Florida 2023 2023 Regular Session

Florida Senate Bill S1444 Analysis / Analysis

Filed 03/27/2023

                    The Florida Senate 
BILL ANALYSIS AND FISCAL IMPACT STATEMENT 
(This document is based on the provisions contained in the legislation as of the latest date listed below.) 
Prepared By: The Professional Staff of the Committee on Children, Families, and Elder Affairs  
 
BILL: SB 1444 
INTRODUCER:  Senator Garcia 
SUBJECT:  Agency for Persons with Disabilities 
DATE: March 24, 2023 
 
 ANALYST STAFF DIRECTOR  REFERENCE  	ACTION 
1. 
Delia 
 
Cox 
 
CF 
  
Favorable 
2.     FP  
 
I. Summary: 
SB 1444 requires adult day training (ADT) programs serving individuals with developmental 
disabilities to be licensed by the Agency for Persons with Disabilities (the APD). The bill also 
prohibits the licensure of comprehensive transitional educational programs (CTEPs) in Florida. 
 
Specifically, the bill makes the following changes: 
 Clarifies the definitions of “adult day training”;  
 Adds a definition for “licensee,” which is the same definition as used in s. 408.803(9), F.S., 
relating to health care licensing by the Agency for Health Care Administration (the AHCA) 
and the same, in part, as used in s. 400.023(2)(a), F.S., relating to nursing homes;  
 Requiresthe licensing and regulation of ADT programs by the APD;  
 Allows the APD to deny licenses for residential facilities and ADT programs when there is 
evidence that the applicant is unqualified due to lack of good moral character; 
 Allows the APD to take disciplinary actions due to the noncompliance of ADT programs; 
 Clarifies the circumstances for which the APD can take disciplinary action related to verified 
findings of abuse, neglect, or abandonment of a child or vulnerable adult being served by an 
APD licensed facility or ADT program;  
 Removes obsolete language regarding CTEPs that no longer operate within the state; 
 Requires APD-licensed facilities and ADT programs to allow local emergency management 
agencies to examine the approved emergency management plans and review and approve 
plans for facilities and programs serving individuals with a complex medical condition; and 
 Clarifies language that the APD must not authorize funds or services to an unlicensed facility 
or ADT program that requires a license.  
 
The bill is expected to have a fiscal impact on state government and will likely have a 
significant, but indeterminate impact on existing ADT programs. See Section V. Fiscal Impact 
Statement. 
REVISED:   BILL: SB 1444   	Page 2 
 
 
 The bill is effective October 1, 2024. 
II. Present Situation: 
Agency for Persons with Disabilities 
The APD is responsible for the provision of services to individuals with developmental 
disabilities and for administering the Home and Community-Based Services (HCBS) Waiver.
1
 
Florida has procured waivers of federal Medicaid requirements for the purpose of providing 
home and community-based services to individuals at risk of institutionalization.
2
 The HCBS 
Waiver provides services to individuals with developmental disabilities that allow them to 
continue to live in their home or home-like setting and avoid institutionalization.
3
 Eligible 
individuals must meet institutional level of care requirements.
4
 The overarching goal for the 
APD is to prevent or reduce the severity of a developmental disability and implement 
community-based services that will help individuals with developmental disabilities achieve their 
greatest potential for independent and productive living in the least restrictive means.
5
 
 
Regional Offices 
In addition to central headquarters in Tallahassee, the APD operates a total of six regional offices 
and 14 field offices throughout the state, as detailed below:
6
 
 
Region 	Counties 
Northwest Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, 
Leon, Liberty, Okaloosa, Santa Rosa, Wakulla, Walton, and Washington 
 
Fields 1 and 2. 
Northeast Alachua, Baker, Bradford, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, 
Hamilton, Lafayette, Levy, Madison, Nassau, Putnam, St. Johns, Suwannee, 
Taylor, Union, and Volusia 
 
Fields 3, 4, and 12. 
Central Brevard, Citrus, Hardee, Hernando, Highlands, Lake, Marion, Orange, Osceola, 
Polk, Seminole, and Sumter 
 
Fields 7, 13, and 14. 
Suncoast Charlotte, Collier, DeSoto, Glades, Hendry, Hillsborough, Lee, Manatee, Pasco, 
Pinellas, and Sarasota  
 
