Florida Senate - 2019                                     SB 528
       By Senator Rouson
       19-00604-19                                            2019528__
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance use
    3         disorders; amending s. 394.455, F.S.; defining the
    4         term “peer specialist”; amending s. 394.4572, F.S.;
    5         requiring a specific level of screening for peer
    6         specialists working in mental health programs and
    7         facilities; amending s. 394.4573, F.S.; specifying
    8         that the use of peer specialists for recovery support
    9         is an essential element of a coordinated system of
   10         behavioral health care; amending s. 397.311, F.S.;
   11         defining the term “peer specialist”; amending s.
   12         397.4073, F.S.; conforming provisions to changes made
   13         by the act; creating s. 397.417, F.S.; providing
   14         legislative findings and intent; authorizing a person
   15         to seek certification as a peer specialist if he or
   16         she meets specified qualifications; requiring a
   17         background screening, completion of a training
   18         program, and a passing score on a competency exam for
   19         a qualified person to obtain certification as a peer
   20         specialist; requiring the Department of Children and
   21         Families to develop a training program for peer
   22         specialists and to give preference to trainers who are
   23         certified peer specialists; requiring the training
   24         program to coincide with a competency exam and to be
   25         based on current practice standards; requiring the
   26         department to certify peer specialists directly or by
   27         designating a nonprofit certification organization;
   28         requiring that a person providing peer specialist
   29         services be certified or supervised by a licensed
   30         behavioral health care professional or a certified
   31         peer specialist; authorizing the department, a
   32         behavioral health managing entity, or the Medicaid
   33         program to reimburse a peer specialist service as a
   34         recovery service; encouraging Medicaid managed care
   35         plans to use peer specialists in providing recovery
   36         services; requiring peer specialists to meet the
   37         requirements of a background screening as a condition
   38         of employment and continued employment; authorizing
   39         the department or the Agency for Health Care
   40         Administration to require by rule that fingerprints be
   41         submitted electronically to the Department of Law
   42         Enforcement; authorizing the Department of Children
   43         and Families or the agency to contract with certain
   44         vendors for fingerprinting; specifying requirements
   45         for vendors; specifying offenses to be considered in
   46         the background screening of a peer specialist;
   47         authorizing a person who does not meet background
   48         screening requirements to request an exemption from
   49         disqualification from the department or the agency;
   50         providing that all peer specialists certified as of
   51         the effective date of this act are recognized as
   52         having met the requirements of this act; amending s.
   53         397.487, F.S.; revising legislative findings relating
   54         to voluntary certification of recovery residences;
   55         requiring recovery residences to comply with specified
   56         Florida Fire Prevention Code provisions; revising
   57         background screening requirements for owners,
   58         directors, and chief financial officers of recovery
   59         residences; amending s. 397.4873, F.S.; providing
   60         exceptions to limitations on referrals by recovery
   61         residences to licensed service providers; prohibiting
   62         recovery residences and specified affiliated
   63         individuals from benefiting from certain referrals;
   64         amending s. 435.07, F.S.; authorizing the exemption of
   65         certain persons from disqualification from employment;
   66         amending ss. 212.055, 394.495, 394.496, 394.9085,
   67         397.416, 409.972, 440.102, 464.012, and 744.2007,
   68         F.S.; conforming cross-references; making technical
   69         changes; providing an effective date.
   71  Be It Enacted by the Legislature of the State of Florida:
   73         Section 1. Present subsections (32) through (48) of section
   74  394.455, Florida Statutes, are redesignated as subsections (33)
   75  through (49), respectively, and a new subsection (32) is added
   76  to that section, to read:
   77         394.455 Definitions.—As used in this part, the term:
   78         (32) “Peer specialist” means a person who has been in
   79  recovery from a substance use disorder or mental illness for the
   80  past 2 years or a family member or caregiver of a person with a
   81  substance use disorder or mental illness and who is certified
   82  under s. 397.417.
   83         Section 2. Paragraph (a) of subsection (1) of section
   84  394.4572, Florida Statutes, is amended to read:
   85         394.4572 Screening of mental health personnel.—
   86         (1)(a) The department and the Agency for Health Care
   87  Administration shall require level 2 background screening
   88  pursuant to chapter 435 for mental health personnel. “Mental
   89  health personnel” includes all program directors, professional
   90  clinicians, staff members, and volunteers working in public or
   91  private mental health programs and facilities who have direct
   92  contact with individuals held for examination or admitted for
   93  mental health treatment. For purposes of this chapter,
   94  employment screening of mental health personnel also includes,
   95  but is not limited to, employment screening as provided under
   96  chapter 435 and s. 408.809. The department and the Agency for
   97  Health Care Administration shall require a level 2 background
   98  screening pursuant to s. 397.417(5) for persons working as peer
   99  specialists in public or private mental health programs or
  100  facilities and who have direct contact with individuals held for
  101  involuntary examination or admitted for mental health treatment.
