Bill Text: FL S0382 | 2015 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Assisted Living Facilities
Spectrum:
Status: (Introduced - Dead) 2015-04-27 - Laid on Table, companion bill(s) passed, see CS/CS/HB 1001 (Ch. 2015-126), CS/SB 7018 (Ch. 2015-31) [S0382 Detail]
Download: Florida-2015-S0382-Introduced.html
Bill Title: Assisted Living Facilities
Spectrum:
Status: (Introduced - Dead) 2015-04-27 - Laid on Table, companion bill(s) passed, see CS/CS/HB 1001 (Ch. 2015-126), CS/SB 7018 (Ch. 2015-31) [S0382 Detail]
Download: Florida-2015-S0382-Introduced.html
Florida Senate - 2015 SB 382 By Senator Sobel 33-00555-15 2015382__ 1 A bill to be entitled 2 An act relating to assisted living facilities; 3 amending s. 394.4574, F.S.; providing that Medicaid 4 managed care plans are responsible for mental health 5 residents enrolled in Medicaid; specifying that 6 managing entities under contract with the Department 7 of Children and Families are responsible for mental 8 health residents who are not enrolled in a Medicaid 9 managed care plan; deleting a provision to conform to 10 changes made by the act; requiring that the community 11 living support plan be completed and provided to the 12 administrator of a facility upon the mental health 13 resident’s admission; requiring the community living 14 support plan to be updated when there is a significant 15 change to the mental health resident’s behavioral 16 health status; requiring the case manager assigned to 17 a mental health resident for whom the mental health 18 services provider is responsible to keep a record of 19 the date and time of face-to-face interactions with 20 the resident and to make the record available to the 21 entity responsible for inspection; requiring that the 22 record be maintained for a specified time; requiring 23 the responsible entity to ensure that there is 24 adequate and consistent monitoring and enforcement of 25 community living support plans and cooperative 26 agreements and that concerns are reported to the 27 appropriate regulatory oversight organization under 28 certain circumstances; amending s. 400.0074, F.S.; 29 requiring that an administrative assessment conducted 30 by a local council be comprehensive in nature; 31 requiring a local council to conduct an exit 32 consultation with the facility administrator or 33 administrator designee to discuss issues and concerns 34 in areas affecting residents’ rights, health, safety, 35 and welfare and make recommendations for any needed 36 improvements; amending s. 400.0078, F.S.; requiring 37 that a resident of a long-term care facility, or his 38 or her representative, be informed that retaliatory 39 action cannot be taken against a resident for 40 presenting grievances or for exercising any other 41 resident right; amending s. 429.07, F.S.; revising the 42 requirement that an extended congregate care license 43 be issued to certain facilities that have been 44 licensed as assisted living facilities under certain 45 circumstances and authorizing the issuance of such 46 license if a specified condition is met; providing the 47 purpose of an extended congregate care license; 48 specifying that the initial extended congregate care 49 license of an assisted living facility is provisional 50 under certain circumstances; requiring a licensee to 51 notify the Agency for Health Care Administration if it 52 accepts a resident who qualifies for extended 53 congregate care services; requiring the agency to 54 inspect the facility for compliance with the 55 requirements of an extended congregate care license; 56 requiring the issuance of an extended congregate care 57 license under certain circumstances; requiring the 58 licensee to immediately suspend extended congregate 59 care services under certain circumstances; requiring a 60 registered nurse representing the agency to visit the 61 facility at least twice a year, rather than quarterly, 62 to monitor residents who are receiving extended 63 congregate care services; authorizing the agency to 64 waive one of the required yearly monitoring visits 65 under certain circumstances; authorizing the agency to 66 deny or revoke a facility’s extended congregate care 67 license; requiring a registered nurse representing the 68 agency to visit the facility at least annually, rather 69 than twice a year, to monitor residents who are 70 receiving limited nursing services; providing that 71 such monitoring visits may be conducted in conjunction 72 with other inspections by the agency; authorizing the 73 agency to waive the required yearly monitoring visit 74 for a facility that is licensed to provide limited 75 nursing services under certain circumstances; amending 76 s. 429.075, F.S.; requiring that an assisted living 77 facility that serves one or more mental health 78 residents, rather than three or more such residents, 79 obtain a limited mental health license; amending s. 80 429.14, F.S.; revising the circumstances under which 81 the agency may deny, revoke, or suspend the license of 82 an assisted living facility and impose an 83 administrative fine; requiring the agency to deny or 84 revoke the license of an assisted living facility 85 under certain circumstances; requiring the agency to 86 impose an immediate moratorium on the license of an 87 assisted living facility under certain circumstances; 88 prohibiting a licensee from restricting agency staff 89 from accessing and copying certain records or 90 conducting certain interviews; deleting a provision 91 requiring the agency to provide a list of facilities 92 with denied, suspended, or revoked licenses to the 93 Department of Business and Professional Regulation; 94 exempting a facility from the 45-day notice 95 requirement if it is required to relocate some or all 96 of its residents; specifying that the exemption does 97 not exempt a facility from any deadlines for 98 corrective action set by the agency; amending s. 99 429.178, F.S.; conforming cross-references; amending 100 s. 429.19, F.S.; revising the amounts and uses of 101 administrative fines; requiring the agency to levy a 102 fine for violations that are corrected before an 103 inspection if noncompliance occurred within a 104 specified period of time; deleting factors that the 105 agency is required to consider in determining 106 penalties and fines; amending s. 429.256, F.S.; 107 revising the term “assistance with self-administration 108 of medication” as it relates to the Assisted Living 109 Facilities Act; amending s. 429.28, F.S.; providing 110 notice requirements for informing facility residents 111 that the name and identity of the resident and 112 complainant in any complaint made to the State Long 113 Term Care Ombudsman Program or a local long-term care 114 ombudsman council is confidential and that retaliatory 115 action may not be taken against a resident for 116 presenting grievances or for exercising any other 117 resident right; requiring that a facility that 118 terminates an individual’s residency after the filing 119 of a complaint be fined if good cause is not shown for 120 the termination; amending s. 429.34, F.S.; requiring 121 certain persons to report elder abuse in assisted 122 living facilities; requiring the agency to regularly 123 inspect each licensed assisted living facility; 124 requiring the agency to conduct more frequent 125 inspections under certain circumstances; requiring the 126 licensee to pay a fee for the cost of additional 127 inspections; requiring the agency to annually adjust 128 the fee; amending s. 429.41, F.S.; providing that 129 certain staffing requirements apply only to residents 130 in continuing care facilities who are receiving 131 relevant services; amending s. 429.52, F.S.; requiring 132 each newly hired employee of an assisted living 133 facility to attend a preservice orientation provided 134 by the assisted living facility; requiring the 135 