Florida Senate - 2023                             CS for SB 1182
       
       
        
       By the Committee on Children, Families, and Elder Affairs; and
       Senators Simon and Book
       
       
       
       
       586-02539-23                                          20231182c1
    1                        A bill to be entitled                      
    2         An act relating to education and training for
    3         Alzheimer’s disease and related forms of dementia;
    4         creating s. 430.5025, F.S.; providing a short title;
    5         defining terms; requiring the Department of Elderly
    6         Affairs to offer certain education about Alzheimer’s
    7         disease and related forms of dementia to the general
    8         public; specifying uniform dementia-related education
    9         and training for employees of covered providers;
   10         requiring the department to provide certain dementia
   11         related employee training in an online format and at
   12         no cost; providing minimum requirements for the
   13         training; requiring the department to make a record of
   14         the completion of the training; providing requirements
   15         for the record; requiring covered providers to
   16         maintain such records of training completion for their
   17         employees; providing that an employee does not have to
   18         repeat such training after changing employment to
   19         another covered provider; providing additional
   20         training and continuing education requirements for
   21         certain employees who provide direct care to patients
   22         with Alzheimer’s disease or related forms of dementia;
   23         authorizing the department to establish training
   24         curriculum guidelines; authorizing the department to
   25         approve training providers and curricula and maintain
   26         a list of approved providers; authorizing training to
   27         be offered in a variety of formats; providing that
   28         certain continuing education does not require the
   29         adoption of curriculum guidelines by the department or
   30         provider or curriculum approval by the department;
   31         authorizing the department to develop or provide
   32         continuing education training or curricula as an
   33         option for covered providers and their employees;
   34         providing qualifications and requirements for training
   35         providers; providing that training curricula approved
   36         before the effective date of the act remain in effect
   37         until their respective expiration dates; authorizing
   38         the department to adopt rules related to training
   39         curriculum guidelines, qualified training providers,
   40         and compliance monitoring procedures; authorizing
   41         certified nursing assistants to count the dementia
   42         related training toward their annual certification
   43         training requirements; authorizing health care
   44         practitioners to count the dementia-related training
   45         requirements toward their continuing education
   46         requirements for licensure; authorizing persons
   47         employed, contracted, or referred to provide services
   48         before the effective date of the act to complete the
   49         required training by a specified date; providing for
   50         the substitution of equivalent training for training
   51         required by this act; authorizing persons to satisfy
   52         the training requirements of this act using training
   53         curricula approved before the effective date of the
   54         act until the department adopts rules for training
   55         curricula guidelines; amending ss. 400.0239, 400.1755,
   56         and 400.4785, F.S.; conforming provisions to changes
   57         made by the act; creating s. 400.510, F.S.; requiring
   58         a person employed, contracted, or referred by a nurse
   59         registry or a person registered with the Agency for
   60         Health Care Administration to provide companion or
   61         homemaker services to complete specified training;
   62         amending ss. 429.178, 429.52, 429.83, 429.917, and
   63         429.918, F.S.; conforming provisions to changes made
   64         by the act; providing an effective date.
   65          
   66  Be It Enacted by the Legislature of the State of Florida:
   67  
   68         Section 1. Section 430.5025, Florida Statutes, is created
   69  to read:
   70         430.5025 Alzheimer’s disease and related forms of dementia;
   71  education and training.—
   72         (1) This section may be cited as the “Alzheimer’s Disease
   73  and Related Forms of Dementia Education and Training Act.”
   74         (2) As used in this section, the term:
   75         (a) “Covered provider” means a nursing home, a home health
   76  agency, a nurse registry, a companion or homemaker service
   77  provider, an assisted living facility, an adult family-care
   78  home, or an adult day care center licensed or registered under
   79  chapter 400 or chapter 429.
   80         (b) “Department” means the Department of Elderly Affairs.
   81         (c) “Employee” means a person, contracted staff, or an
   82  independent contractor employed or referred by a covered
   83  provider who is required to undergo a level 2 background
   84  screening under s. 408.809 and chapter 435.
   85         (d) “Personal care” means providing, through in-person
   86  contact, assistance with activities of daily living, assistance
   87  with self-administration of medication, homemaker or companion
   88  services, nursing services, or other services that promote the
   89  physical, mental, and psychosocial well-being of participants,
   90  patients, and residents of covered providers. The term does not
   91  include duties involving administrative functions or maintaining
   92  the physical environment of a licensed facility, including
   93  grounds maintenance, building maintenance, housekeeping,
   94  laundry, or food preparation.
