Florida Senate - 2023 CS for SB 1594 By the Committee on Health Policy; and Senators Brodeur and Garcia 588-03501-23 20231594c1 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. 393.065, F.S.; requiring 5 the Agency for Persons with Disabilities to make 6 certain eligibility determinations within specified 7 timeframes; authorizing the agency to request 8 additional documentation from applicants if it is 9 necessary to make an eligibility determination; 10 providing eligibility requirements for applicants; 11 authorizing a designee of the agency to notify 12 applicants of eligibility determinations; requiring 13 that the agency authorize admission of certain 14 individuals to an intermediate care facility; 15 requiring the agency or its designee to conduct a 16 certain comprehensive assessment of an individual as 17 part of the authorization; revising provisions related 18 to the home and community-based services Medicaid 19 waiver program; requiring the agency to assign clients 20 seeking such waiver services to their appropriate 21 enrollment categories based on specified criteria; 22 revising requirements for the prioritization of 23 clients waiting for such services; providing 24 eligibility criteria for such services; conforming 25 provisions to changes made by the act; amending s. 26 393.0651, F.S.; conforming provisions to changes made 27 by the act; amending s. 393.0655, F.S.; revising 28 background screening requirements for certain direct 29 service providers; amending s. 393.067, F.S.; 30 requiring the licensure of adult day training 31 programs; conforming related application and licensure 32 provisions to changes made by the act; providing for 33 comprehensive emergency management plans of adult day 34 training programs; providing for inspections of adult 35 day training programs; requiring adult day training 36 programs to adhere to specified rights; conforming 37 provisions to changes made by the act; amending s. 38 393.0673, F.S.; revising provisions related to 39 disciplinary action against certain licensees to 40 include licensed adult day training programs; 41 providing that for purposes of disciplinary action for 42 certain violations, a licensee is ultimately 43 responsible for the care and supervision of clients in 44 its facility or participants of the program; providing 45 construction; revising grounds for denial of a 46 licensure application; defining the term good moral 47 character; authorizing the agency to immediately 48 suspend or revoke the license of adult day training 49 programs under certain circumstances; authorizing the 50 agency to impose an immediate moratorium on service 51 authorizations to licensed facilities and adult day 52 training programs under certain circumstances; 53 amending s. 393.0678, F.S.; conforming provisions to 54 changes made by the act; making a technical change; 55 amending s. 393.135, F.S.; conforming provisions to 56 changes made by the act; repealing s. 393.18, F.S., 57 relating to comprehensive transitional education 58 programs; amending s. 394.875, F.S.; conforming a 59 provision to changes made by the act; amending ss. 60 383.141, 400.063, and 1002.394, F.S.; conforming 61 cross-references; providing an effective date. 62 63 Be It Enacted by the Legislature of the State of Florida: 64 65 Section 1.Subsections (1) and (10) of section 393.063, 66 Florida Statutes, are amended, and a new subsection (25) is 67 added to that section, to read: 68 393.063Definitions.For the purposes of this chapter, the 69 term: 70 (1)Adult day training means a program of training 71 services which takes that take place in a nonresidential 72 setting, separate from the home or facility in which the client 73 resides, and is are intended to support the participation of 74 clients in daily, meaningful, and valued routines of the 75 community. These services include, but are not limited to, the 76 acquisition, retention, or improvement of self-help, 77 socialization, and adaptive skills Such training may be provided 78 in work-like settings that do not meet the definition of 79 supported employment. 80 (10)Comprehensive transitional education program means 81 the program established in s. 393.18. 82 (25)Licensee means an individual, a corporation, a 83 partnership, a firm, an association, a governmental entity, or 84 other entity that is issued a permit, registration, certificate, 85 or license by the agency. The licensee is legally responsible 86 for all aspects of the provider operation. 87 Section 2.Section 393.065, Florida Statutes, is amended to 88 read: 89 393.065Application and eligibility determination. 90 (1)An application for services must shall be made in 91 writing to the agency, in the region service area in which the 92 applicant resides. The agency must shall review each application 93 and make an eligibility determination applicant for eligibility 94 within 45 days after the date the application is signed for 95 children under 6 years of age and within 60 days after receipt 96 of the signed application. If, at the time of application, the 97 applicant requests enrollment in the developmental disabilities 98 home and community-based services Medicaid waiver program due to 99 crisis, as described in paragraph (5)(a), the agency must 100 complete an eligibility determination within 45 days after 101 receipt of the signed application. 102 (a)If the agency determines additional documentation is 103 necessary to make a proper determination on an applicants 104 eligibility, the agency may request the necessary additional 105 documentation from the applicant the date the application is 106 signed for all other applicants. 107 (b)When necessary to definitively identify individual 108 conditions or needs, the agency must arrange for shall provide a 109 comprehensive assessment within this state. 110 (c)If the agency requests additional documentation from 111 the applicant or arranges for a comprehensive assessment, the 112 agencys eligibility determination must be completed within 90 113 days after receipt of the signed application. 