CODING: Words stricken are deletions; words underlined are additions.



                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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  4  ______________________________________________________________

  5                                           ORIGINAL STAMP BELOW

  6

  7

  8

  9

10  ______________________________________________________________

11  The Committee on Health Regulation offered the following:

12

13         Amendment (with title amendment) 

14  Remove everything after the enacting clause

15

16  and insert:

17         Section 1.  Section 397.311, Florida Statutes, is

18  amended to read:

19         397.311  Definitions.--As used in this chapter, except

20  part VIII:

21         (1)  "Ancillary services" are services which include,

22  but are not limited to, special diagnostic, prenatal and

23  postnatal, other medical, mental health, legal, economic,

24  vocational, employment, and educational services.

25         (2)  "Assessment" means the systematic evaluation of

26  information gathered to determine the nature and severity of

27  the client's substance abuse problem and the client's need and

28  motivation for services. Assessment entails the use of a

29  psychosocial history supplemented, as required by rule, by

30  medical examinations, laboratory testing, and psychometric

31  measures.

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1         (3)  "Authorized agent of the department" means a

  2  person designated by the department to conduct any audit,

  3  inspection, monitoring, evaluation, or other duty imposed upon

  4  the department pursuant to this chapter.  An authorized agent

  5  must be identified by the department as:

  6         (a)  Qualified by the requisite expertise and

  7  experience;

  8         (b)  Having a need to know the applicable information;

  9  and

10         (c)  Having the assigned responsibility to carry out

11  the applicable duty.

12         (4)  "Background check" means reviewing the background

13  of service provider personnel who have direct contact with

14  unmarried clients under the age of 18 years or with clients

15  who are developmentally disabled in accordance with the

16  provisions of s. 397.451, and includes, but is not limited to,

17  local criminal records checks through local law enforcement

18  agencies, fingerprinting, statewide criminal records checks

19  through the Department of Law Enforcement, federal criminal

20  records checks through the Federal Bureau of Investigation,

21  and employment history checks.

22         (4)(5)  "Beyond the safe management capabilities of the

23  service provider" refers to a client who is in need of:

24         (a)  Supervision;

25         (b)  Medical care; or

26         (c)  Services,

27

28  beyond that which the service provider or service component

29  can deliver.

30         (5)(6)  "Client" means a recipient of alcohol or other

31  drug services delivered by a service provider but does not

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  include an inmate pursuant to part VIII unless expressly so

  2  provided.

  3         (6)(7)  "Client identifying information" means the

  4  name, address, social security number, fingerprints,

  5  photograph, and similar information by which the identity of a

  6  client can be determined with reasonable accuracy and speed

  7  either directly or by reference to other publicly available

  8  information.

  9         (7)(8)  "Court" means, with respect to all involuntary

10  proceedings under this chapter, the circuit court of the

11  county in which the judicial proceeding is pending or where

12  the substance abuse impaired person resides or is located, and

13  includes any general or special master that may be appointed

14  by the chief judge to preside over all or part of such

15  proceeding. Otherwise, "court" refers to the court of legal

16  jurisdiction in the context in which the term is used in this

17  chapter.

18         (8)(9)  "Department" means the Department of Children

19  and Family Services.

20         (9)(10)  "Director" means the chief administrative

21  officer of a service provider.

22         (10)(11)  "Disclose" or "disclosure" means a

23  communication of client identifying information, the

24  affirmative verification of another person's communication of

25  client identifying information, or the communication of any

26  information of a client who has been identified.  Any

27  disclosure made pursuant to this chapter must be limited to

28  that information which is necessary to carry out the purpose

29  of the disclosure.

30         (11)(12)  "Fee system" means a method of establishing

31  charges for services rendered, in accordance with a client's

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  ability to pay, used by providers that receive state funds.

  2         (12)(13)  "For profit" means registered as for profit

  3  by the Secretary of State and recognized by the Internal

  4  Revenue Service as a for-profit entity.

  5         (13)(14)  "Habitual abuser" means a person who is

  6  brought to the attention of law enforcement for being

  7  substance impaired, who meets the criteria for involuntary

  8  admission in s. 397.675, and who has been taken into custody

  9  for such impairment three or more times during the preceding

10  12 months.

