Florida Senate - 2021 CS for CS for SB 634
By the Committees on Children, Families, and Elder Affairs; and
Health Policy; and Senators Gibson, Baxley, Farmer, and Torres
586-03584-21 2021634c2
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 the Department of Elderly
5 Affairs or its designee to develop or approve certain
6 dementia-related training by a specified date;
7 requiring such training to be offered in a variety of
8 formats; authorizing the department or its designee to
9 approve existing training courses and curricula if
10 they meet certain requirements; requiring the
11 department or its designee to develop a registration
12 process for training providers; specifying
13 requirements for such registration; requiring the
14 department or its designee to issue unique identifiers
15 to approved training providers; requiring training
16 providers to issue employees a certificate upon
17 completing the training and passing the assessments;
18 providing requirements for the certificate; providing
19 that certain employees do not need to repeat certain
20 training when changing employment, under certain
21 circumstances; providing that copies of training
22 certificates for employees and direct care workers
23 must be available for inspection as a requirement of
24 facility licensure; requiring certain entities to
25 provide specified dementia-related training for new
26 employees within a specified timeframe; requiring such
27 entities to maintain copies of the employees’ training
28 certificates; providing that employees who complete
29 such training do not need to repeat the training upon
30 change of employment under certain circumstances;
31 requiring certain employees to receive additional
32 dementia-related training under certain circumstances
33 within a specified timeframe; providing requirements
34 for the training; requiring biennial dementia-related
35 training for certain employees; providing that such
36 training counts toward a certified nursing assistant’s
37 annual training requirements; providing that such
38 training may be used to count toward certain core
39 training requirements; requiring certain employees to
40 receive additional training within a specified
41 timeframe if the employing entity advertises that it
42 provides certain special care for individuals with
43 Alzheimer’s disease or related disorders; providing
44 that such additional training counts toward a
45 certified nursing assistant’s annual training
46 requirements; authorizing certain health care
47 practitioners to count certain continuing education
48 hours toward the dementia-related training
49 requirements under certain circumstances; requiring
50 the department to approve such continuing education
51 hours to satisfy the dementia-related training
52 requirements; amending ss. 400.1755, 400.4785,
53 400.6045, 429.178, 429.52, 429.83, and 429.917, F.S.;
54 revising dementia-related staff training requirements
55 for nursing homes, home health agencies, hospices,
56 facilities that provide special care for persons with
57 Alzheimer’s disease or related disorders, assisted
58 living facilities, adult family-care homes, and adult
59 day care centers, respectively, to conform to changes
60 made by the act; providing an effective date.
61
62 Be It Enacted by the Legislature of the State of Florida:
63
64 Section 1. This act may be cited as the “Florida
65 Alzheimer’s Disease and Dementia Training Act.”
66 Section 2. Section 430.5025, Florida Statutes, is created
67 to read:
68 430.5025 Care for persons with Alzheimer’s disease or a
69 related disorder; staff training.—
70 (1) As used in this section, the term:
71 (a) “Department” means the Department of Elderly Affairs.
72 (b) “Direct care worker” means an individual who, as part
73 of his or her employment duties, provides or is expected to
74 provide direct contact assistance with personal care or
75 activities of daily living to clients, patients, or residents of
76 any facility licensed under part II, part III, or part IV of
77 chapter 400 or chapter 429.
78 (c) “Employee” means any staff member, contracted staff, or
79 independent contractor hired or referred by a licensee who is
80 required to have a level 2 background screening as required by
81 s. 408.809(1)(e). The term includes, but is not limited to,
82 direct care workers; staff responsible for housekeeping, the
83 front desk, maintenance, and other administrative functions; and
84 companions or homemakers.
85 (d) “Licensee” means a person or an entity licensed under
86 part II, part III, or part IV of chapter 400 or chapter 429.
