Florida Senate - 2013 SB 1724
By Senator Garcia
1 A bill to be entitled
2 An act relating to transitional living facilities;
3 creating part XI of ch. 400, F.S., entitled
4 “Transitional Living Facilities”; creating s.
5 400.9970, F.S.; providing legislative intent; creating
6 s. 400.9971, F.S.; providing definitions; creating s.
7 400.9972, F.S.; requiring the licensure of
8 transitional living facilities; providing fees;
9 providing license application requirements; creating
10 s. 400.9973, F.S.; providing requirements for
11 transitional living facilities relating to client
12 admission, transfer, and discharge; creating s.
13 400.9974, F.S.; requiring an individual treatment plan
14 to be developed for each client; providing plan
15 requirements; creating s. 400.9975, F.S.; providing
16 licensee responsibilities; providing notice
17 requirements; prohibiting a licensee or employee of a
18 facility from serving notice upon a client to leave
19 the premises or take other retaliatory action;
20 requiring the client and client’s representative to be
21 provided with certain information; requiring the
22 licensee to develop and implement certain policies and
23 procedures; creating s. 400.9976, F.S.; providing
24 licensee requirements relating to medication
25 practices; creating s. 400.9977, F.S.; providing
26 requirements for the screening of potential employees
27 and monitoring of employees for the protection of
28 clients; requiring licensees to implement certain
29 procedures; creating s. 400.9978, F.S.; providing
30 requirements for the use of physical restraints and
31 chemical restraint medication on clients; creating s.
32 400.9979, F.S.; providing background screening
33 requirements; requiring the licensee to maintain
34 certain personnel records; providing administrative
35 responsibilities for licensees; providing
36 recordkeeping requirements; creating s. 400.9980,
37 F.S.; providing requirements relating to property and
38 personal affairs of clients; providing requirements
39 for a licensee with respect to obtaining surety bonds;
40 providing recordkeeping requirements relating to the
41 safekeeping of personal effects; providing
42 requirements for trust funds received by a licensee
43 and credited to the client; providing a penalty for
44 certain misuse of a resident’s personal needs
45 allowance; providing criminal penalties for
46 violations; providing for the disposition of property
47 in the event of the death of a client; authorizing the
48 Agency for Health Care Administration to adopt rules;
49 creating s. 400.9981, F.S.; requiring the agency, in
50 consultation with the Department of Health, to adopt
51 and enforce certain rules; creating s. 400.9982, F.S.;
52 providing procedures relating to violations and
53 penalties; providing administrative fines for
54 specified classes of violations; creating s. 400.9983,
55 F.S.; authorizing the agency to access the provisions
56 of s. 429.22, F.S., regarding receivership
57 proceedings; creating s. 400.9984, F.S.; requiring the
58 Agency for Health Care Administration, the Department
59 of Health, the Agency for Persons with Disabilities,
60 and the Department of Children and Families to develop
61 an electronic database for certain purposes; repealing
62 s. 400.805, F.S., relating to transitional living
63 facilities; amending s. 381.78, F.S.; conforming
64 provisions to changes made by the act; providing an
65 effective date.
67 Be It Enacted by the Legislature of the State of Florida:
69 Section 1. Sections 400.9970 through 400.9984, Florida
70 Statutes, are designated as part XI of chapter 400, Florida
71 Statutes, entitled “Transitional Living Facilities.”
72 Section 2. Section 400.9970, Florida Statutes, is created
73 to read:
74 400.9970 Legislative intent.—It is the intent of the
75 Legislature to provide for the licensure of transitional living
76 facilities and require the development, establishment, and
77 enforcement of basic standards by the department to ensure
78 quality of care and services to clients in transitional living
79 facilities. It is the policy of the state that the least
80 restrictive appropriate available treatment be used based on the
81 individual needs and best interests of the client and consistent
82 with optimum improvement of the client’s condition. The goal of
83 a transitional living program for individuals who have brain or
84 spinal cord injuries is to assist each individual who has such a
85 disability to achieve a higher level of independent functioning
86 and to enable that person to reenter the community.
87 Section 3. Section 400.9971, Florida Statutes, is created
88 to read:
89 400.9971 Definitions.—As used in this part, the term:
90 (1) “Agency” means the Agency for Health Care
92 (2) “Chemical restraint” means a pharmacologic drug that
93 physically limits, restricts, or deprives an individual of
94 movement or mobility and is used for client protection or safety
95 and is not required for the treatment of medical conditions or
97 (3) “Client’s representative” means the parent of a child
98 client, or the client’s guardian, designated representative or
99 designee, surrogate, or attorney in fact.
100 (4) “Department” means the Department of Health.
