Bill Text: FL S0682 | 2015 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Transitional Living Facilities
Spectrum: Bipartisan Bill
Status: (Passed) 2015-05-15 - Chapter No. 2015-25 [S0682 Detail]
Download: Florida-2015-S0682-Introduced.html
Bill Title: Transitional Living Facilities
Spectrum: Bipartisan Bill
Status: (Passed) 2015-05-15 - Chapter No. 2015-25 [S0682 Detail]
Download: Florida-2015-S0682-Introduced.html
Florida Senate - 2015 SB 682 By Senator Grimsley 21-00365B-15 2015682__ 1 A bill to be entitled 2 An act relating to transitional living facilities; 3 creating part XI of ch. 400, F.S.; creating s. 4 400.997, F.S.; providing legislative intent; creating 5 s. 400.9971, F.S.; providing definitions; creating s. 6 400.9972, F.S.; requiring the licensure of 7 transitional living facilities; providing license fees 8 and application requirements; requiring accreditation 9 of licensed facilities; creating s. 400.9973, F.S.; 10 providing requirements for transitional living 11 facility policies and procedures governing client 12 admission, transfer, and discharge; creating s. 13 400.9974, F.S.; requiring a comprehensive treatment 14 plan to be developed for each client; providing plan 15 and staffing requirements; requiring certain consent 16 for continued treatment in a transitional living 17 facility; creating s. 400.9975, F.S.; providing 18 licensee responsibilities with respect to each client 19 and specified others and requiring written notice of 20 such responsibilities to be provided; prohibiting a 21 licensee or employee of a facility from serving notice 22 upon a client to leave the premises or taking other 23 retaliatory action under certain circumstances; 24 requiring the client and client’s representative to be 25 provided with certain information; requiring the 26 licensee to develop and implement certain policies and 27 procedures governing the release of client 28 information; creating s. 400.9976, F.S.; providing 29 licensee requirements relating to administration of 30 medication; requiring maintenance of medication 31 administration records; providing requirements for the 32 self-administration of medication by clients; creating 33 s. 400.9977, F.S.; providing training and supervision 34 requirements for the administration of medications by 35 unlicensed staff; specifying who may conduct the 36 training; requiring licensees to adopt certain 37 policies and procedures and maintain specified records 38 with respect to the administration of medications by 39 unlicensed staff; requiring the Agency for Health Care 40 Administration to adopt rules; creating s. 400.9978, 41 F.S.; providing requirements for the screening of 42 potential employees and training and monitoring of 43 employees for the protection of clients; requiring 44 licensees to implement certain policies and procedures 45 to protect clients; providing conditions for 46 investigating and reporting incidents of abuse, 47 neglect, mistreatment, or exploitation of clients; 48 creating s. 400.9979, F.S.; providing requirements and 49 limitations for the use of physical restraints, 50 seclusion, and chemical restraint medication on 51 clients; providing a limitation on the duration of an 52 emergency treatment order; requiring notification of 53 certain persons when restraint or seclusion is 54 imposed; authorizing the agency to adopt rules; 55 creating s. 400.998, F.S.; providing background 56 screening requirements for licensee personnel; 57 requiring the licensee to maintain certain personnel 58 records; providing administrative responsibilities for 59 licensees; providing recordkeeping requirements; 60 creating s. 400.9981, F.S.; providing licensee 61 responsibilities with respect to the property and 62 personal affairs of clients; providing requirements 63 for a licensee with respect to obtaining surety bonds; 64 providing recordkeeping requirements relating to the 65 safekeeping of personal effects; providing 66 requirements for trust funds or other property 67 received by a licensee and credited to the client; 68 providing a penalty for certain misuse of a client’s 69 personal funds, property, or personal needs allowance; 70 providing criminal penalties for violations; providing 71 for the disposition of property in the event of the 72 death of a client; authorizing the agency to adopt 73 rules; creating s. 400.9982, F.S.; providing 74 legislative intent; authorizing the agency to adopt 75 and enforce rules establishing specified standards for 76 transitional living facilities and personnel thereof; 77 creating s. 400.9983, F.S.; classifying certain 78 violations and providing penalties therefor; providing 79 administrative fines for specified classes of 80 violations; creating s. 400.9984, F.S.; authorizing 81 the agency to apply certain provisions with regard to 82 receivership proceedings; creating s. 400.9985, F.S.; 83 requiring the agency, the Department of Health, the 84 Agency for Persons with Disabilities, and the 85 Department of Children and Families to develop 86 electronic information systems for certain purposes; 87 transferring and renumbering s. 400.805, F.S., as s. 88 400.9986, F.S.; repealing s. 400.9986, F.S., relating 89 to transitional living facilities, on a specified 90 date; revising the title of part V of ch. 400, F.S.; 91 amending s. 381.745, F.S.; revising the definition of 92 the term “transitional living facility,” to conform to 93 changes made by the act; amending s. 381.75, F.S.; 94 revising the duties of the Department of Health and 95 the agency relating to transitional living facilities; 96 amending ss. 381.78, 400.93, 408.802, and 408.820, 97 F.S.; conforming provisions to changes made by the 98 act; reenacting s. 381.79(1), F.S., to incorporate the 99 amendment made by this act to s. 381.75, F.S., in a 100 reference thereto; providing for the act’s 101 applicability to licensed transitional living 102 facilities licensed on specified dates; providing 103 effective dates. 104 105 Be It Enacted by the Legislature of the State of Florida: 106 107 Section 1. Part XI of chapter 400, Florida Statutes, 108 consisting of sections 400.997 through 400.9986, is created to 109 read: 110 PART XI 111 TRANSITIONAL LIVING FACILITIES 112 400.997 Legislative intent.—It is the intent of the 113 Legislature to provide for the licensure of transitional living 114 facilities and require the development, establishment, and 115 enforcement of basic standards by the Agency for Health Care 116 Administration to ensure quality of care and services to clients 117 in transitional living facilities. It is the policy of the state 118 that the least restrictive appropriate available treatment be 119 used based on the individual needs and best interest of the 120 client, consistent with optimum improvement of the client’s 121 condition. The goal of a transitional living program for persons 122 who have brain or spinal cord injuries is to assist each person 123 who has such an injury to achieve a higher level of independent 124 functioning and to enable the person to reenter the community. 125 It is also the policy of the state that the restraint or 126 seclusion of a client is justified only as an emergency safety 127 measure used in response to danger to the client or others. It 128 is therefore the intent of the Legislature to achieve an ongoing 129 reduction in the use of restraint or seclusion in programs and 130 facilities that serve persons who have brain or spinal cord 131 injuries. 132 400.9971 Definitions.—As used in this part, the term: 133 (1) “Agency” means the Agency for Health Care 134 Administration. 135 (2) “Chemical restraint” means a pharmacologic drug that 136 physically limits, restricts, or deprives a person of movement 137 or mobility, is used for client protection or safety, and is not 138 required for the treatment of medical conditions or symptoms. 