Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. PCS (368338) for SB 2074
       
       
       
       
       
       
                                Barcode 357618                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  01/31/2012           .                                
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       The Committee on Health Regulation (Garcia) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 1190 and 1191
    4  insert:
    5         (3) “Assisted living facility administrator certification”
    6  means a professional credential awarded by a board-approved
    7  third-party credentialing entity to individuals who demonstrate
    8  core competency in the practice of assisted living facility
    9  administration and who meet the education, background screening,
   10  and other criteria specified by the board for licensure as an
   11  assisted living facility administrator.
   12  
   13  
   14         Delete lines 1273 - 1545
   15  and insert:
   16  
   17         (3) Develop by appropriate techniques, including
   18  examinations and investigations, a method for determining
   19  whether an individual meets such standards.
   20         (a) The board shall approve one or more third-party
   21  credentialing entities for the purpose of developing and
   22  administering assisted living facility administrator
   23  certification programs. A third-party credentialing entity must
   24  be a nonprofit organization that has met nationally recognized
   25  standards for developing and administering professional
   26  certification programs. In order to obtain approval, a third
   27  party credentialing entity must also:
   28         1. Establish professional requirements and standards that
   29  applicants must achieve in order to obtain an assisted living
   30  facility administrator certification and to maintain such
   31  certification. At a minimum, these requirements and standards
   32  must include completion of the requirements for assisted living
   33  facility administrators required in this part and in rules
   34  adopted by the board, including all education and continuing
   35  education requirements;
   36         2. Develop and apply core competencies and examination
   37  instruments according to nationally recognized certification and
   38  psychometric standards, and agree to assist the board with
   39  developing the training and testing materials under subsections
   40  (9), (10), and (11);
   41         3. Maintain a professional code of ethics and a
   42  disciplinary process that applies to all persons holding
   43  certification as an assisted living facility administrator;
   44         4. Maintain an internet based database, accessible to the
   45  public, of all persons holding an assisted living facility
   46  administrator certification, including any history of ethical
   47  violations; and
   48         5. Require continuing education and, at least, biennial
   49  certification renewal for persons holding an assisted living
   50  facility administrator certification.
   51         (4) Issue licenses to qualified individuals meeting the
   52  standards of the board and revoke or suspend licenses previously
   53  issued by the board if when the individual holding such license
   54  is determined to have failed to conform substantially conform to
   55  the requirements of such standards.
   56         (5) Establish by rule and carry out procedures, by rule,
   57  designed to ensure that licensed nursing home or assisted living
   58  facility administrators will comply with the standards adopted
   59  by the board.
   60         (6) Receive, investigate, and take appropriate action with
   61  respect to any charge or complaint filed with the department to
   62  the effect that a licensed nursing home or assisted living
   63  facility administrator has failed to comply with the
   64  requirements or standards adopted by the board.
   65         (7) Conduct a continuing study and investigation of nursing
   66  homes and assisted living facilities and the administrators of
   67  nursing homes and assisted living facilities in order to improve
   68  the standards imposed for the licensing of such administrators
   69  and the procedures and methods for enforcing such standards with
   70  respect to licensed administrators of nursing homes who have
   71  been licensed as such.
   72         (8) Set up procedures by rule for advising and acting
   73  together with the department Department of Health and other
   74  boards of other health professions in matters affecting
   75  procedures and methods for effectively enforcing the purpose of
   76  this part and the administration of chapters 400 and 429.
   77         (9) In consultation with the Agency for Health Care
   78  Administration, the Department of Elderly Affairs, and the
   79  Department of Children and Family Services, develop the
   80  following which must be completed by an applicant for licensure
   81  as an assisted living facility administrator:
   82         (a) Assisted living facility administrator core training
   83  that includes at least 40 hours of training, is offered in
   84  English and Spanish, is reviewed at least annually by the board
   85  or its agent, and updated as needed to reflect changes in the
   86  law, rules, and best practices. The curriculum, at a minimum,
   87  must cover the following topics:
   88         1. State law and rules relating to assisted living
   89  facilities.
   90         2. Resident rights and the identification and reporting of
   91  abuse, neglect, and exploitation.
   92         3. The special needs of elderly persons, persons who have
   93  mental illness, and persons who have developmental disabilities
   94  and how to meet those needs.
   95         4. Nutrition and food service, including acceptable
   96  sanitation practices for preparing, storing, and serving food.
   97         5. Medication management, recordkeeping, and proper
   98  techniques for assisting residents who self-administer
   99  medication.
  100         6. Firesafety requirements, including procedures for fire
  101  evacuation drills and other emergency procedures.
  102         7. The care of persons who have Alzheimer’s disease and
  103  related disorders.
  104         8. Elopement prevention.
  105         9. Aggression and behavior management, de-escalation
  106  techniques, and proper protocols and procedures relating to the
  107  Baker Act as provided in part I of chapter 394.
  108         10. Do-not-resuscitate orders.
