Bill Text: FL S0528 | 2019 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
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-Introduced.html
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-Introduced.html
Florida Senate - 2019 SB 528
By Senator Rouson
19-00604-19 2019528__
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; authorizing
39 the department or the Agency for Health Care
40 Administration to require by rule that fingerprints be
41 submitted electronically to the Department of Law
42 Enforcement; authorizing the Department of Children
43 and Families or the agency to contract with certain
44 vendors for fingerprinting; specifying requirements
45 for vendors; specifying offenses to be considered in
46 the background screening of a peer specialist;
47 authorizing a person who does not meet background
48 screening requirements to request an exemption from
49 disqualification from the department or the agency;
50 providing that all peer specialists certified as of
51 the effective date of this act are recognized as
52 having met the requirements of this act; amending s.
53 397.487, F.S.; revising legislative findings relating
54 to voluntary certification of recovery residences;
55 requiring recovery residences to comply with specified
56 Florida Fire Prevention Code provisions; revising
57 background screening requirements for owners,
58 directors, and chief financial officers of recovery
59 residences; amending s. 397.4873, F.S.; providing
60 exceptions to limitations on referrals by recovery
61 residences to licensed service providers; prohibiting
62 recovery residences and specified affiliated
63 individuals from benefiting from certain referrals;
64 amending s. 435.07, F.S.; authorizing the exemption of
65 certain persons from disqualification from employment;
66 amending ss. 212.055, 394.495, 394.496, 394.9085,
67 397.416, 409.972, 440.102, 464.012, and 744.2007,
68 F.S.; conforming cross-references; making technical
69 changes; providing an effective date.
70
71 Be It Enacted by the Legislature of the State of Florida:
72
73 Section 1. Present subsections (32) through (48) of section
74 394.455, Florida Statutes, are redesignated as subsections (33)
75 through (49), respectively, and a new subsection (32) is added
76 to that section, to read:
77 394.455 Definitions.—As used in this part, the term:
78 (32) “Peer specialist” means a person who has been in
79 recovery from a substance use disorder or mental illness for the
80 past 2 years or a family member or caregiver of a person with a
81 substance use disorder or mental illness and who is certified
82 under s. 397.417.
83 Section 2. Paragraph (a) of subsection (1) of section
84 394.4572, Florida Statutes, is amended to read:
85 394.4572 Screening of mental health personnel.—
86 (1)(a) The department and the Agency for Health Care
87 Administration shall require level 2 background screening
88 pursuant to chapter 435 for mental health personnel. “Mental
89 health personnel” includes all program directors, professional
90 clinicians, staff members, and volunteers working in public or
91 private mental health programs and facilities who have direct
92 contact with individuals held for examination or admitted for
93 mental health treatment. For purposes of this chapter,
94 employment screening of mental health personnel also includes,
95 but is not limited to, employment screening as provided under
96 chapter 435 and s. 408.809. The department and the Agency for
97 Health Care Administration shall require a level 2 background
98 screening pursuant to s. 397.417(5) for persons working as peer
99 specialists in public or private mental health programs or
100 facilities and who have direct contact with individuals held for
101 involuntary examination or admitted for mental health treatment.
102 Section 3. Paragraph (l) of subsection (2) of section
103 394.4573, Florida Statutes, is amended to read:
104 394.4573 Coordinated system of care; annual assessment;
105 essential elements; measures of performance; system improvement
106 grants; reports.—On or before December 1 of each year, the
107 department shall submit to the Governor, the President of the
108 Senate, and the Speaker of the House of Representatives an
109 assessment of the behavioral health services in this state. The
110 assessment shall consider, at a minimum, the extent to which
111 designated receiving systems function as no-wrong-door models,
112 the availability of treatment and recovery services that use
113 recovery-oriented and peer-involved approaches, the availability
114 of less-restrictive services, and the use of evidence-informed
115 practices. The department’s assessment shall consider, at a
116 minimum, the needs assessments conducted by the managing
117 entities pursuant to s. 394.9082(5). Beginning in 2017, the
118 department shall compile and include in the report all plans
119 submitted by managing entities pursuant to s. 394.9082(8) and
120 the department’s evaluation of each plan.
