Florida Senate - 2023 CS for CS for SB 1594
By the Committees on Fiscal Policy; and Health Policy; and
Senators Brodeur and Garcia
594-04241-23 20231594c2
1 A bill to be entitled
2 An act relating to the Agency for Persons with
3 Disabilities; requiring the agency to convene an
4 interagency workgroup for a specified purpose;
5 providing for participants and duties of the
6 workgroup; requiring the workgroup to submit an
7 interim and a final report of its findings and
8 recommendations to the Governor and the Legislature by
9 specified dates; amending s. 393.063, F.S.; revising
10 and defining terms; amending s. 393.065, F.S.;
11 requiring the agency to make certain eligibility
12 determinations within specified timeframes;
13 authorizing the agency to request additional
14 documentation from applicants if it is necessary to
15 make an eligibility determination; providing
16 eligibility requirements for applicants; authorizing a
17 designee of the agency to notify applicants of
18 eligibility determinations; requiring that the agency
19 authorize admission of certain individuals to an
20 intermediate care facility; requiring the agency or
21 its designee to conduct a certain comprehensive
22 assessment of an individual as part of the
23 authorization; revising provisions related to the
24 developmental disabilities home and community-based
25 services Medicaid waiver program; requiring the agency
26 to assign clients seeking such waiver services to
27 their appropriate enrollment categories based on
28 specified criteria; providing eligibility criteria for
29 such services; conforming provisions to changes made
30 by the act; amending s. 393.0651, F.S.; conforming
31 provisions to changes made by the act; amending s.
32 393.0655, F.S.; revising background screening
33 requirements for certain direct service providers;
34 amending s. 393.067, F.S.; requiring the licensure of
35 adult day training programs; conforming related
36 application and licensure provisions to changes made
37 by the act; providing for comprehensive emergency
38 management plans of adult day training programs;
39 providing for inspections of adult day training
40 programs; requiring adult day training programs to
41 adhere to specified rights; conforming provisions to
42 changes made by the act; prohibiting the agency from
43 authorizing funds or services to unlicensed adult day
44 training programs beginning on a specified date;
45 amending s. 393.0673, F.S.; revising provisions
46 related to disciplinary action against certain
47 licensees to include licensed adult day training
48 programs; providing that for purposes of disciplinary
49 action for certain violations, a licensee is
50 ultimately responsible for the care and supervision of
51 clients in its facility or participants of the
52 program; providing construction; revising grounds for
53 denial of a licensure application; defining the term
54 “good moral character”; authorizing the agency to
55 immediately suspend or revoke the license of adult day
56 training programs under certain circumstances;
57 authorizing the agency to impose an immediate
58 moratorium on service authorizations to licensed
59 facilities and adult day training programs under
60 certain circumstances; amending s. 393.0678, F.S.;
61 conforming provisions to changes made by the act;
62 making a technical change; amending s. 393.135, F.S.;
63 conforming provisions to changes made by the act;
64 repealing s. 393.18, F.S., relating to comprehensive
65 transitional education programs; amending s. 394.875,
66 F.S.; conforming a provision to changes made by the
67 act; amending ss. 383.141, 400.063, and 1002.394,
68 F.S.; conforming cross-references; providing an
69 effective date.
70
71 Be It Enacted by the Legislature of the State of Florida:
72
73 Section 1. (1) The Agency for Persons with Disabilities
74 shall convene an interagency workgroup to create a continuum of
75 guidance and information for individuals with developmental
76 disabilities and their families, including guidance and
77 information across the lifespan of such individuals related to
78 their education, workforce skills, daily living skills, and
79 supportive services for greater independence.
80 (2) Participants in the workgroup must include, at a
81 minimum, all of the following:
82 (a) One representative from each of the following:
83 1. The Department of Children and Families.
84 2. The Early Steps Program of the Department of Health.
85 3. The Division of Vocational Rehabilitation of the
86 Department of Education.
87 4. The Agency for Health Care Administration.
88 5. The Florida Unique Abilities Partner Program of the
89 Department of Economic Opportunity.
90 6. Project 10: Transition Education Network.
91 7. The Florida Center for Students with Unique Abilities.
92 (b) At least three representatives from school district
93 transition programs.
94 (3) The workgroup shall gather input from stakeholders and
95 Florida families to identify gaps in information and
96 communication across the lifespan of individuals with
97 developmental disabilities and their families, to determine why
98 these gaps occur, and to recommend ways to ensure that
99 information on the availability of resources and supports across
100 the state is more accessible, including, but not limited to,
101 improving relevant agency websites.
102 (4) The workgroup shall submit an interim report by
103 November 1, 2023, and a final report by September 1, 2024, of
104 its findings and recommendations to the Governor, the President
105 of the Senate, and the Speaker of the House of Representatives.
106 Section 2. Subsections (1) and (10) of section 393.063,
107 Florida Statutes, are amended, and a new subsection (25) is
108 added to that section, to read:
109 393.063 Definitions.—For the purposes of this chapter, the
110 term:
111 (1) “Adult day training” means a program of training
112 services which takes that take place in a nonresidential
113 setting, separate from the home or facility in which the client
114 resides, and is are intended to support the participation of
115 clients in daily, meaningful, and valued routines of the
116 community. These services include, but are not limited to, the
117 acquisition, retention, or improvement of self-help,
118 socialization, and adaptive skills Such training may be provided
119 in work-like settings that do not meet the definition of
120 supported employment.
