House Bill 1865

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    Florida House of Representatives - 2000                HB 1865

        By Representative Fiorentino






  1                      A bill to be entitled

  2         An act relating to elderly affairs; amending s.

  3         20.41, F.S.; revising organization and duties

  4         of the Department of Elderly Affairs; amending

  5         ss. 110.501 and 408.036, F.S.; correcting cross

  6         references; amending s. 400.404, F.S.; revising

  7         exemptions for licensure as an assisted living

  8         facility; amending s. 400.618, F.S.; revising

  9         exemptions from licensure as an adult

10         family-care home; amending s. 409.904, F.S.;

11         requiring the Agency for Health Care

12         Administration to assign to the Department of

13         Elderly Affairs, through interagency agreement,

14         certain responsibilities under the Medicaid

15         program; renumbering and amending s. 410.502,

16         F.S., relating to housing and living

17         arrangements for elderly persons; amending s.

18         430.01, F.S., relating to short title of ch.

19         430, F.S.; creating s. 430.016, F.S.; providing

20         for release of confidential information to

21         governmental entities or parties contracting

22         with the department; amending s. 430.03, F.S.;

23         revising purposes of the department; creating

24         s. 430.035, F.S.; providing definitions;

25         creating s. 430.045, F.S.; authorizing the

26         Department of Elderly Affairs to secure

27         patents, copyrights, and trademarks; providing

28         for deposit and use of certain proceeds;

29         amending s. 430.05, F.S., relating to the

30         Department of Elderly Affairs Advisory Council;

31         creating s. 430.065, F.S.; providing for

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  1         designation of area agencies on aging;

  2         providing for operation; providing conditions

  3         for rescinding a designation; providing for

  4         open records and meetings; requiring the

  5         department to adopt rules; amending s. 430.07,

  6         F.S.; establishing a statewide program for the

  7         use of volunteers to provide services to

  8         elderly persons; providing program

  9         responsibilities; requiring the department to

10         adopt certain rules; abolishing the Office of

11         Volunteer Community Service; amending s.

12         430.071, F.S.; revising provisions relating to

13         the "Respite for Elders Living in Everyday

14         Families" (RELIEF) program; requiring the

15         department to adopt certain rules; amending s.

16         430.202, F.S.; revising legislative intent for

17         the community care for the elderly program;

18         amending s. 430.205, F.S.; providing program

19         organization, guidelines, and service

20         requirements; requiring the department to adopt

21         certain rules; creating s. 430.2055, F.S.;

22         providing for community care for the elderly

23         service contracts and copayments; providing for

24         funding and restricting use of certain funds;

25         requiring the department to adopt rules;

26         amending s. 430.206, F.S.; providing for

27         establishment and functions of multiservice

28         senior centers; providing for reversion of

29         state funds; requiring notice to the department

30         prior to sale of a center; amending s. 430.207,

31         F.S., relating to confidentiality of

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  1         information; amending s. 430.41, F.S.; revising

  2         provisions relating to the department's Grants

  3         and Donations Trust Fund; creating s. 430.43,

  4         F.S.; providing for time-limited project,

  5         grant, or trust fund personnel; creating s.

  6         430.5011, F.S.; providing a short title;

  7         renumbering and amending s. 430.501, F.S.;

  8         revising provisions relating to the Alzheimer's

  9         Disease Advisory Committee; amending s.

10         430.502, F.S.; revising provisions relating to

11         establishment of memory disorder clinics;

12         providing rulemaking authority; amending s.

13         430.503, F.S.; providing for copayments for

14         certain services; amending s. 430.504, F.S.,

15         relating to confidentiality of information;

16         amending ss. 430.601, 430.603, 430.604, and

17         430.605, F.S.; revising provisions relating to

18         home care for the elderly and subsidies

19         therefor; expanding rulemaking authority of the

20         department; amending ss. 430.701, 430.702,

21         430.703, 430.705, and 430.707, F.S.; revising

22         provisions relating to the "Long-Term Care

23         Community Diversion Pilot Project Act";

24         providing additional requirements for

25         implementation of projects and contracts with

26         managed care organizations to provide care;

27         repealing ss. 430.02 and 430.04, F.S., relating

28         to legislative intent and duties and

29         responsibilities of the Department of Elderly

30         Affairs; repealing s. 430.101, F.S., relating

31         to administration of federal aging programs;

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  1         repealing ss. 430.203 and 430.204, F.S.,

  2         relating to definitions, core services, and

  3         duties of the department under the community

  4         care for the elderly program; repealing s.

  5         430.602, F.S., relating to definitions under

  6         the home care for the elderly program;

  7         repealing ss. 430.704 and 430.706, F.S.,

  8         relating to evaluation of long-term care

  9         through community diversion pilot projects, and

10         quality of care standards for such pilot

11         projects; repealing s. 430.710, F.S., relating

12         to the long-term care interagency advisory

13         council; providing an effective date.

14

15  Be It Enacted by the Legislature of the State of Florida:

16

17         Section 1.  Section 20.41, Florida Statutes, is amended

18  to read:

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

20  a Department of Elderly Affairs.

21         (1)  The head of the department is the Secretary of

22  Elderly Affairs. The secretary must be appointed by the

23  Governor, subject to confirmation by the Senate. The

24  requirement for Senate confirmation applies to any person so

25  appointed on or after July 1, 1994. The secretary serves at

26  the pleasure of the Governor. The secretary shall administer

27  the affairs of the department and may employ assistants,

28  professional staff, and other employees as necessary to

29  discharge the powers and duties of the department.

30

31

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  1         (2)  The department shall plan and administer its

  2  programs and services through planning and service areas as

  3  designated by the department by rule.

  4         (3)  The department shall maintain its headquarters in

  5  Tallahassee.

  6         (3)(4)  The department shall, in accordance with s. 712

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

  8  as amended, established and operate administratively house the

  9  Office of State Long-Term Care Ombudsman Council, as created

10  under part I of chapter 400. by s. 400.0067, and the district

11  long-term care ombudsman councils, created by s. 400.0069 and

12  shall, as required by s. 712 of the federal Older Americans

13  Act of 1965, ensure that both the state and district long-term

14  care ombudsman councils operate in compliance with the Older

15  Americans Act.  The councils in performance of their duties

16  shall not be subject to control, supervision, or direction by

17  the department.

18         (4)(5)  The department shall be the designated state

19  agency unit on aging in accordance with s. 305 of Pub. L. No.

20  89-73, as defined in the federal Older Americans Act of 1965,

21  as amended, and shall exercise all responsibilities pursuant

22  to that act, including:

23         (a)  Developing and administering a state plan pursuant

24  to the provisions of ss. 307 and 308 of that act.

25         (b)  Receiving and distributing all funds appropriated

26  through the act in accordance with a formula developed by the

27  department.

28         (c)  Being primarily responsible for the planning,

29  policy development, administration, coordination, priority

30  setting, and evaluation of all state activities related to the

31  objectives of that act.

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  1         (6)  In accordance with the federal Older Americans Act

  2  of 1965, as amended, the department shall designate and

  3  contract with area agencies on aging in each of the

  4  department's planning and service areas.  Area agencies on

  5  aging shall ensure a coordinated and integrated provision of

  6  long-term care services to the elderly and shall ensure the

  7  provision of prevention and early intervention services.  The

  8  department shall have overall responsibility for information

  9  system planning.  The department shall ensure, through the

10  development of equipment, software, data, and connectivity

11  standards, the ability to share and integrate information

12  collected and reported by the area agencies in support of

13  their contracted obligations to the state.

14         (7)  The department shall contract with the governing

15  body, hereafter referred to as the "board," of an area agency

16  on aging to fulfill programmatic and funding requirements.

17  The board shall be responsible for the overall direction of

18  the agency's programs and services and shall ensure that the

19  agency is administered in accordance with the terms of its

20  contract with the department, legal requirements, established

21  agency policy, and effective management principles.  The board

22  shall also ensure the accountability of the agency to the

23  local communities included in the planning and service area of

24  the agency.

25         (8)  The area agency on aging board shall, in

26  consultation with the secretary, appoint a chief executive

27  officer, hereafter referred to as the "executive director," to

28  whom shall be delegated responsibility for agency management

29  and for implementation of board policy, and who shall be

30  accountable for the agency's performance.

31

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  1         (9)  Area agencies on aging are subject to chapter 119,

  2  relating to public records, and, when considering any

  3  contracts requiring the expenditure of funds, are subject to

  4  ss. 286.011-286.012, relating to public meetings.

  5         Section 2.  Subsection (1) of section 110.501, Florida

  6  Statutes, is amended to read:

  7         110.501  Definitions.--As used in this act:

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

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

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

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

12  agency, or nonprofit organization, with no monetary or

13  material compensation.  A person registered and serving in

14  Older American Volunteer Programs authorized by the Domestic

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

16  93-113), shall also be defined as a volunteer and shall incur

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

18  shall be eligible for payment of volunteer benefits as

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

20  430.204.

21         Section 3.  Paragraph (h) of subsection (3) of section

22  408.036, Florida Statutes, is amended to read:

23         408.036  Projects subject to review.--

24         (3)  EXEMPTIONS.--Upon request, supported by such

25  documentation as the agency requires, the agency shall grant

26  an exemption from the provisions of subsection (1):

27         (h)  For the establishment of a Medicare-certified home

28  health agency by a facility certified under chapter 651; a

29  retirement community, as defined in s. 400.404(9)(2)(g); or a

30  residential facility that serves only retired military

31  personnel, their dependents, and the surviving dependents of

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  1  deceased military personnel. Medicare-reimbursed home health

  2  services provided through such agency shall be offered

  3  exclusively to residents of the facility or retirement

  4  community or to residents of facilities or retirement

  5  communities owned, operated, or managed by the same corporate

  6  entity. Each visit made to deliver Medicare-reimbursable home

  7  health services to a home health patient who, at the time of

  8  service, is not a resident of the facility or retirement

  9  community shall be a deceptive and unfair trade practice and

10  constitutes a violation of ss. 501.201-501.213.

