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       Florida Senate - 2010                             CS for SB 2138
       By the Committee on Health Regulation; and Senator Gardiner
       588-03195-10                                          20102138c1
    1                        A bill to be entitled                      
    2         An act relating to health care; repealing s.
    3         112.0455(10)(e), F.S., relating to a prohibition
    4         against applying the Drug-Free Workplace Act
    5         retroactively; repealing s. 383.325, F.S., relating to
    6         the requirement of a licensed facility under s.
    7         383.305, F.S., to maintain inspection reports;
    8         repealing s. 395.1046, F.S., relating to the
    9         investigation of complaints regarding hospitals;
   10         repealing s. 395.3037, F.S.; deleting definitions
   11         relating to obsolete provisions governing primary and
   12         comprehensive stroke centers; amending s. 400.0239,
   13         F.S.; deleting an obsolete provision; repealing s.
   14         400.147(10), F.S., relating to a requirement that a
   15         nursing home facility report any notice of a filing of
   16         a claim for a violation of a resident’s rights or a
   17         claim of negligence; repealing s. 400.148, F.S.,
   18         relating to the Medicaid “Up-or-Out” Quality of Care
   19         Contract Management Program; repealing s. 400.195,
   20         F.S., relating to reporting requirements for the
   21         Agency for Health Care Administration; amending s.
   22         400.476, F.S.; providing requirements for an
   23         alternative administrator of a home health agency;
   24         revising the duties of the administrator; revising the
   25         requirements for a director of nursing for a specified
   26         number of home health agencies; prohibiting a home
   27         health agency from using an individual as a home
   28         health aide unless the person has completed training
   29         and an evaluation program; requiring a home health
   30         aide to meet certain standards in order to be
   31         competent in performing certain tasks; requiring a
   32         home health agency and staff to comply with accepted
   33         professional standards; providing certain requirements
   34         for a written contract between certain personnel and
   35         the agency; requiring a home health agency to provide
   36         certain services through its employees; authorizing a
   37         home health agency to provide additional services with
   38         another organization; providing responsibilities of a
   39         home health agency when it provides home health aide
   40         services through another organization; requiring the
   41         home health agency to coordinate personnel who provide
   42         home health services; requiring personnel to
   43         communicate with the home health agency; amending s.
   44         400.487, F.S.; requiring a home health agency to
   45         provide a copy of the agreement between the agency and
   46         a patient which specifies the home health services to
   47         be provided; providing the rights that are protected
   48         by the home health agency; requiring the home health
   49         agency to furnish nursing services by or under the
   50         supervision of a registered nurse; requiring the home
   51         health agency to provide therapy services through a
   52         qualified therapist or therapy assistant; providing
   53         the duties and qualifications of a therapist and
   54         therapy assistant; requiring supervision by a physical
   55         therapist or occupational therapist of a physical
   56         therapist assistant or occupational therapist
   57         assistant; providing duties of a physical therapist
   58         assistant or occupational therapist assistant;
   59         providing for speech therapy services to be provided
   60         by a qualified speech pathologist or audiologist;
   61         providing for a plan of care; providing that only the
   62         staff of a home health agency may administer drugs and
   63         treatments as ordered by certain health professionals;
   64         providing requirements for verbal orders; providing
   65         duties of a registered nurse, licensed practical
   66         nurse, home health aide, and certified nursing
   67         assistant who work for a home health agency; providing
   68         for supervisory visits of services provided by a home
   69         health agency; repealing s. 408.802(11), F.S.,
   70         relating to the applicability of the Health Care
   71         Licensing Procedures Act to private review agents;
   72         repealing s. 409.912(15)(e), (f), and (g), F.S.,
   73         relating to a requirement for the Agency for Health
   74         Care Administration to submit a report to the
   75         Legislature regarding the operations of the CARE
   76         program; repealing s. 429.12(2), F.S., relating to the
   77         sale or transfer of ownership of an assisted living
   78         facility; repealing s. 429.23(5), F.S., relating to
   79         each assisted living facility’s requirement to submit
   80         a report to the agency regarding liability claims
   81         filed against it; repealing s. 429.911, F.S., relating
   82         to grounds for which the agency may take action
   83         against the owner of an adult day care center or its
   84         operator or employee; providing an effective date.
