Bill Amendment: FL S0966 | 2013 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Health Care
Status: 2013-05-03 - Died on Calendar, companion bill(s) passed, see CS/HB 1071 (Ch. 2013-93), CS/CS/HB 1159 (Ch. 2013-153), SB 1520 (Ch. 2013-48) [S0966 Detail]
Download: Florida-2013-S0966-Senate_Floor_Amendment_349184.html
Bill Title: Health Care
Status: 2013-05-03 - Died on Calendar, companion bill(s) passed, see CS/HB 1071 (Ch. 2013-93), CS/CS/HB 1159 (Ch. 2013-153), SB 1520 (Ch. 2013-48) [S0966 Detail]
Download: Florida-2013-S0966-Senate_Floor_Amendment_349184.html
Florida Senate - 2013 SENATOR AMENDMENT Bill No. CS for CS for SB 966 Barcode 349184 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Soto moved the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 1114 - 1150 4 and insert: 5 Section 24. Section 400.0060, Florida Statutes, is amended 6 to read: 7 400.0060 Definitions.—When used in this part, unless the 8 context clearly dictates otherwise, the term: 9 (1) “Administrative assessment” means a review of 10 conditions in a long-term care facility which impact the rights, 11 health, safety, and welfare of residents with the purpose of 12 noting needed improvement and making recommendations to enhance 13 the quality of life for residents. 14 (2) “Agency” means the Agency for Health Care 15 Administration. 16 (3) “Department” means the Department of Elderly Affairs. 17 (4) “District” means a geographical area designated by the 18 state ombudsman in which individuals certified as ombudsmen 19 carry out the duties of the state ombudsman program“Local20council” means a local long-term care ombudsman council21designated by the ombudsman pursuant to s.400.0069. Local22councils are also known as district long-term care ombudsman23councils or district councils. 24 (5) “Long-term care facility” means a nursing home 25 facility, assisted living facility, adult family-care home, 26 board and care facility, facility where continuing long-term 27 care is provided, or any other similar residential adult care 28 facility. 29 (6) “Office” means the Office of State Long-Term Care 30 Ombudsman created by s. 400.0063. 31 (7) “Ombudsman” means an individual who has been certified 32 by the state ombudsman as meeting the requirements of ss. 33 400.0069, 400.0070, and 400.0091the individual appointed by the34Secretary of Elderly Affairs to head the Office of State Long35Term Care Ombudsman. 36 (8) “Representative of the office” means the state 37 ombudsman, an employee of the office, or an individual certified 38 as an ombudsman. 39 (9)(8)“Resident” means an individual 1860years of age or 40 older who resides in a long-term care facility. 41 (10)(9)“Secretary” means the Secretary of Elderly Affairs. 42 (11)(10)“State council” means the State Long-Term Care 43 Ombudsman Council created by s. 400.0067. 44 (12) “State ombudsman” means the individual appointed by 45 the Secretary of Elderly Affairs to head the Office of State 46 Long-Term Care Ombudsman. 47 (13) “State ombudsman program” means the program operating 48 under the direction of the office. 49 Section 25. Section 400.0061, Florida Statutes, is amended 50 to read: 51 400.0061 Legislative findings and intent; long-term care 52 facilities.— 53 (1) The Legislature finds that conditions in long-term care 54 facilities in this state are such that the rights, health, 55 safety, and welfare of residents are not fully ensured by rules 56 of the Department of Elderly Affairs or the Agency for Health 57 Care Administration or by the good faith of owners or operators 58 of long-term care facilities. Furthermore, there is a need for a 59 formal mechanism whereby a long-term care facility resident, a 60 representative of a long-term care facility resident, or any 61 other concerned citizen may make a complaint against the 62 facility or its employees,or against other persons who are in a 63 position to restrict, interfere with, or threaten the rights, 64 health, safety, or welfare of a long-term care facility 65 resident. The Legislature finds that concerned citizens are 66 often more effective advocates for the rights of others than 67 governmental agencies. The Legislature further finds that in 68 order to be eligible to receive an allotment of funds authorized 69 and appropriated under the federal Older Americans Act, the 70 state must establish and operate an Office of State Long-Term 71 Care Ombudsman, to be headed by the stateLong-Term Care72 ombudsman, and carry out a statelong-term careombudsman 73 program. 74 (2) It is the intent of the Legislature, therefore, to 75 utilize voluntary citizen ombudsmenombudsman councilsunder the 76 leadership of the state ombudsman,and, through them, to operate 77 a stateanombudsman program, which shall, without interference 78 by any executive agency, undertake to discover, investigate, and 79 determine the presence of conditions or individuals whowhich80 constitute a threat to the rights, health, safety, or welfare of 81 the residents of long-term care facilities. To ensure that the 82 effectiveness and efficiency of such investigations are not 83 impeded by advance notice or delay, the Legislature intends that 84 representatives of the officeombudsman and ombudsman councils85and their designated representativesnot be required to obtain 86 warrants in order to enter into or conduct investigations or 87 onsite administrative assessments of long-term care facilities. 88 It is the further intent of the Legislature that the environment 89 in long-term care facilities be conducive to the dignity and 90 independence of residents and that investigations by 91 representatives of the officeombudsman councils shallfurther 92 the enforcement of laws, rules, and regulations that safeguard 93 the health, safety, and welfare of residents. 94 Section 26. Section 400.0063, Florida Statutes, is amended 95 to read: 96 400.0063 Establishment of Office of State Long-Term Care 97 Ombudsman; designation of ombudsman and legal advocate.— 98 (1) There is created an Office of State Long-Term Care 99 Ombudsman in the Department of Elderly Affairs. 100 (2)(a) The Office of State Long-Term Care Ombudsman shall 101 be headed by the stateLong-Term Careombudsman, who shall serve 102 on a full-time basis and shall personally, or through 103 representatives of the office, carry out the purposes and 104 functions of the state ombudsman programofficein accordance 105 with state and federal law. 106 (b) The state ombudsman shall be appointed by and shall 107 serve at the pleasure of the Secretary of Elderly Affairs. The 108 secretary shall appoint a person who has expertise and 109 experience in the fields of long-term care and advocacy to serve 110 as state ombudsman. 