                                                
1
 See Section 20.197(3), F.S.  
2
 Rule 59G-13.080(1), F.A.C. 
3
 The Centers for Medicare and Medicaid Services, Home and Community-Based Services 1915(c), available at 
https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/home-
community-based-services-1915c/index.html (last visited March 21, 2023).  
4
 Id.; Rule 59G-13.080(1), F.A.C. 
5
 See s. 393.062, F.S. 
6
 The APD, Regional Offices, available at https://apd.myflorida.com/region/ (last visited March 21, 2023).  BILL: SB 1444   	Page 3 
 
Suncoast Field and Field 8. 
Southeast Broward, Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie 
 
Fields 9 and 10. 
Southern 	Miami-Dade and Monroe 
 
Field 11. 
 
 
 
iBudget Florida Program 
The APD administers Florida’s individual budget-based HCBS Waiver, known as iBudget 
Florida, for individuals with specified developmental disabilities who meet Medicaid eligibility 
requirements. These individuals may choose to receive services in the community through 
iBudget Florida. Alternatively, they may choose to live in an institutional setting known as an 
Intermediate Care Facility for the Developmentally Disabled (ICF/DD)
7
 through traditional 
Medicaid administered by the Agency for Health Care Administration (AHCA).
8
  
 
                                                
7
 Section 393.063(25), F.S., defines “intermediate care facility for the developmentally disabled” to mean a residential facility 
licensed and certified under part VIII of chapter 400, F.S. 
8
 Section 393.0662, F.S.  BILL: SB 1444   	Page 4 
 
The APD initiated implementation of iBudget Florida on May 1, 2011 with the final areas 
transitioned from the previous tiered waiver system on July 1, 2013.
9
 The iBudget Florida 
program uses an algorithm, or formula, to set individuals’ funding allocations for waiver 
services.
10
 The APD administers iBudget Florida pursuant to s. 393.0662, F.S.  
 
The APD serves just over 34,900 individuals through iBudget Florida, contracting with service 
providers to offer 27 supports and services to assist individuals to live in their community.
11
 
Examples of waiver services enabling children and adults to live, learn, and work in their 
communities include residential habilitation, behavioral services, personal supports, adult day 
training, employment services, and occupational and physical therapy.
12
  
 
Licensure of Facilities by the APD 
Pursuant to s. 393.067, F.S., the APD is charged with licensing community-based residential 
facilities that serve and assist individuals with developmental disabilities; these include foster 
care facilities, group home facilities, residential habilitation centers, and Comprehensive 
Transitional Education Program (CTEPs).  
 
The APD currently licenses over 2,100 residential facilities statewide but does not license ADT 
programs.
13
 Through iBudget Florida, there are over 13,700 clients with ADT services on their 
cost plans.
14
 There are also additional participants in ADT programs through Intermediate Care 
Facilities for the Developmentally Disabled (ICF/DDs) and private pay arrangements.
15
 
 
The APD is required to conduct annual inspections and reviews of facilities and programs 
licensed under s. 393.067.
16
 Applications for licensure must be made to the APD on a form 
furnished by it and must be accompanied by the appropriate license fee.
17
 All applications for 
licensure must contain the following: 
 The name and address of the applicant, if an applicant is an individual; if the applicant is a 
firm, partnership, or association, the name and address of each member thereof; if the 
applicant is a corporation, its name and address and the name and address of each director 
and each officer thereof; and the name by which the facility or program is to be known; 
 The location of the facility or program for which a license is sought; 
 The name of the person or persons under whose management or supervision the facility or 
program will be conducted; 
 The number and type of residents or clients for which maintenance, care, education, or 
treatment is to be provided by the facility or program; 
                                                
9
 The APD, Quarterly Report on Agency Services to Floridians with Developmental Disabilities and Their Costs: First 
Quarter Fiscal Year 2022-23, p. 2, November 15, 2022 (on file with the Senate Committee on Children, Families, and Elder 
Affairs) (hereinafter cited as “The Quarterly Report”). 
10
 Id. 
11
 Id. 
12
 Id. 
13
 The APD, Agency Analysis of SB 1444 at p. 2. (On file with the Senate Committee on Children, Families, and Elder 
Affairs). 
14
 Id. 
15
 Id. 
16
 Section 393.067(2), F.S. 
17
 Section 393.067(3), F.S.  BILL: SB 1444   	Page 5 
 
