| 1 | Representative Ausley offered the following: |
| 2 |
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| 3 | Amendment (with directory and title amendments) |
| 4 | Remove lines 2352-2594 and insert: |
| 5 | (4) The department shall notify the Advocacy Center for |
| 6 | Persons with Disabilities, Inc., as to every report of death or |
| 7 | serious injury of a client of the department who is a child with |
| 8 | a disability within 48 hours after the department commences its |
| 9 | investigation. Notification shall include the name of the |
| 10 | alleged victim; the name of the alleged perpetrator; the |
| 11 | complete address, telephone number, and approximate age of each |
| 12 | subject of the investigation; a brief description of the abuse |
| 13 | or neglect, including physical, mental, or sexual injuries; a |
| 14 | description of the victim's disability; and the relationship of |
| 15 | the victim to the alleged perpetrator. For purposes of this |
| 16 | subsection, "serious injury" means an emergency medical |
| 17 | condition as defined in s. 395.002(8) or an injury to an |
| 18 | individual that requires emergency services and care as defined |
| 19 | in s. 395.002(9) or admission to an ambulatory surgical center |
| 20 | as defined in s. 395.002(3) or a hospital as defined in s. |
| 21 | 395.002(12) Florida local advocacy council in the appropriate |
| 22 | district of the department as to every report of institutional |
| 23 | child abuse, abandonment, or neglect in the district in which a |
| 24 | client of the department is alleged or shown to have been |
| 25 | abused, abandoned, or neglected, which notification shall be |
| 26 | made within 48 hours after the department commences its |
| 27 | investigation. |
| 28 | Section 20. Paragraph (v) of subsection (1) of section |
| 29 | 215.22, Florida Statutes, is redesignated as paragraph (u), and |
| 30 | present paragraph (u) of that subsection is amended to read: |
| 31 | 215.22 Certain income and certain trust funds exempt.-- |
| 32 | (1) The following income of a revenue nature or the |
| 33 | following trust funds shall be exempt from the appropriation |
| 34 | required by s. 215.20(1): |
| 35 | (u) The Florida Center for Nursing Trust Fund. |
| 36 | Section 21. Paragraph (c) of subsection (5) and subsection |
| 37 | (12) of section 394.459, Florida Statutes, are amended to read: |
| 38 | 394.459 Rights of patients.-- |
| 39 | (5) COMMUNICATION, ABUSE REPORTING, AND VISITS.-- |
| 40 | (c) Each facility must permit immediate access to any |
| 41 | patient, subject to the patient's right to deny or withdraw |
| 42 | consent at any time, by the patient's family members, guardian, |
| 43 | guardian advocate, representative, Florida statewide or local |
| 44 | advocacy council, or attorney, unless such access would be |
| 45 | detrimental to the patient. If a patient's right to communicate |
| 46 | or to receive visitors is restricted by the facility, written |
| 47 | notice of such restriction and the reasons for the restriction |
| 48 | shall be served on the patient, the patient's attorney, and the |
| 49 | patient's guardian, guardian advocate, or representative; and |
| 50 | such restriction shall be recorded on the patient's clinical |
| 51 | record with the reasons therefor. The restriction of a patient's |
| 52 | right to communicate or to receive visitors shall be reviewed at |
| 53 | least every 7 days. The right to communicate or receive visitors |
| 54 | shall not be restricted as a means of punishment. Nothing in |
| 55 | this paragraph shall be construed to limit the provisions of |
| 56 | paragraph (d). |
| 57 | (12) POSTING OF NOTICE OF RIGHTS OF PATIENTS.--Each |
| 58 | facility shall post a notice listing and describing, in the |
| 59 | language and terminology that the persons to whom the notice is |
| 60 | addressed can understand, the rights provided in this section. |
| 61 | This notice shall include a statement that provisions of the |
| 62 | federal Americans with Disabilities Act apply and the name and |
| 63 | telephone number of a person to contact for further information. |
| 64 | This notice shall be posted in a place readily accessible to |
| 65 | patients and in a format easily seen by patients. This notice |
| 66 | shall include the telephone number numbers of the Florida local |
| 67 | advocacy council and Advocacy Center for Persons with |
| 68 | Disabilities, Inc. |
| 69 | Section 22. Paragraph (d) of subsection (2) of section |
| 70 | 394.4597, Florida Statutes, is amended to read: |
| 71 | 394.4597 Persons to be notified; patient's |
| 72 | representative.-- |
| 73 | (2) INVOLUNTARY PATIENTS.-- |
| 74 | (d) When the receiving or treatment facility selects a |
| 75 | representative, first preference shall be given to a health care |
| 76 | surrogate, if one has been previously selected by the patient. |
| 77 | If the patient has not previously selected a health care |
| 78 | surrogate, the selection, except for good cause documented in |
| 79 | the patient's clinical record, shall be made from the following |