11

12  A request for exemption under this subsection may be made at

13  any time and is not subject to the batching requirements of

14  this section.

15         Section 4.  Section 400.404, Florida Statutes, is

16  amended to read:

17         400.404  Facilities to be licensed; Exemptions from

18  licensure.--

19         (1)  For the administration of this part, facilities to

20  be licensed by the agency shall include all assisted living

21  facilities as defined in this part.

22         (2)  The following are exempt from licensure under this

23  part:

24         (1)(a)  Any facility, institution, or other place

25  operated by the Federal Government or any agency of the

26  Federal Government.

27         (2)(b)  Any facility or part of a facility licensed

28  under chapter 393 or chapter 394.

29         (3)(c)  Any facility licensed as an adult family-care

30  home under part VII.

31

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  1         (4)(d)  Any person who provides housing, meals, and one

  2  or more personal services on a 24-hour basis in the person's

  3  own home to not more than two adults who do not receive

  4  optional state supplementation. The person who provides the

  5  housing, meals, and personal services must own or rent the

  6  home and live in the home reside therein.

  7         (5)  An arrangement whereby a person is receiving a

  8  subsidy for providing home care to an elderly person pursuant

  9  to s. 430.603, the home care for the elderly program.

10         (6)(e)  Any home or facility approved by the United

11  States Department of Veterans Affairs as a residential care

12  home wherein care is provided exclusively to three or fewer

13  veterans.

14         (7)(f)  Any facility that has been incorporated in this

15  state for 50 years or more on or before July 1, 1983, and is

16  governed by a the board of directors of which is nominated or

17  elected by the residents, until such time as the facility is

18  sold or its ownership is transferred.; or

19         (8)  Any facility, with improvements or additions

20  thereto, which has existed and operated continuously in this

21  state for 60 years or more on or before July 1, 1989, is

22  directly or indirectly owned and operated by a nationally

23  recognized fraternal organization, is not open to the public,

24  and accepts only its own members and their spouses as

25  residents.

26         (9)(g)  Any facility certified under chapter 651, or a

27  retirement community, may provide services authorized under

28  this part or part IV of this chapter to its residents who live

29  in single-family homes, duplexes, quadruplexes, or apartments

30  located on the campus without obtaining a license to operate

31  an assisted living facility if residential units within such

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  1  buildings are used by residents who do not require staff

  2  supervision for that portion of the day when personal services

  3  are not being delivered and the owner obtains a home health

  4  license to provide such services.  However, any building or

  5  distinct part of a building on the campus that is designated

  6  for persons who receive personal services and require

  7  supervision beyond that which is available while such services

  8  are being rendered must be licensed in accordance with this

  9  part. If a facility provides personal services to residents

10  who do not otherwise require supervision and the owner is not

11  licensed as a home health agency, the buildings or distinct

12  parts of buildings where such services are rendered must be

13  licensed under this part. A resident of a facility that has

14  obtained obtains a home health license may contract with a

15  licensed home health agency of his or her choice, provided

16  that the home health agency provides liability insurance and

17  workers' compensation coverage for its employees. Facilities

18  covered by this exemption may establish policies that give

19  residents the option of contracting for services and care

20  beyond that which is provided by the facility to enable them

21  to age in place.  For purposes of this section, a retirement

22  community consists of a facility licensed under this part or

23  under part II, and apartments designed for independent living

24  located on the same campus.

25         (10)(h)  Any residential unit for independent living

26  which is located within a facility certified under chapter

27  651, or any residential unit which is colocated with a nursing

28  home licensed under part II or colocated with a facility

29  licensed under this part in which services are provided

30  through an outpatient clinic or a nursing home on an

31  outpatient basis.

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  1         Section 5.  Subsection (2) of section 400.618, Florida

  2  Statutes, is amended to read:

  3         400.618  Definitions.--As used in this part, the term:

  4         (2)  "Adult family-care home" means a full-time,

  5  family-type living arrangement, in a private home, under which

  6  a person who owns or rents the home provides room, board, and

  7  personal care, on a 24-hour basis, for no more than five

  8  disabled adults or frail elders who are not relatives. The

  9  following family-type living arrangements are not required to

10  be licensed as an adult family-care home:

11         (a)  An arrangement whereby the person who owns or

12  rents the home provides room, board, and personal services for

13  not more than two adults who do not receive optional state

14  supplementation under s. 409.212, and does not hold the home

15  out to the public to be an adult family-care home. The person

16  who provides the housing, meals, and personal care must own or

17  rent and live in the home and reside therein.

18         (b)  An arrangement whereby the person who owns or

19  rents the home provides room, board, and personal services

20  only to his or her relatives.

21         (b)(c)  An establishment that is licensed as an

22  assisted living facility under part III.

23         (c)  An arrangement whereby a person is receiving a

24  subsidy for providing home care to an elderly person pursuant

25  to s. 430.603, the home care for the elderly program.

26         Section 6.  Section 409.904, Florida Statutes, is

27  amended to read:

28         409.904  Optional payments for eligible persons.--

29         (1)  The agency may make payments for medical

30  assistance and related services on behalf of the following

31  persons who are determined to be eligible subject to the

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  1  income, assets, and categorical eligibility tests set forth in

  2  federal and state law.  Payment on behalf of these Medicaid

  3  eligible persons is subject to the availability of moneys and

  4  any limitations established by the General Appropriations Act

  5  or chapter 216.

  6         (a)(1)  A person who is age 65 or older or is

  7  determined to be disabled, whose income is at or below 100

  8  percent of federal poverty level, and whose assets do not

  9  exceed established limitations.

10         (b)(2)  A family, a pregnant woman, a child under age

11  18, a person age 65 or over, or a blind or disabled person who

12  would be eligible under any group listed in s. 409.903(1),

13  (2), or (3), except that the income or assets of such family

14  or person exceed established limitations. For a family or

15  person in this group, medical expenses are deductible from

16  income in accordance with federal requirements in order to

17  make a determination of eligibility.  A family or person in

18  this group, which group is known as the "medically needy," is

19  eligible to receive the same services as other Medicaid

20  recipients, with the exception of services in skilled nursing

21  facilities and intermediate care facilities for the

22  developmentally disabled.

23         (c)(3)  A person who is in need of the services of a

24  licensed nursing facility, a licensed intermediate care

25  facility for the developmentally disabled, or a state mental

26  hospital, whose income does not exceed 300 percent of the SSI

27  income standard, and who meets the assets standards

28  established under federal and state law.

29         (d)(4)  A low-income person who meets all other

30  requirements for Medicaid eligibility except citizenship and

31  who is in need of emergency medical services.  The eligibility

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  1  of such a recipient is limited to the period of the emergency,

  2  in accordance with federal regulations.

  3         (e)(5)  Subject to specific federal authorization, a

  4  postpartum woman living in a family that has an income that is

  5  at or below 185 percent of the most current federal poverty

  6  level is eligible for family planning services as specified in

  7  s. 409.905(3) for a period of up to 24 months following a

  8  pregnancy for which Medicaid paid for pregnancy-related

  9  services.

10         (f)(6)  A child born before October 1, 1983, living in

11  a family that has an income which is at or below 100 percent

12  of the current federal poverty level, who has attained the age

13  of 6, but has not attained the age of 19, and who would be

14  eligible in s. 409.903(6), if the child had been born on or

15  after such date.  In determining the eligibility of such a

16  child, an assets test is not required.

17         (g)(7)  A child who has not attained the age of 19 who

18  has been determined eligible for the Medicaid program is

19  deemed to be eligible for a total of 6 months, regardless of

20  changes in circumstances other than attainment of the maximum

21  age. Effective January 1, 1999, a child who has not attained

22  the age of 5 and who has been determined eligible for the

23  Medicaid program is deemed to be eligible for a total of 12

24  months regardless of changes in circumstances other than

25  attainment of the maximum age.

26         (2)  The agency, through interagency agreement, shall

27  assign to the Department of Elderly Affairs responsibility for

28  nursing home preadmission screening established to control the

29  utilization of Medicaid institutional care pursuant to ss.

30  1902 and 1903 of Title XIX of the Social Security Act, and for

31  the administration of the Assisted Living for the Elderly

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  1  Medicaid Waiver, the Aged-Disabled Adult Home and Community

  2  Based Medicaid Waiver, and the Consumer Directed Care Medicaid

  3  Waiver for the Elderly.

  4         Section 7.  Section 410.502, Florida Statutes, is

  5  renumbered as section 430.075, Florida Statutes, and amended

  6  to read:

  7         430.075 410.502  Housing and living arrangements;

  8  special needs of the elderly; services.--The department of

  9  Elderly Affairs shall provide services related to housing and

10  living arrangements which meet the special needs of the

11  elderly.  Such services shall include, but not be limited to:

12         (1)  Providing counseling concerning housing problems

13  and alternate living arrangements when appropriate to the

14  individual's needs.

15         (2)  Coordinating with the Department of Community

16  Affairs to collect gather and maintain data on living

17  arrangements which meet the special needs of the elderly and

18  to disseminate such information to the public.  Such

19  information shall include types of facilities, cost of care,

20  services provided, and possible sources of assistance help in

21  meeting the cost of care for indigent individuals.

