Florida Senate - 2023 CS for CS for SB 1182 By the Appropriations Committee on Health and Human Services; the Committee on Children, Families, and Elder Affairs; and Senators Simon and Book 603-03746-23 20231182c2 1 A bill to be entitled 2 An act relating to education and training for 3 Alzheimers 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 Alzheimers 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 Alzheimers 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. 400.51, F.S.; requiring a 58 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 s. 400.980, F.S.; requiring health care 63 services pools to verify and maintain documentation 64 that certain employees or independent contractors have 65 met specified licensing, certification, training, and 66 continuing education requirements; prohibiting 67 delegation of specified responsibilities; amending s. 68 429.178, F.S.; conforming provisions to changes made 69 by the act; amending s. 429.52, F.S.; conforming 70 provisions to changes made by the act; exempting 71 certain employees of assisted living facilities from 72 specified training requirements; amending ss. 429.83, 73 429.917, and 429.918, F.S.; conforming provisions to 74 changes made by the act; providing an effective date. 75 76 Be It Enacted by the Legislature of the State of Florida: 77 78 Section 1.Section 430.5025, Florida Statutes, is created 79 to read: 80 430.5025Alzheimers disease and related forms of dementia; 81 education and training. 82 (1)This section may be cited as the Alzheimers Disease 83 and Related Forms of Dementia Education and Training Act. 84 (2)As used in this section, the term: 85 (a)Covered provider means a nursing home, a home health 86 agency, a nurse registry, a companion or homemaker service 87 provider, a health care services pool, an assisted living 88 facility, an adult family-care home, or an adult day care center 89 licensed or registered under chapter 400 or chapter 429. 90 (b)Department means the Department of Elderly Affairs. 91 (c)Employee means a person, contracted staff, or an 92 independent contractor employed or referred by a covered 93 provider who is required to undergo a level 2 background 94 screening under s. 408.809 and chapter 435. 95 (d)Personal care means providing, through in-person 96 contact, assistance with activities of daily living, assistance 97 with self-administration of medication, homemaker or companion 98 services, nursing services, or other services that promote the 99 physical, mental, and psychosocial well-being of participants, 100 patients, and residents of covered providers. The term does not 101 include duties involving administrative functions or maintaining 102 the physical environment of a licensed facility, including 103 grounds maintenance, building maintenance, housekeeping, 104 laundry, or food preparation. 105 (e)Regular contact means the performance of duties other 106 than personal care which may require employees to interact in 107 person on a daily basis with participants, patients, or 108 residents. 109 (3)The department shall offer to the general public 110 education about Alzheimers disease and related forms of 111 dementia. Such education must provide basic information about 112 the most common forms of dementia, how to identify the signs and 113 symptoms of dementia, coping skills, how to respond to changes, 114 planning for the future, and how to access additional resources 115 about dementia. 116 (4)Employees of covered providers must complete the 117 following training for Alzheimers disease and related forms of 118 dementia: 119 (a)Upon beginning employment, each employee must receive 120 basic written information about interacting with persons who 121 have Alzheimers disease or related forms of dementia. 122 (b)Within 30 days after beginning employment, each 123 employee who provides personal care to or has regular contact 124 with participants, patients, or residents must complete a 1-hour 125 training program provided by the department. 126 1.The department shall provide the training in an online 127 format at no cost. The 1-hour training program must contain 128 information on understanding the basics about the most common 129 forms of dementia, how to identify the signs and symptoms of 130 dementia, and skills for communicating and interacting with 131 persons with Alzheimers disease or related forms of dementia. A 132 record of the completion of the training program must be made 133 available to the covered provider which identifies the training 134 course, the name of the employee, and the date of completion. 135 2.A covered provider must maintain a record of the 136 employees completion of the training and, upon written request 137 of the employee, must provide the employee with a copy of the 138 record of completion consistent with the employers written 139 policies. 140 3.An employee who has completed the training required in 141 this subsection is not required to repeat the program upon 142 changing employment to a different covered provider. 