121 (2) The essential elements of a coordinated system of care
122 include:
123 (l) Recovery support, including, but not limited to, the
124 use of peer specialists as described in s. 397.417 to assist in
125 the individual’s recovery from a substance use disorder or
126 mental illness, support for competitive employment, educational
127 attainment, independent living skills development, family
128 support and education, wellness management and self-care, and
129 assistance in obtaining housing that meets the individual’s
130 needs. Such housing may include mental health residential
131 treatment facilities, limited mental health assisted living
132 facilities, adult family care homes, and supportive housing.
133 Housing provided using state funds must provide a safe and
134 decent environment free from abuse and neglect.
135 Section 4. Present subsections (30) through (49) of section
136 397.311, Florida Statutes, are redesignated as subsections (31)
137 through (50), respectively, and a new subsection (30) is added
138 to that section, to read:
139 397.311 Definitions.—As used in this chapter, except part
140 VIII, the term:
141 (30) “Peer specialist” means a person who has been in
142 recovery from a substance use disorder or mental illness for the
143 past 2 years or a family member or caregiver of a person with a
144 substance use disorder or mental illness and who is certified
145 under s. 397.417.
146 Section 5. Paragraph (f) of subsection (1) and paragraphs
147 (b) and (c) of subsection (4) of section 397.4073, Florida
148 Statutes, are amended to read:
149 397.4073 Background checks of service provider personnel.—
150 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
151 EXCEPTIONS.—
152 (f) Service provider personnel who request an exemption
153 from disqualification must submit the request within 30 days
154 after being notified of the disqualification. If 5 years or more
155 have elapsed since the most recent disqualifying offense,
156 service provider personnel may work with adults with mental
157 health or substance use disorders or co-occurring disorders
158 under the supervision of a qualified professional licensed under
159 chapter 490 or chapter 491 or a master’s-level-certified
160 addictions professional until the agency makes a final
161 determination regarding the request for an exemption from
162 disqualification.
163 (4) EXEMPTIONS FROM DISQUALIFICATION.—
164 (b) Since rehabilitated substance abuse impaired persons
165 are effective in the successful treatment and rehabilitation of
166 individuals with substance use disorders, for service providers
167 which treat adolescents 13 years of age and older, service
168 provider personnel whose background checks indicate crimes under
169 s. 817.563, s. 893.13, or s. 893.147 may be exempted from
170 disqualification from employment pursuant to this paragraph.
171 (c) The department may grant exemptions from
172 disqualification which would limit service provider personnel to
173 working with adults in substance use disorder abuse treatment
174 facilities.
175 Section 6. Section 397.417, Florida Statutes, is created to
176 read:
177 397.417 Behavioral health peer specialists.—
178 (1) LEGISLATIVE FINDINGS AND INTENT.—
179 (a) The Legislature finds that:
180 1. The ability to provide adequate behavioral health
181 services is limited by a shortage of professionals and
182 paraprofessionals.
183 2. The state is experiencing an increase in opioid
184 addictions, which prove fatal to persons in many cases.
185 3. Peer specialists provide effective support services
186 because they share common life experiences with the persons they
187 assist.
188 4. Peer specialists promote a sense of community among
189 those in recovery.
190 5. Research has shown that peer support facilitates
191 recovery and reduces health care costs.
192 6. Peer specialists may have a criminal history that
193 prevents them from meeting background screening requirements.
194 (b) The Legislature intends to expand the use of peer
195 specialists as a cost-effective means of providing services by
196 ensuring that peer specialists meet specified qualifications,
197 meet modified background screening requirements, and are
198 adequately reimbursed for their services.
199 (2) QUALIFICATIONS.—
200 (a) A person may seek certification as a peer specialist if
201 he or she has been in recovery from a substance use disorder or
202 mental illness for the past 2 years or if he or she is a family
203 member or caregiver of a person with a substance use disorder or
204 mental illness.
205 (b) To obtain certification as a peer specialist, a person
206 must meet the background screening requirements of subsection
207 (5), complete the training program, and achieve a passing score
208 on the competency exam described in paragraph (3)(a).
