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