The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Appropriations
BILL: CS/SB 282
INTRODUCER: Appropriations Committee; and Senator Rouson and others
SUBJECT: Mental Health and Substance Use Disorders
DATE: January 31, 2022
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Delia Cox CF Favorable
2. Sneed Money AHS Recommend: Favorable
3. Sneed Sadberry AP Fav/CS
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 282 promotes the use of peer specialists to assist an individual’s recovery from substance
use disorder (SUD) or mental illness. Peer specialists are persons who have recovered from a
substance use disorder or mental illness who support a person with a current substance use
disorder or mental illness.
Specifically, the bill:
Adds the use of peer specialists as an essential element of a coordinated system of care;
Provides legislative findings and intent related to the use of peer specialists in the provision
of behavioral health care;
Requires the DCF to designate a managing entity with an existing certified recovery peer
specialist training program to provide training for persons seeking certification as peer
specialists. The managing entity must give preference to trainers who are currently certified
peer specialists;
Requires the training program to coincide with a competency exam and be based on current
practice standards;
Revises background screening requirements for peer specialists;
Adds offenses for which individuals seeking certification as a peer specialist may seek an
exemption from eligibility disqualification;
Allows peer specialists to work with adults with mental health disorders, in addition to SUDs
and co-occurring disorders, while a request for an exemption from a background check
disqualification is pending;
REVISED: BILL: CS/SB 282 Page 2
Expands the statutory limit for the number of days during which a service provider can work
while a request for exemption from a background check disqualification is pending to 180
days from the current 90 days; and
Provides that individuals certified as peer specialists by July 1, 2022, will be deemed to have
met the requirements for certification under the bill, but will be required to comply with
minimum standards and requirements needed to maintain certification.
The bill is expected to have an insignificant negative fiscal impact on state government. See
Section V. Fiscal Impact Statement.
The bill is effective July 1, 2022.
II. Present Situation:
Substance Abuse
Substance abuse is the harmful or hazardous use of psychoactive substances, including alcohol
and illicit drugs. Substance use disorder (SUD) is determined based on specified criteria included
in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
1
According
to the DSM-5, a diagnosis of SUD is based on evidence of impaired control, social impairment,
risky use, and pharmacological criteria.
2
SUD occurs when an individual chronically uses
alcohol or drugs, resulting in significant impairment, such as health problems, disability, and
failure to meet major responsibilities at work, school, or home.
3
Repeated drug use leads to
changes in the brain’s structure and function that can make a person more susceptible to
developing a substance abuse disorder.
4
Imaging studies of brains belonging to persons with
SUD reveal physical changes in areas of the brain critical to judgment, decision making, learning
and memory, and behavior control.
5
In 2020, approximately 40.3 million people aged 12 or older had a SUD related to corresponding
use of alcohol or illicit drugs within the previous year, including 28.3 million people diagnosed
with alcohol use disorder (AUD), 18.4 million people diagnosed with drug use disorder, and 6.5
million people diagnosed with both AUD and SUD.
6
The most common substance abuse
1
The World Health Organization, Mental Health and Substance Abuse, available at
https://www.who.int/westernpacific/about/how-we-work/programmes/mental-health-and-substance-abuse; the National
Institute on Drug Abuse (NIDA), The Science of Drug Use and Addiction: The Basics, available at
https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics (last visited January 27, 2022).
2
The National Association of Addiction Treatment Providers, Substance Use Disorder, available at
https://www.naatp.org/resources/clinical/substance-use-disorder (last visited January 27, 2022).
3
The Substance Abuse and Mental Health Services Administration (The SAMHSA), Substance Use Disorders, available at
http://www.samhsa.gov/disorders/substance-use (last visited January 27, 2022).
4
The NIDA, Drugs, Brains, and Behavior: The Science of Addiction, available at
https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction (last visited January
27, 2022).
5
Id.
6
The SAMHSA, Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National
Survey on Drug Use and Health, p. 3, available at
https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PD
FW102121.pdf (last visited January 27, 2022). BILL: CS/SB 282 Page 3
disorders in the United States are from the use of alcohol, tobacco, cannabis, opioids,
hallucinogens, and stimulants.
7
The number of drug overdose deaths in the U.S. rose by nearly 29% over a 12-month period
ending in April 2021, to an estimated 100,306.
8
Over 75% of overdose deaths during this period
were attributable to opioids.
9
Opioid-related deaths increased by 35% over comparative 12-
month periods, from approximately 56,064 as of April 2020 to 75,673 in the period ending in
April 2021.
10
Substance Abuse Treatment in Florida
In the early 1970s, the federal government enacted laws creating formula grants for states to
develop continuums of care for individuals and families affected by substance abuse.
11
The laws
resulted in separate funding streams and requirements for alcoholism and drug abuse. In response
to the laws, the Florida Legislature enacted chs. 396 and 397, F.S., relating to alcohol and drug
abuse, respectively.
12
Each of these laws governed different aspects of addiction, and thus had
different rules adopted by the state to fully implement the respective pieces of legislation.
13
However, because persons with substance abuse issues often do not restrict their misuse to one
substance or another, having two separate laws dealing with the prevention and treatment of
addiction was cumbersome and did not adequately address Florida’s substance abuse problem.
14
In 1993, legislation was adopted to combine ch. 396 and 397, F.S., into a single law, the Hal S.
Marchman Alcohol and Other Drug Services Act (Marchman Act).
15
The Marchman Act encourages individuals to seek services on a voluntary basis within the
existing financial and space capacities of a service provider.
16
However, denial of addiction is a
prevalent symptom of SUD, creating a barrier to timely intervention and effective treatment.
17
7
The Rural Health Information Hub, Defining Substance Abuse and Substance Use Disorders, available at
https://www.ruralhealthinfo.org/toolkits/substance-abuse/1/definition (last visited January 27, 2022).
