Florida Senate - 2015              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. SB 682
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to transitional living facilities;
    3         creating part XI of ch. 400, F.S.; creating s.
    4         400.997, F.S.; providing legislative intent; creating
    5         s. 400.9971, F.S.; providing definitions; creating s.
    6         400.9972, F.S.; requiring the licensure of
    7         transitional living facilities; providing license fees
    8         and application requirements; requiring accreditation
    9         of licensed facilities; creating s. 400.9973, F.S.;
   10         providing requirements for transitional living
   11         facility policies and procedures governing client
   12         admission, transfer, and discharge; creating s.
   13         400.9974, F.S.; requiring a comprehensive treatment
   14         plan to be developed for each client; providing plan
   15         and staffing requirements; requiring certain consent
   16         for continued treatment in a transitional living
   17         facility; creating s. 400.9975, F.S.; providing
   18         licensee responsibilities with respect to each client
   19         and specified others and requiring written notice of
   20         such responsibilities to be provided; prohibiting a
   21         licensee or employee of a facility from serving notice
   22         upon a client to leave the premises or taking other
   23         retaliatory action under certain circumstances;
   24         requiring the client and client’s representative to be
   25         provided with certain information; requiring the
   26         licensee to develop and implement certain policies and
   27         procedures governing the release of client
   28         information; creating s. 400.9976, F.S.; providing
   29         licensee requirements relating to administration of
   30         medication; requiring maintenance of medication
   31         administration records; providing requirements for the
   32         self-administration of medication by clients; creating
   33         s. 400.9977, F.S.; providing training and supervision
   34         requirements for the administration of medications by
   35         unlicensed staff; specifying who may conduct the
   36         training; requiring licensees to adopt certain
   37         policies and procedures and maintain specified records
   38         with respect to the administration of medications by
   39         unlicensed staff; requiring the Agency for Health Care
   40         Administration to adopt rules; creating s. 400.9978,
   41         F.S.; providing requirements for the screening of
   42         potential employees and training and monitoring of
   43         employees for the protection of clients; requiring
   44         licensees to implement certain policies and procedures
   45         to protect clients; providing conditions for
   46         investigating and reporting incidents of abuse,
   47         neglect, mistreatment, or exploitation of clients;
   48         creating s. 400.9979, F.S.; providing requirements and
   49         limitations for the use of physical restraints,
   50         seclusion, and chemical restraint medication on
   51         clients; providing a limitation on the duration of an
   52         emergency treatment order; requiring notification of
   53         certain persons when restraint or seclusion is
   54         imposed; authorizing the agency to adopt rules;
   55         creating s. 400.998, F.S.; providing background
   56         screening requirements for licensee personnel;
   57         requiring the licensee to maintain certain personnel
   58         records; providing administrative responsibilities for
   59         licensees; providing recordkeeping requirements;
   60         creating s. 400.9981, F.S.; providing licensee
   61         responsibilities with respect to the property and
   62         personal affairs of clients; providing requirements
   63         for a licensee with respect to obtaining surety bonds;
   64         providing recordkeeping requirements relating to the
   65         safekeeping of personal effects; providing
   66         requirements for trust funds or other property
   67         received by a licensee and credited to the client;
   68         providing a penalty for certain misuse of a client’s
   69         personal funds, property, or personal needs allowance;
   70         providing criminal penalties for violations; providing
   71         for the disposition of property in the event of the
   72         death of a client; authorizing the agency to adopt
   73         rules; creating s. 400.9982, F.S.; providing
   74         legislative intent; authorizing the agency to adopt
   75         and enforce rules establishing specified standards for
   76         transitional living facilities and personnel thereof;
   77         creating s. 400.9983, F.S.; classifying certain
   78         violations and providing penalties therefor; providing
   79         administrative fines for specified classes of
   80         violations; creating s. 400.9984, F.S.; authorizing
   81         the agency to apply certain provisions with regard to
   82         receivership proceedings; creating s. 400.9985, F.S.;
   83         requiring the agency, the Department of Health, the
   84         Agency for Persons with Disabilities, and the
   85         Department of Children and Families to develop
   86         electronic information systems for certain purposes;
   87         transferring and renumbering s. 400.805, F.S., as s.
   88         400.9986, F.S.; repealing s. 400.9986, F.S., relating
   89         to transitional living facilities, on a specified
   90         date; revising the title of part V of ch. 400, F.S.;
   91         amending s. 381.745, F.S.; revising the definition of
   92         the term “transitional living facility,” to conform to
   93         changes made by the act; amending s. 381.75, F.S.;
   94         revising the duties of the Department of Health and
   95         the agency relating to transitional living facilities;
   96         amending ss. 381.78, 400.93, 408.802, and 408.820,
   97         F.S.; conforming provisions to changes made by the
   98         act; reenacting s. 381.79(1), F.S., relating to the
   99         Brain and Spinal Cord Injury Program Trust Fund, to
  100         incorporate the amendment made by the act to s.
  101         381.75, F.S., in a reference thereto; providing for
  102         the act’s applicability to licensed transitional
  103         living facilities licensed on specified dates;
  104         providing effective dates.
  106  Be It Enacted by the Legislature of the State of Florida:
  108         Section 1. Part XI of chapter 400, Florida Statutes,
  109  consisting of sections 400.997 through 400.9986, is created to
  110  read:
  111                               PART XI                             
  112                   TRANSITIONAL LIVING FACILITIES                  
  113         400.997 Legislative intent.—It is the intent of the
  114  Legislature to provide for the licensure of transitional living
  115  facilities and require the development, establishment, and
  116  enforcement of basic standards by the Agency for Health Care
  117  Administration to ensure quality of care and services to clients
  118  in transitional living facilities. It is the policy of the state
  119  that the least restrictive appropriate available treatment be
  120  used based on the individual needs and best interest of the
  121  client, consistent with optimum improvement of the client’s
  122  condition. The goal of a transitional living program for persons
  123  who have brain or spinal cord injuries is to assist each person
  124  who has such an injury to achieve a higher level of independent
  125  functioning and to enable the person to reenter the community.
  126  It is also the policy of the state that the restraint or
  127  seclusion of a client is justified only as an emergency safety
  128  measure used in response to danger to the client or others. It
  129  is therefore the intent of the Legislature to achieve an ongoing
  130  reduction in the use of restraint or seclusion in programs and
  131  facilities that serve persons who have brain or spinal cord
  132  injuries.
  133         400.9971 Definitions.—As used in this part, the term:
  134         (1) “Agency” means the Agency for Health Care
  135  Administration.
  136         (2) “Chemical restraint” means a pharmacologic drug that
  137  physically limits, restricts, or deprives a person of movement
  138  or mobility, is used for client protection or safety, and is not
  139  required for the treatment of medical conditions or symptoms.
  140         (3) “Client’s representative” means the parent of a child
  141  client or the client’s guardian, designated representative,
  142  designee, surrogate, or attorney in fact.
  143         (4) “Department” means the Department of Health.
