HB 13

1	A bill to be entitled
2	An act relating to the Department of Elderly Affairs;
3	amending s. 20.41, F.S.; deleting provisions relating to
4	contracts by the department with area agencies on aging
5	for certain services; deleting provisions relating to
6	appointment, duties, and responsibilities of the executive
7	director of the area agencies on aging board; providing
8	that certain administering agencies under contract with
9	the department are subject to public records and public
10	meetings requirements; creating s. 430.011, F.S.; defining
11	the terms "department," "secretary," and "planning and
12	service area"; amending s. 430.04, F.S.; deleting
13	provisions relating to the designation of an area agency
14	on aging; amending s. 430.05, F.S.; revising the
15	composition of the membership of the Department of Elderly
16	Affairs Advisory Council; amending s. 430.071, F.S.;
17	revising and deleting definitions and defining the terms
18	"homebound elderly individual" and "RELIEF program";
19	providing that RELIEF services may be delivered to a
20	homebound elderly individual in certain places; providing
21	criteria for eligibility to receive respite services;
22	authorizing the department to give priority for services
23	to persons who are most in need of services in order to
24	prevent their institutionalization; providing duties of
25	the department with respect to administration of the
26	RELIEF program and volunteer services; authorizing the
27	department to adopt rules for the RELIEF program; amending
28	s. 430.101, F.S.; revising provisions to conform to
29	changes made by the act; creating s. 430.103, F.S.;
30	providing for the administration of federal programs for
31	the aged; defining terms; providing for responsibilities
32	of the department and each area agency on aging;
33	authorizing the department to adopt rules authorizing the
34	department to impose penalties and sanctions on an area
35	agency under certain specified circumstances; amending s.
36	430.201, F.S.; conforming a cross-reference; amending s.
37	430.202, F.S.; requiring that the community care for the
38	elderly program be operated through public or private
39	agencies that are not agencies of the state; providing an
40	exception; amending s. 430.203, F.S.; revising and
41	deleting definitions and adding a definition for the term
42	"case management"; amending s. 430.204, F.S.; revising the
43	responsibilities and duties of the department in
44	administering the community-care-for-the-elderly program;
45	directing the department to adopt specified rules;
46	requiring the department to contract with an administering
47	entity in each community care service area; requiring the
48	administrating entity to designate a lead agency in the
49	community care service area; providing duties for
50	administering entities; providing duties for each lead
51	agency; requiring a lead agency to ensure that case
52	management and core services are available to clients in
53	the community care service area; providing eligibility
54	criteria for case management and core services; providing
55	that certain abused adults are entitled to primary
56	consideration for services; requiring training programs;
57	directing eligible persons to the Medicaid program in
58	order to conserve funds of the community-care-for-the-
59	elderly program; authorizing the department to conduct
60	certain demonstration projects; creating s. 430.2043,
61	F.S.; providing procedures for the competitive selection
62	of lead agencies and core service providers; providing for
63	the submission of proposals and the scoring of the
64	proposals; providing that the secretary may waive the
65	competitive-procurement process under specified
66	circumstances; creating s. 430.2045, F.S.; requiring the
67	department to adopt rules to administer the community-
68	care-for-the-elderly program; creating s. 430.2051, F.S.;
69	requiring the department and the Agency for Health Care
70	Administration to create an integrated long-term-care
71	delivery system; providing duties; providing for
72	administration of case management services; authorizing
73	the agency to adopt rules; providing for a service
74	utilization reporting system; requiring integration of
75	specified data systems into one information system within
76	a certain time period; requiring the agency, in
77	consultation with the department, to evaluate the
78	Alzheimer's Disease waiver program and the Adult Day
79	Health Care waiver program; requiring the agency, in
80	consultation with the department, to begin discussions
81	with the federal Centers for Medicare and Medicaid
82	Services regarding the inclusion of Medicare into the
83	integrated long-term-care system; requiring the agency to
84	provide the Governor, the President of the Senate, and the
85	Speaker of the House of Representatives a plan for
86	including Medicare in the integrated long-term-care
87	system; creating s. 430.5001, F.S.; authorizing the
88	department to adopt rules for the Alzheimer's Disease
89	Initiative; amending s. 430.502, F.S.; requiring
90	Alzheimer's respite provider organizations to assess and
91	collect service fees; requiring the department to prepare
92	a fee schedule; amending ss. 430.602, 430.603, 430.604,
93	and 430.606, F.S.; conforming provisions to changes made
94	by the act; amending ss. 400.126, 409.912, 420.36,
95	430.207, 430.504, and 430.705, F.S., conforming cross-
96	references; repealing ss. 430.205, 430.2053, and 430.503,
97	F.S., relating to the community care service system, aging
98	resource centers, and the Alzheimer's Disease Initiative;
99	providing an effective date.
100
101	Be It Enacted by the Legislature of the State of Florida:
102
103	Section 1.  Section 20.41, Florida Statutes, is amended to
104	read:
105	20.41  Department of Elderly Affairs.--There is created a
106	Department of Elderly Affairs.
107	(1)  The head of the department is the Secretary of Elderly
108	Affairs. The secretary must be appointed by the Governor,
109	subject to confirmation by the Senate. The secretary serves at
110	the pleasure of the Governor. The secretary shall administer the
111	affairs of the department and may employ assistants,
112	professional staff, and other employees as necessary to
113	discharge the powers and duties of the department.
114	(2)  The department shall plan and administer its programs
115	and services through planning and service areas as designated by
116	the department.
117	(3)  The department shall maintain its headquarters in
118	Tallahassee.
119	(4)  The department shall administer the State Long-Term
120	Care Ombudsman Council, created by s. 400.0067, and the local
121	long-term care ombudsman councils, created by s. 400.0069 and
122	shall, as required by s. 712 of the federal Older Americans Act
123	of 1965, ensure that both the state and local long-term care
124	ombudsman councils operate in compliance with the Older
125	Americans Act.
126	(5)  The department shall be the state unit on aging as
127	defined in the federal Older Americans Act of 1965, as amended,
128	and shall exercise all responsibilities pursuant to that act.
129	(6)  In accordance with the federal Older Americans Act of
130	1965, as amended, the department shall designate and contract
131	with area agencies on aging in each of the department's planning
132	and service areas. Area agencies on aging shall ensure a
133	coordinated and integrated provision of long-term care services
134	to the elderly and shall ensure the provision of prevention and
135	early intervention services. The department shall have overall
136	responsibility for information system planning. The department
137	shall ensure, through the development of equipment, software,
138	data, and connectivity standards, the ability to share and
139	integrate information collected and reported by the area
140	agencies in support of their contracted obligations to the
141	state.
142	(7)  The department shall contract with the governing body,
143	hereafter referred to as the "board," of an area agency on aging
144	to fulfill programmatic and funding requirements. The board
145	shall be responsible for the overall direction of the agency's
146	programs and services and shall ensure that the agency is
147	administered in accordance with the terms of its contract with
148	the department, legal requirements, established agency policy,
149	and effective management principles. The board shall also ensure
150	the accountability of the agency to the local communities
151	included in the planning and service area of the agency.
152	(8)  The area agency on aging board shall, in consultation
153	with the secretary, appoint a chief executive officer, hereafter
154	referred to as the "executive director," to whom shall be
155	delegated responsibility for agency management and for
156	implementation of board policy, and who shall be accountable for
157	the agency's performance.
158	(6)(9)  Area agencies on aging and other administering
159	entities under contract with the department are subject to
160	chapter 119, relating to public records, and, when considering
161	any contracts requiring the expenditure of funds, are subject to
162	ss. 286.011-286.012, relating to public meetings.
163	Section 2.  Section 430.011, Florida Statutes, is created
164	to read:
165	430.011  Definitions.--As used in this chapter, the term:
166	(1)  "Department" means the Department of Elderly Affairs.
167	(2)  "Secretary" means the Secretary of Elderly Affairs.
168	(3)  "Planning and service area" means a geographic service
169	area established by the department in which the programs of the
170	department are administered and services are delivered.
171	Section 3.  Subsection (2) of section 430.04, Florida
172	Statutes, is amended to read:
173	430.04  Duties and responsibilities of the Department of
174	Elderly Affairs.--The Department of Elderly Affairs shall:
175	(2)  Be responsible for ensuring that each entity with whom
176	it contracts area agency on aging operates in a manner to ensure
177	that the elderly of this state receive the best services
178	possible. The department shall rescind designation of an area
179	agency on aging or take intermediate measures against the
180	agency, including corrective action, unannounced special
181	monitoring, temporary assumption of operation of one or more
182	programs by the department, placement on probationary status,
183	imposing a moratorium on agency action, imposing financial
184	penalties for nonperformance, or other administrative action
185	pursuant to chapter 120, if the department finds that:
186	(a)  An intentional or negligent act of the agency has
187	materially affected the health, welfare, or safety of clients,
188	or substantially and negatively affected the operation of an
189	aging services program.
