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       Florida Senate - 2010                      CS for CS for SB 2138
       By the Committees on Children, Families, and Elder Affairs; and
       Health Regulation; and Senator Gardiner
       586-03772-10                                          20102138c2
    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(2)(a), F.S.,
   82         relating to grounds for which the agency may take
   83         action against the owner of an adult day care center
   84         or its operator or employee; providing an effective
   85         date.
   87  Be It Enacted by the Legislature of the State of Florida:
   89         Section 1. Paragraph (e) of subsection (10) of section
   90  112.0455, Florida Statutes, is repealed.
   91         Section 2. Section 383.325, Florida Statutes, is repealed.
   92         Section 3. Section 395.1046, Florida Statutes, is repealed.
   93         Section 4. Section 395.3037, Florida Statutes, is repealed.
   94         Section 5. Paragraph (g) of subsection (2) of section
   95  400.0239, Florida Statutes, is amended to read:
   96         400.0239 Quality of Long-Term Care Facility Improvement
   97  Trust Fund.—
   98         (2) Expenditures from the trust fund shall be allowable for
   99  direct support of the following:
  100         (g) Other initiatives authorized by the Centers for
  101  Medicare and Medicaid Services for the use of federal civil
  102  monetary penalties, including projects recommended through the
  103  Medicaid “Up-or-Out” Quality of Care Contract Management Program
  104  pursuant to s. 400.148.
  105         Section 6. Subsection (10) of section 400.147, Florida
  106  Statutes, is repealed.
  107         Section 7. Section 400.148, Florida Statutes, is repealed.
  108         Section 8. Section 400.195, Florida Statutes, is repealed.
  109         Section 9. Section 400.476, Florida Statutes, is amended to
  110  read:
  111         400.476 Staffing requirements; notifications; limitations
  112  on staffing services.—
  113         (1) ADMINISTRATOR.—
  114         (a) An administrator may manage only one home health
  115  agency, except that an administrator may manage up to five home
  116  health agencies if all five home health agencies have identical
  117  controlling interests as defined in s. 408.803 and are located
  118  within one agency geographic service area or within an
  119  immediately contiguous county. If the home health agency is
  120  licensed under this chapter and is part of a retirement
  121  community that provides multiple levels of care, an employee of
  122  the retirement community may administer the home health agency
  123  and up to a maximum of four entities licensed under this chapter
  124  or chapter 429 which all have identical controlling interests as
  125  defined in s. 408.803. An administrator shall designate, in
  126  writing, for each licensed entity, a qualified alternate
  127  administrator to serve during the administrator’s absence. An
  128  alternate administrator must meet the requirements in this
  129  paragraph and s. 400.462(1).
  130         (b) An administrator of a home health agency who is a
  131  licensed physician, physician assistant, or registered nurse
  132  licensed to practice in this state may also be the director of
  133  nursing for a home health agency. An administrator may serve as
  134  a director of nursing for up to the number of entities
  135  authorized in subsection (2) only if there are 10 or fewer full
  136  time equivalent employees and contracted personnel in each home
  137  health agency.
  138         (c) The administrator shall organize and direct the
  139  agency’s ongoing functions, maintain an ongoing liaison with the
  140  board members and the staff, employ qualified personnel and
  141  ensure adequate staff education and evaluations, ensure the
  142  accuracy of public informational materials and activities,
  143  implement an effective budgeting and accounting system, and
  144  ensure that the home health agency operates in compliance with
  145  this part and part II of chapter 408 and rules adopted for these
  146  laws.
  147         (d) The administrator shall clearly set forth in writing
  148  the organizational chart, services furnished, administrative
  149  control, and lines of authority for the delegation of
  150  responsibilities for patient care. These responsibilities must
  151  be readily identifiable. Administrative and supervisory
  152  functions may not be delegated to another agency or
  153  organization, and the primary home health agency shall monitor
  154  and control all services that are not furnished directly,
  155  including services provided through contracts.
  156         (2) DIRECTOR OF NURSING.—
  157         (a) A director of nursing may be the director of nursing
  158  for:
  159         1. Up to two licensed home health agencies if the agencies
  160  have identical controlling interests as defined in s. 408.803
  161  and are located within one agency geographic service area or
  162  within an immediately contiguous county; or
  163         2. Up to five licensed home health agencies if:
  164         a. All of the home health agencies have identical
  165  controlling interests as defined in s. 408.803;
  166         b. All of the home health agencies are located within one
  167  agency geographic service area or within an immediately
  168  contiguous county; and
  169         c. Each home health agency has a registered nurse who meets
  170  the qualifications of a director of nursing and who has a
  171  written delegation from the director of nursing to serve as the
  172  director of nursing for that home health agency when the
  173  director of nursing is not present; and.
