Amendment
Bill No. HB 1541

Amendment No. 825909

CHAMBER ACTION
Senate		House
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1	Representative Kreegel offered the following:
2
3	Amendment (with title amendment)
4	Remove lines 979-2030 and insert:
5	(m)  Entities that do not seek reimbursement from insurance
6	companies for medical services paid pursuant to personal injury
7	protection coverage required by s. 627.736, bodily injury
8	liability coverage, personal liability umbrella coverage, or
9	uninsured motorist coverage.
10	Section 14.  Paragraph (a) of subsection (7) of section
11	400.9935, Florida Statutes, is amended to read:
12	400.9935  Clinic responsibilities.--
13	(7)(a)  Each clinic engaged in magnetic resonance imaging
14	services must be accredited by the Joint Commission on
15	Accreditation of Healthcare Organizations, the American College
16	of Radiology, or the Accreditation Association for Ambulatory
17	Health Care, within 1 year after licensure. A clinic that is
18	accredited by the American College of Radiology or is within the
19	original 1-year period after licensure and replaces its core
20	magnetic resonance imaging equipment shall be given 1 year after
21	the date upon which the equipment is replaced to attain
22	accreditation. However, a clinic may request a single, 6-month
23	extension if it provides evidence to the agency establishing
24	that, for good cause shown, such clinic cannot can not be
25	accredited within 1 year after licensure, and that such
26	accreditation will be completed within the 6-month extension.
27	After obtaining accreditation as required by this subsection,
28	each such clinic must maintain accreditation as a condition of
29	renewal of its license. A clinic that files a change of
30	ownership application must comply with the original
31	accreditation timeframe requirements of the transferor. The
32	agency shall deny a change of ownership application if the
33	clinic is not in compliance with the accreditation requirements.
34	When a clinic adds, replaces, or modifies magnetic resonance
35	imaging equipment and the accrediting organization requires new
36	accreditation, the clinic must be accredited within 1 year after
37	the date of the addition, replacement, or modification but may
38	request a single, 6-month extension if the clinic provides
39	evidence of good cause to the agency.
40	Section 15.  Subsection (6) of section 400.995, Florida
41	Statutes, is amended to read:
42	400.995  Agency administrative penalties.--
43	(6)  During an inspection, the agency, as an alternative to
44	or in conjunction with an administrative action against a clinic
45	for violations of this part and adopted rules, shall make a
46	reasonable attempt to discuss each violation and recommended
47	corrective action with the owner, medical director, or clinic
48	director of the clinic, prior to written notification. The
49	agency, instead of fixing a period within which the clinic shall
50	enter into compliance with standards, may request a plan of
51	corrective action from the clinic which demonstrates a good
52	faith effort to remedy each violation by a specific date,
53	subject to the approval of the agency.
54	Section 16.  Subsections (5), (9), and (13) of section
55	408.803, Florida Statutes, are amended to read:
56	408.803  Definitions.--As used in this part, the term:
57	(5)  "Change of ownership" means:
58	(a)  An event in which the licensee sells or otherwise
59	transfers its ownership changes to a different individual or
60	legal entity, as evidenced by a change in federal employer
61	identification number or taxpayer identification number; or
62	(b)  An event in which 51 45 percent or more of the
63	ownership, voting shares, membership, or controlling interest of
64	a licensee is in any manner transferred or otherwise assigned.
65	This paragraph does not apply to a licensee that is publicly
66	traded on a recognized stock exchange. In a corporation whose
67	shares are not publicly traded on a recognized stock exchange is
68	transferred or assigned, including the final transfer or
69	assignment of multiple transfers or assignments over a 2-year
70	period that cumulatively total 45 percent or greater.
71
72	A change solely in the management company or board of directors
73	is not a change of ownership.
74	(9)  "Licensee" means an individual, corporation,
75	partnership, firm, association, or governmental entity, or other
76	entity that is issued a permit, registration, certificate, or
77	license by the agency. The licensee is legally responsible for
78	all aspects of the provider operation.
79	(13)  "Voluntary board member" means a board member of a
80	not-for-profit corporation or organization who serves solely in
81	a voluntary capacity, does not receive any remuneration for his
82	or her services on the board of directors, and has no financial
83	interest in the corporation or organization. The agency shall
84	recognize a person as a voluntary board member following
85	submission of a statement to the agency by the board member and
86	the not-for-profit corporation or organization that affirms that
87	the board member conforms to this definition. The statement
88	affirming the status of the board member must be submitted to
89	the agency on a form provided by the agency.
90	Section 17.  Paragraph (a) of subsection (1), subsection
91	(2), paragraph (c) of subsection (7), and subsection (8) of
92	section 408.806, Florida Statutes, are amended to read:
93	408.806  License application process.--
94	(1)  An application for licensure must be made to the
95	agency on forms furnished by the agency, submitted under oath,
96	and accompanied by the appropriate fee in order to be accepted
97	and considered timely. The application must contain information
98	required by authorizing statutes and applicable rules and must
99	include:
100	(a)  The name, address, and social security number of:
101	1.  The applicant;
102	2.  The administrator or a similarly titled person who is
103	responsible for the day-to-day operation of the provider;
104	3.  The financial officer or similarly titled person who is
105	responsible for the financial operation of the licensee or
106	provider; and
107	4.  Each controlling interest if the applicant or
108	controlling interest is an individual.
109	(2)(a)  The applicant for a renewal license must submit an
110	application that must be received by the agency at least 60 days
111	but no more than 120 days prior to the expiration of the current
112	license. An application received more than 120 days prior to the
113	expiration of the current license shall be returned to the
114	applicant. If the renewal application and fee are received prior
115	to the license expiration date, the license shall not be deemed
116	to have expired if the license expiration date occurs during the
117	agency's review of the renewal application.
118	(b)  The applicant for initial licensure due to a change of
119	ownership must submit an application that must be received by
120	the agency at least 60 days prior to the date of change of
121	ownership.
122	(c)  For any other application or request, the applicant
123	must submit an application or request that must be received by
124	the agency at least 60 days but no more than 120 days prior to
125	the requested effective date, unless otherwise specified in
126	authorizing statutes or applicable rules. An application
127	received more than 120 days prior to the requested effective
128	date shall be returned to the applicant.
