Bill Text: FL S0528 | 2019 | Regular Session | Comm Sub

Bill Title: Mental Health and Substance Use Disorders

Spectrum: Bipartisan Bill

Status: (Failed) 2019-05-03 - Died in Appropriations, companion bill(s) passed, see CS/CS/HB 369 (Ch. 2019-159) [S0528 Detail]

Download: Florida-2019-S0528-Comm_Sub.html
       Florida Senate - 2019                              CS for SB 528
       By the Committee on Children, Families, and Elder Affairs; and
       Senator Rouson
       586-02488-19                                           2019528c1
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance use
    3         disorders; amending s. 394.455, F.S.; defining the
    4         term “peer specialist”; amending s. 394.4572, F.S.;
    5         requiring a specific level of screening for peer
    6         specialists working in mental health programs and
    7         facilities; amending s. 394.4573, F.S.; specifying
    8         that the use of peer specialists for recovery support
    9         is an essential element of a coordinated system of
   10         behavioral health care; amending s. 397.311, F.S.;
   11         defining the term “peer specialist”; amending s.
   12         397.4073, F.S.; conforming provisions to changes made
   13         by the act; creating s. 397.417, F.S.; providing
   14         legislative findings and intent; authorizing a person
   15         to seek certification as a peer specialist if he or
   16         she meets specified qualifications; requiring a
   17         background screening, completion of a training
   18         program, and a passing score on a competency exam for
   19         a qualified person to obtain certification as a peer
   20         specialist; requiring the Department of Children and
   21         Families to develop a training program for peer
   22         specialists and to give preference to trainers who are
   23         certified peer specialists; requiring the training
   24         program to coincide with a competency exam and to be
   25         based on current practice standards; requiring the
   26         department to certify peer specialists directly or by
   27         designating a nonprofit certification organization;
   28         requiring that a person providing peer specialist
   29         services be certified or supervised by a licensed
   30         behavioral health care professional or a certified
   31         peer specialist; authorizing the department, a
   32         behavioral health managing entity, or the Medicaid
   33         program to reimburse a peer specialist service as a
   34         recovery service; encouraging Medicaid managed care
   35         plans to use peer specialists in providing recovery
   36         services; requiring peer specialists to meet the
   37         requirements of a background screening as a condition
   38         of employment and continued employment; requiring the
   39         department to forward fingerprints to the Department
   40         of Law Enforcement; requiring that fees for state and
   41         federal fingerprint processing be borne by the peer
   42         specialist applying for employment; providing that any
   43         arrest record identified through background screening
   44         be forwarded to the department; authorizing the
   45         Department of Children and Families or the agency to
   46         contract with certain vendors for fingerprinting;
   47         specifying requirements for vendors; specifying
   48         offenses to be considered in the background screening
   49         of a peer specialist; authorizing a person who does
   50         not meet background screening requirements to request
   51         an exemption from disqualification from the department
   52         or the agency; providing that all peer specialists
   53         certified as of the effective date of this act are
   54         recognized as having met the requirements of this act;
   55         amending s. 397.487, F.S.; revising legislative
   56         findings relating to voluntary certification of
   57         recovery residences; requiring recovery residences to
   58         comply with specified Florida Fire Prevention Code
   59         provisions; revising background screening requirements
   60         for owners, directors, and chief financial officers of
   61         recovery residences; amending s. 397.4873, F.S.;
   62         providing exceptions to limitations on referrals by
   63         recovery residences to licensed service providers;
   64         prohibiting recovery residences and specified
   65         affiliated individuals from benefiting from certain
   66         referrals; amending s. 435.07, F.S.; authorizing the
   67         exemption of certain persons from disqualification
   68         from employment; amending ss. 212.055, 394.495,
   69         394.496, 394.9085, 397.416, 409.972, 440.102, 464.012,
   70         and 744.2007, F.S.; conforming cross-references;
   71         making technical changes; providing an effective date.
   73  Be It Enacted by the Legislature of the State of Florida:
   75         Section 1. Present subsections (32) through (48) of section
   76  394.455, Florida Statutes, are redesignated as subsections (33)
   77  through (49), respectively, and a new subsection (32) is added
   78  to that section, to read:
   79         394.455 Definitions.—As used in this part, the term:
   80         (32) “Peer specialist” means a person who has been in
   81  recovery from a substance use disorder or mental illness for the
   82  past 2 years or a family member or caregiver of a person with a
   83  substance use disorder or mental illness and who is certified
   84  under s. 397.417.
