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



                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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  4  ______________________________________________________________

  5                                           ORIGINAL STAMP BELOW

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  7

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  9

10  ______________________________________________________________

11  Representative(s) Argenziano offered the following:

12

13         Amendment (with title amendment) 

14  Remove from the bill:  Everything after the enacting clause

15

16  and insert in lieu thereof:

17         Section 1.  Subsections (11) through (17) of section

18  400.021, Florida Statutes, are renumbered as subsections (12)

19  through (18), respectively, and a new subsection (11) is added

20  to said section to read:

21         400.021  Definitions.--When used in this part, unless

22  the context otherwise requires, the term:

23         (11)  "Nursing home bed" means an accommodation which

24  is ready for immediate occupancy, or is capable of being made

25  ready for occupancy within 48 hours, excluding provision of

26  staffing; and which conforms to minimum space requirements,

27  including the availability of appropriate equipment and

28  furnishings within the 48 hours, as specified by rule of the

29  agency, for the provision of services specified in this part

30  to a single resident.

31         Section 2.  Section 400.0225, Florida Statutes, is

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  amended to read:

  2         400.0225  Consumer satisfaction surveys.--The agency,

  3  or its contractor, in consultation with the nursing home

  4  industry and consumer representatives, shall develop an

  5  easy-to-use consumer satisfaction survey, shall ensure that

  6  every nursing facility licensed pursuant to this part

  7  participates in assessing consumer satisfaction, and shall

  8  establish procedures to ensure that, at least annually, a

  9  representative sample of residents of each facility is

10  selected to participate in the survey. The sample shall be of

11  sufficient size to allow comparisons between and among

12  facilities. Family members, guardians, or other resident

13  designees may assist the resident in completing the survey.

14  Employees and volunteers of the nursing facility or of a

15  corporation or business entity with an ownership interest in

16  the facility are prohibited from assisting a resident with or

17  attempting to influence a resident's responses to the consumer

18  satisfaction survey. The agency, or its contractor, shall

19  survey family members, guardians, or other resident designees

20  when the resident is mentally incapable of responding to the

21  survey. The agency, or its contractor, shall specify the

22  protocol for conducting and reporting the consumer

23  satisfaction surveys. Reports of consumer satisfaction surveys

24  shall protect the identity of individual respondents. The

25  agency shall contract for consumer satisfaction surveys and

26  report the results of those surveys in the consumer

27  information materials prepared and distributed by the agency.

28  The agency may adopt rules as necessary to administer this

29  section.

30         Section 3.  Subsections (3) and (8) of section

31  400.0255, Florida Statutes, are amended to read:

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1         400.0255  Resident transfer or discharge; requirements

  2  and procedures; hearings.--

  3         (3)  When a discharge or transfer is initiated by the

  4  nursing home resident is to be discharged or transferred, the

  5  nursing home administrator employed by the nursing home that

  6  is discharging or transferring the resident, or an individual

  7  employed by the nursing home who is designated by the nursing

  8  home administrator to act on behalf of the administration ,

  9  must sign the notice of discharge or transfer. Any notice

10  indicating a medical reason for transfer or discharge must

11  either be signed by the resident's attending physician or the

12  medical director of the facility, or include an attached

13  written order for the discharge or transfer. The notice or the

14  order must be signed by the resident's physician, medical

15  director, treating physician, nurse practitioner, or physician

16  assistant.

17         (8)  The notice required by subsection (7) must be in

18  writing and must contain all information required by state and

19  federal law, rules, or regulations applicable to Medicaid or

20  Medicare cases. The agency shall develop a standard document

21  to be used by all facilities licensed under this part for

22  purposes of notifying residents of a discharge or transfer.

23  Such document must include a means for a resident to request

24  the district long-term care ombudsman council to review the

25  notice and request information about or assistance with

26  initiating a fair hearing with the department's Office of

27  Appeals Hearings. In addition to any other pertinent

28  information included, the form shall specify the reason

29  allowed under federal or state law that the resident is being

30  discharged or transferred, with an explanation to support this

31  action. Further, the form shall state the effective date of

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  the discharge or transfer and the location to which the

  2  resident is being discharged or transferred. The form shall

  3  clearly describe the resident's appeal rights and the

  4  procedures for filing an appeal, including the right to

  5  request the district ombudsman council to review the notice of

  6  discharge or transfer. A copy of the notice must be placed in

  7  the resident's clinical record, and a copy must be transmitted

  8  to the resident's legal guardian or representative and to the

  9  district ombudsman council within 5 business days after

10  signature by the resident or resident designee.