139 (3) “Client’s representative” means the parent of a child 140 client or the client’s guardian, designated representative, 141 designee, surrogate, or attorney in fact. 142 (4) “Department” means the Department of Health. 143 (5) “Physical restraint” means a manual method to restrict 144 freedom of movement of or normal access to a person’s body, or a 145 physical or mechanical device, material, or equipment attached 146 or adjacent to the person’s body that the person cannot easily 147 remove and that restricts freedom of movement of or normal 148 access to the person’s body, including, but not limited to, a 149 half-bed rail, a full-bed rail, a geriatric chair, or a Posey 150 restraint. The term includes any device that is not specifically 151 manufactured as a restraint but is altered, arranged, or 152 otherwise used for this purpose. The term does not include 153 bandage material used for the purpose of binding a wound or 154 injury. 155 (6) “Seclusion” means the physical segregation of a person 156 in any fashion or the involuntary isolation of a person in a 157 room or area from which the person is prevented from leaving. 158 Such prevention may be accomplished by imposition of a physical 159 barrier or by action of a staff member to prevent the person 160 from leaving the room or area. For purposes of this part, the 161 term does not mean isolation due to a person’s medical condition 162 or symptoms. 163 (7) “Transitional living facility” means a site where 164 specialized health care services are provided to persons who 165 have brain or spinal cord injuries, including, but not limited 166 to, rehabilitative services, behavior modification, community 167 reentry training, aids for independent living, and counseling. 168 400.9972 License required; fee; application.— 169 (1) The requirements of part II of chapter 408 apply to the 170 provision of services that require licensure pursuant to this 171 part and part II of chapter 408 and to entities licensed by or 172 applying for licensure from the agency pursuant to this part. A 173 license issued by the agency is required for the operation of a 174 transitional living facility in this state. However, this part 175 does not require a provider licensed by the agency to obtain a 176 separate transitional living facility license to serve persons 177 who have brain or spinal cord injuries as long as the services 178 provided are within the scope of the provider’s license. 179 (2) In accordance with this part, an applicant or a 180 licensee shall pay a fee for each license application submitted 181 under this part. The license fee shall consist of a $4,588 182 license fee and a $90 per-bed fee per biennium and shall conform 183 to the annual adjustment authorized in s. 408.805. 184 (3) An applicant for licensure must provide: 185 (a) The location of the facility for which the license is 186 sought and documentation, signed by the appropriate local 187 government official, which states that the applicant has met 188 local zoning requirements. 189 (b) Proof of liability insurance as provided in s. 190 624.605(1)(b). 191 (c) Proof of compliance with local zoning requirements, 192 including compliance with the requirements of chapter 419 if the 193 proposed facility is a community residential home. 194 (d) Proof that the facility has received a satisfactory 195 firesafety inspection. 196 (e) Documentation that the facility has received a 197 satisfactory sanitation inspection by the county health 198 department. 199 (4) The applicant’s proposed facility must attain and 200 continuously maintain accreditation by an accrediting 201 organization that specializes in evaluating rehabilitation 202 facilities whose standards incorporate licensure regulations 203 comparable to those required by the state. An applicant for 204 licensure as a transitional living facility must acquire 205 accreditation within 12 months after issuance of an initial 206 license. The agency shall accept the accreditation survey report 207 of the accrediting organization in lieu of conducting a 208 licensure inspection if the standards included in the survey 209 report are determined by the agency to document that the 210 facility substantially complies with state licensure 211 requirements. Within 10 days after receiving the accreditation 212 survey report, the applicant shall submit to the agency a copy 213 of the report and evidence of the accreditation decision as a 214 result of the report. The agency may conduct an inspection of a 215 transitional living facility to ensure compliance with the 216 licensure requirements of this part, to validate the inspection 217 process of the accrediting organization, to respond to licensure 218 complaints, or to protect the public health and safety. 219 400.9973 Client admission, transfer, and discharge.— 220 (1) A transitional living facility shall have written 221 policies and procedures governing the admission, transfer, and 222 discharge of clients. 223 (2) The admission of a client to a transitional living 224 facility must be in accordance with the licensee’s policies and 225 procedures. 226 (3) To be admitted to a transitional living facility, an 227 individual must have an acquired internal or external injury to 228 the skull, the brain, or the brain’s covering, caused by a 229 traumatic or nontraumatic event, which produces an altered state 230 of consciousness, or a spinal cord injury, such as a lesion to 231 the spinal cord or cauda equina syndrome, with evidence of 232 significant involvement of at least two of the following 233 deficits or dysfunctions: 234 (a) A motor deficit. 235 (b) A sensory deficit. 236 (c) A cognitive deficit. 237 (d) A behavioral deficit. 238 (e) Bowel and bladder dysfunction. 239 (4) A client whose medical condition and diagnosis do not 240 positively identify a cause of the client’s condition, whose 241 symptoms are inconsistent with the known cause of injury, or 242 whose recovery is inconsistent with the known medical condition 243 may be admitted to a transitional living facility for evaluation 244 for a period not to exceed 90 days. 245 (5) A client admitted to a transitional living facility 246 must be admitted upon prescription by a licensed physician, 247 physician assistant, or advanced registered nurse practitioner 248 and must remain under the care of a licensed physician, 249 physician assistant, or advanced registered nurse practitioner 250 for the duration of the client’s stay in the facility. 251 (6) A transitional living facility may not admit a person 252 whose primary admitting diagnosis is mental illness or an 253 intellectual or developmental disability. 254 (7) A person may not be admitted to a transitional living 255 facility if the person: 256 (a) Presents significant risk of infection to other clients 257 or personnel. A health care practitioner must provide 258 documentation that the person is free of apparent signs and 259 symptoms of communicable disease; 260 (b) Is a danger to himself or herself or others as 261 determined by a physician, physician assistant, or advanced 262 registered nurse practitioner or a mental health practitioner 263 licensed under chapter 490 or chapter 491, unless the facility 264 provides adequate staffing and support to ensure patient safety; 265 (c) Is bedridden; or 266 (d) Requires 24-hour nursing supervision. 267 (8) If the client meets the admission criteria, the medical 268 or nursing director of the facility must complete an initial 269 evaluation of the client’s functional skills, behavioral status, 270 cognitive status, educational or vocational potential, medical 271 status, psychosocial status, sensorimotor capacity, and other 272 related skills and abilities within the first 72 hours after the 273 client’s admission to the facility. An initial comprehensive 274 treatment plan that delineates services to be provided and 275 appropriate sources for such services must be implemented within 276 the first 4 days after admission. 