Florida Senate - 2014                                     SB 872
       
       
        
       By Senator Richter
       
       
       
       
       
       23-01006-14                                            2014872__
    1                        A bill to be entitled                      
    2         An act relating to Alzheimer’s disease; amending s.
    3         120.80, F.S.; exempting grant programs administered by
    4         the Alzheimer’s Disease Research Grant Advisory Board
    5         from the Administrative Procedure Act; amending s.
    6         252.355, F.S.; requiring the Division of Emergency
    7         Management, in coordination with local emergency
    8         management agencies, to maintain a registry of persons
    9         with special needs; requiring the division to develop
   10         and maintain a special needs shelter registration
   11         program; requiring specified agencies and authorizing
   12         specified health care providers to provide
   13         registration information to special needs clients or
   14         their caregivers and to assist emergency management
   15         agencies in registering persons for special needs
   16         shelters; amending s. 381.0303, F.S.; providing
   17         additional staffing requirements for special needs
   18         shelters; requiring special needs shelters to
   19         establish designated shelter areas for persons with
   20         Alzheimer’s disease or related forms of dementia;
   21         authorizing the Department of Health, in coordination
   22         with the division, to adopt rules relating to
   23         standards for the special needs registration program;
   24         creating s. 381.82, F.S.; establishing the Ed and
   25         Ethel Moore Alzheimer’s Disease Research Program
   26         within the department; requiring the program to
   27         provide grants and fellowships for research relating
   28         to Alzheimer’s disease; creating the Alzheimer’s
   29         Disease Research Grant Advisory Board; providing for
   30         appointment and terms of members; providing for
   31         organization, duties, and operating procedures of the
   32         board; requiring the department to provide staff to
   33         assist the board in carrying out its duties; requiring
   34         the board to annually submit recommendations for
   35         proposals to be funded; requiring a report to the
   36         Governor, Legislature, and State Surgeon General;
   37         providing that implementation of the program is
   38         subject to appropriation; amending s. 430.502, F.S.;
   39         requiring the Department of Elderly Affairs to develop
   40         minimum performance standards for memory disorder
   41         clinics to receive base-level annual funding;
   42         requiring the department to provide incentive-based
   43         funding, subject to appropriation, for certain memory
   44         disorder clinics; providing an effective date.
   45          
   46  Be It Enacted by the Legislature of the State of Florida:
   47  
   48         Section 1. Subsection (15) of section 120.80, Florida
   49  Statutes, is amended to read:
   50         120.80 Exceptions and special requirements; agencies.—
   51         (15) DEPARTMENT OF HEALTH.—
   52         (a) Notwithstanding s. 120.57(1)(a), formal hearings may
   53  not be conducted by the State Surgeon General, the Secretary of
   54  Health Care Administration, or a board or member of a board
   55  within the Department of Health or the Agency for Health Care
   56  Administration for matters relating to the regulation of
   57  professions, as defined by chapter 456. Notwithstanding s.
   58  120.57(1)(a), hearings conducted within the Department of Health
   59  in execution of the Special Supplemental Nutrition Program for
   60  Women, Infants, and Children; Child Care Food Program;
   61  Children’s Medical Services Program; the Brain and Spinal Cord
   62  Injury Program; and the exemption from disqualification reviews
   63  for certified nurse assistants program need not be conducted by
   64  an administrative law judge assigned by the division. The
   65  Department of Health may contract with the Department of
   66  Children and Families Family Services for a hearing officer in
   67  these matters.
   68         (b) This chapter does not apply to grant programs
   69  administered by the Alzheimer’s Disease Research Grant Advisory
   70  Board pursuant to s. 381.82.
   71         Section 2. Section 252.355, Florida Statutes, is amended to
   72  read:
   73         252.355 Registry of persons with special needs; notice;
   74  registration program.—
   75         (1) In order to meet the special needs of persons who would
   76  need assistance during evacuations and sheltering because of
   77  physical, mental, cognitive impairment, or sensory disabilities,
   78  the division, in coordination with each local emergency
   79  management agency in the state, shall maintain a registry of
   80  persons with special needs located within the jurisdiction of
   81  the local agency. The registration shall identify those persons
   82  in need of assistance and plan for resource allocation to meet
   83  those identified needs.