209 (3) DUTIES OF THE DEPARTMENT.—
210 (a) The department shall develop a training program for
211 persons seeking certification as peer specialists. The
212 department must give preference to trainers who are certified
213 peer specialists. The training program must coincide with a
214 competency exam and be based on current practice standards.
215 (b) The department shall certify peer specialists. The
216 department may certify peer specialists directly or may
217 designate a private, nonprofit certification organization to
218 certify peer specialists, implement the training program, and
219 administer the competency exam.
220 (c) The department must require that a person providing
221 peer specialist services be certified or be supervised by a
222 licensed behavioral health care professional or a certified peer
223 specialist.
224 (4) PAYMENT.—Peer specialist services may be reimbursed as
225 a recovery service through the department, a behavioral health
226 managing entity, or the Medicaid program. Medicaid managed care
227 plans are encouraged to use peer specialists in providing
228 recovery services.
229 (5) BACKGROUND SCREENING.—
230 (a) A peer specialist must have completed or have been
231 lawfully released from confinement, supervision, or any
232 nonmonetary condition imposed by the court for any felony and
233 must undergo a background screening as a condition of employment
234 and continued employment. The background screening must include
235 fingerprinting for statewide criminal history records checks
236 through the Department of Law Enforcement and national criminal
237 history records checks through the Federal Bureau of
238 Investigation. The background screening may include local
239 criminal records checks through local law enforcement agencies.
240 (b) The department or the Agency for Health Care
241 Administration, as applicable, may require by rule that
242 fingerprints submitted pursuant to this section be submitted
243 electronically to the Department of Law Enforcement.
244 (c) The department or the Agency for Health Care
245 Administration, as applicable, may contract with one or more
246 vendors to perform all or part of the electronic fingerprinting
247 pursuant to this section. Such contracts must ensure that the
248 owners and personnel of the vendor performing the electronic
249 fingerprinting are qualified and will ensure the integrity and
250 security of all personal identifying information.
251 (d) Vendors who submit fingerprints on behalf of employers
252 must:
253 1. Meet the requirements of s. 943.053; and
254 2. Have the ability to communicate electronically with the
255 department or the Agency for Health Care Administration, as
256 applicable, and to accept screening results from the Department
257 of Law Enforcement and provide the applicant’s full first name,
258 middle initial, and last name; social security number or
259 individual taxpayer identification number; date of birth;
260 mailing address; sex; and race.
261 (e) The background screening under this section must ensure
262 that a peer specialist has not, during the previous 3 years,
263 been arrested for and is awaiting final disposition of, been
264 found guilty of, regardless of adjudication, or entered a plea
265 of nolo contendere or guilty to, or been adjudicated delinquent
266 and the record has not been sealed or expunged for, any felony.
267 (f) The background screening under this section must ensure
268 that a peer specialist has not been found guilty of, regardless
269 of adjudication, or entered a plea of nolo contendere or guilty
270 to, or been adjudicated delinquent and the record has not been
271 sealed or expunged for, any offense prohibited under any of the
272 following state laws or similar laws of another jurisdiction:
273 1. Section 393.135, relating to sexual misconduct with
274 certain developmentally disabled clients and reporting of such
275 sexual misconduct.
276 2. Section 394.4593, relating to sexual misconduct with
277 certain mental health patients and reporting of such sexual
278 misconduct.
279 3. Section 409.9201, relating to Medicaid fraud.
280 4. Section 415.111, relating to adult abuse, neglect, or
281 exploitation of aged persons or disabled adults.
282 5. Section 741.28, relating to domestic violence.
283 6. Section 777.04, relating to attempts, solicitation, and
284 conspiracy to commit an offense listed in this section.
285 7. Section 782.04, relating to murder.
286 8. Section 782.07, relating to manslaughter, aggravated
287 manslaughter of an elderly person or disabled adult, aggravated
288 manslaughter of a child, or aggravated manslaughter of an
289 officer, a firefighter, an emergency medical technician, or a
290 paramedic.
291 9. Section 782.071, relating to vehicular homicide.