8
The Center for Disease Control and Prevention, National Center for Health Statistics, Vital Statistics Rapid Release:
Provisional Drug Overdose Death Counts, available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm (last
visited January 27, 2022).
9
U.S. News and World Report, CDC Data: Drug Overdose Deaths Top 100k for First Time, November 17, 2021, available
at https://www.usnews.com/news/health-news/articles/2021-11-17/drug-overdose-deaths-top-100k-over-12-months-for-first-
time (last visited January 27, 2022).
10
Id.
11
The DCF, Baker Act and Marchman Act Project Team Report for Fiscal Year 2016-2017, p. 4-5. (on file with the Senate
Children, Families, and Elder Affairs Committee).
12
Id.
13
Id.
14
Id.
15
Chapter 93-39, s. 2, Laws of Fla., codifying current ch. 397, F.S.
16
See s. 397.601(1) and (2), F.S. An individual who wishes to enter treatment may apply to a service provider for voluntary
admission. Within the financial and space capabilities of the service provider, the individual must be admitted to treatment
when sufficient evidence exists that he or she is impaired by substance abuse and his or her medical and behavioral
conditions are not beyond the safe management capabilities of the service provider.
17
Darran Duchene and Patrick Lane, Fundamentals of the Marchman Act, Risk RX, Vol. 6 No. 2 (Apr. – Jun. 2006) State
University System of Florida Self-Insurance Programs, available at http://flbog.sip.ufl.edu/risk-rx-article/fundamentals-of-
the-marchman-act/ (last visited January 27, 2022). BILL: CS/SB 282 Page 4
As a result, treatment typically must stem from a third party providing the intervention needed
for SUD treatment.
18
The Department of Children and Families (DCF) administers a statewide system of safety-net
services for substance abuse and mental health (SAMH) prevention, treatment and recovery for
children and adults who are otherwise unable to obtain these services. Services are provided
based upon state and federally established priority populations.
19
The DCF provides treatment
for SUD through a community-based provider system offering detoxification,
20
treatment
services
21
and recovery support
22
for individuals affected by substance misuse, abuse or
dependence.
23
Peer Specialists
Research has shown that social support provided by peers is beneficial to those in recovery from
a SUD or mental illness.
24
Section 397.311, F.S., defines a peer specialist as “a person who has
been in recovery from a SUD or mental illness for at least 2 years who uses his or her personal
experience to provide services in behavioral health settings to support others in their recovery, or
a person who has at least 2 years of experience as a family member or caregiver of an individual
who has a SUD or mental illness. The term does not include a qualified professional or a person
otherwise certified under ch. 394 or ch. 397.”
25
There are four primary types of social support provided by peers:
Emotional: where a peer demonstrates empathy, caring or concern to bolster a person’s self-
esteem (i.e., peer mentoring or peer-led support groups).
Informational: where a peer shares knowledge and information to provide life or vocational
skills training (i.e., parenting classes, job readiness training, or wellness seminars).
Instrumental: where a peer provides concrete assistance to help others accomplish tasks (i.e.,
child care, transportation, and help accessing health and human services).
Affiliational: where a peer facilitates contacts with other people to promote learning of social
skills, create a sense of community, and acquire a sense of belonging (i.e., recovery centers,
sports league participation, and alcohol or drug free socialization opportunities).
26
18
Id.
19
See chs. 394 and 397, F.S.
20
Detoxification services use medical and clinical procedures to assist individuals and adults as they withdraw from the
physiological and psychological effects of substance abuse.
21
Treatment services include a wide array of assessment, counseling, case management, and support that are designed to help
individuals who have lost their abilities to control their substance use on their own and require formal, structured intervention
and support.
22
Recovery support services, including transitional housing, life skills training, parenting skills, and peer-based individual
and group counseling, are offered during and following treatment to further assist individuals in their development of the
knowledge and skills necessary to maintain their recovery.
23
The DCF, Treatment for Substance Abuse, available at https://www.myflfamilies.com/service-programs/samh/substance-
abuse.shtml (last visited January 27, 2022).
24
Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, What Are Peer
Recovery Support Services?, available at https://store.samhsa.gov/system/files/sma09-4454.pdf (last visited January 27,
2022).
25
Section 397.311(30), F.S.
26
The DCF, Florida Peer Services Handbook at p. 4-5, 2016, available at https://www.myflfamilies.com/service-
programs/samh/publications/docs/peer-services/DCF-Peer-Guidance.pdf (last visited January 27, 2022). BILL: CS/SB 282 Page 5
In Florida, the DCF and Medicaid both allow reimbursement for peer support services, but only
if provided by certified peer specialists.
27
An individual seeking to become a certified peer specialist must have either been in recovery
from a SUD or mental illness for at least two years, or must have at least two years of experience
as a family member or caregiver of an individual suffering from a substance use disorder or
mental illness.
28
The DCF must approve one or more third-party credentialing entities for the
purposes of certifying peer specialists, approving training programs for individuals seeking
certification as peer specialists, approving continuing education programs, and establishing the
minimum requirements and standards that applicants must achieve to maintain certification.
29
To
obtain approval, the third-party credentialing entity must demonstrate compliance with nationally
recognized standards for developing and administering professional certification programs to
certify peer specialists.
30
All individuals providing DCF-funded recovery support services as a
peer specialist must be certified, however an individual who is not currently certified may work
as a peer specialist for a maximum of one year if they are working toward certification and are
supervised by a qualified professional or by a certified peer specialist with at least three years of
full-time experience as a peer specialist at a licensed behavioral health organization.
31
The Florida Certification Board (FCB) is currently the only credentialing entity approved by the
DCF for certifying peer specialists in the state.
