HB 0501

CS

CHAMBER ACTION

1	The Elder & Long-Term Care Committee recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to assisted care communities; creating ch.
7	429, F.S.; transferring pt. III of ch. 400, F.S., relating
8	to assisted living facilities, to pt. I of ch. 429, F.S.;
9	transferring pt. VII of ch. 400, F.S., relating to adult
10	family-care homes, to pt. II of ch. 429, F.S.;
11	transferring pt. V of ch. 400, F.S., relating to adult day
12	care centers, to pt. III of ch. 429, F.S.; amending ss.
13	101.655, 189.428, 196.1975, 202.125, 205.1965, 212.031,
14	212.08, 296.02, 381.0035, 381.745, 393.063, 393.506,
15	394.455, 394.4574, 394.463, 400.0063, 400.0069, 400.0073,
16	400.0077, 400.0239, 400.119, 400.141, 400.142, 400.191,
17	400.215, 400.402, 400.404, 400.407, 400.4071, 400.408,
18	400.411, 400.412, 400.414, 400.415, 400.417, 400.4174,
19	400.4176, 400.4178, 400.418, 400.419, 400.42, 400.422,
20	400.424, 400.4255, 400.4256, 400.426, 400.427, 400.428,
21	400.429, 400.4293, 400.431, 400.441, 400.442, 400.444,
22	400.447, 400.452, 400.462, 400.464, 400.497, 400.552,
23	400.555, 400.556, 400.557, 400.5572, 400.601, 400.618,
24	400.6194, 400.621, 400.628, 400.93, 400.962, 400.980,
25	400.9905, 401.23, 402.164, 408.032, 408.033, 408.034,
26	408.07, 408.831, 409.212, 409.221, 409.905, 409.906,
27	409.907, 409.912, 410.031, 410.034, 415.1111, 419.001,
28	430.601, 430.703, 435.03, 435.04, 440.13, 465.0235,
29	468.1685, 468.505, 477.025, 483.285, 509.032, 509.241,
30	627.6617, 627.732, 651.011, 651.022, 651.023, 651.055,
31	651.095, 651.118, 765.1103, 765.205, 768.735, 893.13,
32	943.0585, and 943.059, F.S., to conform references to
33	changes made by the act; requesting the Division of
34	Statutory Revision to make necessary conforming changes to
35	the Florida Statutes; providing an effective date.
36
37	Be It Enacted by the Legislature of the State of Florida:
38
39	Section 1.  Chapter 429, Florida Statutes, is created, to
40	be entitled "Assisted Care Communities."
41	Section 2.  Sections 400.401, 400.402, 400.404, 400.407,
42	400.4071, 400.4075, 400.408, 400.411, 400.412, 400.414, 400.415,
43	400.417, 400.4174, 400.4176, 400.4177, 400.4178, 400.418,
44	400.419, 400.4195, 400.42, 400.421, 400.422, 400.423, 400.424,
45	400.4255, 400.4256, 400.426, 400.427, 400.4275, 400.428,
46	400.429, 400.4293, 400.4294, 400.4295, 400.4296, 400.4297,
47	400.4298, 400.431, 400.434, 400.435, 400.441, 400.442, 400.444,
48	400.4445, 400.447, 400.449, 400.451, 400.452, 400.453, and
49	400.454, Florida Statutes, are renumbered as sections 429.01,
50	429.02, 429.04, 429.07, 429.071, 429.075, 429.08, 429.11,
51	429.12, 429.14, 429.15, 429.17, 429.174, 429.176, 429.177,
52	429.178, 429.18, 429.19, 429.195, 429.20, 429.21, 429.22,
53	429.23, 429.24, 429.255, 429.256, 429.26, 429.27, 429.275,
54	429.28, 429.29, 429.293, 429.294, 429.295, 429.296, 429.297,
55	429.298, 429.31, 429.34, 429.35, 429.41, 429.42, 429.44,
56	429.445, 429.47, 429.49, 429.51, 429.52, 429.53, and 429.54,
57	Florida Statutes, respectively, designated as part I of chapter
58	429, Florida Statutes, and entitled "ASSISTED LIVING
59	FACILITIES."
60	Section 3.  Sections 400.616, 400.617, 400.618, 400.619,
61	400.6194, 400.6196, 400.621, 400.6211, 400.622, 400.625,
62	400.6255, 400.628, and 400.629, Florida Statutes, are renumbered
63	as sections 429.60, 429.63, 429.65, 429.67, 429.69, 429.71,
64	429.73, 429.75, 429.77, 429.81, 429.83, 429.85, and 429.87,
65	Florida Statutes, respectively, designated as part II of chapter
66	429, Florida Statutes, and entitled "ADULT FAMILY-CARE HOMES."
67	Section 4.  Sections 400.55, 400.551, 400.552, 400.553,
68	400.554, 400.555, 400.556, 400.5565, 400.557, 400.5571,
69	400.5572, 400.5575, 400.558, 400.559, 400.56, 400.562, 400.563,
70	and 400.564, Florida Statutes, are renumbered as sections
71	429.90, 429.901, 429.903, 429.905, 429.907, 429.909, 429.911,
72	429.913, 429.915, 429.917, 429.919, 429.921, 429.923, 429.925,
73	429.927, 429.929, 429.931, and 429.933, Florida Statutes,
74	designated as part III of chapter 429, Florida Statutes, and
75	entitled "ADULT DAY CARE CENTERS."
76	Section 5.  Subsection (1) of section 101.655, Florida
77	Statutes, is amended to read:
78	101.655  Supervised voting by absent electors in certain
79	facilities.--
80	(1)  The supervisor of elections of a county shall provide
81	supervised voting for absent electors residing in any assisted
82	living facility, as defined in s. 429.02 s. 400.402, or nursing
83	home facility, as defined in s. 400.021, within that county at
84	the request of any administrator of such a facility. Such
85	request for supervised voting in the facility shall be made by
86	submitting a written request to the supervisor of elections no
87	later than 21 days prior to the election for which that request
88	is submitted. The request shall specify the name and address of
89	the facility and the name of the electors who wish to vote
90	absentee in that election. If the request contains the names of
91	fewer than five voters, the supervisor of elections is not
92	required to provide supervised voting.
93	Section 6.  Subsection (9) of section 189.428, Florida
94	Statutes, is amended to read:
95	189.428  Special districts; oversight review process.--
96	(9)  This section does not apply to a deepwater port listed
97	in s. 311.09(1) which is in compliance with a port master plan
98	adopted pursuant to s. 163.3178(2)(k), or to an airport
99	authority operating in compliance with an airport master plan
100	approved by the Federal Aviation Administration, or to any
101	special district organized to operate health systems and
102	facilities licensed under chapter 395, or chapter 400, or
103	chapter 429.
104	Section 7.  Paragraph (b) of subsection (2) of section
105	196.1975, Florida Statutes, is amended to read:
106	196.1975  Exemption for property used by nonprofit homes
107	for the aged.--Nonprofit homes for the aged are exempt to the
108	extent that they meet the following criteria:
109	(2)  A facility will not qualify as a "home for the aged"
110	unless at least 75 percent of the occupants are over the age of
111	62 years or totally and permanently disabled.  For homes for the
112	aged which are exempt from paying income taxes to the United
113	States as specified in subsection (1), licensing by the Agency
114	for Health Care Administration is required for ad valorem tax
115	exemption hereunder only if the home:
116	(b)  Qualifies as an assisted living facility under part
117	III of chapter 429 400.
118	Section 8.  Paragraph (c) of subsection (4) of section
119	202.125, Florida Statutes, is amended to read:
120	202.125  Sales of communications services; specified
121	exemptions.--
122	(4)  The sale of communications services to a home for the
123	aged, religious institution or educational institution that is
124	exempt from federal income tax under s. 501(c)(3) of the
125	Internal Revenue Code, or by a religious institution that is
126	exempt from federal income tax under s. 501(c)(3) of the
127	Internal Revenue Code having an established physical place for
128	worship at which nonprofit religious services and activities are
129	regularly conducted and carried on, is exempt from the taxes
130	imposed or administered pursuant to ss. 202.12 and 202.19. As
131	used in this subsection, the term:
132	(c)  "Home for the aged" includes any nonprofit
133	corporation:
134	1.  In which at least 75 percent of the occupants are 62
135	years of age or older or totally and permanently disabled; which
136	qualifies for an ad valorem property tax exemption under s.
137	196.196, s. 196.197, or s. 196.1975; and which is exempt from
138	the sales tax imposed under chapter 212.
139	2.  Licensed as a nursing home under chapter 400 or an
140	assisted living facility under chapter 429 400 and which is
141	exempt from the sales tax imposed under chapter 212.
142	Section 9.  Section 205.1965, Florida Statutes, is amended
143	to read:
144	205.1965  Assisted living facilities.--A county or
145	municipality may not issue an occupational license for the
146	operation of an assisted living facility pursuant to part III of
147	chapter 429 400 without first ascertaining that the applicant
148	has been licensed by the Agency for Health Care Administration
149	to operate such facility at the specified location or locations.
150	The Agency for Health Care Administration shall furnish to local
151	agencies responsible for issuing occupational licenses
152	sufficient instructions for making the above required
153	determinations.
154	Section 10.  Paragraph (b) of subsection (1) of section
155	212.031, Florida Statutes, is amended to read:
156	212.031  Tax on rental or license fee for use of real
157	property.--
158	(1)
159	(b)  When a lease involves multiple use of real property
160	wherein a part of the real property is subject to the tax
161	herein, and a part of the property would be excluded from the
162	tax under subparagraph (a)1., subparagraph (a)2., subparagraph
163	(a)3., or subparagraph (a)5., the department shall determine,
164	from the lease or license and such other information as may be
165	available, that portion of the total rental charge which is
166	exempt from the tax imposed by this section. The portion of the
167	premises leased or rented by a for-profit entity providing a
168	residential facility for the aged will be exempt on the basis of
169	a pro rata portion calculated by combining the square footage of
170	the areas used for residential units by the aged and for the
171	care of such residents and dividing the resultant sum by the
172	total square footage of the rented premises. For purposes of
173	this section, the term "residential facility for the aged" means
174	a facility that is licensed or certified in whole or in part
175	under chapter 400, chapter 429, or chapter 651; or that provides
176	residences to the elderly and is financed by a mortgage or loan
177	made or insured by the United States Department of Housing and
178	Urban Development under s. 202, s. 202 with a s. 8 subsidy, s.
179	221(d)(3) or (4), s. 232, or s. 236 of the National Housing Act;
180	or other such similar facility that provides residences
181	primarily for the elderly.
182	Section 11.  Paragraph (i) of subsection (7) of section
183	212.08, Florida Statutes, is amended to read:
184	212.08  Sales, rental, use, consumption, distribution, and
185	storage tax; specified exemptions.--The sale at retail, the
186	rental, the use, the consumption, the distribution, and the
187	storage to be used or consumed in this state of the following
188	are hereby specifically exempt from the tax imposed by this
189	chapter.
190	(7)  MISCELLANEOUS EXEMPTIONS.--Exemptions provided to any
191	entity by this chapter do not inure to any transaction that is
192	otherwise taxable under this chapter when payment is made by a
193	representative or employee of the entity by any means,
194	including, but not limited to, cash, check, or credit card, even
195	when that representative or employee is subsequently reimbursed
196	by the entity. In addition, exemptions provided to any entity by
197	this subsection do not inure to any transaction that is
198	otherwise taxable under this chapter unless the entity has
199	obtained a sales tax exemption certificate from the department
200	or the entity obtains or provides other documentation as
201	required by the department. Eligible purchases or leases made
202	with such a certificate must be in strict compliance with this
203	subsection and departmental rules, and any person who makes an
204	exempt purchase with a certificate that is not in strict
205	compliance with this subsection and the rules is liable for and
206	shall pay the tax. The department may adopt rules to administer
207	this subsection.
208	(i)  Hospital meals and rooms.--Also exempt from payment of
209	the tax imposed by this chapter on rentals and meals are
210	patients and inmates of any hospital or other physical plant or
211	facility designed and operated primarily for the care of persons
212	who are ill, aged, infirm, mentally or physically incapacitated,
213	or otherwise dependent on special care or attention. Residents
214	of a home for the aged are exempt from payment of taxes on meals
215	provided through the facility.  A home for the aged is defined
216	as a facility that is licensed or certified in part or in whole
217	under chapter 400, chapter 429, or chapter 651, or that is
218	financed by a mortgage loan made or insured by the United States
219	Department of Housing and Urban Development under s. 202, s. 202
220	with a s. 8 subsidy, s. 221(d)(3) or (4), s. 232, or s. 236 of
221	the National Housing Act, or other such similar facility
222	designed and operated primarily for the care of the aged.
223	Section 12.  Subsection (5) of section 296.02, Florida
224	Statutes, is amended to read:
225	296.02  Definitions.--For the purposes of this part, except
226	where the context clearly indicates otherwise:
227	(5)  "Extended congregate care" has the meaning given to
228	that term under s. 429.02 s. 400.402.
229	Section 13.  Subsections (1) and (3) of section 381.0035,
230	Florida Statutes, are amended to read:
231	381.0035  Educational course on HIV and AIDS; employees and
232	clients of certain health care facilities.--
233	(1)  The Department of Health shall require all employees
234	and clients of facilities licensed under chapters 393, 394, and
235	397 and employees of facilities licensed under chapter 395, and
236	parts II and, III, IV, and VI of chapter 400, and parts I and IV
237	of chapter 429 to complete, biennially, a continuing educational
238	course on the modes of transmission, infection control
239	procedures, clinical management, and prevention of human
240	immunodeficiency virus and acquired immune deficiency syndrome
241	with an emphasis on appropriate behavior and attitude change.
242	Such instruction shall include information on current Florida
243	law and its impact on testing, confidentiality of test results,
244	and treatment of patients and any protocols and procedures
245	applicable to human immunodeficiency counseling and testing,
246	reporting, the offering of HIV testing to pregnant women, and
247	partner notification issues pursuant to ss. 381.004 and 384.25.
248	(3)  Facilities licensed under chapters 393, 394, 395, and
249	397, and parts II, III, and IV, and VI of chapter 400, and part
250	I of chapter 429 shall maintain a record of employees and dates
251	of attendance at human immunodeficiency virus and acquired
252	immune deficiency syndrome educational courses.
253	Section 14.  Subsection (9) of section 381.745, Florida
254	Statutes, is amended to read:
255	381.745  Definitions; ss. 381.739-381.79.--As used in ss.
256	381.739-381.79, the term:
257	(9)  "Transitional living facility" means a state-approved
258	facility, as defined and licensed under chapter 400 or chapter
259	429, or a facility approved by the brain and spinal cord injury
260	program in accordance with this chapter.
261	Section 15.  Subsection (24) of section 393.063, Florida
262	Statutes, is amended to read:
263	393.063  Definitions.--For the purposes of this chapter:
264	(24)  "Intermediate care facility for the developmentally
265	disabled" or "ICF/DD" means a residential facility licensed and
266	certified pursuant to part VIII XI of chapter 400.
267	Section 16.  Paragraph (b) of subsection (1) of section
268	393.506, Florida Statutes, is amended to read:
269	393.506  Administration of medication.--
270	(1)  Notwithstanding the provisions of part I of chapter
271	464, the Nurse Practice Act, unlicensed direct care services
272	staff providing services to persons with developmental
273	disabilities may administer oral, transdermal, inhaled, or
274	topical prescription medications as provided in this section.
275	(b)  For intermediate care facilities for the
276	developmentally disabled licensed pursuant to part VIII XI of
277	chapter 400, unlicensed staff designated by the director may
278	provide medication assistance under the general supervision of a
279	registered nurse licensed pursuant to chapter 464.
280	Section 17.  Subsection (10) of section 394.455, Florida
281	Statutes, is amended to read:
282	394.455  Definitions.--As used in this part, unless the
283	context clearly requires otherwise, the term:
284	(10)  "Facility" means any hospital, community facility,
285	public or private facility, or receiving or treatment facility
286	providing for the evaluation, diagnosis, care, treatment,
287	training, or hospitalization of persons who appear to have a
288	mental illness or have been diagnosed as having a mental
289	illness.  "Facility" does not include any program or entity
290	licensed pursuant to chapter 400 or chapter 429.
291	Section 18.  Paragraphs (b), (c), and (e) of subsection (2)
292	of section 394.4574, Florida Statutes, are amended to read:
293	394.4574  Department responsibilities for a mental health
294	resident who resides in an assisted living facility that holds a
295	limited mental health license.--
296	(2)  The department must ensure that:
297	(b)  A cooperative agreement, as required in s. 429.075 s.
298	400.4075, is developed between the mental health care services
299	provider that serves a mental health resident and the
300	administrator of the assisted living facility with a limited
301	mental health license in which the mental health resident is
302	living. Any entity that provides Medicaid prepaid health plan
303	services shall ensure the appropriate coordination of health
304	care services with an assisted living facility in cases where a
305	Medicaid recipient is both a member of the entity's prepaid
306	health plan and a resident of the assisted living facility. If
307	the entity is at risk for Medicaid targeted case management and
308	behavioral health services, the entity shall inform the assisted
309	living facility of the procedures to follow should an emergent
310	condition arise.
311	(c)  The community living support plan, as defined in s.
312	429.02 s. 400.402, has been prepared by a mental health resident
313	and a mental health case manager of that resident in
314	consultation with the administrator of the facility or the
315	administrator's designee. The plan must be provided to the
316	administrator of the assisted living facility with a limited
317	mental health license in which the mental health resident lives.
318	The support plan and the agreement may be in one document.
319	(e)  The mental health services provider assigns a case
320	manager to each mental health resident who lives in an assisted
321	living facility with a limited mental health license. The case
322	manager is responsible for coordinating the development of and
323	implementation of the community living support plan defined in
324	s. 429.02 s. 400.402. The plan must be updated at least
325	annually.
326	Section 19.  Paragraph (b) of subsection (2) of section
327	394.463, Florida Statutes, is amended to read:
328	394.463  Involuntary examination.--
329	(2)  INVOLUNTARY EXAMINATION.--
330	(b)  A person shall not be removed from any program or
331	residential placement licensed under chapter 400 or chapter 429
332	and transported to a receiving facility for involuntary
333	examination unless an ex parte order, a professional
334	certificate, or a law enforcement officer's report is first
335	prepared.  If the condition of the person is such that
336	preparation of a law enforcement officer's report is not
337	practicable before removal, the report shall be completed as
338	soon as possible after removal, but in any case before the
339	person is transported to a receiving facility.  A receiving
340	facility admitting a person for involuntary examination who is
341	not accompanied by the required ex parte order, professional
342	certificate, or law enforcement officer's report shall notify
343	the Agency for Health Care Administration of such admission by
344	certified mail no later than the next working day.  The
345	provisions of this paragraph do not apply when transportation is
346	provided by the patient's family or guardian.
347	Section 20.  Paragraph (b) of subsection (3) of section
348	400.0063, Florida Statutes, is amended to read:
349	400.0063  Establishment of Office of State Long-Term Care
350	Ombudsman; designation of ombudsman and legal advocate.--
351	(3)
352	(b)  The duties of the legal advocate shall include, but
353	not be limited to:
354	1.  Assisting the ombudsman in carrying out the duties of
355	the office with respect to the abuse, neglect, or violation of
356	rights of residents of long-term care facilities.
357	2.  Assisting the state and local ombudsman councils in
358	carrying out their responsibilities under this part.
359	3.  Initiating and prosecuting legal and equitable actions
360	to enforce the rights of long-term care facility residents as
361	defined in this chapter or chapter 429.
362	4.  Serving as legal counsel to the state and local
363	ombudsman councils, or individual members thereof, against whom
364	any suit or other legal action is initiated in connection with
365	the performance of the official duties of the councils or an
366	individual member.
367	Section 21.  Subsection (3) of section 400.0069, Florida
368	Statutes, is amended to read:
369	400.0069  Local long-term care ombudsman councils; duties;
370	membership.--
371	(3)  In order to carry out the duties specified in
372	subsection (2), the local ombudsman council is authorized,
373	pursuant to ss. 400.19(1) and 429.34 400.434, to enter any long-
374	term care facility without notice or first obtaining a warrant,
375	subject to the provisions of s. 400.0073(5).
376	Section 22.  Paragraphs (c) and (f) of subsection (5) and
377	subsection (6) of section 400.0073, Florida Statutes, are
378	amended to read:
379	400.0073  State and local ombudsman council
380	investigations.--
381	(5)  Any onsite administrative inspection conducted by an
382	ombudsman council shall be subject to the following:
383	(c)  Inspections shall be conducted in a manner which will
384	impose no unreasonable burden on nursing homes or long-term care
385	facilities, consistent with the underlying purposes of this part
386	and chapter 429. Unnecessary duplication of efforts among
387	council members or the councils shall be reduced to the extent
388	possible.
389	(f)  All inspections shall be limited to compliance with
390	part parts II, III, and VII of this chapter, chapter 429, and 42
391	U.S.C. ss. 1396(a) et seq., and any rules or regulations
392	promulgated pursuant to such laws.
393	(6)  An inspection may not be accomplished by forcible
394	entry. Refusal of a long-term care facility to allow entry of
395	any ombudsman council member constitutes a violation of part II,
396	part III, or part VII of this chapter or chapter 429.
397	Section 23.  Subsection (4) of section 400.0077, Florida
398	Statutes, is amended to read:
399	400.0077  Confidentiality.--
400	(4)  Members of any state or local ombudsman council shall
401	not be required to testify in any court with respect to matters
402	held to be confidential under s. 429.14 s. 400.414 except as may
403	be necessary to enforce the provisions of this act.
404	Section 24.  Subsection (1) of section 400.0239, Florida
405	Statutes, is amended to read:
406	400.0239  Quality of Long-Term Care Facility Improvement
407	Trust Fund.--
408	(1)  There is created within the Agency for Health Care
409	Administration a Quality of Long-Term Care Facility Improvement
410	Trust Fund to support activities and programs directly related
411	to improvement of the care of nursing home and assisted living
412	facility residents. The trust fund shall be funded through
413	proceeds generated pursuant to ss. 400.0238 and 429.298
414	400.4298, through funds specifically appropriated by the
415	Legislature, through gifts, endowments, and other charitable
416	contributions allowed under federal and state law, and through
417	federal nursing home civil monetary penalties collected by the
418	Centers for Medicare and Medicaid Services and returned to the
419	state. These funds must be utilized in accordance with federal
420	requirements.
421	Section 25.  Subsections (1) and (4) of section 400.119,
422	Florida Statutes, are amended to read:
423	400.119  Confidentiality of records and meetings of risk
424	management and quality assurance committees.--
425	(1)  Records of meetings of the risk management and quality
426	assurance committee of a long-term care facility licensed under
427	this part or part I III of this chapter 429, as well as incident
428	reports filed with the facility's risk manager and
429	administrator, notifications of the occurrence of an adverse
430	incident, and adverse incident reports from the facility are
431	confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
432	of the State Constitution. However, if the Agency for Health
433	Care Administration has a reasonable belief that conduct by a
434	staff member or employee of a facility is criminal activity or
435	grounds for disciplinary action by a regulatory board, the
436	agency may disclose such records to the appropriate law
437	enforcement agency or regulatory board.
438	(4)  The meetings of an internal risk management and
439	quality assurance committee of a long-term care facility
440	licensed under this part or part I III of this chapter 429 are
441	exempt from s. 286.011 and s. 24(b), Art. I of the State
442	Constitution and are not open to the public.
443	Section 26.  Subsections (4) and (7) of section 400.141,
444	Florida Statutes, are amended to read:
445	400.141  Administration and management of nursing home
446	facilities.--Every licensed facility shall comply with all
447	applicable standards and rules of the agency and shall:
448	(4)  Provide for resident use of a community pharmacy as
449	specified in s. 400.022(1)(q). Any other law to the contrary
450	notwithstanding, a registered pharmacist licensed in Florida,
451	that is under contract with a facility licensed under this
452	chapter or chapter 429, shall repackage a nursing facility
453	resident's bulk prescription medication which has been packaged
454	by another pharmacist licensed in any state in the United States
455	into a unit dose system compatible with the system used by the
456	nursing facility, if the pharmacist is requested to offer such
457	service. In order to be eligible for the repackaging, a resident
458	or the resident's spouse must receive prescription medication
459	benefits provided through a former employer as part of his or
460	her retirement benefits, a qualified pension plan as specified
461	in s. 4972 of the Internal Revenue Code, a federal retirement
462	program as specified under 5 C.F.R. s. 831, or a long-term care
463	policy as defined in s. 627.9404(1). A pharmacist who correctly
464	repackages and relabels the medication and the nursing facility
465	which correctly administers such repackaged medication under the
466	provisions of this subsection shall not be held liable in any
467	civil or administrative action arising from the repackaging. In
468	order to be eligible for the repackaging, a nursing facility
469	resident for whom the medication is to be repackaged shall sign
470	an informed consent form provided by the facility which includes
471	an explanation of the repackaging process and which notifies the
472	resident of the immunities from liability provided herein. A
473	pharmacist who repackages and relabels prescription medications,
474	as authorized under this subsection, may charge a reasonable fee
475	for costs resulting from the implementation of this provision.
476	(7)  If the facility has a standard license or is a Gold
477	Seal facility, exceeds the minimum required hours of licensed
478	nursing and certified nursing assistant direct care per resident
479	per day, and is part of a continuing care facility licensed
480	under chapter 651 or a retirement community that offers other
481	services pursuant to part III of this chapter or part I or part
482	III of chapter 429, part IV, or part V on a single campus, be
483	allowed to share programming and staff. At the time of
484	inspection and in the semiannual report required pursuant to
485	subsection (15), a continuing care facility or retirement
486	community that uses this option must demonstrate through
487	staffing records that minimum staffing requirements for the
488	facility were met. Licensed nurses and certified nursing
489	assistants who work in the nursing home facility may be used to
490	provide services elsewhere on campus if the facility exceeds the
491	minimum number of direct care hours required per resident per
492	day and the total number of residents receiving direct care
493	services from a licensed nurse or a certified nursing assistant
494	does not cause the facility to violate the staffing ratios
495	required under s. 400.23(3)(a). Compliance with the minimum
496	staffing ratios shall be based on total number of residents
497	receiving direct care services, regardless of where they reside
498	on campus. If the facility receives a conditional license, it
499	may not share staff until the conditional license status ends.
500	This subsection does not restrict the agency's authority under
501	federal or state law to require additional staff if a facility
502	is cited for deficiencies in care which are caused by an
503	insufficient number of certified nursing assistants or licensed
504	nurses. The agency may adopt rules for the documentation
505	necessary to determine compliance with this provision.
506
507	Facilities that have been awarded a Gold Seal under the program
508	established in s. 400.235 may develop a plan to provide
509	certified nursing assistant training as prescribed by federal
510	regulations and state rules and may apply to the agency for
511	approval of their program.
512	Section 27.  Subsection (1) of section 400.142, Florida
513	Statutes, is amended to read:
514	400.142  Emergency medication kits; orders not to
515	resuscitate.--
516	(1)  Other provisions of this chapter or of chapter 429,
517	chapter 465, chapter 499, or chapter 893 to the contrary
518	notwithstanding, each nursing home operating pursuant to a
519	license issued by the agency may maintain an emergency
520	medication kit for the purpose of storing medicinal drugs to be
521	administered under emergency conditions to residents residing in
522	such facility.
523	Section 28.  Paragraph (a) of subsection (2) of section
524	400.191, Florida Statutes, is amended to read:
525	400.191  Availability, distribution, and posting of reports
526	and records.--
527	(2)  The agency shall provide additional information in
528	consumer-friendly printed and electronic formats to assist
529	consumers and their families in comparing and evaluating nursing
530	home facilities.
531	(a)  The agency shall provide an Internet site which shall
532	include at least the following information either directly or
533	indirectly through a link to another established site or sites
534	of the agency's choosing:
535	1.  A list by name and address of all nursing home
536	facilities in this state.
537	2.  Whether such nursing home facilities are proprietary or
538	nonproprietary.
539	3.  The current owner of the facility's license and the
540	year that that entity became the owner of the license.
541	4.  The name of the owner or owners of each facility and
542	whether the facility is affiliated with a company or other
543	organization owning or managing more than one nursing facility
544	in this state.
545	5.  The total number of beds in each facility.
546	6.  The number of private and semiprivate rooms in each
547	facility.
548	7.  The religious affiliation, if any, of each facility.
549	8.  The languages spoken by the administrator and staff of
550	each facility.
551	9.  Whether or not each facility accepts Medicare or
552	Medicaid recipients or insurance, health maintenance
553	organization, Veterans Administration, CHAMPUS program, or
554	workers' compensation coverage.
555	10.  Recreational and other programs available at each
556	facility.
557	11.  Special care units or programs offered at each
558	facility.
559	12.  Whether the facility is a part of a retirement
560	community that offers other services pursuant to part III of
561	this chapter or part I or part III of chapter 429, part IV, or
562	part V.
563	13.  Survey and deficiency information contained on the
564	Online Survey Certification and Reporting (OSCAR) system of the
565	federal Health Care Financing Administration, including annual
566	survey, revisit, and complaint survey information, for each
567	facility for the past 45 months.  For noncertified nursing
568	homes, state survey and deficiency information, including annual
569	survey, revisit, and complaint survey information for the past
570	45 months shall be provided.
571	14.  A summary of the Online Survey Certification and
572	Reporting (OSCAR) data for each facility over the past 45
573	months. Such summary may include a score, rating, or comparison
574	ranking with respect to other facilities based on the number of
575	citations received by the facility of annual, revisit, and
576	complaint surveys; the severity and scope of the citations; and
577	the number of annual recertification surveys the facility has
578	had during the past 45 months. The score, rating, or comparison
579	ranking may be presented in either numeric or symbolic form for
580	the intended consumer audience.
581	Section 29.  Paragraph (b) of subsection (2) of section
582	400.215, Florida Statutes, is amended to read:
583	400.215  Personnel screening requirement.--
584	(2)  Employers and employees shall comply with the
585	requirements of s. 435.05.
586	(b)  Employees qualified under the provisions of paragraph
587	(a) who have not maintained continuous residency within the
588	state for the 5 years immediately preceding the date of request
589	for background screening must complete level 2 screening, as
590	provided in chapter 435. Such employees may work in a
591	conditional status up to 180 days pending the receipt of written
592	findings evidencing the completion of level 2 screening. Level 2
593	screening shall not be required of employees or prospective
594	employees who attest in writing under penalty of perjury that
595	they meet the residency requirement. Completion of level 2
596	screening shall require the employee or prospective employee to
597	furnish to the nursing facility a full set of fingerprints to
598	enable a criminal background investigation to be conducted. The
599	nursing facility shall submit the completed fingerprint card to
600	the agency. The agency shall establish a record of the request
601	in the database provided for in paragraph (c) and forward the
602	request to the Department of Law Enforcement, which is
603	authorized to submit the fingerprints to the Federal Bureau of
604	Investigation for a national criminal history records check. The
605	results of the national criminal history records check shall be
606	returned to the agency, which shall maintain the results in the
607	database provided for in paragraph (c). The agency shall notify
608	the administrator of the requesting nursing facility or the
609	administrator of any other facility licensed under chapter 393,
610	chapter 394, chapter 395, chapter 397, chapter 429, or this
611	chapter, as requested by such facility, as to whether or not the
612	employee has qualified under level 1 or level 2 screening. An
613	employee or prospective employee who has qualified under level 2
614	screening and has maintained such continuous residency within
615	the state shall not be required to complete a subsequent level 2
616	screening as a condition of employment at another facility.
617	Section 30.  Section 400.402, Florida Statutes, is
618	renumbered as section 429.02, Florida Statutes, and amended to
619	read:
620	429.02 400.402  Definitions.--When used in this part, the
621	term:
622	(1)  "Activities of daily living" means functions and tasks
623	for self-care, including ambulation, bathing, dressing, eating,
624	grooming, and toileting, and other similar tasks.
625	(2)  "Administrator" means an individual at least 21 years
626	of age who is responsible for the operation and maintenance of
627	an assisted living facility.
628	(3)  "Agency" means the Agency for Health Care
629	Administration.
630	(4)  "Aging in place" or "age in place" means the process
631	of providing increased or adjusted services to a person to
632	compensate for the physical or mental decline that may occur
633	with the aging process, in order to maximize the person's
634	dignity and independence and permit them to remain in a
635	familiar, noninstitutional, residential environment for as long
636	as possible. Such services may be provided by facility staff,
637	volunteers, family, or friends, or through contractual
638	arrangements with a third party.
639	(5)  "Applicant" means an individual owner, corporation,
640	partnership, firm, association, or governmental entity that
641	applies for a license.
642	(6)  "Assisted living facility" means any building or
643	buildings, section or distinct part of a building, private home,
644	boarding home, home for the aged, or other residential facility,
645	whether operated for profit or not, which undertakes through its
646	ownership or management to provide housing, meals, and one or
647	more personal services for a period exceeding 24 hours to one or
648	more adults who are not relatives of the owner or administrator.
649	(7)  "Chemical restraint" means a pharmacologic drug that
650	physically limits, restricts, or deprives an individual of
651	movement or mobility, and is used for discipline or convenience
652	and not required for the treatment of medical symptoms.
653	(8)  "Community living support plan" means a written
654	document prepared by a mental health resident and the resident's
655	mental health case manager in consultation with the
656	administrator of an assisted living facility with a limited
657	mental health license or the administrator's designee. A copy
658	must be provided to the administrator. The plan must include
659	information about the supports, services, and special needs of
660	the resident which enable the resident to live in the assisted
661	living facility and a method by which facility staff can
662	recognize and respond to the signs and symptoms particular to
663	that resident which indicate the need for professional services.
664	(9)  "Cooperative agreement" means a written statement of
665	understanding between a mental health care provider and the
666	administrator of the assisted living facility with a limited
667	mental health license in which a mental health resident is
668	living. The agreement must specify directions for accessing
669	emergency and after-hours care for the mental health resident. A
670	single cooperative agreement may service all mental health
671	residents who are clients of the same mental health care
672	provider.