  174         d. This person, or similarly qualified alternate, is
  175  available at all times during operating hours and participates
  176  in all activities relevant to the professional services
  177  furnished, including, but not limited to, the oversight of
  178  nursing services, home health aides, and certified nursing
  179  assistants, and assignment of personnel.
  181  If a home health agency licensed under this chapter is part of a
  182  retirement community that provides multiple levels of care, an
  183  employee of the retirement community may serve as the director
  184  of nursing of the home health agency and up to a maximum of four
  185  entities, other than home health agencies, licensed under this
  186  chapter or chapter 429 which all have identical controlling
  187  interests as defined in s. 408.803.
  188         (b) A home health agency that provides skilled nursing care
  189  may not operate for more than 30 calendar days without a
  190  director of nursing. A home health agency that provides skilled
  191  nursing care and the director of nursing of a home health agency
  192  must notify the agency within 10 business days after termination
  193  of the services of the director of nursing for the home health
  194  agency. A home health agency that provides skilled nursing care
  195  must notify the agency of the identity and qualifications of the
  196  new director of nursing within 10 days after the new director is
  197  hired. If a home health agency that provides skilled nursing
  198  care operates for more than 30 calendar days without a director
  199  of nursing, the home health agency commits a class II
  200  deficiency. In addition to the fine for a class II deficiency,
  201  the agency may issue a moratorium in accordance with s. 408.814
  202  or revoke the license. The agency shall fine a home health
  203  agency that fails to notify the agency as required in this
  204  paragraph $1,000 for the first violation and $2,000 for a repeat
  205  violation. The agency may not take administrative action against
  206  a home health agency if the director of nursing fails to notify
  207  the department upon termination of services as the director of
  208  nursing for the home health agency.
  209         (c) A home health agency that is not Medicare or Medicaid
  210  certified and does not provide skilled care or provides only
  211  physical, occupational, or speech therapy is not required to
  212  have a director of nursing and is exempt from paragraph (b).
  213         (3) TRAINING.—A home health agency shall ensure that each
  214  certified nursing assistant employed by or under contract with
  215  the home health agency and each home health aide employed by or
  216  under contract with the home health agency is adequately trained
  217  to perform the tasks of a home health aide in the home setting.
  218         (a) The home health agency may not use as a home health
  219  aide on a full-time, temporary, per diem, or other basis, any
  220  individual to provide services unless the individual has
  221  completed a training and competency evaluation program, or a
  222  competency evaluation program, as permitted in s. 400.497, which
  223  meets the minimum standards established by the agency in state
  224  rules.
  225         (b) A home health aide is not competent in any task for
  226  which he or she is evaluated as “unsatisfactory.” The aide must
  227  perform any such task only under direct supervision by a
  228  licensed nurse until he or she receives training in the task and
  229  satisfactorily passes a subsequent evaluation in performing the
  230  task. A home health aide has not successfully passed a
  231  competency evaluation if the aide does not have a passing score
  232  on the test as specified by agency rule.
  233         (4) STAFFING.—Staffing services may be provided anywhere
  234  within the state.
  235         (5) PERSONNEL.—
  236         (a) The home health agency and its staff must comply with
  237  accepted professional standards and principles that apply to
  238  professionals, including, but not limited to, the state practice
  239  acts and the home health agency’s policies and procedures.
  240         (b) If personnel under hourly or per-visit contracts are
  241  used by the home health agency, there must be a written contract
  242  between those personnel and the agency which specifies the
  243  following requirements:
  244         1. Acceptance for care only of patients by the primary home
  245  health agency.
  246         2. The services to be furnished.
  247         3. The necessity to conform to all applicable agency
  248  policies, including personnel qualifications.
  249         4. The responsibility for participating in developing plans
  250  of care.
  251         5. The manner in which services are controlled,
  252  coordinated, and evaluated by the primary home health agency.
  253         6. The procedures for submitting clinical and progress
  254  notes, scheduling of visits, and periodic patient evaluation.
  255         7. The procedures for payment for services furnished under
  256  the contract.
  257         (c) A home health agency shall directly provide at least
  258  one of the types of services through home health agency
  259  employees, but may provide additional services under
  260  arrangements with another agency or organization. Services
  261  furnished under such arrangements must have a written contract
  262  conforming to the requirements specified in paragraph (b).
