Florida Senate - 2022 SB 282 By Senator Rouson 19-00096-22 2022282__ 1 A bill to be entitled 2 An act relating to mental health and substance use 3 disorders; amending s. 394.4573, F.S.; providing that 4 the use of peer specialists is an essential element of 5 a coordinated system of care in recovery from a 6 substance use disorder or mental illness; making a 7 technical change; amending s. 397.4073, F.S.; revising 8 background screening requirements for certain peer 9 specialists; revising authorizations relating to work 10 by applicants who have committed disqualifying 11 offenses; making a technical change; amending s. 12 397.417, F.S.; providing legislative findings and 13 intent; revising requirements for certification as a 14 peer specialist; requiring the Department of Children 15 and Families to develop a training program for peer 16 specialists and to give preference to trainers who are 17 certified peer specialists; requiring the training 18 program to coincide with a competency exam and be 19 based on current practice standards; authorizing the 20 department to certify peer specialists, either 21 directly or by approving a third-party credentialing 22 entity; prohibiting third-party credentialing entities 23 from conducting background screenings for peer 24 specialists; requiring that a person providing 25 recovery support services be certified or be 26 supervised by a licensed behavioral health care 27 professional or a certain certified peer specialist; 28 authorizing the department, a behavioral health 29 managing entity, or the Medicaid program to reimburse 30 recovery support services as a recovery service; 31 encouraging Medicaid managed care plans to use peer 32 specialists in providing recovery services; requiring 33 peer specialists and certain persons to meet the 34 requirements of a background screening as a condition 35 of employment and continued employment; requiring 36 certain entities to forward fingerprints to specified 37 entities; requiring the department to screen results 38 to determine if the peer specialist meets the 39 certification requirements; requiring that fees for 40 state and federal fingerprint processing be borne by 41 the peer specialist applying for employment; requiring 42 that any arrest record identified through background 43 screening be reported to the department; authorizing 44 the department or the Agency for Health Care 45 Administration to contract with certain vendors for 46 fingerprinting; specifying requirements for vendors; 47 specifying disqualifying offenses for a peer 48 specialist who applies for certification; authorizing 49 a person who does not meet background screening 50 requirements to request an exemption from 51 disqualification from the department or the agency; 52 providing that a peer specialist certified as of the 53 effective date of the act is deemed to satisfy the 54 requirements of the act; providing an effective date. 55 56 Be It Enacted by the Legislature of the State of Florida: 57 58 Section 1.Paragraph (l) of subsection (2) and subsection 59 (3) of section 394.4573, Florida Statutes, are amended to read: 60 394.4573Coordinated system of care; annual assessment; 61 essential elements; measures of performance; system improvement 62 grants; reports.On or before December 1 of each year, the 63 department shall submit to the Governor, the President of the 64 Senate, and the Speaker of the House of Representatives an 65 assessment of the behavioral health services in this state. The 66 assessment shall consider, at a minimum, the extent to which 67 designated receiving systems function as no-wrong-door models, 68 the availability of treatment and recovery services that use 69 recovery-oriented and peer-involved approaches, the availability 70 of less-restrictive services, and the use of evidence-informed 71 practices. The assessment shall also consider the availability 72 of and access to coordinated specialty care programs and 73 identify any gaps in the availability of and access to such 74 programs in the state. The departments assessment shall 75 consider, at a minimum, the needs assessments conducted by the 76 managing entities pursuant to s. 394.9082(5). Beginning in 2017, 77 the department shall compile and include in the report all plans 78 submitted by managing entities pursuant to s. 394.9082(8) and 79 the departments evaluation of each plan. 80 (2)The essential elements of a coordinated system of care 81 include: 82 (l)Recovery support, including, but not limited to, the 83 use of peer specialists to assist in the individuals recovery 84 from a substance use disorder or mental illness; support for 85 competitive employment, educational attainment, independent 86 living skills development, family support and education, 87 wellness management, and self-care;, and assistance in obtaining 88 housing that meets the individuals needs. Such housing may 89 include mental health residential treatment facilities, limited 90 mental health assisted living facilities, adult family care 91 homes, and supportive housing. Housing provided using state 92 funds must provide a safe and decent environment free from abuse 93 and neglect. 