22         (3)  Promoting, through the department of Elderly

23  Affairs staff activities and area agencies on aging, the

24  development of a variety of living arrangements through public

25  and private auspices to meet the various needs and desires of

26  the elderly, including, but not limited to:

27         (a)  Adult family-care Foster homes.

28         (b)  Assisted living facilities.

29         (c)  Homes for special services.

30         (d)  Shared housing or other such group living

31  arrangements for independent living.

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  1         (e)  Continuing care facilities which offer all levels

  2  of care, including independent living units, personal care,

  3  home health care supports, assisted living, and skilled

  4  nursing home care.

  5         (f)  Retirement communities for independent communal

  6  living, to be developed in conjunction with the Department of

  7  Community Affairs.

  8         (g)  Other innovative living arrangements.

  9

10  Demonstration projects must be used advisedly to test the

11  extent to which these and other innovative housing and living

12  arrangements do meet the basic and special needs of the

13  elderly.

14         Section 8.  Section 430.01, Florida Statutes, is

15  amended to read:

16         430.01  Short title.--This chapter may be cited as the

17  "Department of Elderly Affairs Act," or the "Pepper Act" as a

18  memorial to Congressman Claude Denson Pepper. The department

19  is also known as the Department of Elder Affairs.

20         Section 9.  Section 430.016, Florida Statutes, is

21  created to read:

22         430.016  Confidential information; other state

23  agencies.--Information held by the department which is

24  confidential and exempt from the provisions of s. 119.07(1)

25  and s. 24(a), Art. I of the State Constitution may be released

26  to other governmental entities or to parties contracting with

27  the department to perform departmental duties. The receiving

28  governmental entity or party shall retain the confidentiality

29  of such information as provided by law.

30         Section 10.  Section 430.03, Florida Statutes, is

31  amended to read:

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  1         430.03  Purposes.--The mission purposes of the

  2  Department of Elderly Affairs is are to advocate for and serve

  3  Florida's elders; promote and implement long-term care

  4  policies and procedures that are elder-friendly; and plan,

  5  coordinate, administer, and initiate programs and services

  6  that empower elders and their caregivers to age in place, with

  7  dignity, security, and purpose, and in an elder-friendly

  8  environment. In order to achieve this purpose, the department

  9  shall:

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

11  state's elderly residents.

12         (2)(1)  Serve as the primary state agency responsible

13  for administering human services programs for elder persons in

14  this state, the elderly and for developing policy

15  recommendations and programs for long-term care, and for

16  evaluating and promulgating regulatory policy for long-term

17  care facilities and the provision of long-term care services.

18         (3)(2)  Combat ageism and create public awareness and

19  understanding of the potentials, and needs, and diversity of

20  the elderly, and provide opportunities for personal

21  development and achievement, and employment, of persons age 60

22  years and older persons.

23         (4)(3)  Develop, arrange, oversee, and conduct research

24  in the field of aging, and promote and implement a variety of

25  pilot programs that demonstrate innovative methods for meeting

26  the needs of elderly residents. Research activities may

27  include contracting with academic institutions and other

28  research organizations, development of educational and

29  training curricula, research related to medical issues

30  affecting the elderly, including Alzheimer's disease, analysis

31  of long-term care and other supportive service needs,

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  1  development of new services and service delivery system

  2  models, development of designs and adaptive innovations

  3  relating to modified living environments, including the use of

  4  assistive devices, and evaluation of pilot programs serving

  5  elders. Study and plan for programs and services to meet

  6  identified and projected needs and to provide opportunities

  7  for personal development and achievement of persons aged 60

  8  years and older.

  9         (4)  Advocate quality programs and services for the

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

11  citizen's needs.

12         (5)  Coordinate interdepartmental policy development

13  and program planning for all state agencies that provide

14  services for the state's elderly population in order to

15  prevent duplicative efforts, to maximize utilization of

16  resources, and to optimize ensure cooperation, communication,

17  and departmental linkages.

18         (6)  Recommend state and community-based local level

19  organizational models for the planning, coordination,

20  implementation, and evaluation of programs serving the elderly

21  population, emphasizing initiatives which seek to coordinate

22  and integrate the continuum-of-care needs of the elderly.

23         (7)  Oversee implementation of federally funded and

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

25  population.

26         (8)  Review and comment upon state plans, budgets, and

27  policies which affect older individuals and provide technical

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

29  representing the needs of older individuals.

30         (9)(8)  Promote more effective use of existing

31  resources and available services, and develop and recommend

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  1  cost-effective legislative budget requests for programs and

  2  services for the state's elderly population.

  3         (10)(9)  Serve as a state-level information

  4  clearinghouse, and encourage and assist in the development of

  5  community-based local-level identifiable points of information

  6  and referral sources regarding all federal, state, and local

  7  resources providing of assistance to elderly residents

  8  citizens.

  9         (11)(10)  Assist elderly persons to secure needed

10  services in accordance with personal choice and in a manner

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

12  eliminates dependency.

13         (12)(11)  Promote the maintenance and improvement of

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

15         (13)(12)  Encourage and enlist the services of

16  volunteers to provide assistance and services to elders, and

17  promote opportunities for volunteerism among the elderly

18  population.

19         (14)(13)  Promote the prevention of neglect, abuse, or

20  exploitation of elderly persons unable to protect their own

21  interests.

22         (15)(14)  Reduce eliminate and prevent inappropriate

23  institutionalization of elderly persons by promoting

24  community-based care, home-based care, self-care, or other

25  forms of less intensive care.

26         (16)(15)  Support and promote the efforts Aid in the

27  support of families and other caregivers of elderly persons.

28         (17)(16)  Promote activities that provide opportunities

29  for persons of all ages and ethnic and cultural backgrounds to

30  benefit from intergenerational relationships that promote

31  unity, support, and respect for one another.

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  1         (18)(17)  Establish and maintain a management

  2  information system which facilitates the collection,

  3  integration, and dissemination of data collected by the

  4  department and its contractees relevant to aging programs and

  5  elder issues. Oversee aging research conducted or funded by

  6  any state agency to ensure that such activities are

  7  coordinated and directed to fulfill the intent and purposes of

  8  this act.

  9         (19)  Participate in efforts to promote the highest

10  quality of compassionate, culturally competent, and adequate

11  end-of-life care that is responsive to the individual wishes

12  and needs of patients and their caregivers.

13         (20)  Develop and establish self-directed care programs

14  which encourage and provide opportunities for the elderly and

15  their caregivers to choose their service providers whenever

16  possible.

17         (21)  Develop mechanisms and promote programs which

18  offer a comprehensive, structurally integrated system of

19  assessment for determining eligibility and level of care for

20  supportive, community-based, long-term care services.

21         (22)  Contract with public or private entities for the

22  planning and provision of services to the elderly, or directly

23  administer such programs, whichever is determined to be the

24  most efficient and cost-effective and maximizes consumer

25  choice.

26         (23)  Develop and implement training programs and other

27  educational opportunities for caregivers and providers of

28  elder care services.

29         (24)  Encourage and actively solicit contributions and

30  grants from private, state, local, and federal resources for

31

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  1  the purpose of developing, promoting, and implementing

  2  innovative programs serving the elderly.

  3         (25)  Promote the development of public-private

  4  partnerships for the purpose of maximizing resources and

  5  consumer choice in the selection of service providers and

  6  programs serving the elderly.

  7         (26)  Hold public meetings throughout the state for

  8  purposes of receiving public input and creating opportunities

  9  for articulating issues of public concern relating to the

10  elderly and their caregivers, and which provide feedback on

11  the relevance and effectiveness of the department's programs

12  and services.

13         (27)  Call upon appropriate state agencies for such

14  assistance as needed in the discharge of the department's

15  duties. All agencies shall cooperate in assisting the

16  department to carry out its responsibilities as prescribed by

17  this section.

18         (28)  Prepare a master plan addressing aging policies

19  and programs in this state.

20         Section 11.  Section 430.035, Florida Statutes, is

21  created to read:

22         430.035  Definitions.--As used in this chapter, the

23  term:

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

25  public or private nonprofit agency or organization designated

26  by the department pursuant to s. 430.065.  An area agency on

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

28  in its planning and service area for planning and fostering

29  the development of comprehensive and coordinated service

30  systems to serve elderly persons.

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

  2  person's health and physical, environmental, behavioral,

  3  psychological, economic, cultural, and social conditions in

  4  order to identify needs and the appropriate level of care, and

  5  to develop a comprehensive care plan.

  6         (3)  "Care plan" means a written listing of an

  7  individual's strengths, coping skills, and needs, and a

  8  description of how the individual's needs will be addressed to

  9  help maintain or improve the person's health and physical,

10  environmental, cultural, behavioral, psychological, economic,

11  and social well-being in the least restrictive, most

12  cost-effective, safe environment.  The plan shall be based on

13  an assessment of the individual and must also address the

14  capabilities of caregivers to provide needed support and care.

15  All available resources and strategies must be considered

16  prior to the use of federal or state funds.

17         (4)  "Caregiver" means a family member or other

18  individual who has responsibility for the care of an elderly

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

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

21         (5)  "Case aide services" means providing, under the

22  direction of a case manager, assistance with the

23  implementation of a care plan, assistance with accessing

24  resources and services, and oversight and supervision of

25  service provider activities, and facilitating linkages with

26  service providers.