   85         Section 2. Paragraph (a) of subsection (1) of section
   86  394.4572, Florida Statutes, is amended to read:
   87         394.4572 Screening of mental health personnel.—
   88         (1)(a) The department and the Agency for Health Care
   89  Administration shall require level 2 background screening
   90  pursuant to chapter 435 for mental health personnel. “Mental
   91  health personnel” includes all program directors, professional
   92  clinicians, staff members, and volunteers working in public or
   93  private mental health programs and facilities who have direct
   94  contact with individuals held for examination or admitted for
   95  mental health treatment. For purposes of this chapter,
   96  employment screening of mental health personnel also includes,
   97  but is not limited to, employment screening as provided under
   98  chapter 435 and s. 408.809. The department and the Agency for
   99  Health Care Administration shall require a level 2 background
  100  screening pursuant to s. 397.417(5) for persons working as peer
  101  specialists in public or private mental health programs or
  102  facilities and who have direct contact with individuals held for
  103  involuntary examination or admitted for mental health treatment.
  104         Section 3. Paragraph (l) of subsection (2) of section
  105  394.4573, Florida Statutes, is amended to read:
  106         394.4573 Coordinated system of care; annual assessment;
  107  essential elements; measures of performance; system improvement
  108  grants; reports.—On or before December 1 of each year, the
  109  department shall submit to the Governor, the President of the
  110  Senate, and the Speaker of the House of Representatives an
  111  assessment of the behavioral health services in this state. The
  112  assessment shall consider, at a minimum, the extent to which
  113  designated receiving systems function as no-wrong-door models,
  114  the availability of treatment and recovery services that use
  115  recovery-oriented and peer-involved approaches, the availability
  116  of less-restrictive services, and the use of evidence-informed
  117  practices. The department’s assessment shall consider, at a
  118  minimum, the needs assessments conducted by the managing
  119  entities pursuant to s. 394.9082(5). Beginning in 2017, the
  120  department shall compile and include in the report all plans
  121  submitted by managing entities pursuant to s. 394.9082(8) and
  122  the department’s evaluation of each plan.
  123         (2) The essential elements of a coordinated system of care
  124  include:
  125         (l) Recovery support, including, but not limited to, the
  126  use of peer specialists as described in s. 397.417 to assist in
  127  the individual’s recovery from a substance use disorder or
  128  mental illness, support for competitive employment, educational
  129  attainment, independent living skills development, family
  130  support and education, wellness management and self-care, and
  131  assistance in obtaining housing that meets the individual’s
  132  needs. Such housing may include mental health residential
  133  treatment facilities, limited mental health assisted living
  134  facilities, adult family care homes, and supportive housing.
  135  Housing provided using state funds must provide a safe and
  136  decent environment free from abuse and neglect.
  137         Section 4. Present subsections (30) through (49) of section
  138  397.311, Florida Statutes, are redesignated as subsections (31)
  139  through (50), respectively, and a new subsection (30) is added
  140  to that section, to read:
  141         397.311 Definitions.—As used in this chapter, except part
  142  VIII, the term:
  143         (30) Peer specialist” means a person who has been in
  144  recovery from a substance use disorder or mental illness for the
  145  past 2 years or a family member or caregiver of a person with a
  146  substance use disorder or mental illness and who is certified
  147  under s. 397.417.
  148         Section 5. Paragraph (f) of subsection (1) and paragraphs
  149  (b) and (c) of subsection (4) of section 397.4073, Florida
  150  Statutes, are amended to read:
  151         397.4073 Background checks of service provider personnel.—
  154         (f) Service provider personnel who request an exemption
  155  from disqualification must submit the request within 30 days
  156  after being notified of the disqualification. If 5 years or more
  157  have elapsed since the most recent disqualifying offense,
  158  service provider personnel may work with adults with mental
  159  health or substance use disorders or co-occurring disorders
  160  under the supervision of a qualified professional licensed under
  161  chapter 490 or chapter 491 or a master’s-level-certified
  162  addictions professional until the agency makes a final
  163  determination regarding the request for an exemption from
  164  disqualification.
  166         (b) Since rehabilitated substance abuse impaired persons
  167  are effective in the successful treatment and rehabilitation of
  168  individuals with substance use disorders, for service providers
  169  which treat adolescents 13 years of age and older, service
  170  provider personnel whose background checks indicate crimes under
  171  s. 817.563, s. 893.13, or s. 893.147 may be exempted from
  172  disqualification from employment pursuant to this paragraph.
  173         (c) The department may grant exemptions from
  174  disqualification which would limit service provider personnel to
  175  working with adults in substance use disorder abuse treatment
  176  facilities.
  177         Section 6. Section 397.417, Florida Statutes, is created to
  178  read:
  179         397.417 Behavioral health peer specialists.—
  181         (a) The Legislature finds that:
  182         1. The ability to provide adequate behavioral health
  183  services is limited by a shortage of professionals and
  184  paraprofessionals.
