The purpose of the proposed rule amendments is to update Chapter 59A-18, F.A.C., to conform to revisions in Chapter 400, Part IV, F.S., as amended by the 2005 Florida Legislature. A new rule is added to establish minimum criteria for nurse registry ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Health Facility and Agency Licensing

RULE NOS.: RULE TITLES:

59A-18.004 Licensure Requirements, Procedures, and Fees

59A-18.005 Registration Policies

59A-18.011 Medical Plan of Treatment

59A-18.012 Clinical Records

59A-18.017 Supplemental Staffing for Health Care Facilities

59A-18.018 Emergency Management Plans

59A-18.0081 Certified Nursing Assistant and Home Health Aide

PURPOSE AND EFFECT: The purpose of the proposed rule amendments is to update Chapter 59A-18, F.A.C., to conform to revisions in Chapter 400, Part IV, F.S., as amended by the 2005 Florida Legislature. A new rule is added to establish minimum criteria for nurse registry comprehensive emergency management plans and plan updates as required in Section 400.506(15) and (16), F.S. In addition, nurse registry application forms referenced in the rules are updated to conform to statutory revisions and a separate renewal application was developed to reduce the amount of information submitted by nurse registries. Other revisions are made to update the rules to current statutory requirements, update addresses, and clarify requirements for advance notification of licensee relocation and health statements.

SUMMARY: The proposed changes to Rule 59A-18.004, F.A.C., to conform to 2005 revisions in Chapter 400, Part IV, F.S., are changing the expiration date of the license from one to two years, increasing the licensure fee from $1,000 to $2,000 for the increased licensure period, changing the expiration date of the license from one to two years, updating the licensure application forms and updating the date for contractors to be background screened. Other changes to Rule 59A-18.004, F.A.C., are: referencing a separate renewal application form requiring less information; referencing the Agencys updated background screening form; adding to application requirements the name of the alternate administrator and the name and license number of nurses available to meet Section 400.506(10), F.S.; changing the collection of license numbers of independent contractors to the renewal application instead of the initial application; and updating addresses including web sites to obtain referenced forms. In addition, nurse registries are required to provide advance notice to AHCA of their office relocation with evidence of compliance with local zoning for the new location and exceptions are made for emergency relocations.

Amendments are proposed to Rule 59A-18.005, F.A.C., which eliminate the mandatory tuberculin skin test, clarifies the requirements for the health statements prior to contact with patients, and specifies actions to be taken if the independent contractor has a communicable disease. Training on HIV and AIDS is required biennially, removing the specified number of hours of training in accordance with Section 381.0035, F.S.

The proposed amendments to Rule 59A-18.0081, F.A.C., replace the monthly nursing assessments with a record of requested registered nurse visits to conform to 2005 statutory changes and update the HIV and AIDS education requirement for certified nursing assistants and home health aides to a biennial course from specified hours of training. A new subsection is added permitting certified nursing assistants and home health aides to assist with self administration of medication pursuant to Section 400.488, F.S., including training requirements, nursing review of the patients medications, receiving written consent, and clarifying the extent of assistance that can be provided.

Rule 59A-18.011, F.A.C., proposed amendments permit physicians assistants and advanced registered nurse practitioners to sign and review the plan of treatment in addition to the physicians, as stated in 2005 law changes. The proposed amendments to Rule 59A-18.017, F.A.C., require independent contractors who provide staffing service to a nursing home but have not lived in Florida for five years to have a level two background screening as required by Section 400.215, F.S.

A new Rule 59A-18.018, F.A.C., is added for emergency management plan requirements pursuant to Section 400.506(16), F.S. An emergency management plan format, developed with the concurrence of the Department of Health, is referenced in the rule. Requirements include submission of plans and plan updates for review; development of contingency plans when phone service is not available; provision of information and assistance to patients with special needs shelter registration; documentation of patients plans prior to and following an emergency; provision of continuing care for patients in private homes, adult family care homes and assisted living facilities unless circumstances beyond the control of the independent contractor makes service provision impossible; and maintenance of a current prioritized list of registered special needs patients, and individual patient lists of medications, supplies and equipment required for continuing care and service in the event of an evacuation.

