Florida Senate - 2014 SB 1254
By Senator Grimsley
21-00602A-14 20141254__
1 A bill to be entitled
2 An act relating to health care services rulemaking;
3 amending ss. 390.012, 400.021, 400.0712, 400.23,
4 400.487, 400.497, 400.506, 400.509, 400.6095, 400.914,
5 400.935, 400.962, 400.967, 400.980, 409.912, 429.255,
6 429.73, 440.102, 483.245, 765.541, and 765.544, F.S.;
7 removing certain rulemaking authority relating to the
8 disposal of fetal remains by abortion clinics, nursing
9 home equipment and furnishings, license applications
10 for nursing home facilities, evaluation of nursing
11 home facilities, home health agencies and
12 cardiopulmonary resuscitation, home health agency
13 standards, nurse registry emergency management plans,
14 registration of certain service providers, hospice and
15 cardiopulmonary resuscitation, standards for
16 prescribed pediatric extended care facilities, minimum
17 standards relating to home medical equipment
18 providers, standards for intermediate care facilities
19 for the developmentally disabled, rules and the
20 classification of deficiencies for intermediate care
21 facilities for the developmentally disabled, the
22 registration of health care service pools,
23 participation in a Medicaid provider lock-in program,
24 assisted living facilities and cardiopulmonary
25 resuscitation, adult family-care homes and
26 cardiopulmonary resuscitation, guidelines for drug
27 free workplace laboratories, penalties for rebates,
28 standards for organ procurement organizations;
29 administrative penalties for violations of the organ
30 and tissue donor education and procurement program;
31 creating s. 400.9141; limiting services at PPEC
32 centers; amending s. 400.934, relating to home medical
33 equipment providers; requiring that the emergency
34 management plan include criteria relating to the
35 maintenance of patient equipment and supply lists;
36 providing an effective date.
37
38 WHEREAS, rulemaking is not a matter of agency discretion;
39 rulemaking authority is delegated by the Legislature for
40 agencies to adopt statements of general applicability that
41 interpret or implement law; the valid adoption of a rule
42 requires both a grant of express rulemaking authority and a
43 specific law to be implemented or interpreted, and
44 WHEREAS, the repeal or deletion of a redundant or
45 unnecessary provision authorizing agency rulemaking does not
46 repeal rulemaking authority otherwise provided that clearly
47 applies to the same subject, and
48 WHEREAS, statutory provisions mandating rules, when the
49 substantive law otherwise would be implemented without the need
50 for administrative rules or by rulemaking under a broader grant
51 of authority, may be repealed without altering the substantive
52 law or rulemaking authority on which existing rules rely, NOW,
53 THEREFORE,
54
55 Be It Enacted by the Legislature of the State of Florida:
56
57 Section 1. Paragraph (d) of subsection (3) of section
58 390.012, Florida Statutes, is amended to read:
59 390.012 Powers of agency; rules; disposal of fetal
60 remains.—
61 (3) For clinics that perform or claim to perform abortions
62 after the first trimester of pregnancy, the agency shall adopt
63 rules pursuant to ss. 120.536(1) and 120.54 to implement the
64 provisions of this chapter, including the following:
65 (d) Rules relating to the medical screening and evaluation
66 of each abortion clinic patient. At a minimum, these rules must
67 shall require:
68 1. A medical history including reported allergies to
69 medications, antiseptic solutions, or latex; past surgeries; and
70 an obstetric and gynecological history.
71 2. A physical examination, including a bimanual examination
72 estimating uterine size and palpation of the adnexa.
73 3. The appropriate laboratory tests, including:
74 a. Urine or blood tests for pregnancy performed before the
75 abortion procedure.
76 b. A test for anemia.
77 c. Rh typing, unless reliable written documentation of
78 blood type is available.
79 d. Other tests as indicated from the physical examination.
80 4. An ultrasound evaluation for all patients. The rules
81 must shall require that if a person who is not a physician
82 performs an ultrasound examination, that person shall have
83 documented evidence that he or she has completed a course in the
84 operation of ultrasound equipment as prescribed in rule. The
85 rules shall require clinics to be in compliance with s.
86 390.0111.
87 5. That the physician is responsible for estimating the
88 gestational age of the fetus based on the ultrasound examination
89 and obstetric standards in keeping with established standards of
90 care regarding the estimation of fetal age as defined in rule
91 and shall write the estimate in the patient’s medical history.
92 The physician shall keep original prints of each ultrasound
93 examination of a patient in the patient’s medical history file.
94 Section 2. Subsection (11) of section 400.021, Florida
95 Statutes, is amended to read:
96 400.021 Definitions.—When used in this part, unless the
97 context otherwise requires, the term:
98 (11) “Nursing home bed” means an accommodation that which
99 is ready for immediate occupancy, or is capable of being made
100 ready for occupancy within 48 hours, excluding the provision of
101 staffing,; and that which conforms to minimum space
102 requirements, including the availability of appropriate
103 equipment and furnishings within the 48 hours, as specified by
104 rule of the agency, for the provision of services specified in
105 this part to a single resident.
106 Section 3. Subsection (3) of section 400.0712, Florida
107 Statutes, is amended to read:
108 400.0712 Application for inactive license.—
109 (3) The agency shall adopt rules pursuant to ss. 120.536(1)
110 and 120.54 necessary to implement this section.
111 Section 4. Section 400.23, Florida Statutes, is amended to
112 read:
113 400.23 Rules; evaluation and deficiencies; licensure
114 status.—
115 (1) It is the intent of the Legislature that rules
116 published and enforced pursuant to this part and part II of
117 chapter 408 shall include criteria by which a reasonable and
118 consistent quality of resident care may be ensured, and the
119 results of such resident care can be demonstrated, and by which
120 safe and sanitary nursing homes can be provided. It is further
121 intended that reasonable efforts be made to accommodate the
122 needs and preferences of residents to enhance the quality of
123 life in a nursing home. In addition, efforts shall be made to
124 minimize the amount of paperwork associated with the reporting
125 and documentation requirements of these rules.
126 (2) Pursuant to the intention of the Legislature, the
127 agency, in consultation with the Department of Health and the
128 Department of Elderly Affairs, may shall adopt and enforce rules
129 to administer implement this part and part II of chapter 408.
130 The rules must specify, but are not limited to, which shall
131 include reasonable and fair criteria relating in relation to:
132 (a) The location of the facility and housing conditions
133 that will ensure the health, safety, and comfort of residents,
134 including an adequate call system. In adopting making such
135 rules, the agency shall be guided by criteria recommended by
136 nationally recognized reputable professional groups and
137 associations that have with knowledge of such subject matters.