  144         (5) “Physical restraint” means a manual method to restrict
  145  freedom of movement of or normal access to a person’s body, or a
  146  physical or mechanical device, material, or equipment attached
  147  or adjacent to the person’s body that the person cannot easily
  148  remove and that restricts freedom of movement of or normal
  149  access to the person’s body, including, but not limited to, a
  150  half-bed rail, a full-bed rail, a geriatric chair, or a Posey
  151  restraint. The term includes any device that is not specifically
  152  manufactured as a restraint but is altered, arranged, or
  153  otherwise used for this purpose. The term does not include
  154  bandage material used for the purpose of binding a wound or
  155  injury.
  156         (6) “Seclusion” means the physical segregation of a person
  157  in any fashion or the involuntary isolation of a person in a
  158  room or area from which the person is prevented from leaving.
  159  Such prevention may be accomplished by imposition of a physical
  160  barrier or by action of a staff member to prevent the person
  161  from leaving the room or area. For purposes of this part, the
  162  term does not mean isolation due to a person’s medical condition
  163  or symptoms.
  164         (7) “Transitional living facility” means a site where
  165  specialized health care services are provided to persons who
  166  have brain or spinal cord injuries, including, but not limited
  167  to, rehabilitative services, behavior modification, community
  168  reentry training, aids for independent living, and counseling.
  169         400.9972 License required; fee; application.—
  170         (1) The requirements of part II of chapter 408 apply to the
  171  provision of services that require licensure pursuant to this
  172  part and part II of chapter 408 and to entities licensed by or
  173  applying for licensure from the agency pursuant to this part. A
  174  license issued by the agency is required for the operation of a
  175  transitional living facility in this state. However, this part
  176  does not require a provider licensed by the agency to obtain a
  177  separate transitional living facility license to serve persons
  178  who have brain or spinal cord injuries as long as the services
  179  provided are within the scope of the provider’s license.
  180         (2) In accordance with this part, an applicant or a
  181  licensee shall pay a fee for each license application submitted
  182  under this part. The license fee shall consist of a $4,588
  183  license fee and a $90 per-bed fee per biennium and shall conform
  184  to the annual adjustment authorized in s. 408.805.
  185         (3) An applicant for licensure must provide:
  186         (a) The location of the facility for which the license is
  187  sought and documentation, signed by the appropriate local
  188  government official, which states that the applicant has met
  189  local zoning requirements.
  190         (b) Proof of liability insurance as provided in s.
  191  624.605(1)(b).
  192         (c) Proof of compliance with local zoning requirements,
  193  including compliance with the requirements of chapter 419 if the
  194  proposed facility is a community residential home.
  195         (d) Proof that the facility has received a satisfactory
  196  firesafety inspection.
  197         (e) Documentation that the facility has received a
  198  satisfactory sanitation inspection by the county health
  199  department.
  200         (4) The applicant’s proposed facility must attain and
  201  continuously maintain accreditation by an accrediting
  202  organization that specializes in evaluating rehabilitation
  203  facilities whose standards incorporate licensure regulations
  204  comparable to those required by the state. An applicant for
  205  licensure as a transitional living facility must acquire
  206  accreditation within 12 months after issuance of an initial
  207  license. The agency shall accept the accreditation survey report
  208  of the accrediting organization in lieu of conducting a
  209  licensure inspection if the standards included in the survey
  210  report are determined by the agency to document that the
  211  facility substantially complies with state licensure
  212  requirements. Within 10 days after receiving the accreditation
  213  survey report, the applicant shall submit to the agency a copy
  214  of the report and evidence of the accreditation decision as a
  215  result of the report. The agency may conduct an inspection of a
  216  transitional living facility to ensure compliance with the
  217  licensure requirements of this part, to validate the inspection
  218  process of the accrediting organization, to respond to licensure
  219  complaints, or to protect the public health and safety.
  220         400.9973 Client admission, transfer, and discharge.—
  221         (1) A transitional living facility shall have written
  222  policies and procedures governing the admission, transfer, and
  223  discharge of clients.
  224         (2) The admission of a client to a transitional living
  225  facility must be in accordance with the licensee’s policies and
  226  procedures.
  227         (3) To be admitted to a transitional living facility, an
  228  individual must have an acquired internal or external injury to
  229  the skull, the brain, or the brain’s covering, caused by a
  230  traumatic or nontraumatic event, which produces an altered state
  231  of consciousness, or a spinal cord injury, such as a lesion to
  232  the spinal cord or cauda equina syndrome, with evidence of
  233  significant involvement of at least two of the following
  234  deficits or dysfunctions:
  235         (a) A motor deficit.
  236         (b) A sensory deficit.
  237         (c) A cognitive deficit.
  238         (d) A behavioral deficit.
  239         (e) Bowel and bladder dysfunction.
  240         (4) A client whose medical condition and diagnosis do not
  241  positively identify a cause of the client’s condition, whose
  242  symptoms are inconsistent with the known cause of injury, or
  243  whose recovery is inconsistent with the known medical condition
  244  may be admitted to a transitional living facility for evaluation
  245  for a period not to exceed 90 days.
  246         (5) A client admitted to a transitional living facility
  247  must be admitted upon prescription by a licensed physician,
  248  physician assistant, or advanced registered nurse practitioner
  249  and must remain under the care of a licensed physician,
  250  physician assistant, or advanced registered nurse practitioner
  251  for the duration of the client’s stay in the facility.
  252         (6) A transitional living facility may not admit a person
  253  whose primary admitting diagnosis is mental illness or an
  254  intellectual or developmental disability.
  255         (7) A person may not be admitted to a transitional living
  256  facility if the person:
  257         (a) Presents significant risk of infection to other clients
  258  or personnel. A health care practitioner must provide
  259  documentation that the person is free of apparent signs and
  260  symptoms of communicable disease;
  261         (b) Is a danger to himself or herself or others as
  262  determined by a physician, physician assistant, or advanced
  263  registered nurse practitioner or a mental health practitioner
  264  licensed under chapter 490 or chapter 491, unless the facility
  265  provides adequate staffing and support to ensure patient safety;
  266         (c) Is bedridden; or
  267         (d) Requires 24-hour nursing supervision.
  268         (8) If the client meets the admission criteria, the medical
  269  or nursing director of the facility must complete an initial
  270  evaluation of the client’s functional skills, behavioral status,
  271  cognitive status, educational or vocational potential, medical
  272  status, psychosocial status, sensorimotor capacity, and other
  273  related skills and abilities within the first 72 hours after the
  274  client’s admission to the facility. An initial comprehensive
  275  treatment plan that delineates services to be provided and
  276  appropriate sources for such services must be implemented within
  277  the first 4 days after admission.
  278         (9) A transitional living facility shall develop a
  279  discharge plan for each client before or upon admission to the
  280  facility. The discharge plan must identify the intended
  281  discharge site and possible alternative discharge sites. For
  282  each discharge site identified, the discharge plan must identify
  283  the skills, behaviors, and other conditions that the client must
  284  achieve to be eligible for discharge. A discharge plan must be
  285  reviewed and updated as necessary but at least once monthly.
