)  Upon receipt of an application for a license,

14  the agency shall examine the application and, within 30 days

15  after receipt, notify the applicant in writing of any apparent

16  errors or omissions and request any additional information

17  required.

18         (b)  Requested information omitted from an application

19  for licensure, license renewal, or change of ownership, other

20  than an inspection, must be filed with the agency within 21

21  days after the agency's request for omitted information or the

22  application shall be deemed incomplete and shall be withdrawn

23  from further consideration and the fees shall be forfeited.

24         (c)  Within 60 days after the receipt of a complete

25  application, the agency shall approve or deny the application.

26         (4)(a)  Licensees subject to the provisions of this

27  part shall be issued biennial licenses unless conditions of

28  the license category specify a shorter license period.

29         (b)  Each license issued must indicate the name of the

30  licensee, the type of provider or service that the licensee is

31  required or authorized to operate or offer, the date the

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 1  license is effective, the expiration date of the license, the

 2  maximum capacity of the licensed premises, if applicable, and

 3  any other information required or deemed necessary by the

 4  agency.

 5         (5)  In accordance with authorizing statutes and

 6  applicable rules, proof of compliance with s. 408.810 must be

 7  submitted with an application for licensure.

 8         (6)  The agency may not issue an initial license to a

 9  health care provider subject to the certificate-of-need

10  provisions in part I of this chapter if the licensee has not

11  been issued a certificate of need or certificate-of-need

12  exemption, when applicable. Failure to apply for the renewal

13  of a license before the expiration date renders the license

14  void.

15         (7)(a)  An applicant must demonstrate compliance with

16  the requirements in this part, authorizing statutes, and

17  applicable rules during an inspection pursuant to s. 408.811,

18  as required by authorizing statutes.

19         (b)  An initial inspection is not required for

20  companion services or homemaker services providers, as

21  provided under part IV of chapter 400, or for health care

22  services pools, as provided under part XII of chapter 400.

23         (c)  If an inspection is required by the authorizing

24  statute for a license application other than an initial

25  application, the inspection must be unannounced. This

26  paragraph does not apply to inspections required pursuant to

27  ss. 383.324, 395.0161(4), and 483.061(2).

28         (d)  If a provider is not available when an inspection

29  is attempted, the application shall be denied.

30  

31  

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 1         (8)  The agency may establish procedures for the

 2  electronic notification and submission of required

 3  information, including, but not limited to:

 4         (a)  Licensure applications.

 5         (b)  Required signatures.

 6         (c)  Payment of fees.

 7         (d)  Notarization of applications.

 8  

 9  Requirements for electronic submission of any documents

10  required by this part or authorizing statutes may be

11  established by rule.

12         408.807  Change of ownership.--Whenever a change of

13  ownership occurs:

14         (1)  The transferor shall notify the agency in writing

15  at least 60 days before the anticipated date of the change of

16  ownership.

17         (2)  The transferee shall make application to the

18  agency for a license within the timeframes required in s.

19  408.806.

20         (3)  The transferor shall be responsible and liable

21  for:

22         (a)  The lawful operation of the provider and the

23  welfare of the clients served until the date the transferee is

24  licensed by the agency.

25         (b)  Any and all penalties imposed against the

26  transferor for violations occurring before the date of change

27  of ownership.

28         (4)  Any restriction on licensure, including a

29  conditional license existing at the time of a change of

30  ownership, shall remain in effect until the agency determines

31  that the grounds for the restriction are corrected.

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 1         (5)  The transferee shall maintain records of the

 2  transferor as required in this part, authorizing statutes, and

 3  applicable rules, including:

 4         (a)  All client records.

 5         (b)  Inspection reports.

 6         (c)  All records required to be maintained pursuant to

 7  s. 409.913, if applicable.

 8         408.808  License categories.--

 9         (1)  STANDARD LICENSE.--A standard license may be

10  issued to an applicant at the time of initial licensure,

11  license renewal, or change of ownership. A standard license

12  shall be issued when the applicant is in compliance with all

13  statutory requirements and agency rules. Unless sooner

14  revoked, a standard license expires 2 years after the date of

15  issue.

16         (2)  PROVISIONAL LICENSE.--A provisional license may be

17  issued to an applicant pursuant to s. 408.809(3). An applicant

18  against whom a proceeding denying or revoking a license is

19  pending at the time of license renewal may be issued a

20  provisional license that is effective until final action but

21  is not subject to further appeal.

