Florida Senate - 2017                                     SB 474
       By Senator Grimsley
       26-00254A-17                                           2017474__
    1                        A bill to be entitled                      
    2         An act relating to hospice care; amending s. 400.6005,
    3         F.S.; revising legislative findings and intent;
    4         amending s. 400.601, F.S.; redefining the term
    5         “hospice”; defining the terms “hospice program” and
    6         “seriously ill”; amending s. 400.60501, F.S.;
    7         requiring the Department of Elderly Affairs, in
    8         conjunction with the Agency for Health Care
    9         Administration, to adopt by rule certain outcome
   10         measures by a specified date; requiring the
   11         department, in conjunction with the agency, to adopt
   12         national hospice outcome measures and develop a system
   13         for publicly reporting the measures; creating s.
   14         400.6093, F.S.; authorizing hospices, or providers
   15         operating under contract with a hospice, to provide
   16         palliative care to seriously ill persons and their
   17         family members; providing construction; amending s.
   18         400.6095, F.S.; making technical changes; creating s.
   19         400.6096, F.S.; authorizing a hospice to assist in the
   20         disposal of certain prescribed controlled substances;
   21         requiring a hospice that chooses to assist in the
   22         disposals of certain prescribed controlled substances
   23         to establish policies, procedures, and systems for the
   24         disposals; authorizing a hospice physician, nurse, or
   25         social worker to assist in the disposals of certain
   26         prescribed controlled substances; providing
   27         requirements for such disposals; providing an
   28         effective date.
   30  Be It Enacted by the Legislature of the State of Florida:
   32         Section 1. Section 400.6005, Florida Statutes, is amended
   33  to read:
   34         400.6005 Legislative findings and intent.—The Legislature
   35  finds that a terminally ill patient individuals and their
   36  families, who is are no longer pursuing curative medical
   37  treatment, and the patient’s family should have the opportunity
   38  to select a support system that allows permits the patient to
   39  exercise maximum independence and dignity during the final days
   40  of life. The Legislature also finds that a seriously ill person
   41  and the person’s family should have the opportunity to select a
   42  support system that provides palliative care and supportive care
   43  and allows the person to exercise maximum independence while
   44  receiving such care. The Legislature finds that hospice care
   45  provides a cost-effective and less intrusive form of medical
   46  care while meeting the social, psychological, and spiritual
   47  needs of terminally ill patients and their families and
   48  seriously ill persons and their families. The intent of this
   49  part is to provide for the development, establishment, and
   50  enforcement of basic standards to ensure the safe and adequate
   51  care of persons receiving hospice services.
   52         Section 2. Section 400.601, Florida Statutes, is amended to
   53  read:
   54         400.601 Definitions.—As used in this part, the term:
   55         (1) “Agency” means the Agency for Health Care
   56  Administration.
   57         (2) “Department” means the Department of Elderly Affairs.
   58         (3) “Hospice” means a centrally administered corporation or
   59  a limited liability company that provides a continuum of
   60  palliative care and supportive care for a the terminally ill
   61  patient and his or her family or a seriously ill person and his
   62  or her family.
   63         (4) “Hospice care team” means an interdisciplinary team of
   64  qualified professionals and volunteers who, in consultation with
   65  a the patient, the patient’s family, and the patient’s primary
   66  or attending physician, collectively assess, coordinate, and
   67  provide the appropriate palliative care and supportive care to
   68  hospice patients and their families.
   69         (5) “Hospice program” means a program offered by a hospice
   70  which provides a continuum of palliative care and supportive
   71  care for a patient and his or her family or a seriously ill
   72  person and his or her family.
   73         (6)(5) “Hospice residential unit” means a homelike living
   74  facility, other than a facility licensed under other parts of
   75  this chapter, under chapter 395, or under chapter 429, which
   76  that is operated by a hospice for the benefit of its patients
   77  and is considered by a patient who lives there to be his or her
   78  primary residence.
   79         (7)(6) “Hospice services” means items and services
   80  furnished to a patient and family by a hospice, or by others
   81  under arrangements with such a program, in a place of temporary
   82  or permanent residence used as the patient’s home for the
   83  purpose of maintaining the patient at home; or, if the patient
   84  needs short-term institutionalization, the services shall be
   85  furnished in cooperation with those contracted institutions or
   86  in the hospice inpatient facility.
   87         (8)(7) “Palliative care” means services or interventions
   88  that which are not curative but are provided for the reduction
   89  or abatement of pain and human suffering.
   90         (9)(8) “Patient” means the terminally ill individual
   91  receiving hospice services.