32
The FCB credentials Certified Recovery Peer
Specialist (CRPS) which assist in providing client directed care by helping individuals develop
skills and relationships that will allow them to achieve and maintain recovery from SUDs and
mental illness.
33
CRPS applicants must attest to having been in recovery for a minimum of two
years.
34
The CRPS must also have demonstrated competency through training and experience in
the performance domains of: Recovery Support, Advocacy, Mentoring, and Professional
Responsibilities.
35
As of June 2020, 630 individuals maintain active CRPS certifications
statewide.
36
Individuals seeking certification must adhere to the CRPS credentialing standards and
requirements, complete a background screening, and have completed all court-ordered sanctions
related to any prior crimes committed for at least three years.
37
Prospective CRPS must also
27
The DCF, Agency Analysis for HB 369 (2019), p. 2, February 8, 2019 (on file with the Senate Committee on Children,
Families, and Elder Affairs). Florida’s Medicaid program currently covers peer recovery services; the DCF allows the state’s
behavioral health managing entities to reimburse for peer recovery services.
28
Section 397.417(1), F.S.
29
Section 397.417(2), F.S.
30
Id.
31
Section 397.417(3), F.S.
32
The DCF, Agency Analysis for SB 130 (2021 Regular Session), p. 2, December 10, 2020 (on file with the Senate
Committee on Children, Families, and Elder Affairs) (hereinafter cited as, “The DCF SB 130 (2021) Analysis”). CS/CS/SB
130 (2021) is substantially identical to SB 282.
33
Id.
34
Id.
35
Id.
36
Id.
37
Id. BILL: CS/SB 282 Page 6
successfully complete training and a competency exam demonstrating proficiency in certain
educational areas.
38
Background Screening
Substance Use Disorder and Criminal History
Certain individuals receiving substance abuse treatment may have a criminal or violent history:
about 54 percent of state prisoners and 61 percent of sentenced jail inmates incarcerated for
violent offenses met the Diagnostic and Statistical Manual of Mental Disorders, 4
th
Edition,
(DSM-IV) criteria for drug dependence or abuse.
39
Additionally, individuals who use illicit drugs
are more likely to commit crimes, and it is common for many offenses, including violent crimes,
to be committed by individuals who had used drugs or alcohol prior to committing the crime, or
who were using at the time of the offense.
40
As a result, individuals who have recovered from a
SUD or mental illness often have a criminal history, which may disqualify them from
employment in the substance abuse treatment industry due to Florida’s background screening
process.
Background Screening Process
Current law establishes standard procedures for criminal history background screening of
prospective employees; ch. 435, F.S., outlines the screening requirements. There are two levels
of background screening: level 1 and level 2. Level 1 screening includes, at a minimum,
employment history checks and statewide criminal correspondence checks through the Florida
Department of Law Enforcement (FDLE) and a check of the Dru Sjodin National Sex Offender
Public Website,
41
and may include criminal records checks through local law enforcement
agencies. A level 2 background screening includes, but is not limited to, fingerprinting for
statewide criminal history records checks through the FDLE and national criminal history checks
through the Federal Bureau of Investigation (FBI), and may include local criminal records
checks through local law enforcement agencies.
42
Every person required by law to be screened pursuant to ch. 435, F.S., must submit a complete
set of information necessary to conduct a screening to his or her employer.
43
Such information
for a level 2 screening includes fingerprints, which are taken by a vendor that submits them
electronically to the FDLE.
44
38
Id.
39
Jennifer Bronson, et al., Drug Use, Dependence, and Abuse Among State Prisoners and Jail Inmates, 2007-2009, U.S.
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics at p. 1, June 2017, available at
https://www.bjs.gov/content/pub/pdf/dudaspji0709.pdf (last visited November 17, 2021).
40
National Institute on Drug Abuse, Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-
Based Guide at p. 12, available at https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/txcriminaljustice_0.pdf (last visited
January 27, 2022).
41
The Dru Sjodin National Sex Offender Public Website is a U.S. government website that links public state, territorial, and
tribal sex offender registries in one national search site, available at https://www.nsopw.gov/ (last visited January 27, 2022).
42
Section 435.04, F.S.
43
Section 435.05(1)(a), F.S.
44
Sections 435.03(1) and 435.04(1)(a), F.S. BILL: CS/SB 282 Page 7
For both level 1 and 2 screenings, an employer must submit the information necessary for
screening to the FDLE within five working days after receiving it.
45
Additionally, for both levels
of screening, the FDLE must perform a criminal history record check of its records.
46
For a level
1 screening, this is the only information searched, and once complete, the FDLE responds to the
employer or agency, who must then inform the employee whether screening has revealed any
disqualifying information.
47
For level 2 screening, the FDLE also requests the FBI to conduct a
national criminal history record check of its records for each employee for whom the request is
made.
48
The person undergoing screening must supply any missing criminal or other necessary
information upon request to the requesting employer or agency within 30 days after receiving the
request for the information.
49
Disqualifying Offenses
Regardless of whether the screening is level 1 or level 2, the screening employer or agency must
make sure that the applicant has good moral character by ensuring that the employee has not
been arrested for and is awaiting final disposition of, been found guilty of, regardless of
adjudication, or entered a plea of nolo contendere or guilty to, or been adjudicated delinquent
and the record has not been sealed or expunged for, any of the following 52 offenses prohibited
under Florida law, or similar law of another jurisdiction:
Section 393.135, F.S., relating to sexual misconduct with certain developmentally disabled
clients and reporting of such sexual misconduct.
Section 394.4593, F.S., relating to sexual misconduct with certain mental health patients and
reporting of such sexual misconduct.
Section 415.111, F.S., relating to adult abuse, neglect, or exploitation of aged persons or
disabled adults.
Section 777.04, F.S., relating to attempts, solicitation, and conspiracy to commit an offense
listed in this subsection.
