Florida Senate - 2009 SB 2596
By Senator Wise
5-01657-09 20092596__
1 A bill to be entitled
2 An act relating to services for persons with
3 disabilities; amending s. 393.0661, F.S.; revising
4 elements required to be included in the plan developed
5 and implemented by the agency to redesign the home and
6 community-based services delivery system; authorizing
7 the Agency for Persons with Disabilities and the
8 Agency for Health Care Administration to implement
9 pilot programs and to seek federal approval therefor;
10 requiring a report to the Governor and Legislature;
11 authorizing the agencies to adopt rules; amending s.
12 409.906, F.S.; requiring the Agency for Health Care
13 Administration, in consultation with the Agency for
14 Persons with Disabilities, to develop and implement a
15 revised procurement process for durable medical
16 equipment and supplies for clients served by
17 developmental disabilities and family and supported
18 living waivers; authorizing development of a plan to
19 use electronic debit cards for the purchase of such
20 equipment and supplies; authorizing a pilot program;
21 requiring a report to the Governor and Legislature;
22 authorizing the agencies to seek federal approval and
23 adopt rules; amending s. 39.201, F.S.; authorizing the
24 Agency for Persons with Disabilities to use
25 information in the central abuse hotline as part of
26 the licensure process; amending s. 393.063, F.S.;
27 revising the definition of “adult day training”;
28 amending s. 393.066, F.S.; requiring the agency to
29 promote adult day training services; deleting
30 provisions relating to habilitation services provided
31 for certain clients in community-based residential
32 facilities; amending s. 393.067, F.S.; revising
33 facility licensure requirements for staff training;
34 amending s. 393.0673, F.S.; providing additional
35 grounds for imposition of a fine or denial,
36 suspension, or revocation of a license; amending s.
37 393.13, F.S.; establishing the right of persons with
38 developmental disabilities to be free from abuse,
39 neglect, and exploitation in residential facilities;
40 amending s. 415.103, F.S.; providing for certain
41 reports to the central abuse hotline relating to
42 vulnerable adults to be immediately transferred to the
43 county sheriff’s office; amending s. 435.04, F.S.;
44 requiring certain residential facility and
45 developmental disabilities center personnel to be
46 screened for certain criminal offenses; correcting a
47 cross-reference; providing an effective date.
48
49 Be It Enacted by the Legislature of the State of Florida:
50
51 Section 1. Subsection (1) of section 393.0661, Florida
52 Statutes, is amended, and subsection (9) is added to that
53 section, to read:
54 393.0661 Home and community-based services delivery system;
55 comprehensive redesign.—The Legislature finds that the home and
56 community-based services delivery system for persons with
57 developmental disabilities and the availability of appropriated
58 funds are two of the critical elements in making services
59 available. Therefore, it is the intent of the Legislature that
60 the Agency for Persons with Disabilities shall develop and
61 implement a comprehensive redesign of the system.
62 (1) The redesign of the home and community-based services
63 system shall include, at a minimum, all actions necessary to
64 achieve an appropriate rate structure; ensure, client choice
65 within a specified service package; provide, appropriate
66 assessment strategies; enhance cost control and system
67 sustainability; predict costs; provide for equitable
68 distribution of available resources based on individual needs
69 assessments, client characteristics, and other assessment
70 methods; provide for increased choice among, and control over,
71 services by clients; develop an efficient billing process that
72 contains reconciliation and monitoring components, a redefined;
73 redefine the role of for support coordinators to avoid that
74 avoids potential conflicts of interest;, and ensure ensures that
75 family/client budgets are linked to levels of need.
76 (a) The agency shall use an assessment instrument that is
77 reliable and valid. The agency may contract with an external
78 vendor or may use support coordinators to complete client
79 assessments if it develops sufficient safeguards and training to
80 ensure ongoing inter-rater reliability.
81 (b) The agency, with the concurrence of the Agency for
82 Health Care Administration, may contract for the determination
83 of medical necessity and establishment of individual budgets.
84 (c) The agency may implement one or more pilot programs to
85 test elements of the plan. The Agency for Health Care
86 Administration, in consultation with the agency, may seek
87 federal approval as necessary to implement any pilot program
88 authorized under this paragraph.