143 (c)Within 7 months after beginning employment for a home 144 health agency, nurse registry, or companion or homemaker service 145 provider, each employee who provides personal care must complete 146 2 hours of training in addition to the training required in 147 paragraphs (a) and (b). The additional training must include, 148 but is not limited to, behavior management, promoting the 149 persons independence in activities of daily living, and skills 150 in working with families and caregivers. 151 (d)Within 7 months after beginning employment for a 152 nursing home, an assisted living facility, an adult family-care 153 home, or an adult day care center, each employee who provides 154 personal care must complete 3 hours of training in addition to 155 the training required in paragraphs (a) and (b). The additional 156 training must include, but is not limited to, behavior 157 management, promoting the persons independence in activities of 158 daily living, skills in working with families and caregivers, 159 group and individual activities, maintaining an appropriate 160 environment, and ethical issues. 161 (e)For an assisted living facility, adult family-care 162 home, or adult day care center that advertises and provides, or 163 is designated to provide, specialized care for persons with 164 Alzheimers disease or related forms of dementia, in addition to 165 the training specified in paragraphs (a) and (b), employees must 166 receive the following training: 167 1.Within 3 months after beginning employment, each 168 employee who provides personal care to or has regular contact 169 with the residents or participants must complete the additional 170 3 hours of training as provided in paragraph (d). 171 2.Within 6 months after beginning employment, each 172 employee who provides personal care must complete an additional 173 4 hours of dementia-specific training. Such training must 174 include, but is not limited to, understanding Alzheimers 175 disease and related forms of dementia, the stages of Alzheimers 176 disease, communication strategies, medical information, and 177 stress management. 178 3.Thereafter, each employee who provides personal care 179 must participate in at least 4 hours of continuing education 180 each calendar year through contact hours, on-the-job training, 181 or electronic learning technology. For this subparagraph, the 182 term on-the-job training means a form of direct coaching in 183 which a facility administrator or his or her designee instructs 184 an employee who provides personal care with guidance, support, 185 or hands-on experience to help develop and refine the employees 186 skills for caring for a person with Alzheimers disease or a 187 related form of dementia. The continuing education must cover at 188 least one of the topics included in the dementia-specific 189 training in which the employee has not received previous 190 training in the previous calendar year. The continuing education 191 may be fulfilled and documented in a minimum of one quarter-hour 192 increments through on-the-job training of the employee by a 193 facility administrator or his or her designee or by an 194 electronic learning technology chosen by the facility 195 administrator. On-the-job training may not account for more than 196 2 hours of continuing education each calendar year. 197 (f)1.An employee provided, assigned, or referred by a 198 health care services pool must complete the training required in 199 paragraph (c), paragraph (d), or paragraph (e) as applicable to 200 the covered provider and the position in which the employee will 201 be working. The documentation verifying the completed training 202 and continuing education of the employee must, if applicable, be 203 provided to the covered provider upon request. 204 2.A health care services pool must verify and maintain 205 documentation as required under s. 400.980(5) before providing, 206 assigning, or referring an employee to a covered provider. 207 (5)The department may establish training curricula 208 guidelines for the training required in paragraphs (4)(c), (d), 209 and (e). The department may approve training providers and 210 training curricula and maintain a list of approved providers. 211 Approved training may be offered in a variety of formats, 212 including, but not limited to, in person, electronically, or on 213 the-job by a facility administrator or his or her designee. 214 Continuing education under this section does not require the 215 adoption of training curricula guidelines by the department or 216 approval of the training provider and curricula by the 217 department. The department may develop or provide continuing 218 education training or curricula as an option for covered 219 providers and employees. 220 (a)A training provider meeting one of the following 221 qualifications may offer training in compliance with the 222 training curricula guidelines without prior approval of the 223 department: 224 1.A person approved by an applicable board or the 225 Department of Health to provide training who is registered with 226 the electronic continuing education tracking system under s. 227 456.025; or 228 2.A training provider approved by the department or its 229 designee before July 1, 2023. 