House Bill hb0545
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Florida House of Representatives - 2002 HB 545
By Representative Andrews
1 A bill to be entitled
2 An act relating to substance abuse services;
3 amending s. 397.311, F.S.; revising
4 definitions; amending s. 397.403, F.S.;
5 providing additional requirements for service
6 provider license applications; amending s.
7 397.405, F.S.; revising exemptions from
8 licensure; amending ss. 212.055, 397.407,
9 397.416, and 440.102, F.S.; correcting cross
10 references; amending s. 397.451, F.S.; revising
11 requirements relating to background checks of
12 service provider personnel; providing for
13 background screening and exemption from
14 disqualification for owners, directors, and
15 managers of service providers; providing for
16 background screening for all personnel who have
17 direct contact with children or adults
18 receiving services; providing an additional
19 requirement for exemption from disqualification
20 for certain rehabilitated substance abusers;
21 providing an effective date.
22
23 Be It Enacted by the Legislature of the State of Florida:
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25 Section 1. Present subsections (4), (19), (28), and
26 (29) of section 397.311, Florida Statutes, are amended to
27 read:
28 397.311 Definitions.--As used in this chapter, except
29 part VIII:
30 (4) "Background check" means reviewing the background
31 of service provider personnel who have direct contact with
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1 unmarried clients under the age of 18 years or with clients
2 who are developmentally disabled in accordance with the
3 provisions of s. 397.451, and includes, but is not limited to,
4 local criminal records checks through local law enforcement
5 agencies, fingerprinting, statewide criminal records checks
6 through the Department of Law Enforcement, federal criminal
7 records checks through the Federal Bureau of Investigation,
8 and employment history checks.
9 (18)(19) "Licensed service provider" means a public
10 agency under this chapter, a private for-profit or
11 not-for-profit agency under this chapter, a physician licensed
12 under chapter 458 or chapter 459, or any other private
13 practitioner licensed under this chapter, or a hospital
14 licensed under chapter 395, which offers substance abuse
15 impairment services through one or more of the following
16 licensable service components:
17 (a) Addictions receiving facility, which is a
18 community-based facility designated by the department to
19 receive, screen, and assess clients found to be substance
20 abuse impaired, in need of emergency treatment for substance
21 abuse impairment, or impaired by substance abuse to such an
22 extent as to meet the criteria for involuntary admission in s.
23 397.675, and to provide detoxification and stabilization. An
24 addictions receiving facility must be state-owned,
25 state-operated, or state-contracted, and licensed pursuant to
26 rules adopted by the department's Substance Abuse Program
27 Office which include specific authorization for the provision
28 of levels of care and a requirement of separate accommodations
29 for adults and minors. Addictions receiving facilities are
30 designated as secure facilities to provide an intensive level
31 of care and must have sufficient staff and the authority to
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1 provide environmental security to handle aggressive and
2 difficult-to-manage behavior and deter elopement.
3 (b) Detoxification, which uses medical and
4 psychological procedures and a supportive counseling regimen
5 to assist clients in managing toxicity and withdrawing and
6 stabilizing from the physiological and psychological effects
7 of substance abuse impairment.
8 (c) Residential treatment, which provides a
9 structured, live-in environment within a nonhospital setting
10 on a 24-hours-a-day, 7-days-a-week basis, and includes
11 treatment and, rehabilitation provided either onsite or at an
12 alternative location, including at a residential facility that
13 provides room and board but is tax exempt under s.
14 212.08(7)(i), and transitional care. If treatment and
15 rehabilitation are provided at an alternative location,
16 licensing and regulatory requirements apply to both the
17 housing and service components.
18 (d) Day and night treatment, which provides a
19 nonresidential environment with a structured schedule of
20 treatment and rehabilitation services.
21 (e) Outpatient treatment, which provides individual,
22 group, or family counseling for clients by appointment during
23 scheduled operating hours, with an emphasis on assessment and
24 treatment.
25 (f) Medication and methadone maintenance treatment
26 that uses methadone or other medication as authorized by state
27 and federal law, in conjunction with medical, rehabilitative,
28 and counseling services in the treatment of clients who are
29 dependent upon opioid drugs.