27         (6)  "Case management" means implementing or

28  supervising the implementation of a care plan by mobilizing,

29  arranging, and facilitating the provision of services needed

30  to maximize an individual's physical, social, and emotional

31  well-being.  Case management includes the development of

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  1  formal and informal resources to assure the availability of

  2  cost-effective services, advocacy, and monitoring, evaluating,

  3  and adjusting services and service delivery, on an ongoing

  4  basis, to assure the continued attainment of desired outcomes.

  5         (7)  "Community care service area" means a designated

  6  geographic area within a planning and service area which is

  7  served by one or more service entities providing assessment,

  8  service coordination, care planning, case management, a

  9  variety of home-delivered services, day care services, and

10  other basic services to functionally impaired elderly persons.

11  Community care service areas shall be determined by the

12  department in consultation with the area agency on aging.

13         (8)  "Department" means the Department of Elderly

14  Affairs as established in s. 20.41.  The department shall also

15  be known as the Department of Elder Affairs.

16         (9)  "Elder," "elderly person," or "older individual"

17  means any person 60 years of age or over.

18         (10)  "Functionally impaired" means any person who has

19  been determined to have physical or mental limitations that

20  restrict the person's ability to perform the activities of

21  daily living and that impede the person's capacity to live

22  independently without the provision of supportive services.

23         (11)  "Lead agency" means an agency selected by an area

24  agency on aging to conduct care planning and provide case

25  management or service coordination, as needed, to functionally

26  impaired elderly persons participating in a community care for

27  the elderly program, and coordinate the activities of

28  individual agencies contracting to provide community care for

29  the elderly services within a community care service area.

30

31

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

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

  3  the department are administered and services are delivered.

  4         (13)  "Respite" means the provision of necessary care

  5  to a functionally impaired elderly person on a temporary

  6  basis, in order to allow the elderly person's caregiver to

  7  leave the elderly person for a period of time.

  8         (14)  "Service coordination" means assisting in

  9  identifying, accessing, and arranging for appropriate

10  resources and cost-effective services and followup and liaison

11  activities on behalf of service recipients, for the purpose of

12  eliminating barriers to responsive and efficient service

13  delivery, and ensuring the delivery of services on a

14  continuing and reliable basis.

15         (15)  "Stipend" means an allotment of funds to enable

16  volunteers to provide services.  The allotment of funds is for

17  a period of service and is not an hourly wage.

18         Section 12.  Section 430.045, Florida Statutes, is

19  created to read:

20         430.045  Patents, copyrights, trademarks; notice to

21  Department of State; confidentiality of trade secrets.--

22         (1)  Notwithstanding any other provision of law to the

23  contrary, the Department of Elderly Affairs is authorized, in

24  its own name, to:

25         (a)  Perform all things necessary to secure letters of

26  patent, copyrights, and trademarks on any legitimately

27  acquired work products and to enforce its right therein.

28         (b)  License, lease, assign, or otherwise give written

29  consent to any person, firm, or corporation for the

30  manufacture or use of any product protected by patent,

31

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  1  copyright, or trademark, whether on a royalty basis or for

  2  such other consideration as the department may deem proper.

  3         (c)  Take any action necessary, including legal action,

  4  to enforce its rights under any agreement and to protect its

  5  property rights from improper or unlawful use or infringement.

  6         (d)  Enforce the collection of any payments or other

  7  obligations due the department for the manufacture or use of

  8  any product by any other party.

  9         (e)  Sell any product, except where otherwise

10  restricted by public records laws, which the department may

11  create or cause to be created, whether or not the product is

12  protected by a department patent, copyright, or trademark, and

13  to execute all instruments necessary to consummate any such

14  sale.

15         (f)  Do all other acts necessary and proper for the

16  execution of powers and duties conferred upon the department

17  in this section.

18         (2)  The department shall notify the Department of

19  State in writing whenever property rights by patent,

20  copyright, or trademark are secured or exploited by the

21  department.

22         (3)  Any proceeds from the sale of products or the

23  right to manufacture or use a product shall be deposited in

24  the department's Grants and Donations Trust Fund and may be

25  appropriated to finance activities of the department.  The

26  department's legislative budget request should give special

27  consideration to using such funds for research and development

28  projects.

29         (4)  As used in this section, the term "product"

30  includes any and all inventions, methodologies, techniques,

31

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  1  and creations that may be properly protected by patent,

  2  copyright, or trademark.

  3         Section 13.  Subsections (1), (2), and (3) of section

  4  430.05, Florida Statutes, are amended to read:

  5         430.05  Department of Elderly Affairs Advisory

  6  Council.--

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

  8  Advisory Council which shall be located for administrative

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

10  intent of the Legislature that the advisory council shall be

11  an independent nonpartisan body and shall not be subject to

12  control, supervision, or direction by the department.

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

14  the Secretary of Elderly Affairs to assist the secretary in

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

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

17  council may make recommendations to the secretary, the

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

19  President of the Senate regarding organizational issues and

20  additions or reductions in the department's duties and

21  responsibilities.

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

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

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

25  accordance with the Older Americans Act, two additional

26  members appointed by the Governor, two members appointed by

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

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

29  appointed in the following manner:

30         1.  The Governor shall appoint one member from each

31  planning and service area and shall select each appointment

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  1  from a list of three nominations submitted by the designated

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

  3  Nominations submitted by an area agency on aging shall be

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

  5  and volunteer sectors of each county in the respective

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

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

  8  person 60 years of age or older.

  9         2.  The Governor shall appoint two additional members,

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

11         3.  The President of the Senate shall appoint two

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

13         4.  The Speaker of the House of Representatives shall

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

15  older.

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

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

18  older and reflect the state's racial and cultural diversity

19  that there shall be balanced minority and gender

20  representation.

21         6.  The Governor shall designate annually a member of

22  the advisory council to serve as chair.

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

24  ex officio member of the advisory council.

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

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

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

28  staggered appointments. in the following manner:

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

30  initial appointees of the President of the Senate shall be

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

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  1  of the Speaker of the House of Representatives shall be

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

  3  total initial appointees of the Governor shall be appointed to

  4  1-year terms, one-third shall be appointed to 2-year terms,

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

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

  7  there results one additional appointee, that appointee shall

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

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

10  there results two additional appointees, one of the additional

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

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

13         2.  Vacancies occurring during an appointee's initial

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

15  appointments, pursuant to subparagraph 1. After the terms

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

17  appointed to 3-year terms.

18         Section 14.  Section 430.065, Florida Statutes, is

19  created to read:

20         430.065  Area agencies on aging.--

21         (1)  In accordance with Pub. L. No. 89-73, the federal

22  Older Americans Act of 1965, as amended, the department shall

23  designate area agencies on aging in each of the department's

24  planning and service areas.

25         (2)  The department shall contract with the governing

26  body, hereafter referred to as the "board," of an area agency

27  on aging to fulfill programmatic and funding requirements of

28  the area agency. The board shall be responsible for the

29  overall direction of the area agency's programs and services

30  and shall ensure that the area agency is administered in

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

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

  2  area agency policy, and cost-effective and efficient

  3  management principles. The board shall also ensure the

  4  accountability of the area agency to the local communities

  5  included in the area agency's planning and service area.

  6         (3)  The area agency on aging board shall, in

  7  consultation with the Secretary of Elderly Affairs, appoint a

  8  chief executive officer, hereafter referred to as the

  9  "executive director," to whom shall be delegated

10  responsibility for area agency management and for

11  implementation of board policy.

12         (4)  The area agency shall ensure the maintenance,

13  collection, and timely reporting to the department of all

14  customer and service information provided by service providers

15  contracting with the area agency to provide services.  The

16  department shall have overall responsibility for the

17  establishment and operation of a management information system

18  and shall ensure the ability to integrate and share

19  information collected and reported to the department.

20         (5)  The department shall be responsible for ensuring

21  that each area agency on aging operates in a manner which

22  ensures that the elderly of this state receive the highest

23  quality services possible in the most efficient and

24  cost-effective manner. The department shall rescind

25  designation of an area agency on aging or take intermediate

26  measures against the area agency, including corrective action,

27  unannounced special monitoring, temporary assumption of

28  operation of one or more programs, placement on probationary

29  status, imposing a moratorium on area agency action, imposing

30  financial penalties for nonperformance including the

31

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  1  withholding of funds, or other administrative action in

  2  accordance with chapter 120, if the department finds that:

  3         (a)  An intentional or negligent act of the area agency

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

  5  elderly persons, or substantially and negatively affected the

  6  operation of an aging services program;

  7         (b)  The area agency has committed multiple or repeated

  8  violations of statutory and regulatory requirements or

  9  department standards;

10         (c)  The area agency has failed to adhere to the terms

11  of its contract with the department;

12         (d)  The area agency lacks financial stability

13  sufficient to meet contractual obligations or that contractual

14  funds have been misappropriated;

15         (e)  The area agency has exceeded budgetary allocations

16  or has permitted a service provider with whom it is

17  contracting to exceed budgetary allocations;

18         (f)  The area agency has failed to expand or continue

19  the provision of services after the declaration of a state of

20  emergency; or

21         (g)  The area agency has failed to implement and

22  maintain a department-approved client grievance resolution

23  procedure.

24         (6)  Area agencies on aging are public entities,

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

26  considering any contracts requiring the expenditure of public

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

28  meetings.

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

30  implement and interpret this section.

31

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  1         Section 15.  Section 430.07, Florida Statutes, is

  2  amended to read:

  3         430.07  Office of Volunteer services Community

  4  Service.--

  5         (1)  The department shall establish a program the

  6  purpose of which is to maximize the use of volunteers to

  7  provide services to elderly persons. There is created within

  8  the Department of Elderly Affairs the Office of Volunteer

  9  Community Service.  The program office shall:

10         (a)  Develop and coordinate a comprehensive statewide

11  volunteer program by and for elderly persons that includes an

12  intergenerational component, draws on the strengths and skills

13  of the state's elder population, and promotes self-care.

