Senate Bill 0682c1

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    Florida Senate - 2000                            CS for SB 682

    By the Committee on Children and Families; and Senator Forman





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  1                      A bill to be entitled

  2         An act relating to mental health services for

  3         children and adolescents; amending s. 39.407,

  4         F.S.; revising provisions governing the

  5         medical, psychiatric, and psychological

  6         examination and treatment of children;

  7         prescribing procedures for the admission of

  8         children or adolescents to residential

  9         treatment centers for residential mental health

10         treatment; amending s. 394.4785, F.S.;

11         prohibiting children and adolescents from

12         admission to state mental health treatment

13         facilities; requiring residential treatment

14         centers for children and adolescents to adhere

15         to certain standards; amending s. 394.67, F.S.;

16         defining the term "residential treatment center

17         for children and adolescents"; amending s.

18         394.875, F.S.; requiring the licensure of

19         residential treatment centers for children and

20         adolescents; requiring the Department of

21         Children and Family Services to adopt rules;

22         amending s. 409.175, F.S.; specifying that

23         residential child-caring agencies do not

24         include residential treatment centers for

25         children and adolescents; providing an

26         effective date.

27

28  Be It Enacted by the Legislature of the State of Florida:

29

30         Section 1.  Section 39.407, Florida Statutes, is

31  amended to read:

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  1         39.407  Medical, psychiatric, and psychological

  2  examination and treatment of child; physical or mental

  3  examination of parent or person requesting custody of child.--

  4         (1)  When any child is removed from the home and

  5  maintained in an out-of-home placement, the department is

  6  authorized to have a medical screening performed on the child

  7  without authorization from the court and without consent from

  8  a parent or legal custodian.  Such medical screening shall be

  9  performed by a licensed health care professional and shall be

10  to examine the child for injury, illness, and communicable

11  diseases and to determine the need for immunization.  The

12  department shall by rule establish the invasiveness of the

13  medical procedures authorized to be performed under this

14  subsection.  In no case does this subsection authorize the

15  department to consent to medical treatment for such children.

16         (2)  When the department has performed the medical

17  screening authorized by subsection (1), or when it is

18  otherwise determined by a licensed health care professional

19  that a child who is in an out-of-home placement, but who has

20  not been committed to the department, is in need of medical

21  treatment, including the need for immunization, consent for

22  medical treatment shall be obtained in the following manner:

23         (a)1.  Consent to medical treatment shall be obtained

24  from a parent or legal custodian of the child; or

25         2.  A court order for such treatment shall be obtained.

26         (b)  If a parent or legal custodian of the child is

27  unavailable and his or her whereabouts cannot be reasonably

28  ascertained, and it is after normal working hours so that a

29  court order cannot reasonably be obtained, an authorized agent

30  of the department shall have the authority to consent to

31  necessary medical treatment, including immunization, for the

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  1  child. The authority of the department to consent to medical

  2  treatment in this circumstance shall be limited to the time

  3  reasonably necessary to obtain court authorization.

  4         (c)  If a parent or legal custodian of the child is

  5  available but refuses to consent to the necessary treatment,

  6  including immunization, a court order shall be required unless

  7  the situation meets the definition of an emergency in s.

  8  743.064 or the treatment needed is related to suspected abuse,

  9  abandonment, or neglect of the child by a parent, caregiver,

10  or legal custodian.  In such case, the department shall have

11  the authority to consent to necessary medical treatment.  This

12  authority is limited to the time reasonably necessary to

13  obtain court authorization.

14

15  In no case shall the department consent to sterilization,

16  abortion, or termination of life support.

17         (3)(a)  A judge may order a child in an out-of-home

18  placement to be examined by a licensed health care

19  professional.

20         (b)  The judge may also order such child to be

21  evaluated by a psychiatrist or a psychologist, by a district

22  school board educational needs assessment team, or, if a

23  developmental disability is suspected or alleged, by the

24  developmental disability diagnostic and evaluation team of the

25  department.  If it is necessary to place a child in a

26  residential facility for such evaluation, then the criteria

27  and procedure established in s. 394.463(2) or chapter 393

28  shall be used, whichever is applicable.

29         (c)  The judge may also order such child to be

30  evaluated by a district school board educational needs

31  assessment team. The educational needs assessment provided by

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  1  the district school board educational needs assessment team

  2  shall include, but not be limited to, reports of intelligence

  3  and achievement tests, screening for learning disabilities and

  4  other handicaps, and screening for the need for alternative

  5  education as defined in s. 230.23.

