CODING: Words stricken are deletions; words underlined are additions.





                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    

                            CHAMBER ACTION
              Senate                               House
                                   .
                                   .
 1                                 .
                                   .
 2                                 .
                                   .
 3                                 .
                                   .
 4                                                                

 5

 6

 7

 8

 9

10                                                                

11  Senator Clary moved the following amendment:

12

13         Senate Amendment (with title amendment) 

14         Delete everything after the enacting clause

15

16  and insert:

17         Section 1.  Subsection (4) of section 20.41, Florida

18  Statutes, is amended to read:

19         20.41  Department of Elderly Affairs.--There is created

20  a Department of Elderly Affairs.

21         (4)  The department shall administratively house the

22  State Long-Term Care Ombudsman Council, created by s.

23  400.0067, and the local district long-term care ombudsman

24  councils, created by s. 400.0069 and shall, as required by s.

25  712 of the federal Older Americans Act of 1965, ensure that

26  both the state and local district long-term care ombudsman

27  councils operate in compliance with the Older Americans Act.

28  The councils in performance of their duties shall not be

29  subject to control, supervision, or direction by the

30  department.

31         Section 2.  Paragraph (h) of subsection (4) of section

                                  1
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  395.3025, Florida Statutes, is amended to read:

 2         395.3025  Patient and personnel records; copies;

 3  examination.--

 4         (4)  Patient records are confidential and must not be

 5  disclosed without the consent of the person to whom they

 6  pertain, but appropriate disclosure may be made without such

 7  consent to:

 8         (h)  The State Long-Term Care Ombudsman Council and the

 9  local district long-term care ombudsman councils, with respect

10  to the records of a patient who has been admitted from a

11  nursing home or long-term care facility, when the councils are

12  conducting an investigation involving the patient as

13  authorized under part II of chapter 400, upon presentation of

14  identification as a council member by the person making the

15  request.  Disclosure under this paragraph shall only be made

16  after a competent patient or the patient's representative has

17  been advised that disclosure may be made and the patient has

18  not objected.

19         Section 3.  Paragraph (b) of subsection (3) of section

20  400.0063, Florida Statutes, is amended to read:

21         400.0063  Establishment of Office of State Long-Term

22  Care Ombudsman; designation of ombudsman and legal advocate.--

23         (3)

24         (b)  The duties of the legal advocate shall include,

25  but not be limited to:

26         1.  Assisting the ombudsman in carrying out the duties

27  of the office with respect to the abuse, neglect, or violation

28  of rights of residents of long-term care facilities.

29         2.  Assisting the state and local district ombudsman

30  councils in carrying out their responsibilities under this

31  part.

                                  2
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1         3.  Initiating and prosecuting legal and equitable

 2  actions to enforce the rights of long-term care facility

 3  residents as defined in this chapter.

 4         4.  Serving as legal counsel to the state and local

 5  district ombudsman councils, or individual members thereof,

 6  against whom any suit or other legal action is initiated in

 7  connection with the performance of the official duties of the

 8  councils or an individual member.

 9         Section 4.  Paragraph (f) of subsection (1) and

10  subsections (2) and (3) of section 400.0065, Florida Statutes,

11  are amended to read:

12         400.0065  State Long-Term Care Ombudsman; duties and

13  responsibilities; conflict of interest.--

14         (1)  The purpose of the Office of State Long-Term Care

15  Ombudsman shall be to:

16         (f)  Provide administrative and technical assistance to

17  state and local district ombudsman councils.

18         (2)  The State Long-Term Care Ombudsman shall have the

19  duty and authority to:

20         (a)  Assist and support the efforts of the State

21  Long-Term Care Ombudsman Council in the establishment and

22  coordination of local district ombudsman councils throughout

23  the state.

24         (b)  Perform the duties specified in state and federal

25  law, rules, and regulations.

26         (c)  Within the limits of federal and state funding

27  authorized and appropriated, employ such personnel, including

28  staff for local district ombudsman councils, as are necessary

29  to perform adequately the functions of the office and provide

30  or contract for legal services to assist the state and local

31  district ombudsman councils in the performance of their

                                  3
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  duties.  Staff positions for each local district ombudsman

 2  council may be established as career service positions, and

 3  shall be filled by the ombudsman after in consultation with

 4  the respective local district ombudsman council.

 5         (d)  Contract for services necessary to carry out the

 6  activities of the office.

 7         (e)  Apply for, receive, and accept grants, gifts, or

 8  other payments, including, but not limited to, real property,

 9  personal property, and services from a governmental entity or

10  other public or private entity or person, and make

11  arrangements for the use of such grants, gifts, or payments.

12         (f)  Annually prepare a budget request that shall be

13  submitted to the Governor by the department for transmittal to

14  the Legislature.

15         (f)  Perform the duties specified in state and federal

16  law without interference by officials of the Department of

17  Elderly Affairs, the Agency for Health Care Administration, or

18  the Department of Children and Family Services. The ombudsman

19  shall report to the Governor, the President of the Senate, and

20  the Speaker of the House of Representatives whenever

21  organizational or departmental policy issues threaten the

22  ability of the Office of State Long-Term Care Ombudsman to

23  carry out its duties under state or federal law.

24         (g)  Coordinate, to the greatest extent possible, state

25  and local district ombudsman services with the protection and

26  advocacy systems for individuals with developmental

27  disabilities and mental illnesses and with legal assistance

28  programs for the poor through adoption of memoranda of

29  understanding and other means.

30         (h)  Enter into a cooperative agreement with the

31  statewide and district human rights advocacy committees for

                                  4
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  the purpose of coordinating advocacy services provided to

 2  residents of long-term care facilities.

 3         (i)  Enter into a cooperative agreement with the office

 4  of state government which is responsible for investigating

 5  Medicaid fraud.

 6         (3)  The State Long-Term Care Ombudsman shall not:

 7         (a)  Have a direct involvement in the licensing or

 8  certification of, or an ownership or investment interest in, a

 9  long-term care facility or a provider of a long-term care

10  service.

11         (b)  Be employed by, or participate in the management

12  of, a long-term care facility.

13         (c)  Receive, or have a right to receive, directly or

14  indirectly, remuneration, in cash or in kind, under a

15  compensation agreement with the owner or operator of a

16  long-term care facility.

17

18  The Department of Elderly Affairs, in consultation with the

19  ombudsman, shall adopt rules to establish procedures to

20  identify and eliminate conflicts of interest as described in

21  this subsection.

22         Section 5.  Section 400.0066, Florida Statutes, is

23  created to read:

24         400.0066  Long-Term Care Ombudsman and departments of

25  state government.--

26         (1)  The Long-Term Care Ombudsman shall perform the

27  duties specified in state and federal law.