   95         (e) “Regular contact” means the performance of duties other
   96  than personal care which may require employees to interact in
   97  person on a daily basis with participants, patients, or
   98  residents.
   99         (3) The department shall offer to the general public
  100  education about Alzheimer’s disease and related forms of
  101  dementia. Such education must provide basic information about
  102  the most common forms of dementia, how to identify the signs and
  103  symptoms of dementia, coping skills, how to respond to changes,
  104  planning for the future, and how to access additional resources
  105  about dementia.
  106         (4) Employees of covered providers must complete the
  107  following training for Alzheimer’s disease and related forms of
  108  dementia:
  109         (a) Upon beginning employment, each employee must receive
  110  basic written information about interacting with persons who
  111  have Alzheimer’s disease or related forms of dementia.
  112         (b) Within 30 days after beginning employment, each
  113  employee who provides personal care to or has regular contact
  114  with participants, patients, or residents must complete a 1-hour
  115  training program provided by the department.
  116         1. The department shall provide the training in an online
  117  format at no cost. The 1-hour training program must contain
  118  information on understanding the basics about the most common
  119  forms of dementia, how to identify the signs and symptoms of
  120  dementia, and skills for communicating and interacting with
  121  persons with Alzheimer’s disease or related forms of dementia. A
  122  record of the completion of the training program must be made
  123  available to the covered provider which identifies the training
  124  course, the name of the employee, and the date of completion.
  125         2. A covered provider must maintain a record of the
  126  employee’s completion of the training and, upon written request
  127  of the employee, must provide the employee with a copy of the
  128  record of completion consistent with the employer’s written
  129  policies.
  130         3. An employee who has completed the training required in
  131  this subsection is not required to repeat the program upon
  132  changing employment to a different covered provider.
  133         (c) Within 7 months after beginning employment for a home
  134  health agency, nurse registry, or companion or homemaker service
  135  provider, each employee who provides personal care must complete
  136  2 hours of training in addition to the training required in
  137  paragraphs (a) and (b). The additional training must include,
  138  but is not limited to, behavior management, promoting the
  139  person’s independence in activities of daily living, and skills
  140  in working with families and caregivers.
  141         (d) Within 7 months after beginning employment for a
  142  nursing home, an assisted living facility, an adult family-care
  143  home, or an adult day care center, each employee who provides
  144  personal care must complete 3 hours of training in addition to
  145  the training required in paragraphs (a) and (b). The additional
  146  training must include, but is not limited to, behavior
  147  management, promoting the person’s independence in activities of
  148  daily living, skills in working with families and caregivers,
  149  group and individual activities, maintaining an appropriate
  150  environment, and ethical issues.
  151         (e) For an assisted living facility, adult family-care
  152  home, or adult day care center that advertises and provides, or
  153  is designated to provide, specialized care for persons with
  154  Alzheimer’s disease or related forms of dementia, in addition to
  155  the training specified in paragraphs (a) and (b), employees must
  156  receive the following training:
  157         1. Within 3 months after beginning employment, each
  158  employee who provides personal care to or has regular contact
  159  with the residents or participants must complete the additional
  160  3 hours of training as provided in paragraph (d).
  161         2. Within 6 months after beginning employment, each
  162  employee who provides personal care must complete an additional
  163  4 hours of dementia-specific training. Such training must
  164  include, but is not limited to, understanding Alzheimer’s
  165  disease and related forms of dementia, the stages of Alzheimer’s
  166  disease, communication strategies, medical information, and
  167  stress management.
  168         3. Thereafter, each employee who provides personal care
  169  must participate in at least 4 hours of continuing education
  170  each calendar year through contact hours, on-the-job training,
  171  or electronic learning technology. For this subparagraph, the
  172  term “on-the-job training” means a form of direct coaching in
  173  which a facility administrator or his or her designee instructs
  174  an employee who provides personal care with guidance, support,
  175  or hands-on experience to help develop and refine the employee’s
  176  skills for caring for a person with Alzheimer’s disease or a
  177  related form of dementia. The continuing education must cover at
  178  least one of the topics included in the dementia-specific
  179  training in which the employee has not received previous
  180  training in the previous calendar year. The continuing education
  181  may be fulfilled and documented in a minimum of one quarter-hour
  182  increments through on-the-job training of the employee by a
  183  facility administrator or his or her designee or by an
  184  electronic learning technology chosen by the facility
  185  administrator. On-the-job training may not account for more than
  186  2 hours of continuing education each calendar year.
