Florida Senate - 2021                                     SB 130
       
       
        
       By Senator Rouson
       
       
       
       
       
       19-00143-21                                            2021130__
    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; amending s. 397.417, F.S.; providing
   10         legislative findings and intent; revising requirements
   11         for certification as a peer specialist; requiring the
   12         Department of Children and Families to develop a
   13         training program for peer specialists and to give
   14         preference to trainers who are certified peer
   15         specialists; requiring the training program to
   16         coincide with a competency exam and to be based on
   17         current practice standards; requiring the department
   18         to certify peer specialists, either directly or by
   19         approving a third-party credentialing entity;
   20         requiring that a person providing recovery support
   21         services be certified or be supervised by a licensed
   22         behavioral health care professional or a certified
   23         peer specialist; authorizing the department, a
   24         behavioral health managing entity, or the Medicaid
   25         program to reimburse a peer specialist service as a
   26         recovery service; encouraging Medicaid managed care
   27         plans to use peer specialists in providing recovery
   28         services; requiring peer specialists and certain
   29         persons to meet the requirements of a background
   30         screening as a condition of employment and continued
   31         employment; requiring certain entities to forward
   32         fingerprints to specified entities; requiring that
   33         fees for state and federal fingerprint processing be
   34         borne by the peer specialist applying for employment;
   35         requiring that any arrest record identified through
   36         background screening be reported to the department;
   37         authorizing the department or certain other agencies
   38         to contract with certain vendors for fingerprinting;
   39         specifying requirements for vendors; specifying
   40         disqualifying offenses for a peer specialist who
   41         applies for certification; authorizing a person who
   42         does not meet background screening requirements to
   43         request an exemption from disqualification from the
   44         department or the agency; providing that a peer
   45         specialist certified as of the effective date of this
   46         act is deemed to satisfy the requirements of this act;
   47         providing an effective date.
   48          
   49  Be It Enacted by the Legislature of the State of Florida:
   50  
   51         Section 1. Paragraph (l) of subsection (2) and subsection
   52  (3) of section 394.4573, Florida Statutes, are amended to read:
   53         394.4573 Coordinated system of care; annual assessment;
   54  essential elements; measures of performance; system improvement
   55  grants; reports.—On or before December 1 of each year, the
   56  department shall submit to the Governor, the President of the
   57  Senate, and the Speaker of the House of Representatives an
   58  assessment of the behavioral health services in this state. The
   59  assessment shall consider, at a minimum, the extent to which
   60  designated receiving systems function as no-wrong-door models,
   61  the availability of treatment and recovery services that use
   62  recovery-oriented and peer-involved approaches, the availability
   63  of less-restrictive services, and the use of evidence-informed
   64  practices. The assessment shall also consider the availability
   65  of and access to coordinated specialty care programs and
   66  identify any gaps in the availability of and access to such
   67  programs in the state. The department’s assessment shall
   68  consider, at a minimum, the needs assessments conducted by the
   69  managing entities pursuant to s. 394.9082(5). Beginning in 2017,
   70  the department shall compile and include in the report all plans
   71  submitted by managing entities pursuant to s. 394.9082(8) and
   72  the department’s evaluation of each plan.
   73         (2) The essential elements of a coordinated system of care
   74  include:
   75         (l) Recovery support, including, but not limited to, the
   76  use of peer specialists to assist in the individual’s recovery
   77  from a substance use disorder or mental illness; support for
   78  competitive employment, educational attainment, independent
   79  living skills development, family support and education,
   80  wellness management, and self-care;, and assistance in obtaining
   81  housing that meets the individual’s needs. Such housing may
   82  include mental health residential treatment facilities, limited
   83  mental health assisted living facilities, adult family care
   84  homes, and supportive housing. Housing provided using state
   85  funds must provide a safe and decent environment free from abuse
   86  and neglect.
