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





                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  The Committee on Elder Affairs & Long-Term Care offered the

12  following:

13

14         Amendment (with title amendment) 

15  Remove from the bill:  Everything after the enacting clause

16

17  and insert in lieu thereof:

18         Section 1.  Section 430.03, Florida Statutes, is

19  amended to read:

20         430.03  Purposes.--The purposes of the Department of

21  Elderly Affairs are to:

22         (1)  Advise, assist, protect, and advocate for the

23  state's elderly residents.

24         (2)(1)  Serve as the primary state agency responsible

25  for administering human services programs for the elderly and

26  for developing policy recommendations for long-term care.

27         (3)(2)  Combat ageism and create public awareness and

28  understanding of the potentials and needs of elderly persons.

29         (4)(3)  Study and plan for programs and services to

30  meet identified and projected needs and to provide

31  opportunities for personal development and achievement of

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  persons aged 60 years and older.

 2         (5)(4)  Advocate quality programs and services for the

 3  state's elderly population and on behalf of the individual

 4  citizen's needs.

 5         (6)(5)  Coordinate interdepartmental policy development

 6  and program planning for all state agencies that provide

 7  services for the elderly population in order to prevent

 8  duplicative efforts, to maximize utilization of resources, and

 9  to ensure cooperation, communication, and departmental

10  linkages.

11         (7)(6)  Recommend state and local level organizational

12  models for the planning, coordination, implementation, and

13  evaluation of programs serving the elderly population.

14         (8)(7)  Oversee implementation of federally funded and

15  state-funded programs and services for the state's elderly

16  population.

17         (8)  Recommend legislative budget requests for programs

18  and services for the state's elderly population.

19         (9)  Review and comment upon state plans, budgets, and

20  policies which affect older individuals and provide technical

21  assistance to any agency, organization, association, or person

22  representing the needs of older individuals.

23         (10)(9)  Serve as a state-level information

24  clearinghouse and encourage the development of local-level

25  identifiable points of information and referral regarding all

26  federal, state, and local resources of assistance to elderly

27  citizens.

28         (11)(10)  Assist elderly persons to secure needed

29  services in accordance with personal choice and in a manner

30  that achieves or maintains autonomy and prevents, reduces, or

31  eliminates dependency.

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1         (12)(11)  Promote the maintenance and improvement of

 2  the physical well-being and mental health of elderly persons.

 3         (13)(12)  Promote opportunities for volunteerism among

 4  the elderly population.

 5         (14)(13)  Promote the prevention of neglect, abuse, or

 6  exploitation of elderly persons unable to protect their own

 7  interests.

 8         (15)(14)  Eliminate and prevent inappropriate

 9  institutionalization of elderly persons by promoting

10  community-based care, home-based care, or other forms of less

11  intensive care.

12         (16)(15)  Aid in the support of families and other

13  caregivers of elderly persons.

14         (17)(16)  Promote intergenerational relationships.

15         (17)  Oversee aging research conducted or funded by any

16  state agency to ensure that such activities are coordinated

17  and directed to fulfill the intent and purposes of this act.

18         (18)  Establish and maintain a management information

19  system which facilitates the collection, integration, and

20  dissemination of data collected by the department and its

21  contractees relevant to aging programs and elder issues.

22         Section 2.  Section 430.035, Florida Statutes, is

23  created to read:

24         430.035  Definitions.--As used in this chapter, the

25  term:

26         (1)  "Area agencies on aging" or "area agency" means a

27  public or private nonprofit agency or organization designated

28  by the department pursuant to s. 430.075.  An area agency on

29  aging serves as both the advocate and the visible focal point

30  in its planning and service area for planning and fostering

31  the development of comprehensive and coordinated service

                                  3

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  systems to serve elderly persons.

 2         (2)  "Community care service area" means a service area

 3  within a planning and service area.

 4         (3)  "Elder," "elderly person," or "older person" means

 5  any person 60 years of age or older.