28         (2)  Officials from the Department of Elderly Affairs,

29  the Agency for Health Care Administration, and the Department

30  of Children and Family Services shall not interfere in the

31  performance of official duties of any ombudsman staff or

                                  5
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  volunteers.

 2         (3)  The Department of Elderly Affairs shall provide

 3  administrative support to the ombudsman program. The

 4  department shall meet the costs associated with these

 5  functions from funds appropriated to the department.

 6         (4)  The department shall include the costs associated

 7  with support of the ombudsman program in developing its budget

 8  requests for consideration by the Governor and submittal to

 9  the Legislature.

10         (5)  The department may divert from the federal

11  ombudsman appropriation an amount not to exceed 10 percent of

12  the federal appropriation for the ombudsman.

13         Section 6.  Section 400.0067, Florida Statutes, is

14  amended to read:

15         400.0067  Establishment of State Long-Term Care

16  Ombudsman Council; duties; membership.--

17         (1)  There is created within the Office of State

18  Long-Term Care Ombudsman, the State Long-Term Care Ombudsman

19  Council.

20         (2)  The State Long-Term Care Ombudsman Council shall:

21         (a)  Assist the ombudsman in reaching a consensus among

22  local district ombudsman councils on issues of statewide

23  concern.

24         (b)  Serve as an appellate body in receiving from the

25  local district ombudsman councils complaints not resolved at

26  the local district level.  The state ombudsman council may

27  enter any long-term care facility involved in an appeal,

28  pursuant to the conditions specified in s. 400.0069(3).

29         (c)  Assist the ombudsman to discover, investigate, and

30  determine the existence of abuse or neglect in any long-term

31  care facility and to develop procedures, in consultation with

                                  6
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  the Department of Elderly Affairs, relating to such

 2  investigations. Investigations may consist, in part, of one or

 3  more onsite administrative inspections.

 4         (d)  Assist the ombudsman in eliciting, receiving,

 5  responding to, and resolving complaints made by or on behalf

 6  of long-term care facility residents and in developing

 7  procedures, in consultation with the Department of Elderly

 8  Affairs, relating to the receipt and resolution of such

 9  complaints.

10         (e)  Elicit and coordinate state, local, and voluntary

11  organizational assistance for the purpose of improving the

12  care received by residents of a long-term care facility.

13         (f)  Be authorized to call upon appropriate agencies of

14  state government for such professional assistance as may be

15  needed in the discharge of its duties, including assistance

16  from the adult protective services program of the Department

17  of Children and Family Services.

18         (g)  Enter into a cooperative agreement with the

19  statewide and district human rights advocacy committees for

20  the purpose of coordinating advocacy services provided to

21  residents of long-term care facilities.

22         (g)(h)  Prepare an annual report describing the

23  activities carried out by the ombudsman and the State

24  Long-Term Care Ombudsman Council in the year for which the

25  report is prepared.  The State Long-Term Care Ombudsman

26  Council shall submit the report to the Commissioner of the

27  United States Administration on Aging, the Governor, the

28  President of the Senate, the Speaker of the House of

29  Representatives, the minority leaders of the House and Senate,

30  the chairpersons of appropriate House and Senate committees,

31  the Secretaries of Elderly Affairs and Children and Family

                                  7
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  Services, and the Director of Health Care Administration.  The

 2  report shall be submitted at least 30 days before the

 3  convening of the regular session of the Legislature and shall,

 4  at a minimum:

 5         1.  Contain and analyze data collected concerning

 6  complaints about and conditions in long-term care facilities.

 7         2.  Evaluate the problems experienced by residents of

 8  long-term care facilities.

 9         3.  Contain recommendations for improving the quality

10  of life of the residents and for protecting the health,

11  safety, welfare, and rights of the residents.

12         4.  Analyze the success of the ombudsman program during

13  the preceding year and identify the barriers that prevent the

14  optimal operation of the program.  The report of the program's

15  successes shall also address the relationship between the

16  state long-term care ombudsman program, the Department of

17  Elderly Affairs, the Agency for Health Care Administration,

18  and the Department of Children and Family Services, and an

19  assessment of how successfully the state long-term care

20  ombudsman program has carried out its responsibilities under

21  the Older Americans Act.

22         5.  Provide policy and regulatory and legislative

23  recommendations to solve identified problems; resolve

24  residents' complaints; improve the quality of care and life of

25  the residents; protect the health, safety, welfare, and rights

26  of the residents; and remove the barriers to the optimal

27  operation of the state long-term care ombudsman program.

28         6.  Contain recommendations from the local district

29  ombudsman councils regarding program functions and activities.

30         7.  Include a report on the activities of the legal

31  advocate and other legal advocates acting on behalf of the

                                  8
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  local district and state councils.

 2         (3)(a)  The State Long-Term Care Ombudsman Council

 3  shall be composed of one active member designated by each

 4  local council plus three persons appointed by the Governor a

 5  number of members equal to the number of district councils in

 6  the state plus three.  Each district ombudsman council,

 7  including the ombudsman councils for subdistricts 3A and 3B,

 8  shall appoint one member and the Governor shall appoint three

 9  members to the State Long-Term Care Ombudsman Council.  An

10  individual designated by a district ombudsman council must

11  have been a member of a district ombudsman council for at

12  least 1 year, and shall continue to serve as an active member

13  at the district level.  The Governor's appointments shall be

14  made from a list of not fewer than eight nominees, to be

15  selected by the secretary in consultation with the State

16  Long-Term Care Ombudsman Council and submitted to the

17  Governor.  If the appointments are not made within 30 days

18  after the Governor receives the list of nominees, the

19  secretary shall, in consultation with the State Long-Term Care

20  Ombudsman Council, appoint three members from the list of

21  nominees submitted to the Governor.  At least one member

22  appointed by the Governor must be over 60 years of age.

23         (b)  The ombudsman, in consultation with the secretary

24  and the state ombudsman council, shall submit to the Governor

25  a list of at least eight names of persons who are not serving

26  on a local council.

27         (c)  The Governor shall appoint three members chosen

28  from the list, at least one of whom must be over 60 years of

29  age.

30         (d)  If the Governor's appointments are not made within

31  60 days after the ombudsman submits the list, the ombudsman,

                                  9
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  in consultation with the State Long-Term Care Ombudsman

 2  Council, shall appoint three members, one of whom must be over

 3  60 years of age.

 4         (e)(b)  All members shall be appointed to serve 3-year

 5  terms. A member of the State Long-Term Care Ombudsman Council

 6  may not serve more than two consecutive terms. Any vacancy

 7  shall be filled in the same manner as the original

 8  appointment. The position of any member missing three

 9  consecutive regular meetings without cause shall be declared

10  vacant. The finding of the ombudsman regarding cause shall be

11  final and binding.

