HB 1295

1	A bill to be entitled
2	An act relating to assisted living communities; amending
3	s. 400.141, F.S.; revising licensing requirements for
4	registered pharmacists under contract with a nursing home
5	and related health care facilities; amending ss. 408.802,
6	408.806, 408.820, 408.831, and 408.832, F.S.; revising
7	applicability of part II of ch. 408, F.S., relating to
8	health care licensing procedures; creating part I of ch.
9	429, F.S., the "Assisted Care Communities Licensing
10	Procedures Act"; creating s. 429.001, F.S.; providing a
11	short title and providing purpose; creating s. 429.002,
12	F.S.; providing definitions; creating s. 429.003, F.S.;
13	requiring providers to have and display a license;
14	providing limitations; creating s. 429.004, F.S.;
15	establishing license fees and conditions for assessment
16	thereof; providing a method for calculating annual
17	adjustment of fees; providing for inspection fees;
18	providing that fees are nonrefundable; limiting the total
19	amount of fees that may be collected; creating s. 429.005,
20	F.S.; providing a license application process; requiring
21	specified information to be included on the application;
22	requiring payment of late fees under certain
23	circumstances; requiring inspections; providing an
24	exception; authorizing the Agency for Health Care
25	Administration to establish procedures and rules for
26	electronic transmission of required information; creating
27	s. 429.006, F.S.; providing procedures for change of
28	ownership; requiring the transferor to notify the agency
29	in writing within a specified time period; providing for
30	duties and liability of the transferor; providing for
31	maintenance of certain records; creating s. 429.007, F.S.;
32	providing license categories and requirements therefor;
33	creating s. 429.008, F.S.; requiring background screening
34	of specified employees; providing for submission of proof
35	of compliance under certain circumstances; providing
36	conditions for granting provisional and standard licenses;
37	providing an exception to screening requirements; creating
38	s. 429.009, F.S.; providing minimum licensure
39	requirements; providing procedures for discontinuance of
40	operation and surrender of license; requiring forwarding
41	of client records; requiring publication of a notice of
42	discontinuance of operation of a licensee; providing for
43	statewide toll-free telephone numbers for reporting
44	complaints and abusive, neglectful, and exploitative
45	practices; requiring proof of legal right to occupy
46	property, proof of insurance, and proof of financial
47	viability, under certain circumstances; requiring
48	disclosure of information relating to financial
49	instability; providing a penalty; creating s. 429.0105,
50	F.S.; providing for inspections and investigations to
51	determine compliance; providing that inspection reports
52	are public records; requiring retention of records for a
53	specified period of time; creating s. 429.011, F.S.;
54	prohibiting certain unlicensed activity by a person or
55	entity operating or maintaining an assisted care
56	community; requiring an unlicensed person or entity to
57	cease activity; providing penalties; requiring reporting
58	of unlicensed activity; creating s. 429.012, F.S.;
59	authorizing the agency to impose administrative fines;
60	creating s. 429.013, F.S.; providing conditions for the
61	agency to impose a moratorium or emergency suspension on a
62	licensee; requiring notice; creating s. 429.014, F.S.;
63	providing grounds for denial or revocation of a license or
64	change-of-ownership application; providing conditions to
65	continue operation; exempting renewal applications from
66	provisions requiring the agency to approve or deny an
67	application within a specified period of time, under
68	certain circumstances; creating s. 429.015, F.S.;
69	authorizing the agency to institute injunction
70	proceedings, under certain circumstances; creating s.
71	429.016, F.S.; providing basis for review of
72	administrative proceedings challenging agency licensure
73	enforcement action; creating s. 429.017, F.S.; authorizing
74	the Department of Elderly Affairs to adopt rules;
75	providing a timeframe for compliance; creating s. 429.018,
76	F.S.; requiring a licensee to have an emergency operations
77	plan; authorizing a licensee to temporarily exceed
78	licensed capacity under emergency conditions for a
79	specified period of time; requiring agency approval of
80	overcapacity requests under certain circumstances;
81	authorizing the agency to issue an inactive license in
82	certain locations under specified conditions; requiring
83	the licensee to provide notice to residents; authorizing
84	the department to adopt rules relating to emergency
85	management and to report that information to the agency;
86	creating s. 429.019, F.S.; providing grounds for denial or
87	revocation of a license or change-of-ownership
88	application; providing conditions to continue operation;
89	exempting renewal applications from provisions requiring
90	the agency to approve or deny an application within a
91	specified period of time, under certain circumstances;
92	amending s. 429.01, F.S.; creating the "Assisted Living
93	Residences Act"; revising the purpose of the act; amending
94	s. 429.02, F.S.; providing, revising, and deleting
95	definitions; amending ss. 429.04, 429.07, 429.075, 429.08,
96	429.11, and 429.17, F.S.; revising provisions relating to
97	licensing of assisted living residences; conforming
98	terminology and references; amending s. 429.12, F.S.;
99	revising provisions relating to the sale or transfer of
100	ownership of an assisted living residence; amending s.
101	429.14, F.S.; revising provisions relating to
102	administrative penalties; amending s. 429.174, F.S.;
103	providing applicability of background screening of
104	personnel; amending ss. 429.177, 429.18, 429.20, 429.22,
105	429.24, 429.44, 429.47, and 429.49, F.S.; conforming
106	references; amending s. 429.178, F.S.; providing safety
107	requirements for residences serving persons with
108	Alzheimer's disease or other related disorders; repealing
109	a provision relating to a facility's responsibility for
110	the payment of certain training fees; amending s. 429.19,
111	F.S.; revising Agency for Health Care Administration
112	procedures for the imposition of fines for violations of
113	ch. 429, F.S.; amending s. 429.195, F.S.; permitting the
114	licensee of an assisted living residences to provide
115	monetary rewards to residents who refer certain
116	individuals to the residence; amending s. 429.23, F.S.;
117	revising adverse incidents reporting requirements;
118	amending s. 429.255, F.S.; permitting certain licensed
119	persons to provide limited nursing services; deleting
120	rulemaking authority of the Department of Elderly Affairs
121	with regard to cardiopulmonary resuscitation in assisted
122	living residences; repealing s. 1 of chapter 2010-200,
123	Laws of Florida, which provides for future implementation
124	of provisions relating to the use of automated external
125	defibrillators in assisted living facilities; amending s.
126	429.256, F.S.; providing additional guidelines for the
127	assistance with self-administration of medication;
128	amending s. 429.26, F.S.; removing a requirement that a
129	facility notify a licensed physician when a resident
130	exhibits certain signs of dementia, cognitive impairment,
131	or change of condition; revising the persons who are
132	authorized to notify a resident's case manager about
133	examining the resident; amending s. 429.27, F.S.; revising
134	provisions relating to the property and personal effects
135	of residents; amending s. 429.275, F.S.; removing
136	rulemaking authority of the Department of Elderly Affairs
137	over financial records, personnel procedures, accounting
138	procedures, reporting procedures, and insurance coverage
139	for residents of assisted living residences; amending s.
140	429.28, F.S., relating to the resident bill of rights;
141	revising provisions relating to termination of residency;
142	removing responsibilities of the agency for conducting
143	compliance surveys and complaint investigations; amending
144	s. 429.293, F.S.; permitting the use of an arbitration
145	process to resolve a resident's claim of a rights
146	violation or negligence; amending s. 429.294, F.S.;
147	authorizing the release of copies of a resident's records
148	to specified persons under certain conditions; providing
149	limits on the frequency of the release of such records;
150	amending s. 429.298, F.S.; providing limits on the amount
151	of punitive damages; removing a provision that provides
152	for a criminal investigation with a finding of liability
153	for punitive damages; removing a provision that provides
154	for admissibility of findings in subsequent civil and
155	criminal actions; providing that the punitive damages
156	awarded are divided between the claimant and the Health
157	Care Trust Fund rather than the Quality of Long-Term Care
158	Facility Improvement Trust Fund; revising the percentages
159	of the division of the settlement amount; amending s.
160	429.31, F.S.; revising responsibilities of an
161	administrator for providing notice of the closing of an
162	assisted living residence; amending s. 429.34, F.S.;
163	removing authorization for state and local long-term care
164	ombudsman councils to enter and inspect residences;
165	amending s. 429.35, F.S.; removing requirement that the
166	agency forward results of residence inspections to certain
167	entities; amending s. 429.41, F.S.; revising rulemaking
168	authority regarding resident care and maintenance of
169	residences; conforming terminology to changes made by the
170	act; amending s. 429.42, F.S.; revising provisions
171	relating to pharmacy services; amending s. 429.445, F.S.;
172	removing a requirement that assisted living residences
173	submit certain information to the agency prior to
174	commencing construction to expand the residence; amending
175	s. 429.52, F.S.; revising training and education
176	requirements for certain administrators, residence staff,
177	and other licensed professionals; requiring trainers
178	certified by the department to meet continuing education
179	requirements and standards; providing conditions for
180	suspension or revocation of a trainer's certificate;
181	amending s. 429.53, F.S.; removing provisions relating to
182	preconstruction approvals and reviews and agency
183	consultations; repealing s. 429.54, F.S., relating to the
184	collection of information regarding the actual cost of
185	providing services in assisted living facilities and local
186	subsidies; amending s. 429.65, F.S.; revising and deleting
187	definitions; amending ss. 429.67 and 429.69, F.S.;
188	revising licensure requirements for adult family-care
189	homes; amending s. 429.71, F.S.; removing a provision
190	authorizing the agency to request a plan to remedy
191	violations by adult family-care homes; amending s. 429.73,
192	F.S.; removing agency rulemaking authority over adult
193	family-care homes; amending ss. 429.75, 429.83, 429.85,
194	429.87, 429.905, 429.907, 429.909, 429.913, 429.919,
195	429.925, and 429.927, F.S.; conforming terminology and
196	references; amending s. 429.81, F.S.; specifying that
197	residency agreements require a resident to provide 30
198	days' written notice of intent to terminate residency;
199	amending s. 429.901, F.S.; removing definitions; amending
200	s. 429.911, F.S.; revising provisions relating to the
201	denial, suspension, and revocation of adult day care
202	center licenses; amending s. 429.915, F.S.; revising
203	provisions relating to conditional licenses to remove a
204	requirement for a plan of correction to accompany the
205	license; amending s. 429.917, F.S.; conforming references;
206	removing a training requirement; creating s. 429.926,
207	F.S.; providing an exemption from applicability of certain
208	minimum licensure requirements to adult day care centers;
209	amending s. 429.929, F.S.; removing agency rulemaking
210	authority over adult daycare centers; conforming a cross-
211	reference; amending ss. 101.62, 101.655, 159.27, 196.1975,
212	202.125, 205.1965, 252.357, 252.385, 380.06, 381.006,
213	381.0072, 381.0303, 394.455, 394.4574, 394.462, 394.4625,
214	394.75, 394.9082, 400.0060, 400.0069, 400.0074, 400.0239,
215	400.148, 400.1755, 400.464, 400.471, 400.474, 400.497,
216	400.506, 400.6045, 400.605, 400.609, 400.701, 400.925,
217	400.93, 405.01, 408.033, 409.212, 409.221, 409.906,
218	409.907, 409.912, 410.031, 410.034, 410.502, 415.102,
219	415.1034, 415.1051, 415.107, 420.626, 430.071, 430.601,
220	456.053, 458.348, 459.025, 468.1695, 468.505, 553.73,
221	627.94073, 633.021, 633.022, 641.31, 651.083, 825.101,
222	893.055, and 893.13, F.S.; conforming cross-references;
223	providing an effective date.
224
225	Be It Enacted by the Legislature of the State of Florida:
226
227	Section 1.  Paragraph (d) of subsection (1) of section
228	400.141, Florida Statutes, is amended to read:
229	400.141  Administration and management of nursing home
230	facilities.-
231	(1)  Every licensed facility shall comply with all
232	applicable standards and rules of the agency and shall:
233	(d)  Provide for resident use of a community pharmacy as
234	specified in s. 400.022(1)(q). Any other law to the contrary
235	notwithstanding, a registered pharmacist licensed in Florida,
236	that is under contract with a facility licensed under this
237	chapter or chapter 429, shall repackage a nursing facility
238	resident's bulk prescription medication which has been packaged
239	by another pharmacist licensed in any state in the United States
240	into a unit dose system compatible with the system used by the
241	nursing facility, if the pharmacist is requested to offer such
242	service. In order to be eligible for the repackaging, a resident
243	or the resident's spouse must receive prescription medication
244	benefits provided through a former employer as part of his or
245	her retirement benefits, a qualified pension plan as specified
246	in s. 4972 of the Internal Revenue Code, a federal retirement
247	program as specified under 5 C.F.R. s. 831, or a long-term care
248	policy as defined in s. 627.9404(1). A pharmacist who correctly
249	repackages and relabels the medication and the nursing facility
250	which correctly administers such repackaged medication under
251	this paragraph may not be held liable in any civil or
252	administrative action arising from the repackaging. In order to
253	be eligible for the repackaging, a nursing facility resident for
254	whom the medication is to be repackaged shall sign an informed
255	consent form provided by the facility which includes an
256	explanation of the repackaging process and which notifies the
257	resident of the immunities from liability provided in this
258	paragraph. A pharmacist who repackages and relabels prescription
259	medications, as authorized under this paragraph, may charge a
260	reasonable fee for costs resulting from the implementation of
261	this provision.
262	Section 2.  Present subsections (15) through (30) of
263	section 408.802, Florida Statutes, are renumbered as subsections
264	(14) through (27), respectively, and subsections (14), (18), and
265	(20) of that section, are amended to read:
266	408.802  Applicability.-The provisions of this part apply
267	to the provision of services that require licensure as defined
268	in this part and to the following entities licensed, registered,
269	or certified by the agency, as described in chapters 112, 383,
270	390, 394, 395, 400, 429, 440, 483, and 765:
271	(14)  Assisted living facilities, as provided under part I
272	of chapter 429.
273	(18)  Adult day care centers, as provided under part III of
274	chapter 429.
275	(20)  Adult family-care homes, as provided under part II of
276	chapter 429.
277	Section 3.  Paragraph (c) of subsection (7) of section
278	408.806, Florida Statutes, is amended to read:
279	408.806  License application process.-
280	(7)
281	(c)  If an inspection is required by the authorizing
282	statute for a license application other than an initial
283	application, the inspection must be unannounced. This paragraph
284	does not apply to inspections required pursuant to ss. 383.324,
285	395.0161(4), 429.67(6), and 483.061(2).
286	Section 4.  Present subsections (14) through (28) of
287	section 408.820, Florida Statutes, are renumbered as subsections
288	(13) through (25), respectively, and subsections (13), (17), and
289	(18) of that section, are amended to read:
290	408.820  Exemptions.-Except as prescribed in authorizing
291	statutes, the following exemptions shall apply to specified
292	requirements of this part:
293	(13)  Assisted living facilities, as provided under part I
294	of chapter 429, are exempt from s. 408.810(10).
295	(17)  Adult day care centers, as provided under part III of
296	chapter 429, are exempt from s. 408.810(10).
297	(18)  Adult family-care homes, as provided under part II of
298	chapter 429, are exempt from s. 408.810(7)-(10).
299	Section 5.  Subsection (3) of section 408.831, Florida
300	Statutes, is amended to read:
301	408.831  Denial, suspension, or revocation of a license,
302	registration, certificate, or application.-
303	(3)  This section provides standards of enforcement
304	applicable to all entities licensed or regulated by the Agency
305	for Health Care Administration. This section controls over any
306	conflicting provisions of chapters 39, 383, 390, 391, 394, 395,
307	400, 408, 429, 468, 483, and 765 or rules adopted pursuant to
308	those chapters.
309	Section 6.  Section 408.832, Florida Statutes, is amended
310	to read:
311	408.832  Conflicts.-In case of conflict between the
312	provisions of this part and the authorizing statutes governing
313	the licensure of health care providers by the Agency for Health
314	Care Administration found in s. 112.0455 and chapters 383, 390,
315	394, 395, 400, 429, 440, 483, and 765, the provisions of this
316	part shall prevail.
317	Section 7.  Part I of chapter 429, Florida Statutes,
318	consisting of sections 429.01, 429.02, 429.04, 429.07, 429.075,
319	429.08, 429.11, 429.12, 429.14, 429.17, 429.174, 429.176,
320	429.177, 429.178, 429.18, 429.19, 429.195, 429.20, 429.22,
321	429.23, 429.24, 429.255, 429.256, 429.26, 429.27, 429.275,
322	429.28, 429.29, 429.293, 429.294, 429.295, 429.296, 429.297,
323	429.298, 429.31, 429.34, 429.35, 429.41, 429.42, 429.44,
324	429.445, 429.47, 429.49, 429.52, 429.53, and 429.54, Florida
325	Statutes, and entitled "ASSISTED LIVING FACILITIES," is
326	designated as part II of chapter 429, Florida Statutes, and
327	renamed "ASSISTED LIVING RESIDENCES."
328	Section 8.  Part II of chapter 429, Florida Statutes,
329	consisting of sections 429.60, 429.63, 429.65, 429.67, 429.69,
330	429.71, 429.73, 429.75, 429.81, 429.83, 429.85, and 429.87,
331	Florida Statutes, is designated as part III of chapter 429,
332	Florida Statutes, and entitled "ADULT FAMILY-CARE HOMES."
333	Section 9.  Part III of chapter 429, Florida Statutes,
334	consisting of sections 429.90, 429.901, 429.903, 429.905,
335	429.907, 429.909, 429.911, 429.913, 429.915, 429.917, 429.919,
336	429.925, 429.927, 429.929, and 429.931, Florida Statutes, is
337	designated as part IV of chapter 429, Florida Statutes, and
338	entitled "ADULT DAY CARE CENTERS."
339	Section 10.  Sections 429.001, 429.002, 429.003, 429.004,
340	429.005, 429.006, 429.007, 429.008, 429.009, 429.0105, 429.011,
341	429.012, 429.013, 429.014, 429.015, 429.016, 429.017, 429.018,
342	and 429.019, Florida Statutes, are designated as part I of
343	chapter 429, Florida Statutes, entitled the "ASSISTED CARE
344	COMMUNITIES LICENSING PROCEDURE ACT," and created to read:
345	429.001  Short title; purpose.-
346	(1)  This part may be cited as the "Assisted Care
347	Communities Licensing Procedures Act."
348	(2)  The Legislature finds that assisted care communities
349	provide appropriate services for elderly persons and adults in
350	need of assistance with activities of daily living and allow
351	those persons to remain in their own homes or reside in a
352	residential homelike environment that is a community-based
353	social model with a health component rather than a medical or
354	nursing home facility. The Legislature further finds that the
355	goal of assisted care communities is to maximize a person's
356	dignity and independence and to support the person's ability to
357	remain in a familiar, nonmedical, residential homelike setting
358	for as long as is appropriate. Therefore, the Legislature
359	intends that assisted care communities be operated as
360	residential homelike environments with supportive services and
361	not as medical or nursing facilities and, as such, should not be
362	subject to the same regulations as medical or nursing facilities
363	but instead should be regulated in a less restrictive manner
364	that is appropriate for a residential, noninstitutional,
365	nonmedical setting.
366	429.002  Definitions.-As used in this part, the term:
367	(1)  "Agency" means the Agency for Health Care
368	Administration, which is the licensing agency under this
369	chapter.
370	(2)  "Applicant" means an individual, corporation,
371	partnership, firm, association, or governmental entity that
372	submits an application for a license to the agency.
373	(3)  "Assisted care community" means an assisted living
374	residence, adult family-care home, or adult day care center as
375	defined under this chapter.
376	(4)  "Change of ownership" means:
377	(a)  An event in which the licensee sells or otherwise
378	transfers its ownership to a different individual or entity as
379	evidenced by a change in federal employer identification number
380	or taxpayer identification number; or
381	(b)  An event in which 51 percent or more of the ownership,
382	shares, membership, or controlling interest of a licensee is in
383	any manner transferred or otherwise assigned. This paragraph
384	does not apply to a licensee that is publicly traded on a
385	recognized stock exchange.
386	(5)  "Controlling interest" means:
387	(a)  The applicant or licensee; or
388	(b)  A person or entity that has a 51-percent or greater
389	ownership interest in the applicant or licensee.
390	(6)  "Department" means the Department of Elderly Affairs.
391	(7)  "License" means any license issued by the agency under
392	this chapter.
393	(8)  "Licensee" means an individual, corporation,
394	partnership, firm, association, governmental entity, or other
395	entity that is issued a license by the agency. The licensee is
396	legally responsible for all aspects of the licensee's operation
397	regulated by the agency under this chapter.
398	(9)  "Moratorium" means a prohibition on the acceptance of
399	new admissions.
400	(10)  "Participant" means a recipient of basic services or
401	supportive and optional services provided by an adult day care
402	center under part IV.
403	(11)  "Resident" means a person residing in and receiving
404	care from an assisted living residence under part II or an adult
405	family-care home under part III.
406	429.003  License required; display.-
407	(1)  It is unlawful to operate an assisted care community
408	without first obtaining a license from the agency.
409	(2)  The license must be displayed in a conspicuous place
410	readily visible to the public who enter at the address that
411	appears on the license and is valid only in the hands of the
412	licensee to whom it is issued and may not be sold, assigned, or
413	otherwise transferred, voluntarily or involuntarily. The license
414	is valid only for the licensee and the location for which the
415	license is issued.
416	429.004  Fees required; adjustments.-License fees must be
417	reasonably calculated by the agency to cover its costs in
418	carrying out its responsibilities under this chapter and
419	applicable rules, including the cost of licensure, inspection,
420	and regulation of assisted care communities.
421	(1)  License fees shall be adjusted to provide for biennial
422	licensure under agency rules.
423	(2)  The agency shall annually adjust license fees,
424	including fees paid per bed, by not more than the change in the
425	Consumer Price Index based on the 12 months immediately
426	preceding the increase.
427	(3)  License fees are nonrefundable.
428	(4)  When a change is reported that requires issuance of a
429	license, a fee may be assessed. The fee must be based on the
430	actual cost of processing and issuing the license.
431	(5)  The agency may charge a fee when a licensee requests a
432	duplicate license. The fee may not exceed the actual cost of
433	duplication and postage and may not exceed $25.
434	(6)  Total fees collected may not exceed the cost of
435	administering this chapter and applicable rules.
436	429.005  License application process.-
437	(1)  An application for licensure must be made to the
438	agency on forms furnished by the agency, submitted under oath,
439	and accompanied by the appropriate fee in order to be accepted
440	and considered timely. The application must contain information
441	required by this chapter and applicable rules and must include:
442	(a)  The name, address, and social security number of:
443	1.  The applicant;
444	2.  The administrator or a similarly titled person who is
445	responsible for the day-to-day operation of the assisted care
446	community;
447	3.  The financial officer or similarly titled person who is
448	responsible for the financial operation of the assisted care
449	community; and
450	4.  Each controlling interest if the applicant or
451	controlling interest is an individual.
452	(b)  The name, address, and federal employer identification
453	number or taxpayer identification number of the applicant and
454	each controlling interest if the applicant or controlling
455	interest is not an individual.
456	(c)  The name by which the assisted care community is to be
457	known.
458	(d)  The total number of beds or capacity requested, as
459	applicable.
460	(e)  The name of the person or persons under whose
461	management or supervision the licensee will operate and the name
462	of the administrator, if required.
463	(f)  If the applicant offers continuing care agreements as
464	defined in chapter 651, proof shall be furnished that the
465	applicant has obtained a certificate of authority as required
466	for operation under chapter 651.
467	(g)  Other information, including satisfactory inspection
468	results, that the agency finds necessary to determine the
469	ability of the applicant to carry out its responsibilities under
470	this part, and applicable rules.
471	(h)  An affidavit, under penalty of perjury, as required in
472	s. 435.05(3), stating compliance with the provisions of this
473	section and chapter 435.
474	(2)(a)  The applicant for a renewal license must submit an
475	application that must be received by the agency at least 60 days
476	but no more than 120 days before the expiration of the current
477	license. An application received more than 120 days before the
478	expiration of the current license shall be returned to the
479	applicant. If the renewal application and fee are received
480	before the license expiration date, the license shall not be
481	deemed to have expired if the license expiration date occurs
482	during the agency's review of the renewal application.
483	(b)  The applicant for initial licensure due to a change of
484	ownership must submit an application that must be received by
485	the agency at least 60 days before the date of change of
486	ownership.
487	(c)  For any other application or request, the applicant
488	must submit an application or request that must be received by
489	the agency at least 60 days but no more than 120 days before the
490	requested effective date, unless otherwise specified in this
491	chapter or applicable rules. An application received more than
492	120 days before the requested effective date shall be returned
493	to the applicant.
494	(d)  The agency shall notify the licensee by mail or
495	electronically at least 90 days before the expiration of a
496	license that a renewal license is necessary to continue
497	operation. The failure to timely submit a renewal application
498	and license fee shall result in a $50 per day late fee charged
499	to the licensee by the agency; however, the aggregate amount of
500	the late fee may not exceed 50 percent of the licensure fee or
501	$500, whichever is less. If an application is received after the
502	required filing date and exhibits a hand-canceled postmark
503	obtained from a United States post office dated on or before the
504	required filing date, no fine will be levied.
505	(3)(a)  Upon receipt of an application for a license, the
506	agency shall examine the application and, within 30 days after
507	receipt, notify the applicant in writing or electronically of
508	any apparent errors or omissions and request any additional
509	information required.
510	(b)  Requested information omitted from an application for
511	licensure, license renewal, or change of ownership, other than
512	an inspection, must be filed with the agency within 21 days
513	after the agency's request for omitted information or the
514	application shall be deemed incomplete and shall be withdrawn
515	from further consideration and the fees shall be forfeited.
516	(c)  Within 60 days after the receipt of a complete
517	application, the agency shall approve or deny the application.
518	(4)(a)  Licensees subject to the provisions of this part
519	shall be issued biennial licenses unless conditions of the
520	license category specify a shorter license period.
521	(b)  Each license issued shall indicate the name of the
522	licensee, the license type, the date the license is effective,
523	the expiration date of the license, and the maximum capacity of
524	the assisted care community.
525	(5)  In accordance with this chapter and applicable rules,
526	proof of compliance with s. 429.009 must be submitted with an
527	application for licensure.
528	(6)(a)  An applicant must demonstrate compliance with the
529	requirements in this chapter and applicable rules during an
530	inspection pursuant to s. 429.0105, as required by part II, part
531	III, or part IV.
532	(b)  If an inspection is required under this chapter for a
533	license application other than an initial application, the
534	inspection must be unannounced. This paragraph does not apply to
535	inspections required pursuant to s. 429.67(6).
536	(c)  If a licensee is not available when an inspection is
537	attempted, the application shall be denied. This paragraph does
538	not apply to inspections required pursuant to s. 429.67(6).
539	(7)  The agency may establish procedures for the electronic
540	notification and submission of required information, including,
541	but not limited to:
542	(a)  Licensure applications.
543	(b)  Required signatures.
544	(c)  Payment of fees.
545	(d)  Notarization of applications.
546	429.006  Change of ownership.-Whenever a change of
547	ownership occurs:
548	(1)  The transferor shall notify the agency in writing at
549	least 60 days before the anticipated date of the change of
550	ownership.
551	(2)  The transferee shall make application to the agency
552	for a license within the timeframes required in s. 429.005.
553	(3)  The transferor shall be responsible and liable for:
554	(a)  The lawful operation of the licensee and the welfare
555	of the residents served until the date the transferee is
556	licensed by the agency.
557	(b)  Any and all penalties imposed against the transferor
558	for violations occurring before the date of change of ownership.
559	(4)  Any restriction on licensure, including a conditional
560	license existing at the time of a change of ownership, shall
561	remain in effect until the agency determines that the grounds
562	for the restriction are corrected.
563	(5)  The transferee shall maintain records of the
564	transferor as required under this chapter and applicable rules,
565	including:
566	(a)  All resident and participant records.
567	(b)  Inspection reports.
568	(c)  All records required to be maintained pursuant to s.
569	409.913, if applicable.
570	429.007  License categories.-
571	(1)  STANDARD LICENSE.-A standard license may be issued to
572	an applicant at the time of initial licensure, license renewal,
573	or change of ownership. A standard license shall be issued when
574	the applicant is in compliance with all statutory requirements
575	and agency rules. Unless sooner revoked, a standard license
576	expires 2 years after the date of issue.
577	(2)  PROVISIONAL LICENSE.-A provisional license shall be
578	issued to an applicant applying for an initial license or for a
579	change of ownership. A provisional license must be limited in
580	duration to a specific period of time, up to 6 months, as
581	determined by the agency.
582	(3)  INACTIVE LICENSES.-A licensee may submit a request to
583	the agency for an inactive license or to extend a previously
584	approved inactive period. Such request must include a written
585	justification for the inactive license with the beginning and
586	ending dates of inactivity specified, a plan for the transfer of
587	any residents, and the appropriate licensure fees. The agency
588	may not accept a request that is submitted after initiating
589	closure, after any suspension of service, or after notifying
590	residents of closure or suspension of service, unless the action
591	is a result of a disaster at the licensed premises. For the
592	purposes of this section, the term "disaster" means a sudden
593	emergency occurrence beyond the control of the licensee, whether
594	natural, technological, or manmade, which renders the licensee
595	inoperable at the premises. Upon agency approval, the licensee
596	shall notify residents of any necessary discharge or transfer as
597	required by part II or part III or applicable rules. The
598	beginning of the inactive license period is the date the
599	licensee ceases operations. The end of the inactive license
600	period shall become the license expiration date. All licensure
601	fees must be current, must be paid in full, and may be prorated.
602	Reactivation of an inactive license requires the approval of a
603	renewal application, including payment of licensure fees and
604	agency inspections indicating compliance with all requirements
605	of this part, parts II and III, and applicable rules.
606	(4)  TEMPORARY LICENSE.-An applicant against whom a
607	proceeding denying, suspending, or revoking a license is pending
608	at the time of license renewal shall be issued a temporary
609	license effective until final action not subject to further
610	appeal.
611	(5)  OTHER LICENSES.-Other types of license categories may
612	be issued pursuant to this chapter or applicable rules.
613	429.008  Background screening; prohibited offenses.-
614	(1)  Level 2 background screening pursuant to chapter 435
615	must be conducted through the agency on each of the following
616	persons, who are considered staff members or employees for the
617	purposes of conducting screening under chapter 435:
618	(a)  The licensee, if an individual.
619	(b)  The administrator or a similarly titled person who is
620	responsible for the day-to-day operation of the assisted living
621	community licensed pursuant to this chapter.
622	(c)  The financial officer or similarly titled individual
623	who is responsible for the financial operation of the licensee.
624	(d)  Any person who is a controlling interest who has been
625	convicted of any offense prohibited by s. 435.04. The licensee
626	shall submit to the agency a description and explanation of the
627	conviction when applying for a license.
628	(e)  Any person, as required by this chapter, seeking
629	employment with a licensee who is expected to, or whose
630	responsibilities may require him or her to, provide personal
631	care or services directly to residents or have access to
632	resident funds, personal property, or living areas; and any
633	person, as required by this chapter, contracting with a licensee
634	whose responsibilities require him or her to provide personal
635	care or personal services directly to residents. Evidence of
636	contractor screening may be retained by the contractor's
637	employer or the licensee.
638	(2)  Every 5 years after his or her licensure, employment,
639	or entry into a contract in a capacity that under subsection (1)
640	would require level 2 background screening under chapter 435,
641	each such person must submit to level 2 background rescreening
642	as a condition of retaining such license or continuing in such
643	employment or contractual status. For any such rescreening, the
644	agency shall request the Department of Law Enforcement to
645	forward the person's fingerprints to the Federal Bureau of
646	Investigation for a national criminal history record check. If
647	the fingerprints of such a person are not retained by the
648	Department of Law Enforcement under s. 943.05(2)(g), the person
649	must file a complete set of fingerprints with the agency and the
650	agency shall forward the fingerprints to the Department of Law
651	Enforcement for state processing, and the Department of Law
652	Enforcement shall forward the fingerprints to the Federal Bureau
653	of Investigation for a national criminal history record check.
654	The fingerprints may be retained by the Department of Law
655	Enforcement under s. 943.05(2)(g). Proof of compliance with
656	level 2 screening standards submitted within the previous 5
657	years to meet any licensee or professional licensure
658	requirements of the agency, the Department of Health, the Agency
659	for Persons with Disabilities, the Department of Children and
660	Family Services, or the Department of Financial Services for an
661	applicant for a certificate of authority or provisional
662	certificate of authority to operate a continuing care retirement
663	community under chapter 651 satisfies the requirements of this
664	section if the person subject to screening has not been
665	unemployed for more than 90 days and such proof is accompanied,
666	under penalty of perjury, by an affidavit of compliance with the
667	provisions of chapter 435 and this section using forms provided
668	by the agency.
669	(3)  All fingerprints must be provided in electronic
670	format. Screening results shall be reviewed by the agency with
671	respect to the offenses specified in s. 435.04 and this section,
672	and the qualifying or disqualifying status of the person named
673	in the request shall be maintained in a database. The qualifying
674	or disqualifying status of the person named in the request shall
675	be posted on a secure website for retrieval by the licensee or
676	designated agent on the licensee's behalf.
677	(4)  In addition to the offenses listed in s. 435.04, all
678	persons required to undergo background screening pursuant to
679	this chapter must not have an arrest awaiting final disposition
680	for, must not have been found guilty of, regardless of
681	adjudication, or entered a plea of guilty to, and must not have
682	been adjudicated delinquent and the record must not have been
683	sealed or expunged for any of the following offenses or any
684	similar offense of another jurisdiction:
685	(a)  This chapter, if the offense was a felony.
686	(b)  Section 409.920, relating to Medicaid provider fraud.
687	(c)  Section 409.9201, relating to Medicaid fraud.
688	(d)  Section 741.28, relating to domestic violence.
689	(e)  Section 817.034, relating to fraudulent acts through
690	mail, wire, radio, electromagnetic, photoelectronic, or
691	photooptical systems.
692	(f)  Section 817.234, relating to false and fraudulent
693	insurance claims.
694	(g)  Section 817.505, relating to patient brokering.
695	(h)  Section 817.568, relating to criminal use of personal
696	identification information.
697	(i)  Section 817.60, relating to obtaining a credit card
698	through fraudulent means.
699	(j)  Section 817.61, relating to fraudulent use of credit
700	cards, if the offense was a felony.
701	(k)  Section 831.01, relating to forgery.
702	(l)  Section 831.02, relating to uttering forged
703	instruments.
704	(m)  Section 831.07, relating to forging bank bills,
705	checks, drafts, or promissory notes.
706	(n)  Section 831.09, relating to uttering forged bank
707	bills, checks, drafts, or promissory notes.
708	(o)  Section 831.30, relating to fraud in obtaining
709	medicinal drugs.
710	(p)  Section 831.31, relating to the sale, manufacture,
711	delivery, or possession with the intent to sell, manufacture, or
712	deliver any counterfeit controlled substance, if the offense was
713	a felony.
714
715	A person who serves as a controlling interest of, is employed
716	by, or contracts with a licensee on July 31, 2011, who has been
717	screened and qualified according to standards specified in s.
718	435.03 or s. 435.04 must be rescreened by July 31, 2016. The
719	agency may adopt rules to establish a schedule to stagger the
720	implementation of the required rescreening over the 5-year
721	period, beginning July 31, 2011, through July 31, 2016. If, upon
722	rescreening, such person has a disqualifying offense that was
723	not a disqualifying offense at the time of the last screening,
724	but is a current disqualifying offense and was committed before
725	the last screening, he or she may apply for an exemption from
726	the appropriate licensing agency and, if agreed to by the
727	employer, may continue to perform his or her duties until the
728	licensing agency renders a decision on the application for
729	exemption if the person is eligible to apply for an exemption
730	and the exemption request is received by the agency within 30
731	days after receipt of the rescreening results by the person.
732	(5)(a)  As provided in chapter 435, the agency may grant an
733	exemption from disqualification to a person who is subject to
734	this section and who:
735	1.  Does not have an active professional license or
736	certification from the Department of Health; or
737	2.  Has an active professional license or certification
738	from the Department of Health but is not providing a service
739	within the scope of that license or certification.
740	(b)  As provided in chapter 435, the appropriate regulatory
741	board within the Department of Health, or the department itself
742	if there is no board, may grant an exemption from
743	disqualification to a person who is subject to this section and
744	who has received a professional license or certification from
745	the Department of Health or a regulatory board within that
746	department and that person is providing a service within the
747	scope of his or her licensed or certified practice.
748	(6)  The agency and the Department of Health may adopt
749	rules pursuant to ss. 120.536(1) and 120.54 to implement this
750	section, chapter 435, and parts II, III, and IV requiring
751	background screening and to implement and adopt criteria
752	relating to retaining fingerprints pursuant to s. 943.05(2).
753	(7)  There is no unemployment compensation or other
754	monetary liability on the part of, and no cause of action for
755	damages arising against, an employer that, upon notice of a
756	disqualifying offense listed under chapter 435 or this section,
757	terminates the person against whom the report was issued,
758	whether or not that person has filed for an exemption with the
759	Department of Health or the agency.
760	429.009  Minimum licensure requirements.-In addition to the
761	licensure requirements specified in this chapter and applicable
762	rules, each applicant and licensee must comply with the
763	requirements of this section in order to obtain and maintain a
764	license.
765	(1)  An applicant for licensure must comply with the
766	background screening requirements of s. 429.008.
767	(2)  An applicant for licensure must provide a description
768	and explanation of any exclusions, suspensions, or terminations
769	of the applicant from the Medicaid program.
770	(3)  Unless otherwise specified in this chapter, or
771	applicable rules, any information required to be reported to the
772	agency must be submitted within 21 calendar days after the
773	report period or effective date of the information, whichever is
774	earlier, including, but not limited to, any change of:
775	(a)  Information contained in the most recent application
776	for licensure.
777	(b)  Required insurance or bonds.
778	(4)  Whenever a licensee discontinues operation:
779	(a)  The licensee must inform the agency not less than 30
780	days before the discontinuance of operation and inform residents
781	or participants of such discontinuance as required by this
782	chapter. Immediately upon discontinuance of operation, the
783	licensee shall surrender the license to the agency and the
784	license shall be canceled.
785	(b)  The licensee shall remain responsible for retaining
786	and appropriately distributing all records within the timeframes
787	prescribed in this chapter and applicable rules. In addition,
788	the licensee or, in the event of death or dissolution of a
789	licensee, the estate or agent of the licensee shall:
790	1.  Make arrangements to forward records for each resident
791	to one of the following, based upon the resident's choice: the
792	resident or the resident's legal representative, the resident's
793	attending physician, or the health care provider where the
794	resident currently receives services; or
795	2.  Cause a notice to be published in the newspaper of
796	greatest general circulation in the county in which the licensee
797	was located that advises residents of the discontinuance of the
798	licensed operation. The notice must inform residents that they
799	may obtain copies of their records and specify the name,
800	address, and telephone number of the person from whom the copies
801	of records may be obtained. The notice must appear at least once
802	a week for 4 consecutive weeks.
803	(5)(a)  On or before the first day services are provided to
804	a resident, a licensee must inform the resident and his or her
805	immediate family or representative, if appropriate, of the right
806	to report:
807	1.  Complaints. The statewide toll-free telephone number
808	for reporting complaints to the agency must be provided to
809	residents in a manner that is clearly legible and must include
810	the words: "To report a complaint regarding the services you
811	receive, please call toll-free (phone number)."
812	2.  Abusive, neglectful, or exploitative practices. The
813	statewide toll-free telephone number for the central abuse
814	hotline must be provided to residents in a manner that is
815	clearly legible and must include the words: "To report abuse,
816	neglect, or exploitation, please call toll-free (phone number)."
817	3.  Medicaid fraud. An agency-written description of
818	Medicaid fraud and the statewide toll-free telephone number for
819	the central Medicaid fraud hotline must be provided to residents
820	in a manner that is clearly legible and must include the words:
821	"To report suspected Medicaid fraud, please call toll-free
822	(phone number)."
823
824	The agency shall publish a minimum of a 90-day advance notice of
825	a change in the toll-free telephone numbers.
826	(b)  Each licensee shall establish appropriate policies and
827	procedures for providing such notice to residents.
828	(6)  An applicant must provide the agency with proof of the
829	applicant's legal right to occupy the property before a license
830	may be issued. Proof may include, but need not be limited to,
831	copies of warranty deeds, lease or rental agreements, contracts
832	for deeds, quitclaim deeds, or other such documentation.
833	(7)  If proof of insurance is required under this chapter,
834	that insurance must be in compliance with chapter 624, chapter
835	626, chapter 627, or chapter 628 and with agency rules.
836	(8)  Upon application for initial licensure or change of
837	ownership licensure, the applicant shall furnish satisfactory
838	proof of the applicant's financial ability to operate in
839	accordance with the requirements of this chapter and applicable
840	rules. The agency shall establish standards that require the
841	applicant to provide information concerning the applicant's
842	controlling interests. The agency shall also establish
843	documentation requirements, to be completed by each applicant,
844	that show anticipated revenues and expenditures, the basis for
845	financing the anticipated cash-flow requirements of the
846	licensee, and an applicant's access to contingency financing. A
847	current certificate of authority, pursuant to chapter 651, may
848	be provided as proof of financial ability to operate. The agency
849	may require a licensee to provide proof of financial ability to
850	operate at any time if there is evidence of financial
851	instability, including, but not limited to, unpaid expenses
852	necessary for the basic operations of the licensee.
853	(9)  A controlling interest may not withhold from the
854	agency any evidence of financial instability, including, but not
855	limited to, checks returned due to insufficient funds,
856	delinquent accounts, nonpayment of withholding taxes, unpaid
857	utility expenses, nonpayment for essential services, or adverse
858	court action concerning the financial viability of the licensee
859	or any other licensee licensed under this part that is under the
860	control of the controlling interest. Any person who violates
861	this subsection commits a misdemeanor of the second degree,
862	punishable as provided in s. 775.082 or s. 775.083. Each day of
863	continuing violation is a separate offense.
864	429.0105  Right of inspection; copies; inspection reports.-
865	(1)  An authorized officer or employee of the agency may
866	make or cause to be made any inspection or investigation deemed
867	necessary by the agency to determine the state of compliance
868	with this chapter and applicable rules. The right of inspection
869	extends to any business that the agency has reason to believe is
870	being operated without a license, but inspection of any business
871	suspected of being operated without the appropriate license may
872	not be made without the permission of the owner or person in
873	charge unless a warrant is first obtained from a circuit court.
874	Any application for a license issued under this chapter or
875	applicable rules constitutes permission for an appropriate
876	inspection to verify the information submitted on or in
877	connection with the application.
878	(a)  All inspections shall be unannounced, except as
879	specified in s. 429.005.
880	(b)  Inspections for relicensure shall be conducted
881	biennially except as specified under this chapter or applicable
882	rules.
883	(2)  The agency shall have access to and the licensee shall
884	provide, or if requested send, copies of all licensee records
885	required during an inspection or other review at no cost to the
886	agency, including records requested during an offsite review.
887	(3)  A violation must be corrected within 30 calendar days
888	after the licensee is notified of inspection results unless an
889	alternative timeframe is required or approved by the agency.