 6         (4)  "Functionally impaired" means any person who has

 7  been determined, according to the department's assessment, to

 8  have physical or mental limitations that restrict the person's

 9  ability to perform the activities of daily living and that

10  impede the person's capacity to live independently without the

11  provision of supportive services.

12         (5)  "Lead agency" means an agency selected by an area

13  agency on aging to conduct care planning, provide case

14  management, direct services, and coordinate the activities of

15  individual agencies contracting to provide community care for

16  the elderly services within a community care service area.

17  Lead agencies may elect not to provide services directly.

18         (6)  "Multiservice senior center" means a facility that

19  serves as the focal point for housing and delivering services

20  to persons 60 years of age or older.

21         (7)  "Planning and service area" means a geographic

22  area designated by the department, in which the programs of

23  the department are administered and services are delivered.

24         (8)  "Service coordination" means assisting

25  functionally impaired elders and case managers in identifying,

26  accessing, and arranging for appropriate cost-effective

27  services. Service coordination helps to eliminate barriers and

28  ensure continuing and reliable services.

29         (9)  "State plan on aging" means the service plan

30  developed by the department which evaluates service needs of

31  the elderly, identifies priority services and target client

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  groups, provides for periodic evaluation of activities and

 2  services funded under the plan, and provides for

 3  administration of funds available through the federal Older

 4  Americans Act. The state plan on aging must be based upon area

 5  plans on aging developed by the area agencies on aging in

 6  order that the priorities and conditions of local communities

 7  are taken into consideration.

 8         Section 3.  Subsections (1), (2), and (3) of section

 9  430.05, Florida Statutes, are amended to read:

10         430.05  Department of Elderly Affairs Advisory

11  Council.--

12         (1)  There is created the Department of Elderly Affairs

13  Advisory Council which shall be located for administrative

14  purposes in the department of Elderly Affairs.  It is the

15  intent of the Legislature that the advisory council shall be

16  an independent nonpartisan body and shall not be subject to

17  control, supervision, or direction by the department.

18         (2)  The council shall serve in an advisory capacity to

19  the Secretary of Elderly Affairs to assist the secretary in

20  carrying out the purposes, duties, and responsibilities of the

21  department, as specified in this chapter and s. 20.41.  The

22  council may make recommendations to the secretary, the

23  Governor, the Speaker of the House of Representatives, and the

24  President of the Senate regarding organizational issues and

25  additions or reductions in the department's duties and

26  responsibilities.

27         (3)(a)  The advisory council shall be composed of one

28  member appointed by the Governor from each of the department's

29  state's planning and service areas, which are designated in

30  accordance with the Older Americans Act, two additional

31  members appointed by the Governor, two members appointed by

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  the President of the Senate, and two members appointed by the

 2  Speaker of the House of Representatives. The members shall be

 3  appointed in the following manner:

 4         1.  The Governor shall appoint one member from each

 5  planning and service area and shall select each appointment

 6  from a list of three nominations submitted by the designated

 7  area agency on aging in each planning and service area.

 8  Nominations submitted by an area agency on aging shall be

 9  solicited from a broad cross section of the public, private,

10  and volunteer sectors of each county in the respective

11  planning and service area.  At least one of the three

12  nominations submitted by an area agency on aging shall be a

13  person 60 years of age or older.

14         2.  The Governor shall appoint two additional members,

15  one of whom shall be 60 years of age or older.

16         3.  The President of the Senate shall appoint two

17  members, one of whom shall be 60 years of age or older.

18         4.  The Speaker of the House of Representatives shall

19  appoint two members, one of whom shall be 60 years of age or

20  older.

21         5.  The Governor shall ensure that a majority of the

22  members of the advisory council shall be 60 years of age or

23  older and reflect the state's diversity that there shall be

24  balanced minority and gender representation.

25         6.  The Governor shall designate annually a member of

26  the advisory council to serve as chair.

27         7.  The Secretary of Elderly Affairs shall serve as an

28  ex officio member of the advisory council.