673	(10)  "Department" means the Department of Elderly Affairs.
674	(11)  "Emergency" means a situation, physical condition, or
675	method of operation which presents imminent danger of death or
676	serious physical or mental harm to facility residents.
677	(12)  "Extended congregate care" means acts beyond those
678	authorized in subsection (17) that may be performed pursuant to
679	part I of chapter 464 by persons licensed thereunder while
680	carrying out their professional duties, and other supportive
681	services which may be specified by rule.  The purpose of such
682	services is to enable residents to age in place in a residential
683	environment despite mental or physical limitations that might
684	otherwise disqualify them from residency in a facility licensed
685	under this part.
686	(13)  "Guardian" means a person to whom the law has
687	entrusted the custody and control of the person or property, or
688	both, of a person who has been legally adjudged incapacitated.
689	(14)  "Limited nursing services" means acts that may be
690	performed pursuant to part I of chapter 464 by persons licensed
691	thereunder while carrying out their professional duties but
692	limited to those acts which the department specifies by rule.
693	Acts which may be specified by rule as allowable limited nursing
694	services shall be for persons who meet the admission criteria
695	established by the department for assisted living facilities and
696	shall not be complex enough to require 24-hour nursing
697	supervision and may include such services as the application and
698	care of routine dressings, and care of casts, braces, and
699	splints.
700	(15)  "Managed risk" means the process by which the
701	facility staff discuss the service plan and the needs of the
702	resident with the resident and, if applicable, the resident's
703	representative or designee or the resident's surrogate,
704	guardian, or attorney in fact, in such a way that the
705	consequences of a decision, including any inherent risk, are
706	explained to all parties and reviewed periodically in
707	conjunction with the service plan, taking into account changes
708	in the resident's status and the ability of the facility to
709	respond accordingly.
710	(16)  "Mental health resident" means an individual who
711	receives social security disability income due to a mental
712	disorder as determined by the Social Security Administration or
713	receives supplemental security income due to a mental disorder
714	as determined by the Social Security Administration and receives
715	optional state supplementation.
716	(17)  "Personal services" means direct physical assistance
717	with or supervision of the activities of daily living and the
718	self-administration of medication and other similar services
719	which the department may define by rule.  "Personal services"
720	shall not be construed to mean the provision of medical,
721	nursing, dental, or mental health services.
722	(18)  "Physical restraint" means a device which physically
723	limits, restricts, or deprives an individual of movement or
724	mobility, including, but not limited to, a half-bed rail, a
725	full-bed rail, a geriatric chair, and a posey restraint. The
726	term "physical restraint" shall also include any device which
727	was not specifically manufactured as a restraint but which has
728	been altered, arranged, or otherwise used for this purpose. The
729	term shall not include bandage material used for the purpose of
730	binding a wound or injury.
731	(19)  "Relative" means an individual who is the father,
732	mother, stepfather, stepmother, son, daughter, brother, sister,
733	grandmother, grandfather, great-grandmother, great-grandfather,
734	grandson, granddaughter, uncle, aunt, first cousin, nephew,
735	niece, husband, wife, father-in-law, mother-in-law, son-in-law,
736	daughter-in-law, brother-in-law, sister-in-law, stepson,
737	stepdaughter, stepbrother, stepsister, half brother, or half
738	sister of an owner or administrator.
739	(20)  "Resident" means a person 18 years of age or older,
740	residing in and receiving care from a facility.
741	(21)  "Resident's representative or designee" means a
742	person other than the owner, or an agent or employee of the
743	facility, designated in writing by the resident, if legally
744	competent, to receive notice of changes in the contract executed
745	pursuant to s. 429.24 s. 400.424; to receive notice of and to
746	participate in meetings between the resident and the facility
747	owner, administrator, or staff concerning the rights of the
748	resident; to assist the resident in contacting the ombudsman
749	council if the resident has a complaint against the facility; or
750	to bring legal action on behalf of the resident pursuant to s.
751	429.29 s. 400.429.
752	(22)  "Service plan" means a written plan, developed and
753	agreed upon by the resident and, if applicable, the resident's
754	representative or designee or the resident's surrogate,
755	guardian, or attorney in fact, if any, and the administrator or
756	designee representing the facility, which addresses the unique
757	physical and psychosocial needs, abilities, and personal
758	preferences of each resident receiving extended congregate care
759	services. The plan shall include a brief written description, in
760	easily understood language, of what services shall be provided,
761	who shall provide the services, when the services shall be
762	rendered, and the purposes and benefits of the services.
763	(23)  "Shared responsibility" means exploring the options
764	available to a resident within a facility and the risks involved
765	with each option when making decisions pertaining to the
766	resident's abilities, preferences, and service needs, thereby
767	enabling the resident and, if applicable, the resident's
768	representative or designee, or the resident's surrogate,
769	guardian, or attorney in fact, and the facility to develop a
770	service plan which best meets the resident's needs and seeks to
771	improve the resident's quality of life.
772	(24)  "Supervision" means reminding residents to engage in
773	activities of daily living and the self-administration of
774	medication, and, when necessary, observing or providing verbal
775	cuing to residents while they perform these activities.
776	(25)  "Supplemental security income," Title XVI of the
777	Social Security Act, means a program through which the Federal
778	Government guarantees a minimum monthly income to every person
779	who is age 65 or older, or disabled, or blind and meets the
780	income and asset requirements.
781	(26)  "Supportive services" means services designed to
782	encourage and assist aged persons or adults with disabilities to
783	remain in the least restrictive living environment and to
784	maintain their independence as long as possible.
785	(27)  "Twenty-four-hour nursing supervision" means services
786	that are ordered by a physician for a resident whose condition
787	requires the supervision of a physician and continued monitoring
788	of vital signs and physical status.  Such services shall be:
789	medically complex enough to require constant supervision,
790	assessment, planning, or intervention by a nurse; required to be
791	performed by or under the direct supervision of licensed nursing
792	personnel or other professional personnel for safe and effective
793	performance; required on a daily basis; and consistent with the
794	nature and severity of the resident's condition or the disease
795	state or stage.
796	Section 31.  Section 400.404, Florida Statutes, is
797	renumbered as section 429.04, Florida Statutes, and amended to
798	read:
799	429.04 400.404  Facilities to be licensed; exemptions.--
800	(1)  For the administration of this part, facilities to be
801	licensed by the agency shall include all assisted living
802	facilities as defined in this part.
803	(2)  The following are exempt from licensure under this
804	part:
805	(a)  Any facility, institution, or other place operated by
806	the Federal Government or any agency of the Federal Government.
807	(b)  Any facility or part of a facility licensed under
808	chapter 393 or chapter 394.
809	(c)  Any facility licensed as an adult family-care home
810	under part II VII.
811	(d)  Any person who provides housing, meals, and one or
812	more personal services on a 24-hour basis in the person's own
813	home to not more than two adults who do not receive optional
814	state supplementation. The person who provides the housing,
815	meals, and personal services must own or rent the home and
816	reside therein.
817	(e)  Any home or facility approved by the United States
818	Department of Veterans Affairs as a residential care home
819	wherein care is provided exclusively to three or fewer veterans.
820	(f)  Any facility that has been incorporated in this state
821	for 50 years or more on or before July 1, 1983, and the board of
822	directors of which is nominated or elected by the residents,
823	until the facility is sold or its ownership is transferred; or
824	any facility, with improvements or additions thereto, which has
825	existed and operated continuously in this state for 60 years or
826	more on or before July 1, 1989, is directly or indirectly owned
827	and operated by a nationally recognized fraternal organization,
828	is not open to the public, and accepts only its own members and
829	their spouses as residents.
830	(g)  Any facility certified under chapter 651, or a
831	retirement community, may provide services authorized under this
832	part or part III IV of this chapter 400 to its residents who
833	live in single-family homes, duplexes, quadruplexes, or
834	apartments located on the campus without obtaining a license to
835	operate an assisted living facility if residential units within
836	such buildings are used by residents who do not require staff
837	supervision for that portion of the day when personal services
838	are not being delivered and the owner obtains a home health
839	license to provide such services.  However, any building or
840	distinct part of a building on the campus that is designated for
841	persons who receive personal services and require supervision
842	beyond that which is available while such services are being
843	rendered must be licensed in accordance with this part. If a
844	facility provides personal services to residents who do not
845	otherwise require supervision and the owner is not licensed as a
846	home health agency, the buildings or distinct parts of buildings
847	where such services are rendered must be licensed under this
848	part. A resident of a facility that obtains a home health
849	license may contract with a home health agency of his or her
850	choice, provided that the home health agency provides liability
851	insurance and workers' compensation coverage for its employees.
852	Facilities covered by this exemption may establish policies that
853	give residents the option of contracting for services and care
854	beyond that which is provided by the facility to enable them to
855	age in place.  For purposes of this section, a retirement
856	community consists of a facility licensed under this part or
857	under part II of chapter 400, and apartments designed for
858	independent living located on the same campus.
859	(h)  Any residential unit for independent living which is
860	located within a facility certified under chapter 651, or any
861	residential unit which is colocated with a nursing home licensed
862	under part II of chapter 400 or colocated with a facility
863	licensed under this part in which services are provided through
864	an outpatient clinic or a nursing home on an outpatient basis.
865	Section 32.  Section 400.407, Florida Statutes, is
866	renumbered as section 429.07, Florida Statutes, and amended to
867	read:
868	429.07 400.407  License required; fee, display.--
869	(1)  A license issued by the agency is required for an
870	assisted living facility operating in this state.
871	(2)  Separate licenses shall be required for facilities
872	maintained in separate premises, even though operated under the
873	same management.  A separate license shall not be required for
874	separate buildings on the same grounds.
875	(3)  Any license granted by the agency must state the
876	maximum resident capacity of the facility, the type of care for
877	which the license is granted, the date the license is issued,
878	the expiration date of the license, and any other information
879	deemed necessary by the agency. Licenses shall be issued for one
880	or more of the following categories of care: standard, extended
881	congregate care, limited nursing services, or limited mental
882	health.
883	(a)  A standard license shall be issued to facilities
884	providing one or more of the personal services identified in s.
885	429.02 s. 400.402. Such facilities may also employ or contract
886	with a person licensed under part I of chapter 464 to administer
887	medications and perform other tasks as specified in s. 429.255
888	s. 400.4255.
889	(b)  An extended congregate care license shall be issued to
890	facilities providing, directly or through contract, services
891	beyond those authorized in paragraph (a), including acts
892	performed pursuant to part I of chapter 464 by persons licensed
893	thereunder, and supportive services defined by rule to persons
894	who otherwise would be disqualified from continued residence in
895	a facility licensed under this part.
896	1.  In order for extended congregate care services to be
897	provided in a facility licensed under this part, the agency must
898	first determine that all requirements established in law and
899	rule are met and must specifically designate, on the facility's
900	license, that such services may be provided and whether the
901	designation applies to all or part of a facility.  Such
902	designation may be made at the time of initial licensure or
903	relicensure, or upon request in writing by a licensee under this
904	part. Notification of approval or denial of such request shall
905	be made within 90 days after receipt of such request and all
906	necessary documentation. Existing facilities qualifying to
907	provide extended congregate care services must have maintained a
908	standard license and may not have been subject to administrative
909	sanctions during the previous 2 years, or since initial
910	licensure if the facility has been licensed for less than 2
911	years, for any of the following reasons:
912	a.  A class I or class II violation;
913	b.  Three or more repeat or recurring class III violations
914	of identical or similar resident care standards as specified in
915	rule from which a pattern of noncompliance is found by the
916	agency;
917	c.  Three or more class III violations that were not
918	corrected in accordance with the corrective action plan approved
919	by the agency;
920	d.  Violation of resident care standards resulting in a
921	requirement to employ the services of a consultant pharmacist or
922	consultant dietitian;
923	e.  Denial, suspension, or revocation of a license for
924	another facility under this part in which the applicant for an
925	extended congregate care license has at least 25 percent
926	ownership interest; or
927	f.  Imposition of a moratorium on admissions or initiation
928	of injunctive proceedings.
929	2.  Facilities that are licensed to provide extended
930	congregate care services shall maintain a written progress
931	report on each person who receives such services, which report
932	describes the type, amount, duration, scope, and outcome of
933	services that are rendered and the general status of the
934	resident's health.  A registered nurse, or appropriate designee,
935	representing the agency shall visit such facilities at least
936	quarterly to monitor residents who are receiving extended
937	congregate care services and to determine if the facility is in
938	compliance with this part and with rules that relate to extended
939	congregate care. One of these visits may be in conjunction with
940	the regular survey.  The monitoring visits may be provided
941	through contractual arrangements with appropriate community
942	agencies.  A registered nurse shall serve as part of the team
943	that inspects such facility. The agency may waive one of the
944	required yearly monitoring visits for a facility that has been
945	licensed for at least 24 months to provide extended congregate
946	care services, if, during the inspection, the registered nurse
947	determines that extended congregate care services are being
948	provided appropriately, and if the facility has no class I or
949	class II violations and no uncorrected class III violations.
950	Before such decision is made, the agency shall consult with the
951	long-term care ombudsman council for the area in which the
952	facility is located to determine if any complaints have been
953	made and substantiated about the quality of services or care.
954	The agency may not waive one of the required yearly monitoring
955	visits if complaints have been made and substantiated.
956	3.  Facilities that are licensed to provide extended
957	congregate care services shall:
958	a.  Demonstrate the capability to meet unanticipated
959	resident service needs.
960	b.  Offer a physical environment that promotes a homelike
961	setting, provides for resident privacy, promotes resident
962	independence, and allows sufficient congregate space as defined
963	by rule.
964	c.  Have sufficient staff available, taking into account
965	the physical plant and firesafety features of the building, to
966	assist with the evacuation of residents in an emergency, as
967	necessary.
968	d.  Adopt and follow policies and procedures that maximize
969	resident independence, dignity, choice, and decisionmaking to
970	permit residents to age in place to the extent possible, so that
971	moves due to changes in functional status are minimized or
972	avoided.
973	e.  Allow residents or, if applicable, a resident's
974	representative, designee, surrogate, guardian, or attorney in
975	fact to make a variety of personal choices, participate in
976	developing service plans, and share responsibility in
977	decisionmaking.
978	f.  Implement the concept of managed risk.
979	g.  Provide, either directly or through contract, the
980	services of a person licensed pursuant to part I of chapter 464.
981	h.  In addition to the training mandated in s. 429.52 s.
982	400.452, provide specialized training as defined by rule for
983	facility staff.
984	4.  Facilities licensed to provide extended congregate care
985	services are exempt from the criteria for continued residency as
986	set forth in rules adopted under s. 429.41 s. 400.441.
987	Facilities so licensed shall adopt their own requirements within
988	guidelines for continued residency set forth by the department
989	in rule. However, such facilities may not serve residents who
990	require 24-hour nursing supervision. Facilities licensed to
991	provide extended congregate care services shall provide each
992	resident with a written copy of facility policies governing
993	admission and retention.
994	5.  The primary purpose of extended congregate care
995	services is to allow residents, as they become more impaired,
996	the option of remaining in a familiar setting from which they
997	would otherwise be disqualified for continued residency.  A
998	facility licensed to provide extended congregate care services
999	may also admit an individual who exceeds the admission criteria
1000	for a facility with a standard license, if the individual is
1001	determined appropriate for admission to the extended congregate
1002	care facility.
1003	6.  Before admission of an individual to a facility
1004	licensed to provide extended congregate care services, the
1005	individual must undergo a medical examination as provided in s.
1006	429.26(4) s. 400.426(4) and the facility must develop a
1007	preliminary service plan for the individual.
1008	7.  When a facility can no longer provide or arrange for
1009	services in accordance with the resident's service plan and
1010	needs and the facility's policy, the facility shall make
1011	arrangements for relocating the person in accordance with s.
1012	429.28(1)(k) s. 400.428(1)(k).
1013	8.  Failure to provide extended congregate care services
1014	may result in denial of extended congregate care license
1015	renewal.
1016	9.  No later than January 1 of each year, the department,
1017	in consultation with the agency, shall prepare and submit to the
1018	Governor, the President of the Senate, the Speaker of the House
1019	of Representatives, and the chairs of appropriate legislative
1020	committees, a report on the status of, and recommendations
1021	related to, extended congregate care services. The status report
1022	must include, but need not be limited to, the following
1023	information:
1024	a.  A description of the facilities licensed to provide
1025	such services, including total number of beds licensed under
1026	this part.
1027	b.  The number and characteristics of residents receiving
1028	such services.
1029	c.  The types of services rendered that could not be
1030	provided through a standard license.
1031	d.  An analysis of deficiencies cited during licensure
1032	inspections.
1033	e.  The number of residents who required extended
1034	congregate care services at admission and the source of
1035	admission.
1036	f.  Recommendations for statutory or regulatory changes.
1037	g.  The availability of extended congregate care to state
1038	clients residing in facilities licensed under this part and in
1039	need of additional services, and recommendations for
1040	appropriations to subsidize extended congregate care services
1041	for such persons.
1042	h.  Such other information as the department considers
1043	appropriate.
1044	(c)  A limited nursing services license shall be issued to
1045	a facility that provides services beyond those authorized in
1046	paragraph (a) and as specified in this paragraph.
1047	1.  In order for limited nursing services to be provided in
1048	a facility licensed under this part, the agency must first
1049	determine that all requirements established in law and rule are
1050	met and must specifically designate, on the facility's license,
1051	that such services may be provided. Such designation may be made
1052	at the time of initial licensure or relicensure, or upon request
1053	in writing by a licensee under this part. Notification of
1054	approval or denial of such request shall be made within 90 days
1055	after receipt of such request and all necessary documentation.
1056	Existing facilities qualifying to provide limited nursing
1057	services shall have maintained a standard license and may not
1058	have been subject to administrative sanctions that affect the
1059	health, safety, and welfare of residents for the previous 2
1060	years or since initial licensure if the facility has been
1061	licensed for less than 2 years.
1062	2.  Facilities that are licensed to provide limited nursing
1063	services shall maintain a written progress report on each person
1064	who receives such nursing services, which report describes the
1065	type, amount, duration, scope, and outcome of services that are
1066	rendered and the general status of the resident's health.  A
1067	registered nurse representing the agency shall visit such
1068	facilities at least twice a year to monitor residents who are
1069	receiving limited nursing services and to determine if the
1070	facility is in compliance with applicable provisions of this
1071	part and with related rules. The monitoring visits may be
1072	provided through contractual arrangements with appropriate
1073	community agencies.  A registered nurse shall also serve as part
1074	of the team that inspects such facility.
1075	3.  A person who receives limited nursing services under
1076	this part must meet the admission criteria established by the
1077	agency for assisted living facilities.  When a resident no
1078	longer meets the admission criteria for a facility licensed
1079	under this part, arrangements for relocating the person shall be
1080	made in accordance with s. 429.28(1)(k) s. 400.428(1)(k), unless
1081	the facility is licensed to provide extended congregate care
1082	services.
1083	(4)(a)  The biennial license fee required of a facility is
1084	$300 per license, with an additional fee of $50 per resident
1085	based on the total licensed resident capacity of the facility,
1086	except that no additional fee will be assessed for beds
1087	designated for recipients of optional state supplementation
1088	payments provided for in s. 409.212. The total fee may not
1089	exceed $10,000, no part of which shall be returned to the
1090	facility.  The agency shall adjust the per bed license fee and
1091	the total licensure fee annually by not more than the change in
1092	the consumer price index based on the 12 months immediately
1093	preceding the increase.
1094	(b)  In addition to the total fee assessed under paragraph
1095	(a), the agency shall require facilities that are licensed to
1096	provide extended congregate care services under this part to pay
1097	an additional fee per licensed facility.  The amount of the
1098	biennial fee shall be $400 per license, with an additional fee
1099	of $10 per resident based on the total licensed resident
1100	capacity of the facility. No part of this fee shall be returned
1101	to the facility. The agency may adjust the per bed license fee
1102	and the annual license fee once each year by not more than the
1103	average rate of inflation for the 12 months immediately
1104	preceding the increase.
1105	(c)  In addition to the total fee assessed under paragraph
1106	(a), the agency shall require facilities that are licensed to
1107	provide limited nursing services under this part to pay an
1108	additional fee per licensed facility.  The amount of the
1109	biennial fee shall be $250 per license, with an additional fee
1110	of $10 per resident based on the total licensed resident
1111	capacity of the facility.  No part of this fee shall be returned
1112	to the facility.  The agency may adjust the per bed license fee
1113	and the biennial license fee once each year by not more than the
1114	average rate of inflation for the 12 months immediately
1115	preceding the increase.
1116	(5)  Counties or municipalities applying for licenses under
1117	this part are exempt from the payment of license fees.
1118	(6)  The license shall be displayed in a conspicuous place
1119	inside the facility.
1120	(7)  A license shall be valid only in the possession of the
1121	individual, firm, partnership, association, or corporation to
1122	which it is issued and shall not be subject to sale, assignment,
1123	or other transfer, voluntary or involuntary; nor shall a license
1124	be valid for any premises other than that for which originally
1125	issued.
1126	(8)  A fee may be charged to a facility requesting a
1127	duplicate license.  The fee shall not exceed the actual cost of
1128	duplication and postage.
1129	Section 33.  Section 400.4071, Florida Statutes, is
1130	renumbered as section 429.071, Florida Statutes, and amended to
1131	read:
1132	429.071 400.4071  Intergenerational respite care assisted
1133	living facility pilot program.--
1134	(1)  It is the intent of the Legislature to establish a
1135	pilot program to:
1136	(a)  Facilitate the receipt of in-home, family-based care
1137	by minors and adults with disabilities and elderly persons with
1138	special needs through respite care for up to 14 days.
1139	(b)  Prevent caregiver "burnout," in which the caregiver's
1140	health declines and he or she is unable to continue to provide
1141	care so that the only option for the person with disabilities or
1142	special needs is to receive institutional care.
1143	(c)  Foster the development of intergenerational respite
1144	care assisted living facilities to temporarily care for minors
1145	and adults with disabilities and elderly persons with special
1146	needs in the same facility and to give caregivers the time they
1147	need for rejuvenation and healing.
1148	(2)  The Agency for Health Care Administration shall
1149	establish a 5-year pilot program, which shall license an
1150	intergenerational respite care assisted living facility that
1151	will provide temporary personal, respite, and custodial care to
1152	minors and adults with disabilities and elderly persons with
1153	special needs who do not require 24-hour nursing services. The
1154	intergenerational respite care assisted living facility must:
1155	(a)  Meet all applicable requirements and standards
1156	contained in this part III of this chapter, except that, for
1157	purposes of this section, the term "resident" means a person of
1158	any age temporarily residing in and receiving care from the
1159	facility.
1160	(b)  Provide respite care services for minors and adults
1161	with disabilities and elderly persons with special needs for a
1162	period of at least 24 hours but not for more than 14 consecutive
1163	days.
1164	(c)  Provide a facility or facilities in which minors and
1165	adults reside in distinct and separate living units.
1166	(d)  Provide a facility that has a maximum of 48 beds, is
1167	located in Miami-Dade County, and is operated by a not-for-
1168	profit entity.
1169	(3)  The agency may establish policies necessary to achieve
1170	the objectives specific to the pilot program and may adopt rules
1171	necessary to implement the program.
1172	(4)  After 4 years, the agency shall present its report on
1173	the effectiveness of the pilot program to the President of the
1174	Senate and the Speaker of the House of Representatives and its
1175	recommendation as to whether the Legislature should make the
1176	program permanent.
1177	Section 34.  Section 400.408, Florida Statutes, is
1178	renumbered as section 429.08, Florida Statutes, and amended to
1179	read:
1180	429.08 400.408  Unlicensed facilities; referral of person
1181	for residency to unlicensed facility; penalties; verification of
1182	licensure status.--
1183	(1)(a)  It is unlawful to own, operate, or maintain an
1184	assisted living facility without obtaining a license under this
1185	part.
1186	(b)  Except as provided under paragraph (d), any person who
1187	owns, operates, or maintains an unlicensed assisted living
1188	facility commits a felony of the third degree, punishable as
1189	provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
1190	continued operation is a separate offense.
1191	(c)  Any person found guilty of violating paragraph (a) a
1192	second or subsequent time commits a felony of the second degree,
1193	punishable as provided under s. 775.082, s. 775.083, or s.
1194	775.084. Each day of continued operation is a separate offense.
1195	(d)  Any person who owns, operates, or maintains an
1196	unlicensed assisted living facility due to a change in this part
1197	or a modification in department rule within 6 months after the
1198	effective date of such change and who, within 10 working days
1199	after receiving notification from the agency, fails to cease
1200	operation or apply for a license under this part commits a
1201	felony of the third degree, punishable as provided in s.
1202	775.082, s. 775.083, or s. 775.084. Each day of continued
1203	operation is a separate offense.
1204	(e)  Any facility that fails to cease operation after
1205	agency notification may be fined for each day of noncompliance
1206	pursuant to s. 429.19 s. 400.419.
1207	(f)  When a licensee has an interest in more than one
1208	assisted living facility, and fails to license any one of these
1209	facilities, the agency may revoke the license, impose a
1210	moratorium, or impose a fine pursuant to s. 429.19 s. 400.419,
1211	on any or all of the licensed facilities until such time as the
1212	unlicensed facility is licensed or ceases operation.
1213	(g)  If the agency determines that an owner is operating or
1214	maintaining an assisted living facility without obtaining a
1215	license and determines that a condition exists in the facility
1216	that poses a threat to the health, safety, or welfare of a
1217	resident of the facility, the owner is subject to the same
1218	actions and fines imposed against a licensed facility as
1219	specified in ss. 429.14 and 429.19 ss. 400.414 and 400.419.
1220	(h)  Any person aware of the operation of an unlicensed
1221	assisted living facility must report that facility to the
1222	agency. The agency shall provide to the department's elder
1223	information and referral providers a list, by county, of
1224	licensed assisted living facilities, to assist persons who are
1225	considering an assisted living facility placement in locating a
1226	licensed facility.
1227	(i)  Each field office of the Agency for Health Care
1228	Administration shall establish a local coordinating workgroup
1229	which includes representatives of local law enforcement
1230	agencies, state attorneys, the Medicaid Fraud Control Unit of
1231	the Department of Legal Affairs, local fire authorities, the
1232	Department of Children and Family Services, the district long-
1233	term care ombudsman council, and the district human rights
1234	advocacy committee to assist in identifying the operation of
1235	unlicensed facilities and to develop and implement a plan to
1236	ensure effective enforcement of state laws relating to such
1237	facilities. The workgroup shall report its findings, actions,
1238	and recommendations semiannually to the Director of Health
1239	Facility Regulation of the agency.
1240	(2)  It is unlawful to knowingly refer a person for
1241	residency to an unlicensed assisted living facility; to an
1242	assisted living facility the license of which is under denial or
1243	has been suspended or revoked; or to an assisted living facility
1244	that has a moratorium on admissions.  Any person who violates
1245	this subsection commits a noncriminal violation, punishable by a
1246	fine not exceeding $500 as provided in s. 775.083.
1247	(a)  Any health care practitioner, as defined in s.
1248	456.001, who is aware of the operation of an unlicensed facility
1249	shall report that facility to the agency. Failure to report a
1250	facility that the practitioner knows or has reasonable cause to
1251	suspect is unlicensed shall be reported to the practitioner's
1252	licensing board.
1253	(b)  Any hospital or community mental health center
1254	licensed under chapter 395 or chapter 394 which knowingly
1255	discharges a patient or client to an unlicensed facility is
1256	subject to sanction by the agency.
1257	(c)  Any employee of the agency or department, or the
1258	Department of Children and Family Services, who knowingly refers
1259	a person for residency to an unlicensed facility; to a facility
1260	the license of which is under denial or has been suspended or
1261	revoked; or to a facility that has a moratorium on admissions is
1262	subject to disciplinary action by the agency or department, or
1263	the Department of Children and Family Services.
1264	(d)  The employer of any person who is under contract with
1265	the agency or department, or the Department of Children and
1266	Family Services, and who knowingly refers a person for residency
1267	to an unlicensed facility; to a facility the license of which is
1268	under denial or has been suspended or revoked; or to a facility
1269	that has a moratorium on admissions shall be fined and required
1270	to prepare a corrective action plan designed to prevent such
1271	referrals.
1272	(e)  The agency shall provide the department and the
1273	Department of Children and Family Services with a list of
1274	licensed facilities within each county and shall update the list
1275	at least quarterly.
1276	(f)  At least annually, the agency shall notify, in
1277	appropriate trade publications, physicians licensed under
1278	chapter 458 or chapter 459, hospitals licensed under chapter
1279	395, nursing home facilities licensed under part II of this
1280	chapter 400, and employees of the agency or the department, or
1281	the Department of Children and Family Services, who are
1282	responsible for referring persons for residency, that it is
1283	unlawful to knowingly refer a person for residency to an
1284	unlicensed assisted living facility and shall notify them of the
1285	penalty for violating such prohibition. The department and the
1286	Department of Children and Family Services shall, in turn,
1287	notify service providers under contract to the respective
1288	departments who have responsibility for resident referrals to
1289	facilities. Further, the notice must direct each noticed
1290	facility and individual to contact the appropriate agency office
1291	in order to verify the licensure status of any facility prior to
1292	referring any person for residency. Each notice must include the
1293	name, telephone number, and mailing address of the appropriate
1294	office to contact.
1295	Section 35.  Section 400.411, Florida Statutes, is
1296	renumbered as section 429.11, Florida Statutes, and amended to
1297	read:
1298	429.11 400.411  Initial application for license;
1299	provisional license.--
1300	(1)  Application for a license shall be made to the agency
1301	on forms furnished by it and shall be accompanied by the
1302	appropriate license fee.
1303	(2)  The applicant may be an individual owner, a
1304	corporation, a partnership, a firm, an association, or a
1305	governmental entity.
1306	(3)  The application must be signed by the applicant under
1307	oath and must contain the following:
1308	(a)  The name, address, date of birth, and social security
1309	number of the applicant and the name by which the facility is to
1310	be known. If the applicant is a firm, partnership, or
1311	association, the application shall contain the name, address,
1312	date of birth, and social security number of every member
1313	thereof. If the applicant is a corporation, the application
1314	shall contain the corporation's name and address; the name,
1315	address, date of birth, and social security number of each of
1316	its directors and officers; and the name and address of each
1317	person having at least a 5-percent ownership interest in the
1318	corporation.
1319	(b)  The name and address of any professional service,
1320	firm, association, partnership, or corporation that is to
1321	provide goods, leases, or services to the facility if a 5-
1322	percent or greater ownership interest in the service, firm,
1323	association, partnership, or corporation is owned by a person
1324	whose name must be listed on the application under paragraph
1325	(a).
1326	(c)  The name and address of any long-term care facility
1327	with which the applicant, administrator, or financial officer
1328	has been affiliated through ownership or employment within 5
1329	years of the date of this license application; and a signed
1330	affidavit disclosing any financial or ownership interest that
1331	the applicant, or any person listed in paragraph (a), holds or
1332	has held within the last 5 years in any facility licensed under
1333	this part, or in any other entity licensed by this state or
1334	another state to provide health or residential care, which
1335	facility or entity closed or ceased to operate as a result of
1336	financial problems, or has had a receiver appointed or a license
1337	denied, suspended or revoked, or was subject to a moratorium on
1338	admissions, or has had an injunctive proceeding initiated
1339	against it.
1340	(d)  A description and explanation of any exclusions,
1341	permanent suspensions, or terminations of the applicant from the
1342	Medicare or Medicaid programs. Proof of compliance with
1343	disclosure of ownership and control interest requirements of the
1344	Medicaid or Medicare programs shall be accepted in lieu of this
1345	submission.
1346	(e)  The names and addresses of persons of whom the agency
1347	may inquire as to the character, reputation, and financial
1348	responsibility of the owner and, if different from the
1349	applicant, the administrator and financial officer.
1350	(f)  Identification of all other homes or facilities,
1351	including the addresses and the license or licenses under which
1352	they operate, if applicable, which are currently operated by the
1353	applicant or administrator and which provide housing, meals, and
1354	personal services to residents.
1355	(g)  The location of the facility for which a license is
1356	sought and documentation, signed by the appropriate local
1357	government official, which states that the applicant has met
1358	local zoning requirements.
1359	(h)  The name, address, date of birth, social security
1360	number, education, and experience of the administrator, if
1361	different from the applicant.
1362	(4)  The applicant shall furnish satisfactory proof of
1363	financial ability to operate and conduct the facility in
1364	accordance with the requirements of this part. A certificate of
1365	authority, pursuant to chapter 651, may be provided as proof of
1366	financial ability.
1367	(5)  If the applicant is a continuing care facility
1368	certified under chapter 651, a copy of the facility's
1369	certificate of authority must be provided.
1370	(6)  The applicant shall provide proof of liability
1371	insurance as defined in s. 624.605.
1372	(7)  If the applicant is a community residential home, the
1373	applicant must provide proof that it has met the requirements
1374	specified in chapter 419.
1375	(8)  The applicant must provide the agency with proof of
1376	legal right to occupy the property.
1377	(9)  The applicant must furnish proof that the facility has
1378	received a satisfactory firesafety inspection.  The local
1379	authority having jurisdiction or the State Fire Marshal must
1380	conduct the inspection within 30 days after written request by
1381	the applicant.
1382	(10)  The applicant must furnish documentation of a
1383	satisfactory sanitation inspection of the facility by the county
1384	health department.
1385	(11)  The applicant must furnish proof of compliance with
1386	level 2 background screening as required under s. 429.174 s.
1387	400.4174.
1388	(12)  A provisional license may be issued to an applicant
1389	making initial application for licensure or making application
1390	for a change of ownership.  A provisional license shall be
1391	limited in duration to a specific period of time not to exceed 6
1392	months, as determined by the agency.
1393	(13)  A county or municipality may not issue an
1394	occupational license that is being obtained for the purpose of
1395	operating a facility regulated under this part without first
1396	ascertaining that the applicant has been licensed to operate
1397	such facility at the specified location or locations by the
1398	agency.  The agency shall furnish to local agencies responsible
1399	for issuing occupational licenses sufficient instruction for
1400	making such determinations.
