Florida Senate - 2016 CS for SB 998 By the Committee on Health Policy; and Senator Ring 588-02317-16 2016998c1 1 A bill to be entitled 2 An act relating to adolescent and child treatment 3 programs; creating s. 394.88, F.S.; providing purpose 4 of adolescent and child residential treatment 5 programs; defining terms; requiring licensure by the 6 Agency for Health Care Administration; requiring the 7 Department of Children and Families to adopt rules for 8 the licensure, administration, and operation of 9 programs and program facilities; providing staffing 10 requirements; requiring a treatment plan for each 11 resident; requiring a review of treatment plans; 12 requiring written documentation of compliance with 13 certain local requirements; providing location 14 requirements for program facilities under certain 15 circumstances; authorizing the department to establish 16 certain requirements; requiring a program to provide a 17 curriculum; requiring a program to conduct certain 18 counseling sessions; creating s. 394.89, F.S.; 19 providing purpose of adolescent and child outdoor 20 programs; defining terms; requiring licensure by the 21 agency; requiring the department to adopt rules for 22 the licensure, administration, and operation of 23 programs; providing regulations and licensing 24 requirements for programs; providing administrative 25 requirements for programs; requiring programs to have 26 an educational component approved by the Department of 27 Education under certain circumstances; providing 28 requirements and qualifications for program staff; 29 requiring the program supervisor to maintain a current 30 list and enrollment records of all participants; 31 requiring program supervisors to develop a written 32 plan for each field group activity and expedition; 33 providing an effective date. 34 35 Be It Enacted by the Legislature of the State of Florida: 36 37 Section 1. Section 394.88, Florida Statutes, is created to 38 read: 39 394.88 Adolescent and child residential treatment 40 programs.— 41 (1) The purpose of an adolescent and child residential 42 treatment program is to offer room and board and to provide, or 43 arrange for the provision of, specialized treatment, specialized 44 therapies as defined in s. 393.063, and services for 45 rehabilitation or habilitation as defined in s. 393.063, for 46 adolescents and children with emotional, psychological, 47 developmental, or behavioral problems or disorders, or substance 48 abuse problems. In an adolescent and child residential treatment 49 program, adolescents and children are assisted in acquiring the 50 social and behavioral skills necessary for a healthy adjustment 51 to school, family life, and community. 52 (2) As used in this section, the term: 53 (a) “Adolescent and child residential treatment program” or 54 “program” means a privately owned and operated 24-hour group 55 living environment for four or more adolescents or children 56 unrelated to the owner or provider. 57 (b) “Program resident” or “resident” means an adolescent or 58 child at least 6 and no more than 18 years of age who enrolls 59 and participates in a program. 60 (3) An adolescent and child residential treatment program 61 must be licensed by the Agency for Health Care Administration in 62 accordance with part II of chapter 408. The department, in 63 consultation with the agency and the Agency for Persons with 64 Disabilities, shall establish by rule requirements for 65 licensure, administration, and operation of programs and program 66 facilities consistent with this section. 67 (4)(a) A program must employ a licensed psychiatrist or a 68 psychologist licensed under chapter 490 as the director of the 69 program. The director is responsible for the operation of the 70 program, the program facility, and the day-to-day supervision of 71 program residents. The director or a member of program staff 72 appointed by the director as his or her substitute must be 73 present at the program facility at all times. The director shall 74 maintain on site a current list of all program residents. 75 (b) Program staff must include, in addition to the 76 director, physicians licensed under chapter 458 or chapter 459, 77 psychologists licensed under chapter 490 or chapter 491, mental 78 health counselors licensed under chapter 491, or advanced 79 registered nurse practitioners licensed under part 1 of chapter 80 464 and certified under s. 464.012 who have been trained in 81 providing medical services and treatment to adolescents and 82 children to serve as professional program staff providing 83 treatment to residents. Such professional program staff must be 84 specifically trained in providing medical services and treatment 85 to adolescents and children diagnosed with mental health and 86 substance abuse problems and to residents with disabilities if 87 the program serves these populations. A program must have a 88 minimum of two such professional staff members on duty at all 89 times and must maintain a professional staff-to-resident ratio 90 of no less than 1 to 4 during awake hours. All program staff, 91 professional and non-professional, and all providers who may be 92 contracted to provide services to residents must undergo a level 93 2 background screening before engaging in any activity that 94 brings them into contact with a resident. The department may 95 establish by rule further staffing requirements to ensure 96 resident safety and service delivery consistent with this 97 section. 98 (5) A program must ensure that a treatment plan exists for 99 each resident. The treatment plan must be reviewed and signed at 100 the time a resident enrolls and periodically after enrollment, 101 as provided in the treatment plan, by the director of the 102 program and the resident’s parent or legal guardian. The 103 department may establish by rule further requirements relating 104 to the treatment and care of residents consistent with this 105 section. 106 (6) A program must maintain written documentation of 107 compliance with the following local requirements, as applicable: 108 (a) Zoning ordinances. 109 (b) Business license requirements. 110 (c) Building codes. 111 (d) Firesafety codes and standards. 112 (e) Health codes. 113 (f) Approval from appropriate governmental agencies for new 114 program services or increased consumer capacity. 