Bill Text: FL S0682 | 2015 | Regular Session | Enrolled
Bill Title: Transitional Living Facilities
Spectrum: Bipartisan Bill
Status: (Passed) 2015-05-15 - Chapter No. 2015-25 [S0682 Detail]
Download: Florida-2015-S0682-Enrolled.html
ENROLLED 2015 Legislature CS for SB 682 2015682er 1 2 An act relating to transitional living facilities; 3 creating part XI of ch. 400, F.S.; creating s. 4 400.997, F.S.; providing legislative intent; creating 5 s. 400.9971, F.S.; providing definitions; creating s. 6 400.9972, F.S.; requiring the licensure of 7 transitional living facilities; providing license fees 8 and application requirements; requiring accreditation 9 of licensed facilities; creating s. 400.9973, F.S.; 10 providing requirements for transitional living 11 facility policies and procedures governing client 12 admission, transfer, and discharge; creating s. 13 400.9974, F.S.; requiring a comprehensive treatment 14 plan to be developed for each client; providing plan 15 and staffing requirements; requiring certain consent 16 for continued treatment in a transitional living 17 facility; creating s. 400.9975, F.S.; providing 18 licensee responsibilities with respect to each client 19 and specified others and requiring written notice of 20 such responsibilities to be provided; prohibiting a 21 licensee or employee of a facility from serving notice 22 upon a client to leave the premises or taking other 23 retaliatory action under certain circumstances; 24 requiring the client and client’s representative to be 25 provided with certain information; requiring the 26 licensee to develop and implement certain policies and 27 procedures governing the release of client 28 information; creating s. 400.9976, F.S.; providing 29 licensee requirements relating to administration of 30 medication; requiring maintenance of medication 31 administration records; providing requirements for the 32 self-administration of medication by clients; creating 33 s. 400.9977, F.S.; providing training and supervision 34 requirements for the administration of medications by 35 unlicensed staff; specifying who may conduct the 36 training; requiring licensees to adopt certain 37 policies and procedures and maintain specified records 38 with respect to the administration of medications by 39 unlicensed staff; requiring the Agency for Health Care 40 Administration to adopt rules; creating s. 400.9978, 41 F.S.; providing requirements for the screening of 42 potential employees and training and monitoring of 43 employees for the protection of clients; requiring 44 licensees to implement certain policies and procedures 45 to protect clients; providing conditions for 46 investigating and reporting incidents of abuse, 47 neglect, mistreatment, or exploitation of clients; 48 creating s. 400.9979, F.S.; providing requirements and 49 limitations for the use of physical restraints, 50 seclusion, and chemical restraint medication on 51 clients; providing a limitation on the duration of an 52 emergency treatment order; requiring notification of 53 certain persons when restraint or seclusion is 54 imposed; authorizing the agency to adopt rules; 55 creating s. 400.998, F.S.; providing background 56 screening requirements for licensee personnel; 57 requiring the licensee to maintain certain personnel 58 records; providing administrative responsibilities for 59 licensees; providing recordkeeping requirements; 60 creating s. 400.9981, F.S.; providing licensee 61 responsibilities with respect to the property and 62 personal affairs of clients; providing requirements 63 for a licensee with respect to obtaining surety bonds; 64 providing recordkeeping requirements relating to the 65 safekeeping of personal effects; providing 66 requirements for trust funds or other property 67 received by a licensee and credited to the client; 68 providing a penalty for certain misuse of a client’s 69 personal funds, property, or personal needs allowance; 70 providing criminal penalties for violations; providing 71 for the disposition of property in the event of the 72 death of a client; authorizing the agency to adopt 73 rules; creating s. 400.9982, F.S.; providing 74 legislative intent; authorizing the agency to adopt 75 and enforce rules establishing specified standards for 76 transitional living facilities and personnel thereof; 77 creating s. 400.9983, F.S.; classifying certain 78 violations and providing penalties therefor; providing 79 administrative fines for specified classes of 80 violations; creating s. 400.9984, F.S.; authorizing 81 the agency to apply certain provisions with regard to 82 receivership proceedings; creating s. 400.9985, F.S.; 83 requiring the agency, the Department of Health, the 84 Agency for Persons with Disabilities, and the 85 Department of Children and Families to develop 86 electronic information systems for certain purposes; 87 transferring and renumbering s. 400.805, F.S., as s. 88 400.9986, F.S.; repealing s. 400.9986, F.S., relating 89 to transitional living facilities, on a specified 90 date; revising the title of part V of ch. 400, F.S.; 91 amending s. 381.745, F.S.; revising the definition of 92 the term “transitional living facility,” to conform to 93 changes made by the act; amending s. 381.75, F.S.; 94 revising the duties of the Department of Health and 95 the agency relating to transitional living facilities; 96 amending ss. 381.78, 400.93, 408.802, and 408.820, 97 F.S.; conforming provisions to changes made by the 98 act; reenacting s. 381.79(1), F.S., relating to the 99 Brain and Spinal Cord Injury Program Trust Fund, to 100 incorporate the amendment made by the act to s. 101 381.75, F.S., in a reference thereto; providing for 102 the act’s applicability to licensed transitional 103 living facilities licensed on specified dates; 104 providing effective dates. 105 106 Be It Enacted by the Legislature of the State of Florida: 107 108 Section 1. Part XI of chapter 400, Florida Statutes, 109 consisting of sections 400.997 through 400.9986, is created to 110 read: 111 PART XI 112 TRANSITIONAL LIVING FACILITIES 113 400.997 Legislative intent.—It is the intent of the 114 Legislature to provide for the licensure of transitional living 115 facilities and require the development, establishment, and 116 enforcement of basic standards by the Agency for Health Care 117 Administration to ensure quality of care and services to clients 118 in transitional living facilities. It is the policy of the state 119 that the least restrictive appropriate available treatment be 120 used based on the individual needs and best interest of the 121 client, consistent with optimum improvement of the client’s 122 condition. The goal of a transitional living program for persons 123 who have brain or spinal cord injuries is to assist each person 124 who has such an injury to achieve a higher level of independent 125 functioning and to enable the person to reenter the community. 126 It is also the policy of the state that the restraint or 127 seclusion of a client is justified only as an emergency safety 128 measure used in response to danger to the client or others. It 129 is therefore the intent of the Legislature to achieve an ongoing 130 reduction in the use of restraint or seclusion in programs and 131 facilities that serve persons who have brain or spinal cord 132 injuries. 133 400.9971 Definitions.—As used in this part, the term: 134 (1) “Agency” means the Agency for Health Care 135 Administration. 136 (2) “Chemical restraint” means a pharmacologic drug that 137 physically limits, restricts, or deprives a person of movement 138 or mobility, is used for client protection or safety, and is not 139 required for the treatment of medical conditions or symptoms. 140 (3) “Client’s representative” means the parent of a child 141 client or the client’s guardian, designated representative, 142 designee, surrogate, or attorney in fact. 143 (4) “Department” means the Department of Health. 