1401	Section 36.  Section 400.412, Florida Statutes, is
1402	renumbered as section 429.12, Florida Statutes, and amended to
1403	read:
1404	429.12 400.412  Sale or transfer of ownership of a
1405	facility.--It is the intent of the Legislature to protect the
1406	rights of the residents of an assisted living facility when the
1407	facility is sold or the ownership thereof is transferred.
1408	Therefore, whenever a facility is sold or the ownership thereof
1409	is transferred, including leasing:
1410	(1)  The transferee shall make application to the agency
1411	for a new license at least 60 days before the date of transfer
1412	of ownership.  The application must comply with the provisions
1413	of s. 429.11 s. 400.411.
1414	(2)(a)  The transferor shall notify the agency in writing
1415	at least 60 days before the date of transfer of ownership.
1416	(b)  The new owner shall notify the residents, in writing,
1417	of the transfer of ownership within 7 days of his or her receipt
1418	of the license.
1419	(3)  The transferor shall be responsible and liable for:
1420	(a)  The lawful operation of the facility and the welfare
1421	of the residents domiciled in the facility until the date the
1422	transferee is licensed by the agency.
1423	(b)  Any and all penalties imposed against the facility for
1424	violations occurring before the date of transfer of ownership
1425	unless the penalty imposed is a moratorium on admissions or
1426	denial of licensure.  The moratorium on admissions or denial of
1427	licensure remains in effect after the transfer of ownership,
1428	unless the agency has approved the transferee's corrective
1429	action plan or the conditions which created the moratorium or
1430	denial have been corrected, and may be grounds for denial of
1431	license to the transferee in accordance with chapter 120.
1432	(c)  Any outstanding liability to the state, unless the
1433	transferee has agreed, as a condition of sale or transfer, to
1434	accept the outstanding liabilities and to guarantee payment
1435	therefor; except that, if the transferee fails to meet these
1436	obligations, the transferor shall remain liable for the
1437	outstanding liability.
1438	(4)  The transferor of a facility the license of which is
1439	denied pending an administrative hearing shall, as a part of the
1440	written transfer-of-ownership contract, advise the transferee
1441	that a plan of correction must be submitted by the transferee
1442	and approved by the agency at least 7 days before the transfer
1443	of ownership and that failure to correct the condition which
1444	resulted in the moratorium on admissions or denial of licensure
1445	is grounds for denial of the transferee's license.
1446	(5)  The transferee must provide the agency with proof of
1447	legal right to occupy the property before a license may be
1448	issued.  Proof may include, but is not limited to, copies of
1449	warranty deeds, or copies of lease or rental agreements,
1450	contracts for deeds, quitclaim deeds, or other such
1451	documentation.
1452	Section 37.  Section 400.414, Florida Statutes, is
1453	renumbered as section 429.14, Florida Statutes, and amended to
1454	read:
1455	429.14 400.414  Denial, revocation, or suspension of
1456	license; imposition of administrative fine; grounds.--
1457	(1)  The agency may deny, revoke, or suspend any license
1458	issued under this part, or impose an administrative fine in the
1459	manner provided in chapter 120, for any of the following actions
1460	by an assisted living facility, for the actions of any person
1461	subject to level 2 background screening under s. 429.174 s.
1462	400.4174, or for the actions of any facility employee:
1463	(a)  An intentional or negligent act seriously affecting
1464	the health, safety, or welfare of a resident of the facility.
1465	(b)  The determination by the agency that the owner lacks
1466	the financial ability to provide continuing adequate care to
1467	residents.
1468	(c)  Misappropriation or conversion of the property of a
1469	resident of the facility.
1470	(d)  Failure to follow the criteria and procedures provided
1471	under part I of chapter 394 relating to the transportation,
1472	voluntary admission, and involuntary examination of a facility
1473	resident.
1474	(e)  A citation of any of the following deficiencies as
1475	defined in s. 429.19 s. 400.419:
1476	1.  One or more cited class I deficiencies.
1477	2.  Three or more cited class II deficiencies.
1478	3.  Five or more cited class III deficiencies that have
1479	been cited on a single survey and have not been corrected within
1480	the times specified.
1481	(f)  A determination that a person subject to level 2
1482	background screening under s. 429.174(1) s. 400.4174(1) does not
1483	meet the screening standards of s. 435.04 or that the facility
1484	is retaining an employee subject to level 1 background screening
1485	standards under s. 429.174(2) s. 400.4174(2) who does not meet
1486	the screening standards of s. 435.03 and for whom exemptions
1487	from disqualification have not been provided by the agency.
1488	(g)  A determination that an employee, volunteer,
1489	administrator, or owner, or person who otherwise has access to
1490	the residents of a facility does not meet the criteria specified
1491	in s. 435.03(2), and the owner or administrator has not taken
1492	action to remove the person. Exemptions from disqualification
1493	may be granted as set forth in s. 435.07. No administrative
1494	action may be taken against the facility if the person is
1495	granted an exemption.
1496	(h)  Violation of a moratorium.
1497	(i)  Failure of the license applicant, the licensee during
1498	relicensure, or a licensee that holds a provisional license to
1499	meet the minimum license requirements of this part, or related
1500	rules, at the time of license application or renewal.
1501	(j)  A fraudulent statement or omission of any material
1502	fact on an application for a license or any other document
1503	required by the agency, including the submission of a license
1504	application that conceals the fact that any board member,
1505	officer, or person owning 5 percent or more of the facility may
1506	not meet the background screening requirements of s. 429.174 s.
1507	400.4174, or that the applicant has been excluded, permanently
1508	suspended, or terminated from the Medicaid or Medicare programs.
1509	(k)  An intentional or negligent life-threatening act in
1510	violation of the uniform firesafety standards for assisted
1511	living facilities or other firesafety standards that threatens
1512	the health, safety, or welfare of a resident of a facility, as
1513	communicated to the agency by the local authority having
1514	jurisdiction or the State Fire Marshal.
1515	(l)  Exclusion, permanent suspension, or termination from
1516	the Medicare or Medicaid programs.
1517	(m)  Knowingly operating any unlicensed facility or
1518	providing without a license any service that must be licensed
1519	under this chapter or chapter 400.
1520	(n)  Any act constituting a ground upon which application
1521	for a license may be denied.
1522
1523	Administrative proceedings challenging agency action under this
1524	subsection shall be reviewed on the basis of the facts and
1525	conditions that resulted in the agency action.
1526	(2)  Upon notification by the local authority having
1527	jurisdiction or by the State Fire Marshal, the agency may deny
1528	or revoke the license of an assisted living facility that fails
1529	to correct cited fire code violations that affect or threaten
1530	the health, safety, or welfare of a resident of a facility.
1531	(3)  The agency may deny a license to any applicant or to
1532	any officer or board member of an applicant who is a firm,
1533	corporation, partnership, or association or who owns 5 percent
1534	or more of the facility, if the applicant, officer, or board
1535	member has or had a 25-percent or greater financial or ownership
1536	interest in any other facility licensed under this part, or in
1537	any entity licensed by this state or another state to provide
1538	health or residential care, which facility or entity during the
1539	5 years prior to the application for a license closed due to
1540	financial inability to operate; had a receiver appointed or a
1541	license denied, suspended, or revoked; was subject to a
1542	moratorium on admissions; had an injunctive proceeding initiated
1543	against it; or has an outstanding fine assessed under this
1544	chapter or chapter 400.
1545	(4)  The agency shall deny or revoke the license of an
1546	assisted living facility that has two or more class I violations
1547	that are similar or identical to violations identified by the
1548	agency during a survey, inspection, monitoring visit, or
1549	complaint investigation occurring within the previous 2 years.
1550	(5)  An action taken by the agency to suspend, deny, or
1551	revoke a facility's license under this part, in which the agency
1552	claims that the facility owner or an employee of the facility
1553	has threatened the health, safety, or welfare of a resident of
1554	the facility be heard by the Division of Administrative Hearings
1555	of the Department of Management Services within 120 days after
1556	receipt of the facility's request for a hearing, unless that
1557	time limitation is waived by both parties. The administrative
1558	law judge must render a decision within 30 days after receipt of
1559	a proposed recommended order.
1560	(6)  The agency shall provide to the Division of Hotels and
1561	Restaurants of the Department of Business and Professional
1562	Regulation, on a monthly basis, a list of those assisted living
1563	facilities that have had their licenses denied, suspended, or
1564	revoked or that are involved in an appellate proceeding pursuant
1565	to s. 120.60 related to the denial, suspension, or revocation of
1566	a license.
1567	(7)  Agency notification of a license suspension or
1568	revocation, or denial of a license renewal, shall be posted and
1569	visible to the public at the facility.
1570	(8)  The agency may issue a temporary license pending final
1571	disposition of a proceeding involving the suspension or
1572	revocation of an assisted living facility license.
1573	Section 38.  Section 400.415, Florida Statutes, is
1574	renumbered as section 429.15, Florida Statutes, and amended to
1575	read:
1576	429.15 400.415  Moratorium on admissions; notice.--The
1577	agency may impose an immediate moratorium on admissions to any
1578	assisted living facility if the agency determines that any
1579	condition in the facility presents a threat to the health,
1580	safety, or welfare of the residents in the facility.
1581	(1)  A facility the license of which is denied, revoked, or
1582	suspended pursuant to s. 429.14 s. 400.414 may be subject to
1583	immediate imposition of a moratorium on admissions to run
1584	concurrently with licensure denial, revocation, or suspension.
1585	(2)  When a moratorium is placed on a facility, notice of
1586	the moratorium shall be posted and visible to the public at the
1587	facility until the moratorium is lifted.
1588	(3)  The department may by rule establish conditions that
1589	constitute grounds for imposing a moratorium on a facility and
1590	procedures for imposing and lifting a moratorium, as necessary
1591	to administer this section.
1592	Section 39.  Section 400.417, Florida Statutes, is
1593	renumbered as section 429.17, Florida Statutes, and amended to
1594	read:
1595	429.17 400.417  Expiration of license; renewal; conditional
1596	license.--
1597	(1)  Biennial licenses, unless sooner suspended or revoked,
1598	shall expire 2 years from the date of issuance. Limited nursing,
1599	extended congregate care, and limited mental health licenses
1600	shall expire at the same time as the facility's standard
1601	license, regardless of when issued. The agency shall notify the
1602	facility at least 120 days prior to expiration that a renewal
1603	license is necessary to continue operation. The notification
1604	must be provided electronically or by mail delivery. Ninety days
1605	prior to the expiration date, an application for renewal shall
1606	be submitted to the agency. Fees must be prorated. The failure
1607	to file a timely renewal application shall result in a late fee
1608	charged to the facility in an amount equal to 50 percent of the
1609	current fee.
1610	(2)  A license shall be renewed within 90 days upon the
1611	timely filing of an application on forms furnished by the agency
1612	and the provision of satisfactory proof of ability to operate
1613	and conduct the facility in accordance with the requirements of
1614	this part and adopted rules, including proof that the facility
1615	has received a satisfactory firesafety inspection, conducted by
1616	the local authority having jurisdiction or the State Fire
1617	Marshal, within the preceding 12 months and an affidavit of
1618	compliance with the background screening requirements of s.
1619	429.174 s. 400.4174.
1620	(3)  An applicant for renewal of a license who has complied
1621	with the provisions of s. 429.11 s. 400.411 with respect to
1622	proof of financial ability to operate shall not be required to
1623	provide further proof unless the facility or any other facility
1624	owned or operated in whole or in part by the same person has
1625	demonstrated financial instability as provided under s.
1626	429.47(2) s. 400.447(2) or unless the agency suspects that the
1627	facility is not financially stable as a result of the annual
1628	survey or complaints from the public or a report from the State
1629	Long-Term Care Ombudsman Council.  Each facility must report to
1630	the agency any adverse court action concerning the facility's
1631	financial viability, within 7 days after its occurrence.  The
1632	agency shall have access to books, records, and any other
1633	financial documents maintained by the facility to the extent
1634	necessary to determine the facility's financial stability.  A
1635	license for the operation of a facility shall not be renewed if
1636	the licensee has any outstanding fines assessed pursuant to this
1637	part which are in final order status.
1638	(4)  A licensee against whom a revocation or suspension
1639	proceeding is pending at the time of license renewal may be
1640	issued a conditional license effective until final disposition
1641	by the agency.  If judicial relief is sought from the final
1642	disposition, the court having jurisdiction may issue a
1643	conditional license for the duration of the judicial proceeding.
1644	(5)  A conditional license may be issued to an applicant
1645	for license renewal if the applicant fails to meet all standards
1646	and requirements for licensure.  A conditional license issued
1647	under this subsection shall be limited in duration to a specific
1648	period of time not to exceed 6 months, as determined by the
1649	agency, and shall be accompanied by an agency-approved plan of
1650	correction.
1651	(6)  When an extended care or limited nursing license is
1652	requested during a facility's biennial license period, the fee
1653	shall be prorated in order to permit the additional license to
1654	expire at the end of the biennial license period. The fee shall
1655	be calculated as of the date the additional license application
1656	is received by the agency.
1657	(7)  The department may by rule establish renewal
1658	procedures, identify forms, and specify documentation necessary
1659	to administer this section.
1660	Section 40.  Section 400.4174, Florida Statutes, is
1661	renumbered as section 429.174, Florida Statutes, and amended to
1662	read:
1663	429.174 400.4174  Background screening; exemptions.--
1664	(1)(a)  Level 2 background screening must be conducted on
1665	each of the following persons, who shall be considered employees
1666	for the purposes of conducting screening under chapter 435:
1667	1.  The facility owner if an individual, the administrator,
1668	and the financial officer.
1669	2.  An officer or board member if the facility owner is a
1670	firm, corporation, partnership, or association, or any person
1671	owning 5 percent or more of the facility if the agency has
1672	probable cause to believe that such person has been convicted of
1673	any offense prohibited by s. 435.04. For each officer, board
1674	member, or person owning 5 percent or more who has been
1675	convicted of any such offense, the facility shall submit to the
1676	agency a description and explanation of the conviction at the
1677	time of license application. This subparagraph does not apply to
1678	a board member of a not-for-profit corporation or organization
1679	if the board member serves solely in a voluntary capacity, does
1680	not regularly take part in the day-to-day operational decisions
1681	of the corporation or organization, receives no remuneration for
1682	his or her services, and has no financial interest and has no
1683	family members with a financial interest in the corporation or
1684	organization, provided that the board member and facility submit
1685	a statement affirming that the board member's relationship to
1686	the facility satisfies the requirements of this subparagraph.
1687	(b)  Proof of compliance with level 2 screening standards
1688	which has been submitted within the previous 5 years to meet any
1689	facility or professional licensure requirements of the agency or
1690	the Department of Health satisfies the requirements of this
1691	subsection, provided that such proof is accompanied, under
1692	penalty of perjury, by an affidavit of compliance with the
1693	provisions of chapter 435. Proof of compliance with the
1694	background screening requirements of the Financial Services
1695	Commission and the Office of Insurance Regulation for applicants
1696	for a certificate of authority to operate a continuing care
1697	retirement community under chapter 651, submitted within the
1698	last 5 years, satisfies the Department of Law Enforcement and
1699	Federal Bureau of Investigation portions of a level 2 background
1700	check.
1701	(c)  The agency may grant a provisional license to a
1702	facility applying for an initial license when each individual
1703	required by this subsection to undergo screening has completed
1704	the Department of Law Enforcement background checks, but has not
1705	yet received results from the Federal Bureau of Investigation,
1706	or when a request for an exemption from disqualification has
1707	been submitted to the agency pursuant to s. 435.07, but a
1708	response has not been issued.
1709	(2)  The owner or administrator of an assisted living
1710	facility must conduct level 1 background screening, as set forth
1711	in chapter 435, on all employees hired on or after October 1,
1712	1998, who perform personal services as defined in s. 429.02(17)
1713	s. 400.402(17). The agency may exempt an individual from
1714	employment disqualification as set forth in chapter 435. Such
1715	persons shall be considered as having met this requirement if:
1716	(a)  Proof of compliance with level 1 screening
1717	requirements obtained to meet any professional license
1718	requirements in this state is provided and accompanied, under
1719	penalty of perjury, by a copy of the person's current
1720	professional license and an affidavit of current compliance with
1721	the background screening requirements.
1722	(b)  The person required to be screened has been
1723	continuously employed in the same type of occupation for which
1724	the person is seeking employment without a breach in service
1725	which exceeds 180 days, and proof of compliance with the level 1
1726	screening requirement which is no more than 2 years old is
1727	provided. Proof of compliance shall be provided directly from
1728	one employer or contractor to another, and not from the person
1729	screened. Upon request, a copy of screening results shall be
1730	provided by the employer retaining documentation of the
1731	screening to the person screened.
1732	(c)  The person required to be screened is employed by a
1733	corporation or business entity or related corporation or
1734	business entity that owns, operates, or manages more than one
1735	facility or agency licensed under this chapter, and for whom a
1736	level 1 screening was conducted by the corporation or business
1737	entity as a condition of initial or continued employment.
1738	Section 41.  Section 400.4176, Florida Statutes, is
1739	renumbered as section 429.176, Florida Statutes, and amended to
1740	read:
1741	429.176 400.4176  Notice of change of administrator.--If,
1742	during the period for which a license is issued, the owner
1743	changes administrators, the owner must notify the agency of the
1744	change within 10 days and provide documentation within 90 days
1745	that the new administrator has completed the applicable core
1746	educational requirements under s. 429.52 s. 400.452. Background
1747	screening shall be completed on any new administrator as
1748	specified in s. 429.174 s. 400.4174.
1749	Section 42.  Section 400.4178, Florida Statutes, is
1750	renumbered as section 429.178, Florida Statutes, and amended to
1751	read:
1752	429.178 400.4178  Special care for persons with Alzheimer's
1753	disease or other related disorders.--
1754	(1)  A facility which advertises that it provides special
1755	care for persons with Alzheimer's disease or other related
1756	disorders must meet the following standards of operation:
1757	(a)1.  If the facility has 17 or more residents, have an
1758	awake staff member on duty at all hours of the day and night; or
1759	2.  If the facility has fewer than 17 residents, have an
1760	awake staff member on duty at all hours of the day and night or
1761	have mechanisms in place to monitor and ensure the safety of the
1762	facility's residents.
1763	(b)  Offer activities specifically designed for persons who
1764	are cognitively impaired.
1765	(c)  Have a physical environment that provides for the
1766	safety and welfare of the facility's residents.
1767	(d)  Employ staff who have completed the training and
1768	continuing education required in subsection (2).
1769	(2)(a)  An individual who is employed by a facility that
1770	provides special care for residents with Alzheimer's disease or
1771	other related disorders, and who has regular contact with such
1772	residents, must complete up to 4 hours of initial dementia-
1773	specific training developed or approved by the department. The
1774	training shall be completed within 3 months after beginning
1775	employment and shall satisfy the core training requirements of
1776	s. 429.52(2)(g) s. 400.452(2)(g).
1777	(b)  A direct caregiver who is employed by a facility that
1778	provides special care for residents with Alzheimer's disease or
1779	other related disorders, and who provides direct care to such
1780	residents, must complete the required initial training and 4
1781	additional hours of training developed or approved by the
1782	department.  The training shall be completed within 9 months
1783	after beginning employment and shall satisfy the core training
1784	requirements of s. 429.52(2)(g) s. 400.452(2)(g).
1785	(c)  An individual who is employed by a facility that
1786	provides special care for residents with Alzheimer's disease or
1787	other related disorders, but who only has incidental contact
1788	with such residents, must be given, at a minimum, general
1789	information on interacting with individuals with Alzheimer's
1790	disease or other related disorders, within 3 months after
1791	beginning employment.
1792	(3)  In addition to the training required under subsection
1793	(2), a direct caregiver must participate in a minimum of 4
1794	contact hours of continuing education each calendar year.  The
1795	continuing education must include one or more topics included in
1796	the dementia-specific training developed or approved by the
1797	department, in which the caregiver has not received previous
1798	training.
1799	(4)  Upon completing any training listed in subsection (2),
1800	the employee or direct caregiver shall be issued a certificate
1801	that includes the name of the training provider, the topic
1802	covered, and the date and signature of the training provider.
1803	The certificate is evidence of completion of training in the
1804	identified topic, and the employee or direct caregiver is not
1805	required to repeat training in that topic if the employee or
1806	direct caregiver changes employment to a different facility.
1807	The employee or direct caregiver must comply with other
1808	applicable continuing education requirements.
1809	(5)  The department, or its designee, shall approve the
1810	initial and continuing education courses and providers.
1811	(6)  The department shall keep a current list of providers
1812	who are approved to provide initial and continuing education for
1813	staff of facilities that provide special care for persons with
1814	Alzheimer's disease or other related disorders.
1815	(7)  Any facility more than 90 percent of whose residents
1816	receive monthly optional supplementation payments is not
1817	required to pay for the training and education programs required
1818	under this section.  A facility that has one or more such
1819	residents shall pay a reduced fee that is proportional to the
1820	percentage of such residents in the facility.  A facility that
1821	does not have any residents who receive monthly optional
1822	supplementation payments must pay a reasonable fee, as
1823	established by the department, for such training and education
1824	programs.
1825	(8)  The department shall adopt rules to establish
1826	standards for trainers and training and to implement this
1827	section.
1828	Section 43.  Section 400.418, Florida Statutes, is
1829	renumbered as section 429.18, Florida Statutes, and amended to
1830	read:
1831	429.18 400.418  Disposition of fees and administrative
1832	fines.--
1833	(1)  Income from license fees, inspection fees, late fees,
1834	and administrative fines generated pursuant to ss. 429.07,
1835	429.08, 429.17, 429.19, and 429.31 ss. 400.407, 400.408,
1836	400.417, 400.419, and 400.431 shall be deposited in the Health
1837	Care Trust Fund administered by the agency.  Such funds shall be
1838	directed to and used by the agency for the following purposes:
1839	(a)  Up to 50 percent of the trust funds accrued each
1840	fiscal year under this part may be used to offset the expenses
1841	of receivership, pursuant to s. 429.22 s. 400.422, if the court
1842	determines that the income and assets of the facility are
1843	insufficient to provide for adequate management and operation.
1844	(b)  An amount of $5,000 of the trust funds accrued each
1845	year under this part shall be allocated to pay for inspection-
1846	related physical and mental health examinations requested by the
1847	agency pursuant to s. 429.26 s. 400.426 for residents who are
1848	either recipients of supplemental security income or have
1849	monthly incomes not in excess of the maximum combined federal
1850	and state cash subsidies available to supplemental security
1851	income recipients, as provided for in s. 409.212.  Such funds
1852	shall only be used where the resident is ineligible for
1853	Medicaid.
1854	(c)  Any trust funds accrued each year under this part and
1855	not used for the purposes specified in paragraphs (a) and (b)
1856	shall be used to offset the costs of the licensure program,
1857	including the costs of conducting background investigations,
1858	verifying information submitted, defraying the costs of
1859	processing the names of applicants, and conducting inspections
1860	and monitoring visits pursuant to this part.
1861	(2)  Income from fees generated pursuant to s. 429.41(5) s.
1862	400.441(5) shall be deposited in the Health Care Trust Fund and
1863	used to offset the costs of printing and postage.
1864	Section 44.  Section 400.419, Florida Statutes, is
1865	renumbered as section 429.19, Florida Statutes, and amended to
1866	read:
1867	429.19 400.419  Violations; imposition of administrative
1868	fines; grounds.--
1869	(1)  The agency shall impose an administrative fine in the
1870	manner provided in chapter 120 for any of the actions or
1871	violations as set forth within this section by an assisted
1872	living facility, for the actions of any person subject to level
1873	2 background screening under s. 429.174 s. 400.4174, for the
1874	actions of any facility employee, or for an intentional or
1875	negligent act seriously affecting the health, safety, or welfare
1876	of a resident of the facility.
1877	(2)  Each violation of this part and adopted rules shall be
1878	classified according to the nature of the violation and the
1879	gravity of its probable effect on facility residents. The agency
1880	shall indicate the classification on the written notice of the
1881	violation as follows:
1882	(a)  Class "I" violations are those conditions or
1883	occurrences related to the operation and maintenance of a
1884	facility or to the personal care of residents which the agency
1885	determines present an imminent danger to the residents or guests
1886	of the facility or a substantial probability that death or
1887	serious physical or emotional harm would result therefrom. The
1888	condition or practice constituting a class I violation shall be
1889	abated or eliminated within 24 hours, unless a fixed period, as
1890	determined by the agency, is required for correction. The agency
1891	shall impose an administrative fine for a cited class I
1892	violation in an amount not less than $5,000 and not exceeding
1893	$10,000 for each violation. A fine may be levied notwithstanding
1894	the correction of the violation.
1895	(b)  Class "II" violations are those conditions or
1896	occurrences related to the operation and maintenance of a
1897	facility or to the personal care of residents which the agency
1898	determines directly threaten the physical or emotional health,
1899	safety, or security of the facility residents, other than class
1900	I violations. The agency shall impose an administrative fine for
1901	a cited class II violation in an amount not less than $1,000 and
1902	not exceeding $5,000 for each violation. A fine shall be levied
1903	notwithstanding the correction of the violation.
1904	(c)  Class "III" violations are those conditions or
1905	occurrences related to the operation and maintenance of a
1906	facility or to the personal care of residents which the agency
1907	determines indirectly or potentially threaten the physical or
1908	emotional health, safety, or security of facility residents,
1909	other than class I or class II violations. The agency shall
1910	impose an administrative fine for a cited class III violation in
1911	an amount not less than $500 and not exceeding $1,000 for each
1912	violation. A citation for a class III violation must specify the
1913	time within which the violation is required to be corrected. If
1914	a class III violation is corrected within the time specified, no
1915	fine may be imposed, unless it is a repeated offense.
1916	(d)  Class "IV" violations are those conditions or
1917	occurrences related to the operation and maintenance of a
1918	building or to required reports, forms, or documents that do not
1919	have the potential of negatively affecting residents. These
1920	violations are of a type that the agency determines do not
1921	threaten the health, safety, or security of residents of the
1922	facility. The agency shall impose an administrative fine for a
1923	cited class IV violation in an amount not less than $100 and not
1924	exceeding $200 for each violation. A citation for a class IV
1925	violation must specify the time within which the violation is
1926	required to be corrected. If a class IV violation is corrected
1927	within the time specified, no fine shall be imposed. Any class
1928	IV violation that is corrected during the time an agency survey
1929	is being conducted will be identified as an agency finding and
1930	not as a violation.
1931	(3)  In determining if a penalty is to be imposed and in
1932	fixing the amount of the fine, the agency shall consider the
1933	following factors:
1934	(a)  The gravity of the violation, including the
1935	probability that death or serious physical or emotional harm to
1936	a resident will result or has resulted, the severity of the
1937	action or potential harm, and the extent to which the provisions
1938	of the applicable laws or rules were violated.
1939	(b)  Actions taken by the owner or administrator to correct
1940	violations.
1941	(c)  Any previous violations.
1942	(d)  The financial benefit to the facility of committing or
1943	continuing the violation.
1944	(e)  The licensed capacity of the facility.
1945	(4)  Each day of continuing violation after the date fixed
1946	for termination of the violation, as ordered by the agency,
1947	constitutes an additional, separate, and distinct violation.
1948	(5)  Any action taken to correct a violation shall be
1949	documented in writing by the owner or administrator of the
1950	facility and verified through followup visits by agency
1951	personnel. The agency may impose a fine and, in the case of an
1952	owner-operated facility, revoke or deny a facility's license
1953	when a facility administrator fraudulently misrepresents action
1954	taken to correct a violation.
1955	(6)  For fines that are upheld following administrative or
1956	judicial review, the violator shall pay the fine, plus interest
1957	at the rate as specified in s. 55.03, for each day beyond the
1958	date set by the agency for payment of the fine.
1959	(7)  Any unlicensed facility that continues to operate
1960	after agency notification is subject to a $1,000 fine per day.
1961	(8)  Any licensed facility whose owner or administrator
1962	concurrently operates an unlicensed facility shall be subject to
1963	an administrative fine of $5,000 per day.
1964	(9)  Any facility whose owner fails to apply for a change-
1965	of-ownership license in accordance with s. 429.12 s. 400.412 and
1966	operates the facility under the new ownership is subject to a
1967	fine of $5,000.
1968	(10)  In addition to any administrative fines imposed, the
1969	agency may assess a survey fee, equal to the lesser of one half
1970	of the facility's biennial license and bed fee or $500, to cover
1971	the cost of conducting initial complaint investigations that
1972	result in the finding of a violation that was the subject of the
1973	complaint or monitoring visits conducted under s. 429.28(3)(c)
1974	s. 400.428(3)(c) to verify the correction of the violations.
1975	(11)  The agency, as an alternative to or in conjunction
1976	with an administrative action against a facility for violations
1977	of this part and adopted rules, shall make a reasonable attempt
1978	to discuss each violation and recommended corrective action with
1979	the owner or administrator of the facility, prior to written
1980	notification. The agency, instead of fixing a period within
1981	which the facility shall enter into compliance with standards,
1982	may request a plan of corrective action from the facility which
1983	demonstrates a good faith effort to remedy each violation by a
1984	specific date, subject to the approval of the agency.
1985	(12)  Administrative fines paid by any facility under this
1986	section shall be deposited into the Health Care Trust Fund and
1987	expended as provided in s. 429.18 s. 400.418.
1988	(13)  The agency shall develop and disseminate an annual
1989	list of all facilities sanctioned or fined $5,000 or more for
1990	violations of state standards, the number and class of
1991	violations involved, the penalties imposed, and the current
1992	status of cases. The list shall be disseminated, at no charge,
1993	to the Department of Elderly Affairs, the Department of Health,
1994	the Department of Children and Family Services, the area
1995	agencies on aging, the Florida Statewide Advocacy Council, and
1996	the state and local ombudsman councils. The Department of
1997	Children and Family Services shall disseminate the list to
1998	service providers under contract to the department who are
1999	responsible for referring persons to a facility for residency.
2000	The agency may charge a fee commensurate with the cost of
2001	printing and postage to other interested parties requesting a
2002	copy of this list.
2003	Section 45.  Section 400.42, Florida Statutes, is
2004	renumbered as section 429.20, Florida Statutes, and amended to
2005	read:
2006	429.20 400.42  Certain solicitation prohibited; third-party
2007	supplementation.--
2008	(1)  A person may not, in connection with the solicitation
2009	of contributions by or on behalf of an assisted living facility
2010	or facilities, misrepresent or mislead any person, by any
2011	manner, means, practice, or device whatsoever, to believe that
2012	the receipts of such solicitation will be used for charitable
2013	purposes, if that is not the fact.
2014	(2)  Solicitation of contributions of any kind in a
2015	threatening, coercive, or unduly forceful manner by or on behalf
2016	of an assisted living facility or facilities by any agent,
2017	employee, owner, or representative of any assisted living
2018	facility or facilities is grounds for denial, suspension, or
2019	revocation of the license of the assisted living facility or
2020	facilities by or on behalf of which such contributions were
2021	solicited.
2022	(3)  The admission or maintenance of assisted living
2023	facility residents whose care is supported, in whole or in part,
2024	by state funds may not be conditioned upon the receipt of any
2025	manner of contribution or donation from any person. The
2026	solicitation or receipt of contributions in violation of this
2027	subsection is grounds for denial, suspension, or revocation of
2028	license, as provided in s. 429.14 s. 400.414, for any assisted
2029	living facility by or on behalf of which such contributions were
2030	solicited.
2031	(4)  An assisted living facility may accept additional
2032	supplementation from third parties on behalf of residents
2033	receiving optional state supplementation in accordance with s.
2034	409.212.
2035	Section 46.  Section 400.422, Florida Statutes, is
2036	renumbered as section 429.22, Florida Statutes, and amended to
2037	read:
2038	429.22 400.422  Receivership proceedings.--
2039	(1)  As an alternative to or in conjunction with an
2040	injunctive proceeding, the agency may petition a court of
2041	competent jurisdiction for the appointment of a receiver, if
2042	suitable alternate placements are not available, when any of the
2043	following conditions exist:
2044	(a)  The facility is operating without a license and
2045	refuses to make application for a license as required by ss.
2046	429.07 and 429.08 ss. 400.407 and 400.408.
2047	(b)  The facility is closing or has informed the agency
2048	that it intends to close and adequate arrangements have not been
2049	made for relocation of the residents within 7 days, exclusive of
2050	weekends and holidays, of the closing of the facility.
2051	(c)  The agency determines there exist in the facility
2052	conditions which present an imminent danger to the health,
2053	safety, or welfare of the residents of the facility or a
2054	substantial probability that death or serious physical harm
2055	would result therefrom.
2056	(d)  The facility cannot meet its financial obligation for
2057	providing food, shelter, care, and utilities.
2058	(2)  Petitions for receivership shall take precedence over
2059	other court business unless the court determines that some other
2060	pending proceeding, having similar statutory precedence, shall
2061	have priority.  A hearing shall be conducted within 5 days of
2062	the filing of the petition, at which time all interested parties
2063	shall have the opportunity to present evidence pertaining to the
2064	petition.  The agency shall notify, by certified mail, the owner
2065	or administrator of the facility named in the petition and the
2066	facility resident or, if applicable, the resident's
2067	representative or designee, or the resident's surrogate,
2068	guardian, or attorney in fact, of its filing, the substance of
2069	the violation, and the date and place set for the hearing.  The
2070	court shall grant the petition only upon finding that the
2071	health, safety, or welfare of facility residents would be
2072	threatened if a condition existing at the time the petition was
2073	filed is permitted to continue.  A receiver shall not be
2074	appointed ex parte unless the court determines that one or more
2075	of the conditions in subsection (1) exist; that the facility
2076	owner or administrator cannot be found; that all reasonable
2077	means of locating the owner or administrator and notifying him
2078	or her of the petition and hearing have been exhausted; or that
2079	the owner or administrator after notification of the hearing
2080	chooses not to attend.  After such findings, the court may
2081	appoint any qualified person as a receiver, except it may not
2082	appoint any owner or affiliate of the facility which is in
2083	receivership.  The receiver may be selected from a list of
2084	persons qualified to act as receivers developed by the agency
2085	and presented to the court with each petition for receivership.
