Florida Senate - 2021              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 130
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance use
    3         disorders; amending s. 394.4573, F.S.; providing that
    4         the use of peer specialists is an essential element of
    5         a coordinated system of care in recovery from a
    6         substance use disorder or mental illness; making a
    7         technical change; amending s. 397.4073, F.S.; revising
    8         background screening requirements for certain peer
    9         specialists; revising authorizations relating to work
   10         by applicants who have committed disqualifying
   11         offenses; amending s. 397.417, F.S.; providing
   12         legislative findings and intent; revising requirements
   13         for certification as a peer specialist; requiring the
   14         Department of Children and Families to develop a
   15         training program for peer specialists and to give
   16         preference to trainers who are certified peer
   17         specialists; requiring the training program to
   18         coincide with a competency exam and to be based on
   19         current practice standards; requiring the department
   20         to certify peer specialists, either directly or by
   21         approving a third-party credentialing entity;
   22         prohibiting third-party credentialing entities from
   23         conducting background screenings for peer specialists;
   24         requiring that a person providing recovery support
   25         services be certified or be supervised by a licensed
   26         behavioral health care professional or a certified
   27         peer specialist; authorizing the department, a
   28         behavioral health managing entity, or the Medicaid
   29         program to reimburse a peer specialist service as a
   30         recovery service; encouraging Medicaid managed care
   31         plans to use peer specialists in providing recovery
   32         services; requiring peer specialists and certain
   33         persons to meet the requirements of a background
   34         screening as a condition of employment and continued
   35         employment; requiring certain entities to forward
   36         fingerprints to specified entities; requiring the
   37         department to screen results to determine if the peer
   38         specialist meets the certification requirements;
   39         requiring that fees for state and federal fingerprint
   40         processing be borne by the peer specialist applying
   41         for employment; requiring that any arrest record
   42         identified through background screening be reported to
   43         the department; authorizing the department or certain
   44         other agencies to contract with certain vendors for
   45         fingerprinting; specifying requirements for vendors;
   46         specifying disqualifying offenses for a peer
   47         specialist who applies for certification; authorizing
   48         a person who does not meet background screening
   49         requirements to request an exemption from
   50         disqualification from the department or the agency;
   51         providing that a peer specialist certified as of the
   52         effective date of this act is deemed to satisfy the
   53         requirements of this act; providing an effective date.
   55  Be It Enacted by the Legislature of the State of Florida:
   57         Section 1. Paragraph (l) of subsection (2) and subsection
   58  (3) of section 394.4573, Florida Statutes, are amended to read:
   59         394.4573 Coordinated system of care; annual assessment;
   60  essential elements; measures of performance; system improvement
   61  grants; reports.—On or before December 1 of each year, the
   62  department shall submit to the Governor, the President of the
   63  Senate, and the Speaker of the House of Representatives an
   64  assessment of the behavioral health services in this state. The
   65  assessment shall consider, at a minimum, the extent to which
   66  designated receiving systems function as no-wrong-door models,
   67  the availability of treatment and recovery services that use
   68  recovery-oriented and peer-involved approaches, the availability
   69  of less-restrictive services, and the use of evidence-informed
   70  practices. The assessment shall also consider the availability
   71  of and access to coordinated specialty care programs and
   72  identify any gaps in the availability of and access to such
   73  programs in the state. The department’s assessment shall
   74  consider, at a minimum, the needs assessments conducted by the
   75  managing entities pursuant to s. 394.9082(5). Beginning in 2017,
   76  the department shall compile and include in the report all plans
   77  submitted by managing entities pursuant to s. 394.9082(8) and
   78  the department’s evaluation of each plan.
   79         (2) The essential elements of a coordinated system of care
   80  include:
   81         (l) Recovery support, including, but not limited to, the
   82  use of peer specialists to assist in the individual’s recovery
   83  from a substance use disorder or mental illness; support for
   84  competitive employment, educational attainment, independent
   85  living skills development, family support and education,
   86  wellness management, and self-care;, and assistance in obtaining
   87  housing that meets the individual’s needs. Such housing may
   88  include mental health residential treatment facilities, limited
   89  mental health assisted living facilities, adult family care
   90  homes, and supportive housing. Housing provided using state
   91  funds must provide a safe and decent environment free from abuse
   92  and neglect.
