HB 7139

CS

CHAMBER ACTION

1	The Health Care Appropriations Committee recommends the
2	following:
3
4	Council/Committee Substitute
5	Remove the entire bill and insert:
6	A bill to be entitled
7	An act relating to emergency management; amending s.
8	252.355, F.S.; specifying additional entities and agencies
9	that are required to provide registration information to
10	persons with disabilities or special needs for purposes of
11	inclusion within the registry of persons with special
12	needs maintained by local emergency management agencies;
13	providing that the Department of Community Affairs shall
14	be the designated lead agency responsible for community
15	education and outreach to the general public, including
16	persons with special needs, regarding registration as a
17	person with special needs, special needs shelters, and
18	general information regarding shelter stays; requiring the
19	department to disseminate educational and outreach
20	information through local emergency management offices;
21	requiring the department to coordinate community education
22	and outreach related to special needs shelters with
23	specified agencies and entities; providing that special
24	needs shelters must allow persons with special needs to
25	bring service animals into special needs shelters;
26	revising provisions with respect to the required
27	notification of residential utility customers of the
28	availability of the special needs registration program;
29	providing that specified confidential and exempt
30	information relating to registration of persons with
31	special needs be provided to the Department of Health and
32	local law enforcement agencies; creating s. 252.3568,
33	F.S.; requiring the Division of Emergency Management to
34	address evacuation of persons with pets in the shelter
35	component of the state comprehensive emergency management
36	plan; creating s. 252.357, F.S., requiring the Florida
37	Comprehensive Emergency Management Plan to permit the
38	Agency for Health Care Administration to make initial
39	contact with each nursing home in a disaster area;
40	requiring the agency to annually publish an emergency
41	telephone number that may be used by nursing homes to
42	contact the agency; amending s. 252.385, F.S., relating to
43	public shelter space; requiring the Division of Emergency
44	Management of the Department of Community Affairs to
45	biennially prepare and submit a statewide emergency
46	shelter plan to the Governor and the Cabinet for approval;
47	providing plan requirements; requiring the Department of
48	Health to provide specified assistance to the division;
49	revising those facilities which are excluded as being
50	suitable for use as public hurricane evacuation shelters;
51	requiring local emergency management agencies to inspect a
52	designated facility prior to activation to determine its
53	readiness; amending s. 381.0303, F.S.; providing for the
54	operation, maintenance, and closure of special needs
55	shelters; providing that local Children's Medical Services
56	offices shall assume lead responsibility for specified
57	coordination with respect to the development of a plan for
58	the staffing and medical management of pediatric special
59	needs shelters; requiring such plans to conform to the
60	local comprehensive emergency management plan; requiring
61	county governments to assist the Department of Health with
62	nonmedical staffing and operation of special needs
63	shelters; requiring local health departments and emergency
64	management agencies to coordinate such efforts to ensure
65	appropriate staffing; providing that the appropriate
66	county health department, Children's Medical Services
67	office, and local emergency management agency shall
68	jointly determine the responsibility for medical
69	supervision in a special needs shelter; providing
70	notification requirements; requiring local emergency
71	management agencies to be responsible for the
72	infrastructure and closure of special needs shelters;
73	requiring the emergency management agency and the local
74	health department to coordinate efforts to ensure
75	appropriate designation, operation, and infrastructure in
76	special needs shelters; providing that a county health
77	department is not prohibited from entering into an
78	alternative agreement with a local emergency management
79	agency to assume the lead responsibility for special needs
80	shelter supplies and equipment; providing that state
81	employees with a preestablished role in disaster response
82	are subject to serve in times of disaster in specified
83	capacities; requiring the Secretary of Elderly Affairs to
84	convene multiagency special needs shelter discharge
85	planning teams to assist local areas that are severely
86	impacted by a natural or manmade disaster that requires
87	the use of special needs shelters; providing duties and
88	responsibilities of such discharge planning teams;
89	providing for the inclusion of specified state agency
90	representatives on each discharge planning team; revising
91	provisions relating to reimbursement of health care
92	practitioners; providing for eligibility of specified
93	health care facilities for reimbursement when a
94	multiagency special needs shelter discharge planning team
95	discharges persons with special needs to such receiving
96	facilities; providing procedures and requirements with
97	respect to such reimbursement; requiring the department to
98	specify by rule expenses that are reimbursable and the
99	rate of reimbursement for services; revising provisions
100	which prescribe means of and procedures for reimbursement;
101	disallowing specified reimbursements; revising provisions
102	with respect to the organization, role, duties, and
103	composition of the special needs shelter interagency
104	committee; requiring the department to adopt specified
105	rules with respect to special needs shelters; providing
106	requirements with respect to emergency management plans
107	submitted to a county health department by a home health
108	agency, nurse registry, hospice, or home medical equipment
109	provider; amending ss. 400.492, 400.497, 400.506, 400.610,
110	and 400.934, F.S.; revising requirements with respect to
111	the comprehensive emergency management plans of home
112	health agencies, nurse registries, and hospices, and
113	providing such requirements with respect to home medical
114	equipment providers, to include the means by which
115	continuing services will be provided to patients who
116	evacuate to special needs shelters; authorizing the
117	establishment of links to local emergency operations
118	centers for specified purposes; providing actions that
119	constitute abandonment of a patient; providing sanctions
120	for abandonment; revising requirements of a county health
121	department with respect to review of a comprehensive
122	emergency management plan submitted by a home health
123	agency, nurse registry, or hospice, and providing such
124	requirements with respect to a home medical equipment
125	provider; providing requirements upon failure to submit a
126	plan or requested information to the department; providing
127	for imposition of a fine; revising requirements of the
128	Department of Health with respect to review of the plan of
129	a home health agency, nurse registry, or hospice that
130	operates in more than one county, and providing such
131	requirements with respect to a home medical equipment
132	provider that operates in more than one county; providing
133	that the preparation and maintenance of a comprehensive
134	emergency management plan by a home medical equipment
135	provider is a requirement for licensure and must meet
136	minimum criteria established by the Agency for Health Care
137	Administration; providing plan requirements; providing
138	that the plan is subject to review and approval by the
139	county health department; requiring each home medical
140	equipment provider to maintain a current prioritized list
141	of patients who need continued services during an
142	emergency; amending s. 400.925, F.S.; defining "life-
143	supporting or life-sustaining equipment" for purposes of
144	pt. X of ch. 400, F.S., relating to home medical equipment
145	providers; amending s. 400.935, F.S.; requiring the Agency
146	for Health Care Administration to adopt rules with respect
147	to the comprehensive emergency management plan prepared by
148	a home medical equipment services provider; amending s.