 The number and location of the component centers or units which will compose the 
comprehensive transitional education program; 
 A description of the types of services and treatment to be provided by the facility or program. 
 Information relating to the number, experience, and training of the employees of the facility 
or program; 
 Certification that the staff of the facility or program will receive training to detect, report, and 
prevent sexual abuse, abuse, neglect, exploitation, and abandonment, as defined in ss. 39.01 
and 415.102, F.S., of residents and clients; and 
 Such other information as the APD determines is necessary to carry out the provisions of ch. 
393, F.S.
18
 
 
As a prerequisite for issuance of an initial or renewal license, the applicant, and any manager, 
supervisor, and staff member of a direct service provider of a licensed facility or program, must 
have submitted to Level 2 background screening as required under s. 393.0655, F.S., and a 
license may not be issued or renewed if the applicant or any manager, supervisor, or staff 
member of the direct service provider has failed background screenings.
19
 The APD is required 
to determine by rule the frequency of background screening.
20
 Applicants must submit with each 
initial or renewal application a signed affidavit under penalty of perjury stating that the applicant 
and any manager, supervisor, or staff member of the direct service provider is in compliance 
with all requirements for background screening.
21
  
 
Applicants are required to furnish satisfactory proof of the financial ability to operate and 
conduct a facility or program in accordance with the requirements of ch. 393, F.S., and agency 
rules.
22
 APD rules
23
 must establish minimum standards for licensed facilities and programs 
including rules requiring facilities and programs to train staff to detect, report, and prevent sexual 
abuse, abuse, neglect, exploitation, and abandonment, as defined in ss. 39.01 and 415.102, F.S., 
respectively, of residents and clients, minimum standards of quality and adequacy of client care, 
incident reporting requirements, and uniform fire safety standards established by the State Fire 
Marshal which are appropriate to the size of the facility or of the component centers or units of 
the program.
24
 
 
After consultation with the Division of Emergency Management (DEM), the APD is also 
required to adopt rules for foster care facilities, group home facilities, and residential habilitation 
centers which establish minimum standards for the preparation and annual update of a 
comprehensive emergency management plan.
25
 At a minimum, the rules must provide for plan 
components that address:  
 Emergency evacuation transportation;  
 Adequate sheltering arrangements;  
 Post-disaster activities, including emergency power, food, and water;  
                                                
18
 Section 393.067(4), F.S. 
19
 Section 393.067(5), F.S. 
20
 Id. 
21
 Id. 
22
 Section 393.067(6), F.S. 
23
 Rules governing health and safety requirements for APD-licensed facilities can be found in Rule 65G-2, F.A.C. 
24
 Section 393.067(7), F.S. 
25
 Section 393.067(8), F.S.  BILL: SB 1444   	Page 6 
 
 Post-disaster transportation;  
 Supplies;  
 Staffing;  
 Emergency equipment;  
 Individual identification of residents and transfer of records; and  
 Responding to family inquiries.
26
  
 
The comprehensive emergency management plan for all CTEPs and for homes serving 
individuals who have complex medical conditions is subject to review and approval by the local 
emergency management agency.
27
 During its review, the local emergency management agency 
shall ensure that the agency and the DEM, at a minimum, are given the opportunity to review the 
plan.
28
 Appropriate volunteer organizations must be given the opportunity to review the plan.
29
 
The local emergency management agency shall complete its review within 60 days and either 
approve the plan or advise the facility of necessary revisions.
30
 
 
The APD may also conduct unannounced inspections to determine compliance by foster care 
facilities, group home facilities, residential habilitation centers, and CTEPs with the applicable 
provisions of ch. 393, F.S., and the associated rules, including the rules adopted for training staff 
of a facility or a program to detect, report, and prevent sexual abuse, abuse, neglect, exploitation, 
and abandonment, as defined in ss. 39.01 and 415.102, of residents and clients.
31
 The facility or 
program must make copies of inspection reports available to the public upon request.
32
 All 
facilities and programs licensed by the APD must also adhere to all provisions of the Bill of 
Rights of Persons with Disabilities, delineated in ch. 393.13, F.S.
33
 
 
Adult Day Training Programs 
Section 393.063, F.S. defines “adult day training” (ADT) to mean training services that take 
place in a nonresidential setting, separate from the home or facility in which the client resides, 
and are intended to support the participation of clients in daily, meaningful, and valued routines 
of the community. ADT may be provided in work-like settings that do not meet the definition of 
supported employment.
34
  