277 (9) A transitional living facility shall develop a 278 discharge plan for each client before or upon admission to the 279 facility. The discharge plan must identify the intended 280 discharge site and possible alternative discharge sites. For 281 each discharge site identified, the discharge plan must identify 282 the skills, behaviors, and other conditions that the client must 283 achieve to be eligible for discharge. A discharge plan must be 284 reviewed and updated as necessary but at least once monthly. 285 (10) A transitional living facility shall discharge a 286 client as soon as practicable when the client no longer requires 287 the specialized services described in s. 400.9971(7), when the 288 client is not making measurable progress in accordance with the 289 client’s comprehensive treatment plan, or when the transitional 290 living facility is no longer the most appropriate and least 291 restrictive treatment option. 292 (11) A transitional living facility shall provide at least 293 30 days’ notice to a client of transfer or discharge plans, 294 including the location of an acceptable transfer location if the 295 client is unable to live independently. This subsection does not 296 apply if a client voluntarily terminates residency. 297 400.9974 Client comprehensive treatment plans; client 298 services.— 299 (1) A transitional living facility shall develop a 300 comprehensive treatment plan for each client as soon as 301 practicable but no later than 30 days after the initial 302 comprehensive treatment plan is developed. The comprehensive 303 treatment plan must be developed by an interdisciplinary team 304 consisting of the case manager, the program director, the 305 advanced registered nurse practitioner, and appropriate 306 therapists. The client or, if appropriate, the client’s 307 representative must be included in developing the comprehensive 308 treatment plan. The comprehensive treatment plan must be 309 reviewed and updated if the client fails to meet projected 310 improvements outlined in the plan or if a significant change in 311 the client’s condition occurs. The comprehensive treatment plan 312 must be reviewed and updated at least once monthly. 313 (2) The comprehensive treatment plan must include: 314 (a) Orders obtained from the physician, physician 315 assistant, or advanced registered nurse practitioner and the 316 client’s diagnosis, medical history, physical examination, and 317 rehabilitative or restorative needs. 318 (b) A preliminary nursing evaluation, including orders for 319 immediate care provided by the physician, physician assistant, 320 or advanced registered nurse practitioner, which shall be 321 completed when the client is admitted. 322 (c) A comprehensive, accurate, reproducible, and 323 standardized assessment of the client’s functional capability; 324 the treatments designed to achieve skills, behaviors, and other 325 conditions necessary for the client to return to the community; 326 and specific measurable goals. 327 (d) Steps necessary for the client to achieve transition 328 into the community and estimated length of time to achieve those 329 goals. 330 (3) The client or, if appropriate, the client’s 331 representative must consent to the continued treatment at the 332 transitional living facility. Consent may be for a period of up 333 to 6 months. If such consent is not given, the transitional 334 living facility shall discharge the client as soon as 335 practicable. 336 (4) A client must receive the professional program services 337 needed to implement the client’s comprehensive treatment plan. 338 (5) The licensee must employ qualified professional staff 339 to carry out and monitor the various professional interventions 340 in accordance with the stated goals and objectives of the 341 client’s comprehensive treatment plan. 342 (6) A client must receive a continuous treatment program 343 that includes appropriate, consistent implementation of 344 specialized and general training, treatment, health services, 345 and related services and that is directed toward: 346 (a) The acquisition of the behaviors and skills necessary 347 for the client to function with as much self-determination and 348 independence as possible. 349 (b) The prevention or deceleration of regression or loss of 350 current optimal functional status. 351 (c) The management of behavioral issues that preclude 352 independent functioning in the community. 353 400.9975 Licensee responsibilities.— 354 (1) The licensee shall ensure that each client: 355 (a) Lives in a safe environment free from abuse, neglect, 356 and exploitation. 357 (b) Is treated with consideration and respect and with due 358 recognition of personal dignity, individuality, and the need for 359 privacy. 360 (c) Retains and uses his or her own clothes and other 361 personal property in his or her immediate living quarters to 362 maintain individuality and personal dignity, except when the 363 licensee demonstrates that such retention and use would be 364 unsafe, impractical, or an infringement upon the rights of other 365 clients. 366 (d) Has unrestricted private communication, including 367 receiving and sending unopened correspondence, access to a 368 telephone, and visits with any person of his or her choice. Upon 369 request, the licensee shall modify visiting hours for caregivers 370 and guests. The facility shall restrict communication in 371 accordance with any court order or written instruction of a 372 client’s representative. Any restriction on a client’s 373 communication for therapeutic reasons shall be documented and 374 reviewed at least weekly and shall be removed as soon as no 375 longer clinically indicated. The basis for the restriction shall 376 be explained to the client and, if applicable, the client’s 377 representative. The client shall retain the right to call the 378 central abuse hotline, the agency, and Disability Rights Florida 379 at any time. 380 (e) Has the opportunity to participate in and benefit from 381 community services and activities to achieve the highest 382 possible level of independence, autonomy, and interaction within 383 the community. 384 (f) Has the opportunity to manage his or her financial 385 affairs unless the client or, if applicable, the client’s 386 representative authorizes the administrator of the facility to 387 provide safekeeping for funds as provided under this part. 388 (g) Has reasonable opportunity for regular exercise more 389 than once per week and to be outdoors at regular and frequent 390 intervals except when prevented by inclement weather. 391 (h) Has the opportunity to exercise civil and religious 392 liberties, including the right to independent personal 393 decisions. However, a religious belief or practice, including 394 attendance at religious services, may not be imposed upon any 395 client. 396 (i) Has access to adequate and appropriate health care 397 consistent with established and recognized community standards. 398 (j) Has the opportunity to present grievances and recommend 399 changes in policies, procedures, and services to the staff of 400 the licensee, governing officials, or any other person without 401 restraint, interference, coercion, discrimination, or reprisal. 402 A licensee shall establish a grievance procedure to facilitate a 403 client’s ability to present grievances, including a system for 404 investigating, tracking, managing, and responding to complaints 405 by a client or, if applicable, the client’s representative and 406 an appeals process. The appeals process must include access to 407 Disability Rights Florida and other advocates and the right to 408 be a member of, be active in, and associate with advocacy or 409 special interest groups. 410 (2) The licensee shall: 411 (a) Promote participation of the client’s representative in 412 the process of providing treatment to the client unless the 413 representative’s participation is unobtainable or inappropriate. 414 (b) Answer communications from the client’s family, 415 guardians, and friends promptly and appropriately. 