  187         (5) The department may establish training curricula
  188  guidelines for the training required in paragraphs (4)(c), (d),
  189  and (e). The department may approve training providers and
  190  training curricula and maintain a list of approved providers.
  191  Approved training may be offered in a variety of formats,
  192  including, but not limited to, in person, electronically, or on
  193  the-job by a facility administrator or his or her designee.
  194  Continuing education under this section does not require the
  195  adoption of training curricula guidelines by the department or
  196  approval of the training provider and curricula by the
  197  department. The department may develop or provide continuing
  198  education training or curricula as an option for covered
  199  providers and employees.
  200         (a) A training provider meeting one of the following
  201  qualifications may offer training in compliance with the
  202  training curricula guidelines without prior approval of the
  203  department:
  204         1. A person approved by an applicable board or the
  205  Department of Health to provide training who is registered with
  206  the electronic continuing education tracking system under s.
  207  456.025; or
  208         2. A training provider approved by the department or its
  209  designee before July 1, 2023.
  210         (b) Training providers qualified under subparagraph (a)1.
  211  must also have:
  212         1. At least 1 year of teaching experience as an educator
  213  for caregivers of persons with Alzheimer’s disease or related
  214  forms of dementia;
  215         2. At least 1 year of practical experience in a program
  216  providing care to persons with Alzheimer’s disease or related
  217  forms of dementia; or
  218         3. Completed a specialized training program in the subject
  219  matter of Alzheimer’s disease and related forms of dementia from
  220  an accredited health care, human services, or gerontology
  221  education provider.
  222         (c) Upon an employee’s completion of the training specified
  223  in paragraphs (4)(c), (d), and (e), the training provider must
  224  provide a record of the completion of the training which
  225  includes the name of the employee, the name of the training
  226  provider, the topics covered, and the date of completion. The
  227  training record is evidence of completion of training in the
  228  identified topic and the employee is not required to repeat
  229  training in that topic if the employee changes employment to a
  230  different covered provider.
  231         (d) Any Alzheimer’s disease and related forms of dementia
  232  training curriculum approved by the department or its designee
  233  before July 1, 2023, remains in effect until the curriculum’s
  234  expiration date.
  235         (6) The department may adopt rules to establish training
  236  curriculum guidelines, requirements for the approval of other
  237  qualified training providers, and a process for conducting a
  238  sampling of training or training curricula as necessary to
  239  monitor for compliance with curricula guidelines.
  240         (7) For a certified nursing assistant as defined in s.
  241  464.201, training hours completed as required under this section
  242  may count toward the total hours of training required to
  243  maintain certification as a nursing assistant.
  244         (8) For a health care practitioner as defined in s.
  245  456.001, training hours completed as required under this section
  246  may count toward the total hours of continuing education
  247  required by that practitioner’s licensing board.
  248         (9) Each person employed, contracted, or referred to
  249  provide services before July 1, 2023, must complete the training
  250  required in this section before July 1, 2026. Proof of
  251  completion of equivalent training completed before July 1, 2023,
  252  shall substitute for the training required in subsection (4).
  253  Each person employed, contracted, or referred to provide
  254  services on or after July 1, 2023, may satisfy the training
  255  requirements by completing training using approved curricula as
  256  specified in paragraph (5)(d) until the effective date of the
  257  rules adopted by the department under subsection (6).
  258         Section 2. Paragraph (b) of subsection (2) of section
  259  400.0239, Florida Statutes, is amended to read:
  260         400.0239 Quality of Long-Term Care Facility Improvement
  261  Trust Fund.—
  262         (2) Expenditures from the trust fund shall be allowable for
  263  direct support of the following:
  264         (b) Development and implementation of specialized training
  265  programs for long-term care facility personnel who provide
  266  direct care for residents with Alzheimer’s disease and other
  267  dementias, including training provided under s. 430.5025,
  268  residents at risk of developing pressure sores, and residents
  269  with special nutrition and hydration needs.