Section 782.04, F.S., relating to murder.
Section 782.07, F.S., relating to manslaughter, aggravated manslaughter of an elderly person
or disabled adult, or aggravated manslaughter of a child.
Section 782.071, F.S., relating to vehicular homicide.
Section 782.09, F.S., relating to killing of an unborn child by injury to the mother.
Chapter 784, F.S., relating to assault, battery, and culpable negligence, if the offense was a
felony.
Section 784.011, F.S., relating to assault, if the victim of the offense was a minor.
Section 784.03, F.S., relating to battery, if the victim of the offense was a minor.
Section 787.01, F.S., relating to kidnapping.
Section 787.02, F.S., relating to false imprisonment.
Section 787.025, F.S., relating to luring or enticing a child.
45
Section 435.05(1)(b)-(c), F.S.
46
Id.
47
Section 435.05(1)(b), F.S.
48
Section 435.05(1)(c), F.S.
49
Section 435.05(1)(d), F.S. BILL: CS/SB 282 Page 8
Section 787.04(2), F.S., relating to taking, enticing, or removing a child beyond the state
limits with criminal intent pending custody proceedings.
Section 787.04(3), F.S., relating to carrying a child beyond the state lines with criminal intent
to avoid producing a child at a custody hearing or delivering the child to the designated
person.
Section 790.115(1), F.S., relating to exhibiting firearms or weapons within 1,000 feet of a
school.
Section 790.115(2)(b), F.S., relating to possessing an electric weapon or device, destructive
device, or other weapon on school property.
Section 794.011, F.S., relating to sexual battery.
Former s. 794.041, F.S., relating to prohibited acts of persons in familial or custodial
authority.
Section 794.05, F.S., relating to unlawful sexual activity with certain minors.
Chapter 796, F.S., relating to prostitution.
Section 798.02, F.S., relating to lewd and lascivious behavior.
Chapter 800, F.S., relating to lewdness and indecent exposure.
Section 806.01, F.S., relating to arson.
Section 810.02, F.S., relating to burglary.
Section 810.14, F.S., relating to voyeurism, if the offense is a felony.
Section 810.145, F.S., relating to video voyeurism, if the offense is a felony.
Chapter 812, F.S., relating to theft, robbery, and related crimes, if the offense is a felony.
Section 817.563, F.S., relating to fraudulent sale of controlled substances, only if the offense
was a felony.
Section 825.102, F.S., relating to abuse, aggravated abuse, or neglect of an elderly person or
disabled adult.
Section 825.1025, F.S., relating to lewd or lascivious offenses committed upon or in the
presence of an elderly person or disabled adult.
Section 825.103, F.S., relating to exploitation of an elderly person or disabled adult, if the
offense was a felony.
Section 826.04, F.S., relating to incest.
Section 827.03, F.S., relating to child abuse, aggravated child abuse, or neglect of a child.
Section 827.04, F.S., relating to contributing to the delinquency or dependency of a child.
Former s. 827.05, F.S., relating to negligent treatment of children.
Section 827.071, F.S., relating to sexual performance by a child.
Section 843.01, F.S., relating to resisting arrest with violence.
Section 843.025, F.S., relating to depriving a law enforcement, correctional, or correctional
probation officer of means of protection or communication.
Section 843.12, F.S., relating to aiding in an escape.
Section 843.13, F.S., relating to aiding in the escape of juvenile inmates in correctional
institutions.
Chapter 847, F.S., relating to obscene literature.
Section 874.05, F.S., relating to encouraging or recruiting another to join a criminal gang.
Chapter 893, F.S., relating to drug abuse prevention and control, only if the offense was a
felony or if any other person involved in the offense was a minor. BILL: CS/SB 282 Page 9
Section 916.1075, F.S., relating to sexual misconduct with certain forensic clients and
reporting of such sexual misconduct.
Section 944.35(3), F.S., relating to inflicting cruel or inhuman treatment on an inmate
resulting in great bodily harm.
Section 944.40, F.S., relating to escape.
Section 944.46, F.S., relating to harboring, concealing, or aiding an escaped prisoner.
Section 944.47, F.S., relating to introduction of contraband into a correctional facility.
Section 985.701, F.S., relating to sexual misconduct in juvenile justice programs.
Section 985.711, F.S., relating to contraband introduced into detention facilities.
50
Exemption from Disqualification
If an individual is disqualified due to a pending arrest, conviction, plea of nolo contendere, or
adjudication of delinquency to one or more of the disqualifying offenses, s. 435.07, F.S., allows
the Secretary of the appropriate agency (in the case of substance abuse treatment, the DCF) to
exempt applicants from disqualification under certain circumstances.
51
Receiving an exemption allows that individual to work despite the disqualifying crime in that
person’s past. However, an individual who is considered a sexual predator,
52
career offender,
53
or
sexual offender (unless not required to register)
54
cannot ever be exempted from
disqualification.
55
Additionally, individuals (including peer specialists) employed, or applicants for employment,
by treatment providers who treat adolescents 13 years of age and older who are disqualified from
employment solely because of certain crimes may be exempted from disqualification from
employment, without applying the 3-year waiting period.
56
These crimes include certain offenses
related to:
Prostitution;
Unarmed burglary of a structure;
Third degree felony grand theft;
Sale of imitation controlled substance;
Forgery;
Uttering or publishing a forged instrument;
Sale, manufacture, delivery, or possession with intent to sell, manufacture, or deliver
controlled substances (excluding drug trafficking);
Use, possession, manufacture, delivery, transportation, advertisement, or sale of drug
paraphernalia; and
Any related criminal attempt, solicitation, or conspiracy.
57
50
Section 435.04(2), F.S.
51
See Section 435.07(1), F.S.
52
Section 775.21, F.S.
53
Section 775.261, F.S.
