Florida Senate - 2021 CS for SB 634
By the Committee on Health Policy; and Senators Gibson, Baxley,
and Farmer
588-02672-21 2021634c1
1 A bill to be entitled
2 An act relating to dementia-related staff training;
3 providing a short title; creating s. 430.5025, F.S.;
4 defining terms; requiring certain entities, as a
5 condition of licensure, to provide specified dementia
6 related training for new employees within a specified
7 timeframe; requiring certain employees to receive
8 additional dementia-related training under certain
9 circumstances within a specified timeframe; providing
10 requirements for the training; requiring annual
11 dementia-related training for certain employees;
12 requiring certain employees to receive additional
13 training developed or approved by the Department of
14 Elderly Affairs under certain circumstances; providing
15 that such additional training counts toward a
16 certified nursing assistant’s total annual training;
17 authorizing certain health care practitioners to count
18 certain continuing education hours toward the
19 dementia-related training requirements under certain
20 circumstances; requiring the department to approve
21 such continuing education hours to satisfy the
22 dementia-related training requirements; requiring the
23 department or its designee to develop a registration
24 process for training providers; specifying
25 requirements for such registration; requiring the
26 department or its designee to issue unique identifiers
27 to approved training providers; requiring the
28 department or its designee to approve courses used to
29 satisfy the dementia-related training requirements;
30 requiring such courses to be approved in various;
31 requiring training providers to develop certain
32 assessments and passing scores for a specified
33 purpose; requiring certain employees to take and pass
34 such assessments upon completion of the training;
35 requiring training providers to issue such employees a
36 certificate upon completing the training and passing
37 the assessments; providing requirements for the
38 certificate; providing that certain employees do not
39 need to repeat certain training when changing
40 employment, under certain circumstances; requiring
41 licensees to maintain copies of training
42 certifications for each of their employees and direct
43 care workers; requiring licensees to make such copies
44 available for inspection for a specified purpose;
45 requiring the department to adopt rules; amending ss.
46 400.1755, 400.4785, 400.6045, 429.178, 429.52, 429.83,
47 and 429.917, F.S.; revising dementia-related staff
48 training requirements for nursing homes, home health
49 agencies, hospices, facilities that provide special
50 care for persons with Alzheimer’s disease or related
51 disorders, assisted living facilities, adult family
52 care homes, and adult day care centers, respectively,
53 to conform to changes made by the act; providing an
54 effective date.
55
56 Be It Enacted by the Legislature of the State of Florida:
57
58 Section 1. This act may be cited as the “Florida
59 Alzheimer’s Disease and Dementia Training Act.”
60 Section 2. Section 430.5025, Florida Statutes, is created
61 to read:
62 430.5025 Care for persons with Alzheimer’s disease or a
63 related disorder; staff training.—
64 (1) As used in this section, the term:
65 (a) “Department” means the Department of Elderly Affairs.
66 (b) “Direct care worker” means an individual who, as part
67 of his or her employment duties, provides or has access to
68 provide direct contact assistance with personal care or
69 activities of daily living to clients, patients, or residents of
70 any facility licensed under part II, part III, or part IV of
71 chapter 400 or chapter 429.
72 (c) “Employee” means any staff member who has regular
73 contact or incidental contact on a recurring basis with clients,
74 patients, or residents of a facility licensed under part II,
75 part III, or part IV of chapter 400 or chapter 429. The term
76 includes, but is not limited to, direct care workers; staff
77 responsible for housekeeping, the front desk, maintenance, and
78 other administrative functions; and any other individuals who
79 may have regular contact or incidental contact on a recurring
80 basis with clients, patients, or residents.
81 (d) “Licensee” means a person or an entity licensed under
82 part II, part III, or part IV of chapter 400 or chapter 429.