190	(b)  The agency lacks financial stability sufficient to
191	meet contractual obligations or that contractual funds have been
192	misappropriated.
193	(c)  The agency has committed multiple or repeated
194	violations of legal and regulatory requirements or department
195	standards.
196	(d)  The agency has failed to continue the provision or
197	expansion of services after the declaration of a state of
198	emergency.
199	(e)  The agency has exceeded its authority or otherwise
200	failed to adhere to the terms of its contract with the
201	department or has exceeded its authority or otherwise failed to
202	adhere to the provisions specifically provided by statute or
203	rule adopted by the department.
204	(f)  The agency has failed to properly determine client
205	eligibility as defined by the department or efficiently manage
206	program budgets.
207	(g)  The agency has failed to implement and maintain a
208	department-approved client grievance resolution procedure.
209	Section 4.  Section 430.05, Florida Statutes, is amended to
210	read:
211	430.05  Department of Elderly Affairs Advisory Council.--
212	(1)  There is created the Department of Elderly Affairs
213	Advisory Council which shall be located for administrative
214	purposes in the Department of Elderly Affairs and established in
215	accordance with s. 20.03(7). It is the intent of the Legislature
216	that the advisory council shall be an independent nonpartisan
217	body and shall not be subject to the control, supervision, or
218	direction by the department.
219	(2)  The council shall serve in an advisory capacity to the
220	secretary of Elderly Affairs to assist the secretary in carrying
221	out the purposes, duties, and responsibilities of the
222	department, as specified in this chapter. The council may make
223	recommendations to the secretary, the Governor, the Speaker of
224	the House of Representatives, and the President of the Senate
225	regarding organizational issues and additions or reductions in
226	the department's duties and responsibilities.
227	(3)(a)  The advisory council shall be composed of members
228	one member appointed by the Governor from each of the state's
229	planning and service areas, which are designated in accordance
230	with the Older Americans Act, two additional members appointed
231	by the Governor, two members appointed by the President of the
232	Senate, and two members appointed by the Speaker of the House of
233	Representatives. The members shall be appointed in the following
234	manner:
235	1.  The Governor shall appoint one member from each
236	planning and service area and two additional at-large members.
237	Members appointed from a planning and service area must maintain
238	their primary residence within the boundaries of the planning
239	and service area that they represent. At-large members must
240	maintain their primary residence in the state. The Governor
241	shall ensure that a majority of his or her appointments to the
242	advisory council are 60 years of age or older and that the
243	membership has a balanced minority and gender representation.
244	shall select each appointment from a list of three nominations
245	submitted by the designated area agency on aging in each
246	planning and service area. Nominations submitted by an area
247	agency on aging shall be solicited from a broad cross section of
248	the public, private, and volunteer sectors of each county in the
249	respective planning and service area. At least one of the three
250	nominations submitted by an area agency on aging shall be a
251	person 60 years of age or older.
252	2.  The Governor shall appoint two additional members, one
253	of whom shall be 60 years of age or older.
254	2.3.  The President of the Senate shall appoint two
255	members. Both appointees must maintain their primary residence
256	in the state, and at least one appointee must, one of whom shall
257	be 60 years of age or older.
258	3.4.  The Speaker of the House of Representatives shall
259	appoint two members. Both appointees must maintain their primary
260	residence in the state, and at least one appointee must, one of
261	whom shall be 60 years of age or older.
262	5.  The Governor shall ensure that a majority of the
263	members of the advisory council shall be 60 years of age or
264	older and that there shall be balanced minority and gender
265	representation.
266	6.  The Governor shall designate annually a member of the
267	advisory council to serve as chair.
268	4.7.  The secretary of Elderly Affairs shall serve as an ex
269	officio member of the advisory council.
270	(b)  Members shall be appointed to 3-year terms. A member
271	may not serve more than two consecutive terms. in the following
272	manner:
273	(c)  Vacancies shall be filled in the same manner as the
274	original appointment, except that when a vacancy occurs in a
275	position occupied by a member representing a planning and
276	service area, the department, after consulting with the board of
277	the local area agency on aging from that planning and service
278	area, shall submit to the Governor a list of recommended persons
279	to fill the appointment. Nominations must be solicited from a
280	cross-section of the public, private, and volunteer sectors of
281	each county in the respective planning and service area after
282	discussions with various local governments and service provider
283	organizations.
284	(d)  The Governor shall appoint a chair to serve a 1-year
285	term. The council may elect a vice chair from among its members
286	to preside over the council in the absence of the chair.
287	1.  In order to stagger the terms of office, one of the
288	initial appointees of the President of the Senate shall be
289	appointed to a 2-year term and one of the initial appointees of
290	the Speaker of the House of Representatives shall be appointed
291	to a 2-year term. Additionally, one-third of the total initial
292	appointees of the Governor shall be appointed to 1-year terms,
293	one-third shall be appointed to 2-year terms, and one-third to
294	3-year terms. If the initial appointments of the Governor are
295	not of a number divisible into thirds, and there results one
296	additional appointee, that appointee shall be appointed to a 2-
297	year term. If the initial appointments of the Governor are not
298	of a number divisible into thirds, and there results two
299	additional appointees, one of the additional appointees shall be
300	appointed to a 1-year term and the other appointee shall be
301	appointed to a 2-year term.
302	2.  Vacancies occurring during an appointee's initial term
303	shall be filled in the same manner as the initial appointments,
304	pursuant to subparagraph 1. After the terms referred to in
305	subparagraph 1. have expired, members shall be appointed to 3-
306	year terms.
307	(4)  In order to enhance its understanding of the various
308	needs of the state's elderly population and to avoid unnecessary
309	duplication of effort, the advisory council shall identify any
310	council, committee, task force, or similar group that is
311	statutorily mandated to represent the interest of older persons,
312	and shall invite a member aged 60 years or older, or a younger
313	member if there are no members aged 60 years or older, from each
314	identified group to serve as a nonvoting ex officio member of
315	the advisory council.
316	(4)(5)  The advisory council shall meet at the call of the
317	chair or of a majority of its members least quarterly, or more
318	frequently as needed.
319	(5)(6)  The department of Elderly Affairs shall provide
320	staff support to assist the advisory council in the performance
321	of its duties.
322	(6)(7)  Members of the advisory council shall receive no
323	salary, but are entitled to reimbursement for travel and per
324	diem expenses, as provided in s. 112.061, while performing their
325	duties under this section.
326	Section 5.  Section 430.071, Florida Statutes, is amended
327	to read:
328	430.071  Respite for elders living in everyday families.--
329	(1)  As used in this section, the term:
330	(a)  "Family unit" means one or more individuals who share
331	space within an enclosed single-family dwelling or other space
332	on the same property of a single-family homestead whose primary
333	residence is with a homebound elderly individual specifically
334	for the purpose of providing care for that homebound elderly
335	individual. The individuals do family does not necessarily need
336	to be related by blood or marriage to the homebound elderly
337	individual.
338	(b)  "Homebound elderly individual" means an individual 60
339	years of age or older who requires assistance to remain in the
340	home and, absent such assistance, would need to move to a
341	skilled nursing or assisted living facility.
342	(c)  "RELIEF program" means the Respite for Elders Living
343	in Everyday Families program created under this section.
344	(d)(b)  "Respite" means temporary in-home assistance or
345	adult day care services for a homebound elderly individual from
346	someone who is not a member of the family unit, which allows the
347	family unit the ability to leave the homebound elderly
348	individual for a period of time.
349	(e)(c)  "Stipend" means an allotment of funds to enable a
350	diverse population of volunteers to provide services. The
351	stipend must be paid at an allotment of funds is for a maximum
352	hourly rate that does shall not exceed an amount equal to the
353	state federal minimum wage.
354	(d)  "Volunteer service system" means an organized network
355	of volunteers and agencies engaged in supporting volunteers to
356	assist a family unit that requires respite.
357	(2)  There is created within the department the "Respite
358	for Elders Living in Everyday Families" (RELIEF) program. The
359	RELIEF program shall will provide one-on-one or congregate in-
360	home respite services as that is an expansion of respite
361	services that are is currently available through other programs,
362	specifically including evening and weekend respite and an
363	expansion of hours for existing adult day care services. The
364	purpose of this service is to increase the ability of a family
365	unit to continue to care for a homebound elderly individual by
366	providing in-home respite services beyond the basic provisions
367	of current public programs.
368	(3)  Respite services under the RELIEF program may be
369	provided in:
370	(a)  The family unit's dwelling or another dwelling located
371	on the property of the family unit; or
372	(b)  Another facility if the homebound elderly individual
373	returns to the family unit's dwelling or property at the
374	conclusion of the respite service.