SUMMARY OF ESTIMATED REGULATORY COSTS: It is anticipated that costs will be less for nurse registries as a result of the reduction in the requirements in these amendments. Nurse registries have been required to have an emergency management plan since the requirement was established in law even though the rules for the plans were not promulgated.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

SPECIFIC AUTHORITY: 400.497 FS., 400.506 FS.

LAW IMPLEMENTED: 400.488 FS., 400.497 FS., 400.506 FS., 400.512 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAW.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULES IS: Jan Benesh, Licensed Home Health Programs Unit, Bureau of Health Facility Regulation, Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 34, Tallahassee, Florida 32308, e-mail: [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULES IS:

 

59A-18.004 Licensure Requirements, Procedures, and Fees.

(1) Prior to operating a nurse registry as defined under Section 400.506, F.S., the owner shall make application for a license on AHCA Form 3110-7001, Nurse Registry Application for Initial License Revised December 2005 Application for Licensure-Nurse Registry, revised September, 2000, incorporated by reference. The application shall be accompanied by a $2,000 $1,000 licensure fee. The application and other pertinent information can be obtained at the AHCA website: http://ahca.myflorida.com under Licensing, Nurse Registry. If the requestor is unable to obtain the forms and related information from the web site, the documents may be obtained from the AHCA Licensed Home Health Programs Unit by contacting [phone] and sending a check or money order to cover the Agency’s costs for copying and mailing. The receipt of a license from AHCA shall be based upon compliance with all applicable rules and regulations, as evidenced by a signed application under oath and upon the results of a survey conducted by AHCA representatives. It is unlawful to operate a registry without first obtaining from AHCA a license authorizing such operation.

(2) The license shall be displayed in a conspicuous place in public view within the licensed premises. The registry license is not transferable. Sale of the licensed nurse registry, assignment, lease or other transfer, whether voluntary or involuntary, shall require relicensure by the new owner prior to taking over the operation pursuant to Section 400.506(8) 400.497(3), F.S. The prospective owner shall submit, at least 60 30 days prior to the effective date of the change, an application for a new license.

(3) No change.

(4) An initial licensure application shall include: Initial licensure – An application for an initial license to operate a nurse registry shall be submitted for a new operation or change of licensee accompanied by a non-refundable license fee of $2,000 $1,000 for each site in operation to be licensed, and must be submitted and signed under oath on AHCA Form 3110-7001, Nurse Registry Application for Initial License Revised December 2005, Revised September 2000 "Application for Licensure,-Nurse Registry", which is incorporated by reference, provided by the agency, and shall include:

(a) through (f) No change.

(g) The name of the registry’s administrator, the alternate administrator and the name and license or certification number, of current independent contractors for the registered nurse or nurses that the nurse registry has available to meet the requirements in Section 400.506(10)(c), F.S., licensed practical nurses and certified nursing assistants, and the name of current independent contractor for home health aides, homemakers and companions;. An application for renewal will include the same information for the administrator, alternate administrator and registered nurse or nurses available to meet the requirements in Section 400.506(10)(c), F.S., unless there has been no changes since the previous application for licensure, as well as the name and license or certification number of current independent contractors for registered nurses, licensed practical nurses and certified nursing assistants, and the name of current independent contractors for home health aides, homemakers and companions.

(h) No change.

(i) A signed affidavit from the administrator, pursuant to Section 400.512(2), F.S. stating that the administrator, the financial officer, and each contractor who was registered with the nurse registry on or after October 1, 2000 1994, has been screened for good moral character and that the remaining contractors pursuant to Section 400.512(2) 400.497(2), F.S. have been continuously registered with the nurse registry since before October 1, 2000 1994.

