Bill Amendment: FL S0382 | 2015 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Assisted Living Facilities
Status: 2015-04-27 - Laid on Table, companion bill(s) passed, see CS/CS/HB 1001 (Ch. 2015-126), CS/SB 7018 (Ch. 2015-31) [S0382 Detail]
Download: Florida-2015-S0382-Senate_Committee_Amendment_113398.html
Bill Title: Assisted Living Facilities
Status: 2015-04-27 - Laid on Table, companion bill(s) passed, see CS/CS/HB 1001 (Ch. 2015-126), CS/SB 7018 (Ch. 2015-31) [S0382 Detail]
Download: Florida-2015-S0382-Senate_Committee_Amendment_113398.html
Florida Senate - 2015 COMMITTEE AMENDMENT Bill No. SB 382 Ì113398JÎ113398 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Flores) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 285 - 531 4 and insert: 5 Section 4. Subsection (2) and paragraph (c) of subsection 6 (3) of section 419.001, Florida Statutes, are amended to read: 7 419.001 Site selection of community residential homes.— 8 (2) Homes withofsix or fewer residents which otherwise 9 meet the definition of a community residential home areshallbe10 deemed a single-family unit and a noncommercial, residential use 11 for the purpose of local laws and ordinances. Homes withofsix 12 or fewer residents which otherwise meet the definition of a 13 community residential home mustshallbe allowed in single 14 family or multifamily zoning without approval by the local 15 government, provided that such homes mayshallnot be located 16 within a radius of 1,000 feet of another existing such home with 17 six or fewer residents. Such homes with six or fewer residents 18 may not be located within a radius of 1,200 feet of a community 19 residential home. Such homes with six or fewer residents may 20shallnot be required to comply with the notification provisions 21 of this section; provided that, prior to licensure, the 22 sponsoring agency provides the local government with the most 23 recently published data compiled from the licensing entities 24 that identifies all community residential homes and all such 25 homes with six or fewer residents within the jurisdictional 26 limits of the local government in which the proposed site is to 27 be located in order to show that no other community residential 28 home is within a radius of 1,200 feet of the proposed home with 29 six or fewer residents and that no other such home with six or 30 fewer residents is within a radius of 1,000 feet of the proposed 31 home with six or fewer residents. At the time of home occupancy, 32 the sponsoring agency must notify the local government that the 33 home is licensed by the licensing entity. 34 (3) 35 (c) The local government mayshallnot deny the siting of a 36 community residential home unless the local government 37 establishes that the siting of the home at the site selected: 38 1. Does not otherwise conform to existing zoning 39 regulations applicable to other multifamily uses in the area. 40 2. Does not meet applicable licensing criteria established 41 and determined by the licensing entity, including requirements 42 that the home be located to assure the safe care and supervision 43 of all clients in the home. 44 3. Would result in such a concentration of community 45 residential homes in the area in proximity to the site selected, 46 or would result in a combination of such homes with other 47 residences in the community,suchthat the nature and character 48 of the area would be substantially altered. A home that is 49 located within a radius of 1,200 feet of another existing 50 community residential home in a multifamily zone is deemed to 51shallbe an overconcentration of such homes that substantially 52 alters the nature and character of the area. A community 53 residential home may not be located within a radius of 1,200 54 feet of a home of six or fewer residents which otherwise meets 55 the definition of a community residential home. Distances must 56 be measured between all community residential homes that are 57 less than 1,200 feet apart if they serve residents who are 58 clients of one or more of the agencies and offices described in 59 paragraph (1)(a). A home that is located within a radius of 500 60 feet of an area of single-family zoning substantially alters the 61 nature and character of the area. 62 Section 5. Paragraphs (b) and (c) of subsection (3) of 63 section 429.07, Florida Statutes, are amended to read: 64 429.07 License required; fee.— 65 (3) In addition to the requirements of s. 408.806, each 66 license granted by the agency must state the type of care for 67 which the license is granted. Licenses shall be issued for one 68 or more of the following categories of care: standard, extended 69 congregate care, limited nursing services, or limited mental 70 health. 