  263         (d) If home health aide services are provided by an
  264  individual who is not employed directly by the home health
  265  agency, the services of the home health aide must be provided
  266  under arrangements as stated in paragraphs (b) and (c). If the
  267  home health agency chooses to provide home health aide services
  268  under arrangements with another organization, the
  269  responsibilities of the home health agency include, but are not
  270  limited to:
  271         1. Ensuring the overall quality of the care provided by the
  272  aide;
  273         2. Supervising the aide’s services as described in s.
  274  400.487; and
  275         3. Ensuring that each home health aide providing services
  276  under arrangements with another organization has met the
  277  training requirements or competency evaluation requirements of
  278  s. 400.497.
  279         (e) The home health agency shall coordinate the efforts of
  280  all personnel furnishing services, and the personnel shall
  281  maintain communication with the home health agency to ensure
  282  that personnel efforts support the objectives outlined in the
  283  plan of care. The clinical record or minutes of case conferences
  284  shall ensure that effective interchange, reporting, and
  285  coordination of patient care occurs.
  286         Section 10. Section 400.487, Florida Statutes, is amended
  287  to read:
  288         400.487 Home health service agreements; physician’s,
  289  physician assistant’s, and advanced registered nurse
  290  practitioner’s treatment orders; patient assessment;
  291  establishment and review of plan of care; provision of services;
  292  orders not to resuscitate.—
  293         (1) Services provided by a home health agency must be
  294  covered by an agreement between the home health agency and the
  295  patient or the patient’s legal representative specifying the
  296  home health services to be provided, the rates or charges for
  297  services paid with private funds, and the sources of payment,
  298  which may include Medicare, Medicaid, private insurance,
  299  personal funds, or a combination thereof. The home health agency
  300  shall provide a copy of the agreement to the patient or the
  301  patient’s legal representative. A home health agency providing
  302  skilled care must make an assessment of the patient’s needs
  303  within 48 hours after the start of services.
  304         (2) When required by the provisions of chapter 464; part I,
  305  part III, or part V of chapter 468; or chapter 486, the
  306  attending physician, physician assistant, or advanced registered
  307  nurse practitioner, acting within his or her respective scope of
  308  practice, shall establish treatment orders for a patient who is
  309  to receive skilled care. The treatment orders must be signed by
  310  the physician, physician assistant, or advanced registered nurse
  311  practitioner before a claim for payment for the skilled services
  312  is submitted by the home health agency. If the claim is
  313  submitted to a managed care organization, the treatment orders
  314  must be signed within the time allowed under the provider
  315  agreement. The treatment orders shall be reviewed, as frequently
  316  as the patient’s illness requires, by the physician, physician
  317  assistant, or advanced registered nurse practitioner in
  318  consultation with the home health agency.
  319         (3) A home health agency shall arrange for supervisory
  320  visits by a registered nurse to the home of a patient receiving
  321  home health aide services as specified in subsection (9) in
  322  accordance with the patient’s direction, approval, and agreement
  323  to pay the charge for the visits.
  324         (4) The home health agency shall protect and promote the
  325  rights of each individual under its care, including each of the
  326  following rights:
  327         (a) Notice of rights.—The home health agency shall provide
  328  the patient with a written notice of the patient’s rights in
  329  advance of furnishing care to the patient or during the initial
  330  evaluation visit before the initiation of treatment. The home
  331  health agency must maintain documentation showing that it has
  332  complied with the requirements of this section.
  333         (b) Exercise of rights and respect for property and
  334  person.
  335         1. The patient has the right to exercise his or her rights
  336  as a patient of the home health agency.
  337         2. The patient has the right to have his or her property
  338  treated with respect.
  339         3. The patient has the right to voice grievances regarding
  340  treatment or care that is or fails to be furnished, or regarding
  341  the lack of respect for property by anyone who is furnishing
  342  services on behalf of the home health agency, and not be
  343  subjected to discrimination or reprisal for doing so.
  344         4. The home health agency must investigate complaints made
  345  by a patient or the patient’s family or guardian regarding
  346  treatment or care that is or fails to be furnished, or regarding
  347  the lack of respect for the patient’s property by anyone
  348  furnishing services on behalf of the home health agency. The
  349  home health agency shall document the existence of the complaint
  350  and its resolution.
  351         5. The patient and his or her immediate family or
  352  representative must be informed of the right to report
  353  complaints via the statewide toll-free telephone number to the
  354  agency as required in s. 408.810.