83 (2) As a condition of licensure, licensees must provide to
84 each of their employees, within 30 days after their employment
85 begins, 1 hour of dementia-related training, which must include
86 methods for interacting with persons with Alzheimer’s disease or
87 a related disorder and for identifying warning signs of
88 dementia.
89 (3) In addition to the training requirements of subsection
90 (2), licensees must require all employees who are direct care
91 workers to receive at least 3 hours of evidence-based training
92 if the direct care workers are expected to, or their
93 responsibilities require them to, have direct contact with
94 clients, patients, or residents with Alzheimer’s disease or a
95 related disorder or with populations that are at a greater risk
96 for Alzheimer’s disease or a related disorder. The training must
97 be completed within the first 3 months after employment begins
98 and must include, but need not be limited to, an overview of
99 Alzheimer’s disease and related disorders and person-centered
100 care, assessment and care planning, activities of daily living,
101 and dementia-related behaviors and communication for clients,
102 patients, and residents with Alzheimer’s disease or a related
103 disorder. Each calendar year thereafter, the licensee must
104 require all of its direct care workers to receive at least 4
105 hours of continuing education, approved by the department, on
106 these topics and any related changes in state or federal law.
107 (4) If a licensee advertises that it provides special care
108 for individuals with Alzheimer’s disease or a related disorder
109 which includes direct care to such individuals, the licensee
110 must require its direct care workers to complete 4 hours of
111 training developed or approved by the department. This training
112 is in addition to the training requirements of subsections (2)
113 and (3) and must be completed within 4 months after employment
114 begins.
115 (5) Completion of the 4 hours of training developed or
116 approved by the department under subsection (4) shall count
117 toward a certified nursing assistant’s annual training
118 requirements.
119 (6) If a health care practitioner as defined in s. 456.001
120 completes continuing education hours as required by that
121 practitioner’s licensing board, he or she may count those
122 continuing education hours toward satisfaction of the training
123 requirements of subsections (3) and (4) if the course curriculum
124 covers the topics required under those subsections. The
125 department must approve such continuing education hours for
126 purposes of satisfying the training requirements of subsections
127 (3) and (4).
128 (7) The department or its designee shall develop a process
129 for registering training providers and maintain a list of those
130 providers approved to provide training required under this
131 section. To be approved, a training provider must have at least
132 2 years of experience related to Alzheimer’s disease or related
133 disorders, gerontology, health care, or a related field. The
134 department or its designee shall issue each approved training
135 provider a unique registration identifier.
136 (8) The department or its designee shall approve the
137 courses that licensees may use to satisfy the training
138 requirements under this section. The department or its designee
139 must approve training offered in a variety of formats,
140 including, but not limited to, Internet-based training, videos,
141 teleconferencing, and classroom instruction.
142 (9) For each training topic required under this section,
143 the training provider shall develop an assessment that measures
144 an individual’s understanding of the topic and indicate a
145 minimum required score to pass the assessment. Upon completion
146 of any training under this section, the employee or direct care
147 worker must pass the related assessment. If an employee or a
148 direct care worker completes a training and passes the related
149 assessment, the training provider must issue the employee or
150 direct care worker a certificate that includes the training
151 provider’s name and unique identifier, the topic covered in the
152 training, the date of completion, and the signature of the
153 training provider. The certificate is evidence of completion of
154 the training and assessment in the identified topic, and the
155 employee or direct care worker is not required to repeat
156 training in that topic if he or she changes employment to a
157 different licensee, but he or she must comply with any
158 applicable continuing education requirements under this section.
159 Licensees must maintain copies of certificates issued to each of
160 their employees or direct care workers under this section and
161 must make them available for inspection to meet the requirements
162 of licensure.
163 (10) The department shall adopt rules to implement this
164 section.
