Bill Text: FL S0718 | 2022 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Provision of Health Care

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Introduced - Dead) 2022-03-03 - Laid on Table, refer to CS/HB 469 [S0718 Detail]

Download: Florida-2022-S0718-Introduced.html
       Florida Senate - 2022                                     SB 718
       
       
        
       By Senator Bradley
       
       
       
       
       
       5-00716A-22                                            2022718__
    1                        A bill to be entitled                      
    2         An act relating to patient care in health care
    3         facilities; amending s. 400.488, F.S.; revising
    4         provisions relating to medications and devices with
    5         which unlicensed individuals may assist patients in
    6         self-administration under certain circumstances;
    7         amending s. 401.252, F.S.; specifying staffing
    8         requirements for advanced life support ambulances
    9         during interfacility transfers; providing that the
   10         person occupying the ambulance who has the highest
   11         medical certification in this state is in charge of
   12         patient care during the transfer; amending s.
   13         464.0156, F.S.; revising the list of medications that
   14         a registered nurse may delegate the administration of
   15         to a certified nursing assistant or home health aide;
   16         amending ss. 401.25, 401.27, and 429.256, F.S.;
   17         conforming provisions to changes made by the act;
   18         providing an effective date.
   19          
   20  Be It Enacted by the Legislature of the State of Florida:
   21  
   22         Section 1. Subsections (2), (3), and (4) of section
   23  400.488, Florida Statutes, are amended to read:
   24         400.488 Assistance with self-administration of medication.—
   25         (2) Patients who are capable of self-administering their
   26  own medications without assistance must shall be encouraged and
   27  allowed to do so. However, an unlicensed person may, consistent
   28  with a dispensed prescription’s label or the package directions
   29  of an over-the-counter medication, assist a patient whose
   30  condition is medically stable with the self-administration of
   31  routine, regularly scheduled medications that are intended to be
   32  self-administered. Assistance with self-medication by an
   33  unlicensed person may occur only upon a documented request by,
   34  and the written informed consent of, a patient or the patient’s
   35  surrogate, guardian, or attorney in fact. For purposes of this
   36  section, self-administered medications include both legend and
   37  over-the-counter oral dosage forms, topical dosage forms,
   38  transdermal patches, and topical ophthalmic, otic, and nasal
   39  dosage forms, including solutions, suspensions, sprays,
   40  inhalers, and nebulizer treatments.
   41         (3) Assistance with self-administration of medication
   42  includes:
   43         (a) Taking the medication, in its previously dispensed,
   44  properly labeled container, from where it is stored and bringing
   45  it to the patient. For purposes of this paragraph, an insulin
   46  syringe that is prefilled with the proper dosage by a pharmacist
   47  and an insulin pen that is prefilled by the manufacturer are
   48  considered medications in previously dispensed, properly labeled
   49  containers.
   50         (b) In the presence of the patient, confirming that the
   51  medication is intended for that patient, orally advising the
   52  patient of the medication name and purpose, opening the
   53  container, removing a prescribed amount of medication from the
   54  container, and closing the container.
   55         (c) Placing an oral dosage in the patient’s hand or placing
   56  the dosage in another container and helping the patient by
   57  lifting the container to his or her mouth.
   58         (d) Applying topical medications, including routine
   59  preventive skin care and applying and replacing bandages for
   60  minor cuts and abrasions as provided by the agency in rule.
   61         (e) Returning the medication container to proper storage.
   62         (f) For nebulizer treatments, assisting with setting up and
   63  cleaning the device in the presence of the patient, confirming
   64  that the medication is intended for that patient, orally
   65  advising the patient of the medication name and purpose, opening
   66  the container, removing the prescribed amount for a single
   67  treatment dose from a properly labeled container, and assisting
   68  the patient with placing the dose into the medicine receptacle
   69  or mouthpiece.