138 The agency shall update or revise the such criteria as the need
139 arises. The agency may require alterations to a building if it
140 determines that an existing condition constitutes a distinct
141 hazard to life, health, or safety. In performing any inspections
142 of facilities authorized by this part or part II of chapter 408,
143 the agency may enforce the special-occupancy provisions of the
144 Florida Building Code and the Florida Fire Prevention Code which
145 apply to nursing homes. A resident Residents or his or her
146 representative must their representatives shall be able to
147 request a change in the placement of the bed in his or her their
148 room if, provided that at admission, the resident is they are
149 presented with a room that meets requirements of the Florida
150 Building Code. The location of a bed may be changed if the
151 requested placement does not infringe on the resident’s roommate
152 or interfere with the resident’s care or safety as determined by
153 the care planning team in accordance with facility policies and
154 procedures. In addition, the bed placement may not be used as a
155 restraint. Each facility shall maintain a log of resident rooms
156 with beds that are not in strict compliance with the Florida
157 Building Code in order for such log to be used by surveyors and
158 nurse monitors during inspections and visits. A resident or a
159 resident’s resident representative who requests that a bed be
160 moved must shall sign a statement indicating that he or she
161 understands that the room will not be in compliance with the
162 Florida Building Code, but that he or she they would prefer to
163 exercise the their right to self-determination. The statement
164 must be retained as part of the resident’s care plan. A Any
165 facility that offers this option must submit a letter signed by
166 the nursing home administrator of record to the agency notifying
167 it of this practice along with a copy of the policies and
168 procedures of the facility. The agency is directed to provide
169 assistance to the Florida Building Commission in updating the
170 construction standards of the code relating relative to nursing
171 homes.
172 (b) The number and qualifications of all personnel,
173 including management, medical, nursing, and other professional
174 personnel, and nursing assistants, orderlies, and support
175 personnel, having responsibility for any part of the care given
176 residents.
177 (c) All sanitary conditions within the facility and its
178 surroundings, including water supply, sewage disposal, food
179 handling, and general hygiene which will ensure the health and
180 comfort of residents.
181 (d) The equipment essential to the health and welfare of
182 the residents.
183 (e) A uniform accounting system.
184 (f) The care, treatment, and maintenance of residents and
185 measurement of the quality and adequacy thereof, based on rules
186 developed under this chapter and the Omnibus Budget
187 Reconciliation Act of 1987, (Pub. L. No. 100-203) (December 22,
188 1987), Title IV (Medicare, Medicaid, and Other Health-Related
189 Programs), Subtitle C (Nursing Home Reform), as amended.
190 (g) The preparation and annual update of a comprehensive
191 emergency management plan. The agency shall establish adopt
192 rules establishing minimum criteria for the plan after
193 consultation with the Division of Emergency Management. At a
194 minimum, the rules must provide for plan components must provide
195 that address emergency evacuation transportation; adequate
196 sheltering arrangements; postdisaster activities, including
197 emergency power, food, and water; postdisaster transportation;
198 supplies; staffing; emergency equipment; individual
199 identification of residents and transfer of records; and
200 responding to family inquiries. The comprehensive emergency
201 management plan is subject to review and approval by the local
202 emergency management agency. During the its review, the local
203 emergency management agency shall ensure that the following
204 agencies, at a minimum, are given the opportunity to review the
205 plan: the Department of Elderly Affairs, the Department of
206 Health, the Agency for Health Care Administration, and the
207 Division of Emergency Management. Also, Appropriate volunteer
208 organizations must also be given the opportunity to review the
209 plan. The local emergency management agency shall complete its
210 review within 60 days and either approve the plan or advise the
211 facility of necessary revisions.
212 (h) The availability, distribution, and posting of reports
213 and records pursuant to s. 400.191 and the Gold Seal Program
214 pursuant to s. 400.235.
215 (3)(a)1. The agency shall enforce adopt rules providing
216 minimum staffing requirements for nursing home facilities.
217 1. These requirements must include, for each facility:
218 a. A combined minimum weekly average of certified nursing
219 assistant and licensed nursing staffing combined of 3.6 hours of
220 direct care per resident per day. As used in this sub
221 subparagraph, a week is defined as Sunday through Saturday.
222 b. A minimum certified nursing assistant staffing of 2.5
223 hours of direct care per resident per day. A facility may not
224 staff below one certified nursing assistant per 20 residents.
225 c. A minimum licensed nursing staffing of 1.0 hour of
226 direct care per resident per day. A facility may not staff below
227 one licensed nurse per 40 residents.
228 2. Nursing assistants employed under s. 400.211(2) may be
229 included in computing the staffing ratio for certified nursing
230 assistants if their job responsibilities include only nursing
231 assistant-related duties.
232 3. Each nursing home facility must document compliance with
233 staffing standards as required under this paragraph and post
234 daily the names of staff on duty for the benefit of facility
235 residents and the public.
236 4. The agency shall recognize the use of licensed nurses
237 for compliance with the minimum staffing requirements for
238 certified nursing assistants if the nursing home facility
239 otherwise meets the minimum staffing requirements for licensed
240 nurses and the licensed nurses are performing the duties of a
241 certified nursing assistants assistant. Unless otherwise
242 approved by the agency, licensed nurses counted toward the
243 minimum staffing requirements for certified nursing assistants
244 must exclusively perform the duties of a certified nursing
245 assistants assistant for the entire shift and not also be
246 counted toward the minimum staffing requirements for licensed
247 nurses. If the agency approved a facility’s request to use a
248 licensed nurse to perform both licensed nursing and certified
249 nursing assistant duties, the facility must allocate the amount
250 of staff time specifically spent on certified nursing assistant
251 duties for the purpose of documenting compliance with minimum
252 staffing requirements for certified and licensed nursing staff.
253 The hours of a licensed nurse with dual job responsibilities may
254 not be counted twice.
255 (b) Nonnursing staff providing eating assistance to
256 residents does shall not count toward compliance with minimum
257 staffing standards.
258 (c) Licensed practical nurses licensed under chapter 464
259 who are providing nursing services in nursing home facilities
260 under this part may supervise the activities of other licensed
261 practical nurses, certified nursing assistants, and other
262 unlicensed personnel providing services in such facilities in
263 accordance with rules adopted by the Board of Nursing.
264 (4) Rules developed pursuant to This section does shall not
265 restrict the use of shared staffing and shared programming in
266 facilities that which are part of retirement communities that
267 provide multiple levels of care and otherwise meet the
268 requirement of law or rule.
