1 | A bill to be entitled |
2 | An act relating to substance abuse and mental health |
3 | services; amending s. 212.055, F.S.; conforming a cross- |
4 | reference; amending s. 394.67, F.S.; redefining the term |
5 | "residential treatment center for children and |
6 | adolescents"; amending s. 394.674, F.S.; establishing |
7 | priority populations of persons who are eligible for |
8 | services funded by the Department of Children and Family |
9 | Services; amending s. 394.9085, F.S.; conforming a cross- |
10 | reference; amending s. 397.301, F.S.; deleting an obsolete |
11 | provision; amending s. 397.305, F.S.; revising the |
12 | legislative findings, intent, and purpose; amending s. |
13 | 397.311, F.S.; providing, deleting, and revising |
14 | definitions; amending s. 397.321, F.S.; revising the |
15 | duties of the Department of Children and Family Services; |
16 | deleting a provision that authorizes the department to |
17 | establish a pilot project to serve certain persons who |
18 | qualify to receive substance abuse or mental health |
19 | services in a specified district; amending s. 397.331, |
20 | F.S.; revising the term "substance abuse programs and |
21 | services" or "drug control"; amending s. 397.401, F.S.; |
22 | providing that it is unlawful for an unlicensed agency to |
23 | act as a substance abuse service provider; amending s. |
24 | 397.403, F.S.; revising requirements for a license |
25 | application; amending s. 397.405, F.S.; providing that a |
26 | crisis stabilization unit is exempt from licensure; |
27 | conforming a cross-reference; providing that ch. 397, |
28 | F.S., does not limit the practice of an advanced |
29 | registered nurse practitioner who provides substance abuse |
30 | treatment under certain circumstances; amending s. |
31 | 397.406, F.S.; providing that substance abuse programs |
32 | operated directly or under contract by the Department of |
33 | Juvenile Justice are subject to licensure and regulation; |
34 | amending s. 397.407, F.S.; conforming a cross-reference; |
35 | revising the licensure process; authorizing the Department |
36 | of Children and Family Services to issue probationary, |
37 | regular, and interim licenses; providing requirements for |
38 | probationary, regular, and interim licenses; repealing s. |
39 | 397.409, F.S., relating to probationary, regular, and |
40 | interim licenses; amending s. 397.411, F.S.; requiring the |
41 | department to notify certain applicable agencies of any |
42 | licensure inspections of service providers; amending s. |
43 | 397.415, F.S.; requiring that fines collected as |
44 | administrative penalties be deposited in the Operations |
45 | and Maintenance Trust Fund of the department rather than |
46 | the Substance Abuse Impairment Provider Licensing Trust |
47 | Fund; revising requirements for suspending or revoking a |
48 | license; amending s. 397.416, F.S.; conforming a cross- |
49 | reference; amending s. 397.419, F.S.; renaming quality |
50 | assurance programs to "quality improvement programs"; |
51 | conforming provisions to changes made by the act; revising |
52 | minimum guidelines for a service provider's quality |
53 | improvement program; providing additional requirements for |
54 | a quality improvement program; deleting a provision that |
55 | requires a quality assurance program to incorporate a peer |
56 | review process; amending s. 397.427, F.S.; specifying that |
57 | medication treatment service providers are providers of |
58 | medication-assisted treatment services for opiate |
59 | addiction; conforming provisions to changes made by the |
60 | act; requiring the department to determine the need for |
61 | establishing medication-assisted treatment services for |
62 | other substance-use disorders; requiring service providers |
63 | that provide medication-assisted treatment for other |
64 | substance-use disorders to provide counseling services; |
65 | requiring the department to adopt rules to administer |
66 | medication-assisted treatment services; authorizing a |
67 | registered nurse, an advanced registered nurse |
68 | practitioner, and a licensed practical nurse to deliver |
69 | medication, other than methadone, for the purpose of |
70 | medication-assisted treatment for opiate addiction under |
71 | certain conditions; requiring a licensed service provider |
72 | that provides medication-assisted treatment to adopt |
73 | written protocols; providing requirements for the |
74 | protocols; requiring a licensed service provider that |
75 | provides medication-assisted treatment to maintain and |
76 | have ready for inspection medical records and protocols; |
77 | amending s. 397.431, F.S.; conforming provisions to |
78 | changes made by the act; amending s. 397.451, F.S.; |
79 | providing that inmate substance abuse programs are exempt |
80 | from level 2 background screenings; clarifying that |
81 | certain personnel employed in an inmate substance abuse |
82 | program are exempt from fingerprinting and background |
83 | check requirements; amending ss. 397.471, 397.501, |
84 | 397.581, 397.601, 397.6751, 397.6752, 397.6758, 397.6773, |
85 | 397.6797, 397.6799, 397.6819, 397.6821, 397.6822, 397.697, |
86 | 397.6971, 397.6975, 397.6977, 397.702, 397.706, 397.801, |
87 | 397.821, 397.94, 397.95, 397.97, and 397.99, F.S.; |
88 | conforming provisions to changes made by the act; amending |
89 | s. 440.102, F.S.; conforming a cross-reference; amending |
90 | s. 766.101, F.S.; redefining the term "medical review |
91 | committee" to include a committee to review mental health |
92 | and substance abuse treatment services provided by the |
93 | department; repealing s. 394.9081, F.S., relating to |
94 | target groups for substance abuse and mental health |
95 | services; providing an effective date. |
96 |
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97 | Be It Enacted by the Legislature of the State of Florida: |
98 |
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99 | Section 1. Paragraph (e) of subsection (5) of section |
100 | 212.055, Florida Statutes, is amended to read: |
101 | 212.055 Discretionary sales surtaxes; legislative intent; |
102 | authorization and use of proceeds.--It is the legislative intent |
103 | that any authorization for imposition of a discretionary sales |
104 | surtax shall be published in the Florida Statutes as a |
105 | subsection of this section, irrespective of the duration of the |
106 | levy. Each enactment shall specify the types of counties |
107 | authorized to levy; the rate or rates which may be imposed; the |
108 | maximum length of time the surtax may be imposed, if any; the |
109 | procedure which must be followed to secure voter approval, if |
110 | required; the purpose for which the proceeds may be expended; |
111 | and such other requirements as the Legislature may provide. |
112 | Taxable transactions and administrative procedures shall be as |
113 | provided in s. 212.054. |
114 | (5) COUNTY PUBLIC HOSPITAL SURTAX.--Any county as defined |
115 | in s. 125.011(1) may levy the surtax authorized in this |
116 | subsection pursuant to an ordinance either approved by |
117 | extraordinary vote of the county commission or conditioned to |
118 | take effect only upon approval by a majority vote of the |
119 | electors of the county voting in a referendum. In a county as |
120 | defined in s. 125.011(1), for the purposes of this subsection, |
121 | "county public general hospital" means a general hospital as |
122 | defined in s. 395.002 which is owned, operated, maintained, or |
123 | governed by the county or its agency, authority, or public |
124 | health trust. |
125 | (e) A governing board, agency, or authority shall be |
126 | chartered by the county commission upon this act becoming law. |
127 | The governing board, agency, or authority shall adopt and |
128 | implement a health care plan for indigent health care services. |
129 | The governing board, agency, or authority shall consist of no |
130 | more than seven and no fewer than five members appointed by the |
131 | county commission. The members of the governing board, agency, |
132 | or authority shall be at least 18 years of age and residents of |
133 | the county. No member may be employed by or affiliated with a |
134 | health care provider or the public health trust, agency, or |
135 | authority responsible for the county public general hospital. |
136 | The following community organizations shall each appoint a |
137 | representative to a nominating committee: the South Florida |
138 | Hospital and Healthcare Association, the Miami-Dade County |
139 | Public Health Trust, the Dade County Medical Association, the |
140 | Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade |
141 | County. This committee shall nominate between 10 and 14 county |
142 | citizens for the governing board, agency, or authority. The |
143 | slate shall be presented to the county commission and the county |
144 | commission shall confirm the top five to seven nominees, |
145 | depending on the size of the governing board. Until such time as |
146 | the governing board, agency, or authority is created, the funds |
147 | provided for in subparagraph (d)2. shall be placed in a |
148 | restricted account set aside from other county funds and not |
149 | disbursed by the county for any other purpose. |
150 | 1. The plan shall divide the county into a minimum of four |
151 | and maximum of six service areas, with no more than one |
152 | participant hospital per service area. The county public general |
153 | hospital shall be designated as the provider for one of the |
154 | service areas. Services shall be provided through participants' |
155 | primary acute care facilities. |
156 | 2. The plan and subsequent amendments to it shall fund a |
157 | defined range of health care services for both indigent persons |
158 | and the medically poor, including primary care, preventive care, |
159 | hospital emergency room care, and hospital care necessary to |
160 | stabilize the patient. For the purposes of this section, |
161 | "stabilization" means stabilization as defined in s. 397.311(33) |
162 | s. 397.311(30). Where consistent with these objectives, the plan |
163 | may include services rendered by physicians, clinics, community |
164 | hospitals, and alternative delivery sites, as well as at least |
165 | one regional referral hospital per service area. The plan shall |
166 | provide that agreements negotiated between the governing board, |
167 | agency, or authority and providers shall recognize hospitals |
168 | that render a disproportionate share of indigent care, provide |
169 | other incentives to promote the delivery of charity care to draw |
170 | down federal funds where appropriate, and require cost |
171 | containment, including, but not limited to, case management. |
172 | From the funds specified in subparagraphs (d)1. and 2. for |
173 | indigent health care services, service providers shall receive |
174 | reimbursement at a Medicaid rate to be determined by the |
175 | governing board, agency, or authority created pursuant to this |
176 | paragraph for the initial emergency room visit, and a per-member |
177 | per-month fee or capitation for those members enrolled in their |
178 | service area, as compensation for the services rendered |
179 | following the initial emergency visit. Except for provisions of |
180 | emergency services, upon determination of eligibility, |
181 | enrollment shall be deemed to have occurred at the time services |
182 | were rendered. The provisions for specific reimbursement of |
183 | emergency services shall be repealed on July 1, 2001, unless |
184 | otherwise reenacted by the Legislature. The capitation amount or |
185 | rate shall be determined prior to program implementation by an |
186 | independent actuarial consultant. In no event shall such |
187 | reimbursement rates exceed the Medicaid rate. The plan must also |
188 | provide that any hospitals owned and operated by government |
189 | entities on or after the effective date of this act must, as a |
190 | condition of receiving funds under this subsection, afford |
191 | public access equal to that provided under s. 286.011 as to any |
192 | meeting of the governing board, agency, or authority the subject |
193 | of which is budgeting resources for the retention of charity |
194 | care, as that term is defined in the rules of the Agency for |
195 | Health Care Administration. The plan shall also include |
196 | innovative health care programs that provide cost-effective |
197 | alternatives to traditional methods of service and delivery |
198 | funding. |
199 | 3. The plan's benefits shall be made available to all |
200 | county residents currently eligible to receive health care |
201 | services as indigents or medically poor as defined in paragraph |
202 | (4)(d). |
203 | 4. Eligible residents who participate in the health care |
204 | plan shall receive coverage for a period of 12 months or the |
205 | period extending from the time of enrollment to the end of the |
206 | current fiscal year, per enrollment period, whichever is less. |
207 | 5. At the end of each fiscal year, the governing board, |
208 | agency, or authority shall prepare an audit that reviews the |
209 | budget of the plan, delivery of services, and quality of |
210 | services, and makes recommendations to increase the plan's |
211 | efficiency. The audit shall take into account participant |
212 | hospital satisfaction with the plan and assess the amount of |
213 | poststabilization patient transfers requested, and accepted or |
214 | denied, by the county public general hospital. |
215 | Section 2. Subsection (21) of section 394.67, Florida |
216 | Statutes, is amended to read: |
217 | 394.67 Definitions.--As used in this part, the term: |
218 | (21) "Residential treatment center for children and |
219 | adolescents" means a 24-hour residential program, including a |
220 | therapeutic group home, which provides mental health services to |
221 | emotionally disturbed children or adolescents as defined in s. |
222 | 394.492(5) or (6) and which is a private for-profit or not-for- |
223 | profit corporation licensed by the agency under contract with |
224 | the department which offers a variety of treatment modalities in |
225 | a more restrictive setting. |
226 | Section 3. Section 394.674, Florida Statutes, is amended |
227 | to read: |
228 | 394.674 Client Clinical eligibility for publicly funded |
229 | substance abuse and mental health services; fee collection |
230 | requirements.-- |
231 | (1) To be eligible to receive substance abuse and mental |
232 | health services funded by the department, a person must be a |
233 | member of at least one of the department's priority populations |
234 | target groups approved by the Legislature, pursuant to s. |
235 | 216.0166. The priority populations include: |
236 | (a) For adult mental health services: |
237 | 1. Adults who have severe and persistent mental illness, |
238 | as designated by the department using criteria that include |
239 | severity of diagnosis, duration of the mental illness, ability |
240 | to independently perform activities of daily living, and receipt |
241 | of disability income for a psychiatric condition. Included |
242 | within this group are: |
243 | a. Older adults in crisis. |
244 | b. Older adults who are at risk of being placed in a more |
245 | restrictive environment because of their mental illness. |
246 | c. Persons deemed incompetent to proceed or not guilty by |
247 | reason of insanity under chapter 916. |
248 | d. Other persons involved in the criminal justice system. |
249 | e. Persons diagnosed as having co-occurring mental illness |
250 | and substance abuse disorders. |
251 | 2. Persons who are experiencing an acute mental or |
252 | emotional crisis as defined in s. 394.67(17). |
253 | (b) For children's mental health services: |
254 | 1. Children who are at risk of emotional disturbance as |
255 | defined in s. 394.492(4). |
256 | 2. Children who have an emotional disturbance as defined |
257 | in s. 394.492(5). |
258 | 3. Children who have a serious emotional disturbance as |
259 | defined in s. 394.492(6). |
260 | 4. Children diagnosed as having a co-occurring substance |
261 | abuse and emotional disturbance or serious emotional |
262 | disturbance. |
263 | (c) For substance abuse treatment services: |
264 | 1. Adults who have substance abuse disorders and a history |
265 | of intravenous drug use. |
266 | 2. Persons diagnosed as having co-occurring substance |
267 | abuse and mental health disorders. |
268 | 3. Parents who put children at risk due to a substance |
269 | abuse disorder. |
270 | 4. Persons who have a substance abuse disorder and have |
271 | been ordered by the court to receive treatment. |
272 | 5. Children at risk for initiating drug use. |
273 | 6. Children under state supervision. |
274 | 7. Children who have a substance abuse disorder but who |
275 | are not under the supervision of a court or in the custody of a |
276 | state agency. |
277 | 8. Persons identified as being part of a priority |
278 | population as a condition for receiving services funded through |
279 | the Mental Health and Substance Abuse Block Grant. |
280 | (2) Crisis services, as defined in s. 394.67, must, within |