   87         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
   88  appropriation by the Legislature, the department may award
   89  system improvement grants to managing entities based on a
   90  detailed plan to enhance services in accordance with the no
   91  wrong-door model as defined in subsection (1) and to address
   92  specific needs identified in the assessment prepared by the
   93  department pursuant to this section. Such a grant must be
   94  awarded through a performance-based contract that links payments
   95  to the documented and measurable achievement of system
   96  improvements.
   97         Section 2. Paragraph (a) of subsection (1) of section
   98  397.4073, Florida Statutes, is amended to read:
   99         397.4073 Background checks of service provider personnel.—
  100         (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
  101  EXCEPTIONS.—
  102         (a) For all individuals screened on or after July 1, 2021
  103  2019, background checks shall apply as follows:
  104         1. All owners, directors, chief financial officers, and
  105  clinical supervisors of service providers are subject to level 2
  106  background screening as provided under s. 408.809 and chapter
  107  435. Inmate substance abuse programs operated directly or under
  108  contract with the Department of Corrections are exempt from this
  109  requirement.
  110         2. All service provider personnel who have direct contact
  111  with children receiving services or with adults who are
  112  developmentally disabled receiving services are subject to level
  113  2 background screening as provided under s. 408.809 and chapter
  114  435.
  115         3. All peer specialists who have direct contact with
  116  individuals receiving services are subject to a background
  117  screening as provided in s. 397.417(5) level 2 background
  118  screening as provided under s. 408.809 and chapter 435.
  119         Section 3. Section 397.417, Florida Statutes, is amended to
  120  read:
  121         397.417 Peer specialists.—
  122         (1) LEGISLATIVE FINDINGS AND INTENT.—
  123         (a) The Legislature finds that:
  124         1. The ability to provide adequate behavioral health
  125  services is limited by a shortage of professionals and
  126  paraprofessionals.
  127         2. The state is experiencing an increase in opioid
  128  addictions, many of which prove fatal.
  129         3. Peer specialists provide effective support services
  130  because they share common life experiences with the persons they
  131  assist.
  132         4. Peer specialists promote a sense of community among
  133  those in recovery.
  134         5. Research has shown that peer support facilitates
  135  recovery and reduces health care costs.
  136         6. Persons who are otherwise qualified to serve as peer
  137  specialists may have a criminal history that prevents them from
  138  meeting background screening requirements.
  139         (b) The Legislature intends to expand the use of peer
  140  specialists as a cost-effective means of providing services. The
  141  Legislature also intends to ensure that peer specialists meet
  142  specified qualifications and modified background screening
  143  requirements and are adequately reimbursed for their services.
  144         (2) QUALIFICATIONS.—
  145         (a) A person may seek certification as a peer specialist if
  146  he or she has been in recovery from a substance use disorder or
  147  mental illness for the past 2 years or if he or she is a family
  148  member or caregiver of a person with a substance use disorder or
  149  mental illness.
  150         (b) To obtain certification as a peer specialist, a person
  151  must complete the training program developed under subsection
  152  (3), achieve a passing score on the competency exam described in
  153  paragraph (3)(a), and meet the background screening requirements
  154  specified in subsection (5).
  155         (3) DUTIES OF THE DEPARTMENT.—
  156         (a) The department shall develop a training program for
  157  persons seeking certification as peer specialists. The
  158  department must give preference to trainers who are certified
  159  peer specialists. The training program must coincide with a
  160  competency exam and be based on current practice standards.
  161         (b) The department may certify peer specialists directly or
  162  may approve one or more third-party credentialing entities for
  163  the purposes of certifying peer specialists, approving training
  164  programs for individuals seeking certification as peer
  165  specialists, approving continuing education programs, and
  166  establishing the minimum requirements and standards applicants
  167  must meet to maintain certification.
  168         (c) The department shall require that a person providing
  169  recovery support services be certified; however, an individual
  170  who is not certified may provide recovery support services as a
  171  peer specialist for up to 1 year if he or she is working toward
  172  certification and is supervised by a qualified professional or
  173  by a certified peer specialist who has at least 2 years of full
  174  time experience as a peer specialist at a licensed behavioral
  175  health organization.