144 (5) “Physical restraint” means a manual method to restrict 145 freedom of movement of or normal access to a person’s body, or a 146 physical or mechanical device, material, or equipment attached 147 or adjacent to the person’s body that the person cannot easily 148 remove and that restricts freedom of movement of or normal 149 access to the person’s body, including, but not limited to, a 150 half-bed rail, a full-bed rail, a geriatric chair, or a Posey 151 restraint. The term includes any device that is not specifically 152 manufactured as a restraint but is altered, arranged, or 153 otherwise used for this purpose. The term does not include 154 bandage material used for the purpose of binding a wound or 155 injury. 156 (6) “Seclusion” means the physical segregation of a person 157 in any fashion or the involuntary isolation of a person in a 158 room or area from which the person is prevented from leaving. 159 Such prevention may be accomplished by imposition of a physical 160 barrier or by action of a staff member to prevent the person 161 from leaving the room or area. For purposes of this part, the 162 term does not mean isolation due to a person’s medical condition 163 or symptoms. 164 (7) “Transitional living facility” means a site where 165 specialized health care services are provided to persons who 166 have brain or spinal cord injuries, including, but not limited 167 to, rehabilitative services, behavior modification, community 168 reentry training, aids for independent living, and counseling. 169 400.9972 License required; fee; application.— 170 (1) The requirements of part II of chapter 408 apply to the 171 provision of services that require licensure pursuant to this 172 part and part II of chapter 408 and to entities licensed by or 173 applying for licensure from the agency pursuant to this part. A 174 license issued by the agency is required for the operation of a 175 transitional living facility in this state. However, this part 176 does not require a provider licensed by the agency to obtain a 177 separate transitional living facility license to serve persons 178 who have brain or spinal cord injuries as long as the services 179 provided are within the scope of the provider’s license. 180 (2) In accordance with this part, an applicant or a 181 licensee shall pay a fee for each license application submitted 182 under this part. The license fee shall consist of a $4,588 183 license fee and a $90 per-bed fee per biennium and shall conform 184 to the annual adjustment authorized in s. 408.805. 185 (3) An applicant for licensure must provide: 186 (a) The location of the facility for which the license is 187 sought and documentation, signed by the appropriate local 188 government official, which states that the applicant has met 189 local zoning requirements. 190 (b) Proof of liability insurance as provided in s. 191 624.605(1)(b). 192 (c) Proof of compliance with local zoning requirements, 193 including compliance with the requirements of chapter 419 if the 194 proposed facility is a community residential home. 195 (d) Proof that the facility has received a satisfactory 196 firesafety inspection. 197 (e) Documentation that the facility has received a 198 satisfactory sanitation inspection by the county health 199 department. 200 (4) The applicant’s proposed facility must attain and 201 continuously maintain accreditation by an accrediting 202 organization that specializes in evaluating rehabilitation 203 facilities whose standards incorporate licensure regulations 204 comparable to those required by the state. An applicant for 205 licensure as a transitional living facility must acquire 206 accreditation within 12 months after issuance of an initial 207 license. The agency shall accept the accreditation survey report 208 of the accrediting organization in lieu of conducting a 209 licensure inspection if the standards included in the survey 210 report are determined by the agency to document that the 211 facility substantially complies with state licensure 212 requirements. Within 10 days after receiving the accreditation 213 survey report, the applicant shall submit to the agency a copy 214 of the report and evidence of the accreditation decision as a 215 result of the report. The agency may conduct an inspection of a 216 transitional living facility to ensure compliance with the 217 licensure requirements of this part, to validate the inspection 218 process of the accrediting organization, to respond to licensure 219 complaints, or to protect the public health and safety. 220 400.9973 Client admission, transfer, and discharge.— 221 (1) A transitional living facility shall have written 222 policies and procedures governing the admission, transfer, and 223 discharge of clients. 224 (2) The admission of a client to a transitional living 225 facility must be in accordance with the licensee’s policies and 226 procedures. 227 (3) To be admitted to a transitional living facility, an 228 individual must have an acquired internal or external injury to 229 the skull, the brain, or the brain’s covering, caused by a 230 traumatic or nontraumatic event, which produces an altered state 231 of consciousness, or a spinal cord injury, such as a lesion to 232 the spinal cord or cauda equina syndrome, with evidence of 233 significant involvement of at least two of the following 234 deficits or dysfunctions: 235 (a) A motor deficit. 236 (b) A sensory deficit. 237 (c) A cognitive deficit. 238 (d) A behavioral deficit. 239 (e) Bowel and bladder dysfunction. 240 (4) A client whose medical condition and diagnosis do not 241 positively identify a cause of the client’s condition, whose 242 symptoms are inconsistent with the known cause of injury, or 243 whose recovery is inconsistent with the known medical condition 244 may be admitted to a transitional living facility for evaluation 245 for a period not to exceed 90 days. 246 (5) A client admitted to a transitional living facility 247 must be admitted upon prescription by a licensed physician, 248 physician assistant, or advanced registered nurse practitioner 249 and must remain under the care of a licensed physician, 250 physician assistant, or advanced registered nurse practitioner 251 for the duration of the client’s stay in the facility. 252 (6) A transitional living facility may not admit a person 253 whose primary admitting diagnosis is mental illness or an 254 intellectual or developmental disability. 255 (7) A person may not be admitted to a transitional living 256 facility if the person: 257 (a) Presents significant risk of infection to other clients 258 or personnel. A health care practitioner must provide 259 documentation that the person is free of apparent signs and 260 symptoms of communicable disease; 261 (b) Is a danger to himself or herself or others as 262 determined by a physician, physician assistant, or advanced 263 registered nurse practitioner or a mental health practitioner 264 licensed under chapter 490 or chapter 491, unless the facility 265 provides adequate staffing and support to ensure patient safety; 266 (c) Is bedridden; or 267 (d) Requires 24-hour nursing supervision. 268 (8) If the client meets the admission criteria, the medical 269 or nursing director of the facility must complete an initial 270 evaluation of the client’s functional skills, behavioral status, 271 cognitive status, educational or vocational potential, medical 272 status, psychosocial status, sensorimotor capacity, and other 273 related skills and abilities within the first 72 hours after the 274 client’s admission to the facility. An initial comprehensive 275 treatment plan that delineates services to be provided and 276 appropriate sources for such services must be implemented within 277 the first 4 days after admission. 278 (9) A transitional living facility shall develop a 279 discharge plan for each client before or upon admission to the 280 facility. The discharge plan must identify the intended 281 discharge site and possible alternative discharge sites. For 282 each discharge site identified, the discharge plan must identify 283 the skills, behaviors, and other conditions that the client must 284 achieve to be eligible for discharge. A discharge plan must be 285 reviewed and updated as necessary but at least once monthly. 