129	(d)  The agency shall notify the licensee by mail or
130	electronically at least 90 days prior to the expiration of a
131	license that a renewal license is necessary to continue
132	operation. The failure to timely submit a renewal application
133	and license fee shall result in a $50 per day late fee charged
134	to the licensee by the agency; however, the aggregate amount of
135	the late fee may not exceed 50 percent of the licensure fee or
136	$500, whichever is less. If an application is received after the
137	required filing date and exhibits a hand-canceled postmark
138	obtained from a United States post office dated on or before the
139	required filing date, no fine will be levied.
140	(7)
141	(c)  If an inspection is required by the authorizing
142	statute for a license application other than an initial
143	application, the inspection must be unannounced. This paragraph
144	does not apply to inspections required pursuant to ss. 383.324,
145	395.0161(4), 429.67(6), and 483.061(2).
146	(8)  The agency may establish procedures for the electronic
147	notification and submission of required information, including,
148	but not limited to:
149	(a)  Licensure applications.
150	(b)  Required signatures.
151	(c)  Payment of fees.
152	(d)  Notarization of applications.
153
154	Requirements for electronic submission of any documents required
155	by this part or authorizing statutes may be established by rule.
156	As an alternative to sending documents as required by
157	authorizing statutes, the agency may provide electronic access
158	to information or documents.
159	Section 18.  Subsection (2) of section 408.808, Florida
160	Statutes, is amended to read:
161	408.808  License categories.--
162	(2)  PROVISIONAL LICENSE.--A provisional license may be
163	issued to an applicant pursuant to s. 408.809(3). An applicant
164	against whom a proceeding denying or revoking a license is
165	pending at the time of license renewal may be issued a
166	provisional license effective until final action not subject to
167	further appeal. A provisional license may also be issued to an
168	applicant applying for a change of ownership. A provisional
169	license shall be limited in duration to a specific period of
170	time, not to exceed 12 months, as determined by the agency.
171	Section 19.  Subsection (5) of section 408.809, Florida
172	Statutes, is amended, and new subsections (5) and (6) are added
173	to that section, to read:
174	408.809  Background screening; prohibited offenses.--
175	(5)  Effective October 1, 2009, in addition to the offenses
176	listed in ss. 435.03 and 435.04, all persons required to undergo
177	background screening pursuant to this part or authorizing
178	statutes must not have been found guilty of, regardless of
179	adjudication, or entered a plea of nolo contendere or guilty to,
180	any of the following offenses or any similar offense of another
181	jurisdiction:
182	(a)  A violation of any authorizing statutes, if the
183	offense was a felony.
184	(b)  A violation of this chapter, if the offense was a
185	felony.
186	(c)  A violation of s. 409.920, relating to Medicaid
187	provider fraud, if the offense was a felony.
188	(d)  A violation of s. 409.9201, relating to Medicaid
189	fraud, if the offense was a felony.
190	(e)  A violation of s. 741.28, relating to domestic
191	violence.
192	(f)  A violation of chapter 784, relating to assault,
193	battery, and culpable negligence, if the offense was a felony.
194	(g)  A violation of s. 810.02, relating to burglary.
195	(h)  A violation of s. 817.034, relating to fraudulent acts
196	through mail, wire, radio, electromagnetic, photoelectronic, or
197	photooptical systems.
198	(i)  A violation of s. 817.234, relating to false and
199	fraudulent insurance claims.
200	(j)  A violation of s. 817.505, relating to patient
201	brokering.
202	(k)  A violation of s. 817.568, relating to criminal use of
203	personal identification information.
204	(l)  A violation of s. 817.60, relating to obtaining a
205	credit card through fraudulent means.
206	(m)  A violation of s. 817.61, relating to fraudulent use
207	of credit cards, if the offense was a felony.
208	(n)  A violation of s. 831.01, relating to forgery.
209	(o)  A violation of s. 831.02, relating to uttering forged
210	instruments.
211	(p)  A violation of s. 831.07, relating to forging bank
212	bills, checks, drafts, or promissory notes.
213	(q)  A violation of s. 831.09, relating to uttering forged
214	bank bills, checks, drafts, or promissory notes.
215	(r)  A violation of s. 831.30, relating to fraud in
216	obtaining medicinal drugs.
217	(s)  A violation of s. 831.31, relating to the sale,
218	manufacture, delivery, or possession with the intent to sell,
219	manufacture, or deliver any counterfeit controlled substance, if
220	the offense was a felony.
221
222	A person who serves as a controlling interest of or is employed
223	by a licensee on September 30, 2009, shall not be required by
224	law to submit to rescreening if that licensee has in its
225	possession written evidence that the person has been screened
226	and qualified according to the standards specified in s. 435.03
227	or s. 435.04. However, if such person has been convicted of a
228	disqualifying offense listed in this subsection, he or she may
229	apply for an exemption from the appropriate licensing agency
230	before September 30, 2009, and if agreed to by the employer, may
231	continue to perform his or her duties until the licensing agency
232	renders a decision on the application for exemption for an
233	offense listed in this subsection. Exemptions from
234	disqualification may be granted pursuant to s. 435.07.
235	(6)  The attestations required under ss. 435.04(5) and
236	435.05(3) must be submitted at the time of license renewal,
237	notwithstanding the provisions of ss. 435.04(5) and 435.05(3)
238	which require annual submission of an affidavit of compliance
239	with background screening requirements.
240	(5)  Background screening is not required to obtain a
241	certificate of exemption issued under s. 483.106.
242	Section 20.  Subsection (3) of section 408.810, Florida
243	Statutes, is amended to read:
244	408.810  Minimum licensure requirements.--In addition to
245	the licensure requirements specified in this part, authorizing
246	statutes, and applicable rules, each applicant and licensee must
247	comply with the requirements of this section in order to obtain
248	and maintain a license.
249	(3)  Unless otherwise specified in this part, authorizing
250	statutes, or applicable rules, any information required to be
251	reported to the agency must be submitted within 21 calendar days
252	after the report period or effective date of the information,
253	whichever is earlier, including, but not limited to, any change
254	of:
255	(a)  Information contained in the most recent application
256	for licensure.
257	(b)  Required insurance or bonds.
