Senate Bill sb0682c1

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    Florida Senate - 2002                            CS for SB 682

    By the Committee on Children and Families; and Senator Peaden





    300-1779C-02

  1                      A bill to be entitled

  2         An act relating to substance-abuse services;

  3         amending s. 397.311, F.S.; redefining the term

  4         "licensed service provider"; requiring that

  5         licensure standards apply to certain housing

  6         locations; redefining the term "service

  7         provider personnel," to add chief financial

  8         officers; requiring that owners, directors, and

  9         chief financial officers of a substance-abuse

10         service provider undergo a background check

11         pursuant to ch. 435, F.S.; requiring that proof

12         of compliance with local zoning ordinances be

13         included in the applications for licensure;

14         amending s. 397.405, F.S.; clarifying that DUI

15         education and screening services must be

16         licensed if they provide treatment services;

17         amending s. 397.407, F.S.; conforming

18         cross-references; amending s. 397.416, F.S.;

19         conforming cross-references; amending s.

20         397.451, F.S.; clarifying provisions; requiring

21         level-2 background screening for employees who

22         work with children and with adults who are

23         developmentally disabled; specifying

24         circumstances under which service provider

25         owners, directors, or chief financial officers

26         are not subject to background screening;

27         allowing personnel to request, and the

28         department to grant, an exemption from

29         disqualification; amending ss. 212.055,

30         440.102, F.S.; conforming cross-references;

31         providing an effective date.

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  1  Be It Enacted by the Legislature of the State of Florida:

  2

  3         Section 1.  Section 397.311, Florida Statutes, is

  4  amended to read:

  5         397.311  Definitions.--As used in this chapter, except

  6  part VIII:

  7         (1)  "Ancillary services" are services which include,

  8  but are not limited to, special diagnostic, prenatal and

  9  postnatal, other medical, mental health, legal, economic,

10  vocational, employment, and educational services.

11         (2)  "Assessment" means the systematic evaluation of

12  information gathered to determine the nature and severity of

13  the client's substance abuse problem and the client's need and

14  motivation for services. Assessment entails the use of a

15  psychosocial history supplemented, as required by rule, by

16  medical examinations, laboratory testing, and psychometric

17  measures.

18         (3)  "Authorized agent of the department" means a

19  person designated by the department to conduct any audit,

20  inspection, monitoring, evaluation, or other duty imposed upon

21  the department pursuant to this chapter.  An authorized agent

22  must be identified by the department as:

23         (a)  Qualified by the requisite expertise and

24  experience;

25         (b)  Having a need to know the applicable information;

26  and

27         (c)  Having the assigned responsibility to carry out

28  the applicable duty.

29         (4)  "Background check" means reviewing the background

30  of service provider personnel who have direct contact with

31  unmarried clients under the age of 18 years or with clients

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  1  who are developmentally disabled in accordance with the

  2  provisions of s. 397.451, and includes, but is not limited to,

  3  local criminal records checks through local law enforcement

  4  agencies, fingerprinting, statewide criminal records checks

  5  through the Department of Law Enforcement, federal criminal

  6  records checks through the Federal Bureau of Investigation,

  7  and employment history checks.

  8         (4)(5)  "Beyond the safe management capabilities of the

  9  service provider" refers to a client who is in need of:

10         (a)  Supervision;

11         (b)  Medical care; or

12         (c)  Services,

13

14  beyond that which the service provider or service component

15  can deliver.

16         (5)(6)  "Client" means a recipient of alcohol or other

17  drug services delivered by a service provider but does not

18  include an inmate pursuant to part VIII unless expressly so

19  provided.

20         (6)(7)  "Client identifying information" means the

21  name, address, social security number, fingerprints,

22  photograph, and similar information by which the identity of a

23  client can be determined with reasonable accuracy and speed

24  either directly or by reference to other publicly available

25  information.

26         (7)(8)  "Court" means, with respect to all involuntary

27  proceedings under this chapter, the circuit court of the

28  county in which the judicial proceeding is pending or where

29  the substance abuse impaired person resides or is located, and

30  includes any general or special master that may be appointed

31  by the chief judge to preside over all or part of such

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  1  proceeding. Otherwise, "court" refers to the court of legal

  2  jurisdiction in the context in which the term is used in this

  3  chapter.

