Florida Senate - 2017                              CS for SB 474
       By the Committee on Health Policy; and Senator Grimsley
       588-02952A-17                                          2017474c1
    1                        A bill to be entitled                      
    2         An act relating to hospice care; amending s.
    3         400.60501, F.S.; requiring the Department of Elderly
    4         Affairs, in conjunction with the Agency for Health
    5         Care Administration, to adopt national hospice outcome
    6         measures by a specified date and to make such measures
    7         available to the public; creating s. 400.6096, F.S.;
    8         authorizing certain hospice personnel to assist in the
    9         disposal of certain prescribed controlled substances;
   10         requiring a hospice that chooses to assist in the
   11         disposal of certain prescribed controlled substances
   12         to establish policies, procedures, and systems for the
   13         disposal; authorizing a hospice physician, nurse, or
   14         social worker to assist in the disposals of certain
   15         prescribed controlled substances; providing
   16         requirements for such disposals; amending s. 400.611,
   17         F.S.; requiring a hospice to maintain an up-to-date
   18         interdisciplinary record of care; revising the patient
   19         records retention period; providing for the
   20         confidentiality of the interdisciplinary record of
   21         patient care; specifying to whom and under what
   22         conditions a hospice may release a patient’s
   23         interdisciplinary record of care; defining a term;
   24         requiring a hospice to release patient statistical
   25         data to certain agencies; specifying that information
   26         from patient records is confidential and exempt from
   27         certain provisions; providing an effective date.
   29  Be It Enacted by the Legislature of the State of Florida:
   31         Section 1. Section 400.60501, Florida Statutes, is amended
   32  to read:
   33         400.60501 Outcome measures; adoption of federal quality
   34  measures; public reporting national initiatives; annual report.—
   35         (1) No later than December 31, 2019 2007, the department of
   36  Elderly Affairs, in conjunction with the agency for Health Care
   37  Administration, shall adopt the national hospice develop outcome
   38  measures in 42 C.F.R. part 418 to determine the quality and
   39  effectiveness of hospice care for hospices licensed in the
   40  state. At a minimum, these outcome measures shall include a
   41  requirement that 50 percent of patients who report severe pain
   42  on a 0-to-10 scale must report a reduction to 5 or less by the
   43  end of the 4th day of care on the hospice program.
   44         (2) For hospices licensed in the state, The department of
   45  Elderly Affairs, in conjunction with the agency for Health Care
   46  Administration, shall:
   47         (a) Make available to the public the national hospice
   48  outcome measures in a format that is comprehensible by a
   49  layperson and that allows a consumer to compare such measures of
   50  one or more hospices Consider and adopt national initiatives,
   51  such as those developed by the national hospice and Palliative
   52  Care Organization, to set benchmarks for measuring the quality
   53  of hospice care provided in the state.
   54         (b) Develop an annual report that analyzes and evaluates
   55  the information collected under this act and any other data
   56  collection or reporting provisions of law.
   57         Section 2. Section 400.6096, Florida Statutes, is created
   58  to read:
   59         400.6096 Disposal of prescribed controlled substances
   60  following the death of a patient in the home.—
   61         (1) A hospice physician, nurse, or social worker is
   62  authorized to assist in the disposal of a controlled substance
   63  prescribed to a patient at the time of the patient’s death
   64  pursuant to the disposal regulations in 21 C.F.R. s. 1317.
   65         (2) A hospice that assists in the disposal of a prescribed
   66  controlled substance found in the patient’s home at the time of
   67  the patient’s death must establish a written policy, procedure,
   68  or system for acceptable disposal methods.
   69         (3) A hospice physician, nurse, or social worker, upon the
   70  patient’s death and with the permission of a family member or a
   71  caregiver of the patient, may assist in the disposal of an
   72  unused controlled substance prescribed to the patient, pursuant
   73  to the written policy, procedure, or system established under
   74  subsection (2).
   75         (4) The prescribed controlled substance disposal procedure
   76  must be carried out in the patient’s home. Hospice staff and
   77  volunteers are not authorized to remove a prescribed controlled
   78  substance from the patient’s home.
   79         Section 3. Section 400.611, Florida Statutes, is amended to
   80  read:
   81         400.611 Interdisciplinary records of care; confidentiality;
   82  release of records.—
   83         (1) A hospice shall maintain an up-to-date,
   84  interdisciplinary record of care being given and patient and
   85  family status shall be kept. Records shall contain pertinent
   86  past and current medical, nursing, social, and other therapeutic
   87  information and such other information that is necessary for the
   88  safe and adequate care of the patient. Notations regarding all
   89  aspects of care for the patient and family shall be made in the
   90  record. When services are terminated, the record shall show the
   91  date and reason for termination.
   92         (2) Patient records shall be retained for a period of 5 6
   93  years after termination of hospice services, unless otherwise
   94  provided by law. In the case of a patient who is a minor, the 5
   95  6-year period shall begin on the date the patient reaches or
   96  would have reached the age of majority.
   97         (3) The interdisciplinary record of patient records of care
   98  and billing records are confidential.
   99         (4) A hospice may not release a patient’s interdisciplinary
  100  record or any portion thereof, unless the person requesting the
  101  information provides to the hospice:
  102         (a) A patient authorization executed by the patient; or
  103  legal guardian has given express written informed consent;
  104         (b) If the patient is incapacitated, a patient
  105  authorization executed before the patient’s death by the
  106  patient’s then acting legal guardian, health care surrogate,
  107  health care proxy, or agent under power of attorney;
  108         (c)A court order appointing the person as the
  109  administrator, curator, executor, or personal representative of
  110  the patient’s estate with authority to obtain the patient’s
  111  medical records;
  112         (d) If a judicial appointment has not been made pursuant to
  113  paragraph (c), a last will that is self-proved under s. 732.503
  114  and designates the person to act as the patient’s personal
  115  representative; or
  116         (e)An order by a court of competent jurisdiction to
  117  release the interdisciplinary record to the person has so
  118  ordered; or
  119         (c) A state or federal agency, acting under its statutory
  120  authority, requires submission of aggregate statistical data.
  121  Any information obtained from patient records by a state agency
  122  pursuant to its statutory authority is confidential and exempt
  123  from the provisions of s. 119.07(1).
  124         (5) For purposes of this section, the term “patient
  125  authorization” means an unrevoked written statement by the
  126  patient, or an oral statement made by the patient which has been
  127  reduced to writing in the patient’s interdisciplinary record of
  128  care, or, in the case of an incapacitated patient, by the
  129  patient’s then acting legal guardian, health care surrogate,
  130  agent under a power of attorney, or health care proxy giving the
  131  patient’s permission to release the interdisciplinary record to
  132  a person requesting the record.
  133         (6) A hospice must release requested aggregate patient
  134  statistical data to a state or federal agency acting under its
  135  statutory authority. Any information obtained from patient
  136  records by a state agency pursuant to its statutory authority is
  137  confidential and exempt from s. 119.07(1).
  138         Section 4. This act shall take effect July 1, 2017.