281 | the limitations of available state and local matching resources, |
282 | be available to each person who is eligible for services under |
283 | subsection (1), regardless of the person's ability to pay for |
284 | such services. A person who is experiencing a mental health |
285 | crisis and who does not meet the criteria for involuntary |
286 | examination under s. 394.463(1), or a person who is experiencing |
287 | a substance abuse crisis and who does not meet the involuntary |
288 | admission criteria in s. 397.675, must contribute to the cost of |
289 | his or her care and treatment pursuant to the sliding fee scale |
290 | developed under subsection (4), unless charging a fee is |
291 | contraindicated because of the crisis situation. |
292 | (3) Mental health services, substance abuse services, and |
293 | crisis services, as defined in s. 394.67, must, within the |
294 | limitations of available state and local matching resources, be |
295 | available to each person who is eligible for services under |
296 | subsection (1). Such person must contribute to the cost of his |
297 | or her care and treatment pursuant to the sliding fee scale |
298 | developed under subsection (4). |
299 | (4) The department shall adopt rules to implement client |
300 | the clinical eligibility, client enrollment, and fee collection |
301 | requirements for publicly funded substance abuse and mental |
302 | health services. |
303 | (a) The rules must require that each provider under |
304 | contract with the department which enrolls eligible persons into |
305 | treatment to develop a sliding fee scale for persons who have a |
306 | net family income at or above 150 percent of the Federal Poverty |
307 | Income Guidelines, unless otherwise required by state or federal |
308 | law. The sliding fee scale must use the uniform schedule of |
309 | discounts by which a provider under contract with the department |
310 | discounts its established client charges for services supported |
311 | with state, federal, or local funds, using, at a minimum, |
312 | factors such as family income, financial assets, and family size |
313 | as declared by the person or the person's guardian. The rules |
314 | must include uniform criteria to be used by all service |
315 | providers in developing the schedule of discounts for the |
316 | sliding fee scale. |
317 | (b) The rules must address the most expensive types of |
318 | treatment, such as residential and inpatient treatment, in order |
319 | to make it possible for a client to responsibly contribute to |
320 | his or her mental health or substance abuse care without |
321 | jeopardizing the family's financial stability. A person who is |
322 | not eligible for Medicaid and whose net family income is less |
323 | than 150 percent of the Federal Poverty Income Guidelines must |
324 | pay a portion of his or her treatment costs which is comparable |
325 | to the copayment amount required by the Medicaid program for |
326 | Medicaid clients pursuant to s. 409.9081. |
327 | (c) The rules must require that persons who receive |
328 | financial assistance from the Federal Government because of a |
329 | disability and are in long-term residential treatment settings |
330 | contribute to their board and care costs and treatment costs and |
331 | must be consistent with the provisions in s. 409.212. |
332 | (5) A person who meets the eligibility criteria in |
333 | subsection (1) shall be served in accordance with the |
334 | appropriate district substance abuse and mental health services |
335 | plan specified in s. 394.75 and within available resources. |
336 | Section 4. Subsection (6) of section 394.9085, Florida |
337 | Statutes, is amended to read: |
338 | 394.9085 Behavioral provider liability.-- |
339 | (6) For purposes of this section, the terms |
340 | "detoxification program," "addictions receiving facility," and |
341 | "receiving facility" have the same meanings as those provided in |
342 | ss. 397.311(17) 397.311(18)(b), 397.311(18)(a), and 394.455(26), |
343 | respectively. |
344 | Section 5. Section 397.301, Florida Statutes, is amended |
345 | to read: |
346 | 397.301 Short title.--This act may be cited as the "Hal S. |
347 | Marchman Alcohol and Other Drug Services Act of 1993." |
348 | Section 6. Section 397.305, Florida Statutes, is amended |
349 | to read: |
350 | 397.305 Legislative findings, intent, and purpose.-- |
351 | (1) Substance abuse is a major health problem that affects |
352 | multiple service systems and leads to such profoundly disturbing |
353 | consequences as serious impairment, chronic addiction, criminal |
354 | behavior, vehicular casualties, spiraling health care costs, |
355 | AIDS, and business losses, and significantly profoundly affects |
356 | the culture, socialization, and learning ability of children |
357 | within our schools and educational systems. Substance abuse |
358 | impairment is a disease which affects the whole family and the |
359 | whole society and requires a system of care that includes |
360 | specialized prevention, intervention, clinical and treatment, |
361 | and recovery support services that support and strengthen the |
362 | family unit. Further, it is the intent of the Legislature to |
363 | require the collaboration of state agencies, services, and |
364 | program offices to achieve the goals of this chapter and address |
365 | the needs of the public; to establish a comprehensive system of |
366 | care for substance abuse; and to reduce duplicative requirements |
367 | across state agencies. This chapter is designed to provide for |
368 | substance abuse services. |
369 | (2) It is the goal of the Legislature to discourage |
370 | substance abuse by promoting healthy lifestyles, healthy |
371 | families, and drug-free schools, workplaces, and communities. |
372 | (3)(2) It is the purpose of this chapter to provide for a |
373 | comprehensive continuum of accessible and quality substance |
374 | abuse prevention, intervention, clinical and treatment, and |
375 | recovery support services in the least restrictive environment |
376 | which promotes long-term recovery while protecting and |
377 | respecting of optimum care that protects and respects the rights |
378 | of individuals clients, especially for involuntary admissions, |
379 | primarily through community-based private not-for-profit |
380 | providers working with local governmental programs involving a |
381 | wide range of agencies from both the public and private sectors. |
382 | (4)(3) It is the intent of the Legislature to ensure |
383 | within available resources a full system of care for continuum |
384 | of substance abuse services based on projected identified needs, |
385 | delivered without discrimination and with adequate provision for |
386 | specialized needs. |
387 | (5) It is the intent of the Legislature to establish |
388 | services for individuals with co-occurring substance use and |
389 | mental disorders. |
390 | (4) It is the goal of the Legislature to discourage |
391 | substance abuse by promoting healthy lifestyles and drug-free |
392 | schools, workplaces, and communities. |
393 | (5) It is the purpose of the Legislature to integrate |
394 | program evaluation efforts, adequate administrative support |
395 | services, and quality assurance strategies with direct service |
396 | provision requirements and to ensure funds for these purposes. |
397 | (6) It is the intent of the Legislature to require the |
398 | cooperation of departmental programs, services, and program |
399 | offices in achieving the goals of this chapter and addressing |
400 | the needs of clients. |
401 | (6)(7) It is the intent of the Legislature to provide, for |
402 | substance abuse impaired adult and juvenile offenders, an |
403 | alternative to criminal imprisonment for substance abuse |
404 | impaired adults and juvenile offenders by encouraging the |
405 | referral of such offenders to service providers not generally |
406 | available within the juvenile justice and correctional systems, |
407 | system instead of or in addition to criminal penalties. |
408 | (7)(8) It is the intent of the Legislature to provide, |
409 | within the limits of appropriations and safe management of the |
410 | juvenile justice and correctional systems system, substance |
411 | abuse services to substance abuse impaired offenders who are |
412 | placed by the Department of Juvenile Justice or who are |
413 | incarcerated within the Department of Corrections, in order to |
414 | better enable these offenders or inmates to adjust to the |
415 | conditions of society presented to them when their terms of |
416 | placement or incarceration end. |
417 | (8)(9) It is the intent of the Legislature to provide for |
418 | assisting substance abuse impaired persons primarily through |
419 | health and other rehabilitative services in order to relieve the |
420 | police, courts, correctional institutions, and other criminal |
421 | justice agencies of a burden that interferes with their ability |
422 | to protect people, apprehend offenders, and maintain safe and |
423 | orderly communities. |
424 | (10) It is the purpose of the Legislature to establish a |
425 | clear framework for the comprehensive provision of substance |
426 | abuse services in the context of a coordinated and orderly |
427 | system. |
428 | (11) It is the intent of the Legislature that the freedom |
429 | of religion of all citizens shall be inviolate. Nothing in this |
430 | act shall give any governmental entity jurisdiction to regulate |
431 | religious, spiritual, or ecclesiastical services. |
432 | Section 7. Section 397.311, Florida Statutes, is amended |
433 | to read: |
434 | 397.311 Definitions.--As used in this chapter, except part |
435 | VIII, the term: |
436 | (1) "Ancillary services" are services that which include, |
437 | but are not limited to, special diagnostic, prenatal and |
438 | postnatal, other medical, mental health, legal, economic, |
439 | vocational, employment, and educational services. |
440 | (2) "Assessment" means the systematic evaluation of |
441 | information gathered to determine the nature and severity of the |
442 | client's substance abuse problem and the client's need and |
443 | motivation for services. Assessment entails the use of a |
444 | psychosocial history supplemented, as required by rule, by |
445 | medical examinations, laboratory testing, and psychometric |
446 | measures. |
447 | (2)(3) "Authorized agent of the department" means a person |
448 | designated by the department to conduct any audit, inspection, |
449 | monitoring, evaluation, or other duty imposed upon the |
450 | department pursuant to this chapter. An authorized agent must be |
451 | qualified by expertise and experience to perform these |
452 | functions. identified by the department as: |
453 | (a) Qualified by the requisite expertise and experience; |
454 | (b) Having a need to know the applicable information; and |
455 | (c) Having the assigned responsibility to carry out the |
456 | applicable duty. |
457 | (3)(4) "Beyond the safe management capabilities of the |
458 | service provider" refers to an individual a client who is in |
459 | need of: |
460 | (a) Supervision; |
461 | (b) Medical care; or |
462 | (c) Services, |
463 |
|
464 | beyond that which the service provider or service component can |
465 | deliver. |
466 | (4) "Clinical assessment" means the collection of detailed |
467 | information concerning an individual's substance use, emotional |
468 | and physical health, social roles, and other areas that may |
469 | reflect the severity of the individual's abuse of alcohol or |
470 | drugs. The collection of information serves as a basis for |
471 | identifying an appropriate treatment regimen. |
472 | (5) "Client" means a recipient of alcohol or other drug |
473 | services delivered by a service provider but does not include an |
474 | inmate pursuant to part VIII unless expressly so provided. |
475 | (6) "Client identifying information" means the name, |
476 | address, social security number, fingerprints, photograph, and |
477 | similar information by which the identity of a client can be |
478 | determined with reasonable accuracy and speed either directly or |
479 | by reference to other publicly available information. |
480 | (5)(7) "Court" means, with respect to all involuntary |
481 | proceedings under this chapter, the circuit court of the county |
482 | in which the judicial proceeding is pending or where the |
483 | substance abuse impaired person resides or is located, and |
484 | includes any general or special magistrate that may be appointed |
485 | by the chief judge to preside over all or part of such |
486 | proceeding. Otherwise, "court" refers to the court of legal |
487 | jurisdiction in the context in which the term is used in this |
488 | chapter. |
489 | (6)(8) "Department" means the Department of Children and |
490 | Family Services. |
491 | (7)(9) "Director" means the chief administrative or |
492 | executive officer of a service provider. |
493 | (8)(10) "Disclose" or "disclosure" means a communication |
494 | of client identifying information, the affirmative verification |
495 | of another person's communication of client identifying |
496 | information, or the communication of any information regarding |
497 | an individual of a client who has received services been |
498 | identified. Any disclosure made pursuant to this chapter must be |
499 | limited to that information which is necessary to carry out the |
500 | purpose of the disclosure. |
501 | (9)(11) "Fee system" means a method of establishing |
502 | charges for services rendered, in accordance with an |
503 | individual's a client's ability to pay, used by providers that |
504 | receive state funds. |
505 | (10)(12) "For profit" means registered as for profit by |
506 | the Secretary of State and recognized by the Internal Revenue |
507 | Service as a for-profit entity. |
508 | (11)(13) "Habitual abuser" means a person who is brought |
509 | to the attention of law enforcement for being substance |
510 | impaired, who meets the criteria for involuntary admission in s. |
511 | 397.675, and who has been taken into custody for such impairment |
512 | three or more times during the preceding 12 months. |
513 | (12)(14) "Hospital" means a hospital or hospital-based |
514 | component licensed under chapter 395. |
515 | (13) "Identifying information" means the name, address, |
516 | social security number, fingerprints, photograph, and similar |
517 | information by which the identity of an individual can be |
518 | determined with reasonable accuracy directly or by reference to |
519 | other publicly available information. |
520 | (14)(15) "Impaired" or "substance abuse impaired" means a |
521 | condition involving the use of alcoholic beverages or any |
522 | psychoactive or mood-altering substance in such a manner as to |
523 | induce mental, emotional, or physical problems and cause |
524 | socially dysfunctional behavior. |
525 | (15) "Individual" means a person who receives alcohol or |
526 | other drug abuse treatment services delivered by a service |
527 | provider. The term does not include an inmate pursuant to part |
528 | VIII of this chapter unless expressly so provided. |
529 | (16) "Individualized treatment or service plan" means an |
530 | immediate and a long-range plan for substance abuse or ancillary |
531 | services developed on the basis of a client's assessed needs. |
532 | (16)(17) "Law enforcement officer" means a law enforcement |
533 | officer as defined in s. 943.10(1). |
534 | (17)(18) "Licensed service provider" means a public agency |
535 | under this chapter, a private for-profit or not-for-profit |
536 | agency under this chapter, a physician or any other private |
537 | practitioner licensed under this chapter, or a hospital that |
538 | offers substance abuse impairment services through one or more |
539 | of the following licensable service components. Licensable |
540 | service components include a comprehensive continuum of |
541 | accessible and quality substance abuse prevention, intervention, |
542 | and clinical treatment services, including the following |
543 | services: |
544 | (a) "Clinical treatment" means a professionally directed, |
545 | deliberate, and planned regimen of services and interventions |
546 | that are designed to reduce or eliminate the misuse of drugs and |
547 | alcohol and promote a healthy, drug-free lifestyle. As defined |
548 | by rule, "clinical treatment services" includes, but is not |
549 | limited to, the following licensable service components: |
550 | 1. "Addictions receiving facility" is a secure, acute-care |
551 | facility operated 24 hours per day, 7 days per week, designated |
552 | by the department to serve individuals found to be substance use |
553 | impaired as described in s. 397.675 and who meet the placement |
554 | criteria for this component. |
555 | 2. "Day or night treatment" is a service provided in a |
556 | nonresidential environment with a structured schedule of |
557 | treatment and rehabilitative services. |
558 | 3. "Day or night treatment with community housing" means a |
559 | program intended for individuals who can benefit from living |
560 | independently in peer community housing while participating in |
561 | treatment services for a minimum of 5 hours per day for a |
