Florida Senate - 2015                                     SB 682
       By Senator Grimsley
       21-00365B-15                                           2015682__
    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., to incorporate the
   99         amendment made by this act to s. 381.75, F.S., in a
  100         reference thereto; providing for the act’s
  101         applicability to licensed transitional living
  102         facilities licensed on specified dates; providing
  103         effective dates.
  105  Be It Enacted by the Legislature of the State of Florida:
  107         Section 1. Part XI of chapter 400, Florida Statutes,
  108  consisting of sections 400.997 through 400.9986, is created to
  109  read:
  110                               PART XI                             
  111                   TRANSITIONAL LIVING FACILITIES                  
  112         400.997 Legislative intent.—It is the intent of the
  113  Legislature to provide for the licensure of transitional living
  114  facilities and require the development, establishment, and
  115  enforcement of basic standards by the Agency for Health Care
  116  Administration to ensure quality of care and services to clients
  117  in transitional living facilities. It is the policy of the state
  118  that the least restrictive appropriate available treatment be
  119  used based on the individual needs and best interest of the
  120  client, consistent with optimum improvement of the client’s
  121  condition. The goal of a transitional living program for persons
  122  who have brain or spinal cord injuries is to assist each person
  123  who has such an injury to achieve a higher level of independent
  124  functioning and to enable the person to reenter the community.
  125  It is also the policy of the state that the restraint or
  126  seclusion of a client is justified only as an emergency safety
  127  measure used in response to danger to the client or others. It
  128  is therefore the intent of the Legislature to achieve an ongoing
  129  reduction in the use of restraint or seclusion in programs and
  130  facilities that serve persons who have brain or spinal cord
  131  injuries.
  132         400.9971 Definitions.—As used in this part, the term:
  133         (1) “Agency” means the Agency for Health Care
  134  Administration.
  135         (2) “Chemical restraint” means a pharmacologic drug that
  136  physically limits, restricts, or deprives a person of movement
  137  or mobility, is used for client protection or safety, and is not
  138  required for the treatment of medical conditions or symptoms.
  139         (3) “Client’s representative” means the parent of a child
  140  client or the client’s guardian, designated representative,
  141  designee, surrogate, or attorney in fact.
  142         (4) “Department” means the Department of Health.
  143         (5) “Physical restraint” means a manual method to restrict
  144  freedom of movement of or normal access to a person’s body, or a
  145  physical or mechanical device, material, or equipment attached
  146  or adjacent to the person’s body that the person cannot easily
  147  remove and that restricts freedom of movement of or normal
  148  access to the person’s body, including, but not limited to, a
  149  half-bed rail, a full-bed rail, a geriatric chair, or a Posey
  150  restraint. The term includes any device that is not specifically
  151  manufactured as a restraint but is altered, arranged, or
  152  otherwise used for this purpose. The term does not include
  153  bandage material used for the purpose of binding a wound or
  154  injury.
  155         (6) “Seclusion” means the physical segregation of a person
  156  in any fashion or the involuntary isolation of a person in a
  157  room or area from which the person is prevented from leaving.
  158  Such prevention may be accomplished by imposition of a physical
  159  barrier or by action of a staff member to prevent the person
  160  from leaving the room or area. For purposes of this part, the
  161  term does not mean isolation due to a person’s medical condition
  162  or symptoms.
  163         (7) “Transitional living facility” means a site where
  164  specialized health care services are provided to persons who
  165  have brain or spinal cord injuries, including, but not limited
  166  to, rehabilitative services, behavior modification, community
  167  reentry training, aids for independent living, and counseling.
  168         400.9972 License required; fee; application.—
  169         (1) The requirements of part II of chapter 408 apply to the
  170  provision of services that require licensure pursuant to this
  171  part and part II of chapter 408 and to entities licensed by or
  172  applying for licensure from the agency pursuant to this part. A
  173  license issued by the agency is required for the operation of a
  174  transitional living facility in this state. However, this part
  175  does not require a provider licensed by the agency to obtain a
  176  separate transitional living facility license to serve persons
  177  who have brain or spinal cord injuries as long as the services
  178  provided are within the scope of the provider’s license.
  179         (2) In accordance with this part, an applicant or a
  180  licensee shall pay a fee for each license application submitted
  181  under this part. The license fee shall consist of a $4,588
  182  license fee and a $90 per-bed fee per biennium and shall conform
  183  to the annual adjustment authorized in s. 408.805.
  184         (3) An applicant for licensure must provide:
  185         (a) The location of the facility for which the license is
  186  sought and documentation, signed by the appropriate local
  187  government official, which states that the applicant has met
  188  local zoning requirements.
  189         (b) Proof of liability insurance as provided in s.
  190  624.605(1)(b).
  191         (c) Proof of compliance with local zoning requirements,
  192  including compliance with the requirements of chapter 419 if the
  193  proposed facility is a community residential home.
  194         (d) Proof that the facility has received a satisfactory
  195  firesafety inspection.
  196         (e) Documentation that the facility has received a
  197  satisfactory sanitation inspection by the county health
  198  department.
  199         (4) The applicant’s proposed facility must attain and
  200  continuously maintain accreditation by an accrediting
  201  organization that specializes in evaluating rehabilitation
  202  facilities whose standards incorporate licensure regulations
  203  comparable to those required by the state. An applicant for
  204  licensure as a transitional living facility must acquire
  205  accreditation within 12 months after issuance of an initial
  206  license. The agency shall accept the accreditation survey report
  207  of the accrediting organization in lieu of conducting a
  208  licensure inspection if the standards included in the survey
  209  report are determined by the agency to document that the
  210  facility substantially complies with state licensure
  211  requirements. Within 10 days after receiving the accreditation
  212  survey report, the applicant shall submit to the agency a copy
  213  of the report and evidence of the accreditation decision as a
  214  result of the report. The agency may conduct an inspection of a
  215  transitional living facility to ensure compliance with the
  216  licensure requirements of this part, to validate the inspection
  217  process of the accrediting organization, to respond to licensure
  218  complaints, or to protect the public health and safety.
  219         400.9973 Client admission, transfer, and discharge.—
  220         (1) A transitional living facility shall have written
  221  policies and procedures governing the admission, transfer, and
  222  discharge of clients.
  223         (2) The admission of a client to a transitional living
  224  facility must be in accordance with the licensee’s policies and
  225  procedures.
