CODING: Words stricken are deletions; words underlined are additions.





                                                  SENATE AMENDMENT

    Bill No. SB 1962

    Amendment No.    

                            CHAMBER ACTION
              Senate                               House
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11  Senator Rossin moved the following amendment:

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13         Senate Amendment (with title amendment) 

14         On page 1, line 30, through

15            page 2, line 13, delete those lines

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17  and insert:

18         (g)  A memory disorder center located in a public

19  hospital that is operated by an independent special hospital

20  taxing district that governs multiple hospitals and is located

21  in a county with a population greater than 800,000 persons;

22         (h)  A memory disorder clinic at St. Mary's Medical

23  Center in Palm Beach County; and

24         (i)  A memory disorder clinic at Tallahassee Memorial

25  Regional Medical Center,

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27  for the purpose of conducting research and training in a

28  diagnostic and therapeutic setting for persons suffering from

29  Alzheimer's disease and related memory disorders.  However,

30  memory disorder clinics funded as of June 30, 1995, shall not

31  receive decreased funding due solely to subsequent additions

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                                                  SENATE AMENDMENT

    Bill No. SB 1962

    Amendment No.    





 1  of memory disorder clinics in this subsection.

 2         (4)  Pursuant to the provisions of s. 287.057, the

 3  Department of Elderly Affairs may shall contract for the

 4  provision of three specialized model day care programs in

 5  conjunction with the each memory disorder clinics clinic.  The

 6  purpose of each model day care program must be to provide

 7  service delivery to persons suffering from Alzheimer's disease

 8  or a related memory disorder and training for health care and

 9  social service personnel in the care of persons having

10  Alzheimer's disease or related memory disorders.

11         Section 2.  Section 430.707, Florida Statutes, is

12  amended to read:

13         430.707  Contracts.--

14         (1)  The department, in consultation with the agency,

15  shall select and contract with managed care organizations to

16  provide long-term care within community diversion pilot

17  project areas.

18         (2)  The department, in consultation with the agency,

19  may contract with entities that have submitted an application

20  as a community nursing home diversion project as of July 1,

21  1998, to provide benefits pursuant to the "Program of

22  All-inclusive Care for the Elderly" as established in Pub. L.

23  No. 105-33. For the purposes of this community nursing home

24  diversion project, such entities shall be exempt from the

25  requirements of chapter 641, if the entity is a private,

26  nonprofit, superior-rated nursing home with at least 50

27  percent of its residents eligible for Medicaid.

28         Section 3.  (1)  There is hereby created the Panel for

29  the Study of End-of-Life Care, which shall be located in the

30  Pepper Institute on Aging and Public Policy at Florida State

31  University, to study the issues related to care provided to

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                                                  SENATE AMENDMENT

    Bill No. SB 1962

    Amendment No.    





 1  persons at the end of life.

 2         (2)  The panel shall be composed of 22 persons, as

 3  follows:

 4         (a)  Two persons who are representatives of hospice

 5  organizations, and one consumer, to be appointed by the

 6  Florida Hospice Association.

 7         (b)  Three persons who are representatives of nursing

 8  homes and assisted living facilities and who have the

 9  expertise necessary to participate in the work of the panel.

10  Two of these persons shall be appointed by the Florida Health

11  Care Association and one by the Florida Association of Homes

12  for the Aging.

13         (c)  Three persons who are representatives of hospitals

14  and who have the expertise necessary to participate in the

15  work of the panel, one each to be appointed by the Florida

16  Hospital Association, the Florida League of Health Systems,

17  and the Association of Community Hospitals and Health Systems

18  of Florida, Inc.

19         (d)  One member each to be appointed by the Florida

20  Medical Association, the Board of Medicine, the Board of

21  Osteopathic Medicine, The Florida Bar, and the Florida Nurses

22  Association, who have the expertise necessary to participate

23  in the work of the panel.

24         (e)  One member of the Florida Senate appointed by the

25  President of the Senate and one member of the Florida House of

26  Representatives appointed by the Speaker of the House.

27         (f)  One representative of the Aging with Dignity

28  Commission.

29         (g)  Two representatives appointed by the Pepper

30  Institute, including a member of the clergy, with the

31  expertise necessary to participate in the work of the panel.

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                                                  SENATE AMENDMENT

    Bill No. SB 1962

    Amendment No.    





 1         (h)  One representative from the Health Quality

 2  Assurance Division of the Agency for Health Care

 3  Administration with expertise in the regulation of long-term

 4  care facilities.

 5         (i)  The Secretary of Elder Affairs, and one consumer

 6  representative appointed by the secretary.

 7         (3)  The members of the panel shall be appointed by

 8  July 1, 1998, and shall hold an initial meeting of the panel

 9  by August 1, 1998. All expenses of the panel, including travel

10  and per diem expenses, shall be paid by the entities

11  appointing members pursuant to subsection (2), in proportion

12  to the number of members appointed by them. The Pepper

13  Institute shall provide such staff support for the panel as is

14  requested by the panel. The panel shall hold such hearings as

15  it deems appropriate to receive public testimony as to its

16  proposed recommendations and findings. Notice of all meetings

17  of the panel and of its public hearings shall be provided in

18  the Florida Administrative Weekly.

19         (4)  The panel is directed to study issues related to

20  the care provided to persons at the end of life. Issues

21  considered by the panel shall include:

22         (a)  Methods to ensure that pain management is a goal

23  in each health care setting.

24         (b)  The identification of barriers that hinder health

25  care professionals from providing satisfactory pain management

26  and palliative care.

27         (c)  Whether mandatory education in pain management and

28  palliative care should be required as a condition for

29  licensure or relicensure of health care professionals. The

30  Pepper Institute shall consult with health care professional

31  licensing boards in completing this phase of the study.

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                                                  SENATE AMENDMENT

    Bill No. SB 1962

    Amendment No.    





 1         (d)  The current use of advance directives, to

 2  determine whether changes are necessary to ensure that, once

 3  prepared, advance directives will be honored in any health

 4  care setting.

 5         (e)  The regulatory and financial incentives that

 6  influence the site or setting of care and of care providers.

 7         (5)  The panel shall submit an interim report by

 8  January 31, 1999, and a final report by August 1, 1999, to the

 9  Governor, the President of the Senate, and the Speaker of the

10  House of Representatives.

11         (6)  This section shall stand repealed effective August

12  1, 1999.

13         Section 4.  This act shall take effect July 1 of the

14  year in which enacted.

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17  ================ T I T L E   A M E N D M E N T ===============

18  And the title is amended as follows:

19         On page 1, lines 2-4, delete those lines

20

21  and insert:

22         An act relating to health care; amending s.

23         430.502, F.S.; establishing additional memory

24         disorder clinics; revising authority of the

25         Department of Elderly Affairs with respect to

26         contracts for specialized model day care

27         programs at such clinics; amending s. 430.707,

28         F.S.; authorizing the department to contract

29         for certain services; exempting certain

30         providers from the provisions of ch. 641, F.S.;

31         creating the Panel for the Study of End-of-Life

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                                                  SENATE AMENDMENT

    Bill No. SB 1962

    Amendment No.    





 1         Care; providing for membership and duties;

 2         requiring a report; providing for future

 3         repeal;

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