114 (2)To be eligible for services under this chapter, the 115 agencys eligibility determination must find that the applicant 116 has met all procedural requirements and eligibility criteria 117 found in rule, which must include, but need not be limited to, 118 the requirement that the applicant have a developmental 119 disability and be domiciled in Florida Only applicants whose 120 domicile is in Florida are eligible for services. Information 121 accumulated by other agencies, including professional reports 122 and collateral data, must shall be considered in this process 123 when available. 124 (2)In order to provide immediate services or crisis 125 intervention to applicants, the agency shall arrange for 126 emergency eligibility determination, with a full eligibility 127 review to be accomplished within 45 days of the emergency 128 eligibility determination. 129 (3)The agency, or its designee, must shall notify each 130 applicant, in writing, of its eligibility determination 131 decision. Any applicant or client determined by the agency to be 132 ineligible for services has the right to appeal this 133 determination decision pursuant to ss. 120.569 and 120.57. 134 (4)Before admission to an intermediate care facility for 135 individuals with intellectual disabilities and to ensure that 136 the setting is the least restrictive to meet the individuals 137 needs, the agency must authorize the admission pursuant to this 138 subsection. As part of the authorization, the agency, or its 139 designee, must conduct a comprehensive assessment that includes 140 medical necessity, level of care, and level of reimbursement The 141 agency shall assess the level of need and medical necessity for 142 prospective residents of intermediate care facilities for the 143 developmentally disabled. The agency may enter into an agreement 144 with the Department of Elderly Affairs for its Comprehensive 145 Assessment and Review for Long-Term-Care Services (CARES) 146 program to conduct assessments to determine the level of need 147 and medical necessity for long-term-care services under this 148 chapter. To the extent permissible under federal law, the 149 assessments shall be funded under Title XIX of the Social 150 Security Act. 151 (5)Except as provided in subsection (7), if a client 152 seeking enrollment in the developmental disabilities home and 153 community-based services Medicaid waiver program meets the level 154 of care requirement for an intermediate care facility for 155 individuals with intellectual disabilities pursuant to 42 C.F.R. 156 ss. 435.217(b)(1) and 440.150, the agency must shall assign the 157 client to an appropriate enrollment category based on the 158 criteria outlined below and must provide priority to clients 159 waiting for waiver services in the following order: 160 (a)Category 1, which includes clients deemed to be in 161 crisis as described in rule, must shall be given first priority 162 in moving from the preenrollment categories waiting list to the 163 waiver. 164 (b)Category 2, which includes clients in the preenrollment 165 categories individuals on the waiting list who are: 166 1.From the child welfare system with an open case in the 167 Department of Children and Families statewide automated child 168 welfare information system and who are either: 169 a.Transitioning out of the child welfare system into 170 permanency at the finalization of an adoption, a reunification 171 with family members, a permanent placement with a relative, or a 172 guardianship with a nonrelative; or 173 b.At least 18 years but not yet 22 years of age and who 174 need both waiver services and extended foster care services; or 175 2.At least 18 years but not yet 22 years of age and who 176 withdrew consent pursuant to s. 39.6251(5)(c) to remain in the 177 extended foster care system. 178 179 For individuals who are at least 18 years but not yet 22 years 180 of age and who are eligible under sub-subparagraph 1.b., the 181 agency must shall provide waiver services, including residential 182 habilitation, and the community-based care lead agency must 183 shall fund room and board at the rate established in s. 184 409.145(3) and provide case management and related services as 185 defined in s. 409.986(3)(e). Individuals may receive both waiver 186 services and services under s. 39.6251. Services may not 187 duplicate services available through the Medicaid state plan. 188 (c)Category 3, which includes, but is not required to be 189 limited to, clients: 190 1.Whose caregiver has a documented condition that is 191 expected to render the caregiver unable to provide care within 192 the next 12 months and for whom a caregiver is required but no 193 alternate caregiver is available; 194 2.At substantial risk of incarceration or court commitment 195 without supports; 196 3.Whose documented behaviors or physical needs place them 197 or their caregiver at risk of serious harm and other supports 198 are not currently available to alleviate the situation; or 199 4.Who are identified as ready for discharge within the 200 next year from a state mental health hospital or skilled nursing 201 facility and who require a caregiver but for whom no caregiver 202 is available or whose caregiver is unable to provide the care 203 needed. 204 (d)Category 4, which includes, but is not required to be 205 limited to, clients whose caregivers are 70 years of age or 206 older and for whom a caregiver is required but no alternate 207 caregiver is available. 208 (e)Category 5, which includes, but is not required to be 209 limited to, clients who are expected to graduate within the next 210 12 months from secondary school and need support to obtain a 211 meaningful day activity, maintain competitive employment, or 212 pursue an accredited program of postsecondary education to which 213 they have been accepted. 