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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to aging and disability services; 2
repealing s. 400.0067, F.S., relating to the State 3
Long-Term Care Ombudsman Council; amending s. 409.979, 4
F.S.; revising requirements for Medicaid recipients to 5
receive an offer for enrollment for long -term care 6
services; requiring the Department of Elderly Affairs 7
to maintain a statewide preenrollment list for certain 8
services; requiring aging and disability resource 9
center personnel to place individuals on certain 10
lists; requiring certain staff to administ er 11
rescreening under certain circumstances; amending s. 12
430.03, F.S.; revising the purposes of the Department 13
of Elderly Affairs to include providing direct 14
services to the elderly population under certain 15
circumstances; amending s. 430.04, F.S.; revising the 16
duties and responsibilities of the department to 17
include designating area agencies on aging; creating 18
s. 430.09, F.S.; providing requirements for area 19
agencies on aging expenditures; prohibiting an 20
administrative employee of an area agency on aging 21
from receiving a specified salary amount; providing 22
construction; amending s. 430.203, F.S.; revising and 23
providing definitions; amending s. 430.204, F.S.; 24
removing certain funding responsibilities of the 25
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department and certain entities; removing 26
responsibility of provider agencies to collect and 27
assess fees for certain services; amending s. 430.205, 28
F.S.; removing certain funding responsibilities of the 29
department; revising frequency of inservice training 30
for certain providers; revising the term "primary 31
consideration" to "priority consideration"; amending 32
s. 430.2053, F.S.; redesignating aging resource 33
centers as aging and disability resource centers; 34
authorizing aging and disability resource centers to 35
place and remove certain individuals on or from 36
preenrollment lists; removing a requirement for 37
convening a work group for certain purposes; removing 38
a requirement for an aging and disability resource 39
center to provide enrollment and coverage information 40
to certain individuals; requiring the aging and 41
disability resource center to receive a waiver to be 42
the provider of other direct services; revising the 43
program to which the department and the agency on 44
aging may not make payments; removing an eligibility 45
requirement for an area agency on aging to transition 46
to an aging resource center; revising who the 47
department may consult with to develop capitation 48
rates; amending s. 430.503, F.S.; removing the 49
responsibility of provider agencies to collect and 50
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assess fees for certain purposes; amending s. 430.602, 51
F.S.; defining the term "functionally impaired elderly 52
person"; amending s. 430.605, F.S.; revising certain 53
subsidy payments to include food and nutritional 54
supplements; creating s. 430.71, F.S.; providing 55
purpose and legislative intent for the Florida 56
Alzheimer's Center of Excellence; providing 57
definitions; providing powers and duties of the 58
center; providing eligibility requirements for 59
services; amending s. 430.901, F.S.; conforming 60
provisions to changes made by the act; amending s. 61
744.2001, F.S.; removing a requ irement for the 62
executive director of the Office of Public and 63
Professional Guardians to report to the Secretary of 64
Elderly Affairs amending s. 744.2003, F.S.; revising 65
the amount of a specified bond maintained by a 66
guardian for certain purposes; requiring the court to 67
enter a written order waiving the bond requirement and 68
include reasons for waiver under certain 69
circumstances; amending ss. 744.2004 and 744.20041, 70
F.S.; revising disciplinary actions; creating s. 71
744.20061, F.S.; providing requirements for a n entity 72
to serve as an office of public guardian; providing 73
definitions; requiring a board member, a director, or 74
an officer of an office of public guardian to disclose 75
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any conflict of interest to the office's board; 76
providing that a conflict of interest in a contract 77
must to be noticed and voted on; providing 78
requirements for certain contracts; providing 79
penalties; amending s. 744.2103, F.S.; revising 80
requirements for a required independent audit for each 81
office of public guardian; amending s. 744.2104, F .S.; 82
providing requirements for Office of Public and 83
Professional Guardians in conducting certain 84
investigations; amending s. 744.351, F.S.; requiring a 85
court to enter a written order with specified 86
information when waiving a certain bond; amending s. 87
744.361, F.S.; revising powers and duties of a 88
guardian; amending s. 744.3701, F.S.; authorizing a 89
clerk of court to disclose certain confidential 90
information to the Department of Elderly Affairs under 91
certain circumstances; amending s. 744.441, F.S.; 92
revising requirements for the sale of any real or 93
personal property by a guardian; creating s. 744.448, 94
F.S.; providing requirements for the sale of a ward's 95
real property; amending ss. 400.0060, 400.0065, 96
400.0073, 400.0075, 400.0087, and 430.504, F.S.; 97
conforming a provision to changes made by the act; 98
providing an effective date. 99
100
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Be It Enacted by the Legislature of the State of Florida: 101
102
Section 1. Section 400.0067, Florida Statutes, is 103
repealed. 104
Section 2. Subsections (2) and (3) of section 409.979 , 105
Florida Statutes, are amended to read: 106
409.979 Eligibility. — 107
(2) ENROLLMENT OFFERS. —Subject to the availability of 108
funds, the Department of Elderly Affairs shall make offers for 109
enrollment to eligible individuals based on a wait -list 110
prioritization. Before making enrollment offers, the agency and 111
the Department of Elderly Affairs shall determine that 112
sufficient funds exist to support additional enrollment into 113
plans. 114
(a) A Medicaid recipient enrolled in one of the following 115
Medicaid home and communi ty-based services waiver programs who 116
meets the eligibility criteria established in subsection (1) is 117
eligible to participate in the long -term care managed care 118
program and must be transitioned into the long -term care managed 119
care program by January 1, 201 8: 120
1. Traumatic Brain and Spinal Cord Injury Waiver. 121
2. Adult Cystic Fibrosis Waiver. 122
3. Project AIDS Care Waiver. 123
(b) The agency shall seek federal approval to terminate 124
the Traumatic Brain and Spinal Cord Injury Waiver, the Adult 125
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Cystic Fibrosis Waiver, and the Project AIDS Care Waiver once 126
all eligible Medicaid recipients have transitioned into the 127
long-term care managed care program. 128
(3) PREENROLLMENT WAIT LIST, RELEASE, AND OFFER PROCESS. —129
The Department of Elderly Affairs shall maintain a sta tewide 130
preenrollment wait list for enrollment for home and community -131
based services through the long -term care managed care program. 132
(a) The Department of Elderly Affairs shall prioritize 133
individuals for potential enrollment for home and community -134
based services through the long -term care managed care program 135
using a frailty-based screening or assessment tool that results 136
in a priority score. The priority score is used to set an order 137
for releasing individuals from the preenrollment wait list for 138
potential enrollment in the long -term care managed care program. 139
If capacity is limited for individuals with identical priority 140
scores, the individual with the oldest date of placement on the 141
preenrollment wait list shall receive priority for release. 142
1. Pursuant to s. 430.2053, aging and disability resource 143
center personnel certified by the Department of Elderly Affairs 144
shall perform the screening or assessment for each individual 145
requesting enrollment for home and community -based services 146
through the long-term care managed care program. Aging and 147
disability resource center personnel shall place an individual 148
on all appropriate preenrollment lists. The Department of 149
Elderly Affairs shall request that the individual or the 150
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individual's authorized representative pr ovide alternate contact 151
names and contact information. 152
2. The individual requesting the long-term care services, 153
or the individual's authorized representative, must participate 154
in an initial screening or assessment rescreening for placement 155
on the preenrollment wait list. The screening or rescreening 156
must be completed in its entirety before placement on the 157
preenrollment wait list. 158
3. Pursuant to s. 430.2053, staff authorized and certified 159
by the Department of Elderly Affairs, including aging resource 160
center personnel, shall administer rescreening annually or upon 161
notification of a significant change in an individual's 162
circumstances for an individual with a high priority score. 163
Aging and disability resource center personnel may administer 164
rescreening annually or upon notification of a significant 165
change in an individual's circumstances for an individual with a 166
low priority score. 167
4. The Department of Elderly Affairs shall adopt by rule a 168
screening tool that generates the priority score and shall m ake 169
publicly available on its website the specific methodology used 170
to calculate an individual's priority score. 171
(b) Upon completion of the screening or rescreening 172
process, the Department of Elderly Affairs shall notify the 173
individual or the individual' s authorized representative that 174
the individual has been placed on the preenrollment wait list, 175
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unless the individual has a low priority score. The Department 176
of Elderly Affairs must maintain contact information for each 177
individual with a low priority scor e for purposes of any future 178
rescreening. Aging and disability resource center personnel 179
shall inform individuals with low priority scores of community 180
resources available to assist them and inform them that they may 181
contact the aging and disability resource center for a new 182
assessment at any time if they experience a change in 183
circumstances. 184
(c) If the Department of Elderly Affairs is unable to 185
contact the individual or the individual's authorized 186
representative to schedule an initial screening or rescre ening, 187
and documents the actions taken to make such contact, it shall 188
send a letter to the last documented address of the individual 189
or the individual's authorized representative. The letter must 190
advise the individual or his or her authorized representativ e 191
that he or she must contact the Department of Elderly Affairs 192
within 30 calendar days after the date of the notice to schedule 193
