Florida Senate - 2023 SB 1444 By Senator Garcia 36-01011B-23 20231444__ 1 A bill to be entitled 2 An act relating to the Agency for Persons with 3 Disabilities; amending s. 393.063, F.S.; revising and 4 defining terms; amending s. 393.0655, F.S.; revising 5 background screening requirements for certain direct 6 service providers; amending s. 393.067, F.S.; 7 requiring the licensure of adult day training 8 programs; conforming related application and licensure 9 provisions to changes made by the act; providing for 10 comprehensive emergency management plans of adult day 11 training programs; providing for inspections of adult 12 day training programs; requiring adult day training 13 programs to adhere to specified rights; conforming 14 provisions to changes made by the act; amending s. 15 393.0673, F.S.; revising provisions related to 16 disciplinary action against certain licensees to 17 include licensed adult day training programs; 18 providing that for purposes of disciplinary action for 19 certain violations, a licensee is ultimately 20 responsible for the care and supervision of clients in 21 its facility or participants of the program; providing 22 construction; revising grounds for denial of a 23 licensure application; defining the term good moral 24 character; authorizing the agency to immediately 25 suspend or revoke the license of adult day training 26 programs under certain circumstances; authorizing the 27 agency to impose an immediate moratorium on service 28 authorizations to licensed facilities and adult day 29 training programs under certain circumstances; 30 amending s. 393.0678, F.S.; conforming provisions to 31 changes made by the act; making a technical 32 correction; amending s. 393.135, F.S.; conforming 33 provisions to changes made by the act; repealing s. 34 393.18, F.S., relating to comprehensive transitional 35 education programs; amending s. 394.875, F.S.; 36 conforming a provision to changes made by the act; 37 amending ss. 383.141, 400.063, and 1002.394, F.S.; 38 conforming cross-references; providing an effective 39 date. 40 41 Be It Enacted by the Legislature of the State of Florida: 42 43 Section 1.Subsections (1) and (10) of section 393.063, 44 Florida Statutes, are amended, and a new subsection (25) is 45 added to that section, to read: 46 393.063Definitions.For the purposes of this chapter, the 47 term: 48 (1)Adult day training means a program of training 49 services which takes that take place in a nonresidential 50 setting, separate from the home or facility in which the client 51 resides, and is are intended to support the participation of 52 clients in daily, meaningful, and valued routines of the 53 community. These services include, but are not limited to, the 54 acquisition, retention, or improvement of self-help, 55 socialization, and adaptive skills Such training may be provided 56 in work-like settings that do not meet the definition of 57 supported employment. 58 (10)Comprehensive transitional education program means 59 the program established in s. 393.18. 60 (25)Licensee means an individual, a corporation, a 61 partnership, a firm, an association, a governmental entity, or 62 other entity that is issued a permit, registration, certificate, 63 or license by the agency. The licensee is legally responsible 64 for all aspects of the provider operation. 65 Section 2.Subsection (1) of section 393.0655, Florida 66 Statutes, is amended to read: 67 393.0655Screening of direct service providers. 68 (1)MINIMUM STANDARDS.The agency shall require level 2 69 employment screening pursuant to chapter 435 for direct service 70 providers who are unrelated to their clients, including support 71 coordinators, and managers and supervisors of residential 72 facilities or adult day training comprehensive transitional 73 education programs licensed under this chapter and any other 74 person, including volunteers, who provide care or services, who 75 have access to a clients living areas, or who have access to a 76 clients funds or personal property. Background screening must 77 shall include employment history checks as provided in s. 78 435.03(1) and local criminal records checks through local law 79 enforcement agencies. 80 (a)A volunteer who assists on an intermittent basis for 81 less than 10 hours per month does not have to be screened if a 82 person who meets the screening requirement of this section is 83 always present and has the volunteer within his or her line of 84 sight. 85 (b)Licensed physicians, nurses, or other professionals 86 licensed and regulated by the Department of Health are not 87 subject to background screening pursuant to this section if they 88 are providing a service that is within their scope of licensed 89 practice. 90 (c)A person selected by the family or the individual with 91 developmental disabilities and paid by the family or the 92 individual to provide supports or services is not required to 93 have a background screening under this section. 