375	(4)(3)  Respite services may shall be provided through a
376	multigenerational corps of volunteers, volunteers who receive a
377	stipend, and any other appropriate personnel as determined by
378	the department.
379	(a)  Volunteers shall be screened, selected, trained, and
380	registered according to standards developed by the Office of
381	Volunteer and Community Services in the department of Elderly
382	Affairs. These standards must be developed to ensure, at a
383	minimum, the safety of a homebound elderly individual who will
384	receive the respite service.
385	(b)  Volunteers may be recruited from a variety of sources,
386	including, but not limited to, volunteer centers, religious
387	organizations, college campuses, corporations, families, Retired
388	Senior Volunteer Programs, Senior Companion Programs, and
389	AmeriCorps Programs.
390	(5)(a)(4)  To receive assistance from the RELIEF program,
391	the family unit must be assessed according to the following
392	guidelines developed by the department to determine the need for
393	respite services. This assessment must determine, at a minimum,
394	that:
395	1.  The family unit is caring for a homebound elderly
396	individual who meets the standards for program eligibility; and
397	2.(a)  The family unit is unable to pay for respite
398	services without jeopardizing other basic needs, including, but
399	not limited to, food, shelter, and medications.
400	(b)  The provider may prioritize the order by which a
401	family unit receives RELIEF program services with priority given
402	first to those determined to be most in need of respite services
403	in order to continue to care for the homebound elderly
404	individual for whom the family unit is caring is 60 years of age
405	or older, requires assistance to remain in the home, and,
406	without this assistance, would need to move to an assisted
407	living facility or a nursing facility.
408	(c)(5)  A family unit that receives respite services from
409	the RELIEF program is not excluded from receiving assistance
410	from other governmental programs, but the provider may take
411	other assistance that the family unit is receiving into account
412	when determining an order of priority for services under the
413	RELIEF program.
414	(6)  The department Office of Volunteer and Community
415	Services shall:
416	(a)  Systematically develop a volunteer service system in
417	order to provide respite services under the RELIEF program. The
418	office shall also Implement, monitor, and evaluate the delivery
419	of respite services provided through the RELIEF under this
420	program.
421	(b)  Develop an organized network of volunteers and
422	agencies engaged in supporting volunteers in order to provide
423	services under the RELIEF program.
424	(c)(b)  Work collaboratively with local, state, and
425	national organizations, including, but not limited to, the
426	Florida Commission on Community Service, to promote the use of
427	volunteers providing offering respite services under this
428	program.
429	(d)(c)  Encourage contributions and grants through public
430	and private sources to promote the delivery of respite to assist
431	family units providing care for homebound elderly individuals.
432	(7)  The department may adopt rules pursuant to ss.
433	120.536(1) and 120.54 to administer the RELIEF program.
434	Section 6.  Section 430.101, Florida Statutes, is amended
435	to read:
436	430.101  State unit on aging; designation; authority
437	Administration of federal aging programs.--The department of
438	Elderly Affairs is designated the state unit on aging under the
439	federal Older Americans Act of 1965, as amended, and shall
440	exercise all responsibilities under that act. The department is
441	the state agency designated to handle all programs of the
442	Federal Government relating to the aging, by virtue of funds
443	appropriated through the Older Americans Act of 1965 and
444	subsequent amendments, requiring actions within the state which
445	are not the specific responsibility of another state agency
446	under the provisions of federal or state law. Authority is
447	hereby conferred on The department may to accept and use any
448	funds in accordance with established state budgetary procedures
449	which might become available pursuant to the purposes set out
450	herein.
451	Section 7.  Section 430.103, Florida Statutes, is created
452	to read:
453	430.103  Administration of federal programs for the aged.--
454	(1)  DEFINITIONS.--As used in this section, the term:
455	(a)  "Agency" means an area agency on aging designated by
456	the department.
457	(b)  "Area agency on aging" means a public or not-for-
458	profit private entity or office designated by the department to
459	coordinate and administer the federal programs on aging and to
460	provide, through contracting entities, services within a
461	planning and service area. Entities under contract with the
462	department to serve as an area agency on aging may also contract
463	with the department to serve as the administering entity for the
464	community-care-for-the-elderly program created under s. 430.204.
465	Entities under contract with the department to serve as an area
466	agency on aging are not agencies, agents, or offices of state
467	government.
468	(c)  "Board" means the governing body of an agency.
469	(d)  "Executive director" means the chief executive officer
470	of an agency appointed by, and serving at the pleasure of, the
471	agency's board.
472	(2)  DEPARTMENT RESPONSIBILITIES.--
473	(a)  In accordance with the federal Older Americans Act,
474	the department shall:
475	1.  Apportion the state into one or more planning and
476	service areas.
477	2.  Administer programs and services of the federal Older
478	Americans Act through the planning and service areas.
479	3.  Execute a contract with the board of each agency to
480	administer services of the federal Older Americans Act within
481	the planning and service area that the agency serves.
482	4.  Develop a state plan on aging in accordance with the
483	federal Older Americans Act that evaluates service needs of the
484	elderly, identifies priority services and target client groups,
485	provides for periodic evaluation of activities and services, and
486	provides for administration of funds available through the
487	federal Older Americans Act.
488	(b)  The department shall regularly monitor the activities
489	of each agency to ensure that each agency meets all of the
490	requirements of federal and state laws and department rules,
491	policies, and contract requirements.
492	(c)  The department shall adopt rules pursuant to ss.
493	120.536(1) and 120.54 to administer and oversee the programs
494	authorized under this section.
495	(3)  BOARD RESPONSIBILITIES.--
496	(a)  The board of each agency shall:
497	1.  Be accountable for the performance of the agency.
498	2.  Be responsible for the overall direction of the
499	programs and services of the agency.
500	3.  Ensure that the agency is administered according to the
501	terms of its contract with the department, established federal
502	and state laws, and department rules and policies, and effective
503	management and budgetary principles.
504	4.  Ensure the accountability of the agency to local
505	governments and local communities located within the planning
506	and service area that the agency serves.
507	(b)  The board shall appoint an executive director. It may
508	delegate to the director the responsibility for day-to-day
509	agency management and operation and for implementing board
510	policy.
511	(4)  DEPARTMENTAL SANCTIONS AND PENALTIES.--
512	(a)  The secretary shall rescind the designation of an
513	agency if the department determines that:
514	1.  An intentional or negligent act or omission by the
515	agency has materially affected the health, welfare, or safety of
516	a client or substantially and negatively affected the operation
517	of a program.
518	2.  The agency has exceeded its authority, has failed to
519	adhere to the terms of its contract with the department, or has
520	otherwise failed to adhere to the relevant federal and state
521	laws or department rules.
522	3.  The agency lacks financial stability sufficient to meet
523	contractual obligations or that contractual funds have been
524	misappropriated or mismanaged.
525	4.  The agency has committed violations of department
526	standards or policies.
527	5.  The agency has repeatedly failed to properly determine
528	client eligibility under federal and state laws or department
529	rules or standards.
530	6.  The agency has failed to implement or maintain a
531	department-approved procedure to resolve client grievances.
532	7.  The agency has failed to continue to provide or expand
533	services after the declaration of a state of emergency.
534	(b)1.  If the department determines that an agency has
535	committed a violation of law, rule, contract, or policy,
536	including those listed in paragraph (a), but the secretary
537	determines that intermediate corrective actions may resolve the
538	issue without rescinding the agency's designation, the secretary
539	may place the agency on probation and take intermediate
540	corrective actions. The secretary may not place an agency on
541	probation or take intermediate corrective actions for a period
542	of less than 30 days or more than 1 year.
543	2.  The secretary shall provide to the board a written
544	notice of probation. The notice must include the reasons for
545	placing the agency on probation, including the specific
546	violations committed by the agency, the length of the probation
547	being imposed, any specific conditions the agency will be
548	subject to while on probation, any actions required of the
549	agency to rectify the violation, any actions the department
550	intends to take related to the probation, and any other
551	information relevant to the violation or probation. A copy of
552	the notice shall be provided to the Governor, the President of
553	the Senate, and the Speaker of the House of Representatives.
554	3.  The secretary may impose, either singularly or in
555	conjunction with, any of the following intermediate corrective
556	actions:
557	a.  Levying financial penalties against the agency which
558	the secretary determines are commensurate with the seriousness
559	of the violation.
560	b.  Temporarily assuming the administration of one or more
561	programs on behalf of the agency or assigning these
562	administrative duties to another qualified entity, including
563	another designated area agency on aging.
564	c.  Conducting unannounced special monitoring of the
565	agency.
566	4.  The secretary may terminate an agency's probation
567	before the date specified in the notice of probation.
