Senate Bill 2360c1
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By the Committee on Health, Aging and Long-Term Care; and
Senator Thomas
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1 A bill to be entitled
2 An act relating to home health agencies;
3 amending s. 400.462, F.S.; providing
4 definitions; amending s. 400.464, F.S.;
5 establishing licensure and exemptions from
6 licensure requirements for home health
7 agencies; amending s. 400.471, F.S.; providing
8 insurance coverage requirements; amending s.
9 400.474, F.S.; providing grounds for
10 disciplinary action, penalties for operating
11 without a license, and grounds for revocation
12 or suspension of license; amending s. 400.484,
13 F.S.; establishing administrative fines for
14 various classes of deficiencies; amending s.
15 400.487, F.S.; providing for patient assessment
16 and establishment and review of plan of care;
17 creating s. 400.488, F.S.; providing for
18 assistance with self-administration of
19 medication; amending s. 400.491, F.S.;
20 providing for maintenance of service provision
21 plan; amending s. 400.497, F.S.; providing for
22 establishment of rules; amending s. 400.506,
23 F.S.; providing for licensure of nurse
24 registries; amending s. 400.509, F.S.;
25 providing for registration of particular
26 service providers; amending s. 400.512, F.S.;
27 providing for screening of home health agency
28 personnel; establishing a Task Force on Home
29 Health Services Licensure Provisions; providing
30 an effective date.
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1 Be It Enacted by the Legislature of the State of Florida:
2
3 Section 1. Section 400.462, Florida Statutes, is
4 amended to read:
5 400.462 Definitions.--As used in this part, the term:
6 (1) "Administrator" means a direct employee of the
7 home health agency or a related organization, or of a
8 management company that has a contract to manage the home
9 health agency, to whom the governing body has delegated the
10 responsibility for day-to-day administration of the home
11 health agency. The administrator must be a licensed
12 physician, physician assistant, or registered nurse licensed
13 to practice in this state or an individual having at least 1
14 year of supervisory or administrative experience in home
15 health care or in a facility licensed under chapter 395 or
16 under part II or part III of chapter 400. An administrator
17 may manage a maximum of five licensed home health agencies
18 located within one agency service district or within an
19 immediately contiguous county. If the home health agency is
20 licensed under this chapter and is part of a retirement
21 community that provides multiple levels of care, an employee
22 of the retirement community may administer the home health
23 agency and up to a maximum of four entities licensed under
24 chapter 400 that are owned, operated, or managed by the same
25 corporate entity. An administrator shall designate, in
26 writing, for each licensed entity, a qualified alternate
27 administrator to serve during absences.
28 (2) "Agency" means the Agency for Health Care
29 Administration.
30 (3)(1) "Certified nursing assistant" means any person
31 who has been issued a certificate under after fulfilling the
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1 requirements of s. 400.211. The licensed home health agency or
2 licensed nurse registry shall ensure that the certified
3 nursing assistant employed by or under contract with the home
4 health agency or licensed nurse registry is adequately trained
5 to perform the tasks of a home health aide in the home
6 setting.
7 (4) "Client" means an elderly, handicapped, or
8 convalescent individual who receives personal care services,
9 companion services, or homemaker services in the individual's
10 home or place of residence.
11 (5)(2) "Companion" or "sitter" means a person who
12 cares for an elderly, handicapped, or convalescent individual
13 and accompanies such individual on trips and outings and may
14 prepare and serve meals to such individual. A companion may
15 not provide hands-on personal care to a client.
16 (6)(3) "Department" means the Department of Children
17 and Family Health and Rehabilitative Services.
18 (7) "Director of nursing" means a registered nurse and
19 direct employee of the agency or related business entity who
20 is a graduate of an approved school of nursing and is licensed
21 in this state; who has at least 1 year of supervisory
22 experience as a registered nurse in a licensed home health
23 agency, a facility licensed under chapter 395, or a facility
24 licensed under part II or part III of chapter 400; and who is
25 responsible for overseeing the professional nursing and home
26 health aid delivery of services of the agency. An employee
27 may be the director of nursing of a maximum of five licensed
28 home health agencies operated by a related business entity and
29 located within one agency service district or within an
30 immediately contiguous county. If the home health agency is
31 licensed under this chapter and is part of a retirement
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1 community that provides multiple levels of care, an employee
2 of the retirement community may serve as the director of
3 nursing of the home health agency and of up to four entities
4 licensed under chapter 400 which are owned, operated, or
5 managed by the same corporate entity. A director of nursing
6 shall designate, in writing, for each licensed entity, a
7 qualified alternate registered nurse to serve during the
8 absence of the director of nursing.
9 (8)(4) "Home health agency" means an organization that
10 provides home health services and staffing services for health
11 care facilities.
12 (9)(5) "Home health agency personnel" means persons
13 who are employed by or under contract with a home health
14 agency and enter the home or place of residence of patients at
15 any time in the course of their employment or contract.
16 (10)(6) "Home health services" means health and
17 medical services and medical supplies furnished by an
18 organization to an individual by home health agency personnel
19 or by others under arrangements with the agency, on a visiting
20 basis, in the individual's home or place of residence. The
21 term includes organizations that provide one or more of, but
22 is not limited to, the following:
23 (a) Nursing care.
24 (b) Physical, occupational, respiratory, or speech
25 therapy.
26 (c) Home health aide services.
27 (d) Dietetics and nutrition practice and nutrition
28 counseling Nutritional guidance.
29 (e) Medical supplies, restricted to drugs and
30 biologicals prescribed by a physician.
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1 (11) "Home health aide" means a person who provides
2 hands-on personal care, performs simple procedures as an
3 extension of therapy or nursing services, assists in
4 ambulation or exercises, or assists in administering
5 medications as permitted in rule and for which the person has
6 received training established by the agency under s.
7 400.497(1).
8 (12)(7) "Homemaker" means a person who performs
9 household chores that include housekeeping, meal planning and
10 preparation, shopping assistance, and routine household
11 activities for an elderly, handicapped, or convalescent
12 individual. A homemaker may not provide hands-on personal care
13 to a client.
14 (13) "Home infusion therapy provider" means an
15 organization that employs, contracts with, or refers a
16 licensed professional, who has received advanced training and
17 experience in intravenous infusion therapy and who administers
18 infusion therapy to a patient in the patient's home or place
19 of residence.
20 (14) "Home infusion therapy" means the administration
21 of intravenous pharmacological or nutritional products to a
22 patient in his or her home.
23 (15)(8) "Nurse registry" means any person that
24 procures, offers, promises, or attempts to secure
25 health-care-related contracts for registered nurses, licensed
26 practical nurses, certified nursing assistants, home health
27 aides sitters, companions, or homemakers, who are compensated
28 by fees as independent contractors, including, but not limited
29 to, contracts for the provision of services to patients and
30 contracts to provide private duty or staffing services to
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1 health care facilities licensed under chapter 395 or this
2 chapter or other business entities.