54
Section 943.0435, F.S.
55
Section 435.07(4)(b), F.S.
56
Section 435.07(2), F.S.
57
Id. BILL: CS/SB 282 Page 10
To seek exemption from disqualification, an employee must submit a request for an exemption
from disqualification within 30 days after being notified of a pending disqualification, and the
DCF must grant or deny the application within 60 days of the receipt of a completed
application.
58
To be exempted from disqualification and thus be able to work, the applicant must demonstrate
by clear and convincing evidence that he or she should not be disqualified from employment.
59
Clear and convincing evidence is a heavier burden than the preponderance of the evidence
standard but less than beyond a reasonable doubt.
60
This means that the evidence presented is
credible and verifiable, and that the memories of witnesses are clear and without confusion.
61
This evidence must create a firm belief and conviction of the truth of the facts presented and,
considered as a whole, must convince DCF representatives without hesitancy that the requester
will not pose a threat if allowed to hold a position of special trust relative to children, vulnerable
adults, or to developmentally disabled individuals.
62
Evidence that may support an exemption
includes, but is not limited to:
Personal references.
Letters from employers or other professionals.
Evidence of rehabilitation, including documentation of successful participation in a
rehabilitation program.
Evidence of further education or training.
Evidence of community involvement.
Evidence of special awards or recognition.
Evidence of military service.
Parenting or other caregiver experiences.
63
After the DCF receives a complete exemption request package from the applicant, the
background screening coordinator searches available data, including, but not limited to, a review
of records and pertinent court documents including case disposition and the applicant’s plea in
order to determine the appropriateness of granting the applicant an exemption.
64
These materials,
in addition to the information provided by the applicant, form the basis for a recommendation as
to whether the exemption should be granted.
65
After all reasonable evidence is gathered, the background screening coordinator consults with his
or her supervisor and, after consultation with the supervisor, the coordinator and the supervisor
will recommend whether the exemption should be granted.
66
The regional legal counsel’s office
58
Section 397.4073(1)(f), F.S.
59
Section 435.07(3)(a), F.S.
60
The DCF, CF Operating Procedure 60-18, Personnel: Exemption from Disqualification, at p. 1, (Aug. 1, 2010), available
at https://www.myflfamilies.com/admin/publications/cfops/CFOP%20060-xx%20Human%20Resources/CFOP%2060-
18,%20Exemption%20from%20Disqualification.pdf (last visited January 27, 2022) (hereinafter, “The DCF Operating
Procedure”).
61
Id.
62
Id.
63
Id. at 3-4.
64
Id. at 5.
65
Id.
66
Id. BILL: CS/SB 282 Page 11
reviews the recommendation to grant or deny an exemption to determine legal sufficiency. The
criminal justice coordinator in the region in which the background screening coordinator is
located also reviews the exemption request file and recommendation and makes an initial
determination whether to grant or deny the exemption.
67
If the regional criminal justice coordinator makes an initial determination that the exemption
should be granted, the exemption request file and recommendations are forwarded to the regional
director, who has delegated authority from the DCF Secretary to grant or deny the exemption.
68
After an exemption request decision is final, the background screener provides a written response
to the applicant as to whether the request is granted or denied.
69
If the DCF grants the exemption, the applicant and the facility or employer are notified of the
decision by regular mail.
70
However, if the request is denied, notification of the decision is sent
by certified mail, return receipt requested, to the applicant, addressed to the last known address
and a separate letter of denial is sent by regular mail to the facility or employer.
71
If the
application is denied, the denial letter must set forth pertinent facts that the background screening
coordinator, the background screening coordinator’s supervisor, the criminal justice coordinator,
and regional director, where appropriate, used in deciding to deny the exemption request.
72
It
must also inform the denied applicant of the availability of an administrative review
73
pursuant to
ch. 120, F.S.
74
Individuals Requiring Background Screening Under Ch. 397, F.S.
Only certain individuals affiliated with substance abuse treatment providers require background
screening. Section 397.4073, F.S., requires peer specialists who have direct contact
75
with
individuals receiving services must undergo a level 2 background screening as provided under s.
408.809 and ch. 435.
76
Applicant peer specialists are required to pay the costs associated with
such screenings.
77
Similarly, all owners, directors, chief financial officers, and clinical
supervisors of service providers, as well as all service provider personnel who have direct
contact with children receiving services or with adults who are developmentally disabled
receiving services must also undergo level 2 background screening.
Other statutory provisions are tailored to facilitate individuals in recovery who have
disqualifying offenses being able to work in substance abuse treatment. The DCF may grant
exemptions from disqualification for an individual seeking certification as a peer specialist if at
least three years have passed since the individual has completed, or been lawfully released from,
67
Id.
68
Id.
69
Id. at 5.
70
Id. at 6.
71
Id.
72
Id.
73
All notices of denial of an exemption shall advise the applicant of the basis for the denial, that an administrative hearing
pursuant to s. 120.57, F.S., may be requested, and that the request must be made within 21 days of receipt of the denial letter
or the applicant’s right to an appeal will be waived.
74
The DCF Operating Procedure at 6.
75
Direct contact is not defined in ch. 397, F.S.
76
Section 397.4073(a)3., F.S.
77
Section 408.809(5), F.S. BILL: CS/SB 282 Page 12
any confinement, supervision, or nonmonetary condition imposed by a court for the individual’s
most recent disqualifying offense.
78
Similar to the conditional employment granted to other
select applicants in s. 397.4073, certified peer specialists may work with adults with SUD for up
to 90 days after being notified of his or her disqualification or until the DCF makes a final
determination regarding the request for an exemption from disqualification if three years or more
have elapsed since the most recent disqualifying offense, whichever is earlier.