121 (10) “Comprehensive transitional education program” means
122 the program established in s. 393.18.
123 (25) “Licensee” means an individual, a corporation, a
124 partnership, a firm, an association, a governmental entity, or
125 other entity that is issued a permit, registration, certificate,
126 or license by the agency. The licensee is legally responsible
127 for all aspects of the provider operation.
128 Section 3. Section 393.065, Florida Statutes, is amended to
129 read:
130 393.065 Application and eligibility determination.—
131 (1) An application for services must shall be made in
132 writing to the agency, in the region service area in which the
133 applicant resides. The agency must shall review each application
134 and make an eligibility determination applicant for eligibility
135 within 45 days after the date the application is signed for
136 children under 6 years of age and within 60 days after receipt
137 of the signed application. If, at the time of application, the
138 applicant requests enrollment in the developmental disabilities
139 home and community-based services Medicaid waiver program due to
140 crisis, as described in paragraph (5)(a), the agency must
141 complete an eligibility determination within 45 days after
142 receipt of the signed application.
143 (a) If the agency determines additional documentation is
144 necessary to make a proper determination on an applicant’s
145 eligibility, the agency may request the necessary additional
146 documentation from the applicant the date the application is
147 signed for all other applicants.
148 (b) When necessary to definitively identify individual
149 conditions or needs, the agency must arrange for shall provide a
150 comprehensive assessment within this state.
151 (c) If the agency requests additional documentation from
152 the applicant or arranges for a comprehensive assessment, the
153 agency’s eligibility determination must be completed within 90
154 days after receipt of the signed application.
155 (2) To be eligible for services under this chapter, the
156 agency’s eligibility determination must find that the applicant
157 has met all procedural requirements and eligibility criteria
158 found in rule, which must include, but need not be limited to,
159 the requirement that the applicant have a developmental
160 disability and be domiciled in Florida Only applicants whose
161 domicile is in Florida are eligible for services. Information
162 accumulated by other agencies, including professional reports
163 and collateral data, must shall be considered in this process
164 when available.
165 (2) In order to provide immediate services or crisis
166 intervention to applicants, the agency shall arrange for
167 emergency eligibility determination, with a full eligibility
168 review to be accomplished within 45 days of the emergency
169 eligibility determination.
170 (3) The agency, or its designee, must shall notify each
171 applicant, in writing, of its eligibility determination
172 decision. Any applicant or client determined by the agency to be
173 ineligible for services has the right to appeal this
174 determination decision pursuant to ss. 120.569 and 120.57.
175 (4) Before admission to an intermediate care facility for
176 individuals with intellectual disabilities and to ensure that
177 the setting is the least restrictive to meet the individual’s
178 needs, the agency must authorize the admission pursuant to this
179 subsection. As part of the authorization, the agency, or its
180 designee, must conduct a comprehensive assessment that includes
181 medical necessity, level of care, and level of reimbursement The
182 agency shall assess the level of need and medical necessity for
183 prospective residents of intermediate care facilities for the
184 developmentally disabled. The agency may enter into an agreement
185 with the Department of Elderly Affairs for its Comprehensive
186 Assessment and Review for Long-Term-Care Services (CARES)
187 program to conduct assessments to determine the level of need
188 and medical necessity for long-term-care services under this
189 chapter. To the extent permissible under federal law, the
190 assessments shall be funded under Title XIX of the Social
191 Security Act.
192 (5) Except as provided in subsection (6), if a client
193 seeking enrollment in the developmental disabilities home and
194 community-based services Medicaid waiver program meets the level
195 of care requirement for an intermediate care facility for
196 individuals with intellectual disabilities pursuant to 42 C.F.R.
197 ss. 435.217(b)(1) and 440.150, the agency must shall assign the
198 client to an appropriate enrollment category based on the
199 criteria outlined below and must provide priority to clients
200 waiting for waiver services in the following order:
201 (a) Category 1, which includes clients deemed to be in
202 crisis as described in rule, must shall be given first priority
203 in moving from the preenrollment categories waiting list to the
204 waiver.
205 (b) Category 2, which includes clients in the preenrollment
206 categories individuals on the waiting list who are:
207 1. From the child welfare system with an open case in the
208 Department of Children and Families’ statewide automated child
209 welfare information system and who are either:
210 a. Transitioning out of the child welfare system into
211 permanency at the finalization of an adoption, a reunification
212 with family members, a permanent placement with a relative, or a
213 guardianship with a nonrelative; or
214 b. At least 18 years but not yet 22 years of age and who
215 need both waiver services and extended foster care services; or
216 2. At least 18 years but not yet 22 years of age and who
217 withdrew consent pursuant to s. 39.6251(5)(c) to remain in the
218 extended foster care system.
