Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. CS for SB 528
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       The Committee on Appropriations (Rouson) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Present subsections (13) through (17) of section
    6  112.0455, Florida Statutes, are redesignated as subsections (14)
    7  through (18), respectively, a new subsection (13) is added to
    8  that section, and paragraph (b) of subsection (6) and paragraph
    9  (a) of present subsection (15) of that section are amended, to
   10  read:
   11         112.0455 Drug-Free Workplace Act.—
   12         (6) NOTICE TO EMPLOYEES.—
   13         (b) Prior to testing, all employees and job applicants for
   14  employment shall be given a written policy statement from the
   15  employer which contains:
   16         1. A general statement of the employer’s policy on employee
   17  drug use, which shall identify:
   18         a. The types of testing an employee or job applicant may be
   19  required to submit to, including reasonable suspicion or other
   20  basis; and
   21         b. The actions the employer may take against an employee or
   22  job applicant on the basis of a positive confirmed drug test
   23  result.
   24         2. A statement advising the employee or job applicant of
   25  the existence of this section.
   26         3. A general statement concerning confidentiality.
   27         4. Procedures for employees and job applicants to
   28  confidentially report the use of prescription or nonprescription
   29  medications both before and after being tested. Additionally,
   30  employees and job applicants shall receive notice of the most
   31  common medications by brand name or common name, as applicable,
   32  as well as by chemical name, which may alter or affect a drug
   33  test. A list of such medications shall be developed by the
   34  Agency for Health Care Administration.
   35         5. The consequences of refusing to submit to a drug test.
   36         6. Names, addresses, and telephone numbers of employee
   37  assistance programs and local alcohol and drug rehabilitation
   38  programs.
   39         7. A statement that an employee or job applicant who
   40  receives a positive confirmed drug test result may contest or
   41  explain the result to the employer within 5 working days after
   42  written notification of the positive test result. If an employee
   43  or job applicant’s explanation or challenge is unsatisfactory to
   44  the employer, the person may contest the drug test result as
   45  provided by subsections (15) and (16) subsections (14) and (15).
   46         8. A statement informing the employee or job applicant of
   47  his or her responsibility to notify the laboratory of any
   48  administrative or civil actions brought pursuant to this
   49  section.
   50         9. A list of all drugs for which the employer will test,
   51  described by brand names or common names, as applicable, as well
   52  as by chemical names.
   53         10. A statement regarding any applicable collective
   54  bargaining agreement or contract and the right to appeal to the
   55  Public Employees Relations Commission.
   56         11. A statement notifying employees and job applicants of
   57  their right to consult the testing laboratory for technical
   58  information regarding prescription and nonprescription
   59  medication.
   61  Before a drug testing facility licensed under part II of chapter
   62  408 may perform any drug-screening test on a urine specimen
   63  collected in this state, a prescreening test including a test
   64  for synthetic urine must be performed to determine the validity
   65  of the specimen.
   66         (16)(15) NONDISCIPLINE REMEDIES.—
   67         (a) Any person alleging a violation of the provisions of
   68  this section, that is not remediable by the commission or an
   69  arbitrator pursuant to subsection (15) subsection (14), must
   70  institute a civil action for injunctive relief or damages, or
   71  both, in a court of competent jurisdiction within 180 days of
   72  the alleged violation, or be barred from obtaining the following
   73  relief. Relief is limited to:
   74         1. An order restraining the continued violation of this
   75  section.
   76         2. An award of the costs of litigation, expert witness
   77  fees, reasonable attorney’s fees, and noneconomic damages
   78  provided that damages shall be limited to the recovery of
   79  damages directly resulting from injury or loss caused by each
   80  violation of this section.
   81         Section 2. Present subsections (17) through (31) and (32)
   82  through (48) of section 394.455, Florida Statutes, are
   83  redesignated as subsections (18) through (32) and (34) through
   84  (50), respectively, and new subsections (17) and (33) are added
   85  to that section, to read:
   86         394.455 Definitions.—As used in this part, the term:
   87         (17)“First episode psychosis program” means a program
   88  grounded in evidence for individuals between 14 and 30 years of
   89  age who are experiencing early indications of serious mental
   90  illness, especially a first episode of psychotic symptoms, and
   91  which includes, but is not limited to, intensive case
   92  management, individual or group therapy, supported employment,
   93  family education and supports, and appropriate psychotropic
   94  medication as indicated.
   95         (33)“Peer specialist” means a person who has been in
   96  recovery from a substance use disorder or mental illness for at
   97  least 2 years who uses his or her personal experience to provide
   98  services in behavioral health settings to support others in
   99  their recovery, or a family member or caregiver of an individual
  100  who has a substance use disorder or mental illness and who is
  101  certified under s. 397.417. The term does not include a
  102  qualified professional or a person otherwise certified under
  103  chapter 397 or this chapter.
  104         Section 3. Paragraph (a) of subsection (6) of section
  105  394.457, Florida Statutes, is amended to read:
  106         394.457 Operation and administration.—
  107         (6) PERSONNEL.—
  108         (a)1. The department shall, by rule, establish minimum
  109  standards of education and experience for professional and
  110  technical personnel employed in mental health programs,
  111  including members of a mobile crisis response service.
  112         2.An individual providing department-funded recovery
  113  support services as a peer specialist must be certified pursuant
  114  to s. 397.417. An individual who is not certified may provide
  115  recovery support services as a peer specialist for up to 1 year
  116  if he or she is working toward certification and is supervised
  117  by a qualified professional or by a certified peer specialist
  118  who has at least 2 years of full-time experience as a peer
  119  specialist at a licensed behavioral health organization.