3 (16) "Organization" means a corporation, government or
4 governmental subdivision or agency, partnership or
5 association, or any other legal or commercial entity, any of
6 which involve more than one health care professional
7 discipline or a health care professional and a home health
8 aide or certified nursing assistant. The term does not
9 include an entity that provides services using only volunteers
10 or only individuals related by blood or marriage to the
11 patient or client.
12 (17)(9) "Patient" means any person who receives home
13 health services in his or her home or place of residence.
14 (18) "Personal care" means assistance to a patient in
15 the activities of daily living, such as dressing, bathing,
16 eating, or personal hygiene, and assistance in physical
17 transfer, ambulation, and in administering medications as
18 permitted by rule.
19 (19) "Physician" means a person licensed under chapter
20 458, chapter 459, chapter 460, or chapter 461.
21 (20)(10) "Screening" means the assessment of the
22 background of home health agency personnel, nurse registry
23 personnel, and persons registered under s. 400.509 and
24 includes employment or contractual history checks, records
25 checks of the department's central abuse hotline under chapter
26 415 relating to vulnerable adults, and statewide criminal
27 records correspondence checks through the Department of Law
28 Enforcement.
29 (21) "Skilled care" means nursing services or
30 therapeutic services delivered by a health care professional
31 who is licensed under chapter 464; part I, part III, or part V
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1 of chapter 468; or chapter 486 and who is employed by or under
2 contract with a licensed home health agency or is referred by
3 a licensed nurse registry.
4 (22)(11) "Staffing services" means services provided
5 to a health care facility or other business entity on a
6 temporary basis by licensed health care personnel, including
7 certified nursing assistants and home heath aides who are
8 employed by, or work under the auspices of, a licensed home
9 health agency or who are registered with a licensed nurse
10 registry.
11 Section 2. Section 400.464, Florida Statutes, is
12 amended to read:
13 400.464 Home health agencies to be licensed;
14 expiration of license; exemptions; unlawful acts; penalties.--
15 (1) Any home health agency must be licensed by the
16 agency for Health Care Administration to operate in this
17 state. A license issued to a home health agency, unless
18 sooner suspended or revoked, expires 1 year after its date of
19 issuance. However, any home health agency that is operated by
20 the Federal Government is exempt from this part.
21 (2) If the licensed home health agency operates
22 related offices, each related office outside the county where
23 the main office is located must be separately licensed. The
24 counties where the related offices are operating must be
25 specified on the license in the main office.
26 (3) An entity receiving a certificate-of-need
27 exemption under s. 408.0366 may request one home health agency
28 license to provide Medicare and non-Medicare home health
29 services to residents of the facility and non-Medicare home
30 health services to persons in one or more counties within the
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1 agency service district where the main office of the home
2 health agency is located.
3 (3) The furnishing of only home dialysis services,
4 supplies, or equipment, or personal care services as provided
5 by a community-care-for-the-elderly lead agency under s.
6 430.205, or personal care services provided through a
7 community-care-for-disabled-adults program under s. 410.604,
8 is exempt from this part. The personal care services
9 exemptions apply only to community-care-for-the-elderly lead
10 agencies and community-care-for-disabled-adults programs that
11 directly provide only personal care services to their clients
12 and do not provide other home health services.
13 (4) Any program offered through a county health
14 department that makes home visits for the purpose of providing
15 only environmental assessments, case management, health
16 education, or personal care services is exempt from this part.
17 (5)(a) It is unlawful for any person to offer or
18 advertise home health services to the public unless he or she
19 has a valid license under this part. It is unlawful for any
20 holder of a license issued under this part to advertise or
21 indicate to the public that it holds a home health agency
22 license other than the one it has been issued.
23 (b) A person who violates paragraph (a) is subject to
24 an injunctive proceeding under s. 400.515. A violation of
25 paragraph (a) is a deceptive and unfair trade practice and
26 constitutes a violation of the Florida Deceptive and Unfair
27 Trade Practices Act.
28 (c) A person who violates paragraph (a) commits a
29 misdemeanor of the second degree, punishable as provided in s.
30 775.082 or s. 775.083. Any person who commits a second or
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1 subsequent violation commits a misdemeanor of the first
2 degree, punishable as provided in s. 775.082 or s. 775.083.
3
4 Each day of continuing violation constitutes a separate
5 offense.
6 (4)(6) Any home infusion therapy provider shall be
7 licensed as a home health agency. Any infusion therapy
8 provider currently authorized to receive Medicare
9 reimbursement under a DME - Part B Provider number for the
10 provision of infusion therapy shall be licensed as a
11 noncertified home health agency. Such a provider shall
12 continue to receive that specified Medicare reimbursement
13 without being certified so long as the reimbursement is
14 limited to those items authorized pursuant to the DME - Part B
15 Provider Agreement and the agency is licensed in compliance
16 with the other provisions of this part.
17 (5)(a) An organization may not provide, offer, or
18 advertise home health services to the public unless the
19 organization has a valid license or is specifically exempted
20 under this part. An organization that offers or advertises to
21 the public any service for which licensure or registration is
22 required under this part must include in the advertisement the
23 license number or regulation number issued to the organization
24 by the agency. The agency shall assess a fine of not less
25 than $100 to any licensee or registrant who fails to include
26 the license or registration number when submitting the
27 advertisement for publication, broadcast or printing. The
28 holder of a license issued under this part may not advertise
29 or indicate to the public that it holds a home health agency
30 or nurse registry license other than the one it has been
31 issued.
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1 (b) A person who violates paragraph (a) is subject to
2 an injunctive proceeding under s. 400.515. A violation of
3 paragraph (a) is a deceptive and unfair trade practice and
4 constitutes a violation of the Florida Unfair and Deceptive
5 Trade Practices Act.
6 (c) A person who violates the provisions of paragraph
7 (a) commits a misdemeanor of the second degree, punishable as
8 provided in s. 775.082 or s. 775.083. Any person who commits
9 a second or subsequent violation commits a misdemeanor of the
10 first degree, punishable as provided in s. 775.082 or s.
11 775.083. Each day of continuing violation constitutes a
12 separate offense.
13 (6) The following are exempt from the licensure
14 requirements of this part:
15 (a) A home health agency operated by the Federal
16 Government.
17 (b) Home health services provided by a state agency,
18 either directly or through a contractor with:
19 1. The Department of Elderly Affairs.
20 2. The Department of Health, a community health
21 center, or a rural health network that furnishes home visits
22 for the purpose of providing environmental assessments, case
23 management, health eduction, personal-care services, family
24 planning, or follow-up treatment, or for the purpose of
25 monitoring and tracking disease.
26 3. Services provided to persons who have developmental
27 disabilities, as defined in s. 393.063(11).
28 (c) A health care professional, whether or not
29 incorporated, who is licensed under chapter 458, chapter 459,
30 chapter 464, part I, part III, part V, or part X of chapter
31 468, chapter 480, chapter 486, chapter 490, or chapter 491,
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1 and who is acting alone within the scope of his or her
2 professional license to provide care to patients in their
3 homes.
4 (d) A home health aide or certified nursing assistant
5 who is acting in his or her individual capacity, within the
6 definitions and standards of his or her occupation, and who
7 provides hands-on care to patients in their homes.