219
220 For individuals who are at least 18 years but not yet 22 years
221 of age and who are eligible under sub-subparagraph 1.b., the
222 agency must shall provide waiver services, including residential
223 habilitation, and the community-based care lead agency must
224 shall fund room and board at the rate established in s.
225 409.145(3) and provide case management and related services as
226 defined in s. 409.986(3)(e). Individuals may receive both waiver
227 services and services under s. 39.6251. Services may not
228 duplicate services available through the Medicaid state plan.
229 (c) Category 3, which includes, but is not required to be
230 limited to, clients:
231 1. Whose caregiver has a documented condition that is
232 expected to render the caregiver unable to provide care within
233 the next 12 months and for whom a caregiver is required but no
234 alternate caregiver is available;
235 2. At substantial risk of incarceration or court commitment
236 without supports;
237 3. Whose documented behaviors or physical needs place them
238 or their caregiver at risk of serious harm and other supports
239 are not currently available to alleviate the situation; or
240 4. Who are identified as ready for discharge within the
241 next year from a state mental health hospital or skilled nursing
242 facility and who require a caregiver but for whom no caregiver
243 is available or whose caregiver is unable to provide the care
244 needed.
245 (d) Category 4, which includes, but is not required to be
246 limited to, clients whose caregivers are 70 years of age or
247 older and for whom a caregiver is required but no alternate
248 caregiver is available.
249 (e) Category 5, which includes, but is not required to be
250 limited to, clients who are expected to graduate within the next
251 12 months from secondary school and need support to obtain a
252 meaningful day activity, maintain competitive employment, or
253 pursue an accredited program of postsecondary education to which
254 they have been accepted.
255 (f) Category 6, which includes clients 21 years of age or
256 older who do not meet the criteria for category 1, category 2,
257 category 3, category 4, or category 5.
258 (g) Category 7, which includes clients younger than 21
259 years of age who do not meet the criteria for category 1,
260 category 2, category 3, or category 4.
261
262 Within categories 3, 4, 5, 6, and 7, the agency shall maintain a
263 waiting list of clients placed in the order of the date that the
264 client is determined eligible for waiver services.
265 (6) The agency must shall allow an individual who meets the
266 eligibility requirements of subsection (2)(1) to receive home
267 and community-based services in this state if the individual’s
268 parent or legal guardian is an active-duty military
269 servicemember and if, at the time of the servicemember’s
270 transfer to this state, the individual was receiving home and
271 community-based services in another state.
272 (7) The agency must shall allow an individual with a
273 diagnosis of Phelan-McDermid syndrome who meets the eligibility
274 requirements of subsection (2)(1) to receive home and community
275 based services.
276 (8) Only a client may be eligible for services under the
277 developmental disabilities home and community-based services
278 Medicaid waiver program. For a client to receive services under
279 the developmental disabilities home and community-based services
280 Medicaid waiver program, there must be available funding
281 pursuant to s. 393.0662 or through a legislative appropriation
282 and the client must meet all of the following:
283 (a) The eligibility criteria in subsection (2), which must
284 be confirmed by the agency.
285 (b) Eligibility requirements for the Florida Medicaid
286 program under Title XIX of the Social Security Act, as amended,
287 or the Supplemental Security Income program.
288 (c) The level of care requirements for an intermediate care
289 facility for individuals with developmental disabilities
290 pursuant to 42 C.F.R. ss. 435.217(b)(1) and 440.150.
291 (d) The requirements provided in the approved federal
292 waiver authorized pursuant to s. 1915(c) of the Social Security
293 Act and 42 C.F.R. s. 441.302.
294 (9)(8) Agency action that selects individuals to receive
295 waiver services pursuant to this section does not establish a
296 right to a hearing or an administrative proceeding under chapter
297 120 for individuals remaining in the preenrollment categories on
298 the waiting list.
299 (10)(9) The client, the client’s guardian, or the client’s
300 family must ensure that accurate, up-to-date contact information
301 is provided to the agency at all times. Notwithstanding s.
302 393.0651, the agency must shall send an annual letter requesting
303 updated information from the client, the client’s guardian, or
304 the client’s family. The agency must shall remove from the
305 preenrollment categories waiting list any individual who cannot
306 be located using the contact information provided to the agency,
307 fails to meet eligibility requirements, or becomes domiciled
308 outside the state.
309 (11)(a)(10)(a) The agency must shall provide the following
310 information to all applicants or their parents, legal guardians,
311 or family members:
312 1. A brief overview of the vocational rehabilitation
313 services offered through the Division of Vocational
314 Rehabilitation of the Department of Education, including a
315 hyperlink or website address that provides access to the
316 application for such services;
317 2. A brief overview of the Florida ABLE program as
318 established under s. 1009.986, including a hyperlink or website
319 address that provides access to the application for establishing
320 an ABLE account as defined in s. 1009.986(2);
321 3. A brief overview of the supplemental security income
322 benefits and social security disability income benefits
323 available under Title XVI of the Social Security Act, as
324 amended, including a hyperlink or website address that provides
325 access to the application for such benefits;
326 4. A statement indicating that the applicant’s local public
327 school district may provide specialized instructional services,
328 including transition programs, for students with special
329 education needs;
330 5. A brief overview of programs and services funded through
331 the Florida Center for Students with Unique Abilities, including
332 contact information for each state-approved Florida
333 Postsecondary Comprehensive Transition Program;
334 6. A brief overview of decisionmaking options for
335 individuals with disabilities, guardianship under chapter 744,
336 and alternatives to guardianship as defined in s. 744.334(1),
337 which may include contact information for organizations that the
338 agency believes would be helpful in assisting with such
339 decisions;
340 7. A brief overview of the referral tools made available
341 through the agency, including a hyperlink or website address
342 that provides access to such tools; and
343 8. A statement indicating that some waiver providers may
344 serve private-pay individuals.
