The purpose is to revise the health care service pool rules in Chapter 59A-27, F.A.C. to reduce the regulatory burden and update the rules to conform to law changes.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Health Facility and Agency Licensing

RULE NOS.:RULE TITLES:

59A-27.002Registration and Change in Registration Information

59A-27.004Penalties and Enforcement Procedures

59A-27.005Pool Administration

59A-27.006Procedures and Records

PURPOSE AND EFFECT: The purpose is to revise the health care service pool rules in Chapter 59A-27, F.A.C. to reduce the regulatory burden and update the rules to conform to law changes.

SUMMARY: Amendments throughout will remove and revise language in conformance with Chapter 408, Part II, and Chapter 59A-35, F.A.C. Other amendments remove the time frame for notification of a new managing employee since it is in Rule 59A-35.110, F.A.C. The requirement to maintain a medical history on all personnel is removed. The health statement requirement for workers adds the phrase “that could be casually transmitted” as recommended by the Department of Health.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will 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 been prepared by the Agency.

The Agency has determined that this will have an adverse impact on small business, however will not 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 been prepared for proposed Rule 59A-27.002, F.A.C., and is available at http://www.ahca.myflorida.com/MCHQ/index.shtml#three select “Health Care Services Pool”. Following is a summary of the SERC for Rule 59A-27.002, F.A.C.:

Paragraph 59A-27.002(1)(a) , F.A.C., updates the biennial registration fee amount for health care services pools from $600 to $616 pursuant to Section 408.805, F.S. The aggregate cost for all health care services pools for the five year period is estimated to be $19,920. The Agency for Health Care Administration will incur the cost of rulemaking, as well the costs associated with enforcing the proposed changes. There is no cost to local government for the revisions in this rule since none of these changes affect local government entities. The Agency has determined that the proposed rules are 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:

For rules where a SERC was not prepared, the Agency prepared a checklist to determine the need 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.

RULEMAKING AUTHORITY: 400.980, 408.819 FS.

LAW IMPLEMENTED: 400.980, 408.815, 408.806, 408.809, 408.810, 408.812, 408.813, 408.815 FS.

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

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Anne Menard at [e-mail] or [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59A-27.002 Registration and Change in Registration Information.

(1) All health care services pools must register with the AHCA using the Health Care Licensing Application Health Care Services Pool form, AHCA form AHCA 3110-1010, Revised September 2013, January 2002, Health Care Licensing Application Health Care Services Pool APPLICATION FOR HEALTH CARE SERVICES POOL REGISTRATION, https://www.flrules.org/Gateway/reference.asp?No=Ref-04011, incorporated herein by reference, before providing health care personnel as temporary employees to any health care facility. The applicant must also submit the Health Care Licensing Application Addendum required in subsection 59A-35.060(1), F.A.C. The application form and addendum can be obtained at http://www.ahca.myflorida.com/HQAlicensureforms. The application form and addendum must be submitted with the registration fee of $616. Applications are reviewed in accordance with the process set forth in Section 408.806, F.S.

(a) Registrations are valid for a period of 2 years from the date of issuance and may not be transferred or assigned.

(a)(b) When a change of ownership, as defined in Section 408.803(5), F.S., is planned, the buyer or transferee must submit an application for a new registration according to the time frame in Section 408.806(2)(b), F.S. The application form, addendum and fee required in subsection (1) Whenever a controlling interest in a health care services pool is sold, a new registration for the pool must be submitted filed with the registration fee of $616 $600 and a certificate of registration must be issued before the pool provides health care personnel as temporary employees to any health care facility.

(b) Screening for the managing employee administrator and the financial officer shall be in accordance with level 2 standards for screening set forth in Section 408.809 400.980(4), F.S. and Rule 59A-35.090, F.A.C. 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, Home Care Unit –Mail Stop 34, 2727 Mahan Drive, Tallahassee, Florida 32308. Screening processing fees for level 2 screening shall be made payable to the Agency for Health Care Administration.

(2) Each health care services pool must renew its registration biennially as required in Section 408.806(2) 400.980, F.S., by submitting the application form, addendum and fee in subsection (1) using. AHCA form AHCA 3110-1010, January 2002 APPLICATION FOR HEALTH CARE SERVICES POOL REGISTRATION. Failure to receive notification of the expiration of a registration does not relieve the registrant of the responsibility of meeting the financial responsibility or registration renewal requirements.

(3) Upon receipt of an application for registration and the registration fee of $600 or an application for renewal of registration and a renewal fee of $600, the department will examine the content of the application to determine its sufficiency under Section 402.48, F.S., and these rules.

(a) Within 30 days from receipt of the application, AHCA will notify the health care services pool by mail if the application was not accompanied by the proper fee, if there are any deficiencies in the content of the application, or if the application is inadequate to meet the requirements of Section 400.980, F.S., and these rules. Failure of AHCA to notify the health care services pool of any deficiencies shall not relieve the pool of any responsibility under the law.