  6         (4)  A judge may order a child in an out-of-home

  7  placement to be treated by a licensed health care professional

  8  based on evidence that the child should receive treatment.

  9  The judge may also order such child to receive mental health

10  or developmental disabilities retardation services from a

11  psychiatrist, psychologist, or other appropriate service

12  provider.  Except as provided in subsection (5), if it is

13  necessary to place the child in a residential facility for

14  such services, then the procedures and criteria established in

15  s. 394.467 or chapter 393 shall be used, whichever is

16  applicable. A child may be provided developmental disabilities

17  or mental health or retardation services in emergency

18  situations, pursuant to the procedures and criteria contained

19  in s. 394.463(1) or chapter 393, whichever is applicable.

20         (5)  Children who are in the legal custody of the

21  department may be placed by the department in a residential

22  treatment center licensed under s. 394.875 or a hospital

23  licensed under chapter 395 for residential mental health

24  treatment only pursuant to this section or may be placed by

25  the court in accordance with an order of involuntary

26  examination or involuntary placement entered pursuant to s.

27  394.463 or s. 394.467. All children placed in a residential

28  treatment program under this subsection must have a guardian

29  ad litem appointed.

30         (a)  As used in this subsection, the term:

31

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  1         1.  "Residential treatment" means placement for

  2  observation, diagnosis, or treatment of an emotional

  3  disturbance in a residential treatment center licensed under

  4  s. 394.875 or a hospital licensed under chapter 395.

  5         2.  "Least-restrictive alternative" means the treatment

  6  and conditions of treatment that, separately and in

  7  combination, are no more intrusive or restrictive of freedom

  8  than reasonably necessary to achieve a substantial therapeutic

  9  benefit or to protect the child or adolescent or others from

10  physical injury.

11         3.  "Suitable for residential treatment" or

12  "suitability" means a determination concerning a child or

13  adolescent with an emotional disturbance as defined in s.

14  394.492(5) or a serious emotional disturbance as defined in s.

15  394.492(6) that each of the following criteria is met:

16         a.  The child requires residential treatment.

17         b.  The child is in need of a residential treatment

18  program and is expected to benefit from mental health

19  treatment.

20         c.  An appropriate, less restrictive alternative to

21  residential treatment is unavailable.

22         (b)  Whenever the department believes that a child in

23  its legal custody is emotionally disturbed and may need

24  residential treatment, an examination and suitability

25  assessment must be conducted by a qualified evaluator who is

26  appointed by the Agency for Health Care Administration. This

27  suitability assessment must be completed before the placement

28  of the child in a residential treatment center for emotionally

29  disturbed children and adolescents or a hospital. The

30  qualified evaluator must be a psychiatrist or a psychologist

31  licensed in Florida who has at least 3 years of experience in

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  1  the diagnosis and treatment of serious emotional disturbances

  2  in children and adolescents and who has no actual or perceived

  3  conflict of interest with any inpatient facility or

  4  residential treatment center or program.

  5         (c)  Before a child is admitted under this subsection,

  6  the child shall be assessed for suitability for residential

  7  treatment by a qualified evaluator who has conducted a

  8  personal examination and assessment of the child and has made

  9  written findings that:

10         1.  The child appears to have an emotional disturbance

11  serious enough to require residential treatment and is

12  reasonably likely to benefit from the treatment.

13         2.  The child has been provided with a clinically

14  appropriate explanation of the nature and purpose of the

15  treatment.

16         3.  All available modalities of treatment less

17  restrictive than residential treatment have been considered,

18  and a less restrictive alternative that would offer comparable

19  benefits to the child is unavailable.

20

21  A copy of the written findings of the evaluation and

22  suitability assessment must be provided to the department and

23  to the guardian ad litem, who shall have the opportunity to

24  discuss the findings with the evaluator.

25         (d)  Immediately upon placing a child in a residential

26  treatment program under this section, the department must

27  notify the guardian ad litem and the court having jurisdiction

28  over the child and must provide the guardian ad litem and the

29  court with a copy of the assessment by the qualified

30  evaluator.