8 (e) An individual who acts alone, in his or her
9 individual capacity, and who is not employed by or affiliated
10 with a licensed home health agency or registered with a
11 licensed nurse registry. This exemption does not entitle an
12 individual to perform home health services without the
13 required professional license.
14 (f) The delivery of instructional services in home
15 dialysis and home dialysis supplies and equipment.
16 (g) The delivery of nursing home services for which
17 the nursing home is licensed under part II of this chapter, to
18 serve its residents in its facility.
19 (h) The delivery of assisted living facility services
20 for which the assisted living facility is licensed under part
21 III of this chapter, to serve its residents in its facility.
22 (i) The delivery of hospice services for which the
23 hospice is licensed under part VI of this chapter, to serve
24 hospice patients admitted to its service.
25 (j) A hospital that provides services for which it is
26 licensed under chapter 395.
27 (k) The delivery of community residential services
28 for which the community residential home is licensed under
29 chapter 419, to serve the residents in its facility.
30 (l) A not-for-profit, community-based agency that
31 provides early intervention services to infants and toddlers.
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1 (m) Certified rehabilitation agencies and
2 comprehensive outpatient rehabilitation facilities that are
3 certified under Title 18 of the Social Security Act.
4 (n) The delivery of adult family care home services
5 for which the adult family care home is licensed under part
6 VII of this chapter, to serve the residents in its facility.
7 Section 3. Section 400.471, Florida Statutes, 1998
8 Supplement, is amended to read:
9 400.471 Application for license; fee; provisional
10 license; temporary permit.--
11 (1) Application for an initial license or for renewal
12 of an existing license must be made under oath to the agency
13 for Health Care Administration on forms furnished by it and
14 must be accompanied by the appropriate license fee as provided
15 in subsection (8). The agency must take final action on an
16 initial licensure application within 60 days after receipt of
17 all required documentation.
18 (2) The applicant must file with the application
19 satisfactory proof that the home health agency is in
20 compliance with this part and applicable rules, including:
21 (a) A listing of services to be provided, either
22 directly by the applicant or through contractual arrangements
23 with existing providers;
24 (b) The number and discipline of professional staff to
25 be employed; and
26 (c) Proof of financial ability to operate.
27
28 If the applicant has applied for a certificate of need under
29 ss. 408.0331-408.045 within the preceding 12 months, the
30 applicant may submit the proof required during the
31 certificate-of-need process along with an attestation that
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1 there has been no substantial change in the facts and
2 circumstances underlying the original submission.
3 (3) An applicant for initial licensure must
4 demonstrate financial ability to operate by submitting a
5 balance sheet and income and expense statement for the first 2
6 years of operation which provide evidence of having sufficient
7 assets, credit, and projected revenues to cover liabilities
8 and expenses. The applicant shall have demonstrated financial
9 ability to operate if the applicant's assets, credit, and
10 projected revenues meet or exceed projected liabilities and
11 expenses. All documents required under this subsection must
12 be prepared in accordance with generally accepted accounting
13 principles, and the financial statement must be signed by a
14 certified public accountant.
15 (4) Each applicant for licensure must comply with the
16 following requirements:
17 (a) Upon receipt of a completed, signed, and dated
18 application, the agency shall require background screening of
19 the applicant, in accordance with the level 2 standards for
20 screening set forth in chapter 435. As used in this
21 subsection, the term "applicant" means the administrator, or a
22 similarly titled person who is responsible for the day-to-day
23 operation of the licensed home health agency, and the
24 financial officer, or similarly titled individual who is
25 responsible for the financial operation of the licensed home
26 health agency.
27 (b) The agency may require background screening for a
28 member of the board of directors of the licensee or an officer
29 or an individual owning 5 percent or more of the licensee if
30 the agency reasonably suspects that such individual has been
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1 convicted of an offense prohibited under the level 2 standards
2 for screening set forth in chapter 435.
3 (c) Proof of compliance with the level 2 background
4 screening requirements of chapter 435 which has been submitted
5 within the previous 5 years in compliance with any other
6 health care or assisted living licensure requirements of this
7 state is acceptable in fulfillment of paragraph (a). Proof of
8 compliance with background screening which has been submitted
9 within the previous 5 years to fulfill the requirements of the
10 Department of Insurance pursuant to chapter 651 as part of an
11 application for a certificate of authority to operate a
12 continuing care retirement community is acceptable in
13 fulfillment of the Department of Law Enforcement and Federal
14 Bureau of Investigation background check.
15 (d) A provisional license may be granted to an
16 applicant when each individual required by this section to
17 undergo background screening has met the standards for the
18 abuse registry background check and the Department of Law
19 Enforcement background check, but the agency has not yet
20 received background screening results from the Federal Bureau
21 of Investigation. A standard license may be granted to the
22 licensee upon the agency's receipt of a report of the results
23 of the Federal Bureau of Investigation background screening
24 for each individual required by this section to undergo
25 background screening which confirms that all standards have
26 been met, or upon the granting of a disqualification exemption
27 by the agency as set forth in chapter 435. Any other person
28 who is required to undergo level 2 background screening may
29 serve in his or her capacity pending the agency's receipt of
30 the report from the Federal Bureau of Investigation. However,
31 the person may not continue to serve if the report indicates
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1 any violation of background screening standards and a
2 disqualification exemption has not been requested of and
3 granted by the agency as set forth in chapter 435.
4 (e) Each applicant must submit to the agency, with its
5 application, a description and explanation of any exclusions,
6 permanent suspensions, or terminations of the licensee or
7 potential licensee from the Medicare or Medicaid programs.
8 Proof of compliance with the requirements for disclosure of
9 ownership and control interest under the Medicaid or Medicare
10 programs may be accepted in lieu of this submission.
11 (f) Each applicant must submit to the agency a
12 description and explanation of any conviction of an offense
13 prohibited under the level 2 standards of chapter 435 by a
14 member of the board of directors of the applicant, its
15 officers, or any individual owning 5 percent or more of the
16 applicant. This requirement does not apply to a director of a
17 not-for-profit corporation or organization if the director
18 serves solely in a voluntary capacity for the corporation or
19 organization, does not regularly take part in the day-to-day
20 operational decisions of the corporation or organization,
21 receives no remuneration for his or her services on the
22 corporation or organization's board of directors, and has no
23 financial interest and has no family members with a financial
24 interest in the corporation or organization, provided that the
25 director and the not-for-profit corporation or organization
26 include in the application a statement affirming that the
27 director's relationship to the corporation satisfies the
28 requirements of this paragraph.
29 (g) A license may not be granted to an applicant if
30 the applicant, administrator, or financial officer has been
31 found guilty of, regardless of adjudication, or has entered a
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1 plea of nolo contendere or guilty to, any offense prohibited
2 under the level 2 standards for screening set forth in chapter
3 435, unless an exemption from disqualification has been
4 granted by the agency as set forth in chapter 435.