  286         (10) A transitional living facility shall discharge a
  287  client as soon as practicable when the client no longer requires
  288  the specialized services described in s. 400.9971(7), when the
  289  client is not making measurable progress in accordance with the
  290  client’s comprehensive treatment plan, or when the transitional
  291  living facility is no longer the most appropriate and least
  292  restrictive treatment option.
  293         (11) A transitional living facility shall provide at least
  294  30 days’ notice to a client of transfer or discharge plans,
  295  including the location of an acceptable transfer location if the
  296  client is unable to live independently. This subsection does not
  297  apply if a client voluntarily terminates residency.
  298         400.9974 Client comprehensive treatment plans; client
  299  services.—
  300         (1) A transitional living facility shall develop a
  301  comprehensive treatment plan for each client as soon as
  302  practicable but no later than 30 days after the initial
  303  comprehensive treatment plan is developed. The comprehensive
  304  treatment plan must be developed by an interdisciplinary team
  305  consisting of the case manager, the program director, the
  306  advanced registered nurse practitioner, and appropriate
  307  therapists. The client or, if appropriate, the client’s
  308  representative must be included in developing the comprehensive
  309  treatment plan. The comprehensive treatment plan must be
  310  reviewed and updated if the client fails to meet projected
  311  improvements outlined in the plan or if a significant change in
  312  the client’s condition occurs. The comprehensive treatment plan
  313  must be reviewed and updated at least once monthly.
  314         (2) The comprehensive treatment plan must include:
  315         (a) Orders obtained from the physician, physician
  316  assistant, or advanced registered nurse practitioner and the
  317  client’s diagnosis, medical history, physical examination, and
  318  rehabilitative or restorative needs.
  319         (b) A preliminary nursing evaluation, including orders for
  320  immediate care provided by the physician, physician assistant,
  321  or advanced registered nurse practitioner, which shall be
  322  completed when the client is admitted.
  323         (c) A comprehensive, accurate, reproducible, and
  324  standardized assessment of the client’s functional capability;
  325  the treatments designed to achieve skills, behaviors, and other
  326  conditions necessary for the client to return to the community;
  327  and specific measurable goals.
  328         (d) Steps necessary for the client to achieve transition
  329  into the community and estimated length of time to achieve those
  330  goals.
  331         (3) The client or, if appropriate, the client’s
  332  representative must consent to the continued treatment at the
  333  transitional living facility. Consent may be for a period of up
  334  to 6 months. If such consent is not given, the transitional
  335  living facility shall discharge the client as soon as
  336  practicable.
  337         (4) A client must receive the professional program services
  338  needed to implement the client’s comprehensive treatment plan.
  339         (5) The licensee must employ qualified professional staff
  340  to carry out and monitor the various professional interventions
  341  in accordance with the stated goals and objectives of the
  342  client’s comprehensive treatment plan.
  343         (6) A client must receive a continuous treatment program
  344  that includes appropriate, consistent implementation of
  345  specialized and general training, treatment, health services,
  346  and related services and that is directed toward:
  347         (a) The acquisition of the behaviors and skills necessary
  348  for the client to function with as much self-determination and
  349  independence as possible.
  350         (b) The prevention or deceleration of regression or loss of
  351  current optimal functional status.
  352         (c) The management of behavioral issues that preclude
  353  independent functioning in the community.
  354         400.9975 Licensee responsibilities.—
  355         (1) The licensee shall ensure that each client:
  356         (a) Lives in a safe environment free from abuse, neglect,
  357  and exploitation.
  358         (b) Is treated with consideration and respect and with due
  359  recognition of personal dignity, individuality, and the need for
  360  privacy.
  361         (c) Retains and uses his or her own clothes and other
  362  personal property in his or her immediate living quarters to
  363  maintain individuality and personal dignity, except when the
  364  licensee demonstrates that such retention and use would be
  365  unsafe, impractical, or an infringement upon the rights of other
  366  clients.
  367         (d) Has unrestricted private communication, including
  368  receiving and sending unopened correspondence, access to a
  369  telephone, and visits with any person of his or her choice. Upon
  370  request, the licensee shall modify visiting hours for caregivers
  371  and guests. The facility shall restrict communication in
  372  accordance with any court order or written instruction of a
  373  client’s representative. Any restriction on a client’s
  374  communication for therapeutic reasons shall be documented and
  375  reviewed at least weekly and shall be removed as soon as no
  376  longer clinically indicated. The basis for the restriction shall
  377  be explained to the client and, if applicable, the client’s
  378  representative. The client shall retain the right to call the
  379  central abuse hotline, the agency, and Disability Rights Florida
  380  at any time.
  381         (e) Has the opportunity to participate in and benefit from
  382  community services and activities to achieve the highest
  383  possible level of independence, autonomy, and interaction within
  384  the community.
  385         (f) Has the opportunity to manage his or her financial
  386  affairs unless the client or, if applicable, the client’s
  387  representative authorizes the administrator of the facility to
  388  provide safekeeping for funds as provided under this part.
  389         (g) Has reasonable opportunity for regular exercise more
  390  than once per week and to be outdoors at regular and frequent
  391  intervals except when prevented by inclement weather.
  392         (h) Has the opportunity to exercise civil and religious
  393  liberties, including the right to independent personal
  394  decisions. However, a religious belief or practice, including
  395  attendance at religious services, may not be imposed upon any
  396  client.
  397         (i) Has access to adequate and appropriate health care
  398  consistent with established and recognized community standards.
  399         (j) Has the opportunity to present grievances and recommend
  400  changes in policies, procedures, and services to the staff of
  401  the licensee, governing officials, or any other person without
  402  restraint, interference, coercion, discrimination, or reprisal.
  403  A licensee shall establish a grievance procedure to facilitate a
  404  client’s ability to present grievances, including a system for
  405  investigating, tracking, managing, and responding to complaints
  406  by a client or, if applicable, the client’s representative and
  407  an appeals process. The appeals process must include access to
  408  Disability Rights Florida and other advocates and the right to
  409  be a member of, be active in, and associate with advocacy or
  410  special interest groups.
  411         (2) The licensee shall:
  412         (a) Promote participation of the client’s representative in
  413  the process of providing treatment to the client unless the
  414  representative’s participation is unobtainable or inappropriate.
  415         (b) Answer communications from the client’s family,
  416  guardians, and friends promptly and appropriately.
  417         (c) Promote visits by persons with a relationship to the
  418  client at any reasonable hour, without requiring prior notice,
  419  in any area of the facility that provides direct care services
  420  to the client, consistent with the client’s and other clients’
  421  privacy, unless the interdisciplinary team determines that such
  422  a visit would not be appropriate.
  423         (d) Promote opportunities for the client to leave the
  424  facility for visits, trips, or vacations.
  425         (e) Promptly notify the client’s representative of a
  426  significant incident or change in the client’s condition,
  427  including, but not limited to, serious illness, accident, abuse,
  428  unauthorized absence, or death.