  4         (8)(9)  "Department" means the Department of Children

  5  and Family Services.

  6         (9)(10)  "Director" means the chief administrative

  7  officer of a service provider.

  8         (10)(11)  "Disclose" or "disclosure" means a

  9  communication of client identifying information, the

10  affirmative verification of another person's communication of

11  client identifying information, or the communication of any

12  information of a client who has been identified.  Any

13  disclosure made pursuant to this chapter must be limited to

14  that information which is necessary to carry out the purpose

15  of the disclosure.

16         (11)(12)  "Fee system" means a method of establishing

17  charges for services rendered, in accordance with a client's

18  ability to pay, used by providers that receive state funds.

19         (12)(13)  "For profit" means registered as for profit

20  by the Secretary of State and recognized by the Internal

21  Revenue Service as a for-profit entity.

22         (13)(14)  "Habitual abuser" means a person who is

23  brought to the attention of law enforcement for being

24  substance impaired, who meets the criteria for involuntary

25  admission in s. 397.675, and who has been taken into custody

26  for such impairment three or more times during the preceding

27  12 months.

28         (14)(15)  "Hospital" means a hospital or hospital-based

29  component licensed under chapter 395.

30         (15)(16)  "Impaired" or "substance abuse impaired"

31  means a condition involving the use of alcoholic beverages or

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  1  any psychoactive or mood-altering substance in such a manner

  2  as to induce mental, emotional, or physical problems and cause

  3  socially dysfunctional behavior.

  4         (16)(17)  "Individualized treatment or service plan"

  5  means an immediate and a long-range plan for substance abuse

  6  or ancillary services developed on the basis of a client's

  7  assessed needs.

  8         (17)(18)  "Law enforcement officer" means a law

  9  enforcement officer as defined in s. 943.10(1).

10         (18)(19)  "Licensed service provider" means a public

11  agency under this chapter, a private for-profit or

12  not-for-profit agency under this chapter, a physician licensed

13  under chapter 458 or chapter 459, or any other private

14  practitioner licensed under this chapter, or a hospital that

15  licensed under chapter 395, which offers substance abuse

16  impairment services through one or more of the following

17  licensable service components:

18         (a)  Addictions receiving facility, which is a

19  community-based facility designated by the department to

20  receive, screen, and assess clients found to be substance

21  abuse impaired, in need of emergency treatment for substance

22  abuse impairment, or impaired by substance abuse to such an

23  extent as to meet the criteria for involuntary admission in s.

24  397.675, and to provide detoxification and stabilization.  An

25  addictions receiving facility must be state-owned,

26  state-operated, or state-contracted, and licensed pursuant to

27  rules adopted by the department's Substance Abuse Program

28  Office which include specific authorization for the provision

29  of levels of care and a requirement of separate accommodations

30  for adults and minors. Addictions receiving facilities are

31  designated as secure facilities to provide an intensive level

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  1  of care and must have sufficient staff and the authority to

  2  provide environmental security to handle aggressive and

  3  difficult-to-manage behavior and deter elopement.

  4         (b)  Detoxification, which uses medical and

  5  psychological procedures and a supportive counseling regimen

  6  to assist clients in managing toxicity and withdrawing and

  7  stabilizing from the physiological and psychological effects

  8  of substance abuse impairment.

  9         (c)  Residential treatment, which provides a

10  structured, live-in environment within a nonhospital setting

11  on a 24-hours-a-day, 7-days-a-week basis, and which includes:

12  treatment, rehabilitation, and transitional care.

13         1.  Facilities that provide room and board and

14  treatment and rehabilitation within the primary residential

15  facility; and

16         2.  Facilities that are used for room and board only

17  and in which treatment and rehabilitation activities are

18  provided on a mandatory basis at locations other than the

19  primary residential facility. In this case, facilities used

20  for room and board and for treatment and rehabilitation are

21  operated under the auspices of the same provider, and

22  licensing and regulatory requirements would apply to both the

23  residential facility and all other facilities in which

24  treatment and rehabilitation activities occur.

25         (d)  Day and night treatment, which provides a

26  nonresidential environment with a structured schedule of

27  treatment and rehabilitation services.

28         (e)  Outpatient treatment, which provides individual,

29  group, or family counseling for clients by appointment during

30  scheduled operating hours, with an emphasis on assessment and

31  treatment.