101 (5) “Licensee” means an individual issued a license by the
103 (6) “Physical restraint” means any manual method or
104 physical or mechanical device, material, or equipment attached
105 or adjacent to the individual’s body so that he or she cannot
106 easily remove the restraint and which restricts freedom of
107 movement or normal access to one’s body, including, but not
108 limited to, a half-bed rail, a full-bed rail, a geriatric chair,
109 and a posey restraint. The term includes any device that was not
110 specifically manufactured as a restraint but that has been
111 altered, arranged, or otherwise used for this purpose. The term
112 does not include bandage material used for the purpose of
113 binding a wound or injury.
114 (7) “Transitional living facility” means a site where
115 specialized health care services are provided, including, but
116 not limited to, rehabilitative services, community reentry
117 training, aids for independent living, and counseling to brain
118 injured persons and spinal-cord-injured persons. The term does
119 not include a hospital licensed under chapter 395 or any
120 federally operated hospital or facility.
121 Section 4. Section 400.9972, Florida Statutes, is created
122 to read:
123 400.9972 License required; fee; application.—
124 (1) The requirements of part II of chapter 408 apply to the
125 provision of services that require licensure pursuant to this
126 part and part II of chapter 408 and to entities licensed by or
127 applying for such licensure from the agency pursuant to this
128 part. A license issued by the agency is required for the
129 operation of a transitional living facility in this state.
130 (2) In accordance with this part, an applicant or a
131 licensee shall pay a fee for each license application submitted
132 under this part. The license fee shall consist of a $4,000
133 license fee and a $90 per-bed fee per biennium and shall conform
134 to the annual adjustment authorized in s. 408.805.
135 (3) Each applicant for licensure must provide:
136 (a) The location of the facility for which a license is
137 sought and documentation, signed by the appropriate local
138 government official, that states that the applicant has met
139 local zoning requirements.
140 (b) Proof of liability insurance as defined in s. 624.605.
141 (c) Proof of compliance with local zoning requirements,
142 including compliance with the requirements of chapter 419 if the
143 proposed facility is a community residential home.
144 (d) Proof that the facility has received a satisfactory
145 firesafety inspection.
146 (e) Documentation of a satisfactory sanitation inspection
147 of the facility by the county health department.
148 Section 5. Section 400.9973, Florida Statutes, is created
149 to read:
150 400.9973 Client admission, transfer, and discharge.—
151 (1) Each transitional living facility must have written
152 policies and procedures governing the admission, transfer, and
153 discharge of clients.
154 (2) The admission of each client to a transitional living
155 facility must be in accordance with the licensee’s policies and
157 (3) A client admitted to a transitional living facility
158 must have a brain or spinal cord injury, such as a lesion to the
159 spinal cord or cauda equina syndrome, with evidence of
160 significant involvement of two of the following deficits or
162 (a) Motor deficit.
163 (b) Sensory deficit.
164 (c) Bowel and bladder dysfunction.
165 (d) An injury to the skull, brain, or its covering that
166 produces an altered state of consciousness or anatomic motor,
167 sensory, cognitive, or behavioral deficits.
168 (4) A client admitted to a transitional living facility
169 must be admitted upon prescription by a licensed physician and
170 must remain under the care of a licensed physician for the
171 duration of the client’s stay in the facility.
172 (5) A transitional living facility may not admit a client
173 whose primary admitting diagnosis is mental illness.
174 (6) A person may not be admitted to a transitional living
175 facility if the person:
176 (a) Presents significant risk of infection to other client
177 or personnel. A health care practitioner must provide
178 documentation that the person is free of apparent signs and
179 symptoms of communicable disease;
180 (b) Is a danger to self or others as determined by a
181 physician, or mental health practitioner licensed under chapter
182 490 or chapter 491, unless the facility provides adequate
183 staffing and support to ensure patient safety;
184 (c) Is bedridden; or
185 (d) Requires 24-hour nursing supervision.
186 (7) If the client meets the admission criteria, the medical
187 or nursing director of the facility must implement a
188 preadmission treatment plan that delineates services to be
189 provided and appropriate sources for such services.
190 (8) Each comprehensive treatment plan and discharge plan
191 must be reviewed and updated as necessary, but at least monthly.
192 A transitional living facility shall discharge as quickly as
193 possible a resident who no longer requires any of the
194 specialized services described in s. 400.9971(6) or is not
195 making measurable progress in accordance with that individual’s
196 comprehensive treatment plan.
197 (9) Each transitional living facility shall provide at
198 least 30 days’ notice to clients of transfer or discharge plans,
199 including the location of an acceptable transfer location if the
200 client is unable to live independently. This requirement does
201 not apply if a client voluntarily terminates residency.
202 (10) Each transitional living facility shall create a
203 discharge plan for each client within 15 days after admission.
