Bill Text: FL H0739 | 2010 | Regular Session | Introduced

Bill Title: Health Care

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2010-04-30 - Died in Committee on Health Care Regulation Policy (HFPC) [H0739 Detail]

Download: Florida-2010-H0739-Introduced.html
HB 739
A bill to be entitled
2An act relating to health care; amending s. 400.462, F.S.;
3revising and providing definitions applicable to
4regulation of home health agencies; amending s. 400.476,
5F.S.; providing requirements for an alternate
6administrator of a home health agency; providing
7additional duties of an administrator and a director of
8nursing of a home health agency; providing additional
9training requirements for a home health aide; requiring a
10written contract between the agency and certain personnel;
11permitting other entities under contract with the home
12health agency to provide services under certain
13conditions; providing supervisory responsibilities of a
14home health agency if services are provided under an
15arrangement with another entity; amending s. 400.487,
16F.S.; requiring the home health agency to provide a copy
17of the service agreement to the patient or the patient's
18legal representative; requiring the home health agency to
19provide patients with a written notice of patient rights;
20providing requirements for the provision of skilled
21nursing and therapy services and the supervision thereof;
22amending s. 400.933, F.S.; revising licensure inspection
23requirements for home medical equipment providers;
24amending s. 400.969, F.S.; providing a penalty for
25violation of federal certification requirements for
26intermediate care facilities for the developmentally
27disabled; amending s. 408.805, F.S.; revising the method
28for calculating the annual adjustment of license fees
29assessed by the Agency for Health Care Administration;
30amending s. 429.41, F.S.; revising firesafety requirements
31for assisted living facilities; amending s. 429.65, F.S.;
32revising definitions applicable to regulation of adult
33family-care homes; providing an effective date.
35Be It Enacted by the Legislature of the State of Florida:
37 Section 1. Subsections (2) and (14) of section 400.462,
38Florida Statutes, are amended, present subsections (27), (28),
39and (29) are renumbered as subsections (28), (29), and (30),
40respectively, and a new subsection (27) is added to that
41section, to read:
42 400.462 Definitions.-As used in this part, the term:
43 (2) "Admission" means a decision by the home health
44agency, during or after an evaluation visit with the patient to
45the patient's home, that there is reasonable expectation that
46the patient's medical, nursing, and social needs for skilled
47care can be adequately met by the agency in the patient's place
48of residence. Admission includes completion of an agreement with
49the patient or the patient's legal representative to provide
50home health services as required in s. 400.487(1).
51 (14) "Home health services" means health and medical
52services and medical supplies furnished by an organization to an
53individual in the individual's home or place of residence. The
54term includes organizations that provide one or more of the
56 (a) Nursing care.
57 (b) Physical, occupational, respiratory, or speech
59 (c) Home health aide services.
60 (d) Dietetics and nutrition practice and nutrition
62 (e) Medical supplies and durable medical equipment,
63restricted to drugs and biologicals prescribed by a physician.
64 (27) "Primary home health agency" means the agency that is
65responsible for the services furnished to patients and for
66implementation of the plan of care.
67 Section 2. Section 400.476, Florida Statutes, is amended
68to read:
69 400.476 Personnel Staffing requirements; notifications;
70limitations on staffing services.-
72 (a) An administrator may manage only one home health
73agency, except that an administrator may manage up to five home
74health agencies if all five home health agencies have identical
75controlling interests as defined in s. 408.803 and are located
76within one agency geographic service area or within an
77immediately contiguous county. If the home health agency is
78licensed under this chapter and is part of a retirement
79community that provides multiple levels of care, an employee of
80the retirement community may administer the home health agency
81and up to a maximum of four entities licensed under this chapter
82or chapter 429 which all have identical controlling interests as
83defined in s. 408.803. An administrator shall designate, in
84writing, for each licensed entity, a qualified alternate
85administrator to serve during the administrator's absence. An
86alternate administrator must meet the requirements of this
87paragraph and the definition of administrator provided in s.
89 (b) An administrator of a home health agency who is a
90licensed physician, physician assistant, or registered nurse
91licensed to practice in this state may also be the director of
92nursing for a home health agency. An administrator may serve as
93a director of nursing for up to the number of entities
94authorized in subsection (2) only if there are 10 or fewer full-
95time equivalent employees and contracted personnel in each home
96health agency.