| 80 | list in the order of listing: |
| 81 | 1. The patient's spouse. |
| 82 | 2. An adult child of the patient. |
| 83 | 3. A parent of the patient. |
| 84 | 4. The adult next of kin of the patient. |
| 85 | 5. An adult friend of the patient. |
| 86 | 6. The appropriate Florida local advocacy council as |
| 87 | provided in s. 402.166. |
| 88 | Section 23. Subsection (1) of section 394.4598, Florida |
| 89 | Statutes, is amended to read: |
| 90 | 394.4598 Guardian advocate.-- |
| 91 | (1) The administrator may petition the court for the |
| 92 | appointment of a guardian advocate based upon the opinion of a |
| 93 | psychiatrist that the patient is incompetent to consent to |
| 94 | treatment. If the court finds that a patient is incompetent to |
| 95 | consent to treatment and has not been adjudicated incapacitated |
| 96 | and a guardian with the authority to consent to mental health |
| 97 | treatment appointed, it shall appoint a guardian advocate. The |
| 98 | patient has the right to have an attorney represent him or her |
| 99 | at the hearing. If the person is indigent, the court shall |
| 100 | appoint the office of the public defender to represent him or |
| 101 | her at the hearing. The patient has the right to testify, cross- |
| 102 | examine witnesses, and present witnesses. The proceeding shall |
| 103 | be recorded either electronically or stenographically, and |
| 104 | testimony shall be provided under oath. One of the professionals |
| 105 | authorized to give an opinion in support of a petition for |
| 106 | involuntary placement, as described in s. 394.4655 or s. |
| 107 | 394.467, must testify. A guardian advocate must meet the |
| 108 | qualifications of a guardian contained in part IV of chapter |
| 109 | 744, except that a professional referred to in this part, an |
| 110 | employee of the facility providing direct services to the |
| 111 | patient under this part, a departmental employee, or a facility |
| 112 | administrator, or member of the Florida local advocacy council |
| 113 | shall not be appointed. A person who is appointed as a guardian |
| 114 | advocate must agree to the appointment. |
| 115 | Section 24. Paragraph (b) of subsection (2) of section |
| 116 | 394.4599, Florida Statutes, is amended to read: |
| 117 | 394.4599 Notice.-- |
| 118 | (2) INVOLUNTARY PATIENTS.-- |
| 119 | (b) A receiving facility shall give prompt notice of the |
| 120 | whereabouts of a patient who is being involuntarily held for |
| 121 | examination, by telephone or in person within 24 hours after the |
| 122 | patient's arrival at the facility, unless the patient requests |
| 123 | that no notification be made. Contact attempts shall be |
| 124 | documented in the patient's clinical record and shall begin as |
| 125 | soon as reasonably possible after the patient's arrival. Notice |
| 126 | that a patient is being admitted as an involuntary patient shall |
| 127 | be given to the Florida local advocacy council no later than the |
| 128 | next working day after the patient is admitted. |
| 129 | Section 25. Subsection (5) of section 394.4615, Florida |
| 130 | Statutes, is amended to read: |
| 131 | 394.4615 Clinical records; confidentiality.-- |
| 132 | (5) Information from clinical records may be used by the |
| 133 | Agency for Health Care Administration and, the department, and |
| 134 | the Florida advocacy councils for the purpose of monitoring |
| 135 | facility activity and complaints concerning facilities. |
| 136 | Section 26. Paragraphs (h) and (i) of subsection (2) of |
| 137 | section 400.0065, Florida Statutes, are redesignated as |
| 138 | paragraphs (g) and (h), respectively, and present paragraph (g) |
| 139 | of that subsection is amended to read: |
| 140 | 400.0065 State Long-Term Care Ombudsman; duties and |
| 141 | responsibilities.-- |
| 142 | (2) The State Long-Term Care Ombudsman shall have the duty |
| 143 | and authority to: |
| 144 | (g) Enter into a cooperative agreement with the Statewide |
| 145 | Advocacy Council for the purpose of coordinating and avoiding |
| 146 | duplication of advocacy services provided to residents. |
| 147 | Section 27. Paragraph (a) of subsection (2) of section |
| 148 | 400.118, Florida Statutes, is amended to read: |
| 149 | 400.118 Quality assurance; early warning system; |
| 150 | monitoring; rapid response teams.-- |
| 151 | (2)(a) The agency shall establish within each district |
| 152 | office one or more quality-of-care monitors, based on the number |
| 153 | of nursing facilities in the district, to monitor all nursing |
| 154 | facilities in the district on a regular, unannounced, aperiodic |
| 155 | basis, including nights, evenings, weekends, and holidays. |
| 156 | Quality-of-care monitors shall visit each nursing facility at |
| 157 | least quarterly. Priority for additional monitoring visits shall |
| 158 | be given to nursing facilities with a history of resident care |
| 159 | deficiencies. Quality-of-care monitors shall be registered |