165 Section 3. Section 400.1755, Florida Statutes, is amended
166 to read:
167 400.1755 Care for persons with Alzheimer’s disease or
168 related disorders; staff training requirements.—
169 (1) As a condition of licensure, facilities licensed under
170 this part must provide to each of their employees training as
171 required in s. 430.5025, upon beginning employment, basic
172 written information about interacting with persons with
173 Alzheimer’s disease or a related disorder.
174 (2) All employees who are expected to, or whose
175 responsibilities require them to, have direct contact with
176 residents with Alzheimer’s disease or a related disorder must,
177 in addition to being provided the information required in
178 subsection (1), also have an initial training of at least 1 hour
179 completed in the first 3 months after beginning employment. This
180 training must include, but is not limited to, an overview of
181 dementias and must provide basic skills in communicating with
182 persons with dementia.
183 (3) An individual who provides direct care shall be
184 considered a direct caregiver and must complete the required
185 initial training and an additional 3 hours of training within 9
186 months after beginning employment. This training shall include,
187 but is not limited to, managing problem behaviors, promoting the
188 resident’s independence in activities of daily living, and
189 skills in working with families and caregivers.
190 (a) The required 4 hours of training for certified nursing
191 assistants are part of the total hours of training required
192 annually.
193 (b) For a health care practitioner as defined in s.
194 456.001, continuing education hours taken as required by that
195 practitioner’s licensing board shall be counted toward this
196 total of 4 hours.
197 (4) For an employee who is a licensed health care
198 practitioner as defined in s. 456.001, training that is
199 sanctioned by that practitioner’s licensing board shall be
200 considered to be approved by the Department of Elderly Affairs.
201 (5) The Department of Elderly Affairs or its designee must
202 approve the initial and continuing training provided in the
203 facilities. The department must approve training offered in a
204 variety of formats, including, but not limited to, Internet
205 based training, videos, teleconferencing, and classroom
206 instruction. The department shall keep a list of current
207 providers who are approved to provide initial and continuing
208 training. The department shall adopt rules to establish
209 standards for the trainers and the training required in this
210 section.
211 (6) Upon completing any training listed in this section,
212 the employee or direct caregiver shall be issued a certificate
213 that includes the name of the training provider, the topic
214 covered, and the date and signature of the training provider.
215 The certificate is evidence of completion of training in the
216 identified topic, and the employee or direct caregiver is not
217 required to repeat training in that topic if the employee or
218 direct caregiver changes employment to a different facility or
219 to an assisted living facility, home health agency, adult day
220 care center, or adult family-care home. The direct caregiver
221 must comply with other applicable continuing education
222 requirements.
223 Section 4. Section 400.4785, Florida Statutes, is amended
224 to read:
225 400.4785 Patients with Alzheimer’s disease or other related
226 disorders; staff training requirements; certain disclosures.—
227 (1) A home health agency must provide the following staff
228 training as required in s. 430.5025:
229 (a) Upon beginning employment with the agency, each
230 employee must receive basic written information about
231 interacting with participants who have Alzheimer’s disease or
232 dementia-related disorders.
233 (b) In addition to the information provided under paragraph
234 (a), newly hired home health agency personnel who will be
235 providing direct care to patients must complete 2 hours of
236 training in Alzheimer’s disease and dementia-related disorders
237 within 9 months after beginning employment with the agency. This
238 training must include, but is not limited to, an overview of
239 dementia, a demonstration of basic skills in communicating with
240 persons who have dementia, the management of problem behaviors,
241 information about promoting the client’s independence in
242 activities of daily living, and instruction in skills for
243 working with families and caregivers.
244 (c) For certified nursing assistants, the required 2 hours
245 of training shall be part of the total hours of training
246 required annually.
247 (d) For a health care practitioner as defined in s.
248 456.001, continuing education hours taken as required by that
249 practitioner’s licensing board shall be counted toward the total
250 of 2 hours.
251 (e) For an employee who is a licensed health care
252 practitioner as defined in s. 456.001, training that is
253 sanctioned by that practitioner’s licensing board shall be
254 considered to be approved by the Department of Elderly Affairs.