22         (3)  INACTIVE LICENSE.--An inactive license may be

23  issued to a health care provider subject to the

24  certificate-of-need provisions in part I of this chapter when

25  the provider is currently licensed, does not have a

26  provisional license, and will be temporarily unable to provide

27  services but is reasonably expected to resume services within

28  12 months. Such designation may be made for a period not to

29  exceed 12 months, but may be renewed by the agency for up to

30  12 additional months upon demonstration by the licensee of the

31  provider's progress toward reopening. A request by a licensee

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 1  for an inactive license or to extend the previously approved

 2  inactive period must be submitted to the agency and must

 3  include a written justification for the inactive license with

 4  the beginning and ending dates of inactivity specified, a plan

 5  for the transfer of any clients to other providers, and the

 6  appropriate licensure fees. The agency may not accept a

 7  request that is submitted after initiating closure, after any

 8  suspension of service, or after notifying clients of closure

 9  or suspension of service unless the action is the result of a

10  disaster at the licensed premises. For the purposes of this

11  section, the term "disaster" means a sudden emergency

12  occurrence beyond the control of the licensee, whether

13  natural, technological, or manmade, which renders the provider

14  inoperable at the premises. Upon agency approval, the provider

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 license period is the date the

18  provider ceases operations. The end of the inactive license

19  period shall become the license-expiration date. All licensure

20  fees must be current, must be paid in full, and may be

21  prorated. Reactivation of an inactive license requires the

22  approval of a renewal application, including payment of

23  licensure fees and agency inspections indicating compliance

24  with all requirements of this part, authorizing statutes, and

25  applicable rules.

26         (4)  OTHER LICENSES.--Other types of license categories

27  may be issued pursuant to authorizing statutes or applicable

28  rules.

29         408.809  Background screening; prohibited offenses.--

30         (1)  Level 2 background screening pursuant to chapter

31  435 must be conducted through the agency for each of the

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 1  following persons, who shall be considered an employee for the

 2  purposes of conducting screening under chapter 435:

 3         (a)  The licensee, if an individual.

 4         (b)  The administrator or a similarly titled person who

 5  is responsible for the day-to-day operation of the provider.

 6         (c)  The financial officer or similarly titled

 7  individual who is responsible for the financial operation of

 8  the licensee or provider.

 9         (d)  Any person who is a controlling interest if the

10  agency has reason to believe that such person has been

11  convicted of any offense prohibited by s. 435.04. For each

12  controlling interest who has been convicted of any such

13  offense, the licensee shall submit to the agency a description

14  and explanation of the conviction at the time of license

15  application.

16         (2)  Proof of compliance with level 2 screening

17  standards submitted within the previous 5 years to meet any

18  provider or professional licensure requirements of the agency,

19  the Department of Health, the Agency for Persons with

20  Disabilities, or the Department of Children and Family

21  Services satisfies the requirements of this section, if such

22  proof is accompanied, under penalty of perjury, by an

23  affidavit of compliance with the provisions of chapter 435

24  using forms provided by the agency. Proof of compliance with

25  the background screening requirements of the Department of

26  Financial Services submitted within the previous 5 years for

27  an applicant for a certificate of authority to operate a

28  continuing care retirement community under chapter 651

29  satisfies the Department of Law Enforcement and Federal Bureau

30  of Investigation portions of a level 2 background check.

31  

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 1         (3)  A provisional license may be granted to an

 2  applicant when each individual required by this section to

 3  undergo background screening has met the standards for the

 4  Department of Law Enforcement background check but the agency

 5  has not yet received background screening results from the

 6  Federal Bureau of Investigation. A standard license may be

 7  granted to the licensee upon the agency's receipt of a report

 8  of the results of the Federal Bureau of Investigation

 9  background screening for each individual required by this

10  section to undergo background screening which confirms that

11  all standards have been met or upon the granting of an

12  exemption from disqualification by the agency as set forth in

13  chapter 435.

14         (4)  When a person is newly employed in a capacity that

15  requires screening under this section, the licensee must

16  notify the agency of the change within the time period

17  specified in the authorizing statute or rules and must submit

18  to the agency information necessary to conduct level 2

19  screening or provide evidence of compliance with background

20  screening requirements of this section. The person may serve

21  in his or her capacity pending the agency's receipt of the

22  report from the Federal Bureau of Investigation if he or she

23  has met the standards for the Department of Law Enforcement

24  background check. However, the person may not continue to

25  serve in his or her capacity if the report indicates any

26  violation of background screening standards unless an

27  exemption from disqualification has been granted by the agency

28  as set forth in chapter 435.

