House Bill hb0545c1
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Florida House of Representatives - 2002 CS/HB 545
By the Council for Healthy Communities and Representative
Andrews
1 A bill to be entitled
2 An act relating to substance abuse services;
3 amending s. 397.311, F.S.; redefining the term
4 "licensed service provider"; requiring that
5 licensure standards apply to certain
6 residential treatment locations; redefining the
7 term "service provider personnel," to add chief
8 financial officers; amending s. 397.403, F.S.;
9 requiring that owners, directors, and chief
10 financial officers of a substance abuse service
11 provider undergo a background check pursuant to
12 ch. 435, F.S.; providing for removal of such
13 person under certain conditions; providing for
14 revocation of the provider's license for
15 failure to remove such person; requiring that
16 proof of compliance with local zoning
17 ordinances be included in the applications for
18 licensure; amending s. 397.405, F.S.;
19 clarifying that DUI education and screening
20 services must be licensed if they provide
21 treatment services; amending s. 397.407, F.S.;
22 conforming cross references; amending s.
23 397.416, F.S.; conforming cross references;
24 amending s. 397.451, F.S.; clarifying
25 provisions relating to background screening of
26 service provider personnel; requiring level 2
27 background screening for employees who work
28 with children and with adults who are
29 developmentally disabled; specifying
30 circumstances under which service provider
31 owners, directors, or chief financial officers
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1 are not subject to background screening;
2 allowing personnel to request, and the
3 department to grant, an exemption from
4 disqualification; amending ss. 212.055 and
5 440.102, F.S.; conforming cross references;
6 providing an effective date.
7
8 Be It Enacted by the Legislature of the State of Florida:
9
10 Section 1. Section 397.311, Florida Statutes, is
11 amended to read:
12 397.311 Definitions.--As used in this chapter, except
13 part VIII:
14 (1) "Ancillary services" are services which include,
15 but are not limited to, special diagnostic, prenatal and
16 postnatal, other medical, mental health, legal, economic,
17 vocational, employment, and educational services.
18 (2) "Assessment" means the systematic evaluation of
19 information gathered to determine the nature and severity of
20 the client's substance abuse problem and the client's need and
21 motivation for services. Assessment entails the use of a
22 psychosocial history supplemented, as required by rule, by
23 medical examinations, laboratory testing, and psychometric
24 measures.
25 (3) "Authorized agent of the department" means a
26 person designated by the department to conduct any audit,
27 inspection, monitoring, evaluation, or other duty imposed upon
28 the department pursuant to this chapter. An authorized agent
29 must be identified by the department as:
30 (a) Qualified by the requisite expertise and
31 experience;
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1 (b) Having a need to know the applicable information;
2 and
3 (c) Having the assigned responsibility to carry out
4 the applicable duty.
5 (4) "Background check" means reviewing the background
6 of service provider personnel who have direct contact with
7 unmarried clients under the age of 18 years or with clients
8 who are developmentally disabled in accordance with the
9 provisions of s. 397.451, and includes, but is not limited to,
10 local criminal records checks through local law enforcement
11 agencies, fingerprinting, statewide criminal records checks
12 through the Department of Law Enforcement, federal criminal
13 records checks through the Federal Bureau of Investigation,
14 and employment history checks.
15 (4)(5) "Beyond the safe management capabilities of the
16 service provider" refers to a client who is in need of:
17 (a) Supervision;
18 (b) Medical care; or
19 (c) Services,
20
21 beyond that which the service provider or service component
22 can deliver.
23 (5)(6) "Client" means a recipient of alcohol or other
24 drug services delivered by a service provider but does not
25 include an inmate pursuant to part VIII unless expressly so
26 provided.
27 (6)(7) "Client identifying information" means the
28 name, address, social security number, fingerprints,
29 photograph, and similar information by which the identity of a
30 client can be determined with reasonable accuracy and speed
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1 either directly or by reference to other publicly available
2 information.
3 (7)(8) "Court" means, with respect to all involuntary
4 proceedings under this chapter, the circuit court of the
5 county in which the judicial proceeding is pending or where
6 the substance abuse impaired person resides or is located, and
7 includes any general or special master that may be appointed
8 by the chief judge to preside over all or part of such
9 proceeding. Otherwise, "court" refers to the court of legal
10 jurisdiction in the context in which the term is used in this
11 chapter.
12 (8)(9) "Department" means the Department of Children
13 and Family Services.
14 (9)(10) "Director" means the chief administrative
15 officer of a service provider.