890	(4)(a)  Each licensee shall maintain as public information,
891	available upon request, records of all inspection reports
892	pertaining to that licensee that have been filed by the agency
893	unless those reports are exempt from or contain information that
894	is exempt from s. 119.07(1) and s. 24(a), Art. I of the State
895	Constitution or is otherwise made confidential by law. Copies of
896	such reports shall be retained in the records of the licensee
897	for at least 3 years following the date the reports are filed
898	and issued, regardless of a change of ownership.
899	(b)  A licensee shall, upon the request of any person who
900	has completed a written application with intent to be admitted
901	by such licensee, any person who is a resident, or any relative,
902	spouse, or guardian of any such person, furnish to the requester
903	a copy of the last inspection report pertaining to the licensee
904	that was issued by the agency if such report is used in lieu of
905	a licensure inspection.
906	429.011  Unlicensed activity.-
907	(1)  A person or entity may not offer or advertise services
908	that require licensure as defined by this chapter or applicable
909	rules to the public without obtaining a valid license from the
910	agency. A licenseholder may not advertise or hold out to the
911	public that he or she holds a license for other than that for
912	which he or she actually holds the license.
913	(2)  The operation or maintenance of an unlicensed assisted
914	care community is a violation of this chapter. Unlicensed
915	activity constitutes harm that materially affects the health,
916	safety, and welfare of residents or participants. The agency or
917	any state attorney may, in addition to other remedies provided
918	in this part, bring an action for an injunction to restrain such
919	violation, or to enjoin the future operation or maintenance of
920	the unlicensed assisted care community in violation of this
921	chapter, until compliance with this chapter and agency rules has
922	been demonstrated to the satisfaction of the agency.
923	(3)  It is unlawful for any person or entity to own,
924	operate, or maintain an assisted care community requiring
925	licensure pursuant to this chapter without obtaining a license.
926	If after receiving notification from the agency, such person or
927	entity fails to cease operation and apply for a license under
928	this chapter, the person or entity shall be subject to penalties
929	as prescribed under this chapter and applicable rules. Each day
930	of continued operation is a separate offense.
931	(4)  Any person or entity that fails to cease operation
932	after agency notification may be fined $1,000 for each day of
933	noncompliance.
934	(5)  When a controlling interest or licensee has an
935	interest in more than one entity and fails to license an entity
936	rendering services that require licensure pursuant to this
937	chapter, the agency may revoke all licenses and impose actions
938	under s. 429.013 and a fine of $1,000 per day, unless otherwise
939	specified under this chapter, against each licensee until such
940	time as the appropriate license is obtained for the unlicensed
941	operation.
942	(6)  In addition to granting injunctive relief pursuant to
943	subsection (2), if the agency determines that a person or entity
944	is operating or maintaining an assisted care community requiring
945	licensure pursuant to this chapter without obtaining a license
946	and determines that a condition exists that poses a threat to
947	the health, safety, or welfare of a resident or participant of
948	the person or entity, the person or entity is subject to the
949	same actions and fines imposed against a licensee as specified
950	in this chapter and agency rules.
951	(7)  Any person aware of the operation of an unlicensed
952	person or entity must report that person or entity to the
953	agency.
954	(8)  An assisted care community under construction is not
955	subject to the provisions of this section.
956	429.012  Administrative fines; violations.-As a penalty for
957	any violation of this chapter, or applicable rules, the agency
958	may impose an administrative fine pursuant to the provisions of
959	this chapter.
960	429.013  Moratorium; emergency suspension.-
961	(1)  The agency may impose an immediate moratorium or
962	emergency suspension as defined in s. 120.60 on any licensee if
963	the agency determines that any condition related to the licensee
964	presents a threat to the health, safety, or welfare of a
965	resident or participant.
966	(2)  A licensee, the license of which is denied or revoked,
967	may be subject to immediate imposition of a moratorium or
968	emergency suspension to run concurrently with licensure denial,
969	revocation, or injunction.
970	(3)  A moratorium or emergency suspension remains in effect
971	after a change of ownership, unless the agency has determined
972	that the conditions that created the moratorium, emergency
973	suspension, or denial of licensure have been corrected.
974	(4)  When a moratorium or emergency suspension is placed on
975	a licensee, notice of the action shall be posted and visible to
976	the public at the location of the licensee until the action is
977	lifted.
978	429.014  License or application denial; revocation.-
979	(1)  In addition to the grounds provided in part II, part
980	III, or part IV, grounds that may be used by the agency for
981	denying or revoking a license or change of ownership application
982	include any of the following actions by a controlling interest:
983	(a)  False representation of a material fact in the license
984	application or omission of any material fact from the
985	application.
986	(b)  An intentional or negligent act materially affecting
987	the health or safety of a resident or participant of an assisted
988	care community.
989	(c)  A violation of this chapter or applicable rules.
990	(d)  A demonstrated pattern of violations.
991	(e)  The applicant, licensee, or controlling interest has
992	been or is currently excluded, suspended, or terminated, for
993	cause, from participation in the Medicaid program.
994	(2)  If a licensee lawfully continues to operate while a
995	denial or revocation is pending in litigation, the licensee must
996	continue to meet all other requirements of this chapter and
997	applicable rules and must file subsequent renewal applications
998	for licensure and pay all licensure fees. The provisions of ss.
999	120.60(1) and 429.005(3)(c) shall not apply to renewal
1000	applications filed during the time period in which the
1001	litigation of the denial or revocation is pending until that
1002	litigation is final.
1003	(3)  An action under s. 429.013 or denial of the license of
1004	the transferor may be grounds for denial of a change of
1005	ownership application of the transferee.
1006	(4)  In addition to the grounds provided in authorizing
1007	statutes, the agency shall deny an application for a license or
1008	license renewal if the applicant or a person having a
1009	controlling interest in an applicant has been:
1010	(a)  Convicted of, or enters a plea of guilty to,
1011	regardless of adjudication, a felony under chapter 409, chapter
1012	817, or chapter 893, unless the sentence and any subsequent
1013	period of probation for such convictions or plea ended more than
1014	15 years before the date of the application;
1015	(b)  Terminated for cause from the Florida Medicaid program
1016	pursuant to s. 409.913, unless the applicant has been in good
1017	standing with the Florida Medicaid program for the most recent 5
1018	years; or
1019	(c)  Terminated for cause, pursuant to the appeals
1020	procedures established by the Florida Medicaid program, unless
1021	the applicant has been in good standing with the Florida
1022	Medicaid program for the most recent 5 years and the termination
1023	occurred at least 20 years before the date of the application.
1024	429.015  Injunctions.-
1025	(1)  In addition to the other powers provided by this
1026	chapter and applicable rules, the agency may institute
1027	injunction proceedings in a court of competent jurisdiction in
1028	the local jurisdiction of the residence to:
1029	(a)  Restrain or prevent the establishment or operation of
1030	a person or entity that does not have a license or is in
1031	violation of any provision of this chapter or applicable rules.
1032	The agency may also institute injunction proceedings in a court
1033	of competent jurisdiction when a violation of this chapter or
1034	applicable rules constitutes an emergency affecting the
1035	immediate health and safety of a resident.
1036	(b)  Enforce the provisions of this chapter or any minimum
1037	standard, rule, or order issued or entered into pursuant thereto
1038	when the attempt by the agency to correct a violation through
1039	administrative sanctions has failed or when the violation
1040	materially affects the health, safety, or welfare of residents
1041	or participants or involves any operation of an unlicensed
1042	assisted care community.
1043	(c)  Terminate the operation of a licensee when a violation
1044	of any provision of this chapter or any standard or rule adopted
1045	pursuant thereto exists that materially affects the health,
1046	safety, or welfare of a resident or participant.
1047	(2)  If action is necessary to protect a resident or
1048	participant of a licensee from an immediate, life-threatening
1049	situation, the court may allow a temporary injunction without
1050	bond upon proper proofs being made. If it appears by competent
1051	evidence or a sworn, substantiated affidavit that a temporary
1052	injunction should be issued, the court, pending the
1053	determination on final hearing, shall enjoin the operation of
1054	the licensee.
1055	429.016  Administrative proceedings.-Administrative
1056	proceedings challenging agency licensure enforcement action
1057	shall be reviewed on the basis of the facts and conditions that
1058	resulted in the agency action.
1059	429.017  Rules.-The department is authorized to adopt rules
1060	as necessary to administer this part. Any licensee that is in
1061	operation at the time of adoption of any applicable rule under
1062	this chapter shall be given a reasonable time under the
1063	particular circumstances, not to exceed 6 months after the date
1064	of such adoption, within which to comply with that rule, unless
1065	otherwise specified by rule.
1066	429.018  Emergency management planning; emergency
1067	operations; inactive license.-
1068	(1)  A licensee required by part II, part III, or part IV
1069	to have an emergency operations plan must designate a safety
1070	liaison to serve as the primary contact for emergency
1071	operations.
1072	(2)  An entity subject to this part may temporarily exceed
1073	its licensed capacity to act as a receiving licensee in
1074	accordance with an approved emergency operations plan for up to
1075	15 days. While in an overcapacity status, each licensee must
1076	furnish or arrange for appropriate care and services to all
1077	residents. In addition, the agency may approve requests for
1078	overcapacity in excess of 15 days, which approvals may be based
1079	upon satisfactory justification and need as provided by the
1080	receiving and sending licensees.
1081	(3)(a)  An inactive license may be issued to a licensee
1082	subject to this section when the licensee is located in a
1083	geographic area in which a state of emergency was declared by
1084	the Governor, if the licensee:
1085	1.  Suffered damage to its operation during the state of
1086	emergency.
1087	2.  Is currently licensed.
1088	3.  Does not have a provisional license.
1089	4.  Will be temporarily unable to provide services but is
1090	reasonably expected to resume services within 12 months.
1091	(b)  An inactive license may be issued for a period not to
1092	exceed 12 months but may be renewed by the agency for up to 12
1093	additional months upon demonstration to the agency of progress
1094	toward reopening. A request by a licensee for an inactive
1095	license or to extend the previously approved inactive period
1096	must be submitted in writing to the agency, accompanied by
1097	written justification for the inactive license, and must state
1098	the beginning and ending dates of inactivity and include a plan
1099	for the transfer of any residents and appropriate licensure
1100	fees. Upon agency approval, the licensee shall notify residents
1101	of any necessary discharge or transfer as required under this
1102	chapter or applicable rules. The beginning of the inactive
1103	licensure period shall be the date the licensee ceases
1104	operations. The end of the inactive period shall become the
1105	license expiration date, and all licensure fees must be current,
1106	must be paid in full, and may be prorated. Reactivation of an
1107	inactive license requires the prior approval by the agency of a
1108	renewal application, including payment of licensure fees and
1109	agency inspections indicating compliance with all requirements
1110	of this chapter and applicable rules and statutes.
1111	(4)  The department may adopt rules relating to emergency
1112	management planning, communications, and operations. Licensees
1113	providing residential services must utilize an online database
1114	approved by the agency to report information to the agency
1115	regarding the licensee's emergency status, planning, or
1116	operations.
1117	429.019  Denial, suspension, or revocation of a license or
1118	application.-
1119	(1)  In addition to any other remedies provided by law, the
1120	agency may deny an application or suspend or revoke the license
1121	of an assisted care community:
1122	(a)  If the applicant, licensee, or a licensee subject to
1123	this part that shares a common controlling interest with the
1124	applicant has failed to pay all outstanding fines, liens, or
1125	overpayments assessed by final order of the agency, not subject
1126	to further appeal, unless a repayment plan is approved by the
1127	agency; or
1128	(b)  For failure to comply with any repayment plan.
1129	(2)  In reviewing an application requesting a change of
1130	ownership or change of the licensee, the transferor shall,
1131	before agency approval of the change, repay or make arrangements
1132	to repay any amounts owed to the agency. The issuance of a
1133	license to the transferee shall be delayed until the transferor
1134	repays or makes arrangements to repay the amounts owed.
1135	Section 11.  Section 429.01, Florida Statutes, is amended
1136	to read:
1137	429.01  Short title; purpose.-
1138	(1)  This act may be cited as the "Assisted Living
1139	Residences Facilities Act."
1140	(2)  The purpose of this act is to promote the availability
1141	of appropriate services for elderly persons and adults with
1142	disabilities in the least restrictive and most homelike
1143	environment, to encourage the development of residences
1144	facilities that promote the dignity, individuality, privacy, and
1145	decisionmaking ability of such persons, to provide for the
1146	health, safety, and welfare of residents of assisted living
1147	residences facilities in the state, to promote continued
1148	improvement of such residences facilities, to encourage the
1149	development of innovative and affordable residences facilities
1150	particularly for persons with low to moderate incomes, to ensure
1151	that all agencies of the state cooperate in the protection of
1152	such residents, and to ensure that needed economic, social,
1153	mental health, health, and leisure services are made available
1154	to residents of such residences facilities through the efforts
1155	of the Agency for Health Care Administration, the Department of
1156	Elderly Affairs, the Department of Children and Family Services,
1157	the Department of Health, assisted living residences facilities,
1158	and other community agencies. To the maximum extent possible,
1159	appropriate community-based programs must be available to state-
1160	supported residents to augment the services provided in assisted
1161	living residences facilities. The Legislature recognizes that
1162	assisted living residences facilities are an important part of
1163	the continuum of long-term care in the state as community-based
1164	social models with a health component and not as medical or
1165	nursing facilities. In support of the goal of aging in place,
1166	the Legislature further recognizes that assisted living
1167	residences facilities should be operated and regulated as
1168	residential environments with supportive services and not as
1169	medical or nursing facilities and, as such, should not be
1170	subject to the same regulations as medical or nursing facilities
1171	but instead be regulated in a less restrictive manner that is
1172	appropriate for a residential, non-medical setting. The services
1173	available in these residences facilities, either directly or
1174	through contract or agreement, are intended to help residents
1175	remain as independent as possible. Regulations governing these
1176	residences facilities must be sufficiently flexible to allow the
1177	residences facilities to adopt policies that enable residents to
1178	age in place when resources are available to meet their needs
1179	and accommodate their preferences.
1180	(3)  The principle that a license issued under this part is
1181	a public trust and a privilege and is not an entitlement should
1182	guide the finder of fact or trier of law at any administrative
1183	proceeding or in a court action initiated by the Agency for
1184	Health Care Administration to enforce this part.
1185	Section 12.  Section 429.02, Florida Statutes, is amended
1186	to read:
1187	429.02  Definitions.-When used in this part, the term:
1188	(1)  "Activities of daily living" means functions and tasks
1189	for self-care, including ambulation, bathing, dressing, eating,
1190	grooming, and toileting, and other similar tasks.
1191	(2)  "Administrator" means an individual at least 21 years
1192	of age who is responsible for the operation and maintenance of
1193	an assisted living residence facility; for promoting the
1194	resident's dignity, autonomy, independence, and privacy in the
1195	least restrictive and most homelike setting consistent with the
1196	resident's preferences and physical and mental status; and for
1197	ensuring the appropriateness of continued placement of a
1198	resident, in consultation with the resident, resident's
1199	representative or designee, if applicable, and the resident's
1200	physician.
1201	(3)  "Agency" means the Agency for Health Care
1202	Administration.
1203	(3)(4)  "Aging in place" or "age in place" means the
1204	process of providing increased or adjusted services to a person
1205	to compensate for the physical or mental decline that may occur
1206	with the aging process, in order to maximize the person's
1207	dignity and independence and permit them to remain in a
1208	familiar, noninstitutional, residential environment for as long
1209	as possible, as determined by the individual, his or her
1210	physician and the administrator. Such services may be provided
1211	by residence facility staff, volunteers, family, or friends, or
1212	through contractual arrangements with a third party.
1213	(4)  "Arbitration" means a process whereby a neutral third
1214	person or panel, called an arbitrator or arbitration panel,
1215	considers the facts and arguments presented by parties and
1216	renders a decision which may be binding or nonbinding as
1217	provided for in chapter 44.
1218	(5)  "Assisted living residence facility" or "residence"
1219	means any residential setting that provides, directly or
1220	indirectly by means of contracts or arrangements, for a period
1221	exceeding 24 hours building or buildings, section or distinct
1222	part of a building, private home, boarding home, home for the
1223	aged, or other residential facility, whether operated for profit
1224	or not, which undertakes through its ownership or management to
1225	provide housing, meals, and one or more personal services that
1226	meet the resident's changing needs and preferences for a period
1227	exceeding 24 hours to one or more adults who are not relatives
1228	of the owner or administrator. "Residential setting" includes,
1229	but is not limited to, a building or buildings, section or
1230	distinct part of a building, private home, or other residence.
1231	(6)  "Chemical restraint" means a pharmacologic drug that
1232	physically limits, restricts, or deprives an individual of
1233	movement or mobility, and is used for discipline or convenience
1234	and not required for the treatment of medical symptoms.
1235	(7)  "Community living support plan" means a written
1236	document prepared by a mental health resident and the resident's
1237	mental health case manager in consultation with the
1238	administrator, or the administrator's designee, of an assisted
1239	living residence facility with a limited mental health license
1240	or the administrator's designee. A copy must be provided to the
1241	administrator. The plan must include information about the
1242	supports, services, and special needs of the resident which
1243	enable the resident to live in the assisted living residence
1244	facility and a method by which residence facility staff can
1245	recognize and respond to the signs and symptoms particular to
1246	that resident which indicate the need for professional services.
1247	(8)  "Cooperative agreement" means a written statement of
1248	understanding between a mental health care provider and the
1249	administrator of the assisted living residence facility with a
1250	limited mental health license in which a mental health resident
1251	is living. The agreement must specify directions for accessing
1252	emergency and after-hours care for the mental health resident. A
1253	single cooperative agreement may service all mental health
1254	residents who are clients of the same mental health care
1255	provider.
1256	(9)  "Department" means the Department of Elderly Affairs.
1257	(10)  "Emergency" means a situation, physical condition, or
1258	method of operation which presents imminent danger of death or
1259	serious physical or mental harm to residence facility residents.
1260	(11)  "Extended congregate care" means acts beyond those
1261	authorized in subsection (18) (16) that may be performed
1262	pursuant to part I of chapter 464 by persons licensed thereunder
1263	while carrying out their professional duties, and other
1264	supportive services which may be specified by rule. The purpose
1265	of such services is to enable residents to age in place in a
1266	residential environment despite mental or physical limitations
1267	that might otherwise disqualify them from residency in a
1268	residence facility licensed pursuant to this chapter under this
1269	part.
1270	(12)  "Guardian" means a person to whom the law has
1271	entrusted the custody and control of the person or property, or
1272	both, of a person who has been legally adjudged incapacitated.
1273	(13)  "Licensed residence" means an assisted living
1274	residence for which a licensee has been issued a license
1275	pursuant to this chapter.
1276	(14)(13)  "Limited nursing services" means acts that may be
1277	performed pursuant to part I of chapter 464 by persons licensed
1278	thereunder while carrying out their professional duties but
1279	limited to those acts which the department specifies by rule.
1280	Acts which may be specified by rule as allowable limited nursing
1281	services shall be for persons who meet the admission criteria
1282	established by the department for assisted living residences
1283	facilities and shall not be complex enough to require 24-hour
1284	nursing supervision and may include such services as the
1285	application and care of routine dressings, and care of casts,
1286	braces, and splints.
1287	(15)(14)  "Managed risk" means the process by which the
1288	residence facility staff discuss the service plan and the needs
1289	of the resident with the resident and, if applicable, the
1290	resident's representative or designee or the resident's
1291	surrogate, guardian, or attorney in fact, in such a way that the
1292	consequences of a decision, including any inherent risk, are
1293	explained to all parties and reviewed periodically in
1294	conjunction with the service plan, taking into account changes
1295	in the resident's status and the ability of the residence
1296	facility to respond accordingly.
1297	(16)(15)  "Mental health resident" means an individual who
1298	receives social security disability income due to a mental
1299	disorder as determined by the Social Security Administration or
1300	receives supplemental security income due to a mental disorder
1301	as determined by the Social Security Administration and receives
1302	optional state supplementation.
1303	(17)  "Person" means any individual, partnership,
1304	corporation, association, or governmental unit.
1305	(18)(16)  "Personal services" means direct physical
1306	assistance with or supervision of the activities of daily living
1307	and the self-administration of medication and other similar
1308	services which the department may define by rule. "Personal
1309	services" shall not be construed to mean the provision of
1310	medical, nursing, dental, or mental health services.
1311	(19)(17)  "Physical restraint" means a device which
1312	physically limits, restricts, or deprives an individual of
1313	movement or mobility, including, but not limited to, a half-bed
1314	rail, a full-bed rail, a geriatric chair, and a posey restraint.
1315	The term "physical restraint" shall also include any device
1316	which was not specifically manufactured as a restraint but which
1317	has been altered, arranged, or otherwise used for this purpose.
1318	The term shall not include bandage material used for the purpose
1319	of binding a wound or injury.
1320	(20)(18)  "Relative" means an individual who is the father,
1321	mother, stepfather, stepmother, son, daughter, brother, sister,
1322	grandmother, grandfather, great-grandmother, great-grandfather,
1323	grandson, granddaughter, uncle, aunt, first cousin, nephew,
1324	niece, husband, wife, father-in-law, mother-in-law, son-in-law,
1325	daughter-in-law, brother-in-law, sister-in-law, stepson,
1326	stepdaughter, stepbrother, stepsister, half brother, or half
1327	sister of an owner or administrator.
1328	(21)(19)  "Resident" means a person 18 years of age or
1329	older, residing in and receiving care from an assisted living
1330	residence a facility.
1331	(22)(20)  "Resident's representative or designee" means a
1332	person other than the owner, or an agent or employee of the
1333	assisted living residence facility, designated in writing by the
1334	resident, if legally competent, to receive notice of changes in
1335	the contract executed pursuant to s. 429.24; to receive notice
1336	of and to participate in meetings between the resident and the
1337	residence facility owner, administrator, or staff concerning the
1338	rights of the resident; to assist the resident in contacting the
1339	ombudsman council if the resident has a complaint against the
1340	residence facility; or to bring legal action on behalf of the
1341	resident pursuant to s. 429.29.
1342	(23)(21)  "Service plan" means a written plan, developed
1343	and agreed upon by the resident and, if applicable, the
1344	resident's representative or designee or the resident's
1345	surrogate, guardian, or attorney in fact, if any, and the
1346	administrator or the administrator's designee representing the
1347	residence facility, which addresses the unique physical and
1348	psychosocial needs, abilities, and personal preferences of each
1349	resident receiving extended congregate care services. The plan
1350	shall include a brief written description, in easily understood
1351	language, of what services shall be provided, who shall provide
1352	the services, when the services shall be rendered, and the
1353	purposes and benefits of the services.
1354	(24)(22)  "Shared responsibility" means exploring the
1355	options available to a resident within a residence facility and
1356	the risks involved with each option when making decisions
1357	pertaining to the resident's abilities, preferences, and service
1358	needs, thereby enabling the resident and, if applicable, the
1359	resident's representative or designee, or the resident's
1360	surrogate, guardian, or attorney in fact, and the residence
1361	facility to develop a service plan which best meets the
1362	resident's needs and seeks to improve the resident's quality of
1363	life.
1364	(25)(23)  "Supervision" means reminding residents to engage
1365	in activities of daily living and the self-administration of
1366	medication, and, when necessary, observing or providing verbal
1367	cuing to residents while they perform these activities.
1368	Supervision does not include one-on-one observation.
1369	(26)(24)  "Supplemental security income," Title XVI of the
1370	Social Security Act, means a program through which the Federal
1371	Government guarantees a minimum monthly income to every person
1372	who is age 65 or older, or disabled, or blind and meets the
1373	income and asset requirements.
1374	(27)(25)  "Supportive services" means services designed to
1375	encourage and assist residents aged persons or adults with
1376	disabilities to remain in the least restrictive living
1377	environment and to maintain their independence as long as
1378	possible.
1379	(28)(26)  "Twenty-four-hour nursing supervision" means
1380	services that are ordered by a physician for a resident whose
1381	condition requires the supervision of a physician and continued
1382	monitoring of vital signs and physical status. Such services
1383	shall be: medically complex enough to require constant
1384	supervision, assessment, planning, or intervention by a nurse;
1385	required to be performed by or under the direct supervision of
1386	licensed nursing personnel or other professional personnel for
1387	safe and effective performance; required on a daily basis; and
1388	consistent with the nature and severity of the resident's
1389	condition or the disease state or stage.
1390	Section 13.  Section 429.04, Florida Statutes, is amended
1391	to read:
1392	429.04  Residences Facilities to be licensed; exemptions.-
1393	(1)  For the administration of this part, residences
1394	facilities to be licensed by the agency shall include all
1395	assisted living residences facilities as defined in this part.
1396	(2)  The following are exempt from licensure under this
1397	part:
1398	(a)  Any facility, institution, or other place operated by
1399	the Federal Government or any agency of the Federal Government.
1400	(b)  Any facility or part of a facility licensed under
1401	chapter 393 or chapter 394.
1402	(c)  Any facility licensed as an adult family-care home
1403	under part II.
1404	(d)  Any person who provides housing, meals, and one or
1405	more personal services on a 24-hour basis in the person's own
1406	home to not more than two adults who do not receive optional
1407	state supplementation. The person who provides the housing,
1408	meals, and personal services must own or rent the home and
1409	reside therein.
1410	(e)  Any home or facility approved by the United States
1411	Department of Veterans Affairs as a residential care home
1412	wherein care is provided exclusively to three or fewer veterans.
1413	(f)  Any facility that has been incorporated in this state
1414	for 50 years or more on or before July 1, 1983, and the board of
1415	directors of which is nominated or elected by the residents,
1416	until the facility is sold or its ownership is transferred; or
1417	any facility, with improvements or additions thereto, which has
1418	existed and operated continuously in this state for 60 years or
1419	more on or before July 1, 1989, is directly or indirectly owned
1420	and operated by a nationally recognized fraternal organization,
1421	is not open to the public, and accepts only its own members and
1422	their spouses as residents.
1423	(g)  Any facility certified under chapter 651, or a
1424	retirement community, may provide services authorized under this
1425	part or part III of chapter 400 to its residents who live in
1426	single-family homes, duplexes, quadruplexes, or apartments
1427	located on the campus without obtaining a license to operate an
1428	assisted living residence facility if residential units within
1429	such buildings are used by residents who do not require staff
1430	supervision for that portion of the day when personal services
1431	are not being delivered and the owner obtains a home health
1432	license to provide such services. However, any building or
1433	distinct part of a building on the campus that is designated for
1434	persons who receive personal services and require supervision
1435	beyond that which is available while such services are being
1436	rendered must be licensed in accordance with this part. If a
1437	facility provides personal services to residents who do not
1438	otherwise require supervision and the owner is not licensed as a
1439	home health agency, the buildings or distinct parts of buildings
1440	where such services are rendered must be licensed under this
1441	part. A resident of a facility that obtains a home health
1442	license may contract with a home health agency of his or her
1443	choice, provided that the home health agency provides liability
1444	insurance and workers' compensation coverage for its employees.
1445	Facilities covered by this exemption may establish policies that
1446	give residents the option of contracting for services and care
1447	beyond that which is provided by the facility to enable them to
1448	age in place. For purposes of this section, a retirement
1449	community consists of a residence facility licensed under this
1450	part or a facility licensed under part II of chapter 400, and
1451	apartments designed for independent living located on the same
1452	campus.
1453	(h)  Any residential unit for independent living which is
1454	located within a facility certified under chapter 651, or any
1455	residential unit for independent living which is colocated with
1456	a nursing home licensed under part II of chapter 400 or
1457	colocated with a residence facility licensed under this part in
1458	which services are provided through an outpatient clinic or a
1459	nursing home on an outpatient basis.
1460	Section 14.  Section 429.07, Florida Statutes, is amended
1461	to read:
1462	429.07  License required; fee.-
1463	(1)  The requirements of part I part II of chapter 408
1464	apply to the provision of services that require licensure
1465	pursuant to this part and part II of chapter 408 and to entities
1466	licensed by or applying for such licensure from the agency
1467	pursuant to this part. A license issued by the agency is
1468	required in order to operate an assisted living residence
1469	facility in this state.
1470	(2)  Separate licenses shall be required for residences
1471	facilities maintained in separate premises, even though operated
1472	under the same management. A separate license shall not be
1473	required for separate buildings on the same grounds.
1474	(3)  In addition to the requirements of part I s. 408.806,
1475	each license granted by the agency must state the type of care
1476	for which the license is granted. Licenses shall be issued for
1477	one or more of the following categories of care: standard,
1478	extended congregate care, limited nursing services, or limited
1479	mental health.
1480	(a)  A standard license shall be issued to a licensee for a
1481	residence facilities providing one or more of the personal
1482	services identified in s. 429.02. Such facilities may also
1483	employ or contract with a person licensed under part I of
1484	chapter 464 to administer medications and perform other tasks as
1485	specified in s. 429.255.
1486	(b)  An extended congregate care license shall be issued to
1487	a licensee for a residence facilities providing, directly or
1488	through contract, services beyond those authorized in paragraph
1489	(a), including services performed by persons licensed under part
1490	I of chapter 464 and supportive services, as defined by rule, to
1491	persons who would otherwise be disqualified from continued
1492	residence in a residence facility licensed under this part.
1493	1.  In order for extended congregate care services to be
1494	provided, the agency must first determine that all requirements
1495	established in law and rule are met and must specifically
1496	designate, on the residence's facility's license, that such
1497	services may be provided and whether the designation applies to
1498	all or part of the residence facility. Such designation may be
1499	made at the time of initial licensure or relicensure, or upon
1500	request in writing by a licensee under this chapter part and
1501	part II of chapter 408. The notification of approval or the
1502	denial of the request shall be made in accordance with part I
1503	part II of chapter 408. Existing facilities qualifying to
1504	provide extended congregate care services must have maintained a
1505	standard license and may not have been subject to administrative
1506	sanctions during the previous 2 years, or since initial
1507	licensure if the facility has been licensed for less than 2
1508	years, for any of the following reasons:
1509	a.  A class I or class II violation;
1510	b.  Three or more repeat or recurring class III violations
1511	of identical or similar resident care standards from which a
1512	pattern of noncompliance is found by the agency;
1513	c.  Three or more class III violations that were not
1514	corrected in accordance with the corrective action plan approved
1515	by the agency;
1516	d.  Violation of resident care standards which results in
1517	requiring the facility to employ the services of a consultant
1518	pharmacist or consultant dietitian;
1519	e.  Denial, suspension, or revocation of a license for
1520	another facility licensed under this part in which the applicant
1521	for an extended congregate care license has at least 25 percent
1522	ownership interest; or
1523	f.  Imposition of a moratorium pursuant to this part or
1524	part II of chapter 408 or initiation of injunctive proceedings.
1525	2.  A licensee facility that is licensed to provide
1526	extended congregate care services shall maintain a written
1527	progress report for on each person who receives services, and
1528	the report must describe which describes the type, amount,
1529	duration, scope, and outcome of services that are rendered and
1530	the general status of the resident's health. A registered nurse,
1531	or appropriate designee, representing the agency shall visit the
1532	facility at least quarterly to monitor residents who are
1533	receiving extended congregate care services and to determine if
1534	the facility is in compliance with this part, part II of chapter
1535	408, and relevant rules. One of the visits may be in conjunction
1536	with the regular survey. The monitoring visits may be provided
1537	through contractual arrangements with appropriate community
1538	agencies. A registered nurse shall serve as part of the team
1539	that inspects the facility. The agency may waive one of the
1540	required yearly monitoring visits for a facility that has been
1541	licensed for at least 24 months to provide extended congregate
1542	care services, if, during the inspection, the registered nurse
1543	determines that extended congregate care services are being
1544	provided appropriately, and if the facility has no class I or
1545	class II violations and no uncorrected class III violations. The
1546	agency must first consult with the long-term care ombudsman
1547	council for the area in which the facility is located to
1548	determine if any complaints have been made and substantiated
1549	about the quality of services or care. The agency may not waive
1550	one of the required yearly monitoring visits if complaints have
1551	been made and substantiated.
1552	3.  A licensee facility that is licensed to provide
1553	extended congregate care services shall must:
1554	a.  Demonstrate the capability to meet unanticipated
1555	resident service needs.
1556	b.  Offer a physical environment that promotes a homelike
1557	setting, provides for resident privacy, promotes resident
1558	independence, and allows sufficient congregate space as defined
1559	by rule.
1560	c.  Have sufficient staff available, taking into account
1561	the physical plant and firesafety features of the residential
1562	setting building, to assist with the evacuation of residents in
1563	an emergency.
1564	d.  Adopt and follow policies and procedures that maximize
1565	resident independence, dignity, choice, and decisionmaking to
1566	permit residents to age in place, so that moves due to changes
1567	in functional status are minimized or avoided.
1568	e.  Allow residents or, if applicable, a resident's
1569	representative, designee, surrogate, guardian, or attorney in
1570	fact to make a variety of personal choices, participate in
1571	developing service plans, and share responsibility in
1572	decisionmaking.
1573	f.  Implement the concept of managed risk.
1574	g.  Provide, directly or through contract, the services of
1575	a person licensed under part I of chapter 464.
1576	h.  In addition to the training mandated in s. 429.52,
1577	provide specialized training as defined by rule for residence
1578	facility staff.
1579	4.  A licensed residence that provides facility that is
1580	licensed to provide extended congregate care services is exempt
1581	from the criteria for continued residency set forth in rules
1582	adopted under s. 429.41. A licensed residence facility must
1583	adopt its own requirements within guidelines for continued
1584	residency set forth by rule. However, the residence facility may
1585	not serve residents who require 24-hour nursing supervision. A
1586	licensed residence facility that provides extended congregate
1587	care services must also provide each resident with a written
1588	copy of residence facility policies governing admission and
1589	retention.
1590	5.  The primary purpose of extended congregate care
1591	services is to allow residents, as they become more impaired,
1592	the option of remaining in a familiar setting from which they
1593	would otherwise be disqualified for continued residency. A
1594	licensed residence that provides facility licensed to provide
1595	extended congregate care services may also admit an individual
1596	who exceeds the admission criteria for a residence facility with
1597	a standard license, if the individual is determined appropriate
1598	for admission to the extended congregate care residence
1599	facility.
1600	6.  Before the admission of an individual to a licensed
1601	residence that provides facility licensed to provide extended
1602	congregate care services, the individual must undergo a medical
1603	examination as provided in s. 429.26(4) and the licensee
1604	facility must develop a preliminary service plan for the
1605	individual.
1606	7.  When a licensee facility can no longer provide or
1607	arrange for services in accordance with the resident's service
1608	plan and needs and the licensee's facility's policy, the
1609	licensee facility shall make arrangements for relocating the
1610	person in accordance with s. 429.28(1)(k).
1611	8.  Failure to provide extended congregate care services
1612	may result in denial of extended congregate care license
1613	renewal.
1614	(c)  A limited nursing services license shall be issued to
1615	a facility that provides services beyond those authorized in
1616	paragraph (a) and as specified in this paragraph.
1617	1.  In order for limited nursing services to be provided in
1618	a facility licensed under this part, the agency must first
1619	determine that all requirements established in law and rule are
1620	met and must specifically designate, on the facility's license,
1621	that such services may be provided. Such designation may be made
1622	at the time of initial licensure or relicensure, or upon request
1623	in writing by a licensee under this part and part II of chapter
1624	408. Notification of approval or denial of such request shall be
1625	made in accordance with part II of chapter 408. Existing
1626	facilities qualifying to provide limited nursing services shall
1627	have maintained a standard license and may not have been subject
1628	to administrative sanctions that affect the health, safety, and
1629	welfare of residents for the previous 2 years or since initial
1630	licensure if the facility has been licensed for less than 2
1631	years.
1632	2.  Facilities that are licensed to provide limited nursing
1633	services shall maintain a written progress report on each person
1634	who receives such nursing services, which report describes the
1635	type, amount, duration, scope, and outcome of services that are
1636	rendered and the general status of the resident's health. A
1637	registered nurse representing the agency shall visit such
1638	facilities at least twice a year to monitor residents who are
1639	receiving limited nursing services and to determine if the
1640	facility is in compliance with applicable provisions of this
1641	part, part II of chapter 408, and related rules. The monitoring
1642	visits may be provided through contractual arrangements with
1643	appropriate community agencies. A registered nurse shall also
1644	serve as part of the team that inspects such facility.
1645	3.  A person who receives limited nursing services under
1646	this part must meet the admission criteria established by the
1647	agency for assisted living facilities. When a resident no longer
1648	meets the admission criteria for a facility licensed under this
1649	part, arrangements for relocating the person shall be made in
1650	accordance with s. 429.28(1)(k), unless the facility is licensed
1651	to provide extended congregate care services.
1652	(4)  In accordance with s. 429.004 408.805, an applicant or
1653	licensee shall pay a fee for each license application submitted
1654	under this chapter part, part II of chapter 408, and applicable
1655	rules. The amount of the fee shall be established by rule.
1656	(a)  The biennial license fee required of a residence
1657	facility is $300 per license, with an additional fee of $50 per
1658	resident based on the total licensed resident capacity of the
1659	residence facility, except that no additional fee will be
1660	assessed for beds designated for recipients of Medicaid optional
1661	state supplementation payments provided for in s. 409.212. The
1662	total fee may not exceed $10,000.
1663	(b)  In addition to the total fee assessed under paragraph
1664	(a), the agency shall require a licensed residence facilities
1665	that provides are licensed to provide extended congregate care
1666	services under this part to pay an additional fee per licensed
1667	residence facility. The amount of the biennial fee shall be $400
1668	per license, with an additional fee of $10 per resident based on
1669	the total licensed resident capacity of the residence facility.
1670	(c)  In addition to the total fee assessed under paragraph
1671	(a), the agency shall require facilities that are licensed to
1672	provide limited nursing services under this part to pay an
1673	additional fee per licensed facility. The amount of the biennial
1674	fee shall be $250 per license, with an additional fee of $10 per
1675	resident based on the total licensed resident capacity of the
1676	facility.
1677	(5)  Counties or municipalities applying for licenses under
1678	this part are exempt from the payment of license fees.
1679	(6)  In order to determine whether the residence is
1680	adequately protecting residents' rights as provided in s.
1681	429.28, the agency shall conduct a biennial survey that includes
1682	private informal conversations with a sample of residents to
1683	discuss the residents' experiences within the residence.
1684	(7)  An assisted living residence that has been cited
1685	within the previous 24-month period for a class I or class II
1686	violation, regardless of the status of any enforcement or
1687	disciplinary action, is subject to periodic unannounced
1688	monitoring to determine if the residence is in compliance with
1689	this part and applicable rules. Monitoring may occur through a
1690	desk review or an onsite assessment. If the class I or class II
1691	violation relates to providing or failing to provide nursing
1692	care, a registered nurse must participate in at least two onsite
1693	monitoring visits within a 12-month period.
1694	Section 15.  Section 429.075, Florida Statutes, is amended
1695	to read:
1696	429.075  Limited mental health license.-A licensee
1697	operating an assisted living residence facility that serves
1698	three or more mental health residents must obtain a limited
1699	mental health license.
1700	(1)  To obtain a limited mental health license, a licensee
1701	must have facility must hold a standard license as an assisted
1702	living residence facility, must not have any current uncorrected
1703	deficiencies or violations, and must ensure that, within 6
1704	months after receiving a limited mental health license, the
1705	residence facility administrator and the staff of the residence
1706	facility who are in direct contact with mental health residents
1707	must complete training of no less than 6 hours related to their
1708	duties. Such designation may be made at the time of initial
1709	licensure or relicensure or upon request in writing by a
1710	licensee under this chapter part and part II of chapter 408.
1711	Notification of approval or denial of such request shall be made
1712	in accordance with this chapter part, part II of chapter 408,
1713	and applicable rules. This training will be provided by or
1714	approved by the Department of Children and Family Services.
1715	(2)  A residence that is Facilities licensed to provide
1716	services to mental health residents shall provide appropriate
1717	supervision and staffing to provide for the health, safety, and
1718	welfare of such residents.
1719	(3)  A residence facility that has a limited mental health
1720	license must:
1721	(a)  Have a copy of each mental health resident's community
1722	living support plan and the cooperative agreement with the
1723	mental health care services provider. The support plan and the
1724	agreement may be combined.
1725	(b)  Have documentation that is provided by the Department
1726	of Children and Family Services that each mental health resident
1727	has been assessed and determined to be able to live in the
1728	community in an assisted living residence facility with a
1729	limited mental health license.
1730	(c)  Make the community living support plan available for
1731	inspection by the resident, the resident's legal guardian, the
1732	resident's health care surrogate, and other individuals who have
1733	a lawful basis for reviewing this document.
1734	(d)  Assist the mental health resident in carrying out the
1735	activities identified in the individual's community living
1736	support plan.
1737	(4)  A residence facility with a limited mental health
1738	license may enter into a cooperative agreement with a private
1739	mental health provider. For purposes of the limited mental
1740	health license, the private mental health provider may act as
1741	the case manager.
1742	Section 16.  Section 429.08, Florida Statutes, is amended
1743	to read:
1744	429.08  Unlicensed residences facilities; referral of
1745	person for residency to unlicensed residence facility;
1746	penalties.-
1747	(1)(a)  This section applies to the unlicensed operation of
1748	an assisted living residence facility in addition to the
1749	requirements of part I part II of chapter 408.
1750	(b)  Except as provided under paragraph (d), any person who
1751	owns, operates, or maintains an unlicensed assisted living
1752	residence for which such person does not hold a valid license
1753	facility commits a felony of the third degree, punishable as
1754	provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
1755	continued operation is a separate offense.
1756	(c)  Any person found guilty of violating paragraph (a) a
1757	second or subsequent time commits a felony of the second degree,
1758	punishable as provided under s. 775.082, s. 775.083, or s.
1759	775.084. Each day of continued operation is a separate offense.
1760	(d)  Any person who owns, operates, or maintains an
1761	unlicensed assisted living residence for which such person does
1762	not hold a valid license facility due to a change in this part
1763	or a modification in rule within 6 months after the effective
1764	date of such change and who, within 10 working days after
1765	receiving notification from the agency, fails to cease operation
1766	or apply for a license under this part commits a felony of the
1767	third degree, punishable as provided in s. 775.082, s. 775.083,
1768	or s. 775.084. Each day of continued operation is a separate
1769	offense.
1770	(e)  The agency shall publish a list, by county, of
1771	licensed assisted living residences facilities. This information
1772	may be provided electronically or through the agency's Internet
1773	site.
1774	(2)  It is unlawful to knowingly refer a person for
1775	residency to an unlicensed assisted living residence facility;
1776	to an assisted living residence for which facility the
1777	licensee's license of which is under denial or has been
1778	suspended or revoked; or to an assisted living residence
1779	facility that has a moratorium pursuant to part I part II of
1780	chapter 408.
1781	(a)  Any health care practitioner, as defined in s.
1782	456.001, or emergency medical technician or paramedic certified
1783	pursuant to part III or chapter 401, who is aware of the
1784	operation of an unlicensed residence facility shall report that
1785	residence facility to the agency. Failure to report an assisted
1786	living residence for which a facility that the practitioner
1787	knows or has reasonable cause to suspect a license has not been
1788	obtained is unlicensed shall be reported to the practitioner's
1789	licensing board.