31

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  1         (e)1.  Within 10 days after the admission of a child to

  2  a residential treatment program, the director of the

  3  residential treatment program or the director's designee must

  4  ensure that an individualized plan of treatment has been

  5  prepared by the program and has been explained to the child,

  6  to the department and to the guardian ad litem, and submitted

  7  to the department. The child must be involved in the

  8  preparation of the plan to the maximum feasible extent

  9  consistent with his or her ability to understand and

10  participate, and the guardian ad litem and the child's foster

11  parents must be involved to the maximum extent consistent with

12  the child's treatment needs. The plan must include a

13  preliminary plan for residential treatment and aftercare upon

14  completion of residential treatment. The plan must include

15  specific behavioral and emotional goals against which the

16  success of the residential treatment may be measured. A copy

17  of the plan must be provided to the child, to the guardian ad

18  litem, and to the department.

19         (f)  Within 30 days after admission, the residential

20  treatment program must review the appropriateness and

21  suitability of the child's placement in the program. The

22  residential treatment program must determine whether the child

23  is receiving benefit towards the treatment goals and whether

24  the child could be treated in a less restrictive treatment

25  program. The residential treatment program shall prepare a

26  written report of its findings and submit the report to the

27  guardian ad litem and to the department. The department must

28  submit the report to the court. The report must include a

29  discharge plan for the child. The residential treatment

30  program must continue to evaluate the child's treatment

31  progress every 30 days thereafter and must include its

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  1  findings in a written report submitted to the department. The

  2  department may not reimburse a facility until the facility has

  3  submitted every written report that is due.

  4         (g)1.  The department must submit, at the beginning of

  5  each month, to the court having jurisdiction over the child a

  6  written report regarding the child's progress towards

  7  achieving the goals specified in the individualized plan of

  8  treatment.

  9         2.  The court must conduct a hearing to review the

10  status of the child's residential treatment plan no later than

11  3 months after the child's admission to the residential

12  treatment program. An independent review of the child's

13  progress towards achieving the goals and objectives of the

14  treatment plan must be completed by a qualified evaluator and

15  submitted to the court before its 3-month review.

16         3.  For any child in residential treatment at the time

17  a judicial review is held pursuant to s. 39.701, the child's

18  continued placement in residential treatment must be a subject

19  of the judicial review.

20         4.  If at any time the court determines that the child

21  is not suitable for continued residential treatment, the court

22  shall order the department to place the child in the least

23  restrictive setting that is best suited to meet his or her

24  needs.

25         (h)  After the initial 3-month review, the court must

26  conduct a review of the child's residential treatment plan

27  every 90 days.

28         (i)  The department must adopt rules for implementing

29  timeframes for the completion of suitability assessments by

30  qualified evaluators and a procedure that includes timeframes

31  for completing the 3-month independent review by the qualified

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  1  evaluators of the child's progress towards achieving the goals

  2  and objectives of the treatment plan which review must be

  3  submitted to the court. The Agency for Health Care

  4  Administration must adopt rules for the registration of

  5  qualified evaluators, the procedure for selecting the

  6  evaluators to conduct the reviews required under this section,

  7  and a reasonable, cost-efficient fee schedule for qualified

  8  evaluators.

  9         (6)(5)  When a child is in an out-of-home placement, a

10  licensed health care professional shall be immediately called

11  if there are indications of physical injury or illness, or the

12  child shall be taken to the nearest available hospital for

13  emergency care.

14         (7)(6)  Except as otherwise provided herein, nothing in

15  this section shall be deemed to eliminate the right of a

16  parent, legal custodian, or the child to consent to

17  examination or treatment for the child.

18         (8)(7)  Except as otherwise provided herein, nothing in

19  this section shall be deemed to alter the provisions of s.

20  743.064.

21         (9)(8)  A court shall not be precluded from ordering

22  services or treatment to be provided to the child by a duly

23  accredited practitioner who relies solely on spiritual means

24  for healing in accordance with the tenets and practices of a

25  church or religious organization, when required by the child's

26  health and when requested by the child.

27         (10)(9)  Nothing in this section shall be construed to

28  authorize the permanent sterilization of the child unless such

29  sterilization is the result of or incidental to medically

30  necessary treatment to protect or preserve the life of the

31  child.

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  1         (11)(10)  For the purpose of obtaining an evaluation or

  2  examination, or receiving treatment as authorized pursuant to

  3  this section, no child alleged to be or found to be dependent

  4  shall be placed in a detention home or other program used

  5  primarily for the care and custody of children alleged or

  6  found to have committed delinquent acts.