97 (c) An administrator of a home health agency shall:
98 1. Organize and direct the agency's ongoing functions.
99 2. Maintain ongoing liaisons with the board members and
100the agency's staff.
101 3. Employ qualified personnel.
102 4. Ensure adequate staff education and evaluations.
103 5. Ensure the accuracy of public information materials and
105 6. Implement an effective budgeting and accounting system.
106 7. Ensure that the home health agency operates in
107compliance with this part, part II of chapter 408, and
108department rules.
109 8. Ensure that the organizational structure, including the
110specific administrative responsibilities and the lines of
111authority for the delegation of responsibility down to the
112patient care level, and the services offered are clearly set
113forth in writing. Administrative and supervisory functions may
114not be delegated to another agency or organization and all
115services not furnished directly by the primary home health
116agency, including services provided through contracts, must be
117monitored and controlled by the primary home health agency.
119 (a) A director of nursing may be the director of nursing
121 1. Up to two licensed home health agencies if the agencies
122have identical controlling interests as defined in s. 408.803
123and are located within one agency geographic service area or
124within an immediately contiguous county; or
125 2. Up to five licensed home health agencies if:
126 a. All of the home health agencies have identical
127controlling interests as defined in s. 408.803;
128 b. All of the home health agencies are located within one
129agency geographic service area or within an immediately
130contiguous county; and
131 c. Each home health agency has a registered nurse who
132meets the qualifications of a director of nursing and who has a
133written delegation from the director of nursing to serve as the
134director of nursing for that home health agency when the
135director of nursing is not present; and
136 d. The director of nursing, or a similarly qualified
137alternate, is available at all times during the operating hours
138of the home health agency and participates in all activities
139related to the provision of professional services by the home
140health agency, including, but not limited to, the assignment of
141personnel and the oversight of nursing services, home health
142aides, and certified nursing assistants.
144If a home health agency licensed under this chapter is part of a
145retirement community that provides multiple levels of care, an
146employee of the retirement community may serve as the director
147of nursing of the home health agency and up to a maximum of four
148entities, other than home health agencies, licensed under this
149chapter or chapter 429 which all have identical controlling
150interests as defined in s. 408.803.
151 (b) A home health agency that provides skilled nursing
152care may not operate for more than 30 calendar days without a
153director of nursing. A home health agency that provides skilled
154nursing care and the director of nursing of a home health agency
155must notify the agency within 10 business days after termination
156of the services of the director of nursing for the home health
157agency. A home health agency that provides skilled nursing care
158must notify the agency of the identity and qualifications of the
159new director of nursing within 10 days after the new director is
160hired. If a home health agency that provides skilled nursing
161care operates for more than 30 calendar days without a director
162of nursing, the home health agency commits a class II
163deficiency. In addition to the fine for a class II deficiency,
164the agency may issue a moratorium in accordance with s. 408.814
165or revoke the license. The agency shall fine a home health
166agency that fails to notify the agency as required in this
167paragraph $1,000 for the first violation and $2,000 for a repeat
168violation. The agency may not take administrative action against
169a home health agency if the director of nursing fails to notify
170the department upon termination of services as the director of
171nursing for the home health agency.
172 (c) A home health agency that is not Medicare or Medicaid
173certified and does not provide skilled care or provides only
174physical, occupational, or speech therapy is not required to
175have a director of nursing and is exempt from paragraph (b).
176 (3) TRAINING.-A home health agency shall ensure that each
177certified nursing assistant employed by or under contract with
178the home health agency and each home health aide employed by or
179under contract with the home health agency is adequately trained
180to perform the tasks of a home health aide in the home setting.
181 (a) The home health agency may not use an individual to
182provide services as a home health aide on a full-time,
183temporary, per diem, or other basis unless the individual has
184completed a training and competency evaluation program or has
185successfully passed a competency test, as provided in s.
186400.497, that meets the minimum standards established under
187agency rules.
188 (b) A home health aide is not considered competent to
189perform any task for which he or she has received an evaluation
190of "unsatisfactory." The aide must not perform that task without
191being under the direct supervision of a licensed practical nurse
192until he or she receives training in that task and subsequently
193receives an evaluation of "satisfactory." A home health aide is
194not considered to have successfully passed a competency
195evaluation if the aide does not have a passing score on the
196competency test as specified in department rule.