1790	(b)  Any provider as defined in s. 408.803 which knowingly
1791	discharges a patient or client to an unlicensed facility is
1792	subject to sanction by the agency.
1793	(b)(c)  Any employee of the agency or department, or the
1794	Department of Children and Family Services, who knowingly refers
1795	a person for residency to an unlicensed residence facility; to a
1796	residence for which the licensee's license facility the license
1797	of which is under denial or has been suspended or revoked; or to
1798	a residence facility that has a moratorium pursuant to part I
1799	part II of chapter 408 is subject to disciplinary action by the
1800	agency or department, or the Department of Children and Family
1801	Services.
1802	(c)(d)  The employer of any person who is under contract
1803	with the agency or department, or the Department of Children and
1804	Family Services, and who knowingly refers a person for residency
1805	to an unlicensed residence facility; to a residence for which
1806	the licensee's license facility the license of which is under
1807	denial or has been suspended or revoked; or to a residence
1808	facility that has a moratorium pursuant to part I part II of
1809	chapter 408 shall be fined and required to prepare a corrective
1810	action plan designed to prevent such referrals.
1811	Section 17.  Section 429.11, Florida Statutes, is amended
1812	to read:
1813	429.11  Initial application for license; provisional
1814	license.-
1815	(1)  Each applicant for licensure must comply with all
1816	provisions of part I part II of chapter 408 and must:
1817	(a)  Identify all other homes or residences facilities,
1818	including the addresses and the license or licenses under which
1819	they operate, if applicable, which are currently operated by the
1820	applicant or administrator and which provide housing, meals, and
1821	personal services to residents.
1822	(b)  Provide the location of the residence facility for
1823	which a license is sought and documentation, signed by the
1824	appropriate local government official, which states that the
1825	applicant has met local zoning requirements.
1826	(c)  Provide the name, address, date of birth, social
1827	security number, education, and experience of the administrator,
1828	if different from the applicant.
1829	(2)  The applicant shall provide proof of liability
1830	insurance as defined in s. 624.605.
1831	(3)  If the applicant is a community residential home, the
1832	applicant must provide proof that it has met the requirements
1833	specified in chapter 419.
1834	(4)  The applicant must furnish proof that the residence
1835	facility has received a satisfactory firesafety inspection. The
1836	local authority having jurisdiction or the State Fire Marshal
1837	must conduct the inspection within 30 days after written request
1838	by the applicant.
1839	(5)  The applicant must furnish documentation of a
1840	satisfactory sanitation inspection of the residence facility by
1841	the county health department.
1842	(6)  In addition to the license categories available in s.
1843	408.808, A provisional license may be issued to an applicant
1844	making initial application for licensure or making application
1845	for a change of ownership. A provisional license shall be
1846	limited in duration to a specific period of time not to exceed 6
1847	months, as determined by the agency.
1848	(7)  A county or municipality may not issue an occupational
1849	license that is being obtained for the purpose of operating a
1850	residence facility regulated under this part without first
1851	ascertaining that the applicant has been licensed to operate
1852	such residence facility at the specified location or locations
1853	by the agency. The agency shall furnish to local agencies
1854	responsible for issuing occupational licenses sufficient
1855	instruction for making such determinations.
1856	Section 18.  Section 429.12, Florida Statutes, is amended
1857	to read:
1858	429.12  Sale or transfer of ownership of a residence
1859	facility.-It is the intent of the Legislature To protect the
1860	rights of the residents of an assisted living residence facility
1861	when the facility is sold or the ownership thereof is
1862	transferred. Therefore, in addition to the requirements of part
1863	I part II of chapter 408, whenever a residence facility is sold
1864	or the ownership thereof is transferred, including leasing:
1865	(1)  The transferee shall notify the residents, in writing,
1866	of the change of ownership within 7 days after receipt of the
1867	new license.
1868	(2)  The transferor of a residence facility the license of
1869	which is denied pending an administrative hearing shall, as a
1870	part of the written change-of-ownership contract, advise the
1871	transferee of such action that a plan of correction must be
1872	submitted by the transferee and approved by the agency at least
1873	7 days before the change of ownership and that failure to
1874	correct the condition which resulted in the moratorium pursuant
1875	to part II of chapter 408 or denial of licensure is grounds for
1876	denial of the transferee's license.
1877	Section 19.  Section 429.14, Florida Statutes, is amended
1878	to read:
1879	429.14  Administrative penalties.-
1880	(1)  In addition to the requirements of part I part II of
1881	chapter 408, the agency may deny, revoke, and suspend any
1882	license issued under this chapter part and impose an
1883	administrative fine in the manner provided in chapter 120
1884	against a licensee for a violation of any provision of this
1885	chapter part, part II of chapter 408, or applicable rules, or
1886	for any of the following actions by a licensee, or for the
1887	actions of any person subject to level 2 background screening
1888	under s. 429.008 408.809, or for the actions of any facility
1889	employee:
1890	(a)  An intentional or negligent act seriously affecting
1891	the health, safety, or welfare of a resident of the residence
1892	facility.
1893	(b)  The determination by the agency that the owner lacks
1894	the financial ability to provide continuing adequate care to
1895	residents.
1896	(c)  Misappropriation or conversion of the property of a
1897	resident of the facility.
1898	(d)  Failure to follow the criteria and procedures provided
1899	under part I of chapter 394 relating to the transportation,
1900	voluntary admission, and involuntary examination of a facility
1901	resident.
1902	(c)(e)  A citation of any of the following violations
1903	deficiencies as specified in s. 429.19:
1904	1.  One or more cited class I violations deficiencies.
1905	2.  Three or more cited class II violations deficiencies.
1906	3.  Five or more cited class III violations deficiencies
1907	that have been cited on a single survey and have not been
1908	corrected within the times specified.
1909	(d)(f)  Failure to comply with the background screening
1910	standards of this part, s. 429.008 408.809(1), or chapter 435.
1911	(e)(g)  Violation of a moratorium.
1912	(f)(h)  Failure of the license applicant, the licensee
1913	during relicensure, or a licensee that holds a provisional
1914	license to meet the minimum license requirements of this part,
1915	or related rules, at the time of license application or renewal.
1916	(g)(i)  An intentional or negligent life-threatening act in
1917	violation of the uniform firesafety standards for assisted
1918	living residences facilities or other firesafety standards that
1919	threatens the health, safety, or welfare of a resident of a
1920	residence facility, as communicated to the agency by the local
1921	authority having jurisdiction or the State Fire Marshal.
1922	(h)(j)  Knowingly operating any unlicensed residence
1923	facility or providing without a license any service that must be
1924	licensed under this chapter or chapter 400.
1925	(i)(k)  Any act constituting a ground upon which
1926	application for a license may be denied.
1927	(2)  Upon notification by the local authority having
1928	jurisdiction or by the State Fire Marshal, the agency may deny
1929	or revoke the license of a licensee of an assisted living
1930	residence facility that fails to correct cited fire code
1931	violations that affect or threaten the health, safety, or
1932	welfare of a resident of the residence a facility.
1933	(3)  The agency may deny a license to any applicant or
1934	controlling interest that as defined in part II of chapter 408
1935	which has or had a 51 percent 25-percent or greater financial or
1936	ownership interest in any other residence facility licensed
1937	under this part, or in any entity licensed by this state or
1938	another state to provide health or residential care, which
1939	facility or entity during the 5 years prior to the application
1940	for a license closed due to financial inability to operate; had
1941	a receiver appointed or a license denied, suspended, or revoked;
1942	was subject to a moratorium; or had an injunctive proceeding
1943	initiated against it.
1944	(4)  The agency shall deny or revoke the license of an
1945	assisted living facility that has two or more class I violations
1946	that are similar or identical to violations identified by the
1947	agency during a survey, inspection, monitoring visit, or
1948	complaint investigation occurring within the previous 2 years.
1949	(4)(5)  An action taken by the agency to suspend, deny, or
1950	revoke a licensee's facility's license under this part or part I
1951	part II of chapter 408, in which the agency claims that the
1952	residence facility owner or a staff member an employee of the
1953	residence facility has threatened the health, safety, or welfare
1954	of a resident of the residence facility be heard by the Division
1955	of Administrative Hearings of the Department of Management
1956	Services within 120 days after receipt of the residence's
1957	facility's request for a hearing, unless that time limitation is
1958	waived by both parties. The administrative law judge must render
1959	a decision within 30 days after receipt of a proposed
1960	recommended order.
1961	(6)  The agency shall provide to the Division of Hotels and
1962	Restaurants of the Department of Business and Professional
1963	Regulation, on a monthly basis, a list of those assisted living
1964	facilities that have had their licenses denied, suspended, or
1965	revoked or that are involved in an appellate proceeding pursuant
1966	to s. 120.60 related to the denial, suspension, or revocation of
1967	a license.
1968	(5)(7)  Agency notification of a license suspension or
1969	revocation, or denial of a license renewal, shall be posted and
1970	visible to the public at the residence facility.
1971	Section 20.  Section 429.17, Florida Statutes, is amended
1972	to read:
1973	429.17  Expiration of license; renewal; conditional
1974	license.-
1975	(1)  Limited nursing, Extended congregate care, and limited
1976	mental health licenses shall expire at the same time as the
1977	residence's facility's standard license, regardless of when
1978	issued.
1979	(2)  A license shall be renewed in accordance with part I
1980	part II of chapter 408 and upon the provision of satisfactory
1981	proof of ability to operate and conduct the facility in
1982	accordance with the requirements of this part and adopted rules,
1983	including proof that the residence facility has received a
1984	satisfactory firesafety inspection, conducted by the local
1985	authority having jurisdiction or the State Fire Marshal, within
1986	the preceding 12 months.
1987	(3)  In addition to the requirements of part I part II of
1988	chapter 408, each residence facility must report to the agency
1989	any adverse court action concerning the residence's facility's
1990	financial viability, within 7 days after its occurrence. The
1991	agency shall have access to books, records, and any other
1992	financial documents maintained by the residence facility to the
1993	extent necessary to determine the residence's facility's
1994	financial stability.
1995	(4)  In addition to the license categories available in
1996	part I s. 408.808, a conditional license may be issued to an
1997	applicant for license renewal if the applicant fails to meet all
1998	standards and requirements for licensure. A conditional license
1999	issued under this subsection shall be limited in duration to a
2000	specific period of time not to exceed 6 months, as determined by
2001	the agency, and shall be accompanied by an agency-approved plan
2002	of correction.
2003	(5)  When an extended congregate care or limited nursing
2004	license is requested during a residence's facility's biennial
2005	license period, the fee shall be prorated in order to permit the
2006	additional license to expire at the end of the biennial license
2007	period. The fee shall be calculated as of the date the
2008	additional license application is received by the agency.
2009	(6)  The department may by rule establish renewal
2010	procedures, identify forms, and specify documentation necessary
2011	to administer this section. The agency, in consultation with the
2012	department, may adopt rules to administer the requirements of
2013	part II of chapter 408.
2014	Section 21.  Section 429.174, Florida Statutes, is amended
2015	to read:
2016	429.174  Background screening.-The agency shall require
2017	level 2 background screening for personnel as required in s.
2018	429.008(1)(e) 408.809(1)(e) pursuant to chapter 435 and s.
2019	429.008 408.809.
2020	Section 22.  Section 429.177, Florida Statutes, is amended
2021	to read:
2022	429.177  Patients with Alzheimer's disease or other related
2023	disorders; certain disclosures.-A licensed residence that
2024	facility licensed under this part which claims that it provides
2025	special care for persons who have Alzheimer's disease or other
2026	related disorders must disclose in its advertisements or in a
2027	separate document those services that distinguish the care as
2028	being especially applicable to, or suitable for, such persons.
2029	The residence facility must give a copy of all such
2030	advertisements or a copy of the document to each person who
2031	requests information about programs and services for persons
2032	with Alzheimer's disease or other related disorders offered by
2033	the residence facility and must maintain a copy of all such
2034	advertisements and documents in its records. The agency shall
2035	examine all such advertisements and documents in the residence's
2036	facility's records as part of the license renewal procedure.
2037	Section 23.  Section 429.178, Florida Statutes, is amended
2038	to read:
2039	429.178  Special care for persons with Alzheimer's disease
2040	or other related disorders.-
2041	(1)  A residence that facility which advertises that it
2042	provides special care for persons with Alzheimer's disease or
2043	other related disorders must meet the following standards of
2044	operation:
2045	(a)1.  If the facility has 17 or more residents, Have an
2046	awake staff member on duty at all hours of the day and night for
2047	each secured unit of the residence that houses any residents
2048	with Alzheimer's disease or other related disorders.; or
2049	2.  If the facility has fewer than 17 residents, have an
2050	awake staff member on duty at all hours of the day and night or
2051	have mechanisms in place to monitor and ensure the safety of the
2052	facility's residents.
2053	(b)  Offer activities specifically designed for persons who
2054	are cognitively impaired.
2055	(c)  Have a physical environment that provides for the
2056	safety and welfare of the facility's residents of the residence.
2057	(d)  Employ staff who have completed the training and
2058	continuing education required in subsection (2).
2059
2060	For the safety and protection of residents with Alzheimer's
2061	disease, related disorders, or dementia, a secured locked unit
2062	may be designated. The unit may consist of the entire building
2063	or a distinct part of the building. Exit doors shall be equipped
2064	with an operating alarm system which releases upon activation of
2065	the fire alarm. These units are exempt from specific life safety
2066	requirements to which assisted living residences are normally
2067	subject. A staff member must be awake and present in the secured
2068	unit at all times.
2069	(2)(a)  A staff member An individual who is employed by a
2070	residence facility that provides special care for residents with
2071	Alzheimer's disease or other related disorders, and who has
2072	regular contact with such residents, must complete up to 4 hours
2073	of initial dementia-specific training developed or approved by
2074	the department. The training shall be completed within 3 months
2075	after beginning employment and shall satisfy the core training
2076	requirements of s. 429.52(2)(g).
2077	(b)  A direct care staff member caregiver who is employed
2078	by a residence facility that provides special care for residents
2079	with Alzheimer's disease or other related disorders, and who
2080	provides direct care to such residents, must complete the
2081	required initial training required in paragraph (a) and 4
2082	additional hours of training developed or approved by the
2083	department. The training shall be completed within 9 months
2084	after beginning employment and shall satisfy the core training
2085	requirements of s. 429.52(2)(g).
2086	(c)  A staff member An individual who is employed by a
2087	residence facility that provides special care for residents with
2088	Alzheimer's disease or other related disorders, but who only has
2089	incidental contact with such residents, must be given, at a
2090	minimum, general information on interacting with individuals
2091	with Alzheimer's disease or other related disorders, within 3
2092	months after beginning employment.
2093	(3)  In addition to the training required under subsection
2094	(2), a direct care staff member caregiver must participate in a
2095	minimum of 4 contact hours of continuing education each calendar
2096	year. The continuing education must include one or more topics
2097	included in the dementia-specific training developed or approved
2098	by the department, in which the caregiver has not received
2099	previous training.
2100	(4)  Upon completing any training listed in subsection (2),
2101	the staff member employee or direct care staff member caregiver
2102	shall be issued a certificate that includes the name of the
2103	training provider, the topic covered, and the date and signature
2104	of the training provider. The certificate is evidence of
2105	completion of training in the identified topic, and the staff
2106	member employee or direct care staff member caregiver is not
2107	required to repeat training in that topic if the staff member
2108	employee or direct care staff member caregiver changes
2109	employment to a different residence facility. The staff member
2110	employee or direct care staff member caregiver must comply with
2111	other applicable continuing education requirements.
2112	(5)  The department, or its designee, shall approve the
2113	initial and continuing education courses and providers.
2114	(6)  The department shall maintain and post on its website
2115	keep a current list of providers who are approved to provide
2116	initial and continuing education for staff and direct care staff
2117	members of residences facilities that provide special care for
2118	persons with Alzheimer's disease or other related disorders.
2119	(7)  Any facility more than 90 percent of whose residents
2120	receive monthly optional supplementation payments is not
2121	required to pay for the training and education programs required
2122	under this section. A facility that has one or more such
2123	residents shall pay a reduced fee that is proportional to the
2124	percentage of such residents in the facility. A facility that
2125	does not have any residents who receive monthly optional
2126	supplementation payments must pay a reasonable fee, as
2127	established by the department, for such training and education
2128	programs.
2129	(7)(8)  The department shall adopt rules to establish
2130	standards for trainers and training and to implement this
2131	section.
2132	Section 24.  Section 429.18, Florida Statutes, is amended
2133	to read:
2134	429.18  Disposition of fees and administrative fines.-
2135	Income from fees and fines collected under this part shall be
2136	directed to and used by the agency for the following purposes:
2137	(1)  Up to 50 percent of the trust funds accrued each
2138	fiscal year under this part may be used to offset the expenses
2139	of receivership, pursuant to s. 429.22, if the court determines
2140	that the income and assets of the residence facility are
2141	insufficient to provide for adequate management and operation.
2142	(2)  An amount of $5,000 of the trust funds accrued each
2143	year under this part shall be allocated to pay for inspection-
2144	related physical and mental health examinations requested by the
2145	agency pursuant to s. 429.26 for residents who are either
2146	recipients of supplemental security income or have monthly
2147	incomes not in excess of the maximum combined federal and state
2148	cash subsidies available to supplemental security income
2149	recipients, as provided for in s. 409.212. Such funds shall only
2150	be used where the resident is ineligible for Medicaid.
2151	(3)  Any trust funds accrued each year under this part and
2152	not used for the purposes specified in subsections (1) and (2)
2153	shall be used to offset the costs of the licensure program,
2154	verifying information submitted, defraying the costs of
2155	processing the names of applicants, and conducting inspections
2156	and monitoring visits pursuant to this part and part I part II
2157	of chapter 408.
2158	Section 25.  Section 429.19, Florida Statutes, is amended
2159	to read:
2160	429.19  Violations; imposition of administrative fines;
2161	grounds.-
2162	(1)  In addition to the requirements of part II of chapter
2163	408, The agency shall impose an administrative fine in the
2164	manner provided in chapter 120 for the violation of any
2165	provision of this chapter part, part II of chapter 408, and
2166	applicable rules by an assisted living residence facility, for
2167	the actions of any person subject to level 2 background
2168	screening under s.429.008 408.809, for the actions of any
2169	facility employee, or for an intentional or negligent act
2170	seriously affecting the health, safety, or welfare of a resident
2171	of the residence facility.
2172	(2)  Each violation of this part and adopted rules shall be
2173	classified according to the nature of the violation and the
2174	gravity of its probable effect on residents of the residence
2175	facility residents. The agency shall indicate the classification
2176	on the written notice of the violation as follows:
2177	(a)  Class "I" violations are those conditions or
2178	occurrences related to the operation and maintenance of a
2179	residence or to the care of residents which the agency
2180	determines present an imminent danger to the residents or a
2181	substantial probability that death or serious physical or
2182	emotional harm would result therefrom. The condition or practice
2183	constituting a class I violation shall be abated or eliminated
2184	within 24 hours, unless a fixed period, as determined by the
2185	agency, is required for correction defined in s. 408.813. The
2186	agency shall impose an administrative fine for a cited class I
2187	violation in an amount not less than $5,000 and not exceeding
2188	$10,000 for each violation. A fine shall be levied
2189	notwithstanding the correction of the violation.
2190	(b)  Class "II" violations are those conditions or
2191	occurrences related to the operation and maintenance of a
2192	residence or to the care of residents which the agency
2193	determines directly threaten the physical or emotional health,
2194	safety, or security of the residents, other than class I
2195	violations defined in s. 408.813. The agency shall impose an
2196	administrative fine for a cited class II violation in an amount
2197	not less than $1,000 and not exceeding $5,000 for each
2198	violation. A fine shall be levied notwithstanding the correction
2199	of the violation.
2200	(c)  Class "III" violations are those conditions or
2201	occurrences related to the operation and maintenance of a
2202	residence or to the care of residents which the agency
2203	determines indirectly or potentially threaten the physical or
2204	emotional health, safety, or security of residents, other than
2205	class I or class II violations defined in s. 408.813. The agency
2206	shall impose an administrative fine for a cited class III
2207	violation in an amount not less than $500 and not exceeding
2208	$1,000 for each violation. If a class III violation is corrected
2209	within the time specified, a fine may not be imposed.
2210	(d)  Class "IV" violations are those conditions or
2211	occurrences related to the operation and maintenance of a
2212	residence or to required reports, forms, or documents that do
2213	not have the potential of negatively affecting residents. These
2214	violations are of a type that the agency determines do not
2215	threaten the health, safety, or security of residents defined in
2216	s. 408.813. The agency shall impose an administrative fine for a
2217	cited class IV violation in an amount not less than $100 and not
2218	exceeding $200 for each violation. A citation for a class IV
2219	violation must specify the time within which the violation is
2220	required to be corrected. If a class IV violation is corrected
2221	within the time specified, a fine may not be imposed.
2222	(3)  For purposes of this section, in determining if a
2223	penalty is to be imposed and in fixing the amount of the fine,
2224	the agency shall consider the following factors:
2225	(a)  The gravity of the violation, including the
2226	probability that death or serious physical or emotional harm to
2227	a resident will result or has resulted, the severity of the
2228	action or potential harm, and the extent to which the provisions
2229	of the applicable laws or rules were violated.
2230	(b)  Actions taken by the owner or administrator to correct
2231	violations.
2232	(c)  Any previous violations.
2233	(d)  The financial benefit to the residence facility of
2234	committing or continuing the violation.
2235	(e)  The licensed capacity of the residence facility.
2236	(4)  Each day of continuing violation after the date fixed
2237	for termination of the violation, as ordered by the agency,
2238	constitutes an additional, separate, and distinct violation.
2239	(5)  Any action taken to correct a violation shall be
2240	documented in writing by the licensee owner or administrator of
2241	the residence facility and verified through followup visits by
2242	agency personnel or desk review. The agency may impose a fine
2243	and, in the case of an owner-operated residence facility, revoke
2244	or deny a licensee's facility's license when the agency has
2245	documented that a residence facility administrator has
2246	fraudulently misrepresented misrepresents action taken to
2247	correct a violation.
2248	(6)  Any residence facility whose owner fails to apply for
2249	a change-of-ownership license in accordance with part I part II
2250	of chapter 408 and operates the residence facility under the new
2251	ownership is subject to a fine of $5,000.
2252	(7)  In addition to any administrative fines imposed, the
2253	agency may assess a survey fee, equal to the lesser of one half
2254	of the residence's facility's biennial license and bed fee or
2255	$500, to cover the cost of conducting initial complaint
2256	investigations that result in the finding of a violation that
2257	was the subject of the complaint or monitoring visits conducted
2258	under s. 429.28(3)(c) to verify the correction of the
2259	violations.
2260	(8)  During an inspection, the agency shall make a
2261	reasonable attempt to discuss each violation with the owner or
2262	administrator of the residence, before facility, prior to
2263	written notification.
2264	(9)  The agency shall develop and disseminate an annual
2265	list of all facilities sanctioned or fined for violations of
2266	state standards, the number and class of violations involved,
2267	the penalties imposed, and the current status of cases. The list
2268	shall be disseminated, at no charge, to the Department of
2269	Elderly Affairs, the Department of Health, the Department of
2270	Children and Family Services, the Agency for Persons with
2271	Disabilities, the area agencies on aging, the Florida Statewide
2272	Advocacy Council, and the state and local ombudsman councils.
2273	The Department of Children and Family Services shall disseminate
2274	the list to service providers under contract to the department
2275	who are responsible for referring persons to a facility for
2276	residency. The agency may charge a fee commensurate with the
2277	cost of printing and postage to other interested parties
2278	requesting a copy of this list. This information may be provided
2279	electronically or through the agency's Internet site.
2280	Section 26.  Section 429.195, Florida Statutes, is amended
2281	to read:
2282	429.195  Rebates prohibited; penalties.-
2283	(1)  It is unlawful for the licensee of any assisted living
2284	residence facility licensed under this chapter part to contract
2285	or promise to pay or receive any commission, bonus, kickback, or
2286	rebate or engage in any split-fee arrangement in any form
2287	whatsoever with any physician, surgeon, organization, agency, or
2288	person, either directly or indirectly, for residents referred to
2289	a licensed an assisted living residence facility licensed under
2290	this part. A licensee for a residence facility may employ or
2291	contract with persons to market the residence facility, provided
2292	the employee or contract provider clearly indicates that he or
2293	she represents the residence facility. A person or agency
2294	independent of the residence facility may provide placement or
2295	referral services for a fee to individuals seeking assistance in
2296	finding a suitable residence facility; however, any fee paid for
2297	placement or referral services must be paid by the individual
2298	looking for a residence facility, not by the residence facility.
2299	(2)  A violation of this section shall be considered
2300	patient brokering and is punishable as provided in s. 817.505.
2301	(3)  This section does not apply to residents of an
2302	assisted living residence who refer friends, family members, or
2303	other individuals with whom they have a personal relationship to
2304	the assisted living residence, and does not prohibit the
2305	licensee of the assisted living residence from providing a
2306	monetary reward to the resident for making such a referral.
2307	Section 27.  Section 429.20, Florida Statutes, is amended
2308	to read:
2309	429.20  Certain solicitation prohibited; third-party
2310	supplementation.-
2311	(1)  A person may not, in connection with the solicitation
2312	of contributions by or on behalf of an assisted living residence
2313	facility or residences facilities, misrepresent or mislead any
2314	person, by any manner, means, practice, or device whatsoever, to
2315	believe that the receipts of such solicitation will be used for
2316	charitable purposes, if that is not the fact.
2317	(2)  Solicitation of contributions of any kind in a
2318	threatening, coercive, or unduly forceful manner by or on behalf
2319	of an assisted living residence facility or residences
2320	facilities by any agent, employee, owner, or representative of
2321	any assisted living residence facility or residences facilities
2322	is prohibited grounds for denial, suspension, or revocation of
2323	the license of the assisted living facility or facilities by or
2324	on behalf of which such contributions were solicited.
2325	(3)  The admission or maintenance of assisted living
2326	residence facility residents whose care is supported, in whole
2327	or in part, by state funds may not be conditioned upon the
2328	receipt of any manner of contribution or donation from any
2329	person. The solicitation or receipt of contributions in
2330	violation of this subsection is grounds for denial, suspension,
2331	or revocation of license, as provided in s. 429.14, for any
2332	assisted living facility by or on behalf of which such
2333	contributions were solicited.
2334	(4)  An assisted living residence facility may accept
2335	additional supplementation from third parties on behalf of
2336	residents receiving optional state supplementation in accordance
2337	with s. 409.212.
2338	Section 28.  Section 429.22, Florida Statutes, is amended
2339	to read:
2340	429.22  Receivership proceedings.-
2341	(1)  As an alternative to or in conjunction with an
2342	injunctive proceeding, the agency may petition a court of
2343	competent jurisdiction for the appointment of a receiver, if
2344	suitable alternate placements are not available, when any of the
2345	following conditions exist:
2346	(a)  The residence facility is operating without a license
2347	having been obtained by a licensee and refuses to make
2348	application for a license as required by ss. 429.07 and 429.08.
2349	(b)  The residence facility is closing or has informed the
2350	agency that it intends to close and adequate arrangements have
2351	not been made for relocation of the residents within 7 days,
2352	exclusive of weekends and holidays, of the closing of the
2353	residence facility.
2354	(c)  The agency determines there exist in the residence
2355	facility conditions which present an imminent danger to the
2356	health, safety, or welfare of the residents of the residence
2357	facility or a substantial probability that death or serious
2358	physical harm would result therefrom.
2359	(d)  The licensee of the residence facility cannot meet its
2360	financial obligation for providing food, shelter, care, and
2361	utilities.
2362	(2)  Petitions for receivership shall take precedence over
2363	other court business unless the court determines that some other
2364	pending proceeding, having similar statutory precedence, shall
2365	have priority. A hearing shall be conducted within 5 days of the
2366	filing of the petition, at which time all interested parties
2367	shall have the opportunity to present evidence pertaining to the
2368	petition. The agency shall notify, by certified mail, the
2369	licensee, owner or administrator of the residence facility named
2370	in the petition, and the residence facility resident or, if
2371	applicable, the resident's representative or designee, or the
2372	resident's surrogate, guardian, or attorney in fact, of its
2373	filing, the substance of the violation, and the date and place
2374	set for the hearing. The court shall grant the petition only
2375	upon finding that the health, safety, or welfare of residence
2376	facility residents would be threatened if a condition existing
2377	at the time the petition was filed is permitted to continue. A
2378	receiver shall not be appointed ex parte unless the court
2379	determines that one or more of the conditions in subsection (1)
2380	exist; that the residence licensee, facility owner, or
2381	administrator cannot be found; that all reasonable means of
2382	locating the licensee, owner, or administrator and notifying him
2383	or her of the petition and hearing have been exhausted; or that
2384	the licensee, owner, or administrator after notification of the
2385	hearing chooses not to attend. After such findings, the court
2386	may appoint any qualified person as a receiver, except it may
2387	not appoint any owner or affiliate of the residence that
2388	facility which is in receivership. The receiver may be selected
2389	from a list of persons qualified to act as receivers developed
2390	by the agency and presented to the court with each petition for
2391	receivership. Under no circumstances may the agency or
2392	designated agency employee be appointed as a receiver for more
2393	than 60 days; however, the receiver may petition the court, one
2394	time only, for a 30-day extension. The court shall grant the
2395	extension upon a showing of good cause.
2396	(3)  The receiver must make provisions for the continued
2397	health, safety, and welfare of all residents of the residence
2398	facility and:
2399	(a)  Shall exercise those powers and perform those duties
2400	set out by the court.
2401	(b)  Shall operate the residence facility in such a manner
2402	as to assure safety and adequate health care for the residents.
2403	(c)  Shall take such action as is reasonably necessary to
2404	protect or conserve the assets or property of the residence
2405	facility for which the receiver is appointed, or the proceeds
2406	from any transfer thereof, and may use them only in the
2407	performance of the powers and duties set forth in this section
2408	and by order of the court.
2409	(d)  May use the building, fixtures, furnishings, and any
2410	accompanying consumable goods in the provision of care and
2411	services to residents and to any other persons receiving
2412	services from the residence facility at the time the petition
2413	for receivership was filed. The receiver shall collect payments
2414	for all goods and services provided to residents or others
2415	during the period of the receivership at the same rate of
2416	payment charged by the owners at the time the petition for
2417	receivership was filed, or at a fair and reasonable rate
2418	otherwise approved by the court.
2419	(e)  May correct or eliminate any deficiency in the
2420	structure or furnishings of the residence facility which
2421	endangers the safety or health of residents while they remain in
2422	the residence facility, if the total cost of correction does not
2423	exceed $10,000. The court may order expenditures for this
2424	purpose in excess of $10,000 on application from the receiver
2425	after notice to the owner and a hearing.
2426	(f)  May let contracts and hire agents and employees to
2427	carry out the powers and duties of the receiver.
2428	(g)  Shall honor all leases, mortgages, and secured
2429	transactions governing the building or buildings in which the
2430	residence facility is located and all goods and fixtures in the
2431	building or buildings of which the receiver has taken
2432	possession, but only to the extent of payments which, in the
2433	case of a rental agreement, are for the use of the property
2434	during the period of the receivership, or which, in the case of
2435	a purchase agreement, become due during the period of the
2436	receivership.
2437	(h)  Shall have full power to direct and manage and to
2438	discharge employees of the residence facility, subject to any
2439	contract rights they may have. The receiver shall pay employees
2440	at the rate of compensation, including benefits, approved by the
2441	court. A receivership does not relieve the licensee or owner of
2442	any obligation to employees made prior to the appointment of a
2443	receiver and not carried out by the receiver.
2444	(i)  Shall be entitled to and take possession of all
2445	property or assets of residents which are in the possession of a
2446	residence, licensee, facility or its owner. The receiver shall
2447	preserve all property, assets, and records of residents of which
2448	the receiver takes possession and shall provide for the prompt
2449	transfer of the property, assets, and records to the new
2450	placement of any transferred resident. An inventory list
2451	certified by the licensee or owner and receiver shall be made
2452	immediately at the time the receiver takes possession of the
2453	residence facility.
2454	(4)(a)  A person who is served with notice of an order of
2455	the court appointing a receiver and of the receiver's name and
2456	address shall be liable to pay the receiver for any goods or
2457	services provided by the receiver after the date of the order if
2458	the person would have been liable for the goods or services as
2459	supplied by the licensee or owner. The receiver shall give a
2460	receipt for each payment and shall keep a copy of each receipt
2461	on file. The receiver shall deposit accounts received in a
2462	separate account and shall use this account for all
2463	disbursements.
2464	(b)  The receiver may bring an action to enforce the
2465	liability created by paragraph (a).
2466	(c)  A payment to the receiver of any sum owing to the
2467	residence, licensee, facility or its owner shall discharge any
2468	obligation to the residence facility to the extent of the
2469	payment.
2470	(5)(a)  A receiver may petition the court that he or she
2471	not be required to honor any lease, mortgage, secured
2472	transaction, or other wholly or partially executory contract
2473	entered into by the licensee or owner of the residence facility
2474	if the rent, price, or rate of interest required to be paid
2475	under the agreement was substantially in excess of a reasonable
2476	rent, price, or rate of interest at the time the contract was
2477	entered into, or if any material provision of the agreement was
2478	unreasonable, when compared to contracts negotiated under
2479	similar conditions. Any relief in this form provided by the
2480	court shall be limited to the life of the receivership, unless
2481	otherwise determined by the court.
2482	(b)  If the receiver is in possession of real estate or
2483	goods subject to a lease, mortgage, or security interest which
2484	the receiver has obtained a court order to avoid under paragraph
2485	(a), and if the real estate or goods are necessary for the
2486	continued operation of the residence facility under this
2487	section, the receiver may apply to the court to set a reasonable
2488	rental, price, or rate of interest to be paid by the receiver
2489	during the duration of the receivership. The court shall hold a
2490	hearing on the application within 15 days. The receiver shall
2491	send notice of the application to any known persons who own the
2492	property involved at least 10 days prior to the hearing. Payment
2493	by the receiver of the amount determined by the court to be
2494	reasonable is a defense to any action against the receiver for
2495	payment or for possession of the goods or real estate subject to
2496	the lease, security interest, or mortgage involved by any person
2497	who received such notice, but the payment does not relieve the
2498	licensee or owner of the residence facility of any liability for
2499	the difference between the amount paid by the receiver and the
2500	amount due under the original lease, security interest, or
2501	mortgage involved.
2502	(6)  The court shall set the compensation of the receiver,
2503	which will be considered a necessary expense of a receivership.
2504	(7)  A receiver may be held liable in a personal capacity
2505	only for the receiver's own gross negligence, intentional acts,
2506	or breach of fiduciary duty.
2507	(8)  The court may require a receiver to post a bond.
2508	(9)  The court may direct the agency to allocate funds from
2509	the Health Care Trust Fund to the receiver, subject to the
2510	provisions of s. 429.18.
2511	(10)  The court may terminate a receivership when:
2512	(a)  The court determines that the receivership is no
2513	longer necessary because the conditions which gave rise to the
2514	receivership no longer exist or the agency grants the licensee
2515	of the residence facility a new license; or
2516	(b)  All of the residents in the residence facility have
2517	been transferred or discharged.
2518	(11)  Within 30 days after termination, the receiver shall
2519	give the court a complete accounting of all property of which
2520	the receiver has taken possession, of all funds collected, and
2521	of the expenses of the receivership.
2522	(12)  Nothing in this section shall be deemed to relieve
2523	any licensee, owner, administrator, or employee of a residence
2524	facility placed in receivership of any civil or criminal
2525	liability incurred, or any duty imposed by law, by reason of
2526	acts or omissions of the licensee, owner, administrator, or
2527	employee prior to the appointment of a receiver; nor shall
2528	anything contained in this section be construed to suspend
2529	during the receivership any obligation of the owner,
2530	administrator, or employee for payment of taxes or other
2531	operating and maintenance expenses of the residence facility or
2532	of the licensee, owner, administrator, employee, or any other
2533	person for the payment of mortgages or liens. The owner shall
2534	retain the right to sell or mortgage any residence facility
2535	under receivership, subject to approval of the court which
2536	ordered the receivership.
2537	Section 29.  Section 429.23, Florida Statutes, is amended
2538	to read:
2539	429.23  Internal risk management and quality assurance
2540	program; adverse incidents and reporting requirements.-
2541	(1)  Every licensed residence facility licensed under this
2542	part may, as part of its administrative functions, voluntarily
2543	establish a risk management and quality assurance program, the
2544	purpose of which is to assess resident care practices, residence
2545	facility incident reports, violations deficiencies cited by the
2546	agency, adverse incident reports, and resident grievances and
2547	develop plans of action to correct and respond quickly to
2548	identify quality differences.
2549	(2)  Every licensed residence facility licensed under this
2550	part is required to maintain adverse incident reports. For
2551	purposes of this section, the term, "adverse incident" means:
2552	(a)  An event over which residence staff facility personnel
2553	could exercise control rather than as a result of the resident's
2554	condition and results in:
2555	1.  Death;
2556	2.  Brain or spinal damage;
2557	3.  Permanent disfigurement;
2558	4.  Fracture or dislocation of bones or joints;
2559	5.  Any condition that required medical attention to which
2560	the resident has not given his or her consent, excluding
2561	proceedings governed by part I of chapter 394, but including
2562	failure to honor advanced directives;
2563	6.  Any condition that requires the transfer of the
2564	resident from the residence facility to a unit providing more
2565	acute care due to the incident rather than the resident's
2566	condition before the incident; or
2567	7.  An event that is reported to law enforcement or its
2568	personnel for investigation; or
2569	(b)  Resident elopement, if the elopement places the
2570	resident at risk of harm or injury.
2571	(3)  Licensed facilities shall provide within 1 business
2572	day after the occurrence of an adverse incident, by electronic
2573	mail, facsimile, or United States mail, a preliminary report to
2574	the agency on all adverse incidents specified under this
2575	section. The report must include information regarding the
2576	identity of the affected resident, the type of adverse incident,
2577	and the status of the facility's investigation of the incident.
2578	(3)(4)  Licensed residences facilities shall provide within
2579	7 business 15 days after the occurrence of an adverse incident,
2580	by electronic mail, facsimile, or United States mail, a full
2581	report to the agency on the all adverse incident, including
2582	information regarding the identity of the affected resident, the
2583	type of adverse incident, and incidents specified in this
2584	section. The report must include the results of the residence's
2585	facility's investigation into the adverse incident.
2586	(5)  Each facility shall report monthly to the agency any
2587	liability claim filed against it. The report must include the
2588	name of the resident, the dates of the incident leading to the
2589	claim, if applicable, and the type of injury or violation of
2590	rights alleged to have occurred. This report is not discoverable
2591	in any civil or administrative action, except in such actions
2592	brought by the agency to enforce the provisions of this part.
2593	(4)(6)  Abuse, neglect, or exploitation must be reported to
2594	the Department of Children and Family Services as required under
2595	chapter 415.
2596	(5)(7)  The information reported to the agency pursuant to
2597	subsection (3) which relates to persons licensed under chapter
2598	458, chapter 459, chapter 461, chapter 464, or chapter 465 shall
2599	be reviewed by the agency. The agency shall determine whether
2600	any of the incidents potentially involved conduct by a health
2601	care professional who is subject to disciplinary action, in
2602	which case the provisions of s. 456.073 apply. The agency may
2603	investigate, as it deems appropriate, any such incident and
2604	prescribe measures that must or may be taken in response to the
2605	incident. The agency shall review each incident and determine
2606	whether it potentially involved conduct by a health care
2607	professional who is subject to disciplinary action, in which
2608	case the provisions of s. 456.073 apply.
2609	(6)(8)  If the agency, through its receipt of the adverse
2610	incident reports prescribed in this part or through any
2611	investigation, has reasonable belief that conduct by a staff
2612	member or employee of a licensed residence facility is grounds
2613	for disciplinary action by the appropriate board, the agency
2614	shall report this fact to such regulatory board.
2615	(7)(9)  The adverse incident report reports and preliminary
2616	adverse incident reports required under this section is are
2617	confidential as provided by law and is are not discoverable or
2618	admissible in any civil or administrative action, except in
2619	disciplinary proceedings by the agency or appropriate regulatory
2620	board.
2621	(8)(10)  The Department of Elderly Affairs may adopt rules
2622	necessary to administer this section.
2623	Section 30.  Section 429.24, Florida Statutes, is amended
2624	to read:
2625	429.24  Contracts.-
2626	(1)  The presence of each resident in a residence facility
2627	shall be covered by a contract, executed at the time of
2628	admission or prior thereto, between the licensee and the
2629	resident or his or her designee or legal representative. Each
2630	party to the contract shall be provided with a duplicate
2631	original thereof, and the licensee shall keep on file in the
2632	residence facility all such contracts. The licensee may not
2633	destroy or otherwise dispose of any such contract until 5 years
2634	after its expiration.
2635	(2)  Each contract must contain express provisions
2636	specifically setting forth the services and accommodations to be
2637	provided by the residence facility; the rates or charges;
2638	provision for at least 30 days' written notice of a rate
2639	increase; the rights, duties, and obligations of the residents,
2640	other than those specified in s. 429.28; and other matters that
2641	the parties deem appropriate. Whenever money is deposited or
2642	advanced by a resident in a contract as security for performance
2643	of the contract agreement or as advance rent for other than the
2644	next immediate rental period:
2645	(a)  Such funds shall be deposited in a banking institution
2646	in this state that is located, if possible, in the same
2647	community in which the residence facility is located; shall be
2648	kept separate from the funds and property of the residence
2649	facility; may not be represented as part of the assets of the
2650	residence facility on financial statements; and shall be used,
2651	or otherwise expended, only for the account of the resident.
2652	(b)  The licensee shall, within 30 days of receipt of
2653	advance rent or a security deposit, notify the resident or
2654	residents in writing of the manner in which the licensee is
2655	holding the advance rent or security deposit and state the name
2656	and address of the depository where the moneys are being held.
2657	The licensee shall notify residents of the residence's
2658	facility's policy on disposition of advance deposits.
2659	(3)(a)  The contract shall include a refund policy to be
2660	implemented at the time of a resident's transfer, discharge, or
2661	death. The refund policy shall provide that the resident or
2662	responsible party is entitled to a prorated refund based on the
2663	daily rate for any unused portion of payment beyond the
2664	termination date after all charges, including the cost of
2665	damages to the residential unit resulting from circumstances
2666	other than normal use, have been paid to the licensee. For the
2667	purpose of this paragraph, the termination date shall be the
2668	date the unit is vacated by the resident and cleared of all
2669	personal belongings. If the amount of belongings does not
2670	preclude renting the unit, the residence facility may clear the
2671	unit and charge the resident or his or her estate for moving and
2672	storing the items at a rate equal to the actual cost to the
2673	residence facility, not to exceed 20 percent of the regular rate
2674	for the unit, provided that 14 days' advance written
2675	notification is given. If the resident's possessions are not
2676	claimed within 45 days after notification, the residence
2677	facility may dispose of them. The contract shall also specify
2678	any other conditions under which claims will be made against the
2679	refund due the resident. Except in the case of death or a
2680	discharge due to medical reasons, the refunds shall be computed
2681	in accordance with the notice of relocation requirements
2682	specified in the contract. However, a resident may not be
2683	required to provide the licensee with more than 30 days' notice
2684	of termination. If after a contract is terminated, the licensee
2685	facility intends to make a claim against a refund due the
2686	resident, the licensee facility shall notify the resident or
2687	responsible party in writing of the claim and shall provide said
2688	party with a reasonable time period of no less than 14 calendar
2689	days to respond. The licensee facility shall provide a refund to
2690	the resident or responsible party within 45 days after the
2691	transfer, discharge, or death of the resident. The agency shall
2692	impose a fine upon a licensee facility that fails to comply with
2693	the refund provisions of the paragraph, which fine shall be
2694	equal to three times the amount due to the resident. One-half of
2695	the fine shall be remitted to the resident or his or her estate,
2696	and the other half to the Health Care Trust Fund to be used for
2697	the purpose specified in s. 429.18.