94 (d)Persons 12 years of age or older, including family 95 members, residing with a direct services provider who provides 96 services to clients in his or her own place of residence are 97 subject to background screening; however, such persons who are 98 12 to 18 years of age shall be screened for delinquency records 99 only. 100 Section 3.Section 393.067, Florida Statutes, is amended to 101 read: 102 393.067Facility licensure. 103 (1)The agency shall provide through its licensing 104 authority and by rule license application procedures, provider 105 qualifications, facility and client care standards, requirements 106 for client records, requirements for staff qualifications and 107 training, and requirements for monitoring foster care 108 facilities, group home facilities, residential habilitation 109 centers, and adult day training comprehensive transitional 110 education programs that serve agency clients. 111 (2)The agency shall conduct annual inspections and reviews 112 of facilities and adult day training programs licensed under 113 this section. 114 (3)An application for a license under this section must be 115 made to the agency on a form furnished by it and shall be 116 accompanied by the appropriate license fee. 117 (4)The application shall be under oath and shall contain 118 the following: 119 (a)The name and address of the applicant, if an applicant 120 is an individual; if the applicant is a firm, partnership, or 121 association, the name and address of each member thereof; if the 122 applicant is a corporation, its name and address and the name 123 and address of each director and each officer thereof; and the 124 name by which the facility or program is to be known. 125 (b)The location of the facility or adult day training 126 program for which a license is sought. 127 (c)The name of the person or persons under whose 128 management or supervision the facility or adult day training 129 program will be conducted. 130 (d)The number and type of residents or clients for which 131 maintenance, care, education, or treatment is to be provided by 132 the facility or adult day training program. 133 (e)The number and location of the component centers or 134 units which will compose the comprehensive transitional 135 education program. 136 (f)A description of the types of services and treatment to 137 be provided by the facility or adult day training program. 138 (f)(g)Information relating to the number, experience, and 139 training of the employees of the facility or adult day training 140 program. 141 (g)(h)Certification that the staff of the facility or 142 adult day training program will receive training to detect, 143 report, and prevent sexual abuse, abuse, neglect, exploitation, 144 and abandonment, as defined in ss. 39.01 and 415.102, of 145 residents and clients. 146 (h)(i)Such other Information as the agency determines is 147 necessary to carry out the provisions of this chapter. 148 (5)As a prerequisite for issuance of an initial or renewal 149 license, the applicant, and any manager, supervisor, and staff 150 member of the direct service provider of a facility or adult day 151 training program licensed under this section, must have 152 submitted to background screening as required under s. 393.0655. 153 A license may not be issued or renewed if the applicant or any 154 manager, supervisor, or staff member of the direct service 155 provider has a disqualifying offense revealed by failed 156 background screenings as required under s. 393.0655. The agency 157 shall determine by rule the frequency of background screening. 158 The applicant shall submit with each initial or renewal 159 application a signed affidavit under penalty of perjury stating 160 that the applicant and any manager, supervisor, or staff member 161 of the direct service provider is in compliance with all 162 requirements for background screening. 163 (6)A facility or program The applicant shall furnish 164 satisfactory proof of financial ability to operate and conduct 165 the facility or program in accordance with the requirements of 166 this chapter and adopted rules. 167 (7)The agency shall adopt rules establishing minimum 168 standards for facilities and adult day training programs 169 licensed under this section, including rules requiring 170 facilities and adult day training programs to train staff to 171 detect, report, and prevent sexual abuse, abuse, neglect, 172 exploitation, and abandonment, as defined in ss. 39.01 and 173 415.102, of residents and clients, minimum standards of quality 174 and adequacy of client care, incident reporting requirements, 175 and uniform firesafety standards established by the State Fire 176 Marshal which are appropriate to the size of the facility or 177 adult day training of the component centers or units of the 178 program. 