16 (10)(11) "Disclose" or "disclosure" means a
17 communication of client identifying information, the
18 affirmative verification of another person's communication of
19 client identifying information, or the communication of any
20 information of a client who has been identified. Any
21 disclosure made pursuant to this chapter must be limited to
22 that information which is necessary to carry out the purpose
23 of the disclosure.
24 (11)(12) "Fee system" means a method of establishing
25 charges for services rendered, in accordance with a client's
26 ability to pay, used by providers that receive state funds.
27 (12)(13) "For profit" means registered as for profit
28 by the Secretary of State and recognized by the Internal
29 Revenue Service as a for-profit entity.
30 (13)(14) "Habitual abuser" means a person who is
31 brought to the attention of law enforcement for being
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1 substance impaired, who meets the criteria for involuntary
2 admission in s. 397.675, and who has been taken into custody
3 for such impairment three or more times during the preceding
4 12 months.
5 (14)(15) "Hospital" means a hospital or hospital-based
6 component licensed under chapter 395.
7 (15)(16) "Impaired" or "substance abuse impaired"
8 means a condition involving the use of alcoholic beverages or
9 any psychoactive or mood-altering substance in such a manner
10 as to induce mental, emotional, or physical problems and cause
11 socially dysfunctional behavior.
12 (16)(17) "Individualized treatment or service plan"
13 means an immediate and a long-range plan for substance abuse
14 or ancillary services developed on the basis of a client's
15 assessed needs.
16 (17)(18) "Law enforcement officer" means a law
17 enforcement officer as defined in s. 943.10(1).
18 (18)(19) "Licensed service provider" means a public
19 agency under this chapter, a private for-profit or
20 not-for-profit agency under this chapter, a physician licensed
21 under chapter 458 or chapter 459, or any other private
22 practitioner licensed under this chapter, or a hospital that
23 licensed under chapter 395, which offers substance abuse
24 impairment services through one or more of the following
25 licensable service components:
26 (a) Addictions receiving facility, which is a
27 community-based facility designated by the department to
28 receive, screen, and assess clients found to be substance
29 abuse impaired, in need of emergency treatment for substance
30 abuse impairment, or impaired by substance abuse to such an
31 extent as to meet the criteria for involuntary admission in s.
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1 397.675, and to provide detoxification and stabilization. An
2 addictions receiving facility must be state-owned,
3 state-operated, or state-contracted, and licensed pursuant to
4 rules adopted by the department's Substance Abuse Program
5 Office which include specific authorization for the provision
6 of levels of care and a requirement of separate accommodations
7 for adults and minors. Addictions receiving facilities are
8 designated as secure facilities to provide an intensive level
9 of care and must have sufficient staff and the authority to
10 provide environmental security to handle aggressive and
11 difficult-to-manage behavior and deter elopement.
12 (b) Detoxification, which uses medical and
13 psychological procedures and a supportive counseling regimen
14 to assist clients in managing toxicity and withdrawing and
15 stabilizing from the physiological and psychological effects
16 of substance abuse impairment.
17 (c) Residential treatment, which provides a
18 structured, live-in environment within a nonhospital setting
19 on a 24-hours-a-day, 7-days-a-week basis, and which includes:
20 treatment, rehabilitation, and transitional care.
21 1. Facilities that provide room and board and
22 treatment and rehabilitation within the primary residential
23 facility; and
24 2. Facilities that are used for room and board only
25 and in which treatment and rehabilitation activities are
26 provided on a mandatory basis at locations other than the
27 primary residential facility. In this case, facilities used
28 for room and board and for treatment and rehabilitation are
29 operated under the auspices of the same provider, and
30 licensing and regulatory requirements would apply to both the
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1 residential facility and all other facilities in which
2 treatment and rehabilitation activities occur.
3 (d) Day and night treatment, which provides a
4 nonresidential environment with a structured schedule of
5 treatment and rehabilitation services.
6 (e) Outpatient treatment, which provides individual,
7 group, or family counseling for clients by appointment during
8 scheduled operating hours, with an emphasis on assessment and
9 treatment.
10 (f) Medication and methadone maintenance treatment
11 that uses methadone or other medication as authorized by state
12 and federal law, in conjunction with medical, rehabilitative,
13 and counseling services in the treatment of clients who are
14 dependent upon opioid drugs.
15 (g) Prevention, which is a process involving
16 strategies aimed at the individual, the environment, or the
17 substance, which strategies preclude, forestall, or impede the
18 development of substance abuse problems and promote
19 responsible personal and social growth of individuals and
20 families toward full human potential.