2698	(b)  If a licensee agrees to reserve a bed for a resident
2699	who is admitted to a medical facility, including, but not
2700	limited to, a nursing home, health care facility, or psychiatric
2701	facility, the resident or his or her responsible party shall
2702	notify the licensee of any change in status that would prevent
2703	the resident from returning to the residence facility. Until
2704	such notice is received, the agreed-upon daily rate may be
2705	charged by the licensee.
2706	(c)  The purpose of any advance payment and a refund policy
2707	for such payment, including any advance payment for housing,
2708	meals, or personal services, shall be covered in the contract.
2709	(4)  The contract shall state whether or not the residence
2710	facility is affiliated with any religious organization and, if
2711	so, which organization and its general responsibility to the
2712	residence facility.
2713	(5)  Neither the contract nor any provision thereof
2714	relieves any licensee of any requirement or obligation imposed
2715	upon the licensee it by this part or rules adopted under this
2716	part.
2717	(6)  In lieu of the provisions of this section, facilities
2718	certified under chapter 651 shall comply with the requirements
2719	of s. 651.055.
2720	(7)  Notwithstanding the provisions of this section,
2721	residences facilities which consist of 60 or more dwelling units
2722	apartments may require refund policies and termination notices
2723	in accordance with the provisions of part II of chapter 83,
2724	provided that the lease is terminated automatically without
2725	financial penalty in the event of a resident's death or
2726	relocation due to psychiatric hospitalization or to medical
2727	reasons which necessitate services or care beyond which the
2728	licensee facility is licensed to provide. The date of
2729	termination in such instances shall be the date the unit is
2730	fully vacated. A lease may be substituted for the contract if it
2731	meets the disclosure requirements of this section. For the
2732	purpose of this section, the term "apartment" means a room or
2733	set of rooms with a kitchen or kitchenette and lavatory located
2734	within one or more buildings containing other similar or like
2735	residential units.
2736	(8)  The department may by rule clarify terms, establish
2737	procedures, clarify refund policies and contract provisions, and
2738	specify documentation as necessary to administer this section.
2739	Section 31.  Section 429.255, Florida Statutes, is amended
2740	to read:
2741	429.255  Use of personnel; emergency care.-
2742	(1)(a)  Persons under contract to the residence facility,
2743	or residence facility staff, or volunteers, who are licensed
2744	according to part I of chapter 464, or those persons exempt
2745	under s. 464.022(1), and others as defined by rule, may
2746	administer medications to residents, take residents' vital
2747	signs, manage individual weekly pill organizers for residents
2748	who self-administer medication, give prepackaged enemas ordered
2749	by a physician, observe residents, document observations on the
2750	appropriate resident's record, report observations to the
2751	resident's physician, and contract or allow residents or a
2752	resident's representative, designee, surrogate, guardian, or
2753	attorney in fact to contract with a third party, provided
2754	residents meet the criteria for appropriate placement as defined
2755	in s. 429.26. Nursing assistants certified pursuant to part II
2756	of chapter 464 may take residents' vital signs as directed by a
2757	licensed nurse or physician. Persons under contract to the
2758	residence or residence staff who are licensed under part I of
2759	chapter 464 may provide limited nursing services.
2760	(b)  All staff in residences facilities licensed under this
2761	part shall exercise their professional responsibility to observe
2762	residents, to document observations on the appropriate
2763	resident's record, and to report the observations to the
2764	administrator or the administrator's designee resident's
2765	physician. The However, the owner or administrator of the
2766	residence facility shall be responsible for determining that the
2767	resident receiving services is appropriate for residence in the
2768	assisted living residence facility.
2769	(c)  In an emergency situation, licensed personnel may
2770	carry out their professional duties pursuant to part I of
2771	chapter 464 until emergency medical personnel assume
2772	responsibility for care.
2773	(2)  In residences for which a licensee has been facilities
2774	licensed to provide extended congregate care, persons under
2775	contract to the residence facility, or residence facility staff,
2776	or volunteers, who are licensed according to part I of chapter
2777	464, or those persons exempt under s. 464.022(1), or those
2778	persons certified as nursing assistants pursuant to part II of
2779	chapter 464, may also perform all duties within the scope of
2780	their license or certification, as approved by the residence
2781	facility administrator and pursuant to this part.
2782	(3)  Residence Facility staff may withhold or withdraw
2783	cardiopulmonary resuscitation if presented with an order not to
2784	resuscitate executed pursuant to s. 401.45. The department shall
2785	adopt rules providing for the implementation of such orders.
2786	Residence Facility staff and residences facilities shall not be
2787	subject to criminal prosecution or civil liability, nor be
2788	considered to have engaged in negligent or unprofessional
2789	conduct, for withholding or withdrawing cardiopulmonary
2790	resuscitation pursuant to such an order and rules adopted by the
2791	department. The absence of an order to resuscitate executed
2792	pursuant to s. 401.45 does not preclude a physician from
2793	withholding or withdrawing cardiopulmonary resuscitation as
2794	otherwise permitted by law.
2795	Section 32.  Section 429.256, Florida Statutes, is amended
2796	to read:
2797	429.256  Assistance with self-administration of
2798	medication.-
2799	(1)  For the purposes of this section, the term:
2800	(a)  "Informed consent" means advising the resident, or the
2801	resident's surrogate, guardian, or attorney in fact, that an
2802	assisted living residence facility is not required to have a
2803	licensed nurse on staff, that the resident may be receiving
2804	assistance with self-administration of medication from an
2805	unlicensed person, and that such assistance, if provided by an
2806	unlicensed person, will or will not be overseen by a licensed
2807	nurse.
2808	(b)  "Unlicensed person" means an individual not currently
2809	licensed to practice nursing or medicine who is employed by or
2810	under contract to an assisted living residence facility and who
2811	has received training with respect to assisting with the self-
2812	administration of medication in an assisted living residence
2813	facility as provided under s. 429.52 prior to providing such
2814	assistance as described in this section.
2815	(2)  Residents who are capable of self-administering their
2816	own medications without assistance shall be encouraged and
2817	allowed to do so. However, an unlicensed person may, consistent
2818	with a dispensed prescription's label or the package directions
2819	of an over-the-counter medication, assist a resident whose
2820	condition is medically stable with the self-administration of
2821	routine, regularly scheduled medications that are intended to be
2822	self-administered. Assistance with self-medication by an
2823	unlicensed person may occur only upon a documented request by,
2824	and the written informed consent of, a resident or the
2825	resident's surrogate, guardian, or attorney in fact. To minimize
2826	the potential risk for improper dosage administration of
2827	prescription drugs, a residence may require standard medication
2828	dispensing systems for residents' prescriptions. For the
2829	purposes of this section, self-administered medications include
2830	both legend and over-the-counter oral dosage forms, topical
2831	dosage forms and topical ophthalmic, otic, and nasal dosage
2832	forms including solutions, suspensions, sprays, and inhalers.
2833	(3)  Assistance with self-administration of medication
2834	includes:
2835	(a)  Taking the medication, in its previously dispensed,
2836	properly labeled container, from where it is stored, and
2837	bringing it to the resident.
2838	(b)  In the presence of the resident, reading the label,
2839	opening the container, removing a prescribed amount of
2840	medication from the container, and closing the container.
2841	(c)  Placing an oral dosage in the resident's hand or
2842	placing the dosage in another container and helping the resident
2843	by lifting the container to his or her mouth.
2844	(d)  Applying topical medications.
2845	(e)  Returning the medication container to proper storage.
2846	(f)  Keeping a record of when a resident receives
2847	assistance with self-administration under this section.
2848	(g)  Preparing syringes for injection or the administration
2849	of medications by any injectable route.
2850	(h)  Administering medications through intermittent
2851	positive pressure breathing machines or a nebulizer.
2852	(i)  Using a glucometer to perform blood glucose checks.
2853	(j)  Assisting with the putting on and taking off ted hose.
2854	(4)  Assistance with self-administration does not include:
2855	(a)  Mixing, compounding, converting, or calculating
2856	medication doses, except for measuring a prescribed amount of
2857	liquid medication or breaking a scored tablet or crushing a
2858	tablet as prescribed.
2859	(b)  The preparation of syringes for injection or the
2860	administration of medications by any injectable route.
2861	(c)  Administration of medications through intermittent
2862	positive pressure breathing machines or a nebulizer.
2863	(b)(d)  Administration of medications by way of a tube
2864	inserted in a cavity of the body.
2865	(c)(e)  Administration of parenteral preparations.
2866	(d)(f)  Irrigations or debriding agents used in the
2867	treatment of a skin condition.
2868	(e)(g)  Rectal, urethral, or vaginal preparations.
2869	(f)(h)  Medications ordered by the physician or health care
2870	professional with prescriptive authority to be given "as
2871	needed," unless the order is written with specific parameters
2872	that preclude independent judgment on the part of the unlicensed
2873	person, and at the request of a competent resident.
2874	(g)(i)  Medications for which the time of administration,
2875	the amount, the strength of dosage, the method of
2876	administration, or the reason for administration requires
2877	judgment or discretion on the part of the unlicensed person.
2878	(5)  Assistance with the self-administration of medication
2879	by an unlicensed person as described in this section shall not
2880	be considered administration as defined in s. 465.003.
2881	(6)  The department may by rule establish residence
2882	facility procedures and interpret terms as necessary to
2883	implement this section.
2884	Section 33.  Section 429.26, Florida Statutes, is amended
2885	to read:
2886	429.26  Appropriateness of placements; examinations of
2887	residents.-
2888	(1)  The owner or administrator of a residence facility is
2889	responsible for determining the appropriateness of admission of
2890	an individual to the residence facility and for determining the
2891	continued appropriateness of residency residence of an
2892	individual in the residence facility. A determination shall be
2893	based upon an assessment of the strengths, needs, and
2894	preferences of the resident, the care and services offered or
2895	arranged for by the residence facility in accordance with
2896	residence facility policy, and any limitations in law or rule
2897	related to admission criteria or continued residency for the
2898	type of license held by the licensee of the residence facility
2899	under this part. A resident may not be moved from one residence
2900	facility to another without consultation with and agreement from
2901	the resident or, if applicable, the resident's representative or
2902	designee or the resident's family, guardian, surrogate, or
2903	attorney in fact. In the case of a resident who has been placed
2904	by the department or the Department of Children and Family
2905	Services, the administrator must notify the appropriate contact
2906	person in the applicable department.
2907	(2)  A physician, physician assistant, or nurse
2908	practitioner who is employed by an assisted living residence
2909	facility to provide an initial examination for admission
2910	purposes may not have financial interest in the residence
2911	facility.
2912	(3)  Persons licensed under part I of chapter 464 who are
2913	employed by or under contract with a residence facility shall,
2914	on a routine basis or at least monthly, perform a nursing
2915	assessment of the residents for whom they are providing nursing
2916	services ordered by a physician, except administration of
2917	medication, and shall document such assessment, including any
2918	significant change substantial changes in a resident's status
2919	which may necessitate relocation to a nursing home, hospital, or
2920	specialized health care facility. Such records shall be
2921	maintained in the residence facility for inspection by the
2922	agency and shall be forwarded to the resident's case manager, if
2923	applicable.
2924	(4)  If possible, each resident shall have been examined by
2925	a licensed physician, a licensed physician assistant, or a
2926	licensed nurse practitioner within 60 days before admission to
2927	the residence facility. The signed and completed medical
2928	examination report shall be submitted to the owner or
2929	administrator of the residence facility who shall use the
2930	information contained therein to assist in the determination of
2931	the appropriateness of the resident's admission and continued
2932	stay in the residence facility. The medical examination report
2933	shall become a permanent part of the record of the resident at
2934	the residence facility and shall be made available to the agency
2935	during inspection or upon request. An assessment that has been
2936	completed through the Comprehensive Assessment and Review for
2937	Long-Term Care Services (CARES) Program fulfills the
2938	requirements for a medical examination under this subsection and
2939	s. 429.07(3)(b)6.
2940	(5)  Except as provided in s. 429.07, if a medical
2941	examination has not been completed within 60 days before the
2942	admission of the resident to the residence facility, a licensed
2943	physician, licensed physician assistant, or licensed nurse
2944	practitioner shall examine the resident and complete a medical
2945	examination form provided by the agency within 30 days following
2946	the admission to the residence facility to enable the residence
2947	licensee, facility owner or administrator to determine the
2948	appropriateness of the admission. The medical examination form
2949	shall become a permanent part of the record of the resident at
2950	the residence facility and shall be made available to the agency
2951	during inspection by the agency or upon request.
2952	(6)  Any resident accepted in a residence facility and
2953	placed by the department or the Department of Children and
2954	Family Services shall have been examined by medical personnel
2955	within 30 days before placement in the residence facility. The
2956	examination shall include an assessment of the appropriateness
2957	of placement in a residence facility. The findings of this
2958	examination shall be recorded on the examination form provided
2959	by the agency. The completed form shall accompany the resident
2960	and shall be submitted to the residence facility owner or
2961	administrator. Additionally, in the case of a mental health
2962	resident, the Department of Children and Family Services must
2963	provide documentation that the individual has been assessed by a
2964	psychiatrist, clinical psychologist, clinical social worker, or
2965	psychiatric nurse, or an individual who is supervised by one of
2966	these professionals, and determined to be appropriate to reside
2967	in an assisted living residence facility. The documentation must
2968	be in the residence facility within 30 days after the mental
2969	health resident has been admitted to the residence facility. An
2970	evaluation completed upon discharge from a state mental hospital
2971	meets the requirements of this subsection related to
2972	appropriateness for placement as a mental health resident
2973	providing it was completed within 90 days prior to admission to
2974	the residence facility. The applicable department shall provide
2975	to the residence facility administrator any information about
2976	the resident that would help the administrator meet his or her
2977	responsibilities under subsection (1). Further, department
2978	personnel shall explain to the residence administrator facility
2979	operator any special needs of the resident and advise the
2980	administrator operator whom to call should problems arise. The
2981	applicable department shall advise and assist the residence
2982	facility administrator where the special needs of residents who
2983	are recipients of optional state supplementation require such
2984	assistance.
2985	(7)  The facility must notify a licensed physician when a
2986	resident exhibits signs of dementia or cognitive impairment or
2987	has a change of condition in order to rule out the presence of
2988	an underlying physiological condition that may be contributing
2989	to such dementia or impairment. The notification must occur
2990	within 30 days after the acknowledgment of such signs by
2991	facility staff. If an underlying condition is determined to
2992	exist, the facility shall arrange, with the appropriate health
2993	care provider, the necessary care and services to treat the
2994	condition.
2995	(7)(8)  The Department of Children and Family Services may
2996	require an examination for supplemental security income and
2997	optional state supplementation recipients residing in facilities
2998	at any time and shall provide the examination whenever a
2999	resident's condition requires it. Any facility administrator;
3000	personnel of the agency, the department, or the Department of
3001	Children and Family Services; or long-term care ombudsman
3002	council member who believes a resident needs to be evaluated
3003	shall notify the resident's case manager, who shall take
3004	appropriate action. A report of the examination findings shall
3005	be provided to the resident's case manager and the facility
3006	administrator to help the administrator meet his or her
3007	responsibilities under subsection (1).
3008	(8)(9)  A terminally ill resident who no longer meets the
3009	criteria for continued residency may remain in the residence
3010	facility if the arrangement is mutually agreeable to the
3011	resident and the administrator, facility; additional care is
3012	rendered through a licensed hospice, and the resident is under
3013	the care of a physician who agrees that the physical needs of
3014	the resident are being met.
3015	(9)(10)  Residences Facilities licensed to provide extended
3016	congregate care services shall promote aging in place by
3017	determining appropriateness of continued residency based on a
3018	comprehensive review of the resident's physical and functional
3019	status; the ability of the residence facility, family members,
3020	friends, or any other pertinent individuals or agencies to
3021	provide the care and services required; and documentation that a
3022	written service plan consistent with residence facility policy
3023	has been developed and implemented to ensure that the resident's
3024	needs and preferences are addressed.
3025	(10)(11)  A No resident who requires 24-hour nursing
3026	supervision, except for a resident who is an enrolled hospice
3027	patient pursuant to part IV of chapter 400, may not shall be
3028	retained in a licensed residence facility licensed under this
3029	part.
3030	Section 34.  Section 429.27, Florida Statutes, is amended
3031	to read:
3032	429.27  Property and personal affairs of residents.-
3033	(1)(a)  A resident shall be given the option of using his
3034	or her own belongings, as space permits; choosing his or her
3035	roommate; and, whenever possible, unless the resident is
3036	adjudicated incompetent or incapacitated under state law,
3037	managing his or her own affairs.
3038	(b)  The admission of a resident to a residence facility
3039	and his or her presence therein shall not give confer on the
3040	residence facility or its licensee, owner, administrator,
3041	employees, or representatives any authority to manage, use, or
3042	dispose of any property of the resident; nor shall such
3043	admission or presence confer on any of such persons any
3044	authority or responsibility for the personal affairs of the
3045	resident, except that which may be necessary for the safe
3046	management of the residence facility or for the safety of the
3047	resident.
3048	(2)  The licensee, A facility, or an owner, administrator,
3049	or employee of an assisted living residence, or representative
3050	thereof, may not act as the guardian, trustee, or conservator
3051	for any resident of the residence assisted living facility or
3052	any of such resident's property. A licensee, An owner,
3053	administrator, or staff member, or representative thereof, may
3054	not act as a competent resident's payee for social security,
3055	veteran's, or railroad benefits without the consent of the
3056	resident. Any residence facility whose licensee, owner,
3057	administrator, or staff, or representative thereof, serves as
3058	representative payee for any resident of the residence facility
3059	shall file a surety bond with the agency in an amount equal to
3060	twice the average monthly aggregate income or personal funds due
3061	to residents, or expendable for their account, which are
3062	received by a residence facility. Any residence facility whose
3063	licensee, owner, administrator, or staff, or a representative
3064	thereof, is granted power of attorney for any resident of the
3065	residence facility shall file a surety bond with the agency for
3066	each resident for whom such power of attorney is granted. The
3067	surety bond shall be in an amount equal to twice the average
3068	monthly income of the resident, plus the value of any resident's
3069	property under the control of the attorney in fact. The bond
3070	shall be executed by the residence's licensee, owner,
3071	administrator, or staff, or a representative thereof, facility
3072	as principal and a licensed surety company. The bond shall be
3073	conditioned upon the faithful compliance of the licensee, owner,
3074	administrator, or staff, or a representative thereof, of the
3075	residence facility with this section and shall run to the agency
3076	for the benefit of any resident who suffers a financial loss as
3077	a result of the misuse or misappropriation by a licensee, owner,
3078	administrator, or staff, or representative thereof, of the
3079	residence facility of funds held pursuant to this subsection.
3080	Any surety company that cancels or does not renew the bond of
3081	any licensee shall notify the agency in writing not less than 30
3082	days in advance of such action, giving the reason for the
3083	cancellation or nonrenewal. Any residence's licensee, facility
3084	owner, administrator, or staff, or representative thereof, who
3085	is granted power of attorney for any resident of the residence
3086	facility shall, on a monthly basis, be required to provide the
3087	resident a written statement of any transaction made on behalf
3088	of the resident pursuant to this subsection, and a copy of such
3089	statement given to the resident shall be retained in each
3090	resident's file and available for agency inspection.
3091	(3)  A residence administrator facility, upon mutual
3092	consent with the resident, shall provide for the safekeeping in
3093	the residence facility of personal effects, including funds, not
3094	in excess of $500 and funds of the resident not in excess of
3095	$200 cash, and shall keep complete and accurate records of all
3096	such funds and personal effects received. If a resident is
3097	absent from a residence facility for 24 hours or more, the
3098	residence facility may provide for the safekeeping of the
3099	resident's personal effects, including funds, in excess of $500.
3100	(4)  Any funds or other property belonging to or due to a
3101	resident, or expendable for his or her account, which is
3102	received by the administrator a facility shall be trust funds
3103	which shall be kept separate from the funds and property of the
3104	residence facility and other residents or shall be specifically
3105	credited to such resident. Such trust funds shall be used or
3106	otherwise expended only for the account of the resident. Upon
3107	written request, at least once every 3 months, unless upon order
3108	of a court of competent jurisdiction, the administrator facility
3109	shall furnish the resident and his or her guardian, trustee, or
3110	conservator, if any, a complete and verified statement of all
3111	funds and other property to which this subsection applies,
3112	detailing the amount and items received, together with their
3113	sources and disposition. In any event, the administrator
3114	facility shall furnish such statement annually and upon the
3115	discharge or transfer of a resident. Any governmental agency or
3116	private charitable agency contributing funds or other property
3117	to the account of a resident shall also be entitled to receive
3118	such statement annually and upon the discharge or transfer of
3119	the resident.
3120	(5)  Any personal funds available to residence facility
3121	residents may be used by residents as they choose to obtain
3122	clothing, personal items, leisure activities, and other supplies
3123	and services for their personal use. An administrator A facility
3124	may not demand, require, or contract for payment of all or any
3125	part of the personal funds in satisfaction of the residence
3126	facility rate for supplies and services beyond that amount
3127	agreed to in writing and may not levy an additional charge to
3128	the individual or the account for any supplies or services that
3129	the facility has agreed by contract to provide as part of the
3130	standard monthly rate. Any service or supplies provided by the
3131	residence facility which are charged separately to the
3132	individual or the account may be provided only with the specific
3133	written consent of the individual, who shall be furnished in
3134	advance of the provision of the services or supplies with an
3135	itemized written statement to be attached to the contract
3136	setting forth the charges for the services or supplies.
3137	(6)(a)  In addition to any damages or civil penalties to
3138	which a person is subject, any person who:
3139	1.  Intentionally withholds a resident's personal funds,
3140	personal property, or personal needs allowance, or who demands,
3141	beneficially receives, or contracts for payment of all or any
3142	part of a resident's personal property or personal needs
3143	allowance in satisfaction of the residence facility rate for
3144	supplies and services; or
3145	2.  Borrows from or pledges any personal funds of a
3146	resident, other than the amount agreed to by written contract
3147	under s. 429.24,
3148
3149	commits a misdemeanor of the first degree, punishable as
3150	provided in s. 775.082 or s. 775.083.
3151	(b)  Any residence, licensee, facility owner,
3152	administrator, or staff, or representative thereof, who is
3153	granted power of attorney for any resident of the residence
3154	facility and who misuses or misappropriates funds obtained
3155	through this power commits a felony of the third degree,
3156	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
3157	(7)  In the event of the death of a resident, a licensee
3158	shall return all refunds, funds, and property held in trust to
3159	the resident's personal representative, if one has been
3160	appointed at the time the residence facility disburses such
3161	funds, and, if not, to the resident's spouse or adult next of
3162	kin named in a beneficiary designation form provided by the
3163	licensee facility to the resident. If the resident has no spouse
3164	or adult next of kin or such person cannot be located, funds due
3165	the resident shall be placed in an interest-bearing account, and
3166	all property held in trust by the licensee facility shall be
3167	safeguarded until such time as the funds and property are
3168	disbursed pursuant to the Florida Probate Code. Such funds shall
3169	be kept separate from the funds and property of the residence
3170	facility and other residents of the residence facility. If the
3171	funds of the deceased resident are not disbursed pursuant to the
3172	Florida Probate Code within 2 years after the resident's death,
3173	the funds shall be deposited in the Health Care Trust Fund
3174	administered by the agency.
3175	(8)  The department may by rule clarify terms and specify
3176	procedures and documentation necessary to administer the
3177	provisions of this section relating to the proper management of
3178	residents' funds and personal property and the execution of
3179	surety bonds.
3180	Section 35.  Section 429.275, Florida Statutes, is amended
3181	to read:
3182	429.275  Business practice; personnel records; liability
3183	insurance.-The assisted living residence facility shall be
3184	administered on a sound financial basis that is consistent with
3185	good business practices.
3186	(1)  The licensee, administrator, or owner of a residence
3187	facility shall maintain accurate business records that identify,
3188	summarize, and classify funds received and expenses disbursed
3189	and shall use written accounting procedures and a recognized
3190	accounting system.
3191	(2)  The licensee, administrator, or owner of a residence
3192	facility shall maintain personnel records for each staff member
3193	which contain, at a minimum, documentation of background
3194	screening, if applicable, documentation of compliance with all
3195	training requirements of this part or applicable rule, and a
3196	copy of all licenses or certification held by each staff who
3197	performs services for which licensure or certification is
3198	required under this part or rule.
3199	(3)  The licensee, administrator, or owner of a residence
3200	facility shall maintain liability insurance coverage that is in
3201	force at all times.
3202	(4)  The department may by rule clarify terms, establish
3203	requirements for financial records, accounting procedures,
3204	personnel procedures, insurance coverage, and reporting
3205	procedures, and specify documentation as necessary to implement
3206	the requirements of this section.
3207	Section 36.  Section 429.28, Florida Statutes, is amended
3208	to read:
3209	429.28  Resident bill of rights.-
3210	(1)  No resident of a residence facility shall be deprived
3211	of any civil or legal rights, benefits, or privileges guaranteed
3212	by law, the Constitution of the State of Florida, or the
3213	Constitution of the United States as a resident of an assisted
3214	living residence a facility. Every resident of a residence
3215	facility shall have the right to:
3216	(a)  Live in a safe and decent living environment, free
3217	from abuse and neglect.
3218	(b)  Be treated with consideration and respect and with due
3219	recognition of personal dignity, individuality, and the need for
3220	privacy.
3221	(c)  Retain and use his or her own clothes and other
3222	personal property in his or her immediate living quarters, so as
3223	to maintain individuality and personal dignity, except when the
3224	residence facility can demonstrate that such would be unsafe,
3225	impractical, or an infringement upon the rights of other
3226	residents.
3227	(d)  Unrestricted private communication, including
3228	receiving and sending unopened correspondence, access to a
3229	telephone, and visiting with any person of his or her choice, at
3230	any time between the hours of 9 a.m. and 9 p.m. at a minimum.
3231	Upon request, the administrator facility shall make provisions
3232	to extend visiting hours for caregivers and out-of-town guests,
3233	and in other similar situations.
3234	(e)  Freedom to participate in and benefit from community
3235	services and activities and to achieve the highest possible
3236	level of independence, autonomy, and interaction within the
3237	community.
3238	(f)  Manage his or her financial affairs unless the
3239	resident or, if applicable, the resident's representative,
3240	designee, surrogate, guardian, or attorney in fact authorizes
3241	the administrator of the residence facility to provide
3242	safekeeping for funds as provided in s. 429.27.
3243	(g)  Share a room with his or her spouse if both are
3244	residents of the residence facility.
3245	(h)  Reasonable opportunity for regular exercise several
3246	times a week and to be outdoors at regular and frequent
3247	intervals except when prevented by inclement weather.
3248	(i)  Exercise civil and religious liberties, including the
3249	right to independent personal decisions. No religious beliefs or
3250	practices, nor any attendance at religious services, shall be
3251	imposed upon any resident.
3252	(j)  Access to adequate and appropriate health care
3253	consistent with established and recognized standards within the
3254	community.
3255	(k)  At least 30 45 days' notice of relocation or
3256	termination of residency from the residence facility unless, for
3257	medical reasons, the resident is certified by a physician to
3258	require an emergency relocation to a facility providing a more
3259	skilled level of care or the resident engages in a pattern of
3260	conduct that is harmful or offensive to other residents. In the
3261	case of a resident who has been adjudicated mentally
3262	incapacitated, the guardian shall be given at least 30 45 days'
3263	notice of a nonemergency relocation or residency termination.
3264	Reasons for relocation shall be set forth in writing. In order
3265	for a facility to terminate the residency of an individual
3266	without notice as provided herein, the facility shall show good
3267	cause in a court of competent jurisdiction.
3268	(l)  Present grievances and recommend changes in policies,
3269	procedures, and services to the staff of the residence facility,
3270	governing officials, or any other person without restraint,
3271	interference, coercion, discrimination, or reprisal. The
3272	administrator of each residence Each facility shall establish a
3273	grievance procedure to facilitate the residents' exercise of
3274	this right. This right includes access to ombudsman volunteers
3275	and advocates and the right to be a member of, to be active in,
3276	and to associate with advocacy or special interest groups.
3277	(2)  The administrator of a residence facility shall ensure
3278	that a written notice of the rights, obligations, and
3279	prohibitions set forth in this part is posted in a prominent
3280	place in each residence facility and read or explained to
3281	residents who cannot read. This notice shall include the name,
3282	address, and telephone numbers of the local ombudsman council
3283	and central abuse hotline and, when applicable, the Advocacy
3284	Center for Persons with Disabilities, Inc., and the Florida
3285	local advocacy council, where complaints may be lodged. The
3286	administrator facility must ensure a resident's access to a
3287	telephone to call the local ombudsman council, central abuse
3288	hotline, Advocacy Center for Persons with Disabilities, Inc.,
3289	and the Florida local advocacy council.
3290	(3)(a)  The agency shall conduct a survey to determine
3291	general compliance with facility standards and compliance with
3292	residents' rights as a prerequisite to initial licensure or
3293	licensure renewal.
3294	(b)  In order to determine whether the facility is
3295	adequately protecting residents' rights, the biennial survey
3296	shall include private informal conversations with a sample of
3297	residents and consultation with the ombudsman council in the
3298	planning and service area in which the facility is located to
3299	discuss residents' experiences within the facility.
3300	(c)  During any calendar year in which no survey is
3301	conducted, the agency shall conduct at least one monitoring
3302	visit of each facility cited in the previous year for a class I
3303	or class II violation, or more than three uncorrected class III
3304	violations.
3305	(d)  The agency may conduct periodic followup inspections
3306	as necessary to monitor the compliance of facilities with a
3307	history of any class I, class II, or class III violations that
3308	threaten the health, safety, or security of residents.
3309	(e)  The agency may conduct complaint investigations as
3310	warranted to investigate any allegations of noncompliance with
3311	requirements required under this part or rules adopted under
3312	this part.
3313	(3)(4)  The administrator shall ensure that facility shall
3314	not hamper or prevent residents are not hampered or prevented
3315	from exercising their rights as specified in this section.
3316	(4)(5)  No staff member facility or employee of a residence
3317	facility may serve notice upon a resident to leave the premises
3318	or take any other retaliatory action against any person who:
3319	(a)  Exercises any right set forth in this section.
3320	(b)  Appears as a witness in any hearing, inside or outside
3321	the residence facility.
3322	(c)  Files a civil action alleging a violation of the
3323	provisions of this part or notifies a state attorney or the
3324	Attorney General of a possible violation of such provisions.
3325	(5)(6)  An administrator shall not terminate Any facility
3326	which terminates the residency of an individual who participated
3327	in activities specified in subsection (4)(5) shall show good
3328	cause in a court of competent jurisdiction.
3329	(6)(7)  Any person who submits or reports a complaint
3330	concerning a suspected violation of the provisions of this part
3331	or concerning services and conditions in residences facilities,
3332	or who testifies in any administrative or judicial proceeding
3333	arising from such a complaint, shall have immunity from any
3334	civil or criminal liability therefor, unless such person has
3335	acted in bad faith or with malicious purpose or the court finds
3336	that there was a complete absence of a justiciable issue of
3337	either law or fact raised by the losing party.
3338	Section 37.  Section 429.293, Florida Statutes, is amended
3339	to read:
3340	429.293  Presuit notice; investigation; notification of
3341	violation of residents' rights or alleged negligence; claims
3342	evaluation procedure; informal discovery; review; settlement
3343	offer; mediation.-
3344	(1)  As used in this section, the term:
3345	(a)  "Claim for residents' rights violation or negligence"
3346	means a negligence claim alleging injury to or the death of a
3347	resident arising out of an asserted violation of the rights of a
3348	resident under s. 429.28 or an asserted deviation from the
3349	applicable standard of care.
3350	(b)  "Insurer" means any self-insurer authorized under s.
3351	627.357, liability insurance carrier, joint underwriting
3352	association, or uninsured prospective defendant.
3353	(2)  Prior to filing a claim for a violation of a
3354	resident's rights or a claim for negligence, a claimant alleging
3355	injury to or the death of a resident shall notify each
3356	prospective defendant by certified mail, return receipt
3357	requested, of an asserted violation of a resident's rights
3358	provided in s. 429.28 or deviation from the standard of care.
3359	Such notification shall include an identification of the rights
3360	the prospective defendant has violated and the negligence
3361	alleged to have caused the incident or incidents and a brief
3362	description of the injuries sustained by the resident which are
3363	reasonably identifiable at the time of notice. The notice shall
3364	contain a certificate of counsel that counsel's reasonable
3365	investigation gave rise to a good faith belief that grounds
3366	exist for an action against each prospective defendant.
3367	(3)(a)  No suit may be filed for a period of 75 days after
3368	notice is mailed to any prospective defendant. During the 75-day
3369	period, the prospective defendants or their insurers shall
3370	conduct an evaluation of the claim to determine the liability of
3371	each defendant and to evaluate the damages of the claimants.
3372	Each defendant or insurer of the defendant shall have a
3373	procedure for the prompt evaluation of claims during the 75-day
3374	period. The procedure shall include one or more of the
3375	following:
3376	1.  Internal review by a duly qualified facility risk
3377	manager or claims adjuster;
3378	2.  Internal review by counsel for each prospective
3379	defendant;
3380	3.  A quality assurance committee authorized under any
3381	applicable state or federal statutes or regulations; or
3382	4.  Any other similar procedure that fairly and promptly
3383	evaluates the claims.
3384
3385	Each defendant or insurer of the defendant shall evaluate the
3386	claim in good faith.
3387	(b)  At or before the end of the 75 days, the defendant or
3388	insurer of the defendant shall provide the claimant with a
3389	written response:
3390	1.  Rejecting the claim; or
3391	2.  Making a settlement offer.
3392	(c)  The response shall be delivered to the claimant if not
3393	represented by counsel or to the claimant's attorney, by
3394	certified mail, return receipt requested. Failure of the
3395	prospective defendant or insurer of the defendant to reply to
3396	the notice within 75 days after receipt shall be deemed a
3397	rejection of the claim for purposes of this section.
3398	(4)  The notification of a violation of a resident's rights
3399	or alleged negligence shall be served within the applicable
3400	statute of limitations period; however, during the 75-day
3401	period, the statute of limitations is tolled as to all
3402	prospective defendants. Upon written stipulation by the parties,
3403	the 75-day period may be extended and the statute of limitations
3404	is tolled during any such extension. Upon receiving written
3405	notice by certified mail, return receipt requested, of
3406	termination of negotiations in an extended period, the claimant
3407	shall have 30 60 days or the remainder of the period of the
3408	statute of limitations, whichever is greater, within which to
3409	file suit.
3410	(5)  No statement, discussion, written document, report, or
3411	other work product generated by presuit claims evaluation
3412	procedures under this section is discoverable or admissible in
3413	any civil action for any purpose by the opposing party. All
3414	participants, including, but not limited to, physicians,
3415	investigators, witnesses, and employees or associates of the
3416	defendant, are immune from civil liability arising from
3417	participation in the presuit claims evaluation procedure. Any
3418	licensed physician or registered nurse may be retained by either
3419	party to provide an opinion regarding the reasonable basis of
3420	the claim. The presuit opinions of the expert are not
3421	discoverable or admissible in any civil action for any purpose
3422	by the opposing party.
3423	(6)  Upon receipt by a prospective defendant of a notice of
3424	claim, the parties shall make discoverable information available
3425	without formal discovery as provided in subsection (7).
3426	(7)  Informal discovery may be used by a party to obtain
3427	unsworn statements and the production of documents or things, as
3428	follows:
3429	(a)  Unsworn statements.-Any party may require other
3430	parties to appear for the taking of an unsworn statement. Such
3431	statements may be used only for the purpose of claims evaluation
3432	and are not discoverable or admissible in any civil action for
3433	any purpose by any party. A party seeking to take the unsworn
3434	statement of any party must give reasonable notice in writing to
3435	all parties. The notice must state the time and place for taking
3436	the statement and the name and address of the party to be
3437	examined. Unless otherwise impractical, the examination of any
3438	party must be done at the same time by all other parties. Any
3439	party may be represented by counsel at the taking of an unsworn
3440	statement. An unsworn statement may be recorded electronically,
3441	stenographically, or on videotape. The taking of unsworn
3442	statements is subject to the provisions of the Florida Rules of
3443	Civil Procedure and may be terminated for abuses.
3444	(b)  Documents or things.-Any party may request discovery
3445	of relevant documents or things relevant to evaluating the
3446	merits of the claim. The documents or things must be produced,
3447	at the expense of the requesting party, within 20 days after the
3448	date of receipt of the request. A party is required to produce
3449	relevant and discoverable documents or things within that
3450	party's possession or control, if in good faith it can
3451	reasonably be done within the timeframe of the claims evaluation
3452	process.
3453	(8)  Each request for and notice concerning informal
3454	discovery pursuant to this section must be in writing, and a
3455	copy thereof must be sent to all parties. Such a request or
3456	notice must bear a certificate of service identifying the name
3457	and address of the person to whom the request or notice is
3458	served, the date of the request or notice, and the manner of
3459	service thereof.
3460	(9)  If a prospective defendant makes a written settlement
3461	offer, the claimant shall have 15 days from the date of receipt
3462	to accept the offer. An offer shall be deemed rejected unless
3463	accepted by delivery of a written notice of acceptance.
3464	(10)  To the extent not inconsistent with this part, the
3465	provisions of the Florida Mediation Code, Florida Rules of Civil
3466	Procedure, shall be applicable to such proceedings.
3467	(11)  An arbitration process as provided for in chapter 44
3468	may be used to resolve a claim filed pursuant to this section.
3469	(12)(11)  Within 30 days after the claimant's receipt of
3470	defendant's response to the claim, the parties or their
3471	designated representatives shall meet in mediation to discuss
3472	the issues of liability and damages in accordance with the
3473	mediation rules of practice and procedures adopted by the
3474	Supreme Court. Upon written stipulation of the parties, this 30-
3475	day period may be extended and the statute of limitations is
3476	tolled during the mediation and any such extension. At the
3477	conclusion of mediation, the claimant shall have 30 60 days or
3478	the remainder of the period of the statute of limitations,
3479	whichever is greater, within which to file suit.
3480	Section 38.  Section 429.294, Florida Statutes, is amended
3481	to read:
3482	429.294  Availability of residence facility records for
3483	investigation of resident's rights violations and defenses;
3484	penalty.-
3485	(1)  Unless expressly prohibited by a legally competent
3486	resident, an assisted living residence licensed under this part
3487	shall furnish to the spouse, guardian, surrogate, proxy, or
3488	attorney in fact, as provided in chapters 744 and 765, of a
3489	current resident, within 7 working days after receipt of a
3490	written request, or of a former resident, within 10 working days
3491	after receipt of a written request, a copy of that resident's
3492	records that are in the possession of the residence. Such
3493	records shall include medical and psychiatric records and any
3494	records concerning the care and treatment of the resident
3495	performed by the residence, except progress notes and
3496	consultation report sections of a psychiatric nature. Copies of
3497	such records shall not be considered part of a deceased
3498	resident's estate and may be made available before the
3499	administration of an estate, upon request, to the spouse,
3500	guardian, surrogate, proxy, or attorney in fact, as provided in
3501	chapters 744 and 765. A residence may charge a reasonable fee
3502	for the copying of resident records. Such fee shall not exceed
3503	$1 per page for the first 25 pages and 25 cents per page for
3504	each additional page in excess of 25 pages. The residence shall
3505	further allow any such spouse, guardian, surrogate, proxy, or
3506	attorney in fact, as provided in chapters 744 and 765, to
3507	examine the original records in its possession, or microfilms or
3508	other suitable reproductions of the records, upon such
3509	reasonable terms as shall be imposed, to help ensure that the
3510	records are not damaged, destroyed, or altered.
3511	(2)  No person shall be allowed to obtain copies of
3512	residents' records pursuant to this section more often than once
3513	per month, except that physician's reports in the residents'
3514	records may be obtained as often as necessary to effectively
3515	monitor the residents' condition.
3516	(3)(1)  Failure to provide complete copies of a resident's
3517	records, including, but not limited to, all medical records and
3518	the resident's chart, within the control or possession of the
3519	residence facility within 10 days, in accordance with the
3520	provisions of this section s. 400.145, shall constitute evidence
3521	of failure of that party to comply with good faith discovery
3522	requirements and shall waive the good faith certificate and
3523	presuit notice requirements under this part by the requesting
3524	party.
3525	(4)(2)  No licensee facility shall be held liable for any
3526	civil damages as a result of complying with this section.
3527	Section 39.  Section 429.298, Florida Statutes, is amended
3528	to read:
3529	429.298  Punitive damages; limitation.-
3530	(1)(a)  Except as provided in paragraphs (b) and (c), An
3531	award of punitive damages may not exceed the greater of:
3532	1.  Three times the amount of compensatory damages awarded
3533	to each claimant entitled thereto, consistent with the remaining
3534	provisions of this section; or
3535	2.  The sum of $250,000 $1 million.
3536	(b)  Where the fact finder determines that the wrongful
3537	conduct proven under this section was motivated primarily by
3538	unreasonable financial gain and determines that the unreasonably
3539	dangerous nature of the conduct, together with the high
3540	likelihood of injury resulting from the conduct, was actually
3541	known by the managing agent, director, officer, or other person
3542	responsible for making policy decisions on behalf of the
3543	defendant, it may award an amount of punitive damages not to
3544	exceed the greater of:
3545	1.  Four times the amount of compensatory damages awarded
3546	to each claimant entitled thereto, consistent with the remaining
3547	provisions of this section; or
3548	2.  The sum of $4 million.
3549	(c)  Where the fact finder determines that at the time of
3550	injury the defendant had a specific intent to harm the claimant
3551	and determines that the defendant's conduct did in fact harm the
3552	claimant, there shall be no cap on punitive damages.
3553	(b)(d)  This subsection is not intended to prohibit an
3554	appropriate court from exercising its jurisdiction under s.
3555	768.74 in determining the reasonableness of an award of punitive
3556	damages that is less than three times the amount of compensatory
3557	damages.