11         (14)(15)  "Hospital" means a hospital or hospital-based

12  component licensed under chapter 395.

13         (15)(16)  "Impaired" or "substance abuse impaired"

14  means a condition involving the use of alcoholic beverages or

15  any psychoactive or mood-altering substance in such a manner

16  as to induce mental, emotional, or physical problems and cause

17  socially dysfunctional behavior.

18         (16)(17)  "Individualized treatment or service plan"

19  means an immediate and a long-range plan for substance abuse

20  or ancillary services developed on the basis of a client's

21  assessed needs.

22         (17)(18)  "Law enforcement officer" means a law

23  enforcement officer as defined in s. 943.10(1).

24         (18)(19)  "Licensed service provider" means a public

25  agency under this chapter, a private for-profit or

26  not-for-profit agency under this chapter, a physician licensed

27  under chapter 458 or chapter 459, or any other private

28  practitioner licensed under this chapter, or a hospital that

29  licensed under chapter 395, which offers substance abuse

30  impairment services through one or more of the following

31  licensable service components:

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1         (a)  Addictions receiving facility, which is a

  2  community-based facility designated by the department to

  3  receive, screen, and assess clients found to be substance

  4  abuse impaired, in need of emergency treatment for substance

  5  abuse impairment, or impaired by substance abuse to such an

  6  extent as to meet the criteria for involuntary admission in s.

  7  397.675, and to provide detoxification and stabilization.  An

  8  addictions receiving facility must be state-owned,

  9  state-operated, or state-contracted, and licensed pursuant to

10  rules adopted by the department's Substance Abuse Program

11  Office which include specific authorization for the provision

12  of levels of care and a requirement of separate accommodations

13  for adults and minors. Addictions receiving facilities are

14  designated as secure facilities to provide an intensive level

15  of care and must have sufficient staff and the authority to

16  provide environmental security to handle aggressive and

17  difficult-to-manage behavior and deter elopement.

18         (b)  Detoxification, which uses medical and

19  psychological procedures and a supportive counseling regimen

20  to assist clients in managing toxicity and withdrawing and

21  stabilizing from the physiological and psychological effects

22  of substance abuse impairment.

23         (c)  Residential treatment, which provides a

24  structured, live-in environment within a nonhospital setting

25  on a 24-hours-a-day, 7-days-a-week basis, and which includes:

26  treatment, rehabilitation, and transitional care.

27         1.  Facilities that provide room and board and

28  treatment and rehabilitation within the primary residential

29  facility; and

30         2.  Facilities that are used for room and board only

31  and in which treatment and rehabilitation activities are

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  provided on a mandatory basis at locations other than the

  2  primary residential facility. In this case, facilities used

  3  for room and board and for treatment and rehabilitation are

  4  operated under the auspices of the same provider, and

  5  licensing and regulatory requirements would apply to both the

  6  residential facility and all other facilities in which

  7  treatment and rehabilitation activities occur.

  8         (d)  Day and night treatment, which provides a

  9  nonresidential environment with a structured schedule of

10  treatment and rehabilitation services.

11         (e)  Outpatient treatment, which provides individual,

12  group, or family counseling for clients by appointment during

13  scheduled operating hours, with an emphasis on assessment and

14  treatment.

15         (f)  Medication and methadone maintenance treatment

16  that uses methadone or other medication as authorized by state

17  and federal law, in conjunction with medical, rehabilitative,

18  and counseling services in the treatment of clients who are

19  dependent upon opioid drugs.

20         (g)  Prevention, which is a process involving

21  strategies aimed at the individual, the environment, or the

22  substance, which strategies preclude, forestall, or impede the

23  development of substance abuse problems and promote

24  responsible personal and social growth of individuals and

25  families toward full human potential.

26         (h)  Intervention, which consists of structured

27  services targeted toward individuals or groups at risk and

28  focused on reducing those factors associated with the onset or

29  the early stages of substance abuse, and related problems.

30         (19)(20)  "Not for profit" means registered as not for

31  profit by the Secretary of State and recognized by the

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  Internal Revenue Service as a not-for-profit entity.