  185         2. The state is experiencing an increase in opioid
  186  addictions, which prove fatal to persons in many cases.
  187         3. Peer specialists provide effective support services
  188  because they share common life experiences with the persons they
  189  assist.
  190         4. Peer specialists promote a sense of community among
  191  those in recovery.
  192         5. Research has shown that peer support facilitates
  193  recovery and reduces health care costs.
  194         6. Peer specialists may have a criminal history that
  195  prevents them from meeting background screening requirements.
  196         (b) The Legislature intends to expand the use of peer
  197  specialists as a cost-effective means of providing services by
  198  ensuring that peer specialists meet specified qualifications,
  199  meet modified background screening requirements, and are
  200  adequately reimbursed for their services.
  201         (2) QUALIFICATIONS.—
  202         (a) A person may seek certification as a peer specialist if
  203  he or she has been in recovery from a substance use disorder or
  204  mental illness for the past 2 years or if he or she is a family
  205  member or caregiver of a person with a substance use disorder or
  206  mental illness.
  207         (b) To obtain certification as a peer specialist, a person
  208  must meet the background screening requirements of subsection
  209  (5), complete the training program, and achieve a passing score
  210  on the competency exam described in paragraph (3)(a).
  211         (3) DUTIES OF THE DEPARTMENT.—
  212         (a) The department shall develop a training program for
  213  persons seeking certification as peer specialists. The
  214  department must give preference to trainers who are certified
  215  peer specialists. The training program must coincide with a
  216  competency exam and be based on current practice standards.
  217         (b) The department shall certify peer specialists. The
  218  department may certify peer specialists directly or may
  219  designate a private, nonprofit certification organization to
  220  certify peer specialists, implement the training program, and
  221  administer the competency exam.
  222         (c) The department must require that a person providing
  223  peer specialist services be certified or be supervised by a
  224  licensed behavioral health care professional or a certified peer
  225  specialist.
  226         (4) PAYMENT.—Peer specialist services may be reimbursed as
  227  a recovery service through the department, a behavioral health
  228  managing entity, or the Medicaid program. Medicaid managed care
  229  plans are encouraged to use peer specialists in providing
  230  recovery services.
  231         (5) BACKGROUND SCREENING.—
  232         (a) A peer specialist must have completed or have been
  233  lawfully released from confinement, supervision, or any
  234  nonmonetary condition imposed by the court for any felony and
  235  must undergo a background screening as a condition of employment
  236  and continued employment. The applicant must submit a full set
  237  of fingerprints to the department or to a vendor, entity, or
  238  agency authorized by s. 943.053(13). The department, vendor,
  239  entity, or agency shall forward the fingerprints to the
  240  Department of Law Enforcement for state processing and the
  241  Department of Law Enforcement shall forward the fingerprints to
  242  the Federal Bureau of Investigation for national processing.
  243  Fees for state and federal fingerprint processing and retention
  244  shall be borne by the applicant. The state cost for fingerprint
  245  processing shall be as provided in s. 943.053(3)(e) for records
  246  provided to persons or entities other than those specified as
  247  exceptions therein. Fingerprints submitted to the Department of
  248  Law Enforcement pursuant to this paragraph shall be retained as
  249  provided by s. 435.12 and, when the Department of Law
  250  Enforcement begins participation in the program, enrolled in the
  251  Federal Bureau of Investigation’s national retained fingerprint
  252  arrest notification program, as provided in s. 943.05(4). Any
  253  arrest record identified shall be reported to the department.
  254         (c) The department or the Agency for Health Care
  255  Administration, as applicable, may contract with one or more
  256  vendors to perform all or part of the electronic fingerprinting
  257  pursuant to this section. Such contracts must ensure that the
  258  owners and personnel of the vendor performing the electronic
  259  fingerprinting are qualified and will ensure the integrity and
  260  security of all personal identifying information.
  261         (d) Vendors who submit fingerprints on behalf of employers
  262  must:
  263         1. Meet the requirements of s. 943.053; and
  264         2. Have the ability to communicate electronically with the
  265  department or the Agency for Health Care Administration, as
  266  applicable, and to accept screening results from the Department
  267  of Law Enforcement and provide the applicant’s full first name,
  268  middle initial, and last name; social security number or
  269  individual taxpayer identification number; date of birth;
  270  mailing address; sex; and race.
  271         (e) The background screening under this section must ensure
  272  that a peer specialist has not, during the previous 3 years,
  273  been arrested for and is awaiting final disposition of, been
  274  found guilty of, regardless of adjudication, or entered a plea
  275  of nolo contendere or guilty to, or been adjudicated delinquent
  276  and the record has not been sealed or expunged for, any felony.