11         Section 4.

12         400.141  Administration and management of nursing home

13  facilities.--Every licensed facility shall comply with all

14  applicable standards and rules of the agency and shall:

15         (1)  Be under the administrative direction and charge

16  of a licensed administrator.

17         (2)  Appoint a medical director licensed pursuant to

18  chapter 458 or chapter 459. The agency may establish by rule

19  more specific criteria for the appointment of a medical

20  director.

21         (3)  Have available the regular, consultative, and

22  emergency services of physicians licensed by the state.

23         (4) (5)  Provide for resident use of a community

24  pharmacy as specified in s. 400.022(1)(q). Any other law to

25  the contrary notwithstanding, a registered pharmacist licensed

26  in Florida , that is under contract with a facility licensed

27  under this chapter, shall may repackage a nursing facility

28  resident's bulk prescription medication which has been

29  packaged by another pharmacist licensed in any state in the

30  United States into a unit dose system compatible with the

31  system used by the nursing facility, if the pharmacist is

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  requested to offer such service. if such To be eligible for

  2  repackaging, a resident or the resident's spouse must receive

  3  has bulk prescription medication benefits provided through a

  4  former employer as part of his or her retirement benefits

  5  covered under a qualified pension plan as specified in s. 4972

  6  of the Internal Revenue Code, a federal retirement program as

  7  specified under 5 C.F.R. s. 831, or a long-term care policy as

  8  defined in s. 627.9404(1). A pharmacist who correctly

  9  repackages and relabels the medication and the nursing

10  facility which correctly administers such repackaged

11  medication under the provisions of this subsection shall not

12  be held liable in any civil or administrative action arising

13  from the repackaging. In order to be eligible for the

14  repackaging, a nursing facility resident for whom the

15  medication is to be repackaged shall sign an informed consent

16  form provided by the facility which includes an explanation of

17  the repackaging process and which notifies the resident of the

18  immunities from liability provided herein. A pharmacist who

19  repackages and relabels prescription medications, as

20  authorized under this subsection, may charge a reasonable fee

21  for costs resulting from the implementation of this provision.

22         (5) (4)  Provide for the access of the facility

23  residents to dental and other health-related services,

24  recreational services, rehabilitative services, and social

25  work services appropriate to their needs and conditions and

26  not directly furnished by the licensee.  When a geriatric

27  outpatient nurse clinic is conducted in accordance with rules

28  adopted by the agency, outpatients attending such clinic shall

29  not be counted as part of the general resident population of

30  the nursing home facility, nor shall the nursing staff of the

31  geriatric outpatient clinic be counted as part of the nursing

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  staff of the facility, until the outpatient clinic load

  2  exceeds 15 a day.

  3         (6)  Be allowed and encouraged by the agency to provide

  4  other needed services under certain conditions. If the

  5  facility has a standard licensure status, and has had no class

  6  I or class II deficiencies during the past 2 years or has been

  7  awarded a Gold Seal under the program established in s.

  8  400.235, it may be encouraged by the agency to provide

  9  services, including, but not limited to, respite and adult day

10  services, which enable individuals to move in and out of the

11  facility.  A facility is not subject to any additional

12  licensure requirements for providing these services. Respite

13  care may be offered to persons in need of short-term or

14  temporary nursing home services. Respite care must be provided

15  in accordance with this part and rules adopted by the agency.