12         (f)(c)  The state ombudsman council shall elect a

13  chairperson for a term of 1 year from among the members who

14  have served for at least 1 year.  The chairperson shall select

15  a vice chairperson from among the members.  The vice

16  chairperson shall preside over the council in the absence of

17  the chairperson.

18         (g)(d)  The state ombudsman council shall meet upon the

19  call of the chairperson, at least quarterly or more frequently

20  as needed.

21         (h)(e)  Members shall receive no compensation but shall

22  be reimbursed for per diem and travel expenses as provided in

23  s. 112.061.

24         (4)  Members shall be appointed and serve 3-year terms

25  as provided by this section.

26         (4)(5)  No officer, employee, or representative of the

27  Office of State Long-Term Care Ombudsman or of the State

28  Long-Term Care Ombudsman Council, nor any member of the

29  immediate family of such officer, employee, or representative,

30  may have a conflict of interest. The Department of Elderly

31  Affairs, in consultation with the ombudsman, shall adopt rules

                                  10
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  to identify and remove conflicts of interest.

 2         (5)(6)  The Department of Elderly Affairs shall make a

 3  separate and distinct request for an appropriation for all

 4  expenses for the state and local district ombudsman councils.

 5         Section 7.  Section 400.0069, Florida Statutes, is

 6  amended to read:

 7         400.0069  Local District long-term care ombudsman

 8  councils; duties; membership.--

 9         (1)  There shall be at least one long-term care

10  ombudsman council in each of the planning and service areas of

11  the Department of Elderly Affairs, which shall function under

12  the direction of the ombudsman and the state ombudsman

13  council.

14         (2)  The duties of the local district ombudsman council

15  are:

16         (a)  To serve as a third-party mechanism for protecting

17  the health, safety, welfare, and civil and human rights of

18  residents of a long-term care facility.

19         (b)  To discover, investigate, and determine the

20  existence of abuse or neglect in any long-term care facility

21  and to use the procedures provided for in ss. 415.101-415.113

22  when applicable. Investigations may consist, in part, of one

23  or more onsite administrative inspections.

24         (c)  To elicit, receive, investigate, respond to, and

25  resolve complaints made by, or on behalf of, long-term care

26  facility residents.

27         (d)  To review and, if necessary, to comment on, for

28  their effect on the rights of long-term care facility

29  residents, all existing or proposed rules, regulations, and

30  other governmental policies relating to long-term care

31  facilities.

                                  11
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1         (e)  To review personal property and money accounts of

 2  Medicaid residents pursuant to an investigation to obtain

 3  information regarding a specific complaint or problem.

 4         (f)  To represent the interests of residents before

 5  government agencies and to seek administrative, legal, and

 6  other remedies to protect the health, safety, welfare, and

 7  rights of the residents.

 8         (g)  To carry out other activities that the ombudsman

 9  determines to be appropriate.

10         (3)  In order to carry out the duties specified in

11  subsection (2), the local district ombudsman council is

12  authorized, pursuant to ss. 400.19(1) and 400.434, to enter

13  any long-term care facility without notice or first obtaining

14  a warrant, subject to the provisions of s. 400.0073(5).

15         (4)  Each local district ombudsman council shall be

16  composed of no less than 15 members and no more than 30

17  members from the local planning and service area district, to

18  include the following:  one medical or osteopathic physician

19  whose practice includes or has included a substantial number

20  of geriatric patients and who may have limited practice in a

21  long-term care facility; one registered nurse who has

22  geriatric experience, if possible; one licensed pharmacist;

23  one registered dietitian; at least six nursing home residents

24  or representative consumer advocates for nursing home

25  residents; at least three residents of assisted living

26  facilities or adult family-care homes or three representative

27  consumer advocates for long-term care facility residents; one

28  attorney; and one professional social worker.  In no case

29  shall the medical director of a long-term care facility or an

30  employee of the Agency for Health Care Administration, the

31  Department of Children and Family Services, or the Department

                                  12
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  of Elderly Affairs serve as a member or as an ex officio

 2  member of a council.  Each member of the council shall certify

 3  that neither the council member nor any member of the council

 4  member's immediate family has any conflict of interest

 5  pursuant to subsection (10).  Local District ombudsman

 6  councils are encouraged to recruit council members who are 60

 7  years of age or older.

 8         (5)  All members shall be appointed to serve 3-year

 9  terms.  Upon expiration of a term and in case of any other

10  vacancy, the council shall select appoint a replacement by

11  majority vote of the council, subject to the approval of the

12  Governor. The ombudsman shall review the selection of the

13  council and recommend approval or disapproval to the Governor.

14  If no action is taken by the Governor to approve or disapprove

15  the replacement of a member within 30 days after the ombudsman

16  council has notified the Governor of his or her

17  recommendation, the appointment, the appointment of the

18  replacement shall be considered disapproved and the process

19  for selection of a replacement shall be repeated approved. The

20  term of any member missing three consecutive regular meetings

21  without cause shall be declared vacant.

22         (6)  The local district ombudsman council shall elect a

23  chair for a term of 1 year from members who have served at

24  least 1 year.  The chair shall select a vice chair from among

25  the members of the council.  The vice chair shall preside over

26  the council in the absence of the chair.

27         (7)  The local district ombudsman council shall meet

28  upon the call of the chair or the ombudsman, at least once a

29  month or more frequently as needed to handle emergency

30  situations.

31         (8)  A member of a local district ombudsman council

                                  13
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  shall receive no compensation but shall be reimbursed for

 2  travel expenses both within and outside the county of

 3  residence in accordance with the provisions of s. 112.061.

 4         (9)  The local district ombudsman councils are

 5  authorized to call upon appropriate agencies of state

 6  government for such professional assistance as may be needed

 7  in the discharge of their duties. All state agencies shall

 8  cooperate with the local district ombudsman councils in

 9  providing requested information and agency representatives at

10  council meetings. The Department of Children and Family

11  Services shall continue to provide space and in-kind

12  administrative support for each district ombudsman council

13  staff within available resources until the Legislature

14  appropriates funds for office space and administrative

15  support.

16         (10)  No officer, employee, or representative of a

17  local district long-term care ombudsman council, nor any

18  member of the immediate family of such officer, employee, or

19  representative, may have a conflict of interest. The

20  Department of Elderly Affairs, in consultation with the

21  ombudsman, shall adopt rules to identify and remove conflicts

22  of interest.

23         Section 8.  Section 400.0071, Florida Statutes, is

24  amended to read:

25         400.0071  Complaint procedures.--

26         (1)  The state ombudsman council shall establish state

27  and local district procedures for receiving complaints against

28  a nursing home or long-term care facility or its employee.

29         (2)  These procedures shall be posted in full view in

30  every nursing home or long-term care facility.  Every resident

31  or representative of a resident shall receive, upon admission

                                  14
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  to a nursing home or long-term care facility, a printed copy

 2  of the procedures of the state and the local district

 3  ombudsman councils.

