Florida Senate - 2025                                     SB 890
       
       
        
       By Senator Yarborough
       
       
       
       
       
       4-01449-25                                             2025890__
    1                        A bill to be entitled                      
    2         An act relating to improving screening for and
    3         treatment of blood clots; amending s. 385.102, F.S.;
    4         revising legislative findings under the Chronic
    5         Diseases Act; creating s. 385.213, F.S.; requiring the
    6         Department of Health to establish, or contract to
    7         establish, a statewide registry for a specified
    8         purpose; requiring certain licensed facilities to
    9         report specified information to the department for
   10         inclusion in the registry; specifying limitations on
   11         the use and publication of information from the
   12         registry; providing that certain personal identifying
   13         information is confidential and exempt from public
   14         records requirements, with exceptions; specifying
   15         requirements for the use of certain appropriated
   16         funds; authorizing the department, by rule, to
   17         classify facilities for purposes of certain reporting
   18         requirements; requiring the department to exempt
   19         certain facilities from certain reporting
   20         requirements; providing applicability; creating s.
   21         395.3042, F.S.; requiring certain licensed facilities
   22         to arrange for the rendering of appropriate medical
   23         attention for persons at risk for certain conditions;
   24         specifying requirements for the manner in which such
   25         facilities must provide such medical attention,
   26         including admission, training, and practice policies;
   27         amending s. 400.211, F.S.; revising requirements for
   28         certain annual inservice training for certified
   29         nursing assistants employed by nursing home
   30         facilities; revising training requirements for certain
   31         certified nursing assistants who may be delegated
   32         tasks in nursing home facilities; amending s. 429.41,
   33         F.S.; revising minimum standards for the care of
   34         residents in assisted living facilities; amending s.
   35         429.52, F.S.; revising requirements for the core
   36         competency test for administrators of assisted living
   37         facilities; providing an effective date.
   38          
   39  Be It Enacted by the Legislature of the State of Florida:
   40  
   41         Section 1. Subsection (1) of section 385.102, Florida
   42  Statutes, is amended to read:
   43         385.102 Legislative intent.—It is the finding of the
   44  Legislature that:
   45         (1) Chronic diseases exist in high proportions among the
   46  people of this state. These chronic diseases include, but are
   47  not limited to, heart disease, hypertension, diabetes, renal
   48  disease, chronic obstructive pulmonary disease, cancer, chronic
   49  critical illness, and genetic predisposition for developing
   50  blood clots and pulmonary embolisms chronic obstructive lung
   51  disease. These diseases are often interrelated, and they
   52  directly and indirectly account for a high rate of death and
   53  illness.
   54         Section 2. Section 385.213, Florida Statutes, is created to
   55  read:
   56         385.213 Blood clot and pulmonary embolism registry.—
   57         (1)The Department of Health shall establish, or contract
   58  with a recognized medical organization in this state and its
   59  affiliated institutions to establish, a statewide registry to
   60  ensure blood clot and pulmonary embolism reports required under
   61  this section are maintained and available for use in the course
   62  of research for the purpose of reducing morbidity and mortality,
   63  and liability of any kind or character for damages or other
   64  relief may not arise or be enforced against any hospital by
   65  reason of having provided such information or material to the
   66  department for inclusion in the registry.
   67         (2)Each facility licensed under chapter 395 or chapter 408
   68  shall report to the department for inclusion in the registry all
   69  of the following information, and as further specified by
   70  department rule, for each instance of a blood clot, pulmonary
   71  embolism, or deep vein thrombosis identified in a patient:
   72         (a)The number of blood clots, pulmonary embolisms, and
   73  deep vein thromboses identified and diagnosed.
   74         (b)The age of the patient.
   75         (c)The zip code of the patient.
   76         (d)The sex of the patient.
   77         (e)Whether the patient is a resident of a licensed nursing
   78  home or assisted living facility.
   79         (f)Whether the blood clot, pulmonary embolism, or deep
   80  vein thrombosis was fatal.
   81         (g)How the diagnosis was made, such as by using imaging
   82  modalities.
   83         (h)The treatment that was recommended for the blood clot,
   84  pulmonary embolism, or deep vein thrombosis, as applicable.