179 (8)The agency, after consultation with the Division of 180 Emergency Management, shall adopt rules for foster care 181 facilities, group home facilities, and residential habilitation 182 centers, and adult day training programs which establish minimum 183 standards for the preparation and annual update of a 184 comprehensive emergency management plan. At a minimum, the rules 185 must provide for plan components that address emergency 186 evacuation transportation; adequate sheltering arrangements; 187 postdisaster activities, including emergency power, food, and 188 water; postdisaster transportation; supplies; staffing; 189 emergency equipment; individual identification of residents and 190 transfer of records; and responding to family inquiries. The 191 comprehensive emergency management plan for all facilities and 192 adult day training comprehensive transitional education programs 193 and for homes serving individuals who have a complex medical 194 condition conditions is subject to review and approval by the 195 local emergency management agency. During its review, the local 196 emergency management agency shall ensure that the agency and the 197 Division of Emergency Management, at a minimum, are given the 198 opportunity to review the plan. Also, appropriate volunteer 199 organizations must be given the opportunity to review the plan. 200 The local emergency management agency shall complete its review 201 within 60 days and either approve the plan or advise the 202 facility or program of necessary revisions. 203 (9)The agency may conduct unannounced inspections to 204 determine compliance by foster care facilities, group home 205 facilities, residential habilitation centers, and adult day 206 training comprehensive transitional education programs with the 207 applicable provisions of this chapter and the rules adopted 208 pursuant hereto, including the rules adopted for training staff 209 of a facility or an adult day training a program to detect, 210 report, and prevent sexual abuse, abuse, neglect, exploitation, 211 and abandonment, as defined in ss. 39.01 and 415.102, of 212 residents and clients. The facility or adult day training 213 program shall make copies of inspection reports available to the 214 public upon request. 215 (10)Each facility or program licensed under this section 216 shall forward annually to the agency a true and accurate sworn 217 statement of its costs of providing care to clients funded by 218 the agency. 219 (11)The agency may audit the records of any facility or 220 program that it has reason to believe may not be in full 221 compliance with the provisions of this section; provided that, 222 any financial audit of such facility or program is shall be 223 limited to the records of clients funded by the agency. 224 (12)The agency shall establish, for the purpose of control 225 of licensure costs, a uniform management information system and 226 a uniform reporting system with uniform definitions and 227 reporting categories. 228 (13)Facilities and adult day training programs licensed 229 under pursuant to this section shall adhere to all rights 230 specified in s. 393.13, including those enumerated in s. 231 393.13(4). 232 (14)The agency may not authorize funds or services to an 233 unlicensed facility or adult day training program that requires 234 a license under this section may not receive state funds. A 235 license for the operation of a facility or an adult day training 236 program may shall not be renewed if the licensee has any 237 outstanding fines assessed pursuant to this chapter wherein 238 final adjudication of such fines has been entered. 239 (15)The agency is not required to contract with facilities 240 or adult day training programs licensed under pursuant to this 241 chapter. 242 Section 4.Section 393.0673, Florida Statutes, is amended 243 to read: 244 393.0673Denial, suspension, or revocation of license; 245 moratorium on admissions; administrative fines; procedures. 246 (1)The following constitute grounds for which the agency 247 may take disciplinary action, including revoking or suspending 248 revoke or suspend a license and imposing or impose an 249 administrative fine, not to exceed $1,000 per violation per day, 250 if: 251 (a)The licensee has: 252 1.Falsely represented or omitted a material fact in its 253 license application submitted under s. 393.067; 254 2.Had prior action taken against it under the Medicaid or 255 Medicare program; or 256 3.Failed to comply with the applicable requirements of 257 this chapter or rules applicable to the licensee; or 258 (b)The Department of Children and Families has verified 259 that the licensee is responsible for the abuse, neglect, or 260 abandonment of a child or the abuse, neglect, or exploitation of 261 a vulnerable adult. 262 (2)For purposes of disciplinary action under this section 263 for verified findings of abuse, neglect, abandonment, or 264 exploitation of a child or vulnerable adult, the licensee is 265 responsible not only for administration of the facilities in 266 compliance with the standards set out by statute and 267 administrative rule, but is ultimately responsible for the care 268 and supervision of the clients in the facility or the 269 participants of the program. 270 (a)A licensee may not delegate to others the ultimate 271 responsibility for the safety of the clients in its care. 272 (b)A licensee is subject to disciplinary action for an 273 employees lapse in care or supervision of the clients at the 274 facility or the participants of the program in which a verified 275 finding of abuse, neglect, abandonment, or exploitation 276 occurred. 