Florida Senate - 2019                                    SB 1540
       
       
        
       By Senator Lee
       
       
       
       
       
       20-01390-19                                           20191540__
    1                        A bill to be entitled                      
    2         An act relating to recovery care services; amending s.
    3         395.001, F.S.; revising legislative intent; amending
    4         s. 395.002, F.S.; revising and providing definitions;
    5         amending s. 395.003, F.S.; providing for licensure of
    6         recovery care centers by the Agency for Health Care
    7         Administration; creating s. 395.0171, F.S.; providing
    8         criteria for the admission of patients to recovery
    9         care centers; requiring recovery care centers to have
   10         emergency care, transfer, and discharge protocols;
   11         authorizing the agency to adopt rules; amending s.
   12         395.1055, F.S.; requiring the agency to adopt rules
   13         establishing separate, minimum standards for the care
   14         and treatment of patients in recovery care centers;
   15         amending s. 395.10973, F.S.; directing the agency to
   16         enforce special-occupancy provisions of the Florida
   17         Building Code applicable to recovery care centers;
   18         amending s. 408.802, F.S.; providing applicability of
   19         the Health Care Licensing Procedures Act to recovery
   20         care centers; amending s. 408.820, F.S.; exempting
   21         recovery care centers from specified minimum licensure
   22         requirements; amending ss. 385.211, 394.4787, and
   23         409.975, F.S.; conforming cross-references; providing
   24         an effective date.
   25          
   26  Be It Enacted by the Legislature of the State of Florida:
   27  
   28         Section 1. Section 395.001, Florida Statutes, is amended to
   29  read:
   30         395.001 Legislative intent.—It is the intent of the
   31  Legislature to provide for the protection of public health and
   32  safety in the establishment, construction, maintenance, and
   33  operation of hospitals, recovery care centers, and ambulatory
   34  surgical centers by providing for licensure of same and for the
   35  development, establishment, and enforcement of minimum standards
   36  with respect thereto.
   37         Section 2. Subsections (24) through (32) of section
   38  395.002, Florida Statutes, are renumbered as subsections (26)
   39  through (34), respectively, subsections (3), (16), and (22) are
   40  amended, and new subsections (24) and (25) are added to that
   41  section, to read:
   42         395.002 Definitions.—As used in this chapter:
   43         (3) “Ambulatory surgical center” means a facility the
   44  primary purpose of which is to provide elective surgical care,
   45  in which the patient is admitted to and discharged from such
   46  facility within 48 hours the same working day and is not
   47  permitted to stay overnight, and which is not part of a
   48  hospital. However, a facility existing for the primary purpose
   49  of performing terminations of pregnancy, an office maintained by
   50  a physician for the practice of medicine, or an office
   51  maintained for the practice of dentistry may not be construed to
   52  be an ambulatory surgical center, provided that any facility or
   53  office that which is certified or seeks certification as a
   54  Medicare ambulatory surgical center shall be licensed as an
   55  ambulatory surgical center pursuant to s. 395.003.
   56         (16) “Licensed facility” means a hospital, recovery care
   57  center, or ambulatory surgical center licensed in accordance
   58  with this chapter.
   59         (22) “Premises” means those buildings, beds, and equipment
   60  located at the address of the licensed facility and all other
   61  buildings, beds, and equipment for the provision of hospital
   62  care, recovery care, or ambulatory surgical care located in such
   63  reasonable proximity to the address of the licensed facility as
   64  to appear to the public to be under the dominion and control of
   65  the licensee. For any licensee that is a teaching hospital as
   66  defined in s. 408.07, reasonable proximity includes any
   67  buildings, beds, services, programs, and equipment under the
   68  dominion and control of the licensee that are located at a site
   69  with a main address that is within 1 mile of the main address of
   70  the licensed facility; and all such buildings, beds, and
   71  equipment may, at the request of a licensee or applicant, be
   72  included on the facility license as a single premises.
   73         (24)“Recovery care center” means a facility the primary
   74  purpose of which is to provide recovery care services, in which
   75  a patient is admitted and discharged within 72 hours, and which
   76  is not part of a hospital.
   77         (25)“Recovery care services” means postsurgical and
   78  postdiagnostic medical and general nursing care provided to a
   79  patient for whom acute care hospitalization is not required and
   80  an uncomplicated recovery is reasonably expected. The term
   81  includes postsurgical rehabilitation services. The term does not