   70         (g) Keeping a record of when a patient receives assistance
   71  with self-administration under this section.
   72         (g)Assisting with the use of a nebulizer, including
   73  removing the cap of a nebulizer, opening the unit dose of
   74  nebulizer solutions, and pouring the prescribed premeasured dose
   75  of medication into the dispensing cup of the nebulizer.
   76         (h)Using a glucometer to perform blood-glucose level
   77  checks.
   78         (i)Assisting with putting on and taking off antiembolism
   79  stockings.
   80         (j)Assisting with applying and removing an oxygen cannula
   81  but not with titrating the prescribed oxygen settings.
   82         (k)Assisting with the use of a continuous positive airway
   83  pressure device but not with titrating the prescribed setting of
   84  the device.
   85         (l)Assisting with measuring vital signs.
   86         (m)Assisting with colostomy bags.
   87         (4) Assistance with self-administration does not include:
   88         (a) Mixing, compounding, converting, or calculating
   89  medication doses, except for measuring a prescribed amount of
   90  liquid medication or breaking a scored tablet or crushing a
   91  tablet as prescribed.
   92         (b) The preparation of syringes for injection or the
   93  administration of medications by any injectable route.
   94         (c) Administration of medications through intermittent
   95  positive pressure breathing machines or a nebulizer.
   96         (d) Administration of medications by way of a tube inserted
   97  in a cavity of the body.
   98         (d)(e) Administration of parenteral preparations.
   99         (e)(f) Irrigations or debriding agents used in the
  100  treatment of a skin condition.
  101         (f)(g) Rectal, urethral, or vaginal preparations.
  102         (g)(h) Medications ordered by the physician or health care
  103  professional with prescriptive authority to be given “as
  104  needed,” unless the order is written with specific parameters
  105  that preclude independent judgment on the part of the unlicensed
  106  person, and at the request of a competent patient.
  107         (h)(i) Medications for which the time of administration,
  108  the amount, the strength of dosage, the method of
  109  administration, or the reason for administration requires
  110  judgment or discretion on the part of the unlicensed person.
  111         Section 2. Section 401.252, Florida Statutes, is amended to
  112  read:
  113         401.252 Interfacility transfer.—
  114         (1) When conducting an interfacility transfer, a permitted
  115  advanced life support ambulance must be occupied by at least two
  116  persons: one patient attendant who is a certified paramedic, a
  117  registered nurse authorized under subsection (2), or a licensed
  118  physician; and one who is a certified emergency medical
  119  technician, a certified paramedic, a licensed physician, or an
  120  ambulance driver who meets the driver requirements of s.
  121  401.281. The person occupying the ambulance who has the highest
  122  medical certification in this state is in charge of patient care
  123  during the interfacility transfer.
  124         (2) A licensed basic or advanced life support ambulance
  125  service may conduct interfacility transfers in a permitted
  126  ambulance, using a registered nurse in place of an emergency
  127  medical technician or paramedic, if:
  128         (a) The registered nurse holds a current certificate of
  129  successful course completion in advanced cardiac life support;
  130         (b) The physician in charge has granted permission for such
  131  a transfer, has designated the level of service required for
  132  such transfer, and has deemed the patient to be in such a
  133  condition appropriate to this type of ambulance staffing; and
  134         (c) The registered nurse operates within the scope of part
  135  I of chapter 464.
  136         (3)(2) A licensed basic or advanced life support service
  137  may conduct interfacility transfers in a permitted ambulance if
  138  the patient’s treating physician certifies that the transfer is
  139  medically appropriate and the physician provides reasonable
  140  transfer orders. An interfacility transfer must be conducted in
  141  a permitted ambulance if it is determined that the patient
  142  needs, or is likely to need, medical attention during transport.
  143  If the emergency medical technician or paramedic believes the
  144  level of patient care required during the transfer is beyond his
  145  or her capability, the medical director, or his or her designee,
  146  must be contacted for clearance prior to conducting the
  147  transfer. If necessary, the medical director, or his or her