197 (4) STAFFING.-Staffing services may be provided anywhere
198within the state.
199 (5) PERSONNEL.-
200 (a) A home health agency and its staff must comply with
201accepted professional standards and principles, including, but
202not limited to, the applicable practice act and the home health
203agency's policies and procedures.
204 (b) A home health agency that employs personnel on an
205hourly or per-visit basis must provide a written contract
206between the agency and those personnel that specifies the
208 1. The acceptance of patients for care only by the primary
209home health agency.
210 2. The services that shall be provided to the patient.
211 3. The necessity for personnel to conform to all
212applicable agency policies, including personnel qualifications.
213 4. The responsibility of personnel to participate in
214developing plans of care.
215 5. The manner in which services will be controlled,
216coordinated, and evaluated by the primary home health agency.
217 6. The procedures for submitting clinical and progress
218notes, the scheduling of visits, and the periodic evaluation of
220 7. The procedures for payment for services furnished under
221the contract.
222 (c) A home health agency shall provide at least one type
223of service directly through home health agency employees but may
224provide additional services under an arrangement with another
225agency or organization. Services provided under those
226arrangements must have a written contract that conforms with the
227requirements specified in paragraph (b).
228 (d) If home health aide services are provided by an
229individual who is not employed directly by the home health
230agency, the services of that home health aide must be provided
231pursuant to paragraphs (b) and (c). If the home health agency
232chooses to provide home health aide services under an
233arrangement with another agency or organization, the
234responsibilities of the home health agency shall include, but
235are not limited to:
236 1. Ensuring the overall quality of the care provided by
237the home health aide.
238 2. Supervising the services provided by the home health
239aide as described in s. 400.487.
240 3. Ensuring that a home health aide who provides services
241under an arrangement with another agency or organization has met
242the training and competency evaluation requirements of s.
244 (e) All personnel furnishing home health services to a
245patient must maintain liaison with the other home health aides
246providing services to that patient to ensure that their efforts
247are coordinated effectively and to support the objectives
248outlined in the patient's plan of care. The clinical record or
249minutes of case conferences shall be reviewed by the agency to
250determine whether effective exchange, reporting, and
251coordination of information regarding patient care has occurred.
252 Section 3. Section 400.487, Florida Statutes, is amended
253to read:
254 400.487 Home health service agreements; physician's,
255physician assistant's, and advanced registered nurse
256practitioner's treatment orders; notice of patient' rights;
257patient assessment; establishment and review of plan of care;
258provision of services; orders not to resuscitate.-
259 (1) Services provided by a home health agency must be
260covered by an agreement between the home health agency and the
261patient or the patient's legal representative specifying the
262home health services to be provided, the rates or charges for
263services paid with private funds, and the sources of payment,
264which may include Medicare, Medicaid, private insurance,
265personal funds, or a combination thereof. The home health agency
266shall provide a copy of the agreement to the patient or the
267patient's legal representative. A home health agency providing
268skilled care must make an assessment of the patient's needs
269within 48 hours after the start of services.
270 (2) When required by the provisions of chapter 464; part
271I, part III, or part V of chapter 468; or chapter 486, the
272attending physician, physician assistant, or advanced registered
273nurse practitioner, acting within his or her respective scope of
274practice, shall establish treatment orders for a patient who is
275to receive skilled care. The treatment orders must be signed by
276the physician, physician assistant, or advanced registered nurse
277practitioner before a claim for payment for the skilled services
278is submitted by the home health agency. If the claim is
279submitted to a managed care organization, the treatment orders
280must be signed within the time allowed under the provider
281agreement. The treatment orders shall be reviewed, as frequently
282as the patient's illness requires, by the physician, physician
283assistant, or advanced registered nurse practitioner in
284consultation with the home health agency.
285 (3) A home health agency shall arrange for supervisory
286visits by a registered nurse to the home of a patient receiving
287home health aide services as specified in subsection (9) in
288accordance with the patient's direction, approval, and agreement
289to pay the charge for the visits.
290 (4) A home health agency shall protect and promote the
291rights of each individual under its care, including:
292 (a) Notice of rights.-The home health agency shall provide
293the patient with a written notice of the patient's rights before
294furnishing care to the patient or during the initial evaluation
295visit before the initiation of treatment or care. The home
296health agency shall maintain documentation showing that it has
297complied with the requirements of this subsection.
