2020 Legislature                   CS for SB 1344, 1st Engrossed
    2         An act relating to intermediate care facilities;
    3         amending s. 400.962, F.S.; requiring certain
    4         facilities that have been granted a certificate-of
    5         need exemption to demonstrate and maintain compliance
    6         with specified criteria; amending s. 408.036, F.S.;
    7         providing an exemption from a certificate-of-need
    8         requirement for certain intermediate care facilities;
    9         limiting the number of such exemptions the Agency for
   10         Health Care Administration may grant; providing that a
   11         specific legislative appropriation is not required for
   12         the exemption; providing timeframes and a monitoring
   13         process for the exemptions granted by the agency;
   14         providing for future legislative review and repeal of
   15         the exemption; providing an effective date.
   17  Be It Enacted by the Legislature of the State of Florida:
   19         Section 1. Subsection (6) is added to section 400.962,
   20  Florida Statutes, to read:
   21         400.962 License required; license application.—
   22         (6)An applicant that has been granted a certificate-of
   23  need exemption under s. 408.036(3)(o) must also demonstrate and
   24  maintain compliance with the following criteria:
   25         (a)The total number of beds per home within the facility
   26  may not exceed eight, with each resident having his or her own
   27  bedroom and bathroom. Each eight-bed home must be colocated on
   28  the same property with two other eight-bed homes and must serve
   29  individuals with severe maladaptive behaviors and co-occurring
   30  psychiatric diagnoses.
   31         (b)A minimum of 16 beds within the facility must be
   32  designated for individuals with severe maladaptive behaviors who
   33  have been assessed using the Agency for Persons with
   34  Disabilities’ Global Behavioral Service Need Matrix with a score
   35  of at least Level 4 and up to Level 6, or assessed using the
   36  criteria deemed appropriate by the Agency for Health Care
   37  Administration regarding the need for a specialized placement in
   38  an intermediate care facility for the developmentally disabled.
   39  For home and community-based Medicaid waiver clients under
   40  chapter 393, the Agency for Persons with Disabilities shall
   41  offer choice counseling to clients regarding appropriate
   42  residential placement based on the needs of the individual.
   43         (c)The applicant has not had a facility license denied,
   44  revoked, or suspended within the 36 months preceding the request
   45  for exemption.
   46         (d)The applicant must have at least 10 years of experience
   47  serving individuals with severe maladaptive behaviors in the
   48  state.
   49         (e)The applicant must implement a state-approved staff
   50  training curriculum and monitoring requirements specific to the
   51  individuals whose behaviors require higher intensity, frequency,
   52  and duration of services.
   53         (f)The applicant must make available medical and nursing
   54  services 24 hours per day, 7 days per week.
   55         (g)The applicant must demonstrate a history of using
   56  interventions that are least restrictive and that follow a
   57  behavioral hierarchy.
   58         (h)The applicant must maintain a policy prohibiting the
   59  use of mechanical restraints.
   60         Section 2. Paragraph (o) is added to subsection (3) of
   61  section 408.036, Florida Statutes, to read:
   62         408.036 Projects subject to review; exemptions.—
   63         (3) EXEMPTIONS.—Upon request, the following projects are
   64  subject to exemption from subsection (1):
   65         (o)For a new intermediate care facility for the
   66  developmentally disabled as defined in s. 408.032 which has a
   67  total of 24 beds, comprising three eight-bed homes, for use by
   68  individuals exhibiting severe maladaptive behaviors and co
   69  occurring psychiatric diagnoses requiring increased levels of
   70  behavioral, medical, and therapeutic oversight. The applicant
   71  must not have had a license denied, revoked, or suspended within
   72  the 36 months preceding the request for exemption and must have
   73  at least 10 years of experience serving individuals with severe
   74  maladaptive behaviors in this state. The agency may grant no
   75  more than three exemptions under this paragraph.
   76         1. The exemption under this paragraph does not require a
   77  specific legislative appropriation.
   78         2.An exemption under this paragraph shall terminate 18
   79  months after the date of issuance unless the exemption holder
   80  has commenced construction. The agency shall monitor the
   81  progress of the holder of the certificate of exemption in
   82  meeting the timetable for project development specified in the
   83  application for exemption. The agency shall extend the time
   84  period for a project if the exemption holder demonstrates to the
   85  satisfaction of the agency that good-faith commencement of the
   86  project is being delayed by litigation or by governmental action
   87  or inaction with respect to regulations or permitting precluding
   88  commencement of the project.
   89         3.This paragraph and subsection (6) of s. 400.962 are
   90  repealed July 1, 2022, unless reviewed and saved from repeal by
   91  the Legislature.
   92         Section 3. This act shall take effect July 1, 2020.