111 (3)(a) There is created in the office the position of legal 112 advocate, who shall be selected by and serve at the pleasure of 113 the state ombudsman and shall be a member in good standing of 114 The Florida Bar. 115 (b) The duties of the legal advocate shall include, but not 116 be limited to: 117 1. Assisting the state ombudsman in carrying out the duties 118 of the office with respect to the abuse, neglect, exploitation, 119 or violation of rights of residents of long-term care 120 facilities. 121 2. Assisting the state council and representatives of the 122 officelocal councilsin carrying out their responsibilities 123 under this part. 124 3. Pursuing administrative, legal, and other appropriate 125 remedies on behalf of residents. 126 4. Serving as legal counsel to the state council and 127 representatives of the officelocal councils, or individual128members thereof,against whom any suit or other legal action is 129 initiated in connection with the performance of the official 130 duties of the state ombudsman programcouncils or an individual131member. 132 Section 27. Section 400.0065, Florida Statutes, is amended 133 to read: 134 400.0065 Office of State Long-Term Care Ombudsman; duties 135 and responsibilities.— 136 (1) The purpose of the Office of State Long-Term Care 137 Ombudsman isshall beto: 138 (a) Identify, investigate, and resolve complaints made by 139 or on behalf of residents of long-term care facilities relating 140 to actions or omissions by providers or representatives of 141 providers of long-term care services, other public or private 142 agencies, guardians, or representative payees that may adversely 143 affect the health, safety, welfare, or rights of the residents. 144 (b) Provide services that assist in protecting the health, 145 safety, welfare, and rights of residents. 146 (c) Inform residents, their representatives, and other 147 citizens about obtaining the services of the stateLong-Term148Careombudsman program and its representatives. 149 (d) Ensure that residents have regular and timely access to 150 the services provided through the office and that residents and 151 complainants receive timely responses from representatives of 152 the office to their complaints. 153 (e) Represent the interests of residents before 154 governmental agencies and seek administrative, legal, and other 155 remedies to protect the health, safety, welfare, and rights of 156 the residents. 157 (f) Administer the state counciland local councils. 158 (g) Analyze, comment on, and monitor the development and 159 implementation of federal, state, and local laws, rules, and 160 regulations, and other governmental policies and actions, that 161 pertain to the health, safety, welfare, and rights of the 162 residents, with respect to the adequacy of long-term care 163 facilities and services in the state, and recommend any changes 164 in such laws, rules, regulations, policies, and actions as the 165 office determines to be appropriate and necessary. 166 (h) Provide technical support for the development of 167 resident and family councils to protect the well-being and 168 rights of residents. 169 (2) The stateLong-Term Careombudsman hasshall havethe 170 duty and authority to: 171 (a) Establish and coordinate districtslocal councils172 throughout the state. 173 (b) Perform the duties specified in state and federal law, 174 rules, and regulations. 175 (c) Within the limits of appropriated federal and state 176 funding, employ such personnel as are necessary to perform 177 adequately the functions of the office and provide or contract 178 for legal services to assist the state council and 179 representatives of the officelocal councilsin the performance 180 of their duties.Staff positions established for the purpose of181coordinating the activities of each local council and assisting182its members may be filled by the ombudsman after approval by the183secretary. Notwithstanding any other provision of this part,184upon certification by the ombudsman that the staff member hired185to fill any such position has completed the initial training186required under s.400.0091, such person shall be considered a187representative of the State Long-Term Care Ombudsman Program for188purposes of this part.189 (d) Contract for services necessary to carry out the 190 activities of the office. 191 (e) Apply for, receive, and accept grants, gifts, or other 192 payments, including, but not limited to, real property, personal 193 property, and services from a governmental entity or other 194 public or private entity or person, and make arrangements for 195 the use of such grants, gifts, or payments. 196 (f) Coordinate, to the greatest extent possible, state and 197 local ombudsman services with the protection and advocacy 198 systems for individuals with developmental disabilities and 199 mental illnesses and with legal assistance programs for the poor 200 through adoption of memoranda of understanding and other means. 201(g) Enter into a cooperative agreement with the Statewide202Advocacy Council for the purpose of coordinating and avoiding203duplication of advocacy services provided to residents.204 (g)(h)Enter into a cooperative agreement with the Medicaid 205 Fraud Division as prescribed under s. 731(e)(2)(B) of the Older 206 Americans Act. 207 (h)(i)Prepare an annual report describing the activities 208 carried out by the office, the state council, and the districts 209local councilsin the year for which the report is prepared. The 210 state ombudsman shall submit the report to the secretary, the 211 United States Assistant Secretary for Aging, the Governor, the 212 President of the Senate, the Speaker of the House of 213 Representatives, the Secretary of Children and Families, and the 214 Secretary of Health Care Administration at least 30 days before 215 the convening of the regular session of the Legislature.The216secretary shall in turn submit the report to the United States217Assistant Secretary for Aging, the Governor, the President of218the Senate, the Speaker of the House of Representatives, the219Secretary of Children and Family Services, and the Secretary of220Health Care Administration.The report shall, at a minimum: 221 1. Contain and analyze data collected concerning complaints 222 about and conditions in long-term care facilities and the 223 disposition of such complaints. 224 2. Evaluate the problems experienced by residents. 225 3. Analyze the successes of the state ombudsman program 226 during the preceding year, including an assessment of how 227 successfully the officeprogramhas carried out its 228 responsibilities under the Older Americans Act. 229 4. Provide recommendations for policy, regulatory, and 230 statutory changes designed to solve identified problems; resolve 231 residents’ complaints; improve residents’ lives and quality of 232 care; protect residents’ rights, health, safety, and welfare; 233 and remove any barriers to the optimal operation of the state 234Long-Term Careombudsman program. 