298 (b) Exercise of patient rights and respect for property
299and person.-The patient has the right to exercise his or her
300rights as a patient of the home health agency, which shall
302 1. The patient has the right to have his or her property
303treated with respect.
304 2. The patient has the right to voice grievances regarding
305treatment or care that is or fails to be furnished or a failure
306to respect the patient's property by anyone who is furnishing
307services on behalf of the home health agency, and the patient
308may not be subjected to discrimination or reprisal for voicing
309such grievances.
310 3. The home health agency must investigate complaints made
311by a patient or the patient's family or legal representative
312regarding treatment or care that is or fails to be furnished or
313a failure to respect the patient's property by anyone furnishing
314services on behalf of the home health agency, and the home
315health agency shall document both the existence of the complaint
316and the resolution of the complaint.
317 4. The patient and his or her immediate family or legal
318representative must be informed of the right to report
319complaints to the agency statewide toll-free telephone number as
320provided in s. 408.810.
321 (c) Right to be informed and participate in planning
322treatment and care.-
323 1. The Each patient has the right to be informed in
324advance by the home health agency of: and
325 a. The right to participate in the planning of his or her
326treatment and care and planning any changes to the treatment and
328 b. The individuals who will provide the treatment and care
329and the proposed frequency of their visits.
330 2. Each patient must be provided, upon request, a copy of
331the plan of care established and maintained for that patient by
332the home health agency.
333 (5) When nursing services are ordered, the home health
334agency to which a patient has been admitted for care must
335provide the initial admission visit, all service evaluation
336visits, and the discharge visit by a direct employee. Services
337provided by others under contractual arrangements to a home
338health agency must be monitored and managed by the admitting
339home health agency. The admitting home health agency is fully
340responsible for ensuring that all care provided through its
341employees or contract staff is delivered in accordance with this
342part and applicable rules.
343 (6) The skilled care services provided by a home health
344agency, directly or under contract, must be supervised and
345coordinated in accordance with the plan of care. The home health
346agency shall provide skilled nursing services by or under the
347supervision of a registered nurse and in accordance with the
348plan of care. Any therapy services offered by the home health
349agency directly or under a contractual arrangement shall be
350provided by a qualified therapist or a qualified therapy
351assistant under the supervision of a qualified therapist and in
352accordance with the plan of care.
353 (a) A qualified therapist assists the physician in
354evaluating the patient's level of functioning, helps develop the
355plan of care and revises the plan as necessary, prepares
356clinical and progress notes, advises and consults with the
357family and other agency personnel, and participates in inservice
359 (b) The therapist or therapy assistant must meet the
360qualifications in the applicable practice act and related rules.
361 (c) A physical therapist assistant or occupational therapy
362assistant who provides services must be under the supervision of
363a qualified physical therapist or occupational therapist as
364required in the applicable practice act and related rules.
365 (d) A physical therapist assistant or occupational therapy
366assistant performs services planned, delegated, and supervised
367by the therapist, assists in preparing clinical notes and
368progress reports, participates in educating the patient and
369family, and participates in inservice training programs.
370 (e) Speech therapy services are furnished only by or under
371the supervision of a qualified speech-language pathologist or
372audiologist as required in the applicable practice act and
373related rules.
374 (f) Services are provided according to a written plan of
375care. The plan of care shall be reviewed by the physician or
376health professional who provided the treatment orders in
377subsection (2) and home health agency personnel as often as the
378severity of the patient's condition requires, but at least once
379every 60 days or more frequently when there is a beneficiary-
380elected transfer, there is a significant change in the patient's
381condition resulting in a change in the case-mix assignment, or a
382patient is discharged and subsequently returned to the same home
383health agency during the 60-day period. Home health agency
384personnel shall promptly alert the physician or other health
385professional who provided the treatment orders regarding any
386changes that suggest a need to alter the plan of care.
387 (g) Drugs and treatments may only be administered by home
388health agency personnel as ordered by a physician or health
389professional as specified in subsection (2), except that
390influenza and pneumococcal polysaccharide vaccines may be
391administered according to the agency's policy, which shall be
392developed in consultation with a physician, and after an
393assessment for contraindications. Verbal orders shall be put in
394writing and signed and dated with the date of receipt by the
395registered nurse or qualified therapist responsible for
396furnishing or supervising the ordered services. Verbal orders
397shall only be accepted by personnel authorized to do so under
398applicable state law and department rules and by the home health
399agency's internal policies.