258	Section 21.  Present subsection (4) of section 408.811,
259	Florida Statutes, is renumbered as subsection (6), subsections
260	(2) and (3) are amended, and new subsections (4) and (5) are
261	added to that section, to read:
262	408.811  Right of inspection; copies; inspection reports;
263	plan for correction of deficiencies.--
264	(2)  Inspections conducted in conjunction with
265	certification, comparable licensure requirements, or a
266	recognized or approved accreditation organization may be
267	accepted in lieu of a complete licensure inspection. However, a
268	licensure inspection may also be conducted to review any
269	licensure requirements that are not also requirements for
270	certification.
271	(3)  The agency shall have access to and the licensee shall
272	provide, or if requested send, copies of all provider records
273	required during an inspection or other review at no cost to the
274	agency, including records requested during an offsite review.
275	(4)  Deficiencies must be corrected within 30 calendar days
276	after the provider is notified of inspection results unless an
277	alternative timeframe is required or approved by the agency.
278	(5)  The agency may require an applicant or licensee to
279	submit a plan of correction for deficiencies. If required, the
280	plan of correction must be filed with the agency within 10
281	calendar days after notification unless an alternative timeframe
282	is required.
283	Section 22.  Section 408.813, Florida Statutes, is amended
284	to read:
285	408.813  Administrative fines; violations.--As a penalty
286	for any violation of this part, authorizing statutes, or
287	applicable rules, the agency may impose an administrative fine.
288	(1)  Unless the amount or aggregate limitation of the fine
289	is prescribed by authorizing statutes or applicable rules, the
290	agency may establish criteria by rule for the amount or
291	aggregate limitation of administrative fines applicable to this
292	part, authorizing statutes, and applicable rules. Each day of
293	violation constitutes a separate violation and is subject to a
294	separate fine, unless a per-violation fine is prescribed by law.
295	For fines imposed by final order of the agency and not subject
296	to further appeal, the violator shall pay the fine plus interest
297	at the rate specified in s. 55.03 for each day beyond the date
298	set by the agency for payment of the fine.
299	(2)  Violations of this part, authorizing statutes, or
300	applicable rules shall be classified according to the nature of
301	the violation and the gravity of its probable effect on clients.
302	The scope of a violation may be cited as an isolated, patterned,
303	or widespread deficiency. An isolated deficiency is a deficiency
304	affecting one or a very limited number of clients, or involving
305	one or a very limited number of staff, or a situation that
306	occurred only occasionally or in a very limited number of
307	locations. A patterned deficiency is a deficiency in which more
308	than a very limited number of clients are affected, or more than
309	a very limited number of staff are involved, or the situation
310	has occurred in several locations, or the same client or clients
311	have been affected by repeated occurrences of the same deficient
312	practice but the effect of the deficient practice is not found
313	to be pervasive throughout the provider. A widespread deficiency
314	is a deficiency in which the problems causing the deficiency are
315	pervasive in the provider or represent systemic failure that has
316	affected or has the potential to affect a large portion of the
317	provider's clients. This subsection does not affect the
318	legislative determination of the amount of a fine imposed under
319	authorizing statutes. Violations shall be classified on the
320	written notice as follows:
321	(a)  Class "I" violations are those conditions or
322	occurrences related to the operation and maintenance of a
323	provider or to the care of clients which the agency determines
324	present an imminent danger to the clients of the provider or a
325	substantial probability that death or serious physical or
326	emotional harm would result therefrom. The condition or practice
327	constituting a class I violation shall be abated or eliminated
328	within 24 hours, unless a fixed period, as determined by the
329	agency, is required for correction. The agency shall impose an
330	administrative fine as provided by law for a cited class I
331	violation. A fine shall be levied notwithstanding the correction
332	of the violation.
333	(b)  Class "II" violations are those conditions or
334	occurrences related to the operation and maintenance of a
335	provider or to the care of clients which the agency determines
336	directly threaten the physical or emotional health, safety, or
337	security of the clients, other than class I violations. The
338	agency shall impose an administrative fine as provided by law
339	for a cited class II violation. A fine shall be levied
340	notwithstanding the correction of the violation.
341	(c)  Class "III" violations are those conditions or
342	occurrences related to the operation and maintenance of a
343	provider or to the care of clients which the agency determines
344	indirectly or potentially threaten the physical or emotional
345	health, safety, or security of clients, other than class I or
346	class II violations. The agency shall impose an administrative
347	fine as provided by law for a cited class III violation. A
348	citation for a class III violation must specify the time within
349	which the violation is required to be corrected. If a class III
350	violation is corrected within the time specified, a fine may not
351	be imposed.
352	(d)  Class "IV" violations are those conditions or
353	occurrences related to the operation and maintenance of a
354	provider or to required reports, forms, or documents that do not
355	have the potential of negatively affecting clients. These
356	violations are of a type that the agency determines do not
357	threaten the health, safety, or security of clients. The agency
358	shall impose an administrative fine as provided by law for a
359	cited class IV violation. A citation for a class IV violation
360	must specify the time within which the violation is required to
361	be corrected. If a class IV violation is corrected within the
362	time specified, a fine may not be imposed.
363	Section 23.  Subsections (12) through (29) of section
364	408.820, Florida Statutes, are renumbered as subsections (11)
365	through (28), respectively, and present subsections (11), (12),
366	(13), (21), and (26) of that section are amended to read:
367	408.820  Exemptions.--Except as prescribed in authorizing
368	statutes, the following exemptions shall apply to specified
369	requirements of this part:
370	(11)  Private review agents, as provided under part I of
371	chapter 395, are exempt from ss. 408.806(7), 408.810, and
372	408.811.
373	(11)(12)  Health care risk managers, as provided under part
374	I of chapter 395, are exempt from ss. 408.806(7), 408.810(4)-
375	(10), and 408.811.
376	(12)(13)  Nursing homes, as provided under part II of
377	chapter 400, are exempt from ss. s. 408.810(7) and 408.813(2).
378	(20)(21)  Transitional living facilities, as provided under
379	part V of chapter 400, are exempt from s. 408.810(7)-(10).
380	(25)(26)  Health care clinics, as provided under part X of
381	chapter 400, are exempt from s. ss. 408.809 and 408.810(1), (6),
382	(7), and (10).
383	Section 24.  Section 408.821, Florida Statutes, is created
384	to read:
385	408.821  Emergency management planning; emergency
386	operations; inactive license.--
387	(1)  Licensees required by authorizing statutes to have an
388	emergency operations plan must designate a safety liaison to
389	serve as the primary contact for emergency operations.