94 (3)SYSTEM IMPROVEMENT GRANTS.Subject to a specific 95 appropriation by the Legislature, the department may award 96 system improvement grants to managing entities based on a 97 detailed plan to enhance services in accordance with the no 98 wrong-door model as defined in subsection (1) and to address 99 specific needs identified in the assessment prepared by the 100 department pursuant to this section. Such a grant must be 101 awarded through a performance-based contract that links payments 102 to the documented and measurable achievement of system 103 improvements. 104 Section 2.Paragraphs (a) and (g) of subsection (1) of 105 section 397.4073, Florida Statutes, are amended to read: 106 397.4073Background checks of service provider personnel. 107 (1)PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND 108 EXCEPTIONS. 109 (a)For all individuals screened on or after July 1, 2022 110 2019, background checks shall apply as follows: 111 1.All owners, directors, chief financial officers, and 112 clinical supervisors of service providers are subject to level 2 113 background screening as provided under s. 408.809 and chapter 114 435. Inmate substance abuse programs operated directly or under 115 contract with the Department of Corrections are exempt from this 116 requirement. 117 2.All service provider personnel who have direct contact 118 with children receiving services or with adults who are 119 developmentally disabled receiving services are subject to level 120 2 background screening as provided under s. 408.809 and chapter 121 435. 122 3.All peer specialists who have direct contact with 123 individuals receiving services are subject to a background 124 screening as provided in s. 397.417(5) level 2 background 125 screening as provided under s. 408.809 and chapter 435. 126 (g)If 5 years or more, or 3 years or more in the case of a 127 certified peer specialist or an individual seeking certification 128 as a peer specialist pursuant to s. 397.417, have elapsed since 129 an applicant for an exemption from disqualification has 130 completed or has been lawfully released from confinement, 131 supervision, or a nonmonetary condition imposed by a court for 132 the applicants most recent disqualifying offense, the applicant 133 may work with adults with substance use disorders, mental health 134 disorders, or co-occurring disorders under the supervision of 135 persons who meet all personnel requirements of this chapter for 136 up to 180 90 days after being notified of his or her 137 disqualification or until the department makes a final 138 determination regarding his or her request for an exemption from 139 disqualification, whichever is earlier. 140 Section 3.Section 397.417, Florida Statutes, is amended to 141 read: 142 397.417Peer specialists. 143 (1)LEGISLATIVE FINDINGS AND INTENT. 144 (a)The Legislature finds that: 145 1.The ability to provide adequate behavioral health 146 services is limited by a shortage of professionals and 147 paraprofessionals. 148 2.The state is experiencing an increase in opioid 149 addictions, many of which prove fatal. 150 3.Peer specialists provide effective support services 151 because they share common life experiences with the persons they 152 assist. 153 4.Peer specialists promote a sense of community among 154 those in recovery. 155 5.Research has shown that peer support facilitates 156 recovery and reduces health care costs. 157 6.Persons who are otherwise qualified to serve as peer 158 specialists may have a criminal history that prevents them from 159 meeting background screening requirements. 160 (b)The Legislature intends to expand the use of peer 161 specialists as a cost-effective means of providing services. The 162 Legislature also intends to ensure that peer specialists meet 163 specified qualifications and modified background screening 164 requirements and are adequately reimbursed for their services. 165 (2)QUALIFICATIONS. 166 (a)A person may seek certification as a peer specialist if 167 he or she has been in recovery from a substance use disorder or 168 mental illness for the past 2 years or if he or she is a family 169 member or caregiver of a person with a substance use disorder or 170 mental illness. 