79
Managing Entities (MEs)
The DCF administers a statewide system of safety-net services for substance abuse and mental
health (SAMH) prevention, treatment and recovery for children and adults who are otherwise
unable to obtain these services. SAMH programs include a range of prevention, acute
interventions (e.g. crisis stabilization), residential treatment, transitional housing, outpatient
treatment, and recovery support services. Services are provided based upon state and federally
established priority populations.
80
In 2001, the Legislature authorized the DCF to implement behavioral health managing entities
(ME) as the management structure for the delivery of local mental health and substance abuse
services.
81
The implementation of the ME system initially began on a pilot basis and, in 2008,
the Legislature authorized DCF to implement MEs statewide.
82
Full implementation of the
statewide ME system occurred in 2013 and all geographic regions are now served by a managing
entity.
83
The DCF contracts with the following seven MEs below:
Northwest Florida Health Network.
Lutheran Services Florida.
Central Florida Cares Health System.
Central Florida Behavioral Health Network, Inc.
Southeast Florida Behavioral Health.
Broward Behavioral Health Network, Inc.
Thriving Mind South Florida.
84
78
Section 397.4073(4)(b)1.a., F.S.
79
Section 397.4073(1)(g), F.S.
80
See chs. 394 and 397, F.S.
81
Chapter 2001-191, L.O.F.
82
Chapter 2008-243, L.O.F.
83
Florida Tax Watch, Analysis of Florida’s Behavioral Health Managing Entity Models, p. 4, March 2015, available at
https://floridataxwatch.org/Research/Full-Library/ArtMID/34407/ArticleID/15758/Analysis-of-Floridas-Behavioral-Health-
Managing-Entities-Model (last visited January 27, 2022).
84
The DCF, Assessment of Behavioral Health Services, Fiscal Year 2021-2022, Dec. 1, 2021, p. 5, available at
https://www.myflfamilies.com/service-
programs/samh/publications/docs/Assessment%20of%20Behavioral%20Health%20Services%20FY%2021-
22%20with%20Appendix%201.pdff (last visited January 27, 2022)(hereinafter cited as “The 2021-2022 Report”). BILL: CS/SB 282 Page 13
The MEs in turn contract with local service providers for the delivery of mental health and
substance abuse services.
85
In Fiscal Year 2020-21, the network service providers under contract
with the MEs served 225,927 individuals.
86
III. Effect of Proposed Changes:
Coordinated System of Care
The bill amends s. 394.4573, F.S., relating to coordinated systems of care, to add the use of peer
specialists to assist in an individual’s recovery from a substance use disorder or mental illness to
the list of essential elements of a coordinated system of behavioral health care.
Legislative Findings and Intent
The bill provides legislative findings and intent, as follows:
The Legislature finds that the ability to provide adequate behavioral health services is limited
by a shortage of professionals and paraprofessionals.
The Legislature finds that the state is experiencing an increase in opioid addictions, many of
which prove fatal.
The Legislature finds that peer specialists provide effective support services because they
share common life experiences with the persons they assist.
The Legislature finds that peer specialists promote a sense of community among those in
recovery.
The Legislature finds that research has shown that peer support facilitates recovery and
reduces health care costs.
The Legislature finds that persons who are otherwise qualified to serve as peer specialists
may have a criminal history that prevents them from meeting background screening
requirements.
It is the intent of the Legislature that the use of peer specialists be expanded as a cost-
effective means of providing services.
It is the intent of the Legislature to ensure that peer specialists meet specified qualifications
and modified background screening requirements and are adequately reimbursed for their
services.
Criteria for Becoming a Certified Peer Specialist
The bill codifies a number of criteria currently used by the Florida Certification Board (FCB) in
the process of certifying peer specialists. Specifically, the bill requires that persons seeking
certification as peer specialists:
Be in recovery from a substance use disorder (SUD) or mental illness for the past two years,
or be a family member or caregiver of an individual with a history of SUD or mental illness;
Pass a competency exam developed under the bill by the Department of Children and
Families (DCF); and
85
Managing entities create and manage provider networks by contracting with service providers for the delivery of substance
abuse and mental health services.
86
The 2021-2022 Report at p. 10. BILL: CS/SB 282 Page 14
Undergo background screening as provided under the bill.
Duties of the Department of Children and Families (DCF)
Currently, the FCB provides training and administers a competency exam for peer specialists
seeking certification. The bill requires the Department of Children and Families (DCF) to
designate an ME with an existing certified peer specialist training program to provide training for
those applying to become certified peer specialists. The ME must give preference to trainers who
have already achieved certification, and the training program offered by the managing entity
must be based on current practice standards.
Individuals may practice as a peer specialist prior to becoming certified for up to one year if the
individual is actively working toward certification and is supervised by a qualified professional
87
or a certified peer specialist with at least two years of full-time experience as a peer specialist at
a licensed behavioral health organization.
Background Screening
The bill specifies revised background screening requirements, requiring applicants to submit a
full set of fingerprints to the DCF, or to a vendor, entity, or agency
88
that has entered into an
agreement with the Florida Department of Law Enforcement (FDLE). Fingerprints must then be
forwarded to the FDLE for state processing and retention, and to the FBI for national processing
and retention. This will enable the FDLE to conduct ongoing, fingerprint-based, state and
national background checks on certified peer specialists. The bill mandates any arrest record
discovered be reported to the DCF. The bill requires the DCF to screen results in order to ensure
an applicant meets the requirements of certification, and it provides that the applicant peer
specialist is to pay all fees charged in connection with state and federal fingerprint processing
and retention.