 4         Section 9.  Section 400.0073, Florida Statutes, is

 5  amended to read:

 6         400.0073  State and local district ombudsman council

 7  investigations.--

 8         (1)  A local district ombudsman council shall

 9  investigate any complaint of a resident or representative of a

10  resident based on an action by an administrator or employee of

11  a nursing home or long-term care facility which might be:

12         (a)  Contrary to law.

13         (b)  Unreasonable, unfair, oppressive, or unnecessarily

14  discriminatory, even though in accordance with law.

15         (c)  Based on a mistake of fact.

16         (d)  Based on improper or irrelevant grounds.

17         (e)  Unaccompanied by an adequate statement of reasons.

18         (f)  Performed in an inefficient manner.

19         (g)  Otherwise erroneous.

20         (2)  In an investigation, both the state and local

21  district ombudsman councils have the authority to hold

22  hearings.

23         (3)  Subsequent to an appeal from a local district

24  ombudsman council, the state ombudsman council may investigate

25  any nursing home or long-term care facility.

26         (4)  In addition to any specific investigation made

27  pursuant to a complaint, the local district ombudsman council

28  shall conduct, at least annually, an investigation, which

29  shall consist, in part, of an onsite administrative

30  inspection, of each nursing home or long-term care facility

31  within its jurisdiction.

                                  15
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1         (5)  Any onsite administrative inspection conducted by

 2  an ombudsman council shall be subject to the following:

 3         (a)  All inspections shall be at times and for

 4  durations necessary to produce the information required to

 5  carry out the duties of the council.

 6         (b)  No advance notice of an inspection shall be

 7  provided to any nursing home or long-term care facility,

 8  except that notice of followup inspections on specific

 9  problems may be provided.

10         (c)  Inspections shall be conducted in a manner which

11  will impose no unreasonable burden on nursing homes or

12  long-term care facilities, consistent with the underlying

13  purposes of this part. Unnecessary duplication of efforts

14  among council members or the councils shall be reduced to the

15  extent possible.

16         (d)  Any ombudsman council member physically present

17  for the inspection shall identify himself or herself and the

18  statutory authority for his or her inspection of the facility.

19         (e)  Inspections may not unreasonably interfere with

20  the programs and activities of clients within the facility.

21  Ombudsman council members shall respect the rights of

22  residents.

23         (f)  All inspections shall be limited to compliance

24  with parts II, III, and VII of this chapter and 42 U.S.C. ss.

25  1396(a) et seq., and any rules or regulations promulgated

26  pursuant to such laws.

27         (g)  No ombudsman council member shall enter a

28  single-family residential unit within a long-term care

29  facility without the permission of the resident or the

30  representative of the resident.

31         (h)  Any inspection resulting from a specific complaint

                                  16
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  made to an ombudsman council concerning a facility shall be

 2  conducted within a reasonable time after the complaint is

 3  made.

 4         (6)  An inspection may not be accomplished by forcible

 5  entry. Refusal of a long-term care facility to allow entry of

 6  any ombudsman council member constitutes a violation of part

 7  II, part III, or part VII of this chapter.

 8         Section 10.  Section 400.0075, Florida Statutes, is

 9  amended to read:

10         400.0075  Complaint resolution procedures.--

11         (1)  Any complaint, including any problem identified by

12  an ombudsman council as a result of an investigation, deemed

13  valid and requiring remedial action by the local district

14  ombudsman council shall be identified and brought to the

15  attention of the long-term care facility administrator in

16  writing.  Upon receipt of such document, the administrator, in

17  concurrence with the local district ombudsman council chair,

18  shall establish target dates for taking appropriate remedial

19  action.  If, by the target date, the remedial action is not

20  completed or forthcoming, the local district ombudsman council

21  may:

22         (a)  Extend the target date if the council has reason

23  to believe such action would facilitate the resolution of the

24  complaint.

25         (b)  In accordance with s. 400.0077, publicize the

26  complaint, the recommendations of the council, and the

27  response of the long-term care facility.

28         (c)  Refer the complaint to the state ombudsman

29  council.

30

31  If the health, safety, welfare, or rights of the resident are

                                  17
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  in imminent danger, the local district long-term care

 2  ombudsman council may seek immediate legal or administrative

 3  remedies to protect the resident.

 4         (2)  Upon referral from the local district ombudsman

 5  council, the state ombudsman council shall assume the

 6  responsibility for the disposition of the complaint.  If a

 7  long-term care facility fails to take action on a complaint

 8  found valid by the state ombudsman council, the state council

 9  may:

10         (a)  In accordance with s. 400.0077, publicize the

11  complaint, the recommendations of the council, and the

12  response of the long-term care facility.

13         (b)  Recommend to the agency a series of facility

14  reviews pursuant to s. 400.19(4) to assure correction and

15  nonrecurrence of conditions that give rise to complaints

16  against a long-term care facility.

17         (c)  Recommend to the agency changes in rules for

18  inspecting and licensing or certifying long-term care

19  facilities, and recommend to the Agency for Health Care

20  Administration changes in rules for licensing and regulating

21  long-term care facilities.

22         (d)  Refer the complaint to the state attorney for

23  prosecution if there is reason to believe the long-term care

24  facility or its employee is guilty of a criminal act.

25         (e)  Recommend to the Agency for Health Care

26  Administration that the long-term care facility no longer

27  receive payments under the State Medical Assistance Program

28  (Medicaid).

29         (f)  Recommend that the agency initiate procedures for

30  revocation of license in accordance with chapter 120.

31         (g)  Seek legal, administrative, or other remedies to

                                  18
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  protect the health, safety, welfare, or rights of the

 2  resident.

 3

 4  If the health, safety, welfare, or rights of the resident are

 5  in imminent danger, the State Long-Term Care Ombudsman Council

 6  shall seek immediate legal or administrative remedies to

 7  protect the resident.

 8         (3)  The state ombudsman council shall provide, as part

 9  of its annual report required pursuant to s.

10  400.0067(2)(g)(h), information relating to the disposition of

11  all complaints to the Department of Elderly Affairs.

12         Section 11.  Paragraph (a) of subsection (1) and

13  subsections (4) and (5) of section 400.0077, Florida Statutes,

14  are amended to read:

15         400.0077  Confidentiality.--

16         (1)  The following are confidential and exempt from the

17  provisions of s. 119.07(1):

18         (a)  Resident records held by the ombudsman or by the

19  state or a local district ombudsman council.

20         (4)  Members of any state or local district ombudsman

21  council shall not be required to testify in any court with

22  respect to matters held to be confidential under s. 400.414

23  except as may be necessary to enforce the provisions of this

24  act.