employee and administrator to sign a statement that 136 the employee completed the required preservice 137 orientation and keep the signed statement in the 138 employee’s personnel record; requiring 2 additional 139 hours of training for assistance with medication; 140 conforming a cross-reference; requiring the Office of 141 Program Policy Analysis and Government Accountability 142 to study the reliability of facility surveys and 143 submit to the Governor and the Legislature its 144 findings and recommendations; requiring the agency to 145 implement a rating system for assisted living 146 facilities by a specified date, adopt rules, and 147 create content for the agency’s website by a specified 148 date which provides consumers information regarding 149 assisted living facilities; providing criteria for the 150 content; providing appropriations; providing an 151 effective date. 152 153 Be It Enacted by the Legislature of the State of Florida: 154 155 Section 1. Section 394.4574, Florida Statutes, is amended 156 to read: 157 394.4574DepartmentResponsibilities for coordination of 158 services for a mental health resident who resides in an assisted 159 living facility that holds a limited mental health license.— 160 (1) As used in this section, the term “mental health 161 resident”“mental health resident,”for purposes of this162section,means an individual who receives social security 163 disability income due to a mental disorder as determined by the 164 Social Security Administration or receives supplemental security 165 income due to a mental disorder as determined by the Social 166 Security Administration and receives optional state 167 supplementation. 168 (2) Medicaid managed care plans are responsible for 169 Medicaid-enrolled mental health residents, and managing entities 170 under contract with the department are responsible for mental 171 health residents who are not enrolled in a Medicaid health plan. 172 A Medicaid managed care plan or a managing entity, as 173 appropriate, shallThe department mustensure that: 174 (a) A mental health resident has been assessed by a 175 psychiatrist, clinical psychologist, clinical social worker, or 176 psychiatric nurse, or an individual who is supervised by one of 177 these professionals, and determined to be appropriate to reside 178 in an assisted living facility. The documentation must be 179 provided to the administrator of the facility within 30 days 180 after the mental health resident has been admitted to the 181 facility. An evaluation completed upon discharge from a state 182 mental hospital meets the requirements of this subsection 183 related to appropriateness for placement as a mental health 184 resident if it was completed within 90 days beforeprior to185 admission to the facility. 186 (b) A cooperative agreement, as required in s. 429.075, is 187 developed bybetweenthe mental health care services provider 188 that serves a mental health resident and the administrator of 189 the assisted living facility with a limited mental health 190 license in which the mental health resident is living.Any191entity that provides Medicaid prepaid health plan services shall192ensure the appropriate coordination of health care services with193an assisted living facility in cases where a Medicaid recipient194is both a member of the entity’s prepaid health plan and a195resident of the assisted living facility. If the entity is at196risk for Medicaid targeted case management and behavioral health197services, the entity shall inform the assisted living facility198of the procedures to follow should an emergent condition arise.199 (c) The community living support plan, as defined in s. 200 429.02, has been prepared by a mental health resident and his or 201 heramental health case managerof that residentin 202 consultation with the administrator of the facility or the 203 administrator’s designee. The plan must be completed and 204 provided to the administrator of the assisted living facility 205 with a limited mental health license in which the mental health 206 resident lives upon the resident’s admission. The support plan 207 and the agreement may be in one document. 208 (d) The assisted living facility with a limited mental 209 health license is provided with documentation that the 210 individual meets the definition of a mental health resident. 211 (e) The mental health services provider assigns a case 212 manager to each mental health resident for whom the entity is 213 responsiblewho lives in an assisted living facility with a214limited mental health license. The case manager shall coordinate 215is responsible for coordinatingthe developmentofand 216 implementation of the community living support plan defined in 217 s. 429.02. The plan must be updated at least annually, or when 218 there is a significant change in the resident’s behavioral 219 health status, such as an inpatient admission or a change in 220 medication, level of service, or residence. Each case manager 221 shall keep a record of the date and time of any face-to-face 222 interaction with the resident and make the record available to 223 the responsible entity for inspection. The record must be 224 retained for at least 2 years after the date of the most recent 225 interaction. 226 (f) Adequate and consistent monitoring and enforcement of 227 community living support plans and cooperative agreements are 228 conducted by the resident’s case manager. 229 (g) Concerns are reported to the appropriate regulatory 230 oversight organization if a regulated provider fails to deliver 231 appropriate services or otherwise acts in a manner that has the 232 potential to result in harm to the resident. 233 (3) The Secretary of Children and Families, in consultation 234 with the Agency for Health Care Administration, shallannually235 require each district administrator to develop, with community 236 input, a detailed annual plan that demonstratesdetailed plans237that demonstratehow the district will ensure the provision of 238 state-funded mental health and substance abuse treatment 239 services to residents of assisted living facilities that hold a 240 limited mental health license. This planThese plansmust be 241 consistent with the substance abuse and mental health district 242 plan developed pursuant to s. 394.75 and must address case 243 management services; access to consumer-operated drop-in 244 centers; access to services during evenings, weekends, and 245 holidays; supervision of the clinical needs of the residents; 246 and access to emergency psychiatric care. 247 Section 2. Subsection (1) of section 400.0074, Florida 248 Statutes, is amended, and paragraph (h) is added to subsection 249 (2) of that section, to read: 250 400.0074 Local ombudsman council onsite administrative 251 assessments.— 252 (1) In addition to any specific investigation conducted 253 pursuant to a complaint, the local council shall conduct, at 254 least annually, an onsite administrative assessment of each 255 nursing home, assisted living facility, and adult family-care 256 home within its jurisdiction. This administrative assessment 257 must be comprehensive in nature and mustshallfocus on factors 258 affecting residents’therights, health, safety, and welfareof259the residents. Each local council is encouraged to conduct a 260 similar onsite administrative assessment of each additional 261 long-term care facility within its jurisdiction. 262 (2) An onsite administrative assessment conducted by a 263 local council shall be subject to the following conditions: 264 (h) The local council shall conduct an exit consultation 265 with the facility administrator or administrator’s designee to 266 discuss issues and concerns in areas affecting residents’ 267 rights, health, safety, and welfare and, if needed, make 268 recommendations for improvement. 