   85         (3)The department or contractor operating the registry may
   86  use or publish information from the registry only for the
   87  purpose of advancing medical research or medical education in
   88  the interest of reducing morbidity or mortality, except that a
   89  summary of such entries without any personal identifying
   90  information may be released for general publication. Information
   91  which discloses or could lead to the disclosure of personal
   92  identifying information of any person whose condition or
   93  treatment has been reported and studied is confidential and
   94  exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I
   95  of the State Constitution as specified in s. 119.0712(1), except
   96  that:
   97         (a)Such information may be released with the express
   98  written consent of the person or his or her legally authorized
   99  representative;
  100         (b)The department or the contractor may contact
  101  individuals for the purpose of epidemiologic investigation and
  102  monitoring, provided such information that is confidential under
  103  this section is not further disclosed; and
  104         (c)The department may exchange data that includes personal
  105  identifying information with any other governmental agency or
  106  the contractor for the purpose of medical or scientific
  107  research, provided such governmental agency or contractor does
  108  not further disclose information that is confidential and
  109  exempt.
  110         (4)Funds appropriated for implementation of this section
  111  must be used for establishing, administering, compiling,
  112  processing, and providing biometric and statistical analyses to
  113  the reporting facilities. Funds may also be used to ensure the
  114  quality and accuracy of the information reported and to provide
  115  management information to the reporting facilities.
  116         (5)The department may, by rule, classify facilities for
  117  purposes of reports made to the registry and specify the content
  118  and frequency of the reports. In classifying facilities, the
  119  department must exempt certain facilities from reporting blood
  120  clot and pulmonary embolism information that was previously
  121  reported to the department or retrieved from existing state
  122  reports made to the department or the Agency for Health Care
  123  Administration.
  124         (6)This section does not apply to any facility whose
  125  primary function is to provide psychiatric care to its patients.
  126         Section 3. Section 395.3042, Florida Statutes, is created
  127  to read:
  128         395.3042 Screening for blood clots, pulmonary embolisms,
  129  and deep vein thrombosis in licensed facilities.—Any licensed
  130  facility that provides emergency room services, orthopedic
  131  services, pregnancy services, or cancer treatment shall arrange
  132  for the rendering of appropriate medical attention for persons
  133  at risk of blood clots, pulmonary embolisms, or deep vein
  134  thrombosis in the following manner:
  135         (1)Upon admission to such a facility, a patient must be
  136  assessed for risk of blood clots, pulmonary embolisms, and deep
  137  vein thrombosis using a nationally recognized risk assessment
  138  tool.
  139         (2)The training of all staff in the facility must include
  140  continuing education annually on how to recognize a blood clot,
  141  pulmonary embolism, or deep vein thrombosis.
  142         (3)The facility shall have established protocols for staff
  143  to ensure that patients diagnosed with a life-threatening blood
  144  clot, pulmonary embolism, or deep vein thrombosis are assessed
  145  for various treatment options.
  146         (4)The facility shall have an established policy in place
  147  requiring a follow-up for all orthopedic patients who have
  148  undergone lower extremity or pelvic surgery, to occur within 60
  149  days after discharge.
  150         (5)The facility shall have procedures in place to provide
  151  ongoing blood clot risk assessment for patients who are at high
  152  risk of developing blood clots, are pregnant, or are being
  153  treated for cancer.
  154         Section 4. Subsection (4) and paragraph (a) of subsection
  155  (5) of section 400.211, Florida Statutes, are amended to read:
  156         400.211 Persons employed as nursing assistants;
  157  certification requirement; qualified medication aide designation
  158  and requirements.—
  159         (4) When employed by a nursing home facility for a 12-month
  160  period or longer, a nursing assistant, to maintain
  161  certification, shall submit to a performance review every 12
  162  months and must receive regular inservice education based on the
  163  outcome of such reviews. The inservice training must:
  164         (a) Be sufficient to ensure the continuing competence of
  165  nursing assistants and must meet the standard specified in s.
  166  464.203(7);
  167         (b) Include, at a minimum:
  168         1. Techniques for assisting with eating and proper feeding;
  169         2. Principles of adequate nutrition and hydration;
  170         3. Techniques for assisting and responding to the