25         (5)  Subject to the provisions of this section, the

26  Department of Elderly Affairs, in consultation with the

27  ombudsman and the State Long-Term Care Ombudsman Council,

28  shall adopt rules for the disclosure by the ombudsman or local

29  district ombudsman councils of files maintained by the

30  program.

31         Section 12.  Subsection (2) of section 400.0079,

                                  19
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  Florida Statutes, is amended to read:

 2         400.0079  Immunity.--

 3         (2)  The ombudsman or any person acting on behalf of

 4  the Office of State Long-Term Care Ombudsman or the state or a

 5  local district long-term care ombudsman council shall be

 6  immune from any liability, civil or criminal, that otherwise

 7  might be incurred or imposed, during the good faith

 8  performance of official duties.

 9         Section 13.  Section 400.0081, Florida Statutes, is

10  amended to read:

11         400.0081  Access.--

12         (1)  The Office of State Long-Term Care Ombudsman, the

13  State Long-Term Care Ombudsman Council, and the local district

14  long-term care ombudsman councils, or their representatives,

15  shall have access to:

16         (a)  Long-term care facilities and residents.

17         (b)  Medical and social records of a resident for

18  review, if:

19         1.  The office has the permission of the resident or

20  the legal representative of the resident; or

21         2.  The resident is unable to consent to the review and

22  has no legal representative.

23         (c)  Medical and social records of the resident as

24  necessary to investigate a complaint, if:

25         1.  A legal guardian of the resident refuses to give

26  permission.

27         2.  The office has reasonable cause to believe that the

28  guardian is not acting in the best interests of the resident.

29         3.  The representative obtains the approval of the

30  ombudsman.

31         (d)  The administrative records, policies, and

                                  20
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  documents to which the residents, or the general public, have

 2  access.

 3         (e)  Upon request, copies of all licensing and

 4  certification records maintained by the state with respect to

 5  a long-term care facility.

 6         (2)  Notwithstanding paragraph (1)(b), if, pursuant to

 7  a complaint investigation by the state ombudsman council or a

 8  local district ombudsman council, the legal representative of

 9  the resident refuses to give permission for the release of the

10  resident's records, and if the Office of the State Long-Term

11  Care Ombudsman Council has reasonable cause to find that the

12  legal representative is not acting in the best interests of

13  the resident, the medical and social records of the resident

14  must be made available to the state or local district council

15  as is necessary for the members of the council to investigate

16  the complaint.

17         (3)  The Department of Elderly Affairs, in consultation

18  with the ombudsman and the State Long-Term Care Ombudsman

19  Council, shall adopt rules to establish procedures to ensure

20  access as described in this section.

21         Section 14.  Subsections (1) and (2) of section

22  400.0083, Florida Statutes, are amended to read:

23         400.0083  Interference; retaliation; penalties.--

24         (1)  It shall be unlawful for any person, long-term

25  care facility, or other entity to willfully interfere with a

26  representative of the Office of the State Long-Term Care

27  Ombudsman, the State Long-Term Care Ombudsman Council, or a

28  local district long-term care ombudsman council in the

29  performance of official duties.

30         (2)  It shall be unlawful for any person, long-term

31  care facility, or other entity to retaliate against any

                                  21
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  resident, employee, or other person for filing a complaint

 2  with, providing information to, or otherwise cooperating with

 3  any representative of the Office of the State Long-Term Care

 4  Ombudsman, the State Long-Term Care Ombudsman Council, or a

 5  local district long-term care ombudsman council.

 6         Section 15.  Section 400.0087, Florida Statutes, is

 7  amended to read:

 8         400.0087  Agency oversight.--

 9         (1)  The Department of Elderly Affairs shall monitor

10  the local district ombudsman councils responsible for carrying

11  out the duties delegated by s. 400.0069 and federal law.  The

12  department, in consultation with the ombudsman and the State

13  Long-Term Care Ombudsman Council, shall adopt rules to

14  establish the policies and procedures for the monitoring of

15  local district ombudsman councils.

16         (2)  The department is responsible for ensuring that

17  the Office of State Long-Term Care Ombudsman prepares its

18  annual report; provides information to public and private

19  agencies, legislators, and others; provides appropriate

20  training to representatives of the office or of the state or

21  local district long-term care ombudsman councils; and

22  coordinates ombudsman services with the Advocacy Center for

23  Persons with Disabilities and with providers of legal services

24  to residents of long-term care facilities in compliance with

25  state and federal laws.

26         (3)  The Department of Elderly Affairs is the

27  designated state unit on aging for purposes of complying with

28  the federal Older Americans Act. The Department of Elderly

29  Affairs shall ensure that the ombudsman program has the

30  objectivity and independence required to qualify it for

31  funding under the federal Older Americans Act, and shall carry

                                  22
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  out the long-term care ombudsman program through the Office of

 2  the State Long-Term Care Ombudsman Council.  The Department of

 3  Elderly Affairs shall also:

 4         (a)  Receive and disburse state and federal funds for

 5  purposes that the state ombudsman council has formulated in

 6  accordance with the Older Americans Act.

 7         (b)  Act as liaison between the federal program

 8  representatives, the staffs of the state and local district

 9  ombudsman councils, and members of the state and local

10  district ombudsman councils.

11         Section 16.  Section 400.0089, Florida Statutes, is

12  amended to read:

13         400.0089  Agency reports.--The State Long-Term Care

14  Ombudsman Council, shall, in cooperation with the Department

15  of Elderly Affairs, maintain a statewide uniform reporting

16  system to collect and analyze data relating to complaints and

17  conditions in long-term care facilities and to residents, for

18  the purpose of identifying and resolving significant problems.

19  The council shall submit such data as part of its annual

20  report required pursuant to s. 400.0067(2)(g)(h) to the Agency

21  for Health Care Administration, the Department of Children and

22  Family Services, the Statewide Human Rights Advocacy

23  Committee, the Advocacy Center for Persons with Disabilities,

24  the Commissioner for the United States Administration on

25  Aging, the National Ombudsman Resource Center, and any other

26  state or federal entities that the ombudsman determines

27  appropriate.

28         Section 17.  Section 400.0091, Florida Statutes, is

29  amended to read:

30         400.0091  Training.--The ombudsman shall provide

31  appropriate training to all employees of the Office of State

                                  23
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  Long-Term Care Ombudsman and to the state and local district

 2  long-term care ombudsman councils, including all unpaid

 3  volunteers.  The ombudsman shall implement the training

 4  program no later than June 1, 1994.  No employee, officer, or

 5  representative of the office or of the state or local district

 6  long-term care ombudsman councils, other than the ombudsman,

 7  may carry out any authorized ombudsman duty or responsibility

 8  unless the person has received the training required by this

 9  section and has been approved by the ombudsman as qualified to

10  carry out ombudsman activities on behalf of the office or the

11  state or local district long-term care ombudsman councils.