3558	(e)  In any case in which the findings of fact support an
3559	award of punitive damages pursuant to paragraph (b) or paragraph
3560	(c), the clerk of the court shall refer the case to the
3561	appropriate law enforcement agencies, to the state attorney in
3562	the circuit where the long-term care facility that is the
3563	subject of the underlying civil cause of action is located, and,
3564	for multijurisdictional facility owners, to the Office of the
3565	Statewide Prosecutor; and such agencies, state attorney, or
3566	Office of the Statewide Prosecutor shall initiate a criminal
3567	investigation into the conduct giving rise to the award of
3568	punitive damages. All findings by the trier of fact which
3569	support an award of punitive damages under this paragraph shall
3570	be admissible as evidence in any subsequent civil or criminal
3571	proceeding relating to the acts giving rise to the award of
3572	punitive damages under this paragraph.
3573	(2)  The claimant's attorney's fees, if payable from the
3574	judgment, are, to the extent that the fees are based on the
3575	punitive damages, calculated based on the final judgment for
3576	punitive damages. This subsection does not limit the payment of
3577	attorney's fees based upon an award of damages other than
3578	punitive damages.
3579	(3)  The jury may neither be instructed nor informed as to
3580	the provisions of this section.
3581	(4)  Notwithstanding any other law to the contrary, the
3582	amount of punitive damages awarded pursuant to this section
3583	shall be equally divided between the claimant and the Health
3584	Care Quality of Long-Term Care Facility Improvement Trust Fund,
3585	in accordance with the following provisions:
3586	(a)  The clerk of the court shall transmit a copy of the
3587	jury verdict to the Chief Financial Officer by certified mail.
3588	In the final judgment, the court shall order the percentages of
3589	the award, payable as provided herein.
3590	(b)  A settlement agreement entered into between the
3591	original parties to the action after a verdict has been returned
3592	must provide a proportionate share payable to the Health Care
3593	Quality of Long-Term Care Facility Improvement Trust Fund
3594	specified herein. For purposes of this paragraph, the a
3595	proportionate share payable to the Health Care Trust Fund must
3596	be is a 75 percent 50-percent share of that percentage of the
3597	settlement amount which the punitive damages portion of the
3598	verdict bore to the total of the compensatory and punitive
3599	damages in the verdict.
3600	(c)  The Department of Financial Services shall collect or
3601	cause to be collected all payments due the state under this
3602	section. Such payments are made to the Chief Financial Officer
3603	and deposited in the appropriate fund specified in this
3604	subsection.
3605	(d)  If the full amount of punitive damages awarded cannot
3606	be collected, the claimant and the other recipient designated
3607	pursuant to this subsection are each entitled to a proportionate
3608	share of the punitive damages collected.
3609	(5)  This section is remedial in nature and shall take
3610	effect upon becoming a law.
3611	Section 40.  Section 429.31, Florida Statutes, is amended
3612	to read:
3613	429.31  Closing of residence facility; notice; penalty.-
3614	(1)  In addition to the requirements of part I part II of
3615	chapter 408, the administrator of the residence facility shall
3616	inform each resident or the next of kin, legal representative,
3617	or agency acting on each resident's behalf, of the fact and the
3618	proposed time of discontinuance of operation, after following
3619	the notification requirements provided in s. 429.28(1)(k). In
3620	the event a resident has no person to represent him or her, the
3621	administrator of the residence facility shall be responsible for
3622	referral to an appropriate social service agency for placement.
3623	(2)  Immediately upon the notice by the agency of the
3624	voluntary or involuntary termination of such operation, the
3625	agency or its receiver shall monitor the transfer of residents
3626	to other facilities and ensure that residents' rights are being
3627	protected. The agency department, in consultation with the
3628	Department of Children and Family Services, shall specify
3629	procedures for ensuring that all residents who receive services
3630	are appropriately relocated.
3631	(3)  All charges shall be prorated as of the date on which
3632	the residence facility discontinues operation, and if any
3633	payments have been made in advance, the payments for services
3634	not received shall be refunded to the resident or the resident's
3635	guardian within 10 working days after of voluntary or
3636	involuntary closure of the residence facility, whether or not
3637	such refund is requested by the resident or guardian.
3638	(4)  The agency may levy a fine in an amount no greater
3639	than $5,000 upon the licensee and each person or business entity
3640	that owns any interest in a residence facility that terminates
3641	operation without providing notice to the agency and the
3642	residents of the residence facility at least 30 days before
3643	operation ceases. This fine shall not be levied against any
3644	licensee of a residence facility involuntarily closed at the
3645	initiation of the agency. The agency shall use the proceeds of
3646	the fines to operate the residence facility until all residents
3647	of the residence facility are relocated.
3648	Section 41.  Section 429.34, Florida Statutes, is amended
3649	to read:
3650	429.34  Right of entry and inspection.-In addition to the
3651	requirements of s. 429.0105 s. 408.811, any duly designated
3652	officer or employee of the department, the Department of
3653	Children and Family Services, the Medicaid Fraud Control Unit of
3654	the Office of the Attorney General, or the state or local fire
3655	marshal, or a member of the state or local long-term care
3656	ombudsman council shall have the right to enter unannounced upon
3657	and into the premises of any licensed residence facility
3658	licensed pursuant to this part in order to determine the state
3659	of compliance with the provisions of this part, part I part II
3660	of chapter 408, and applicable rules. Data collected by the
3661	state or local long-term care ombudsman councils or the state or
3662	local advocacy councils may be used by the agency in
3663	investigations involving violations of regulatory standards.
3664	Section 42.  Section 429.35, Florida Statutes, is amended
3665	to read:
3666	429.35  Maintenance of records; reports.-
3667	(1)  Every administrator facility shall maintain, as public
3668	information available for public inspection under such
3669	conditions as the agency shall prescribe, records containing
3670	copies of all inspection reports pertaining to the residence
3671	facility that have been issued by the agency to the residence
3672	facility. Copies of inspection reports shall be retained in the
3673	records for 5 years from the date the reports are filed or
3674	issued.
3675	(2)  Within 60 days after the date of the biennial
3676	inspection visit required under s. 408.811 or within 30 days
3677	after the date of any interim visit, the agency shall forward
3678	the results of the inspection to the local ombudsman council in
3679	whose planning and service area, as defined in part II of
3680	chapter 400, the facility is located; to at least one public
3681	library or, in the absence of a public library, the county seat
3682	in the county in which the inspected assisted living facility is
3683	located; and, when appropriate, to the district Adult Services
3684	and Mental Health Program Offices.
3685	(2)(3)  The administrator of a residence Every facility
3686	shall post a copy of the last inspection report of the agency
3687	for that residence facility in a prominent location within the
3688	residence facility so as to be accessible to all residents and
3689	to the public. Upon request, the administrator facility shall
3690	also provide a copy of the report to any resident of the
3691	residence facility or to an applicant for admission to the
3692	residence facility.
3693	Section 43.  Section 429.41, Florida Statutes, is amended
3694	to read:
3695	429.41  Rules establishing standards.-
3696	(1)  It is the intent of the Legislature that rules
3697	published and enforced pursuant to this section shall include
3698	criteria by which a reasonable and consistent quality of
3699	resident care and quality of life may be ensured and the results
3700	of such resident care may be demonstrated. Such rules shall also
3701	ensure a safe and sanitary environment that is residential and
3702	noninstitutional in design or nature. It is further intended
3703	that reasonable efforts be made to accommodate the needs and
3704	preferences of residents to enhance the quality of life in a
3705	residence facility. The agency, in consultation with the
3706	department, may adopt rules to administer the requirements of
3707	part II of chapter 408. In order to provide safe and sanitary
3708	residences facilities and the highest quality of resident care
3709	accommodating the needs and preferences of residents, the
3710	department, in consultation with the agency, the Department of
3711	Children and Family Services, and the Department of Health,
3712	shall adopt rules, policies, and procedures to administer this
3713	section part, which must include reasonable and fair minimum
3714	standards in relation to:
3715	(a)  The requirements for and maintenance of residences
3716	facilities, not in conflict with the provisions of chapter 553,
3717	relating to plumbing, heating, cooling, lighting, ventilation,
3718	living space, and other housing conditions, which will ensure
3719	the health, safety, and comfort of residents and protection from
3720	fire hazard, including adequate provisions for fire alarm and
3721	other fire protection suitable to the size of the structure.
3722	Uniform firesafety standards shall be established and enforced
3723	by the State Fire Marshal in cooperation with the agency, the
3724	department, and the Department of Health.
3725	1.  Evacuation capability determination.-
3726	a.  The provisions of the National Fire Protection
3727	Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
3728	for determining the ability of the residents, with or without
3729	staff assistance, to relocate from or within a licensed
3730	residence facility to a point of safety as provided in the fire
3731	codes adopted herein. An evacuation capability evaluation for
3732	initial licensure shall be conducted within 6 months after the
3733	date of licensure. For existing licensed residences facilities
3734	that are not equipped with an automatic fire sprinkler system,
3735	the administrator shall evaluate the evacuation capability of
3736	residents at least annually. The evacuation capability
3737	evaluation for each residence facility not equipped with an
3738	automatic fire sprinkler system shall be validated, without
3739	liability, by the State Fire Marshal, by the local fire marshal,
3740	or by the local authority having jurisdiction over firesafety,
3741	before the license renewal date. If the State Fire Marshal,
3742	local fire marshal, or local authority having jurisdiction over
3743	firesafety has reason to believe that the evacuation capability
3744	of a residence facility as reported by the administrator may
3745	have changed, it may, with assistance from the residence
3746	facility administrator, reevaluate the evacuation capability
3747	through timed exiting drills. Translation of timed fire exiting
3748	drills to evacuation capability may be determined:
3749	(I)  Three minutes or less: prompt.
3750	(II)  More than 3 minutes, but not more than 13 minutes:
3751	slow.
3752	(III)  More than 13 minutes: impractical.
3753	b.  The Office of the State Fire Marshal shall provide or
3754	cause the provision of training and education on the proper
3755	application of Chapter 5, NFPA 101A, 1995 edition, to its
3756	employees, to staff of the Agency for Health Care Administration
3757	who are responsible for regulating facilities under this part,
3758	and to local governmental inspectors. The Office of the State
3759	Fire Marshal shall provide or cause the provision of this
3760	training within its existing budget, but may charge a fee for
3761	this training to offset its costs. The initial training must be
3762	delivered within 6 months after July 1, 1995, and as needed
3763	thereafter.
3764	c.  The Office of the State Fire Marshal, in cooperation
3765	with provider associations, shall provide or cause the provision
3766	of a training program designed to inform facility operators on
3767	how to properly review bid documents relating to the
3768	installation of automatic fire sprinklers. The Office of the
3769	State Fire Marshal shall provide or cause the provision of this
3770	training within its existing budget, but may charge a fee for
3771	this training to offset its costs. The initial training must be
3772	delivered within 6 months after July 1, 1995, and as needed
3773	thereafter.
3774	b.d.  The administrator of a licensed residence facility
3775	shall sign an affidavit verifying the number of residents
3776	occupying the residence facility at the time of the evacuation
3777	capability evaluation.
3778	2.  Firesafety requirements.-
3779	a.  Except for the special applications provided herein,
3780	effective January 1, 1996, the provisions of the National Fire
3781	Protection Association, Life Safety Code, NFPA 101, 1994
3782	edition, Chapter 22 for new residences facilities and Chapter 23
3783	for existing residences facilities shall be the uniform fire
3784	code applied by the State Fire Marshal for assisted living
3785	residences facilities, pursuant to s. 633.022.
3786	b.  Any new residence facility, regardless of size, that
3787	applies for a license on or after January 1, 1996, must be
3788	equipped with an automatic fire sprinkler system. The exceptions
3789	as provided in s. 22-2.3.5.1, NFPA 101, 1994 edition, as adopted
3790	herein, apply to any new residence facility housing eight or
3791	fewer residents. On July 1, 1995, local governmental entities
3792	responsible for the issuance of permits for construction shall
3793	inform, without liability, any facility whose permit for
3794	construction is obtained prior to January 1, 1996, of this
3795	automatic fire sprinkler requirement. As used in this part, the
3796	term "a new residence facility" does not mean an existing
3797	residence facility that has undergone change of ownership.
3798	c.  Notwithstanding any provision of s. 633.022 or of the
3799	National Fire Protection Association, NFPA 101A, Chapter 5, 1995
3800	edition, to the contrary, any existing residence facility
3801	housing eight or fewer residents is not required to install an
3802	automatic fire sprinkler system, nor to comply with any other
3803	requirement in Chapter 23, NFPA 101, 1994 edition, that exceeds
3804	the firesafety requirements of NFPA 101, 1988 edition, that
3805	applies to this size residence facility, unless the residence
3806	facility has been classified as impractical to evacuate. Any
3807	existing residence facility housing eight or fewer residents
3808	that is classified as impractical to evacuate must install an
3809	automatic fire sprinkler system within the timeframes mutually
3810	agreed to by the local fire marshal and the agency granted in
3811	this section.
3812	d.  Any existing facility that is required to install an
3813	automatic fire sprinkler system under this paragraph need not
3814	meet other firesafety requirements of Chapter 23, NFPA 101, 1994
3815	edition, which exceed the provisions of NFPA 101, 1988 edition.
3816	The mandate contained in this paragraph which requires certain
3817	facilities to install an automatic fire sprinkler system
3818	supersedes any other requirement.
3819	d.e.  This paragraph does not supersede the exceptions
3820	granted in NFPA 101, 1988 edition or 1994 edition.
3821	e.f.  This paragraph does not exempt residences facilities
3822	from other firesafety provisions adopted under s. 633.022 and
3823	local building code requirements in effect before July 1, 1995.
3824	g.  A local government may charge fees only in an amount
3825	not to exceed the actual expenses incurred by local government
3826	relating to the installation and maintenance of an automatic
3827	fire sprinkler system in an existing and properly licensed
3828	assisted living facility structure as of January 1, 1996.
3829	h.  If a licensed facility undergoes major reconstruction
3830	or addition to an existing building on or after January 1, 1996,
3831	the entire building must be equipped with an automatic fire
3832	sprinkler system. Major reconstruction of a building means
3833	repair or restoration that costs in excess of 50 percent of the
3834	value of the building as reported on the tax rolls, excluding
3835	land, before reconstruction. Multiple reconstruction projects
3836	within a 5-year period the total costs of which exceed 50
3837	percent of the initial value of the building at the time the
3838	first reconstruction project was permitted are to be considered
3839	as major reconstruction. Application for a permit for an
3840	automatic fire sprinkler system is required upon application for
3841	a permit for a reconstruction project that creates costs that go
3842	over the 50-percent threshold.
3843	i.  Any facility licensed before January 1, 1996, that is
3844	required to install an automatic fire sprinkler system shall
3845	ensure that the installation is completed within the following
3846	timeframes based upon evacuation capability of the facility as
3847	determined under subparagraph 1.:
3848	(I)  Impractical evacuation capability, 24 months.
3849	(II)  Slow evacuation capability, 48 months.
3850	(III)  Prompt evacuation capability, 60 months.
3851
3852	The beginning date from which the deadline for the automatic
3853	fire sprinkler installation requirement must be calculated is
3854	upon receipt of written notice from the local fire official that
3855	an automatic fire sprinkler system must be installed. The local
3856	fire official shall send a copy of the document indicating the
3857	requirement of a fire sprinkler system to the Agency for Health
3858	Care Administration.
3859	j.  It is recognized that the installation of an automatic
3860	fire sprinkler system may create financial hardship for some
3861	facilities. The appropriate local fire official shall, without
3862	liability, grant two 1-year extensions to the timeframes for
3863	installation established herein, if an automatic fire sprinkler
3864	installation cost estimate and proof of denial from two
3865	financial institutions for a construction loan to install the
3866	automatic fire sprinkler system are submitted. However, for any
3867	facility with a class I or class II, or a history of uncorrected
3868	class III, firesafety deficiencies, an extension must not be
3869	granted. The local fire official shall send a copy of the
3870	document granting the time extension to the Agency for Health
3871	Care Administration.
3872	k.  A facility owner whose facility is required to be
3873	equipped with an automatic fire sprinkler system under Chapter
3874	23, NFPA 101, 1994 edition, as adopted herein, must disclose to
3875	any potential buyer of the facility that an installation of an
3876	automatic fire sprinkler requirement exists. The sale of the
3877	facility does not alter the timeframe for the installation of
3878	the automatic fire sprinkler system.
3879	l.  Existing facilities required to install an automatic
3880	fire sprinkler system as a result of construction-type
3881	restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
3882	herein, or evacuation capability requirements shall be notified
3883	by the local fire official in writing of the automatic fire
3884	sprinkler requirement, as well as the appropriate date for final
3885	compliance as provided in this subparagraph. The local fire
3886	official shall send a copy of the document to the Agency for
3887	Health Care Administration.
3888	f.m.  Except in cases of life-threatening fire hazards, if
3889	an existing residence facility experiences a change in the
3890	evacuation capability, or if the local authority having
3891	jurisdiction identifies a construction-type restriction, such
3892	that an automatic fire sprinkler system is required, it shall be
3893	afforded time for installation as provided in this subparagraph.
3894
3895	Residences Facilities that are fully sprinkled and in compliance
3896	with other firesafety standards are not required to conduct more
3897	than one of the required fire drills between the hours of 11
3898	p.m. and 7 a.m., per year. In lieu of the remaining drills,
3899	staff responsible for residents during such hours may be
3900	required to participate in a mock drill that includes a review
3901	of evacuation procedures. Such standards must be included or
3902	referenced in the rules adopted by the State Fire Marshal.
3903	Pursuant to s. 633.022(1)(b), the State Fire Marshal is the
3904	final administrative authority for firesafety standards
3905	established and enforced pursuant to this section. All licensed
3906	residences facilities must have an annual fire inspection
3907	conducted by the local fire marshal or authority having
3908	jurisdiction.
3909	3.  Resident elopement requirements.-Residences Facilities
3910	are required to conduct a minimum of two resident elopement
3911	prevention and response drills per year. All administrators and
3912	direct care staff must participate in the drills which shall
3913	include a review of procedures to address resident elopement.
3914	Residence administrators Facilities must document the
3915	implementation of the drills and ensure that the drills are
3916	conducted in a manner consistent with the residence's facility's
3917	resident elopement policies and procedures.
3918	(b)  The preparation and annual update of a comprehensive
3919	emergency management plan. Such standards must be included in
3920	the rules adopted by the department after consultation with the
3921	Department of Community Affairs. At a minimum, the rules must
3922	provide for plan components that address emergency evacuation
3923	transportation; adequate sheltering arrangements; postdisaster
3924	activities, including provision of emergency power, food, and
3925	water; postdisaster transportation; supplies; staffing;
3926	emergency equipment; individual identification of residents and
3927	transfer of records; communication with families; and responses
3928	to family inquiries. The comprehensive emergency management plan
3929	is subject to review and approval by the local emergency
3930	management agency. During its review, the local emergency
3931	management agency shall ensure that the following agencies, at a
3932	minimum, are given the opportunity to review the plan: the
3933	Department of Elderly Affairs, the Department of Health, the
3934	Agency for Health Care Administration, and the Department of
3935	Community Affairs. Also, appropriate volunteer organizations
3936	must be given the opportunity to review the plan. The local
3937	emergency management agency shall complete its review within 60
3938	days and either approve the plan or advise the residence
3939	administrator facility of necessary revisions.
3940	(c)  The number, training, and qualifications of all staff
3941	responsible personnel having responsibility for the care of
3942	residents. The rules must require adequate staff to provide for
3943	the safety of all residents. Residences Facilities licensed for
3944	17 or more residents are required to maintain an alert staff for
3945	24 hours per day.
3946	(d)  All sanitary conditions within the residence facility
3947	and its surroundings which will ensure the health and comfort of
3948	residents.
3949	(e)  To ensure that inspections are not duplicative, the
3950	rules must clearly delineate the responsibilities of the agency
3951	regarding agency's licensure and survey inspections staff, the
3952	county health departments regarding food safety and sanitary
3953	inspections, and the local fire marshal regarding firesafety
3954	inspections authority having jurisdiction over firesafety and
3955	ensure that inspections are not duplicative. The agency may
3956	collect fees for food service inspections conducted by the
3957	county health departments and transfer such fees to the
3958	Department of Health.
3959	(f)(e)  License application and license renewal, transfer
3960	of ownership, proper management of resident funds and personal
3961	property, surety bonds, resident contracts, refund policies,
3962	financial ability to operate, and residence facility and staff
3963	records.
3964	(g)(f)  Inspections, complaint investigations, moratoriums,
3965	classification of deficiencies, levying and enforcement of
3966	penalties, and use of income from fees and fines.
3967	(h)(g)  The enforcement of the resident bill of rights
3968	specified in s. 429.28.
3969	(i)(h)  The care and maintenance of residents, which must
3970	include, but is not limited to:
3971	1.  The supervision of residents;
3972	2.  The provision of personal services;
3973	3.  The provision of, or arrangement for, social and
3974	leisure activities;
3975	4.  The arrangement for appointments and transportation to
3976	appropriate medical, dental, nursing, or mental health services,
3977	as needed by residents;
3978	5.  The management of medication;
3979	6.  The food service nutritional needs of residents; and
3980	7.  Resident records.; and
3981	8.  Internal risk management and quality assurance.
3982	(j)(i)  Residences Facilities holding an a limited nursing,
3983	extended congregate care, or limited mental health license.
3984	(k)(j)  The establishment of specific criteria to define
3985	appropriateness of resident admission and continued residency in
3986	a resident facility holding a standard, limited nursing,
3987	extended congregate care, and limited mental health license.
3988	(l)(k)  The use of physical or chemical restraints. The use
3989	of physical restraints is limited to half-bed rails as
3990	prescribed and documented by the resident's physician with the
3991	consent of the resident or, if applicable, the resident's
3992	representative or designee or the resident's surrogate,
3993	guardian, or attorney in fact. The use of chemical restraints is
3994	limited to prescribed dosages of medications authorized by the
3995	resident's physician and must be consistent with the resident's
3996	diagnosis. Residents who are receiving medications that can
3997	serve as chemical restraints must be evaluated by their
3998	physician at least annually to assess:
3999	1.  The continued need for the medication.
4000	2.  The level of the medication in the resident's blood.
4001	3.  The need for adjustments in the prescription.
4002	(l)  The establishment of specific policies and procedures
4003	on resident elopement. Facilities shall conduct a minimum of two
4004	resident elopement drills each year. All administrators and
4005	direct care staff shall participate in the drills. Facilities
4006	shall document the drills.
4007	(2)  In adopting any rules pursuant to this part, the
4008	department, in conjunction with the agency, shall make distinct
4009	standards for residences facilities based upon residence
4010	facility size; the types of care provided; the physical and
4011	mental capabilities and needs of residents; the type, frequency,
4012	and amount of services and care offered; and the staffing
4013	characteristics of the residence facility. Rules developed
4014	pursuant to this section shall not restrict the use of shared
4015	staffing and shared programming in residences facilities that
4016	are part of retirement communities that provide multiple levels
4017	of care and otherwise meet the requirements of law and rule.
4018	Except for uniform firesafety standards, the department shall
4019	adopt by rule separate and distinct standards for residences
4020	facilities with 16 or fewer beds and for residences facilities
4021	with 17 or more beds. The standards for residences facilities
4022	with 16 or fewer beds shall be appropriate for a
4023	noninstitutional residential environment, provided that the
4024	structure is no more than two stories in height and all persons
4025	who cannot exit the residence facility unassisted in an
4026	emergency reside on the first floor. The department, in
4027	conjunction with the agency, may make other distinctions among
4028	types of residences facilities as necessary to enforce the
4029	provisions of this part. Where appropriate, the agency shall
4030	offer alternate solutions for complying with established
4031	standards, based on distinctions made by the department and the
4032	agency relative to the physical characteristics of residences
4033	facilities and the types of care offered therein.
4034	(3)  The department shall submit a copy of proposed rules
4035	to the Speaker of the House of Representatives, the President of
4036	the Senate, and appropriate committees of substance for review
4037	and comment prior to the promulgation thereof. Rules promulgated
4038	by the department shall encourage the development of homelike
4039	facilities which promote the dignity, individuality, personal
4040	strengths, and decisionmaking ability of residents.
4041	(3)(4)  The agency, in consultation with the department,
4042	may waive rules promulgated pursuant to this part in order to
4043	demonstrate and evaluate innovative or cost-effective congregate
4044	care alternatives which enable individuals to age in place. Such
4045	waivers may be granted only in instances where there is
4046	reasonable assurance that the health, safety, or welfare of
4047	residents will not be endangered. To apply for a waiver, the
4048	licensee shall submit to the agency a written description of the
4049	concept to be demonstrated, including goals, objectives, and
4050	anticipated benefits; the number and types of residents who will
4051	be affected, if applicable; a brief description of how the
4052	demonstration will be evaluated; and any other information
4053	deemed appropriate by the agency. Any residence facility granted
4054	a waiver shall submit a report of findings to the agency and the
4055	department within 12 months. At such time, the agency may renew
4056	or revoke the waiver or pursue any regulatory or statutory
4057	changes necessary to allow other residences facilities to adopt
4058	the same practices. The department may by rule clarify terms and
4059	establish waiver application procedures, criteria for reviewing
4060	waiver proposals, and procedures for reporting findings, as
4061	necessary to implement this subsection.
4062	(4)(5)  The agency shall may use an abbreviated biennial
4063	standard licensure inspection that consists of a review of key
4064	quality-of-care standards in lieu of a full inspection in a
4065	residence facility that has a good record of past performance.
4066	However, a full inspection must be conducted in a residence
4067	facility that has a history of class I or class II violations,
4068	uncorrected class III violations, confirmed ombudsman council
4069	complaints, or confirmed licensure complaints, within the
4070	previous licensure period immediately preceding the inspection
4071	or if a potentially serious problem is identified during the
4072	abbreviated inspection. The agency, in consultation with the
4073	department, shall develop, maintain, and update the key quality-
4074	of-care standards with input from the State Long-Term Care
4075	Ombudsman Council and representatives of associations and
4076	organizations representing assisted living residences provider
4077	groups for incorporation into its rules.
4078	Section 44.  Section 429.42, Florida Statutes, is amended
4079	to read:
4080	429.42  Pharmacy and dietary services.-
4081	(1)  Any assisted living residence for facility in which
4082	the agency has documented a class I or class II violation
4083	deficiency or uncorrected class III violations deficiencies
4084	regarding medicinal drugs or over-the-counter preparations,
4085	including their storage, use, delivery, or administration, or
4086	dietary services, or both, during a biennial survey or a
4087	monitoring visit or an investigation in response to a complaint,
4088	shall, in addition to or as an alternative to any penalties
4089	imposed under s. 429.19, be required to employ the consultant
4090	services of a licensed pharmacist, a licensed registered nurse,
4091	or a registered or licensed dietitian, as applicable. The
4092	consultant shall, at a minimum, provide onsite quarterly
4093	consultation until the inspection team from the agency
4094	determines that such consultation services are no longer
4095	required.
4096	(2)  A corrective action plan for deficiencies related to
4097	assistance with the self-administration of medication or the
4098	administration of medication must be developed and implemented
4099	by the facility within 48 hours after notification of such
4100	deficiency, or sooner if the deficiency is determined by the
4101	agency to be life-threatening.
4102	(3)  The agency shall employ at least two pharmacists
4103	licensed pursuant to chapter 465 among its personnel who
4104	biennially inspect assisted living facilities licensed under
4105	this part, to participate in biennial inspections or consult
4106	with the agency regarding deficiencies relating to medicinal
4107	drugs or over-the-counter preparations.
4108	(2)(4)  The department may by rule establish procedures and
4109	specify documentation as necessary to implement this section.
4110	Section 45.  Section 429.44, Florida Statutes, is amended
4111	to read:
4112	429.44  Construction and renovation; requirements.-
4113	(1)  The requirements for the construction and renovation
4114	of a residence facility shall comply with the provisions of
4115	chapter 553 which pertain to building construction standards,
4116	including plumbing, electrical code, glass, manufactured
4117	buildings, accessibility for persons with disabilities, and the
4118	state minimum building code and with the provisions of s.
4119	633.022, which pertain to uniform firesafety standards.
4120	(2)  Upon notification by the local authority having
4121	jurisdiction over life-threatening violations which seriously
4122	threaten the health, safety, or welfare of a resident of a
4123	residence facility, the agency shall take action as specified in
4124	s. 429.14.
4125	(3)  The department may adopt rules to establish procedures
4126	and specify the documentation necessary to implement this
4127	section.
4128	Section 46.  Section 429.445, Florida Statutes, is amended
4129	to read:
4130	429.445  Compliance with local zoning requirements.-No
4131	facility licensed under this part may commence any construction
4132	which will expand the size of the existing structure unless the
4133	licensee first submits to the agency proof that such
4134	construction will be in compliance with applicable local zoning
4135	requirements. Residences Facilities with a licensed capacity of
4136	less than 15 persons shall comply with the provisions of chapter
4137	419.
4138	Section 47.  Section 429.47, Florida Statutes, is amended
4139	to read:
4140	429.47  Prohibited acts; penalties for violation.-
4141	(1)  While an assisted living residence a facility is under
4142	construction, the owner may advertise to the public prior to
4143	obtaining a license. Facilities that are certified under chapter
4144	651 shall comply with the advertising provisions of s. 651.095
4145	rather than those provided for in this subsection.
4146	(2)  A freestanding residence facility shall not advertise
4147	or imply that any part of it is a nursing home. For the purpose
4148	of this subsection, "freestanding residence facility" means a
4149	residence facility that is not operated in conjunction with a
4150	nursing home to which residents of the residence facility are
4151	given priority when nursing care is required. A person who
4152	violates this subsection is subject to fine as specified in s.
4153	429.19.
4154	(3)  Any residence facility which is affiliated with any
4155	religious organization or which has a name implying religious
4156	affiliation shall include in its advertising whether or not it
4157	is affiliated with any religious organization and, if so, which
4158	organization.
4159	(4)  A licensed residence facility licensed under this part
4160	which is not part of a facility authorized under chapter 651
4161	shall include the residence's facility's license number as given
4162	by the agency in all advertising. A company or person owning
4163	more than one residence facility shall include at least one
4164	license number per advertisement. All advertising shall include
4165	the term "assisted living residence" or "ALR facility" before
4166	the license number.
4167	Section 48.  Section 429.49, Florida Statutes, is amended
4168	to read:
4169	429.49  Resident records; penalties for alteration.-
4170	(1)  Any person who fraudulently alters, defaces, or
4171	falsifies any medical or other resident record of an assisted
4172	living residence facility, or causes or procures any such
4173	offense to be committed, commits a misdemeanor of the second
4174	degree, punishable as provided in s. 775.082 or s. 775.083.
4175	(2)  A conviction under subsection (1) is also grounds for
4176	restriction, suspension, or termination of license privileges.
4177	Section 49.  Section 429.52, Florida Statutes, is amended
4178	to read:
4179	429.52  Staff training and educational programs; core
4180	educational requirement.-
4181	(1)  Administrators and other assisted living residence
4182	facility staff must meet minimum training and education
4183	requirements established by the Department of Elderly Affairs by
4184	rule. This training and education is intended to assist
4185	residences facilities to appropriately respond to the needs of
4186	residents, to maintain resident care and residence facility
4187	standards, and to meet licensure requirements.
4188	(2)  The department shall establish a competency test and a
4189	minimum required score to indicate successful completion of the
4190	training and educational requirements. The competency test must
4191	be developed by the department in conjunction with the agency
4192	and providers. The required training and education must cover at
4193	least the following topics:
4194	(a)  State law and rules relating to assisted living
4195	residences facilities.
4196	(b)  Resident rights and identifying and reporting abuse,
4197	neglect, and exploitation.
4198	(c)  Special needs of elderly persons, persons with mental
4199	illness, and persons with developmental disabilities and how to
4200	meet those needs.
4201	(d)  Nutrition and food service, including acceptable
4202	sanitation practices for preparing, storing, and serving food.
4203	(e)  Medication management, recordkeeping, and proper
4204	techniques for assisting residents with self-administered
4205	medication.
4206	(f)  Firesafety requirements, including fire evacuation
4207	drill procedures and other emergency procedures.
4208	(g)  Care of persons with Alzheimer's disease and related
4209	disorders.
4210	(3)  Effective January 1, 2004, a new residence facility
4211	administrator must complete the required training and education,
4212	including the competency test, within a reasonable time after
4213	being employed as an administrator, as determined by the
4214	department. Failure to do so is a violation of this part and
4215	subjects the violator to an administrative fine as prescribed in
4216	s. 429.19. Administrators licensed in accordance with part II of
4217	chapter 468 are exempt from this requirement. Other licensed
4218	professionals may be exempted, as determined by the department
4219	by rule.
4220	(4)  Administrators are required to participate in
4221	continuing education for a minimum of 12 contact hours every 2
4222	years.
4223	(5)  Staff involved with the management of medications and
4224	assisting with the self-administration of medications under s.
4225	429.256 must complete a minimum of 4 additional hours of
4226	training provided by a registered nurse, licensed pharmacist, or
4227	department staff, and must complete 2 hours of continuing
4228	education training annually. The department shall establish by
4229	rule the minimum requirements of this additional training.
4230	(6)  Other residence facility staff shall participate in
4231	training relevant to their job duties as specified by rule of
4232	the department.
4233	(7)  If the department or the agency determines that there
4234	are problems in a residence facility that could be reduced
4235	through specific staff training or education beyond that already
4236	required under this section, the department or the agency may
4237	require, and provide, or cause to be provided, the training or
4238	education of any direct personal care staff in the residence
4239	facility.
4240	(8)  The department shall adopt rules related to these
4241	training requirements, the competency test, necessary
4242	procedures, and competency test fees and shall adopt or contract
4243	with another entity to develop a curriculum, which shall be used
4244	as the minimum core training requirements. The department shall
4245	consult with representatives of stakeholder associations and
4246	organizations representing assisted living residences and
4247	agencies in the development of the curriculum.
4248	(9)  The training required by this section shall be
4249	conducted by persons registered with the department as having
4250	the requisite experience and credentials to conduct the
4251	training. A person seeking to register as a trainer must provide
4252	the department with proof of completion of the minimum core
4253	training education requirements, successful passage of the
4254	competency test established under this section, and proof of
4255	compliance with the continuing education requirement in
4256	subsection (4).
4257	(10)  A person seeking to register as a trainer must also:
4258	(a)  Provide proof of completion of a 4-year degree from an
4259	accredited college or university and must have worked in a
4260	management position in an assisted living residence facility for
4261	3 years after being core certified;
4262	(b)  Have worked in a management position in an assisted
4263	living residence facility for 5 years after being core certified
4264	and have 1 year of teaching experience as an educator or staff
4265	trainer for persons who work in assisted living residences
4266	facilities or other long-term care settings;
4267	(c)  Have been previously employed as a core trainer for
4268	the department; or
4269	(d)  Meet other qualification criteria as defined in rule,
4270	which the department is authorized to adopt.
4271	(11)  A trainer certified by the department must continue
4272	to meet continuing education requirements and other standards as
4273	set forth in rules adopted by the department. Noncompliance with
4274	the standards set forth in the rules may result in suspension or
4275	revocation of a trainer's certificate.
4276	(12)(11)  The department shall adopt rules to establish
4277	trainer registration requirements.
4278	Section 50.  Section 429.53, Florida Statutes, is amended
4279	to read:
4280	429.53  Consultation by the agency.-
4281	(1)  The area offices of licensure and certification of the
4282	agency shall provide consultation to the following upon request:
4283	(a)  A licensee of a residence facility.
4284	(b)  A person interested in obtaining a license to operate
4285	a residence facility under this part.
4286	(2)  As used in this section, "consultation" includes:
4287	(a)  An explanation of the requirements of this part and
4288	rules adopted pursuant thereto;
4289	(b)  An explanation of the license application and renewal
4290	procedures;
4291	(c)  The provision of a checklist of general local and
4292	state approvals required prior to constructing or developing a
4293	facility and a listing of the types of agencies responsible for
4294	such approvals;
4295	(d)  An explanation of benefits and financial assistance
4296	available to a recipient of supplemental security income
4297	residing in a facility;
4298	(c)(e)  Any other information which the agency deems
4299	necessary to promote compliance with the requirements of this
4300	part.; and
4301	(f)  A preconstruction review of a facility to ensure
4302	compliance with agency rules and this part.
4303	(3)  The agency may charge a fee commensurate with the cost
4304	of providing consultation under this section.
4305	Section 51.  Section 429.54, Florida Statutes, is repealed.
4306	Section 52.  Section 429.65, Florida Statutes, is amended
4307	to read:
4308	429.65  Definitions.-As used in this part, the term:
4309	(1)  "Activities of daily living" means functions and tasks
4310	for self-care, including eating, bathing, grooming, dressing,
4311	ambulating, and other similar tasks.
4312	(2)  "Adult family-care home" means a full-time, family-
4313	type living arrangement, in a private home, under which a person
4314	who owns or rents the home provides room, board, and personal
4315	care, on a 24-hour basis, for no more than five disabled adults
4316	or frail elders who are not relatives. The following family-type
4317	living arrangements are not required to be licensed as an adult
4318	family-care home:
4319	(a)  An arrangement whereby the person who owns or rents
4320	the home provides room, board, and personal services for not
4321	more than two adults who do not receive optional state
4322	supplementation under s. 409.212. The person who provides the
4323	housing, meals, and personal care must own or rent the home and
4324	reside therein.
4325	(b)  An arrangement whereby the person who owns or rents
4326	the home provides room, board, and personal services only to his
4327	or her relatives.
4328	(c)  An establishment that is licensed as an assisted
4329	living residence facility under this chapter.
4330	(3)  "Agency" means the Agency for Health Care
4331	Administration.
4332	(3)(4)  "Aging in place" means remaining in a
4333	noninstitutional living environment despite the physical or
4334	mental changes that may occur in a person who is aging. For
4335	aging in place to occur, needed services are added, increased,
4336	or adjusted to compensate for a person's physical or mental
4337	changes.
4338	(4)(5)  "Appropriate placement" means that the resident's
4339	needs can be met by the adult family-care home or can be met by
4340	services arranged by the adult family-care home or the resident.
4341	(5)(6)  "Chemical restraint" means a pharmacologic drug
4342	that physically limits, restricts, or deprives an individual of
4343	movement or mobility, and is used for discipline or convenience
4344	and not required for the treatment of medical symptoms.
4345	(6)(7)  "Department" means the Department of Elderly
4346	Affairs.
4347	(7)(8)  "Disabled adult" means any person between 18 and 59
4348	years of age, inclusive, who is a resident of the state and who
4349	has one or more permanent physical or mental limitations that
4350	restrict the person's ability to perform the normal activities
4351	of daily living.
4352	(8)(9)  "Frail elder" means a functionally impaired elderly
4353	person who is 60 years of age or older and who has physical or
4354	mental limitations that restrict the person's ability to perform
4355	the normal activities of daily living and that impede the
4356	person's capacity to live independently.
4357	(9)(10)  "Personal services" or "personal care" includes
4358	individual assistance with or supervision of the activities of
4359	daily living and the self-administration of medication, and
4360	other similar services.
4361	(11)  "Provider" means a person who is licensed to operate
4362	an adult family-care home.
4363	(10)(12)  "Relative" means an individual who is the father,
4364	mother, son, daughter, brother, sister, grandfather,
4365	grandmother, great-grandfather, great-grandmother, uncle, aunt,
4366	first cousin, nephew, niece, husband, wife, father-in-law,
4367	mother-in-law, son-in-law, daughter-in-law, brother-in-law,
4368	sister-in-law, stepfather, stepmother, stepson, stepdaughter,
4369	stepbrother, stepsister, half brother, or half sister of a
4370	licensee provider.
4371	(11)(13)  "Relief person" means an adult designated by the
4372	licensee provider to supervise the residents during the
4373	licensee's provider's absence.
4374	(12)(14)  "Resident" means a person receiving room, board,
4375	and personal care in an adult family-care home.
4376	Section 53.  Section 429.67, Florida Statutes, is amended
4377	to read:
4378	429.67  Licensure.-
4379	(1)  The requirements of part I part II of chapter 408
4380	apply to the provision of services that require licensure
4381	pursuant to this chapter part and part II of chapter 408 and to
4382	entities licensed by or applying for such licensure from the
4383	agency for Health Care Administration pursuant to this part. A
4384	license issued by the agency is required in order to operate an
4385	adult family-care home in this state.
4386	(2)  A person who applies for licensure as intends to be an
4387	adult family-care home provider must own or rent the adult
4388	family-care home that is to be licensed and reside therein.
4389	(3)  In accordance with s. 429.004 s. 408.805, an applicant
4390	or licensee shall pay a fee for each license application
4391	submitted under this chapter part, part II of chapter 408, and
4392	applicable rules. The amount of the fee shall be $200 per
4393	biennium.
4394	(4)   The agency shall require level 2 background screening
4395	for personnel as required in s. 429.008(1)(e) s. 408.809(1)(e),
4396	including the adult family-care home licensee provider, the
4397	designated relief person, and all adult household members,
4398	pursuant to chapter 435 and s. 429.008 s. 408.809.
4399	(5)  Unless the adult family-care home is a community
4400	residential home subject to chapter 419, the applicant must
4401	provide documentation, signed by the appropriate governmental
4402	official, that the home has met local zoning requirements for
4403	the location for which the license is sought.
4404	(6)  In addition to the requirements of s. 429.020 s.
4405	408.811, access to a licensed adult family-care home must be
4406	provided at reasonable times for the appropriate officials of
4407	the department, the Department of Health, the Department of
4408	Children and Family Services, the agency, and the State Fire
4409	Marshal, who are responsible for the development and maintenance
4410	of fire, health, sanitary, and safety standards, to inspect the
4411	adult family-care home facility to assure compliance with these
4412	standards. In addition, access to a licensed adult family-care
4413	home must be provided at reasonable times for the local long-
4414	term care ombudsman council.
4415	(7)  The licensed maximum capacity of each adult family-
4416	care home is based on the service needs of the residents and the
4417	capability of the licensee provider to meet the needs of the
4418	residents. Any relative who lives in the adult family-care home
4419	and who is a disabled adult or frail elder must be included in
4420	that limitation.
4421	(8)  Each adult family-care home must designate at least
4422	one licensed space for a resident receiving optional state
4423	supplementation. The Department of Children and Family Services
4424	shall specify by rule the procedures to be followed for
4425	referring residents who receive optional state supplementation
4426	to adult family-care homes. Those homes licensed as adult foster
4427	homes or assisted living residences facilities prior to January
4428	1, 1994, that convert to adult family-care homes, are exempt
4429	from this requirement.
4430	(9)  In addition to the license categories available in s.
4431	429.007 s. 408.808, the agency may issue a conditional license
4432	to a licensee provider for the purpose of bringing the adult
4433	family-care home into compliance with licensure requirements. A
4434	conditional license must be limited to a specific period, not
4435	exceeding 6 months. The department shall, by rule, establish
4436	criteria for issuing conditional licenses.
4437	(10)  The department may adopt rules to establish
4438	procedures, identify forms, specify documentation, and clarify
4439	terms, as necessary, to administer this section.
4440	(11)  The agency may adopt rules to administer the
4441	requirements of part II of chapter 408.