  355         (c) Right to be informed and to participate in planning
  356  care and treatment.
  357         1. The patient has the right to be informed, in advance,
  358  about the care to be furnished and of any changes in the care to
  359  be furnished. The home health agency shall advise the patient in
  360  advance of which disciplines will furnish care and the frequency
  361  of visits proposed to be furnished. The home health agency must
  362  advise the patient in advance of any change in the plan of care
  363  before the change is made.
  364         2. The patient has the right to participate in the planning
  365  of the care. The home health agency must advise the patient in
  366  advance of the right to participate in planning the care or
  367  treatment and in planning changes in the care or treatment. Each
  368  patient has the right to be informed of and to participate in
  369  the planning of his or her care. Each patient must be provided,
  370  upon request, a copy of the plan of care established and
  371  maintained for that patient by the home health agency.
  372         (5) When nursing services are ordered, the home health
  373  agency to which a patient has been admitted for care must
  374  provide the initial admission visit, all service evaluation
  375  visits, and the discharge visit by a direct employee. Services
  376  provided by others under contractual arrangements to a home
  377  health agency must be monitored and managed by the admitting
  378  home health agency. The admitting home health agency is fully
  379  responsible for ensuring that all care provided through its
  380  employees or contract staff is delivered in accordance with this
  381  part and applicable rules.
  382         (6) The skilled care services provided by a home health
  383  agency, directly or under contract, must be supervised and
  384  coordinated in accordance with the plan of care. The home health
  385  agency shall furnish skilled nursing services by or under the
  386  supervision of a registered nurse and in accordance with the
  387  plan of care. Any therapy services offered directly or under
  388  arrangement by the home health agency must be provided by a
  389  qualified therapist or by a qualified therapy assistant under
  390  the supervision of a qualified therapist and in accordance with
  391  the plan of care.
  392         (a) Duties and qualifications.—A qualified therapist shall
  393  assist the physician in evaluating the level of function, help
  394  develop or revise the plan of care, prepare clinical and
  395  progress notes, advise and consult with the family and other
  396  agency personnel, and participate in in-service programs. The
  397  therapist or therapy assistant must meet the qualifications in
  398  the state practice acts and related applicable rules.
  399         (b) Physical therapy assistants and occupational therapy
  400  assistants.—Services provided by a physical therapy assistant or
  401  occupational therapy assistant must be under the supervision of
  402  a qualified physical therapist or occupational therapist as
  403  required in chapter 486 and part III of chapter 468,
  404  respectively, and related applicable rules. A physical therapy
  405  assistant or occupational therapy assistant shall perform
  406  services planned, delegated, and supervised by the therapist,
  407  assist in preparing clinical notes and progress reports,
  408  participate in educating the patient and his or her family, and
  409  participate in in-service programs.
  410         (c) Speech therapy services.—Speech therapy services shall
  411  be furnished only by or under supervision of a qualified speech
  412  pathologist or audiologist as required in part I of chapter 468
  413  and related applicable rules.
  414         (d) Care follows a written plan of care.—The plan of care
  415  shall be reviewed by the physician or health professional who
  416  provided the treatment orders pursuant to subsection (2) and
  417  home health agency personnel as often as the severity of the
  418  patient’s condition requires, but at least once every 60 days or
  419  more when there is a patient-elected transfer, a significant
  420  change in condition, or a discharge and return to the same home
  421  health agency during the 60-day episode. Professional staff of a
  422  home health agency shall promptly alert the physician or other
  423  health professional who provided the treatment orders of any
  424  change that suggests a need to alter the plan of care.
  425         (e) Administration of drugs and treatment.—Only
  426  professional staff of a home health agency may administer drugs
  427  and treatments as ordered by the physician or health
  428  professional pursuant to subsection (2), with the exception of
  429  influenza and pneumococcal polysaccharide vaccines, which may be
  430  administered according to the policy of the home health agency
  431  developed in consultation with a physician and after an
  432  assessment for contraindications. Verbal orders shall be in
  433  writing and signed and dated with the date of receipt by the
  434  registered nurse or qualified therapist who is responsible for
  435  furnishing or supervising the ordered service. A verbal order
  436  may be accepted only by personnel who are authorized to do so by
  437  applicable state laws, rules, and internal policies of the home
  438  health agency.