269 (5) The agency, in collaboration with the Division of
270 Children’s Medical Services of the Department of Health, must
271 adopt rules for:
272 (a) Minimum standards of care for persons under 21 years of
273 age who reside in nursing home facilities may be established by
274 the agency, in collaboration with the Division of Children’s
275 Medical Services of the Department of Health. A facility may be
276 exempted from these standards and the provisions of paragraph
277 (b) for specified specific persons between 18 and 21 years of
278 age, if the person’s physician agrees that minimum standards of
279 care based on age are not necessary.
280 (b) The following Minimum staffing requirements for persons
281 under 21 years of age who reside in nursing home facilities,
282 which apply in lieu of the requirements contained in subsection
283 (3):.
284 1. For persons under 21 years of age who require skilled
285 care:
286 a. A minimum combined average of 3.9 hours of direct care
287 per resident per day must be provided by licensed nurses,
288 respiratory therapists, respiratory care practitioners, and
289 certified nursing assistants.
290 b. A minimum licensed nursing staffing of 1.0 hour of
291 direct care per resident per day must be provided.
292 c. Up to No more than 1.5 hours of certified nursing
293 assistant care per resident per day may be counted in
294 determining the minimum direct care hours required.
295 d. One registered nurse must be on duty on the site 24
296 hours per day on the unit where children reside.
297 2. For persons under 21 years of age who are medically
298 fragile:
299 a. A minimum combined average of 5.0 hours of direct care
300 per resident per day must be provided by licensed nurses,
301 respiratory therapists, respiratory care practitioners, and
302 certified nursing assistants.
303 b. A minimum licensed nursing staffing of 1.7 hours of
304 direct care per resident per day must be provided.
305 c. Up to No more than 1.5 hours of certified nursing
306 assistant care per resident per day may be counted in
307 determining the minimum direct care hours required.
308 d. One registered nurse must be on duty on the site 24
309 hours per day on a the unit where children reside.
310 (6) Before Prior to conducting a survey of the facility,
311 the survey team shall obtain a copy of the local long-term care
312 ombudsman council report on the facility. Problems noted in the
313 report shall be incorporated into and followed up through the
314 agency’s inspection process. This procedure does not preclude
315 the local long-term care ombudsman council from requesting the
316 agency to conduct a followup visit to the facility.
317 (7) The agency shall, at least every 15 months, evaluate
318 all nursing home facilities and determine make a determination
319 as to the degree of compliance by each licensee with the
320 established rules adopted under this part as a basis for
321 assigning a licensure status to a that facility. The agency
322 shall base its evaluation on the most recent inspection report,
323 taking into consideration findings from other official reports,
324 surveys, interviews, investigations, and inspections. In
325 addition to license categories authorized under part II of
326 chapter 408, the agency shall assign a licensure status of
327 standard or conditional licensure status to each nursing home.
328 (a) A standard licensure status means that a facility has
329 no class I or class II deficiencies and has corrected all class
330 III deficiencies within the time established by the agency.
331 (b) A conditional licensure status means that a facility,
332 due to the presence of one or more class I or class II
333 deficiencies, or class III deficiencies not corrected within the
334 time established by the agency, is not in substantial compliance
335 at the time of the survey with criteria established under this
336 part or with rules adopted by the agency. If the facility has no
337 class I, class II, or class III deficiencies at the time of the
338 followup survey, a standard licensure status may be assigned.
339 (c) In evaluating the overall quality of care and services
340 and determining whether the facility will receive a conditional
341 or standard license, the agency shall consider the needs and
342 limitations of residents in the facility and the results of
343 interviews and surveys of a representative sampling of
344 residents, families of residents, ombudsman council members in
345 the planning and service area in which the facility is located,
346 guardians of residents, and staff of the nursing home facility.
347 (d) The current licensure status of each facility must be
348 indicated in bold print on the face of the license. A list of
349 the deficiencies of the facility shall be posted in a prominent
350 place that is in clear and unobstructed public view at or near
351 the place where residents are being admitted to that facility.
352 Licensees receiving a conditional licensure status for a
353 facility shall prepare, within 10 working days after receiving
354 notice of deficiencies, a plan for correction of all
355 deficiencies and shall submit the plan to the agency for
356 approval.
357 (e) The agency shall adopt rules that:
358 1. Establish uniform procedures for the evaluation of
359 facilities.
360 2. Provide criteria in the areas referenced in paragraph
361 (c).
362 3. Address other areas necessary for carrying out the
363 intent of this section.
364 (8) The agency shall ensure adopt rules pursuant to this
365 part and part II of chapter 408 to provide that, if when the
366 criteria established under subsection (2) are not met, such
367 deficiencies shall be classified according to the nature and the
368 scope of the deficiency. The scope shall be cited as isolated,
369 patterned, or widespread. An isolated deficiency is a deficiency
370 affecting one or a very limited number of residents, or
371 involving one or a very limited number of staff, or a situation
372 that occurred only occasionally or in a very limited number of
373 locations. A patterned deficiency is a deficiency in which where
374 more than a very limited number of residents are affected, or
375 more than a very limited number of staff are involved, or the
376 situation has occurred in several locations, or the same
377 resident or residents have been affected by repeated occurrences
378 of the same deficient practice but the effect of the deficient
379 practice is not found to be pervasive throughout the facility. A
380 widespread deficiency is a deficiency in which the problems
381 causing the deficiency are pervasive in the facility or
382 represent systemic failure that has affected or has the
383 potential to affect a large portion of the facility’s residents.
384 The agency shall indicate the classification on the face of the
385 notice of deficiencies as follows:
386 (a) A class I deficiency is a deficiency that the agency
387 determines presents a situation in which immediate corrective
388 action is necessary because the facility’s noncompliance has
389 caused, or is likely to cause, serious injury, harm, impairment,
390 or death to a resident receiving care in a facility. The
391 condition or practice constituting a class I violation must
392 shall be abated or eliminated immediately, unless a fixed period
393 of time, as determined by the agency, is required for
394 correction. A class I deficiency is subject to a civil penalty
395 of $10,000 for an isolated deficiency, $12,500 for a patterned
396 deficiency, and $15,000 for a widespread deficiency. The fine
397 amount is shall be doubled for each deficiency if the facility
398 was previously cited for one or more class I or class II
399 deficiencies during the last licensure inspection or during an
400 any inspection or complaint investigation since the last
401 licensure inspection. A fine must be levied notwithstanding the
402 correction of the deficiency.
