The revised text of the proposed rule development is: DEPARTMENT OF HEALTH CHAPTER 64-3 SPECIAL NEEDS SHELTER DRAFT- Special Needs Shelter Rules 64-3.010 Authority 64-3.020 Definition of a Person with Special Needs 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 Process 64-3.060 Addressing the Needs of Families 64-3.070 Pre-event Planning Activities 64-3.080 Service Reimbursement 64-3.010 Authority (1) These rules regarding the special needs shelters are adopted pursuant to Section 381.0303, Florida Statutes. Specific Authority 381.0303(6)(a)-(g) FS. Law Implemented 381.0303(6)(a)-(g) FS.. History New 64-3.020 Definition of a Person with Special Needs (1) A person with special needs is defined as a person who during periods of evacuation or emergency will require assistance that exceeds the basic level of care provided at the general population shelter, but will not require the level of care provided at a skilled medical facility except that this shall not include any person residing in a facility required by state law to have an evacuation and emergency management plan for natural and manmade disasters. (2) Criteria for special needs shelter client may include, but not be limited to: (a) A person with a stable medical condition that requires periodic observation, assessment, and maintenance e.g., glucose readings, vital signs, ostomy care, or urinary catheter care. (b) A person requiring assistance with periodic wound care. (c) A person with limitations requiring assistance with activities of daily living. (d) A person requiring assistance with oral, subcutaneous or intramuscular injectable, or topical medication. (e) A person requiring oxygen that can be manually supplied. (f) A person medically dependent on uninterrupted electricity for therapies, e.g. oxygen, nebulizer, or feeding tubes. (g) A person with mental or cognitive impairment or sensory disabilities who is accompanied by a fulltime caregiver for the duration of their stay in the shelter. (h) A person requiring complete care who is accompanied by a caregiver for the duration of their stay in the shelter. (i) A person whose weight does not exceed the safety weight restrictions established by the county special needs shelter program or the local special needs shelter authority. (j) A person with a mobility impairment who can be safely transferred and does not require specialty lifting or transferring equipment. (3) Special needs shelters are refuges of last resort. These shelters have auxiliary power. Special needs shelter services are provided, in an austere environment that is intended to maintain pre-disaster levels of health. (4) Every reasonable effort shall be made to avoid admitting a client with a known communicable from person to person condition, who requires isolation, e.g. Methicillin Resistant Staphylococcus aureus (MRSA), or who requires airborne isolation such as infectious Tuberculosis (TB). (5) Counties with special needs shelters having resources that can safely accept a person exceeding the above criteria may choose to do so. Specific Authority 381.0303(6)(a) FS. Law Implemented 381.0303(6)(a) FS.. History New 64-3.030 Guidelines for Special Needs Shelter Staffing Levels (1) The following is a guideline for special needs shelter staffing. Staffing may require adjustment as the sheltering event warrants. Variables may include the stage of the sheltering event, acuity of the client, presence of a caregiver, or availability volunteers.