 
ADT services are training services intended to support the participation of recipients in valued 
routines of the community, including volunteering, job exploration, accessing community 
resources, and self-advocacy, in settings that are age and culturally appropriate.
35
 Adult day 
                                                
26
 Id. 
27
 Id. 
28
 Id. 
29
 Id. 
30
 Id. 
31
 Section 393.067(9), F.S. 
32
 Id. 
33
 Section 393.067(13), F.S. 
34
 “Supported employment” is defined as “employment located or provided in an integrated work setting, with earnings paid 
on a commensurate wage basis, and for which continued support is needed for job maintenance.” Section 393.063(43), F.S. 
35
 The Agency for Health Care Administration (the AHCA), Developmental Disabilities Individual Budgeting Waiver 
Services Coverage and Limitations Handbook at p. 2-20. September 2021, available at  BILL: SB 1444   	Page 7 
 
training services can include meaningful day activities and training in the activities of daily 
living, adaptive skills, social skills, and employment.
36
 The training, activities, and routine 
established by the ADT must be meaningful to the recipient and provide an appropriate level of 
variation and interest.
37
 
 
ADT services generally begin at age 22 when a recipient is out of the public school system or 
when they have graduated from the public school system.
38
 Recipients who are age 22 years or 
older who have not graduated are also eligible.
39
 Providers of ADT services must be designated 
by the APD regional office as ADT providers.
40
 The service expectation for ADT services is to 
achieve individually determined goals and support recipient participation in less restrictive 
settings.
41
 ADT must be provided in accordance with a formal implementation plan, developed 
under the direction of the recipient, reflecting goals from the recipient’s current support plan.
42
 
 
 
The APD checks to see if those ADT programs that provide iBudget Waiver services meet the 
minimum education, experience, and background screening requirements to offer services at the 
time of the provider enrollment process.
43
 This process currently does not include review of 
client care standards, site of services, operator(s), program(s), or ongoing monitoring.
44
 
 
ADT program providers operate through the iBudget Waiver via a contract with the APD called 
a Medicaid Waiver Services Agreement (MWSA).
 45
 However, current regulations and the 
current MWSA used by the APD does not provide the agency with a mechanism to ensure that 
the physical facility where clients receive ADT services is adequate to meet the health and safety 
needs of its clients.
46
 
 
Some ADT programs are not enrolled iBudget Waiver providers, and these settings are 
reimbursed via private pay arrangements with clients and their families. The absence of the 
provider having either a license or contract with APDeffectively prevents the APD from 
initiating any type of disciplinary action against such programs in response to health and safety 
issues.
47
 
 
                                                
https://apd.myflorida.com/ibudget/docs/September%202021%2059G-13.070_DD_iBudget_Waiver_Services.pdf (last visited 
March 21, 2023) (hereinafter cited as, “The iBudget Handbook”). 
36
 Id. 
37
 Id. 
38
 Id. 
39
 Id. 
40
 Id. 
41
 Id. 
42
 Id. 
43
 Id. 
44
 Id. 
45
 See The APD, Medicaid Waiver Services Agreement, available at https://apd.myflorida.com/forms/medicaid-waiver-
services-agreement.doc (last visited March 21, 2023). 
46
 The APD Analysis at p. 2. 
47
 The APD Analysis at p. 3.  BILL: SB 1444   	Page 8 
 
The APD has the ability to levy administrative fines, sanctions, and moratoriums for residential 
facilities licensed by the agency,
48
 but there is no comparable statutory authority related to ADT 
facilities. 
 
The APD can revoke an ADT providers MWSA; however, the APD does not have a mechanism 
to sanction an ADT for not meeting specific health and safety-related standards of care.
49
 
Terminating a MWSA impacts all programs, such as group homes, operated by those same 
providers, as opposed to addressing and correcting issues solely pertaining to the ADTs operated 
by those providers.
50
 
 
Verified Findings of Abuse, Neglect, Exploitation, or Sexual Misconduct 
The APD is required to conduct a termination review of an ADT provider’s MWSA following 
incidents of abuse, neglect, exploitation, or sexual misconduct against a recipient of services, in 
addition to any other legal sanctions available.
51
 The failure of a provider to report any incident 
of abuse, neglect, exploitation, or sexual misconduct on behalf of the recipient will also result in 
the termination review of the provider's MWSA.
52
 Abuse, neglect, exploitation, or sexual 
misconduct related to the recipient by an employee of a provider or an employee’s failure to 
report an incident of abuse, neglect, exploitation, or sexual misconduct can be imputed to the 
provider and will result in termination review of the provider’s MWSA.
53
 