  120         Section 4. Section 394.4573, Florida Statutes, is amended
  121  to read:
  122         394.4573 Coordinated system of care; annual assessment;
  123  essential elements; measures of performance; system improvement
  124  grants; reports.—On or before December 1 of each year, the
  125  department shall submit to the Governor, the President of the
  126  Senate, and the Speaker of the House of Representatives an
  127  assessment of the behavioral health services in this state. The
  128  assessment shall consider, at a minimum, the extent to which
  129  designated receiving systems function as no-wrong-door models,
  130  the availability of treatment and recovery services that use
  131  recovery-oriented and peer-involved approaches, the availability
  132  of less-restrictive services, and the use of evidence-informed
  133  practices. The assessment must also describe the availability of
  134  and access to first episode psychosis programs, and any gaps in
  135  their availability and access, in all areas of the state. The
  136  department’s assessment shall consider, at a minimum, the needs
  137  assessments conducted by the managing entities pursuant to s.
  138  394.9082(5). Beginning in 2017, the department shall compile and
  139  include in the report all plans submitted by managing entities
  140  pursuant to s. 394.9082(8) and the department’s evaluation of
  141  each plan.
  142         (1) As used in this section:
  143         (a) “Care coordination” means the implementation of
  144  deliberate and planned organizational relationships and service
  145  procedures that improve the effectiveness and efficiency of the
  146  behavioral health system by engaging in purposeful interactions
  147  with individuals who are not yet effectively connected with
  148  services to ensure service linkage. Examples of care
  149  coordination activities include development of referral
  150  agreements, shared protocols, and information exchange
  151  procedures. The purpose of care coordination is to enhance the
  152  delivery of treatment services and recovery supports and to
  153  improve outcomes among priority populations.
  154         (b) “Case management” means those direct services provided
  155  to a client in order to assess his or her needs, plan or arrange
  156  services, coordinate service providers, link the service system
  157  to a client, monitor service delivery, and evaluate patient
  158  outcomes to ensure the client is receiving the appropriate
  159  services.
  160         (c) “Coordinated system of care” means the full array of
  161  behavioral and related services in a region or community offered
  162  by all service providers, whether participating under contract
  163  with the managing entity or by another method of community
  164  partnership or mutual agreement.
  165         (d) “No-wrong-door model” means a model for the delivery of
  166  acute care services to persons who have mental health or
  167  substance use disorders, or both, which optimizes access to
  168  care, regardless of the entry point to the behavioral health
  169  care system.
  170         (2) The essential elements of a coordinated system of care
  171  include:
  172         (a) Community interventions, such as prevention, primary
  173  care for behavioral health needs, therapeutic and supportive
  174  services, crisis response services, and diversion programs.
  175         (b) A designated receiving system that consists of one or
  176  more facilities serving a defined geographic area and
  177  responsible for assessment and evaluation, both voluntary and
  178  involuntary, and treatment or triage of patients who have a
  179  mental health or substance use disorder, or co-occurring
  180  disorders.
  181         1. A county or several counties shall plan the designated
  182  receiving system using a process that includes the managing
  183  entity and is open to participation by individuals with
  184  behavioral health needs and their families, service providers,
  185  law enforcement agencies, and other parties. The county or
  186  counties, in collaboration with the managing entity, shall
  187  document the designated receiving system through written
  188  memoranda of agreement or other binding arrangements. The county
  189  or counties and the managing entity shall complete the plan and
  190  implement the designated receiving system by July 1, 2017, and
  191  the county or counties and the managing entity shall review and
  192  update, as necessary, the designated receiving system at least
  193  once every 3 years.
  194         2. To the extent permitted by available resources, the
  195  designated receiving system shall function as a no-wrong-door
  196  model. The designated receiving system may be organized in any
  197  manner which functions as a no-wrong-door model that responds to
  198  individual needs and integrates services among various
  199  providers. Such models include, but are not limited to:
  200         a. A central receiving system that consists of a designated
  201  central receiving facility that serves as a single entry point
  202  for persons with mental health or substance use disorders, or
  203  co-occurring disorders. The central receiving facility shall be
  204  capable of assessment, evaluation, and triage or treatment or
  205  stabilization of persons with mental health or substance use
  206  disorders, or co-occurring disorders.
  207         b. A coordinated receiving system that consists of multiple
  208  entry points that are linked by shared data systems, formal
  209  referral agreements, and cooperative arrangements for care
  210  coordination and case management. Each entry point shall be a
  211  designated receiving facility and shall, within existing
  212  resources, provide or arrange for necessary services following
  213  an initial assessment and evaluation.
  214         c. A tiered receiving system that consists of multiple
  215  entry points, some of which offer only specialized or limited
  216  services. Each service provider shall be classified according to
  217  its capabilities as either a designated receiving facility or
  218  another type of service provider, such as a triage center, a
  219  licensed detoxification facility, or an access center. All
  220  participating service providers shall, within existing
  221  resources, be linked by methods to share data, formal referral
  222  agreements, and cooperative arrangements for care coordination
  223  and case management.
  225  An accurate inventory of the participating service providers
  226  which specifies the capabilities and limitations of each
  227  provider and its ability to accept patients under the designated
  228  receiving system agreements and the transportation plan
  229  developed pursuant to this section shall be maintained and made
  230  available at all times to all first responders in the service
  231  area.
  232         (c) Transportation in accordance with a plan developed
  233  under s. 394.462.
  234         (d) Crisis services, including mobile response teams,
  235  crisis stabilization units, addiction receiving facilities, and
  236  detoxification facilities.
  237         (e) Case management. Each case manager or person directly
  238  supervising a case manager who provides Medicaid-funded targeted
  239  case management services shall hold a valid certification from a
  240  department-approved credentialing entity as defined in s.
  241  397.311(10) by July 1, 2017, and, thereafter, within 6 months
  242  after hire.
  243         (f) Care coordination that involves coordination with other
  244  local systems and entities, public and private, which are
  245  involved with the individual, such as primary care, child
  246  welfare, behavioral health care, and criminal and juvenile
  247  justice organizations.
  248         (g) Outpatient services.
  249         (h) Residential services.
  250         (i) Hospital inpatient care.
  251         (j) Aftercare and other postdischarge services.
  252         (k) Medication-assisted treatment and medication
  253  management.