416 (c) Promote visits by persons with a relationship to the 417 client at any reasonable hour, without requiring prior notice, 418 in any area of the facility that provides direct care services 419 to the client, consistent with the client’s and other clients’ 420 privacy, unless the interdisciplinary team determines that such 421 a visit would not be appropriate. 422 (d) Promote opportunities for the client to leave the 423 facility for visits, trips, or vacations. 424 (e) Promptly notify the client’s representative of a 425 significant incident or change in the client’s condition, 426 including, but not limited to, serious illness, accident, abuse, 427 unauthorized absence, or death. 428 (3) The administrator of a facility shall ensure that a 429 written notice of licensee responsibilities is posted in a 430 prominent place in each building where clients reside and is 431 read or explained to clients who cannot read. This notice shall 432 be provided to clients in a manner that is clearly legible, 433 shall include the statewide toll-free telephone number for 434 reporting complaints to the agency, and shall include the words: 435 “To report a complaint regarding the services you receive, 436 please call toll-free ...[telephone number]... or Disability 437 Rights Florida ...[telephone number]....” The statewide toll 438 free telephone number for the central abuse hotline shall be 439 provided to clients in a manner that is clearly legible and 440 shall include the words: “To report abuse, neglect, or 441 exploitation, please call toll-free ...[telephone number]....” 442 The licensee shall ensure a client’s access to a telephone where 443 telephone numbers are posted as required by this subsection. 444 (4) A licensee or employee of a facility may not serve 445 notice upon a client to leave the premises or take any other 446 retaliatory action against another person solely because of the 447 following: 448 (a) The client or other person files an internal or 449 external complaint or grievance regarding the facility. 450 (b) The client or other person appears as a witness in a 451 hearing inside or outside the facility. 452 (5) Before or at the time of admission, the client and, if 453 applicable, the client’s representative shall receive a copy of 454 the licensee’s responsibilities, including grievance procedures 455 and telephone numbers, as provided in this section. 456 (6) The licensee must develop and implement policies and 457 procedures governing the release of client information, 458 including consent necessary from the client or, if applicable, 459 the client’s representative. 460 400.9976 Administration of medication.— 461 (1) An individual medication administration record must be 462 maintained for each client. A dose of medication, including a 463 self-administered dose, shall be properly recorded in the 464 client’s record. A client who self-administers medication shall 465 be given a pill organizer. Medication must be placed in the pill 466 organizer by a nurse. A nurse shall document the date and time 467 that medication is placed into each client’s pill organizer. All 468 medications must be administered in compliance with orders of a 469 physician, physician assistant, or advanced registered nurse 470 practitioner. 471 (2) If an interdisciplinary team determines that self 472 administration of medication is an appropriate objective, and if 473 the physician, physician assistant, or advanced registered nurse 474 practitioner does not specify otherwise, the client must be 475 instructed by the physician, physician assistant, or advanced 476 registered nurse practitioner to self-administer his or her 477 medication without the assistance of a staff person. All forms 478 of self-administration of medication, including administration 479 orally, by injection, and by suppository, shall be included in 480 the training. The client’s physician, physician assistant, or 481 advanced registered nurse practitioner must be informed of the 482 interdisciplinary team’s decision that self-administration of 483 medication is an objective for the client. A client may not 484 self-administer medication until he or she demonstrates the 485 competency to take the correct medication in the correct dosage 486 at the correct time, to respond to missed doses, and to contact 487 the appropriate person with questions. 488 (3) Medication administration discrepancies and adverse 489 drug reactions must be recorded and reported immediately to a 490 physician, physician assistant, or advanced registered nurse 491 practitioner. 492 400.9977 Assistance with medication.— 493 (1) Notwithstanding any provision of part I of chapter 494 464, the Nurse Practice Act, unlicensed direct care services 495 staff who provide services to clients in a facility licensed 496 under this part may administer prescribed, prepackaged, and 497 premeasured medications after the completion of training in 498 medication administration and under the general supervision of a 499 registered nurse as provided under this section and applicable 500 rules. 501 (2) Training required by this section and applicable rules 502 shall be conducted by a registered nurse licensed under chapter 503 464, a physician licensed under chapter 458 or chapter 459, or a 504 pharmacist licensed under chapter 465. 505 (3) A facility that allows unlicensed direct care service 506 staff to administer medications pursuant to this section shall: 507 (a) Develop and implement policies and procedures that 508 include a plan to ensure the safe handling, storage, and 509 administration of prescription medications. 510 (b) Maintain written evidence of the expressed and informed 511 consent for each client. 512 (c) Maintain a copy of the written prescription, including 513 the name of the medication, the dosage, and the administration 514 schedule and termination date. 515 (d) Maintain documentation of compliance with required 516 training. 517 (4) The agency shall adopt rules to implement this section. 518 400.9978 Protection of clients from abuse, neglect, 519 mistreatment, and exploitation.—The licensee shall develop and 520 implement policies and procedures for the screening and training 521 of employees; the protection of clients; and the prevention, 522 identification, investigation, and reporting of abuse, neglect, 523 mistreatment, and exploitation. The licensee shall identify 524 clients whose personal histories render them at risk for abusing 525 other clients, develop intervention strategies to prevent 526 occurrences of abuse, monitor clients for changes that would 527 trigger abusive behavior, and reassess the interventions on a 528 regular basis. A licensee shall: 529 (1) Screen each potential employee for a history of abuse, 530 neglect, mistreatment, or exploitation of clients. The screening 531 shall include an attempt to obtain information from previous and 532 current employers and verification of screening information by 533 the appropriate licensing boards. 534 (2) Train employees through orientation and ongoing 535 sessions regarding issues related to abuse prohibition 536 practices, including identification of abuse, neglect, 537 mistreatment, and exploitation; appropriate interventions to 538 address aggressive or catastrophic reactions of clients; the 539 process for reporting allegations without fear of reprisal; and 540 recognition of signs of frustration and stress that may lead to 541 abuse. 542 (3) Provide clients, families, and staff with information 543 regarding how and to whom they may report concerns, incidents, 544 and grievances without fear of retribution and provide feedback 545 regarding the concerns that are expressed. A licensee shall 546 identify, correct, and intervene in situations in which abuse, 547 neglect, mistreatment, or exploitation is likely to occur, 548 including: 549 (a) Evaluating the physical environment of the facility to 550 identify characteristics that may make abuse or neglect more 551 likely to occur, such as secluded areas. 