Florida Senate - 2013                        COMMITTEE AMENDMENT
       Bill No. CS for SB 966
       
       
       
       
       
       
                                Barcode 342762                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/22/2013           .                                
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       The Committee on Appropriations (Bean) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraphs (d) and (e) of subsection (12) of
    6  section 112.0455, Florida Statutes, are amended to read:
    7         112.0455 Drug-Free Workplace Act.—
    8         (12) DRUG-TESTING STANDARDS; LABORATORIES.—
    9         (d) The laboratory shall submit to the Agency for Health
   10  Care Administration a monthly report with statistical
   11  information regarding the testing of employees and job
   12  applicants. The reports shall include information on the methods
   13  of analyses conducted, the drugs tested for, the number of
   14  positive and negative results for both initial and confirmation
   15  tests, and any other information deemed appropriate by the
   16  Agency for Health Care Administration. No monthly report shall
   17  identify specific employees or job applicants.
   18         (d)(e) Laboratories shall provide technical assistance to
   19  the employer, employee, or job applicant for the purpose of
   20  interpreting any positive confirmed test results which could
   21  have been caused by prescription or nonprescription medication
   22  taken by the employee or job applicant.
   23         Section 2. Paragraph (n) of subsection (1) of section
   24  154.11, Florida Statutes, is amended to read:
   25         154.11 Powers of board of trustees.—
   26         (1) The board of trustees of each public health trust shall
   27  be deemed to exercise a public and essential governmental
   28  function of both the state and the county and in furtherance
   29  thereof it shall, subject to limitation by the governing body of
   30  the county in which such board is located, have all of the
   31  powers necessary or convenient to carry out the operation and
   32  governance of designated health care facilities, including, but
   33  without limiting the generality of, the foregoing:
   34         (n) To appoint originally the staff of physicians to
   35  practice in a any designated facility owned or operated by the
   36  board and to approve the bylaws and rules to be adopted by the
   37  medical staff of a any designated facility owned and operated by
   38  the board, such governing regulations to be in accordance with
   39  the standards of the Joint Commission, the American Osteopathic
   40  Association/Healthcare Facilities Accreditation Program, or a
   41  national accrediting organization that is approved by the
   42  Centers for Medicare and Medicaid Services and whose standards
   43  incorporate comparable licensure regulations required by the
   44  state on the Accreditation of Hospitals which provide, among
   45  other things, for the method of appointing additional staff
   46  members and for the removal of staff members.
   47         Section 3. Subsection (4) of section 322.142, Florida
   48  Statutes, is amended to read:
   49         322.142 Color photographic or digital imaged licenses.—
   50         (4) The department may maintain a film negative or print
   51  file. The department shall maintain a record of the digital
   52  image and signature of the licensees, together with other data
   53  required by the department for identification and retrieval.
   54  Reproductions from the file or digital record are exempt from
   55  the provisions of s. 119.07(1) and shall be made and issued only
   56  for departmental administrative purposes; for the issuance of
   57  duplicate licenses; in response to law enforcement agency
   58  requests; to the Department of Business and Professional
   59  Regulation pursuant to an interagency agreement for the purpose
   60  of accessing digital images for reproduction of licenses issued
   61  by the Department of Business and Professional Regulation; to
   62  the Department of State pursuant to an interagency agreement to
   63  facilitate determinations of eligibility of voter registration
   64  applicants and registered voters in accordance with ss. 98.045
   65  and 98.075; to the Department of Revenue pursuant to an
   66  interagency agreement for use in establishing paternity and
   67  establishing, modifying, or enforcing support obligations in
   68  Title IV-D cases; to the Department of Children and Family
   69  Services pursuant to an interagency agreement to conduct
   70  protective investigations under part III of chapter 39 and
   71  chapter 415; to the Department of Children and Family Services
   72  pursuant to an interagency agreement specifying the number of
   73  employees in each of that department’s regions to be granted
   74  access to the records for use as verification of identity to
   75  expedite the determination of eligibility for public assistance
   76  and for use in public assistance fraud investigations; to the
   77  Agency for Health Care Administration pursuant to an interagency
   78  agreement for the purpose of verifying photographs in the Care
   79  Provider Background Screening Clearinghouse authorized in s.
   80  435.12; to the Department of Financial Services pursuant to an
   81  interagency agreement to facilitate the location of owners of
   82  unclaimed property, the validation of unclaimed property claims,
   83  and the identification of fraudulent or false claims; or to
   84  district medical examiners pursuant to an interagency agreement
   85  for the purpose of identifying a deceased individual,
   86  determining cause of death, and notifying next of kin of any
   87  investigations, including autopsies and other laboratory
   88  examinations, authorized in s. 406.011.
   89         Section 4. Subsection (9) of section 381.745, Florida
   90  Statutes, is amended to read:
   91         381.745 Definitions; ss. 381.739-381.79.—As used in ss.
   92  381.739-381.79, the term:
   93         (9) “Transitional living facility,for the purpose of this
   94  part, means a state-approved facility, as defined and licensed
   95  under chapter 400 or chapter 429, or a facility approved by the
   96  brain and spinal cord injury program in accordance with this
   97  chapter.
   98         Section 5. Section 381.75, Florida Statutes, is amended to
   99  read:
  100         381.75 Duties and responsibilities of the department, of
  101  transitional living facilities, and of residents.—Consistent
  102  with the mandate of s. 381.7395, the department shall develop
  103  and administer a multilevel treatment program for individuals
  104  who sustain brain or spinal cord injuries and who are referred
  105  to the brain and spinal cord injury program.
  106         (1) Within 15 days after any report of an individual who
  107  has sustained a brain or spinal cord injury, the department
  108  shall notify the individual or the most immediate available
  109  family members of their right to assistance from the state, the
  110  services available, and the eligibility requirements.
  111         (2) The department shall refer individuals who have brain
  112  or spinal cord injuries to other state agencies to assure that
  113  rehabilitative services, if desired, are obtained by that
  114  individual.
  115         (3) The department, in consultation with emergency medical
  116  service, shall develop standards for an emergency medical
  117  evacuation system that will ensure that all individuals who
  118  sustain traumatic brain or spinal cord injuries are transported
  119  to a department-approved trauma center that meets the standards
  120  and criteria established by the emergency medical service and
  121  the acute-care standards of the brain and spinal cord injury
  122  program.
  123         (4) The department shall develop standards for designation
  124  of rehabilitation centers to provide rehabilitation services for
  125  individuals who have brain or spinal cord injuries.
  126         (5) The department shall determine the appropriate number
  127  of designated acute-care facilities, inpatient rehabilitation
  128  centers, and outpatient rehabilitation centers, needed based on
  129  incidence, volume of admissions, and other appropriate criteria.
  130         (6) The department shall develop standards for designation
  131  of transitional living facilities to provide transitional living
  132  services for individuals who participate in the brain and spinal
  133  cord injury program the opportunity to adjust to their
  134  disabilities and to develop physical and functional skills in a
  135  supported living environment.
  136         (a) The Agency for Health Care Administration, in
  137  consultation with the department, shall develop rules for the
  138  licensure of transitional living facilities for individuals who
  139  have brain or spinal cord injuries.
  140         (b) The goal of a transitional living program for
  141  individuals who have brain or spinal cord injuries is to assist
  142  each individual who has such a disability to achieve a higher
  143  level of independent functioning and to enable that person to
  144  reenter the community. The program shall be focused on preparing
  145  participants to return to community living.
  146         (c) A transitional living facility for an individual who
  147  has a brain or spinal cord injury shall provide to such
  148  individual, in a residential setting, a goal-oriented treatment
  149  program designed to improve the individual’s physical,
  150  cognitive, communicative, behavioral, psychological, and social
  151  functioning, as well as to provide necessary support and
  152  supervision. A transitional living facility shall offer at least
  153  the following therapies: physical, occupational, speech,
  154  neuropsychology, independent living skills training, behavior
  155  analysis for programs serving brain-injured individuals, health
  156  education, and recreation.
  157         (d) All residents shall use the transitional living
  158  facility as a temporary measure and not as a permanent home or
  159  domicile. The transitional living facility shall develop an
  160  initial treatment plan for each resident within 3 days after the
  161  resident’s admission. The transitional living facility shall
  162  develop a comprehensive plan of treatment and a discharge plan
  163  for each resident as soon as practical, but no later than 30
  164  days after the resident’s admission. Each comprehensive
  165  treatment plan and discharge plan must be reviewed and updated
  166  as necessary, but no less often than quarterly. This subsection
  167  does not require the discharge of an individual who continues to
  168  require any of the specialized services described in paragraph
  169  (c) or who is making measurable progress in accordance with that
  170  individual’s comprehensive treatment plan. The transitional
  171  living facility shall discharge any individual who has an
  172  appropriate discharge site and who has achieved the goals of his
  173  or her discharge plan or who is no longer making progress toward
  174  the goals established in the comprehensive treatment plan and
  175  the discharge plan. The discharge location must be the least
  176  restrictive environment in which an individual’s health, well
  177  being, and safety is preserved.
  178         (7) Recipients of services, under this section, from any of
  179  the facilities referred to in this section shall pay a fee based
  180  on ability to pay.
  181         Section 6. Subsection (4) of section 381.78, Florida
  182  Statutes, is amended to read:
  183         381.78 Advisory council on brain and spinal cord injuries.—
  184         (4) The council shall:
  185         (a) provide advice and expertise to the department in the
  186  preparation, implementation, and periodic review of the brain
  187  and spinal cord injury program.
  188         (b) Annually appoint a five-member committee composed of
  189  one individual who has a brain injury or has a family member
  190  with a brain injury, one individual who has a spinal cord injury
  191  or has a family member with a spinal cord injury, and three
  192  members who shall be chosen from among these representative
  193  groups: physicians, other allied health professionals,
  194  administrators of brain and spinal cord injury programs, and
  195  representatives from support groups with expertise in areas
  196  related to the rehabilitation of individuals who have brain or
  197  spinal cord injuries, except that one and only one member of the
  198  committee shall be an administrator of a transitional living
  199  facility. Membership on the council is not a prerequisite for
  200  membership on this committee.
  201         1. The committee shall perform onsite visits to those
  202  transitional living facilities identified by the Agency for
  203  Health Care Administration as being in possible violation of the
  204  statutes and rules regulating such facilities. The committee
  205  members have the same rights of entry and inspection granted
  206  under s. 400.805(4) to designated representatives of the agency.
  207         2. Factual findings of the committee resulting from an
  208  onsite investigation of a facility pursuant to subparagraph 1.
  209  shall be adopted by the agency in developing its administrative
  210  response regarding enforcement of statutes and rules regulating
  211  the operation of the facility.
  212         3. Onsite investigations by the committee shall be funded
  213  by the Health Care Trust Fund.
  214         4. Travel expenses for committee members shall be
  215  reimbursed in accordance with s. 112.061.
  216         5. Members of the committee shall recuse themselves from
  217  participating in any investigation that would create a conflict
  218  of interest under state law, and the council shall replace the
  219  member, either temporarily or permanently.
  220         Section 7. Section 385.2035, Florida Statutes, is created
  221  to read:
  222         385.2035Resource for research in the prevention and
  223  treatment of diabetes.—The Florida Hospital Sanford-Burnham
  224  Translational Research Institute for Metabolism and Diabetes is
  225  designated as a resource in this state for research in the
  226  prevention and treatment of diabetes.
  227         Section 8. Section 394.4574, Florida Statutes, is amended
  228  to read:
  229         394.4574 Department Responsibilities for coordination of
  230  services for a mental health resident who resides in an assisted
  231  living facility that holds a limited mental health license.—
  232         (1) As used in this section, the term “mental health
  233  resident” “mental health resident,” for purposes of this
  234  section, means an individual who receives social security
  235  disability income due to a mental disorder as determined by the
  236  Social Security Administration or receives supplemental security
  237  income due to a mental disorder as determined by the Social
  238  Security Administration and receives optional state
  239  supplementation.
  240         (2) Medicaid prepaid behavioral health plans are
  241  responsible for enrolled mental health residents, and managing
  242  entities under contract with the department are responsible for
  243  mental health residents who are not enrolled with a Medicaid
  244  prepaid behavioral health plan. Each responsible entity shall
  245  The department must ensure that:
  246         (a) A mental health resident has been assessed by a
  247  psychiatrist, clinical psychologist, clinical social worker, or
  248  psychiatric nurse, or an individual who is supervised by one of
  249  these professionals, and determined to be appropriate to reside
  250  in an assisted living facility. The documentation must be
  251  provided to the administrator of the facility within 30 days
  252  after the mental health resident has been admitted to the
  253  facility. An evaluation completed upon discharge from a state
  254  mental hospital meets the requirements of this subsection
  255  related to appropriateness for placement as a mental health
  256  resident if it was completed within 90 days before prior to
  257  admission to the facility.
  258         (b) A cooperative agreement, as required in s. 429.075, is
  259  developed between the mental health care services provider that
  260  serves a mental health resident and the administrator of the
  261  assisted living facility with a limited mental health license in
  262  which the mental health resident is living. Any entity that
  263  provides Medicaid prepaid health plan services shall ensure the
  264  appropriate coordination of health care services with an
  265  assisted living facility in cases where a Medicaid recipient is
  266  both a member of the entity’s prepaid health plan and a resident
  267  of the assisted living facility. If the entity is at risk for
  268  Medicaid targeted case management and behavioral health
  269  services, the entity shall inform the assisted living facility
  270  of the procedures to follow should an emergent condition arise.
  271         (c) The community living support plan, as defined in s.
  272  429.02, has been prepared by a mental health resident and a
  273  mental health case manager of that resident in consultation with
  274  the administrator of the facility or the administrator’s
  275  designee. The plan must be completed and provided to the
  276  administrator of the assisted living facility with a limited
  277  mental health license in which the mental health resident lives
  278  upon the resident’s admission. The support plan and the
  279  agreement may be in one document.
  280         (d) The assisted living facility with a limited mental
  281  health license is provided with documentation that the
  282  individual meets the definition of a mental health resident.
  283         (e) The mental health services provider assigns a case
  284  manager to each mental health resident for whom the entity is
  285  responsible who lives in an assisted living facility with a
  286  limited mental health license. The case manager is responsible
  287  for coordinating the development of and implementation of the
  288  community living support plan defined in s. 429.02. The plan
  289  must be updated at least annually, or when there is a
  290  significant change to the resident’s behavioral health status,
  291  such as an inpatient admission or a change in behavioral status,
  292  medications, level of service, or residence. Each case manager
  293  shall keep a record of the date and time of any face-to-face
  294  interaction with the resident and make the record available to
  295  the responsible entity for inspection. The record must be
  296  retained for at least 2 years after the date of the most recent
  297  interaction.
  298         (f)Adequate and consistent monitoring and enforcement of
  299  community living support plans and cooperative agreements are
  300  conducted by the resident’s case manager.
  301         (g) Concerns are reported to the appropriate regulatory
  302  oversight organization if a regulated provider fails to deliver
  303  appropriate services or otherwise acts in a manner that has the
  304  potential to result in harm to the resident.
  305         (3) The Secretary of Children and Family Services, in
  306  consultation with the Agency for Health Care Administration,
  307  shall annually require each district administrator to develop,
  308  with community input, a detailed annual plan that demonstrates
  309  detailed plans that demonstrate how the district will ensure the
  310  provision of state-funded mental health and substance abuse
  311  treatment services to residents of assisted living facilities
  312  that hold a limited mental health license. These plans must be
  313  consistent with the substance abuse and mental health district
  314  plan developed pursuant to s. 394.75 and must address case
  315  management services; access to consumer-operated drop-in
  316  centers; access to services during evenings, weekends, and
  317  holidays; supervision of the clinical needs of the residents;
  318  and access to emergency psychiatric care.
  319         Section 9. Subsection (2) of section 394.741, Florida
  320  Statutes, is amended to read:
  321         394.741 Accreditation requirements for providers of
  322  behavioral health care services.—
  323         (2) Notwithstanding any provision of law to the contrary,
  324  accreditation shall be accepted by the agency and department in
  325  lieu of the agency’s and department’s facility licensure onsite
  326  review requirements and shall be accepted as a substitute for
  327  the department’s administrative and program monitoring
  328  requirements, except as required by subsections (3) and (4),
  329  for:
  330         (a) An Any organization from which the department purchases
  331  behavioral health care services which that is accredited by the
  332  Joint Commission, American Osteopathic Association/the
  333  Healthcare Facilities Accreditation Program, a national
  334  accrediting organization that is approved by the Centers for
  335  Medicare and Medicaid Services and whose standards incorporate
  336  comparable licensure regulations required by the state, on
  337  Accreditation of Healthcare Organizations or the Council on
  338  Accreditation for Children and Family Services, or CARF
  339  International for the has those services that are being
  340  purchased by the department accredited by CARF—the
  341  Rehabilitation Accreditation Commission.
  342         (b) A Any mental health facility licensed by the agency or
  343  a any substance abuse component licensed by the department which
  344  that is accredited by the Joint Commission, the American
  345  Osteopathic Association/Healthcare Facilities Accreditation
  346  Program, a national accrediting organization that is approved by
  347  the Centers for Medicare and Medicaid Services and whose
  348  standards incorporate comparable licensure regulations required
  349  by the state, CARF International on Accreditation of Healthcare
  350  Organizations, CARF—the Rehabilitation Accreditation Commission,
  351  or the Council on Accreditation of Children and Family Services.
  352         (c) A Any network of providers from which the department or
  353  the agency purchases behavioral health care services accredited
  354  by the Joint Commission, the American Osteopathic
  355  Association/Healthcare Facilities Accreditation Program, a
  356  national accrediting organization that is approved by the
  357  Centers for Medicare and Medicaid Services and whose standards
  358  incorporate comparable licensure regulations required by the
  359  state, CARF International on Accreditation of Healthcare
  360  Organizations, CARF—the Rehabilitation Accreditation Commission,
  361  the Council on Accreditation of Children and Family Services, or
  362  the National Committee for Quality Assurance. A provider
  363  organization that, which is part of an accredited network, is
  364  afforded the same rights under this part.
  365         Section 10. Subsection (3) of section 395.0161, Florida
  366  Statutes, is amended to read:
  367         395.0161 Licensure inspection.—
  368         (3) In accordance with s. 408.805, an applicant or licensee
  369  shall pay a fee for each license application submitted under
  370  this part, part II of chapter 408, and applicable rules. With
  371  the exception of state-operated licensed facilities, each
  372  facility licensed under this part shall pay to the agency, at
  373  the time of inspection, the following fees:
  374         (a) Inspection for licensure.—A fee shall be paid which is
  375  not less than $8 per hospital bed, nor more than $12 per
  376  hospital bed, except that the minimum fee shall be $400 per
  377  facility.
  378         (b) Inspection for lifesafety only.—A fee shall be paid
  379  which is not less than 75 cents per hospital bed, nor more than
  380  $1.50 per hospital bed, except that the minimum fee shall be $40
  381  per facility.
  382         Section 11. Section 395.1046, Florida Statutes, is
  383  repealed.
  384         Section 12. Section 395.3038, Florida Statutes, is amended
  385  to read:
  386         395.3038 State-listed primary stroke centers and
  387  comprehensive stroke centers; notification of hospitals.—
  388         (1) The agency shall make available on its website and to
  389  the department a list of the name and address of each hospital
  390  that meets the criteria for a primary stroke center and the name
  391  and address of each hospital that meets the criteria for a
  392  comprehensive stroke center. The list of primary and
  393  comprehensive stroke centers must shall include only those
  394  hospitals that attest in an affidavit submitted to the agency
  395  that the hospital meets the named criteria, or those hospitals
  396  that attest in an affidavit submitted to the agency that the
  397  hospital is certified as a primary or a comprehensive stroke
  398  center by the Joint Commission, the American Osteopathic
  399  Association/Healthcare Facilities Accreditation Program, or a
  400  national accrediting organization that is approved by the
  401  Centers for Medicare and Medicaid Services and whose standards
  402  incorporate comparable licensure regulations required by the
  403  state on Accreditation of Healthcare Organizations.
  404         (2)(a) If a hospital no longer chooses to meet the criteria
  405  for a primary or comprehensive stroke center, the hospital shall
  406  notify the agency and the agency shall immediately remove the
  407  hospital from the list.
  408         (b)1. This subsection does not apply if the hospital is
  409  unable to provide stroke treatment services for a period of time
  410  not to exceed 2 months. The hospital shall immediately notify
  411  all local emergency medical services providers when the
  412  temporary unavailability of stroke treatment services begins and
  413  when the services resume.
  414         2. If stroke treatment services are unavailable for more
  415  than 2 months, the agency shall remove the hospital from the
  416  list of primary or comprehensive stroke centers until the
  417  hospital notifies the agency that stroke treatment services have
  418  been resumed.
  419         (3) The agency shall notify all hospitals in this state by
  420  February 15, 2005, that the agency is compiling a list of
  421  primary stroke centers and comprehensive stroke centers in this
  422  state. The notice shall include an explanation of the criteria
  423  necessary for designation as a primary stroke center and the
  424  criteria necessary for designation as a comprehensive stroke
  425  center. The notice shall also advise hospitals of the process by
  426  which a hospital might be added to the list of primary or
  427  comprehensive stroke centers.
  428         (3)(4) The agency shall adopt by rule criteria for a
  429  primary stroke center which are substantially similar to the
  430  certification standards for primary stroke centers of the Joint
  431  Commission, the American Osteopathic Association/Healthcare
  432  Facilities Accreditation Program, or a national accrediting
  433  organization that is approved by the Centers for Medicare and
  434  Medicaid Services and whose standards incorporate comparable
  435  licensure regulations required by the state on Accreditation of
  436  Healthcare Organizations.
  437         (4)(5) The agency shall adopt by rule criteria for a
  438  comprehensive stroke center. However, if the Joint Commission,
  439  the American Osteopathic Association/Healthcare Facilities
  440  Accreditation Program, or a national accrediting organization
  441  that is approved by the Centers for Medicare and Medicaid
  442  Services and whose standards incorporate comparable licensure
  443  regulations required by the state on Accreditation of Healthcare
  444  Organizations establishes criteria for a comprehensive stroke
  445  center, the agency shall establish criteria for a comprehensive
  446  stroke center which are substantially similar to those criteria
  447  established by the Joint Commission, the American Osteopathic
  448  Association/Healthcare Facilities Accreditation Program, or such
  449  national accrediting organization on Accreditation of Healthcare
  450  Organizations.
  451         (5)(6) This act is not a medical practice guideline and may
  452  not be used to restrict the authority of a hospital to provide
  453  services for which it is licensed has received a license under
  454  chapter 395. The Legislature intends that all patients be
  455  treated individually based on each patient’s needs and
  456  circumstances.
  457         Section 13. Section 395.40, Florida Statutes, is repealed.
  458         Section 14. Paragraph (a) of subsection (7) and subsection
  459  (14) of section 395.4001, Florida Statutes, are amended to read:
  460         395.4001 Definitions.—As used in this part, the term:
  461         (7) “Level II trauma center” means a trauma center that:
  462         (a) Is verified by the department to be in substantial
  463  compliance with Level II trauma center standards and has been
  464  approved by the department to operate as a Level II trauma
  465  center or is designated pursuant to subsection (14).