  277         (f) The background screening under this section must ensure
  278  that a peer specialist has not been found guilty of, regardless
  279  of adjudication, or entered a plea of nolo contendere or guilty
  280  to, or been adjudicated delinquent and the record has not been
  281  sealed or expunged for, any offense prohibited under any of the
  282  following state laws or similar laws of another jurisdiction:
  283         1. Section 393.135, relating to sexual misconduct with
  284  certain developmentally disabled clients and reporting of such
  285  sexual misconduct.
  286         2. Section 394.4593, relating to sexual misconduct with
  287  certain mental health patients and reporting of such sexual
  288  misconduct.
  289         3. Section 409.9201, relating to Medicaid fraud.
  290         4. Section 415.111, relating to adult abuse, neglect, or
  291  exploitation of aged persons or disabled adults.
  292         5.Section 741.28, relating to domestic violence.
  293         6. Section 777.04, relating to attempts, solicitation, and
  294  conspiracy to commit an offense listed in this section.
  295         7. Section 782.04, relating to murder.
  296         8. Section 782.07, relating to manslaughter, aggravated
  297  manslaughter of an elderly person or disabled adult, aggravated
  298  manslaughter of a child, or aggravated manslaughter of an
  299  officer, a firefighter, an emergency medical technician, or a
  300  paramedic.
  301         9. Section 782.071, relating to vehicular homicide.
  302         10. Section 782.09, relating to killing of an unborn child
  303  by injury to the mother.
  304         11. Chapter 784, relating to assault, battery, and culpable
  305  negligence, if the offense was a felony.
  306         12. Section 787.01, relating to kidnapping.
  307         13. Section 787.02, relating to false imprisonment.
  308         14. Section 787.025, relating to luring or enticing a
  309  child.
  310         15. Section 787.04(2), relating to leading, taking,
  311  enticing, or removing a minor beyond the state limits, or
  312  concealing the location of a minor, with criminal intent pending
  313  custody proceedings.
  314         16. Section 787.04(3), relating to leading, taking,
  315  enticing, or removing a minor beyond the state limits, or
  316  concealing the location of a minor, with criminal intent pending
  317  dependency proceedings or proceedings concerning alleged abuse
  318  or neglect of a minor.
  319         17. Section 790.115(1), relating to exhibiting firearms or
  320  weapons within 1,000 feet of a school.
  321         18. Section 790.115(2)(b), relating to possessing an
  322  electric weapon or device, destructive device, or other weapon
  323  on school property.
  324         19. Section 794.011, relating to sexual battery.
  325         20.Former s. 794.041, relating to prohibited acts of
  326  persons in familial or custodial authority.
  327         21. Section 794.05, relating to unlawful sexual activity
  328  with certain minors.
  329         22. Section 794.08, relating to female genital mutilation.
  330         23. Section 798.02, relating to lewd and lascivious
  331  behavior.
  332         24. Chapter 800, relating to lewdness and indecent
  333  exposure.
  334         25. Section 806.01, relating to arson.
  335         26. Section 810.02, relating to burglary, if the offense
  336  was a felony of the first degree.
  337         27. Section 810.14, relating to voyeurism, if the offense
  338  was a felony.
  339         28. Section 810.145, relating to video voyeurism, if the
  340  offense was a felony.
  341         29. Section 812.13, relating to robbery.
  342         30. Section 812.131, relating to robbery by sudden
  343  snatching.
  344         31. Section 812.133, relating to carjacking.
  345         32. Section 812.135, relating to home-invasion robbery.
  346         33.Section 817.50, relating to fraudulently obtaining
  347  goods or services from a health care provider and false reports
  348  of a communicable disease.
  349         34. Section 817.505, relating to patient brokering.
  350         35. Section 825.102, relating to abuse, aggravated abuse,
  351  or neglect of an elderly person or disabled adult.
  352         36. Section 825.1025, relating to lewd or lascivious
  353  offenses committed upon or in the presence of an elderly person
  354  or disabled person.
  355         37. Section 825.103, relating to exploitation of an elderly
  356  person or disabled adult, if the offense was a felony.
  357         38. Section 826.04, relating to incest.
  358         39. Section 827.03, relating to child abuse, aggravated
  359  child abuse, or neglect of a child.
  360         40. Section 827.04, relating to contributing to the
  361  delinquency or dependency of a child.
  362         41. Former s. 827.05, relating to negligent treatment of
  363  children.
  364         42. Section 827.071, relating to sexual performance by a
  365  child.