   93         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
   94  appropriation by the Legislature, the department may award
   95  system improvement grants to managing entities based on a
   96  detailed plan to enhance services in accordance with the no
   97  wrong-door model as defined in subsection (1) and to address
   98  specific needs identified in the assessment prepared by the
   99  department pursuant to this section. Such a grant must be
  100  awarded through a performance-based contract that links payments
  101  to the documented and measurable achievement of system
  102  improvements.
  103         Section 2. Paragraphs (a) and (g) of subsection (1) of
  104  section 397.4073, Florida Statutes, are amended to read:
  105         397.4073 Background checks of service provider personnel.—
  108         (a) For all individuals screened on or after July 1, 2021
  109  2019, background checks shall apply as follows:
  110         1. All owners, directors, chief financial officers, and
  111  clinical supervisors of service providers are subject to level 2
  112  background screening as provided under s. 408.809 and chapter
  113  435. Inmate substance abuse programs operated directly or under
  114  contract with the Department of Corrections are exempt from this
  115  requirement.
  116         2. All service provider personnel who have direct contact
  117  with children receiving services or with adults who are
  118  developmentally disabled receiving services are subject to level
  119  2 background screening as provided under s. 408.809 and chapter
  120  435.
  121         3. All peer specialists who have direct contact with
  122  individuals receiving services are subject to a background
  123  screening as provided in s. 397.417(5) level 2 background
  124  screening as provided under s. 408.809 and chapter 435.
  125         (g) If 5 years or more, or 3 years or more in the case of a
  126  certified peer specialist or an individual seeking certification
  127  as a peer specialist pursuant to s. 397.417, have elapsed since
  128  an applicant for an exemption from disqualification has
  129  completed or has been lawfully released from confinement,
  130  supervision, or a nonmonetary condition imposed by a court for
  131  the applicant’s most recent disqualifying offense, the applicant
  132  may work with adults with substance use disorders, mental health
  133  disorders, or co-occurring disorders under the supervision of
  134  persons who meet all personnel requirements of this chapter for
  135  up to 180 90 days after being notified of his or her
  136  disqualification or until the department makes a final
  137  determination regarding his or her request for an exemption from
  138  disqualification, whichever is earlier.
  139         Section 3. Section 397.417, Florida Statutes, is amended to
  140  read:
  141         397.417 Peer specialists.—
  143         (a) The Legislature finds that:
  144         1. The ability to provide adequate behavioral health
  145  services is limited by a shortage of professionals and
  146  paraprofessionals.
  147         2. The state is experiencing an increase in opioid
  148  addictions, many of which prove fatal.
  149         3. Peer specialists provide effective support services
  150  because they share common life experiences with the persons they
  151  assist.
  152         4. Peer specialists promote a sense of community among
  153  those in recovery.
  154         5. Research has shown that peer support facilitates
  155  recovery and reduces health care costs.
  156         6. Persons who are otherwise qualified to serve as peer
  157  specialists may have a criminal history that prevents them from
  158  meeting background screening requirements.
  159         (b) The Legislature intends to expand the use of peer
  160  specialists as a cost-effective means of providing services. The
  161  Legislature also intends to ensure that peer specialists meet
  162  specified qualifications and modified background screening
  163  requirements and are adequately reimbursed for their services.
  164         (2) QUALIFICATIONS.—
  165         (a) A person may seek certification as a peer specialist if
  166  he or she has been in recovery from a substance use disorder or
  167  mental illness for the past 2 years or if he or she is a family
  168  member or caregiver of a person with a substance use disorder or
  169  mental illness.
  170         (b) To obtain certification as a peer specialist, a person
  171  must complete the training program developed under subsection
  172  (3), achieve a passing score on the competency exam described in
  173  paragraph (3)(a), and meet the background screening requirements
  174  specified in subsection (5).
  175         (3) DUTIES OF THE DEPARTMENT.—
  176         (a) The department shall develop a training program for
  177  persons seeking certification as peer specialists. The
  178  department must give preference to trainers who are certified
  179  peer specialists. The training program must coincide with a
  180  competency exam and be based on current practice standards.
