Florida Senate - 2025                              CS for SB 890
       
       
        
       By the Appropriations Committee on Health and Human Services;
       and Senators Yarborough, Berman, Gruters, and Rouson
       
       
       
       
       603-03585-25                                           2025890c1
    1                        A bill to be entitled                      
    2         An act relating to improving screening for and
    3         treatment of blood clots; providing a short title;
    4         amending s. 385.102, F.S.; revising legislative
    5         findings under the Chronic Diseases Act; amending s.
    6         395.1012, F.S.; requiring hospitals with emergency
    7         departments and ambulatory surgical centers to develop
    8         and implement policies and procedures and conduct
    9         training for the rendering of appropriate medical
   10         attention for persons at risk of forming venous
   11         thromboembolisms; creating s. 395.3042, F.S.;
   12         requiring the Agency for Health Care Administration to
   13         contract with a private entity to establish a
   14         statewide venous thromboembolism registry at no cost
   15         to the state; providing requirements for the private
   16         entity; requiring hospitals with an emergency
   17         department and ambulatory surgical centers, beginning
   18         on a date certain, to regularly report certain
   19         information to the statewide venous thromboembolism
   20         registry; requiring the agency to require the private
   21         entity to use a nationally recognized platform to
   22         collect certain data; requiring the private entity to
   23         provide regular reports to the agency on such data;
   24         requiring the agency, by a date certain, to provide to
   25         the Governor and the Legislature a specified report;
   26         providing requirements for such report; providing
   27         applicability; amending s. 400.211, F.S.; revising
   28         requirements for certain annual inservice training for
   29         certified 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. This act may be cited as the “Emily Adkins
   42  Family Protection Act.”
   43         Section 2. Subsection (1) of section 385.102, Florida
   44  Statutes, is amended to read:
   45         385.102 Legislative intent.—It is the finding of the
   46  Legislature that:
   47         (1) Chronic diseases exist in high proportions among the
   48  people of this state. These chronic diseases include, but are
   49  not limited to, heart disease, hypertension, diabetes, renal
   50  disease, chronic obstructive pulmonary disease, cancer, chronic
   51  critical illness, and genetic predisposition for developing
   52  venous thromboembolisms chronic obstructive lung disease. These
   53  diseases are often interrelated, and they directly and
   54  indirectly account for a high rate of death and illness.
   55         Section 3. Subsection (5) is added to section 395.1012,
   56  Florida Statutes, to read:
   57         395.1012 Patient safety.—
   58         (5)Each hospital with an emergency department and each
   59  ambulatory surgical center must:
   60         (a)Develop and implement policies and procedures for the
   61  rendering of appropriate medical attention for persons at risk
   62  of forming venous thromboembolisms which reflect evidence-based
   63  best practices relating to, at a minimum:
   64         1.Assessing patients for risk of venous thromboembolism
   65  using a nationally recognized risk assessment tool.
   66         2.Treatment options for a patient diagnosed with venous
   67  thromboembolism.
   68         (b)Train all nonphysician personnel at least annually on
   69  the policies and procedures developed under this subsection. For
   70  purposes of this subsection, “nonphysician personnel” means all
   71  personnel of the licensed facility working in clinical areas and
   72  providing patient care, except those persons licensed as health
   73  care practitioners.
   74         Section 4. Section 395.3042, Florida Statutes, is created
   75  to read:
   76         395.3042Statewide venous thromboembolism registry.—
   77         (1)(a)The agency shall contract with a private entity,
   78  that meets all of the conditions of paragraph (b), to establish
   79  and maintain, at no cost to the state, a statewide venous
   80  thromboembolism registry to ensure that the performance measures
   81  required to be submitted under subsection (2) are maintained and
   82  available for use to improve or modify the venous
   83  thromboembolism care system, ensure compliance with nationally
   84  recognized guidelines, and monitor venous thromboembolism
   85  patient outcomes.