  466         (14) “Trauma center” means a hospital that has been
  467  verified by the department to be in substantial compliance with
  468  the requirements in s. 395.4025 and has been approved by the
  469  department to operate as a Level I trauma center, Level II
  470  trauma center, or pediatric trauma center, or is designated by
  471  the department as a Level II trauma center pursuant to
  472  subsection (14).
  473         Section 15. Paragraph (b) of subsection (1) and paragraph
  474  (3) of section 395.401, Florida Statutes, are amended to read:
  475         395.401 Trauma services system plans; approval of trauma
  476  centers and pediatric trauma centers; procedures; renewal.—
  477         (1)
  478         (b) The local and regional trauma agencies shall develop
  479  and submit to the department plans for local and regional trauma
  480  services systems. The plans must include, at a minimum, the
  481  following components:
  482         1. The organizational structure of the trauma system.
  483         2. Prehospital care management guidelines for triage and
  484  transportation of trauma cases.
  485         3. Flow patterns of trauma cases and transportation system
  486  design and resources, including air transportation services,
  487  provision for interfacility trauma transfer, and the prehospital
  488  transportation of trauma victims. The trauma agency shall plan
  489  for the development of a system of transportation of trauma
  490  alert victims to trauma centers where the distance or time to a
  491  trauma center or transportation resources diminish access by
  492  trauma alert victims.
  493         4. The number and location of needed trauma centers based
  494  on local needs, population, and location and distribution of
  495  resources.
  496         4.5. Data collection regarding system operation and patient
  497  outcome.
  498         5.6. Periodic performance evaluation of the trauma system
  499  and its components.
  500         6.7. The use of air transport services within the
  501  jurisdiction of the local trauma agency.
  502         7.8. Public information and education about the trauma
  503  system.
  504         8.9. Emergency medical services communication system usage
  505  and dispatching.
  506         9.10. The coordination and integration between the trauma
  507  center and other acute care hospitals.
  508         10.11. Medical control and accountability.
  509         11.12. Quality control and system evaluation.
  510         (3) The department may withdraw local or regional agency
  511  authority, prescribe corrective actions, or use the
  512  administrative remedies as provided in s. 395.1065 for the
  513  violation of any provision of this section and ss. 395.4015,
  514  395.402, 395.4025, 395.403, 395.404, and 395.4045 or rules
  515  adopted thereunder. All amounts collected pursuant to this
  516  subsection shall be deposited into the Emergency Medical
  517  Services Trust Fund provided in s. 401.34.
  518         Section 16. Subsection (1) of section 395.4015, Florida
  519  Statutes, is amended to read:
  520         395.4015 State regional trauma planning; trauma regions.—
  521         (1) The department shall establish a state trauma system
  522  plan. As part of the state trauma system plan, the department
  523  shall establish trauma regions that cover all geographical areas
  524  of the state and have boundaries that are coterminous with the
  525  boundaries of the regional domestic security task forces
  526  established under s. 943.0312. These regions may serve as the
  527  basis for the development of department-approved local or
  528  regional trauma plans. However, such regional plans shall
  529  recognize trauma service areas that reflect well established
  530  patient flow patterns. The delivery of trauma services by or in
  531  coordination with a trauma agency established before July 1,
  532  2004, may continue in accordance with public and private
  533  agreements and operational procedures entered into as provided
  534  in s. 395.401.
  535         Section 17. Section 395.402, Florida Statutes, is repealed.
  536         Section 18. Subsections (12)and (14) of section 395.4025,
  537  Florida Statutes, are amended to read:
  538         395.4025 Trauma centers; selection; quality assurance;
  539  records.—
  540         (12) Patient care, transport, or treatment records or
  541  reports, or patient care quality assurance proceedings, records,
  542  or reports obtained or made pursuant to this section, s.
  543  395.3025(4)(f), s. 395.401, s. 395.4015, s. 395.402, s. 395.403,
  544  s. 395.404, s. 395.4045, s. 395.405, s. 395.50, or s. 395.51
  545  must be held confidential by the department or its agent and are
  546  exempt from the provisions of s. 119.07(1). Patient care quality
  547  assurance proceedings, records, or reports obtained or made
  548  pursuant to these sections are not subject to discovery or
  549  introduction into evidence in any civil or administrative
  550  action.
  551         (14) Notwithstanding the procedures established pursuant to
  552  subsections (1) through (13) in this section, hospitals located
  553  in areas with limited access to trauma center services shall be
  554  designated by the department as a Level II trauma center based
  555  on documentation of a valid certificate of trauma center
  556  verification from the American College of Surgeons. Areas with
  557  limited access to trauma center services are defined by the
  558  following criteria:
  559         (a) The hospital is located in a trauma service area with a
  560  population greater than 600,000 persons but a population density
  561  of less than 300 persons per square mile; and,
  562         (b) The hospital is located in a county with no designated
  563  or provisional trauma center; and,
  564         (c) The hospital is located at least 15 miles or 20 minutes
  565  travel time by ground transport from the nearest trauma center.
  566         any other provisions of this section and rules adopted
  567  pursuant to this section, until the department has conducted the
  568  review provided under s. 395.402, only hospitals located in
  569  trauma services areas where there is no existing trauma center
  570  may apply.
  571         Section 19. Section 395.405, Florida Statutes, is amended
  572  to read
  573         395.405 Rulemaking.—The department shall adopt and enforce
  574  all rules necessary to administer ss. 395.401, 395.4015,
  575  395.402, 395.4025, 395.403, 395.404, and 395.4045.
  576         Section 20. Paragraph (c) of subsection (1) of section
  577  395.701, Florida Statutes, is amended to read:
  578         395.701 Annual assessments on net operating revenues for
  579  inpatient and outpatient services to fund public medical
  580  assistance; administrative fines for failure to pay assessments
  581  when due; exemption.—
  582         (1) For the purposes of this section, the term:
  583         (c) “Hospital” means a health care institution as defined
  584  in s. 395.002(12), but does not include any hospital operated by
  585  a state the agency or the Department of Corrections.
  586         Section 21. Section 395.7015, Florida Statutes, is
  587  repealed.
  588         Section 22. Section 395.7016, Florida Statutes, is amended
  589  to read:
  590         395.7016 Annual appropriation.—The Legislature shall
  591  appropriate each fiscal year from either the General Revenue
  592  Fund or the Agency for Health Care Administration Tobacco
  593  Settlement Trust Fund an amount sufficient to replace the funds
  594  lost due to reduction by chapter 2000-256, Laws of Florida, of
  595  the assessment on other health care entities under s. 395.7015,
  596  and the reduction by chapter 2000-256 in the assessment on
  597  hospitals under s. 395.701, and to maintain federal approval of
  598  the reduced amount of funds deposited into the Public Medical
  599  Assistance Trust Fund under s. 395.701, as state match for the
  600  state’s Medicaid program.
  601         Section 23. Subsection (3) of section 397.403, Florida
  602  Statutes, is amended to read:
  603         397.403 License application.—
  604         (3) The department shall accept proof of accreditation by
  605  CARF International, the Commission on Accreditation of
  606  Rehabilitation Facilities(CARF) or the Joint Commission, the
  607  American Osteopathic Association/Healthcare Facilities
  608  Accreditation Program, or a national accrediting organization
  609  that is approved by the Centers for Medicare and Medicaid
  610  Services and whose standards incorporate comparable licensure
  611  regulations required by the state; or through another any other
  612  nationally recognized certification process that is acceptable
  613  to the department and meets the minimum licensure requirements
  614  under this chapter, in lieu of requiring the applicant to submit
  615  the information required by paragraphs (1)(a)-(c).
  616         Section 24. Subsection (1) of section 400.0074, Florida
  617  Statutes, is amended, and paragraph (h) is added to subsection
  618  (2) of that section, to read:
  619         400.0074 Local ombudsman council onsite administrative
  620  assessments.—
  621         (1) In addition to any specific investigation conducted
  622  pursuant to a complaint, the local council shall conduct, at
  623  least annually, an onsite administrative assessment of each
  624  nursing home, assisted living facility, and adult family-care
  625  home within its jurisdiction. This administrative assessment
  626  must be comprehensive in nature and must shall focus on factors
  627  affecting the rights, health, safety, and welfare of the
  628  residents. Each local council is encouraged to conduct a similar
  629  onsite administrative assessment of each additional long-term
  630  care facility within its jurisdiction.
  631         (2) An onsite administrative assessment conducted by a
  632  local council shall be subject to the following conditions:
  633         (h) The local council shall conduct an exit consultation
  634  with the facility administrator or administrator designee to
  635  discuss issues and concerns in areas affecting the rights,
  636  health, safety, and welfare of the residents and make
  637  recommendations for improvement, if any.
  638         Section 25. Subsection (2) of section 400.0078, Florida
  639  Statutes, is amended to read:
  640         400.0078 Citizen access to State Long-Term Care Ombudsman
  641  Program services.—
  642         (2) Every resident or representative of a resident shall
  643  receive, Upon admission to a long-term care facility, each
  644  resident or representative of a resident must receive
  645  information regarding the purpose of the State Long-Term Care
  646  Ombudsman Program, the statewide toll-free telephone number for
  647  receiving complaints, information that retaliatory action cannot
  648  be taken against a resident for presenting grievances or for
  649  exercising any other resident right, and other relevant
  650  information regarding how to contact the program. Residents or
  651  their representatives must be furnished additional copies of
  652  this information upon request.
  653         Section 26. Subsection (21) of section 400.462, Florida
  654  Statutes, is amended to read:
  655         400.462 Definitions.—As used in this part, the term:
  656         (21) “Nurse registry” means any person that procures,
  657  offers, promises, or attempts to secure health-care-related
  658  contracts for registered nurses, licensed practical nurses,
  659  certified nursing assistants, home health aides, companions, or
  660  homemakers, who are compensated by fees as independent
  661  contractors, including, but not limited to, contracts for the
  662  provision of services to patients and contracts to provide
  663  private duty or staffing services to health care facilities
  664  licensed under chapter 395, this chapter, or chapter 429 or
  665  other business entities. For the purposes of the delivery of
  666  services under s. 627.94071(5), a nurse registry may be
  667  considered a “home health agency” as defined in s. 400.462(12).
  668         Section 27. Section 400.805, Florida Statutes, is repealed.
  669         Section 28. Subsection (1) of section 400.925, Florida
  670  Statutes, is amended to read:
  671         400.925 Definitions.—As used in this part, the term:
  672         (1) “Accrediting organizations” means the Joint Commission,
  673  the American Osteopathic Association/Healthcare Facilities
  674  Accreditation Program, a national accrediting organization that
  675  is approved by the Centers for Medicare and Medicaid Services
  676  and whose standards incorporate comparable licensure regulations
  677  required by the state, on Accreditation of Healthcare
  678  Organizations or other national accrediting accreditation
  679  agencies whose standards for accreditation are comparable to
  680  those required by this part for licensure.
  681         Section 29. Subsection (5) of section 400.93, Florida
  682  Statutes, is amended to read:
  683         400.93 Licensure required; exemptions; unlawful acts;
  684  penalties.—
  685         (5) The following are exempt from home medical equipment
  686  provider licensure, unless they have a separate company,
  687  corporation, or division that is in the business of providing
  688  home medical equipment and services for sale or rent to
  689  consumers at their regular or temporary place of residence
  690  pursuant to the provisions of this part:
  691         (a) Providers operated by the Department of Health or
  692  Federal Government.
  693         (b) Nursing homes licensed under part II.
  694         (c) Assisted living facilities licensed under chapter 429,
  695  when serving their residents.
  696         (d) Home health agencies licensed under part III.
  697         (e) Hospices licensed under part IV.
  698         (f) Intermediate care facilities, homes for special
  699  services, and transitional living facilities licensed under part
  700  V.
  701         (g) Transitional living facilities licensed under part XI.
  702         (h)(g) Hospitals and ambulatory surgical centers licensed
  703  under chapter 395.
  704         (i)(h) Manufacturers and wholesale distributors when not
  705  selling directly to consumers.
  706         (j)(i) Licensed health care practitioners who utilize home
  707  medical equipment in the course of their practice, but do not
  708  sell or rent home medical equipment to their patients.
  709         (k)(j) Pharmacies licensed under chapter 465.
  710         Section 30. Paragraphs (l) and (m) of subsection (4) of
  711  section 400.9905, Florida Statutes, is amended to read:
  712         400.9905 Definitions.—
  713         (4) “Clinic” means an entity where health care services are
  714  provided to individuals and which tenders charges for
  715  reimbursement for such services, including a mobile clinic and a
  716  portable equipment provider. As used in this part, the term does
  717  not include and the licensure requirements of this part do not
  718  apply to:
  719         (l) Orthotic, or prosthetic, pediatric cardiology, or
  720  perinatology clinical facilities or anesthesia clinical
  721  facilities that are not otherwise exempt under paragraph (a) or
  722  paragraph (k) and that are a publicly traded corporation or that
  723  are wholly owned, directly or indirectly, by a publicly traded
  724  corporation. As used in this paragraph, a publicly traded
  725  corporation is a corporation that issues securities traded on an
  726  exchange registered with the United States Securities and
  727  Exchange Commission as a national securities exchange.
  728         (m) Entities that are owned by a corporation that has $250
  729  million or more in total annual sales of health care services
  730  provided by licensed health care practitioners where one or more
  731  of the persons responsible for the operations of the entity
  732  owners is a health care practitioner who is licensed in this
  733  state and who is responsible for supervising the business
  734  activities of the entity and is legally responsible for the
  735  entity’s compliance with state law for purposes of this part.
  736  
  737  Notwithstanding this subsection, an entity shall be deemed a
  738  clinic and must be licensed under this part in order to receive
  739  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  740  627.730-627.7405, unless exempted under s. 627.736(5)(h).
  741         Section 31. Paragraph (g) of subsection (1) and subsection
  742  (7) of section 400.9935, Florida Statutes, are amended to read:
  743         400.9935 Clinic responsibilities.—
  744         (1) Each clinic shall appoint a medical director or clinic
  745  director who shall agree in writing to accept legal
  746  responsibility for the following activities on behalf of the
  747  clinic. The medical director or the clinic director shall:
  748         (g) Conduct systematic reviews of clinic billings to ensure
  749  that the billings are not fraudulent or unlawful. Upon discovery
  750  of an unlawful charge, the medical director or clinic director
  751  shall take immediate corrective action. If the clinic performs
  752  only the technical component of magnetic resonance imaging,
  753  static radiographs, computed tomography, or positron emission
  754  tomography, and provides the professional interpretation of such
  755  services, in a fixed facility that is accredited by the Joint
  756  Commission, the American Osteopathic Association/Healthcare
  757  Facilities Accreditation Program, on Accreditation of Healthcare
  758  Organizations or the Accreditation Association for Ambulatory
  759  Health Care, Inc., or a national accrediting organization that
  760  is approved by the Centers for Medicare and Medicaid Services
  761  and whose standards incorporate comparable licensure regulations
  762  required by the state; and the American College of Radiology;
  763  and if, in the preceding quarter, the percentage of scans
  764  performed by that clinic which was billed to all personal injury
  765  protection insurance carriers was less than 15 percent, the
  766  chief financial officer of the clinic may, in a written
  767  acknowledgment provided to the agency, assume the responsibility
  768  for the conduct of the systematic reviews of clinic billings to
  769  ensure that the billings are not fraudulent or unlawful.
  770         (7)(a) Each clinic engaged in magnetic resonance imaging
  771  services must be accredited by the Joint Commission, the
  772  American Osteopathic Association/Healthcare Facilities
  773  Accreditation Program, a national accrediting organization that
  774  is approved by the Centers for Medicare and Medicaid Services
  775  and whose standards incorporate comparable licensure regulations
  776  required by the state on Accreditation of Healthcare
  777  Organizations, the American College of Radiology, or the
  778  Accreditation Association for Ambulatory Health Care, Inc.,
  779  within 1 year after licensure. A clinic that is accredited by
  780  the American College of Radiology or that is within the original
  781  1-year period after licensure and replaces its core magnetic
  782  resonance imaging equipment shall be given 1 year after the date
  783  on which the equipment is replaced to attain accreditation.
  784  However, a clinic may request a single, 6-month extension if it
  785  provides evidence to the agency establishing that, for good
  786  cause shown, such clinic cannot be accredited within 1 year
  787  after licensure, and that such accreditation will be completed
  788  within the 6-month extension. After obtaining accreditation as
  789  required by this subsection, each such clinic must maintain
  790  accreditation as a condition of renewal of its license. A clinic
  791  that files a change of ownership application must comply with
  792  the original accreditation timeframe requirements of the
  793  transferor. The agency shall deny a change of ownership
  794  application if the clinic is not in compliance with the
  795  accreditation requirements. When a clinic adds, replaces, or
  796  modifies magnetic resonance imaging equipment and the
  797  accrediting accreditation agency requires new accreditation, the
  798  clinic must be accredited within 1 year after the date of the
  799  addition, replacement, or modification but may request a single,
  800  6-month extension if the clinic provides evidence of good cause
  801  to the agency.
  802         (b) The agency may deny the application or revoke the
  803  license of an any entity formed for the purpose of avoiding
  804  compliance with the accreditation provisions of this subsection
  805  and whose principals were previously principals of an entity
  806  that was unable to meet the accreditation requirements within
  807  the specified timeframes. The agency may adopt rules as to the
  808  accreditation of magnetic resonance imaging clinics.
  809         Section 32. Sections 400.9970 through 400.9984, Florida
  810  Statutes, are designated as part XI of chapter 400, Florida
  811  Statutes, entitled “Transitional Living Facilities.”
  812         Section 33. Section 400.9970, Florida Statutes, is created
  813  to read:
  814         400.9970 Legislative intent.—It is the intent of the
  815  Legislature to provide for the licensure of transitional living
  816  facilities and require the development, establishment, and
  817  enforcement of basic standards by the Agency for Health Care
  818  Administration to ensure quality of care and services to clients
  819  in transitional living facilities. It is the policy of the state
  820  that the least restrictive appropriate available treatment be
  821  used based on the individual needs and best interest of the
  822  client and consistent with optimum improvement of the client’s
  823  condition. The goal of a transitional living program for
  824  individuals who have brain or spinal cord injuries is to assist
  825  each individual who has such an injury to achieve a higher level
  826  of independent functioning and to enable that individual to
  827  reenter the community. It is also the policy of this state that
  828  the use of restraints and seclusion of clients is justified only
  829  as an emergency safety measure to be used in response to danger
  830  to the client or others. It is, therefore, the intent of the
  831  Legislature to achieve an ongoing reduction in the use of
  832  restraints and seclusion in programs and facilities that serve
  833  persons who have brain injury or spinal cord injuries.
  834         Section 34. Section 400.9971, Florida Statutes, is created
  835  to read:
  836         400.9971 Definitions.—As used in this part, the term:
  837         (1) “Agency” means the Agency for Health Care
  838  Administration.
  839         (2) “Chemical restraint” means a pharmacologic drug that
  840  physically limits, restricts, or deprives an individual of
  841  movement or mobility, is used for client protection or safety,
  842  and is not required for the treatment of medical conditions or
  843  symptoms.
  844         (3) “Client’s representative” means the parent of a child
  845  client or the client’s guardian, designated representative or
  846  designee, surrogate, or attorney in fact.
  847         (4) “Department” means the Department of Health.
  848         (5) “Physical restraint” means any manual method to
  849  restrict freedom of movement of or normal access to an
  850  individual’s body or a physical or mechanical device, material,
  851  or equipment attached or adjacent to the individual’s body so
  852  that he or she cannot easily remove the restraint and which
  853  restricts freedom of movement of or normal access to one’s body,
  854  including, but not limited to, a half-bed rail, a full-bed rail,
  855  a geriatric chair, and a posey restraint. The term includes any
  856  device that was not specifically manufactured as a restraint but
  857  that has been altered, arranged, or otherwise used for this
  858  purpose. The term does not include bandage material used for the
  859  purpose of binding a wound or injury.
  860         (6)“Seclusion” means the physical segregation of a person
  861  in any fashion or the involuntary isolation of a person in a
  862  room or area from which the person is prevented from leaving.
  863  The prevention may be by physical barrier or by a staff member
  864  who is acting in a manner, or who is physically situated, so as
  865  to prevent the person from leaving the room or area. For
  866  purposes of this chapter, the term does not mean isolation due
  867  to a person’s medical condition or symptoms.
  868         (7) “Transitional living facility” means a site where
  869  specialized health care services are provided, including, but
  870  not limited to, rehabilitative services, behavior modification,
  871  community reentry training, aids for independent living, and
  872  counseling to individuals who have brain injuries or spinal cord
  873  injuries. The term does not require a provider that is licensed
  874  by the agency to obtain a separate transitional living facility
  875  license to serve persons who have brain injuries or spinal cord
  876  injuries as long as the services provided are within the scope
  877  of the provider’s license.
  878         Section 35. Section 400.9972, Florida Statutes, is created
  879  to read:
  880         400.9972 License required; fee; application.—
  881         (1) The requirements of part II of chapter 408 apply to the
  882  provision of services that require licensure pursuant to this
  883  part and part II of chapter 408 and to entities licensed by or
  884  applying for such licensure from the agency pursuant to this
  885  part. A license issued by the agency is required for the
  886  operation of a transitional living facility in this state. Every
  887  transitional living facility licensed under s. 400.805 on or
  888  before July 1, 2013, shall be granted a license under the
  889  provisions of part XI of chapter 400.
  890         (2) In accordance with this part, an applicant or a
  891  licensee shall pay a fee for each license application submitted
  892  under this part. The license fee shall consist of a $4,588
  893  license fee and a $90 per-bed fee per biennium and shall conform
  894  to the annual adjustment authorized in s. 408.805.
  895         (3) Each applicant for licensure must provide the
  896  following:
  897         (a) The location of the facility for which a license is
  898  sought and documentation, signed by the appropriate local
  899  government official, which states that the applicant has met
  900  local zoning requirements.
  901         (b) Proof of liability insurance as provided in s. 624.605.
  902         (c) Proof of compliance with local zoning requirements,
  903  including compliance with the requirements of chapter 419 if the
  904  proposed facility is a community residential home.
  905         (d) Proof that the facility has received a satisfactory
  906  firesafety inspection.
  907         (e) Documentation of a satisfactory sanitation inspection
  908  of the facility by the county health department.
  909  
  910  The applicant’s proposed facility must attain and continuously
  911  maintain accreditation by an accrediting organization
  912  specializing in evaluating rehabilitation facilities whose
  913  standards incorporate comparable licensure regulations required
  914  by the state. An applicant for licensure as a transitional
  915  living facility must acquire accreditation within 12 months
  916  after the issuance of an initial license. The agency shall
  917  accept the accreditation survey report of the accrediting
  918  organization in lieu of conducting a licensure inspection if the
  919  standards included in the survey report are determined by the
  920  agency to document that the facility is in substantial
  921  compliance with state licensure requirements. The applicant
  922  shall submit to the agency within 10 days after receipt a copy
  923  of any accreditation survey report and evidence of the
  924  accreditation decision subsequent to a survey by the accrediting
  925  organization on the facility. This part does not preclude the
  926  agency from conducting periodic inspections of a transitional
  927  living facility to ensure compliance with all licensure
  928  requirements, and as it deems necessary to carry out the
  929  functions of the agency. An inspection may be conducted to
  930  ensure compliance with licensure requirements of this part, to
  931  validate the inspection process of accrediting organizations, to
  932  respond to licensure complaints, or to protect the public health
  933  and safety.
