Florida Senate - 2018                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 622, 1st Eng.
                              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)
    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 more
   10  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.
   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.
   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
   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,