21 (h) Intervention, which consists of structured
22 services targeted toward individuals or groups at risk and
23 focused on reducing those factors associated with the onset or
24 the early stages of substance abuse, and related problems.
25 (19)(20) "Not for profit" means registered as not for
26 profit by the Secretary of State and recognized by the
27 Internal Revenue Service as a not-for-profit entity.
28 (20)(21) "Physician" means a person licensed under
29 chapter 458 to practice medicine or licensed under chapter 459
30 to practice osteopathic medicine, and may include, if the
31 context so indicates, an intern or resident enrolled in an
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1 intern or resident training program affiliated with an
2 approved medical school, hospital, or other facility through
3 which training programs are normally conducted.
4 (21)(22) "Preliminary screening" means the gathering
5 of initial information to be used in determining a person's
6 need for assessment or for referral.
7 (22)(23) "Private practitioner" means a physician
8 licensed under chapter 458 or chapter 459, a psychologist
9 licensed under chapter 490, or a clinical social worker,
10 marriage and family therapist, or mental health counselor
11 licensed under chapter 491.
12 (23)(24) "Program evaluation" or "evaluation" means a
13 systematic measurement of a service provider's achievement of
14 desired client or service outcomes.
15 (24)(25) "Qualified professional" means a physician
16 licensed under chapter 458 or chapter 459; a professional
17 licensed under chapter 490 or chapter 491; or a person who is
18 certified through a department-recognized certification
19 process for substance abuse treatment services and who holds,
20 at a minimum, a bachelor's degree. A person who is certified
21 in substance abuse treatment services by a state-recognized
22 certification process in another state at the time of
23 employment with a licensed substance abuse provider in this
24 state may perform the functions of a qualified professional as
25 defined in this chapter but must meet certification
26 requirements contained in this subsection no later than 1 year
27 after his or her date of employment.
28 (25)(26) "Quality assurance" means the objective and
29 internal systematic monitoring of the appropriateness and
30 quality of client care rendered by a service provider.
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1 (26)(27) "Secure facility," except where the context
2 indicates a correctional system facility, means a provider
3 that has the authority to deter the premature departure of
4 involuntary clients whose leaving constitutes a violation of a
5 court order or community-based supervision as provided by law.
6 The term "secure facility" includes addictions receiving
7 facilities and facilities authorized by local ordinance for
8 the treatment of habitual abusers.
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, chief financial officers,
16 staff, and volunteers, including foster parents, of a service
17 provider.
18 (29)(30) "Stabilization" means:
19 (a) Alleviation of a crisis condition; or
20 (b) Prevention of further deterioration,
21
22 and connotes short-term emergency treatment.
23 Section 2. Subsection (1) of section 397.403, Florida
24 Statutes, is amended to read:
25 397.403 License application.--
26 (1) Applicants for a license under this chapter must
27 apply to the department on forms provided by the department
28 and in accordance with rules adopted by the department.
29 Applications must include at a minimum:
30
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1 (a) Information establishing the name and address of
2 the applicant service provider and its director, and also of
3 each member, owner, officer, and shareholder, if any.
4 (b) Information establishing the competency and
5 ability of the applicant service provider and its director to
6 carry out the requirements of this chapter.
7 (c) Proof satisfactory to the department of the
8 applicant service provider's financial ability and
9 organizational capability to operate in accordance with this
10 chapter.
11 (d) Proof of liability insurance coverage in amounts
12 set by the department by rule.
13 (e) Sufficient information to conduct background
14 screening as provided in s. 397.451 Personnel fingerprints for
15 background checks as required by this chapter.
16 1. If the results of the background screening indicate
17 that any owner, director, or chief financial officer has been
18 found guilty of, regardless of adjudication, or has entered a
19 plea of nolo contendere or guilty to any offense prohibited
20 under the screening standard, a license may not be issued to
21 the applicant service provider unless an exemption from
22 disqualification has been granted by the department as set
23 forth in chapter 435. The owner, director, or chief financial
24 officer has 90 days within which to obtain the required
25 exemption, during which time the applicant's license remains
26 in effect.
27 2. If any owner, director, or chief financial officer
28 is found guilty of, regardless of adjudication, or has entered
29 a plea of nolo contendere or guilty to any offense prohibited
30 under the screening standard while acting in that capacity,
31 the provider shall immediately remove the person from that
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1 position and shall notify the department within 2 days after
2 such removal, excluding weekends and holidays. Failure to
3 remove the owner, director, or chief financial officer will
4 result in revocation of the provider's license.