235 5. Contain recommendations from the stateLong-Term Care236Ombudsmancouncil regarding program functions and activities and 237 recommendations for policy, regulatory, and statutory changes 238 designed to protect residents’ rights, health, safety, and 239 welfare. 240 6. Contain any relevant recommendations from 241 representatives of the officelocal councilsregarding program 242 functions and activities. 243 Section 28. Section 400.0067, Florida Statutes, is amended 244 to read: 245 400.0067 State Long-Term Care Ombudsman Council; duties; 246 membership.— 247 (1) There is created, within the Office of State Long-Term 248 Care Ombudsman, the State Long-Term Care Ombudsman Council. 249 (2) The stateLong-Term Care Ombudsmancouncil shall: 250 (a) Serve as an advisory body to assist the state ombudsman 251 in reaching a consensus among districtslocal councilson issues 252 affecting residents and impacting the optimal operation of the 253 program. 254 (b) Serve as an appellate body in receiving from the 255 districtslocal councilscomplaints not resolved at the district 256locallevel. Any individual member or members of the state 257 council may enter any long-term care facility involved in an 258 appeal, pursuant to the conditions specified in s. 400.0074(2). 259 (c) Assist the state ombudsman to discover, investigate, 260 and determine the existence of abuse or neglect in any long-term 261 care facility, and work with the adult protective services 262 program as required in ss. 415.101-415.113. 263 (d) Assist the state ombudsman in eliciting, receiving, 264 responding to, and resolving complaints made by or on behalf of 265 residents. 266 (e) Elicit and coordinate state, districtlocal, and 267 voluntary organizational assistance for the purpose of improving 268 the care received by residents. 269 (f) Assist the state ombudsman in preparing the annual 270 report described in s. 400.0065. 271 (3) The stateLong-Term Care Ombudsmancouncil shall be 272 composed of one active certified ombudsman from each district 273local council member elected by each local councilplus three 274 at-large members appointed by the secretaryGovernor. 275 (a) Each district manager, in consultation with the 276 district ombudsmen, shall select a district ombudsmanlocal277council shall elect by majority vote a representative from among278the council membersto represent the interests of the district 279local councilon the state council.A local council chair may280not serve as the representative of the local council on the281state council.282 (b)1. The state ombudsmansecretary, after consulting with283the ombudsman,shall submit to the secretaryGovernora list of 284 individualspersonsrecommended for appointment to the at-large 285 positions on the state council. The list mayshallnot include 286 the name of any individualpersonwho is currently serving in a 287 districton a local council. 288 2. The secretaryGovernorshall appoint three at-large 289 members chosen from the list. 290 3. If the secretaryGovernordoes not appoint an at-large 291 member to fill a vacant position within 60 days after the list 292 is submitted, the statesecretary, after consulting with the293 ombudsman,shall appoint an at-large member to fill that vacant 294 position. 295 (4)(a)(c)1.AllState council members shall serve 3-year 296 terms. 2972.A member of the state council may not serve more than 298 two consecutive terms. 299 (b)3.A district manager, in consultation with the district 300 ombudsmen,local councilmay recommend replacementremovalof 301 its selected ombudsman onelected representativefromthe state 302 councilby a majority vote. If the district manager, in 303 consultation with the district ombudsmen, selects a replacement 304 ombudsman,council votes to remove its representative, the local305council chair shall immediately notifythe state ombudsman must 306 be notified.The secretary shall advise the Governor of the307local council’s vote upon receiving notice from the ombudsman.308 (c)4.The position of any member missing three state 309 council meetings within a 1-year period without cause may be 310 declared vacant by the state ombudsman. The findings of the 311 state ombudsman regarding cause shall be final and binding. 312 (d)5.Any vacancy on the state council shall be filled in 313 the same manner as the original appointment. 314 (e)(d)1. The state council shall elect a chair to serve for 315 a term of 1 year. A chair may not serve more than two 316 consecutive terms. 317 2. The chair shall select a vice chair from among the 318 members. The vice chair shall preside over the state council in 319 the absence of the chair. 320 3. The chair may create additional executive positions as 321 necessary to carry out the duties of the state council. Any 322 person appointed to an executive position shall serve at the 323 pleasure of the chair, and his or her term shall expire on the 324 same day as the term of the chair. 325 4. A chair may be immediately removed from office before 326prior tothe expiration of his or her term by a vote of two 327 thirds of all state council members present at any meeting at 328 which a quorum is present. If a chair is removed from office 329 beforeprior tothe expiration of his or her term, a replacement 330 chair shall be chosen during the same meeting in the same manner 331 as described in this paragraph, and the term of the replacement 332 chair shall begin immediately. The replacement chair shall serve 333 for the remainder of the term and is eligible to serve two 334 subsequent consecutive terms. 335 (f)(e)1. The state council shall meet upon the call of the 336 chair or upon the call of the state ombudsman. The state council 337 shall meet at least quarterly but may meet more frequently as 338 needed. 339 2. A quorum shall be considered present if more than 50 340 percent of all active state council members are in attendance at 341 the same meeting. 342 3. The state council may not vote on or otherwise make any 343 decisions resulting in a recommendation that will directly 344 impact the state council or any districtlocal council, outside 345 of a publicly noticed meeting at which a quorum is present. 346 (g)(f)Members shall receive no compensation but shall, 347 with approval from the state ombudsman, be reimbursed for per 348 diem and travel expenses as provided in s. 112.061. 349 Section 29. Section 400.0069, Florida Statutes, is amended 350 to read: 351 400.0069LocalLong-term care ombudsman districtscouncils; 352 duties; appointmentmembership.