Florida Senate - 2013                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1724
                                Barcode 731698                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/09/2013           .                                

       The Committee on Health Policy (Garcia) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Sections 400.9970 through 400.9984, Florida
    6  Statutes, are designated as part XI of chapter 400, Florida
    7  Statutes, entitled “Transitional Living Facilities.”
    8         Section 2. Section 400.9970, Florida Statutes, is created
    9  to read:
   10         400.9970 Legislative intent.—It is the intent of the
   11  Legislature to provide for the licensure of transitional living
   12  facilities and require the development, establishment, and
   13  enforcement of basic standards by the Agency for Health Care
   14  Administration to ensure quality of care and services to clients
   15  in transitional living facilities. It is the policy of the state
   16  that the least restrictive appropriate available treatment be
   17  used based on the individual needs and best interest of the
   18  client and consistent with optimum improvement of the client’s
   19  condition. The goal of a transitional living program for
   20  individuals who have brain or spinal cord injuries is to assist
   21  each individual who has such an injury to achieve a higher level
   22  of independent functioning and to enable that individual to
   23  reenter the community. It is also the policy of this state that
   24  the use of restraints and seclusion on clients is justified only
   25  as an emergency safety measure to be used in response to danger
   26  to the client or others. It is, therefore, the intent of the
   27  Legislature to achieve an ongoing reduction in the use of
   28  restraints and seclusion in programs and facilities that serve
   29  persons who have brain injury or spinal cord injuries.
   30         Section 3. Section 400.9971, Florida Statutes, is created
   31  to read:
   32         400.9971 Definitions.—As used in this part, the term:
   33         (1) “Agency” means the Agency for Health Care
   34  Administration.
   35         (2) “Chemical restraint” means a pharmacologic drug that
   36  physically limits, restricts, or deprives an individual of
   37  movement or mobility, is used for client protection or safety,
   38  and is not required for the treatment of medical conditions or
   39  symptoms.
   40         (3) “Client’s representative” means the parent of a child
   41  client or the client’s guardian, designated representative or
   42  designee, surrogate, or attorney in fact.
   43         (4) “Department” means the Department of Health.
   44         (5) “Physical restraint” means any manual method to
   45  restrict freedom of movement of or normal access to an
   46  individual’s body or a physical or mechanical device, material,
   47  or equipment attached or adjacent to the individual’s body so
   48  that he or she cannot easily remove the restraint and which
   49  restricts freedom of movement of or normal access to one’s body,
   50  including, but not limited to, a half-bed rail, a full-bed rail,
   51  a geriatric chair, and a posey restraint. The term includes any
   52  device that was not specifically manufactured as a restraint but
   53  which has been altered, arranged, or otherwise used for this
   54  purpose. The term does not include bandage material used for the
   55  purpose of binding a wound or injury.
   56         (6)“Seclusion” means the physical segregation of a person
   57  in any fashion or the involuntary isolation of a person in a
   58  room or area from which the person is prevented from leaving.
   59  The prevention may be by physical barrier or by a staff member
   60  who is acting in a manner, or who is physically situated, so as
   61  to prevent the person from leaving the room or area. For
   62  purposes of this chapter, the term does not mean isolation due
   63  to a person’s medical condition or symptoms.
   64         (7) “Transitional living facility” means a site where
   65  specialized health care services are provided, including, but
   66  not limited to, rehabilitative services, behavior modification,
   67  community reentry training, aids for independent living, and
   68  counseling to individuals who have brain injuries or spinal cord
   69  injuries. The term does not require a provider that is licensed
   70  by the agency to obtain a separate transitional living facility
   71  license to serve persons who have brain injuries or spinal cord
   72  injuries as long as the services provided are within the scope
   73  of the provider’s license.
   74         Section 4. Section 400.9972, Florida Statutes, is created
   75  to read:
   76         400.9972 License required; fee; application.—
   77         (1) The requirements of part II of chapter 408 apply to the
   78  provision of services that require licensure pursuant to this
   79  part and part II of chapter 408 and to entities licensed by or
   80  applying for such licensure from the agency pursuant to this
   81  part. A license issued by the agency is required for the
   82  operation of a transitional living facility in this state.
   83         (2) In accordance with this part, an applicant or a
   84  licensee shall pay a fee for each license application submitted
   85  under this part. The license fee shall consist of a $4,588
   86  license fee and a $90 per-bed fee per biennium and shall conform
   87  to the annual adjustment authorized in s. 408.805.
   88         (3) Each applicant for licensure must provide the
   89  following:
   90         (a) The location of the facility for which a license is
   91  sought and documentation, signed by the appropriate local
   92  government official, which states that the applicant has met
   93  local zoning requirements.
   94         (b) Proof of liability insurance as provided in s. 624.605.
   95         (c) Proof of compliance with local zoning requirements,
   96  including compliance with the requirements of chapter 419 if the
   97  proposed facility is a community residential home.
   98         (d) Proof that the facility has received a satisfactory
   99  firesafety inspection.
  100         (e) Documentation of a satisfactory sanitation inspection
  101  of the facility by the county health department.
  103  The applicant’s proposed facility must attain and continuously
  104  maintain accreditation by an accrediting organization
  105  specializing in evaluating rehabilitation facilities whose
  106  standards incorporate comparable licensure regulations required
  107  by the state. An applicant for licensure as a transitional
  108  living facility must acquire accreditation within 12 months
  109  after the issuance of an initial license. The agency shall
  110  accept the accreditation survey report of the accrediting
  111  organization in lieu of conducting a licensure inspection if the
  112  standards included in the survey report are determined by the
  113  agency to document that the facility is in substantial
  114  compliance with state licensure requirements. The applicant
  115  shall submit to the agency within 10 days after receipt a copy
  116  of any accreditation survey report and evidence of the
  117  accreditation decision subsequent to a survey by the accrediting
  118  organization on the facility. This part does not preclude the
  119  agency from conducting periodic inspections of a transitional
  120  living facility to ensure compliance with all licensure
  121  requirements, and as it deems necessary to carry out the
  122  functions of the agency. An inspection may be conducted to
  123  ensure compliance with licensure requirements of this part, to
  124  validate the inspection process of accrediting organizations, to
  125  respond to licensure complaints, or to protect the public health
  126  and safety.
  127         Section 5. Section 400.9973, Florida Statutes, is created
  128  to read:
  129         400.9973 Client admission, transfer, and discharge.—
  130         (1) Each transitional living facility must have written
  131  policies and procedures governing the admission, transfer, and
  132  discharge of clients.
  133         (2) The admission of each client to a transitional living
  134  facility must be in accordance with the licensee’s policies and
  135  procedures.