  270         Section 3. Section 400.1755, Florida Statutes, is amended
  271  to read:
  272         400.1755 Care for persons with Alzheimer’s disease or
  273  related disorders; staff training requirements.—
  274         (1) As a condition of licensure, the employees of
  275  facilities licensed under this part must complete the training
  276  required under s. 430.5025 provide to each of their employees,
  277  upon beginning employment, basic written information about
  278  interacting with persons with Alzheimer’s disease or a related
  279  disorder.
  280         (2) All employees who are expected to, or whose
  281  responsibilities require them to, have direct contact with
  282  residents with Alzheimer’s disease or a related disorder must,
  283  in addition to being provided the information required in
  284  subsection (1), also have an initial training of at least 1 hour
  285  completed in the first 3 months after beginning employment. This
  286  training must include, but is not limited to, an overview of
  287  dementias and must provide basic skills in communicating with
  288  persons with dementia.
  289         (3) An individual who provides direct care shall be
  290  considered a direct caregiver and must complete the required
  291  initial training and an additional 3 hours of training within 9
  292  months after beginning employment. This training shall include,
  293  but is not limited to, managing problem behaviors, promoting the
  294  resident’s independence in activities of daily living, and
  295  skills in working with families and caregivers.
  296         (a) The required 4 hours of training for certified nursing
  297  assistants are part of the total hours of training required
  298  annually.
  299         (b) For a health care practitioner as defined in s.
  300  456.001, continuing education hours taken as required by that
  301  practitioner’s licensing board shall be counted toward this
  302  total of 4 hours.
  303         (4) For an employee who is a licensed health care
  304  practitioner as defined in s. 456.001, training that is
  305  sanctioned by that practitioner’s licensing board shall be
  306  considered to be approved by the Department of Elderly Affairs.
  307         (5) The Department of Elderly Affairs or its designee must
  308  approve the initial and continuing training provided in the
  309  facilities. The department must approve training offered in a
  310  variety of formats, including, but not limited to, Internet
  311  based training, videos, teleconferencing, and classroom
  312  instruction. The department shall keep a list of current
  313  providers who are approved to provide initial and continuing
  314  training. The department shall adopt rules to establish
  315  standards for the trainers and the training required in this
  316  section.
  317         (6) Upon completing any training listed in this section,
  318  the employee or direct caregiver shall be issued a certificate
  319  that includes the name of the training provider, the topic
  320  covered, and the date and signature of the training provider.
  321  The certificate is evidence of completion of training in the
  322  identified topic, and the employee or direct caregiver is not
  323  required to repeat training in that topic if the employee or
  324  direct caregiver changes employment to a different facility or
  325  to an assisted living facility, home health agency, adult day
  326  care center, or adult family-care home. The direct caregiver
  327  must comply with other applicable continuing education
  328  requirements.
  329         Section 4. Section 400.4785, Florida Statutes, is amended
  330  to read:
  331         400.4785 Patients with Alzheimer’s disease or other related
  332  disorders; staff training requirements; certain disclosures.—
  333         (1) The employees of a home health agency must complete the
  334  training required under s. 430.5025 A home health agency must
  335  provide the following staff training:
  336         (a) Upon beginning employment with the agency, each
  337  employee must receive basic written information about
  338  interacting with participants who have Alzheimer’s disease or
  339  dementia-related disorders.
  340         (b) In addition to the information provided under paragraph
  341  (a), newly hired home health agency personnel who will be
  342  providing direct care to patients must complete 2 hours of
  343  training in Alzheimer’s disease and dementia-related disorders
  344  within 9 months after beginning employment with the agency. This
  345  training must include, but is not limited to, an overview of
  346  dementia, a demonstration of basic skills in communicating with
  347  persons who have dementia, the management of problem behaviors,
  348  information about promoting the client’s independence in
  349  activities of daily living, and instruction in skills for
  350  working with families and caregivers.
  351         (c) For certified nursing assistants, the required 2 hours
  352  of training shall be part of the total hours of training
  353  required annually.
  354         (d) For a health care practitioner as defined in s.
  355  456.001, continuing education hours taken as required by that
  356  practitioner’s licensing board shall be counted toward the total
  357  of 2 hours.
  358         (e) For an employee who is a licensed health care
  359  practitioner as defined in s. 456.001, training that is
  360  sanctioned by that practitioner’s licensing board shall be
  361  considered to be approved by the Department of Elderly Affairs.