5 (h) The agency may deny or revoke licensure if the
6 applicant:
7 1. Has falsely represented a material fact in the
8 application required by paragraph (e) or paragraph (f), or has
9 omitted any material fact from the application required by
10 paragraph (e) or paragraph (f); or
11 2. Has been or is currently excluded, suspended,
12 terminated from, or has involuntarily withdrawn from
13 participation in this state's Medicaid program, or the
14 Medicaid program of any other state, or from participation in
15 the Medicare program or any other governmental or private
16 health care or health insurance program.
17 (i) An application for license renewal must contain
18 the information required under paragraphs (e) and (f).
19 (5) The home health agency must also obtain and
20 maintain the following liability insurance coverages in an.
21 Proof of liability insurance, as defined in s. 624.605, must
22 be submitted with the application. The Agency for Health Care
23 Administration shall set the required amounts of liability
24 insurance by rule, but the required amount of must not be less
25 than $250,000 per claim, and the home health agency must
26 submit proof of coverage with an initial application for
27 licensure and with each annual application for license
28 renewal:
29 (a) Malpractice insurance as defined in s.
30 624.605(1)(k);
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1 (b) Liability insurance as defined in s.
2 624.605(1)(b).
3 (6) Ninety Sixty days before the expiration date, an
4 application for renewal must be submitted to the agency for
5 Health Care Administration under oath on forms furnished by
6 it, and a license must be renewed if the applicant has met the
7 requirements established under this part and applicable rules.
8 The home health agency must file with the application
9 satisfactory proof that it is in compliance with this part and
10 applicable rules. If there is evidence of financial
11 instability, the home health agency must submit satisfactory
12 proof of its financial ability to comply with the requirements
13 of this part.
14 (7) When transferring the ownership of a home health
15 agency, the transferee must submit an application for a
16 license at least 60 days before the effective date of the
17 transfer. If the home health agency is being leased, a copy
18 of the lease agreement must be filed with the application.
19 (8) The license fee and annual renewal fee required of
20 a home health agency are is nonrefundable. The agency for
21 Health Care Administration shall set the fees in an amount
22 that is sufficient to cover its costs in carrying out its
23 responsibilities under this part, but not to exceed $1,000.
24 However, state, county, or municipal governments applying for
25 licenses under this part are exempt from the payment of
26 license fees. All fees collected under this part must be
27 deposited in the Health Care Trust Fund for the administration
28 of this part.
29 (9) The license must be displayed in a conspicuous
30 place in the administrative office of the home health agency
31 and is valid only while in the possession of the person to
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1 which it is issued. The license may not be sold, assigned, or
2 otherwise transferred, voluntarily or involuntarily, and is
3 valid only for the home health agency and location for which
4 originally issued.
5 (10) A home health agency against whom a revocation or
6 suspension proceeding is pending at the time of license
7 renewal may be issued a provisional license effective until
8 final disposition by the agency for Health Care Administration
9 of such proceedings. If judicial relief is sought from the
10 final disposition, the court that has jurisdiction may issue a
11 temporary permit for the duration of the judicial proceeding.
12 (11) The agency may department shall not issue a
13 license designated as certified to a home health agency that
14 which fails to receive a certificate of need under the
15 provisions of ss. 408.031-408.045 or that fails to satisfy the
16 requirements of a Medicare certification survey from the
17 agency.
18 (12) The agency may not issue a license to a home
19 health agency that has any unpaid fines assessed under this
20 part.
21 Section 4. Section 400.474, Florida Statutes, 1998
22 Supplement, is amended to read:
23 400.474 Denial, suspension, revocation of license;
24 injunction; grounds; penalties.--
25 (1) The agency for Health Care Administration may
26 deny, revoke, or suspend a license, or impose an
27 administrative fine in the manner provided in chapter 120, or
28 initiate injunctive proceedings under s. 400.515.
29 (2) Any of the following actions by a home health
30 agency or its employee is grounds for disciplinary action by
31 the agency for Health Care Administration:
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1 (a) Violation of this part or of applicable rules.
2 (b) An intentional, reckless, or negligent act that
3 materially affects the health or safety of a patient.
4 (c) Knowingly providing home health services in an
5 unlicensed assisted living facility or unlicensed adult
6 family-care home, unless the home health agency or employee
7 reports the unlicensed facility or home to the agency within
8 72 hours after providing the services.
9 (3) The agency may impose the following penalties for
10 operating without a license upon an applicant or owner who has
11 in the past operated, or who currently operates, a licensed
12 home health agency.
13 (a) If a home health agency that is found to be
14 operating without a license wishes to apply for a license, the
15 home health agency may submit an application only after the
16 agency has verified that the home health agency no longer
17 operates an unlicensed home health agency.
18 (b) Any person, partnership, or corporation that
19 violates paragraph (a) and that previously operated a licensed
20 home health agency or concurrently operates both a licensed
21 home health agency and an unlicensed home health agency
22 commits a felony of the third degree punishable as provided in
23 s. 775.082, s. 775.083, or s. 775.084. If an owner has an
24 interest in more than one home health agency and fails to
25 license any one of those home health agencies, the agency must
26 issue a cease and desist order for the activities of the
27 unlicensed home health agency and impose a moratorium on any
28 or all of the licensed related home health agencies until the
29 unlicensed home health agency is licensed.
30 (c) If any home health agency meets the criteria in
31 paragraph (a) or paragraph (b) and that home health agency has
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1 received any government reimbursement for services provided by
2 an unlicensed home health agency, the agency shall make a
3 fraud referral to the appropriate government reimbursement
4 program.
5 (4) The agency may deny, revoke, or suspend the
6 license of a home health agency, or may impose on a home
7 health agency administrative fines not to exceed the aggregate
8 sum of $5,000 if:
9 (a) The agency is unable to obtain entry to the home
10 health agency to conduct a licensure survey, complaint
11 investigation, surveillance visit, or monitoring visit.
12 (b) An applicant or a licensed home health agency has
13 falsely represented a material fact in the application, or has
14 omitted from the application any material fact, including, but
15 not limited to, the fact that the controlling or ownership
16 interest is held by any officer, director, agent, manager,
17 employee, affiliated person, partner, or shareholder who is
18 not eligible to participate.
19 (c) An applicant, owner, or person who has a 5 percent
20 or greater interest in a licensed entity:
21 1. Has been previously found by any licensing,
22 certifying, or professional standards board or agency to have
23 violated the standards or conditions that relate to home
24 health-related licensure or certification, or to the quality
25 of home health-related services provided; or
26 2. Has been or is currently excluded, suspended,
27 terminated from, or has involuntarily withdrawn from,
28 participation in the Medicaid program of this state or any
29 other state, the Medicare program, or any other governmental
30 health care or health insurance program.
31
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1 Section 5. Section 400.484, Florida Statutes, is
2 amended to read:
3 400.484 Right of inspection; deficiencies; fines.--
4 (1) Any duly authorized officer or employee of the
5 agency for Health Care Administration may make such
6 inspections and investigations as are necessary in order to
7 determine the state of compliance with this part and with
8 applicable rules. The right of inspection extends to any
9 business that the agency for Health Care Administration has
10 reason to believe is being operated as a home health agency
11 without a license, but such inspection of any such business
12 may not be made without the permission of the owner or person
13 in charge unless a warrant is first obtained from a circuit
14 court. Any application for a license issued under this part or
15 for license renewal constitutes permission for an appropriate
16 inspection to verify the information submitted on or in
17 connection with the application.