292 10. Section 782.09, relating to killing of an unborn child
293 by injury to the mother.
294 11. Chapter 784, relating to assault, battery, and culpable
295 negligence, if the offense was a felony.
296 12. Section 787.01, relating to kidnapping.
297 13. Section 787.02, relating to false imprisonment.
298 14. Section 787.025, relating to luring or enticing a
299 child.
300 15. Section 787.04(2), relating to leading, taking,
301 enticing, or removing a minor beyond the state limits, or
302 concealing the location of a minor, with criminal intent pending
303 custody proceedings.
304 16. Section 787.04(3), relating to leading, taking,
305 enticing, or removing a minor beyond the state limits, or
306 concealing the location of a minor, with criminal intent pending
307 dependency proceedings or proceedings concerning alleged abuse
308 or neglect of a minor.
309 17. Section 790.115(1), relating to exhibiting firearms or
310 weapons within 1,000 feet of a school.
311 18. Section 790.115(2)(b), relating to possessing an
312 electric weapon or device, destructive device, or other weapon
313 on school property.
314 19. Section 794.011, relating to sexual battery.
315 20. Former s. 794.041, relating to prohibited acts of
316 persons in familial or custodial authority.
317 21. Section 794.05, relating to unlawful sexual activity
318 with certain minors.
319 22. Section 794.08, relating to female genital mutilation.
320 23. Section 798.02, relating to lewd and lascivious
321 behavior.
322 24. Chapter 800, relating to lewdness and indecent
323 exposure.
324 25. Section 806.01, relating to arson.
325 26. Section 810.02, relating to burglary, if the offense
326 was a felony of the first degree.
327 27. Section 810.14, relating to voyeurism, if the offense
328 was a felony.
329 28. Section 810.145, relating to video voyeurism, if the
330 offense was a felony.
331 29. Section 812.13, relating to robbery.
332 30. Section 812.131, relating to robbery by sudden
333 snatching.
334 31. Section 812.133, relating to carjacking.
335 32. Section 812.135, relating to home-invasion robbery.
336 33. 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 34. Section 817.505, relating to patient brokering.
340 35. Section 825.102, relating to abuse, aggravated abuse,
341 or neglect of an elderly person or disabled adult.
342 36. Section 825.1025, relating to lewd or lascivious
343 offenses committed upon or in the presence of an elderly person
344 or disabled person.
345 37. Section 825.103, relating to exploitation of an elderly
346 person or disabled adult, if the offense was a felony.
347 38. Section 826.04, relating to incest.
348 39. Section 827.03, relating to child abuse, aggravated
349 child abuse, or neglect of a child.
350 40. Section 827.04, relating to contributing to the
351 delinquency or dependency of a child.
352 41. Former s. 827.05, relating to negligent treatment of
353 children.
354 42. Section 827.071, relating to sexual performance by a
355 child.
356 43. Section 831.30, relating to fraud in obtaining
357 medicinal drugs.
358 44. Section 831.31, relating to sale, manufacture,
359 delivery, possession with intent to sell, manufacture, or
360 deliver any counterfeit controlled substance if the offense was
361 a felony.
362 45. Section 843.01, relating to resisting arrest with
363 violence.
364 46. Section 843.025, relating to depriving a law
365 enforcement, correctional, or correctional probation officer of
366 the means of protection or communication.
367 47. Section 843.12, relating to aiding in an escape.
368 48. Section 843.13, relating to aiding in the escape of
369 juvenile inmates of correctional institutions.
370 49. Chapter 847, relating to obscene literature.
371 50. Section 874.05, relating to encouraging or recruiting
372 another to join a criminal gang.
373 51. Chapter 893, relating to drug abuse prevention and
374 control, if the offense was a felony of the second degree or
375 greater severity.
376 52. Section 895.03, relating to racketeering and collection
377 of unlawful debts.
378 53. Section 896.101, relating to the Florida Money
379 Laundering Act.
380 54. Section 916.1075, relating to sexual misconduct with
381 certain forensic clients and reporting of such sexual
382 misconduct.
383 55. Section 944.35(3), relating to inflicting cruel or
384 inhuman treatment on an inmate resulting in great bodily harm.