  109         11. Infection control.
  110         12. Admission and continued residency.
  111         13. Phases of care and interacting with residents.
  112         14. Best practices in the industry.
  113         15. Business operations, including, but not limited to,
  114  human resources, financial management, and supervision of staff.
  115         (b) An assisted living facility administrator examination
  116  that tests the applicant’s knowledge and training of the core
  117  training topics listed in paragraph (a). The examination must be
  118  offered in English and Spanish, reviewed at least annually by
  119  the board or its agent, and updated as needed to reflect changes
  120  in the law, rules, and best practices. A minimum score of 80 is
  121  required to demonstrate successful completion of the training
  122  requirements.
  123         (10) In consultation with the Agency for Health Care
  124  Administration, the Department of Elderly Affairs, and the
  125  Department of Children and Family Services, develop a continuing
  126  education curriculum, for licensed assisted living facility
  127  administrators. Administrators who are employed by extended
  128  congregate care, limited nursing services, or limited mental
  129  health licensees must complete additional credit hours as
  130  determined by the board. The board or its agent shall also
  131  develop a short examination that corresponds with each
  132  continuing education course and must be offered in English and
  133  Spanish. The board or its agent must review the continuing
  134  education curriculum and each examination at least annually, and
  135  update the curriculum and examinations as needed to reflect
  136  changes in the law, rules, and best practices. Continuing
  137  education must include topics similar to those of the core
  138  training in paragraph (9), and may include additional subject
  139  matter that enhances the knowledge, skills, and abilities of
  140  assisted living facility administrators, as adopted by rule.
  141         (11) In consultation with a panel of at least three mental
  142  health professionals, develop a limited mental health curriculum
  143  and examination, which must be completed by an assisted living
  144  facility administrator within 30 days after being employed by a
  145  limited mental health licensee. The examination must be offered
  146  in English and Spanish and must be available online. The board
  147  or its agent shall review the examination at least annually and
  148  update as needed.
  149         (12) In consultation with stakeholders, develop the
  150  standardized staff training curriculum required under s. 429.52
  151  for assisted living facility staff members, other than an
  152  administrator, who provide regular or direct care to residents.
  153  The curriculum must be reviewed at least annually by the board
  154  or its agent, and updated as needed to reflect changes in the
  155  law, rules, and best practices. The curriculum must include at
  156  least 20 hours of inservice training, with at least 1 hour of
  157  training per topic, covering at least the following topics:
  158         (a) Reporting major incidents.
  159         (b) Reporting adverse incidents.
  160         (c) Facility emergency procedures, including chain-of
  161  command and staff member roles relating to emergency evacuation.
  162         (d)Resident rights in an assisted living facility.
  163         (e) Recognizing and reporting resident abuse, neglect, and
  164  exploitation.
  165         (f) Resident behavior and needs.
  166         (g) Providing assistance with the activities of daily
  167  living.
  168         (h) Infection control.
  169         (i) Aggression and behavior management and deescalation
  170  techniques.
  171         (13) In consultation with the Agency for Health Care
  172  Administration, the Department of Elderly Affairs, the
  173  Department of Children and Family Services, and stakeholders,
  174  develop the interactive online tutorial required under s. 429.52
  175  which must be completed by assisted living facility staff
  176  members who provide regular or direct care to assisted living
  177  facility residents. The tutorial must be based on the training
  178  required under subsection (12). The board must offer the
  179  tutorial in English and Spanish and update the tutorial as
  180  needed, but at least annually.
  181         (14) In consultation with the Agency for Health Care
  182  Administration, the Department of Elderly Affairs, and the
  183  Department of Children and Family Services, develop the
  184  continuing education curriculum required under s. 429.52 for
  185  staff members of an assisted living facility who provide regular
  186  or direct care to assisted living facility residents. The board
  187  shall require additional credit hours for assisted living
  188  facility staff who are employed by extended congregate care,
  189  limited nursing services, or limited mental health licensees.
  190  The board or its agent must review the continuing education
  191  curriculum at least annually and update the curriculum as
  192  needed. Continuing education must include topics similar to
  193  those listed in subsection (12), and may include additional
  194  subject matter that enhances the knowledge, skills, and
  195  abilities of assisted living facility staff, as adopted by rule.
  196         (15) In consultation with a panel of at least three mental
  197  health professionals, develop the limited mental health
  198  curriculum and online interactive tutorial required under s.
  199  429.521(3) which must be completed by assisted living facility
  200  staff, other than the administrator, who provide regular and
  201  direct care to mental health residents. The board or its agents
  202  must ensure that the tutorial is offered in English and Spanish,
  203  and must be updated as needed, but at least annually.
  204         (16) Require and provide, or cause to be provided, the
  205  training or education of staff members of an assisted living
  206  facility beyond that which is required under this part if the
  207  board or department determines that there are problems in a
  208  facility which could be reduced through specific staff training
  209  or education.