345 (b) The agency must provide the information required in
346 paragraph (a) in writing to an applicant or his or her parent,
347 legal guardian, or family member along with a written disclosure
348 statement in substantially the following form:
349
350 DISCLOSURE STATEMENT
351
352 Each program and service has its own eligibility requirements.
353 By providing the information specified in section 393.065(11)(a)
354 393.065(10)(a), Florida Statutes, the agency does not guarantee
355 an applicant’s eligibility for or enrollment in any program or
356 service.
357 (c) The agency must shall also publish the information
358 required in paragraph (a) and the disclosure statement in
359 paragraph (b) on its website, and must shall provide that
360 information and statement annually to each client applicant
361 placed in the preenrollment categories on the waiting list or to
362 the parent, legal guardian, or family member of such client
363 applicant.
364 (12)(11) The agency and the Agency for Health Care
365 Administration may adopt rules specifying application
366 procedures, criteria associated with the preenrollment waiting
367 list categories, procedures for administering the preenrollment
368 categories waiting list, including tools for prioritizing waiver
369 enrollment within categories, and eligibility criteria as needed
370 to administer this section.
371 Section 4. Section 393.0651, Florida Statutes, is amended
372 to read:
373 393.0651 Family or individual support plan.—The agency
374 shall provide directly or contract for the development of a
375 family support plan for children ages 3 to 18 years of age and
376 an individual support plan for each client. The client, if
377 competent, the client’s parent or guardian, or, when
378 appropriate, the client advocate, shall be consulted in the
379 development of the plan and shall receive a copy of the plan.
380 Each plan must include the most appropriate, least restrictive,
381 and most cost-beneficial environment for accomplishment of the
382 objectives for client progress and a specification of all
383 services authorized. The plan must include provisions for the
384 most appropriate level of care for the client. Within the
385 specification of needs and services for each client, when
386 residential care is necessary, the agency shall move toward
387 placement of clients in residential facilities based within the
388 client’s community. The ultimate goal of each plan, whenever
389 possible, shall be to enable the client to live a dignified life
390 in the least restrictive setting, be that in the home or in the
391 community. For children under 6 years of age, The family or
392 individual support plan must shall be developed within 60 days
393 after the agency determines the client eligible pursuant to s.
394 393.065(3) the 45-day application period as specified in s.
395 393.065(1); for all applicants 6 years of age or older, the
396 family or individual support plan shall be developed within the
397 60-day period as specified in that subsection.
398 (1) The agency shall develop and specify by rule the core
399 components of support plans.
400 (2) The family or individual support plan shall be
401 integrated with the individual education plan (IEP) for all
402 clients who are public school students entitled to a free
403 appropriate public education under the Individuals with
404 Disabilities Education Act, I.D.E.A., as amended. The family or
405 individual support plan and IEP must shall be implemented to
406 maximize the attainment of educational and habilitation goals.
407 (a) If the IEP for a student enrolled in a public school
408 program indicates placement in a public or private residential
409 program is necessary to provide special education and related
410 services to a client, the local education agency must shall
411 provide for the costs of that service in accordance with the
412 requirements of the Individuals with Disabilities Education Act,
413 I.D.E.A., as amended. This does shall not preclude local
414 education agencies and the agency from sharing the residential
415 service costs of students who are clients and require
416 residential placement.
417 (b) For clients who are entering or exiting the school
418 system, an interdepartmental staffing team composed of
419 representatives of the agency and the local school system shall
420 develop a written transitional living and training plan with the
421 participation of the client or with the parent or guardian of
422 the client, or the client advocate, as appropriate.
423 (3) Each family or individual support plan shall be
424 facilitated through case management designed solely to advance
425 the individual needs of the client.
426 (4) In the development of the family or individual support
427 plan, a client advocate may be appointed by the support planning
428 team for a client who is a minor or for a client who is not
429 capable of express and informed consent when:
430 (a) The parent or guardian cannot be identified;
431 (b) The whereabouts of the parent or guardian cannot be
432 discovered; or
433 (c) The state is the only legal representative of the
434 client.
435
436 Such appointment may shall not be construed to extend the powers
437 of the client advocate to include any of those powers delegated
438 by law to a legal guardian.
439 (5) The agency shall place a client in the most appropriate
440 and least restrictive, and cost-beneficial, residential facility
441 according to his or her individual support plan. The client, if
442 competent, the client’s parent or guardian, or, when
443 appropriate, the client advocate, and the administrator of the
444 facility to which placement is proposed shall be consulted in
445 determining the appropriate placement for the client.