255 (f) The Department of Elderly Affairs, or its designee,
256 must approve the required training. The department must consider
257 for approval training offered in a variety of formats. The
258 department shall keep a list of current providers who are
259 approved to provide the 2-hour training. The department shall
260 adopt rules to establish standards for the employees who are
261 subject to this training, for the trainers, and for the training
262 required in this section.
263 (g) Upon completing the training listed in this section,
264 the employee shall be issued a certificate that states that the
265 training mandated under this section has been received. The
266 certificate shall be dated and signed by the training provider.
267 The certificate is evidence of completion of this training, and
268 the employee is not required to repeat this training if the
269 employee changes employment to a different home health agency.
270 (2)(h) A licensed home health agency whose unduplicated
271 census during the most recent calendar year was composed
272 comprised of at least 90 percent of individuals aged 21 years or
273 younger at the date of admission is exempt from the training
274 requirements in this section.
275 (3)(2) An agency licensed under this part which claims that
276 it provides special care for persons who have Alzheimer’s
277 disease or other related disorders must disclose in its
278 advertisements or in a separate document those services that
279 distinguish the care as being especially applicable to, or
280 suitable for, such persons. The agency must give a copy of all
281 such advertisements or a copy of the document to each person who
282 requests information about the agency and must maintain a copy
283 of all such advertisements and documents in its records. The
284 Agency for Health Care Administration shall examine all such
285 advertisements and documents in the agency’s records as part of
286 the license renewal procedure.
287 Section 5. Subsection (1) of section 400.6045, Florida
288 Statutes, is amended to read:
289 400.6045 Patients with Alzheimer’s disease or other related
290 disorders; staff training requirements; certain disclosures.—
291 (1) A hospice licensed under this part must provide the
292 following staff training as required in s. 430.5025:
293 (a) Upon beginning employment with the agency, each
294 employee must receive basic written information about
295 interacting with persons who have Alzheimer’s disease or
296 dementia-related disorders.
297 (b) In addition to the information provided under paragraph
298 (a), employees who are expected to, or whose responsibilities
299 require them to, have direct contact with participants who have
300 Alzheimer’s disease or dementia-related disorders must complete
301 initial training of at least 1 hour within the first 3 months
302 after beginning employment. The training must include an
303 overview of dementias and must provide instruction in basic
304 skills for communicating with persons who have dementia.
305 (c) In addition to the requirements of paragraphs (a) and
306 (b), an employee who will be providing direct care to a
307 participant who has Alzheimer’s disease or a dementia-related
308 disorder must complete an additional 3 hours of training within
309 9 months after beginning employment. This training must include,
310 but is not limited to, the management of problem behaviors,
311 information about promoting the patient’s independence in
312 activities of daily living, and instruction in skills for
313 working with families and caregivers.
314 (d) For certified nursing assistants, the required 4 hours
315 of training shall be part of the total hours of training
316 required annually.
317 (e) For a health care practitioner as defined in s.
318 456.001, continuing education hours taken as required by that
319 practitioner’s licensing board shall be counted toward the total
320 of 4 hours.
321 (f) For an employee who is a licensed health care
322 practitioner as defined in s. 456.001, training that is
323 sanctioned by that practitioner’s licensing board shall be
324 considered to be approved by the Department of Elderly Affairs.
325 (g) The Department of Elderly Affairs or its designee must
326 approve the required 1-hour and 3-hour training provided to
327 employees or direct caregivers under this section. The
328 department must consider for approval training offered in a
329 variety of formats. The department shall keep a list of current
330 providers who are approved to provide the 1-hour and 3-hour
331 training. The department shall adopt rules to establish
332 standards for the employees who are subject to this training,
333 for the trainers, and for the training required in this section.
334 (h) Upon completing any training described in this section,
335 the employee or direct caregiver shall be issued a certificate
336 that includes the name of the training provider, the topic
337 covered, and the date and signature of the training provider.