  136         (3) A client admitted to a transitional living facility
  137  must have a brain or spinal cord injury, such as a lesion to the
  138  spinal cord or cauda equina syndrome, with evidence of
  139  significant involvement of two of the following deficits or
  140  dysfunctions:
  141         (a) A motor deficit.
  142         (b) A sensory deficit.
  143         (c) Bowel and bladder dysfunction.
  144         (d) An acquired internal or external injury to the skull,
  145  the brain, or the brain’s covering, whether caused by a
  146  traumatic or nontraumatic event, which produces an altered state
  147  of consciousness or an anatomic motor, sensory, cognitive, or
  148  behavioral deficit.
  149         (4) A client whose medical condition and diagnosis does not
  150  positively identify a cause of the client’s condition, whose
  151  symptoms are inconsistent with the known cause of injury, or
  152  whose recovery is inconsistent with the known medical condition
  153  may be admitted to a transitional living facility for evaluation
  154  for a period not to exceed 90 days.
  155         (5) A client admitted to a transitional living facility
  156  must be admitted upon prescription by a licensed physician and
  157  must remain under the care of a licensed physician for the
  158  duration of the client’s stay in the facility.
  159         (6) A transitional living facility may not admit a client
  160  whose primary admitting diagnosis is mental illness or an
  161  intellectual or a developmental disability.
  162         (7) An individual may not be admitted to a transitional
  163  living facility if the individual:
  164         (a) Presents significant risk of infection to other clients
  165  or personnel. A health care practitioner must provide
  166  documentation that the individual is free of apparent signs and
  167  symptoms of communicable disease;
  168         (b) Is a danger to self or others as determined by a
  169  physician or mental health practitioner licensed under chapter
  170  490 or chapter 491, unless the facility provides adequate
  171  staffing and support to ensure patient safety;
  172         (c) Is bedridden; or
  173         (d) Requires 24-hour nursing supervision.
  174         (8) If the client meets the admission criteria, the medical
  175  or nursing director of the facility must complete an initial
  176  evaluation of the client’s functional skills, behavioral status,
  177  cognitive status, educational or vocational potential, medical
  178  status, psychosocial status, sensorimotor capacity, and other
  179  related skills and abilities within the first 72 hours after the
  180  client’s admission to the facility. An initial comprehensive
  181  treatment plan that delineates services to be provided and
  182  appropriate sources for such services must be implemented within
  183  the first 4 days after admission.
  184         (9) Each transitional living facility shall develop a
  185  discharge plan for each client before or upon admission to the
  186  facility. The discharge plan must identify the intended
  187  discharge site and possible alternative discharge sites. For
  188  each discharge site identified, the discharge plan must identify
  189  the skills, behaviors, and other conditions that the client must
  190  achieve to be appropriate for discharge. Discharge plans must be
  191  reviewed and updated as necessary, but no less often than once
  192  monthly.
  193         (10) As soon as practicable, a transitional living facility
  194  shall discharge a client when he or she no longer requires any
  195  of the specialized services described in s. 400.9971(7) or is
  196  not making measurable progress in accordance with his or her
  197  comprehensive treatment plan, or if the transitional living
  198  facility is no longer the most appropriate, least restrictive
  199  treatment option.
  200         (11) Each transitional living facility shall provide at
  201  least 30 days’ notice to clients of transfer or discharge plans,
  202  including the location of an acceptable transfer location if the
  203  client is unable to live independently. This requirement does
  204  not apply if a client voluntarily terminates residency.
  205         Section 6. Section 400.9974, Florida Statutes, is created
  206  to read:
  207         400.9974 Client comprehensive treatment plans; client
  208  services.—
  209         (1) Each transitional living facility shall develop a
  210  comprehensive treatment plan for each client as soon as
  211  possible, but no later than 30 days following development of the
  212  initial comprehensive treatment plan. Comprehensive treatment
  213  plans must be reviewed and updated if the client fails to meet
  214  projected improvements in the plan or if a significant change in
  215  the client’s condition occurs. Comprehensive treatment plans
  216  must be reviewed and updated at least once monthly.
  217  Comprehensive treatment plans must be developed by an
  218  interdisciplinary team consisting of the case manager, the
  219  program director, the nurse, and appropriate therapists. The
  220  client or, if appropriate, the client’s representative must be
  221  included in developing the comprehensive treatment plan.
  222         (2) The comprehensive treatment plan must include the
  223  following:
  224         (a) The physician’s orders and the client’s diagnosis,
  225  medical history, physical examination, and rehabilitative or
  226  restorative needs.
  227         (b) A preliminary nursing evaluation with physician’s
  228  orders for immediate care, completed on admission.
  229         (c) A comprehensive, accurate, reproducible, and
  230  standardized assessment of the client’s functional capability;
  231  the treatments designed to achieve skills, behaviors, and other
  232  conditions necessary to return to the community; and specific
  233  measurable goals.
  234         (d) Steps necessary for the client to achieve transition to
  235  the community and estimated length of time to achieve the goals.
  236         (3) The client or, if appropriate, the client’s
  237  representative must consent to the continued treatment at the
  238  transitional living facility. Consent may be for a period of up
  239  to 3 months. If such consent is not given, the transitional
  240  living facility shall discharge the client as soon as
  241  practicable.
  242         (4) Each client must receive the professional program
  243  services needed to implement the client’s comprehensive
  244  treatment plan.
  245         (5) The licensee must employ qualified professional staff
  246  to carry out and monitor the various professional interventions
  247  in accordance with the stated goals and objectives of every
  248  client’s comprehensive treatment plan.
  249         (6) Each client must receive a continuous treatment program
  250  that includes appropriate, consistent implementation of a
  251  program of specialized and general training, treatment, health
  252  services, and related services which is directed toward:
  253         (a) The acquisition of the behaviors and skills necessary
  254  for the client to function with as much self-determination and
  255  independence as possible;
  256         (b) The prevention or deceleration of regression or loss of
  257  current optimal functional status; and
  258         (c) The management of behavioral issues that preclude
  259  independent functioning in the community.
  260         Section 7. Section 400.9975, Florida Statutes, is created
  261  to read:
  262         400.9975 Licensee responsibilities.—
  263         (1) The licensee shall ensure that each client:
  264         (a) Lives in a safe environment free from abuse, neglect,
  265  and exploitation.
  266         (b) Is treated with consideration and respect and with due
  267  recognition of personal dignity, individuality, and the need for
  268  privacy.
  269         (c) Retains and uses his or her own clothes and other
  270  personal property in his or her immediate living quarters, so as
  271  to maintain individuality and personal dignity, except when the
  272  licensee can demonstrate that such retention and use would be
  273  unsafe, impractical, or an infringement upon the rights of other
  274  clients.