171 (b)To obtain certification as a peer specialist, a person 172 must complete the training program developed under subsection 173 (3), achieve a passing score on the competency exam described in 174 paragraph (3)(a), and meet the background screening requirements 175 specified in subsection (5). 176 (3)DUTIES OF THE DEPARTMENT. 177 (a)The department shall develop a training program for 178 persons seeking certification as peer specialists. The 179 department must give preference to trainers who are certified 180 peer specialists. The training program must coincide with a 181 competency exam and be based on current practice standards. 182 (b)The department may certify peer specialists directly or 183 may approve one or more third-party credentialing entities for 184 the purposes of certifying peer specialists, approving training 185 programs for individuals seeking certification as peer 186 specialists, approving continuing education programs, and 187 establishing the minimum requirements and standards applicants 188 must meet to maintain certification. Background screening 189 required for achieving certification must be conducted as 190 provided in subsection (5) and may not be conducted by third 191 party credentialing entities. 192 (c)The department shall require that a person providing 193 recovery support services be certified; however, an individual 194 who is not certified may provide recovery support services as a 195 peer specialist for up to 1 year if he or she is working toward 196 certification and is supervised by a qualified professional or 197 by a certified peer specialist who has at least 2 years of full 198 time experience as a peer specialist at a licensed behavioral 199 health organization. 200 (4)PAYMENT.Recovery support services may be reimbursed as 201 a recovery service through the department, a behavioral health 202 managing entity, or the Medicaid program. Medicaid managed care 203 plans are encouraged to use peer specialists in providing 204 recovery services. 205 (5)BACKGROUND SCREENING. 206 (a)A peer specialist, or an individual who is working 207 toward certification and providing recovery support services as 208 provided in subsection (3), must have completed or have been 209 lawfully released from confinement, supervision, or any 210 nonmonetary condition imposed by the court for any felony and 211 must undergo a background screening as a condition of initial 212 and continued employment. The applicant must submit a full set 213 of fingerprints to the department or to a vendor, an entity, or 214 an agency that enters into an agreement with the Department of 215 Law Enforcement as provided in s. 943.053(13). The department, 216 vendor, entity, or agency shall forward the fingerprints to the 217 Department of Law Enforcement for state processing and the 218 Department of Law Enforcement shall forward the fingerprints to 219 the Federal Bureau of Investigation for national processing. The 220 department shall screen the results to determine if a peer 221 specialist meets certification requirements. The applicant is 222 responsible for all fees charged in connection with state and 223 federal fingerprint processing and retention. The state cost for 224 fingerprint processing shall be as provided in s. 943.053(3)(e) 225 for records provided to persons or entities other than those 226 specified as exceptions therein. Fingerprints submitted to the 227 Department of Law Enforcement pursuant to this paragraph shall 228 be retained as provided in s. 435.12 and, when the Department of 229 Law Enforcement begins participation in the program, enrolled in 230 the Federal Bureau of Investigations national retained 231 fingerprint arrest notification program, as provided in s. 232 943.05(4). Any arrest record identified must be reported to the 233 department. 234 (b)The department or the Agency for Health Care 235 Administration, as applicable, may contract with one or more 236 vendors to perform all or part of the electronic fingerprinting 237 pursuant to this section. Such contracts must ensure that the 238 owners and personnel of the vendor performing the electronic 239 fingerprinting are qualified and will ensure the integrity and 240 security of all personal identifying information. 