269 Section 3. Subsection (2) of section 400.0078, Florida 270 Statutes, is amended to read: 271 400.0078 Citizen access to State Long-Term Care Ombudsman 272 Program services.— 273 (2)Every resident or representative of a resident shall274receive,Upon admission to a long-term care facility, each 275 resident or representative of a resident must receive 276 information regarding the purpose of the State Long-Term Care 277 Ombudsman Program, the statewide toll-free telephone number for 278 receiving complaints, information that retaliatory action cannot 279 be taken against a resident for presenting grievances or for 280 exercising any other resident right, and other relevant 281 information regarding how to contact the program. Each resident 282 or his or her representativeResidents or their representatives283 must be furnished additional copies of this information upon 284 request. 285 Section 4. Paragraphs (b) and (c) of subsection (3) of 286 section 429.07, Florida Statutes, are amended to read: 287 429.07 License required; fee.— 288 (3) In addition to the requirements of s. 408.806, each 289 license granted by the agency must state the type of care for 290 which the license is granted. Licenses shall be issued for one 291 or more of the following categories of care: standard, extended 292 congregate care, limited nursing services, or limited mental 293 health. 294 (b) An extended congregate care license shall be issued to 295 each facility that has been licensed as an assisted living 296 facility for 2 or more years and that provides services 297facilities providing, directly or through contract,services298 beyond those authorized in paragraph (a), including services 299 performed by persons licensed under part I of chapter 464 and 300 supportive services, as defined by rule, to persons who would 301 otherwise be disqualified from continued residence in a facility 302 licensed under this part. An extended congregate care license 303 may be issued to a facility that has a provisional extended 304 congregate care license and meets the requirements for licensure 305 under subparagraph 2. The primary purpose of extended congregate 306 care services is to allow residents the option of remaining in a 307 familiar setting from which they would otherwise be disqualified 308 for continued residency as they become more impaired. A facility 309 licensed to provide extended congregate care services may also 310 admit an individual who exceeds the admission criteria for a 311 facility with a standard license if the individual is determined 312 appropriate for admission to the extended congregate care 313 facility. 314 1. In order for extended congregate care services to be 315 provided, the agency must first determine that all requirements 316 established in law and rule are met and must specifically 317 designate,on the facility’s license,that such services may be 318 provided and whether the designation applies to all or part of 319 the facility. ThisSuchdesignation may be made at the time of 320 initial licensure or licensure renewalrelicensure, or upon 321 request in writing by a licensee under this part and part II of 322 chapter 408. The notification of approval or the denial of the 323 request shall be made in accordance with part II of chapter 408. 324 Each existing facility that qualifiesfacilities qualifyingto 325 provide extended congregate care services must have maintained a 326 standard license and may not have been subject to administrative 327 sanctions during the previous 2 years, or since initial 328 licensure if the facility has been licensed for less than 2 329 years, for any of the following reasons: 330 a. A class I or class II violation; 331 b. Three or more repeat or recurring class III violations 332 of identical or similar resident care standards from which a 333 pattern of noncompliance is found by the agency; 334 c. Three or more class III violations that were not 335 corrected in accordance with the corrective action plan approved 336 by the agency; 337 d. Violation of resident care standards which results in 338 requiring the facility to employ the services of a consultant 339 pharmacist or consultant dietitian; 340 e. Denial, suspension, or revocation of a license for 341 another facility licensed under this part in which the applicant 342 for an extended congregate care license has at least 25 percent 343 ownership interest; or 344 f. Imposition of a moratorium pursuant to this part or part 345 II of chapter 408 or initiation of injunctive proceedings. 346 347 The agency may deny or revoke a facility’s extended congregate 348 care license if it fails to meet the criteria for an extended 349 congregate care license as provided in this subparagraph. 350 2. If an assisted living facility has been licensed for 351 less than 2 years, the initial extended congregate care license 352 must be provisional and may not exceed 6 months. Within the 353 first 3 months after the provisional license is issued, the 354 licensee shall notify the agency, in writing, when it admits at 355 least one extended congregate care resident, after which an 356 unannounced inspection shall be made to determine compliance 357 with requirements of an extended congregate care license. 358 Failure to admit an extended congregate care resident within the 359 first 3 months renders the extended congregate care license 360 void. A licensee that has a provisional extended congregate care 361 license which demonstrates compliance with all of the 362 requirements of an extended congregate care license during the 363 inspection shall be issued an extended congregate care license. 364 In addition to sanctions authorized under this part, if 365 violations are found during the inspection and the licensee 366 fails to demonstrate compliance with all assisted living 367 requirements during a followup inspection, the licensee shall 368 immediately suspend extended congregate care services, and the 369 provisional extended congregate care license expires. The agency 370 may extend the provisional license for not more than 1 month in 371 order to complete a followup visit. 372 3.2.A facility that is licensed to provide extended 373 congregate care services shall maintain a written progress 374 report on each person who receives services which describes the 375 type, amount, duration, scope, and outcome of services that are 376 rendered and the general status of the resident’s health. A 377 registered nurse, or appropriate designee, representing the 378 agency shall visit the facility at least twice a yearquarterly379 to monitor residents who are receiving extended congregate care 380 services and to determine if the facility is in compliance with 381 this part, part II of chapter 408, and relevant rules. One of 382 the visits may be in conjunction with the regular survey. The 383 monitoring visits may be provided through contractual 384 arrangements with appropriate community agencies. A registered 385 nurse shall serve as part of the team that inspects the 386 facility. The agency may waive one of the required yearly 387 monitoring visits for a facility that has: 388 a. Held an extended congregate care license for at least 24 389 months;been licensed for at least 24 months to provide extended390congregate care services, if, during the inspection, the391registered nurse determines that extended congregate care392services are being provided appropriately, and if the facility393has394 b. No class I or class II violations and no uncorrected 395 class III violations; and.396 c. No ombudsman council complaints that resulted in a 397 citation for licensureThe agency must first consult with the398long-term care ombudsman council for the area in which the399facility is located to determine if any complaints have been400made and substantiated about the quality of services or care. 401The agency may not waive one of the required yearly monitoring402visits if complaints have been made and substantiated.403 4.3.A facility that is licensed to provide extended 404 congregate care services must: 405 a. Demonstrate the capability to meet unanticipated 406 resident service needs. 