568	5.  Upon terminating the probation, the secretary shall
569	determine whether the agency has taken sufficient actions
570	necessary to rectify the violations listed in the notice of
571	probation and whether the agency is capable of continuing to
572	serve as a designated area agency on aging. The secretary shall
573	submit to the board a written notice of his or her
574	determination. A copy of the notice shall be provided to the
575	Governor, the President of the Senate, and the Speaker of the
576	House of Representatives.
577	6.  If the secretary determines that the agency has not
578	made sufficient progress to correct the violations listed in the
579	notice of probation, the secretary shall rescind the agency's
580	designation.
581	7.  The secretary shall rescind the designation of any
582	agency that has been placed on probation twice and that commits
583	a third violation within 5 years after the date the first
584	probation was imposed.
585	Section 8.  Section 430.201, Florida Statutes, is amended
586	to read:
587	430.201  Short title.--Sections 430.201-430.2045 430.201-
588	430.201-430.207 may be cited as the "Community Care for the
589	Elderly Act."
590	Section 9.  Section 430.202, Florida Statutes, is amended
591	to read:
592	430.202  Community care for the elderly; legislative
593	intent.--The purpose of ss. 430.201-430.2045 ss. 430.201-430.207
594	is to assist functionally impaired elderly persons to live in
595	living dignified and reasonably independent lives in their own
596	homes or in the homes of relatives or caregivers through the
597	development, expansion, reorganization, and coordination of
598	various community-based services provided and administered
599	through public or private entities that are not agencies or
600	offices of state government except as defined in s.
601	430.204(1)(d). The Legislature intends that a continuum of care
602	be established so that functionally impaired elderly persons age
603	60 and older may be assured the least restrictive environment
604	suitable to their needs. The development of innovative
605	approaches to program management, staff training, and service
606	delivery which have an impact on cost-avoidance, cost-
607	effectiveness, and program efficiency is encouraged.
608	Section 10.  Section 430.203, Florida Statutes, is amended
609	to read:
610	430.203  Community care for the elderly; definitions.--As
611	used in ss. 430.201-430.2045 ss. 430.201-430.207, the term:
612	(1)  "Administering entity" "Area agency on aging" means a
613	public or not-for-profit nonprofit private entity agency or
614	office under contract with designated by the department to
615	coordinate and administer the department's programs and to
616	provide, through contracting agencies, services within a
617	community care planning and service area. Local governments or
618	other entities under contract with the department to serve as
619	administering entities are not agencies, agents, or offices of
620	state government An area agency on aging serves as both the
621	advocate and the visible focal point in its planning and service
622	area to foster the development of comprehensive and coordinated
623	service systems to serve older individuals.
624	(2)  "Community care service area" means a geographic area
625	designated by the department for the purpose of organizing the
626	local provision of community-care-for-the-elderly case
627	management and core services service area within a planning and
628	service area.
629	(3)  "Community care service system" means a service system
630	that is organized to provide various and necessary case
631	management and core services through, when feasible, a multitude
632	of entities to network comprising a variety of home-delivered
633	services, day care services, and other basic services,
634	hereinafter referred to as "core services," for functionally
635	impaired elderly persons residing within the boundaries of the
636	community care service area. The system is under the direction
637	of the entities selected under ss. 430.204 and 430.2043 which
638	are provided by or through a single lead agency. The Its purpose
639	of the system is to provide a continuum of care encompassing a
640	full range of preventive, maintenance, and restorative services
641	for functionally impaired elderly persons to prevent unnecessary
642	institutionalization.
643	(4)  "Case management" means a client-centered series of
644	activities that include planning, arranging for, and
645	coordinating community-based services for an eligible client of
646	the community-care-for-the-elderly program. Case management
647	includes referral services, travel time related to the client's
648	case, a comprehensive client assessment, development of an
649	individualized care plan with planned client outcomes, and
650	followup contacts for the purpose of monitoring the client's
651	situation and assuring timely, effective delivery of services.
652	"Contracting agency" means an area agency on aging, a lead
653	agency, or any other agency contracting to provide program
654	administration or to provide services.
655	(5)  "Core services" means a variety of home-delivered
656	services, day care services, personal care services, and other
657	basic services that are provided to functionally impaired
658	elderly persons may be provided by several entities. Core
659	services are those services that are required most needed to
660	assist a functionally impaired elderly person to live in his or
661	her own home or in the home of a relative or caregiver. Without
662	receiving core services, the individual would likely be required
663	to move to a more institutionalized care setting. For the
664	purposes of ss. 430.201-430.2045, case management is considered
665	as a separate service and is not a core service prevent
666	unnecessary institutionalization. The area agency on aging shall
667	not directly provide core services.
668	(6)  "Department" means the Department of Elderly Affairs.
669	(6)(7)  "Functionally impaired elderly person" means any
670	person, 60 years of age or older, having physical or mental
671	limitations that restrict individual ability to perform the
672	normal activities of daily living and that impede individual
673	capacity to live independently in his or her own home or in the
674	home of a relative or caregiver without receiving the provision
675	of core services. Functional impairment shall be determined
676	through a functional assessment administered to each applicant
677	for community-care-for-the-elderly core services. The functional
678	assessment shall be developed by the department.
679	(8)  "Health maintenance services" means those routine
680	health services that are necessary to help maintain the health
681	of a functionally impaired elderly person, but that are limited
682	to medical therapeutic services, nonmedical prevention services,
683	personal care services, home health aide services, home nursing
684	services, and emergency response systems.
685	(7)(9)  "Lead agency" means an agency designated at least
686	once every 3 years by an administering entity under s. 430.204
687	area agency on aging as the result of a request for proposal
688	process to be in place no later than the state fiscal year 1996-
689	1997. A lead agency directs the activities of the community care
690	service system within the boundaries of the community care
691	service area that the agency is designated to serve. A lead
692	agency is not an agency, agent, or office of state government.
693	(a)  The guidelines for the request for proposal must be
694	developed by the department in consultation with the area
695	agencies on aging. Such guidelines must include requirements for
696	the assurance of quality and cost-efficiency of services,
697	minimum personnel standards, and employee benefits.
698	(b)  The area agency on aging, in consultation with the
699	department, shall exempt from the competitive bid process any
700	contract with a provider who meets or exceeds established
701	minimum standards, as determined by the department.
702	(c)  In each community care service system the lead agency
703	must be given the authority and responsibility to coordinate
704	some or all of the services, either directly or through
705	subcontracts, for functionally impaired elderly persons. These
706	services must include case management, homemaker and chore
707	services, respite care, adult day care, personal care services,
708	home-delivered meals, counseling, information and referral, and
709	emergency home repair services. The lead agency must compile
710	community care statistics and monitor, when applicable,
711	subcontracts with agencies providing core services.
712	(8)(10)  "Personal care services" means services to assist
713	with bathing, dressing, ambulation, housekeeping, supervision,
714	emotional security, eating, supervision of self-administered
715	medications, and assistance in securing health care from
716	appropriate sources. Personal care services does not include
717	medical services.
718	(11)  "Planning and service area" means a geographic
719	service area established by the department, in which the
720	programs of the department are administered and services are
721	delivered.
722	(12)  "State Plan on Aging" means the service plan
723	developed by the department which evaluates service needs of the
724	elderly, identifies priority services and target client groups,
725	provides for periodic evaluation of activities and services
726	funded under the plan, and provides for administration of funds
727	available through the federal Older Americans Act. The state
728	plan on aging must be based upon area plans on aging developed
729	by the area agencies on aging in order that the priorities and
730	conditions of local communities are taken into consideration.
731	Section 11.  Section 430.204, Florida Statutes, is amended
732	to read:
733	430.204  Community-care-for-the-elderly program core
734	services; departmental powers and duties.--
735	(1)  In order to administer the community-care-for-the-
736	elderly program, the department shall:
737	(a)  Designate community care service areas for the purpose
738	of organizing and providing community-care-for-the-elderly case
739	management and core services to functionally impaired elderly
740	persons in local communities throughout the state.
741	(b)  Ensure that there exists in each county, as defined in
742	s. 125.011(1), more than one but not more than three community
743	care service systems.
744	(c)  Designate one or more geographic service areas in the
745	state which may include one or more community care service
746	areas, the purpose of which is to set the boundaries within
747	which a designated administering entity shall have
748	administration and oversight authority through contract with the
749	department.
750	(d)  Contract with an administering entity or entities at
751	least once every 3 years to fund, administer, and oversee the
752	delivery of community-care-for-the-elderly case management and
753	core services to functionally impaired elderly persons residing
754	in each designated community care service area in the state.
755	When it is essential for the continued health, safety, and
756	welfare of functionally impaired elderly persons, the department
757	may serve as the administering entity for one or more community
758	care service areas.
759	(e)  Regularly monitor each administering entity to ensure
760	that it is in compliance with all federal and state laws and
761	department rules, policies, and contract requirements.