400 (7) The registered nurse shall make the initial evaluation
401visit, regularly reevaluate the patient's nursing needs,
402initiate the plan of care and necessary revisions, furnish those
403services requiring substantial and specialized nursing skill,
404initiate appropriate preventive and rehabilitative nursing
405procedures, prepare clinical and progress notes, coordinate
406services, inform the physician and other personnel of changes in
407the patient's condition and needs, counsel the patient and
408family regarding meeting nursing and related needs, participate
409in inservice training programs, and supervise and teach other
410nursing personnel.
411 (8) The licensed practical nurse shall furnish services in
412accordance with agency policies, prepare clinical and progress
413notes, assist the physician and registered nurse in performing
414specialized procedures, prepare equipment and materials for
415treatments, observing aseptic technique as required, and assist
416the patient in learning appropriate self-care techniques.
417 (9) The home health aide and the certified nursing
418assistant provide services that are ordered by the physician in
419the plan of care and that the home health aide or the certified
420nursing assistant is permitted to perform under state law. The
421duties of a home health aide and a certified nursing assistant
422include the provision of hands-on personal care, performance of
423simple procedures as an extension of therapy or nursing
424services, assistance in ambulation or exercises, and assistance
425in administering medications that are ordinarily self-
426administered, as specified in state rules. Home health aide
427services offered by a home health agency must be provided by a
428qualified home health aide or a certified nursing assistant.
429 (a) The home health aide or the certified nursing
430assistant shall be assigned to a specific patient by the
431registered nurse. Written patient care instructions for the home
432health aide and the certified nursing assistant shall be
433prepared by the registered nurse or other appropriate
434professional who is responsible for the supervision of the home
435health aide and the certified nursing assistant.
436 (b) If the patient receives skilled nursing care, the
437registered nurse shall perform the supervisory visit. If the
438patient is not receiving skilled nursing care but is receiving
439physical therapy, occupational therapy, or speech-language
440pathology services, the appropriate therapist may perform the
441supervisory visit. The registered nurse or other professional
442must make an onsite visit to the patient's home no less
443frequently than every 2 weeks. The visit is not required to be
444while the home health aide or the certified nursing assistant is
445providing care.
446 (c) If home health aide services are provided to a patient
447who is not receiving skilled nursing care, physical or
448occupational therapy, or speech-language pathology services, the
449registered nurse must make a supervisory visit to the patient's
450home at least every 60 days. In these cases, to ensure that the
451home health aide or the certified nursing assistant is properly
452caring for the patient, each supervisory visit must occur while
453the home health aide or the certified nursing assistant is
454providing patient care.
455 (10)(7) Home health agency personnel may withhold or
456withdraw cardiopulmonary resuscitation if presented with an
457order not to resuscitate executed pursuant to s. 401.45. The
458agency shall adopt rules providing for the implementation of
459such orders. Home health personnel and agencies shall not be
460subject to criminal prosecution or civil liability, nor be
461considered to have engaged in negligent or unprofessional
462conduct, for withholding or withdrawing cardiopulmonary
463resuscitation pursuant to such an order and rules adopted by the
465 Section 4. Subsection (2) of section 400.933, Florida
466Statutes, is amended to read:
467 400.933 Licensure inspections and investigations.-
468 (2) The agency shall accept, in lieu of its own periodic
469inspections for licensure, submission of the following:
470 (a) The survey or inspection of an accrediting
471organization, provided the accreditation of the licensed home
472medical equipment provider is not conditional or provisional and
473provided the licensed home medical equipment provider authorizes
474release of, and the agency receives the report of, the
475accrediting organization.; or
476 (b) A copy of a valid medical oxygen retail establishment
477permit issued by the Department of Health, pursuant to chapter
479 Section 5. Subsection (1) of section 400.969, Florida
480Statutes, is amended to read:
481 400.969 Violation of part; penalties.-
482 (1) In addition to the requirements of part II of chapter
483408, and except as provided in s. 400.967(3), a violation of any
484provision of federal certification required pursuant to s.