407 b. Offer a physical environment that promotes a homelike 408 setting, provides for resident privacy, promotes resident 409 independence, and allows sufficient congregate space as defined 410 by rule. 411 c. Have sufficient staff available, taking into account the 412 physical plant and firesafety features of the building, to 413 assist with the evacuation of residents in an emergency. 414 d. Adopt and follow policies and procedures that maximize 415 resident independence, dignity, choice, and decisionmaking to 416 permit residents to age in place, so that moves due to changes 417 in functional status are minimized or avoided. 418 e. Allow residents or, if applicable, a resident’s 419 representative, designee, surrogate, guardian, or attorney in 420 fact to make a variety of personal choices, participate in 421 developing service plans, and share responsibility in 422 decisionmaking. 423 f. Implement the concept of managed risk. 424 g. Provide, directly or through contract, the services of a 425 person licensed under part I of chapter 464. 426 h. In addition to the training mandated in s. 429.52, 427 provide specialized training as defined by rule for facility 428 staff. 429 5.4.A facility that is licensed to provide extended 430 congregate care services is exempt from the criteria for 431 continued residency set forth in rules adopted under s. 429.41. 432 A licensed facility must adopt its own requirements within 433 guidelines for continued residency set forth by rule. However, 434 the facility may not serve residents who require 24-hour nursing 435 supervision. A licensed facility that provides extended 436 congregate care services must also provide each resident with a 437 written copy of facility policies governing admission and 438 retention. 4395. The primary purpose of extended congregate care services440is to allow residents, as they become more impaired, the option441of remaining in a familiar setting from which they would442otherwise be disqualified for continued residency. A facility443licensed to provide extended congregate care services may also444admit an individual who exceeds the admission criteria for a445facility with a standard license, if the individual is446determined appropriate for admission to the extended congregate447care facility.448 6. Before the admission of an individual to a facility 449 licensed to provide extended congregate care services, the 450 individual must undergo a medical examination as provided in s. 451 429.26(4) and the facility must develop a preliminary service 452 plan for the individual. 453 7. IfWhena facility can no longer provide or arrange for 454 services in accordance with the resident’s service plan and 455 needs and the facility’s policy, the facility mustshallmake 456 arrangements for relocating the person in accordance with s. 457 429.28(1)(k). 4588. Failure to provide extended congregate care services may459result in denial of extended congregate care license renewal.460 (c) A limited nursing services license shall be issued to a 461 facility that provides services beyond those authorized in 462 paragraph (a) and as specified in this paragraph. 463 1. In order for limited nursing services to be provided in 464 a facility licensed under this part, the agency must first 465 determine that all requirements established in law and rule are 466 met and must specifically designate, on the facility’s license, 467 that such services may be provided. ThisSuchdesignation may be 468 made at the time of initial licensure or licensure renewal 469relicensure, or upon request in writing by a licensee under this 470 part and part II of chapter 408. Notification of approval or 471 denial of such request shall be made in accordance with part II 472 of chapter 408. An existing facility that qualifiesfacilities473qualifyingto provide limited nursing services mustshallhave 474 maintained a standard license and may not have been subject to 475 administrative sanctions that affect the health, safety, and 476 welfare of residents for the previous 2 years or since initial 477 licensure if the facility has been licensed for less than 2 478 years. 479 2. A facilityFacilitiesthat isarelicensed to provide 480 limited nursing services shall maintain a written progress 481 report on each person who receives such nursing services. The,482whichreport must describedescribesthe type, amount, duration, 483 scope, and outcome of services that are rendered and the general 484 status of the resident’s health. A registered nurse representing 485 the agency shall visit the facilitysuch facilitiesat least 486 annuallytwice a yearto monitor residents who are receiving 487 limited nursing services and to determine if the facility is in 488 compliance with applicable provisions of this part, part II of 489 chapter 408, and related rules. The monitoring visits may be 490 provided through contractual arrangements with appropriate 491 community agencies. A registered nurse shall also serve as part 492 of the team that inspects such facility. Visits may be in 493 conjunction with other agency inspections. The agency may waive 494 the required yearly monitoring visit for a facility that has: 495 a. Had a limited nursing services license for at least 24 496 months; 497 b. No class I or class II violations and no uncorrected 498 class III violations; and 499 c. No ombudsman council complaints that resulted in a 500 citation for licensure. 501 3. A person who receives limited nursing services under 502 this part must meet the admission criteria established by the 503 agency for assisted living facilities. When a resident no longer 504 meets the admission criteria for a facility licensed under this 505 part, arrangements for relocating the person shall be made in 506 accordance with s. 429.28(1)(k), unless the facility is licensed 507 to provide extended congregate care services. 508 Section 5. Section 429.075, Florida Statutes, is amended to 509 read: 510 429.075 Limited mental health license.—An assisted living 511 facility that serves onethreeor more mental health residents 512 must obtain a limited mental health license. 513 (1) To obtain a limited mental health license, a facility 514 must hold a standard license as an assisted living facility, 515 must not have any current uncorrecteddeficiencies or516 violations, and must ensure that, within 6 months after 517 receiving a limited mental health license, the facility 518 administrator and the staff of the facility who are in direct 519 contact with mental health residents must complete training of 520 no less than 6 hours related to their duties. ThisSuch521 designation may be made at the time of initial licensure or 522 licensure renewalrelicensureor upon request in writing by a 523 licensee under this part and part II of chapter 408. 524 Notification of approval or denial of such request shall be made 525 in accordance with this part, part II of chapter 408, and 526 applicable rules. This training mustwillbe provided by or 527 approved by the Department of Children and Families. 528 (2) A facility that isFacilitieslicensed to provide 529 services to mental health residents mustshallprovide 530 appropriate supervision and staffing to provide for the health, 531 safety, and welfare of such residents. 532 (3) A facility that has a limited mental health license 533 must: 534 (a) Have a copy of each mental health resident’s community 535 living support plan and the cooperative agreement with the 536 mental health care services provider. The support plan and the 537 agreement may be combined. 