  429         (3) The administrator of a facility shall ensure that a
  430  written notice of licensee responsibilities is posted in a
  431  prominent place in each building where clients reside and is
  432  read or explained to clients who cannot read. This notice shall
  433  be provided to clients in a manner that is clearly legible,
  434  shall include the statewide toll-free telephone number for
  435  reporting complaints to the agency, and shall include the words:
  436  “To report a complaint regarding the services you receive,
  437  please call toll-free ...[telephone number]... or Disability
  438  Rights Florida ...[telephone number]....” The statewide toll
  439  free telephone number for the central abuse hotline shall be
  440  provided to clients in a manner that is clearly legible and
  441  shall include the words: “To report abuse, neglect, or
  442  exploitation, please call toll-free ...[telephone number]....”
  443  The licensee shall ensure a client’s access to a telephone where
  444  telephone numbers are posted as required by this subsection.
  445         (4) A licensee or employee of a facility may not serve
  446  notice upon a client to leave the premises or take any other
  447  retaliatory action against another person solely because of the
  448  following:
  449         (a) The client or other person files an internal or
  450  external complaint or grievance regarding the facility.
  451         (b) The client or other person appears as a witness in a
  452  hearing inside or outside the facility.
  453         (5) Before or at the time of admission, the client and, if
  454  applicable, the client’s representative shall receive a copy of
  455  the licensee’s responsibilities, including grievance procedures
  456  and telephone numbers, as provided in this section.
  457         (6) The licensee must develop and implement policies and
  458  procedures governing the release of client information,
  459  including consent necessary from the client or, if applicable,
  460  the client’s representative.
  461         400.9976 Administration of medication.—
  462         (1) An individual medication administration record must be
  463  maintained for each client. A dose of medication, including a
  464  self-administered dose, shall be properly recorded in the
  465  client’s record. A client who self-administers medication shall
  466  be given a pill organizer. Medication must be placed in the pill
  467  organizer by a nurse. A nurse shall document the date and time
  468  that medication is placed into each client’s pill organizer. All
  469  medications must be administered in compliance with orders of a
  470  physician, physician assistant, or advanced registered nurse
  471  practitioner.
  472         (2) If an interdisciplinary team determines that self
  473  administration of medication is an appropriate objective, and if
  474  the physician, physician assistant, or advanced registered nurse
  475  practitioner does not specify otherwise, the client must be
  476  instructed by the physician, physician assistant, or advanced
  477  registered nurse practitioner to self-administer his or her
  478  medication without the assistance of a staff person. All forms
  479  of self-administration of medication, including administration
  480  orally, by injection, and by suppository, shall be included in
  481  the training. The client’s physician, physician assistant, or
  482  advanced registered nurse practitioner must be informed of the
  483  interdisciplinary team’s decision that self-administration of
  484  medication is an objective for the client. A client may not
  485  self-administer medication until he or she demonstrates the
  486  competency to take the correct medication in the correct dosage
  487  at the correct time, to respond to missed doses, and to contact
  488  the appropriate person with questions.
  489         (3) Medication administration discrepancies and adverse
  490  drug reactions must be recorded and reported immediately to a
  491  physician, physician assistant, or advanced registered nurse
  492  practitioner.
  493         400.9977 Assistance with medication.—
  494         (1)  Notwithstanding any provision of part I of chapter
  495  464, the Nurse Practice Act, unlicensed direct care services
  496  staff who provide services to clients in a facility licensed
  497  under this part may administer prescribed, prepackaged, and
  498  premeasured medications after the completion of training in
  499  medication administration and under the general supervision of a
  500  registered nurse as provided under this section and applicable
  501  rules.
  502         (2) Training required by this section and applicable rules
  503  shall be conducted by a registered nurse licensed under chapter
  504  464, a physician licensed under chapter 458 or chapter 459, or a
  505  pharmacist licensed under chapter 465.
  506         (3) A facility that allows unlicensed direct care service
  507  staff to administer medications pursuant to this section shall:
  508         (a) Develop and implement policies and procedures that
  509  include a plan to ensure the safe handling, storage, and
  510  administration of prescription medications.
  511         (b) Maintain written evidence of the expressed and informed
  512  consent for each client.
  513         (c) Maintain a copy of the written prescription, including
  514  the name of the medication, the dosage, and the administration
  515  schedule and termination date.
  516         (d) Maintain documentation of compliance with required
  517  training.
  518         (4) The agency shall adopt rules to implement this section.
  519         400.9978 Protection of clients from abuse, neglect,
  520  mistreatment, and exploitation.—The licensee shall develop and
  521  implement policies and procedures for the screening and training
  522  of employees; the protection of clients; and the prevention,
  523  identification, investigation, and reporting of abuse, neglect,
  524  mistreatment, and exploitation. The licensee shall identify
  525  clients whose personal histories render them at risk for abusing
  526  other clients, develop intervention strategies to prevent
  527  occurrences of abuse, monitor clients for changes that would
  528  trigger abusive behavior, and reassess the interventions on a
  529  regular basis. A licensee shall:
  530         (1) Screen each potential employee for a history of abuse,
  531  neglect, mistreatment, or exploitation of clients. The screening
  532  shall include an attempt to obtain information from previous and
  533  current employers and verification of screening information by
  534  the appropriate licensing boards.
  535         (2) Train employees through orientation and ongoing
  536  sessions regarding issues related to abuse prohibition
  537  practices, including identification of abuse, neglect,
  538  mistreatment, and exploitation; appropriate interventions to
  539  address aggressive or catastrophic reactions of clients; the
  540  process for reporting allegations without fear of reprisal; and
  541  recognition of signs of frustration and stress that may lead to
  542  abuse.
  543         (3) Provide clients, families, and staff with information
  544  regarding how and to whom they may report concerns, incidents,
  545  and grievances without fear of retribution and provide feedback
  546  regarding the concerns that are expressed. A licensee shall
  547  identify, correct, and intervene in situations in which abuse,
  548  neglect, mistreatment, or exploitation is likely to occur,
  549  including:
  550         (a) Evaluating the physical environment of the facility to
  551  identify characteristics that may make abuse or neglect more
  552  likely to occur, such as secluded areas.
  553         (b) Providing sufficient staff on each shift to meet the
  554  needs of the clients and ensuring that the assigned staff have
  555  knowledge of each client’s care needs.
  556         (c) Identifying inappropriate staff behaviors, such as
  557  using derogatory language, rough handling of clients, ignoring
  558  clients while giving care, and directing clients who need
  559  toileting assistance to urinate or defecate in their beds.
  560         (d) Assessing, monitoring, and planning care for clients
  561  with needs and behaviors that might lead to conflict or neglect,
  562  such as a history of aggressive behaviors including entering
  563  other clients’ rooms without permission, exhibiting self
  564  injurious behaviors or communication disorders, requiring
  565  intensive nursing care, or being totally dependent on staff.
  566         (4) Identify events, such as suspicious bruising of
  567  clients, occurrences, patterns, and trends that may constitute
  568  abuse and determine the direction of the investigation.