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  1         (f)  Medication and methadone maintenance treatment

  2  that uses methadone or other medication as authorized by state

  3  and federal law, in conjunction with medical, rehabilitative,

  4  and counseling services in the treatment of clients who are

  5  dependent upon opioid drugs.

  6         (g)  Prevention, which is a process involving

  7  strategies aimed at the individual, the environment, or the

  8  substance, which strategies preclude, forestall, or impede the

  9  development of substance abuse problems and promote

10  responsible personal and social growth of individuals and

11  families toward full human potential.

12         (h)  Intervention, which consists of structured

13  services targeted toward individuals or groups at risk and

14  focused on reducing those factors associated with the onset or

15  the early stages of substance abuse, and related problems.

16         (19)(20)  "Not for profit" means registered as not for

17  profit by the Secretary of State and recognized by the

18  Internal Revenue Service as a not-for-profit entity.

19         (20)(21)  "Physician" means a person licensed under

20  chapter 458 to practice medicine or licensed under chapter 459

21  to practice osteopathic medicine, and may include, if the

22  context so indicates, an intern or resident enrolled in an

23  intern or resident training program affiliated with an

24  approved medical school, hospital, or other facility through

25  which training programs are normally conducted.

26         (21)(22)  "Preliminary screening" means the gathering

27  of initial information to be used in determining a person's

28  need for assessment or for referral.

29         (22)(23)  "Private practitioner" means a physician

30  licensed under chapter 458 or chapter 459, a psychologist

31  licensed under chapter 490, or a clinical social worker,

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  1  marriage and family therapist, or mental health counselor

  2  licensed under chapter 491.

  3         (23)(24)  "Program evaluation" or "evaluation" means a

  4  systematic measurement of a service provider's achievement of

  5  desired client or service outcomes.

  6         (24)(25)  "Qualified professional" means a physician

  7  licensed under chapter 458 or chapter 459; a professional

  8  licensed under chapter 490 or chapter 491; or a person who is

  9  certified through a department-recognized certification

10  process for substance abuse treatment services and who holds,

11  at a minimum, a bachelor's degree.  A person who is certified

12  in substance abuse treatment services by a state-recognized

13  certification process in another state at the time of

14  employment with a licensed substance abuse provider in this

15  state may perform the functions of a qualified professional as

16  defined in this chapter but must meet certification

17  requirements contained in this subsection no later than 1 year

18  after his or her date of employment.

19         (25)(26)  "Quality assurance" means the objective and

20  internal systematic monitoring of the appropriateness and

21  quality of client care rendered by a service provider.

22         (26)(27)  "Secure facility," except where the context

23  indicates a correctional system facility, means a provider

24  that has the authority to deter the premature departure of

25  involuntary clients whose leaving constitutes a violation of a

26  court order or community-based supervision as provided by law.

27  The term "secure facility" includes addictions receiving

28  facilities and facilities authorized by local ordinance for

29  the treatment of habitual abusers.

30         (27)(28)  "Service provider" or "provider" means a

31  public agency, a private for-profit or not-for-profit agency,

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  1  a person who is a private practitioner, or a hospital, which

  2  agency, person, or hospital is licensed under this chapter or

  3  exempt from licensure under this chapter.

  4         (28)(29)  "Service provider personnel" or "personnel"

  5  includes all owners, directors, chief financial officers,

  6  staff, and volunteers, including foster parents, of a service

  7  provider.

  8         (29)(30)  "Stabilization" means:

  9         (a)  Alleviation of a crisis condition; or

10         (b)  Prevention of further deterioration,

11

12  and connotes short-term emergency treatment.

13         Section 2.  Subsection (1) of section 397.403, Florida

14  Statutes, is amended to read:

15         397.403  License application.--

16         (1)  Applicants for a license under this chapter must

17  apply to the department on forms provided by the department

18  and in accordance with rules adopted by the department.

19  Applications must include at a minimum:

20         (a)  Information establishing the name and address of

21  the applicant service provider and its director, and also of

22  each member, owner, officer, and shareholder, if any.

23         (b)  Information establishing the competency and

24  ability of the applicant service provider and its director to

25  carry out the requirements of this chapter.

26         (c)  Proof satisfactory to the department of the

27  applicant service provider's financial ability and

28  organizational capability to operate in accordance with this

29  chapter.