241 (c)Vendors who submit fingerprints on behalf of employers 242 must: 243 1.Meet the requirements of s. 943.053; and 244 2.Have the ability to communicate electronically with the 245 state agency accepting screening results from the Department of 246 Law Enforcement and provide the applicants full first name, 247 middle initial, and last name; social security number or 248 individual taxpayer identification number; date of birth; 249 mailing address; sex; and race. 250 (d)The background screening conducted under this 251 subsection must ensure that a peer specialist has not, during 252 the previous 3 years, been arrested for and is awaiting final 253 disposition of, been found guilty of, regardless of 254 adjudication, or entered a plea of nolo contendere or guilty to, 255 or been adjudicated delinquent and the record has not been 256 sealed or expunged for, any felony. 257 (e)The background screening conducted under this 258 subsection must ensure that a peer specialist has not been found 259 guilty of, regardless of adjudication, or entered a plea of nolo 260 contendere or guilty to, or been adjudicated delinquent and the 261 record has not been sealed or expunged for, any offense 262 prohibited under any of the following state laws or similar laws 263 of another jurisdiction: 264 1.Section 393.135, relating to sexual misconduct with 265 certain developmentally disabled clients and reporting of such 266 sexual misconduct. 267 2.Section 394.4593, relating to sexual misconduct with 268 certain mental health patients and reporting of such sexual 269 misconduct. 270 3.Section 409.920, relating to Medicaid provider fraud, if 271 the offense was a felony of the first or second degree. 272 4.Section 415.111, relating to abuse, neglect, or 273 exploitation of vulnerable adults. 274 5. Any offense that constitutes domestic violence as 275 defined in s. 741.28. 276 6.Section 777.04, relating to attempts, solicitation, and 277 conspiracy to commit an offense listed in this paragraph. 278 7.Section 782.04, relating to murder. 279 8.Section 782.07, relating to manslaughter, aggravated 280 manslaughter of an elderly person or a disabled adult, 281 aggravated manslaughter of a child, or aggravated manslaughter 282 of an officer, a firefighter, an emergency medical technician, 283 or a paramedic. 284 9.Section 782.071, relating to vehicular homicide. 285 10.Section 782.09, relating to killing an unborn child by 286 injury to the mother. 287 11.Chapter 784, relating to assault, battery, and culpable 288 negligence, if the offense was a felony. 289 12.Section 787.01, relating to kidnapping. 290 13.Section 787.02, relating to false imprisonment. 291 14.Section 787.025, relating to luring or enticing a 292 child. 293 15.Section 787.04(2), relating to leading, taking, 294 enticing, or removing a minor beyond state limits, or concealing 295 the location of a minor, with criminal intent pending custody 296 proceedings. 297 16.Section 787.04(3), relating to leading, taking, 298 enticing, or removing a minor beyond state limits, or concealing 299 the location of a minor, with criminal intent pending dependency 300 proceedings or proceedings concerning alleged abuse or neglect 301 of a minor. 302 17.Section 790.115(1), relating to exhibiting firearms or 303 weapons within 1,000 feet of a school. 304 18.Section 790.115(2)(b), relating to possessing an 305 electric weapon or device, a destructive device, or any other 306 weapon on school property. 307 19.Section 794.011, relating to sexual battery. 308 20.Former s. 794.041, relating to prohibited acts of 309 persons in familial or custodial authority. 310 21.Section 794.05, relating to unlawful sexual activity 311 with certain minors. 312 22.Section 794.08, relating to female genital mutilation. 313 23.Section 796.07, relating to procuring another to commit 314 prostitution, except for those offenses expunged pursuant to s. 315 943.0583. 316 24.Section 798.02, relating to lewd and lascivious 317 behavior. 318 25.Chapter 800, relating to lewdness and indecent 319 exposure. 320 26.Section 806.01, relating to arson. 321 27.Section 810.02, relating to burglary, if the offense 322 was a felony of the first degree. 323 28.Section 810.14, relating to voyeurism, if the offense 324 was a felony. 325 29.Section 810.145, relating to video voyeurism, if the 326 offense was a felony. 327 30.Section 812.13, relating to robbery. 328 31.Section 812.131, relating to robbery by sudden 329 snatching. 330 32.Section 812.133, relating to carjacking. 331 33.Section 812.135, relating to home-invasion robbery. 332 34.Section 817.034, relating to communications fraud, if 333 the offense was a felony of the first degree. 334 35.Section 817.234, relating to false and fraudulent 335 insurance claims, if the offense was a felony of the first or 336 second degree. 337 36.Section 817.50, relating to fraudulently obtaining 338 goods or services from a health care provider and false reports 339 of a communicable disease. 340 37.Section 817.505, relating to patient brokering. 