29         (b)  Members shall be appointed to 3-year staggered

30  terms. Vacancies occurring in the middle of a term shall be

31  filled only for the remainder of the term in order to maintain

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  staggered appointments. in the following manner:

 2         1.  In order to stagger the terms of office, one of the

 3  initial appointees of the President of the Senate shall be

 4  appointed to a 2-year term and one of the initial appointees

 5  of the Speaker of the House of Representatives shall be

 6  appointed to a 2-year term.  Additionally, one-third of the

 7  total initial appointees of the Governor shall be appointed to

 8  1-year terms, one-third shall be appointed to 2-year terms,

 9  and one-third to 3-year terms.  If the initial appointments of

10  the Governor are not of a number divisible into thirds, and

11  there results one additional appointee, that appointee shall

12  be appointed to a 2-year term.  If the initial appointments of

13  the Governor are not of a number divisible into thirds, and

14  there results two additional appointees, one of the additional

15  appointees shall be appointed to a 1-year term and the other

16  appointee shall be appointed to a 2-year term.

17         2.  Vacancies occurring during an appointee's initial

18  term shall be filled in the same manner as the initial

19  appointments, pursuant to subparagraph 1. After the terms

20  referred to in subparagraph 1. have expired, members shall be

21  appointed to 3-year terms.

22         Section 4.  Section 430.075, Florida Statutes, is

23  created to read:

24         430.075  Area agencies on aging.--In accordance with

25  Pub. L. No. 89-73, the federal Older Americans Act of 1965, as

26  amended, the department shall designate area agencies on aging

27  in each of the department's planning and service areas.

28         (1)  The department shall contract with the area agency

29  on aging governing body, hereafter referred to as the "board,"

30  to fulfill programmatic and funding requirements.

31         (a)  The board shall be responsible for the overall

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  direction of the area agency on aging's programs and services

 2  and shall ensure that the area agency is administered in

 3  accordance with the terms of its contract with the department,

 4  state and federal laws, rules, and regulations, established

 5  area agency policies, and cost-effective and efficient

 6  management principles.

 7         (b)  The board shall ensure the accountability of the

 8  area agency to the local communities in the area agency's

 9  planning and service area.

10         (c)  The board, in consultation with the secretary of

11  the department, shall appoint a chief executive officer,

12  hereafter referred to as the "executive director," to whom

13  shall be delegated responsibility for area agency management

14  and for implementation of board policy.

15         (2)  The area agency on aging shall:

16         (a)  Collect, maintain, and report to the department

17  data as directed by the department in rule or in contract.

18         (b)  Maintain financial stability sufficient to meet

19  contractual obligations and use restricted or contract funds

20  appropriately.

21         (c)  Maintain spending within budgetary allocations and

22  ensure that contracted service providers do not exceed

23  budgetary allocations.

24         (d)  Expand or continue the provision of services after

25  the declaration of a state of emergency.

26         (e)  Implement and maintain a department-approved

27  client grievance resolution procedure.

28         (f)  Provide a "comprehensive and coordinated system"

29  for providing all necessary supportive services, including

30  nutrition services, in a manner designed to:

31         1.  Facilitate accessibility to, and use of, all

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  supportive services and nutrition services provided within the

 2  geographic area served by such system by any public or private

 3  agency or organization;

 4         2.  Develop and make the most efficient use of

 5  supportive services and nutrition services in meeting the

 6  needs of older individuals;

 7         3.  Use available resources efficiently and with a

 8  minimum of duplication; and

 9         4.  Encourage and assist public and private entities

10  that have unrealized potential for meeting the service needs

11  of older individuals to assist the older individuals on a

12  voluntary basis.

13         (3)  Each area agency on aging shall prepare a plan as

14  required by the federal Older Americans Act and shall submit

15  the plan to the department for approval. In addition to the

16  federally required elements, the plan shall include the

17  following:

18         (a)  A detailed description of the design and structure

19  of the community care for the elderly program within the

20  planning and service area.

21         (b)  Documentation of public hearings held to receive

22  testimony and comment about the design and structure of the

23  community care for the elderly service system. Area agencies

24  shall actively seek participation in the public hearings from

25  elders, caregivers, volunteers, service providers, lead

26  agencies, providers not currently providing community care for

27  the elderly services, and representatives of culturally

28  distinct communities.

