64-3.030: Guidelines for Special Needs Shelter Staffing Levels
PURPOSE AND EFFECT: The purpose of the proposed rule is to implement section 381.0303(3) and section 381.0303(6), F.S. The statute establishes requirements for definitions, guidelines and standards related to persons with special needs, the registration process for persons with special needs, and special needs shelters.
SUMMARY: The proposed new rule defines a person with special needs including eligibility criteria for access to the special needs shelter. The rule identifies the service environment and the type of service the person with special needs should expect. The rule provides scalable guidelines for special need shelter staffing. The rule defines special needs shelter and equipment and the responsibility of the person with special needs or his or her home medical equipment provider to ensure that his or her own life-sustaining or life-supporting equipment is brought to the special needs shelter. The rule specifies the registration information that should be gathered on all persons with special needs, which will be used for pre-event planning. The rule also specifies that the local emergency management and county health department share this information to determine appropriate placement for sheltering. Information from the unregistered person with special needs is gathered upon his or her arrival at the shelter. The rule makes allowances for families to shelter together. The rule requires the county health department to invite local health and medical stakeholders to participate in special needs shelter planning. The rule establishes how the health care practitioner and facilities may apply for reimbursement.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
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.
SPECIFIC AUTHORITY:
LAW IMPLEMENTED:
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: April 11, 2007 at 9:00 a.m. – 12:00 p.m.
PLACE: Building 4040, Room 301, 4040 Esplanade Way, Tallahassee, FL 32399-7000
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Christie Brown, 4052 Bald Cypress Way, Bin C27, Tallahassee, FL 32399-1711, Phone Number: (850) 245-4444, Extension: 3871
THE FULL TEXT OF THE PROPOSED RULE IS:
DEPARTMENT OF HEALTH
CHAPTER 64-3 SPECIAL NEEDS SHELTER
64-3.010 Definitions
64-3.020 Eligibility Criteria for Special Needs Shelters
64-3.030 Guidelines for Special Needs Shelter Staffing Levels
64-3.040 Definition of Special Needs Shelter Supplies and Equipment
64-3.050 Special Needs Shelter Registration
64-3.060 Addressing the Needs of Families
64-3.070 Pre-event Planning Activities
64-3.080 Service Reimbursement
64-3.010 Definitions
(1) A person with special needs is someone, who during periods of evacuation or emergency, requires sheltering assistance, due to physical impairment, mental impairment, cognitive impairment, or sensory disabilities, that exceeds the basic level of care provided at a general population shelter, but does not require the level of care provided at a skilled medical facility. A person with special needs is not a person residing in a facility required by state law to have an evacuation and emergency management plan for natural and man-made disasters.
(2) A caregiver is an individual who is familiar with the care requirements of the person with special needs, is capable of providing the level of care necessary to maintain the health of the person with special needs and has been identified by the person with special needs to be his or her caregiver.
(3) Special needs shelters are locations that are, in whole or in part, designated in pre-event planning activities as refuges that provide shelter to persons with special needs who have no other option for sheltering. These shelters have back-up generator power. Special needs shelter services are provided in an austere environment, with the intent of minimizing deterioration of pre-disaster levels of health.
Specific Authority 381.0303(6)(a), F.S. Law Implemented 381.0303(6)(a), F.S. History–New
64-3.020 Eligibility Criteria for Special Needs Shelters
(1) A person shall be eligible for access to a special needs shelter if they are a person with special needs.
(2) Special needs shelters may choose to accept persons with care needs that exceed the criteria stated in 64-3.010(1).
(3) Determination as to the capacity (either in skills or assets) of the special needs shelter is made by the local emergency management agency and the county health department or their designees.
(4) Every reasonable effort shall be made to avoid admitting a person with a known communicable condition or a condition that requires airborne precautions.
Specific Authority 381.0303(6)(a), F.S. Law Implemented 381.0303(6)(a), F.S. History–New
64-3.030 Guidelines for Special Needs Shelter Staffing Levels
(1) The following is a guideline for special needs shelter staffing:
(a) Each special needs shelter should be staffed at a minimum with one registered nurse or advanced registered nurse practitioner on every shift during the sheltering event.
(b) The special needs shelter may be additionally staffed with one licensed medical practitioner per 20 persons with special needs per shift during the sheltering event.
(c) The special needs shelter may be additionally staffed with one unlicensed person per 20 persons with special needs per shift during the sheltering event.
(2) Staffing levels may require adjustment as the sheltering event warrants. Variables may include the stage of the sheltering event, acuity of the persons with special needs, presence of caregivers, or availability of volunteers.
Specific Authority 381.0303(6)(c), F.S. Law Implemented 381.0303(6)(c), F.S. History–New
64-3.040 Definition of Special Needs Shelter Supplies and Equipment
(1) Special needs shelter supplies and equipment are the items necessary to provide services in a special needs shelter during an evacuation or emergency to minimize deterioration of the person’s pre-disaster levels of health.