  7         (12)(11)  The parents or legal custodian of a child in

  8  an out-of-home placement remain financially responsible for

  9  the cost of medical treatment provided to the child even if

10  either one or both of the parents or if the legal custodian

11  did not consent to the medical treatment. After a hearing, the

12  court may order the parents or legal custodian, if found able

13  to do so, to reimburse the department or other provider of

14  medical services for treatment provided.

15         (13)(12)  Nothing in this section alters the authority

16  of the department to consent to medical treatment for a

17  dependent child when the child has been committed to the

18  department and the department has become the legal custodian

19  of the child.

20         (14)(13)  At any time after the filing of a shelter

21  petition or petition for dependency, when the mental or

22  physical condition, including the blood group, of a parent,

23  caregiver, legal custodian, or other person requesting custody

24  of a child is in controversy, the court may order the person

25  to submit to a physical or mental examination by a qualified

26  professional.  The order may be made only upon good cause

27  shown and pursuant to notice and procedures as set forth by

28  the Florida Rules of Juvenile Procedure.

29         Section 2.  Section 394.4785, Florida Statutes, is

30  amended to read:

31

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  1         394.4785  Children and adolescents Minors; admission

  2  and placement in mental facilities.--

  3         (1)  A child or adolescent as defined in s. 394.492 may

  4  not be admitted to a state-owned or state-operated mental

  5  health treatment facility. A child may be admitted pursuant to

  6  s. 394.4625 or s. 394.467 to a crisis stabilization unit or a

  7  residential treatment center licensed under chapter 394 or a

  8  hospital licensed under chapter 395. The treatment center,

  9  unit, or hospital must provide the least-restrictive available

10  treatment that is appropriate to the individual needs of the

11  child or adolescent and must adhere to the guiding principles,

12  system of care, and service planning provisions contained in

13  part III of chapter 394. (a)  A minor who is admitted to a

14  state mental hospital and placed in the general population or

15  in a specialized unit for children or adolescents shall reside

16  in living quarters separate from adult patients, and a minor

17  who has not attained the age of 14 shall reside in living

18  quarters separate from minors who are 14 years of age or

19  older.

20         (2)(b)  A person minor under the age of 14 who is

21  admitted to any hospital licensed pursuant to chapter 395 may

22  shall not be admitted to a bed in a room or ward with an adult

23  patient in a mental health unit or share common areas with an

24  adult patient in a mental health unit.  However, a person

25  minor 14 years of age or older may be admitted to a bed in a

26  room or ward in the mental health unit with an adult if the

27  admitting physician documents in the case record that such

28  placement is medically indicated or for reasons of safety.

29  Such placement shall be reviewed by the attending physician or

30  a designee or on-call physician each day and documented in the

31  case record.

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  1         (2)  In all cases involving the admission of minors to

  2  a state mental hospital, the case record shall document that a

  3  good faith effort was made to place the minor in a less

  4  restrictive form of treatment.  Admission to a state mental

  5  hospital shall be regarded as the last and only treatment

  6  option available. Notwithstanding the provision of paragraph

  7  (1)(a), an individual under the age of 18 may be housed in the

  8  general population if the hospital multidisciplinary treatment

  9  and rehabilitation team has reviewed the patient and has

10  documented in the case record that such placement is necessary

11  for reasons of safety.  Such patients placed in the general

12  population must be reviewed by this team every 30 days and

13  recertified as appropriate for placement in the general

14  population.

15         Section 3.  Present subsections (18), (19), and (20) of

16  section 394.67, Florida Statutes, are redesignated as

17  subsections (19), (20), and (21), respectively, and a new

18  subsection (18) is added to that section to read:

19         394.67  Definitions.--As used in this part, the term:

20         (18)  "Residential treatment center for children and

21  adolescents" means a 24-hour residential program, including a

22  therapeutic group home, which provides mental health services

23  to emotionally disturbed children or adolescents as defined in

24  s. 394.492(5) or (6) and which is a private for-profit or

25  not-for-profit corporation under contract with the department

26  which offers a variety of treatment modalities in a more

27  restrictive setting.

