HB 7139

1	A bill to be entitled
2	An act relating to emergency management; amending s.
3	252.355, F.S.; specifying additional entities and agencies
4	that are required to provide registration information to
5	persons with disabilities or special needs for purposes of
6	inclusion within the registry of persons with special
7	needs maintained by local emergency management agencies;
8	providing that the Department of Community Affairs shall
9	be the designated lead agency responsible for community
10	education and outreach to the general public, including
11	persons with special needs, regarding registration as a
12	person with special needs, special needs shelters, and
13	general information regarding shelter stays; requiring the
14	department to disseminate educational and outreach
15	information through local emergency management offices;
16	requiring the department to coordinate community education
17	and outreach related to special needs shelters with
18	specified agencies and entities; providing that special
19	needs shelters must allow persons with special needs to
20	bring service animals into special needs shelters;
21	revising provisions with respect to the required
22	notification of residential utility customers of the
23	availability of the special needs registration program;
24	providing that specified confidential and exempt
25	information relating to registration of persons with
26	special needs be provided to the Department of Health and
27	local law enforcement agencies; creating s. 252.3568,
28	F.S.; requiring the Division of Emergency Management to
29	address evacuation of persons with pets in the shelter
30	component of the state comprehensive emergency management
31	plan; creating s. 252.357, F.S., requiring the Florida
32	Comprehensive Emergency Management Plan to permit the
33	Agency for Health Care Administration to make initial
34	contact with each nursing home in a disaster area;
35	requiring the agency to annually publish an emergency
36	telephone number that may be used by nursing homes to
37	contact the agency; amending s. 252.385, F.S., relating to
38	public shelter space; requiring the Division of Emergency
39	Management of the Department of Community Affairs to
40	biennially prepare and submit a statewide emergency
41	shelter plan to the Governor and the Cabinet for approval;
42	providing plan requirements; requiring the Department of
43	Health to provide specified assistance to the division;
44	revising those facilities which are excluded as being
45	suitable for use as public hurricane evacuation shelters;
46	requiring local emergency management agencies to inspect a
47	designated facility prior to activation to determine its
48	readiness; amending s. 381.0303, F.S.; providing for the
49	operation, maintenance, and closure of special needs
50	shelters; providing that local Children's Medical Services
51	offices shall assume lead responsibility for specified
52	coordination with respect to the development of a plan for
53	the staffing and medical management of pediatric special
54	needs shelters; requiring such plans to conform to the
55	local comprehensive emergency management plan; requiring
56	county governments to assist the Department of Health with
57	nonmedical staffing and operation of special needs
58	shelters; requiring local health departments and emergency
59	management agencies to coordinate such efforts to ensure
60	appropriate staffing; providing that the appropriate
61	county health department, Children's Medical Services
62	office, and local emergency management agency shall
63	jointly determine the responsibility for medical
64	supervision in a special needs shelter; providing
65	notification requirements; requiring local emergency
66	management agencies to be responsible for the
67	infrastructure and closure of special needs shelters;
68	requiring the emergency management agency and the local
69	health department to coordinate efforts to ensure
70	appropriate designation, operation, and infrastructure in
71	special needs shelters; providing that a county health
72	department is not prohibited from entering into an
73	alternative agreement with a local emergency management
74	agency to assume the lead responsibility for special needs
75	shelter supplies and equipment; providing that state
76	employees with a preestablished role in disaster response
77	are subject to serve in times of disaster in specified
78	capacities; requiring the Secretary of Elderly Affairs to
79	convene multiagency special needs shelter discharge
80	planning teams to assist local areas that are severely
81	impacted by a natural or manmade disaster that requires
82	the use of special needs shelters; providing duties and
83	responsibilities of such discharge planning teams;
84	providing for the inclusion of specified state agency
85	representatives on each discharge planning team; revising
86	provisions relating to reimbursement of health care
87	practitioners; providing for eligibility of specified
88	health care facilities for reimbursement when a
89	multiagency special needs shelter discharge planning team
90	discharges persons with special needs to such receiving
91	facilities; providing procedures and requirements with
92	respect to such reimbursement; requiring the department to
93	specify by rule expenses that are reimbursable and the
94	rate of reimbursement for services; revising provisions
95	which prescribe means of and procedures for reimbursement;
96	disallowing specified reimbursements; revising provisions
97	with respect to the organization, role, duties, and
98	composition of the special needs shelter interagency
99	committee; requiring the department to adopt specified
100	rules with respect to special needs shelters; providing
101	requirements with respect to emergency management plans
102	submitted to a county health department by a home health
103	agency, nurse registry, hospice, or home medical equipment
104	provider; amending ss. 400.492, 400.497, 400.506, 400.610,
105	and 400.934, F.S.; revising requirements with respect to
106	the comprehensive emergency management plans of home
107	health agencies, nurse registries, and hospices, and
108	providing such requirements with respect to home medical
109	equipment providers, to include the means by which
110	continuing services will be provided to patients who
111	evacuate to special needs shelters; authorizing the
112	establishment of links to local emergency operations
113	centers for specified purposes; providing actions that
114	constitute abandonment of a patient; providing sanctions
115	for abandonment; revising requirements of a county health
116	department with respect to review of a comprehensive
117	emergency management plan submitted by a home health
118	agency, nurse registry, or hospice, and providing such
119	requirements with respect to a home medical equipment
120	provider; providing requirements upon failure to submit a
121	plan or requested information to the department; providing
122	for imposition of a fine; revising requirements of the
123	Department of Health with respect to review of the plan of
124	a home health agency, nurse registry, or hospice that
125	operates in more than one county, and providing such
126	requirements with respect to a home medical equipment
127	provider that operates in more than one county; providing
128	that the preparation and maintenance of a comprehensive
129	emergency management plan by a home medical equipment
130	provider is a requirement for licensure and must meet
131	minimum criteria established by the Agency for Health Care
132	Administration; providing plan requirements; providing
133	that the plan is subject to review and approval by the
134	county health department; requiring each home medical
135	equipment provider to maintain a current prioritized list
136	of patients who need continued services during an
137	emergency; amending s. 400.925, F.S.; defining "life-
138	supporting or life-sustaining equipment" for purposes of
139	pt. X of ch. 400, F.S., relating to home medical equipment
140	providers; amending s. 400.935, F.S.; requiring the Agency
141	for Health Care Administration to adopt rules with respect
142	to the comprehensive emergency management plan prepared by
143	a home medical equipment services provider; amending s.