214 (f)Category 6, which includes clients 21 years of age or 215 older who do not meet the criteria for category 1, category 2, 216 category 3, category 4, or category 5. 217 (g)Category 7, which includes clients younger than 21 218 years of age who do not meet the criteria for category 1, 219 category 2, category 3, or category 4. 220 (6)Within each enrollment category, the agency must 221 prioritize enrollment based on the time each client has been 222 assigned to any preenrollment category without interruption, 223 with the longest uninterrupted time spent in a preenrollment 224 category having the highest priority. A client who resides in an 225 institutional setting, including, but not limited to, a penal 226 institution, an intermediate care facility for the 227 developmentally disabled, a mental health hospital, a nursing 228 home, or a forensic facility operated by the agency pursuant to 229 chapter 916, may not be assigned to a preenrollment category 230 Within categories 3, 4, 5, 6, and 7, the agency shall maintain a 231 waiting list of clients placed in the order of the date that the 232 client is determined eligible for waiver services. 233 (7)(6)The agency must shall allow an individual who meets 234 the eligibility requirements of subsection (2) subsection (1) to 235 receive home and community-based services in this state if the 236 individuals parent or legal guardian is an active-duty military 237 servicemember and if, at the time of the servicemembers 238 transfer to this state, the individual was receiving home and 239 community-based services in another state. 240 (8)(7)The agency must shall allow an individual with a 241 diagnosis of Phelan-McDermid syndrome who meets the eligibility 242 requirements of subsection (2) subsection (1) to receive home 243 and community-based services. 244 (9)Only a client may be eligible for services under the 245 developmental disabilities home and community-based services 246 Medicaid waiver program. For a client to receive services under 247 the developmental disabilities home and community-based services 248 Medicaid waiver program, there must be available funding 249 pursuant to s. 393.0662 or through a legislative appropriation 250 and the client must meet all of the following: 251 (a)The eligibility criteria in subsection (2), which must 252 be confirmed by the agency. 253 (b)Eligibility requirements for the Florida Medicaid 254 program under Title XIX of the Social Security Act, as amended, 255 or the Supplemental Security Income program. 256 (c)The level of care requirements for an intermediate care 257 facility for individuals with developmental disabilities 258 pursuant to 42 C.F.R. ss. 435.217(b)(1) and 440.150. 259 (d)The requirements provided in the approved federal 260 waiver authorized pursuant to s. 1915(c) of the Social Security 261 Act and 42 C.F.R. s. 441.302. 262 (10)(8)Agency action that selects individuals to receive 263 waiver services pursuant to this section does not establish a 264 right to a hearing or an administrative proceeding under chapter 265 120 for individuals remaining in the preenrollment categories on 266 the waiting list. 267 (11)(9)The client, the clients guardian, or the clients 268 family must ensure that accurate, up-to-date contact information 269 is provided to the agency at all times. Notwithstanding s. 270 393.0651, the agency must shall send an annual letter requesting 271 updated information from the client, the clients guardian, or 272 the clients family. The agency must shall remove from the 273 preenrollment categories waiting list any individual who cannot 274 be located using the contact information provided to the agency, 275 fails to meet eligibility requirements, or becomes domiciled 276 outside the state. 277 (12)(a)(10)(a)The agency must shall provide the following 278 information to all applicants or their parents, legal guardians, 279 or family members: 280 1.A brief overview of the vocational rehabilitation 281 services offered through the Division of Vocational 282 Rehabilitation of the Department of Education, including a 283 hyperlink or website address that provides access to the 284 application for such services; 285 2.A brief overview of the Florida ABLE program as 286 established under s. 1009.986, including a hyperlink or website 287 address that provides access to the application for establishing 288 an ABLE account as defined in s. 1009.986(2); 289 3.A brief overview of the supplemental security income 290 benefits and social security disability income benefits 291 available under Title XVI of the Social Security Act, as 292 amended, including a hyperlink or website address that provides 293 access to the application for such benefits; 294 4.A statement indicating that the applicants local public 295 school district may provide specialized instructional services, 296 including transition programs, for students with special 297 education needs; 298 5.A brief overview of programs and services funded through 299 the Florida Center for Students with Unique Abilities, including 300 contact information for each state-approved Florida 301 Postsecondary Comprehensive Transition Program; 302 6.A brief overview of decisionmaking options for 303 individuals with disabilities, guardianship under chapter 744, 304 and alternatives to guardianship as defined in s. 744.334(1), 305 which may include contact information for organizations that the 306 agency believes would be helpful in assisting with such 307 decisions; 308 7.A brief overview of the referral tools made available 309 through the agency, including a hyperlink or website address 310 that provides access to such tools; and 311 8.A statement indicating that some waiver providers may 312 serve private-pay individuals. 313 (b)The agency must provide the information required in 314 paragraph (a) in writing to an applicant or his or her parent, 315 legal guardian, or family member along with a written disclosure 316 statement in substantially the following form: 317 318 DISCLOSURE STATEMENT 319 320 Each program and service has its own eligibility requirements. 