   86         (b)The private entity must:
   87         1.Be a not-for-profit corporation qualified as tax-exempt
   88  under s. 501(c)(3) of the Internal Revenue Code.
   89         2.Have existed for at least 15 consecutive years with a
   90  mission of advancing the prevention, early diagnosis, and
   91  successful treatment of blood clots.
   92         3.Have experience operating a medical registry with at
   93  least 25,000 participants.
   94         4.Have experience in providing continuing education on
   95  venous thromboembolism to medical professionals.
   96         5.Have sponsored a public health education campaign on
   97  venous thromboembolism.
   98         6.Be affiliated with a medical and scientific advisory
   99  board.
  100         (2)Beginning July 1, 2026, each hospital with an emergency
  101  department and each ambulatory surgical center shall regularly
  102  report to the statewide venous thromboembolism registry
  103  information containing nationally recognized venous
  104  thromboembolism measures and data on the incidence and
  105  prevalence of venous thromboembolisms. Such data must include
  106  the following information:
  107         (a)The number of venous thromboembolisms identified and
  108  diagnosed.
  109         (b)The age of the patient.
  110         (c)The zip code of the patient.
  111         (d)The sex of the patient.
  112         (e)Whether the patient is a resident of a licensed nursing
  113  home or assisted living facility.
  114         (f)Whether the venous thromboembolism was fatal.
  115         (g)How the diagnosis was made, such as by using imaging
  116  modalities.
  117         (h)The treatment that was recommended for the venous
  118  thromboembolism.
  119         (3)The agency shall require the contracted private entity
  120  to use a nationally recognized platform to collect data from
  121  each hospital with an emergency department and each ambulatory
  122  surgical center on the performance measures required under
  123  subsection (2). The contracted private entity shall provide
  124  regular reports to the agency on the data collected.
  125         (4)By March 1, 2026, the agency must submit to the
  126  Governor, the President of the Senate, and the Speaker of the
  127  House of Representatives a detailed report on the incidence of
  128  venous thromboembolism using inpatient, outpatient, and
  129  ambulatory surgical center data for services provided between
  130  July 1, 2024, and July 1, 2025. The report shall provide
  131  analyses of all of the following:
  132         (a)Age category, initial primary diagnosis and procedure,
  133  and secondary diagnoses, readmission rates for inpatients,
  134  admission rates for venous thromboembolism for which the patient
  135  had an ambulatory surgery procedure, and emergency department
  136  visits for venous thromboembolism linked to any previous
  137  admission.
  138         (b)Whether the venous thromboembolism was present upon
  139  admission.
  140         (c)The incidence of venous thromboembolism procedures
  141  reported on the agency’s Florida Health Finder website.
  142         (d)The principal payor, the sex of the patient, and the
  143  patient’s discharge status.
  144         (5)The contracted private entity operating the registry
  145  may only use or publish information from the registry for the
  146  purposes of advancing medical research or medical education in
  147  the interest of reducing morbidity or mortality.
  148         Section 5. Subsection (4) and paragraph (a) of subsection
  149  (5) of section 400.211, Florida Statutes, are amended to read:
  150         400.211 Persons employed as nursing assistants;
  151  certification requirement; qualified medication aide designation
  152  and requirements.—
  153         (4) When employed by a nursing home facility for a 12-month
  154  period or longer, a nursing assistant, to maintain
  155  certification, shall submit to a performance review every 12
  156  months and must receive regular inservice education based on the
  157  outcome of such reviews. The inservice training must:
  158         (a) Be sufficient to ensure the continuing competence of
  159  nursing assistants and must meet the standard specified in s.
  160  464.203(7);
  161         (b) Include, at a minimum:
  162         1. Techniques for assisting with eating and proper feeding;
  163         2. Principles of adequate nutrition and hydration;
  164         3. Techniques for assisting and responding to the
  165  cognitively impaired resident or the resident with difficult
  166  behaviors;
  167         4. Techniques for caring for the resident at the end-of
  168  life; and
  169         5. Recognizing changes that place a resident at risk for
  170  pressure ulcers and falls; and
  171         6.Recognizing signs and symptoms of venous thromboembolism
  172  and techniques for providing an emergency response; and
  173         (c) Address areas of weakness as determined in nursing
  174  assistant performance reviews and may address the special needs
  175  of residents as determined by the nursing home facility staff.