28         Section 4.  Section 394.875, Florida Statutes, is

29  amended to read:

30         394.875  Crisis stabilization units, and residential

31  treatment facilities, and residential treatment centers for

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  1  children and adolescents; authorized services; license

  2  required; penalties.--

  3         (1)(a)  The purpose of a crisis stabilization unit is

  4  to stabilize and redirect a client to the most appropriate and

  5  least restrictive community setting available, consistent with

  6  the client's needs.  Crisis stabilization units may screen,

  7  assess, and admit for stabilization persons who present

  8  themselves to the unit and persons who are brought to the unit

  9  under s. 394.463.  Clients may be provided 24-hour

10  observation, medication prescribed by a physician or

11  psychiatrist, and other appropriate services.  Crisis

12  stabilization units shall provide services regardless of the

13  client's ability to pay and shall be limited in size to a

14  maximum of 30 beds.

15         (b)  The purpose of a residential treatment facility is

16  to be a part of a comprehensive treatment program for mentally

17  ill individuals in a community-based residential setting.

18         (c)  The purpose of a residential treatment center for

19  children and adolescents is to provide mental health

20  assessment and treatment services pursuant to ss. 394.491,

21  394.495, and 394.496 to children and adolescents who meet the

22  target population criteria specified in s. 394.493(1)(a), (b),

23  or (c).

24         (2)  It is unlawful for any entity to hold itself out

25  as a crisis stabilization unit, or a residential treatment

26  facility, or a residential treatment center for children and

27  adolescents, or to act as a crisis stabilization unit, or a

28  residential treatment facility, or a residential treatment

29  center for children and adolescents, unless it is licensed by

30  the agency pursuant to this chapter.

31

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  1         (3)  Any person who violates subsection (2) is guilty

  2  of a misdemeanor of the first degree, punishable as provided

  3  in s. 775.082 or s. 775.083.

  4         (4)  The agency may maintain an action in circuit court

  5  to enjoin the unlawful operation of a crisis stabilization

  6  unit, or a residential treatment facility, or a residential

  7  treatment center for children and adolescents if the agency

  8  first gives the violator 14 days' notice of its intention to

  9  maintain such action and if the violator fails to apply for

10  licensure within such 14-day period.

11         (5)  Subsection (2) does not apply to:

12         (a)  Homes for special services licensed under chapter

13  400; or

14         (b)  Nursing homes licensed under chapter 400.; or

15         (c)  Comprehensive transitional education programs

16  Residential child caring facilities licensed under s. 393.067

17  s. 409.175.

18         (6)  The department, in consultation with the agency,

19  may establish multiple license classifications for residential

20  treatment facilities.

21         (7)  The agency may not issue a license to a crisis

22  stabilization unit unless the unit receives state mental

23  health funds and is affiliated with a designated public

24  receiving facility.

25         (8)  The agency may issue a license for a crisis

26  stabilization unit or short-term residential treatment

27  facility, certifying the number of authorized beds for such

28  facility as indicated by existing need and available

29  appropriations.  The agency may disapprove an application for

30  such a license if it determines that a facility should not be

31  licensed pursuant to the provisions of this chapter.  Any

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  1  facility operating beds in excess of those authorized by the

  2  agency shall, upon demand of the agency, reduce the number of

  3  beds to the authorized number, forfeit its license, or provide

  4  evidence of a license issued pursuant to chapter 395 for the

  5  excess beds.

  6         (9)  A children's crisis stabilization unit which does

  7  not exceed 20 licensed beds and which provides separate

  8  facilities or a distinct part of a facility, separate

  9  staffing, and treatment exclusively for minors may be located

10  on the same premises as a crisis stabilization unit serving

11  adults. The department, in consultation with the agency, shall

12  adopt rules governing facility construction, staffing and

13  licensure requirements, and the operation of such units for

14  minors.

15         (10)  The department, in consultation with the agency,

16  must adopt rules governing a residential treatment center for

17  children and adolescents which specify licensure standards

18  for:  admission; length of stay; program and staffing;

19  discharge and discharge planning; treatment planning;

20  seclusion, restraints, and time-out; rights of patients under

21  s. 394.459; use of psychotropic medications; and standards for

22  the operation of such centers.

23         (11)(10)  Notwithstanding the provisions of subsection

24  (8), crisis stabilization units may not exceed their licensed

25  capacity by more than 10 percent, nor may they exceed their

26  licensed capacity for more than 3 consecutive working days or

27  for more than 7 days in 1 month.

28         (12)(11)  Notwithstanding the other provisions of this

29  section, any facility licensed under chapters 396 and 397 for

30  detoxification, residential level I care, and outpatient

31  treatment may elect to license concurrently all of the beds at

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  1  such facility both for that purpose and as a long-term

  2  residential treatment facility pursuant to this section, if

  3  all of the following conditions are met:

  4         (a)  The licensure application is received by the

  5  department prior to January 1, 1993.