(b) The health care services pool shall have 30 days from the date of AHCA’s notification of deficiencies to correct any deficiencies which are noted. Prior to final agency action rejecting the application for registration or the application for renewal of registration, AHCA shall notify the health care services pool of the pending rejection and shall provide an opportunity for the pool to request formal or informal proceedings pursuant to Section 120.57, F.S. If an application is rejected, a complete refiling of the documents, including the payment of filing fees, shall be required.

(3)(4) Registrants will receive a certificate acknowledging their registration and each renewal of registration. The current certificate of registration or renewal of registration must be conspicuously displayed on the premises and must be readily visible from the entrance.

(4)(5) Change in Registration Information. A Within 14 days prior to any change in registration information, a registered health care services pool shall notify advise the AHCA Home Care Unit Department of any change in business name; location; or mailing address as required in Rule 59A-35.040, F.A.C. Telephone, email and fax number changes or phone number. Such information shall be reported by email, mail or fax to AHCA Home Care Unit to [e-mail], AHCA Home Care Unit, 2727 Mahan Drive – Mail Stop 34, Tallahassee, Florida 32308, or fax [phone]. Any request that results in the agency issuing a new registration certificate other than at initial application, renewal, or change of ownership must be accompanied with the fee required in subsections 59A-35.050(3), (4), F.A.C of $15.00.

(6) All forms referenced in these rules may be obtained at  www.fdhc.state.fl.us or by calling AHCA Home Care Unit [phone].

Rulemaking Authority 400.980, 408.819 FS. Law Implemented 400.980, 408.805, 408.806, 408.809, 408.810 FS. History–New 1-7-90, Amended 8-12-91, Formerly 7G-1.007, Amended 10-17-94, 2-27-97, Formerly 61E6-1.007, 64B22-1.002, Amended 6-27-02,___________.

 

59A-27.004 Penalties and Enforcement Procedures.

(1) Any person or entity operating a health care services pool without a registration, with an expired registration, or with a revoked registration, shall immediately cease operations until a proper registration can be acquired and be fined $2,500. Failure to cease operations after agency notification may result in a fine as stated in Section 408.812, F.S.

(2)(a) If the Health Care Services Pool fails to screen all employees or contractors, or employs persons who are disqualified from employment based on a criminal record check, a fine, as permitted in Section 408.813(3), F.S., not to exceed $1,000 shall be assessed, for each employee or contractor.

(b) If AHCA determines the fine to be insufficient to the violation, it may deny, suspend or revoke the registration as permitted in Section 408.815, F.S as well.

(3) The failure to file a timely application for a renewal certificate of registration shall result in an administrative fine, pursuant to Section 408.806(2)(d) 400.980(13), F.S., charged to the pool in the amount of $50.00 per day, each day constituting a separate violation. As established in Section 400.980(8), F.S., a timely filed application is one that is received by AHCA at least 30 days prior to the expiration date of the registration or, in the case of a change of ownership, the application for a new registration is required at least 30 days prior to the sale of a controlling interest in a health care services pool. In no event shall such fine aggregate more than $1,500.

(4) Any other violations of provisions of law or rule can result in a fine pursuant to Section 400.980, F.S. of $2,500 or revocation of the certificate of registration, or both.

(5) After AHCA determines that a violation has occurred, it shall notify the pool operator of the alleged violations through the issuance of a notice to show cause. The notice shall also state the facts upon which such violations are based and shall advise the recipient, pursuant to Chapter 120, F.S., of their right to either a formal hearing, if disputed issues of material fact exists, or an informal proceeding, if no disputed issues of material fact exist.

(6) No change.

Rulemaking Authority 400.980, 408.819 FS. Law Implemented 400.980, 408.806, 408.812, 408.813, 408.815 FS. History–New 8-2-90, Formerly 7G-1.013, Amended 10-17-94, Formerly 61E6-1.013, 64B22-1.004, Amended 6-27-02,__________.

 

59A-27.005 Pool Administration.

Health care services pools shall meet the following minimum standards of operation:

(1) Each pool, at the time of initial registration and at each registration renewal, shall identify a managing employee the individual who will be responsible for the day-to-day supervision and administration of the pool and shall designate this individual, on the biennial registration application form required in subsection 59A-27.002(1), F.A.C. (entitled APPLICATION FOR HEALTH CARE SERVICES POOL REGISTRATION, as referenced in Rule 59A-27.002, F.A.C.), as the pool’s representative for purposes of any communications with AHCA Home Care Unit. The managing employee This individual must be familiar with the work requirements and the prerequisites for licensure or certification in each of the health care disciplines and specialties for which the pool is providing referrals. Any time there is a change in this position, the pool shall give written notice to AHCA Home Care Unit of such change. Such notice shall be filed with AHCA Home Care Unit with the name of the replacement managing employee as required in paragraph 59A-35.110(1)(c), F.S the department within 14 days prior to the change becoming effective.