   82  include intensive care services, coronary care services, or
   83  critical care services.
   84         Section 3. Paragraphs (a) and (b) of subsection (1) of
   85  section 395.003, Florida Statutes, are amended to read:
   86         395.003 Licensure; denial, suspension, and revocation.—
   87         (1)(a) The requirements of part II of chapter 408 apply to
   88  the provision of services that require licensure pursuant to ss.
   89  395.001-395.1065 and part II of chapter 408 and to entities
   90  licensed by or applying for such licensure from the Agency for
   91  Health Care Administration pursuant to ss. 395.001-395.1065. A
   92  license issued by the agency is required in order to operate a
   93  hospital, recovery care center, or ambulatory surgical center in
   94  this state.
   95         (b)1. It is unlawful for a person to use or advertise to
   96  the public, in any way or by any medium whatsoever, any facility
   97  as a “hospital,“recovery care center,” or “ambulatory surgical
   98  center” unless such facility has first secured a license under
   99  this part.
  100         2. This part does not apply to veterinary hospitals or to
  101  commercial business establishments using the word “hospital,”
  102  “recovery care center,” or “ambulatory surgical center” as a
  103  part of a trade name if no treatment of human beings is
  104  performed on the premises of such establishments.
  105         Section 4. Section 395.0171, Florida Statutes, is created
  106  to read:
  107         395.0171Recovery care center admissions; emergency care
  108  and transfer protocols; discharge planning and protocols.—
  109         (1)Admission to a recovery care center is restricted to a
  110  patient who is in need of recovery care services and who has
  111  been certified by his or her attending or referring physician,
  112  or by a physician on staff at the facility, as medically stable
  113  and not in need of acute care hospitalization before admission
  114  to the recovery care center.
  115         (2)A patient may be admitted for recovery care services
  116  postdiagnosis and posttreatment or upon discharge from a
  117  hospital or an ambulatory surgical center.
  118         (3)A recovery care center must have emergency care and
  119  transfer protocols, including transportation arrangements, and
  120  referral or admission agreements with at least one hospital.
  121         (4)A recovery care center must have procedures for
  122  discharge planning and discharge protocols.
  123         (5)The agency may adopt rules to implement this section.
  124         Section 5. Subsections (10) through (12) of section
  125  395.1055, Florida Statutes, are renumbered as subsections (11)
  126  through (13), respectively, subsections (2) and (8) are amended,
  127  and a new subsection (10) is added to that section, to read:
  128         395.1055 Rules and enforcement.—
  129         (2) Separate standards may be provided for general and
  130  specialty hospitals, ambulatory surgical centers, recovery care
  131  centers, and statutory rural hospitals as defined in s. 395.602.
  132         (8) The agency may not adopt any rule governing the design,
  133  construction, erection, alteration, modification, repair, or
  134  demolition of any public or private hospital, intermediate
  135  residential treatment facility, recovery care center, or
  136  ambulatory surgical center. It is the intent of the Legislature
  137  to preempt that function to the Florida Building Commission and
  138  the State Fire Marshal through adoption and maintenance of the
  139  Florida Building Code and the Florida Fire Prevention Code.
  140  However, the agency shall provide technical assistance to the
  141  commission and the State Fire Marshal in updating the
  142  construction standards of the Florida Building Code and the
  143  Florida Fire Prevention Code which govern hospitals,
  144  intermediate residential treatment facilities, recovery care
  145  centers, and ambulatory surgical centers.
  146         (10)The agency shall adopt rules for recovery care centers
  147  which include fair and reasonable minimum standards for ensuring
  148  that recovery care centers have:
  149         (a)A dietetic department, service, or other similarly
  150  titled unit, either on the premises or under contract, which
  151  shall be organized, directed, and staffed to ensure the
  152  provision of appropriate nutritional care and quality food
  153  service.
  154         (b)Procedures to ensure the proper administration of
  155  medications. Such procedures shall address the prescribing,
  156  ordering, preparing, and dispensing of medications and
  157  appropriate monitoring of the effects of such medications on a
  158  patient.
  159         (c)A pharmacy, pharmaceutical department, or
  160  pharmaceutical service, or other similarly titled unit, on the
  161  premises or under contract.
  162         Section 6. Subsection (3) of section 395.10973, Florida
  163  Statutes, is amended to read:
  164         395.10973 Powers and duties of the agency.—It is the
  165  function of the agency to:
  166         (3) Enforce the special-occupancy provisions of the Florida
  167  Building Code which apply to hospitals, intermediate residential