71 (b) An extended congregate care license shall be issued to 72 each facility that has been licensed as an assisted living 73 facility for 2 or more years and that provides services 74facilities providing, directly or through contract,services75 beyond those authorized in paragraph (a), including services 76 performed by persons licensed under part I of chapter 464 and 77 supportive services, as defined by rule, to persons who would 78 otherwise be disqualified from continued residence in a facility 79 licensed under this part. An extended congregate care license 80 may be issued to a facility that has a provisional extended 81 congregate care license and meets the requirements for licensure 82 under subparagraph 2. The primary purpose of extended congregate 83 care services is to allow residents the option of remaining in a 84 familiar setting from which they would otherwise be disqualified 85 for continued residency as they become more impaired. A facility 86 licensed to provide extended congregate care services may also 87 admit an individual who exceeds the admission criteria for a 88 facility with a standard license if the individual is determined 89 appropriate for admission to the extended congregate care 90 facility. 91 1. In order for extended congregate care services to be 92 provided, the agency must first determine that all requirements 93 established in law and rule are met and must specifically 94 designate,on the facility’s license,that such services may be 95 provided and whether the designation applies to all or part of 96 the facility. ThisSuchdesignation may be made at the time of 97 initial licensure or licensure renewalrelicensure, or upon 98 request in writing by a licensee under this part and part II of 99 chapter 408. The notification of approval or the denial of the 100 request mustshallbe made in accordance with part II of chapter 101 408. Each existing facility that qualifiesfacilities qualifying102 to provide extended congregate care services must have 103 maintained a standard license and may not have been subject to 104 administrative sanctions during the previous 2 years, or since 105 initial licensure if the facility has been licensed for less 106 than 2 years, for any of the following reasons: 107 a. A class I or class II violation; 108 b. Three or more repeat or recurring class III violations 109 of identical or similar resident care standards from which a 110 pattern of noncompliance is found by the agency; 111 c. Three or more class III violations that were not 112 corrected in accordance with the corrective action plan approved 113 by the agency; 114 d. Violation of resident care standards which results in 115 requiring the facility to employ the services of a consultant 116 pharmacist or consultant dietitian; 117 e. Denial, suspension, or revocation of a license for 118 another facility licensed under this part in which the applicant 119 for an extended congregate care license has at least 25 percent 120 ownership interest; or 121 f. Imposition of a moratorium pursuant to this part or part 122 II of chapter 408 or initiation of injunctive proceedings. 123 124 The agency may deny or revoke a facility’s extended congregate 125 care license if it fails to meet the criteria for an extended 126 congregate care license as provided in this subparagraph. 127 2. If an assisted living facility has been licensed for 128 less than 2 years, the initial extended congregate care license 129 must be provisional and may not exceed 6 months. Within the 130 first 3 months after the provisional license is issued, the 131 licensee shall notify the agency, in writing, when it admits at 132 least one extended congregate care resident, after which an 133 unannounced inspection shall be made to determine compliance 134 with requirements of an extended congregate care license. 135 Failure to admit an extended congregate care resident within the 136 first 3 months renders the extended congregate care license 137 void. A licensee that has a provisional extended congregate care 138 license which demonstrates compliance with all of the 139 requirements of an extended congregate care license during the 140 inspection shall be issued an extended congregate care license. 141 In addition to sanctions authorized under this part, if 142 violations are found during the inspection and the licensee 143 fails to demonstrate compliance with all assisted living 144 requirements during a followup inspection, the licensee shall 145 immediately suspend extended congregate care services, and the 146 provisional extended congregate care license expires. The agency 147 may extend the provisional license for not more than 1 month in 148 order to complete a followup visit. 