277 (c)Remedial action taken by the licensee does not affect 278 the agencys ability to impose disciplinary action for the 279 underlying violation. 280 (3)The agency may deny an application for licensure 281 submitted under s. 393.067 if: 282 (a)The applicant has: 283 1.Falsely represented or omitted a material fact in its 284 license application submitted under s. 393.067; 285 2.Had prior action taken against it under the Medicaid or 286 Medicare program; 287 3.Failed to comply with the applicable requirements of 288 this chapter or rules applicable to the applicant; or 289 4.Previously had a license to operate a residential 290 facility or adult day training program revoked by the agency, 291 the Department of Children and Families, or the Agency for 292 Health Care Administration; or 293 (b)The Department of Children and Families has verified 294 that the applicant is responsible for the abuse, neglect, or 295 abandonment of a child or the abuse, neglect, or exploitation of 296 a vulnerable adult; or 297 (c)The agency has determined that there is clear and 298 convincing evidence that the applicant is unqualified for a 299 license because of a lack of good moral character. For purposes 300 of this paragraph, the term good moral character means a 301 personal history of honesty, fairness, and respect for the 302 rights of others and for the laws of this state and the Federal 303 Government. 304 (4)(3)All hearings must shall be held within the county in 305 which the licensee or applicant operates or applies for a 306 license to operate a facility or adult day training program as 307 defined herein. 308 (5)(4)The agency, as a part of any final order issued by 309 it under this chapter, may impose such fine as it deems proper, 310 except that such fine may not exceed $1,000 for each violation. 311 Each day a violation of this chapter occurs constitutes a 312 separate violation and is subject to a separate fine, but in no 313 event may the aggregate amount of any fine exceed $10,000. Fines 314 paid by any facility licensee under the provisions of this 315 subsection shall be deposited in the Health Care Trust Fund and 316 expended as provided in s. 400.063. 317 (6)(5)The agency may issue an order immediately suspending 318 or revoking a license when it determines that any condition of 319 in the facility or adult day training program presents a danger 320 to the health, safety, or welfare of the residents in the 321 facility or the program participants. 322 (7)(6)The agency may impose an immediate moratorium on 323 admissions to any facility or service authorizations to a 324 facility or adult day training program when the agency 325 determines that any condition of in the facility or adult day 326 training program presents a threat to the health, safety, or 327 welfare of the residents in the facility or the program 328 participants. 329 (8)(7)The agency shall establish by rule criteria for 330 evaluating the severity of violations and for determining the 331 amount of fines imposed. 332 Section 5.Subsection (1) of section 393.0678, Florida 333 Statutes, is amended to read: 334 393.0678Receivership proceedings. 335 (1)The agency may petition a court of competent 336 jurisdiction for the appointment of a receiver for a 337 comprehensive transitional education program, a residential 338 habilitation center, or a group home facility owned and operated 339 by a corporation or partnership when any of the following 340 conditions exist: 341 (a)Any person is operating a facility without a license 342 and refuses to make application for a license as required by s. 343 393.067. 344 (b)The licensee is closing the facility or has informed 345 the agency department that it intends to close the facility; and 346 adequate arrangements have not been made for relocation of the 347 residents within 7 days, exclusive of weekends and holidays, of 348 the closing of the facility. 349 (c)The agency determines that conditions exist in the 350 facility which present an imminent danger to the health, safety, 351 or welfare of the residents of the facility or which present a 352 substantial probability that death or serious physical harm 353 would result therefrom. Whenever possible, the agency shall 354 facilitate the continued operation of the program. 355 (d)The licensee cannot meet its financial obligations to 356 provide food, shelter, care, and utilities. Evidence such as the 357 issuance of bad checks or the accumulation of delinquent bills 358 for such items as personnel salaries, food, drugs, or utilities 359 constitutes prima facie evidence that the ownership of the 360 facility lacks the financial ability to operate the home in 361 accordance with the requirements of this chapter and all rules 362 adopted promulgated thereunder. 363 Section 6.Subsection (2) of section 393.135, Florida 364 Statutes, is amended to read: 365 393.135Sexual misconduct prohibited; reporting required; 366 penalties. 