Florida Senate - 2014 COMMITTEE AMENDMENT
Bill No. SB 1254
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LEGISLATIVE ACTION
Senate . House
Comm: RCS .
03/25/2014 .
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following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Paragraph (d) of subsection (3) of section
6 390.012, Florida Statutes, is amended to read:
7 390.012 Powers of agency; rules; disposal of fetal
8 remains.—
9 (3) For clinics that perform or claim to perform abortions
10 after the first trimester of pregnancy, the agency shall adopt
11 rules pursuant to ss. 120.536(1) and 120.54 to implement the
12 provisions of this chapter, including the following:
13 (d) Rules relating to the medical screening and evaluation
14 of each abortion clinic patient. At a minimum, these rules must
15 shall require:
16 1. A medical history including reported allergies to
17 medications, antiseptic solutions, or latex; past surgeries; and
18 an obstetric and gynecological history.
19 2. A physical examination, including a bimanual examination
20 estimating uterine size and palpation of the adnexa.
21 3. The appropriate laboratory tests, including:
22 a. Urine or blood tests for pregnancy performed before the
23 abortion procedure.
24 b. A test for anemia.
25 c. Rh typing, unless reliable written documentation of
26 blood type is available.
27 d. Other tests as indicated from the physical examination.
28 4. An ultrasound evaluation for all patients. The rules
29 must shall require that if a person who is not a physician
30 performs an ultrasound examination, that person shall have
31 documented evidence that he or she has completed a course in the
32 operation of ultrasound equipment as prescribed in rule. The
33 rules shall require clinics to be in compliance with s.
34 390.0111.
35 5. That the physician is responsible for estimating the
36 gestational age of the fetus based on the ultrasound examination
37 and obstetric standards in keeping with established standards of
38 care regarding the estimation of fetal age as defined in rule
39 and shall write the estimate in the patient’s medical history.
40 The physician shall keep original prints of each ultrasound
41 examination of a patient in the patient’s medical history file.
42 Section 2. Subsection (11) of section 400.021, Florida
43 Statutes, is amended to read:
44 400.021 Definitions.—When used in this part, unless the
45 context otherwise requires, the term:
46 (11) “Nursing home bed” means an accommodation that which
47 is ready for immediate occupancy, or is capable of being made
48 ready for occupancy within 48 hours, excluding the provision of
49 staffing,; and that which conforms to minimum space
50 requirements, including the availability of appropriate
51 equipment and furnishings within the 48 hours, as specified by
52 rule of the agency, for the provision of services specified in
53 this part to a single resident.
54 Section 3. Subsection (3) of section 400.0712, Florida
55 Statutes, is amended to read:
56 400.0712 Application for inactive license.—
57 (3) The agency shall adopt rules pursuant to ss. 120.536(1)
58 and 120.54 necessary to implement this section.
59 Section 4. Section 400.23, Florida Statutes, is amended to
60 read:
61 400.23 Rules; evaluation and deficiencies; licensure
62 status.—
63 (1) It is the intent of the Legislature that rules
64 published and enforced pursuant to this part and part II of
65 chapter 408 shall include criteria by which a reasonable and
66 consistent quality of resident care may be ensured, and the
67 results of such resident care can be demonstrated, and by which
68 safe and sanitary nursing homes can be provided. It is further
69 intended that reasonable efforts be made to accommodate the
70 needs and preferences of residents to enhance the quality of
71 life in a nursing home. In addition, efforts shall be made to
72 minimize the amount of paperwork associated with the reporting
73 and documentation requirements of these rules.
74 (2) Pursuant to the intention of the Legislature, the
75 agency, in consultation with the Department of Health and the
76 Department of Elderly Affairs, may shall adopt and enforce rules
77 to administer implement this part and part II of chapter 408.
78 The rules must specify, but are not limited to, which shall
79 include reasonable and fair criteria relating in relation to:
80 (a) The location of the facility and housing conditions
81 that will ensure the health, safety, and comfort of residents,
82 including an adequate call system. In adopting making such
83 rules, the agency shall be guided by criteria recommended by
84 nationally recognized reputable professional groups and
85 associations that have with knowledge of such subject matters.
86 The agency shall update or revise the such criteria as the need
87 arises. The agency may require alterations to a building if it
88 determines that an existing condition constitutes a distinct
89 hazard to life, health, or safety. In performing any inspections
90 of facilities authorized by this part or part II of chapter 408,
91 the agency may enforce the special-occupancy provisions of the
92 Florida Building Code and the Florida Fire Prevention Code which
93 apply to nursing homes. A resident Residents or his or her
94 representative must their representatives shall be able to
95 request a change in the placement of the bed in his or her their
96 room if, provided that at admission, the resident is they are
97 presented with a room that meets requirements of the Florida
98 Building Code. The location of a bed may be changed if the
99 requested placement does not infringe on the resident’s roommate
100 or interfere with the resident’s care or safety as determined by
101 the care planning team in accordance with facility policies and
102 procedures. In addition, the bed placement may not be used as a
103 restraint. Each facility shall maintain a log of resident rooms
104 with beds that are not in strict compliance with the Florida
105 Building Code in order for such log to be used by surveyors and
106 nurse monitors during inspections and visits. A resident or a
107 resident’s resident representative who requests that a bed be
108 moved must shall sign a statement indicating that he or she
109 understands that the room will not be in compliance with the
110 Florida Building Code, but that he or she they would prefer to
111 exercise the their right to self-determination. The statement
112 must be retained as part of the resident’s care plan. A Any
113 facility that offers this option must submit a letter signed by
114 the nursing home administrator of record to the agency notifying
115 it of this practice along with a copy of the policies and
116 procedures of the facility. The agency is directed to provide
117 assistance to the Florida Building Commission in updating the
118 construction standards of the code relating relative to nursing
119 homes.
120 (b) The number and qualifications of all personnel,
121 including management, medical, nursing, and other professional
122 personnel, and nursing assistants, orderlies, and support
123 personnel, having responsibility for any part of the care given
124 residents.
125 (c) All sanitary conditions within the facility and its
126 surroundings, including water supply, sewage disposal, food
127 handling, and general hygiene which will ensure the health and
128 comfort of residents.
129 (d) The equipment essential to the health and welfare of
130 the residents.
131 (e) A uniform accounting system.
132 (f) The care, treatment, and maintenance of residents and
133 measurement of the quality and adequacy thereof, based on rules
134 developed under this chapter and the Omnibus Budget
135 Reconciliation Act of 1987, (Pub. L. No. 100-203) (December 22,
136 1987), Title IV (Medicare, Medicaid, and Other Health-Related
137 Programs), Subtitle C (Nursing Home Reform), as amended.
138 (g) The preparation and annual update of a comprehensive
139 emergency management plan. The agency shall establish adopt
140 rules establishing minimum criteria for the plan after
141 consultation with the Division of Emergency Management. At a
142 minimum, the rules must provide for plan components must provide
143 that address emergency evacuation transportation; adequate
144 sheltering arrangements; postdisaster activities, including
145 emergency power, food, and water; postdisaster transportation;
146 supplies; staffing; emergency equipment; individual
147 identification of residents and transfer of records; and
148 responding to family inquiries. The comprehensive emergency
149 management plan is subject to review and approval by the local
150 emergency management agency. During the its review, the local
151 emergency management agency shall ensure that the following
152 agencies, at a minimum, are given the opportunity to review the
153 plan: the Department of Elderly Affairs, the Department of
154 Health, the Agency for Health Care Administration, and the
155 Division of Emergency Management. Also, Appropriate volunteer
156 organizations must also be given the opportunity to review the
157 plan. The local emergency management agency shall complete its
158 review within 60 days and either approve the plan or advise the
159 facility of necessary revisions.