149	408.831, F.S.; providing that entities regulated or
150	licensed by the Agency for Health Care Administration may
151	exceed their licensed capacity to act as a receiving
152	facility under specified circumstances; providing
153	requirements while such entities are in an overcapacity
154	status; providing for issuance of an inactive license to
155	such licensees under specified conditions; providing
156	requirements and procedures with respect to the issuance
157	and reactivation of an inactive license; providing fees;
158	providing legislative findings with respect to the
159	equipping of all designated public special needs hurricane
160	evacuation shelters with permanent emergency power
161	generating capacity by a specified date; requiring the
162	Department of Community Affairs to work with local
163	communities to ensure a sufficient number of public
164	special needs shelters designated to meet anticipated
165	demand; specifying the percentage of local match for such
166	projects; providing an appropriation to the Department of
167	Community Affairs to establish a competitive award
168	process; specifying a limit with respect to administration
169	of the funding; providing legislative findings with
170	respect to retrofitting public hurricane evacuation
171	shelters; providing criteria for the retrofitting of a
172	public hurricane evacuation shelter; providing an
173	appropriation to the Department of Community Affairs to
174	establish a competitive award process; specifying a limit
175	with respect to administration of the funding; providing
176	an appropriation to implement the provisions of emergency
177	management plan reviews for home health agencies and nurse
178	registry, hospice, and home medical equipment providers;
179	providing an effective date.
180
181	Be It Enacted by the Legislature of the State of Florida:
182
183	Section 1.  Section 252.355, Florida Statutes, is amended
184	to read:
185	252.355  Registry of persons with special needs; notice.--
186	(1)  In order to meet the special needs of persons who
187	would need assistance during evacuations and sheltering because
188	of physical, mental, cognitive impairment, or sensory
189	disabilities, each local emergency management agency in the
190	state shall maintain a registry of persons with special needs
191	located within the jurisdiction of the local agency. The
192	registration shall identify those persons in need of assistance
193	and plan for resource allocation to meet those identified needs.
194	To assist the local emergency management agency in identifying
195	such persons, home health agencies, hospices, nurse registries,
196	home medical equipment providers, the Department of Children and
197	Family Services, the Department of Health, the Agency for Health
198	Care Administration, the Department of Education, Agency for
199	Persons with Disabilities, Department of Labor and Employment
200	Security, and the Department of Elderly Affairs shall provide
201	registration information to all of their special needs clients
202	and to all people with disabilities or special needs who receive
203	services incoming clients as a part of the intake process. The
204	registry shall be continuously maintained updated annually. The
205	registration program shall give persons with special needs the
206	option of preauthorizing emergency response personnel to enter
207	their homes during search and rescue operations if necessary to
208	assure their safety and welfare following disasters.
209	(2)  The Department of Community Affairs shall be the
210	designated lead agency responsible for community education and
211	outreach to the general public, including special needs clients,
212	regarding registration and special needs shelters and general
213	information regarding shelter stays. The Department of Community
214	Affairs shall disseminate such educational and outreach
215	information through the local emergency management offices. The
216	department shall coordinate the development of curriculum and
217	dissemination of all community education and outreach related to
218	special needs shelters with the Clearinghouse on Disability
219	Information of the Governor's Working Group on the Americans
220	with Disabilities Act, the Department of Children and Family
221	Services, the Department of Health, the Agency for Health Care
222	Administration, the Department of Education, the Agency for
223	Persons with Disabilities, and the Department of Elderly
224	Affairs.
225	(3)  A person with special needs shall be allowed to bring
226	his or her service animal into a special needs shelter in
227	compliance with the Americans with Disabilities Act of 1990,
228	Pub. L. No. 101-336. Because a special needs shelter is
229	considered a public facility when it is activated for a
230	disaster, persons with disabilities must be allowed access to
231	special needs shelters when accompanied by a service animal in
232	compliance with the Americans with Disabilities Act, which
233	provides that businesses and organizations that serve the public
234	must allow people with disabilities to bring their service
235	animals into all areas of a facility where customers are
236	normally allowed to go.
237	(4)(2)  On or before May 1 of each year Each electric
238	utility in the state shall annually notify residential customers
239	in its service area of the availability of the registration
240	program available through their local emergency management
241	agency with either:.
242	(a)  An initial notification upon the activation of new
243	residential service with the electric utility followed by one
244	annual notification between January 1 and May 31; or
245	(b)  Two separate annual notifications between January 1
246	and May 31.
247
248	The notification required under this subsection may be made by
249	any available means, including, but not limited to, written,
250	electronic, or verbal notification, and may be made concurrently
251	with any other notification to residential customers required by
252	law or rule.
253	(5)(3)  All records, data, information, correspondence, and
254	communications relating to the registration of persons with
255	special needs as provided in subsection (1) are confidential and
256	exempt from the provisions of s. 119.07(1), except that such
257	information shall be available to other emergency response
258	agencies, as determined by the local emergency management
259	director, and to the Department of Health in the furtherance of
260	its duties and responsibilities. Local law enforcement agencies
261	shall be provided complete shelter registration information upon
262	request.
263	(6)(4)  All appropriate agencies and community-based
264	service providers, including home health care providers,
265	hospices, nurse registries, and home medical equipment
266	providers, shall assist emergency management agencies by
267	collecting registration information for persons with special
268	needs as part of program intake processes, establishing programs
269	to increase the awareness of the registration process, and
270	educating clients about the procedures that may be necessary for
271	their safety during disasters. Clients of state or federally
272	funded service programs with physical, mental, cognitive
273	impairment, or sensory disabilities who need assistance in
274	evacuating, or when in shelters, must register as persons with
275	special needs.
276	Section 2.  Section 252.3568, Florida Statutes, is created
277	to read:
278	252.3568  Emergency sheltering of persons with pets.--In
279	accordance with the provisions of s. 252.35, the division shall
280	address the evacuation of persons with pets in the shelter
281	component of the state comprehensive emergency management plan.
282	The Department of Agriculture and Consumer Services shall assist
283	the division in determining strategies regarding this activity.
284	Section 3.  Section 252.357, Florida Statutes, is created
285	to read:
286	252.357  Monitoring of nursing homes during disaster.--The
287	Florida Comprehensive Emergency Management Plan shall permit the
288	Agency for Health Care Administration, working from the agency's
289	offices or in the Emergency Operations Center, ESF-8, to make
290	initial contact with each nursing home in the disaster area. The
291	agency, by July 15, 2006, and annually thereafter, shall publish
292	on the Internet an emergency telephone number that may be used
293	by nursing homes to contact the agency on a schedule established
294	by the agency to report requests for assistance. The agency may
295	also provide the telephone number to each facility when it makes
296	the initial facility call.