12         Section 18.  Present subsections (8), (9), and (10) of

13  section 400.021, Florida Statutes, are renumbered as

14  subsections (7), (8), and (9), respectively, and present

15  subsection (7) is renumbered as subsection (10) and amended to

16  read:

17         400.021  Definitions.--When used in this part, unless

18  the context otherwise requires, the term:

19         (10)(7)  "Local District ombudsman council" means a

20  local district long-term care ombudsman council established

21  pursuant to s. 400.0069, located within the Older Americans

22  Act planning and service areas.

23         Section 19.  Paragraph (c) of subsection (1) and

24  subsections (2) and (3) of section 400.022, Florida Statutes,

25  are amended to read:

26         400.022  Residents' rights.--

27         (1)  All licensees of nursing home facilities shall

28  adopt and make public a statement of the rights and

29  responsibilities of the residents of such facilities and shall

30  treat such residents in accordance with the provisions of that

31  statement.  The statement shall assure each resident the

                                  24
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  following:

 2         (c)  Any entity or individual that provides health,

 3  social, legal, or other services to a resident has the right

 4  to have reasonable access to the resident.  The resident has

 5  the right to deny or withdraw consent to access at any time by

 6  any entity or individual. Notwithstanding the visiting policy

 7  of the facility, the following individuals must be permitted

 8  immediate access to the resident:

 9         1.  Any representative of the federal or state

10  government, including, but not limited to, representatives of

11  the Department of Children and Family Services, the Department

12  of Health, the Agency for Health Care Administration, the

13  Office of the Attorney General, and the Department of Elderly

14  Affairs; any law enforcement officer; members of the state or

15  local district ombudsman council; and the resident's

16  individual physician.

17         2.  Subject to the resident's right to deny or withdraw

18  consent, immediate family or other relatives of the resident.

19

20  The facility must allow representatives of the State Long-Term

21  Care Ombudsman Council to examine a resident's clinical

22  records with the permission of the resident or the resident's

23  legal representative and consistent with state law.

24         (2)  The licensee for each nursing home shall orally

25  inform the resident of the resident's rights and provide a

26  copy of the statement required by subsection (1) to each

27  resident or the resident's legal representative at or before

28  the resident's admission to a facility.  The licensee shall

29  provide a copy of the resident's rights to each staff member

30  of the facility.  Each such licensee shall prepare a written

31  plan and provide appropriate staff training to implement the

                                  25
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  provisions of this section.  The written statement of rights

 2  must include a statement that a resident may file a complaint

 3  with the agency or local district ombudsman council. The

 4  statement must be in boldfaced type and shall include the

 5  name, address, and telephone numbers of the local district

 6  ombudsman council and adult abuse registry where complaints

 7  may be lodged.

 8         (3)  Any violation of the resident's rights set forth

 9  in this section shall constitute grounds for action by the

10  agency under the provisions of s. 400.102.  In order to

11  determine whether the licensee is adequately protecting

12  residents' rights, the annual inspection of the facility shall

13  include private informal conversations with a sample of

14  residents to discuss residents' experiences within the

15  facility with respect to rights specified in this section and

16  general compliance with standards, and consultation with the

17  ombudsman council in the local district in which the nursing

18  home is located.

19         Section 20.  Subsections (8), (9), (11), (12), (13),

20  and (14) of section 400.0255, Florida Statutes, are amended to

21  read:

22         400.0255  Resident transfer or discharge; requirements

23  and procedures; hearings.--

24         (8)  The notice required by subsection (7) must be in

25  writing and must contain all information required by state and

26  federal law, rules, or regulations applicable to Medicaid or

27  Medicare cases. The agency shall develop a standard document

28  to be used by all facilities licensed under this part for

29  purposes of notifying residents of a discharge or transfer.

30  Such document must include a means for a resident to request

31  the local district long-term care ombudsman council to review

                                  26
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  the notice and request information about or assistance with

 2  initiating a fair hearing with the department's Office of

 3  Appeals Hearings. In addition to any other pertinent

 4  information included, the form shall specify the reason

 5  allowed under federal or state law that the resident is being

 6  discharged or transferred, with an explanation to support this

 7  action. Further, the form shall state the effective date of

 8  the discharge or transfer and the location to which the

 9  resident is being discharged or transferred. The form shall

10  clearly describe the resident's appeal rights and the

11  procedures for filing an appeal, including the right to

12  request the local district ombudsman council to review the

13  notice of discharge or transfer. A copy of the notice must be

14  placed in the resident's clinical record, and a copy must be

15  transmitted to the resident's legal guardian or representative

16  and to the local district ombudsman council.

17         (9)  A resident may request that the local district

18  ombudsman council review any notice of discharge or transfer

19  given to the resident. When requested by a resident to review

20  a notice of discharge or transfer, the local district

21  ombudsman council shall do so within 7 days after receipt of

22  the request. The nursing home administrator, or the

23  administrator's designee, must forward the request for review

24  contained in the notice to the local district ombudsman

25  council within 24 hours after such request is submitted.

26  Failure to forward the request within 24 hours after the

27  request is submitted shall toll the running of the 30-day

28  advance notice period until the request has been forwarded.

29         (11)  Notwithstanding paragraph (10)(b), an emergency

30  discharge or transfer may be implemented as necessary pursuant

31  to state or federal law during the period of time after the

                                  27
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  notice is given and before the time a hearing decision is

 2  rendered. Notice of an emergency discharge or transfer to the

 3  resident, the resident's legal guardian or representative, and

 4  the local district ombudsman council if requested pursuant to

 5  subsection (9) must be by telephone or in person. This notice

 6  shall be given before the transfer, if possible, or as soon

 7  thereafter as practicable. A local district ombudsman council

 8  conducting a review under this subsection shall do so within

 9  24 hours after receipt of the request. The resident's file

10  must be documented to show who was contacted, whether the

11  contact was by telephone or in person, and the date and time

12  of the contact. If the notice is not given in writing, written

13  notice meeting the requirements of subsection (8) must be

14  given the next working day.

15         (12)  After receipt of any notice required under this

16  section, the local district ombudsman council may request a

17  private informal conversation with a resident to whom the

18  notice is directed, and, if known, a family member or the

19  resident's legal guardian or designee, to ensure that the

20  facility is proceeding with the discharge or transfer in

21  accordance with the requirements of this section. If

22  requested, the local district ombudsman council shall assist

23  the resident with filing an appeal of the proposed discharge

24  or transfer.

25         (13)  The following persons must be present at all

26  hearings authorized under this section:

27         (a)  The resident, or the resident's legal

28  representative or designee.

29         (b)  The facility administrator, or the facility's

30  legal representative or designee.