 
The APD conducted an analysis of incident data and abuse, neglect, or exploitation data and 
discovered a significant number of issues adversely impacting the health and safety of APD 
clients related to ADT services.
54
 During the last 4 years, there have been 125 instances where 
the Department of Children and Families (the DCF) conducted protective services investigations 
for abuse, neglect, or exploitation related to ADT services with 34 instances of verified 
findings.
55
 Additionally, APD received 2,807 incident reports related to ADT services.
56
 
 
The APD reviewed prior incident reports occurring in ADT facilities in order to mitigate similar 
future incidents.
57
 The APD found that some incidents occurred as a result of environmental 
hazards not addressed through current waiver standards for ADT services.
58
 Additionally, the 
agency believes that increased enforcement of appropriate staffing ratios could reduce some 
incidents, such as elopements and client injuries.
59
 Required training could also assist ADTs in 
proper use of medical equipment and the implementation of behavioral interventions.
60
 The APD 
                                                
48
 See s. 393.0673, F.S. 
49
  
50
 Id. 
51
 The iBudget Handbook at p. 1-10.  
52
 Id. 
53
 Id. 
54
 The APD Analysis at p. 3. 
55
 Id. 
56
 Id. 
57
 Id. 
58
 Id. 
59
 Id. 
60
 Id.  BILL: SB 1444   	Page 9 
 
believes that establishing facility licensure standards and enforcement authority could prevent, or 
reduce the prevalence of, such incidents in the future.
61
 
 
Comprehensive Transitional Education Programs 
A CTEP is a group of jointly operating centers or units that provide a sequential series of 
educational care, training, treatment, habilitation, and rehabilitation services to persons who have 
developmental disabilities and who have severe or moderate maladaptive behaviors.
62
 The 
Legislature created the CTEP license in 2006 to serve individuals primarily, though not limited 
to those with developmental disabilities, who have severe or moderate maladaptive behaviors.
63
 
The services provided by the CTEP were proscribed as “temporary in nature and delivered in a 
structured residential setting, having the primary goal of incorporating the principle of self-
determination in establishing permanent residence for persons with maladaptive behaviors in 
facilities that are not associated with the comprehensive transitional education program.”
64
 
 
Carlton Palms, run by Bellwether Behavioral Health, was the only licensed CTEP in Florida.
65
 
The facility closed in 2018 following the death of a resident and numerous documented cases of 
abuse and neglect over the course of several years.
66
 All 200 residents of Carlton Palms were 
moved to smaller community settings.  
 
However, s. 393.18, F.S., still authorizes the CTEP license.
67
 CTEPs provide treatment in large-
scale residential settings but federal law prohibits the provision of iBudget Waiver services in 
such environments.
68
 Because the majority of the APD’s clients are receiving services through 
the iBudget Waiver, the agency states that it is focused on offering community-based services in 
smaller and more family-like settings and does not anticipate licensing new CTEPs.
69
 
III. Effect of Proposed Changes: 
ADT Licensure Requirements 
The bill clarifies that ADT services specifically include, but are not limited to, the acquisition, 
retention, or improvement of self-help, socialization, and adaptive kills. The bill eliminates a 
provision allowing ADT to be provided in work like settings that do not meet the definition of 
supported employment. 
 
                                                
61
 Id. 
62
 Section 393.18, F.S. 
63
 Ch, 2006-227, L.O.F.; Disability Rights Florida, Monitoring and Investigation of Carlton Palms Educational Center, 
Results and Recommendations March 2018 at p. 3., available at 
https://disabilityrightsflorida.org/documents/Carlton_Palms_Report_3-5-18.pdf (last visited March 21, 2023) (hereinafter 
cited as, “The DRF Report”). 
64
 The DRF Report at p. 3. 
65
 Id. at p. 1. 
66
 The Daily Commercial, Troubled Cartlon Palms Home for the Disabled to Close, May 11, 2018, available at 
https://www.dailycommercial.com/story/news/local/mount-dora/2018/05/11/troubled-carlton-palms-home-for-disabled-to-
close/12261119007/ (last visited March 21, 2023). 
67
 The APD Analysis at p. 3. 
68
 Id. 
69
 Id.  BILL: SB 1444   	Page 10 
 