  569         (5) Investigate alleged violations and different types of
  570  incidents, identify the staff member responsible for initial
  571  reporting, and report results to the proper authorities. The
  572  licensee shall analyze the incidents to determine whether
  573  policies and procedures need to be changed to prevent further
  574  incidents and take necessary corrective actions.
  575         (6) Protect clients from harm during an investigation.
  576         (7) Report alleged violations and substantiated incidents,
  577  as required under chapters 39 and 415, to the licensing
  578  authorities and all other agencies, as required, and report any
  579  knowledge of actions by a court of law that would indicate an
  580  employee is unfit for service.
  581         400.9979 Restraint and seclusion; client safety.—
  582         (1) A facility shall provide a therapeutic milieu that
  583  supports a culture of individual empowerment and responsibility.
  584  The health and safety of the client shall be the facility’s
  585  primary concern at all times.
  586         (2) The use of physical restraints must be ordered and
  587  documented by a physician, physician assistant, or advanced
  588  registered nurse practitioner and must be consistent with the
  589  policies and procedures adopted by the facility. The client or,
  590  if applicable, the client’s representative shall be informed of
  591  the facility’s physical restraint policies and procedures when
  592  the client is admitted.
  593         (3) The use of chemical restraints shall be limited to
  594  prescribed dosages of medications as ordered by a physician,
  595  physician assistant, or advanced registered nurse practitioner
  596  and must be consistent with the client’s diagnosis and the
  597  policies and procedures adopted by the facility. The client and,
  598  if applicable, the client’s representative shall be informed of
  599  the facility’s chemical restraint policies and procedures when
  600  the client is admitted.
  601         (4) Based on the assessment by a physician, physician
  602  assistant, or advanced registered nurse practitioner, if a
  603  client exhibits symptoms that present an immediate risk of
  604  injury or death to himself or herself or others, a physician,
  605  physician assistant, or advanced registered nurse practitioner
  606  may issue an emergency treatment order to immediately administer
  607  rapid-response psychotropic medications or other chemical
  608  restraints. Each emergency treatment order must be documented
  609  and maintained in the client’s record.
  610         (a) An emergency treatment order is not effective for more
  611  than 24 hours.
  612         (b) Whenever a client is medicated under this subsection,
  613  the client’s representative or a responsible party and the
  614  client’s physician, physician assistant, or advanced registered
  615  nurse practitioner shall be notified as soon as practicable.
  616         (5) A client who is prescribed and receives a medication
  617  that can serve as a chemical restraint for a purpose other than
  618  an emergency treatment order must be evaluated by his or her
  619  physician, physician assistant, or advanced registered nurse
  620  practitioner at least monthly to assess:
  621         (a) The continued need for the medication.
  622         (b) The level of the medication in the client’s blood.
  623         (c) The need for adjustments to the prescription.
  624         (6) The licensee shall ensure that clients are free from
  625  unnecessary drugs and physical restraints and are provided
  626  treatment to reduce dependency on drugs and physical restraints.
  627         (7) The licensee may only employ physical restraints and
  628  seclusion as authorized by the facility’s written policies,
  629  which shall comply with this section and applicable rules.
  630         (8) Interventions to manage dangerous client behavior shall
  631  be employed with sufficient safeguards and supervision to ensure
  632  that the safety, welfare, and civil and human rights of a client
  633  are adequately protected.
  634         (9) A facility shall notify the parent, guardian, or, if
  635  applicable, the client’s representative when restraint or
  636  seclusion is employed. The facility must provide the
  637  notification within 24 hours after the restraint or seclusion is
  638  employed. Reasonable efforts must be taken to notify the parent,
  639  guardian, or, if applicable, the client’s representative by
  640  telephone or e-mail, or both, and these efforts must be
  641  documented.
  642         (10) The agency may adopt rules that establish standards
  643  and procedures for the use of restraints, restraint positioning,
  644  seclusion, and emergency treatment orders for psychotropic
  645  medications, restraint, and seclusion. If rules are adopted, the
  646  rules must include duration of restraint, staff training,
  647  observation of the client during restraint, and documentation
  648  and reporting standards.
  649         400.998 Personnel background screening; administration and
  650  management procedures.—
  651         (1) The agency shall require level 2 background screening
  652  for licensee personnel as required in s. 408.809(1)(e) and
  653  pursuant to chapter 435 and s. 408.809.
  654         (2) The licensee shall maintain personnel records for each
  655  staff member that contain, at a minimum, documentation of
  656  background screening, a job description, documentation of
  657  compliance with the training requirements of this part and
  658  applicable rules, the employment application, references, a copy
  659  of each job performance evaluation, and, for each staff member
  660  who performs services for which licensure or certification is
  661  required, a copy of all licenses or certification held by that
  662  staff member.
  663         (3) The licensee must:
  664         (a) Develop and implement infection control policies and
  665  procedures and include the policies and procedures in the
  666  licensee’s policy manual.
  667         (b) Maintain liability insurance as defined in s.
  668  624.605(1)(b).
  669         (c) Designate one person as an administrator to be
  670  responsible and accountable for the overall management of the
  671  facility.
  672         (d) Designate in writing a person to be responsible for the
  673  facility when the administrator is absent from the facility for
  674  more than 24 hours.
  675         (e) Designate in writing a program director to be
  676  responsible for supervising the therapeutic and behavioral
  677  staff, determining the levels of supervision, and determining
  678  room placement for each client.
  679         (f) Designate in writing a person to be responsible when
  680  the program director is absent from the facility for more than
  681  24 hours.
  682         (g) Obtain approval of the comprehensive emergency
  683  management plan, pursuant to s. 400.9982(2)(e), from the local
  684  emergency management agency. Pending the approval of the plan,
  685  the local emergency management agency shall ensure that the
  686  following agencies, at a minimum, are given the opportunity to
  687  review the plan: the Department of Health, the Agency for Health
  688  Care Administration, and the Division of Emergency Management.
  689  Appropriate volunteer organizations shall also be given the
  690  opportunity to review the plan. The local emergency management
  691  agency shall complete its review within 60 days after receipt of
  692  the plan and either approve the plan or advise the licensee of
  693  necessary revisions.
  694         (h) Maintain written records in a form and system that
  695  comply with medical and business practices and make the records
  696  available by the facility for review or submission to the agency
  697  upon request. The records shall include:
  698         1. A daily census record that indicates the number of
  699  clients currently receiving services in the facility, including
  700  information regarding any public funding of such clients.
  701         2. A record of each accident or unusual incident involving
  702  a client or staff member that caused, or had the potential to
  703  cause, injury or harm to any person or property within the
  704  facility. The record shall contain a clear description of each
  705  accident or incident; the names of the persons involved; a
  706  description of medical or other services provided to these
  707  persons, including the provider of the services; and the steps
  708  taken to prevent recurrence of such accident or incident.
  709         3. A copy of current agreements with third-party providers.
  710         4. A copy of current agreements with each consultant
  711  employed by the licensee and documentation of a consultant’s
  712  visits and required written and dated reports.