552 (b) Providing sufficient staff on each shift to meet the 553 needs of the clients and ensuring that the assigned staff have 554 knowledge of each client’s care needs. 555 (c) Identifying inappropriate staff behaviors, such as 556 using derogatory language, rough handling of clients, ignoring 557 clients while giving care, and directing clients who need 558 toileting assistance to urinate or defecate in their beds. 559 (d) Assessing, monitoring, and planning care for clients 560 with needs and behaviors that might lead to conflict or neglect, 561 such as a history of aggressive behaviors including entering 562 other clients’ rooms without permission, exhibiting self 563 injurious behaviors or communication disorders, requiring 564 intensive nursing care, or being totally dependent on staff. 565 (4) Identify events, such as suspicious bruising of 566 clients, occurrences, patterns, and trends that may constitute 567 abuse and determine the direction of the investigation. 568 (5) Investigate alleged violations and different types of 569 incidents, identify the staff member responsible for initial 570 reporting, and report results to the proper authorities. The 571 licensee shall analyze the incidents to determine whether 572 policies and procedures need to be changed to prevent further 573 incidents and take necessary corrective actions. 574 (6) Protect clients from harm during an investigation. 575 (7) Report alleged violations and substantiated incidents, 576 as required under chapters 39 and 415, to the licensing 577 authorities and all other agencies, as required, and report any 578 knowledge of actions by a court of law that would indicate an 579 employee is unfit for service. 580 400.9979 Restraint and seclusion; client safety.— 581 (1) A facility shall provide a therapeutic milieu that 582 supports a culture of individual empowerment and responsibility. 583 The health and safety of the client shall be the facility’s 584 primary concern at all times. 585 (2) The use of physical restraints must be ordered and 586 documented by a physician, physician assistant, or advanced 587 registered nurse practitioner and must be consistent with the 588 policies and procedures adopted by the facility. The client or, 589 if applicable, the client’s representative shall be informed of 590 the facility’s physical restraint policies and procedures when 591 the client is admitted. 592 (3) The use of chemical restraints shall be limited to 593 prescribed dosages of medications as ordered by a physician, 594 physician assistant, or advanced registered nurse practitioner 595 and must be consistent with the client’s diagnosis and the 596 policies and procedures adopted by the facility. The client and, 597 if applicable, the client’s representative shall be informed of 598 the facility’s chemical restraint policies and procedures when 599 the client is admitted. 600 (4) Based on the assessment by a physician, physician 601 assistant, or advanced registered nurse practitioner, if a 602 client exhibits symptoms that present an immediate risk of 603 injury or death to himself or herself or others, a physician, 604 physician assistant, or advanced registered nurse practitioner 605 may issue an emergency treatment order to immediately administer 606 rapid-response psychotropic medications or other chemical 607 restraints. Each emergency treatment order must be documented 608 and maintained in the client’s record. 609 (a) An emergency treatment order is not effective for more 610 than 24 hours. 611 (b) Whenever a client is medicated under this subsection, 612 the client’s representative or a responsible party and the 613 client’s physician, physician assistant, or advanced registered 614 nurse practitioner shall be notified as soon as practicable. 615 (5) A client who is prescribed and receives a medication 616 that can serve as a chemical restraint for a purpose other than 617 an emergency treatment order must be evaluated by his or her 618 physician, physician assistant, or advanced registered nurse 619 practitioner at least monthly to assess: 620 (a) The continued need for the medication. 621 (b) The level of the medication in the client’s blood. 622 (c) The need for adjustments to the prescription. 623 (6) The licensee shall ensure that clients are free from 624 unnecessary drugs and physical restraints and are provided 625 treatment to reduce dependency on drugs and physical restraints. 626 (7) The licensee may only employ physical restraints and 627 seclusion as authorized by the facility’s written policies, 628 which shall comply with this section and applicable rules. 629 (8) Interventions to manage dangerous client behavior shall 630 be employed with sufficient safeguards and supervision to ensure 631 that the safety, welfare, and civil and human rights of a client 632 are adequately protected. 633 (9) A facility shall notify the parent, guardian, or, if 634 applicable, the client’s representative when restraint or 635 seclusion is employed. The facility must provide the 636 notification within 24 hours after the restraint or seclusion is 637 employed. Reasonable efforts must be taken to notify the parent, 638 guardian, or, if applicable, the client’s representative by 639 telephone or e-mail, or both, and these efforts must be 640 documented. 641 (10) The agency may adopt rules that establish standards 642 and procedures for the use of restraints, restraint positioning, 643 seclusion, and emergency treatment orders for psychotropic 644 medications, restraint, and seclusion. If rules are adopted, the 645 rules must include duration of restraint, staff training, 646 observation of the client during restraint, and documentation 647 and reporting standards. 648 400.998 Personnel background screening; administration and 649 management procedures.— 650 (1) The agency shall require level 2 background screening 651 for licensee personnel as required in s. 408.809(1)(e) and 652 pursuant to chapter 435 and s. 408.809. 653 (2) The licensee shall maintain personnel records for each 654 staff member that contain, at a minimum, documentation of 655 background screening, a job description, documentation of 656 compliance with the training requirements of this part and 657 applicable rules, the employment application, references, a copy 658 of each job performance evaluation, and, for each staff member 659 who performs services for which licensure or certification is 660 required, a copy of all licenses or certification held by that 661 staff member. 662 (3) The licensee must: 663 (a) Develop and implement infection control policies and 664 procedures and include the policies and procedures in the 665 licensee’s policy manual. 666 (b) Maintain liability insurance as defined in s. 667 624.605(1)(b). 668 (c) Designate one person as an administrator to be 669 responsible and accountable for the overall management of the 670 facility. 671 (d) Designate in writing a person to be responsible for the 672 facility when the administrator is absent from the facility for 673 more than 24 hours. 674 (e) Designate in writing a program director to be 675 responsible for supervising the therapeutic and behavioral 676 staff, determining the levels of supervision, and determining 677 room placement for each client. 678 (f) Designate in writing a person to be responsible when 679 the program director is absent from the facility for more than 680 24 hours. 681 (g) Obtain approval of the comprehensive emergency 682 management plan, pursuant to s. 400.9982(2)(e), from the local 683 emergency management agency. Pending the approval of the plan, 684 the local emergency management agency shall ensure that the 685 following agencies, at a minimum, are given the opportunity to 686 review the plan: the Department of Health, the Agency for Health 687 Care Administration, and the Division of Emergency Management. 