Senate Bill 0188er

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    1998 Legislature                  CS for SB 188, 1st Engrossed



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  2         An act relating to transitional living

  3         facilities for brain-injured and

  4         spinal-cord-injured persons; amending s.

  5         400.805, F.S.; providing for the regulation of

  6         transitional living facilities; providing for

  7         right of entry and inspection; providing for

  8         injunctive proceedings; providing for a

  9         moratorium on admissions; amending s. 413.49,

10         F.S.; providing duties of transitional living

11         facilities to provide certain therapies and

12         plans; amending s. 413.605, F.S.; providing

13         additional duties of the advisory council on

14         brain and spinal cord injuries; providing an

15         effective date.

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17  Be It Enacted by the Legislature of the State of Florida:

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19         Section 1.  Present subsection (7) of section 400.805,

20  Florida Statutes, is redesignated as subsection (10) and new

21  subsections (7), (8), and (9) are added to that section to

22  read:

23         400.805  Transitional living facilities.--

24         (7)  Any designated officer or employee of the agency,

25  of the state or of the local fire marshal, may enter

26  unannounced upon and into the premises of any facility

27  licensed under this section in order to determine the state of

28  compliance with this section and the rules or standards in

29  force under this section. The right of entry and inspection

30  also extends to any premises that the agency has reason to

31  believe are being operated or maintained as a facility without


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    1998 Legislature                  CS for SB 188, 1st Engrossed



  1  a license; but such an entry or inspection may not be made

  2  without the permission of the owner or person in charge of the

  3  facility unless a warrant that authorizes the entry is first

  4  obtained from the circuit court. The warrant requirement

  5  extends only to a facility that the agency has reason to

  6  believe is being operated or maintained as a facility without

  7  a license. An application for a license or renewal thereof

  8  which is made under this section constitutes permission for,

  9  and acquiescence in, any entry or inspection of the premises

10  for which the license is sought, in order to facilitate

11  verification of the information submitted on or in connection

12  with the application; to discover, investigate, and determine

13  the existence of abuse or neglect; or to elicit, receive,

14  respond to, and resolve complaints. A current valid license

15  constitutes unconditional permission for, and acquiescence in,

16  any entry or inspection of the premises by authorized

17  personnel. The agency retains the right of entry and

18  inspection of facilities that have had a license revoked or

19  suspended within the previous 24 months, to ensure that the

20  facility is not operating unlawfully. However, before the

21  facility is entered, a statement of probable cause must be

22  filed with the director of the agency, who must approve or

23  disapprove the action within 48 hours. Probable cause

24  includes, but is not limited to, evidence that the facility

25  holds itself out to the public as a provider of personal

26  assistance services, or the receipt by the advisory council on

27  brain and spinal cord injuries of a complaint about the

28  facility.

29         (8)  The agency may institute injunctive proceedings in

30  a court of competent jurisdiction for temporary or permanent

31  relief to:


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    1998 Legislature                  CS for SB 188, 1st Engrossed



  1         (a)  Enforce this section or any minimum standard,

  2  rule, or order issued pursuant thereto if the agency's effort

  3  to correct a violation through administrative fines has failed

  4  or when the violation materially affects the health, safety,

  5  or welfare of residents; or

  6         (b)  Terminate the operation of a facility if a

  7  violation of this section or of any standard or rule adopted

  8  pursuant thereto exists which materially affects the health,

  9  safety, or welfare of residents.

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11  The Legislature recognizes that, in some instances, action is

12  necessary to protect residents of facilities from immediately

13  life-threatening situations. If it appears by competent

14  evidence or a sworn, substantiated affidavit that a temporary

15  injunction should issue, the court, pending the determination

16  on final hearing, shall enjoin operation of the facility.

17         (9)  The agency may impose an immediate moratorium on

18  admissions to a facility when the agency determines that any

19  condition in the facility presents a threat to the health,

20  safety, or welfare of the residents in the facility. If a

21  facility's license is denied, revoked, or suspended, the

22  facility may be subject to the immediate imposition of a

23  moratorium on admissions to run concurrently with licensure

24  denial, revocation, or suspension.

25         Section 2.  Section 413.49, Florida Statutes, is

26  amended to read:

27         413.49  Duties and responsibilities of the division, of

28  transitional living facilities, and of residents.--Consistent

29  with the mandate of s. 413.46, the division shall develop and

30  administer a multilevel treatment program for persons who have

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    1998 Legislature                  CS for SB 188, 1st Engrossed



  1  brain or spinal cord injuries and who are referred to the

  2  brain and spinal cord injury program.

  3         (1)  Within 15 days after any report of a person who

  4  has a brain or spinal cord injury, the division shall notify

  5  the individual or the most immediate available family members

  6  of their right to assistance from the state, the services

  7  available, and the eligibility requirements.

  8         (2)  The division shall refer persons who have brain or

  9  spinal cord injuries to other state agencies to assure that

10  rehabilitative services, if desired, are obtained by that

11  person.

12         (3)  The division, in consultation with emergency

13  medical service, shall develop standards for an emergency

14  medical evacuation system that will ensure that all persons

15  who sustain traumatic brain or spinal cord injuries are

16  transported to a division-approved trauma center that meets

17  the standards and criteria established by the emergency

18  medical service and the acute-care standards of the brain and

19  spinal cord injury program.