29         (c)  The geographic area of each community care service

30  area within the planning and service area.

31         (d)  Provisions that identify and ensure equal access,

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  coordination, and delivery of services to culturally distinct

 2  communities within community care service areas.

 3         (4)  The area agency shall be subject to disciplinary

 4  action by the department, including imposition of corrective

 5  action requirements, unannounced special monitoring, temporary

 6  assumption by the department of the operation of the agency,

 7  placement of the area agency on probationary status,

 8  imposition of a moratorium on area agency action, imposition

 9  of financial penalties for nonperformance including the

10  withholding of funds, and rescinding of the area agency's

11  designation, if the department finds that the area agency:

12         (a)  Has failed to comply with the requirements of

13  subsection (2);

14         (b)  Has committed an intentional or negligent act that

15  has materially affected the health, welfare, or safety of

16  elderly persons;

17         (c)  Has committed multiple or repeated violations of

18  statutory or regulatory requirements or department standards;

19  or

20         (d)  Has failed to adhere to the terms of its contract

21  with the department.

22         (5)  Area agencies on aging are public entities,

23  subject to chapter 119, relating to public records, and when

24  considering any contracts requiring the expenditure of public

25  funds, are subject to ss. 286.011-286.012, relating to public

26  meetings.

27         (6)  When adequate services are not available in a

28  planning and service area, an area agency on aging may

29  directly provide services as permitted by federal regulation

30  and with the concurrence of the department. Such direct

31  provision of services shall be for a limited period of time

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  until a request for proposals or an invitation to negotiate

 2  can be executed and a contract commenced.

 3         (7)  The department shall adopt rules as necessary to

 4  implement this section.

 5         Section 5.  Section 430.202, Florida Statutes, is

 6  amended to read:

 7         430.202  Community care for the elderly; legislative

 8  intent.--The purpose of ss. 430.201-430.207 is to assist

 9  functionally impaired elderly persons to live in living

10  dignified and reasonably independent lives in their own homes,

11  or in the homes of relatives or caregivers, through the

12  development, expansion, reorganization, and coordination of

13  various community-based services.  The Legislature intends

14  that a coordinated continuum of care be established so that

15  functionally impaired elderly persons age 60 and older may age

16  in place in be assured the least restrictive, most

17  cost-effective, safe environment suitable to meeting their

18  needs. The Legislature intends that those functionally

19  impaired elders who are the most frail be served first,

20  provided that it has been determined that maintaining such

21  persons in their homes does not exceed the average annual cost

22  of nursing home care and does not jeopardize their safety. The

23  development of innovative approaches to program management,

24  staff training, and service delivery which have an impact on

25  cost-avoidance, cost-effectiveness, and program efficiency,

26  including the use of volunteers, is encouraged.

27         Section 6.  Section 430.203, Florida Statutes, is

28  amended to read:

29         430.203  Community care for the elderly;

30  definitions.--As used in ss. 430.201-430.207, the term:

31         (1)  "Assessment" means an evaluation of an elder

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  person's health and physical, economic, and social conditions

 2  to identify needs and to develop a care plan. Assessment also

 3  includes an evaluation of the capacity of any caregivers to

 4  continue providing care.

 5         (2)  "Care plan" means a written description of how the

 6  individual's needs will be addressed to help maintain or

 7  improve the person's health and physical and social well-being

 8  in the least restrictive, most cost-effective, safe

 9  environment.

10         (3)  "Caregiver" means a family member or other

11  individual who has responsibility for the care of an elderly

12  person, either voluntarily, by contract, by receipt of payment

13  for care, or as a result of the operation of law.

14         (4)  "Case aide services" means providing, under the

15  direction of a case manager, assistance with accessing

16  resources and services, and facilitating linkages with service

17  providers.

18         (5)  "Case management" means assessing, planning,

19  implementing, or supervising the implementation of a care plan

20  by arranging, coordinating, and facilitating the services

21  needed.  Case management includes the development of formal

22  and informal resources, advocacy, monitoring, evaluating, and

23  adjusting services and service delivery on an ongoing basis.

