PCS for HB 937 — Acute Hospital Care at Home, Florida House of Representatives (2022)
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- 2022 3093 Professions Public Health Subcommittee Proposed Committee Bills Pcbs Fn Pcs For
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- 2022 3093 Professions Public Health Subcommittee Proposed Committee Bills Pcbs Fn Pcs For Hb 937
Summary
A Florida House of Representatives proposed committee substitute, PCS for HB 937 (2022), a bill relating to acute hospital care at home. It amends s. 401.23, F.S., and s. 465.003, F.S., to define acute hospital care at home as acute and post-acute services in a patient's permanent residence through a program approved by the Centers for Medicare and Medicaid Services and the Agency for Health Care Administration. It amends s. 401.272, F.S., to let paramedics provide basic and advanced life support services to such patients, making the supervising physician liable for the paramedic's acts or omissions, and amends s. 465.019, F.S., to let Class III institutional pharmacies fill prescriptions for these patients. Other sections conform cross-references in ss. 14.33, 252.515, 395.1027, and 401.245, and the act takes effect July 1, 2022.
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“PCS for HB 937 — Acute Hospital Care at Home, Florida House of Representatives (2022).”
Original at www.flhouse.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/2022-3093-professions-public-health-subcommittee-proposed-committee-bills-pcbs-fn-pcs-for-hb-937/
, SHA-256 4b344e621ed09a792bad54d93604ad304b9493523821e351691e10b412560a8c.Full text
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
PCS for HB 937 2022
1 A bill to be entitled
2 An act relating to acute hospital care at home;
3 amending s. 401.23, F.S.; defining the term "acute
4 hospital care at home"; amending s. 401.272, F.S.;
5 authorizing paramedics to perform basic life support
6 services and advanced life support services to acute
7 hospital care at home patients under certain
8 circumstances; providing that a physician or medical
9 director who supervises or directs the provision of
10 such services by a paramedic is liable for any act or
11 omission during the provision of such services;
12 authorizing the Department of Health to adopt rules;
13 amending s. 465.003, F.S.; defining the term "acute
14 hospital care at home"; amending s. 465.019, F.S.;
15 specifying that Class III institutional pharmacies may
16 dispense, distribute, compound, and fill prescriptions
17 for medicinal drugs for inpatient treatment and acute
18 care at home patients; amending ss. 14.33, 252.515,
19 395.1027, and 401.245, F.S.; conforming cross-
20 references; providing an effective date.
21
22 Be It Enacted by the Legislature of the State of Florida:
23
24 Section 1. Present subsections (1) through (22) of section
25 401.23, Florida Statutes, are redesignated as subsections (2)
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26 through (23), respectively, a new subsection (1) is added to
27 that section, and present subsection (19) of that section is
28 amended, to read:
29 401.23 Definitions.—As used in this part, the term:
30 (1) "Acute hospital care at home" means acute and post-
31 acute health care services provided in a clinically qualified
32 patient’s permanent residence, as defined in s. 196.012, through
33 a program approved by the Centers for Medicare and Medicaid
34 Services and the Agency for Health Care Administration.
35 (20)(19) "Physician" means a practitioner who is licensed
36 under the provisions of chapter 458 or chapter 459. For the
37 purpose of providing "medical direction" as defined in this
38 section subsection (14) for the treatment of patients
39 immediately before prior to or during transportation to a United
40 States Department of Veterans Affairs medical facility,
41 "physician" also means a practitioner employed by the United
42 States Department of Veterans Affairs.
43 Section 2. Paragraph (c) is added to subsection (2) of
44 section 401.272, Florida Statutes, to read:
45 401.272 Emergency medical services community health care. —
46 (2) Notwithstanding any other provision of law to the
47 contrary:
48 (c) Paramedics may provide basic life support services and
49 advanced life support services to acute hospital care at home
50 patients as specified in the paramedic’s supervisory
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51 relationship with a physician or standing orders as described in
52 s. 401.265, s. 458.348, or s. 459.025. Each physician who
53 supervises or provides medical direction to a paramedic who
54 administers basic life support services or advanced life support
55 services to acute care at home patients pursuant to a formal
56 supervisory relationship or standing orders is liable for any
57 act or omission of the paramedic acting under the physician’s
58 supervision or medical direction when performing such services.
