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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