144	408.831, F.S.; providing that entities regulated or
145	licensed by the Agency for Health Care Administration may
146	exceed their licensed capacity to act as a receiving
147	facility under specified circumstances; providing
148	requirements while such entities are in an overcapacity
149	status; providing for issuance of an inactive license to
150	such licensees under specified conditions; providing
151	requirements and procedures with respect to the issuance
152	and reactivation of an inactive license; providing fees;
153	providing an effective date.
154
155	Be It Enacted by the Legislature of the State of Florida:
156
157	Section 1.  Section 252.355, Florida Statutes, is amended
158	to read:
159	252.355  Registry of persons with special needs; notice.--
160	(1)  In order to meet the special needs of persons who
161	would need assistance during evacuations and sheltering because
162	of physical, mental, cognitive impairment, or sensory
163	disabilities, each local emergency management agency in the
164	state shall maintain a registry of persons with special needs
165	located within the jurisdiction of the local agency. The
166	registration shall identify those persons in need of assistance
167	and plan for resource allocation to meet those identified needs.
168	To assist the local emergency management agency in identifying
169	such persons, home health agencies, hospices, nurse registries,
170	home medical equipment providers, the Department of Children and
171	Family Services, the Department of Health, the Agency for Health
172	Care Administration, the Department of Education, Agency for
173	Persons with Disabilities, Department of Labor and Employment
174	Security, and the Department of Elderly Affairs shall provide
175	registration information to all of their special needs clients
176	and to all people with disabilities or special needs who receive
177	services incoming clients as a part of the intake process. The
178	registry shall be continuously maintained updated annually. The
179	registration program shall give persons with special needs the
180	option of preauthorizing emergency response personnel to enter
181	their homes during search and rescue operations if necessary to
182	assure their safety and welfare following disasters.
183	(2)  The Department of Community Affairs shall be the
184	designated lead agency responsible for community education and
185	outreach to the general public, including special needs clients,
186	regarding registration and special needs shelters and general
187	information regarding shelter stays. The Department of Community
188	Affairs shall disseminate such educational and outreach
189	information through the local emergency management offices. The
190	department shall coordinate the development of curriculum and
191	dissemination of all community education and outreach related to
192	special needs shelters with the Clearinghouse on Disability
193	Information of the Governor's Working Group on the Americans
194	with Disabilities Act, the Department of Children and Family
195	Services, the Department of Health, the Agency for Health Care
196	Administration, the Department of Education, the Agency for
197	Persons with Disabilities, and the Department of Elderly
198	Affairs.
199	(3)  A person with special needs shall be allowed to bring
200	his or her service animal into a special needs shelter in
201	compliance with the Americans with Disabilities Act of 1990,
202	Pub. L. No. 101-336. Because a special needs shelter is
203	considered a public facility when it is activated for a
204	disaster, persons with disabilities must be allowed access to
205	special needs shelters when accompanied by a service animal in
206	compliance with the Americans with Disabilities Act, which
207	provides that businesses and organizations that serve the public
208	must allow people with disabilities to bring their service
209	animals into all areas of a facility where customers are
210	normally allowed to go.
211	(4)(2)  On or before May 1 of each year Each electric
212	utility in the state shall annually notify residential customers
213	in its service area of the availability of the registration
214	program available through their local emergency management
215	agency with either:.
216	(a)  An initial notification upon the activation of new
217	residential service with the electric utility followed by one
218	annual notification between January 1 and May 31; or
219	(b)  Two separate annual notifications between January 1
220	and May 31.
221
222	The notification required under this subsection may be made by
223	any available means, including, but not limited to, written,
224	electronic, or verbal notification, and may be made concurrently
225	with any other notification to residential customers required by
226	law or rule.
227	(5)(3)  All records, data, information, correspondence, and
228	communications relating to the registration of persons with
229	special needs as provided in subsection (1) are confidential and
230	exempt from the provisions of s. 119.07(1), except that such
231	information shall be available to other emergency response
232	agencies, as determined by the local emergency management
233	director, and to the Department of Health in the furtherance of
234	its duties and responsibilities. Local law enforcement agencies
235	shall be provided complete shelter registration information upon
236	request.
237	(6)(4)  All appropriate agencies and community-based
238	service providers, including home health care providers,
239	hospices, nurse registries, and home medical equipment
240	providers, shall assist emergency management agencies by
241	collecting registration information for persons with special
242	needs as part of program intake processes, establishing programs
243	to increase the awareness of the registration process, and
244	educating clients about the procedures that may be necessary for
245	their safety during disasters. Clients of state or federally
246	funded service programs with physical, mental, cognitive
247	impairment, or sensory disabilities who need assistance in
248	evacuating, or when in shelters, must register as persons with
249	special needs.
250	Section 2.  Section 252.3568, Florida Statutes, is created
251	to read:
252	252.3568  Emergency sheltering of persons with pets.--In
253	accordance with the provisions of s. 252.35, the division shall
254	address the evacuation of persons with pets in the shelter
255	component of the state comprehensive emergency management plan.
256	The Department of Agriculture and Consumer Services shall assist
257	the division in determining strategies regarding this activity.
258	Section 3.  Section 252.357, Florida Statutes, is created
259	to read:
260	252.357  Monitoring of nursing homes during disaster.--The
261	Florida Comprehensive Emergency Management Plan shall permit the
262	Agency for Health Care Administration, working from the agency's
263	offices or in the Emergency Operations Center, ESF-8, to make
264	initial contact with each nursing home in the disaster area. The
265	agency, by July 15, 2006, and annually thereafter, shall publish
266	on the Internet an emergency telephone number that may be used
267	by nursing homes to contact the agency on a schedule established
268	by the agency to report requests for assistance. The agency may
269	also provide the telephone number to each facility when it makes
270	the initial facility call.