562 | minimum of 25 hours per week. |
563 | 4. "Detoxification" is a service involving subacute care |
564 | that is provided on an inpatient or outpatient basis to assist |
565 | individuals to withdraw from the physiological and psychological |
566 | effects of substance use disorders and who meet the placement |
567 | criteria for this component. |
568 | 5. "Intensive inpatient treatment" includes a planned |
569 | regimen of evaluation, observation, medical monitoring, and |
570 | clinical protocols delivered through an interdisciplinary team |
571 | approach provided 24 hours per day, 7 days per week, in a highly |
572 | structured, live-in environment. |
573 | 6. "Intensive outpatient treatment" is a service that |
574 | provides individual or group counseling in a more structured |
575 | environment, is of higher intensity and duration than outpatient |
576 | treatment, and is provided to individuals who meet the placement |
577 | criteria for this component. |
578 | 7. "Medication-assisted treatment for opiate addiction" is |
579 | a service that uses methadone or other medication as authorized |
580 | by state and federal law, in combination with medical, |
581 | rehabilitative, and counseling services, in the treatment of |
582 | individuals who are dependent on opioid drugs. |
583 | 8. "Outpatient treatment" is a service that provides |
584 | individual, group, or family counseling by appointment during |
585 | scheduled operating hours for individuals who meet the placement |
586 | criteria for this component. |
587 | 9. "Residential treatment" is a service provided in a |
588 | structured live-in environment within a nonhospital setting on a |
589 | 24 hour-per-day, 7 day-per-week basis, and is intended for |
590 | individuals who meet the placement criteria for this component. |
591 | (b) "Intervention" means structured services targeted |
592 | toward individuals or groups at risk of substance abuse and |
593 | focused on reducing or impeding those factors associated with |
594 | the onset or the early stages of substance use and related |
595 | problems. |
596 | (c) "Prevention" means a process involving strategies |
597 | aimed at the individual, family, community, or substance that |
598 | precludes, forestalls, or impedes the development of substance |
599 | use problems and promotes responsible lifestyles. |
600 | (a) Addictions receiving facility, which is a community- |
601 | based facility designated by the department to receive, screen, |
602 | and assess clients found to be substance abuse impaired, in need |
603 | of emergency treatment for substance abuse impairment, or |
604 | impaired by substance abuse to such an extent as to meet the |
605 | criteria for involuntary admission in s. 397.675, and to provide |
606 | detoxification and stabilization. An addictions receiving |
607 | facility must be state-owned, state-operated, or state- |
608 | contracted, and licensed pursuant to rules adopted by the |
609 | department's Substance Abuse Program Office which include |
610 | specific authorization for the provision of levels of care and a |
611 | requirement of separate accommodations for adults and minors. |
612 | Addictions receiving facilities are designated as secure |
613 | facilities to provide an intensive level of care and must have |
614 | sufficient staff and the authority to provide environmental |
615 | security to handle aggressive and difficult-to-manage behavior |
616 | and deter elopement. |
617 | (b) Detoxification, which uses medical and psychological |
618 | procedures and a supportive counseling regimen to assist clients |
619 | in managing toxicity and withdrawing and stabilizing from the |
620 | physiological and psychological effects of substance abuse |
621 | impairment. |
622 | (c) Intensive inpatient treatment, which includes a |
623 | planned regimen of professionally directed evaluation, |
624 | observation, medical monitoring, and clinical protocols provided |
625 | 24 hours per day, 7 days per week, in a highly structured, live- |
626 | in environment. |
627 | (d) Residential treatment, which provides a structured, |
628 | live-in environment within a nonhospital setting on a 24-hours- |
629 | a-day, 7-days-a-week basis, and which includes: |
630 | 1. Facilities that provide room and board and treatment |
631 | and rehabilitation within the primary residential facility; and |
632 | 2. Facilities that are used for room and board only and in |
633 | which treatment and rehabilitation activities are provided on a |
634 | mandatory basis at locations other than the primary residential |
635 | facility. In this case, facilities used for room and board and |
636 | for treatment and rehabilitation are operated under the auspices |
637 | of the same provider, and licensing and regulatory requirements |
638 | would apply to both the residential facility and all other |
639 | facilities in which treatment and rehabilitation activities |
640 | occur. |
641 | (e) Day and night treatment, which provides a |
642 | nonresidential environment with a structured schedule of |
643 | treatment and rehabilitation services. |
644 | (f) Outpatient treatment, which provides individual, |
645 | group, or family counseling for clients by appointment during |
646 | scheduled operating hours, with an emphasis on assessment and |
647 | treatment. |
648 | (g) Medication and methadone maintenance treatment that |
649 | uses methadone or other medication as authorized by state and |
650 | federal law, in conjunction with medical, rehabilitative, and |
651 | counseling services in the treatment of clients who are |
652 | dependent upon opioid drugs. |
653 | (h) Prevention, which is a process involving strategies |
654 | aimed at the individual, the environment, or the substance, |
655 | which strategies preclude, forestall, or impede the development |
656 | of substance abuse problems and promote responsible personal and |
657 | social growth of individuals and families toward full human |
658 | potential. |
659 | (i) Intervention, which consists of structured services |
660 | targeted toward individuals or groups at risk and focused on |
661 | reducing those factors associated with the onset or the early |
662 | stages of substance abuse, and related problems. |
663 | (18)(19) "Medical monitoring" means oversight and |
664 | treatment, 24 hours per day by medical personnel who are |
665 | licensed under chapter 458, chapter 459, or chapter 464, of |
666 | individuals clients whose subacute biomedical, emotional, |
667 | psychosocial, behavioral, or cognitive problems are so severe |
668 | that the individuals clients require intensive inpatient |
669 | treatment by an interdisciplinary team. |
670 | (19) "Medication-assisted treatment (MAT)" is the use of |
671 | medications approved by the United States Food and Drug |
672 | Administration, in combination with counseling and behavioral |
673 | therapies, to provide a holistic approach to the treatment of |
674 | substance use disorders. |
675 | (20) "Not for profit" means registered as not for profit |
676 | by the Secretary of State and recognized by the Internal Revenue |
677 | Service as a not-for-profit entity. |
678 | (21) "Physician" means a person licensed under chapter 458 |
679 | to practice medicine or licensed under chapter 459 to practice |
680 | osteopathic medicine, and may include, if the context so |
681 | indicates, an intern or resident enrolled in an intern or |
682 | resident training program affiliated with an approved medical |
683 | school, hospital, or other facility through which training |
684 | programs are normally conducted. |
685 | (22) "Preliminary screening" means the gathering of |
686 | initial information to be used in determining a person's need |
687 | for assessment or for referral. |
688 | (22)(23) "Private practitioner" means a physician licensed |
689 | under chapter 458 or chapter 459, a psychologist licensed under |
690 | chapter 490, or a clinical social worker, marriage and family |
691 | therapist, or mental health counselor licensed under chapter |
692 | 491. |
693 | (23)(24) "Program evaluation" or "evaluation" means a |
694 | systematic measurement of a service provider's achievement of |
695 | desired individual client or service outcomes. |
696 | (24)(25) "Qualified professional" means a physician |
697 | licensed under chapter 458 or chapter 459; a professional |
698 | licensed under chapter 490 or chapter 491; an advanced |
699 | registered nurse practitioner licensed under part I of chapter |
700 | 464; or a person who is certified through a department- |
701 | recognized certification process for substance abuse treatment |
702 | services and who holds, at a minimum, a bachelor's degree. A |
703 | person who is certified in substance abuse treatment services by |
704 | a state-recognized certification process in another state at the |
705 | time of employment with a licensed substance abuse provider in |
706 | this state may perform the functions of a qualified professional |
707 | as defined in this chapter but must meet certification |
708 | requirements contained in this subsection no later than 1 year |
709 | after his or her date of employment. |
710 | (25) "Quality improvement" means a systematic and |
711 | organized approach to monitor and continuously improve the |
712 | quality of services in order to maintain, restore, or improve |
713 | outcomes for individuals and populations throughout a system of |
714 | care. |
715 | (26) "Recovery" means a process of personal change through |
716 | which individuals abstain from alcohol or drug use and improve |
717 | health, wellness, and quality of life. |
718 | (27) "Recovery support" means services designed to |
719 | strengthen or assist individuals to regain skills, develop the |
720 | environmental supports necessary to help the individual thrive |
721 | in the community, and meet life goals that promote recovery from |
722 | alcohol and drug use. These services include, but are not |
723 | limited to, economic, vocational, employment, educational, |
724 | housing, and other ancillary services. |
725 | (28) "Screening" means the gathering of initial |
726 | information to be used in determining a person's need for |
727 | assessment, services, or referral. |
728 | (26) "Quality assurance" means the objective and internal |
729 | systematic monitoring of the appropriateness and quality of |
730 | client care rendered by a service provider. |
731 | (29)(27) "Secure facility," except where the context |
732 | indicates a correctional system facility, means a provider that |
733 | has the authority to deter the premature departure of |
734 | involuntary individuals clients whose leaving constitutes a |
735 | violation of a court order or community-based supervision as |
736 | provided by law. The term "secure facility" includes addictions |
737 | receiving facilities and facilities authorized by local |
738 | ordinance for the treatment of habitual abusers. |
739 | (30) "Service component" or "component" means a discrete |
740 | operational entity within a service provider that is subject to |
741 | licensing as defined by rule. Service components include |
742 | prevention, intervention, and clinical treatment described in |
743 | subsection (17). |
744 | (31)(28) "Service provider" or "provider" means a public |
745 | agency, a private for-profit or not-for-profit agency, a person |
746 | who is a private practitioner, or a hospital licensed under this |
747 | chapter or exempt from licensure under this chapter. |
748 | (32)(29) "Service provider personnel" or "personnel" |
749 | includes all owners, directors, chief financial officers, staff, |
750 | and volunteers, including foster parents, of a service provider. |
751 | (33)(30) "Stabilization" means: |
752 | (a) Alleviation of a crisis condition; or |
753 | (b) Prevention of further deterioration, |
754 |
|
755 | and connotes short-term emergency treatment. |
756 | (34) "Substate entity" means a departmental office |
757 | designated to serve a geographical area specified by the |
758 | department. |
759 | (35) "System of care" means a coordinated continuum of |
760 | community-based services and supports that are organized to meet |
761 | the challenges and needs of individuals who are at risk of |
762 | developing substance abuse problems or individuals who have |
763 | substance abuse problems. |
764 | (36) "Treatment plan" means an immediate and a long-range |
765 | plan based upon an individual's assessed needs and used to |
766 | address and monitor an individual's recovery from substance |
767 | abuse. |
768 | Section 8. Subsections (18) and (19) of section 397.321, |
769 | Florida Statutes, are renumbered as subsections (19) and (20), |
770 | respectively, subsections (2) and (14) and present subsection |
771 | (20) are amended, subsection (17) is renumbered as subsection |
772 | (18) and amended, and a new subsection (17) is added to that |
773 | section, to read: |
774 | 397.321 Duties of the department.--The department shall: |
775 | (2) Ensure that a plan for substance abuse services is |
776 | developed at the local substate entity district level in |
777 | accordance with the provisions of part IV of chapter 394. |
778 | (7) Ensure that each licensed service provider develops a |
779 | system and procedures for: |
780 | (a) Clinical Client assessment. |
781 | (b) Individualized Treatment or services planning. |
782 | (c) Client Referral. |
783 | (d) Client Progress reviews. |
784 | (e) Client Followup. |
785 | (14) In cooperation with service providers, foster and |
786 | actively seek additional funding to enhance resources for |
787 | prevention, intervention, clinical and treatment, and recovery |
788 | support services, including, but not limited to, the development |
789 | of partnerships with: |
790 | (a) Private industry. |
791 | (b) Intradepartmental and interdepartmental program |
792 | offices, including, but not limited to, child care services; |
793 | family safety; delinquency services; health services; economic |
794 | services; and children's medical services. |
795 | (c) State agencies, including, but not limited to, the |
796 | Department Departments of Corrections, the Department of |
797 | Education, the Department of Juvenile Justice, the Department of |
798 | Community Affairs, the Department of Elderly Affairs, the |
799 | Department of Health, the Department of Financial Services, and |
800 | the Agency for Health Care Administration Insurance. |
801 | (17) Develop a certification process by rule for community |
802 | substance abuse prevention coalitions. |
803 | (18)(17) Provide sufficient and qualified staff to oversee |
804 | all contracting, licensing, and planning functions within each |
805 | of its substate district offices, as permitted by legislative |
806 | appropriation. |
807 | (19)(18) Ensure that the department develops and ensures |
808 | the implementation of procedures between its Substance Abuse |
809 | Program Office and other departmental programs regarding the |
810 | referral of substance abuse impaired persons to service |
811 | providers, information on service providers, information on |
812 | methods of identifying substance abuse impaired juveniles, and |
813 | procedures for referring such juveniles to appropriate service |
814 | providers. |
815 | (20)(19) Designate addictions receiving facilities for the |
816 | purpose of ensuring that only qualified service providers render |
817 | services within the context of a secure facility setting. |
818 | (20) The department may establish in District 9, in |
819 | cooperation with the Palm Beach County Board of County |
820 | Commissioners, a pilot project to serve in a managed care |
821 | arrangement non-Medicaid eligible persons who qualify to receive |
822 | substance abuse or mental health services from the department. |
823 | The department may contract with a not-for-profit entity to |
824 | conduct the pilot project. The results of the pilot project |
825 | shall be reported to the district administrator, and the |
826 | secretary 18 months after the initiation. The department shall |
827 | incur no additional administrative costs for the pilot project. |
828 | Section 9. Paragraph (b) of subsection (1) of section |
829 | 397.331, Florida Statutes, is amended to read: |
830 | 397.331 Definitions; legislative intent.-- |
831 | (1) As used in this act, the term: |
832 | (b) "Substance abuse programs and services" or "drug |
833 | control" applies generally to the broad continuum of prevention, |
834 | intervention, clinical and treatment, recovery support |
835 | initiatives, and efforts to limit substance abuse, and also |
836 | includes initiatives and efforts by law enforcement agencies to |
837 | limit substance abuse. |
838 | Section 10. Subsections (1), (3), and (4) of section |
839 | 397.401, Florida Statutes, are amended to read: |
840 | 397.401 License required; penalty; injunction; rules |
841 | waivers.-- |
842 | (1) It is unlawful for any person or agency to act as a |
843 | substance abuse service provider unless it is licensed or exempt |
844 | from licensure under this chapter. |
845 | (3) The department may maintain an action in circuit court |
846 | to enjoin the unlawful operation of a substance abuse service |