  226         (3) To be admitted to a transitional living facility, an
  227  individual must have an acquired internal or external injury to
  228  the skull, the brain, or the brain’s covering, caused by a
  229  traumatic or nontraumatic event, which produces an altered state
  230  of consciousness, or a spinal cord injury, such as a lesion to
  231  the spinal cord or cauda equina syndrome, with evidence of
  232  significant involvement of at least two of the following
  233  deficits or dysfunctions:
  234         (a) A motor deficit.
  235         (b) A sensory deficit.
  236         (c) A cognitive deficit.
  237         (d) A behavioral deficit.
  238         (e) Bowel and bladder dysfunction.
  239         (4) A client whose medical condition and diagnosis do not
  240  positively identify a cause of the client’s condition, whose
  241  symptoms are inconsistent with the known cause of injury, or
  242  whose recovery is inconsistent with the known medical condition
  243  may be admitted to a transitional living facility for evaluation
  244  for a period not to exceed 90 days.
  245         (5) A client admitted to a transitional living facility
  246  must be admitted upon prescription by a licensed physician,
  247  physician assistant, or advanced registered nurse practitioner
  248  and must remain under the care of a licensed physician,
  249  physician assistant, or advanced registered nurse practitioner
  250  for the duration of the client’s stay in the facility.
  251         (6) A transitional living facility may not admit a person
  252  whose primary admitting diagnosis is mental illness or an
  253  intellectual or developmental disability.
  254         (7) A person may not be admitted to a transitional living
  255  facility if the person:
  256         (a) Presents significant risk of infection to other clients
  257  or personnel. A health care practitioner must provide
  258  documentation that the person is free of apparent signs and
  259  symptoms of communicable disease;
  260         (b) Is a danger to himself or herself or others as
  261  determined by a physician, physician assistant, or advanced
  262  registered nurse practitioner or a mental health practitioner
  263  licensed under chapter 490 or chapter 491, unless the facility
  264  provides adequate staffing and support to ensure patient safety;
  265         (c) Is bedridden; or
  266         (d) Requires 24-hour nursing supervision.
  267         (8) If the client meets the admission criteria, the medical
  268  or nursing director of the facility must complete an initial
  269  evaluation of the client’s functional skills, behavioral status,
  270  cognitive status, educational or vocational potential, medical
  271  status, psychosocial status, sensorimotor capacity, and other
  272  related skills and abilities within the first 72 hours after the
  273  client’s admission to the facility. An initial comprehensive
  274  treatment plan that delineates services to be provided and
  275  appropriate sources for such services must be implemented within
  276  the first 4 days after admission.
  277         (9) A transitional living facility shall develop a
  278  discharge plan for each client before or upon admission to the
  279  facility. The discharge plan must identify the intended
  280  discharge site and possible alternative discharge sites. For
  281  each discharge site identified, the discharge plan must identify
  282  the skills, behaviors, and other conditions that the client must
  283  achieve to be eligible for discharge. A discharge plan must be
  284  reviewed and updated as necessary but at least once monthly.
  285         (10) A transitional living facility shall discharge a
  286  client as soon as practicable when the client no longer requires
  287  the specialized services described in s. 400.9971(7), when the
  288  client is not making measurable progress in accordance with the
  289  client’s comprehensive treatment plan, or when the transitional
  290  living facility is no longer the most appropriate and least
  291  restrictive treatment option.
  292         (11) A transitional living facility shall provide at least
  293  30 days’ notice to a client of transfer or discharge plans,
  294  including the location of an acceptable transfer location if the
  295  client is unable to live independently. This subsection does not
  296  apply if a client voluntarily terminates residency.
  297         400.9974 Client comprehensive treatment plans; client
  298  services.—
  299         (1) A transitional living facility shall develop a
  300  comprehensive treatment plan for each client as soon as
  301  practicable but no later than 30 days after the initial
  302  comprehensive treatment plan is developed. The comprehensive
  303  treatment plan must be developed by an interdisciplinary team
  304  consisting of the case manager, the program director, the
  305  advanced registered nurse practitioner, and appropriate
  306  therapists. The client or, if appropriate, the client’s
  307  representative must be included in developing the comprehensive
  308  treatment plan. The comprehensive treatment plan must be
  309  reviewed and updated if the client fails to meet projected
  310  improvements outlined in the plan or if a significant change in
  311  the client’s condition occurs. The comprehensive treatment plan
  312  must be reviewed and updated at least once monthly.
  313         (2) The comprehensive treatment plan must include:
  314         (a) Orders obtained from the physician, physician
  315  assistant, or advanced registered nurse practitioner and the
  316  client’s diagnosis, medical history, physical examination, and
  317  rehabilitative or restorative needs.
  318         (b) A preliminary nursing evaluation, including orders for
  319  immediate care provided by the physician, physician assistant,
  320  or advanced registered nurse practitioner, which shall be
  321  completed when the client is admitted.
  322         (c) A comprehensive, accurate, reproducible, and
  323  standardized assessment of the client’s functional capability;
  324  the treatments designed to achieve skills, behaviors, and other
  325  conditions necessary for the client to return to the community;
  326  and specific measurable goals.
  327         (d) Steps necessary for the client to achieve transition
  328  into the community and estimated length of time to achieve those
  329  goals.
  330         (3) The client or, if appropriate, the client’s
  331  representative must consent to the continued treatment at the
  332  transitional living facility. Consent may be for a period of up
  333  to 6 months. If such consent is not given, the transitional
  334  living facility shall discharge the client as soon as
  335  practicable.
  336         (4) A client must receive the professional program services
  337  needed to implement the client’s comprehensive treatment plan.
  338         (5) The licensee must employ qualified professional staff
  339  to carry out and monitor the various professional interventions
  340  in accordance with the stated goals and objectives of the
  341  client’s comprehensive treatment plan.
  342         (6) A client must receive a continuous treatment program
  343  that includes appropriate, consistent implementation of
  344  specialized and general training, treatment, health services,
  345  and related services and that is directed toward:
  346         (a) The acquisition of the behaviors and skills necessary
  347  for the client to function with as much self-determination and
  348  independence as possible.
  349         (b) The prevention or deceleration of regression or loss of
  350  current optimal functional status.
  351         (c) The management of behavioral issues that preclude
  352  independent functioning in the community.