89 (d) The agency and the Agency for Health Care
90 Administration may adopt any rules necessary to administer this
91 subsection.
92 (9) No later than February 1, 2010, the agency shall submit
93 a report to the Governor, the President of the Senate, and the
94 Speaker of the House of Representatives regarding the agency’s
95 plan for redesigning the home and community-based services
96 delivery system and the status of any pilot projects being
97 implemented by the agency. The report shall describe alternative
98 methods for determining the equitable distribution of resources,
99 provisions to increase consumer direction and flexibility, and
100 any estimated fiscal impact.
101 Section 2. Subsection (10) of section 409.906, Florida
102 Statutes, is amended to read:
103 409.906 Optional Medicaid services.—Subject to specific
104 appropriations, the agency may make payments for services which
105 are optional to the state under Title XIX of the Social Security
106 Act and are furnished by Medicaid providers to recipients who
107 are determined to be eligible on the dates on which the services
108 were provided. Any optional service that is provided shall be
109 provided only when medically necessary and in accordance with
110 state and federal law. Optional services rendered by providers
111 in mobile units to Medicaid recipients may be restricted or
112 prohibited by the agency. Nothing in this section shall be
113 construed to prevent or limit the agency from adjusting fees,
114 reimbursement rates, lengths of stay, number of visits, or
115 number of services, or making any other adjustments necessary to
116 comply with the availability of moneys and any limitations or
117 directions provided for in the General Appropriations Act or
118 chapter 216. If necessary to safeguard the state’s systems of
119 providing services to elderly and disabled persons and subject
120 to the notice and review provisions of s. 216.177, the Governor
121 may direct the Agency for Health Care Administration to amend
122 the Medicaid state plan to delete the optional Medicaid service
123 known as “Intermediate Care Facilities for the Developmentally
124 Disabled.” Optional services may include:
125 (10) DURABLE MEDICAL EQUIPMENT.—The agency may authorize
126 and pay for certain durable medical equipment and supplies
127 provided to a Medicaid recipient as medically necessary.
128 (a) In order to reduce costs for durable medical equipment
129 and supplies while ensuring adequate provision of services, the
130 agency, in consultation with the Agency for Persons with
131 Disabilities, shall develop and implement a revised procurement
132 process for durable medical equipment and supplies for clients
133 receiving services through the developmental disabilities and
134 family and supported living waivers. The revised procurement
135 process may include a schedule of standard prices for selected
136 products or competitive procurement on a regional or statewide
137 basis for selected products.
138 (b) The agency, in consultation with the Agency for Persons
139 with Disabilities, may develop a plan to use electronic debit
140 cards for payments for authorized purchases of durable and
141 consumable medical equipment and supplies and other goods and
142 services as determined appropriate for clients receiving
143 services through the developmental disabilities and family and
144 supported living waivers. The agency and the Agency for Persons
145 with Disabilities may implement a pilot program for the use of
146 electronic debit cards. If implemented, the pilot program shall
147 assess the technical requirements for and costs of administering
148 an electronic debit card system, analyze potential cost savings
149 to the state, and evaluate the impact on consumers, providers,
150 and the service delivery system. The Agency for Persons with
151 Disabilities shall submit a report on the status of any pilot
152 program to the Governor, the President of the Senate, and the
153 Speaker of the House of Representatives no later than December
154 15, 2010.
155 (c) The agency, in consultation with the Agency for Persons
156 with Disabilities, may seek federal approval, as necessary, and
157 may adopt rules pursuant to ss. 120.536(1) and 120.54, to
158 implement this subsection.
159 Section 3. Subsection (6) of section 39.201, Florida
160 Statutes, is amended to read:
161 39.201 Mandatory reports of child abuse, abandonment, or
162 neglect; mandatory reports of death; central abuse hotline.—
163 (6) Information in the central abuse hotline may not be
164 used for employment screening, except as provided in s.
165 39.202(2)(a) and (h). Information in the central abuse hotline
166 and the department’s automated abuse information system may be
167 used by the department, its authorized agents or contract
168 providers, the Department of Health, or county agencies as part
169 of the licensure or registration process pursuant to ss.