286 (10) A transitional living facility shall discharge a 287 client as soon as practicable when the client no longer requires 288 the specialized services described in s. 400.9971(7), when the 289 client is not making measurable progress in accordance with the 290 client’s comprehensive treatment plan, or when the transitional 291 living facility is no longer the most appropriate and least 292 restrictive treatment option. 293 (11) A transitional living facility shall provide at least 294 30 days’ notice to a client of transfer or discharge plans, 295 including the location of an acceptable transfer location if the 296 client is unable to live independently. This subsection does not 297 apply if a client voluntarily terminates residency. 298 400.9974 Client comprehensive treatment plans; client 299 services.— 300 (1) A transitional living facility shall develop a 301 comprehensive treatment plan for each client as soon as 302 practicable but no later than 30 days after the initial 303 comprehensive treatment plan is developed. The comprehensive 304 treatment plan must be developed by an interdisciplinary team 305 consisting of the case manager, the program director, the 306 advanced registered nurse practitioner, and appropriate 307 therapists. The client or, if appropriate, the client’s 308 representative must be included in developing the comprehensive 309 treatment plan. The comprehensive treatment plan must be 310 reviewed and updated if the client fails to meet projected 311 improvements outlined in the plan or if a significant change in 312 the client’s condition occurs. The comprehensive treatment plan 313 must be reviewed and updated at least once monthly. 314 (2) The comprehensive treatment plan must include: 315 (a) Orders obtained from the physician, physician 316 assistant, or advanced registered nurse practitioner and the 317 client’s diagnosis, medical history, physical examination, and 318 rehabilitative or restorative needs. 319 (b) A preliminary nursing evaluation, including orders for 320 immediate care provided by the physician, physician assistant, 321 or advanced registered nurse practitioner, which shall be 322 completed when the client is admitted. 323 (c) A comprehensive, accurate, reproducible, and 324 standardized assessment of the client’s functional capability; 325 the treatments designed to achieve skills, behaviors, and other 326 conditions necessary for the client to return to the community; 327 and specific measurable goals. 328 (d) Steps necessary for the client to achieve transition 329 into the community and estimated length of time to achieve those 330 goals. 331 (3) The client or, if appropriate, the client’s 332 representative must consent to the continued treatment at the 333 transitional living facility. Consent may be for a period of up 334 to 6 months. If such consent is not given, the transitional 335 living facility shall discharge the client as soon as 336 practicable. 337 (4) A client must receive the professional program services 338 needed to implement the client’s comprehensive treatment plan. 339 (5) The licensee must employ qualified professional staff 340 to carry out and monitor the various professional interventions 341 in accordance with the stated goals and objectives of the 342 client’s comprehensive treatment plan. 343 (6) A client must receive a continuous treatment program 344 that includes appropriate, consistent implementation of 345 specialized and general training, treatment, health services, 346 and related services and that is directed toward: 347 (a) The acquisition of the behaviors and skills necessary 348 for the client to function with as much self-determination and 349 independence as possible. 350 (b) The prevention or deceleration of regression or loss of 351 current optimal functional status. 352 (c) The management of behavioral issues that preclude 353 independent functioning in the community. 354 400.9975 Licensee responsibilities.— 355 (1) The licensee shall ensure that each client: 356 (a) Lives in a safe environment free from abuse, neglect, 357 and exploitation. 358 (b) Is treated with consideration and respect and with due 359 recognition of personal dignity, individuality, and the need for 360 privacy. 361 (c) Retains and uses his or her own clothes and other 362 personal property in his or her immediate living quarters to 363 maintain individuality and personal dignity, except when the 364 licensee demonstrates that such retention and use would be 365 unsafe, impractical, or an infringement upon the rights of other 366 clients. 367 (d) Has unrestricted private communication, including 368 receiving and sending unopened correspondence, access to a 369 telephone, and visits with any person of his or her choice. Upon 370 request, the licensee shall modify visiting hours for caregivers 371 and guests. The facility shall restrict communication in 372 accordance with any court order or written instruction of a 373 client’s representative. Any restriction on a client’s 374 communication for therapeutic reasons shall be documented and 375 reviewed at least weekly and shall be removed as soon as no 376 longer clinically indicated. The basis for the restriction shall 377 be explained to the client and, if applicable, the client’s 378 representative. The client shall retain the right to call the 379 central abuse hotline, the agency, and Disability Rights Florida 380 at any time. 381 (e) Has the opportunity to participate in and benefit from 382 community services and activities to achieve the highest 383 possible level of independence, autonomy, and interaction within 384 the community. 385 (f) Has the opportunity to manage his or her financial 386 affairs unless the client or, if applicable, the client’s 387 representative authorizes the administrator of the facility to 388 provide safekeeping for funds as provided under this part. 389 (g) Has reasonable opportunity for regular exercise more 390 than once per week and to be outdoors at regular and frequent 391 intervals except when prevented by inclement weather. 392 (h) Has the opportunity to exercise civil and religious 393 liberties, including the right to independent personal 394 decisions. However, a religious belief or practice, including 395 attendance at religious services, may not be imposed upon any 396 client. 397 (i) Has access to adequate and appropriate health care 398 consistent with established and recognized community standards. 399 (j) Has the opportunity to present grievances and recommend 400 changes in policies, procedures, and services to the staff of 401 the licensee, governing officials, or any other person without 402 restraint, interference, coercion, discrimination, or reprisal. 403 A licensee shall establish a grievance procedure to facilitate a 404 client’s ability to present grievances, including a system for 405 investigating, tracking, managing, and responding to complaints 406 by a client or, if applicable, the client’s representative and 407 an appeals process. The appeals process must include access to 408 Disability Rights Florida and other advocates and the right to 409 be a member of, be active in, and associate with advocacy or 410 special interest groups. 411 (2) The licensee shall: 412 (a) Promote participation of the client’s representative in 413 the process of providing treatment to the client unless the 414 representative’s participation is unobtainable or inappropriate. 415 (b) Answer communications from the client’s family, 416 guardians, and friends promptly and appropriately. 417 (c) Promote visits by persons with a relationship to the 418 client at any reasonable hour, without requiring prior notice, 419 in any area of the facility that provides direct care services 420 to the client, consistent with the client’s and other clients’ 421 privacy, unless the interdisciplinary team determines that such 422 a visit would not be appropriate. 423 (d) Promote opportunities for the client to leave the 424 facility for visits, trips, or vacations. 