Florida Senate - 2018 SENATOR AMENDMENT Bill No. CS for CS for SB 622, 1st Eng. Ì855822,Î855822 LEGISLATIVE ACTION Senate . House . . . Floor: 1/AD/3R . 03/03/2018 10:05 AM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Brandes moved the following: 1 Senate Amendment (with directory and title amendments) 2 3 Between lines 833 and 834 4 insert: 5 (6) 6 (b) A specialty-licensed children’s hospital that has 7 licensed neonatal intensive care unit beds and is located in 8 District 5 or District 11, as defined in s. 408.032, as of 9 January 1, 2018,a county with a population of 1,750,000 or more10 may provide obstetrical services, in accordance with the 11 pertinent guidelines promulgated by the American College of 12 Obstetricians and Gynecologists and with verification of 13 guidelines and compliance with internal safety standards by the 14 Voluntary Review for Quality of Care Program of the American 15 College of Obstetricians and Gynecologists and in compliance 16 with the agency’s rules pertaining to the obstetrical department 17 in a hospital and offer healthy mothers all necessary critical 18 care equipment, services, and the capability of providing up to 19 10 beds for labor and delivery care, which services are 20 restricted to the diagnosis, care, and treatment of pregnant 21 women of any age who have documentation by an examining 22 physician that includes information regarding: 23 1. At least one fetal characteristic or condition diagnosed 24 intra-utero that would characterize the pregnancy or delivery as 25 high risk including structural abnormalities of the digestive, 26 central nervous, and cardiovascular systems and disorders of 27 genetic malformations and skeletal dysplasia, acute metabolic 28 emergencies, and babies of mothers with rheumatologic disorders; 29 or 30 2. Medical advice or a diagnosis indicating that the fetus 31 may require at least one perinatal intervention. 32 33 This paragraph shall not preclude a specialty-licensed 34 children’s hospital from complying with s. 395.1041 or the 35 Emergency Medical Treatment and Active Labor Act, 42 U.S.C. 36 1395dd. 37 38 ====== D I R E C T O R Y C L A U S E A M E N D M E N T ====== 39 And the directory clause is amended as follows: 40 Delete lines 799 - 800 41 and insert: 42 Section 1. Paragraphs (a) and (b) of subsection (1), 43 paragraph (b) of subsection (2), and paragraph (b) of subsection 44 (6) of section 395.003, Florida 45 46 ================= T I T L E A M E N D M E N T ================ 47 And the title is amended as follows: 48 Delete lines 27 - 299 49 and insert: 50 amending s. 395.003, F.S.; conforming provisions to 51 changes made by the act; authorizing certain 52 specialty-licensed children’s hospitals to provide 53 obstetrical services under certain circumstances; 54 creating the public health trust; amending ss. 55 381.0031, 381.004, 384.31, 395.009, 400.0625, and 56 409.905, F.S.; eliminating state licensure 57 requirements for clinical laboratories; requiring 58 clinical laboratories to be federally certified; 59 amending s. 381.915, F.S.; increasing the number of 60 years that a cancer center may participate in Tier 3 61 of the Florida Consortium of National Cancer Institute 62 Centers Program; increasing the number of years after 63 qualification that a certain Tier 3 cancer center may 64 pursue specified NCI designations; amending s. 65 383.313, F.S.; requiring a birth center to be 66 federally certified and meet specified requirements to 67 perform certain laboratory tests; repealing s. 68 383.335, F.S., relating to partial exemptions from 69 licensure requirements for certain facilities that 70 provide obstetrical and gynecological surgical 71 services; amending s. 395.002, F.S.; revising and 72 deleting definitions to remove the term “mobile 73 surgical facility”; conforming a cross-reference; 74 creating s. 395.0091, F.S.; requiring the Agency for 75 Health Care Administration, in consultation with the 76 Board of Clinical Laboratory Personnel, to adopt rules 77 establishing criteria for alternate-site laboratory 78 testing; requiring specifications to be included in 79 the criteria; defining the term “alternate-site 80 testing”; amending ss. 395.0161 and 395.0163, F.S.; 81 deleting licensure and inspection requirements for 82 mobile surgical facilities to conform to changes made 83 by the act; amending s. 395.0197, F.S.; requiring the 84 manager of a hospital or ambulatory surgical center 85 internal risk management program to demonstrate 86 competence in specified administrative and health care 87 service areas; conforming provisions to changes made 88 by the act; repealing s. 395.1046, F.S., relating to 89 hospital complaint investigation procedures; amending 