160 (h) The availability, distribution, and posting of reports
161 and records pursuant to s. 400.191 and the Gold Seal Program
162 pursuant to s. 400.235.
163 (3)(a)1. The agency shall enforce adopt rules providing
164 minimum staffing requirements for nursing home facilities.
165 1. These requirements must include, for each facility:
166 a. A combined minimum weekly average of certified nursing
167 assistant and licensed nursing staffing combined of 3.6 hours of
168 direct care per resident per day. As used in this sub
169 subparagraph, a week is defined as Sunday through Saturday.
170 b. A minimum certified nursing assistant staffing of 2.5
171 hours of direct care per resident per day. A facility may not
172 staff below one certified nursing assistant per 20 residents.
173 c. A minimum licensed nursing staffing of 1.0 hour of
174 direct care per resident per day. A facility may not staff below
175 one licensed nurse per 40 residents.
176 2. Nursing assistants employed under s. 400.211(2) may be
177 included in computing the staffing ratio for certified nursing
178 assistants if their job responsibilities include only nursing
179 assistant-related duties.
180 3. Each nursing home facility must document compliance with
181 staffing standards as required under this paragraph and post
182 daily the names of staff on duty for the benefit of facility
183 residents and the public.
184 4. The agency shall recognize the use of licensed nurses
185 for compliance with the minimum staffing requirements for
186 certified nursing assistants if the nursing home facility
187 otherwise meets the minimum staffing requirements for licensed
188 nurses and the licensed nurses are performing the duties of a
189 certified nursing assistants assistant. Unless otherwise
190 approved by the agency, licensed nurses counted toward the
191 minimum staffing requirements for certified nursing assistants
192 must exclusively perform the duties of a certified nursing
193 assistants assistant for the entire shift and not also be
194 counted toward the minimum staffing requirements for licensed
195 nurses. If the agency approved a facility’s request to use a
196 licensed nurse to perform both licensed nursing and certified
197 nursing assistant duties, the facility must allocate the amount
198 of staff time specifically spent on certified nursing assistant
199 duties for the purpose of documenting compliance with minimum
200 staffing requirements for certified and licensed nursing staff.
201 The hours of a licensed nurse with dual job responsibilities may
202 not be counted twice.
203 (b) Nonnursing staff providing eating assistance to
204 residents does shall not count toward compliance with minimum
205 staffing standards.
206 (c) Licensed practical nurses licensed under chapter 464
207 who are providing nursing services in nursing home facilities
208 under this part may supervise the activities of other licensed
209 practical nurses, certified nursing assistants, and other
210 unlicensed personnel providing services in such facilities in
211 accordance with rules adopted by the Board of Nursing.
212 (4) Rules developed pursuant to This section does shall not
213 restrict the use of shared staffing and shared programming in
214 facilities that which are part of retirement communities that
215 provide multiple levels of care and otherwise meet the
216 requirement of law or rule.
217 (5) The agency, in collaboration with the Division of
218 Children’s Medical Services of the Department of Health, must
219 adopt rules for:
220 (a) Minimum standards of care for persons under 21 years of
221 age who reside in nursing home facilities may be established by
222 the agency, in collaboration with the Division of Children’s
223 Medical Services of the Department of Health. A facility may be
224 exempted from these standards and the provisions of paragraph
225 (b) for specified specific persons between 18 and 21 years of
226 age, if the person’s physician agrees that minimum standards of
227 care based on age are not necessary.
228 (b) The following Minimum staffing requirements for persons
229 under 21 years of age who reside in nursing home facilities,
230 which apply in lieu of the requirements contained in subsection
231 (3):.
232 1. For persons under 21 years of age who require skilled
233 care:
234 a. A minimum combined average of 3.9 hours of direct care
235 per resident per day must be provided by licensed nurses,
236 respiratory therapists, respiratory care practitioners, and
237 certified nursing assistants.
238 b. A minimum licensed nursing staffing of 1.0 hour of
239 direct care per resident per day must be provided.
240 c. Up to No more than 1.5 hours of certified nursing
241 assistant care per resident per day may be counted in
242 determining the minimum direct care hours required.
243 d. One registered nurse must be on duty on the site 24
244 hours per day on the unit where children reside.
245 2. For persons under 21 years of age who are medically
246 fragile:
247 a. A minimum combined average of 5.0 hours of direct care
248 per resident per day must be provided by licensed nurses,
249 respiratory therapists, respiratory care practitioners, and
250 certified nursing assistants.
251 b. A minimum licensed nursing staffing of 1.7 hours of
252 direct care per resident per day must be provided.
253 c. Up to No more than 1.5 hours of certified nursing
254 assistant care per resident per day may be counted in
255 determining the minimum direct care hours required.
256 d. One registered nurse must be on duty on the site 24
257 hours per day on a the unit where children reside.
258 (6) Before Prior to conducting a survey of the facility,
259 the survey team shall obtain a copy of the local long-term care
260 ombudsman council report on the facility. Problems noted in the
261 report shall be incorporated into and followed up through the
262 agency’s inspection process. This procedure does not preclude
263 the local long-term care ombudsman council from requesting the
264 agency to conduct a followup visit to the facility.
265 (7) The agency shall, at least every 15 months, evaluate
266 all nursing home facilities and determine make a determination
267 as to the degree of compliance by each licensee with the
268 established rules adopted under this part as a basis for
269 assigning a licensure status to a that facility. The agency
270 shall base its evaluation on the most recent inspection report,
271 taking into consideration findings from other official reports,
272 surveys, interviews, investigations, and inspections. In
273 addition to license categories authorized under part II of
274 chapter 408, the agency shall assign a licensure status of
275 standard or conditional licensure status to each nursing home.
276 (a) A standard licensure status means that a facility has
277 no class I or class II deficiencies and has corrected all class
278 III deficiencies within the time established by the agency.
279 (b) A conditional licensure status means that a facility,
280 due to the presence of one or more class I or class II
281 deficiencies, or class III deficiencies not corrected within the
282 time established by the agency, is not in substantial compliance
283 at the time of the survey with criteria established under this
284 part or with rules adopted by the agency. If the facility has no
285 class I, class II, or class III deficiencies at the time of the
286 followup survey, a standard licensure status may be assigned.
287 (c) In evaluating the overall quality of care and services
288 and determining whether the facility will receive a conditional
289 or standard license, the agency shall consider the needs and
290 limitations of residents in the facility and the results of
291 interviews and surveys of a representative sampling of
292 residents, families of residents, ombudsman council members in
293 the planning and service area in which the facility is located,
294 guardians of residents, and staff of the nursing home facility.