  275         (d) Has unrestricted private communication, including
  276  receiving and sending unopened correspondence, access to a
  277  telephone, and visiting with any person of his or her choice.
  278  Upon request, the licensee shall make provisions to modify
  279  visiting hours for caregivers and guests. The facility shall
  280  restrict communication in accordance with any court order or
  281  written instruction of a client’s representative. Any
  282  restriction on a client’s communication for therapeutic reasons
  283  shall be documented and reviewed at least weekly and shall be
  284  removed as soon as it is no longer clinically indicated. The
  285  basis for the restriction shall be explained to the client and,
  286  if applicable, the client’s representative. The client shall
  287  nonetheless retain the right to call the abuse hotline, the
  288  agency, and Disability Rights Florida at any and all times.
  289         (e) Has the opportunity to participate in and benefits from
  290  community services and activities to achieve the highest
  291  possible level of independence, autonomy, and interaction within
  292  the community.
  293         (f) Has the opportunity to manage his or her financial
  294  affairs unless the client or, if applicable, the client’s
  295  representative authorizes the administrator of the facility to
  296  provide safekeeping for funds as provided in this part.
  297         (g) Has reasonable opportunity for regular exercise several
  298  times a week and to be outdoors at regular and frequent
  299  intervals except when prevented by inclement weather.
  300         (h) Has the opportunity to exercise civil and religious
  301  liberties, including the right to independent personal
  302  decisions. No religious belief or practice, including attendance
  303  at religious services, shall be imposed upon any client.
  304         (i) Has access to adequate and appropriate health care
  305  consistent with established and recognized standards within the
  306  community.
  307         (j) Has the ability to present grievances and recommend
  308  changes in policies, procedures, and services to the staff of
  309  the licensee, governing officials, or any other person without
  310  restraint, interference, coercion, discrimination, or reprisal.
  311  Each licensee shall establish a grievance procedure to
  312  facilitate a client’s ability to present grievances, including a
  313  system for investigating, tracking, managing, and responding to
  314  complaints by persons receiving services or individuals acting
  315  on their behalf, and an appeals process. This process must
  316  include access to Disability Rights Florida and other advocates
  317  and the right to be a member of, be active in, and associate
  318  with advocacy or special interest groups.
  319         (2) The licensee shall:
  320         (a) Promote participation of each client’s representative
  321  in the process of providing treatment to the client unless the
  322  representative’s participation is unobtainable or inappropriate.
  323         (b) Answer communications from each client’s family,
  324  guardians, and friends promptly and appropriately.
  325         (c) Promote visits by individuals with a relationship to
  326  the client at any reasonable hour, without requiring prior
  327  notice, or in any area of the facility which provides direct
  328  client care services to the client, consistent with the client’s
  329  and other clients’ privacy, unless the interdisciplinary team
  330  determines that such a visit would not be appropriate.
  331         (d) Promote leave from the facility for visits, trips, or
  332  vacations.
  333         (e) Promptly notify the client’s representative of any
  334  significant incidents or changes in the client’s condition,
  335  including, but not limited to, serious illness, accident, abuse,
  336  unauthorized absence, or death.
  337         (3) The administrator of a facility shall ensure that a
  338  written notice of licensee responsibilities is posted in a
  339  prominent place in each building where clients reside and read
  340  or explained to clients who cannot read. This notice shall
  341  include the statewide toll-free telephone number for reporting
  342  complaints to the agency, must be provided to clients in a
  343  manner that is clearly legible, and must include the words: “To
  344  report a complaint regarding the services you receive, please
  345  call toll-free ...[telephone number]... or Disability Rights
  346  Florida ...[telephone number]...”; and the statewide toll-free
  347  telephone number for the central abuse hotline must be provided
  348  to clients in a manner that is clearly legible and must include
  349  the words: “To report abuse, neglect or exploitation, please
  350  call toll-free ...[telephone number where complaints may be
  351  lodged]....” The licensee must ensure a client’s access to a
  352  telephone, where telephone numbers required in this subsection
  353  are readily available to call the agency, central abuse hotline,
  354  or Disability Rights Florida.
  355         (4) A licensee or employee of a facility may not serve
  356  notice upon a client to leave the premises or take any other
  357  retaliatory action against any person solely due to the
  358  following:
  359         (a) The client or other person files an internal or
  360  external complaint or grievance regarding the facility.
  361         (b) The client or other person appears as a witness in any
  362  hearing inside or outside the facility.
  363         (5) Before or at the time of admission, the client and the
  364  client’s representative shall be provided with a copy of the
  365  licensee’s responsibilities as provided in this section,
  366  including grievance procedures and the telephone numbers
  367  provided in this section.
  368         (6) The licensee must develop and implement policies and
  369  procedures governing the release of any client information,
  370  including consent necessary from the client or the client’s
  371  representative.
  372         Section 8. Section 400.9976, Florida Statutes, is created
  373  to read:
  374         400.9976 Medication practices.—
  375         (1) An individual medication administration record must be
  376  maintained for each client. Each dose of medication, including a
  377  self-administered dose, shall be properly recorded in the
  378  client’s record. Each client who self-administers medication
  379  shall be given a pill organizer. Medication must be placed in
  380  the pill organizer by a nurse. A nurse shall document the date
  381  and time medication is placed into each client’s pill organizer.
  382  All medications must be administered in compliance with the
  383  physician’s orders.
  384         (2) If the interdisciplinary team determines that self
  385  administration of medications is an appropriate objective, and
  386  if the physician does not specify otherwise, a client must be
  387  taught to self-administer his or her medication without a staff
  388  person. This includes all forms of administration, including
  389  orally, via injection, and via suppository. The client’s
  390  physician must be informed of the interdisciplinary team’s
  391  decision that self-administration of medications is an objective
  392  for the client. A client may not self-administer medication
  393  until he or she demonstrates the competency to take the correct
  394  medication in the correct dosage at the correct time, to respond
  395  to missed doses, and to contact an appropriate person with
  396  questions.
  397         (3) Medication administration discrepancies and adverse
  398  drug reactions must be recorded and reported immediately to a
  399  physician.
  400         Section 9. Section 400.9977, Florida Statutes, is created
  401  to read:
  402         400.9977 Protection from abuse, neglect, mistreatment, and
  403  exploitation.—The licensee must develop and implement policies
  404  and procedures for the screening and training of employees, the
  405  protection of clients, and the prevention, identification,
  406  investigation, and reporting of abuse, neglect, and
  407  exploitation. This includes the licensee’s identification of
  408  clients whose personal histories render them at risk for abusing
  409  other clients, development of intervention strategies to prevent
  410  occurrences, monitoring for changes that would trigger abusive
  411  behavior, and reassessment of the interventions on a regular
  412  basis. A licensee shall implement procedures to:
  413         (1) Screen potential employees for a history of abuse,
  414  neglect, or mistreatment of clients. The screening shall include
  415  an attempt to obtain information from previous employers and
  416  current employers and verification with the appropriate
  417  licensing boards.