385 56. Section 944.40, relating to escape.
386 57. Section 944.46, relating to harboring, concealing, or
387 aiding an escaped prisoner.
388 58. Section 944.47, relating to introduction of contraband
389 into a correctional facility.
390 59. Section 985.701, relating to sexual misconduct in
391 juvenile justice programs.
392 60. Section 985.711, relating to contraband introduced into
393 detention facilities.
394 (6) EXEMPTION REQUESTS.—A person who wishes to become a
395 peer specialist and is disqualified under subsection (5) may
396 request an exemption from disqualification pursuant to s. 435.07
397 from the department or the Agency for Health Care
398 Administration, as applicable.
399 (7) GRANDFATHER CLAUSE.—All peer specialists certified as
400 of the effective date of this act are recognized as having met
401 the requirements of this act.
402 Section 7. Subsection (1), paragraph (m) of subsection (3),
403 and subsection (6) of section 397.487, Florida Statutes, are
404 amended to read:
405 397.487 Voluntary certification of recovery residences.—
406 (1) The Legislature finds that a person suffering from
407 addiction has a higher success rate of achieving long-lasting
408 sobriety when given the opportunity to build a stronger
409 foundation by living in a recovery residence while receiving
410 treatment or after completing treatment. The Legislature further
411 finds that this state and its subdivisions have a legitimate
412 state interest in protecting these persons, who represent a
413 vulnerable consumer population in need of adequate housing. It
414 is the intent of the Legislature to protect persons who reside
415 in a recovery residence.
416 (3) A credentialing entity shall require the recovery
417 residence to submit the following documents with the completed
418 application and fee:
419 (m) Proof of satisfactory fire, safety, and health
420 inspections. A recovery residence must comply with the
421 provisions of the Florida Fire Prevention Code which apply to
422 one-family and two-family dwellings, public lodging
423 establishments, rooming houses, or other housing facilities, as
424 applicable.
425 (6) All owners, directors, and chief financial officers of
426 an applicant recovery residence are subject to level 2
427 background screening as provided under chapter 435 and s.
428 408.809. A recovery residence is ineligible for certification,
429 and a credentialing entity shall deny a recovery residence’s
430 application, if any owner, director, or chief financial officer
431 has been found guilty of, or has entered a plea of guilty or
432 nolo contendere to, regardless of adjudication, any offense
433 listed in s. 408.809(4) or s. 435.04(2) unless the department
434 has issued an exemption under s. 397.4073 or s. 397.4872. In
435 accordance with s. 435.04, the department shall notify the
436 credentialing agency of an owner’s, director’s, or chief
437 financial officer’s eligibility based on the results of his or
438 her background screening.
439 Section 8. Section 397.4873, Florida Statutes, is amended
440 to read:
441 397.4873 Referrals to or from recovery residences;
442 prohibitions; penalties.—
443 (1) A service provider licensed under this part may not
444 make a referral of a prospective, current, or discharged patient
445 to, or accept a referral of such a patient from, a recovery
446 residence unless the recovery residence holds a valid
447 certificate of compliance as provided in s. 397.487 and is
448 actively managed by a certified recovery residence administrator
449 as provided in s. 397.4871.
450 (2) Subsection (1) does not apply to:
451 (a) A licensed service provider under contract with a
452 managing entity as defined in s. 394.9082.
453 (b) Referrals by a recovery residence to a licensed service
454 provider when a resident has experienced a recurrence of
455 substance use and, in the best judgment of the recovery
456 residence administrator, it appears that the resident may
457 benefit from clinical treatment services the recovery residence
458 or its owners, directors, operators, or employees do not
459 benefit, directly or indirectly, from the referral.
460 (c) Referrals made before January 1, 2020 July 1, 2018, by
461 a licensed service provider to that licensed service provider’s
462 wholly owned subsidiary, if applications and associated fees are
463 submitted by July 1, 2019.
464 (3) A recovery residence or its owners, directors,
465 operators, employees, or volunteers may not receive a pecuniary
466 benefit, directly or indirectly, from a licensed service
467 provider for a referral made pursuant to subsection (1) or
468 subsection (2).