   86  Be It Enacted by the Legislature of the State of Florida:
   88         Section 1. Paragraph (e) of subsection (10) of section
   89  112.0455, Florida Statutes, is repealed.
   90         Section 2. Section 383.325, Florida Statutes, is repealed.
   91         Section 3. Section 395.1046, Florida Statutes, is repealed.
   92         Section 4. Section 395.3037, Florida Statutes, is repealed.
   93         Section 5. Paragraph (g) of subsection (2) of section
   94  400.0239, Florida Statutes, is amended to read:
   95         400.0239 Quality of Long-Term Care Facility Improvement
   96  Trust Fund.—
   97         (2) Expenditures from the trust fund shall be allowable for
   98  direct support of the following:
   99         (g) Other initiatives authorized by the Centers for
  100  Medicare and Medicaid Services for the use of federal civil
  101  monetary penalties, including projects recommended through the
  102  Medicaid “Up-or-Out” Quality of Care Contract Management Program
  103  pursuant to s. 400.148.
  104         Section 6. Subsection (10) of section 400.147, Florida
  105  Statutes, is repealed.
  106         Section 7. Section 400.148, Florida Statutes, is repealed.
  107         Section 8. Section 400.195, Florida Statutes, is repealed.
  108         Section 9. Section 400.476, Florida Statutes, is amended to
  109  read:
  110         400.476 Staffing requirements; notifications; limitations
  111  on staffing services.—
  112         (1) ADMINISTRATOR.—
  113         (a) An administrator may manage only one home health
  114  agency, except that an administrator may manage up to five home
  115  health agencies if all five home health agencies have identical
  116  controlling interests as defined in s. 408.803 and are located
  117  within one agency geographic service area or within an
  118  immediately contiguous county. If the home health agency is
  119  licensed under this chapter and is part of a retirement
  120  community that provides multiple levels of care, an employee of
  121  the retirement community may administer the home health agency
  122  and up to a maximum of four entities licensed under this chapter
  123  or chapter 429 which all have identical controlling interests as
  124  defined in s. 408.803. An administrator shall designate, in
  125  writing, for each licensed entity, a qualified alternate
  126  administrator to serve during the administrator’s absence. An
  127  alternate administrator must meet the requirements in this
  128  paragraph and s. 400.462(1).
  129         (b) An administrator of a home health agency who is a
  130  licensed physician, physician assistant, or registered nurse
  131  licensed to practice in this state may also be the director of
  132  nursing for a home health agency. An administrator may serve as
  133  a director of nursing for up to the number of entities
  134  authorized in subsection (2) only if there are 10 or fewer full
  135  time equivalent employees and contracted personnel in each home
  136  health agency.
  137         (c) The administrator shall organize and direct the
  138  agency’s ongoing functions, maintain an ongoing liaison with the
  139  board members and the staff, employ qualified personnel and
  140  ensure adequate staff education and evaluations, ensure the
  141  accuracy of public informational materials and activities,
  142  implement an effective budgeting and accounting system, and
  143  ensure that the home health agency operates in compliance with
  144  this part and part II of chapter 408 and rules adopted for these
  145  laws.
  146         (d) The administrator shall clearly set forth in writing
  147  the organizational chart, services furnished, administrative
  148  control, and lines of authority for the delegation of
  149  responsibilities for patient care. These responsibilities must
  150  be readily identifiable. Administrative and supervisory
  151  functions may not be delegated to another agency or
  152  organization, and the primary home health agency shall monitor
  153  and control all services that are not furnished directly,
  154  including services provided through contracts.
  155         (2) DIRECTOR OF NURSING.—
  156         (a) A director of nursing may be the director of nursing
  157  for:
  158         1. Up to two licensed home health agencies if the agencies
  159  have identical controlling interests as defined in s. 408.803
  160  and are located within one agency geographic service area or
  161  within an immediately contiguous county; or
  162         2. Up to five licensed home health agencies if:
  163         a. All of the home health agencies have identical
  164  controlling interests as defined in s. 408.803;
  165         b. All of the home health agencies are located within one
  166  agency geographic service area or within an immediately
  167  contiguous county; and
  168         c. Each home health agency has a registered nurse who meets
  169  the qualifications of a director of nursing and who has a
  170  written delegation from the director of nursing to serve as the
  171  director of nursing for that home health agency when the
  172  director of nursing is not present; and.
