Florida Senate - 2025                        COMMITTEE AMENDMENT
       Bill No. SB 890
       
       
       
       
       
       
                                Ì185632(Î185632                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/15/2025           .                                
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       The Appropriations Committee on Health and Human Services
       (Yarborough) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. This act may be cited as the “Emily Adkins
    6  Family Protection Act.”
    7         Section 2. Subsection (1) of section 385.102, Florida
    8  Statutes, is amended to read:
    9         385.102 Legislative intent.—It is the finding of the
   10  Legislature that:
   11         (1) Chronic diseases exist in high proportions among the
   12  people of this state. These chronic diseases include, but are
   13  not limited to, heart disease, hypertension, diabetes, renal
   14  disease, chronic obstructive pulmonary disease, cancer, chronic
   15  critical illness, and genetic predisposition for developing
   16  venous thromboembolisms chronic obstructive lung disease. These
   17  diseases are often interrelated, and they directly and
   18  indirectly account for a high rate of death and illness.
   19         Section 3. Subsection (5) is added to section 395.1012,
   20  Florida Statutes, to read:
   21         395.1012 Patient safety.—
   22         (5)Each hospital with an emergency department and each
   23  ambulatory surgical center must:
   24         (a)Develop and implement policies and procedures for the
   25  rendering of appropriate medical attention for persons at risk
   26  of forming venous thromboembolisms which reflect evidence-based
   27  best practices relating to, at a minimum:
   28         1.Assessing patients for risk of venous thromboembolism
   29  using a nationally recognized risk assessment tool.
   30         2.Treatment options for a patient diagnosed with venous
   31  thromboembolism.
   32         (b)Train all nonphysician personnel at least annually on
   33  the policies and procedures developed under this subsection. For
   34  purposes of this subsection, “nonphysician personnel” means all
   35  personnel of the licensed facility working in clinical areas and
   36  providing patient care, except those persons licensed as health
   37  care practitioners.
   38         Section 4. Section 395.3042, Florida Statutes, is created
   39  to read:
   40         395.3042Statewide venous thromboembolism registry.—
   41         (1)(a)The agency shall contract with a private entity,
   42  that meets all of the conditions of paragraph (b), to establish
   43  and maintain, at no cost to the state, a statewide venous
   44  thromboembolism registry to ensure that the performance measures
   45  required to be submitted under subsection (2) are maintained and
   46  available for use to improve or modify the venous
   47  thromboembolism care system, ensure compliance with nationally
   48  recognized guidelines, and monitor venous thromboembolism
   49  patient outcomes.
   50         (b)The private entity must:
   51         1.Be a not-for-profit corporation qualified as tax-exempt
   52  under s. 501(c)(3) of the Internal Revenue Code.
   53         2.Have existed for at least 15 consecutive years with a
   54  mission of advancing the prevention, early diagnosis, and
   55  successful treatment of blood clots.
   56         3.Have experience operating a medical registry with at
   57  least 25,000 participants.
   58         4.Have experience in providing continuing education on
   59  venous thromboembolism to medical professionals.
   60         5.Have sponsored a public health education campaign on
   61  venous thromboembolism.
   62         6.Be affiliated with a medical and scientific advisory
   63  board.
   64         (2)Beginning July 1, 2026, each hospital with an emergency
   65  department and each ambulatory surgical center shall regularly
   66  report to the statewide venous thromboembolism registry
   67  information containing nationally recognized venous
   68  thromboembolism measures and data on the incidence and
   69  prevalence of venous thromboembolisms. Such data must include
   70  the following information:
   71         (a)The number of venous thromboembolisms identified and
   72  diagnosed.
   73         (b)The age of the patient.
   74         (c)The zip code of the patient.
   75         (d)The sex of the patient.
   76         (e)Whether the patient is a resident of a licensed nursing
   77  home or assisted living facility.
   78         (f)Whether the venous thromboembolism was fatal.
   79         (g)How the diagnosis was made, such as by using imaging
   80  modalities.
   81         (h)The treatment that was recommended for the venous
   82  thromboembolism.