87 (2) By January 1, 2022, the department or its designee must
88 develop or approve the courses that licensees may use to satisfy
89 the training requirements under this section. The department or
90 its designee must develop or approve training offered in a
91 variety of formats and languages, including, but not limited to,
92 Internet-based training, videos, teleconferencing, and classroom
93 instruction. The department or its designee may approve any
94 existing training course or curriculum that is being used by
95 licensees if it meets the requirements of this section.
96 (3) The department or its designee shall develop a process
97 for registering training providers and maintain a list of those
98 providers approved to provide training required under this
99 section. The process must take into account those training
100 providers who are already approved and include a method to
101 verify that all training providers are actively providing
102 training required under this section. To be approved, a training
103 provider must have at least 2 years of experience related to
104 Alzheimer’s disease or related disorders, gerontology, health
105 care, or a related field. The department or its designee shall
106 issue each approved training provider a unique registration
107 identifier.
108 (4) Upon completion of any training under this section, the
109 training provider must issue the employee or direct care worker
110 a certificate that includes the training provider’s name and
111 unique identifier, the topic covered in the training, the date
112 of completion, and the signature of the training provider. The
113 certificate is evidence of completion of the training and
114 assessment in the identified topic, and the employee or direct
115 care worker is not required to repeat training in that topic if
116 he or she changes employment to a different licensee, but he or
117 she must comply with any applicable continuing education
118 requirements under this section. Copies of the employee’s or
119 direct care worker’s training certificate issued under this
120 section must be available for inspection in each facility in
121 which he or she may be employed in order to meet the
122 requirements of that facility’s licensure.
123 (5) Licensees must provide to each of their employees 1
124 hour of dementia-related training that includes methods for
125 interacting with individuals with Alzheimer’s disease or a
126 related disorder and for identifying warning signs of dementia.
127 (a) A licensee must require an employee to complete the
128 training within 30 days after employment begins. Employees hired
129 on or before October 1, 2021, must be required to complete the
130 training within 3 months after the training is developed or
131 approved pursuant to subsection (2).
132 (b) A licensee must maintain a copy of the employee’s
133 training certificate in the employee’s personnel records.
134 (c) An employee who has completed the training required by
135 this subsection is not required to repeat the course upon
136 changing employment to a different licensee if he or she has a
137 copy of the training certificate.
138 (6) In addition to the training requirements of subsection
139 (5), licensees must require all employees who are direct care
140 workers to receive at least 3 hours of evidence-based training
141 developed or approved pursuant to subsection (2). The training
142 must be completed within the first 4 months after employment
143 begins and must include, but need not be limited to, an overview
144 of Alzheimer’s disease and related disorders and person-centered
145 care, assessment and care planning, activities of daily living,
146 and dementia-related behaviors and communication for clients,
147 patients, and residents with Alzheimer’s disease or a related
148 disorder. Except for providers licensed under part IV of chapter
149 400, every 2 calendar years thereafter, the licensee must
150 require all of its direct care workers to receive at least 2
151 hours of continuing education, developed or approved pursuant to
152 subsection (2), on these topics and any related changes in state
153 or federal law.
154 (a) Employees hired on or before October 1, 2021, must
155 complete the training under this subsection within 6 months
156 after the training is developed or approved pursuant to
157 subsection (2) if they have not received any applicable
158 dementia-related training within the preceding calendar year.
159 (b) Completion of the 2 hours of continuing education under
160 this subsection counts toward a certified nursing assistant’s
161 annual training requirements.
162 (c) Continuing education under this subsection may count
163 toward core training requirements as described under s. 429.52.
164 (7) In addition to the training requirements of subsections
165 (5) and (6), if a licensee advertises that it provides special
166 care for individuals with Alzheimer’s disease or a related
167 disorder which includes direct care to such individuals, the
168 licensee must require its direct care workers to complete 4
169 hours of training developed or approved pursuant to subsection
170 (2). This training must be completed within 4 months after
171 employment begins and shall count toward a certified nursing
172 assistant’s annual training requirements.