  2         (20)(21)  "Physician" means a person licensed under

  3  chapter 458 to practice medicine or licensed under chapter 459

  4  to practice osteopathic medicine, and may include, if the

  5  context so indicates, an intern or resident enrolled in an

  6  intern or resident training program affiliated with an

  7  approved medical school, hospital, or other facility through

  8  which training programs are normally conducted.

  9         (21)(22)  "Preliminary screening" means the gathering

10  of initial information to be used in determining a person's

11  need for assessment or for referral.

12         (22)(23)  "Private practitioner" means a physician

13  licensed under chapter 458 or chapter 459, a psychologist

14  licensed under chapter 490, or a clinical social worker,

15  marriage and family therapist, or mental health counselor

16  licensed under chapter 491.

17         (23)(24)  "Program evaluation" or "evaluation" means a

18  systematic measurement of a service provider's achievement of

19  desired client or service outcomes.

20         (24)(25)  "Qualified professional" means a physician

21  licensed under chapter 458 or chapter 459; a professional

22  licensed under chapter 490 or chapter 491; or a person who is

23  certified through a department-recognized certification

24  process for substance abuse treatment services and who holds,

25  at a minimum, a bachelor's degree.  A person who is certified

26  in substance abuse treatment services by a state-recognized

27  certification process in another state at the time of

28  employment with a licensed substance abuse provider in this

29  state may perform the functions of a qualified professional as

30  defined in this chapter but must meet certification

31  requirements contained in this subsection no later than 1 year

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  after his or her date of employment.

  2         (25)(26)  "Quality assurance" means the objective and

  3  internal systematic monitoring of the appropriateness and

  4  quality of client care rendered by a service provider.

  5         (26)(27)  "Secure facility," except where the context

  6  indicates a correctional system facility, means a provider

  7  that has the authority to deter the premature departure of

  8  involuntary clients whose leaving constitutes a violation of a

  9  court order or community-based supervision as provided by law.

10  The term "secure facility" includes addictions receiving

11  facilities and facilities authorized by local ordinance for

12  the treatment of habitual abusers.

13         (27)(28)  "Service provider" or "provider" means a

14  public agency, a private for-profit or not-for-profit agency,

15  a person who is a private practitioner, or a hospital, which

16  agency, person, or hospital is licensed under this chapter or

17  exempt from licensure under this chapter.

18         (28)(29)  "Service provider personnel" or "personnel"

19  includes all owners, directors, chief financial officers,

20  staff, and volunteers, including foster parents, of a service

21  provider.

22         (29)(30)  "Stabilization" means:

23         (a)  Alleviation of a crisis condition; or

24         (b)  Prevention of further deterioration,

25

26  and connotes short-term emergency treatment.

27         Section 2.  Subsection (1) of section 397.403, Florida

28  Statutes, is amended to read:

29         397.403  License application.--

30         (1)  Applicants for a license under this chapter must

31  apply to the department on forms provided by the department

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  and in accordance with rules adopted by the department.

  2  Applications must include at a minimum:

  3         (a)  Information establishing the name and address of

  4  the applicant service provider and its director, and also of

  5  each member, owner, officer, and shareholder, if any.

  6         (b)  Information establishing the competency and

  7  ability of the applicant service provider and its director to

  8  carry out the requirements of this chapter.

  9         (c)  Proof satisfactory to the department of the

10  applicant service provider's financial ability and

11  organizational capability to operate in accordance with this

12  chapter.

13         (d)  Proof of liability insurance coverage in amounts

14  set by the department by rule.

15         (e)  Sufficient information to conduct background

16  screening as provided in s. 397.451 Personnel fingerprints for

17  background checks as required by this chapter.

18         1.  If the results of the background screening indicate

19  that any owner, director, or chief financial officer has been

20  found guilty of, regardless of adjudication, or has entered a

21  plea of nolo contendere or guilty to any offense prohibited

22  under the screening standard, a license may not be issued to

23  the applicant service provider unless an exemption from

24  disqualification has been granted by the department as set

25  forth in chapter 435. The owner, director, or chief financial

26  officer has 90 days within which to obtain the required

27  exemption, during which time the applicant's license remains

28  in effect.