   84         (2) In order to ensure that all persons with special needs
   85  may register, the division shall develop and maintain a special
   86  needs shelter registration program.
   87         (a) The registration program shall include, at a minimum, a
   88  uniform electronic registration form and a database for
   89  uploading and storing submitted registration forms which may be
   90  accessed by the appropriate local emergency management agency.
   91  The link to the registration form shall be easily accessible on
   92  each local emergency management agency’s website. Upon receipt
   93  of a paper registration form, the local emergency management
   94  agency shall enter the person’s registration information into
   95  the database.
   96         (b) To assist the local emergency management agency in
   97  identifying such persons with special needs, home health
   98  agencies, hospices, nurse registries, home medical equipment
   99  providers, the Department of Children and Families Family
  100  Services, the Department of Health, the Agency for Health Care
  101  Administration, the Department of Education, the Agency for
  102  Persons with Disabilities, the and Department of Elderly
  103  Affairs, and memory disorder clinics shall, and any physician
  104  licensed under chapter 458 or chapter 459 and any pharmacy
  105  licensed under chapter 465 may, annually shall provide
  106  registration information to all of their special needs clients
  107  or their caregivers and to all persons with special needs who
  108  receive services. The division shall develop a brochure that
  109  provides information regarding special needs shelter
  110  registration procedures. The brochure shall be published on the
  111  division’s website. All appropriate agencies and community-based
  112  service providers, including memory disorder clinics, home
  113  health care providers, hospices, nurse registries, and home
  114  medical equipment providers shall, and any physician licensed
  115  under chapter 458 or chapter 459 may, assist emergency
  116  management agencies by annually registering persons with special
  117  needs for special needs shelters, collecting registration
  118  information for persons with special needs as part of the
  119  program intake process, and establishing programs to educate
  120  clients about the registration process and disaster preparedness
  121  safety procedures. A client of a state-funded or federally
  122  funded service program who has a physical, mental, or cognitive
  123  impairment or sensory disability and who needs assistance in
  124  evacuating or while in a shelter must register as a person with
  125  special needs. The registry shall be updated annually. The
  126  registration program shall give persons with special needs the
  127  option of preauthorizing emergency response personnel to enter
  128  their homes during search and rescue operations if necessary to
  129  ensure assure their safety and welfare following disasters.
  130         (c)(2) The division shall be the designated lead agency
  131  responsible for community education and outreach to the public,
  132  including special needs clients, regarding registration and
  133  special needs shelters and general information regarding shelter
  134  stays.
  135         (d)(4)(a) On or before May 31 of each year, each electric
  136  utility in the state shall annually notify residential customers
  137  in its service area of the availability of the registration
  138  program available through their local emergency management
  139  agency by:
  140         1. An initial notification upon the activation of new
  141  residential service with the electric utility, followed by one
  142  annual notification between January 1 and May 31; or
  143         2. Two separate annual notifications between January 1 and
  144  May 31.
  145  
  146  (b) The notification may be made by any available means,
  147  including, but not limited to, written, electronic, or verbal
  148  notification, and may be made concurrently with any other
  149  notification to residential customers required by law or rule.
  150         (3) A person with special needs must be allowed to bring
  151  his or her service animal into a special needs shelter in
  152  accordance with s. 413.08.
  153         (4)(5) All records, data, information, correspondence, and
  154  communications relating to the registration of persons with
  155  special needs as provided in subsection (1) are confidential and
  156  exempt from the provisions of s. 119.07(1), except that such
  157  information shall be available to other emergency response
  158  agencies, as determined by the local emergency management
  159  director. Local law enforcement agencies shall be given complete
  160  shelter roster information upon request.