14         (1)  Compile an inventory of services needed by elderly

15  persons.

16         (2)  Compile an inventory of services being provided to

17  elderly persons to meet those needs.

18         (3)  Determine which services needed by elderly persons

19  are not being provided.

20         (b)(4)  Determine which services may currently not

21  being provided can be provided by older persons acting as

22  volunteers.

23         (c)(5)  Identify those state rules and policies which

24  restrict volunteer service by or for older persons and propose

25  corrective actions.

26         (d)(6)  Identify methods of promoting volunteer service

27  for the programs administered by the department, the area

28  agencies on aging, and other area agency service providers by

29  and for older persons.

30         (7)  Develop a comprehensive volunteer program that

31  includes an intergenerational component and draws on the

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  1  strengths and skills of the state's older population and, to

  2  the extent possible, implements the volunteer service credit

  3  program.

  4         (e)  Encourage and coordinate volunteer services in and

  5  between the various area agencies on aging and service

  6  providers.

  7         (f)  Provide training, technical assistance, and

  8  oversight to volunteer initiatives.

  9         (g)  Promote the recognition of the contribution made

10  by volunteers to the programs administered by the department

11  and the area agencies on aging.

12         (h)(8)  Encourage contributions and grants through

13  private, state, and federal sources for the purpose of

14  promoting, implementing, or evaluating, and recognizing

15  volunteer programs and self-care initiatives by or for older

16  persons.

17         (2)  The department shall adopt rules establishing

18  standards of practice relating to the screening, selection,

19  training, and supervision of volunteers providing services, as

20  well as volunteer program components.

21         Section 16.  Section 430.071, Florida Statutes, is

22  amended to read:

23         430.071  Respite for elders living in everyday

24  families.--

25         (1)  As used in this section, the term:

26         (a)  "Family unit" means one or more individuals whose

27  primary residence is with a homebound elderly individual

28  specifically for the purpose of providing care for that

29  homebound elderly individual. The family does not necessarily

30  need to be related by blood or marriage to the homebound

31  elderly individual.

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  1         (b)  "Respite" means in-home assistance for a homebound

  2  elderly individual from someone who is not a member of the

  3  family unit, which allows the family unit the ability to leave

  4  the homebound elderly individual for a period of time.

  5         (c)  "Stipend" means an allotment of funds to enable a

  6  diverse population of volunteers to provide services. The

  7  allotment of funds is for a period of service and is not an

  8  hourly wage.

  9         (d)  "Volunteer service system" means an organized

10  network of volunteers and agencies engaged in supporting

11  volunteers to assist a family unit that requires respite.

12         (1)(2)  The department shall establish a "Respite for

13  Elders Living in Everyday Families" (RELIEF) program to will

14  provide in-home respite care that is an expansion of respite

15  services that is currently available through other programs,

16  specifically including evening and weekend respite, in order.

17  The purpose of this service is to increase the ability of

18  caregivers whose primary residence is with a homebound

19  functionally impaired elderly person a family unit to continue

20  to care for the elderly person a homebound elderly individual

21  by providing in-home respite beyond the basic provisions of

22  current public programs.

23         (2)(3)  Respite services shall be provided through a

24  multigenerational corps of volunteers, volunteers who receive

25  a stipend, and any other appropriate personnel as determined

26  by the department.

27         (a)  Volunteers shall be screened, selected, trained,

28  and registered according to standards established under s.

29  430.07 developed by the Office of Volunteer and Community

30  Services in the Department of Elderly Affairs. These standards

31  must be developed to ensure, at a minimum, address the safety

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  1  of a homebound elderly individual who will receive the respite

  2  service.

  3         (b)  Volunteers may be recruited from a variety of

  4  sources, including, but not limited to, volunteer centers,

  5  religious organizations, college campuses, corporations,

  6  families, Retired Senior Volunteer Programs, Senior Companion

  7  Programs, and AmeriCorps Programs.

  8         (3)(4)  To receive assistance from the RELIEF program,

  9  caregivers the family unit must be assessed according to the

10  following guidelines developed by the department to determine

11  the need for respite services. This assessment must determine,

12  at a minimum, that:

13         (a)  The caregiver family unit is unable to pay for

14  respite without jeopardizing other basic needs, including, but

15  not limited to, food, shelter, and medications.

16         (b)  The homebound elderly person individual for whom

17  the caregiver family unit is caring is 60 years of age or

18  older, requires assistance to remain in the home, and, without

19  this assistance, would need to move to an assisted living

20  facility, an adult family-care home, or a nursing facility.

21         (4)(5)  Caregivers who receive A family unit that

22  receives respite services from the RELIEF program are is not

23  excluded from receiving assistance from other governmental

24  programs.

25         (5)(6)  The department Office of Volunteer and

26  Community Services shall:

27         (a)  Systematically develop and implement an organized

28  network of volunteers pursuant to s. 430.07 a volunteer

29  service system in order to provide respite services under the

30  RELIEF program.

31

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  1         (b)  The office shall also implement, Monitor, and

  2  evaluate the delivery of respite services under this program.

  3         (b)  Work collaboratively with local, state, and

  4  national organizations, including, but not limited to, the

  5  Florida Commission on Community Service, to promote the use of

  6  volunteers offering respite under this program.

  7         (c)  Encourage contributions and grants through public

  8  and private sources to promote the delivery of respite to

  9  assist caregivers caring family units providing care for

10  homebound elderly individuals.

11         (6)  The department shall adopt rules establishing

12  program components, and standards and procedures for

13  determining the need for respite services and for service

14  delivery.

15         Section 17.  Section 430.202, Florida Statutes, is

16  amended to read:

17         430.202  Community care for the elderly; legislative

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

19  functionally impaired elderly persons to live in living

20  dignified and reasonably independent lives in their own homes,

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

22  development, expansion, reorganization, and coordination of

23  various community-based services.  The Legislature intends

24  that a coordinated continuum of care be established so that

25  functionally impaired elderly persons age 60 and older may age

26  in place in be assured the least restrictive, most

27  cost-effective, safe environment suitable to meeting their

28  needs. The Legislature intends that the most frail elders be

29  served first, provided that it has been determined that

30  maintaining such persons in their home does not exceed the

31  average annual cost of nursing home care and does not

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  1  jeopardize their safety. The development of innovative

  2  approaches to program management, staff training, and service

  3  delivery, including the use of volunteers and private

  4  resources, which have an impact on cost-avoidance,

  5  cost-effectiveness, and program efficiency is encouraged.

  6         Section 18.  Section 430.205, Florida Statutes, is

  7  amended to read:

  8         430.205  Community care for the elderly program service

  9  system.--

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

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

12  community care for the elderly program service system that

13  provides assessment, care planning, service coordination, case

14  aide services, or case management; legal assistance;

15  counseling; material aid; companion, homemaker, and chore

16  services; shopping assistance; escort; transportation;

17  home-delivered meals; emergency home repair; respite care;

18  adult day care; adult day health care; personal care services;

19  home health aide services; emergency alert response;

20  consumable medical supplies; medical therapeutics; home

21  nursing; and other in-home and community-based community

22  services as needed to help functionally impaired elderly

23  persons the older person maintain independence and prevent or

24  delay more costly institutional care. To the maximum extent

25  practicable, the community care for the elderly program shall

26  be organized so as to provide a coordinated continuum and

27  appropriate level of care to such persons as their needs

28  change.

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

30  pursuant to a request for proposals or an invitation to

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

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  1  support services may be furnished by public or private

  2  agencies or organizations. Each community care service system

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

  4  the activities of individual contracting agencies providing

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

  6  the activities of a community care service area must be

  7  directed from a multiservice senior center and coordinated

  8  with other services offered therein. This subsection does not

  9  require programs in existence prior to the effective date of

10  this act to be relocated.

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

12  guidelines developed by the department, in consultation with

13  the area agencies on aging, and adopted by rule. Such

14  guidelines must:

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

16  cost-effective services.

17         2.  Encourage competition among service providers and

18  promote consumer choice.

19         3.  Ensure that case managers and service coordinators

20  act on behalf of consumers and not as promoters of services

21  provided by their agency.

22         (b)  An area agency on aging, with the concurrence of

23  the department, may exempt from the selection process:

24         1.  Any lead agency or service provider who meets or

25  exceeds established minimum standards, as determined by the

26  department; or

27         2.  Units of local government which provide a

28  fair-share local cash match, provide value-added activities,

29  provide elders with a choice of case managers, meet the

30  guidelines provided in paragraph (a), and are subject to an

31  annual review to ensure compliance with these requirements.

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  1         (c)  Each lead agency must compile community care for

  2  the elderly program statistics for its service area.

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

  4  is to be provided or coordinated within a community care

  5  service area and establish rules and minimum standards for the

  6  delivery of core services.

  7         (4)  The department may conduct or contract for

  8  research and demonstration projects to determine the

  9  desirability of new concepts of organization, administration,

10  regulation, or service delivery designed to prevent the

11  premature institutionalization of functionally impaired

12  elderly persons. Evaluations shall be made of the

13  cost-effectiveness cost-avoidance of such demonstration

14  projects, the minimization of factors causing acute episodes

15  which result in hospitalization, the ability of the projects

16  to reduce the rate of placement of functionally impaired

17  elderly persons in long-term care institutions, and the impact

18  of projects on the use of institutional services and

19  facilities.

