Florida Senate - 2014                              CS for SB 872
       
       
        
       By the Committee on Health Policy; and Senators Richter and Soto
       
       
       
       
       
       588-02827-14                                           2014872c1
    1                        A bill to be entitled                      
    2         An act relating to Alzheimer’s disease; amending s.
    3         120.80, F.S.; exempting grant programs administered by
    4         the Alzheimer’s Disease Research Grant Advisory Board
    5         from the Administrative Procedure Act; amending s.
    6         252.355, F.S.; requiring the Division of Emergency
    7         Management, in coordination with local emergency
    8         management agencies, to maintain a registry of persons
    9         with special needs; requiring the division to develop
   10         and maintain a special needs shelter registration
   11         program by a specified date; requiring specified
   12         agencies and authorizing specified health care
   13         providers to provide registration information to
   14         special needs clients or their caregivers and to
   15         assist emergency management agencies in registering
   16         persons for special needs shelters; amending s.
   17         381.0303, F.S.; providing additional staffing
   18         requirements for special needs shelters; requiring
   19         special needs shelters to establish designated shelter
   20         areas for persons with Alzheimer’s disease or related
   21         forms of dementia; authorizing the Department of
   22         Health, in coordination with the division, to adopt
   23         rules relating to standards for the special needs
   24         registration program; creating s. 381.82, F.S.;
   25         establishing the Ed and Ethel Moore Alzheimer’s
   26         Disease Research Program within the department;
   27         requiring the program to provide grants and
   28         fellowships for research relating to Alzheimer’s
   29         disease; creating the Alzheimer’s Disease Research
   30         Grant Advisory Board; providing for appointment and
   31         terms of members; providing for organization, duties,
   32         and operating procedures of the board; requiring the
   33         department to provide staff to assist the board in
   34         carrying out its duties; requiring the board to
   35         annually submit recommendations for proposals to be
   36         funded; requiring a report to the Governor,
   37         Legislature, and State Surgeon General; providing that
   38         implementation of the program is subject to
   39         appropriation; amending s. 430.502, F.S.; requiring
   40         the Department of Elderly Affairs to develop minimum
   41         performance standards for memory disorder clinics to
   42         receive base-level annual funding; requiring the
   43         department to provide incentive-based funding, subject
   44         to appropriation, for certain memory disorder clinics;
   45         providing an effective date.
   46          
   47  Be It Enacted by the Legislature of the State of Florida:
   48  
   49         Section 1. Subsection (15) of section 120.80, Florida
   50  Statutes, is amended to read:
   51         120.80 Exceptions and special requirements; agencies.—
   52         (15) DEPARTMENT OF HEALTH.—
   53         (a) Notwithstanding s. 120.57(1)(a), formal hearings may
   54  not be conducted by the State Surgeon General, the Secretary of
   55  Health Care Administration, or a board or member of a board
   56  within the Department of Health or the Agency for Health Care
   57  Administration for matters relating to the regulation of
   58  professions, as defined by chapter 456. Notwithstanding s.
   59  120.57(1)(a), hearings conducted within the Department of Health
   60  in execution of the Special Supplemental Nutrition Program for
   61  Women, Infants, and Children; Child Care Food Program;
   62  Children’s Medical Services Program; the Brain and Spinal Cord
   63  Injury Program; and the exemption from disqualification reviews
   64  for certified nurse assistants program need not be conducted by
   65  an administrative law judge assigned by the division. The
   66  Department of Health may contract with the Department of
   67  Children and Families Family Services for a hearing officer in
   68  these matters.
   69         (b) This chapter does not apply to grant programs
   70  administered by the Alzheimer’s Disease Research Grant Advisory
   71  Board pursuant to s. 381.82.
   72         Section 2. Section 252.355, Florida Statutes, is amended to
   73  read:
   74         252.355 Registry of persons with special needs; notice;
   75  registration program.—
   76         (1) In order to meet the special needs of persons who would
   77  need assistance during evacuations and sheltering because of
   78  physical, mental, cognitive impairment, or sensory disabilities,
   79  the division, in coordination with each local emergency
   80  management agency in the state, shall maintain a registry of
   81  persons with special needs located within the jurisdiction of
   82  the local agency. The registration shall identify those persons
   83  in need of assistance and plan for resource allocation to meet
   84  those identified needs.