  181         (b) The department may certify peer specialists directly or
  182  may approve one or more third-party credentialing entities for
  183  the purposes of certifying peer specialists, approving training
  184  programs for individuals seeking certification as peer
  185  specialists, approving continuing education programs, and
  186  establishing the minimum requirements and standards applicants
  187  must meet to maintain certification. Background screening
  188  required for achieving certification must be conducted as
  189  provided in subsection (5) and may not be conducted by third
  190  party credentialing entities.
  191         (c) The department shall require that a person providing
  192  recovery support services be certified; however, an individual
  193  who is not certified may provide recovery support services as a
  194  peer specialist for up to 1 year if he or she is working toward
  195  certification and is supervised by a qualified professional or
  196  by a certified peer specialist who has at least 2 years of full
  197  time experience as a peer specialist at a licensed behavioral
  198  health organization.
  199         (4) PAYMENT.—Recovery support services may be reimbursed as
  200  a recovery service through the department, a behavioral health
  201  managing entity, or the Medicaid program. Medicaid managed care
  202  plans are encouraged to use peer specialists in providing
  203  recovery services.
  204         (5) BACKGROUND SCREENING.—
  205         (a) A peer specialist, or an individual who is working
  206  toward certification and providing recovery support services as
  207  provided in subsection (3), must have completed or have been
  208  lawfully released from confinement, supervision, or any
  209  nonmonetary condition imposed by the court for any felony and
  210  must undergo a background screening as a condition of initial
  211  and continued employment. The applicant must submit a full set
  212  of fingerprints to the department or to a vendor, an entity, or
  213  an agency that enters into an agreement with the Department of
  214  Law Enforcement as provided in s. 943.053(13). The department,
  215  vendor, entity, or agency shall forward the fingerprints to the
  216  Department of Law Enforcement for state processing and the
  217  Department of Law Enforcement shall forward the fingerprints to
  218  the Federal Bureau of Investigation for national processing. The
  219  department shall screen the results to determine if a peer
  220  specialist meets certification requirements. The applicant is
  221  responsible for all fees charged in connection with state and
  222  federal fingerprint processing and retention. The state cost for
  223  fingerprint processing shall be as provided in s. 943.053(3)(e)
  224  for records provided to persons or entities other than those
  225  specified as exceptions therein. Fingerprints submitted to the
  226  Department of Law Enforcement pursuant to this paragraph shall
  227  be retained as provided in s. 435.12 and, when the Department of
  228  Law Enforcement begins participation in the program, enrolled in
  229  the Federal Bureau of Investigation’s national retained
  230  fingerprint arrest notification program, as provided in s.
  231  943.05(4). Any arrest record identified must be reported to the
  232  department.
  233         (b) The department or the Agency for Health Care
  234  Administration, as applicable, may contract with one or more
  235  vendors to perform all or part of the electronic fingerprinting
  236  pursuant to this section. Such contracts must ensure that the
  237  owners and personnel of the vendor performing the electronic
  238  fingerprinting are qualified and will ensure the integrity and
  239  security of all personal identifying information.
  240         (c) Vendors who submit fingerprints on behalf of employers
  241  must:
  242         1. Meet the requirements of s. 943.053; and
  243         2. Have the ability to communicate electronically with the
  244  state agency accepting screening results from the Department of
  245  Law Enforcement and provide the applicant’s full first name,
  246  middle initial, and last name; social security number or
  247  individual taxpayer identification number; date of birth;
  248  mailing address; sex; and race.
  249         (d) The background screening conducted under this
  250  subsection must ensure that a peer specialist has not, during
  251  the previous 3 years, been arrested for and is awaiting final
  252  disposition of, been found guilty of, regardless of
  253  adjudication, or entered a plea of nolo contendere or guilty to,
  254  or been adjudicated delinquent and the record has not been
  255  sealed or expunged for, any felony.
  256         (e) The background screening conducted under this
  257  subsection must ensure that a peer specialist has not been found
  258  guilty of, regardless of adjudication, or entered a plea of nolo
  259  contendere or guilty to, or been adjudicated delinquent and the
  260  record has not been sealed or expunged for, any offense
  261  prohibited under any of the following state laws or similar laws
  262  of another jurisdiction:
  263         1. Section 393.135, relating to sexual misconduct with
  264  certain developmentally disabled clients and reporting of such
  265  sexual misconduct.