  254         (l) Recovery support, including, but not limited to, the
  255  use of peer specialists to assist in the individual’s recovery
  256  from a substance use disorder or mental illness, support for
  257  competitive employment, educational attainment, independent
  258  living skills development, family support and education,
  259  wellness management and self-care, and assistance in obtaining
  260  housing that meets the individual’s needs. Such housing may
  261  include mental health residential treatment facilities, limited
  262  mental health assisted living facilities, adult family care
  263  homes, and supportive housing. Housing provided using state
  264  funds must provide a safe and decent environment free from abuse
  265  and neglect.
  266         (m) Care plans shall assign specific responsibility for
  267  initial and ongoing evaluation of the supervision and support
  268  needs of the individual and the identification of housing that
  269  meets such needs. For purposes of this paragraph, the term
  270  “supervision” means oversight of and assistance with compliance
  271  with the clinical aspects of an individual’s care plan.
  272         (n)First episode psychosis programs.
  273         (3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific
  274  appropriation by the Legislature, the department may award
  275  system improvement grants to managing entities based on a
  276  detailed plan to enhance services in accordance with the no
  277  wrong-door model as defined in subsection (1) and to address
  278  specific needs identified in the assessment prepared by the
  279  department pursuant to this section. Such a grant must be
  280  awarded through a performance-based contract that links payments
  281  to the documented and measurable achievement of system
  282  improvements.
  283         Section 5. Present subsections (30) through (49) of section
  284  397.311, Florida Statutes, are redesignated as subsections (31)
  285  through (50), respectively, and a new subsection (30) is added
  286  to that section, to read:
  287         397.311 Definitions.—As used in this chapter, except part
  288  VIII, the term:
  289         (30)“Peer specialist” has the same meaning as in s.
  290  394.455.
  291         Section 6. Section 397.4012, Florida Statutes, is amended
  292  to read:
  293         397.4012 Exemptions from licensure.—The following are
  294  exempt from the licensing provisions of this chapter:
  295         (1) A hospital or hospital-based component licensed under
  296  chapter 395.
  297         (2) A nursing home facility as defined in s. 400.021.
  298         (3) A substance abuse education program established
  299  pursuant to s. 1003.42.
  300         (4) A facility or institution operated by the Federal
  301  Government.
  302         (5) A physician or physician assistant licensed under
  303  chapter 458 or chapter 459.
  304         (6) A psychologist licensed under chapter 490.
  305         (7) A social worker, marriage and family therapist, or
  306  mental health counselor licensed under chapter 491.
  307         (8) A legally cognizable church or nonprofit religious
  308  organization or denomination providing substance abuse services,
  309  including prevention services, which are solely religious,
  310  spiritual, or ecclesiastical in nature. A church or nonprofit
  311  religious organization or denomination providing any of the
  312  licensed service components itemized under s. 397.311(26) is not
  313  exempt from substance abuse licensure but retains its exemption
  314  with respect to all services which are solely religious,
  315  spiritual, or ecclesiastical in nature.
  316         (9) Facilities licensed under chapter 393 which, in
  317  addition to providing services to persons with developmental
  318  disabilities, also provide services to persons developmentally
  319  at risk as a consequence of exposure to alcohol or other legal
  320  or illegal drugs while in utero.
  321         (10) DUI education and screening services provided pursuant
  322  to ss. 316.192, 316.193, 322.095, 322.271, and 322.291. Persons
  323  or entities providing treatment services must be licensed under
  324  this chapter unless exempted from licensing as provided in this
  325  section.
  326         (11) A facility licensed under s. 394.875 as a crisis
  327  stabilization unit.
  329  The exemptions from licensure in subsections (3), (4), (8), (9),
  330  and (10) this section do not apply to any service provider that
  331  receives an appropriation, grant, or contract from the state to
  332  operate as a service provider as defined in this chapter or to
  333  any substance abuse program regulated pursuant to s. 397.4014.
  334  Furthermore, this chapter may not be construed to limit the
  335  practice of a physician or physician assistant licensed under
  336  chapter 458 or chapter 459, a psychologist licensed under
  337  chapter 490, a psychotherapist licensed under chapter 491, or an
  338  advanced practice registered nurse licensed under part I of
  339  chapter 464, who provides substance abuse treatment, so long as
  340  the physician, physician assistant, psychologist,
  341  psychotherapist, or advanced practice registered nurse does not
  342  represent to the public that he or she is a licensed service
  343  provider and does not provide services to individuals pursuant
  344  to part V of this chapter. Failure to comply with any
  345  requirement necessary to maintain an exempt status under this
  346  section is a misdemeanor of the first degree, punishable as
  347  provided in s. 775.082 or s. 775.083.
  348         Section 7. Subsection (3) of section 397.403, Florida
  349  Statutes, is amended to read:
  350         397.403 License application.—
  351         (3) Applications for licensure renewal must include proof
  352  of application for accreditation for each licensed service
  353  component providing clinical treatment by an accrediting
  354  organization that is acceptable to the department for the first
  355  renewal, and proof of accreditation for any subsequent renewals.
  356  This subsection does not apply to any inmate substance abuse
  357  program operated by or under an exclusive contract with a jail
  358  or the Department of Corrections.
  359         Section 8. Paragraph (g) of subsection (1) of section
  360  397.4073, Florida Statutes, is redesignated as paragraph (h), a
  361  new paragraph (g) is added to that subsection, and paragraphs
  362  (a) and (f) of that subsection and paragraphs (b) and (c) of
  363  subsection (4) are amended, to read:
  364         397.4073 Background checks of service provider personnel.—
  367         (a) For all individuals screened on or after July 1, 2019,
  368  background checks shall apply as follows:
  369         1. All owners, directors, chief financial officers, and
  370  clinical supervisors of service providers are subject to level 2
  371  background screening as provided under s. 408.809 and chapter
  372  435. Inmate substance abuse programs operated directly or under
  373  contract with the Department of Corrections are exempt from this
  374  requirement.
  375         2. All service provider personnel who have direct contact
  376  with children receiving services or with adults who are
  377  developmentally disabled receiving services are subject to level
  378  2 background screening as provided under s. 408.809 and chapter
  379  435.