89
The bill authorizes the DCF or the Agency for Health Care Administration (the AHCA) to
contract with vendors for electronic fingerprinting, provided that such contracts ensure the
integrity and security of all personal identifying information obtained. Vendors who submit
fingerprints on behalf of employees must:
Meet the requirements of s. 943.053, F.S.;
90
87
Section 397.311(35) defines “qualified professional” to mean “a physician or a physician assistant licensed under chapter
458 or chapter 459; a professional licensed under chapter 490 or chapter 491; an advanced practice registered nurse licensed
under part I of chapter 464; or a person who is certified through a department-recognized certification process for substance
abuse treatment services and who holds, at a minimum, a bachelor’s degree.” A person who is certified in substance abuse
treatment services by a state-recognized certification process in another state at the time of employment with a licensed
substance abuse provider in this state may perform the functions of a qualified professional as defined in this chapter but
must meet certification requirements contained in this subsection no later than 1 year after his or her date of employment.
88
Section 943.053(13), F.S., provides criteria which must be followed in order for the FDLE to accept fingerprint
submissions from private vendors, entities, or agencies.
89
This cost is already borne by the applicant under current law requiring level 2 background screening for certified peer
specialists. See ss. 397.4073(1)(a)3. and 408.809(5), F.S.
90
Section 943.053, F.S., provides, among other things, standards for vendors meant to ensure that all persons having direct or
indirect responsibility for verifying identification, taking fingerprints, and electronically submitting fingerprints are qualified
to do so and will ensure the integrity and security of all personal information gathered from the persons whose fingerprints
are submitted. BILL: CS/SB 282 Page 15
Be capable of communicating electronically with the state agency accepting screening results
from the FDLE; and
Be capable of providing the applicant’s:
o Full first name, middle initial, and last name;
o Social security number or individual taxpayer identification number;
o Date of birth;
o Mailing address;
o Sex; and
o Race.
The bill provides that a background screening of a peer specialist must ensure that a prospective
peer specialist has not been arrested for and awaiting final disposition of, found guilty of,
regardless of adjudication, or entered a plea of nolo contendere or guilty to, or been adjudicated
delinquent and the record has not been sealed or expunged for, any felony within the past three
years. The bill also requires that background screening ensure the applicant has not, at any time,
been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to,
or been adjudicated delinquent and the record has not been sealed or expunged for, the following
laws or similar laws of other jurisdictions:
Section 393.135, relating to sexual misconduct with certain developmentally disabled clients
and reporting of such sexual misconduct.
Section 394.4593, relating to sexual misconduct with certain mental health patients and
reporting of such sexual misconduct.
Section 409.920, relating to Medicaid provider fraud, if the offense was a felony of the first
or second degree.
Section 415.111, relating to abuse, neglect, or exploitation of vulnerable adults.
Any offense that constitutes domestic violence as defined in s. 741.28, F.S.
Section 777.04, relating to attempts, solicitation, and conspiracy to commit an offense listed
in this paragraph.
Section 782.04, relating to murder.
Section 782.07, relating to manslaughter, aggravated manslaughter of an elderly person or a
disabled adult, aggravated manslaughter of a child, or aggravated manslaughter of an officer,
a firefighter, an emergency medical technician, or a paramedic.
Section 782.071, relating to vehicular homicide.
Section 782.09, relating to killing an unborn child by injury to the mother.
Chapter 784, relating to assault, battery, and culpable negligence, if the offense was a felony.
Section 787.01, relating to kidnapping.
Section 787.02, relating to false imprisonment.
Section 787.025, relating to luring or enticing a child.
Section 787.04(2), relating to leading, taking, enticing, or removing a minor beyond state
limits, or concealing the location of a minor, with criminal intent pending custody
proceedings.
Section 787.04(3), relating to leading, taking, enticing, or removing a minor beyond state
limits, or concealing the location of a minor, with criminal intent pending dependency
proceedings or proceedings concerning alleged abuse or neglect of a minor.
Section 790.115(1), relating to exhibiting firearms or weapons within 1,000 feet of a school. BILL: CS/SB 282 Page 16
Section 790.115(2)(b), relating to possessing an electric weapon or device, a destructive
device, or any other weapon on school property.
Section 794.011, relating to sexual battery.
Former s. 794.041, relating to prohibited acts of persons in familial or custodial authority.
Section 794.05, relating to unlawful sexual activity with certain minors.
Section 794.08, relating to female genital mutilation.
Section 796.07, relating to procuring another to commit prostitution, except for those
offenses expunged pursuant to s. 943.0583.
Section 798.02, relating to lewd and lascivious behavior.
Chapter 800, relating to lewdness and indecent exposure.
Section 806.01, relating to arson.
Section 810.02, relating to burglary, if the offense was a felony of the first degree.
Section 810.14, relating to voyeurism, if the offense was a felony.
Section 810.145, relating to video voyeurism, if the offense was a felony.
Section 812.13, relating to robbery.
Section 812.131, relating to robbery by sudden snatching.
Section 812.133, relating to carjacking.
Section 812.135, relating to home-invasion robbery.
Section 817.034, relating to communications fraud, if the offense was a felony of the first
degree.
Section 817.234, relating to false and fraudulent insurance claims, if the offense was a felony
of the first or second degree.
Section 817.50, relating to fraudulently obtaining goods or services from a health care
provider and false reports of a communicable disease.
Section 817.505, relating to patient brokering.
Section 817.568, relating to fraudulent use of personal identification, if the offense was a
felony of the first or second degree.
Section 825.102, relating to abuse, aggravated abuse, or neglect of an elderly person or a
disabled adult.
Section 825.1025, relating to lewd or lascivious offenses committed upon or in the presence
of an elderly person or a disabled person.
Section 825.103, relating to exploitation of an elderly person or a disabled adult, if the
offense was a felony.
Section 826.04, relating to incest.
Section 827.03, relating to child abuse, aggravated child abuse, or neglect of a child.
Section 827.04, relating to contributing to the delinquency or dependency of a child.
Former s. 827.05, relating to negligent treatment of children.
Section 827.071, relating to sexual performance by a child.