403 (b) A class II deficiency is a deficiency that the agency
404 determines has compromised a the resident’s ability to maintain
405 or reach his or her highest practicable physical, mental, and
406 psychosocial well-being, as defined by an accurate and
407 comprehensive resident assessment, plan of care, and provision
408 of services. A class II deficiency is subject to a civil penalty
409 of $2,500 for an isolated deficiency, $5,000 for a patterned
410 deficiency, and $7,500 for a widespread deficiency. The fine
411 amount is shall be doubled for each deficiency if the facility
412 was previously cited for one or more class I or class II
413 deficiencies during the last licensure inspection or an any
414 inspection or complaint investigation since the last licensure
415 inspection. A fine shall be levied notwithstanding the
416 correction of the deficiency.
417 (c) A class III deficiency is a deficiency that the agency
418 determines will result in no more than minimal physical, mental,
419 or psychosocial discomfort to a the resident or has the
420 potential to compromise a the resident’s ability to maintain or
421 reach his or her highest practical physical, mental, or
422 psychosocial well-being, as defined by an accurate and
423 comprehensive resident assessment, plan of care, and provision
424 of services. A class III deficiency is subject to a civil
425 penalty of $1,000 for an isolated deficiency, $2,000 for a
426 patterned deficiency, and $3,000 for a widespread deficiency.
427 The fine amount is shall be doubled for each deficiency if the
428 facility was previously cited for one or more class I or class
429 II deficiencies during the last licensure inspection or an any
430 inspection or complaint investigation since the last licensure
431 inspection. A citation for a class III deficiency must specify
432 the time within which the deficiency is required to be
433 corrected. If a class III deficiency is corrected within the
434 time specified, a civil penalty may not be imposed.
435 (d) A class IV deficiency is a deficiency that the agency
436 determines has the potential for causing no more than a minor
437 negative impact on a the resident. If the class IV deficiency is
438 isolated, no plan of correction is required.
439 (9) Civil penalties paid by a any licensee under subsection
440 (8) shall be deposited in the Health Care Trust Fund and
441 expended as provided in s. 400.063.
442 (10) Agency records, reports, ranking systems, Internet
443 information, and publications must be promptly updated to
444 reflect the most current agency actions.
445 Section 5. Subsection (7) of section 400.487, Florida
446 Statutes, is amended to read:
447 400.487 Home health service agreements; physician’s,
448 physician assistant’s, and advanced registered nurse
449 practitioner’s treatment orders; patient assessment;
450 establishment and review of plan of care; provision of services;
451 orders not to resuscitate.—
452 (7) Home health agency personnel may withhold or withdraw
453 cardiopulmonary resuscitation if presented with an order not to
454 resuscitate executed pursuant to s. 401.45. The agency shall
455 adopt rules providing for the implementation of such orders.
456 Home health personnel and agencies are shall not be subject to
457 criminal prosecution or civil liability and are not, nor be
458 considered to have engaged in negligent or unprofessional
459 conduct, for withholding or withdrawing cardiopulmonary
460 resuscitation pursuant to such an order and rules adopted by the
461 agency.
462 Section 6. Section 400.497, Florida Statutes, is amended to
463 read:
464 400.497 Rules establishing minimum standards.—The agency
465 may shall adopt, publish, and enforce rules to administer
466 implement part II of chapter 408 and this part, including the
467 agency’s duties and responsibilities under, as applicable, ss.
468 400.506 and 400.509. Rules shall specify, but are not limited
469 to, which must provide reasonable and fair minimum standards
470 relating to:
471 (1) The home health aide competency test and home health
472 aide training. The agency shall create the home health aide
473 competency test and establish the curriculum and instructor
474 qualifications for home health aide training. Licensed home
475 health agencies may provide this training and shall furnish
476 documentation of such training to other licensed home health
477 agencies upon request. Successful passage of the competency test
478 by home health aides may be substituted for the training
479 required under this section and agency any rule adopted pursuant
480 thereto.
481 (2) Shared staffing. The agency shall allow Shared staffing
482 is allowed if the home health agency is part of a retirement
483 community that provides multiple levels of care, is located on
484 one campus, is licensed under this chapter or chapter 429, and
485 otherwise meets the requirements of law and rule.
486 (3) The criteria for the frequency of onsite licensure
487 surveys.
488 (4) Licensure application and renewal.
489 (5) Oversight by the director of nursing, including. The
490 agency shall develop rules related to:
491 (a) Standards that address oversight responsibilities by
492 the director of nursing for of skilled nursing and personal care
493 services provided by the home health agency’s staff;
494 (b) Requirements for a director of nursing to provide to
495 the agency, upon request, a certified daily report of the home
496 health services provided by a specified direct employee or
497 contracted staff member on behalf of the home health agency. The
498 agency may request a certified daily report for up to only for a
499 period not to exceed 2 years before prior to the date of the
500 request; and
501 (c) A quality assurance program for home health services
502 provided by the home health agency.
503 (6) Conditions for using a recent unannounced licensure
504 inspection for the inspection required under in s. 408.806
505 related to a licensure application associated with a change in
506 ownership of a licensed home health agency.
507 (7) The requirements for onsite and electronic
508 accessibility of supervisory personnel of home health agencies.
509 (8) Information to be included in patients’ records.
510 (9) Geographic service areas.
511 (10) Preparation of a comprehensive emergency management
512 plan pursuant to s. 400.492.
513 (a) The Agency for Health Care Administration shall adopt
514 rules establishing minimum criteria for the plan and plan
515 updates, with the concurrence of the Department of Health and in
516 consultation with the Division of Emergency Management.
517 (a)(b) An emergency plan The rules must address the
518 requirements in s. 400.492. In addition, the rules shall provide
519 for the maintenance of patient-specific medication lists that
520 can accompany patients who are transported from their homes.
521 (b)(c) The plan is subject to review and approval by the
522 county health department. During its review, the county health
523 department shall contact state and local health and medical
524 stakeholders when necessary. The county health department shall
525 complete its review to ensure that the plan is in accordance
526 with the requirements of law criteria in the Agency for Health
527 Care Administration rules within 90 days after receipt of the
528 plan and shall approve the plan or advise the home health agency
529 of necessary revisions. If the home health agency fails to
530 submit a plan or fails to submit the requested information or
531 revisions to the county health department within 30 days after
532 written notification from the county health department, the
533 county health department shall notify the Agency for Health Care
534 Administration. The agency shall notify the home health agency
535 that its failure constitutes a deficiency, subject to a fine of
536 $5,000 per occurrence. If the plan is not submitted, information
537 is not provided, or revisions are not made as requested, the
538 agency may impose the fine.