204 The discharge plan must identify the intended discharge site and
205 possible alternative discharge sites. For each discharge site,
206 the discharge plan must identify the skills, behaviors, and
207 other conditions that the client must achieve to be appropriate
208 for discharge. A transitional living facility shall discharge a
209 client as soon as practicable if the transitional living
210 facility is no longer the most appropriate, least restrictive
211 treatment option.
212 (11) A client may not reside in a transitional living
213 facility for a period of more than 2 years. An exception may be
214 made if a referral is made to Disability Rights Florida at least
215 21 months after admission and the client or, if appropriate, the
216 client’s guardian requests that the client continue to receive
217 treatment at the transitional living facility. However, the
218 extension may not exceed a 1 year.
219 Section 6. Section 400.9974, Florida Statutes, is created
220 to read:
221 400.9974 Individual treatment plans; client services.—
222 (1) An interdisciplinary team, consisting of the case
223 manager, program director, nurse, behavior specialist, and
224 appropriate therapists, must develop an individual treatment
225 plan for each client. The client and his or her representative
226 must also be included in developing the treatment plan.
227 (2) The individual treatment plan must include:
228 (a) The physician’s orders and the client’s diagnosis,
229 medical history, physical examination, and rehabilitative or
230 restorative needs.
231 (b) A preliminary nursing evaluation with physician’s
232 orders for immediate care, completed on admission.
233 (c) A comprehensive, accurate, reproducible, and
234 standardized assessment of the client’s functional capability
235 and the treatments designed to achieve skills, behaviors, and
236 other conditions to return to the community, and shall specify
237 measurable goals.
238 (d) Steps necessary for the client to achieve transition to
239 the community and estimated length of time to achieve the goals.
240 (3) The individual treatment plan must be completed before
241 admission to the facility and be reevaluated and updated at
242 least every 90 days thereafter. A reevaluation of the plan must
243 also occur if the client fails to meet projected improvements in
244 the plan or a significant change in the client’s condition
245 occurs. The client, the client’s guardian or responsible party,
246 and any other person approved by the client, and members of the
247 comprehensive treatment team are allowed to attend and
248 participate in formulating updates to the discharge and
249 treatment plans. At each quarterly meeting, the client or, if
250 appropriate, the client’s guardian, shall consent to the
251 continued treatment at the transitional living facility. If such
252 consent is not given, the transitional living facility shall
253 discharge the client as soon as practicable.
254 (4) Each client must receive the professional program
255 services needed to implement the client’s individual program
257 (5) The licensee must employ available qualified
258 professional staff to carry out and monitor the various
259 professional interventions in accordance with the stated goals
260 and objectives of every individual program plan.
261 (6) Each client must receive a continuous treatment program
262 that includes appropriate, consistent implementation of a
263 program of specialized and general training, treatment, health
264 services, and related services that is directed toward:
265 (a) The acquisition of the behaviors necessary for the
266 client to function with as much self-determination and
267 independence as possible;
268 (b) The prevention or deceleration of regression or loss of
269 current optimal functional status; and
270 (c) An appropriate plan to address behavioral issues that
271 preclude independent functioning in the community.
272 Section 7. Section 400.9975, Florida Statutes, is created
273 to read:
274 400.9975 Licensee responsibilities.—
275 (1) The licensee shall ensure that each client:
276 (a) Lives in a safe environment free from abuse, neglect,
277 and exploitation.
278 (b) Is treated with consideration and respect and with due
279 recognition of personal dignity, individuality, and the need for
281 (c) Retains and uses his or her own clothes and other
282 personal property in his or her immediate living quarters, so as
283 to maintain individuality and personal dignity, except when the
284 licensee can demonstrate that such retention and use would be
285 unsafe, impractical, or an infringement upon the rights of other
287 (d) Has unrestricted private communication, including
288 receiving and sending unopened correspondence, access to a
289 telephone, and visiting with any person of his or her choice.
290 Upon request, the licensee shall make provisions to modify
291 visiting hours for caregivers and guests. The facility shall
292 restrict communication in accordance with any court order or
293 written instruction of a guardian. Any restriction on a client’s
294 communication for therapeutic reasons shall be reviewed no less
295 often than weekly and the restrictions shall be removed as soon
296 as it is no longer clinically indicated. The basis for the
297 restrictions shall be explained to the client and, if
298 applicable, the client’s representative. The client shall
299 nonetheless retain the right to call the abuse hotline, the
300 agency, and Disability Rights Florida at any and all times.
301 (e) Participates in and benefits from community services
302 and activities to achieve the highest possible level of
303 independence, autonomy, and interaction within the community.
304 (f) Manages his or her financial affairs unless the client
305 or, if applicable, the client’s representative authorizes the
306 administrator of the facility to provide safekeeping for funds
307 as provided in this part.
308 (g) Has reasonable opportunity for regular exercise several
309 times a week and to be outdoors at regular and frequent
310 intervals except when prevented by inclement weather.