16  However, the agency shall, by rule, adopt modified

17  requirements for resident assessment, resident care plans,

18  resident contracts, physician orders, and other provisions, as

19  appropriate, for short-term or temporary nursing home

20  services.  The agency shall allow for shared programming and

21  staff in a facility which meets minimum standards and offers

22  services pursuant to this subsection, but, if the facility is

23  cited for deficiencies in patient care, may require additional

24  staff and programs appropriate to the needs of service

25  recipients. A person who receives respite care may not be

26  counted as a resident of the facility for purposes of the

27  facility's licensed capacity unless that person receives

28  24-hour respite care. A person receiving either respite care

29  for 24 hours or longer or adult day services must be included

30  when calculating minimum staffing for the facility. Any costs

31  and revenues generated by a nursing home facility from

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  nonresidential programs or services shall be excluded from the

  2  calculations of Medicaid per diems for nursing home

  3  institutional care reimbursement.

  4         (7)  If the facility has a standard licensure status or

  5  is a Gold Seal facility, exceeds minimum staffing standards,

  6  and is part of a retirement community that offers other

  7  services pursuant to part III, part IV, or part V, be allowed

  8  to share programming and staff.  At the time of relicensure, a

  9  retirement community that uses this option must demonstrate

10  through staffing records that minimum staffing requirements

11  for the facility were exceeded.

12         (8)  Maintain the facility premises and equipment and

13  conduct its operations in a safe and sanitary manner.

14         (9)  If the licensee furnishes food service, provide a

15  wholesome and nourishing diet sufficient to meet generally

16  accepted standards of proper nutrition for its residents and

17  provide such therapeutic diets as may be prescribed by

18  attending physicians.  In making rules to implement this

19  subsection, the agency shall be guided by standards

20  recommended by nationally recognized professional groups and

21  associations with knowledge of dietetics.

22         (10)  Keep full records of resident admissions and

23  discharges; medical and general health status, including

24  medical records, personal and social history, and identity and

25  address of next of kin or other persons who may have

26  responsibility for the affairs of the residents; and

27  individual resident care plans including, but not limited to,

28  prescribed services, service frequency and duration, and

29  service goals.  The records shall be open to inspection by the

30  agency.

31         (11)  Keep such fiscal records of its operations and

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  conditions as may be necessary to provide information pursuant

  2  to this part.

  3         (12)  Furnish copies of personnel records for employees

  4  affiliated with such facility, to any other facility licensed

  5  by this state requesting this information pursuant to this

  6  part.  Such information contained in the records may include,

  7  but is not limited to, disciplinary matters and any reason for

  8  termination. Any facility releasing such records pursuant to

  9  this part shall be considered to be acting in good faith and

10  may not be held liable for information contained in such

11  records, absent a showing that the facility maliciously

12  falsified such records.

13         (13)  Publicly display a poster provided by the agency

14  containing the names, addresses, and telephone numbers for the

15  state's abuse hotline, the State Long-Term Care Ombudsman, the

16  Agency for Health Care Administration consumer hotline, the

17  Advocacy Center for Persons with Disabilities, the Statewide

18  Human Rights Advocacy Committee, and the Medicaid Fraud

19  Control Unit, with a clear description of the assistance to be

20  expected from each.

21

22  Facilities that have been awarded a Gold Seal under the

23  program established in s. 400.235 may develop a plan to

24  provide certified nursing assistant training as prescribed by

25  federal regulations and state rules and may apply to the

26  agency for approval of its program.

27         Section 5.  Subsection (2) of section 400.191, Florida

28  Statutes, is amended, and subsection (6) is added to said

29  section, to read:

30         400.191  Availability, distribution, and posting of

31  reports and records.--

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1         (2)  The agency shall provide additional information in

  2  consumer-friendly printed and electronic formats to assist

  3  consumers and their families in comparing and evaluating

  4  nursing home facilities.

  5         (a)  The agency shall provide an Internet site which

  6  shall include at least the following information either

  7  directly or indirectly through a link to another established

  8  site or sites of the agency's choosing:

  9         1.  A list by name and address of all nursing home

10  facilities in this state.

11         2.  Whether such nursing home facilities are

12  proprietary or nonproprietary.

13         3.  The current owner of the facility's license and the

14  year that that entity became the owner of the license. The

15  licensure status of each facility.

16         4.  The ownership history of each facility.

17         4.5.  The name of the owner or owners of each facility

18  and whether the facility is affiliated with a part of a

19  company or other organization corporation owning or managing

20  operating more than one nursing facility in this state.