30 (g) Prevention, which is a process involving
31 strategies aimed at the individual, the environment, or the
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1 substance, which strategies preclude, forestall, or impede the
2 development of substance abuse problems and promote
3 responsible personal and social growth of individuals and
4 families toward full human potential.
5 (h) Intervention, which consists of structured
6 services targeted toward individuals or groups at risk and
7 focused on reducing those factors associated with the onset or
8 the early stages of substance abuse, and related problems.
9 (27)(28) "Service provider" or "provider" means a
10 public agency, a private for-profit or not-for-profit agency,
11 a person who is a private practitioner, or a hospital, which
12 agency, person, or hospital is licensed under this chapter or
13 exempt from licensure under this chapter.
14 (28)(29) "Service provider personnel" or "personnel"
15 includes all owners, directors, managers, staff, and
16 volunteers, including foster parents, of a service provider.
17 Section 2. Subsection (1) of section 397.403, Florida
18 Statutes, is amended to read:
19 397.403 License application.--
20 (1) Applicants for a license under this chapter must
21 apply to the department on forms provided by the department
22 and in accordance with rules adopted by the department.
23 Applications must include at a minimum:
24 (a) Information establishing the name and address of
25 the applicant service provider and its director, and also of
26 each member, owner, officer, and shareholder, if any.
27 (b) Information establishing the competency and
28 ability of the applicant service provider and its director to
29 carry out the requirements of this chapter.
30 (c) Proof satisfactory to the department of the
31 applicant service provider's financial ability and
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1 organizational capability to operate in accordance with this
2 chapter.
3 (d) Proof of liability insurance coverage in amounts
4 set by the department by rule.
5 (e) Sufficient information to conduct background
6 screening as provided under s. 397.451 Personnel fingerprints
7 for background checks as required by this chapter.
8 1. If the results of the level 2 background screening
9 indicate that any owner, director, or manager has been found
10 guilty of, regardless of adjudication, or has entered a plea
11 of nolo contendere or guilty to, any offense prohibited under
12 the level 2 screening standard, a license shall not be issued
13 to the applicant service provider unless an exemption from
14 disqualification has been granted by the department as set
15 forth in chapter 435. The owner, director, or manager shall
16 have 90 days to obtain the required exemption, during which
17 time the applicant's license shall remain in effect.
18 2. If any owner, director, or manager is found guilty
19 of, regardless of adjudication, or has entered a plea of nolo
20 contendere or guilty to, any offense prohibited under the
21 level 2 screening standard while acting in that capacity, the
22 provider shall immediately remove the person from that
23 position and shall notify the department within 2 days,
24 excluding weekends and holidays, after such removal. Failure
25 to remove the owner, director, or manager shall result in
26 revocation of the provider's license.
27 (f) Proof of satisfactory fire, safety, and health
28 inspections and compliance with local zoning ordinances and
29 other requirements of local government that are not
30 inconsistent with state law.
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1 (g) A comprehensive outline of the proposed services
2 for:
3 1. Any new applicant; or
4 2. Any licensed service provider adding a new
5 licensable service component.
6 Section 3. Section 397.405, Florida Statutes, is
7 amended to read:
8 397.405 Exemptions from licensure.--The following are
9 exempt from the licensing provisions of this chapter:
10 (1) A hospital or hospital-based component licensed
11 under chapter 395.
12 (2) A nursing home facility as defined in s. 400.021.
13 (3) A substance abuse education program established
14 pursuant to s. 233.061.
15 (4) A facility or institution operated by the Federal
16 Government.
17 (5) A physician licensed under chapter 458 or chapter
18 459.
19 (6) A psychologist licensed under chapter 490.
20 (7) A social worker, marriage and family therapist, or
21 mental health counselor licensed under chapter 491.
22 (8) An established and legally cognizable church or
23 nonprofit religious organization or, denomination, or sect
24 providing substance abuse services, including prevention
25 services, which are exclusively religious, spiritual, or
26 ecclesiastical in nature. A church or nonprofit religious
27 organization or, denomination, or sect providing any of the
28 licensable service components itemized under s.
29 397.311(18)(19) is not exempt for purposes of its provision of
30 such licensable service components but retains its exemption
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1 with respect to all services which are exclusively religious,
2 spiritual, or ecclesiastical in nature.