  418         (2) Train employees, through orientation and ongoing
  419  sessions, on issues related to abuse prohibition practices,
  420  including identification of abuse, neglect, mistreatment, and
  421  exploitation, appropriate interventions to deal with aggressive
  422  or catastrophic reactions of clients, the process to report
  423  allegations without fear of reprisal, and recognition of signs
  424  of frustration and stress that may lead to abuse.
  425         (3) Provide clients, families, and staff with information
  426  on how and to whom they may report concerns, incidents, and
  427  grievances without the fear of retribution and provide feedback
  428  regarding the concerns that have been expressed. A licensee must
  429  identify, correct, and intervene in situations in which abuse,
  430  neglect, mistreatment, or exploitation is likely to occur,
  431  including:
  432         (a) Evaluating the physical environment of the facility to
  433  identify characteristics that may make abuse or neglect more
  434  likely to occur, such as secluded areas.
  435         (b) Providing sufficient staff on each shift to meet the
  436  needs of the clients, and ensuring that the staff assigned have
  437  knowledge of the individual clients’ care needs. The licensee
  438  shall identify inappropriate behaviors of its staff, such as
  439  using derogatory language, rough handling, ignoring clients
  440  while giving care, and directing clients who need toileting
  441  assistance to urinate or defecate in their beds.
  442         (c) Assessing, planning care for, and monitoring clients
  443  with needs and behaviors that might lead to conflict or neglect,
  444  such as clients with a history of aggressive behaviors, clients
  445  who have behaviors such as entering other clients’ rooms,
  446  clients with self-injurious behaviors, clients with
  447  communication disorders, and clients who require heavy nursing
  448  care or are totally dependent on staff.
  449         (4) Identify events, such as suspicious bruising of
  450  clients, occurrences, patterns, and trends that may constitute
  451  abuse and determine the direction of the investigation.
  452         (5) Investigate different types of incidents, identify the
  453  staff member responsible for the initial reporting, investigate
  454  alleged violations, and report results to the proper
  455  authorities. The licensee must analyze the occurrences to
  456  determine what changes are needed, if any, to policies and
  457  procedures to prevent further occurrences and to take all
  458  necessary corrective action depending on the results of the
  459  investigation.
  460         (6) Protect clients from harm during an investigation.
  461         (7) Report all alleged violations and all substantiated
  462  incidents, as required under chapters 39 and 415, to the
  463  licensing authorities and all other agencies as required and to
  464  report any knowledge it has of any actions by a court of law
  465  that would indicate an employee is unfit for service.
  466         Section 10. Section 400.9978, Florida Statutes, is created
  467  to read:
  468         400.9978 Restraints and seclusion; client safety.—
  469         (1) Each facility shall provide a therapeutic milieu that
  470  supports a culture of individual empowerment and responsibility.
  471  The health and safety of the client shall be the primary concern
  472  at all times.
  473         (2) The use of physical restraints must be ordered and
  474  documented by a physician and must be consistent with policies
  475  and procedures adopted by the facility. The client or, if
  476  applicable, the client’s representative must be informed of the
  477  facility’s physical restraint policies and procedures at the
  478  time of the client’s admission.
  479         (3) The use of chemical restraints is limited to prescribed
  480  dosages of medications as ordered by a physician and must be
  481  consistent with the client’s diagnosis and the policies and
  482  procedures adopted by the facility. The client and, if
  483  applicable, the client’s representative must be informed of the
  484  facility’s chemical restraint policies and procedures at the
  485  time of the client’s admission.
  486         (4) Based on a physician’s assessment, if a client exhibits
  487  symptoms that present an immediate risk of injury or death to
  488  self or others, a physician may issue an emergency treatment
  489  order to immediately administer rapid response psychotropic
  490  medications or other chemical restraints. Each emergency
  491  treatment order must be documented and maintained in the
  492  client’s record.
  493         (a) An emergency treatment order is effective for no more
  494  than 24 hours.
  495         (b) Whenever a client is medicated in accordance with this
  496  subsection, the client’s representative or responsible party and
  497  the client’s physician must be notified as soon as practicable.
  498         (5) A client who is prescribed and receiving a medication
  499  that can serve as a chemical restraint for a purpose other than
  500  an emergency treatment order must be evaluated by his or her
  501  physician at least monthly to assess the following:
  502         (a) The continued need for the medication.
  503         (b) The level of the medication in the client’s blood, as
  504  appropriate.
  505         (c) The need for adjustments in the prescription.
  506         (6) The licensee shall ensure that clients are free from
  507  unnecessary drugs and physical restraints and are provided
  508  treatment to reduce dependency on drugs and physical restraints.
  509         (7) The licensee may use physical restraints and seclusion
  510  only as authorized by the facility’s written physical restraint
  511  and seclusion policies, which must be in compliance with this
  512  section and applicable rules.
  513         (8) Interventions to manage dangerous client behavior must
  514  be employed with sufficient safeguards and supervision to ensure
  515  that the safety, welfare, and civil and human rights of each
  516  client are adequately protected.
  517         (9) A facility shall notify the parent or guardian of a
  518  client each time restraint or seclusion is used. Such
  519  notification must be within 24 hours from the time the restraint
  520  or seclusion occurs. Reasonable efforts must be taken to notify
  521  the parent or guardian by telephone or e-mail, or both, and
  522  these efforts must be documented.
  523         (10) The agency may adopt by rule standards and procedures
  524  relating to the use of restraints, restraint positioning,
  525  seclusion, and emergency treatment orders for psychotropic
  526  medications, restraint, and seclusion. These rules must include
  527  duration of restraint use, staff training, client observation
  528  during restraint, and documentation and reporting standards.
  529         Section 11. Section 400.9979, Florida Statutes, is created
  530  to read:
  531         400.9979 Background screening; administration and
  532  management.—
  533         (1) The agency shall require level 2 background screening
  534  for personnel as required in s. 408.809(1)(e) pursuant to
  535  chapter 435 and s. 408.809.
  536         (2) The licensee shall maintain personnel records for each
  537  staff member which contain, at a minimum, documentation of
  538  background screening, if applicable, a job description,
  539  documentation of compliance with all training requirements of
  540  this part or applicable rule, the employment application,
  541  references, a copy of all job performance evaluations, and, for
  542  each staff member who performs services for which licensure or
  543  certification is required, a copy of all licenses or
  544  certification held by the staff member.
  545         (3) The licensee must:
  546         (a) Develop and implement infection control policies and
  547  procedures and include such policies and procedures in the
  548  licensee’s policy manual.