29         2.  If any owner, director, or chief financial officer

30  is found guilty of, regardless of adjudication, or has entered

31  a plea of nolo contendere or guilty to any offense prohibited

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  under the screening standard while acting in that capacity,

  2  the provider shall immediately remove the person from that

  3  position and shall notify the department within 2 days after

  4  such removal, excluding weekends and holidays. Failure to

  5  remove the owner, director, or chief financial officer will

  6  result in revocation of the provider's license.

  7         (f)  Proof of satisfactory fire, safety, and health

  8  inspections, and compliance with local zoning ordinances.

  9  Service providers operating under a regular annual license

10  shall have 18 months from the expiration date of their regular

11  license within which to meet local zoning requirements.

12  Applicants for a new license must demonstrate proof of

13  compliance with zoning requirements prior to the department

14  issuing a probationary license.

15         (g)  A comprehensive outline of the proposed services

16  for:

17         1.  Any new applicant; or

18         2.  Any licensed service provider adding a new

19  licensable service component.

20         Section 3.  Section 397.405, Florida Statutes, is

21  amended to read:

22         397.405  Exemptions from licensure.--The following are

23  exempt from the licensing provisions of this chapter:

24         (1)  A hospital or hospital-based component licensed

25  under chapter 395.

26         (2)  A nursing home facility as defined in s. 400.021.

27         (3)  A substance abuse education program established

28  pursuant to s. 233.061.

29         (4)  A facility or institution operated by the Federal

30  Government.

31         (5)  A physician licensed under chapter 458 or chapter

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  459.

  2         (6)  A psychologist licensed under chapter 490.

  3         (7)  A social worker, marriage and family therapist, or

  4  mental health counselor licensed under chapter 491.

  5         (8)  An established and legally cognizable church or

  6  nonprofit religious organization or, denomination, or sect

  7  providing substance abuse services, including prevention

  8  services, which are exclusively religious, spiritual, or

  9  ecclesiastical in nature.  A church or nonprofit religious

10  organization or, denomination, or sect providing any of the

11  licensable service components itemized under s. 397.311(18) s.

12  397.311(19) is not exempt for purposes of its provision of

13  such licensable service components but retains its exemption

14  with respect to all services which are exclusively religious,

15  spiritual, or ecclesiastical in nature.

16         (9)  Facilities licensed under s. 393.063(8) that, in

17  addition to providing services to persons who are

18  developmentally disabled as defined therein, also provide

19  services to persons developmentally at risk as a consequence

20  of exposure to alcohol or other legal or illegal drugs while

21  in utero.

22         (10)  DUI education and screening services provided

23  required to be attended pursuant to ss. 316.192, 316.193,

24  322.095, 322.271, and 322.291 are exempt from licensure under

25  this chapter.  Persons or entities providing treatment

26  services programs must continue to be licensed under this

27  chapter unless exempted from licensing as provided in this

28  section.

29

30  The exemptions from licensure in this section do not apply to

31  any service provider that facility or entity which receives an

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  appropriation, grant, or contract from the state to operate as

  2  a service provider as defined in this chapter or to any

  3  substance abuse program regulated pursuant to s. 397.406.

  4  Furthermore, No provision of this chapter may not shall be

  5  construed to limit the practice of a physician licensed under

  6  chapter 458 or chapter 459, a psychologist licensed under

  7  chapter 490, or a psychotherapist licensed under chapter 491

  8  who provides, providing outpatient or inpatient substance

  9  abuse treatment to a voluntary patient, so long as the

10  physician, psychologist, or psychotherapist does not represent

11  to the public that he or she is a licensed service provider

12  and does not provide services to clients pursuant to part V of

13  this chapter under this act. Failure to comply with any

14  requirement necessary to maintain an exempt status under this

15  section is a misdemeanor of the first degree, punishable as

16  provided in s. 775.082 or s. 775.083.