   83         (3)The agency shall require the contracted private entity
   84  to use a nationally recognized platform to collect data from
   85  each hospital with an emergency department and each ambulatory
   86  surgical center on the performance measures required under
   87  subsection (2). The contracted private entity shall provide
   88  regular reports to the agency on the data collected.
   89         (4)By March 1, 2026, the agency must submit to the
   90  Governor, the President of the Senate, and the Speaker of the
   91  House of Representatives a detailed report on the incidence of
   92  venous thromboembolism using inpatient, outpatient, and
   93  ambulatory surgical center data for services provided between
   94  July 1, 2024, and July 1, 2025. The report shall provide
   95  analyses of all of the following:
   96         (a)Age category, initial primary diagnosis and procedure,
   97  and secondary diagnoses, readmission rates for inpatients,
   98  admission rates for venous thromboembolism for which the patient
   99  had an ambulatory surgery procedure, and emergency department
  100  visits for venous thromboembolism linked to any previous
  101  admission.
  102         (b)Whether the venous thromboembolism was present upon
  103  admission.
  104         (c)The incidence of venous thromboembolism procedures
  105  reported on the agency’s Florida Health Finder website.
  106         (d)The principal payor, the sex of the patient, and the
  107  patient’s discharge status.
  108         (5)The contracted private entity operating the registry
  109  may only use or publish information from the registry for the
  110  purposes of advancing medical research or medical education in
  111  the interest of reducing morbidity or mortality.
  112         Section 5. Subsection (4) and paragraph (a) of subsection
  113  (5) of section 400.211, Florida Statutes, are amended to read:
  114         400.211 Persons employed as nursing assistants;
  115  certification requirement; qualified medication aide designation
  116  and requirements.—
  117         (4) When employed by a nursing home facility for a 12-month
  118  period or longer, a nursing assistant, to maintain
  119  certification, shall submit to a performance review every 12
  120  months and must receive regular inservice education based on the
  121  outcome of such reviews. The inservice training must:
  122         (a) Be sufficient to ensure the continuing competence of
  123  nursing assistants and must meet the standard specified in s.
  124  464.203(7);
  125         (b) Include, at a minimum:
  126         1. Techniques for assisting with eating and proper feeding;
  127         2. Principles of adequate nutrition and hydration;
  128         3. Techniques for assisting and responding to the
  129  cognitively impaired resident or the resident with difficult
  130  behaviors;
  131         4. Techniques for caring for the resident at the end-of
  132  life; and
  133         5. Recognizing changes that place a resident at risk for
  134  pressure ulcers and falls; and
  135         6.Recognizing signs and symptoms of venous thromboembolism
  136  and techniques for providing an emergency response; and
  137         (c) Address areas of weakness as determined in nursing
  138  assistant performance reviews and may address the special needs
  139  of residents as determined by the nursing home facility staff.
  140  
  141  Costs associated with this training may not be reimbursed from
  142  additional Medicaid funding through interim rate adjustments.
  143         (5) A nursing home, in accordance with chapter 464 and
  144  rules adopted pursuant to this section, may authorize a
  145  registered nurse to delegate tasks, including medication
  146  administration, to a certified nursing assistant who meets the
  147  requirements of this subsection.
  148         (a) In addition to the initial 6-hour training course and
  149  determination of competency required under s. 464.2035, to be
  150  eligible to administer medication to a resident of a nursing
  151  home facility, a certified nursing assistant must:
  152         1. Hold a clear and active certification from the
  153  Department of Health for a minimum of 1 year immediately
  154  preceding the delegation;
  155         2. Complete an additional 34-hour training course approved
  156  by the Board of Nursing in medication administration and
  157  associated tasks, including, but not limited to, blood glucose
  158  level checks, dialing oxygen flow meters to prescribed settings,
  159  and assisting with continuous positive airway pressure devices,
  160  and identification of signs and symptoms of venous
  161  thromboembolism and how to assist with a response protocol; and
  162         3. Demonstrate clinical competency by successfully
  163  completing a supervised clinical practice in medication
  164  administration and associated tasks conducted in the facility.