149 3.2.A facility that is licensed to provide extended 150 congregate care services shall maintain a written progress 151 report on each person who receives services which describes the 152 type, amount, duration, scope, and outcome of services that are 153 rendered and the general status of the resident’s health. A 154 registered nurse, or appropriate designee, representing the 155 agency shall visit the facility at least twice a yearquarterly156 to monitor residents who are receiving extended congregate care 157 services and to determine if the facility is in compliance with 158 this part, part II of chapter 408, and relevant rules. One of 159 the visits may be in conjunction with the regular survey. The 160 monitoring visits may be provided through contractual 161 arrangements with appropriate community agencies. A registered 162 nurse shall serve as part of the team that inspects the 163 facility. The agency may waive one of the required yearly 164 monitoring visits for a facility that has: 165 a. Held an extended congregate care license for at least 24 166 months;been licensed for at least 24 months to provide extended167congregate care services, if, during the inspection, the168registered nurse determines that extended congregate care169services are being provided appropriately, and if the facility170has171 b. No class I or class II violations and no uncorrected 172 class III violations; and.173 c. No ombudsman council complaints that resulted in a 174 citation for licensureThe agency must first consult with the175long-term care ombudsman council for the area in which the176facility is located to determine if any complaints have been177made and substantiated about the quality of services or care. 178The agency may not waive one of the required yearly monitoring179visits if complaints have been made and substantiated. 180 4.3.A facility that is licensed to provide extended 181 congregate care services must: 182 a. Demonstrate the capability to meet unanticipated 183 resident service needs. 184 b. Offer a physical environment that promotes a homelike 185 setting, provides for resident privacy, promotes resident 186 independence, and allows sufficient congregate space as defined 187 by rule. 188 c. Have sufficient staff available, taking into account the 189 physical plant and firesafety features of the building, to 190 assist with the evacuation of residents in an emergency. 191 d. Adopt and follow policies and procedures that maximize 192 resident independence, dignity, choice, and decisionmaking to 193 permit residents to age in place, so that moves due to changes 194 in functional status are minimized or avoided. 195 e. Allow residents or, if applicable, a resident’s 196 representative, designee, surrogate, guardian, or attorney in 197 fact to make a variety of personal choices, participate in 198 developing service plans, and share responsibility in 199 decisionmaking. 200 f. Implement the concept of managed risk. 201 g. Provide, directly or through contract, the services of a 202 person licensed under part I of chapter 464. 203 h. In addition to the training mandated in s. 429.52, 204 provide specialized training as defined by rule for facility 205 staff. 206 5.4.A facility that is licensed to provide extended 207 congregate care services is exempt from the criteria for 208 continued residency set forth in rules adopted under s. 429.41. 209 A licensed facility must adopt its own requirements within 210 guidelines for continued residency set forth by rule. However, 211 the facility may not serve residents who require 24-hour nursing 212 supervision. A licensed facility that provides extended 213 congregate care services must also provide each resident with a 214 written copy of facility policies governing admission and 215 retention. 2165. The primary purpose of extended congregate care services217is to allow residents, as they become more impaired, the option218of remaining in a familiar setting from which they would219otherwise be disqualified for continued residency. A facility220licensed to provide extended congregate care services may also221admit an individual who exceeds the admission criteria for a222facility with a standard license, if the individual is223determined appropriate for admission to the extended congregate224care facility.225 6. Before the admission of an individual to a facility 226 licensed to provide extended congregate care services, the 227 individual must undergo a medical examination as provided in s. 228 429.26(4) and the facility must develop a preliminary service 229 plan for the individual. 230 7. IfWhena facility can no longer provide or arrange for 231 services in accordance with the resident’s service plan and 232 needs and the facility’s policy, the facility mustshallmake 233 arrangements for relocating the person in accordance with s. 234 429.28(1)(k). 2358. Failure to provide extended congregate care services may236result in denial of extended congregate care license renewal.237 (c) A limited nursing services license shall be issued to a 238 facility that provides services beyond those authorized in 239 paragraph (a) and as specified in this paragraph. 