311 (h) Exercises civil and religious liberties, including the
312 right to independent personal decisions. No religious belief or
313 practice, including attendance at religious services, shall be
314 imposed upon any client.
315 (i) Has access to adequate and appropriate health care as
316 appropriate for the client and consistent with established and
317 recognized standards within the community.
318 (j) Has the ability to present grievances and recommend
319 changes in policies, procedures, and services to the staff of
320 the licensee, governing officials, or any other person without
321 restraint, interference, coercion, discrimination, or reprisal.
322 Each licensee shall establish a grievance procedure to
323 facilitate a client’s exercise of this right. This right
324 includes access to Disability Rights Florida and other advocates
325 and the right to be a member of, be active in, and associate
326 with advocacy or special interest groups.
327 (2) The licensee shall:
328 (a) Promote participation of each client’s representative
329 in the process of providing treatment to the client unless the
330 representative’s participation is unobtainable or inappropriate.
331 (b) Answer communications from each client’s family and
332 friends promptly and appropriately.
333 (c) Promote visits by individuals with a relationship to
334 the client at any reasonable hour, without requiring prior
335 notice, or in any area of the facility that provides direct
336 client care services to the client, consistent with the client’s
337 and other clients’ privacy, unless the interdisciplinary team
338 determines that such a visit would not be appropriate.
339 (d) Promote leave from the facility for visits, trips, or
341 (e) Promptly notify the client’s representative of any
342 significant incidents or changes in the client’s condition,
343 including, but not limited to, serious illness, accident, abuse,
344 unauthorized absence, or death.
345 (3) The administrator of a facility shall ensure that a
346 written notice of licensee responsibilities is posted in a
347 prominent place in each building where clients reside and read
348 or explained to clients who cannot read. This notice shall
349 include the statewide toll-free telephone number for reporting
350 complaints to the agency, must be provided to clients in a
351 manner that is clearly legible, and must include the words: “To
352 report a complaint regarding the services you receive, please
353 call toll-free ...[telephone number]...; the Disability Rights
354 Florida (telephone number); and the statewide toll-free
355 telephone number for the central abuse hotline must be provided
356 to clients in a manner that is clearly legible and must include
357 the words: “To report abuse, neglect or exploitation, please
358 call toll-free ...[telephone number]...” where complaints may be
359 lodged. The licensee must ensure a client’s access to a
360 telephone to call the agency, central abuse hotline, Disability
361 Rights Florida.
362 (4) No licensee or employee of a facility may serve notice
363 upon a client to leave the premises or take any other
364 retaliatory action against any person who:
365 (a) Files an internal or external complaint or grievance
366 regarding the facility.
367 (b) Appears as a witness in any hearing inside or outside
368 the facility.
369 (5) Before or at the time of admission, the client and the
370 client’s representative shall be provided with a copy of the
371 client’s contract and a copy of the licensee’s responsibilities
372 as provided in subsection (1).
373 (6) The licensee must develop and implement policies and
374 procedures governing the release of any client information,
375 including consent necessary from the client or the client’s
377 Section 8. Section 400.9976, Florida Statutes, is created
378 to read:
379 400.9976 Medication practices.—
380 (1) An individual medication administration record must be
381 maintained for each client. Each dose of medication, including a
382 self administered dose, shall be properly recorded in the
383 client’s record. Each patient who is self administering
384 medication shall be given a pill organizer. Medication must be
385 placed in the pill organizer by a nurse. A nurse shall document
386 the date and time medication is placed into each patient’s pill
387 organizer. All medications must be administered in compliance
388 with the physician’s orders.
389 (2) If the interdisciplinary team determines that self
390 administration of medications is an appropriate objective, and
391 if the physician does not specify otherwise, a client must be
392 taught to self administer his or her medication without a staff
393 person. This includes all forms of administration, including
394 orally, via injection, and via suppository. The client’s
395 physician must be informed of the interdisciplinary team’s
396 decision that self administration of medications is an objective
397 for the client. A client may not self administer medication
398 until he or she demonstrates the competency to take the correct
399 medication in the correct dosage at the correct time, knows how
400 to respond to missed doses, and knows who to contact with
402 (3) Medication administration discrepancies and adverse
403 drug reactions must be recorded and reported immediately to a
405 Section 9. Section 400.9977, Florida Statutes, is created
406 to read:
407 400.9977 Protection from abuse, neglect, mistreatment, and
408 exploitation.—The licensee must develop and implement policies
409 and procedures for the screening and training of employees, the
410 protection of clients, and the prevention, identification,
411 investigation, and reporting of abuse, neglect, and
412 exploitation. This includes the licensee’s identification of
413 clients whose personal histories render them at risk for abusing
414 other clients, development of intervention strategies to prevent
415 occurrences, monitoring for changes that would trigger abusive
416 behavior, and reassessment of the interventions on a regular
417 basis. A licensee shall implement procedures to:
418 (1) Screen potential employees for a history of abuse,
419 neglect, or mistreatment of clients. The screening shall include
420 an attempt to obtain information from previous employers and
421 current employers and verification with the appropriate
422 licensing boards and registries.