271	Section 4.  Subsection (2) and paragraphs (a) and (b) of
272	subsection (4) of section 252.385, Florida Statutes, are amended
273	to read:
274	252.385  Public shelter space.--
275	(2)(a)  The division shall administer a program to survey
276	existing schools, universities, community colleges, and other
277	state-owned, municipally owned, and county-owned public
278	buildings and any private facility that the owner, in writing,
279	agrees to provide for use as a public hurricane evacuation
280	shelter to identify those that are appropriately designed and
281	located to serve as such shelters. The owners of the facilities
282	must be given the opportunity to participate in the surveys. The
283	Board of Regents, district school boards, community college
284	boards of trustees, and the Department of Education are
285	responsible for coordinating and implementing the survey of
286	public schools, universities, and community colleges with the
287	division or the local emergency management agency.
288	(b)  By January 31 of each even-numbered year, the division
289	shall prepare and submit a statewide emergency shelter plan to
290	the Governor and the Cabinet for approval, subject to the
291	requirements for approval provided in s. 1013.37(2). The plan
292	shall identify the general location and square footage of
293	special needs shelters, by regional planning council region,
294	during the next 5 years. The plan shall also include information
295	on the availability of shelters that accept pets. The Department
296	of Health shall assist the division in determining the estimated
297	need for special needs shelter space and the adequacy of
298	facilities to meet the needs of persons with special needs based
299	on information from the registries of persons with special needs
300	and other information.
301	(4)(a)  Public facilities, including schools, postsecondary
302	education facilities, and other facilities owned or leased by
303	the state or local governments, but excluding hospitals, hospice
304	care facilities, assisted living facilities, or nursing homes,
305	which are suitable for use as public hurricane evacuation
306	shelters shall be made available at the request of the local
307	emergency management agencies. The local emergency management
308	agency shall inspect a designated facility to determine its
309	readiness prior to activating the facility for a specific
310	hurricane or disaster. Such agencies shall coordinate with the
311	appropriate school board, university, community college, or
312	local governing board when requesting the use of such facilities
313	as public hurricane evacuation shelters.
314	(b)  The Department of Management Services shall
315	incorporate provisions for the use of suitable leased public
316	facilities as public hurricane evacuation shelters into lease
317	agreements for state agencies. Suitable leased public facilities
318	include leased public facilities that are solely occupied by
319	state agencies and have at least 2,000 square feet of net floor
320	area in a single room or in a combination of rooms having a
321	minimum of 400 square feet in each room. The net square footage
322	of floor area shall must be determined by subtracting from the
323	gross square footage the square footage of spaces such as
324	mechanical and electrical rooms, storage rooms, open corridors,
325	restrooms, kitchens, science or computer laboratories, shop or
326	mechanical areas, administrative offices, records vaults, and
327	crawl spaces.
328	Section 5.  Section 381.0303, Florida Statutes, is amended
329	to read:
330	381.0303  Health practitioner recruitment for Special needs
331	shelters.--
332	(1)  PURPOSE.--The purpose of this section is to provide
333	for the operation, maintenance, and closure of special needs
334	shelters and to designate the Department of Health, through its
335	county health departments, as the lead agency for coordination
336	of the recruitment of health care practitioners, as defined in
337	s. 456.001(4), to staff special needs shelters in times of
338	emergency or disaster and to provide resources to the department
339	to carry out this responsibility. However, nothing in this
340	section prohibits a county health department from entering into
341	an agreement with a local emergency management agency to assume
342	the lead responsibility for recruiting health care
343	practitioners.
344	(2)  SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE; STATE
345	AGENCY ASSISTANCE AND STAFFING.--Provided funds have been
346	appropriated to support medical services disaster coordinator
347	positions in county health departments:,
348	(a)  The department shall assume lead responsibility for
349	the local coordination of local medical and health care
350	providers, the American Red Cross, and other interested parties
351	in developing a plan for the staffing and medical management of
352	special needs shelters. The local Children's Medical Services
353	offices shall assume lead responsibility for the coordination of
354	local medical and health care providers, the American Red Cross,
355	and other interested parties in developing a plan for the
356	staffing and medical management of pediatric special needs
357	shelters. Plans shall conform to The plan shall be in
358	conformance with the local comprehensive emergency management
359	plan.
360	(b)(a)  County health departments shall, in conjunction
361	with the local emergency management agencies, have the lead
362	responsibility for coordination of the recruitment of health
363	care practitioners to staff local special needs shelters. County
364	health departments shall assign their employees to work in
365	special needs shelters when those employees are needed to
366	protect the health and safety of persons with special needs of
367	patients. County governments shall assist the Department of
368	Health with nonmedical staffing and the operation of special
369	needs shelters. The local health department and emergency
370	management agency shall coordinate these efforts to ensure
371	appropriate staffing in special needs shelters.
372	(c)(b)  The appropriate county health department,
373	Children's Medical Services office, and local emergency
374	management agency shall jointly decide determine who has
375	responsibility for medical supervision in each a special needs
376	shelter and shall notify the Division of Emergency Management
377	and the Department of Health of their decision.
378	(d)(c)  Local emergency management agencies shall be
379	responsible for the designation, and operation, and
380	infrastructure of special needs shelters during times of
381	emergency or disaster and the closure of the facilities
382	following an emergency or disaster. The emergency management
383	agency and the local health department shall coordinate these
384	efforts to ensure appropriate designation, operation, and
385	infrastructure in special needs shelters. County health
386	departments shall assist the local emergency management agency
387	with regard to the management of medical services in special
388	needs shelters. However, nothing in this section prohibits a
389	county health department from entering into an alternative
390	agreement with a local emergency management agency to assume the
391	lead responsibility for special needs shelter supplies and
392	equipment.
393	(e)  Any state employee with a preestablished role in
394	disaster response that has been designated by the employing
395	agency is subject to serve in times of disaster in a capacity
396	that is commensurate with the employee's knowledge, skills, and
397	abilities and to participate in any needed activities related to
398	the disaster unless the employee has other mandated response
399	activities that preclude participation.
400	(f)  The Secretary of Elderly Affairs, or his or her
401	designee, shall convene, at any time that he or she deems
402	appropriate and necessary, a multiagency special needs shelter
403	discharge planning team or teams to assist local areas that are
404	severely impacted by a natural or manmade disaster that requires
405	the use of special needs shelters. Multiagency special needs
406	shelter discharge planning teams shall provide assistance to
407	local emergency management agencies with the continued operation
408	or closure of the shelters, as well as with the discharge of
409	special needs clients to alternate facilities if necessary.