  176         (4) PAYMENT.—Recovery support services may be reimbursed as
  177  a recovery service through the department, a behavioral health
  178  managing entity, or the Medicaid program. Medicaid managed care
  179  plans are encouraged to use peer specialists in providing
  180  recovery services.
  181         (5) BACKGROUND SCREENING.—
  182         (a) A peer specialist, or an individual who is working
  183  toward certification and providing recovery support services as
  184  provided in subsection (3), must have completed or have been
  185  lawfully released from confinement, supervision, or any
  186  nonmonetary condition imposed by the court for any felony and
  187  must undergo a background screening as a condition of initial
  188  and continued employment. The applicant must submit a full set
  189  of fingerprints to the department or to a vendor, an entity, or
  190  an agency that enters into an agreement with the Department of
  191  Law Enforcement as provided in s. 943.053(13). The department,
  192  vendor, entity, or agency shall forward the fingerprints to the
  193  Department of Law Enforcement for state processing and the
  194  Department of Law Enforcement shall forward the fingerprints to
  195  the Federal Bureau of Investigation for national processing. The
  196  applicant is responsible for all fees charged in connection with
  197  state and federal fingerprint processing and retention. The
  198  state cost for fingerprint processing shall be as provided in s.
  199  943.053(3)(e) for records provided to persons or entities other
  200  than those specified as exceptions therein. Fingerprints
  201  submitted to the Department of Law Enforcement pursuant to this
  202  paragraph shall be retained as provided in s. 435.12 and, when
  203  the Department of Law Enforcement begins participation in the
  204  program, enrolled in the Federal Bureau of Investigation’s
  205  national retained fingerprint arrest notification program, as
  206  provided in s. 943.05(4). Any arrest record identified must be
  207  reported to the department.
  208         (b) The department or the Agency for Health Care
  209  Administration, as applicable, may contract with one or more
  210  vendors to perform all or part of the electronic fingerprinting
  211  pursuant to this section. Such contracts must ensure that the
  212  owners and personnel of the vendor performing the electronic
  213  fingerprinting are qualified and will ensure the integrity and
  214  security of all personal identifying information.
  215         (c) Vendors who submit fingerprints on behalf of employers
  216  must:
  217         1. Meet the requirements of s. 943.053; and
  218         2. Have the ability to communicate electronically with the
  219  department or the Agency for Health Care Administration, as
  220  applicable, and to accept screening results from the Department
  221  of Law Enforcement and provide the applicant’s full first name,
  222  middle initial, and last name; social security number or
  223  individual taxpayer identification number; date of birth;
  224  mailing address; sex; and race.
  225         (d) The background screening conducted under this
  226  subsection must ensure that a peer specialist has not, during
  227  the previous 3 years, been arrested for and is awaiting final
  228  disposition of, been found guilty of, regardless of
  229  adjudication, or entered a plea of nolo contendere or guilty to,
  230  or been adjudicated delinquent and the record has not been
  231  sealed or expunged for, any felony.
  232         (e) The background screening conducted under this
  233  subsection must ensure that a peer specialist has not been found
  234  guilty of, regardless of adjudication, or entered a plea of nolo
  235  contendere or guilty to, or been adjudicated delinquent and the
  236  record has not been sealed or expunged for, any offense
  237  prohibited under any of the following state laws or similar laws
  238  of another jurisdiction:
  239         1. Section 393.135, relating to sexual misconduct with
  240  certain developmentally disabled clients and reporting of such
  241  sexual misconduct.
  242         2. Section 394.4593, relating to sexual misconduct with
  243  certain mental health patients and reporting of such sexual
  244  misconduct.
  245         3. Section 409.920, relating to Medicaid provider fraud, if
  246  the offense was a felony of the first or second degree.