4442	Section 54.  Section 429.69, Florida Statutes, is amended
4443	to read:
4444	429.69  Denial, revocation, and suspension of a license.-In
4445	addition to the requirements of part I part II of chapter 408,
4446	the agency may deny, suspend, and revoke a license for any of
4447	the following reasons:
4448	(1)  Failure to comply with the background screening
4449	standards of this part, s. 429.008 s. 408.809(1), or chapter
4450	435.
4451	(2)  Failure to correct cited fire code violations that
4452	threaten the health, safety, or welfare of residents.
4453	Section 55.  Section 429.71, Florida Statutes, is amended
4454	to read:
4455	429.71  Classification of deficiencies; administrative
4456	fines.-
4457	(1)  In addition to the requirements of part I part II of
4458	chapter 408 and in addition to any other liability or penalty
4459	provided by law, the agency may impose an administrative fine on
4460	a licensee provider according to the following classification:
4461	(a)  Class I violations are those conditions or practices
4462	related to the operation and maintenance of an adult family-care
4463	home or to the care of residents which the agency determines
4464	present an imminent danger to the residents or guests of the
4465	adult family-care home facility or a substantial probability
4466	that death or serious physical or emotional harm would result
4467	therefrom. The condition or practice that constitutes a class I
4468	violation must be abated or eliminated within 24 hours, unless a
4469	fixed period, as determined by the agency, is required for
4470	correction. A class I violation deficiency is subject to an
4471	administrative fine in an amount not less than $500 and not
4472	exceeding $1,000 for each violation. A fine may be levied
4473	notwithstanding the correction of the violation deficiency.
4474	(b)  Class II violations are those conditions or practices
4475	related to the operation and maintenance of an adult family-care
4476	home or to the care of residents which the agency determines
4477	directly threaten the physical or emotional health, safety, or
4478	security of the residents, other than class I violations. A
4479	class II violation is subject to an administrative fine in an
4480	amount not less than $250 and not exceeding $500 for each
4481	violation. A citation for a class II violation must specify the
4482	time within which the violation is required to be corrected. If
4483	a class II violation is corrected within the time specified, no
4484	civil penalty shall be imposed, unless it is a repeated offense.
4485	(c)  Class III violations are those conditions or practices
4486	related to the operation and maintenance of an adult family-care
4487	home or to the care of residents which the agency determines
4488	indirectly or potentially threaten the physical or emotional
4489	health, safety, or security of residents, other than class I or
4490	class II violations. A class III violation is subject to an
4491	administrative fine in an amount not less than $100 and not
4492	exceeding $250 for each violation. A citation for a class III
4493	violation shall specify the time within which the violation is
4494	required to be corrected. If a class III violation is corrected
4495	within the time specified, no civil penalty shall be imposed,
4496	unless it is a repeated offense.
4497	(d)  Class IV violations are those conditions or
4498	occurrences related to the operation and maintenance of an adult
4499	family-care home, or related to the required reports, forms, or
4500	documents, which do not have the potential of negatively
4501	affecting the residents. A licensee provider that does not
4502	correct a class IV violation within the time limit specified by
4503	the agency is subject to an administrative fine in an amount not
4504	less than $50 and not exceeding $100 for each violation. Any
4505	class IV violation that is corrected during the time the agency
4506	survey is conducted will be identified as an agency finding and
4507	not as a violation.
4508	(2)  The agency may impose an administrative fine for
4509	violations which do not qualify as class I, class II, class III,
4510	or class IV violations. The amount of the fine shall not exceed
4511	$250 for each violation or $2,000 in the aggregate. Unclassified
4512	violations may include:
4513	(a)  Violating any term or condition of a license.
4514	(b)  Violating any provision of this chapter part, part II
4515	of chapter 408, or applicable rules.
4516	(c)  Failure to follow the criteria and procedures provided
4517	under part I of chapter 394 relating to the transportation,
4518	voluntary admission, and involuntary examination of adult
4519	family-care home residents.
4520	(d)  Exceeding licensed capacity.
4521	(e)  Providing services beyond the scope of the license.
4522	(f)  Violating a moratorium.
4523	(3)  Each day during which a violation occurs constitutes a
4524	separate offense.
4525	(4)  In determining whether a penalty is to be imposed, and
4526	in fixing the amount of any penalty to be imposed, the agency
4527	must consider:
4528	(a)  The gravity of the violation.
4529	(b)  Actions taken by the licensee provider to correct a
4530	violation.
4531	(c)  Any previous violation by the licensee provider.
4532	(d)  The financial benefit to the licensee provider of
4533	committing or continuing the violation.
4534	(5)  As an alternative to or in conjunction with an
4535	administrative action against a provider, the agency may request
4536	a plan of corrective action that demonstrates a good faith
4537	effort to remedy each violation by a specific date, subject to
4538	the approval of the agency.
4539	(5)(6)  The department shall set forth, by rule, notice
4540	requirements and procedures for correction of violations
4541	deficiencies.
4542	Section 56.  Section 429.73, Florida Statutes, is amended
4543	to read:
4544	429.73  Rules and standards relating to adult family-care
4545	homes.-
4546	(1)  The agency, in consultation with the department, may
4547	adopt rules to administer the requirements of part II of chapter
4548	408. The department, in consultation with the Department of
4549	Health, the Department of Children and Family Services, and the
4550	agency shall, by rule, establish minimum standards to ensure the
4551	health, safety, and well-being of each resident in the adult
4552	family-care home pursuant to this part. The rules must address:
4553	(a)  Requirements for the physical site and maintenance of
4554	the adult family-care home facility and facility maintenance.
4555	(b)  Services that must be provided to all residents of an
4556	adult family-care home and standards for such services, which
4557	must include, but need not be limited to:
4558	1.  Room and board.
4559	2.  Assistance necessary to perform the activities of daily
4560	living.
4561	3.  Assistance necessary to administer medication.
4562	4.  Supervision of residents.
4563	5.  Health monitoring.
4564	6.  Social and leisure activities.
4565	(c)  Standards and procedures for license application and
4566	annual license renewal, advertising, proper management of each
4567	resident's funds and personal property and personal affairs,
4568	financial ability to operate, medication management,
4569	inspections, complaint investigations, and adult family-care
4570	home facility, staff, and resident records.
4571	(d)  Qualifications, training, standards, and
4572	responsibilities for licensees providers and staff.
4573	(e)  Compliance with chapter 419, relating to community
4574	residential homes.
4575	(f)  Criteria and procedures for determining the
4576	appropriateness of a resident's placement and continued
4577	residency in an adult family-care home. A resident who requires
4578	24-hour nursing supervision may not be retained in an adult
4579	family-care home unless such resident is an enrolled hospice
4580	patient and the resident's continued residency is mutually
4581	agreeable to the resident and the licensee provider.
4582	(g)  Procedures for providing notice and assuring the least
4583	possible disruption of residents' lives when residents are
4584	relocated, an adult family-care home is closed, or the ownership
4585	of an adult family-care home is transferred.
4586	(h)  Procedures to protect the residents' rights as
4587	provided in s. 429.85.
4588	(i)  Procedures to promote the growth of adult family-care
4589	homes as a component of a long-term care system.
4590	(j)  Procedures to promote the goal of aging in place for
4591	residents of adult family-care homes.
4592	(2)  The department shall by rule provide minimum standards
4593	and procedures for emergencies. Pursuant to s. 633.022, the
4594	State Fire Marshal, in consultation with the department and the
4595	agency, shall adopt uniform firesafety standards for adult
4596	family-care homes.
4597	(3)  The department shall adopt rules providing for the
4598	implementation of orders not to resuscitate. The licensee
4599	provider may withhold or withdraw cardiopulmonary resuscitation
4600	if presented with an order not to resuscitate executed pursuant
4601	to s. 401.45. The licensee provider shall not be subject to
4602	criminal prosecution or civil liability, nor be considered to
4603	have engaged in negligent or unprofessional conduct, for
4604	withholding or withdrawing cardiopulmonary resuscitation
4605	pursuant to such an order and applicable rules.
4606	Section 57.  Section 429.75, Florida Statutes, is amended
4607	to read:
4608	429.75  Training and education programs.-
4609	(1)  Each adult family-care home licensee provider shall
4610	complete training and education programs.
4611	(2)  Training and education programs must include
4612	information relating to:
4613	(a)  State law and rules governing adult family-care homes,
4614	with emphasis on appropriateness of placement of residents in an
4615	adult family-care home.
4616	(b)  Identifying and reporting abuse, neglect, and
4617	exploitation.
4618	(c)  Identifying and meeting the special needs of disabled
4619	adults and frail elders.
4620	(d)  Monitoring the health of residents, including
4621	guidelines for prevention and care of pressure ulcers.
4622	(3)  Licensees Effective January 1, 2004, providers must
4623	complete the training and education program within a reasonable
4624	time determined by the department. Failure to complete the
4625	training and education program within the time set by the
4626	department is a violation of this part and subjects the licensee
4627	provider to revocation of the license.
4628	(4)  If the Department of Children and Family Services, the
4629	agency, or the department determines that there are problems in
4630	an adult family-care home which could be reduced through
4631	specific training or education beyond that required under this
4632	section, the agency may require the licensee provider or staff
4633	to complete such training or education.
4634	(5)  The department may adopt rules as necessary to
4635	administer this section.
4636	Section 58.  Section 429.81, Florida Statutes, is amended
4637	to read:
4638	429.81  Residency agreements.-
4639	(1)  Each resident must be covered by a residency
4640	agreement, executed before or at the time of admission, between
4641	the licensee provider and the resident or the resident's
4642	designee or legal representative. Each party to the contract
4643	must be provided a duplicate copy or the original agreement, and
4644	the licensee provider must keep the residency agreement on file
4645	for 5 years after expiration of the agreement.
4646	(2)  Each residency agreement must specify the personal
4647	care and accommodations to be provided by the adult family-care
4648	home, the rates or charges, a requirement of at least 30 days'
4649	notice before a rate increase, and any other provisions required
4650	by rule of the department.
4651	(3)  Each residency agreement must specify that the
4652	resident must give the provider a 30 days' written notice of
4653	intent to terminate his or her residency from the adult family-
4654	care home.
4655	Section 59.  Section 429.83, Florida Statutes, is amended
4656	to read:
4657	429.83  Residents with Alzheimer's disease or other related
4658	disorders; certain disclosures.-An adult family-care home
4659	licensed under this part which claims that it provides special
4660	care for persons who have Alzheimer's disease or other related
4661	disorders must disclose in its advertisements or in a separate
4662	document those services that distinguish the care as being
4663	especially applicable to, or suitable for, such persons. The
4664	adult family-care home must give a copy of all such
4665	advertisements or a copy of the document to each person who
4666	requests information about programs and services for persons
4667	with Alzheimer's disease or other related disorders offered by
4668	the adult family-care home and must maintain a copy of all such
4669	advertisements and documents in its records. The agency shall
4670	examine all such advertisements and documents in the adult
4671	family-care home's records as part of the license renewal
4672	procedure.
4673	Section 60.  Section 429.85, Florida Statutes, is amended
4674	to read:
4675	429.85  Residents' bill of rights.-
4676	(1)  A resident of an adult family-care home may not be
4677	deprived of any civil or legal rights, benefits, or privileges
4678	guaranteed by law, the State Constitution, or the Constitution
4679	of the United States solely by reason of status as a resident of
4680	the adult family-care home. Each resident has the right to:
4681	(a)  Live in a safe and decent living environment, free
4682	from abuse and neglect.
4683	(b)  Be treated with consideration and respect and with due
4684	recognition of personal dignity, individuality, and privacy.
4685	(c)  Keep and use the resident's own clothes and other
4686	personal property in the resident's immediate living quarters,
4687	so as to maintain individuality and personal dignity, except
4688	when the licensee provider can demonstrate that to do so would
4689	be unsafe or an infringement upon the rights of other residents.
4690	(d)  Have unrestricted private communication, including
4691	receiving and sending unopened correspondence, having access to
4692	a telephone, and visiting with any person of his or her choice,
4693	at any time between the hours of 9 a.m. and 9 p.m. at a minimum.
4694	(e)  Be free to participate in and benefit from community
4695	services and activities and to achieve the highest possible
4696	level of independence, autonomy, and interaction within the
4697	community.
4698	(f)  Manage the resident's own financial affairs unless the
4699	resident or the resident's guardian authorizes the licensee
4700	provider to provide safekeeping for funds in accordance with
4701	procedures equivalent to those provided in s. 429.27.
4702	(g)  Share a room with the resident's spouse if both are
4703	residents of the adult family-care home.
4704	(h)  Have reasonable opportunity for regular exercise
4705	several times a week and to be outdoors at regular and frequent
4706	intervals.
4707	(i)  Exercise civil and religious liberties, including the
4708	right to independent personal decisions. Religious beliefs or
4709	practices and attendance at religious services may not be
4710	imposed upon a resident.
4711	(j)  Have access to adequate and appropriate health care.
4712	(k)  Be free from chemical and physical restraints.
4713	(l)  Have at least 30 days' notice of relocation or
4714	termination of residency from the  adult family-care home
4715	unless, for medical reasons, the resident is certified by a
4716	physician to require an emergency relocation to a facility
4717	providing a more skilled level of care or the resident engages
4718	in a pattern of conduct that is harmful or offensive to other
4719	residents. If a resident has been adjudicated mentally
4720	incompetent, the resident's guardian must be given at least 30
4721	days' notice, except in an emergency, of the relocation of a
4722	resident or of the termination of a residency. The reasons for
4723	relocating a resident must be set forth in writing.
4724	(m)  Present grievances and recommend changes to the
4725	licensee provider, to staff, or to any other person without
4726	restraint, interference, coercion, discrimination, or reprisal.
4727	This right includes the right to have access to ombudsman
4728	volunteers and advocates and the right to be a member of, to be
4729	active in, and to associate with advocacy or special interest
4730	groups.
4731	(2)  The licensee provider shall ensure that residents and
4732	their legal representatives are made aware of the rights,
4733	obligations, and prohibitions set forth in this part. Residents
4734	must also be given the names, addresses, and telephone numbers
4735	of the local ombudsman council and the central abuse hotline
4736	where they may lodge complaints.
4737	(3)  The adult family-care home may not hamper or prevent
4738	residents from exercising the rights specified in this section.
4739	(4)  A licensee provider or staff of an adult family-care
4740	home may not serve notice upon a resident to leave the premises
4741	or take any other retaliatory action against any person who:
4742	(a)  Exercises any right set forth in this section.
4743	(b)  Appears as a witness in any hearing, in or out of the
4744	adult family-care home.
4745	(c)  Files a civil action alleging a violation of this part
4746	or notifies a state attorney or the Attorney General of a
4747	possible violation of this part.
4748	(5)  Any adult family-care home that terminates the
4749	residency of an individual who has participated in activities
4750	specified in subsection (4) must show good cause for the
4751	termination in a court of competent jurisdiction.
4752	(6)  Any person who reports a complaint concerning a
4753	suspected violation of this part or the services and conditions
4754	in an adult family-care home, or who testifies in any
4755	administrative or judicial proceeding arising from such a
4756	complaint, is immune from any civil or criminal liability
4757	therefor, unless the person acted in bad faith or with malicious
4758	purpose or the court finds that there was a complete absence of
4759	a justiciable issue of either law or fact raised by the losing
4760	party.
4761	Section 61.  Section 429.87, Florida Statutes, is amended
4762	to read:
4763	429.87  Civil actions to enforce rights.-
4764	(1)  Any person or resident whose rights as specified in
4765	this part are violated has a cause of action against any adult
4766	family-care home, licensee provider, or staff responsible for
4767	the violation. The action may be brought by the resident or the
4768	resident's guardian, or by a person or organization acting on
4769	behalf of a resident with the consent of the resident or the
4770	resident's guardian, to enforce the right. The action may be
4771	brought in any court of competent jurisdiction to enforce such
4772	rights and to recover actual damages, and punitive damages when
4773	malicious, wanton, or willful disregard of the rights of others
4774	can be shown. Any plaintiff who prevails in any such action is
4775	entitled to recover reasonable attorney's fees, costs of the
4776	action, and damages, unless the court finds that the plaintiff
4777	has acted in bad faith or with malicious purpose or that there
4778	was a complete absence of a justiciable issue of either law or
4779	fact. A prevailing defendant is entitled to recover reasonable
4780	attorney's fees pursuant to s. 57.105. The remedies provided in
4781	this section are in addition to other legal and administrative
4782	remedies available to a resident or to the agency.
4783	(2)  To recover attorney's fees under this section, the
4784	following conditions precedent must be met:
4785	(a)  Within 120 days after the filing of a responsive
4786	pleading or defensive motion to a complaint brought under this
4787	section and before trial, the parties or their designated
4788	representatives shall meet in mediation to discuss the issues of
4789	liability and damages in accordance with this paragraph for the
4790	purpose of an early resolution of the matter.
4791	1.  Within 60 days after the filing of the responsive
4792	pleading or defensive motion, the parties shall:
4793	a.  Agree on a mediator. If the parties cannot agree on a
4794	mediator, the defendant shall immediately notify the court,
4795	which shall appoint a mediator within 10 days after such notice.
4796	b.  Set a date for mediation.
4797	c.  Prepare an order for the court that identifies the
4798	mediator, the scheduled date of the mediation, and other terms
4799	of the mediation. Absent any disagreement between the parties,
4800	the court may issue the order for the mediation submitted by the
4801	parties without a hearing.
4802	2.  The mediation must be concluded within 120 days after
4803	the filing of a responsive pleading or defensive motion. The
4804	date may be extended only by agreement of all parties subject to
4805	mediation under this subsection.
4806	3.  The mediation shall be conducted in the following
4807	manner:
4808	a.  Each party shall ensure that all persons necessary for
4809	complete settlement authority are present at the mediation.
4810	b.  Each party shall mediate in good faith.
4811	4.  All aspects of the mediation which are not specifically
4812	established by this subsection must be conducted according to
4813	the rules of practice and procedure adopted by the Supreme Court
4814	of this state.
4815	(b)  If the parties do not settle the case pursuant to
4816	mediation, the last offer of the defendant made at mediation
4817	shall be recorded by the mediator in a written report that
4818	states the amount of the offer, the date the offer was made in
4819	writing, and the date the offer was rejected. If the matter
4820	subsequently proceeds to trial under this section and the
4821	plaintiff prevails but is awarded an amount in damages,
4822	exclusive of attorney's fees, which is equal to or less than the
4823	last offer made by the defendant at mediation, the plaintiff is
4824	not entitled to recover any attorney's fees.
4825	(c)  This subsection applies only to claims for liability
4826	and damages and does not apply to actions for injunctive relief.
4827	(d)  This subsection applies to all causes of action that
4828	accrue on or after October 1, 1999.
4829	(3)  Discovery of financial information for the purpose of
4830	determining the value of punitive damages may not be had unless
4831	the plaintiff shows the court by proffer or evidence in the
4832	record that a reasonable basis exists to support a claim for
4833	punitive damages.
4834	(4)  In addition to any other standards for punitive
4835	damages, any award of punitive damages must be reasonable in
4836	light of the actual harm suffered by the resident and the
4837	egregiousness of the conduct that caused the actual harm to the
4838	resident.
4839	Section 62.  Section 429.901, Florida Statutes, is amended
4840	to read:
4841	429.901  Definitions.-As used in this part, the term:
4842	(1)  "Adult day care center" or "center" means any
4843	building, buildings, or part of a building, whether operated for
4844	profit or not, in which is provided through its ownership or
4845	management, for a part of a day, basic services to three or more
4846	persons who are 18 years of age or older, who are not related to
4847	the owner or operator by blood or marriage, and who require such
4848	services.
4849	(2)  "Agency" means the Agency for Health Care
4850	Administration.
4851	(2)(3)  "Basic services" include, but are not limited to,
4852	providing a protective setting that is as noninstitutional as
4853	possible; therapeutic programs of social and health activities
4854	and services; leisure activities; self-care training; rest;
4855	nutritional services; and respite care.
4856	(3)(4)  "Department" means the Department of Elderly
4857	Affairs.
4858	(4)(5)  "Multiple or repeated violations" means 2 or more
4859	violations that present an imminent danger to the health,
4860	safety, or welfare of participants or 10 or more violations
4861	within a 5-year period that threaten the health, safety, or
4862	welfare of the participants.
4863	(6)  "Operator" means the licensee or person having general
4864	administrative charge of an adult day care center.
4865	(7)  "Owner" means the licensee of an adult day care
4866	center.
4867	(5)(8)  "Participant" means a recipient of basic services
4868	or of supportive and optional services provided by an adult day
4869	care center.
4870	(6)(9)  "Supportive and optional services" include, but are
4871	not limited to, speech, occupational, and physical therapy;
4872	direct transportation; legal consultation; consumer education;
4873	and referrals for followup services.
4874	Section 63.  Section 429.905, Florida Statutes, is amended
4875	to read:
4876	429.905  Exemptions; monitoring of adult day care center
4877	programs colocated with assisted living residences facilities or
4878	licensed nursing home facilities.-
4879	(1)  The following are exempt from this part:
4880	(a)  Any facility, institution, or other place that is
4881	operated by the Federal Government or any agency thereof.
4882	(b)  Any freestanding inpatient hospice facility that is
4883	licensed by the state and which provides day care services to
4884	hospice patients only.
4885	(2)  A licensed assisted living residence facility, a
4886	licensed hospital, or a licensed nursing home facility may
4887	provide services during the day which include, but are not
4888	limited to, social, health, therapeutic, recreational,
4889	nutritional, and respite services, to adults who are not
4890	residents. Such a residence or facility need not be licensed as
4891	an adult day care center; however, the agency must monitor the
4892	residence or facility during the regular inspection and at least
4893	biennially to ensure adequate space and sufficient staff. If an
4894	assisted living residence facility, a hospital, or a nursing
4895	home holds itself out to the public as an adult day care center,
4896	it must be licensed as such and meet all standards prescribed by
4897	statute and rule.
4898	Section 64.  Section 429.907, Florida Statutes, is amended
4899	to read:
4900	429.907  License requirement; fee; exemption; display.-
4901	(1)  The requirements of part I part II of chapter 408
4902	apply to the provision of services that require licensure
4903	pursuant to this chapter part and part II of chapter 408 and to
4904	entities licensed by or applying for such licensure from the
4905	agency for Health Care Administration pursuant to this part. A
4906	license issued by the agency is required in order to operate an
4907	adult day care center in this state.
4908	(2)(a)  Except as otherwise provided in this subsection,
4909	separate licenses are required for centers operated on separate
4910	premises, even though operated under the same management.
4911	Separate licenses are not required for separate buildings on the
4912	same premises.
4913	(b)  In the event a licensed center becomes wholly or
4914	substantially unusable due to a disaster as defined in s.
4915	252.34(1) or due to an emergency as defined in s. 252.34(3):
4916	1.  The licensee may continue to operate under its current
4917	license in a premise or premises separate from that authorized
4918	under the license if the licensee has:
4919	a.  Specified the location of the premise or premises in
4920	its comprehensive emergency management plan submitted to and
4921	approved by the applicable county emergency management
4922	authority; and
4923	b.  Notified the agency and the county emergency management
4924	authority within 24 hours of operating in the separate premise
4925	or premises.
4926	2.  The licensee shall operate the separate premise or
4927	premises only while the licensed center's original location is
4928	substantially unusable and for no longer than 180 days. The
4929	agency may extend use of the alternate premise or premises
4930	beyond the initial 180 days. The agency may also review the
4931	operation of the disaster premise or premises quarterly.
4932	(3)  In accordance with s. 429.004 s. 408.805, an applicant
4933	or licensee shall pay a fee for each license application
4934	submitted under this part and part I II of chapter 408. The
4935	amount of the fee shall be established by rule and may not
4936	exceed $150.
4937	(4)  County-operated or municipally operated centers
4938	applying for licensure under this part are exempt from the
4939	payment of license fees.
4940	Section 65.  Section 429.909, Florida Statutes, is amended
4941	to read:
4942	429.909  Application for license.-In addition to all
4943	provisions of part I part II of chapter 408, the applicant for
4944	licensure must furnish a description of the physical and mental
4945	capabilities and needs of the participants to be served and the
4946	availability, frequency, and intensity of basic services and of
4947	supportive and optional services to be provided and proof of
4948	adequate liability insurance coverage.
4949	Section 66.  Section 429.911, Florida Statutes, is amended
4950	to read:
4951	429.911  Denial, suspension, revocation of license;
4952	emergency action; administrative fines; investigations and
4953	inspections.-
4954	(1)  The agency may deny, revoke, and suspend a license
4955	under this part, impose an action under s. 429.013 s. 408.814,
4956	and impose an administrative fine against the licensee owner of
4957	an adult day care center or its operator or employee in the
4958	manner provided in chapter 120 for the violation of any
4959	provision of this chapter part, part II of chapter 408, or
4960	applicable rules.
4961	(2)  Each of the following actions by the licensee owner of
4962	an adult day care center or by its operator or employee is a
4963	ground for action by the agency against the licensee owner of
4964	the center or its operator or employee:
4965	(a)  An intentional or negligent act materially affecting
4966	the health or safety of center participants.
4967	(b)  A violation of this part or of any standard or rule
4968	under this chapter part or part II of chapter 408.
4969	(c)   Failure to comply with the background screening
4970	standards of this part, s. 429.008 s. 408.809(1), or chapter
4971	435.
4972	(d)  Failure to follow the criteria and procedures provided
4973	under part I of chapter 394 relating to the transportation,
4974	voluntary admission, and involuntary examination of center
4975	participants.
4976	(e)  Multiple or repeated violations of this part or of any
4977	standard or rule adopted under this chapter part or part II of
4978	chapter 408.
4979	(3)  The agency is responsible for all investigations and
4980	inspections conducted pursuant to this part and s. 429.0105 s.
4981	408.811.
4982	Section 67.  Section 429.913, Florida Statutes, is amended
4983	to read:
4984	429.913  Administrative fines.-
4985	(1)(a)  In addition to the requirements of part I part II
4986	of chapter 408, if the agency determines that an adult day care
4987	center is not operated in compliance with this part or with
4988	rules adopted under this part, the agency, notwithstanding any
4989	other administrative action it takes, shall make a reasonable
4990	attempt to discuss with the licensee owner each violation and
4991	recommended corrective action prior to providing the licensee
4992	owner with written notification. The agency may request the
4993	submission of a corrective action plan for the center which
4994	demonstrates a good faith effort to remedy each violation by a
4995	specific date, subject to the approval of the agency.
4996	(b)  The licensee owner of a center or its operator or
4997	employee found in violation of this chapter part, part II of
4998	chapter 408, or applicable rules may be fined by the agency. A
4999	fine may not exceed $500 for each violation. In no event,
5000	however, may such fines in the aggregate exceed $5,000.
5001	(c)  The failure to correct a violation by the date set by
5002	the agency, or the failure to comply with an approved corrective
5003	action plan, is a separate violation for each day such failure
5004	continues, unless the agency approves an extension to a specific
5005	date.
5006	(2)  In determining whether to impose a fine and in fixing
5007	the amount of any fine, the agency shall consider the following
5008	factors:
5009	(a)  The gravity of the violation, including the
5010	probability that death or serious physical or emotional harm to
5011	a participant will result or has resulted, the severity of the
5012	actual or potential harm, and the extent to which the provisions
5013	of the applicable statutes or rules were violated.
5014	(b)  Actions taken by the licensee owner or operator to
5015	correct violations.
5016	(c)  Any previous violations.
5017	(d)  The financial benefit to the center of committing or
5018	continuing the violation.
5019	Section 68.  Section 429.915, Florida Statutes, is amended
5020	to read:
5021	429.915  Conditional license.-In addition to the license
5022	categories available in part I part II of chapter 408, the
5023	agency may issue a conditional license to an applicant for
5024	license renewal or change of ownership if the applicant fails to
5025	meet all standards and requirements for licensure. A conditional
5026	license issued under this subsection must be limited to a
5027	specific period not exceeding 6 months, as determined by the
5028	agency, and must be accompanied by an approved plan of
5029	correction.
5030	Section 69.  Section 429.917, Florida Statutes, is amended
5031	to read:
5032	429.917  Patients with Alzheimer's disease or other related
5033	disorders; staff training requirements; certain disclosures.-
5034	(1)  An adult day care center licensed under this part must
5035	provide the following staff training:
5036	(a)  Upon beginning employment with the adult day care
5037	center facility, each employee must receive basic written
5038	information about interacting with participants who have
5039	Alzheimer's disease or dementia-related disorders.
5040	(b)  In addition to the information provided under
5041	paragraph (a), newly hired adult day care center personnel who
5042	are expected to, or whose responsibilities require them to, have
5043	direct contact with participants who have Alzheimer's disease or
5044	dementia-related disorders must complete initial training of at
5045	least 1 hour within the first 3 months after beginning
5046	employment. The training must include an overview of dementias
5047	and must provide instruction in basic skills for communicating
5048	with persons who have dementia.
5049	(c)  In addition to the requirements of paragraphs (a) and
5050	(b), an employee who will be providing direct care to a
5051	participant who has Alzheimer's disease or a dementia-related
5052	disorder must complete an additional 3 hours of training within
5053	9 months after beginning employment. This training must include,
5054	but is not limited to, the management of problem behaviors,
5055	information about promoting the participant's independence in
5056	activities of daily living, and instruction in skills for
5057	working with families and caregivers.
5058	(d)  For certified nursing assistants, the required 4 hours
5059	of training shall be part of the total hours of training
5060	required annually.
5061	(e)  For a health care practitioner as defined in s.
5062	456.001, continuing education hours taken as required by that
5063	practitioner's licensing board shall be counted toward the total
5064	of 4 hours.
5065	(f)  For an employee who is a licensed health care
5066	practitioner as defined in s. 456.001, training that is
5067	sanctioned by that practitioner's licensing board shall be
5068	considered to be approved by the department of Elderly Affairs.
5069	(g)  The department of Elderly Affairs or its designee must
5070	approve the 1-hour and 3-hour training provided to employees and
5071	direct caregivers under this section. The department must
5072	consider for approval training offered in a variety of formats.
5073	The department shall keep a list of current providers who are
5074	approved to provide the 1-hour and 3-hour training. The
5075	department shall adopt rules to establish standards for the
5076	employees who are subject to this training, for the trainers,
5077	and for the training required in this section.
5078	(h)  Upon completing any training described in this
5079	section, the employee or direct caregiver shall be issued a
5080	certificate that includes the name of the training provider, the
5081	topic covered, and the date and signature of the training
5082	provider. The certificate is evidence of completion of training
5083	in the identified topic, and the employee or direct caregiver is
5084	not required to repeat training in that topic if the employee or
5085	direct caregiver changes employment to a different adult day
5086	care center or to an assisted living residence facility, nursing
5087	home, home health agency, or hospice. The direct caregiver must
5088	comply with other applicable continuing education requirements.
5089	(i)  An employee who is hired on or after July 1, 2004,
5090	must complete the training required by this section.
5091	(2)  A center licensed under this part which claims that it
5092	provides special care for persons who have Alzheimer's disease
5093	or other related disorders must disclose in its advertisements
5094	or in a separate document those services that distinguish the
5095	care as being especially applicable to, or suitable for, such
5096	persons. The center must give a copy of all such advertisements
5097	or a copy of the document to each person who requests
5098	information about the center and must maintain a copy of all
5099	such advertisements and documents in its records. The agency
5100	shall examine all such advertisements and documents in the
5101	center's records as part of the license renewal procedure.
5102	Section 70.  Section 429.919, Florida Statutes, is amended
5103	to read:
5104	429.919  Background screening.-The agency shall require
5105	level 2 background screening for personnel as required in s.
5106	429.008(1)(e) s. 408.809(1)(e) pursuant to chapter 435 and s.
5107	408.809.
5108	Section 71.  Section 429.925, Florida Statutes, is amended
5109	to read:
5110	429.925  Discontinuance of operation of adult day care
5111	centers.-In addition to the requirements of part I part II of
5112	chapter 408, before operation of an adult day care center may be
5113	voluntarily discontinued, the licensee operator must, at least
5114	60 days before the discontinuance of operation, inform each
5115	participant of the fact and the proposed date of discontinuance
5116	of operation.
5117	Section 72.  Section 429.926, Florida Statutes, is created
5118	to read:
5119	429.926  Minimum licensure requirements; exemption.-The
5120	provisions of s. 429.009(7)-(9), relating to minimum licensure
5121	requirements, do not apply to adult day care centers licensed
5122	under this part.
5123	Section 73.  Section 429.927, Florida Statutes, is amended
5124	to read:
5125	429.927  Right of entry and inspection.-In accordance with
5126	429.0105 s. 408.811, the agency or department has the right to
5127	enter the premises of any adult day care center licensed
5128	pursuant to this part, at any reasonable time, in order to
5129	determine the state of compliance with this chapter part, part
5130	II of chapter 408, and applicable rules.
5131	Section 74.  Section 429.929, Florida Statutes, is amended
5132	to read:
5133	429.929  Rules establishing standards.-
5134	(1)  The agency, in consultation with the department, may
5135	adopt rules to administer the requirements of part II of chapter
5136	408. The department of Elderly Affairs, in conjunction with the
5137	agency, shall adopt rules to implement the provisions of this
5138	part. The rules must include reasonable and fair standards. Any
5139	conflict between these standards and those that may be set forth
5140	in local, county, or municipal ordinances shall be resolved in
5141	favor of those having statewide effect. Such standards must
5142	relate to:
5143	(a)  The maintenance of adult day care centers with respect
5144	to plumbing, heating, lighting, ventilation, and other building
5145	conditions, including adequate meeting space, to ensure the
5146	health, safety, and comfort of participants and protection from
5147	fire hazard. Such standards may not conflict with chapter 553
5148	and must be based upon the size of the structure and the number
5149	of participants.
5150	(b)  The number and qualifications of all personnel
5151	employed by adult day care centers who have responsibilities for
5152	the care of participants.
5153	(c)  All sanitary conditions within adult day care centers
5154	and their surroundings, including water supply, sewage disposal,
5155	food handling, and general hygiene, and maintenance of sanitary
5156	conditions, to ensure the health and comfort of participants.
5157	(d)  Basic services provided by adult day care centers.
5158	(e)  Supportive and optional services provided by adult day
5159	care centers.
5160	(f)  Data and information relative to participants and
5161	programs of adult day care centers, including, but not limited
5162	to, the physical and mental capabilities and needs of the
5163	participants, the availability, frequency, and intensity of
5164	basic services and of supportive and optional services provided,
5165	the frequency of participation, the distances traveled by
5166	participants, the hours of operation, the number of referrals to
5167	other centers or elsewhere, and the incidence of illness.
5168	(g)  Components of a comprehensive emergency management
5169	plan, developed in consultation with the Department of Health,
5170	the agency for Health Care Administration, and the Department of
5171	Community Affairs.
5172	(2)  Pursuant to this part, s. 429.0105 s. 408.811, and
5173	applicable rules, the agency may conduct an abbreviated biennial
5174	inspection of key quality-of-care standards, in lieu of a full
5175	inspection, of a center that has a record of good performance.
5176	However, the agency must conduct a full inspection of a center
5177	that has had one or more confirmed complaints within the
5178	licensure period immediately preceding the inspection or which
5179	has a serious problem identified during the abbreviated
5180	inspection. The agency shall develop the key quality-of-care
5181	standards, taking into consideration the comments and
5182	recommendations of the department of Elderly Affairs and of
5183	associations and organizations representing adult day care
5184	centers provider groups. These standards shall be included in
5185	rules adopted by the department of Elderly Affairs.
5186	Section 75.  Paragraph (b) of subsection (4) of section
5187	101.62, Florida Statutes, is amended to read:
5188	101.62  Request for absentee ballots.-
5189	(4)
5190	(b)  The supervisor shall provide an absentee ballot to
5191	each elector by whom a request for that ballot has been made by
5192	one of the following means:
5193	1.  By nonforwardable, return-if-undeliverable mail to the
5194	elector's current mailing address on file with the supervisor,
5195	unless the elector specifies in the request that:
5196	a.  The elector is absent from the county and does not plan
5197	to return before the day of the election;
5198	b.  The elector is temporarily unable to occupy the
5199	residence because of hurricane, tornado, flood, fire, or other
5200	emergency or natural disaster; or
5201	c.  The elector is in a hospital, assisted living residence
5202	facility, nursing home, short-term medical or rehabilitation
5203	facility, or correctional facility,
5204
5205	in which case the supervisor shall mail the ballot by
5206	nonforwardable, return-if-undeliverable mail to any other
5207	address the elector specifies in the request.
5208	2.  By forwardable mail, e-mail, or facsimile machine
5209	transmission to absent uniformed services voters and overseas
5210	voters. The absent uniformed services voter or overseas voter
5211	may designate in the absentee ballot request the preferred
5212	method of transmission. If the voter does not designate the
5213	method of transmission, the absentee ballot shall be mailed.
5214	3.  By personal delivery before 7 p.m. on election day to
5215	the elector, upon presentation of the identification required in
5216	s. 101.043.
5217	4.  By delivery to a designee on election day or up to 5
5218	days prior to the day of an election. Any elector may designate
5219	in writing a person to pick up the ballot for the elector;
5220	however, the person designated may not pick up more than two
5221	absentee ballots per election, other than the designee's own
5222	ballot, except that additional ballots may be picked up for
5223	members of the designee's immediate family. For purposes of this
5224	section, "immediate family" means the designee's spouse or the
5225	parent, child, grandparent, or sibling of the designee or of the
5226	designee's spouse. The designee shall provide to the supervisor
5227	the written authorization by the elector and a picture
5228	identification of the designee and must complete an affidavit.
5229	The designee shall state in the affidavit that the designee is
5230	authorized by the elector to pick up that ballot and shall
5231	indicate if the elector is a member of the designee's immediate
5232	family and, if so, the relationship. The department shall
5233	prescribe the form of the affidavit. If the supervisor is
5234	satisfied that the designee is authorized to pick up the ballot
5235	and that the signature of the elector on the written
5236	authorization matches the signature of the elector on file, the
5237	supervisor shall give the ballot to that designee for delivery
5238	to the elector.
5239	Section 76.  Subsection (1) of section 101.655, Florida
5240	Statutes, is amended to read:
5241	101.655  Supervised voting by absent electors in certain
5242	facilities.-
5243	(1)  The supervisor of elections of a county shall provide
5244	supervised voting for absent electors residing in any assisted
5245	living residence facility, as defined in s. 429.02, or nursing
5246	home facility, as defined in s. 400.021, within that county at
5247	the request of any administrator of such a facility. Such
5248	request for supervised voting in the facility shall be made by
5249	submitting a written request to the supervisor of elections no
5250	later than 21 days prior to the election for which that request
5251	is submitted. The request shall specify the name and address of
5252	the facility and the name of the electors who wish to vote
5253	absentee in that election. If the request contains the names of
5254	fewer than five voters, the supervisor of elections is not
5255	required to provide supervised voting.
5256	Section 77.  Subsection (16) of section 159.27, Florida
5257	Statutes, is amended to read:
5258	159.27  Definitions.-The following words and terms, unless
5259	the context clearly indicates a different meaning, shall have
5260	the following meanings:
5261	(16)  "Health care facility" means property operated in the
5262	private sector, whether operated for profit or not, used for or
5263	useful in connection with the diagnosis, treatment, therapy,
5264	rehabilitation, housing, or care of or for aged, sick, ill,
5265	injured, infirm, impaired, disabled, or handicapped persons,
5266	without discrimination among such persons due to race, religion,
5267	or national origin; or for the prevention, detection, and
5268	control of disease, including, without limitation thereto,
5269	hospital, clinic, emergency, outpatient, and intermediate care,
5270	including, but not limited to, facilities for the elderly such
5271	as assisted living residences facilities, facilities defined in
5272	s. 154.205(8), day care and share-a-home facilities, nursing
5273	homes, and the following related property when used for or in
5274	connection with the foregoing: laboratory; research; pharmacy;
5275	laundry; health personnel training and lodging; patient, guest,
5276	and health personnel food service facilities; and offices and
5277	office buildings for persons engaged in health care professions
5278	or services; provided, if required by ss. 400.601-400.611 and
5279	ss. 408.031-408.045, a certificate of need therefor is obtained
5280	prior to the issuance of the bonds.
5281	Section 78.  Paragraph (b) of subsection (2) of section
5282	196.1975, Florida Statutes, is amended to read:
5283	196.1975  Exemption for property used by nonprofit homes
5284	for the aged.-Nonprofit homes for the aged are exempt to the
5285	extent that they meet the following criteria:
5286	(2)  A facility will not qualify as a "home for the aged"
5287	unless at least 75 percent of the occupants are over the age of
5288	62 years or totally and permanently disabled. For homes for the
5289	aged which are exempt from paying income taxes to the United
5290	States as specified in subsection (1), licensing by the Agency
5291	for Health Care Administration is required for ad valorem tax
5292	exemption hereunder only if the home:
5293	(b)  Qualifies as an assisted living residence facility
5294	under chapter 429.
5295	Section 79.  Paragraph (c) of subsection (4) of section
5296	202.125, Florida Statutes, is amended to read:
5297	202.125  Sales of communications services; specified
5298	exemptions.-
5299	(4)  The sale of communications services to a home for the
5300	aged, religious institution or educational institution that is
5301	exempt from federal income tax under s. 501(c)(3) of the
5302	Internal Revenue Code, or by a religious institution that is
5303	exempt from federal income tax under s. 501(c)(3) of the
5304	Internal Revenue Code having an established physical place for
5305	worship at which nonprofit religious services and activities are
5306	regularly conducted and carried on, is exempt from the taxes
5307	imposed or administered pursuant to ss. 202.12 and 202.19. As
5308	used in this subsection, the term:
5309	(c)  "Home for the aged" includes any nonprofit
5310	corporation:
5311	1.  In which at least 75 percent of the occupants are 62
5312	years of age or older or totally and permanently disabled; which
5313	qualifies for an ad valorem property tax exemption under s.
5314	196.196, s. 196.197, or s. 196.1975; and which is exempt from
5315	the sales tax imposed under chapter 212.
5316	2.  Licensed as a nursing home under chapter 400 or an
5317	assisted living residence facility under chapter 429 and which
5318	is exempt from the sales tax imposed under chapter 212.
5319	Section 80.  Section 205.1965, Florida Statutes, is amended
5320	to read:
5321	205.1965  Assisted living residences facilities.-A county
5322	or municipality may not issue a business tax receipt for the
5323	operation of an assisted living residence facility pursuant to
5324	chapter 429 without first ascertaining that the applicant has
5325	been licensed by the Agency for Health Care Administration to
5326	operate such facility at the specified location or locations.
5327	The Agency for Health Care Administration shall furnish to local
5328	agencies responsible for issuing business tax receipts
5329	sufficient instructions for making the required determinations.
5330	Section 81.  Section 252.357, Florida Statutes, is amended
5331	to read:
5332	252.357  Monitoring of nursing homes and assisted living
5333	residences facilities during disaster.-The Florida Comprehensive
5334	Emergency Management Plan shall permit the Agency for Health
5335	Care Administration, working from the agency's offices or in the
5336	Emergency Operations Center, ESF-8, to make initial contact with
5337	each nursing home and assisted living residence facility in the
5338	disaster area. The agency, by July 15, 2006, and annually
5339	thereafter, shall publish on the Internet an emergency telephone
5340	number that may be used by nursing homes and assisted living
5341	residences facilities to contact the agency on a schedule
5342	established by the agency to report requests for assistance. The
5343	agency may also provide the telephone number to each facility
5344	when it makes the initial facility call.