| 160 | nurses who are trained and experienced in nursing facility |
| 161 | regulation, standards of practice in long-term care, and |
| 162 | evaluation of patient care. Individuals in these positions shall |
| 163 | not be deployed by the agency as a part of the district survey |
| 164 | team in the conduct of routine, scheduled surveys, but shall |
| 165 | function solely and independently as quality-of-care monitors. |
| 166 | Quality-of-care monitors shall assess the overall quality of |
| 167 | life in the nursing facility and shall assess specific |
| 168 | conditions in the facility directly related to resident care, |
| 169 | including the operations of internal quality improvement and |
| 170 | risk management programs and adverse incident reports. The |
| 171 | quality-of-care monitor shall include in an assessment visit |
| 172 | observation of the care and services rendered to residents and |
| 173 | formal and informal interviews with residents, family members, |
| 174 | facility staff, resident guests, volunteers, other regulatory |
| 175 | staff, and representatives of a long-term care ombudsman council |
| 176 | or Florida advocacy council. |
| 177 | Section 28. Subsections (13) and (20) of section 400.141, |
| 178 | Florida Statutes, are amended to read: |
| 179 | 400.141 Administration and management of nursing home |
| 180 | facilities.--Every licensed facility shall comply with all |
| 181 | applicable standards and rules of the agency and shall: |
| 182 | (13) Publicly display a poster provided by the agency |
| 183 | containing the names, addresses, and telephone numbers for the |
| 184 | state's abuse hotline, the State Long-Term Care Ombudsman, the |
| 185 | Agency for Health Care Administration consumer hotline, the |
| 186 | Advocacy Center for Persons with Disabilities, the Florida |
| 187 | Statewide Advocacy Council, and the Medicaid Fraud Control Unit, |
| 188 | with a clear description of the assistance to be expected from |
| 189 | each. |
| 190 | (20) Maintain general and professional liability insurance |
| 191 | coverage that is in force at all times. In lieu of general and |
| 192 | professional liability insurance coverage, a state-designated |
| 193 | teaching nursing home and its affiliated assisted living |
| 194 | facilities created under s. 430.80 may demonstrate proof of |
| 195 | financial responsibility as provided in s. 430.80(3)(h). |
| 196 |
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| 197 | Facilities that have been awarded a Gold Seal under the program |
| 198 | established in s. 400.235 may develop a plan to provide |
| 199 | certified nursing assistant training as prescribed by federal |
| 200 | regulations and state rules and may apply to the agency for |
| 201 | approval of their program. |
| 202 | Section 29. Paragraph (a) of subsection (1) of section |
| 203 | 415.1034, Florida Statutes, is amended to read: |
| 204 | 415.1034 Mandatory reporting of abuse, neglect, or |
| 205 | exploitation of vulnerable adults; mandatory reports of death.-- |
| 206 | (1) MANDATORY REPORTING.-- |
| 207 | (a) Any person, including, but not limited to, any: |
| 208 | 1. Physician, osteopathic physician, medical examiner, |
| 209 | chiropractic physician, nurse, paramedic, emergency medical |
| 210 | technician, or hospital personnel engaged in the admission, |
| 211 | examination, care, or treatment of vulnerable adults; |
| 212 | 2. Health professional or mental health professional other |
| 213 | than one listed in subparagraph 1.; |
| 214 | 3. Practitioner who relies solely on spiritual means for |
| 215 | healing; |
| 216 | 4. Nursing home staff; assisted living facility staff; |
| 217 | adult day care center staff; adult family-care home staff; |
| 218 | social worker; or other professional adult care, residential, or |
| 219 | institutional staff; |
| 220 | 5. State, county, or municipal criminal justice employee |
| 221 | or law enforcement officer; |
| 222 | 6. An employee of the Department of Business and |
| 223 | Professional Regulation conducting inspections of public lodging |
| 224 | establishments under s. 509.032; |
| 225 | 7. Florida advocacy council member or Long-term care |
| 226 | ombudsman council member; or |
| 227 | 8. Bank, savings and loan, or credit union officer, |
| 228 | trustee, or employee, |
| 229 |
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| 230 | who knows, or has reasonable cause to suspect, that a vulnerable |
| 231 | adult has been or is being abused, neglected, or exploited shall |
| 232 | immediately report such knowledge or suspicion to the central |
| 233 | abuse hotline. |
| 234 | Section 30. Subsection (1) of section 415.104, Florida |
| 235 | Statutes, is amended to read: |
| 236 | 415.104 Protective investigations of cases of abuse, |
| 237 | neglect, or exploitation of vulnerable adults; transmittal of |
| 238 | records to state attorney.-- |
| 239 | (1)(a) The department shall, upon receipt of a report |
| 240 | alleging abuse, neglect, or exploitation of a vulnerable adult, |