a screening or rescreening and must notify the individual that 194
failure to complete the screening or rescreening will result in 195
his or her termination from the screening process and the 196
preenrollment wait list. 197
(d) After notification by the agency of available 198
capacity, the CARES program shall conduct a prerelease 199
assessment. The Department of Elderly Affairs shall release 200
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individuals from the preenrollment wait list based on the 201
priority scoring process and prerelease assessment results. Upon 202
release, individuals who meet all eligibility criteria may 203
enroll in the long-term care managed care program. 204
(e) The Department of Elderly Affairs may terminate an 205
individual's inclusion on the preenrollment wait list if the 206
individual: 207
1. Does not have a current priority score due to the 208
individual's action or inaction; 209
2. Requests to be removed from the preenrollment wait 210
list; 211
3. Does not keep an appointment to complete the 212
rescreening without scheduling another appointment and has not 213
responded to three documented attempts by the Department of 214
Elderly Affairs to contact the individual; 215
4. Receives an offer to begin the eligibility 216
determination process for the long -term care managed care 217
program; or 218
5. Begins receiving services through the long -term care 219
managed care program. 220
221
An individual whose inclusion on the preenrollment wait list is 222
terminated must initiate a new request for placement on the 223
preenrollment wait list, and any previous priority 224
considerations must be disregarded. 225
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(f) Notwithstanding this subsection, the following 226
individuals are afforded priority enrollment for home and 227
community-based services through the long -term care managed care 228
program and do not have to complete the screening or 229
preenrollment list wait-list process if all other long -term care 230
managed care program eligibility requirements are met: 231
1. An individual who is 18, 19, or 20 years of age who has 232
a chronic debilitating disease or condition of one or more 233
physiological or organ systems which generally make the 234
individual dependent upon 24 -hour-per-day medical, nursing, or 235
health supervision or intervention. 236
2. A nursing facility resident who requests to transition 237
into the community and who has resided in a Florida -licensed 238
skilled nursing facility for at least 60 consecutive days. 239
3. An individual who is referred by the Department of 240
Children and Families pursu ant to the Adult Protective Services 241
Act, ss. 415.101-415.113, as high risk and who is placed in an 242
assisted living facility temporarily funded by the Department of 243
Children and Families. 244
(g) The Department of Elderly Affairs and the agency may 245
adopt rules to implement this subsection. 246
Section 3. Subsection (7) of section 430.03, Florida 247
Statutes, is amended to read: 248
430.03 Purposes.—The purposes of the Department of Elderly 249
Affairs are to: 250
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(7) Oversee implementation of federally funded and state -251
funded programs and services for the state's elderly population 252
and provide direct services to the state's elderly population 253
when the department determines it appropriate and necessary . 254
Section 4. Subsection (2) of section 430.04, Florida 255
Statutes, is amended to read: 256
430.04 Duties and responsibilities of the Department of 257
Elderly Affairs.—The Department of Elderly Affairs shall: 258
(2) Designate area agencies on aging, as authorized under 259
the Older Americans Act of 1965, and be responsible for ensuri ng 260
that each area agency on aging operates in a manner to ensure 261
that the elderly of this state receive the best services 262
possible. The department shall rescind designation of an area 263
agency on aging or take intermediate measures against the 264
agency, including corrective action, unannounced special 265
monitoring, temporary assumption of operation of one or more 266
programs by the department, placement on probationary status, 267
imposing a moratorium on agency action, imposing financial 268
penalties for nonperformance, o r other administrative action 269
pursuant to chapter 120, if the department finds that: 270
(a) An intentional or negligent act of the agency has 271
materially affected the health, welfare, or safety of clients, 272
or substantially and negatively affected the operati on of an 273
aging services program. 274
(b) The agency lacks financial stability sufficient to 275
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meet contractual obligations or that contractual funds have been 276
misappropriated. 277
(c) The agency has committed multiple or repeated 278
violations of legal and regulato ry requirements or department 279
standards. 280
(d) The agency has failed to continue the provision or 281
expansion of services after the declaration of a state of 282
emergency. 283
(e) The agency has exceeded its authority or otherwise 284
failed to adhere to the terms of its contract with the 285
department or has exceeded its authority or otherwise failed to 286
adhere to the provisions specifically provided by statute or 287
rule adopted by the department. 288
(f) The agency has failed to properly determine client 289
eligibility as defined by the department . 290
(g) The agency has failed to or efficiently manage program 291
budgets. 292
(h)(g) The agency has failed to implement and maintain a 293
department-approved client grievance resolution procedure. 294
Section 5. Section 430.09, Florida Statut es, is created to 295
read: 296
430.09 Area agencies on aging expenditures. — 297
(1) The procurement of commodities or contractual services 298
by an area agency on aging and its subcontractors is governed by 299
the financial guidelines developed by the department and mu st 300
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comply with applicable state and federal law and follow good 301
business practices. 302
(a) In accordance with s. 287.017(2), area agencies on 303
aging shall competitively procure all contracts with related 304
parties. 305
(b) Financial consequences as established b y the 306
department and incorporated into the contract, must be imposed 307
by the department for noncompliance with applicable local, 308
state, or federal law for the procurement of commodities or 309
contractual services. 310
(2) Notwithstanding any other provision of l aw, an 311
administrative employee of an area agency on aging may not 312
receive a salary, whether base pay or base pay combined with any 313
bonus or incentive payments, in excess of 150 percent of the 314
annual salary paid to the secretary of the Department of Elderly 315
Affairs from state-appropriated funds, including state -316
appropriated federal funds. This limitation applies regardless 317
of the number of contracts an area agency on aging may execute 318
with the department. This subsection does not prohibit any party 319
from providing cash that is not from appropriated state funds to 320
an area agency on aging administrative employee. 321
Section 6. Subsections (7) through (12) of section 322
430.203, Florida Statutes, are renumbered as subsections (8) 323
through (13), respectively, subsect ions (3) and (5) and present 324
subsection (10) are amended, and a new subsection (7) is added 325
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to that section, to read: 326
430.203 Community care for the elderly; definitions. —As 327
used in ss. 430.201-430.207, the term: 328
(3) "Community care service system" mea ns a service 329
network comprising a variety of home -delivered services, day 330
care services, and other basic services, hereinafter referred to 331
as "core services," for functionally impaired elderly persons 332
which are provided by or through a designated single lead 333
agency. Its purpose is to provide a continuum of care 334
encompassing a full range of preventive, maintenance, and 335
restorative services for functionally impaired elderly persons. 336
(5) "Core services" means a variety of home -delivered 337
services, day care se rvices, and other basic services that may 338
be provided by several entities. Core services are those 339
services that are most needed to prevent unnecessary 340
institutionalization. The area agency on aging may shall not 341
directly provide core services unless the designated lead agency 342
is unable to perform its duties and the Department approves . 343
(7) "Elderly person" means a person 60 years of age or 344
over who is currently a resident of this state and has an intent 345
to remain in this state. 346
(10) "Personal care serv ices" has the same meaning as in 347
400.462 means services to assist with bathing, dressing, 348
ambulation, housekeeping, supervision, emotional security, 349
eating, supervision of self -administered medications, and 350
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assistance in securing health care from appropria te sources. 351
Personal care services does not include medical services . 352
Section 7. Subsections (6) and (7) of section 430.204, 353
Florida Statutes, are renumbered as subsections (5) and (6), 354
respectively, and subsections (1) and (5) and present subsection 355
(8) of that section are amended, to read: 356
430.204 Community-care-for-the-elderly core services; 357
departmental powers and duties. — 358
(1)(a) The department shall fund, through each area agency 359
on aging, at least one community care service system the primary 360
purpose of which is the prevention of unnecessary 361
institutionalization of functionally impaired elderly persons 362
through the provision of community -based core services. Whenever 363
feasible, an area agency on aging shall be the contracting 364
agency of preference to engage only in the planning and funding 365
of community-care-for-the-elderly core services for functionally 366
impaired elderly persons. 367
(b) The department shall fund, through each area agency on 368
aging in each county as defined in s. 125.011(1), more than one 369
community care service system the primary purpose of which is 370
the prevention of unnecessary institutionalization of 371
functionally impaired elderly persons through the provision of 372
community-based core services. 373
(5) Entities contracting to provide core services under 374
ss. 430.201-430.207 must provide a minimum of 10 percent of the 375
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funding necessary for the support of project operations. In -kind 376
contributions, whether materials, commodities, transportation, 377
office space, other types of facilities, or pers onal services, 378
and contributions of money or services from functionally 379
impaired elderly persons may be evaluated and counted as part or 380
all of the required local funding. 381
(8) Provider agencies are responsible for the collection 382
of fees for services in accordance with rules adopted by the 383