338 The certificate is evidence of completion of training in the
339 identified topic, and the employee or direct caregiver is not
340 required to repeat training in that topic if the employee or
341 direct caregiver changes employment to a different hospice or to
342 a home health agency, assisted living facility, nursing home, or
343 adult day care center.
344 Section 6. Subsections (2) through (8) of section 429.178,
345 Florida Statutes, are amended to read:
346 429.178 Special care for persons with Alzheimer’s disease
347 or other related disorders.—
348 (2)(a) An individual who is employed by a facility that
349 provides special care for residents who have Alzheimer’s disease
350 or other related disorders, and who has regular contact with
351 such residents, must complete the up to 4 hours of initial
352 dementia-specific training as required in s. 430.5025 developed
353 or approved by the department. The training must be completed
354 within 3 months after beginning employment and satisfy the core
355 training requirements of s. 429.52(3)(g).
356 (b) A direct caregiver who is employed by a facility that
357 provides special care for residents who have Alzheimer’s disease
358 or other related disorders and provides direct care to such
359 residents must complete the required initial training and 4
360 additional hours of training developed or approved by the
361 department. The training must be completed within 9 months after
362 beginning employment and satisfy the core training requirements
363 of s. 429.52(3)(g).
364 (c) An individual who is employed by a facility that
365 provides special care for residents with Alzheimer’s disease or
366 other related disorders, but who only has incidental contact
367 with such residents, must be given, at a minimum, general
368 information on interacting with individuals with Alzheimer’s
369 disease or other related disorders, within 3 months after
370 beginning employment.
371 (3) In addition to the training required under subsection
372 (2), a direct caregiver must participate in a minimum of 4
373 contact hours of continuing education each calendar year. The
374 continuing education must include one or more topics included in
375 the dementia-specific training developed or approved by the
376 department, in which the caregiver has not received previous
377 training.
378 (4) Upon completing any training listed in subsection (2),
379 the employee or direct caregiver shall be issued a certificate
380 that includes the name of the training provider, the topic
381 covered, and the date and signature of the training provider.
382 The certificate is evidence of completion of training in the
383 identified topic, and the employee or direct caregiver is not
384 required to repeat training in that topic if the employee or
385 direct caregiver changes employment to a different facility. The
386 employee or direct caregiver must comply with other applicable
387 continuing education requirements.
388 (5) The department, or its designee, shall approve the
389 initial and continuing education courses and providers.
390 (6) The department shall keep a current list of providers
391 who are approved to provide initial and continuing education for
392 staff of facilities that provide special care for persons with
393 Alzheimer’s disease or other related disorders.
394 (3)(7) Any facility more than 90 percent of whose residents
395 receive monthly optional supplementation payments is not
396 required to pay for the training and education programs required
397 under this section. A facility that has one or more such
398 residents must shall pay a reduced fee that is proportional to
399 the percentage of such residents in the facility. A facility
400 that does not have any residents who receive monthly optional
401 supplementation payments must pay a reasonable fee, as
402 established by the department, for such training and education
403 programs.
404 (4)(8) The department shall adopt rules to establish
405 standards for trainers and training and to implement this
406 section.
407 Section 7. Subsection (1) of section 429.52, Florida
408 Statutes, is amended to read:
409 429.52 Staff training and educational requirements.—
410 (1) Each new assisted living facility employee who has not
411 previously completed core training must attend a preservice
412 orientation provided by the facility before interacting with
413 residents. The preservice orientation must be at least 2 hours
414 in duration and cover topics that help the employee provide
415 responsible care and respond to the needs of facility residents.
416 Upon completion, the employee and the administrator of the
417 facility must sign a statement that the employee completed the
418 required preservice orientation. The facility must keep the
419 signed statement in the employee’s personnel record. Each
420 assisted living facility shall provide staff training as
421 required in s. 430.5025.