20         (5)(4)  A preservice and inservice training program for

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

22  be designed and implemented to help ensure assure the delivery

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

24  training standards and requirements for the

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

26  Training must be sufficient to ensure that quality services

27  are provided to consumers clients and that appropriate skills

28  are developed to conduct the program.

29         (6)(5)  Functional impairment shall be determined

30  through an assessment administered to each applicant pursuant

31  to criteria developed by the department and adopted by rule.

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  1  Any person who has been classified as a functionally impaired

  2  elderly person is eligible to receive community care for the

  3  elderly community-care-for-the-elderly core services. However,

  4  the assessment criteria shall permit the department to

  5  prioritize service delivery to those most at risk for nursing

  6  home placement, provided that it has been determined that

  7  maintaining the person in the home provides the most

  8  cost-effective delivery of needed care and does not jeopardize

  9  the person's safety. Those elderly persons who are determined

10  by adult protective services to be elderly persons in need of

11  services, pursuant to s. 415.1045(2)(b), or to be victims of

12  abuse, neglect, or exploitation who are in need of immediate

13  services to prevent further harm and are referred by adult

14  protective services, shall be given primary consideration for

15  receiving community-care-for-the-elderly services. As used in

16  this subsection, "Primary consideration" means that an

17  assessment and services must commence within 72 hours after

18  referral to the department or as established in accordance

19  with department contracts by local protocols developed between

20  department service providers and adult protective services.

21  The department shall serve first those individuals most in

22  need as determined by the assessment, regardless of referral

23  source.

24         (7)  In order to maximize resources, services shall

25  also be obtained through:

26         (a)  The Florida Plan for Medical Assistance under

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

28  benefits available through a corporate retirement program.

29         (b)  The state plan developed by the department

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

31  Americans Act of 1965, as amended.

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  1         (c)  Health care taxing districts.

  2         (d)  Religious or charitable organizations or volunteer

  3  programs.

  4         (8)  The department shall evaluate the coordination and

  5  delivery of services within community care service areas.

  6  Accurate analyses of the costs and benefits associated with

  7  the establishment and operation of the programs, as determined

  8  through a uniform cost-accounting and reporting system, shall

  9  be maintained to provide an assessment of the ability of these

10  programs to:

11         (a)  Reduce the rate of inappropriate entry and

12  placement of functionally impaired elderly persons in

13  institutions; and

14         (b)  Reduce the use of institutional services and

15  facilities,

16

17  and to provide recommendations for legislative and

18  administrative action.

19         (9)  The department shall adopt rules establishing

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

21  selection, training, and supervision of service providers and

22  staff providing services pursuant to this program.

23         Section 19.  Section 430.2055, Florida Statutes, is

24  created to read:

25         430.2055  Community care for the elderly service

26  contracts and copayments.--

27         (1)  The department or its designee agency shall

28  contract with public or private agencies or organizations for

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

30  elderly program. Whenever feasible, an area agency on aging

31  shall be the designee agency of preference. The contracting

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  1  agency shall ensure that all other funding sources and

  2  informal community resources available have been considered

  3  prior to utilizing community care for the elderly funds. The

  4  department and contracting agency may accept gifts and grants

  5  in order to fund services within a community care service

  6  area.

  7         (2)  Agencies or organizations contracting to provide

  8  community care for the elderly services under ss.

  9  430.201-430.207 must provide a minimum of 10 percent of the

10  funding necessary for the support of project operations.

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

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

13  local funding.

14         (3)  Funds appropriated for community care for the

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

16  for the elderly services and directly related expenditures.

17  The department may provide advance funding for a community

18  care for the elderly program. An area agency on aging may

19  directly provide services as permitted by federal regulation

20  and with the concurrence of the department.

21         (4)  At the time of the initial assessment, a copayment

22  shall be assessed for services in accordance with a schedule

23  established by the department, in consultation with area

24  agencies on aging, lead agencies, and service providers, and

25  adopted by rule. The copayment schedule shall be proportional

26  to the functionally impaired elderly person's overall ability

27  to pay.

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

29  section.

30         Section 20.  Section 430.206, Florida Statutes, is

31  amended to read:

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  1         430.206  Multiservice senior center.--

  2         (1)  If practicable, multiservice senior centers shall

  3  be established to provide a structurally integrated system for

  4  delivering a broad spectrum of services, including health,

  5  mental health, social, nutritional, and educational services;

  6  wellness and preventive health programs; housing resources;

  7  information and referral; and the provision of facilities for

  8  recreational activities, to center services shall be available

  9  to functionally impaired elderly persons and their caregivers

10  in a culturally appropriate fashion.

11         (2)  If feasible, a multiservice senior center must be

12  centrally located and easily accessible to public

13  transportation. Provision may be made for transporting persons

14  to the center.  A center shall be designed to provide ease of

15  access and use, considering the infirmities of elderly

16  persons.

17         (3)  State funds appropriated to construct, acquire, or

18  renovate a multiservice senior center shall entitle the

19  department to a proportionate reversionary interest in the

20  center. The sale of such center shall not occur without

21  written notice to the department.

22         Section 21.  Section 430.207, Florida Statutes, is

23  amended to read:

24         430.207  Confidentiality of information.--Information

25  about functionally impaired elderly persons who receive

26  services under ss. 430.201-430.206 which is received through

27  files, reports, inspections, or otherwise, by the department

28  or by authorized departmental employees, by persons who

29  volunteer services, or by persons who provide services to

30  functionally impaired elderly persons under ss.

31  430.201-430.206 through contracts with the department is

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  1  confidential and exempt from the provisions of s. 119.07(1).

  2  Such information may not be disclosed publicly in such a

  3  manner as to identify a functionally impaired elderly person,

  4  unless that person or his or her legal guardian provides

  5  written consent.

  6         Section 22.  Section 430.41, Florida Statutes, is

  7  amended to read:

  8         430.41  Grants and Donations Trust Fund.--

  9         (1)  The Grants and Donations Trust Fund is hereby

10  created, to be administered by the Department of Elderly

11  Affairs.  Funds to be credited to the trust fund shall include

12  all public and private grants and donations to the department,

13  except for grants provided by the Federal Government and other

14  earnings that are deposited into the Operations and

15  Maintenance Trust Fund of the department.  Funds from the

16  Grants and Donations Trust Fund shall be used to fulfill

17  agreements made with grantors and contributors and such other

18  purposes as may be appropriate and shall only be expended

19  pursuant to legislative appropriation or an approved amendment

20  to the department's operating budget pursuant to the

21  provisions of chapter 216. The department may seek and receive

22  grants, donations, honoraria, and sponsorships to be credited

23  to the trust fund and used in support of the mission of the

24  department, including training and education of caregivers,

25  service providers, and administrators, and for publishing of

26  the Elder Update, and educational newspaper for the elderly.

27         (2)  Notwithstanding the provisions of s. 216.301 and

28  pursuant to s. 216.351, any balance in the trust fund at the

29  end of any fiscal year shall remain in the trust fund and

30  shall be available for carrying out the purposes of the trust

31

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  1  fund. The trust fund is exempt from the service charges

  2  imposed by s. 215.20.

  3         Section 23.  Section 430.42, Florida Statutes, is

  4  renumbered as section 430.82, Florida Statutes.

  5         Section 24.  Section 430.43, Florida Statutes, is

  6  created to read:

  7         430.43  Time-limited project, grant, or trust fund

  8  personnel.--If, in executing the terms of grants, trust funds,

  9  or contracts for specific projects, the employment of

10  personnel is required, such personnel shall not be subject to

11  the requirements for authorized positions provided in s.

12  216.262(1)(a). In addition, the personnel employed to plan and

13  administer such projects in certain positions specified by the

14  Secretary of Elderly Affairs, upon consultation with the

15  Department of Management Services, shall be considered in

16  time-limited employment not to exceed the duration of the

17  grant or until completion of the project, whichever first

18  occurs. Such time-limited employees shall not acquire

19  retention rights under the Career Service System, the

20  provisions of s. 110.205(1) to the contrary notwithstanding.

21  However, all other career service rights remain applicable

22  unless the specified time-limited position is also designated

23  by the secretary to be in the Selected Exempt Service System.

24  Any employee holding permanent career service status in the

25  department who is appointed to a specified time-limited

26  position, not designated as selected exempt service, shall

27  retain such permanent status in the career service.

28         Section 25.  Section 430.5011, Florida Statutes, is

29  created to read:

30         430.5011  Short title.--Sections 430.5011-430.504 may

31  be cited as the "Alzheimer's Disease Initiative."

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  1         Section 26.  Section 430.501, Florida Statutes, is

  2  renumbered as section 430.5012, and amended to read:

  3         430.5012 430.501  Alzheimer's Disease Advisory

  4  Committee; research grants.--

  5         (1)  It is the finding of the Legislature that

  6  Alzheimer's disease and similar major memory disorders affect

  7  an alarmingly high percentage of citizens, primarily those

  8  over 65 years of age, and yet little is known of the cause,

  9  prevention, or treatment of this disease.

10         (1)(2)  There is created an Alzheimer's Disease

11  Advisory Committee, composed of 10 members to be selected by

12  the Governor, which shall advise the Department of Elderly

13  Affairs in the performance of its duties under this act. All

14  members must be residents of the state. The committee shall

15  advise the department regarding legislative, programmatic, and

16  administrative matters that relate to Alzheimer's disease and

17  related disorders, and victims thereof and their caretakers.