  380         3.All peer specialists who have direct contact with
  381  individuals held for examination under s. 394.463 or receiving
  382  mental health or substance abuse treatment or services are
  383  subject to level 2 background screening as provided under s.
  384  397.417.
  385         (f) Service provider personnel who request an exemption
  386  from disqualification must submit the request within 30 days
  387  after being notified of the disqualification. The department
  388  shall grant or deny the request within 60 days after receipt of
  389  a complete application.
  390         (g) If 5 years or more, or 3 years or more in the case of a
  391  certified peer specialist or an individual seeking certification
  392  as a peer specialist pursuant to s. 397.417, have elapsed since
  393  an applicant for an exemption from disqualification has
  394  completed or has been lawfully released from confinement,
  395  supervision, or a nonmonetary condition imposed by a court for
  396  the applicant’s most recent disqualifying offense, the applicant
  397  may work with adults with substance use disorders or co
  398  occurring disorders under the supervision of persons who meet
  399  all personnel requirements of this chapter for up to 90 days
  400  after being notified of his or her disqualification or until the
  401  department makes a final determination regarding his or her
  402  request for an exemption from disqualification, whichever is
  403  earlier the most recent disqualifying offense, service provider
  404  personnel may work with adults with substance use disorders
  405  under the supervision of a qualified professional licensed under
  406  chapter 490 or chapter 491 or a master’s-level-certified
  407  addictions professional until the agency makes a final
  408  determination regarding the request for an exemption from
  409  disqualification.
  411         (b) Since rehabilitated substance abuse impaired persons
  412  are effective in the successful treatment and rehabilitation of
  413  individuals with substance use disorders, for service providers
  414  which treat adolescents 13 years of age and older, service
  415  provider personnel whose background checks indicate crimes under
  416  s. 817.563, s. 893.13, or s. 893.147 may be exempted from
  417  disqualification from employment pursuant to this paragraph.
  418         (c) The department may grant exemptions from
  419  disqualification which would limit service provider personnel to
  420  working with adults in substance use disorder abuse treatment
  421  facilities.
  422         Section 9. Section 397.417, Florida Statutes, is created to
  423  read:
  424         397.417 Behavioral health peer specialists.—
  426         (a) The Legislature finds that:
  427         1. The ability to provide adequate behavioral health
  428  services is limited by a shortage of professionals and
  429  paraprofessionals.
  430         2. The state is experiencing an increase in opioid
  431  addictions, which prove fatal to persons in many cases.
  432         3. Peer specialists provide effective support services
  433  because they share common life experiences with the persons they
  434  assist.
  435         4. Peer specialists promote a sense of community among
  436  those in recovery.
  437         5. Research has shown that peer support facilitates
  438  recovery and reduces health care costs.
  439         6. Peer specialists may have a criminal history that
  440  prevents them from meeting background screening requirements.
  441         (b) The Legislature intends to expand the use of peer
  442  specialists as a cost-effective means of providing services by
  443  ensuring that peer specialists meet specified qualifications,
  444  meet modified background screening requirements, and are
  445  adequately reimbursed for their services.
  446         (2) QUALIFICATIONS.—
  447         (a) A person may seek certification as a peer specialist if
  448  he or she has been in recovery from a substance use disorder or
  449  mental illness for the past 2 years or if he or she is a family
  450  member or caregiver of a person with a substance use disorder or
  451  mental illness.
  452         (b) To obtain certification as a peer specialist, a person
  453  must meet the background screening requirements of subsection
  454  (5), complete the training program, and achieve a passing score
  455  on the competency exam described in paragraph (3)(a).
  456         (3) DUTIES OF THE DEPARTMENT.—
  457         (a) The department shall develop a training program for
  458  persons seeking certification as peer specialists. The
  459  department must give preference to trainers who are certified
  460  peer specialists. The training program must coincide with a
  461  competency exam and be based on current practice standards.
  462         (b) The department shall certify peer specialists. The
  463  department may certify peer specialists directly or may approve
  464  one or more third-party credentialing entities for the purposes
  465  of certifying peer specialists, approving training programs for
  466  individuals seeking certification as peer specialists, approving
  467  continuing education programs, and establishing the minimum
  468  requirements and standards that applicants must achieve to
  469  maintain certification.
  470         (c) The department must require that a person providing
  471  peer specialist services be certified or be supervised by a
  472  licensed behavioral health care professional or a certified peer
  473  specialist. An individual who is not certified may provide
  474  recovery support services as a peer specialist for up to 1 year
  475  if he or she is working toward certification and is supervised
  476  by a qualified professional or by a certified peer specialist.
  477         (4) PAYMENT.—Peer specialist services may be reimbursed as
  478  a recovery service through the department, a behavioral health
  479  managing entity, or the Medicaid program. Medicaid managed care
  480  plans are encouraged to use peer specialists in providing
  481  recovery services.
  482         (5) BACKGROUND SCREENING.—
  483         (a) A peer specialist must have completed or have been
  484  lawfully released from confinement, supervision, or any
  485  nonmonetary condition imposed by the court for any felony and
  486  must undergo a background screening as a condition of employment
  487  and continued employment. The applicant must submit a full set
  488  of fingerprints to the department or to a vendor, entity, or
  489  agency authorized by s. 943.053(13). The department, vendor,
  490  entity, or agency shall forward the fingerprints to the
  491  Department of Law Enforcement for state processing and the
  492  Department of Law Enforcement shall forward the fingerprints to
  493  the Federal Bureau of Investigation for national processing.
  494  Fees for state and federal fingerprint processing and retention
  495  shall be borne by the applicant. The state cost for fingerprint
  496  processing shall be as provided in s. 943.053(3)(e) for records
  497  provided to persons or entities other than those specified as
  498  exceptions therein. Fingerprints submitted to the Department of
  499  Law Enforcement pursuant to this paragraph shall be retained as
  500  provided by s. 435.12 and, when the Department of Law
  501  Enforcement begins participation in the program, enrolled in the
  502  Federal Bureau of Investigation’s national retained fingerprint
  503  arrest notification program, as provided in s. 943.05(4). Any
  504  arrest record identified shall be reported to the department.