425 (e) Promptly notify the client’s representative of a 426 significant incident or change in the client’s condition, 427 including, but not limited to, serious illness, accident, abuse, 428 unauthorized absence, or death. 429 (3) The administrator of a facility shall ensure that a 430 written notice of licensee responsibilities is posted in a 431 prominent place in each building where clients reside and is 432 read or explained to clients who cannot read. This notice shall 433 be provided to clients in a manner that is clearly legible, 434 shall include the statewide toll-free telephone number for 435 reporting complaints to the agency, and shall include the words: 436 “To report a complaint regarding the services you receive, 437 please call toll-free ...[telephone number]... or Disability 438 Rights Florida ...[telephone number]....” The statewide toll 439 free telephone number for the central abuse hotline shall be 440 provided to clients in a manner that is clearly legible and 441 shall include the words: “To report abuse, neglect, or 442 exploitation, please call toll-free ...[telephone number]....” 443 The licensee shall ensure a client’s access to a telephone where 444 telephone numbers are posted as required by this subsection. 445 (4) A licensee or employee of a facility may not serve 446 notice upon a client to leave the premises or take any other 447 retaliatory action against another person solely because of the 448 following: 449 (a) The client or other person files an internal or 450 external complaint or grievance regarding the facility. 451 (b) The client or other person appears as a witness in a 452 hearing inside or outside the facility. 453 (5) Before or at the time of admission, the client and, if 454 applicable, the client’s representative shall receive a copy of 455 the licensee’s responsibilities, including grievance procedures 456 and telephone numbers, as provided in this section. 457 (6) The licensee must develop and implement policies and 458 procedures governing the release of client information, 459 including consent necessary from the client or, if applicable, 460 the client’s representative. 461 400.9976 Administration of medication.— 462 (1) An individual medication administration record must be 463 maintained for each client. A dose of medication, including a 464 self-administered dose, shall be properly recorded in the 465 client’s record. A client who self-administers medication shall 466 be given a pill organizer. Medication must be placed in the pill 467 organizer by a nurse. A nurse shall document the date and time 468 that medication is placed into each client’s pill organizer. All 469 medications must be administered in compliance with orders of a 470 physician, physician assistant, or advanced registered nurse 471 practitioner. 472 (2) If an interdisciplinary team determines that self 473 administration of medication is an appropriate objective, and if 474 the physician, physician assistant, or advanced registered nurse 475 practitioner does not specify otherwise, the client must be 476 instructed by the physician, physician assistant, or advanced 477 registered nurse practitioner to self-administer his or her 478 medication without the assistance of a staff person. All forms 479 of self-administration of medication, including administration 480 orally, by injection, and by suppository, shall be included in 481 the training. The client’s physician, physician assistant, or 482 advanced registered nurse practitioner must be informed of the 483 interdisciplinary team’s decision that self-administration of 484 medication is an objective for the client. A client may not 485 self-administer medication until he or she demonstrates the 486 competency to take the correct medication in the correct dosage 487 at the correct time, to respond to missed doses, and to contact 488 the appropriate person with questions. 489 (3) Medication administration discrepancies and adverse 490 drug reactions must be recorded and reported immediately to a 491 physician, physician assistant, or advanced registered nurse 492 practitioner. 493 400.9977 Assistance with medication.— 494 (1) Notwithstanding any provision of part I of chapter 495 464, the Nurse Practice Act, unlicensed direct care services 496 staff who provide services to clients in a facility licensed 497 under this part may administer prescribed, prepackaged, and 498 premeasured medications after the completion of training in 499 medication administration and under the general supervision of a 500 registered nurse as provided under this section and applicable 501 rules. 502 (2) Training required by this section and applicable rules 503 shall be conducted by a registered nurse licensed under chapter 504 464, a physician licensed under chapter 458 or chapter 459, or a 505 pharmacist licensed under chapter 465. 506 (3) A facility that allows unlicensed direct care service 507 staff to administer medications pursuant to this section shall: 508 (a) Develop and implement policies and procedures that 509 include a plan to ensure the safe handling, storage, and 510 administration of prescription medications. 511 (b) Maintain written evidence of the expressed and informed 512 consent for each client. 513 (c) Maintain a copy of the written prescription, including 514 the name of the medication, the dosage, and the administration 515 schedule and termination date. 516 (d) Maintain documentation of compliance with required 517 training. 518 (4) The agency shall adopt rules to implement this section. 519 400.9978 Protection of clients from abuse, neglect, 520 mistreatment, and exploitation.—The licensee shall develop and 521 implement policies and procedures for the screening and training 522 of employees; the protection of clients; and the prevention, 523 identification, investigation, and reporting of abuse, neglect, 524 mistreatment, and exploitation. The licensee shall identify 525 clients whose personal histories render them at risk for abusing 526 other clients, develop intervention strategies to prevent 527 occurrences of abuse, monitor clients for changes that would 528 trigger abusive behavior, and reassess the interventions on a 529 regular basis. A licensee shall: 530 (1) Screen each potential employee for a history of abuse, 531 neglect, mistreatment, or exploitation of clients. The screening 532 shall include an attempt to obtain information from previous and 533 current employers and verification of screening information by 534 the appropriate licensing boards. 535 (2) Train employees through orientation and ongoing 536 sessions regarding issues related to abuse prohibition 537 practices, including identification of abuse, neglect, 538 mistreatment, and exploitation; appropriate interventions to 539 address aggressive or catastrophic reactions of clients; the 540 process for reporting allegations without fear of reprisal; and 541 recognition of signs of frustration and stress that may lead to 542 abuse. 543 (3) Provide clients, families, and staff with information 544 regarding how and to whom they may report concerns, incidents, 545 and grievances without fear of retribution and provide feedback 546 regarding the concerns that are expressed. A licensee shall 547 identify, correct, and intervene in situations in which abuse, 548 neglect, mistreatment, or exploitation is likely to occur, 549 including: 550 (a) Evaluating the physical environment of the facility to 551 identify characteristics that may make abuse or neglect more 552 likely to occur, such as secluded areas. 553 (b) Providing sufficient staff on each shift to meet the 554 needs of the clients and ensuring that the assigned staff have 555 knowledge of each client’s care needs. 556 (c) Identifying inappropriate staff behaviors, such as 557 using derogatory language, rough handling of clients, ignoring 558 clients while giving care, and directing clients who need 559 toileting assistance to urinate or defecate in their beds. 560 (d) Assessing, monitoring, and planning care for clients 561 with needs and behaviors that might lead to conflict or neglect, 562 such as a history of aggressive behaviors including entering 563 other clients’ rooms without permission, exhibiting self 564 injurious behaviors or communication disorders, requiring 565 intensive nursing care, or being totally dependent on staff. 