  210         (17) Certify assisted living training providers who meet
  211  the qualifications under s. 429.522.
  212         (18) Approve testing and training centers pursuant to s.
  213  429.523.
  214         Section 30. Subsection (2) of section 468.1695, Florida
  215  Statutes, is amended and subsections (5) through (9) are added
  216  to that section, to read:
  217         468.1695 Licensure by examination; licensure by
  218  certification.—
  219         (2) The department shall examine each applicant for a
  220  nursing home administrator license who the board certifies has
  221  completed the application form and remitted an examination fee
  222  set by the board not to exceed $250 and who:
  223         (a)1. Holds a baccalaureate degree from an accredited
  224  college or university and majored in health care administration
  225  or has credit for at least 60 semester hours in subjects, as
  226  prescribed by rule of the board, which prepare the applicant for
  227  total management of a nursing home; and
  228         2. Has fulfilled the requirements of a college-affiliated
  229  or university-affiliated internship in nursing home
  230  administration or of a 1,000-hour nursing home administrator-in
  231  training program prescribed by the board; or
  232         (b)1. Holds a baccalaureate degree from an accredited
  233  college or university; and
  234         2.a. Has fulfilled the requirements of a 2,000-hour nursing
  235  home administrator-in-training program prescribed by the board;
  236  or
  237         b. Has 1 year of management experience allowing for the
  238  application of executive duties and skills, including the
  239  staffing, budgeting, and directing of resident care, dietary,
  240  and bookkeeping departments within a skilled nursing facility,
  241  hospital, hospice, assisted living facility with a minimum of 60
  242  licensed beds, or geriatric residential treatment program and,
  243  if such experience is not in a skilled nursing facility, has
  244  fulfilled the requirements of a 1,000-hour nursing home
  245  administrator-in-training program prescribed by the board.
  246         (5) Any person desiring to be licensed as an assisted
  247  living facility administrator must apply to the department,
  248  remit a fee set by the board not to exceed $500, and provide
  249  proof of a current and valid assisted living facility
  250  administrator certification.
  251         (6) An assisted living facility administrator certification
  252  must be issued by a board-approved third-party credentialing
  253  entity that certifies the individual:
  254         (a) Is at least 21 years old;
  255         (b) Holds a 4-year baccalaureate degree from an accredited
  256  college or university that includes some coursework in health
  257  care, gerontology, or geriatrics; a 4-year baccalaureate degree
  258  from an accredited college or university and at least 2 years of
  259  experience in direct care in an assisted living facility or
  260  nursing home; or a 2-year associate degree that includes
  261  coursework in health care, gerontology, or geriatrics and at
  262  least 2 years of experience in direct care in an assisted living
  263  facility or nursing home;
  264         (c) Has completed a least 40 hours of core training;
  265         (d) Has passed an examination that documents core
  266  competencies in the training required for assisted living
  267  facility administrators prior to licensure with a minimum score
  268  of 80;
  269         (e) Has completed background screening pursuant to s.
  270  429.174 and s. 456.0365; and
  271         (f) Otherwise meets the requirements of this part and part
  272  I of chapter 429.
  273         (7) An assisted living facility administrator who is
  274  continuously employed as a facility administrator, or a nursing
  275  home administrator who is continuously employed as a nursing
  276  home administrator, for at least the 2 years before July 1,
  277  2012, is eligible for certification as an assisted living
  278  facility administrator without meeting the educational
  279  requirements of this section or taking the licensure examination
  280  if:
  281         (a) The core training under this part has been completed.
  282         (b) All continuing education requirements have been
  283  completed.
  284         (c) The applicant was not the administrator of a facility
  285  or nursing home that was cited for a class I or class II
  286  violation within the 2 years before July 1, 2012.
  287         (8) Other licensed professionals may be exempted from some
  288  or all of the training requirements of this section to be
  289  eligible for assisted living facility administrator
  290  certification, as determined by the board by rule.
  291         (9)A licensed assisted living facility administrator
  292  applying for relicensure must submit an application, remit
  293  applicable fees, and demonstrate that he or she has maintained
  294  his or her assisted living facility administrator certification
  295  which substantiates the individual has completed all continuing
  296  education and other requirements under this part to obtain
  297  licensure renewal.
  298  
  299  
  300  ================= T I T L E  A M E N D M E N T ================
  301         And the title is amended as follows:
  302         Delete lines 109 - 121
  303  and insert:
  304         F.S.; revising duties of the board to include
  305         approving third-party credentialing entities for the
  306         purpose of an assisted living facility administrator
  307         certification program; establishing requirements and
  308         standards for certification; providing for the
  309         development of assisted living facility administrator
  310         trainings and testing and staff trainings and
  311         interactive tutorials; authorizing additional training
  312         for certain facilities; and certifying trainers and
  313         testing and training centers; amending s. 468.1695;
  314         providing for licensure of assisted living facility
  315         administrators through certification; establishing a
  316         maximum fee; amending s. 468.1705, F.S.,