The bill adds a definition of “licensee” to that section. Specifically, the bill defines “licensee” to 
mean “an individual, a corporation, a partnership, a firm, an association, a governmental entity, 
or other entity that is issued a permit, registration, certificate, or license by the agency. The 
licensee is legally responsible for all aspects of the provider operation.” This is the same 
definition of “licensee” used in s. 408.803(9), F.S., relating to health care licensing by the 
Agency for Health Care Administration (the AHCA) and the same, in part, as used in s. 
400.023(2)(a), F.S., relating to nursing homes. 
 
The bill requires all direct service providers employed by ADT programs to undergo a level 2 
background screening. The bill also requires applicants, managers, supervisors, and staff 
members of direct service providers employed by ADT programs to undergo level 2 background 
screenings. 
 
The bill applies the facility licensure requirements currently in place for foster care facilities, 
group home facilities, and residential habilitation facilities to ADT programs. The bill also 
requires the APD to conduct annual inspections and reviews of ADT programs licensed under 
the bill. 
 
The bill implements many of the same application requirements for other facilities licensed by 
the APD to applications for licensure as ADT programs. Specifically, an application for licensure 
as an ADT program must include: 
 The location of the ADT program for which a license is sought; 
 The name of the person or persons under whose management or supervision the ADT 
program will be conducted; 
 The number and type of residents or clients for which maintenance, care, education or 
treatment is to be provided by the ADT program; 
 A description of the type of services and treatment to be provided by the facility or ADT 
program; 
 Information relating to the number, experience, and training of the employees of the ADT 
program; 
 Certification that the staff of the ADT program will receive training to detect, report, and 
prevent sexual abuse, abuse, neglect, exploitation, and abandonment of residents and clients; 
and 
 Information the APD determines is necessary to carry out other statutory requirements 
delineated in s. 393.067, F.S. 
 
The bill requires applicants for licensure as ADT programs to furnish satisfactory proof of 
financial ability to operate and conduct the program in accordance with s. 393.067, F.S., and 
adopted rules. 
 
The bill requires the APD to adopt rules establishing minimum standards for ADT programs, 
including:  
 Rules requiring ADT programs to train staff to detect, report, and prevent sexual abuse, 
abuse, neglect, exploitation, and abandonment of residents and clients;  
 Minimum standards of quality and adequacy of client care;  
 Incident reporting requirements; and  BILL: SB 1444   	Page 11 
 
 Uniform fire safety standards established by the State Fire Marshal which are appropriate to 
the size of the ADT program. 
 
Under the bill, as with other facilities licensed by the agency, the APD must consult with the 
Division of Emergency Management and adopt rules for ADT programs which establish 
minimum standards for the preparation and annual update of a comprehensive emergency 
management plan. As with plans applicable to other APD-licensed facilities and providers, the 
plan is subject to review and approval by the local emergency management agency, and the local 
emergency management agency must complete its review within 60 days and either approve the 
plan or advise the ADT program of necessary revisions. 
 
The bill permits the APD to conduct unannounced inspections of ADT programs to determine 
compliance with the standards described above and throughout ch. 393.067, F.S., as well as 
applicable rules, specifically including the rules adopted to detect sexual abuse, abuse, neglect, 
exploitation, and abandonment of residents and clients. ADT programs are required to make 
copies of inspection reports available to the public upon request. 
 
The bill requires licensed ADT programs to adhere to all provisions of the Bill of Rights of 
Persons with Disabilities delineated in ch. 393.13, F.S. 
 
The bill prohibits the APD from authorizing funds or services to unlicensed ADT programs, and 
prohibits the APD from renewing a license for and ADT program if the licensee has any 
outstanding fines assessed wherein final adjudication of such fines has not been entered. 
 
The bill specifies that the APD is not required to contract with licensed ADT programs. 
 
The bill applies many of the same grounds for which the APD can take disciplinary action 
against a licensed facility to ADT programs licensed under the bill. Disciplinary action may 
include revoking or suspending a license and imposing an administrative fine not to exceed 
$1,000 per day. Grounds for discipline include instances where the licensee has: 
 Falsely represented or omitted a material fact in its license application submitted under s. 
393.067, F.S.;   
 Had prior action taken against it under the Medicaid or Medicare program; or  
 Failed to comply with the applicable requirements of ch. 393, F.S., or rules applicable to the 
licensee. 
 