24         (1)  "Area agency on aging" means a public or nonprofit

25  private agency or office designated by the department to

26  coordinate and administer the department's programs and to

27  provide, through contracting agencies, services within a

28  planning and service area.  An area agency on aging serves as

29  both the advocate and the visible focal point in its planning

30  and service area to foster the development of comprehensive

31  and coordinated service systems to serve older individuals.

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1         (2)  "Community care service area" means a service area

 2  within a planning and service area.

 3         (3)  "Community care service system" means a service

 4  network comprising a variety of home-delivered services, day

 5  care services, and other basic services, hereinafter referred

 6  to as "core services," for functionally impaired elderly

 7  persons which are provided by several agencies under the

 8  direction of a single lead agency.  Its purpose is to provide

 9  a continuum of care encompassing a full range of preventive,

10  maintenance, and restorative services for functionally

11  impaired elderly persons.

12         (4)  "Contracting agency" means an area agency on

13  aging, a lead agency, or any other agency contracting to

14  provide program administration or to provide services.

15         (5)  "Core services" means a variety of home-delivered

16  services, day care services, and other basic services that may

17  be provided by several entities.  Core services are those

18  services that are most needed to prevent unnecessary

19  institutionalization.  The area agency on aging shall not

20  directly provide core services.

21         (6)  "Department" means the Department of Elderly

22  Affairs.

23         (7)  "Functionally impaired elderly person" means any

24  person, 60 years of age or older, having physical or mental

25  limitations that restrict individual ability to perform the

26  normal activities of daily living and that impede individual

27  capacity to live independently without the provision of core

28  services.  Functional impairment shall be determined through a

29  functional assessment administered to each applicant for

30  community-care-for-the-elderly core services. The functional

31  assessment shall be developed by the department.

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1         (8)  "Health maintenance services" means those routine

 2  health services that are necessary to help maintain the health

 3  of a functionally impaired elderly person, but that are

 4  limited to medical therapeutic services, nonmedical prevention

 5  services, personal care services, home health aide services,

 6  home nursing services, and emergency response systems.

 7         (9)  "Lead agency" means an agency designated at least

 8  once every 3 years by an area agency on aging as the result of

 9  a request for proposal process to be in place no later than

10  the state fiscal year 1996-1997.

11         (a)  The guidelines for the request for proposal must

12  be developed by the department in consultation with the area

13  agencies on aging.  Such guidelines must include requirements

14  for the assurance of quality and cost-efficiency of services,

15  minimum personnel standards, and employee benefits.

16         (b)  The area agency on aging, in consultation with the

17  department, may exempt from the competitive bid process any

18  contract with a provider who meets or exceeds established

19  minimum standards, as determined by the department.

20         (c)  In each community care service system the lead

21  agency must be given the authority and responsibility to

22  coordinate some or all of the services, either directly or

23  through subcontracts, for functionally impaired elderly

24  persons. These services must include case management and may

25  include homemaker and chore services, respite care, adult day

26  care, personal care services, home-delivered meals,

27  counseling, information and referral, and emergency home

28  repair services.  The lead agency must compile community care

29  statistics and monitor, when applicable, subcontracts with

30  agencies providing core services.

31         (10)  "Multiservice senior center" means a facility

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  that serves as the focal point for housing and delivering

 2  services to persons 60 years of age or older.

 3         (11)  "Personal care services" means services to assist

 4  with bathing, dressing, ambulation, housekeeping, supervision,

 5  emotional security, eating, supervision of self-administered

 6  medications, and assistance in securing health care from

 7  appropriate sources.  Personal care services does not include

 8  medical services.

 9         (12)  "Planning and service area" means a geographic

10  service area established by the department, in which the

11  programs of the department are administered and services are

12  delivered.