  266         2. Section 394.4593, relating to sexual misconduct with
  267  certain mental health patients and reporting of such sexual
  268  misconduct.
  269         3. Section 409.920, relating to Medicaid provider fraud, if
  270  the offense was a felony of the first or second degree.
  271         4. Section 415.111, relating to abuse, neglect, or
  272  exploitation of vulnerable adults.
  273         5. Any offense that constitutes domestic violence as
  274  defined in s. 741.28.
  275         6. Section 777.04, relating to attempts, solicitation, and
  276  conspiracy to commit an offense listed in this paragraph.
  277         7. Section 782.04, relating to murder.
  278         8. Section 782.07, relating to manslaughter, aggravated
  279  manslaughter of an elderly person or a disabled adult,
  280  aggravated manslaughter of a child, or aggravated manslaughter
  281  of an officer, a firefighter, an emergency medical technician,
  282  or a paramedic.
  283         9. Section 782.071, relating to vehicular homicide.
  284         10. Section 782.09, relating to killing an unborn child by
  285  injury to the mother.
  286         11. Chapter 784, relating to assault, battery, and culpable
  287  negligence, if the offense was a felony.
  288         12. Section 787.01, relating to kidnapping.
  289         13. Section 787.02, relating to false imprisonment.
  290         14. Section 787.025, relating to luring or enticing a
  291  child.
  292         15. Section 787.04(2), relating to leading, taking,
  293  enticing, or removing a minor beyond state limits, or concealing
  294  the location of a minor, with criminal intent pending custody
  295  proceedings.
  296         16. Section 787.04(3), relating to leading, taking,
  297  enticing, or removing a minor beyond state limits, or concealing
  298  the location of a minor, with criminal intent pending dependency
  299  proceedings or proceedings concerning alleged abuse or neglect
  300  of a minor.
  301         17. Section 790.115(1), relating to exhibiting firearms or
  302  weapons within 1,000 feet of a school.
  303         18. Section 790.115(2)(b), relating to possessing an
  304  electric weapon or device, a destructive device, or any other
  305  weapon on school property.
  306         19. Section 794.011, relating to sexual battery.
  307         20. Former s. 794.041, relating to prohibited acts of
  308  persons in familial or custodial authority.
  309         21. Section 794.05, relating to unlawful sexual activity
  310  with certain minors.
  311         22. Section 794.08, relating to female genital mutilation.
  312         23.Section 796.07, relating to procuring another to commit
  313  prostitution, except for those offenses expunged pursuant to s.
  314  943.0583.
  315         24. Section 798.02, relating to lewd and lascivious
  316  behavior.
  317         25. Chapter 800, relating to lewdness and indecent
  318  exposure.
  319         26. Section 806.01, relating to arson.
  320         27. Section 810.02, relating to burglary, if the offense
  321  was a felony of the first degree.
  322         28. Section 810.14, relating to voyeurism, if the offense
  323  was a felony.
  324         29. Section 810.145, relating to video voyeurism, if the
  325  offense was a felony.
  326         30. Section 812.13, relating to robbery.
  327         31. Section 812.131, relating to robbery by sudden
  328  snatching.
  329         32. Section 812.133, relating to carjacking.
  330         33. Section 812.135, relating to home-invasion robbery.
  331         34. Section 817.034, relating to communications fraud, if
  332  the offense was a felony of the first degree.
  333         35. Section 817.234, relating to false and fraudulent
  334  insurance claims, if the offense was a felony of the first or
  335  second degree.
  336         36. Section 817.50, relating to fraudulently obtaining
  337  goods or services from a health care provider and false reports
  338  of a communicable disease.
  339         37. Section 817.505, relating to patient brokering.
  340         38. Section 817.568, relating to fraudulent use of personal
  341  identification, if the offense was a felony of the first or
  342  second degree.
  343         39. Section 825.102, relating to abuse, aggravated abuse,
  344  or neglect of an elderly person or a disabled adult.