30         (d)  Proof of liability insurance coverage in amounts

31  set by the department by rule.

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  1         (e)  Sufficient information to conduct background

  2  screening as provided in s. 397.451 Personnel fingerprints for

  3  background checks as required by this chapter.

  4         1.  If the results of the background screening indicate

  5  that any owner, director, or chief financial officer has been

  6  found guilty of, regardless of adjudication, or has entered a

  7  plea of nolo contendere or guilty to any offense prohibited

  8  under the screening standard, a license may not be issued to

  9  the applicant service provider unless an exemption from

10  disqualification has been granted by the department as set

11  forth in chapter 435. The owner, director, or manager has 90

12  days within which to obtain the required exemption, during

13  which time the applicant's license remains in effect.

14         2.  If any owner, director, or chief financial officer

15  is arrested or found guilty of, regardless of adjudication, or

16  has entered a plea of nolo contendere or guilty to any offense

17  prohibited under the screening standard while acting in that

18  capacity, the provider shall immediately remove the person

19  from that position and shall notify the department within 2

20  days after such removal, excluding weekends and holidays.

21  Failure to remove the owner, director, or manager will result

22  in revocation of the provider's license.

23         (f)  Proof of satisfactory fire, safety, and health

24  inspections, and compliance with local zoning ordinances.

25  Service providers operating under a regular annual license

26  shall have 18 months from the expiration date of their regular

27  license within which to meet local zoning requirements.

28  Applicants for a new license must demonstrate proof of

29  compliance with zoning requirements prior to the department

30  issuing a probationary license.

31

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  1         (g)  A comprehensive outline of the proposed services

  2  for:

  3         1.  Any new applicant; or

  4         2.  Any licensed service provider adding a new

  5  licensable service component.

  6         Section 3.  Section 397.405, Florida Statutes, is

  7  amended to read:

  8         397.405  Exemptions from licensure.--The following are

  9  exempt from the licensing provisions of this chapter:

10         (1)  A hospital or hospital-based component licensed

11  under chapter 395.

12         (2)  A nursing home facility as defined in s. 400.021.

13         (3)  A substance abuse education program established

14  pursuant to s. 233.061.

15         (4)  A facility or institution operated by the Federal

16  Government.

17         (5)  A physician licensed under chapter 458 or chapter

18  459.

19         (6)  A psychologist licensed under chapter 490.

20         (7)  A social worker, marriage and family therapist, or

21  mental health counselor licensed under chapter 491.

22         (8)  An established and legally cognizable church or

23  nonprofit religious organization or, denomination, or sect

24  providing substance abuse services, including prevention

25  services, which are exclusively religious, spiritual, or

26  ecclesiastical in nature.  A church or nonprofit religious

27  organization or, denomination, or sect providing any of the

28  licensable service components itemized under s. 397.311(18) s.

29  397.311(19) is not exempt for purposes of its provision of

30  such licensable service components but retains its exemption

31

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  1  with respect to all services which are exclusively religious,

  2  spiritual, or ecclesiastical in nature.

  3         (9)  Facilities licensed under s. 393.063(8) that, in

  4  addition to providing services to persons who are

  5  developmentally disabled as defined therein, also provide

  6  services to persons developmentally at risk as a consequence

  7  of exposure to alcohol or other legal or illegal drugs while

  8  in utero.

  9         (10)  DUI education and screening services provided

10  required to be attended pursuant to ss. 316.192, 316.193,

11  322.095, 322.271, and 322.291 are exempt from licensure under

12  this chapter.  Persons or entities providing treatment

13  services programs must continue to be licensed under this

14  chapter unless exempted from licensing as provided in this

15  section.

16

17  The exemptions from licensure in this section do not apply to

18  any service provider that facility or entity which receives an

19  appropriation, grant, or contract from the state to operate as

20  a service provider as defined in this chapter or to any

21  substance abuse program regulated pursuant to s. 397.406.

22  Furthermore, No provision of this chapter may not shall be

23  construed to limit the practice of a physician licensed under

24  chapter 458 or chapter 459, a psychologist licensed under

25  chapter 490, or a psychotherapist licensed under chapter 491

26  who provides, providing outpatient or inpatient substance

27  abuse treatment to a voluntary patient, so long as the

28  physician, psychologist, or psychotherapist does not represent

29  to the public that he or she is a licensed service provider

30  and does not provide services to clients pursuant to part V of

31  this chapter under this act. Failure to comply with any

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  1  requirement necessary to maintain an exempt status under this

  2  section is a misdemeanor of the first degree, punishable as

  3  provided in s. 775.082 or s. 775.083.