   85         (2) In order to ensure that all persons with special needs
   86  may register, the division shall develop and maintain a special
   87  needs shelter registration program. The registration program
   88  must be developed by January 1, 2015, and fully implemented by
   89  March 1, 2015.
   90         (a) The registration program shall include, at a minimum, a
   91  uniform electronic registration form and a database for
   92  uploading and storing submitted registration forms which may be
   93  accessed by the appropriate local emergency management agency.
   94  The link to the registration form shall be easily accessible on
   95  each local emergency management agency’s website. Upon receipt
   96  of a paper registration form, the local emergency management
   97  agency shall enter the person’s registration information into
   98  the database.
   99         (b) To assist the local emergency management agency in
  100  identifying such persons with special needs, home health
  101  agencies, hospices, nurse registries, home medical equipment
  102  providers, the Department of Children and Families Family
  103  Services, the Department of Health, the Agency for Health Care
  104  Administration, the Department of Education, the Agency for
  105  Persons with Disabilities, the and Department of Elderly
  106  Affairs, and memory disorder clinics shall, and any physician
  107  licensed under chapter 458 or chapter 459 and any pharmacy
  108  licensed under chapter 465 may, annually shall provide
  109  registration information to all of their special needs clients
  110  or their caregivers and to all persons with special needs who
  111  receive services. The division shall develop a brochure that
  112  provides information regarding special needs shelter
  113  registration procedures. The brochure shall be published on the
  114  division’s website. All appropriate agencies and community-based
  115  service providers, including memory disorder clinics, home
  116  health care providers, hospices, nurse registries, and home
  117  medical equipment providers shall, and any physician licensed
  118  under chapter 458 or chapter 459 may, assist emergency
  119  management agencies by annually registering persons with special
  120  needs for special needs shelters, collecting registration
  121  information for persons with special needs as part of the
  122  program intake process, and establishing programs to educate
  123  clients about the registration process and disaster preparedness
  124  safety procedures. A client of a state-funded or federally
  125  funded service program who has a physical, mental, or cognitive
  126  impairment or sensory disability and who needs assistance in
  127  evacuating or while in a shelter must register as a person with
  128  special needs. The registry shall be updated annually. The
  129  registration program shall give persons with special needs the
  130  option of preauthorizing emergency response personnel to enter
  131  their homes during search and rescue operations if necessary to
  132  ensure assure their safety and welfare following disasters.
  133         (c)(2) The division shall be the designated lead agency
  134  responsible for community education and outreach to the public,
  135  including special needs clients, regarding registration and
  136  special needs shelters and general information regarding shelter
  137  stays.
  138         (d)(4)(a) On or before May 31 of each year, each electric
  139  utility in the state shall annually notify residential customers
  140  in its service area of the availability of the registration
  141  program available through their local emergency management
  142  agency by:
  143         1. An initial notification upon the activation of new
  144  residential service with the electric utility, followed by one
  145  annual notification between January 1 and May 31; or
  146         2. Two separate annual notifications between January 1 and
  147  May 31.
  148  
  149  (b) The notification may be made by any available means,
  150  including, but not limited to, written, electronic, or verbal
  151  notification, and may be made concurrently with any other
  152  notification to residential customers required by law or rule.
  153         (3) A person with special needs must be allowed to bring
  154  his or her service animal into a special needs shelter in
  155  accordance with s. 413.08.
  156         (4)(5) All records, data, information, correspondence, and
  157  communications relating to the registration of persons with
  158  special needs as provided in subsection (1) are confidential and
  159  exempt from the provisions of s. 119.07(1), except that such
  160  information shall be available to other emergency response
  161  agencies, as determined by the local emergency management
  162  director. Local law enforcement agencies shall be given complete
  163  shelter roster information upon request.