— 353 (1)(a) The state ombudsman shall designate districtslocal354long-term care ombudsman councilsto carry out the duties of the 355 stateLong-Term Careombudsman programwithin local communities. 356 Each districtlocal councilshall function under the direction 357 of the state ombudsman. 358 (b) The state ombudsman shall ensure that there are 359 representatives of the officeis at least one local council360 operating in each districtof the department’s planning and361service areas. The ombudsman may create additional local362councilsas necessary to ensure that residents throughout the 363 state have adequate access to stateLong-Term Careombudsman 364 program services.The ombudsman, after approval from the365secretary, shall designate the jurisdictional boundaries of each366local council.367 (2) The duties of the representatives of the office in the 368 districtslocal councilsare to: 369 (a) Provide services to assist inServe as a third-party370mechanism forprotecting the health, safety, welfare, andcivil371and humanrights of residents. 372 (b) Discover, investigate, and determine the existence of 373 abuse,orneglect, or exploitation usingin any long-term care374facility and to usethe procedures provided for in ss. 415.101 375 415.113 when applicable. 376 (c) IdentifyElicit, receive, investigate,respond to,and 377 resolve complaints made by or on behalf of residents relating to 378 actions or omissions by providers or representatives of 379 providers of long-term care services, other public or private 380 agencies, guardians, or representative payees that may adversely 381 affect the health, safety, welfare, or rights of residents. 382 (d) Review and, if necessary, comment on all existing or 383 proposed rules, regulations, and other governmental policies and 384 actions relating to long-term care facilities that may 385 potentially have an effect on the rights, health, safety, and 386 welfare of residents. 387 (e) Review personal property and money accounts of 388 residents who are receiving assistance under the Medicaid 389 program pursuant to an investigation to obtain information 390 regarding a specific complaintor problem. 391 (f) Recommend that the state ombudsman and the legal 392 advocate seek administrative, legal, and other remedies to 393 protect the health, safety, welfare, and rights ofthe394 residents. 395 (g) Provide technical assistance for the development of 396 resident and family councils within long-term care facilities. 397 (h)(g)Carry out other activities that the state ombudsman 398 determines to be appropriate. 399 (3) In order to carry out the duties specified in 400 subsection (2), a representative of the office maymember of a401local council is authorized toenter any long-term care facility 402 without notice or without first obtaining a warrant; however, 403subject to the provisions ofs. 400.0074(2) may apply regarding 404 notice of a followup administrative assessment. 405 (4) Each districtlocal councilshall be composed of 406 ombudsmenmemberswhose primary residences areresidence is407 located within the boundaries of the districtlocal council’s408jurisdiction. 409 (a) Upon good cause shown, the state ombudsman, in his or 410 her sole discretion, may appoint an ombudsman to another 411 districtThe ombudsman shall strive to ensure that each local412council include the following persons as members:4131. At least one medical or osteopathic physician whose414practice includes or has included a substantial number of415geriatric patients and who may practice in a long-term care416facility;4172. At least one registered nurse who has geriatric418experience;4193. At least one licensed pharmacist;4204. At least one registered dietitian;4215. At least six nursing home residents or representative422consumer advocates for nursing home residents;4236. At least three residents of assisted living facilities424or adult family-care homes or three representative consumer425advocates for alternative long-term care facility residents;4267. At least one attorney; and4278. At least one professional social worker. 428 (b) The following individuals may not be appointed as 429 ombudsmen: 430 1. The owner or representative of a long-term care 431 facility. 432 2. A provider or representative of a provider of long-term 433 care services. 434 3. An employee of the agency. 435 4. An employee of the department, except for a 436 representative of the office. 437 5. An employee of the Department of Children and Families. 438 6. An employee of the Agency for Persons with Disabilities 439In no case shall the medical director of a long-term care440facility or an employee of the agency, the department, the441Department of Children and Family Services, or the Agency for442Persons with Disabilities serve as a member or as an ex officio443member of a council. 444 (5)(a) To be appointed as an ombudsman, an individual must: 445 1.Individuals wishing to join a local council shallSubmit 446 an application to the state ombudsman or his or her designee. 447 2. Successfully complete level 2 background screening 448 pursuant to s. 430.0402 and chapter 435The ombudsman shall449review the individual’s application and advise the secretary of450his or her recommendation for approval or disapproval of the451candidate’s membership on the local council.If the secretary452approves of the individual’s membership, the individual shall be453appointed as a member of the local council.454 (b) The state ombudsman shall approve or deny the 455 appointment of the individual as an ombudsmanThe secretary may456rescind the ombudsman’s approval of a member on a local council457at any time.If the secretary rescinds the approval of a member458on a local council, the ombudsman shall ensure that the459individual is immediately removed from the local council on460which he or she serves and the individual may no longer461represent the State Long-Term Care Ombudsman Program until the462secretary provides his or her approval.463 (c) Upon appointment as an ombudsman, the individual may 464 participate in district activities but may not represent the 465 office or conduct any authorized program duties until the 466 individual has completed the initial training specified in s. 467 400.0091(1) and has been certified by the state ombudsman. 