20         (4)  The division shall develop standards for

21  designation of rehabilitation centers to provide

22  rehabilitation services for persons who have brain or spinal

23  cord injuries.

24         (5)  The division shall determine the appropriate

25  number of designated acute-care facilities, inpatient

26  rehabilitation centers, and outpatient rehabilitation centers,

27  needed based on incidence, volume of admissions, and other

28  appropriate criteria.

29         (6)  The division shall develop standards for

30  designation of transitional living facilities to provide

31  individuals the opportunity to adjust to their disabilities


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    1998 Legislature                  CS for SB 188, 1st Engrossed



  1  and to develop physical and functional skills in a supported

  2  living environment.

  3         (a)  The Agency for Health Care Administration, in

  4  consultation with the division, shall develop rules for the

  5  licensure of transitional living facilities for persons who

  6  have brain or spinal cord injuries.

  7         (b)  The goal of a transitional living program for

  8  persons who have brain or spinal cord injuries is to assist

  9  each person who has such a disability to achieve a higher

10  level of independent functioning and to enable that person to

11  reenter the community. The program shall be focused on

12  preparing participants to return to community living.

13         (c)  A transitional living facility for a person who

14  has a brain or spinal cord injury shall provide to such

15  person, in a residential setting, a time-limited,

16  goal-oriented treatment program designed to improve the

17  person's physical, cognitive, communicative, behavioral,

18  psychological, and social functioning, as well as to provide

19  necessary support and supervision. A transitional living

20  facility shall offer at least the following therapies:

21  physical, occupational, speech, neuropsychology, independent

22  living skills training, behavior analysis for programs serving

23  brain-injured persons, health education, and recreation.

24         (d)  All residents shall use the transitional living

25  facility as a temporary measure and not as a permanent home or

26  domicile. The transitional living facility shall develop an

27  initial treatment plan for each resident within 3 days after

28  the resident's admission. The transitional living facility

29  shall develop a comprehensive plan of treatment and a

30  discharge plan for each resident as soon as practical but no

31  later than 30 days after the resident's admission. Each


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    1998 Legislature                  CS for SB 188, 1st Engrossed



  1  comprehensive treatment plan and discharge plan must be

  2  reviewed and updated as necessary but no less often than

  3  quarterly. This subsection does not require the discharge of

  4  an individual who continues to require any of the specialized

  5  services described in paragraph (c) or who is making

  6  measurable progress in accordance with that individual's

  7  comprehensive treatment plan. The transitional living facility

  8  shall discharge any individual who has an appropriate

  9  discharge site and who has achieved the goals of his or her

10  discharge plan or who is no longer making progress toward the

11  goals established in the comprehensive treatment plan and the

12  discharge plan. The discharge location must be the least

13  restrictive environment in which an individual's health,

14  well-being, and safety is preserved.

15         (7)  Recipients of services, under this section, from

16  any of the facilities referred to in this section shall pay a

17  fee based on ability to pay.

18         Section 3.  Subsection (4) of section 413.605, Florida

19  Statutes, is amended to read:

20         413.605  Advisory council on brain and spinal cord

21  injuries.--

22         (4)  The council shall:

23         (a)  Provide advice and expertise to the division in

24  the preparation, implementation, and periodic review of the

25  brain and spinal cord injury program as referenced in s.

26  413.49.

27         (b)  Annually appoint a five-member committee composed

28  of one person who has a brain injury or has a family member

29  with a brain injury, one person who has a spinal cord injury

30  or has a family member with a spinal cord injury, and three

31  members who shall be chosen from among these representative


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    1998 Legislature                  CS for SB 188, 1st Engrossed



  1  groups:  physicians, other allied health professionals,

  2  administrators of brain and spinal cord injury programs, and

  3  representatives from support groups with expertise in areas

  4  related to the rehabilitation of persons who have brain or

  5  spinal cord injuries, except that one and only one member of

  6  the committee shall be an administrator of a transitional

  7  living facility. Membership on the council is not a

  8  prerequisite for membership on this committee.

  9         1.  The committee shall perform onsite visits to those

10  transitional living facilities identified by the Agency for

11  Health Care Administration as being in possible violation of

12  the statutes and rules regulating such facilities. The

13  committee members have the same rights of entry and inspection

14  granted under s. 400.805(7) to designated representatives of

15  the agency.

16         2.  Factual findings of the committee resulting from an

17  onsite investigation of a facility pursuant to subparagraph 1.

18  shall be adopted by the agency in developing its

19  administrative response regarding enforcement of statutes and

20  rules regulating the operation of the facility.

21         3.  Onsite investigations by the committee shall be

22  funded by the Health Care Trust Fund.

23         4.  Travel expenses for committee members shall be

24  reimbursed in accordance with s. 112.061. Members of the

25  committee shall recuse themselves from participating in any

26  investigation that would create a conflict of interest under

27  state law, and the council shall replace the member, either

28  temporarily or permanently.

29         Section 4.  This act shall take effect October 1, 1998.

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