5 (f) Proof of satisfactory fire, safety, and health
6 inspections, and compliance with local zoning ordinances.
7 Service providers operating under a regular annual license
8 shall have 18 months after the expiration date of their
9 regular license within which to meet local zoning
10 requirements. Applicants for a new license must demonstrate
11 proof of compliance with zoning requirements prior to the
12 department issuing a probationary license.
13 (g) A comprehensive outline of the proposed services
14 for:
15 1. Any new applicant; or
16 2. Any licensed service provider adding a new
17 licensable service component.
18 Section 3. Section 397.405, Florida Statutes, is
19 amended to read:
20 397.405 Exemptions from licensure.--The following are
21 exempt from the licensing provisions of this chapter:
22 (1) A hospital or hospital-based component licensed
23 under chapter 395.
24 (2) A nursing home facility as defined in s. 400.021.
25 (3) A substance abuse education program established
26 pursuant to s. 233.061.
27 (4) A facility or institution operated by the Federal
28 Government.
29 (5) A physician licensed under chapter 458 or chapter
30 459.
31 (6) A psychologist licensed under chapter 490.
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1 (7) A social worker, marriage and family therapist, or
2 mental health counselor licensed under chapter 491.
3 (8) An established and legally cognizable church or
4 nonprofit religious organization or, denomination, or sect
5 providing substance abuse services, including prevention
6 services, which are exclusively religious, spiritual, or
7 ecclesiastical in nature. A church or nonprofit religious
8 organization or, denomination, or sect providing any of the
9 licensable service components itemized under s.
10 397.311(18)(19) is not exempt for purposes of its provision of
11 such licensable service components but retains its exemption
12 with respect to all services which are exclusively religious,
13 spiritual, or ecclesiastical in nature.
14 (9) Facilities licensed under s. 393.063(8) that, in
15 addition to providing services to persons who are
16 developmentally disabled as defined therein, also provide
17 services to persons developmentally at risk as a consequence
18 of exposure to alcohol or other legal or illegal drugs while
19 in utero.
20 (10) DUI education and screening services provided
21 required to be attended pursuant to ss. 316.192, 316.193,
22 322.095, 322.271, and 322.291 are exempt from licensure under
23 this chapter. Persons or entities providing treatment services
24 programs must continue to be licensed under this chapter
25 unless exempted from licensing as provided in this section.
26
27 The exemptions from licensure in this section do not apply to
28 any service provider that facility or entity which receives an
29 appropriation, grant, or contract from the state to operate as
30 a service provider as defined in this chapter or to any
31 substance abuse program regulated pursuant to s. 397.406.
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1 Furthermore, No provision of this chapter may not shall be
2 construed to limit the practice of a physician licensed under
3 chapter 458 or chapter 459, a psychologist licensed under
4 chapter 490, or a psychotherapist licensed under chapter 491
5 who provides, providing outpatient or inpatient substance
6 abuse treatment to a voluntary patient, so long as the
7 physician, psychologist, or psychotherapist does not represent
8 to the public that he or she is a licensed service provider
9 and does not provide services to clients pursuant to part V of
10 this chapter under this act. Failure to comply with any
11 requirement necessary to maintain an exempt status under this
12 section is a misdemeanor of the first degree, punishable as
13 provided in s. 775.082 or s. 775.083.
14 Section 4. Subsection (1) of section 397.407, Florida
15 Statutes, is amended to read:
16 397.407 Licensure fees.--
17 (1) The department shall establish licensure fees by
18 rule. The rule must prescribe a fee range that is based, at
19 least in part, on the number and complexity of programs listed
20 in s. 397.311(18)(19) which are operated by a licensee. The
21 fee range must be implemented over a 5-year period. The fee
22 schedule for licensure of service components must be increased
23 annually in substantially equal increments so that, by July 1,
24 1998, the fees from the licensure of service components are
25 sufficient to cover at least 50 percent of the costs of
26 regulating the service components. The department shall
27 specify by rule a fee range and phase-in plan for privately
28 funded licensed service providers and a fee range and phase-in
29 plan for publicly funded licensed service providers. Fees for
30 privately funded licensed service providers must exceed the
31 fees for publicly funded licensed service providers. The
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1 first year phase-in licensure fees must be at least $150 per
2 initial license. The rule must provide for a reduction in
3 licensure fees for licensed service providers who hold more
4 than one license.