  4         Section 4.  Subsection (1) of section 397.407, Florida

  5  Statutes, is amended to read:

  6         397.407  Licensure fees.--

  7         (1)  The department shall establish licensure fees by

  8  rule.  The rule must prescribe a fee range that is based, at

  9  least in part, on the number and complexity of programs listed

10  in s. 397.311(18) s. 397.311(19) which are operated by a

11  licensee.  The fee range must be implemented over a 5-year

12  period.  The fee schedule for licensure of service components

13  must be increased annually in substantially equal increments

14  so that, by July 1, 1998, the fees from the licensure of

15  service components are sufficient to cover at least 50 percent

16  of the costs of regulating the service components.  The

17  department shall specify by rule a fee range and phase-in plan

18  for privately funded licensed service providers and a fee

19  range and phase-in plan for publicly funded licensed service

20  providers.  Fees for privately funded licensed service

21  providers must exceed the fees for publicly funded licensed

22  service providers.  The first year phase-in licensure fees

23  must be at least $150 per initial license. The rule must

24  provide for a reduction in licensure fees for licensed service

25  providers who hold more than one license.

26         Section 5.  Subsection (2) of section 397.416, Florida

27  Statutes, is amended to read:

28         397.416  Substance abuse treatment services; qualified

29  professional.--

30         (2)  Notwithstanding any other provision of law, a

31  person who was certified through a certification process

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  1  recognized by the former Department of Health and

  2  Rehabilitative Services before January 1, 1995, may perform

  3  the duties of a qualified professional with respect to

  4  substance abuse treatment services as defined in this chapter,

  5  and need not meet the certification requirements contained in

  6  s. 397.311(24) s. 397.311(25).

  7         Section 6.  Section 397.451, Florida Statutes, is

  8  amended to read:

  9         397.451  Background checks of service provider

10  personnel who have direct contact with unmarried minor clients

11  or clients who are developmentally disabled.--

12         (1)  PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND

13  EXCEPTIONS.--

14         (a)  Background checks shall apply as follows:

15         1.  All owners, directors, and chief financial officers

16  of service providers are subject to level-2 background

17  screening as provided under chapter 435.

18         2.  All service provider personnel who have direct

19  contact with children receiving services or with adults who

20  are developmentally disabled receiving services are subject to

21  level-2 background screening as provided under chapter 435.

22  Service provider personnel who have direct contact with

23  unmarried clients under the age of 18 years or with clients

24  who are developmentally disabled are subject to background

25  checks, except as otherwise provided in this section.

26         (b)  Students in the health care professions who are

27  interning under the actual physical presence supervision of a

28  licensed health care professional in a service provider

29  licensed under chapter 395, where the primary purpose of the

30  service provider is not the treatment of unmarried minors or

31

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  1  of persons who are developmentally disabled, are exempt from

  2  the fingerprinting and background check requirements.

  3         (c)  Personnel working in a service provider licensed

  4  under chapter 395 who have less than 15 hours per week of

  5  direct contact with unmarried minors or with persons who are

  6  developmentally disabled, or personnel who are health care

  7  professionals licensed by the Department of Business and

  8  Professional Regulation or a board thereunder who are not

  9  employed in a service provider where the primary purpose is

10  the treatment of unmarried minors or of persons who are

11  developmentally disabled are exempt from the fingerprinting

12  and background check requirements.

13         (b)(d)  Members of a foster family and persons residing

14  with the foster family who are between 12 and 18 years of age

15  are not required to be fingerprinted but must have their

16  backgrounds checked for delinquency records. Members of the

17  foster family and persons residing with the foster family over

18  18 years of age are subject to full background checks.

19         (c)(e)  A volunteer who assists on an intermittent

20  basis for fewer than 40 hours per month and is under direct

21  and constant supervision by persons who meet all personnel

22  requirements of this chapter is exempt from fingerprinting and

23  background check requirements.