485400.960(8), this part, part II of chapter 408, or applicable
486rules is punishable by payment of an administrative or civil
487penalty not to exceed $5,000.
488 Section 6. Section 408.805, Florida Statutes, is amended
489to read:
490 408.805 Fees required; adjustments.-Unless otherwise
491limited by authorizing statutes, License fees must be reasonably
492calculated by the agency to cover its costs in carrying out its
493responsibilities under this part, authorizing statutes, and
494applicable rules, including the cost of licensure, inspection,
495and regulation of providers.
496 (1) Licensure fees shall be adjusted to provide for
497biennial licensure under agency rules.
498 (2) The agency shall annually adjust licensure fees,
499including fees paid per bed, by not more than 10 percent above
500the change in the Consumer Price Index based on the 12 months
501immediately preceding the increase.
502 (3) An inspection fee must be paid as required in
503authorizing statutes.
504 (4) Fees are nonrefundable.
505 (5) When a change is reported that requires issuance of a
506license, a fee may be assessed. The fee must be based on the
507actual cost of processing and issuing the license.
508 (6) A fee may be charged to a licensee requesting a
509duplicate license. The fee may not exceed the actual cost of
510duplication and postage.
511 (7) Total fees collected may not exceed the cost of
512administering this part, authorizing statutes, and applicable
514 Section 7. Paragraph (a) of subsection (1) of section
515429.41, Florida Statutes, is amended to read:
516 429.41 Rules establishing standards.-
517 (1) It is the intent of the Legislature that rules
518published and enforced pursuant to this section shall include
519criteria by which a reasonable and consistent quality of
520resident care and quality of life may be ensured and the results
521of such resident care may be demonstrated. Such rules shall also
522ensure a safe and sanitary environment that is residential and
523noninstitutional in design or nature. It is further intended
524that reasonable efforts be made to accommodate the needs and
525preferences of residents to enhance the quality of life in a
526facility. The agency, in consultation with the department, may
527adopt rules to administer the requirements of part II of chapter
528408. In order to provide safe and sanitary facilities and the
529highest quality of resident care accommodating the needs and
530preferences of residents, the department, in consultation with
531the agency, the Department of Children and Family Services, and
532the Department of Health, shall adopt rules, policies, and
533procedures to administer this part, which must include
534reasonable and fair minimum standards in relation to:
535 (a) The requirements for and maintenance of facilities,
536not in conflict with the provisions of chapter 553, relating to
537plumbing, heating, cooling, lighting, ventilation, living space,
538and other housing conditions, which will ensure the health,
539safety, and comfort of residents and protection from fire
540hazard, including adequate provisions for fire alarm and other
541fire protection suitable to the size of the structure. Uniform
542firesafety standards shall be established and enforced by the
543State Fire Marshal in cooperation with the agency, the
544department, and the Department of Health.
545 1. Evacuation capability determination.-
546 a. The provisions of the National Fire Protection
547Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
548for determining the ability of the residents, with or without
549staff assistance, to relocate from or within a licensed facility
550to a point of safety as provided in the fire codes adopted
551herein. An evacuation capability evaluation for initial
552licensure shall be conducted within 6 months after the date of
553licensure. For existing licensed facilities that are not
554equipped with an automatic fire sprinkler system, the
555administrator shall evaluate the evacuation capability of
556residents at least annually. The evacuation capability
557evaluation for each facility not equipped with an automatic fire
558sprinkler system shall be validated, without liability, by the
559State Fire Marshal, by the local fire marshal, or by the local
560authority having jurisdiction over firesafety, before the
561license renewal date. If the State Fire Marshal, local fire
562marshal, or local authority having jurisdiction over firesafety
563has reason to believe that the evacuation capability of a
564facility as reported by the administrator may have changed, it
565may, with assistance from the facility administrator, reevaluate
566the evacuation capability through timed exiting drills.
567Translation of timed fire exiting drills to evacuation
568capability may be determined:
569 (I) Three minutes or less: prompt.
570 (II) More than 3 minutes, but not more than 13 minutes:
572 (III) More than 13 minutes: impractical.