170 402.301-402.319 and ss. 409.175-409.176 and by the Agency for
171 Persons with Disabilities as part of the licensure process
172 pursuant to ss. 393.067 and 393.0673.
173 Section 4. Subsection (2) of section 393.063, Florida
174 Statutes, is amended to read:
175 393.063 Definitions.—For the purposes of this chapter, the
176 term:
177 (2) “Adult day training” means training services that which
178 take place in a nonresidential setting offsite and, separate
179 from the home or facility in which the client resides; are
180 intended to support the participation of clients in daily,
181 meaningful, and valued routines of the community; and may
182 include work-like settings that do not meet the definition of
183 supported employment.
184 Section 5. Subsection (5) of section 393.066, Florida
185 Statutes, is amended to read:
186 393.066 Community services and treatment.—
187 (5) In order to improve the potential for utilization of
188 more cost-effective, community-based programs residential
189 facilities, the agency shall promote the statewide development
190 of adult day training habilitation services for clients who live
191 with a direct service provider in a community-based residential
192 facility and who do not require 24-hour-a-day care in a hospital
193 or other health care institution, but who may, in the absence of
194 day habilitation services, require admission to a developmental
195 disabilities center. Each adult day training service facility
196 shall provide a protective physical environment for clients and,
197 ensure that direct service providers meet minimum screening
198 standards as required in s. 393.0655, make available to all day
199 habilitation service participants at least one meal on each day
200 of operation, provide facilities to enable participants to
201 obtain needed rest while attending the program, as appropriate,
202 and provide social and educational activities designed to
203 stimulate interest and provide socialization skills.
204 Section 6. Subsections (4), (7), and (9) of section
205 393.067, Florida Statutes, are amended to read:
206 393.067 Facility licensure.—
207 (4) The application shall be signed under oath and shall
208 contain the following:
209 (a) The name and address of the applicant, if an applicant
210 is an individual; if the applicant is a firm, partnership, or
211 association, the name and address of each member thereof; if the
212 applicant is a corporation, its name and address and the name
213 and address of each director and each officer thereof; and the
214 name by which the facility or program is to be known.
215 (b) The location of the facility or program for which a
216 license is sought.
217 (c) The name of the person or persons under whose
218 management or supervision the facility or program will be
219 conducted.
220 (d) The number and type of residents or clients for which
221 maintenance, care, education, or treatment is to be provided by
222 the facility or program.
223 (e) The number and location of the component centers or
224 units which will compose the comprehensive transitional
225 education program.
226 (f) A description of the types of services and treatment to
227 be provided by the facility or program.
228 (g) Information relating to the number, experience, and
229 training of the employees of the facility or program.
230 (h) Certification that the staff of the facility or program
231 will receive training to detect, report, and prevent sexual
232 abuse, neglect, and exploitation of residents and clients.
233 (i) Such other information as the agency determines is
234 necessary to carry out the provisions of this chapter.
235 (7) The agency shall adopt rules establishing minimum
236 standards for facilities and programs licensed under this
237 section, including rules requiring facilities and programs to
238 train staff to detect, report, and prevent sexual abuse,
239 neglect, and exploitation of residents and clients, minimum
240 standards of quality and adequacy of client care, incident
241 reporting requirements, and uniform firesafety standards
242 established by the State Fire Marshal which are appropriate to
243 the size of the facility or of the component centers or units of
244 the program.
245 (9) The agency may conduct unannounced inspections to
246 determine compliance by foster care facilities, group home
247 facilities, residential habilitation centers, and comprehensive
248 transitional education programs with the applicable provisions
249 of this chapter and the rules adopted pursuant hereto, including
250 the rules adopted for training staff of a facility or a program
251 to detect, report, and prevent sexual abuse, neglect, and
252 exploitation of residents and clients. The facility or program
253 shall make copies of inspection reports available to the public
254 upon request.
255 Section 7. Paragraph (b) of subsection (1) and paragraph
256 (b) of subsection (2) of section 393.0673, Florida Statutes, are
257 amended to read:
258 393.0673 Denial, suspension, or revocation of license;
259 moratorium on admissions; administrative fines; procedures.—
260 (1) The agency may revoke or suspend a license or impose an
261 administrative fine, not to exceed $1,000 per violation per day,
262 if:
263 (b) The Department of Children and Family Services has
264 verified that the licensee is responsible for the abuse,
265 neglect, or abandonment of a child as those terms are defined in
266 s. 39.01 or the abuse, sexual abuse, neglect, or exploitation of
267 a vulnerable adult as those terms are defined in s. 415.102.