410	Local emergency management agencies may request the assistance
411	of a multiagency special needs shelter discharge planning team
412	by alerting statewide emergency management officials of the
413	necessity for additional assistance in their area. The Secretary
414	of Elderly Affairs is encouraged to proactively work with other
415	state agencies prior to any natural disasters for which warnings
416	are provided to ensure that multiagency special needs shelter
417	discharge planning teams are ready to assemble and deploy
418	rapidly upon a determination by state emergency management
419	officials that a disaster area requires additional assistance.
420	The Secretary of Elderly Affairs may call upon any state agency
421	or office to provide staff to assist a multiagency special needs
422	shelter discharge planning team or teams. Unless the secretary
423	determines that the nature or circumstances surrounding the
424	disaster do not warrant participation from a particular agency's
425	staff, each multiagency special needs shelter discharge planning
426	team shall include at least one representative from each of the
427	following state agencies:
428	1.  Department of Elderly Affairs.
429	2.  Department of Health.
430	3.  Department of Children and Family Services.
431	4.  Department of Veterans' Affairs.
432	5.  Department of Community Affairs.
433	6.  Agency for Health Care Administration.
434	7.  Agency for Persons with Disabilities.
435	(3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
436	FACILITIES.--
437	(a)  The Department of Health shall upon request reimburse,
438	subject to the availability of funds for this purpose, health
439	care practitioners, as defined in s. 456.001, provided the
440	practitioner is not providing care to a patient under an
441	existing contract, and emergency medical technicians and
442	paramedics licensed under pursuant to chapter 401 for medical
443	care provided at the request of the department in special needs
444	shelters or at other locations during times of emergency or a
445	declared major disaster. Reimbursement for health care
446	practitioners, except for physicians licensed under pursuant to
447	chapter 458 or chapter 459, shall be based on the average hourly
448	rate that such practitioners were paid according to the most
449	recent survey of Florida hospitals conducted by the Florida
450	Hospital Association or other nationally or state recognized
451	data source. Reimbursement shall be requested on forms prepared
452	by the Department of Health and shall be paid as specified in
453	paragraph (c).
454	(b)  If, upon closure of a special needs shelter, a
455	multiagency special needs shelter discharge planning team
456	determines that it is necessary to discharge persons with
457	special needs to other health care facilities, such as
458	hospitals, nursing homes, assisted living facilities, and
459	community residential homes, the receiving facilities shall be
460	eligible for reimbursement for services provided to the
461	individuals for up to 90 days. Any facility eligible for
462	reimbursement under this paragraph shall submit invoices for
463	reimbursement on forms developed by the department. A facility
464	must show proof of a written request from a representative of an
465	agency serving on the multiagency special needs shelter
466	discharge planning team that the individual for whom the
467	facility is seeking reimbursement for services rendered was
468	referred to that facility from a special needs shelter. The
469	department shall specify by rule which expenses are reimbursable
470	and the rate of reimbursement for each service. Reimbursement
471	for the services described in this paragraph shall be paid as
472	specified in paragraph (c).
473	(c)  If a Presidential Disaster Declaration has been issued
474	made, and the Federal Government makes funds available, the
475	department shall request federal use such funds for
476	reimbursement of eligible expenditures. In other situations, or
477	if federal funds do not fully compensate the department for
478	reimbursements permissible under reimbursement made pursuant to
479	this section, the department shall process a budget amendment to
480	obtain reimbursement from unobligated, unappropriated moneys in
481	the General Revenue Fund. The department shall not provide
482	reimbursement to facilities under this subsection for services
483	provided to a person with special needs if, during the period of
484	time in which the services were provided, the individual was
485	enrolled in another state-funded program, such as Medicaid or
486	another similar program, was covered under a policy of health
487	insurance as defined in s. 624.603, or was a member of a health
488	maintenance organization or prepaid health clinic as defined in
489	chapter 641, which would otherwise pay for the same services.
490	Travel expense and per diem costs shall be reimbursed pursuant
491	to s. 112.061.
492	(4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may
493	use the registries established in ss. 401.273 and 456.38 when
494	health care practitioners are needed to staff special needs
495	shelters or to assist with other disaster-related activities
496	staff disaster medical assistance teams.
497	(5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
498	Secretary Department of Health may establish a special needs
499	shelter interagency committee and serve as or appoint a designee
500	to serve as the committee's chair. The department shall provide
501	any necessary staff and resources to support the committee in
502	the performance of its duties, to be chaired and staffed by the
503	department. The committee shall address and resolve problems
504	related to special needs shelters not addressed in the state
505	comprehensive emergency medical plan and shall consult on serve
506	as an oversight committee to monitor the planning and operation
507	of special needs shelters.
508	(a)  The committee shall may:
509	1.  Develop, and negotiate, and regularly review any
510	necessary interagency agreements.
511	2.  Undertake other such activities as the department deems
512	necessary to facilitate the implementation of this section.
513	3.  Submit recommendations to the Legislature as necessary.
514	(b)  The special needs shelter interagency committee shall
515	be composed of representatives of emergency management, health,
516	medical, and social services organizations. Membership shall
517	include, but shall not be limited to, representatives of the
518	Departments of Health, Community Affairs, Children and Family
519	Services, Elderly Affairs, Labor and Employment Security, and
520	Education; the Agency for Health Care Administration; the
521	Florida Medical Association; the Florida Osteopathic Medical
522	Association; Associated Home Health Industries of Florida, Inc.;
523	the Florida Nurses Association; the Florida Health Care
524	Association; the Florida Assisted Living Affiliation
525	Association; the Florida Hospital Association; the Florida
526	Statutory Teaching Hospital Council; the Florida Association of
527	Homes for the Aging; the Florida Emergency Preparedness
528	Association; the American Red Cross; Florida Hospices and
529	Palliative Care, Inc.; the Association of Community Hospitals
530	and Health Systems; the Florida Association of Health
531	Maintenance Organizations; the Florida League of Health Systems;
532	Private Care Association; and the Salvation Army; the Florida
533	Association of Aging Services Providers; AARP; and the Florida
534	Renal Coalition.
535	(c)  Meetings of the committee shall be held in
536	Tallahassee, and members of the committee shall serve at the
537	expense of the agencies or organizations they represent. The
538	committee shall make every effort to use teleconference or video
539	conference capabilities in order to ensure statewide input and
540	participation.