department. Provider agencies shall assess fees for services 384
rendered in accordance with those rules. To help pay for 385
services received from community care for the elderly, a 386
functionally impaired elderly person shall b e assessed a fee 387
based on an overall ability to pay. The fee to be assessed shall 388
be fixed according to a schedule established by the department 389
in cooperation with area agencies, lead agencies, and service 390
providers. 391
Section 8. Subsections (1), (2), a nd (4) and paragraph (a) 392
of (5) of section 430.205, Florida Statutes, are amended to 393
read: 394
430.205 Community care service system. — 395
(1)(a) The department, through the area agency on aging, 396
shall fund in each planning and service area at least one 397
community care service system that provides case management and 398
other in-home and community services as needed to help the older 399
person maintain independence and prevent or delay more costly 400
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institutional care. 401
(b) The department shall fund, through the area a gency on 402
aging in each county as defined in s. 125.011(1), more than one 403
community care service system that provides case management and 404
other in-home and community services as needed to help elderly 405
persons maintain independence and prevent or delay more costly 406
institutional care. 407
(2) Core services and other support services may be 408
furnished by public or private agencies or organizations. Each 409
community care service system must be under the direction of a 410
lead agency that coordinates the activities of in dividual 411
contracting agencies providing community -care-for-the-elderly 412
services. When practicable, the activities of a community care 413
service area may be directed from a multiservice senior center, 414
as defined in s. 430.901, and coordinated with other servi ces 415
offered therein. This subsection does not require programs in 416
existence prior to the effective date of this act to be 417
relocated. 418
(4) An annual A preservice and inservice training program 419
for community-care-for-the-elderly service providers and staff 420
may be designed and implemented to help assure the delivery of 421
quality services. The department shall specify in rules the 422
training standards and requirements for the community -care-for-423
the-elderly service providers and staff. Training must be 424
sufficient to ensure that quality services are provided to 425
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clients and that appropriate skills are developed to conduct the 426
program. 427
(5) Any person who has been classified as a functionally 428
impaired elderly person is eligible to receive community -care-429
for-the-elderly core services. 430
(a) Those elderly persons who are determined high risk by 431
protective investigations to be vulnerable adults in need of 432
services, pursuant to s. 415.104(3)(b), or to be victims of 433
abuse, neglect, or exploitation who are in need of immediate 434
services to prevent further harm and are referred by the adult 435
protective services program, shall be given priority primary 436
consideration for receiving community -care-for-the-elderly 437
services. As used in this paragraph, " priority primary 438
consideration" means that an assessment and services must 439
commence within 72 hours after referral to the department or as 440
established in accordance with department contracts by local 441
protocols developed between department service providers and the 442
adult protective services program. Regardless, a community -care-443
for-the-elderly services provide r may dispute a referral under 444
this paragraph by requesting that adult protective services 445
negotiate the referral placement of, and the services to be 446
provided to, a vulnerable adult or victim of abuse, neglect, or 447
exploitation. If an agreement cannot be r eached with adult 448
protective services for modification of the referral decision, 449
the determination by adult protective services shall prevail. 450
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Section 9. Section 430.2053, Florida Statutes, is amended 451
to read: 452
430.2053 Aging and disability resource centers.— 453
(1) The department, in consultation with the Agency for 454
Health Care Administration and the Department of Children and 455
Families, shall develop pilot projects for aging and disability 456
resource centers. 457
(2) The purposes of an aging and disability resource 458
center shall be: 459
(a) To provide Florida's elders , adults with disabilities, 460
and their families with a locally focused, coordinated approach 461
to integrating information and referral for all available 462
services for persons elders with the eligibility determination 463
entities for state and federally funded long -term-care services. 464
(b) To provide for easier access to long -term-care 465
services by Florida's elders , adults with disabilities, and 466
their families by creating multiple access points to the long -467
term-care network that flow through one established entity with 468
wide community recognition. 469
(3) The duties of an aging and disability resource center 470
are to: 471
(a) Develop referral agreements with local community 472
service organizations, such as senior ce nters, existing elder 473
service providers, volunteer associations, and other similar 474
organizations, to better assist clients who do not need or do 475
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not wish to enroll in programs funded by the department or the 476
agency. The referral agreements must also includ e a protocol, 477
developed and approved by the department, which provides 478
specific actions that an aging and disability resource center 479
and local community service organizations must take when a 480
person or a person's an elder or an elder's representative 481
seeking information on long -term-care services contacts a local 482
community service organization before prior to contacting the 483
aging and disability resource center. The protocol shall be 484
designed to ensure that persons elders and their families are 485
able to access information and services in the most efficient 486
and least cumbersome manner possible. 487
(b) Provide an initial screening of all clients who 488
request long-term-care services to determine whether the person 489
would be most appropriately served through any comb ination of 490
federally funded programs, state -funded programs, locally funded 491
or community volunteer programs, or private funding for 492
services. 493
(c) Determine eligibility for the programs and services 494
listed in subsection (9) for persons residing within the 495
geographic area served by the aging and disability resource 496
center and determine a priority ranking for services which is 497
based upon the potential recipient's frailty level and 498
likelihood of institutional placement without such services. 499
(d) Place on and remove from the preenrollment lists 500
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clients eligible for the Alzheimer's Disease Initiative, 501
Community Care for the Elderly, Home Care for the Elderly, and 502
Statewide Medicaid Managed Care Long -Term Care programs. 503
(e)(d) Manage the availability of finan cial resources for 504
the programs and services listed in subsection (9) for persons 505
residing within the geographic area served by the aging and 506
disability resource center. 507
(f)(e) When financial resources become available, refer a 508
client to the most appropr iate entity to begin receiving 509
services. The aging and disability resource center shall make 510
referrals to lead agencies for service provision that ensure 511
that persons individuals who are vulnerable adults in need of 512
services pursuant to s. 415.104(3)(b), o r who are victims of 513
abuse, neglect, or exploitation in need of immediate services to 514
prevent further harm and are referred by the adult protective 515
services program, are given primary consideration for receiving 516
community-care-for-the-elderly services in c ompliance with the 517
requirements of s. 430.205(5)(a) and that other referrals for 518
services are in compliance with s. 430.205(5)(b). 519
(f) Convene a work group to advise in the planning, 520
implementation, and evaluation of the aging resource center. The 521
work group shall be comprised of representatives of local 522
service providers, Alzheimer's Association chapters, housing 523
authorities, social service organizations, advocacy groups, 524
representatives of clients receiving services through the aging 525
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resource center, and any other persons or groups as determined 526
by the department. The aging resource center, in consultation 527
with the work group, must develop annual program improvement 528
plans that shall be submitted to the department for 529
consideration. The department shall r eview each annual 530
improvement plan and make recommendations on how to implement 531
the components of the plan. 532
(g) Enhance the existing area agency on aging in each 533
planning and service area by integrating, either physically or 534
virtually, the staff and serv ices of the area agency on aging 535
with the staff of the department's local CARES Medicaid 536
preadmission screening unit and a sufficient number of staff 537
from the Department of Children and Families' Economic Self -538
Sufficiency Unit necessary to determine the fi nancial 539
eligibility for all persons age 60 and older residing within the 540
area served by the aging and disability resource center that are 541
seeking Medicaid services, Supplemental Security Income, and 542
food assistance. 543
(h) Assist clients who request long -term care services in 544
being evaluated for eligibility for enrollment in the Medicaid 545
long-term care managed care program as eligible plans become 546
available in each of the regions pursuant to s. 409.981(2). 547
(i) Provide enrollment and coverage information to 548
Medicaid managed long -term care enrollees as qualified plans 549
become available in each of the regions pursuant to s. 550
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409.981(2). 551
(i)(j) Assist Medicaid recipients enrolled in the Medicaid 552
long-term care managed care program with informally resolving 553
grievances with a managed care network and assist Medicaid 554
recipients in accessing the managed care network's formal 555
grievance process as el igible plans become available in each of 556
the regions defined in s. 409.981(2). 557
(4) The department shall select the entities to become 558
aging and disability resource centers based on each entity's 559
readiness and ability to perform the duties listed in subse ction 560
(3) and the entity's: 561
(a) Expertise in the needs of each target population the 562
center proposes to serve and a thorough knowledge of the 563
providers that serve these populations. 564
(b) Strong connections to service providers, volunteer 565