173 (8) If a health care practitioner as defined in s. 456.001
174 completes continuing education hours as required by that
175 practitioner’s licensing board, he or she may count those
176 continuing education hours toward satisfaction of the training
177 requirements of subsections (5) and (6) if the course curriculum
178 covers the topics required under those subsections. The
179 department must approve such continuing education hours for
180 purposes of satisfying the training requirements of subsections
181 (5) and (6).
182 Section 3. Section 400.1755, Florida Statutes, is amended
183 to read:
184 400.1755 Care for persons with Alzheimer’s disease or
185 related disorders; staff training requirements.—
186 (1) As a condition of licensure, facilities licensed under
187 this part must provide to each of their employees training as
188 required in s. 430.5025, upon beginning employment, basic
189 written information about interacting with persons with
190 Alzheimer’s disease or a related disorder.
191 (2) All employees who are expected to, or whose
192 responsibilities require them to, have direct contact with
193 residents with Alzheimer’s disease or a related disorder must,
194 in addition to being provided the information required in
195 subsection (1), also have an initial training of at least 1 hour
196 completed in the first 3 months after beginning employment. This
197 training must include, but is not limited to, an overview of
198 dementias and must provide basic skills in communicating with
199 persons with dementia.
200 (3) An individual who provides direct care shall be
201 considered a direct caregiver and must complete the required
202 initial training and an additional 3 hours of training within 9
203 months after beginning employment. This training shall include,
204 but is not limited to, managing problem behaviors, promoting the
205 resident’s independence in activities of daily living, and
206 skills in working with families and caregivers.
207 (a) The required 4 hours of training for certified nursing
208 assistants are part of the total hours of training required
209 annually.
210 (b) For a health care practitioner as defined in s.
211 456.001, continuing education hours taken as required by that
212 practitioner’s licensing board shall be counted toward this
213 total of 4 hours.
214 (4) For an employee who is a licensed health care
215 practitioner as defined in s. 456.001, training that is
216 sanctioned by that practitioner’s licensing board shall be
217 considered to be approved by the Department of Elderly Affairs.
218 (5) The Department of Elderly Affairs or its designee must
219 approve the initial and continuing training provided in the
220 facilities. The department must approve training offered in a
221 variety of formats, including, but not limited to, Internet
222 based training, videos, teleconferencing, and classroom
223 instruction. The department shall keep a list of current
224 providers who are approved to provide initial and continuing
225 training. The department shall adopt rules to establish
226 standards for the trainers and the training required in this
227 section.
228 (6) Upon completing any training listed in this section,
229 the employee or direct caregiver shall be issued a certificate
230 that includes the name of the training provider, the topic
231 covered, and the date and signature of the training provider.
232 The certificate is evidence of completion of training in the
233 identified topic, and the employee or direct caregiver is not
234 required to repeat training in that topic if the employee or
235 direct caregiver changes employment to a different facility or
236 to an assisted living facility, home health agency, adult day
237 care center, or adult family-care home. The direct caregiver
238 must comply with other applicable continuing education
239 requirements.
240 Section 4. Section 400.4785, Florida Statutes, is amended
241 to read:
242 400.4785 Patients with Alzheimer’s disease or other related
243 disorders; staff training requirements; certain disclosures.—
244 (1) A home health agency must provide the following staff
245 training as required in s. 430.5025:
246 (a) Upon beginning employment with the agency, each
247 employee must receive basic written information about
248 interacting with participants who have Alzheimer’s disease or
249 dementia-related disorders.
250 (b) In addition to the information provided under paragraph
251 (a), newly hired home health agency personnel who will be
252 providing direct care to patients must complete 2 hours of
253 training in Alzheimer’s disease and dementia-related disorders
254 within 9 months after beginning employment with the agency. This
255 training must include, but is not limited to, an overview of
256 dementia, a demonstration of basic skills in communicating with
257 persons who have dementia, the management of problem behaviors,
258 information about promoting the client’s independence in
259 activities of daily living, and instruction in skills for
260 working with families and caregivers.
261 (c) For certified nursing assistants, the required 2 hours
262 of training shall be part of the total hours of training
263 required annually.