  353         400.9975 Licensee responsibilities.—
  354         (1) The licensee shall ensure that each client:
  355         (a) Lives in a safe environment free from abuse, neglect,
  356  and exploitation.
  357         (b) Is treated with consideration and respect and with due
  358  recognition of personal dignity, individuality, and the need for
  359  privacy.
  360         (c) Retains and uses his or her own clothes and other
  361  personal property in his or her immediate living quarters to
  362  maintain individuality and personal dignity, except when the
  363  licensee demonstrates that such retention and use would be
  364  unsafe, impractical, or an infringement upon the rights of other
  365  clients.
  366         (d) Has unrestricted private communication, including
  367  receiving and sending unopened correspondence, access to a
  368  telephone, and visits with any person of his or her choice. Upon
  369  request, the licensee shall modify visiting hours for caregivers
  370  and guests. The facility shall restrict communication in
  371  accordance with any court order or written instruction of a
  372  client’s representative. Any restriction on a client’s
  373  communication for therapeutic reasons shall be documented and
  374  reviewed at least weekly and shall be removed as soon as no
  375  longer clinically indicated. The basis for the restriction shall
  376  be explained to the client and, if applicable, the client’s
  377  representative. The client shall retain the right to call the
  378  central abuse hotline, the agency, and Disability Rights Florida
  379  at any time.
  380         (e) Has the opportunity to participate in and benefit from
  381  community services and activities to achieve the highest
  382  possible level of independence, autonomy, and interaction within
  383  the community.
  384         (f) Has the opportunity to manage his or her financial
  385  affairs unless the client or, if applicable, the client’s
  386  representative authorizes the administrator of the facility to
  387  provide safekeeping for funds as provided under this part.
  388         (g) Has reasonable opportunity for regular exercise more
  389  than once per week and to be outdoors at regular and frequent
  390  intervals except when prevented by inclement weather.
  391         (h) Has the opportunity to exercise civil and religious
  392  liberties, including the right to independent personal
  393  decisions. However, a religious belief or practice, including
  394  attendance at religious services, may not be imposed upon any
  395  client.
  396         (i) Has access to adequate and appropriate health care
  397  consistent with established and recognized community standards.
  398         (j) Has the opportunity to present grievances and recommend
  399  changes in policies, procedures, and services to the staff of
  400  the licensee, governing officials, or any other person without
  401  restraint, interference, coercion, discrimination, or reprisal.
  402  A licensee shall establish a grievance procedure to facilitate a
  403  client’s ability to present grievances, including a system for
  404  investigating, tracking, managing, and responding to complaints
  405  by a client or, if applicable, the client’s representative and
  406  an appeals process. The appeals process must include access to
  407  Disability Rights Florida and other advocates and the right to
  408  be a member of, be active in, and associate with advocacy or
  409  special interest groups.
  410         (2) The licensee shall:
  411         (a) Promote participation of the client’s representative in
  412  the process of providing treatment to the client unless the
  413  representative’s participation is unobtainable or inappropriate.
  414         (b) Answer communications from the client’s family,
  415  guardians, and friends promptly and appropriately.
  416         (c) Promote visits by persons with a relationship to the
  417  client at any reasonable hour, without requiring prior notice,
  418  in any area of the facility that provides direct care services
  419  to the client, consistent with the client’s and other clients’
  420  privacy, unless the interdisciplinary team determines that such
  421  a visit would not be appropriate.
  422         (d) Promote opportunities for the client to leave the
  423  facility for visits, trips, or vacations.
  424         (e) Promptly notify the client’s representative of a
  425  significant incident or change in the client’s condition,
  426  including, but not limited to, serious illness, accident, abuse,
  427  unauthorized absence, or death.
  428         (3) The administrator of a facility shall ensure that a
  429  written notice of licensee responsibilities is posted in a
  430  prominent place in each building where clients reside and is
  431  read or explained to clients who cannot read. This notice shall
  432  be provided to clients in a manner that is clearly legible,
  433  shall include the statewide toll-free telephone number for
  434  reporting complaints to the agency, and shall include the words:
  435  “To report a complaint regarding the services you receive,
  436  please call toll-free ...[telephone number]... or Disability
  437  Rights Florida ...[telephone number]....” The statewide toll
  438  free telephone number for the central abuse hotline shall be
  439  provided to clients in a manner that is clearly legible and
  440  shall include the words: “To report abuse, neglect, or
  441  exploitation, please call toll-free ...[telephone number]....”
  442  The licensee shall ensure a client’s access to a telephone where
  443  telephone numbers are posted as required by this subsection.
  444         (4) A licensee or employee of a facility may not serve
  445  notice upon a client to leave the premises or take any other
  446  retaliatory action against another person solely because of the
  447  following:
  448         (a) The client or other person files an internal or
  449  external complaint or grievance regarding the facility.
  450         (b) The client or other person appears as a witness in a
  451  hearing inside or outside the facility.
  452         (5) Before or at the time of admission, the client and, if
  453  applicable, the client’s representative shall receive a copy of
  454  the licensee’s responsibilities, including grievance procedures
  455  and telephone numbers, as provided in this section.
  456         (6) The licensee must develop and implement policies and
  457  procedures governing the release of client information,
  458  including consent necessary from the client or, if applicable,
  459  the client’s representative.
  460         400.9976 Administration of medication.—
  461         (1) An individual medication administration record must be
  462  maintained for each client. A dose of medication, including a
  463  self-administered dose, shall be properly recorded in the
  464  client’s record. A client who self-administers medication shall
  465  be given a pill organizer. Medication must be placed in the pill
  466  organizer by a nurse. A nurse shall document the date and time
  467  that medication is placed into each client’s pill organizer. All
  468  medications must be administered in compliance with orders of a
  469  physician, physician assistant, or advanced registered nurse
  470  practitioner.
  471         (2) If an interdisciplinary team determines that self
  472  administration of medication is an appropriate objective, and if
  473  the physician, physician assistant, or advanced registered nurse
  474  practitioner does not specify otherwise, the client must be
  475  instructed by the physician, physician assistant, or advanced
  476  registered nurse practitioner to self-administer his or her
  477  medication without the assistance of a staff person. All forms
  478  of self-administration of medication, including administration
  479  orally, by injection, and by suppository, shall be included in
  480  the training. The client’s physician, physician assistant, or
  481  advanced registered nurse practitioner must be informed of the
  482  interdisciplinary team’s decision that self-administration of
  483  medication is an objective for the client. A client may not
  484  self-administer medication until he or she demonstrates the
  485  competency to take the correct medication in the correct dosage
  486  at the correct time, to respond to missed doses, and to contact
  487  the appropriate person with questions.