24         (d)(f)  Service providers that are exempt from

25  licensing provisions of this chapter are exempt from personnel

26  fingerprinting and background check requirements, except as

27  otherwise provided in this section.  A church or nonprofit

28  religious organization exempt from licensure under this

29  chapter is required to comply with personnel fingerprinting

30  and background check requirements.

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  1         (e)(g)  Personnel employed by the Department of

  2  Corrections in a substance abuse service component who have

  3  direct contact with unmarried inmates under the age of 18 or

  4  with inmates who are developmentally disabled are exempt from

  5  the fingerprinting and background check requirements of this

  6  section.

  7         (f)  Service provider personnel who request an

  8  exemption from disqualification must submit the request within

  9  30 days after being notified of a pending disqualification.

10  The employment of service provider personnel shall not be

11  adversely affected pending disposition of the request for an

12  exemption. Disapproval of a request for an exemption shall

13  result in the immediate dismissal of the service provider

14  personnel from employment with the provider.

15         (2)  EMPLOYMENT HISTORY CHECKS; CHECKS OF

16  REFERENCES.--The department shall assess employment history

17  checks and checks of references for all owners, directors, and

18  chief financial officers, and the directors shall assess

19  employment history checks and checks of references for each

20  employee who has direct contact with children receiving

21  services or adults who are developmentally disabled receiving

22  services unmarried clients under the age of 18 years or with

23  clients who are developmentally disabled.

24         (3)  MINIMUM BACKGROUND CHECK STANDARDS.--The

25  department shall require employment screening pursuant to

26  chapter 435, using level 2 standards for screening set forth

27  in that chapter, of service provider personnel who have direct

28  contact with unmarried clients under the age of 18 years or

29  with clients who are developmentally disabled.

30         (3)(4)  PERSONNEL EXEMPT FROM BEING REFINGERPRINTED OR

31  RECHECKED.--

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  1         (a)  Service provider personnel who have been

  2  fingerprinted or had their backgrounds checked pursuant to

  3  chapter 393, chapter 394, chapter 402, or chapter 409, or this

  4  section, and teachers who have been fingerprinted pursuant to

  5  chapter 231, who have not been unemployed for more than 90

  6  days thereafter and who, under the penalty of perjury, attest

  7  to the completion of such fingerprinting or background checks

  8  and to compliance with the provisions of this section and the

  9  standards contained in chapter 435 and this section, are not

10  required to be refingerprinted or rechecked in order to comply

11  with service provider personnel fingerprinting or background

12  check requirements.

13         (b)  Service provider owners, directors, or chief

14  financial officers who are not covered by paragraph (a) who

15  provide proof of compliance with the level-2 background

16  screening requirements which has been submitted within the

17  previous 5 years in compliance with any other state health

18  care licensure requirements are not required to be

19  refingerprinted or rechecked.

20         (4)(5)  EXEMPTIONS FROM DISQUALIFICATION.--

21         (a)  The department may grant to any service provider

22  personnel an exemption from disqualification from working with

23  children or the developmentally disabled as provided in s.

24  435.07.

25         (b)  Since rehabilitated substance abuse impaired

26  persons are effective in the successful treatment and

27  rehabilitation of substance abuse impaired adolescents, for

28  service providers which treat adolescents 13 years of age and

29  older, service provider personnel whose background checks

30  indicate crimes under s. 817.563, s. 893.13, or s.  893.147

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  1  may be exempted from disqualification from employment pursuant

  2  to this paragraph.

  3         (c)  The department may grant exemptions from

  4  disqualification which would limit service provider personnel

  5  to working with adults in substance-abuse-treatment

  6  facilities.

  7         (5)(6)  PAYMENT FOR PROCESSING OF FINGERPRINTS AND

  8  STATE CRIMINAL RECORDS CHECKS.--The employing service provider

  9  or the personnel who are having their backgrounds checked are

10  responsible for paying the costs of processing fingerprints

11  and criminal records checks.

12         (6)(7)  DISQUALIFICATION FROM RECEIVING STATE

13  FUNDS.--State funds may not be disseminated to any service

14  provider owned or operated by an owner, or director, or chief

15  financial officer who has been convicted of, has entered a

16  plea of guilty or nolo contendere to, or has had adjudication

17  withheld for, a violation of s. 893.135 pertaining to

18  trafficking in controlled substances, or a violation of the

19  law of another state, the District of Columbia, the United

20  States or any possession or territory thereof, or any foreign

21  jurisdiction which is substantially similar in elements and

22  penalties to a trafficking offense in this state, unless the

23  owner's or director's civil rights have been restored.