297	Section 4.  Subsection (2) and paragraphs (a) and (b) of
298	subsection (4) of section 252.385, Florida Statutes, are amended
299	to read:
300	252.385  Public shelter space.--
301	(2)(a)  The division shall administer a program to survey
302	existing schools, universities, community colleges, and other
303	state-owned, municipally owned, and county-owned public
304	buildings and any private facility that the owner, in writing,
305	agrees to provide for use as a public hurricane evacuation
306	shelter to identify those that are appropriately designed and
307	located to serve as such shelters. The owners of the facilities
308	must be given the opportunity to participate in the surveys. The
309	Board of Regents, district school boards, community college
310	boards of trustees, and the Department of Education are
311	responsible for coordinating and implementing the survey of
312	public schools, universities, and community colleges with the
313	division or the local emergency management agency.
314	(b)  By January 31 of each even-numbered year, the division
315	shall prepare and submit a statewide emergency shelter plan to
316	the Governor and the Cabinet for approval, subject to the
317	requirements for approval provided in s. 1013.37(2). The plan
318	shall identify the general location and square footage of
319	special needs shelters, by regional planning council region,
320	during the next 5 years. The plan shall also include information
321	on the availability of shelters that accept pets. The Department
322	of Health shall assist the division in determining the estimated
323	need for special needs shelter space and the adequacy of
324	facilities to meet the needs of persons with special needs based
325	on information from the registries of persons with special needs
326	and other information.
327	(4)(a)  Public facilities, including schools, postsecondary
328	education facilities, and other facilities owned or leased by
329	the state or local governments, but excluding hospitals, hospice
330	care facilities, assisted living facilities, or nursing homes,
331	which are suitable for use as public hurricane evacuation
332	shelters shall be made available at the request of the local
333	emergency management agencies. The local emergency management
334	agency shall inspect a designated facility to determine its
335	readiness prior to activating the facility for a specific
336	hurricane or disaster. Such agencies shall coordinate with the
337	appropriate school board, university, community college, or
338	local governing board when requesting the use of such facilities
339	as public hurricane evacuation shelters.
340	(b)  The Department of Management Services shall
341	incorporate provisions for the use of suitable leased public
342	facilities as public hurricane evacuation shelters into lease
343	agreements for state agencies. Suitable leased public facilities
344	include leased public facilities that are solely occupied by
345	state agencies and have at least 2,000 square feet of net floor
346	area in a single room or in a combination of rooms having a
347	minimum of 400 square feet in each room. The net square footage
348	of floor area shall must be determined by subtracting from the
349	gross square footage the square footage of spaces such as
350	mechanical and electrical rooms, storage rooms, open corridors,
351	restrooms, kitchens, science or computer laboratories, shop or
352	mechanical areas, administrative offices, records vaults, and
353	crawl spaces.
354	Section 5.  Section 381.0303, Florida Statutes, is amended
355	to read:
356	381.0303  Health practitioner recruitment for Special needs
357	shelters.--
358	(1)  PURPOSE.--The purpose of this section is to provide
359	for the operation, maintenance, and closure of special needs
360	shelters and to designate the Department of Health, through its
361	county health departments, as the lead agency for coordination
362	of the recruitment of health care practitioners, as defined in
363	s. 456.001(4), to staff special needs shelters in times of
364	emergency or disaster and to provide resources to the department
365	to carry out this responsibility. However, nothing in this
366	section prohibits a county health department from entering into
367	an agreement with a local emergency management agency to assume
368	the lead responsibility for recruiting health care
369	practitioners.
370	(2)  SPECIAL NEEDS SHELTER PLAN; STAFFING; CLOSURE; STATE
371	AGENCY ASSISTANCE AND STAFFING.--Provided funds have been
372	appropriated to support medical services disaster coordinator
373	positions in county health departments:,
374	(a)  The department shall assume lead responsibility for
375	the local coordination of local medical and health care
376	providers, the American Red Cross, and other interested parties
377	in developing a plan for the staffing and medical management of
378	special needs shelters. The local Children's Medical Services
379	offices shall assume lead responsibility for the coordination of
380	local medical and health care providers, the American Red Cross,
381	and other interested parties in developing a plan for the
382	staffing and medical management of pediatric special needs
383	shelters. Plans shall conform to The plan shall be in
384	conformance with the local comprehensive emergency management
385	plan.
386	(b)(a)  County health departments shall, in conjunction
387	with the local emergency management agencies, have the lead
388	responsibility for coordination of the recruitment of health
389	care practitioners to staff local special needs shelters. County
390	health departments shall assign their employees to work in
391	special needs shelters when those employees are needed to
392	protect the health and safety of persons with special needs of
393	patients. County governments shall assist the Department of
394	Health with nonmedical staffing and the operation of special
395	needs shelters. The local health department and emergency
396	management agency shall coordinate these efforts to ensure
397	appropriate staffing in special needs shelters.
398	(c)(b)  The appropriate county health department,
399	Children's Medical Services office, and local emergency
400	management agency shall jointly decide determine who has
401	responsibility for medical supervision in each a special needs
402	shelter and shall notify the Division of Emergency Management
403	and the Department of Health of their decision.
404	(d)(c)  Local emergency management agencies shall be
405	responsible for the designation, and operation, and
406	infrastructure of special needs shelters during times of
407	emergency or disaster and the closure of the facilities
408	following an emergency or disaster. The emergency management
409	agency and the local health department shall coordinate these
410	efforts to ensure appropriate designation, operation, and
411	infrastructure in special needs shelters. County health
412	departments shall assist the local emergency management agency
413	with regard to the management of medical services in special
414	needs shelters. However, nothing in this section prohibits a
415	county health department from entering into an alternative
416	agreement with a local emergency management agency to assume the
417	lead responsibility for special needs shelter supplies and
418	equipment.
419	(e)  Any state employee with a preestablished role in
420	disaster response that has been designated by the employing
421	agency is subject to serve in times of disaster in a capacity
422	that is commensurate with the employee's knowledge, skills, and
423	abilities and to participate in any needed activities related to
424	the disaster unless the employee has other mandated response
425	activities that preclude participation.
426	(f)  The Secretary of Elderly Affairs, or his or her
427	designee, shall convene, at any time that he or she deems
428	appropriate and necessary, a multiagency special needs shelter
429	discharge planning team or teams to assist local areas that are
430	severely impacted by a natural or manmade disaster that requires
431	the use of special needs shelters. Multiagency special needs
432	shelter discharge planning teams shall provide assistance to
433	local emergency management agencies with the continued operation
434	or closure of the shelters, as well as with the discharge of
435	special needs clients to alternate facilities if necessary.