268 (2) The agency may deny an application for licensure
269 submitted under s. 393.067 if:
270 (b) The Department of Children and Family Services has
271 verified that the applicant is responsible for the abuse,
272 neglect, or abandonment of a child as those terms are defined in
273 s. 39.01 or the abuse, sexual abuse, neglect, or exploitation of
274 a vulnerable adult as those terms are defined in s. 415.102.
275 Section 8. Paragraph (a) of subsection (3) of section
276 393.13, Florida Statutes, is amended to read:
277 393.13 Treatment of persons with developmental
278 disabilities.—
279 (3) RIGHTS OF ALL PERSONS WITH DEVELOPMENTAL DISABILITIES.
280 The rights described in this subsection shall apply to all
281 persons with developmental disabilities, whether or not such
282 persons are clients of the agency.
283 (a) Persons with developmental disabilities shall have a
284 right to dignity, privacy, and humane care, including the right
285 to be free from sexual abuse, neglect, and exploitation in
286 residential facilities.
287 Section 9. Paragraph (c) of subsection (1) of section
288 415.103, Florida Statutes, is amended to read:
289 415.103 Central abuse hotline.—
290 (1) The department shall establish and maintain a central
291 abuse hotline that receives all reports made pursuant to s.
292 415.1034 in writing or through a single statewide toll-free
293 telephone number. Any person may use the statewide toll-free
294 telephone number to report known or suspected abuse, neglect, or
295 exploitation of a vulnerable adult at any hour of the day or
296 night, any day of the week. The central abuse hotline must be
297 operated in such a manner as to enable the department to:
298 (c) Immediately transfer calls to the appropriate county
299 sheriff’s office if the report is of known or suspected abuse,
300 neglect, or exploitation of a vulnerable adult by someone other
301 than a relative, caregiver, or household member and, when
302 appropriate, refer calls that do not allege the abuse, neglect,
303 or exploitation of a vulnerable adult to other organizations
304 that might better resolve the reporter’s concerns.
305 Section 10. Subsection (4) of section 435.04, Florida
306 Statutes, is amended to read:
307 435.04 Level 2 screening standards.—
308 (4) Standards must also ensure that the person:
309 (a) For employees or employers licensed or registered
310 pursuant to chapter 400 or chapter 429, and for employees and
311 employers at a residential facility licensed under chapter 393
312 or a developmental disabilities center as defined in s. 393.063
313 who are required to undergo employment screening pursuant to s.
314 393.0655 or s. 400.964, has not been convicted of, regardless of
315 adjudication, or entered a plea of guilty or nolo contendere to,
316 any offense prohibited under any of the following provisions of
317 the Florida Statutes or under any similar statute of another
318 jurisdiction: does not have a confirmed report of abuse,
319 neglect, or exploitation as defined in s. 415.102(6), which has
320 been uncontested or upheld under s. 415.103.
321 1. Sections 409.920 and 409.9201, relating to Medicaid
322 fraud.
323 2. Chapter 784, relating to assault, battery, and culpable
324 negligence, if the offense is a felony.
325 3. Section 810.02, relating to burglary, if the offense is
326 a felony.
327 4. Section 817.034, relating to communications fraud.
328 5. Section 817.234, relating to false and fraudulent
329 insurance claims.
330 6. Section 817.505, relating to patient brokering.
331 7. Section 817.568, relating to criminal use of personal
332 identification information.
333 8. Sections 817.60 and 817.61, relating to theft of, and
334 fraudulent use of, credit cards, if the offense is a felony.
335 9. Sections 831.01, 831.02, 831.07, 831.09, 831.30, and
336 831.31, relating to forgery, uttering, and counterfeiting.
337 (b) Has not committed an act that constitutes domestic
338 violence as defined in s. 741.28 741.30.
339 Section 11. This act shall take effect July 1, 2009.