566 (4) Identify events, such as suspicious bruising of 567 clients, occurrences, patterns, and trends that may constitute 568 abuse and determine the direction of the investigation. 569 (5) Investigate alleged violations and different types of 570 incidents, identify the staff member responsible for initial 571 reporting, and report results to the proper authorities. The 572 licensee shall analyze the incidents to determine whether 573 policies and procedures need to be changed to prevent further 574 incidents and take necessary corrective actions. 575 (6) Protect clients from harm during an investigation. 576 (7) Report alleged violations and substantiated incidents, 577 as required under chapters 39 and 415, to the licensing 578 authorities and all other agencies, as required, and report any 579 knowledge of actions by a court of law that would indicate an 580 employee is unfit for service. 581 400.9979 Restraint and seclusion; client safety.— 582 (1) A facility shall provide a therapeutic milieu that 583 supports a culture of individual empowerment and responsibility. 584 The health and safety of the client shall be the facility’s 585 primary concern at all times. 586 (2) The use of physical restraints must be ordered and 587 documented by a physician, physician assistant, or advanced 588 registered nurse practitioner and must be consistent with the 589 policies and procedures adopted by the facility. The client or, 590 if applicable, the client’s representative shall be informed of 591 the facility’s physical restraint policies and procedures when 592 the client is admitted. 593 (3) The use of chemical restraints shall be limited to 594 prescribed dosages of medications as ordered by a physician, 595 physician assistant, or advanced registered nurse practitioner 596 and must be consistent with the client’s diagnosis and the 597 policies and procedures adopted by the facility. The client and, 598 if applicable, the client’s representative shall be informed of 599 the facility’s chemical restraint policies and procedures when 600 the client is admitted. 601 (4) Based on the assessment by a physician, physician 602 assistant, or advanced registered nurse practitioner, if a 603 client exhibits symptoms that present an immediate risk of 604 injury or death to himself or herself or others, a physician, 605 physician assistant, or advanced registered nurse practitioner 606 may issue an emergency treatment order to immediately administer 607 rapid-response psychotropic medications or other chemical 608 restraints. Each emergency treatment order must be documented 609 and maintained in the client’s record. 610 (a) An emergency treatment order is not effective for more 611 than 24 hours. 612 (b) Whenever a client is medicated under this subsection, 613 the client’s representative or a responsible party and the 614 client’s physician, physician assistant, or advanced registered 615 nurse practitioner shall be notified as soon as practicable. 616 (5) A client who is prescribed and receives a medication 617 that can serve as a chemical restraint for a purpose other than 618 an emergency treatment order must be evaluated by his or her 619 physician, physician assistant, or advanced registered nurse 620 practitioner at least monthly to assess: 621 (a) The continued need for the medication. 622 (b) The level of the medication in the client’s blood. 623 (c) The need for adjustments to the prescription. 624 (6) The licensee shall ensure that clients are free from 625 unnecessary drugs and physical restraints and are provided 626 treatment to reduce dependency on drugs and physical restraints. 627 (7) The licensee may only employ physical restraints and 628 seclusion as authorized by the facility’s written policies, 629 which shall comply with this section and applicable rules. 630 (8) Interventions to manage dangerous client behavior shall 631 be employed with sufficient safeguards and supervision to ensure 632 that the safety, welfare, and civil and human rights of a client 633 are adequately protected. 634 (9) A facility shall notify the parent, guardian, or, if 635 applicable, the client’s representative when restraint or 636 seclusion is employed. The facility must provide the 637 notification within 24 hours after the restraint or seclusion is 638 employed. Reasonable efforts must be taken to notify the parent, 639 guardian, or, if applicable, the client’s representative by 640 telephone or e-mail, or both, and these efforts must be 641 documented. 642 (10) The agency may adopt rules that establish standards 643 and procedures for the use of restraints, restraint positioning, 644 seclusion, and emergency treatment orders for psychotropic 645 medications, restraint, and seclusion. If rules are adopted, the 646 rules must include duration of restraint, staff training, 647 observation of the client during restraint, and documentation 648 and reporting standards. 649 400.998 Personnel background screening; administration and 650 management procedures.— 651 (1) The agency shall require level 2 background screening 652 for licensee personnel as required in s. 408.809(1)(e) and 653 pursuant to chapter 435 and s. 408.809. 654 (2) The licensee shall maintain personnel records for each 655 staff member that contain, at a minimum, documentation of 656 background screening, a job description, documentation of 657 compliance with the training requirements of this part and 658 applicable rules, the employment application, references, a copy 659 of each job performance evaluation, and, for each staff member 660 who performs services for which licensure or certification is 661 required, a copy of all licenses or certification held by that 662 staff member. 663 (3) The licensee must: 664 (a) Develop and implement infection control policies and 665 procedures and include the policies and procedures in the 666 licensee’s policy manual. 667 (b) Maintain liability insurance as defined in s. 668 624.605(1)(b). 669 (c) Designate one person as an administrator to be 670 responsible and accountable for the overall management of the 671 facility. 672 (d) Designate in writing a person to be responsible for the 673 facility when the administrator is absent from the facility for 674 more than 24 hours. 675 (e) Designate in writing a program director to be 676 responsible for supervising the therapeutic and behavioral 677 staff, determining the levels of supervision, and determining 678 room placement for each client. 679 (f) Designate in writing a person to be responsible when 680 the program director is absent from the facility for more than 681 24 hours. 682 (g) Obtain approval of the comprehensive emergency 683 management plan, pursuant to s. 400.9982(2)(e), from the local 684 emergency management agency. Pending the approval of the plan, 685 the local emergency management agency shall ensure that the 686 following agencies, at a minimum, are given the opportunity to 687 review the plan: the Department of Health, the Agency for Health 688 Care Administration, and the Division of Emergency Management. 689 Appropriate volunteer organizations shall also be given the 690 opportunity to review the plan. The local emergency management 691 agency shall complete its review within 60 days after receipt of 692 the plan and either approve the plan or advise the licensee of 693 necessary revisions. 694 (h) Maintain written records in a form and system that 695 comply with medical and business practices and make the records 696 available by the facility for review or submission to the agency 697 upon request. The records shall include: 698 1. A daily census record that indicates the number of 699 clients currently receiving services in the facility, including 700 information regarding any public funding of such clients. 