18  All members must be residents of the state.

19         (2)(3)(a)  The committee membership shall be

20  representative as follows:

21         1.  At least 4 of the 10 members must be licensed

22  pursuant to chapter 458 or chapter 459 or hold a Ph.D. degree

23  and be currently involved in the research of Alzheimer's

24  disease.

25         2.  The 10 members must include at least 4 persons who

26  have been caregivers of victims of Alzheimer's disease.

27         3.  Whenever possible, the 10 members shall include 1

28  each of the following professionals:  a gerontologist, a

29  geriatric psychiatrist, a geriatrician, a neurologist, a

30  social worker, and a registered nurse.

31

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  1         (b)1.  The Governor shall appoint members from a broad

  2  cross section of public, private, and volunteer sectors.  All

  3  nominations shall be forwarded to the Governor by the

  4  secretary of the department Elderly Affairs in accordance with

  5  this subsection.

  6         2.  Members shall be appointed to 4-year staggered

  7  terms in accordance with s. 20.052.

  8         3.  The secretary of the department Elderly Affairs

  9  shall serve as an ex officio member of the committee.

10         4.  The committee shall elect one of its members to

11  serve as chair for a term of 1 year.

12         5.  The committee may establish subcommittees as

13  necessary to carry out the functions of the committee.

14         6.  The committee shall meet quarterly, or as

15  frequently as needed.

16         7.  The department of Elderly Affairs shall provide

17  staff support to assist the committee in the performance of

18  its duties.

19         8.  Members of the committee and subcommittees shall

20  receive no salary, but are entitled to reimbursement for

21  travel and per diem expenses, as provided in s. 112.061, while

22  performing their duties under this section.

23         (3)  The Alzheimer's Disease Advisory Committee shall

24  evaluate the need for additional memory disorder clinics as

25  established in s. 430.502.

26         (4)  If funds are made available through gifts, grants,

27  or other sources, the Department of Elderly Affairs shall

28  deposit such funds into its Grants and Donations Trust Fund

29  and shall award research grants to qualified profit or

30  nonprofit associations and institutions or governmental

31  agencies in order to plan, establish, or conduct programs in

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  1  Alzheimer's disease control or prevention, education and

  2  training, and research.  The department may adopt rules

  3  necessary to carry out these duties.

  4         Section 27.  Section 430.502, Florida Statutes, is

  5  amended to read:

  6         430.502  Alzheimer's disease; memory disorder clinics

  7  and day care and respite care programs.--

  8         (1)  The Legislature finds that Alzheimer's disease and

  9  similar major memory disorders affect an alarmingly high

10  percentage of adults, primarily those over 65 years of age,

11  and yet little is known of the cause, prevention, or treatment

12  of this disease. Therefore, the Legislature intends that

13  memory disorder clinics be established for the purpose of

14  conducting research and training in a diagnostic and

15  therapeutic setting for persons suffering from Alzheimer's

16  disease and related memory disorders.

17         (2)(1)  There is established:

18         (a)  A memory disorder clinic at each of the three

19  medical schools in this state;

20         (b)  A memory disorder clinic at a major private

21  nonprofit research-oriented teaching hospital, and may fund a

22  memory disorder clinic at any of the other affiliated teaching

23  hospitals;

24         (c)  A memory disorder clinic at the Mayo Clinic in

25  Jacksonville;

26         (d)  A memory disorder clinic at the West Florida

27  Regional Medical Center;

28         (e)  The East Central Florida Memory Disorder Clinic at

29  the Joint Center for Advanced Therapeutics and Biomedical

30  Research of the Florida Institute of Technology and Holmes

31  Regional Medical Center, Inc.;

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  1         (f)  A memory disorder clinic at the Orlando Regional

  2  Healthcare System, Inc.;

  3         (g)  A memory disorder center located in a public

  4  hospital that is operated by an independent special hospital

  5  taxing district that governs multiple hospitals and is located

  6  in a county with a population greater than 800,000 persons;

  7         (h)  A memory disorder clinic at St. Mary's Medical

  8  Center in Palm Beach County;

  9         (i)  A memory disorder clinic at the Tallahassee

10  Memorial Regional Medical Center;

11         (j)  A memory disorder clinic at Lee Memorial Hospital

12  created by chapter 63-1552, Laws of Florida, as amended; and

13         (k)  A memory disorder clinic at Sarasota Memorial

14  Hospital in Sarasota County.,

15

16  for the purpose of conducting research and training in a

17  diagnostic and therapeutic setting for persons suffering from

18  Alzheimer's disease and related memory disorders. However,

19  Memory disorder clinics funded as of June 30, 1995, shall not

20  receive decreased funding due solely to subsequent additions

21  of memory disorder clinics in this subsection.

22         (3)(2)  It is the intent of the Legislature that

23  Research conducted by a memory disorder clinic and supported

24  by state funds pursuant to subsection (2) shall (1) be applied

25  research, be service-related, and be selected in consultation

26  conjunction with the department.  Such research may address,

27  but is not limited to, diagnostic technique, therapeutic

28  interventions, and supportive services for persons suffering

29  from Alzheimer's disease and related memory disorders and

30  their caregivers.  Research A memory disorder clinic shall be

31  conducted conduct such research in accordance with a research

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  1  plan and incorporate developed by the clinic which establishes

  2  research objectives as specified in this section that are in

  3  accordance with this legislative intent.  A memory disorder

  4  clinic shall also complete and submit to the department

  5  periodic research status updates and a final report of the

  6  findings, conclusions, and recommendations of completed

  7  research, and shall provide all site data to the department's

  8  Alzheimer's research database.  This subsection does not apply

  9  to those memory disorder clinics at the three medical schools

10  in the state or at the major private nonprofit

11  research-oriented teaching hospital or other affiliated

12  teaching hospital.

13         (3)  The Alzheimer's Disease Advisory Committee must

14  evaluate the need for additional memory disorder clinics in

15  the state.  The first report will be due by December 31, 1995.

16         (4)  Pursuant to the provisions of s. 287.057, the

17  department of Elderly Affairs may contract with the memory

18  disorder clinics for the provision of specialized model day

19  care programs in conjunction with the memory disorder clinics.

20  The purpose of each model day care program must be to provide

21  innovative service delivery to persons suffering from

22  Alzheimer's disease or a related memory disorder and training

23  for health care and social service personnel in the care of

24  persons having Alzheimer's disease or related memory

25  disorders.

26         (5)  Pursuant to s. 287.057, the department of Elderly

27  Affairs shall contract for the provision of respite care. All

28  funds appropriated for the provision of respite care shall be

29  distributed annually by the department to each planning and

30  service area funded county according to an allocation formula

31  developed by the department.  In developing the formula, the

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  1  department shall consider the number and proportion of the

  2  county population of individuals in the area who are 75 years

  3  of age and older.

  4         (6)  Each respite care program may shall be used as a

  5  resource for research and statistical data by the memory

  6  disorder clinics established in this section part.  In

  7  consultation with the memory disorder clinics, the department

  8  shall specify the information to be provided by the respite

  9  care programs for such research purposes. The memory disorder

10  clinic shall be responsible for reporting any research results

11  as provided under subsection (3).

12         (7)  If funds are made available for Alzheimer's

13  research through gifts, grants, or other sources, the

14  department shall deposit such funds into its Grants and

15  Donations Trust Fund, and shall award research grants to

16  qualified profit or not-for-profit associations and

17  institutions or governmental agencies in order to plan,

18  establish, or conduct programs in Alzheimer's disease control

19  or prevention, education and training, and research.

20         (8)  The department shall adopt rules as necessary to

21  implement this section.

22         (6)  Each contract entered into pursuant to this

23  section must contain a requirement for a research component to

24  be completed and reported on in writing to the department

25  according to specifications and within a timeframe provided by

26  the department.

27         Section 28.  Section 430.503, Florida Statutes, is

28  amended to read:

29         430.503  Alzheimer's Disease Initiative copayments;

30  fees and administrative expense.--

31

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  1         (1)  Sections 430.501-430.504 may be cited as the

  2  "Alzheimer's Disease Initiative."

  3         (2)  To assist in covering the cost of services

  4  provided pursuant to the Alzheimer's Disease Initiative,

  5  provider agencies shall be are responsible for assessing a

  6  copayment the collection of fees for services in accordance

  7  with a schedule established rules adopted by the department

  8  and adopted by rule. The copayment schedule shall be

  9  proportional to the Provider agencies shall assess fees for

10  services rendered in accordance with those rules.  To help pay

11  for services received pursuant to the Alzheimer's Disease

12  Initiative, a functionally impaired elderly person's overall

13  ability to pay and person shall be assessed a fee based on an

14  overall ability to pay.  The fee to be assessed shall be fixed

15  according to a schedule to be established by the department.

16  Services of specified value may be accepted in lieu of a fee.

17  The fee schedule shall be developed in consultation

18  cooperation with the Alzheimer's Disease Advisory Committee,

19  area agencies on aging, and service providers. The area agency

20  on aging shall determine who shall be responsible for

21  collecting the copayment.

22         Section 29.  Section 430.504, Florida Statutes, is

23  amended to read:

24         430.504  Confidentiality of information.--Information

25  about clients of programs created or funded under s. 430.502

26  430.501 or s. 430.503 which is received through files,

27  reports, inspections, or otherwise, by the department or by

28  authorized departmental employees, by persons who volunteer

29  services, or by persons who provide services to clients of

30  programs created or funded under s. 430.502 430.501 or s.

31  430.503 through contracts with the department is confidential

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  1  and exempt from the provisions of s. 119.07(1).  Such

  2  information may not be disclosed publicly in such a manner as

  3  to identify a person who receives services under s. 430.502

  4  430.501 or s. 430.503, unless that person or that person's

  5  legal guardian provides written consent.