321 By providing the information specified in section 393.065(11)(a) 322 393.065(10)(a), Florida Statutes, the agency does not guarantee 323 an applicants eligibility for or enrollment in any program or 324 service. 325 (c)The agency must shall also publish the information 326 required in paragraph (a) and the disclosure statement in 327 paragraph (b) on its website, and must shall provide that 328 information and statement annually to each client applicant 329 placed in the preenrollment categories on the waiting list or to 330 the parent, legal guardian, or family member of such client 331 applicant. 332 (13)(11)The agency and the Agency for Health Care 333 Administration may adopt rules specifying application 334 procedures, criteria associated with the preenrollment waiting 335 list categories, procedures for administering the preenrollment 336 categories waiting list, including tools for prioritizing waiver 337 enrollment within categories, and eligibility criteria as needed 338 to administer this section. 339 Section 3.Section 393.0651, Florida Statutes, is amended 340 to read: 341 393.0651Family or individual support plan.The agency 342 shall provide directly or contract for the development of a 343 family support plan for children ages 3 to 18 years of age and 344 an individual support plan for each client. The client, if 345 competent, the clients parent or guardian, or, when 346 appropriate, the client advocate, shall be consulted in the 347 development of the plan and shall receive a copy of the plan. 348 Each plan must include the most appropriate, least restrictive, 349 and most cost-beneficial environment for accomplishment of the 350 objectives for client progress and a specification of all 351 services authorized. The plan must include provisions for the 352 most appropriate level of care for the client. Within the 353 specification of needs and services for each client, when 354 residential care is necessary, the agency shall move toward 355 placement of clients in residential facilities based within the 356 clients community. The ultimate goal of each plan, whenever 357 possible, shall be to enable the client to live a dignified life 358 in the least restrictive setting, be that in the home or in the 359 community. For children under 6 years of age, The family or 360 individual support plan must shall be developed within 60 days 361 after the agency determines the client eligible pursuant to s. 362 393.065(3) the 45-day application period as specified in s. 363 393.065(1); for all applicants 6 years of age or older, the 364 family or individual support plan shall be developed within the 365 60-day period as specified in that subsection. 366 (1)The agency shall develop and specify by rule the core 367 components of support plans. 368 (2)The family or individual support plan shall be 369 integrated with the individual education plan (IEP) for all 370 clients who are public school students entitled to a free 371 appropriate public education under the Individuals with 372 Disabilities Education Act, I.D.E.A., as amended. The family or 373 individual support plan and IEP must shall be implemented to 374 maximize the attainment of educational and habilitation goals. 375 (a)If the IEP for a student enrolled in a public school 376 program indicates placement in a public or private residential 377 program is necessary to provide special education and related 378 services to a client, the local education agency must shall 379 provide for the costs of that service in accordance with the 380 requirements of the Individuals with Disabilities Education Act, 381 I.D.E.A., as amended. This does shall not preclude local 382 education agencies and the agency from sharing the residential 383 service costs of students who are clients and require 384 residential placement. 385 (b)For clients who are entering or exiting the school 386 system, an interdepartmental staffing team composed of 387 representatives of the agency and the local school system shall 388 develop a written transitional living and training plan with the 389 participation of the client or with the parent or guardian of 390 the client, or the client advocate, as appropriate. 391 (3)Each family or individual support plan shall be 392 facilitated through case management designed solely to advance 393 the individual needs of the client. 394 (4)In the development of the family or individual support 395 plan, a client advocate may be appointed by the support planning 396 team for a client who is a minor or for a client who is not 397 capable of express and informed consent when: 398 (a)The parent or guardian cannot be identified; 399 (b)The whereabouts of the parent or guardian cannot be 400 discovered; or 401 (c)The state is the only legal representative of the 402 client. 403 404 Such appointment may shall not be construed to extend the powers 405 of the client advocate to include any of those powers delegated 406 by law to a legal guardian. 407 (5)The agency shall place a client in the most appropriate 408 and least restrictive, and cost-beneficial, residential facility 409 according to his or her individual support plan. The client, if 410 competent, the clients parent or guardian, or, when 411 appropriate, the client advocate, and the administrator of the 412 facility to which placement is proposed shall be consulted in 413 determining the appropriate placement for the client. 414 Considerations for placement shall be made in the following 415 order: 416 (a)Clients own home or the home of a family member or 417 direct service provider. 418 (b)Foster care facility. 419 (c)Group home facility. 420 (d)Intermediate care facility for the developmentally 421 disabled. 422 (e)Other facilities licensed by the agency which offer 423 special programs for people with developmental disabilities. 