847 | provider if the department first gives the violator 14 days' |
848 | notice of its intent to maintain such action and the violator |
849 | fails to apply for licensure within that 14-day period. If the |
850 | department determines that the health, safety, and welfare of |
851 | individuals are clients is jeopardized, the department may move |
852 | to enjoin the operation at any time during the 14-day period. If |
853 | the service provider has already applied for licensure under |
854 | this chapter and has been denied licensure, the department may |
855 | move immediately to obtain an injunction. |
856 | (4) In accordance with this subsection, the department may |
857 | waive rules adopted pursuant to this chapter in order to allow |
858 | service providers to demonstrate and evaluate innovative or |
859 | cost-effective substance abuse services alternatives. Rules |
860 | waivers may be granted only in instances where there is |
861 | reasonable assurance that the health, safety, or welfare of |
862 | individuals clients will not be endangered. To apply for a rules |
863 | waiver, the applicant must be a service provider licensed under |
864 | this chapter and must submit to the department a written |
865 | description of the concept to be demonstrated, including: |
866 | (a) Objectives and anticipated benefits. |
867 | (b) The number and types of individuals clients who will |
868 | be affected. |
869 | (c) A description of how the demonstration will be |
870 | evaluated. |
871 | (d) Any other information requested by the department. |
872 |
|
873 | A service provider granted a rules waiver under this subsection |
874 | must submit a detailed report of the results of its findings to |
875 | the department within 12 months after receiving the rules |
876 | waiver. Upon receiving and evaluating the detailed report, the |
877 | department may renew or revoke the rules waiver or seek any |
878 | regulatory or statutory changes necessary to allow other service |
879 | providers to implement the same alternative service. |
880 | Section 11. Paragraph (e) of subsection (1) and subsection |
881 | (3) of section 397.403, Florida Statutes, are amended to read: |
882 | 397.403 License application.-- |
883 | (1) Applicants for a license under this chapter must apply |
884 | to the department on forms provided by the department and in |
885 | accordance with rules adopted by the department. Applications |
886 | must include at a minimum: |
887 | (e) Sufficient information to conduct background screening |
888 | as provided in s. 397.451. |
889 | 1. If the results of the background screening indicate |
890 | that any owner, director, or chief financial officer has been |
891 | found guilty of, regardless of adjudication, or has entered a |
892 | plea of nolo contendere or guilty to any offense prohibited |
893 | under the screening standard, a license may not be issued to the |
894 | applicant service provider unless an exemption from |
895 | disqualification has been granted by the department as set forth |
896 | in chapter 435. The owner, director, or chief financial officer |
897 | manager has 90 days within which to obtain the required |
898 | exemption, during which time the applicant's license remains in |
899 | effect. |
900 | 2. If any owner, director, or chief financial officer is |
901 | arrested or found guilty of, regardless of adjudication, or has |
902 | entered a plea of nolo contendere or guilty to any offense |
903 | prohibited under the screening standard while acting in that |
904 | capacity, the provider shall immediately remove the person from |
905 | that position and shall notify the department within 2 days |
906 | after such removal, excluding weekends and holidays. Failure to |
907 | remove the owner, director, or chief financial officer manager |
908 | will result in revocation of the provider's license. |
909 | (3) The department shall accept proof of accreditation by |
910 | the Commission on Accreditation of Rehabilitation Facilities |
911 | (CARF) CARF--the Rehabilitation Accreditation Commission or the |
912 | Joint Commission on Accreditation of Health Care Organizations |
913 | (JCAHCO), or through any other nationally recognized |
914 | certification process that is acceptable to the department and |
915 | meets the minimum licensure requirements under this chapter, in |
916 | lieu of requiring the applicant to submit the information |
917 | required by paragraphs (1)(a)-(c). |
918 | Section 12. Section 397.405, Florida Statutes, is amended |
919 | to read: |
920 | 397.405 Exemptions from licensure.--The following are |
921 | exempt from the licensing provisions of this chapter: |
922 | (1) A hospital or hospital-based component licensed under |
923 | chapter 395. |
924 | (2) A nursing home facility as defined in s. 400.021. |
925 | (3) A substance abuse education program established |
926 | pursuant to s. 1003.42. |
927 | (4) A facility or institution operated by the Federal |
928 | Government. |
929 | (5) A physician licensed under chapter 458 or chapter 459. |
930 | (6) A psychologist licensed under chapter 490. |
931 | (7) A social worker, marriage and family therapist, or |
932 | mental health counselor licensed under chapter 491. |
933 | (8) A An established and legally cognizable church or |
934 | nonprofit religious organization or denomination providing |
935 | substance abuse services, including prevention services, which |
936 | are solely exclusively religious, spiritual, or ecclesiastical |
937 | in nature. A church or nonprofit religious organization or |
938 | denomination providing any of the licensable service components |
939 | itemized under s. 397.311(17) s. 397.311(18) is not exempt from |
940 | substance abuse licensure for purposes of its provision of such |
941 | licensable service components but retains its exemption with |
942 | respect to all services which are solely exclusively religious, |
943 | spiritual, or ecclesiastical in nature. |
944 | (9) Facilities licensed under chapter 393 which, in |
945 | addition to providing services to persons with developmental |
946 | disabilities, also provide services to persons developmentally |
947 | at risk as a consequence of exposure to alcohol or other legal |
948 | or illegal drugs while in utero. |
949 | (10) DUI education and screening services provided |
950 | pursuant to ss. 316.192, 316.193, 322.095, 322.271, and 322.291. |
951 | Persons or entities providing treatment services must be |
952 | licensed under this chapter unless exempted from licensing as |
953 | provided in this section. |
954 | (11) A facility licensed under s. 394.875 as a crisis |
955 | stabilization unit. |
956 |
|
957 | The exemptions from licensure in this section do not apply to |
958 | any service provider that receives an appropriation, grant, or |
959 | contract from the state to operate as a service provider as |
960 | defined in this chapter or to any substance abuse program |
961 | regulated pursuant to s. 397.406. Furthermore, this chapter may |
962 | not be construed to limit the practice of a physician licensed |
963 | under chapter 458 or chapter 459, a psychologist licensed under |
964 | chapter 490, or a psychotherapist licensed under chapter 491, or |
965 | an advanced registered nurse practitioner licensed under part I |
966 | of chapter 464, who provides substance abuse treatment, so long |
967 | as the physician, psychologist, or psychotherapist, or advanced |
968 | registered nurse practitioner does not represent to the public |
969 | that he or she is a licensed service provider and does not |
970 | provide services to individuals clients pursuant to part V of |
971 | this chapter. Failure to comply with any requirement necessary |
972 | to maintain an exempt status under this section is a misdemeanor |
973 | of the first degree, punishable as provided in s. 775.082 or s. |
974 | 775.083. |
975 | Section 13. Section 397.406, Florida Statutes, is amended |
976 | to read: |
977 | 397.406 Licensure and regulation of government-operated |
978 | substance abuse programs.--Substance abuse programs operated |
979 | directly or under contract by the department, the Department of |
980 | Corrections, the Department of Juvenile Justice, any other state |
981 | agency, or any local correctional agency or authority, which |
982 | programs constitute any service provider licensable components |
983 | as defined in this chapter, are subject to licensure and |
984 | regulation in accordance with rules jointly developed by the |
985 | department and the state or local agency operating the program. |
986 | The department has authority to promulgate rules exempting such |
987 | government-operated programs from specific licensure provisions |
988 | of this part, including, but not limited to, licensure fees and |
989 | personnel background checks, and to enforce the regulatory |
990 | requirements governing such programs. |
991 | Section 14. Section 397.407, Florida Statutes, is amended |
992 | to read: |
993 | 397.407 Licensure process; fees.-- |
994 | (1) The department shall establish by rule the licensure |
995 | process to include fees and categories of licenses fees by rule. |
996 | The rule must prescribe a fee range that is based, at least in |
997 | part, on the number and complexity of programs listed in s. |
998 | 397.311(17) s. 397.311(18) which are operated by a licensee. The |
999 | fee range must be implemented over a 5-year period. The fee |
1000 | schedule for licensure of service components must be increased |
1001 | annually in substantially equal increments so that, by July 1, |
1002 | 1998, The fees from the licensure of service components must be |
1003 | are sufficient to cover at least 50 percent of the costs of |
1004 | regulating the service components. The department shall specify |
1005 | by rule a fee range for publicly and privately funded and phase- |
1006 | in plan for privately funded licensed service providers and a |
1007 | fee range and phase-in plan for publicly funded licensed service |
1008 | providers. Fees for privately funded licensed service providers |
1009 | must exceed the fees for publicly funded licensed service |
1010 | providers. In developing the rule governing the licensure |
1011 | process and fees, the department shall carefully consider the |
1012 | potential adverse impact on small not-for-profit service |
1013 | providers. The first year phase-in licensure fees must be at |
1014 | least $150 per initial license. The rule must provide for a |
1015 | reduction in licensure fees for licensed service providers who |
1016 | hold more than one license. |
1017 | (2) The department shall assess a fee of $100 per licensed |
1018 | service component license for the late filing of an application |
1019 | for renewal of a license. |
1020 | (3) Licensure and renewal fees must be deposited in the |
1021 | Operations and Maintenance Trust Fund to be used for the actual |
1022 | cost of monitoring, inspecting, and overseeing licensed service |
1023 | providers. |
1024 | (4) Each application for licensure or renewal must be |
1025 | accompanied by the required fee, except that a service provider |
1026 | that has an all-volunteer staff is exempt from the licensure and |
1027 | renewal fees. |
1028 | (5) The department may issue probationary, regular, and |
1029 | interim licenses. Upon adoption of the rule governing the |
1030 | licensure process and fees, the department shall issue one |
1031 | license for each service component that is operated by a service |
1032 | provider and defined in rule pursuant to s. 397.311(17). The |
1033 | license is valid only for the specific service components listed |
1034 | for each specific location identified on the license. The |
1035 | licensed service provider shall apply for a new license at least |
1036 | 60 days before the addition of any service components or 30 days |
1037 | before the relocation of any of its service sites. Provision of |
1038 | service components or delivery of services at a location not |
1039 | identified on the license may be considered an unlicensed |
1040 | operation that authorizes the department to seek an injunction |
1041 | against operation as provided in s. 397.401, in addition to |
1042 | other sanctions authorized by s. 397.415. Probationary and |
1043 | regular licenses may be issued only after all required |
1044 | information has been submitted. A license may not be |
1045 | transferred. As used in this subsection, the term "transfer" |
1046 | includes, but is not limited to, the transfer of a majority of |
1047 | the ownership interest in the licensed entity or transfer of |
1048 | responsibilities under the license to another entity by |
1049 | contractual arrangement. |
1050 | (6) A probationary license may be issued to a service |
1051 | provider applicant in the initial stages of developing services |
1052 | that are not yet fully operational upon completion of all |
1053 | application requirements itemized in s. 397.403(1) and upon |
1054 | demonstration of the applicant's ability to comply with all |
1055 | applicable statutory and regulatory requirements. A probationary |
1056 | license expires 90 days after issuance and may be reissued once |
1057 | for an additional 90-day period if the applicant has |
1058 | substantially complied with all requirements for regular |
1059 | licensure or has initiated action to satisfy all requirements. |
1060 | During the probationary period the department shall monitor the |
1061 | delivery of services. Notwithstanding s. 120.60(5), the |
1062 | department may order a probationary licensee to cease and desist |
1063 | operations at any time it is found to be substantially out of |
1064 | compliance with licensure standards. This cease-and-desist order |
1065 | is exempt from the requirements of s. 120.60(6). |
1066 | (7) A regular license may be issued to: |
1067 | (a) A new applicant at the end of the probationary period. |
1068 | (b) A licensed applicant that holds a regular license and |
1069 | is seeking renewal. |
1070 | (c) An applicant for a service component operating under |
1071 | an interim license upon successful satisfaction of the |
1072 | requirements for a regular license. |
1073 |
|
1074 | In order to be issued a regular license, the applicant must be |
1075 | in compliance with statutory and regulatory requirements. |
1076 | Standards and timeframes for the issuance of a regular license |
1077 | must be established by rule. An application for renewal of a |
1078 | regular license must be submitted to the department at least 60 |
1079 | days before the license expires. |
1080 | (8) The department may issue an interim license to a |
1081 | service provider for a period established by the department |
1082 | which does not exceed 90 days if the department finds that: |
1083 | (a) A service component of the provider is in substantial |
1084 | noncompliance with licensure standards; |
1085 | (b) The service provider has failed to provide |
1086 | satisfactory proof of conformance to fire, safety, or health |
1087 | requirements; or |
1088 | (c) The service provider is involved in license suspension |
1089 | or revocation proceedings. |
1090 |
|
1091 | An interim license applies only to the licensable service |
1092 | component of the provider's services which is in substantial |
1093 | noncompliance with statutory or regulatory requirements. An |
1094 | interim license expires 90 days after it is issued; however, it |
1095 | may be reissued once for an additional 90-day period in a case |
1096 | of extreme hardship in which the noncompliance is not |
1097 | attributable to the licensed service provider. If the service |
1098 | provider is appealing the final disposition of license |
1099 | suspension or revocation proceedings, the court before which the |
1100 | appeal is taken may order the extension of the interim license |
1101 | for a period specified in the order. |
1102 | (9) A separate license is required for each service |
1103 | component maintained by the service provider. |
1104 | (10) The license must be displayed in a conspicuous place |
1105 | inside the facility providing the licensed service component. |
1106 | Section 15. Section 397.409, Florida Statutes, is |
1107 | repealed. |
1108 | Section 16. Subsection (3) of section 397.411, Florida |
1109 | Statutes, is amended, present subsection (5) of that section is |
1110 | redesignated as subsection (6), and a new subsection (5) is |
1111 | added to that section, to read: |
1112 | 397.411 Inspection; right of entry; records.-- |
1113 | (3) Notwithstanding the confidentiality provisions of this |
1114 | chapter, a designated and authorized agent of the department may |
1115 | access the records of the individuals served by clients of |
1116 | licensed service providers, but only for purposes of licensing, |
1117 | monitoring, and investigation. The department may interview |
1118 | individuals clients, as specified by rule. |
1119 | (5) In an effort to coordinate inspections among agencies, |
1120 | the department shall notify applicable state agencies of any |
1121 | scheduled licensure inspections of service providers jointly |
1122 | served by the agencies. |
1123 | Section 17. Subsections (1), (2), and (4) of section |
1124 | 397.415, Florida Statutes, are amended to read: |
1125 | 397.415 Denial, suspension, and revocation; other |