436	Local emergency management agencies may request the assistance
437	of a multiagency special needs shelter discharge planning team
438	by alerting statewide emergency management officials of the
439	necessity for additional assistance in their area. The Secretary
440	of Elderly Affairs is encouraged to proactively work with other
441	state agencies prior to any natural disasters for which warnings
442	are provided to ensure that multiagency special needs shelter
443	discharge planning teams are ready to assemble and deploy
444	rapidly upon a determination by state emergency management
445	officials that a disaster area requires additional assistance.
446	The Secretary of Elderly Affairs may call upon any state agency
447	or office to provide staff to assist a multiagency special needs
448	shelter discharge planning team or teams. Unless the secretary
449	determines that the nature or circumstances surrounding the
450	disaster do not warrant participation from a particular agency's
451	staff, each multiagency special needs shelter discharge planning
452	team shall include at least one representative from each of the
453	following state agencies:
454	1.  Department of Elderly Affairs.
455	2.  Department of Health.
456	3.  Department of Children and Family Services.
457	4.  Department of Veterans' Affairs.
458	5.  Department of Community Affairs.
459	6.  Agency for Health Care Administration.
460	7.  Agency for Persons with Disabilities.
461	(3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
462	FACILITIES.--
463	(a)  The Department of Health shall upon request reimburse,
464	subject to the availability of funds for this purpose, health
465	care practitioners, as defined in s. 456.001, provided the
466	practitioner is not providing care to a patient under an
467	existing contract, and emergency medical technicians and
468	paramedics licensed under pursuant to chapter 401 for medical
469	care provided at the request of the department in special needs
470	shelters or at other locations during times of emergency or a
471	declared major disaster. Reimbursement for health care
472	practitioners, except for physicians licensed under pursuant to
473	chapter 458 or chapter 459, shall be based on the average hourly
474	rate that such practitioners were paid according to the most
475	recent survey of Florida hospitals conducted by the Florida
476	Hospital Association or other nationally or state recognized
477	data source. Reimbursement shall be requested on forms prepared
478	by the Department of Health and shall be paid as specified in
479	paragraph (c).
480	(b)  If, upon closure of a special needs shelter, a
481	multiagency special needs shelter discharge planning team
482	determines that it is necessary to discharge persons with
483	special needs to other health care facilities, such as
484	hospitals, nursing homes, assisted living facilities, and
485	community residential homes, the receiving facilities shall be
486	eligible for reimbursement for services provided to the
487	individuals for up to 90 days. Any facility eligible for
488	reimbursement under this paragraph shall submit invoices for
489	reimbursement on forms developed by the department. A facility
490	must show proof of a written request from a representative of an
491	agency serving on the multiagency special needs shelter
492	discharge planning team that the individual for whom the
493	facility is seeking reimbursement for services rendered was
494	referred to that facility from a special needs shelter. The
495	department shall specify by rule which expenses are reimbursable
496	and the rate of reimbursement for each service. Reimbursement
497	for the services described in this paragraph shall be paid as
498	specified in paragraph (c).
499	(c)  If a Presidential Disaster Declaration has been issued
500	made, and the Federal Government makes funds available, the
501	department shall request federal use such funds for
502	reimbursement of eligible expenditures. In other situations, or
503	if federal funds do not fully compensate the department for
504	reimbursements permissible under reimbursement made pursuant to
505	this section, the department shall process a budget amendment to
506	obtain reimbursement from unobligated, unappropriated moneys in
507	the General Revenue Fund. The department shall not provide
508	reimbursement to facilities under this subsection for services
509	provided to a person with special needs if, during the period of
510	time in which the services were provided, the individual was
511	enrolled in another state-funded program, such as Medicaid or
512	another similar program, was covered under a policy of health
513	insurance as defined in s. 624.603, or was a member of a health
514	maintenance organization or prepaid health clinic as defined in
515	chapter 641, which would otherwise pay for the same services.
516	Travel expense and per diem costs shall be reimbursed pursuant
517	to s. 112.061.
518	(4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may
519	use the registries established in ss. 401.273 and 456.38 when
520	health care practitioners are needed to staff special needs
521	shelters or to assist with other disaster-related activities
522	staff disaster medical assistance teams.
523	(5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The
524	Secretary Department of Health may establish a special needs
525	shelter interagency committee and serve as or appoint a designee
526	to serve as the committee's chair. The department shall provide
527	any necessary staff and resources to support the committee in
528	the performance of its duties, to be chaired and staffed by the
529	department. The committee shall address and resolve problems
530	related to special needs shelters not addressed in the state
531	comprehensive emergency medical plan and shall consult on serve
532	as an oversight committee to monitor the planning and operation
533	of special needs shelters.
534	(a)  The committee shall may:
535	1.  Develop, and negotiate, and regularly review any
536	necessary interagency agreements.
537	2.  Undertake other such activities as the department deems
538	necessary to facilitate the implementation of this section.
539	3.  Submit recommendations to the Legislature as necessary.
540	(b)  The special needs shelter interagency committee shall
541	be composed of representatives of emergency management, health,
542	medical, and social services organizations. Membership shall
543	include, but shall not be limited to, representatives of the
544	Departments of Health, Community Affairs, Children and Family
545	Services, Elderly Affairs, Labor and Employment Security, and
546	Education; the Agency for Health Care Administration; the
547	Florida Medical Association; the Florida Osteopathic Medical
548	Association; Associated Home Health Industries of Florida, Inc.;
549	the Florida Nurses Association; the Florida Health Care
550	Association; the Florida Assisted Living Affiliation
551	Association; the Florida Hospital Association; the Florida
552	Statutory Teaching Hospital Council; the Florida Association of
553	Homes for the Aging; the Florida Emergency Preparedness
554	Association; the American Red Cross; Florida Hospices and
555	Palliative Care, Inc.; the Association of Community Hospitals
556	and Health Systems; the Florida Association of Health
557	Maintenance Organizations; the Florida League of Health Systems;
558	Private Care Association; and the Salvation Army; the Florida
559	Association of Aging Services Providers; AARP; and the Florida
560	Renal Coalition.
561	(c)  Meetings of the committee shall be held in
562	Tallahassee, and members of the committee shall serve at the
563	expense of the agencies or organizations they represent. The
564	committee shall make every effort to use teleconference or video
565	conference capabilities in order to ensure statewide input and
566	participation.
567	(6)  RULES.--The department has the authority to adopt
568	rules necessary to implement this section. Rules shall may
569	include:
570	(a)  The a definition of a "person with special needs",
571	including eligibility criteria for individuals with physical,
572	mental, cognitive impairment, or sensory disabilities and the
573	services a person with special needs can expect to receive in a
574	special needs shelter patient, specify physician reimbursement,
575	and designate which county health departments will have
576	responsibility for implementation of subsections (2) and (3).