5345	Section 82.  Subsection (4) of section 252.385, Florida
5346	Statutes, is amended to read:
5347	252.385  Public shelter space.-
5348	(4)(a)  Public facilities, including schools, postsecondary
5349	education facilities, and other facilities owned or leased by
5350	the state or local governments, but excluding hospitals, hospice
5351	care facilities, assisted living residences facilities, and
5352	nursing homes, which are suitable for use as public hurricane
5353	evacuation shelters shall be made available at the request of
5354	the local emergency management agencies. The local emergency
5355	management agency shall coordinate with these entities to ensure
5356	that designated facilities are ready to activate prior to a
5357	specific hurricane or disaster. Such agencies shall coordinate
5358	with the appropriate school board, university, community
5359	college, state agency, or local governing board when requesting
5360	the use of such facilities as public hurricane evacuation
5361	shelters.
5362	(b)  The Department of Management Services shall
5363	incorporate provisions for the use of suitable leased public
5364	facilities as public hurricane evacuation shelters into lease
5365	agreements for state agencies. Suitable leased public facilities
5366	include leased public facilities that are solely occupied by
5367	state agencies and have at least 2,000 square feet of net floor
5368	area in a single room or in a combination of rooms having a
5369	minimum of 400 square feet in each room. The net square footage
5370	of floor area shall be determined by subtracting from the gross
5371	square footage the square footage of spaces such as mechanical
5372	and electrical rooms, storage rooms, open corridors, restrooms,
5373	kitchens, science or computer laboratories, shop or mechanical
5374	areas, administrative offices, records vaults, and crawl spaces.
5375	(c)  The Department of Management Services shall, in
5376	consultation with local and state emergency management agencies,
5377	assess Department of Management Services facilities to identify
5378	the extent to which each facility has public hurricane
5379	evacuation shelter space. The Department of Management Services
5380	shall submit proposed facility retrofit projects that
5381	incorporate hurricane protection enhancements to the department
5382	for assessment and inclusion in the annual report prepared in
5383	accordance with subsection (3).
5384	(d)  The Department of Management Services shall include in
5385	the annual state facilities inventory report required under ss.
5386	216.015-216.016 a separate list of state-owned facilities,
5387	including, but not limited to, meeting halls, auditoriums,
5388	conference centers, and training centers that have unoccupied
5389	space suitable for use as an emergency shelter during a storm or
5390	other catastrophic event. Facilities must be listed by the
5391	county and municipality where the facility is located and must
5392	be made available in accordance with paragraph (a). As used in
5393	this paragraph, the term "suitable for use as an emergency
5394	shelter" means meeting the standards set by the American Red
5395	Cross for a hurricane evacuation shelter, and the term
5396	"unoccupied" means vacant due to suspended operation or nonuse.
5397	The list must be updated by May 31 of each year.
5398	Section 83.  Paragraph (p) of subsection (24) of section
5399	380.06, Florida Statutes, is amended to read:
5400	380.06  Developments of regional impact.-
5401	(24)  STATUTORY EXEMPTIONS.-
5402	(p)  Any proposed nursing home or assisted living residence
5403	facility is exempt from this section.
5404
5405	If a use is exempt from review as a development of regional
5406	impact under paragraphs (a)-(s), but will be part of a larger
5407	project that is subject to review as a development of regional
5408	impact, the impact of the exempt use must be included in the
5409	review of the larger project, unless such exempt use involves a
5410	development of regional impact that includes a landowner,
5411	tenant, or user that has entered into a funding agreement with
5412	the Office of Tourism, Trade, and Economic Development under the
5413	Innovation Incentive Program and the agreement contemplates a
5414	state award of at least $50 million.
5415	Section 84.  Subsection (16) of section 381.006, Florida
5416	Statutes, is amended to read:
5417	381.006  Environmental health.-The department shall conduct
5418	an environmental health program as part of fulfilling the
5419	state's public health mission. The purpose of this program is to
5420	detect and prevent disease caused by natural and manmade factors
5421	in the environment. The environmental health program shall
5422	include, but not be limited to:
5423	(16)  A group-care-facilities function. As used in this
5424	subsection, the term "group care facility" means any public or
5425	private school, assisted living residence facility, adult
5426	family-care home, adult day care center, short-term residential
5427	treatment center, residential treatment facility, home for
5428	special services, transitional living facility, crisis
5429	stabilization unit, hospice, prescribed pediatric extended care
5430	center, intermediate care facility for persons with
5431	developmental disabilities, or boarding school. The department
5432	may adopt rules necessary to protect the health and safety of
5433	residents, staff, and patrons of group care facilities. Rules
5434	related to public and private schools shall be developed by the
5435	Department of Education in consultation with the department.
5436	Rules adopted under this subsection may include definitions of
5437	terms; provisions relating to operation and maintenance of
5438	facilities, buildings, grounds, equipment, furnishings, and
5439	occupant-space requirements; lighting; heating, cooling, and
5440	ventilation; food service; water supply and plumbing; sewage;
5441	sanitary facilities; insect and rodent control; garbage; safety;
5442	personnel health, hygiene, and work practices; and other matters
5443	the department finds are appropriate or necessary to protect the
5444	safety and health of the residents, staff, students, faculty, or
5445	patrons. The department may not adopt rules that conflict with
5446	rules adopted by the licensing or certifying agency. The
5447	department may enter and inspect at reasonable hours to
5448	determine compliance with applicable statutes or rules. In
5449	addition to any sanctions that the department may impose for
5450	violations of rules adopted under this section, the department
5451	shall also report such violations to any agency responsible for
5452	licensing or certifying the group care facility. The licensing
5453	or certifying agency may also impose any sanction based solely
5454	on the findings of the department.
5455
5456	The department may adopt rules to carry out the provisions of
5457	this section.
5458	Section 85.  Paragraph (b) of subsection (1) of section
5459	381.0072, Florida Statutes, is amended to read:
5460	381.0072  Food service protection.-It shall be the duty of
5461	the Department of Health to adopt and enforce sanitation rules
5462	consistent with law to ensure the protection of the public from
5463	food-borne illness. These rules shall provide the standards and
5464	requirements for the storage, preparation, serving, or display
5465	of food in food service establishments as defined in this
5466	section and which are not permitted or licensed under chapter
5467	500 or chapter 509.
5468	(1)  DEFINITIONS.-As used in this section, the term:
5469	(b)  "Food service establishment" means detention
5470	facilities, public or private schools, migrant labor camps,
5471	assisted living residences facilities, adult family-care homes,
5472	adult day care centers, short-term residential treatment
5473	centers, residential treatment facilities, homes for special
5474	services, transitional living facilities, crisis stabilization
5475	units, hospices, prescribed pediatric extended care centers,
5476	intermediate care facilities for persons with developmental
5477	disabilities, boarding schools, civic or fraternal
5478	organizations, bars and lounges, vending machines that dispense
5479	potentially hazardous foods at facilities expressly named in
5480	this paragraph, and facilities used as temporary food events or
5481	mobile food units at any facility expressly named in this
5482	paragraph, where food is prepared and intended for individual
5483	portion service, including the site at which individual portions
5484	are provided, regardless of whether consumption is on or off the
5485	premises and regardless of whether there is a charge for the
5486	food. The term does not include any entity not expressly named
5487	in this paragraph; nor does the term include a domestic violence
5488	center certified and monitored by the Department of Children and
5489	Family Services under part XIII of chapter 39 if the center does
5490	not prepare and serve food to its residents and does not
5491	advertise food or drink for public consumption.
5492	Section 86.  Paragraph (a) of subsection (3) and paragraph
5493	(g) of subsection (6) of section 381.0303, Florida Statutes, are
5494	amended to read:
5495	381.0303  Special needs shelters.-
5496	(3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS AND
5497	FACILITIES.-
5498	(a)  The department shall, upon request, reimburse in
5499	accordance with paragraph (b):
5500	1.  Health care practitioners, as defined in s. 456.001,
5501	provided the practitioner is not providing care to a patient
5502	under an existing contract, and emergency medical technicians
5503	and paramedics licensed under chapter 401 for medical care
5504	provided at the request of the department in special needs
5505	shelters or at other locations during times of emergency or a
5506	declared disaster. Reimbursement for health care practitioners,
5507	except for physicians licensed under chapter 458 or chapter 459,
5508	shall be based on the average hourly rate that such
5509	practitioners were paid according to the most recent survey of
5510	Florida hospitals conducted by the Florida Hospital Association
5511	or other nationally recognized or state-recognized data source.
5512	2.  Health care facilities, such as hospitals, nursing
5513	homes, assisted living residences facilities, and community
5514	residential homes, if, upon closure of a special needs shelter,
5515	a multiagency special needs shelter discharge planning team
5516	determines that it is necessary to discharge persons with
5517	special needs to other health care facilities. The receiving
5518	facilities are eligible for reimbursement for services provided
5519	to the individuals for up to 90 days. A facility must show proof
5520	of a written request from a representative of an agency serving
5521	on the multiagency special needs shelter discharge planning team
5522	that the individual for whom the facility is seeking
5523	reimbursement for services rendered was referred to that
5524	facility from a special needs shelter. The department shall
5525	specify by rule which expenses are reimbursable and the rate of
5526	reimbursement for each service.
5527	(6)  RULES.-The department has the authority to adopt rules
5528	necessary to implement this section. Rules shall include:
5529	(g)  The requirement of the county health departments to
5530	seek the participation of hospitals, nursing homes, assisted
5531	living residences facilities, home health agencies, hospice
5532	providers, nurse registries, home medical equipment providers,
5533	dialysis centers, and other health and medical emergency
5534	preparedness stakeholders in pre-event planning activities.
5535	Section 87.  Subsection (17) of section 394.455, Florida
5536	Statutes, is amended to read:
5537	394.455  Definitions.-As used in this part, unless the
5538	context clearly requires otherwise, the term:
5539	(17)  "Mental health overlay program" means a mobile
5540	service which provides an independent examination for voluntary
5541	admissions and a range of supplemental onsite services to
5542	persons with a mental illness in a residential setting such as a
5543	nursing home, assisted living residence facility, adult family-
5544	care home, or nonresidential setting such as an adult day care
5545	center. Independent examinations provided pursuant to this part
5546	through a mental health overlay program must only be provided
5547	under contract with the department for this service or be
5548	attached to a public receiving facility that is also a community
5549	mental health center.
5550	Section 88.  Section 394.4574, Florida Statutes, is amended
5551	to read:
5552	394.4574  Department responsibilities for a mental health
5553	resident who resides in an assisted living residence facility
5554	that holds a limited mental health license.-
5555	(1)  The term "mental health resident," for purposes of
5556	this section, means an individual who receives social security
5557	disability income due to a mental disorder as determined by the
5558	Social Security Administration or receives supplemental security
5559	income due to a mental disorder as determined by the Social
5560	Security Administration and receives optional state
5561	supplementation.
5562	(2)  The department must ensure that:
5563	(a)  A mental health resident has been assessed by a
5564	psychiatrist, clinical psychologist, clinical social worker, or
5565	psychiatric nurse, or an individual who is supervised by one of
5566	these professionals, and determined to be appropriate to reside
5567	in an assisted living residence facility. The documentation must
5568	be provided to the administrator of the facility within 30 days
5569	after the mental health resident has been admitted to the
5570	facility. An evaluation completed upon discharge from a state
5571	mental hospital meets the requirements of this subsection
5572	related to appropriateness for placement as a mental health
5573	resident if it was completed within 90 days prior to admission
5574	to the facility.
5575	(b)  A cooperative agreement, as required in s. 429.075, is
5576	developed between the mental health care services provider that
5577	serves a mental health resident and the administrator of the
5578	assisted living residence facility with a limited mental health
5579	license in which the mental health resident is living. Any
5580	entity that provides Medicaid prepaid health plan services shall
5581	ensure the appropriate coordination of health care services with
5582	an assisted living residence facility in cases where a Medicaid
5583	recipient is both a member of the entity's prepaid health plan
5584	and a resident of the assisted living residence facility. If the
5585	entity is at risk for Medicaid targeted case management and
5586	behavioral health services, the entity shall inform the assisted
5587	living residence facility of the procedures to follow should an
5588	emergent condition arise.
5589	(c)  The community living support plan, as defined in s.
5590	429.02, has been prepared by a mental health resident and a
5591	mental health case manager of that resident in consultation with
5592	the administrator of the facility or the administrator's
5593	designee. The plan must be provided to the administrator of the
5594	assisted living residence facility with a limited mental health
5595	license in which the mental health resident lives. The support
5596	plan and the agreement may be in one document.
5597	(d)  The assisted living residence facility with a limited
5598	mental health license is provided with documentation that the
5599	individual meets the definition of a mental health resident.
5600	(e)  The mental health services provider assigns a case
5601	manager to each mental health resident who lives in an assisted
5602	living residence facility with a limited mental health license.
5603	The case manager is responsible for coordinating the development
5604	of and implementation of the community living support plan
5605	defined in s. 429.02. The plan must be updated at least
5606	annually.
5607	(3)  The Secretary of Children and Family Services, in
5608	consultation with the Agency for Health Care Administration,
5609	shall annually require each district administrator to develop,
5610	with community input, detailed plans that demonstrate how the
5611	district will ensure the provision of state-funded mental health
5612	and substance abuse treatment services to residents of assisted
5613	living residences facilities that hold a limited mental health
5614	license. These plans must be consistent with the substance abuse
5615	and mental health district plan developed pursuant to s. 394.75
5616	and must address case management services; access to consumer-
5617	operated drop-in centers; access to services during evenings,
5618	weekends, and holidays; supervision of the clinical needs of the
5619	residents; and access to emergency psychiatric care.
5620	Section 89.  Paragraph (l) of subsection (1) of section
5621	394.462, Florida Statutes, is amended to read:
5622	394.462  Transportation.-
5623	(1)  TRANSPORTATION TO A RECEIVING FACILITY.-
5624	(l)  When a jurisdiction has entered into a contract with
5625	an emergency medical transport service or a private transport
5626	company for transportation of persons to receiving facilities,
5627	such service or company shall be given preference for
5628	transportation of persons from nursing homes, assisted living
5629	residences facilities, adult day care centers, or adult family-
5630	care homes, unless the behavior of the person being transported
5631	is such that transportation by a law enforcement officer is
5632	necessary.
5633	Section 90.  Paragraph (b) of subsection (1) of section
5634	394.4625, Florida Statutes, is amended to read:
5635	394.4625  Voluntary admissions.-
5636	(1)  AUTHORITY TO RECEIVE PATIENTS.-
5637	(b)  A mental health overlay program or a mobile crisis
5638	response service or a licensed professional who is authorized to
5639	initiate an involuntary examination pursuant to s. 394.463 and
5640	is employed by a community mental health center or clinic must,
5641	pursuant to district procedure approved by the respective
5642	district administrator, conduct an initial assessment of the
5643	ability of the following persons to give express and informed
5644	consent to treatment before such persons may be admitted
5645	voluntarily:
5646	1.  A person 60 years of age or older for whom transfer is
5647	being sought from a nursing home, assisted living residence
5648	facility, adult day care center, or adult family-care home, when
5649	such person has been diagnosed as suffering from dementia.
5650	2.  A person 60 years of age or older for whom transfer is
5651	being sought from a nursing home pursuant to s. 400.0255(12).
5652	3.  A person for whom all decisions concerning medical
5653	treatment are currently being lawfully made by the health care
5654	surrogate or proxy designated under chapter 765.
5655	Section 91.  Subsection (5) of section 394.75, Florida
5656	Statutes, is amended to read:
5657	394.75  State and district substance abuse and mental
5658	health plans.-
5659	(5)  The district plan shall address how substance abuse
5660	and mental health services will be provided and how a system of
5661	care for target populations will be provided given the resources
5662	available in the service district. The plan must include
5663	provisions for maximizing client access to the most recently
5664	developed psychiatric medications approved by the United States
5665	Food and Drug Administration, for developing independent housing
5666	units through participation in the Section 811 program operated
5667	by the United States Department of Housing and Urban
5668	Development, for developing supported employment services
5669	through the Division of Vocational Rehabilitation of the
5670	Department of Education, for providing treatment services to
5671	persons with co-occurring mental illness and substance abuse
5672	problems which are integrated across treatment systems, and for
5673	providing services to adults who have a serious mental illness,
5674	as defined in s. 394.67, and who reside in assisted living
5675	residences facilities.
5676	Section 92.  Paragraph (l) of subsection (5) of section
5677	394.9082, Florida Statutes, is amended to read:
5678	394.9082  Behavioral health managing entities.-
5679	(5)  GOALS.-The goal of the service delivery strategies is
5680	to provide a design for an effective coordination, integration,
5681	and management approach for delivering effective behavioral
5682	health services to persons who are experiencing a mental health
5683	or substance abuse crisis, who have a disabling mental illness
5684	or a substance use or co-occurring disorder, and require
5685	extended services in order to recover from their illness, or who
5686	need brief treatment or longer-term supportive interventions to
5687	avoid a crisis or disability. Other goals include:
5688	(l)  Promoting specialized behavioral health services to
5689	residents of assisted living residences facilities.
5690	Section 93.  Subsection (5) of section 400.0060, Florida
5691	Statutes, is amended to read:
5692	400.0060  Definitions.-When used in this part, unless the
5693	context clearly dictates otherwise, the term:
5694	(5)  "Long-term care facility" means a nursing home
5695	facility, assisted living residence facility, adult family-care
5696	home, board and care facility, or any other similar residential
5697	adult care facility.
5698	Section 94.  Paragraph (a) of subsection (4) of section
5699	400.0069, Florida Statutes, is amended to read:
5700	400.0069  Local long-term care ombudsman councils; duties;
5701	membership.-
5702	(4)  Each local council shall be composed of members whose
5703	primary residence is located within the boundaries of the local
5704	council's jurisdiction.
5705	(a)  The ombudsman shall strive to ensure that each local
5706	council include the following persons as members:
5707	1.  At least one medical or osteopathic physician whose
5708	practice includes or has included a substantial number of
5709	geriatric patients and who may practice in a long-term care
5710	facility;
5711	2.  At least one registered nurse who has geriatric
5712	experience;
5713	3.  At least one licensed pharmacist;
5714	4.  At least one registered dietitian;
5715	5.  At least six nursing home residents or representative
5716	consumer advocates for nursing home residents;
5717	6.  At least three residents of assisted living residences
5718	facilities or adult family-care homes or three representative
5719	consumer advocates for alternative long-term care facility
5720	residents;
5721	7.  At least one attorney; and
5722	8.  At least one professional social worker.
5723	Section 95.  Subsection (1) and paragraph (a) of subsection
5724	(2) of section 400.0074, Florida Statutes, are amended to read:
5725	400.0074  Local ombudsman council onsite administrative
5726	assessments.-
5727	(1)  In addition to any specific investigation conducted
5728	pursuant to a complaint, the local council shall conduct, at
5729	least annually, an onsite administrative assessment of each
5730	nursing home, assisted living residence facility, and adult
5731	family-care home within its jurisdiction. This administrative
5732	assessment shall focus on factors affecting the rights, health,
5733	safety, and welfare of the residents. Each local council is
5734	encouraged to conduct a similar onsite administrative assessment
5735	of each additional long-term care facility within its
5736	jurisdiction.
5737	(2)  An onsite administrative assessment conducted by a
5738	local council shall be subject to the following conditions:
5739	(a)  To the extent possible and reasonable, the
5740	administrative assessments shall not duplicate the efforts of
5741	the agency surveys and inspections conducted under part II of
5742	this chapter and parts I, and II, and III of chapter 429.
5743	Section 96.  Subsection (1) of section 400.0239, Florida
5744	Statutes, is amended to read:
5745	400.0239  Quality of Long-Term Care Facility Improvement
5746	Trust Fund.-
5747	(1)  There is created within the Agency for Health Care
5748	Administration a Quality of Long-Term Care Facility Improvement
5749	Trust Fund to support activities and programs directly related
5750	to improvement of the care of nursing home and assisted living
5751	residence facility residents. The trust fund shall be funded
5752	through proceeds generated pursuant to ss. 400.0238 and 429.298,
5753	through funds specifically appropriated by the Legislature,
5754	through gifts, endowments, and other charitable contributions
5755	allowed under federal and state law, and through federal nursing
5756	home civil monetary penalties collected by the Centers for
5757	Medicare and Medicaid Services and returned to the state. These
5758	funds must be utilized in accordance with federal requirements.
5759	Section 97.  Subsections (1) and (5) of section 400.148,
5760	Florida Statutes, are amended to read:
5761	400.148  Medicaid "Up-or-Out" Quality of Care Contract
5762	Management Program.-
5763	(1)  The Legislature finds that the federal Medicare
5764	program has implemented successful models of managing the
5765	medical and supportive-care needs of long-term nursing home
5766	residents. These programs have maintained the highest
5767	practicable level of good health and have the potential to
5768	reduce the incidence of preventable illnesses among long-stay
5769	residents of nursing homes, thereby increasing the quality of
5770	care for residents and reducing the number of lawsuits against
5771	nursing homes. Such models are operated at no cost to the state.
5772	It is the intent of the Legislature that the Agency for Health
5773	Care Administration replicate such oversight for Medicaid
5774	recipients in poor-performing nursing homes and in assisted
5775	living residences facilities and nursing homes that are
5776	experiencing disproportionate numbers of lawsuits, with the goal
5777	of improving the quality of care in such homes or facilitating
5778	the revocation of licensure.
5779	(5)  The agency shall, jointly with the Statewide Public
5780	Guardianship Office, develop a system in the pilot project areas
5781	to identify Medicaid recipients who are residents of a
5782	participating nursing home or assisted living residence facility
5783	who have diminished ability to make their own decisions and who
5784	do not have relatives or family available to act as guardians in
5785	nursing homes listed on the Nursing Home Guide Watch List. The
5786	agency and the Statewide Public Guardianship Office shall give
5787	such residents priority for publicly funded guardianship
5788	services.
5789	Section 98.  Subsection (6) of section 400.1755, Florida
5790	Statutes, is amended to read:
5791	400.1755  Care for persons with Alzheimer's disease or
5792	related disorders.-
5793	(6)  Upon completing any training listed in this section,
5794	the employee or direct caregiver shall be issued a certificate
5795	that includes the name of the training provider, the topic
5796	covered, and the date and signature of the training provider.
5797	The certificate is evidence of completion of training in the
5798	identified topic, and the employee or direct caregiver is not
5799	required to repeat training in that topic if the employee or
5800	direct caregiver changes employment to a different facility or
5801	to an assisted living residence facility, home health agency,
5802	adult day care center, or adult family-care home. The direct
5803	caregiver must comply with other applicable continuing education
5804	requirements.
5805	Section 99.  Paragraph (h) of subsection (5) of section
5806	400.464, Florida Statutes, is amended to read:
5807	400.464  Home health agencies to be licensed; expiration of
5808	license; exemptions; unlawful acts; penalties.-
5809	(5)  The following are exempt from the licensure
5810	requirements of this part:
5811	(h)  The delivery of assisted living residence facility
5812	services for which the assisted living residence facility is
5813	licensed under part I of chapter 429, to serve its residents in
5814	its facility.
5815	Section 100.  Paragraphs (b), (k), and (l) of subsection
5816	(10) of section 400.471, Florida Statutes, are amended to read:
5817	400.471  Application for license; fee.-
5818	(10)  The agency may not issue a renewal license for a home
5819	health agency in any county having at least one licensed home
5820	health agency and that has more than one home health agency per
5821	5,000 persons, as indicated by the most recent population
5822	estimates published by the Legislature's Office of Economic and
5823	Demographic Research, if the applicant or any controlling
5824	interest has been administratively sanctioned by the agency
5825	during the 2 years prior to the submission of the licensure
5826	renewal application for one or more of the following acts:
5827	(b)  Knowingly providing home health services in an
5828	unlicensed assisted living residence facility or unlicensed
5829	adult family-care home, unless the home health agency or
5830	employee reports the unlicensed facility or home to the agency
5831	within 72 hours after providing the services;
5832	(k)  Providing services to residents in an assisted living
5833	residence facility for which the home health agency does not
5834	receive fair market value remuneration; or
5835	(l)  Providing staffing to an assisted living residence
5836	facility for which the home health agency does not receive fair
5837	market value remuneration.
5838	Section 101.  Paragraph (c) of subsection (2) and
5839	paragraphs (b), (c), and (d) of subsection (6) of section
5840	400.474, Florida Statutes, are amended to read:
5841	400.474  Administrative penalties.-
5842	(2)  Any of the following actions by a home health agency
5843	or its employee is grounds for disciplinary action by the
5844	agency:
5845	(c)  Knowingly providing home health services in an
5846	unlicensed assisted living residence facility or unlicensed
5847	adult family-care home, unless the home health agency or
5848	employee reports the unlicensed facility or home to the agency
5849	within 72 hours after providing the services.
5850	(6)  The agency may deny, revoke, or suspend the license of
5851	a home health agency and shall impose a fine of $5,000 against a
5852	home health agency that:
5853	(b)  Provides services to residents in an assisted living
5854	residence facility for which the home health agency does not
5855	receive fair market value remuneration.
5856	(c)  Provides staffing to an assisted living residence
5857	facility for which the home health agency does not receive fair
5858	market value remuneration.
5859	(d)  Fails to provide the agency, upon request, with copies
5860	of all contracts with assisted living residences facilities
5861	which were executed within 5 years before the request.
5862
5863	Nothing in paragraph (e) or paragraph (j) shall be interpreted
5864	as applying to or precluding any discount, compensation, waiver
5865	of payment, or payment practice permitted by 42 U.S.C. s. 1320a-
5866	7(b) or regulations adopted thereunder, including 42 C.F.R. s.
5867	1001.952 or s. 1395nn or regulations adopted thereunder.
5868	Section 102.  Paragraph (e) of subsection (10) of section
5869	400.497, Florida Statutes, is amended to read:
5870	400.497  Rules establishing minimum standards.-The agency
5871	shall adopt, publish, and enforce rules to implement part II of
5872	chapter 408 and this part, including, as applicable, ss. 400.506
5873	and 400.509, which must provide reasonable and fair minimum
5874	standards relating to:
5875	(10)  Preparation of a comprehensive emergency management
5876	plan pursuant to s. 400.492.
5877	(e)  The requirements in this subsection do not apply to:
5878	1.  A facility that is certified under chapter 651 and has
5879	a licensed home health agency used exclusively by residents of
5880	the facility; or
5881	2.  A retirement community that consists of residential
5882	units for independent living and either a licensed nursing home
5883	or an assisted living residence facility, and has a licensed
5884	home health agency used exclusively by the residents of the
5885	retirement community, provided the comprehensive emergency
5886	management plan for the facility or retirement community
5887	provides for continuous care of all residents with special needs
5888	during an emergency.
5889	Section 103.  Paragraph (a) of subsection (15) of section
5890	400.506, Florida Statutes, is amended to read:
5891	400.506  Licensure of nurse registries; requirements;
5892	penalties.-
5893	(15)(a)  The agency may deny, suspend, or revoke the
5894	license of a nurse registry and shall impose a fine of $5,000
5895	against a nurse registry that:
5896	1.  Provides services to residents in an assisted living
5897	residence facility for which the nurse registry does not receive
5898	fair market value remuneration.
5899	2.  Provides staffing to an assisted living residence
5900	facility for which the nurse registry does not receive fair
5901	market value remuneration.
5902	3.  Fails to provide the agency, upon request, with copies
5903	of all contracts with assisted living residences facilities
5904	which were executed within the last 5 years.
5905	4.  Gives remuneration to a case manager, discharge
5906	planner, facility-based staff member, or third-party vendor who
5907	is involved in the discharge planning process of a facility
5908	licensed under chapter 395 or this chapter and from whom the
5909	nurse registry receives referrals. A nurse registry is exempt
5910	from this subparagraph if it does not bill the Florida Medicaid
5911	program or the Medicare program or share a controlling interest
5912	with any entity licensed, registered, or certified under part II
5913	of chapter 408 that bills the Florida Medicaid program or the
5914	Medicare program.
5915	5.  Gives remuneration to a physician, a member of the
5916	physician's office staff, or an immediate family member of the
5917	physician, and the nurse registry received a patient referral in
5918	the last 12 months from that physician or the physician's office
5919	staff. A nurse registry is exempt from this subparagraph if it
5920	does not bill the Florida Medicaid program or the Medicare
5921	program or share a controlling interest with any entity
5922	licensed, registered, or certified under part II of chapter 408
5923	that bills the Florida Medicaid program or the Medicare program.
5924	Section 104.  Paragraph (h) of subsection (1) of section
5925	400.6045, Florida Statutes, is amended to read:
5926	400.6045  Patients with Alzheimer's disease or other
5927	related disorders; staff training requirements; certain
5928	disclosures.-
5929	(1)  A hospice licensed under this part must provide the
5930	following staff training:
5931	(h)  Upon completing any training described in this
5932	section, the employee or direct caregiver shall be issued a
5933	certificate that includes the name of the training provider, the
5934	topic covered, and the date and signature of the training
5935	provider. The certificate is evidence of completion of training
5936	in the identified topic, and the employee or direct caregiver is
5937	not required to repeat training in that topic if the employee or
5938	direct caregiver changes employment to a different hospice or to
5939	a home health agency, assisted living residence facility,
5940	nursing home, or adult day care center.
5941	Section 105.  Paragraph (g) of subsection (1) of section
5942	400.605, Florida Statutes, is amended to read:
5943	400.605  Administration; forms; fees; rules; inspections;
5944	fines.-
5945	(1)  The agency, in consultation with the department, may
5946	adopt rules to administer the requirements of part II of chapter
5947	408. The department, in consultation with the agency, shall by
5948	rule establish minimum standards and procedures for a hospice
5949	pursuant to this part. The rules must include:
5950	(g)  Standards for hospice care provided in freestanding
5951	inpatient facilities that are not otherwise licensed medical
5952	facilities and in residential care facilities such as nursing
5953	homes, assisted living residences facilities, adult family-care
5954	homes, and hospice residential units and facilities.
5955	Section 106.  Subsection (3) of section 400.609, Florida
5956	Statutes, is amended to read:
5957	400.609  Hospice services.-Each hospice shall provide a
5958	continuum of hospice services which afford the patient and the
5959	family of the patient a range of service delivery which can be
5960	tailored to specific needs and preferences of the patient and
5961	family at any point in time throughout the length of care for
5962	the terminally ill patient and during the bereavement period.
5963	These services must be available 24 hours a day, 7 days a week,
5964	and must include:
5965	(3)  HOSPICE RESIDENTIAL CARE.-Hospice care and services,
5966	to the extent practicable and compatible with the needs and
5967	preferences of the patient, may be provided by the hospice care
5968	team to a patient living in an assisted living residence
5969	facility, adult family-care home, nursing home, hospice
5970	residential unit or facility, or other nondomestic place of
5971	permanent or temporary residence. A resident or patient living
5972	in an assisted living residence facility, adult family-care
5973	home, nursing home, or other facility subject to state licensing
5974	who has been admitted to a hospice program shall be considered a
5975	hospice patient, and the hospice program shall be responsible
5976	for coordinating and ensuring the delivery of hospice care and
5977	services to such person pursuant to the standards and
5978	requirements of this part and rules adopted under this part.
5979	Section 107.  Section 400.701, Florida Statutes, is amended
5980	to read:
5981	400.701  Intermediate care facilities; intent.-The
5982	Legislature recognizes the need to develop a continuum of long-
5983	term care in this state to meet the needs of the elderly and
5984	disabled persons. The Legislature finds that there is a gap
5985	between the level of care provided in assisted living residences
5986	facilities and in nursing homes. The Legislature finds that
5987	exploration of intermediate-level care facilities which would
5988	fill the gap between assisted living residences facilities and
5989	nursing homes, where both the federal and state government share
5990	the cost of providing care, is an appropriate option to explore
5991	in the continuum of care.
5992	Section 108.  Subsection (13) of section 400.925, Florida
5993	Statutes, is amended to read:
5994	400.925  Definitions.-As used in this part, the term:
5995	(13)  "Residence" means the consumer's home or place of
5996	residence, which may include nursing homes, assisted living
5997	residences facilities, transitional living facilities, adult
5998	family-care homes, or other congregate residential facilities.
5999	Section 109.  Paragraph (c) of subsection (5) of section
6000	400.93, Florida Statutes, is amended to read:
6001	400.93  Licensure required; exemptions; unlawful acts;
6002	penalties.-
6003	(5)  The following are exempt from home medical equipment
6004	provider licensure, unless they have a separate company,
6005	corporation, or division that is in the business of providing
6006	home medical equipment and services for sale or rent to
6007	consumers at their regular or temporary place of residence
6008	pursuant to the provisions of this part:
6009	(c)  Assisted living residences facilities licensed under
6010	chapter 429, when serving their residents.
6011	Section 110.  Section 405.01, Florida Statutes, is amended
6012	to read:
6013	405.01  Release of medical information to certain study
6014	groups; exemption from liability.-Any person, hospital, assisted
6015	living residence facility, hospice, sanatorium, nursing or rest
6016	home or other organization may provide information, interviews,
6017	reports, statements, memoranda, or other data relating to the
6018	condition and treatment of any person to research groups,
6019	governmental health agencies, medical associations and
6020	societies, and in-hospital medical staff committees, to be used
6021	in the course of any study for the purpose of reducing morbidity
6022	or mortality. No liability of any kind or character for damages
6023	or other relief shall arise or be enforced against any person or
6024	organization by reason of having provided such information or
6025	material, or by reason of having released or published the
6026	findings and conclusions of such groups to advance medical
6027	research and medical education, or by reason of having released
6028	or published generally a summary of such studies.
6029	Section 111.  Paragraphs (a), (b), and (c) of subsection
6030	(2) of section 408.033, Florida Statutes, are amended to read:
6031	408.033  Local and state health planning.-
6032	(2)  FUNDING.-
6033	(a)  The Legislature intends that the cost of local health
6034	councils be borne by assessments on selected health care
6035	facilities subject to facility licensure by the Agency for
6036	Health Care Administration, including abortion clinics, assisted
6037	living residences facilities, ambulatory surgical centers,
6038	birthing centers, clinical laboratories except community
6039	nonprofit blood banks and clinical laboratories operated by
6040	practitioners for exclusive use regulated under s. 483.035, home
6041	health agencies, hospices, hospitals, intermediate care
6042	facilities for the developmentally disabled, nursing homes,
6043	health care clinics, and multiphasic testing centers and by
6044	assessments on organizations subject to certification by the
6045	agency pursuant to chapter 641, part III, including health
6046	maintenance organizations and prepaid health clinics.
6047	(b)1.  A hospital licensed under chapter 395, a nursing
6048	home licensed under chapter 400, and an assisted living
6049	residence facility licensed under chapter 429 shall be assessed
6050	an annual fee based on number of beds.
6051	2.  All other facilities and organizations listed in
6052	paragraph (a) shall each be assessed an annual fee of $150.
6053	3.  Facilities operated by the Department of Children and
6054	Family Services, the Department of Health, or the Department of
6055	Corrections and any hospital which meets the definition of rural
6056	hospital pursuant to s. 395.602 are exempt from the assessment
6057	required in this subsection.
6058	(c)1.  The agency shall, by rule, establish fees for
6059	hospitals and nursing homes based on an assessment of $2 per
6060	bed. However, no such facility shall be assessed more than a
6061	total of $500 under this subsection.
6062	2.  The agency shall, by rule, establish fees for assisted
6063	living residences facilities based on an assessment of $1 per
6064	bed. However, no such facility shall be assessed more than a
6065	total of $150 under this subsection.
6066	3.  The agency shall, by rule, establish an annual fee of
6067	$150 for all other facilities and organizations listed in
6068	paragraph (a).
6069	Section 112.  Paragraph (a) of subsection (1), subsection
6070	(3), and paragraph (a) of subsection (4) of section 409.212,
6071	Florida Statutes, are amended to read:
6072	409.212  Optional supplementation.-
6073	(1)  There may be monthly optional supplementation
6074	payments, made in such amount as determined by the department,
6075	to any person who:
6076	(a)  Meets all the program eligibility criteria for an
6077	assisted living residence facility or for adult foster care,
6078	family placement, or other specialized living arrangement; and
6079	(3)  Assisted living residences facilities, adult family-
6080	care homes, family placement, or any other specialized living
6081	arrangement accepting residents who receive optional
6082	supplementation payments must comply with the requirements of 42
6083	U.S.C. s. 1382e(e).
6084	(4)  In addition to the amount of optional supplementation
6085	provided by the state, a person may receive additional
6086	supplementation from third parties to contribute to his or her
6087	cost of care. Additional supplementation may be provided under
6088	the following conditions:
6089	(a)  Payments shall be made to the assisted living
6090	residence facility, or to the operator of an adult family-care
6091	home, family placement, or other special living arrangement, on
6092	behalf of the person and not directly to the optional state
6093	supplementation recipient.
6094	Section 113.  Paragraph (e) of subsection (4) of section
6095	409.221, Florida Statutes, is amended to read:
6096	409.221  Consumer-directed care program.-
6097	(4)  CONSUMER-DIRECTED CARE.-
6098	(e)  Services.-Consumers shall use the budget allowance
6099	only to pay for home and community-based services that meet the
6100	consumer's long-term care needs and are a cost-efficient use of
6101	funds. Such services may include, but are not limited to, the
6102	following:
6103	1.  Personal care.
6104	2.  Homemaking and chores, including housework, meals,
6105	shopping, and transportation.
6106	3.  Home modifications and assistive devices which may
6107	increase the consumer's independence or make it possible to
6108	avoid institutional placement.
6109	4.  Assistance in taking self-administered medication.
6110	5.  Day care and respite care services, including those
6111	provided by nursing home facilities pursuant to s. 400.141(1)(f)
6112	or by adult day care facilities licensed pursuant to s. 429.907.
6113	6.  Personal care and support services provided in an
6114	assisted living residence facility.
6115	Section 114.  Subsection (25) of section 409.906, Florida
6116	Statutes, is amended to read:
6117	409.906  Optional Medicaid services.-Subject to specific
6118	appropriations, the agency may make payments for services which
6119	are optional to the state under Title XIX of the Social Security
6120	Act and are furnished by Medicaid providers to recipients who
6121	are determined to be eligible on the dates on which the services
6122	were provided. Any optional service that is provided shall be
6123	provided only when medically necessary and in accordance with
6124	state and federal law. Optional services rendered by providers
6125	in mobile units to Medicaid recipients may be restricted or
6126	prohibited by the agency. Nothing in this section shall be
6127	construed to prevent or limit the agency from adjusting fees,
6128	reimbursement rates, lengths of stay, number of visits, or
6129	number of services, or making any other adjustments necessary to
6130	comply with the availability of moneys and any limitations or
6131	directions provided for in the General Appropriations Act or
6132	chapter 216. If necessary to safeguard the state's systems of
6133	providing services to elderly and disabled persons and subject
6134	to the notice and review provisions of s. 216.177, the Governor
6135	may direct the Agency for Health Care Administration to amend
6136	the Medicaid state plan to delete the optional Medicaid service
6137	known as "Intermediate Care Facilities for the Developmentally
6138	Disabled." Optional services may include:
6139	(25)  ASSISTIVE-CARE SERVICES.-The agency may pay for
6140	assistive-care services provided to recipients with functional
6141	or cognitive impairments residing in assisted living residences
6142	facilities, adult family-care homes, or residential treatment
6143	facilities. These services may include health support,
6144	assistance with the activities of daily living and the
6145	instrumental acts of daily living, assistance with medication
6146	administration, and arrangements for health care.
6147	Section 115.  Subsection (7) and paragraph (a) of
6148	subsection (8) of section 409.907, Florida Statutes, are amended
6149	to read:
6150	409.907  Medicaid provider agreements.-The agency may make
6151	payments for medical assistance and related services rendered to
6152	Medicaid recipients only to an individual or entity who has a
6153	provider agreement in effect with the agency, who is performing
6154	services or supplying goods in accordance with federal, state,
6155	and local law, and who agrees that no person shall, on the
6156	grounds of handicap, race, color, or national origin, or for any
6157	other reason, be subjected to discrimination under any program
6158	or activity for which the provider receives payment from the
6159	agency.
6160	(7)  The agency may require, as a condition of
6161	participating in the Medicaid program and before entering into
6162	the provider agreement, that the provider submit information, in
6163	an initial and any required renewal applications, concerning the
6164	professional, business, and personal background of the provider
6165	and permit an onsite inspection of the provider's service
6166	location by agency staff or other personnel designated by the
6167	agency to perform this function. The agency shall perform a
6168	random onsite inspection, within 60 days after receipt of a
6169	fully complete new provider's application, of the provider's
6170	service location prior to making its first payment to the
6171	provider for Medicaid services to determine the applicant's
6172	ability to provide the services that the applicant is proposing
6173	to provide for Medicaid reimbursement. The agency is not
6174	required to perform an onsite inspection of a provider or
6175	program that is licensed by the agency, that provides services
6176	under waiver programs for home and community-based services, or
6177	that is licensed as a medical foster home by the Department of
6178	Children and Family Services. As a continuing condition of
6179	participation in the Medicaid program, a provider shall
6180	immediately notify the agency of any current or pending
6181	bankruptcy filing. Before entering into the provider agreement,
6182	or as a condition of continuing participation in the Medicaid
6183	program, the agency may also require that Medicaid providers
6184	reimbursed on a fee-for-services basis or fee schedule basis
6185	which is not cost-based, post a surety bond not to exceed
6186	$50,000 or the total amount billed by the provider to the
6187	program during the current or most recent calendar year,
6188	whichever is greater. For new providers, the amount of the
6189	surety bond shall be determined by the agency based on the
6190	provider's estimate of its first year's billing. If the
6191	provider's billing during the first year exceeds the bond
6192	amount, the agency may require the provider to acquire an
6193	additional bond equal to the actual billing level of the
6194	provider. A provider's bond shall not exceed $50,000 if a
6195	physician or group of physicians licensed under chapter 458,
6196	chapter 459, or chapter 460 has a 50 percent or greater
6197	ownership interest in the provider or if the provider is an
6198	assisted living residence facility licensed under chapter 429.
6199	The bonds permitted by this section are in addition to the bonds
6200	referenced in s. 400.179(2)(d). If the provider is a
6201	corporation, partnership, association, or other entity, the
6202	agency may require the provider to submit information concerning
6203	the background of that entity and of any principal of the
6204	entity, including any partner or shareholder having an ownership
6205	interest in the entity equal to 5 percent or greater, and any
6206	treating provider who participates in or intends to participate
6207	in Medicaid through the entity. The information must include:
6208	(a)  Proof of holding a valid license or operating
6209	certificate, as applicable, if required by the state or local
6210	jurisdiction in which the provider is located or if required by
6211	the Federal Government.
6212	(b)  Information concerning any prior violation, fine,
6213	suspension, termination, or other administrative action taken
6214	under the Medicaid laws, rules, or regulations of this state or
6215	of any other state or the Federal Government; any prior
6216	violation of the laws, rules, or regulations relating to the
6217	Medicare program; any prior violation of the rules or
6218	regulations of any other public or private insurer; and any
6219	prior violation of the laws, rules, or regulations of any
6220	regulatory body of this or any other state.