469 (4)(3) For purposes of this section, a licensed service
470 provider or recovery residence shall be considered to have made
471 a referral if the provider or recovery residence has informed a
472 patient by any means about the name, address, or other details
473 of a recovery residence or licensed service provider, or
474 informed a licensed service provider or a recovery residence of
475 any identifying details about a patient.
476 (5)(4) A licensed service provider shall maintain records
477 of referrals to or from recovery residences as may be prescribed
478 by the department in rule.
479 (6)(5) After June 30, 2019, a licensed service provider
480 violating this section shall be subject to an administrative
481 fine of $1,000 per occurrence. Repeat violations of this section
482 may subject a provider to license suspension or revocation
483 pursuant to s. 397.415.
484 (7)(6) Nothing in this section requires a licensed service
485 provider to refer a patient to or to accept a referral of a
486 patient from a recovery residence.
487 Section 9. Subsection (2) of section 435.07, Florida
488 Statutes, is amended to read:
489 435.07 Exemptions from disqualification.—Unless otherwise
490 provided by law, the provisions of this section apply to
491 exemptions from disqualification for disqualifying offenses
492 revealed pursuant to background screenings required under this
493 chapter, regardless of whether those disqualifying offenses are
494 listed in this chapter or other laws.
495 (2) Persons employed, or applicants for employment, by
496 treatment providers who treat adolescents 13 years of age and
497 older, and who are disqualified from employment solely because
498 of crimes under s. 796.07(2)(e), s. 810.02(4), s. 812.014(2)(c),
499 s. 817.563, s. 831.01, s. 831.02, s. 893.13, or s. 893.147, and
500 any related criminal attempt, solicitation, or conspiracy under
501 s. 777.04, may be exempted from disqualification from employment
502 pursuant to this chapter without application of the waiting
503 period in subparagraph (1)(a)1.
504 Section 10. Paragraph (e) of subsection (5) of section
505 212.055, Florida Statutes, is amended to read:
506 212.055 Discretionary sales surtaxes; legislative intent;
507 authorization and use of proceeds.—It is the legislative intent
508 that any authorization for imposition of a discretionary sales
509 surtax shall be published in the Florida Statutes as a
510 subsection of this section, irrespective of the duration of the
511 levy. Each enactment shall specify the types of counties
512 authorized to levy; the rate or rates which may be imposed; the
513 maximum length of time the surtax may be imposed, if any; the
514 procedure which must be followed to secure voter approval, if
515 required; the purpose for which the proceeds may be expended;
516 and such other requirements as the Legislature may provide.
517 Taxable transactions and administrative procedures shall be as
518 provided in s. 212.054.
519 (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
520 s. 125.011(1) may levy the surtax authorized in this subsection
521 pursuant to an ordinance either approved by extraordinary vote
522 of the county commission or conditioned to take effect only upon
523 approval by a majority vote of the electors of the county voting
524 in a referendum. In a county as defined in s. 125.011(1), for
525 the purposes of this subsection, “county public general
526 hospital” means a general hospital as defined in s. 395.002
527 which is owned, operated, maintained, or governed by the county
528 or its agency, authority, or public health trust.
529 (e) A governing board, agency, or authority shall be
530 chartered by the county commission upon this act becoming law.
531 The governing board, agency, or authority shall adopt and
532 implement a health care plan for indigent health care services.
533 The governing board, agency, or authority shall consist of no
534 more than seven and no fewer than five members appointed by the
535 county commission. The members of the governing board, agency,
536 or authority shall be at least 18 years of age and residents of
537 the county. A No member may not be employed by or affiliated
538 with a health care provider or the public health trust, agency,
539 or authority responsible for the county public general hospital.
540 The following community organizations shall each appoint a
541 representative to a nominating committee: the South Florida
542 Hospital and Healthcare Association, the Miami-Dade County
543 Public Health Trust, the Dade County Medical Association, the
544 Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
545 County. This committee shall nominate between 10 and 14 county
546 citizens for the governing board, agency, or authority. The
547 slate shall be presented to the county commission and the county
548 commission shall confirm the top five to seven nominees,
549 depending on the size of the governing board. Until such time as
550 the governing board, agency, or authority is created, the funds
551 provided for in subparagraph (d)2. shall be placed in a
552 restricted account set aside from other county funds and not
553 disbursed by the county for any other purpose.
