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.
72
73 Be It Enacted by the Legislature of the State of Florida:
74
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.—
152 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
153 EXCEPTIONS.—
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.
165 (4) EXEMPTIONS FROM 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.—
180 (1) LEGISLATIVE FINDINGS AND INTENT.—
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.
