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. 28 29 Be It Enacted by the Legislature of the State of Florida: 30 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.