18 (2) The agency shall impose fines for various classes
19 of deficiencies in accordance with the following schedule:
20 (a) A class I deficiency is any act, omission, or
21 practice that results in a patient's death, disablement, or
22 permanent injury, or places a patient at imminent risk of
23 death, disablement, or permanent injury. Upon finding a class
24 I deficiency, the agency may impose an administrative fine in
25 the amount of $5,000 for each occurrence and each day that the
26 deficiency exists. In addition, the agency may immediately
27 revoke the license, or impose a moratorium on the admission of
28 new patients, until the factors causing the deficiency have
29 been corrected.
30 (b) A class II deficiency is any act, omission, or
31 practice that has a direct adverse effect on the health,
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1 safety, or security of a patient. Upon finding a class II
2 deficiency, the agency may impose an administrative fine in
3 the amount of $1,000 for each occurrence and each day that the
4 deficiency exists. In addition, the agency may suspend the
5 license, or impose a moratorium on the admission of new
6 patients, until the deficiency has been corrected.
7 (c) A class III deficiency is any act, omission, or
8 practice that has an indirect, adverse effect on the health,
9 safety, or security of a patient. Upon finding an uncorrected
10 or repeated class III deficiency, the agency may impose an
11 administrative fine not to exceed $500 for each occurrence and
12 each day that the uncorrected or repeated deficiency exists.
13 (d) A class IV deficiency is any act, omission, or
14 practice related to required reports, forms, or documents
15 which does not have the potential of negatively affecting
16 patients. These violations are of a type that the agency
17 determines do not threaten the health, safety, or security of
18 patients. Upon finding an uncorrected or repeated class IV
19 deficiency, the agency may impose an administrative fine not
20 to exceed $200 for each occurrence and each day that the
21 uncorrected or repeated deficiency exists.
22 Section 6. Section 400.487, Florida Statutes, is
23 amended to read:
24 400.487 Patient assessment; establishment and review
25 of plan of care; provision of services.--
26 (1) The home health agency providing skilled care and
27 treatment must make an assessment of the patient's needs
28 within 48 hours after the start of services.
29 (2) The attending physician for a patient who is to
30 receive skilled receiving care or treatment provided by a
31 licensed nurse or by a physical, occupational, or speech
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1 therapist must establish treatment orders a plan of care for
2 the patient on behalf of the home health agency that provides
3 services to the patient. The original plan of treatment
4 orders must be signed by the physician within 24 days after
5 the start of care and must be reviewed, at least every 62 days
6 or more frequently if the patient's illness requires, by the
7 physician in consultation with home health agency personnel
8 that provide services to the patient.
9 (3) If a client is accepted for home health aide
10 services or homemaker or companion services and such services
11 do not require a physician's order, the home health agency
12 shall establish a service provision plan and maintain a record
13 of the services provided.
14 (4)(3) Each patient or client has the right to be
15 informed of and to participate in the planning of his or her
16 care. Each patient must be provided, upon request, a copy of
17 the plan of care or service provision plan established and
18 maintained for that patient or client by the home health
19 agency.
20 (4) Home health services that are provided to a
21 patient must be evaluated in the patient's home by a physician
22 licensed under chapter 458, chapter 459, chapter 460, or
23 chapter 461 or by a registered nurse licensed under chapter
24 464 as frequently as necessary to assure safe and adequate
25 care, but not less frequently than once every 62 days.
26 (5) When nursing services are ordered, the home health
27 agency to which a patient has been admitted for care must
28 provide the initial admission visit, all service evaluation
29 visits, and the discharge visit by qualified personnel who are
30 on the payroll of, and to whom an IRS payroll form W-2 will be
31 issued by, the home health agency. A home health agency must
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1 provide at least one home health service to patients for whom
2 it has agreed to provide care. Services provided by others
3 under contractual arrangements to a home health agency
4 agency's patients must be monitored and managed controlled by
5 the admitting home health agency. The admitting home health
6 agency is fully responsible for ensuring that all care
7 provided through its employees or contract staff is delivered
8 in accordance with this part and applicable rules.
9 (6) The skilled care services provided by a home
10 health agency, directly or under contract, must be supervised
11 and coordinated in accordance with the plan of care.
12 Section 7. Section 400.488, Florida Statutes, is
13 created to read:
14 400.488 Assistance with self-administration of
15 medication.--
16 (1) For purposes of this section, the term:
17 (a) "Informed consent" means advising the patient, or
18 the patient's surrogate, guardian, or attorney in fact, that
19 the patient may be receiving assistance with
20 self-administration of medication from an unlicensed person.
21 (b) "Unlicensed person" means an individual not
22 currently licensed to practice nursing or medicine who is
23 employed by or under contract to a home health agency and who
24 has received training with respect to assisting with the
25 self-administration of medication as provided by agency rule.
26 (2) Patients who are capable of self-administering
27 their own medications without assistance shall be encouraged
28 and allowed to do so. However, an unlicensed person may,
29 consistent with a dispensed prescription's label or the
30 package directions of an over-the-counter medication, assist a
31 patient whose condition is medically stable with the
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1 self-administration of routine, regularly scheduled
2 medications that are intended to be self-administered.
3 Assistance with self-medication by an unlicensed person may
4 occur only upon a documented request by, and the written
5 informed consent of, a patient or the patient's surrogate,
6 guardian, or attorney in fact. For purposes of this section,
7 self-administered medications include both legend and
8 over-the-counter oral dosage forms, topical dosage forms, and
9 topical opthalmic, otic, and nasal dosage forms, including
10 solutions, suspensions, sprays, and inhalers.
11 (3) Assistance with self-administration of medication
12 includes:
13 (a) Taking the medication, in its previously
14 dispensed, properly labeled container, from where it is stored
15 and bringing it to the patient.
16 (b) In the presence of the patient, reading the label,
17 opening the container, removing a prescribed amount of
18 medication from the container, and closing the container.
19 (c) Placing an oral dosage in the patient's hand or
20 placing the dosage in another container and helping the
21 patient by lifting the container to his or her mouth.
22 (d) Applying topical medications.
23 (e) Returning the medication container to proper
24 storage.
25 (f) Keeping a record of when a patient receives
26 assistance with self-administration under this section.
27 (4) Assistance with self-administration does not
28 include:
29 (a) Mixing, compounding, converting, or calculating
30 medication doses, except for measuring a prescribed amount of
31
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1 liquid medication or breaking a scored tablet or crushing a
2 tablet as prescribed.
3 (b) The preparation of syringes for injection or the
4 administration of medications by any injectable route.
5 (c) Administration of medications through intermittent
6 positive pressure breathing machines or a nebulizer.
7 (d) Administration of medications by way of a tube
8 inserted in a cavity of the body.
9 (e) Administration of parenteral preparations.
10 (f) Irrigations or debriding agents used in the
11 treatment of a skin condition.