5 Section 5. Subsection (2) of section 397.416, Florida
6 Statutes, is amended to read:
7 397.416 Substance abuse treatment services; qualified
8 professional.--
9 (2) Notwithstanding any other provision of law, a
10 person who was certified through a certification process
11 recognized by the former Department of Health and
12 Rehabilitative Services before January 1, 1995, may perform
13 the duties of a qualified professional with respect to
14 substance abuse treatment services as defined in this chapter,
15 and need not meet the certification requirements contained in
16 s. 397.311(24)(25).
17 Section 6. Section 397.451, Florida Statutes, is
18 amended to read:
19 397.451 Background checks of service provider
20 personnel who have direct contact with unmarried minor clients
21 or clients who are developmentally disabled.--
22 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
23 EXCEPTIONS.--
24 (a) Background checks shall apply as follows:
25 1. All owners, directors, and chief financial officers
26 of service providers are subject to level 2 background
27 screening as provided under chapter 435.
28 2. All service provider personnel who have direct
29 contact with children receiving services or with adults who
30 are developmentally disabled receiving services are subject to
31 level 2 background screening as provided under chapter 435.
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1 Service provider personnel who have direct contact with
2 unmarried clients under the age of 18 years or with clients
3 who are developmentally disabled are subject to background
4 checks, except as otherwise provided in this section.
5 (b) Students in the health care professions who are
6 interning under the actual physical presence supervision of a
7 licensed health care professional in a service provider
8 licensed under chapter 395, where the primary purpose of the
9 service provider is not the treatment of unmarried minors or
10 of persons who are developmentally disabled, are exempt from
11 the fingerprinting and background check requirements.
12 (c) Personnel working in a service provider licensed
13 under chapter 395 who have less than 15 hours per week of
14 direct contact with unmarried minors or with persons who are
15 developmentally disabled, or personnel who are health care
16 professionals licensed by the Department of Business and
17 Professional Regulation or a board thereunder who are not
18 employed in a service provider where the primary purpose is
19 the treatment of unmarried minors or of persons who are
20 developmentally disabled are exempt from the fingerprinting
21 and background check requirements.
22 (b)(d) Members of a foster family and persons residing
23 with the foster family who are between 12 and 18 years of age
24 are not required to be fingerprinted but must have their
25 backgrounds checked for delinquency records. Members of the
26 foster family and persons residing with the foster family over
27 18 years of age are subject to full background checks.
28 (c)(e) A volunteer who assists on an intermittent
29 basis for fewer than 40 hours per month and is under direct
30 and constant supervision by persons who meet all personnel
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1 requirements of this chapter is exempt from fingerprinting and
2 background check requirements.
3 (d)(f) Service providers that are exempt from
4 licensing provisions of this chapter are exempt from personnel
5 fingerprinting and background check requirements, except as
6 otherwise provided in this section. A church or nonprofit
7 religious organization exempt from licensure under this
8 chapter is required to comply with personnel fingerprinting
9 and background check requirements.
10 (e)(g) Personnel employed by the Department of
11 Corrections in a substance abuse service component who have
12 direct contact with unmarried inmates under the age of 18 or
13 with inmates who are developmentally disabled are exempt from
14 the fingerprinting and background check requirements of this
15 section.
16 (f) Service provider personnel who request an
17 exemption from disqualification must submit the request within
18 30 days after being notified of a pending disqualification.
19 The employment of service provider personnel shall not be
20 adversely affected pending disposition of the request for an
21 exemption. Disapproval of a request for an exemption shall
22 result in the immediate dismissal of the service provider
23 personnel from employment with the provider.
24 (2) EMPLOYMENT HISTORY CHECKS; CHECKS OF
25 REFERENCES.--The department shall assess employment history
26 checks and checks of references for all owners, directors, and
27 chief financial officers, and the directors shall assess
28 employment history checks and checks of references for each
29 employee who has direct contact with children receiving
30 services or adults receiving services who are developmentally
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1 disabled unmarried clients under the age of 18 years or with
2 clients who are developmentally disabled.
3 (3) MINIMUM BACKGROUND CHECK STANDARDS.--The
4 department shall require employment screening pursuant to
5 chapter 435, using level 2 standards for screening set forth
6 in that chapter, of service provider personnel who have direct
7 contact with unmarried clients under the age of 18 years or
8 with clients who are developmentally disabled.