468 (d) The state ombudsman, for good cause shown, such as 469 development of a conflict of interest, failure to adhere to the 470 policies and procedures established by the office, or 471 demonstrated inability to carry out the responsibilities of the 472 office, may rescind the appointment of an individual as an 473 ombudsman. After the appointment is rescinded, the individual 474 may not conduct any duties as an ombudsman and may not represent 475 the office or the state ombudsman programA local council may476recommend the removal of one or more of its members by477submitting to the ombudsman a resolution adopted by a two-thirds478vote of the members of the council stating the name of the479member or members recommended for removal and the reasons for480the recommendation.If such a recommendation is adopted by a481local council, the local council chair or district coordinator482shall immediately report the council’s recommendation to the483ombudsman. The ombudsman shall review the recommendation of the484local council and advise the secretary of his or her485recommendation regarding removal of the council member or486members.487(6)(a) Each local council shall elect a chair for a term of4881 year. There shall be no limitation on the number of terms that489an approved member of a local council may serve as chair.490(b) The chair shall select a vice chair from among the491members of the council. The vice chair shall preside over the492council in the absence of the chair.493(c) The chair may create additional executive positions as494necessary to carry out the duties of the local council. Any495person appointed to an executive position shall serve at the496pleasure of the chair, and his or her term shall expire on the497same day as the term of the chair.498(d) A chair may be immediately removed from office prior to499the expiration of his or her term by a vote of two-thirds of the500members of the local council. If any chair is removed from501office prior to the expiration of his or her term, a replacement502chair shall be elected during the same meeting, and the term of503the replacement chair shall begin immediately. The replacement504chair shall serve for the remainder of the term of the person he505or she replaced.506(7) Each local council shall meet upon the call of its507chair or upon the call of the ombudsman. Each local council508shall meet at least once a month but may meet more frequently if509necessary.510 (6)(8)An ombudsman may notA member of a local council511shallreceivenocompensation but shall, with approval from the 512 state ombudsman, be reimbursed for travel expensesboth within513and outside the jurisdiction of the local councilin accordance 514 withthe provisions ofs. 112.061. 515 (7)(9)The representatives of the officelocal councilsare 516 authorized to call upon appropriate state agenciesof state517governmentforsuchprofessional assistance asmay beneeded in 518 the discharge of their duties, and such. Allstate agencies 519 shall cooperatewith the local councilsin providing requested 520 information and agency representationat council meetings. 521 Section 30. Section 400.0070, Florida Statutes, is amended 522 to read: 523 400.0070 Conflicts of interest.— 524 (1) A representative of the officeThe ombudsmanshall not: 525 (a) Have a direct involvement in the licensing or 526 certification of, or an ownership or investment interest in, a 527 long-term care facility or a provider of a long-term care 528 service. 529 (b) Be employed by, or participate in the management of, a 530 long-term care facility. 531 (c) Receive, or have a right to receive, directly or 532 indirectly, remuneration, in cash or in kind, under a 533 compensation agreement with the owner or operator of a long-term 534 care facility. 535 (2) Each representativeemployeeof the office, each state536council member, and each local council membershall certify that 537 he or she has no conflict of interest. 538 (3) The department, in consultation with the state 539 ombudsman, shall define by rule: 540 (a) Situations that constitute an individual’sa person541 having a conflict of interest that could materially affect the 542 objectivity or capacity of the individuala personto serve as a 543 representativeon an ombudsman council, or as an employeeof the 544 office, while carrying out the purposes of the State Long-Term545Care Ombudsman Program as specified in this part. 546 (b) The procedure by which an individuala personlisted in 547 subsection (2) shall certify that he or she has no conflict of 548 interest. 549 Section 31. Section 400.0071, Florida Statutes, is amended 550 to read: 551 400.0071 StateLong-Term Careombudsman program complaint 552 procedures.—The department, in consultation with the state 553 ombudsman, shall adopt rules implementing state and local 554 complaint procedures. The rules must include procedures for 555 receiving, investigating, identifying, and resolving complaints 556 concerning the health, safety, welfare, and rights of residents:557(1) Receiving complaints against a long-term care facility558or an employee of a long-term care facility. 559(2) Conducting investigations of a long-term care facility560or an employee of a long-term care facility subsequent to561receiving a complaint.562(3) Conducting onsite administrative assessments of long563term care facilities.564 Section 32. Section 400.0073, Florida Statutes, is amended 565 to read: 566 400.0073 ComplaintState and local ombudsman council567 investigations.— 568 (1) A representative of the officelocal councilshall 569 identify and investigate, within a reasonable time after a570complaint is made,any complaint made by or on behalf of a 571 resident that, a representative of a resident, or any other572credible source based on an action or omission by an573administrator, an employee, or a representative of a long-term574care facility whichmight be: 575 (a) Contrary to law; 576 (b) Unreasonable, unfair, oppressive, or unnecessarily 577 discriminatory, even though in accordance with law; 578 (c) Based on a mistake of fact; 579 (d) Based on improper or irrelevant grounds; 580 (e) Unaccompanied by an adequate statement of reasons; 581 (f) Performed in an inefficient manner; or 582 (g) Otherwise adversely affecting the health, safety, 583 welfare, or rights of a resident. 584(2) In an investigation, both the state and local councils585have the authority to hold public hearings.586(3) Subsequent to an appeal from a local council, the state587council may investigate any complaint received by the local588council involving a long-term care facility or a resident.589 (2)(4)If a representative of the officethe ombudsman or590any state or local council memberis not allowed to enter a 591 long-term care facility, the administrator of the facility shall 592 be considered to have interfered with a representative of the 593 office, the state council, or the local councilin the 594 performance of official duties as described in s. 400.0083(1) 595 and to have committed a violation of this part. The 596 representative of the officeombudsmanshall report a facility’s 597 refusal to allow entry to the facility to the state ombudsman or 598 his or her designee, who shall then report the incident to the 599 agency, and the agency shall record the report and take it into 600 consideration when determining actions allowable under s. 601 400.102, s. 400.121, s. 429.14, s. 429.19, s. 429.69, or s. 602 429.71. 