2086	Under no circumstances may the agency or designated agency
2087	employee be appointed as a receiver for more than 60 days;
2088	however, the receiver may petition the court, one time only, for
2089	a 30-day extension.  The court shall grant the extension upon a
2090	showing of good cause.
2091	(3)  The receiver must make provisions for the continued
2092	health, safety, and welfare of all residents of the facility
2093	and:
2094	(a)  Shall exercise those powers and perform those duties
2095	set out by the court.
2096	(b)  Shall operate the facility in such a manner as to
2097	assure safety and adequate health care for the residents.
2098	(c)  Shall take such action as is reasonably necessary to
2099	protect or conserve the assets or property of the facility for
2100	which the receiver is appointed, or the proceeds from any
2101	transfer thereof, and may use them only in the performance of
2102	the powers and duties set forth in this section and by order of
2103	the court.
2104	(d)  May use the building, fixtures, furnishings, and any
2105	accompanying consumable goods in the provision of care and
2106	services to residents and to any other persons receiving
2107	services from the facility at the time the petition for
2108	receivership was filed.  The receiver shall collect payments for
2109	all goods and services provided to residents or others during
2110	the period of the receivership at the same rate of payment
2111	charged by the owners at the time the petition for receivership
2112	was filed, or at a fair and reasonable rate otherwise approved
2113	by the court.
2114	(e)  May correct or eliminate any deficiency in the
2115	structure or furnishings of the facility which endangers the
2116	safety or health of residents while they remain in the facility,
2117	if the total cost of correction does not exceed $10,000.  The
2118	court may order expenditures for this purpose in excess of
2119	$10,000 on application from the receiver after notice to the
2120	owner and a hearing.
2121	(f)  May let contracts and hire agents and employees to
2122	carry out the powers and duties of the receiver.
2123	(g)  Shall honor all leases, mortgages, and secured
2124	transactions governing the building in which the facility is
2125	located and all goods and fixtures in the building of which the
2126	receiver has taken possession, but only to the extent of
2127	payments which, in the case of a rental agreement, are for the
2128	use of the property during the period of the receivership, or
2129	which, in the case of a purchase agreement, become due during
2130	the period of the receivership.
2131	(h)  Shall have full power to direct and manage and to
2132	discharge employees of the facility, subject to any contract
2133	rights they may have.  The receiver shall pay employees at the
2134	rate of compensation, including benefits, approved by the court.
2135	A receivership does not relieve the owner of any obligation to
2136	employees made prior to the appointment of a receiver and not
2137	carried out by the receiver.
2138	(i)  Shall be entitled to and take possession of all
2139	property or assets of residents which are in the possession of a
2140	facility or its owner. The receiver shall preserve all property,
2141	assets, and records of residents of which the receiver takes
2142	possession and shall provide for the prompt transfer of the
2143	property, assets, and records to the new placement of any
2144	transferred resident.  An inventory list certified by the owner
2145	and receiver shall be made immediately at the time the receiver
2146	takes possession of the facility.
2147	(4)(a)  A person who is served with notice of an order of
2148	the court appointing a receiver and of the receiver's name and
2149	address shall be liable to pay the receiver for any goods or
2150	services provided by the receiver after the date of the order if
2151	the person would have been liable for the goods or services as
2152	supplied by the owner.  The receiver shall give a receipt for
2153	each payment and shall keep a copy of each receipt on file.  The
2154	receiver shall deposit accounts received in a separate account
2155	and shall use this account for all disbursements.
2156	(b)  The receiver may bring an action to enforce the
2157	liability created by paragraph (a).
2158	(c)  A payment to the receiver of any sum owing to the
2159	facility or its owner shall discharge any obligation to the
2160	facility to the extent of the payment.
2161	(5)(a)  A receiver may petition the court that he or she
2162	not be required to honor any lease, mortgage, secured
2163	transaction, or other wholly or partially executory contract
2164	entered into by the owner of the facility if the rent, price, or
2165	rate of interest required to be paid under the agreement was
2166	substantially in excess of a reasonable rent, price, or rate of
2167	interest at the time the contract was entered into, or if any
2168	material provision of the agreement was unreasonable, when
2169	compared to contracts negotiated under similar conditions.  Any
2170	relief in this form provided by the court shall be limited to
2171	the life of the receivership, unless otherwise determined by the
2172	court.
2173	(b)  If the receiver is in possession of real estate or
2174	goods subject to a lease, mortgage, or security interest which
2175	the receiver has obtained a court order to avoid under paragraph
2176	(a), and if the real estate or goods are necessary for the
2177	continued operation of the facility under this section, the
2178	receiver may apply to the court to set a reasonable rental,
2179	price, or rate of interest to be paid by the receiver during the
2180	duration of the receivership. The court shall hold a hearing on
2181	the application within 15 days.  The receiver shall send notice
2182	of the application to any known persons who own the property
2183	involved at least 10 days prior to the hearing. Payment by the
2184	receiver of the amount determined by the court to be reasonable
2185	is a defense to any action against the receiver for payment or
2186	for possession of the goods or real estate subject to the lease,
2187	security interest, or mortgage involved by any person who
2188	received such notice, but the payment does not relieve the owner
2189	of the facility of any liability for the difference between the
2190	amount paid by the receiver and the amount due under the
2191	original lease, security interest, or mortgage involved.
2192	(6)  The court shall set the compensation of the receiver,
2193	which will be considered a necessary expense of a receivership.
2194	(7)  A receiver may be held liable in a personal capacity
2195	only for the receiver's own gross negligence, intentional acts,
2196	or breach of fiduciary duty.
2197	(8)  The court may require a receiver to post a bond.
2198	(9)  The court may direct the agency to allocate funds from
2199	the Health Care Trust Fund to the receiver, subject to the
2200	provisions of s. 429.18(1) s. 400.418(1).
2201	(10)  The court may terminate a receivership when:
2202	(a)  The court determines that the receivership is no
2203	longer necessary because the conditions which gave rise to the
2204	receivership no longer exist or the agency grants the facility a
2205	new license; or
2206	(b)  All of the residents in the facility have been
2207	transferred or discharged.
2208	(11)  Within 30 days after termination, the receiver shall
2209	give the court a complete accounting of all property of which
2210	the receiver has taken possession, of all funds collected, and
2211	of the expenses of the receivership.
2212	(12)  Nothing in this section shall be deemed to relieve
2213	any owner, administrator, or employee of a facility placed in
2214	receivership of any civil or criminal liability incurred, or any
2215	duty imposed by law, by reason of acts or omissions of the
2216	owner, administrator, or employee prior to the appointment of a
2217	receiver; nor shall anything contained in this section be
2218	construed to suspend during the receivership any obligation of
2219	the owner, administrator, or employee for payment of taxes or
2220	other operating and maintenance expenses of the facility or of
2221	the owner, administrator, employee, or any other person for the
2222	payment of mortgages or liens.  The owner shall retain the right
2223	to sell or mortgage any facility under receivership, subject to
2224	approval of the court which ordered the receivership.
2225	Section 47.  Section 400.424, Florida Statutes, is
2226	renumbered as section 429.24, Florida Statutes, and amended to
2227	read:
2228	429.24 400.424  Contracts.--
2229	(1)  The presence of each resident in a facility shall be
2230	covered by a contract, executed at the time of admission or
2231	prior thereto, between the licensee and the resident or his or
2232	her designee or legal representative. Each party to the contract
2233	shall be provided with a duplicate original thereof, and the
2234	licensee shall keep on file in the facility all such contracts.
2235	The licensee may not destroy or otherwise dispose of any such
2236	contract until 5 years after its expiration.
2237	(2)  Each contract must contain express provisions
2238	specifically setting forth the services and accommodations to be
2239	provided by the facility; the rates or charges; provision for at
2240	least 30 days' written notice of a rate increase; the rights,
2241	duties, and obligations of the residents, other than those
2242	specified in s. 429.28 s. 400.428; and other matters that the
2243	parties deem appropriate. Whenever money is deposited or
2244	advanced by a resident in a contract as security for performance
2245	of the contract agreement or as advance rent for other than the
2246	next immediate rental period:
2247	(a)  Such funds shall be deposited in a banking institution
2248	in this state that is located, if possible, in the same
2249	community in which the facility is located; shall be kept
2250	separate from the funds and property of the facility; may not be
2251	represented as part of the assets of the facility on financial
2252	statements; and shall be used, or otherwise expended, only for
2253	the account of the resident.
2254	(b)  The licensee shall, within 30 days of receipt of
2255	advance rent or a security deposit, notify the resident or
2256	residents in writing of the manner in which the licensee is
2257	holding the advance rent or security deposit and state the name
2258	and address of the depository where the moneys are being held.
2259	The licensee shall notify residents of the facility's policy on
2260	advance deposits.
2261	(3)(a)  The contract shall include a refund policy to be
2262	implemented at the time of a resident's transfer, discharge, or
2263	death.  The refund policy shall provide that the resident or
2264	responsible party is entitled to a prorated refund based on the
2265	daily rate for any unused portion of payment beyond the
2266	termination date after all charges, including the cost of
2267	damages to the residential unit resulting from circumstances
2268	other than normal use, have been paid to the licensee.  For the
2269	purpose of this paragraph, the termination date shall be the
2270	date the unit is vacated by the resident and cleared of all
2271	personal belongings.  If the amount of belongings does not
2272	preclude renting the unit, the facility may clear the unit and
2273	charge the resident or his or her estate for moving and storing
2274	the items at a rate equal to the actual cost to the facility,
2275	not to exceed 20 percent of the regular rate for the unit,
2276	provided that 14 days' advance written notification is given.
2277	If the resident's possessions are not claimed within 45 days
2278	after notification, the facility may dispose of them.  The
2279	contract shall also specify any other conditions under which
2280	claims will be made against the refund due the resident.  Except
2281	in the case of death or a discharge due to medical reasons, the
2282	refunds shall be computed in accordance with the notice of
2283	relocation requirements specified in the contract.  However, a
2284	resident may not be required to provide the licensee with more
2285	than 30 days' notice of termination.  If after a contract is
2286	terminated, the facility intends to make a claim against a
2287	refund due the resident, the facility shall notify the resident
2288	or responsible party in writing of the claim and shall provide
2289	said party with a reasonable time period of no less than 14
2290	calendar days to respond.  The facility shall provide a refund
2291	to the resident or responsible party within 45 days after the
2292	transfer, discharge, or death of the resident. The agency shall
2293	impose a fine upon a facility that fails to comply with the
2294	refund provisions of the paragraph, which fine shall be equal to
2295	three times the amount due to the resident. One-half of the fine
2296	shall be remitted to the resident or his or her estate, and the
2297	other half to the Health Care Trust Fund to be used for the
2298	purpose specified in s. 429.18 s. 400.418.
2299	(b)  If a licensee agrees to reserve a bed for a resident
2300	who is admitted to a medical facility, including, but not
2301	limited to, a nursing home, health care facility, or psychiatric
2302	facility, the resident or his or her responsible party shall
2303	notify the licensee of any change in status that would prevent
2304	the resident from returning to the facility.  Until such notice
2305	is received, the agreed-upon daily rate may be charged by the
2306	licensee.
2307	(c)  The purpose of any advance payment and a refund policy
2308	for such payment, including any advance payment for housing,
2309	meals, or personal services, shall be covered in the contract.
2310	(4)  The contract shall state whether or not the facility
2311	is affiliated with any religious organization and, if so, which
2312	organization and its general responsibility to the facility.
2313	(5)  Neither the contract nor any provision thereof
2314	relieves any licensee of any requirement or obligation imposed
2315	upon it by this part or rules adopted under this part.
2316	(6)  In lieu of the provisions of this section, facilities
2317	certified under chapter 651 shall comply with the requirements
2318	of s. 651.055.
2319	(7)  Notwithstanding the provisions of this section,
2320	facilities which consist of 60 or more apartments may require
2321	refund policies and termination notices in accordance with the
2322	provisions of part II of chapter 83, provided that the lease is
2323	terminated automatically without financial penalty in the event
2324	of a resident's death or relocation due to psychiatric
2325	hospitalization or to medical reasons which necessitate services
2326	or care beyond which the facility is licensed to provide.  The
2327	date of termination in such instances shall be the date the unit
2328	is fully vacated.  A lease may be substituted for the contract
2329	if it meets the disclosure requirements of this section.  For
2330	the purpose of this section, the term "apartment" means a room
2331	or set of rooms with a kitchen or kitchenette and lavatory
2332	located within one or more buildings containing other similar or
2333	like residential units.
2334	(8)  The department may by rule clarify terms, establish
2335	procedures, clarify refund policies and contract provisions, and
2336	specify documentation as necessary to administer this section.
2337	Section 48.  Section 400.4255, Florida Statutes, is
2338	renumbered as section 429.255, Florida Statutes, and amended to
2339	read:
2340	429.255 400.4255  Use of personnel; emergency care.--
2341	(1)(a)  Persons under contract to the facility, facility
2342	staff, or volunteers, who are licensed according to part I of
2343	chapter 464, or those persons exempt under s. 464.022(1), and
2344	others as defined by rule, may administer medications to
2345	residents, take residents' vital signs, manage individual weekly
2346	pill organizers for residents who self-administer medication,
2347	give prepackaged enemas ordered by a physician, observe
2348	residents, document observations on the appropriate resident's
2349	record, report observations to the resident's physician, and
2350	contract or allow residents or a resident's representative,
2351	designee, surrogate, guardian, or attorney in fact to contract
2352	with a third party, provided residents meet the criteria for
2353	appropriate placement as defined in s. 429.26 s. 400.426.
2354	Nursing assistants certified pursuant to part II of chapter 464
2355	may take residents' vital signs as directed by a licensed nurse
2356	or physician.
2357	(b)  All staff in facilities licensed under this part shall
2358	exercise their professional responsibility to observe residents,
2359	to document observations on the appropriate resident's record,
2360	and to report the observations to the resident's physician.
2361	However, the owner or administrator of the facility shall be
2362	responsible for determining that the resident receiving services
2363	is appropriate for residence in the facility.
2364	(c)  In an emergency situation, licensed personnel may
2365	carry out their professional duties pursuant to part I of
2366	chapter 464 until emergency medical personnel assume
2367	responsibility for care.
2368	(2)  In facilities licensed to provide extended congregate
2369	care, persons under contract to the facility, facility staff, or
2370	volunteers, who are licensed according to part I of chapter 464,
2371	or those persons exempt under s. 464.022(1), or those persons
2372	certified as nursing assistants pursuant to part II of chapter
2373	464, may also perform all duties within the scope of their
2374	license or certification, as approved by the facility
2375	administrator and pursuant to this part.
2376	(3)  Facility staff may withhold or withdraw
2377	cardiopulmonary resuscitation if presented with an order not to
2378	resuscitate executed pursuant to s. 401.45. The department shall
2379	adopt rules providing for the implementation of such orders.
2380	Facility staff and facilities shall not be subject to criminal
2381	prosecution or civil liability, nor be considered to have
2382	engaged in negligent or unprofessional conduct, for withholding
2383	or withdrawing cardiopulmonary resuscitation pursuant to such an
2384	order and rules adopted by the department. The absence of an
2385	order to resuscitate executed pursuant to s. 401.45 does not
2386	preclude a physician from withholding or withdrawing
2387	cardiopulmonary resuscitation as otherwise permitted by law.
2388	Section 49.  Section 400.4256, Florida Statutes, is
2389	renumbered as section 429.256, Florida Statutes, and amended to
2390	read:
2391	429.256 400.4256  Assistance with self-administration of
2392	medication.--
2393	(1)  For the purposes of this section, the term:
2394	(a)  "Informed consent" means advising the resident, or the
2395	resident's surrogate, guardian, or attorney in fact, that an
2396	assisted living facility is not required to have a licensed
2397	nurse on staff, that the resident may be receiving assistance
2398	with self-administration of medication from an unlicensed
2399	person, and that such assistance, if provided by an unlicensed
2400	person, will or will not be overseen by a licensed nurse.
2401	(b)  "Unlicensed person" means an individual not currently
2402	licensed to practice nursing or medicine who is employed by or
2403	under contract to an assisted living facility and who has
2404	received training with respect to assisting with the self-
2405	administration of medication in an assisted living facility as
2406	provided under s. 429.52 s. 400.452 prior to providing such
2407	assistance as described in this section.
2408	(2)  Residents who are capable of self-administering their
2409	own medications without assistance shall be encouraged and
2410	allowed to do so. However, an unlicensed person may, consistent
2411	with a dispensed prescription's label or the package directions
2412	of an over-the-counter medication, assist a resident whose
2413	condition is medically stable with the self-administration of
2414	routine, regularly scheduled medications that are intended to be
2415	self-administered. Assistance with self-medication by an
2416	unlicensed person may occur only upon a documented request by,
2417	and the written informed consent of, a resident or the
2418	resident's surrogate, guardian, or attorney in fact. For the
2419	purposes of this section, self-administered medications include
2420	both legend and over-the-counter oral dosage forms, topical
2421	dosage forms and topical ophthalmic, otic, and nasal dosage
2422	forms including solutions, suspensions, sprays, and inhalers.
2423	(3)  Assistance with self-administration of medication
2424	includes:
2425	(a)  Taking the medication, in its previously dispensed,
2426	properly labeled container, from where it is stored, and
2427	bringing it to the resident.
2428	(b)  In the presence of the resident, reading the label,
2429	opening the container, removing a prescribed amount of
2430	medication from the container, and closing the container.
2431	(c)  Placing an oral dosage in the resident's hand or
2432	placing the dosage in another container and helping the resident
2433	by lifting the container to his or her mouth.
2434	(d)  Applying topical medications.
2435	(e)  Returning the medication container to proper storage.
2436	(f)  Keeping a record of when a resident receives
2437	assistance with self-administration under this section.
2438	(4)  Assistance with self-administration does not include:
2439	(a)  Mixing, compounding, converting, or calculating
2440	medication doses, except for measuring a prescribed amount of
2441	liquid medication or breaking a scored tablet or crushing a
2442	tablet as prescribed.
2443	(b)  The preparation of syringes for injection or the
2444	administration of medications by any injectable route.
2445	(c)  Administration of medications through intermittent
2446	positive pressure breathing machines or a nebulizer.
2447	(d)  Administration of medications by way of a tube
2448	inserted in a cavity of the body.
2449	(e)  Administration of parenteral preparations.
2450	(f)  Irrigations or debriding agents used in the treatment
2451	of a skin condition.
2452	(g)  Rectal, urethral, or vaginal preparations.
2453	(h)  Medications ordered by the physician or health care
2454	professional with prescriptive authority to be given "as
2455	needed," unless the order is written with specific parameters
2456	that preclude independent judgment on the part of the unlicensed
2457	person, and at the request of a competent resident.
2458	(i)  Medications for which the time of administration, the
2459	amount, the strength of dosage, the method of administration, or
2460	the reason for administration requires judgment or discretion on
2461	the part of the unlicensed person.
2462	(5)  Assistance with the self-administration of medication
2463	by an unlicensed person as described in this section shall not
2464	be considered administration as defined in s. 465.003.
2465	(6)  The department may by rule establish facility
2466	procedures and interpret terms as necessary to implement this
2467	section.
2468	Section 50.  Section 400.426, Florida Statutes, is
2469	renumbered as section 429.26, Florida Statutes, and amended to
2470	read:
2471	429.26 400.426  Appropriateness of placements; examinations
2472	of residents.--
2473	(1)  The owner or administrator of a facility is
2474	responsible for determining the appropriateness of admission of
2475	an individual to the facility and for determining the continued
2476	appropriateness of residence of an individual in the facility.
2477	A determination shall be based upon an assessment of the
2478	strengths, needs, and preferences of the resident, the care and
2479	services offered or arranged for by the facility in accordance
2480	with facility policy, and any limitations in law or rule related
2481	to admission criteria or continued residency for the type of
2482	license held by the facility under this part.  A resident may
2483	not be moved from one facility to another without consultation
2484	with and agreement from the resident or, if applicable, the
2485	resident's representative or designee or the resident's family,
2486	guardian, surrogate, or attorney in fact.  In the case of a
2487	resident who has been placed by the department or the Department
2488	of Children and Family Services, the administrator must notify
2489	the appropriate contact person in the applicable department.
2490	(2)  A physician or nurse practitioner who is employed by
2491	an assisted living facility to provide an initial examination
2492	for admission purposes may not have financial interest in the
2493	facility.
2494	(3)  Persons licensed under part I of chapter 464 who are
2495	employed by or under contract with a facility shall, on a
2496	routine basis or at least monthly, perform a nursing assessment
2497	of the residents for whom they are providing nursing services
2498	ordered by a physician, except administration of medication, and
2499	shall document such assessment, including any substantial
2500	changes in a resident's status which may necessitate relocation
2501	to a nursing home, hospital, or specialized health care
2502	facility.  Such records shall be maintained in the facility for
2503	inspection by the agency and shall be forwarded to the
2504	resident's case manager, if applicable.
2505	(4)  If possible, each resident shall have been examined by
2506	a licensed physician or a licensed nurse practitioner within 60
2507	days before admission to the facility.  The signed and completed
2508	medical examination report shall be submitted to the owner or
2509	administrator of the facility who shall use the information
2510	contained therein to assist in the determination of the
2511	appropriateness of the resident's admission and continued stay
2512	in the facility.  The medical examination report shall become a
2513	permanent part of the record of the resident at the facility and
2514	shall be made available to the agency during inspection or upon
2515	request.  An assessment that has been completed through the
2516	Comprehensive Assessment and Review for Long-Term Care Services
2517	(CARES) Program fulfills the requirements for a medical
2518	examination under this subsection and s. 429.07(3)(b)6. s.
2519	400.407(3)(b)6.
2520	(5)  Except as provided in s. 429.07 s. 400.407, if a
2521	medical examination has not been completed within 60 days before
2522	the admission of the resident to the facility, a licensed
2523	physician or licensed nurse practitioner shall examine the
2524	resident and complete a medical examination form provided by the
2525	agency within 30 days following the admission to the facility to
2526	enable the facility owner or administrator to determine the
2527	appropriateness of the admission. The medical examination form
2528	shall become a permanent part of the record of the resident at
2529	the facility and shall be made available to the agency during
2530	inspection by the agency or upon request.
2531	(6)  Any resident accepted in a facility and placed by the
2532	department or the Department of Children and Family Services
2533	shall have been examined by medical personnel within 30 days
2534	before placement in the facility. The examination shall include
2535	an assessment of the appropriateness of placement in a facility.
2536	The findings of this examination shall be recorded on the
2537	examination form provided by the agency. The completed form
2538	shall accompany the resident and shall be submitted to the
2539	facility owner or administrator. Additionally, in the case of a
2540	mental health resident, the Department of Children and Family
2541	Services must provide documentation that the individual has been
2542	assessed by a psychiatrist, clinical psychologist, clinical
2543	social worker, or psychiatric nurse, or an individual who is
2544	supervised by one of these professionals, and determined to be
2545	appropriate to reside in an assisted living facility. The
2546	documentation must be in the facility within 30 days after the
2547	mental health resident has been admitted to the facility. An
2548	evaluation completed upon discharge from a state mental hospital
2549	meets the requirements of this subsection related to
2550	appropriateness for placement as a mental health resident
2551	providing it was completed within 90 days prior to admission to
2552	the facility.  The applicable department shall provide to the
2553	facility administrator any information about the resident that
2554	would help the administrator meet his or her responsibilities
2555	under subsection (1).  Further, department personnel shall
2556	explain to the facility operator any special needs of the
2557	resident and advise the operator whom to call should problems
2558	arise. The applicable department shall advise and assist the
2559	facility administrator where the special needs of residents who
2560	are recipients of optional state supplementation require such
2561	assistance.
2562	(7)  The facility must notify a licensed physician when a
2563	resident exhibits signs of dementia or cognitive impairment or
2564	has a change of condition in order to rule out the presence of
2565	an underlying physiological condition that may be contributing
2566	to such dementia or impairment. The notification must occur
2567	within 30 days after the acknowledgment of such signs by
2568	facility staff. If an underlying condition is determined to
2569	exist, the facility shall arrange, with the appropriate health
2570	care provider, the necessary care and services to treat the
2571	condition.
2572	(8)  The Department of Children and Family Services may
2573	require an examination for supplemental security income and
2574	optional state supplementation recipients residing in facilities
2575	at any time and shall provide the examination whenever a
2576	resident's condition requires it.  Any facility administrator;
2577	personnel of the agency, the department, or the Department of
2578	Children and Family Services; or long-term care ombudsman
2579	council member who believes a resident needs to be evaluated
2580	shall notify the resident's case manager, who shall take
2581	appropriate action.  A report of the examination findings shall
2582	be provided to the resident's case manager and the facility
2583	administrator to help the administrator meet his or her
2584	responsibilities under subsection (1).
2585	(9)  If, at any time after admission to a facility, a
2586	resident appears to need care beyond that which the facility is
2587	licensed to provide, the agency shall require the resident to be
2588	physically examined by a licensed physician or licensed nurse
2589	practitioner.  This examination shall, to the extent possible,
2590	be performed by the resident's preferred physician or nurse
2591	practitioner and shall be paid for by the resident with personal
2592	funds, except as provided in s. 429.18(1)(b) s. 400.418(1)(b).
2593	Following this examination, the examining physician or licensed
2594	nurse practitioner shall complete and sign a medical form
2595	provided by the agency. The completed medical form shall be
2596	submitted to the agency within 30 days after the date the
2597	facility owner or administrator is notified by the agency that
2598	the physical examination is required.  After consultation with
2599	the physician or licensed nurse practitioner who performed the
2600	examination, a medical review team designated by the agency
2601	shall then determine whether the resident is appropriately
2602	residing in the facility.  The medical review team shall base
2603	its decision on a comprehensive review of the resident's
2604	physical and functional status, including the resident's
2605	preferences, and not on an isolated health-related problem.  In
2606	the case of a mental health resident, if the resident appears to
2607	have needs in addition to those identified in the community
2608	living support plan, the agency may require an evaluation by a
2609	mental health professional, as determined by the Department of
2610	Children and Family Services.  A facility may not be required to
2611	retain a resident who requires more services or care than the
2612	facility is able to provide in accordance with its policies and
2613	criteria for admission and continued residency. Members of the
2614	medical review team making the final determination may not
2615	include the agency personnel who initially questioned the
2616	appropriateness of a resident's placement. Such determination is
2617	final and binding upon the facility and the resident. Any
2618	resident who is determined by the medical review team to be
2619	inappropriately residing in a facility shall be given 30 days'
2620	written notice to relocate by the owner or administrator, unless
2621	the resident's continued residence in the facility presents an
2622	imminent danger to the health, safety, or welfare of the
2623	resident or a substantial probability exists that death or
2624	serious physical harm would result to the resident if allowed to
2625	remain in the facility.
2626	(10)  A terminally ill resident who no longer meets the
2627	criteria for continued residency may remain in the facility if
2628	the arrangement is mutually agreeable to the resident and the
2629	facility; additional care is rendered through a licensed
2630	hospice, and the resident is under the care of a physician who
2631	agrees that the physical needs of the resident are being met.
2632	(11)  Facilities licensed to provide extended congregate
2633	care services shall promote aging in place by determining
2634	appropriateness of continued residency based on a comprehensive
2635	review of the resident's physical and functional status; the
2636	ability of the facility, family members, friends, or any other
2637	pertinent individuals or agencies to provide the care and
2638	services required; and documentation that a written service plan
2639	consistent with facility policy has been developed and
2640	implemented to ensure that the resident's needs and preferences
2641	are addressed.
2642	(12)  No resident who requires 24-hour nursing supervision,
2643	except for a resident who is an enrolled hospice patient
2644	pursuant to part IV VI of this chapter 400, shall be retained in
2645	a facility licensed under this part.
2646	Section 51.  Section 400.427, Florida Statutes, is
2647	renumbered as section 429.27, Florida Statutes, and amended to
2648	read:
2649	429.27 400.427  Property and personal affairs of
2650	residents.--
2651	(1)(a)  A resident shall be given the option of using his
2652	or her own belongings, as space permits; choosing his or her
2653	roommate; and, whenever possible, unless the resident is
2654	adjudicated incompetent or incapacitated under state law,
2655	managing his or her own affairs.
2656	(b)  The admission of a resident to a facility and his or
2657	her presence therein shall not confer on the facility or its
2658	owner, administrator, employees, or representatives any
2659	authority to manage, use, or dispose of any property of the
2660	resident; nor shall such admission or presence confer on any of
2661	such persons any authority or responsibility for the personal
2662	affairs of the resident, except that which may be necessary for
2663	the safe management of the facility or for the safety of the
2664	resident.
2665	(2)  A facility, or an owner, administrator, employee, or
2666	representative thereof, may not act as the guardian, trustee, or
2667	conservator for any resident of the assisted living facility or
2668	any of such resident's property. An owner, administrator, or
2669	staff member, or representative thereof, may not act as a
2670	competent resident's payee for social security, veteran's, or
2671	railroad benefits without the consent of the resident.  Any
2672	facility whose owner, administrator, or staff, or representative
2673	thereof, serves as representative payee for any resident of the
2674	facility shall file a surety bond with the agency in an amount
2675	equal to twice the average monthly aggregate income or personal
2676	funds due to residents, or expendable for their account, which
2677	are received by a facility.  Any facility whose owner,
2678	administrator, or staff, or a representative thereof, is granted
2679	power of attorney for any resident of the facility shall file a
2680	surety bond with the agency for each resident for whom such
2681	power of attorney is granted.  The surety bond shall be in an
2682	amount equal to twice the average monthly income of the
2683	resident, plus the value of any resident's property under the
2684	control of the attorney in fact.  The bond shall be executed by
2685	the facility as principal and a licensed surety company.  The
2686	bond shall be conditioned upon the faithful compliance of the
2687	facility with this section and shall run to the agency for the
2688	benefit of any resident who suffers a financial loss as a result
2689	of the misuse or misappropriation by a facility of funds held
2690	pursuant to this subsection.  Any surety company that cancels or
2691	does not renew the bond of any licensee shall notify the agency
2692	in writing not less than 30 days in advance of such action,
2693	giving the reason for the cancellation or nonrenewal.  Any
2694	facility owner, administrator, or staff, or representative
2695	thereof, who is granted power of attorney for any resident of
2696	the facility shall, on a monthly basis, be required to provide
2697	the resident a written statement of any transaction made on
2698	behalf of the resident pursuant to this subsection, and a copy
2699	of such statement given to the resident shall be retained in
2700	each resident's file and available for agency inspection.
2701	(3)  A facility, upon mutual consent with the resident,
2702	shall provide for the safekeeping in the facility of personal
2703	effects not in excess of $500 and funds of the resident not in
2704	excess of $200 cash, and shall keep complete and accurate
2705	records of all such funds and personal effects received. If a
2706	resident is absent from a facility for 24 hours or more, the
2707	facility may provide for the safekeeping of the resident's
2708	personal effects in excess of $500.
2709	(4)  Any funds or other property belonging to or due to a
2710	resident, or expendable for his or her account, which is
2711	received by a facility shall be trust funds which shall be kept
2712	separate from the funds and property of the facility and other
2713	residents or shall be specifically credited to such resident.
2714	Such trust funds shall be used or otherwise expended only for
2715	the account of the resident. At least once every 3 months,
2716	unless upon order of a court of competent jurisdiction, the
2717	facility shall furnish the resident and his or her guardian,
2718	trustee, or conservator, if any, a complete and verified
2719	statement of all funds and other property to which this
2720	subsection applies, detailing the amount and items received,
2721	together with their sources and disposition.  In any event, the
2722	facility shall furnish such statement annually and upon the
2723	discharge or transfer of a resident.  Any governmental agency or
2724	private charitable agency contributing funds or other property
2725	to the account of a resident shall also be entitled to receive
2726	such statement annually and upon the discharge or transfer of
2727	the resident.
2728	(5)  Any personal funds available to facility residents may
2729	be used by residents as they choose to obtain clothing, personal
2730	items, leisure activities, and other supplies and services for
2731	their personal use.  A facility may not demand, require, or
2732	contract for payment of all or any part of the personal funds in
2733	satisfaction of the facility rate for supplies and services
2734	beyond that amount agreed to in writing and may not levy an
2735	additional charge to the individual or the account for any
2736	supplies or services that the facility has agreed by contract to
2737	provide as part of the standard monthly rate.  Any service or
2738	supplies provided by the facility which are charged separately
2739	to the individual or the account may be provided only with the
2740	specific written consent of the individual, who shall be
2741	furnished in advance of the provision of the services or
2742	supplies with an itemized written statement to be attached to
2743	the contract setting forth the charges for the services or
2744	supplies.
2745	(6)(a)  In addition to any damages or civil penalties to
2746	which a person is subject, any person who:
2747	1.  Intentionally withholds a resident's personal funds,
2748	personal property, or personal needs allowance, or who demands,
2749	beneficially receives, or contracts for payment of all or any
2750	part of a resident's personal property or personal needs
2751	allowance in satisfaction of the facility rate for supplies and
2752	services; or
2753	2.  Borrows from or pledges any personal funds of a
2754	resident, other than the amount agreed to by written contract
2755	under s. 429.24 s. 400.424,
2756
2757	commits a misdemeanor of the first degree, punishable as
2758	provided in s. 775.082 or s. 775.083.
2759	(b)  Any facility owner, administrator, or staff, or
2760	representative thereof, who is granted power of attorney for any
2761	resident of the facility and who misuses or misappropriates
2762	funds obtained through this power commits a felony of the third
2763	degree, punishable as provided in s. 775.082, s. 775.083, or s.
2764	775.084.