29         (5)  Background screening is not required in order to

30  obtain a certificate of exemption issued under s. 483.106.

31  

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 1         408.810  Minimum licensure requirements.--In addition

 2  to the licensure requirements specified in this part,

 3  authorizing statutes, and applicable rules, each applicant and

 4  licensee must comply with the requirements of this section in

 5  order to obtain and maintain a license.

 6         (1)  An applicant for licensure must comply with the

 7  background screening requirements of s. 408.809.

 8         (2)  An applicant for licensure must provide a

 9  description and explanation of any exclusions, suspensions, or

10  terminations of the applicant from the Medicare, Medicaid, or

11  federal Clinical Laboratory Improvement Amendment (CLIA)

12  programs.

13         (3)  Unless otherwise specified in this part,

14  authorizing statutes, or applicable rules, any information

15  required to be reported to the agency must be submitted within

16  21 calendar days after the report period or effective date of

17  the information.

18         (4)  Whenever a licensee discontinues operation of a

19  provider:

20         (a)  The licensee must inform the agency not less than

21  30 days before discontinuance of operation and inform clients

22  as required by authorizing statutes. Immediately upon

23  discontinuance of operation of a provider, the licensee shall

24  surrender the license to the agency and the license shall be

25  canceled.

26         (b)  The licensee shall remain responsible for

27  retaining and appropriately distributing all records within

28  the timeframes prescribed in authorizing statutes and

29  applicable rules. In addition, the licensee or, in the event

30  of death or dissolution of a licensee, the estate or agent of

31  the licensee shall:

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 1         1.  Make arrangements to forward records for each

 2  client to one of the following, based upon the client's

 3  choice: the client or the client's legal representative, the

 4  client's attending physician, or the health care provider

 5  where the client currently receives services; or

 6         2.  Cause a notice to be published in the newspaper of

 7  greatest general circulation in the county in which the

 8  provider was located which advises clients of the

 9  discontinuance of the provider operation. The notice must

10  inform clients that they may obtain copies of their records

11  and specify the name, address, and telephone number of the

12  person from whom the copies of records may be obtained. The

13  notice must appear at least once a week for 4 consecutive

14  weeks.

15         (5)(a)  On or before the first day services are

16  provided to a client, a licensee must inform the client and

17  his or her immediate family or representative, if appropriate,

18  of the right to report:

19         1.  Complaints. The statewide toll-free telephone

20  number for reporting complaints to the agency must be provided

21  to clients in a manner that is clearly legible and must

22  include the words: "To report a complaint regarding the

23  services you receive, please call toll-free (phone number)."

24         2.  Abusive, neglectful, or exploitative practices. The

25  statewide toll-free telephone number for the central abuse

26  hotline must be provided to clients in a manner that is

27  clearly legible and must include the words: "To report abuse,

28  neglect, or exploitation, please call toll-free (phone

29  number)." The agency shall publish a minimum of a 90-day

30  advance notice of a change in the toll-free telephone numbers.

31  

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 1         (b)  Each licensee shall establish appropriate policies

 2  and procedures for providing such notice to clients.

 3         (6)  An applicant must provide the agency with proof of

 4  the applicant's legal right to occupy the property before a

 5  license may be issued. Proof may include, but need not be

 6  limited to, copies of warranty deeds, lease or rental

 7  agreements, contracts for deeds, quitclaim deeds, or other

 8  such documentation.

 9         (7)  If proof of insurance is required by the

10  authorizing statute, that insurance must be in compliance with

11  chapter 624, chapter 626, chapter 627, or chapter 628 and with

12  agency rules.

13         (8)  Upon application for initial licensure or

14  change-of-ownership licensure, the applicant shall furnish

15  satisfactory proof of the applicant's financial ability to

16  operate in accordance with the requirements of this part,

17  authorizing statutes, and applicable rules. The agency shall

18  establish standards for this purpose, including information

19  concerning the applicant's controlling interests. The agency

20  shall also establish documentation requirements, to be

21  completed by each applicant, which show anticipated provider

22  revenues and expenditures, the basis for financing, the

23  anticipated cash-flow requirements of the provider, and the

24  applicant's access to contingency financing. A current

25  certificate of authority, pursuant to chapter 651, may be

26  provided as proof of financial ability to operate. The agency

27  may require a licensee to provide proof of financial ability

28  to operate at any time if there is evidence of financial

29  instability, including, but not limited to, unpaid expenses

30  necessary for the basic operations of the provider.