  345         40. Section 825.1025, relating to lewd or lascivious
  346  offenses committed upon or in the presence of an elderly person
  347  or a disabled person.
  348         41. Section 825.103, relating to exploitation of an elderly
  349  person or a disabled adult, if the offense was a felony.
  350         42. Section 826.04, relating to incest.
  351         43. Section 827.03, relating to child abuse, aggravated
  352  child abuse, or neglect of a child.
  353         44. Section 827.04, relating to contributing to the
  354  delinquency or dependency of a child.
  355         45. Former s. 827.05, relating to negligent treatment of
  356  children.
  357         46. Section 827.071, relating to sexual performance by a
  358  child.
  359         47. Section 831.30, relating to fraud in obtaining
  360  medicinal drugs.
  361         48. Section 831.31, relating to sale, manufacture,
  362  delivery, possession with intent to sell, manufacture, or
  363  deliver of any counterfeit controlled substance, if the offense
  364  was a felony.
  365         49. Section 843.01, relating to resisting arrest with
  366  violence.
  367         50. Section 843.025, relating to depriving a law
  368  enforcement, correctional, or correctional probation officer of
  369  the means of protection or communication.
  370         51. Section 843.12, relating to aiding in an escape.
  371         52. Section 843.13, relating to aiding in the escape of
  372  juvenile inmates of correctional institutions.
  373         53. Chapter 847, relating to obscenity.
  374         54. Section 874.05, relating to encouraging or recruiting
  375  another to join a criminal gang.
  376         55. Chapter 893, relating to drug abuse prevention and
  377  control, if the offense was a felony of the second degree or
  378  greater severity.
  379         56. Section 895.03, relating to racketeering and collection
  380  of unlawful debts.
  381         57. Section 896.101, relating to the Florida Money
  382  Laundering Act.
  383         58. Section 916.1075, relating to sexual misconduct with
  384  certain forensic clients and reporting of such sexual
  385  misconduct.
  386         59. Section 944.35(3), relating to inflicting cruel or
  387  inhuman treatment on an inmate resulting in great bodily harm.
  388         60. Section 944.40, relating to escape.
  389         61. Section 944.46, relating to harboring, concealing, or
  390  aiding an escaped prisoner.
  391         62. Section 944.47, relating to introduction of contraband
  392  into a correctional institution.
  393         63. Section 985.701, relating to sexual misconduct in
  394  juvenile justice programs.
  395         64. Section 985.711, relating to introduction of contraband
  396  into a detention facility.
  397         (6) EXEMPTION REQUESTS.—A person who wishes to become a
  398  peer specialist and is disqualified under subsection (5) may
  399  request an exemption from disqualification pursuant to s. 435.07
  400  from the department or the Agency for Health Care
  401  Administration, as applicable.
  402         (7) GRANDFATHER CLAUSE.—A peer specialist certified as of
  403  the effective date of this act is deemed to satisfy the
  404  requirements of this act
  405         (1) An individual may seek certification as a peer
  406  specialist if he or she has been in recovery from a substance
  407  use disorder or mental illness for at least 2 years, or if he or
  408  she has at least 2 years of experience as a family member or
  409  caregiver of a person with a substance use disorder or mental
  410  illness.
  411         (2) The department shall approve one or more third-party
  412  credentialing entities for the purposes of certifying peer
  413  specialists, approving training programs for individuals seeking
  414  certification as peer specialists, approving continuing
  415  education programs, and establishing the minimum requirements
  416  and standards that applicants must achieve to maintain
  417  certification. To obtain approval, the third-party credentialing
  418  entity must demonstrate compliance with nationally recognized
  419  standards for developing and administering professional
  420  certification programs to certify peer specialists.
  421         (3) An individual providing department-funded recovery
  422  support services as a peer specialist shall be certified
  423  pursuant to subsection (2). An individual who is not certified
  424  may provide recovery support services as a peer specialist for
  425  up to 1 year if he or she is working toward certification and is
  426  supervised by a qualified professional or by a certified peer
  427  specialist who has at least 3 years of full-time experience as a
  428  peer specialist at a licensed behavioral health organization.
  429         Section 4. This act shall take effect July 1, 2021.