  164         (6) All appropriate agencies and community-based service
  165  providers, including home health care providers, hospices, nurse
  166  registries, and home medical equipment providers, shall assist
  167  emergency management agencies by collecting registration
  168  information for persons with special needs as part of program
  169  intake processes, establishing programs to increase the
  170  awareness of the registration process, and educating clients
  171  about the procedures that may be necessary for their safety
  172  during disasters. Clients of state or federally funded service
  173  programs with physical, mental, cognitive impairment, or sensory
  174  disabilities who need assistance in evacuating, or when in
  175  shelters, must register as persons with special needs.
  176         Section 3. Present subsections (3) through (7) of section
  177  381.0303, Florida Statutes, are redesignated as subsections (4)
  178  through (8), respectively, paragraph (b) of subsection (2) and
  179  present subsection (6) are amended, and a new subsection (3) is
  180  added to that section, to read:
  181         381.0303 Special needs shelters.—
  182         (2) SPECIAL NEEDS SHELTER PLAN; STAFFING; STATE AGENCY
  183  ASSISTANCE.—If funds have been appropriated to support disaster
  184  coordinator positions in county health departments:
  185         (b) County health departments shall, in conjunction with
  186  the local emergency management agencies, have the lead
  187  responsibility for coordination of the recruitment of health
  188  care practitioners to staff local special needs shelters. County
  189  health departments shall assign their employees to work in
  190  special needs shelters when those employees are needed to
  191  protect the health and safety of persons with special needs.
  192  County governments shall assist the department with nonmedical
  193  staffing and the operation of special needs shelters. The local
  194  health department and emergency management agency shall
  195  coordinate these efforts to ensure appropriate staffing in
  196  special needs shelters, including a staff member who is familiar
  197  with the needs of persons with Alzheimer’s disease.
  198         (3) SPECIAL CARE FOR PERSONS WITH ALZHEIMER’S DISEASE OR
  199  RELATED FORMS OF DEMENTIA.—All special needs shelters must
  200  establish designated shelter areas for persons with Alzheimer’s
  201  disease or related forms of dementia to enable those persons to
  202  maintain their normal habits and routines to the greatest extent
  203  possible.
  204         (7)(6) RULES.—The department, in coordination with the
  205  Division of Emergency Management, may has the authority to adopt
  206  rules necessary to implement this section. Rules shall include:
  207         (a) The definition of a “person with special needs,”
  208  including eligibility criteria for individuals with physical,
  209  mental, cognitive impairment, or sensory disabilities and the
  210  services a person with special needs can expect to receive in a
  211  special needs shelter.
  212         (b) The process for special needs shelter health care
  213  practitioners and facility reimbursement for services provided
  214  in a disaster.
  215         (c) Guidelines for special needs shelter staffing levels to
  216  provide services.
  217         (d) The definition of and standards for special needs
  218  shelter supplies and equipment, including durable medical
  219  equipment.
  220         (e) Standards for the special needs shelter registration
  221  program process, including all necessary forms and guidelines
  222  for addressing the needs of unregistered persons in need of a
  223  special needs shelter.
  224         (f) Standards for addressing the needs of families where
  225  only one dependent is eligible for admission to a special needs
  226  shelter and the needs of adults with special needs who are
  227  caregivers for individuals without special needs.
  228         (g) The requirement of the county health departments to
  229  seek the participation of hospitals, nursing homes, assisted
  230  living facilities, home health agencies, hospice providers,
  231  nurse registries, home medical equipment providers, dialysis
  232  centers, and other health and medical emergency preparedness
  233  stakeholders in pre-event planning activities.
  234         Section 4. Section 381.82, Florida Statutes, is created to
  235  read:
  236         381.82 Ed and Ethel Moore Alzheimer’s Disease Research
  237  Program.—
  238         (1) There is established the Ed and Ethel Moore Alzheimer’s
  239  Disease Research Program within the Department of Health. The
  240  purpose of the program is to fund research leading to prevention
  241  of or a cure for Alzheimer’s disease. The long-term goals of the
  242  program are to:
  243         (a) Enhance the health of Floridians by researching
  244  improved prevention, diagnosis, treatment, and cure of
  245  Alzheimer’s disease.
  246         (b) Expand the foundation of knowledge relating to the
  247  prevention, diagnosis, treatment, and cure of Alzheimer’s
  248  disease.