446 Considerations for placement shall be made in the following
447 order:
448 (a) Client’s own home or the home of a family member or
449 direct service provider.
450 (b) Foster care facility.
451 (c) Group home facility.
452 (d) Intermediate care facility for the developmentally
453 disabled.
454 (e) Other facilities licensed by the agency which offer
455 special programs for people with developmental disabilities.
456 (f) Developmental disabilities center.
457 (6) In developing a client’s annual family or individual
458 support plan, the individual or family with the assistance of
459 the support planning team shall identify measurable objectives
460 for client progress and shall specify a time period expected for
461 achievement of each objective.
462 (7) The individual, family, and support coordinator shall
463 review progress in achieving the objectives specified in each
464 client’s family or individual support plan, and shall revise the
465 plan annually, following consultation with the client, if
466 competent, or with the parent or guardian of the client, or,
467 when appropriate, the client advocate. The agency or designated
468 contractor shall annually report in writing to the client, if
469 competent, or to the parent or guardian of the client, or to the
470 client advocate, when appropriate, with respect to the client’s
471 habilitative and medical progress.
472 (8) Any client, or any parent of a minor client, or
473 guardian, authorized guardian advocate, or client advocate for a
474 client, who is substantially affected by the client’s initial
475 family or individual support plan, or the annual review thereof,
476 shall have the right to file a notice to challenge the decision
477 pursuant to ss. 120.569 and 120.57. Notice of such right to
478 appeal shall be included in all support plans provided by the
479 agency.
480 Section 5. Subsection (1) of section 393.0655, Florida
481 Statutes, is amended to read:
482 393.0655 Screening of direct service providers.—
483 (1) MINIMUM STANDARDS.—The agency shall require level 2
484 employment screening pursuant to chapter 435 for direct service
485 providers who are unrelated to their clients, including support
486 coordinators, and managers and supervisors of residential
487 facilities or adult day training comprehensive transitional
488 education programs licensed under this chapter and any other
489 person, including volunteers, who provide care or services, who
490 have access to a client’s living areas, or who have access to a
491 client’s funds or personal property. Background screening must
492 shall include employment history checks as provided in s.
493 435.03(1) and local criminal records checks through local law
494 enforcement agencies.
495 (a) A volunteer who assists on an intermittent basis for
496 less than 10 hours per month does not have to be screened if a
497 person who meets the screening requirement of this section is
498 always present and has the volunteer within his or her line of
499 sight.
500 (b) Licensed physicians, nurses, or other professionals
501 licensed and regulated by the Department of Health are not
502 subject to background screening pursuant to this section if they
503 are providing a service that is within their scope of licensed
504 practice.
505 (c) A person selected by the family or the individual with
506 developmental disabilities and paid by the family or the
507 individual to provide supports or services is not required to
508 have a background screening under this section.
509 (d) Persons 12 years of age or older, including family
510 members, residing with a direct services provider who provides
511 services to clients in his or her own place of residence are
512 subject to background screening; however, such persons who are
513 12 to 18 years of age shall be screened for delinquency records
514 only.
515 Section 6. Section 393.067, Florida Statutes, is amended to
516 read:
517 393.067 Facility licensure.—
518 (1) The agency shall provide through its licensing
519 authority and by rule license application procedures, provider
520 qualifications, facility and client care standards, requirements
521 for client records, requirements for staff qualifications and
522 training, and requirements for monitoring foster care
523 facilities, group home facilities, residential habilitation
524 centers, and adult day training comprehensive transitional
525 education programs that serve agency clients.
526 (2) The agency shall conduct annual inspections and reviews
527 of facilities and adult day training programs licensed under
528 this section.
529 (3) An application for a license under this section must be
530 made to the agency on a form furnished by it and shall be
531 accompanied by the appropriate license fee.
532 (4) The application shall be under oath and shall contain
533 the following:
534 (a) The name and address of the applicant, if an applicant
535 is an individual; if the applicant is a firm, partnership, or
536 association, the name and address of each member thereof; if the
537 applicant is a corporation, its name and address and the name
538 and address of each director and each officer thereof; and the
539 name by which the facility or adult day training program is to
540 be known.
541 (b) The location of the facility or adult day training
542 program for which a license is sought.
543 (c) The name of the person or persons under whose
544 management or supervision the facility or adult day training
545 program will be conducted.
546 (d) The number and type of residents or clients for which
547 maintenance, care, education, or treatment is to be provided by
548 the facility or adult day training program.
549 (e) The number and location of the component centers or
550 units which will compose the comprehensive transitional
551 education program.
552 (f) A description of the types of services and treatment to
553 be provided by the facility or adult day training program.
554 (f)(g) Information relating to the number, experience, and
555 training of the employees of the facility or adult day training
556 program.
557 (g)(h) Certification that the staff of the facility or
558 adult day training program will receive training to detect,
559 report, and prevent sexual abuse, abuse, neglect, exploitation,
560 and abandonment, as defined in ss. 39.01 and 415.102, of
561 residents and clients.