  488         (3) Medication administration discrepancies and adverse
  489  drug reactions must be recorded and reported immediately to a
  490  physician, physician assistant, or advanced registered nurse
  491  practitioner.
  492         400.9977 Assistance with medication.—
  493         (1)  Notwithstanding any provision of part I of chapter
  494  464, the Nurse Practice Act, unlicensed direct care services
  495  staff who provide services to clients in a facility licensed
  496  under this part may administer prescribed, prepackaged, and
  497  premeasured medications after the completion of training in
  498  medication administration and under the general supervision of a
  499  registered nurse as provided under this section and applicable
  500  rules.
  501         (2) Training required by this section and applicable rules
  502  shall be conducted by a registered nurse licensed under chapter
  503  464, a physician licensed under chapter 458 or chapter 459, or a
  504  pharmacist licensed under chapter 465.
  505         (3) A facility that allows unlicensed direct care service
  506  staff to administer medications pursuant to this section shall:
  507         (a) Develop and implement policies and procedures that
  508  include a plan to ensure the safe handling, storage, and
  509  administration of prescription medications.
  510         (b) Maintain written evidence of the expressed and informed
  511  consent for each client.
  512         (c) Maintain a copy of the written prescription, including
  513  the name of the medication, the dosage, and the administration
  514  schedule and termination date.
  515         (d) Maintain documentation of compliance with required
  516  training.
  517         (4) The agency shall adopt rules to implement this section.
  518         400.9978 Protection of clients from abuse, neglect,
  519  mistreatment, and exploitation.—The licensee shall develop and
  520  implement policies and procedures for the screening and training
  521  of employees; the protection of clients; and the prevention,
  522  identification, investigation, and reporting of abuse, neglect,
  523  mistreatment, and exploitation. The licensee shall identify
  524  clients whose personal histories render them at risk for abusing
  525  other clients, develop intervention strategies to prevent
  526  occurrences of abuse, monitor clients for changes that would
  527  trigger abusive behavior, and reassess the interventions on a
  528  regular basis. A licensee shall:
  529         (1) Screen each potential employee for a history of abuse,
  530  neglect, mistreatment, or exploitation of clients. The screening
  531  shall include an attempt to obtain information from previous and
  532  current employers and verification of screening information by
  533  the appropriate licensing boards.
  534         (2) Train employees through orientation and ongoing
  535  sessions regarding issues related to abuse prohibition
  536  practices, including identification of abuse, neglect,
  537  mistreatment, and exploitation; appropriate interventions to
  538  address aggressive or catastrophic reactions of clients; the
  539  process for reporting allegations without fear of reprisal; and
  540  recognition of signs of frustration and stress that may lead to
  541  abuse.
  542         (3) Provide clients, families, and staff with information
  543  regarding how and to whom they may report concerns, incidents,
  544  and grievances without fear of retribution and provide feedback
  545  regarding the concerns that are expressed. A licensee shall
  546  identify, correct, and intervene in situations in which abuse,
  547  neglect, mistreatment, or exploitation is likely to occur,
  548  including:
  549         (a) Evaluating the physical environment of the facility to
  550  identify characteristics that may make abuse or neglect more
  551  likely to occur, such as secluded areas.
  552         (b) Providing sufficient staff on each shift to meet the
  553  needs of the clients and ensuring that the assigned staff have
  554  knowledge of each client’s care needs.
  555         (c) Identifying inappropriate staff behaviors, such as
  556  using derogatory language, rough handling of clients, ignoring
  557  clients while giving care, and directing clients who need
  558  toileting assistance to urinate or defecate in their beds.
  559         (d) Assessing, monitoring, and planning care for clients
  560  with needs and behaviors that might lead to conflict or neglect,
  561  such as a history of aggressive behaviors including entering
  562  other clients’ rooms without permission, exhibiting self
  563  injurious behaviors or communication disorders, requiring
  564  intensive nursing care, or being totally dependent on staff.
  565         (4) Identify events, such as suspicious bruising of
  566  clients, occurrences, patterns, and trends that may constitute
  567  abuse and determine the direction of the investigation.
  568         (5) Investigate alleged violations and different types of
  569  incidents, identify the staff member responsible for initial
  570  reporting, and report results to the proper authorities. The
  571  licensee shall analyze the incidents to determine whether
  572  policies and procedures need to be changed to prevent further
  573  incidents and take necessary corrective actions.
  574         (6) Protect clients from harm during an investigation.
  575         (7) Report alleged violations and substantiated incidents,
  576  as required under chapters 39 and 415, to the licensing
  577  authorities and all other agencies, as required, and report any
  578  knowledge of actions by a court of law that would indicate an
  579  employee is unfit for service.
  580         400.9979 Restraint and seclusion; client safety.—
  581         (1) A facility shall provide a therapeutic milieu that
  582  supports a culture of individual empowerment and responsibility.
  583  The health and safety of the client shall be the facility’s
  584  primary concern at all times.
  585         (2) The use of physical restraints must be ordered and
  586  documented by a physician, physician assistant, or advanced
  587  registered nurse practitioner and must be consistent with the
  588  policies and procedures adopted by the facility. The client or,
  589  if applicable, the client’s representative shall be informed of
  590  the facility’s physical restraint policies and procedures when
  591  the client is admitted.
  592         (3) The use of chemical restraints shall be limited to
  593  prescribed dosages of medications as ordered by a physician,
  594  physician assistant, or advanced registered nurse practitioner
  595  and must be consistent with the client’s diagnosis and the
  596  policies and procedures adopted by the facility. The client and,
  597  if applicable, the client’s representative shall be informed of
  598  the facility’s chemical restraint policies and procedures when
  599  the client is admitted.
  600         (4) Based on the assessment by a physician, physician
  601  assistant, or advanced registered nurse practitioner, if a
  602  client exhibits symptoms that present an immediate risk of
  603  injury or death to himself or herself or others, a physician,
  604  physician assistant, or advanced registered nurse practitioner
  605  may issue an emergency treatment order to immediately administer
  606  rapid-response psychotropic medications or other chemical
  607  restraints. Each emergency treatment order must be documented
  608  and maintained in the client’s record.