  161         (6) All appropriate agencies and community-based service
  162  providers, including home health care providers, hospices, nurse
  163  registries, and home medical equipment providers, shall assist
  164  emergency management agencies by collecting registration
  165  information for persons with special needs as part of program
  166  intake processes, establishing programs to increase the
  167  awareness of the registration process, and educating clients
  168  about the procedures that may be necessary for their safety
  169  during disasters. Clients of state or federally funded service
  170  programs with physical, mental, cognitive impairment, or sensory
  171  disabilities who need assistance in evacuating, or when in
  172  shelters, must register as persons with special needs.
  173         Section 3. Present subsections (3) through (7) of section
  174  381.0303, Florida Statutes, are redesignated as subsections (4)
  175  through (8), respectively, paragraph (b) of subsection (2) and
  176  present subsection (6) are amended, and a new subsection (3) is
  177  added to that section, to read:
  178         381.0303 Special needs shelters.—
  179         (2) SPECIAL NEEDS SHELTER PLAN; STAFFING; STATE AGENCY
  180  ASSISTANCE.—If funds have been appropriated to support disaster
  181  coordinator positions in county health departments:
  182         (b) County health departments shall, in conjunction with
  183  the local emergency management agencies, have the lead
  184  responsibility for coordination of the recruitment of health
  185  care practitioners to staff local special needs shelters. County
  186  health departments shall assign their employees to work in
  187  special needs shelters when those employees are needed to
  188  protect the health and safety of persons with special needs.
  189  County governments shall assist the department with nonmedical
  190  staffing and the operation of special needs shelters. The local
  191  health department and emergency management agency shall
  192  coordinate these efforts to ensure appropriate staffing in
  193  special needs shelters, including a staff member who is familiar
  194  with the needs of persons with Alzheimer’s disease.
  195         (3) SPECIAL CARE FOR PERSONS WITH ALZHEIMER’S DISEASE OR
  196  RELATED FORMS OF DEMENTIA.—All special needs shelters must
  197  establish designated shelter areas for persons with Alzheimer’s
  198  disease or related forms of dementia to enable those persons to
  199  maintain their normal habits and routines to the greatest extent
  200  possible.
  201         (7)(6) RULES.—The department, in coordination with the
  202  Division of Emergency Management, may has the authority to adopt
  203  rules necessary to implement this section. Rules shall include:
  204         (a) The definition of a “person with special needs,”
  205  including eligibility criteria for individuals with physical,
  206  mental, cognitive impairment, or sensory disabilities and the
  207  services a person with special needs can expect to receive in a
  208  special needs shelter.
  209         (b) The process for special needs shelter health care
  210  practitioners and facility reimbursement for services provided
  211  in a disaster.
  212         (c) Guidelines for special needs shelter staffing levels to
  213  provide services.
  214         (d) The definition of and standards for special needs
  215  shelter supplies and equipment, including durable medical
  216  equipment.
  217         (e) Standards for the special needs shelter registration
  218  program process, including all necessary forms and guidelines
  219  for addressing the needs of unregistered persons in need of a
  220  special needs shelter.
  221         (f) Standards for addressing the needs of families where
  222  only one dependent is eligible for admission to a special needs
  223  shelter and the needs of adults with special needs who are
  224  caregivers for individuals without special needs.
  225         (g) The requirement of the county health departments to
  226  seek the participation of hospitals, nursing homes, assisted
  227  living facilities, home health agencies, hospice providers,
  228  nurse registries, home medical equipment providers, dialysis
  229  centers, and other health and medical emergency preparedness
  230  stakeholders in pre-event planning activities.
  231         Section 4. Section 381.82, Florida Statutes, is created to
  232  read:
  233         381.82 Ed and Ethel Moore Alzheimer’s Disease Research
  234  Program.—
  235         (1) There is established the Ed and Ethel Moore Alzheimer’s
  236  Disease Research Program within the Department of Health. The
  237  purpose of the program is to fund research leading to prevention
  238  of or a cure for Alzheimer’s disease. The long-term goals of the
  239  program are to:
  240         (a) Enhance the health of Floridians by researching
  241  improved prevention, diagnosis, treatment, and cure of
  242  Alzheimer’s disease.
  243         (b) Expand the foundation of knowledge relating to the
  244  prevention, diagnosis, treatment, and cure of Alzheimer’s
  245  disease.