541	(6)  RULES.--The department has the authority to adopt rules
542	necessary to implement this section. Rules shall may include:
543	(a)  The a definition of a "person with special needs",
544	including eligibility criteria for individuals with physical,
545	mental, cognitive impairment, or sensory disabilities and the
546	services a person with special needs can expect to receive in a
547	special needs shelter patient, specify physician reimbursement,
548	and designate which county health departments will have
549	responsibility for implementation of subsections (2) and (3).
550	(b)  The process for special needs shelter health care
551	practitioners and facility reimbursement for services provided in
552	a disaster.
553	(c)  Guidelines for special needs shelter staffing levels to
554	provide services.
555	(d)  The definition of and standards for special needs
556	shelter supplies and equipment, including durable medical
557	equipment.
558	(e)  Compliance with applicable laws relating to service
559	animals.
560	(f)  Standards for the special needs shelter registration
561	process, including guidelines for addressing the needs of
562	unregistered persons in need of a special needs shelter.
563	(g)  Standards for addressing the needs of families where
564	only one dependent is eligible for admission to a special needs
565	shelter and the needs of adults with special needs who are
566	caregivers for individuals without special needs.
567	(h)  The requirement of the county health departments to
568	seek the participation of hospitals, nursing homes, assisted
569	living facilities, home health agencies, hospice providers,
570	nurse registries, home medical equipment providers, dialysis
571	centers, and other health and medical emergency preparedness
572	stakeholders in preevent planning activities.
573	(7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY OF
574	CARE.--Each emergency management plan submitted to a county
575	health department by a home health agency under s. 400.492, by a
576	nurse registry pursuant to s. 400.506(16)(e), by a hospice
577	pursuant to s. 400.610(1)(b), or by a home medical equipment
578	provider pursuant to s. 400.934(20)(a) shall specify the means
579	by which the home health agency, nurse registry, hospice, or
580	home medical equipment provider will continue to provide staff
581	and equipment to perform the same type and quantity of services
582	for their patients who evacuate to special needs shelters that
583	were being provided to those patients prior to evacuation. The
584	submission of emergency management plans to county health
585	departments by home health agencies, pursuant to s.
586	400.497(8)(c) and (d) and by nurse registries, pursuant to s.
587	400.506(16)(e) and by hospice programs, pursuant to s.
588	400.610(1)(b) and home medical equipment providers is
589	conditional upon the receipt of an appropriation by the
590	department to establish medical services disaster coordinator
591	positions in county health departments unless the secretary of
592	the department and a local county commission jointly determine
593	to require such plans to be submitted based on a determination
594	that there is a special need to protect public health in the
595	local area during an emergency.
596	Section 6.  Section 400.492, Florida Statutes, is amended
597	to read:
598	400.492  Provision of services during an emergency.--Each
599	home health agency shall prepare and maintain a comprehensive
600	emergency management plan that is consistent with the standards
601	adopted by national or state accreditation organizations and
602	consistent with the local special needs plan. The plan shall be
603	updated annually and shall provide for continuing home health
604	services during an emergency that interrupts patient care or
605	services in the patient's home. The plan shall include the means
606	by which the home health agency will continue to provide staff
607	to perform the same type and quantity of services to their
608	patients who evacuate to special needs shelters that were being
609	provided to those patients prior to evacuation. The plan shall
610	describe how the home health agency establishes and maintains an
611	effective response to emergencies and disasters, including:
612	notifying staff when emergency response measures are initiated;
613	providing for communication between staff members, county health
614	departments, and local emergency management agencies, including
615	a backup system; identifying resources necessary to continue
616	essential care or services or referrals to other organizations
617	subject to written agreement; and prioritizing and contacting
618	patients who need continued care or services.
619	(1)  Each patient record for patients who are listed in the
620	registry established pursuant to s. 252.355 shall include a
621	description of how care or services will be continued in the
622	event of an emergency or disaster. The home health agency shall
623	discuss the emergency provisions with the patient and the
624	patient's caregivers, including where and how the patient is to
625	evacuate, procedures for notifying the home health agency in the
626	event that the patient evacuates to a location other than the
627	shelter identified in the patient record, and a list of
628	medications and equipment which must either accompany the
629	patient or will be needed by the patient in the event of an
630	evacuation.
631	(2)  Each home health agency shall maintain a current
632	prioritized list of patients who need continued services during
633	an emergency. The list shall indicate how services shall be
634	continued in the event of an emergency or disaster for each
635	patient and if the patient is to be transported to a special
636	needs shelter, and shall indicate if the patient is receiving
637	skilled nursing services and the patient's medication and
638	equipment needs. The list shall be furnished to county health
639	departments and to local emergency management agencies, upon
640	request.
641	(3)  Home health agencies shall not be required to continue
642	to provide care to patients in emergency situations that are
643	beyond their control and that make it impossible to provide
644	services, such as when roads are impassable or when patients do
645	not go to the location specified in their patient records. Home
646	health agencies may establish links to local emergency
647	operations centers to determine a mechanism to approach specific
648	areas within a disaster area in order for the agency to reach
649	its clients. The presentation of a home health agency client to
650	a special needs shelter without the home health agency making a
651	good faith effort to provide services in the shelter setting
652	shall be considered abandonment of the client and constitutes a
653	class II deficiency, subject to sanctions provided in s.
654	400.484(2)(b). For purposes of this section, "good faith effort"
655	may be demonstrated by documented attempts of staff to follow
656	procedures as outlined in the home health agency's comprehensive
657	emergency management plan, and by the patient's record, which
658	support a finding that continuing care has been provided for
659	those patients who have been identified as needing care by the
660	home health agency in the event of an emergency or disaster
661	under subsection (1).
662	(4)  Notwithstanding the provisions of s. 400.464(2) or any
663	other provision of law to the contrary, a home health agency may
664	provide services in a special needs shelter located in any
665	county.