21         6.  Performance, regulatory, and enforcement

22  information about the corporation, as well as the facility.

23         5.7.  The total number of beds in each facility.

24         6.8.  The number of private and semiprivate rooms in

25  each facility.

26         7.9.  The religious affiliation, if any, of each

27  facility.

28         8.10.  The languages spoken by the administrator and

29  staff of each facility.

30         9.11.  Whether or not each facility accepts Medicare or

31  Medicaid recipients or insurance, health maintenance

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  organization, Veterans Administration, CHAMPUS program, or

  2  workers' compensation coverage.

  3         10.12.  Recreational and other programs available at

  4  each facility.

  5         13.  For nursing homes certified for Medicare or

  6  Medicaid, information from the Minimum Data Set system of the

  7  federal Health Care Financing Administration about the

  8  clinical performance of each facility, including information

  9  related to the nursing home quality indicators.

10         14.  Information about the licensure status and

11  regulatory history of each facility.

12         11.15.  Special care units or programs offered at each

13  facility.

14         12.16.  Whether the facility is a part of a retirement

15  community that offers other services pursuant to part III,

16  part IV, or part V.

17         13.17.  The results of consumer and family satisfaction

18  surveys for each facility, as described in s. 400.0225. The

19  results may be converted to a score or scores, which may be

20  presented in either numeric or symbolic form for the intended

21  consumer audience.

22         18.  The licensure status and rating history for the

23  past 5 years for each facility.

24         14.19.  Survey and deficiency information contained on

25  the Online Survey Certification and Reporting (OSCAR) system

26  of the federal Health Care Financing Administration, including

27  annual survey, revisit, and complaint survey information, for

28  each facility for the past 45 months 3 years.  For

29  noncertified nursing homes, state survey and deficiency

30  information, including annual survey, revisit, and complaint

31  survey information for the past 45 months 3 years shall be

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  provided.

  2         15.  A summary of the Online Survey Certification and

  3  Reporting (OSCAR) data for each facility over the past 45

  4  months. Such summary may include a score, rating, or

  5  comparison ranking with respect to other facilities based on

  6  the number of citations received by the facility of annual,

  7  revisit, and complaint surveys, the severity and scope of the

  8  citations, and the number of annual recertification surveys

  9  the facility has had during the past 45 months. The score,

10  rating, or comparison ranking may be presented in either

11  numeric or symbolic form for the intended consumer audience.

12         (b)  The agency shall provide the following information

13  in printed form:

14         1.  A list by name and address of all nursing home

15  facilities in this state.

16         2.  Whether such nursing home facilities are

17  proprietary or nonproprietary and their current ownership.

18         3.  The current owner or owners of the facility's

19  license and the year that entity became the owner of the

20  license The licensure status of each facility.

21         4.  The total number of beds, and of private and

22  semiprivate rooms, in each facility.

23         5.  The religious affiliation, if any, of each

24  facility.

25         6.  The name of the owner of each facility and whether

26  the facility is affiliated with a company or other

27  organization owning or managing more than one nursing facility

28  in this state.

29         7.6.  The languages spoken by the administrator and

30  staff of each facility.

31         7.  Whether or not each facility accepts Medicare or

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  Medicaid recipients.

  2         8.  Whether or not each facility accepts Medicare or

  3  Medicaid recipients or insurance, health maintenance

  4  organization, Veterans Administration, CHAMPUS program, or

  5  workers' compensation coverage.

  6         9.8.  Recreational programs, special care units, and

  7  other programs available at each facility.

  8         9.  A summary of information from the Minimum Data Set

  9  system of the federal Health Care Financing Administration

10  about the clinical performance of each facility.

11         10.  Information about the licensure status and

12  regulatory history of each facility.

13         10.11.  The results of consumer and family satisfaction

14  surveys for each facility, as described in s. 400.0225. The

15  results may be converted to a score or scores, which may be

16  presented in either numeric or symbolic form for the intended

17  consumer audience.

18         11.12.  The Internet address for the site where more

19  detailed information can be seen.

20         12.13.  A statement advising consumers that each

21  facility will have its own policies and procedures related to

22  protecting resident property.