agencies, and community institutions. 566
(c) Expertise in information and referral activities. 567
(d) Knowledge of long -term-care resources, including 568
resources designed to provide services in the least restrictive 569
setting. 570
(e) Financial solvency and stability. 571
(f) Ability to collect, monitor, and analyze data in a 572
timely and accurate manner, along with systems that meet the 573
department's standards. 574
(g) Commitment to adequate staffing by qualified personnel 575
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to effectively perform all functions. 576
(h) Ability to meet al l performance standards established 577
by the department. 578
(5) The aging and disability resource center shall have a 579
governing body which shall be the same entity described in s. 580
20.41(7), and an executive director who may be the same person 581
as described in s. 20.41(7). The governing body shall annually 582
evaluate the performance of the executive director. 583
(6) The aging and disability resource center may not be a 584
provider of direct services other than information and referral 585
services, outreach, and screening, and intake. The aging and 586
disability resource center must receive a waiver to be the 587
provider of any other direct services . 588
(7) The aging and disability resource center must agree to 589
allow the department to review any financial information the 590
department determines is necessary for monitoring or reporting 591
purposes, including financial relationships. 592
(8) The duties and responsibilities of the community care 593
for the elderly lead agencies within each area served by an 594
aging and disability resource center shall be to: 595
(a) Develop strong community partnerships to maximize the 596
use of community resources for the purpose of assisting persons 597
elders to remain in their community settings for as long as it 598
is safely possible. 599
(b) Conduct comprehensive assessm ents of clients that have 600
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been determined eligible and develop a care plan consistent with 601
established protocols that ensures that the unique needs of each 602
client are met. 603
(9) The services to be administered through the aging and 604
disability resource center shall include those funded by the 605
following programs: 606
(a) Community care for the elderly. 607
(b) Home care for the elderly. 608
(c) Contracted services. 609
(d) Alzheimer's disease initiative. 610
(e) Older Americans Act. 611
(10) The department shall, before prior to designation of 612
an aging and disability resource center, develop by rule 613
operational and quality assurance standards and outcome measures 614
to ensure that clients receiving services through all long -term-615
care programs administered through an aging and disability 616
resource center are receiving the appropriate care they require 617
and that contractors and subcontractors are adhering to the 618
terms of their contracts and are acting in the best interests of 619
the clients they are serving, consistent with the inte nt of the 620
Legislature to reduce the use of and cost of nursing home care. 621
The department shall by rule provide operating procedures for 622
aging and disability resource centers, which shall include: 623
(a) Minimum standards for financial operation, including 624
audit procedures. 625
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(b) Procedures for monitoring and sanctioning of service 626
providers. 627
(c) Minimum standards for technology utilized by the aging 628
and disability resource center. 629
(d) Minimum staff requirements which shall ensure that the 630
aging and disability resource center employs sufficient quality 631
and quantity of staff to adequately meet the needs of the elders 632
residing within the area served by the aging and disability 633
resource center. 634
(e) Minimum accessibility standards, including hours of 635
operation. 636
(f) Minimum oversight standards for the governing body of 637
the aging and disability resource center to ensure its 638
continuous involvement in, and accountability for, all matters 639
related to the development, implementation, staffing, 640
administration, and operations of the aging and disability 641
resource center. 642
(g) Minimum education and experience requirements for 643
executive directors and other executive staff positions of aging 644
and disability resource centers. 645
(h) Minimum requirements regarding any execu tive staff 646
positions that the aging and disability resource center must 647
employ and minimum requirements that a candidate must meet in 648
order to be eligible for appointment to such positions. 649
(11) In an area in which the department has designated an 650
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area agency on aging as an aging and disability resource center, 651
the department and the agency may shall not make payments for 652
the services listed in subsection (9) and the Statewide Medicaid 653
Managed Care Long-Term Care Program Long-Term Care Community 654
Diversion Project for such persons who were not screened and 655
enrolled through the aging and disability resource center. The 656
department shall cease making payments for recipients in 657
eligible plans as eligible plans become available in each of the 658
regions defined in s. 409.981(2). 659
(12) Each aging and disability resource center shall enter 660
into a memorandum of understanding with the department for 661
collaboration with the CARES unit staff. The memorandum of 662
understanding shall outline the staff person responsible for 663
each function and shall provide the staffing levels necessary to 664
carry out the functions of the aging and disability resource 665
center. 666
(13) Each aging and disability resource center shall enter 667
into a memorandum of understanding with the Department of 668
Children and Families for collaboration with the Economic Self -669
Sufficiency Unit staff. The memorandum of understanding shall 670
outline which staff persons are responsible for which functions 671
and shall provide the staffing levels necessary to carry out the 672
functions of the aging and disability resource center. 673
(14) If any of the state activities described in this 674
section are outsourced, either in part or in whole, the contract 675
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executing the outsourcing shall mandate that the contractor or 676
its subcontractors shal l, either physically or virtually, 677
execute the provisions of the memorandum of understanding 678
instead of the state entity whose function the contractor or 679
subcontractor now performs. 680
(15) In order to be eligible to begin transitioning to an 681
aging resource center, an area agency on aging board must ensure 682
that the area agency on aging which it oversees meets all of the 683
minimum requirements set by law and in rule. 684
(15)(a)(16)(a) Once an aging resource center is 685
operational, The department, in consultation with the aging and 686
disability resource center agency, may develop capitation rates 687
for any of the programs administered through the agency aging 688
resource center. Capitation rates for programs shall be based on 689
the historical cost experience of the state in providing those 690
same services to the population age 60 or older residing within 691
each area served by an aging and disability resource center. 692
Each capitated rate may vary by geographic area as determined by 693
the department. 694
(b) The department and the agen cy may determine for each 695
area served by an aging and disability resource center whether 696
it is appropriate, consistent with federal and state laws and 697
regulations, to develop and pay separate capitated rates for 698
each program administered through the aging and disability 699
resource center or to develop and pay capitated rates for 700
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service packages which include more than one program or service 701
administered through the aging and disability resource center. 702
(c) Once capitation rates have been developed and 703
certified as actuarially sound, the department and the agency 704
may pay service providers the capitated rates for services when 705
appropriate. 706
(d) The department, in consultation with the agency, shall 707
annually reevaluate and recertify the capitation rates, 708
adjusting forward to account for inflation, programmatic 709
changes. 710
(16)(17) This section does shall not be construed to allow 711
an aging and disability resource center to restrict, manage, or 712
impede the local fundraising activities of service providers. 713
Section 10. Section 430.503, Florida Statutes, is amended 714
to read: 715
430.503 Alzheimer's Disease Initiative; fees and 716
administrative expense. — 717
(1) Sections 430.501-430.504 may be cited as the 718
"Alzheimer's Disease Initiative." 719
(2) Provider agencies are responsible for the collection 720
of fees for services in accordance with rules adopted by the 721
department. Provider agencies shall assess fees for services 722
rendered in accordance with those rules. To help pay for 723
services received pursuant to the Alzheimer's Disease 724
Initiative, a functionally impaired elderly person shall be 725
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assessed a fee based on an overall ability to pay. The fee to be 726
assessed shall be fixed according to a schedule to be 727
established by the department. Services of specified value may 728
be accepted in lieu of a fee. The fee schedule shall be 729
developed in cooperation with the Alzheimer's Disease Advisory 730
Committee, area agencies on aging, and service providers. 731
Section 11. Subsection (3) of section 430.602, Florida 732
Statutes, is renumbered a s subsection (4), and a new subsection 733
(3) is added to that section, to read: 734
430.602 Home care for the elderly; definitions. —As used in 735
ss. 430.601-430.606, the term: 736
(3) "Functionally impaired elderly person" means any 737
person who is 60 years of age o r older and has physical or 738
mental limitations that restrict the person's ability to perform 739
the normal activities of daily living and that impede his or her 740
capacity to live independently without the provision of core 741
services. Functional impairment shall be determined through a 742
functional assessment administered to each applicant for home 743
care for the elderly core services. The functional assessment 744
shall be developed by the department. 745
Section 12. Subsection (3) of section 430.605, Florida 746
Statutes, is amended to read: 747
430.605 Subsidy payments. —The department shall develop a 748
schedule of subsidy payments to be made to persons providing 749
home care, and to providers of goods and services, for certain 750
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eligible elderly persons. Payments must be based on t he 751
financial status of the person receiving care. Payments must 752
include, but need not be limited to: 753