2765	(7)  In the event of the death of a resident, a licensee
2766	shall return all refunds, funds, and property held in trust to
2767	the resident's personal representative, if one has been
2768	appointed at the time the facility disburses such funds, and, if
2769	not, to the resident's spouse or adult next of kin named in a
2770	beneficiary designation form provided by the facility to the
2771	resident. If the resident has no spouse or adult next of kin or
2772	such person cannot be located, funds due the resident shall be
2773	placed in an interest-bearing account, and all property held in
2774	trust by the facility shall be safeguarded until such time as
2775	the funds and property are disbursed pursuant to the Florida
2776	Probate Code.  Such funds shall be kept separate from the funds
2777	and property of the facility and other residents of the
2778	facility. If the funds of the deceased resident are not
2779	disbursed pursuant to the Florida Probate Code within 2 years
2780	after the resident's death, the funds shall be deposited in the
2781	Health Care Trust Fund administered by the agency.
2782	(8)  The department may by rule clarify terms and specify
2783	procedures and documentation necessary to administer the
2784	provisions of this section relating to the proper management of
2785	residents' funds and personal property and the execution of
2786	surety bonds.
2787	Section 52.  Section 400.428, Florida Statutes, is
2788	renumbered as section 429.28, Florida Statutes, and amended to
2789	read:
2790	429.28 400.428  Resident bill of rights.--
2791	(1)  No resident of a facility shall be deprived of any
2792	civil or legal rights, benefits, or privileges guaranteed by
2793	law, the Constitution of the State of Florida, or the
2794	Constitution of the United States as a resident of a facility.
2795	Every resident of a facility shall have the right to:
2796	(a)  Live in a safe and decent living environment, free
2797	from abuse and neglect.
2798	(b)  Be treated with consideration and respect and with due
2799	recognition of personal dignity, individuality, and the need for
2800	privacy.
2801	(c)  Retain and use his or her own clothes and other
2802	personal property in his or her immediate living quarters, so as
2803	to maintain individuality and personal dignity, except when the
2804	facility can demonstrate that such would be unsafe, impractical,
2805	or an infringement upon the rights of other residents.
2806	(d)  Unrestricted private communication, including
2807	receiving and sending unopened correspondence, access to a
2808	telephone, and visiting with any person of his or her choice, at
2809	any time between the hours of 9 a.m. and 9 p.m. at a minimum.
2810	Upon request, the facility shall make provisions to extend
2811	visiting hours for caregivers and out-of-town guests, and in
2812	other similar situations.
2813	(e)  Freedom to participate in and benefit from community
2814	services and activities and to achieve the highest possible
2815	level of independence, autonomy, and interaction within the
2816	community.
2817	(f)  Manage his or her financial affairs unless the
2818	resident or, if applicable, the resident's representative,
2819	designee, surrogate, guardian, or attorney in fact authorizes
2820	the administrator of the facility to provide safekeeping for
2821	funds as provided in s. 429.27 s. 400.427.
2822	(g)  Share a room with his or her spouse if both are
2823	residents of the facility.
2824	(h)  Reasonable opportunity for regular exercise several
2825	times a week and to be outdoors at regular and frequent
2826	intervals except when prevented by inclement weather.
2827	(i)  Exercise civil and religious liberties, including the
2828	right to independent personal decisions.  No religious beliefs
2829	or practices, nor any attendance at religious services, shall be
2830	imposed upon any resident.
2831	(j)  Access to adequate and appropriate health care
2832	consistent with established and recognized standards within the
2833	community.
2834	(k)  At least 45 days' notice of relocation or termination
2835	of residency from the facility unless, for medical reasons, the
2836	resident is certified by a physician to require an emergency
2837	relocation to a facility providing a more skilled level of care
2838	or the resident engages in a pattern of conduct that is harmful
2839	or offensive to other residents.  In the case of a resident who
2840	has been adjudicated mentally incapacitated, the guardian shall
2841	be given at least 45 days' notice of a nonemergency relocation
2842	or residency termination.  Reasons for relocation shall be set
2843	forth in writing.  In order for a facility to terminate the
2844	residency of an individual without notice as provided herein,
2845	the facility shall show good cause in a court of competent
2846	jurisdiction.
2847	(l)  Present grievances and recommend changes in policies,
2848	procedures, and services to the staff of the facility, governing
2849	officials, or any other person without restraint, interference,
2850	coercion, discrimination, or reprisal. Each facility shall
2851	establish a grievance procedure to facilitate the residents'
2852	exercise of this right.  This right includes access to ombudsman
2853	volunteers and advocates and the right to be a member of, to be
2854	active in, and to associate with advocacy or special interest
2855	groups.
2856	(2)  The administrator of a facility shall ensure that a
2857	written notice of the rights, obligations, and prohibitions set
2858	forth in this part is posted in a prominent place in each
2859	facility and read or explained to residents who cannot read.
2860	This notice shall include the name, address, and telephone
2861	numbers of the local ombudsman council and central abuse hotline
2862	and, when applicable, the Advocacy Center for Persons with
2863	Disabilities, Inc., and the Florida local advocacy council,
2864	where complaints may be lodged.  The facility must ensure a
2865	resident's access to a telephone to call the local ombudsman
2866	council, central abuse hotline, Advocacy Center for Persons with
2867	Disabilities, Inc., and the Florida local advocacy council.
2868	(3)(a)  The agency shall conduct a survey to determine
2869	general compliance with facility standards and compliance with
2870	residents' rights as a prerequisite to initial licensure or
2871	licensure renewal.
2872	(b)  In order to determine whether the facility is
2873	adequately protecting residents' rights, the biennial survey
2874	shall include private informal conversations with a sample of
2875	residents and consultation with the ombudsman council in the
2876	planning and service area in which the facility is located to
2877	discuss residents' experiences within the facility.
2878	(c)  During any calendar year in which no survey is
2879	conducted, the agency shall conduct at least one monitoring
2880	visit of each facility cited in the previous year for a class I
2881	or class II violation, or more than three uncorrected class III
2882	violations.
2883	(d)  The agency may conduct periodic followup inspections
2884	as necessary to monitor the compliance of facilities with a
2885	history of any class I, class II, or class III violations that
2886	threaten the health, safety, or security of residents.
2887	(e)  The agency may conduct complaint investigations as
2888	warranted to investigate any allegations of noncompliance with
2889	requirements required under this part or rules adopted under
2890	this part.
2891	(4)  The facility shall not hamper or prevent residents
2892	from exercising their rights as specified in this section.
2893	(5)  No facility or employee of a facility may serve notice
2894	upon a resident to leave the premises or take any other
2895	retaliatory action against any person who:
2896	(a)  Exercises any right set forth in this section.
2897	(b)  Appears as a witness in any hearing, inside or outside
2898	the facility.
2899	(c)  Files a civil action alleging a violation of the
2900	provisions of this part or notifies a state attorney or the
2901	Attorney General of a possible violation of such provisions.
2902	(6)  Any facility which terminates the residency of an
2903	individual who participated in activities specified in
2904	subsection (5) shall show good cause in a court of competent
2905	jurisdiction.
2906	(7)  Any person who submits or reports a complaint
2907	concerning a suspected violation of the provisions of this part
2908	or concerning services and conditions in facilities, or who
2909	testifies in any administrative or judicial proceeding arising
2910	from such a complaint, shall have immunity from any civil or
2911	criminal liability therefor, unless such person has acted in bad
2912	faith or with malicious purpose or the court finds that there
2913	was a complete absence of a justiciable issue of either law or
2914	fact raised by the losing party.
2915	Section 53.  Section 400.429, Florida Statutes, is
2916	renumbered as section 429.29, Florida Statutes, and amended to
2917	read:
2918	429.29 400.429  Civil actions to enforce rights.--
2919	(1)  Any person or resident whose rights as specified in
2920	this part are violated shall have a cause of action.  The action
2921	may be brought by the resident or his or her guardian, or by a
2922	person or organization acting on behalf of a resident with the
2923	consent of the resident or his or her guardian, or by the
2924	personal representative of the estate of a deceased resident
2925	regardless of the cause of death. If the action alleges a claim
2926	for the resident's rights or for negligence that caused the
2927	death of the resident, the claimant shall be required to elect
2928	either survival damages pursuant to s. 46.021 or wrongful death
2929	damages pursuant to s. 768.21. If the action alleges a claim for
2930	the resident's rights or for negligence that did not cause the
2931	death of the resident, the personal representative of the estate
2932	may recover damages for the negligence that caused injury to the
2933	resident. The action may be brought in any court of competent
2934	jurisdiction to enforce such rights and to recover actual
2935	damages, and punitive damages for violation of the rights of a
2936	resident or negligence. Any resident who prevails in seeking
2937	injunctive relief or a claim for an administrative remedy is
2938	entitled to recover the costs of the action and a reasonable
2939	attorney's fee assessed against the defendant not to exceed
2940	$25,000. Fees shall be awarded solely for the injunctive or
2941	administrative relief and not for any claim or action for
2942	damages whether such claim or action is brought together with a
2943	request for an injunction or administrative relief or as a
2944	separate action, except as provided under s. 768.79 or the
2945	Florida Rules of Civil Procedure. Sections 429.29-429.298
2946	400.429-400.4303 provide the exclusive remedy for a cause of
2947	action for recovery of damages for the personal injury or death
2948	of a resident arising out of negligence or a violation of rights
2949	specified in s. 429.28 s. 400.428. This section does not
2950	preclude theories of recovery not arising out of negligence or
2951	s. 429.28 s. 400.428 which are available to a resident or to the
2952	agency. The provisions of chapter 766 do not apply to any cause
2953	of action brought under ss. 429.29-429.298 ss. 400.429-400.4303.
2954	(2)  In any claim brought pursuant to this part alleging a
2955	violation of resident's rights or negligence causing injury to
2956	or the death of a resident, the claimant shall have the burden
2957	of proving, by a preponderance of the evidence, that:
2958	(a)  The defendant owed a duty to the resident;
2959	(b)  The defendant breached the duty to the resident;
2960	(c)  The breach of the duty is a legal cause of loss,
2961	injury, death, or damage to the resident; and
2962	(d)  The resident sustained loss, injury, death, or damage
2963	as a result of the breach.
2964
2965	Nothing in this part shall be interpreted to create strict
2966	liability. A violation of the rights set forth in s. 429.28 s.
2967	400.428 or in any other standard or guidelines specified in this
2968	part or in any applicable administrative standard or guidelines
2969	of this state or a federal regulatory agency shall be evidence
2970	of negligence but shall not be considered negligence per se.
2971	(3)  In any claim brought pursuant to this section, a
2972	licensee, person, or entity shall have a duty to exercise
2973	reasonable care.  Reasonable care is that degree of care which a
2974	reasonably careful licensee, person, or entity would use under
2975	like circumstances.
2976	(4)  In any claim for resident's rights violation or
2977	negligence by a nurse licensed under part I of chapter 464, such
2978	nurse shall have the duty to exercise care consistent with the
2979	prevailing professional standard of care for a nurse. The
2980	prevailing professional standard of care for a nurse shall be
2981	that level of care, skill, and treatment which, in light of all
2982	relevant surrounding circumstances, is recognized as acceptable
2983	and appropriate by reasonably prudent similar nurses.
2984	(5)  Discovery of financial information for the purpose of
2985	determining the value of punitive damages may not be had unless
2986	the plaintiff shows the court by proffer or evidence in the
2987	record that a reasonable basis exists to support a claim for
2988	punitive damages.
2989	(6)  In addition to any other standards for punitive
2990	damages, any award of punitive damages must be reasonable in
2991	light of the actual harm suffered by the resident and the
2992	egregiousness of the conduct that caused the actual harm to the
2993	resident.
2994	(7)  The resident or the resident's legal representative
2995	shall serve a copy of any complaint alleging in whole or in part
2996	a violation of any rights specified in this part to the Agency
2997	for Health Care Administration at the time of filing the initial
2998	complaint with the clerk of the court for the county in which
2999	the action is pursued. The requirement of providing a copy of
3000	the complaint to the agency does not impair the resident's legal
3001	rights or ability to seek relief for his or her claim.
3002	Section 54.  Section 400.4293, Florida Statutes, is
3003	renumbered as section 429.293, Florida Statutes, and amended to
3004	read:
3005	429.293 400.4293  Presuit notice; investigation;
3006	notification of violation of residents' rights or alleged
3007	negligence; claims evaluation procedure; informal discovery;
3008	review; settlement offer; mediation.--
3009	(1)  As used in this section, the term:
3010	(a)  "Claim for residents' rights violation or negligence"
3011	means a negligence claim alleging injury to or the death of a
3012	resident arising out of an asserted violation of the rights of a
3013	resident under s. 429.28 s. 400.428 or an asserted deviation
3014	from the applicable standard of care.
3015	(b)  "Insurer" means any self-insurer authorized under s.
3016	627.357, liability insurance carrier, joint underwriting
3017	association, or uninsured prospective defendant.
3018	(2)  Prior to filing a claim for a violation of a
3019	resident's rights or a claim for negligence, a claimant alleging
3020	injury to or the death of a resident shall notify each
3021	prospective defendant by certified mail, return receipt
3022	requested, of an asserted violation of a resident's rights
3023	provided in s. 429.28 s. 400.428 or deviation from the standard
3024	of care. Such notification shall include an identification of
3025	the rights the prospective defendant has violated and the
3026	negligence alleged to have caused the incident or incidents and
3027	a brief description of the injuries sustained by the resident
3028	which are reasonably identifiable at the time of notice. The
3029	notice shall contain a certificate of counsel that counsel's
3030	reasonable investigation gave rise to a good faith belief that
3031	grounds exist for an action against each prospective defendant.
3032	(3)(a)  No suit may be filed for a period of 75 days after
3033	notice is mailed to any prospective defendant. During the 75-day
3034	period, the prospective defendants or their insurers shall
3035	conduct an evaluation of the claim to determine the liability of
3036	each defendant and to evaluate the damages of the claimants.
3037	Each defendant or insurer of the defendant shall have a
3038	procedure for the prompt evaluation of claims during the 75-day
3039	period. The procedure shall include one or more of the
3040	following:
3041	1.  Internal review by a duly qualified facility risk
3042	manager or claims adjuster;
3043	2.  Internal review by counsel for each prospective
3044	defendant;
3045	3.  A quality assurance committee authorized under any
3046	applicable state or federal statutes or regulations; or
3047	4.  Any other similar procedure that fairly and promptly
3048	evaluates the claims.
3049
3050	Each defendant or insurer of the defendant shall evaluate the
3051	claim in good faith.
3052	(b)  At or before the end of the 75 days, the defendant or
3053	insurer of the defendant shall provide the claimant with a
3054	written response:
3055	1.  Rejecting the claim; or
3056	2.  Making a settlement offer.
3057	(c)  The response shall be delivered to the claimant if not
3058	represented by counsel or to the claimant's attorney, by
3059	certified mail, return receipt requested. Failure of the
3060	prospective defendant or insurer of the defendant to reply to
3061	the notice within 75 days after receipt shall be deemed a
3062	rejection of the claim for purposes of this section.
3063	(4)  The notification of a violation of a resident's rights
3064	or alleged negligence shall be served within the applicable
3065	statute of limitations period; however, during the 75-day
3066	period, the statute of limitations is tolled as to all
3067	prospective defendants. Upon stipulation by the parties, the 75-
3068	day period may be extended and the statute of limitations is
3069	tolled during any such extension. Upon receiving written notice
3070	by certified mail, return receipt requested, of termination of
3071	negotiations in an extended period, the claimant shall have 60
3072	days or the remainder of the period of the statute of
3073	limitations, whichever is greater, within which to file suit.
3074	(5)  No statement, discussion, written document, report, or
3075	other work product generated by presuit claims evaluation
3076	procedures under this section is discoverable or admissible in
3077	any civil action for any purpose by the opposing party. All
3078	participants, including, but not limited to, physicians,
3079	investigators, witnesses, and employees or associates of the
3080	defendant, are immune from civil liability arising from
3081	participation in the presuit claims evaluation procedure. Any
3082	licensed physician or registered nurse may be retained by either
3083	party to provide an opinion regarding the reasonable basis of
3084	the claim. The presuit opinions of the expert are not
3085	discoverable or admissible in any civil action for any purpose
3086	by the opposing party.
3087	(6)  Upon receipt by a prospective defendant of a notice of
3088	claim, the parties shall make discoverable information available
3089	without formal discovery as provided in subsection (7).
3090	(7)  Informal discovery may be used by a party to obtain
3091	unsworn statements and the production of documents or things, as
3092	follows:
3093	(a)  Unsworn statements.--Any party may require other
3094	parties to appear for the taking of an unsworn statement. Such
3095	statements may be used only for the purpose of claims evaluation
3096	and are not discoverable or admissible in any civil action for
3097	any purpose by any party. A party seeking to take the unsworn
3098	statement of any party must give reasonable notice in writing to
3099	all parties. The notice must state the time and place for taking
3100	the statement and the name and address of the party to be
3101	examined. Unless otherwise impractical, the examination of any
3102	party must be done at the same time by all other parties. Any
3103	party may be represented by counsel at the taking of an unsworn
3104	statement. An unsworn statement may be recorded electronically,
3105	stenographically, or on videotape. The taking of unsworn
3106	statements is subject to the provisions of the Florida Rules of
3107	Civil Procedure and may be terminated for abuses.
3108	(b)  Documents or things.--Any party may request discovery
3109	of relevant documents or things. The documents or things must be
3110	produced, at the expense of the requesting party, within 20 days
3111	after the date of receipt of the request. A party is required to
3112	produce relevant and discoverable documents or things within
3113	that party's possession or control, if in good faith it can
3114	reasonably be done within the timeframe of the claims evaluation
3115	process.
3116	(8)  Each request for and notice concerning informal
3117	discovery pursuant to this section must be in writing, and a
3118	copy thereof must be sent to all parties. Such a request or
3119	notice must bear a certificate of service identifying the name
3120	and address of the person to whom the request or notice is
3121	served, the date of the request or notice, and the manner of
3122	service thereof.
3123	(9)  If a prospective defendant makes a written settlement
3124	offer, the claimant shall have 15 days from the date of receipt
3125	to accept the offer. An offer shall be deemed rejected unless
3126	accepted by delivery of a written notice of acceptance.
3127	(10)  To the extent not inconsistent with this part, the
3128	provisions of the Florida Mediation Code, Florida Rules of Civil
3129	Procedure, shall be applicable to such proceedings.
3130	(11)  Within 30 days after the claimant's receipt of
3131	defendant's response to the claim, the parties or their
3132	designated representatives shall meet in mediation to discuss
3133	the issues of liability and damages in accordance with the
3134	mediation rules of practice and procedures adopted by the
3135	Supreme Court. Upon stipulation of the parties, this 30-day
3136	period may be extended and the statute of limitations is tolled
3137	during the mediation and any such extension. At the conclusion
3138	of mediation, the claimant shall have 60 days or the remainder
3139	of the period of the statute of limitations, whichever is
3140	greater, within which to file suit.
3141	Section 55.  Section 400.431, Florida Statutes, is
3142	renumbered as section 429.31, Florida Statutes, and amended to
3143	read:
3144	429.31 400.431  Closing of facility; notice; penalty.--
3145	(1)  Whenever a facility voluntarily discontinues
3146	operation, it shall inform the agency in writing at least 90
3147	days prior to the discontinuance of operation.  The facility
3148	shall also inform each resident or the next of kin, legal
3149	representative, or agency acting on each resident's behalf, of
3150	the fact and the proposed time of such discontinuance, following
3151	the notification requirements provided in s. 429.28(1)(k) s.
3152	400.428(1)(k).  In the event a resident has no person to
3153	represent him or her, the facility shall be responsible for
3154	referral to an appropriate social service agency for placement.
3155	(2)  Immediately upon the notice by the agency of the
3156	voluntary or involuntary termination of such operation, the
3157	agency shall monitor the transfer of residents to other
3158	facilities and ensure that residents' rights are being
3159	protected.  The department, in consultation with the Department
3160	of Children and Family Services, shall specify procedures for
3161	ensuring that all residents who receive services are
3162	appropriately relocated.
3163	(3)  All charges shall be prorated as of the date on which
3164	the facility discontinues operation, and if any payments have
3165	been made in advance, the payments for services not received
3166	shall be refunded to the resident or the resident's guardian
3167	within 10 working days of voluntary or involuntary closure of
3168	the facility, whether or not such refund is requested by the
3169	resident or guardian.
3170	(4)  Immediately upon discontinuance of the operation of a
3171	facility, the owner shall surrender the license therefor to the
3172	agency, and the license shall be canceled.
3173	(5)  The agency may levy a fine in an amount no greater
3174	than $5,000 upon each person or business entity that owns any
3175	interest in a facility that terminates operation without
3176	providing notice to the agency and the residents of the facility
3177	at least 30 days before operation ceases.  This fine shall not
3178	be levied against any facility involuntarily closed at the
3179	initiation of the agency.  The agency shall use the proceeds of
3180	the fines to operate the facility until all residents of the
3181	facility are relocated and shall deposit any balance of the
3182	proceeds into the Health Care Trust Fund established pursuant to
3183	s. 429.18 s. 400.418.
3184	Section 56.  Section 400.441, Florida Statutes, is
3185	renumbered as section 429.41, Florida Statutes, and amended to
3186	read:
3187	429.41 400.441  Rules establishing standards.--
3188	(1)  It is the intent of the Legislature that rules
3189	published and enforced pursuant to this section shall include
3190	criteria by which a reasonable and consistent quality of
3191	resident care and quality of life may be ensured and the results
3192	of such resident care may be demonstrated.  Such rules shall
3193	also ensure a safe and sanitary environment that is residential
3194	and noninstitutional in design or nature.  It is further
3195	intended that reasonable efforts be made to accommodate the
3196	needs and preferences of residents to enhance the quality of
3197	life in a facility. In order to provide safe and sanitary
3198	facilities and the highest quality of resident care
3199	accommodating the needs and preferences of residents, the
3200	department, in consultation with the agency, the Department of
3201	Children and Family Services, and the Department of Health,
3202	shall adopt rules, policies, and procedures to administer this
3203	part, which must include reasonable and fair minimum standards
3204	in relation to:
3205	(a)  The requirements for and maintenance of facilities,
3206	not in conflict with the provisions of chapter 553, relating to
3207	plumbing, heating, cooling, lighting, ventilation, living space,
3208	and other housing conditions, which will ensure the health,
3209	safety, and comfort of residents and protection from fire
3210	hazard, including adequate provisions for fire alarm and other
3211	fire protection suitable to the size of the structure. Uniform
3212	firesafety standards shall be established and enforced by the
3213	State Fire Marshal in cooperation with the agency, the
3214	department, and the Department of Health.
3215	1.  Evacuation capability determination.--
3216	a.  The provisions of the National Fire Protection
3217	Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
3218	for determining the ability of the residents, with or without
3219	staff assistance, to relocate from or within a licensed facility
3220	to a point of safety as provided in the fire codes adopted
3221	herein. An evacuation capability evaluation for initial
3222	licensure shall be conducted within 6 months after the date of
3223	licensure. For existing licensed facilities that are not
3224	equipped with an automatic fire sprinkler system, the
3225	administrator shall evaluate the evacuation capability of
3226	residents at least annually. The evacuation capability
3227	evaluation for each facility not equipped with an automatic fire
3228	sprinkler system shall be validated, without liability, by the
3229	State Fire Marshal, by the local fire marshal, or by the local
3230	authority having jurisdiction over firesafety, before the
3231	license renewal date. If the State Fire Marshal, local fire
3232	marshal, or local authority having jurisdiction over firesafety
3233	has reason to believe that the evacuation capability of a
3234	facility as reported by the administrator may have changed, it
3235	may, with assistance from the facility administrator, reevaluate
3236	the evacuation capability through timed exiting drills.
3237	Translation of timed fire exiting drills to evacuation
3238	capability may be determined:
3239	(I)  Three minutes or less: prompt.
3240	(II)  More than 3 minutes, but not more than 13 minutes:
3241	slow.
3242	(III)  More than 13 minutes: impractical.
3243	b.  The Office of the State Fire Marshal shall provide or
3244	cause the provision of training and education on the proper
3245	application of Chapter 5, NFPA 101A, 1995 edition, to its
3246	employees, to staff of the Agency for Health Care Administration
3247	who are responsible for regulating facilities under this part,
3248	and to local governmental inspectors. The Office of the State
3249	Fire Marshal shall provide or cause the provision of this
3250	training within its existing budget, but may charge a fee for
3251	this training to offset its costs. The initial training must be
3252	delivered within 6 months after July 1, 1995, and as needed
3253	thereafter.
3254	c.  The Office of the State Fire Marshal, in cooperation
3255	with provider associations, shall provide or cause the provision
3256	of a training program designed to inform facility operators on
3257	how to properly review bid documents relating to the
3258	installation of automatic fire sprinklers. The Office of the
3259	State Fire Marshal shall provide or cause the provision of this
3260	training within its existing budget, but may charge a fee for
3261	this training to offset its costs. The initial training must be
3262	delivered within 6 months after July 1, 1995, and as needed
3263	thereafter.
3264	d.  The administrator of a licensed facility shall sign an
3265	affidavit verifying the number of residents occupying the
3266	facility at the time of the evacuation capability evaluation.
3267	2.  Firesafety requirements.--
3268	a.  Except for the special applications provided herein,
3269	effective January 1, 1996, the provisions of the National Fire
3270	Protection Association, Life Safety Code, NFPA 101, 1994
3271	edition, Chapter 22 for new facilities and Chapter 23 for
3272	existing facilities shall be the uniform fire code applied by
3273	the State Fire Marshal for assisted living facilities, pursuant
3274	to s. 633.022.
3275	b.  Any new facility, regardless of size, that applies for
3276	a license on or after January 1, 1996, must be equipped with an
3277	automatic fire sprinkler system. The exceptions as provided in
3278	section 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein,
3279	apply to any new facility housing eight or fewer residents. On
3280	July 1, 1995, local governmental entities responsible for the
3281	issuance of permits for construction shall inform, without
3282	liability, any facility whose permit for construction is
3283	obtained prior to January 1, 1996, of this automatic fire
3284	sprinkler requirement. As used in this part, the term "a new
3285	facility" does not mean an existing facility that has undergone
3286	change of ownership.
3287	c.  Notwithstanding any provision of s. 633.022 or of the
3288	National Fire Protection Association, NFPA 101A, Chapter 5, 1995
3289	edition, to the contrary, any existing facility housing eight or
3290	fewer residents is not required to install an automatic fire
3291	sprinkler system, nor to comply with any other requirement in
3292	Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
3293	requirements of NFPA 101, 1988 edition, that applies to this
3294	size facility, unless the facility has been classified as
3295	impractical to evacuate. Any existing facility housing eight or
3296	fewer residents that is classified as impractical to evacuate
3297	must install an automatic fire sprinkler system within the
3298	timeframes granted in this section.
3299	d.  Any existing facility that is required to install an
3300	automatic fire sprinkler system under this paragraph need not
3301	meet other firesafety requirements of Chapter 23, NFPA 101, 1994
3302	edition, which exceed the provisions of NFPA 101, 1988 edition.
3303	The mandate contained in this paragraph which requires certain
3304	facilities to install an automatic fire sprinkler system
3305	supersedes any other requirement.
3306	e.  This paragraph does not supersede the exceptions
3307	granted in NFPA 101, 1988 edition or 1994 edition.
3308	f.  This paragraph does not exempt facilities from other
3309	firesafety provisions adopted under s. 633.022 and local
3310	building code requirements in effect before July 1, 1995.
3311	g.  A local government may charge fees only in an amount
3312	not to exceed the actual expenses incurred by local government
3313	relating to the installation and maintenance of an automatic
3314	fire sprinkler system in an existing and properly licensed
3315	assisted living facility structure as of January 1, 1996.
3316	h.  If a licensed facility undergoes major reconstruction
3317	or addition to an existing building on or after January 1, 1996,
3318	the entire building must be equipped with an automatic fire
3319	sprinkler system. Major reconstruction of a building means
3320	repair or restoration that costs in excess of 50 percent of the
3321	value of the building as reported on the tax rolls, excluding
3322	land, before reconstruction. Multiple reconstruction projects
3323	within a 5-year period the total costs of which exceed 50
3324	percent of the initial value of the building at the time the
3325	first reconstruction project was permitted are to be considered
3326	as major reconstruction. Application for a permit for an
3327	automatic fire sprinkler system is required upon application for
3328	a permit for a reconstruction project that creates costs that go
3329	over the 50-percent threshold.
3330	i.  Any facility licensed before January 1, 1996, that is
3331	required to install an automatic fire sprinkler system shall
3332	ensure that the installation is completed within the following
3333	timeframes based upon evacuation capability of the facility as
3334	determined under subparagraph 1.:
3335	(I)  Impractical evacuation capability, 24 months.
3336	(II)  Slow evacuation capability, 48 months.
3337	(III)  Prompt evacuation capability, 60 months.
3338
3339	The beginning date from which the deadline for the automatic
3340	fire sprinkler installation requirement must be calculated is
3341	upon receipt of written notice from the local fire official that
3342	an automatic fire sprinkler system must be installed. The local
3343	fire official shall send a copy of the document indicating the
3344	requirement of a fire sprinkler system to the Agency for Health
3345	Care Administration.
3346	j.  It is recognized that the installation of an automatic
3347	fire sprinkler system may create financial hardship for some
3348	facilities. The appropriate local fire official shall, without
3349	liability, grant two 1-year extensions to the timeframes for
3350	installation established herein, if an automatic fire sprinkler
3351	installation cost estimate and proof of denial from two
3352	financial institutions for a construction loan to install the
3353	automatic fire sprinkler system are submitted. However, for any
3354	facility with a class I or class II, or a history of uncorrected
3355	class III, firesafety deficiencies, an extension must not be
3356	granted. The local fire official shall send a copy of the
3357	document granting the time extension to the Agency for Health
3358	Care Administration.
3359	k.  A facility owner whose facility is required to be
3360	equipped with an automatic fire sprinkler system under Chapter
3361	23, NFPA 101, 1994 edition, as adopted herein, must disclose to
3362	any potential buyer of the facility that an installation of an
3363	automatic fire sprinkler requirement exists. The sale of the
3364	facility does not alter the timeframe for the installation of
3365	the automatic fire sprinkler system.
3366	l.  Existing facilities required to install an automatic
3367	fire sprinkler system as a result of construction-type
3368	restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
3369	herein, or evacuation capability requirements shall be notified
3370	by the local fire official in writing of the automatic fire
3371	sprinkler requirement, as well as the appropriate date for final
3372	compliance as provided in this subparagraph. The local fire
3373	official shall send a copy of the document to the Agency for
3374	Health Care Administration.
3375	m.  Except in cases of life-threatening fire hazards, if an
3376	existing facility experiences a change in the evacuation
3377	capability, or if the local authority having jurisdiction
3378	identifies a construction-type restriction, such that an
3379	automatic fire sprinkler system is required, it shall be
3380	afforded time for installation as provided in this subparagraph.
3381
3382	Facilities that are fully sprinkled and in compliance with other
3383	firesafety standards are not required to conduct more than one
3384	of the required fire drills between the hours of 11 p.m. and 7
3385	a.m., per year. In lieu of the remaining drills, staff
3386	responsible for residents during such hours may be required to
3387	participate in a mock drill that includes a review of evacuation
3388	procedures. Such standards must be included or referenced in the
3389	rules adopted by the State Fire Marshal. Pursuant to s.
3390	633.022(1)(b), the State Fire Marshal is the final
3391	administrative authority for firesafety standards established
3392	and enforced pursuant to this section. All licensed facilities
3393	must have an annual fire inspection conducted by the local fire
3394	marshal or authority having jurisdiction.
3395	3.  Resident elopement requirements.--Facilities are
3396	required to conduct a minimum of two resident elopement
3397	prevention and response drills per year. All administrators and
3398	direct care staff must participate in the drills which shall
3399	include a review of procedures to address resident elopement.
3400	Facilities must document the implementation of the drills and
3401	ensure that the drills are conducted in a manner consistent with
3402	the facility's resident elopement policies and procedures.
3403	(b)  The preparation and annual update of a comprehensive
3404	emergency management plan.  Such standards must be included in
3405	the rules adopted by the department after consultation with the
3406	Department of Community Affairs.  At a minimum, the rules must
3407	provide for plan components that address emergency evacuation
3408	transportation; adequate sheltering arrangements; postdisaster
3409	activities, including provision of emergency power, food, and
3410	water; postdisaster transportation; supplies; staffing;
3411	emergency equipment; individual identification of residents and
3412	transfer of records; communication with families; and responses
3413	to family inquiries.  The comprehensive emergency management
3414	plan is subject to review and approval by the local emergency
3415	management agency. During its review, the local emergency
3416	management agency shall ensure that the following agencies, at a
3417	minimum, are given the opportunity to review the plan:  the
3418	Department of Elderly Affairs, the Department of Health, the
3419	Agency for Health Care Administration, and the Department of
3420	Community Affairs.  Also, appropriate volunteer organizations
3421	must be given the opportunity to review the plan.  The local
3422	emergency management agency shall complete its review within 60
3423	days and either approve the plan or advise the facility of
3424	necessary revisions.
3425	(c)  The number, training, and qualifications of all
3426	personnel having responsibility for the care of residents.  The
3427	rules must require adequate staff to provide for the safety of
3428	all residents.  Facilities licensed for 17 or more residents are
3429	required to maintain an alert staff for 24 hours per day.
3430	(d)  All sanitary conditions within the facility and its
3431	surroundings which will ensure the health and comfort of
3432	residents.  The rules must clearly delineate the
3433	responsibilities of the agency's licensure and survey staff, the
3434	county health departments, and the local authority having
3435	jurisdiction over fire safety and ensure that inspections are
3436	not duplicative.  The agency may collect fees for food service
3437	inspections conducted by the county health departments and
3438	transfer such fees to the Department of Health.
3439	(e)  License application and license renewal, transfer of
3440	ownership, proper management of resident funds and personal
3441	property, surety bonds, resident contracts, refund policies,
3442	financial ability to operate, and facility and staff records.