422 Section 8. Section 429.83, Florida Statutes, is amended to
423 read:
424 429.83 Residents with Alzheimer’s disease or other related
425 disorders; training; certain disclosures.—
426 (1) An adult family-care home licensed under this part must
427 provide staff training as required in s. 430.5025.
428 (2) An adult family-care home licensed under this part
429 which claims that it provides special care for persons who have
430 Alzheimer’s disease or other related disorders must Disclose in
431 its advertisements or in a separate document those services that
432 distinguish the care as being especially applicable to, or
433 suitable for, such persons. The home must give a copy of all
434 such advertisements or a copy of the document to each person who
435 requests information about programs and services for persons
436 with Alzheimer’s disease or other related disorders offered by
437 the home and must maintain a copy of all such advertisements and
438 documents in its records. The agency shall examine all such
439 advertisements and documents in the home’s records as part of
440 the license renewal procedure.
441 Section 9. Subsection (1) of section 429.917, Florida
442 Statutes, is amended to read:
443 429.917 Patients with Alzheimer’s disease or other related
444 disorders; staff training requirements; certain disclosures.—
445 (1) An adult day care center licensed under this part must
446 provide the following staff training as required in s. 430.5025:
447 (a) Upon beginning employment with the facility, each
448 employee must receive basic written information about
449 interacting with participants who have Alzheimer’s disease or
450 dementia-related disorders.
451 (b) In addition to the information provided under paragraph
452 (a), newly hired adult day care center personnel who are
453 expected to, or whose responsibilities require them to, have
454 direct contact with participants who have Alzheimer’s disease or
455 dementia-related disorders must complete initial training of at
456 least 1 hour within the first 3 months after beginning
457 employment. The training must include an overview of dementias
458 and must provide instruction in basic skills for communicating
459 with persons who have dementia.
460 (c) In addition to the requirements of paragraphs (a) and
461 (b), an employee who will be providing direct care to a
462 participant who has Alzheimer’s disease or a dementia-related
463 disorder must complete an additional 3 hours of training within
464 9 months after beginning employment. This training must include,
465 but is not limited to, the management of problem behaviors,
466 information about promoting the participant’s independence in
467 activities of daily living, and instruction in skills for
468 working with families and caregivers.
469 (d) For certified nursing assistants, the required 4 hours
470 of training shall be part of the total hours of training
471 required annually.
472 (e) For a health care practitioner as defined in s.
473 456.001, continuing education hours taken as required by that
474 practitioner’s licensing board shall be counted toward the total
475 of 4 hours.
476 (f) For an employee who is a licensed health care
477 practitioner as defined in s. 456.001, training that is
478 sanctioned by that practitioner’s licensing board shall be
479 considered to be approved by the Department of Elderly Affairs.
480 (g) The Department of Elderly Affairs or its designee must
481 approve the 1-hour and 3-hour training provided to employees and
482 direct caregivers under this section. The department must
483 consider for approval training offered in a variety of formats.
484 The department shall keep a list of current providers who are
485 approved to provide the 1-hour and 3-hour training. The
486 department shall adopt rules to establish standards for the
487 employees who are subject to this training, for the trainers,
488 and for the training required in this section.
489 (h) Upon completing any training described in this section,
490 the employee or direct caregiver shall be issued a certificate
491 that includes the name of the training provider, the topic
492 covered, and the date and signature of the training provider.
493 The certificate is evidence of completion of training in the
494 identified topic, and the employee or direct caregiver is not
495 required to repeat training in that topic if the employee or
496 direct caregiver changes employment to a different adult day
497 care center or to an assisted living facility, nursing home,
498 home health agency, or hospice. The direct caregiver must comply
499 with other applicable continuing education requirements.
500 (i) An employee who is hired on or after July 1, 2004, must
501 complete the training required by this section.
502 Section 10. This act shall take effect July 1, 2021.