  366         43.Section 831.30, relating to fraud in obtaining
  367  medicinal drugs.
  368         44. Section 831.31, relating to sale, manufacture,
  369  delivery, possession with intent to sell, manufacture, or
  370  deliver any counterfeit controlled substance if the offense was
  371  a felony.
  372         45. Section 843.01, relating to resisting arrest with
  373  violence.
  374         46. Section 843.025, relating to depriving a law
  375  enforcement, correctional, or correctional probation officer of
  376  the means of protection or communication.
  377         47. Section 843.12, relating to aiding in an escape.
  378         48. Section 843.13, relating to aiding in the escape of
  379  juvenile inmates of correctional institutions.
  380         49. Chapter 847, relating to obscene literature.
  381         50. Section 874.05, relating to encouraging or recruiting
  382  another to join a criminal gang.
  383         51. Chapter 893, relating to drug abuse prevention and
  384  control, if the offense was a felony of the second degree or
  385  greater severity.
  386         52.Section 895.03, relating to racketeering and collection
  387  of unlawful debts.
  388         53. Section 896.101, relating to the Florida Money
  389  Laundering Act.
  390         54. Section 916.1075, relating to sexual misconduct with
  391  certain forensic clients and reporting of such sexual
  392  misconduct.
  393         55. Section 944.35(3), relating to inflicting cruel or
  394  inhuman treatment on an inmate resulting in great bodily harm.
  395         56. Section 944.40, relating to escape.
  396         57. Section 944.46, relating to harboring, concealing, or
  397  aiding an escaped prisoner.
  398         58. Section 944.47, relating to introduction of contraband
  399  into a correctional facility.
  400         59. Section 985.701, relating to sexual misconduct in
  401  juvenile justice programs.
  402         60. Section 985.711, relating to contraband introduced into
  403  detention facilities.
  404         (6) EXEMPTION REQUESTS.—A person who wishes to become a
  405  peer specialist and is disqualified under subsection (5) may
  406  request an exemption from disqualification pursuant to s. 435.07
  407  from the department or the Agency for Health Care
  408  Administration, as applicable.
  409         (7) GRANDFATHER CLAUSE.—All peer specialists certified as
  410  of the effective date of this act are recognized as having met
  411  the requirements of this act.
  412         Section 7. Subsection (1), paragraph (m) of subsection (3),
  413  and subsection (6) of section 397.487, Florida Statutes, are
  414  amended to read:
  415         397.487 Voluntary certification of recovery residences.—
  416         (1) The Legislature finds that a person suffering from
  417  addiction has a higher success rate of achieving long-lasting
  418  sobriety when given the opportunity to build a stronger
  419  foundation by living in a recovery residence while receiving
  420  treatment or after completing treatment. The Legislature further
  421  finds that this state and its subdivisions have a legitimate
  422  state interest in protecting these persons, who represent a
  423  vulnerable consumer population in need of adequate housing. It
  424  is the intent of the Legislature to protect persons who reside
  425  in a recovery residence.
  426         (3) A credentialing entity shall require the recovery
  427  residence to submit the following documents with the completed
  428  application and fee:
  429         (m) Proof of satisfactory fire, safety, and health
  430  inspections. A recovery residence must comply with the
  431  provisions of the Florida Fire Prevention Code which apply to
  432  one-family and two-family dwellings, public lodging
  433  establishments, rooming houses, or other housing facilities, as
  434  applicable.
  435         (6) All owners, directors, and chief financial officers of
  436  an applicant recovery residence are subject to level 2
  437  background screening as provided under chapter 435 and s.
  438  408.809. A recovery residence is ineligible for certification,
  439  and a credentialing entity shall deny a recovery residence’s
  440  application, if any owner, director, or chief financial officer
  441  has been found guilty of, or has entered a plea of guilty or
  442  nolo contendere to, regardless of adjudication, any offense
  443  listed in s. 408.809(4) or s. 435.04(2) unless the department
  444  has issued an exemption under s. 397.4073 or s. 397.4872. In
  445  accordance with s. 435.04, the department shall notify the
  446  credentialing agency of an owner’s, director’s, or chief
  447  financial officer’s eligibility based on the results of his or
  448  her background screening.
  449         Section 8. Section 397.4873, Florida Statutes, is amended
  450  to read:
  451         397.4873 Referrals to or from recovery residences;
  452  prohibitions; penalties.—
  453         (1) A service provider licensed under this part may not
  454  make a referral of a prospective, current, or discharged patient
  455  to, or accept a referral of such a patient from, a recovery
  456  residence unless the recovery residence holds a valid
  457  certificate of compliance as provided in s. 397.487 and is
  458  actively managed by a certified recovery residence administrator
  459  as provided in s. 397.4871.