538 (b) Have documentationthat isprovided by the Department 539 of Children and Families that each mental health resident has 540 been assessed and determined to be able to live in the community 541 in an assisted living facility that haswitha limited mental 542 health license. 543 (c) Make the community living support plan available for 544 inspection by the resident, the resident’s legal guardian or,545the resident’shealth care surrogate, and other individuals who 546 have a lawful basis for reviewing this document. 547 (d) Assist the mental health resident in carrying out the 548 activities identified in the individual’s community living 549 support plan. 550 (4) A facility that haswitha limited mental health 551 license may enter into a cooperative agreement with a private 552 mental health provider. For purposes of the limited mental 553 health license, the private mental health provider may act as 554 the case manager. 555 Section 6. Section 429.14, Florida Statutes, is amended to 556 read: 557 429.14 Administrative penalties.— 558 (1) In addition to the requirements of part II of chapter 559 408, the agency may deny, revoke, and suspend any license issued 560 under this part and impose an administrative fine in the manner 561 provided in chapter 120 against a licensee for a violation of 562any provision ofthis part, part II of chapter 408, or 563 applicable rules, or for any of the following actions by a 564 licensee,for the actions ofany person subject to level 2 565 background screening under s. 408.809, orfor the actions ofany 566 facility staffemployee: 567 (a) An intentional or negligent act seriously affecting the 568 health, safety, or welfare of a resident of the facility. 569 (b) AThedetermination by the agency that the owner lacks 570 the financial ability to provide continuing adequate care to 571 residents. 572 (c) Misappropriation or conversion of the property of a 573 resident of the facility. 574 (d) Failure to follow the criteria and procedures provided 575 under part I of chapter 394 relating to the transportation, 576 voluntary admission, and involuntary examination of a facility 577 resident. 578 (e) A citation forofany of the following violations 579deficienciesas specified in s. 429.19: 580 1. One or more cited class I violationsdeficiencies. 581 2. Three or more cited class II violationsdeficiencies. 582 3. Five or more cited class III violationsdeficiencies583 that have been cited on a single survey and have not been 584 corrected within the times specified. 585 (f) Failure to comply with the background screening 586 standards of this part, s. 408.809(1), or chapter 435. 587 (g) Violation of a moratorium. 588 (h) Failure of the license applicant, the licensee during 589 licensure renewalrelicensure, or a licensee that holds a 590 provisional license to meet the minimum license requirements of 591 this part, or related rules, at the time of license application 592 or renewal. 593 (i) An intentional or negligent life-threatening act in 594 violation of the uniform firesafety standards for assisted 595 living facilities or other firesafety standards whichthat596 threatens the health, safety, or welfare of a resident of a 597 facility, as communicated to the agency by the local authority 598 having jurisdiction or the State Fire Marshal. 599 (j) Knowingly operating any unlicensed facility or 600 providing without a license any service that must be licensed 601 under this chapter or chapter 400. 602 (k) Any act constituting a ground upon which application 603 for a license may be denied. 604 (2) Upon notification by the local authority having 605 jurisdiction or by the State Fire Marshal, the agency may deny 606 or revoke the license of an assisted living facility that fails 607 to correct cited fire code violations that affect or threaten 608 the health, safety, or welfare of a resident of a facility. 609 (3) The agency may deny or revoke a license of anto any610 applicant or controlling interest as defined in part II of 611 chapter 408 which has or had a 25 percent25-percentor greater 612 financial or ownership interest in any other facility that is 613 licensed under this part, or in any entity licensed by this 614 state or another state to provide health or residential care, if 615 thatwhichfacility or entity during the 5 years beforeprior to616 the application for a license closed due to financial inability 617 to operate; had a receiver appointed or a license denied, 618 suspended, or revoked; was subject to a moratorium; or had an 619 injunctive proceeding initiated against it. 620 (4) The agency shall deny or revoke the license of an 621 assisted living facility if any of the following apply: 622 (a) There are two moratoria, issued pursuant to this part 623 or part II of chapter 408, within a 2-year period which are 624 imposed by final order. 625 (b) The facility is cited for two or more class I 626 violations arising from unrelated circumstances during the same 627 survey or investigation. 628 (c) The facility is cited for two or more class I 629 violations arising from separate surveys or investigations 630 within a 2-year periodthat has two or more class I violations631that are similar or identical to violations identified by the632agency during a survey, inspection, monitoring visit, or633complaint investigation occurring within the previous 2 years. 634 (5) An action taken by the agency to suspend, deny, or 635 revoke a facility’s license under this part or part II of 636 chapter 408, in which the agency claims that the facility owner 637 or an employee of the facility has threatened the health, 638 safety, or welfare of a resident of the facility, shall be heard 639 by the Division of Administrative Hearings of the Department of 640 Management Services within 120 days after receipt of the 641 facility’s request for a hearing, unless that time limitation is 642 waived by both parties. The administrative law judge shallmust643 render a decision within 30 days after receipt of a proposed 644 recommended order. 645 (6) As provided under s. 408.814, the agency shall impose 646 an immediate moratorium on an assisted living facility that 647 fails to provide the agency access to the facility or prohibits 648 the agency from conducting a regulatory inspection. The licensee 649 may not restrict agency staff in accessing and copying records 650 or in conducting confidential interviews with facility staff or 651 any individual who receives services from the facilityprovide652to the Division of Hotels and Restaurants of the Department of653Business and Professional Regulation, on a monthly basis, a list654of those assisted living facilities that have had their licenses655denied, suspended, or revoked or that are involved in an656appellate proceeding pursuant to s. 120.60 related to the657denial, suspension, or revocation of a license. 658 (7) Agency notification of a license suspension or 659 revocation, or denial of a license renewal, shall be posted and 660 visible to the public at the facility. 661 (8) If a facility is required to relocate some or all of 662 its residents due to agency action, that facility is exempt from 663 the 45 days’ notice requirement imposed under s. 429.28(1)(k). 664 This subsection does not exempt the facility from any deadline 665 for corrective action set by the agency. 666 Section 7. Paragraphs (a) and (b) of subsection (2) of 667 section 429.178, Florida Statutes, are amended to read: 668 429.178 Special care for persons with Alzheimer’s disease 669 or other related disorders.— 670 (2)(a) An individual who is employed by a facility that 671 provides special care for residents who havewithAlzheimer’s 672 disease or other related disorders, and who has regular contact 673 with such residents, must complete up to 4 hours of initial 674 dementia-specific training developed or approved by the 675 department. The training mustshallbe completed within 3 months 676 after beginning employment andshallsatisfy the core training 677 requirements of s. 429.52(3)(g)s. 429.52(2)(g). 