390	(2)  An entity subject to this part may temporarily exceed
391	its licensed capacity to act as a receiving provider in
392	accordance with an approved emergency operations plan for up to
393	15 days. While in an overcapacity status, each provider must
394	furnish or arrange for appropriate care and services to all
395	clients. In addition, the agency may approve requests for
396	overcapacity in excess of 15 days, which approvals may be based
397	upon satisfactory justification and need as provided by the
398	receiving and sending providers.
399	(3)(a)  An inactive license may be issued to a licensee
400	subject to this section when the provider is located in a
401	geographic area in which a state of emergency was declared by
402	the Governor if the provider:
403	1.  Suffered damage to its operation during the state of
404	emergency.
405	2.  Is currently licensed.
406	3.  Does not have a provisional license.
407	4.  Will be temporarily unable to provide services but is
408	reasonably expected to resume services within 12 months.
409	(b)  An inactive license may be issued for a period not to
410	exceed 12 months but may be renewed by the agency for up to 12
411	additional months upon demonstration to the agency of progress
412	toward reopening. A request by a licensee for an inactive
413	license or to extend the previously approved inactive period
414	must be submitted in writing to the agency, accompanied by
415	written justification for the inactive license, which states the
416	beginning and ending dates of inactivity and includes a plan for
417	the transfer of any clients to other providers and appropriate
418	licensure fees. Upon agency approval, the licensee shall notify
419	clients of any necessary discharge or transfer as required by
420	authorizing statutes or applicable rules. The beginning of the
421	inactive licensure period shall be the date the provider ceases
422	operations. The end of the inactive period shall become the
423	license expiration date, and all licensure fees must be current,
424	must be paid in full, and may be prorated. Reactivation of an
425	inactive license requires the prior approval by the agency of a
426	renewal application, including payment of licensure fees and
427	agency inspections indicating compliance with all requirements
428	of this part and applicable rules and statutes.
429	(4)  The agency may adopt rules relating to emergency
430	management planning, communications, and operations. Licensees
431	providing residential or inpatient services must utilize an
432	online database approved by the agency to report information to
433	the agency regarding the provider's emergency status, planning,
434	or operations.
435	Section 25.  Subsections (3), (4), and (5) of section
436	408.831, Florida Statutes, are amended to read:
437	408.831  Denial, suspension, or revocation of a license,
438	registration, certificate, or application.--
439	(3)  An entity subject to this section may exceed its
440	licensed capacity to act as a receiving facility in accordance
441	with an emergency operations plan for clients of evacuating
442	providers from a geographic area where an evacuation order has
443	been issued by a local authority having jurisdiction. While in
444	an overcapacity status, each provider must furnish or arrange
445	for appropriate care and services to all clients. In addition,
446	the agency may approve requests for overcapacity beyond 15 days,
447	which approvals may be based upon satisfactory justification and
448	need as provided by the receiving and sending facilities.
449	(4)(a)  An inactive license may be issued to a licensee
450	subject to this section when the provider is located in a
451	geographic area where a state of emergency was declared by the
452	Governor if the provider:
453	1.  Suffered damage to its operation during that state of
454	emergency.
455	2.  Is currently licensed.
456	3.  Does not have a provisional license.
457	4.  Will be temporarily unable to provide services but is
458	reasonably expected to resume services within 12 months.
459	(b)  An inactive license may be issued for a period not to
460	exceed 12 months but may be renewed by the agency for up to 12
461	additional months upon demonstration to the agency of progress
462	toward reopening. A request by a licensee for an inactive
463	license or to extend the previously approved inactive period
464	must be submitted in writing to the agency, accompanied by
465	written justification for the inactive license, which states the
466	beginning and ending dates of inactivity and includes a plan for
467	the transfer of any clients to other providers and appropriate
468	licensure fees. Upon agency approval, the licensee shall notify
469	clients of any necessary discharge or transfer as required by
470	authorizing statutes or applicable rules. The beginning of the
471	inactive licensure period shall be the date the provider ceases
472	operations. The end of the inactive period shall become the
473	licensee expiration date, and all licensure fees must be
474	current, paid in full, and may be prorated. Reactivation of an
475	inactive license requires the prior approval by the agency of a
476	renewal application, including payment of licensure fees and
477	agency inspections indicating compliance with all requirements
478	of this part and applicable rules and statutes.
479	(3)(5)  This section provides standards of enforcement
480	applicable to all entities licensed or regulated by the Agency
481	for Health Care Administration. This section controls over any
482	conflicting provisions of chapters 39, 383, 390, 391, 394, 395,
483	400, 408, 429, 468, 483, and 765 or rules adopted pursuant to
484	those chapters.
485	Section 26.  Subsection (2) of section 408.918, Florida
486	Statutes, is amended, and subsection (3) is added to that
487	section, to read:
488	408.918  Florida 211 Network; uniform certification
489	requirements.--
490	(2)  In order to participate in the Florida 211 Network, a
491	211 provider must be fully accredited by the National certified
492	by the Agency for Health Care Administration. The agency shall
493	develop criteria for certification, as recommended by the
494	Florida Alliance of Information and Referral Services or have
495	received approval to operate, pending accreditation, from its
496	affiliate, the Florida Alliance of Information and Referral
497	Services, and shall adopt the criteria as administrative rules.
498	(a)  If any provider of information and referral services
499	or other entity leases a 211 number from a local exchange
500	company and is not authorized as described in this section,
501	certified by the agency, the agency shall, after consultation
502	with the local exchange company and the Public Service
503	Commission shall, request that the Federal Communications
504	Commission direct the local exchange company to revoke the use
505	of the 211 number.
506	(b)  The agency shall seek the assistance and guidance of
507	the Public Service Commission and the Federal Communications
508	Commission in resolving any disputes arising over jurisdiction
509	related to 211 numbers.
510	(3)  The Florida Alliance of Information and Referral
511	Services is the 211 collaborative organization for the state
512	that is responsible for studying, designing, implementing,
513	supporting, and coordinating the Florida 211 Network and
514	receiving federal grants.