  168  treatment facilities, recovery care centers, and ambulatory
  169  surgical centers in conducting any inspection authorized by this
  170  chapter and part II of chapter 408.
  171         Section 7. Subsection (27) is added to section 408.802,
  172  Florida Statutes, to read:
  173         408.802 Applicability.—The provisions of this part apply to
  174  the provision of services that require licensure as defined in
  175  this part and to the following entities licensed, registered, or
  176  certified by the agency, as described in chapters 112, 383, 390,
  177  394, 395, 400, 429, 440, 483, and 765:
  178         (27)Recovery care centers, as provided under part I of
  179  chapter 395.
  180         Section 8. Subsection (26) is added to section 408.820,
  181  Florida Statutes, to read:
  182         408.820 Exemptions.—Except as prescribed in authorizing
  183  statutes, the following exemptions shall apply to specified
  184  requirements of this part:
  185         (26)Recovery care centers, as provided under part I of
  186  chapter 395, are exempt from s. 408.810(7)-(10).
  187         Section 9. Subsection (2) of section 385.211, Florida
  188  Statutes, is amended to read:
  189         385.211 Refractory and intractable epilepsy treatment and
  190  research at recognized medical centers.—
  191         (2) Notwithstanding chapter 893, medical centers recognized
  192  pursuant to s. 381.925, or an academic medical research
  193  institution legally affiliated with a licensed children’s
  194  specialty hospital as defined in s. 395.002(29) 395.002(27) that
  195  contracts with the Department of Health, may conduct research on
  196  cannabidiol and low-THC cannabis. This research may include, but
  197  is not limited to, the agricultural development, production,
  198  clinical research, and use of liquid medical derivatives of
  199  cannabidiol and low-THC cannabis for the treatment for
  200  refractory or intractable epilepsy. The authority for recognized
  201  medical centers to conduct this research is derived from 21
  202  C.F.R. parts 312 and 316. Current state or privately obtained
  203  research funds may be used to support the activities described
  204  in this section.
  205         Section 10. Subsection (7) of section 394.4787, Florida
  206  Statutes, is amended to read:
  207         394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, and
  208  394.4789.—As used in this section and ss. 394.4786, 394.4788,
  209  and 394.4789:
  210         (7) “Specialty psychiatric hospital” means a hospital
  211  licensed by the agency pursuant to s. 395.002(29) 395.002(27)
  212  and part II of chapter 408 as a specialty psychiatric hospital.
  213         Section 11. Paragraph (b) of subsection (1) of section
  214  409.975, Florida Statutes, is amended to read:
  215         409.975 Managed care plan accountability.—In addition to
  216  the requirements of s. 409.967, plans and providers
  217  participating in the managed medical assistance program shall
  218  comply with the requirements of this section.
  219         (1) PROVIDER NETWORKS.—Managed care plans must develop and
  220  maintain provider networks that meet the medical needs of their
  221  enrollees in accordance with standards established pursuant to
  222  s. 409.967(2)(c). Except as provided in this section, managed
  223  care plans may limit the providers in their networks based on
  224  credentials, quality indicators, and price.
  225         (b) Certain providers are statewide resources and essential
  226  providers for all managed care plans in all regions. All managed
  227  care plans must include these essential providers in their
  228  networks. Statewide essential providers include:
  229         1. Faculty plans of Florida medical schools.
  230         2. Regional perinatal intensive care centers as defined in
  231  s. 383.16(2).
  232         3. Hospitals licensed as specialty children’s hospitals as
  233  defined in s. 395.002(29) 395.002(27).
  234         4. Accredited and integrated systems serving medically
  235  complex children which comprise separately licensed, but
  236  commonly owned, health care providers delivering at least the
  237  following services: medical group home, in-home and outpatient
  238  nursing care and therapies, pharmacy services, durable medical
  239  equipment, and Prescribed Pediatric Extended Care.
  240  
  241  Managed care plans that have not contracted with all statewide
  242  essential providers in all regions as of the first date of
  243  recipient enrollment must continue to negotiate in good faith.
  244  Payments to physicians on the faculty of nonparticipating
  245  Florida medical schools shall be made at the applicable Medicaid
  246  rate. Payments for services rendered by regional perinatal
  247  intensive care centers shall be made at the applicable Medicaid
  248  rate as of the first day of the contract between the agency and
  249  the plan. Except for payments for emergency services, payments
  250  to nonparticipating specialty children’s hospitals shall equal
  251  the highest rate established by contract between that provider
  252  and any other Medicaid managed care plan.
  253         Section 12. This act shall take effect July 1, 2019.