230 (b)Training providers qualified under subparagraph (a)1. 231 must also have: 232 1.At least 1 year of teaching experience as an educator 233 for caregivers of persons with Alzheimers disease or related 234 forms of dementia; 235 2.At least 1 year of practical experience in a program 236 providing care to persons with Alzheimers disease or related 237 forms of dementia; or 238 3.Completed a specialized training program in the subject 239 matter of Alzheimers disease and related forms of dementia from 240 an accredited health care, human services, or gerontology 241 education provider. 242 (c)Upon an employees completion of the training specified 243 in paragraphs (4)(c), (d), and (e), the training provider must 244 provide a record of the completion of the training which 245 includes the name of the employee, the name of the training 246 provider, the topics covered, and the date of completion. The 247 training record is evidence of completion of training in the 248 identified topic and the employee is not required to repeat 249 training in that topic if the employee changes employment to a 250 different covered provider. 251 (d)Any Alzheimers disease and related forms of dementia 252 training curriculum approved by the department or its designee 253 before July 1, 2023, remains in effect until the curriculums 254 expiration date. 255 (6)The department may adopt rules to establish training 256 curriculum guidelines, requirements for the approval of other 257 qualified training providers, and a process for conducting a 258 sampling of training or training curricula as necessary to 259 monitor for compliance with curricula guidelines. 260 (7)For a certified nursing assistant as defined in s. 261 464.201, training hours completed as required under this section 262 may count toward the total hours of training required to 263 maintain certification as a nursing assistant. 264 (8)For a health care practitioner as defined in s. 265 456.001, training hours completed as required under this section 266 may count toward the total hours of continuing education 267 required by that practitioners licensing board. 268 (9)Each person employed, contracted, or referred to 269 provide services before July 1, 2023, must complete the training 270 required in this section before July 1, 2026. Proof of 271 completion of equivalent training completed before July 1, 2023, 272 shall substitute for the training required in subsection (4). 273 Each person employed, contracted, or referred to provide 274 services on or after July 1, 2023, may satisfy the training 275 requirements by completing training using approved curricula as 276 specified in paragraph (5)(d) until the effective date of the 277 rules adopted by the department under subsection (6). 278 Section 2.Paragraph (b) of subsection (2) of section 279 400.0239, Florida Statutes, is amended to read: 280 400.0239Quality of Long-Term Care Facility Improvement 281 Trust Fund. 282 (2)Expenditures from the trust fund shall be allowable for 283 direct support of the following: 284 (b)Development and implementation of specialized training 285 programs for long-term care facility personnel who provide 286 direct care for residents with Alzheimers disease and other 287 dementias, including training provided under s. 430.5025, 288 residents at risk of developing pressure sores, and residents 289 with special nutrition and hydration needs. 290 Section 3.Section 400.1755, Florida Statutes, is amended 291 to read: 292 400.1755Care for persons with Alzheimers disease or 293 related disorders; staff training requirements. 294 (1)As a condition of licensure, the employees of 295 facilities licensed under this part must complete the training 296 required under s. 430.5025 provide to each of their employees, 297 upon beginning employment, basic written information about 298 interacting with persons with Alzheimers disease or a related 299 disorder. 300 (2)All employees who are expected to, or whose 301 responsibilities require them to, have direct contact with 302 residents with Alzheimers disease or a related disorder must, 303 in addition to being provided the information required in 304 subsection (1), also have an initial training of at least 1 hour 305 completed in the first 3 months after beginning employment. This 306 training must include, but is not limited to, an overview of 307 dementias and must provide basic skills in communicating with 308 persons with dementia. 309 (3)An individual who provides direct care shall be 310 considered a direct caregiver and must complete the required 311 initial training and an additional 3 hours of training within 9 312 months after beginning employment. This training shall include, 313 but is not limited to, managing problem behaviors, promoting the 314 residents independence in activities of daily living, and 315 skills in working with families and caregivers. 