554 1. The plan shall divide the county into a minimum of four
555 and maximum of six service areas, with no more than one
556 participant hospital per service area. The county public general
557 hospital shall be designated as the provider for one of the
558 service areas. Services shall be provided through participants’
559 primary acute care facilities.
560 2. The plan and subsequent amendments to it shall fund a
561 defined range of health care services for both indigent persons
562 and the medically poor, including primary care, preventive care,
563 hospital emergency room care, and hospital care necessary to
564 stabilize the patient. For the purposes of this section,
565 “stabilization” means stabilization as defined in s. 397.311 s.
566 397.311(45). Where consistent with these objectives, the plan
567 may include services rendered by physicians, clinics, community
568 hospitals, and alternative delivery sites, as well as at least
569 one regional referral hospital per service area. The plan shall
570 provide that agreements negotiated between the governing board,
571 agency, or authority and providers shall recognize hospitals
572 that render a disproportionate share of indigent care, provide
573 other incentives to promote the delivery of charity care to draw
574 down federal funds where appropriate, and require cost
575 containment, including, but not limited to, case management.
576 From the funds specified in subparagraphs (d)1. and 2. for
577 indigent health care services, service providers shall receive
578 reimbursement at a Medicaid rate to be determined by the
579 governing board, agency, or authority created pursuant to this
580 paragraph for the initial emergency room visit, and a per-member
581 per-month fee or capitation for those members enrolled in their
582 service area, as compensation for the services rendered
583 following the initial emergency visit. Except for provisions of
584 emergency services, upon determination of eligibility,
585 enrollment shall be deemed to have occurred at the time services
586 were rendered. The provisions for specific reimbursement of
587 emergency services shall be repealed on July 1, 2001, unless
588 otherwise reenacted by the Legislature. The capitation amount or
589 rate shall be determined before program implementation by an
590 independent actuarial consultant. In no event shall such
591 reimbursement rates exceed the Medicaid rate. The plan must also
592 provide that any hospitals owned and operated by government
593 entities on or after the effective date of this act must, as a
594 condition of receiving funds under this subsection, afford
595 public access equal to that provided under s. 286.011 as to any
596 meeting of the governing board, agency, or authority the subject
597 of which is budgeting resources for the retention of charity
598 care, as that term is defined in the rules of the Agency for
599 Health Care Administration. The plan shall also include
600 innovative health care programs that provide cost-effective
601 alternatives to traditional methods of service and delivery
602 funding.
603 3. The plan’s benefits shall be made available to all
604 county residents currently eligible to receive health care
605 services as indigents or medically poor as defined in paragraph
606 (4)(d).
607 4. Eligible residents who participate in the health care
608 plan shall receive coverage for a period of 12 months or the
609 period extending from the time of enrollment to the end of the
610 current fiscal year, per enrollment period, whichever is less.
611 5. At the end of each fiscal year, the governing board,
612 agency, or authority shall prepare an audit that reviews the
613 budget of the plan, delivery of services, and quality of
614 services, and makes recommendations to increase the plan’s
615 efficiency. The audit shall take into account participant
616 hospital satisfaction with the plan and assess the amount of
617 poststabilization patient transfers requested, and accepted or
618 denied, by the county public general hospital.
619 Section 11. Subsection (3) of section 394.495, Florida
620 Statutes, is amended to read:
621 394.495 Child and adolescent mental health system of care;
622 programs and services.—
623 (3) Assessments must be performed by:
624 (a) A professional as defined in s. 394.455(5), (7), (33)
625 (32), (36) (35), or (37) (36);
626 (b) A professional licensed under chapter 491; or
627 (c) A person who is under the direct supervision of a
628 qualified professional as defined in s. 394.455(5), (7), (33)
629 (32), (36) (35), or (37) (36) or a professional licensed under
630 chapter 491.