424 (f)Developmental disabilities center. 425 (6)In developing a clients annual family or individual 426 support plan, the individual or family with the assistance of 427 the support planning team shall identify measurable objectives 428 for client progress and shall specify a time period expected for 429 achievement of each objective. 430 (7)The individual, family, and support coordinator shall 431 review progress in achieving the objectives specified in each 432 clients family or individual support plan, and shall revise the 433 plan annually, following consultation with the client, if 434 competent, or with the parent or guardian of the client, or, 435 when appropriate, the client advocate. The agency or designated 436 contractor shall annually report in writing to the client, if 437 competent, or to the parent or guardian of the client, or to the 438 client advocate, when appropriate, with respect to the clients 439 habilitative and medical progress. 440 (8)Any client, or any parent of a minor client, or 441 guardian, authorized guardian advocate, or client advocate for a 442 client, who is substantially affected by the clients initial 443 family or individual support plan, or the annual review thereof, 444 shall have the right to file a notice to challenge the decision 445 pursuant to ss. 120.569 and 120.57. Notice of such right to 446 appeal shall be included in all support plans provided by the 447 agency. 448 Section 4.Subsection (1) of section 393.0655, Florida 449 Statutes, is amended to read: 450 393.0655Screening of direct service providers. 451 (1)MINIMUM STANDARDS.The agency shall require level 2 452 employment screening pursuant to chapter 435 for direct service 453 providers who are unrelated to their clients, including support 454 coordinators, and managers and supervisors of residential 455 facilities or adult day training comprehensive transitional 456 education programs licensed under this chapter and any other 457 person, including volunteers, who provide care or services, who 458 have access to a clients living areas, or who have access to a 459 clients funds or personal property. Background screening must 460 shall include employment history checks as provided in s. 461 435.03(1) and local criminal records checks through local law 462 enforcement agencies. 463 (a)A volunteer who assists on an intermittent basis for 464 less than 10 hours per month does not have to be screened if a 465 person who meets the screening requirement of this section is 466 always present and has the volunteer within his or her line of 467 sight. 468 (b)Licensed physicians, nurses, or other professionals 469 licensed and regulated by the Department of Health are not 470 subject to background screening pursuant to this section if they 471 are providing a service that is within their scope of licensed 472 practice. 473 (c)A person selected by the family or the individual with 474 developmental disabilities and paid by the family or the 475 individual to provide supports or services is not required to 476 have a background screening under this section. 477 (d)Persons 12 years of age or older, including family 478 members, residing with a direct services provider who provides 479 services to clients in his or her own place of residence are 480 subject to background screening; however, such persons who are 481 12 to 18 years of age shall be screened for delinquency records 482 only. 483 Section 5.Section 393.067, Florida Statutes, is amended to 484 read: 485 393.067Facility licensure. 486 (1)The agency shall provide through its licensing 487 authority and by rule license application procedures, provider 488 qualifications, facility and client care standards, requirements 489 for client records, requirements for staff qualifications and 490 training, and requirements for monitoring foster care 491 facilities, group home facilities, residential habilitation 492 centers, and adult day training comprehensive transitional 493 education programs that serve agency clients. 494 (2)The agency shall conduct annual inspections and reviews 495 of facilities and adult day training programs licensed under 496 this section. 497 (3)An application for a license under this section must be 498 made to the agency on a form furnished by it and shall be 499 accompanied by the appropriate license fee. 500 (4)The application shall be under oath and shall contain 501 the following: 502 (a)The name and address of the applicant, if an applicant 503 is an individual; if the applicant is a firm, partnership, or 504 association, the name and address of each member thereof; if the 505 applicant is a corporation, its name and address and the name 506 and address of each director and each officer thereof; and the 507 name by which the facility or program is to be known. 508 (b)The location of the facility or adult day training 509 program for which a license is sought. 510 (c)The name of the person or persons under whose 511 management or supervision the facility or adult day training 512 program will be conducted. 513 (d)The number and type of residents or clients for which 514 maintenance, care, education, or treatment is to be provided by 515 the facility or adult day training program. 516 (e)The number and location of the component centers or 517 units which will compose the comprehensive transitional 518 education program. 519 (f)A description of the types of services and treatment to 520 be provided by the facility or adult day training program. 521 (f)(g)Information relating to the number, experience, and 522 training of the employees of the facility or adult day training 523 program. 524 (g)(h)Certification that the staff of the facility or 525 adult day training program will receive training to detect, 526 report, and prevent sexual abuse, abuse, neglect, exploitation, 527 and abandonment, as defined in ss. 39.01 and 415.102, of 528 residents and clients. 