1. Screening for good moral character for the administrator and the financial officer shall be in accordance with level 2 standards for screening set forth in Section 400.506(2) 400.471(4), F.S. The fingerprint card for level 2 screening for the administrator and the financial officer can be obtained from, and must be submitted to, the Agency for Health Care Administration, Licensed Home Health Programs Unit Home Care Unit, 2727 Mahan Drive, Mail Stop 34, Building 1, Room 200, Tallahassee, Florida 32308. Screening processing fees for level 2 screening shall be made payable to the Agency for Health Care Administration.

2. Level 1 screening for good moral character for each contractor shall consist of:

a. Submission of the Level 1 Request for Criminal History Request Check, AHCA Form form 3110-002, Revised July 2005 June 1998, incorporated by reference, to the Background Screening Unit, AHCA, 2727 Mahan Drive – Mail Stop 40, Tallahassee, Florida 32308 or to the Florida Department of Law Enforcement, Crime Information Bureau, Post Office Box 1489, Tallahassee, Florida 32302.

b. This form may be obtained at the Agency for Health Care Administration web site, http://ahca.myflorida.com, at the Background Screening Unit page from the Agency for Health Care Administration, Health Facility Regulation Licensed Home Health Programs Unit, 2727 Mahan Drive, Building 1, Room 200, Tallahassee, Florida 32308. The cost of processing the criminal records check shall be borne by the nurse registry or the contractor being screened, at the determination of the administrator of the nurse registry. The checks for level 1 screening shall be made payable to AHCA when forms are submitted to the Background Screening Unit at AHCA the Florida Department of Law Enforcement for the criminal records check. When forms are submitted to the Florida Department of Law Enforcement, the check shall be made payable to the Florida Department of Law Enforcement.

(j) through (m) No change.

(5) All nurse registries must apply for a geographic service area on their initial license application. Nurse registries may apply for a geographic service area which encompasses one or more of the counties within the specific AHCA area boundaries, pursuant to Section 408.032(5), F.S., and Section 400.497(7)(8), F.S., in which the main office is located. However, any agency holding a current nurse registry license from AHCA, as of the effective date of this rule, may continue to serve clients in those counties listed on its current license.

(6) A license, unless sooner suspended or revoked, shall automatically expire 2 years 1 year from the date of issuance and shall be renewable biennially annually.

(7) An application for renewal of a registry license shall be submitted, as referenced in Section 400.506(5), F.S. subsection 59A-18.004(1), F.A.C., not less than 60 days prior to expiration of the license. The submission shall be on AHCA Form 3110-7004, Nurse Registry Application for Renewal of License December 2005 , incorporated by reference, and shall include a renewal fee of $2,000 $1,000. The application shall include: All of the information required by paragraphs (4)(a) through (i)(m) above.

(8) No change.

(9) An application for a change of ownership of a registry shall be submitted, on AHCA Form 3110-7001, Nurse Registry Application for Initial License, Revised December 05, as referenced in subsection 59A-18.004(1), F.A.C., not less than 60 days prior to the effective date of the change. The submission shall include the change of ownership licensure fee of $2,000 $1,000. The application shall include all of the information required by paragraphs (4)(a) through (m) above.

(10) through (11) No change.

(12) If a change of address is to occur, the nurse registry must provide 14 days advance notice in writing to the AHCA Licensed Home Health Programs Unit in Tallahassee and the AHCA field office. The nurse registry must submit to the AHCA Licensed Home Health Programs Unit evidence of compliance with local zoning authorities for the new location. Emergency relocations must be reported within seven days, with the reason for the relocation documented. An emergency relocation can be due to any of the following situations:

(a) An eviction notice;

(b) Environmental conditions on or near the site which are not conducive to the health and well being of staff and clients, including a fire or flooding;

(c) An element near the site which would make the premises harmful or dangerous;

(d) Circumstances arising from or caused by weather conditions and/or a natural disaster; or

(e) A change in property zoning that requires the nurse registry to move.

Specific Authority 400.497, 400.506 FS. Law Implemented 400.497, 400.506, 400.512 FS. History–New 2-9-93, Amended 1-27-94, 12-24-00, ________.

 

59A-18.005 Registration Policies.

(1) Each nurse registry shall disseminate the following rules and statutes to each applicable independent contractor at the time of registration.