603 Section 33. Section 400.0074, Florida Statutes, is amended 604 to read: 605 400.0074Local ombudsman councilOnsite administrative 606 assessments.— 607 (1) A representative of the office mustIn addition to any608specific investigation conducted pursuant to a complaint, the609local council shallconduct, at least annually, an onsite 610 administrative assessment of each nursing home, assisted living 611 facility, and adult family-care homewithin its jurisdiction. 612 This administrative assessment must be resident-centered and 613shallfocus on factors affecting the rights, health, safety, and 614 welfare of the residents.Each local council is encouraged to615conduct a similar onsite administrative assessment of each616additional long-term care facility within its jurisdiction.617 (2) An onsite administrative assessment isconducted by a618local council shall besubject to the following conditions: 619 (a) To the extent possible and reasonable, the 620 administrative assessmentassessmentsshall not duplicate the 621 efforts ofthe agencysurveys and inspections conducted by state 622 agencies of long-term care facilitiesunder part II of this623chapter and parts I and II of chapter 429. 624 (b) An administrative assessment shall be conducted at a 625 time and for a duration necessary to produce the information 626 required to complete the assessmentcarry out the duties of the627local council. 628 (c) Advance notice of an administrative assessment may not 629 be provided to a long-term care facility, except that notice of 630 followup assessments on specific problems may be provided. 631 (d) A representative of the officelocal council member632physicallypresent for the administrative assessment mustshall633 identify himself or herself to the administratorand cite the634specific statutory authority for his or her assessmentof the 635 facility or his or her designee. 636 (e) An administrative assessment may not unreasonably 637 interfere with the programs and activities of residents. 638 (f) A representative of the officelocal council membermay 639 not enter a single-family residential unit within a long-term 640 care facility during an administrative assessment without the 641 permission of the resident or the representative of the 642 resident. 643 (g) An administrative assessment must be conducted in a 644 manner that will impose no unreasonable burden on a long-term 645 care facility. 646(3) Regardless of jurisdiction, the ombudsman may authorize647a state or local council member to assist another local council648to perform the administrative assessments described in this649section.650 (3)(4)An onsite administrative assessment may not be 651 accomplished by forcible entry. However, if a representative of 652 the officeombudsman or a state or local council memberis not 653 allowed to enter a long-term care facility, the administrator of 654 the facility shall be considered to have interfered with a 655 representative of the office, the state council, or the local656councilin the performance of official duties as described in s. 657 400.0083(1) and to have committed a violation of this part. The 658 representative of the officeombudsmanshall report the refusal 659 by a facility to allow entry to the state ombudsman or his or 660 her designee, who shall then report the incident to the agency, 661 and the agency shall record the report and take it into 662 consideration when determining actions allowable under s. 663 400.102, s. 400.121, s. 429.14, s. 429.19, s. 429.69, or s. 664 429.71. 665 (4) The department, in consultation with the state 666 ombudsman, may adopt rules implementing procedures for 667 conducting onsite administrative assessments of long-term care 668 facilities. 669 Section 34. Section 400.0075, Florida Statutes, is amended 670 to read: 671 400.0075 Complaint notification and resolution procedures.— 672 (1)(a) Any complaintor problemverified by a 673 representative of the officean ombudsman councilas a result of 674 an investigation mayor onsite administrative assessment, which675complaint or problem is determined to require remedial action by676the local council, shallbe identified and brought to the 677 attention of the long-term care facility administrator subject 678 to the confidentiality provisions of s. 400.0077in writing. 679 Upon receipt of the informationsuch document, the 680 administrator, with the concurrence of the representative of the 681 officelocal council chair, shall establish target dates for 682 taking appropriate remedial action. If, by the target date, the 683 remedial action is not completed or forthcoming, the 684 representative may extend the target date if there is reason to 685 believe such action would facilitate the resolution of the 686 complaint, or the representative may refer the complaint to the 687 district managerlocal council chair may, after obtaining688approval from the ombudsman and a majority of the members of the689local council:6901. Extend the target date if the chair has reason to691believe such action would facilitate the resolution of the692complaint. 6932. In accordance with s.400.0077, publicize the complaint,694the recommendations of the council, and the response of the695long-term care facility.6963. Refer the complaint to the state council.697 (b) If an ombudsman determinesthe local council chair698believesthat the health, safety, welfare, or rights of athe699 resident are in imminent danger, the ombudsman must immediately 700 notify the district manager. The district managerchair shall701notify the ombudsman or legal advocate, who, after verifying 702 that such imminent danger exists, must notify the appropriate 703 state agencies, including law enforcement, the state ombudsman, 704 and the legal advocate to ensure the protection ofshall seek705immediate legal or administrative remedies to protectthe 706 resident. 707 (c) If the state ombudsman or legal advocate has reason to 708 believe that the long-term care facility or an employee of the 709 facility has committed a criminal act, the state ombudsman or 710 legal advocate shall provide the local law enforcement agency 711 with the relevant information to initiate an investigation of 712 the case. 713 (2)(a)Upon referral from a districtlocal council, the 714 state ombudsman or his or her designeecouncilshall assume the 715 responsibility for the disposition of the complaint. If a long 716 term care facility fails to take action to resolve or remedy the 717on acomplaintby the state council, the state ombudsmancouncil718 may, after obtaining approval from the ombudsman and a majority719of the state council members: 720 (a)1.In accordance with s. 400.0077, publicize the 721 complaint, the recommendations of the representatives of the 722 officelocal or state council, and the response of the long-term 723 care facility. 