13         (13)  "State Plan on Aging" means the service plan

14  developed by the department which evaluates service needs of

15  the elderly, identifies priority services and target client

16  groups, provides for periodic evaluation of activities and

17  services funded under the plan, and provides for

18  administration of funds available through the federal Older

19  Americans Act. The state plan on aging must be based upon area

20  plans on aging developed by the area agencies on aging in

21  order that the priorities and conditions of local communities

22  are taken into consideration.

23         Section 7.  Section 430.205, Florida Statutes, is

24  amended to read:

25         430.205  Community care for the elderly program service

26  system.--

27         (1)  The department, through the area agency on aging,

28  shall fund in each planning and service area at least one

29  community care for the elderly program service system that

30  provides case management and other in-home and community

31  services as needed to help the older person maintain

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  independence and prevent or delay more costly institutional

 2  care. It is the Legislature's preference that each community

 3  care service area be served by a single lead agency unless

 4  elders' needs are not being met. The department shall ensure

 5  that each local community care for the elderly program is

 6  given by the area agency on aging the flexibility to purchase

 7  those services that are needed in that area pursuant to the

 8  area plan. Those services may include, but are not limited to:

 9  adult day care; assessment; care planning; case aide; case

10  management; chore; companion; consumable medical supplies;

11  counseling; emergency alert response; emergency home repair;

12  escort; home health aide; homemaker; home-delivered meals;

13  home nursing; legal assistance; respite; shopping assistance;

14  and transportation. The care plan must be adjusted as the

15  consumer's needs change. The community care for the elderly

16  program is one part of the comprehensive and coordinated

17  system in each planning and service area.

18         (2)  Lead agencies shall be selected every 3 years

19  pursuant to a request for proposals or an invitation to

20  negotiate issued by the area agency. Core services and other

21  support services may be furnished by public or private

22  agencies or organizations.  Each community care service system

23  must be under the direction of a lead agency that coordinates

24  the activities of individual contracting agencies providing

25  community-care-for-the-elderly services.  When practicable,

26  the activities of a community care service area must be

27  directed from a multiservice senior center and coordinated

28  with other services offered therein. This subsection does not

29  require programs in existence prior to the effective date of

30  this act to be relocated.

31         (a)  The area agency shall select lead agencies using

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  guidelines developed by the department and adopted by rule, in

 2  consultation with the area agencies on aging. Such guidelines

 3  must:

 4         1.  Promote high-quality, elder-friendly,

 5  cost-effective services.

 6         2.  Encourage better and more accessible services

 7  through competition among service providers, and ensure

 8  consumer choice.

 9         3.  Ensure that case managers and service coordinators

10  act on behalf of consumers.

11         4.  Ensure that referrals for services are not made to

12  benefit one provider over another equally qualified provider.

13         (b)  An area agency on aging, in consultation with the

14  department, may exempt from competitive selection requirements

15  any lead agency that meets department established minimum

16  standards.

17         (c)  Each lead agency must compile and submit to the

18  department community care for the elderly program data and

19  statistics for its service area as required by the department.

20         (3)  The department shall define each core service that

21  is to be provided or coordinated within a community care

22  service area and establish rules and minimum standards for the

23  delivery of core services.

24         (4)  The department shall ensure that the community

25  care for the elderly services are monitored by the area

26  agencies on aging.

27         (a)  This monitoring shall include, but not be limited

28  to, information provided directly to the area agency on aging

29  by individuals receiving services, caregivers, family members,

30  and volunteers, related to the services received and the

31  extent to which the services meet the needs of the individual.

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  The monitoring shall consider compliance with all requirements

 2  of this section.

 3         (b)  When the area agency determines, in consultation

 4  with the department, that the needs of elders within a

 5  community care service area are not being met by the lead

 6  agency in the area, and the lead agency has been given

 7  reasonable opportunity to remove the deficiency and has

 8  failed, the area agency may issue a request for proposal or

 9  invitation to negotiate for one or more additional lead

10  agencies. The department shall adopt rules establishing the

11  standards against which a lead agency shall be evaluated for

12  compliance with the requirements of this section, prior to the

13  issuance by the area agency of a request for proposal or

14  invitation to negotiate.