  362         (f) The Department of Elderly Affairs, or its designee,
  363  must approve the required training. The department must consider
  364  for approval training offered in a variety of formats. The
  365  department shall keep a list of current providers who are
  366  approved to provide the 2-hour training. The department shall
  367  adopt rules to establish standards for the employees who are
  368  subject to this training, for the trainers, and for the training
  369  required in this section.
  370         (g) Upon completing the training listed in this section,
  371  the employee shall be issued a certificate that states that the
  372  training mandated under this section has been received. The
  373  certificate shall be dated and signed by the training provider.
  374  The certificate is evidence of completion of this training, and
  375  the employee is not required to repeat this training if the
  376  employee changes employment to a different home health agency.
  377         (2)(h) A licensed home health agency whose unduplicated
  378  census during the most recent calendar year was composed
  379  comprised of at least 90 percent of individuals aged 21 years or
  380  younger at the date of admission is exempt from the training
  381  requirements in this section.
  382         (3)(2) An agency licensed under this part which claims that
  383  it provides special care for persons who have Alzheimer’s
  384  disease or other related disorders must disclose in its
  385  advertisements or in a separate document those services that
  386  distinguish the care as being especially applicable to, or
  387  suitable for, such persons. The agency must give a copy of all
  388  such advertisements or a copy of the document to each person who
  389  requests information about the agency and must maintain a copy
  390  of all such advertisements and documents in its records. The
  391  Agency for Health Care Administration shall examine all such
  392  advertisements and documents in the agency’s records as part of
  393  the license renewal procedure.
  394         Section 5. Section 400.510, Florida Statutes, is created to
  395  read:
  396         400.510 Patients with Alzheimer’s disease or other related
  397  disorders; staff training requirements.—A person employed,
  398  contracted, or referred by a nurse registry or a person
  399  registered with the agency to provide companion or homemaker
  400  services must complete the training required under s. 430.5025.
  401         Section 6. Section 429.178, Florida Statutes, is amended to
  402  read:
  403         429.178 Special care for persons with Alzheimer’s disease
  404  or other related disorders.—
  405         (1) A facility that which advertises that it provides
  406  special care for persons with Alzheimer’s disease or other
  407  related disorders must meet the following standards of
  408  operation:
  409         (1)(a)1. If the facility has 17 or more residents, have an
  410  awake staff member on duty at all hours of the day and night; or
  411         (b)2. If the facility has fewer than 17 residents, have an
  412  awake staff member on duty at all hours of the day and night or
  413  have mechanisms in place to monitor and ensure the safety of the
  414  facility’s residents.
  415         (2)(b) Offer activities specifically designed for persons
  416  who are cognitively impaired.
  417         (3)(c) Have a physical environment that provides for the
  418  safety and welfare of the facility’s residents.
  419         (4)(d)Require employed Employ staff to complete who have
  420  completed the training and continuing education required under
  421  s. 430.5025 in subsection (2).
  422         (2)(a) An individual who is employed by a facility that
  423  provides special care for residents who have Alzheimer’s disease
  424  or other related disorders, and who has regular contact with
  425  such residents, must complete up to 4 hours of initial dementia
  426  specific training developed or approved by the department. The
  427  training must be completed within 3 months after beginning
  428  employment and satisfy the core training requirements of s.
  429  429.52(3)(g).
  430         (b) A direct caregiver who is employed by a facility that
  431  provides special care for residents who have Alzheimer’s disease
  432  or other related disorders and provides direct care to such
  433  residents must complete the required initial training and 4
  434  additional hours of training developed or approved by the
  435  department. The training must be completed within 9 months after
  436  beginning employment and satisfy the core training requirements
  437  of s. 429.52(3)(g).
  438         (c) An individual who is employed by a facility that
  439  provides special care for residents with Alzheimer’s disease or
  440  other related disorders, but who only has incidental contact
  441  with such residents, must be given, at a minimum, general
  442  information on interacting with individuals with Alzheimer’s
  443  disease or other related disorders, within 3 months after
  444  beginning employment.
  445         (3) In addition to the training required under subsection
  446  (2), a direct caregiver must participate in a minimum of 4
  447  contact hours of continuing education each calendar year. The
  448  continuing education must include one or more topics included in
  449  the dementia-specific training developed or approved by the
  450  department, in which the caregiver has not received previous
  451  training.