  247         4. Section 415.111, relating to abuse, neglect, or
  248  exploitation of vulnerable adults.
  249         5. Section 741.28, relating to domestic violence.
  250         6. Section 777.04, relating to attempts, solicitation, and
  251  conspiracy to commit an offense listed in this paragraph.
  252         7. Section 782.04, relating to murder.
  253         8. Section 782.07, relating to manslaughter, aggravated
  254  manslaughter of an elderly person or a disabled adult,
  255  aggravated manslaughter of a child, or aggravated manslaughter
  256  of an officer, a firefighter, an emergency medical technician,
  257  or a paramedic.
  258         9. Section 782.071, relating to vehicular homicide.
  259         10. Section 782.09, relating to killing an unborn child by
  260  injury to the mother.
  261         11. Chapter 784, relating to assault, battery, and culpable
  262  negligence, if the offense was a felony.
  263         12. Section 787.01, relating to kidnapping.
  264         13. Section 787.02, relating to false imprisonment.
  265         14. Section 787.025, relating to luring or enticing a
  266  child.
  267         15. Section 787.04(2), relating to leading, taking,
  268  enticing, or removing a minor beyond state limits, or concealing
  269  the location of a minor, with criminal intent pending custody
  270  proceedings.
  271         16. Section 787.04(3), relating to leading, taking,
  272  enticing, or removing a minor beyond state limits, or concealing
  273  the location of a minor, with criminal intent pending dependency
  274  proceedings or proceedings concerning alleged abuse or neglect
  275  of a minor.
  276         17. Section 790.115(1), relating to exhibiting firearms or
  277  weapons within 1,000 feet of a school.
  278         18. Section 790.115(2)(b), relating to possessing an
  279  electric weapon or device, a destructive device, or any other
  280  weapon on school property.
  281         19. Section 794.011, relating to sexual battery.
  282         20. Former s. 794.041, relating to prohibited acts of
  283  persons in familial or custodial authority.
  284         21. Section 794.05, relating to unlawful sexual activity
  285  with certain minors.
  286         22. Section 794.08, relating to female genital mutilation.
  287         23.Section 796.07, relating to procuring another to commit
  288  prostitution, except for those offenses expunged pursuant to s.
  289  943.0583.
  290         24. Section 798.02, relating to lewd and lascivious
  291  behavior.
  292         25. Chapter 800, relating to lewdness and indecent
  293  exposure.
  294         26. Section 806.01, relating to arson.
  295         27. Section 810.02, relating to burglary, if the offense
  296  was a felony of the first degree.
  297         28. Section 810.14, relating to voyeurism, if the offense
  298  was a felony.
  299         29. Section 810.145, relating to video voyeurism, if the
  300  offense was a felony.
  301         30. Section 812.13, relating to robbery.
  302         31. Section 812.131, relating to robbery by sudden
  303  snatching.
  304         32. Section 812.133, relating to carjacking.
  305         33. Section 812.135, relating to home-invasion robbery.
  306         34. Section 817.034, relating to communications fraud, if
  307  the offense was a felony of the first degree.
  308         35. Section 817.234, relating to false and fraudulent
  309  insurance claims, if the offense was a felony of the first or
  310  second degree.
  311         36. Section 817.50, relating to fraudulently obtaining
  312  goods or services from a health care provider and false reports
  313  of a communicable disease.
  314         37. Section 817.505, relating to patient brokering.
  315         38. Section 817.568, relating to fraudulent use of personal
  316  identification, if the offense was a felony of the first or
  317  second degree.
  318         39. Section 825.102, relating to abuse, aggravated abuse,
  319  or neglect of an elderly person or a disabled adult.
  320         40. Section 825.1025, relating to lewd or lascivious
  321  offenses committed upon or in the presence of an elderly person
  322  or a disabled person.
  323         41. Section 825.103, relating to exploitation of an elderly
  324  person or a disabled adult, if the offense was a felony.