678 (b) A direct caregiver who is employed by a facility that 679 provides special care for residents who havewithAlzheimer’s 680 disease or other related disorders, and who provides direct care 681 to such residents, must complete the required initial training 682 and 4 additional hours of training developed or approved by the 683 department. The training mustshallbe completed within 9 months 684 after beginning employment andshallsatisfy the core training 685 requirements of s. 429.52(3)(g)s. 429.52(2)(g). 686 Section 8. Section 429.19, Florida Statutes, is amended to 687 read: 688 429.19 Violations; imposition of administrative fines; 689 grounds.— 690 (1) In addition to the requirements of part II of chapter 691 408, the agency shall impose an administrative fine in the 692 manner provided in chapter 120 for the violation of any 693 provision of this part, part II of chapter 408, and applicable 694 rules by an assisted living facility, for the actions of any 695 person subject to level 2 background screening under s. 408.809, 696 for the actions of any facility employee, or for an intentional 697 or negligent act seriously affecting the health, safety, or 698 welfare of a resident of the facility. 699 (2) Each violation of this part and adopted rules shall be 700 classified according to the nature of the violation and the 701 gravity of its probable effect on facility residents. 702 (a) The agency shall indicate the classification on the 703 written notice of the violation as follows: 704 1.(a)Class “I” violations are defined in s. 408.813. The 705 agency shall impose an administrative fine of $7,500 for eacha706 cited class I violation in a facility that is licensed for fewer 707 than 100 beds at the time of thein an amount not less than708$5,000 and not exceeding $10,000 for eachviolation. The agency 709 shall impose an administrative fine of $11,250 for each cited 710 class I violation in a facility that is licensed for 100 or more 711 beds at the time of the violation. If the agency has knowledge 712 of a class I violation that occurred within 12 months before an 713 inspection, a fine must be levied for that violation regardless 714 of whether the noncompliance was corrected before the 715 inspection. 716 2.(b)Class “II” violations are defined in s. 408.813. The 717 agency shall impose an administrative fine of $3,000 for eacha718 cited class II violation in a facility that is licensed for 719 fewer than 100 beds at the time of thein an amountnot less720than $1,000 and not exceeding $5,000 for eachviolation. The 721 agency shall impose an administrative fine of $4,500 for each 722 cited class II violation in a facility that is licensed for 100 723 or more beds at the time of the violation. 724 3.(c)Class “III” violations are defined in s. 408.813. The 725 agency shall impose an administrative fine of $750 for eacha726 cited class III violation in a facility that is licensed for 727 fewer than 100 beds at the time of thein an amount not less728than $500 and not exceeding $1,000 for eachviolation. The 729 agency shall impose an administrative fine of $1,125 for each 730 cited class III violation in a facility that is licensed for 100 731 or more beds at the time of the violation. 732 4.(d)Class “IV” violations are defined in s. 408.813. The 733 agency shall impose an administrative fine of $150 for eacha734 cited class IV violation in a facility that is licensed for 735 fewer than 100 beds at the time of thein an amount not less736than $100 and not exceeding $200 for eachviolation. The agency 737 shall impose an administrative fine of $225 for each cited class 738 IV violation in a facility that is licensed for 100 or more beds 739 at the time of the violation. 740 (b) Any fine imposed for a class I violation or a class II 741 violation must be doubled if a facility was previously cited for 742 one or more class I or class II violations during the agency’s 743 last licensure inspection or any inspection or complaint 744 investigation since the last licensure inspection. 745 (c) Notwithstanding s. 408.813(2)(c) and (d) and s. 746 408.832, a fine must be imposed for each class III or class IV 747 violation, regardless of correction, if a facility was 748 previously cited for one or more class III or class IV 749 violations during the agency’s last licensure inspection or any 750 inspection or complaint investigation since the last licensure 751 inspection for the same regulatory violation. A fine imposed for 752 a class III or a class IV violation must be doubled if a 753 facility was previously cited for one or more class III or class 754 IV violations during the agency’s last two licensure inspections 755 for the same regulatory violation. 756 (d) Regardless of the class of violation cited, instead of 757 the fine amounts listed in subparagraphs (a)1.-4., the agency 758 shall impose an administrative fine of $500 if a facility is 759 found not to be in compliance with the background screening 760 requirements as provided in s. 408.809. 761(3) For purposes of this section, in determining if a762penalty is to be imposed and in fixing the amount of the fine,763the agency shall consider the following factors:764(a) The gravity of the violation, including the probability765that death or serious physical or emotional harm to a resident766will result or has resulted, the severity of the action or767potential harm, and the extent to which the provisions of the768applicable laws or rules were violated.769(b) Actions taken by the owner or administrator to correct770violations.771(c) Any previous violations.772(d) The financial benefit to the facility of committing or773continuing the violation.774(e) The licensed capacity of the facility.775 (3)(4)Each day of continuing violation after the date 776 established by the agencyfixedfor correctionterminationof 777 the violation, as ordered by the agency,constitutes an 778 additional, separate, and distinct violation. 779 (4)(5)AnAnyaction taken to correct a violation shall be 780 documented in writing by the owner or administrator of the 781 facility and verified through followup visits by agency 782 personnel. The agency may impose a fine and, in the case of an 783 owner-operated facility, revoke or deny a facility’s license 784 when a facility administrator fraudulently misrepresents action 785 taken to correct a violation. 786 (5)(6)AAnyfacility whose owner fails to apply for a 787 change-of-ownership license in accordance with part II of 788 chapter 408 and operates the facility under the new ownership is 789 subject to a fine of $5,000. 790 (6)(7)In addition to any administrative fines imposed, the 791 agency may assess a survey fee, equal to the lesser of one half 792 of the facility’s biennial license and bed fee or $500, to cover 793 the cost of conducting initial complaint investigations that 794 result in the finding of a violation that was the subject of the 795 complaint or monitoring visits conducted under s. 429.28(3)(c) 796 to verify the correction of the violations. 797 (7)(8)During an inspection, the agency shall make a 798 reasonable attempt to discuss each violation with the owner or 799 administrator of the facility, beforeprior towritten 800 notification. 801 (8)(9)The agency shall develop and disseminate an annual 802 list of all facilities sanctioned or fined for violations of 803 state standards, the number and class of violations involved, 804 the penalties imposed, and the current status of cases. The list 805 shall be disseminated, at no charge, to the Department of 806 Elderly Affairs, the Department of Health, the Department of 807 Children and Families, the Agency for Persons with Disabilities, 808 the area agencies on aging, the Florida Statewide Advocacy 809 Council, and the state and local ombudsman councils. The 810 Department of Children and Families shall disseminate the list 811 to service providers under contract to the department who are 812 responsible for referring persons to a facility for residency. 