762	(f)  Adopt rules to:
763	1.  Define each core service to be provided through the
764	program.
765	2.  Establish quality assurance standards for the delivery
766	of case management and core services.
767	3.  Establish procedures by which to designate the
768	administering entity.
769	4.  Establish standards that entities must meet in order to
770	be eligible to serve as an administering entity.
771	5.  Establish standards for an entity to be eligible to
772	serve as a lead agency.
773	6.  Establish standards for an entity to be eligible to
774	provide core services.
775	7.  Establish procedures for terminating a contract with an
776	administering entity that violates the law, a rule, or its
777	contract with the department and procedures for transferring
778	administrative duties to another administering entity. Each
779	procedure must ensure the minimum adversity for the clients of
780	the program.
781	8.  Establish procedures that an administering entity or
782	lead agency must follow in order to sanction a service provider
783	for noncompliance with federal or state laws or department
784	rules, policies, or contract requirements.
785	9.  Establish procedures that an administering entity or
786	lead agency must follow in order to:
787	a.  Terminate a contract with a lead agency or service
788	provider that violates the law, a rule, or its contract or that
789	otherwise fails to meet the standards necessary to continue
790	providing services; and
791	b.  Transfer the responsibility for services to another
792	qualified lead agency or service provider while causing minimal
793	disruption to the program's clients.
794	(2)  The department may designate each administering entity
795	as an aging resource center.
796	(a)  The purpose of an aging resource center shall be to
797	provide Florida's elders and their families with a coordinated
798	approach to integrating information and referral for all non-
799	Older-Americans-Act services for elders.
800	(b)  The duties of an aging resource center are to provide
801	access to all long-term care supports through intake assessment,
802	eligibility screening, and programmatic and financial
803	eligibility determinations that are integrated or closely
804	coordinated. Each aging resource center shall utilize a
805	management information system that supports the functions of the
806	program, including tracking client intake, needs assessment,
807	care plans, utilization, and costs.
808	(c)  Each aging resource center is encouraged to enter into
809	a memorandum of understanding with the department for
810	collaboration with the CARES unit staff.
811	(d)  Each aging resource center is encouraged to enter into
812	a memorandum of understanding with the Department of Children
813	and Family Services for collaboration with the Economic Self-
814	Sufficiency Unit staff.
815	(3)(a)  Each administering entity in the state shall
816	designate one lead agency for each community care service area
817	within the boundaries of the geographic area it serves. Lead
818	agencies shall be designated at least once every 3 years by
819	means of the competitive selection process under s. 430.2043.
820	(b)  An administering entity must regularly monitor each
821	lead agency with which it has a contract to ensure that the lead
822	agency is meeting all federal and state laws and department
823	rules, policies, and contract requirements.
824	(c)  An administering entity may not provide case
825	management or core services to clients of the community-care-
826	for-the-elderly program unless the department determines that
827	special circumstances exist which warrant the temporary
828	provision of those services by an administering entity.
829	(a)  The department shall fund, through each area agency on
830	aging, at least one community care service system the primary
831	purpose of which is the prevention of unnecessary
832	institutionalization of functionally impaired elderly persons
833	through the provision of community-based core services. Whenever
834	feasible, an area agency on aging shall be the contracting
835	agency of preference to engage only in the planning and funding
836	of community-care-for-the-elderly core services for functionally
837	impaired elderly persons.
838	(b)  The department shall fund, through each area agency on
839	aging in each county as defined in s. 125.011(1), more than one
840	community care service system the primary purpose of which is
841	the prevention of unnecessary institutionalization of
842	functionally impaired elderly persons through the provision of
843	community-based core services.
844	(4)(2)  Each lead agency shall organize a community care
845	service system for its community care service area. The lead
846	agency shall coordinate the activities of the individual
847	contracting agencies within the system. All existing community
848	resources available to functionally impaired elderly persons
849	shall be coordinated into the a community care service system to
850	provide a continuum of care for these to such persons as their
851	needs change. Additional services may be provided, but may not
852	be funded from the community-care-for-the-elderly core service
853	funds appropriated by the Legislature. Agencies providing
854	services with these funds contracting with the department shall
855	ensure that all other local funding sources available have been
856	used before using prior to utilizing community-care-for-the-
857	elderly funds. The department, administering entities, and other
858	entities agencies contracting with the department may accept
859	gifts and grants in order to provide services within a community
860	care service area may accept grants and gifts in order to expand
861	those services to additional clients or to new service areas.
862	(5)(a)  The lead agency shall ensure that case management
863	and core services are available for all clients enrolled in the
864	program within its community care service area and that, when
865	feasible, policies, procedures, and contracts are in place to
866	offer prospective and current clients an unbiased choice of
867	service providers within the community care service system.
868	(b)  In each community care service system, the lead agency
869	shall provide case-management services. Core services may be
870	provided by any public or private entity, including the lead
871	agency, if the entity meets the requirements of paragraph (c)
872	and the standards adopted by rule of the department for service
873	providers.
874	(c)  The administering entity shall ensure that:
875	1.  Whenever feasible, functionally impaired elderly
876	persons are provided with a choice of service providers within a
877	community care service system.
878	2.  The entities under contract to provide core services
879	within the system are the most cost-effective service providers
880	available to serve the community care service area. The
881	administering entity shall ensure that service providers meet
882	standards for client safety, satisfaction, and quality assurance
883	by requiring each lead agency to competitively select core
884	service providers to create its service system. The
885	administering entity may not allow a lead agency to provide a
886	core service if the agency does not meet the requirements of
887	this subparagraph for that service.
888	(d)  The lead agency must compile statistics on community
889	care and monitor, when applicable, subcontracts with agencies
890	providing core services within its system.
891	(6)(a)  A person who has been classified as a functionally
892	impaired elderly person is eligible to receive case management
893	and those core services that the person requires to prevent or
894	delay the person's movement to a more institutionalized care
895	setting. Eligibility for community-care-for-the-elderly services
896	does not entitle a person to each core service available under
897	the program. The department shall adopt a rule specifying the
898	criteria that will ensure that a person's plan of care is
899	commensurate with his or her care needs specifically in order to
900	prevent or delay movement to a more institutionalized care
901	setting. This section is not intended to guarantee the provision
902	of all services identified in a person's plan of care.
903	(b)  Functional impairment shall be determined through a
904	functional assessment administered to each applicant seeking
905	community-care-for-the-elderly services. The functional
906	assessment instrument shall be developed by the department in
907	rule.
908	(c)1.  The department shall determine an order of
909	prioritization for all functionally impaired elderly persons
910	seeking community-care-for-the-elderly services which is based
911	on the frailty level of the applicant and the applicant's
912	likelihood of institutional placement if he or she does not
913	receive program services. After determining the applicant's
914	frailty level and likelihood of institutional placement, if the
915	list of potential recipients requires further prioritization,
916	the department shall consider the applicant's ability to pay for
917	similar services. Those who are less able to pay for services
918	must receive higher priority than those who are better able to
919	pay for the services. An applicant's ability to pay may be
920	determined by using the applicant's self-declared statement of
921	income and expenses.
922	2.  Administering entities, lead agencies, and service
923	providers may not provide core services, as defined in
924	430.203(5) to a client using community-care-for-the-elderly
925	funds if the individual is not within a priority category
926	established by the criteria of this paragraph.
927	3.  The department may temporarily waive the requirements
928	of this paragraph if the secretary determines that an emergency
929	situation exists.
930	(d)  Notwithstanding paragraph (c), a person who is 60
931	years of age or older and who is determined by a protective
932	investigation to be a vulnerable adult in need of services under
933	s. 415.104(3), or to be a victim of abuse, neglect, or
934	exploitation who is in need of immediate services in order to
935	prevent further harm, and who is referred by the adult
936	protective services program, shall be given primary
937	consideration for receiving community-care-for-the-elderly core
938	services. As used in this paragraph, the term "primary
939	consideration" means that an assessment and services must start
940	within 72 hours after the person is referred to the department
941	or as established in accordance with department contracts by
942	local protocols developed between department service providers
943	and the adult protective services program.
944	(7)  A preservice and in-service training program for
945	community-care-for-the-elderly service providers and staff shall
946	be designed and implemented by the department to help ensure the
947	delivery of quality services. The department shall adopt a rule
948	specifying the training standards and requirements for service
949	providers and staff. Training must be sufficient to ensure that
950	quality services are provided to clients and that appropriate
951	skills are developed to conduct the program.
952	(8)(3)  The use of volunteers shall be maximized to provide
953	a range of services for the functionally impaired elderly
954	persons person. The department shall provide or arrange for the
955	provision of training and supervision of volunteers to ensure
956	the delivery of quality services. The department or contracting
957	agency may provide, or it may require administering entities,
958	lead agencies, or service providers under contract to provide,
959	appropriate insurance coverage to protect volunteers from
960	personal liability while acting within the scope of their
961	volunteer assignments under a community care service area. The
962	coverage may also include excess automobile liability
963	protection.