316 (a)The required 4 hours of training for certified nursing 317 assistants are part of the total hours of training required 318 annually. 319 (b)For a health care practitioner as defined in s. 320 456.001, continuing education hours taken as required by that 321 practitioners licensing board shall be counted toward this 322 total of 4 hours. 323 (4)For an employee who is a licensed health care 324 practitioner as defined in s. 456.001, training that is 325 sanctioned by that practitioners licensing board shall be 326 considered to be approved by the Department of Elderly Affairs. 327 (5)The Department of Elderly Affairs or its designee must 328 approve the initial and continuing training provided in the 329 facilities. The department must approve training offered in a 330 variety of formats, including, but not limited to, Internet 331 based training, videos, teleconferencing, and classroom 332 instruction. The department shall keep a list of current 333 providers who are approved to provide initial and continuing 334 training. The department shall adopt rules to establish 335 standards for the trainers and the training required in this 336 section. 337 (6)Upon completing any training listed in this section, 338 the employee or direct caregiver shall be issued a certificate 339 that includes the name of the training provider, the topic 340 covered, and the date and signature of the training provider. 341 The certificate is evidence of completion of training in the 342 identified topic, and the employee or direct caregiver is not 343 required to repeat training in that topic if the employee or 344 direct caregiver changes employment to a different facility or 345 to an assisted living facility, home health agency, adult day 346 care center, or adult family-care home. The direct caregiver 347 must comply with other applicable continuing education 348 requirements. 349 Section 4.Section 400.4785, Florida Statutes, is amended 350 to read: 351 400.4785Patients with Alzheimers disease or other related 352 disorders; staff training requirements; certain disclosures. 353 (1)The employees of a home health agency must complete the 354 training required under s. 430.5025 A home health agency must 355 provide the following staff training: 356 (a)Upon beginning employment with the agency, each 357 employee must receive basic written information about 358 interacting with participants who have Alzheimers disease or 359 dementia-related disorders. 360 (b)In addition to the information provided under paragraph 361 (a), newly hired home health agency personnel who will be 362 providing direct care to patients must complete 2 hours of 363 training in Alzheimers disease and dementia-related disorders 364 within 9 months after beginning employment with the agency. This 365 training must include, but is not limited to, an overview of 366 dementia, a demonstration of basic skills in communicating with 367 persons who have dementia, the management of problem behaviors, 368 information about promoting the clients independence in 369 activities of daily living, and instruction in skills for 370 working with families and caregivers. 371 (c)For certified nursing assistants, the required 2 hours 372 of training shall be part of the total hours of training 373 required annually. 374 (d)For a health care practitioner as defined in s. 375 456.001, continuing education hours taken as required by that 376 practitioners licensing board shall be counted toward the total 377 of 2 hours. 378 (e)For an employee who is a licensed health care 379 practitioner as defined in s. 456.001, training that is 380 sanctioned by that practitioners licensing board shall be 381 considered to be approved by the Department of Elderly Affairs. 382 (f)The Department of Elderly Affairs, or its designee, 383 must approve the required training. The department must consider 384 for approval training offered in a variety of formats. The 385 department shall keep a list of current providers who are 386 approved to provide the 2-hour training. The department shall 387 adopt rules to establish standards for the employees who are 388 subject to this training, for the trainers, and for the training 389 required in this section. 390 (g)Upon completing the training listed in this section, 391 the employee shall be issued a certificate that states that the 392 training mandated under this section has been received. The 393 certificate shall be dated and signed by the training provider. 394 The certificate is evidence of completion of this training, and 395 the employee is not required to repeat this training if the 396 employee changes employment to a different home health agency. 397 (2)(h)A licensed home health agency whose unduplicated 398 census during the most recent calendar year was composed 399 comprised of at least 90 percent of individuals aged 21 years or 400 younger at the date of admission is exempt from the training 401 requirements in this section. 