577	(b)  The process for special needs shelter health care
578	practitioners and facility reimbursement for services provided
579	in a disaster.
580	(c)  Guidelines for special needs shelter staffing levels
581	to provide services.
582	(d)  The definition of and standards for special needs
583	shelter supplies and equipment, including durable medical
584	equipment.
585	(e)  Compliance with applicable laws relating to service
586	animals.
587	(f)  Standards for the special needs shelter registration
588	process, including guidelines for addressing the needs of
589	unregistered persons in need of a special needs shelter.
590	(g)  Standards for addressing the needs of families where
591	only one dependent is eligible for admission to a special needs
592	shelter and the needs of adults with special needs who are
593	caregivers for individuals without special needs.
594	(h)  The requirement of the county health departments to
595	seek the participation of hospitals, nursing homes, assisted
596	living facilities, home health agencies, hospice providers,
597	nurse registries, home medical equipment providers, dialysis
598	centers, and other health and medical emergency preparedness
599	stakeholders in preevent planning activities.
600	(7)  REVIEW OF EMERGENCY MANAGEMENT PLANS; CONTINUITY OF
601	CARE.--Each emergency management plan submitted to a county
602	health department by a home health agency under s. 400.492, by a
603	nurse registry pursuant to s. 400.506(16)(e), by a hospice
604	pursuant to s. 400.610(1)(b), or by a home medical equipment
605	provider pursuant to s. 400.934(20)(a) shall specify the means
606	by which the home health agency, nurse registry, hospice, or
607	home medical equipment provider will continue to provide staff
608	and equipment to perform the same type and quantity of services
609	for their patients who evacuate to special needs shelters that
610	were being provided to those patients prior to evacuation. The
611	submission of emergency management plans to county health
612	departments by home health agencies, pursuant to s.
613	400.497(8)(c) and (d) and by nurse registries, pursuant to s.
614	400.506(16)(e) and by hospice programs, pursuant to s.
615	400.610(1)(b) and home medical equipment providers is
616	conditional upon the receipt of an appropriation by the
617	department to establish medical services disaster coordinator
618	positions in county health departments unless the secretary of
619	the department and a local county commission jointly determine
620	to require such plans to be submitted based on a determination
621	that there is a special need to protect public health in the
622	local area during an emergency.
623	Section 6.  Section 400.492, Florida Statutes, is amended
624	to read:
625	400.492  Provision of services during an emergency.--Each
626	home health agency shall prepare and maintain a comprehensive
627	emergency management plan that is consistent with the standards
628	adopted by national or state accreditation organizations and
629	consistent with the local special needs plan. The plan shall be
630	updated annually and shall provide for continuing home health
631	services during an emergency that interrupts patient care or
632	services in the patient's home. The plan shall include the means
633	by which the home health agency will continue to provide staff
634	to perform the same type and quantity of services to their
635	patients who evacuate to special needs shelters that were being
636	provided to those patients prior to evacuation. The plan shall
637	describe how the home health agency establishes and maintains an
638	effective response to emergencies and disasters, including:
639	notifying staff when emergency response measures are initiated;
640	providing for communication between staff members, county health
641	departments, and local emergency management agencies, including
642	a backup system; identifying resources necessary to continue
643	essential care or services or referrals to other organizations
644	subject to written agreement; and prioritizing and contacting
645	patients who need continued care or services.
646	(1)  Each patient record for patients who are listed in the
647	registry established pursuant to s. 252.355 shall include a
648	description of how care or services will be continued in the
649	event of an emergency or disaster. The home health agency shall
650	discuss the emergency provisions with the patient and the
651	patient's caregivers, including where and how the patient is to
652	evacuate, procedures for notifying the home health agency in the
653	event that the patient evacuates to a location other than the
654	shelter identified in the patient record, and a list of
655	medications and equipment which must either accompany the
656	patient or will be needed by the patient in the event of an
657	evacuation.
658	(2)  Each home health agency shall maintain a current
659	prioritized list of patients who need continued services during
660	an emergency. The list shall indicate how services shall be
661	continued in the event of an emergency or disaster for each
662	patient and if the patient is to be transported to a special
663	needs shelter, and shall indicate if the patient is receiving
664	skilled nursing services and the patient's medication and
665	equipment needs. The list shall be furnished to county health
666	departments and to local emergency management agencies, upon
667	request.
668	(3)  Home health agencies shall not be required to continue
669	to provide care to patients in emergency situations that are
670	beyond their control and that make it impossible to provide
671	services, such as when roads are impassable or when patients do
672	not go to the location specified in their patient records. Home
673	health agencies may establish links to local emergency
674	operations centers to determine a mechanism to approach specific
675	areas within a disaster area in order for the agency to reach
676	its clients. The presentation of a home health agency client to
677	a special needs shelter without the home health agency making a
678	good faith effort to provide services in the shelter setting
679	shall be considered abandonment of the client and constitutes a
680	class II deficiency, subject to sanctions provided in s.
681	400.484(2)(b). For purposes of this section, "good faith effort"
682	may be demonstrated by documented attempts of staff to follow
683	procedures as outlined in the home health agency's comprehensive
684	emergency management plan, and by the patient's record, which
685	support a finding that continuing care has been provided for
686	those patients who have been identified as needing care by the
687	home health agency in the event of an emergency or disaster
688	under subsection (1).
689	(4)  Notwithstanding the provisions of s. 400.464(2) or any
690	other provision of law to the contrary, a home health agency may
691	provide services in a special needs shelter located in any
692	county.
693	Section 7.  Paragraphs (c) and (d) of subsection (8) of
694	section 400.497, Florida Statutes, are amended to read:
695	400.497  Rules establishing minimum standards.--The agency
696	shall adopt, publish, and enforce rules to implement this part,
697	including, as applicable, ss. 400.506 and 400.509, which must
698	provide reasonable and fair minimum standards relating to:
699	(8)  Preparation of a comprehensive emergency management
700	plan pursuant to s. 400.492.
701	(c)  The plan is subject to review and approval by the
702	county health department. During its review, the county health
703	department shall contact state and local health and medical
704	stakeholders during its review when necessary. ensure that the
705	following agencies, at a minimum, are given the opportunity to
706	review the plan:
707	1.  The local emergency management agency.
708	2.  The Agency for Health Care Administration.
709	3.  The local chapter of the American Red Cross or other
710	lead sheltering agency.