529 (h)(i)Such other Information as the agency determines is 530 necessary to carry out the provisions of this chapter. 531 (5)As a prerequisite for issuance of an initial or renewal 532 license, the applicant, and any manager, supervisor, and staff 533 member of the direct service provider of a facility or an adult 534 day training program licensed under this section, must have 535 submitted to background screening as required under s. 393.0655. 536 A license may not be issued or renewed if the applicant or any 537 manager, supervisor, or staff member of the direct service 538 provider has a disqualifying offense revealed by failed 539 background screenings as required under s. 393.0655. The agency 540 shall determine by rule the frequency of background screening. 541 The applicant shall submit with each initial or renewal 542 application a signed affidavit under penalty of perjury stating 543 that the applicant and any manager, supervisor, or staff member 544 of the direct service provider is in compliance with all 545 requirements for background screening. 546 (6)A facility or an adult day training program The 547 applicant shall furnish satisfactory proof of financial ability 548 to operate and conduct the facility or program in accordance 549 with the requirements of this chapter and adopted rules. 550 (7)The agency shall adopt rules establishing minimum 551 standards for facilities and adult day training programs 552 licensed under this section, including rules requiring 553 facilities and adult day training programs to train staff to 554 detect, report, and prevent sexual abuse, abuse, neglect, 555 exploitation, and abandonment, as defined in ss. 39.01 and 556 415.102, of residents and clients, minimum standards of quality 557 and adequacy of client care, incident reporting requirements, 558 and uniform firesafety standards established by the State Fire 559 Marshal which are appropriate to the size of the facility or 560 adult day training of the component centers or units of the 561 program. 562 (8)The agency, after consultation with the Division of 563 Emergency Management, shall adopt rules for foster care 564 facilities, group home facilities, and residential habilitation 565 centers, and adult day training programs which establish minimum 566 standards for the preparation and annual update of a 567 comprehensive emergency management plan. At a minimum, the rules 568 must provide for plan components that address emergency 569 evacuation transportation; adequate sheltering arrangements; 570 postdisaster activities, including emergency power, food, and 571 water; postdisaster transportation; supplies; staffing; 572 emergency equipment; individual identification of residents and 573 transfer of records; and responding to family inquiries. The 574 comprehensive emergency management plan for all facilities and 575 adult day training comprehensive transitional education programs 576 and for homes serving individuals who have a complex medical 577 condition conditions is subject to review and approval by the 578 local emergency management agency. During its review, the local 579 emergency management agency shall ensure that the agency and the 580 Division of Emergency Management, at a minimum, are given the 581 opportunity to review the plan. Also, appropriate volunteer 582 organizations must be given the opportunity to review the plan. 583 The local emergency management agency shall complete its review 584 within 60 days and either approve the plan or advise the 585 facility or program of necessary revisions. 586 (9)The agency may conduct unannounced inspections to 587 determine compliance by foster care facilities, group home 588 facilities, residential habilitation centers, and adult day 589 training comprehensive transitional education programs with the 590 applicable provisions of this chapter and the rules adopted 591 pursuant hereto, including the rules adopted for training staff 592 of a facility or an adult day training a program to detect, 593 report, and prevent sexual abuse, abuse, neglect, exploitation, 594 and abandonment, as defined in ss. 39.01 and 415.102, of 595 residents and clients. The facility or adult day training 596 program shall make copies of inspection reports available to the 597 public upon request. 598 (10)Each facility or program licensed under this section 599 shall forward annually to the agency a true and accurate sworn 600 statement of its costs of providing care to clients funded by 601 the agency. 602 (11)The agency may audit the records of any facility or 603 program that it has reason to believe may not be in full 604 compliance with the provisions of this section; provided that, 605 any financial audit of such facility or program is shall be 606 limited to the records of clients funded by the agency. 607 (12)The agency shall establish, for the purpose of control 608 of licensure costs, a uniform management information system and 609 a uniform reporting system with uniform definitions and 610 reporting categories. 611 (13)Facilities and adult day training programs licensed 612 under pursuant to this section shall adhere to all rights 613 specified in s. 393.13, including those enumerated in s. 614 393.13(4). 615 (14)The agency may not authorize funds or services to an 616 unlicensed facility or adult day training program that is 617 required to be licensed under this section may not receive state 618 funds. A license for the operation of a facility or an adult day 619 training program may shall not be renewed if the licensee has 620 any outstanding fines assessed pursuant to this chapter wherein 621 final adjudication of such fines has been entered. 622 (15)The agency is not required to contract with facilities 623 or adult day training programs licensed under pursuant to this 624 chapter. 625 Section 6.Section 393.0673, Florida Statutes, is amended 626 to read: 627 393.0673Denial, suspension, or revocation of license; 628 moratorium on admissions; administrative fines; procedures. 