341 38.Section 817.568, relating to fraudulent use of personal 342 identification, if the offense was a felony of the first or 343 second degree. 344 39.Section 825.102, relating to abuse, aggravated abuse, 345 or neglect of an elderly person or a disabled adult. 346 40.Section 825.1025, relating to lewd or lascivious 347 offenses committed upon or in the presence of an elderly person 348 or a disabled person. 349 41.Section 825.103, relating to exploitation of an elderly 350 person or a disabled adult, if the offense was a felony. 351 42.Section 826.04, relating to incest. 352 43.Section 827.03, relating to child abuse, aggravated 353 child abuse, or neglect of a child. 354 44.Section 827.04, relating to contributing to the 355 delinquency or dependency of a child. 356 45.Former s. 827.05, relating to negligent treatment of 357 children. 358 46.Section 827.071, relating to sexual performance by a 359 child. 360 47.Section 831.30, relating to fraud in obtaining 361 medicinal drugs. 362 48.Section 831.31, relating to the sale, manufacture, 363 delivery, or possession with intent to sell, manufacture, or 364 deliver of any counterfeit controlled substance, if the offense 365 was a felony. 366 49.Section 843.01, relating to resisting arrest with 367 violence. 368 50.Section 843.025, relating to depriving a law 369 enforcement, correctional, or correctional probation officer of 370 the means of protection or communication. 371 51.Section 843.12, relating to aiding in an escape. 372 52.Section 843.13, relating to aiding in the escape of 373 juvenile inmates of correctional institutions. 374 53.Chapter 847, relating to obscenity. 375 54.Section 874.05, relating to encouraging or recruiting 376 another to join a criminal gang. 377 55.Chapter 893, relating to drug abuse prevention and 378 control, if the offense was a felony of the second degree or 379 greater severity. 380 56.Section 895.03, relating to racketeering and collection 381 of unlawful debts. 382 57.Section 896.101, relating to the Florida Money 383 Laundering Act. 384 58.Section 916.1075, relating to sexual misconduct with 385 certain forensic clients and reporting of such sexual 386 misconduct. 387 59.Section 944.35(3), relating to inflicting cruel or 388 inhuman treatment on an inmate resulting in great bodily harm. 389 60.Section 944.40, relating to escape. 390 61.Section 944.46, relating to harboring, concealing, or 391 aiding an escaped prisoner. 392 62.Section 944.47, relating to introduction of contraband 393 into a correctional institution. 394 63.Section 985.701, relating to sexual misconduct in 395 juvenile justice programs. 396 64.Section 985.711, relating to introduction of contraband 397 into a detention facility. 398 (6)EXEMPTION REQUESTS.A person who wishes to become a 399 peer specialist and is disqualified under subsection (5) may 400 request an exemption from disqualification pursuant to s. 435.07 401 from the department or the Agency for Health Care 402 Administration, as applicable. 403 (7)GRANDFATHER CLAUSE.A peer specialist certified as of 404 July 1, 2022, is deemed to satisfy the requirements of this 405 section. 406 (1)An individual may seek certification as a peer 407 specialist if he or she has been in recovery from a substance 408 use disorder or mental illness for at least 2 years, or if he or 409 she has at least 2 years of experience as a family member or 410 caregiver of a person with a substance use disorder or mental 411 illness. 412 (2)The department shall approve one or more third-party 413 credentialing entities for the purposes of certifying peer 414 specialists, approving training programs for individuals seeking 415 certification as peer specialists, approving continuing 416 education programs, and establishing the minimum requirements 417 and standards that applicants must achieve to maintain 418 certification. To obtain approval, the third-party credentialing 419 entity must demonstrate compliance with nationally recognized 420 standards for developing and administering professional 421 certification programs to certify peer specialists. 422 (3)An individual providing department-funded recovery 423 support services as a peer specialist shall be certified 424 pursuant to subsection (2). An individual who is not certified 425 may provide recovery support services as a peer specialist for 426 up to 1 year if he or she is working toward certification and is 427 supervised by a qualified professional or by a certified peer 428 specialist who has at least 3 years of full-time experience as a 429 peer specialist at a licensed behavioral health organization. 430 Section 4.This act shall take effect July 1, 2022.