240 1. In order for limited nursing services to be provided in 241 a facility licensed under this part, the agency must first 242 determine that all requirements established in law and rule are 243 met and must specifically designate, on the facility’s license, 244 that such services may be provided. ThisSuchdesignation may be 245 made at the time of initial licensure or licensure renewal 246relicensure, or upon request in writing by a licensee under this 247 part and part II of chapter 408. Notification of approval or 248 denial of such request shall be made in accordance with part II 249 of chapter 408. An existing facility that qualifiesfacilities250qualifyingto provide limited nursing services mustshallhave 251 maintained a standard license and may not have been subject to 252 administrative sanctions that affect the health, safety, and 253 welfare of residents for the previous 2 years or since initial 254 licensure if the facility has been licensed for less than 2 255 years. 256 2. A facilityFacilitiesthat isarelicensed to provide 257 limited nursing services shall maintain a written progress 258 report on each person who receives such nursing services. The 259 report must describe, whichreportdescribesthe type, amount, 260 duration, scope, and outcome of services that are rendered and 261 the general status of the resident’s health. A registered nurse 262 representing the agency shall visit the facilitysuch facilities263 at least annuallytwice a yearto monitor residents who are 264 receiving limited nursing services and to determine if the 265 facility is in compliance with applicable provisions of this 266 part, part II of chapter 408, and related rules. The monitoring 267 visits may be provided through contractual arrangements with 268 appropriate community agencies. A registered nurse shall also 269 serve as part of the team that inspects such facility. Visits 270 may be in conjunction with other agency inspections. The agency 271 may waive the required yearly monitoring visit for a facility 272 that has: 273 a. Had a limited nursing services license for at least 24 274 months; 275 b. No class I or class II violations and no uncorrected 276 class III violations; and 277 c. No ombudsman council complaints that resulted in a 278 citation for licensure. 279 3. A person who receives limited nursing services under 280 this part must meet the admission criteria established by the 281 agency for assisted living facilities. When a resident no longer 282 meets the admission criteria for a facility licensed under this 283 part, arrangements for relocating the person shall be made in 284 accordance with s. 429.28(1)(k), unless the facility is licensed 285 to provide extended congregate care services. 286 Section 6. Subsection (2) of s. 393.501, Florida Statutes, 287 is reenacted for the purpose of incorporating the amendment made 288 by this act to s. 419.001, Florida Statutes, in references 289 thereto. 290 Section 7. Paragraph (a) of subsection (1) of s. 429.22, 291 and subsection (5) of s. 429.26, Florida Statutes, are reenacted 292 for the purpose of incorporating the amendment made by this act 293 to s. 429.07, Florida Statutes, in references thereto. 294 Section 8. Subsection (2) of s. 409.212, Florida Statutes, 295 is reenacted for the purpose of incorporating the amendment made 296 by this act to s. 429.075, Florida Statutes, in references 297 thereto. 298 Section 9. Section 429.075, Florida Statutes, is amended to 299 read: 300 429.075 Limited mental health license.—An assisted living 301 facility that serves onethreeor more mental health residents 302 must obtain a limited mental health license. 303 (1) To obtain a limited mental health license, a facility 304 must hold a standard license as an assisted living facility, 305 must not have any current uncorrecteddeficiencies or306 violations, and must ensure that, within 6 months after 307 receiving a limited mental health license, the facility 308 administrator and the staff of the facility who are in direct 309 contact with mental health residents must complete training of 310 no less than 6 hours related to their duties. ThisSuch311 designation may be made at the time of initial licensure or 312 licensure renewalrelicensureor upon request in writing by a 313 licensee under this part and part II of chapter 408. 314 Notification of approval or denial of such request shall be made 315 in accordance with this part, part II of chapter 408, and 316 applicable rules. This training mustwillbe provided by or 317 approved by the Department of Children and Families. 