6221	(c)  Full and accurate disclosure of any financial or
6222	ownership interest that the provider, or any principal, partner,
6223	or major shareholder thereof, may hold in any other Medicaid
6224	provider or health care related entity or any other entity that
6225	is licensed by the state to provide health or residential care
6226	and treatment to persons.
6227	(d)  If a group provider, identification of all members of
6228	the group and attestation that all members of the group are
6229	enrolled in or have applied to enroll in the Medicaid program.
6230	(8)(a)  Each provider, or each principal of the provider if
6231	the provider is a corporation, partnership, association, or
6232	other entity, seeking to participate in the Medicaid program
6233	must submit a complete set of his or her fingerprints to the
6234	agency for the purpose of conducting a criminal history record
6235	check. Principals of the provider include any officer, director,
6236	billing agent, managing employee, or affiliated person, or any
6237	partner or shareholder who has an ownership interest equal to 5
6238	percent or more in the provider. However, a director of a not-
6239	for-profit corporation or organization is not a principal for
6240	purposes of a background investigation as required by this
6241	section if the director: serves solely in a voluntary capacity
6242	for the corporation or organization, does not regularly take
6243	part in the day-to-day operational decisions of the corporation
6244	or organization, receives no remuneration from the not-for-
6245	profit corporation or organization for his or her service on the
6246	board of directors, has no financial interest in the not-for-
6247	profit corporation or organization, and has no family members
6248	with a financial interest in the not-for-profit corporation or
6249	organization; and if the director submits an affidavit, under
6250	penalty of perjury, to this effect to the agency and the not-
6251	for-profit corporation or organization submits an affidavit,
6252	under penalty of perjury, to this effect to the agency as part
6253	of the corporation's or organization's Medicaid provider
6254	agreement application. Notwithstanding the above, the agency may
6255	require a background check for any person reasonably suspected
6256	by the agency to have been convicted of a crime. This subsection
6257	does not apply to:
6258	1.  A hospital licensed under chapter 395;
6259	2.  A nursing home licensed under chapter 400;
6260	3.  A hospice licensed under chapter 400;
6261	4.  An assisted living residence facility licensed under
6262	chapter 429;
6263	5.  A unit of local government, except that requirements of
6264	this subsection apply to nongovernmental providers and entities
6265	contracting with the local government to provide Medicaid
6266	services. The actual cost of the state and national criminal
6267	history record checks must be borne by the nongovernmental
6268	provider or entity; or
6269	6.  Any business that derives more than 50 percent of its
6270	revenue from the sale of goods to the final consumer, and the
6271	business or its controlling parent is required to file a form
6272	10-K or other similar statement with the Securities and Exchange
6273	Commission or has a net worth of $50 million or more.
6274	Section 116.  Paragraph (b) of subsection (4) and
6275	subsection (36) of section 409.912, Florida Statutes, are
6276	amended to read:
6277	409.912  Cost-effective purchasing of health care.-The
6278	agency shall purchase goods and services for Medicaid recipients
6279	in the most cost-effective manner consistent with the delivery
6280	of quality medical care. To ensure that medical services are
6281	effectively utilized, the agency may, in any case, require a
6282	confirmation or second physician's opinion of the correct
6283	diagnosis for purposes of authorizing future services under the
6284	Medicaid program. This section does not restrict access to
6285	emergency services or poststabilization care services as defined
6286	in 42 C.F.R. part 438.114. Such confirmation or second opinion
6287	shall be rendered in a manner approved by the agency. The agency
6288	shall maximize the use of prepaid per capita and prepaid
6289	aggregate fixed-sum basis services when appropriate and other
6290	alternative service delivery and reimbursement methodologies,
6291	including competitive bidding pursuant to s. 287.057, designed
6292	to facilitate the cost-effective purchase of a case-managed
6293	continuum of care. The agency shall also require providers to
6294	minimize the exposure of recipients to the need for acute
6295	inpatient, custodial, and other institutional care and the
6296	inappropriate or unnecessary use of high-cost services. The
6297	agency shall contract with a vendor to monitor and evaluate the
6298	clinical practice patterns of providers in order to identify
6299	trends that are outside the normal practice patterns of a
6300	provider's professional peers or the national guidelines of a
6301	provider's professional association. The vendor must be able to
6302	provide information and counseling to a provider whose practice
6303	patterns are outside the norms, in consultation with the agency,
6304	to improve patient care and reduce inappropriate utilization.
6305	The agency may mandate prior authorization, drug therapy
6306	management, or disease management participation for certain
6307	populations of Medicaid beneficiaries, certain drug classes, or
6308	particular drugs to prevent fraud, abuse, overuse, and possible
6309	dangerous drug interactions. The Pharmaceutical and Therapeutics
6310	Committee shall make recommendations to the agency on drugs for
6311	which prior authorization is required. The agency shall inform
6312	the Pharmaceutical and Therapeutics Committee of its decisions
6313	regarding drugs subject to prior authorization. The agency is
6314	authorized to limit the entities it contracts with or enrolls as
6315	Medicaid providers by developing a provider network through
6316	provider credentialing. The agency may competitively bid single-
6317	source-provider contracts if procurement of goods or services
6318	results in demonstrated cost savings to the state without
6319	limiting access to care. The agency may limit its network based
6320	on the assessment of beneficiary access to care, provider
6321	availability, provider quality standards, time and distance
6322	standards for access to care, the cultural competence of the
6323	provider network, demographic characteristics of Medicaid
6324	beneficiaries, practice and provider-to-beneficiary standards,
6325	appointment wait times, beneficiary use of services, provider
6326	turnover, provider profiling, provider licensure history,
6327	previous program integrity investigations and findings, peer
6328	review, provider Medicaid policy and billing compliance records,
6329	clinical and medical record audits, and other factors. Providers
6330	shall not be entitled to enrollment in the Medicaid provider
6331	network. The agency shall determine instances in which allowing
6332	Medicaid beneficiaries to purchase durable medical equipment and
6333	other goods is less expensive to the Medicaid program than long-
6334	term rental of the equipment or goods. The agency may establish
6335	rules to facilitate purchases in lieu of long-term rentals in
6336	order to protect against fraud and abuse in the Medicaid program
6337	as defined in s. 409.913. The agency may seek federal waivers
6338	necessary to administer these policies.
6339	(4)  The agency may contract with:
6340	(b)  An entity that is providing comprehensive behavioral
6341	health care services to certain Medicaid recipients through a
6342	capitated, prepaid arrangement pursuant to the federal waiver
6343	provided for by s. 409.905(5). Such entity must be licensed
6344	under chapter 624, chapter 636, or chapter 641, or authorized
6345	under paragraph (c) or paragraph (d), and must possess the
6346	clinical systems and operational competence to manage risk and
6347	provide comprehensive behavioral health care to Medicaid
6348	recipients. As used in this paragraph, the term "comprehensive
6349	behavioral health care services" means covered mental health and
6350	substance abuse treatment services that are available to
6351	Medicaid recipients. The secretary of the Department of Children
6352	and Family Services shall approve provisions of procurements
6353	related to children in the department's care or custody before
6354	enrolling such children in a prepaid behavioral health plan. Any
6355	contract awarded under this paragraph must be competitively
6356	procured. In developing the behavioral health care prepaid plan
6357	procurement document, the agency shall ensure that the
6358	procurement document requires the contractor to develop and
6359	implement a plan to ensure compliance with s. 394.4574 related
6360	to services provided to residents of licensed assisted living
6361	residences facilities that hold a limited mental health license.
6362	Except as provided in subparagraph 8., and except in counties
6363	where the Medicaid managed care pilot program is authorized
6364	pursuant to s. 409.91211, the agency shall seek federal approval
6365	to contract with a single entity meeting these requirements to
6366	provide comprehensive behavioral health care services to all
6367	Medicaid recipients not enrolled in a Medicaid managed care plan
6368	authorized under s. 409.91211, a provider service network
6369	authorized under paragraph (d), or a Medicaid health maintenance
6370	organization in an AHCA area. In an AHCA area where the Medicaid
6371	managed care pilot program is authorized pursuant to s.
6372	409.91211 in one or more counties, the agency may procure a
6373	contract with a single entity to serve the remaining counties as
6374	an AHCA area or the remaining counties may be included with an
6375	adjacent AHCA area and are subject to this paragraph. Each
6376	entity must offer a sufficient choice of providers in its
6377	network to ensure recipient access to care and the opportunity
6378	to select a provider with whom they are satisfied. The network
6379	shall include all public mental health hospitals. To ensure
6380	unimpaired access to behavioral health care services by Medicaid
6381	recipients, all contracts issued pursuant to this paragraph must
6382	require 80 percent of the capitation paid to the managed care
6383	plan, including health maintenance organizations and capitated
6384	provider service networks, to be expended for the provision of
6385	behavioral health care services. If the managed care plan
6386	expends less than 80 percent of the capitation paid for the
6387	provision of behavioral health care services, the difference
6388	shall be returned to the agency. The agency shall provide the
6389	plan with a certification letter indicating the amount of
6390	capitation paid during each calendar year for behavioral health
6391	care services pursuant to this section. The agency may reimburse
6392	for substance abuse treatment services on a fee-for-service
6393	basis until the agency finds that adequate funds are available
6394	for capitated, prepaid arrangements.
6395	1.  By January 1, 2001, the agency shall modify the
6396	contracts with the entities providing comprehensive inpatient
6397	and outpatient mental health care services to Medicaid
6398	recipients in Hillsborough, Highlands, Hardee, Manatee, and Polk
6399	Counties, to include substance abuse treatment services.
6400	2.  By July 1, 2003, the agency and the Department of
6401	Children and Family Services shall execute a written agreement
6402	that requires collaboration and joint development of all policy,
6403	budgets, procurement documents, contracts, and monitoring plans
6404	that have an impact on the state and Medicaid community mental
6405	health and targeted case management programs.
6406	3.  Except as provided in subparagraph 8., by July 1, 2006,
6407	the agency and the Department of Children and Family Services
6408	shall contract with managed care entities in each AHCA area
6409	except area 6 or arrange to provide comprehensive inpatient and
6410	outpatient mental health and substance abuse services through
6411	capitated prepaid arrangements to all Medicaid recipients who
6412	are eligible to participate in such plans under federal law and
6413	regulation. In AHCA areas where eligible individuals number less
6414	than 150,000, the agency shall contract with a single managed
6415	care plan to provide comprehensive behavioral health services to
6416	all recipients who are not enrolled in a Medicaid health
6417	maintenance organization, a provider service network authorized
6418	under paragraph (d), or a Medicaid capitated managed care plan
6419	authorized under s. 409.91211. The agency may contract with more
6420	than one comprehensive behavioral health provider to provide
6421	care to recipients who are not enrolled in a Medicaid capitated
6422	managed care plan authorized under s. 409.91211, a provider
6423	service network authorized under paragraph (d), or a Medicaid
6424	health maintenance organization in AHCA areas where the eligible
6425	population exceeds 150,000. In an AHCA area where the Medicaid
6426	managed care pilot program is authorized pursuant to s.
6427	409.91211 in one or more counties, the agency may procure a
6428	contract with a single entity to serve the remaining counties as
6429	an AHCA area or the remaining counties may be included with an
6430	adjacent AHCA area and shall be subject to this paragraph.
6431	Contracts for comprehensive behavioral health providers awarded
6432	pursuant to this section shall be competitively procured. Both
6433	for-profit and not-for-profit corporations are eligible to
6434	compete. Managed care plans contracting with the agency under
6435	subsection (3) or paragraph (d), shall provide and receive
6436	payment for the same comprehensive behavioral health benefits as
6437	provided in AHCA rules, including handbooks incorporated by
6438	reference. In AHCA area 11, the agency shall contract with at
6439	least two comprehensive behavioral health care providers to
6440	provide behavioral health care to recipients in that area who
6441	are enrolled in, or assigned to, the MediPass program. One of
6442	the behavioral health care contracts must be with the existing
6443	provider service network pilot project, as described in
6444	paragraph (d), for the purpose of demonstrating the cost-
6445	effectiveness of the provision of quality mental health services
6446	through a public hospital-operated managed care model. Payment
6447	shall be at an agreed-upon capitated rate to ensure cost
6448	savings. Of the recipients in area 11 who are assigned to
6449	MediPass under s. 409.9122(2)(k), a minimum of 50,000 of those
6450	MediPass-enrolled recipients shall be assigned to the existing
6451	provider service network in area 11 for their behavioral care.
6452	4.  By October 1, 2003, the agency and the department shall
6453	submit a plan to the Governor, the President of the Senate, and
6454	the Speaker of the House of Representatives which provides for
6455	the full implementation of capitated prepaid behavioral health
6456	care in all areas of the state.
6457	a.  Implementation shall begin in 2003 in those AHCA areas
6458	of the state where the agency is able to establish sufficient
6459	capitation rates.
6460	b.  If the agency determines that the proposed capitation
6461	rate in any area is insufficient to provide appropriate
6462	services, the agency may adjust the capitation rate to ensure
6463	that care will be available. The agency and the department may
6464	use existing general revenue to address any additional required
6465	match but may not over-obligate existing funds on an annualized
6466	basis.
6467	c.  Subject to any limitations provided in the General
6468	Appropriations Act, the agency, in compliance with appropriate
6469	federal authorization, shall develop policies and procedures
6470	that allow for certification of local and state funds.
6471	5.  Children residing in a statewide inpatient psychiatric
6472	program, or in a Department of Juvenile Justice or a Department
6473	of Children and Family Services residential program approved as
6474	a Medicaid behavioral health overlay services provider may not
6475	be included in a behavioral health care prepaid health plan or
6476	any other Medicaid managed care plan pursuant to this paragraph.
6477	6.  In converting to a prepaid system of delivery, the
6478	agency shall in its procurement document require an entity
6479	providing only comprehensive behavioral health care services to
6480	prevent the displacement of indigent care patients by enrollees
6481	in the Medicaid prepaid health plan providing behavioral health
6482	care services from facilities receiving state funding to provide
6483	indigent behavioral health care, to facilities licensed under
6484	chapter 395 which do not receive state funding for indigent
6485	behavioral health care, or reimburse the unsubsidized facility
6486	for the cost of behavioral health care provided to the displaced
6487	indigent care patient.
6488	7.  Traditional community mental health providers under
6489	contract with the Department of Children and Family Services
6490	pursuant to part IV of chapter 394, child welfare providers
6491	under contract with the Department of Children and Family
6492	Services in areas 1 and 6, and inpatient mental health providers
6493	licensed pursuant to chapter 395 must be offered an opportunity
6494	to accept or decline a contract to participate in any provider
6495	network for prepaid behavioral health services.
6496	8.  All Medicaid-eligible children, except children in area
6497	1 and children in Highlands County, Hardee County, Polk County,
6498	or Manatee County of area 6, that are open for child welfare
6499	services in the HomeSafeNet system, shall receive their
6500	behavioral health care services through a specialty prepaid plan
6501	operated by community-based lead agencies through a single
6502	agency or formal agreements among several agencies. The
6503	specialty prepaid plan must result in savings to the state
6504	comparable to savings achieved in other Medicaid managed care
6505	and prepaid programs. Such plan must provide mechanisms to
6506	maximize state and local revenues. The specialty prepaid plan
6507	shall be developed by the agency and the Department of Children
6508	and Family Services. The agency may seek federal waivers to
6509	implement this initiative. Medicaid-eligible children whose
6510	cases are open for child welfare services in the HomeSafeNet
6511	system and who reside in AHCA area 10 are exempt from the
6512	specialty prepaid plan upon the development of a service
6513	delivery mechanism for children who reside in area 10 as
6514	specified in s. 409.91211(3)(dd).
6515	(36)  Any entity that provides Medicaid prepaid health plan
6516	services shall ensure the appropriate coordination of health
6517	care services with an assisted living residence facility in
6518	cases where a Medicaid recipient is both a member of the
6519	entity's prepaid health plan and a resident of the assisted
6520	living residence facility. If the entity is at risk for Medicaid
6521	targeted case management and behavioral health services, the
6522	entity shall inform the assisted living residence facility of
6523	the procedures to follow should an emergent condition arise.
6524	Section 117.  Section 410.031, Florida Statutes, is amended
6525	to read:
6526	410.031  Legislative intent.-It is the intent of the
6527	Legislature to encourage the provision of care for disabled
6528	adults in family-type living arrangements in private homes as an
6529	alternative to institutional or nursing home care for such
6530	persons. The provisions of ss.      410.031-410.036 are intended
6531	to be supplemental to the provisions of chapters 400 and 429,
6532	relating to the licensing and regulation of nursing homes and
6533	assisted living residences facilities, and do not exempt any
6534	person who is otherwise subject to regulation under chapter 400
6535	or chapter 429.
6536	Section 118.  Section 410.034, Florida Statutes, is amended
6537	to read:
6538	410.034  Department determination of fitness to provide
6539	home care.-In accordance with s. 429.02, a person caring for an
6540	adult who is related to such person by blood or marriage is not
6541	subject to the Assisted Living Residences Facilities Act. If,
6542	however, the person who plans to provide home care under this
6543	act is found by the department to be unable to provide this
6544	care, the department shall notify the person wishing to provide
6545	home care of this determination, and the person shall not be
6546	eligible for subsidy payments under ss. 410.031-410.036.
6547	Section 119.  Paragraph (b) of subsection (3) of section
6548	410.502, Florida Statutes, is amended to read:
6549	410.502  Housing and living arrangements; special needs of
6550	the elderly; services.-The Department of Elderly Affairs shall
6551	provide services related to housing and living arrangements
6552	which meet the special needs of the elderly. Such services shall
6553	include, but not be limited to:
6554	(3)  Promoting, through the Department of Elderly Affairs
6555	staff activities and area agencies on aging, the development of
6556	a variety of living arrangements through public and private
6557	auspices to meet the various needs and desires of the elderly,
6558	including, but not limited to:
6559	(b)  Assisted living residence facilities.
6560
6561	Demonstration projects must be used advisedly to test the extent
6562	to which these and other innovative housing and living
6563	arrangements do meet the basic and special needs of the elderly.
6564	Section 120.  Subsection (9) of section 415.102, Florida
6565	Statutes, is amended to read:
6566	415.102  Definitions of terms used in ss. 415.101-415.113.-
6567	As used in ss. 415.101-415.113, the term:
6568	(9)  "Facility" means any location providing day or
6569	residential care or treatment for vulnerable adults. The term
6570	"facility" may include, but is not limited to, any hospital,
6571	state institution, nursing home, assisted living residence
6572	facility, adult family-care home, adult day care center,
6573	residential facility licensed under chapter 393, adult day
6574	training center, or mental health treatment center.
6575	Section 121.  Paragraph (a) of subsection (1) of section
6576	415.1034, Florida Statutes, is amended to read:
6577	415.1034  Mandatory reporting of abuse, neglect, or
6578	exploitation of vulnerable adults; mandatory reports of death.-
6579	(1)  MANDATORY REPORTING.-
6580	(a)  Any person, including, but not limited to, any:
6581	1.  Physician, osteopathic physician, medical examiner,
6582	chiropractic physician, nurse, paramedic, emergency medical
6583	technician, or hospital personnel engaged in the admission,
6584	examination, care, or treatment of vulnerable adults;
6585	2.  Health professional or mental health professional other
6586	than one listed in subparagraph 1.;
6587	3.  Practitioner who relies solely on spiritual means for
6588	healing;
6589	4.  Nursing home staff; assisted living residence facility
6590	staff; adult day care center staff; adult family-care home
6591	staff; social worker; or other professional adult care,
6592	residential, or institutional staff;
6593	5.  State, county, or municipal criminal justice employee
6594	or law enforcement officer;
6595	6.  An employee of the Department of Business and
6596	Professional Regulation conducting inspections of public lodging
6597	establishments under s. 509.032;
6598	7.  Florida advocacy council member or long-term care
6599	ombudsman council member; or
6600	8.  Bank, savings and loan, or credit union officer,
6601	trustee, or employee,
6602
6603	who knows, or has reasonable cause to suspect, that a vulnerable
6604	adult has been or is being abused, neglected, or exploited shall
6605	immediately report such knowledge or suspicion to the central
6606	abuse hotline.
6607	Section 122.  Paragraph (b) of subsection (3) of section
6608	415.1051, Florida Statutes, is amended to read:
6609	415.1051  Protective services interventions when capacity
6610	to consent is lacking; nonemergencies; emergencies; orders;
6611	limitations.-
6612	(3)  PROTECTIVE SERVICES ORDER.-In ordering any protective
6613	services under this section, the court shall adhere to the
6614	following limitations:
6615	(b)  Protective services ordered may not include a change
6616	of residence, unless the court specifically finds such action is
6617	necessary to ameliorate the conditions creating the abuse,
6618	neglect, or exploitation and the court gives specific approval
6619	for such action in the order. Placement may be made to such
6620	facilities as adult family-care homes, assisted living
6621	residences facilities, or nursing homes, or to other appropriate
6622	facilities. Placement may not be made to residences facilities
6623	for the acutely mentally ill, except as provided in chapter 394.
6624	Section 123.  Paragraph (a) of subsection (3) of section
6625	415.107, Florida Statutes, is amended to read:
6626	415.107  Confidentiality of reports and records.-
6627	(3)  Access to all records, excluding the name of the
6628	reporter which shall be released only as provided in subsection
6629	(6), shall be granted only to the following persons, officials,
6630	and agencies:
6631	(a)  Employees or agents of the department, the Agency for
6632	Persons with Disabilities, the Agency for Health Care
6633	Administration, or the Department of Elderly Affairs who are
6634	responsible for carrying out protective investigations, ongoing
6635	protective services, or licensure or approval of nursing homes,
6636	assisted living residences facilities, adult day care centers,
6637	adult family-care homes, home care for the elderly, hospices,
6638	residential facilities licensed under chapter 393, or other
6639	facilities used for the placement of vulnerable adults.
6640	Section 124.  Subsection (2) of section 420.626, Florida
6641	Statutes, is amended to read:
6642	420.626  Homelessness; discharge guidelines.-
6643	(2)  The following facilities and institutions are
6644	encouraged to develop and implement procedures designed to
6645	reduce the discharge of persons into homelessness when such
6646	persons are admitted or housed for more than 24 hours at such
6647	facilities or institutions: hospitals and inpatient medical
6648	facilities; crisis stabilization units; residential treatment
6649	facilities; assisted living residences facilities; and
6650	detoxification centers.
6651	Section 125.  Paragraph (b) of subsection (4) of section
6652	430.071, Florida Statutes, is amended to read:
6653	430.071  Respite for elders living in everyday families.-
6654	(4)  To receive assistance from the RELIEF program, the
6655	family unit must be assessed according to the following
6656	guidelines developed by the department to determine the need for
6657	respite services. This assessment must determine, at a minimum,
6658	that:
6659	(b)  The homebound elderly individual for whom the family
6660	unit is caring is 60 years of age or older, requires assistance
6661	to remain in the home, and, without this assistance, would need
6662	to move to an assisted living residence facility or a nursing
6663	facility.
6664	Section 126.  Section 430.601, Florida Statutes, is amended
6665	to read:
6666	430.601  Home care for the elderly; legislative intent.-It
6667	is the intent of the Legislature to encourage the provision of
6668	care for the elderly in family-type living arrangements in
6669	private homes as an alternative to institutional or nursing home
6670	care for such persons. The provisions of ss.      430.601-
6671	430.606 are intended to be supplemental to the provisions of
6672	chapters 400 and 429, relating to the licensing and regulation
6673	of nursing homes and assisted living residences facilities, and
6674	do not exempt any person who is otherwise subject to regulation
6675	under those chapters.
6676	Section 127.  Paragraph (o) of subsection (3) of section
6677	456.053, Florida Statutes, is amended to read:
6678	456.053  Financial arrangements between referring health
6679	care providers and providers of health care services.-
6680	(3)  DEFINITIONS.-For the purpose of this section, the
6681	word, phrase, or term:
6682	(o)  "Referral" means any referral of a patient by a health
6683	care provider for health care services, including, without
6684	limitation:
6685	1.  The forwarding of a patient by a health care provider
6686	to another health care provider or to an entity which provides
6687	or supplies designated health services or any other health care
6688	item or service.; or
6689	2.  The request or establishment of a plan of care by a
6690	health care provider, which includes the provision of designated
6691	health services or other health care item or service.
6692	3.  The following orders, recommendations, or plans of care
6693	shall not constitute a referral by a health care provider:
6694	a.  By a radiologist for diagnostic-imaging services.
6695	b.  By a physician specializing in the provision of
6696	radiation therapy services for such services.
6697	c.  By a medical oncologist for drugs and solutions to be
6698	prepared and administered intravenously to such oncologist's
6699	patient, as well as for the supplies and equipment used in
6700	connection therewith to treat such patient for cancer and the
6701	complications thereof.
6702	d.  By a cardiologist for cardiac catheterization services.
6703	e.  By a pathologist for diagnostic clinical laboratory
6704	tests and pathological examination services, if furnished by or
6705	under the supervision of such pathologist pursuant to a
6706	consultation requested by another physician.
6707	f.  By a health care provider who is the sole provider or
6708	member of a group practice for designated health services or
6709	other health care items or services that are prescribed or
6710	provided solely for such referring health care provider's or
6711	group practice's own patients, and that are provided or
6712	performed by or under the direct supervision of such referring
6713	health care provider or group practice; provided, however, that
6714	effective July 1, 1999, a physician licensed pursuant to chapter
6715	458, chapter 459, chapter 460, or chapter 461 may refer a
6716	patient to a sole provider or group practice for diagnostic
6717	imaging services, excluding radiation therapy services, for
6718	which the sole provider or group practice billed both the
6719	technical and the professional fee for or on behalf of the
6720	patient, if the referring physician has no investment interest
6721	in the practice. The diagnostic imaging service referred to a
6722	group practice or sole provider must be a diagnostic imaging
6723	service normally provided within the scope of practice to the
6724	patients of the group practice or sole provider. The group
6725	practice or sole provider may accept no more than 15 percent of
6726	their patients receiving diagnostic imaging services from
6727	outside referrals, excluding radiation therapy services.
6728	g.  By a health care provider for services provided by an
6729	ambulatory surgical center licensed under chapter 395.
6730	h.  By a urologist for lithotripsy services.
6731	i.  By a dentist for dental services performed by an
6732	employee of or health care provider who is an independent
6733	contractor with the dentist or group practice of which the
6734	dentist is a member.
6735	j.  By a physician for infusion therapy services to a
6736	patient of that physician or a member of that physician's group
6737	practice.
6738	k.  By a nephrologist for renal dialysis services and
6739	supplies, except laboratory services.
6740	l.  By a health care provider whose principal professional
6741	practice consists of treating patients in their private
6742	residences for services to be rendered in such private
6743	residences, except for services rendered by a home health agency
6744	licensed under chapter 400. For purposes of this sub-
6745	subparagraph, the term "private residences" includes patients'
6746	private homes, independent living centers, and assisted living
6747	residences facilities, but does not include skilled nursing
6748	facilities.
6749	m.  By a health care provider for sleep-related testing.
6750	Section 128.  Paragraph (e) of subsection (4) of section
6751	458.348, Florida Statutes, is amended to read:
6752	458.348  Formal supervisory relationships, standing orders,
6753	and established protocols; notice; standards.-
6754	(4)  SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.-
6755	A physician who supervises an advanced registered nurse
6756	practitioner or physician assistant at a medical office other
6757	than the physician's primary practice location, where the
6758	advanced registered nurse practitioner or physician assistant is
6759	not under the onsite supervision of a supervising physician,
6760	must comply with the standards set forth in this subsection. For
6761	the purpose of this subsection, a physician's "primary practice
6762	location" means the address reflected on the physician's profile
6763	published pursuant to s. 456.041.
6764	(e)  This subsection does not apply to health care services
6765	provided in residences facilities licensed under chapter 395 or
6766	in conjunction with a college of medicine, a college of nursing,
6767	an accredited graduate medical program, or a nursing education
6768	program; not-for-profit, family-planning clinics that are not
6769	licensed pursuant to chapter 390; rural and federally qualified
6770	health centers; health care services provided in a nursing home
6771	licensed under part II of chapter 400, an assisted living
6772	residence facility licensed under part I of chapter 429, a
6773	continuing care residence facility licensed under chapter 651,
6774	or a retirement community consisting of independent living units
6775	and a licensed nursing home or assisted living residence
6776	facility; anesthesia services provided in accordance with law;
6777	health care services provided in a designated rural health
6778	clinic; health care services provided to persons enrolled in a
6779	program designed to maintain elderly persons and persons with
6780	disabilities in a home or community-based setting; university
6781	primary care student health centers; school health clinics; or
6782	health care services provided in federal, state, or local
6783	government facilities. Subsection (3) and this subsection do not
6784	apply to offices at which the exclusive service being performed
6785	is laser hair removal by an advanced registered nurse
6786	practitioner or physician assistant.
6787	Section 129.  Paragraph (e) of subsection (3) of section
6788	459.025, Florida Statutes, is amended to read:
6789	459.025  Formal supervisory relationships, standing orders,
6790	and established protocols; notice; standards.-
6791	(3)  SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.-
6792	An osteopathic physician who supervises an advanced registered
6793	nurse practitioner or physician assistant at a medical office
6794	other than the osteopathic physician's primary practice
6795	location, where the advanced registered nurse practitioner or
6796	physician assistant is not under the onsite supervision of a
6797	supervising osteopathic physician, must comply with the
6798	standards set forth in this subsection. For the purpose of this
6799	subsection, an osteopathic physician's "primary practice
6800	location" means the address reflected on the physician's profile
6801	published pursuant to s. 456.041.
6802	(e)  This subsection does not apply to health care services
6803	provided in residences facilities licensed under chapter 395 or
6804	in conjunction with a college of medicine or college of nursing
6805	or an accredited graduate medical or nursing education program;
6806	offices where the only service being performed is hair removal
6807	by an advanced registered nurse practitioner or physician
6808	assistant; not-for-profit, family-planning clinics that are not
6809	licensed pursuant to chapter 390; rural and federally qualified
6810	health centers; health care services provided in a nursing home
6811	licensed under part II of chapter 400, an assisted living
6812	residence facility licensed under part I of chapter 429, a
6813	continuing care facility licensed under chapter 651, or a
6814	retirement community consisting of independent living units and
6815	either a licensed nursing home or assisted living residence
6816	facility; anesthesia services provided in accordance with law;
6817	health care services provided in a designated rural health
6818	clinic; health care services provided to persons enrolled in a
6819	program designed to maintain elderly persons and persons with
6820	disabilities in a home or community-based setting; university
6821	primary care student health centers; school health clinics; or
6822	health care services provided in federal, state, or local
6823	government facilities.
6824	Section 130.  Paragraph (b) of subsection (2) of section
6825	468.1695, Florida Statutes, is amended to read:
6826	468.1695  Licensure by examination.-
6827	(2)  The department shall examine each applicant who the
6828	board certifies has completed the application form and remitted
6829	an examination fee set by the board not to exceed $250 and who:
6830	(b)1.  Holds a baccalaureate degree from an accredited
6831	college or university; and
6832	2.a.  Has fulfilled the requirements of a 2,000-hour
6833	nursing home administrator-in-training program prescribed by the
6834	board; or
6835	b.  Has 1 year of management experience allowing for the
6836	application of executive duties and skills, including the
6837	staffing, budgeting, and directing of resident care, dietary,
6838	and bookkeeping departments within a skilled nursing facility,
6839	hospital, hospice, assisted living residence facility with a
6840	minimum of 60 licensed beds, or geriatric residential treatment
6841	program and, if such experience is not in a skilled nursing
6842	facility, has fulfilled the requirements of a 1,000-hour nursing
6843	home administrator-in-training program prescribed by the board.
6844	Section 131.  Paragraph (k) of subsection (1) of section
6845	468.505, Florida Statutes, is amended to read:
6846	468.505  Exemptions; exceptions.-
6847	(1)  Nothing in this part may be construed as prohibiting
6848	or restricting the practice, services, or activities of:
6849	(k)  A person employed by a hospital licensed under chapter
6850	395, by a nursing home licensed under part II of chapter 400, by
6851	an assisted living residence facility licensed under chapter
6852	429, or by a continuing care facility certified under chapter
6853	651, if the person is employed in compliance with the laws and
6854	rules adopted thereunder regarding the operation of its dietetic
6855	department.
6856	Section 132.  Subsection (2) of section 553.73, Florida
6857	Statutes, is amended to read:
6858	553.73  Florida Building Code.-
6859	(2)  The Florida Building Code shall contain provisions or
6860	requirements for public and private buildings, structures, and
6861	facilities relative to structural, mechanical, electrical,
6862	plumbing, energy, and gas systems, existing buildings,
6863	historical buildings, manufactured buildings, elevators, coastal
6864	construction, lodging facilities, food sales and food service
6865	facilities, health care facilities, including assisted living
6866	residences facilities, adult day care facilities, hospice
6867	residential and inpatient facilities and units, and facilities
6868	for the control of radiation hazards, public or private
6869	educational facilities, swimming pools, and correctional
6870	facilities and enforcement of and compliance with such
6871	provisions or requirements. Further, the Florida Building Code
6872	must provide for uniform implementation of ss. 515.25, 515.27,
6873	and 515.29 by including standards and criteria for residential
6874	swimming pool barriers, pool covers, latching devices, door and
6875	window exit alarms, and other equipment required therein, which
6876	are consistent with the intent of s. 515.23. Technical
6877	provisions to be contained within the Florida Building Code are
6878	restricted to requirements related to the types of materials
6879	used and construction methods and standards employed in order to
6880	meet criteria specified in the Florida Building Code. Provisions
6881	relating to the personnel, supervision or training of personnel,
6882	or any other professional qualification requirements relating to
6883	contractors or their workforce may not be included within the
6884	Florida Building Code, and subsections (4), (6), (7), (8), and
6885	(9) are not to be construed to allow the inclusion of such
6886	provisions within the Florida Building Code by amendment. This
6887	restriction applies to both initial development and amendment of
6888	the Florida Building Code.
6889	Section 133.  Subsection (3) of section 627.94073, Florida
6890	Statutes, is amended to read:
6891	627.94073  Notice of cancellation; grace period.-
6892	(3)  If a policy is canceled due to nonpayment of premium,
6893	the policyholder is entitled to have the policy reinstated if,
6894	within a period of not less than 5 months after the date of
6895	cancellation, the policyholder or any secondary addressee
6896	designated pursuant to subsection (2) demonstrates that the
6897	failure to pay the premium when due was unintentional and due to
6898	the policyholder's cognitive impairment, loss of functional
6899	capacity, or continuous confinement in a hospital, skilled
6900	nursing facility, or assisted living residence facility for a
6901	period in excess of 60 days. Policy reinstatement shall be
6902	subject to payment of overdue premiums. The standard of proof of
6903	cognitive impairment or loss of functional capacity shall not be
6904	more stringent than the benefit eligibility criteria for
6905	cognitive impairment or the loss of functional capacity, if any,
6906	contained in the policy and certificate. The insurer may require
6907	payment of an interest charge not in excess of 8 percent per
6908	year for the number of days elapsing before the payment of the
6909	premium, during which period the policy shall continue in force
6910	if the demonstration of cognitive impairment is made. If the
6911	policy becomes a claim during the 180-day period before the
6912	overdue premium is paid, the amount of the premium or premiums
6913	with interest not in excess of 8 percent per year may be
6914	deducted in any settlement under the policy.
6915	Section 134.  Paragraph (d) of subsection (5) of section
6916	633.021, Florida Statutes, is amended to read:
6917	633.021  Definitions.-As used in this chapter:
6918	(5)
6919	(d)  "Contractor IV" means a contractor whose business is
6920	limited to the execution of contracts requiring the ability to
6921	lay out, fabricate, install, inspect, alter, repair, and service
6922	automatic fire sprinkler systems for detached one-family
6923	dwellings, detached two-family dwellings, and mobile homes,
6924	excluding preengineered systems and excluding single-family
6925	homes in cluster units, such as apartments, condominiums, and
6926	assisted living residences facilities or any building that is
6927	connected to other dwellings.
6928
6929	The definitions in this subsection must not be construed to
6930	include fire protection engineers or architects and do not limit
6931	or prohibit a licensed fire protection engineer or architect
6932	from designing any type of fire protection system. A distinction
6933	is made between system design concepts prepared by the design
6934	professional and system layout as defined in this section and
6935	typically prepared by the contractor. However, persons certified
6936	as a Contractor I, Contractor II, or Contractor IV under this
6937	chapter may design fire protection systems of 49 or fewer
6938	sprinklers, and may design the alteration of an existing fire
6939	sprinkler system if the alteration consists of the relocation,
6940	addition, or deletion of not more than 49 sprinklers,
6941	notwithstanding the size of the existing fire sprinkler system.
6942	A Contractor I, Contractor II, or Contractor IV may design a
6943	fire protection system the scope of which complies with NFPA
6944	13D, Standard for the Installation of Sprinkler Systems in One-
6945	and Two-Family Dwellings and Manufactured Homes, as adopted by
6946	the State Fire Marshal, notwithstanding the number of fire
6947	sprinklers. Contractor-developed plans may not be required by
6948	any local permitting authority to be sealed by a registered
6949	professional engineer.
6950	Section 135.  Paragraph (b) of subsection (1) of section
6951	633.022, Florida Statutes, is amended to read:
6952	633.022  Uniform firesafety standards.-The Legislature
6953	hereby determines that to protect the public health, safety, and
6954	welfare it is necessary to provide for firesafety standards
6955	governing the construction and utilization of certain buildings
6956	and structures. The Legislature further determines that certain
6957	buildings or structures, due to their specialized use or to the
6958	special characteristics of the person utilizing or occupying
6959	these buildings or structures, should be subject to firesafety
6960	standards reflecting these special needs as may be appropriate.
6961	(1)  The department shall establish uniform firesafety
6962	standards that apply to:
6963	(b)  All new, existing, and proposed hospitals, nursing
6964	homes, assisted living residences facilities, adult family-care
6965	homes, correctional facilities, public schools, transient public
6966	lodging establishments, public food service establishments,
6967	elevators, migrant labor camps, mobile home parks, lodging
6968	parks, recreational vehicle parks, recreational camps,
6969	residential and nonresidential child care facilities, facilities
6970	for the developmentally disabled, motion picture and television
6971	special effects productions, tunnels, and self-service gasoline
6972	stations, of which standards the State Fire Marshal is the final
6973	administrative interpreting authority.
6974
6975	In the event there is a dispute between the owners of the
6976	buildings specified in paragraph (b) and a local authority
6977	requiring a more stringent uniform firesafety standard for
6978	sprinkler systems, the State Fire Marshal shall be the final
6979	administrative interpreting authority and the State Fire
6980	Marshal's interpretation regarding the uniform firesafety
6981	standards shall be considered final agency action.
6982	Section 136.  Subsection (25) of section 641.31, Florida
6983	Statutes, is amended to read:
6984	641.31  Health maintenance contracts.-
6985	(25)  If a subscriber is a resident of a continuing care
6986	facility certified under chapter 651 or a retirement facility
6987	consisting of a nursing home or assisted living residence
6988	facility and residential apartments, the subscriber's primary
6989	care physician must refer the subscriber to that facility's
6990	skilled nursing unit or assisted living residence facility if
6991	requested by the subscriber and agreed to by the facility; if
6992	the primary care physician finds that such care is medically
6993	necessary; if the facility agrees to be reimbursed at the health
6994	maintenance organization's contract rate negotiated with similar
6995	providers for the same services and supplies; and if the
6996	facility meets all guidelines established by the health
6997	maintenance organization related to quality of care,
6998	utilization, referral authorization, risk assumption, use of the
6999	health maintenance organization's network, and other criteria
7000	applicable to providers under contract for the same services and
7001	supplies. If a health maintenance organization enrolls a new
7002	subscriber who already resides in a continuing care facility or
7003	a retirement facility as described in this subsection, the
7004	health maintenance organization must provide in writing a
7005	disclosure of the subscriber's rights under this subsection. If
7006	a subscriber's request to be referred to the skilled nursing
7007	unit or assisted living residence facility that is part of the
7008	subscriber's place of residence is not honored, the subscriber
7009	may use the grievance process provided in s. 641.511.
7010	Section 137.  Subsection (6) of section 651.083, Florida
7011	Statutes, is amended to read:
7012	651.083  Residents' rights.-
7013	(6)  This section does not supersede any bill of rights
7014	provided by law for residents of nursing homes or assisted
7015	living residences facilities.
7016	Section 138.  Subsection (7) of section 825.101, Florida
7017	Statutes, is amended to read:
7018	825.101  Definitions.-As used in this chapter:
7019	(7)  "Facility" means any location providing day or
7020	residential care or treatment for elderly persons or disabled
7021	adults. The term "facility" may include, but is not limited to,
7022	any hospital, training center, state institution, nursing home,
7023	assisted living residence facility, adult family-care home,
7024	adult day care center, group home, mental health treatment
7025	center, or continuing care community.
7026	Section 139.  Subsection (14) of section 893.055, Florida
7027	Statutes, is amended to read:
7028	893.055  Prescription drug monitoring program.-
7029	(14)  A pharmacist, pharmacy, or dispensing health care
7030	practitioner or his or her agent, before releasing a controlled
7031	substance to any person not known to such dispenser, shall
7032	require the person purchasing, receiving, or otherwise acquiring
7033	the controlled substance to present valid photographic
7034	identification or other verification of his or her identity to
7035	the dispenser. If the person does not have proper
7036	identification, the dispenser may verify the validity of the
7037	prescription and the identity of the patient with the prescriber
7038	or his or her authorized agent. Verification of health plan
7039	eligibility through a real-time inquiry or adjudication system
7040	will be considered to be proper identification. This subsection
7041	does not apply in an institutional setting or to a long-term
7042	care facility, including, but not limited to, an assisted living
7043	residence facility or a hospital to which patients are admitted.
7044	As used in this subsection, the term "proper identification"
7045	means an identification that is issued by a state or the Federal
7046	Government containing the person's photograph, printed name, and
7047	signature or a document considered acceptable under 8 C.F.R. s.
7048	274a.2(b)(1)(v)(A) and (B).
7049	Section 140.  Paragraph (h) of subsection (1) of section
7050	893.13, Florida Statutes, is amended to read:
7051	893.13  Prohibited acts; penalties.-
7052	(1)
7053	(h)  Except as authorized by this chapter, it is unlawful
7054	for any person to sell, manufacture, or deliver, or possess with
7055	intent to sell, manufacture, or deliver, a controlled substance
7056	in, on, or within 1,000 feet of the real property comprising an
7057	assisted living residence facility, as that term is used in
7058	chapter 429. Any person who violates this paragraph with respect
7059	to:
7060	1.  A controlled substance named or described in s.
7061	893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.
7062	commits a felony of the first degree, punishable as provided in
7063	s. 775.082, s. 775.083, or s. 775.084.
7064	2.  A controlled substance named or described in s.
7065	893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6.,
7066	(2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) commits a felony of
7067	the second degree, punishable as provided in s. 775.082, s.
7068	775.083, or s. 775.084.
7069	Section 141.  This act shall take effect July 1, 2011.

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