666	Section 7.  Paragraphs (c) and (d) of subsection (8) of
667	section 400.497, Florida Statutes, are amended to read:
668	400.497  Rules establishing minimum standards.--The agency
669	shall adopt, publish, and enforce rules to implement this part,
670	including, as applicable, ss. 400.506 and 400.509, which must
671	provide reasonable and fair minimum standards relating to:
672	(8)  Preparation of a comprehensive emergency management
673	plan pursuant to s. 400.492.
674	(c)  The plan is subject to review and approval by the
675	county health department. During its review, the county health
676	department shall contact state and local health and medical
677	stakeholders during its review when necessary. ensure that the
678	following agencies, at a minimum, are given the opportunity to
679	review the plan:
680	1.  The local emergency management agency.
681	2.  The Agency for Health Care Administration.
682	3.  The local chapter of the American Red Cross or other
683	lead sheltering agency.
684	4.  The district office of the Department of Children and
685	Family Services.
686
687	The county health department shall complete its review to ensure
688	that the plan is in accordance with the criteria set forth in
689	the rules of the Agency for Health Care Administration within 90
690	60 days after receipt of the plan and shall either approve the
691	plan or advise the home health agency of necessary revisions. If
692	the home health agency fails to submit a plan or fails to submit
693	the requested information or revisions to the county health
694	department within 30 days after written notification from the
695	county health department, the county health department shall
696	notify the Agency for Health Care Administration. The agency
697	shall notify the home health agency that such failure
698	constitutes a deficiency, subject to a fine of $5,000 per
699	occurrence. If the plan is not submitted, information is not
700	provided, or revisions are not made as requested, the agency may
701	impose the fine.
702	(d)  For any home health agency that operates in more than
703	one county, the Department of Health shall review the plan,
704	after consulting with state and local health and medical
705	stakeholders, when necessary all of the county health
706	departments, the agency, and all the local chapters of the
707	American Red Cross or other lead sheltering agencies in the
708	areas of operation for that particular home health agency. The
709	department of Health shall complete its review within 90 days
710	after receipt of the plan and shall either approve the plan or
711	advise the home health agency of necessary revisions. The
712	department of Health shall make every effort to avoid imposing
713	differing requirements on a home health agency that operates in
714	more than one county as a result of differing or conflicting
715	comprehensive plan requirements of the based on differences
716	between counties in which on the home health agency operates.
717	Section 8.  Subsection (16) of section 400.506, Florida
718	Statutes, is amended to read:
719	400.506  Licensure of nurse registries; requirements;
720	penalties.--
721	(16)  Each nurse registry shall prepare and maintain a
722	comprehensive emergency management plan that is consistent with
723	the criteria in this subsection and with the local special needs
724	plan. The plan shall be updated annually. The plan shall include
725	the means by which the nurse registry will continue to provide
726	staff to perform the same type and quantity of services to their
727	patients who evacuate to special needs shelters that were being
728	provided to those patients prior to evacuation. The plan shall
729	specify how the nurse registry shall facilitate the provision of
730	continuous care by persons referred for contract to persons who
731	are registered pursuant to s. 252.355 during an emergency that
732	interrupts the provision of care or services in private
733	residencies. Nurse registries may establish links to local
734	emergency operations centers to determine a mechanism to
735	approach specific areas within a disaster area in order for a
736	provider to reach its clients. The presentation of nurse
737	registry clients to a special needs shelter without the nurse
738	registry provider making a good faith effort to provide services
739	in the shelter setting shall be considered abandonment of the
740	patient and constitutes a class II deficiency, subject to
741	sanctions provided in s. 400.484(2)(b). For purposes of this
742	section, "good faith effort" may be demonstrated by documented
743	attempts of staff to follow procedures as outlined in the nurse
744	registry's comprehensive emergency management plan which support
745	a finding that continuing care has been provided for those
746	patients who have been identified as needing care by the nurse
747	registry in the event of an emergency under s. 400.506(1).
748	(a)  All persons referred for contract who care for persons
749	registered pursuant to s. 252.355 must include in the patient
750	record a description of how care will be continued during a
751	disaster or emergency that interrupts the provision of care in
752	the patient's home. It shall be the responsibility of the person
753	referred for contract to ensure that continuous care is
754	provided.
755	(b)  Each nurse registry shall maintain a current
756	prioritized list of patients in private residences who are
757	registered pursuant to s. 252.355 and are under the care of
758	persons referred for contract and who need continued services
759	during an emergency. This list shall indicate, for each patient,
760	if the client is to be transported to a special needs shelter
761	and if the patient is receiving skilled nursing services. Nurse
762	registries shall make this list available to county health
763	departments and to local emergency management agencies upon
764	request.
765	(c)  Each person referred for contract who is caring for a
766	patient who is registered pursuant to s. 252.355 shall provide a
767	list of the patient's medication and equipment needs to the
768	nurse registry. Each person referred for contract shall make
769	this information available to county health departments and to
770	local emergency management agencies upon request.
771	(d)  Each person referred for contract shall not be
772	required to continue to provide care to patients in emergency
773	situations that are beyond the person's control and that make it
774	impossible to provide services, such as when roads are
775	impassable or when patients do not go to the location specified
776	in their patient records.
777	(e)  The comprehensive emergency management plan required
778	by this subsection is subject to review and approval by the
779	county health department. During its review, the county health
780	department shall contact state and local health and medical
781	stakeholders, when necessary ensure that, at a minimum, the
782	local emergency management agency, the Agency for Health Care
783	Administration, and the local chapter of the American Red Cross
784	or other lead sheltering agency are given the opportunity to
785	review the plan. The county health department shall complete its
786	review to ensure that the plan is in accordance with the
787	criteria set forth in the rules of the Agency for Health Care
788	Administration within 90 60 days after receipt of the plan and
789	shall either approve the plan or advise the nurse registry of
790	necessary revisions. If a nurse registry fails to submit a plan
791	or fails to submit requested information or revisions to the
792	county health department within 30 days after written
793	notification from the county health department, the county
794	health department shall notify the Agency for Health Care
795	Administration. The agency shall notify the nurse registry that
796	such failure constitutes a deficiency, subject to a fine of
797	$5,000 per occurrence. If the plan is not submitted, information
798	is not provided, or revisions are not made as requested, the
799	agency may impose the fine.