12 (g) Rectal, urethral, or vaginal preparations.
13 (h) Medications ordered by the physician or health
14 care professional with prescriptive authority to be given "as
15 needed," unless the order is written with specific parameters
16 that preclude independent judgment on the part of the
17 unlicensed person, and at the request of a competent patient.
18 (i) Medications for which the time of administration,
19 the amount, the strength of dosage, the method of
20 administration, or the reason for administration requires
21 judgment or discretion on the part of the unlicensed person.
22 (5) Assistance with the self-administration of
23 medication by an unlicensed person as described in this
24 section does not constitute administration as defined in s.
25 465.003.
26 (6) The agency may by rule establish procedures and
27 interpret terms as necessary to administer this section.
28 Section 8. Section 400.491, Florida Statutes, 1998
29 Supplement, is amended to read:
30 400.491 Clinical records.--
31
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1 (1) The home health agency must maintain for each
2 patient who receives skilled care a clinical record that
3 includes the services the home health agency provides directly
4 and those provided through arrangement with another health
5 care provider, except for those services provided by persons
6 referred under s. 400.509. Such records must contain
7 pertinent past and current medical, nursing, social and other
8 therapeutic information, the plan of treatment orders, and
9 other such information as is necessary for the safe and
10 adequate care of the patient. When home health services are
11 terminated, the record must show the date and reason for
12 termination. Such records are considered patient records
13 under s. 455.241 s. 455.667, and must be maintained by the
14 home health agency for 5 years following termination of
15 services. If a patient transfers to another home health
16 agency, a copy of his or her record must be provided to the
17 other home health agency upon request.
18 (2) The home health agency must maintain for each
19 client who receives nonskilled care a service-provision plan.
20 Such records must be maintained by the home health agency for
21 1 year following termination of services.
22 Section 9. Section 400.497, Florida Statutes, is
23 amended to read:
24 400.497 Rules establishing minimum standards.--The
25 agency for Health Care Administration shall adopt, publish,
26 and enforce rules to implement this part, including, as
27 applicable, ss. 400.506 and 400.509, which must provide
28 reasonable and fair minimum standards relating to:
29 (1) Scope of home health services to be provided.
30 (1)(2) The qualifications, and minimum training
31 requirements, and supervision requirements of all home health
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1 agency personnel. The agency shall establish the curriculum
2 and instructor qualifications for home health aide training.
3 Licensed home health agencies may provide this training and
4 shall furnish documentation of such training to other licensed
5 home health agencies upon request. The agency shall allow
6 shared staffing if the home health agency is part of a
7 retirement community that provides multiple levels of care, is
8 located on one campus, is licensed under this chapter, and
9 otherwise meets the requirements of law and rule.
10 (2)(3) Requirements for prospective employees
11 procedures for maintaining a record of the employment history
12 of all home health agency personnel. A home health agency
13 must require prospective employees and contractors its
14 personnel to submit an employment or contractual history to
15 the home health agency, and it must verify the employment or
16 contractual history unless through diligent efforts such
17 verification is not possible. The agency for Health Care
18 Administration shall prescribe by rule the minimum
19 requirements for establishing that diligent efforts have been
20 made. The administrator of a home health agency must review
21 the employment history and references of home health agency
22 personnel and applicants for employment. The Agency for
23 Health Care Administration must review the employment history
24 and references of each administrator of a home health agency.
25 There is no monetary liability on the part of, and no cause of
26 action for damages arising arises against, a former employer
27 of a prospective employee of or prospective independent
28 contractor with a licensed home health agency who reasonably
29 and in good faith communicates his or her honest opinions
30 about the former employee's job performance. This subsection
31
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1 does not affect the official immunity of an officer or
2 employee of a public corporation.
3 (3)(4) Licensure application and renewal.
4 (4)(5) The administration of the home health agency,
5 including requirements for onsite and electronic accessibility
6 of supervisory personnel.
7 (5)(6) Procedures for administering drugs and
8 biologicals.
9 (6)(7) Procedures for maintaining patients' patient
10 records.
11 (7)(8) Ensuring that the home health services provided
12 by a home health agency are provided in accordance with the
13 plan of treatment orders established for each patient for whom
14 physician orders are required.
15 (8)(9) Geographic service areas.
16 (9)(10) Standards for contractual arrangements for the
17 provision of home health services by providers not employed by
18 the home health agency to whom the patient has been admitted
19 providing for the patient's care and treatment.
20 Section 10. Subsections (1) and (10) of section
21 400.506, Florida Statutes, 1998 Supplement, are amended to
22 read:
23 400.506 Licensure of nurse registries; requirements;
24 penalties.--
25 (1) A nurse registry is exempt from the licensing
26 requirements of a home health agency, but must be licensed as
27 a nurse registry. Each operational site of the nurse registry
28 must be licensed, unless there is more than one site within a
29 county. If there is more than one site within a county only
30 one license per county is required. Each operational site
31 must be listed on the license.
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1 (10)(a) A nurse registry may refer for contract in
2 private residences registered nurses and licensed practical
3 nurses registered and licensed under chapter 464, certified
4 nursing assistants certified under s. 400.211, home health
5 aides who present documented proof of successful completion of
6 the training required by rule of the agency, and sitters,
7 companions, or homemakers for the purposes of providing those
8 services authorized under s. 400.509(1). Each person referred
9 by a nurse registry must provide current documentation that he
10 or she is free from communicable diseases.
11 (b) A certified nursing assistant or home health aide
12 may be referred for a contract to provide care to a patient in
13 his or her home only if that patient is under a physician's
14 care. A certified nursing assistant or home health aide
15 referred for contract in a private residence shall be limited
16 to assisting a patient with bathing, dressing, toileting,
17 grooming, eating, physical transfer, and those normal daily
18 routines the patient could perform for himself or herself were
19 he or she physically capable. A certified nursing assistant
20 or home health aide may not provide medical or other health
21 care services that require specialized training and that may
22 be performed only by licensed health care professionals. The
23 nurse registry shall obtain the name and address of the
24 attending physician and send written notification to the
25 physician within 48 hours after a contract is concluded that a
26 certified nursing assistant or home health aide will be
27 providing care for that patient.
28 (c) A registered nurse shall make monthly visits to
29 the patient's home to assess the patient's condition and
30 quality of care being provided by the certified nursing
31 assistant or home health aide. Any condition which in the
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1 professional judgment of the nurse requires further medical
2 attention shall be reported to the attending physician and the
3 nurse registry. The assessment shall become a part of the
4 patient's file with the nurse registry and may be reviewed by
5 the agency for Health Care Administration during their survey
6 procedure.
7 (d) In order to refer for contract in private
8 residences a certified nursing assistant or any person
9 specified in s. 400.509(1), the nurse registry and such person
10 registered with the nurse registry must also be registered
11 under s. 400.509. Any person registered as an independent
12 contractor with a nurse registry for the purpose of providing
13 services authorized under s. 400.509(1) on or before October
14 1, 1990, is exempt from registration under s. 400.509 so long
15 as such person remains continuously registered with that nurse
16 registry.