(3) When necessary, special supplements to provide for any 754
goods and services, including food and nutritional supplements, 755
and specialized care required to maintain the health , safety, 756
and well-being of the elderly person. Extraordinary medical, 757
dental, or pharmaceutical expenses may be paid as a special 758
supplement. 759
Section 13. Section 430.71, Florida Statutes, is created 760
to read: 761
430.71 Florida Alzh eimer's Center of Excellence. — 762
(1)(a) PURPOSE AND INTENT. —The purpose of this section is 763
to assist and support persons with Alzheimer's disease or 764
related forms of dementia and their caregivers by connecting 765
them with resources in their communities. The Legislature 766
intends to create a holistic care model for persons with 767
Alzheimer's disease or related forms of dementia and their 768
caregivers to address two primary goals: 769
1. To allow Floridians living with Alzheimer's disease or 770
related forms of dementia t o age in place. 771
2. To empower family caregivers to improve their own well -772
being. 773
(b) The development of innovative approaches to program 774
management, staff training, and service delivery which have an 775
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impact on cost-avoidance, cost-effectiveness, and pr ogram 776
efficiency is encouraged. 777
(2) DEFINITIONS.—As used in this section, the term: 778
(a) "Center" means the Florida Alzheimer's Center for 779
Excellence. 780
(b) "Department" means the Department of Elderly Affairs. 781
(3) POWERS AND DUTIES. — 782
(a) There is created within the Department of Elderly 783
Affairs the Florida Alzheimer's Center of Excellence, which 784
shall be responsible for improving the quality of care for 785
persons living with Alzheimer's disease or related forms of 786
dementia and improved quality of life for family caregivers. 787
(b) The center shall aim to address, at a minimum, all of 788
the following: 789
1. Early and accurate diagnosis. 790
2. Caregiver health. 791
3. Improved access to care. 792
4. Healthcare use costs. 793
5. Dementia capable workforce. 794
6. Underreporting of Alzheimer's disease and related forms 795
of dementia. 796
7. Disparities in access to dementia care. 797
(c) The center shall provide caregivers access to 798
services, including, but not limited to, all of the following: 799
1. Care consultation. 800
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2. Support groups. 801
3. Education and training programs. 802
4. Caregiver support services such as: 803
a. Caregiver companion. 804
b. Caregiver wellness programs. 805
c. Care support teams. 806
d. Technology based services. 807
e. Coordinating or monitoring care and services. 808
f. Assistance in obtaining diagnosis or prognosis of 809
dementia. 810
g. Assistance in obtaining end -of-life care. 811
h. Assistance connecting to resources for medical care. 812
i. Assistance with planning for current or future care. 813
j. Guidance for coping with relationship changes for 814
persons with dementia and their caregivers. 815
k. Skills for communicating with persons with dementia. 816
l. Understanding or managing behavioral symptoms of 817
dementia. 818
(d) When possible, the center shall work with the A rea 819
Agencies on Aging; Alzheimer's Disease Advisory Committee; 820
Alzheimer's Disease Initiative, including the state -funded 821
memory disorder clinics; Dementia Care and Cure Initiative; 822
universities; hospitals; and other available community resources 823
to ensure full use of the state's infrastructure. 824
(e) As necessary to fulfill its duties under this section, 825
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the center may provide direct services or contract for the 826
provision of services. 827
(4) ELIGIBILITY FOR SERVICES. — 828
(a) Persons seeking assistance from t he center must meet 829
all of the following criteria to be eligible for services: 830
1. At least one person in the household is a caregiver for 831
a person who has been diagnosed with, or is suspected to have, 832
Alzheimer's disease or a related form of dementia. 833
2. The caregiver or person who has been diagnosed with, or 834
is suspected to have, Alzheimer's disease or a related form of 835
dementia, is a resident of this state. 836
3. Have the goal of providing in -home care for the person 837
who has been diagnosed with, or is suspected to have, 838
Alzheimer's disease or related form of dementia. 839
(b) If the person seeking assistance meets the criteria in 840
paragraph (a), the center may provide assistance to the 841
caregiving family, subject to the availability of funds and 842
resources. 843
Section 14. Subsection (2) of section 430.901, Florida 844
Statutes, is amended to read: 845
430.901 Multiservice senior center; definition; purpose. —A 846
"multiservice senior center" is: 847
(2) An entity that may partner with an aging and 848
disability resource center to provide for easier access to long -849
term care services by seniors and their families who reside 850
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within the local community. 851
Section 15. Subsection (1) and paragraph (e) of subsection 852
(2) of section 744.2001, Florida Statutes, are amended to read: 853
744.2001 Office of Public and Professional Guardians. —854
There is created the Office of Public and Professional Guardians 855
within the Department of Elderly Affairs. 856
(1) The Secretary of Elderly Affairs shall appoint the 857
executive director, who shall be th e head of the Office of 858
Public and Professional Guardians. The executive director must 859
be a member of The Florida Bar, knowledgeable of guardianship 860
law and of the social services available to meet the needs of 861
incapacitated persons, shall serve on a full -time basis, and 862
shall personally, or through a representative of the office, 863
carry out the purposes and functions of the Office of Public and 864
Professional Guardians in accordance with state and federal law. 865
The executive director shall serve at the pleasur e of and report 866
to the secretary. 867
(2) The executive director shall, within available 868
resources: 869
(e) Produce and make available information about 870
alternatives to and types of guardianship for dissemination by 871
area agencies on aging as defined in s. 430. 203 and aging and 872
disability resource centers as described in s. 430.2053. 873
Section 16. Subsections (3) through (10) of section 874
744.2003, Florida Statutes, are renumbered as subsections (4) 875
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through (11), respectively, subsection (2) and present 876
subsection (8) are amended, and a new subsection (3) is added to 877
that section, to read: 878
744.2003 Regulation of professional guardians; 879
application; bond required; educational requirements. — 880
(2) Each professional guardian who files a petition for 881
appointment after October 1, 1997, shall post a blanket 882
fiduciary bond with the clerk of the circuit court in the county 883
in which the guardian's primary place of business is located. 884
The guardian shall provide proof of the fiduciary bond to the 885
clerks of each additional circuit court in which he or she is 886
serving as a professional guardian. The bond shall be maintained 887
by the guardian in an amount not less than $250,000 $50,000. The 888
bond must cover all wards for whom the guardian has been 889
appointed at any given time. The liability of the provider of 890
the bond is limited to the face amount of the bond, regardless 891
of the number of wards for whom the professional guardian has 892
been appointed. The act or omissions of each employee of a 893
professional guardian who has direct conta ct with the ward or 894
access to the ward's assets is covered by the terms of such 895
bond. The bond must be payable to the Governor of the State of 896
Florida and his or her successors in office and conditioned on 897
the faithful performance of all duties by the guar dian. In form, 898
the bond must be joint and several. The bond is in addition to 899
any bonds required under s. 744.351. This subsection does not 900
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apply to any attorney who is licensed to practice law in this 901
state and who is in good standing, to any financial in stitution 902
as defined in s. 744.309(4), or a public guardian. The expenses 903
incurred to satisfy the bonding requirements prescribed in this 904
section may not be paid with the assets of any ward. 905
(3) In the event a circuit judge decides to waive the 906
requirement for the posting of a blanket fiduciary bond by a 907
guardian, the court shall enter a written order waiving the bond 908
requirement. The court must include in its written order the 909
reasons for waiving the bond requirement. 910
(9)(8) The Department of Elderly A ffairs shall waive the 911
examination requirement in subsection (7) (6) if a professional 912
guardian can provide: 913
(a) Proof that the guardian has actively acted as a 914
professional guardian for 5 years or more; and 915
(b) A letter from a circuit judge before who m the 916
professional guardian practiced at least 1 year which states 917
that the professional guardian had demonstrated to the court 918
competency as a professional guardian. 919
Section 17. Subsection (2) of section 744.2004, Florida 920
Statutes, is amended to read: 921
744.2004 Complaints; disciplinary proceedings; penalties; 922
enforcement.— 923
(2) The Office of Public and Professional Guardians shall 924
establish disciplinary proceedings, conduct hearings, and take 925
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administrative action pursuant to chapter 120. Disciplinar y 926
actions may include, but are not limited to, requiring a 927
professional guardian to participate in additional educational 928
courses provided or approved by the Office of Public and 929
Professional Guardians, imposing additional monitoring by the 930
Office of Public and Professional Guardians office of the 931
guardianships to which the professional guardian is appointed, 932
restitution, fine, costs of investigation and disciplinary 933
actions, and suspension or revocation of a professional 934
guardian's registration. 935
Section 18. Subsections (1) and (2) of section 744.20041, 936
Florida Statutes, are amended to read: 937
744.20041 Grounds for discipline; penalties; enforcement. — 938
(1) The following acts by a professional guardian shall 939
constitute grounds for which the disciplinary actions specified 940
in subsection (2) may be taken: 941
(a) Making misleading, deceptive, or fraudulent 942
representations in or related to the practice of guardianship. 943
(b) Withholding information from the court involving 944
apparent or actual conflicts of intere st or that could result in 945
the appearance of or actual self -dealing. 946
(c)(b) Violating any rule governing guardians or 947
guardianships adopted by the Office of Public and Professional 948
Guardians. 949
(d)(c) Being convicted or found guilty of, or entering a 950