964	(4)  The department or contracting agency shall contract
965	for the provision of the core services required by a community
966	care service area.
967	(9)(5)  Lead agencies and entities under contract with a
968	lead agency providing Entities contracting to provide core
969	services under ss. 430.201-430.2045 ss. 430.201-430.207 must
970	provide a minimum of 10 percent of the funding necessary for the
971	support of the program's operation project operations. In-kind
972	contributions, including whether materials, commodities,
973	transportation, office space, other types of facilities, or
974	personal services, and contributions of money or services from
975	functionally impaired elderly persons may be evaluated and
976	counted as part or all of the required local funding.
977	(10)(6)  Whenever When possible, services shall be provided
978	to elderly persons under the Florida Plan for Medical Assistance
979	under Title XIX of the Social Security Act in place of using
980	community-care-for-the-elderly funds. This subsection does not
981	prevent the temporary delivery of services to elderly persons
982	who are awaiting determination of eligibility under the Medicaid
983	program. However, if a functionally impaired elderly person
984	receiving community-care-for-the-elderly core services is
985	determined to be eligible for substantially similar services
986	under the Medicaid program, the person must be transferred
987	immediately to the Medicaid program. obtained under:
988	(a)  The Florida Plan for Medical Assistance under Title
989	XIX of the Social Security Act; or
990	(b)  The State Plan on Aging under the Older Americans Act.
991	(11)(7)  Funds appropriated for the community-care-for-the-
992	elderly program community care for the elderly must be used only
993	for the provision of community-care-for-the-elderly core
994	services, case management, and directly related expenditures.
995	The department may provide advance funding for the community-
996	care-for-the-elderly program.
997	(12)(8)  Provider agencies are responsible for the
998	collection of fees for services in accordance with rules adopted
999	by the department. Provider agencies shall assess fees for
1000	services rendered in accordance with those rules. To help pay
1001	for services received through the community-care-for-the-elderly
1002	program from community care for the elderly, a functionally
1003	impaired elderly person shall be assessed a fee based on the
1004	person's an overall ability to pay for core services without
1005	jeopardizing the person's ability to pay for other basic living
1006	necessities such as expenses for food, living space,
1007	medications, and other similar life-sustaining expenditures. The
1008	fee to be assessed shall be fixed according to a schedule
1009	established by the department in cooperation with area agencies,
1010	lead agencies, and service providers.
1011	(13)(9)  The department shall evaluate the delivery of
1012	services within community care service areas and recommend
1013	legislative and administrative action as necessary. The
1014	department shall analyze Accurate analysis of the costs and
1015	benefits associated with the establishment and operation of the
1016	program programs as determined through a uniform cost accounting
1017	and reporting system designed shall be maintained to provide an
1018	assessment of the ability of these programs to:
1019	(a)  Reduce the rate of inappropriate entry and placement
1020	of functionally impaired elderly persons into more restrictive
1021	care settings in institutions; and
1022	(b)  Reduce the use of institutional services and
1023	facilities.; and
1024	(c)  Recommend legislative and administrative action.
1025	(14)  Notwithstanding other provisions of this section, the
1026	department may conduct or contract for demonstration projects to
1027	determine the desirability of new concepts of organization,
1028	administration, or service delivery which are designed to
1029	prevent the institutionalization of functionally impaired
1030	elderly persons. The department shall evaluate the cost-
1031	avoidance features of the demonstration projects, the ability of
1032	the projects to reduce the rate of placing functionally impaired
1033	elderly persons into institutions, and the impact of the
1034	projects on the use of institutional services and facilities.
1035	Section 12.  Section 430.2043, Florida Statutes, is created
1036	to read:
1037	430.2043  Competitive selection of lead agencies and core
1038	service providers.--
1039	(1)  An entity may be designated as a lead agency for a
1040	community care service area under the community-care-for-the-
1041	elderly program only after the review committee, as established
1042	in this section, examines and impartially scores the competitive
1043	sealed proposals. An administering entity must follow the
1044	procedures set forth in this section when conducting the
1045	competitive-procurement process.
1046	(a)  A process of competitive procurement shall be
1047	announced simultaneously to all prospective vendors using
1048	multiple written or recorded advertisements through such mediums
1049	as newspapers, television, Internet websites, e-mail, and other
1050	community advertisements. The request for proposals must
1051	include:
1052	1.  A statement of the commodities or contractual services
1053	sought;
1054	2.  The latest possible time and date for the receipt of a
1055	proposal and the location to which the proposal must be sent in
1056	order to be considered;
1057	3.  The time, date, and location of the public opening of
1058	all proposals;
1059	4.  A listing of the names and professional titles of each
1060	member and alternate member of the review committee;
1061	5.  The grievance procedure for any vendor wishing to file
1062	a bid protest relating to the impartiality or legality of the
1063	competitive-selection or scoring process; and
1064	6.  All contractual terms and conditions applicable to the
1065	procurement, including the criteria, which must include, but
1066	need not be limited to, cost-effectiveness, quality, variety of
1067	services offered, and geographic service area to be served,
1068	which criteria shall be scored and used to determine the most
1069	advantageous proposal.
1070	(b)  Cost-effectiveness and maximizing the number of
1071	clients served using available funds each year shall count for
1072	not less than 80 percent of the total possible score for each
1073	proposal, and the relative importance of the other evaluation
1074	criteria shall be indicated in the initial request for
1075	proposals. Failure to include any measuring criteria in the
1076	initial request for proposals prohibits that criteria from being
1077	used in determining the most advantageous proposal, unless the
1078	administering entity discontinues the competitive-selection
1079	process before any scoring takes place and reissues the request
1080	for proposals. Once scoring the proposals has begun, the
1081	selection process must continue to completion and a contract
1082	must be awarded, pending the outcome of a bid protest.
1083	(c)  The administering agency shall publicly notice and
1084	conduct, not less than 15 days before the final date for receipt
1085	of all proposals, a conference for purposes of ensuring that
1086	each prospective interested vendor fully understands the
1087	solicitation requirements. The vendors shall be accorded fair
1088	and equal treatment in posing questions and receiving responses
1089	to their questions during the conference. The administering
1090	entity shall provide notice in writing, not less than 10 days
1091	before the date for receipt of all proposals, the questions and
1092	answers for each inquiry posed by a prospective vendor during
1093	the conference.
1094	(d)  The governing board of the administering entity or, if
1095	no governing board exists, the chief executive officer, shall
1096	appoint an impartial review committee consisting of an odd
1097	number of no fewer than five members to evaluate all proposals.
1098	Two alternate members shall also be appointed. The review
1099	committee members must collectively have experience and
1100	knowledge in the program areas and service requirements for the
1101	commodities or contractual services being sought. More than 50
1102	percent of the review committee's composition must be persons
1103	who have no working or personal relationship or affiliation with
1104	the administering entity or any likely prospective bidder, but
1105	such persons may be employees of other administrating entities
1106	in the state.
1107	(e)  The administering entity shall conduct, at the time
1108	and place noted in the initial request for proposals, a public
1109	opening of all bids where members of the review committee will
1110	be presented with all proposals. During the public bid-opening
1111	meeting, once all bids have been opened but before any member of
1112	the review committee inspects a proposal, each member must sign
1113	an attestation that he or she has no conflict of interest or
1114	working or personal relationship with any of the vendors that
1115	submitted proposals. If a member of the review committee, upon
1116	learning the names of the vendors that submitted bids,
1117	determines that he or she has a conflict of interest with a
1118	vendor that submitted a proposal, the member shall be dismissed
1119	from his or her scoring duties and the first alternate shall
1120	take his or her place on the committee. The administering entity
1121	may reschedule the date of the public opening of all bids from
1122	the date noted in the initial request for proposals by publicly
1123	noticing the new date not less than 10 days before the date of
1124	the rescheduled meeting.
1125	(f)  Scoring of proposals shall be conducted only by those
1126	members of the review committee who are appointed and noted in
1127	the initial request for proposals. Alternates may not score
1128	proposals unless a committee member was determined to have a
1129	conflict of interest. Each committee member shall review and
1130	score all submitted proposals. Scoring shall be conducted in an
1131	independent, unbiased manner for the sole purpose of choosing
1132	the most advantageous proposal for the program's enrollees
1133	through the scoring methodology described in the initial request
1134	for proposals. Scoring of proposals need not occur in a public
1135	meeting; however, scoring pages, member notes pertaining to the
1136	scoring, final scores, and other similar documentation shall all
1137	be available for public inspection following an award. Members
1138	of the review committee may not discuss with each other the
1139	proposals until an award has been made. The chief executive
1140	officer of the administering entity, in the presence of at least
1141	two unrelated witnesses who are not employees of the entity,
1142	shall collect all final scoring pages from the review committee
1143	and shall determine the proposal that received the highest
1144	cumulative score among the total scores awarded by the committee
1145	members to each vendor.