31  

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 1         (9)  A controlling interest may not withhold from the

 2  agency any evidence of financial instability, including, but

 3  not limited to, checks returned due to insufficient funds,

 4  delinquent accounts, nonpayment of withholding taxes, unpaid

 5  utility expenses, nonpayment for essential services, or

 6  adverse court action concerning the financial viability of the

 7  provider or any other provider licensed under this part which

 8  is under the control of the controlling interest. Any person

 9  who violates this subsection commits a misdemeanor of the

10  second degree, punishable as provided in s. 775.082 or s.

11  775.083. Each day of continuing violation is a separate

12  offense.

13         (10)  The agency may not issue a license to a health

14  care provider subject to the certificate-of-need provisions in

15  part I of this chapter if the health care provider has not

16  been issued a certificate of need or an exemption. Upon

17  initial licensure of any such provider, the authorization

18  contained in the certificate of need shall be considered fully

19  implemented and merged into the license and shall have no

20  force and effect upon termination of the license for any

21  reason.

22         408.811  Right of inspection; copies; inspection

23  reports.--

24         (1)  An authorized officer or employee of the agency

25  may make or cause to be made any inspection or investigation

26  deemed necessary by the agency to determine the state of

27  compliance with this part, authorizing statutes, and

28  applicable rules. The right of inspection extends to any

29  business that the agency has reason to believe is being

30  operated as a provider without a license, but inspection of

31  any business suspected of being operated without the

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 1  appropriate license may not be made without the permission of

 2  the owner or person in charge unless a warrant is first

 3  obtained from a circuit court. Any application for a license

 4  issued under this part, authorizing statutes, or applicable

 5  rules constitutes permission for an appropriate inspection to

 6  verify the information submitted on or in connection with the

 7  application.

 8         (a)  All inspections shall be unannounced, except as

 9  specified in s. 408.806.

10         (b)  Inspections for relicensure shall be conducted

11  biennially unless otherwise specified by authorizing statutes

12  or applicable rules.

13         (2)  Inspections conducted in conjunction with

14  certification may be accepted in lieu of a complete licensure

15  inspection. However, a licensure inspection may also be

16  conducted to review any licensure requirements that are not

17  also requirements for certification.

18         (3)  The agency shall have access to and the licensee

19  shall provide copies of all provider records required during

20  an inspection at no cost to the agency.

21         (4)(a)  Each licensee shall maintain as public

22  information, available upon request, records of all inspection

23  reports pertaining to that provider which have been filed by

24  the agency unless those reports are exempt from or contain

25  information that is exempt from s. 119.07(1) and s. 24(a),

26  Art. I of the State Constitution or otherwise made

27  confidential by law. Effective October 1, 2006, copies of such

28  reports shall be retained in the records of the provider for

29  at least 3 years following the date the reports are filed and

30  issued, regardless of a change of ownership.

31  

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 1         (b)  A licensee shall, upon the request of any person

 2  who has completed a written application with intent to be

 3  admitted by such provider, any person who is a client of such

 4  provider, or any relative, spouse, or guardian of any such

 5  person, furnish to the requester a copy of the last inspection

 6  report pertaining to the licensed provider which was issued by

 7  the agency or by an accrediting organization if such report is

 8  used in lieu of a licensure inspection.

 9         408.812  Unlicensed activity.--

10         (1)  A person or entity may not offer or advertise

11  services that require licensure as defined by this part,

12  authorizing statutes, or applicable rules to the public

13  without obtaining a valid license from the agency. A

14  licenseholder may not advertise or hold out to the public that

15  he or she holds a license for other than that for which he or

16  she actually holds the license.

17         (2)  The operation or maintenance of an unlicensed

18  provider or the performance of any services that require

19  licensure without proper licensure is a violation of this part

20  and authorizing statutes. Unlicensed activity constitutes harm

21  that materially affects the health, safety, and welfare of

22  clients. The agency or any state attorney may, in addition to

23  other remedies provided in this part, bring an action for an

24  injunction to restrain such violation or to enjoin the future

25  operation or maintenance of the unlicensed provider or the

26  performance of any services in violation of this part and

27  authorizing statutes, until compliance with this part,

28  authorizing statutes, and agency rules has been demonstrated

29  to the satisfaction of the agency.