688 Appropriate volunteer organizations shall also be given the 689 opportunity to review the plan. The local emergency management 690 agency shall complete its review within 60 days after receipt of 691 the plan and either approve the plan or advise the licensee of 692 necessary revisions. 693 (h) Maintain written records in a form and system that 694 comply with medical and business practices and make the records 695 available by the facility for review or submission to the agency 696 upon request. The records shall include: 697 1. A daily census record that indicates the number of 698 clients currently receiving services in the facility, including 699 information regarding any public funding of such clients. 700 2. A record of each accident or unusual incident involving 701 a client or staff member that caused, or had the potential to 702 cause, injury or harm to any person or property within the 703 facility. The record shall contain a clear description of each 704 accident or incident; the names of the persons involved; a 705 description of medical or other services provided to these 706 persons, including the provider of the services; and the steps 707 taken to prevent recurrence of such accident or incident. 708 3. A copy of current agreements with third-party providers. 709 4. A copy of current agreements with each consultant 710 employed by the licensee and documentation of a consultant’s 711 visits and required written and dated reports. 712 400.9981 Property and personal affairs of clients.— 713 (1) A client shall be given the option of using his or her 714 own belongings, as space permits; choosing a roommate if 715 practical and not clinically contraindicated; and, whenever 716 possible, unless the client is adjudicated incompetent or 717 incapacitated under state law, managing his or her own affairs. 718 (2) The admission of a client to a facility and his or her 719 presence therein does not confer on a licensee or administrator, 720 or an employee or representative thereof, any authority to 721 manage, use, or dispose of the property of the client, and the 722 admission or presence of a client does not confer on such person 723 any authority or responsibility for the personal affairs of the 724 client except that which may be necessary for the safe 725 management of the facility or for the safety of the client. 726 (3) A licensee or administrator, or an employee or 727 representative thereof, may: 728 (a) Not act as the guardian, trustee, or conservator for a 729 client or a client’s property. 730 (b) Act as a competent client’s payee for social security, 731 veteran’s, or railroad benefits if the client provides consent 732 and the licensee files a surety bond with the agency in an 733 amount equal to twice the average monthly aggregate income or 734 personal funds due to the client, or expendable for the client’s 735 account, that are received by a licensee. 736 (c) Act as the attorney in fact for a client if the 737 licensee files a surety bond with the agency in an amount equal 738 to twice the average monthly income of the client, plus the 739 value of a client’s property under the control of the attorney 740 in fact. 741 742 The surety bond required under paragraph (b) or paragraph (c) 743 shall be executed by the licensee as principal and a licensed 744 surety company. The bond shall be conditioned upon the faithful 745 compliance of the licensee with the requirements of licensure 746 and is payable to the agency for the benefit of a client who 747 suffers a financial loss as a result of the misuse or 748 misappropriation of funds held pursuant to this subsection. A 749 surety company that cancels or does not renew the bond of a 750 licensee shall notify the agency in writing at least 30 days 751 before the action, giving the reason for cancellation or 752 nonrenewal. A licensee or administrator, or an employee or 753 representative thereof, who is granted power of attorney for a 754 client of the facility shall, on a monthly basis, notify the 755 client in writing of any transaction made on behalf of the 756 client pursuant to this subsection, and a copy of the 757 notification given to the client shall be retained in the 758 client’s file and available for agency inspection. 759 (4) A licensee, with the consent of the client, shall 760 provide for safekeeping in the facility of the client’s personal 761 effects of a value not in excess of $1,000 and the client’s 762 funds not in excess of $500 cash and shall keep complete and 763 accurate records of the funds and personal effects received. If 764 a client is absent from a facility for 24 hours or more, the 765 licensee may provide for safekeeping of the client’s personal 766 effects of a value in excess of $1,000. 767 (5) Funds or other property belonging to or due to a client 768 or expendable for the client’s account that are received by a 769 licensee shall be regarded as funds held in trust and shall be 770 kept separate from the funds and property of the licensee and 771 other clients or shall be specifically credited to the client. 772 The funds held in trust shall be used or otherwise expended only 773 for the account of the client. At least once every month, except 774 pursuant to an order of a court of competent jurisdiction, the 775 licensee shall furnish the client and, if applicable, the 776 client’s representative with a complete and verified statement 777 of all funds and other property to which this subsection 778 applies, detailing the amount and items received, together with 779 their sources and disposition. The licensee shall furnish the 780 statement annually and upon discharge or transfer of a client. A 781 governmental agency or private charitable agency contributing 782 funds or other property to the account of a client is also 783 entitled to receive a statement monthly and upon the discharge 784 or transfer of the client. 785 (6)(a) In addition to any damages or civil penalties to 786 which a person is subject, a person who: 787 1. Intentionally withholds a client’s personal funds, 788 personal property, or personal needs allowance; 789 2. Demands, beneficially receives, or contracts for payment 790 of all or any part of a client’s personal property or personal 791 needs allowance in satisfaction of the facility rate for 792 supplies and services; or 793 3. Borrows from or pledges any personal funds of a client, 794 other than the amount agreed to by written contract under s. 795 429.24, 796 797 commits a misdemeanor of the first degree, punishable as 798 provided in s. 775.082 or s. 775.083. 799 (b) A licensee or administrator, or an employee, or 800 representative thereof, who is granted power of attorney for a 801 client and who misuses or misappropriates funds obtained through 802 this power commits a felony of the third degree, punishable as 803 provided in s. 775.082, s. 775.083, or s. 775.084. 804 (7) In the event of the death of a client, a licensee shall 805 return all refunds, funds, and property held in trust to the 806 client’s personal representative, if one has been appointed at 807 the time the licensee disburses such funds, or, if not, to the 808 client’s spouse or adult next of kin named in a beneficiary 809 designation form provided by the licensee to the client. If the 810 client does not have a spouse or adult next of kin or such 811 person cannot be located, funds due to be returned to the client 812 shall be placed in an interest-bearing account, and all property 813 held in trust by the licensee shall be safeguarded until such 814 time as the funds and property are disbursed pursuant to the 815 Florida Probate Code. The funds shall be kept separate from the 816 funds and property of the licensee and other clients of the 817 facility. If the funds of the deceased client are not disbursed 818 pursuant to the Florida Probate Code within 2 years after the 819 client’s death, the funds shall be deposited in the Health Care 820 Trust Fund administered by the agency. 