573 b. The Office of the State Fire Marshal shall provide or
574cause the provision of training and education on the proper
575application of Chapter 5, NFPA 101A, 1995 edition, to its
576employees, to staff of the Agency for Health Care Administration
577who are responsible for regulating facilities under this part,
578and to local governmental inspectors. The Office of the State
579Fire Marshal shall provide or cause the provision of this
580training within its existing budget, but may charge a fee for
581this training to offset its costs. The initial training must be
582delivered within 6 months after July 1, 1995, and as needed
584 c. The Office of the State Fire Marshal, in cooperation
585with provider associations, shall provide or cause the provision
586of a training program designed to inform facility operators on
587how to properly review bid documents relating to the
588installation of automatic fire sprinklers. The Office of the
589State Fire Marshal shall provide or cause the provision of this
590training within its existing budget, but may charge a fee for
591this training to offset its costs. The initial training must be
592delivered within 6 months after July 1, 1995, and as needed
594 d. The administrator of a licensed facility shall sign an
595affidavit verifying the number of residents occupying the
596facility at the time of the evacuation capability evaluation.
597 2. Firesafety requirements.-
598 a. Except for the special applications provided herein,
599effective January 1, 2011 1996, the provisions of the current
600edition of the National Fire Protection Association, Life Safety
601Code, NFPA 101, 1994 edition, Chapter 22 for new facilities and
602Chapter 23 for existing facilities shall be the uniform fire
603code applied by the State Fire Marshal for assisted living
604facilities, pursuant to s. 633.022.
605 b. Any new facility, regardless of size, that applies for
606a license on or after January 1, 1996, must be equipped with an
607automatic fire sprinkler system. The exceptions as provided in
608s. 22-, NFPA 101, 1994 edition, as adopted herein, apply
609to any new facility housing eight or fewer residents. On July 1,
6101995, local governmental entities responsible for the issuance
611of permits for construction shall inform, without liability, any
612facility whose permit for construction is obtained prior to
613January 1, 1996, of this automatic fire sprinkler requirement.
614As used in this part, the term "a new facility" does not mean an
615existing facility that has undergone change of ownership.
616 c. Notwithstanding any provision of s. 633.022 or of the
617National Fire Protection Association, NFPA 101A, Chapter 5, 1995
618edition, to the contrary, any existing facility housing eight or
619fewer residents is not required to install an automatic fire
620sprinkler system, nor to comply with any other requirement in
621Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
622requirements of NFPA 101, 1988 edition, that applies to this
623size facility, unless the facility has been classified as
624impractical to evacuate. Any existing facility housing eight or
625fewer residents that is classified as impractical to evacuate
626must install an automatic fire sprinkler system within the
627timeframes granted in this section.
628 d. Any existing facility that is required to install an
629automatic fire sprinkler system under this paragraph need not
630meet other firesafety requirements of Chapter 23, NFPA 101, 1994
631edition, which exceed the provisions of NFPA 101, 1988 edition.
632The mandate contained in this paragraph which requires certain
633facilities to install an automatic fire sprinkler system
634supersedes any other requirement.
635 e. This paragraph does not supersede the exceptions
636granted in NFPA 101, 1988 edition or 1994 edition.
637 f. This paragraph does not exempt facilities from other
638firesafety provisions adopted under s. 633.022 and local
639building code requirements in effect before July 1, 1995.
640 g. A local government may charge fees only in an amount
641not to exceed the actual expenses incurred by local government
642relating to the installation and maintenance of an automatic
643fire sprinkler system in an existing and properly licensed
644assisted living facility structure as of January 1, 1996.
645 h. If a licensed facility undergoes major reconstruction
646or addition to an existing building on or after January 1, 1996,
647the entire building must be equipped with an automatic fire
648sprinkler system. Major reconstruction of a building means
649repair or restoration that costs in excess of 50 percent of the
650value of the building as reported on the tax rolls, excluding
651land, before reconstruction. Multiple reconstruction projects
652within a 5-year period the total costs of which exceed 50
653percent of the initial value of the building at the time the
654first reconstruction project was permitted are to be considered
655as major reconstruction. Application for a permit for an
656automatic fire sprinkler system is required upon application for
657a permit for a reconstruction project that creates costs that go
658over the 50-percent threshold.
659 i. Any facility licensed before January 1, 1996, that is
660required to install an automatic fire sprinkler system shall
661ensure that the installation is completed within the following
662timeframes based upon evacuation capability of the facility as
663determined under subparagraph 1.:
664 (I) Impractical evacuation capability, 24 months.