423 (2) Train employees, through orientation and ongoing
424 sessions, on issues related to abuse prohibition practices,
425 including identification of abuse, neglect, mistreatment, and
426 exploitation, appropriate interventions to deal with aggressive
427 or catastrophic reactions of clients, the process to report
428 allegations without fear of reprisal, and recognition of signs
429 of frustration and stress that may lead to abuse.
430 (3) Provide clients, families, and staff with information
431 on how and to whom they may report concerns, incidents, and
432 grievances without the fear of retribution and provide feedback
433 regarding the concerns that have been expressed. A licensee must
434 identify, correct, and intervene in situations in which abuse,
435 neglect, mistreatment, or exploitation is likely to occur,
437 (a) Evaluating the physical environment of the facility to
438 identify characteristics that may make abuse or neglect more
439 likely to occur, such as secluded areas.
440 (b) Providing sufficient staff on each shift to meet the
441 needs of the clients, and ensuring that the staff assigned have
442 knowledge of the individual clients’ care needs. The licensee
443 shall identify inappropriate behaviors of its staff, such as
444 using derogatory language, rough handling, ignoring clients
445 while giving care, and directing clients who need toileting
446 assistance to urinate or defecate in their beds.
447 (c) Assessing, planning care for, and monitoring clients
448 with needs and behaviors that might lead to conflict or neglect,
449 such as clients with a history of aggressive behaviors, clients
450 who have behaviors such as entering other clients’ rooms,
451 clients with self-injurious behaviors, clients with
452 communication disorders, and clients who require heavy nursing
453 care or are totally dependent on staff.
454 (4) Identify events, such as suspicious bruising of
455 clients, occurrences, patterns, and trends that may constitute
456 abuse and determine the direction of the investigation.
457 (5) Investigate different types of incidents, identify the
458 staff member responsible for the initial reporting, investigate
459 alleged violations, and report results to the proper
460 authorities. The licensee must analyze the occurrences to
461 determine what changes are needed, if any, to policies and
462 procedures to prevent further occurrences and to take all
463 necessary corrective actions depending on the results of the
465 (6) Protect clients from harm during an investigation.
466 (7) Report all alleged violations and all substantiated
467 incidents, as required under chapters 39 and 415, to the
468 licensing authorities and to all other agencies as required, and
469 to report any knowledge it has of any actions by a court of law
470 that would indicate an employee is unfit for service.
471 Section 10. Section 400.9978, Florida Statutes, is created
472 to read:
473 400.9978 Restraints and seclusion; client safety.—
474 (1) The use of physical restraints must be ordered and
475 documented by the a physician and must be consistent with
476 policies and procedures adopted by the facility. The client or,
477 if applicable, the client’s representative must be informed of
478 the facility’s physical restraint policies and procedures at the
479 time of admission.
480 (2) The use of chemical restraints is limited to prescribed
481 dosages of medications as ordered by a physician, must be
482 consistent with the client’s diagnosis and the policies and
483 procedures adopted by the facility. The client or, if
484 applicable, the client’s representative, must be informed of the
485 facility’s chemical restraint policies and procedures at the
486 time of admission.
487 (3) Based on a physician’s assessment, when a patient
488 exhibits symptoms that present an immediate risk of injury or
489 death to self or others, a physician may issue an emergency
490 treatment order to immediately administer rapid response
491 psychotropic medications or other chemical restraints. Each
492 emergency treatment order must be documented and maintained in
493 the patient’s record.
494 (a) An emergency treatment order is effective for no more
495 than 24 hours.
496 (b) Whenever a client is medicated in accordance with this
497 section, the client’s representative or responsible party and
498 the client’s physician must be notified as soon as practicable.
499 (4) A client who is prescribed and receiving a medication
500 that can serve as a chemical restraint, but not on an emergency
501 basis, must be evaluated by his or her physician at least
502 monthly to assess:
503 (a) The continued need for the medication.
504 (b) The level of the medication in the client’s blood as
506 (c) The need for adjustments in the prescription.
507 (5) The licensee shall ensure that clients are free from
508 unnecessary drugs and physical restraints and are provided
509 treatment to reduce dependency on drugs and physical restraints.
510 (6) The licensee may use physical restraints only as an
511 integral part of an individual program plan that is intended to
512 lead to less restrictive means of managing and eliminating the
513 behavior for which the restraint is applied.