711	4.  The district office of the Department of Children and
712	Family Services.
713
714	The county health department shall complete its review to ensure
715	that the plan is in accordance with the criteria set forth in
716	the rules of the Agency for Health Care Administration within 90
717	60 days after receipt of the plan and shall either approve the
718	plan or advise the home health agency of necessary revisions. If
719	the home health agency fails to submit a plan or fails to submit
720	the requested information or revisions to the county health
721	department within 30 days after written notification from the
722	county health department, the county health department shall
723	notify the Agency for Health Care Administration. The agency
724	shall notify the home health agency that such failure
725	constitutes a deficiency, subject to a fine of $5,000 per
726	occurrence. If the plan is not submitted, information is not
727	provided, or revisions are not made as requested, the agency may
728	impose the fine.
729	(d)  For any home health agency that operates in more than
730	one county, the Department of Health shall review the plan,
731	after consulting with state and local health and medical
732	stakeholders, when necessary all of the county health
733	departments, the agency, and all the local chapters of the
734	American Red Cross or other lead sheltering agencies in the
735	areas of operation for that particular home health agency. The
736	department of Health shall complete its review within 90 days
737	after receipt of the plan and shall either approve the plan or
738	advise the home health agency of necessary revisions. The
739	department of Health shall make every effort to avoid imposing
740	differing requirements on a home health agency that operates in
741	more than one county as a result of differing or conflicting
742	comprehensive plan requirements of the based on differences
743	between counties in which on the home health agency operates.
744	Section 8.  Subsection (16) of section 400.506, Florida
745	Statutes, is amended to read:
746	400.506  Licensure of nurse registries; requirements;
747	penalties.--
748	(16)  Each nurse registry shall prepare and maintain a
749	comprehensive emergency management plan that is consistent with
750	the criteria in this subsection and with the local special needs
751	plan. The plan shall be updated annually. The plan shall include
752	the means by which the nurse registry will continue to provide
753	staff to perform the same type and quantity of services to their
754	patients who evacuate to special needs shelters that were being
755	provided to those patients prior to evacuation. The plan shall
756	specify how the nurse registry shall facilitate the provision of
757	continuous care by persons referred for contract to persons who
758	are registered pursuant to s. 252.355 during an emergency that
759	interrupts the provision of care or services in private
760	residencies. Nurse registries may establish links to local
761	emergency operations centers to determine a mechanism to
762	approach specific areas within a disaster area in order for a
763	provider to reach its clients. The presentation of nurse
764	registry clients to a special needs shelter without the nurse
765	registry provider making a good faith effort to provide services
766	in the shelter setting shall be considered abandonment of the
767	patient and constitutes a class II deficiency, subject to
768	sanctions provided in s. 400.484(2)(b). For purposes of this
769	section, "good faith effort" may be demonstrated by documented
770	attempts of staff to follow procedures as outlined in the nurse
771	registry's comprehensive emergency management plan which support
772	a finding that continuing care has been provided for those
773	patients who have been identified as needing care by the nurse
774	registry in the event of an emergency under s. 400.506(1).
775	(a)  All persons referred for contract who care for persons
776	registered pursuant to s. 252.355 must include in the patient
777	record a description of how care will be continued during a
778	disaster or emergency that interrupts the provision of care in
779	the patient's home. It shall be the responsibility of the person
780	referred for contract to ensure that continuous care is
781	provided.
782	(b)  Each nurse registry shall maintain a current
783	prioritized list of patients in private residences who are
784	registered pursuant to s. 252.355 and are under the care of
785	persons referred for contract and who need continued services
786	during an emergency. This list shall indicate, for each patient,
787	if the client is to be transported to a special needs shelter
788	and if the patient is receiving skilled nursing services. Nurse
789	registries shall make this list available to county health
790	departments and to local emergency management agencies upon
791	request.
792	(c)  Each person referred for contract who is caring for a
793	patient who is registered pursuant to s. 252.355 shall provide a
794	list of the patient's medication and equipment needs to the
795	nurse registry. Each person referred for contract shall make
796	this information available to county health departments and to
797	local emergency management agencies upon request.
798	(d)  Each person referred for contract shall not be
799	required to continue to provide care to patients in emergency
800	situations that are beyond the person's control and that make it
801	impossible to provide services, such as when roads are
802	impassable or when patients do not go to the location specified
803	in their patient records.
804	(e)  The comprehensive emergency management plan required
805	by this subsection is subject to review and approval by the
806	county health department. During its review, the county health
807	department shall contact state and local health and medical
808	stakeholders, when necessary ensure that, at a minimum, the
809	local emergency management agency, the Agency for Health Care
810	Administration, and the local chapter of the American Red Cross
811	or other lead sheltering agency are given the opportunity to
812	review the plan. The county health department shall complete its
813	review to ensure that the plan is in accordance with the
814	criteria set forth in the rules of the Agency for Health Care
815	Administration within 90 60 days after receipt of the plan and
816	shall either approve the plan or advise the nurse registry of
817	necessary revisions. If a nurse registry fails to submit a plan
818	or fails to submit requested information or revisions to the
819	county health department within 30 days after written
820	notification from the county health department, the county
821	health department shall notify the Agency for Health Care
822	Administration. The agency shall notify the nurse registry that
823	such failure constitutes a deficiency, subject to a fine of
824	$5,000 per occurrence. If the plan is not submitted, information
825	is not provided, or revisions are not made as requested, the
826	agency may impose the fine.
827	(f)  The Department of Health shall review the
828	comprehensive emergency management plan of any nurse registry
829	that operates in more than one county. The department shall
830	complete its review within 90 days after receipt of the plan and
831	shall either approve the plan or advise the nurse registry of
832	necessary revisions. The department shall make every effort to
833	avoid imposing differing requirements on nurse registries that
834	operate in more than one county as a result of differing or
835	conflicting comprehensive plan requirements of the counties in
836	which the nurse registry operates.
837	(g)(f)  The Agency for Health Care Administration shall
838	adopt rules establishing minimum criteria for the comprehensive
839	emergency management plan and plan updates required by this
840	subsection, with the concurrence of the Department of Health and
841	in consultation with the Department of Community Affairs.