  165         Section 6. Paragraph (g) of subsection (1) of section
  166  429.41, Florida Statutes, is amended to read:
  167         429.41 Rules establishing standards.—
  168         (1) It is the intent of the Legislature that rules
  169  published and enforced pursuant to this section shall include
  170  criteria by which a reasonable and consistent quality of
  171  resident care and quality of life may be ensured and the results
  172  of such resident care may be demonstrated. Such rules shall also
  173  promote a safe and sanitary environment that is residential and
  174  noninstitutional in design or nature and may allow for
  175  technological advances in the provision of care, safety, and
  176  security, including the use of devices, equipment, and other
  177  security measures related to wander management, emergency
  178  response, staff risk management, and the general safety and
  179  security of residents, staff, and the facility. It is further
  180  intended that reasonable efforts be made to accommodate the
  181  needs and preferences of residents to enhance the quality of
  182  life in a facility. The agency, in consultation with the
  183  Department of Children and Families and the Department of
  184  Health, shall adopt rules to administer this part, which must
  185  include reasonable and fair minimum standards in relation to:
  186         (g) The care of residents provided by the facility, which
  187  must include:
  188         1. The supervision of residents;
  189         2. The provision of personal services;
  190         3. The provision of, or arrangement for, social and leisure
  191  activities;
  192         4. The assistance in making arrangements for appointments
  193  and transportation to appropriate medical, dental, nursing, or
  194  mental health services, as needed by residents;
  195         5. The management of medication stored within the facility
  196  and as needed by residents;
  197         6. The dietary needs of residents;
  198         7. Resident records; and
  199         8. Internal risk management and quality assurance; and
  200         9.Identification of residents who are at risk for
  201  developing venous thromboembolism and the treating facility’s
  202  response protocols to help ensure access to timely treatment.
  203         Section 7. Paragraph (h) is added to subsection (3) of
  204  section 429.52, Florida Statutes, to read:
  205         429.52 Staff training and educational requirements.—
  206         (3) The agency, in conjunction with providers, shall
  207  develop core training requirements for administrators consisting
  208  of core training learning objectives, a competency test, and a
  209  minimum required score to indicate successful passage of the
  210  core competency test. The required core competency test must
  211  cover at least the following topics:
  212         (h)Identification of and responding to residents at high
  213  risk of developing venous thromboembolism.
  214         Section 8. This act shall take effect July 1, 2025.
  215  
  216  ================= T I T L E  A M E N D M E N T ================
  217  And the title is amended as follows:
  218         Delete everything before the enacting clause
  219  and insert:
  220                        A bill to be entitled                      
  221         An act relating to improving screening for and
  222         treatment of blood clots; providing a short title;
  223         amending s. 385.102, F.S.; revising legislative
  224         findings under the Chronic Diseases Act; amending s.
  225         395.1012, F.S.; requiring hospitals with emergency
  226         departments and ambulatory surgical centers to develop
  227         and implement policies and procedures and conduct
  228         training for the rendering of appropriate medical
  229         attention for persons at risk of forming venous
  230         thromboembolisms; creating s. 395.3042, F.S.;
  231         requiring the Agency for Health Care Administration to
  232         contract with a private entity to establish a
  233         statewide venous thromboembolism registry at no cost
  234         to the state; providing requirements for the private
  235         entity; requiring hospitals with an emergency
  236         department and ambulatory surgical centers, beginning
  237         on a date certain, to regularly report certain
  238         information to the statewide venous thromboembolism
  239         registry; requiring the agency to require the private
  240         entity to use a nationally recognized platform to
  241         collect certain data; requiring the private entity to
  242         provide regular reports to the agency on such data;
  243         requiring the agency, by a date certain, to provide to
  244         the Governor and the Legislature a specified report;
  245         providing requirements for such report; providing
  246         applicability; amending s. 400.211, F.S.; revising
  247         requirements for certain annual inservice training for
  248         certified nursing assistants employed by nursing home
  249         facilities; revising training requirements for certain
  250         certified nursing assistants who may be delegated
  251         tasks in nursing home facilities; amending s. 429.41,
  252         F.S.; revising minimum standards for the care of
  253         residents in assisted living facilities; amending s.
  254         429.52, F.S.; revising requirements for the core
  255         competency test for administrators of assisted living
  256         facilities; providing an effective date.