318 (2) A facility that isFacilitieslicensed to provide 319 services to mental health residents shall provide appropriate 320 supervision and staffing to provide for the health, safety, and 321 welfare of such residents. A facility located in an area zoned 322 for residential use in a municipality having a population 323 greater than 200,000 shall also do the following: 324 (a) Maintain on the premises of the facility 24-hour 325 security services provided by uniformed security personnel, 326 licensed under part III of chapter 493 or by a licensed security 327 officer as defined in s. 493.6101. The security officer must 328 wear a uniform that bears at least one patch or emblem that is 329 visible at all times and clearly displays his or her employing 330 agency and identity as a licensed security officer. 331 (b) Notify the municipality within 20 days after accepting 332 a resident who has been discharged from the criminal justice 333 system or who has a history of criminal arrest within the past 5 334 years. 335 (c) Maintain surveillance cameras on the premises 336 sufficient to ensure the safety of its residents and the 337 community at large. 338 (d) Maintain a log of residents who have been discharged 339 from the criminal justice system or who have a history of 340 criminal arrest within the past 5 years. The log must contain 341 the name of the transferring department and the previous address 342 for each such resident. The facility or home shall require 343 residents to sign the log each time they enter or exit the 344 premises. The facility shall send a copy of the log to the chief 345 administrative officer of the municipality in which the facility 346 is located on a quarterly basis and shall keep the log current, 347 maintain it in an accessible area on the premises, and allow its 348 inspection or copying within 45 days of a request by the 349 municipality. 350 351 ================= T I T L E A M E N D M E N T ================ 352 And the title is amended as follows: 353 Delete lines 41 - 79 354 and insert: 355 resident right; amending s. 419.001, F.S.; prohibiting 356 the colocation of a home of six or fewer residents 357 which otherwise meets the definition of a community 358 residential home and a community residential home 359 within a certain distance; requiring the measuring of 360 certain distances between community residential homes; 361 amending s. 429.07, F.S.; revising the requirement 362 that an extended congregate care license be issued to 363 certain facilities that have been licensed as assisted 364 living facilities under certain circumstances and 365 authorizing the issuance of such license if a 366 specified condition is met; providing the purpose of 367 an extended congregate care license; specifying that 368 the initial extended congregate care license of an 369 assisted living facility is provisional under certain 370 circumstances; requiring a licensee to notify the 371 Agency for Health Care Administration if it accepts a 372 resident who qualifies for extended congregate care 373 services; requiring the agency to inspect the facility 374 for compliance with the requirements of an extended 375 congregate care license; requiring the issuance of an 376 extended congregate care license under certain 377 circumstances; requiring the licensee to immediately 378 suspend extended congregate care services under 379 certain circumstances; requiring a registered nurse 380 representing the agency to visit the facility at least 381 twice a year, rather than quarterly, to monitor 382 residents who are receiving extended congregate care 383 services; authorizing the agency to waive one of the 384 required yearly monitoring visits under certain 385 circumstances; authorizing the agency to deny or 386 revoke a facility’s extended congregate care license; 387 requiring a registered nurse representing the agency 388 to visit the facility at least annually, rather than 389 twice a year, to monitor residents who are receiving 390 limited nursing services; providing that such 391 monitoring visits may be conducted in conjunction with 392 other inspections by the agency; authorizing the 393 agency to waive the required yearly monitoring visit 394 for a facility that is licensed to provide limited 395 nursing services under certain circumstances; 396 reenacting s. 393.501(2), F.S., to incorporate the 397 amendment made to s. 419.001, F.S., in references 398 thereto; reenacting ss. 429.22(1)(a) and 429.26(5), 399 F.S., to incorporate the amendment made to s. 429.07, 400 F.S., in references thereto; reenacting s. 409.212(2), 401 F.S., to incorporate the amendment made to s. 429.075, 402 F.S., in references thereto; amending s. 429.075, 403 F.S.; requiring that an assisted living facility that 404 serves one or more mental health residents, rather 405 than three or more such residents, obtain a limited 406 mental health license; requiring the adoption, use and 407 maintenance of certain security measures and practices 408 by assisted living facilities in municipalities having 409 a population greater than 200,000; amending s.