539 (c)(d) For a any home health agency that operates in more
540 than one county, the Department of Health shall review the plan,
541 after consulting with state and local health and medical
542 stakeholders when necessary. The department shall complete its
543 review within 90 days after receipt of the plan and shall
544 approve the plan or advise the home health agency of necessary
545 revisions. The department shall make every effort to avoid
546 imposing differing requirements on a home health agency that
547 operates in more than one county as a result of differing or
548 conflicting comprehensive plan requirements of the counties in
549 which the home health agency operates.
550 (d)(e) The requirements in this subsection do not apply to:
551 1. A facility that is certified under chapter 651 and has a
552 licensed home health agency used exclusively by residents of the
553 facility; or
554 2. A retirement community that consists of both residential
555 units for independent living and either a licensed nursing home
556 or an assisted living facility, and has a licensed home health
557 agency used exclusively by the residents of the retirement
558 community, if, provided the comprehensive emergency management
559 plan for the facility or retirement community provides for
560 continuous care of all residents with special needs during an
561 emergency.
562 Section 7. Paragraph (f) of subsection (12) and subsection
563 (17) of section 400.506, Florida Statutes, are amended to read:
564 400.506 Licensure of nurse registries; requirements;
565 penalties.—
566 (12) Each nurse registry shall prepare and maintain a
567 comprehensive emergency management plan that is consistent with
568 the criteria in this subsection and with the local special needs
569 plan. The plan shall be updated annually. The plan shall include
570 the means by which the nurse registry will continue to provide
571 the same type and quantity of services to its patients who
572 evacuate to special needs shelters which were being provided to
573 those patients prior to evacuation. The plan shall specify how
574 the nurse registry shall facilitate the provision of continuous
575 care by persons referred for contract to persons who are
576 registered pursuant to s. 252.355 during an emergency that
577 interrupts the provision of care or services in private
578 residences. Nurse registries may establish links to local
579 emergency operations centers to determine a mechanism by which
580 to approach specific areas within a disaster area in order for a
581 provider to reach its clients. Nurse registries shall
582 demonstrate a good faith effort to comply with the requirements
583 of this subsection by documenting attempts of staff to follow
584 procedures outlined in the nurse registry’s comprehensive
585 emergency management plan which support a finding that the
586 provision of continuing care has been attempted for patients
587 identified as needing care by the nurse registry and registered
588 under s. 252.355 in the event of an emergency under this
589 subsection.
590 (f) The Agency for Health Care Administration shall adopt
591 rules establishing minimum criteria for the comprehensive
592 emergency management plan and plan updates required by this
593 subsection, with the concurrence of the Department of Health and
594 in consultation with the Division of Emergency Management.
595 (17) The Agency for Health Care Administration shall adopt
596 rules to implement this section and part II of chapter 408.
597 Section 8. Subsection (7) of section 400.509, Florida
598 Statutes, is amended to read:
599 400.509 Registration of particular service providers exempt
600 from licensure; certificate of registration; regulation of
601 registrants.—
602 (7) The Agency for Health Care Administration shall adopt
603 rules to administer this section and part II of chapter 408.
604 Section 9. Subsection (8) of section 400.6095, Florida
605 Statutes, is amended to read:
606 400.6095 Patient admission; assessment; plan of care;
607 discharge; death.—
608 (8) The hospice care team may withhold or withdraw
609 cardiopulmonary resuscitation if presented with an order not to
610 resuscitate executed pursuant to s. 401.45. The department shall
611 adopt rules providing for the implementation of such orders.
612 Hospice staff are shall not be subject to criminal prosecution
613 or civil liability, nor be considered to have engaged in
614 negligent or unprofessional conduct, for withholding or
615 withdrawing cardiopulmonary resuscitation pursuant to such an
616 order and applicable rules. The absence of an order to
617 resuscitate executed pursuant to s. 401.45 does not preclude a
618 physician from withholding or withdrawing cardiopulmonary
619 resuscitation as otherwise permitted by law.
620 Section 10. Section 400.914, Florida Statutes, is amended
621 to read:
622 400.914 Rulemaking; Rules establishing standards.—
623 (1) Pursuant to the intention of the Legislature to provide
624 safe and sanitary facilities and healthful programs, the agency
625 in conjunction with the Division of Children’s Medical Services
626 of the Department of Health may shall adopt and publish rules to
627 administer implement the provisions of this part and part II of
628 chapter 408, which shall include reasonable and fair standards.
629 Any conflict between these rules standards and those established
630 that may be set forth in local, county, or city ordinances shall
631 be resolved in favor of those having statewide effect.
632 (2) The rules must specify, but are not limited to,
633 reasonable and fair standards relating Such standards shall
634 relate to:
635 (a) The assurance that PPEC services are family centered
636 and provide individualized medical, developmental, and family
637 training services.
638 (b) The maintenance of PPEC centers, not in conflict with
639 the provisions of chapter 553 and based upon the size of the
640 structure and number of children, relating to plumbing, heating,
641 lighting, ventilation, and other building conditions, including
642 adequate space, which will ensure the health, safety, comfort,
643 and protection from fire of the children served.
644 (c) The application of the appropriate provisions of the
645 most recent edition of the “Life Safety Code” (NFPA-101) shall
646 be applied.
647 (d) The number and qualifications of all personnel who have
648 responsibility for the care of the children served.
649 (e) All sanitary conditions within the PPEC center and its
650 surroundings, including water supply, sewage disposal, food
651 handling, and general hygiene, and maintenance thereof, which
652 will ensure the health and comfort of children served.
653 (f) Programs and basic services promoting and maintaining
654 the health and development of the children served and meeting
655 the training needs of the children’s legal guardians.
656 (g) Supportive, contracted, other operational, and
657 transportation services.
658 (h) Maintenance of appropriate medical records, data, and
659 information relative to the children and programs. Such records
660 shall be maintained in the facility for inspection by the
661 agency.
662 (2) The agency shall adopt rules to ensure that:
663 (a) No child attends a PPEC center for more than 12 hours
664 within a 24-hour period.
665 (b) No PPEC center provides services other than those
666 provided to medically or technologically dependent children.
667 Section 11. Section 400.9141, Florida Statutes, is created
668 to read:
669 400.9141 Limitations.—
670 (1) A child may not attend a PPEC center for more than 12
671 hours within a 24-hour period.
672 (2) A PPEC center may provide services only to medically or
673 technologically dependent children.