  173         d. This person, or similarly qualified alternate, is
  174  available at all times during operating hours and participates
  175  in all activities relevant to the professional services
  176  furnished, including, but not limited to, the oversight of
  177  nursing services, home health aides, and certified nursing
  178  assistants, and assignment of personnel.
  180  If a home health agency licensed under this chapter is part of a
  181  retirement community that provides multiple levels of care, an
  182  employee of the retirement community may serve as the director
  183  of nursing of the home health agency and up to a maximum of four
  184  entities, other than home health agencies, licensed under this
  185  chapter or chapter 429 which all have identical controlling
  186  interests as defined in s. 408.803.
  187         (b) A home health agency that provides skilled nursing care
  188  may not operate for more than 30 calendar days without a
  189  director of nursing. A home health agency that provides skilled
  190  nursing care and the director of nursing of a home health agency
  191  must notify the agency within 10 business days after termination
  192  of the services of the director of nursing for the home health
  193  agency. A home health agency that provides skilled nursing care
  194  must notify the agency of the identity and qualifications of the
  195  new director of nursing within 10 days after the new director is
  196  hired. If a home health agency that provides skilled nursing
  197  care operates for more than 30 calendar days without a director
  198  of nursing, the home health agency commits a class II
  199  deficiency. In addition to the fine for a class II deficiency,
  200  the agency may issue a moratorium in accordance with s. 408.814
  201  or revoke the license. The agency shall fine a home health
  202  agency that fails to notify the agency as required in this
  203  paragraph $1,000 for the first violation and $2,000 for a repeat
  204  violation. The agency may not take administrative action against
  205  a home health agency if the director of nursing fails to notify
  206  the department upon termination of services as the director of
  207  nursing for the home health agency.
  208         (c) A home health agency that is not Medicare or Medicaid
  209  certified and does not provide skilled care or provides only
  210  physical, occupational, or speech therapy is not required to
  211  have a director of nursing and is exempt from paragraph (b).
  212         (3) TRAINING.—A home health agency shall ensure that each
  213  certified nursing assistant employed by or under contract with
  214  the home health agency and each home health aide employed by or
  215  under contract with the home health agency is adequately trained
  216  to perform the tasks of a home health aide in the home setting.
  217         (a) The home health agency may not use as a home health
  218  aide on a full-time, temporary, per diem, or other basis, any
  219  individual to provide services unless the individual has
  220  completed a training and competency evaluation program, or a
  221  competency evaluation program, as permitted in s. 400.497, which
  222  meets the minimum standards established by the agency in state
  223  rules.
  224         (b) A home health aide is not competent in any task for
  225  which he or she is evaluated as “unsatisfactory.” The aide must
  226  perform any such task only under direct supervision by a
  227  licensed nurse until he or she receives training in the task and
  228  satisfactorily passes a subsequent evaluation in performing the
  229  task. A home health aide has not successfully passed a
  230  competency evaluation if the aide does not have a passing score
  231  on the test as specified by agency rule.
  232         (4) STAFFING.—Staffing services may be provided anywhere
  233  within the state.
  234         (5) PERSONNEL.—
  235         (a) The home health agency and its staff must comply with
  236  accepted professional standards and principles that apply to
  237  professionals, including, but not limited to, the state practice
  238  acts and the home health agency’s policies and procedures.
  239         (b) If personnel under hourly or per-visit contracts are
  240  used by the home health agency, there must be a written contract
  241  between those personnel and the agency which specifies the
  242  following requirements:
  243         1. Acceptance for care only of patients by the primary home
  244  health agency.
  245         2. The services to be furnished.
  246         3. The necessity to conform to all applicable agency
  247  policies, including personnel qualifications.
  248         4. The responsibility for participating in developing plans
  249  of care.
  250         5. The manner in which services are controlled,
  251  coordinated, and evaluated by the primary home health agency.
  252         6. The procedures for submitting clinical and progress
  253  notes, scheduling of visits, and periodic patient evaluation.
  254         7. The procedures for payment for services furnished under
  255  the contract.
  256         (c) A home health agency shall directly provide at least
  257  one of the types of services through home health agency
  258  employees, but may provide additional services under
  259  arrangements with another agency or organization. Services
  260  furnished under such arrangements must have a written contract
  261  conforming to the requirements specified in paragraph (b).