562 (h)(i) Such other Information as the agency determines is
563 necessary to carry out the provisions of this chapter.
564 (5) As a prerequisite for issuance of an initial or renewal
565 license, the applicant, and any manager, supervisor, and staff
566 member of the direct service provider of a facility or an adult
567 day training program licensed under this section, must have
568 submitted to background screening as required under s. 393.0655.
569 A license may not be issued or renewed if the applicant or any
570 manager, supervisor, or staff member of the direct service
571 provider has a disqualifying offense revealed by failed
572 background screenings as required under s. 393.0655. The agency
573 shall determine by rule the frequency of background screening.
574 The applicant shall submit with each initial or renewal
575 application a signed affidavit under penalty of perjury stating
576 that the applicant and any manager, supervisor, or staff member
577 of the direct service provider is in compliance with all
578 requirements for background screening.
579 (6) A facility or an adult day training program The
580 applicant shall furnish satisfactory proof of financial ability
581 to operate and conduct the facility or adult day training
582 program in accordance with the requirements of this chapter and
583 adopted rules.
584 (7) The agency shall adopt rules establishing minimum
585 standards for facilities and adult day training programs
586 licensed under this section, including rules requiring
587 facilities and adult day training programs to train staff to
588 detect, report, and prevent sexual abuse, abuse, neglect,
589 exploitation, and abandonment, as defined in ss. 39.01 and
590 415.102, of residents and clients, minimum standards of quality
591 and adequacy of client care, incident reporting requirements,
592 and uniform firesafety standards established by the State Fire
593 Marshal which are appropriate to the size of the facility or
594 adult day training of the component centers or units of the
595 program.
596 (8) The agency, after consultation with the Division of
597 Emergency Management, shall adopt rules for foster care
598 facilities, group home facilities, and residential habilitation
599 centers, and adult day training programs which establish minimum
600 standards for the preparation and annual update of a
601 comprehensive emergency management plan. At a minimum, the rules
602 must provide for plan components that address emergency
603 evacuation transportation; adequate sheltering arrangements;
604 postdisaster activities, including emergency power, food, and
605 water; postdisaster transportation; supplies; staffing;
606 emergency equipment; individual identification of residents and
607 transfer of records; and responding to family inquiries. The
608 comprehensive emergency management plan for all facilities and
609 adult day training comprehensive transitional education programs
610 and for homes serving individuals who have a complex medical
611 condition conditions is subject to review and approval by the
612 local emergency management agency. During its review, the local
613 emergency management agency shall ensure that the agency and the
614 Division of Emergency Management, at a minimum, are given the
615 opportunity to review the plan. Also, appropriate volunteer
616 organizations must be given the opportunity to review the plan.
617 The local emergency management agency shall complete its review
618 within 60 days and either approve the plan or advise the
619 facility or program of necessary revisions.
620 (9) The agency may conduct unannounced inspections to
621 determine compliance by foster care facilities, group home
622 facilities, residential habilitation centers, and adult day
623 training comprehensive transitional education programs with the
624 applicable provisions of this chapter and the rules adopted
625 pursuant hereto, including the rules adopted for training staff
626 of a facility or an adult day training a program to detect,
627 report, and prevent sexual abuse, abuse, neglect, exploitation,
628 and abandonment, as defined in ss. 39.01 and 415.102, of
629 residents and clients. The facility or adult day training
630 program shall make copies of inspection reports available to the
631 public upon request.
632 (10) Each facility or adult day training program licensed
633 under this section shall forward annually to the agency a true
634 and accurate sworn statement of its costs of providing care to
635 clients funded by the agency.
636 (11) The agency may audit the records of any facility or
637 adult day training program that it has reason to believe may not
638 be in full compliance with the provisions of this section;
639 provided that, any financial audit of such facility or program
640 is shall be limited to the records of clients funded by the
641 agency.
642 (12) The agency shall establish, for the purpose of control
643 of licensure costs, a uniform management information system and
644 a uniform reporting system with uniform definitions and
645 reporting categories.
646 (13) Facilities and adult day training programs licensed
647 under pursuant to this section shall adhere to all rights
648 specified in s. 393.13, including those enumerated in s.
649 393.13(4).
650 (14) The agency may not authorize funds or services to an
651 unlicensed facility or, beginning October 1, 2024, to an
652 unlicensed adult day training program that is required to be
653 licensed under this section may not receive state funds. A
654 license for the operation of a facility or an adult day training
655 program may shall not be renewed if the licensee has any
656 outstanding fines assessed pursuant to this chapter wherein
657 final adjudication of such fines has been entered.
658 (15) The agency is not required to contract with facilities
659 or adult day training programs licensed under pursuant to this
660 chapter.