23         13.  A summary of the Online Survey Certification and

24  Reporting (OSCAR) data for each facility over the past 45

25  months. Such summary may include a score, rating, or

26  comparison ranking with respect to other facilities based on

27  the number of citations received by the facility on annual,

28  revisit, and complaint surveys, the severity and scope of the

29  citations, the number of citations, the number of annual

30  recertification surveys the facility has had during the past

31  45 months. The score, rating, or comparison ranking may be

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  presented in either numeric or symbolic form for the intended

  2  consumer audience.

  3         (c)  For purposes of this subsection, references to the

  4  Online Survey Certification and Reporting (OSCAR) system shall

  5  refer to any future system that the Health Care Financing

  6  Administration develops to replace the current OSCAR system.

  7         (d)  The agency may provide the following additional

  8  information on an Internet site or in printed form as the

  9  information becomes available:

10         1.  The licensure status history of each facility.

11         2.  The rating history of each facility.

12         3.  The regulatory history of each facility, which may

13  include federal sanctions, state sanctions, federal fines,

14  state fines, and other actions.

15         4.  Whether the facility currently possesses the Gold

16  Seal designation awarded pursuant to s. 400.235.

17         5.  Internet links to the Internet sites of the

18  facilities or their affiliates.

19         (6)  The agency may adopt rules as necessary to

20  administer this section.

21         Section 6.  Subsection (5) of section 400.23, Florida

22  Statutes, is amended to read:

23         400.23  Rules; evaluation and deficiencies; licensure

24  status.--

25         (5)  The agency, in collaboration with the Division of

26  Children's Medical Services of the Department of Health, must,

27  no later than December 31, 1993, adopt rules for minimum

28  standards of care for persons under 21 years of age who reside

29  in nursing home facilities.  The rules must include a

30  methodology for reviewing a nursing home facility under ss.

31  408.031-408.045 which serves only persons under 21 years of

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  age. A facility may be exempt from these standards for

  2  specific persons between 18 and 21 years of age, if the

  3  person's physician agrees that minimum standards of care based

  4  on age are not necessary.

  5         Section 7.  Paragraph (a) of subsection (3), subsection

  6  (4), and paragraphs (e) and (h) of subsection (5) of section

  7  400.235, Florida Statutes, are amended, and subsection (9) is

  8  added to said section, to read:

  9         400.235  Nursing home quality and licensure status;

10  Gold Seal Program.--

11         (3)(a)  The Gold Seal Program shall be developed and

12  implemented by the Governor's Panel on Excellence in Long-Term

13  Care which shall operate under the authority of the Executive

14  Office of the Governor. The panel shall be composed of three

15  persons appointed by the Governor, to include a consumer

16  advocate for senior citizens and two persons with expertise in

17  the fields of quality management, service delivery excellence,

18  or public sector accountability; three persons appointed by

19  the Secretary of Elderly Affairs, to include an active member

20  of a nursing facility family and resident care council and a

21  member of the University Consortium on Aging; the State

22  Long-Term Care Ombudsman; one person appointed by the Florida

23  Life Care Residents Association; one person appointed by the

24  Secretary of Health; two persons appointed by the Director of

25  Health Care Administration, to include the Deputy Director for

26  State Health Purchasing; one person appointed by the Florida

27  Association of Homes for the Aging; and one person appointed

28  by the Florida Health Care Association. All members of the

29  panel shall be appointed by October 1, 1999, and the panel

30  shall hold its organizational meeting no later than December

31  10, 1999. Vacancies on the panel shall be filled in the same

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  manner as the original appointments. No member shall serve for

  2  more than 4 consecutive years from the date of appointment.

  3         (4)  The panel shall consider at least the quality of

  4  care provided to residents following resident-based quality

  5  indicator domains when evaluating a facility for the Gold Seal

  6  Program. The panel shall determine the procedure or procedures

  7  for measuring the quality of care.:

  8         (a)  Accidents.

  9         (b)  Behavioral/emotional patterns.

10         (c)  Clinical management.

11         (d)  Cognitive patterns.

12         (e)  Elimination/continence.

13         (f)  Infection control.