  934         Section 36. Section 400.9973, Florida Statutes, is created
  935  to read:
  936         400.9973 Client admission, transfer, and discharge.—
  937         (1) Each transitional living facility must have written
  938  policies and procedures governing the admission, transfer, and
  939  discharge of clients.
  940         (2) The admission of each client to a transitional living
  941  facility must be in accordance with the licensee’s policies and
  942  procedures.
  943         (3) A client admitted to a transitional living facility
  944  must have a brain or spinal cord injury, such as a lesion to the
  945  spinal cord or cauda equina syndrome, with evidence of
  946  significant involvement of two of the following deficits or
  947  dysfunctions:
  948         (a) A motor deficit.
  949         (b) A sensory deficit.
  950         (c) Bowel and bladder dysfunction.
  951         (d) An acquired internal or external injury to the skull,
  952  the brain, or the brain’s covering, whether caused by a
  953  traumatic or nontraumatic event, which produces an altered state
  954  of consciousness or an anatomic motor, sensory, cognitive, or
  955  behavioral deficit.
  956         (4) A client whose medical condition and diagnosis do not
  957  positively identify a cause of the client’s condition, whose
  958  symptoms are inconsistent with the known cause of injury, or
  959  whose recovery is inconsistent with the known medical condition
  960  may be admitted to a transitional living facility for evaluation
  961  for a period not to exceed 90 days.
  962         (5) A client admitted to a transitional living facility
  963  must be admitted upon prescription by a licensed physician and
  964  must remain under the care of a licensed physician for the
  965  duration of the client’s stay in the facility.
  966         (6) A transitional living facility may not admit a client
  967  whose primary admitting diagnosis is mental illness or an
  968  intellectual or a developmental disability.
  969         (7) An individual may not be admitted to a transitional
  970  living facility if the individual:
  971         (a) Presents significant risk of infection to other clients
  972  or personnel. A health care practitioner must provide
  973  documentation that the individual is free of apparent signs and
  974  symptoms of communicable disease;
  975         (b) Is a danger to self or others as determined by a
  976  physician or mental health practitioner licensed under chapter
  977  490 or chapter 491, unless the facility provides adequate
  978  staffing and support to ensure patient safety;
  979         (c) Is bedridden; or
  980         (d) Requires 24-hour nursing supervision.
  981         (8) If the client meets the admission criteria, the medical
  982  or nursing director of the facility must complete an initial
  983  evaluation of the client’s functional skills, behavioral status,
  984  cognitive status, educational or vocational potential, medical
  985  status, psychosocial status, sensorimotor capacity, and other
  986  related skills and abilities within the first 72 hours after the
  987  client’s admission to the facility. An initial comprehensive
  988  treatment plan that delineates services to be provided and
  989  appropriate sources for such services must be implemented within
  990  the first 4 days after admission.
  991         (9) Each transitional living facility shall develop a
  992  discharge plan for each client before or upon admission to the
  993  facility. The discharge plan must identify the intended
  994  discharge site and possible alternative discharge sites. For
  995  each discharge site identified, the discharge plan must identify
  996  the skills, behaviors, and other conditions that the client must
  997  achieve to be appropriate for discharge. Discharge plans must be
  998  reviewed and updated as necessary, but no less often than once
  999  monthly.
 1000         (10) As soon as practicable, a transitional living facility
 1001  shall discharge a client when he or she no longer requires any
 1002  of the specialized services described in s. 400.9971(7) or is
 1003  not making measurable progress in accordance with his or her
 1004  comprehensive treatment plan, or if the transitional living
 1005  facility is no longer the most appropriate, least restrictive
 1006  treatment option.
 1007         (11) Each transitional living facility shall provide at
 1008  least 30 days’ notice to clients of transfer or discharge plans,
 1009  including the location of an acceptable transfer location if the
 1010  client is unable to live independently. This requirement does
 1011  not apply if a client voluntarily terminates residency.
 1012         Section 37. Section 400.9974, Florida Statutes, is created
 1013  to read:
 1014         400.9974 Client comprehensive treatment plans; client
 1015  services.—
 1016         (1) Each transitional living facility shall develop a
 1017  comprehensive treatment plan for each client as soon as
 1018  possible, but no later than 30 days following development of the
 1019  initial comprehensive treatment plan. Comprehensive treatment
 1020  plans must be reviewed and updated if the client fails to meet
 1021  projected improvements in the plan or if a significant change in
 1022  the client’s condition occurs. Comprehensive treatment plans
 1023  must be reviewed and updated at least once monthly.
 1024  Comprehensive treatment plans must be developed by an
 1025  interdisciplinary team consisting of the case manager, the
 1026  program director, the nurse, and appropriate therapists. The
 1027  client or, if appropriate, the client’s representative must be
 1028  included in developing the comprehensive treatment plan.
 1029         (2) The comprehensive treatment plan must include the
 1030  following:
 1031         (a) The physician’s orders and the client’s diagnosis,
 1032  medical history, physical examination, and rehabilitative or
 1033  restorative needs.
 1034         (b) A preliminary nursing evaluation with physician’s
 1035  orders for immediate care, completed on admission.
 1036         (c) A comprehensive, accurate, reproducible, and
 1037  standardized assessment of the client’s functional capability;
 1038  the treatments designed to achieve skills, behaviors, and other
 1039  conditions necessary to return to the community; and specific
 1040  measurable goals.
 1041         (d) Steps necessary for the client to achieve transition to
 1042  the community and estimated length of time to achieve the goals.
 1043         (3) The client or, if appropriate, the client’s
 1044  representative must consent to the continued treatment at the
 1045  transitional living facility. Consent may be for a period of up
 1046  to 3 months. If such consent is not given, the transitional
 1047  living facility shall discharge the client as soon as
 1048  practicable.
 1049         (4) Each client must receive the professional program
 1050  services needed to implement the client’s comprehensive
 1051  treatment plan.
 1052         (5) The licensee must employ qualified professional staff
 1053  to carry out and monitor the various professional interventions
 1054  in accordance with the stated goals and objectives of every
 1055  client’s comprehensive treatment plan.
 1056         (6) Each client must receive a continuous treatment program
 1057  that includes appropriate, consistent implementation of a
 1058  program of specialized and general training, treatment, health
 1059  services, and related services and that is directed toward:
 1060         (a) The acquisition of the behaviors and skills necessary
 1061  for the client to function with as much self-determination and
 1062  independence as possible;
 1063         (b) The prevention or deceleration of regression or loss of
 1064  current optimal functional status; and
 1065         (c) The management of behavioral issues that preclude
 1066  independent functioning in the community.
 1067         Section 38. Section 400.9975, Florida Statutes, is created
 1068  to read:
 1069         400.9975 Licensee responsibilities.—
 1070         (1) The licensee shall ensure that each client:
 1071         (a) Lives in a safe environment free from abuse, neglect,
 1072  and exploitation.
 1073         (b) Is treated with consideration and respect and with due
 1074  recognition of personal dignity, individuality, and the need for
 1075  privacy.
 1076         (c) Retains and uses his or her own clothes and other
 1077  personal property in his or her immediate living quarters, so as
 1078  to maintain individuality and personal dignity, except when the
 1079  licensee can demonstrate that such retention and use would be
 1080  unsafe, impractical, or an infringement upon the rights of other
 1081  clients.
 1082         (d) Has unrestricted private communication, including
 1083  receiving and sending unopened correspondence, access to a
 1084  telephone, and visiting with any person of his or her choice.
 1085  Upon request, the licensee shall make provisions to modify
 1086  visiting hours for caregivers and guests. The facility shall
 1087  restrict communication in accordance with any court order or
 1088  written instruction of a client’s representative. Any
 1089  restriction on a client’s communication for therapeutic reasons
 1090  shall be documented and reviewed at least weekly and shall be
 1091  removed as soon as it is no longer clinically indicated. The
 1092  basis for the restriction shall be explained to the client and,
 1093  if applicable, the client’s representative. The client shall
 1094  nonetheless retain the right to call the abuse hotline, the
 1095  agency, and Disability Rights Florida at any and all times.
 1096         (e) Has the opportunity to participate in and benefits from
 1097  community services and activities to achieve the highest
 1098  possible level of independence, autonomy, and interaction within
 1099  the community.
 1100         (f) Has the opportunity to manage his or her financial
 1101  affairs unless the client or, if applicable, the client’s
 1102  representative authorizes the administrator of the facility to
 1103  provide safekeeping for funds as provided in this part.
 1104         (g) Has reasonable opportunity for regular exercise several
 1105  times a week and to be outdoors at regular and frequent
 1106  intervals except when prevented by inclement weather.
 1107         (h) Has the opportunity to exercise civil and religious
 1108  liberties, including the right to independent personal
 1109  decisions. No religious belief or practice, including attendance
 1110  at religious services, shall be imposed upon any client.
 1111         (i) Has access to adequate and appropriate health care
 1112  consistent with established and recognized standards within the
 1113  community.
 1114         (j) Has the ability to present grievances and recommend
 1115  changes in policies, procedures, and services to the staff of
 1116  the licensee, governing officials, or any other person without
 1117  restraint, interference, coercion, discrimination, or reprisal.
 1118  Each licensee shall establish a grievance procedure to
 1119  facilitate a client’s ability to present grievances, including a
 1120  system for investigating, tracking, managing, and responding to
 1121  complaints by persons receiving services or individuals acting
 1122  on their behalf, and an appeals process. This process must
 1123  include access to Disability Rights Florida and other advocates
 1124  and the right to be a member of, be active in, and associate
 1125  with advocacy or special interest groups.
 1126         (2) The licensee shall:
 1127         (a) Promote participation of each client’s representative
 1128  in the process of providing treatment to the client unless the
 1129  representative’s participation is unobtainable or inappropriate.
 1130         (b) Answer communications from each client’s family,
 1131  guardians, and friends promptly and appropriately.
 1132         (c) Promote visits by individuals with a relationship to
 1133  the client at any reasonable hour, without requiring prior
 1134  notice, or in any area of the facility which provides direct
 1135  client care services to the client, consistent with the client’s
 1136  and other clients’ privacy, unless the interdisciplinary team
 1137  determines that such a visit would not be appropriate.
 1138         (d) Promote leave from the facility for visits, trips, or
 1139  vacations.
 1140         (e) Promptly notify the client’s representative of any
 1141  significant incidents or changes in the client’s condition,
 1142  including, but not limited to, serious illness, accident, abuse,
 1143  unauthorized absence, or death.
 1144         (3) The administrator of a facility shall ensure that a
 1145  written notice of licensee responsibilities is posted in a
 1146  prominent place in each building where clients reside, and is
 1147  read, or explained, to clients who cannot read. This notice must
 1148  include the statewide toll-free telephone number for reporting
 1149  complaints to the agency, must be provided to clients in a
 1150  manner that is clearly legible, and must include the words: “To
 1151  report a complaint regarding the services you receive, please
 1152  call toll-free ...[telephone number]... or Disability Rights
 1153  Florida ...[telephone number]...”; and the statewide toll-free
 1154  telephone number for the central abuse hotline must be provided
 1155  to clients in a manner that is clearly legible and must include
 1156  the words: “To report abuse, neglect, or exploitation, please
 1157  call toll-free ...[telephone number where complaints may be
 1158  lodged]....” The licensee must ensure a client’s access to a
 1159  telephone where telephone numbers required in this subsection
 1160  are readily available to call the agency, central abuse hotline,
 1161  or Disability Rights Florida.
 1162         (4) A licensee or employee of a facility may not serve
 1163  notice upon a client to leave the premises or take any other
 1164  retaliatory action against any person solely due to the
 1165  following:
 1166         (a) The client or other person files an internal or
 1167  external complaint or grievance regarding the facility.
 1168         (b) The client or other person appears as a witness in any
 1169  hearing inside or outside the facility.
 1170         (5) Before or at the time of admission, the client and the
 1171  client’s representative shall be provided with a copy of the
 1172  licensee’s responsibilities as provided in this section,
 1173  including grievance procedures and the telephone numbers
 1174  provided in this section.
 1175         (6) The licensee must develop and implement policies and
 1176  procedures governing the release of any client information,
 1177  including consent necessary from the client or the client’s
 1178  representative.
 1179         Section 39. Section 400.9976, Florida Statutes, is created
 1180  to read:
 1181         400.9976 Medication practices.—
 1182         (1) An individual medication administration record must be
 1183  maintained for each client. Each dose of medication, including a
 1184  self-administered dose, shall be properly recorded in the
 1185  client’s record. Each client who self-administers medication
 1186  shall be given a pill organizer. Medication must be placed in
 1187  the pill organizer by a nurse. A nurse shall document the date
 1188  and time medication is placed into each client’s pill organizer.
 1189  All medications must be administered in compliance with the
 1190  physician’s orders.
 1191         (2) If the interdisciplinary team determines that self
 1192  administration of medications is an appropriate objective, and
 1193  if the physician does not specify otherwise, a client must be
 1194  taught to self-administer his or her medication without a staff
 1195  person. This includes all forms of administration, including
 1196  orally, via injection, and via suppository. The client’s
 1197  physician must be informed of the interdisciplinary team’s
 1198  decision that self-administration of medications is an objective
 1199  for the client. A client may not self-administer medication
 1200  until he or she demonstrates the competency to take the correct
 1201  medication in the correct dosage at the correct time, to respond
 1202  to missed doses, and to contact an appropriate person with
 1203  questions.
 1204         (3) Medication administration discrepancies and adverse
 1205  drug reactions must be recorded and reported immediately to a
 1206  physician.
 1207         Section 40. Section 400.9977, Florida Statutes, is created
 1208  to read:
 1209         400.9977 Protection from abuse, neglect, mistreatment, and
 1210  exploitation.—The licensee must develop and implement policies
 1211  and procedures for the screening and training of employees; the
 1212  protection of clients; and the prevention, identification,
 1213  investigation, and reporting of abuse, neglect, and
 1214  exploitation. This includes the licensee’s identification of
 1215  clients whose personal histories render them at risk for abusing
 1216  other clients, development of intervention strategies to prevent
 1217  occurrences, monitoring for changes that would trigger abusive
 1218  behavior, and reassessment of the interventions on a regular
 1219  basis. A licensee shall implement procedures to:
 1220         (1) Screen potential employees for a history of abuse,
 1221  neglect, or mistreatment of clients. The screening shall include
 1222  an attempt to obtain information from previous employers and
 1223  current employers and verification with the appropriate
 1224  licensing boards.
 1225         (2) Train employees, through orientation and ongoing
 1226  sessions, on issues related to abuse prohibition practices,
 1227  including identification of abuse, neglect, mistreatment, and
 1228  exploitation, appropriate interventions to deal with aggressive
 1229  or catastrophic reactions of clients, the process to report
 1230  allegations without fear of reprisal, and recognition of signs
 1231  of frustration and stress that may lead to abuse.
 1232         (3) Provide clients, families, and staff with information
 1233  on how and to whom they may report concerns, incidents, and
 1234  grievances without the fear of retribution and provide feedback
 1235  regarding the concerns that have been expressed. A licensee must
 1236  identify, correct, and intervene in situations in which abuse,
 1237  neglect, mistreatment, or exploitation is likely to occur,
 1238  including:
 1239         (a) Evaluating the physical environment of the facility to
 1240  identify characteristics that may make abuse or neglect more
 1241  likely to occur, such as secluded areas.
 1242         (b) Providing sufficient staff on each shift to meet the
 1243  needs of the clients, and ensuring that the staff assigned have
 1244  knowledge of the individual clients’ care needs. The licensee
 1245  shall identify inappropriate behaviors of its staff, such as
 1246  using derogatory language, rough handling, ignoring clients
 1247  while giving care, and directing clients who need toileting
 1248  assistance to urinate or defecate in their beds.
 1249         (c) Assessing, planning care for, and monitoring clients
 1250  with needs and behaviors that might lead to conflict or neglect,
 1251  such as clients with a history of aggressive behaviors, clients
 1252  who have behaviors such as entering other clients’ rooms,
 1253  clients with self-injurious behaviors, clients with
 1254  communication disorders, and clients who require heavy nursing
 1255  care or are totally dependent on staff.
 1256         (4) Identify events, such as suspicious bruising of
 1257  clients, occurrences, patterns, and trends that may constitute
 1258  abuse and determine the direction of the investigation.
 1259         (5) Investigate different types of incidents, identify the
 1260  staff member responsible for the initial reporting, investigate
 1261  alleged violations, and report results to the proper
 1262  authorities. The licensee must analyze the occurrences to
 1263  determine what changes are needed, if any, to policies and
 1264  procedures to prevent further occurrences and to take all
 1265  necessary corrective action depending on the results of the
 1266  investigation.
 1267         (6) Protect clients from harm during an investigation.
 1268         (7) Report all alleged violations and all substantiated
 1269  incidents, as required under chapters 39 and 415, to the
 1270  licensing authorities and all other agencies as required, and to
 1271  report any knowledge it has of any actions by a court of law
 1272  that would indicate an employee is unfit for service.
 1273         Section 41. Section 400.9978, Florida Statutes, is created
 1274  to read:
 1275         400.9978 Restraints and seclusion; client safety.—
 1276         (1) Each facility shall provide a therapeutic milieu that
 1277  supports a culture of individual empowerment and responsibility.
 1278  The health and safety of the client shall be the primary concern
 1279  at all times.
 1280         (2) The use of physical restraints must be ordered and
 1281  documented by a physician and must be consistent with policies
 1282  and procedures adopted by the facility. The client or, if
 1283  applicable, the client’s representative must be informed of the
 1284  facility’s physical restraint policies and procedures at the
 1285  time of the client’s admission.
 1286         (3) The use of chemical restraints is limited to prescribed
 1287  dosages of medications as ordered by a physician and must be
 1288  consistent with the client’s diagnosis and the policies and
 1289  procedures adopted by the facility. The client and, if
 1290  applicable, the client’s representative must be informed of the
 1291  facility’s chemical restraint policies and procedures at the
 1292  time of the client’s admission.
 1293         (4) Based on a physician’s assessment, if a client exhibits
 1294  symptoms that present an immediate risk of injury or death to
 1295  self or others, a physician may issue an emergency treatment
 1296  order to immediately administer rapid response psychotropic
 1297  medications or other chemical restraints. Each emergency
 1298  treatment order must be documented and maintained in the
 1299  client’s record.
 1300         (a) An emergency treatment order is effective for no more
 1301  than 24 hours.
 1302         (b) Whenever a client is medicated in accordance with this
 1303  subsection, the client’s representative or responsible party and
 1304  the client’s physician must be notified as soon as practicable.
 1305         (5) A client who is prescribed and receiving a medication
 1306  that can serve as a chemical restraint for a purpose other than
 1307  an emergency treatment order must be evaluated by his or her
 1308  physician at least monthly to assess the following:
 1309         (a) The continued need for the medication.
 1310         (b) The level of the medication in the client’s blood, as
 1311  appropriate.
 1312         (c) The need for adjustments in the prescription.
 1313         (6) The licensee shall ensure that clients are free from
 1314  unnecessary drugs and physical restraints and are provided
 1315  treatment to reduce dependency on drugs and physical restraints.
 1316         (7) The licensee may use physical restraints and seclusion
 1317  only as authorized by the facility’s written physical restraint
 1318  and seclusion policies, which must be in compliance with this
 1319  section and applicable rules.
 1320         (8) Interventions to manage dangerous client behavior must
 1321  be employed with sufficient safeguards and supervision to ensure
 1322  that the safety, welfare, and civil and human rights of each
 1323  client are adequately protected.
 1324         (9) A facility shall notify the parent or guardian of a
 1325  client each time restraint or seclusion is used. Such
 1326  notification must be within 24 hours from the time the restraint
 1327  or seclusion occurs. Reasonable efforts must be taken to notify
 1328  the parent or guardian by telephone or e-mail, or both, and
 1329  these efforts must be documented.
 1330         (10) The agency may adopt by rule standards and procedures
 1331  relating to the use of restraints, restraint positioning,
 1332  seclusion, and emergency treatment orders for psychotropic
 1333  medications, restraint, and seclusion. These rules must include
 1334  duration of restraint use, staff training, client observation
 1335  during restraint, and documentation and reporting standards.
 1336         Section 42. Section 400.9979, Florida Statutes, is created
 1337  to read:
 1338         400.9979 Background screening; administration and
 1339  management.—
 1340         (1) The agency shall require level 2 background screening
 1341  for personnel as required in s. 408.809(1)(e) pursuant to s.
 1342  408.809 and chapter 435.
 1343         (2) The licensee shall maintain personnel records for each
 1344  staff member which contain, at a minimum, documentation of
 1345  background screening, if applicable, a job description,
 1346  documentation of compliance with all training requirements of
 1347  this part or applicable rule, the employment application,
 1348  references, a copy of all job performance evaluations, and, for
 1349  each staff member who performs services for which licensure or
 1350  certification is required, a copy of all licenses or
 1351  certification held by the staff member.
 1352         (3) The licensee must:
 1353         (a) Develop and implement infection control policies and
 1354  procedures and include such policies and procedures in the
 1355  licensee’s policy manual.
 1356         (b) Maintain liability insurance as defined in s. 624.605.
 1357         (c) Designate one person as an administrator who is
 1358  responsible and accountable for the overall management of the
 1359  facility.
 1360         (d) Designate a person in writing to be responsible for the
 1361  facility when the administrator is absent from the facility for
 1362  more than 24 hours.
 1363         (e) Designate in writing a program director who is
 1364  responsible for supervising the therapeutic and behavioral staff
 1365  and who determines the levels of supervision and the room
 1366  placement for each client.
 1367         (f) Designate in writing a person to be responsible when
 1368  the program director is absent from the facility for more than
 1369  24 hours.
 1370         (g) Obtain approval of the comprehensive emergency
 1371  management plan, pursuant to s. 400.9981(2)(e), from the local
 1372  emergency management agency. Pending the approval of the plan,
 1373  the local emergency management agency shall ensure that the
 1374  following agencies, at a minimum, are given the opportunity to
 1375  review the plan: the Department of Health, the Agency for Health
 1376  Care Administration, and the Division of Emergency Management.
 1377  Appropriate volunteer organizations must also be given the
 1378  opportunity to review the plan. The local emergency management
 1379  agency shall complete its review within 60 days and either
 1380  approve the plan or advise the licensee of necessary revisions.
 1381         (h) Maintain written records in a form and system that
 1382  comply with medical and business practices and make such records
 1383  available in the facility for review or submission to the agency
 1384  upon request. The records shall include:
 1385         1. A daily census record that indicates the number of
 1386  clients currently receiving services in the facility, including
 1387  information regarding any public funding of such clients.
 1388         2. A record of all accidents or unusual incidents involving
 1389  any client or staff member which caused, or had the potential to
 1390  cause, injury or harm to any person or property within the
 1391  facility. Such records must contain a clear description of each
 1392  accident or incident, the names of the persons involved, a
 1393  description of all medical or other services provided to these
 1394  persons specifying who provided such services, and the steps
 1395  taken to prevent recurrence of such accidents or incidents.
 1396         3. A copy of current agreements with third-party providers.
 1397         4. A copy of current agreements with each consultant
 1398  employed by the licensee and documentation of each consultant’s
 1399  visits and required written, dated reports.