1126 | remedies.-- |
1127 | (1) If the department determines that an applicant or |
1128 | licensed service provider or licensed service component thereof |
1129 | is not in compliance with all statutory and regulatory |
1130 | requirements, the department may deny, suspend, revoke, or |
1131 | impose reasonable restrictions or penalties on the license or |
1132 | any portion of the license. In such case, the department: |
1133 | (a) May impose a moratorium on admissions to any service |
1134 | component of a licensed service provider if the department |
1135 | determines that conditions within such component are a threat to |
1136 | the public health or safety. |
1137 | (b) May impose an administrative penalty of up to $500 per |
1138 | day against a licensed service provider operating in violation |
1139 | of any fire-related, safety-related, or health-related statutory |
1140 | or regulatory requirement. Fines collected under this paragraph |
1141 | must be deposited in the Operations and Maintenance Substance |
1142 | Abuse Impairment Provider Licensing Trust Fund. |
1143 | (c) May suspend or revoke the license of a service |
1144 | provider or may suspend or revoke the license as to the |
1145 | operation of any service component or location identified on the |
1146 | license if, after notice, the department it determines that a |
1147 | service provider has failed to correct the substantial or |
1148 | chronic violation of any statutory or regulatory requirement |
1149 | that such as impacts the quality of client care. |
1150 | (2) If a provider's license is revoked of a facility or |
1151 | any service component of a facility is revoked, the service |
1152 | provider is barred from submitting any application for licensure |
1153 | of the affected facility or service component to the department |
1154 | for a period of 1 year after the revocation. If the provider's |
1155 | license is revoked as to any service component or location |
1156 | identified on the license, the provider is barred from applying |
1157 | for licensure of the affected service component or location for |
1158 | 1 year after the revocation. |
1159 | (4) The department may maintain an action in court to |
1160 | enjoin the operation of any licensed or unlicensed provider, |
1161 | service component, or location facility in violation of this |
1162 | chapter or the rules adopted under this chapter. |
1163 | Section 18. Section 397.416, Florida Statutes, is amended |
1164 | to read: |
1165 | 397.416 Substance abuse treatment services; qualified |
1166 | professional.--Notwithstanding any other provision of law, a |
1167 | person who was certified through a certification process |
1168 | recognized by the former Department of Health and Rehabilitative |
1169 | Services before January 1, 1995, may perform the duties of a |
1170 | qualified professional with respect to substance abuse treatment |
1171 | services as defined in this chapter, and need not meet the |
1172 | certification requirements contained in s. 397.311(24) s. |
1173 | 397.311(25). |
1174 | Section 19. Section 397.419, Florida Statutes, is amended |
1175 | to read: |
1176 | 397.419 Quality improvement assurance programs.-- |
1177 | (1) Each service provider must maintain a an ongoing |
1178 | quality improvement assurance program to objectively and |
1179 | systematically monitor and evaluate the appropriateness and |
1180 | quality of client care, to ensure that services are rendered |
1181 | consistent with prevailing professional standards, and to |
1182 | identify and resolve problems. |
1183 | (2) For each service provider, a written plan must be |
1184 | developed with a copy made available upon request submitted to |
1185 | the department which addresses the minimum guidelines for the |
1186 | provider's quality improvement assurance program, including, but |
1187 | not limited to: |
1188 | (a) Individual Client care and services standards. |
1189 | (b) Individual Client records maintenance procedures. |
1190 | (c) Staff development policies and procedures. |
1191 | (d) Service-environment Facility safety and maintenance |
1192 | standards. |
1193 | (e) Peer review and utilization management review |
1194 | procedures. |
1195 | (f) Incident reporting policies and procedures that |
1196 | include, including verification of corrective action, and |
1197 | provision for reporting to the department within a time period |
1198 | prescribed by rule, documentation that incident reporting is the |
1199 | affirmative duty of all staff, and a provision that specifies |
1200 | that a person who files an incident report may not be subjected |
1201 | to any civil action by virtue of that incident report. |
1202 | (3) The quality improvement assurance program is the |
1203 | responsibility of the director and is subject to review and |
1204 | approval by the governing board of the service provider. |
1205 | (4) Each director shall designate a person who is an |
1206 | employee of or under contract with the service provider as the |
1207 | provider's quality improvement assurance manager. |
1208 | (5) Incident reporting is the affirmative duty of all |
1209 | staff. |
1210 | (6) A person who files an incident report may not be |
1211 | subjected to any civil action by virtue of that incident report. |
1212 | (5)(7) The department may access all service provider |
1213 | records necessary to determine compliance with this section. |
1214 | Records relating solely to actions taken in carrying out this |
1215 | section and records obtained by the department to determine a |
1216 | provider's compliance with this section are confidential and |
1217 | exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I |
1218 | of the State Constitution. Such records are not admissible in |
1219 | any civil or administrative action except in disciplinary |
1220 | proceedings by the Department of Business and Professional |
1221 | Regulation or the appropriate regulatory board, and are not part |
1222 | of the record of investigation and prosecution in disciplinary |
1223 | proceedings made available to the public by the Department of |
1224 | Business and Professional Regulation or the appropriate |
1225 | regulatory board. Meetings or portions of meetings of quality |
1226 | improvement assurance program committees that relate solely to |
1227 | actions taken pursuant to this section are exempt from s. |
1228 | 286.011. |
1229 | (6)(8) The quality improvement assurance program must also |
1230 | shall be implemented as part of the department's contract |
1231 | management process. The quality assurance program shall: |
1232 | (a) Track performance measures and standards established |
1233 | by the Legislature as part of the performance-based program |
1234 | budgeting process; |
1235 | (a)(b) Provide a framework for evaluating outcomes which |
1236 | is separate from the performance-based program budgeting |
1237 | process, including: |
1238 | 1. Output measures, such as capacities, technologies, and |
1239 | infrastructure, that make up the system of care. |
1240 | 2. Process measures, such as administrative and clinical |
1241 | components of treatment. |
1242 | 3. Outcome measures pertaining to the outcomes of |
1243 | services; |
1244 | (b)(c) Provide for a system of analyzing those factors |
1245 | which have an effect on performance at the local level; |
1246 | (c)(d) Provide for a system of reporting the results of |
1247 | quality improvement assurance reviews; and |
1248 | (d)(e) Incorporate best practice models for use in |
1249 | improving performance in those areas which are deficient. |
1250 | (9) The quality assurance program shall incorporate a peer |
1251 | review process into its protocol, to include: |
1252 | (a) Reviews of providers by departmental district staff |
1253 | and other providers. |
1254 | (b) Reviews of individual districts by other districts. |
1255 | (7)(10) Contingent upon specific appropriation, a quality |
1256 | improvement assurance coordinator position shall be established |
1257 | within each substate entity service district to oversee the |
1258 | implementation and operation of the quality improvement |
1259 | assurance program. |
1260 | Section 20. Section 397.427, Florida Statutes, is amended |
1261 | to read: |
1262 | 397.427 Medication-assisted Medication treatment service |
1263 | providers; rehabilitation program; needs assessment and |
1264 | provision of services; persons authorized to issue takeout |
1265 | medication methadone; unlawful operation; penalty.-- |
1266 | (1) Medication treatment service Providers of medication- |
1267 | assisted treatment services for opiate addiction may not be |
1268 | licensed unless they provide supportive rehabilitation programs. |
1269 | Supportive rehabilitation programs include, but are not limited |
1270 | to, counseling, therapy, and vocational rehabilitation. |
1271 | (2) The department shall determine the need for |
1272 | establishing medication treatment service providers of |
1273 | medication-assisted treatment services for opiate addiction. |
1274 | (a) Medication treatment service Providers of medication- |
1275 | assisted treatment services for opiate addiction may be |
1276 | established only in response to the department's determination |
1277 | and publication of need for additional medication treatment |
1278 | services. |
1279 | (b) The department shall prescribe by rule the types of |
1280 | medication-assisted medication treatment services for opiate |
1281 | addiction for which it is necessary to conduct annual |
1282 | assessments of need. If needs assessment is required, the |
1283 | department shall annually conduct the assessment and publish a |
1284 | statement of findings which identifies each substate entity's |
1285 | district's need. |
1286 | (c) Notwithstanding paragraphs (a) and (b), the license |
1287 | for medication-assisted medication treatment programs for opiate |
1288 | addiction licensed before October 1, 1990, may not be revoked |
1289 | solely because of the department's determination concerning the |
1290 | need for medication-assisted medication treatment services for |
1291 | opiate addiction. |
1292 | (3) The department shall adopt rules necessary to |
1293 | administer this section, including, but not limited to, rules |
1294 | prescribing criteria and procedures for: |
1295 | (a) Determining the need for additional medication- |
1296 | assisted medication treatment services for opiate addiction. |
1297 | (b) Selecting medication treatment service providers for |
1298 | medication-assisted treatment services for opiate addiction when |
1299 | the number of responses to a publication of need exceeds the |
1300 | determined need. |
1301 | (c) Administering any federally required rules, |
1302 | regulations, or procedures. |
1303 | (4) A service provider operating in violation of this |
1304 | section is subject to proceedings in accordance with this |
1305 | chapter to enjoin that unlawful operation. |
1306 | (5) Notwithstanding the provisions of s. 465.019(2), a |
1307 | registered nurse, an advanced registered nurse practitioner, or |
1308 | a licensed practical nurse working for a licensed service |
1309 | provider is authorized to deliver takeout medication for opiate |
1310 | treatment methadone to persons enrolled in a methadone |
1311 | maintenance treatment program for medication-assisted treatment |
1312 | for opiate addiction if provided that: |
1313 | (a) The medication-assisted methadone maintenance |
1314 | treatment program for opiate addiction has an appropriate valid |
1315 | permit issued pursuant to rules adopted promulgated by the Board |
1316 | of Pharmacy; |
1317 | (b) The medication for treatment of opiate addiction has |
1318 | been delivered pursuant to a valid prescription written by the |
1319 | program's physician licensed pursuant to chapter 458 or chapter |
1320 | 459; |
1321 | (c) The medication for treatment of opiate addiction which |
1322 | is ordered appears on a formulary and is prepackaged and |
1323 | prelabeled with dosage instructions and distributed from a |
1324 | source authorized under chapter 499; |
1325 | (d) Each licensed provider adopts written protocols which |
1326 | provide for supervision of the registered nurse, advanced |
1327 | registered nurse practitioner, or licensed practical nurse by a |
1328 | physician licensed pursuant to chapter 458 or chapter 459 and |
1329 | for the procedures by which patients' medications may be |
1330 | delivered by the registered nurse, advanced registered nurse |
1331 | practitioner, or licensed practical nurse. Such protocols shall |
1332 | be signed by the supervising physician and either the |
1333 | administering registered nurse, the advanced registered nurse |
1334 | practitioner, or the licensed practical nurse. |
1335 | (e) Each licensed service provider maintains and has |
1336 | available for inspection by representatives of the Board of |
1337 | Pharmacy all medical records and patient care protocols, |
1338 | including records of medications delivered to patients, in |
1339 | accordance with the board. |
1340 | (6) The department shall also determine the need for |
1341 | establishing medication-assisted treatment for substance abuse |
1342 | disorders other than opiate dependence. Service providers within |
1343 | the publicly funded system shall be funded for provision of |
1344 | these services based on the availability of funds. |
1345 | (7) Service providers that provide medication-assisted |
1346 | treatment for substance abuse disorders other than opiate |
1347 | dependence shall provide counseling services in conjunction with |
1348 | medication-assisted treatment. |
1349 | (8) The department shall adopt rules necessary to |
1350 | administer medication-assisted treatment services, including, |
1351 | but not limited to, rules prescribing criteria and procedures |
1352 | for: |
1353 | (a) Determining the need for medication-assisted treatment |
1354 | services within the publicly funded system. |
1355 | (b) Selecting medication-assisted service providers within |
1356 | the publicly funded system. |
1357 | (c) Administering any federally required rules, |
1358 | regulations, or procedures related to the provision of |
1359 | medication-assisted treatment. |
1360 | (9) A registered nurse, an advanced registered nurse |
1361 | practitioner, or a licensed practical nurse working for a |
1362 | licensed service provider may deliver medication as prescribed |
1363 | by rule if: |
1364 | (a) The service provider authorized to provide medication- |
1365 | assisted treatment has an appropriate valid permit issued |
1366 | pursuant to rules adopted by the Board of Pharmacy; |
1367 | (b) The medication has been delivered pursuant to a valid |
1368 | prescription written by the program's physician who is licensed |
1369 | under chapter 458 or chapter 459; and |
1370 | (c) The medication ordered appears on a formulary or meets |
1371 | federal requirements for medication-assisted treatment. |
1372 | (10) Each licensed service provider that provides |
1373 | medication-assisted treatment must adopt written protocols as |
1374 | specified by the department and in accordance with federally |
1375 | required rules, regulations, or procedures. The protocol shall |
1376 | provide for the supervision of the registered nurse, advanced |
1377 | registered nurse practitioner, or licensed practical nurse |
1378 | working under the supervision of a physician who is licensed |
1379 | under chapter 458 or chapter 459. The protocol must specify how |
1380 | the medication will be used in conjunction with counseling or |
1381 | psychosocial treatment and that the services provided will be |
1382 | included on the treatment plan. The protocol must specify the |
1383 | procedures by which medication-assisted treatment may be |
1384 | delivered by the registered nurse, advanced registered nurse |
1385 | practitioner, or licensed practical nurse. These protocols shall |
1386 | be signed by the supervising physician and the administering |
1387 | registered nurse, advanced registered nurse practitioner, or |
1388 | licensed practical nurse. |
1389 | (11) Each licensed service provider shall maintain and |
1390 | have available for inspection by representatives of the Board of |
1391 | Pharmacy all medical records and protocols, including records of |
1392 | medications delivered to individuals in accordance with rules of |
1393 | the board. |
1394 | Section 21. Section 397.431, Florida Statutes, is amended |
1395 | to read: |
1396 | 397.431 Individual Client responsibility for cost of |
1397 | substance abuse impairment services.-- |
1398 | (1) Before Prior to accepting an individual a client for |
1399 | admission and in accordance with confidentiality guidelines, |
1400 | both the full charge for services and the fee charged to the |
1401 | individual client for such services under the provider's fee |
1402 | system or payment policy must be disclosed to each individual |
1403 | client or his or her authorized personal representative, or |
1404 | parent or legal guardian if the individual client is a minor who |
1405 | did not seek treatment voluntarily and without parental consent. |
1406 | (2) An individual A client or his or her authorized |
1407 | personal representative, or parent or legal guardian if the |