  6         (b)  On January 1, 1993, the facility was licensed

  7  under chapters 396 and 397 as a facility for detoxification,

  8  residential level I care, and outpatient treatment of

  9  substance abuse.

10         (c)  The facility restricted its practice to the

11  treatment of law enforcement personnel for a period of at

12  least 12 months beginning after January 1, 1992.

13         (d)  The number of beds to be licensed under chapter

14  394 is equal to or less than the number of beds licensed under

15  chapters 396 and 397 as of January 1, 1993.

16         (e)  The licensee agrees in writing to a condition

17  placed upon the license that the facility will limit its

18  treatment exclusively to law enforcement personnel and their

19  immediate families who are seeking admission on a voluntary

20  basis and who are exhibiting symptoms of posttraumatic stress

21  disorder or other mental health problems, including drug or

22  alcohol abuse, which are directly related to law enforcement

23  work and which are amenable to verbal treatment therapies; the

24  licensee agrees to coordinate the provision of appropriate

25  postresidential care for discharged individuals; and the

26  licensee further agrees in writing that a failure to meet any

27  condition specified in this paragraph shall constitute grounds

28  for a revocation of the facility's license as a residential

29  treatment facility.

30         (f)  The licensee agrees that the facility will meet

31  all licensure requirements for a residential treatment

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  1  facility, including minimum standards for compliance with

  2  lifesafety requirements, except those licensure requirements

  3  which are in express conflict with the conditions and other

  4  provisions specified in this subsection.

  5         (g)  The licensee agrees that the conditions stated in

  6  this subsection must be agreed to in writing by any person

  7  acquiring the facility by any means.

  8

  9  Any facility licensed under this subsection is not required to

10  provide any services to any persons except those included in

11  the specified conditions of licensure, and is exempt from any

12  requirements related to the 60-day or greater average length

13  of stay imposed on community-based residential treatment

14  facilities otherwise licensed under this chapter.

15         (13)(12)  Each applicant for licensure must comply with

16  the following requirements:

17         (a)  Upon receipt of a completed, signed, and dated

18  application, the agency shall require background screening, in

19  accordance with the level 2 standards for screening set forth

20  in chapter 435,  of the managing employee and financial

21  officer, or other similarly titled individual who is

22  responsible for the financial operation of the facility,

23  including billings for client care and services. The applicant

24  must comply with the procedures for level 2 background

25  screening as set forth in chapter 435, as well as the

26  requirements of s. 435.03(3).

27         (b)  The agency may require background screening of any

28  other individual who is an applicant if the agency has

29  probable cause to believe that he or she has been convicted of

30  a crime or has committed any other offense prohibited under

31  the level 2 standards for screening set forth in chapter 435.

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  1         (c)  Proof of compliance with the level 2 background

  2  screening requirements of chapter 435 which has been submitted

  3  within the previous 5 years in compliance with any other

  4  health care licensure requirements of this state is acceptable

  5  in fulfillment of the requirements of paragraph (a).

  6         (d)  A provisional license may be granted to an

  7  applicant when each individual required by this section to

  8  undergo background screening has met the standards for the

  9  abuse registry background check and the Department of Law

10  Enforcement background check, but the agency has not yet

11  received background screening results from the Federal Bureau

12  of Investigation, or a request for a disqualification

13  exemption has been submitted to the agency as set forth in

14  chapter 435, but a response has not yet been issued. A

15  standard license may be granted to the applicant upon the

16  agency's receipt of a report of the results of the Federal

17  Bureau of Investigation background screening for each

18  individual required by this section to undergo background

19  screening which confirms that all standards have been met, or

20  upon the granting of a disqualification exemption by the

21  agency as set forth in chapter 435. Any other person who is

22  required to undergo level 2 background screening may serve in

23  his or her capacity pending the agency's receipt of the report

24  from the Federal Bureau of Investigation. However, the person

25  may not continue to serve if the report indicates any

26  violation of background screening standards and a

27  disqualification exemption has not been requested of and

28  granted by the agency as set forth in chapter 435.

29         (e)  Each applicant must submit to the agency, with its

30  application, a description and explanation of any exclusions,

31  permanent suspensions, or terminations of the applicant from

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  1  the Medicare or Medicaid programs. Proof of compliance with

  2  the requirements for disclosure of ownership and control

  3  interests under the Medicaid or Medicare programs shall be

  4  accepted in lieu of this submission.