  549         (b) Maintain liability insurance as defined in s. 624.605.
  550         (c) Designate one person as an administrator who is
  551  responsible and accountable for the overall management of the
  552  facility.
  553         (d) Designate a person in writing to be responsible for the
  554  facility when the administrator is absent from the facility for
  555  more than 24 hours.
  556         (e) Designate in writing a program director who is
  557  responsible for supervising the therapeutic and behavioral
  558  staff, determining the levels of supervision, and determining
  559  room placement for each client.
  560         (f) Designate in writing a person to be responsible when
  561  the program director is absent from the facility for more than
  562  24 hours.
  563         (g) Obtain approval of the comprehensive emergency
  564  management plan, pursuant to s. 400.9981(2)(e), from the local
  565  emergency management agency. Pending the approval of the plan,
  566  the local emergency management agency shall ensure that the
  567  following agencies, at a minimum, are given the opportunity to
  568  review the plan: the Department of Health, the Agency for Health
  569  Care Administration, and the Division of Emergency Management.
  570  Appropriate volunteer organizations must also be given the
  571  opportunity to review the plan. The local emergency management
  572  agency shall complete its review within 60 days and either
  573  approve the plan or advise the licensee of necessary revisions.
  574         (h) Maintain written records in a form and system that
  575  comply with medical and business practices and make such records
  576  available in the facility for review or submission to the agency
  577  upon request. The records shall include:
  578         1. A daily census record that indicates the number of
  579  clients currently receiving services in the facility, including
  580  information regarding any public funding of such clients.
  581         2. A record of all accidents or unusual incidents involving
  582  any client or staff member that caused, or had the potential to
  583  cause, injury or harm to any person or property within the
  584  facility. Such records must contain a clear description of each
  585  accident or incident, the names of the persons involved, a
  586  description of all medical or other services provided to these
  587  persons specifying who provided such services, and the steps
  588  taken to prevent recurrence of such accidents or incidents.
  589         3. A copy of current agreements with third-party providers.
  590         4. A copy of current agreements with each consultant
  591  employed by the licensee and documentation of each consultant’s
  592  visits and required written, dated reports.
  593         Section 12. Section 400.9980, Florida Statutes, is created
  594  to read:
  595         400.9980 Property and personal affairs of clients.—
  596         (1) A client shall be given the option of using his or her
  597  own belongings, as space permits; choosing his or her roommate
  598  if practical and not clinically contraindicated; and, whenever
  599  possible, unless the client is adjudicated incompetent or
  600  incapacitated under state law, managing his or her own affairs.
  601         (2) The admission of a client to a facility and his or her
  602  presence therein shall not confer on a licensee, administrator,
  603  employee, or representative thereof any authority to manage,
  604  use, or dispose of any property of the client, nor shall such
  605  admission or presence confer on any of such persons any
  606  authority or responsibility for the personal affairs of the
  607  client except that which may be necessary for the safe
  608  management of the facility or for the safety of the client.
  609         (3) A licensee, administrator, employee, or representative
  610  thereof may:
  611         (a) Not act as the guardian, trustee, or conservator for
  612  any client or any of such client’s property.
  613         (b) Act as a competent client’s payee for social security,
  614  veteran’s, or railroad benefits if the client provides consent
  615  and the licensee files a surety bond with the agency in an
  616  amount equal to twice the average monthly aggregate income or
  617  personal funds due to the client, or expendable for the client’s
  618  account, that are received by a licensee.
  619         (c) Act as the power of attorney for a client if the
  620  licensee has filed a surety bond with the agency in an amount
  621  equal to twice the average monthly income of the client, plus
  622  the value of any client’s property under the control of the
  623  attorney in fact.
  625  The bond under paragraph (b) or paragraph (c) shall be executed
  626  by the licensee as principal and a licensed surety company. The
  627  bond shall be conditioned upon the faithful compliance of the
  628  licensee with the requirements of licensure and shall be payable
  629  to the agency for the benefit of any client who suffers a
  630  financial loss as a result of the misuse or misappropriation of
  631  funds held pursuant to this subsection. Any surety company that
  632  cancels or does not renew the bond of any licensee shall notify
  633  the agency in writing not less than 30 days in advance of such
  634  action, giving the reason for the cancellation or nonrenewal.
  635  Any licensee, administrator, employee, or representative thereof
  636  who is granted power of attorney for any client of the facility
  637  shall, on a monthly basis, notify the client in writing of any
  638  transaction made on behalf of the client pursuant to this
  639  subsection, and a copy of such notification given to the client
  640  shall be retained in each client’s file and available for agency
  641  inspection.
  642         (4) A licensee, upon mutual consent with the client, shall
  643  provide for the safekeeping in the facility of the client’s
  644  personal effects of a value not in excess of $1,000 and the
  645  client’s funds not in excess of $500 cash and shall keep
  646  complete and accurate records of all such funds and personal
  647  effects received. If a client is absent from a facility for 24
  648  hours or more, the licensee may provide for the safekeeping of
  649  the client’s personal effects of a value in excess of $1,000.
  650         (5) Any funds or other property belonging to or due to a
  651  client or expendable for his or her account that is received by
  652  licensee shall be trust funds and shall be kept separate from
  653  the funds and property of the licensee and other clients or
  654  shall be specifically credited to such client. Such trust funds
  655  shall be used or otherwise expended only for the account of the
  656  client. At least once every month, unless upon order of a court
  657  of competent jurisdiction, the licensee shall furnish the client
  658  and the client’s representative a complete and verified
  659  statement of all funds and other property to which this
  660  subsection applies, detailing the amount and items received,
  661  together with their sources and disposition. In any event, the
  662  licensee shall furnish such statement annually and upon the
  663  discharge or transfer of a client. Any governmental agency or
  664  private charitable agency contributing funds or other property
  665  to the account of a client shall also be entitled to receive
  666  such statement monthly and upon the discharge or transfer of the
  667  client.
  668         (6)(a) In addition to any damages or civil penalties to
  669  which a person is subject, any person who:
  670         1. Intentionally withholds a client’s personal funds,
  671  personal property, or personal needs allowance, or who demands,
  672  beneficially receives, or contracts for payment of all or any
  673  part of a client’s personal property or personal needs allowance
  674  in satisfaction of the facility rate for supplies and services;
  675  or
  676         2. Borrows from or pledges any personal funds of a client,
  677  other than the amount agreed to by written contract under s.
  678  429.24,
  680  commits a misdemeanor of the first degree, punishable as
  681  provided in s. 775.082 or s. 775.083.
  682         (b) Any licensee, administrator, employee, or
  683  representative thereof who is granted power of attorney for any
  684  client of the facility and who misuses or misappropriates funds
  685  obtained through this power commits a felony of the third
  686  degree, punishable as provided in s. 775.082, s. 775.083, or s.