24         Section 7.  Paragraph (e) of subsection (5) of section

25  212.055, Florida Statutes, is amended to read:

26         212.055  Discretionary sales surtaxes; legislative

27  intent; authorization and use of proceeds.--It is the

28  legislative intent that any authorization for imposition of a

29  discretionary sales surtax shall be published in the Florida

30  Statutes as a subsection of this section, irrespective of the

31  duration of the levy.  Each enactment shall specify the types

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  1  of counties authorized to levy; the rate or rates which may be

  2  imposed; the maximum length of time the surtax may be imposed,

  3  if any; the procedure which must be followed to secure voter

  4  approval, if required; the purpose for which the proceeds may

  5  be expended; and such other requirements as the Legislature

  6  may provide.  Taxable transactions and administrative

  7  procedures shall be as provided in s. 212.054.

  8         (5)  COUNTY PUBLIC HOSPITAL SURTAX.--Any county as

  9  defined in s. 125.011(1) may levy the surtax authorized in

10  this subsection pursuant to an ordinance either approved by

11  extraordinary vote of the county commission or conditioned to

12  take effect only upon approval by a majority vote of the

13  electors of the county voting in a referendum.  In a county as

14  defined in s. 125.011(1), for the purposes of this subsection,

15  "county public general hospital" means a general hospital as

16  defined in s. 395.002 which is owned, operated, maintained, or

17  governed by the county or its agency, authority, or public

18  health trust.

19         (e)  A governing board, agency, or authority shall be

20  chartered by the county commission upon this act becoming law.

21  The governing board, agency, or authority shall adopt and

22  implement a health care plan for indigent health care

23  services.  The governing board, agency, or authority shall

24  consist of no more than seven and no fewer than five members

25  appointed by the county commission.  The members of the

26  governing board, agency, or authority shall be at least 18

27  years of age and residents of the county.  No member may be

28  employed by or affiliated with a health care provider or the

29  public health trust, agency, or authority responsible for the

30  county public general hospital. The following community

31  organizations shall each appoint a representative to a

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  1  nominating committee:  the South Florida Hospital and

  2  Healthcare Association, the Miami-Dade County Public Health

  3  Trust, the Dade County Medical Association, the Miami-Dade

  4  County Homeless Trust, and the Mayor of Miami-Dade County.

  5  This committee shall nominate between 10 and 14 county

  6  citizens for the governing board, agency, or authority.  The

  7  slate shall be presented to the county commission and the

  8  county commission shall confirm the top five to seven

  9  nominees, depending on the size of the governing board.  Until

10  such time as the governing board, agency, or authority is

11  created, the funds provided for in subparagraph (d)2. shall be

12  placed in a restricted account set aside from other county

13  funds and not disbursed by the county for any other purpose.

14         1.  The plan shall divide the county into a minimum of

15  four and maximum of six service areas, with no more than one

16  participant hospital per service area. The county public

17  general hospital shall be designated as the provider for one

18  of the service areas.  Services shall be provided through

19  participants' primary acute care facilities.

20         2.  The plan and subsequent amendments to it shall fund

21  a defined range of health care services for both indigent

22  persons and the medically poor, including primary care,

23  preventive care, hospital emergency room care, and hospital

24  care necessary to stabilize the patient. For the purposes of

25  this section, "stabilization" means stabilization as defined

26  in s. 397.311(29) s. 397.311(30). Where consistent with these

27  objectives, the plan may include services rendered by

28  physicians, clinics, community hospitals, and alternative

29  delivery sites, as well as at least one regional referral

30  hospital per service area. The plan shall provide that

31  agreements negotiated between the governing board, agency, or

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  1  authority and providers shall recognize hospitals that render

  2  a disproportionate share of indigent care, provide other

  3  incentives to promote the delivery of charity care to draw

  4  down federal funds where appropriate, and require cost

  5  containment, including, but not limited to, case management.