3443	(f)  Inspections, complaint investigations, moratoriums,
3444	classification of deficiencies, levying and enforcement of
3445	penalties, and use of income from fees and fines.
3446	(g)  The enforcement of the resident bill of rights
3447	specified in s. 429.28 s. 400.428.
3448	(h)  The care and maintenance of residents, which must
3449	include, but is not limited to:
3450	1.  The supervision of residents;
3451	2.  The provision of personal services;
3452	3.  The provision of, or arrangement for, social and
3453	leisure activities;
3454	4.  The arrangement for appointments and transportation to
3455	appropriate medical, dental, nursing, or mental health services,
3456	as needed by residents;
3457	5.  The management of medication;
3458	6.  The nutritional needs of residents;
3459	7.  Resident records; and
3460	8.  Internal risk management and quality assurance.
3461	(i)  Facilities holding a limited nursing, extended
3462	congregate care, or limited mental health license.
3463	(j)  The establishment of specific criteria to define
3464	appropriateness of resident admission and continued residency in
3465	a facility holding a standard, limited nursing, extended
3466	congregate care, and limited mental health license.
3467	(k)  The use of physical or chemical restraints.  The use
3468	of physical restraints is limited to half-bed rails as
3469	prescribed and documented by the resident's physician with the
3470	consent of the resident or, if applicable, the resident's
3471	representative or designee or the resident's surrogate,
3472	guardian, or attorney in fact.  The use of chemical restraints
3473	is limited to prescribed dosages of medications authorized by
3474	the resident's physician and must be consistent with the
3475	resident's diagnosis. Residents who are receiving medications
3476	that can serve as chemical restraints must be evaluated by their
3477	physician at least annually to assess:
3478	1.  The continued need for the medication.
3479	2.  The level of the medication in the resident's blood.
3480	3.  The need for adjustments in the prescription.
3481	(l)  The establishment of specific policies and procedures
3482	on resident elopement. Facilities shall conduct a minimum of two
3483	resident elopement drills each year. All administrators and
3484	direct care staff shall participate in the drills. Facilities
3485	shall document the drills.
3486	(2)  In adopting any rules pursuant to this part, the
3487	department, in conjunction with the agency, shall make distinct
3488	standards for facilities based upon facility size; the types of
3489	care provided; the physical and mental capabilities and needs of
3490	residents; the type, frequency, and amount of services and care
3491	offered; and the staffing characteristics of the facility. Rules
3492	developed pursuant to this section shall not restrict the use of
3493	shared staffing and shared programming in facilities that are
3494	part of retirement communities that provide multiple levels of
3495	care and otherwise meet the requirements of law and rule.
3496	Except for uniform firesafety standards, the department shall
3497	adopt by rule separate and distinct standards for facilities
3498	with 16 or fewer beds and for facilities with 17 or more beds.
3499	The standards for facilities with 16 or fewer beds shall be
3500	appropriate for a noninstitutional residential environment,
3501	provided that the structure is no more than two stories in
3502	height and all persons who cannot exit the facility unassisted
3503	in an emergency reside on the first floor.  The department, in
3504	conjunction with the agency, may make other distinctions among
3505	types of facilities as necessary to enforce the provisions of
3506	this part. Where appropriate, the agency shall offer alternate
3507	solutions for complying with established standards, based on
3508	distinctions made by the department and the agency relative to
3509	the physical characteristics of facilities and the types of care
3510	offered therein.
3511	(3)  The department shall submit a copy of proposed rules
3512	to the Speaker of the House of Representatives, the President of
3513	the Senate, and appropriate committees of substance for review
3514	and comment prior to the promulgation thereof.
3515	(a)  Rules promulgated by the department shall encourage
3516	the development of homelike facilities which promote the
3517	dignity, individuality, personal strengths, and decisionmaking
3518	ability of residents.
3519	(b)  The agency, in consultation with the department, may
3520	waive rules promulgated pursuant to this part in order to
3521	demonstrate and evaluate innovative or cost-effective congregate
3522	care alternatives which enable individuals to age in place.
3523	Such waivers may be granted only in instances where there is
3524	reasonable assurance that the health, safety, or welfare of
3525	residents will not be endangered.  To apply for a waiver, the
3526	licensee shall submit to the agency a written description of the
3527	concept to be demonstrated, including goals, objectives, and
3528	anticipated benefits; the number and types of residents who will
3529	be affected, if applicable; a brief description of how the
3530	demonstration will be evaluated; and any other information
3531	deemed appropriate by the agency.  Any facility granted a waiver
3532	shall submit a report of findings to the agency and the
3533	department within 12 months.  At such time, the agency may renew
3534	or revoke the waiver or pursue any regulatory or statutory
3535	changes necessary to allow other facilities to adopt the same
3536	practices. The department may by rule clarify terms and
3537	establish waiver application procedures, criteria for reviewing
3538	waiver proposals, and procedures for reporting findings, as
3539	necessary to implement this subsection.
3540	(4)  The agency may use an abbreviated biennial standard
3541	licensure inspection that consists of a review of key quality-
3542	of-care standards in lieu of a full inspection in facilities
3543	which have a good record of past performance. However, a full
3544	inspection shall be conducted in facilities which have had a
3545	history of class I or class II violations, uncorrected class III
3546	violations, confirmed ombudsman council complaints, or confirmed
3547	licensure complaints, within the previous licensure period
3548	immediately preceding the inspection or when a potentially
3549	serious problem is identified during the abbreviated inspection.
3550	The agency, in consultation with the department, shall develop
3551	the key quality-of-care standards with input from the State
3552	Long-Term Care Ombudsman Council and representatives of provider
3553	groups for incorporation into its rules. The department, in
3554	consultation with the agency, shall report annually to the
3555	Legislature concerning its implementation of this subsection.
3556	The report shall include, at a minimum, the key quality-of-care
3557	standards which have been developed; the number of facilities
3558	identified as being eligible for the abbreviated inspection; the
3559	number of facilities which have received the abbreviated
3560	inspection and, of those, the number that were converted to full
3561	inspection; the number and type of subsequent complaints
3562	received by the agency or department on facilities which have
3563	had abbreviated inspections; any recommendations for
3564	modification to this subsection; any plans by the agency to
3565	modify its implementation of this subsection; and any other
3566	information which the department believes should be reported.
3567	(5)  A fee shall be charged by the department to any person
3568	requesting a copy of this part or rules promulgated under this
3569	part.  Such fees shall not exceed the actual cost of duplication
3570	and postage.
3571	Section 57.  Section 400.442, Florida Statutes, is
3572	renumbered as section 429.42, Florida Statutes, and amended to
3573	read:
3574	429.42 400.442  Pharmacy and dietary services.--
3575	(1)  Any assisted living facility in which the agency has
3576	documented a class I or class II deficiency or uncorrected class
3577	III deficiencies regarding medicinal drugs or over-the-counter
3578	preparations, including their storage, use, delivery, or
3579	administration, or dietary services, or both, during a biennial
3580	survey or a monitoring visit or an investigation in response to
3581	a complaint, shall, in addition to or as an alternative to any
3582	penalties imposed under s. 429.19 s. 400.419, be required to
3583	employ the consultant services of a licensed pharmacist, a
3584	licensed registered nurse, or a registered or licensed
3585	dietitian, as applicable.  The consultant shall, at a minimum,
3586	provide onsite quarterly consultation until the inspection team
3587	from the agency determines that such consultation services are
3588	no longer required.
3589	(2)  A corrective action plan for deficiencies related to
3590	assistance with the self-administration of medication or the
3591	administration of medication must be developed and implemented
3592	by the facility within 48 hours after notification of such
3593	deficiency, or sooner if the deficiency is determined by the
3594	agency to be life-threatening.
3595	(3)  The agency shall employ at least two pharmacists
3596	licensed pursuant to chapter 465 among its personnel who
3597	biennially inspect assisted living facilities licensed under
3598	this part, to participate in biennial inspections or consult
3599	with the agency regarding deficiencies relating to medicinal
3600	drugs or over-the-counter preparations.
3601	(4)  The department may by rule establish procedures and
3602	specify documentation as necessary to implement this section.
3603	Section 58.  Section 400.444, Florida Statutes, is
3604	renumbered as section 429.44, Florida Statutes, and amended to
3605	read:
3606	429.44 400.444  Construction and renovation;
3607	requirements.--
3608	(1)  The requirements for the construction and renovation
3609	of a facility shall comply with the provisions of chapter 553
3610	which pertain to building construction standards, including
3611	plumbing, electrical code, glass, manufactured buildings,
3612	accessibility for persons with disabilities, and the state
3613	minimum building code and with the provisions of s. 633.022,
3614	which pertain to uniform firesafety standards.
3615	(2)  Upon notification by the local authority having
3616	jurisdiction over life-threatening violations which seriously
3617	threaten the health, safety, or welfare of a resident of a
3618	facility, the agency shall take action as specified in s. 429.14
3619	s. 400.414.
3620	(3)  The department may adopt rules to establish procedures
3621	and specify the documentation necessary to implement this
3622	section.
3623	Section 59.  Section 400.447, Florida Statutes, is
3624	renumbered as section 429.47, Florida Statutes, and amended to
3625	read:
3626	429.47 400.447  Prohibited acts; penalties for violation.--
3627	(1)  It is unlawful for any person or public body to offer
3628	or advertise to the public, in any way by any medium whatever,
3629	personal services as defined in this act, without obtaining a
3630	valid current license.  It is unlawful for any holder of a
3631	license issued pursuant to the provisions of this act to
3632	advertise or hold out to the public that it holds a license for
3633	a facility other than that for which it actually holds a
3634	license.
3635	(2)  It is unlawful for any holder of a license issued
3636	pursuant to the provisions of this act to withhold from the
3637	agency any evidence of financial instability, including, but not
3638	limited to, bad checks, delinquent accounts, nonpayment of
3639	withholding taxes, unpaid utility expenses, nonpayment for
3640	essential services, or adverse court action concerning the
3641	financial viability of the facility or any other facility
3642	licensed under this part or under part II of chapter 400 or part
3643	III of this chapter which is owned by the licensee.
3644	(3)  Any person found guilty of violating subsection (1) or
3645	subsection (2) commits a misdemeanor of the second degree,
3646	punishable as provided in s. 775.083.  Each day of continuing
3647	violation shall be considered a separate offense.
3648	(4)  While a facility is under construction, the owner may
3649	advertise to the public prior to obtaining a license. Facilities
3650	that are certified under chapter 651 shall comply with the
3651	advertising provisions of s. 651.095 rather than those provided
3652	for in this subsection.
3653	(5)  A freestanding facility shall not advertise or imply
3654	that any part of it is a nursing home.  For the purpose of this
3655	subsection, "freestanding facility" means a facility that is not
3656	operated in conjunction with a nursing home to which residents
3657	of the facility are given priority when nursing care is
3658	required.  A person who violates this subsection is subject to
3659	fine as specified in s. 429.19 s. 400.419.
3660	(6)  Any facility which is affiliated with any religious
3661	organization or which has a name implying religious affiliation
3662	shall include in its advertising whether or not it is affiliated
3663	with any religious organization and, if so, which organization.
3664	(7)  A facility licensed under this part which is not part
3665	of a facility authorized under chapter 651 shall include the
3666	facility's license number as given by the agency in all
3667	advertising.  A company or person owning more than one facility
3668	shall include at least one license number per advertisement.
3669	All advertising shall include the term "assisted living
3670	facility" before the license number.
3671	Section 60.  Section 400.452, Florida Statutes, is
3672	renumbered as section 429.52, Florida Statutes, and amended to
3673	read:
3674	429.52 400.452  Staff training and educational programs;
3675	core educational requirement.--
3676	(1)  Administrators and other assisted living facility
3677	staff must meet minimum training and education requirements
3678	established by the Department of Elderly Affairs by rule. This
3679	training and education is intended to assist facilities to
3680	appropriately respond to the needs of residents, to maintain
3681	resident care and facility standards, and to meet licensure
3682	requirements.
3683	(2)  The department shall establish a competency test and a
3684	minimum required score to indicate successful completion of the
3685	training and educational requirements. The competency test must
3686	be developed by the department in conjunction with the agency
3687	and providers. The required training and education must cover at
3688	least the following topics:
3689	(a)  State law and rules relating to assisted living
3690	facilities.
3691	(b)  Resident rights and identifying and reporting abuse,
3692	neglect, and exploitation.
3693	(c)  Special needs of elderly persons, persons with mental
3694	illness, and persons with developmental disabilities and how to
3695	meet those needs.
3696	(d)  Nutrition and food service, including acceptable
3697	sanitation practices for preparing, storing, and serving food.
3698	(e)  Medication management, recordkeeping, and proper
3699	techniques for assisting residents with self-administered
3700	medication.
3701	(f)  Firesafety requirements, including fire evacuation
3702	drill procedures and other emergency procedures.
3703	(g)  Care of persons with Alzheimer's disease and related
3704	disorders.
3705	(3)  Effective January 1, 2004, a new facility
3706	administrator must complete the required training and education,
3707	including the competency test, within a reasonable time after
3708	being employed as an administrator, as determined by the
3709	department.  Failure to do so is a violation of this part and
3710	subjects the violator to an administrative fine as prescribed in
3711	s. 429.19 s. 400.419. Administrators licensed in accordance with
3712	chapter 468, part II, are exempt from this requirement. Other
3713	licensed professionals may be exempted, as determined by the
3714	department by rule.
3715	(4)  Administrators are required to participate in
3716	continuing education for a minimum of 12 contact hours every 2
3717	years.
3718	(5)  Staff involved with the management of medications and
3719	assisting with the self-administration of medications under s.
3720	429.256 s. 400.4256 must complete a minimum of 4 additional
3721	hours of training provided by a registered nurse, licensed
3722	pharmacist, or department staff. The department shall establish
3723	by rule the minimum requirements of this additional training.
3724	(6)  Other facility staff shall participate in training
3725	relevant to their job duties as specified by rule of the
3726	department.
3727	(7)  If the department or the agency determines that there
3728	are problems in a facility that could be reduced through
3729	specific staff training or education beyond that already
3730	required under this section, the department or the agency may
3731	require, and provide, or cause to be provided, the training or
3732	education of any personal care staff in the facility.
3733	(8)  The department shall adopt rules related to these
3734	training requirements, the competency test, necessary
3735	procedures, and competency test fees.
3736	Section 61.  Subsections (1), (10), and (18) of section
3737	400.462, Florida Statutes, are amended to read:
3738	400.462  Definitions.--As used in this part, the term:
3739	(1)  "Administrator" means a direct employee, as defined in
3740	subsection (9). The administrator must be a licensed physician,
3741	physician assistant, or registered nurse licensed to practice in
3742	this state or an individual having at least 1 year of
3743	supervisory or administrative experience in home health care or
3744	in a facility licensed under chapter 395, or under part II or
3745	part III of this chapter, or chapter 429. An administrator may
3746	manage a maximum of five licensed home health agencies located
3747	within one agency service district or within an immediately
3748	contiguous county. If the home health agency is licensed under
3749	this chapter and is part of a retirement community that provides
3750	multiple levels of care, an employee of the retirement community
3751	may administer the home health agency and up to a maximum of
3752	four entities licensed under this chapter or chapter 429 that
3753	are owned, operated, or managed by the same corporate entity. An
3754	administrator shall designate, in writing, for each licensed
3755	entity, a qualified alternate administrator to serve during
3756	absences.
3757	(10)  "Director of nursing" means a registered nurse who is
3758	a direct employee, as defined in subsection (9), of the agency
3759	and who is a graduate of an approved school of nursing and is
3760	licensed in this state; who has at least 1 year of supervisory
3761	experience as a registered nurse; and who is responsible for
3762	overseeing the professional nursing and home health aid delivery
3763	of services of the agency. A director of nursing may be the
3764	director of a maximum of five licensed home health agencies
3765	operated by a related business entity and located within one
3766	agency service district or within an immediately contiguous
3767	county. If the home health agency is licensed under this chapter
3768	and is part of a retirement community that provides multiple
3769	levels of care, an employee of the retirement community may
3770	serve as the director of nursing of the home health agency and
3771	of up to four entities licensed under this chapter or chapter
3772	429 which are owned, operated, or managed by the same corporate
3773	entity.
3774	(18)  "Nurse registry" means any person that procures,
3775	offers, promises, or attempts to secure health-care-related
3776	contracts for registered nurses, licensed practical nurses,
3777	certified nursing assistants, home health aides, companions, or
3778	homemakers, who are compensated by fees as independent
3779	contractors, including, but not limited to, contracts for the
3780	provision of services to patients and contracts to provide
3781	private duty or staffing services to health care facilities
3782	licensed under chapter 395, or this chapter, or chapter 429 or
3783	other business entities.
3784	Section 62.  Paragraphs (h), (i), and (n) of subsection (5)
3785	of section 400.464, Florida Statutes, are amended to read:
3786	400.464  Home health agencies to be licensed; expiration of
3787	license; exemptions; unlawful acts; penalties.--
3788	(5)  The following are exempt from the licensure
3789	requirements of this part:
3790	(h)  The delivery of assisted living facility services for
3791	which the assisted living facility is licensed under part I III
3792	of this chapter 429, to serve its residents in its facility.
3793	(i)  The delivery of hospice services for which the hospice
3794	is licensed under part IV VI of this chapter, to serve hospice
3795	patients admitted to its service.
3796	(n)  The delivery of adult family care home services for
3797	which the adult family care home is licensed under part II VII
3798	of this chapter 429, to serve the residents in its facility.
3799	Section 63.  Subsection (2) of section 400.497, Florida
3800	Statutes, is amended to read:
3801	400.497  Rules establishing minimum standards.--The agency
3802	shall adopt, publish, and enforce rules to implement this part,
3803	including, as applicable, ss. 400.506 and 400.509, which must
3804	provide reasonable and fair minimum standards relating to:
3805	(2)  Shared staffing. The agency shall allow shared
3806	staffing if the home health agency is part of a retirement
3807	community that provides multiple levels of care, is located on
3808	one campus, is licensed under this chapter or chapter 429, and
3809	otherwise meets the requirements of law and rule.
3810	Section 64.  Section 400.552, Florida Statutes, is
3811	renumbered as section 429.903, Florida Statutes, and amended to
3812	read:
3813	429.903 400.552  Applicability.--Any facility that comes
3814	within the definition of an adult day care center which is not
3815	exempt under s. 429.905 s. 400.553 must be licensed by the
3816	agency as an adult day care center.
3817	Section 65.  Section 400.555, Florida Statutes, is
3818	renumbered as section 429.909, Florida Statutes, and amended to
3819	read:
3820	429.909 400.555  Application for license.--
3821	(1)  An application for a license to operate an adult day
3822	care center must be made to the agency on forms furnished by the
3823	agency and must be accompanied by the appropriate license fee
3824	unless the applicant is exempt from payment of the fee as
3825	provided in s. 429.907(4) s. 400.554(4).
3826	(2)  The applicant for licensure must furnish:
3827	(a)  A description of the physical and mental capabilities
3828	and needs of the participants to be served and the availability,
3829	frequency, and intensity of basic services and of supportive and
3830	optional services to be provided;
3831	(b)  Satisfactory proof of financial ability to operate and
3832	conduct the center in accordance with the requirements of this
3833	part, which must include, in the case of an initial application,
3834	a 1-year operating plan and proof of a 3-month operating reserve
3835	fund; and
3836	(c)  Proof of adequate liability insurance coverage.
3837	(d)  Proof of compliance with level 2 background screening
3838	as required under s. 429.919 s. 400.5572.
3839	(e)  A description and explanation of any exclusions,
3840	permanent suspensions, or terminations of the application from
3841	the Medicare or Medicaid programs. Proof of compliance with
3842	disclosure of ownership and control interest requirements of the
3843	Medicare or Medicaid programs shall be accepted in lieu of this
3844	submission.
3845	Section 66.  Section 400.556, Florida Statutes, is
3846	renumbered as section 429.911, Florida Statutes, and amended to
3847	read:
3848	429.911 400.556  Denial, suspension, revocation of license;
3849	administrative fines; investigations and inspections.--
3850	(1)  The agency may deny, revoke, or suspend a license
3851	under this part or may impose an administrative fine against the
3852	owner of an adult day care center or its operator or employee in
3853	the manner provided in chapter 120.
3854	(2)  Each of the following actions by the owner of an adult
3855	day care center or by its operator or employee is a ground for
3856	action by the agency against the owner of the center or its
3857	operator or employee:
3858	(a)  An intentional or negligent act materially affecting
3859	the health or safety of center participants.
3860	(b)  A violation of this part or of any standard or rule
3861	under this part.
3862	(c)  A failure of persons subject to level 2 background
3863	screening under s. 429.174(1) s. 400.4174(1) to meet the
3864	screening standards of s. 435.04, or the retention by the center
3865	of an employee subject to level 1 background screening standards
3866	under s. 429.174(2) s. 400.4174(2) who does not meet the
3867	screening standards of s. 435.03 and for whom exemptions from
3868	disqualification have not been provided by the agency.
3869	(d)  Failure to follow the criteria and procedures provided
3870	under part I of chapter 394 relating to the transportation,
3871	voluntary admission, and involuntary examination of center
3872	participants.
3873	(e)  Multiple or repeated violations of this part or of any
3874	standard or rule adopted under this part.
3875	(f)  Exclusion, permanent suspension, or termination of the
3876	owner, if an individual, officer, or board member of the adult
3877	day care center, if the owner is a firm, corporation,
3878	partnership, or association, or any person owning 5 percent or
3879	more of the center, from the Medicare or Medicaid program.
3880	(3)  The agency is responsible for all investigations and
3881	inspections conducted pursuant to this part.
3882	Section 67.  Section 400.557, Florida Statutes, is
3883	renumbered as section 429.915, Florida Statutes, and amended to
3884	read:
3885	429.915 400.557  Expiration of license; renewal;
3886	conditional license or permit.--
3887	(1)  A license issued for the operation of an adult day
3888	care center, unless sooner suspended or revoked, expires 2 years
3889	after the date of issuance. The agency shall notify a licensee
3890	at least 120 days before the expiration date that license
3891	renewal is required to continue operation. The notification must
3892	be provided electronically or by mail delivery. At least 90 days
3893	prior to the expiration date, an application for renewal must be
3894	submitted to the agency. A license shall be renewed, upon the
3895	filing of an application on forms furnished by the agency, if
3896	the applicant has first met the requirements of this part and of
3897	the rules adopted under this part. The applicant must file with
3898	the application satisfactory proof of financial ability to
3899	operate the center in accordance with the requirements of this
3900	part and in accordance with the needs of the participants to be
3901	served and an affidavit of compliance with the background
3902	screening requirements of s. 429.919 s. 400.5572.
3903	(2)  A licensee against whom a revocation or suspension
3904	proceeding is pending at the time for license renewal may be
3905	issued a conditional license effective until final disposition
3906	by the agency of the proceeding. If judicial relief is sought
3907	from the final disposition, the court having jurisdiction may
3908	issue a conditional permit effective for the duration of the
3909	judicial proceeding.
3910	(3)  The agency may issue a conditional license to an
3911	applicant for license renewal or change of ownership if the
3912	applicant fails to meet all standards and requirements for
3913	licensure. A conditional license issued under this subsection
3914	must be limited to a specific period not exceeding 6 months, as
3915	determined by the agency, and must be accompanied by an approved
3916	plan of correction.
3917	Section 68.  Section 400.5572, Florida Statutes, is
3918	renumbered as section 429.919, Florida Statutes, and amended to
3919	read:
3920	429.919 400.5572  Background screening.--
3921	(1)(a)  Level 2 background screening must be conducted on
3922	each of the following persons, who shall be considered employees
3923	for the purposes of conducting screening under chapter 435:
3924	1.  The adult day care center owner if an individual, the
3925	operator, and the financial officer.
3926	2.  An officer or board member if the owner of the adult
3927	day care center is a firm, corporation, partnership, or
3928	association, or any person owning 5 percent or more of the
3929	facility, if the agency has probable cause to believe that such
3930	person has been convicted of any offense prohibited by s.
3931	435.04. For each officer, board member, or person owning 5
3932	percent or more who has been convicted of any such offense, the
3933	facility shall submit to the agency a description and
3934	explanation of the conviction at the time of license
3935	application. This subparagraph does not apply to a board member
3936	of a not-for-profit corporation or organization if the board
3937	member serves solely in a voluntary capacity, does not regularly
3938	take part in the day-to-day operational decisions of the
3939	corporation or organization, receives no remuneration for his or
3940	her services, and has no financial interest and has no family
3941	members with a financial interest in the corporation or
3942	organization, provided that the board member and facility submit
3943	a statement affirming that the board member's relationship to
3944	the facility satisfies the requirements of this subparagraph.
3945	(b)  Proof of compliance with level 2 screening standards
3946	which has been submitted within the previous 5 years to meet any
3947	facility or professional licensure requirements of the agency or
3948	the Department of Health satisfies the requirements of this
3949	subsection.
3950	(c)  The agency may grant a provisional license to an adult
3951	day care center applying for an initial license when each
3952	individual required by this subsection to undergo screening has
3953	completed the Department of Law Enforcement background check,
3954	but has not yet received results from the Federal Bureau of
3955	Investigation, or when a request for an exemption from
3956	disqualification has been submitted to the agency pursuant to s.
3957	435.07, but a response has not been issued.
3958	(2)  The owner or administrator of an adult day care center
3959	must conduct level 1 background screening as set forth in
3960	chapter 435 on all employees hired on or after October 1, 1998,
3961	who provide basic services or supportive and optional services
3962	to the participants. Such persons satisfy this requirement if:
3963	(a)  Proof of compliance with level 1 screening
3964	requirements obtained to meet any professional license
3965	requirements in this state is provided and accompanied, under
3966	penalty of perjury, by a copy of the person's current
3967	professional license and an affidavit of current compliance with
3968	the background screening requirements.
3969	(b)  The person required to be screened has been
3970	continuously employed, without a breach in service that exceeds
3971	180 days, in the same type of occupation for which the person is
3972	seeking employment and provides proof of compliance with the
3973	level 1 screening requirement which is no more than 2 years old.
3974	Proof of compliance must be provided directly from one employer
3975	or contractor to another, and not from the person screened. Upon
3976	request, a copy of screening results shall be provided to the
3977	person screened by the employer retaining documentation of the
3978	screening.
3979	(c)  The person required to be screened is employed by a
3980	corporation or business entity or related corporation or
3981	business entity that owns, operates, or manages more than one
3982	facility or agency licensed under this chapter or under chapter
3983	400, and for whom a level 1 screening was conducted by the
3984	corporation or business entity as a condition of initial or
3985	continued employment.
3986	Section 69.  Subsection (5) of section 400.601, Florida
3987	Statutes, is amended to read:
3988	400.601  Definitions.--As used in this part, the term:
3989	(5)  "Hospice residential unit" means a homelike living
3990	facility, other than a facility licensed under other parts of
3991	this chapter, or under chapter 395, or under chapter 429, that
3992	is operated by a hospice for the benefit of its patients and is
3993	considered by a patient who lives there to be his or her primary
3994	residence.
3995	Section 70.  Section 400.618, Florida Statutes, is
3996	renumbered as section 429.65, Florida Statutes, and amended to
3997	read:
3998	429.65 400.618  Definitions.--As used in this part, the
3999	term:
4000	(1)  "Activities of daily living" means functions and tasks
4001	for self-care, including eating, bathing, grooming, dressing,
4002	ambulating, and other similar tasks.
4003	(2)  "Adult family-care home" means a full-time, family-
4004	type living arrangement, in a private home, under which a person
4005	who owns or rents the home provides room, board, and personal
4006	care, on a 24-hour basis, for no more than five disabled adults
4007	or frail elders who are not relatives. The following family-type
4008	living arrangements are not required to be licensed as an adult
4009	family-care home:
4010	(a)  An arrangement whereby the person who owns or rents
4011	the home provides room, board, and personal services for not
4012	more than two adults who do not receive optional state
4013	supplementation under s. 409.212. The person who provides the
4014	housing, meals, and personal care must own or rent the home and
4015	reside therein.
4016	(b)  An arrangement whereby the person who owns or rents
4017	the home provides room, board, and personal services only to his
4018	or her relatives.
4019	(c)  An establishment that is licensed as an assisted
4020	living facility under this chapter part III.
4021	(3)  "Agency" means the Agency for Health Care
4022	Administration.
4023	(4)  "Aging in place" means remaining in a noninstitutional
4024	living environment despite the physical or mental changes that
4025	may occur in a person who is aging. For aging in place to occur,
4026	needed services are added, increased, or adjusted to compensate
4027	for a person's physical or mental changes.
4028	(5)  "Appropriate placement" means that the resident's
4029	needs can be met by the adult family-care home or can be met by
4030	services arranged by the adult family-care home or the resident.
4031	(6)  "Chemical restraint" means a pharmacologic drug that
4032	physically limits, restricts, or deprives an individual of
4033	movement or mobility, and is used for discipline or convenience
4034	and not required for the treatment of medical symptoms.
4035	(7)  "Department" means the Department of Elderly Affairs.
4036	(8)  "Disabled adult" means any person between 18 and 59
4037	years of age, inclusive, who is a resident of the state and who
4038	has one or more permanent physical or mental limitations that
4039	restrict the person's ability to perform the normal activities
4040	of daily living.
4041	(9)  "Frail elder" means a functionally impaired elderly
4042	person who is 60 years of age or older and who has physical or
4043	mental limitations that restrict the person's ability to perform
4044	the normal activities of daily living and that impede the
4045	person's capacity to live independently.
4046	(10)  "Personal services" or "personal care" includes
4047	individual assistance with or supervision of the activities of
4048	daily living and the self-administration of medication, and
4049	other similar services.
4050	(11)  "Provider" means a person who is licensed to operate
4051	an adult family-care home.
4052	(12)  "Relative" means an individual who is the father,
4053	mother, son, daughter, brother, sister, grandfather,
4054	grandmother, great-grandfather, great-grandmother, uncle, aunt,
4055	first cousin, nephew, niece, husband, wife, father-in-law,
4056	mother-in-law, son-in-law, daughter-in-law, brother-in-law,
4057	sister-in-law, stepfather, stepmother, stepson, stepdaughter,
4058	stepbrother, stepsister, half brother, or half sister of a
4059	provider.
4060	(13)  "Relief person" means an adult designated by the
4061	provider to supervise the residents during the provider's
4062	absence.
4063	(14)  "Resident" means a person receiving room, board, and
4064	personal care in an adult family-care home.
4065	Section 71.  Section 400.6194, Florida Statutes, is
4066	renumbered as section 429.69, Florida Statutes, and amended to
4067	read:
4068	429.69 400.6194  Denial, revocation, or suspension of a
4069	license.--The agency may deny, suspend, or revoke a license for
4070	any of the following reasons:
4071	(1)  Failure of any of the persons required to undergo
4072	background screening under s. 429.67 s. 400.619 to meet the
4073	level 1 screening standards of s. 435.03, unless an exemption
4074	from disqualification has been provided by the agency.
4075	(2)  An intentional or negligent act materially affecting
4076	the health, safety, or welfare of the adult family-care home
4077	residents.
4078	(3)  Submission of fraudulent information or omission of
4079	any material fact on a license application or any other document
4080	required by the agency.
4081	(4)  Failure to pay an administrative fine assessed under
4082	this part.
4083	(5)  A violation of this part or adopted rules which
4084	results in conditions or practices that directly threaten the
4085	physical or emotional health, safety, or welfare of residents.
4086	(6)  Failure to correct cited fire code violations that
4087	threaten the health, safety, or welfare of residents.
4088	(7)  Failure to submit a completed initial license
4089	application or to complete an application for license renewal
4090	within the specified timeframes.
4091	(8)  Exclusion, permanent suspension, or termination of the
4092	provider from the Medicare or Medicaid program.
4093	Section 72.  Section 400.621, Florida Statutes, is
4094	renumbered as section 429.73, Florida Statutes, and amended to
4095	read:
4096	429.73 400.621  Rules and standards relating to adult
4097	family-care homes.--
4098	(1)  The department, in consultation with the Department of
4099	Health, the Department of Children and Family Services, and the
4100	agency shall, by rule, establish minimum standards to ensure the
4101	health, safety, and well-being of each resident in the adult
4102	family-care home. The rules must address:
4103	(a)  Requirements for the physical site of the facility and
4104	facility maintenance.
4105	(b)  Services that must be provided to all residents of an
4106	adult family-care home and standards for such services, which
4107	must include, but need not be limited to:
4108	1.  Room and board.
4109	2.  Assistance necessary to perform the activities of daily
4110	living.
4111	3.  Assistance necessary to administer medication.
4112	4.  Supervision of residents.
4113	5.  Health monitoring.
4114	6.  Social and leisure activities.
4115	(c)  Standards and procedures for license application and
4116	annual license renewal, advertising, proper management of each
4117	resident's funds and personal property and personal affairs,
4118	financial ability to operate, medication management,
4119	inspections, complaint investigations, and facility, staff, and
4120	resident records.
4121	(d)  Qualifications, training, standards, and
4122	responsibilities for providers and staff.
4123	(e)  Compliance with chapter 419, relating to community
4124	residential homes.
4125	(f)  Criteria and procedures for determining the
4126	appropriateness of a resident's placement and continued
4127	residency in an adult family-care home. A resident who requires
4128	24-hour nursing supervision may not be retained in an adult
4129	family-care home unless such resident is an enrolled hospice
4130	patient and the resident's continued residency is mutually
4131	agreeable to the resident and the provider.
4132	(g)  Procedures for providing notice and assuring the least
4133	possible disruption of residents' lives when residents are
4134	relocated, an adult family-care home is closed, or the ownership
4135	of an adult family-care home is transferred.
4136	(h)  Procedures to protect the residents' rights as
4137	provided in s. 429.85 s. 400.628.
4138	(i)  Procedures to promote the growth of adult family-care
4139	homes as a component of a long-term care system.
4140	(j)  Procedures to promote the goal of aging in place for
4141	residents of adult family-care homes.