515	Section 27.  Paragraph (e) of subsection (4) of section
516	409.221, Florida Statutes, is amended to read:
517	409.221  Consumer-directed care program.--
518	(4)  CONSUMER-DIRECTED CARE.--
519	(e)  Services.--Consumers shall use the budget allowance
520	only to pay for home and community-based services that meet the
521	consumer's long-term care needs and are a cost-efficient use of
522	funds. Such services may include, but are not limited to, the
523	following:
524	1.  Personal care.
525	2.  Homemaking and chores, including housework, meals,
526	shopping, and transportation.
527	3.  Home modifications and assistive devices which may
528	increase the consumer's independence or make it possible to
529	avoid institutional placement.
530	4.  Assistance in taking self-administered medication.
531	5.  Day care and respite care services, including those
532	provided by nursing home facilities pursuant to s.
533	400.141(1)(f)(6) or by adult day care facilities licensed
534	pursuant to s. 429.907.
535	6.  Personal care and support services provided in an
536	assisted living facility.
537	Section 28.  Subsection (5) of section 409.901, Florida
538	Statutes, is amended to read:
539	409.901  Definitions; ss. 409.901-409.920.--As used in ss.
540	409.901-409.920, except as otherwise specifically provided, the
541	term:
542	(5)  "Change of ownership" means:
543	(a)  An event in which the provider ownership changes to a
544	different individual legal entity, as evidenced by a change in
545	federal employer identification number or taxpayer
546	identification number; or
547	(b)  An event in which 51 45 percent or more of the
548	ownership, voting shares, membership, or controlling interest of
549	a provider is in any manner transferred or otherwise assigned.
550	This paragraph does not apply to a licensee that is publicly
551	traded on a recognized stock exchange; or
552	(c)  When the provider is licensed or registered by the
553	agency, an event considered a change of ownership for licensure
554	as defined in s. 408.803 in a corporation whose shares are not
555	publicly traded on a recognized stock exchange is transferred or
556	assigned, including the final transfer or assignment of multiple
557	transfers or assignments over a 2-year period that cumulatively
558	total 45 percent or more.
559
560	A change solely in the management company or board of directors
561	is not a change of ownership.
562	Section 29.  Section 429.071, Florida Statutes, is
563	repealed.
564	Section 30.  Paragraph (e) of subsection (1) and
565	subsections (2) and (3) of section 429.08, Florida Statutes, are
566	amended to read:
567	429.08  Unlicensed facilities; referral of person for
568	residency to unlicensed facility; penalties; verification of
569	licensure status.--
570	(1)
571	(e)  The agency shall publish provide to the department's
572	elder information and referral providers a list, by county, of
573	licensed assisted living facilities, to assist persons who are
574	considering an assisted living facility placement in locating a
575	licensed facility. This information may be provided
576	electronically or on the agency's Internet website.
577	(2)  Each field office of the Agency for Health Care
578	Administration shall establish a local coordinating workgroup
579	which includes representatives of local law enforcement
580	agencies, state attorneys, the Medicaid Fraud Control Unit of
581	the Department of Legal Affairs, local fire authorities, the
582	Department of Children and Family Services, the district long-
583	term care ombudsman council, and the district human rights
584	advocacy committee to assist in identifying the operation of
585	unlicensed facilities and to develop and implement a plan to
586	ensure effective enforcement of state laws relating to such
587	facilities. The workgroup shall report its findings, actions,
588	and recommendations semiannually to the Director of Health
589	Quality Assurance of the agency.
590	(2)(3)  It is unlawful to knowingly refer a person for
591	residency to an unlicensed assisted living facility; to an
592	assisted living facility the license of which is under denial or
593	has been suspended or revoked; or to an assisted living facility
594	that has a moratorium pursuant to part II of chapter 408. Any
595	person who violates this subsection commits a noncriminal
596	violation, punishable by a fine not exceeding $500 as provided
597	in s. 775.083.
598	(a)  Any health care practitioner, as defined in s.
599	456.001, who is aware of the operation of an unlicensed facility
600	shall report that facility to the agency. Failure to report a
601	facility that the practitioner knows or has reasonable cause to
602	suspect is unlicensed shall be reported to the practitioner's
603	licensing board.
604	(b)  Any provider as defined in s. 408.803 that hospital or
605	community mental health center licensed under chapter 395 or
606	chapter 394 which knowingly discharges a patient or client to an
607	unlicensed facility is subject to sanction by the agency.
608	(c)  Any employee of the agency or department, or the
609	Department of Children and Family Services, who knowingly refers
610	a person for residency to an unlicensed facility; to a facility
611	the license of which is under denial or has been suspended or
612	revoked; or to a facility that has a moratorium pursuant to part
613	II of chapter 408 is subject to disciplinary action by the
614	agency or department, or the Department of Children and Family
615	Services.
616	(d)  The employer of any person who is under contract with
617	the agency or department, or the Department of Children and
618	Family Services, and who knowingly refers a person for residency
619	to an unlicensed facility; to a facility the license of which is
620	under denial or has been suspended or revoked; or to a facility
621	that has a moratorium pursuant to part II of chapter 408 shall
622	be fined and required to prepare a corrective action plan
623	designed to prevent such referrals.
624	(e)  The agency shall provide the department and the
625	Department of Children and Family Services with a list of
626	licensed facilities within each county and shall update the list
627	at least quarterly.
628	(f)  At least annually, the agency shall notify, in
629	appropriate trade publications, physicians licensed under
630	chapter 458 or chapter 459, hospitals licensed under chapter
631	395, nursing home facilities licensed under part II of chapter
632	400, and employees of the agency or the department, or the
633	Department of Children and Family Services, who are responsible
634	for referring persons for residency, that it is unlawful to
635	knowingly refer a person for residency to an unlicensed assisted
636	living facility and shall notify them of the penalty for
637	violating such prohibition. The department and the Department of
638	Children and Family Services shall, in turn, notify service
639	providers under contract to the respective departments who have
640	responsibility for resident referrals to facilities. Further,
641	the notice must direct each noticed facility and individual to
642	contact the appropriate agency office in order to verify the
643	licensure status of any facility prior to referring any person
644	for residency. Each notice must include the name, telephone
645	number, and mailing address of the appropriate office to
646	contact.