  687  775.084.
  688         (7) In the event of the death of a client, a licensee shall
  689  return all refunds, funds, and property held in trust to the
  690  client’s personal representative, if one has been appointed at
  691  the time the licensee disburses such funds, or, if not, to the
  692  client’s spouse or adult next of kin named in a beneficiary
  693  designation form provided by the licensee to the client. If the
  694  client has no spouse or adult next of kin or such person cannot
  695  be located, funds due the client shall be placed in an interest
  696  bearing account and all property held in trust by the licensee
  697  shall be safeguarded until such time as the funds and property
  698  are disbursed pursuant to the Florida Probate Code. Such funds
  699  shall be kept separate from the funds and property of the
  700  licensee and other clients of the facility. If the funds of the
  701  deceased client are not disbursed pursuant to the Florida
  702  Probate Code within 2 years after the client’s death, the funds
  703  shall be deposited in the Health Care Trust Fund administered by
  704  the agency.
  705         (8) The agency, by rule, may clarify terms and specify
  706  procedures and documentation necessary to administer the
  707  provisions of this section relating to the proper management of
  708  clients’ funds and personal property and the execution of surety
  709  bonds.
  710         Section 13. Section 400.9981, Florida Statutes, is created
  711  to read:
  712         400.9981 Rules establishing standards.—
  713         (1) It is the intent of the Legislature that rules
  714  published and enforced pursuant to this part and part II of
  715  chapter 408 include criteria to ensure reasonable and consistent
  716  quality of care and client safety. Rules should make reasonable
  717  efforts to accommodate the needs and preferences of clients to
  718  enhance the quality of life in transitional living facilities.
  719         (2) The agency may adopt and enforce rules to implement
  720  this part and part II of chapter 408, which shall include
  721  reasonable and fair criteria in relation to the following:
  722         (a) The location of transitional living facilities.
  723         (b) The number of qualifications of all personnel,
  724  including management, medical, nursing, and other professional
  725  personnel and nursing assistants and support personnel having
  726  responsibility for any part of the care given to clients. The
  727  licensee must have enough qualified professional staff available
  728  to carry out and monitor the various professional interventions
  729  in accordance with the stated goals and objectives of each
  730  comprehensive treatment plan.
  731         (c) Requirements for personnel procedures, reporting
  732  procedures, and documentation necessary to implement this part.
  733         (d) Services provided to clients of transitional living
  734  facilities.
  735         (e) The preparation and annual update of a comprehensive
  736  emergency management plan in consultation with the Division of
  737  Emergency Management. At a minimum, the rules must provide for
  738  plan components that address emergency evacuation
  739  transportation; adequate sheltering arrangements; postdisaster
  740  activities, including provision of emergency power, food, and
  741  water; postdisaster transportation; supplies; staffing;
  742  emergency equipment; individual identification of clients and
  743  transfer of records; communication with families; and responses
  744  to family inquiries.
  745         Section 14. Section 400.9982, Florida Statutes, is created
  746  to read:
  747         400.9982 Violations; penalties.—
  748         (1) Each violation of this part and rules adopted pursuant
  749  thereto shall be classified according to the nature of the
  750  violation and the gravity of its probable effect on facility
  751  clients. The agency shall indicate the classification on the
  752  written notice of the violation as follows:
  753         (a) Class “I” violations are defined in s. 408.813. The
  754  agency shall issue a citation regardless of correction and
  755  impose an administrative fine of $5,000 for an isolated
  756  violation, $7,500 for a patterned violation, and $10,000 for a
  757  widespread violation. Violations may be identified and a fine
  758  must be levied notwithstanding the correction of the deficiency
  759  giving rise to the violation.
  760         (b) Class “II” violations are defined in s. 408.813. The
  761  agency shall impose an administrative fine of $1,000 for an
  762  isolated violation, $2,500 for a patterned violation, and $5,000
  763  for a widespread violation. A fine must be levied
  764  notwithstanding the correction of the deficiency giving rise to
  765  the violation.
  766         (c) Class “III” violations are defined in s. 408.813. The
  767  agency shall impose an administrative fine of $500 for an
  768  isolated violation, $750 for a patterned violation, and $1,000
  769  for a widespread violation. If a deficiency giving rise to a
  770  class “III” violation is corrected within the time specified by
  771  the agency, a fine may not be imposed.
  772         (d) Class “IV” violations are defined in s. 408.813. The
  773  agency shall impose an administrative fine for a cited class IV
  774  violation in an amount not less than $100 and not exceeding $200
  775  for each violation. If a deficiency giving rise to a class “IV”
  776  violation is corrected within the time specified by the agency,
  777  a fine may not be imposed.
  778         Section 15. Section 400.9983, Florida Statutes, is created
  779  to read:
  780         400.9983 Receivership proceedings.—The agency may apply s.
  781  429.22 with regard to receivership proceedings for transitional
  782  living facilities.
  783         Section 16. Section 400.9984, Florida Statutes, is created
  784  to read:
  785         400.9984 Interagency communication.—The agency, the
  786  department, the Agency for Persons with Disabilities, and the
  787  Department of Children and Families shall develop electronic
  788  systems to ensure that relevant information pertaining to the
  789  regulation of transitional living facilities and clients is
  790  timely and effectively communicated among agencies in order to
  791  facilitate the protection of clients. Electronic sharing of
  792  information shall include, at a minimum, a brain and spinal cord
  793  injury registry and a client abuse registry.
  794         Section 17. Section 400.805, Florida Statutes, is repealed.
  795  Every transitional living facility licensed under s. 400.805 on
  796  or before July 1, 2013, shall be licensed under the provisions
  797  of this act.
  798         Section 18. Subsection (9) of section 381.745, Florida
  799  Statutes, is amended to read:
  800         381.745 Definitions; ss. 381.739-381.79.—As used in ss.
  801  381.739-381.79, the term:
  802         (9) “Transitional living facility,for the purpose of this
  803  part, means a state-approved facility, as defined and licensed
  804  under chapter 400 or chapter 429, or a facility approved by the
  805  brain and spinal cord injury program in accordance with this
  806  chapter.
  807         Section 19. Section 381.75, Florida Statutes, is amended to
  808  read:
  809         381.75 Duties and responsibilities of the department, of
  810  transitional living facilities, and of residents.—Consistent
  811  with the mandate of s. 381.7395, the department shall develop
  812  and administer a multilevel treatment program for individuals
  813  who sustain brain or spinal cord injuries and who are referred
  814  to the brain and spinal cord injury program.