  249         (c) Stimulate economic activity in the state in areas
  250  related to Alzheimer’s disease research.
  251         (2)(a) Funds appropriated for the Ed and Ethel Moore
  252  Alzheimer’s Disease Research Program shall be used exclusively
  253  for the award of grants and fellowships through a competitive,
  254  peer-reviewed process for research relating to the prevention,
  255  diagnosis, treatment, and cure of Alzheimer’s disease and for
  256  expenses incurred in the administration of this section.
  257  Priority shall be granted to research designed to prevent or
  258  cure Alzheimer’s disease.
  259         (b) Applications for Alzheimer’s disease research funding
  260  under the program may be submitted from any university or
  261  established research institute in the state. All qualified
  262  investigators in the state, regardless of institution
  263  affiliation, shall have equal access and opportunity to compete
  264  for research funding. The following types of applications may be
  265  considered for funding:
  266         1. Investigator-initiated research grants.
  267         2. Institutional research grants.
  268         3. Predoctoral and postdoctoral research fellowships.
  269         4. Collaborative research grants, including those that
  270  advance the finding of cures through basic or applied research.
  271         (3) There is created the Alzheimer’s Disease Research Grant
  272  Advisory Board within the Department of Health.
  273         (a) The board shall consist of 11 members appointed by the
  274  State Surgeon General. The board shall be composed of two
  275  gerontologists, two geriatric psychiatrists, two geriatricians,
  276  two neuroscientists, and three neurologists. Initial
  277  appointments to the board shall be made by October 1, 2014. The
  278  board members shall serve 4-year terms, except that, to provide
  279  for staggered terms, six of the initial appointees shall serve
  280  2-year terms and six shall serve 4-year terms. All subsequent
  281  appointments shall be for 4-year terms. The chair of the board
  282  shall be elected from the membership of the board and shall
  283  serve as chair for 2 years. An appointed member may not serve
  284  more than two consecutive terms. Appointed members must have
  285  experience in Alzheimer’s disease or related biomedical
  286  research. The board shall adopt internal organizational
  287  procedures as necessary for its organization. The board shall
  288  establish and follow guidelines for ethical conduct and adhere
  289  to a policy established to avoid conflicts of interest. A member
  290  of the board may not participate in any discussion or decision
  291  of the board or a panel with respect to a research proposal by
  292  any firm, entity, or agency with which the member is associated
  293  as a member of the governing body or as an employee or with
  294  which the member has entered into a contractual arrangement.
  295         (b) The department shall provide such staff, information,
  296  and other assistance as necessary to assist the board in
  297  carrying out its responsibilities. Members of the board shall
  298  serve without compensation and may not receive reimbursement for
  299  per diem or travel expenses.
  300         (c) The board shall advise the State Surgeon General as to
  301  the scope of the research program and shall submit its
  302  recommendations for proposals to be funded to the State Surgeon
  303  General by December 15 of each year. Grants and fellowships
  304  shall be awarded by the State Surgeon General, after
  305  consultation with the board, on the basis of scientific merit.
  306  Other responsibilities of the board may include, but are not
  307  limited to, providing advice on program priorities and emphases;
  308  assisting in the development of appropriate linkages to
  309  nonacademic entities, such as voluntary organizations, health
  310  care delivery institutions, industry, government agencies, and
  311  public officials; and developing and providing oversight
  312  regarding mechanisms for the dissemination of research results.
  313         (4) The board shall submit a fiscal-year progress report on
  314  the programs under its purview to the Governor, the President of
  315  the Senate, the Speaker of the House of Representatives, and the
  316  State Surgeon General by February 15 of each year. The report
  317  must include:
  318         (a) A list of research projects supported by grants or
  319  fellowships awarded under the program.
  320         (b) A list of recipients of program grants or fellowships.
  321         (c) A list of publications in peer-reviewed journals
  322  involving research supported by grants or fellowships awarded
  323  under the program.