  171  cognitively impaired resident or the resident with difficult
  172  behaviors;
  173         4. Techniques for caring for the resident at the end-of
  174  life; and
  175         5. Recognizing changes that place a resident at risk for
  176  pressure ulcers and falls; and
  177         6.Recognizing signs and symptoms of a blood clot,
  178  pulmonary embolism, or deep vein thrombosis and techniques for
  179  providing an emergency response; and
  180         (c) Address areas of weakness as determined in nursing
  181  assistant performance reviews and may address the special needs
  182  of residents as determined by the nursing home facility staff.
  183  
  184  Costs associated with this training may not be reimbursed from
  185  additional Medicaid funding through interim rate adjustments.
  186         (5) A nursing home, in accordance with chapter 464 and
  187  rules adopted pursuant to this section, may authorize a
  188  registered nurse to delegate tasks, including medication
  189  administration, to a certified nursing assistant who meets the
  190  requirements of this subsection.
  191         (a) In addition to the initial 6-hour training course and
  192  determination of competency required under s. 464.2035, to be
  193  eligible to administer medication to a resident of a nursing
  194  home facility, a certified nursing assistant must:
  195         1. Hold a clear and active certification from the
  196  Department of Health for a minimum of 1 year immediately
  197  preceding the delegation;
  198         2. Complete an additional 34-hour training course approved
  199  by the Board of Nursing in medication administration and
  200  associated tasks, including, but not limited to, blood glucose
  201  level checks, dialing oxygen flow meters to prescribed settings,
  202  and assisting with continuous positive airway pressure devices,
  203  and identification of signs and symptoms of a blood clot and how
  204  to assist with a response protocol; and
  205         3. Demonstrate clinical competency by successfully
  206  completing a supervised clinical practice in medication
  207  administration and associated tasks conducted in the facility.
  208         Section 5. Paragraph (g) of subsection (1) of section
  209  429.41, Florida Statutes, is amended to read:
  210         429.41 Rules establishing standards.—
  211         (1) It is the intent of the Legislature that rules
  212  published and enforced pursuant to this section shall include
  213  criteria by which a reasonable and consistent quality of
  214  resident care and quality of life may be ensured and the results
  215  of such resident care may be demonstrated. Such rules shall also
  216  promote a safe and sanitary environment that is residential and
  217  noninstitutional in design or nature and may allow for
  218  technological advances in the provision of care, safety, and
  219  security, including the use of devices, equipment, and other
  220  security measures related to wander management, emergency
  221  response, staff risk management, and the general safety and
  222  security of residents, staff, and the facility. It is further
  223  intended that reasonable efforts be made to accommodate the
  224  needs and preferences of residents to enhance the quality of
  225  life in a facility. The agency, in consultation with the
  226  Department of Children and Families and the Department of
  227  Health, shall adopt rules to administer this part, which must
  228  include reasonable and fair minimum standards in relation to:
  229         (g) The care of residents provided by the facility, which
  230  must include:
  231         1. The supervision of residents;
  232         2. The provision of personal services;
  233         3. The provision of, or arrangement for, social and leisure
  234  activities;
  235         4. The assistance in making arrangements for appointments
  236  and transportation to appropriate medical, dental, nursing, or
  237  mental health services, as needed by residents;
  238         5. The management of medication stored within the facility
  239  and as needed by residents;
  240         6. The dietary needs of residents;
  241         7. Resident records; and
  242         8. Internal risk management and quality assurance; and
  243         9.Identification of residents who are at risk for
  244  developing blood clots, and the treating facility’s response
  245  protocols to help ensure access to timely treatment.
  246         Section 6. Paragraph (h) is added to subsection (3) of
  247  section 429.52, Florida Statutes, to read:
  248         429.52 Staff training and educational requirements.—
  249         (3) The agency, in conjunction with providers, shall
  250  develop core training requirements for administrators consisting
  251  of core training learning objectives, a competency test, and a
  252  minimum required score to indicate successful passage of the
  253  core competency test. The required core competency test must
  254  cover at least the following topics:
  255         (h) Identification of and responding to residents at high
  256  risk of developing blood clots and pulmonary embolisms.
  257         Section 7. This act shall take effect July 1, 2025.