  713         400.9981 Property and personal affairs of clients.—
  714         (1) A client shall be given the option of using his or her
  715  own belongings, as space permits; choosing a roommate if
  716  practical and not clinically contraindicated; and, whenever
  717  possible, unless the client is adjudicated incompetent or
  718  incapacitated under state law, managing his or her own affairs.
  719         (2) The admission of a client to a facility and his or her
  720  presence therein does not confer on a licensee or administrator,
  721  or an employee or representative thereof, any authority to
  722  manage, use, or dispose of the property of the client, and the
  723  admission or presence of a client does not confer on such person
  724  any authority or responsibility for the personal affairs of the
  725  client except that which may be necessary for the safe
  726  management of the facility or for the safety of the client.
  727         (3) A licensee or administrator, or an employee or
  728  representative thereof, may:
  729         (a) Not act as the guardian, trustee, or conservator for a
  730  client or a client’s property.
  731         (b) Act as a competent client’s payee for social security,
  732  veteran’s, or railroad benefits if the client provides consent
  733  and the licensee files a surety bond with the agency in an
  734  amount equal to twice the average monthly aggregate income or
  735  personal funds due to the client, or expendable for the client’s
  736  account, that are received by a licensee.
  737         (c) Act as the attorney in fact for a client if the
  738  licensee files a surety bond with the agency in an amount equal
  739  to twice the average monthly income of the client, plus the
  740  value of a client’s property under the control of the attorney
  741  in fact.
  743  The surety bond required under paragraph (b) or paragraph (c)
  744  shall be executed by the licensee as principal and a licensed
  745  surety company. The bond shall be conditioned upon the faithful
  746  compliance of the licensee with the requirements of licensure
  747  and is payable to the agency for the benefit of a client who
  748  suffers a financial loss as a result of the misuse or
  749  misappropriation of funds held pursuant to this subsection. A
  750  surety company that cancels or does not renew the bond of a
  751  licensee shall notify the agency in writing at least 30 days
  752  before the action, giving the reason for cancellation or
  753  nonrenewal. A licensee or administrator, or an employee or
  754  representative thereof, who is granted power of attorney for a
  755  client of the facility shall, on a monthly basis, notify the
  756  client in writing of any transaction made on behalf of the
  757  client pursuant to this subsection, and a copy of the
  758  notification given to the client shall be retained in the
  759  client’s file and available for agency inspection.
  760         (4) A licensee, with the consent of the client, shall
  761  provide for safekeeping in the facility of the client’s personal
  762  effects of a value not in excess of $1,000 and the client’s
  763  funds not in excess of $500 cash and shall keep complete and
  764  accurate records of the funds and personal effects received. If
  765  a client is absent from a facility for 24 hours or more, the
  766  licensee may provide for safekeeping of the client’s personal
  767  effects of a value in excess of $1,000.
  768         (5) Funds or other property belonging to or due to a client
  769  or expendable for the client’s account that are received by a
  770  licensee shall be regarded as funds held in trust and shall be
  771  kept separate from the funds and property of the licensee and
  772  other clients or shall be specifically credited to the client.
  773  The funds held in trust shall be used or otherwise expended only
  774  for the account of the client. At least once every month, except
  775  pursuant to an order of a court of competent jurisdiction, the
  776  licensee shall furnish the client and, if applicable, the
  777  client’s representative with a complete and verified statement
  778  of all funds and other property to which this subsection
  779  applies, detailing the amount and items received, together with
  780  their sources and disposition. The licensee shall furnish the
  781  statement annually and upon discharge or transfer of a client. A
  782  governmental agency or private charitable agency contributing
  783  funds or other property to the account of a client is also
  784  entitled to receive a statement monthly and upon the discharge
  785  or transfer of the client.
  786         (6)(a) In addition to any damages or civil penalties to
  787  which a person is subject, a person who:
  788         1. Intentionally withholds a client’s personal funds,
  789  personal property, or personal needs allowance;
  790         2. Demands, beneficially receives, or contracts for payment
  791  of all or any part of a client’s personal property or personal
  792  needs allowance in satisfaction of the facility rate for
  793  supplies and services; or
  794         3. Borrows from or pledges any personal funds of a client,
  795  other than the amount agreed to by written contract under s.
  796  429.24,
  798  commits a misdemeanor of the first degree, punishable as
  799  provided in s. 775.082 or s. 775.083.
  800         (b) A licensee or administrator, or an employee, or
  801  representative thereof, who is granted power of attorney for a
  802  client and who misuses or misappropriates funds obtained through
  803  this power commits a felony of the third degree, punishable as
  804  provided in s. 775.082, s. 775.083, or s. 775.084.
  805         (7) In the event of the death of a client, a licensee shall
  806  return all refunds, funds, and property held in trust to the
  807  client’s personal representative, if one has been appointed at
  808  the time the licensee disburses such funds, or, if not, to the
  809  client’s spouse or adult next of kin named in a beneficiary
  810  designation form provided by the licensee to the client. If the
  811  client does not have a spouse or adult next of kin or such
  812  person cannot be located, funds due to be returned to the client
  813  shall be placed in an interest-bearing account, and all property
  814  held in trust by the licensee shall be safeguarded until such
  815  time as the funds and property are disbursed pursuant to the
  816  Florida Probate Code. The funds shall be kept separate from the
  817  funds and property of the licensee and other clients of the
  818  facility. If the funds of the deceased client are not disbursed
  819  pursuant to the Florida Probate Code within 2 years after the
  820  client’s death, the funds shall be deposited in the Health Care
  821  Trust Fund administered by the agency.
  822         (8) The agency, by rule, may clarify terms and specify
  823  procedures and documentation necessary to administer the
  824  provisions of this section relating to the proper management of
  825  clients’ funds and personal property and the execution of surety
  826  bonds.
  827         400.9982 Rules establishing standards.—
  828         (1) It is the intent of the Legislature that rules adopted
  829  and enforced pursuant to this part and part II of chapter 408
  830  include criteria to ensure reasonable and consistent quality of
  831  care and client safety. The rules should make reasonable efforts
  832  to accommodate the needs and preferences of the client to
  833  enhance the client’s quality of life while residing in a
  834  transitional living facility.
  835         (2) The agency may adopt and enforce rules to implement
  836  this part and part II of chapter 408, which may include
  837  reasonable and fair criteria with respect to:
  838         (a) The location of transitional living facilities.
  839         (b) The qualifications of personnel, including management,
  840  medical, nursing, and other professional personnel and nursing
  841  assistants and support staff, who are responsible for client
  842  care. The licensee must employ enough qualified professional
  843  staff to carry out and monitor interventions in accordance with
  844  the stated goals and objectives of each comprehensive treatment
  845  plan.
  846         (c) Requirements for personnel procedures, reporting
  847  procedures, and documentation necessary to implement this part.
  848         (d) Services provided to clients of transitional living
  849  facilities.