1146	(g)  The designation of a lead agency and the corresponding
1147	contract shall be awarded to the responsible and responsive
1148	vendor whose proposal receives the highest cumulative score from
1149	the review committee. The administering entity shall submit in
1150	writing to its board of directors, with a copy to the secretary,
1151	a statement supporting the basis upon which the award was made.
1152	(h)  The administering entity must establish, before
1153	advertising its request for proposals, an agreement with an
1154	experienced mediator who has no conflict of interest with the
1155	procurement process, the administering entity, or any likely
1156	respondents to the proposal. The mediator must agree to
1157	impartially consider the arguments of any bidder who is not
1158	awarded the contract as the lead agency but who timely filed a
1159	proposal in a bid protest directed to the impartiality or
1160	legality of the selection procedures or scoring process. The
1161	mediator must adhere to the guidelines for a bid protest set out
1162	in the initial request for proposals. The mediator must also
1163	consider any information provided by the administering entity
1164	and the review committee to refute or substantiate the claims of
1165	the protestor. After reviewing the facts of the protest and the
1166	selection process, the mediator shall report whether the
1167	procurement process was conducted substantially fairly, openly,
1168	and impartially. If the mediator determines that the process was
1169	flawed by some act or omission by the administering entity or
1170	review committee which substantially affected the outcome of the
1171	selection process in a negative manner, the administering entity
1172	shall dismiss the award and conduct a new selection process.
1173	(2)  The secretary may waive in writing the competitive-
1174	procurement process described in this section for a period of
1175	180 days and may approve an award of a contract by the
1176	administrative entity using a noncompetitive process if the
1177	secretary determines that there is an immediate danger to the
1178	public health, safety, or welfare or a substantial loss to the
1179	state and that emergency action is required.
1180	Section 13.  Section 430.2045, Florida Statutes, is created
1181	to read:
1182	430.2045  Rules.--The department may adopt rules pursuant
1183	to ss. 120.536(1) and 120.54 to administer the
1184	community-care-for-the-elderly program.
1185	Section 14.  Section 430.2051, Florida Statutes, is created
1186	to read:
1187	430.2051  Integrated long-term-care delivery
1188	system.--Notwithstanding other requirements of this chapter, the
1189	department and the Agency for Health Care Administration shall
1190	develop an integrated long-term-care delivery system.
1191	(1)  The duties of the integrated system shall include
1192	organizing and administering service delivery for the elderly,
1193	obtaining contracts for services with providers in each service
1194	area, monitoring the quality of services provided, determining
1195	levels of need and disability for payment purposes, and other
1196	activities determined necessary by the department and the agency
1197	in order to operate an integrated system.
1198	(2)  The agency and the department shall reimburse
1199	providers for case management services on a capitated basis and
1200	develop uniform standards for case management within the Aged
1201	and Disabled Adult Medicaid waiver program. The coordination of
1202	acute and chronic medical services for individuals may be
1203	included in the capitated rate for case management services. The
1204	agency, in consultation with the department, shall adopt rules
1205	pursuant to ss. 120.536(1) and 120.54 necessary to comply with
1206	or administer these requirements.
1207	(3)  The agency, in consultation with the department, shall
1208	work with the fiscal agent for the Medicaid program to develop a
1209	service utilization reporting system that operates through the
1210	fiscal agent for the capitated plans.
1211	(4)  The department, in consultation with the agency, shall
1212	integrate the database systems for the Comprehensive Assessment
1213	and Review for Long-Term Care Services (CARES) program and the
1214	Client Information and Referral Tracking System (CIRTS) into a
1215	single operating assessment information system by October 30,
1216	2006.
1217	(5)  During the 2006-2007 fiscal year:
1218	(a)  The agency, in consultation with the department, shall
1219	evaluate the Alzheimer's Disease waiver program and the Adult
1220	Day Health Care waiver program to assess whether providing
1221	limited intensive services through these waiver programs
1222	produces better outcomes for individuals than providing those
1223	services through the fee-for-service or capitated programs that
1224	provide a larger array of services.
1225	(b)  The agency, in consultation with the department, shall
1226	begin discussions with the federal Centers for Medicare and
1227	Medicaid Services regarding the inclusion of Medicare into the
1228	integrated long-term-care system. By December 31, 2006, the
1229	agency shall provide to the Governor, the President of the
1230	Senate, and the Speaker of the House of Representatives a plan
1231	for including Medicare in the integrated long-term-care system.
1232	Section 15.  Section 430.207, Florida Statutes, is amended
1233	to read:
1234	430.207  Confidentiality of information.--Information about
1235	functionally impaired elderly persons who receive services under
1236	ss. 430.201-430.2045 ss. 430.201-430.206 which is received
1237	through files, reports, inspections, or otherwise, by the
1238	department or by authorized departmental employees, by persons
1239	who volunteer services, or by persons who provide services to
1240	functionally impaired elderly persons under ss. 430.201-430.2045
1241	ss. 430.201-430.206 through contracts with the department is
1242	confidential and exempt from the provisions of s. 119.07(1).
1243	Such information may not be disclosed publicly in such a manner
1244	as to identify a functionally impaired elderly person, unless
1245	that person or his or her legal guardian provides written
1246	consent.
1247	Section 16.  Section 430.5001, Florida Statutes, is created
1248	to read:
1249	430.5001  Alzheimer's disease initiative; short title; rule
1250	authority.--
1251	(1)  Sections 430.5001-430.504 may be cited as the
1252	"Alzheimer's Disease Initiative."
1253	(2)  The department may adopt rules pursuant to ss.
1254	120.536(1) and 120.54 necessary to administer the programs
1255	created under ss. 430.5001-430.504.
1256	Section 17.  Subsection (5) of section 430.502, Florida
1257	Statutes, is amended to read:
1258	430.502  Alzheimer's disease; memory disorder clinics and
1259	day care and respite care programs.--
1260	(5)  Pursuant to s. 287.057, the department of Elderly
1261	Affairs shall contract for the provision of respite care and
1262	adult day care services. All funds appropriated for the
1263	provision of respite care shall be distributed annually by the
1264	department to each funded county according to an allocation
1265	formula. In developing the formula, the department shall
1266	consider the number and proportion of the county population of
1267	individuals who are 75 years of age and older. Each respite care
1268	program shall be used as a resource for research and statistical
1269	data by the memory disorder clinics established in this section
1270	part. In consultation with the memory disorder clinics, the
1271	department shall specify the information to be provided by the
1272	respite care programs for research purposes. Respite provider
1273	organizations shall assess and collect fees for services
1274	according to rules adopted by the department. To help pay for
1275	services received through the Alzheimer's Disease Initiative, a
1276	functionally impaired elderly person shall be assessed a fee
1277	based on the person's ability to pay for those services without
1278	jeopardizing the person's ability to pay the expenses for other
1279	basic living necessities. The fee to be assessed shall be fixed
1280	in a schedule to be prepared by the department. Services of
1281	specified value may be accepted in lieu of a fee. The fee
1282	schedule shall be developed in cooperation with the Alzheimer's
1283	Disease Advisory Committee and updated as necessary.
1284	Section 18.  Section 430.504, Florida Statutes, is amended
1285	to read:
1286	430.504  Confidentiality of information.--Information about
1287	clients of programs created or funded under s. 430.501 or s.
1288	430.503 which is received through files, reports, inspections,
1289	or otherwise, by the department or by authorized departmental
1290	employees, by persons who volunteer services, or by persons who
1291	provide services to clients of programs created or funded under
1292	s. 430.501 or s. 430.502(5) s. 430.503 through contracts with
1293	the department is confidential and exempt from the provisions of
1294	s. 119.07(1). Such information may not be disclosed publicly in
1295	such a manner as to identify a person who receives services
1296	under s. 430.501 or s. 430.502(5) s. 430.503, unless that person
1297	or that person's legal guardian provides written consent.
1298	Section 19.  Section 430.602, Florida Statutes, is amended
1299	to read:
1300	430.602  Home care for the elderly; definitions.--As used
1301	in ss. 430.601-430.606:
1302	(1)  "Department" means the Department of Elderly Affairs.
1303	(1)(2)  "Elderly person" means any person 60 years of age
1304	or older over who is currently a resident of this state and has
1305	an intent to remain in this state.
1306	(2)(3)  "Home care for the elderly" means a full-time
1307	family-type living arrangement, in a private home, under which a
1308	person or group of persons provides, on a nonprofit basis, basic
1309	services of maintenance and supervision, and any necessary
1310	specialized services as may be needed, for three or fewer
1311	elderly persons.