  324         (d) The state ranking and total amount of Alzheimer’s
  325  disease research funding allocated to the state from the
  326  National Institutes of Health.
  327         (e) New grants for Alzheimer’s disease research which were
  328  funded based on research supported by grants or fellowships
  329  awarded under the program.
  330         (f) Progress toward programmatic goals, particularly in the
  331  prevention, diagnosis, treatment, and cure of Alzheimer’s
  332  disease.
  333         (g) Recommendations to further the mission of the program.
  334         (5) Implementation of the Ed and Ethel Moore Alzheimer’s
  335  Disease Research Program is subject to legislative
  336  appropriation.
  337         Section 5. Present subsections (3) through (9) of section
  338  430.502, Florida Statutes, are redesignated as subsections (6)
  339  through (12), respectively, new subsections (3), (4), and (5)
  340  are added to that section, and present subsections (4), (5),
  341  (8), and (9) of that section are amended, to read:
  342         430.502 Alzheimer’s disease; memory disorder clinics and
  343  day care and respite care programs.—
  344         (3) The department shall develop minimum performance
  345  standards for memory disorder clinics and include those
  346  standards in each memory disorder clinic contract as a condition
  347  for receiving base-level funding. The performance standards must
  348  address, at a minimum, quality of care, comprehensiveness of
  349  services, and access to services.
  350         (4) The department shall develop performance goals that
  351  exceed the minimum performance standards developed under
  352  subsection (3) which must be achieved in order for a memory
  353  disorder clinic to be eligible for incentive funding above the
  354  base level, subject to legislative appropriation. Incentive
  355  funding shall be based on criteria including, but not limited
  356  to:
  357         (a) A significant increase in the volume of clinical
  358  services.
  359         (b) A significant increase in public outreach to low-income
  360  and minority populations.
  361         (c) A significant increase in the acceptance of Medicaid
  362  and commercial insurance policies.
  363         (d) Significant institutional financial commitments.
  364         (5) The department shall measure and score each memory
  365  disorder clinic based on minimum performance standards and
  366  incentive performance goals.
  367         (7)(4) Pursuant to the provisions of s. 287.057, the
  368  department of Elderly Affairs may contract for the provision of
  369  specialized model day care programs in conjunction with the
  370  memory disorder clinics. The purpose of each model day care
  371  program must be to provide service delivery to persons suffering
  372  from Alzheimer’s disease or a related memory disorder and
  373  training for health care and social service personnel in the
  374  care of persons having Alzheimer’s disease or a related memory
  375  disorder disorders.
  376         (8)(5) Pursuant to s. 287.057, the department of Elderly
  377  Affairs shall contract for the provision of respite care. All
  378  funds appropriated for the provision of respite care shall be
  379  distributed annually by the department to each funded county
  380  according to an allocation formula. In developing the formula,
  381  the department shall consider the number and proportion of the
  382  county population of individuals who are 75 years of age and
  383  older. Each respite care program shall be used as a resource for
  384  research and statistical data by the memory disorder clinics
  385  established in this part. In consultation with the memory
  386  disorder clinics, the department shall specify the information
  387  to be provided by the respite care programs for research
  388  purposes.
  389         (11)(8) The department shall implement the waiver program
  390  specified in subsection (10) (7). The agency and the department
  391  shall ensure the selection of that providers who have a history
  392  of successfully serving persons with Alzheimer’s disease are
  393  selected. The department and the agency shall develop
  394  specialized standards for providers and services tailored to
  395  persons in the early, middle, and late stages of Alzheimer’s
  396  disease and designate a level of care determination process and
  397  standard that is most appropriate to this population. The
  398  department and the agency shall include in the waiver services
  399  designed to assist the caregiver in continuing to provide in
  400  home care. The department shall implement this waiver program
  401  subject to a specific appropriation or as provided in the
  402  General Appropriations Act.
  403         (12)(9) Authority to continue the waiver program specified
  404  in subsection (10) (7) shall be automatically eliminated at the
  405  close of the 2010 Regular Session of the Legislature unless
  406  further legislative action is taken to continue it before prior
  407  to such time.
  408         Section 6. This act shall take effect July 1, 2014.