3 (9) Facilities licensed under s. 393.063(8) that, in
4 addition to providing services to persons who are
5 developmentally disabled as defined therein, also provide
6 services to persons developmentally at risk as a consequence
7 of exposure to alcohol or other legal or illegal drugs while
8 in utero.
9 (10) DUI education and screening services provided
10 required to be attended pursuant to ss. 316.192, 316.193,
11 322.095, 322.271, and 322.291 are exempt from licensure under
12 this chapter. Persons or entities providing treatment
13 services programs must continue to be licensed under this
14 chapter unless exempt from licensure as provided in this
15 section.
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17 The exemptions from licensure in this section do not apply to
18 any service provider facility or entity which receives an
19 appropriation, grant, or contract from the state to operate as
20 a service provider as defined in this chapter or to any
21 substance abuse program regulated pursuant to s. 397.406.
22 Further, No provision of this chapter shall not be construed
23 to limit the practice of a physician licensed under chapter
24 458 or chapter 459, a psychologist licensed under chapter 490,
25 or a psychotherapist licensed under chapter 491, providing
26 outpatient or inpatient substance abuse treatment to a
27 voluntary patient, so long as the physician, psychologist, or
28 psychotherapist does not represent to the public that he or
29 she is a licensed service provider and does not provide
30 services to clients pursuant to part V under this act. Failure
31 to comply with any requirement necessary to maintain an exempt
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1 status under this section is a misdemeanor of the first
2 degree, punishable as provided in s. 775.082 or s. 775.083.
3 Section 4. Subsection (1) of section 397.407, Florida
4 Statutes, is amended to read:
5 397.407 Licensure fees.--
6 (1) The department shall establish licensure fees by
7 rule. The rule must prescribe a fee range that is based, at
8 least in part, on the number and complexity of programs listed
9 in s. 397.311(18)(19) which are operated by a licensee. The
10 fee range must be implemented over a 5-year period. The fee
11 schedule for licensure of service components must be increased
12 annually in substantially equal increments so that, by July 1,
13 1998, the fees from the licensure of service components are
14 sufficient to cover at least 50 percent of the costs of
15 regulating the service components. The department shall
16 specify by rule a fee range and phase-in plan for privately
17 funded licensed service providers and a fee range and phase-in
18 plan for publicly funded licensed service providers. Fees for
19 privately funded licensed service providers must exceed the
20 fees for publicly funded licensed service providers. The
21 first year phase-in licensure fees must be at least $150 per
22 initial license. The rule must provide for a reduction in
23 licensure fees for licensed service providers who hold more
24 than one license.
25 Section 5. Subsection (2) of section 397.416, Florida
26 Statutes, is amended to read:
27 397.416 Substance abuse treatment services; qualified
28 professional.--
29 (2) Notwithstanding any other provision of law, a
30 person who was certified through a certification process
31 recognized by the former Department of Health and
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1 Rehabilitative Services before January 1, 1995, may perform
2 the duties of a qualified professional with respect to
3 substance abuse treatment services as defined in this chapter,
4 and need not meet the certification requirements contained in
5 s. 397.311(24)(25).
6 Section 6. Section 397.451, Florida Statutes, is
7 amended to read:
8 397.451 Background checks of service provider
9 personnel who have direct contact with unmarried minor clients
10 or clients who are developmentally disabled.--
11 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
12 EXCEPTIONS.--
13 (a) All owners, directors, and managers of service
14 providers, and all service provider personnel who have direct
15 contact with children or adults receiving services, unmarried
16 clients under the age of 18 years or with clients who are
17 developmentally disabled are subject to level 2 background
18 screening, as provided under chapter 435 background checks,
19 except as otherwise provided in this section.
20 (b) Students in the health care professions who are
21 interning under the actual physical presence supervision of a
22 licensed health care professional in a service provider
23 licensed under chapter 395, where the primary purpose of the
24 service provider is not the treatment of unmarried minors or
25 of persons who are developmentally disabled, are exempt from
26 the fingerprinting and background check requirements.