  176  
  177  Costs associated with this training may not be reimbursed from
  178  additional Medicaid funding through interim rate adjustments.
  179         (5) A nursing home, in accordance with chapter 464 and
  180  rules adopted pursuant to this section, may authorize a
  181  registered nurse to delegate tasks, including medication
  182  administration, to a certified nursing assistant who meets the
  183  requirements of this subsection.
  184         (a) In addition to the initial 6-hour training course and
  185  determination of competency required under s. 464.2035, to be
  186  eligible to administer medication to a resident of a nursing
  187  home facility, a certified nursing assistant must:
  188         1. Hold a clear and active certification from the
  189  Department of Health for a minimum of 1 year immediately
  190  preceding the delegation;
  191         2. Complete an additional 34-hour training course approved
  192  by the Board of Nursing in medication administration and
  193  associated tasks, including, but not limited to, blood glucose
  194  level checks, dialing oxygen flow meters to prescribed settings,
  195  and assisting with continuous positive airway pressure devices,
  196  and identification of signs and symptoms of venous
  197  thromboembolism and how to assist with a response protocol; and
  198         3. Demonstrate clinical competency by successfully
  199  completing a supervised clinical practice in medication
  200  administration and associated tasks conducted in the facility.
  201         Section 6. Paragraph (g) of subsection (1) of section
  202  429.41, Florida Statutes, is amended to read:
  203         429.41 Rules establishing standards.—
  204         (1) It is the intent of the Legislature that rules
  205  published and enforced pursuant to this section shall include
  206  criteria by which a reasonable and consistent quality of
  207  resident care and quality of life may be ensured and the results
  208  of such resident care may be demonstrated. Such rules shall also
  209  promote a safe and sanitary environment that is residential and
  210  noninstitutional in design or nature and may allow for
  211  technological advances in the provision of care, safety, and
  212  security, including the use of devices, equipment, and other
  213  security measures related to wander management, emergency
  214  response, staff risk management, and the general safety and
  215  security of residents, staff, and the facility. It is further
  216  intended that reasonable efforts be made to accommodate the
  217  needs and preferences of residents to enhance the quality of
  218  life in a facility. The agency, in consultation with the
  219  Department of Children and Families and the Department of
  220  Health, shall adopt rules to administer this part, which must
  221  include reasonable and fair minimum standards in relation to:
  222         (g) The care of residents provided by the facility, which
  223  must include:
  224         1. The supervision of residents;
  225         2. The provision of personal services;
  226         3. The provision of, or arrangement for, social and leisure
  227  activities;
  228         4. The assistance in making arrangements for appointments
  229  and transportation to appropriate medical, dental, nursing, or
  230  mental health services, as needed by residents;
  231         5. The management of medication stored within the facility
  232  and as needed by residents;
  233         6. The dietary needs of residents;
  234         7. Resident records; and
  235         8. Internal risk management and quality assurance; and
  236         9.Identification of residents who are at risk for
  237  developing venous thromboembolism and the treating facility’s
  238  response protocols to help ensure access to timely treatment.
  239         Section 7. Paragraph (h) is added to subsection (3) of
  240  section 429.52, Florida Statutes, to read:
  241         429.52 Staff training and educational requirements.—
  242         (3) The agency, in conjunction with providers, shall
  243  develop core training requirements for administrators consisting
  244  of core training learning objectives, a competency test, and a
  245  minimum required score to indicate successful passage of the
  246  core competency test. The required core competency test must
  247  cover at least the following topics:
  248         (h)Identification of and responding to residents at high
  249  risk of developing venous thromboembolism.
  250         Section 8. This act shall take effect July 1, 2025.