  460         (2) Subsection (1) does not apply to:
  461         (a) A licensed service provider under contract with a
  462  managing entity as defined in s. 394.9082.
  463         (b) Referrals by a recovery residence to a licensed service
  464  provider when a resident has experienced a recurrence of
  465  substance use and, in the best judgment of the recovery
  466  residence administrator, it appears that the resident may
  467  benefit from clinical treatment services the recovery residence
  468  or its owners, directors, operators, or employees do not
  469  benefit, directly or indirectly, from the referral.
  470         (c) Referrals made before January 1, 2020 July 1, 2018, by
  471  a licensed service provider to that licensed service provider’s
  472  wholly owned subsidiary, if applications and associated fees are
  473  submitted by July 1, 2019.
  474         (3) A recovery residence or its owners, directors,
  475  operators, employees, or volunteers may not receive a pecuniary
  476  benefit, directly or indirectly, from a licensed service
  477  provider for a referral made pursuant to subsection (1) or
  478  subsection (2).
  479         (4)(3) For purposes of this section, a licensed service
  480  provider or recovery residence shall be considered to have made
  481  a referral if the provider or recovery residence has informed a
  482  patient by any means about the name, address, or other details
  483  of a recovery residence or licensed service provider, or
  484  informed a licensed service provider or a recovery residence of
  485  any identifying details about a patient.
  486         (5)(4) A licensed service provider shall maintain records
  487  of referrals to or from recovery residences as may be prescribed
  488  by the department in rule.
  489         (6)(5) After June 30, 2019, a licensed service provider
  490  violating this section shall be subject to an administrative
  491  fine of $1,000 per occurrence. Repeat violations of this section
  492  may subject a provider to license suspension or revocation
  493  pursuant to s. 397.415.
  494         (7)(6) Nothing in this section requires a licensed service
  495  provider to refer a patient to or to accept a referral of a
  496  patient from a recovery residence.
  497         Section 9. Subsection (2) of section 435.07, Florida
  498  Statutes, is amended to read:
  499         435.07 Exemptions from disqualification.—Unless otherwise
  500  provided by law, the provisions of this section apply to
  501  exemptions from disqualification for disqualifying offenses
  502  revealed pursuant to background screenings required under this
  503  chapter, regardless of whether those disqualifying offenses are
  504  listed in this chapter or other laws.
  505         (2) Persons employed, or applicants for employment, by
  506  treatment providers who treat adolescents 13 years of age and
  507  older, and who are disqualified from employment solely because
  508  of crimes under s. 796.07(2)(e), s. 810.02(4), s. 812.014(2)(c),
  509  s. 817.563, s. 831.01, s. 831.02, s. 893.13, or s. 893.147, and
  510  any related criminal attempt, solicitation, or conspiracy under
  511  s. 777.04, may be exempted from disqualification from employment
  512  pursuant to this chapter without application of the waiting
  513  period in subparagraph (1)(a)1.
  514         Section 10. Paragraph (e) of subsection (5) of section
  515  212.055, Florida Statutes, is amended to read:
  516         212.055 Discretionary sales surtaxes; legislative intent;
  517  authorization and use of proceeds.—It is the legislative intent
  518  that any authorization for imposition of a discretionary sales
  519  surtax shall be published in the Florida Statutes as a
  520  subsection of this section, irrespective of the duration of the
  521  levy. Each enactment shall specify the types of counties
  522  authorized to levy; the rate or rates which may be imposed; the
  523  maximum length of time the surtax may be imposed, if any; the
  524  procedure which must be followed to secure voter approval, if
  525  required; the purpose for which the proceeds may be expended;
  526  and such other requirements as the Legislature may provide.
  527  Taxable transactions and administrative procedures shall be as
  528  provided in s. 212.054.
  529         (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
  530  s. 125.011(1) may levy the surtax authorized in this subsection
  531  pursuant to an ordinance either approved by extraordinary vote
  532  of the county commission or conditioned to take effect only upon
  533  approval by a majority vote of the electors of the county voting
  534  in a referendum. In a county as defined in s. 125.011(1), for
  535  the purposes of this subsection, “county public general
  536  hospital” means a general hospital as defined in s. 395.002
  537  which is owned, operated, maintained, or governed by the county
  538  or its agency, authority, or public health trust.
  539         (e) A governing board, agency, or authority shall be
  540  chartered by the county commission upon this act becoming law.
  541  The governing board, agency, or authority shall adopt and
  542  implement a health care plan for indigent health care services.