701 2. A record of each accident or unusual incident involving 702 a client or staff member that caused, or had the potential to 703 cause, injury or harm to any person or property within the 704 facility. The record shall contain a clear description of each 705 accident or incident; the names of the persons involved; a 706 description of medical or other services provided to these 707 persons, including the provider of the services; and the steps 708 taken to prevent recurrence of such accident or incident. 709 3. A copy of current agreements with third-party providers. 710 4. A copy of current agreements with each consultant 711 employed by the licensee and documentation of a consultant’s 712 visits and required written and dated reports. 713 400.9981 Property and personal affairs of clients.— 714 (1) A client shall be given the option of using his or her 715 own belongings, as space permits; choosing a roommate if 716 practical and not clinically contraindicated; and, whenever 717 possible, unless the client is adjudicated incompetent or 718 incapacitated under state law, managing his or her own affairs. 719 (2) The admission of a client to a facility and his or her 720 presence therein does not confer on a licensee or administrator, 721 or an employee or representative thereof, any authority to 722 manage, use, or dispose of the property of the client, and the 723 admission or presence of a client does not confer on such person 724 any authority or responsibility for the personal affairs of the 725 client except that which may be necessary for the safe 726 management of the facility or for the safety of the client. 727 (3) A licensee or administrator, or an employee or 728 representative thereof, may: 729 (a) Not act as the guardian, trustee, or conservator for a 730 client or a client’s property. 731 (b) Act as a competent client’s payee for social security, 732 veteran’s, or railroad benefits if the client provides consent 733 and the licensee files a surety bond with the agency in an 734 amount equal to twice the average monthly aggregate income or 735 personal funds due to the client, or expendable for the client’s 736 account, that are received by a licensee. 737 (c) Act as the attorney in fact for a client if the 738 licensee files a surety bond with the agency in an amount equal 739 to twice the average monthly income of the client, plus the 740 value of a client’s property under the control of the attorney 741 in fact. 742 743 The surety bond required under paragraph (b) or paragraph (c) 744 shall be executed by the licensee as principal and a licensed 745 surety company. The bond shall be conditioned upon the faithful 746 compliance of the licensee with the requirements of licensure 747 and is payable to the agency for the benefit of a client who 748 suffers a financial loss as a result of the misuse or 749 misappropriation of funds held pursuant to this subsection. A 750 surety company that cancels or does not renew the bond of a 751 licensee shall notify the agency in writing at least 30 days 752 before the action, giving the reason for cancellation or 753 nonrenewal. A licensee or administrator, or an employee or 754 representative thereof, who is granted power of attorney for a 755 client of the facility shall, on a monthly basis, notify the 756 client in writing of any transaction made on behalf of the 757 client pursuant to this subsection, and a copy of the 758 notification given to the client shall be retained in the 759 client’s file and available for agency inspection. 760 (4) A licensee, with the consent of the client, shall 761 provide for safekeeping in the facility of the client’s personal 762 effects of a value not in excess of $1,000 and the client’s 763 funds not in excess of $500 cash and shall keep complete and 764 accurate records of the funds and personal effects received. If 765 a client is absent from a facility for 24 hours or more, the 766 licensee may provide for safekeeping of the client’s personal 767 effects of a value in excess of $1,000. 768 (5) Funds or other property belonging to or due to a client 769 or expendable for the client’s account that are received by a 770 licensee shall be regarded as funds held in trust and shall be 771 kept separate from the funds and property of the licensee and 772 other clients or shall be specifically credited to the client. 773 The funds held in trust shall be used or otherwise expended only 774 for the account of the client. At least once every month, except 775 pursuant to an order of a court of competent jurisdiction, the 776 licensee shall furnish the client and, if applicable, the 777 client’s representative with a complete and verified statement 778 of all funds and other property to which this subsection 779 applies, detailing the amount and items received, together with 780 their sources and disposition. The licensee shall furnish the 781 statement annually and upon discharge or transfer of a client. A 782 governmental agency or private charitable agency contributing 783 funds or other property to the account of a client is also 784 entitled to receive a statement monthly and upon the discharge 785 or transfer of the client. 786 (6)(a) In addition to any damages or civil penalties to 787 which a person is subject, a person who: 788 1. Intentionally withholds a client’s personal funds, 789 personal property, or personal needs allowance; 790 2. Demands, beneficially receives, or contracts for payment 791 of all or any part of a client’s personal property or personal 792 needs allowance in satisfaction of the facility rate for 793 supplies and services; or 794 3. Borrows from or pledges any personal funds of a client, 795 other than the amount agreed to by written contract under s. 796 429.24, 797 798 commits a misdemeanor of the first degree, punishable as 799 provided in s. 775.082 or s. 775.083. 800 (b) A licensee or administrator, or an employee, or 801 representative thereof, who is granted power of attorney for a 802 client and who misuses or misappropriates funds obtained through 803 this power commits a felony of the third degree, punishable as 804 provided in s. 775.082, s. 775.083, or s. 775.084. 805 (7) In the event of the death of a client, a licensee shall 806 return all refunds, funds, and property held in trust to the 807 client’s personal representative, if one has been appointed at 808 the time the licensee disburses such funds, or, if not, to the 809 client’s spouse or adult next of kin named in a beneficiary 810 designation form provided by the licensee to the client. If the 811 client does not have a spouse or adult next of kin or such 812 person cannot be located, funds due to be returned to the client 813 shall be placed in an interest-bearing account, and all property 814 held in trust by the licensee shall be safeguarded until such 815 time as the funds and property are disbursed pursuant to the 816 Florida Probate Code. The funds shall be kept separate from the 817 funds and property of the licensee and other clients of the 818 facility. If the funds of the deceased client are not disbursed 819 pursuant to the Florida Probate Code within 2 years after the 820 client’s death, the funds shall be deposited in the Health Care 821 Trust Fund administered by the agency. 822 (8) The agency, by rule, may clarify terms and specify 823 procedures and documentation necessary to administer the 824 provisions of this section relating to the proper management of 825 clients’ funds and personal property and the execution of surety 826 bonds. 827 400.9982 Rules establishing standards.— 828 (1) It is the intent of the Legislature that rules adopted 829 and enforced pursuant to this part and part II of chapter 408 830 include criteria to ensure reasonable and consistent quality of 831 care and client safety. The rules should make reasonable efforts 832 to accommodate the needs and preferences of the client to 833 enhance the client’s quality of life while residing in a 834 transitional living facility. 835 (2) The agency may adopt and enforce rules to implement 836 this part and part II of chapter 408, which may include 837 reasonable and fair criteria with respect to: 838 (a) The location of transitional living facilities. 