295 (d) The current licensure status of each facility must be
296 indicated in bold print on the face of the license. A list of
297 the deficiencies of the facility shall be posted in a prominent
298 place that is in clear and unobstructed public view at or near
299 the place where residents are being admitted to that facility.
300 Licensees receiving a conditional licensure status for a
301 facility shall prepare, within 10 working days after receiving
302 notice of deficiencies, a plan for correction of all
303 deficiencies and shall submit the plan to the agency for
304 approval.
305 (e) The agency shall adopt rules that:
306 1. Establish uniform procedures for the evaluation of
307 facilities.
308 2. Provide criteria in the areas referenced in paragraph
309 (c).
310 3. Address other areas necessary for carrying out the
311 intent of this section.
312 (8) The agency shall ensure adopt rules pursuant to this
313 part and part II of chapter 408 to provide that, if when the
314 criteria established under subsection (2) are not met, such
315 deficiencies shall be classified according to the nature and the
316 scope of the deficiency. The scope shall be cited as isolated,
317 patterned, or widespread. An isolated deficiency is a deficiency
318 affecting one or a very limited number of residents, or
319 involving one or a very limited number of staff, or a situation
320 that occurred only occasionally or in a very limited number of
321 locations. A patterned deficiency is a deficiency in which where
322 more than a very limited number of residents are affected, or
323 more than a very limited number of staff are involved, or the
324 situation has occurred in several locations, or the same
325 resident or residents have been affected by repeated occurrences
326 of the same deficient practice but the effect of the deficient
327 practice is not found to be pervasive throughout the facility. A
328 widespread deficiency is a deficiency in which the problems
329 causing the deficiency are pervasive in the facility or
330 represent systemic failure that has affected or has the
331 potential to affect a large portion of the facility’s residents.
332 The agency shall indicate the classification on the face of the
333 notice of deficiencies as follows:
334 (a) A class I deficiency is a deficiency that the agency
335 determines presents a situation in which immediate corrective
336 action is necessary because the facility’s noncompliance has
337 caused, or is likely to cause, serious injury, harm, impairment,
338 or death to a resident receiving care in a facility. The
339 condition or practice constituting a class I violation must
340 shall be abated or eliminated immediately, unless a fixed period
341 of time, as determined by the agency, is required for
342 correction. A class I deficiency is subject to a civil penalty
343 of $10,000 for an isolated deficiency, $12,500 for a patterned
344 deficiency, and $15,000 for a widespread deficiency. The fine
345 amount is shall be doubled for each deficiency if the facility
346 was previously cited for one or more class I or class II
347 deficiencies during the last licensure inspection or during an
348 any inspection or complaint investigation since the last
349 licensure inspection. A fine must be levied notwithstanding the
350 correction of the deficiency.
351 (b) A class II deficiency is a deficiency that the agency
352 determines has compromised a the resident’s ability to maintain
353 or reach his or her highest practicable physical, mental, and
354 psychosocial well-being, as defined by an accurate and
355 comprehensive resident assessment, plan of care, and provision
356 of services. A class II deficiency is subject to a civil penalty
357 of $2,500 for an isolated deficiency, $5,000 for a patterned
358 deficiency, and $7,500 for a widespread deficiency. The fine
359 amount is shall be doubled for each deficiency if the facility
360 was previously cited for one or more class I or class II
361 deficiencies during the last licensure inspection or an any
362 inspection or complaint investigation since the last licensure
363 inspection. A fine shall be levied notwithstanding the
364 correction of the deficiency.
365 (c) A class III deficiency is a deficiency that the agency
366 determines will result in no more than minimal physical, mental,
367 or psychosocial discomfort to a the resident or has the
368 potential to compromise a the resident’s ability to maintain or
369 reach his or her highest practical physical, mental, or
370 psychosocial well-being, as defined by an accurate and
371 comprehensive resident assessment, plan of care, and provision
372 of services. A class III deficiency is subject to a civil
373 penalty of $1,000 for an isolated deficiency, $2,000 for a
374 patterned deficiency, and $3,000 for a widespread deficiency.
375 The fine amount is shall be doubled for each deficiency if the
376 facility was previously cited for one or more class I or class
377 II deficiencies during the last licensure inspection or an any
378 inspection or complaint investigation since the last licensure
379 inspection. A citation for a class III deficiency must specify
380 the time within which the deficiency is required to be
381 corrected. If a class III deficiency is corrected within the
382 time specified, a civil penalty may not be imposed.
383 (d) A class IV deficiency is a deficiency that the agency
384 determines has the potential for causing no more than a minor
385 negative impact on a the resident. If the class IV deficiency is
386 isolated, no plan of correction is required.
387 (9) Civil penalties paid by a any licensee under subsection
388 (8) shall be deposited in the Health Care Trust Fund and
389 expended as provided in s. 400.063.
390 (10) Agency records, reports, ranking systems, Internet
391 information, and publications must be promptly updated to
392 reflect the most current agency actions.
393 Section 5. Subsection (7) of section 400.487, Florida
394 Statutes, is amended to read:
395 400.487 Home health service agreements; physician’s,
396 physician assistant’s, and advanced registered nurse
397 practitioner’s treatment orders; patient assessment;
398 establishment and review of plan of care; provision of services;
399 orders not to resuscitate.—
400 (7) Home health agency personnel may withhold or withdraw
401 cardiopulmonary resuscitation if presented with an order not to
402 resuscitate executed pursuant to s. 401.45. The agency shall
403 adopt rules providing for the implementation of such orders.
404 Home health personnel and agencies are shall not be subject to
405 criminal prosecution or civil liability and are not, nor be
406 considered to have engaged in negligent or unprofessional
407 conduct, for withholding or withdrawing cardiopulmonary
408 resuscitation pursuant to such an order and rules adopted by the
409 agency.
410 Section 6. Section 400.497, Florida Statutes, is amended to
411 read:
412 400.497 Rules establishing minimum standards.—The agency
413 may shall adopt, publish, and enforce rules to administer
414 implement part II of chapter 408 and this part, including the
415 provider’s duties and responsibilities under, as applicable, ss.
416 400.506 and 400.509. Rules shall specify, but are not limited
417 to, which must provide reasonable and fair minimum standards
418 relating to:
419 (1) The home health aide competency test and home health
420 aide training. The agency shall create the home health aide
421 competency test and establish the curriculum and instructor
422 qualifications for home health aide training. Licensed home
423 health agencies may provide this training and shall furnish
424 documentation of such training to other licensed home health
425 agencies upon request. Successful passage of the competency test
426 by home health aides may be substituted for the training
427 required under this section and agency any rule adopted pursuant
428 thereto.
429 (2) Shared staffing. The agency shall allow Shared staffing
430 is allowed if the home health agency is part of a retirement
431 community that provides multiple levels of care, is located on
432 one campus, is licensed under this chapter or chapter 429, and
433 otherwise meets the requirements of law and rule.
434 (3) The criteria for the frequency of onsite licensure
435 surveys.