(2) The Department of Health maintains a list of recommended special needs shelter supplies and equipment. The list may be requested from the Department of Health, Office of Public Health Nursing,
(3) The person with special needs or his or her home medical equipment provider will be required to ensure all life sustaining or life supporting equipment is available at the special needs shelter in accordance with Section 400.925(13) and Section 400.934(20)(a)1., F.S.
Specific Authority 381.0303(6)(d), F.S. Law Implemented 381.0303(6)(d), F.S. History–New
64-3.050 Special Needs Shelter Registration
(1) The entity registering a person with special needs for access to the special needs shelter will gather information on the person with special needs. The information items gathered will be used for pre-event planning and will include but not be limited to the following:
(a) Full name.
(b) Phone number and street address including the city and zip code.
(e) Height and weight.
(f) Primary language.
(g) Emergency contact information for a local and non-local emergency point of contact including the name, relationship, and phone number.
(h) Residence type and living situation, whether alone or with a relative or caregiver.
(i) Any type of medical dependence on electricity, such as oxygen concentrator, nebulizer, feeding pump, continuous positive airway pressure equipment, suction equipment, or medication requiring refrigeration.
(j) Any type of medical dependence on oxygen, including the type, rate, and mode of administration.
(k) Any assistance required with medications.
(l) Any cognitive impairment, mental health problems, psychiatric, or personality disorder such as Alzheimer’s disease, dementia, obsessive compulsive disorder, autism, conduct disorder, anxiety, or depression.
(m) Any sensory loss or impairment and any related assistive device.
(n) Any mobility impairment and any related assistive device.
(o) Any use of a trained service animal.
(p) Any type of incontinence.
(q) Any dependence on dialysis.
(r) Name and contact information for any other medical support providers, such as home health agency, hospice, nurse registry, home medical equipment provider, and dialysis center.
(s) A list of all medical conditions.
(t) A list of all medications.
(u) Any transportation needs.
(2) The registry application information of all persons with special needs will be provided to the county health department or the agency with the responsibility for the management of care in the special needs shelter at pre-determined intervals established jointly by the county emergency management agency and the county health department or the agency with the responsibility for the management of care in the special needs shelter.
(3) The county health department or the agency with the responsibility for the management of care in the special needs shelter will review the registry application information to determine if the applicant is appropriate to place in the special needs shelter during an evacuation or emergency. The county emergency management agency will be notified of the determination.
(4) The application information of all persons with special needs who are on the county emergency management agency’s special needs shelter list will be provided to the county health department or the agency with the responsibility for the management of care in the special needs shelter immediately prior to a sheltering event.
(5) Persons with special needs who are unregistered, but who arrive at the special needs shelter during a sheltering event, will be assessed at the activated special needs shelter point of intake, and assessed for appropriate shelter placement.
Specific Authority 381.0303(6)(e), F.S. Law Implemented 381.0303(6)(e), F.S. History–New
64-3.060 Addressing the Needs of Families
(1) The caregiver of a person with special needs who is eligible for admission to a special needs shelter, and all persons for whom he or she is the caregiver, will be allowed to shelter together in the special needs shelter.
(2) A person with special needs, who is also responsible for the care of individuals without special needs, will be allowed to shelter in the special needs shelter with the persons for whom he or she is the caregiver.
Specific Authority 381.0303(6)(f), F.S. Law Implemented 381.0303(6)(f), F.S. History–New
64-3.070 Pre-event Planning Activities
The local emergency management agency will be the lead agency in the coordination of integrated and comprehensive special needs shelter planning in cooperation with county health department, or locally designated ESF 8 Health and Medical lead agency, consistent with Appendix 8 (Health and Medical Services) of the State Comprehensive Emergency Management Plan. This planning process will seek to include, but not be limited to, the participation of Children’s Medical Services, hospitals, nursing homes, assisted living facilities, home health agencies, hospice providers, nurse registries, home medical equipment providers, oxygen providers, dialysis centers, and other health and medical emergency preparedness stakeholders in the pre-event planning activities to enhance the safety and well-being of persons with special needs before, during, and after a disaster.
Specific Authority 381.0303(6)(g), F.S. Law Implemented 381.0303(6)(g), F.S. History–New
64-3.080 Service Reimbursement
(1) Health care practitioners shall make reimbursement requests for services rendered under Section 381.0303(3)(a)1. consistent with Section 381.0303(3)(b), F.S. using the DOH form # DH 1989, 12/06, “Vendor Invoice for Special Needs Health Care Practitioner”, which is incorporated by reference. This document is available from the Department of Health, Bureau of Finance and Accounting,
(2) Vendors shall make reimbursement requests for services rendered under Section 381.0303(3)(a)2. consistent with Section 381.0303(3)(b), F.S. using DOH form # DH 1990, 12/06, “Vendor Invoice for Services Rendered to Special Needs Clients Placed by the Multiagency Special Needs Shelter Discharge Planning Team”, which is incorporated by reference. This document is available from the Department of Health, Bureau of Finance and Accounting,
Specific Authority 381.0303(3)(a)2.; 381.0303(6)(b), F.S. Law Implemented 381.0303(3)(a)2., 381.0303(3)(b), 381.0303(6)(b), F.S. History–New