  246         (c) Stimulate economic activity in the state in areas
  247  related to Alzheimer’s disease research.
  248         (2)(a) Funds appropriated for the Ed and Ethel Moore
  249  Alzheimer’s Disease Research Program shall be used exclusively
  250  for the award of grants and fellowships through a competitive,
  251  peer-reviewed process for research relating to the prevention,
  252  diagnosis, treatment, and cure of Alzheimer’s disease and for
  253  expenses incurred in the administration of this section.
  254  Priority shall be granted to research designed to prevent or
  255  cure Alzheimer’s disease.
  256         (b) Applications for Alzheimer’s disease research funding
  257  under the program may be submitted from any university or
  258  established research institute in the state. All qualified
  259  investigators in the state, regardless of institution
  260  affiliation, shall have equal access and opportunity to compete
  261  for research funding. The following types of applications may be
  262  considered for funding:
  263         1. Investigator-initiated research grants.
  264         2. Institutional research grants.
  265         3. Predoctoral and postdoctoral research fellowships.
  266         4. Collaborative research grants, including those that
  267  advance the finding of cures through basic or applied research.
  268         (3) There is created the Alzheimer’s Disease Research Grant
  269  Advisory Board within the Department of Health.
  270         (a) The board shall consist of 12 members appointed by the
  271  State Surgeon General. The board shall be composed of three
  272  gerontologists, three geriatric psychiatrists, three
  273  geriatricians, and three neurologists. Initial appointments to
  274  the board shall be made by October 1, 2014. The board members
  275  shall serve 4-year terms, except that, to provide for staggered
  276  terms, six of the initial appointees shall serve 2-year terms
  277  and six shall serve 4-year terms. All subsequent appointments
  278  shall be for 4-year terms. The chair of the board shall be
  279  elected from the membership of the board and shall serve as
  280  chair for 2 years. An appointed member may not serve more than
  281  two consecutive terms. Appointed members must have experience in
  282  Alzheimer’s disease or related biomedical research. The board
  283  shall adopt internal organizational procedures as necessary for
  284  its organization. The board shall establish and follow
  285  guidelines for ethical conduct and adhere to a policy
  286  established to avoid conflicts of interest. A member of the
  287  board may not participate in any discussion or decision of the
  288  board or a panel with respect to a research proposal by any
  289  firm, entity, or agency with which the member is associated as a
  290  member of the governing body or as an employee or with which the
  291  member has entered into a contractual arrangement.
  292         (b) The department shall provide such staff, information,
  293  and other assistance as necessary to assist the board in
  294  carrying out its responsibilities. Members of the board shall
  295  serve without compensation and may not receive reimbursement for
  296  per diem or travel expenses.
  297         (c) The board shall advise the State Surgeon General as to
  298  the scope of the research program and shall submit its
  299  recommendations for proposals to be funded to the State Surgeon
  300  General by December 15 of each year. Grants and fellowships
  301  shall be awarded by the State Surgeon General, after
  302  consultation with the board, on the basis of scientific merit.
  303  Other responsibilities of the board may include, but are not
  304  limited to, providing advice on program priorities and emphases;
  305  assisting in the development of appropriate linkages to
  306  nonacademic entities, such as voluntary organizations, health
  307  care delivery institutions, industry, government agencies, and
  308  public officials; and developing and providing oversight
  309  regarding mechanisms for the dissemination of research results.
  310         (4) The board shall submit a fiscal-year progress report on
  311  the programs under its purview to the Governor, the President of
  312  the Senate, the Speaker of the House of Representatives, and the
  313  State Surgeon General by February 15 of each year. The report
  314  must include:
  315         (a) A list of research projects supported by grants or
  316  fellowships awarded under the program.
  317         (b) A list of recipients of program grants or fellowships.
  318         (c) A list of publications in peer-reviewed journals
  319  involving research supported by grants or fellowships awarded
  320  under the program.
