Amendment
Bill No. CS/HB 7083

Amendment No. 987943

CHAMBER ACTION
Senate		House
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1	Representative R. Garcia offered the following:
2
3	Amendment (with directory amendment)
4	Remove lines 96-157 and insert:
5	400.462  Definitions.--As used in this part, the term:
6	(1)  "Administrator" means a direct employee, as defined in
7	subsection (9), who is. The administrator must be a licensed
8	physician, physician assistant, or registered nurse licensed to
9	practice in this state or an individual having at least 1 year
10	of supervisory or administrative experience in home health care
11	or in a facility licensed under chapter 395, under part II of
12	this chapter, or under part I of chapter 429. An administrator
13	may manage a maximum of five licensed home health agencies
14	located within one agency service district or within an
15	immediately contiguous county. If the home health agency is
16	licensed under this chapter and is part of a retirement
17	community that provides multiple levels of care, an employee of
18	the retirement community may administer the home health agency
19	and up to a maximum of four entities licensed under this chapter
20	or chapter 429 that are owned, operated, or managed by the same
21	corporate entity. An administrator shall designate, in writing,
22	for each licensed entity, a qualified alternate administrator to
23	serve during absences.
24	(2)  "Admission" means a decision by the home health
25	agency, during or after an evaluation visit to the patient's
26	home, that there is reasonable expectation that the patient's
27	medical, nursing, and social needs for skilled care can be
28	adequately met by the agency in the patient's place of
29	residence. Admission includes completion of an agreement with
30	the patient or the patient's legal representative to provide
31	home health services as required in s. 400.487(1).
32	(3)  "Advanced registered nurse practitioner" means a
33	person licensed in this state to practice professional nursing
34	and certified in advanced or specialized nursing practice, as
35	defined in s. 464.003.
36	(4)  "Agency" means the Agency for Health Care
37	Administration.
38	(5)  "Certified nursing assistant" means any person who has
39	been issued a certificate under part II of chapter 464. The
40	licensed home health agency or licensed nurse registry shall
41	ensure that the certified nursing assistant employed by or under
42	contract with the home health agency or licensed nurse registry
43	is adequately trained to perform the tasks of a home health aide
44	in the home setting.
45	(6)  "Client" means an elderly, handicapped, or
46	convalescent individual who receives companion services or
47	homemaker services in the individual's home or place of
48	residence.
49	(7)  "Companion" or "sitter" means a person who spends time
50	with or cares for an elderly, handicapped, or convalescent
51	individual and accompanies such individual on trips and outings
52	and may prepare and serve meals to such individual. A companion
53	may not provide hands-on personal care to a client.
54	(8)  "Department" means the Department of Children and
55	Family Services.
56	(9)  "Direct employee" means an employee for whom one of
57	the following entities pays withholding taxes: a home health
58	agency; a management company that has a contract to manage the
59	home health agency on a day-to-day basis; or an employee leasing
60	company that has a contract with the home health agency to
61	handle the payroll and payroll taxes for the home health agency.
62	(10)  "Director of nursing" means a registered nurse who is
63	a direct employee, as defined in subsection (9), of the agency
64	and who is a graduate of an approved school of nursing and is
65	licensed in this state; who has at least 1 year of supervisory
66	experience as a registered nurse; and who is responsible for
67	overseeing the professional nursing and home health aid delivery
68	of services of the agency. A director of nursing may be the
69	director of a maximum of five licensed home health agencies
70	operated by a related business entity and located within one
71	agency service district or within an immediately contiguous
72	county. If the home health agency is licensed under this chapter
73	and is part of a retirement community that provides multiple
74	levels of care, an employee of the retirement community may
75	serve as the director of nursing of the home health agency and
76	of up to four entities licensed under this chapter or chapter
77	429 which are owned, operated, or managed by the same corporate
78	entity.
79	(11)  "Fair market value" means the value in arms length
80	transactions, consistent with the price that an asset would
81	bring as a result of bona fide bargaining between well-informed
82	buyers and sellers who are not otherwise in a position to
83	generate business for the other party, or the compensation that
84	would be included in a service agreement as a result of bona
85	fide bargaining between well-informed parties to the agreement
86	who are not otherwise in a position to generate business for the
87	other party, on the date of acquisition of the asset or at the
88	time of the service agreement.
89	(12)(11)  "Home health agency" means an organization that
90	provides home health services and staffing services.
91	(13)(12)  "Home health agency personnel" means persons who
92	are employed by or under contract with a home health agency and
93	enter the home or place of residence of patients at any time in
94	the course of their employment or contract.
95	(14)(13)  "Home health services" means health and medical