  505         (b) The department or the Agency for Health Care
  506  Administration, as applicable, may contract with one or more
  507  vendors to perform all or part of the electronic fingerprinting
  508  pursuant to this section. Such contracts must ensure that the
  509  owners and personnel of the vendor performing the electronic
  510  fingerprinting are qualified and will ensure the integrity and
  511  security of all personal identifying information.
  512         (c) Vendors who submit fingerprints on behalf of employers
  513  must:
  514         1. Meet the requirements of s. 943.053; and
  515         2. Have the ability to communicate electronically with the
  516  department or the Agency for Health Care Administration, as
  517  applicable, and to accept screening results from the Department
  518  of Law Enforcement and provide the applicant’s full first name,
  519  middle initial, and last name; social security number or
  520  individual taxpayer identification number; date of birth;
  521  mailing address; sex; and race.
  522         (d) The background screening under this section must ensure
  523  that a peer specialist has not, during the previous 3 years,
  524  been arrested for and is awaiting final disposition of, been
  525  found guilty of, regardless of adjudication, or entered a plea
  526  of nolo contendere or guilty to, or been adjudicated delinquent
  527  and the record has not been sealed or expunged for, any felony.
  528         (e) The background screening under this section must ensure
  529  that a peer specialist has not been found guilty of, regardless
  530  of adjudication, or entered a plea of nolo contendere or guilty
  531  to, or been adjudicated delinquent and the record has not been
  532  sealed or expunged for, any offense prohibited under any of the
  533  following state laws or similar laws of another jurisdiction:
  534         1. Section 393.135, relating to sexual misconduct with
  535  certain developmentally disabled clients and reporting of such
  536  sexual misconduct.
  537         2. Section 394.4593, relating to sexual misconduct with
  538  certain mental health patients and reporting of such sexual
  539  misconduct.
  540         3. Section 409.920, relating to Medicaid fraud, if the
  541  offense was a felony of the first or second degree.
  542         4. Section 415.111, relating to adult abuse, neglect, or
  543  exploitation of aged persons or disabled adults.
  544         5.Section 741.28, relating to domestic violence.
  545         6. Section 777.04, relating to attempts, solicitation, and
  546  conspiracy to commit an offense listed in this section.
  547         7. Section 782.04, relating to murder.
  548         8. Section 782.07, relating to manslaughter, aggravated
  549  manslaughter of an elderly person or disabled adult, aggravated
  550  manslaughter of a child, or aggravated manslaughter of an
  551  officer, a firefighter, an emergency medical technician, or a
  552  paramedic.
  553         9. Section 782.071, relating to vehicular homicide.
  554         10. Section 782.09, relating to killing of an unborn child
  555  by injury to the mother.
  556         11. Chapter 784, relating to assault, battery, and culpable
  557  negligence, if the offense was a felony.
  558         12. Section 787.01, relating to kidnapping.
  559         13. Section 787.02, relating to false imprisonment.
  560         14. Section 787.025, relating to luring or enticing a
  561  child.
  562         15. Section 787.04(2), relating to leading, taking,
  563  enticing, or removing a minor beyond the state limits, or
  564  concealing the location of a minor, with criminal intent pending
  565  custody proceedings.
  566         16. Section 787.04(3), relating to leading, taking,
  567  enticing, or removing a minor beyond the state limits, or
  568  concealing the location of a minor, with criminal intent pending
  569  dependency proceedings or proceedings concerning alleged abuse
  570  or neglect of a minor.
  571         17. Section 790.115(1), relating to exhibiting firearms or
  572  weapons within 1,000 feet of a school.
  573         18. Section 790.115(2)(b), relating to possessing an
  574  electric weapon or device, destructive device, or other weapon
  575  on school property.
  576         19. Section 794.011, relating to sexual battery.
  577         20.Former s. 794.041, relating to prohibited acts of
  578  persons in familial or custodial authority.
  579         21. Section 794.05, relating to unlawful sexual activity
  580  with certain minors.
  581         22. Section 794.08, relating to female genital mutilation.
  582         23. Section 796.07, relating to procuring another to commit
  583  prostitution, except for those offenses expunged pursuant to s.
  584  943.0583.
  585         24. Section 798.02, relating to lewd and lascivious
  586  behavior.
  587         25. Chapter 800, relating to lewdness and indecent
  588  exposure.
  589         26. Section 806.01, relating to arson.
  590         27. Section 810.02, relating to burglary, if the offense
  591  was a felony of the first degree.
  592         28. Section 810.14, relating to voyeurism, if the offense
  593  was a felony.
  594         29. Section 810.145, relating to video voyeurism, if the
  595  offense was a felony.
  596         30. Section 812.13, relating to robbery.
  597         31. Section 812.131, relating to robbery by sudden
  598  snatching.
  599         32. Section 812.133, relating to carjacking.
  600         33. Section 812.135, relating to home-invasion robbery.
  601         34.Section 817.034, relating to communications fraud, if
  602  the offense was a felony of the first degree.
  603         35.Section 817.234, relating to false and fraudulent
  604  insurance claims, if the offense was a felony of the first or
  605  second degree.
  606         36.Section 817.50, relating to fraudulently obtaining
  607  goods or services from a health care provider and false reports
  608  of a communicable disease.
  609         37. Section 817.505, relating to patient brokering.
  610         38.Section 817.568, relating to fraudulent use of personal
  611  identification, if the offense was a felony of the first or
  612  second degree.
  613         39. Section 825.102, relating to abuse, aggravated abuse,
  614  or neglect of an elderly person or disabled adult.
  615         40. Section 825.1025, relating to lewd or lascivious
  616  offenses committed upon or in the presence of an elderly person
  617  or disabled person.
  618         41. Section 825.103, relating to exploitation of an elderly
  619  person or disabled adult, if the offense was a felony.
  620         42. Section 826.04, relating to incest.
  621         43. Section 827.03, relating to child abuse, aggravated
  622  child abuse, or neglect of a child.
  623         44. Section 827.04, relating to contributing to the
  624  delinquency or dependency of a child.