 1400         Section 43. Section 400.9980, Florida Statutes, is created
 1401  to read:
 1402         400.9980 Property and personal affairs of clients.—
 1403         (1) A client shall be given the option of using his or her
 1404  own belongings, as space permits; choosing his or her roommate
 1405  if practical and not clinically contraindicated; and, whenever
 1406  possible, unless the client is adjudicated incompetent or
 1407  incapacitated under state law, managing his or her own affairs.
 1408         (2) The admission of a client to a facility and his or her
 1409  presence therein shall not confer on a licensee, administrator,
 1410  employee, or representative thereof any authority to manage,
 1411  use, or dispose of any property of the client, nor shall such
 1412  admission or presence confer on any of such persons any
 1413  authority or responsibility for the personal affairs of the
 1414  client except that which may be necessary for the safe
 1415  management of the facility or for the safety of the client.
 1416         (3) A licensee, administrator, employee, or representative
 1417  thereof may:
 1418         (a) Not act as the guardian, trustee, or conservator for
 1419  any client or any of such client’s property.
 1420         (b) Act as a competent client’s payee for social security,
 1421  veteran’s, or railroad benefits if the client provides consent
 1422  and the licensee files a surety bond with the agency in an
 1423  amount equal to twice the average monthly aggregate income or
 1424  personal funds due to the client, or expendable for the client’s
 1425  account, which are received by a licensee.
 1426         (c) Act as the power of attorney for a client if the
 1427  licensee has filed a surety bond with the agency in an amount
 1428  equal to twice the average monthly income of the client, plus
 1429  the value of any client’s property under the control of the
 1430  attorney in fact.
 1431  
 1432  The bond under paragraph (b) or paragraph (c) shall be executed
 1433  by the licensee as principal and a licensed surety company. The
 1434  bond shall be conditioned upon the faithful compliance of the
 1435  licensee with the requirements of licensure and shall be payable
 1436  to the agency for the benefit of any client who suffers a
 1437  financial loss as a result of the misuse or misappropriation of
 1438  funds held pursuant to this subsection. Any surety company that
 1439  cancels or does not renew the bond of any licensee shall notify
 1440  the agency in writing not less than 30 days in advance of such
 1441  action, giving the reason for the cancellation or nonrenewal.
 1442  Any licensee, administrator, employee, or representative thereof
 1443  who is granted power of attorney for any client of the facility
 1444  shall, on a monthly basis, notify the client in writing of any
 1445  transaction made on behalf of the client pursuant to this
 1446  subsection, and a copy of such notification given to the client
 1447  shall be retained in each client’s file and available for agency
 1448  inspection.
 1449         (4) A licensee, upon mutual consent with the client, shall
 1450  provide for the safekeeping in the facility of the client’s
 1451  personal effects of a value not in excess of $1,000 and the
 1452  client’s funds not in excess of $500 cash and shall keep
 1453  complete and accurate records of all such funds and personal
 1454  effects received. If a client is absent from a facility for 24
 1455  hours or more, the licensee may provide for the safekeeping of
 1456  the client’s personal effects of a value in excess of $1,000.
 1457         (5) Any funds or other property belonging to or due to a
 1458  client or expendable for his or her account which is received by
 1459  a licensee shall be trust funds and shall be kept separate from
 1460  the funds and property of the licensee and other clients or
 1461  shall be specifically credited to such client. Such trust funds
 1462  shall be used or otherwise expended only for the account of the
 1463  client. At least once every month, unless upon order of a court
 1464  of competent jurisdiction, the licensee shall furnish the client
 1465  and the client’s representative a complete and verified
 1466  statement of all funds and other property to which this
 1467  subsection applies, detailing the amount and items received,
 1468  together with their sources and disposition. In any event, the
 1469  licensee shall furnish such statement annually and upon the
 1470  discharge or transfer of a client. Any governmental agency or
 1471  private charitable agency contributing funds or other property
 1472  to the account of a client shall also be entitled to receive
 1473  such statement monthly and upon the discharge or transfer of the
 1474  client.
 1475         (6)(a) In addition to any damages or civil penalties to
 1476  which a person is subject, any person who:
 1477         1. Intentionally withholds a client’s personal funds,
 1478  personal property, or personal needs allowance, or who demands,
 1479  beneficially receives, or contracts for payment of all or any
 1480  part of a client’s personal property or personal needs allowance
 1481  in satisfaction of the facility rate for supplies and services;
 1482  or
 1483         2. Borrows from or pledges any personal funds of a client,
 1484  other than the amount agreed to by written contract under s.
 1485  429.24,
 1486  
 1487  commits a misdemeanor of the first degree, punishable as
 1488  provided in s. 775.082 or s. 775.083.
 1489         (b) Any licensee or any administrator, employee, or
 1490  representative thereof who is granted power of attorney for any
 1491  client of the facility and who misuses or misappropriates funds
 1492  obtained through this power commits a felony of the third
 1493  degree, punishable as provided in s. 775.082, s. 775.083, or s.
 1494  775.084.
 1495         (7) In the event of the death of a client, a licensee shall
 1496  return all refunds, funds, and property held in trust to the
 1497  client’s personal representative, if one has been appointed at
 1498  the time the licensee disburses such funds, or, if not, to the
 1499  client’s spouse or adult next of kin named in a beneficiary
 1500  designation form provided by the licensee to the client. If the
 1501  client has no spouse or adult next of kin or such person cannot
 1502  be located, funds due the client shall be placed in an interest
 1503  bearing account and all property held in trust by the licensee
 1504  shall be safeguarded until such time as the funds and property
 1505  are disbursed pursuant to the Florida Probate Code. Such funds
 1506  shall be kept separate from the funds and property of the
 1507  licensee and other clients of the facility. If the funds of the
 1508  deceased client are not disbursed pursuant to the Florida
 1509  Probate Code within 2 years after the client’s death, the funds
 1510  shall be deposited in the Health Care Trust Fund administered by
 1511  the agency.
 1512         (8) The agency, by rule, may clarify terms and specify
 1513  procedures and documentation necessary to administer the
 1514  provisions of this section relating to the proper management of
 1515  clients’ funds and personal property and the execution of surety
 1516  bonds.
 1517         Section 44. Section 400.9981, Florida Statutes, is created
 1518  to read:
 1519         400.9981 Rules establishing standards.—
 1520         (1) It is the intent of the Legislature that rules
 1521  published and enforced pursuant to this part and part II of
 1522  chapter 408 include criteria to ensure reasonable and consistent
 1523  quality of care and client safety. Rules should make reasonable
 1524  efforts to accommodate the needs and preferences of clients to
 1525  enhance the quality of life in transitional living facilities.
 1526         (2) The agency may adopt and enforce rules to implement
 1527  this part and part II of chapter 408, which shall include
 1528  reasonable and fair criteria in relation to the following:
 1529         (a) The location of transitional living facilities.
 1530         (b) The number of qualifications of all personnel,
 1531  including management, medical, nursing, and other professional
 1532  personnel and nursing assistants and support personnel having
 1533  responsibility for any part of the care given to clients. The
 1534  licensee must have enough qualified professional staff available
 1535  to carry out and monitor the various professional interventions
 1536  in accordance with the stated goals and objectives of each
 1537  comprehensive treatment plan.
 1538         (c) Requirements for personnel procedures, reporting
 1539  procedures, and documentation necessary to implement this part.
 1540         (d) Services provided to clients of transitional living
 1541  facilities.
 1542         (e) The preparation and annual update of a comprehensive
 1543  emergency management plan in consultation with the Division of
 1544  Emergency Management. At a minimum, the rules must provide for
 1545  plan components that address emergency evacuation
 1546  transportation; adequate sheltering arrangements; postdisaster
 1547  activities, including provision of emergency power, food, and
 1548  water; postdisaster transportation; supplies; staffing;
 1549  emergency equipment; individual identification of clients and
 1550  transfer of records; communication with families; and responses
 1551  to family inquiries.
 1552         Section 45. Section 400.9982, Florida Statutes, is created
 1553  to read:
 1554         400.9982 Violations; penalties.—
 1555         (1) Each violation of this part and rules adopted pursuant
 1556  thereto shall be classified according to the nature of the
 1557  violation and the gravity of its probable effect on facility
 1558  clients. The agency shall indicate the classification on the
 1559  written notice of the violation as follows:
 1560         (a) Class “I” violations are defined in s. 408.813. The
 1561  agency shall issue a citation regardless of correction and
 1562  impose an administrative fine of $5,000 for an isolated
 1563  violation, $7,500 for a patterned violation, and $10,000 for a
 1564  widespread violation. Violations may be identified and a fine
 1565  must be levied notwithstanding the correction of the deficiency
 1566  giving rise to the violation.
 1567         (b) Class “II” violations are defined in s. 408.813. The
 1568  agency shall impose an administrative fine of $1,000 for an
 1569  isolated violation, $2,500 for a patterned violation, and $5,000
 1570  for a widespread violation. A fine must be levied
 1571  notwithstanding the correction of the deficiency giving rise to
 1572  the violation.
 1573         (c) Class “III” violations are defined in s. 408.813. The
 1574  agency shall impose an administrative fine of $500 for an
 1575  isolated violation, $750 for a patterned violation, and $1,000
 1576  for a widespread violation. If a deficiency giving rise to a
 1577  class III violation is corrected within the time specified by
 1578  the agency, a fine may not be imposed.
 1579         (d) Class “IV” violations are defined in s. 408.813. The
 1580  agency shall impose an administrative fine for a cited class IV
 1581  violation in an amount not less than $100 and not exceeding $200
 1582  for each violation. If a deficiency giving rise to a class IV
 1583  violation is corrected within the time specified by the agency,
 1584  a fine may not be imposed.
 1585         Section 46. Section 400.9983, Florida Statutes, is created
 1586  to read:
 1587         400.9983 Receivership proceedings.—The agency may apply s.
 1588  429.22 with regard to receivership proceedings for transitional
 1589  living facilities.
 1590         Section 47. Section 400.9984, Florida Statutes, is created
 1591  to read:
 1592         400.9984 Interagency communication.—The agency, the
 1593  department, the Agency for Persons with Disabilities, and the
 1594  Department of Children and Families shall develop electronic
 1595  systems to ensure that relevant information pertaining to the
 1596  regulation of transitional living facilities and clients is
 1597  timely and effectively communicated among agencies in order to
 1598  facilitate the protection of clients. Electronic sharing of
 1599  information shall include, at a minimum, a brain and spinal cord
 1600  injury registry and a client abuse registry.
 1601         Section 48. Subsections (1) and (2) of section 402.7306,
 1602  Florida Statutes, are amended to read:
 1603         402.7306 Administrative monitoring of child welfare
 1604  providers, and administrative, licensure, and programmatic
 1605  monitoring of mental health and substance abuse service
 1606  providers.—The Department of Children and Family Services, the
 1607  Department of Health, the Agency for Persons with Disabilities,
 1608  the Agency for Health Care Administration, community-based care
 1609  lead agencies, managing entities as defined in s. 394.9082, and
 1610  agencies who have contracted with monitoring agents shall
 1611  identify and implement changes that improve the efficiency of
 1612  administrative monitoring of child welfare services, and the
 1613  administrative, licensure, and programmatic monitoring of mental
 1614  health and substance abuse service providers. For the purpose of
 1615  this section, the term “mental health and substance abuse
 1616  service provider” means a provider who provides services to this
 1617  state’s priority population as defined in s. 394.674. To assist
 1618  with that goal, each such agency shall adopt the following
 1619  policies:
 1620         (1) Limit administrative monitoring to once every 3 years
 1621  if the child welfare provider is accredited by the Joint
 1622  Commission, a national accrediting organization that is approved
 1623  by the Centers for Medicare and Medicaid Services and whose
 1624  standards incorporate comparable licensure regulations required
 1625  by the state, CARF International the Commission on Accreditation
 1626  of Rehabilitation Facilities, or the Council on Accreditation.
 1627  If the accrediting body does not require documentation that the
 1628  state agency requires, that documentation shall be requested by
 1629  the state agency and may be posted by the service provider on
 1630  the data warehouse for the agency’s review. Notwithstanding the
 1631  survey or inspection of an accrediting organization specified in
 1632  this subsection, an agency specified in and subject to this
 1633  section may continue to monitor the service provider as
 1634  necessary with respect to:
 1635         (a) Ensuring that services for which the agency is paying
 1636  are being provided.
 1637         (b) Investigating complaints or suspected problems and
 1638  monitoring the service provider’s compliance with any resulting
 1639  negotiated terms and conditions, including provisions relating
 1640  to consent decrees that are unique to a specific service and are
 1641  not statements of general applicability.
 1642         (c) Ensuring compliance with federal and state laws,
 1643  federal regulations, or state rules if such monitoring does not
 1644  duplicate the accrediting organization’s review pursuant to
 1645  accreditation standards.
 1646  
 1647  Medicaid certification and precertification reviews are exempt
 1648  from this subsection to ensure Medicaid compliance.
 1649         (2) Limit administrative, licensure, and programmatic
 1650  monitoring to once every 3 years if the mental health or
 1651  substance abuse service provider is accredited by the Joint
 1652  Commission, the American Osteopathic Association/Healthcare
 1653  Facilities Accreditation Program, a national accrediting
 1654  organization that is approved by the Centers for Medicare and
 1655  Medicaid Services and whose standards incorporate comparable
 1656  licensure regulations required by the state, CARF International
 1657  the Commission on Accreditation of Rehabilitation Facilities, or
 1658  the Council on Accreditation. If the services being monitored
 1659  are not the services for which the provider is accredited, the
 1660  limitations of this subsection do not apply. If the accrediting
 1661  body does not require documentation that the state agency
 1662  requires, that documentation, except documentation relating to
 1663  licensure applications and fees, must be requested by the state
 1664  agency and may be posted by the service provider on the data
 1665  warehouse for the agency’s review. Notwithstanding the survey or
 1666  inspection of an accrediting organization specified in this
 1667  subsection, an agency specified in and subject to this section
 1668  may continue to monitor the service provider as necessary with
 1669  respect to:
 1670         (a) Ensuring that services for which the agency is paying
 1671  are being provided.
 1672         (b) Investigating complaints, identifying problems that
 1673  would affect the safety or viability of the service provider,
 1674  and monitoring the service provider’s compliance with any
 1675  resulting negotiated terms and conditions, including provisions
 1676  relating to consent decrees that are unique to a specific
 1677  service and are not statements of general applicability.
 1678         (c) Ensuring compliance with federal and state laws,
 1679  federal regulations, or state rules if such monitoring does not
 1680  duplicate the accrediting organization’s review pursuant to
 1681  accreditation standards.
 1682  
 1683  Federal certification and precertification reviews are exempt
 1684  from this subsection to ensure Medicaid compliance.
 1685         Section 49. Subsection (4) of section 408.061, Florida
 1686  Statutes, is amended to read:
 1687         408.061 Data collection; uniform systems of financial
 1688  reporting; information relating to physician charges;
 1689  confidential information; immunity.—
 1690         (4) Within 120 days after the end of its fiscal year, each
 1691  health care facility, excluding continuing care facilities,
 1692  hospitals operated by state agencies, and nursing homes as
 1693  defined in s. 408.07(14) and (37), shall file with the agency,
 1694  on forms adopted by the agency and based on the uniform system
 1695  of financial reporting, its actual financial experience for that
 1696  fiscal year, including expenditures, revenues, and statistical
 1697  measures. Such data may be based on internal financial reports
 1698  which are certified to be complete and accurate by the provider.
 1699  However, hospitals’ actual financial experience shall be their
 1700  audited actual experience. Every nursing home shall submit to
 1701  the agency, in a format designated by the agency, a statistical
 1702  profile of the nursing home residents. The agency, in
 1703  conjunction with the Department of Elderly Affairs and the
 1704  Department of Health, shall review these statistical profiles
 1705  and develop recommendations for the types of residents who might
 1706  more appropriately be placed in their homes or other
 1707  noninstitutional settings.
 1708         Section 50. Subsection (4) of section 408.20, Florida
 1709  Statutes, is amended to read:
 1710         408.20 Assessments; Health Care Trust Fund.—
 1711         (4) Hospitals operated by state agencies the Department of
 1712  Children and Family Services, the Department of Health, or the
 1713  Department of Corrections are exempt from the assessments
 1714  required under this section.
 1715         Section 51. Subsection (21) of section 408.802, Florida
 1716  Statutes, is amended to read:
 1717         408.802 Applicability.—The provisions of this part apply to
 1718  the provision of services that require licensure as defined in
 1719  this part and to the following entities licensed, registered, or
 1720  certified by the agency, as described in chapters 112, 383, 390,
 1721  394, 395, 400, 429, 440, 483, and 765:
 1722         (21) Transitional living facilities, as provided under part
 1723  XI V of chapter 400.
 1724         Section 52. Subsection (4) of section 408.809, Florida
 1725  Statutes, is amended to read:
 1726         408.809 Background screening; prohibited offenses.—
 1727         (4) In addition to the offenses listed in s. 435.04, all
 1728  persons required to undergo background screening pursuant to
 1729  this part or authorizing statutes must not have an arrest
 1730  awaiting final disposition for, must not have been found guilty
 1731  of, regardless of adjudication, or entered a plea of nolo
 1732  contendere or guilty to, and must not have been adjudicated
 1733  delinquent and the record not have been sealed or expunged for
 1734  any of the following offenses or any similar offense of another
 1735  jurisdiction:
 1736         (a) Any authorizing statutes, if the offense was a felony.
 1737         (b) This chapter, if the offense was a felony.
 1738         (c) Section 409.920, relating to Medicaid provider fraud.
 1739         (d) Section 409.9201, relating to Medicaid fraud.
 1740         (e) Section 741.28, relating to domestic violence.
 1741         (f) Section 777.04, relating to attempts, solicitation, and
 1742  conspiracy to commit an offense listed in this subsection.
 1743         (g)(f) Section 817.034, relating to fraudulent acts through
 1744  mail, wire, radio, electromagnetic, photoelectronic, or
 1745  photooptical systems.
 1746         (h)(g) Section 817.234, relating to false and fraudulent
 1747  insurance claims.
 1748         (i) Section 817.481, relating to obtaining goods by using
 1749  false, expired, etc., credit cards, if the offense was a felony.
 1750         (j) Section 817.50, relating to fraudulently obtaining
 1751  goods, services, etc., from a health care provider.
 1752         (k)(h) Section 817.505, relating to patient brokering.
 1753         (l)(i) Section 817.568, relating to criminal use of
 1754  personal identification information.
 1755         (m)(j) Section 817.60, relating to obtaining a credit card
 1756  through fraudulent means.
 1757         (n)(k) Section 817.61, relating to fraudulent use of credit
 1758  cards, if the offense was a felony.
 1759         (o)(l) Section 831.01, relating to forgery.
 1760         (p)(m) Section 831.02, relating to uttering forged
 1761  instruments.
 1762         (q)(n) Section 831.07, relating to forging bank bills,
 1763  checks, drafts, or promissory notes.
 1764         (r)(o) Section 831.09, relating to uttering forged bank
 1765  bills, checks, drafts, or promissory notes.
 1766         (s)(p) Section 831.30, relating to fraud in obtaining
 1767  medicinal drugs.
 1768         (t)(q) Section 831.31, relating to the sale, manufacture,
 1769  delivery, or possession with the intent to sell, manufacture, or
 1770  deliver any counterfeit controlled substance, if the offense was
 1771  a felony.
 1772         (u) Section 895.03, relating to racketeering and illegal
 1773  debts.
 1774         (v) Section 896.101, relating to the Florida Money
 1775  Laundering Act.
 1776         Section 53. Subsection (20) of section 408.820, Florida
 1777  Statutes, is amended to read:
 1778         408.820 Exemptions.—Except as prescribed in authorizing
 1779  statutes, the following exemptions shall apply to specified
 1780  requirements of this part:
 1781         (20) Transitional living facilities, as provided under part
 1782  XI V of chapter 400, are exempt from s. 408.810(10).
 1783         Section 54. Subsections (3) through (21) of section
 1784  409.9122, Florida Statutes, are renumbered as subsection (4)
 1785  through (22), paragraphs (l) and (m) of subsection (2) of that
 1786  section are amended, and a new subsection (3) is added to that
 1787  section, to read:
 1788         409.9122 Mandatory Medicaid managed care enrollment;
 1789  programs and procedures.—
 1790         (2)
 1791         (l) If the Medicaid recipient is diagnosed with HIV/AIDS,
 1792  the agency shall assign the Medicaid recipient to a managed care
 1793  plan that is a health maintenance organization authorized under
 1794  chapter 641, is under contract with the agency on July 1, 2011,
 1795  and which offers a delivery system through a university-based
 1796  teaching and research-oriented organization that specializes in
 1797  providing health care services and treatment for individuals
 1798  diagnosed with HIV/AIDS.
 1799         (l)(m) Notwithstanding the provisions of chapter 287, the
 1800  agency may, at its discretion, renew cost-effective contracts
 1801  for choice counseling services once or more for such periods as
 1802  the agency may decide. However, all such renewals may not
 1803  combine to exceed a total period longer than the term of the
 1804  original contract.
 1805  
 1806  This subsection expires October 1, 2014.
 1807         (3) If the Medicaid recipient is diagnosed with HIV/AIDS,
 1808  the agency shall assign the Medicaid recipient to a managed care
 1809  plan that is a health maintenance organization authorized under
 1810  chapter 641, is under contract with the agency as an HIV/AIDS
 1811  specialty plan, and offers a delivery system through a
 1812  university-based teaching and research-oriented organization
 1813  that specializes in providing health care services and treatment
 1814  for individuals diagnosed with HIV/AIDS.
 1815         Section 55. Paragraph (a) of subsection (3) of section
 1816  409.966, Florida Statutes, is amended to read:
 1817         409.966 Eligible plans; selection.—
 1818         (3) QUALITY SELECTION CRITERIA.—
 1819         (a) The invitation to negotiate must specify the criteria
 1820  and the relative weight of the criteria that will be used for
 1821  determining the acceptability of the reply and guiding the
 1822  selection of the organizations with which the agency negotiates.
 1823  In addition to criteria established by the agency, the agency
 1824  shall consider the following factors in the selection of
 1825  eligible plans:
 1826         1. Accreditation by the National Committee for Quality
 1827  Assurance, the Joint Commission, the American Osteopathic
 1828  Association/Healthcare Facilities Accreditation Program, a
 1829  national accrediting organization that is approved by the
 1830  Centers for Medicare and Medicaid Services and whose standards
 1831  incorporate comparable licensure regulations required by the
 1832  state, or another nationally recognized accrediting body.
 1833         2. Experience serving similar populations, including the
 1834  organization’s record in achieving specific quality standards
 1835  with similar populations.
 1836         3. Availability and accessibility of primary care and
 1837  specialty physicians in the provider network.
 1838         4. Establishment of community partnerships with providers
 1839  that create opportunities for reinvestment in community-based
 1840  services.
 1841         5. Organization commitment to quality improvement and
 1842  documentation of achievements in specific quality improvement
 1843  projects, including active involvement by organization
 1844  leadership.
 1845         6. Provision of additional benefits, particularly dental
 1846  care and disease management, and other initiatives that improve
 1847  health outcomes.
 1848         7. Evidence that an eligible plan has written agreements or
 1849  signed contracts or has made substantial progress in
 1850  establishing relationships with providers before the plan
 1851  submitting a response.
 1852         8. Comments submitted in writing by an any enrolled
 1853  Medicaid provider relating to a specifically identified plan
 1854  participating in the procurement in the same region as the
 1855  submitting provider.