436 (4) Licensure application and renewal.
437 (5) Oversight by the director of nursing, including. The
438 agency shall develop rules related to:
439 (a) Standards that address oversight responsibilities by
440 the director of nursing for of skilled nursing and personal care
441 services provided by the home health agency’s staff;
442 (b) Requirements for a director of nursing to provide to
443 the agency, upon request, a certified daily report of the home
444 health services provided by a specified direct employee or
445 contracted staff member on behalf of the home health agency. The
446 agency may request a certified daily report for up to only for a
447 period not to exceed 2 years before prior to the date of the
448 request; and
449 (c) A quality assurance program for home health services
450 provided by the home health agency.
451 (6) Conditions for using a recent unannounced licensure
452 inspection for the inspection required under in s. 408.806
453 related to a licensure application associated with a change in
454 ownership of a licensed home health agency.
455 (7) The requirements for onsite and electronic
456 accessibility of supervisory personnel of home health agencies.
457 (8) Information to be included in patients’ records.
458 (9) Geographic service areas.
459 (10) Preparation of a comprehensive emergency management
460 plan pursuant to s. 400.492.
461 (a) The Agency for Health Care Administration shall adopt
462 rules establishing minimum criteria for the plan and plan
463 updates, with the concurrence of the Department of Health and in
464 consultation with the Division of Emergency Management.
465 (a)(b) An emergency plan The rules must address the
466 requirements in s. 400.492. In addition, the rules shall provide
467 for the maintenance of patient-specific medication lists that
468 can accompany patients who are transported from their homes.
469 (b)(c) The plan is subject to review and approval by the
470 county health department. During its review, the county health
471 department shall contact state and local health and medical
472 stakeholders when necessary. The county health department shall
473 complete its review to ensure that the plan is in accordance
474 with the requirements of law criteria in the Agency for Health
475 Care Administration rules within 90 days after receipt of the
476 plan and shall approve the plan or advise the home health agency
477 of necessary revisions. If the home health agency fails to
478 submit a plan or fails to submit the requested information or
479 revisions to the county health department within 30 days after
480 written notification from the county health department, the
481 county health department shall notify the Agency for Health Care
482 Administration. The agency shall notify the home health agency
483 that its failure constitutes a deficiency, subject to a fine of
484 $5,000 per occurrence. If the plan is not submitted, information
485 is not provided, or revisions are not made as requested, the
486 agency may impose the fine.
487 (c)(d) For a any home health agency that operates in more
488 than one county, the Department of Health shall review the plan,
489 after consulting with state and local health and medical
490 stakeholders when necessary. The department shall complete its
491 review within 90 days after receipt of the plan and shall
492 approve the plan or advise the home health agency of necessary
493 revisions. The department shall make every effort to avoid
494 imposing differing requirements on a home health agency that
495 operates in more than one county as a result of differing or
496 conflicting comprehensive plan requirements of the counties in
497 which the home health agency operates.
498 (d)(e) The requirements in this subsection do not apply to:
499 1. A facility that is certified under chapter 651 and has a
500 licensed home health agency used exclusively by residents of the
501 facility; or
502 2. A retirement community that consists of both residential
503 units for independent living and either a licensed nursing home
504 or an assisted living facility, and has a licensed home health
505 agency used exclusively by the residents of the retirement
506 community, if, provided the comprehensive emergency management
507 plan for the facility or retirement community provides for
508 continuous care of all residents with special needs during an
509 emergency.
510 Section 7. Paragraph (f) of subsection (12) and subsection
511 (17) of section 400.506, Florida Statutes, are amended to read:
512 400.506 Licensure of nurse registries; requirements;
513 penalties.—
514 (12) Each nurse registry shall prepare and maintain a
515 comprehensive emergency management plan that is consistent with
516 the criteria in this subsection and with the local special needs
517 plan. The plan shall be updated annually. The plan shall include
518 the means by which the nurse registry will continue to provide
519 the same type and quantity of services to its patients who
520 evacuate to special needs shelters which were being provided to
521 those patients prior to evacuation. The plan shall specify how
522 the nurse registry shall facilitate the provision of continuous
523 care by persons referred for contract to persons who are
524 registered pursuant to s. 252.355 during an emergency that
525 interrupts the provision of care or services in private
526 residences. Nurse registries may establish links to local
527 emergency operations centers to determine a mechanism by which
528 to approach specific areas within a disaster area in order for a
529 provider to reach its clients. Nurse registries shall
530 demonstrate a good faith effort to comply with the requirements
531 of this subsection by documenting attempts of staff to follow
532 procedures outlined in the nurse registry’s comprehensive
533 emergency management plan which support a finding that the
534 provision of continuing care has been attempted for patients
535 identified as needing care by the nurse registry and registered
536 under s. 252.355 in the event of an emergency under this
537 subsection.
538 (f) The Agency for Health Care Administration shall adopt
539 rules establishing minimum criteria for the comprehensive
540 emergency management plan and plan updates required by this
541 subsection, with the concurrence of the Department of Health and
542 in consultation with the Division of Emergency Management.
543 (17) The Agency for Health Care Administration shall adopt
544 rules to implement this section and part II of chapter 408.
545 Section 8. Subsection (7) of section 400.509, Florida
546 Statutes, is amended to read:
547 400.509 Registration of particular service providers exempt
548 from licensure; certificate of registration; regulation of
549 registrants.—
550 (7) The Agency for Health Care Administration shall adopt
551 rules to administer this section and part II of chapter 408.
552 Section 9. Subsection (8) of section 400.6095, Florida
553 Statutes, is amended to read:
554 400.6095 Patient admission; assessment; plan of care;
555 discharge; death.—
556 (8) The hospice care team may withhold or withdraw
557 cardiopulmonary resuscitation if presented with an order not to
558 resuscitate executed pursuant to s. 401.45. The department shall
559 adopt rules providing for the implementation of such orders.
560 Hospice staff are shall not be subject to criminal prosecution
561 or civil liability, nor be considered to have engaged in
562 negligent or unprofessional conduct, for withholding or
563 withdrawing cardiopulmonary resuscitation pursuant to such an
564 order and applicable rules. The absence of an order to
565 resuscitate executed pursuant to s. 401.45 does not preclude a
566 physician from withholding or withdrawing cardiopulmonary
567 resuscitation as otherwise permitted by law.
568 Section 10. Section 400.914, Florida Statutes, is amended
569 to read:
570 400.914 Rulemaking; Rules establishing standards.—
571 (1) Pursuant to the intention of the Legislature to provide
572 safe and sanitary facilities and healthful programs, the agency
573 in conjunction with the Division of Children’s Medical Services
574 of the Department of Health may shall adopt and publish rules to
575 administer implement the provisions of this part and part II of
576 chapter 408, which shall include reasonable and fair standards.
577 Any conflict between these rules standards and those established
578 that may be set forth in local, county, or city ordinances shall
579 be resolved in favor of those having statewide effect.
580 (2) The rules must specify, but are not limited to,
581 reasonable and fair standards relating Such standards shall
582 relate to:
583 (a) The assurance that PPEC services are family centered
584 and provide individualized medical, developmental, and family
585 training services.