14         (g)  Nutrition and eating.

15         (h)  Physical functioning.

16         (i)  Psychotropic drug use.

17         (j)  Quality of life.

18         (k)  Sensory functioning and communication.

19         (l)  Skin care.

20         (5)  Facilities must meet the following additional

21  criteria for recognition as a Gold Seal Program facility:

22         (e)  Have a stable workforce, as evidenced by a

23  relatively low rate of turnover among certified nursing

24  assistants and licensed registered nurses within the 30 months

25  preceding application for the Gold Seal Program, and

26  demonstrate a continuing effort to maintain a stable workforce

27  and to reduce turnover of licensed nurses and certified

28  nursing assistants.

29         (h)  Evidence superior levels of clinical outcomes as

30  measured in the Minimum Data Set system of the federal Health

31  Care Financing Administration. Facilities that are not

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  certified for Medicare or Medicaid are not required to

  2  complete the Minimum Data Set in order to qualify for the Gold

  3  Seal Program. Such facilities may demonstrate superior levels

  4  of performance with an alternate assessment as approved by the

  5  panel.

  6

  7  A facility assigned a conditional licensure status may not

  8  qualify for consideration for the Gold Seal Program until

  9  after it has operated for 30 months with no class I or class

10  II deficiencies and has completed a regularly scheduled

11  relicensure survey.

12         (9)  The agency may adopt rules as necessary to

13  administer this section.

14         Section 8.  Subsection (1) of section 400.962, Florida

15  Statutes, is amended to read:

16         400.962  License required; license application.--

17         (1)  It is unlawful to operate an intermediate care

18  facility for the developmentally disabled or a comprehensive

19  transitional educational program without a license.

20         Section 9.  Subsection (2) of section 397.405, Florida

21  Statutes, is amended to read:

22         397.405  Exemptions from licensure.--The following are

23  exempt from the licensing provisions of this chapter:

24         (2)  A nursing home facility as defined in s.

25  400.021(12)(11).

26         Section 10.  The Board of Pharmacy, in cooperation with

27  the Agency for Health Care Administration, shall undertake a

28  study of the feasibility, efficiency, cost-effectiveness, and

29  safety of using automated medication dispensing machines in

30  nursing facilities. The board and the agency may authorize the

31  establishment of demonstration projects in up to five nursing

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  facilities with a class I institutional pharmacy as part of

  2  the study. Demonstration projects may be allowed to continue

  3  for up to 12 months. A report summarizing the results of the

  4  study shall be submitted by the board and the agency to the

  5  Speaker of the House of Representatives and the President of

  6  the Senate by January 1, 2001. If the study determines that

  7  such dispensing machines would benefit residents of nursing

  8  facilities and should be allowed, the report shall identify

  9  those specific statutory changes necessary to allow nursing

10  facilities to use automated medication dispensing machines.

11         Section 11.  Section 180.136, Florida Statutes, is

12  created to read:

13         180.136  Water or sewer utilities; notice.--Before a

14  local government water or sewer utility increases any rate,

15  charge, or fee for water or sewer utility service, the utility

16  shall provide notice of the proposed increase to each customer

17  of the utility through the utility's billing process.  The

18  notice shall state the date, time, and place of the meeting of

19  the governing board of the local government at which such

20  increase will be considered. The notice required in this

21  section is in addition to any notice and public meeting

22  requirements for ordinance adoption as provided by general

23  law.

24         Section 12.  Section 350.0611, Florida Statutes, is

25  amended to read:

26         350.0611  Public Counsel; duties and powers.--It shall

27  be the duty of the Public Counsel to provide legal

28  representation for the people of the state in proceedings

29  before the commission and in proceedings before counties

30  pursuant to s. 367.171(8).  The Public Counsel shall have such

31  powers as are necessary to carry out the duties of his or her

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  office, including, but not limited to, the following specific

  2  powers:

  3         (1)  To recommend to the commission, by petition, the

  4  commencement of any proceeding or action or to appear, in the

  5  name of the state or its citizens, in any proceeding or action

  6  before the commission and urge therein any position which he

  7  or she deems to be in the public interest, whether consistent

  8  or inconsistent with positions previously adopted by the

  9  commission, and utilize therein all forms of discovery

10  available to attorneys in civil actions generally, subject to

11  protective orders of the commission which shall be reviewable

12  by summary procedure in the circuit courts of this state.;