27 (c) Personnel working in a service provider licensed
28 under chapter 395 who have less than 15 hours per week of
29 direct contact with unmarried minors or with persons who are
30 developmentally disabled, or personnel who are health care
31 professionals licensed by the Department of Business and
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1 Professional Regulation or a board thereunder who are not
2 employed in a service provider where the primary purpose is
3 the treatment of unmarried minors or of persons who are
4 developmentally disabled are exempt from the fingerprinting
5 and background check requirements.
6 (b)(d) Members of a foster family and persons residing
7 with the foster family who are between 12 and 18 years of age
8 are not required to be fingerprinted but must have their
9 backgrounds checked for delinquency records. Members of the
10 foster family and persons residing with the foster family over
11 18 years of age are subject to full background checks.
12 (c)(e) A volunteer who assists on an intermittent
13 basis for fewer than 20 40 hours per month and is under direct
14 and constant supervision by persons who meet all personnel
15 requirements of this chapter is exempt from fingerprinting and
16 background check requirements.
17 (d)(f) Service providers that are exempt from
18 licensing provisions of this chapter are exempt from personnel
19 fingerprinting and background check requirements, except as
20 otherwise provided in this section. A church or nonprofit
21 religious organization exempt from licensure under this
22 chapter is required to comply with personnel fingerprinting
23 and background check requirements.
24 (e)(g) Personnel employed by the Department of
25 Corrections in a substance abuse service component who have
26 direct contact with unmarried inmates under the age of 18 or
27 with inmates who are developmentally disabled are exempt from
28 the fingerprinting and background check requirements of this
29 section.
30 (2) EMPLOYMENT HISTORY CHECKS; CHECKS OF
31 REFERENCES.--The department shall assess employment history
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1 checks and checks of references for all owners, directors, and
2 managers, and the directors shall assess employment history
3 checks and checks of references for each employee who has
4 direct contact with children or adults receiving services
5 unmarried clients under the age of 18 years or with clients
6 who are developmentally disabled.
7 (3) MINIMUM BACKGROUND CHECK STANDARDS.--The
8 department shall require employment screening pursuant to
9 chapter 435, using level 2 standards for screening set forth
10 in that chapter, of service provider personnel who have direct
11 contact with unmarried clients under the age of 18 years or
12 with clients who are developmentally disabled.
13 (3)(4) PERSONNEL EXEMPT FROM BEING REFINGERPRINTED OR
14 RECHECKED.--
15 (a) Service provider personnel who have direct contact
16 with children or adults receiving services as described under
17 s. 397.451 and who have been fingerprinted or had their
18 backgrounds checked pursuant to chapter 393, chapter 394,
19 chapter 402, or chapter 409, or this section, and teachers who
20 have been fingerprinted pursuant to chapter 231, who have not
21 been unemployed for more than 90 days thereafter, and who,
22 under the penalty of perjury, attest to the completion of such
23 fingerprinting or background checks and to compliance with the
24 provisions of this section and the standards contained in
25 chapter 435 and this section, are not required to be
26 refingerprinted or rechecked in order to comply with service
27 provider personnel fingerprinting or background check
28 requirements.
29 (b) Service provider owners, directors, or managers
30 not covered by paragraph (a) who provide proof of compliance
31 with the level 2 background screening requirements which has
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1 been submitted within the previous 5 years in compliance with
2 any other state health care licensure requirements are not
3 required to be refingerprinted or rechecked.
4 (4)(5) EXEMPTIONS FROM DISQUALIFICATION.--
5 (a) The department may grant to any service provider
6 personnel an exemption from disqualification from working with
7 children or the developmentally disabled as provided in s.
8 435.07.
9 (b) Since rehabilitated substance abuse impaired
10 persons are effective in the successful treatment and
11 rehabilitation of substance abuse impaired adolescents, for
12 service providers which treat adolescents 13 years of age and
13 older, service provider personnel whose background checks
14 indicate crimes under s. 817.563, s. 893.13, or s. 893.147
15 may be exempted from disqualification from employment pursuant
16 to this paragraph, provided the person has not used such
17 substances in the 2 years immediately preceding employment.
18 (5)(6) PAYMENT FOR PROCESSING OF FINGERPRINTS AND
19 STATE CRIMINAL RECORDS CHECKS.--The employing service provider
20 or the personnel who are having their backgrounds checked are
21 responsible for paying the costs of processing fingerprints
22 and criminal records checks.