586 (b) The maintenance of PPEC centers, not in conflict with
587 the provisions of chapter 553 and based upon the size of the
588 structure and number of children, relating to plumbing, heating,
589 lighting, ventilation, and other building conditions, including
590 adequate space, which will ensure the health, safety, comfort,
591 and protection from fire of the children served.
592 (c) The application of the appropriate provisions of the
593 most recent edition of the “Life Safety Code” (NFPA-101) shall
594 be applied.
595 (d) The number and qualifications of all personnel who have
596 responsibility for the care of the children served.
597 (e) All sanitary conditions within the PPEC center and its
598 surroundings, including water supply, sewage disposal, food
599 handling, and general hygiene, and maintenance thereof, which
600 will ensure the health and comfort of children served.
601 (f) Programs and basic services promoting and maintaining
602 the health and development of the children served and meeting
603 the training needs of the children’s legal guardians.
604 (g) Supportive, contracted, other operational, and
605 transportation services.
606 (h) Maintenance of appropriate medical records, data, and
607 information relative to the children and programs. Such records
608 shall be maintained in the facility for inspection by the
609 agency.
610 (2) The agency shall adopt rules to ensure that:
611 (a) No child attends a PPEC center for more than 12 hours
612 within a 24-hour period.
613 (b) No PPEC center provides services other than those
614 provided to medically or technologically dependent children.
615 Section 11. Section 400.9141, Florida Statutes, is created
616 to read:
617 400.9141 Limitations.—
618 (1) A child may not attend a PPEC center for more than 12
619 hours within a 24-hour period.
620 (2) A PPEC center may provide services only to medically or
621 technologically dependent children.
622 Section 12. Paragraph (a) of subsection (20) of section
623 400.934, Florida Statutes, is amended to read:
624 400.934 Minimum standards.—As a requirement of licensure,
625 home medical equipment providers shall:
626 (20)(a) Prepare and maintain a comprehensive emergency
627 management plan that meets minimum criteria established by
628 agency rule, including criteria for the maintenance of patient
629 equipment and supply lists that accompany patients who are
630 transported from their homes. Such rules shall be formulated in
631 consultation with the Department of Health and the Division of
632 Emergency Management under s. 400.935. The plan shall be updated
633 annually and shall provide for continuing home medical equipment
634 services for life-supporting or life-sustaining equipment, as
635 defined in s. 400.925, during an emergency that interrupts home
636 medical equipment services in a patient’s home. The plan must
637 shall include:
638 1. The means by which the home medical equipment provider
639 will continue to provide equipment to perform the same type and
640 quantity of services to its patients who evacuate to special
641 needs shelters which were being provided to those patients
642 before prior to evacuation.
643 2. The means by which the home medical equipment provider
644 establishes and maintains an effective response to emergencies
645 and disasters, including plans for:
646 a. Notification of staff when emergency response measures
647 are initiated.
648 b. Communication between staff members, county health
649 departments, and local emergency management agencies, which
650 includes provisions for a backup communications system.
651 c. Identification of resources necessary to continue
652 essential care or services or referrals to other organizations
653 subject to written agreement.
654 d. Contacting and prioritizing patients in need of
655 continued medical equipment services and supplies.
656 Section 13. Section 400.935, Florida Statutes, is amended
657 to read:
658 400.935 Rule authority Rules establishing minimum
659 standards.—The agency shall adopt, publish, and enforce rules as
660 necessary to implement this part and part II of chapter 408. The
661 rules shall specify, but not be limited to, which must provide
662 reasonable and fair minimum standards relating to:
663 (1) The qualifications and minimum training requirements of
664 all home medical equipment provider personnel.
665 (2) Financial ability to operate.
666 (2)(3) The administration of the home medical equipment
667 provider.
668 (4) Procedures for maintaining patient records.
669 (3)(5) Ensuring that the home medical equipment and
670 services provided by a home medical equipment provider are in
671 accordance with the plan of treatment established for each
672 patient, when provided as a part of a plan of treatment.
673 (4)(6) Contractual arrangements for the provision of home
674 medical equipment and services by providers not employed by the
675 home medical equipment provider providing for the consumer’s
676 needs.
677 (5)(7) Physical location and zoning requirements.
678 (6)(8) Home medical equipment requiring home medical
679 equipment services.
680 (9) Preparation of the comprehensive emergency management
681 plan under s. 400.934 and the establishment of minimum criteria
682 for the plan, including the maintenance of patient equipment and
683 supply lists that can accompany patients who are transported
684 from their homes. Such rules shall be formulated in consultation
685 with the Department of Health and the Division of Emergency
686 Management.
687 Section 14. Subsection (5) of section 400.962, Florida
688 Statutes, is amended to read:
689 400.962 License required; license application.—
690 (5) The applicant must agree to provide or arrange for
691 active treatment services by an interdisciplinary team in order
692 to maximize individual independence or prevent regression or
693 loss of functional status. Standards for active treatment shall
694 be adopted by the Agency for Health Care Administration by rule
695 pursuant to ss. 120.536(1) and 120.54. Active treatment services
696 shall be provided in accordance with the individual support plan
697 and shall be reimbursed as part of the per diem rate as paid
698 under the Medicaid program.
699 Section 15. Subsections (2) and (3) of section 400.967,
700 Florida Statutes, are amended to read:
701 400.967 Rules and classification of deficiencies.—
702 (2) Pursuant to the intention of the Legislature, The
703 agency, in consultation with the Agency for Persons with
704 Disabilities and the Department of Elderly Affairs, may shall
705 adopt and enforce rules as necessary to administer this part and
706 part II of chapter 408, which shall include reasonable and fair
707 criteria governing:
708 (a) The location and construction of the facility;
709 including fire and life safety, plumbing, heating, cooling,
710 lighting, ventilation, and other housing conditions that ensure
711 the health, safety, and comfort of residents. The agency shall
712 establish standards for facilities and equipment to increase the
713 extent to which new facilities, and a new wing or floor added to
714 an existing facility after July 1, 2000, are structurally
715 capable of serving as shelters only for residents, staff, and
716 families of residents and staff, and equipped to be self
717 supporting during and immediately following disasters. The
718 agency shall update or revise the criteria as the need arises.
719 All Facilities must comply with the those lifesafety code
720 requirements and building code standards applicable when at the
721 time of approval of their construction plans are approved. The
722 agency may require alterations to a building if it determines
723 that an existing condition constitutes a distinct hazard to
724 life, health, or safety. The agency may state the shall adopt
725 fair and reasonable rules setting forth conditions under which
726 existing facilities undergoing additions, alterations,
727 conversions, renovations, or repairs are required to comply with
728 the most recent updated or revised standards.
729 (b) The number and qualifications of all personnel,
730 including management, medical, nursing, and other personnel,
731 having responsibility for any part of the care given to
732 residents.
733 (c) All Sanitary conditions within the facility and its
734 surroundings, including water supply, sewage disposal, food
735 handling, and general hygiene, which will ensure the health and
736 comfort of residents.
737 (d) The Equipment essential to the health and welfare of
738 the residents.
