Florida Senate - 2016                              CS for SB 998
       
       
        
       By the Committee on Health Policy; and Senator Ring
       
       588-02317-16                                           2016998c1
    1                        A bill to be entitled                      
    2         An act relating to adolescent and child treatment
    3         programs; creating s. 394.88, F.S.; providing purpose
    4         of adolescent and child residential treatment
    5         programs; defining terms; requiring licensure by the
    6         Agency for Health Care Administration; requiring the
    7         Department of Children and Families to adopt rules for
    8         the licensure, administration, and operation of
    9         programs and program facilities; providing staffing
   10         requirements; requiring a treatment plan for each
   11         resident; requiring a review of treatment plans;
   12         requiring written documentation of compliance with
   13         certain local requirements; providing location
   14         requirements for program facilities under certain
   15         circumstances; authorizing the department to establish
   16         certain requirements; requiring a program to provide a
   17         curriculum; requiring a program to conduct certain
   18         counseling sessions; creating s. 394.89, F.S.;
   19         providing purpose of adolescent and child outdoor
   20         programs; defining terms; requiring licensure by the
   21         agency; requiring the department to adopt rules for
   22         the licensure, administration, and operation of
   23         programs; providing regulations and licensing
   24         requirements for programs; providing administrative
   25         requirements for programs; requiring programs to have
   26         an educational component approved by the Department of
   27         Education under certain circumstances; providing
   28         requirements and qualifications for program staff;
   29         requiring the program supervisor to maintain a current
   30         list and enrollment records of all participants;
   31         requiring program supervisors to develop a written
   32         plan for each field group activity and expedition;
   33         providing an effective date.
   34          
   35  Be It Enacted by the Legislature of the State of Florida:
   36  
   37         Section 1. Section 394.88, Florida Statutes, is created to
   38  read:
   39         394.88 Adolescent and child residential treatment
   40  programs.—
   41         (1) The purpose of an adolescent and child residential
   42  treatment program is to offer room and board and to provide, or
   43  arrange for the provision of, specialized treatment, specialized
   44  therapies as defined in s. 393.063, and services for
   45  rehabilitation or habilitation as defined in s. 393.063, for
   46  adolescents and children with emotional, psychological,
   47  developmental, or behavioral problems or disorders, or substance
   48  abuse problems. In an adolescent and child residential treatment
   49  program, adolescents and children are assisted in acquiring the
   50  social and behavioral skills necessary for a healthy adjustment
   51  to school, family life, and community.
   52         (2) As used in this section, the term:
   53         (a) “Adolescent and child residential treatment program” or
   54  “program” means a privately owned and operated 24-hour group
   55  living environment for four or more adolescents or children
   56  unrelated to the owner or provider.
   57         (b) “Program resident” or “resident” means an adolescent or
   58  child at least 6 and no more than 18 years of age who enrolls
   59  and participates in a program.
   60         (3) An adolescent and child residential treatment program
   61  must be licensed by the Agency for Health Care Administration in
   62  accordance with part II of chapter 408. The department, in
   63  consultation with the agency and the Agency for Persons with
   64  Disabilities, shall establish by rule requirements for
   65  licensure, administration, and operation of programs and program
   66  facilities consistent with this section.
   67         (4)(a)A program must employ a licensed psychiatrist or a
   68  psychologist licensed under chapter 490 as the director of the
   69  program. The director is responsible for the operation of the
   70  program, the program facility, and the day-to-day supervision of
   71  program residents. The director or a member of program staff
   72  appointed by the director as his or her substitute must be
   73  present at the program facility at all times. The director shall
   74  maintain on site a current list of all program residents.
   75         (b) Program staff must include, in addition to the
   76  director, physicians licensed under chapter 458 or chapter 459,
   77  psychologists licensed under chapter 490 or chapter 491, mental
   78  health counselors licensed under chapter 491, or advanced
   79  registered nurse practitioners licensed under part 1 of chapter
   80  464 and certified under s. 464.012 who have been trained in
   81  providing medical services and treatment to adolescents and
   82  children to serve as professional program staff providing
   83  treatment to residents. Such professional program staff must be
   84  specifically trained in providing medical services and treatment
   85  to adolescents and children diagnosed with mental health and
   86  substance abuse problems and to residents with disabilities if
   87  the program serves these populations. A program must have a
   88  minimum of two such professional staff members on duty at all
   89  times and must maintain a professional staff-to-resident ratio
   90  of no less than 1 to 4 during awake hours. All program staff,
   91  professional and non-professional, and all providers who may be
   92  contracted to provide services to residents must undergo a level
   93  2 background screening before engaging in any activity that
   94  brings them into contact with a resident. The department may
   95  establish by rule further staffing requirements to ensure
   96  resident safety and service delivery consistent with this
   97  section.
   98         (5) A program must ensure that a treatment plan exists for
   99  each resident. The treatment plan must be reviewed and signed at
  100  the time a resident enrolls and periodically after enrollment,
  101  as provided in the treatment plan, by the director of the
  102  program and the resident’s parent or legal guardian. The
  103  department may establish by rule further requirements relating
  104  to the treatment and care of residents consistent with this
  105  section.
  106         (6) A program must maintain written documentation of
  107  compliance with the following local requirements, as applicable:
  108         (a) Zoning ordinances.
  109         (b) Business license requirements.
  110         (c) Building codes.
  111         (d) Firesafety codes and standards.