674 Section 12. Paragraph (a) of subsection (20) of section
675 400.934, Florida Statutes, is amended to read:
676 400.934 Minimum standards.—As a requirement of licensure,
677 home medical equipment providers shall:
678 (20)(a) Prepare and maintain a comprehensive emergency
679 management plan that meets minimum criteria established by
680 agency rule, including criteria for the maintenance of patient
681 equipment and supply lists that accompany patients who are
682 transported from their homes. Such rules shall be formulated in
683 consultation with the Department of Health and the Division of
684 Emergency Management under s. 400.935. The plan shall be updated
685 annually and shall provide for continuing home medical equipment
686 services for life-supporting or life-sustaining equipment, as
687 defined in s. 400.925, during an emergency that interrupts home
688 medical equipment services in a patient’s home. The plan must
689 shall include:
690 1. The means by which the home medical equipment provider
691 will continue to provide equipment to perform the same type and
692 quantity of services to its patients who evacuate to special
693 needs shelters which were being provided to those patients
694 before prior to evacuation.
695 2. The means by which the home medical equipment provider
696 establishes and maintains an effective response to emergencies
697 and disasters, including plans for:
698 a. Notification of staff when emergency response measures
699 are initiated.
700 b. Communication between staff members, county health
701 departments, and local emergency management agencies, which
702 includes provisions for a backup communications system.
703 c. Identification of resources necessary to continue
704 essential care or services or referrals to other organizations
705 subject to written agreement.
706 d. Contacting and prioritizing patients in need of
707 continued medical equipment services and supplies.
708 Section 13. Section 400.935, Florida Statutes, is amended
709 to read:
710 400.935 Rule authority Rules establishing minimum
711 standards.—The agency shall adopt, publish, and enforce rules as
712 necessary to administer implement this part and part II of
713 chapter 408, which must provide reasonable and fair minimum
714 standards relating to:
715 (1) The qualifications and minimum training requirements of
716 all home medical equipment provider personnel.
717 (2) Financial ability to operate.
718 (3) The administration of the home medical equipment
719 provider.
720 (4) Procedures for maintaining patient records.
721 (5) Ensuring that the home medical equipment and services
722 provided by a home medical equipment provider are in accordance
723 with the plan of treatment established for each patient, when
724 provided as a part of a plan of treatment.
725 (6) Contractual arrangements for the provision of home
726 medical equipment and services by providers not employed by the
727 home medical equipment provider providing for the consumer’s
728 needs.
729 (7) Physical location and zoning requirements.
730 (8) Home medical equipment requiring home medical equipment
731 services.
732 (9) Preparation of the comprehensive emergency management
733 plan under s. 400.934 and the establishment of minimum criteria
734 for the plan, including the maintenance of patient equipment and
735 supply lists that can accompany patients who are transported
736 from their homes. Such rules shall be formulated in consultation
737 with the Department of Health and the Division of Emergency
738 Management.
739 Section 14. Subsection (5) of section 400.962, Florida
740 Statutes, is amended to read:
741 400.962 License required; license application.—
742 (5) The applicant must agree to provide or arrange for
743 active treatment services by an interdisciplinary team in order
744 to maximize individual independence or prevent regression or
745 loss of functional status. Standards for active treatment shall
746 be adopted by the Agency for Health Care Administration by rule
747 pursuant to ss. 120.536(1) and 120.54. Active treatment services
748 shall be provided in accordance with the individual support plan
749 and shall be reimbursed as part of the per diem rate as paid
750 under the Medicaid program.
751 Section 15. Subsections (2) and (3) of section 400.967,
752 Florida Statutes, are amended to read:
753 400.967 Rules and classification of deficiencies.—
754 (2) Pursuant to the intention of the Legislature, The
755 agency, in consultation with the Agency for Persons with
756 Disabilities and the Department of Elderly Affairs, may shall
757 adopt and enforce rules as necessary to administer this part and
758 part II of chapter 408, which shall include reasonable and fair
759 criteria governing:
760 (a) The location and construction of the facility;
761 including fire and life safety, plumbing, heating, cooling,
762 lighting, ventilation, and other housing conditions that ensure
763 the health, safety, and comfort of residents. The agency shall
764 establish standards for facilities and equipment to increase the
765 extent to which new facilities, and a new wing or floor added to
766 an existing facility after July 1, 2000, are structurally
767 capable of serving as shelters only for residents, staff, and
768 families of residents and staff, and equipped to be self
769 supporting during and immediately following disasters. The
770 agency shall update or revise the criteria as the need arises.
771 All Facilities must comply with the those lifesafety code
772 requirements and building code standards applicable when at the
773 time of approval of their construction plans are approved. The
774 agency may require alterations to a building if it determines
775 that an existing condition constitutes a distinct hazard to
776 life, health, or safety. The agency may state the shall adopt
777 fair and reasonable rules setting forth conditions under which
778 existing facilities undergoing additions, alterations,
779 conversions, renovations, or repairs are required to comply with
780 the most recent updated or revised standards.
781 (b) The number and qualifications of all personnel,
782 including management, medical, nursing, and other personnel,
783 having responsibility for any part of the care given to
784 residents.
785 (c) All Sanitary conditions within the facility and its
786 surroundings, including water supply, sewage disposal, food
787 handling, and general hygiene, which will ensure the health and
788 comfort of residents.
789 (d) The Equipment essential to the health and welfare of
790 the residents.
791 (e) A uniform accounting system.
792 (f) The care, treatment, and maintenance of residents and
793 the assessment measurement of the quality and adequacy thereof.
794 (g) The preparation and annual update of a comprehensive
795 emergency management plan. After consultation with the Division
796 of Emergency Management, the agency may establish shall adopt
797 rules establishing minimum criteria for the plan after
798 consultation with the Division of Emergency Management. At a
799 minimum, the rules must provide for plan components that address
800 emergency evacuation transportation; adequate sheltering
801 arrangements; postdisaster activities, including emergency
802 power, food, and water; postdisaster transportation; supplies;
803 staffing; emergency equipment; individual identification of
804 residents and transfer of records; and responding to family
805 inquiries. The comprehensive emergency management plan is
806 subject to review and approval by the local emergency management
807 agency. During the its review, the local emergency management
808 agency shall ensure that the following agencies, at a minimum,
809 are given the opportunity to review the plan: the Department of
810 Elderly Affairs, the Agency for Persons with Disabilities, the
811 Agency for Health Care Administration, and the Division of
812 Emergency Management. Also, Appropriate volunteer organizations
813 must also be given the opportunity to review the plan. The local
814 emergency management agency shall complete its review within 60
815 days and either approve the plan or advise the facility of
816 necessary revisions.