   92         (10)(9) “Plan of care” means a written assessment by the
   93  hospice of each patient’s and family’s needs and preferences,
   94  and the services to be provided by the hospice to meet those
   95  needs.
   96         (11) “Seriously ill” means that the person has a persistent
   97  medical condition that materially and adversely affects the
   98  person’s quality of life; that is burdensome in its symptoms,
   99  pain, or caregiver stress; and that may be managed through
  100  palliative care.
  101         (12)(10) “Terminally ill” means that the patient has a
  102  medical prognosis that his or her life expectancy is 1 year or
  103  less if the illness runs its normal course.
  104         Section 3. Section 400.60501, Florida Statutes, is amended
  105  to read:
  106         400.60501 Outcome measures; adoption of federal quality
  107  measures; public reporting national initiatives; annual report.—
  108         (1) No later than December 31, 2019 2007, the department of
  109  Elderly Affairs, in conjunction with the agency for Health Care
  110  Administration, shall adopt develop outcome measures to
  111  determine the quality and effectiveness of hospice care for
  112  hospices licensed in the state. At a minimum, these outcome
  113  measures shall include a requirement that 50 percent of patients
  114  who report severe pain on a 0-to-10 scale must report a
  115  reduction to 5 or less by the end of the 4th day of care on the
  116  hospice program.
  117         (2) For hospices licensed in the state, the department of
  118  Elderly Affairs, in conjunction with the agency for Health Care
  119  Administration, shall:
  120         (a) Consider and Adopt national initiatives, such as those
  121  developed by the national hospice outcome measures found in 42
  122  C.F.R. part 418 and Palliative Care Organization, to set
  123  benchmarks for measuring the quality of hospice care provided in
  124  the state.
  125         (b) Develop a system for publicly reporting these national
  126  hospice outcome measures identified as useful consumer
  127  information.
  128         (c)(b) Develop an annual report that analyzes and evaluates
  129  the information collected under this act and any other data
  130  collection or reporting provisions of law.
  131         Section 4. Section 400.6093, Florida Statutes, is created
  132  to read:
  133         400.6093 Community palliative care services.
  134  Notwithstanding any other provision of law, a hospice may
  135  provide palliative care to a seriously ill person and his or her
  136  family members. Such care may be provided directly by the
  137  hospice or by other providers under contract with the hospice.
  138  This section does not preclude the provision of palliative care
  139  to seriously ill persons by any other health care provider or
  140  health care facility that is otherwise authorized to provide
  141  such care. This section does not mandate or prescribe additional
  142  Medicaid coverage.
  143         Section 5. Subsections (1) and (2) of section 400.6095,
  144  Florida Statutes, are amended to read:
  145         400.6095 Patient admission; assessment; plan of care;
  146  discharge; death.—
  147         (1) Each hospice shall make its services available to all
  148  patients terminally ill persons and their families without
  149  regard to age, gender, national origin, sexual orientation,
  150  disability, diagnosis, cost of therapy, ability to pay, or life
  151  circumstances. A hospice may shall not impose any value or
  152  belief system on its patients or their families and shall
  153  respect the values and belief systems of its patients and their
  154  families.
  155         (2) Admission of a patient with a terminal illness to a
  156  hospice program shall be made upon a diagnosis and prognosis of
  157  terminal illness by a physician licensed pursuant to chapter 458
  158  or chapter 459 and must shall be dependent on the expressed
  159  request and informed consent of the patient.
  160         Section 6. Section 400.6096, Florida Statutes, is created
  161  to read:
  162         400.6096 Disposal of prescribed controlled substances
  163  following the death of a patient in the home.—
  164         (1) A hospice that assists in the disposal of a prescribed
  165  controlled substance in the patient’s home under this section
  166  must establish clearly defined policies, procedures, and systems
  167  for acceptable disposal methods.
  168         (2) A hospice physician, nurse, or social worker, upon the
  169  patient’s death and with the permission of a family member or a
  170  caregiver of the patient, is authorized to assist in the
  171  disposal in the patient’s home of an unused controlled substance
  172  prescribed to the decedent pursuant to the procedures
  173  established under subsection (1).
  174         (3) Established disposal procedures must be carried out in
  175  the patient’s home. Hospice staff and volunteers are not
  176  authorized to remove a prescribed controlled substance from the
  177  patient’s home.
  178         (4) Disposal of a prescribed controlled substance in the
  179  patient’s home is optional for a hospice. The authorization
  180  provided in subsection (2) does not require a hospice to
  181  establish policies, procedures, or systems for acceptable
  182  disposal methods of a prescribed controlled substance in the
  183  patient’s home.
  184         Section 7. This act shall take effect July 1, 2017.