402 (3)(2)An agency licensed under this part which claims that 403 it provides special care for persons who have Alzheimers 404 disease or other related disorders must disclose in its 405 advertisements or in a separate document those services that 406 distinguish the care as being especially applicable to, or 407 suitable for, such persons. The agency must give a copy of all 408 such advertisements or a copy of the document to each person who 409 requests information about the agency and must maintain a copy 410 of all such advertisements and documents in its records. The 411 Agency for Health Care Administration shall examine all such 412 advertisements and documents in the agencys records as part of 413 the license renewal procedure. 414 Section 5.Section 400.51, Florida Statutes, is created to 415 read: 416 400.51Patients with Alzheimers disease or other related 417 disorders; staff training requirements.A person employed, 418 contracted, or referred by a nurse registry or a person 419 registered with the agency to provide companion or homemaker 420 services must complete the training required under s. 430.5025. 421 Section 6.Subsection (5) of section 400.980, Florida 422 Statutes, is amended to read: 423 400.980Health care services pools. 424 (5)A health care services pool shall verify and maintain 425 documentation document that each temporary employee or 426 independent contractor provided, assigned, or referred to a 427 health care facility has met the licensing, certification, 428 training, or continuing education requirements, as established 429 by the appropriate regulatory agency, for the position in which 430 he or she will be working. The requirements of this subsection 431 may not be delegated to another provider as defined in s. 432 408.803. 433 Section 7.Section 429.178, Florida Statutes, is amended to 434 read: 435 429.178Special care for persons with Alzheimers disease 436 or other related disorders. 437 (1)A facility that which advertises that it provides 438 special care for persons with Alzheimers disease or other 439 related disorders must meet the following standards of 440 operation: 441 (1)(a)1.If the facility has 17 or more residents, have an 442 awake staff member on duty at all hours of the day and night; or 443 (b)2.If the facility has fewer than 17 residents, have an 444 awake staff member on duty at all hours of the day and night or 445 have mechanisms in place to monitor and ensure the safety of the 446 facilitys residents. 447 (2)(b)Offer activities specifically designed for persons 448 who are cognitively impaired. 449 (3)(c)Have a physical environment that provides for the 450 safety and welfare of the facilitys residents. 451 (4)(d)Require employed Employ staff to complete who have 452 completed the training and continuing education required under 453 s. 430.5025 in subsection (2). 454 (2)(a)An individual who is employed by a facility that 455 provides special care for residents who have Alzheimers disease 456 or other related disorders, and who has regular contact with 457 such residents, must complete up to 4 hours of initial dementia 458 specific training developed or approved by the department. The 459 training must be completed within 3 months after beginning 460 employment and satisfy the core training requirements of s. 461 429.52(3)(g). 462 (b)A direct caregiver who is employed by a facility that 463 provides special care for residents who have Alzheimers disease 464 or other related disorders and provides direct care to such 465 residents must complete the required initial training and 4 466 additional hours of training developed or approved by the 467 department. The training must be completed within 9 months after 468 beginning employment and satisfy the core training requirements 469 of s. 429.52(3)(g). 470 (c)An individual who is employed by a facility that 471 provides special care for residents with Alzheimers disease or 472 other related disorders, but who only has incidental contact 473 with such residents, must be given, at a minimum, general 474 information on interacting with individuals with Alzheimers 475 disease or other related disorders, within 3 months after 476 beginning employment. 477 (3)In addition to the training required under subsection 478 (2), a direct caregiver must participate in a minimum of 4 479 contact hours of continuing education each calendar year. The 480 continuing education must include one or more topics included in 481 the dementia-specific training developed or approved by the 482 department, in which the caregiver has not received previous 483 training. 484 (4)Upon completing any training listed in subsection (2), 485 the employee or direct caregiver shall be issued a certificate 486 that includes the name of the training provider, the topic 487 covered, and the date and signature of the training provider. 488 The certificate is evidence of completion of training in the 489 identified topic, and the employee or direct caregiver is not 490 required to repeat training in that topic if the employee or 491 direct caregiver changes employment to a different facility. The 492 employee or direct caregiver must comply with other applicable 493 continuing education requirements. 