  625         45. Former s. 827.05, relating to negligent treatment of
  626  children.
  627         46. Section 827.071, relating to sexual performance by a
  628  child.
  629         47.Section 831.30, relating to fraud in obtaining
  630  medicinal drugs.
  631         48. Section 831.31, relating to sale, manufacture,
  632  delivery, possession with intent to sell, manufacture, or
  633  deliver any counterfeit controlled substance if the offense was
  634  a felony.
  635         49. Section 843.01, relating to resisting arrest with
  636  violence.
  637         50. Section 843.025, relating to depriving a law
  638  enforcement, correctional, or correctional probation officer of
  639  the means of protection or communication.
  640         51. Section 843.12, relating to aiding in an escape.
  641         52. Section 843.13, relating to aiding in the escape of
  642  juvenile inmates of correctional institutions.
  643         53. Chapter 847, relating to obscene literature.
  644         54. Section 874.05, relating to encouraging or recruiting
  645  another to join a criminal gang.
  646         55. Chapter 893, relating to drug abuse prevention and
  647  control, if the offense was a felony of the second degree or
  648  greater severity.
  649         56.Section 895.03, relating to racketeering and collection
  650  of unlawful debts.
  651         57. Section 896.101, relating to the Florida Money
  652  Laundering Act.
  653         58. Section 916.1075, relating to sexual misconduct with
  654  certain forensic clients and reporting of such sexual
  655  misconduct.
  656         59. Section 944.35(3), relating to inflicting cruel or
  657  inhuman treatment on an inmate resulting in great bodily harm.
  658         60. Section 944.40, relating to escape.
  659         61. Section 944.46, relating to harboring, concealing, or
  660  aiding an escaped prisoner.
  661         62. Section 944.47, relating to introduction of contraband
  662  into a correctional facility.
  663         63. Section 985.701, relating to sexual misconduct in
  664  juvenile justice programs.
  665         64. Section 985.711, relating to contraband introduced into
  666  detention facilities.
  667         (6) EXEMPTION REQUESTS.—A person who wishes to become a
  668  peer specialist and is disqualified under subsection (5) may
  669  request an exemption from disqualification pursuant to s. 435.07
  670  from the department or the Agency for Health Care
  671  Administration, as applicable.
  672         (7) GRANDFATHER CLAUSE.—All peer specialists certified as
  673  of the effective date of this act are recognized as having met
  674  the requirements of this act.
  675         Section 10. Paragraph (e) of subsection (5) of section
  676  212.055, Florida Statutes, is amended to read:
  677         212.055 Discretionary sales surtaxes; legislative intent;
  678  authorization and use of proceeds.—It is the legislative intent
  679  that any authorization for imposition of a discretionary sales
  680  surtax shall be published in the Florida Statutes as a
  681  subsection of this section, irrespective of the duration of the
  682  levy. Each enactment shall specify the types of counties
  683  authorized to levy; the rate or rates which may be imposed; the
  684  maximum length of time the surtax may be imposed, if any; the
  685  procedure which must be followed to secure voter approval, if
  686  required; the purpose for which the proceeds may be expended;
  687  and such other requirements as the Legislature may provide.
  688  Taxable transactions and administrative procedures shall be as
  689  provided in s. 212.054.
  690         (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
  691  s. 125.011(1) may levy the surtax authorized in this subsection
  692  pursuant to an ordinance either approved by extraordinary vote
  693  of the county commission or conditioned to take effect only upon
  694  approval by a majority vote of the electors of the county voting
  695  in a referendum. In a county as defined in s. 125.011(1), for
  696  the purposes of this subsection, “county public general
  697  hospital” means a general hospital as defined in s. 395.002
  698  which is owned, operated, maintained, or governed by the county
  699  or its agency, authority, or public health trust.
  700         (e) A governing board, agency, or authority shall be
  701  chartered by the county commission upon this act becoming law.
  702  The governing board, agency, or authority shall adopt and
  703  implement a health care plan for indigent health care services.
  704  The governing board, agency, or authority shall consist of no
  705  more than seven and no fewer than five members appointed by the
  706  county commission. The members of the governing board, agency,
  707  or authority shall be at least 18 years of age and residents of
  708  the county. A No member may not be employed by or affiliated
  709  with a health care provider or the public health trust, agency,
  710  or authority responsible for the county public general hospital.
  711  The following community organizations shall each appoint a
  712  representative to a nominating committee: the South Florida
  713  Hospital and Healthcare Association, the Miami-Dade County
  714  Public Health Trust, the Dade County Medical Association, the
  715  Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
  716  County. This committee shall nominate between 10 and 14 county
  717  citizens for the governing board, agency, or authority. The
  718  slate shall be presented to the county commission and the county
  719  commission shall confirm the top five to seven nominees,
  720  depending on the size of the governing board. Until such time as
  721  the governing board, agency, or authority is created, the funds
  722  provided for in subparagraph (d)2. shall be placed in a
  723  restricted account set aside from other county funds and not
  724  disbursed by the county for any other purpose.
  725         1. The plan shall divide the county into a minimum of four
  726  and maximum of six service areas, with no more than one
  727  participant hospital per service area. The county public general
  728  hospital shall be designated as the provider for one of the
  729  service areas. Services shall be provided through participants’
  730  primary acute care facilities.
  731         2. The plan and subsequent amendments to it shall fund a
  732  defined range of health care services for both indigent persons
  733  and the medically poor, including primary care, preventive care,
  734  hospital emergency room care, and hospital care necessary to
  735  stabilize the patient. For the purposes of this section,
  736  “stabilization” means stabilization as defined in s. 397.311 s.
  737  397.311(45). Where consistent with these objectives, the plan
  738  may include services rendered by physicians, clinics, community
  739  hospitals, and alternative delivery sites, as well as at least
  740  one regional referral hospital per service area. The plan shall
  741  provide that agreements negotiated between the governing board,
  742  agency, or authority and providers shall recognize hospitals
  743  that render a disproportionate share of indigent care, provide
  744  other incentives to promote the delivery of charity care to draw
  745  down federal funds where appropriate, and require cost
  746  containment, including, but not limited to, case management.