1408 | individual client is a minor, is required to contribute toward |
1409 | the cost of substance abuse services in accordance with his or |
1410 | her ability to pay, unless otherwise provided by law. |
1411 | (3) The parent, legal guardian, or legal custodian of a |
1412 | minor is not liable for payment for any substance abuse services |
1413 | provided to the minor without parental consent pursuant to s. |
1414 | 397.601(4), unless the parent, legal guardian, or legal |
1415 | custodian participates or is ordered to participate in the |
1416 | services, and only for the substance abuse services rendered. If |
1417 | the minor is receiving services as a juvenile offender, the |
1418 | obligation to pay is governed by the law relating to juvenile |
1419 | offenders. |
1420 | (4) Service providers that do not contract for state funds |
1421 | to provide substance abuse services as defined in this chapter |
1422 | may establish their own admission policies regarding provisions |
1423 | for payment for services. Such policies must comply with other |
1424 | statutory and regulatory requirements governing state or federal |
1425 | reimbursements to a provider for services delivered to |
1426 | individuals individual clients. As used in this subsection, the |
1427 | term "contract for state funds" does not include Medicaid funds. |
1428 | (5) Service providers that contract for state funds to |
1429 | provide substance abuse services as defined in this chapter must |
1430 | establish a fee system based upon an individual's a client's |
1431 | ability to pay and, if space and sufficient state resources are |
1432 | available, may not deny an individual a client access to |
1433 | services solely on the basis of the individual's client's |
1434 | inability to pay. |
1435 | Section 22. Paragraphs (a) and (e) of subsection (1) of |
1436 | section 397.451, Florida Statutes, are amended to read: |
1437 | 397.451 Background checks of service provider personnel.-- |
1438 | (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND |
1439 | EXCEPTIONS.-- |
1440 | (a) Background checks shall apply as follows: |
1441 | 1. All owners, directors, and chief financial officers of |
1442 | service providers are subject to level 2 background screening as |
1443 | provided under chapter 435. Inmate substance abuse programs |
1444 | operated directly or under contract with the Department of |
1445 | Corrections are exempt from this requirement. |
1446 | 2. All service provider personnel who have direct contact |
1447 | with children receiving services or with adults who are |
1448 | developmentally disabled receiving services are subject to level |
1449 | 2 background screening as provided under chapter 435. |
1450 | (e) Personnel employed directly or under contract with by |
1451 | the Department of Corrections in an inmate substance abuse |
1452 | program a substance abuse service component who have direct |
1453 | contact with unmarried inmates under the age of 18 or with |
1454 | inmates who are developmentally disabled are exempt from the |
1455 | fingerprinting and background check requirements of this |
1456 | section. |
1457 | Section 23. Paragraphs (a) and (b) of subsection (1) of |
1458 | section 397.471, Florida Statutes, are amended to read: |
1459 | 397.471 Service provider facility standards.-- |
1460 | (1) Each service provider must ensure: |
1461 | (a) Sufficient numbers and types of qualified personnel on |
1462 | duty and available to provide necessary and adequate client |
1463 | safety and care. |
1464 | (b) Adequate space for each individual served within |
1465 | client of a residential facility. |
1466 | Section 24. Section 397.501, Florida Statutes, is amended |
1467 | to read: |
1468 | 397.501 Rights of individuals clients.--Individuals |
1469 | Clients receiving substance abuse services from any service |
1470 | provider are guaranteed protection of the rights specified in |
1471 | this section, unless otherwise expressly provided, and service |
1472 | providers must ensure the protection of such rights. |
1473 | (1) RIGHT TO INDIVIDUAL DIGNITY.--The individual dignity |
1474 | of the individual served client must be respected at all times |
1475 | and upon all occasions, including any occasion when the |
1476 | individual client is admitted, retained, or transported. |
1477 | Individuals served Substance abuse clients who are not accused |
1478 | of a crime or delinquent act may not be detained or incarcerated |
1479 | in jails, detention centers, or training schools of the state, |
1480 | except for purposes of protective custody in strict accordance |
1481 | with this chapter. An individual A client may not be deprived of |
1482 | any constitutional right. |
1483 | (2) RIGHT TO NONDISCRIMINATORY SERVICES.-- |
1484 | (a) Service providers may not deny an individual a client |
1485 | access to substance abuse services solely on the basis of race, |
1486 | gender, ethnicity, age, sexual preference, human |
1487 | immunodeficiency virus status, prior service departures against |
1488 | medical advice, disability, or number of relapse episodes. |
1489 | Service providers may not deny an individual a client who takes |
1490 | medication prescribed by a physician access to substance abuse |
1491 | services solely on that basis. Service providers who receive |
1492 | state funds to provide substance abuse services may not, if |
1493 | provided space and sufficient state resources are available, |
1494 | deny a client access to services based solely on inability to |
1495 | pay. |
1496 | (b) Each individual client in treatment must be afforded |
1497 | the opportunity to participate in the formulation and periodic |
1498 | review of his or her individualized treatment or service plan to |
1499 | the extent of his or her ability to so participate. |
1500 | (c) It is the policy of the state to use the least |
1501 | restrictive and most appropriate services available, based on |
1502 | the needs and the best interests of the individual client and |
1503 | consistent with optimum care of the individual client. |
1504 | (d) Each individual client must be afforded the |
1505 | opportunity to participate in activities designed to enhance |
1506 | self-image. |
1507 | (3) RIGHT TO QUALITY SERVICES.-- |
1508 | (a) Each individual client must be delivered services |
1509 | suited to his or her needs, administered skillfully, safely, |
1510 | humanely, with full respect for his or her dignity and personal |
1511 | integrity, and in accordance with all statutory and regulatory |
1512 | requirements. |
1513 | (b) These services must include the use of methods and |
1514 | techniques to control aggressive client behavior that poses an |
1515 | immediate threat to the individual client or to other persons. |
1516 | Such methods and techniques include the use of restraints, the |
1517 | use of seclusion, the use of time-out, and other behavior |
1518 | management techniques. When authorized, these methods and |
1519 | techniques may be applied only by persons who are employed by |
1520 | service providers and trained in the application and use of |
1521 | these methods and techniques. The department must specify by |
1522 | rule the methods that may be used and the techniques that may be |
1523 | applied by service providers to control aggressive client |
1524 | behavior and must specify by rule the physical facility |
1525 | requirements for seclusion rooms, including dimensions, safety |
1526 | features, methods of observation, and contents. |
1527 | (4) RIGHT TO COMMUNICATION.-- |
1528 | (a) Each individual client has the right to communicate |
1529 | freely and privately with other persons within the limitations |
1530 | imposed by service provider policy. |
1531 | (b) Because the delivery of services can only be effective |
1532 | in a substance abuse free environment, close supervision of each |
1533 | individual's client's communications and correspondence is |
1534 | necessary, particularly in the initial stages of treatment, and |
1535 | the service provider must therefore set reasonable rules for |
1536 | telephone, mail, and visitation rights, giving primary |
1537 | consideration to the well-being and safety of individuals |
1538 | clients, staff, and the community. It is the duty of the service |
1539 | provider to inform the individual client and his or her family |
1540 | if the family is involved at the time of admission about the |
1541 | provider's rules relating to communications and correspondence. |
1542 | (5) RIGHT TO CARE AND CUSTODY OF PERSONAL EFFECTS OF |
1543 | CLIENTS.--An individual A client has the right to possess |
1544 | clothing and other personal effects. The service provider may |
1545 | take temporary custody of the individual's client's personal |
1546 | effects only when required for medical or safety reasons, with |
1547 | the reason for taking custody and a list of the personal effects |
1548 | recorded in the individual's client's clinical record. |
1549 | (6) RIGHT TO EDUCATION OF MINORS.--Each minor client in a |
1550 | residential service component is guaranteed education and |
1551 | training appropriate to his or her needs. The service provider |
1552 | shall coordinate with local education agencies to ensure that |
1553 | education and training is provided to each minor client in |
1554 | accordance with other applicable laws and regulations and that |
1555 | parental responsibilities related to such education and training |
1556 | are established within the provisions of such applicable laws |
1557 | and regulations. Nothing in This chapter does not may be |
1558 | construed to relieve any local education authority of its |
1559 | obligation under law to provide a free and appropriate education |
1560 | to every child. |
1561 | (7) RIGHT TO CONFIDENTIALITY OF INDIVIDUAL CLIENT |
1562 | RECORDS.-- |
1563 | (a) The records of service providers which pertain to the |
1564 | identity, diagnosis, and prognosis of and service provision to |
1565 | any individual client are confidential in accordance with this |
1566 | chapter and with applicable federal confidentiality regulations |
1567 | and are exempt from the provisions of s. 119.07(1) and s. 24(a), |
1568 | Art. I of the State Constitution. Such records may not be |
1569 | disclosed without the written consent of the individual client |
1570 | to whom they pertain except that appropriate disclosure may be |
1571 | made without such consent: |
1572 | 1. To medical personnel in a medical emergency. |
1573 | 2. To service provider personnel if such personnel need to |
1574 | know the information in order to carry out duties relating to |
1575 | the provision of services to an individual a client. |
1576 | 3. To the secretary of the department or the secretary's |
1577 | designee, for purposes of scientific research, in accordance |
1578 | with federal confidentiality regulations, but only upon |
1579 | agreement in writing that the individual's client's name and |
1580 | other identifying information will not be disclosed. |
1581 | 4. In the course of review of service-provider records on |
1582 | service provider premises by persons who are performing an audit |
1583 | or evaluation on behalf of any federal, state, or local |
1584 | government agency, or third-party payor providing financial |
1585 | assistance or reimbursement to the service provider; however, |
1586 | reports produced as a result of such audit or evaluation may not |
1587 | disclose client names or other identifying information and must |
1588 | be in accordance accord with federal confidentiality |
1589 | regulations. |
1590 | 5. Upon court order based on application showing good |
1591 | cause for disclosure. In determining whether there is good cause |
1592 | for disclosure, the court shall examine whether the public |
1593 | interest and the need for disclosure outweigh the potential |
1594 | injury to the individual client, to the service provider and the |
1595 | individual provider-client relationship, and to the service |
1596 | provider itself. |
1597 | (b) The restrictions on disclosure and use in this section |
1598 | do not apply to communications from provider personnel to law |
1599 | enforcement officers which: |
1600 | 1. Are directly related to an individual's a client's |
1601 | commission of a crime on the premises of the provider or against |
1602 | provider personnel or to a threat to commit such a crime; and |
1603 | 2. Are limited to the circumstances of the incident, |
1604 | including the client status of the individual committing or |
1605 | threatening to commit the crime, that individual's name and |
1606 | address, and that individual's last known whereabouts. |
1607 | (c) The restrictions on disclosure and use in this section |
1608 | do not apply to the reporting of incidents of suspected child |
1609 | abuse and neglect to the appropriate state or local authorities |
1610 | as required by law. However, such restrictions continue to apply |
1611 | to the original substance abuse client records maintained by the |
1612 | provider, including their disclosure and use for civil or |
1613 | criminal proceedings which may arise out of the report of |
1614 | suspected child abuse and neglect. |
1615 | (d) Any answer to a request for a disclosure of individual |
1616 | client records which is not permissible under this section or |
1617 | under the appropriate federal regulations must be made in a way |
1618 | that will not affirmatively reveal that an identified individual |
1619 | has been, or is being diagnosed or treated for substance abuse. |
1620 | The regulations do not restrict a disclosure that an identified |
1621 | individual is not and has never received services has been a |
1622 | client. |
1623 | (e)1. Since a minor acting alone has the legal capacity to |
1624 | voluntarily apply for and obtain substance abuse treatment, any |
1625 | written consent for disclosure may be given only by the minor |
1626 | client. This restriction includes, but is not limited to, any |
1627 | disclosure of client identifying information to the parent, |
1628 | legal guardian, or custodian of a minor client for the purpose |
1629 | of obtaining financial reimbursement. |
1630 | 2. When the consent of a parent, legal guardian, or |
1631 | custodian is required under this chapter in order for a minor to |
1632 | obtain substance abuse treatment, any written consent for |
1633 | disclosure must be given by both the minor and the parent, legal |
1634 | guardian, or custodian. |
1635 | (f) An order of a court of competent jurisdiction |
1636 | authorizing disclosure and use of confidential information is a |
1637 | unique kind of court order. Its only purpose is to authorize a |
1638 | disclosure or use of client identifying information which would |
1639 | otherwise be prohibited by this section. Such an order does not |
1640 | compel disclosure. A subpoena or a similar legal mandate must be |
1641 | issued in order to compel disclosure. This mandate may be |
1642 | entered at the same time as, and accompany, an authorizing court |
1643 | order entered under this section. |
1644 | (g) An order authorizing the disclosure of an individual's |
1645 | client records may be applied for by any person having a legally |
1646 | recognized interest in the disclosure which is sought. The |
1647 | application may be filed separately or as part of a pending |
1648 | civil action in which it appears that the individual's client |
1649 | records are needed to provide evidence. An application must use |
1650 | a fictitious name, such as John Doe or Jane Doe, to refer to any |
1651 | individual client and may not contain or otherwise disclose any |
1652 | client identifying information unless the individual client is |
1653 | the applicant or has given a written consent to disclosure or |
1654 | the court has ordered the record of the proceeding sealed from |
1655 | public scrutiny. |
1656 | (h) The individual client and the person holding the |
1657 | records from whom disclosure is sought must be given adequate |
1658 | notice in a manner which will not disclose client identifying |
1659 | information to other persons, and an opportunity to file a |
1660 | written response to the application, or to appear in person, for |
1661 | the limited purpose of providing evidence on the statutory and |
1662 | regulatory criteria for the issuance of the court order. |
1663 | (i) Any oral argument, review of evidence, or hearing on |
1664 | the application must be held in the judge's chambers or in some |
1665 | manner which ensures that client identifying information is not |
1666 | disclosed to anyone other than a party to the proceeding, the |
1667 | individual client, or the person holding the record, unless the |
1668 | individual client requests an open hearing. The proceeding may |
1669 | include an examination by the judge of the client records |
1670 | referred to in the application. |
1671 | (j) A court may authorize the disclosure and use of client |
1672 | records for the purpose of conducting a criminal investigation |
1673 | or prosecution of an individual a client only if the court finds |
1674 | that all of the following criteria are met: |
1675 | 1. The crime involved is extremely serious, such as one |
1676 | which causes or directly threatens loss of life or serious |