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plea of guilty or nolo contendere to, regardless of 951
adjudication, a crime in any jurisdiction which relates to the 952
practice of or the ability to practice as a professional 953
guardian. 954
(e) Misusing any advance directive, including a power of 955
attorney, living will, designation of health care surrogate, or 956
do-not-resuscitate order to the detriment of the principal or 957
benefit of the professional guardian, regardless of whether the 958
professional guardian is the guardian of the principal at the 959
time. 960
(f)(d) Failing to comply with the educational course 961
requirements contained in s. 744.2003. 962
(g)(e) Having a registration, a license, or the authority 963
to practice a regulated profession revoked, suspended, or 964
otherwise acted against, including the denial of registra tion or 965
licensure, by the registering or licensing authority of any 966
jurisdiction, including its agencies or subdivisions, for a 967
violation under Florida law. The registering or licensing 968
authority's acceptance of a relinquishment of registration or 969
licensure, stipulation, consent order, or other settlement 970
offered in response to or in anticipation of the filing of 971
charges against the registration or license shall be construed 972
as an action against the registration or license. 973
(h)(f) Knowingly filing a false report or complaint with 974
the Office of Public and Professional Guardians against another 975
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guardian. 976
(i) Retaliating against a ward, a ward's family, or other 977
interested party after a complaint has been filed concerning 978
that ward. 979
(j)(g) Attempting to obtain, obtaining, or renewing a 980
registration or license to practice a profession by bribery, by 981
fraudulent misrepresentation, or as a result of an error by the 982
Office of Public and Professional Guardians which is known and 983
not disclosed to the Office of Pu blic and Professional 984
Guardians. 985
(k)(h) Failing to report to the Office of Public and 986
Professional Guardians any person who the professional guardian 987
knows is in violation of this chapter or the rules of the Office 988
of Public and Professional Guardians. 989
(l)(i) Failing to perform any statutory or legal 990
obligation placed upon a professional guardian. 991
(m)(j) Making or filing a report or record that the 992
professional guardian knows to be false, intentionally or 993
negligently failing to file a report or record required by state 994
or federal law, or willfully impeding or obstructing another 995
person's attempt to do so. Such reports or records shall include 996
only those that are signed in the guardian's capacity as a 997
professional guardian. 998
(n)(k) Using the position o f guardian for the purpose of 999
financial gain by a professional guardian or a third party, 1000
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other than the funds awarded to the professional guardian by the 1001
court pursuant to s. 744.108. 1002
(o)(l) Violating a lawful order of the Office of Public 1003
and Professional Guardians or failing to comply with a lawfully 1004
issued subpoena of the Office of Public and Professional 1005
Guardians. 1006
(p)(m) Improperly interfering with an investigation or 1007
inspection authorized by statute or rule or with any 1008
disciplinary proceeding. 1009
(q)(n) Using the guardian relationship to engage or 1010
attempt to engage the ward, or an immediate family member or a 1011
representative of the ward, in verbal, written, electronic, or 1012
physical sexual activity. 1013
(r)(o) Failing to report to the Office of Public a nd 1014
Professional Guardians in writing within 30 days after being 1015
convicted or found guilty of, or entered a plea of nolo 1016
contendere to, regardless of adjudication, a crime in any 1017
jurisdiction. 1018
(s)(p) Being unable to perform the functions of a 1019
professional guardian with reasonable skill by reason of illness 1020
or use of alcohol, drugs, narcotics, chemicals, or any other 1021
type of substance or as a result of any mental or physical 1022
condition. 1023
(t)(q) Failing to post and maintain a blanket fiduciary 1024
bond pursuant to s. 744.2003. 1025
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(u)(r) Failing to maintain all records pertaining to a 1026
guardianship for a reasonable time after the court has closed 1027
the guardianship matter. 1028
(v) Failing to immediately report the Department of 1029
Children and Families' Adult Protective Se rvices Unit and local 1030
law enforcement incidents of abuse, neglect, or exploitation. 1031
(w)(s) Violating any provision of this chapter or any rule 1032
adopted pursuant thereto. 1033
(2) When the Office of Public and Professional Guardians 1034
finds any person a professional guardian guilty of violating 1035
subsection (1), it may enter an order imposing one or more of 1036
the following penalties: 1037
(a) Refusal to register an applicant as a professional 1038
guardian. 1039
(b) Suspension or permanent revocation of a professional 1040
guardian's registration. 1041
(c) Issuance of a reprimand or letter of concern. 1042
(d) Requirement that the professional guardian undergo 1043
treatment, attend continuing education courses, submit to 1044
reexamination, or satisfy any terms that are reasonably tailored 1045
to the violations found. 1046
(e) Requirement that the professional guardian pay 1047
restitution of any funds obtained, disbursed, or obtained 1048
through a violation of any statute, rule, or other legal 1049
authority to a ward or the ward's estate, if applicable. 1050
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(f) Requirement that the professional guardian pay a fine, 1051
not to exceed $500 per violation. 1052
(g) Requirement that the professional guardian pay the 1053
costs of investigation and prosecution. 1054
(h)(f) Requirement that the professional guardian undergo 1055
remedial education. 1056
Section 19. Section 744.20061, Florida Statutes, is 1057
created to read: 1058
744.20061 Office of public guardian boards; conflicts of 1059
interest.— 1060
(1) In order to serve as an office of public guardian, an 1061
entity must: 1062
(a) Be organized as a Florida corpo ration or a 1063
governmental entity. 1064
(b)1. Be governed by a board of directors. Board members 1065
shall provide oversight and ensure accountability and 1066
transparency for the system of care. The board of directors 1067
shall provide fiduciary oversight to prevent confl icts of 1068
interest, promote accountability and transparency, and protect 1069
state and federal funding from misuse. The board of directors 1070
shall act in accordance with s. 617.0830. The membership of the 1071
board of directors must be described in the bylaws or artic les 1072
of incorporation of each office of public guardian, which must 1073
provide that 100 percent of the membership of the board of 1074
directors must be composed of persons residing within the 1075
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service area of the office of public guardian. The office of 1076
public guardian shall ensure that board members participate in 1077
annual training related to their responsibilities. The 1078
Department of Elderly Affairs shall provide minimum training 1079
criteria in the contracts with the offices of public guardian. 1080
2. The powers of the bo ard of directors include, but are 1081
not limited to, approving the office of public guardian's budget 1082
and setting the office of public guardian's operational policy 1083
and procedures. A board of directors must additionally have the 1084
power to hire the office of pu blic guardian's executive 1085
director. 1086
(c) Demonstrate financial responsibility through an 1087
organized plan for regular fiscal audits and the posting of a 1088
performance bond to cover any costs associated with the assessed 1089
penalties related to a failure to discl ose a conflict of 1090
interest under subsection (3). 1091
(2) As used in this section, the term: 1092
(a) "Activity" includes, but is not limited to, a contract 1093
for goods and services, a contract for the purchase of any real 1094
or tangible property, or an agreement to engage with an office 1095
of public guardian for the benefit of a third party in exchange 1096
for an interest in real or tangible property, a monetary 1097
benefit, or an in-kind contribution. 1098
(b) "Conflict of interest" means when a board member, a 1099
director, or an officer, or a relative of a board member, a 1100
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director, or an officer of an office of public guardian does any 1101
of the following: 1102
1. Enters into a contract or other transaction for goo ds 1103
or services with the office of public guardian. 1104
2. Holds a direct or indirect interest in a corporation, 1105
limited liability corporation, partnership, limited liability 1106
partnership, or other business entity that conducts business 1107
with the office of publ ic guardian or proposes to enter into a 1108
contract or other transaction with the office of public 1109
guardian. For purposes of this paragraph, the term "indirect 1110
interest" has the same meaning as in s. 112.312. 1111
3. Knowingly obtains a direct or indirect person al, 1112
financial, professional, or other benefit as a result of the 1113
relationship of such board member, director, or officer, or 1114
relative of the board member, director, or officer, with the 1115
office of public guardian. For purposes of this paragraph, the 1116
term "benefit" does not include per diem and travel expenses 1117
paid or reimbursed to board members or officers of the office of 1118
public guardian in connection with their service on the board. 1119
(c) "Related party" means any entity of which a director 1120
or an officer of the entity is also directly or indirectly 1121
related to, or has a direct or indirect financial or other 1122
material interest in, the office of public guardian. The term 1123
also includes any subsidiary firm, parent entity, associate 1124
firm, or joint venture. 1125
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(d) "Relative" means a relative within the third degree of 1126
consanguinity by blood or marriage. 1127
(3)(a)1. For any activity that is presented to the board 1128
of an office of public guardian for its initial consideration 1129
and approval, or any activity that involves a contract that is 1130
being considered for renewal, a board member, a director, or an 1131
officer of an office of public guardian shall disclose to the 1132
board any activity that may reasonably be construed to be a 1133
conflict of interest before such activity is initia lly 1134
considered and approved or a contract is renewed by the board. A 1135
rebuttable presumption of a conflict of interest exists if the 1136
activity was acted on by the board without prior notice as 1137
required under paragraph (b). The board shall immediately 1138
disclose any known actual or potential conflicts to the 1139
Department of Elderly Affairs. 1140