23 (6)(7) DISQUALIFICATION FROM RECEIVING STATE
24 FUNDS.--State funds may not be disseminated to any service
25 provider owned or operated by an owner, or director, or
26 manager who has been convicted of, has entered a plea of
27 guilty or nolo contendere to, or has had adjudication withheld
28 for, a violation of s. 893.135 pertaining to trafficking in
29 controlled substances, or a violation of the law of another
30 state, the District of Columbia, the United States or any
31 possession or territory thereof, or any foreign jurisdiction
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1 which is substantially similar in elements and penalties to a
2 trafficking offense in this state, unless the owner's or
3 director's civil rights have been restored.
4 Section 7. Paragraphs (d) and (g) of subsection (1) of
5 section 440.102, Florida Statutes, are amended to read:
6 440.102 Drug-free workplace program requirements.--The
7 following provisions apply to a drug-free workplace program
8 implemented pursuant to law or to rules adopted by the Agency
9 for Health Care Administration:
10 (1) DEFINITIONS.--Except where the context otherwise
11 requires, as used in this act:
12 (d) "Drug rehabilitation program" means a service
13 provider, established pursuant to s. 397.311(27)(28), that
14 provides confidential, timely, and expert identification,
15 assessment, and resolution of employee drug abuse.
16 (g) "Employee assistance program" means an established
17 program capable of providing expert assessment of employee
18 personal concerns; confidential and timely identification
19 services with regard to employee drug abuse; referrals of
20 employees for appropriate diagnosis, treatment, and
21 assistance; and followup services for employees who
22 participate in the program or require monitoring after
23 returning to work. If, in addition to the above activities, an
24 employee assistance program provides diagnostic and treatment
25 services, these services shall in all cases be provided by
26 service providers pursuant to s. 397.311(27)(28).
27 Section 8. Paragraph (e) of subsection (5) of section
28 212.055, Florida Statutes, is amended to read:
29 212.055 Discretionary sales surtaxes; legislative
30 intent; authorization and use of proceeds.--It is the
31 legislative intent that any authorization for imposition of a
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1 discretionary sales surtax shall be published in the Florida
2 Statutes as a subsection of this section, irrespective of the
3 duration of the levy. Each enactment shall specify the types
4 of counties authorized to levy; the rate or rates which may be
5 imposed; the maximum length of time the surtax may be imposed,
6 if any; the procedure which must be followed to secure voter
7 approval, if required; the purpose for which the proceeds may
8 be expended; and such other requirements as the Legislature
9 may provide. Taxable transactions and administrative
10 procedures shall be as provided in s. 212.054.
11 (5) COUNTY PUBLIC HOSPITAL SURTAX.--Any county as
12 defined in s. 125.011(1) may levy the surtax authorized in
13 this subsection pursuant to an ordinance either approved by
14 extraordinary vote of the county commission or conditioned to
15 take effect only upon approval by a majority vote of the
16 electors of the county voting in a referendum. In a county as
17 defined in s. 125.011(1), for the purposes of this subsection,
18 "county public general hospital" means a general hospital as
19 defined in s. 395.002 which is owned, operated, maintained, or
20 governed by the county or its agency, authority, or public
21 health trust.
22 (e) A governing board, agency, or authority shall be
23 chartered by the county commission upon this act becoming law.
24 The governing board, agency, or authority shall adopt and
25 implement a health care plan for indigent health care
26 services. The governing board, agency, or authority shall
27 consist of no more than seven and no fewer than five members
28 appointed by the county commission. The members of the
29 governing board, agency, or authority shall be at least 18
30 years of age and residents of the county. No member may be
31 employed by or affiliated with a health care provider or the
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1 public health trust, agency, or authority responsible for the
2 county public general hospital. The following community
3 organizations shall each appoint a representative to a
4 nominating committee: the South Florida Hospital and
5 Healthcare Association, the Miami-Dade County Public Health
6 Trust, the Dade County Medical Association, the Miami-Dade
7 County Homeless Trust, and the Mayor of Miami-Dade County.
8 This committee shall nominate between 10 and 14 county
9 citizens for the governing board, agency, or authority. The
10 slate shall be presented to the county commission and the
11 county commission shall confirm the top five to seven
12 nominees, depending on the size of the governing board. Until
13 such time as the governing board, agency, or authority is
14 created, the funds provided for in subparagraph (d)2. shall be
15 placed in a restricted account set aside from other county
16 funds and not disbursed by the county for any other purpose.