  262         (d) If home health aide services are provided by an
  263  individual who is not employed directly by the home health
  264  agency, the services of the home health aide must be provided
  265  under arrangements as stated in paragraphs (b) and (c). If the
  266  home health agency chooses to provide home health aide services
  267  under arrangements with another organization, the
  268  responsibilities of the home health agency include, but are not
  269  limited to:
  270         1. Ensuring the overall quality of the care provided by the
  271  aide;
  272         2. Supervising the aide’s services as described in s.
  273  400.487; and
  274         3. Ensuring that each home health aide providing services
  275  under arrangements with another organization has met the
  276  training requirements or competency evaluation requirements of
  277  s. 400.497.
  278         (e) The home health agency shall coordinate the efforts of
  279  all personnel furnishing services, and the personnel shall
  280  maintain communication with the home health agency to ensure
  281  that personnel efforts support the objectives outlined in the
  282  plan of care. The clinical record or minutes of case conferences
  283  shall ensure that effective interchange, reporting, and
  284  coordination of patient care occurs.
  285         Section 10. Section 400.487, Florida Statutes, is amended
  286  to read:
  287         400.487 Home health service agreements; physician’s,
  288  physician assistant’s, and advanced registered nurse
  289  practitioner’s treatment orders; patient assessment;
  290  establishment and review of plan of care; provision of services;
  291  orders not to resuscitate.—
  292         (1) Services provided by a home health agency must be
  293  covered by an agreement between the home health agency and the
  294  patient or the patient’s legal representative specifying the
  295  home health services to be provided, the rates or charges for
  296  services paid with private funds, and the sources of payment,
  297  which may include Medicare, Medicaid, private insurance,
  298  personal funds, or a combination thereof. The home health agency
  299  shall provide a copy of the agreement to the patient or the
  300  patient’s legal representative. A home health agency providing
  301  skilled care must make an assessment of the patient’s needs
  302  within 48 hours after the start of services.
  303         (2) When required by the provisions of chapter 464; part I,
  304  part III, or part V of chapter 468; or chapter 486, the
  305  attending physician, physician assistant, or advanced registered
  306  nurse practitioner, acting within his or her respective scope of
  307  practice, shall establish treatment orders for a patient who is
  308  to receive skilled care. The treatment orders must be signed by
  309  the physician, physician assistant, or advanced registered nurse
  310  practitioner before a claim for payment for the skilled services
  311  is submitted by the home health agency. If the claim is
  312  submitted to a managed care organization, the treatment orders
  313  must be signed within the time allowed under the provider
  314  agreement. The treatment orders shall be reviewed, as frequently
  315  as the patient’s illness requires, by the physician, physician
  316  assistant, or advanced registered nurse practitioner in
  317  consultation with the home health agency.
  318         (3) A home health agency shall arrange for supervisory
  319  visits by a registered nurse to the home of a patient receiving
  320  home health aide services as specified in subsection (9) in
  321  accordance with the patient’s direction, approval, and agreement
  322  to pay the charge for the visits.
  323         (4) The home health agency shall protect and promote the
  324  rights of each individual under its care, including each of the
  325  following rights:
  326         (a) Notice of rights.—The home health agency shall provide
  327  the patient with a written notice of the patient’s rights in
  328  advance of furnishing care to the patient or during the initial
  329  evaluation visit before the initiation of treatment. The home
  330  health agency must maintain documentation showing that it has
  331  complied with the requirements of this section.
  332         (b) Exercise of rights and respect for property and
  333  person.
  334         1. The patient has the right to exercise his or her rights
  335  as a patient of the home health agency.
  336         2. The patient has the right to have his or her property
  337  treated with respect.
  338         3. The patient has the right to voice grievances regarding
  339  treatment or care that is or fails to be furnished, or regarding
  340  the lack of respect for property by anyone who is furnishing
  341  services on behalf of the home health agency, and not be
  342  subjected to discrimination or reprisal for doing so.
  343         4. The home health agency must investigate complaints made
  344  by a patient or the patient’s family or guardian regarding
  345  treatment or care that is or fails to be furnished, or regarding
  346  the lack of respect for the patient’s property by anyone
  347  furnishing services on behalf of the home health agency. The
  348  home health agency shall document the existence of the complaint
  349  and its resolution.
  350         5. The patient and his or her immediate family or
  351  representative must be informed of the right to report
  352  complaints via the statewide toll-free telephone number to the
  353  agency as required in s. 408.810.