2. An office of public guardian may not enter into a 1141
contract or be a party to any transaction with related parties 1142
if a conflict of interest is not properly disclosed. 1143
(b)1. If a board member, a director, or an officer of an 1144
office of public guardian, or a relative of a board member or an 1145
officer, proposes to engage in an activity as described in 1146
subparagraph (a)1., the proposed activity must be listed on the 1147
meeting agenda for the next general or special meeting of the 1148
board members, and copies of all contracts and transactional 1149
documents related to the proposed activity must be included in 1150
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the agenda. The meeting agenda must clearly identify the 1151
existence of a potential co nflict of interest for the proposed 1152
activity. Before a board member or an officer of the office of 1153
public guardian, or a relative of a board member or an officer, 1154
engages in the proposed activity, the activity and contract or 1155
other transactional documents must be approved by an affirmative 1156
vote of two-thirds of all other board members present. 1157
2. If a board member, a director, or an officer of the 1158
office of public guardian notifies the board of a potential 1159
conflict of interest with the board member or off icer, or a 1160
relative of the board member or officer, under an existing 1161
contract as described in subparagraph (a)2., the board must 1162
notice the activity on a meeting agenda for the next general or 1163
special meeting of the board members, and copies of all 1164
contracts and transactional documents related to the activity 1165
must be attached. The meeting agenda must clearly identify the 1166
existence of a potential conflict of interest. The board must be 1167
given the opportunity to approve or disapprove the conflict of 1168
interest by a vote of two-thirds of all other board members 1169
present. 1170
(c)1. If the board votes against the proposed activity 1171
under subparagraph (b)1., the board member or officer of the 1172
office of public guardian, or the relative of the board member 1173
or officer, must notify the board in writing of his or her 1174
intention, or his or her relative's intention, not to pursue the 1175
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proposed activity, or the board member or officer shall withdraw 1176
from office before the next scheduled board meeting. If the 1177
board finds that a boa rd member or officer has violated this 1178
paragraph, the board member or officer shall be removed from 1179
office before the next scheduled board meeting. 1180
2. In the event that the board does not approve a conflict 1181
of interest as required under subparagraph (b)2 ., the parties to 1182
the activity may opt to cancel the activity or, in the 1183
alternative, the board member or officer of the office of public 1184
guardian must resign from the board before the next scheduled 1185
board meeting. If the activity canceled is a contract, t he 1186
office of public guardian is only liable for the reasonable 1187
value of the goods and services provided up to the time of 1188
cancellation and is not liable for any termination fee, 1189
liquidated damages, or other form of penalty for such 1190
cancellation. 1191
(d) A board member or an officer of an office of public 1192
guardian, or a relative of a board member or an officer, who is 1193
a party to, or has an interest in, an activity that is a 1194
possible conflict of interest may attend the meeting at which 1195
the activity is considere d by the board and may make a 1196
presentation to the board regarding the activity. After the 1197
presentation, the board member or officer, or the relative of 1198
the board member or officer, must leave the meeting during the 1199
discussion of, and the vote on, the activ ity. A board member or 1200
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an officer who is a party to, or has an interest in, the 1201
activity shall recuse himself or herself from the vote. 1202
(e) A contract entered into between a board member or an 1203
officer of an office of public guardian, or a relative of a 1204
board member, a director, or an officer, and the office of 1205
public guardian which has not been properly disclosed as a 1206
conflict of interest or potential conflict of interest under 1207
this section is voidable and terminates upon the filing of a 1208
written notice terminating the contract with the board of 1209
directors which contains the consent of at least 20 percent of 1210
the voting interests of the office of public guardian. 1211
(f)1. All Department of Elderly Affairs contracts with 1212
offices of public guardian must contain the following 1213
contractual penalty provisions: 1214
a. Penalties in the amount of $5,000 per occurrence must 1215
be imposed for each known and potential conflict of interest, as 1216
described in paragraph (b), which is not disclosed to the 1217
Department of Elderly Affair s. 1218
b. If a contract is executed for which a conflict of 1219
interest was not disclosed to the Department of Elderly Affairs 1220
before execution of the contract, the following penalties apply: 1221
(I) A penalty in the amount of $20,000 for a first 1222
offense. 1223
(II) A penalty in the amount of $30,000 for a second or 1224
subsequent offense. 1225
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(III) Removal of the board member who did not disclose a 1226
known conflict of interest. 1227
2. The penalties for failure to disclose a conflict of 1228
interest under sub-subparagraphs 1.a. and b. apply to any 1229
contract entered into, regardless of the method of procurement, 1230
including, but not limited to, formal procurement, single -source 1231
contracts, and contracts that do not meet the minimum threshold 1232
for formal procurement. 1233
3. A contract procur ed for which a conflict of interest 1234
was not disclosed to the Department of Elderly Affairs before 1235
execution of the contract must be reprocured. The Department of 1236
Elderly Affairs shall recoup from the office of public guardian 1237
expenses related to a contract that was executed without 1238
disclosure of a conflict of interest. 1239
Section 20. Subsection (5) of section 744.2103, Florida 1240
Statutes, is amended to read: 1241
744.2103 Reports and standards. — 1242
(5)(a) Each office of public guardian shall undergo an 1243
independent audit by a qualified certified public accountant at 1244
least annually, including all ward property under the control or 1245
administration of the guardian. Upon receipt, once every 2 1246
years. a copy of the audit report shall be submitted to the 1247
Office of Public and Professional Guardians. 1248
(b) If the public guardian is a corporate not for profit, 1249
it shall submit a copy of its annual IRS Form 990 to the Office 1250
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of Public and Professional Guardians annually. 1251
(c)(b) In addition to regular monitoring activities, th e 1252
Office of Public and Professional Guardians shall conduct an 1253
investigation into the practices of each office of public 1254
guardian related to the managing of each ward's personal affairs 1255
and property. If feasible, the investigation shall be conducted 1256
in conjunction with the financial audit of each office of public 1257
guardian under paragraph (a). 1258
Section 21. Subsection (2) of section 744.2104, Florida 1259
Statutes, is renumbered as subsection (4), and new subsections 1260
(2) and (3) are added to that section, amend ed to read: 1261
744.2104 Access to records by the Office of Public and 1262
Professional Guardians; confidentiality. — 1263
(2) In conducting an investigation, the Office of Public 1264
and Professional Guardians may issue subpoenas duces tecum to 1265
financial institutions, insurance companies, the ward's 1266
caregivers, any facility at which the ward is or has resided, 1267
and the guardian to compel the production of records relevant to 1268
the investigation conducted by the office. 1269
(3) If there is substantial noncompliance with a subpoena 1270
duces tecum issued by the office, the office may petition the 1271
court in the county in which the person res ides or has or his 1272
place of business for an order requiring the person to produce 1273
such records as specified in the subpoena duces tecum. 1274
Section 22. Subsection (1) of section 744.351, Florida 1275
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Statutes, is amended to read: 1276
744.351 Bond of guardian. — 1277
(1) Before exercising his or her authority as guardian, 1278
every person appointed a guardian of the property of a ward in 1279
this state shall file a bond with surety as prescribed in s. 1280
45.011 to be approved by the clerk. The bond shall be payable to 1281
the Governor of the state and the Governor's successors in 1282
office, conditioned on the faithful performance of all duties by 1283
the guardian. In form the bond shall be joint and several. When 1284
the petitioner or guardian presents compelling reasons, the 1285
court may waive a bond or require the use of a designated 1286
financial institution as defined in s. 655.005(1) , by entering a 1287
written order detailing the compelling reasons relied on in 1288
waiving the bond. 1289
Section 23. Paragraph (b) of subsection (13) and paragraph 1290
(d) of subsection (14) of section 744.361, Florida Statutes, are 1291
amended to read: 1292
744.361 Powers and duties of guardian. — 1293
(13) Recognizing that every individual has unique needs 1294
and abilities, a guardian who is given authority over a ward's 1295
person shall, as appr opriate under the circumstances: 1296
(b) Allow the ward to maintain visitation or other contact 1297
with his or her family and friends unless a court has: the 1298
guardian believes that such contact may cause harm to the ward. 1299
1. Determined that such visitation or other contact is not 1300
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in the best interests of the ward; or 1301
2. Placed reasonable limitations on such visitation or 1302
other contact in a court order. 1303
(14) A professional guardian must ensure that each of the 1304
guardian's wards is personally visited by the g uardian or one of 1305
the guardian's professional staff at least once each calendar 1306
quarter. During the personal visit, the guardian or the 1307
guardian's professional staff person shall assess: 1308
(d) The nature and extent of visitation or other contact 1309
and communication with the ward's family and friends. 1310
1311
This subsection does not apply to a professional guardian who 1312
has been appointed only as guardian of the property. 1313
Section 24. Subsection (4) of section 744.3701, Florida 1314
Statutes, is amended to read: 1315
744.3701 Confidentiality. — 1316
(4) The clerk may disclose confidential information to the 1317
Department of Children and Families , the Department of Elderly 1318
Affairs, or law enforcement agencies for other purposes as 1319
provided by court order. 1320
Section 25. Subsection (12) of section 744.441, Florida 1321