  102         Section 3. Paragraph (l) of subsection (2) of section
  103  394.4573, Florida Statutes, is amended to read:
  104         394.4573 Coordinated system of care; annual assessment;
  105  essential elements; measures of performance; system improvement
  106  grants; reports.—On or before December 1 of each year, the
  107  department shall submit to the Governor, the President of the
  108  Senate, and the Speaker of the House of Representatives an
  109  assessment of the behavioral health services in this state. The
  110  assessment shall consider, at a minimum, the extent to which
  111  designated receiving systems function as no-wrong-door models,
  112  the availability of treatment and recovery services that use
  113  recovery-oriented and peer-involved approaches, the availability
  114  of less-restrictive services, and the use of evidence-informed
  115  practices. The department’s assessment shall consider, at a
  116  minimum, the needs assessments conducted by the managing
  117  entities pursuant to s. 394.9082(5). Beginning in 2017, the
  118  department shall compile and include in the report all plans
  119  submitted by managing entities pursuant to s. 394.9082(8) and
  120  the department’s evaluation of each plan.
  121         (2) The essential elements of a coordinated system of care
  122  include:
  123         (l) Recovery support, including, but not limited to, the
  124  use of peer specialists as described in s. 397.417 to assist in
  125  the individual’s recovery from a substance use disorder or
  126  mental illness, support for competitive employment, educational
  127  attainment, independent living skills development, family
  128  support and education, wellness management and self-care, and
  129  assistance in obtaining housing that meets the individual’s
  130  needs. Such housing may include mental health residential
  131  treatment facilities, limited mental health assisted living
  132  facilities, adult family care homes, and supportive housing.
  133  Housing provided using state funds must provide a safe and
  134  decent environment free from abuse and neglect.
  135         Section 4. Present subsections (30) through (49) of section
  136  397.311, Florida Statutes, are redesignated as subsections (31)
  137  through (50), respectively, and a new subsection (30) is added
  138  to that section, to read:
  139         397.311 Definitions.—As used in this chapter, except part
  140  VIII, the term:
  141         (30) Peer specialist” means a person who has been in
  142  recovery from a substance use disorder or mental illness for the
  143  past 2 years or a family member or caregiver of a person with a
  144  substance use disorder or mental illness and who is certified
  145  under s. 397.417.
  146         Section 5. Paragraph (f) of subsection (1) and paragraphs
  147  (b) and (c) of subsection (4) of section 397.4073, Florida
  148  Statutes, are amended to read:
  149         397.4073 Background checks of service provider personnel.—
  152         (f) Service provider personnel who request an exemption
  153  from disqualification must submit the request within 30 days
  154  after being notified of the disqualification. If 5 years or more
  155  have elapsed since the most recent disqualifying offense,
  156  service provider personnel may work with adults with mental
  157  health or substance use disorders or co-occurring disorders
  158  under the supervision of a qualified professional licensed under
  159  chapter 490 or chapter 491 or a master’s-level-certified
  160  addictions professional until the agency makes a final
  161  determination regarding the request for an exemption from
  162  disqualification.
  164         (b) Since rehabilitated substance abuse impaired persons
  165  are effective in the successful treatment and rehabilitation of
  166  individuals with substance use disorders, for service providers
  167  which treat adolescents 13 years of age and older, service
  168  provider personnel whose background checks indicate crimes under
  169  s. 817.563, s. 893.13, or s. 893.147 may be exempted from
  170  disqualification from employment pursuant to this paragraph.
  171         (c) The department may grant exemptions from
  172  disqualification which would limit service provider personnel to
  173  working with adults in substance use disorder abuse treatment
  174  facilities.
  175         Section 6. Section 397.417, Florida Statutes, is created to
  176  read:
  177         397.417 Behavioral health peer specialists.—
  179         (a) The Legislature finds that:
  180         1. The ability to provide adequate behavioral health
  181  services is limited by a shortage of professionals and
  182  paraprofessionals.
  183         2. The state is experiencing an increase in opioid
  184  addictions, which prove fatal to persons in many cases.
  185         3. Peer specialists provide effective support services
  186  because they share common life experiences with the persons they
  187  assist.