17         Section 4.  Subsection (1) of section 397.407, Florida

18  Statutes, is amended to read:

19         397.407  Licensure fees.--

20         (1)  The department shall establish licensure fees by

21  rule.  The rule must prescribe a fee range that is based, at

22  least in part, on the number and complexity of programs listed

23  in s. 397.311(18) s. 397.311(19) which are operated by a

24  licensee.  The fee range must be implemented over a 5-year

25  period.  The fee schedule for licensure of service components

26  must be increased annually in substantially equal increments

27  so that, by July 1, 1998, the fees from the licensure of

28  service components are sufficient to cover at least 50 percent

29  of the costs of regulating the service components.  The

30  department shall specify by rule a fee range and phase-in plan

31  for privately funded licensed service providers and a fee

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  range and phase-in plan for publicly funded licensed service

  2  providers.  Fees for privately funded licensed service

  3  providers must exceed the fees for publicly funded licensed

  4  service providers.  The first year phase-in licensure fees

  5  must be at least $150 per initial license. The rule must

  6  provide for a reduction in licensure fees for licensed service

  7  providers who hold more than one license.

  8         Section 5.  Subsection (2) of section 397.416, Florida

  9  Statutes, is amended to read:

10         397.416  Substance abuse treatment services; qualified

11  professional.--

12         (2)  Notwithstanding any other provision of law, a

13  person who was certified through a certification process

14  recognized by the former Department of Health and

15  Rehabilitative Services before January 1, 1995, may perform

16  the duties of a qualified professional with respect to

17  substance abuse treatment services as defined in this chapter,

18  and need not meet the certification requirements contained in

19  s. 397.311(24) s. 397.311(25).

20         Section 6.  Section 397.451, Florida Statutes, is

21  amended to read:

22         397.451  Background checks of service provider

23  personnel who have direct contact with unmarried minor clients

24  or clients who are developmentally disabled.--

25         (1)  PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND

26  EXCEPTIONS.--

27         (a)  Background checks shall apply as follows:

28         1.  All owners, directors, and chief financial officers

29  of service providers are subject to level-2 background

30  screening as provided under chapter 435.

31         2.  All service provider personnel who have direct

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  contact with children receiving services or with adults who

  2  are developmentally disabled receiving services are subject to

  3  level-2 background screening as provided under chapter 435.

  4  Service provider personnel who have direct contact with

  5  unmarried clients under the age of 18 years or with clients

  6  who are developmentally disabled are subject to background

  7  checks, except as otherwise provided in this section.

  8         (b)  Students in the health care professions who are

  9  interning under the actual physical presence supervision of a

10  licensed health care professional in a service provider

11  licensed under chapter 395, where the primary purpose of the

12  service provider is not the treatment of unmarried minors or

13  of persons who are developmentally disabled, are exempt from

14  the fingerprinting and background check requirements.

15         (c)  Personnel working in a service provider licensed

16  under chapter 395 who have less than 15 hours per week of

17  direct contact with unmarried minors or with persons who are

18  developmentally disabled, or personnel who are health care

19  professionals licensed by the Department of Business and

20  Professional Regulation or a board thereunder who are not

21  employed in a service provider where the primary purpose is

22  the treatment of unmarried minors or of persons who are

23  developmentally disabled are exempt from the fingerprinting

24  and background check requirements.

25         (b)(d)  Members of a foster family and persons residing

26  with the foster family who are between 12 and 18 years of age

27  are not required to be fingerprinted but must have their

28  backgrounds checked for delinquency records. Members of the

29  foster family and persons residing with the foster family over

30  18 years of age are subject to full background checks.

31         (c)(e)  A volunteer who assists on an intermittent

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  basis for fewer than 40 hours per month and is under direct

  2  and constant supervision by persons who meet all personnel

  3  requirements of this chapter is exempt from fingerprinting and

  4  background check requirements.

  5         (d)(f)  Service providers that are exempt from

  6  licensing provisions of this chapter are exempt from personnel

  7  fingerprinting and background check requirements, except as

  8  otherwise provided in this section.  A church or nonprofit

  9  religious organization exempt from licensure under this

10  chapter is required to comply with personnel fingerprinting

11  and background check requirements.

12         (e)(g)  Personnel employed by the Department of

13  Corrections in a substance abuse service component who have

14  direct contact with unmarried inmates under the age of 18 or

15  with inmates who are developmentally disabled are exempt from

16  the fingerprinting and background check requirements of this

17  section.

18         (f)  Service provider personnel who request an

19  exemption from disqualification must submit the request within

20  30 days after being notified of a pending disqualification.

21  The employment of service provider personnel shall not be

22  adversely affected pending disposition of the request for an

23  exemption. Disapproval of a request for an exemption shall

24  result in the immediate dismissal of the service provider

25  personnel from employment with the provider.