4142	(2)  The department shall by rule provide minimum standards
4143	and procedures for emergencies. Pursuant to s. 633.022, the
4144	State Fire Marshal, in consultation with the department and the
4145	agency, shall adopt uniform firesafety standards for adult
4146	family-care homes.
4147	(3)  The department shall adopt rules providing for the
4148	implementation of orders not to resuscitate. The provider may
4149	withhold or withdraw cardiopulmonary resuscitation if presented
4150	with an order not to resuscitate executed pursuant to s. 401.45.
4151	The provider shall not be subject to criminal prosecution or
4152	civil liability, nor be considered to have engaged in negligent
4153	or unprofessional conduct, for withholding or withdrawing
4154	cardiopulmonary resuscitation pursuant to such an order and
4155	rules adopted by the department.
4156	(4)  The provider of any adult family-care home that is in
4157	operation at the time any rules are adopted or amended under
4158	this part may be given a reasonable time, not exceeding 6
4159	months, within which to comply with the new or revised rules and
4160	standards.
4161	Section 73.  Section 400.628, Florida Statutes, is
4162	renumbered as section 429.85, Florida Statutes, and amended to
4163	read:
4164	429.85 400.628  Residents' bill of rights.--
4165	(1)  A resident of an adult family-care home may not be
4166	deprived of any civil or legal rights, benefits, or privileges
4167	guaranteed by law, the State Constitution, or the Constitution
4168	of the United States solely by reason of status as a resident of
4169	the home. Each resident has the right to:
4170	(a)  Live in a safe and decent living environment, free
4171	from abuse and neglect.
4172	(b)  Be treated with consideration and respect and with due
4173	recognition of personal dignity, individuality, and privacy.
4174	(c)  Keep and use the resident's own clothes and other
4175	personal property in the resident's immediate living quarters,
4176	so as to maintain individuality and personal dignity, except
4177	when the provider can demonstrate that to do so would be unsafe
4178	or an infringement upon the rights of other residents.
4179	(d)  Have unrestricted private communication, including
4180	receiving and sending unopened correspondence, having access to
4181	a telephone, and visiting with any person of his or her choice,
4182	at any time between the hours of 9 a.m. and 9 p.m. at a minimum.
4183	(e)  Be free to participate in and benefit from community
4184	services and activities and to achieve the highest possible
4185	level of independence, autonomy, and interaction within the
4186	community.
4187	(f)  Manage the resident's own financial affairs unless the
4188	resident or the resident's guardian authorizes the provider to
4189	provide safekeeping for funds in accordance with procedures
4190	equivalent to those provided in s. 429.27 s. 400.427.
4191	(g)  Share a room with the resident's spouse if both are
4192	residents of the home.
4193	(h)  Have reasonable opportunity for regular exercise
4194	several times a week and to be outdoors at regular and frequent
4195	intervals.
4196	(i)  Exercise civil and religious liberties, including the
4197	right to independent personal decisions. Religious beliefs or
4198	practices and attendance at religious services may not be
4199	imposed upon a resident.
4200	(j)  Have access to adequate and appropriate health care.
4201	(k)  Be free from chemical and physical restraints.
4202	(l)  Have at least 30 days' notice of relocation or
4203	termination of residency from the home unless, for medical
4204	reasons, the resident is certified by a physician to require an
4205	emergency relocation to a facility providing a more skilled
4206	level of care or the resident engages in a pattern of conduct
4207	that is harmful or offensive to other residents. If a resident
4208	has been adjudicated mentally incompetent, the resident's
4209	guardian must be given at least 30 days' notice, except in an
4210	emergency, of the relocation of a resident or of the termination
4211	of a residency. The reasons for relocating a resident must be
4212	set forth in writing.
4213	(m)  Present grievances and recommend changes to the
4214	provider, to staff, or to any other person without restraint,
4215	interference, coercion, discrimination, or reprisal. This right
4216	includes the right to have access to ombudsman volunteers and
4217	advocates and the right to be a member of, to be active in, and
4218	to associate with advocacy or special interest groups.
4219	(2)  The provider shall ensure that residents and their
4220	legal representatives are made aware of the rights, obligations,
4221	and prohibitions set forth in this part. Residents must also be
4222	given the names, addresses, and telephone numbers of the local
4223	ombudsman council and the central abuse hotline where they may
4224	lodge complaints.
4225	(3)  The adult family-care home may not hamper or prevent
4226	residents from exercising the rights specified in this section.
4227	(4)  A provider or staff of an adult family-care home may
4228	not serve notice upon a resident to leave the premises or take
4229	any other retaliatory action against any person who:
4230	(a)  Exercises any right set forth in this section.
4231	(b)  Appears as a witness in any hearing, in or out of the
4232	adult family-care home.
4233	(c)  Files a civil action alleging a violation of this part
4234	or notifies a state attorney or the Attorney General of a
4235	possible violation of this part.
4236	(5)  Any adult family-care home that terminates the
4237	residency of an individual who has participated in activities
4238	specified in subsection (4) must show good cause for the
4239	termination in a court of competent jurisdiction.
4240	(6)  Any person who reports a complaint concerning a
4241	suspected violation of this part or the services and conditions
4242	in an adult family-care home, or who testifies in any
4243	administrative or judicial proceeding arising from such a
4244	complaint, is immune from any civil or criminal liability
4245	therefor, unless the person acted in bad faith or with malicious
4246	purpose or the court finds that there was a complete absence of
4247	a justiciable issue of either law or fact raised by the losing
4248	party.
4249	Section 74.  Paragraphs (c), (d), (e), and (f) of
4250	subsection (5) of section 400.93, Florida Statutes, are amended
4251	to read:
4252	400.93  Licensure required; exemptions; unlawful acts;
4253	penalties.--
4254	(5)  The following are exempt from home medical equipment
4255	provider licensure, unless they have a separate company,
4256	corporation, or division that is in the business of providing
4257	home medical equipment and services for sale or rent to
4258	consumers at their regular or temporary place of residence
4259	pursuant to the provisions of this part:
4260	(c)  Assisted living facilities licensed under chapter 429
4261	part III, when serving their residents.
4262	(d)  Home health agencies licensed under part III IV.
4263	(e)  Hospices licensed under part IV VI.
4264	(f)  Intermediate care facilities, homes for special
4265	services, and transitional living facilities licensed under part
4266	V VIII.
4267	Section 75.  Paragraph (c) of subsection (10) of section
4268	400.962, Florida Statutes, is amended to read:
4269	400.962  License required; license application.--
4270	(10)
4271	(c)  Proof of compliance with the level 2 background
4272	screening requirements of chapter 435 which has been submitted
4273	within the previous 5 years in compliance with any other
4274	licensure requirements under this chapter or chapter 429
4275	satisfies the requirements of paragraph (a). Proof of compliance
4276	with background screening which has been submitted within the
4277	previous 5 years to fulfill the requirements of the Financial
4278	Services Commission and the Office of Insurance Regulation under
4279	chapter 651 as part of an application for a certificate of
4280	authority to operate a continuing care retirement community
4281	satisfies the requirements for the Department of Law Enforcement
4282	and Federal Bureau of Investigation background checks.
4283	Section 76.  Paragraph (b) of subsection (1) of section
4284	400.980, Florida Statutes, is amended to read:
4285	400.980  Health care services pools.--
4286	(1)  As used in this section, the term:
4287	(b)  "Health care services pool" means any person, firm,
4288	corporation, partnership, or association engaged for hire in the
4289	business of providing temporary employment in health care
4290	facilities, residential facilities, and agencies for licensed,
4291	certified, or trained health care personnel including, without
4292	limitation, nursing assistants, nurses' aides, and orderlies.
4293	However, the term does not include nursing registries, a
4294	facility licensed under this chapter or chapter 429 400, a
4295	health care services pool established within a health care
4296	facility to provide services only within the confines of such
4297	facility, or any individual contractor directly providing
4298	temporary services to a health care facility without use or
4299	benefit of a contracting agent.
4300	Section 77.  Paragraphs (a), (b), (c), and (d) of
4301	subsection (4) of section 400.9905, Florida Statutes, are
4302	amended to read:
4303	400.9905  Definitions.--
4304	(4)  "Clinic" means an entity at which health care services
4305	are provided to individuals and which tenders charges for
4306	reimbursement for such services, including a mobile clinic and a
4307	portable equipment provider. For purposes of this part, the term
4308	does not include and the licensure requirements of this part do
4309	not apply to:
4310	(a)  Entities licensed or registered by the state under
4311	chapter 395; or entities licensed or registered by the state and
4312	providing only health care services within the scope of services
4313	authorized under their respective licenses granted under ss.
4314	383.30-383.335, chapter 390, chapter 394, chapter 397, this
4315	chapter except part X XIII, chapter 429, chapter 463, chapter
4316	465, chapter 466, chapter 478, part I of chapter 483, chapter
4317	484, or chapter 651; end-stage renal disease providers
4318	authorized under 42 C.F.R. part 405, subpart U; or providers
4319	certified under 42 C.F.R. part 485, subpart B or subpart H; or
4320	any entity that provides neonatal or pediatric hospital-based
4321	health care services by licensed practitioners solely within a
4322	hospital licensed under chapter 395.
4323	(b)  Entities that own, directly or indirectly, entities
4324	licensed or registered by the state pursuant to chapter 395; or
4325	entities that own, directly or indirectly, entities licensed or
4326	registered by the state and providing only health care services
4327	within the scope of services authorized pursuant to their
4328	respective licenses granted under ss. 383.30-383.335, chapter
4329	390, chapter 394, chapter 397, this chapter except part X XIII,
4330	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
4331	part I of chapter 483, chapter 484, chapter 651; end-stage renal
4332	disease providers authorized under 42 C.F.R. part 405, subpart
4333	U; or providers certified under 42 C.F.R. part 485, subpart B or
4334	subpart H; or any entity that provides neonatal or pediatric
4335	hospital-based health care services by licensed practitioners
4336	solely within a hospital licensed under chapter 395.
4337	(c)  Entities that are owned, directly or indirectly, by an
4338	entity licensed or registered by the state pursuant to chapter
4339	395; or entities that are owned, directly or indirectly, by an
4340	entity licensed or registered by the state and providing only
4341	health care services within the scope of services authorized
4342	pursuant to their respective licenses granted under ss. 383.30-
4343	383.335, chapter 390, chapter 394, chapter 397, this chapter
4344	except part X XIII, chapter 429, chapter 463, chapter 465,
4345	chapter 466, chapter 478, part I of chapter 483, chapter 484, or
4346	chapter 651; end-stage renal disease providers authorized under
4347	42 C.F.R. part 405, subpart U; or providers certified under 42
4348	C.F.R. part 485, subpart B or subpart H; or any entity that
4349	provides neonatal or pediatric hospital-based health care
4350	services by licensed practitioners solely within a hospital
4351	under chapter 395.
4352	(d)  Entities that are under common ownership, directly or
4353	indirectly, with an entity licensed or registered by the state
4354	pursuant to chapter 395; or entities that are under common
4355	ownership, directly or indirectly, with an entity licensed or
4356	registered by the state and providing only health care services
4357	within the scope of services authorized pursuant to their
4358	respective licenses granted under ss. 383.30-383.335, chapter
4359	390, chapter 394, chapter 397, this chapter except part X XIII,
4360	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
4361	part I of chapter 483, chapter 484, or chapter 651; end-stage
4362	renal disease providers authorized under 42 C.F.R. part 405,
4363	subpart U; or providers certified under 42 C.F.R. part 485,
4364	subpart B or subpart H; or any entity that provides neonatal or
4365	pediatric hospital-based health care services by licensed
4366	practitioners solely within a hospital licensed under chapter
4367	395.
4368	Section 78.  Subsection (12) of section 401.23, Florida
4369	Statutes, is amended to read:
4370	401.23  Definitions.--As used in this part, the term:
4371	(12)  "Interfacility transfer" means the transportation by
4372	ambulance of a patient between two facilities licensed under
4373	chapter 393, chapter 395, or chapter 400, or chapter 429,
4374	pursuant to this part.
4375	Section 79.  Paragraph (b) of subsection (2) of section
4376	402.164, Florida Statutes, is amended to read:
4377	402.164  Legislative intent; definitions.--
4378	(2)  As used in ss. 402.164-402.167, the term:
4379	(b)  "Client" means a client as defined in s. 393.063, s.
4380	394.67, s. 397.311, or s. 400.960, a forensic client or client
4381	as defined in s. 916.106, a child or youth as defined in s.
4382	39.01, a child as defined in s. 827.01, a family as defined in
4383	s. 414.0252, a participant as defined in s. 429.901 s. 400.551,
4384	a resident as defined in s. 429.02 s. 400.402, a Medicaid
4385	recipient or recipient as defined in s. 409.901, a child
4386	receiving child care as defined in s. 402.302, a disabled adult
4387	as defined in s. 410.032 or s. 410.603, or a victim as defined
4388	in s. 39.01 or s. 415.102 as each definition applies within its
4389	respective chapter.
4390	Section 80.  Subsection (10) of section 408.032, Florida
4391	Statutes, is amended to read:
4392	408.032  Definitions relating to Health Facility and
4393	Services Development Act.--As used in ss. 408.031-408.045, the
4394	term:
4395	(10)  "Hospice" or "hospice program" means a hospice as
4396	defined in part IV VI of chapter 400.
4397	Section 81.  Paragraph (b) of subsection (2) of section
4398	408.033, Florida Statutes, is amended to read:
4399	408.033  Local and state health planning.--
4400	(2)  FUNDING.--
4401	(b)1.  A hospital licensed under chapter 395, a nursing
4402	home licensed under chapter 400, and an assisted living facility
4403	licensed under chapter 429 400 shall be assessed an annual fee
4404	based on number of beds.
4405	2.  All other facilities and organizations listed in
4406	paragraph (a) shall each be assessed an annual fee of $150.
4407	3.  Facilities operated by the Department of Children and
4408	Family Services, the Department of Health, or the Department of
4409	Corrections and any hospital which meets the definition of rural
4410	hospital pursuant to s. 395.602 are exempt from the assessment
4411	required in this subsection.
4412	Section 82.  Subsection (2) of section 408.034, Florida
4413	Statutes, is amended to read:
4414	408.034  Duties and responsibilities of agency; rules.--
4415	(2)  In the exercise of its authority to issue licenses to
4416	health care facilities and health service providers, as provided
4417	under chapters 393 and, 395, and parts II and IV VI of chapter
4418	400, the agency may not issue a license to any health care
4419	facility or health service provider that fails to receive a
4420	certificate of need or an exemption for the licensed facility or
4421	service.
4422	Section 83.  Subsections (28) and (29) of section 408.07,
4423	Florida Statutes, are amended to read:
4424	408.07  Definitions.--As used in this chapter, with the
4425	exception of ss. 408.031-408.045, the term:
4426	(28)  "Home health agency" means an organization licensed
4427	under part III IV of chapter 400.
4428	(29)  "Hospice" means an organization licensed under part
4429	IV VI of chapter 400.
4430	Section 84.  Subsection (3) of section 408.831, Florida
4431	Statutes, is amended to read:
4432	408.831  Denial, suspension, or revocation of a license,
4433	registration, certificate, or application.--
4434	(3)  This section provides standards of enforcement
4435	applicable to all entities licensed or regulated by the Agency
4436	for Health Care Administration. This section controls over any
4437	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
4438	394, 395, 400, 408, 429, 468, 483, and 641 or rules adopted
4439	pursuant to those chapters.
4440	Section 85.  Subsection (2) of section 409.212, Florida
4441	Statutes, is amended to read:
4442	409.212  Optional supplementation.--
4443	(2)  The base rate of payment for optional state
4444	supplementation shall be established by the department within
4445	funds appropriated. Additional amounts may be provided for
4446	mental health residents in facilities designed to provide
4447	limited mental health services as provided for in s. 429.075 s.
4448	400.4075. The base rate of payment does not include the personal
4449	needs allowance.
4450	Section 86.  Paragraph (e) of subsection (4) of section
4451	409.221, Florida Statutes, is amended to read:
4452	409.221  Consumer-directed care program.--
4453	(4)  CONSUMER-DIRECTED CARE.--
4454	(e)  Services.--Consumers shall use the budget allowance
4455	only to pay for home and community-based services that meet the
4456	consumer's long-term care needs and are a cost-efficient use of
4457	funds. Such services may include, but are not limited to, the
4458	following:
4459	1.  Personal care.
4460	2.  Homemaking and chores, including housework, meals,
4461	shopping, and transportation.
4462	3.  Home modifications and assistive devices which may
4463	increase the consumer's independence or make it possible to
4464	avoid institutional placement.
4465	4.  Assistance in taking self-administered medication.
4466	5.  Day care and respite care services, including those
4467	provided by nursing home facilities pursuant to s. 400.141(6) or
4468	by adult day care facilities licensed pursuant to s. 429.907 s.
4469	400.554.
4470	6.  Personal care and support services provided in an
4471	assisted living facility.
4472	Section 87.  Subsection (4) of section 409.905, Florida
4473	Statutes, is amended to read:
4474	409.905  Mandatory Medicaid services.--The agency may make
4475	payments for the following services, which are required of the
4476	state by Title XIX of the Social Security Act, furnished by
4477	Medicaid providers to recipients who are determined to be
4478	eligible on the dates on which the services were provided. Any
4479	service under this section shall be provided only when medically
4480	necessary and in accordance with state and federal law.
4481	Mandatory services rendered by providers in mobile units to
4482	Medicaid recipients may be restricted by the agency. Nothing in
4483	this section shall be construed to prevent or limit the agency
4484	from adjusting fees, reimbursement rates, lengths of stay,
4485	number of visits, number of services, or any other adjustments
4486	necessary to comply with the availability of moneys and any
4487	limitations or directions provided for in the General
4488	Appropriations Act or chapter 216.
4489	(4)  HOME HEALTH CARE SERVICES.--The agency shall pay for
4490	nursing and home health aide services, supplies, appliances, and
4491	durable medical equipment, necessary to assist a recipient
4492	living at home. An entity that provides services pursuant to
4493	this subsection shall be licensed under part III IV of chapter
4494	400. These services, equipment, and supplies, or reimbursement
4495	therefor, may be limited as provided in the General
4496	Appropriations Act and do not include services, equipment, or
4497	supplies provided to a person residing in a hospital or nursing
4498	facility.
4499	(a)  In providing home health care services, the agency may
4500	require prior authorization of care based on diagnosis.
4501	(b)  The agency shall implement a comprehensive utilization
4502	management program that requires prior authorization of all
4503	private duty nursing services, an individualized treatment plan
4504	that includes information about medication and treatment orders,
4505	treatment goals, methods of care to be used, and plans for care
4506	coordination by nurses and other health professionals. The
4507	utilization management program shall also include a process for
4508	periodically reviewing the ongoing use of private duty nursing
4509	services. The assessment of need shall be based on a child's
4510	condition, family support and care supplements, a family's
4511	ability to provide care, and a family's and child's schedule
4512	regarding work, school, sleep, and care for other family
4513	dependents. When implemented, the private duty nursing
4514	utilization management program shall replace the current
4515	authorization program used by the Agency for Health Care
4516	Administration and the Children's Medical Services program of
4517	the Department of Health. The agency may competitively bid on a
4518	contract to select a qualified organization to provide
4519	utilization management of private duty nursing services. The
4520	agency is authorized to seek federal waivers to implement this
4521	initiative.
4522	Section 88.  Subsection (14) of section 409.906, Florida
4523	Statutes, is amended to read:
4524	409.906  Optional Medicaid services.--Subject to specific
4525	appropriations, the agency may make payments for services which
4526	are optional to the state under Title XIX of the Social Security
4527	Act and are furnished by Medicaid providers to recipients who
4528	are determined to be eligible on the dates on which the services
4529	were provided. Any optional service that is provided shall be
4530	provided only when medically necessary and in accordance with
4531	state and federal law. Optional services rendered by providers
4532	in mobile units to Medicaid recipients may be restricted or
4533	prohibited by the agency. Nothing in this section shall be
4534	construed to prevent or limit the agency from adjusting fees,
4535	reimbursement rates, lengths of stay, number of visits, or
4536	number of services, or making any other adjustments necessary to
4537	comply with the availability of moneys and any limitations or
4538	directions provided for in the General Appropriations Act or
4539	chapter 216. If necessary to safeguard the state's systems of
4540	providing services to elderly and disabled persons and subject
4541	to the notice and review provisions of s. 216.177, the Governor
4542	may direct the Agency for Health Care Administration to amend
4543	the Medicaid state plan to delete the optional Medicaid service
4544	known as "Intermediate Care Facilities for the Developmentally
4545	Disabled." Optional services may include:
4546	(14)  HOSPICE CARE SERVICES.--The agency may pay for all
4547	reasonable and necessary services for the palliation or
4548	management of a recipient's terminal illness, if the services
4549	are provided by a hospice that is licensed under part IV VI of
4550	chapter 400 and meets Medicare certification requirements.
4551	Section 89.  Subsection (7) and paragraph (a) of subsection
4552	(8) of section 409.907, Florida Statutes, are amended to read:
4553	409.907  Medicaid provider agreements.--The agency may make
4554	payments for medical assistance and related services rendered to
4555	Medicaid recipients only to an individual or entity who has a
4556	provider agreement in effect with the agency, who is performing
4557	services or supplying goods in accordance with federal, state,
4558	and local law, and who agrees that no person shall, on the
4559	grounds of handicap, race, color, or national origin, or for any
4560	other reason, be subjected to discrimination under any program
4561	or activity for which the provider receives payment from the
4562	agency.
4563	(7)  The agency may require, as a condition of
4564	participating in the Medicaid program and before entering into
4565	the provider agreement, that the provider submit information, in
4566	an initial and any required renewal applications, concerning the
4567	professional, business, and personal background of the provider
4568	and permit an onsite inspection of the provider's service
4569	location by agency staff or other personnel designated by the
4570	agency to perform this function. The agency shall perform a
4571	random onsite inspection, within 60 days after receipt of a
4572	fully complete new provider's application, of the provider's
4573	service location prior to making its first payment to the
4574	provider for Medicaid services to determine the applicant's
4575	ability to provide the services that the applicant is proposing
4576	to provide for Medicaid reimbursement. The agency is not
4577	required to perform an onsite inspection of a provider or
4578	program that is licensed by the agency, that provides services
4579	under waiver programs for home and community-based services, or
4580	that is licensed as a medical foster home by the Department of
4581	Children and Family Services. As a continuing condition of
4582	participation in the Medicaid program, a provider shall
4583	immediately notify the agency of any current or pending
4584	bankruptcy filing. Before entering into the provider agreement,
4585	or as a condition of continuing participation in the Medicaid
4586	program, the agency may also require that Medicaid providers
4587	reimbursed on a fee-for-services basis or fee schedule basis
4588	which is not cost-based, post a surety bond not to exceed
4589	$50,000 or the total amount billed by the provider to the
4590	program during the current or most recent calendar year,
4591	whichever is greater. For new providers, the amount of the
4592	surety bond shall be determined by the agency based on the
4593	provider's estimate of its first year's billing. If the
4594	provider's billing during the first year exceeds the bond
4595	amount, the agency may require the provider to acquire an
4596	additional bond equal to the actual billing level of the
4597	provider. A provider's bond shall not exceed $50,000 if a
4598	physician or group of physicians licensed under chapter 458,
4599	chapter 459, or chapter 460 has a 50 percent or greater
4600	ownership interest in the provider or if the provider is an
4601	assisted living facility licensed under part III of chapter 429
4602	400. The bonds permitted by this section are in addition to the
4603	bonds referenced in s. 400.179(5)(d). If the provider is a
4604	corporation, partnership, association, or other entity, the
4605	agency may require the provider to submit information concerning
4606	the background of that entity and of any principal of the
4607	entity, including any partner or shareholder having an ownership
4608	interest in the entity equal to 5 percent or greater, and any
4609	treating provider who participates in or intends to participate
4610	in Medicaid through the entity. The information must include:
4611	(a)  Proof of holding a valid license or operating
4612	certificate, as applicable, if required by the state or local
4613	jurisdiction in which the provider is located or if required by
4614	the Federal Government.
4615	(b)  Information concerning any prior violation, fine,
4616	suspension, termination, or other administrative action taken
4617	under the Medicaid laws, rules, or regulations of this state or
4618	of any other state or the Federal Government; any prior
4619	violation of the laws, rules, or regulations relating to the
4620	Medicare program; any prior violation of the rules or
4621	regulations of any other public or private insurer; and any
4622	prior violation of the laws, rules, or regulations of any
4623	regulatory body of this or any other state.
4624	(c)  Full and accurate disclosure of any financial or
4625	ownership interest that the provider, or any principal, partner,
4626	or major shareholder thereof, may hold in any other Medicaid
4627	provider or health care related entity or any other entity that
4628	is licensed by the state to provide health or residential care
4629	and treatment to persons.
4630	(d)  If a group provider, identification of all members of
4631	the group and attestation that all members of the group are
4632	enrolled in or have applied to enroll in the Medicaid program.
4633	(8)(a)  Each provider, or each principal of the provider if
4634	the provider is a corporation, partnership, association, or
4635	other entity, seeking to participate in the Medicaid program
4636	must submit a complete set of his or her fingerprints to the
4637	agency for the purpose of conducting a criminal history record
4638	check.  Principals of the provider include any officer,
4639	director, billing agent, managing employee, or affiliated
4640	person, or any partner or shareholder who has an ownership
4641	interest equal to 5 percent or more in the provider. However, a
4642	director of a not-for-profit corporation or organization is not
4643	a principal for purposes of a background investigation as
4644	required by this section if the director: serves solely in a
4645	voluntary capacity for the corporation or organization, does not
4646	regularly take part in the day-to-day operational decisions of
4647	the corporation or organization, receives no remuneration from
4648	the not-for-profit corporation or organization for his or her
4649	service on the board of directors, has no financial interest in
4650	the not-for-profit corporation or organization, and has no
4651	family members with a financial interest in the not-for-profit
4652	corporation or organization; and if the director submits an
4653	affidavit, under penalty of perjury, to this effect to the
4654	agency and the not-for-profit corporation or organization
4655	submits an affidavit, under penalty of perjury, to this effect
4656	to the agency as part of the corporation's or organization's
4657	Medicaid provider agreement application. Notwithstanding the
4658	above, the agency may require a background check for any person
4659	reasonably suspected by the agency to have been convicted of a
4660	crime. This subsection shall not apply to:
4661	1.  A hospital licensed under chapter 395;
4662	2.  A nursing home licensed under chapter 400;
4663	3.  A hospice licensed under chapter 400;
4664	4.  An assisted living facility licensed under chapter 429;
4665	400.
4666	5.  A unit of local government, except that requirements of
4667	this subsection apply to nongovernmental providers and entities
4668	when contracting with the local government to provide Medicaid
4669	services. The actual cost of the state and national criminal
4670	history record checks must be borne by the nongovernmental
4671	provider or entity; or
4672	6.  Any business that derives more than 50 percent of its
4673	revenue from the sale of goods to the final consumer, and the
4674	business or its controlling parent either is required to file a
4675	form 10-K or other similar statement with the Securities and
4676	Exchange Commission or has a net worth of $50 million or more.
4677	Section 90.  Paragraph (c) of subsection (5) of section
4678	409.912, Florida Statutes, is amended to read:
4679	409.912  Cost-effective purchasing of health care.--The
4680	agency shall purchase goods and services for Medicaid recipients
4681	in the most cost-effective manner consistent with the delivery
4682	of quality medical care. To ensure that medical services are
4683	effectively utilized, the agency may, in any case, require a
4684	confirmation or second physician's opinion of the correct
4685	diagnosis for purposes of authorizing future services under the
4686	Medicaid program. This section does not restrict access to
4687	emergency services or poststabilization care services as defined
4688	in 42 C.F.R. part 438.114. Such confirmation or second opinion
4689	shall be rendered in a manner approved by the agency. The agency
4690	shall maximize the use of prepaid per capita and prepaid
4691	aggregate fixed-sum basis services when appropriate and other
4692	alternative service delivery and reimbursement methodologies,
4693	including competitive bidding pursuant to s. 287.057, designed
4694	to facilitate the cost-effective purchase of a case-managed
4695	continuum of care. The agency shall also require providers to
4696	minimize the exposure of recipients to the need for acute
4697	inpatient, custodial, and other institutional care and the
4698	inappropriate or unnecessary use of high-cost services. The
4699	agency shall contract with a vendor to monitor and evaluate the
4700	clinical practice patterns of providers in order to identify
4701	trends that are outside the normal practice patterns of a
4702	provider's professional peers or the national guidelines of a
4703	provider's professional association. The vendor must be able to
4704	provide information and counseling to a provider whose practice
4705	patterns are outside the norms, in consultation with the agency,
4706	to improve patient care and reduce inappropriate utilization.
4707	The agency may mandate prior authorization, drug therapy
4708	management, or disease management participation for certain
4709	populations of Medicaid beneficiaries, certain drug classes, or
4710	particular drugs to prevent fraud, abuse, overuse, and possible
4711	dangerous drug interactions. The Pharmaceutical and Therapeutics
4712	Committee shall make recommendations to the agency on drugs for
4713	which prior authorization is required. The agency shall inform
4714	the Pharmaceutical and Therapeutics Committee of its decisions
4715	regarding drugs subject to prior authorization. The agency is
4716	authorized to limit the entities it contracts with or enrolls as
4717	Medicaid providers by developing a provider network through
4718	provider credentialing. The agency may competitively bid single-
4719	source-provider contracts if procurement of goods or services
4720	results in demonstrated cost savings to the state without
4721	limiting access to care. The agency may limit its network based
4722	on the assessment of beneficiary access to care, provider
4723	availability, provider quality standards, time and distance
4724	standards for access to care, the cultural competence of the
4725	provider network, demographic characteristics of Medicaid
4726	beneficiaries, practice and provider-to-beneficiary standards,
4727	appointment wait times, beneficiary use of services, provider
4728	turnover, provider profiling, provider licensure history,
4729	previous program integrity investigations and findings, peer
4730	review, provider Medicaid policy and billing compliance records,
4731	clinical and medical record audits, and other factors. Providers
4732	shall not be entitled to enrollment in the Medicaid provider
4733	network. The agency shall determine instances in which allowing
4734	Medicaid beneficiaries to purchase durable medical equipment and
4735	other goods is less expensive to the Medicaid program than long-
4736	term rental of the equipment or goods. The agency may establish
4737	rules to facilitate purchases in lieu of long-term rentals in
4738	order to protect against fraud and abuse in the Medicaid program
4739	as defined in s. 409.913. The agency may seek federal waivers
4740	necessary to administer these policies.
4741	(5)  By December 1, 2005, the Agency for Health Care
4742	Administration, in partnership with the Department of Elderly
4743	Affairs, shall create an integrated, fixed-payment delivery
4744	system for Medicaid recipients who are 60 years of age or older.
4745	The Agency for Health Care Administration shall implement the
4746	integrated system initially on a pilot basis in two areas of the
4747	state. In one of the areas enrollment shall be on a voluntary
4748	basis. The program must transfer all Medicaid services for
4749	eligible elderly individuals who choose to participate into an
4750	integrated-care management model designed to serve Medicaid
4751	recipients in the community. The program must combine all
4752	funding for Medicaid services provided to individuals 60 years
4753	of age or older into the integrated system, including funds for
4754	Medicaid home and community-based waiver services; all Medicaid
4755	services authorized in ss. 409.905 and 409.906, excluding funds
4756	for Medicaid nursing home services unless the agency is able to
4757	demonstrate how the integration of the funds will improve
4758	coordinated care for these services in a less costly manner; and
4759	Medicare coinsurance and deductibles for persons dually eligible
4760	for Medicaid and Medicare as prescribed in s. 409.908(13).
4761	(c)  The agency must ensure that the capitation-rate-
4762	setting methodology for the integrated system is actuarially
4763	sound and reflects the intent to provide quality care in the
4764	least restrictive setting. The agency must also require
4765	integrated-system providers to develop a credentialing system
4766	for service providers and to contract with all Gold Seal nursing
4767	homes, where feasible, and exclude, where feasible, chronically
4768	poor-performing facilities and providers as defined by the
4769	agency. The integrated system must provide that if the recipient
4770	resides in a noncontracted residential facility licensed under
4771	chapter 400 or chapter 429 at the time the integrated system is
4772	initiated, the recipient must be permitted to continue to reside
4773	in the noncontracted facility as long as the recipient desires.
4774	The integrated system must also provide that, in the absence of
4775	a contract between the integrated-system provider and the
4776	residential facility licensed under chapter 400 or chapter 429,
4777	current Medicaid rates must prevail. The agency and the
4778	Department of Elderly Affairs must jointly develop procedures to
4779	manage the services provided through the integrated system in
4780	order to ensure quality and recipient choice.
4781	Section 91.  Section 410.031, Florida Statutes, is amended
4782	to read:
4783	410.031  Legislative intent.--It is the intent of the
4784	Legislature to encourage the provision of care for disabled
4785	adults in family-type living arrangements in private homes as an
4786	alternative to institutional or nursing home care for such
4787	persons. The provisions of ss. 410.031-410.036 are intended to
4788	be supplemental to the provisions of chapters chapter 400 and
4789	429, relating to the licensing and regulation of nursing homes
4790	and assisted living facilities, and do not exempt any person who
4791	is otherwise subject to regulation under chapter 400 or chapter
4792	429.
4793	Section 92.  Section 410.034, Florida Statutes, is amended
4794	to read:
4795	410.034  Department determination of fitness to provide
4796	home care.--In accordance with s. 429.02 s. 400.402, a person
4797	caring for an adult who is related to such person by blood or
4798	marriage is not subject to the Assisted Living Facilities Act.
4799	If, however, the person who plans to provide home care under
4800	this act is found by the department to be unable to provide this
4801	care, the department shall notify the person wishing to provide
4802	home care of this determination, and the person shall not be
4803	eligible for subsidy payments under ss. 410.031-410.036.