The APD can also take disciplinary action when the DCF has verified that the licensee is 
responsible for the abuse, neglect, exploitation, of a vulnerable adult. 
 
The bill provides that for purposes of disciplinary action for verified findings of abuse, neglect, 
abandonment, or exploitation of a child or vulnerable adult, all APD licensees, including 
facilities already requiring licensure in current law and ADT programs newly requiring licensure 
under the bill, are responsible not only for administration of the facilities in compliance with the 
standards set out by statute and administrative rule, but for the care and supervision of the clients 
in the facility or the participants of the program.  
  BILL: SB 1444   	Page 12 
 
The bill specifies that a licensee may not delegate to others the ultimate responsibility for the 
safety of the clients in its care. Further, a licensee is subject to disciplinary action for an 
employee’s lapse in care or supervision of the clients at the facility or the participants of the 
program in which a verified finding of abuse, neglect, abandonment, or exploitation occurred. 
The bill requires that remedial action taken by the licensee not affect the APD’s ability to impose 
disciplinary action for the underlying violation. 
 
The bill also specifies that the APD may deny an application for licensure if:  
 An applicant has previously had a license to operate an ADT program revoked by the APD; 
 The DCF has verified that the applicant is responsible for the abuse, neglect, abandonment, 
or exploitation of a child or vulnerable adult; or 
 The APD has determined that there is clear and convincing evidence that the applicant is 
unqualified for a license because of a lack of good moral character. Under the bill, the term 
“good moral character” means “a personal history of honesty, fairness, and respect for the 
rights of others and for the laws of this state and the Federal Government.” 
 
Under the bill, all licensee hearings must be held within the county in which the licensee or 
applicant operates or applies for a license to operate an ADT program. The APD is permitted to 
issue orders immediately suspending or revoking a license when it determines that any condition 
of an ADT program presents a danger to the health, safety, or welfare of the program 
participants. 
 
The bill allows the APD to impose an immediate moratorium on service authorizations to a 
facility or ADT program when the agency determines that any condition of the facility or the 
program presents a threat to the health, safety, or welfare of the residents in the facility or the 
program participants. 
 
Repeal of CTEP Provisions  
The bill strikes the definition of “comprehensive transitional education program” in s. 393.063, 
F.S., and removes a requirement for CTEP employees to undergo level 2 background screenings, 
as the statutory authority to license a CTEP is removed entirely by the bill. The bill repeals s. 
393.18, F.S., which authorizes the licensure of CTEPs. The bill makes other conforming changes 
and removes all references to CTEPs remaining in statute. 
 
The bill is effective October 1, 2024. 
IV. Constitutional Issues: 
A. Municipality/County Mandates Restrictions: 
None. 
B. Public Records/Open Meetings Issues: 
None.  BILL: SB 1444   	Page 13 
 
C. Trust Funds Restrictions: 
None. 
D. State Tax or Fee Increases: 
None. 
E. Other Constitutional Issues: 
None identified. 
V. Fiscal Impact Statement: 
A. Tax/Fee Issues: 
None. 
B. Private Sector Impact: 
There will likely be an indeterminate fiscal impact to existing ADT programs relating to 
the cost of licensure application and other costs associated with obtaining initial and 
continuing licensure. 
C. Government Sector Impact: 
The APD anticipates that the bill will require 7 FTE for implementation, totaling 
$457,616 in recurring funds.
70
 
VI. Technical Deficiencies: 
None. 
VII. Related Issues: 
None. 
VIII. Statutes Affected: 
This bill substantially amends sections 393.063, 393.0655, 393.067, 393.0673, 393.0678, 
393.135, 394.875, 383.141, 400.063, and 1002.394 of the Florida Statutes.  
 
This bill repeals section 393.18 of the Florida Statutes.  
                                                
70
 The APD Analysis at p. 5.  BILL: SB 1444   	Page 14 
 
IX. Additional Information: 
A. Committee Substitute – Statement of Changes: 
(Summarizing differences between the Committee Substitute and the prior version of the bill.) 
None. 
B. Amendments: 
None. 
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.