631 Section 12. Subsection (5) of section 394.496, Florida
632 Statutes, is amended to read:
633 394.496 Service planning.—
634 (5) A professional as defined in s. 394.455(5), (7), (33)
635 (32), (36) (35), or (37) (36) or a professional licensed under
636 chapter 491 must be included among those persons developing the
637 services plan.
638 Section 13. Subsection (6) of section 394.9085, Florida
639 Statutes, is amended to read:
640 394.9085 Behavioral provider liability.—
641 (6) For purposes of this section, the term terms
642 “detoxification services,” has the same meaning as
643 detoxification in s. 397.311(26)(a), “addictions receiving
644 facility,” has the same meaning as provided in s.
645 397.311(26)(a), and “receiving facility” has have the same
646 meaning meanings as those provided in s. 394.455 ss.
647 397.311(26)(a)4., 397.311(26)(a)1., and 394.455(39),
648 respectively.
649 Section 14. Section 397.416, Florida Statutes, is amended
650 to read:
651 397.416 Substance use disorder abuse treatment services;
652 qualified professional.—Notwithstanding any other provision of
653 law, a person who was certified through a certification process
654 recognized by the former Department of Health and Rehabilitative
655 Services before January 1, 1995, may perform the duties of a
656 qualified professional with respect to substance use abuse
657 treatment services as defined in this chapter, and need not meet
658 the certification requirements contained in s. 397.311(35) s.
659 397.311(34).
660 Section 15. Paragraph (b) of subsection (1) of section
661 409.972, Florida Statutes, is amended to read:
662 409.972 Mandatory and voluntary enrollment.—
663 (1) The following Medicaid-eligible persons are exempt from
664 mandatory managed care enrollment required by s. 409.965, and
665 may voluntarily choose to participate in the managed medical
666 assistance program:
667 (b) Medicaid recipients residing in residential commitment
668 facilities operated through the Department of Juvenile Justice
669 or in a treatment facility as defined in s. 394.455 s.
670 394.455(47).
671 Section 16. Paragraphs (d) and (g) of subsection (1) of
672 section 440.102, Florida Statutes, are amended to read:
673 440.102 Drug-free workplace program requirements.—The
674 following provisions apply to a drug-free workplace program
675 implemented pursuant to law or to rules adopted by the Agency
676 for Health Care Administration:
677 (1) DEFINITIONS.—Except where the context otherwise
678 requires, as used in this act:
679 (d) “Drug rehabilitation program” means a service provider
680 as defined in s. 397.311 which, established pursuant to s.
681 397.311(43), that provides confidential, timely, and expert
682 identification, assessment, and resolution of employee drug
683 abuse.
684 (g) “Employee assistance program” means an established
685 program capable of providing expert assessment of employee
686 personal concerns; confidential and timely identification
687 services with regard to employee drug abuse; referrals of
688 employees for appropriate diagnosis, treatment, and assistance;
689 and followup services for employees who participate in the
690 program or require monitoring after returning to work. If, in
691 addition to the above activities, an employee assistance program
692 provides diagnostic and treatment services, these services shall
693 in all cases be provided by service providers as defined in s.
694 397.311 pursuant to s. 397.311(43).
695 Section 17. Paragraph (e) of subsection (4) of section
696 464.012, Florida Statutes, is amended to read:
697 464.012 Licensure of advanced practice registered nurses;
698 fees; controlled substance prescribing.—
699 (4) In addition to the general functions specified in
700 subsection (3), an advanced practice registered nurse may
701 perform the following acts within his or her specialty:
702 (e) A psychiatric nurse, who meets the requirements in s.
703 394.455(36) s. 394.455(35), within the framework of an
704 established protocol with a psychiatrist, may prescribe
705 psychotropic controlled substances for the treatment of mental
706 disorders.
707 Section 18. Subsection (7) of section 744.2007, Florida
708 Statutes, is amended to read:
709 744.2007 Powers and duties.—
710 (7) A public guardian may not commit a ward to a treatment
711 facility, as defined in s. 394.455 s. 394.455(47), without an
712 involuntary placement proceeding as provided by law.
713 Section 19. This act shall take effect July 1, 2019.