  543  The governing board, agency, or authority shall consist of no
  544  more than seven and no fewer than five members appointed by the
  545  county commission. The members of the governing board, agency,
  546  or authority shall be at least 18 years of age and residents of
  547  the county. A No member may not be employed by or affiliated
  548  with a health care provider or the public health trust, agency,
  549  or authority responsible for the county public general hospital.
  550  The following community organizations shall each appoint a
  551  representative to a nominating committee: the South Florida
  552  Hospital and Healthcare Association, the Miami-Dade County
  553  Public Health Trust, the Dade County Medical Association, the
  554  Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
  555  County. This committee shall nominate between 10 and 14 county
  556  citizens for the governing board, agency, or authority. The
  557  slate shall be presented to the county commission and the county
  558  commission shall confirm the top five to seven nominees,
  559  depending on the size of the governing board. Until such time as
  560  the governing board, agency, or authority is created, the funds
  561  provided for in subparagraph (d)2. shall be placed in a
  562  restricted account set aside from other county funds and not
  563  disbursed by the county for any other purpose.
  564         1. The plan shall divide the county into a minimum of four
  565  and maximum of six service areas, with no more than one
  566  participant hospital per service area. The county public general
  567  hospital shall be designated as the provider for one of the
  568  service areas. Services shall be provided through participants’
  569  primary acute care facilities.
  570         2. The plan and subsequent amendments to it shall fund a
  571  defined range of health care services for both indigent persons
  572  and the medically poor, including primary care, preventive care,
  573  hospital emergency room care, and hospital care necessary to
  574  stabilize the patient. For the purposes of this section,
  575  “stabilization” means stabilization as defined in s. 397.311 s.
  576  397.311(45). Where consistent with these objectives, the plan
  577  may include services rendered by physicians, clinics, community
  578  hospitals, and alternative delivery sites, as well as at least
  579  one regional referral hospital per service area. The plan shall
  580  provide that agreements negotiated between the governing board,
  581  agency, or authority and providers shall recognize hospitals
  582  that render a disproportionate share of indigent care, provide
  583  other incentives to promote the delivery of charity care to draw
  584  down federal funds where appropriate, and require cost
  585  containment, including, but not limited to, case management.
  586  From the funds specified in subparagraphs (d)1. and 2. for
  587  indigent health care services, service providers shall receive
  588  reimbursement at a Medicaid rate to be determined by the
  589  governing board, agency, or authority created pursuant to this
  590  paragraph for the initial emergency room visit, and a per-member
  591  per-month fee or capitation for those members enrolled in their
  592  service area, as compensation for the services rendered
  593  following the initial emergency visit. Except for provisions of
  594  emergency services, upon determination of eligibility,
  595  enrollment shall be deemed to have occurred at the time services
  596  were rendered. The provisions for specific reimbursement of
  597  emergency services shall be repealed on July 1, 2001, unless
  598  otherwise reenacted by the Legislature. The capitation amount or
  599  rate shall be determined before program implementation by an
  600  independent actuarial consultant. In no event shall such
  601  reimbursement rates exceed the Medicaid rate. The plan must also
  602  provide that any hospitals owned and operated by government
  603  entities on or after the effective date of this act must, as a
  604  condition of receiving funds under this subsection, afford
  605  public access equal to that provided under s. 286.011 as to any
  606  meeting of the governing board, agency, or authority the subject
  607  of which is budgeting resources for the retention of charity
  608  care, as that term is defined in the rules of the Agency for
  609  Health Care Administration. The plan shall also include
  610  innovative health care programs that provide cost-effective
  611  alternatives to traditional methods of service and delivery
  612  funding.
  613         3. The plan’s benefits shall be made available to all
  614  county residents currently eligible to receive health care
  615  services as indigents or medically poor as defined in paragraph
  616  (4)(d).
  617         4. Eligible residents who participate in the health care
  618  plan shall receive coverage for a period of 12 months or the
  619  period extending from the time of enrollment to the end of the
  620  current fiscal year, per enrollment period, whichever is less.
  621         5. At the end of each fiscal year, the governing board,
  622  agency, or authority shall prepare an audit that reviews the
  623  budget of the plan, delivery of services, and quality of
  624  services, and makes recommendations to increase the plan’s
  625  efficiency. The audit shall take into account participant
  626  hospital satisfaction with the plan and assess the amount of
  627  poststabilization patient transfers requested, and accepted or
  628  denied, by the county public general hospital.
  629         Section 11. Subsection (3) of section 394.495, Florida
  630  Statutes, is amended to read:
  631         394.495 Child and adolescent mental health system of care;
  632  programs and services.—
  633         (3) Assessments must be performed by:
  634         (a) A professional as defined in s. 394.455(5), (7), (33)
  635  (32), (36) (35), or (37) (36);
  636         (b) A professional licensed under chapter 491; or
  637         (c) A person who is under the direct supervision of a
  638  qualified professional as defined in s. 394.455(5), (7), (33)
  639  (32), (36) (35), or (37) (36) or a professional licensed under
  640  chapter 491.