 1856         9. Documentation of policies and procedures for preventing
 1857  fraud and abuse.
 1858         10. The business relationship an eligible plan has with
 1859  another any other eligible plan that responds to the invitation
 1860  to negotiate.
 1861         Section 56. Paragraph (e) of subsection (2) of section
 1862  409.967, Florida Statutes, is amended to read:
 1863         409.967 Managed care plan accountability.—
 1864         (2) The agency shall establish such contract requirements
 1865  as are necessary for the operation of the statewide managed care
 1866  program. In addition to any other provisions the agency may deem
 1867  necessary, the contract must require:
 1868         (e) Continuous improvement.—The agency shall establish
 1869  specific performance standards and expected milestones or
 1870  timelines for improving performance over the term of the
 1871  contract.
 1872         1. Each managed care plan shall establish an internal
 1873  health care quality improvement system, including enrollee
 1874  satisfaction and disenrollment surveys. The quality improvement
 1875  system must include incentives and disincentives for network
 1876  providers.
 1877         2. Each plan must collect and report the Health Plan
 1878  Employer Data and Information Set (HEDIS) measures, as specified
 1879  by the agency. These measures must be published on the plan’s
 1880  website in a manner that allows recipients to reliably compare
 1881  the performance of plans. The agency shall use the HEDIS
 1882  measures as a tool to monitor plan performance.
 1883         3. Each managed care plan must be accredited by the
 1884  National Committee for Quality Assurance, the Joint Commission,
 1885  a national accrediting organization that is approved by the
 1886  Centers for Medicare and Medicaid Services and whose standards
 1887  incorporate comparable licensure regulations required by the
 1888  state, or another nationally recognized accrediting body, or
 1889  have initiated the accreditation process, within 1 year after
 1890  the contract is executed. The agency shall suspend automatic
 1891  assignment under ss. 409.977 and 409.984 for a any plan not
 1892  accredited within 18 months after executing the contract, the
 1893  agency shall suspend automatic assignment under s. 409.977 and
 1894  409.984.
 1895         4. By the end of the fourth year of the first contract
 1896  term, the agency shall issue a request for information to
 1897  determine whether cost savings could be achieved by contracting
 1898  for plan oversight and monitoring, including analysis of
 1899  encounter data, assessment of performance measures, and
 1900  compliance with other contractual requirements.
 1901         Section 57. Paragraphs (b) and (c) of subsection (3) of
 1902  section 429.07, Florida Statutes, are amended to read:
 1903         429.07 License required; fee.—
 1904         (3) In addition to the requirements of s. 408.806, each
 1905  license granted by the agency must state the type of care for
 1906  which the license is granted. Licenses shall be issued for one
 1907  or more of the following categories of care: standard, extended
 1908  congregate care, limited nursing services, or limited mental
 1909  health.
 1910         (b) An extended congregate care license shall be issued to
 1911  facilities that have been licensed as assisted living facilities
 1912  for 2 or more years and that provide providing, directly or
 1913  through contract, services beyond those authorized in paragraph
 1914  (a), including services performed by persons licensed under part
 1915  I of chapter 464 and supportive services, as defined by rule, to
 1916  persons who would otherwise be disqualified from continued
 1917  residence in a facility licensed under this part. An extended
 1918  congregate care license may also be issued to those facilities
 1919  that have provisional extended congregate care licenses and meet
 1920  the requirements for licensure under subparagraph 2. The primary
 1921  purpose of extended congregate care services is to allow
 1922  residents, as they become more impaired, the option of remaining
 1923  in a familiar setting from which they would otherwise be
 1924  disqualified for continued residency. A facility licensed to
 1925  provide extended congregate care services may also admit an
 1926  individual who exceeds the admission criteria for a facility
 1927  with a standard license, if the individual is determined
 1928  appropriate for admission to the extended congregate care
 1929  facility.
 1930         1. In order for extended congregate care services to be
 1931  provided, the agency must first determine that all requirements
 1932  established in law and rule are met and must specifically
 1933  designate, on the facility’s license, that such services may be
 1934  provided and whether the designation applies to all or part of
 1935  the facility. Such designation may be made at the time of
 1936  initial licensure or relicensure, or upon request in writing by
 1937  a licensee under this part and part II of chapter 408. The
 1938  notification of approval or the denial of the request shall be
 1939  made in accordance with part II of chapter 408. Existing
 1940  facilities qualifying to provide extended congregate care
 1941  services must have maintained a standard license and may not
 1942  have been subject to administrative sanctions during the
 1943  previous 2 years, or since initial licensure if the facility has
 1944  been licensed for less than 2 years, for any of the following
 1945  reasons:
 1946         a. A class I or class II violation;
 1947         b. Three or more repeat or recurring class III violations
 1948  of identical or similar resident care standards from which a
 1949  pattern of noncompliance is found by the agency;
 1950         c. Three or more class III violations that were not
 1951  corrected in accordance with the corrective action plan approved
 1952  by the agency;
 1953         d. Violation of resident care standards which results in
 1954  requiring the facility to employ the services of a consultant
 1955  pharmacist or consultant dietitian;
 1956         e. Denial, suspension, or revocation of a license for
 1957  another facility licensed under this part in which the applicant
 1958  for an extended congregate care license has at least 25 percent
 1959  ownership interest; or
 1960         f. Imposition of a moratorium pursuant to this part or part
 1961  II of chapter 408 or initiation of injunctive proceedings.
 1962         2.If an assisted living facility has been licensed for
 1963  less than 2 years but meets all other licensure requirements for
 1964  an extended congregate care license, it shall be issued a
 1965  provisional extended congregate care license for a period of 6
 1966  months. Within the first 3 months after the provisional license
 1967  is issued, the licensee shall notify the agency when it has
 1968  admitted an extended congregate care resident, after which an
 1969  unannounced inspection shall be made to determine compliance
 1970  with requirements of an extended congregate care license. If the
 1971  licensee demonstrates compliance with all of the requirements of
 1972  an extended congregate care license during the inspection, the
 1973  licensee shall be issued an extended congregate care license. In
 1974  addition to sanctions authorized under this part, if violations
 1975  are found during the inspection and the licensee fails to
 1976  demonstrate compliance with all assisted living requirements
 1977  during a followup inspection, the licensee shall immediately
 1978  suspend extended congregate care services, and the provisional
 1979  extended congregate care license expires.
 1980         3.2. A facility that is licensed to provide extended
 1981  congregate care services shall maintain a written progress
 1982  report on each person who receives services which describes the
 1983  type, amount, duration, scope, and outcome of services that are
 1984  rendered and the general status of the resident’s health. A
 1985  registered nurse, or appropriate designee, representing the
 1986  agency shall visit the facility at least twice a year quarterly
 1987  to monitor residents who are receiving extended congregate care
 1988  services and to determine if the facility is in compliance with
 1989  this part, part II of chapter 408, and relevant rules. One of
 1990  the visits may be in conjunction with the regular survey. The
 1991  monitoring visits may be provided through contractual
 1992  arrangements with appropriate community agencies. A registered
 1993  nurse shall serve as part of the team that inspects the
 1994  facility. The agency may waive one of the required yearly
 1995  monitoring visits for a facility that has been licensed for at
 1996  least 24 months to provide extended congregate care services,
 1997  if, during the inspection, the registered nurse determines that
 1998  extended congregate care services are being provided
 1999  appropriately, and if the facility has held an extended
 2000  congregate care license during the last 24 months, has had no
 2001  class I or class II violations, has had and no uncorrected class
 2002  III violations, and has had no confirmed ombudsman council
 2003  complaints that resulted in a citation for licensure. The agency
 2004  must first consult with the long-term care ombudsman council for
 2005  the area in which the facility is located to determine if any
 2006  complaints have been made and substantiated about the quality of
 2007  services or care. The agency may not waive one of the required
 2008  yearly monitoring visits if complaints have been made and
 2009  substantiated.
 2010         4.3. A facility that is licensed to provide extended
 2011  congregate care services must:
 2012         a. Demonstrate the capability to meet unanticipated
 2013  resident service needs.
 2014         b. Offer a physical environment that promotes a homelike
 2015  setting, provides for resident privacy, promotes resident
 2016  independence, and allows sufficient congregate space as defined
 2017  by rule.
 2018         c. Have sufficient staff available, taking into account the
 2019  physical plant and firesafety features of the building, to
 2020  assist with the evacuation of residents in an emergency.
 2021         d. Adopt and follow policies and procedures that maximize
 2022  resident independence, dignity, choice, and decisionmaking to
 2023  permit residents to age in place, so that moves due to changes
 2024  in functional status are minimized or avoided.
 2025         e. Allow residents or, if applicable, a resident’s
 2026  representative, designee, surrogate, guardian, or attorney in
 2027  fact to make a variety of personal choices, participate in
 2028  developing service plans, and share responsibility in
 2029  decisionmaking.
 2030         f. Implement the concept of managed risk.
 2031         g. Provide, directly or through contract, the services of a
 2032  person licensed under part I of chapter 464.
 2033         h. In addition to the training mandated in s. 429.52,
 2034  provide specialized training as defined by rule for facility
 2035  staff.
 2036         5.4. A facility that is licensed to provide extended
 2037  congregate care services is exempt from the criteria for
 2038  continued residency set forth in rules adopted under s. 429.41.
 2039  A licensed facility must adopt its own requirements within
 2040  guidelines for continued residency set forth by rule. However,
 2041  the facility may not serve residents who require 24-hour nursing
 2042  supervision. A licensed facility that provides extended
 2043  congregate care services must also provide each resident with a
 2044  written copy of facility policies governing admission and
 2045  retention.
 2046         5. The primary purpose of extended congregate care services
 2047  is to allow residents, as they become more impaired, the option
 2048  of remaining in a familiar setting from which they would
 2049  otherwise be disqualified for continued residency. A facility
 2050  licensed to provide extended congregate care services may also
 2051  admit an individual who exceeds the admission criteria for a
 2052  facility with a standard license, if the individual is
 2053  determined appropriate for admission to the extended congregate
 2054  care facility.
 2055         6. Before the admission of an individual to a facility
 2056  licensed to provide extended congregate care services, the
 2057  individual must undergo a medical examination as provided in s.
 2058  429.26(4) and the facility must develop a preliminary service
 2059  plan for the individual.
 2060         7. If When a facility can no longer provide or arrange for
 2061  services in accordance with the resident’s service plan and
 2062  needs and the facility’s policy, the facility must shall make
 2063  arrangements for relocating the person in accordance with s.
 2064  429.28(1)(k).
 2065         8. Failure to provide extended congregate care services may
 2066  result in denial of extended congregate care license renewal.
 2067  
 2068  The agency may deny or revoke a facility’s extended congregate
 2069  care license for not meeting the standards of an extended
 2070  congregate care license or for any of the grounds listed in this
 2071  subsection.
 2072         (c) A limited nursing services license shall be issued to a
 2073  facility that provides services beyond those authorized in
 2074  paragraph (a) and as specified in this paragraph.
 2075         1. In order for limited nursing services to be provided in
 2076  a facility licensed under this part, the agency must first
 2077  determine that all requirements established in law and rule are
 2078  met and must specifically designate, on the facility’s license,
 2079  that such services may be provided. Such designation may be made
 2080  at the time of initial licensure or licensure renewal
 2081  relicensure, or upon request in writing by a licensee under this
 2082  part and part II of chapter 408. Notification of approval or
 2083  denial of such request shall be made in accordance with part II
 2084  of chapter 408. An existing facility that qualifies facilities
 2085  qualifying to provide limited nursing services must shall have
 2086  maintained a standard license and may not have been subject to
 2087  administrative sanctions that affect the health, safety, and
 2088  welfare of residents for the previous 2 years or since initial
 2089  licensure if the facility has been licensed for less than 2
 2090  years.
 2091         2. A facility Facilities that is are licensed to provide
 2092  limited nursing services shall maintain a written progress
 2093  report on each person who receives such nursing services. The,
 2094  which report must describe describes the type, amount, duration,
 2095  scope, and outcome of services that are rendered and the general
 2096  status of the resident’s health. A registered nurse representing
 2097  the agency shall visit the facility such facilities at least
 2098  annually twice a year to monitor residents who are receiving
 2099  limited nursing services and to determine if the facility is in
 2100  compliance with applicable provisions of this part, part II of
 2101  chapter 408, and related rules. The monitoring visits may be
 2102  provided through contractual arrangements with appropriate
 2103  community agencies. A registered nurse shall also serve as part
 2104  of the team that inspects such facility. Visits may be in
 2105  conjunction with other agency inspections. The agency may waive
 2106  one of the required yearly monitoring visits for a facility that
 2107  has:
 2108         a. A limited nursing services license for at least 24
 2109  months;
 2110         b. No class I or class II violations and no uncorrected
 2111  class III violations; and
 2112         c. No confirmed ombudsman council complaints that resulted
 2113  in a citation for licensure.
 2114         3. A person who receives limited nursing services under
 2115  this part must meet the admission criteria established by the
 2116  agency for assisted living facilities. When a resident no longer
 2117  meets the admission criteria for a facility licensed under this
 2118  part, arrangements for relocating the person shall be made in
 2119  accordance with s. 429.28(1)(k), unless the facility is licensed
 2120  to provide extended congregate care services.
 2121         Section 58. Section 429.075, Florida Statutes, is amended
 2122  to read:
 2123         429.075 Limited mental health license.—An assisted living
 2124  facility that serves one three or more mental health residents
 2125  must obtain a limited mental health license.
 2126         (1) To obtain a limited mental health license, a facility
 2127  must hold a standard license as an assisted living facility,
 2128  must not have any current uncorrected deficiencies or
 2129  violations, and must ensure that, within 6 months after
 2130  receiving a limited mental health license, the facility
 2131  administrator and the staff of the facility who are in direct
 2132  contact with mental health residents must complete training of
 2133  no less than 6 hours related to their duties. Such designation
 2134  may be made at the time of initial licensure or relicensure or
 2135  upon request in writing by a licensee under this part and part
 2136  II of chapter 408. Notification of approval or denial of such
 2137  request shall be made in accordance with this part, part II of
 2138  chapter 408, and applicable rules. This training must will be
 2139  provided by or approved by the Department of Children and Family
 2140  Services.
 2141         (2) A facility that is Facilities licensed to provide
 2142  services to mental health residents must shall provide
 2143  appropriate supervision and staffing to provide for the health,
 2144  safety, and welfare of such residents.
 2145         (3) A facility that has a limited mental health license
 2146  must:
 2147         (a) Have a copy of each mental health resident’s community
 2148  living support plan and the cooperative agreement with the
 2149  mental health care services provider. The support plan and the
 2150  agreement may be combined.
 2151         (b) Have documentation that is provided by the Department
 2152  of Children and Family Services that each mental health resident
 2153  has been assessed and determined to be able to live in the
 2154  community in an assisted living facility that has with a limited
 2155  mental health license.
 2156         (c) Make the community living support plan available for
 2157  inspection by the resident, the resident’s legal guardian, the
 2158  resident’s health care surrogate, and other individuals who have
 2159  a lawful basis for reviewing this document.
 2160         (d) Assist the mental health resident in carrying out the
 2161  activities identified in the individual’s community living
 2162  support plan.
 2163         (4) A facility that has with a limited mental health
 2164  license may enter into a cooperative agreement with a private
 2165  mental health provider. For purposes of the limited mental
 2166  health license, the private mental health provider may act as
 2167  the case manager.
 2168         Section 59. Section 429.14, Florida Statutes, is amended to
 2169  read:
 2170         429.14 Administrative penalties.—
 2171         (1) In addition to the requirements of part II of chapter
 2172  408, the agency may deny, revoke, and suspend any license issued
 2173  under this part and impose an administrative fine in the manner
 2174  provided in chapter 120 against a licensee for a violation of
 2175  any provision of this part, part II of chapter 408, or
 2176  applicable rules, or for any of the following actions by a
 2177  licensee, for the actions of any person subject to level 2
 2178  background screening under s. 408.809, or for the actions of any
 2179  facility staff employee:
 2180         (a) An intentional or negligent act seriously affecting the
 2181  health, safety, or welfare of a resident of the facility.
 2182         (b) A The determination by the agency that the owner lacks
 2183  the financial ability to provide continuing adequate care to
 2184  residents.
 2185         (c) Misappropriation or conversion of the property of a
 2186  resident of the facility.
 2187         (d) Failure to follow the criteria and procedures provided
 2188  under part I of chapter 394 relating to the transportation,
 2189  voluntary admission, and involuntary examination of a facility
 2190  resident.
 2191         (e) A citation of any of the following violations
 2192  deficiencies as specified in s. 429.19:
 2193         1. One or more cited class I violations deficiencies.
 2194         2. Three or more cited class II violations deficiencies.
 2195         3. Five or more cited class III violations deficiencies
 2196  that have been cited on a single survey and have not been
 2197  corrected within the times specified.
 2198         (f) Failure to comply with the background screening
 2199  standards of this part, s. 408.809(1), or chapter 435.
 2200         (g) Violation of a moratorium.
 2201         (h) Failure of the license applicant, the licensee during
 2202  relicensure, or a licensee that holds a provisional license to
 2203  meet the minimum license requirements of this part, or related
 2204  rules, at the time of license application or renewal.
 2205         (i) An intentional or negligent life-threatening act in
 2206  violation of the uniform firesafety standards for assisted
 2207  living facilities or other firesafety standards which that
 2208  threatens the health, safety, or welfare of a resident of a
 2209  facility, as communicated to the agency by the local authority
 2210  having jurisdiction or the State Fire Marshal.
 2211         (j) Knowingly operating any unlicensed facility or
 2212  providing without a license any service that must be licensed
 2213  under this chapter or chapter 400.
 2214         (k) Any act constituting a ground upon which application
 2215  for a license may be denied.
 2216         (2) Upon notification by the local authority having
 2217  jurisdiction or by the State Fire Marshal, the agency may deny
 2218  or revoke the license of an assisted living facility that fails
 2219  to correct cited fire code violations that affect or threaten
 2220  the health, safety, or welfare of a resident of a facility.
 2221         (3) The agency may deny or revoke a license of an to any
 2222  applicant or controlling interest as defined in part II of
 2223  chapter 408 which has or had a 25-percent or greater financial
 2224  or ownership interest in any other facility that is licensed
 2225  under this part, or in any entity licensed by this state or
 2226  another state to provide health or residential care, if that
 2227  which facility or entity during the 5 years prior to the
 2228  application for a license closed due to financial inability to
 2229  operate; had a receiver appointed or a license denied,
 2230  suspended, or revoked; was subject to a moratorium; or had an
 2231  injunctive proceeding initiated against it.
 2232         (4) The agency shall deny or revoke the license of an
 2233  assisted living facility if:
 2234         (a)There are two moratoria, issued pursuant to this part
 2235  or part II of chapter 408, within a 2-year period which are
 2236  imposed by final order;
 2237         (b)The facility is cited for two or more class I
 2238  violations arising from unrelated circumstances during the same
 2239  survey or investigation; or
 2240         (c)The facility is cited for two or more class I
 2241  violations arising from separate surveys or investigations
 2242  within a 2-year period that has two or more class I violations
 2243  that are similar or identical to violations identified by the
 2244  agency during a survey, inspection, monitoring visit, or
 2245  complaint investigation occurring within the previous 2 years.
 2246         (5) An action taken by the agency to suspend, deny, or
 2247  revoke a facility’s license under this part or part II of
 2248  chapter 408, in which the agency claims that the facility owner
 2249  or an employee of the facility has threatened the health,
 2250  safety, or welfare of a resident of the facility must be heard
 2251  by the Division of Administrative Hearings of the Department of
 2252  Management Services within 120 days after receipt of the
 2253  facility’s request for a hearing, unless that time limitation is
 2254  waived by both parties. The administrative law judge shall must
 2255  render a decision within 30 days after receipt of a proposed
 2256  recommended order.
 2257         (6) The agency shall impose an immediate moratorium, as
 2258  provided under s. 408.814, on an assisted living facility that
 2259  fails to provide the agency access to the facility or prohibits
 2260  the agency from conducting a regulatory inspection. The licensee
 2261  may not restrict agency staff in accessing and copying records
 2262  or in conducting confidential interviews with facility staff or
 2263  any individual who receives services from the facility provide
 2264  to the Division of Hotels and Restaurants of the Department of
 2265  Business and Professional Regulation, on a monthly basis, a list
 2266  of those assisted living facilities that have had their licenses
 2267  denied, suspended, or revoked or that are involved in an
 2268  appellate proceeding pursuant to s. 120.60 related to the
 2269  denial, suspension, or revocation of a license.
 2270         (7) Agency notification of a license suspension or
 2271  revocation, or denial of a license renewal, shall be posted and
 2272  visible to the public at the facility.
 2273         (8) If a facility is required to relocate some or all of
 2274  its residents due to agency action, that facility is exempt from
 2275  the 45 days’ notice requirement in s. 429.28(1)(k). This
 2276  provision does not exempt the facility from any deadlines for
 2277  corrective action set by the agency.
 2278         Section 60. Paragraphs (a) and (b) of subsection (2) of
 2279  section 429.178, Florida Statutes, are amended to read:
 2280         429.178 Special care for persons with Alzheimer’s disease
 2281  or other related disorders.—
 2282         (2)(a) An individual who is employed by a facility that
 2283  provides special care for residents with Alzheimer’s disease or
 2284  other related disorders, and who has regular contact with such
 2285  residents, must complete up to 4 hours of initial dementia
 2286  specific training developed or approved by the department. The
 2287  training must shall be completed within 3 months after beginning
 2288  employment and satisfy shall satisfy the core training
 2289  requirements of s. 429.52(3)(g) s. 429.52(2)(g).
 2290         (b) A direct caregiver who is employed by a facility that
 2291  provides special care for residents with Alzheimer’s disease or
 2292  other related disorders, and who provides direct care to such
 2293  residents, must complete the required initial training and 4
 2294  additional hours of training developed or approved by the
 2295  department. The training must shall be completed within 9 months
 2296  after beginning employment and satisfy shall satisfy the core
 2297  training requirements of s. 429.52(3)(g) s. 429.52(2)(g).
 2298         Section 61. Section 429.19, Florida Statutes, is amended to
 2299  read:
 2300         429.19 Violations; imposition of administrative fines;
 2301  grounds.—
 2302         (1) In addition to the requirements of part II of chapter
 2303  408, the agency shall impose an administrative fine in the
 2304  manner provided in chapter 120 for the violation of any
 2305  provision of this part, part II of chapter 408, and applicable
 2306  rules by an assisted living facility, for the actions of any
 2307  person subject to level 2 background screening under s. 408.809,
 2308  for the actions of any facility employee, or for an intentional
 2309  or negligent act seriously affecting the health, safety, or
 2310  welfare of a resident of the facility.
 2311         (2) Each violation of this part and adopted rules must
 2312  shall be classified according to the nature of the violation and
 2313  the gravity of its probable effect on facility residents. The
 2314  agency shall indicate the classification on the written notice
 2315  of the violation as follows:
 2316         (a) Class “I” violations are defined in s. 408.813. The
 2317  agency shall impose an administrative fine of $7,500 for each a
 2318  cited class I violation in a facility that is licensed for fewer
 2319  than 100 beds at the time of the violation in an amount not less
 2320  than $5,000 and not exceeding $10,000 for each violation. The
 2321  agency shall impose an administrative fine of $11,250 for each
 2322  cited class I violation in a facility that is licensed for 100
 2323  or more beds at the time of the violation. If the noncompliance
 2324  occurs within the prior 12 months, the fine must be levied for
 2325  violations that are corrected before an inspection.