842	Section 9.  Paragraph (b) of subsection (1) of section
843	400.610, Florida Statutes, is amended to read:
844	400.610  Administration and management of a hospice.--
845	(1)  A hospice shall have a clearly defined organized
846	governing body, consisting of a minimum of seven persons who are
847	representative of the general population of the community
848	served. The governing body shall have autonomous authority and
849	responsibility for the operation of the hospice and shall meet
850	at least quarterly. The governing body shall:
851	(b)1.  Prepare and maintain a comprehensive emergency
852	management plan that provides for continuing hospice services in
853	the event of an emergency that is consistent with local special
854	needs plans. The plan shall include provisions for ensuring
855	continuing care to hospice patients who go to special needs
856	shelters. The plan shall include the means by which the hospice
857	provider will continue to provide staff to perform the same type
858	and quantity of services to their patients who evacuate to
859	special needs shelters that were being provided to those
860	patients prior to evacuation. The plan is subject to review and
861	approval by the county health department, except as provided in
862	subparagraph 2. During its review, the county health department
863	shall contact state and local health and medical stakeholders,
864	when necessary ensure that the department, the agency, and the
865	local chapter of the American Red Cross or other lead sheltering
866	agency have an opportunity to review and comment on the plan.
867	The county health department shall complete its review to ensure
868	that the plan is in accordance with the criteria set forth in
869	the rules of the Department of Elderly Affairs within 90 60 days
870	after receipt of the plan and shall either approve the plan or
871	advise the hospice of necessary revisions. Hospice providers may
872	establish links to local emergency operations centers to
873	determine a mechanism to approach specific areas within a
874	disaster area in order for the provider to reach its clients.
875	The presentation of hospice clients to a special needs shelter
876	without the hospice provider making a good faith effort to
877	provide services in the shelter setting shall be considered
878	abandonment of the client subject to sanction as provided by law
879	or rule. For the purposes of this section, "good faith effort"
880	may be demonstrated by documented attempts of staff to follow
881	procedures as outlined in the hospice's comprehensive emergency
882	management plan and to provide continuing care for those hospice
883	clients who have been identified as needing alternative
884	caregiver services in the event of an emergency.
885	2.  For any hospice that operates in more than one county,
886	the Department of Health during its review shall contact state
887	and local health and medical stakeholders, when necessary review
888	the plan, after consulting with all of the county health
889	departments, the agency, and all the local chapters of the
890	American Red Cross or other lead sheltering agency in the areas
891	of operation for that particular hospice. The Department of
892	Health shall complete its review to ensure that the plan is in
893	accordance with the criteria set forth in the rules of the
894	Department of Elderly Affairs within 90 days after receipt of
895	the plan and shall either approve the plan or advise the hospice
896	of necessary revisions. The Department of Health shall make
897	every effort to avoid imposing on the hospice differing
898	requirements on a hospice that operates in more than one county
899	as a result of differing or conflicting comprehensive plan
900	requirements of the based on differences between counties in
901	which the hospice operates.
902	Section 10.  Subsections (13) through (16) of section
903	400.925, Florida Statutes, are renumbered as subsections (14)
904	through (17), respectively, and a new subsection (13) is added
905	to that section to read:
906	400.925  Definitions.--As used in this part, the term:
907	(13)  "Life-supporting or life-sustaining equipment" means
908	a device that is essential to, or that yields information that
909	is essential to, the restoration or continuation of a bodily
910	function important to the continuation of human life. Life-
911	supporting or life-sustaining equipment includes apnea monitors,
912	enteral feeding pumps, infusion pumps, portable home dialysis
913	equipment, and ventilator equipment and supplies for all related
914	equipment, including oxygen equipment and related respiratory
915	equipment.
916	Section 11.  Subsections (20), (21), and (22) are added to
917	section 400.934, Florida Statutes, to read:
918	400.934  Minimum standards.--As a requirement of licensure,
919	home medical equipment providers shall:
920	(20)(a)  Prepare and maintain a comprehensive emergency
921	management plan that meets minimum criteria established by the
922	agency in rule under s. 400.935. The plan shall be updated
923	annually and shall provide for continuing home medical equipment
924	services for life-supporting or life-sustaining equipment, as
925	defined in 400.925, during an emergency that interrupts home
926	medical equipment services in a patient's home. The plan shall
927	include:
928	1.  The means by which the home medical equipment provider
929	will continue to provide equipment to perform the same type and
930	quantity of services to its patients who evacuate to special
931	needs shelters that were being provided to those patients prior
932	to evacuation.
933	2.  The means by which the home medical equipment provider
934	establishes and maintains an effective response to emergencies
935	and disasters, including plans for:
936	a.  Notification of staff when emergency response measures
937	are initiated.
938	b.  Communication between staff members, county health
939	departments, and local emergency management agencies, which
940	shall include provisions for a backup communications system.
941	c.  Identification of resources necessary to continue
942	essential care or services or referrals to other organizations
943	subject to written agreement.
944	d.  Contacting and prioritizing patients in need of
945	continued medical equipment services and supplies.
946	(b)  The plan is subject to review and approval by the
947	county health department. During its review, the county health
948	department shall contact state and local health and medical
949	stakeholders, when necessary. The county health department shall
950	complete its review to ensure that the plan is in accordance
951	with the criteria set forth in the rules of the Agency for
952	Health Care Administration within 90 days after receipt of the
953	plan. If a home medical equipment provider fails to submit a
954	plan or fails to submit requested information or revisions to
955	the county health department within 30 days after written
956	notification from the county health department, the county
957	health department shall notify the Agency for Health Care
958	Administration. The agency shall notify the home medical
959	equipment provider that such failure constitutes a deficiency,
960	subject to a fine of $5,000 per occurrence. If the plan is not
961	submitted, information is not provided, or revisions are not
962	made as requested, the agency may impose the fine.
963	(c)  The Department of Health shall review the
964	comprehensive emergency management plan of any home medical
965	equipment provider that operates in more than one county. The
966	department shall complete its review within 90 days after
967	receipt of the plan and shall either approve the plan or advise
968	the home medical equipment provider of necessary revisions. The
969	department shall make every effort to avoid imposing differing
970	requirements on home medical equipment providers that operate in
971	more than one county as a result of differing or conflicting
972	comprehensive plan requirements of the counties in which the
973	home medical equipment provider operates.
974	(21)  Each home medical equipment provider shall maintain a
975	current prioritized list of patients who need continued services
976	during an emergency. The list shall indicate the means by which
977	services shall be continued for each patient in the event of an
978	emergency or disaster, whether the patient is to be transported
979	to a special needs shelter, and whether the patient has life-
980	supporting or life-sustaining equipment, including the specific
981	type of equipment and related supplies. The list shall be
982	furnished to county health departments and local emergency
983	management agencies, upon request.
984	(22)  Home medical equipment providers may establish links
985	to local emergency operations centers to determine a mechanism
986	to approach specific areas within a disaster area in order for
987	the provider to reach its patients.