  321         (d) The state ranking and total amount of Alzheimer’s
  322  disease research funding allocated to the state from the
  323  National Institutes of Health.
  324         (e) New grants for Alzheimer’s disease research which were
  325  funded based on research supported by grants or fellowships
  326  awarded under the program.
  327         (f) Progress toward programmatic goals, particularly in the
  328  prevention, diagnosis, treatment, and cure of Alzheimer’s
  329  disease.
  330         (g) Recommendations to further the mission of the program.
  331         (5) Implementation of the Ed and Ethel Moore Alzheimer’s
  332  Disease Research Program is subject to legislative
  333  appropriation.
  334         Section 5. Present subsections (3) through (9) of section
  335  430.502, Florida Statutes, are redesignated as subsections (6)
  336  through (12), respectively, new subsections (3), (4), and (5)
  337  are added to that section, and present subsections (4), (5),
  338  (8), and (9) of that section are amended, to read:
  339         430.502 Alzheimer’s disease; memory disorder clinics and
  340  day care and respite care programs.—
  341         (3) The department shall develop minimum performance
  342  standards for memory disorder clinics and include those
  343  standards in each memory disorder clinic contract as a condition
  344  for receiving base-level funding. The performance standards must
  345  address, at a minimum, quality of care, comprehensiveness of
  346  services, and access to services.
  347         (4) The department shall develop performance goals that
  348  exceed the minimum performance standards developed under
  349  subsection (3) which must be achieved in order for a memory
  350  disorder clinic to be eligible for incentive funding above the
  351  base level, subject to legislative appropriation. Incentive
  352  funding shall be based on criteria including, but not limited
  353  to:
  354         (a) A significant increase in the volume of clinical
  355  services.
  356         (b) A significant increase in public outreach to low-income
  357  and minority populations.
  358         (c) A significant increase in the acceptance of Medicaid
  359  and commercial insurance policies.
  360         (d) Significant institutional financial commitments.
  361         (5) The department shall measure and score each memory
  362  disorder clinic based on minimum performance standards and
  363  incentive performance goals.
  364         (7)(4) Pursuant to the provisions of s. 287.057, the
  365  department of Elderly Affairs may contract for the provision of
  366  specialized model day care programs in conjunction with the
  367  memory disorder clinics. The purpose of each model day care
  368  program must be to provide service delivery to persons suffering
  369  from Alzheimer’s disease or a related memory disorder and
  370  training for health care and social service personnel in the
  371  care of persons having Alzheimer’s disease or a related memory
  372  disorder disorders.
  373         (8)(5) Pursuant to s. 287.057, the department of Elderly
  374  Affairs shall contract for the provision of respite care. All
  375  funds appropriated for the provision of respite care shall be
  376  distributed annually by the department to each funded county
  377  according to an allocation formula. In developing the formula,
  378  the department shall consider the number and proportion of the
  379  county population of individuals who are 75 years of age and
  380  older. Each respite care program shall be used as a resource for
  381  research and statistical data by the memory disorder clinics
  382  established in this part. In consultation with the memory
  383  disorder clinics, the department shall specify the information
  384  to be provided by the respite care programs for research
  385  purposes.
  386         (11)(8) The department shall implement the waiver program
  387  specified in subsection (10) (7). The agency and the department
  388  shall ensure the selection of that providers who have a history
  389  of successfully serving persons with Alzheimer’s disease are
  390  selected. The department and the agency shall develop
  391  specialized standards for providers and services tailored to
  392  persons in the early, middle, and late stages of Alzheimer’s
  393  disease and designate a level of care determination process and
  394  standard that is most appropriate to this population. The
  395  department and the agency shall include in the waiver services
  396  designed to assist the caregiver in continuing to provide in
  397  home care. The department shall implement this waiver program
  398  subject to a specific appropriation or as provided in the
  399  General Appropriations Act.
  400         (12)(9) Authority to continue the waiver program specified
  401  in subsection (10) (7) shall be automatically eliminated at the
  402  close of the 2010 Regular Session of the Legislature unless
  403  further legislative action is taken to continue it before prior
  404  to such time.
  405         Section 6. This act shall take effect July 1, 2014.