| 241 | begin within 24 hours a protective investigation of the facts |
| 242 | alleged therein. If a caregiver refuses to allow the department |
| 243 | to begin a protective investigation or interferes with the |
| 244 | conduct of such an investigation, the appropriate law |
| 245 | enforcement agency shall be contacted for assistance. If, during |
| 246 | the course of the investigation, the department has reason to |
| 247 | believe that the abuse, neglect, or exploitation is perpetrated |
| 248 | by a second party, the appropriate law enforcement agency and |
| 249 | state attorney shall be orally notified. The department and the |
| 250 | law enforcement agency shall cooperate to allow the criminal |
| 251 | investigation to proceed concurrently with, and not be hindered |
| 252 | by, the protective investigation. The department shall make a |
| 253 | preliminary written report to the law enforcement agencies |
| 254 | within 5 working days after the oral report. The department |
| 255 | shall, within 24 hours after receipt of the report, notify the |
| 256 | appropriate Florida local advocacy council, or long-term care |
| 257 | ombudsman council, when appropriate, that an alleged abuse, |
| 258 | neglect, or exploitation perpetrated by a second party has |
| 259 | occurred. Notice to the Florida local advocacy council or long- |
| 260 | term care ombudsman council may be accomplished orally or in |
| 261 | writing and shall include the name and location of the |
| 262 | vulnerable adult alleged to have been abused, neglected, or |
| 263 | exploited and the nature of the report. |
| 264 | (b) The department shall notify the Advocacy Center for |
| 265 | Persons with Disabilities, Inc., as to every report of death or |
| 266 | serious injury of a vulnerable adult that occurs in or at a |
| 267 | facility, program, or service that is operated, licensed, or |
| 268 | monitored by the Agency for Persons with Disabilities, the |
| 269 | Department of Children and Family Services, or the Agency for |
| 270 | Health Care Administration within 48 hours after the department |
| 271 | commences its investigation. Notification shall include the name |
| 272 | of the alleged victim; the name of the alleged perpetrator; the |
| 273 | complete address, telephone number, and approximate age of each |
| 274 | subject of the investigation; a brief description of the abuse |
| 275 | or neglect, including physical, mental, or sexual injuries; a |
| 276 | description of the victim's disability or infirmity; and the |
| 277 | relationship of the victim to the alleged perpetrator. For |
| 278 | purposes of this paragraph, "serious injury" means an emergency |
| 279 | medical condition as defined in s. 395.002(8) or an injury to an |
| 280 | individual that requires emergency services and care as defined |
| 281 | in s. 395.002(9) or admission to an ambulatory surgical center |
| 282 | as defined in s. 395.002(3) or a hospital as defined in s. |
| 283 | 395.002(12). |
| 284 |
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| 285 |
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| 286 |
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| 287 | ----------------------------------------------------- |
| 288 | D I R E C T O R Y A M E N D M E N T |
| 289 | Remove lines 2346-2348 and insert: |
| 290 | Section 19. Subsection (4) of section 39.302, Florida |
| 291 | Statutes, is |
| 292 |
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| 293 |
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| 294 |
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| 295 | ----------------------------------------------------- |
| 296 | T I T L E A M E N D M E N T |
| 297 | Remove lines 106-109 and insert: |
| 298 | Florida Center for Nursing Trust Fund; amending s. 39.302, F.S.; |
| 299 | requiring the Department of Children and Family Services to |
| 300 | provide notice to the Advocacy Center for Persons with |
| 301 | Disabilities, Inc., of reports of death or serious injury of a |
| 302 | client of the department who is a child with a disability within |
| 303 | a specified timeframe; providing for contents of the notice; |
| 304 | defining the term "serious injury"; amending s. 415.104, F.S.; |
| 305 | conforming provisions to changes made by the act; requiring the |
| 306 | Department of Children and Family Services to provide notice to |
| 307 | the Advocacy Center for Persons with Disabilities, Inc., of |
| 308 | reports of death or serious injury of a vulnerable adult that |
| 309 | occurs in a facility, program, or service operated, licensed, or |
| 310 | monitored by the Agency for Persons with Disabilities, the |
| 311 | Department of Children and Family Services, or the Agency for |
| 312 | Health Care Administration within a specified timeframe; |
| 313 | providing for contents of the notice; defining the term "serious |
| 314 | injury"; amending ss. 39.001, 39.0011, 39.202, 215.22, 394.459, |
| 315 | 394.4597, 394.4598, 394.4599, 394.4615, 400.0065, 400.118, |
| 316 | 400.141, 415.1034, 415.1055, 415.106, 415.107, |