514 (7) Interventions to manage inappropriate client behavior
515 must be employed with sufficient safeguards and supervision to
516 ensure that the safety, welfare, and civil and human rights of
517 each client are adequately protected.
518 Section 11. Section 400.9979, Florida Statutes, is created
519 to read:
520 400.9979 Background screening; administration and
522 (1) The agency shall require level 2 background screening
523 for personnel as required in s. 408.809(1)(e) pursuant to
524 chapter 435 and s. 408.809.
525 (2) The licensee shall maintain personnel records for each
526 staff member that contain, at a minimum, documentation of
527 background screening, if applicable, a job description,
528 documentation of compliance with all training requirements of
529 this part or applicable rule, the employment application,
530 references, a copy of all job performance evaluations, and, for
531 each staff member who performs services for which licensure or
532 certification is required, a copy of all licenses or
533 certification held by the staff member.
534 (3) The licensee must:
535 (a) Develop and implement infection control policies and
536 procedures and include such policies and procedures in the
537 licensee’s policy manual.
538 (b) Maintain liability insurance as defined in s. 624.605.
539 (c) Designate one person as an administrator who is
540 responsible and accountable for the overall management of the
542 (d) Designate a person in writing to be responsible for the
543 facility when the administrator is absent from the facility for
544 more than 24 hours.
545 (e) Designate in writing a program director who is
546 responsible for supervising the therapeutic and behavioral
547 staff, determining the levels of supervision, and room placement
548 for each client.
549 (f) Designate in writing a person to be responsible when
550 the program director is absent from the facility for more than
551 24 hours.
552 (g) Obtain approval of the comprehensive emergency
553 management plan, pursuant to s. 400.9981(2)(e), from the local
554 emergency management agency. Pending the approval of the plan,
555 the local emergency management agency shall ensure that the
556 following agencies, at a minimum, are given the opportunity to
557 review the plan: the Department of Health, the Agency for Health
558 Care Administration, and the Division of Emergency Management.
559 Appropriate volunteer organizations must also be given the
560 opportunity to review the plan. The local emergency management
561 agency shall complete its review within 60 days and either
562 approve the plan or advise the licensee of necessary revisions.
563 (h) Maintain written records in a form and system that
564 comply with medical and business practices and make such records
565 available in the facility for review or submission to the agency
566 upon request. The records shall include:
567 1. A daily census record that indicates the number of
568 clients currently receiving services in the facility, including
569 information regarding any public funding of such clients.
570 2. A record of all accidents or unusual incidents involving
571 any client or staff member that caused, or had the potential to
572 cause, injury or harm to any person or property within the
573 facility. Such records must contain a clear description of each
574 accident or incident, the names of the persons involved, a
575 description of all medical or other services provided to these
576 persons specifying who provided such services, and the steps
577 taken to prevent recurrence of such accidents or incidents.
578 3. A copy of current agreements with third-party providers.
579 4. A copy of current agreements with each consultant
580 employed by the licensee and documentation of each consultant’s
581 visits and required written, dated reports.
582 Section 12. Section 400.9980, Florida Statutes, is created
583 to read:
584 400.9980 Property and personal affairs of clients.—
585 (1) A client shall be given the option of using his or her
586 own belongings, as space permits; choosing his or her roommate
587 if practical and not clinically contraindicated; and, whenever
588 possible, unless the client is adjudicated incompetent or
589 incapacitated under state law, managing his or her own affairs.
590 (2) The admission of a client to a facility and his or her
591 presence therein shall not confer on a licensee, administrator,
592 employee, or representative thereof any authority to manage,
593 use, or dispose of any property of the client, nor shall such
594 admission or presence confer on any of such persons any
595 authority or responsibility for the personal affairs of the
596 client except that which may be necessary for the safe
597 management of the facility or for the safety of the client.
598 (3) A licensee, administrator, employee, or representative
599 thereof may:
600 (a) Not act as the guardian, trustee, or conservator for
601 any client or any of such client’s property.
602 (b) Act as a competent client’s payee for social security,
603 veteran’s, or railroad benefits if the client provides consent
604 and the licensee files a surety bond with the agency in an
605 amount equal to twice the average monthly aggregate income or
606 personal funds due to the client, or expendable for the client’s
607 account, that are received by a licensee.
608 (c) Act as the power of attorney for a client if the
609 licensee has filed a surety bond with the agency in an amount
610 equal to twice the average monthly income of the client, plus
611 the value of any client’s property under the control of the
612 attorney in fact.
614 The bond under paragraph (b) or paragraph (c) shall be executed
615 by the licensee as principal and a licensed surety company. The
616 bond shall be conditioned upon the faithful compliance of the
617 licensee with the requirements of licensure and shall be payable
618 to the agency for the benefit of any client who suffers a
619 financial loss as a result of the misuse or misappropriation of
620 funds held pursuant to this subsection. Any surety company that
621 cancels or does not renew the bond of any licensee shall notify
622 the agency in writing not less than 30 days in advance of such
623 action, giving the reason for the cancellation or nonrenewal.