96	services and medical supplies furnished by an organization to an
97	individual in the individual's home or place of residence. The
98	term includes organizations that provide one or more of the
99	following:
100	(a)  Nursing care.
101	(b)  Physical, occupational, respiratory, or speech
102	therapy.
103	(c)  Home health aide services.
104	(d)  Dietetics and nutrition practice and nutrition
105	counseling.
106	(e)  Medical supplies, restricted to drugs and biologicals
107	prescribed by a physician.
108	(15)(14)  "Home health aide" means a person who is trained
109	or qualified, as provided by rule, and who provides hands-on
110	personal care, performs simple procedures as an extension of
111	therapy or nursing services, assists in ambulation or exercises,
112	or assists in administering medications as permitted in rule and
113	for which the person has received training established by the
114	agency under s. 400.497(1). The licensed home health agency or
115	licensed nurse registry shall ensure that the home health aide
116	employed by or under contract with the home health agency or
117	licensed nurse registry is adequately trained to perform the
118	tasks of a home health aide in the home setting.
119	(16)(15)  "Homemaker" means a person who performs household
120	chores that include housekeeping, meal planning and preparation,
121	shopping assistance, and routine household activities for an
122	elderly, handicapped, or convalescent individual. A homemaker
123	may not provide hands-on personal care to a client.
124	(17)  "Home infusion therapy" means the administration of
125	intravenous pharmacological or nutritional products to a patient
126	in his or her home.
127	(18)(16)  "Home infusion therapy provider" means an
128	organization that employs, contracts with, or refers a licensed
129	professional who has received advanced training and experience
130	in intravenous infusion therapy and who administers infusion
131	therapy to a patient in the patient's home or place of
132	residence.
133	(19)  "Immediate family member" means a husband or wife; a
134	birth or adoptive parent, child, or sibling; a stepparent,
135	stepchild, stepbrother, or stepsister; a father-in-law, mother-
136	in-law, son-in-law, daughter-in-law, brother-in-law, or sister-
137	in-law; a grandparent or grandchild; or a spouse of a
138	grandparent or grandchild.
139	(20)(18)  "Nurse registry" means any person that procures,
140	offers, promises, or attempts to secure health-care-related
141	contracts for registered nurses, licensed practical nurses,
142	certified nursing assistants, home health aides, companions, or
143	homemakers, who are compensated by fees as independent
144	contractors, including, but not limited to, contracts for the
145	provision of services to patients and contracts to provide
146	private duty or staffing services to health care facilities
147	licensed under chapter 395, this chapter, or chapter 429 or
148	other business entities.
149	(21)(19)  "Organization" means a corporation, government or
150	governmental subdivision or agency, partnership or association,
151	or any other legal or commercial entity, any of which involve
152	more than one health care professional discipline; a health care
153	professional and a home health aide or certified nursing
154	assistant; more than one home health aide; more than one
155	certified nursing assistant; or a home health aide and a
156	certified nursing assistant. The term does not include an entity
157	that provides services using only volunteers or only individuals
158	related by blood or marriage to the patient or client.
159	(22)(20)  "Patient" means any person who receives home
160	health services in his or her home or place of residence.
161	(23)(21)  "Personal care" means assistance to a patient in
162	the activities of daily living, such as dressing, bathing,
163	eating, or personal hygiene, and assistance in physical
164	transfer, ambulation, and in administering medications as
165	permitted by rule.
166	(24)(22)  "Physician" means a person licensed under chapter
167	458, chapter 459, chapter 460, or chapter 461.
168	(25)(23)  "Physician assistant" means a person who is a
169	graduate of an approved program or its equivalent, or meets
170	standards approved by the boards, and is licensed to perform
171	medical services delegated by the supervising physician, as
172	defined in s. 458.347 or s. 459.022.
173	(26)  "Remuneration" means any payment or other benefit
174	made directly or indirectly, overtly or covertly, in cash or in
175	kind.
176	(27)(24)  "Skilled care" means nursing services or
177	therapeutic services required by law to be delivered by a health
178	care professional who is licensed under part I of chapter 464;
179	part I, part III, or part V of chapter 468; or chapter 486 and
180	who is employed by or under contract with a licensed home health
181	agency or is referred by a licensed nurse registry.
182	(28)(25)  "Staffing services" means services provided to a
183	health care facility, school, or other business entity on a
184	temporary or school-year basis pursuant to a written contract by
185	licensed health care personnel and by certified nursing
186	assistants and home health heath aides who are employed by, or
187	work under the auspices of, a licensed home health agency or who
188	are registered with a licensed nurse registry. Staffing services
189	may be provided anywhere within the state.
190
191
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193	D I R E C T O R Y  A M E N D M E N T
194	Remove lines 94-95 and insert:
195	Section 2.  Section 400.462, Florida Statutes, is amended
196	to read:

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