739 (e) A uniform accounting system.
740 (f) The care, treatment, and maintenance of residents and
741 the assessment measurement of the quality and adequacy thereof.
742 (g) The preparation and annual update of a comprehensive
743 emergency management plan. After consultation with the Division
744 of Emergency Management, the agency may establish shall adopt
745 rules establishing minimum criteria for the plan after
746 consultation with the Division of Emergency Management. At a
747 minimum, the rules must provide for plan components that address
748 emergency evacuation transportation; adequate sheltering
749 arrangements; postdisaster activities, including emergency
750 power, food, and water; postdisaster transportation; supplies;
751 staffing; emergency equipment; individual identification of
752 residents and transfer of records; and responding to family
753 inquiries. The comprehensive emergency management plan is
754 subject to review and approval by the local emergency management
755 agency. During the its review, the local emergency management
756 agency shall ensure that the following agencies, at a minimum,
757 are given the opportunity to review the plan: the Department of
758 Elderly Affairs, the Agency for Persons with Disabilities, the
759 Agency for Health Care Administration, and the Division of
760 Emergency Management. Also, Appropriate volunteer organizations
761 must also be given the opportunity to review the plan. The local
762 emergency management agency shall complete its review within 60
763 days and either approve the plan or advise the facility of
764 necessary revisions.
765 (h) The use of restraint and seclusion. Such criteria rules
766 must be consistent with recognized best practices; prohibit
767 inherently dangerous restraint or seclusion procedures;
768 establish limitations on the use and duration of restraint and
769 seclusion; establish measures to ensure the safety of clients
770 and staff during an incident of restraint or seclusion;
771 establish procedures for staff to follow before, during, and
772 after incidents of restraint or seclusion, including
773 individualized plans for the use of restraints or seclusion in
774 emergency situations; establish professional qualifications of
775 and training for staff who may order or be engaged in the use of
776 restraint or seclusion; establish requirements for facility data
777 collection and reporting relating to the use of restraint and
778 seclusion; and establish procedures relating to the
779 documentation of the use of restraint or seclusion in the
780 client’s facility or program record.
781 (3) If The agency shall adopt rules to provide that, when
782 the criteria established under this part and part II of chapter
783 408 are not met, such deficiencies shall be classified according
784 to the nature of the deficiency. The agency shall indicate the
785 classification on the face of the notice of deficiencies as
786 follows:
787 (a) Class I deficiencies are those which the agency
788 determines present an imminent danger to the residents or guests
789 of the facility or a substantial probability that death or
790 serious physical harm will would result therefrom. The condition
791 or practice constituting a class I violation must be abated or
792 eliminated immediately, unless the agency determines that a
793 fixed period of time, as determined by the agency, is required
794 for correction. A class I deficiency is subject to a civil
795 penalty in an amount of at least not less than $5,000 but not
796 more than and not exceeding $10,000 for each deficiency. A fine
797 may be levied notwithstanding the correction of the deficiency.
798 (b) Class II deficiencies are those which the agency
799 determines have a direct or immediate relationship to the
800 health, safety, or security of the facility residents but do not
801 meet the criteria established for, other than class I
802 deficiencies. A class II deficiency is subject to a civil
803 penalty in an amount of at least not less than $1,000 and not
804 more than not exceeding $5,000 for each deficiency. A citation
805 for a class II deficiency must shall specify the time within
806 which the deficiency must be corrected. If a class II deficiency
807 is corrected within the time specified, a no civil penalty may
808 not shall be imposed, unless it is a repeated offense.
809 (c) Class III deficiencies are those which the agency
810 determines to have an indirect or potential relationship to the
811 health, safety, or security of the facility residents but do not
812 meet the criteria for, other than class I or class II
813 deficiencies. A class III deficiency is subject to a civil
814 penalty of at least not less than $500 and not more than
815 exceeding $1,000 for each deficiency. A citation for a class III
816 deficiency must shall specify the time within which the
817 deficiency must be corrected. If a class III deficiency is
818 corrected within the time specified, a no civil penalty may not
819 shall be imposed, unless it is a repeated offense.
820 Section 16. Subsection (2) of section 400.980, Florida
821 Statutes, is amended to read:
822 400.980 Health care services pools.—
823 (2) The requirements of part II of chapter 408 apply to the
824 provision of services that require licensure or registration
825 pursuant to this part and part II of chapter 408 and to entities
826 registered by or applying for such registration from the agency
827 pursuant to this part. Registration or a license issued by the
828 agency is required for the operation of a health care services
829 pool in this state. In accordance with s. 408.805, an applicant
830 or licensee shall pay a fee for each license application
831 submitted using this part, part II of chapter 408, and
832 applicable rules. The agency shall adopt rules and provide forms
833 required for such registration and shall impose a registration
834 fee in an amount sufficient to cover the cost of administering
835 this part and part II of chapter 408. In addition to the
836 requirements in part II of chapter 408, the registrant must
837 provide the agency with any change of information contained on
838 the original registration application within 14 days before
839 prior to the change.
840 Section 17. Subsection (43) of section 409.912, Florida
841 Statutes, is amended to read:
842 409.912 Cost-effective purchasing of health care.—The
843 agency shall purchase goods and services for Medicaid recipients
844 in the most cost-effective manner consistent with the delivery
845 of quality medical care. To ensure that medical services are
846 effectively utilized, the agency may, in any case, require a
847 confirmation or second physician’s opinion of the correct
848 diagnosis for purposes of authorizing future services under the
849 Medicaid program. This section does not restrict access to
850 emergency services or poststabilization care services as defined
851 in 42 C.F.R. part 438.114. Such confirmation or second opinion
852 shall be rendered in a manner approved by the agency. The agency
853 shall maximize the use of prepaid per capita and prepaid
854 aggregate fixed-sum basis services when appropriate and other
855 alternative service delivery and reimbursement methodologies,
856 including competitive bidding pursuant to s. 287.057, designed
857 to facilitate the cost-effective purchase of a case-managed
858 continuum of care. The agency shall also require providers to
859 minimize the exposure of recipients to the need for acute
860 inpatient, custodial, and other institutional care and the
861 inappropriate or unnecessary use of high-cost services. The
862 agency shall contract with a vendor to monitor and evaluate the
863 clinical practice patterns of providers in order to identify
864 trends that are outside the normal practice patterns of a
865 provider’s professional peers or the national guidelines of a
866 provider’s professional association. The vendor must be able to
867 provide information and counseling to a provider whose practice
868 patterns are outside the norms, in consultation with the agency,
869 to improve patient care and reduce inappropriate utilization.