  6         Section 30.  Section 430.601, Florida Statutes, is

  7  amended to read:

  8         430.601  Home care for the elderly; legislative

  9  intent.--It is the intent of the Legislature to encourage the

10  provision of care for elderly persons living the elderly in

11  family-type living arrangements in private homes as an

12  alternative to institutional or nursing home care. for such

13  persons.  The provisions of ss. 430.601-430.606 are intended

14  to be supplemental to the provisions of chapter 400, relating

15  to the licensing and regulation of nursing homes and assisted

16  living facilities, and do not exempt any person who is

17  otherwise subject to regulation under the provisions of that

18  chapter.

19         Section 31.  Section 430.603, Florida Statutes, is

20  amended to read:

21         430.603  Home care for the elderly program; rules.--

22         (1)  The department shall administer the home care for

23  the elderly program, which provides a subsidy to a person who

24  provides, on a not-for-profit basis, basic maintenance and

25  supervision, and any necessary additional in-home services,

26  for one to three elderly persons in a family-type living

27  arrangement in a private home.

28         (2)  The department shall by rule establish minimum

29  standards and procedures for the provision of home care for

30  the elderly and for the screening, selection, training, and

31  supervision approval of persons seeking to provide such care.

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  1  Any person who is approved to provide care, goods, or services

  2  for an elderly person shall be eligible for the subsidy

  3  payments described in s. 430.605. However, the home care for

  4  the elderly program must be operated within the funds

  5  appropriated by the Legislature.

  6         Section 32.  Section 430.604, Florida Statutes, is

  7  amended to read:

  8         430.604  Department determination of inability to

  9  provide home care.--Any If a person planning who plans to

10  provide home care under ss. 430.601-430.606 who is found by

11  the department, or its designee, to be unable to provide this

12  care must be notified, the department must notify the person

13  seeking to provide home care of this determination, and that

14  the person is not eligible for subsidy payments under ss.

15  430.601-430.606.

16         Section 33.  Section 430.605, Florida Statutes, is

17  amended to read:

18         430.605  Subsidy payments.--The department shall

19  develop and adopt by rule a schedule of subsidy payments to be

20  made to persons providing home care, and to providers of goods

21  and services, for certain eligible elderly persons.  Payments

22  must be based on the financial status of the person receiving

23  care and include.  Payments must include, but need not be

24  limited to:

25         (1)  A basic support and maintenance payment for

26  element, including costs of housing, food, clothing, and

27  incidentals.

28         (2)  Payments for medical, pharmaceutical, and dental

29  services essential to maintain the health of the elderly

30  person and not covered by Medicare, Medicaid, or any form of

31  insurance.

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  1         (2)(3)  When necessary, special supplement payments

  2  supplements to provide for any goods and services and

  3  specialized care required to maintain the health and

  4  well-being of the elderly person not already covered by public

  5  or private insurance, including Medicare or Medicaid.

  6  Extraordinary medical, dental, or pharmaceutical expenses may

  7  be paid as a special supplement.

  8         Section 34.  Section 430.701, Florida Statutes, is

  9  amended to read:

10         430.701  Legislative findings and intent.--The

11  Legislature finds that state expenditures for long-term care

12  services continue to increase at a rapid rate and that Florida

13  faces increasing pressure in its efforts to meet the long-term

14  care needs of its elderly residents the public.  It is

15  therefore the intent of the Legislature that the department of

16  Elderly Affairs, in consultation with the Agency for Health

17  Care Administration, implement long-term care community

18  diversion pilot projects to test the effectiveness of managed

19  care and outcome-based reimbursement principles to the

20  provision of cost-effective when applied to long-term care.

21         Section 35.  Section 430.702, Florida Statutes, is

22  amended to read:

23         430.702  Short title.--Sections 430.701-430.710 This

24  act may be cited as the "Long-Term Care Community Diversion

25  Pilot Project Act."

26         Section 36.  Section 430.703, Florida Statutes, is

27  amended to read:

28         430.703  Definitions.--As used in ss. 430.701-430.710

29  this act, the term:

30         (1)  "Agency" means the Agency for Health Care

31  Administration.

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  1         (2)  "Community diversion" means a strategy that places

  2  participants in the most appropriate care settings and

  3  provides comprehensive home and community-based services of

  4  sufficient quantity, type, and duration to prevent or delay

  5  the need for long-term placement in a nursing facility.

  6         (2)(3)  "Community diversion pilot project" means any

  7  pilot service delivery system that places participants in the

  8  most appropriate care settings and provides comprehensive home

  9  and community-based services of sufficient quantity, type, and

10  duration to prevent or delay the need for long-term placement

11  in a nursing facility.

12         (3)(4)  "Community diversion pilot project area" means

13  a geographic area selected by the department where the

14  department will conduct a community diversion pilot project.

15         (5)  "Department" means the Department of Elderly

16  Affairs.

17         (4)(6)  "Managed care organization" means an entity

18  that meets the requirements of the Department of Insurance for

19  operation as a health maintenance organization and meets the

20  qualifications for participation as a managed care

21  organization established by the agency and the department.

22         (5)(7)  "Participant" means an individual enrolled in a

23  community diversion pilot project.

24         Section 37.  Section 430.705, Florida Statutes, is

25  amended to read:

26         430.705  Implementation of the long-term care community

27  diversion pilot projects.--

28         (1)  In designing and implementing the community

29  diversion pilot projects, the department shall:

30         (a)  Work in consultation with the agency.

31         (b)  Develop a capitation rate-setting method that:

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  1         1.  Ensures sufficient savings from the state Medicaid

  2  nursing home budget category to fund community diversion pilot

  3  projects.

  4         2.  Ensures that expenditures do not exceed the average

  5  nursing home cost in the pilot project area, excluding

  6  Medicaid acute care costs and Medicaid cost-sharing.

  7         (c)  Evaluate:

  8         1.  The standards in existing Medicaid managed care

  9  contracts to determine if they are sufficient to ensure

10  access, quality, and cost-effective services to frail elders.

11         2.  The cost-effectiveness of the services provided

12  through the pilot projects.

13         3.  The impact of nursing home bed growth on state

14  expenditures.

15         4.  Methods to encourage competition among long-term

16  care service providers in order to facilitate improved service

17  quality, price, and participant satisfaction.

18         5.  Criteria for selecting managed care organizations,

19  including quality assurance processes, grievance procedures,

20  service costs, accessibility, adequacy of provider networks,

21  and administrative costs.

22         6.  Criteria for participant eligibility.

23         7.  The provision of services to determine if the

24  participants' quality of life has improved.

25         (d)(2)  The department shall Select projects whose

26  design and providers demonstrate capacity to maximize the

27  placement of participants in the least restrictive appropriate

28  care setting.

29         (e)(3)  The department shall Provide to prospective

30  participants a choice of participating in a community

31  diversion pilot project or any other appropriate placement

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  1  available.  To the extent possible, individuals shall be

  2  allowed to choose their care providers, including long-term

  3  care service providers affiliated with an individual's

  4  religious faith or denomination.

  5         (f)(4)  The department shall Enroll participants.

  6  Providers shall not directly enroll participants in community

  7  diversion pilot projects.

  8         (2)(5)  In selecting the pilot project area, the

  9  department shall consider the following factors in the area:

10         (a)  The nursing home occupancy level.

11         (b)  The number of certificates of need awarded for

12  nursing home beds for which renovation, expansion, or

13  construction has not begun.

14         (c)  The annual number of additional nursing home beds.

15         (d)  The annual number of nursing home admissions.

16         (e)  The adequacy of community-based long-term care

17  service providers.

18         (f)  The availability of managed care organizations.

19         (3)(6)  The department may require participants to

20  contribute to their cost of care in an amount not to exceed

21  the cost-sharing required of Medicaid-eligible nursing home

22  residents.

23         (4)(7)  Community diversion pilot projects must:

24         (a)  Provide services for participants that are of

25  sufficient quality, quantity, type, and duration to prevent or

26  delay nursing facility placement.

27         (b)  Integrate acute and long-term care services, and

28  the funding sources for such services, as feasible.

29         (c)  Encourage individuals, families, and communities

30  to plan for their long-term care needs.

31

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  1         (d)  Provide skilled and intermediate nursing facility

  2  care for participants who cannot be adequately cared for in

  3  noninstitutional settings.

  4         Section 38.  Subsection (1) of section 430.707, Florida

  5  Statutes, is amended to read:

  6         430.707  Contracts.--

  7         (1)  The department, in consultation with the agency,

  8  shall select and contract with managed care organizations to

  9  provide long-term care within community diversion pilot

10  project areas. Such contracts shall include qualifications for

11  participation as a managed care organization, criteria for

12  participant eligibility, and quality of care standards for

13  community diversion pilot projects.  Such quality of care

14  standards shall apply to all contractors and subcontractors

15  and must include outcome measures, utilization review,

16  grievance and conflict resolution, patient satisfaction, and

17  care and service standards.

18         Section 39.  Section 430.80, Florida Statutes, is

19  renumbered as section 400.337, Florida Statutes.

20         Section 40.  Sections 430.02, 430.04, 430.101, 430.203,

21  430.204, 430.602, 430.704, 430.706, and 430.710, Florida

22  Statutes, are repealed.

23         Section 41.  This act shall take effect July 1, 2000.

24

25            *****************************************

26                          HOUSE SUMMARY

27
      Revises, clarifies, and conforms provisions relating to
28    organization and responsibilities of the Department of
      Elderly Affairs and to various programs administered by
29    the department.

30

31

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