724 (b)2.Recommend to the department and the agency a series 725 of facility reviews pursuant to s. 400.19, s. 429.34, or s. 726 429.67 to ensure correction and nonrecurrence of the conditions 727 that gavegiverise to the complaintcomplaintsagainst thea728 long-term care facility. 729 (c)3.Recommend to the department and the agency that the 730 long-term care facility no longer receive payments under any 731 state assistance program, including Medicaid. 732 (d)4.Recommend to the department and the agency that 733 procedures be initiated for action againstrevocation ofthe 734 long-term care facility’s license in accordance with chapter 735 120. 736(b) If the state council chair believes that the health,737safety, welfare, or rights of the resident are in imminent738danger, the chair shall notify the ombudsman or legal advocate,739who, after verifying that such imminent danger exists, shall740seek immediate legal or administrative remedies to protect the741resident.742 (3)(c)If the state ombudsman, after consultation with the 743 legal advocate, has reason to believe that the long-term care 744 facility or an employee of the facility has committed a criminal 745 act, the officeombudsmanshall provide local law enforcement 746 with the relevant information to initiate an investigation of 747 the case. 748 Section 35. Section 400.0078, Florida Statutes, is amended 749 to read: 750 400.0078 Citizen access to stateLong-Term Careombudsman 751 program services.— 752 (1) The office shall establish a statewide toll-free 753 telephone number and e-mail address for receiving complaints 754 concerning matters adversely affecting the health, safety, 755 welfare, or rights of residents. 756 (2)Every resident or representative of a resident shall757receive,Upon admission to a long-term care facility, each 758 resident or representative of a resident must receive 759 information regarding: 760 (a) The purpose of the stateLong-Term Careombudsman 761 program.,762 (b) The statewide toll-free telephone number and e-mail 763 address for receiving complaints., and764 (c) Information that retaliatory action cannot be taken 765 against a resident for presenting grievances or for exercising 766 any other resident rights. 767 (d) Other relevant information regarding how to contact 768 representatives of the officeprogram. 769 770 Residents or their representatives must be furnished additional 771 copies of this information upon request. 772 Section 36. Section 400.0079, Florida Statutes, is amended 773 to read: 774 400.0079 Immunity.— 775 (1) Any person making a complaint pursuant to this part who 776 does so in good faith shall be immune from any liability, civil 777 or criminal, that otherwise might be incurred or imposed as a 778 direct or indirect result of making the complaint. 779 (2) Representatives of the office andThe ombudsman or any780person authorized by the ombudsman to act on behalf of the781office, as well as allmembers of the state counciland local782councils,shall be immune from any liability, civil or criminal, 783 that otherwise might be incurred or imposed during the good 784 faith performance of official duties. 785 Section 37. Section 400.0081, Florida Statutes, is amended 786 to read: 787 400.0081 Access to facilities, residents, and records.— 788 (1) A long-term care facility shall provide representatives 789 of the office with, the state council and its members, and the790local councils and their members access to: 791 (a) Access toAny portion ofthe long-term care facility 792 and residentsany resident as necessary to investigate or793resolve a complaint. 794 (b) Appropriate access to medical and social records of a 795 resident for reviewas necessary to investigate or resolve a796complaint,if: 797 1. The representative of the office has the permission of 798 the resident or the legal representative of the resident; or 799 2. The resident is unable to consent to the review and has 800 no legal representative. 801 (c) Access to medical and social records of atheresident 802as necessary to investigate or resolve a complaint,if: 803 1. A legal representative or guardian of the resident 804 refuses to give permission; 805 2. A representative of the office has reasonable cause to 806 believe that the legal representative or guardian is not acting 807 in the best interests of the resident; and 808 3. The representative of the officestate or local council809memberobtains the approval of the state ombudsman. 810 (d) Access to the administrative records, policies, and 811 documents to which residents or the general public have access. 812 (e) Upon request, copies of all licensing and certification 813 records maintained by the state with respect to a long-term care 814 facility. 815 (2) The department, in consultation with the state 816 ombudsmanand the state council, may adopt rules to establish 817 procedures to ensure access to facilities, residents, and 818 records as described in this section. 819 Section 38. Section 400.0083, Florida Statutes, is amended 820 to read: 821 400.0083 Interference; retaliation; penalties.— 822 (1) It shall be unlawful for any person, long-term care 823 facility, or other entity to willfully interfere with a 824 representative of the office or,the state council, or a local825councilin the performance of official duties. 826 (2) It shall be unlawful for any person, long-term care 827 facility, or other entity to knowingly or willfully take action 828 or retaliate against any resident, employee, or other person for 829 filing a complaint with, providing information to, or otherwise 830 cooperating with any representative of the office or,the state 831 council, or a local council. 832 (3) Any person, long-term care facility, or other entity 833 that violates this section: 834 (a) Shall be liable for damages and equitable relief as 835 determined by law. 836 (b) Commits a misdemeanor of the second degree, punishable 837 as provided in s. 775.083. 838 Section 39. Section 400.0087, Florida Statutes, is amended 839 to read: 840 400.0087 Department oversight; funding.— 841 (1) The department shall meet the costs associated with the 842 stateLong-Term Careombudsman program from funds appropriated 843 to it. 844 (a) The department shall include the costs associated with 845 support of the stateLong-Term Careombudsman program when 846 developing its budget requests for consideration by the Governor 847 and submittal to the Legislature. 