  188         4. Peer specialists promote a sense of community among
  189  those in recovery.
  190         5. Research has shown that peer support facilitates
  191  recovery and reduces health care costs.
  192         6. Peer specialists may have a criminal history that
  193  prevents them from meeting background screening requirements.
  194         (b) The Legislature intends to expand the use of peer
  195  specialists as a cost-effective means of providing services by
  196  ensuring that peer specialists meet specified qualifications,
  197  meet modified background screening requirements, and are
  198  adequately reimbursed for their services.
  199         (2) QUALIFICATIONS.—
  200         (a) A person may seek certification as a peer specialist if
  201  he or she has been in recovery from a substance use disorder or
  202  mental illness for the past 2 years or if he or she is a family
  203  member or caregiver of a person with a substance use disorder or
  204  mental illness.
  205         (b) To obtain certification as a peer specialist, a person
  206  must meet the background screening requirements of subsection
  207  (5), complete the training program, and achieve a passing score
  208  on the competency exam described in paragraph (3)(a).
  209         (3) DUTIES OF THE DEPARTMENT.—
  210         (a) The department shall develop a training program for
  211  persons seeking certification as peer specialists. The
  212  department must give preference to trainers who are certified
  213  peer specialists. The training program must coincide with a
  214  competency exam and be based on current practice standards.
  215         (b) The department shall certify peer specialists. The
  216  department may certify peer specialists directly or may
  217  designate a private, nonprofit certification organization to
  218  certify peer specialists, implement the training program, and
  219  administer the competency exam.
  220         (c) The department must require that a person providing
  221  peer specialist services be certified or be supervised by a
  222  licensed behavioral health care professional or a certified peer
  223  specialist.
  224         (4) PAYMENT.—Peer specialist services may be reimbursed as
  225  a recovery service through the department, a behavioral health
  226  managing entity, or the Medicaid program. Medicaid managed care
  227  plans are encouraged to use peer specialists in providing
  228  recovery services.
  229         (5) BACKGROUND SCREENING.—
  230         (a) A peer specialist must have completed or have been
  231  lawfully released from confinement, supervision, or any
  232  nonmonetary condition imposed by the court for any felony and
  233  must undergo a background screening as a condition of employment
  234  and continued employment. The background screening must include
  235  fingerprinting for statewide criminal history records checks
  236  through the Department of Law Enforcement and national criminal
  237  history records checks through the Federal Bureau of
  238  Investigation. The background screening may include local
  239  criminal records checks through local law enforcement agencies.
  240         (b) The department or the Agency for Health Care
  241  Administration, as applicable, may require by rule that
  242  fingerprints submitted pursuant to this section be submitted
  243  electronically to the Department of Law Enforcement.
  244         (c) The department or the Agency for Health Care
  245  Administration, as applicable, may contract with one or more
  246  vendors to perform all or part of the electronic fingerprinting
  247  pursuant to this section. Such contracts must ensure that the
  248  owners and personnel of the vendor performing the electronic
  249  fingerprinting are qualified and will ensure the integrity and
  250  security of all personal identifying information.
  251         (d) Vendors who submit fingerprints on behalf of employers
  252  must:
  253         1. Meet the requirements of s. 943.053; and
  254         2. Have the ability to communicate electronically with the
  255  department or the Agency for Health Care Administration, as
  256  applicable, and to accept screening results from the Department
  257  of Law Enforcement and provide the applicant’s full first name,
  258  middle initial, and last name; social security number or
  259  individual taxpayer identification number; date of birth;
  260  mailing address; sex; and race.
  261         (e) The background screening under this section must ensure
  262  that a peer specialist has not, during the previous 3 years,
  263  been arrested for and is awaiting final disposition of, been
  264  found guilty of, regardless of adjudication, or entered a plea
  265  of nolo contendere or guilty to, or been adjudicated delinquent
  266  and the record has not been sealed or expunged for, any felony.
  267         (f) The background screening under this section must ensure
  268  that a peer specialist has not been found guilty of, regardless
  269  of adjudication, or entered a plea of nolo contendere or guilty
  270  to, or been adjudicated delinquent and the record has not been
  271  sealed or expunged for, any offense prohibited under any of the
  272  following state laws or similar laws of another jurisdiction:
  273         1. Section 393.135, relating to sexual misconduct with
  274  certain developmentally disabled clients and reporting of such
  275  sexual misconduct.
  276         2. Section 394.4593, relating to sexual misconduct with
  277  certain mental health patients and reporting of such sexual
  278  misconduct.