115 116 A program facility that provides services to residents with 117 disabilities must be located where schools, churches, recreation 118 facilities, and other community facilities are available. The 119 department may establish by rule further requirements relating 120 to the program facility, including, but not limited to, interior 121 and exterior building dimensions, housing and kitchen standards, 122 meal plan guidelines, medication management, resident privacy 123 and accountability for his or her personal effects, and 124 cleanliness and safety standards, consistent with this section. 125 (7) A program must: 126 (a) Provide a curriculum approved by the Department of 127 Education to residents. A program that provides its own school 128 must be recognized and approved by the State Board of Education, 129 the Southern Association of Colleges and Schools, or another 130 educational accreditation organization. 131 (b) Conduct individual, group, couple, and family 132 counseling sessions or other appropriate treatment, including 133 skills development therapy, at least weekly, or more often if 134 required by a resident’s treatment plan. The program must 135 document the time, date, and nature of such services, including 136 the signature of the counselor providing them, in the individual 137 record for each resident. 138 Section 2. Section 394.89, Florida Statutes, is created to 139 read: 140 394.89 Adolescent and child outdoor programs.— 141 (1) The purpose of an adolescent and child outdoor program 142 is to offer wilderness hiking and camping experiences through 143 program field group activities and expeditions as a form of 144 rehabilitation and treatment for adolescents or children with 145 emotional, psychological, developmental, or behavioral problems 146 or disorders, or substance abuse problems. In an adolescent and 147 child outdoor program, adolescents and children are assisted in 148 acquiring the social and behavioral skills necessary for a 149 healthy adjustment to school, family life, and community. 150 (2) As used in this section, the term: 151 (a) “Adolescent and child outdoor program” or “program” 152 means a privately owned and operated 24-hour group wilderness 153 hiking and camping experience for four or more adolescents or 154 children unrelated to the owner or provider. A program may be 155 established independently or as an adjunct and subsidiary of an 156 adolescent and child residential treatment program established 157 pursuant to s. 394.88. 158 (b) “Program participant” or “participant” means an 159 adolescent or child at least 6 and no more than 18 years of age 160 who enrolls and participates in a program. The term does not 161 include the parent or contracting agent that enrolls the 162 adolescent or child in the program. 163 (3)(a) An adolescent and child outdoor program must be 164 licensed by the Agency for Health Care Administration in 165 accordance with part II of chapter 408. The department, in 166 consultation with the agency and the Agency for Persons with 167 Disabilities, shall establish by rule requirements for 168 licensure, administration, and operation of programs consistent 169 with this section. All local, state, and federal regulations and 170 professional licensing requirements must be met by a program as 171 a condition of licensure by the agency. The agency must review 172 and approve a program’s training plan specifying the program’s 173 goals and methodologies. The training plan must include 174 provisions governing a participant’s conduct and the 175 consequences for his or her conduct while enrolled in the 176 program. 177 (b) A program must provide an educational component 178 approved by the Department of Education to a participant who is 179 absent from his or her school or educational setting for more 180 than 30 days. Before enrolling a participant, the program 181 supervisor must coordinate with the local school board to 182 provide an educational component as part of the participant’s 183 program experience. To offer educational credit to participants, 184 the program must be recognized and approved by the State Board 185 of Education. 186 (4)(a) A program must employ a licensed psychiatrist or a 187 psychologist licensed under chapter 490 as its program 188 supervisor. The program supervisor is responsible for and has 189 authority over the policies and activities of the program. The 190 program supervisor shall coordinate office and support services, 191 supervise the operations of the program, and ensure that all 192 program staff are adequately trained. The program supervisor 193 shall maintain on file at all times enrollment records of all 194 participants and a current list of participants, including each 195 participant’s group field activity or expedition and his or her 196 geographic location. The list must be updated every 24 hours. 197 The program supervisor must develop and sign a written plan for 198 each group field activity and expedition. Plans must not expose 199 participants to unreasonable risks. 200 (b) Each group field activity or expedition must have field 201 staff working directly with the participants. A program must 202 have field support staff members who are responsible for the 203 delivery of supplies to the field, mail delivery, 204 communications, and first aid support. 205 (c) Each program must provide its participants access to a 206 multidisciplinary team of licensed health care providers and 207 licensed mental health counselors who have been trained in 208 providing medical services and treatment to adolescents and 209 children and which includes, at a minimum, the following: 210 1. A physician licensed under chapter 458 or chapter 459. 211 2. At least one of the following: 212 a. A psychologist licensed under chapter 490 or chapter 213 491. 214 b. A licensed clinical social worker. 215 c. A mental health counselor licensed under chapter 491. 216 d. A licensed marriage and family therapist. 217 e. A certified school counselor. 218 (d) All program staff, professional and non-professional, 219 and all providers who may be contracted to provide services to 220 participants must undergo a level 2 background screening before 221 engaging in any activity that brings them into contact with a 222 participant. The department may establish by rule further 223 staffing requirements consistent with this section. 224 Section 3. This act shall take effect July 1, 2016.