2017 Legislature                            CS for CS for SB 474
    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 and survey data by a specified date and to
    7         make such measures available to the public; creating
    8         s. 400.6096, F.S.; authorizing certain hospice
    9         personnel to assist in the disposal of certain
   10         prescribed controlled substances; requiring a hospice
   11         that chooses to assist in the disposal of certain
   12         prescribed controlled substances to establish
   13         policies, procedures, and systems for the disposal;
   14         authorizing a hospice physician, nurse, or social
   15         worker to assist in the disposals of certain
   16         prescribed controlled substances; providing
   17         requirements for such disposals; amending s. 400.611,
   18         F.S.; requiring a hospice to maintain an up-to-date
   19         interdisciplinary record of care; revising the patient
   20         records retention period; providing for the
   21         confidentiality of the interdisciplinary record of
   22         patient care; specifying to whom and under what
   23         conditions a hospice may release a patient’s
   24         interdisciplinary record of care; defining a term;
   25         requiring a hospice to release patient statistical
   26         data to certain agencies; specifying that information
   27         from patient records is confidential and exempt from
   28         certain provisions; providing an effective date.
   30  Be It Enacted by the Legislature of the State of Florida:
   32         Section 1. Section 400.60501, Florida Statutes, is amended
   33  to read:
   34         400.60501 Outcome measures; adoption of federal quality
   35  measures; public reporting national initiatives; annual report.—
   36         (1) No later than December 31, 2019 2007, the department of
   37  Elderly Affairs, in conjunction with the agency for Health Care
   38  Administration, shall adopt the national hospice develop outcome
   39  measures and survey data in 42 C.F.R. part 418 to determine the
   40  quality and effectiveness of hospice care for hospices licensed
   41  in the state. At a minimum, these outcome measures shall include
   42  a requirement that 50 percent of patients who report severe pain
   43  on a 0-to-10 scale must report a reduction to 5 or less by the
   44  end of the 4th day of care on the hospice program.
   45         (2) For hospices licensed in the state, The department of
   46  Elderly Affairs, in conjunction with the agency for Health Care
   47  Administration, shall:
   48         (a) Make available to the public the national hospice
   49  outcome measures and survey data in a format that is
   50  comprehensible by a layperson and that allows a consumer to
   51  compare such measures of one or more hospices Consider and adopt
   52  national initiatives, such as those developed by the national
   53  hospice and Palliative Care Organization, to set benchmarks for
   54  measuring the quality of hospice care provided in the state.
   55         (b) Develop an annual report that analyzes and evaluates
   56  the information collected under this act and any other data
   57  collection or reporting provisions of law.
   58         Section 2. Section 400.6096, Florida Statutes, is created
   59  to read:
   60         400.6096 Disposal of prescribed controlled substances
   61  following the death of a patient in the home.—
   62         (1) A hospice physician, nurse, or social worker is
   63  authorized to assist in the disposal of a controlled substance
   64  prescribed to a patient at the time of the patient’s death
   65  pursuant to the disposal regulations in 21 C.F.R. s. 1317.
   66         (2) A hospice that assists in the disposal of a prescribed
   67  controlled substance found in the patient’s home at the time of
   68  the patient’s death must establish a written policy, procedure,
   69  or system for acceptable disposal methods.
   70         (3) A hospice physician, nurse, or social worker, upon the
   71  patient’s death and with the permission of a family member or a
   72  caregiver of the patient, may assist in the disposal of an
   73  unused controlled substance prescribed to the patient, pursuant
   74  to the written policy, procedure, or system established under
   75  subsection (2).
   76         (4) The prescribed controlled substance disposal procedure
   77  must be carried out in the patient’s home. Hospice staff and
   78  volunteers are not authorized to remove a prescribed controlled
   79  substance from the patient’s home.
   80         Section 3. Section 400.611, Florida Statutes, is amended to
   81  read:
   82         400.611 Interdisciplinary records of care; confidentiality;
   83  release of records.—
   84         (1) A hospice shall maintain an up-to-date,
   85  interdisciplinary record of care being given and patient and
   86  family status shall be kept. Records shall contain pertinent
   87  past and current medical, nursing, social, and other therapeutic
   88  information and such other information that is necessary for the
   89  safe and adequate care of the patient. Notations regarding all
   90  aspects of care for the patient and family shall be made in the
   91  record. When services are terminated, the record shall show the
   92  date and reason for termination.
   93         (2) Patient records shall be retained for a period of 6 5
   94  years after termination of hospice services, unless otherwise
   95  provided by law. In the case of a patient who is a minor, the 6
   96  year 5-year period shall begin on the date the patient reaches
   97  or would have reached the age of majority.
   98         (3) The interdisciplinary record of patient records of care
   99  and billing records are confidential.
  100         (4) A hospice may not release a patient’s interdisciplinary
  101  record or any portion thereof, unless the person requesting the
  102  information provides to the hospice:
  103         (a) A patient authorization executed by the patient; or
  104  legal guardian has given express written informed consent;
  105         (b) In the case of an incapacitated patient, a patient
  106  authorization executed prior to the patient’s death by the
  107  patient’s then acting legal guardian, health care surrogate as
  108  defined in s. 765.101(21), health care proxy as defined in s.
  109  765.101(19), or agent under power of attorney;
  110         (c)A court order appointing the person as the
  111  administrator, curator, executor, or personal representative of
  112  the patient’s estate with authority to obtain the patient’s
  113  medical records;
  114         (d) If a judicial appointment has not been made pursuant to
  115  paragraph (c), a last will that is self-proved under s. 732.503
  116  and designates the person to act as the patient’s personal
  117  representative; or
  118         (e)An order by a court of competent jurisdiction to
  119  release the interdisciplinary record to the person has so
  120  ordered; or
  121         (c) A state or federal agency, acting under its statutory
  122  authority, requires submission of aggregate statistical data.
  123  Any information obtained from patient records by a state agency
  124  pursuant to its statutory authority is confidential and exempt
  125  from the provisions of s. 119.07(1).
  126         (5) For purposes of this section, the term “patient
  127  authorization” means an unrevoked written statement by the
  128  patient, or an oral statement made by the patient which has been
  129  reduced to writing in the patient’s interdisciplinary record of
  130  care, or, in the case of an incapacitated patient, by the
  131  patient’s then acting legal guardian, health care surrogate,
  132  agent under a power of attorney, or health care proxy giving the
  133  patient’s permission to release the interdisciplinary record to
  134  a person requesting the record.
  135         (6) A hospice must release requested aggregate patient
  136  statistical data to a state or federal agency acting under its
  137  statutory authority. Any information obtained from patient
  138  records by a state agency pursuant to its statutory authority is
  139  confidential and exempt from s. 119.07(1).
  140         Section 4. This act shall take effect July 1, 2017.