4804	Section 93.  Section 415.1111, Florida Statutes, is amended
4805	to read:
4806	415.1111  Civil actions.--A vulnerable adult who has been
4807	abused, neglected, or exploited as specified in this chapter has
4808	a cause of action against any perpetrator and may recover actual
4809	and punitive damages for such abuse, neglect, or exploitation.
4810	The action may be brought by the vulnerable adult, or that
4811	person's guardian, by a person or organization acting on behalf
4812	of the vulnerable adult with the consent of that person or that
4813	person's guardian, or by the personal representative of the
4814	estate of a deceased victim without regard to whether the cause
4815	of death resulted from the abuse, neglect, or exploitation. The
4816	action may be brought in any court of competent jurisdiction to
4817	enforce such action and to recover actual and punitive damages
4818	for any deprivation of or infringement on the rights of a
4819	vulnerable adult. A party who prevails in any such action may be
4820	entitled to recover reasonable attorney's fees, costs of the
4821	action, and damages. The remedies provided in this section are
4822	in addition to and cumulative with other legal and
4823	administrative remedies available to a vulnerable adult.
4824	Notwithstanding the foregoing, any civil action for damages
4825	against any licensee or entity who establishes, controls,
4826	conducts, manages, or operates a facility licensed under part II
4827	of chapter 400 relating to its operation of the licensed
4828	facility shall be brought pursuant to s. 400.023, or against any
4829	licensee or entity who establishes, controls, conducts, manages,
4830	or operates a facility licensed under part I III of chapter 429
4831	400 relating to its operation of the licensed facility shall be
4832	brought pursuant to s. 429.29 s. 400.429. Such licensee or
4833	entity shall not be vicariously liable for the acts or omissions
4834	of its employees or agents or any other third party in an action
4835	brought under this section.
4836	Section 94.  Paragraph (d) of subsection (1) of section
4837	419.001, Florida Statutes, is amended to read:
4838	419.001  Site selection of community residential homes.--
4839	(1)  For the purposes of this section, the following
4840	definitions shall apply:
4841	(d)  "Resident" means any of the following: a frail elder
4842	as defined in s. 429.65 s. 400.618; a physically disabled or
4843	handicapped person as defined in s. 760.22(7)(a); a
4844	developmentally disabled person as defined in s. 393.063; a
4845	nondangerous mentally ill person as defined in s. 394.455(18);
4846	or a child as defined in s. 39.01(14), s. 984.03(9) or (12), or
4847	s. 985.03(8).
4848	Section 95.  Section 430.601, Florida Statutes, is amended
4849	to read:
4850	430.601  Home care for the elderly; legislative intent.--It
4851	is the intent of the Legislature to encourage the provision of
4852	care for the elderly in family-type living arrangements in
4853	private homes as an alternative to institutional or nursing home
4854	care for such persons. The provisions of ss. 430.601-430.606 are
4855	intended to be supplemental to the provisions of chapters
4856	chapter 400 and 429, relating to the licensing and regulation of
4857	nursing homes and assisted living facilities, and do not exempt
4858	any person who is otherwise subject to regulation under those
4859	chapters the provisions of that chapter.
4860	Section 96.  Subsection (7) of section 430.703, Florida
4861	Statutes, is amended to read:
4862	430.703  Definitions.--As used in this act, the term:
4863	(7)  "Other qualified provider" means an entity licensed
4864	under chapter 400 or chapter 429 that demonstrates a long-term
4865	care continuum and meets all requirements pursuant to an
4866	interagency agreement between the agency and the department.
4867	Section 97.  Paragraph (a) of subsection (3) of section
4868	435.03, Florida Statutes, is amended to read:
4869	435.03  Level 1 screening standards.--
4870	(3)  Standards must also ensure that the person:
4871	(a)  For employees and employers licensed or registered
4872	pursuant to chapter 400 or chapter 429, and for employees and
4873	employers of developmental services institutions as defined in
4874	s. 393.063, intermediate care facilities for the developmentally
4875	disabled as defined in s. 393.063, and mental health treatment
4876	facilities as defined in s. 394.455, meets the requirements of
4877	this chapter.
4878	Section 98.  Paragraph (a) of subsection (4) of section
4879	435.04, Florida Statutes, is amended to read:
4880	435.04  Level 2 screening standards.--
4881	(4)  Standards must also ensure that the person:
4882	(a)  For employees or employers licensed or registered
4883	pursuant to chapter 400 or chapter 429, does not have a
4884	confirmed report of abuse, neglect, or exploitation as defined
4885	in s. 415.102(6), which has been uncontested or upheld under s.
4886	415.103.
4887	Section 99.  Paragraph (g) of subsection (1) of section
4888	440.13, Florida Statutes, is amended to read:
4889	440.13  Medical services and supplies; penalty for
4890	violations; limitations.--
4891	(1)  DEFINITIONS.--As used in this section, the term:
4892	(g)  "Health care facility" means any hospital licensed
4893	under chapter 395 and any health care institution licensed under
4894	chapter 400 or chapter 429.
4895	Section 100.  Subsection (1) of section 465.0235, Florida
4896	Statutes, is amended to read:
4897	465.0235  Automated pharmacy systems used by long-term care
4898	facilities, hospices, or state correctional institutions.--
4899	(1)  A pharmacy may provide pharmacy services to a
4900	long-term care facility or hospice licensed under chapter 400 or
4901	chapter 429 or a state correctional institution operated under
4902	chapter 944 through the use of an automated pharmacy system that
4903	need not be located at the same location as the pharmacy.
4904	Section 101.  Subsection (8) of section 468.1685, Florida
4905	Statutes, is amended to read:
4906	468.1685  Powers and duties of board and department.--It is
4907	the function and duty of the board, together with the
4908	department, to:
4909	(8)  Set up procedures by rule for advising and acting
4910	together with the Department of Health and other boards of other
4911	health professions in matters affecting procedures and methods
4912	for effectively enforcing the purpose of this part and the
4913	administration of chapters chapter 400 and 429.
4914	Section 102.  Paragraph (k) of subsection (1) of section
4915	468.505, Florida Statutes, is amended to read:
4916	468.505  Exemptions; exceptions.--
4917	(1)  Nothing in this part may be construed as prohibiting
4918	or restricting the practice, services, or activities of:
4919	(k)  A person employed by a hospital licensed under chapter
4920	395, or by a nursing home or assisted living facility licensed
4921	under part II or part III of chapter 400, by an assisted living
4922	facility licensed under chapter 429, or by a continuing care
4923	facility certified under chapter 651, if the person is employed
4924	in compliance with the laws and rules adopted thereunder
4925	regarding the operation of its dietetic department.
4926	Section 103.  Subsection (11) of section 477.025, Florida
4927	Statutes, is amended to read:
4928	477.025  Cosmetology salons; specialty salons; requisites;
4929	licensure; inspection; mobile cosmetology salons.--
4930	(11)  Facilities licensed under part II or part III of
4931	chapter 400 or part I of chapter 429 are shall be exempt from
4932	the provisions of this section, and a cosmetologist licensed
4933	pursuant to s. 477.019 may provide salon services exclusively
4934	for facility residents.
4935	Section 104.  Subsection (5) of section 483.285, Florida
4936	Statutes, is amended to read:
4937	483.285  Application of part; exemptions.--This part
4938	applies to all multiphasic health testing centers within the
4939	state, but does not apply to:
4940	(5)  A home health agency licensed under part III IV of
4941	chapter 400.
4942	Section 105.  Paragraph (a) of subsection (2) of section
4943	509.032, Florida Statutes, is amended to read:
4944	509.032  Duties.--
4945	(2)  INSPECTION OF PREMISES.--
4946	(a)  The division has responsibility and jurisdiction for
4947	all inspections required by this chapter.  The division has
4948	responsibility for quality assurance.  Each licensed
4949	establishment shall be inspected at least biannually, except for
4950	transient and nontransient apartments, which shall be inspected
4951	at least annually, and shall be inspected at such other times as
4952	the division determines is necessary to ensure the public's
4953	health, safety, and welfare.  The division shall establish a
4954	system to determine inspection frequency.  Public lodging units
4955	classified as resort condominiums or resort dwellings are not
4956	subject to this requirement, but shall be made available to the
4957	division upon request.  If, during the inspection of a public
4958	lodging establishment classified for renting to transient or
4959	nontransient tenants, an inspector identifies vulnerable adults
4960	who appear to be victims of neglect, as defined in s. 415.102,
4961	or, in the case of a building that is not equipped with
4962	automatic sprinkler systems, tenants or clients who may be
4963	unable to self-preserve in an emergency, the division shall
4964	convene meetings with the following agencies as appropriate to
4965	the individual situation: the Department of Health, the
4966	Department of Elderly Affairs, the area agency on aging, the
4967	local fire marshal, the landlord and affected tenants and
4968	clients, and other relevant organizations, to develop a plan
4969	which improves the prospects for safety of affected residents
4970	and, if necessary, identifies alternative living arrangements
4971	such as facilities licensed under part II or part III of chapter
4972	400 or under chapter 429.
4973	Section 106.  Subsection (1) of section 509.241, Florida
4974	Statutes, is amended to read:
4975	509.241  Licenses required; exceptions.--
4976	(1)  LICENSES; ANNUAL RENEWALS.--Each public lodging
4977	establishment and public food service establishment shall obtain
4978	a license from the division. Such license may not be transferred
4979	from one place or individual to another. It shall be a
4980	misdemeanor of the second degree, punishable as provided in s.
4981	775.082 or s. 775.083, for such an establishment to operate
4982	without a license. Local law enforcement shall provide immediate
4983	assistance in pursuing an illegally operating establishment. The
4984	division may refuse a license, or a renewal thereof, to any
4985	establishment that is not constructed and maintained in
4986	accordance with law and with the rules of the division. The
4987	division may refuse to issue a license, or a renewal thereof, to
4988	any establishment an operator of which, within the preceding 5
4989	years, has been adjudicated guilty of, or has forfeited a bond
4990	when charged with, any crime reflecting on professional
4991	character, including soliciting for prostitution, pandering,
4992	letting premises for prostitution, keeping a disorderly place,
4993	or illegally dealing in controlled substances as defined in
4994	chapter 893, whether in this state or in any other jurisdiction
4995	within the United States, or has had a license denied, revoked,
4996	or suspended pursuant to s. 429.14 s. 400.414. Licenses shall be
4997	renewed annually, and the division shall adopt a rule
4998	establishing a staggered schedule for license renewals. If any
4999	license expires while administrative charges are pending against
5000	the license, the proceedings against the license shall continue
5001	to conclusion as if the license were still in effect.
5002	Section 107.  Subsection (1) of section 627.6617, Florida
5003	Statutes, is amended to read:
5004	627.6617  Coverage for home health care services.--
5005	(1)  Any group health insurance policy providing coverage
5006	on an expense-incurred basis shall provide coverage for home
5007	health care by a home health care agency licensed pursuant to
5008	part III IV of chapter 400. Such coverage may be limited to home
5009	health care under a plan of treatment prescribed by a licensed
5010	physician. Services may be performed by a registered graduate
5011	nurse, a licensed practical nurse, a physical therapist, a
5012	speech therapist, an occupational therapist, or a home health
5013	aide. Provisions for utilization review may be imposed, provided
5014	that similar provisions apply to all other types of health care
5015	services.
5016	Section 108.  Subsection (1) of section 627.732, Florida
5017	Statutes, is amended to read:
5018	627.732  Definitions.--As used in ss. 627.730-627.7405, the
5019	term:
5020	(1)  "Broker" means any person not possessing a license
5021	under chapter 395, chapter 400, chapter 429, chapter 458,
5022	chapter 459, chapter 460, chapter 461, or chapter 641 who
5023	charges or receives compensation for any use of medical
5024	equipment and is not the 100-percent owner or the 100-percent
5025	lessee of such equipment. For purposes of this section, such
5026	owner or lessee may be an individual, a corporation, a
5027	partnership, or any other entity and any of its 100-percent-
5028	owned affiliates and subsidiaries. For purposes of this
5029	subsection, the term "lessee" means a long-term lessee under a
5030	capital or operating lease, but does not include a part-time
5031	lessee. The term "broker" does not include a hospital or
5032	physician management company whose medical equipment is
5033	ancillary to the practices managed, a debt collection agency, or
5034	an entity that has contracted with the insurer to obtain a
5035	discounted rate for such services; nor does the term include a
5036	management company that has contracted to provide general
5037	management services for a licensed physician or health care
5038	facility and whose compensation is not materially affected by
5039	the usage or frequency of usage of medical equipment or an
5040	entity that is 100-percent owned by one or more hospitals or
5041	physicians. The term "broker" does not include a person or
5042	entity that certifies, upon request of an insurer, that:
5043	(a)  It is a clinic licensed under ss. 400.990-400.995;
5044	(b)  It is a 100-percent owner of medical equipment; and
5045	(c)  The owner's only part-time lease of medical equipment
5046	for personal injury protection patients is on a temporary basis
5047	not to exceed 30 days in a 12-month period, and such lease is
5048	solely for the purposes of necessary repair or maintenance of
5049	the 100-percent-owned medical equipment or pending the arrival
5050	and installation of the newly purchased or a replacement for the
5051	100-percent-owned medical equipment, or for patients for whom,
5052	because of physical size or claustrophobia, it is determined by
5053	the medical director or clinical director to be medically
5054	necessary that the test be performed in medical equipment that
5055	is open-style. The leased medical equipment cannot be used by
5056	patients who are not patients of the registered clinic for
5057	medical treatment of services. Any person or entity making a
5058	false certification under this subsection commits insurance
5059	fraud as defined in s. 817.234. However, the 30-day period
5060	provided in this paragraph may be extended for an additional 60
5061	days as applicable to magnetic resonance imaging equipment if
5062	the owner certifies that the extension otherwise complies with
5063	this paragraph.
5064	Section 109.  Subsection (2) of section 651.011, Florida
5065	Statutes, is amended to read:
5066	651.011  Definitions.--For the purposes of this chapter,
5067	the term:
5068	(2)  "Continuing care" or "care" means furnishing pursuant
5069	to a contract shelter and either nursing care or personal
5070	services as defined in s. 429.02 s. 400.402, whether such
5071	nursing care or personal services are provided in the facility
5072	or in another setting designated by the contract for continuing
5073	care, to an individual not related by consanguinity or affinity
5074	to the provider furnishing such care, upon payment of an
5075	entrance fee. Other personal services provided shall be
5076	designated in the continuing care contract. Contracts to provide
5077	continuing care include agreements to provide care for any
5078	duration, including contracts that are terminable by either
5079	party.
5080	Section 110.  Paragraph (c) of subsection (2) of section
5081	651.022, Florida Statutes, is amended to read:
5082	651.022  Provisional certificate of authority;
5083	application.--
5084	(2)  The application for a provisional certificate of
5085	authority shall be on a form prescribed by the commission and
5086	shall contain the following information:
5087	(c)1.  Evidence that the applicant is reputable and of
5088	responsible character.  If the applicant is a firm, association,
5089	organization, partnership, business trust, corporation, or
5090	company, the form shall require evidence that the members or
5091	shareholders are reputable and of responsible character, and the
5092	person in charge of providing care under a certificate of
5093	authority shall likewise be required to produce evidence of
5094	being reputable and of responsible character.
5095	2.  Evidence satisfactory to the office of the ability of
5096	the applicant to comply with the provisions of this chapter and
5097	with rules adopted by the commission pursuant to this chapter.
5098	3.  A statement of whether a person identified in the
5099	application for a provisional certificate of authority or the
5100	administrator or manager of the facility, if such person has
5101	been designated, or any such person living in the same location:
5102	a.  Has been convicted of a felony or has pleaded nolo
5103	contendere to a felony charge, or has been held liable or has
5104	been enjoined in a civil action by final judgment, if the felony
5105	or civil action involved fraud, embezzlement, fraudulent
5106	conversion, or misappropriation of property.
5107	b.  Is subject to a currently effective injunctive or
5108	restrictive order or federal or state administrative order
5109	relating to business activity or health care as a result of an
5110	action brought by a public agency or department, including,
5111	without limitation, an action affecting a license under chapter
5112	400 or chapter 429.
5113
5114	The statement shall set forth the court or agency, the date of
5115	conviction or judgment, and the penalty imposed or damages
5116	assessed, or the date, nature, and issuer of the order.  Before
5117	determining whether a provisional certificate of authority is to
5118	be issued, the office may make an inquiry to determine the
5119	accuracy of the information submitted pursuant to subparagraphs
5120	1. and 2.
5121	Section 111.  Subsection (6) of section 651.023, Florida
5122	Statutes, is amended to read:
5123	651.023  Certificate of authority; application.--
5124	(6)  The timeframes provided under s. 651.022(5) and (6)
5125	apply to applications submitted under s. 651.021(2). The office
5126	may not issue a certificate of authority under this chapter to
5127	any facility which does not have a component which is to be
5128	licensed pursuant to part II or part III of chapter 400 or part
5129	I of chapter 429 or which will not offer personal services or
5130	nursing services through written contractual agreement. Any
5131	written contractual agreement must be disclosed in the
5132	continuing care contract and is subject to the provisions of s.
5133	651.1151, relating to administrative, vendor, and management
5134	contracts.
5135	Section 112.  Subsection (8) of section 651.055, Florida
5136	Statutes, is amended to read:
5137	651.055  Contracts; right to rescind.--
5138	(8)  The provisions of this section shall control over any
5139	conflicting provisions contained in part II or part III of
5140	chapter 400 or in part I of chapter 429.
5141	Section 113.  Subsection (5) of section 651.095, Florida
5142	Statutes, is amended to read:
5143	651.095  Advertisements; requirements; penalties.--
5144	(5)  The provisions of this section shall control over any
5145	conflicting provisions contained in part II or part III of
5146	chapter 400 or in part I of chapter 429.
5147	Section 114.  Subsections (1), (4), (6), (7), and (8) of
5148	section 651.118, Florida Statutes, are amended to read:
5149	651.118  Agency for Health Care Administration;
5150	certificates of need; sheltered beds; community beds.--
5151	(1)  The provisions of this section shall control in the
5152	case of conflict with the provisions of the Health Facility and
5153	Services Development Act, ss. 408.031-408.045; the provisions of
5154	chapter 395; or the provisions of part II parts II and III of
5155	chapter 400; or the provisions of part I of chapter 429.
5156	(4)  The Agency for Health Care Administration shall
5157	approve one sheltered nursing home bed for every four proposed
5158	residential units, including those that are licensed under part
5159	I of chapter 429 part III of chapter 400, in the continuing care
5160	facility unless the provider demonstrates the need for a lesser
5161	number of sheltered nursing home beds based on proposed
5162	utilization by prospective residents or demonstrates the need
5163	for additional sheltered nursing home beds based on actual
5164	utilization and demand by current residents.
5165	(6)  Unless the provider already has a component that is to
5166	be a part of the continuing care facility and that is licensed
5167	under chapter 395, or part II or part III of chapter 400, or
5168	part I of chapter 429 at the time of construction of the
5169	continuing care facility, the provider must construct the
5170	nonnursing home portion of the facility and the nursing home
5171	portion of the facility at the same time. If a provider
5172	constructs less than the number of residential units approved in
5173	the certificate of authority, the number of licensed sheltered
5174	nursing home beds shall be reduced by a proportionate share.
5175	(7)  Notwithstanding the provisions of subsection (2), at
5176	the discretion of the continuing care provider, sheltered
5177	nursing home beds may be used for persons who are not residents
5178	of the continuing care facility and who are not parties to a
5179	continuing care contract for a period of up to 5 years after the
5180	date of issuance of the initial nursing home license. A provider
5181	whose 5-year period has expired or is expiring may request the
5182	Agency for Health Care Administration for an extension, not to
5183	exceed 30 percent of the total sheltered nursing home beds, if
5184	the utilization by residents of the nursing home facility in the
5185	sheltered beds will not generate sufficient income to cover
5186	nursing home facility expenses, as evidenced by one of the
5187	following:
5188	(a)  The nursing home facility has a net loss for the most
5189	recent fiscal year as determined under generally accepted
5190	accounting principles, excluding the effects of extraordinary or
5191	unusual items, as demonstrated in the most recently audited
5192	financial statement; or
5193	(b)  The nursing home facility would have had a pro forma
5194	loss for the most recent fiscal year, excluding the effects of
5195	extraordinary or unusual items, if revenues were reduced by the
5196	amount of revenues from persons in sheltered beds who were not
5197	residents, as reported on by a certified public accountant.
5198
5199	The agency shall be authorized to grant an extension to the
5200	provider based on the evidence required in this subsection. The
5201	agency may request a continuing care facility to use up to 25
5202	percent of the patient days generated by new admissions of
5203	nonresidents during the extension period to serve Medicaid
5204	recipients for those beds authorized for extended use if there
5205	is a demonstrated need in the respective service area and if
5206	funds are available. A provider who obtains an extension is
5207	prohibited from applying for additional sheltered beds under the
5208	provision of subsection (2), unless additional residential units
5209	are built or the provider can demonstrate need by continuing
5210	care facility residents to the Agency for Health Care
5211	Administration. The 5-year limit does not apply to up to five
5212	sheltered beds designated for inpatient hospice care as part of
5213	a contractual arrangement with a hospice licensed under part IV
5214	VI of chapter 400. A continuing care facility that uses such
5215	beds after the 5-year period shall report such use to the Agency
5216	for Health Care Administration. For purposes of this subsection,
5217	"resident" means a person who, upon admission to the continuing
5218	care facility, initially resides in a part of the continuing
5219	care facility not licensed under part II of chapter 400.
5220	(8)  A provider may petition the Agency for Health Care
5221	Administration to use a designated number of sheltered nursing
5222	home beds to provide extended congregate care as defined in s.
5223	429.02 s. 400.402 if the beds are in a distinct area of the
5224	nursing home which can be adapted to meet the requirements for
5225	extended congregate care. The provider may subsequently use such
5226	beds as sheltered beds after notifying the agency of the
5227	intended change. Any sheltered beds used to provide extended
5228	congregate care pursuant to this subsection may not qualify for
5229	funding under the Medicaid waiver. Any sheltered beds used to
5230	provide extended congregate care pursuant to this subsection may
5231	share common areas, services, and staff with beds designated for
5232	nursing home care, provided that all of the beds are under
5233	common ownership. For the purposes of this subsection, fire and
5234	life safety codes applicable to nursing home facilities shall
5235	apply.
5236	Section 115.  Subsection (2) of section 765.1103, Florida
5237	Statutes, is amended to read:
5238	765.1103  Pain management and palliative care.--
5239	(2)  Health care providers and practitioners regulated
5240	under chapter 458, chapter 459, or chapter 464 must, as
5241	appropriate, comply with a request for pain management or
5242	palliative care from a patient under their care or, for an
5243	incapacitated patient under their care, from a surrogate, proxy,
5244	guardian, or other representative permitted to make health care
5245	decisions for the incapacitated patient. Facilities regulated
5246	under chapter 395, or chapter 400, or chapter 429 must comply
5247	with the pain management or palliative care measures ordered by
5248	the patient's physician.
5249	Section 116.  Subsection (2) of section 765.205, Florida
5250	Statutes, is amended to read:
5251	765.205  Responsibility of the surrogate.--
5252	(2)  The surrogate may authorize the release of information
5253	and medical records to appropriate persons to ensure the
5254	continuity of the principal's health care and may authorize the
5255	admission, discharge, or transfer of the principal to or from a
5256	health care facility or other facility or program licensed under
5257	chapter 400 or chapter 429.
5258	Section 117.  Subsection (1) of section 768.735, Florida
5259	Statutes, is amended to read:
5260	768.735  Punitive damages; exceptions; limitation.--
5261	(1)  Sections 768.72(2)-(4), 768.725, and 768.73 do not
5262	apply to any civil action based upon child abuse, abuse of the
5263	elderly under chapter 415, or abuse of the developmentally
5264	disabled. Such actions are governed by applicable statutes and
5265	controlling judicial precedent. This section does not apply to
5266	claims brought pursuant to s. 400.023 or s. 429.29 s. 400.429.
5267	Section 118.  Paragraph (h) of subsection (1) of section
5268	893.13, Florida Statutes, is amended to read:
5269	893.13  Prohibited acts; penalties.--
5270	(1)
5271	(h)  Except as authorized by this chapter, it is unlawful
5272	for any person to sell, manufacture, or deliver, or possess with
5273	intent to sell, manufacture, or deliver, a controlled substance
5274	in, on, or within 1,000 feet of the real property comprising an
5275	assisted living facility, as that term is used in chapter 429
5276	400. Any person who violates this paragraph with respect to:
5277	1.  A controlled substance named or described in s.
5278	893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.
5279	commits a felony of the first degree, punishable as provided in
5280	s. 775.082, s. 775.083, or s. 775.084.
5281	2.  A controlled substance named or described in s.
5282	893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6.,
5283	(2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) commits a felony of
5284	the second degree, punishable as provided in s. 775.082, s.
5285	775.083, or s. 775.084.
5286	Section 119.  Paragraph (a) of subsection (4) of section
5287	943.0585, Florida Statutes, is amended to read:
5288	943.0585  Court-ordered expunction of criminal history
5289	records.--The courts of this state have jurisdiction over their
5290	own procedures, including the maintenance, expunction, and
5291	correction of judicial records containing criminal history
5292	information to the extent such procedures are not inconsistent
5293	with the conditions, responsibilities, and duties established by
5294	this section. Any court of competent jurisdiction may order a
5295	criminal justice agency to expunge the criminal history record
5296	of a minor or an adult who complies with the requirements of
5297	this section. The court shall not order a criminal justice
5298	agency to expunge a criminal history record until the person
5299	seeking to expunge a criminal history record has applied for and
5300	received a certificate of eligibility for expunction pursuant to
5301	subsection (2). A criminal history record that relates to a
5302	violation of s. 393.135, s. 394.4593, s. 787.025, chapter 794,
5303	s. 796.03, s. 800.04, s. 817.034, s. 825.1025, s. 827.071,
5304	chapter 839, s. 847.0133, s. 847.0135, s. 847.0145, s. 893.135,
5305	s. 916.1075, or a violation enumerated in s. 907.041 may not be
5306	expunged, without regard to whether adjudication was withheld,
5307	if the defendant was found guilty of or pled guilty or nolo
5308	contendere to the offense, or if the defendant, as a minor, was
5309	found to have committed, or pled guilty or nolo contendere to
5310	committing, the offense as a delinquent act. The court may only
5311	order expunction of a criminal history record pertaining to one
5312	arrest or one incident of alleged criminal activity, except as
5313	provided in this section. The court may, at its sole discretion,
5314	order the expunction of a criminal history record pertaining to
5315	more than one arrest if the additional arrests directly relate
5316	to the original arrest. If the court intends to order the
5317	expunction of records pertaining to such additional arrests,
5318	such intent must be specified in the order. A criminal justice
5319	agency may not expunge any record pertaining to such additional
5320	arrests if the order to expunge does not articulate the
5321	intention of the court to expunge a record pertaining to more
5322	than one arrest. This section does not prevent the court from
5323	ordering the expunction of only a portion of a criminal history
5324	record pertaining to one arrest or one incident of alleged
5325	criminal activity. Notwithstanding any law to the contrary, a
5326	criminal justice agency may comply with laws, court orders, and
5327	official requests of other jurisdictions relating to expunction,
5328	correction, or confidential handling of criminal history records
5329	or information derived therefrom. This section does not confer
5330	any right to the expunction of any criminal history record, and
5331	any request for expunction of a criminal history record may be
5332	denied at the sole discretion of the court.
5333	(4)  EFFECT OF CRIMINAL HISTORY RECORD EXPUNCTION.--Any
5334	criminal history record of a minor or an adult which is ordered
5335	expunged by a court of competent jurisdiction pursuant to this
5336	section must be physically destroyed or obliterated by any
5337	criminal justice agency having custody of such record; except
5338	that any criminal history record in the custody of the
5339	department must be retained in all cases. A criminal history
5340	record ordered expunged that is retained by the department is
5341	confidential and exempt from the provisions of s. 119.07(1) and
5342	s. 24(a), Art. I of the State Constitution and not available to
5343	any person or entity except upon order of a court of competent
5344	jurisdiction. A criminal justice agency may retain a notation
5345	indicating compliance with an order to expunge.
5346	(a)  The person who is the subject of a criminal history
5347	record that is expunged under this section or under other
5348	provisions of law, including former s. 893.14, former s. 901.33,
5349	and former s. 943.058, may lawfully deny or fail to acknowledge
5350	the arrests covered by the expunged record, except when the
5351	subject of the record:
5352	1.  Is a candidate for employment with a criminal justice
5353	agency;
5354	2.  Is a defendant in a criminal prosecution;
5355	3.  Concurrently or subsequently petitions for relief under
5356	this section or s. 943.059;
5357	4.  Is a candidate for admission to The Florida Bar;
5358	5.  Is seeking to be employed or licensed by or to contract
5359	with the Department of Children and Family Services or the
5360	Department of Juvenile Justice or to be employed or used by such
5361	contractor or licensee in a sensitive position having direct
5362	contact with children, the developmentally disabled, the aged,
5363	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
5364	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
5365	409.175(2)(i), s. 415.102(4), s. 916.106(10) and (13), s.
5366	985.407, or chapter 400, or chapter 429; or
5367	6.  Is seeking to be employed or licensed by the Department
5368	of Education, any district school board, any university
5369	laboratory school, any charter school, any private or parochial
5370	school, or any local governmental entity that licenses child
5371	care facilities.
5372	Section 120.  Paragraph (a) of subsection (4) of section
5373	943.059, Florida Statutes, is amended to read:
5374	943.059  Court-ordered sealing of criminal history
5375	records.--The courts of this state shall continue to have
5376	jurisdiction over their own procedures, including the
5377	maintenance, sealing, and correction of judicial records
5378	containing criminal history information to the extent such
5379	procedures are not inconsistent with the conditions,
5380	responsibilities, and duties established by this section. Any
5381	court of competent jurisdiction may order a criminal justice
5382	agency to seal the criminal history record of a minor or an
5383	adult who complies with the requirements of this section. The
5384	court shall not order a criminal justice agency to seal a
5385	criminal history record until the person seeking to seal a
5386	criminal history record has applied for and received a
5387	certificate of eligibility for sealing pursuant to subsection
5388	(2). A criminal history record that relates to a violation of s.
5389	393.135, s. 394.4593, s. 787.025, chapter 794, s. 796.03, s.
5390	800.04, s. 817.034, s. 825.1025, s. 827.071, chapter 839, s.
5391	847.0133, s. 847.0135, s. 847.0145, s. 893.135, s. 916.1075, or
5392	a violation enumerated in s. 907.041 may not be sealed, without
5393	regard to whether adjudication was withheld, if the defendant
5394	was found guilty of or pled guilty or nolo contendere to the
5395	offense, or if the defendant, as a minor, was found to have
5396	committed or pled guilty or nolo contendere to committing the
5397	offense as a delinquent act. The court may only order sealing of
5398	a criminal history record pertaining to one arrest or one
5399	incident of alleged criminal activity, except as provided in
5400	this section. The court may, at its sole discretion, order the
5401	sealing of a criminal history record pertaining to more than one
5402	arrest if the additional arrests directly relate to the original
5403	arrest. If the court intends to order the sealing of records
5404	pertaining to such additional arrests, such intent must be
5405	specified in the order. A criminal justice agency may not seal
5406	any record pertaining to such additional arrests if the order to
5407	seal does not articulate the intention of the court to seal
5408	records pertaining to more than one arrest. This section does
5409	not prevent the court from ordering the sealing of only a
5410	portion of a criminal history record pertaining to one arrest or
5411	one incident of alleged criminal activity. Notwithstanding any
5412	law to the contrary, a criminal justice agency may comply with
5413	laws, court orders, and official requests of other jurisdictions
5414	relating to sealing, correction, or confidential handling of
5415	criminal history records or information derived therefrom. This
5416	section does not confer any right to the sealing of any criminal
5417	history record, and any request for sealing a criminal history
5418	record may be denied at the sole discretion of the court.
5419	(4)  EFFECT OF CRIMINAL HISTORY RECORD SEALING.--A criminal
5420	history record of a minor or an adult which is ordered sealed by
5421	a court of competent jurisdiction pursuant to this section is
5422	confidential and exempt from the provisions of s. 119.07(1) and
5423	s. 24(a), Art. I of the State Constitution and is available only
5424	to the person who is the subject of the record, to the subject's
5425	attorney, to criminal justice agencies for their respective
5426	criminal justice purposes, or to those entities set forth in
5427	subparagraphs (a)1., 4., 5., and 6. for their respective
5428	licensing and employment purposes.
5429	(a)  The subject of a criminal history record sealed under
5430	this section or under other provisions of law, including former
5431	s. 893.14, former s. 901.33, and former s. 943.058, may lawfully
5432	deny or fail to acknowledge the arrests covered by the sealed
5433	record, except when the subject of the record:
5434	1.  Is a candidate for employment with a criminal justice
5435	agency;
5436	2.  Is a defendant in a criminal prosecution;
5437	3.  Concurrently or subsequently petitions for relief under
5438	this section or s. 943.0585;
5439	4.  Is a candidate for admission to The Florida Bar;
5440	5.  Is seeking to be employed or licensed by or to contract
5441	with the Department of Children and Family Services or the
5442	Department of Juvenile Justice or to be employed or used by such
5443	contractor or licensee in a sensitive position having direct
5444	contact with children, the developmentally disabled, the aged,
5445	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
5446	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
5447	409.175(2)(i), s. 415.102(4), s. 415.103, s. 916.106(10) and
5448	(13), s. 985.407, or chapter 400, or chapter 429; or
5449	6.  Is seeking to be employed or licensed by the Department
5450	of Education, any district school board, any university
5451	laboratory school, any charter school, any private or parochial
5452	school, or any local governmental entity that licenses child
5453	care facilities.
5454	Section 121.  The Division of Statutory Revision of the
5455	Office of Legislative Services is requested to prepare a
5456	reviser's bill for introduction at a subsequent session of the
5457	Legislature to conform the Florida Statutes to changes made by
5458	this act.
5459	Section 122.  This act shall take effect July 1, 2006.

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