59 The department may adopt and enforce rules necessary to enforce
60 this paragraph.
61 Section 3. Subsections (1) through (22) of section
62 465.003, Florida Statutes, are renumbered as subsections (2)
63 through (23), respectively, and subsection (1) is added to that
64 section, to read:
65 465.003 Definitions.—As used in this chapter, the term:
66 (1) "Acute hospital care at home" means acute and post-
67 acute health care services provided in a clinically qualified
68 patient’s permanent residence, as defined in s. 196.012, through
69 a program approved by the Centers for Medicare and Medicaid
70 Services and the Agency for Health Care Administration.
71 Section 4. Paragraph (d) of subsection (2) and par agraph
72 (a) of subsection (4) of section 465.019, Florida Statutes, are
73 amended to read:
74 465.019 Institutional pharmacies; permits.—
75 (2) The following classes of institutional pharmacies are
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76 established:
77 (d)1. "Class III institutional pharmacies" are those
78 institutional pharmacies, including central distribution
79 facilities, affiliated with a hospital which that provide the
80 same services that are authorized by a Class II institutional
81 pharmacy permit. Class III institutional pharmacies may also:
82 a. Dispense, distribute, compound, and fill prescriptions
83 for medicinal drugs for inpatient treatment or for acute
84 hospital care at home program patients.
85 b. Prepare prepackaged drug products.
86 c. Conduct other pharmaceutical services for the
87 affiliated hospital and for entities under common control that
88 are each permitted under this chapter to possess medicinal
89 drugs.
90 d. Provide the services in sub-subparagraphs a.-c. to an
91 entity under common control which holds an active health care
92 clinic establishment permit as required under s. 499.01(2)(r).
93 2. A Class III institutional pharmacy shall maintain
94 policies and procedures addressing:
95 a. The consultant pharmacist responsible for
96 pharmaceutical services.
97 b. Safe practices for the preparation, dispensing ,
98 prepackaging, distribution, and transportation of medicinal
99 drugs and prepackaged drug products.
100 c. Recordkeeping to monitor the movement, distribution,
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101 and transportation of medicinal drugs and prepackaged drug
102 products.
103 d. Recordkeeping of pharmacy staff responsible for each
104 step in the preparation, dispensing, prepackaging,
105 transportation, and distribution of medicinal drugs and
106 prepackaged drug products.
107 e. Medicinal drugs and prepackaged drug products that may
108 not be safely distributed among Class III institutional
109 pharmacies.
110 (4)(a) Medicinal drugs shall be dispensed by in an
111 institutional pharmacy to outpatients only when that institution
112 has secured a community pharmacy permit from the department.
113 However, medicinal drugs may be dispensed by a hospital that
114 operates a Class II or Class III institutional pharmacy to a
115 patient of the hospital's emergency department or a hospital
116 inpatient upon discharge if a prescriber, as defined in s.
117 465.025(1), treating the patient in such hospital determines
118 that the medicinal drug is warranted and that community pharmacy
119 services are not readily accessible, geographically or
120 otherwise, to the patient. Such prescribing and dispensing must
121 be for a supply of the drug that will last for the greater of
122 the following:
123 1. Up to 48 hours; or
124 2. Through the end of the next business day.
125 Section 5. Subsection (1) of section 14.33, Florida
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126 Statutes, is amended to read:
127 14.33 Medal of Heroism.—
128 (1) The Governor may award a Medal of Heroism of
129 appropriate design, with ribbons and appurtenances, to a law
130 enforcement, correctional, or correctional probation officer , as
131 defined in s. 943.10(14); a firefighter, as defined in s.