629 (1)The following constitute grounds for which the agency 630 may take disciplinary action, including revoking or suspending 631 revoke or suspend a license and imposing or impose an 632 administrative fine, not to exceed $1,000 per violation per day, 633 if: 634 (a)The licensee has: 635 1.Falsely represented or omitted a material fact in its 636 license application submitted under s. 393.067; 637 2.Had prior action taken against it under the Medicaid or 638 Medicare program; or 639 3.Failed to comply with the applicable requirements of 640 this chapter or rules applicable to the licensee; or 641 (b)The Department of Children and Families has verified 642 that the licensee is responsible for the abuse, neglect, or 643 abandonment of a child or the abuse, neglect, or exploitation of 644 a vulnerable adult. 645 (2)For purposes of disciplinary action under this section 646 for verified findings of abuse, neglect, abandonment, or 647 exploitation of a child or vulnerable adult, the licensee is 648 responsible not only for administration of the facilities in 649 compliance with the standards set out by statute and 650 administrative rule, but is ultimately responsible for the care 651 and supervision of the clients in the facility or the 652 participants of the program. 653 (a)A licensee may not delegate to others the ultimate 654 responsibility for the safety of the clients in its care. 655 (b)A licensee is subject to disciplinary action for an 656 employees lapse in care or supervision of the clients at the 657 facility or the participants of the program in which a verified 658 finding of abuse, neglect, abandonment, or exploitation 659 occurred. 660 (c)Remedial action taken by the licensee does not affect 661 the agencys ability to impose disciplinary action for the 662 underlying violation. 663 (3)The agency may deny an application for licensure 664 submitted under s. 393.067 if: 665 (a)The applicant has: 666 1.Falsely represented or omitted a material fact in its 667 license application submitted under s. 393.067; 668 2.Had prior action taken against it under the Medicaid or 669 Medicare program; 670 3.Failed to comply with the applicable requirements of 671 this chapter or rules applicable to the applicant; or 672 4.Previously had a license to operate a residential 673 facility or adult day training program revoked by the agency, 674 the Department of Children and Families, or the Agency for 675 Health Care Administration; or 676 (b)The Department of Children and Families has verified 677 that the applicant is responsible for the abuse, neglect, or 678 abandonment of a child or the abuse, neglect, or exploitation of 679 a vulnerable adult; or 680 (c)The agency has determined that there is clear and 681 convincing evidence that the applicant is unqualified for a 682 license because of a lack of good moral character. For purposes 683 of this paragraph, the term good moral character means a 684 personal history of honesty, fairness, and respect for the 685 rights of others and for the laws of this state and the Federal 686 Government. 687 (4)(3)All hearings must shall be held within the county in 688 which the licensee or applicant operates or applies for a 689 license to operate a facility or an adult day training program 690 as defined herein. 691 (5)(4)The agency, as a part of any final order issued by 692 it under this chapter, may impose such fine as it deems proper, 693 except that such fine may not exceed $1,000 for each violation. 694 Each day a violation of this chapter occurs constitutes a 695 separate violation and is subject to a separate fine, but in no 696 event may the aggregate amount of any fine exceed $10,000. Fines 697 paid by any facility licensee under the provisions of this 698 subsection shall be deposited in the Health Care Trust Fund and 699 expended as provided in s. 400.063. 700 (6)(5)The agency may issue an order immediately suspending 701 or revoking a license when it determines that any condition of 702 in the facility or adult day training program presents a danger 703 to the health, safety, or welfare of the residents in the 704 facility or the program participants. 705 (7)(6)The agency may impose an immediate moratorium on 706 admissions to any facility or on service authorizations to a 707 facility or an adult day training program when the agency 708 determines that any condition of in the facility or adult day 709 training program presents a threat to the health, safety, or 710 welfare of the residents in the facility or the program 711 participants. 712 (8)(7)The agency shall establish by rule criteria for 713 evaluating the severity of violations and for determining the 714 amount of fines imposed. 715 Section 7.Subsection (1) of section 393.0678, Florida 716 Statutes, is amended to read: 717 393.0678Receivership proceedings. 718 (1)The agency may petition a court of competent 719 jurisdiction for the appointment of a receiver for a 720 comprehensive transitional education program, a residential 721 habilitation center, or a group home facility owned and operated 722 by a corporation or partnership when any of the following 723 conditions exist: 724 (a)Any person is operating a facility without a license 725 and refuses to make application for a license as required by s. 726 393.067. 727 (b)The licensee is closing the facility or has informed 728 the agency department that it intends to close the facility; and 729 adequate arrangements have not been made for relocation of the 730 residents within 7 days, exclusive of weekends and holidays, of 731 the closing of the facility. 732 (c)The agency determines that conditions exist in the 733 facility which present an imminent danger to the health, safety, 734 or welfare of the residents of the facility or which present a 735 substantial probability that death or serious physical harm 736 would result therefrom. Whenever possible, the agency shall 737 facilitate the continued operation of the program. 