  747  From the funds specified in subparagraphs (d)1. and 2. for
  748  indigent health care services, service providers shall receive
  749  reimbursement at a Medicaid rate to be determined by the
  750  governing board, agency, or authority created pursuant to this
  751  paragraph for the initial emergency room visit, and a per-member
  752  per-month fee or capitation for those members enrolled in their
  753  service area, as compensation for the services rendered
  754  following the initial emergency visit. Except for provisions of
  755  emergency services, upon determination of eligibility,
  756  enrollment shall be deemed to have occurred at the time services
  757  were rendered. The provisions for specific reimbursement of
  758  emergency services shall be repealed on July 1, 2001, unless
  759  otherwise reenacted by the Legislature. The capitation amount or
  760  rate shall be determined before program implementation by an
  761  independent actuarial consultant. In no event shall such
  762  reimbursement rates exceed the Medicaid rate. The plan must also
  763  provide that any hospitals owned and operated by government
  764  entities on or after the effective date of this act must, as a
  765  condition of receiving funds under this subsection, afford
  766  public access equal to that provided under s. 286.011 as to any
  767  meeting of the governing board, agency, or authority the subject
  768  of which is budgeting resources for the retention of charity
  769  care, as that term is defined in the rules of the Agency for
  770  Health Care Administration. The plan shall also include
  771  innovative health care programs that provide cost-effective
  772  alternatives to traditional methods of service and delivery
  773  funding.
  774         3. The plan’s benefits shall be made available to all
  775  county residents currently eligible to receive health care
  776  services as indigents or medically poor as defined in paragraph
  777  (4)(d).
  778         4. Eligible residents who participate in the health care
  779  plan shall receive coverage for a period of 12 months or the
  780  period extending from the time of enrollment to the end of the
  781  current fiscal year, per enrollment period, whichever is less.
  782         5. At the end of each fiscal year, the governing board,
  783  agency, or authority shall prepare an audit that reviews the
  784  budget of the plan, delivery of services, and quality of
  785  services, and makes recommendations to increase the plan’s
  786  efficiency. The audit shall take into account participant
  787  hospital satisfaction with the plan and assess the amount of
  788  poststabilization patient transfers requested, and accepted or
  789  denied, by the county public general hospital.
  790         Section 11. Subsection (3) of section 394.495, Florida
  791  Statutes, is amended to read:
  792         394.495 Child and adolescent mental health system of care;
  793  programs and services.—
  794         (3) Assessments must be performed by:
  795         (a) A professional as defined in s. 394.455(5), (7), (33)
  796  (32), (36) (35), or (37) (36);
  797         (b) A professional licensed under chapter 491; or
  798         (c) A person who is under the direct supervision of a
  799  qualified professional as defined in s. 394.455(5), (7), (33)
  800  (32), (36) (35), or (37) (36) or a professional licensed under
  801  chapter 491.
  802         Section 12. Subsection (5) of section 394.496, Florida
  803  Statutes, is amended to read:
  804         394.496 Service planning.—
  805         (5) A professional as defined in s. 394.455(5), (7), (34)
  806  (32), (37) (35), or (38) (36) or a professional licensed under
  807  chapter 491 must be included among those persons developing the
  808  services plan.
  809         Section 13. Subsection (6) of section 394.9085, Florida
  810  Statutes, is amended to read:
  811         394.9085 Behavioral provider liability.—
  812         (6) For purposes of this section, the term terms
  813  “detoxification services,has the same meaning as
  814  detoxification in s. 397.311(26)(a), “addictions receiving
  815  facility,has the same meaning as provided in s.
  816  397.311(26)(a), and “receiving facility” has have the same
  817  meaning meanings as those provided in s. 394.455 ss.
  818  397.311(26)(a)4., 397.311(26)(a)1., and 394.455(39),
  819  respectively.
  820         Section 14. Section 397.416, Florida Statutes, is amended
  821  to read:
  822         397.416 Substance use disorder abuse treatment services;
  823  qualified professional.—Notwithstanding any other provision of
  824  law, a person who was certified through a certification process
  825  recognized by the former Department of Health and Rehabilitative
  826  Services before January 1, 1995, may perform the duties of a
  827  qualified professional with respect to substance use abuse
  828  treatment services as defined in this chapter, and need not meet
  829  the certification requirements contained in s. 397.311(35) s.
  830  397.311(34).
  831         Section 15. Paragraph (b) of subsection (1) of section
  832  409.972, Florida Statutes, is amended to read:
  833         409.972 Mandatory and voluntary enrollment.—
  834         (1) The following Medicaid-eligible persons are exempt from
  835  mandatory managed care enrollment required by s. 409.965, and
  836  may voluntarily choose to participate in the managed medical
  837  assistance program:
  838         (b) Medicaid recipients residing in residential commitment
  839  facilities operated through the Department of Juvenile Justice
  840  or in a treatment facility as defined in s. 394.455 s.
  841  394.455(47).
  842         Section 16. Paragraphs (d) and (g) of subsection (1) of
  843  section 440.102, Florida Statutes, are amended to read:
  844         440.102 Drug-free workplace program requirements.—The
  845  following provisions apply to a drug-free workplace program
  846  implemented pursuant to law or to rules adopted by the Agency
  847  for Health Care Administration:
  848         (1) DEFINITIONS.—Except where the context otherwise
  849  requires, as used in this act:
  850         (d) “Drug rehabilitation program” means a service provider
  851  as defined in s. 397.311 which, established pursuant to s.
  852  397.311(43), that provides confidential, timely, and expert
  853  identification, assessment, and resolution of employee drug
  854  abuse.
  855         (g) “Employee assistance program” means an established
  856  program capable of providing expert assessment of employee
  857  personal concerns; confidential and timely identification
  858  services with regard to employee drug abuse; referrals of
  859  employees for appropriate diagnosis, treatment, and assistance;
  860  and followup services for employees who participate in the
  861  program or require monitoring after returning to work. If, in
  862  addition to the above activities, an employee assistance program
  863  provides diagnostic and treatment services, these services shall
  864  in all cases be provided by service providers as defined in s.