  609         (a) An emergency treatment order is not effective for more
  610  than 24 hours.
  611         (b) Whenever a client is medicated under this subsection,
  612  the client’s representative or a responsible party and the
  613  client’s physician, physician assistant, or advanced registered
  614  nurse practitioner shall be notified as soon as practicable.
  615         (5) A client who is prescribed and receives a medication
  616  that can serve as a chemical restraint for a purpose other than
  617  an emergency treatment order must be evaluated by his or her
  618  physician, physician assistant, or advanced registered nurse
  619  practitioner at least monthly to assess:
  620         (a) The continued need for the medication.
  621         (b) The level of the medication in the client’s blood.
  622         (c) The need for adjustments to the prescription.
  623         (6) The licensee shall ensure that clients are free from
  624  unnecessary drugs and physical restraints and are provided
  625  treatment to reduce dependency on drugs and physical restraints.
  626         (7) The licensee may only employ physical restraints and
  627  seclusion as authorized by the facility’s written policies,
  628  which shall comply with this section and applicable rules.
  629         (8) Interventions to manage dangerous client behavior shall
  630  be employed with sufficient safeguards and supervision to ensure
  631  that the safety, welfare, and civil and human rights of a client
  632  are adequately protected.
  633         (9) A facility shall notify the parent, guardian, or, if
  634  applicable, the client’s representative when restraint or
  635  seclusion is employed. The facility must provide the
  636  notification within 24 hours after the restraint or seclusion is
  637  employed. Reasonable efforts must be taken to notify the parent,
  638  guardian, or, if applicable, the client’s representative by
  639  telephone or e-mail, or both, and these efforts must be
  640  documented.
  641         (10) The agency may adopt rules that establish standards
  642  and procedures for the use of restraints, restraint positioning,
  643  seclusion, and emergency treatment orders for psychotropic
  644  medications, restraint, and seclusion. If rules are adopted, the
  645  rules must include duration of restraint, staff training,
  646  observation of the client during restraint, and documentation
  647  and reporting standards.
  648         400.998 Personnel background screening; administration and
  649  management procedures.—
  650         (1) The agency shall require level 2 background screening
  651  for licensee personnel as required in s. 408.809(1)(e) and
  652  pursuant to chapter 435 and s. 408.809.
  653         (2) The licensee shall maintain personnel records for each
  654  staff member that contain, at a minimum, documentation of
  655  background screening, a job description, documentation of
  656  compliance with the training requirements of this part and
  657  applicable rules, the employment application, references, a copy
  658  of each job performance evaluation, and, for each staff member
  659  who performs services for which licensure or certification is
  660  required, a copy of all licenses or certification held by that
  661  staff member.
  662         (3) The licensee must:
  663         (a) Develop and implement infection control policies and
  664  procedures and include the policies and procedures in the
  665  licensee’s policy manual.
  666         (b) Maintain liability insurance as defined in s.
  667  624.605(1)(b).
  668         (c) Designate one person as an administrator to be
  669  responsible and accountable for the overall management of the
  670  facility.
  671         (d) Designate in writing a person to be responsible for the
  672  facility when the administrator is absent from the facility for
  673  more than 24 hours.
  674         (e) Designate in writing a program director to be
  675  responsible for supervising the therapeutic and behavioral
  676  staff, determining the levels of supervision, and determining
  677  room placement for each client.
  678         (f) Designate in writing a person to be responsible when
  679  the program director is absent from the facility for more than
  680  24 hours.
  681         (g) Obtain approval of the comprehensive emergency
  682  management plan, pursuant to s. 400.9982(2)(e), from the local
  683  emergency management agency. Pending the approval of the plan,
  684  the local emergency management agency shall ensure that the
  685  following agencies, at a minimum, are given the opportunity to
  686  review the plan: the Department of Health, the Agency for Health
  687  Care Administration, and the Division of Emergency Management.
  688  Appropriate volunteer organizations shall also be given the
  689  opportunity to review the plan. The local emergency management
  690  agency shall complete its review within 60 days after receipt of
  691  the plan and either approve the plan or advise the licensee of
  692  necessary revisions.
  693         (h) Maintain written records in a form and system that
  694  comply with medical and business practices and make the records
  695  available by the facility for review or submission to the agency
  696  upon request. The records shall include:
  697         1. A daily census record that indicates the number of
  698  clients currently receiving services in the facility, including
  699  information regarding any public funding of such clients.
  700         2. A record of each accident or unusual incident involving
  701  a client or staff member that caused, or had the potential to
  702  cause, injury or harm to any person or property within the
  703  facility. The record shall contain a clear description of each
  704  accident or incident; the names of the persons involved; a
  705  description of medical or other services provided to these
  706  persons, including the provider of the services; and the steps
  707  taken to prevent recurrence of such accident or incident.
  708         3. A copy of current agreements with third-party providers.
  709         4. A copy of current agreements with each consultant
  710  employed by the licensee and documentation of a consultant’s
  711  visits and required written and dated reports.
  712         400.9981 Property and personal affairs of clients.—
  713         (1) A client shall be given the option of using his or her
  714  own belongings, as space permits; choosing a roommate if
  715  practical and not clinically contraindicated; and, whenever
  716  possible, unless the client is adjudicated incompetent or
  717  incapacitated under state law, managing his or her own affairs.
  718         (2) The admission of a client to a facility and his or her
  719  presence therein does not confer on a licensee or administrator,
  720  or an employee or representative thereof, any authority to
  721  manage, use, or dispose of the property of the client, and the
  722  admission or presence of a client does not confer on such person
  723  any authority or responsibility for the personal affairs of the
  724  client except that which may be necessary for the safe
  725  management of the facility or for the safety of the client.
  726         (3) A licensee or administrator, or an employee or
  727  representative thereof, may:
  728         (a) Not act as the guardian, trustee, or conservator for a
  729  client or a client’s property.
  730         (b) Act as a competent client’s payee for social security,
  731  veteran’s, or railroad benefits if the client provides consent
  732  and the licensee files a surety bond with the agency in an
  733  amount equal to twice the average monthly aggregate income or
  734  personal funds due to the client, or expendable for the client’s
  735  account, that are received by a licensee.