661 Section 7. Section 393.0673, Florida Statutes, is amended
662 to read:
663 393.0673 Denial, suspension, or revocation of license;
664 moratorium on admissions; administrative fines; procedures.—
665 (1) The following constitute grounds for which the agency
666 may take disciplinary action, including revoking or suspending
667 revoke or suspend a license and imposing or impose an
668 administrative fine, not to exceed $1,000 per violation per day,
669 if:
670 (a) The licensee has:
671 1. Falsely represented or omitted a material fact in its
672 license application submitted under s. 393.067;
673 2. Had prior action taken against it under the Medicaid or
674 Medicare program; or
675 3. Failed to comply with the applicable requirements of
676 this chapter or rules applicable to the licensee; or
677 (b) The Department of Children and Families has verified
678 that the licensee is responsible for the abuse, neglect, or
679 abandonment of a child or the abuse, neglect, or exploitation of
680 a vulnerable adult.
681 (2) For purposes of disciplinary action under this section
682 for verified findings of abuse, neglect, abandonment, or
683 exploitation of a child or vulnerable adult, the licensee is
684 responsible not only for administration of the facilities in
685 compliance with the standards set out by statute and
686 administrative rule, but is ultimately responsible for the care
687 and supervision of the clients in the facility or the
688 participants of the program.
689 (a) A licensee may not delegate to others the ultimate
690 responsibility for the safety of the clients in its care.
691 (b) A licensee is subject to disciplinary action for an
692 employee’s lapse in care or supervision of the clients at the
693 facility or the participants of the program in which a verified
694 finding of abuse, neglect, abandonment, or exploitation
695 occurred.
696 (c) Remedial action taken by the licensee does not affect
697 the agency’s ability to impose disciplinary action for the
698 underlying violation.
699 (3) The agency may deny an application for licensure
700 submitted under s. 393.067 if:
701 (a) The applicant has:
702 1. Falsely represented or omitted a material fact in its
703 license application submitted under s. 393.067;
704 2. Had prior action taken against it under the Medicaid or
705 Medicare program;
706 3. Failed to comply with the applicable requirements of
707 this chapter or rules applicable to the applicant; or
708 4. Previously had a license to operate a residential
709 facility or adult day training program revoked by the agency,
710 the Department of Children and Families, or the Agency for
711 Health Care Administration; or
712 (b) The Department of Children and Families has verified
713 that the applicant is responsible for the abuse, neglect, or
714 abandonment of a child or the abuse, neglect, or exploitation of
715 a vulnerable adult; or
716 (c) The agency has determined that there is clear and
717 convincing evidence that the applicant is unqualified for a
718 license because of a lack of good moral character. For purposes
719 of this paragraph, the term “good moral character” means a
720 personal history of honesty, fairness, and respect for the
721 rights of others and for the laws of this state and the Federal
722 Government.
723 (4)(3) All hearings must shall be held within the county in
724 which the licensee or applicant operates or applies for a
725 license to operate a facility or an adult day training program
726 as defined herein.
727 (5)(4) The agency, as a part of any final order issued by
728 it under this chapter, may impose such fine as it deems proper,
729 except that such fine may not exceed $1,000 for each violation.
730 Each day a violation of this chapter occurs constitutes a
731 separate violation and is subject to a separate fine, but in no
732 event may the aggregate amount of any fine exceed $10,000. Fines
733 paid by any facility licensee under the provisions of this
734 subsection shall be deposited in the Health Care Trust Fund and
735 expended as provided in s. 400.063.
736 (6)(5) The agency may issue an order immediately suspending
737 or revoking a license when it determines that any condition of
738 in the facility or adult day training program presents a danger
739 to the health, safety, or welfare of the residents in the
740 facility or the program participants.
741 (7)(6) The agency may impose an immediate moratorium on
742 admissions to any facility or on service authorizations to a
743 facility or an adult day training program when the agency
744 determines that any condition of in the facility or adult day
745 training program presents a threat to the health, safety, or
746 welfare of the residents in the facility or the program
747 participants.
748 (8)(7) The agency shall establish by rule criteria for
749 evaluating the severity of violations and for determining the
750 amount of fines imposed.
751 Section 8. Subsection (1) of section 393.0678, Florida
752 Statutes, is amended to read:
753 393.0678 Receivership proceedings.—
754 (1) The agency may petition a court of competent
755 jurisdiction for the appointment of a receiver for a
756 comprehensive transitional education program, a residential
757 habilitation center, or a group home facility owned and operated
758 by a corporation or partnership when any of the following
759 conditions exist:
760 (a) Any person is operating a facility without a license
761 and refuses to make application for a license as required by s.
762 393.067.
763 (b) The licensee is closing the facility or has informed
764 the agency department that it intends to close the facility; and
765 adequate arrangements have not been made for relocation of the
766 residents within 7 days, exclusive of weekends and holidays, of
767 the closing of the facility.
768 (c) The agency determines that conditions exist in the
769 facility which present an imminent danger to the health, safety,
770 or welfare of the residents of the facility or which present a
771 substantial probability that death or serious physical harm
772 would result therefrom. Whenever possible, the agency shall
773 facilitate the continued operation of the program.
774 (d) The licensee cannot meet its financial obligations to
775 provide food, shelter, care, and utilities. Evidence such as the
776 issuance of bad checks or the accumulation of delinquent bills
777 for such items as personnel salaries, food, drugs, or utilities
778 constitutes prima facie evidence that the ownership of the
779 facility lacks the financial ability to operate the home in
780 accordance with the requirements of this chapter and all rules
781 adopted promulgated thereunder.