132 112.191(1)(b); an emergency medical technician, as defined in s.
133 401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s.
134 401.23(17). A recipient must have distinguished himself or
135 herself conspicuously by gallantry and intrepidity, must have
136 risked his or her life deliberately above and beyond the call of
137 duty while performing duty in his or her respective position,
138 and must have engaged in hazardous or perilous activities to
139 preserve lives with the knowledge that such activities might
140 result in great personal harm.
141 Section 6. Paragraph (a) of subsection (3) of section
142 252.515, Florida Statutes, is amended to read:
143 252.515 Postdisaster Relief Assistance Act; immunity from
144 civil liability.—
145 (3) As used in this section, the term:
146 (a) "Emergency first responder" means:
147 1. A physician licensed under chapter 458.
148 2. An osteopathic physician licensed under chapter 459.
149 3. A chiropractic physician licensed under chapter 460.
150 4. A podiatric physician licensed under chapter 461.
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151 5. A dentist licensed under chapter 466.
152 6. An advanced practice registered nurse licensed under s.
153 464.012.
154 7. A physician assistant licensed under s. 458.347 or s.
155 459.022.
156 8. A worker employed by a public or private hospital in
157 the state.
158 9. A paramedic as defined in s. 401.23 s. 401.23(17).
159 10. An emergency medical technician as defined in s.
160 401.23 s. 401.23(11).
161 11. A firefighter as defined in s. 633.102.
162 12. A law enforcement officer as defined in s. 943.10.
163 13. A member of the Florida National Guard.
164 14. Any other personnel designated as emergency personnel
165 by the Governor pursuant to a declared emergency.
166 Section 7. Subsection (5) of section 395.1027, Florida
167 Statutes, is amended to read:
168 395.1027 Regional poison control centers.—
169 (5) By October 1, 1999, each regional poison control
170 center shall develop a prehospital emergency dispatch protocol
171 with each licensee as defined in s. 401.23 by s. 401.23(13) in
172 the geographic area covered by the regional poison control
173 center. The prehospital emergency dispatch protocol shall be
174 developed by each licensee's medical director in conjunction
175 with the designated regional poison control center responsible
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176 for the geographic area in which the licensee operates. The
177 protocol shall define toxic substances and describe the
178 procedure by which the designated regional poison control center
179 may be consulted by the licensee. If a call is transferred to
180 the designated regional poison control center in accordance with
181 the protocol established under this section and s. 401.268, the
182 designated regional poison control center shall assume
183 responsibility and liability for the call.
184 Section 8. Paragraph (b) of subsection (2) of section
185 401.245, Florida Statutes, is amended to read:
186 401.245 Emergency Medical Services Advisory Council. —
187 (2)
188 (b) Representation on the Emergency Medical Services
189 Advisory Council shall include: two licensed physicians who are
190 "medical directors" as defined in s. 401.23 s. 401.23(15) or
191 whose medical practice is closely related to emergency medical
192 services; two emergency medical service administrators, one of
193 whom is employed by a fire service; two certified paramedics,
194 one of whom is employed by a fire service; two certified
195 emergency medical technicians, one of whom is employed by a fire
196 service; one emergency medical services educator; one emergency
197 nurse; one hospital administrator; one representative of air
198 ambulance services; one representative of a commercial ambulance
199 operator; and two laypersons who are in no way connected with
200 emergency medical services, one of whom is a representative of
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201 the elderly. Ex officio members of the advisory council from
202 state agencies shall include, but are shall not be limited to,
203 representatives from the Department of Education, the Department
204 of Management Services, the State Fire Marshal, the Department
205 of Highway Safety and Motor Vehicles, the Department of
206 Transportation, and the Division of Emergency Management.
207 Section 9. This act shall take effect July 1, 2022.
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