  736         (c) Act as the attorney in fact for a client if the
  737  licensee files a surety bond with the agency in an amount equal
  738  to twice the average monthly income of the client, plus the
  739  value of a client’s property under the control of the attorney
  740  in fact.
  742  The surety bond required under paragraph (b) or paragraph (c)
  743  shall be executed by the licensee as principal and a licensed
  744  surety company. The bond shall be conditioned upon the faithful
  745  compliance of the licensee with the requirements of licensure
  746  and is payable to the agency for the benefit of a client who
  747  suffers a financial loss as a result of the misuse or
  748  misappropriation of funds held pursuant to this subsection. A
  749  surety company that cancels or does not renew the bond of a
  750  licensee shall notify the agency in writing at least 30 days
  751  before the action, giving the reason for cancellation or
  752  nonrenewal. A licensee or administrator, or an employee or
  753  representative thereof, who is granted power of attorney for a
  754  client of the facility shall, on a monthly basis, notify the
  755  client in writing of any transaction made on behalf of the
  756  client pursuant to this subsection, and a copy of the
  757  notification given to the client shall be retained in the
  758  client’s file and available for agency inspection.
  759         (4) A licensee, with the consent of the client, shall
  760  provide for safekeeping in the facility of the client’s personal
  761  effects of a value not in excess of $1,000 and the client’s
  762  funds not in excess of $500 cash and shall keep complete and
  763  accurate records of the funds and personal effects received. If
  764  a client is absent from a facility for 24 hours or more, the
  765  licensee may provide for safekeeping of the client’s personal
  766  effects of a value in excess of $1,000.
  767         (5) Funds or other property belonging to or due to a client
  768  or expendable for the client’s account that are received by a
  769  licensee shall be regarded as funds held in trust and shall be
  770  kept separate from the funds and property of the licensee and
  771  other clients or shall be specifically credited to the client.
  772  The funds held in trust shall be used or otherwise expended only
  773  for the account of the client. At least once every month, except
  774  pursuant to an order of a court of competent jurisdiction, the
  775  licensee shall furnish the client and, if applicable, the
  776  client’s representative with a complete and verified statement
  777  of all funds and other property to which this subsection
  778  applies, detailing the amount and items received, together with
  779  their sources and disposition. The licensee shall furnish the
  780  statement annually and upon discharge or transfer of a client. A
  781  governmental agency or private charitable agency contributing
  782  funds or other property to the account of a client is also
  783  entitled to receive a statement monthly and upon the discharge
  784  or transfer of the client.
  785         (6)(a) In addition to any damages or civil penalties to
  786  which a person is subject, a person who:
  787         1. Intentionally withholds a client’s personal funds,
  788  personal property, or personal needs allowance;
  789         2. Demands, beneficially receives, or contracts for payment
  790  of all or any part of a client’s personal property or personal
  791  needs allowance in satisfaction of the facility rate for
  792  supplies and services; or
  793         3. Borrows from or pledges any personal funds of a client,
  794  other than the amount agreed to by written contract under s.
  795  429.24,
  797  commits a misdemeanor of the first degree, punishable as
  798  provided in s. 775.082 or s. 775.083.
  799         (b) A licensee or administrator, or an employee, or
  800  representative thereof, who is granted power of attorney for a
  801  client and who misuses or misappropriates funds obtained through
  802  this power commits a felony of the third degree, punishable as
  803  provided in s. 775.082, s. 775.083, or s. 775.084.
  804         (7) In the event of the death of a client, a licensee shall
  805  return all refunds, funds, and property held in trust to the
  806  client’s personal representative, if one has been appointed at
  807  the time the licensee disburses such funds, or, if not, to the
  808  client’s spouse or adult next of kin named in a beneficiary
  809  designation form provided by the licensee to the client. If the
  810  client does not have a spouse or adult next of kin or such
  811  person cannot be located, funds due to be returned to the client
  812  shall be placed in an interest-bearing account, and all property
  813  held in trust by the licensee shall be safeguarded until such
  814  time as the funds and property are disbursed pursuant to the
  815  Florida Probate Code. The funds shall be kept separate from the
  816  funds and property of the licensee and other clients of the
  817  facility. If the funds of the deceased client are not disbursed
  818  pursuant to the Florida Probate Code within 2 years after the
  819  client’s death, the funds shall be deposited in the Health Care
  820  Trust Fund administered by the agency.
  821         (8) The agency, by rule, may clarify terms and specify
  822  procedures and documentation necessary to administer the
  823  provisions of this section relating to the proper management of
  824  clients’ funds and personal property and the execution of surety
  825  bonds.
  826         400.9982 Rules establishing standards.—
  827         (1) It is the intent of the Legislature that rules adopted
  828  and enforced pursuant to this part and part II of chapter 408
  829  include criteria to ensure reasonable and consistent quality of
  830  care and client safety. The rules should make reasonable efforts
  831  to accommodate the needs and preferences of the client to
  832  enhance the client’s quality of life while residing in a
  833  transitional living facility.
  834         (2) The agency may adopt and enforce rules to implement
  835  this part and part II of chapter 408, which may include
  836  reasonable and fair criteria with respect to:
  837         (a) The location of transitional living facilities.
  838         (b) The qualifications of personnel, including management,
  839  medical, nursing, and other professional personnel and nursing
  840  assistants and support staff, who are responsible for client
  841  care. The licensee must employ enough qualified professional
  842  staff to carry out and monitor interventions in accordance with
  843  the stated goals and objectives of each comprehensive treatment
  844  plan.
  845         (c) Requirements for personnel procedures, reporting
  846  procedures, and documentation necessary to implement this part.
  847         (d) Services provided to clients of transitional living
  848  facilities.
  849         (e) The preparation and annual update of a comprehensive
  850  emergency management plan in consultation with the Division of
  851  Emergency Management. At a minimum, the rules must provide for
  852  plan components that address emergency evacuation
  853  transportation; adequate sheltering arrangements; postdisaster
  854  activities, including provision of emergency power, food, and
  855  water; postdisaster transportation; supplies; staffing;
  856  emergency equipment; individual identification of clients and
  857  transfer of records; communication with families; and responses
  858  to family inquiries.