848 (b) The department may divert from the federal ombudsman 849 appropriation an amount equal to the department’s administrative 850 cost ratio to cover the costs associated with administering the 851 state ombudsman program. The remaining allotment from the Older 852 Americans Act program shall be expended on direct ombudsman 853 activities. 854 (2) The department shall monitor the office and,the state 855 council, and the local councilsto ensure that each is carrying 856 out the duties delegated to it by state and federal law. 857 (3) The department is responsible for ensuring that the 858 office: 859 (a) Has the objectivity and independence required to 860 qualify it for funding under the federal Older Americans Act. 861 (b) Provides information to public and private agencies, 862 legislators, and others. 863 (c) Provides appropriate training to representatives of the 864 officeor of the state or local councils. 865 (d) Coordinates ombudsman services with Disability Rights 866 Floridathe Advocacy Center for Persons with Disabilitiesand 867 with providers of legal services to residentsof long-term care868facilitiesin compliance with state and federal laws. 869 (4) The department shall also: 870 (a) Receive and disburse state and federal funds for 871 purposes that the state ombudsman has formulated in accordance 872 with the Older Americans Act. 873 (b) Whenever necessary, act as liaison between agencies and 874 branches of the federal and state governments and the office 875State Long-Term Care Ombudsman Program. 876 Section 40. Section 400.0089, Florida Statutes, is amended 877 to read: 878 400.0089 Complaint data reports.—The office shall maintain 879 a statewide uniform reporting system to collect and analyze data 880 relating to complaints and conditions in long-term care 881 facilities and to residents for the purpose of identifying and 882 resolving significant complaintsproblems. The office shall 883 publish quarterly and make readily available information 884 pertaining to the number and types of complaints received by the 885 stateLong-Term Careombudsman program and shall include such 886 information in the annual report required under s. 400.0065. 887 Section 41. Section 400.0091, Florida Statutes, is amended 888 to read: 889 400.0091 Training.—The state ombudsman shall ensure that 890 appropriate training is provided to all representatives 891employeesof the officeand to the members of the state and892local councils. 893 (1) All representativesstate and local council members and894employeesof the office shall be given a minimum of 20 hours of 895 training upon employment with the office or appointment as an 896 ombudsman. Tenapproval as a state or local council member and89710hours of continuing education are required annually 898 thereafter. 899 (2) The state ombudsman shall approve the curriculum for 900 the initial and continuing education training, which must, at a 901 minimum, address: 902 (a) Resident confidentiality. 903 (b) Guardianships and powers of attorney. 904 (c) Medication administration. 905 (d) Care and medication of residents with dementia and 906 Alzheimer’s disease. 907 (e) Accounting for residents’ funds. 908 (f) Discharge rights and responsibilities. 909 (g) Cultural sensitivity. 910 (h) Any other topic related to residency within a long-term 911 care facilityrecommended by the secretary. 912 (3) An individualNo employee, officer, or representative913of the office or of the state or local councils, other than the 914 state ombudsman, may not hold himself or herself out as a 915 representative of the officeState Long-Term Care Ombudsman916Programor conduct any authorized program duty described in this 917 part unless the individualpersonhas received the training 918 required by this section and has been certified by the state 919 ombudsman as qualified to carry out ombudsman activities on 920 behalf of the officeor the state or local councils. 921 922 ================= T I T L E A M E N D M E N T ================ 923 And the title is amended as follows: 924 Delete lines 90 - 106 925 and insert: 926 amending s. 397.403, F.S.; revising references to 927 certain accrediting agencies to changes made by the 928 act; amending s. 400.0060, F.S.; revising and 929 providing definitions; amending s. 400.0061, F.S.; 930 revising legislative intent with respect to citizen 931 ombudsmen; deleting references to ombudsman councils 932 and transferring their responsibilities to 933 representatives of the Office of State Long-Term Care 934 Ombudsman; amending s. 400.0063, F.S.; revising duties 935 of the office; amending s. 400.0065, F.S.; revising 936 the purpose of the Office of State Long-Term Care 937 Ombudsman; establishing districts; requiring the state 938 ombudsman to submit an annual report to the Governor, 939 the Legislature, and specified agencies and entities; 940 amending s. 400.0067, F.S.; revising duties and 941 membership of the State Long-Term Care Ombudsman 942 Council; amending s. 400.0069, F.S.; requiring the 943 state ombudsman to designate and direct program 944 districts; providing duties of representatives of the 945 office in the districts; providing for appointment and 946 qualifications of district ombudsmen; prohibiting 947 certain individuals from serving as ombudsmen; 948 providing for appointment of ombudsmen; amending s. 949 400.0070, F.S.; providing conditions under which a 950 representative of the office could be found to have a 951 conflict of interest; amending s. 400.0071, F.S.; 952 requiring the Department of Elderly Affairs to consult 953 with the state ombudsman before adopting rules 954 pertaining to complaint resolution; amending s. 955 400.0073, F.S.; providing procedures for investigation 956 of complaints; amending s. 400.0074, F.S.; revising 957 procedures for conducting onsite administrative 958 assessments; authorizing the department to adopt 959 rules; amending s. 400.0075, F.S.; revising complaint 960 notification and resolution procedures; amending s. 961 400.0078, F.S.; providing for a resident or 962 representative of a resident to receive additional 963 information regarding resident rights; amending s. 964 400.0079, F.S.; providing immunity from liability for 965 a representative of the office under certain 966 circumstances; amending s. 400.0081, F.S.; requiring 967 long-term care facilities to provide representatives 968 of the office with access to facilities, residents, 969 and records for certain purposes; amending s. 970 400.0083, F.S.; conforming provisions to changes made 971 by the act; amending s. 400.0087, F.S.; providing for 972 the office to coordinate ombudsman services with 973 Disability Rights Florida; amending s. 400.0089, F.S.; 974 conforming provisions to changes made by the act; 975 amending s. 400.0091, F.S.; revising training 976 requirements for representatives of the office and 977 ombudsmen; amending s. 400.462, F.S.; defining