  279         3. Section 409.9201, relating to Medicaid fraud.
  280         4. Section 415.111, relating to adult abuse, neglect, or
  281  exploitation of aged persons or disabled adults.
  282         5.Section 741.28, relating to domestic violence.
  283         6. Section 777.04, relating to attempts, solicitation, and
  284  conspiracy to commit an offense listed in this section.
  285         7. Section 782.04, relating to murder.
  286         8. Section 782.07, relating to manslaughter, aggravated
  287  manslaughter of an elderly person or disabled adult, aggravated
  288  manslaughter of a child, or aggravated manslaughter of an
  289  officer, a firefighter, an emergency medical technician, or a
  290  paramedic.
  291         9. Section 782.071, relating to vehicular homicide.
  292         10. Section 782.09, relating to killing of an unborn child
  293  by injury to the mother.
  294         11. Chapter 784, relating to assault, battery, and culpable
  295  negligence, if the offense was a felony.
  296         12. Section 787.01, relating to kidnapping.
  297         13. Section 787.02, relating to false imprisonment.
  298         14. Section 787.025, relating to luring or enticing a
  299  child.
  300         15. Section 787.04(2), relating to leading, taking,
  301  enticing, or removing a minor beyond the state limits, or
  302  concealing the location of a minor, with criminal intent pending
  303  custody proceedings.
  304         16. Section 787.04(3), relating to leading, taking,
  305  enticing, or removing a minor beyond the state limits, or
  306  concealing the location of a minor, with criminal intent pending
  307  dependency proceedings or proceedings concerning alleged abuse
  308  or neglect of a minor.
  309         17. Section 790.115(1), relating to exhibiting firearms or
  310  weapons within 1,000 feet of a school.
  311         18. Section 790.115(2)(b), relating to possessing an
  312  electric weapon or device, destructive device, or other weapon
  313  on school property.
  314         19. Section 794.011, relating to sexual battery.
  315         20.Former s. 794.041, relating to prohibited acts of
  316  persons in familial or custodial authority.
  317         21. Section 794.05, relating to unlawful sexual activity
  318  with certain minors.
  319         22. Section 794.08, relating to female genital mutilation.
  320         23. Section 798.02, relating to lewd and lascivious
  321  behavior.
  322         24. Chapter 800, relating to lewdness and indecent
  323  exposure.
  324         25. Section 806.01, relating to arson.
  325         26. Section 810.02, relating to burglary, if the offense
  326  was a felony of the first degree.
  327         27. Section 810.14, relating to voyeurism, if the offense
  328  was a felony.
  329         28. Section 810.145, relating to video voyeurism, if the
  330  offense was a felony.
  331         29. Section 812.13, relating to robbery.
  332         30. Section 812.131, relating to robbery by sudden
  333  snatching.
  334         31. Section 812.133, relating to carjacking.
  335         32. Section 812.135, relating to home-invasion robbery.
  336         33.Section 817.50, relating to fraudulently obtaining
  337  goods or services from a health care provider and false reports
  338  of a communicable disease.
  339         34. Section 817.505, relating to patient brokering.
  340         35. Section 825.102, relating to abuse, aggravated abuse,
  341  or neglect of an elderly person or disabled adult.
  342         36. Section 825.1025, relating to lewd or lascivious
  343  offenses committed upon or in the presence of an elderly person
  344  or disabled person.
  345         37. Section 825.103, relating to exploitation of an elderly
  346  person or disabled adult, if the offense was a felony.
  347         38. Section 826.04, relating to incest.
  348         39. Section 827.03, relating to child abuse, aggravated
  349  child abuse, or neglect of a child.
  350         40. Section 827.04, relating to contributing to the
  351  delinquency or dependency of a child.
  352         41. Former s. 827.05, relating to negligent treatment of
  353  children.
  354         42. Section 827.071, relating to sexual performance by a
  355  child.
  356         43.Section 831.30, relating to fraud in obtaining
  357  medicinal drugs.
  358         44. Section 831.31, relating to sale, manufacture,
  359  delivery, possession with intent to sell, manufacture, or
  360  deliver any counterfeit controlled substance if the offense was
  361  a felony.
  362         45. Section 843.01, relating to resisting arrest with
  363  violence.
  364         46. Section 843.025, relating to depriving a law
  365  enforcement, correctional, or correctional probation officer of
  366  the means of protection or communication.
  367         47. Section 843.12, relating to aiding in an escape.
  368         48. Section 843.13, relating to aiding in the escape of
  369  juvenile inmates of correctional institutions.