870 The agency may mandate prior authorization, drug therapy
871 management, or disease management participation for certain
872 populations of Medicaid beneficiaries, certain drug classes, or
873 particular drugs to prevent fraud, abuse, overuse, and possible
874 dangerous drug interactions. The Pharmaceutical and Therapeutics
875 Committee shall make recommendations to the agency on drugs for
876 which prior authorization is required. The agency shall inform
877 the Pharmaceutical and Therapeutics Committee of its decisions
878 regarding drugs subject to prior authorization. The agency is
879 authorized to limit the entities it contracts with or enrolls as
880 Medicaid providers by developing a provider network through
881 provider credentialing. The agency may competitively bid single
882 source-provider contracts if procurement of goods or services
883 results in demonstrated cost savings to the state without
884 limiting access to care. The agency may limit its network based
885 on the assessment of beneficiary access to care, provider
886 availability, provider quality standards, time and distance
887 standards for access to care, the cultural competence of the
888 provider network, demographic characteristics of Medicaid
889 beneficiaries, practice and provider-to-beneficiary standards,
890 appointment wait times, beneficiary use of services, provider
891 turnover, provider profiling, provider licensure history,
892 previous program integrity investigations and findings, peer
893 review, provider Medicaid policy and billing compliance records,
894 clinical and medical record audits, and other factors. Providers
895 are not entitled to enrollment in the Medicaid provider network.
896 The agency shall determine instances in which allowing Medicaid
897 beneficiaries to purchase durable medical equipment and other
898 goods is less expensive to the Medicaid program than long-term
899 rental of the equipment or goods. The agency may establish rules
900 to facilitate purchases in lieu of long-term rentals in order to
901 protect against fraud and abuse in the Medicaid program as
902 defined in s. 409.913. The agency may seek federal waivers
903 necessary to administer these policies.
904 (43) Subject to the availability of funds, the agency shall
905 mandate a recipient’s participation in a provider lock-in
906 program, when appropriate, if a recipient is found by the agency
907 to have used Medicaid goods or services at a frequency or amount
908 not medically necessary, limiting the receipt of goods or
909 services to medically necessary providers after the 21-day
910 appeal process has ended, for at least a period of not less than
911 1 year. The lock-in programs must shall include, but are not
912 limited to, pharmacies, medical doctors, and infusion clinics.
913 The limitation does not apply to emergency services and care
914 provided to the recipient in a hospital emergency department.
915 The agency shall seek any federal waivers necessary to implement
916 this subsection. The agency shall adopt any rules necessary to
917 comply with or administer this subsection. This subsection
918 expires October 1, 2014.
919 Section 18. Subsection (13) of section 409.962, Florida
920 Statutes, is amended to read:
921 409.962 Definitions.—As used in this part, except as
922 otherwise specifically provided, the term:
923 (13) “Provider service network” means an entity qualified
924 pursuant to s. 409.912(4)(d) of which a controlling interest is
925 owned by a health care provider, or group of affiliated
926 providers affiliated for the purpose of providing health care,
927 or a public agency or entity that delivers health services.
928 Health care providers include Florida-licensed health care
929 practitioners professionals or licensed health care facilities,
930 federally qualified health care centers, and home health care
931 agencies.
932 Section 19. Paragraph (e) of subsection (2) of section
933 409.972, Florida Statutes, is amended to read:
934 409.972 Mandatory and voluntary enrollment.—
935 (2) The following Medicaid-eligible persons are exempt from
936 mandatory managed care enrollment required by s. 409.965, and
937 may voluntarily choose to participate in the managed medical
938 assistance program:
939 (e) Medicaid recipients enrolled in the home and community
940 based services waiver pursuant to chapter 393, and Medicaid
941 recipients waiting for waiver services, and Medicaid recipients
942 under the age of 21 who are not receiving waiver services but
943 are authorized by the Agency for Persons with Disabilities or
944 the Department of Children and Families to reside in a group
945 home facility licensed pursuant to chapter 393.
946 Section 20. Subsection (1) of section 409.974, Florida
947 Statutes, is amended to read:
948 409.974 Eligible plans.—
949 (1) ELIGIBLE PLAN SELECTION.—The agency shall select and
950 contract with eligible plans through the procurement process
951 described in s. 409.966. The agency shall notice invitations to
952 negotiate by no later than January 1, 2013.
953 (a) The agency shall procure and contract with two plans
954 for Region 1. At least one plan shall be a provider service
955 network if any provider service networks submit a responsive
956 bid.
957 (b) The agency shall procure and contract with two plans
958 for Region 2. At least one plan shall be a provider service
959 network if any provider service networks submit a responsive
960 bid.
961 (c) The agency shall procure and contract with at least
962 three plans and up to five plans for Region 3. At least one plan
963 must be a provider service network if any provider service
964 networks submit a responsive bid.
965 (d) The agency shall procure and contract with at least
966 three plans and up to five plans for Region 4. At least one plan
967 must be a provider service network if any provider service
968 networks submit a responsive bid.
969 (e) The agency shall procure and contract with at least two
970 plans and up to four plans for Region 5. At least one plan must
971 be a provider service network if any provider service networks
972 submit a responsive bid.
973 (f) The agency shall procure and contract with at least
974 four plans and up to seven plans for Region 6. At least one plan
975 must be a provider service network if any provider service
976 networks submit a responsive bid.
977 (g) The agency shall procure and contract with at least
978 three plans and up to six plans for Region 7. At least one plan
979 must be a provider service network if any provider service
980 networks submit a responsive bid.
981 (h) The agency shall procure and contract with at least two
982 plans and up to four plans for Region 8. At least one plan must
983 be a provider service network if any provider service networks
984 submit a responsive bid.
985 (i) The agency shall procure and contract with at least two
986 plans and up to four plans for Region 9. At least one plan must
987 be a provider service network if any provider service networks
988 submit a responsive bid.
989 (j) The agency shall procure and contract with at least two
990 plans and up to four plans for Region 10. At least one plan must
991 be a provider service network if any provider service networks
992 submit a responsive bid.
993 (k) The agency shall procure and contract with at least
994 five plans and up to 10 plans for Region 11. At least one plan
995 must be a provider service network if any provider service
996 networks submit a responsive bid.
997
998 If no provider service network submits a responsive bid, the
999 agency shall procure up to no more than one less than the
1000 maximum number of eligible plans permitted in that region and,.
1001 within the next 12 months after the initial invitation to
1002 negotiate, shall issue an invitation to negotiate in order the
1003 agency shall attempt to procure and contract with a provider
1004 service network. In a region in which the agency has contracted
1005 with only one provider service network and changes in the
1006 ownership or business structure of the network result in the
1007 network no longer meeting the definition of a provider service
1008 network under s. 409.962, the agency must, within the next 12
1009 months, terminate the contract, provide shall notice of another
1010 invitation to negotiate, and procure and contract only with a
1011 provider service network in that region networks in those
1012 regions where no provider service network has been selected.
1013 Section 21. Subsection (4) of section 429.255, Florida
1014 Statutes, is amended to read:
1015 429.255 Use of personnel; emergency care.—
1016 (4) Facility staff may withhold or withdraw cardiopulmonary
1017 resuscitation or the use of an automated external defibrillator
1018 if presented with an order not to resuscitate executed pursuant
1019 to s. 401.45. The department shall adopt rules providing for the
1020 implementation of such orders. Facility staff and facilities are
1021 shall not be subject to criminal prosecution or civil liability,
1022 nor be considered to have engaged in negligent or unprofessional
1023 conduct, for withholding or withdrawing cardiopulmonary
1024 resuscitation or use of an automated external defibrillator
1025 pursuant to such an order and rules adopted by the department.