17 Section 11. Subsections (1), (2), and (3) of section
18 400.509, Florida Statutes, are amended, present subsections
19 (4), (5), and (6) of that section are amended and renumbered
20 as subsections (5), (6), and (7), respectively, present
21 subsections (7), (8), (9), (10), (11), (12), and (13) of that
22 section are renumbered as subsections (8), (9), (10), (11),
23 (12), (13), and (14), respectively, and a new subsection (4)
24 is added to that section, to read:
25 400.509 Registration of particular service providers
26 exempt from licensure; certificate of registration; regulation
27 of registrants.--
28 (1) Any organization person that provides domestic
29 maid services, sitter services, companion services, or
30 homemaker services and does not provide a home health service
31 to a person is exempt from licensure under this part. However,
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1 any organization person that provides sitter services for
2 adults, companion services, or homemaker services must
3 register with the agency for Health Care Administration.
4 (2) Registration consists of annually filing with the
5 agency for Health Care Administration, under oath, on forms
6 provided by it, the following information:
7 (a) The name, address, date of birth, and social
8 security number of the individual, or the name and address of
9 the person, providing the service.
10 (a)(b) If the registrant is a firm or partnership, the
11 name, address, date of birth, and social security number of
12 every member.
13 (b)(c) If the registrant is a corporation or
14 association, its name and address, the name, address, date of
15 birth, and social security number of each of its directors and
16 officers, and the name and address of each person having at
17 least a 5-percent 10-percent interest in the corporation or
18 association.
19 (c)(d) The name, address, date of birth, and social
20 security number of each person employed by or under contract
21 with the organization.
22 (3) The agency for Health Care Administration shall
23 charge a registration fee of $25 to be submitted with the
24 information required under subsection (2).
25 (4) Each applicant for registration must comply with
26 the following requirements:
27 (a) Upon receipt of a completed, signed, and dated
28 application, the agency shall require background screening, in
29 accordance with the level 1 standards for screening set forth
30 in chapter 435, of every individual who will have contact with
31 the client. The agency shall require background screening of
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1 the managing employee or other similarly titled individual who
2 is responsible for the operation of the entity, and of the
3 financial officer or other similarly titled individual who is
4 responsible for the financial operation of the entity,
5 including billings for client services in accordance with the
6 level 2 standards for background screening as set forth in
7 chapter 435.
8 (b) The agency may require background screening of any
9 other individual who is affiliated with the applicant if the
10 agency has a reasonable basis for believing that he or she has
11 been convicted of a crime or has committed any other offense
12 prohibited under the level 2 standards for screening set forth
13 in chapter 435.
14 (c) Proof of compliance with the level 2 background
15 screening requirements of chapter 435 which has been submitted
16 within the previous 5 years in compliance with any other
17 healthcare or assisted living licensure requirements of this
18 state is acceptable in fulfillment of paragraph (a).
19 (d) A provisional registration may be granted to an
20 applicant when each individual required by this section to
21 undergo background screening has met the standards for the
22 abuse-registry background check and the Department of Law
23 Enforcement background check but the agency has not yet
24 received background screening results from the Federal Bureau
25 of Investigation. A standard registration may be granted to
26 the applicant upon the agency's receipt of a report of the
27 results of the Federal Bureau of Investigation background
28 screening for each individual required by this section to
29 undergo background screening which confirms that all standards
30 have been met, or upon the granting of a disqualification
31 exemption by the agency as set forth in chapter 435. Any
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1 other person who is required to undergo level 2 background
2 screening may serve in his or her capacity pending the
3 agency's receipt of the report from the Federal Bureau of
4 Investigation. However, the person may not continue to serve
5 if the report indicates any violation of background screening
6 standards and if a disqualification exemption has not been
7 requested of and granted by the agency as set forth in chapter
8 435.
9 (e) Each applicant must submit to the agency, with its
10 application, a description and explanation of any exclusions,
11 permanent suspensions, or terminations of the applicant from
12 the Medicare or Medicaid programs. Proof of compliance with
13 the requirements for disclosure of ownership and control
14 interests under the Medicaid or Medicare programs may be
15 accepted in lieu of this submission.
16 (f) Each applicant must submit to the agency a
17 description and explanation of any conviction of an offense
18 prohibited under the level 2 standards of chapter 435 which
19 was committed by a member of the board of directors of the
20 applicant, its officers, or any individual owning 5 percent or
21 more of the applicant. This requirement does not apply to a
22 director of a not-for-profit corporation or organization who
23 serves solely in a voluntary capacity for the corporation or
24 organization, does not regularly take part in the day-to-day
25 operational decisions of the corporation or organization,
26 receives no remuneration for his or her services on the
27 corporation's or organization's board of directors, and has no
28 financial interest and no family members having a financial
29 interest in the corporation or organization, if the director
30 and the not-for-profit corporation or organization include in
31 the application a statement affirming that the director's
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1 relationship to the corporation satisfies the requirements of
2 this paragraph.
3 (g) A registration may not be granted to an applicant
4 if the applicant or managing employee has been found guilty
5 of, regardless of adjudication, or has entered a plea of nolo
6 contendere or guilty to, any offense prohibited under the
7 level 2 standards for screening set forth in chapter 435,
8 unless an exemption from disqualification has been granted by
9 the agency as set forth in chapter 435.
10 (h) The agency may deny or revoke the registration of
11 any applicant who:
12 1. Has falsely represented a material fact in the
13 application required by paragraph (e) or paragraph (f), or has
14 omitted any material fact from the application required by
15 paragraph (e) or paragraph (f); or
16 2. Has had prior action taken against the applicant
17 under the Medicaid or Medicare program as set forth in
18 paragraph (e).
19 (i) An application for licensure renewal must contain
20 the information required under paragraphs (e) and (f).
21 (5)(4) Each registrant must obtain establish the
22 employment or contract history of persons who are employed by
23 or under contract with the organization and who will have
24 having contact at any time with patients or clients in their
25 homes by:
26 (a) Requiring such persons employed or under contract
27 to submit an employment or contractual history to the
28 registrant; and
29 (b) Verifying the employment or contractual history,
30 unless through diligent efforts such verification is not
31 possible. The agency for Health Care Administration shall
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1 prescribe by rule the minimum requirements for establishing
2 that diligent efforts have been made.
3
4 There is no monetary liability on the part of, and no cause of
5 action for damages arises against, a former employer of a
6 prospective employee of or prospective independent contractor
7 with a registrant who reasonably and in good faith
8 communicates his or her honest opinions about the former
9 employee's or contractor's job performance. This subsection
10 does not affect the official immunity of an officer or
11 employee of a public corporation.
12 (6)(5) On or before the first day on which services
13 are provided to a patient or client, any registrant under this
14 part must inform the patient or client and his or her
15 immediate family, if appropriate, of the right to report
16 abusive, neglectful, or exploitative practices. The statewide
17 toll-free telephone number for the central abuse registry must
18 be provided to patients or clients in a manner that is clearly
19 legible and must include the words: "To report abuse, neglect,
20 or exploitation, please call toll-free ...(phone number)...."