(2) through (7) No change.

(8) The various entities to which a health care services pool might send personnel differ considerably in their requirements and these requirements are subject to change. A Therefore, it is incumbent on the health care services pool must to remain knowledgeable on the current regulations of each of the facility types and entities to which they send personnel so as to ensure that they are in compliance with Section 400.980(6)(11), F.S., and only place personnel that meet all the needs and requirements of the facility or entity to which they are being sent. Each pool shall maintain health records and a medical history on all health care workers who have direct contact with patients and shall require evidence of a physical examination. The pool employee or independent contractor must submit a statement from a health care professional licensed under Chapter 458 or 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 employee or contractor is in good health sufficient to provide services to individuals with compromised health. It is the responsibility of the health care services pool to ensure that patients are not placed at risk by pool employees or contractors. 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 the physical examination must be kept on file. If a person is found to have a communicable disease that could be casually transmitted, that person shall be removed from contact with patients until a physician’s statement, indicating that the person is no longer has a communicable disease that can be casually transmitted, is received.

(9) through (10) No change.

(11) The failure to comply with the financial responsibility law, Section 400.980(7)(12), F.S., and these rules, the furnishing of false or misleading information, the failure to timely notify the AHCA of a change in status, or the failure to document compliance with the financial responsibility law upon request by the AHCA shall be grounds for disciplinary action, including fines or registration revocation, or both.

Rulemaking Authority 400.980 FS. Law Implemented 400.980 FS. History–New 8-2-90, Formerly 7G-1.015, Amended 10-17-94, Formerly 61E6-1.015, 64B22-1.005, Amended 6-27-02,___________.

 

59A-27.006 Procedures and Records.

(1) Each health care services pool shall, to the extent applicable, maintain the following business records and shall make these records available for inspection by the department upon request:

(a) Copies of corporate articles of incorporation and bylaws, if applicable;

(b) Records documenting the work performed by personnel referred by the pool including: the date of initial referral of a worker by the pool, dates and location of each placement and the names and addresses of client health care facilities. Copies of personnel time records cards or invoices identifying the services provided are acceptable records for meeting this requirement;

(c) No change.

(2)(a) through (b) No change.

(c) Documentation of personnel information ensuring compliance with Section 400.980(6)(11), F.S.

(d) through (i) No change.

(3) Background Screening is required as stated in Section 408.809, F.S. and Rule 59A-35.090, F.A.C. Proof of requried background screening shall be maintained by the health care services pool for all persons that are required to be screened. All pool employees and those who are independent contractors placed by the pool shall be subjected to background screening.

(a) Level 1 Background Screening:

1. Submission of the Request for Criminal History Check, AHCA form 3110-002, June 1998, incorporated by reference, should be made to the Florida Department of Law Enforcement, Crime Information Bureau, Post Office Box 1489, Tallahassee, Florida 32302.

2. This form may be obtained on the Background Screening page located on the Agency for Health Care Administration web site, www.fdhc.state.fl.us or by calling AHCA Home Care Unit [phone]. The cost of processing the criminal records check shall be borne by the petitioning party pursuant to Section 435.08, F.S. The checks for Level 1 screening shall be made payable to the Florida Department of Law Enforcement for criminal records check.

(b) Level 2 Background Screening:

1. The managing employee and the financial officer of the pool shall both be required to satisfy a level 2 background screening as stated in paragraph 59A-27.002(1)(c), F.A.C.

2. Any pool employee or independent contractor, who has not lived in Florida continuously for the previous five years, must first satisfy a level 2 background screening before being referred by the pool for employment in a nursing home.

3. Fingerprint cards may be ordered by e-mail from the Background Screening page on the AHCA website, www.fdhc.state.fl.us.

4. Unless they accompany an initial application for a Health Care Services Pool certification as stated in paragraph 59A-27.002(1)(c), F.A.C., completed fingerprint cards should be submitted to AHCA Background Screening, 2727 Mahan Drive, Mail Stop 40, Tallahassee, Florida 32308. The costs of processing the criminal background check shall be borne by the petitioning party pursuant to Section 435.08, F.S. Checks submitted with fingerprint cards for level 2 background screening should be made payable to AHCA.

Rulemaking Authority 400.980, 408.809 FS. Law Implemented 400.980, 408.819 FS. History–New 8-2-90, Formerly 7G-1.017, Amended 10-17-94, Formerly 61E6-1.017, 64B22-1.006, Amended 6-27-02,__________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Anne Menard

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: March 4, 2014

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: November 12, 2013