Florida Senate - 2015 CS for SB 682
By the Committee on Appropriations; and Senator Grimsley
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
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
133 400.9971 Definitions.—As used in this part, the term:
134 (1) “Agency” means the Agency for Health Care
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
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.
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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,
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
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.
669 (c) Designate one person as an administrator to be
670 responsible and accountable for the overall management of the
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.
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
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
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
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
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
, 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
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
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
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;
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
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
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
1119 Section 13. Except as otherwise expressly provided in this
1120 act, this act shall take effect July 1, 2015.