  452         (4) Upon completing any training listed in subsection (2),
  453  the employee or direct caregiver shall be issued a certificate
  454  that includes the name of the training provider, the topic
  455  covered, and the date and signature of the training provider.
  456  The certificate is evidence of completion of training in the
  457  identified topic, and the employee or direct caregiver is not
  458  required to repeat training in that topic if the employee or
  459  direct caregiver changes employment to a different facility. The
  460  employee or direct caregiver must comply with other applicable
  461  continuing education requirements.
  462         (5) The department, or its designee, shall approve the
  463  initial and continuing education courses and providers.
  464         (6) The department shall keep a current list of providers
  465  who are approved to provide initial and continuing education for
  466  staff of facilities that provide special care for persons with
  467  Alzheimer’s disease or other related disorders.
  468         (7) Any facility more than 90 percent of whose residents
  469  receive monthly optional supplementation payments is not
  470  required to pay for the training and education programs required
  471  under this section. A facility that has one or more such
  472  residents shall pay a reduced fee that is proportional to the
  473  percentage of such residents in the facility. A facility that
  474  does not have any residents who receive monthly optional
  475  supplementation payments must pay a reasonable fee, as
  476  established by the department, for such training and education
  477  programs.
  478         (8) The department shall adopt rules to establish standards
  479  for trainers and training and to implement this section.
  480         Section 7. Subsection (1) of section 429.52, Florida
  481  Statutes, is amended to read:
  482         429.52 Staff training and educational requirements.—
  483         (1)(a) Each new assisted living facility employee who has
  484  not previously completed core training must attend a preservice
  485  orientation provided by the facility before interacting with
  486  residents. The preservice orientation must be at least 2 hours
  487  in duration and cover topics that help the employee provide
  488  responsible care and respond to the needs of facility residents.
  489  Upon completion, the employee and the administrator of the
  490  facility must sign a statement that the employee completed the
  491  required preservice orientation. The facility must keep the
  492  signed statement in the employee’s personnel record.
  493         (b) Each employee must complete the training required under
  494  s. 430.5025.
  495         (c) If completed before interacting with residents, the 1
  496  hour training required in s. 430.5025 concerning information on
  497  Alzheimer’s disease and related forms of dementia may count
  498  toward the 2 hours of preservice orientation required under
  499  paragraph (a).
  500         Section 8. Section 429.83, Florida Statutes, is amended to
  501  read:
  502         429.83 Residents with Alzheimer’s disease or other related
  503  disorders; training; certain disclosures.—
  504         (1)The employees of an adult family-care home must
  505  complete the training required under s. 430.5025.
  506         (2) An adult family-care home licensed under this part
  507  which claims that it provides special care for persons who have
  508  Alzheimer’s disease or other related disorders must disclose in
  509  its advertisements or in a separate document those services that
  510  distinguish the care as being especially applicable to, or
  511  suitable for, such persons. The home must give a copy of all
  512  such advertisements or a copy of the document to each person who
  513  requests information about programs and services for persons
  514  with Alzheimer’s disease or other related disorders offered by
  515  the home and must maintain a copy of all such advertisements and
  516  documents in its records. The agency shall examine all such
  517  advertisements and documents in the home’s records as part of
  518  the license renewal procedure.
  519         Section 9. Subsection (1) of section 429.917, Florida
  520  Statutes, is amended to read:
  521         429.917 Patients with Alzheimer’s disease or other related
  522  disorders; staff training requirements; certain disclosures.—
  523         (1) The employees of an adult day care center licensed
  524  under this part must complete the training required under s.
  525  430.5025 provide the following staff training:
  526         (a) Upon beginning employment with the facility, each
  527  employee must receive basic written information about
  528  interacting with participants who have Alzheimer’s disease or
  529  dementia-related disorders.
  530         (b) In addition to the information provided under paragraph
  531  (a), newly hired adult day care center personnel who are
  532  expected to, or whose responsibilities require them to, have
  533  direct contact with participants who have Alzheimer’s disease or
  534  dementia-related disorders must complete initial training of at
  535  least 1 hour within the first 3 months after beginning
  536  employment. The training must include an overview of dementias
  537  and must provide instruction in basic skills for communicating
  538  with persons who have dementia.