1312	Section 20.  Section 430.603, Florida Statutes, is amended
1313	to read:
1314	430.603  Home care for the elderly; rules.--There is
1315	created within the department the home care for the elderly
1316	program. The department shall adopt rules pursuant to ss.
1317	120.536(1) and 120.54 to by rule establish minimum standards and
1318	procedures for the provision of home care for the elderly and
1319	for the approval of persons seeking to provide this such care.
1320	Any person who is approved to provide care, goods, or services
1321	for an elderly person shall be eligible for the subsidy payments
1322	described in s. 430.605. However, the cost of administration and
1323	subsidy payments made under the home care for the elderly
1324	program must not exceed the amount specifically be operated
1325	within the funds appropriated by the Legislature for the program
1326	each year.
1327	Section 21.  Section 430.604, Florida Statutes, is amended
1328	to read:
1329	430.604  Department determination of inability to provide
1330	home care.--If a person who is providing or plans to provide
1331	home care under ss. 430.601-430.606 is found by the department,
1332	or its designee, to be unable to provide this care, the
1333	department must notify the person seeking to provide home care
1334	of this determination, and the person is immediately ineligible
1335	to receive not eligible for subsidy payments under the program
1336	ss. 430.601-430.606.
1337	Section 22.  Section 430.606, Florida Statutes, is amended
1338	to read:
1339	430.606  Eligibility for services.--The criteria for
1340	determining eligibility for the home care for the elderly this
1341	program shall be substantially similar to the criteria used to
1342	determine eligibility for nursing home care under the Medicaid
1343	institutional care program of the state.
1344	Section 23.  Paragraph (c) of subsection (2) of section
1345	430.705, Florida Statutes, is amended to read:
1346	430.705  Implementation of the long-term care community
1347	diversion pilot projects.--
1348	(2)
1349	(c)  The requirements of paragraph (b) do not apply to
1350	entities selected to provide services to the pilot projects
1351	authorized under s. 430.2051(3) s. 430.205(6)(b)2. The
1352	department, in consultation with the agency, shall develop by
1353	rule minimum financial solvency and reporting standards for
1354	these providers that are reflective of the amount of risk the
1355	provider will assume under the pilot project. The standards
1356	adopted by rule shall ensure safety for the pilot project
1357	enrollees and financial protection for the state in the event of
1358	a provider's inability to continue providing services to the
1359	project.
1360	Section 24.  Sections 430.205, 430.2053, and 430.503,
1361	Florida Statutes, are repealed.
1362	Section 25.  Subsection (12) of section 400.126, Florida
1363	Statutes, is amended to read:
1364	400.126  Receivership proceedings.--
1365	(12)  Concurrently with the appointment of a receiver, the
1366	agency and the Department of Elderly Affairs shall coordinate an
1367	assessment of each resident in the facility by the Comprehensive
1368	Assessment and Review for Long-Term-Care (CARES) Program for the
1369	purpose of evaluating each resident's need for the level of care
1370	provided in a nursing facility and the potential for providing
1371	such care in alternative settings. If the CARES assessment
1372	determines that a resident could be cared for in a less
1373	restrictive setting or does not meet the criteria for skilled or
1374	intermediate care in a nursing home, the department and agency
1375	shall refer the resident for such care, as is appropriate for
1376	the resident. Residents referred under pursuant to this
1377	subsection shall be given primary consideration for receiving
1378	services under the community care for the elderly program in the
1379	same manner as persons classified to receive such services under
1380	s. 430.204(5) pursuant to s. 430.205.
1381	Section 26.  Paragraph (h) of subsection (4) of section
1382	409.912, Florida Statutes, is amended to read:
1383	409.912  Cost-effective purchasing of health care.--The
1384	agency shall purchase goods and services for Medicaid recipients
1385	in the most cost-effective manner consistent with the delivery
1386	of quality medical care. To ensure that medical services are
1387	effectively utilized, the agency may, in any case, require a
1388	confirmation or second physician's opinion of the correct
1389	diagnosis for purposes of authorizing future services under the
1390	Medicaid program. This section does not restrict access to
1391	emergency services or poststabilization care services as defined
1392	in 42 C.F.R. part 438.114. Such confirmation or second opinion
1393	shall be rendered in a manner approved by the agency. The agency
1394	shall maximize the use of prepaid per capita and prepaid
1395	aggregate fixed-sum basis services when appropriate and other
1396	alternative service delivery and reimbursement methodologies,
1397	including competitive bidding pursuant to s. 287.057, designed
1398	to facilitate the cost-effective purchase of a case-managed
1399	continuum of care. The agency shall also require providers to
1400	minimize the exposure of recipients to the need for acute
1401	inpatient, custodial, and other institutional care and the
1402	inappropriate or unnecessary use of high-cost services. The
1403	agency shall contract with a vendor to monitor and evaluate the
1404	clinical practice patterns of providers in order to identify
1405	trends that are outside the normal practice patterns of a
1406	provider's professional peers or the national guidelines of a
1407	provider's professional association. The vendor must be able to
1408	provide information and counseling to a provider whose practice
1409	patterns are outside the norms, in consultation with the agency,
1410	to improve patient care and reduce inappropriate utilization.
1411	The agency may mandate prior authorization, drug therapy
1412	management, or disease management participation for certain
1413	populations of Medicaid beneficiaries, certain drug classes, or
1414	particular drugs to prevent fraud, abuse, overuse, and possible
1415	dangerous drug interactions. The Pharmaceutical and Therapeutics
1416	Committee shall make recommendations to the agency on drugs for
1417	which prior authorization is required. The agency shall inform
1418	the Pharmaceutical and Therapeutics Committee of its decisions
1419	regarding drugs subject to prior authorization. The agency is
1420	authorized to limit the entities it contracts with or enrolls as
1421	Medicaid providers by developing a provider network through
1422	provider credentialing. The agency may competitively bid single-
1423	source-provider contracts if procurement of goods or services
1424	results in demonstrated cost savings to the state without
1425	limiting access to care. The agency may limit its network based
1426	on the assessment of beneficiary access to care, provider
1427	availability, provider quality standards, time and distance
1428	standards for access to care, the cultural competence of the
1429	provider network, demographic characteristics of Medicaid
1430	beneficiaries, practice and provider-to-beneficiary standards,
1431	appointment wait times, beneficiary use of services, provider
1432	turnover, provider profiling, provider licensure history,
1433	previous program integrity investigations and findings, peer
1434	review, provider Medicaid policy and billing compliance records,
1435	clinical and medical record audits, and other factors. Providers
1436	shall not be entitled to enrollment in the Medicaid provider
1437	network. The agency shall determine instances in which allowing
1438	Medicaid beneficiaries to purchase durable medical equipment and
1439	other goods is less expensive to the Medicaid program than long-
1440	term rental of the equipment or goods. The agency may establish
1441	rules to facilitate purchases in lieu of long-term rentals in
1442	order to protect against fraud and abuse in the Medicaid program
1443	as defined in s. 409.913. The agency may seek federal waivers
1444	necessary to administer these policies.
1445	(4)  The agency may contract with:
1446	(h)  An entity authorized in s. 430.204 s. 430.205 to
1447	contract with the agency and the Department of Elderly Affairs
1448	to provide health care and social services on a prepaid or
1449	fixed-sum basis to elderly recipients. Such prepaid health care
1450	services entities are exempt from the provisions of part I of
1451	chapter 641 for the first 3 years of operation. An entity
1452	recognized under this paragraph that demonstrates to the
1453	satisfaction of the Office of Insurance Regulation that it is
1454	backed by the full faith and credit of one or more counties in
1455	which it operates may be exempted from s. 641.225.
1456	Section 27.  Paragraph (c) of subsection (3) of section
1457	420.36, Florida Statutes, is amended to read:
1458	420.36  Low-income Emergency Home Repair Program.--There is
1459	established within the Department of Community Affairs the
1460	Low-income Emergency Home Repair Program to assist low-income
1461	persons, especially the elderly and physically disabled, in
1462	making emergency repairs which directly affect their health and
1463	safety.
1464	(3)
1465	(c)  Each grantee shall be required to provide an in-kind
1466	or cash match of at least 20 percent of the funds granted.
1467	Grantees and subgrantees are shall be encouraged to use
1468	community resources to provide the such match, including family,
1469	church, and neighborhood volunteers and materials provided by
1470	local groups and businesses. Grantees shall coordinate with
1471	local governments through their community development block
1472	grant entitlement programs and other housing programs, local
1473	housing partnerships, and agencies under contract to a lead
1474	agency for the provisions of services under the Community Care
1475	for the Elderly Act, ss. 430.201-430.2045 ss. 430.201-430.207.
1476	Section 28.  This act shall take effect July 1, 2006.

CODING: Words stricken are deletions; words underlined are additions.