264 (d) For a health care practitioner as defined in s.
265 456.001, continuing education hours taken as required by that
266 practitioner’s licensing board shall be counted toward the total
267 of 2 hours.
268 (e) For an employee who is a licensed health care
269 practitioner as defined in s. 456.001, training that is
270 sanctioned by that practitioner’s licensing board shall be
271 considered to be approved by the Department of Elderly Affairs.
272 (f) The Department of Elderly Affairs, or its designee,
273 must approve the required training. The department must consider
274 for approval training offered in a variety of formats. The
275 department shall keep a list of current providers who are
276 approved to provide the 2-hour training. The department shall
277 adopt rules to establish standards for the employees who are
278 subject to this training, for the trainers, and for the training
279 required in this section.
280 (g) Upon completing the training listed in this section,
281 the employee shall be issued a certificate that states that the
282 training mandated under this section has been received. The
283 certificate shall be dated and signed by the training provider.
284 The certificate is evidence of completion of this training, and
285 the employee is not required to repeat this training if the
286 employee changes employment to a different home health agency.
287 (2)(h) A licensed home health agency whose unduplicated
288 census during the most recent calendar year was composed
289 comprised of at least 90 percent of individuals aged 21 years or
290 younger at the date of admission is exempt from the training
291 requirements in this section.
292 (3)(2) An agency licensed under this part which claims that
293 it provides special care for persons who have Alzheimer’s
294 disease or other related disorders must disclose in its
295 advertisements or in a separate document those services that
296 distinguish the care as being especially applicable to, or
297 suitable for, such persons. The agency must give a copy of all
298 such advertisements or a copy of the document to each person who
299 requests information about the agency and must maintain a copy
300 of all such advertisements and documents in its records. The
301 Agency for Health Care Administration shall examine all such
302 advertisements and documents in the agency’s records as part of
303 the license renewal procedure.
304 Section 5. Subsection (1) of section 400.6045, Florida
305 Statutes, is amended to read:
306 400.6045 Patients with Alzheimer’s disease or other related
307 disorders; staff training requirements; certain disclosures.—
308 (1) A hospice licensed under this part must provide the
309 following staff training as required in s. 430.5025:
310 (a) Upon beginning employment with the agency, each
311 employee must receive basic written information about
312 interacting with persons who have Alzheimer’s disease or
313 dementia-related disorders.
314 (b) In addition to the information provided under paragraph
315 (a), employees who are expected to, or whose responsibilities
316 require them to, have direct contact with participants who have
317 Alzheimer’s disease or dementia-related disorders must complete
318 initial training of at least 1 hour within the first 3 months
319 after beginning employment. The training must include an
320 overview of dementias and must provide instruction in basic
321 skills for communicating with persons who have dementia.
322 (c) In addition to the requirements of paragraphs (a) and
323 (b), an employee who will be providing direct care to a
324 participant who has Alzheimer’s disease or a dementia-related
325 disorder must complete an additional 3 hours of training within
326 9 months after beginning employment. This training must include,
327 but is not limited to, the management of problem behaviors,
328 information about promoting the patient’s independence in
329 activities of daily living, and instruction in skills for
330 working with families and caregivers.
331 (d) For certified nursing assistants, the required 4 hours
332 of training shall be part of the total hours of training
333 required annually.
334 (e) For a health care practitioner as defined in s.
335 456.001, continuing education hours taken as required by that
336 practitioner’s licensing board shall be counted toward the total
337 of 4 hours.
338 (f) For an employee who is a licensed health care
339 practitioner as defined in s. 456.001, training that is
340 sanctioned by that practitioner’s licensing board shall be
341 considered to be approved by the Department of Elderly Affairs.
342 (g) The Department of Elderly Affairs or its designee must
343 approve the required 1-hour and 3-hour training provided to
344 employees or direct caregivers under this section. The
345 department must consider for approval training offered in a
346 variety of formats. The department shall keep a list of current
347 providers who are approved to provide the 1-hour and 3-hour
348 training. The department shall adopt rules to establish
349 standards for the employees who are subject to this training,
350 for the trainers, and for the training required in this section.