839 (b) The qualifications of personnel, including management, 840 medical, nursing, and other professional personnel and nursing 841 assistants and support staff, who are responsible for client 842 care. The licensee must employ enough qualified professional 843 staff to carry out and monitor interventions in accordance with 844 the stated goals and objectives of each comprehensive treatment 845 plan. 846 (c) Requirements for personnel procedures, reporting 847 procedures, and documentation necessary to implement this part. 848 (d) Services provided to clients of transitional living 849 facilities. 850 (e) The preparation and annual update of a comprehensive 851 emergency management plan in consultation with the Division of 852 Emergency Management. At a minimum, the rules must provide for 853 plan components that address emergency evacuation 854 transportation; adequate sheltering arrangements; postdisaster 855 activities, including provision of emergency power, food, and 856 water; postdisaster transportation; supplies; staffing; 857 emergency equipment; individual identification of clients and 858 transfer of records; communication with families; and responses 859 to family inquiries. 860 400.9983 Violations; penalties.—A violation of this part or 861 any rule adopted pursuant thereto shall be classified according 862 to the nature of the violation and the gravity of its probable 863 effect on facility clients. The agency shall indicate the 864 classification on the written notice of the violation as 865 follows: 866 (1) Class “I” violations are defined in s. 408.813. The 867 agency shall issue a citation regardless of correction and 868 impose an administrative fine of $5,000 for an isolated 869 violation, $7,500 for a patterned violation, or $10,000 for a 870 widespread violation. Violations may be identified, and a fine 871 must be levied, notwithstanding the correction of the deficiency 872 giving rise to the violation. 873 (2) Class “II” violations are defined in s. 408.813. The 874 agency shall impose an administrative fine of $1,000 for an 875 isolated violation, $2,500 for a patterned violation, or $5,000 876 for a widespread violation. A fine must be levied 877 notwithstanding the correction of the deficiency giving rise to 878 the violation. 879 (3) Class “III” violations are defined in s. 408.813. The 880 agency shall impose an administrative fine of $500 for an 881 isolated violation, $750 for a patterned violation, or $1,000 882 for a widespread violation. If a deficiency giving rise to a 883 class III violation is corrected within the time specified by 884 the agency, the fine may not be imposed. 885 (4) Class “IV” violations are defined in s. 408.813. The 886 agency shall impose for a cited class IV violation an 887 administrative fine of at least $100 but not exceeding $200 for 888 each violation. If a deficiency giving rise to a class IV 889 violation is corrected within the time specified by the agency, 890 the fine may not be imposed. 891 400.9984 Receivership proceedings.—The agency may apply s. 892 429.22 with regard to receivership proceedings for transitional 893 living facilities. 894 400.9985 Interagency communication.—The agency, the 895 department, the Agency for Persons with Disabilities, and the 896 Department of Children and Families shall develop electronic 897 systems to ensure that relevant information pertaining to the 898 regulation of transitional living facilities and clients is 899 timely and effectively communicated among agencies in order to 900 facilitate the protection of clients. Electronic sharing of 901 information shall include, at a minimum, a brain and spinal cord 902 injury registry and a client abuse registry. 903 Section 2. Section 400.805, Florida Statutes, is 904 transferred and renumbered as s. 400.9986, Florida Statutes. 905 Section 3. Effective July 1, 2016, s. 400.9986, Florida 906 Statutes, is repealed. 907 Section 4. The title of part V of chapter 400, Florida 908 Statutes, consisting of sections 400.701 and 400.801, is 909 redesignated as “INTERMEDIATE CARE FACILITIES.” 910 Section 5. Subsection (9) of section 381.745, Florida 911 Statutes, is amended to read: 912 381.745 Definitions; ss. 381.739-381.79.—As used in ss. 913 381.739-381.79, the term: 914 (9) “Transitional living facility” means a state-approved 915 facility,as defined and licensed under chapter 400or chapter916429, or a facility approved by the brain and spinal cord injury917program in accordance with this chapter. 918 Section 6. Section 381.75, Florida Statutes, is amended to 919 read: 920 381.75 Duties and responsibilities of the department, of921transitional living facilities, and of residents.—Consistent 922 with the mandate of s. 381.7395, the department shall develop 923 and administer a multilevel treatment program for individuals 924 who sustain brain or spinal cord injuries and who are referred 925 to the brain and spinal cord injury program. 926 (1) Within 15 days after any report of an individual who 927 has sustained a brain or spinal cord injury, the department 928 shall notify the individual or the most immediate available 929 family members of their right to assistance from the state, the 930 services available, and the eligibility requirements. 931 (2) The department shall refer individuals who have brain 932 or spinal cord injuries to other state agencies to ensureassure933 that rehabilitative services, if desired, are obtained by that 934 individual. 935 (3) The department, in consultation with emergency medical 936 service, shall develop standards for an emergency medical 937 evacuation system that will ensure that all individuals who 938 sustain traumatic brain or spinal cord injuries are transported 939 to a department-approved trauma center that meets the standards 940 and criteria established by the emergency medical service and 941 the acute-care standards of the brain and spinal cord injury 942 program. 943 (4) The department shall develop standards for designation 944 of rehabilitation centers to provide rehabilitation services for 945 individuals who have brain or spinal cord injuries. 946 (5) The department shall determine the appropriate number 947 of designated acute-care facilities, inpatient rehabilitation 948 centers, and outpatient rehabilitation centers,needed based on 949 incidence, volume of admissions, and other appropriate criteria. 950 (6) The department shall develop standards for designation 951 of transitional living facilities to provide transitional living 952 services for individuals who participate in the brain and spinal 953 cord injury programthe opportunity to adjust to their954disabilities and to develop physical and functional skills in a955supported living environment. 956(a) The Agency for Health Care Administration, in957consultation with the department, shall develop rules for the958licensure of transitional living facilities for individuals who959have brain or spinal cord injuries.960(b) The goal of a transitional living program for961individuals who have brain or spinal cord injuries is to assist962each individual who has such a disability to achieve a higher963level of independent functioning and to enable that person to964reenter the community. The program shall be focused on preparing965participants to return to community living.966(c) A transitional living facility for an individual who967has a brain or spinal cord injury shall provide to such968individual, in a residential setting, a goal-oriented treatment969program designed to improve the individual’s physical,970cognitive, communicative, behavioral, psychological, and social971functioning, as well as to provide necessary support and972supervision. A transitional living facility shall offer at least973the following therapies: physical, occupational, speech,974neuropsychology, independent living skills training, behavior975analysis for programs serving brain-injured individuals, health976education, and recreation.977(d) All residents shall use the transitional living978facility as a temporary measure and not as a