(a) Each special needs shelter will 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 special needs shelter clients per shift during the sheltering event. (c) The special needs shelter may be additionally staffed with one unlicensed personnel per 20 special needs shelter clients per shift during the sheltering event. Specific Authority 381.0303(6)(c) FS. Law Implemented 381.0303(6)(c) FS.. 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 emergency to help maintain the client s pre-disaster levels of health. (2) The Department of Health will maintain a list of recommended special needs shelter supplies and equipment. The list will be provided upon request to the Florida Department of Health, Office of Public Health Nursing, 4052 Bald Cypress Way, Bin #C27, Tallahassee, FL 32399-1711. (3) The client or client s Home Medical Equipment provider will be required to assure 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., Florida Statutes. Specific Authority 381.0303(6)(d) FS. Law Implemented 381.0303(6)(d) FS.. History New 64-3.050 Special Needs Shelter Registration Process (1) The registry application will gather information on the person with special needs to be used for pre-event planning. The information items gathered 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 including insulin injections or insulin pump. (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 applications of all persons with special needs will be provided to the county health department at pre-determined intervals established jointly by the county emergency management and the county health department. (3) The county health department or its designee will review the registry application to determine if the applicant is appropriate to place in the special needs shelter during an evacuation event. The county emergency management agency will be notified of the determination. (4) The applications 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 its designee 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 point of intake to the activated SpNS, and a determination for appropriate shelter placement will be made. Specific Authority 381.0303(6)(e) FS. Law Implemented 381.0303(6)(e) FS.. History New 64-3.060 Addressing the Needs of Families (1) Caregivers of a person with special needs who is eligible for admission to a special needs shelter, and all person(s) for whom they are the caregiver, will be allowed to shelter together in the special needs shelter. (2) Persons with special needs, who are caregivers for individuals without special needs, will be allowed to shelter with the person for whom they are the caregiver in the special needs shelter. Specific Authority 381.0303(6)(f) FS. Law Implemented 381.0303(6)(f) FS.. History New 64-3.070 Pre-event Planning Activities (1) In cooperation with the local emergency management agency, the county health department, or the locally designated agency as the ESF 8 Health and Medical lead, will coordinate the integrated and comprehensive special needs shelter planning, 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) FS. Law Implemented 381.0303(6)(g) FS.. History New 64-3.080 Service Reimbursement (1) The department shall reimburse health care practitioners for services rendered under section 381.0303(3)(a)1. consistent with section 381.0303(3)(b) Florida Statutes. (a) Payment for services will be invoiced using Vendor Invoice for Special Needs Health Care Practitioner, DOH form #, 2007, which is incorporated by reference. This document is available from the Department of Health, Finance and Accounting Office, 4052 Bald Cypress Way, Bin # B01, Tallahassee, FL 32399-1729. (2) The department shall reimburse at the Medicaid rate for those services rendered under section 381.0303(3)(a)2. consistent with section 381.0303(3)(b) Florida Statutes. (a) Payment for services will be invoiced using Vendor Invoice for Special Needs Placement, DOH form #, 2007, which is incorporated by reference. This document is available from the Department of Health, Finance and Accounting Office, 4052 Bald Cypress Way, Bin # B01, Tallahassee, FL 32399-1729. (3) Invoices for reimbursement will be returned to the Department of Health, Finance and Accounting Office, 4052 Bald Cypress Way, Bin # B01, Tallahassee, FL 32399-1729. Specific Authority 381.0303(3)(a)2.; 381.0303(6)(b) FS. Law Implemented 381.0303(3)(a)2., 381.0303(3)(b), 381.0303(6)(b) FS.. History New
Vendor Invoice for Special Needs Health Care Practitioner Payments will be processed in accordance with Florida Statutes 215.422 Disaster / Emergency Event: Mission #: County: Health Care Practitioner (HCP) Name: HCP Address: HCP FEID#: (if applicable) HCP Phone Numbers: HCP Contact Name: HCP Signature: Office: Fax: Cell: Other: Description of Good and/or Services Provided Date Description Invoice Amount Total Vendor verifies that the above described services are not covered under any other pay source consistent with section 381.0303(3)(b), Florida Statutes. ESF 8 Use Only FEMA Category: Object Code: 72 HRS Status: Audited By: DOH Form #, Effective:, 2007 Full Payment Partial Payment
Disaster / Emergency Event: Mission #: County: Vendor Name: Vendor Address: Vendor FEID#: DRAFT- Special Needs Shelter Rules Vendor Invoice for Special Needs Placement Payments will be processed in accordance with Florida Statutes 215.422 Vendor Phone Numbers: Office: Vendor Contact Name: Vendor Signature: Fax: Cell: Other: Description of Good and/or Services Provided Date Description Invoice Amount Total Case Manager: Contact Number: Enclosed proof of a written request from a representative of an agency serving on the Multiagency Special Needs Shelter Discharge Planning Team that the individual for whom the facility is seeking reimbursement for services rendered was referred from a Special Needs Shelter. Vendor verifies that the above described services are not covered under any other pay source consistent with section 381.0303(3)(b), Florida Statutes. Agency Representative Name: Contact Number FEMA Category: Object Code: 72 HRS Status: Audited By: ESF 8 Use Only Full Payment Partial Payment DOH Form #, Effective:, 2007