(a) Registered nurses and licensed practical nurses RN’s and LPN’s shall receive for their use and reference:

1. Subsection 59A-18.005(6), F.A.C., regarding health statements and communicable disease.

2.1. Rule 59A-18.007, F.A.C., Registered Nurses and Licensed Practical Nurses.

3.2. Rule 59A-18.011, F.A.C., Medical Plan of Treatment.

4.3. Rule 59A-18.012, F.A.C., Clinical Records.

5.4. Rule 59A-18.013, F.A.C., Administration of Biologicals.

6.5. Sections 400.506, 400.512, 400.484, 400.462, and 400.495, F.S.

(b) Certified nursing assistants C.N.A.’s and home health aides HHA’s shall receive for their use and reference:

1. Subsection 59A-18.005(6), F.A.C., regarding health statements and communicable disease.

2.1. Rule 59A-18.0081, F.A.C., Certified Nursing Assistant and Home Health Aide.

3.2. Sections 400.506, 400.512, 400.484, 400.462, and 400.495, F.S.

(c) Homemakers and/ Companions shall receive for their use and reference:

1. Rule 59A-18.009, F.A.C., Homemakers or Companions.

2. Sections 400.506, 400.512, 400.484, 400.462, and 400.495, F.S.

(2) through (5) No change.

(6) Prior to contact with patients, each new independent contractor referred for client care must furnish to the registry the results of a Mantoux method tuberculin skin text (TST) performed pursuant to Section 381.0011(4), F.S. The independent contractor must also submit a statement from a health care professional licensed under Chapter 458, F.S., or Chapter 459, F.S., a physician’s assistant, or an advanced registered nurse practitioner (ARNP) or a registered nurse licensed under Chapter 464, F.S., under the supervision of a licensed physician, or acting pursuant to an established protocol signed by a licensed physician, based upon an examination within the last six months, that the contractor is in reasonably good health and appears to be free from apparent signs or symptoms of a communicable disease including tuberculosis, pursuant to Section 381.0011(4), F.S sufficient to provide services to individuals with compromised health. If any independent contractor is later found to have, or is suspected of having, a communicable disease, he or she shall immediately cease to be referred as an independent contractor. If the independent contractor later provides a statement from a health care professional that such condition no longer exists, then the nurse registry can again refer patients to the independent contractor. It is the responsibility of the independent contractor nurse registry to ensure that patients are not placed at risk by immediately removing him or herself as a caregiver if he or she is found to have or is suspected of having a communicable disease. In the event that an independent contractor refuses to remove him or herself, the nurse registry shall report the situation to the county health department as an immediate threat to health, welfare and safety contractors with positive tuberculosis test results TST (10 or more MM’s). Positive test reactors shall submit a statement from a health care professional licensed under Chapter 458, F.S., or Chapter 459, F.S., that the independent contractor does not constitute a risk of communicating tuberculosis. A new contractor who has been a contractor of another nurse registry or employed by a home health agency may provide a copy of his health care statement from the files of the former nurse registry or home health agency provided that the statement was not issued more than 1 year prior and that the contractor has not had a break in service of more than 90 days. Upon the specific written request of an individual staff member, copies of the most recent tuberculosis test result and above mentioned health statement may be released by one employer or registry and provided to another employer or registry within 2 years of the initial date of the test results and statement. Medical information is confidential and must not be disclosed without the specific consent of the person to whom it pertains. The written request to release medical information the physical examination must be kept on file. If a person is found to have a communicable disease, that person shall be removed from contact with patients until a physician’s statement is received.

(7) No change.

(8) Registration folders on each independent contractor must contain the information required in Section 400.506(12), F.S.:

(a) through (c) No change.

(d) Evidence of HIV/AIDS training specified by the respective licensing board and that each non-licensed contractor received a continuing education course biennially on HIV and AIDS pursuant to Section 381.0035, F.S. a minimum of 2 hours of initial HIV/AIDS training and 1 hour biennially of continuing HIV/AIDS education units;

Specific Authority 400.497, 400.506 FS, Law Implemented 400.497, 400.506 FS. History–New 2-9-93, Amended 1-27-94, 12-24-00, ________.