 2326         (b) Class “II” violations are defined in s. 408.813. The
 2327  agency shall impose an administrative fine of $3,000 for each a
 2328  cited class II violation in a facility that is licensed for
 2329  fewer than 100 beds at the time of the violation in an amount
 2330  not less than $1,000 and not exceeding $5,000 for each
 2331  violation. The agency shall impose an administrative fine of
 2332  $4,500 for each cited class II violation in a facility that is
 2333  licensed for 100 or more beds at the time of the violation.
 2334         (c) Class “III” violations are defined in s. 408.813. The
 2335  agency shall impose an administrative fine of $750 for each a
 2336  cited class III violation in a facility that is licensed for
 2337  fewer than 100 beds at the time of the violation in an amount
 2338  not less than $500 and not exceeding $1,000 for each violation.
 2339  The agency shall impose an administrative fine of $1,125 for
 2340  each cited class III violation in a facility that is licensed
 2341  for 100 or more beds at the time of the violation.
 2342         (d) Class “IV” violations are defined in s. 408.813. The
 2343  agency shall impose an administrative fine of $150 for each a
 2344  cited class IV violation in a facility that is licensed for
 2345  fewer than 100 beds at the time of the violation in an amount
 2346  not less than $100 and not exceeding $200 for each violation.
 2347  The agency shall impose an administrative fine of $225 for each
 2348  cited class IV violation in a facility that is licensed for 100
 2349  or more beds at the time of the violation.
 2350         (e) Any fine imposed for class I and class II violations
 2351  must be doubled if a facility was previously cited for one or
 2352  more class I or class II violations during the agency’s last
 2353  licensure inspection or any inspection or complaint
 2354  investigation since the last licensure inspection.
 2355         (f) Notwithstanding s. 408.813(2)(c) and (d) and s.
 2356  408.832, a fine must be imposed for each class III and class IV
 2357  violation, regardless of correction, if a facility was
 2358  previously cited for one or more class III or class IV
 2359  violations during the agency’s last licensure inspection or any
 2360  inspection or complaint investigation since the last licensure
 2361  inspection, for the same regulatory violation. A fine imposed
 2362  for class III or class IV violations must be doubled if a
 2363  facility was previously cited for one or more class III or class
 2364  IV violations during the agency’s last two licensure inspections
 2365  for the same regulatory violation.
 2366         (g) Regardless of the class of violation cited, instead of
 2367  the fine amounts listed in paragraphs (a)-(d), the agency shall
 2368  impose an administrative fine of $500 if a facility is found not
 2369  to be in compliance with the background screening requirements
 2370  as provided in s. 408.809.
 2371         (3) For purposes of this section, in determining if a
 2372  penalty is to be imposed and in fixing the amount of the fine,
 2373  the agency shall consider the following factors:
 2374         (a) The gravity of the violation, including the probability
 2375  that death or serious physical or emotional harm to a resident
 2376  will result or has resulted, the severity of the action or
 2377  potential harm, and the extent to which the provisions of the
 2378  applicable laws or rules were violated.
 2379         (b) Actions taken by the owner or administrator to correct
 2380  violations.
 2381         (c) Any previous violations.
 2382         (d) The financial benefit to the facility of committing or
 2383  continuing the violation.
 2384         (e) The licensed capacity of the facility.
 2385         (3)(4) Each day of continuing violation after the date
 2386  established by the agency fixed for correction termination of
 2387  the violation, as ordered by the agency, constitutes an
 2388  additional, separate, and distinct violation.
 2389         (4)(5)An Any action taken to correct a violation shall be
 2390  documented in writing by the owner or administrator of the
 2391  facility and verified through followup visits by agency
 2392  personnel. The agency may impose a fine and, in the case of an
 2393  owner-operated facility, revoke or deny a facility’s license
 2394  when a facility administrator fraudulently misrepresents action
 2395  taken to correct a violation.
 2396         (5)(6)A Any facility whose owner fails to apply for a
 2397  change-of-ownership license in accordance with part II of
 2398  chapter 408 and operates the facility under the new ownership is
 2399  subject to a fine of $5,000.
 2400         (6)(7) In addition to any administrative fines imposed, the
 2401  agency may assess a survey fee, equal to the lesser of one half
 2402  of the facility’s biennial license and bed fee or $500, to cover
 2403  the cost of conducting initial complaint investigations that
 2404  result in the finding of a violation that was the subject of the
 2405  complaint or monitoring visits conducted under s. 429.28(3)(c)
 2406  to verify the correction of the violations.
 2407         (7)(8) During an inspection, the agency shall make a
 2408  reasonable attempt to discuss each violation with the owner or
 2409  administrator of the facility, prior to written notification.
 2410         (8)(9) The agency shall develop and disseminate an annual
 2411  list of all facilities sanctioned or fined for violations of
 2412  state standards, the number and class of violations involved,
 2413  the penalties imposed, and the current status of cases. The list
 2414  shall be disseminated, at no charge, to the Department of
 2415  Elderly Affairs, the Department of Health, the Department of
 2416  Children and Family Services, the Agency for Persons with
 2417  Disabilities, the area agencies on aging, the Florida Statewide
 2418  Advocacy Council, and the state and local ombudsman councils.
 2419  The Department of Children and Family Services shall disseminate
 2420  the list to service providers under contract to the department
 2421  who are responsible for referring persons to a facility for
 2422  residency. The agency may charge a fee commensurate with the
 2423  cost of printing and postage to other interested parties
 2424  requesting a copy of this list. This information may be provided
 2425  electronically or through the agency’s Internet site.
 2426         Section 62. Subsection (1) of section 429.26, Florida
 2427  Statutes, is amended to read:
 2428         429.26 Appropriateness of placements; examinations of
 2429  residents.—
 2430         (1) The owner or administrator of a facility is responsible
 2431  for determining the appropriateness of admission of an
 2432  individual to the facility and for determining the continued
 2433  appropriateness of residence of an individual in the facility. A
 2434  determination shall be based upon an assessment of the
 2435  strengths, needs, and preferences of the resident, the care and
 2436  services offered or arranged for by the facility in accordance
 2437  with facility policy, and any limitations in law or rule related
 2438  to admission criteria or continued residency for the type of
 2439  license held by the facility under this part. A resident who
 2440  requires assistance with portable oxygen, colostomy care, and
 2441  anti-embolism stockings or hosiery, and who otherwise meets the
 2442  admission criteria, may be admitted to a standard licensed
 2443  assisted living facility as long as the facility has a licensed
 2444  nurse on staff or under contract to perform the services. A
 2445  resident may not be moved from one facility to another without
 2446  consultation with and agreement from the resident or, if
 2447  applicable, the resident’s representative or designee or the
 2448  resident’s family, guardian, surrogate, or attorney in fact. In
 2449  the case of a resident who has been placed by the department or
 2450  the Department of Children and Family Services, the
 2451  administrator must notify the appropriate contact person in the
 2452  applicable department.
 2453         Section 63. Subsections (2) and (6) of section 429.28,
 2454  Florida Statutes, are amended to read:
 2455         429.28 Resident bill of rights.—
 2456         (2) The administrator of a facility shall ensure that a
 2457  written notice of the rights, obligations, and prohibitions set
 2458  forth in this part is posted in a prominent place in each
 2459  facility and read or explained to residents who cannot read. The
 2460  This notice must shall include the name, address, and telephone
 2461  numbers of the local ombudsman council and central abuse hotline
 2462  and, if when applicable, Disability Rights Florida the Advocacy
 2463  Center for Persons with Disabilities, Inc., and the Florida
 2464  local advocacy council, where complaints may be lodged. The
 2465  notice must state that a complaint made to the Office of State
 2466  Long-Term Care Ombudsman or a local long-term care ombudsman
 2467  council, the names and identities of the residents involved in
 2468  the complaint, and the identity of complainants are kept
 2469  confidential pursuant to s. 400.0077 and that retaliatory action
 2470  cannot be taken against a resident for presenting grievances or
 2471  for exercising any other resident right. The facility must
 2472  ensure a resident’s access to a telephone to call the local
 2473  ombudsman council, central abuse hotline, and Disability Rights
 2474  Florida Advocacy Center for Persons with Disabilities, Inc., and
 2475  the Florida local advocacy council.
 2476         (6) A Any facility that which terminates the residency of
 2477  an individual who participated in activities specified in
 2478  subsection (5) must shall show good cause in a court of
 2479  competent jurisdiction. If good cause is not shown, the agency
 2480  shall impose a fine of $2,500 in addition to any other penalty
 2481  assessed against the facility.
 2482         Section 64. Section 429.34, Florida Statutes, is amended to
 2483  read:
 2484         429.34 Right of entry and inspection.—
 2485         (1) In addition to the requirements of s. 408.811, any duly
 2486  designated officer or employee of the department, the Department
 2487  of Children and Family Services, the Medicaid Fraud Control Unit
 2488  of the Office of the Attorney General, the state or local fire
 2489  marshal, or a member of the state or local long-term care
 2490  ombudsman council has shall have the right to enter unannounced
 2491  upon and into the premises of any facility licensed pursuant to
 2492  this part in order to determine the state of compliance with the
 2493  provisions of this part, part II of chapter 408, and applicable
 2494  rules. Data collected by the state or local long-term care
 2495  ombudsman councils or the state or local advocacy councils may
 2496  be used by the agency in investigations involving violations of
 2497  regulatory standards. A person specified in this section who
 2498  knows or has reasonable cause to suspect that a vulnerable adult
 2499  has been or is being abused, neglected, or exploited shall
 2500  immediately report such knowledge or suspicion to the central
 2501  abuse hotline pursuant to chapter 415.
 2502         (2) Each licensed assisted living facility must be
 2503  inspected by the agency at least once every 24 months to
 2504  determine compliance with this chapter and related rules. If an
 2505  assisted living facility is cited for one or more class I
 2506  violations or two or more class II violations arising from
 2507  separate surveys within a 60-day period or due to unrelated
 2508  circumstances during the same survey, the agency must conduct an
 2509  additional licensure inspection within 6 months. In addition to
 2510  any fines imposed on the facility under s. 429.19, the licensee
 2511  must pay a fee for the cost of the additional inspection
 2512  equivalent to the standard assisted living facility license and
 2513  per-bed fees, without exception for beds designated for
 2514  recipients of optional state supplementation. The agency shall
 2515  adjust the fee in accordance with s. 408.805.
 2516         Section 65. Present subsections (1) through (11) of section
 2517  429.52, Florida Statutes, are redesignated as subsections (2)
 2518  through (12), respectively, a new subsection (1) is added to
 2519  that section, and present subsection (9) of that section is
 2520  amended, to read:
 2521         429.52 Staff training and educational programs; core
 2522  educational requirement.—
 2523         (1) Effective October 1, 2013, each new assisted living
 2524  facility employee who has not previously completed core training
 2525  must attend a preservice orientation provided by the facility
 2526  before interacting with residents. The preservice orientation
 2527  must be at least 2 hours in duration and cover topics that help
 2528  the employee provide responsible care and respond to the needs
 2529  of residents of the facility. Upon completion, the employee and
 2530  the administrator of the facility must sign an affidavit stating
 2531  that the employee completed the required preservice orientation.
 2532  The facility must keep the affidavit in the employee’s work
 2533  file.
 2534         (10)(9) The training required by this section must shall be
 2535  conducted by persons registered with the department as having
 2536  the requisite experience and credentials to conduct the
 2537  training. A person seeking to register as a trainer must provide
 2538  the department with proof of completion of the minimum core
 2539  training education requirements, successful passage of the
 2540  competency test established under this section, and proof of
 2541  compliance with the continuing education requirement in
 2542  subsection (5)(4).
 2543         Section 66. The Legislature finds that consistent
 2544  regulation of assisted living facilities benefits residents and
 2545  operators of such facilities. To determine whether surveys are
 2546  consistent between surveys and surveyors, the Agency for Health
 2547  Care Administration shall conduct a study of intersurveyor
 2548  reliability for assisted living facilities. By November 1, 2013,
 2549  the agency shall report to the Governor, the President of the
 2550  Senate, and the Speaker of the House of Representatives its
 2551  findings and make any recommendations to improve intersurveyor
 2552  reliability.
 2553         Section 67. The Legislature finds that consumers need
 2554  additional information on the quality of care and service in
 2555  assisted living facilities in order to select the best facility
 2556  for themselves or their loved ones. Therefore, the Agency for
 2557  Health Care Administration shall:
 2558         (1)Propose a rating system for assisted living facilities.
 2559  The proposal must include, but is not limited to, the data
 2560  elements to be used, the method of collecting the data, the
 2561  method of determining the rating, an estimate of the initial and
 2562  ongoing costs of a rating system to both the agency and assisted
 2563  living facilities, and a timetable for the implementation of the
 2564  rating system for assisted living facilities. The agency shall
 2565  submit its proposal to the Governor, the President of the
 2566  Senate, and the Speaker of the House of Representatives by
 2567  November 1, 2013.
 2568         (2) By January 1, 2014, create a content that is easily
 2569  accessible through the front page of the agency’s website. At a
 2570  minimum, the content must include:
 2571         (a)Information on each licensed assisted living facility,
 2572  including, but not limited to:
 2573         1.The name and address of the facility.
 2574         2.The number and type of licensed beds in the facility.
 2575         3.The types of licenses held by the facility.
 2576         4.The facility’s license expiration date and status.
 2577         5.Other relevant information that the agency currently
 2578  collects.
 2579         (b) A list of the facility’s violations, including, for
 2580  each violation:
 2581         1. A summary of the violation which is presented in a
 2582  manner understandable by the general public;
 2583         2. Any sanctions imposed by final order; and
 2584         3. A summary of any corrective action taken by the
 2585  facility.
 2586         (c) Links to inspection reports that the agency has on
 2587  file.
 2588         (d)A monitored comment page, maintained by the agency,
 2589  which allows members of the public to anonymously comment on
 2590  assisted living facilities that are licensed to operate in the
 2591  state. This comment page must, at a minimum, allow members of
 2592  the public to post comments on their experiences with, or
 2593  observations of, an assisted living facility and to review other
 2594  people’s comments. Comments posted to the agency’s comment page
 2595  may not contain profanity and are intended to provide meaningful
 2596  feedback about the assisted living facility. The agency shall
 2597  provide for a webpage moderator to review comments for profane
 2598  content before the comments are posted to the page. An employee,
 2599  owner, or controlling interest in an assisted living facility is
 2600  prohibited from posting comments on the page.
 2601         Section 68. Paragraph (b) of subsection (3) of section
 2602  430.80, Florida Statutes, is amended to read:
 2603         430.80 Implementation of a teaching nursing home pilot
 2604  project.—
 2605         (3) To be designated as a teaching nursing home, a nursing
 2606  home licensee must, at a minimum:
 2607         (b) Participate in a nationally recognized accrediting
 2608  accreditation program and hold a valid accreditation, such as
 2609  the accreditation awarded by the Joint Commission on
 2610  Accreditation of Healthcare Organizations, a national
 2611  accrediting organization that is approved by the Centers for
 2612  Medicare and Medicaid Services and whose standards incorporate
 2613  comparable licensure regulations required by the state, or, at
 2614  the time of initial designation, possess a Gold Seal Award as
 2615  conferred by the state on its licensed nursing home;
 2616         Section 69. Paragraphs (d) through (yy) of subsection (2)
 2617  of section 435.04, Florida Statutes, are redesignated as
 2618  paragraphs (e) through (zz), respectively, paragraph (e) of
 2619  subsection (1) of that section is amended, and a new paragraph
 2620  (d) is added to subsection (2) of that section, to read:
 2621         435.04 Level 2 screening standards.—
 2622         (1)
 2623         (e) Vendors who submit fingerprints on behalf of employers
 2624  must:
 2625         1. Meet the requirements of s. 943.053; and
 2626         2. Have the ability to communicate electronically with the
 2627  state agency accepting screening results from the Department of
 2628  Law Enforcement and provide the first, middle, and last name;
 2629  social security number; date of birth; mailing address; sex; and
 2630  race of the applicant a photograph of the applicant taken at the
 2631  time the fingerprints are submitted.
 2632         (2) The security background investigations under this
 2633  section must ensure that no persons subject to the provisions of
 2634  this section have been arrested for and are awaiting final
 2635  disposition of, have been found guilty of, regardless of
 2636  adjudication, or entered a plea of nolo contendere or guilty to,
 2637  or have been adjudicated delinquent and the record has not been
 2638  sealed or expunged for, any offense prohibited under any of the
 2639  following provisions of state law or similar law of another
 2640  jurisdiction:
 2641         (d) Section 777.04, relating to attempts, solicitation, and
 2642  conspiracy to commit an offense listed in this subsection.
 2643         Section 70. Subsections (1) and (2) of section 435.07,
 2644  Florida Statutes, are amended to read:
 2645         435.07 Exemptions from disqualification.—Unless otherwise
 2646  provided by law, the provisions of this section apply to
 2647  exemptions from disqualification for disqualifying offenses
 2648  revealed pursuant to background screenings required under this
 2649  chapter, regardless of whether those disqualifying offenses are
 2650  listed in this chapter or other laws.
 2651         (1)(a) The head of the appropriate agency may grant to any
 2652  employee otherwise disqualified from employment an exemption
 2653  from disqualification for:
 2654         1.(a) Felonies for which at least 3 years have elapsed
 2655  since the applicant for the exemption has completed or been
 2656  lawfully released from confinement, supervision, or nonmonetary
 2657  condition imposed by the court sanction for the disqualifying
 2658  felony;
 2659         2.(b) Misdemeanors prohibited under any of the statutes
 2660  cited in this chapter or under similar statutes of other
 2661  jurisdictions for which the applicant for the exemption has
 2662  completed or been lawfully released from confinement,
 2663  supervision, or nonmonetary condition imposed by the court
 2664  sanction;
 2665         3.(c) Offenses that were felonies when committed but that
 2666  are now misdemeanors and for which the applicant for the
 2667  exemption has completed or been lawfully released from
 2668  confinement, supervision, or nonmonetary condition imposed by
 2669  the court sanction; or
 2670         4.(d) Findings of delinquency. For offenses that would be
 2671  felonies if committed by an adult and the record has not been
 2672  sealed or expunged, the exemption may not be granted until at
 2673  least 3 years have elapsed since the applicant for the exemption
 2674  has completed or been lawfully released from confinement,
 2675  supervision, or nonmonetary condition imposed by the court
 2676  sanction for the disqualifying offense.
 2677         (b) A person who wishes to apply for an exemption who was
 2678  ordered to pay any amount for any fee, fine, fund, lien, civil
 2679  judgment, application, costs of prosecution, trust, or
 2680  restitution as part of the judgment and sentence for any
 2681  disqualifying felony or misdemeanor must have paid the court
 2682  ordered amount in full before being eligible for an exemption.
 2683  
 2684  For the purposes of this subsection, the term “felonies” means
 2685  both felonies prohibited under any of the statutes cited in this
 2686  chapter or under similar statutes of other jurisdictions.
 2687         (2) Persons employed, or applicants for employment, by
 2688  treatment providers who treat adolescents 13 years of age and
 2689  older who are disqualified from employment solely because of
 2690  crimes under s. 817.563, s. 893.13, or s. 893.147 may be
 2691  exempted from disqualification from employment pursuant to this
 2692  chapter without application of the waiting period in
 2693  subparagraph (1)(a)1 paragraph (1)(a).
 2694         Section 71. Subsection (2) of section 435.12, Florida
 2695  Statutes, is amended to read:
 2696         435.12 Care Provider Background Screening Clearinghouse.—
 2697         (2)(a) To ensure that the information in the clearinghouse
 2698  is current, the fingerprints of an employee required to be
 2699  screened by a specified agency and included in the clearinghouse
 2700  must be:
 2701         1. Retained by the Department of Law Enforcement pursuant
 2702  to s. 943.05(2)(g) and (h) and (3), and the Department of Law
 2703  Enforcement must report the results of searching those
 2704  fingerprints against state incoming arrest fingerprint
 2705  submissions to the Agency for Health Care Administration for
 2706  inclusion in the clearinghouse.
 2707         2. Resubmitted for a Federal Bureau of Investigation
 2708  national criminal history check every 5 years until such time as
 2709  the fingerprints are retained by the Federal Bureau of
 2710  Investigation.
 2711         3. Subject to retention on a 5-year renewal basis with fees
 2712  collected at the time of initial submission or resubmission of
 2713  fingerprints.
 2714         4. Submitted with a photograph of the person taken at the
 2715  time the fingerprints are submitted.
 2716         (b) Until such time as the fingerprints are retained at the
 2717  Federal Bureau of Investigation, an employee with a break in
 2718  service of more than 90 days from a position that requires
 2719  screening by a specified agency must submit to a national
 2720  screening if the person returns to a position that requires
 2721  screening by a specified agency.
 2722         (c) An employer of persons subject to screening by a
 2723  specified agency must register with the clearinghouse and
 2724  maintain the employment status of all employees within the
 2725  clearinghouse. Initial employment status and any changes in
 2726  status must be reported within 10 business days.
 2727         (d) An employer must register and initiate all criminal
 2728  history checks through the clearinghouse before referring an
 2729  employee or potential employee for electronic fingerprint
 2730  submission to the Department of Law Enforcement. The
 2731  registration must include the employee’s full name (first,
 2732  middle, last), social security number, date of birth, mailing
 2733  address, sex, and race.
 2734         Section 72. Paragraphs (b) and (d) of subsection (9) of
 2735  section 440.102, Florida Statutes, are amended to read:
 2736         440.102 Drug-free workplace program requirements.—The
 2737  following provisions apply to a drug-free workplace program
 2738  implemented pursuant to law or to rules adopted by the Agency
 2739  for Health Care Administration:
 2740         (9) DRUG-TESTING STANDARDS FOR LABORATORIES.—
 2741         (b) A laboratory may analyze initial or confirmation test
 2742  specimens only if:
 2743         1. The laboratory obtains a license under part II of
 2744  chapter 408 and s. 112.0455(17). Each applicant for licensure
 2745  and each licensee must comply with all requirements of this
 2746  section, part II of chapter 408, and applicable rules.
 2747         2. The laboratory has written procedures to ensure the
 2748  chain of custody.
 2749         3. The laboratory follows proper quality control
 2750  procedures, including, but not limited to:
 2751         a. The use of internal quality controls, including the use
 2752  of samples of known concentrations which are used to check the
 2753  performance and calibration of testing equipment, and periodic
 2754  use of blind samples for overall accuracy.
 2755         b. An internal review and certification process for drug
 2756  test results, conducted by a person qualified to perform that
 2757  function in the testing laboratory.
 2758         c. Security measures implemented by the testing laboratory
 2759  to preclude adulteration of specimens and drug test results.
 2760         d. Other necessary and proper actions taken to ensure
 2761  reliable and accurate drug test results.
 2762         (d) The laboratory shall submit to the Agency for Health
 2763  Care Administration a monthly report with statistical
 2764  information regarding the testing of employees and job
 2765  applicants. The report must include information on the methods
 2766  of analysis conducted, the drugs tested for, the number of
 2767  positive and negative results for both initial tests and
 2768  confirmation tests, and any other information deemed appropriate
 2769  by the Agency for Health Care Administration. A monthly report
 2770  must not identify specific employees or job applicants.