624 Any licensee, administrator, employee, or representative thereof
625 who is granted power of attorney for any client of the facility
626 shall, on a monthly basis, notify the client in writing of any
627 transaction made on behalf of the client pursuant to this
628 subsection, and a copy of such notification given to the client
629 shall be retained in each client’s file and available for agency
631 (4) A licensee, upon mutual consent with the client, shall
632 provide for the safekeeping in the facility of the client’s
633 personal effects of a value not in excess of $1,000 and the
634 client’s funds not in excess of $500 cash and shall keep
635 complete and accurate records of all such funds and personal
636 effects received. If a client is absent from a facility for 24
637 hours or more, the licensee may provide for the safekeeping of
638 the client’s personal effects of a value in excess of $1,000.
639 (5) Any funds or other property belonging to or due to a
640 client or expendable for his or her account that is received by
641 licensee shall be trust funds and shall be kept separate from
642 the funds and property of the licensee and other clients or
643 shall be specifically credited to such client. Such trust funds
644 shall be used or otherwise expended only for the account of the
645 client. At least once every month, unless upon order of a court
646 of competent jurisdiction, the licensee shall furnish the client
647 and the client’s representative a complete and verified
648 statement of all funds and other property to which this
649 subsection applies, detailing the amount and items received,
650 together with their sources and disposition. In any event, the
651 licensee shall furnish such statement annually and upon the
652 discharge or transfer of a client. Any governmental agency or
653 private charitable agency contributing funds or other property
654 to the account of a client shall also be entitled to receive
655 such statement monthly and upon the discharge or transfer of the
657 (6)(a) In addition to any damages or civil penalties to
658 which a person is subject, any person who:
659 1. Intentionally withholds a client’s personal funds,
660 personal property, or personal needs allowance, or who demands,
661 beneficially receives, or contracts for payment of all or any
662 part of a client’s personal property or personal needs allowance
663 in satisfaction of the facility rate for supplies and services;
665 2. Borrows from or pledges any personal funds of a client,
666 other than the amount agreed to by written contract under s.
669 commits a misdemeanor of the first degree, punishable as
670 provided in s. 775.082 or s. 775.083.
671 (b) Any licensee, administrator, employee, or
672 representative thereof who is granted power of attorney for any
673 client of the facility and who misuses or misappropriates funds
674 obtained through this power commits a felony of the third
675 degree, punishable as provided in s. 775.082, s. 775.083, or s.
677 (7) In the event of the death of a client, a licensee shall
678 return all refunds, funds, and property held in trust to the
679 client’s personal representative, if one has been appointed at
680 the time the licensee disburses such funds, or, if not, to the
681 client’s spouse or adult next of kin named in a beneficiary
682 designation form provided by the licensee to the client. If the
683 client has no spouse or adult next of kin or such person cannot
684 be located, funds due the client shall be placed in an interest
685 bearing account and all property held in trust by the licensee
686 shall be safeguarded until such time as the funds and property
687 are disbursed pursuant to the Florida Probate Code. Such funds
688 shall be kept separate from the funds and property of the
689 licensee and other clients of the facility. If the funds of the
690 deceased client are not disbursed pursuant to the Florida
691 Probate Code within 2 years after the client’s death, the funds
692 shall be deposited in the Health Care Trust Fund administered by
693 the agency.
694 (8) The agency may by rule clarify terms and specify
695 procedures and documentation necessary to administer the
696 provisions of this section relating to the proper management of
697 clients’ funds and personal property and the execution of surety
699 Section 13. Section 400.9981, Florida Statutes, is created
700 to read:
701 400.9981 Rules establishing standards.—
702 (1) It is the intent of the Legislature that rules
703 published and enforced pursuant to this part and part II of
704 chapter 408 include criteria to ensure reasonable and consistent
705 quality of care and client safety. Rules should make reasonable
706 efforts to accommodate the needs and preferences of clients to
707 enhance the quality of life in transitional living facilities.
708 (2) The agency, in consultation with the Department of
709 Health, may adopt and enforce rules to implement this part and
710 part II of chapter 408, which shall include reasonable and fair
711 criteria in relation to:
712 (a) The location of transitional living facilities.
713 (b) The number of qualifications of all personnel,
714 including management, medical, nursing, and other professional
715 personnel and nursing assistants and support personnel having
716 responsibility for any part of the care given to clients. The
717 licensee must have enough qualified professional staff available
718 to carry out and monitor the various professional interventions
719 in accordance with the stated goals and objectives of each
720 individual program plan.