17 1. The plan shall divide the county into a minimum of
18 four and maximum of six service areas, with no more than one
19 participant hospital per service area. The county public
20 general hospital shall be designated as the provider for one
21 of the service areas. Services shall be provided through
22 participants' primary acute care facilities.
23 2. The plan and subsequent amendments to it shall fund
24 a defined range of health care services for both indigent
25 persons and the medically poor, including primary care,
26 preventive care, hospital emergency room care, and hospital
27 care necessary to stabilize the patient. For the purposes of
28 this section, "stabilization" means stabilization as defined
29 in s. 397.311(29)(30). Where consistent with these objectives,
30 the plan may include services rendered by physicians, clinics,
31 community hospitals, and alternative delivery sites, as well
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1 as at least one regional referral hospital per service area.
2 The plan shall provide that agreements negotiated between the
3 governing board, agency, or authority and providers shall
4 recognize hospitals that render a disproportionate share of
5 indigent care, provide other incentives to promote the
6 delivery of charity care to draw down federal funds where
7 appropriate, and require cost containment, including, but not
8 limited to, case management. From the funds specified in
9 subparagraphs (d)1. and 2. for indigent health care services,
10 service providers shall receive reimbursement at a Medicaid
11 rate to be determined by the governing board, agency, or
12 authority created pursuant to this paragraph for the initial
13 emergency room visit, and a per-member per-month fee or
14 capitation for those members enrolled in their service area,
15 as compensation for the services rendered following the
16 initial emergency visit. Except for provisions of emergency
17 services, upon determination of eligibility, enrollment shall
18 be deemed to have occurred at the time services were rendered.
19 The provisions for specific reimbursement of emergency
20 services shall be repealed on July 1, 2001, unless otherwise
21 reenacted by the Legislature. The capitation amount or rate
22 shall be determined prior to program implementation by an
23 independent actuarial consultant. In no event shall such
24 reimbursement rates exceed the Medicaid rate. The plan must
25 also provide that any hospitals owned and operated by
26 government entities on or after the effective date of this act
27 must, as a condition of receiving funds under this subsection,
28 afford public access equal to that provided under s. 286.011
29 as to any meeting of the governing board, agency, or authority
30 the subject of which is budgeting resources for the retention
31 of charity care, as that term is defined in the rules of the
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1 Agency for Health Care Administration. The plan shall also
2 include innovative health care programs that provide
3 cost-effective alternatives to traditional methods of service
4 and delivery funding.
5 3. The plan's benefits shall be made available to all
6 county residents currently eligible to receive health care
7 services as indigents or medically poor as defined in
8 paragraph (4)(d).
9 4. Eligible residents who participate in the health
10 care plan shall receive coverage for a period of 12 months or
11 the period extending from the time of enrollment to the end of
12 the current fiscal year, per enrollment period, whichever is
13 less.
14 5. At the end of each fiscal year, the governing
15 board, agency, or authority shall prepare an audit that
16 reviews the budget of the plan, delivery of services, and
17 quality of services, and makes recommendations to increase the
18 plan's efficiency. The audit shall take into account
19 participant hospital satisfaction with the plan and assess the
20 amount of poststabilization patient transfers requested, and
21 accepted or denied, by the county public general hospital.
22 Section 9. This act shall take effect July 1, 2002.
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2 HOUSE SUMMARY
3
Revises definitions, licensure application requirements,
4 and exemptions from licensure relating to substance abuse
service providers. Revises personnel for whom background
5 screening is required, to include owners, directors, and
managers of service providers, provider personnel who
6 have direct contact with children or adults receiving
services, and volunteers providing assistance for 20 or
7 more hours per month. Provides procedures for the grant
of exemption from disqualification for an owner,
8 director, or manager who has committed a screenable
offense or for the removal of such person from his or her
9 position with the service provider. Requires a
rehabilitated substance abuser to be substance-abuse free
10 for 2 years prior to receiving an exemption from
disqualification for employment with a service provider
11 treating adolescents.
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