15         (5)  The department may conduct or contract for

16  research and demonstration projects to determine the

17  desirability of new concepts of organization, administration,

18  regulation, or service delivery designed to prevent or delay

19  the institutionalization of functionally impaired elderly

20  persons. Evaluations shall be made of the cost-effectiveness

21  cost-avoidance of such demonstration projects, the ability of

22  the projects to reduce the rate of placement of functionally

23  impaired elderly persons in long-term care institutions, any

24  effect on reducing hospitalizations, and the impact of

25  projects on the use of institutional services and facilities.

26  The department shall report to the Legislature annually on the

27  status, results, and costs of all research and demonstration

28  projects.

29         (6)(4)  A preservice and inservice training program for

30  community-care-for-the-elderly service providers and staff may

31  be designed and implemented to help ensure assure the delivery

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  of quality services. The department shall specify in rules the

 2  training standards and requirements for the

 3  community-care-for-the-elderly service providers and staff.

 4  Training must be sufficient to ensure that quality services

 5  are provided to consumers clients and that appropriate skills

 6  are developed to conduct the program.

 7         (7)(5)  The level of functional impairment shall be

 8  determined through an assessment administered to each

 9  applicant pursuant to criteria developed by the department and

10  adopted by rule. Any person who has been classified as a

11  functionally impaired elderly person is eligible to receive

12  community care for the elderly community-care-for-the-elderly

13  core services. However, the assessment criteria shall permit

14  the department to prioritize service delivery to those most at

15  risk for nursing home placement, provided that it has been

16  determined that maintaining the person in the home provides

17  the most cost-effective delivery of needed care and does not

18  jeopardize the person's safety. Those elderly persons who are

19  determined by adult protective services to be elderly persons

20  in need of services, pursuant to s. 415.1045(2)(b), or to be

21  victims of abuse, neglect, or exploitation who are in need of

22  immediate services to prevent further harm and are referred by

23  adult protective services, shall be given primary

24  consideration for receiving community-care-for-the-elderly

25  services. As used in this subsection, "primary consideration"

26  means that an assessment and services must commence within 72

27  hours after referral to the department or as established in

28  accordance with department contracts by local protocols

29  developed between department service providers and adult

30  protective services. The department shall serve first those

31  individuals most in need as determined by the assessment,

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  regardless of referral source.

 2         (8)  In order to maximize resources, services shall

 3  also be obtained through:

 4         (a)  The Florida Plan for Medical Assistance under

 5  Title XIX of the Social Security Act, private insurance, or

 6  benefits available through a corporate retirement program.

 7         (b)  The state plan developed by the department

 8  pursuant to s. 305 of Pub. L. No. 89-73 of the federal Older

 9  Americans Act, as amended.

10         (c)  Health care taxing districts.

11         (d)  Religious or charitable organizations or volunteer

12  programs.

13         (9)  The department shall adopt rules establishing

14  standards for the provision of care and for the screening,

15  selection, training, and supervision of service providers and

16  staff providing services pursuant to this program.

17         Section 8.  Section 430.2055, Florida Statutes, is

18  created to read:

19         430.2055  Community care for the elderly program

20  service contracts and copayments.--

21         (1)  The department or its designee agency shall

22  contract with public or private agencies or organizations for

23  the provision of services required by a community care for the

24  elderly program. Unless the department determines that the

25  health, safety, or welfare of elderly persons is otherwise in

26  jeopardy, an area agency on aging shall be the designee agency

27  of preference. The contracting agency shall ensure that all

28  other funding sources and informal community resources

29  available have been considered prior to utilizing community

30  care for the elderly program funds. The department and

31  contracting agency may accept gifts and grants in order to

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  fund services within a community care service area.

 2         (2)  Agencies or organizations contracting to provide

 3  community care for the elderly services under ss.

 4  430.201-430.207 must provide a minimum of 10 percent of the

 5  funding necessary for the support of project operations.

 6  In-kind contributions, and contributions of money or services,

 7  may be evaluated and counted as part or all of the required

 8  local funding.

 9         (3)  Funds appropriated for community care for the

10  elderly must be used only for the provision of community care

11  for the elderly services and directly related expenditures.