  325         42. Section 826.04, relating to incest.
  326         43. Section 827.03, relating to child abuse, aggravated
  327  child abuse, or neglect of a child.
  328         44. Section 827.04, relating to contributing to the
  329  delinquency or dependency of a child.
  330         45. Former s. 827.05, relating to negligent treatment of
  331  children.
  332         46. Section 827.071, relating to sexual performance by a
  333  child.
  334         47. Section 831.30, relating to fraud in obtaining
  335  medicinal drugs.
  336         48. Section 831.31, relating to sale, manufacture,
  337  delivery, possession with intent to sell, manufacture, or
  338  deliver of any counterfeit controlled substance, if the offense
  339  was a felony.
  340         49. Section 843.01, relating to resisting arrest with
  341  violence.
  342         50. Section 843.025, relating to depriving a law
  343  enforcement, correctional, or correctional probation officer of
  344  the means of protection or communication.
  345         51. Section 843.12, relating to aiding in an escape.
  346         52. Section 843.13, relating to aiding in the escape of
  347  juvenile inmates of correctional institutions.
  348         53. Chapter 847, relating to obscenity.
  349         54. Section 874.05, relating to encouraging or recruiting
  350  another to join a criminal gang.
  351         55. Chapter 893, relating to drug abuse prevention and
  352  control, if the offense was a felony of the second degree or
  353  greater severity.
  354         56. Section 895.03, relating to racketeering and collection
  355  of unlawful debts.
  356         57. Section 896.101, relating to the Florida Money
  357  Laundering Act.
  358         58. Section 916.1075, relating to sexual misconduct with
  359  certain forensic clients and reporting of such sexual
  360  misconduct.
  361         59. Section 944.35(3), relating to inflicting cruel or
  362  inhuman treatment on an inmate resulting in great bodily harm.
  363         60. Section 944.40, relating to escape.
  364         61. Section 944.46, relating to harboring, concealing, or
  365  aiding an escaped prisoner.
  366         62. Section 944.47, relating to introduction of contraband
  367  into a correctional institution.
  368         63. Section 985.701, relating to sexual misconduct in
  369  juvenile justice programs.
  370         64. Section 985.711, relating to introduction of contraband
  371  into a detention facility.
  372         (6) EXEMPTION REQUESTS.—A person who wishes to become a
  373  peer specialist and is disqualified under subsection (5) may
  374  request an exemption from disqualification pursuant to s. 435.07
  375  from the department or the Agency for Health Care
  376  Administration, as applicable.
  377         (7) GRANDFATHER CLAUSE.—A peer specialist certified as of
  378  the effective date of this act is deemed to satisfy the
  379  requirements of this act
  380         (1) An individual may seek certification as a peer
  381  specialist if he or she has been in recovery from a substance
  382  use disorder or mental illness for at least 2 years, or if he or
  383  she has at least 2 years of experience as a family member or
  384  caregiver of a person with a substance use disorder or mental
  385  illness.
  386         (2) The department shall approve one or more third-party
  387  credentialing entities for the purposes of certifying peer
  388  specialists, approving training programs for individuals seeking
  389  certification as peer specialists, approving continuing
  390  education programs, and establishing the minimum requirements
  391  and standards that applicants must achieve to maintain
  392  certification. To obtain approval, the third-party credentialing
  393  entity must demonstrate compliance with nationally recognized
  394  standards for developing and administering professional
  395  certification programs to certify peer specialists.
  396         (3) An individual providing department-funded recovery
  397  support services as a peer specialist shall be certified
  398  pursuant to subsection (2). An individual who is not certified
  399  may provide recovery support services as a peer specialist for
  400  up to 1 year if he or she is working toward certification and is
  401  supervised by a qualified professional or by a certified peer
  402  specialist who has at least 3 years of full-time experience as a
  403  peer specialist at a licensed behavioral health organization.
  404         Section 4. This act shall take effect July 1, 2021.