  641         Section 12. Subsection (5) of section 394.496, Florida
  642  Statutes, is amended to read:
  643         394.496 Service planning.—
  644         (5) A professional as defined in s. 394.455(5), (7), (33)
  645  (32), (36) (35), or (37) (36) or a professional licensed under
  646  chapter 491 must be included among those persons developing the
  647  services plan.
  648         Section 13. Subsection (6) of section 394.9085, Florida
  649  Statutes, is amended to read:
  650         394.9085 Behavioral provider liability.—
  651         (6) For purposes of this section, the term terms
  652  “detoxification services,has the same meaning as
  653  detoxification in s. 397.311(26)(a), “addictions receiving
  654  facility,has the same meaning as provided in s.
  655  397.311(26)(a), and “receiving facility” has have the same
  656  meaning meanings as those provided in s. 394.455 ss.
  657  397.311(26)(a)4., 397.311(26)(a)1., and 394.455(39),
  658  respectively.
  659         Section 14. Section 397.416, Florida Statutes, is amended
  660  to read:
  661         397.416 Substance use disorder abuse treatment services;
  662  qualified professional.—Notwithstanding any other provision of
  663  law, a person who was certified through a certification process
  664  recognized by the former Department of Health and Rehabilitative
  665  Services before January 1, 1995, may perform the duties of a
  666  qualified professional with respect to substance use abuse
  667  treatment services as defined in this chapter, and need not meet
  668  the certification requirements contained in s. 397.311(35) s.
  669  397.311(34).
  670         Section 15. Paragraph (b) of subsection (1) of section
  671  409.972, Florida Statutes, is amended to read:
  672         409.972 Mandatory and voluntary enrollment.—
  673         (1) The following Medicaid-eligible persons are exempt from
  674  mandatory managed care enrollment required by s. 409.965, and
  675  may voluntarily choose to participate in the managed medical
  676  assistance program:
  677         (b) Medicaid recipients residing in residential commitment
  678  facilities operated through the Department of Juvenile Justice
  679  or in a treatment facility as defined in s. 394.455 s.
  680  394.455(47).
  681         Section 16. Paragraphs (d) and (g) of subsection (1) of
  682  section 440.102, Florida Statutes, are amended to read:
  683         440.102 Drug-free workplace program requirements.—The
  684  following provisions apply to a drug-free workplace program
  685  implemented pursuant to law or to rules adopted by the Agency
  686  for Health Care Administration:
  687         (1) DEFINITIONS.—Except where the context otherwise
  688  requires, as used in this act:
  689         (d) “Drug rehabilitation program” means a service provider
  690  as defined in s. 397.311 which, established pursuant to s.
  691  397.311(43), that provides confidential, timely, and expert
  692  identification, assessment, and resolution of employee drug
  693  abuse.
  694         (g) “Employee assistance program” means an established
  695  program capable of providing expert assessment of employee
  696  personal concerns; confidential and timely identification
  697  services with regard to employee drug abuse; referrals of
  698  employees for appropriate diagnosis, treatment, and assistance;
  699  and followup services for employees who participate in the
  700  program or require monitoring after returning to work. If, in
  701  addition to the above activities, an employee assistance program
  702  provides diagnostic and treatment services, these services shall
  703  in all cases be provided by service providers as defined in s.
  704  397.311 pursuant to s. 397.311(43).
  705         Section 17. Paragraph (e) of subsection (4) of section
  706  464.012, Florida Statutes, is amended to read:
  707         464.012 Licensure of advanced practice registered nurses;
  708  fees; controlled substance prescribing.—
  709         (4) In addition to the general functions specified in
  710  subsection (3), an advanced practice registered nurse may
  711  perform the following acts within his or her specialty:
  712         (e) A psychiatric nurse, who meets the requirements in s.
  713  394.455(36) s. 394.455(35), within the framework of an
  714  established protocol with a psychiatrist, may prescribe
  715  psychotropic controlled substances for the treatment of mental
  716  disorders.
  717         Section 18. Subsection (7) of section 744.2007, Florida
  718  Statutes, is amended to read:
  719         744.2007 Powers and duties.—
  720         (7) A public guardian may not commit a ward to a treatment
  721  facility, as defined in s. 394.455 s. 394.455(47), without an
  722  involuntary placement proceeding as provided by law.
  723         Section 19. This act shall take effect July 1, 2019.