26         (2)  EMPLOYMENT HISTORY CHECKS; CHECKS OF

27  REFERENCES.--The department shall assess employment history

28  checks and checks of references for all owners, directors, and

29  chief financial officers, and the directors shall assess

30  employment history checks and checks of references for each

31  employee who has direct contact with children receiving

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  services or adults who are developmentally disabled receiving

  2  services unmarried clients under the age of 18 years or with

  3  clients who are developmentally disabled.

  4         (3)  MINIMUM BACKGROUND CHECK STANDARDS.--The

  5  department shall require employment screening pursuant to

  6  chapter 435, using level 2 standards for screening set forth

  7  in that chapter, of service provider personnel who have direct

  8  contact with unmarried clients under the age of 18 years or

  9  with clients who are developmentally disabled.

10         (3)(4)  PERSONNEL EXEMPT FROM BEING REFINGERPRINTED OR

11  RECHECKED.--

12         (a)  Service provider personnel who have been

13  fingerprinted or had their backgrounds checked pursuant to

14  chapter 393, chapter 394, chapter 402, or chapter 409, or this

15  section, and teachers who have been fingerprinted pursuant to

16  chapter 231, who have not been unemployed for more than 90

17  days thereafter and who, under the penalty of perjury, attest

18  to the completion of such fingerprinting or background checks

19  and to compliance with the provisions of this section and the

20  standards contained in chapter 435 and this section, are not

21  required to be refingerprinted or rechecked in order to comply

22  with service provider personnel fingerprinting or background

23  check requirements.

24         (b)  Service provider owners, directors, or chief

25  financial officers who are not covered by paragraph (a) who

26  provide proof of compliance with the level-2 background

27  screening requirements which has been submitted within the

28  previous 5 years in compliance with any other state health

29  care licensure requirements are not required to be

30  refingerprinted or rechecked.

31         (4)(5)  EXEMPTIONS FROM DISQUALIFICATION.--

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

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  1         (a)  The department may grant to any service provider

  2  personnel an exemption from disqualification from working with

  3  children or the developmentally disabled as provided in s.

  4  435.07.

  5         (b)  Since rehabilitated substance abuse impaired

  6  persons are effective in the successful treatment and

  7  rehabilitation of substance abuse impaired adolescents, for

  8  service providers which treat adolescents 13 years of age and

  9  older, service provider personnel whose background checks

10  indicate crimes under s. 817.563, s. 893.13, or s.  893.147

11  may be exempted from disqualification from employment pursuant

12  to this paragraph.

13         (c)  The department may grant exemptions from

14  disqualification which would limit service provider personnel

15  to working with adults in substance-abuse-treatment

16  facilities.

17         (5)(6)  PAYMENT FOR PROCESSING OF FINGERPRINTS AND

18  STATE CRIMINAL RECORDS CHECKS.--The employing service provider

19  or the personnel who are having their backgrounds checked are

20  responsible for paying the costs of processing fingerprints

21  and criminal records checks.

22         (6)(7)  DISQUALIFICATION FROM RECEIVING STATE

23  FUNDS.--State funds may not be disseminated to any service

24  provider owned or operated by an owner, or director, or chief

25  financial officer who has been convicted of, has entered a

26  plea of guilty or nolo contendere to, or has had adjudication

27  withheld for, a violation of s. 893.135 pertaining to

28  trafficking in controlled substances, or a violation of the

29  law of another state, the District of Columbia, the United

30  States or any possession or territory thereof, or any foreign

31  jurisdiction which is substantially similar in elements and

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

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  1  penalties to a trafficking offense in this state, unless the

  2  owner's or director's civil rights have been restored.

  3         Section 7.  Paragraph (e) of subsection (5) of section

  4  212.055, Florida Statutes, is amended to read:

  5         212.055  Discretionary sales surtaxes; legislative

  6  intent; authorization and use of proceeds.--It is the

  7  legislative intent that any authorization for imposition of a

  8  discretionary sales surtax shall be published in the Florida

  9  Statutes as a subsection of this section, irrespective of the

10  duration of the levy.  Each enactment shall specify the types

11  of counties authorized to levy; the rate or rates which may be

12  imposed; the maximum length of time the surtax may be imposed,

13  if any; the procedure which must be followed to secure voter

14  approval, if required; the purpose for which the proceeds may

15  be expended; and such other requirements as the Legislature

16  may provide.  Taxable transactions and administrative

17  procedures shall be as provided in s. 212.054.