30         (3)  It is unlawful for any person or entity to own,

31  operate, or maintain an unlicensed provider. If, after

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 1  receiving notification from the agency, such person or entity

 2  fails to cease operation and apply for a license under this

 3  part and authorizing statutes, that person or entity is

 4  subject to penalties as prescribed by authorizing statutes and

 5  applicable rules. Each day of continued operation is a

 6  separate offense.

 7         (4)  Any person or entity that fails to cease operation

 8  after agency notification may be fined $1,000 for each day of

 9  noncompliance.

10         (5)  When a controlling interest or licensee has an

11  interest in more than one provider and fails to license a

12  provider rendering services that require licensure, the agency

13  may revoke all licenses, impose actions under s. 408.814 and a

14  fine of $1,000 per day, unless otherwise specified by

15  authorizing statutes, against each licensee until such time as

16  the appropriate license is obtained for the unlicensed

17  operation.

18         (6)  In addition to granting injunctive relief pursuant

19  to subsection (2), if the agency determines that a person or

20  entity is operating or maintaining a provider without

21  obtaining a license and determines that a condition exists

22  that poses a threat to the health, safety, or welfare of a

23  client of the provider, the person or entity is subject to the

24  same actions and fines imposed against a licensee as specified

25  in this part, authorizing statutes, and agency rules.

26         (7)  Any person who is aware of the operation of an

27  unlicensed provider must report that provider to the agency.

28         408.813  Administrative fines.--As a penalty for any

29  violation of this part, authorizing statutes, or applicable

30  rules, the agency may impose an administrative fine. Unless

31  the amount or aggregate limitation of the fine is prescribed

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 1  by authorizing statutes or applicable rules, the agency may

 2  establish criteria by rule for the amount or aggregate

 3  limitation of administrative fines applicable to this part,

 4  authorizing statutes, and applicable rules. Each day of

 5  violation constitutes a separate violation and is subject to a

 6  separate fine. For fines that are imposed by final order of

 7  the agency and that are not subject to further appeal, the

 8  violator shall pay the fine plus interest at the rate

 9  specified in s. 55.03 for each day beyond the date set by the

10  agency for payment of the fine.

11         408.814  Moratoriums; emergency suspensions.--

12         (1)  The agency may impose an immediate moratorium or

13  emergency suspension as defined in s. 120.60 on any provider

14  if the agency determines that any condition related to the

15  provider or licensee presents a threat to the health, safety,

16  or welfare of a client.

17         (2)  A provider or licensee, the license of which is

18  denied or revoked, may be subject to immediate imposition of a

19  moratorium or emergency suspension to run concurrently with

20  licensure denial, revocation, or injunction.

21         (3)  A moratorium or emergency suspension remains in

22  effect after a change of ownership, unless the agency has

23  determined that the conditions that created the moratorium,

24  emergency suspension, or denial of licensure have been

25  corrected.

26         (4)  When a moratorium or emergency suspension is

27  placed on a provider or licensee, notice of the action shall

28  be posted and visible to the public at the location of the

29  provider until the action is lifted.

30         408.815  License or application denial; revocation.--

31  

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 1         (1)  In addition to the grounds provided in authorizing

 2  statutes, grounds that may be used by the agency for denying

 3  and revoking a license or change-of-ownership application

 4  include any of the following actions by a controlling

 5  interest:

 6         (a)  False representation of a material fact in the

 7  license application or omission of any material fact from the

 8  application.

 9         (b)  An intentional or negligent act materially

10  affecting the health or safety of a client of the provider.

11         (c)  A violation of this part, authorizing statutes, or

12  applicable rules.

13         (d)  A demonstrated pattern of deficient performance.

14         (e)  The applicant, licensee, or controlling interest

15  has been or is currently excluded, suspended, terminated from

16  participation in the state Medicaid program, the Medicaid

17  program of any other state, or the Medicare program.

18         (2)  If a licensee lawfully continues to operate while

19  a denial or revocation is pending in litigation, the licensee

20  must continue to meet all other requirements of this part,

21  authorizing statutes, and applicable rules and must file

22  subsequent renewal applications for licensure and pay all

23  licensure fees. The provisions of ss. 120.60(1) and

24  408.806(3)(c) do not apply to renewal applications filed

25  during the time period in which the litigation of the denial

26  or revocation is pending until that litigation is final.

