The Florida Agency for Health Care Administration (AHCA) has published proposed revisions to Rule 59A-18.018, which governs comprehensive emergency management plans (CEMPs) for nurse registries.

The Notice of Proposed Rule was published August 14. Written comments and requests for a hearing are due September 4. The proposed changes are not yet in effect.

What the Proposed Rule Would Change

The proposal would replace the May 2015 CEMP form with the substantially revised March 2026 Emergency Management Planning Criteria for Nurse Registries.

The revised rule would also:

• Require each nurse registry to review its CEMP annually and forward plans containing substantive changes for review
• Require significant modifications to an approved plan to be submitted within 30 days
• Define a significant modification as a change to required criteria, procedures, agreements, contracts, or appendices that alters how the plan will be carried out
• Clarify how changes to staff and emergency contact information must be reported
• Establish reporting responsibilities for nurse registries licensed in multiple counties

Draft Emergency Management Planning Criteria

The eight-page draft form would serve as both the minimum planning framework and the checklist used by designated plan approvers. A nurse registry would submit the form with its CEMP and identify the page and paragraph where each criterion is addressed.

The draft criteria cover:

• Provider, administrator, alternate administrator, safety liaison, and plan developer information
• An all-hazards vulnerability analysis addressing weather, flooding, fire, disease outbreaks, cyber threats, power failures, active-shooter incidents, and other local risks
• Emergency command structure, activation triggers, staffing, essential supplies, alternate communications, and continuity of services
• Procedures involving special-needs-registry patients, independent contractors, evacuation, receiving arrangements, patient tracking, and returning after an emergency
• Annual training, two exercises each year, after-action reports, standard operating procedures, maps, agreements, rosters, and patient information maintained as appendices

County emergency management agencies could require additional information based on local risks and circumstances.

Because the form remains a draft, registries should carefully review whether its terminology, documentation requirements, and county-by-county processes fit the nurse registry model. The draft includes several references to “facilities” and “residents,” repeats certain criteria, and refers to an Appendix H that is not included in the appendices section. These are appropriate subjects for clarification during the comment period.

Conditional Hearing and Comment Information

AHCA has reserved September 10 for a public hearing. However, the hearing will occur only if requested by the September 4 deadline. The posted hearing agenda includes an opportunity for public comment.

Comment and Hearing-Request Deadline: Friday, September 4, 2026

Conditional Hearing: Thursday, September 10, 2026, 2:00-3:00 PM ET

In Person:

Agency for Health Care Administration
2727 Mahan Drive
Building 2, Conference Room B
Tallahassee, FL 32308

By Phone:

(850) 792-4898
Conference code: 470 496 155#

Comments and questions may be directed to HQARuleComments@ahca.myflorida.com or Kelli Fillyaw at (850) 412-4402.

HCAF encourages nurse registries to review the proposed rule and draft planning criteria and consider how the changes would affect existing plans, independent-contractor operations, multi-county reporting, training, documentation, and annual review practices. HCAF will continue monitoring the rulemaking and welcomes member feedback on operational concerns that should be raised with AHCA.

Additional materials are available on AHCA’s rulemaking page.