988	Section 12.  Subsection (11) is added to section 400.935,
989	Florida Statutes, to read:
990	400.935  Rules establishing minimum standards.--The agency
991	shall adopt, publish, and enforce rules to implement this part,
992	which must provide reasonable and fair minimum standards
993	relating to:
994	(11)  Preparation of the comprehensive emergency management
995	plan under s. 400.934 and the establishment of minimum criteria
996	for the plan, including the maintenance of patient equipment and
997	supply lists that can accompany patients who are transported
998	from their homes. Such rules shall be formulated in consultation
999	with the Department of Health and the Department of Community
1000	Affairs.
1001	Section 13.  Section 408.831, Florida Statutes, is amended
1002	to read:
1003	408.831  Denial, suspension, or revocation of a license,
1004	registration, certificate, or application.--
1005	(1)  In addition to any other remedies provided by law, the
1006	agency may deny each application or suspend or revoke each
1007	license, registration, or certificate of entities regulated or
1008	licensed by it:
1009	(a)  If the applicant, licensee, registrant, or
1010	certificateholder, or, in the case of a corporation,
1011	partnership, or other business entity, if any officer, director,
1012	agent, or managing employee of that business entity or any
1013	affiliated person, partner, or shareholder having an ownership
1014	interest equal to 5 percent or greater in that business entity,
1015	has failed to pay all outstanding fines, liens, or overpayments
1016	assessed by final order of the agency or final order of the
1017	Centers for Medicare and Medicaid Services, not subject to
1018	further appeal, unless a repayment plan is approved by the
1019	agency; or
1020	(b)  For failure to comply with any repayment plan.
1021	(2)  In reviewing any application requesting a change of
1022	ownership or change of the licensee, registrant, or
1023	certificateholder, the transferor shall, prior to agency
1024	approval of the change, repay or make arrangements to repay any
1025	amounts owed to the agency. Should the transferor fail to repay
1026	or make arrangements to repay the amounts owed to the agency,
1027	the issuance of a license, registration, or certificate to the
1028	transferee shall be delayed until repayment or until
1029	arrangements for repayment are made.
1030	(3)  Entities subject to this section may exceed their
1031	licensed capacity to act as a receiving facility in accordance
1032	with an emergency operations plan for clients of evacuating
1033	providers from a geographic area where an evacuation order has
1034	been issued by a local authority having jurisdiction. While in
1035	an overcapacity status, each provider must furnish or arrange
1036	for appropriate care and services to all clients. In addition,
1037	the agency may approve requests for overcapacity beyond 15 days,
1038	which approvals may be based upon satisfactory justification and
1039	need as provided by the receiving and sending facility.
1040	(4)  An inactive license may be issued to a licensee
1041	subject to this section when the provider is located in a
1042	geographic area where a state of emergency was declared by the
1043	Governor if the provider:
1044	(a)  Suffered damage to the provider's operation during
1045	that state of emergency.
1046	(b)  Is currently licensed.
1047	(c)  Does not have a provisional license.
1048	(d)  Will be temporarily unable to provide services but is
1049	reasonably expected to resume services within 12 months.
1050
1051	An inactive license may be issued for a period not to exceed 12
1052	months but may be renewed by the agency for up to 6 additional
1053	months upon demonstration to the agency of progress toward
1054	reopening. A request by a licensee for an inactive license or to
1055	extend the previously approved inactive period must be submitted
1056	in writing to the agency, accompanied by written justification
1057	for the inactive license which states the beginning and ending
1058	dates of inactivity and includes a plan for the transfer of any
1059	clients to other providers and appropriate licensure fees. Upon
1060	agency approval, the licensee shall notify clients of any
1061	necessary discharge or transfer as required by authorizing
1062	statutes or applicable rules. The beginning of the inactive
1063	licensure period shall be the date the provider ceases
1064	operations. The end of the inactive period shall become the
1065	licensee expiration date, and all licensure fees must be
1066	current, paid in full, and may be prorated. Reactivation of an
1067	inactive license requires the prior approval by the agency of a
1068	renewal application, including payment of licensure fees and
1069	agency inspections indicating compliance with all requirements
1070	of this part and applicable rules and statutes.
1071	(5)(3)  This section provides standards of enforcement
1072	applicable to all entities licensed or regulated by the Agency
1073	for Health Care Administration. This section controls over any
1074	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
1075	394, 395, 400, 408, 468, 483, and 641 or rules adopted pursuant
1076	to those chapters.
1077	Section 14.  The Legislature finds that all designated
1078	public special needs hurricane evacuation shelters should be
1079	equipped with permanent emergency power generating capacity to
1080	provide the necessary equipment, heating, ventilation, and air-
1081	conditioning to meet the medical needs of patients by June 1,
1082	2007. The Department of Community Affairs shall work with local
1083	communities to ensure that there is a sufficient number of
1084	public special needs shelters designated to meet the anticipated
1085	demand based on best available data as determined by the
1086	department and the Department of Health. Local match for these
1087	projects shall be no less than 25 percent of project cost. There
1088	is hereby appropriated $21.5 million from the U.S. Contributions
1089	Trust Fund in fixed capital outlay to the Department of
1090	Community Affairs to establish a competitive award process to
1091	implement this section. No more than 5 percent of the funds
1092	provided under this section may be used by the department for
1093	administration of the funding.
1094	Section 15.  The Legislature finds that retrofitting public
1095	hurricane evacuation shelters is an efficient and economical
1096	method of accelerating the state and local efforts to reduce the
1097	shelter deficit. Criteria for the retrofitting of a public
1098	hurricane evacuation shelter shall include, but not be limited
1099	to, the project's ability to meet the structural and siting
1100	requirements of American Red Cross Standard ARC 4496,
1101	"Guidelines for Hurricane Evacuation Shelter Selection," once
1102	completed; the shelter needs for the local government, as well
1103	as the overall needs of the hurricane evacuation planning
1104	region; the cost-effectiveness of the project in terms of the
1105	number of public hurricane evacuation spaces; and the priority
1106	ranking of the proposed project in the applicable local
1107	mitigation strategy. There is hereby appropriated $9 million
1108	from the U.S. Contributions Trust Fund in fixed capital outlay
1109	to the Department of Community Affairs to establish a
1110	competitive award process to implement this section. No more
1111	than 5 percent of the funds provided under this section may be
1112	used by the department for administration of this funding.
1113	Section 16.  For the 2006-2007 fiscal year, the sums of
1114	$896,799 from recurring general revenue funds and $104,156 from
1115	nonrecurring general revenue funds are appropriated, and 20
1116	full-time equivalent positions are authorized at 872,644 salary
1117	rate, to implement the provisions of emergency management plan
1118	reviews for home health agencies and nurse registry, hospice,
1119	and home medical equipment providers.
1120	Section 17.  This act shall take effect July 1, 2006.

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