9 (3)(4) PERSONNEL EXEMPT FROM BEING REFINGERPRINTED OR
10 RECHECKED.--
11 (a) Service provider personnel who have been
12 fingerprinted or had their backgrounds checked pursuant to
13 chapter 393, chapter 394, chapter 402, or chapter 409, or this
14 section, and teachers who have been fingerprinted pursuant to
15 chapter 231, who have not been unemployed for more than 90
16 days thereafter and who, under the penalty of perjury, attest
17 to the completion of such fingerprinting or background checks
18 and to compliance with the provisions of this section and the
19 standards contained in chapter 435 and this section, are not
20 required to be refingerprinted or rechecked in order to comply
21 with service provider personnel fingerprinting or background
22 check requirements.
23 (b) Service provider owners, directors, or chief
24 financial officers who are not covered by paragraph (a) who
25 provide proof of compliance with the level 2 background
26 screening requirements which has been submitted within the
27 previous 5 years in compliance with any other state health
28 care licensure requirements are not required to be
29 refingerprinted or rechecked.
30 (4)(5) EXEMPTIONS FROM DISQUALIFICATION.--
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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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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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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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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)(30). Where consistent with these objectives,
6 the plan may include services rendered by physicians, clinics,
7 community hospitals, and alternative delivery sites, as well
8 as at least one regional referral hospital per service area.
9 The plan shall provide that agreements negotiated between the
10 governing board, agency, or authority and providers shall
11 recognize hospitals that render a disproportionate share of
12 indigent care, provide other incentives to promote the
13 delivery of charity care to draw down federal funds where
14 appropriate, and require cost containment, including, but not
15 limited to, case management. From the funds specified in
16 subparagraphs (d)1. and 2. for indigent health care services,
17 service providers shall receive reimbursement at a Medicaid
18 rate to be determined by the governing board, agency, or
19 authority created pursuant to this paragraph for the initial
20 emergency room visit, and a per-member per-month fee or
21 capitation for those members enrolled in their service area,
22 as compensation for the services rendered following the
23 initial emergency visit. Except for provisions of emergency
24 services, upon determination of eligibility, enrollment shall
25 be deemed to have occurred at the time services were rendered.
26 The provisions for specific reimbursement of emergency
27 services shall be repealed on July 1, 2001, unless otherwise
28 reenacted by the Legislature. The capitation amount or rate
29 shall be determined prior to program implementation by an
30 independent actuarial consultant. In no event shall such
31 reimbursement rates exceed the Medicaid rate. The plan must
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1 also provide that any hospitals owned and operated by
2 government entities on or after the effective date of this act
3 must, as a condition of receiving funds under this subsection,
4 afford public access equal to that provided under s. 286.011
5 as to any meeting of the governing board, agency, or authority
6 the subject of which is budgeting resources for the retention
7 of charity care, as that term is defined in the rules of the
8 Agency for Health Care Administration. The plan shall also
9 include innovative health care programs that provide
10 cost-effective alternatives to traditional methods of service
11 and delivery funding.
12 3. The plan's benefits shall be made available to all
13 county residents currently eligible to receive health care
14 services as indigents or medically poor as defined in
15 paragraph (4)(d).
16 4. Eligible residents who participate in the health
17 care plan shall receive coverage for a period of 12 months or
18 the period extending from the time of enrollment to the end of
19 the current fiscal year, per enrollment period, whichever is
20 less.
21 5. At the end of each fiscal year, the governing
22 board, agency, or authority shall prepare an audit that
23 reviews the budget of the plan, delivery of services, and
24 quality of services, and makes recommendations to increase the
25 plan's efficiency. The audit shall take into account
26 participant hospital satisfaction with the plan and assess the
27 amount of poststabilization patient transfers requested, and
28 accepted or denied, by the county public general hospital.
29 Section 8. Paragraphs (d) and (g) of subsection (1) of
30 section 440.102, Florida Statutes, are amended to read:
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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)(28), that
9 provides confidential, timely, and expert identification,
10 assessment, and resolution of employee drug abuse.
11 (g) "Employee assistance program" means an established
12 program capable of providing expert assessment of employee
13 personal concerns; confidential and timely identification
14 services with regard to employee drug abuse; referrals of
15 employees for appropriate diagnosis, treatment, and
16 assistance; and followup services for employees who
17 participate in the program or require monitoring after
18 returning to work. If, in addition to the above activities, an
19 employee assistance program provides diagnostic and treatment
20 services, these services shall in all cases be provided by
21 service providers pursuant to s. 397.311(27)(28).
22 Section 9. This act shall take effect July 1, 2002.
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