18         (5)  COUNTY PUBLIC HOSPITAL SURTAX.--Any county as

19  defined in s. 125.011(1) may levy the surtax authorized in

20  this subsection pursuant to an ordinance either approved by

21  extraordinary vote of the county commission or conditioned to

22  take effect only upon approval by a majority vote of the

23  electors of the county voting in a referendum.  In a county as

24  defined in s. 125.011(1), for the purposes of this subsection,

25  "county public general hospital" means a general hospital as

26  defined in s. 395.002 which is owned, operated, maintained, or

27  governed by the county or its agency, authority, or public

28  health trust.

29         (e)  A governing board, agency, or authority shall be

30  chartered by the county commission upon this act becoming law.

31  The governing board, agency, or authority shall adopt and

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

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  1  implement a health care plan for indigent health care

  2  services.  The governing board, agency, or authority shall

  3  consist of no more than seven and no fewer than five members

  4  appointed by the county commission.  The members of the

  5  governing board, agency, or authority shall be at least 18

  6  years of age and residents of the county.  No member may be

  7  employed by or affiliated with a health care provider or the

  8  public health trust, agency, or authority responsible for the

  9  county public general hospital. The following community

10  organizations shall each appoint a representative to a

11  nominating committee:  the South Florida Hospital and

12  Healthcare Association, the Miami-Dade County Public Health

13  Trust, the Dade County Medical Association, the Miami-Dade

14  County Homeless Trust, and the Mayor of Miami-Dade County.

15  This committee shall nominate between 10 and 14 county

16  citizens for the governing board, agency, or authority.  The

17  slate shall be presented to the county commission and the

18  county commission shall confirm the top five to seven

19  nominees, depending on the size of the governing board.  Until

20  such time as the governing board, agency, or authority is

21  created, the funds provided for in subparagraph (d)2. shall be

22  placed in a restricted account set aside from other county

23  funds and not disbursed by the county for any other purpose.

24         1.  The plan shall divide the county into a minimum of

25  four and maximum of six service areas, with no more than one

26  participant hospital per service area. The county public

27  general hospital shall be designated as the provider for one

28  of the service areas.  Services shall be provided through

29  participants' primary acute care facilities.

30         2.  The plan and subsequent amendments to it shall fund

31  a defined range of health care services for both indigent

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1  persons and the medically poor, including primary care,

  2  preventive care, hospital emergency room care, and hospital

  3  care necessary to stabilize the patient. For the purposes of

  4  this section, "stabilization" means stabilization as defined

  5  in s. 397.311(29) s. 397.311(30). Where consistent with these

  6  objectives, the plan may include services rendered by

  7  physicians, clinics, community hospitals, and alternative

  8  delivery sites, as well as at least one regional referral

  9  hospital per service area. The plan shall provide that

10  agreements negotiated between the governing board, agency, or

11  authority and providers shall recognize hospitals that render

12  a disproportionate share of indigent care, provide other

13  incentives to promote the delivery of charity care to draw

14  down federal funds where appropriate, and require cost

15  containment, including, but not limited to, case management.

16  From the funds specified in subparagraphs (d)1. and 2. for

17  indigent health care services, service providers shall receive

18  reimbursement at a Medicaid rate to be determined by the

19  governing board, agency, or authority created pursuant to this

20  paragraph for the initial emergency room visit, and a

21  per-member per-month fee or capitation for those members

22  enrolled in their service area, as compensation for the

23  services rendered following the initial emergency visit.