27         (3)  An action under s. 408.814 or denial of the

28  license of the transferor may be grounds for denial of a

29  change-of-ownership application of the transferee.

30         408.816  Injunctions.--

31  

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 1         (1)  In addition to the other powers provided by this

 2  part, authorizing statutes, and applicable rules, the agency

 3  may institute injunction proceedings in a court of competent

 4  jurisdiction to:

 5         (a)  Restrain or prevent the establishment or operation

 6  of a provider that does not have a license or is in violation

 7  of any provision of this part, authorizing statutes, or

 8  applicable rules. The agency may also institute injunction

 9  proceedings in a court of competent jurisdiction when a

10  violation of this part, authorizing statutes, or applicable

11  rules constitutes an emergency affecting the immediate health

12  and safety of a client.

13         (b)  Enforce the provisions of this part, authorizing

14  statutes, or any minimum standard, rule, or order issued or

15  entered into pursuant thereto when the attempt by the agency

16  to correct a violation through administrative sanctions has

17  failed or when the violation materially affects the health,

18  safety, or welfare of clients or involves any operation of an

19  unlicensed provider.

20         (c)  Terminate the operation of a provider when a

21  violation of any provision of this part, authorizing statutes,

22  or any rule adopted pursuant thereto exists which materially

23  affects the health, safety, or welfare of a client.

24  

25  Such injunctive relief may be temporary or permanent.

26         (2)  If action is necessary to protect clients of

27  providers from immediate, life-threatening situations, the

28  court may allow a temporary injunction without bond upon

29  proper proof being made. If it appears by competent evidence

30  or a sworn, substantiated affidavit that a temporary

31  injunction should be issued, the court, pending the

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 1  determination on final hearing, shall enjoin the operation of

 2  the provider.

 3         408.817  Administrative proceedings.--Administrative

 4  proceedings challenging licensure-enforcement action by the

 5  agency shall be reviewed on the basis of the facts and

 6  conditions that resulted in the agency action.

 7         408.818  Health Care Trust Fund.--Unless otherwise

 8  prescribed by authorizing statutes, all fees and fines

 9  collected under this part, authorizing statutes, and

10  applicable rules shall be deposited into the Health Care Trust

11  Fund, created in s. 408.16, and used to pay the costs of the

12  agency in administering the provider program paying the fees

13  or fines.

14         408.819  Rules.--The agency may adopt rules as

15  necessary to administer this part. Any licensed provider that

16  is in operation at the time of adoption of any applicable rule

17  under this part or authorizing statutes shall be given a

18  reasonable time under the particular circumstances, not to

19  exceed 6 months after the date of such adoption, within which

20  to comply with such rule, unless otherwise specified by rule.

21         408.820  Exemptions.--Except as prescribed in

22  authorizing statutes, the following exemptions shall apply to

23  specified requirements of this part:

24         (1)  Laboratories authorized to perform testing under

25  the Drug-Free Workplace Act, as provided under ss. 112.0455

26  and 440.102, are exempt from s. 408.810(5)-(10).

27         (2)  Birth centers, as provided under chapter 383, are

28  exempt from s. 408.810(7)-(10).

29         (3)  Abortion clinics, as provided under chapter 390,

30  are exempt from s. 408.810(7)-(10).

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 1         (4)  Crisis-stabilization units, as provided under

 2  parts I and IV of chapter 394, are exempt from s.

 3  408.810(8)-(10).

 4         (5)  Short-term residential treatment facilities, as

 5  provided under parts I and IV of chapter 394, are exempt from

 6  s. 408.810(8)-(10).

 7         (6)  Residential treatment facilities, as provided

 8  under part IV of chapter 394, are exempt from s.

 9  408.810(8)-(10).

10         (7)  Residential treatment centers for children and

11  adolescents, as provided under part IV of chapter 394, are

12  exempt from s. 408.810(8)-(10).

13         (8)  Hospitals, as provided under part I of chapter

14  395, are exempt from s. 408.810(7)-(9).

15         (9)  Ambulatory surgical centers, as provided under

16  part I of chapter 395, are exempt from s. 408.810(7)-(10).

17         (10)  Mobile surgical facilities, as provided under

18  part I of chapter 395, are exempt from s. 408.810(7)-(10).

19         (11)  Private review agents, as provided under part I

20  of chapter 395, are exempt from ss. 408.806(7), 408.810, and

21  408.811.