  859         400.9983 Violations; penalties.—A violation of this part or
  860  any rule adopted pursuant thereto shall be classified according
  861  to the nature of the violation and the gravity of its probable
  862  effect on facility clients. The agency shall indicate the
  863  classification on the written notice of the violation as
  864  follows:
  865         (1) Class “I” violations are defined in s. 408.813. The
  866  agency shall issue a citation regardless of correction and
  867  impose an administrative fine of $5,000 for an isolated
  868  violation, $7,500 for a patterned violation, or $10,000 for a
  869  widespread violation. Violations may be identified, and a fine
  870  must be levied, notwithstanding the correction of the deficiency
  871  giving rise to the violation.
  872         (2) Class “II” violations are defined in s. 408.813. The
  873  agency shall impose an administrative fine of $1,000 for an
  874  isolated violation, $2,500 for a patterned violation, or $5,000
  875  for a widespread violation. A fine must be levied
  876  notwithstanding the correction of the deficiency giving rise to
  877  the violation.
  878         (3) Class “III” violations are defined in s. 408.813. The
  879  agency shall impose an administrative fine of $500 for an
  880  isolated violation, $750 for a patterned violation, or $1,000
  881  for a widespread violation. If a deficiency giving rise to a
  882  class III violation is corrected within the time specified by
  883  the agency, the fine may not be imposed.
  884         (4) Class “IV” violations are defined in s. 408.813. The
  885  agency shall impose for a cited class IV violation an
  886  administrative fine of at least $100 but not exceeding $200 for
  887  each violation. If a deficiency giving rise to a class IV
  888  violation is corrected within the time specified by the agency,
  889  the fine may not be imposed.
  890         400.9984 Receivership proceedings.—The agency may apply s.
  891  429.22 with regard to receivership proceedings for transitional
  892  living facilities.
  893         400.9985 Interagency communication.—The agency, the
  894  department, the Agency for Persons with Disabilities, and the
  895  Department of Children and Families shall develop electronic
  896  systems to ensure that relevant information pertaining to the
  897  regulation of transitional living facilities and clients is
  898  timely and effectively communicated among agencies in order to
  899  facilitate the protection of clients. Electronic sharing of
  900  information shall include, at a minimum, a brain and spinal cord
  901  injury registry and a client abuse registry.
  902         Section 2. Section 400.805, Florida Statutes, is
  903  transferred and renumbered as s. 400.9986, Florida Statutes.
  904         Section 3. Effective July 1, 2016, s. 400.9986, Florida
  905  Statutes, is repealed.
  906         Section 4. The title of part V of chapter 400, Florida
  907  Statutes, consisting of sections 400.701 and 400.801, is
  908  redesignated as “INTERMEDIATE CARE FACILITIES.”
  909         Section 5. Subsection (9) of section 381.745, Florida
  910  Statutes, is amended to read:
  911         381.745 Definitions; ss. 381.739-381.79.—As used in ss.
  912  381.739-381.79, the term:
  913         (9) “Transitional living facility” means a state-approved
  914  facility, as defined and licensed under chapter 400 or chapter
  915  429, or a facility approved by the brain and spinal cord injury
  916  program in accordance with this chapter.
  917         Section 6. Section 381.75, Florida Statutes, is amended to
  918  read:
  919         381.75 Duties and responsibilities of the department, of
  920  transitional living facilities, and of residents.—Consistent
  921  with the mandate of s. 381.7395, the department shall develop
  922  and administer a multilevel treatment program for individuals
  923  who sustain brain or spinal cord injuries and who are referred
  924  to the brain and spinal cord injury program.
  925         (1) Within 15 days after any report of an individual who
  926  has sustained a brain or spinal cord injury, the department
  927  shall notify the individual or the most immediate available
  928  family members of their right to assistance from the state, the
  929  services available, and the eligibility requirements.
  930         (2) The department shall refer individuals who have brain
  931  or spinal cord injuries to other state agencies to ensure assure
  932  that rehabilitative services, if desired, are obtained by that
  933  individual.
  934         (3) The department, in consultation with emergency medical
  935  service, shall develop standards for an emergency medical
  936  evacuation system that will ensure that all individuals who
  937  sustain traumatic brain or spinal cord injuries are transported
  938  to a department-approved trauma center that meets the standards
  939  and criteria established by the emergency medical service and
  940  the acute-care standards of the brain and spinal cord injury
  941  program.
  942         (4) The department shall develop standards for designation
  943  of rehabilitation centers to provide rehabilitation services for
  944  individuals who have brain or spinal cord injuries.
  945         (5) The department shall determine the appropriate number
  946  of designated acute-care facilities, inpatient rehabilitation
  947  centers, and outpatient rehabilitation centers, needed based on
  948  incidence, volume of admissions, and other appropriate criteria.
  949         (6) The department shall develop standards for designation
  950  of transitional living facilities to provide transitional living
  951  services for individuals who participate in the brain and spinal
  952  cord injury program the opportunity to adjust to their
  953  disabilities and to develop physical and functional skills in a
  954  supported living environment.
  955         (a) The Agency for Health Care Administration, in
  956  consultation with the department, shall develop rules for the
  957  licensure of transitional living facilities for individuals who
  958  have brain or spinal cord injuries.
  959         (b) The goal of a transitional living program for
  960  individuals who have brain or spinal cord injuries is to assist
  961  each individual who has such a disability to achieve a higher
  962  level of independent functioning and to enable that person to
  963  reenter the community. The program shall be focused on preparing
  964  participants to return to community living.
  965         (c) A transitional living facility for an individual who
  966  has a brain or spinal cord injury shall provide to such
  967  individual, in a residential setting, a goal-oriented treatment
  968  program designed to improve the individual’s physical,
  969  cognitive, communicative, behavioral, psychological, and social
  970  functioning, as well as to provide necessary support and
  971  supervision. A transitional living facility shall offer at least
  972  the following therapies: physical, occupational, speech,
  973  neuropsychology, independent living skills training, behavior
  974  analysis for programs serving brain-injured individuals, health
  975  education, and recreation.