24  Except for provisions of emergency services, upon

25  determination of eligibility, enrollment shall be deemed to

26  have occurred at the time services were rendered. The

27  provisions for specific reimbursement of emergency services

28  shall be repealed on July 1, 2001, unless otherwise reenacted

29  by the Legislature. The capitation amount or rate shall be

30  determined prior to program implementation by an independent

31  actuarial consultant. In no event shall such reimbursement

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

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  1  rates exceed the Medicaid rate. The plan must also provide

  2  that any hospitals owned and operated by government entities

  3  on or after the effective date of this act must, as a

  4  condition of receiving funds under this subsection, afford

  5  public access equal to that provided under s. 286.011 as to

  6  any meeting of the governing board, agency, or authority the

  7  subject of which is budgeting resources for the retention of

  8  charity care, as that term is defined in the rules of the

  9  Agency for Health Care Administration. The plan shall also

10  include innovative health care programs that provide

11  cost-effective alternatives to traditional methods of service

12  and delivery funding.

13         3.  The plan's benefits shall be made available to all

14  county residents currently eligible to receive health care

15  services as indigents or medically poor as defined in

16  paragraph (4)(d).

17         4.  Eligible residents who participate in the health

18  care plan shall receive coverage for a period of 12 months or

19  the period extending from the time of enrollment to the end of

20  the current fiscal year, per enrollment period, whichever is

21  less.

22         5.  At the end of each fiscal year, the governing

23  board, agency, or authority shall prepare an audit that

24  reviews the budget of the plan, delivery of services, and

25  quality of services, and makes recommendations to increase the

26  plan's efficiency.  The audit shall take into account

27  participant hospital satisfaction with the plan and assess the

28  amount of poststabilization patient transfers requested, and

29  accepted or denied, by the county public general hospital.

30         Section 8.  Paragraphs (d) and (g) of subsection (1) of

31  section 440.102, Florida Statutes, are amended to read:

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1         440.102  Drug-free workplace program requirements.--The

  2  following provisions apply to a drug-free workplace program

  3  implemented pursuant to law or to rules adopted by the Agency

  4  for Health Care Administration:

  5         (1)  DEFINITIONS.--Except where the context otherwise

  6  requires, as used in this act:

  7         (d)  "Drug rehabilitation program" means a service

  8  provider, established pursuant to s. 397.311(27) s.

  9  397.311(28), that provides confidential, timely, and expert

10  identification, assessment, and resolution of employee drug

11  abuse.

12         (g)  "Employee assistance program" means an established

13  program capable of providing expert assessment of employee

14  personal concerns; confidential and timely identification

15  services with regard to employee drug abuse; referrals of

16  employees for appropriate diagnosis, treatment, and

17  assistance; and followup services for employees who

18  participate in the program or require monitoring after

19  returning to work. If, in addition to the above activities, an

20  employee assistance program provides diagnostic and treatment

21  services, these services shall in all cases be provided by

22  service providers pursuant to s. 397.311(27) s. 397.311(28).

23         Section 9.  This act shall take effect July 1, 2002.

24

25

26  ================ T I T L E   A M E N D M E N T ===============

27  And the title is amended as follows:

28         On page 1, line 2, after the semicolon,

29  remove:  all of said lines

30

31  and insert:

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                                                   HOUSE AMENDMENT

                                                   Bill No. HB 545

    Amendment No. 1 (for drafter's use only)





  1         An act relating to substance-abuse services;

  2         amending s. 397.311, F.S.; redefining the term

  3         "licensed service provider"; requiring that

  4         licensure standards apply to certain housing

  5         locations; redefining the term "service

  6         provider personnel," to add chief financial

  7         officers; requiring that owners, directors, and

  8         chief financial officers of a substance-abuse

  9         service provider undergo a background check

10         pursuant to ch. 435, F.S.; requiring that proof

11         of compliance with local zoning ordinances be

12         included in the applications for licensure;

13         amending s. 397.405, F.S.; clarifying that DUI

14         education and screening services must be

15         licensed if they provide treatment services;

16         amending s. 397.407, F.S.; conforming

17         cross-references; amending s. 397.416, F.S.;

18         conforming cross-references; amending s.

19         397.451, F.S.; clarifying provisions; requiring

20         level-2 background screening for employees who

21         work with children and with adults who are

22         developmentally disabled; specifying

23         circumstances under which service provider

24         owners, directors, or chief financial officers

25         are not subject to background screening;

26         allowing personnel to request, and the

27         department to grant, an exemption from

28         disqualification; amending ss. 212.055,

29         440.102, F.S.; conforming cross-references;

30         providing an effective date.

31

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