  370         49. Chapter 847, relating to obscene literature.
  371         50. Section 874.05, relating to encouraging or recruiting
  372  another to join a criminal gang.
  373         51. Chapter 893, relating to drug abuse prevention and
  374  control, if the offense was a felony of the second degree or
  375  greater severity.
  376         52.Section 895.03, relating to racketeering and collection
  377  of unlawful debts.
  378         53. Section 896.101, relating to the Florida Money
  379  Laundering Act.
  380         54. Section 916.1075, relating to sexual misconduct with
  381  certain forensic clients and reporting of such sexual
  382  misconduct.
  383         55. Section 944.35(3), relating to inflicting cruel or
  384  inhuman treatment on an inmate resulting in great bodily harm.
  385         56. Section 944.40, relating to escape.
  386         57. Section 944.46, relating to harboring, concealing, or
  387  aiding an escaped prisoner.
  388         58. Section 944.47, relating to introduction of contraband
  389  into a correctional facility.
  390         59. Section 985.701, relating to sexual misconduct in
  391  juvenile justice programs.
  392         60. Section 985.711, relating to contraband introduced into
  393  detention facilities.
  394         (6) EXEMPTION REQUESTS.—A person who wishes to become a
  395  peer specialist and is disqualified under subsection (5) may
  396  request an exemption from disqualification pursuant to s. 435.07
  397  from the department or the Agency for Health Care
  398  Administration, as applicable.
  399         (7) GRANDFATHER CLAUSE.—All peer specialists certified as
  400  of the effective date of this act are recognized as having met
  401  the requirements of this act.
  402         Section 7. Subsection (1), paragraph (m) of subsection (3),
  403  and subsection (6) of section 397.487, Florida Statutes, are
  404  amended to read:
  405         397.487 Voluntary certification of recovery residences.—
  406         (1) The Legislature finds that a person suffering from
  407  addiction has a higher success rate of achieving long-lasting
  408  sobriety when given the opportunity to build a stronger
  409  foundation by living in a recovery residence while receiving
  410  treatment or after completing treatment. The Legislature further
  411  finds that this state and its subdivisions have a legitimate
  412  state interest in protecting these persons, who represent a
  413  vulnerable consumer population in need of adequate housing. It
  414  is the intent of the Legislature to protect persons who reside
  415  in a recovery residence.
  416         (3) A credentialing entity shall require the recovery
  417  residence to submit the following documents with the completed
  418  application and fee:
  419         (m) Proof of satisfactory fire, safety, and health
  420  inspections. A recovery residence must comply with the
  421  provisions of the Florida Fire Prevention Code which apply to
  422  one-family and two-family dwellings, public lodging
  423  establishments, rooming houses, or other housing facilities, as
  424  applicable.
  425         (6) All owners, directors, and chief financial officers of
  426  an applicant recovery residence are subject to level 2
  427  background screening as provided under chapter 435 and s.
  428  408.809. A recovery residence is ineligible for certification,
  429  and a credentialing entity shall deny a recovery residence’s
  430  application, if any owner, director, or chief financial officer
  431  has been found guilty of, or has entered a plea of guilty or
  432  nolo contendere to, regardless of adjudication, any offense
  433  listed in s. 408.809(4) or s. 435.04(2) unless the department
  434  has issued an exemption under s. 397.4073 or s. 397.4872. In
  435  accordance with s. 435.04, the department shall notify the
  436  credentialing agency of an owner’s, director’s, or chief
  437  financial officer’s eligibility based on the results of his or
  438  her background screening.
  439         Section 8. Section 397.4873, Florida Statutes, is amended
  440  to read:
  441         397.4873 Referrals to or from recovery residences;
  442  prohibitions; penalties.—
  443         (1) A service provider licensed under this part may not
  444  make a referral of a prospective, current, or discharged patient
  445  to, or accept a referral of such a patient from, a recovery
  446  residence unless the recovery residence holds a valid
  447  certificate of compliance as provided in s. 397.487 and is
  448  actively managed by a certified recovery residence administrator
  449  as provided in s. 397.4871.
  450         (2) Subsection (1) does not apply to:
  451         (a) A licensed service provider under contract with a
  452  managing entity as defined in s. 394.9082.
  453         (b) Referrals by a recovery residence to a licensed service
  454  provider when a resident has experienced a recurrence of
  455  substance use and, in the best judgment of the recovery
  456  residence administrator, it appears that the resident may
  457  benefit from clinical treatment services the recovery residence
  458  or its owners, directors, operators, or employees do not
  459  benefit, directly or indirectly, from the referral.