 

59A-18.0081 Certified Nursing Assistant and Home Health Aide.

(1) No change.

(2) Be responsible for documenting services provided to the patient or client and for filing said documentation with the nurse registry on a regular basis. These service logs will be stored by the nurse registry in the client’s file, along with a record of requested registered nurse visits the monthly nurse assessments. The service logs shall include the name of the patient or client and a listing of the services provided;

(3) through (10) No change.

(11) C.N.A.’s and home health aides referred by nurse registries must have received a continuing education course biennially on HIV and AIDS minimum of 2 hours of initial training in HIV/AIDS and 1 hour biennially of HIV/AIDS training, pursuant to Section 381.0035, F.S.; and training to maintain a current CPR certification.

(12) C.N.A.’s and home health aides referred by nurse registries may assist with self-administration of medication as described in Section 400.488, F.S.

(a) Home health aides and C.N.A.’s assisting with self-administered medication, as described in Section 400.488, F.S., shall have received a minimum of 2 hours of training covering the following content:

1. Training shall cover state law and rule requirements with respect to the assistance with self-administration of medications in the home, procedures for assisting the resident with self-administration of medication, common medications, recognition of side effects and adverse reactions and procedures to follow when patients appear to be experiencing side effects and adverse reactions. Training must include verification that each C.N.A. and home health aide can read the prescription label and any instructions.

2. Individuals who cannot read shall not be permitted to assist with prescription medications.

(b) Documentation of training on assistance with self-administered medication from one of the following sources is acceptable:

1. Documentation of 2 hours of training in compliance with subsection 59A-8.0095(5), F.A.C., from a home health agency if the home health aide or C.N.A. previously worked for the home health agency;

2. A training certificate for 4 hours of training for assisted living facility staff in compliance with subsection 58A-5.0191(5), F.A.C.

3. A training certificate for at least 2 hours of training from a career education school licensed pursuant to Chapter 1005, F.S., and Chapter 6E, F.A.C., by the Department of Education, Commission for Independent Education.

(c) Documentation of the training must be maintained in the file of each home health aide and C.N.A. that assists patients with self-administered medication.

(d) In cases where a home health aide or a C.N.A. will provide assistance with self-administered medications as described in Section 400.488, F.S., and paragraph (e) below, a review of the medications for which assistance is to be provided shall be conducted by a registered nurse or licensed practical nurse to ensure the C.N.A. and home health aide is able to assist in accordance with their training and with the medication prescription. The patient or the patient’s caregiver must give written consent for a home health aide or C.N.A. to provide assistance with self-administered medications, as required in Section 400.488(2), F.S.

(e) The trained home health aide and C.N.A. may also provide the following assistance with self-administered medication, as needed by the patient and as described in Section 400.488, F.S.:

1. Prepare necessary items such as juice, water, cups, or spoons to assist the patient in the self-administration of medication;

2. Open and close the medication container or tear the foil of prepackaged medications;

3. Assist the resident in the self-administration process. Examples of such assistance include the steadying of the arm, hand, or other parts of the patient’s body so as to allow the self-administration of medication;

4. Assist the patient by placing unused doses of solid medication back into the medication container.

Specific Authority 400.497, 400.506 FS, Law Implemented 400.488, 400.497, 400.506 FS. History–New 1-27-94, Amended 12-24-00, ________.

 

59A-18.011 Medical Plan of Treatment.

(1) No change.

(2) The licensed nurse providing care to the patient is responsible for having the medical plan of treatment signed by the physician, physician assistant, or advanced registered nurse practitioner, acting within his or her respective scope of practice, within 30 days from the initiation of services and reviewed by the physician, physician assistant, or advanced registered nurse practitioner in consultation with the licensed nurse at least every 2 months.

(3) The licensed nurse responsible for delivering care to the patient is responsible for the medical plan of treatment which shall include, at a minimum, the following:

(a) through (d) No change.

(e) Dated signature of physician, physician assistant, or advanced registered nurse practitioner.