  815         (1) Within 15 days after any report of an individual who
  816  has sustained a brain or spinal cord injury, the department
  817  shall notify the individual or the most immediate available
  818  family members of their right to assistance from the state, the
  819  services available, and the eligibility requirements.
  820         (2) The department shall refer individuals who have brain
  821  or spinal cord injuries to other state agencies to assure that
  822  rehabilitative services, if desired, are obtained by that
  823  individual.
  824         (3) The department, in consultation with emergency medical
  825  service, shall develop standards for an emergency medical
  826  evacuation system that will ensure that all individuals who
  827  sustain traumatic brain or spinal cord injuries are transported
  828  to a department-approved trauma center that meets the standards
  829  and criteria established by the emergency medical service and
  830  the acute-care standards of the brain and spinal cord injury
  831  program.
  832         (4) The department shall develop standards for designation
  833  of rehabilitation centers to provide rehabilitation services for
  834  individuals who have brain or spinal cord injuries.
  835         (5) The department shall determine the appropriate number
  836  of designated acute-care facilities, inpatient rehabilitation
  837  centers, and outpatient rehabilitation centers, needed based on
  838  incidence, volume of admissions, and other appropriate criteria.
  839         (6) The department shall develop standards for designation
  840  of transitional living facilities to provide transitional living
  841  services for individuals who participate in the brain and spinal
  842  cord injury program the opportunity to adjust to their
  843  disabilities and to develop physical and functional skills in a
  844  supported living environment.
  845         (a) The Agency for Health Care Administration, in
  846  consultation with the department, shall develop rules for the
  847  licensure of transitional living facilities for individuals who
  848  have brain or spinal cord injuries.
  849         (b) The goal of a transitional living program for
  850  individuals who have brain or spinal cord injuries is to assist
  851  each individual who has such a disability to achieve a higher
  852  level of independent functioning and to enable that person to
  853  reenter the community. The program shall be focused on preparing
  854  participants to return to community living.
  855         (c) A transitional living facility for an individual who
  856  has a brain or spinal cord injury shall provide to such
  857  individual, in a residential setting, a goal-oriented treatment
  858  program designed to improve the individual’s physical,
  859  cognitive, communicative, behavioral, psychological, and social
  860  functioning, as well as to provide necessary support and
  861  supervision. A transitional living facility shall offer at least
  862  the following therapies: physical, occupational, speech,
  863  neuropsychology, independent living skills training, behavior
  864  analysis for programs serving brain-injured individuals, health
  865  education, and recreation.
  866         (d) All residents shall use the transitional living
  867  facility as a temporary measure and not as a permanent home or
  868  domicile. The transitional living facility shall develop an
  869  initial treatment plan for each resident within 3 days after the
  870  resident’s admission. The transitional living facility shall
  871  develop a comprehensive plan of treatment and a discharge plan
  872  for each resident as soon as practical, but no later than 30
  873  days after the resident’s admission. Each comprehensive
  874  treatment plan and discharge plan must be reviewed and updated
  875  as necessary, but no less often than quarterly. This subsection
  876  does not require the discharge of an individual who continues to
  877  require any of the specialized services described in paragraph
  878  (c) or who is making measurable progress in accordance with that
  879  individual’s comprehensive treatment plan. The transitional
  880  living facility shall discharge any individual who has an
  881  appropriate discharge site and who has achieved the goals of his
  882  or her discharge plan or who is no longer making progress toward
  883  the goals established in the comprehensive treatment plan and
  884  the discharge plan. The discharge location must be the least
  885  restrictive environment in which an individual’s health, well
  886  being, and safety is preserved.
  887         (7) Recipients of services, under this section, from any of
  888  the facilities referred to in this section shall pay a fee based
  889  on ability to pay.
  890         Section 20. Subsection (4) of section 381.78, Florida
  891  Statutes, is amended to read:
  892         381.78 Advisory council on brain and spinal cord injuries.—
  893         (4) The council shall:
  894         (a) provide advice and expertise to the department in the
  895  preparation, implementation, and periodic review of the brain
  896  and spinal cord injury program.
  897         (b) Annually appoint a five-member committee composed of
  898  one individual who has a brain injury or has a family member
  899  with a brain injury, one individual who has a spinal cord injury
  900  or has a family member with a spinal cord injury, and three
  901  members who shall be chosen from among these representative
  902  groups: physicians, other allied health professionals,
  903  administrators of brain and spinal cord injury programs, and
  904  representatives from support groups with expertise in areas
  905  related to the rehabilitation of individuals who have brain or
  906  spinal cord injuries, except that one and only one member of the
  907  committee shall be an administrator of a transitional living
  908  facility. Membership on the council is not a prerequisite for
  909  membership on this committee.
  910         1. The committee shall perform onsite visits to those
  911  transitional living facilities identified by the Agency for
  912  Health Care Administration as being in possible violation of the
  913  statutes and rules regulating such facilities. The committee
  914  members have the same rights of entry and inspection granted
  915  under s. 400.805(4) to designated representatives of the agency.
  916         2. Factual findings of the committee resulting from an
  917  onsite investigation of a facility pursuant to subparagraph 1.
  918  shall be adopted by the agency in developing its administrative
  919  response regarding enforcement of statutes and rules regulating
  920  the operation of the facility.
  921         3. Onsite investigations by the committee shall be funded
  922  by the Health Care Trust Fund.
  923         4. Travel expenses for committee members shall be
  924  reimbursed in accordance with s. 112.061.
  925         5. Members of the committee shall recuse themselves from
  926  participating in any investigation that would create a conflict
  927  of interest under state law, and the council shall replace the
  928  member, either temporarily or permanently.
  929         Section 21. Subsection (21) of section 408.802, Florida
  930  Statutes, is amended to read:
  931         408.802 Applicability.—The provisions of this part apply to
  932  the provision of services that require licensure as defined in
  933  this part and to the following entities licensed, registered, or
  934  certified by the agency, as described in chapters 112, 383, 390,
  935  394, 395, 400, 429, 440, 483, and 765:
  936         (21) Transitional living facilities, as provided under part
  937  XI V of chapter 400.
  938         Section 22. Subsection (20) of section 408.820, Florida
  939  Statutes, is amended to read:
  940         408.820 Exemptions.—Except as prescribed in authorizing
  941  statutes, the following exemptions shall apply to specified
  942  requirements of this part:
  943         (20) Transitional living facilities, as provided under part
  944  XI V of chapter 400, are exempt from s. 408.810(10).
  945         Section 23. Subsection (5) of section 400.93, Florida
  946  Statutes, is amended to read:
  947         400.93 Licensure required; exemptions; unlawful acts;
  948  penalties.—
  949         (5) The following are exempt from home medical equipment
  950  provider licensure, unless they have a separate company,
  951  corporation, or division that is in the business of providing
  952  home medical equipment and services for sale or rent to
  953  consumers at their regular or temporary place of residence
  954  pursuant to the provisions of this part:
  955         (a) Providers operated by the Department of Health or
  956  Federal Government.
  957         (b) Nursing homes licensed under part II.