  439         (7) A registered nurse shall conduct the initial evaluation
  440  visit, regularly reevaluate the patient’s nursing needs,
  441  initiate the plan of care and necessary revisions, furnish those
  442  services requiring substantial and specialized nursing skill,
  443  initiate appropriate preventive and rehabilitative nursing
  444  procedures, prepare clinical and progress notes, coordinate
  445  services, inform the physician and other personnel of changes in
  446  the patient’s condition and needs, counsel the patient and his
  447  or her family in meeting nursing and related needs, participate
  448  in in-service programs, and supervise and teach other nursing
  449  personnel, unless the home health agency providing the home
  450  health aide services is not Medicare-certified or Medicaid
  451  certified and does not provide skilled care.
  452         (8) A licensed practical nurse shall furnish services in
  453  accordance with agency policies, prepare clinical and progress
  454  notes, assist the physician and registered nurse in performing
  455  specialized procedures, prepare equipment and materials for
  456  treatments observing aseptic technique as required, and assist
  457  the patient in learning appropriate self-care techniques.
  458         (9) A home health aide and certified nursing assistant
  459  shall provide services that are in the service provision plan
  460  provided in s. 400.491 and other services that the home health
  461  aide or certified nursing assistant is permitted to perform
  462  under state law. The duties of a home health aide or certified
  463  nursing assistant include the provision of hands-on personal
  464  care, performance of simple procedures as an extension of
  465  therapy or nursing services, assistance in ambulation or
  466  exercises, and assistance in administering medications that are
  467  ordinarily self-administered and are specified in agency rules.
  468  Any services by a home health aide which are offered by a home
  469  health agency must be provided by a qualified home health aide
  470  or certified nursing assistant.
  471         (a) Assignment and duties.—A home health aide or certified
  472  nursing assistant shall be assigned to a specific patient by a
  473  registered nurse, unless the home health agency providing the
  474  home health aide services is not Medicare-certified or Medicaid
  475  certified and does not provide skilled care. Written patient
  476  care instructions for the home health aide and certified nursing
  477  assistant must be prepared by the registered nurse or other
  478  appropriate professional who is responsible for the supervision
  479  of the home health aide and certified nursing assistant as
  480  stated in this section.
  481         (b) Supervision.—If a patient receives skilled nursing
  482  care, the registered nurse shall perform the supervisory visit.
  483  If the patient is not receiving skilled nursing care but is
  484  receiving physical therapy, occupational therapy, or speech
  485  language pathology services, the appropriate therapist may
  486  provide the supervision. A registered nurse or other
  487  professional must make an onsite visit to the patient’s home at
  488  least once every 2 weeks. The visit is not required while the
  489  aide is providing care.
  490         (c) Supervising visits.—If home health aide services are
  491  provided to a patient who is not receiving skilled nursing care,
  492  physical or occupational therapy, or speech-language pathology
  493  services, a registered nurse must make a supervisory visit to
  494  the patient’s home at least once every 60 days, unless the home
  495  health agency providing the home health aide services is not
  496  Medicare or Medicaid certified and does not provide skilled
  497  care, either directly or through contracts. The registered nurse
  498  shall ensure that the aide is properly caring for the patient
  499  and each supervisory visit must occur while the home health aide
  500  is providing patient care. In addition to the requirements in
  501  this subsection, a home health agency shall arrange for
  502  additional supervisory visits by a registered nurse to the home
  503  of a patient receiving home health aide services in accordance
  504  with the patient’s direction, approval, and agreement to pay the
  505  charge for the visits.
  506         (10)(7) Home health agency personnel may withhold or
  507  withdraw cardiopulmonary resuscitation if presented with an
  508  order not to resuscitate executed pursuant to s. 401.45. The
  509  agency shall adopt rules providing for the implementation of
  510  such orders. Home health personnel and agencies shall not be
  511  subject to criminal prosecution or civil liability, nor be
  512  considered to have engaged in negligent or unprofessional
  513  conduct, for withholding or withdrawing cardiopulmonary
  514  resuscitation pursuant to such an order and rules adopted by the
  515  agency.
  516         Section 11. Subsection (11) of section 408.802, Florida
  517  Statutes, is repealed.
  518         Section 12. Paragraphs (e), (f), and (g) of subsection (15)
  519  of section 409.912, Florida Statutes, are repealed.
  520         Section 13. Subsection (2) of section 429.12, Florida
  521  Statutes, is repealed.
  522         Section 14. Subsection (5) of section 429.23, Florida
  523  Statutes, is repealed.
  524         Section 15. Paragraph (a) of subsection (2) of section
  525  429.911, Florida Statutes, is repealed.
  526         Section 16. This act shall take effect July 1, 2010.

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