90 s. 395.1055, F.S.; requiring hospitals that provide 91 specified services to meet agency licensure 92 requirements; providing standards to be included in 93 licensure requirements; conforming a provision to 94 changes made by the act; requiring a level 2 95 background screening for personnel of distinct part 96 nursing units; requiring the agency to adopt rules 97 establishing standards for pediatric cardiac 98 catheterization and pediatric cardiovascular surgery 99 programs; providing requirements for such programs; 100 requiring pediatric cardiac programs to participate in 101 the clinical outcome reporting systems; revising 102 duties and membership of the pediatric cardiac 103 technical advisory panel; repealing ss. 395.10971 and 104 395.10972, F.S., relating to the purpose and the 105 establishment of the Health Care Risk Manager Advisory 106 Council, respectively; amending s. 395.10973, F.S.; 107 removing requirements relating to agency standards for 108 health care risk managers to conform provisions to 109 changes made by the act; repealing s. 395.10974, F.S., 110 relating to licensure of health care risk managers, 111 qualifications, licensure, and fees; repealing s. 112 395.10975, F.S., relating to grounds for denial, 113 suspension, or revocation of a health care risk 114 manager’s license and an administrative fine; amending 115 s. 395.602, F.S.; deleting definitions for the terms 116 “emergency care hospital,” “essential access community 117 hospital,” “inactive rural hospital bed,” and “rural 118 primary care hospital”; amending s. 395.603, F.S.; 119 deleting provisions relating to deactivation of 120 general hospital beds by certain rural and emergency 121 care hospitals; repealing s. 395.604, F.S., relating 122 to other rural hospital programs; repealing s. 123 395.605, F.S., relating to emergency care hospitals; 124 amending s. 395.701, F.S.; revising the definition of 125 the term “hospital” to exclude hospitals operated by a 126 state agency; amending s. 400.191, F.S.; removing the 127 30-month reporting timeframe for the Nursing Home 128 Guide; amending s. 400.464, F.S.; requiring that a 129 license issued to a home health agency on or after a 130 specified date specify the services the organization 131 is authorized to perform and whether the services 132 constitute skilled care; providing that the provision 133 or advertising of certain services constitutes 134 unlicensed activity under certain circumstances; 135 authorizing certain persons, entities or organizations 136 providing home health services to voluntarily apply 137 for a certificate of exemption from licensure by 138 providing certain information to the agency; providing 139 that the certificate is valid for a specified time and 140 is nontransferable; authorizing the agency to charge a 141 fee for the certificate; amending s. 400.471, F.S.; 142 revising home health agency licensure requirements; 143 providing requirements for proof of accreditation for 144 home health agencies applying for change of ownership 145 or the addition of skilled care services; removing a 146 provision prohibiting the agency from issuing a 147 license to a home health agency that fails to satisfy 148 the requirements of a Medicare certification survey 149 from the agency; amending s. 400.474, F.S.; revising 150 conditions for the imposition of a fine against a home 151 health agency; amending s. 400.476, F.S.; requiring a 152 home health agency providing skilled nursing care to 153 have a director of nursing; amending s. 400.484, F.S.; 154 imposing administrative fines on home health agencies 155 for specified classes of violations; amending s. 156 400.497, F.S.; requiring the agency to adopt, publish, 157 and enforce rules establishing standards for 158 certificates of exemption; amending s. 400.506, F.S.; 159 specifying a criminal penalty for any person who owns, 160 operates, or maintains an unlicensed nurse registry 161 that fails to cease operation immediately and apply 162 for a license after notification from the agency; 163 revising provisions authorizing the agency to impose a 164 fine on a nurse registry that fails to cease operation 165 after agency notification; revising circumstances 166 under which the agency is authorized to deny, suspend, 167 or revoke a license or impose a fine on a nurse 168 registry; prohibiting a nurse registry from 169 monitoring, supervising, managing, or training a 170 certain caregiver who is an independent contractor; 171 amending s. 400.606, F.S.; removing a requirement that 172 an existing licensed health care provider’s hospice 173 licensure application be accompanied by a copy of the 174 most recent profit-loss statement and licensure 175 inspection