494 (5)The department, or its designee, shall approve the 495 initial and continuing education courses and providers. 496 (6)The department shall keep a current list of providers 497 who are approved to provide initial and continuing education for 498 staff of facilities that provide special care for persons with 499 Alzheimers disease or other related disorders. 500 (7)Any facility more than 90 percent of whose residents 501 receive monthly optional supplementation payments is not 502 required to pay for the training and education programs required 503 under this section. A facility that has one or more such 504 residents shall pay a reduced fee that is proportional to the 505 percentage of such residents in the facility. A facility that 506 does not have any residents who receive monthly optional 507 supplementation payments must pay a reasonable fee, as 508 established by the department, for such training and education 509 programs. 510 (8)The department shall adopt rules to establish standards 511 for trainers and training and to implement this section. 512 Section 8.Subsection (1) of section 429.52, Florida 513 Statutes, is amended to read: 514 429.52Staff training and educational requirements. 515 (1)(a)Each new assisted living facility employee who has 516 not previously completed core training must attend a preservice 517 orientation provided by the facility before interacting with 518 residents. The preservice orientation must be at least 2 hours 519 in duration and cover topics that help the employee provide 520 responsible care and respond to the needs of facility residents. 521 Upon completion, the employee and the administrator of the 522 facility must sign a statement that the employee completed the 523 required preservice orientation. The facility must keep the 524 signed statement in the employees personnel record. 525 (b)Each assisted living facility employee must complete 526 the training required under s. 430.5025. However, an employee of 527 an assisted living facility licensed as a limited mental health 528 facility under s. 429.075 is exempt from the training 529 requirements under s. 430.5025(4)(d). 530 (c)If completed before interacting with residents, the 1 531 hour training required in s. 430.5025 concerning information on 532 Alzheimers disease and related forms of dementia may count 533 toward the 2 hours of preservice orientation required under 534 paragraph (a). 535 Section 9.Section 429.83, Florida Statutes, is amended to 536 read: 537 429.83Residents with Alzheimers disease or other related 538 disorders; training; certain disclosures. 539 (1)The employees of an adult family-care home must 540 complete the training required under s. 430.5025. 541 (2)An adult family-care home licensed under this part 542 which claims that it provides special care for persons who have 543 Alzheimers disease or other related disorders must disclose in 544 its advertisements or in a separate document those services that 545 distinguish the care as being especially applicable to, or 546 suitable for, such persons. The home must give a copy of all 547 such advertisements or a copy of the document to each person who 548 requests information about programs and services for persons 549 with Alzheimers disease or other related disorders offered by 550 the home and must maintain a copy of all such advertisements and 551 documents in its records. The agency shall examine all such 552 advertisements and documents in the homes records as part of 553 the license renewal procedure. 554 Section 10.Subsection (1) of section 429.917, Florida 555 Statutes, is amended to read: 556 429.917Patients with Alzheimers disease or other related 557 disorders; staff training requirements; certain disclosures. 558 (1)The employees of an adult day care center licensed 559 under this part must complete the training required under s. 560 430.5025 provide the following staff training: 561 (a)Upon beginning employment with the facility, each 562 employee must receive basic written information about 563 interacting with participants who have Alzheimers disease or 564 dementia-related disorders. 565 (b)In addition to the information provided under paragraph 566 (a), newly hired adult day care center personnel who are 567 expected to, or whose responsibilities require them to, have 568 direct contact with participants who have Alzheimers disease or 569 dementia-related disorders must complete initial training of at 570 least 1 hour within the first 3 months after beginning 571 employment. The training must include an overview of dementias 572 and must provide instruction in basic skills for communicating 573 with persons who have dementia. 574 (c)In addition to the requirements of paragraphs (a) and 575 (b), an employee who will be providing direct care to a 576 participant who has Alzheimers disease or a dementia-related 577 disorder must complete an additional 3 hours of training within 578 9 months after beginning employment. This training must include, 579 but is not limited to, the management of problem behaviors, 580 information about promoting the participants independence in 581 activities of daily living, and instruction in skills for 582 working with families and caregivers. 