813 The agency may charge a fee commensurate with the cost of 814 printing and postage to other interested parties requesting a 815 copy of this list. This information may be provided 816 electronically or through the agency’s websiteInternet site. 817 Section 9. Subsection (3) and paragraph (c) of subsection 818 (4) of section 429.256, Florida Statutes, are amended to read: 819 429.256 Assistance with self-administration of medication.— 820 (3) Assistance with self-administration of medication 821 includes: 822 (a) Taking the medication, in its previously dispensed, 823 properly labeled container, including an insulin syringe that is 824 prefilled with the proper dosage by a pharmacist and an insulin 825 pen that is prefilled by the manufacturer, from where it is 826 stored, and bringing it to the resident. 827 (b) In the presence of the resident, reading the label, 828 opening the container, removing a prescribed amount of 829 medication from the container, and closing the container. 830 (c) Placing an oral dosage in the resident’s hand or 831 placing the dosage in another container and helping the resident 832 by lifting the container to his or her mouth. 833 (d) Applying topical medications. 834 (e) Returning the medication container to proper storage. 835 (f) Keeping a record of when a resident receives assistance 836 with self-administration under this section. 837 (g) Assisting with the use of a nebulizer, including 838 removing the cap of a nebulizer, opening the unit dose of 839 nebulizer solution, and pouring the prescribed premeasured dose 840 of medication into the dispensing cup of the nebulizer. 841 (h) Using a glucometer to perform blood-glucose level 842 checks. 843 (i) Assisting with putting on and taking off antiembolism 844 stockings. 845 (j) Assisting with applying and removing an oxygen cannula, 846 but not with titrating the prescribed oxygen settings. 847 (k) Assisting with the use of a continuous positive airway 848 pressure (CPAP) device, but not with titrating the prescribed 849 setting of the device. 850 (l) Assisting with measuring vital signs. 851 (m) Assisting with colostomy bags. 852 (4) Assistance with self-administration does not include: 853(c) Administration of medications through intermittent854positive pressure breathing machines or a nebulizer.855 Section 10. Subsections (2), (5), and (6) of section 856 429.28, Florida Statutes, are amended to read: 857 429.28 Resident bill of rights.— 858 (2) The administrator of a facility shall ensure that a 859 written notice of the rights, obligations, and prohibitions set 860 forth in this part is posted in a prominent place in each 861 facility and read or explained to residents who cannot read. The 862Thisnotice mustshallinclude the name, address, and telephone 863 numbers of the local ombudsman council, theandcentral abuse 864 hotline, and, ifwhenapplicable, Disability Rights Floridathe865Advocacy Center for Persons with Disabilities, Inc., and the866Florida local advocacy council, where complaints may be lodged. 867 The notice must state that a complaint made to the Office of 868 State Long-Term Care Ombudsman or a local long-term care 869 ombudsman council, the names and identities of the residents 870 involved in the complaint, and the identity of complainants are 871 kept confidential pursuant to s. 400.0077 and that retaliatory 872 action cannot be taken against a resident for presenting 873 grievances or for exercising any other resident right. The 874 facility must ensure a resident’s access to a telephone to call 875 the local ombudsman council, central abuse hotline, and 876 Disability Rights FloridaAdvocacy Center for Persons with877Disabilities, Inc., and the Florida local advocacy council. 878 (5) ANofacility or employee of a facility may not serve 879 notice upon a resident to leave the premises or take any other 880 retaliatory action against any person who: 881 (a) Exercises any right set forth in this section. 882 (b) Appears as a witness in any hearing, inside or outside 883 the facility. 884 (c) Files a civil action alleging a violation of the 885 provisions of this part or notifies a state attorney or the 886 Attorney General of a possible violation of such provisions. 887 (6) AAnyfacility thatwhichterminates the residency of 888 an individual who participated in activities specified in 889 subsection (5) mustshallshow good cause in a court of 890 competent jurisdiction. If good cause is not shown, the agency 891 shall impose a fine of $2,500 in addition to any other penalty 892 assessed against the facility. 893 Section 11. Section 429.34, Florida Statutes, is amended to 894 read: 895 429.34 Right of entry and inspection.— 896 (1) In addition to the requirements of s. 408.811, any duly 897 designated officer or employee of the department, the Department 898 of Children and Families, the Medicaid Fraud Control Unit of the 899 Office of the Attorney General, the state or local fire marshal, 900 or a member of the state or local long-term care ombudsman 901 council hasshall havethe right to enter unannounced upon and 902 into the premises of any facility licensed pursuant to this part 903 in order to determine the state of compliance withthe904provisions ofthis part, part II of chapter 408, and applicable 905 rules. Data collected by the state or local long-term care 906 ombudsman councils or the state or local advocacy councils may 907 be used by the agency in investigations involving violations of 908 regulatory standards. A person specified in this section who 909 knows or has reasonable cause to suspect that a vulnerable adult 910 has been or is being abused, neglected, or exploited shall 911 immediately report such knowledge or suspicion to the central 912 abuse hotline pursuant to chapter 415. 913 (2) The agency shall inspect each licensed assisted living 914 facility at least once every 24 months to determine compliance 915 with this chapter and related rules. If an assisted living 916 facility is cited for one or more class I violations or two or 917 more class II violations arising from separate surveys within a 918 60-day period or due to unrelated circumstances during the same 919 survey, the agency must conduct an additional licensure 920 inspection within 6 months. In addition to any fine imposed on 921 the facility under s. 429.19, the licensee shall pay a fee for 922 the cost of the additional inspection equivalent to the standard 923 assisted living facility license and per-bed fees, without 924 exception for beds designated for recipients of optional state 925 supplementation. The agency shall adjust the fee in accordance 926 with s. 408.805. 927 Section 12. Subsection (2) of section 429.41, Florida 928 Statutes, is amended to read: 929 429.41 Rules establishing standards.