800	(f)  The Department of Health shall review the
801	comprehensive emergency management plan of any nurse registry
802	that operates in more than one county. The department shall
803	complete its review within 90 days after receipt of the plan and
804	shall either approve the plan or advise the nurse registry of
805	necessary revisions. The department shall make every effort to
806	avoid imposing differing requirements on nurse registries that
807	operate in more than one county as a result of differing or
808	conflicting comprehensive plan requirements of the counties in
809	which the nurse registry operates.
810	(g)(f)  The Agency for Health Care Administration shall
811	adopt rules establishing minimum criteria for the comprehensive
812	emergency management plan and plan updates required by this
813	subsection, with the concurrence of the Department of Health and
814	in consultation with the Department of Community Affairs.
815	Section 9.  Paragraph (b) of subsection (1) of section
816	400.610, Florida Statutes, is amended to read:
817	400.610  Administration and management of a hospice.--
818	(1)  A hospice shall have a clearly defined organized
819	governing body, consisting of a minimum of seven persons who are
820	representative of the general population of the community
821	served. The governing body shall have autonomous authority and
822	responsibility for the operation of the hospice and shall meet
823	at least quarterly. The governing body shall:
824	(b)1.  Prepare and maintain a comprehensive emergency
825	management plan that provides for continuing hospice services in
826	the event of an emergency that is consistent with local special
827	needs plans. The plan shall include provisions for ensuring
828	continuing care to hospice patients who go to special needs
829	shelters. The plan shall include the means by which the hospice
830	provider will continue to provide staff to perform the same type
831	and quantity of services to their patients who evacuate to
832	special needs shelters that were being provided to those
833	patients prior to evacuation. The plan is subject to review and
834	approval by the county health department, except as provided in
835	subparagraph 2. During its review, the county health department
836	shall contact state and local health and medical stakeholders,
837	when necessary ensure that the department, the agency, and the
838	local chapter of the American Red Cross or other lead sheltering
839	agency have an opportunity to review and comment on the plan.
840	The county health department shall complete its review to ensure
841	that the plan is in accordance with the criteria set forth in
842	the rules of the Department of Elderly Affairs within 90 60 days
843	after receipt of the plan and shall either approve the plan or
844	advise the hospice of necessary revisions. Hospice providers may
845	establish links to local emergency operations centers to
846	determine a mechanism to approach specific areas within a
847	disaster area in order for the provider to reach its clients.
848	The presentation of hospice clients to a special needs shelter
849	without the hospice provider making a good faith effort to
850	provide services in the shelter setting shall be considered
851	abandonment of the client subject to sanction as provided by law
852	or rule. For the purposes of this section, "good faith effort"
853	may be demonstrated by documented attempts of staff to follow
854	procedures as outlined in the hospice's comprehensive emergency
855	management plan and to provide continuing care for those hospice
856	clients who have been identified as needing alternative
857	caregiver services in the event of an emergency.
858	2.  For any hospice that operates in more than one county,
859	the Department of Health during its review shall contact state
860	and local health and medical stakeholders, when necessary review
861	the plan, after consulting with all of the county health
862	departments, the agency, and all the local chapters of the
863	American Red Cross or other lead sheltering agency in the areas
864	of operation for that particular hospice. The Department of
865	Health shall complete its review to ensure that the plan is in
866	accordance with the criteria set forth in the rules of the
867	Department of Elderly Affairs within 90 days after receipt of
868	the plan and shall either approve the plan or advise the hospice
869	of necessary revisions. The Department of Health shall make
870	every effort to avoid imposing on the hospice differing
871	requirements on a hospice that operates in more than one county
872	as a result of differing or conflicting comprehensive plan
873	requirements of the based on differences between counties in
874	which the hospice operates.
875	Section 10.  Subsections (13) through (16) of section
876	400.925, Florida Statutes, are renumbered as subsections (14)
877	through (17), respectively, and a new subsection (13) is added
878	to that section to read:
879	400.925  Definitions.--As used in this part, the term:
880	(13)  "Life-supporting or life-sustaining equipment" means
881	a device that is essential to, or that yields information that
882	is essential to, the restoration or continuation of a bodily
883	function important to the continuation of human life. Life-
884	supporting or life-sustaining equipment includes apnea monitors,
885	enteral feeding pumps, infusion pumps, portable home dialysis
886	equipment, and ventilator equipment and supplies for all related
887	equipment, including oxygen equipment and related respiratory
888	equipment.
889	Section 11.  Subsections (20), (21), and (22) are added to
890	section 400.934, Florida Statutes, to read:
891	400.934  Minimum standards.--As a requirement of licensure,
892	home medical equipment providers shall:
893	(20)(a)  Prepare and maintain a comprehensive emergency
894	management plan that meets minimum criteria established by the
895	agency in rule under s. 400.935. The plan shall be updated
896	annually and shall provide for continuing home medical equipment
897	services for life-supporting or life-sustaining equipment, as
898	defined in 400.925, during an emergency that interrupts home
899	medical equipment services in a patient's home. The plan shall
900	include:
901	1.  The means by which the home medical equipment provider
902	will continue to provide equipment to perform the same type and
903	quantity of services to its patients who evacuate to special
904	needs shelters that were being provided to those patients prior
905	to evacuation.
906	2.  The means by which the home medical equipment provider
907	establishes and maintains an effective response to emergencies
908	and disasters, including plans for:
909	a.  Notification of staff when emergency response measures
910	are initiated.
911	b.  Communication between staff members, county health
912	departments, and local emergency management agencies, which
913	shall include provisions for a backup communications system.
914	c.  Identification of resources necessary to continue
915	essential care or services or referrals to other organizations
916	subject to written agreement.
917	d.  Contacting and prioritizing patients in need of
918	continued medical equipment services and supplies.