  865  397.311 pursuant to s. 397.311(43).
  867         (b) A laboratory may analyze initial or confirmation test
  868  specimens only if:
  869         1. The laboratory obtains a license under part II of
  870  chapter 408 and s. 112.0455(18) s. 112.0455(17). Each applicant
  871  for licensure and each licensee must comply with all
  872  requirements of this section, part II of chapter 408, and
  873  applicable rules.
  874         2. The laboratory has written procedures to ensure the
  875  chain of custody.
  876         3. The laboratory follows proper quality control
  877  procedures, including, but not limited to:
  878         a. The use of internal quality controls, including the use
  879  of samples of known concentrations which are used to check the
  880  performance and calibration of testing equipment, and periodic
  881  use of blind samples for overall accuracy.
  882         b. An internal review and certification process for drug
  883  test results, conducted by a person qualified to perform that
  884  function in the testing laboratory.
  885         c. Security measures implemented by the testing laboratory
  886  to preclude adulteration of specimens and drug test results.
  887         d. Other necessary and proper actions taken to ensure
  888  reliable and accurate drug test results.
  889         Section 17. Paragraph (e) of subsection (4) of section
  890  464.012, Florida Statutes, is amended to read:
  891         464.012 Licensure of advanced practice registered nurses;
  892  fees; controlled substance prescribing.—
  893         (4) In addition to the general functions specified in
  894  subsection (3), an advanced practice registered nurse may
  895  perform the following acts within his or her specialty:
  896         (e) A psychiatric nurse, who meets the requirements in s.
  897  394.455(37) s. 394.455(35), within the framework of an
  898  established protocol with a psychiatrist, may prescribe
  899  psychotropic controlled substances for the treatment of mental
  900  disorders.
  901         Section 18. Subsection (7) of section 744.2007, Florida
  902  Statutes, is amended to read:
  903         744.2007 Powers and duties.—
  904         (7) A public guardian may not commit a ward to a treatment
  905  facility, as defined in s. 394.455 s. 394.455(47), without an
  906  involuntary placement proceeding as provided by law.
  907         Section 19. This act shall take effect July 1, 2019.
  909  ================= T I T L E  A M E N D M E N T ================
  910  And the title is amended as follows:
  911         Delete everything before the enacting clause
  912  and insert:
  913                        A bill to be entitled                      
  914         An act relating to mental health and substance use
  915         disorders; amending s. 112.0455, F.S.; requiring that
  916         certain prescreening tests be performed before certain
  917         drug-testing facilities may perform drug-screening
  918         tests on urine specimens collected in this state;
  919         amending s. 394.455, F.S.; defining the terms “first
  920         episode psychosis program” and “peer specialist”;
  921         amending s. 394.457, F.S.; requiring that individuals
  922         performing certain services as a peer specialist be
  923         certified; providing exemptions; amending s. 394.4573,
  924         F.S.; revising requirements for the annual state
  925         behavioral health assessment; revising the essential
  926         elements of a coordinated system of behavioral health
  927         care; amending s. 397.311, F.S.; defining the term
  928         “peer specialist”; amending s. 397.4012, F.S.;
  929         revising the applicability of exemptions from
  930         licensure for certain entities; amending s. 397.403,
  931         F.S.; providing an exemption from certain
  932         accreditation requirements relating to licensure
  933         renewal for certain inmate substance abuse programs;
  934         amending s. 397.4073, F.S.; requiring individuals
  935         screened on or after a specified date to undergo a
  936         specified background screening; requiring the
  937         Department of Children and Families to grant or deny a
  938         request for an exemption from disqualification within
  939         a certain timeframe; authorizing certain applicants
  940         for an exemption to work under the supervision of
  941         certain persons for a specified period of time while
  942         his or her application for an exemption from
  943         disqualification is pending; deleting a provision
  944         exempting certain persons from disqualification from
  945         employment; creating s. 397.417, F.S.; providing
  946         legislative findings and intent; authorizing a person
  947         to seek certification as a peer specialist if he or
  948         she meets specified qualifications; requiring a
  949         background screening, completion of a training
  950         program, and a passing score on a competency exam for
  951         a qualified person to obtain certification as a peer
  952         specialist; requiring the department to develop a
  953         training program for peer specialists and to give
  954         preference to trainers who are certified peer
  955         specialists; requiring the training program to
  956         coincide with a competency exam and to be based on
  957         current practice standards; requiring the department
  958         to certify peer specialists directly or by designating
  959         a third-party credentialing entity; requiring that a
  960         person providing peer specialist services be certified
  961         or supervised by a licensed behavioral health care
  962         professional or a certified peer specialist; providing
  963         an exception; authorizing the department, a behavioral
  964         health managing entity, or the Medicaid program to
  965         reimburse a peer specialist service as a recovery
  966         service; encouraging Medicaid managed care plans to
  967         use peer specialists in providing recovery services;
  968         requiring peer specialists to meet the requirements of
  969         a background screening as a condition of employment
  970         and continued employment; requiring the department to
  971         forward fingerprints to the Department of Law
  972         Enforcement; requiring that fees for state and federal
  973         fingerprint processing be borne by the peer specialist
  974         applying for employment; providing that any arrest
  975         record identified through background screening be
  976         forwarded to the department; authorizing the
  977         Department of Children and Families or the agency to
  978         contract with certain vendors for fingerprinting;
  979         specifying requirements for vendors; specifying
  980         offenses to be considered in the background screening
  981         of a peer specialist; authorizing a person who does
  982         not meet background screening requirements to request
  983         an exemption from disqualification from the department
  984         or the agency; providing that all peer specialists
  985         certified as of the effective date of this act are
  986         recognized as having met the requirements of this act;
  987         amending ss. 212.055, 394.495, 394.496, 394.9085,
  988         397.416, 409.972, 440.102, 464.012, and 744.2007,
  989         F.S.; conforming cross-references; making technical
  990         changes; providing an effective date.