report; amending s. 400.925, F.S.; revising 176 the definition of the term “home medical equipment”; 177 amending s. 400.931, F.S.; requiring a home medical 178 equipment provider to notify the agency of certain 179 personnel changes within a specified timeframe; 180 amending s. 400.933, F.S.; requiring the agency to 181 accept the submission of a valid medical oxygen retail 182 establishment permit issued by the Department of 183 Business and Professional Regulation in lieu of an 184 agency inspection for licensure; amending s. 400.980, 185 F.S.; revising the timeframe within which a health 186 care services pool registrant must provide the agency 187 with certain changes of information; amending s. 188 400.9935, F.S.; specifying that a voluntary 189 certificate of exemption may be valid for up to 2 190 years; amending s. 408.036, F.S.; conforming 191 provisions to changes made by the act; deleting 192 obsolete provisions relating to certificate of need 193 requirements for specified services; amending s. 194 408.0361, F.S.; providing an exception for a hospital 195 to become a Level I Adult Cardiovascular provider if 196 certain requirements are met; amending s. 408.05, 197 F.S.; requiring the agency to contract with the 198 Society of Thoracic Surgeons and the American College 199 of Cardiology for the collection of certain data for 200 publication on the agency’s website for certain 201 purposes; amending s. 408.061, F.S.; excluding 202 hospitals operated by state agencies from certain 203 financial reporting requirements; conforming a cross 204 reference; amending s. 408.07, F.S.; deleting the 205 definition for the term “clinical laboratory”; 206 amending s. 408.20, F.S.; exempting hospitals operated 207 by any state agency from assessments against the 208 Health Care Trust Fund to fund certain agency 209 activities; repealing s. 408.7056, F.S., relating to 210 the Subscriber Assistance Program; amending s. 211 408.803, F.S.; defining the term “relative” for 212 purposes of the Health Care Licensing Procedures Act; 213 amending s. 408.806, F.S.; authorizing licensees who 214 hold licenses for multiple providers to request that 215 the agency align related license expiration dates; 216 authorizing the agency to issue licenses for an 217 abbreviated licensure period and to charge a prorated 218 licensure fee; amending s. 408.809, F.S.; expanding 219 the scope of persons subject to a level 2 background 220 screening to include any employee of a licensee who is 221 a controlling interest and certain part-time 222 contractors; amending s. 408.810, F.S.; providing that 223 an applicant for change of ownership licensure is 224 exempt from furnishing proof of financial ability to 225 operate if certain conditions are met; authorizing the 226 agency to adopt rules governing circumstances under 227 which a controlling interest may act in certain legal 228 capacities on behalf of a patient or client; requiring 229 a licensee to ensure that certain persons do not hold 230 an ownership interest if the licensee is not organized 231 as or owned by a publicly traded corporation; defining 232 the term “publicly traded corporation”; amending s. 233 408.812, F.S.; providing that certain unlicensed 234 activity by a provider constitutes abuse and neglect; 235 clarifying that the agency may impose a fine or 236 penalty, as prescribed in an authorizing statute, if 237 an unlicensed provider who has received notification 238 fails to cease operation; authorizing the agency to 239 revoke all licenses and impose a fine or penalties 240 upon a controlling interest or licensee who has an 241 interest in more than one provider and who fails to 242 license a provider rendering services that require 243 licensure in certain circumstances; amending s. 244 408.820, F.S.; deleting certain exemptions from part 245 II of ch. 408, F.S., for specified providers to 246 conform provisions to changes made by the act; 247 amending s. 409.907, F.S.; removing the agency’s 248 authority to consider certain factors in determining 249 whether to enter into, and in maintaining, a Medicaid 250 provider agreement; amending s. 429.02, F.S.; revising 251 definitions of the terms “assisted living facility” 252 and “personal services”; amending s. 429.04, F.S.; 253 providing additional exemptions from licensure as an 254 assisted living facility; requiring a person or entity 255 asserting the exemption to provide documentation that 256 substantiates the claim upon agency investigation of 257 unlicensed activity; amending s. 429.08, F.S.; 258 providing criminal penalties and fines for a person 259 who rents or otherwise maintains a building or 260 property used as an unlicensed assisted living 261 