22         (12)  Health care risk managers, as provided under part

23  I of chapter 395, are exempt from ss. 408.806(7), 408.810,

24  408.811.

25         (13)  Nursing homes, as provided under part II of

26  chapter 400, are exempt from s. 408.810(7).

27         (14)  Assisted living facilities, as provided under

28  part III of chapter 400, are exempt from s. 408.810(10).

29         (15)  Home health agencies, as provided under part IV

30  of chapter 400, are exempt from s. 408.810(10).

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    Florida Senate - 2006                           CS for SB 2214
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 1         (16)  Nurse registries, as provided under part IV of

 2  chapter 400, are exempt from s. 408.810(6) and (10).

 3         (17)  Companion services or homemaker services

 4  providers, as provided under part IV of chapter 400, are

 5  exempt from s. 408.810(6)-(10).

 6         (18)  Adult day care centers, as provided under part V

 7  of chapter 400, are exempt from s. 408.810(10).

 8         (19)  Adult family-care homes, as provided under part

 9  VII of chapter 400, are exempt from s. 408.810(7)-(10).

10         (20)  Homes for special services, as provided under

11  part VIII of chapter 400, are exempt from s. 408.810(7)-(10).

12         (21)  Transitional living facilities, as provided under

13  part VIII of chapter 400, are exempt from s. 408.810(7)-(10).

14         (22)  Prescribed pediatric extended care centers, as

15  provided under part IX of chapter 400, are exempt from s.

16  408.810(10).

17         (23)  Home medical equipment providers, as provided

18  under part X of chapter 400, are exempt from s. 408.810(10).

19         (24)  Intermediate care facilities for persons with

20  developmental disabilities, as provided under part XI of

21  chapter 400, are exempt from s. 408.810(7).

22         (25)  Health care services pools, as provided under

23  part XII of chapter 400, are exempt from s. 408.810(6)-(10).

24         (26)  Health care clinics, as provided under part XIII

25  of chapter 400, are exempt from ss. 408.809 and 408.810(1),

26  (6), (7) and (10).

27         (27)  Clinical laboratories, as provided under part I

28  of chapter 483, are exempt from s. 408.810(5)-(10).

29         (28)  Multiphasic health testing centers, as provided

30  under part II of chapter 483, are exempt from s.

31  408.810(5)-(10).

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    Florida Senate - 2006                           CS for SB 2214
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 1         (29)  Organ and tissue procurement agencies, as

 2  provided under chapter 765, are exempt from s.

 3  408.810(5)-(10).

 4         Section 8.  Paragraph (b) of subsection (1) of section

 5  400.801, Florida Statutes, is amended to read:

 6         400.801  Homes for special services.--

 7         (1)  As used in this section, the term:

 8         (b)  "Home for special services" means a site licensed

 9  by the agency before January 1, 2006, where specialized health

10  care services are provided, including personal and custodial

11  care, but not continuous nursing services.

12         Section 9.  Paragraphs (e) and (i) of subsection (4) of

13  section 400.9905, Florida Statutes, are amended, and paragraph

14  (k) is added to that subsection, to read:

15         400.9905  Definitions.--

16         (4)  "Clinic" means an entity at which health care

17  services are provided to individuals and which tenders charges

18  for reimbursement for such services, including a mobile clinic

19  and a portable equipment provider. For purposes of this part,

20  the term does not include and the licensure requirements of

21  this part do not apply to:

22         (e)  An entity that is exempt from federal taxation

23  under 26 U.S.C. s. 501(c)(3) or s. 501(c)(4), an employee

24  stock ownership plan under 26 U.S.C. s. 409 having a board of

25  trustees of which no fewer than two-thirds are

26  Florida-licensed health care practitioners and providing only

27  physical therapy services under physician orders, any

28  community college or university clinic, and any entity owned

29  or operated by the federal or state government, including

30  agencies, subdivisions, or municipalities thereof.

31  

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    Florida Senate - 2006                           CS for SB 2214
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 1         (i)  Entities that provide only oncology or radiation

 2  therapy services by physicians licensed under chapter 458 or

 3  chapter 459.

 4         (k)  Entities that provide licensed practitioners to

 5  staff emergency departments or to deliver anesthesia services

 6  in facilities licensed under chapter 395 and that derive at

 7  least 90 percent of their gross annual revenues from the

 8  provision of such services. Entities claiming exemption from

 9  licensure under this paragraph must provide documentation

10  demonstrating compliance.