  539         (c) In addition to the requirements of paragraphs (a) and
  540  (b), an employee who will be providing direct care to a
  541  participant who has Alzheimer’s disease or a dementia-related
  542  disorder must complete an additional 3 hours of training within
  543  9 months after beginning employment. This training must include,
  544  but is not limited to, the management of problem behaviors,
  545  information about promoting the participant’s independence in
  546  activities of daily living, and instruction in skills for
  547  working with families and caregivers.
  548         (d) For certified nursing assistants, the required 4 hours
  549  of training shall be part of the total hours of training
  550  required annually.
  551         (e) For a health care practitioner as defined in s.
  552  456.001, continuing education hours taken as required by that
  553  practitioner’s licensing board shall be counted toward the total
  554  of 4 hours.
  555         (f) For an employee who is a licensed health care
  556  practitioner as defined in s. 456.001, training that is
  557  sanctioned by that practitioner’s licensing board shall be
  558  considered to be approved by the Department of Elderly Affairs.
  559         (g) The Department of Elderly Affairs or its designee must
  560  approve the 1-hour and 3-hour training provided to employees and
  561  direct caregivers under this section. The department must
  562  consider for approval training offered in a variety of formats.
  563  The department shall keep a list of current providers who are
  564  approved to provide the 1-hour and 3-hour training. The
  565  department shall adopt rules to establish standards for the
  566  employees who are subject to this training, for the trainers,
  567  and for the training required in this section.
  568         (h) Upon completing any training described in this section,
  569  the employee or direct caregiver shall be issued a certificate
  570  that includes the name of the training provider, the topic
  571  covered, and the date and signature of the training provider.
  572  The certificate is evidence of completion of training in the
  573  identified topic, and the employee or direct caregiver is not
  574  required to repeat training in that topic if the employee or
  575  direct caregiver changes employment to a different adult day
  576  care center or to an assisted living facility, nursing home,
  577  home health agency, or hospice. The direct caregiver must comply
  578  with other applicable continuing education requirements.
  579         (i) An employee who is hired on or after July 1, 2004, must
  580  complete the training required by this section.
  581         Section 10. Subsection (6) of section 429.918, Florida
  582  Statutes, is amended to read:
  583         429.918 Licensure designation as a specialized Alzheimer’s
  584  services adult day care center; training.—
  585         (6)(a) An adult day care center having a license designated
  586  under this section must provide the following staff training and
  587  supervision:
  588         (a)1. A registered nurse or licensed practical nurse must
  589  be on site daily for at least 75 percent of the time that the
  590  center is open to ADRD participants. Each licensed practical
  591  nurse who works at the center must be supervised in accordance
  592  with chapter 464.
  593         (b) Each employee must complete the training and continuing
  594  education required under s. 430.5025.
  595         2. Upon beginning employment with the center, each employee
  596  must receive and review basic written information about
  597  interacting with ADRD participants.
  598         3. In addition to the information provided in subparagraph
  599  2., every employee hired on or after July 1, 2012, who has
  600  direct contact with ADRD participants shall complete 4 hours of
  601  dementia-specific training within 3 months after employment.
  602         4. In addition to the requirements of subparagraphs 2. and
  603  3., each employee hired on or after July 1, 2012, who provides
  604  direct care to ADRD participants shall complete an additional 4
  605  hours of dementia-specific training within 6 months after
  606  employment.
  607         (b) The Department of Elderly Affairs or its designee shall
  608  approve the training required under this section. The department
  609  shall adopt rules to establish standards for employees who are
  610  subject to this training, for trainers, and for the training
  611  required in this section.
  612         (c) Upon completing any training described in this section,
  613  the employee shall be issued a certificate that includes the
  614  name of the training provider, the topics covered, and the date
  615  and signature of the training provider. The certificate is
  616  evidence of completion of training in the identified topics, and
  617  the employee is not required to repeat training in those topics
  618  if the employee changes employment to a different adult day care
  619  center.
  620         (c)(d) Each employee hired on or after July 1, 2012, who
  621  provides direct care to ADRD participants, must receive and
  622  review an orientation plan that includes, at a minimum:
  623         1. Procedures to locate an ADRD participant who has
  624  wandered from the center. These procedures must shall be
  625  reviewed regularly with all direct care staff.
  626         2. Information on the Silver Alert program in this state.
  627         3. Information regarding available products or programs
  628  used to identify ADRD participants or prevent them from
  629  wandering away from the center, their home, or other locations.
  630         Section 11. This act shall take effect July 1, 2023.