12  The department may provide advance funding for a community

13  care for the elderly program. When no feasible alternatives

14  exist within the planning and service area, the department may

15  contract for or directly provide services for a regulation and

16  with the concurrence of the department, for a limited period

17  of time until a request for proposal or an invitation to

18  negotiate can be executed and a contract commenced.

19         (4)  The department, in consultation with the area

20  agencies on aging and lead agencies, shall adopt a copayment

21  schedule in rule. The copayment schedule shall be proportional

22  to the functionally impaired elderly person's overall ability

23  to pay. At the time of the initial assessment, a copayment in

24  accordance with the department's adopted copayment schedule

25  shall be assessed.

26         (5)  The department shall adopt rules to implement this

27  section.

28         Section 9.  Subsection (1) of section 110.501, Florida

29  Statutes, is amended to read:

30         110.501  Definitions.--As used in this act:

31         (1)  "Volunteer" means any person who, of his or her

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1  own free will, provides goods or services, or conveys an

 2  interest in or otherwise consents to the use of real property

 3  pursuant to ss. 260.011-260.018, to any state department or

 4  agency, or nonprofit organization, with no monetary or

 5  material compensation.  A person registered and serving in

 6  Older American Volunteer Programs authorized by the Domestic

 7  Volunteer Service Act of 1973, as amended (Pub. L. No.

 8  93-113), shall also be defined as a volunteer and shall incur

 9  no civil liability as provided by s. 768.1355.  A volunteer

10  shall be eligible for payment of volunteer benefits as

11  specified in Pub. L. No. 93-113 and, this section, and s.

12  430.204.

13         Section 10.  Subsections (6), (7), (8), and (9) of

14  section 20.41, Florida Statutes, and section 430.204, Florida

15  Statutes, are repealed.

16         Section 11.  This act shall take effect July 1, 2000.

17

18

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

20  And the title is amended as follows:

21  remove from the title of the bill:  the entire title

22

23  and insert in lieu thereof:

24                  A bill to be entitled

25         An act relating to elderly affairs; amending s.

26         430.03, F.S.; revising purposes of the

27         Department of Elderly Affairs; creating s.

28         430.035, F.S.; providing definitions; amending

29         s. 430.05, F.S.; revising provisions relating

30         to the Department of Elderly Affairs Advisory

31         Council; creating s. 430.075, F.S.; providing

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1         for designation of area agencies on aging;

 2         providing for department contracts with area

 3         agency on aging governing boards; providing

 4         responsibilities of the boards and the area

 5         agencies; providing grounds for department

 6         disciplinary actions against an area agency;

 7         providing for public meetings and records;

 8         providing for direct provision of services by

 9         an area agency under certain circumstances;

10         providing department rulemaking authority;

11         amending s. 430.202, F.S., relating to

12         community care for the elderly; providing

13         legislative intent; amending s. 430.203, F.S.;

14         revising definitions; amending s. 430.205,

15         F.S.; revising provisions relating to the

16         community care for the elderly program service

17         system; providing for services; providing for

18         periodic selection of lead agencies by the area

19         agencies; providing for guidelines; providing

20         for area agency monitoring of community care

21         for the elderly services; providing department

22         rulemaking authority; providing for department

23         research and demonstration projects; requiring

24         annual reports to the Legislature; providing

25         for assessment to prioritize service delivery;

26         providing additional sources of services;

27         creating s. 430.2055, F.S.; providing for

28         community care for the elderly program service

29         contracts and copayments; providing funding

30         requirements; providing department rulemaking

31         authority; amending s. 110.501, F.S.;

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1865

    Amendment No.     (for drafter's use only)





 1         correcting a cross reference; repealing s.

 2         20.41(6), (7), (8), and (9), F.S., relating to

 3         duties of the department with respect to the

 4         federal Older Americans Act and the area

 5         agencies on aging; repealing s. 430.204, F.S.,

 6         relating to department powers and duties with

 7         respect to community care for the elderly core

 8         services; providing an effective date.

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