1677 | bodily injury, including but not limited to homicide, sexual |
1678 | assault, sexual battery, kidnapping, armed robbery, assault with |
1679 | a deadly weapon, and child abuse and neglect. |
1680 | 2. There is reasonable likelihood that the records will |
1681 | disclose information of substantial value in the investigation |
1682 | or prosecution. |
1683 | 3. Other ways of obtaining the information are not |
1684 | available or would not be effective. |
1685 | 4. The potential injury to the individual client, to the |
1686 | physician-individual physician-client relationship and to the |
1687 | ability of the program to provide services to other individuals |
1688 | clients is outweighed by the public interest and the need for |
1689 | the disclosure. |
1690 | (8) RIGHT TO COUNSEL.--Each individual client must be |
1691 | informed that he or she has the right to be represented by |
1692 | counsel in any involuntary proceeding for assessment, |
1693 | stabilization, or treatment and that he or she, or if the |
1694 | individual client is a minor his or her parent, legal guardian, |
1695 | or legal custodian, may apply immediately to the court to have |
1696 | an attorney appointed if he or she cannot afford one. |
1697 | (9) RIGHT TO HABEAS CORPUS.--At any time, and without |
1698 | notice, an individual a client involuntarily retained by a |
1699 | provider, or the individual's client's parent, guardian, |
1700 | custodian, or attorney on behalf of the individual client, may |
1701 | petition for a writ of habeas corpus to question the cause and |
1702 | legality of such retention and request that the court issue a |
1703 | writ for the individual's client's release. |
1704 | (10) LIABILITY AND IMMUNITY.-- |
1705 | (a) Service provider personnel who violate or abuse any |
1706 | right or privilege of an individual a client under this chapter |
1707 | are liable for damages as determined by law. |
1708 | (b) All persons acting in good faith, reasonably, and |
1709 | without negligence in connection with the preparation or |
1710 | execution of petitions, applications, certificates, or other |
1711 | documents or the apprehension, detention, discharge, |
1712 | examination, transportation, or treatment of a person under the |
1713 | provisions of this chapter shall be free from all liability, |
1714 | civil or criminal, by reason of such acts. |
1715 | Section 25. Section 397.581, Florida Statutes, is amended |
1716 | to read: |
1717 | 397.581 Unlawful activities relating to client assessment |
1718 | and treatment; penalties.-- |
1719 | (1) Knowingly furnishing false information for the purpose |
1720 | of obtaining emergency or other involuntary admission for any |
1721 | person is a misdemeanor of the first degree, punishable as |
1722 | provided in s. 775.082 and by a fine not exceeding $5,000. |
1723 | (2) Causing or otherwise securing, or conspiring with or |
1724 | assisting another to cause or secure, without reason for |
1725 | believing a person to be impaired, any emergency or other |
1726 | involuntary procedure for the person is a misdemeanor of the |
1727 | first degree, punishable as provided in s. 775.082 and by a fine |
1728 | not exceeding $5,000. |
1729 | (3) Causing, or conspiring with or assisting another to |
1730 | cause, the denial to any person of any right accorded pursuant |
1731 | to this chapter is a misdemeanor of the first degree, punishable |
1732 | as provided in s. 775.082 and by a fine not exceeding $5,000. |
1733 | Section 26. Paragraph (a) of subsection (4) of section |
1734 | 397.601, Florida Statutes, is amended to read: |
1735 | 397.601 Voluntary admissions.-- |
1736 | (4)(a) The disability of minority for persons under 18 |
1737 | years of age is removed solely for the purpose of obtaining |
1738 | voluntary substance abuse impairment services from a licensed |
1739 | service provider, and consent to such services by a minor has |
1740 | the same force and effect as if executed by an individual a |
1741 | client who has reached the age of majority. Such consent is not |
1742 | subject to later disaffirmance based on minority. |
1743 | Section 27. Subsections (1) and (3) of section 397.6751, |
1744 | Florida Statutes, are amended to read: |
1745 | 397.6751 Service provider responsibilities regarding |
1746 | involuntary admissions.-- |
1747 | (1) It is the responsibility of the service provider to: |
1748 | (a) Ensure that a person who is admitted to a licensed |
1749 | service component meets the admission criteria specified in s. |
1750 | 397.675; |
1751 | (b) Ascertain whether the medical and behavioral |
1752 | conditions of the person, as presented, are beyond the safe |
1753 | management capabilities of the service provider; |
1754 | (c) Provide for the admission of the person to the service |
1755 | component that represents the least restrictive available |
1756 | setting that is responsive to the person's treatment needs; |
1757 | (d) Verify that the admission of the person to the service |
1758 | component does not result in a census in excess of its licensed |
1759 | service capacity; |
1760 | (e) Determine whether the cost of services is within the |
1761 | financial means of the person or those who are financially |
1762 | responsible for the person's care; and |
1763 | (f) Take all necessary measures to ensure that each |
1764 | individual client in treatment is provided with a safe |
1765 | environment, and to ensure that each individual client whose |
1766 | medical condition or behavioral problem becomes such that he or |
1767 | she cannot be safely managed by the service component is |
1768 | discharged and referred to a more appropriate setting for care. |
1769 | (3) When, in the judgment of the service provider, the |
1770 | medical conditions or behavioral problems of an involuntary |
1771 | individual client become such that they cannot be safely managed |
1772 | by the service component, the service provider must discharge |
1773 | the individual client and attempt to assist him or her in |
1774 | securing more appropriate services in a setting more responsive |
1775 | to his or her needs. Upon completing these efforts, the service |
1776 | provider must, within 72 hours, report in writing to the |
1777 | referral source, in compliance with federal confidentiality |
1778 | regulations: |
1779 | (a) The basis for the individual's client's discharge;, |
1780 | and |
1781 | (b) Documentation of the service provider's efforts to |
1782 | assist the person in gaining access to appropriate services. |
1783 | Section 28. Section 397.6752, Florida Statutes, is amended |
1784 | to read: |
1785 | 397.6752 Referral of involuntarily admitted individual |
1786 | client for voluntary treatment.--Upon giving his or her written |
1787 | informed consent, an involuntarily admitted individual client |
1788 | may be referred to a service provider for voluntary admission |
1789 | when the service provider determines that the individual client |
1790 | no longer meets involuntary criteria. |
1791 | Section 29. Section 397.6758, Florida Statutes, is amended |
1792 | to read: |
1793 | 397.6758 Release of individual client from protective |
1794 | custody, emergency admission, involuntary assessment, |
1795 | involuntary treatment, and alternative involuntary assessment of |
1796 | a minor.--An individual A client involuntarily admitted to a |
1797 | licensed service provider may be released without further order |
1798 | of the court only by a qualified professional in a hospital, a |
1799 | detoxification facility, an addictions receiving facility, or |
1800 | any less restrictive treatment component. Notice of the release |
1801 | must be provided to the applicant in the case of an emergency |
1802 | admission or an alternative involuntary assessment for a minor, |
1803 | or to the petitioner and the court if the involuntary assessment |
1804 | or treatment was court ordered. In the case of a minor client, |
1805 | the release must be: |
1806 | (1) To the individual's client's parent, legal guardian, |
1807 | or legal custodian or the authorized designee thereof; |
1808 | (2) To the Department of Children and Family Services |
1809 | pursuant to s. 39.401; or |
1810 | (3) To the Department of Juvenile Justice pursuant to s. |
1811 | 984.13. |
1812 | Section 30. Section 397.6773, Florida Statutes, is amended |
1813 | to read: |
1814 | 397.6773 Dispositional alternatives after protective |
1815 | custody.-- |
1816 | (1) An individual A client who is in protective custody |
1817 | must be released by a qualified professional when: |
1818 | (a) The individual client no longer meets the involuntary |
1819 | admission criteria in s. 397.675(1); |
1820 | (b) The 72-hour period has elapsed; or |
1821 | (c) The individual client has consented to remain |
1822 | voluntarily at the licensed service provider. |
1823 | (2) An individual A client may only be retained in |
1824 | protective custody beyond the 72-hour period when a petition for |
1825 | involuntary assessment or treatment has been initiated. The |
1826 | timely filing of the petition authorizes the service provider to |
1827 | retain physical custody of the individual client pending further |
1828 | order of the court. |
1829 | Section 31. Section 397.6797, Florida Statutes, is amended |
1830 | to read: |
1831 | 397.6797 Dispositional alternatives after emergency |
1832 | admission.--Within 72 hours after an emergency admission to a |
1833 | hospital or a licensed detoxification or addictions receiving |
1834 | facility, the individual client must be assessed by the |
1835 | attending physician to determine the need for further services. |
1836 | Within 5 days after an emergency admission to a nonresidential |
1837 | component of a licensed service provider, the individual client |
1838 | must be assessed by a qualified professional to determine the |
1839 | need for further services. Based upon that assessment, a |
1840 | qualified professional of the hospital, detoxification facility, |
1841 | or addictions receiving facility, or a qualified professional if |
1842 | a less restrictive component was used, must either: |
1843 | (1) Release the individual client and, where appropriate, |
1844 | refer the individual client to other needed services; or |
1845 | (2) Retain the individual client when: |
1846 | (a) The individual client has consented to remain |
1847 | voluntarily at the licensed provider; or |
1848 | (b) A petition for involuntary assessment or treatment has |
1849 | been initiated, the timely filing of which authorizes the |
1850 | service provider to retain physical custody of the individual |
1851 | client pending further order of the court. |
1852 | Section 32. Section 397.6799, Florida Statutes, is amended |
1853 | to read: |
1854 | 397.6799 Disposition of minor client upon completion of |
1855 | alternative involuntary assessment.--A minor who has been |
1856 | assessed pursuant to s. 397.6798 must, within the time |
1857 | specified, be released or referred for further voluntary or |
1858 | involuntary treatment, whichever is most appropriate to the |
1859 | needs of the minor. |
1860 | Section 33. Section 397.6819, Florida Statutes, is amended |
1861 | to read: |
1862 | 397.6819 Involuntary assessment and stabilization; |
1863 | responsibility of licensed service provider.--A licensed service |
1864 | provider may admit an individual a client for involuntary |
1865 | assessment and stabilization for a period not to exceed 5 days. |
1866 | The individual client must be assessed without unnecessary delay |
1867 | by a qualified professional. If an assessment is performed by a |
1868 | qualified professional who is not a physician, the assessment |
1869 | must be reviewed by a physician before prior to the end of the |
1870 | assessment period. |
1871 | Section 34. Section 397.6821, Florida Statutes, is amended |
1872 | to read: |
1873 | 397.6821 Extension of time for completion of involuntary |
1874 | assessment and stabilization.--If a licensed service provider is |
1875 | unable to complete the involuntary assessment and, if necessary, |
1876 | stabilization of an individual a client within 5 days after the |
1877 | court's order, it may, within the original time period, file a |
1878 | written request for an extension of time to complete its |
1879 | assessment, and shall, in accordance with confidentiality |
1880 | requirements, furnish a copy to all parties. With or without a |
1881 | hearing, the court may grant additional time, not to exceed 7 |
1882 | days after the date of the renewal order, for the completion of |
1883 | the involuntary assessment and stabilization of the individual |
1884 | client. The original court order authorizing the involuntary |
1885 | assessment and stabilization, or a request for an extension of |
1886 | time to complete the assessment and stabilization that is timely |
1887 | filed pursuant to this section, constitutes legal authority to |
1888 | involuntarily hold the individual client for a period not to |
1889 | exceed 10 days in the absence of a court order to the contrary. |
1890 | Section 35. Section 397.6822, Florida Statutes, is amended |
1891 | to read: |
1892 | 397.6822 Disposition of individual client after |
1893 | involuntary assessment.--Based upon the involuntary assessment, |
1894 | a qualified professional of the hospital, detoxification |
1895 | facility, or addictions receiving facility, or a qualified |
1896 | professional when a less restrictive component has been used, |
1897 | must: |
1898 | (1) Release the individual client and, where appropriate, |
1899 | refer the individual client to another treatment facility or |
1900 | service provider, or to community services; |
1901 | (2) Allow the individual client, with consent if the |
1902 | client has consented, to remain voluntarily at the licensed |
1903 | provider; or |
1904 | (3) Retain the individual client when a petition for |
1905 | involuntary treatment has been initiated, the timely filing of |
1906 | which authorizes the service provider to retain physical custody |
1907 | of the individual client pending further order of the court. |
1908 |
|
1909 | Adhering to federal confidentiality regulations, notice of |
1910 | disposition must be provided to the petitioner and to the court. |
1911 | Section 36. Subsections (1) and (3) of section 397.697, |
1912 | Florida Statutes, are amended to read: |
1913 | 397.697 Court determination; effect of court order for |
1914 | involuntary substance abuse treatment.-- |
1915 | (1) When the court finds that the conditions for |
1916 | involuntary substance abuse treatment have been proved by clear |
1917 | and convincing evidence, it may order the respondent to undergo |
1918 | involuntary treatment by a licensed service provider for a |
1919 | period not to exceed 60 days. If the court finds it necessary, |
1920 | it may direct the sheriff to take the respondent into custody |
1921 | and deliver him or her to the licensed service provider |
1922 | specified in the court order, or to the nearest appropriate |
1923 | licensed service provider, for involuntary treatment. When the |
1924 | conditions justifying involuntary treatment no longer exist, the |
1925 | individual client must be released as provided in s. 397.6971. |
1926 | When the conditions justifying involuntary treatment are |
1927 | expected to exist after 60 days of treatment, a renewal of the |
1928 | involuntary treatment order may be requested pursuant to s. |
1929 | 397.6975 prior to the end of the 60-day period. |
1930 | (3) An involuntary treatment order authorizes the licensed |
1931 | service provider to require the individual client to undergo |
1932 | such treatment as will benefit him or her, including treatment |
1933 | at any licensable service component of a licensed service |
1934 | provider. |
1935 | Section 37. Section 397.6971, Florida Statutes, is amended |
1936 | to read: |
1937 | 397.6971 Early release from involuntary substance abuse |
1938 | treatment.-- |
1939 | (1) At any time prior to the end of the 60-day involuntary |
1940 | treatment period, or prior to the end of any extension granted |
1941 | pursuant to s. 397.6975, an individual a client admitted for |
1942 | involuntary treatment may be determined eligible for discharge |
1943 | to the most appropriate referral or disposition for the |
1944 | individual client when: |
1945 | (a) The individual client no longer meets the criteria for |
1946 | involuntary admission and has given his or her informed consent |
1947 | to be transferred to voluntary treatment status; |
1948 | (b) If the individual client was admitted on the grounds |
1949 | of likelihood of infliction of physical harm upon himself or |
1950 | herself or others, such likelihood no longer exists; or |
1951 | (c) If the individual client was admitted on the grounds |
1952 | of need for assessment and stabilization or treatment, |
1953 | accompanied by inability to make a determination respecting such |
1954 | need, either: |
1955 | 1. Such inability no longer exists; or |
1956 | 2. It is evident that further treatment will not bring |
1957 | about further significant improvements in the individual's |
1958 | client's condition; |
1959 | (d) The individual client is no longer in need of |
1960 | services; or |