665 (II) Slow evacuation capability, 48 months.
666 (III) Prompt evacuation capability, 60 months.
668The beginning date from which the deadline for the automatic
669fire sprinkler installation requirement must be calculated is
670upon receipt of written notice from the local fire official that
671an automatic fire sprinkler system must be installed. The local
672fire official shall send a copy of the document indicating the
673requirement of a fire sprinkler system to the Agency for Health
674Care Administration.
675 j. It is recognized that the installation of an automatic
676fire sprinkler system may create financial hardship for some
677facilities. The appropriate local fire official shall, without
678liability, grant two 1-year extensions to the timeframes for
679installation established herein, if an automatic fire sprinkler
680installation cost estimate and proof of denial from two
681financial institutions for a construction loan to install the
682automatic fire sprinkler system are submitted. However, for any
683facility with a class I or class II, or a history of uncorrected
684class III, firesafety deficiencies, an extension must not be
685granted. The local fire official shall send a copy of the
686document granting the time extension to the Agency for Health
687Care Administration.
688 k. A facility owner whose facility is required to be
689equipped with an automatic fire sprinkler system under Chapter
69023, NFPA 101, 1994 edition, as adopted herein, must disclose to
691any potential buyer of the facility that an installation of an
692automatic fire sprinkler requirement exists. The sale of the
693facility does not alter the timeframe for the installation of
694the automatic fire sprinkler system.
695 l. Existing facilities required to install an automatic
696fire sprinkler system as a result of construction-type
697restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
698herein, or evacuation capability requirements shall be notified
699by the local fire official in writing of the automatic fire
700sprinkler requirement, as well as the appropriate date for final
701compliance as provided in this subparagraph. The local fire
702official shall send a copy of the document to the Agency for
703Health Care Administration.
704 m. Except in cases of life-threatening fire hazards, if an
705existing facility experiences a change in the evacuation
706capability, or if the local authority having jurisdiction
707identifies a construction-type restriction, such that an
708automatic fire sprinkler system is required, it shall be
709afforded time for installation as provided in this subparagraph.
711Facilities that are fully sprinkled and in compliance with other
712firesafety standards are not required to conduct more than one
713of the required fire drills between the hours of 11 p.m. and 7
714a.m., per year. In lieu of the remaining drills, staff
715responsible for residents during such hours may be required to
716participate in a mock drill that includes a review of evacuation
717procedures. Such standards must be included or referenced in the
718rules adopted by the State Fire Marshal. Pursuant to s.
719633.022(1)(b), the State Fire Marshal is the final
720administrative authority for firesafety standards established
721and enforced pursuant to this section. All licensed facilities
722must have an annual fire inspection conducted by the local fire
723marshal or authority having jurisdiction.
724 3. Resident elopement requirements.-Facilities are
725required to conduct a minimum of two resident elopement
726prevention and response drills per year. All administrators and
727direct care staff must participate in the drills which shall
728include a review of procedures to address resident elopement.
729Facilities must document the implementation of the drills and
730ensure that the drills are conducted in a manner consistent with
731the facility's resident elopement policies and procedures.
732 Section 8. Subsections (2) and (11) of section 429.65,
733Florida Statutes, are amended to read:
734 429.65 Definitions.-As used in this part, the term:
735 (2) "Adult family-care home" means a full-time, family-
736type living arrangement, in a private home, under which up to
737two individuals a person who reside in the home and own or rent
738owns or rents the home provide provides room, board, and
739personal care, on a 24-hour basis, for no more than five
740disabled adults or frail elders who are not relatives. The
741following family-type living arrangements are not required to be
742licensed as an adult family-care home:
743 (a) An arrangement whereby a the person who resides in the
744home and owns or rents the home provides room, board, and
745personal care services for not more than two adults who do not
746receive optional state supplementation under s. 409.212. The
747person who provides the housing, meals, and personal care must
748own or rent the home and reside therein.
749 (b) An arrangement whereby a the person who owns or rents
750the home provides room, board, and personal services only to his
751or her relatives.
752 (c) An establishment that is licensed as an assisted
753living facility under this chapter.
754 (11) "Provider" means one or two individuals a person who
755are is licensed to operate an adult family-care home.
756 Section 9. This act shall take effect July 1, 2010.
CODING: Words stricken are deletions; words underlined are additions.