647	Section 31.  Paragraph (e) of subsection (1) of section
648	429.14, Florida Statutes, is amended to read:
649	429.14  Administrative penalties.--
650	(1)  In addition to the requirements of part II of chapter
651	408, the agency may deny, revoke, and suspend any license issued
652	under this part and impose an administrative fine in the manner
653	provided in chapter 120 against a licensee of an assisted living
654	facility for a violation of any provision of this part, part II
655	of chapter 408, or applicable rules, or for any of the following
656	actions by a licensee of an assisted living facility, for the
657	actions of any person subject to level 2 background screening
658	under s. 408.809, or for the actions of any facility employee:
659	(e)  A citation of any of the following deficiencies as
660	specified defined in s. 429.19:
661	1.  One or more cited class I deficiencies.
662	2.  Three or more cited class II deficiencies.
663	3.  Five or more cited class III deficiencies that have
664	been cited on a single survey and have not been corrected within
665	the times specified.
666	Section 32.  Subsections (2), (8), and (9) of section
667	429.19, Florida Statutes, are amended to read:
668	429.19  Violations; imposition of administrative fines;
669	grounds.--
670	(2)  Each violation of this part and adopted rules shall be
671	classified according to the nature of the violation and the
672	gravity of its probable effect on facility residents. The agency
673	shall indicate the classification on the written notice of the
674	violation as follows:
675	(a)  Class "I" violations are defined in s. 408.813 those
676	conditions or occurrences related to the operation and
677	maintenance of a facility or to the personal care of residents
678	which the agency determines present an imminent danger to the
679	residents or guests of the facility or a substantial probability
680	that death or serious physical or emotional harm would result
681	therefrom. The condition or practice constituting a class I
682	violation shall be abated or eliminated within 24 hours, unless
683	a fixed period, as determined by the agency, is required for
684	correction. The agency shall impose an administrative fine for a
685	cited class I violation in an amount not less than $5,000 and
686	not exceeding $10,000 for each violation. A fine may be levied
687	notwithstanding the correction of the violation.
688	(b)  Class "II" violations are defined in s. 408.813 those
689	conditions or occurrences related to the operation and
690	maintenance of a facility or to the personal care of residents
691	which the agency determines directly threaten the physical or
692	emotional health, safety, or security of the facility residents,
693	other than class I violations. The agency shall impose an
694	administrative fine for a cited class II violation in an amount
695	not less than $1,000 and not exceeding $5,000 for each
696	violation. A fine shall be levied notwithstanding the correction
697	of the violation.
698	(c)  Class "III" violations are defined in s. 408.813 those
699	conditions or occurrences related to the operation and
700	maintenance of a facility or to the personal care of residents
701	which the agency determines indirectly or potentially threaten
702	the physical or emotional health, safety, or security of
703	facility residents, other than class I or class II violations.
704	The agency shall impose an administrative fine for a cited class
705	III violation in an amount not less than $500 and not exceeding
706	$1,000 for each violation. A citation for a class III violation
707	must specify the time within which the violation is required to
708	be corrected. If a class III violation is corrected within the
709	time specified, no fine may be imposed, unless it is a repeated
710	offense.
711	(d)  Class "IV" violations are defined in s. 408.813 those
712	conditions or occurrences related to the operation and
713	maintenance of a building or to required reports, forms, or
714	documents that do not have the potential of negatively affecting
715	residents. These violations are of a type that the agency
716	determines do not threaten the health, safety, or security of
717	residents of the facility. The agency shall impose an
718	administrative fine for a cited class IV violation in an amount
719	not less than $100 and not exceeding $200 for each violation. A
720	citation for a class IV violation must specify the time within
721	which the violation is required to be corrected. If a class IV
722	violation is corrected within the time specified, no fine shall
723	be imposed. Any class IV violation that is corrected during the
724	time an agency survey is being conducted will be identified as
725	an agency finding and not as a violation.
726	(8)  During an inspection, the agency, as an alternative to
727	or in conjunction with an administrative action against a
728	facility for violations of this part and adopted rules, shall
729	make a reasonable attempt to discuss each violation and
730	recommended corrective action with the owner or administrator of
731	the facility, prior to written notification. The agency, instead
732	of fixing a period within which the facility shall enter into
733	compliance with standards, may request a plan of corrective
734	action from the facility which demonstrates a good faith effort
735	to remedy each violation by a specific date, subject to the
736	approval of the agency.
737	(9)  The agency shall develop and disseminate an annual
738	list of all facilities sanctioned or fined $5,000 or more for
739	violations of state standards, the number and class of
740	violations involved, the penalties imposed, and the current
741	status of cases. The list shall be disseminated, at no charge,
742	to the Department of Elderly Affairs, the Department of Health,
743	the Department of Children and Family Services, the Agency for
744	Persons with Disabilities, the area agencies on aging, the
745	Florida Statewide Advocacy Council, and the state and local
746	ombudsman councils. The Department of Children and Family
747	Services shall disseminate the list to service providers under
748	contract to the department who are responsible for referring
749	persons to a facility for residency. The agency may charge a fee
750	commensurate with the cost of printing and postage to other
751	interested parties requesting a copy of this list. This
752	information may be provided electronically or on the agency's
753	Internet website.
754	Section 33.  Subsections (2) and (6) of section 429.23,
755	Florida Statutes, are amended to read:
756	429.23  Internal risk management and quality assurance
757	program; adverse incidents and reporting requirements.--
758	(2)  Every facility licensed under this part is required to
759	maintain adverse incident reports. For purposes of this section,
760	the term, "adverse incident" means:
761	(a)  An event over which facility personnel could exercise
762	control rather than as a result of the resident's condition and
763	results in:
764	1.  Death;
765	2.  Brain or spinal damage;
766	3.  Permanent disfigurement;
767	4.  Fracture or dislocation of bones or joints;
768	5.  Any condition that required medical attention to which
769	the resident has not given his or her consent, including failure
770	to honor advanced directives;
771	6.  Any condition that requires the transfer of the
772	resident from the facility to a unit providing more acute care
773	due to the incident rather than the resident's condition before
774	the incident; or.
775	7.  An event that is reported to law enforcement or its
776	personnel for investigation; or
777	(b)  Abuse, neglect, or exploitation as defined in s.
778	415.102;
779	(c)  Events reported to law enforcement; or
780	(b)(d)  Resident elopement, if the elopement places the
781	resident at risk of harm or injury.
782	(6)  Abuse, neglect, or exploitation must be reported to
783	the Department of Children and Family Services as required under
784	chapter 415. The agency shall annually submit to the Legislature
785	a report on assisted living facility adverse incident reports.