1961 | (e) The director of the service provider determines that |
1962 | the individual client is beyond the safe management capabilities |
1963 | of the provider. |
1964 | (2) Whenever a qualified professional determines that an |
1965 | individual a client admitted for involuntary treatment is ready |
1966 | for early release for any of the reasons listed in subsection |
1967 | (1), the service provider shall immediately discharge the |
1968 | individual client, and must notify all persons specified by the |
1969 | court in the original treatment order. |
1970 | Section 38. Section 397.6975, Florida Statutes, is amended |
1971 | to read: |
1972 | 397.6975 Extension of involuntary substance abuse |
1973 | treatment period.-- |
1974 | (1) Whenever a service provider believes that an |
1975 | individual a client who is nearing the scheduled date of release |
1976 | from involuntary treatment continues to meet the criteria for |
1977 | involuntary treatment in s. 397.693, a petition for renewal of |
1978 | the involuntary treatment order may be filed with the court at |
1979 | least 10 days before prior to the expiration of the court- |
1980 | ordered treatment period. The court shall immediately schedule a |
1981 | hearing to be held not more than 15 days after filing of the |
1982 | petition. The court shall provide the copy of the petition for |
1983 | renewal and the notice of the hearing to all parties to the |
1984 | proceeding. The hearing is conducted pursuant to s. 397.6957. |
1985 | (2) If the court finds that the petition for renewal of |
1986 | the involuntary treatment order should be granted, it may order |
1987 | the respondent to undergo involuntary treatment for a period not |
1988 | to exceed an additional 90 days. When the conditions justifying |
1989 | involuntary treatment no longer exist, the individual client |
1990 | must be released as provided in s. 397.6971. When the conditions |
1991 | justifying involuntary treatment continue to exist after 90 days |
1992 | of additional treatment, a new petition requesting renewal of |
1993 | the involuntary treatment order may be filed pursuant to this |
1994 | section. |
1995 | Section 39. Section 397.6977, Florida Statutes, is amended |
1996 | to read: |
1997 | 397.6977 Disposition of individual client upon completion |
1998 | of involuntary substance abuse treatment.--At the conclusion of |
1999 | the 60-day period of court-ordered involuntary treatment, the |
2000 | individual client is automatically discharged unless a motion |
2001 | for renewal of the involuntary treatment order has been filed |
2002 | with the court pursuant to s. 397.6975. |
2003 | Section 40. Paragraph (e) of subsection (2) of section |
2004 | 397.702, Florida Statutes, is amended to read: |
2005 | 397.702 Authorization of local ordinances for treatment of |
2006 | habitual abusers in licensed secure facilities.-- |
2007 | (2) Ordinances for the treatment of habitual abusers must |
2008 | provide: |
2009 | (e) That, if the individual client still meets the |
2010 | criteria for involuntary admission in s. 397.675 at or near the |
2011 | expiration of the treatment period ordered by the court pursuant |
2012 | to paragraph (d), the agent of the county or municipality may |
2013 | file another habitual abuser petition pursuant to paragraph (b) |
2014 | for a period not exceeding 180 days for each such petition. |
2015 | Section 41. Subsections (2) and (3) of section 397.706, |
2016 | Florida Statutes, are amended to read: |
2017 | 397.706 Screening, assessment, and disposition of juvenile |
2018 | offenders.-- |
2019 | (2) The juvenile and circuit courts, in conjunction with |
2020 | department substate entity district administration, shall |
2021 | establish policies and procedures to ensure that juvenile |
2022 | offenders are appropriately screened for substance abuse |
2023 | problems and that diversionary and adjudicatory proceedings |
2024 | include appropriate conditions and sanctions to address |
2025 | substance abuse problems. Policies and procedures must address: |
2026 | (a) The designation of local service providers responsible |
2027 | for screening and assessment services and dispositional |
2028 | recommendations to the department and the court. |
2029 | (b) The means by which juvenile offenders are processed to |
2030 | ensure participation in screening and assessment services. |
2031 | (c) The role of the court in securing assessments when |
2032 | juvenile offenders or their families are noncompliant. |
2033 | (d) Safeguards to ensure that information derived through |
2034 | screening and assessment is used solely to assist in |
2035 | dispositional decisions and not for purposes of determining |
2036 | innocence or guilt. |
2037 | (3) Because resources available to support screening and |
2038 | assessment services are limited, the judicial circuits and |
2039 | department substate entity district administration must develop |
2040 | those capabilities to the extent possible within available |
2041 | resources according to the following priorities: |
2042 | (a) Juvenile substance abuse offenders. |
2043 | (b) Juvenile offenders who are substance abuse impaired at |
2044 | the time of the offense. |
2045 | (c) Second or subsequent juvenile offenders. |
2046 | (d) Minors taken into custody. |
2047 | Section 42. Subsection (2) of section 397.801, Florida |
2048 | Statutes, is amended to read: |
2049 | 397.801 Substance abuse impairment coordination.-- |
2050 | (2) The department shall establish, within each of its |
2051 | substate entities service districts, the full-time position of |
2052 | substance abuse impairment prevention coordinator, to be filled |
2053 | by a person with expertise in the area of substance abuse |
2054 | impairment. The primary responsibility of this person is to |
2055 | develop and implement activities which foster the prevention of |
2056 | substance abuse impairment. |
2057 | Section 43. Subsections (1) and (3) of section 397.821, |
2058 | Florida Statutes, are amended to read: |
2059 | 397.821 Juvenile substance abuse impairment prevention and |
2060 | early intervention councils.-- |
2061 | (1) Each judicial circuit as set forth in s. 26.021 may |
2062 | establish a juvenile substance abuse impairment prevention and |
2063 | early intervention council composed of at least 12 members, |
2064 | including representatives from law enforcement, the department, |
2065 | school districts, state attorney and public defender offices, |
2066 | the circuit court, the religious community, substance abuse |
2067 | impairment professionals, child advocates from the community, |
2068 | business leaders, parents, and high school students. However, |
2069 | those circuits which already have in operation a council of |
2070 | similar composition may designate the existing body as the |
2071 | juvenile substance abuse impairment prevention and early |
2072 | intervention council for the purposes of this section. Each |
2073 | council shall establish bylaws providing for the length of term |
2074 | of its members, but the term may not exceed 4 years. The |
2075 | substate entity district administrator, as defined in s. 20.19, |
2076 | and the chief judge of the circuit court shall each appoint six |
2077 | members of the council. The substate entity district |
2078 | administrator shall appoint a representative from the |
2079 | department, a school district representative, a substance abuse |
2080 | impairment treatment professional, a child advocate, a parent, |
2081 | and a high school student. The chief judge of the circuit court |
2082 | shall appoint a business leader and representatives from the |
2083 | state attorney's office, the public defender's office, the |
2084 | religious community, the circuit court, and law enforcement |
2085 | agencies. |
2086 | (3) The council shall provide recommendations to the |
2087 | Program Director for Substance Abuse annually for consideration |
2088 | for inclusion in the substance abuse district alcohol, drug |
2089 | abuse, and mental health substate-entity plans. |
2090 | Section 44. Subsection (1), paragraph (c) of subsection |
2091 | (2), and subsection (3) of section 397.94, Florida Statutes, are |
2092 | amended to read: |
2093 | 397.94 Children's substance abuse services; information |
2094 | and referral network.-- |
2095 | (1) Each substate entity service district of the |
2096 | department shall develop a plan for and implement a districtwide |
2097 | comprehensive children's substance abuse information and |
2098 | referral network to be operational by July 1, 2000. |
2099 | (2) The substate entity district shall determine the most |
2100 | cost-effective method for delivering this service and may select |
2101 | a new provider or utilize an existing provider or providers with |
2102 | a record of success in providing information and referral |
2103 | services. |
2104 | (c) Develop and implement procedures for documenting |
2105 | requests for services, including, but not limited to: |
2106 | 1. Number of calls by type of service requested, if any; |
2107 | 2. Ages of children for whom services are requested; and |
2108 | 3. Disposition on all referrals, including location of |
2109 | resource if referred for face-to-face screening. |
2110 | (3) In planning the information and referral network, the |
2111 | substate entity district shall consider the establishment of a |
2112 | 24-hour toll-free telephone number to call for information and a |
2113 | public service campaign to inform the public about the |
2114 | information and referral service. |
2115 | Section 45. Section 397.95, Florida Statutes, is amended |
2116 | to read: |
2117 | 397.95 Children's substance abuse services; services |
2118 | provided by licensed providers.--Each substate entity service |
2119 | district of the department shall ensure that all screening, |
2120 | intake, assessment, enrollment, service planning, and case |
2121 | management services provided under this part are provided by |
2122 | children's substance abuse services providers licensed under |
2123 | part II of this chapter and in accordance with standards set |
2124 | forth in department rules. |
2125 | Section 46. Paragraph (a) of subsection (3) of section |
2126 | 397.97, Florida Statutes, is amended to read: |
2127 | 397.97 Children's substance abuse services; demonstration |
2128 | models.-- |
2129 | (3) PURCHASE OF SERVICES; OPERATION CRITERIA.-- |
2130 | (a) Each demonstration model shall be governed by a |
2131 | multiagency consortium of state and county agencies or other |
2132 | public agencies, or a community-based, not-for-profit substance |
2133 | abuse or behavioral health network designated by the department, |
2134 | hereafter referred to as the purchasing agent, which shall |
2135 | purchase individualized services for children who are at risk of |
2136 | substance abuse or have a substance abuse problem. Services |
2137 | shall be based on client need rather than on traditional |
2138 | services limited to narrowly defined cost centers or |
2139 | appropriations categories. Approval to operate as a Children's |
2140 | Network of Care Demonstration Model shall be given by the |
2141 | secretary of the department and shall be based on criteria |
2142 | developed by the department. |
2143 | Section 47. Paragraph (g) of subsection (2) of section |
2144 | 397.99, Florida Statutes, is amended to read: |
2145 | 397.99 School substance abuse prevention partnership |
2146 | grants.-- |
2147 | (2) APPLICATION PROCEDURES; FUNDING REQUIREMENTS.-- |
2148 | (g) The department shall consider the following in |
2149 | awarding such grants: |
2150 | 1. The number of youths that will be targeted. |
2151 | 2. The validity of the program design to achieve project |
2152 | goals and objectives that are clearly related to performance- |
2153 | based program budgeting effectiveness measures. |
2154 | 3. The desirability of funding at least one approved |
2155 | project in each of the department's substate entities service |
2156 | districts. |
2157 | Section 48. Paragraphs (d) and (g) of subsection (1) of |
2158 | section 440.102, Florida Statutes, are amended to read: |
2159 | 440.102 Drug-free workplace program requirements.--The |
2160 | following provisions apply to a drug-free workplace program |
2161 | implemented pursuant to law or to rules adopted by the Agency |
2162 | for Health Care Administration: |
2163 | (1) DEFINITIONS.--Except where the context otherwise |
2164 | requires, as used in this act: |
2165 | (d) "Drug rehabilitation program" means a service |
2166 | provider, established pursuant to s. 397.311(31) s. 397.311(28), |
2167 | that provides confidential, timely, and expert identification, |
2168 | assessment, and resolution of employee drug abuse. |
2169 | (g) "Employee assistance program" means an established |
2170 | program capable of providing expert assessment of employee |
2171 | personal concerns; confidential and timely identification |
2172 | services with regard to employee drug abuse; referrals of |
2173 | employees for appropriate diagnosis, treatment, and assistance; |
2174 | and followup services for employees who participate in the |
2175 | program or require monitoring after returning to work. If, in |
2176 | addition to the above activities, an employee assistance program |
2177 | provides diagnostic and treatment services, these services shall |
2178 | in all cases be provided by service providers pursuant to s. |
2179 | 397.311(31) s. 397.311(28). |
2180 | Section 49. Paragraph (a) of subsection (1) of section |
2181 | 766.101, Florida Statutes, is amended to read: |
2182 | 766.101 Medical review committee, immunity from |
2183 | liability.-- |
2184 | (1) As used in this section: |
2185 | (a) The term "medical review committee" or "committee" |
2186 | means: |
2187 | 1.a. A committee of a hospital or ambulatory surgical |
2188 | center licensed under chapter 395 or a health maintenance |
2189 | organization certificated under part I of chapter 641, |
2190 | b. A committee of a physician-hospital organization, a |
2191 | provider-sponsored organization, or an integrated delivery |
2192 | system, |
2193 | c. A committee of a state or local professional society of |
2194 | health care providers, |
2195 | d. A committee of a medical staff of a licensed hospital |
2196 | or nursing home, provided the medical staff operates pursuant to |
2197 | written bylaws that have been approved by the governing board of |
2198 | the hospital or nursing home, |
2199 | e. A committee of the Department of Corrections or the |
2200 | Correctional Medical Authority as created under s. 945.602, or |
2201 | employees, agents, or consultants of either the department or |
2202 | the authority or both, |
2203 | f. A committee of a professional service corporation |
2204 | formed under chapter 621 or a corporation organized under |
2205 | chapter 607 or chapter 617, which is formed and operated for the |
2206 | practice of medicine as defined in s. 458.305(3), and which has |
2207 | at least 25 health care providers who routinely provide health |
2208 | care services directly to patients, |
2209 | g. A committee of the Department of Children and Family |
2210 | Services which includes employees, agents, or consultants to the |
2211 | department as deemed necessary to provide peer review, |
2212 | utilization review, and mortality review of treatment services |
2213 | provided pursuant to chapters 394, 397, and 916, |
2214 | h.g. A committee of a mental health treatment facility |
2215 | licensed under chapter 394 or a community mental health center |
2216 | as defined in s. 394.907, provided the quality assurance program |
2217 | operates pursuant to the guidelines which have been approved by |
2218 | the governing board of the agency, |
2219 | i.h. A committee of a substance abuse treatment and |
2220 | education prevention program licensed under chapter 397 provided |
2221 | the quality assurance program operates pursuant to the |
2222 | guidelines which have been approved by the governing board of |
2223 | the agency, |
2224 | j.i. A peer review or utilization review committee |
2225 | organized under chapter 440, |
2226 | k.j. A committee of the Department of Health, a county |
2227 | health department, healthy start coalition, or certified rural |
2228 | health network, when reviewing quality of care, or employees of |
2229 | these entities when reviewing mortality records, or |
2230 | l.k. A continuous quality improvement committee of a |
2231 | pharmacy licensed pursuant to chapter 465, |
2232 |
|
2233 | which committee is formed to evaluate and improve the quality of |
2234 | health care rendered by providers of health service, or to |
2235 | determine that health services rendered were professionally |
2236 | indicated or were performed in compliance with the applicable |
2237 | standard of care, or that the cost of health care rendered was |
2238 | considered reasonable by the providers of professional health |
2239 | services in the area; or |
2240 | 2. A committee of an insurer, self-insurer, or joint |
2241 | underwriting association of medical malpractice insurance, or |
2242 | other persons conducting review under s. 766.106. |
2243 | Section 50. Section 394.9081, Florida Statutes, is |
2244 | repealed. |
2245 | Section 51. This act shall take effect July 1, 2009. |