919	(b)  The plan is subject to review and approval by the
920	county health department. During its review, the county health
921	department shall contact state and local health and medical
922	stakeholders, when necessary. The county health department shall
923	complete its review to ensure that the plan is in accordance
924	with the criteria set forth in the rules of the Agency for
925	Health Care Administration within 90 days after receipt of the
926	plan. If a home medical equipment provider fails to submit a
927	plan or fails to submit requested information or revisions to
928	the county health department within 30 days after written
929	notification from the county health department, the county
930	health department shall notify the Agency for Health Care
931	Administration. The agency shall notify the home medical
932	equipment provider that such failure constitutes a deficiency,
933	subject to a fine of $5,000 per occurrence. If the plan is not
934	submitted, information is not provided, or revisions are not
935	made as requested, the agency may impose the fine.
936	(c)  The Department of Health shall review the
937	comprehensive emergency management plan of any home medical
938	equipment provider that operates in more than one county. The
939	department shall complete its review within 90 days after
940	receipt of the plan and shall either approve the plan or advise
941	the home medical equipment provider of necessary revisions. The
942	department shall make every effort to avoid imposing differing
943	requirements on home medical equipment providers that operate in
944	more than one county as a result of differing or conflicting
945	comprehensive plan requirements of the counties in which the
946	home medical equipment provider operates.
947	(21)  Each home medical equipment provider shall maintain a
948	current prioritized list of patients who need continued services
949	during an emergency. The list shall indicate the means by which
950	services shall be continued for each patient in the event of an
951	emergency or disaster, whether the patient is to be transported
952	to a special needs shelter, and whether the patient has life-
953	supporting or life-sustaining equipment, including the specific
954	type of equipment and related supplies. The list shall be
955	furnished to county health departments and local emergency
956	management agencies, upon request.
957	(22)  Home medical equipment providers may establish links
958	to local emergency operations centers to determine a mechanism
959	to approach specific areas within a disaster area in order for
960	the provider to reach its patients.
961	Section 12.  Subsection (11) is added to section 400.935,
962	Florida Statutes, to read:
963	400.935  Rules establishing minimum standards.--The agency
964	shall adopt, publish, and enforce rules to implement this part,
965	which must provide reasonable and fair minimum standards
966	relating to:
967	(11)  Preparation of the comprehensive emergency management
968	plan under s. 400.934 and the establishment of minimum criteria
969	for the plan, including the maintenance of patient equipment and
970	supply lists that can accompany patients who are transported
971	from their homes. Such rules shall be formulated in consultation
972	with the Department of Health and the Department of Community
973	Affairs.
974	Section 13.  Section 408.831, Florida Statutes, is amended
975	to read:
976	408.831  Denial, suspension, or revocation of a license,
977	registration, certificate, or application.--
978	(1)  In addition to any other remedies provided by law, the
979	agency may deny each application or suspend or revoke each
980	license, registration, or certificate of entities regulated or
981	licensed by it:
982	(a)  If the applicant, licensee, registrant, or
983	certificateholder, or, in the case of a corporation,
984	partnership, or other business entity, if any officer, director,
985	agent, or managing employee of that business entity or any
986	affiliated person, partner, or shareholder having an ownership
987	interest equal to 5 percent or greater in that business entity,
988	has failed to pay all outstanding fines, liens, or overpayments
989	assessed by final order of the agency or final order of the
990	Centers for Medicare and Medicaid Services, not subject to
991	further appeal, unless a repayment plan is approved by the
992	agency; or
993	(b)  For failure to comply with any repayment plan.
994	(2)  In reviewing any application requesting a change of
995	ownership or change of the licensee, registrant, or
996	certificateholder, the transferor shall, prior to agency
997	approval of the change, repay or make arrangements to repay any
998	amounts owed to the agency. Should the transferor fail to repay
999	or make arrangements to repay the amounts owed to the agency,
1000	the issuance of a license, registration, or certificate to the
1001	transferee shall be delayed until repayment or until
1002	arrangements for repayment are made.
1003	(3)  Entities subject to this section may exceed their
1004	licensed capacity to act as a receiving facility in accordance
1005	with an emergency operations plan for clients of evacuating
1006	providers from a geographic area where an evacuation order has
1007	been issued by a local authority having jurisdiction. While in
1008	an overcapacity status, each provider must furnish or arrange
1009	for appropriate care and services to all clients. In addition,
1010	the agency may approve requests for overcapacity beyond 15 days,
1011	which approvals may be based upon satisfactory justification and
1012	need as provided by the receiving and sending facility.
1013	(4)  An inactive license may be issued to a licensee
1014	subject to this section when the provider is located in a
1015	geographic area where a state of emergency was declared by the
1016	Governor if the provider:
1017	(a)  Suffered damage to the provider's operation during
1018	that state of emergency.
1019	(b)  Is currently licensed.
1020	(c)  Does not have a provisional license.
1021	(d)  Will be temporarily unable to provide services but is
1022	reasonably expected to resume services within 12 months.
1023
1024	An inactive license may be issued for a period not to exceed 12
1025	months but may be renewed by the agency for up to 6 additional
1026	months upon demonstration to the agency of progress toward
1027	reopening. A request by a licensee for an inactive license or to
1028	extend the previously approved inactive period must be submitted
1029	in writing to the agency, accompanied by written justification
1030	for the inactive license which states the beginning and ending
1031	dates of inactivity and includes a plan for the transfer of any
1032	clients to other providers and appropriate licensure fees. Upon
1033	agency approval, the licensee shall notify clients of any
1034	necessary discharge or transfer as required by authorizing
1035	statutes or applicable rules. The beginning of the inactive
1036	licensure period shall be the date the provider ceases
1037	operations. The end of the inactive period shall become the
1038	licensee expiration date, and all licensure fees must be
1039	current, paid in full, and may be prorated. Reactivation of an
1040	inactive license requires the prior approval by the agency of a
1041	renewal application, including payment of licensure fees and
1042	agency inspections indicating compliance with all requirements
1043	of this part and applicable rules and statutes.
1044	(5)(3)  This section provides standards of enforcement
1045	applicable to all entities licensed or regulated by the Agency
1046	for Health Care Administration. This section controls over any
1047	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
1048	394, 395, 400, 408, 468, 483, and 641 or rules adopted pursuant
1049	to those chapters.
1050	Section 14.  This act shall take effect July 1, 2006.

CODING: Words stricken are deletions; words underlined are additions.