 2771         Section 73. Paragraph (a) of subsection (2) of section
 2772  440.13, Florida Statutes, is amended to read:
 2773         440.13 Medical services and supplies; penalty for
 2774  violations; limitations.—
 2775         (2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.—
 2776         (a) Subject to the limitations specified elsewhere in this
 2777  chapter, the employer shall furnish to the employee such
 2778  medically necessary remedial treatment, care, and attendance for
 2779  such period as the nature of the injury or the process of
 2780  recovery may require, which is in accordance with established
 2781  practice parameters and protocols of treatment as provided for
 2782  in this chapter, including medicines, medical supplies, durable
 2783  medical equipment, orthoses, prostheses, and other medically
 2784  necessary apparatus. Remedial treatment, care, and attendance,
 2785  including work-hardening programs or pain-management programs
 2786  accredited by CARF International, the Commission on
 2787  Accreditation of Rehabilitation Facilities or Joint Commission,
 2788  the American Osteopathic Association/Healthcare Facilities
 2789  Accreditation Program, or a national accrediting organization
 2790  that is approved by the Centers for Medicare and Medicaid
 2791  Services and whose standards incorporate comparable licensure
 2792  regulations required by the state, on the Accreditation of
 2793  Health Organizations or pain-management programs affiliated with
 2794  medical schools, shall be considered as covered treatment only
 2795  when such care is given based on a referral by a physician as
 2796  defined in this chapter. Medically necessary treatment, care,
 2797  and attendance does not include chiropractic services in excess
 2798  of 24 treatments or rendered 12 weeks beyond the date of the
 2799  initial chiropractic treatment, whichever comes first, unless
 2800  the carrier authorizes additional treatment or the employee is
 2801  catastrophically injured.
 2802  
 2803  Failure of the carrier to timely comply with this subsection
 2804  shall be a violation of this chapter and the carrier shall be
 2805  subject to penalties as provided for in s. 440.525.
 2806         Section 74. Section 465.1902, Florida Statutes, is created
 2807  to read:
 2808         465.1902Preemption.—This chapter preempts to the state all
 2809  regulation of the licensure, activity, and operation of
 2810  pharmacies and pharmacists as defined in this chapter. A local
 2811  government or political subdivision of the state may not enact
 2812  or enforce an ordinance that imposes a levy, charge, or fee
 2813  upon, or that otherwise regulates, pharmacies and pharmacists as
 2814  defined in this chapter, except that this preemption does not
 2815  prohibit a local government or political subdivision from
 2816  enacting an ordinance regarding the following:
 2817         (1) Local business taxes adopted pursuant to chapter 205.
 2818         (2) Land use development regulations adopted pursuant to
 2819  chapter 163, which include regulation of any aspect of
 2820  development, including a subdivision, building construction,
 2821  sign regulation, and any other regulation concerning the
 2822  development of land, landscaping, or tree protection, and which
 2823  do not include restrictions on pain-management services, health
 2824  care services, or the prescribing of controlled substances.
 2825         Section 75. Paragraph (b) of subsection (54) of section
 2826  499.003, Florida Statutes, is amended to read:
 2827         499.003 Definitions of terms used in this part.—As used in
 2828  this part, the term:
 2829         (54) “Wholesale distribution” means distribution of
 2830  prescription drugs to persons other than a consumer or patient,
 2831  but does not include:
 2832         (a) Any of the following activities, which is not a
 2833  violation of s. 499.005(21) or s. 499.0051(13)(f) if such
 2834  activity is conducted in accordance with s. 499.01(2)(g):
 2835         1. The purchase or other acquisition by a hospital or other
 2836  health care entity that is a member of a group purchasing
 2837  organization of a prescription drug for its own use from the
 2838  group purchasing organization or from other hospitals or health
 2839  care entities that are members of that organization.
 2840         2. The sale, purchase, or trade of a prescription drug or
 2841  an offer to sell, purchase, or trade a prescription drug by a
 2842  charitable organization described in s. 501(c)(3) of the
 2843  Internal Revenue Code of 1986, as amended and revised, to a
 2844  nonprofit affiliate of the organization to the extent otherwise
 2845  permitted by law.
 2846         3. The sale, purchase, or trade of a prescription drug or
 2847  an offer to sell, purchase, or trade a prescription drug among
 2848  hospitals or other health care entities that are under common
 2849  control. For purposes of this subparagraph, “common control”
 2850  means the power to direct or cause the direction of the
 2851  management and policies of a person or an organization, whether
 2852  by ownership of stock, by voting rights, by contract, or
 2853  otherwise.
 2854         4. The sale, purchase, trade, or other transfer of a
 2855  prescription drug from or for any federal, state, or local
 2856  government agency or any entity eligible to purchase
 2857  prescription drugs at public health services prices pursuant to
 2858  Pub. L. No. 102-585, s. 602 to a contract provider or its
 2859  subcontractor for eligible patients of the agency or entity
 2860  under the following conditions:
 2861         a. The agency or entity must obtain written authorization
 2862  for the sale, purchase, trade, or other transfer of a
 2863  prescription drug under this subparagraph from the Secretary of
 2864  Business and Professional Regulation or his or her designee.
 2865         b. The contract provider or subcontractor must be
 2866  authorized by law to administer or dispense prescription drugs.
 2867         c. In the case of a subcontractor, the agency or entity
 2868  must be a party to and execute the subcontract.
 2869         d. The contract provider and subcontractor must maintain
 2870  and produce immediately for inspection all records of movement
 2871  or transfer of all the prescription drugs belonging to the
 2872  agency or entity, including, but not limited to, the records of
 2873  receipt and disposition of prescription drugs. Each contractor
 2874  and subcontractor dispensing or administering these drugs must
 2875  maintain and produce records documenting the dispensing or
 2876  administration. Records that are required to be maintained
 2877  include, but are not limited to, a perpetual inventory itemizing
 2878  drugs received and drugs dispensed by prescription number or
 2879  administered by patient identifier, which must be submitted to
 2880  the agency or entity quarterly.
 2881         e. The contract provider or subcontractor may administer or
 2882  dispense the prescription drugs only to the eligible patients of
 2883  the agency or entity or must return the prescription drugs for
 2884  or to the agency or entity. The contract provider or
 2885  subcontractor must require proof from each person seeking to
 2886  fill a prescription or obtain treatment that the person is an
 2887  eligible patient of the agency or entity and must, at a minimum,
 2888  maintain a copy of this proof as part of the records of the
 2889  contractor or subcontractor required under sub-subparagraph d.
 2890         f. In addition to the departmental inspection authority set
 2891  forth in s. 499.051, the establishment of the contract provider
 2892  and subcontractor and all records pertaining to prescription
 2893  drugs subject to this subparagraph shall be subject to
 2894  inspection by the agency or entity. All records relating to
 2895  prescription drugs of a manufacturer under this subparagraph
 2896  shall be subject to audit by the manufacturer of those drugs,
 2897  without identifying individual patient information.
 2898         (b) Any of the following activities, which is not a
 2899  violation of s. 499.005(21) or s. 499.0051(13)(f) if such
 2900  activity is conducted in accordance with rules established by
 2901  the department:
 2902         1. The sale, purchase, or trade of a prescription drug
 2903  among federal, state, or local government health care entities
 2904  that are under common control and are authorized to purchase
 2905  such prescription drug.
 2906         2. The sale, purchase, or trade of a prescription drug or
 2907  an offer to sell, purchase, or trade a prescription drug for
 2908  emergency medical reasons. For purposes of this subparagraph,
 2909  the term “emergency medical reasons” includes transfers of
 2910  prescription drugs by a retail pharmacy to another retail
 2911  pharmacy to alleviate a temporary shortage.
 2912         3. The transfer of a prescription drug acquired by a
 2913  medical director on behalf of a licensed emergency medical
 2914  services provider to that emergency medical services provider
 2915  and its transport vehicles for use in accordance with the
 2916  provider’s license under chapter 401.
 2917         4. The revocation of a sale or the return of a prescription
 2918  drug to the person’s prescription drug wholesale supplier.
 2919         5. The donation of a prescription drug by a health care
 2920  entity to a charitable organization that has been granted an
 2921  exemption under s. 501(c)(3) of the Internal Revenue Code of
 2922  1986, as amended, and that is authorized to possess prescription
 2923  drugs.
 2924         6. The transfer of a prescription drug by a person
 2925  authorized to purchase or receive prescription drugs to a person
 2926  licensed or permitted to handle reverse distributions or
 2927  destruction under the laws of the jurisdiction in which the
 2928  person handling the reverse distribution or destruction receives
 2929  the drug.
 2930         7. The transfer of a prescription drug by a hospital or
 2931  other health care entity, either directly or through the
 2932  hospital’s or health care entity’s prescription drug wholesale
 2933  supplier or the manufacturer, to a person licensed under this
 2934  part to repackage prescription drugs for the purpose of
 2935  repackaging the prescription drug for use by that hospital, or
 2936  other health care entity and other health care entities that are
 2937  under common control, and the transfer of the drugs by the
 2938  repackager to the hospital or other healthcare entity, if
 2939  ownership of the prescription drugs remains with the hospital or
 2940  other health care entity at all times. In addition to the
 2941  recordkeeping requirements of s. 499.0121(6), the hospital or
 2942  health care entity that transfers prescription drugs pursuant to
 2943  this subparagraph must reconcile all drugs transferred and
 2944  returned and resolve any discrepancies in a timely manner. The
 2945  repackager must comply with the recordkeeping requirements of s.
 2946  499.01212(2).
 2947         Section 76. Paragraph (b) of subsection (2) of section
 2948  499.01, Florida Statutes, is amended to read
 2949         499.01 Permits.—
 2950         (2) The following permits are established:
 2951         (b) Prescription drug repackager permit.—A prescription
 2952  drug repackager permit is required for any person that
 2953  repackages a prescription drug in this state or any person
 2954  located in another state who repackages and distributes
 2955  prescription drugs in or into this state which are received in a
 2956  transfer pursuant to s. 499.003(54)(b)7.
 2957         1. A person that operates an establishment permitted as a
 2958  prescription drug repackager may engage in wholesale
 2959  distribution of prescription drugs repackaged at that
 2960  establishment and must comply with all the provisions of this
 2961  part and the rules adopted under this part that apply to a
 2962  wholesale distributor.
 2963         2. A prescription drug repackager must comply with all
 2964  appropriate state and federal good manufacturing practices.
 2965         Section 77. Subsection (2) of section 499.01212, Florida
 2966  Statutes, is amended to read:
 2967         499.01212 Pedigree paper.—
 2968         (2) FORMAT.—A pedigree paper must contain the following
 2969  information:
 2970         (a) For the wholesale distribution of a prescription drug
 2971  within the normal distribution chain or pursuant to a transfer
 2972  described in s. 499.003(54)(b)7. if the wholesale distributor
 2973  purchased the specific unit of the prescription drug directly
 2974  from the manufacturer and the wholesale distributor transfers
 2975  title to the prescription drug within the normal distribution
 2976  chain, but delivers physical possession to a repackager licensed
 2977  under this part:
 2978         1. The following statement: “This wholesale distributor
 2979  purchased the specific unit of the prescription drug directly
 2980  from the manufacturer.”
 2981         2. The manufacturer’s national drug code identifier and the
 2982  name and address of the wholesale distributor and the purchaser
 2983  of the prescription drug.
 2984         3. The name of the prescription drug as it appears on the
 2985  label.
 2986         4. The quantity, dosage form, and strength of the
 2987  prescription drug.
 2988  
 2989  The wholesale distributor must also maintain and make available
 2990  to the department, upon request, the point of origin of the
 2991  prescription drugs, including intracompany transfers, the date
 2992  of the shipment from the manufacturer to the wholesale
 2993  distributor, the lot numbers of such drugs, and the invoice
 2994  numbers from the manufacturer. If a repackager further
 2995  distributes prescription drugs to a hospital or other health
 2996  care entity pursuant to s. 499.003(54)(b)7., and the hospital or
 2997  other health care entity receives the statement from the
 2998  wholesale distributor in this subsection, the repackager’s
 2999  pedigree paper must contain the statement from the wholesale
 3000  distributor in this subsection, along with the lot numbers of
 3001  the prescription drugs, the name and address of the repackager
 3002  and his or her signature, the date of receipt, and the name and
 3003  address of the person authorized by law to purchase prescription
 3004  drugs for the purpose of administering or dispensing the drug,
 3005  as defined in s. 465.003.
 3006         (b) For all other wholesale distributions of prescription
 3007  drugs and all other transfers of prescription drugs by
 3008  repackagers pursuant to s. 499.003(54)(b)7.:
 3009         1. The quantity, dosage form, and strength of the
 3010  prescription drugs.
 3011         2. The lot numbers of the prescription drugs.
 3012         3. The name and address of each owner of the prescription
 3013  drug and his or her signature.
 3014         4. Shipping information, including the name and address of
 3015  each person certifying delivery or receipt of the prescription
 3016  drug.
 3017         5. An invoice number, a shipping document number, or
 3018  another number uniquely identifying the transaction.
 3019         6. A certification that the recipient wholesale distributor
 3020  has authenticated the pedigree papers.
 3021         7. The unique serialization of the prescription drug, if
 3022  the manufacturer or repackager has uniquely serialized the
 3023  individual prescription drug unit.
 3024         8. The name, address, telephone number, and, if available,
 3025  e-mail contact information of each wholesale distributor
 3026  involved in the chain of the prescription drug’s custody.
 3027  
 3028  When an affiliated group member obtains title to a prescription
 3029  drug before distributing the prescription drug as the
 3030  manufacturer under s. 499.003(31)(e), information regarding the
 3031  distribution between those affiliated group members may be
 3032  omitted from a pedigree paper required under this paragraph for
 3033  subsequent distributions of that prescription drug.
 3034         Section 78. Subsection (8) of section 499.041, Florida
 3035  Statutes, is amended to read
 3036         499.041 Schedule of fees for drug, device, and cosmetic
 3037  applications and permits, product registrations, and free-sale
 3038  certificates.—
 3039         (8) The department shall assess a prescription drug
 3040  repackager applicant or permitee physically located outside of
 3041  the state or an out-of-state prescription drug wholesale
 3042  distributor applicant or permittee an onsite inspection fee of
 3043  not less than $1,000 or more than $3,000 annually, to be based
 3044  on the actual cost of the inspection if an onsite inspection is
 3045  performed by agents of the department.
 3046         Section 79. Subsection (1) of section 627.645, Florida
 3047  Statutes, is amended to read:
 3048         627.645 Denial of health insurance claims restricted.—
 3049         (1) A No claim for payment under a health insurance policy
 3050  or self-insured program of health benefits for treatment, care,
 3051  or services in a licensed hospital that which is accredited by
 3052  the Joint Commission, the American Osteopathic
 3053  Association/Healthcare Facilities Accreditation Program, a
 3054  national accrediting organization that is approved by the
 3055  Centers for Medicare and Medicaid Services and whose standards
 3056  incorporate comparable licensure regulations required by the
 3057  state on the Accreditation of Hospitals, the American
 3058  Osteopathic Association, or CARF International may not the
 3059  Commission on the Accreditation of Rehabilitative Facilities
 3060  shall be denied because such hospital lacks major surgical
 3061  facilities and is primarily of a rehabilitative nature, if such
 3062  rehabilitation is specifically for treatment of physical
 3063  disability.
 3064         Section 80. Paragraph (c) of subsection (2) of section
 3065  627.668, Florida Statutes, is amended to read:
 3066         627.668 Optional coverage for mental and nervous disorders
 3067  required; exception.—
 3068         (2) Under group policies or contracts, inpatient hospital
 3069  benefits, partial hospitalization benefits, and outpatient
 3070  benefits consisting of durational limits, dollar amounts,
 3071  deductibles, and coinsurance factors shall not be less favorable
 3072  than for physical illness generally, except that:
 3073         (c) Partial hospitalization benefits shall be provided
 3074  under the direction of a licensed physician. For purposes of
 3075  this part, the term “partial hospitalization services” is
 3076  defined as those services offered by a program that is
 3077  accredited by the Joint Commission, the American Osteopathic
 3078  Association/Healthcare Facilities Accreditation Program, or a
 3079  national accrediting organization approved by the Centers for
 3080  Medicare and Medicaid Services and whose standards incorporate
 3081  comparable licensure regulations required by the state; on
 3082  Accreditation of Hospitals (JCAH) or that is in compliance with
 3083  equivalent standards. Alcohol rehabilitation programs accredited
 3084  by the Joint Commission on Accreditation of Hospitals or
 3085  approved by the state and licensed drug abuse rehabilitation
 3086  programs shall also be qualified providers under this section.
 3087  In a given any benefit year, if partial hospitalization services
 3088  or a combination of inpatient and partial hospitalization are
 3089  used utilized, the total benefits paid for all such services may
 3090  shall not exceed the cost of 30 days after of inpatient
 3091  hospitalization for psychiatric services, including physician
 3092  fees, which prevail in the community in which the partial
 3093  hospitalization services are rendered. If partial
 3094  hospitalization services benefits are provided beyond the limits
 3095  set forth in this paragraph, the durational limits, dollar
 3096  amounts, and coinsurance factors thereof need not be the same as
 3097  those applicable to physical illness generally.
 3098         Section 81. Subsection (3) of section 627.669, Florida
 3099  Statutes, is amended to read:
 3100         627.669 Optional coverage required for substance abuse
 3101  impaired persons; exception.—
 3102         (3) The benefits provided under this section are shall be
 3103  applicable only if treatment is provided by, or under the
 3104  supervision of, or is prescribed by, a licensed physician or
 3105  licensed psychologist and if services are provided in a program
 3106  that is accredited by the Joint Commission, the American
 3107  Osteopathic Association/Healthcare Facilities Accreditation
 3108  Program, or a national accrediting organization that is approved
 3109  by the Centers for Medicare and Medicaid Services and whose
 3110  standards incorporate comparable licensure regulations required
 3111  by the state on Accreditation of Hospitals or that is approved
 3112  by the state.
 3113         Section 82. Paragraph (a) of subsection (1) of section
 3114  627.736, Florida Statutes, is amended to read:
 3115         627.736 Required personal injury protection benefits;
 3116  exclusions; priority; claims.—
 3117         (1) REQUIRED BENEFITS.—An insurance policy complying with
 3118  the security requirements of s. 627.733 must provide personal
 3119  injury protection to the named insured, relatives residing in
 3120  the same household, persons operating the insured motor vehicle,
 3121  passengers in the motor vehicle, and other persons struck by the
 3122  motor vehicle and suffering bodily injury while not an occupant
 3123  of a self-propelled vehicle, subject to subsection (2) and
 3124  paragraph (4)(e), to a limit of $10,000 in medical and
 3125  disability benefits and $5,000 in death benefits resulting from
 3126  bodily injury, sickness, disease, or death arising out of the
 3127  ownership, maintenance, or use of a motor vehicle as follows:
 3128         (a) Medical benefits.—Eighty percent of all reasonable
 3129  expenses for medically necessary medical, surgical, X-ray,
 3130  dental, and rehabilitative services, including prosthetic
 3131  devices and medically necessary ambulance, hospital, and nursing
 3132  services if the individual receives initial services and care
 3133  pursuant to subparagraph 1. within 14 days after the motor
 3134  vehicle accident. The medical benefits provide reimbursement
 3135  only for:
 3136         1. Initial services and care that are lawfully provided,
 3137  supervised, ordered, or prescribed by a physician licensed under
 3138  chapter 458 or chapter 459, a dentist licensed under chapter
 3139  466, or a chiropractic physician licensed under chapter 460 or
 3140  that are provided in a hospital or in a facility that owns, or
 3141  is wholly owned by, a hospital. Initial services and care may
 3142  also be provided by a person or entity licensed under part III
 3143  of chapter 401 which provides emergency transportation and
 3144  treatment.
 3145         2. Upon referral by a provider described in subparagraph
 3146  1., followup services and care consistent with the underlying
 3147  medical diagnosis rendered pursuant to subparagraph 1. which may
 3148  be provided, supervised, ordered, or prescribed only by a
 3149  physician licensed under chapter 458 or chapter 459, a
 3150  chiropractic physician licensed under chapter 460, a dentist
 3151  licensed under chapter 466, or, to the extent permitted by
 3152  applicable law and under the supervision of such physician,
 3153  osteopathic physician, chiropractic physician, or dentist, by a
 3154  physician assistant licensed under chapter 458 or chapter 459 or
 3155  an advanced registered nurse practitioner licensed under chapter
 3156  464. Followup services and care may also be provided by any of
 3157  the following persons or entities:
 3158         a. A hospital or ambulatory surgical center licensed under
 3159  chapter 395.
 3160         b. An entity wholly owned by one or more physicians
 3161  licensed under chapter 458 or chapter 459, chiropractic
 3162  physicians licensed under chapter 460, or dentists licensed
 3163  under chapter 466 or by such practitioners and the spouse,
 3164  parent, child, or sibling of such practitioners.
 3165         c. An entity that owns or is wholly owned, directly or
 3166  indirectly, by a hospital or hospitals.
 3167         d. A physical therapist licensed under chapter 486, based
 3168  upon a referral by a provider described in this subparagraph.
 3169         e. A health care clinic licensed under part X of chapter
 3170  400 which is accredited by the Joint Commission, the American
 3171  Osteopathic Association/Healthcare Facilities Accreditation
 3172  Program, a national accrediting organization that is approved by
 3173  the Centers for Medicare and Medicaid Services and whose
 3174  standards incorporate comparable licensure regulations required
 3175  by the state, CARF International on Accreditation of Healthcare
 3176  Organizations, the American Osteopathic Association, the
 3177  Commission on Accreditation of Rehabilitation Facilities, or the
 3178  Accreditation Association for Ambulatory Health Care, Inc., or
 3179         (I) Has a medical director licensed under chapter 458,
 3180  chapter 459, or chapter 460;
 3181         (II) Has been continuously licensed for more than 3 years
 3182  or is a publicly traded corporation that issues securities
 3183  traded on an exchange registered with the United States
 3184  Securities and Exchange Commission as a national securities
 3185  exchange; and
 3186         (III) Provides at least four of the following medical
 3187  specialties:
 3188         (A) General medicine.
 3189         (B) Radiography.
 3190         (C) Orthopedic medicine.
 3191         (D) Physical medicine.
 3192         (E) Physical therapy.
 3193         (F) Physical rehabilitation.
 3194         (G) Prescribing or dispensing outpatient prescription
 3195  medication.
 3196         (H) Laboratory services.
 3197         3. Reimbursement for services and care provided in
 3198  subparagraph 1. or subparagraph 2. up to $10,000 if a physician
 3199  licensed under chapter 458 or chapter 459, a dentist licensed
 3200  under chapter 466, a physician assistant licensed under chapter
 3201  458 or chapter 459, or an advanced registered nurse practitioner
 3202  licensed under chapter 464 has determined that the injured
 3203  person had an emergency medical condition.
 3204         4. Reimbursement for services and care provided in
 3205  subparagraph 1. or subparagraph 2. is limited to $2,500 if a any
 3206  provider listed in subparagraph 1. or subparagraph 2. determines
 3207  that the injured person did not have an emergency medical
 3208  condition.
 3209         5. Medical benefits do not include massage as defined in s.