  6  From the funds specified in subparagraphs (d)1. and 2. for

  7  indigent health care services, service providers shall receive

  8  reimbursement at a Medicaid rate to be determined by the

  9  governing board, agency, or authority created pursuant to this

10  paragraph for the initial emergency room visit, and a

11  per-member per-month fee or capitation for those members

12  enrolled in their service area, as compensation for the

13  services rendered following the initial emergency visit.

14  Except for provisions of emergency services, upon

15  determination of eligibility, enrollment shall be deemed to

16  have occurred at the time services were rendered. The

17  provisions for specific reimbursement of emergency services

18  shall be repealed on July 1, 2001, unless otherwise reenacted

19  by the Legislature. The capitation amount or rate shall be

20  determined prior to program implementation by an independent

21  actuarial consultant. In no event shall such reimbursement

22  rates exceed the Medicaid rate. The plan must also provide

23  that any hospitals owned and operated by government entities

24  on or after the effective date of this act must, as a

25  condition of receiving funds under this subsection, afford

26  public access equal to that provided under s. 286.011 as to

27  any meeting of the governing board, agency, or authority the

28  subject of which is budgeting resources for the retention of

29  charity care, as that term is defined in the rules of the

30  Agency for Health Care Administration. The plan shall also

31  include innovative health care programs that provide

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  1  cost-effective alternatives to traditional methods of service

  2  and delivery funding.

  3         3.  The plan's benefits shall be made available to all

  4  county residents currently eligible to receive health care

  5  services as indigents or medically poor as defined in

  6  paragraph (4)(d).

  7         4.  Eligible residents who participate in the health

  8  care plan shall receive coverage for a period of 12 months or

  9  the period extending from the time of enrollment to the end of

10  the current fiscal year, per enrollment period, whichever is

11  less.

12         5.  At the end of each fiscal year, the governing

13  board, agency, or authority shall prepare an audit that

14  reviews the budget of the plan, delivery of services, and

15  quality of services, and makes recommendations to increase the

16  plan's efficiency.  The audit shall take into account

17  participant hospital satisfaction with the plan and assess the

18  amount of poststabilization patient transfers requested, and

19  accepted or denied, by the county public general hospital.

20         Section 8.  Paragraphs (d) and (g) of subsection (1) of

21  section 440.102, Florida Statutes, are amended to read:

22         440.102  Drug-free workplace program requirements.--The

23  following provisions apply to a drug-free workplace program

24  implemented pursuant to law or to rules adopted by the Agency

25  for Health Care Administration:

26         (1)  DEFINITIONS.--Except where the context otherwise

27  requires, as used in this act:

28         (d)  "Drug rehabilitation program" means a service

29  provider, established pursuant to s. 397.311(27) s.

30  397.311(28), that provides confidential, timely, and expert

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  1  identification, assessment, and resolution of employee drug

  2  abuse.

  3         (g)  "Employee assistance program" means an established

  4  program capable of providing expert assessment of employee

  5  personal concerns; confidential and timely identification

  6  services with regard to employee drug abuse; referrals of

  7  employees for appropriate diagnosis, treatment, and

  8  assistance; and followup services for employees who

  9  participate in the program or require monitoring after

10  returning to work. If, in addition to the above activities, an

11  employee assistance program provides diagnostic and treatment

12  services, these services shall in all cases be provided by

13  service providers pursuant to s. 397.311(27) s. 397.311(28).

14         Section 9.  This act shall take effect July 1, 2002.

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  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 682

  3

  4
    Clarifies the circumstances under which a substance abuse
  5  service provider with multiple locations would be licensed
    under chapter 397.
  6
    Specifies that the Department of Children and Family Services
  7  may grant exemptions from disqualification that would limit
    service provider personnel to working with adults in substance
  8  abuse treatment facilities.

  9  Requires that service provider personnel submit a request for
    exemption from disqualification within 30 days of being
10  notified of a pending disqualification so that this employee
    may not be adversely affected pending disposition of his or
11  her request.

12  Specifies that service providers operating under a regular
    annual license under chapter 397, F.S., will have 18 months
13  from the expiration date of their regular license to meet
    local zoning requirements.
14
    Specifies that applicants for a new license under chapter 397,
15  F.S., must demonstrate proof of compliance with zoning
    requirements prior to the department issuing a probationary
16  license.

17  Modifies the background screening requirement to specify that
    provider personnel who work with adults who are
18  developmentally disabled are subject to level 2 background
    screening under chapter 435, F.S.
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