367 (2)A covered person who engages in sexual misconduct with 368 an individual with a developmental disability who: 369 (a)Resides in a residential facility, including any 370 comprehensive transitional education program, developmental 371 disabilities center, foster care facility, group home facility, 372 intermediate care facility for the developmentally disabled, or 373 residential habilitation center; or 374 (b)Is eligible to receive services from the agency under 375 this chapter, 376 377 commits a felony of the second degree, punishable as provided in 378 s. 775.082, s. 775.083, or s. 775.084. A covered person may be 379 found guilty of violating this subsection without having 380 committed the crime of sexual battery. 381 Section 7.Section 393.18, Florida Statutes, is repealed. 382 Section 8.Paragraph (c) of subsection (3) of section 383 394.875, Florida Statutes, is amended to read: 384 394.875Crisis stabilization units, residential treatment 385 facilities, and residential treatment centers for children and 386 adolescents; authorized services; license required. 387 (3)The following are exempt from licensure as required in 388 ss. 394.455-394.903: 389 (c)Comprehensive transitional education programs licensed 390 under s. 393.067. 391 Section 9.Paragraph (b) of subsection (1) of section 392 383.141, Florida Statutes, is amended to read: 393 383.141Prenatally diagnosed conditions; patient to be 394 provided information; definitions; information clearinghouse; 395 advisory council. 396 (1)As used in this section, the term: 397 (b)Developmental disability includes Down syndrome and 398 other developmental disabilities defined by s. 393.063 s. 399 393.063(12). 400 Section 10.Subsection (1) of section 400.063, Florida 401 Statutes, is amended to read: 402 400.063Resident protection. 403 (1)The Health Care Trust Fund shall be used for the 404 purpose of collecting and disbursing funds generated from the 405 license fees and administrative fines as provided for in ss. 406 393.0673(5) ss. 393.0673(4), 400.062(3), 400.121(2), and 407 400.23(8). Such funds shall be for the sole purpose of paying 408 for the appropriate alternate placement, care, and treatment of 409 residents who are removed from a facility licensed under this 410 part or a facility specified in s. 393.0678(1) in which the 411 agency determines that existing conditions or practices 412 constitute an immediate danger to the health, safety, or 413 security of the residents. If the agency determines that it is 414 in the best interest of the health, safety, or security of the 415 residents to provide for an orderly removal of the residents 416 from the facility, the agency may utilize such funds to maintain 417 and care for the residents in the facility pending removal and 418 alternative placement. The maintenance and care of the residents 419 shall be under the direction and control of a receiver appointed 420 pursuant to s. 393.0678(1) or s. 400.126(1). However, funds may 421 be expended in an emergency upon a filing of a petition for a 422 receiver, upon the declaration of a state of local emergency 423 pursuant to s. 252.38(3)(a)5., or upon a duly authorized local 424 order of evacuation of a facility by emergency personnel to 425 protect the health and safety of the residents. 426 Section 11.Paragraph (d) of subsection (2) of section 427 1002.394, Florida Statutes, is amended to read: 428 1002.394The Family Empowerment Scholarship Program. 429 (2)DEFINITIONS.As used in this section, the term: 430 (d)Disability means, for a 3- or 4-year-old child or for 431 a student in kindergarten to grade 12, autism spectrum disorder, 432 as defined in the Diagnostic and Statistical Manual of Mental 433 Disorders, Fifth Edition, published by the American Psychiatric 434 Association; cerebral palsy, as defined in s. 393.063; Down 435 syndrome, as defined in s. 393.063; an intellectual disability, 436 as defined in s. 393.063; a speech impairment; a language 437 impairment; an orthopedic impairment; any an other health 438 impairment; an emotional or a behavioral disability; a specific 439 learning disability, including, but not limited to, dyslexia, 440 dyscalculia, or developmental aphasia; Phelan-McDermid syndrome, 441 as defined in s. 393.063; Prader-Willi syndrome, as defined in 442 s. 393.063; spina bifida, as defined in s. 393.063; being a 443 high-risk child, as defined in s. 393.063(22)(a) s. 444 393.063(23)(a); muscular dystrophy; Williams syndrome; rare 445 diseases which affect patient populations of fewer than 200,000 446 individuals in the United States, as defined by the National 447 Organization for Rare Disorders; anaphylaxis; a hearing 448 impairment, including deafness; a visual impairment, including 449 blindness; traumatic brain injury; hospital or homebound; or 450 identification as dual sensory impaired, as defined by rules of 451 the State Board of Education and evidenced by reports from local 452 school districts. The term hospital or homebound includes a 453 student who has a medically diagnosed physical or psychiatric 454 condition or illness, as defined by the state board in rule, and 455 who is confined to the home or hospital for more than 6 months. 456 Section 12.This act shall take effect October 1, 2024.