The Agency is proposing to amend a rule within Chapter 59A-13, F.A.C., Prescribed Pediatric Extended Care Centers (PPEC). The Agency proposes to update Rule 59A-13.010, F.A.C., Nursing Services, to clarify qualifications and requirements for ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Health Facility and Agency Licensing

RULE NO.:RULE TITLE:

59A-13.010Nursing Services

PURPOSE AND EFFECT: The Agency is proposing to amend a rule within Chapter 59A-13, F.A.C., Prescribed Pediatric Extended Care Centers (PPEC). The Agency proposes to update Rule 59A-13.010, F.A.C., Nursing Services, to clarify qualifications and requirements for nursing services within Prescribed Pediatric Extended Care Centers.

SUMMARY: Rule 59A-13.010, F.A.C., Nursing Services details nursing requirements for Prescribed Pediatric Extended Care Centers. The Agency proposes to update the rule to clarify qualifications and requirements for nursing services within Prescribed Pediatric Extended Care Centers.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A SERC has not been prepared by the agency. For rules listed where no SERC was prepared, the Agency prepared a checklist for each rule to determine the necessity for a SERC. Based on this information at the time of the analysis and pursuant to section 120.541, Florida Statutes, the rule will not require legislative ratification. 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.

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.

RULEMAKING AUTHORITY: 400.914, FS.

LAW IMPLEMENTED: 400.914(1)(d), FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Monday, October 21, 2019, 10:30 a.m. - 11:30 a.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 1, Room 100, Tallahassee, FL 32308

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 3 days before the workshop/meeting by contacting: Jacqueline Williams, Bureau of Health Facility Regulation, 2727 Mahan Drive, Tallahassee, Florida, [phone]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Jacqueline Williams at [phone] or email at: [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59A-13.010 Nursing Services.

(1) A registered nurse (RN) will serve full-time as the Director of Nursing. The Director of Nursing must have at least the following qualifications:

(a) Hold a current Florida registered nurse license.

(b) Hold a current certification in Cardiopulmonary Resuscitation (CPR).

(c) Have a minimum of two (2) years general pediatric nursing experience of which at least six (6) months must have been spent caring for medically fragile infants or children in a pediatric intensive care, neonatal intensive care, PPEC or similar care setting during the previous five (5) years.

(2) The Director of Nursing is responsible for the daily operation of the PPEC center.

(3) Registered nurse staffing standards:

(a) The registered nurse must have at least the following qualifications and experience:

1. Licensed as a registered nurse in Florida, pursuant to Chapter 464, F.S., and two (2) or more years of pediatric experience, with at least six (6) months experience caring for medically or technologically dependent children.

2. Current certification in CPR.

3. Pediatric nursing experience, defined as being responsible for the care of acutely ill or chronically ill children, within the previous 24 months.

(b) The registered nurse staff must provide:

1. Nursing interventions; educational services to increase the parent’s or guardian’s confidence and competence in caring for the child with special needs; assistance to facilitate coping with the effects of chronic illness on the child and family and support effective relationships among siblings and the ill child; interventions to foster normal development and psychosocial adaptation.

2. Information regarding availability and access to community resources.

3. A collaborative relationship with the interdisciplinary health team.

(4) Licensed practical nurse (LPN) staffing standards:

Licensed practical nurses working in a PPEC center must be supervised by a registered nurse and have the following qualifications and experience;

(a) Hold a current Florida licensed practical nurse license pursuant to Chapter 464, F.S.; and

(b) Have two (2) years experience in pediatrics; and

(b)(c) Hold a current certification in CPR.

(5) Direct care personnel staffing standards. For the purposes of this subsection, other direct care personnel include: nursing assistants, nursing assistants certified pursuant to Chapter 464, F.S., patient care technicians, medical assistants, Emergency Medical Technicians (EMT) or Paramedics licensed pursuant to Chapter 401, F.S., and individuals with training and experience in education, social services or child care related fields.

(a) Direct care personnel must meet the following requirements:

1. Have one (1) year experience in the care of infants and toddlers,

2. Employment references documenting skill in the care of infants or and children, and,

3. Hold a current certification in CPR.

(b) Direct care personnel must work under the supervision of the registered nurse and be responsible for providing direct care to PPEC center children.

(6) Total staffing for nursing services and direct care must, at a minimum, meet the following ratios:

Children	Total Staff	RN	RN or LPN	Direct Care, or Licensed Nurse (RN or LPN)
1	1	1
2-6	2	1		1
7-9	3	1	1	1
10-12	4	1	1	2
13-15	5	2	1	2
16-18	6	2	1	3
19-21	7	2	2	3
22-24	8	2	2	4
25-27	9	3	2	4
28-30	10	3	2	5
31-33	11	3	3	5
34-36	12	3	3	6
37-39	13	4	3	6
40-42	14	4	3	7
43-45	15	4	4	7

If the PPEC center has a census of more than 45 children, the staffing must increase by one staff for every three (3) children alternating between a direct care staff and licensed nurse.

Rulemaking Authority 400.914(1) FS. Law Implemented 400.914(1)(d) FS. History–New 3-8-89, Formerly 10D-102.010, Amended 6-22-06, _______.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jacqueline Williams

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Mary Mayhew, Secretary

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: September 09, 2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: April 11, 2019