Statutes, is amended to read: 1322
744.441 Powers of guardian upon court approval. —After 1323
obtaining approval of the court pursuant to a petition for 1324
authorization to act, a plenary guardian of the property, or a 1325
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limited guardian of the property within the powers granted by 1326
the order appointing the guardian or an approved annual or 1327
amended guardianship report, may do all of the following: 1328
(12) Sell, mortgage, or lease any real or personal 1329
property of the estate, includi ng homestead property, or any 1330
interest therein for cash or credit, or for part cash and part 1331
credit, and with or without security for unpaid balances if the 1332
filed petition includes all details of the sale, including, at a 1333
minimum, the identity of the real estate agent, the company for 1334
which the agent is employed and to be used to sell the property, 1335
whether there is any relationship between the guardian and the 1336
company and, if so, the nature of that relationship and whether 1337
the guardian will benefit from usi ng that real estate agent or 1338
company identified within the petition . 1339
Section 26. Section 744.448, Florida Statutes, is created 1340
to read: 1341
744.448 Real property transactions. - 1342
(1) Notwithstanding any other provision of law to the 1343
contrary, a written, certified appraisal of the ward's real 1344
property must be completed before filing the petition for 1345
authorization to act. The appraisal must be completed by 1346
appraiser who has an active registration, license, or 1347
certification pursuant to part II, chapter 475. The appraisal 1348
must determine the fair market value the ward's real property 1349
and certified no longer than 90 days before filing the petition 1350
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for authorization to act. 1351
(2) The guardian shall make every effort to market the 1352
property effectively, which inclu des, but is not limited to, 1353
employing a qualified real estate agent or broker to market the 1354
property appropriately in order to obtain the highest sale 1355
price. 1356
(a) Unless there is a compelling reason not to, all real 1357
property marketed for sale shall be pla ced on the multiple-1358
listing service (MLS) for a reasonable amount of time. 1359
(b) If real property is not sold by using the MLS, the 1360
guardian shall maintain detailed records supporting the 1361
compelling reasons the MLS was not used, for inspection by the 1362
court or the Office of Public and Professional Guardians. 1363
(3) In addition to the requirements in s. 744.447., the 1364
petition for authorization to act must be verified by the 1365
guardian and include: 1366
(a) How the proceeds from the sale will be used for the 1367
benefit the ward, as provided for under the terms of the 1368
guardianship plan or by law; 1369
(b) A full disclosure of any financial interest, direct or 1370
indirect, related to the sale or the proposed use of the 1371
proceeds of the sale by the guardian or the guardian's fami ly 1372
member, business partner, employer, employee, member of the 1373
board of a corporate professional guardian, attorney, agent, or 1374
any corporation or trust in which the guardian or a family 1375
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member of the guardian has a beneficial interest in the 1376
transaction. 1377
(c) Documentation of any conflicts of interest, actual or 1378
perceived, related to the sale or the proposed use of the 1379
proceeds of the sale by the guardian or the guardian's family 1380
member, business partner, employer, employee, member of the 1381
board of a corporate professional guardian, attorney, agent, or 1382
any corporation or trust in which the guardian or a family 1383
member of the guardian has a beneficial interest in the 1384
transaction. 1385
(d) Notice of the petition for authorization to act must 1386
be given to the ward, to the next of kin, if any, and to those 1387
persons who have filed requests for notices and copies of 1388
pleadings and provide 20 days to file objections to the sale. 1389
(e) Provide the compelling reasons the MLS was not used, 1390
if applicable. 1391
(4) The guardian sh all maintain detailed records of all 1392
negotiations, offers, and communications related to the sale of 1393
the real property, along with copies of all documents for a 1394
period of 5 years after her or his discharge, notwithstanding 1395
any other provision of law to the contrary. The records must be 1396
made available for inspection and review by the Office of Public 1397
and Professional Guardians and the court. 1398
(5) In the annual accounting following the sale of the 1399
real property, the guardian must include the: 1400
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(a) The executed sales contract. 1401
(b) The closing statement. 1402
(c) Evidence of how the proceeds have been used to date. 1403
Section 27. Subsection (12) of section 400.0060, Florida 1404
Statutes, is amended to read: 1405
400.0060 Definitions. —When used in this part, unless the 1406
context clearly dictates otherwise, the term: 1407
(12) "State council" means the State Long -Term Care 1408
Ombudsman Council created by s. 400.0067. 1409
Section 28. Paragraph (h) of subsection (2) of section 1410
400.0065, Florida Statutes, is amended to read: 1411
400.0065 State Long-Term Care Ombudsman Program; duties 1412
and responsibilities. — 1413
(2) The State Long-Term Care Ombudsman has the duty and 1414
authority to: 1415
(h) Prepare an annual report describing the activities 1416
carried out by the office, the state council, the districts, and 1417
the local councils in the year for which the report is prepared. 1418
The state ombudsman shall submit the report to the secretary, 1419
the United States Assistant Secretary for Aging, the Governor, 1420
the President of the Senate, the Speaker of the Ho use of 1421
Representatives, the Secretary of Children and Families, and the 1422
Secretary of the Agency for Health Care Administration at least 1423
30 days before the convening of the regular session of the 1424
Legislature. The report must, at a minimum: 1425
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1. Contain and analyze data collected concerning 1426
complaints about and conditions in long -term care facilities and 1427
the disposition of such complaints. 1428
2. Evaluate the problems experienced by residents. 1429
3. Analyze the successes of the State Long -Term Care 1430
Ombudsman Program during the preceding year, including an 1431
assessment of how successfully the program has carried out its 1432
responsibilities under the Older Americans Act. 1433
4. Provide recommendations for policy, regulatory, and 1434
statutory changes designed to solve identif ied problems; resolve 1435
residents' complaints; improve residents' lives and quality of 1436
care; protect residents' rights, health, safety, and welfare; 1437
and remove any barriers to the optimal operation of the State 1438
Long-Term Care Ombudsman Program. 1439
5. Contain recommendations from the State Long -Term Care 1440
Ombudsman Council regarding program functions and activities and 1441
recommendations for policy, regulatory, and statutory changes 1442
designed to protect residents' rights, health, safety, and 1443
welfare. 1444
6. Contain any relevant recommendations from the 1445
representatives of the State Long -Term Care Ombudsman Program 1446
regarding program functions and activities. 1447
Section 29. Subsection (2) of section 400.0073, Florida 1448
Statutes, is amended to read: 1449
400.0073 State and loc al ombudsman council 1450
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investigations.— 1451
(2) Subsequent to an appeal from a local council, the 1452
state council may investigate any complaint received by the 1453
local council involving a long -term care facility or a resident. 1454
Section 30. Paragraph (a) of subs ection (1) and paragraph 1455
(a) of subsection (2) of section 400.0075, Florida Statutes, are 1456
amended to read: 1457
400.0075 Complaint notification and resolution 1458
procedures.— 1459
(1)(a) Any complaint verified by a representative of the 1460
State Long-Term Care Ombudsman Program as a result of an 1461
investigation which is determined by the local council to 1462
require remedial action may be identified and brought to the 1463
attention of the long -term care facility administrator subject 1464
to the confidentiality provisions of s. 400.0 077. Upon receipt 1465
of the information, the administrator, with the concurrence of 1466
the representative of the State Long -Term Care Ombudsman 1467
Program, shall establish target dates for taking appropriate 1468
remedial action. If, by the target date, the remedial act ion is 1469
not completed or forthcoming, the representative of the State 1470
Long-Term Care Ombudsman Program may extend the target date if 1471
there is reason to believe such action would facilitate the 1472
resolution of the complaint, or the representative of the State 1473
Long-Term Care Ombudsman Program may refer the complaint to the 1474
district manager, who may refer the complaint to the state 1475
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council. 1476
(2) Upon referral from a district or local council, the 1477
state ombudsman or his or her designee shall assume the 1478
responsibility for the disposition of the complaint. If a long -1479
term care facility fails to take action to resolve or remedy the 1480
complaint, the state ombudsman may: 1481
(a) In accordance with s. 400.0077, publicize the 1482
complaint, the recommendations of the lo cal or state council, 1483
and the response of the long -term care facility. 1484
Section 31. Subsection (2) of section 400.0087, Florida 1485
Statutes, is amended to read: 1486
400.0087 Department oversight; funding. — 1487
(2) The department shall monitor the State Long-Term Care 1488
Ombudsman Program, the state council, and the local councils to 1489
ensure that each is carrying out the duties delegated to it by 1490
state and federal law. 1491
Section 32. Section 430.504, Florida Statutes, is amended 1492
to read: 1493
430.504 Confidentiality o f information.—Information about 1494
clients of programs created or funded under s. 430.501 or s. 1495
430.503 which is received through files, reports, inspections, 1496
or otherwise, by the department or by authorized departmental 1497
employees, by persons who volunteer s ervices, or by persons who 1498
provide services to clients of programs created or funded under 1499
s. 430.501 or s. 430.503 through contracts with the department 1500
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is confidential and exempt from the provisions of s. 119.07(1). 1501
Such information may not be disclosed publicly in such a manner 1502
as to identify a person who receives services under s. 430.501 1503
or s. 430.503, unless that person or that person's legal 1504
guardian provides written consent. 1505
Section 33. This act shall take effect July 1, 2025. 1506