31

                                  28
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  A representative of the local district long-term care

 2  ombudsman council may be present at all hearings authorized by

 3  this section.

 4         (14)  In any hearing under this section, the following

 5  information concerning the parties shall be confidential and

 6  exempt from the provisions of s. 119.07(1):

 7         (a)  Names and addresses.

 8         (b)  Medical services provided.

 9         (c)  Social and economic conditions or circumstances.

10         (d)  Evaluation of personal information.

11         (e)  Medical data, including diagnosis and past history

12  of disease or disability.

13         (f)  Any information received verifying income

14  eligibility and amount of medical assistance payments.  Income

15  information received from the Social Security Administration

16  or the Internal Revenue Service must be safeguarded according

17  to the requirements of the agency that furnished the data.

18

19  The exemption created by this subsection does not prohibit

20  access to such information by a local district long-term care

21  ombudsman council upon request, by a reviewing court if such

22  information is required to be part of the record upon

23  subsequent review, or as specified in s. 24(a), Art. I of the

24  State Constitution.

25         Section 21.  Subsection (1) of section 400.19, Florida

26  Statutes, is amended to read:

27         400.19  Right of entry and inspection.--

28         (1)  The agency and any duly designated officer or

29  employee thereof or a member of the State Long-Term Care

30  Ombudsman Council or the local district long-term care

31  ombudsman council shall have the right to enter upon and into

                                  29
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  the premises of any facility licensed pursuant to this part,

 2  or any distinct nursing home unit of a hospital licensed under

 3  chapter 395 or any freestanding facility licensed under

 4  chapter 395 that provides extended care or other long-term

 5  care services, at any reasonable time in order to determine

 6  the state of compliance with the provisions of this part and

 7  rules in force pursuant thereto.  The right of entry and

 8  inspection shall also extend to any premises which the agency

 9  has reason to believe is being operated or maintained as a

10  facility without a license, but no such entry or inspection of

11  any premises shall be made without the permission of the owner

12  or person in charge thereof, unless a warrant is first

13  obtained from the circuit court authorizing same.  Any

14  application for a facility license or renewal thereof, made

15  pursuant to this part, shall constitute permission for and

16  complete acquiescence in any entry or inspection of the

17  premises for which the license is sought, in order to

18  facilitate verification of the information submitted on or in

19  connection with the application; to discover, investigate, and

20  determine the existence of abuse or neglect; or to elicit,

21  receive, respond to, and resolve complaints. The agency shall,

22  within 60 days after receipt of a complaint made by a resident

23  or resident's representative, complete its investigation and

24  provide to the complainant its findings and resolution.

25         Section 22.  Subsection (1) of section 400.191, Florida

26  Statutes, is amended to read:

27         400.191  Availability, distribution, and posting of

28  reports and records.--

29         (1)  The agency shall provide information to the public

30  about all of the licensed nursing home facilities operating in

31  the state. The agency shall, within 60 days after an annual

                                  30
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  inspection visit or within 30 days after any interim visit to

 2  a facility, send copies of the inspection reports to the local

 3  district long-term care ombudsman council, the agency's local

 4  office, and a public library or the county seat for the county

 5  in which the facility is located.

 6         Section 23.  Subsection (6) and paragraph (c) of

 7  subsection (7) of section 400.23, Florida Statutes, are

 8  amended to read:

 9         400.23  Rules; evaluation and deficiencies; licensure

10  status.--

11         (6)  Prior to conducting a survey of the facility, the

12  survey team shall obtain a copy of the local district

13  long-term care ombudsman council report on the facility.

14  Problems noted in the report shall be incorporated into and

15  followed up through the agency's inspection process. This

16  procedure does not preclude the local district nursing home

17  and long-term care facility ombudsman council from requesting

18  the agency to conduct a followup visit to the facility.

19         (7)  The agency shall, at least every 15 months,

20  evaluate all nursing home facilities and make a determination

21  as to the degree of compliance by each licensee with the

22  established rules adopted under this part as a basis for

23  assigning a licensure status to that facility.  The agency

24  shall base its evaluation on the most recent inspection

25  report, taking into consideration findings from other official

26  reports, surveys, interviews, investigations, and inspections.

27  The agency shall assign a licensure status of standard or

28  conditional to each nursing home.

29         (c)  In evaluating the overall quality of care and

30  services and determining whether the facility will receive a

31  conditional or standard license, the agency shall consider the

                                  31
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  needs and limitations of residents in the facility and the

 2  results of interviews and surveys of a representative sampling

 3  of residents, families of residents, ombudsman council members

 4  in the planning and service area district in which the

 5  facility is located, guardians of residents, and staff of the

 6  nursing home facility.

 7         Section 24.  Subsection (13) of section 400.419,

 8  Florida Statutes, is amended to read:

 9         400.419  Violations; administrative fines.--

10         (13)  The agency shall develop and disseminate an

11  annual list of all facilities sanctioned or fined $5,000 or

12  more for violations of state standards, the number and class

13  of violations involved, the penalties imposed, and the current

14  status of cases. The list shall be disseminated, at no charge,

15  to the Department of Elderly Affairs, the Department of

16  Health, the Department of Children and Family Services, the

17  area agencies on aging, the Statewide Human Rights Advocacy

18  Committee, and the state and local district nursing home

19  ombudsman councils. The Department of Children and Family

20  Services shall disseminate the list to service providers under

21  contract to the department who are responsible for referring

22  persons to a facility for residency. The agency may charge a

23  fee commensurate with the cost of printing and postage to

24  other interested parties requesting a copy of this list.

25         Section 25.  Subsection (2) of section 400.428, Florida

26  Statutes, is amended to read:

27         400.428  Resident bill of rights.--

28         (2)  The administrator of a facility shall ensure that

29  a written notice of the rights, obligations, and prohibitions

30  set forth in this part is posted in a prominent place in each

31  facility and read or explained to residents who cannot read.

                                  32
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  This notice shall include the name, address, and telephone

 2  numbers of the local district ombudsman council and adult

 3  abuse registry and, when applicable, the Advocacy Center for

 4  Persons with Disabilities, Inc., and the district human rights

 5  advocacy committee, where complaints may be lodged.  The

 6  facility must ensure a resident's access to a telephone to

 7  call the local district ombudsman council, adult abuse

 8  registry, Advocacy Center for Persons with Disabilities, Inc.,

 9  and district human rights advocacy committee.