351 (h) Upon completing any training described in this section,
352 the employee or direct caregiver shall be issued a certificate
353 that includes the name of the training provider, the topic
354 covered, and the date and signature of the training provider.
355 The certificate is evidence of completion of training in the
356 identified topic, and the employee or direct caregiver is not
357 required to repeat training in that topic if the employee or
358 direct caregiver changes employment to a different hospice or to
359 a home health agency, assisted living facility, nursing home, or
360 adult day care center.
361 Section 6. Subsections (2) through (8) of section 429.178,
362 Florida Statutes, are amended to read:
363 429.178 Special care for persons with Alzheimer’s disease
364 or other related disorders.—
365 (2)(a) An individual who is employed by a facility that
366 provides special care for residents who have Alzheimer’s disease
367 or other related disorders, and who has regular contact with
368 such residents, must complete the up to 4 hours of initial
369 dementia-specific training as required in s. 430.5025 developed
370 or approved by the department. The training must be completed
371 within 3 months after beginning employment and satisfy the core
372 training requirements of s. 429.52(3)(g).
373 (b) A direct caregiver who is employed by a facility that
374 provides special care for residents who have Alzheimer’s disease
375 or other related disorders and provides direct care to such
376 residents must complete the required initial training and 4
377 additional hours of training developed or approved by the
378 department. The training must be completed within 9 months after
379 beginning employment and satisfy the core training requirements
380 of s. 429.52(3)(g).
381 (c) An individual who is employed by a facility that
382 provides special care for residents with Alzheimer’s disease or
383 other related disorders, but who only has incidental contact
384 with such residents, must be given, at a minimum, general
385 information on interacting with individuals with Alzheimer’s
386 disease or other related disorders, within 3 months after
387 beginning employment.
388 (3) In addition to the training required under subsection
389 (2), a direct caregiver must participate in a minimum of 4
390 contact hours of continuing education each calendar year. The
391 continuing education must include one or more topics included in
392 the dementia-specific training developed or approved by the
393 department, in which the caregiver has not received previous
394 training.
395 (4) Upon completing any training listed in subsection (2),
396 the employee or direct caregiver shall be issued a certificate
397 that includes the name of the training provider, the topic
398 covered, and the date and signature of the training provider.
399 The certificate is evidence of completion of training in the
400 identified topic, and the employee or direct caregiver is not
401 required to repeat training in that topic if the employee or
402 direct caregiver changes employment to a different facility. The
403 employee or direct caregiver must comply with other applicable
404 continuing education requirements.
405 (5) The department, or its designee, shall approve the
406 initial and continuing education courses and providers.
407 (6) The department shall keep a current list of providers
408 who are approved to provide initial and continuing education for
409 staff of facilities that provide special care for persons with
410 Alzheimer’s disease or other related disorders.
411 (3)(7) Any facility more than 90 percent of whose residents
412 receive monthly optional supplementation payments is not
413 required to pay for the training and education programs required
414 under this section. A facility that has one or more such
415 residents must shall pay a reduced fee that is proportional to
416 the percentage of such residents in the facility. A facility
417 that does not have any residents who receive monthly optional
418 supplementation payments must pay a reasonable fee, as
419 established by the department, for such training and education
420 programs.
421 (4)(8) The department shall adopt rules to establish
422 standards for trainers and training and to implement this
423 section.
424 Section 7. Subsection (1) of section 429.52, Florida
425 Statutes, is amended to read:
426 429.52 Staff training and educational requirements.—
427 (1) Each new assisted living facility employee who has not
428 previously completed core training must attend a preservice
429 orientation provided by the facility before interacting with
430 residents. The preservice orientation must be at least 2 hours
431 in duration and cover topics that help the employee provide
432 responsible care and respond to the needs of facility residents.