  460         (c) Referrals made before January 1, 2020 July 1, 2018, by
  461  a licensed service provider to that licensed service provider’s
  462  wholly owned subsidiary, if applications and associated fees are
  463  submitted by July 1, 2019.
  464         (3) A recovery residence or its owners, directors,
  465  operators, employees, or volunteers may not receive a pecuniary
  466  benefit, directly or indirectly, from a licensed service
  467  provider for a referral made pursuant to subsection (1) or
  468  subsection (2).
  469         (4)(3) For purposes of this section, a licensed service
  470  provider or recovery residence shall be considered to have made
  471  a referral if the provider or recovery residence has informed a
  472  patient by any means about the name, address, or other details
  473  of a recovery residence or licensed service provider, or
  474  informed a licensed service provider or a recovery residence of
  475  any identifying details about a patient.
  476         (5)(4) A licensed service provider shall maintain records
  477  of referrals to or from recovery residences as may be prescribed
  478  by the department in rule.
  479         (6)(5) After June 30, 2019, a licensed service provider
  480  violating this section shall be subject to an administrative
  481  fine of $1,000 per occurrence. Repeat violations of this section
  482  may subject a provider to license suspension or revocation
  483  pursuant to s. 397.415.
  484         (7)(6) Nothing in this section requires a licensed service
  485  provider to refer a patient to or to accept a referral of a
  486  patient from a recovery residence.
  487         Section 9. Subsection (2) of section 435.07, Florida
  488  Statutes, is amended to read:
  489         435.07 Exemptions from disqualification.—Unless otherwise
  490  provided by law, the provisions of this section apply to
  491  exemptions from disqualification for disqualifying offenses
  492  revealed pursuant to background screenings required under this
  493  chapter, regardless of whether those disqualifying offenses are
  494  listed in this chapter or other laws.
  495         (2) Persons employed, or applicants for employment, by
  496  treatment providers who treat adolescents 13 years of age and
  497  older, and who are disqualified from employment solely because
  498  of crimes under s. 796.07(2)(e), s. 810.02(4), s. 812.014(2)(c),
  499  s. 817.563, s. 831.01, s. 831.02, s. 893.13, or s. 893.147, and
  500  any related criminal attempt, solicitation, or conspiracy under
  501  s. 777.04, may be exempted from disqualification from employment
  502  pursuant to this chapter without application of the waiting
  503  period in subparagraph (1)(a)1.
  504         Section 10. Paragraph (e) of subsection (5) of section
  505  212.055, Florida Statutes, is amended to read:
  506         212.055 Discretionary sales surtaxes; legislative intent;
  507  authorization and use of proceeds.—It is the legislative intent
  508  that any authorization for imposition of a discretionary sales
  509  surtax shall be published in the Florida Statutes as a
  510  subsection of this section, irrespective of the duration of the
  511  levy. Each enactment shall specify the types of counties
  512  authorized to levy; the rate or rates which may be imposed; the
  513  maximum length of time the surtax may be imposed, if any; the
  514  procedure which must be followed to secure voter approval, if
  515  required; the purpose for which the proceeds may be expended;
  516  and such other requirements as the Legislature may provide.
  517  Taxable transactions and administrative procedures shall be as
  518  provided in s. 212.054.
  519         (5) COUNTY PUBLIC HOSPITAL SURTAX.—Any county as defined in
  520  s. 125.011(1) may levy the surtax authorized in this subsection
  521  pursuant to an ordinance either approved by extraordinary vote
  522  of the county commission or conditioned to take effect only upon
  523  approval by a majority vote of the electors of the county voting
  524  in a referendum. In a county as defined in s. 125.011(1), for
  525  the purposes of this subsection, “county public general
  526  hospital” means a general hospital as defined in s. 395.002
  527  which is owned, operated, maintained, or governed by the county
  528  or its agency, authority, or public health trust.
  529         (e) A governing board, agency, or authority shall be
  530  chartered by the county commission upon this act becoming law.
  531  The governing board, agency, or authority shall adopt and
  532  implement a health care plan for indigent health care services.
  533  The governing board, agency, or authority shall consist of no
  534  more than seven and no fewer than five members appointed by the
  535  county commission. The members of the governing board, agency,
  536  or authority shall be at least 18 years of age and residents of
  537  the county. A No member may not be employed by or affiliated
  538  with a health care provider or the public health trust, agency,
  539  or authority responsible for the county public general hospital.