  354         (c) Right to be informed and to participate in planning
  355  care and treatment.
  356         1. The patient has the right to be informed, in advance,
  357  about the care to be furnished and of any changes in the care to
  358  be furnished. The home health agency shall advise the patient in
  359  advance of which disciplines will furnish care and the frequency
  360  of visits proposed to be furnished. The home health agency must
  361  advise the patient in advance of any change in the plan of care
  362  before the change is made.
  363         2. The patient has the right to participate in the planning
  364  of the care. The home health agency must advise the patient in
  365  advance of the right to participate in planning the care or
  366  treatment and in planning changes in the care or treatment. Each
  367  patient has the right to be informed of and to participate in
  368  the planning of his or her care. Each patient must be provided,
  369  upon request, a copy of the plan of care established and
  370  maintained for that patient by the home health agency.
  371         (5) When nursing services are ordered, the home health
  372  agency to which a patient has been admitted for care must
  373  provide the initial admission visit, all service evaluation
  374  visits, and the discharge visit by a direct employee. Services
  375  provided by others under contractual arrangements to a home
  376  health agency must be monitored and managed by the admitting
  377  home health agency. The admitting home health agency is fully
  378  responsible for ensuring that all care provided through its
  379  employees or contract staff is delivered in accordance with this
  380  part and applicable rules.
  381         (6) The skilled care services provided by a home health
  382  agency, directly or under contract, must be supervised and
  383  coordinated in accordance with the plan of care. The home health
  384  agency shall furnish skilled nursing services by or under the
  385  supervision of a registered nurse and in accordance with the
  386  plan of care. Any therapy services offered directly or under
  387  arrangement by the home health agency must be provided by a
  388  qualified therapist or by a qualified therapy assistant under
  389  the supervision of a qualified therapist and in accordance with
  390  the plan of care.
  391         (a) Duties and qualifications.—A qualified therapist shall
  392  assist the physician in evaluating the level of function, help
  393  develop or revise the plan of care, prepare clinical and
  394  progress notes, advise and consult with the family and other
  395  agency personnel, and participate in in-service programs. The
  396  therapist or therapy assistant must meet the qualifications in
  397  the state practice acts and related applicable rules.
  398         (b) Physical therapy assistants and occupational therapy
  399  assistants.—Services provided by a physical therapy assistant or
  400  occupational therapy assistant must be under the supervision of
  401  a qualified physical therapist or occupational therapist as
  402  required in chapter 486 and part III of chapter 468,
  403  respectively, and related applicable rules. A physical therapy
  404  assistant or occupational therapy assistant shall perform
  405  services planned, delegated, and supervised by the therapist,
  406  assist in preparing clinical notes and progress reports,
  407  participate in educating the patient and his or her family, and
  408  participate in in-service programs.
  409         (c) Speech therapy services.—Speech therapy services shall
  410  be furnished only by or under supervision of a qualified speech
  411  pathologist or audiologist as required in part I of chapter 468
  412  and related applicable rules.
  413         (d) Care follows a written plan of care.—The plan of care
  414  shall be reviewed by the physician or health professional who
  415  provided the treatment orders pursuant to subsection (2) and
  416  home health agency personnel as often as the severity of the
  417  patient’s condition requires, but at least once every 60 days or
  418  more when there is a patient-elected transfer, a significant
  419  change in condition, or a discharge and return to the same home
  420  health agency during the 60-day episode. Professional staff of a
  421  home health agency shall promptly alert the physician or other
  422  health professional who provided the treatment orders of any
  423  change that suggests a need to alter the plan of care.
  424         (e) Administration of drugs and treatment.—Only
  425  professional staff of a home health agency may administer drugs
  426  and treatments as ordered by the physician or health
  427  professional pursuant to subsection (2), with the exception of
  428  influenza and pneumococcal polysaccharide vaccines, which may be
  429  administered according to the policy of the home health agency
  430  developed in consultation with a physician and after an
  431  assessment for contraindications. Verbal orders shall be in
  432  writing and signed and dated with the date of receipt by the
  433  registered nurse or qualified therapist who is responsible for
  434  furnishing or supervising the ordered service. A verbal order
  435  may be accepted only by personnel who are authorized to do so by
  436  applicable state laws, rules, and internal policies of the home
  437  health agency.