433 Upon completion, the employee and the administrator of the
434 facility must sign a statement that the employee completed the
435 required preservice orientation. The facility must keep the
436 signed statement in the employee’s personnel record. Each
437 assisted living facility shall provide staff training as
438 required in s. 430.5025.
439 Section 8. Section 429.83, Florida Statutes, is amended to
440 read:
441 429.83 Residents with Alzheimer’s disease or other related
442 disorders; training; certain disclosures.—
443 (1) An adult family-care home licensed under this part must
444 provide staff training as required in s. 430.5025.
445 (2) An adult family-care home licensed under this part
446 which claims that it provides special care for persons who have
447 Alzheimer’s disease or other related disorders must Disclose in
448 its advertisements or in a separate document those services that
449 distinguish the care as being especially applicable to, or
450 suitable for, such persons. The home must give a copy of all
451 such advertisements or a copy of the document to each person who
452 requests information about programs and services for persons
453 with Alzheimer’s disease or other related disorders offered by
454 the home and must maintain a copy of all such advertisements and
455 documents in its records. The agency shall examine all such
456 advertisements and documents in the home’s records as part of
457 the license renewal procedure.
458 Section 9. Subsection (1) of section 429.917, Florida
459 Statutes, is amended to read:
460 429.917 Patients with Alzheimer’s disease or other related
461 disorders; staff training requirements; certain disclosures.—
462 (1) An adult day care center licensed under this part must
463 provide the following staff training as required in s. 430.5025:
464 (a) Upon beginning employment with the facility, each
465 employee must receive basic written information about
466 interacting with participants who have Alzheimer’s disease or
467 dementia-related disorders.
468 (b) In addition to the information provided under paragraph
469 (a), newly hired adult day care center personnel who are
470 expected to, or whose responsibilities require them to, have
471 direct contact with participants who have Alzheimer’s disease or
472 dementia-related disorders must complete initial training of at
473 least 1 hour within the first 3 months after beginning
474 employment. The training must include an overview of dementias
475 and must provide instruction in basic skills for communicating
476 with persons who have dementia.
477 (c) In addition to the requirements of paragraphs (a) and
478 (b), an employee who will be providing direct care to a
479 participant who has Alzheimer’s disease or a dementia-related
480 disorder must complete an additional 3 hours of training within
481 9 months after beginning employment. This training must include,
482 but is not limited to, the management of problem behaviors,
483 information about promoting the participant’s independence in
484 activities of daily living, and instruction in skills for
485 working with families and caregivers.
486 (d) For certified nursing assistants, the required 4 hours
487 of training shall be part of the total hours of training
488 required annually.
489 (e) For a health care practitioner as defined in s.
490 456.001, continuing education hours taken as required by that
491 practitioner’s licensing board shall be counted toward the total
492 of 4 hours.
493 (f) For an employee who is a licensed health care
494 practitioner as defined in s. 456.001, training that is
495 sanctioned by that practitioner’s licensing board shall be
496 considered to be approved by the Department of Elderly Affairs.
497 (g) The Department of Elderly Affairs or its designee must
498 approve the 1-hour and 3-hour training provided to employees and
499 direct caregivers under this section. The department must
500 consider for approval training offered in a variety of formats.
501 The department shall keep a list of current providers who are
502 approved to provide the 1-hour and 3-hour training. The
503 department shall adopt rules to establish standards for the
504 employees who are subject to this training, for the trainers,
505 and for the training required in this section.
506 (h) Upon completing any training described in this section,
507 the employee or direct caregiver shall be issued a certificate
508 that includes the name of the training provider, the topic
509 covered, and the date and signature of the training provider.
510 The certificate is evidence of completion of training in the
511 identified topic, and the employee or direct caregiver is not
512 required to repeat training in that topic if the employee or
513 direct caregiver changes employment to a different adult day
514 care center or to an assisted living facility, nursing home,
515 home health agency, or hospice. The direct caregiver must comply
516 with other applicable continuing education requirements.
517 (i) An employee who is hired on or after July 1, 2004, must
518 complete the training required by this section.
519 Section 10. This act shall take effect October 1, 2021.