(4) through (5) No change.

(6) The nurse registry shall inform nurse registrants that the shift nurse that communicates with the physician’s office, the physician assistant or the advanced registered practitioner of the physician, about any changes in the physician’s orders should update the plan of treatment.

Specific Authority 400.497, 400.506 FS, Law Implemented 400.497, 400.506 FS. History–New 2-9-93, Amended 1-27-94, 12-24-00, ________.

 

59A-18.012 Clinical Records.

(1) through (2) No change.

(3) Plan of treatment as required in Section 400.506(17)(15), F.S.

(4) through (7) No change.

Specific Authority 400.497, 400.506 FS, Law Implemented 400.497, 400.506 FS. History–New 2-9-93, Amended 1-27-94, 12-24-00, ________.

 

59A-18.017 Supplemental Staffing for Health Care Facilities

(1) through (7) No change.

(8) If a nurse registry refers contractors to provide staffing service to a nursing home and the contractor has not lived in Florida for 5 years, that contractor will be required to undergo a level 2 background screening as required by Section 400.215, F.S.

(9)(8) Each nurse registry shall maintain files in an organized manner and such files will be made available for inspection by the agency during the hours the registry is in operation.

Specific Authority 400.497, 400.506 FS, Law Implemented 400.497, 400.506 FS. History–New 2-9-93, Amended 1-27-94, 12-24-00, ________.

 

59A-18.018 Emergency Management Plans.

(1) Pursuant to Section 400.506(16), F.S., each nurse registry shall prepare and maintain a written comprehensive emergency management plan, in accordance with the Comprehensive Emergency Management Plan for Nurse Registries, AHCA Form 3110-1016, December 2005, incorporated by reference. This document is available from the Agency for Health Care Administration at http://ahca.myflorida.com under Licensing, Nurse Registry. The plan shall describe how the nurse registry establishes and maintains an effective response to emergencies and disasters. The plan, once completed, will be sent by e-mail by multi-county nurse registries to the Office of Public Health Nursing, Department of Health or to the contact designated by the Department of Health for single county nurse registries as required in Section 400.506(16)(e), F.S.

(2) The nurse registry shall review its emergency management plan on an annual basis and make any substantive changes. Plans with any substantive changes will be forwarded for review to the entities identified in subsection (1).

(3) Changes in the telephone numbers of those administrative staff who are coordinating the nurse registry’s emergency response must be reported to the county emergency management office and to the county health department. For nurse registries with multiple counties on their license, the changes must be reported to each county health department and each county emergency management office. The telephone numbers must include numbers where the coordinating staff can be contacted outside of the nurse registry’s regular office hours. All nurse registries must report these changes, whether their plan has been previously reviewed or not, as defined in subsection (1).

(4) When a nurse registry goes through a change of ownership the new owner shall review the registry’s emergency management plan and make any substantive changes, including changes noted in subsection (3). Those nurse registries will need to report any substantive changes in their plans to the reviewing entity in subsection (1).

(5) In the event of an emergency, the nurse registry shall implement the nurse registry’s emergency management plan pursuant to Section 400.506(16), F.S. Also, the registry must meet the following requirements:

(a) All administrative staff shall be informed of responsibilities for implementing the emergency management plan.

(b) If telephone service is not available during an emergency, the registry shall have a contingency plan to support communication, pursuant to Section 400.506, F.S. A contingency plan may include cell phones, contact with a community based ham radio group, public announcements through radio or television stations, driving directly to the patient’s home, and, in medical emergency situations, contact with police or emergency rescue services.

(6) Nurse registries shall make available to patients information gathered from the county emergency management offices including the procedures and documents required for assisting patients with registration for special needs shelters.

(a) Upon initial contract for services, and at a minimum on an annual basis, each nurse registry shall, pursuant to Sections 400.506(15) and 252.355, F.S., inform patients, by the best method possible as it pertains to the person’s disability, and patient caregivers of the special needs registry and procedures for registration at the special needs registry maintained by their county emergency management office.