  112         (e) Health codes.
  113         (f) Approval from appropriate governmental agencies for new
  114  program services or increased consumer capacity.
  115  
  116  A program facility that provides services to residents with
  117  disabilities must be located where schools, churches, recreation
  118  facilities, and other community facilities are available. The
  119  department may establish by rule further requirements relating
  120  to the program facility, including, but not limited to, interior
  121  and exterior building dimensions, housing and kitchen standards,
  122  meal plan guidelines, medication management, resident privacy
  123  and accountability for his or her personal effects, and
  124  cleanliness and safety standards, consistent with this section.
  125         (7) A program must:
  126         (a) Provide a curriculum approved by the Department of
  127  Education to residents. A program that provides its own school
  128  must be recognized and approved by the State Board of Education,
  129  the Southern Association of Colleges and Schools, or another
  130  educational accreditation organization.
  131         (b) Conduct individual, group, couple, and family
  132  counseling sessions or other appropriate treatment, including
  133  skills development therapy, at least weekly, or more often if
  134  required by a resident’s treatment plan. The program must
  135  document the time, date, and nature of such services, including
  136  the signature of the counselor providing them, in the individual
  137  record for each resident.
  138         Section 2. Section 394.89, Florida Statutes, is created to
  139  read:
  140         394.89 Adolescent and child outdoor programs.—
  141         (1) The purpose of an adolescent and child outdoor program
  142  is to offer wilderness hiking and camping experiences through
  143  program field group activities and expeditions as a form of
  144  rehabilitation and treatment for adolescents or children with
  145  emotional, psychological, developmental, or behavioral problems
  146  or disorders, or substance abuse problems. In an adolescent and
  147  child outdoor program, adolescents and children are assisted in
  148  acquiring the social and behavioral skills necessary for a
  149  healthy adjustment to school, family life, and community.
  150         (2) As used in this section, the term:
  151         (a) “Adolescent and child outdoor program” or “program”
  152  means a privately owned and operated 24-hour group wilderness
  153  hiking and camping experience for four or more adolescents or
  154  children unrelated to the owner or provider. A program may be
  155  established independently or as an adjunct and subsidiary of an
  156  adolescent and child residential treatment program established
  157  pursuant to s. 394.88.
  158         (b) “Program participant” or “participant” means an
  159  adolescent or child at least 6 and no more than 18 years of age
  160  who enrolls and participates in a program. The term does not
  161  include the parent or contracting agent that enrolls the
  162  adolescent or child in the program.
  163         (3)(a) An adolescent and child outdoor program must be
  164  licensed by the Agency for Health Care Administration in
  165  accordance with part II of chapter 408. The department, in
  166  consultation with the agency and the Agency for Persons with
  167  Disabilities, shall establish by rule requirements for
  168  licensure, administration, and operation of programs consistent
  169  with this section. All local, state, and federal regulations and
  170  professional licensing requirements must be met by a program as
  171  a condition of licensure by the agency. The agency must review
  172  and approve a program’s training plan specifying the program’s
  173  goals and methodologies. The training plan must include
  174  provisions governing a participant’s conduct and the
  175  consequences for his or her conduct while enrolled in the
  176  program.
  177         (b) A program must provide an educational component
  178  approved by the Department of Education to a participant who is
  179  absent from his or her school or educational setting for more
  180  than 30 days. Before enrolling a participant, the program
  181  supervisor must coordinate with the local school board to
  182  provide an educational component as part of the participant’s
  183  program experience. To offer educational credit to participants,
  184  the program must be recognized and approved by the State Board
  185  of Education.
  186         (4)(a) A program must employ a licensed psychiatrist or a
  187  psychologist licensed under chapter 490 as its program
  188  supervisor. The program supervisor is responsible for and has
  189  authority over the policies and activities of the program. The
  190  program supervisor shall coordinate office and support services,
  191  supervise the operations of the program, and ensure that all
  192  program staff are adequately trained. The program supervisor
  193  shall maintain on file at all times enrollment records of all
  194  participants and a current list of participants, including each
  195  participant’s group field activity or expedition and his or her
  196  geographic location. The list must be updated every 24 hours.
  197  The program supervisor must develop and sign a written plan for
  198  each group field activity and expedition. Plans must not expose
  199  participants to unreasonable risks.
  200         (b) Each group field activity or expedition must have field
  201  staff working directly with the participants. A program must
  202  have field support staff members who are responsible for the
  203  delivery of supplies to the field, mail delivery,
  204  communications, and first aid support.
  205         (c)Each program must provide its participants access to a
  206  multidisciplinary team of licensed health care providers and
  207  licensed mental health counselors who have been trained in
  208  providing medical services and treatment to adolescents and
  209  children and which includes, at a minimum, the following:
  210         1. A physician licensed under chapter 458 or chapter 459.
  211         2. At least one of the following:
  212         a. A psychologist licensed under chapter 490 or chapter
  213  491.
  214         b. A licensed clinical social worker.
  215         c. A mental health counselor licensed under chapter 491.
  216         d. A licensed marriage and family therapist.
  217         e. A certified school counselor.
  218         (d) All program staff, professional and non-professional,
  219  and all providers who may be contracted to provide services to
  220  participants must undergo a level 2 background screening before
  221  engaging in any activity that brings them into contact with a
  222  participant. The department may establish by rule further
  223  staffing requirements consistent with this section.
  224         Section 3. This act shall take effect July 1, 2016.