— 930 (2) In adopting any rules pursuant to this part, the 931 department, in conjunction with the agency, shall make distinct 932 standards for facilities based upon facility size; the types of 933 care provided; the physical and mental capabilities and needs of 934 residents; the type, frequency, and amount of services and care 935 offered; and the staffing characteristics of the facility. Rules 936 developed pursuant to this section mayshallnot restrict the 937 use of shared staffing and shared programming in facilities that 938 are part of retirement communities that provide multiple levels 939 of care and otherwise meet the requirements of law and rule. If 940 a continuing care facility licensed under chapter 651 or a 941 retirement community offering multiple levels of care obtains a 942 license pursuant to this chapter for a building or part of a 943 building designated for independent living, staffing 944 requirements established in rule apply only to residents who 945 receive personal services, limited nursing services, or extended 946 congregate care services under this part. Such facilities shall 947 retain a log listing the names and unit number for residents 948 receiving these services. The log must be available to surveyors 949 upon request. Except for uniform firesafety standards, the 950 department shall adopt by rule separate and distinct standards 951 for facilities with 16 or fewer beds and for facilities with 17 952 or more beds. The standards for facilities with 16 or fewer beds 953 mustshallbe appropriate for a noninstitutional residential 954 environment; however,provided thatthe structure may not beis955nomore than two stories in height and all persons who cannot 956 exit the facility unassisted in an emergency must reside on the 957 first floor. The department, in conjunction with the agency, may 958 make other distinctions among types of facilities as necessary 959 to enforce the provisions of this part. Where appropriate, the 960 agency shall offer alternate solutions for complying with 961 established standards, based on distinctions made by the 962 department and the agency relative to the physical 963 characteristics of facilities and the types of care offered 964therein. 965 Section 13. Present subsections (1) through (11) of section 966 429.52, Florida Statutes, are redesignated as subsections (2) 967 through (12), respectively, a new subsection (1) is added to 968 that section, and present subsections (5) and (9) of that 969 section are amended, to read: 970 429.52 Staff training and educational programs; core 971 educational requirement.— 972 (1) Effective October 1, 2015, each new assisted living 973 facility employee who has not previously completed core training 974 must attend a preservice orientation provided by the facility 975 before interacting with residents. The preservice orientation 976 must be at least 2 hours in duration and cover topics that help 977 the employee provide responsible care and respond to the needs 978 of facility residents. Upon completion, the employee and the 979 administrator of the facility must sign a statement that the 980 employee completed the required preservice orientation. The 981 facility must keep the signed statement in the employee’s 982 personnel record. 983 (6)(5)Staff involved with the management of medications 984 and assisting with the self-administration of medications under 985 s. 429.256 must complete a minimum of 64additional hours of 986 training provided by a registered nurse, licensed pharmacist, or 987 department staff. The department shall establish by rule the 988 minimum requirements of this additional training. 989 (10)(9)The training required by this section other than 990 the preservice orientation mustshallbe conducted by persons 991 registered with the department as having the requisite 992 experience and credentials to conduct the training. A person 993 seeking to register as a trainer must provide the department 994 with proof of completion of the minimum core training education 995 requirements, successful passage of the competency test 996 established under this section, and proof of compliance with the 997 continuing education requirement in subsection (5)(4). 998 Section 14. The Legislature finds that consistent 999 regulation of assisted living facilities benefits residents and 1000 operators of such facilities. To determine whether surveys are 1001 consistent between surveys and surveyors, the Office of Program 1002 Policy Analysis and Government Accountability (OPPAGA) shall 1003 conduct a study of intersurveyor reliability for assisted living 1004 facilities. By November 1, 2015, OPPAGA shall report its 1005 findings to the Governor, the President of the Senate, and the 1006 Speaker of the House of Representatives and make any 1007 recommendations for improving intersurveyor reliability. 1008 Section 15. The Legislature finds that consumers need 1009 additional information on the quality of care and service in 1010 assisted living facilities in order to select the best facility 1011 for themselves or their loved ones. Therefore, the Agency for 1012 Health Care Administration shall: 1013 (1) Implement a rating system for assisted living 1014 facilities by March 1, 2016. The agency shall adopt rules to 1015 administer this subsection. 1016 (2) By November 1, 2015, create content that is easily 1017 accessible through the front page of the agency’s website. At a 1018 minimum, the content must include: 1019 (a) Information on each licensed assisted living facility, 1020 including, but not limited to: 1021 1. The name and address of the facility. 1022 2. The number and type of licensed beds in the facility. 1023 3. The types of licenses held by the facility. 1024 4. The facility’s license expiration date and status. 1025 5. Other relevant information that the agency currently 1026 collects. 1027 (b) A list of the facility’s violations, including, for 1028 each violation: 1029 1. A summary of the violation which is presented in a 1030 manner understandable by the general public; 1031 2. Any sanctions imposed by final order; and 1032 3. The date the corrective action was confirmed by the 1033 agency. 1034 (c) Links to inspection reports that the agency has on 1035 file. 1036 (d) A monitored comment page, maintained by the agency, 1037 which allows members of the public to anonymously comment on 1038 assisted living facilities that are licensed to operate in this 1039 state. This comment page must, at a minimum, allow members of 1040 the public to post comments on their experiences with, or 1041 observations of, an assisted living facility and to review other 1042 people’s comments. Comments posted to the agency’s comment page 1043 may not contain profanity and are intended to provide meaningful 1044 feedback about the assisted living facility. The agency shall 1045 review comments for profane content before the comments are 1046 posted to the page. A controlling interest, as defined in s. 1047 408.803, Florida Statutes, in an assisted living facility, or an 1048 employee or owner of an assisted living facility, is prohibited 1049 from posting comments on the page, except that a controlling 1050 interest, employee, or owner may respond to comments on the 1051 page. The agency shall ensure that such responses are identified 1052 as being those of a representative of the facility. 1053 Section 16. For the 2015-2016 fiscal year, the sums of 1054 $156,943 in recurring funds and $7,546 in nonrecurring funds are 1055 appropriated from the Health Care Trust Fund and two full-time 1056 equivalent senior attorney positions with associated salary rate 1057 of 103,652 are authorized in the Agency for Health Care 1058 Administration for the purpose of implementing the regulatory 1059 provisions of this act. 1060 Section 17. For the 2015-2016 fiscal year, for the purpose 1061 of implementing and maintaining the public information website 1062 enhancements provided under this act: 1063 (1) The sums of $72,435 in recurring funds and $3,773 in 1064 nonrecurring funds are appropriated from the Health Care Trust 1065 Fund and one full-time equivalent health services and facilities 1066 consultant position with associated salary rate of 46,560 is 1067 authorized in the Agency for Health Care Administration; 1068 (2) The sums of $30,000 in recurring funds and $15,000 in 1069 nonrecurring funds are appropriated from the Health Care Trust 1070 Fund to the Agency for Health Care Administration for software 1071 purchase, installation, and maintenance services; and 1072 (3) The sums of $2,474 in recurring funds and $82,806 in 1073 nonrecurring funds are appropriated from the Health Care Trust 1074 Fund to the Agency for Health Care Administration for contracted 1075 services. 1076 Section 18. This act shall take effect July 1, 2015.