721 (c) Requirements for personnel procedures, insurance
722 coverage, reporting procedures, and documentation necessary to
723 implement this part.
724 (d) Services provided to clients of transitional living
726 (e) The preparation and annual update of a comprehensive
727 emergency management plan in consultation with the Division of
728 Emergency Management. At a minimum, the rules must provide for
729 plan components that address emergency evacuation
730 transportation; adequate sheltering arrangements; postdisaster
731 activities, including provision of emergency power, food, and
732 water; postdisaster transportation; supplies; staffing;
733 emergency equipment; individual identification of clients and
734 transfer of records; communication with families; and responses
735 to family inquiries.
736 Section 14. Section 400.9982, Florida Statutes, is created
737 to read:
738 400.9982 Violations; penalties.—
739 (1) Each violation of this part and rules adopted pursuant
740 thereto shall be classified according to the nature of the
741 violation and the gravity of its probable effect on facility
742 clients. The agency shall indicate the classification on the
743 written notice of the violation as follows:
744 (a) Class “I” violations are defined in s. 408.813. The
745 agency shall issue a citation regardless of correction and
746 impose an administrative fine of $5,000 for an isolated
747 violation, $7,500 for a patterned violation, and $10,000 for a
748 widespread violation. Violations may be identified and a fine
749 must be levied notwithstanding the correction of the deficiency
750 giving rise to the violation.
751 (b) Class “II” violations are defined in s. 408.813. The
752 agency shall impose an administrative fine of $1,000 for an
753 isolated violation, $2,500 for a patterned violation, and $5,000
754 for a widespread violation. A fine must be levied
755 notwithstanding the correction of the deficiency giving rise to
756 the violation.
757 (c) Class “III” violations are defined in s. 408.813. The
758 agency shall impose an administrative fine of $500 for an
759 isolated violation, $750 for a patterned violation, and $1,000
760 for a widespread violation. If a deficiency giving rise to a
761 class “III” violation is corrected within the time specified by
762 the agency, a fine may not be imposed.
763 (d) Class “IV” violations are defined in s. 408.813. The
764 agency shall impose an administrative fine for a cited class IV
765 violation in an amount not less than $100 and not exceeding $200
766 for each violation.
767 Section 15. Section 400.9983, Florida Statutes, is created
768 to read:
769 400.9983 Receivership proceedings.—The agency may access
770 the provisions of s. 429.22 regarding receivership proceedings
771 for transitional living facilities.
772 Section 16. Section 400.9984, Florida Statutes, is created
773 to read:
774 400.9984 Interagency communication.—The agency, the
775 department, the Agency for Persons with Disabilities, and the
776 Department of Children and Families shall develop an electronic
777 database to ensure that relevant information pertaining to the
778 regulation of transitional living facilities and clients is
779 timely and effectively communicated among agencies in order to
780 facilitate the protection of clients. Electronic sharing of
781 information shall include, at a minimum, a brain and spinal cord
782 injury registry and a client abuse registry.
783 Section 17. Section 400.805, Florida Statutes, is repealed.
784 Section 18. Paragraph (b) of subsection (4) of section
785 381.78, Florida Statutes, is amended to read:
786 381.78 Advisory council on brain and spinal cord injuries.—
787 (4) The council shall:
788 (b) Annually appoint a five-member committee composed of
789 one individual who has a brain injury or has a family member
790 with a brain injury, one individual who has a spinal cord injury
791 or has a family member with a spinal cord injury, and three
792 members who shall be chosen from among these representative
793 groups: physicians, other allied health professionals,
794 administrators of brain and spinal cord injury programs, and
795 representatives from support groups with expertise in areas
796 related to the rehabilitation of individuals who have brain or
797 spinal cord injuries, except that one and only one member of the
798 committee shall be an administrator of a transitional living
799 facility. Membership on the council is not a prerequisite for
800 membership on this committee.
801 1. The committee shall perform onsite visits to those
802 transitional living facilities identified by the Agency for
803 Health Care Administration as being in possible violation of the
804 statutes and rules regulating such facilities.
805 members have the same rights of entry and inspection granted
806 under s. 400.805 (4) to designated representatives of the agency.
807 2. Factual findings of the committee resulting from an
808 onsite investigation of a facility pursuant to subparagraph 1.
809 shall be adopted by the agency in developing its administrative
810 response regarding enforcement of statutes and rules regulating
811 the operation of the facility.
812 3. Onsite investigations by the committee shall be funded
813 by the Health Care Trust Fund.
814 4. Travel expenses for committee members shall be
815 reimbursed in accordance with s. 112.061.
816 5. Members of the committee shall recuse themselves from
817 participating in any investigation that would create a conflict
818 of interest under state law, and the council shall replace the
819 member, either temporarily or permanently.
820 Section 19. This act shall take effect July 1, 2013.