  540  The following community organizations shall each appoint a
  541  representative to a nominating committee: the South Florida
  542  Hospital and Healthcare Association, the Miami-Dade County
  543  Public Health Trust, the Dade County Medical Association, the
  544  Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade
  545  County. This committee shall nominate between 10 and 14 county
  546  citizens for the governing board, agency, or authority. The
  547  slate shall be presented to the county commission and the county
  548  commission shall confirm the top five to seven nominees,
  549  depending on the size of the governing board. Until such time as
  550  the governing board, agency, or authority is created, the funds
  551  provided for in subparagraph (d)2. shall be placed in a
  552  restricted account set aside from other county funds and not
  553  disbursed by the county for any other purpose.
  554         1. The plan shall divide the county into a minimum of four
  555  and maximum of six service areas, with no more than one
  556  participant hospital per service area. The county public general
  557  hospital shall be designated as the provider for one of the
  558  service areas. Services shall be provided through participants’
  559  primary acute care facilities.
  560         2. The plan and subsequent amendments to it shall fund a
  561  defined range of health care services for both indigent persons
  562  and the medically poor, including primary care, preventive care,
  563  hospital emergency room care, and hospital care necessary to
  564  stabilize the patient. For the purposes of this section,
  565  “stabilization” means stabilization as defined in s. 397.311 s.
  566  397.311(45). Where consistent with these objectives, the plan
  567  may include services rendered by physicians, clinics, community
  568  hospitals, and alternative delivery sites, as well as at least
  569  one regional referral hospital per service area. The plan shall
  570  provide that agreements negotiated between the governing board,
  571  agency, or authority and providers shall recognize hospitals
  572  that render a disproportionate share of indigent care, provide
  573  other incentives to promote the delivery of charity care to draw
  574  down federal funds where appropriate, and require cost
  575  containment, including, but not limited to, case management.
  576  From the funds specified in subparagraphs (d)1. and 2. for
  577  indigent health care services, service providers shall receive
  578  reimbursement at a Medicaid rate to be determined by the
  579  governing board, agency, or authority created pursuant to this
  580  paragraph for the initial emergency room visit, and a per-member
  581  per-month fee or capitation for those members enrolled in their
  582  service area, as compensation for the services rendered
  583  following the initial emergency visit. Except for provisions of
  584  emergency services, upon determination of eligibility,
  585  enrollment shall be deemed to have occurred at the time services
  586  were rendered. The provisions for specific reimbursement of
  587  emergency services shall be repealed on July 1, 2001, unless
  588  otherwise reenacted by the Legislature. The capitation amount or
  589  rate shall be determined before program implementation by an
  590  independent actuarial consultant. In no event shall such
  591  reimbursement rates exceed the Medicaid rate. The plan must also
  592  provide that any hospitals owned and operated by government
  593  entities on or after the effective date of this act must, as a
  594  condition of receiving funds under this subsection, afford
  595  public access equal to that provided under s. 286.011 as to any
  596  meeting of the governing board, agency, or authority the subject
  597  of which is budgeting resources for the retention of charity
  598  care, as that term is defined in the rules of the Agency for
  599  Health Care Administration. The plan shall also include
  600  innovative health care programs that provide cost-effective
  601  alternatives to traditional methods of service and delivery
  602  funding.
  603         3. The plan’s benefits shall be made available to all
  604  county residents currently eligible to receive health care
  605  services as indigents or medically poor as defined in paragraph
  606  (4)(d).
  607         4. Eligible residents who participate in the health care
  608  plan shall receive coverage for a period of 12 months or the
  609  period extending from the time of enrollment to the end of the
  610  current fiscal year, per enrollment period, whichever is less.
  611         5. At the end of each fiscal year, the governing board,
  612  agency, or authority shall prepare an audit that reviews the
  613  budget of the plan, delivery of services, and quality of
  614  services, and makes recommendations to increase the plan’s
  615  efficiency. The audit shall take into account participant
  616  hospital satisfaction with the plan and assess the amount of
  617  poststabilization patient transfers requested, and accepted or
  618  denied, by the county public general hospital.
  619         Section 11. Subsection (3) of section 394.495, Florida
  620  Statutes, is amended to read:
  621         394.495 Child and adolescent mental health system of care;
  622  programs and services.—
  623         (3) Assessments must be performed by:
  624         (a) A professional as defined in s. 394.455(5), (7), (33)
  625  (32), (36) (35), or (37) (36);
  626         (b) A professional licensed under chapter 491; or
  627         (c) A person who is under the direct supervision of a
  628  qualified professional as defined in s. 394.455(5), (7), (33)
  629  (32), (36) (35), or (37) (36) or a professional licensed under
  630  chapter 491.