  850         (e) The preparation and annual update of a comprehensive
  851  emergency management plan in consultation with the Division of
  852  Emergency Management. At a minimum, the rules must provide for
  853  plan components that address emergency evacuation
  854  transportation; adequate sheltering arrangements; postdisaster
  855  activities, including provision of emergency power, food, and
  856  water; postdisaster transportation; supplies; staffing;
  857  emergency equipment; individual identification of clients and
  858  transfer of records; communication with families; and responses
  859  to family inquiries.
  860         400.9983 Violations; penalties.—A violation of this part or
  861  any rule adopted pursuant thereto shall be classified according
  862  to the nature of the violation and the gravity of its probable
  863  effect on facility clients. The agency shall indicate the
  864  classification on the written notice of the violation as
  865  follows:
  866         (1) Class “I” violations are defined in s. 408.813. The
  867  agency shall issue a citation regardless of correction and
  868  impose an administrative fine of $5,000 for an isolated
  869  violation, $7,500 for a patterned violation, or $10,000 for a
  870  widespread violation. Violations may be identified, and a fine
  871  must be levied, notwithstanding the correction of the deficiency
  872  giving rise to the violation.
  873         (2) Class “II” violations are defined in s. 408.813. The
  874  agency shall impose an administrative fine of $1,000 for an
  875  isolated violation, $2,500 for a patterned violation, or $5,000
  876  for a widespread violation. A fine must be levied
  877  notwithstanding the correction of the deficiency giving rise to
  878  the violation.
  879         (3) Class “III” violations are defined in s. 408.813. The
  880  agency shall impose an administrative fine of $500 for an
  881  isolated violation, $750 for a patterned violation, or $1,000
  882  for a widespread violation. If a deficiency giving rise to a
  883  class III violation is corrected within the time specified by
  884  the agency, the fine may not be imposed.
  885         (4) Class “IV” violations are defined in s. 408.813. The
  886  agency shall impose for a cited class IV violation an
  887  administrative fine of at least $100 but not exceeding $200 for
  888  each violation. If a deficiency giving rise to a class IV
  889  violation is corrected within the time specified by the agency,
  890  the fine may not be imposed.
  891         400.9984 Receivership proceedings.—The agency may apply s.
  892  429.22 with regard to receivership proceedings for transitional
  893  living facilities.
  894         400.9985 Interagency communication.—The agency, the
  895  department, the Agency for Persons with Disabilities, and the
  896  Department of Children and Families shall develop electronic
  897  systems to ensure that relevant information pertaining to the
  898  regulation of transitional living facilities and clients is
  899  timely and effectively communicated among agencies in order to
  900  facilitate the protection of clients. Electronic sharing of
  901  information shall include, at a minimum, a brain and spinal cord
  902  injury registry and a client abuse registry.
  903         Section 2. Section 400.805, Florida Statutes, is
  904  transferred and renumbered as s. 400.9986, Florida Statutes.
  905         Section 3. Effective July 1, 2016, s. 400.9986, Florida
  906  Statutes, is repealed.
  907         Section 4. The title of part V of chapter 400, Florida
  908  Statutes, consisting of sections 400.701 and 400.801, is
  909  redesignated as “INTERMEDIATE CARE FACILITIES.”
  910         Section 5. Subsection (9) of section 381.745, Florida
  911  Statutes, is amended to read:
  912         381.745 Definitions; ss. 381.739-381.79.—As used in ss.
  913  381.739-381.79, the term:
  914         (9) “Transitional living facility” means a state-approved
  915  facility, as defined and licensed under chapter 400 or chapter
  916  429, or a facility approved by the brain and spinal cord injury
  917  program in accordance with this chapter.
  918         Section 6. Section 381.75, Florida Statutes, is amended to
  919  read:
  920         381.75 Duties and responsibilities of the department, of
  921  transitional living facilities, and of residents.—Consistent
  922  with the mandate of s. 381.7395, the department shall develop
  923  and administer a multilevel treatment program for individuals
  924  who sustain brain or spinal cord injuries and who are referred
  925  to the brain and spinal cord injury program.
  926         (1) Within 15 days after any report of an individual who
  927  has sustained a brain or spinal cord injury, the department
  928  shall notify the individual or the most immediate available
  929  family members of their right to assistance from the state, the
  930  services available, and the eligibility requirements.
  931         (2) The department shall refer individuals who have brain
  932  or spinal cord injuries to other state agencies to ensure assure
  933  that rehabilitative services, if desired, are obtained by that
  934  individual.
  935         (3) The department, in consultation with emergency medical
  936  service, shall develop standards for an emergency medical
  937  evacuation system that will ensure that all individuals who
  938  sustain traumatic brain or spinal cord injuries are transported
  939  to a department-approved trauma center that meets the standards
  940  and criteria established by the emergency medical service and
  941  the acute-care standards of the brain and spinal cord injury
  942  program.
  943         (4) The department shall develop standards for designation
  944  of rehabilitation centers to provide rehabilitation services for
  945  individuals who have brain or spinal cord injuries.
  946         (5) The department shall determine the appropriate number
  947  of designated acute-care facilities, inpatient rehabilitation
  948  centers, and outpatient rehabilitation centers, needed based on
  949  incidence, volume of admissions, and other appropriate criteria.
  950         (6) The department shall develop standards for designation
  951  of transitional living facilities to provide transitional living
  952  services for individuals who participate in the brain and spinal
  953  cord injury program the opportunity to adjust to their
  954  disabilities and to develop physical and functional skills in a
  955  supported living environment.
  956         (a) The Agency for Health Care Administration, in
  957  consultation with the department, shall develop rules for the
  958  licensure of transitional living facilities for individuals who
  959  have brain or spinal cord injuries.
  960         (b) The goal of a transitional living program for
  961  individuals who have brain or spinal cord injuries is to assist
  962  each individual who has such a disability to achieve a higher
  963  level of independent functioning and to enable that person to
  964  reenter the community. The program shall be focused on preparing
  965  participants to return to community living.
  966         (c) A transitional living facility for an individual who
  967  has a brain or spinal cord injury shall provide to such
  968  individual, in a residential setting, a goal-oriented treatment
  969  program designed to improve the individual’s physical,
  970  cognitive, communicative, behavioral, psychological, and social
  971  functioning, as well as to provide necessary support and
  972  supervision. A transitional living facility shall offer at least
  973  the following therapies: physical, occupational, speech,
  974  neuropsychology, independent living skills training, behavior
  975  analysis for programs serving brain-injured individuals, health
  976  education, and recreation.
  977         (d) All residents shall use the transitional living
  978  facility as a temporary measure and not as a permanent home or
  979  domicile. The transitional living facility shall develop an
  980  initial treatment plan for each resident within 3 days after the
  981  resident’s admission. The transitional living facility shall
  982  develop a comprehensive plan of treatment and a discharge plan
  983  for each resident as soon as practical, but no later than 30
  984  days after the resident’s admission. Each comprehensive
  985  treatment plan and discharge plan must be reviewed and updated
  986  as necessary, but no less often than quarterly. This subsection
  987  does not require the discharge of an individual who continues to
  988  require any of the specialized services described in paragraph
  989  (c) or who is making measurable progress in accordance with that
  990  individual’s comprehensive treatment plan. The transitional
  991  living facility shall discharge any individual who has an
  992  appropriate discharge site and who has achieved the goals of his
  993  or her discharge plan or who is no longer making progress toward
  994  the goals established in the comprehensive treatment plan and
  995  the discharge plan. The discharge location must be the least
  996  restrictive environment in which an individual’s health, well
  997  being, and safety is preserved.