21 Registrants must establish appropriate policies and procedures
22 for providing such notice to patients or clients.
23 (7)(6) The provisions of s. 400.512 regarding
24 screening apply to any person or business entity registered
25 under this section on or after October 1, 1994 1989.
26 Section 12. Section 400.512, Florida Statutes, is
27 amended to read:
28 400.512 Screening of home health agency personnel;
29 nurse registry personnel; and sitters, companions, and
30 homemakers.--The agency for Health Care Administration shall
31 require employment or contractor screening as provided in
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1 chapter 435, using the level 1 standards for screening set
2 forth in that chapter, for home health agency personnel;
3 persons referred for employment by nurse registries; and
4 persons employed by sitter, companion, or homemaker services
5 registered under s. 400.509.
6 (1) The agency for Health Care Administration may
7 grant exemptions from disqualification from employment or
8 contracting under this section as provided in s. 435.07.
9 (2) The administrator of each home health agency, the
10 managing employee of each nurse registry, and the managing
11 employee of each or sitter, companion, or homemaker service
12 registered under s. 400.509 must sign an affidavit annually,
13 under penalty of perjury, stating that all personnel hired,
14 contracted with, or registered on or after October 1, 1994
15 1989, who enter the home of a patient or client in the
16 capacity of their service capacity employment have been
17 screened and that its remaining personnel have worked for the
18 home health agency or registrant continuously since before
19 October 1, 1994 1989.
20 (3) As a prerequisite to operating as a home health
21 agency, nurse registry, or sitter, companion, or homemaker
22 service under s. 400.509, the administrator or managing
23 employee, respectively, must submit to the agency his or her
24 for Health Care Administration their name and any other
25 information necessary to conduct a complete screening
26 according to this section. The agency for Health Care
27 Administration shall submit the information to the Department
28 of Law Enforcement and the department's abuse hotline for
29 state processing. The agency for Health Care Administration
30 shall review the record of the administrator or manager with
31 respect to the offenses specified in this section and shall
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1 notify the owner of its findings. If disposition information
2 is missing on a criminal record, the administrator or manager,
3 upon request of the agency for Health Care Administration,
4 must obtain and supply within 30 days the missing disposition
5 information to the agency for Health Care Administration.
6 Failure to supply missing information within 30 days or to
7 show reasonable efforts to obtain such information will result
8 in automatic disqualification.
9 (4) Proof of compliance with the screening
10 requirements of chapter 435 shall be accepted in lieu of the
11 requirements of this section if the provided that such person
12 has been continuously employed or registered without a breach
13 in service that exceeds 180 days, the proof of compliance is
14 not more than 2 years old, and the person has been screened
15 through the central abuse registry and tracking system of the
16 department and by the Department of Law Enforcement. A home
17 health agency, nurse registry, or companion or homemaker
18 service registered under s. 400.509 shall directly provide
19 proof of compliance to another home health agency, nurse
20 registry, or companion or homemaker service registered under
21 s. 400.509. The recipient home health agency, nurse registry,
22 or companion or homemaker service registered under s. 400.509
23 may not accept any proof of compliance directly from the
24 person who requires screening. Proof of compliance with the
25 screening requirements of this section shall be provided upon
26 request to the person screened by the home health agencies;
27 nurse registries; or sitter, companion, or homemaker services
28 registered under s. 400.509.
29 (5) There is no monetary liability on the part of, and
30 no cause of action for damages arises against, a licensed home
31 health agency, licensed nurse registry, or sitter, companion,
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1 or homemaker service registered under s. 400.509, that, upon
2 notice of a confirmed report of adult abuse, neglect, or
3 exploitation under paragraph (2)(b), terminates the employee
4 or contractor against whom the report was issued, whether or
5 not the employee or contractor has filed for an exemption with
6 the agency in accordance with chapter 435 for Health Care
7 Administration under subparagraph (3)(a)5. and whether or not
8 the time for filing has expired.
9 (6) The costs of processing the statewide
10 correspondence criminal records checks and the search of the
11 department's central abuse hotline must be borne by the home
12 health agency; the nurse registry; or the sitter, companion,
13 or homemaker service registered under s. 400.509, or by the
14 person being screened, at the discretion of the home health
15 agency, nurse registry, or s. 400.509 registrant.
16 (7) The Agency for Health Care Administration; the
17 home health agency; nurse registry; or sitter, companion, or
18 homemaker service registered under s. 400.509 may not use the
19 criminal records, juvenile records, or central abuse hotline
20 information of a person for any purpose other than determining
21 whether that person meets minimum standards of good moral
22 character for home health agency personnel. The criminal
23 records, juvenile records, or central abuse hotline
24 information obtained by the Agency for Health Care
25 Administration; home health agency; nurse registry; or sitter,
26 companion, or homemaker service for determining the moral
27 character of such personnel are confidential and exempt from
28 the provisions of s. 119.07(1) and s. 24(a), Art. I of the
29 State Constitution.
30
31
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1 (7)(8)(a) It is a misdemeanor of the first degree,
2 punishable under s. 775.082 or s. 775.083, for any person
3 willfully, knowingly, or intentionally to:
4 1. Fail, by false statement, misrepresentation,
5 impersonation, or other fraudulent means, to disclose in any
6 application for voluntary or paid employment a material fact
7 used in making a determination as to such person's
8 qualifications to be an employee under this section;
9 2. Operate or attempt to operate an entity licensed or
10 registered under this part with persons who do not meet the
11 minimum standards for good moral character as contained in
12 this section; or
13 3. Use information from the criminal records or
14 central abuse hotline obtained under this section for any
15 purpose other than screening that person for employment as
16 specified in this section or release such information to any
17 other person for any purpose other than screening for
18 employment under this section.
19 (b) It is a felony of the third degree, punishable
20 under s. 775.082, s. 775.083, or s. 775.084, for any person
21 willfully, knowingly, or intentionally to use information from
22 the juvenile records of a person obtained under this section
23 for any purpose other than screening for employment under this
24 section.
25 Section 13. Task Force on Home Health Services
26 Licensure Provisions.--There is created a task force composed
27 of representatives of the Agency for Health Care
28 Administration, the Department of Elderly Affairs, the
29 Department of Health, and Associated Home Health Industries to
30 review the provisions of part IV of chapter 400, Florida
31 Statutes, and recommend additional legislative revisions. The
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1 review must address, at a minimum, the following issues:
2 whether Adult Abuse Registry screening should continue to be
3 mandated; whether individuals who provide home health services
4 should be exempted from all state regulatory oversight; and
5 whether mandatory registration for organizations that provide
6 companion and homemaker services should continue. A report
7 must be submitted to the appropriate legislative committees by
8 December 31, 1999.
9 Section 14. This act shall take effect October 1,
10 1999.
11
12 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
13 SB 2360
14
15 Revises the definition of "organization" that is created in
the bill; limits application of home health licensure, with
16 respect to infusion therapy providers, to home infusion
therapy providers, as that term is defined in the bill; and
17 requires persons or business entities that register as
providers of companion or homemaker services, as provided in
18 the bill, to screen their personnel in accordance with
statutory employment screening laws.
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