13         (2)  To have access to and use of all files, records,

14  and data of the commission available to any other attorney

15  representing parties in a proceeding before the commission.;

16         (3)  In any proceeding in which he or she has

17  participated as a party, to seek review of any determination,

18  finding, or order of the commission, or of any hearing

19  examiner designated by the commission, in the name of the

20  state or its citizens.;

21         (4)  To prepare and issue reports, recommendations, and

22  proposed orders to the commission, the Governor, and the

23  Legislature on any matter or subject within the jurisdiction

24  of the commission, and to make such recommendations as he or

25  she deems appropriate for legislation relative to commission

26  procedures, rules, jurisdiction, personnel, and functions.;

27         (5)  To appear before other state agencies, federal

28  agencies, and state and federal courts in connection with

29  matters under the jurisdiction of the commission, in the name

30  of the state or its citizens.

31         Section 13.  Subsection (8) of section 367.171, Florida

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1  Statutes, is amended to read:

  2         367.171  Effectiveness of this chapter.--

  3         (8)  Each county which is excluded from the provisions

  4  of this chapter shall regulate the rates of all utilities in

  5  that county which would otherwise be subject to regulation by

  6  the commission pursuant to s. 367.081(1), (2), (3), and (6).

  7  The county shall not regulate the rates or charges of any

  8  system or facility which would otherwise be exempt from

  9  commission regulation pursuant to s. 367.022(2).  For this

10  purpose the county or its agency shall proceed as though the

11  county or agency is the commission. In all proceedings

12  conducted by a county or its agency under the authority of

13  this chapter, the provisions of ss. 120.569 and 120.57 shall

14  apply.

15         Section 14.  This act shall take effect upon becoming a

16  law.

17

18

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

20  And the title is amended as follows:

21  remove from the title of the bill:  the entire title

22

23  and insert in lieu thereof:

24         An act relating to nursing homes and related

25         health care facilities; amending s. 400.021,

26         F.S.;  defining "nursing home bed"; amending s.

27         400.0225, F.S.; modifying provisions relating

28         to consumer satisfaction surveys; authorizing

29         the Agency for Health Care Administration to

30         adopt rules; amending s. 400.0255, F.S.;

31         providing for medication repackaging; amending

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1         s. 400.141, F.S.; requiring a signed order by a

  2         physician when the nursing home initiates

  3         transfer or discharge of a resident; providing

  4         time requirement for notice of discharge or

  5         transfer to certain persons; amending s.

  6         400.191, F.S.; modifying requirements for

  7         consumer information reporting; authorizing the

  8         agency to adopt rules; amending s. 400.23,

  9         F.S.; providing an exemption for nursing home

10         residents age 18 to 21 years from certain

11         standards of care based on age, under certain

12         circumstances; amending s. 400.235, F.S.;

13         modifying requirements relating to designation

14         under the nursing home Gold Seal Program;

15         authorizing the agency to adopt rules; amending

16         s. 400.962, F.S.; exempting comprehensive

17         transitional education programs from licensure

18         requirements under pt. XI of ch. 400, F.S.;

19         amending s. 397.405, F.S.; correcting a cross

20         reference; requiring a study relating to use of

21         automated medication dispensing machines in

22         nursing facilities; providing for demonstration

23         projects; requiring a report; creating s.

24         180.136, F.S.; requiring notice of proposed

25         increases in certain water or sewer utility

26         service rates, charges, or fees; specifying

27         such notice is in addition to other notice and

28         meeting requirments; amending s. 350.0611,

29         F.S.; requiring the Public Counsel to provide

30         legal representation in proceedings before

31         counties under certain circumstances; amending

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                                                   HOUSE AMENDMENT

                                                  Bill No. SB 1280

    Amendment No. ___ (for drafter's use only)





  1         s. 367.171, F.S.; requiring county rate

  2         proceedings to follow certain provisions of the

  3         Administrative Procedure Act; providing an

  4         effective date.

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