  5         (f)  Each applicant must submit to the agency a

  6  description and explanation of any conviction of an offense

  7  prohibited under the level 2 standards of chapter 435 by a

  8  member of the board of directors of the applicant, its

  9  officers, or any individual owning 5 percent or more of the

10  applicant. This requirement does not apply to a director of a

11  not-for-profit corporation or organization if the director

12  serves solely in a voluntary capacity for the corporation or

13  organization, does not regularly take part in the day-to-day

14  operational decisions of the corporation or organization,

15  receives no remuneration for his or her services on the

16  corporation or organization's board of directors, and has no

17  financial interest and has no family members with a financial

18  interest in the corporation or organization, provided that the

19  director and the not-for-profit corporation or organization

20  include in the application a statement affirming that the

21  director's relationship to the corporation satisfies the

22  requirements of this paragraph.

23         (g)  A license may not be granted to an applicant if

24  the applicant or managing employee has been found guilty of,

25  regardless of adjudication, or has entered a plea of nolo

26  contendere or guilty to, any offense prohibited under the

27  level 2 standards for screening set forth in chapter 435,

28  unless an exemption from disqualification has been granted by

29  the agency as set forth in chapter 435.

30         (h)  The agency may deny or revoke licensure if the

31  applicant:

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  1         1.  Has falsely represented a material fact in the

  2  application required by paragraph (e) or paragraph (f), or has

  3  omitted any material fact from the application required by

  4  paragraph (e) or paragraph (f); or

  5         2.  Has had prior action taken against the applicant

  6  under the Medicaid or Medicare program as set forth in

  7  paragraph (e).

  8         (i)  An application for license renewal must contain

  9  the information required under paragraphs (e) and (f).

10         Section 5.  Paragraph (j) of subsection (2) of section

11  409.175, Florida Statutes, is amended to read:

12         409.175  Licensure of family foster homes, residential

13  child-caring agencies, and child-placing agencies.--

14         (2)  As used in this section, the term:

15         (j)  "Residential child-caring agency" means any

16  person, corporation, or agency, public or private, other than

17  the child's parent or legal guardian, that provides staffed

18  24-hour care for children in facilities maintained for that

19  purpose, regardless of whether operated for profit or whether

20  a fee is charged.  Such residential child-caring agencies

21  include, but are not limited to, maternity homes, runaway

22  shelters, group homes that are administered by an agency,

23  emergency shelters that are not in private residences, and

24  wilderness camps.  Residential child-caring agencies do not

25  include hospitals, boarding schools, summer or recreation

26  camps, nursing homes, or facilities operated by a governmental

27  agency for the training, treatment, or secure care of

28  delinquent youth, or facilities licensed under s. 393.067 or

29  s. 394.875 or chapter 397.

30         Section 6.  This act shall take effect October 1, 2000.

31

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  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 682

  3

  4  -     Removes the provision that the voluntariness hearing in
          s. 394.4625, F.S., be conducted by the court for the
  5        voluntary admission of children and adolescents to
          mental health facilities.
  6
    -     Establishes a procedure for the Department of Children
  7        and Family Services to place children for whom they have
          legal custody in a residential treatment program. This
  8        placement procedure assures that:

  9       -      A qualified evaluator identified by the Agency for
                Health Care Administration has determined that the
10              child needs the most restrictive mental health
                treatment setting.
11
         -      The court having jurisdiction over the child is
12              informed of the child's placement.

13       -      The residential facility reports monthly to the
                department on the child's progress toward
14              discharge and the department submits this report
                to the court having jurisdiction over the child.
15
         -      The court conduct a hearing 3 months after the
16              child is placed in the residential facility to
                review the status of the child's treatment
17              progress, review the placement of a child's 6
                month review already required in ch. 39, and
18              review the child's placement at least every 90
                days thereafter.
19
         -      The Department of Children and Family Services and
20              the Agency for Health Care Administration are
                directed to adopt rules to implement these
21              procedures.

22  -     Specifies that residential treatment centers for
          children and adolescents include therapeutic group
23        homes.

24  -     Adds several residential treatment center licensure
          provisions for which the Department of Children and
25        Family Services may adopt rules including standards for
          admission; length of stay; discharge and discharge
26        planning; treatment planning; seclusion, restraints, and
          time-out; and use of psychotropic medications.
27

28

29

30

31

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