817 (h) The use of restraint and seclusion. Such criteria rules
818 must be consistent with recognized best practices; prohibit
819 inherently dangerous restraint or seclusion procedures;
820 establish limitations on the use and duration of restraint and
821 seclusion; establish measures to ensure the safety of clients
822 and staff during an incident of restraint or seclusion;
823 establish procedures for staff to follow before, during, and
824 after incidents of restraint or seclusion, including
825 individualized plans for the use of restraints or seclusion in
826 emergency situations; establish professional qualifications of
827 and training for staff who may order or be engaged in the use of
828 restraint or seclusion; establish requirements for facility data
829 collection and reporting relating to the use of restraint and
830 seclusion; and establish procedures relating to the
831 documentation of the use of restraint or seclusion in the
832 client’s facility or program record.
833 (3) If The agency shall adopt rules to provide that, when
834 the criteria established under this part and part II of chapter
835 408 are not met, such deficiencies shall be classified according
836 to the nature of the deficiency. The agency shall indicate the
837 classification on the face of the notice of deficiencies as
838 follows:
839 (a) Class I deficiencies are those which the agency
840 determines present an imminent danger to the residents or guests
841 of the facility or a substantial probability that death or
842 serious physical harm will would result therefrom. The condition
843 or practice constituting a class I violation must be abated or
844 eliminated immediately, unless the agency determines that a
845 fixed period of time, as determined by the agency, is required
846 for correction. A class I deficiency is subject to a civil
847 penalty in an amount of at least not less than $5,000 but not
848 more than and not exceeding $10,000 for each deficiency. A fine
849 may be levied notwithstanding the correction of the deficiency.
850 (b) Class II deficiencies are those which the agency
851 determines have a direct or immediate relationship to the
852 health, safety, or security of the facility residents but do not
853 meet the criteria established for, other than class I
854 deficiencies. A class II deficiency is subject to a civil
855 penalty in an amount of at least not less than $1,000 and not
856 more than not exceeding $5,000 for each deficiency. A citation
857 for a class II deficiency must shall specify the time within
858 which the deficiency must be corrected. If a class II deficiency
859 is corrected within the time specified, a no civil penalty may
860 not shall be imposed, unless it is a repeated offense.
861 (c) Class III deficiencies are those which the agency
862 determines to have an indirect or potential relationship to the
863 health, safety, or security of the facility residents but do not
864 meet the criteria for, other than class I or class II
865 deficiencies. A class III deficiency is subject to a civil
866 penalty of at least not less than $500 and not more than
867 exceeding $1,000 for each deficiency. A citation for a class III
868 deficiency must shall specify the time within which the
869 deficiency must be corrected. If a class III deficiency is
870 corrected within the time specified, a no civil penalty may not
871 shall be imposed, unless it is a repeated offense.
872 Section 16. Subsection (2) of section 400.980, Florida
873 Statutes, is amended to read:
874 400.980 Health care services pools.—
875 (2) The requirements of part II of chapter 408 apply to the
876 provision of services that require licensure or registration
877 pursuant to this part and part II of chapter 408 and to entities
878 registered by or applying for such registration from the agency
879 pursuant to this part. Registration or a license issued by the
880 agency is required for the operation of a health care services
881 pool in this state. In accordance with s. 408.805, an applicant
882 or licensee shall pay a fee for each license application
883 submitted using this part, part II of chapter 408, and
884 applicable rules. The agency shall adopt rules and provide forms
885 required for such registration and shall impose a registration
886 fee in an amount sufficient to cover the cost of administering
887 this part and part II of chapter 408. In addition to the
888 requirements in part II of chapter 408, the registrant must
889 provide the agency with any change of information contained on
890 the original registration application within 14 days before
891 prior to the change.
892 Section 17. Subsection (43) of section 409.912, Florida
893 Statutes, is amended to read:
894 409.912 Cost-effective purchasing of health care.—The
895 agency shall purchase goods and services for Medicaid recipients
896 in the most cost-effective manner consistent with the delivery
897 of quality medical care. To ensure that medical services are
898 effectively utilized, the agency may, in any case, require a
899 confirmation or second physician’s opinion of the correct
900 diagnosis for purposes of authorizing future services under the
901 Medicaid program. This section does not restrict access to
902 emergency services or poststabilization care services as defined
903 in 42 C.F.R. part 438.114. Such confirmation or second opinion
904 shall be rendered in a manner approved by the agency. The agency
905 shall maximize the use of prepaid per capita and prepaid
906 aggregate fixed-sum basis services when appropriate and other
907 alternative service delivery and reimbursement methodologies,
908 including competitive bidding pursuant to s. 287.057, designed
909 to facilitate the cost-effective purchase of a case-managed
910 continuum of care. The agency shall also require providers to
911 minimize the exposure of recipients to the need for acute
912 inpatient, custodial, and other institutional care and the
913 inappropriate or unnecessary use of high-cost services. The
914 agency shall contract with a vendor to monitor and evaluate the
915 clinical practice patterns of providers in order to identify
916 trends that are outside the normal practice patterns of a
917 provider’s professional peers or the national guidelines of a
918 provider’s professional association. The vendor must be able to
919 provide information and counseling to a provider whose practice
920 patterns are outside the norms, in consultation with the agency,
921 to improve patient care and reduce inappropriate utilization.
922 The agency may mandate prior authorization, drug therapy
923 management, or disease management participation for certain
924 populations of Medicaid beneficiaries, certain drug classes, or
925 particular drugs to prevent fraud, abuse, overuse, and possible
926 dangerous drug interactions. The Pharmaceutical and Therapeutics
927 Committee shall make recommendations to the agency on drugs for
928 which prior authorization is required. The agency shall inform
929 the Pharmaceutical and Therapeutics Committee of its decisions
930 regarding drugs subject to prior authorization. The agency is
931 authorized to limit the entities it contracts with or enrolls as
932 Medicaid providers by developing a provider network through
933 provider credentialing. The agency may competitively bid single
934 source-provider contracts if procurement of goods or services
935 results in demonstrated cost savings to the state without
936 limiting access to care. The agency may limit its network based
937 on the assessment of beneficiary access to care, provider
938 availability, provider quality standards, time and distance
939 standards for access to care, the cultural competence of the
940 provider network, demographic characteristics of Medicaid
941 beneficiaries, practice and provider-to-beneficiary standards,
942 appointment wait times, beneficiary use of services, provider
943 turnover, provider profiling, provider licensure history,
944 previous program integrity investigations and findings, peer
945 review, provider Medicaid policy and billing compliance records,
946 clinical and medical record audits, and other factors. Providers
947 are not entitled to enrollment in the Medicaid provider network.