facility; providing criminal penalties and fines for a 262 person who owns, operates, or maintains an unlicensed 263 assisted living facility after receiving notice from 264 the agency; amending s. 429.176, F.S.; prohibiting an 265 assisted living facility from operating for more than 266 a specified time without an administrator who has 267 completed certain educational requirements; amending 268 s. 429.24, F.S.; providing that 30-day written notice 269 of rate increase for residency in an assisted living 270 facility is not required in certain situations; 271 amending s. 429.28, F.S.; revising the assisted living 272 facility resident bill of rights to include assistance 273 with obtaining access to adequate and appropriate 274 health care; defining the term “adequate and 275 appropriate health care”; deleting a requirement that 276 the agency conduct at least one monitoring visit under 277 certain circumstances; deleting provisions authorizing 278 the agency to conduct periodic followup inspections 279 and complaint investigations under certain 280 circumstances; amending s. 429.294, F.S.; deleting the 281 specified timeframe within which an assisted living 282 facility must provide complete copies of a resident’s 283 records in an investigation of resident’s rights; 284 amending s. 429.34, F.S.; authorizing the agency to 285 inspect and investigate assisted living facilities as 286 necessary to determine compliance with certain laws; 287 removing a provision requiring the agency to inspect 288 each licensed assisted living facility at least 289 biennially; authorizing the agency to conduct 290 monitoring visits of each facility cited for prior 291 violations under certain circumstances; amending s. 292 429.52, F.S.; requiring an assisted living facility 293 administrator to complete required training and 294 education within a specified timeframe; amending s. 295 435.04, F.S.; providing that security background 296 investigations must ensure that a person has not been 297 arrested for, and is not awaiting final disposition 298 of, certain offenses; requiring that security 299 background investigations for purposes of 300 participation in the Medicaid program screen for 301 violations of federal or state law, rule, or 302 regulation governing any state Medicaid program, the 303 Medicare program, or any other publicly funded federal 304 or state health care or health insurance program; 305 specifying offenses under federal law or any state law 306 that the security background investigations must 307 screen for; amending s. 456.054, F.S.; prohibiting any 308 person or entity from paying or receiving a kickback 309 for referring patients to a clinical laboratory; 310 prohibiting a clinical laboratory from providing 311 personnel to perform certain functions or duties in a 312 health care practitioner’s office or dialysis 313 facility; providing an exception; prohibiting a 314 clinical laboratory from leasing space in any part of 315 a health care practitioner’s office or dialysis 316 facility; repealing part I of ch. 483, F.S., relating 317 to clinical laboratories; amending s. 483.294, F.S.; 318 removing a requirement that the agency inspect 319 multiphasic health testing centers at least once 320 annually; amending s. 483.801, F.S.; providing an 321 exemption from regulation for certain persons employed 322 by certain laboratories; amending s. 483.803, F.S.; 323 revising definitions of the terms “clinical 324 laboratory” and “clinical laboratory examination”; 325 removing a cross-reference; amending s. 641.511, F.S.; 326 revising health maintenance organization subscriber 327 grievance reporting requirements; repealing s. 641.60, 328 F.S., relating to the Statewide Managed Care Ombudsman 329 Committee; repealing s. 641.65, F.S., relating to 330 district managed care ombudsman committees; repealing 331 s. 641.67, F.S., relating to a district managed care 332 ombudsman committee, exemption from public records 333 requirements, and exceptions; repealing s. 641.68, 334 F.S., relating to a district managed care ombudsman 335 committee and exemption from public meeting 336 requirements; repealing s. 641.70, F.S., relating to 337 agency duties relating to the Statewide Managed Care 338 Ombudsman Committee and the district managed care 339 ombudsman committees; repealing s. 641.75, F.S., 340 relating to immunity from liability and limitation on 341 testimony; amending s. 945.36, F.S.; authorizing law 342 enforcement personnel to conduct drug tests on certain 343 inmates and releasees; amending ss. 20.43, 220.1845, 344 376.30781, 376.86, 381.0034, 381.0405, 383.14, 383.30, 345 383.301, 383.302, 383.305, 383.309, 383.33, 385.211, 346 394.4787, 395.001, 395.7015, 400.9905,