821 (8) The agency, by rule, may clarify terms and specify 822 procedures and documentation necessary to administer the 823 provisions of this section relating to the proper management of 824 clients’ funds and personal property and the execution of surety 825 bonds. 826 400.9982 Rules establishing standards.— 827 (1) It is the intent of the Legislature that rules adopted 828 and enforced pursuant to this part and part II of chapter 408 829 include criteria to ensure reasonable and consistent quality of 830 care and client safety. The rules should make reasonable efforts 831 to accommodate the needs and preferences of the client to 832 enhance the client’s quality of life while residing in a 833 transitional living facility. 834 (2) The agency may adopt and enforce rules to implement 835 this part and part II of chapter 408, which may include 836 reasonable and fair criteria with respect to: 837 (a) The location of transitional living facilities. 838 (b) The qualifications of personnel, including management, 839 medical, nursing, and other professional personnel and nursing 840 assistants and support staff, who are responsible for client 841 care. The licensee must employ enough qualified professional 842 staff to carry out and monitor interventions in accordance with 843 the stated goals and objectives of each comprehensive treatment 844 plan. 845 (c) Requirements for personnel procedures, reporting 846 procedures, and documentation necessary to implement this part. 847 (d) Services provided to clients of transitional living 848 facilities. 849 (e) The preparation and annual update of a comprehensive 850 emergency management plan in consultation with the Division of 851 Emergency Management. At a minimum, the rules must provide for 852 plan components that address emergency evacuation 853 transportation; adequate sheltering arrangements; postdisaster 854 activities, including provision of emergency power, food, and 855 water; postdisaster transportation; supplies; staffing; 856 emergency equipment; individual identification of clients and 857 transfer of records; communication with families; and responses 858 to family inquiries. 859 400.9983 Violations; penalties.—A violation of this part or 860 any rule adopted pursuant thereto shall be classified according 861 to the nature of the violation and the gravity of its probable 862 effect on facility clients. The agency shall indicate the 863 classification on the written notice of the violation as 864 follows: 865 (1) Class “I” violations are defined in s. 408.813. The 866 agency shall issue a citation regardless of correction and 867 impose an administrative fine of $5,000 for an isolated 868 violation, $7,500 for a patterned violation, or $10,000 for a 869 widespread violation. Violations may be identified, and a fine 870 must be levied, notwithstanding the correction of the deficiency 871 giving rise to the violation. 872 (2) Class “II” violations are defined in s. 408.813. The 873 agency shall impose an administrative fine of $1,000 for an 874 isolated violation, $2,500 for a patterned violation, or $5,000 875 for a widespread violation. A fine must be levied 876 notwithstanding the correction of the deficiency giving rise to 877 the violation. 878 (3) Class “III” violations are defined in s. 408.813. The 879 agency shall impose an administrative fine of $500 for an 880 isolated violation, $750 for a patterned violation, or $1,000 881 for a widespread violation. If a deficiency giving rise to a 882 class III violation is corrected within the time specified by 883 the agency, the fine may not be imposed. 884 (4) Class “IV” violations are defined in s. 408.813. The 885 agency shall impose for a cited class IV violation an 886 administrative fine of at least $100 but not exceeding $200 for 887 each violation. If a deficiency giving rise to a class IV 888 violation is corrected within the time specified by the agency, 889 the fine may not be imposed. 890 400.9984 Receivership proceedings.—The agency may apply s. 891 429.22 with regard to receivership proceedings for transitional 892 living facilities. 893 400.9985 Interagency communication.—The agency, the 894 department, the Agency for Persons with Disabilities, and the 895 Department of Children and Families shall develop electronic 896 systems to ensure that relevant information pertaining to the 897 regulation of transitional living facilities and clients is 898 timely and effectively communicated among agencies in order to 899 facilitate the protection of clients. Electronic sharing of 900 information shall include, at a minimum, a brain and spinal cord 901 injury registry and a client abuse registry. 902 Section 2. Section 400.805, Florida Statutes, is 903 transferred and renumbered as s. 400.9986, Florida Statutes. 904 Section 3. Effective July 1, 2016, s. 400.9986, Florida 905 Statutes, is repealed. 906 Section 4. The title of part V of chapter 400, Florida 907 Statutes, consisting of sections 400.701 and 400.801, is 908 redesignated as “INTERMEDIATE CARE FACILITIES.” 909 Section 5. Subsection (9) of section 381.745, Florida 910 Statutes, is amended to read: 911 381.745 Definitions; ss. 381.739-381.79.—As used in ss. 912 381.739-381.79, the term: 913 (9) “Transitional living facility” means a state-approved 914 facility,as defined and licensed under chapter 400or chapter915429, or a facility approved by the brain and spinal cord injury916program in accordance with this chapter. 917 Section 6. Section 381.75, Florida Statutes, is amended to 918 read: 919 381.75 Duties and responsibilities of the department, of920transitional living facilities, and of residents.—Consistent 921 with the mandate of s. 381.7395, the department shall develop 922 and administer a multilevel treatment program for individuals 923 who sustain brain or spinal cord injuries and who are referred 924 to the brain and spinal cord injury program. 925 (1) Within 15 days after any report of an individual who 926 has sustained a brain or spinal cord injury, the department 927 shall notify the individual or the most immediate available 928 family members of their right to assistance from the state, the 929 services available, and the eligibility requirements. 930 (2) The department shall refer individuals who have brain 931 or spinal cord injuries to other state agencies to ensureassure932 that rehabilitative services, if desired, are obtained by that 933 individual. 934 (3) The department, in consultation with emergency medical 935 service, shall develop standards for an emergency medical 936 evacuation system that will ensure that all individuals who 937 sustain traumatic brain or spinal cord injuries are transported 938 to a department-approved trauma center that meets the standards 939 and criteria established by the emergency medical service and 940 the acute-care standards of the brain and spinal cord injury 941 program. 942 (4) The department shall develop standards for designation 943 of rehabilitation centers to provide rehabilitation services for 944 individuals who have brain or spinal cord injuries. 945 (5) The department shall determine the appropriate number 946 of designated acute-care facilities, inpatient rehabilitation 947 centers, and outpatient rehabilitation centers,needed based on 948 incidence, volume of admissions, and other appropriate criteria. 949 (6) The department shall develop standards for designation 950 of transitional living facilities to provide transitional living 951 services for individuals who participate in the brain and spinal 952 cord injury programthe opportunity to adjust to their953disabilities and to develop physical and functional skills in a954supported living environment. 