1026 The absence of an order to resuscitate executed pursuant to s.
1027 401.45 does not preclude a physician from withholding or
1028 withdrawing cardiopulmonary resuscitation or use of an automated
1029 external defibrillator as otherwise permitted by law.
1030 Section 22. Subsection (3) of section 429.73, Florida
1031 Statutes, is amended to read:
1032 429.73 Rules and standards relating to adult family-care
1033 homes.—
1034 (3) The department shall adopt rules providing for the
1035 implementation of orders not to resuscitate. The provider may
1036 withhold or withdraw cardiopulmonary resuscitation if presented
1037 with an order not to resuscitate executed pursuant to s. 401.45.
1038 The provider is shall not be subject to criminal prosecution or
1039 civil liability, nor be considered to have engaged in negligent
1040 or unprofessional conduct, for withholding or withdrawing
1041 cardiopulmonary resuscitation pursuant to such an order and
1042 applicable rules.
1043 Section 23. Subsection (10) of section 440.102, Florida
1044 Statutes, is amended to read:
1045 440.102 Drug-free workplace program requirements.—The
1046 following provisions apply to a drug-free workplace program
1047 implemented pursuant to law or to rules adopted by the Agency
1048 for Health Care Administration:
1049 (10) RULES.—The Agency for Health Care Administration shall
1050 adopt rules Pursuant to s. 112.0455, part II of chapter 408, and
1051 using criteria established by the United States Department of
1052 Health and Human Services, the agency shall adopt rules as
1053 general guidelines for modeling drug-free workplace
1054 laboratories, including concerning, but not limited to:
1055 (a) Standards for licensing drug-testing laboratories and
1056 suspension and revocation of such licenses.
1057 (b) Urine, hair, blood, and other body specimens and
1058 minimum specimen amounts that are appropriate for drug testing.
1059 (c) Methods of analysis and procedures to ensure reliable
1060 drug-testing results, including standards for initial tests and
1061 confirmation tests.
1062 (d) Minimum cutoff detection levels for each drug or
1063 metabolites of such drug for the purposes of determining a
1064 positive test result.
1065 (e) Chain-of-custody procedures to ensure proper
1066 identification, labeling, and handling of specimens tested.
1067 (f) Retention, storage, and transportation procedures to
1068 ensure reliable results on confirmation tests and retests.
1069 Section 24. Subsection (2) of section 483.245, Florida
1070 Statutes, is amended to read:
1071 483.245 Rebates prohibited; penalties.—
1072 (2) The agency may establish and shall adopt rules that
1073 assess administrative penalties for acts prohibited by
1074 subsection (1). If In the case of an entity is licensed by the
1075 agency, such penalties may include any disciplinary action
1076 available to the agency under the appropriate licensing laws. If
1077 In the case of an entity is not licensed by the agency, such
1078 penalties may include:
1079 (a) A fine not to exceed $1,000;
1080 (b) If applicable, a recommendation by the agency to the
1081 appropriate licensing board that disciplinary action be taken.
1082 Section 25. Subsection (2) of section 765.541, Florida
1083 Statutes, is amended to read:
1084 765.541 Licensure Certification of procurement
1085 organizations; agency responsibilities.—The agency shall:
1086 (1) Establish a program for the licensure certification of
1087 organizations, corporations, or other entities engaged in the
1088 procurement of organs, tissues, and eyes within the state for
1089 transplantation.
1090 (2) Adopt rules as necessary to implement that set forth
1091 appropriate standards and guidelines for the program in
1092 accordance with ss. 765.541-765.546 and part II of chapter 408.
1093 (a) These Standards and guidelines for the program adopted
1094 by the agency must be substantially based on the existing laws
1095 of the Federal Government and this state, and the existing
1096 standards and guidelines of the Organ Procurement and
1097 Transplantation Network (OPTN), the Association of Organ
1098 Procurement Organizations (AOPO)United Network for Organ Sharing
1099 (UNOS), the American Association of Tissue Banks (AATB), the
1100 South-Eastern Organ Procurement Foundation (SEOPF), the North
1101 American Transplant Coordinators Organization (NATCO), and the
1102 Eye Bank Association of America (EBAA). In addition, the agency
1103 shall, before adopting these standards and guidelines, seek
1104 input from all procurement organizations based in this state.
1105 Section 26. Subsection (2) of section 765.544, Florida
1106 Statutes, is amended to read:
1107 765.544 Fees; organ and tissue donor education and
1108 procurement.—
1109 (2) The agency shall specify by rule the administrative
1110 penalties for the purpose of ensuring adherence to the standards
1111 of quality and practice required by this chapter, part II of
1112 chapter 408, and applicable rules of the agency for continued
1113 certification.
1114 Section 27. This act shall take effect July 1, 2014.
1115
1116 ================= T I T L E A M E N D M E N T ================
1117 And the title is amended as follows:
1118 Delete everything before the enacting clause
1119 and insert:
1120 A bill to be entitled
1121 An act relating to health care services; amending ss.
1122 390.012, 400.021, 400.0712, 400.23, 400.487, 400.497,
1123 400.506, 400.509, 400.6095, 400.914, 400.935, 400.962,
1124 400.967, 400.980, 409.912, 429.255, 429.73, 440.102,
1125 483.245, 765.541, and 765.544, F.S.; removing certain
1126 rulemaking authority relating to the disposal of fetal
1127 remains by abortion clinics, nursing home equipment
1128 and furnishings, license applications for nursing home
1129 facilities, evaluation of nursing home facilities,
1130 home health agencies and cardiopulmonary
1131 resuscitation, home health agency standards, nurse
1132 registry emergency management plans, registration of
1133 certain service providers, hospice and cardiopulmonary
1134 resuscitation, standards for prescribed pediatric
1135 extended care facilities, minimum standards relating
1136 to home medical equipment providers, standards for
1137 intermediate care facilities for the developmentally
1138 disabled, rules and the classification of deficiencies
1139 for intermediate care facilities for the
1140 developmentally disabled, the registration of health
1141 care service pools, participation in a Medicaid
1142 provider lock-in program, assisted living facilities
1143 and cardiopulmonary resuscitation, adult family-care
1144 homes and cardiopulmonary resuscitation, guidelines
1145 for drug-free workplace laboratories, penalties for
1146 rebates, standards for organ procurement
1147 organizations; administrative penalties for violations
1148 of the organ and tissue donor education and
1149 procurement program; creating s. 400.9141; limiting
1150 services at PPEC centers; amending s. 400.934,
1151 relating to home medical equipment providers;
1152 requiring that the emergency management plan include
1153 criteria relating to the maintenance of patient
1154 equipment and supply lists; amending s. 409.962, F.S.;
1155 redefining the term “provider service network”;
1156 amending s. 409.972; exempting certain people from the
1157 requirement to enroll in Medicaid managed care;
1158 amending s. 409.974, F.S.; providing for contracting
1159 with eligible plans; revising provisions relating to
1160 negotiation with a provider service network; providing
1161 requirements for termination of a contract with a
1162 provider service network; providing an effective date.