Florida Senate - 2011                                    SB 1838
       By Senator Wise
       5-01267-11                                            20111838__
    1                        A bill to be entitled                      
    2         An act relating to assisted living facilities;
    3         creating the Florida Assisted Living Quality
    4         Improvement Initiative Pilot Project; providing
    5         purpose; requiring the Agency for Health Care
    6         Administration to create pilot projects in area
    7         offices; authorizing licensed assisted living
    8         facilities to enroll in the pilot project; authorizing
    9         the agency to provide, or execute contracts with
   10         private providers to provide, consultative services;
   11         requiring a facility to provide notice to the agency
   12         of enrollment in the project; establishing quality
   13         improvement teams; providing composition and duties of
   14         a quality improvement team; providing conditions for
   15         termination of a quality improvement agreement with a
   16         facility; providing for termination of a quality
   17         enrollment team by the agency and resumption of
   18         inspections by the agency under certain circumstances;
   19         providing procedures for investigating and monitoring
   20         complaints; requiring the agency to develop an
   21         assessment tool to evaluate the project; requiring the
   22         agency to report to the Governor and Legislature;
   23         providing that reports and documents of the quality
   24         improvement team may not be used in certain tort
   25         actions and are exempt from discovery; providing for
   26         the expiration of the project; providing an effective
   27         date.
   29  Be It Enacted by the Legislature of the State of Florida:
   31         Section 1. Florida Assisted Living Quality Improvement
   32  Initiative Pilot Project.—
   33         (1) There is created within the Agency for Health Care
   34  Administration the Florida Assisted Living Quality Improvement
   35  Initiative Pilot Project. The purpose of the pilot project is to
   36  identify best practices for providing care to residents of
   37  licensed assisted living facilities, provide caregivers with
   38  methods to implement best practices, and develop, in
   39  collaboration with the facility, a plan to improve the quality
   40  of care and living arrangements in the facility to reduce the
   41  need for institutional care.
   42         (2) The agency shall create a pilot project in each area
   43  office that allows licensed assisted living facilities to enroll
   44  in the Florida Assisted Living Quality Improvement Initiative
   45  Pilot Project.
   46         (3) The agency may provide consultative services, or
   47  execute contracts with private individuals, companies, or trade
   48  associations to offer consultative services, to assist in
   49  achieving the goals of the pilot project.
   50         (4) The administrator of a licensed facility shall notify
   51  the agency when the facility has agreed to enroll in the pilot
   52  project. Enrollment in the pilot project is voluntary, and a
   53  facility may withdraw from the pilot project at any time.
   54  Enrollment in the pilot project shall begin on January 1 of each
   55  year.
   56         (5) The owner and the administrator of the facility
   57  enrolled in the pilot project shall execute an agreement with
   58  the agency, or with a private provider that has been approved
   59  and authorized by the agency to participate in the project, and
   60  the quality improvement team established under subsection (6) to
   61  implement an approved quality improvement plan for that facility
   62  and shall collaborate with the consultants to meet the goals
   63  outlined in the plan.
   64         (6) A quality improvement team shall be established to
   65  evaluate the progress of the facility in meeting quality
   66  improvement plan goals. A quality improvement team shall include
   67  a quality improvement specialist, a licensed registered nurse, a
   68  licensed dietician, and a staff development representative.
   69         (7) Each quality improvement team shall:
   70         (a) Conduct an annual assessment and followup visits as
   71  needed to monitor progress.
   72         (b) Consult with the owner and the administrator to meet
   73  plan requirements, create systems to monitor compliance with
   74  agency rules, ensure that training standards established under
   75  s. 429.52, Florida Statutes, are met, and provide access to
   76  community-based services that would improve the care of the
   77  residents and the conditions in the facility.
   78         (c) Maintain records of the assessments and ongoing efforts
   79  to help facilities meet quality improvement goals.
   80         (d) Issue a certification to each facility that meets
   81  agency standards and complies with the goals of its quality
   82  improvement plan.
   83         (8) A quality improvement team may elect to terminate the
   84  agreement executed under subsection (5) with a facility that has
   85  failed to meet the goals of the plan after reasonable efforts
   86  are made to seek cooperation and assistance from the owner and
   87  the administrator.
   88         (9) If a facility’s enrollment in the pilot project is
   89  terminated, the quality improvement team shall notify the agency
   90  and that facility shall be subject to the survey, inspection,
   91  and monitoring visits conducted under s. 408.811, Florida
   92  Statutes. The facility is not eligible to reenroll in the pilot
   93  project until the agency has certified that the facility meets
   94  substantial compliance with its quality improvement plan.
   95         (10) A facility that has executed an agreement with an
   96  approved quality improvement team may terminate that agreement
   97  and execute a new agreement with another approved team. If such
   98  termination is sought, the facility administrator shall notify
   99  the agency area office in writing, specifying the reasons the
  100  facility seeks to terminate the agreement, and the area office
  101  supervisor shall approve or reject the request.
  102         (11) A complaint made against a facility that is enrolled
  103  in the pilot project shall be referred to the approved quality
  104  improvement team for followup investigation and monitoring of
  105  corrections. The team shall investigate the complaint and shall
  106  work with the owner or administrator to address concerns. If
  107  there is a pattern of repeated complaints, the agency may
  108  investigate those complaints and refer the complaints to the
  109  local jurisdiction enforcement body for investigation to ensure
  110  the health, safety, and well-being of the facility residents.
  111         (12) At any time, based on reasonable cause or concern for
  112  the health, safety, or well-being of the residents of a
  113  facility, the agency may investigate and conduct periodic
  114  appraisal visits to ensure compliance with the approved quality
  115  improvement plans and assess both the quality improvement team
  116  and the facility. If the agency finds that the facility is in
  117  substantial noncompliance with the quality improvement plan, the
  118  agency may terminate the agreement, which shall result in the
  119  termination of that quality improvement team from the approved
  120  list of providers and shall require the facility to be subject
  121  to the survey, inspection, and monitoring visits conducted under
  122  s. 408.811, Florida Statutes.
  123         (13) The agency shall develop an assessment tool to measure
  124  the success of the pilot project and shall use indicators to
  125  evaluate the implementation of best practices, staff development
  126  activities, physical plant improvements, care-related outcomes,
  127  and reductions in referrals to institutional care. The agency
  128  shall estimate the savings and reduction in workforce and costs
  129  associated with the implementation of the pilot project. The
  130  agency shall submit a report of its findings to the Governor,
  131  the President of the Senate, and the Speaker of the House of
  132  Representatives by July 1 of each year.
  133         (14) Reports and documents generated by the quality
  134  improvement teams may not be used in any tort action sought
  135  against the licenseholder and are exempt from discovery.
  136         (15) The Florida Assisted Living Quality Improvement
  137  Initiative Pilot Project and this section expire July 1, 2016,
  138  unless reenacted by the Legislature.
  139         Section 2. This act shall take effect July 1, 2011.