  998         (7) Recipients of services, under this section, from any of
  999  the facilities referred to in this section shall pay a fee based
 1000  on ability to pay.
 1001         Section 7. Subsection (4) of section 381.78, Florida
 1002  Statutes, is amended to read:
 1003         381.78 Advisory council on brain and spinal cord injuries.—
 1004         (4) The council shall:
 1005         (a) provide advice and expertise to the department in the
 1006  preparation, implementation, and periodic review of the brain
 1007  and spinal cord injury program.
 1008         (b) Annually appoint a five-member committee composed of
 1009  one individual who has a brain injury or has a family member
 1010  with a brain injury, one individual who has a spinal cord injury
 1011  or has a family member with a spinal cord injury, and three
 1012  members who shall be chosen from among these representative
 1013  groups: physicians, other allied health professionals,
 1014  administrators of brain and spinal cord injury programs, and
 1015  representatives from support groups with expertise in areas
 1016  related to the rehabilitation of individuals who have brain or
 1017  spinal cord injuries, except that one and only one member of the
 1018  committee shall be an administrator of a transitional living
 1019  facility. Membership on the council is not a prerequisite for
 1020  membership on this committee.
 1021         1. The committee shall perform onsite visits to those
 1022  transitional living facilities identified by the Agency for
 1023  Health Care Administration as being in possible violation of the
 1024  statutes and rules regulating such facilities. The committee
 1025  members have the same rights of entry and inspection granted
 1026  under s. 400.805(4) to designated representatives of the agency.
 1027         2. Factual findings of the committee resulting from an
 1028  onsite investigation of a facility pursuant to subparagraph 1.
 1029  shall be adopted by the agency in developing its administrative
 1030  response regarding enforcement of statutes and rules regulating
 1031  the operation of the facility.
 1032         3. Onsite investigations by the committee shall be funded
 1033  by the Health Care Trust Fund.
 1034         4. Travel expenses for committee members shall be
 1035  reimbursed in accordance with s. 112.061.
 1036         5. Members of the committee shall recuse themselves from
 1037  participating in any investigation that would create a conflict
 1038  of interest under state law, and the council shall replace the
 1039  member, either temporarily or permanently.
 1040         Section 8. Subsection (5) of section 400.93, Florida
 1041  Statutes, is amended to read:
 1042         400.93 Licensure required; exemptions; unlawful acts;
 1043  penalties.—
 1044         (5) The following are exempt from home medical equipment
 1045  provider licensure, unless they have a separate company,
 1046  corporation, or division that is in the business of providing
 1047  home medical equipment and services for sale or rent to
 1048  consumers at their regular or temporary place of residence
 1049  pursuant to the provisions of this part:
 1050         (a) Providers operated by the Department of Health or
 1051  Federal Government.
 1052         (b) Nursing homes licensed under part II.
 1053         (c) Assisted living facilities licensed under chapter 429,
 1054  when serving their residents.
 1055         (d) Home health agencies licensed under part III.
 1056         (e) Hospices licensed under part IV.
 1057         (f) Intermediate care facilities and, homes for special
 1058  services, and transitional living facilities licensed under part
 1059  V.
 1060         (g) Transitional living facilities licensed under part XI.
 1061         (h)(g) Hospitals and ambulatory surgical centers licensed
 1062  under chapter 395.
 1063         (i)(h) Manufacturers and wholesale distributors when not
 1064  selling directly to consumers.
 1065         (j)(i) Licensed health care practitioners who use utilize
 1066  home medical equipment in the course of their practice, but do
 1067  not sell or rent home medical equipment to their patients.
 1068         (k)(j) Pharmacies licensed under chapter 465.
 1069         Section 9. Subsection (21) of section 408.802, Florida
 1070  Statutes, is amended to read:
 1071         408.802 Applicability.—The provisions of this part apply to
 1072  the provision of services that require licensure as defined in
 1073  this part and to the following entities licensed, registered, or
 1074  certified by the agency, as described in chapters 112, 383, 390,
 1075  394, 395, 400, 429, 440, 483, and 765:
 1076         (21) Transitional living facilities, as provided under part
 1077  XI V of chapter 400.
 1078         Section 10. Subsection (20) of section 408.820, Florida
 1079  Statutes, is amended to read:
 1080         408.820 Exemptions.—Except as prescribed in authorizing
 1081  statutes, the following exemptions shall apply to specified
 1082  requirements of this part:
 1083         (20) Transitional living facilities, as provided under part
 1084  XI V of chapter 400, are exempt from s. 408.810(10).
 1085         Section 11. For the purpose of incorporating the amendment
 1086  made by this act to section 381.75, Florida Statutes, in a
 1087  reference thereto, subsection (1) of section 381.79, Florida
 1088  Statutes, is reenacted to read:
 1089         381.79 Brain and Spinal Cord Injury Program Trust Fund.—
 1090         (1) There is created in the State Treasury the Brain and
 1091  Spinal Cord Injury Program Trust Fund. Moneys in the fund shall
 1092  be appropriated to the department for the purpose of providing
 1093  the cost of care for brain or spinal cord injuries as a payor of
 1094  last resort to residents of this state, for multilevel programs
 1095  of care established pursuant to s. 381.75.
 1096         (a) Authorization of expenditures for brain or spinal cord
 1097  injury care shall be made only by the department.
 1098         (b) Authorized expenditures include acute care,
 1099  rehabilitation, transitional living, equipment and supplies
 1100  necessary for activities of daily living, public information,
 1101  prevention, education, and research. In addition, the department
 1102  may provide matching funds for public or private assistance
 1103  provided under the brain and spinal cord injury program and may
 1104  provide funds for any approved expansion of services for
 1105  treating individuals who have sustained a brain or spinal cord
 1106  injury.
 1107         Section 12. (1)A transitional living facility that is
 1108  licensed under s. 400.805, Florida Statutes, on June 30, 2015,
 1109  must be licensed under and in compliance with s. 400.9986,
 1110  Florida Statutes, until the licensee becomes licensed under and
 1111  in compliance with part XI of ch. 400, Florida Statutes, as
 1112  created by this act. Such licensees must be licensed under and
 1113  in compliance with part XI of chapter 400, Florida Statutes, as
 1114  created by this act, on or before July 1, 2016.
 1115         (2)A transitional living facility that is licensed on or
 1116  after July 1, 2015, must be licensed under and in compliance
 1117  with part XI of ch. 400, Florida Statutes, as created by this
 1118  act.
 1119         Section 13. Except as otherwise expressly provided in this
 1120  act, this act shall take effect July 1, 2015.