786	The report must include the following information arranged by
787	county:
788	(a)  A total number of adverse incidents;
789	(b)  A listing, by category, of the type of adverse
790	incidents occurring within each category and the type of staff
791	involved;
792	(c)  A listing, by category, of the types of injuries, if
793	any, and the number of injuries occurring within each category;
794	(d)  Types of liability claims filed based on an adverse
795	incident report or reportable injury; and
796	(e)  Disciplinary action taken against staff, categorized
797	by the type of staff involved.
798	Section 34.  Subsections (10) through (12) of section
799	429.26, Florida Statutes, are renumbered as subsections (9)
800	through (11), respectively, and present subsection (9) of that
801	section is amended to read:
802	429.26  Appropriateness of placements; examinations of
803	residents.--
804	(9)  If, at any time after admission to a facility, a
805	resident appears to need care beyond that which the facility is
806	licensed to provide, the agency shall require the resident to be
807	physically examined by a licensed physician, physician
808	assistant, or licensed nurse practitioner. This examination
809	shall, to the extent possible, be performed by the resident's
810	preferred physician or nurse practitioner and shall be paid for
811	by the resident with personal funds, except as provided in s.
812	429.18(2). Following this examination, the examining physician,
813	physician assistant, or licensed nurse practitioner shall
814	complete and sign a medical form provided by the agency. The
815	completed medical form shall be submitted to the agency within
816	30 days after the date the facility owner or administrator is
817	notified by the agency that the physical examination is
818	required. After consultation with the physician, physician
819	assistant, or licensed nurse practitioner who performed the
820	examination, a medical review team designated by the agency
821	shall then determine whether the resident is appropriately
822	residing in the facility. The medical review team shall base its
823	decision on a comprehensive review of the resident's physical
824	and functional status, including the resident's preferences, and
825	not on an isolated health-related problem. In the case of a
826	mental health resident, if the resident appears to have needs in
827	addition to those identified in the community living support
828	plan, the agency may require an evaluation by a mental health
829	professional, as determined by the Department of Children and
830	Family Services. A facility may not be required to retain a
831	resident who requires more services or care than the facility is
832	able to provide in accordance with its policies and criteria for
833	admission and continued residency. Members of the medical review
834	team making the final determination may not include the agency
835	personnel who initially questioned the appropriateness of a
836	resident's placement. Such determination is final and binding
837	upon the facility and the resident. Any resident who is
838	determined by the medical review team to be inappropriately
839	residing in a facility shall be given 30 days' written notice to
840	relocate by the owner or administrator, unless the resident's
841	continued residence in the facility presents an imminent danger
842	to the health, safety, or welfare of the resident or a
843	substantial probability exists that death or serious physical
844	harm would result to the resident if allowed to remain in the
845	facility.
846	Section 35.  Paragraph (h) of subsection (3) of section
847	430.80, Florida Statutes, is amended to read:
848	430.80  Implementation of a teaching nursing home pilot
849	project.--
850	(3)  To be designated as a teaching nursing home, a nursing
851	home licensee must, at a minimum:
852	(h)  Maintain insurance coverage pursuant to s.
853	400.141(1)(s)(20) or proof of financial responsibility in a
854	minimum amount of $750,000. Such proof of financial
855	responsibility may include:
856	1.  Maintaining an escrow account consisting of cash or
857	assets eligible for deposit in accordance with s. 625.52; or
858	2.  Obtaining and maintaining pursuant to chapter 675 an
859	unexpired, irrevocable, nontransferable and nonassignable letter
860	of credit issued by any bank or savings association organized
861	and existing under the laws of this state or any bank or savings
862	association organized under the laws of the United States that
863	has its principal place of business in this state or has a
864	branch office which is authorized to receive deposits in this
865	state. The letter of credit shall be used to satisfy the
866	obligation of the facility to the claimant upon presentment of a
867	final judgment indicating liability and awarding damages to be
868	paid by the facility or upon presentment of a settlement
869	agreement signed by all parties to the agreement when such final
870	judgment or settlement is a result of a liability claim against
871	the facility.
872	Section 36.  Subsection (5) of section 435.04, Florida
873	Statutes, is amended to read:
874	435.04  Level 2 screening standards.--
875	(5)  Under penalty of perjury, all employees in such
876	positions of trust or responsibility shall attest to meeting the
877	requirements for qualifying for employment and agreeing to
878	inform the employer immediately if convicted of any of the
879	disqualifying offenses while employed by the employer. Each
880	employer of employees in such positions of trust or
881	responsibilities which is licensed or registered by a state
882	agency shall submit to the licensing agency annually or at the
883	time of license renewal, under penalty of perjury, an affidavit
884	of compliance with the provisions of this section.
885	Section 37.  Subsection (3) of section 435.05, Florida
886	Statutes, is amended to read:
887	435.05  Requirements for covered employees.--Except as
888	otherwise provided by law, the following requirements shall
889	apply to covered employees:
890	(3)  Each employer required to conduct level 2 background
891	screening must sign an affidavit annually or at the time of
892	license renewal, under penalty of perjury, stating that all
893	covered employees have been screened or are newly hired and are
894	awaiting the results of the required screening checks.
895	Section 38.  Subsection (2) of section 483.031, Florida
896	Statutes, is amended to read:
897	483.031  Application of part; exemptions.--This part
898	applies to all clinical laboratories within this state, except:
899	(2)  A clinical laboratory that performs only waived tests
900	and has received a certificate of exemption from the agency
901	under s. 483.106.
902	Section 39.  Subsection (10) of section 483.041, Florida
903	Statutes, is amended to read:
904	483.041  Definitions.--As used in this part, the term:
905	(10)  "Waived test" means a test that the federal Centers
906	for Medicare and Medicaid Services Health Care Financing
907	Administration has determined qualifies for a certificate of
908	waiver under the federal Clinical Laboratory Improvement
909	Amendments of 1988, and the federal rules adopted thereunder.
910	Section 40.  Section 483.106, Florida Statutes, is
911	repealed.
912	Section 41.  Subsection (3) of section 483.172, Florida
913	Statutes, is amended to read:
914	483.172  License fees.--
915	(3)  The agency shall assess a biennial fee of $100 for a
916	certificate of exemption and a $100 biennial license fee under
917	this section for facilities surveyed by an approved accrediting
918	organization.