738 (d)The licensee cannot meet its financial obligations to 739 provide food, shelter, care, and utilities. Evidence such as the 740 issuance of bad checks or the accumulation of delinquent bills 741 for such items as personnel salaries, food, drugs, or utilities 742 constitutes prima facie evidence that the ownership of the 743 facility lacks the financial ability to operate the home in 744 accordance with the requirements of this chapter and all rules 745 adopted promulgated thereunder. 746 Section 8.Subsection (2) of section 393.135, Florida 747 Statutes, is amended to read: 748 393.135Sexual misconduct prohibited; reporting required; 749 penalties. 750 (2)A covered person who engages in sexual misconduct with 751 an individual with a developmental disability who: 752 (a)Resides in a residential facility, including any 753 comprehensive transitional education program, developmental 754 disabilities center, foster care facility, group home facility, 755 intermediate care facility for the developmentally disabled, or 756 residential habilitation center; or 757 (b)Is eligible to receive services from the agency under 758 this chapter, 759 760 commits a felony of the second degree, punishable as provided in 761 s. 775.082, s. 775.083, or s. 775.084. A covered person may be 762 found guilty of violating this subsection without having 763 committed the crime of sexual battery. 764 Section 9.Section 393.18, Florida Statutes, is repealed. 765 Section 10.Paragraph (c) of subsection (3) of section 766 394.875, Florida Statutes, is amended to read: 767 394.875Crisis stabilization units, residential treatment 768 facilities, and residential treatment centers for children and 769 adolescents; authorized services; license required. 770 (3)The following are exempt from licensure as required in 771 ss. 394.455-394.903: 772 (c)Comprehensive transitional education programs licensed 773 under s. 393.067. 774 Section 11.Paragraph (b) of subsection (1) of section 775 383.141, Florida Statutes, is amended to read: 776 383.141Prenatally diagnosed conditions; patient to be 777 provided information; definitions; information clearinghouse; 778 advisory council. 779 (1)As used in this section, the term: 780 (b)Developmental disability includes Down syndrome and 781 other developmental disabilities defined by s. 393.063 s. 782 393.063(12). 783 Section 12.Subsection (1) of section 400.063, Florida 784 Statutes, is amended to read: 785 400.063Resident protection. 786 (1)The Health Care Trust Fund shall be used for the 787 purpose of collecting and disbursing funds generated from the 788 license fees and administrative fines as provided for in ss. 789 393.0673(5) ss. 393.0673(4), 400.062(3), 400.121(2), and 790 400.23(8). Such funds shall be for the sole purpose of paying 791 for the appropriate alternate placement, care, and treatment of 792 residents who are removed from a facility licensed under this 793 part or a facility specified in s. 393.0678(1) in which the 794 agency determines that existing conditions or practices 795 constitute an immediate danger to the health, safety, or 796 security of the residents. If the agency determines that it is 797 in the best interest of the health, safety, or security of the 798 residents to provide for an orderly removal of the residents 799 from the facility, the agency may utilize such funds to maintain 800 and care for the residents in the facility pending removal and 801 alternative placement. The maintenance and care of the residents 802 shall be under the direction and control of a receiver appointed 803 pursuant to s. 393.0678(1) or s. 400.126(1). However, funds may 804 be expended in an emergency upon a filing of a petition for a 805 receiver, upon the declaration of a state of local emergency 806 pursuant to s. 252.38(3)(a)5., or upon a duly authorized local 807 order of evacuation of a facility by emergency personnel to 808 protect the health and safety of the residents. 809 Section 13.Paragraph (d) of subsection (2) of section 810 1002.394, Florida Statutes, is amended to read: 811 1002.394The Family Empowerment Scholarship Program. 812 (2)DEFINITIONS.As used in this section, the term: 813 (d)Disability means, for a 3- or 4-year-old child or for 814 a student in kindergarten to grade 12, autism spectrum disorder, 815 as defined in the Diagnostic and Statistical Manual of Mental 816 Disorders, Fifth Edition, published by the American Psychiatric 817 Association; cerebral palsy, as defined in s. 393.063; Down 818 syndrome, as defined in s. 393.063; an intellectual disability, 819 as defined in s. 393.063; a speech impairment; a language 820 impairment; an orthopedic impairment; any an other health 821 impairment; an emotional or a behavioral disability; a specific 822 learning disability, including, but not limited to, dyslexia, 823 dyscalculia, or developmental aphasia; Phelan-McDermid syndrome, 824 as defined in s. 393.063; Prader-Willi syndrome, as defined in 825 s. 393.063; spina bifida, as defined in s. 393.063; being a 826 high-risk child, as defined in s. 393.063(22)(a) s. 827 393.063(23)(a); muscular dystrophy; Williams syndrome; rare 828 diseases which affect patient populations of fewer than 200,000 829 individuals in the United States, as defined by the National 830 Organization for Rare Disorders; anaphylaxis; a hearing 831 impairment, including deafness; a visual impairment, including 832 blindness; traumatic brain injury; hospital or homebound; or 833 identification as dual sensory impaired, as defined by rules of 834 the State Board of Education and evidenced by reports from local 835 school districts. The term hospital or homebound includes a 836 student who has a medically diagnosed physical or psychiatric 837 condition or illness, as defined by the state board in rule, and 838 who is confined to the home or hospital for more than 6 months. 839 Section 14.This act shall take effect October 1, 2024.