 3210  480.033 or acupuncture as defined in s. 457.102, regardless of
 3211  the person, entity, or licensee providing massage or
 3212  acupuncture, and a licensed massage therapist or licensed
 3213  acupuncturist may not be reimbursed for medical benefits under
 3214  this section.
 3215         6. The Financial Services Commission shall adopt by rule
 3216  the form that must be used by an insurer and a health care
 3217  provider specified in sub-subparagraph 2.b., sub-subparagraph
 3218  2.c., or sub-subparagraph 2.e. to document that the health care
 3219  provider meets the criteria of this paragraph. Such, which rule
 3220  must include a requirement for a sworn statement or affidavit.
 3221  
 3222  Only insurers writing motor vehicle liability insurance in this
 3223  state may provide the required benefits of this section, and
 3224  such insurer may not require the purchase of any other motor
 3225  vehicle coverage other than the purchase of property damage
 3226  liability coverage as required by s. 627.7275 as a condition for
 3227  providing such benefits. Insurers may not require that property
 3228  damage liability insurance in an amount greater than $10,000 be
 3229  purchased in conjunction with personal injury protection. Such
 3230  insurers shall make benefits and required property damage
 3231  liability insurance coverage available through normal marketing
 3232  channels. An insurer writing motor vehicle liability insurance
 3233  in this state who fails to comply with such availability
 3234  requirement as a general business practice violates part IX of
 3235  chapter 626, and such violation constitutes an unfair method of
 3236  competition or an unfair or deceptive act or practice involving
 3237  the business of insurance. An insurer committing such violation
 3238  is subject to the penalties provided under that part, as well as
 3239  those provided elsewhere in the insurance code.
 3240         Section 83. Subsection (12) of section 641.495, Florida
 3241  Statutes, is amended to read:
 3242         641.495 Requirements for issuance and maintenance of
 3243  certificate.—
 3244         (12) The provisions of part I of chapter 395 do not apply
 3245  to a health maintenance organization that, on or before January
 3246  1, 1991, provides not more than 10 outpatient holding beds for
 3247  short-term and hospice-type patients in an ambulatory care
 3248  facility for its members, provided that such health maintenance
 3249  organization maintains current accreditation by the Joint
 3250  Commission on Accreditation of Health Care Organizations, a
 3251  national accrediting organization that is approved by the
 3252  Centers for Medicare and Medicaid Services and whose standards
 3253  incorporate comparable licensure regulations required by the
 3254  state, the Accreditation Association for Ambulatory Health Care,
 3255  Inc., or the National Committee for Quality Assurance.
 3256         Section 84. Subsection (2) of section 766.1015, Florida
 3257  Statutes, is amended to read:
 3258         766.1015 Civil immunity for members of or consultants to
 3259  certain boards, committees, or other entities.—
 3260         (2) Such committee, board, group, commission, or other
 3261  entity must be established in accordance with state law, or in
 3262  accordance with requirements of the Joint Commission, the
 3263  American Osteopathic Association/Healthcare Facilities
 3264  Accreditation Program, or a national accrediting organization
 3265  that is approved by the Centers for Medicare and Medicaid
 3266  Services and whose standards incorporate comparable licensure
 3267  regulations required by the state on Accreditation of Healthcare
 3268  Organizations, established and duly constituted by one or more
 3269  public or licensed private hospitals or behavioral health
 3270  agencies, or established by a governmental agency. To be
 3271  protected by this section, the act, decision, omission, or
 3272  utterance may not be made or done in bad faith or with malicious
 3273  intent.
 3274         Section 85. Section 893.0552, Florida Statutes, is created
 3275  to read:
 3276         893.0552Preemption of regulation.—
 3277         (1) This section preempts to the state all regulation of
 3278  the licensure, activity, and operation of pain-management
 3279  clinics as defined in ss. 458.3265 and 459.0137 in the following
 3280  circumstances:
 3281         (a) The clinic is wholly owned and operated by a physician
 3282  who performs interventional pain procedures of the type
 3283  routinely billed using surgical codes, who has never been
 3284  suspended or revoked for prescribing a controlled substance in
 3285  Schedule II or Schedule III of s. 893.03 and drugs containing
 3286  Alprazolam in excessive or inappropriate quantities that are not
 3287  in the best interest of a patient, and who:
 3288         1. Has completed a fellowship in pain medicine which is
 3289  approved by the Accreditation Council for Graduate Medical
 3290  Education or the American Osteopathic Association;
 3291         2. Is board-certified in pain medicine by the American
 3292  Board of Pain Medicine, board-certified by the American Board of
 3293  Interventional Pain Physicians; or
 3294         3. Has a board certification or subcertification in pain
 3295  management or pain medicine by a specialty board approved by the
 3296  American Board of Medical Specialties or the American
 3297  Osteopathic Association.
 3298         (b) The clinic is wholly owned and operated by a physician
 3299  multispecialty practice if one or more board-eligible or board
 3300  certified medical specialists has one of the qualifications
 3301  specified in subparagraph (a)1., subparagraph (a)2., or
 3302  subparagraph (a)3., performs interventional pain procedures of
 3303  the type routinely billed using surgical codes, and has never
 3304  been suspended or revoked for prescribing a controlled substance
 3305  in Schedule II or Schedule III of s. 893.03 and drugs containing
 3306  Alprazolam in excessive or inappropriate quantities that are not
 3307  in the best interest of a patient.
 3308         (2) Notwithstanding subsection (1), the preemption does not
 3309  prohibit a local government or political subdivision from
 3310  enacting an ordinance regarding local business taxes adopted
 3311  pursuant to chapter 205 and land use development regulations
 3312  adopted pursuant to chapter 163. A pain-management clinic in
 3313  which the regulation of its licensure, activity, and operation
 3314  is preempted to the state pursuant to subsection (1) is a
 3315  permissible use in a land use or zoning category that permits
 3316  hospitals and other health care facilities or clinics as defined
 3317  in chapter 395 or s. 408.07. Upon the request of a local
 3318  government, a pain-management clinic must annually demonstrate
 3319  that it qualifies for preemption pursuant to subsection (1).
 3320         Section 86. This act shall take effect July 1, 2013.
 3321  
 3322  ================= T I T L E  A M E N D M E N T ================
 3323         And the title is amended as follows:
 3324         Delete everything before the enacting clause
 3325  and insert:
 3326                        A bill to be entitled                      
 3327         An act relating to health care; amending s. 112.0455,
 3328         F.S.; deleting a monthly reporting requirement for
 3329         laboratories; amending s. 154.11, F.S.; revising
 3330         references to certain accrediting organizations to
 3331         conform to changes made by the act; amending s.
 3332         322.142, F.S.; allowing the Department of Highway
 3333         Safety and Motor Vehicles to share driver license
 3334         photographs with the Agency for Health Care
 3335         Administration pursuant to an interagency agreement;
 3336         revising references to certain accrediting
 3337         organizations to conform to changes made by the act;
 3338         amending s. 381.745, F.S.; revising a definition;
 3339         amending s. 381.75, F.S.; revising the duties of the
 3340         Department of Health as they relate to transitional
 3341         living facilities; amending s. 381.78, F.S.;
 3342         conforming provisions to changes made by the act;
 3343         creating s. 385.2035, F.S.; designating the Florida
 3344         Hospital Sanford-Burnham Translational Research
 3345         Institute for Metabolism and Diabetes as a resource
 3346         for diabetes research in this state; amending s.
 3347         394.4574, F.S.; providing that Medicaid prepaid
 3348         behavioral health plans are responsible for enrolled
 3349         mental health residents; providing that managing
 3350         entities under contract with the Department of
 3351         Children and Families are responsible for mental
 3352         health residents who are not enrolled with a Medicaid
 3353         prepaid behavioral health plan; deleting a provision
 3354         to conform to changes made by the act; requiring that
 3355         the community living support plan be completed and
 3356         provided to the administrator of a facility upon the
 3357         mental health resident’s admission; requiring the
 3358         community living support plan to be updated when there
 3359         is a significant change to the mental health
 3360         resident’s behavioral health; requiring the case
 3361         manager assigned to a mental health resident of an
 3362         assisted living facility that holds a limited mental
 3363         health license to keep a record of the date and time
 3364         of face-to-face interactions with the resident and to
 3365         make the record available to the responsible entity
 3366         for inspection; requiring that the record be
 3367         maintained for a specified time; requiring the
 3368         responsible entity to ensure that there is adequate
 3369         and consistent monitoring and enforcement of community
 3370         living support plans and cooperative agreements and
 3371         that concerns are reported to the appropriate
 3372         regulatory oversight organization under certain
 3373         circumstances; amending s. 394.741, F.S.; revising
 3374         references to certain accrediting organizations to
 3375         conform to changes made by the act; amending s.
 3376         395.0161, F.S.; deleting a requirement that hospitals
 3377         pay certain inspection fees at the time of the
 3378         inspection; repealing s. 395.1046, F.S., relating to
 3379         the investigation by the Agency for Health Care
 3380         Administration of certain complaints against
 3381         hospitals; amending s. 395.3038, F.S.; deleting an
 3382         obsolete provision relating to stroke centers;
 3383         revising references to certain accrediting
 3384         organizations to conform; repealing s. 395.40, F.S.;
 3385         amending s. 395.4001, F.S.; revising the definition of
 3386         the terms “level II trauma center” and “trauma
 3387         center”; amending s. 395.401, F.S.; revising the
 3388         components of plans for local and regional trauma
 3389         services systems; amending s. 395.4015, F.S.;
 3390         requiring regional trauma plans to recognize trauma
 3391         service areas that reflect well established patient
 3392         flow patterns; repealing s. 395.402, F.S.; amending
 3393         s. 395.4025, F.S.; establishing criteria for
 3394         designating Level II trauma centers in areas with
 3395         limited access to trauma center services; amending s.
 3396         395.701, F.S.; revising the definition of the term
 3397         “hospital” for purposes of annual assessments on net
 3398         operating revenues for inpatient and outpatient
 3399         services to fund public medical assistance; repealing
 3400         s. 395.7015, F.S., relating to annual assessments on
 3401         health care entities; amending s. 395.7016, F.S.;
 3402         revising a cross-reference to conform to changes made
 3403         by the act; amending ss. 397.403, F.S.; amending s.
 3404         400.0074, F.S.; providing that an administrative
 3405         assessment conducted by a local council be
 3406         comprehensive in nature and focus on factors affecting
 3407         the rights, health, safety, and welfare of the
 3408         residents of a nursing home; requiring a local council
 3409         to conduct an exit consultation with the facility
 3410         administrator or administrator designee to discuss
 3411         issues and concerns in areas affecting rights, health,
 3412         safety, and welfare of residents and make
 3413         recommendations for improvement; revising references
 3414         to certain accrediting organizations to conform to
 3415         changes made by the act; amending s. 400.0078, F.S.;
 3416         requiring that residents of long-term care facilities
 3417         be informed that retaliatory action cannot be taken
 3418         against a resident for presenting grievances or for
 3419         exercising any other resident right; amending s.
 3420         400.462, F.S.; defining the term “home health agency”
 3421         to include a Nurse Registry under certain
 3422         circumstances; repealing s. 400.805, F.S., relating to
 3423         transitional living facilities; providing that every
 3424         transitional living facility licensed under s.
 3425         400.805, F.S., on or before a specified date is
 3426         licensed under the provisions of the act; amending s.
 3427         400.925, F.S.; revising references to certain
 3428         accrediting organizations to conform to changes made
 3429         by the act; amending s. 400.93, F.S.; providing that
 3430         transitional living facilities licensed under part XI
 3431         of ch. 400, F.S., are exempt from home medical
 3432         equipment provider licensure; amending s. 400.9905,
 3433         F.S.; revising a definition; amending s. 400.9935,
 3434         F.S.; revising references to certain accrediting
 3435         organizations to conform to changes made by the act;
 3436         creating part XI of ch. 400, F.S., entitled
 3437         “Transitional Living Facilities”; creating s.
 3438         400.9970, F.S.; providing legislative intent; creating
 3439         s. 400.9971, F.S.; providing definitions; creating s.
 3440         400.9972, F.S.; requiring the licensure of
 3441         transitional living facilities; providing fees;
 3442         providing license application requirements; creating
 3443         s. 400.9973, F.S.; providing requirements for
 3444         transitional living facilities relating to client
 3445         admission, transfer, and discharge; creating s.
 3446         400.9974, F.S.; requiring a comprehensive treatment
 3447         plan to be developed for each client; providing plan
 3448         requirements; creating s. 400.9975, F.S.; providing
 3449         licensee responsibilities; providing notice
 3450         requirements; prohibiting a licensee or employee of a
 3451         facility from serving notice upon a client to leave
 3452         the premises or take other retaliatory action;
 3453         requiring the client and client’s representative to be
 3454         provided with certain information; requiring the
 3455         licensee to develop and implement certain policies and
 3456         procedures; creating s. 400.9976, F.S.; providing
 3457         licensee requirements relating to medication
 3458         practices; creating s. 400.9977, F.S.; providing
 3459         requirements for the screening of potential employees
 3460         and monitoring of employees for the protection of
 3461         clients; requiring licensees to implement certain
 3462         procedures; creating s. 400.9978, F.S.; requiring a
 3463         facility to provide a therapeutic milieu that supports
 3464         a culture of individual empowerment and
 3465         responsibility; providing that the health and safety
 3466         of the client is the primary concern of the facility;
 3467         providing requirements and limitations for the use of
 3468         physical restraints, seclusion, and chemical restraint
 3469         medication on clients; requiring the Agency for Health
 3470         Care Administration to adopt rules; creating s.
 3471         400.9979, F.S.; providing background screening
 3472         requirements; requiring the licensee to maintain
 3473         certain personnel records; providing administrative
 3474         responsibilities for licensees; providing
 3475         recordkeeping requirements; creating s. 400.9980,
 3476         F.S.; providing requirements relating to property and
 3477         personal affairs of clients; providing requirements
 3478         for a licensee with respect to obtaining surety bonds;
 3479         providing recordkeeping requirements relating to the
 3480         safekeeping of personal effects; providing
 3481         requirements for trust funds received by licensee and
 3482         credited to the client; providing a penalty for
 3483         certain misuse of a resident’s personal needs
 3484         allowance; providing criminal penalties for
 3485         violations; providing for the disposition of property
 3486         in the event of the death of a client; authorizing the
 3487         Agency for Health Care Administration to adopt rules;
 3488         creating s. 400.9981, F.S.; authorizing the agency to
 3489         adopt and enforce certain rules; creating s. 400.9982,
 3490         F.S.; providing procedures relating to violations and
 3491         penalties; providing administrative fines for
 3492         specified classes of violations; creating s. 400.9983,
 3493         F.S.; authorizing the agency to apply certain
 3494         provisions with regard to receivership proceedings;
 3495         creating s. 400.9984, F.S.; requiring the Agency for
 3496         Health Care Administration, the Department of Health,
 3497         the Agency for Persons with Disabilities, and the
 3498         Department of Children and Families to develop
 3499         electronic systems for certain purposes; amending s.
 3500         402.7306, F.S.; revising a reference to certain
 3501         accrediting organizations to conform to changes made
 3502         by the act; amending s. 408.061, F.S.; exempting
 3503         hospitals operated by state agencies from certain
 3504         annual fiscal experience reporting requirements;
 3505         amending s. 408.20, F.S.; exempting hospitals operated
 3506         by state agencies from certain assessments; amending
 3507         ss. 408.802 and 408.820, F.S.; conforming a provision
 3508         to changes made by the act; amending s. 408.809, F.S.;
 3509         adding additional disqualifying offenses to background
 3510         screening provisions; amending s. 409.9122, F.S.;
 3511         deleting a requirement that Medicaid recipients with
 3512         HIV/AIDS be referred to a Health Maintenance
 3513         Organization under contract with the agency; requiring
 3514         Medicaid recipients diagnosed with HIV/AIDS be
 3515         assigned to a managed care plan that is a health
 3516         maintenance organization under ch. 641, F.S., that is
 3517         under contract with the agency, and that offers a
 3518         delivery system through a university-based teaching
 3519         and research-oriented organization specializing in
 3520         treating individuals with HIV/AIDS; amending ss.
 3521         409.966 and 409.967, F.S.; revising references to
 3522         certain accrediting organizations to conform to
 3523         changes made by the act; amending s. 429.07, F.S.;
 3524         providing that an extended congregate care license is
 3525         issued to certain facilities that have been licensed
 3526         as assisted living facilities under certain
 3527         circumstances; providing the purpose of an extended
 3528         congregate care license; providing that the initial
 3529         extended congregate care license of an assisted living
 3530         facility is provisional under certain circumstances;
 3531         requiring the licensee to notify the Agency for Health
 3532         Care Administration whenever it accepts a resident who
 3533         qualifies for extended congregate care services;
 3534         requiring the agency to inspect the facility for
 3535         compliance with the requirements of an extended
 3536         congregate care license; authorizing the agency to
 3537         waive one of the required yearly monitoring visits
 3538         under certain circumstances; authorizing the agency to
 3539         deny or revoke a facility’s extended congregate care
 3540         license for certain reasons or on certain grounds;
 3541         requiring a registered nurse representing the agency
 3542         to visit the facility at least annually, rather than
 3543         twice a year, to monitor residents who are receiving
 3544         limited nursing services; providing that the agency’s
 3545         monitoring visits may be in conjunction with other
 3546         agency inspections; authorizing the agency to waive
 3547         one of the required yearly monitoring visits for
 3548         certain facilities; amending s. 429.075, F.S.;
 3549         requiring an assisted living facility that serves one
 3550         or more mental health residents to obtain a limited
 3551         mental health license; amending s. 429.14, F.S.;
 3552         revising the actions in which the agency may deny,
 3553         revoke, or suspend the license of an assisted living
 3554         facility and impose an administrative fine; revising
 3555         the criteria upon which the agency must deny or revoke
 3556         the license of an assisted living facility; requiring
 3557         the agency to impose an immediate moratorium on the
 3558         license of an assisted living facility under certain
 3559         circumstances; deleting a provision requiring the
 3560         agency to provide a list of facilities with denied,
 3561         suspended, or revoked licenses to the Department of
 3562         Business and Professional Regulation; exempting a
 3563         facility from the 45-day notice requirement if it is
 3564         required to relocate some or all of its residents;
 3565         amending s. 429.178, F.S.; conforming cross
 3566         references; amending s. 429.19, F.S.; revising the
 3567         amounts and uses of administrative fines; requiring
 3568         the agency to levy a fine for violations that are
 3569         corrected before an inspection if noncompliance
 3570         occurred within a specified period of time; deleting
 3571         factors that the agency is required to consider to
 3572         determine penalties and fines; amending s. 429.26,
 3573         F.S.; providing that certain residents may be admitted
 3574         to a standard licensed assisted living facility under
 3575         certain circumstances; amending s. 429.28, F.S.;
 3576         requiring that residents of facilities be informed
 3577         that the identity of the resident and complainant in a
 3578         complaint made to the State Long-Term Care Ombudsman
 3579         Program is confidential and that retaliatory action
 3580         cannot be taken against a resident for presenting
 3581         grievances or for exercising any other resident right;
 3582         providing that a facility that terminates an
 3583         individual’s residency is fined if good cause is not
 3584         shown in court; amending s. 429.34, F.S.; requiring
 3585         certain persons to report elder abuse in assisted
 3586         living facilities; requiring the agency to regularly
 3587         inspect every licensed assisted living facility;
 3588         requiring the agency to conduct more frequent
 3589         inspections under certain circumstances; requiring the
 3590         licensee to pay a fee for the cost of additional
 3591         inspections; requiring the agency to adjust the fee;
 3592         amending s. 429.52, F.S.; requiring each newly hired
 3593         employee of an assisted living facility to attend a
 3594         preservice orientation provided by the assisted living
 3595         facility; requiring the employee and administrator to
 3596         sign an affidavit upon completion of the preservice
 3597         orientation; requiring the assisted living facility to
 3598         maintain the signed affidavit in each employee’s work
 3599         file; conforming a cross-reference; requiring the
 3600         Agency for Health Care Administration to study the
 3601         reliability of facility surveys and submit to the
 3602         Governor and the Legislature its findings and
 3603         recommendations; requiring the agency to propose a
 3604         rating system of assisted living facilities for
 3605         consumers and create content for the agency’s website
 3606         that makes available to consumers information
 3607         regarding assisted living facilities; providing
 3608         criteria for the content; amending s. 430.80, F.S.;
 3609         revising references to certain accrediting
 3610         organizations to conform to changes made by the act;
 3611         amending s. 435.04, F.S.; revising information to be
 3612         submitted for a background screening; adding
 3613         additional disqualifying offenses; amending s. 435.07,
 3614         F.S.; revising terminology; requiring that individuals
 3615         seeking an exemption from disqualification have
 3616         completed all nonmonetary conditions imposed by the
 3617         court for the disqualifying felony; requiring that all
 3618         persons seeking an exemption from disqualification pay
 3619         any court-ordered monetary penalty in full before
 3620         being eligible to apply; amending s. 435.12, F.S.;
 3621         requiring that a photograph of the person taken at the
 3622         time the fingerprints are processed be submitted to
 3623         the Care Provider Background Screening Clearinghouse
 3624         before submission of the electronic fingerprints;
 3625         requiring specified information to be included with
 3626         the initiation of the screening registration within
 3627         the clearinghouse; amending s. 440.102, F.S.; revising
 3628         certain drug-testing standards for laboratories;
 3629         deleting a requirement that a laboratory comply with
 3630         certain criteria to conduct an initial analysis of
 3631         test specimens; deleting a monthly reporting
 3632         requirement for laboratories; amending s. 440.13,
 3633         F.S.; revising references to certain accrediting
 3634         organizations to conform to changes made by the act;
 3635         creating s. 465.1902, F.S.; providing that regulation
 3636         of the licensure, activity, and operation of
 3637         pharmacies and pharmacists is preempted to the state;
 3638         prohibiting a local government or political
 3639         subdivision of the state from enacting or enforcing an
 3640         ordinance that imposes a levy, charge, or fee upon, or
 3641         that otherwise regulates, pharmacies and pharmacists,
 3642         except for ordinances regarding local business taxes
 3643         and land development; amending s. 499.003, F.S.;
 3644         exempting prescription drugs transferred either
 3645         directly or through a hospital’s or health care
 3646         entity’s supplier or the manufacturer for the purpose
 3647         of repackaging from the definition of the term
 3648         “wholesale distribution”; amending s. 499.01, F.S.;
 3649         requiring a permit for prescription drug repackagers
 3650         located in other states who repackage and distribute
 3651         drugs for limited purposes into this state; amending
 3652         s. 499.01212, F.S.; requiring pedigree papers for
 3653         transfers pursuant to s. 499.003(54)(b)7., F.S., to
 3654         include specified information; amending 499.041, F.S.;
 3655         assessing an onsite inspection fee on a prescription
 3656         drug repackager applicant or licensee located out of
 3657         the state; amending ss. 627.645, 627.668, 627.669,
 3658         627.736, 641.495, and 766.1015, F.S.; revising
 3659         references to certain accrediting organizations to
 3660         conform to changes made by the act; creating s.
 3661         893.0552, F.S.; providing that regulation of the
 3662         licensure, activity, and operation of pain-management
 3663         clinics is preempted to the state under certain
 3664         circumstances; authorizing a local government or
 3665         political subdivision of the state to enact certain
 3666         ordinances regarding local business taxes and land
 3667         development; providing an effective date.