10         Section 26.  Section 400.434, Florida Statutes, is

11  amended to read:

12         400.434  Right of entry and inspection.--Any duly

13  designated officer or employee of the department, the

14  Department of Children and Family Services, the agency, the

15  state or local fire marshal, or a member of the state or local

16  district long-term care ombudsman council shall have the right

17  to enter unannounced upon and into the premises of any

18  facility licensed pursuant to this part in order to determine

19  the state of compliance with the provisions of this part and

20  of rules or standards in force pursuant thereto.  The right of

21  entry and inspection shall also extend to any premises which

22  the agency has reason to believe is being operated or

23  maintained as a facility without a license; but no such entry

24  or inspection of any premises may be made without the

25  permission of the owner or person in charge thereof, unless a

26  warrant is first obtained from the circuit court authorizing

27  such entry.  The warrant requirement shall extend only to a

28  facility which the agency has reason to believe is being

29  operated or maintained as a facility without a license.  Any

30  application for a license or renewal thereof made pursuant to

31  this part shall constitute permission for, and complete

                                  33
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  acquiescence in, any entry or inspection of the premises for

 2  which the license is sought, in order to facilitate

 3  verification of the information submitted on or in connection

 4  with the application; to discover, investigate, and determine

 5  the existence of abuse or neglect; or to elicit, receive,

 6  respond to, and resolve complaints. Any current valid license

 7  shall constitute unconditional permission for, and complete

 8  acquiescence in, any entry or inspection of the premises by

 9  authorized personnel.  The agency shall retain the right of

10  entry and inspection of facilities that have had a license

11  revoked or suspended within the previous 24 months, to ensure

12  that the facility is not operating unlawfully. However, before

13  entering the facility, a statement of probable cause must be

14  filed with the director of the agency, who must approve or

15  disapprove the action within 48 hours.  Probable cause shall

16  include, but is not limited to, evidence that the facility

17  holds itself out to the public as a provider of personal care

18  services or the receipt of a complaint by the long-term care

19  ombudsman council about the facility.

20         Section 27.  Subsection (2) of section 400.435, Florida

21  Statutes, is amended to read:

22         400.435  Maintenance of records; reports.--

23         (2)  Within 60 days after the date of the biennial

24  inspection visit or within 30 days after the date of any

25  interim visit, the agency shall forward the results of the

26  inspection to the local district ombudsman council in whose

27  planning and service area, as defined in part II, the facility

28  is located; to at least one public library or, in the absence

29  of a public library, the county seat in the county in which

30  the inspected assisted living facility is located; and, when

31  appropriate, to the district adult services and district

                                  34
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  alcohol, drug abuse, and mental health program offices.

 2         Section 28.  Paragraph (i) of subsection (1) and

 3  subsection (5) of section 400.4415, Florida Statutes, are

 4  amended to read:

 5         400.4415  Assisted living facilities advisory

 6  committee.--

 7         (1)  There is created the assisted living facilities

 8  advisory committee, which shall assist the agency in

 9  developing and implementing a pilot rating system for

10  facilities. The committee shall consist of nine members who

11  are to be appointed by, and report directly to, the director

12  of the agency.  The membership is to include:

13         (i)  One consumer representative from a local district

14  long-term care ombudsman council.

15         (5)  In determining the rating and evaluating the

16  overall quality of care and services, the agency shall

17  consider the needs and limitations of residents in the

18  facility and the results of interviews and surveys of a

19  representative sampling of residents, families of residents,

20  long-term care ombudsman council members in the planning and

21  service area district in which the facility is located,

22  guardians of residents, and staff of the facility.

23         Section 29.  Subsection (7) of section 400.619, Florida

24  Statutes, is amended to read:

25         400.619  Licensure application and renewal.--

26         (7)  Access to a licensed adult family-care home must

27  be provided at reasonable times for the appropriate officials

28  of the department, the Department of Health, the Department of

29  Children and Family Services, the agency, and the State Fire

30  Marshal, who are responsible for the development and

31  maintenance of fire, health, sanitary, and safety standards,

                                  35
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  to inspect the facility to assure compliance with these

 2  standards.  In addition, access to a licensed adult

 3  family-care home must be provided at reasonable times for the

 4  local district long-term care ombudsman council.

 5         Section 30.  Subsection (2) of section 400.628, Florida

 6  Statutes, is amended to read:

 7         400.628  Residents' bill of rights.--

 8         (2)  The provider shall ensure that residents and their

 9  legal representatives are made aware of the rights,

10  obligations, and prohibitions set forth in this part.

11  Residents must also be given the names, addresses, and

12  telephone numbers of the local district ombudsman council and

13  the adult abuse registry where they may lodge complaints.

14         Section 31.  (1)  The sum of $40,000 is appropriated

15  from the General Revenue Fund to the Long-Term Care Ombudsman

16  Program in the Department of Elderly Affairs to be used for

17  training members of the state and local long-term care

18  ombudsman councils.

19         (2)  The sum of $40,000 is appropriated from the

20  General Revenue Fund to the Long-Term Care Ombudsman Program

21  in the Department of Elderly Affairs to be used for materials

22  to educate residents of long-term care facilities, their

23  families, visitors, facility staff, and the public about the

24  ombudsman program and to encourage people to seek assistance

25  from the Long-Term Care Ombudsman Program.

26         Section 32.  This act shall take effect July 1, 2000.

27

28

29  ================ T I T L E   A M E N D M E N T ===============

30  And the title is amended as follows:

31         Delete everything before the enacting clause

                                  36
    6:42 PM   04/25/00                               h1539.hc07.1a




                                                  SENATE AMENDMENT

    Bill No. CS/HB 1539, 1st Eng.

    Amendment No.    





 1  and insert:

 2                      A bill to be entitled

 3         An act relating to the long-term care ombudsman

 4         program; amending s. 400.0065, F.S.; providing

 5         duty of the State Long-Term Care Ombudsman to

 6         prepare and submit annual budget requests;

 7         creating s. 400.0066, F.S.; specifying

 8         additional duties of the Long-Term Care

 9         Ombudsman and other state agencies; limiting

10         administrative charges; amending ss. 400.0067

11         and 400.0069, F.S.; revising provisions

12         relating to appointment and terms of service of

13         members of the state and local ombudsman

14         councils; amending ss. 400.0077, 400.0081, and

15         400.0087, F.S.; providing authority of the

16         Office of State Long-Term Care Ombudsman to

17         adopt rules relating to disclosure of files

18         maintained by the program, access to facilities

19         and residents, and monitoring of local

20         ombudsman councils by the Department of Elderly

21         Affairs; deleting rulemaking authority of the

22         department; amending ss. 20.41, 395.3025,

23         400.0063, 400.0071, 400.0073, 400.0075,

24         400.0079, 400.0083, 400.0089, 400.0091,

25         400.021, 400.022, 400.0255, 400.19, 400.191,

26         400.23, 400.419, 400.428, 400.434, 400.435,

27         400.4415, 400.619, and 400.628, F.S.;

28         clarifying and conforming references and

29         cross-references; providing appropriations;

30         providing an effective date.

31

                                  37
    6:42 PM   04/25/00                               h1539.hc07.1a