  958         (c) Assisted living facilities licensed under chapter 429,
  959  when serving their residents.
  960         (d) Home health agencies licensed under part III.
  961         (e) Hospices licensed under part IV.
  962         (f) Intermediate care facilities, homes for special
  963  services, and transitional living facilities licensed under part
  964  V.
  965         (g) Transitional living facilities licensed under part XI.
  966         (h)(g) Hospitals and ambulatory surgical centers licensed
  967  under chapter 395.
  968         (i)(h) Manufacturers and wholesale distributors when not
  969  selling directly to consumers.
  970         (j)(i) Licensed health care practitioners who utilize home
  971  medical equipment in the course of their practice, but do not
  972  sell or rent home medical equipment to their patients.
  973         (k)(j) Pharmacies licensed under chapter 465.
  974         Section 24. Paragraph (l) of subsection (4) of section
  975  400.9905, Florida Statutes, is amended to read:
  976         400.9905 Definitions.—
  977         (4) “Clinic” means an entity where health care services are
  978  provided to individuals and which tenders charges for
  979  reimbursement for such services, including a mobile clinic and a
  980  portable equipment provider. As used in this part, the term does
  981  not include and the licensure requirements of this part do not
  982  apply to:
  983         (l) Orthotic, or prosthetic, pediatric cardiology, or
  984  perinatology clinical facilities or anesthesia clinical
  985  facilities that are not otherwise exempt under paragraph (a) or
  986  paragraph (k) and that are a publicly traded corporation or that
  987  are wholly owned, directly or indirectly, by a publicly traded
  988  corporation. As used in this paragraph, a publicly traded
  989  corporation is a corporation that issues securities traded on an
  990  exchange registered with the United States Securities and
  991  Exchange Commission as a national securities exchange.
  993  Notwithstanding this subsection, an entity shall be deemed a
  994  clinic and must be licensed under this part in order to receive
  995  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  996  627.730-627.7405, unless exempted under s. 627.736(5)(h).
  997         Section 25. This act shall take effect July 1, 2013.
  999  ================= T I T L E  A M E N D M E N T ================
 1000         And the title is amended as follows:
 1001         Delete everything before the enacting clause
 1002  and insert:
 1003                        A bill to be entitled                      
 1004         An act relating to transitional living facilities;
 1005         creating part XI of ch. 400, F.S., entitled
 1006         “Transitional Living Facilities”; creating s.
 1007         400.9970, F.S.; providing legislative intent; creating
 1008         s. 400.9971, F.S.; providing definitions; creating s.
 1009         400.9972, F.S.; requiring the licensure of
 1010         transitional living facilities; providing fees;
 1011         providing license application requirements; creating
 1012         s. 400.9973, F.S.; providing requirements for
 1013         transitional living facilities relating to client
 1014         admission, transfer, and discharge; creating s.
 1015         400.9974, F.S.; requiring a comprehensive treatment
 1016         plan to be developed for each client; providing plan
 1017         requirements; creating s. 400.9975, F.S.; providing
 1018         licensee responsibilities; providing notice
 1019         requirements; prohibiting a licensee or employee of a
 1020         facility from serving notice upon a client to leave
 1021         the premises or take other retaliatory action;
 1022         requiring the client and client’s representative to be
 1023         provided with certain information; requiring the
 1024         licensee to develop and implement certain policies and
 1025         procedures; creating s. 400.9976, F.S.; providing
 1026         licensee requirements relating to medication
 1027         practices; creating s. 400.9977, F.S.; providing
 1028         requirements for the screening of potential employees
 1029         and monitoring of employees for the protection of
 1030         clients; requiring licensees to implement certain
 1031         procedures; creating s. 400.9978, F.S.; requiring a
 1032         facility to provide a therapeutic milieu that supports
 1033         a culture of individual empowerment and
 1034         responsibility; providing that the health and safety
 1035         of the client is the primary concern of the facility;
 1036         providing requirements and limitations for the use of
 1037         physical restraints, seclusion, and chemical restraint
 1038         medication on clients; requiring the Agency for Health
 1039         Care Administration to adopt rules; creating s.
 1040         400.9979, F.S.; providing background screening
 1041         requirements; requiring the licensee to maintain
 1042         certain personnel records; providing administrative
 1043         responsibilities for licensees; providing
 1044         recordkeeping requirements; creating s. 400.9980,
 1045         F.S.; providing requirements relating to property and
 1046         personal affairs of clients; providing requirements
 1047         for a licensee with respect to obtaining surety bonds;
 1048         providing recordkeeping requirements relating to the
 1049         safekeeping of personal effects; providing
 1050         requirements for trust funds received by licensee and
 1051         credited to the client; providing a penalty for
 1052         certain misuse of a resident’s personal needs
 1053         allowance; providing criminal penalties for
 1054         violations; providing for the disposition of property
 1055         in the event of the death of a client; authorizing the
 1056         Agency for Health Care Administration to adopt rules;
 1057         creating s. 400.9981, F.S.; authorizing the agency to
 1058         adopt and enforce certain rules; creating s. 400.9982,
 1059         F.S.; providing procedures relating to violations and
 1060         penalties; providing administrative fines for
 1061         specified classes of violations; creating s. 400.9983,
 1062         F.S.; authorizing the agency to apply certain
 1063         provisions with regard to receivership proceedings;
 1064         creating s. 400.9984, F.S.; requiring the Agency for
 1065         Health Care Administration, the Department of Health,
 1066         the Agency for Persons with Disabilities, and the
 1067         Department of Children and Families to develop
 1068         electronic systems for certain purposes; repealing s.
 1069         400.805, F.S., relating to transitional living
 1070         facilities; providing that every transitional living
 1071         facilities licensed under s. 400.805, F.S., on or
 1072         before a specified date is licensed under the
 1073         provisions of the act; amending s. 381.745, F.S.;
 1074         revising a definition; amending s. 381.75, F.S.;
 1075         revising the duties of the Department of Health as
 1076         they relate to transitional living facilities;
 1077         amending s. 381.78, F.S.; conforming provisions to
 1078         changes made by the act; amending ss. 408.802 and
 1079         408.820, F.S.; conforming a provision to changes made
 1080         by the act; amending s. 400.93, F.S.; providing that
 1081         transitional living facilities licensed under part XI
 1082         of ch. 400, F.S., are exempt from home medical
 1083         equipment provider licensure; amending s. 400.9905,
 1084         F.S.; revising a definition; providing an effective
 1085         date.