permanent home or979domicile. The transitional living facility shall develop an980initial treatment plan for each resident within 3 days after the981resident’s admission. The transitional living facility shall982develop a comprehensive plan of treatment and a discharge plan983for each resident as soon as practical, but no later than 30984days after the resident’s admission. Each comprehensive985treatment plan and discharge plan must be reviewed and updated986as necessary, but no less often than quarterly. This subsection987does not require the discharge of an individual who continues to988require any of the specialized services described in paragraph989(c) or who is making measurable progress in accordance with that990individual’s comprehensive treatment plan. The transitional991living facility shall discharge any individual who has an992appropriate discharge site and who has achieved the goals of his993or her discharge plan or who is no longer making progress toward994the goals established in the comprehensive treatment plan and995the discharge plan. The discharge location must be the least996restrictive environment in which an individual’s health, well997being, and safety is preserved.998(7) Recipients of services, under this section, from any of999the facilities referred to in this section shall pay a fee based1000on ability to pay.1001 Section 7. Subsection (4) of section 381.78, Florida 1002 Statutes, is amended to read: 1003 381.78 Advisory council on brain and spinal cord injuries.— 1004 (4) The council shall:1005(a)provide advice and expertise to the department in the 1006 preparation, implementation, and periodic review of the brain 1007 and spinal cord injury program. 1008(b) Annually appoint a five-member committee composed of1009one individual who has a brain injury or has a family member1010with a brain injury, one individual who has a spinal cord injury1011or has a family member with a spinal cord injury, and three1012members who shall be chosen from among these representative1013groups: physicians, other allied health professionals,1014administrators of brain and spinal cord injury programs, and1015representatives from support groups with expertise in areas1016related to the rehabilitation of individuals who have brain or1017spinal cord injuries, except that one and only one member of the1018committee shall be an administrator of a transitional living1019facility. Membership on the council is not a prerequisite for1020membership on this committee.10211. The committee shall perform onsite visits to those1022transitional living facilities identified by the Agency for1023Health Care Administration as being in possible violation of the1024statutes and rules regulating such facilities. The committee1025members have the same rights of entry and inspection granted1026under s. 400.805(4) to designated representatives of the agency.10272. Factual findings of the committee resulting from an1028onsite investigation of a facility pursuant to subparagraph 1.1029shall be adopted by the agency in developing its administrative1030response regarding enforcement of statutes and rules regulating1031the operation of the facility. 10323. Onsite investigations by the committee shall be funded1033by the Health Care Trust Fund.10344. Travel expenses for committee members shall be1035reimbursed in accordance with s. 112.061.10365. Members of the committee shall recuse themselves from1037participating in any investigation that would create a conflict1038of interest under state law, and the council shall replace the1039member, either temporarily or permanently.1040 Section 8. Subsection (5) of section 400.93, Florida 1041 Statutes, is amended to read: 1042 400.93 Licensure required; exemptions; unlawful acts; 1043 penalties.— 1044 (5) The following are exempt from home medical equipment 1045 provider licensure, unless they have a separate company, 1046 corporation, or division that is in the business of providing 1047 home medical equipment and services for sale or rent to 1048 consumers at their regular or temporary place of residence 1049 pursuant to the provisions of this part: 1050 (a) Providers operated by the Department of Health or 1051 Federal Government. 1052 (b) Nursing homes licensed under part II. 1053 (c) Assisted living facilities licensed under chapter 429, 1054 when serving their residents. 1055 (d) Home health agencies licensed under part III. 1056 (e) Hospices licensed under part IV. 1057 (f) Intermediate care facilities and,homes for special 1058 services, and transitional living facilitieslicensed under part 1059 V. 1060 (g) Transitional living facilities licensed under part XI. 1061 (h)(g)Hospitals and ambulatory surgical centers licensed 1062 under chapter 395. 1063 (i)(h)Manufacturers and wholesale distributors when not 1064 selling directly to consumers. 1065 (j)(i)Licensed health care practitioners who useutilize1066 home medical equipment in the course of their practice,but do 1067 not sell or rent home medical equipment to their patients. 1068 (k)(j)Pharmacies licensed under chapter 465. 1069 Section 9. Subsection (21) of section 408.802, Florida 1070 Statutes, is amended to read: 1071 408.802 Applicability.—The provisions of this part apply to 1072 the provision of services that require licensure as defined in 1073 this part and to the following entities licensed, registered, or 1074 certified by the agency, as described in chapters 112, 383, 390, 1075 394, 395, 400, 429, 440, 483, and 765: 1076 (21) Transitional living facilities, as provided under part 1077 XIVof chapter 400. 1078 Section 10. Subsection (20) of section 408.820, Florida 1079 Statutes, is amended to read: 1080 408.820 Exemptions.—Except as prescribed in authorizing 1081 statutes, the following exemptions shall apply to specified 1082 requirements of this part: 1083 (20) Transitional living facilities, as provided under part 1084 XIVof chapter 400, are exempt from s. 408.810(10). 1085 Section 11. For the purpose of incorporating the amendment 1086 made by this act to section 381.75, Florida Statutes, in a 1087 reference thereto, subsection (1) of section 381.79, Florida 1088 Statutes, is reenacted to read: 1089 381.79 Brain and Spinal Cord Injury Program Trust Fund.— 1090 (1) There is created in the State Treasury the Brain and 1091 Spinal Cord Injury Program Trust Fund. Moneys in the fund shall 1092 be appropriated to the department for the purpose of providing 1093 the cost of care for brain or spinal cord injuries as a payor of 1094 last resort to residents of this state, for multilevel programs 1095 of care established pursuant to s. 381.75. 1096 (a) Authorization of expenditures for brain or spinal cord 1097 injury care shall be made only by the department. 1098 (b) Authorized expenditures include acute care, 1099 rehabilitation, transitional living, equipment and supplies 1100 necessary for activities of daily living, public information, 1101 prevention, education, and research. In addition, the department 1102 may provide matching funds for public or private assistance 1103 provided under the brain and spinal cord injury program and may 1104 provide funds for any approved expansion of services for 1105 treating individuals who have sustained a brain or spinal cord 1106 injury. 1107 Section 12. (1) A transitional living facility that is 1108 licensed under s. 400.805, Florida Statutes, on June 30, 2015, 1109 must be licensed under and in compliance with s. 400.9986, 1110 Florida Statutes, until the licensee becomes licensed under and 1111 in compliance with part XI of ch. 400, Florida Statutes, as 1112 created by this act. Such licensees must be licensed under and 1113 in compliance with part XI of chapter 400, Florida Statutes, as 1114 created by this act, on or before July 1, 2016. 1115 (2) A transitional living facility that is licensed on or 1116 after July 1, 2015, must be licensed under and in compliance 1117 with part XI of ch. 400, Florida Statutes, as created by this 1118 act. 1119 Section 13. Except as otherwise expressly provided in this 1120 act, this act shall take effect July 1, 2015.