New Emergency Environmental Control Rules for ALF's and Nursing Homes

An Update on Florida’s Emergency Environmental Control Rules for Adult Assisted Living Facilities and Nursing Homes

From Orange County Commissioner Bryan Nelson

At the meeting of the Orange County Board of County Commissioners this week, the County’s Office of Emergency Management (OEM) presented an update on the State’s recently passed legislation and subsequently adopted rules establishing new requirements for Adult Assisted Living Facilities (ALFs) and nursing homes to maintain a safe environment for residents in the event of a loss of power. The new legislation requires these facilities to develop an Emergency Power Plan and to have the plan approved by the local emergency management agency. The presentation included details on which types of facilities in the county are affected by the new legislation, as well as how the process of attaining OEM approval for an Emergency Power Plan is accomplished.

Orange County Commissioner Bryan Nelson

In September of last year, a tragic incident occurred at a nursing home in Broward County following Hurricane Irma; 14 patients died as a result of a failure of the nursing home’s air cooling system (climate control system) during the storm-related power outage. Temperatures in the facility rose to nearly 100 degrees Fahrenheit in some areas for extended periods of time. Ultimately, the facility was shut down by the State. Following this incident, Governor Rick Scott issued an Emergency Power Rule requiring all Assisted Living Facilitates (ALFs) and nursing homes to have an alternate power source available to run climate control systems during a loss of primary power.

For emergency power plans, there are two rules that apply: Rule 58A-5.036-Emergency Environmental Control for Assisted Living Facilities; and Rule 59A-4.1265-Emergency Environmental Control for Nursing Homes. On March 26, 2018, the Governor signed legislation making the rules for emergency power plans official. This legislation applies to 115 ALFs and 34 nursing homes in Orange County. These rules require facilities to: Maintain an alternate power source; ensure that ambient temperatures can be kept at 81 degrees Fahrenheit or less for up to 96 hours after the loss of primary power; store enough fuel on-site to run the alternate source of power for specified time periods (varies by facility size); submit a plan to local Emergency Management for approval; and comply with the local zoning and Florida Building Codes for the location of an alternate power source.

In terms of alternate power sources, the new regulations do not require the sources to be a fixed or installed generator in all cases. Where deemed appropriate by a licensed engineer, electrician or climate control technician, portable generators may suffice. Although there may be variations in how facilities meet the emergency power requirements, one thing is essential – the alternate power source must be able to maintain the facility’s climate control system for at least 96 hours during a loss of primary power. The law sets April 26, 2018, as the deadline for all plans to be submitted to local emergency management for approval, and mandates that the plans be implemented by June 1, 2018. Extensions to the June 1^stimplementation date are granted by the State’s Agency for Health Care Administration (AHCA).

To help standardize and facilitate plan review and approval, Orange County has established its own Emergency Power Plan Approval Process. Criteria for approving plans were developed in coordination with OEM, the County Attorney’s Office, Building Safety, Environmental Protection Division, the Orange County Fire Marshall’s Office and municipalities within the County. The plan approval process starts with the submission of the plan to OEM by April 26, 2018. The plan will then be reviewed by OEM staff, with the goal being to complete the review within 30 days. If the plan is approved, OEM issues a letter to the facility, which is then forwarded to the facility to AHCA. This process flow assumes a best-case scenario. If plan approval is not granted, OEM staff will work with the facility to clarify the changes that must be made before resubmission of the plan.

In terms of regulatory authority, Orange County’s role in this important life-safety process currently is limited to review and approval of plans, ensuring that the plans are in compliance with local zoning and permitting regulations and enforcement of the Florida Fire Prevention Code as it pertains to fuel storage and concomitant fire hazards. Ensuring that emergency power plans have been implemented, to include conducting on-site inspections and issuing sanctions for non-compliance is the responsibility of the State’s Agency for Health Care Administration. Sanctions for non-compliance can include loss of a facility’s license to operate an ALF or nursing home in Florida

Residents who wish to view the full presentation from the Board Meeting may do so here: http://netapps.ocfl.net/Mod/meetings/1.