  976         (d) All residents shall use the transitional living
  977  facility as a temporary measure and not as a permanent home or
  978  domicile. The transitional living facility shall develop an
  979  initial treatment plan for each resident within 3 days after the
  980  resident’s admission. The transitional living facility shall
  981  develop a comprehensive plan of treatment and a discharge plan
  982  for each resident as soon as practical, but no later than 30
  983  days after the resident’s admission. Each comprehensive
  984  treatment plan and discharge plan must be reviewed and updated
  985  as necessary, but no less often than quarterly. This subsection
  986  does not require the discharge of an individual who continues to
  987  require any of the specialized services described in paragraph
  988  (c) or who is making measurable progress in accordance with that
  989  individual’s comprehensive treatment plan. The transitional
  990  living facility shall discharge any individual who has an
  991  appropriate discharge site and who has achieved the goals of his
  992  or her discharge plan or who is no longer making progress toward
  993  the goals established in the comprehensive treatment plan and
  994  the discharge plan. The discharge location must be the least
  995  restrictive environment in which an individual’s health, well
  996  being, and safety is preserved.
  997         (7) Recipients of services, under this section, from any of
  998  the facilities referred to in this section shall pay a fee based
  999  on ability to pay.
 1000         Section 7. Subsection (4) of section 381.78, Florida
 1001  Statutes, is amended to read:
 1002         381.78 Advisory council on brain and spinal cord injuries.—
 1003         (4) The council shall:
 1004         (a) provide advice and expertise to the department in the
 1005  preparation, implementation, and periodic review of the brain
 1006  and spinal cord injury program.
 1007         (b) Annually appoint a five-member committee composed of
 1008  one individual who has a brain injury or has a family member
 1009  with a brain injury, one individual who has a spinal cord injury
 1010  or has a family member with a spinal cord injury, and three
 1011  members who shall be chosen from among these representative
 1012  groups: physicians, other allied health professionals,
 1013  administrators of brain and spinal cord injury programs, and
 1014  representatives from support groups with expertise in areas
 1015  related to the rehabilitation of individuals who have brain or
 1016  spinal cord injuries, except that one and only one member of the
 1017  committee shall be an administrator of a transitional living
 1018  facility. Membership on the council is not a prerequisite for
 1019  membership on this committee.
 1020         1. The committee shall perform onsite visits to those
 1021  transitional living facilities identified by the Agency for
 1022  Health Care Administration as being in possible violation of the
 1023  statutes and rules regulating such facilities. The committee
 1024  members have the same rights of entry and inspection granted
 1025  under s. 400.805(4) to designated representatives of the agency.
 1026         2. Factual findings of the committee resulting from an
 1027  onsite investigation of a facility pursuant to subparagraph 1.
 1028  shall be adopted by the agency in developing its administrative
 1029  response regarding enforcement of statutes and rules regulating
 1030  the operation of the facility.
 1031         3. Onsite investigations by the committee shall be funded
 1032  by the Health Care Trust Fund.
 1033         4. Travel expenses for committee members shall be
 1034  reimbursed in accordance with s. 112.061.
 1035         5. Members of the committee shall recuse themselves from
 1036  participating in any investigation that would create a conflict
 1037  of interest under state law, and the council shall replace the
 1038  member, either temporarily or permanently.
 1039         Section 8. Subsection (5) of section 400.93, Florida
 1040  Statutes, is amended to read:
 1041         400.93 Licensure required; exemptions; unlawful acts;
 1042  penalties.—
 1043         (5) The following are exempt from home medical equipment
 1044  provider licensure, unless they have a separate company,
 1045  corporation, or division that is in the business of providing
 1046  home medical equipment and services for sale or rent to
 1047  consumers at their regular or temporary place of residence
 1048  pursuant to the provisions of this part:
 1049         (a) Providers operated by the Department of Health or
 1050  Federal Government.
 1051         (b) Nursing homes licensed under part II.
 1052         (c) Assisted living facilities licensed under chapter 429,
 1053  when serving their residents.
 1054         (d) Home health agencies licensed under part III.
 1055         (e) Hospices licensed under part IV.
 1056         (f) Intermediate care facilities and, homes for special
 1057  services, and transitional living facilities licensed under part
 1058  V.
 1059         (g) Transitional living facilities licensed under part XI.
 1060         (h)(g) Hospitals and ambulatory surgical centers licensed
 1061  under chapter 395.
 1062         (i)(h) Manufacturers and wholesale distributors when not
 1063  selling directly to consumers.
 1064         (j)(i) Licensed health care practitioners who use utilize
 1065  home medical equipment in the course of their practice, but do
 1066  not sell or rent home medical equipment to their patients.
 1067         (k)(j) Pharmacies licensed under chapter 465.
 1068         Section 9. Subsection (21) of section 408.802, Florida
 1069  Statutes, is amended to read:
 1070         408.802 Applicability.—The provisions of this part apply to
 1071  the provision of services that require licensure as defined in
 1072  this part and to the following entities licensed, registered, or
 1073  certified by the agency, as described in chapters 112, 383, 390,
 1074  394, 395, 400, 429, 440, 483, and 765:
 1075         (21) Transitional living facilities, as provided under part
 1076  XI V of chapter 400.
 1077         Section 10. Subsection (20) of section 408.820, Florida
 1078  Statutes, is amended to read:
 1079         408.820 Exemptions.—Except as prescribed in authorizing
 1080  statutes, the following exemptions shall apply to specified
 1081  requirements of this part:
 1082         (20) Transitional living facilities, as provided under part
 1083  XI V of chapter 400, are exempt from s. 408.810(10).
 1084         Section 11. Subsection (1) of s. 381.79 is reenacted for
 1085  the purpose of incorporating the amendment made by this act to
 1086  s. 381.75, Florida Statutes, in a reference thereto.
 1087         Section 12. (1)A transitional living facility that is
 1088  licensed under s. 400.805, Florida Statutes, on June 30, 2015,
 1089  must be licensed under and in compliance with s. 400.9986,
 1090  Florida Statutes, until the licensee becomes licensed under and
 1091  in compliance with part XI of ch. 400, Florida Statutes, as
 1092  created by this act. Such licensees must be licensed under and
 1093  in compliance with part XI of chapter 400, Florida Statutes, as
 1094  created by this act, on or before July 1, 2016.
 1095         (2)A transitional living facility that is licensed on or
 1096  after July 1, 2015, must be licensed under and in compliance
 1097  with part XI of ch. 400, Florida Statutes, as created by this
 1098  act.
 1099         Section 13. Except as otherwise expressly provided in this
 1100  act, this act shall take effect July 1, 2015.