919	Section 42.  Paragraph (b) of subsection (1) of section
920	627.4239, Florida Statutes, is amended to read:
921	627.4239  Coverage for use of drugs in treatment of
922	cancer.--
923	(1)  DEFINITIONS.--As used in this section, the term:
924	(b)  "Standard reference compendium" means authoritative
925	compendia identified by the Secretary of the United States
926	Department of Health and Human Services and recognized by the
927	federal Centers for Medicare and Medicaid Services:
928	1.  The United States Pharmacopeia Drug Information;
929	2.  The American Medical Association Drug Evaluations; or
930	3.  The American Hospital Formulary Service Drug
931	Information.
932
933
934	-----------------------------------------------------
935	T I T L E  A M E N D M E N T
936	Remove lines 46-163 and insert:
937	coverage, bodily injury liability coverage, personal
938	liability umbrella coverage, or uninsured motorist
939	coverage; amending s. 400.9935, F.S.; revising
940	accreditation requirements for clinics providing magnetic
941	resonance imaging services; amending s. 400.995, F.S.;
942	revising agency responsibilities with respect to personnel
943	and operations in certain injunctive proceedings; amending
944	s. 408.803, F.S.; revising definitions applicable to pt.
945	II of ch. 408, F.S., the "Health Care Licensing Procedures
946	Act"; amending s. 408.806, F.S.; revising contents of and
947	procedures relating to health care provider applications
948	for licensure; providing an exception from certain
949	licensure inspections for adult family-care homes;
950	authorizing the agency to provide electronic access to
951	certain information and documents; amending s. 408.808,
952	F.S.; providing for a provisional license to be issued to
953	applicants applying for a change of ownership; providing a
954	time limit on provisional licenses; amending s. 408.809,
955	F.S.; revising provisions relating to background screening
956	of specified employees; exempting certain persons from
957	rescreening; permitting certain persons to apply for an
958	exemption from disqualification under certain
959	circumstances; requiring health care providers to submit
960	to the agency an affidavit of compliance with background
961	screening requirements at the time of license renewal;
962	deleting a provision to conform to changes made by the
963	act; amending s. 408.810, F.S.; revising provisions
964	relating to information required for licensure; amending
965	s. 408.811, F.S.; providing for certain inspections to be
966	accepted in lieu of complete licensure inspections;
967	granting agency access to records requested during an
968	offsite review; providing timeframes for correction of
969	certain deficiencies and submission of plans to correct
970	such deficiencies; amending s. 408.813, F.S.; providing
971	classifications of violations of pt. II of ch. 408, F.S.;
972	providing for fines; amending s. 408.820, F.S.; revising
973	applicability of exemptions from specified requirements of
974	pt. II of ch. 408, F.S.; conforming references; creating
975	s. 408.821, F.S.; requiring entities regulated or licensed
976	by the agency to designate a safety liaison for emergency
977	operations; providing that entities regulated or licensed
978	by the agency may temporarily exceed their licensed
979	capacity to act as receiving providers under specified
980	circumstances; providing requirements while such entities
981	are in an overcapacity status; providing for issuance of
982	an inactive license to such licensees under specified
983	conditions; providing requirements and procedures with
984	respect to the issuance and reactivation of an inactive
985	license; authorizing the agency to adopt rules; amending
986	s. 408.831, F.S.; deleting provisions relating to
987	authorization for entities regulated or licensed by the
988	agency to exceed their licensed capacity to act as
989	receiving facilities and issuance and reactivation of
990	inactive licenses; amending s. 408.918, F.S.; requiring
991	accreditation by the National Alliance of Information and
992	Referral Services for participation in the Florida 211
993	Network; eliminating the requirement that the agency seek
994	certain assistance and guidance in resolving certain
995	disputes; removing certain agency obligations relating to
996	the Florida 211 Network; requiring the Florida Alliance of
997	Information and Referral Services to perform certain
998	functions related to the Florida 211 Network; amending s.
999	409.221, F.S.; conforming a cross-reference; amending s.
1000	409.901, F.S.; revising a definition applicable to
1001	Medicaid providers; repealing s. 429.071, F.S., relating
1002	to the intergenerational respite care assisted living
1003	facility pilot program; amending s. 429.08, F.S.;
1004	authorizing the agency to provide information regarding
1005	licensed assisted living facilities electronically or on
1006	its Internet website; abolishing local coordinating
1007	workgroups established by agency field offices; deleting a
1008	fine; deleting provisions requiring the agency to provide
1009	certain information and notice to service providers;
1010	amending s. 429.14, F.S.; conforming a reference; amending
1011	s. 429.19, F.S.; revising agency procedures for imposition
1012	of fines for violations of pt. I of ch. 429, F.S., the
1013	"Assisted Living Facilities Act"; providing for the
1014	posting of certain information electronically or on the
1015	agency's Internet website; amending s. 429.23, F.S.;
1016	revising the definition of the term "adverse incident" for
1017	reporting purposes; requiring abuse, neglect, and
1018	exploitation to be reported to the agency and the
1019	Department of Children and Family Services; deleting a
1020	requirement that the agency submit an annual report on
1021	assisted living facility adverse incidents to the
1022	Legislature; amending s. 429.26, F.S.; removing
1023	requirement for a resident of an assisted living facility
1024	to undergo examinations and evaluations under certain
1025	circumstances; amending s. 430.80, F.S.; conforming a
1026	cross-reference; amending ss. 435.04 and 435.05, F.S.;
1027	requiring employers of certain employees to submit an
1028	affidavit of compliance with level 2 screening
1029	requirements at the time of license renewal; amending s.
1030	483.031, F.S.; conforming a reference; amending s.
1031	483.041, F.S.; revising a definition applicable to pt. I
1032	of ch. 483, F.S., the "Florida Clinical Laboratory Law";
1033	repealing s. 483.106, F.S., relating to applications for
1034	certificates of exemption by clinical laboratories that
1035	perform certain tests; amending s. 483.172, F.S.;
1036	conforming a reference; amending s. 627.4239, F.S.;
1037	revising the definition of the term "standard reference
1038	compendium" for purposes of regulating the insurance
1039	coverage of drugs used in the treatment of cancer;
1040	amending s. 651.118, F.S.; conforming a cross-reference;
1041	providing an effective date.

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