  148  designee, shall attempt to contact the treating physician for
  149  consultation to determine the appropriateness of the transfer.
  150         (4)(3) Infants younger less than 28 days old or infants
  151  weighing less than 5 kilograms, who require critical care
  152  interfacility transport to a neonatal intensive care unit must,
  153  shall be transported in a permitted advanced life support or
  154  basic life support transport ambulance, or in a permitted
  155  advanced life support or basic life support ambulance that is
  156  recognized by the department as meeting designated criteria for
  157  neonatal interfacility critical care transport.
  158         Section 3. Subsection (2) of section 464.0156, Florida
  159  Statutes, is amended to read:
  160         464.0156 Delegation of duties.—
  161         (2) A registered nurse may delegate to a certified nursing
  162  assistant or a home health aide the administration of oral,
  163  transdermal, ophthalmic, otic, rectal, inhaled, enteral, or
  164  topical prescription medications to a patient of a home health
  165  agency, if the certified nursing assistant or home health aide
  166  meets the requirements of s. 464.2035 or s. 400.489,
  167  respectively. A registered nurse may not delegate the
  168  administration of any controlled substance listed in Schedule
  169  II, Schedule III, or Schedule IV of s. 893.03 or 21 U.S.C. s.
  170  812, except for the administration of an insulin syringe that is
  171  prefilled with the proper dosage by a pharmacist or an insulin
  172  pen that is prefilled by the manufacturer.
  173         Section 4. Subsection (7) of section 401.25, Florida
  174  Statutes, is amended to read:
  175         401.25 Licensure as a basic life support or an advanced
  176  life support service.—
  177         (7)(a) Each permitted basic life support ambulance not
  178  specifically exempted from this part, when transporting a person
  179  who is sick, injured, wounded, incapacitated, or helpless, must
  180  be occupied by at least two persons: one patient attendant who
  181  is a certified emergency medical technician, certified
  182  paramedic, or licensed physician; and one ambulance driver who
  183  meets the requirements of s. 401.281. This paragraph does not
  184  apply to interfacility transfers governed by s. 401.252 s.
  185  401.252(1).
  186         (b) Each permitted advanced life support ambulance not
  187  specifically exempted from this part, when transporting a person
  188  who is sick, injured, wounded, incapacitated, or helpless, must
  189  be occupied by at least two persons: one who is a certified
  190  paramedic or licensed physician; and one who is a certified
  191  emergency medical technician, certified paramedic, or licensed
  192  physician who also meets the requirements of s. 401.281 for
  193  drivers. The person with the highest medical certifications
  194  shall be in charge of patient care. This paragraph does not
  195  apply to interfacility transfers governed by s. 401.252 s.
  196  401.252(1).
  197         Section 5. Subsection (1) of section 401.27, Florida
  198  Statutes, is amended to read:
  199         401.27 Personnel; standards and certification.—
  200         (1) Each permitted ambulance not specifically exempted from
  201  this part, when transporting a person who is sick, injured,
  202  wounded, incapacitated, or helpless, must be occupied by at
  203  least two persons, one of whom must be a certified emergency
  204  medical technician, certified paramedic, or licensed physician
  205  and one of whom must be a driver who meets the requirements for
  206  ambulance drivers. This subsection does not apply to
  207  interfacility transfers governed by s. 401.252 s. 401.252(1).
  208         Section 6. Paragraph (a) of subsection (3) of section
  209  429.256, Florida Statutes, is amended to read:
  210         429.256 Assistance with self-administration of medication.—
  211         (3) Assistance with self-administration of medication
  212  includes:
  213         (a) Taking the medication, in its previously dispensed,
  214  properly labeled container, including an insulin syringe that is
  215  prefilled with the proper dosage by a pharmacist and an insulin
  216  pen that is prefilled by the manufacturer, from where it is
  217  stored, and bringing it to the resident. For purposes of this
  218  paragraph, an insulin syringe that is prefilled with the proper
  219  dosage by a pharmacist and an insulin pen that is prefilled by
  220  the manufacturer are considered medications in previously
  221  dispensed, properly labeled containers.
  222         Section 7. This act shall take effect July 1, 2022.

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