  438         (7) A registered nurse shall conduct the initial evaluation
  439  visit, regularly reevaluate the patient’s nursing needs,
  440  initiate the plan of care and necessary revisions, furnish those
  441  services requiring substantial and specialized nursing skill,
  442  initiate appropriate preventive and rehabilitative nursing
  443  procedures, prepare clinical and progress notes, coordinate
  444  services, inform the physician and other personnel of changes in
  445  the patient’s condition and needs, counsel the patient and his
  446  or her family in meeting nursing and related needs, participate
  447  in in-service programs, and supervise and teach other nursing
  448  personnel.
  449         (8) A licensed practical nurse shall furnish services in
  450  accordance with agency policies, prepare clinical and progress
  451  notes, assist the physician and registered nurse in performing
  452  specialized procedures, prepare equipment and materials for
  453  treatments observing aseptic technique as required, and assist
  454  the patient in learning appropriate self-care techniques.
  455         (9) A home health aide and certified nursing assistant
  456  shall provide services that are ordered by the physician in the
  457  plan of care and that the aide or assistant is permitted to
  458  perform under state law. The duties of a home health aide or
  459  certified nursing assistant include the provision of hands-on
  460  personal care, performance of simple procedures as an extension
  461  of therapy or nursing services, assistance in ambulation or
  462  exercises, and assistance in administering medications that are
  463  ordinarily self-administered and are specified in agency rules.
  464  Any services by a home health aide which are offered by a home
  465  health agency must be provided by a qualified home health aide
  466  or certified nursing assistant.
  467         (a) Assignment and duties.—A home health aide or certified
  468  nursing assistant shall be assigned to a specific patient by a
  469  registered nurse. Written patient care instructions for the home
  470  health aide and certified nursing assistant must be prepared by
  471  the registered nurse or other appropriate professional who is
  472  responsible for the supervision of the home health aide and
  473  certified nursing assistant as stated in this section.
  474         (b) Supervision.—If a patient receives skilled nursing
  475  care, the registered nurse shall perform the supervisory visit.
  476  If the patient is not receiving skilled nursing care but is
  477  receiving physical therapy, occupational therapy, or speech
  478  language pathology services, the appropriate therapist may
  479  provide the supervision. A registered nurse or other
  480  professional must make an onsite visit to the patient’s home at
  481  least once every 2 weeks. The visit is not required while the
  482  aide is providing care.
  483         (c) Supervising visits.—If home health aide services are
  484  provided to a patient who is not receiving skilled nursing care,
  485  physical or occupational therapy, or speech-language pathology
  486  services, a registered nurse must make a supervisory visit to
  487  the patient’s home at least once every 60 days, unless the home
  488  health agency providing the home health aide services is not
  489  Medicare or Medicaid certified and does not provide skilled
  490  care, either directly or through contracts. The registered nurse
  491  shall ensure that the aide is properly caring for the patient
  492  and each supervisory visit must occur while the home health aide
  493  is providing patient care. In addition to the requirements in
  494  this subsection, a home health agency shall arrange for
  495  additional supervisory visits by a registered nurse to the home
  496  of a patient receiving home health aide services in accordance
  497  with the patient’s direction, approval, and agreement to pay the
  498  charge for the visits.
  499         (10)(7) Home health agency personnel may withhold or
  500  withdraw cardiopulmonary resuscitation if presented with an
  501  order not to resuscitate executed pursuant to s. 401.45. The
  502  agency shall adopt rules providing for the implementation of
  503  such orders. Home health personnel and agencies shall not be
  504  subject to criminal prosecution or civil liability, nor be
  505  considered to have engaged in negligent or unprofessional
  506  conduct, for withholding or withdrawing cardiopulmonary
  507  resuscitation pursuant to such an order and rules adopted by the
  508  agency.
  509         Section 11. Subsection (11) of section 408.802, Florida
  510  Statutes, is repealed.
  511         Section 12. Paragraphs (e), (f), and (g) of subsection (15)
  512  of section 409.912, Florida Statutes, are repealed.
  513         Section 13. Subsection (2) of section 429.12, Florida
  514  Statutes, is repealed.
  515         Section 14. Subsection (5) of section 429.23, Florida
  516  Statutes, is repealed.
  517         Section 15. Section 429.911(2)(b), Florida Statutes, is
  518  repealed.
  519         Section 16. This act shall take effect July 1, 2010.

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