955(a) The Agency for Health Care Administration, in956consultation with the department, shall develop rules for the957licensure of transitional living facilities for individuals who958have brain or spinal cord injuries.959(b) The goal of a transitional living program for960individuals who have brain or spinal cord injuries is to assist961each individual who has such a disability to achieve a higher962level of independent functioning and to enable that person to963reenter the community. The program shall be focused on preparing964participants to return to community living.965(c) A transitional living facility for an individual who966has a brain or spinal cord injury shall provide to such967individual, in a residential setting, a goal-oriented treatment968program designed to improve the individual’s physical,969cognitive, communicative, behavioral, psychological, and social970functioning, as well as to provide necessary support and971supervision. A transitional living facility shall offer at least972the following therapies: physical, occupational, speech,973neuropsychology, independent living skills training, behavior974analysis for programs serving brain-injured individuals, health975education, and recreation.976(d) All residents shall use the transitional living977facility as a temporary measure and not as a permanent home or978domicile. The transitional living facility shall develop an979initial treatment plan for each resident within 3 days after the980resident’s admission. The transitional living facility shall981develop a comprehensive plan of treatment and a discharge plan982for each resident as soon as practical, but no later than 30983days after the resident’s admission. Each comprehensive984treatment plan and discharge plan must be reviewed and updated985as necessary, but no less often than quarterly. This subsection986does not require the discharge of an individual who continues to987require any of the specialized services described in paragraph988(c) or who is making measurable progress in accordance with that989individual’s comprehensive treatment plan. The transitional990living facility shall discharge any individual who has an991appropriate discharge site and who has achieved the goals of his992or her discharge plan or who is no longer making progress toward993the goals established in the comprehensive treatment plan and994the discharge plan. The discharge location must be the least995restrictive environment in which an individual’s health, well996being, and safety is preserved.997(7) Recipients of services, under this section, from any of998the facilities referred to in this section shall pay a fee based999on ability to pay.1000 Section 7. Subsection (4) of section 381.78, Florida 1001 Statutes, is amended to read: 1002 381.78 Advisory council on brain and spinal cord injuries.— 1003 (4) The council shall:1004(a)provide advice and expertise to the department in the 1005 preparation, implementation, and periodic review of the brain 1006 and spinal cord injury program. 1007(b) Annually appoint a five-member committee composed of1008one individual who has a brain injury or has a family member1009with a brain injury, one individual who has a spinal cord injury1010or has a family member with a spinal cord injury, and three1011members who shall be chosen from among these representative1012groups: physicians, other allied health professionals,1013administrators of brain and spinal cord injury programs, and1014representatives from support groups with expertise in areas1015related to the rehabilitation of individuals who have brain or1016spinal cord injuries, except that one and only one member of the1017committee shall be an administrator of a transitional living1018facility. Membership on the council is not a prerequisite for1019membership on this committee.10201. The committee shall perform onsite visits to those1021transitional living facilities identified by the Agency for1022Health Care Administration as being in possible violation of the1023statutes and rules regulating such facilities. The committee1024members have the same rights of entry and inspection granted1025under s. 400.805(4) to designated representatives of the agency.10262. Factual findings of the committee resulting from an1027onsite investigation of a facility pursuant to subparagraph 1.1028shall be adopted by the agency in developing its administrative1029response regarding enforcement of statutes and rules regulating1030the operation of the facility. 10313. Onsite investigations by the committee shall be funded1032by the Health Care Trust Fund.10334. Travel expenses for committee members shall be1034reimbursed in accordance with s. 112.061.10355. Members of the committee shall recuse themselves from1036participating in any investigation that would create a conflict1037of interest under state law, and the council shall replace the1038member, either temporarily or permanently.1039 Section 8. Subsection (5) of section 400.93, Florida 1040 Statutes, is amended to read: 1041 400.93 Licensure required; exemptions; unlawful acts; 1042 penalties.— 1043 (5) The following are exempt from home medical equipment 1044 provider licensure, unless they have a separate company, 1045 corporation, or division that is in the business of providing 1046 home medical equipment and services for sale or rent to 1047 consumers at their regular or temporary place of residence 1048 pursuant to the provisions of this part: 1049 (a) Providers operated by the Department of Health or 1050 Federal Government. 1051 (b) Nursing homes licensed under part II. 1052 (c) Assisted living facilities licensed under chapter 429, 1053 when serving their residents. 1054 (d) Home health agencies licensed under part III. 1055 (e) Hospices licensed under part IV. 1056 (f) Intermediate care facilities and,homes for special 1057 services, and transitional living facilitieslicensed under part 1058 V. 1059 (g) Transitional living facilities licensed under part XI. 1060 (h)(g)Hospitals and ambulatory surgical centers licensed 1061 under chapter 395. 1062 (i)(h)Manufacturers and wholesale distributors when not 1063 selling directly to consumers. 1064 (j)(i)Licensed health care practitioners who useutilize1065 home medical equipment in the course of their practice,but do 1066 not sell or rent home medical equipment to their patients. 1067 (k)(j)Pharmacies licensed under chapter 465. 1068 Section 9. Subsection (21) of section 408.802, Florida 1069 Statutes, is amended to read: 1070 408.802 Applicability.—The provisions of this part apply to 1071 the provision of services that require licensure as defined in 1072 this part and to the following entities licensed, registered, or 1073 certified by the agency, as described in chapters 112, 383, 390, 1074 394, 395, 400, 429, 440, 483, and 765: 1075 (21) Transitional living facilities, as provided under part 1076 XIVof chapter 400. 1077 Section 10. Subsection (20) of section 408.820, Florida 1078 Statutes, is amended to read: 1079 408.820 Exemptions.—Except as prescribed in authorizing 1080 statutes, the following exemptions shall apply to specified 1081 requirements of this part: 1082 (20) Transitional living facilities, as provided under part 1083 XIVof chapter 400, are exempt from s. 408.810(10). 1084 Section 11. Subsection (1) of s. 381.79 is reenacted for 1085 the purpose of incorporating the amendment made by this act to 1086 s. 381.75, Florida Statutes, in a reference thereto. 1087 Section 12. (1) A transitional living facility that is 1088 licensed under s. 400.805, Florida Statutes, on June 30, 2015, 1089 must be licensed under and in compliance with s. 400.9986, 1090 Florida Statutes, until the licensee becomes licensed under and 1091 in compliance with part XI of ch. 400, Florida Statutes, as 1092 created by this act. Such licensees must be licensed under and 1093 in compliance with part XI of chapter 400, Florida Statutes, as 1094 created by this act, on or before July 1, 2016. 1095 (2) A transitional living facility that is licensed on or 1096 after July 1, 2015, must be licensed under and in compliance 1097 with part XI of ch. 400, Florida Statutes, as created by this 1098 act. 1099 Section 13. Except as otherwise expressly provided in this 1100 act, this act shall take effect July 1, 2015.