(b) If the patient is to be registered at the special needs registry, the nurse registry shall assist the patient with registering, pursuant to Section 400.506(15) and (16)(b), F.S., and must document in the patient’s file if the patient plans to evacuate or remain at home; if the patient’s caregiver or family can take responsibility during the emergency for services normally provided by independent contractors referred by the registry; or if the registry needs to make referrals in order for services to continue. If the patient has a case manager through the Community Care for the Elderly or the Medicaid Waiver programs or any other state funded program designated in law to help clients register with the special needs registry, then the nurse registry will check with the case manager to verify if the patient has already been registered. If so, a note will be made in the patient’s file by the nurse registry that the patient’s need for registration has already been reviewed and handled by the other program’s case manager.

(c) The independent contractors referred by the nurse registry, or registry staff, shall inform patients registered with the special needs registry that special needs shelters are an option of last resort and that services will not be equal to what they have received in their homes.

(d) This registration information, when collected, shall be submitted, pursuant to Section 400.506(15) and (16)(b) and (c), F.S., to the county emergency management office, or on a periodic basis as determined by the registry’s county emergency management office.

(7) The person referred for contract to a patient registered with the special needs registry, which shall include special needs registry patients being served in assisted living facilities and adult family care homes, shall ensure that continuous care is provided, either in the special needs shelter, or in the patient’s home pursuant to Section 400.506(16)(a), F.S., unless circumstances beyond the control of the independent contractor as described in Section 400.506(16)(d), F.S., make it impossible to continue services.

(8) Upon eminent threat of an emergency or disaster the nurse registry must contact those patients needing ongoing services pursuant to Section 400.506(16)(a), F.S., and confirm each patient’s plan during and immediately following an emergency. The nurse registry shall contact the assisted living facility and adult family care home patients and confirm their plans during and immediately following an emergency.

(9) If the independent contractor is unable to provide services to special needs registry patients, including any assisted living facility and adult family care home special needs registry patients, due to circumstances beyond their control pursuant to Section 400.506(16)(d), F.S., then the nurse registry will make reasonable efforts to find another independent contractor for the patient, pursuant to Section 400.506(16), F.S.

(10) During emergency situations, when there is not a mandatory evacuation order issued by the local county emergency management office, some patients, registered pursuant to Section 252.355, F.S., may decide not to evacuate and will stay in their homes. The nurse registry must establish procedures, prior to the time of an emergency, which will delineate to what extent the registry will continue to arrange for care during and immediately following an emergency pursuant to Section 400.506(16)(a), F.S. The registry shall also make reasonable attempts to ascertain which patients remaining at home or in their assisted living facility or adult family care home will need services from the registry and which patients have plans to receive care from their family or caregivers. If the assisted living facility or adult family care home does relocate the residents to another assisted living facility or adult family care home in the geographic area served by the nurse registry, the registry will continue to provide services to the residents. If the patients relocated outside the area served by the registry, the registry will assist the assisted living facility and adult family care home in obtaining the services of another registry already licensed for that area until the patient returns back to their original location.

(11) The prioritized list of registered special needs patients maintained by the nurse registry shall be kept current and shall include information, as defined in Section 400.506(16)(b) and (c), F.S. This list also shall be furnished to county health departments and to the county emergency management office, upon request.

(12) The independent contractor from the nurse registry is required to maintain in the home of the special needs patient a list of patient-specific medications, supplies and equipment required for continuing care and service should the patient be evacuated as per Section 400.506(16)(c), F.S.. The list must include the names of all medications, their dose, frequency, route, time of day and any special considerations for administration. The list must also include any allergies; the name of the patient’s physician and the physician’s phone number; and the name, phone number and address of the patient’s pharmacy. If the patient permits, the list can also include the patient’s diagnosis.

(13) The patient record for each person registered as a special needs patient shall include the list described in subsection (12) above and information as listed in Section 400.506(16)(a) and (b), F.S.

Specific Authority 400.506 FS. Law Implemented 400.506 FS. History–New ________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jan Benesh

NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Jeffrey N. Gregg

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: January 28, 2006

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: June 1, 2005