11         Section 10.  Subsections (1) and (3) of section

12  408.831, Florida Statutes, are amended to read:

13         408.831  Denial, suspension, or revocation of a

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

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

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

17  license, registration, or certificate of entities regulated or

18  licensed by it:

19         (a)  If the applicant, licensee, or a licensee subject

20  to this part which shares a common controlling interest with

21  the applicant registrant, or certificateholder, or, in the

22  case of a corporation, partnership, or other business entity,

23  if any officer, director, agent, or managing employee of that

24  business entity or any affiliated person, partner, or

25  shareholder having an ownership interest equal to 5 percent or

26  greater in that business entity, has failed to pay all

27  outstanding fines, liens, or overpayments assessed by final

28  order of the agency or final order of the Centers for Medicare

29  and Medicaid Services, not subject to further appeal, unless a

30  repayment plan is approved by the agency; or

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

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    Florida Senate - 2006                           CS for SB 2214
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 1         (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 765 641 or rules

 6  adopted pursuant to those chapters.

 7         Section 11.  Subsection (10) is added to section

 8  400.991, Florida Statutes, to read:

 9         400.991  License requirements; background screenings;

10  prohibitions.--

11         (10)  A license may not be granted to a clinic if it is

12  owned by an entity licensed under chapter 627 or chapter 641.

13         Section 12.  In case of conflict between the provisions

14  of part II of chapter 408, Florida Statutes, and the

15  authorizing statutes governing the licensure of health care

16  providers by the Agency for Health Care Administration found

17  in s. 112.0455, chapter 383, chapter 390, chapter 394, chapter

18  395, chapter 400, chapter 440, chapter 483, and chapter 765,

19  Florida Statutes, the provisions of part II of chapter 408,

20  Florida Statutes, shall prevail.

21         Section 13.  All provisions that apply to the entities

22  specified in s. 408.802, Florida Statutes, as created by this

23  act, in effect on October 1, 2006, which provides for annual

24  licensure fees are adjusted to provide for biennial licensure

25  fees with a corresponding doubling of the amount.

26         Section 14.  The Legislature recognizes that there is a

27  need to conform the Florida Statutes to the policy decisions

28  reflected in this act and that there may be a need to resolve

29  apparent conflicts between authorizing statutes or any other

30  legislation that has been or may be enacted during 2006 and

31  the creation by this act of parts I, II, III, and IV of

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 1  chapter 408, Florida Statutes. Therefore, in the interim

 2  between this act becoming a law and the 2007 Regular Session

 3  of the Legislature or an earlier special session addressing

 4  this issue, the Division of Statutory Revision shall provide

 5  the relevant substantive committees of the Senate and the

 6  House of Representatives with assistance, upon request, to

 7  enable such committees to prepare draft legislation to conform

 8  the Florida Statutes and any legislation enacted during 2006

 9  to the provisions of this act.

10         Section 15.  For the purpose of staggering license

11  expiration dates, the Agency for Health Care Administration

12  may issue a license for less than a 2-year period to those

13  providers making the transition from annual to biennial

14  licensure as authorized in this act. The agency shall charge a

15  prorated licensure fee for this shortened period. This

16  authority shall expire September 30, 2008.

17         Section 16.  This act shall take effect October 1,

18  2006.

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

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    Florida Senate - 2006                           CS for SB 2214
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 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 2214

 3                                 

 4  Provides an exemption from the prohibition against use of
    conduction anesthesia in birth centers for a period of three
 5  years to a specific birthing center meeting certain criteria.
    The Agency for Health Care Administration is directed to
 6  review the safety and outcome data for patients served at this
    center to determine the viability of extending the exemption
 7  statewide.

 8  Provides a certificate-of-need exemption for the creation of a
    single nursing home under specific circumstances.  This
 9  exemption ends upon the expiration of the nursing home
    certificate-of-need moratorium.
10  
    Exempts from definition of a health clinic certain entities
11  that provide physical therapy services under physician orders
    and entities that provide licensed practitioners to staff
12  emergency departments or deliver anesthesia services in
    facilities licensed under chapter 395.  Documentation
13  demonstrating compliance with this requirement must be
    provided to the agency. A requirement that an exempt entity
14  provide only oncology or radiation therapy services is also
    deleted.
15  
    Prohibits the granting of a health care clinic license to an
16  entity owned by an insurance entity regulated by chapter 627
    or 641, F.S.
17  

18  

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

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