948 The agency shall determine instances in which allowing Medicaid
949 beneficiaries to purchase durable medical equipment and other
950 goods is less expensive to the Medicaid program than long-term
951 rental of the equipment or goods. The agency may establish rules
952 to facilitate purchases in lieu of long-term rentals in order to
953 protect against fraud and abuse in the Medicaid program as
954 defined in s. 409.913. The agency may seek federal waivers
955 necessary to administer these policies.
956 (43) Subject to the availability of funds, the agency shall
957 mandate a recipient’s participation in a provider lock-in
958 program, when appropriate, if a recipient is found by the agency
959 to have used Medicaid goods or services at a frequency or amount
960 not medically necessary, limiting the receipt of goods or
961 services to medically necessary providers after the 21-day
962 appeal process has ended, for at least a period of not less than
963 1 year. The lock-in programs must shall include, but are not
964 limited to, pharmacies, medical doctors, and infusion clinics.
965 The limitation does not apply to emergency services and care
966 provided to the recipient in a hospital emergency department.
967 The agency shall seek any federal waivers necessary to implement
968 this subsection. The agency shall adopt any rules necessary to
969 comply with or administer this subsection. This subsection
970 expires October 1, 2014.
971 Section 18. Subsection (4) of section 429.255, Florida
972 Statutes, is amended to read:
973 429.255 Use of personnel; emergency care.—
974 (4) Facility staff may withhold or withdraw cardiopulmonary
975 resuscitation or the use of an automated external defibrillator
976 if presented with an order not to resuscitate executed pursuant
977 to s. 401.45. The department shall adopt rules providing for the
978 implementation of such orders. Facility staff and facilities are
979 shall not be subject to criminal prosecution or civil liability,
980 nor be considered to have engaged in negligent or unprofessional
981 conduct, for withholding or withdrawing cardiopulmonary
982 resuscitation or use of an automated external defibrillator
983 pursuant to such an order and rules adopted by the department.
984 The absence of an order to resuscitate executed pursuant to s.
985 401.45 does not preclude a physician from withholding or
986 withdrawing cardiopulmonary resuscitation or use of an automated
987 external defibrillator as otherwise permitted by law.
988 Section 19. Subsection (3) of section 429.73, Florida
989 Statutes, is amended to read:
990 429.73 Rules and standards relating to adult family-care
991 homes.—
992 (3) The department shall adopt rules providing for the
993 implementation of orders not to resuscitate. The provider may
994 withhold or withdraw cardiopulmonary resuscitation if presented
995 with an order not to resuscitate executed pursuant to s. 401.45.
996 The provider is shall not be subject to criminal prosecution or
997 civil liability, nor be considered to have engaged in negligent
998 or unprofessional conduct, for withholding or withdrawing
999 cardiopulmonary resuscitation pursuant to such an order and
1000 applicable rules.
1001 Section 20. Subsection (10) of section 440.102, Florida
1002 Statutes, is amended to read:
1003 440.102 Drug-free workplace program requirements.—The
1004 following provisions apply to a drug-free workplace program
1005 implemented pursuant to law or to rules adopted by the Agency
1006 for Health Care Administration:
1007 (10) RULES.—The Agency for Health Care Administration shall
1008 adopt rules Pursuant to s. 112.0455, part II of chapter 408, and
1009 criteria established by the United States Department of Health
1010 and Human Services, the agency shall adopt as general guidelines
1011 for modeling drug-free workplace laboratories, including
1012 concerning, but not limited to:
1013 (a) Standards for licensing drug-testing laboratories and
1014 suspension and revocation of such licenses.
1015 (b) Urine, hair, blood, and other body specimens and
1016 minimum specimen amounts that are appropriate for drug testing.
1017 (c) Methods of analysis and procedures to ensure reliable
1018 drug-testing results, including standards for initial tests and
1019 confirmation tests.
1020 (d) Minimum cutoff detection levels for each drug or
1021 metabolites of such drug for the purposes of determining a
1022 positive test result.
1023 (e) Chain-of-custody procedures to ensure proper
1024 identification, labeling, and handling of specimens tested.
1025 (f) Retention, storage, and transportation procedures to
1026 ensure reliable results on confirmation tests and retests.
1027 Section 21. Subsection (2) of section 483.245, Florida
1028 Statutes, is amended to read:
1029 483.245 Rebates prohibited; penalties.—
1030 (2) The agency may establish and shall adopt rules that
1031 assess administrative penalties for acts prohibited by
1032 subsection (1). If In the case of an entity is licensed by the
1033 agency, such penalties may include any disciplinary action
1034 available to the agency under the appropriate licensing laws. If
1035 In the case of an entity is not licensed by the agency, such
1036 penalties may include:
1037 (a) A fine not to exceed $1,000;
1038 (b) If applicable, a recommendation by the agency to the
1039 appropriate licensing board that disciplinary action be taken.
1040 Section 22. Subsection (2) of section 765.541, Florida
1041 Statutes, is amended to read:
1042 765.541 Certification of procurement organizations; agency
1043 responsibilities.—The agency shall:
1044 (2) Adopt rules as necessary to administer that set forth
1045 appropriate standards and guidelines for the program in
1046 accordance with ss. 765.541-765.546 and part II of chapter 408.
1047 (a) These Standards and guidelines for the program adopted
1048 by the agency must be substantially based on the existing laws
1049 of the Federal Government and this state, and the existing
1050 standards and guidelines of the United Network for Organ Sharing
1051 (UNOS), the American Association of Tissue Banks (AATB), the
1052 South-Eastern Organ Procurement Foundation (SEOPF), the North
1053 American Transplant Coordinators Organization (NATCO), and the
1054 Eye Bank Association of America (EBAA) which were in effect as
1055 of January 1, 2014.
1056 (b) In addition, the agency shall, Before adopting these
1057 standards and guidelines for the program, the agency shall seek
1058 input from all procurement organizations based in this state.
1059 Section 23. Subsection (2) of section 765.544, Florida
1060 Statutes, is amended to read:
1061 765.544 Fees; organ and tissue donor education and
1062 procurement.—
1063 (2) The agency shall specify by rule the administrative
1064 penalties for the purpose of ensuring adherence to the standards
1065 of quality and practice required by this chapter, part II of
1066 chapter 408, and applicable rules of the agency for continued
1067 certification.
1068 Section 24. This act shall take effect July 1, 2014.