782 Section 9. Subsection (2) of section 393.135, Florida
783 Statutes, is amended to read:
784 393.135 Sexual misconduct prohibited; reporting required;
785 penalties.—
786 (2) A covered person who engages in sexual misconduct with
787 an individual with a developmental disability who:
788 (a) Resides in a residential facility, including any
789 comprehensive transitional education program, developmental
790 disabilities center, foster care facility, group home facility,
791 intermediate care facility for the developmentally disabled, or
792 residential habilitation center; or
793 (b) Is eligible to receive services from the agency under
794 this chapter,
795
796 commits a felony of the second degree, punishable as provided in
797 s. 775.082, s. 775.083, or s. 775.084. A covered person may be
798 found guilty of violating this subsection without having
799 committed the crime of sexual battery.
800 Section 10. Section 393.18, Florida Statutes, is repealed.
801 Section 11. Paragraph (c) of subsection (3) of section
802 394.875, Florida Statutes, is amended to read:
803 394.875 Crisis stabilization units, residential treatment
804 facilities, and residential treatment centers for children and
805 adolescents; authorized services; license required.—
806 (3) The following are exempt from licensure as required in
807 ss. 394.455-394.903:
808 (c) Comprehensive transitional education programs licensed
809 under s. 393.067.
810 Section 12. Paragraph (b) of subsection (1) of section
811 383.141, Florida Statutes, is amended to read:
812 383.141 Prenatally diagnosed conditions; patient to be
813 provided information; definitions; information clearinghouse;
814 advisory council.—
815 (1) As used in this section, the term:
816 (b) “Developmental disability” includes Down syndrome and
817 other developmental disabilities defined by s. 393.063 s.
818 393.063(12).
819 Section 13. Subsection (1) of section 400.063, Florida
820 Statutes, is amended to read:
821 400.063 Resident protection.—
822 (1) The Health Care Trust Fund shall be used for the
823 purpose of collecting and disbursing funds generated from the
824 license fees and administrative fines as provided for in ss.
825 393.0673(5) ss. 393.0673(4), 400.062(3), 400.121(2), and
826 400.23(8). Such funds shall be for the sole purpose of paying
827 for the appropriate alternate placement, care, and treatment of
828 residents who are removed from a facility licensed under this
829 part or a facility specified in s. 393.0678(1) in which the
830 agency determines that existing conditions or practices
831 constitute an immediate danger to the health, safety, or
832 security of the residents. If the agency determines that it is
833 in the best interest of the health, safety, or security of the
834 residents to provide for an orderly removal of the residents
835 from the facility, the agency may utilize such funds to maintain
836 and care for the residents in the facility pending removal and
837 alternative placement. The maintenance and care of the residents
838 shall be under the direction and control of a receiver appointed
839 pursuant to s. 393.0678(1) or s. 400.126(1). However, funds may
840 be expended in an emergency upon a filing of a petition for a
841 receiver, upon the declaration of a state of local emergency
842 pursuant to s. 252.38(3)(a)5., or upon a duly authorized local
843 order of evacuation of a facility by emergency personnel to
844 protect the health and safety of the residents.
845 Section 14. Paragraph (d) of subsection (2) of section
846 1002.394, Florida Statutes, is amended to read:
847 1002.394 The Family Empowerment Scholarship Program.—
848 (2) DEFINITIONS.—As used in this section, the term:
849 (d) “Disability” means, for a 3- or 4-year-old child or for
850 a student in kindergarten to grade 12, autism spectrum disorder,
851 as defined in the Diagnostic and Statistical Manual of Mental
852 Disorders, Fifth Edition, published by the American Psychiatric
853 Association; cerebral palsy, as defined in s. 393.063; Down
854 syndrome, as defined in s. 393.063; an intellectual disability,
855 as defined in s. 393.063; a speech impairment; a language
856 impairment; an orthopedic impairment; any an other health
857 impairment; an emotional or a behavioral disability; a specific
858 learning disability, including, but not limited to, dyslexia,
859 dyscalculia, or developmental aphasia; Phelan-McDermid syndrome,
860 as defined in s. 393.063; Prader-Willi syndrome, as defined in
861 s. 393.063; spina bifida, as defined in s. 393.063; being a
862 high-risk child, as defined in s. 393.063(22)(a) s.
863 393.063(23)(a); muscular dystrophy; Williams syndrome; rare
864 diseases which affect patient populations of fewer than 200,000
865 individuals in the United States, as defined by the National
866 Organization for Rare Disorders; anaphylaxis; a hearing
867 impairment, including deafness; a visual impairment, including
868 blindness; traumatic brain injury; hospital or homebound; or
869 identification as dual sensory impaired, as defined by rules of
870 the State Board of Education and evidenced by reports from local
871 school districts. The term “hospital or homebound” includes a
872 student who has a medically diagnosed physical or psychiatric
873 condition or illness, as defined by the state board in rule, and
874 who is confined to the home or hospital for more than 6 months.
875 Section 15. This act shall take effect July 1, 2023.