  631         Section 12. Subsection (5) of section 394.496, Florida
  632  Statutes, is amended to read:
  633         394.496 Service planning.—
  634         (5) A professional as defined in s. 394.455(5), (7), (33)
  635  (32), (36) (35), or (37) (36) or a professional licensed under
  636  chapter 491 must be included among those persons developing the
  637  services plan.
  638         Section 13. Subsection (6) of section 394.9085, Florida
  639  Statutes, is amended to read:
  640         394.9085 Behavioral provider liability.—
  641         (6) For purposes of this section, the term terms
  642  “detoxification services,has the same meaning as
  643  detoxification in s. 397.311(26)(a), “addictions receiving
  644  facility,has the same meaning as provided in s.
  645  397.311(26)(a), and “receiving facility” has have the same
  646  meaning meanings as those provided in s. 394.455 ss.
  647  397.311(26)(a)4., 397.311(26)(a)1., and 394.455(39),
  648  respectively.
  649         Section 14. Section 397.416, Florida Statutes, is amended
  650  to read:
  651         397.416 Substance use disorder abuse treatment services;
  652  qualified professional.—Notwithstanding any other provision of
  653  law, a person who was certified through a certification process
  654  recognized by the former Department of Health and Rehabilitative
  655  Services before January 1, 1995, may perform the duties of a
  656  qualified professional with respect to substance use abuse
  657  treatment services as defined in this chapter, and need not meet
  658  the certification requirements contained in s. 397.311(35) s.
  659  397.311(34).
  660         Section 15. Paragraph (b) of subsection (1) of section
  661  409.972, Florida Statutes, is amended to read:
  662         409.972 Mandatory and voluntary enrollment.—
  663         (1) The following Medicaid-eligible persons are exempt from
  664  mandatory managed care enrollment required by s. 409.965, and
  665  may voluntarily choose to participate in the managed medical
  666  assistance program:
  667         (b) Medicaid recipients residing in residential commitment
  668  facilities operated through the Department of Juvenile Justice
  669  or in a treatment facility as defined in s. 394.455 s.
  670  394.455(47).
  671         Section 16. Paragraphs (d) and (g) of subsection (1) of
  672  section 440.102, Florida Statutes, are amended to read:
  673         440.102 Drug-free workplace program requirements.—The
  674  following provisions apply to a drug-free workplace program
  675  implemented pursuant to law or to rules adopted by the Agency
  676  for Health Care Administration:
  677         (1) DEFINITIONS.—Except where the context otherwise
  678  requires, as used in this act:
  679         (d) “Drug rehabilitation program” means a service provider
  680  as defined in s. 397.311 which, established pursuant to s.
  681  397.311(43), that provides confidential, timely, and expert
  682  identification, assessment, and resolution of employee drug
  683  abuse.
  684         (g) “Employee assistance program” means an established
  685  program capable of providing expert assessment of employee
  686  personal concerns; confidential and timely identification
  687  services with regard to employee drug abuse; referrals of
  688  employees for appropriate diagnosis, treatment, and assistance;
  689  and followup services for employees who participate in the
  690  program or require monitoring after returning to work. If, in
  691  addition to the above activities, an employee assistance program
  692  provides diagnostic and treatment services, these services shall
  693  in all cases be provided by service providers as defined in s.
  694  397.311 pursuant to s. 397.311(43).
  695         Section 17. Paragraph (e) of subsection (4) of section
  696  464.012, Florida Statutes, is amended to read:
  697         464.012 Licensure of advanced practice registered nurses;
  698  fees; controlled substance prescribing.—
  699         (4) In addition to the general functions specified in
  700  subsection (3), an advanced practice registered nurse may
  701  perform the following acts within his or her specialty:
  702         (e) A psychiatric nurse, who meets the requirements in s.
  703  394.455(36) s. 394.455(35), within the framework of an
  704  established protocol with a psychiatrist, may prescribe
  705  psychotropic controlled substances for the treatment of mental
  706  disorders.
  707         Section 18. Subsection (7) of section 744.2007, Florida
  708  Statutes, is amended to read:
  709         744.2007 Powers and duties.—
  710         (7) A public guardian may not commit a ward to a treatment
  711  facility, as defined in s. 394.455 s. 394.455(47), without an
  712  involuntary placement proceeding as provided by law.
  713         Section 19. This act shall take effect July 1, 2019.