583 (d)For certified nursing assistants, the required 4 hours 584 of training shall be part of the total hours of training 585 required annually. 586 (e)For a health care practitioner as defined in s. 587 456.001, continuing education hours taken as required by that 588 practitioners licensing board shall be counted toward the total 589 of 4 hours. 590 (f)For an employee who is a licensed health care 591 practitioner as defined in s. 456.001, training that is 592 sanctioned by that practitioners licensing board shall be 593 considered to be approved by the Department of Elderly Affairs. 594 (g)The Department of Elderly Affairs or its designee must 595 approve the 1-hour and 3-hour training provided to employees and 596 direct caregivers under this section. The department must 597 consider for approval training offered in a variety of formats. 598 The department shall keep a list of current providers who are 599 approved to provide the 1-hour and 3-hour training. The 600 department shall adopt rules to establish standards for the 601 employees who are subject to this training, for the trainers, 602 and for the training required in this section. 603 (h)Upon completing any training described in this section, 604 the employee or direct caregiver shall be issued a certificate 605 that includes the name of the training provider, the topic 606 covered, and the date and signature of the training provider. 607 The certificate is evidence of completion of training in the 608 identified topic, and the employee or direct caregiver is not 609 required to repeat training in that topic if the employee or 610 direct caregiver changes employment to a different adult day 611 care center or to an assisted living facility, nursing home, 612 home health agency, or hospice. The direct caregiver must comply 613 with other applicable continuing education requirements. 614 (i)An employee who is hired on or after July 1, 2004, must 615 complete the training required by this section. 616 Section 11.Subsection (6) of section 429.918, Florida 617 Statutes, is amended to read: 618 429.918Licensure designation as a specialized Alzheimers 619 services adult day care center; training. 620 (6)(a)An adult day care center having a license designated 621 under this section must provide the following staff training and 622 supervision: 623 (a)1.A registered nurse or licensed practical nurse must 624 be on site daily for at least 75 percent of the time that the 625 center is open to ADRD participants. Each licensed practical 626 nurse who works at the center must be supervised in accordance 627 with chapter 464. 628 (b)Each employee must complete the training and continuing 629 education required under s. 430.5025. 630 2.Upon beginning employment with the center, each employee 631 must receive and review basic written information about 632 interacting with ADRD participants. 633 3.In addition to the information provided in subparagraph 634 2., every employee hired on or after July 1, 2012, who has 635 direct contact with ADRD participants shall complete 4 hours of 636 dementia-specific training within 3 months after employment. 637 4.In addition to the requirements of subparagraphs 2. and 638 3., each employee hired on or after July 1, 2012, who provides 639 direct care to ADRD participants shall complete an additional 4 640 hours of dementia-specific training within 6 months after 641 employment. 642 (b)The Department of Elderly Affairs or its designee shall 643 approve the training required under this section. The department 644 shall adopt rules to establish standards for employees who are 645 subject to this training, for trainers, and for the training 646 required in this section. 647 (c)Upon completing any training described in this section, 648 the employee shall be issued a certificate that includes the 649 name of the training provider, the topics covered, and the date 650 and signature of the training provider. The certificate is 651 evidence of completion of training in the identified topics, and 652 the employee is not required to repeat training in those topics 653 if the employee changes employment to a different adult day care 654 center. 655 (c)(d)Each employee hired on or after July 1, 2012, who 656 provides direct care to ADRD participants, must receive and 657 review an orientation plan that includes, at a minimum: 658 1.Procedures to locate an ADRD participant who has 659 wandered from the center. These procedures must shall be 660 reviewed regularly with all direct care staff. 661 2.Information on the Silver Alert program in this state. 662 3.Information regarding available products or programs 663 used to identify ADRD participants or prevent them from 664 wandering away from the center, their home, or other locations. 665 Section 12.This act shall take effect July 1, 2023.