Section 831.30, relating to fraud in obtaining medicinal drugs.
Section 831.31, relating to sale, manufacture, delivery, possession with intent to sell,
manufacture, or deliver of any counterfeit controlled substance, if the offense was a felony.
Section 843.01, relating to resisting arrest with violence.
Section 843.025, relating to depriving a law enforcement, correctional, or correctional
probation officer of the means of protection or communication.
Section 843.12, relating to aiding in an escape. BILL: CS/SB 282 Page 17
Section 843.13, relating to aiding in the escape of juvenile inmates of correctional
institutions.
Chapter 847, relating to obscenity.
Section 874.05, relating to encouraging or recruiting another to join a criminal gang.
Chapter 893, relating to drug abuse prevention and control, if the offense was a felony of the
second degree or greater severity.
Section 895.03, relating to racketeering and collection of unlawful debts.
Section 896.101, relating to the Florida Money Laundering Act.
Section 916.1075, relating to sexual misconduct with certain forensic clients and reporting of
such sexual misconduct.
Section 944.35(3), relating to inflicting cruel or inhuman treatment on an inmate resulting in
great bodily harm.
Section 944.40, relating to escape.
Section 944.46, relating to harboring, concealing, or aiding an escaped prisoner.
Section 944.47, relating to introduction of contraband into a correctional institution.
Section 985.701, relating to sexual misconduct in juvenile justice programs.
Section 985.711, relating to introduction of contraband into a detention facility.
The new screening requirements of the bill eliminate the following disqualifying offenses from
current law for peer specialists:
Misdemeanor assault, or battery (Ch. 784, F.S.).
Prostitution (Ch. 796, F.S.), with the exception of those offenses listed in s. 796.07, F.S.,
which have not been expunged.
Lower level burglary offenses (s. 810.02, F.S.).
Lower level theft and robbery offenses (Ch. 812, F.S.).
Lower level drug abuse offenses (s. 817.563 and Ch. 893, F.S.).
Credit card fraud (ss. 817.481, 817.60, and 817.61, F.S.).
Forgery (ss. 831.01, 831.02, 831.07 and 831.09, F.S.).
The bill allows individuals who wish to become peer specialists, but have a disqualifying offense
in their background, to request an exemption from disqualification pursuant to s. 435.07, F.S.,
from the DCF or the AHCA, as applicable.
The bill also allows service provider personnel, including peer specialists, to work with adults
with mental health disorders (in addition to the current allowance to work with adults suffering
from SUDs or co-occurring disorders) while an exemption request is pending, and extends the
time limit for such work from 90 days to 180 days.
The bill grandfathers in all peer specialists certified as of July 1, 2022, by stating they are
recognized as having met the requirements of the bill. However, the bill specifies that
certification for such individuals is subject to ongoing compliance with minimum standards and
requirements needed for maintaining certification.
BILL: CS/SB 282 Page 18
Deleted Provisions of s. 397.417, F.S.
The bill eliminates and replaces several of the current provisions of s. 397.417, F.S. Specifically,
the bill:
Eliminates the requirement that a family member or caregiver of an individual with a SUD or
mental illness have at least two years of experience in order to attain certification as a peer
specialist; and
Permits an individual with two years of full-time experience as a peer specialist to supervise
an individual providing recovery support services and working toward certification
(supervisory certified peer specialists currently must have at least three years of experience).
Effective Date
The bill is effective July 1, 2022
IV. Constitutional Issues:
A. Municipality/County Mandates Restrictions:
None.
B. Public Records/Open Meetings Issues:
None.
C. Trust Funds Restrictions:
None.
D. State Tax or Fee Increases:
None.
E. Other Constitutional Issues:
None identified.
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
B. Private Sector Impact:
CS/SB 282 eliminates several disqualifying criminal offenses that often result in
disqualification from certification eligibility, and as a result the DCF stated that there BILL: CS/SB 282 Page 19
might be additional revenues generated for certification providers from fees paid by a
greater number of individuals seeking certification.
91
C. Government Sector Impact:
The DCF estimates there may be a negative impact to state government due to a potential
increase in background screenings being conducted, and a possible increase in the
number of exemptions from disqualification requested, leading to a heavier workload for
the department’s Background Screening Office.
92
However, any additional workload will
likely be absorbed within existing department resources.
VI. Technical Deficiencies:
None.
VII. Related Issues:
None.
VIII. Statutes Affected:
This bill substantially amends the following sections of the Florida Statutes: 394.4573, 397.4073,
and 397.417.
IX. Additional Information:
A. Committee Substitute – Statement of Substantial Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
CS by Appropriations on January 27, 2022:
The committee substitute:
Removes the requirement that the DCF develop a training program for peer
specialists;
Removes the ability of the DCF to directly certify peer specialists;
Requires the DCF to designate an ME with an existing certified recovery peer
specialist training program to provide training for persons seeking certification as
peer specialists. The ME must give preference to trainers who are currently certified
peer specialists;
Requires the training program to coincide with a competency exam and be based on
current practice standards;
Keeps language from current law that was struck from the original bill requiring DCF
to approve one or more third-party credentialing entities for the purposes of certifying
peer specialists, approving training programs and continuing education programs, and
establishing minimum requirements and standards applicants must achieve to
maintain certification;
91
The DCF SB 130 (2021) Analysis at p. 6.
92
Id at p. 5. BILL: CS/SB 282 Page 20
Keeps language from current law that was struck from the original bill requiring
third-party credentialing entities to demonstrate compliance with nationally
recognized standards for developing and administering professional certification
programs to certify peer specialists;
Removes language permitting recovery support services to be reimbursed through the
DCF, a managing entity, or Medicaid, and removes language encouraging managed
care plans to use peer specialists in providing recovery services;
Revises background screening requirements from those provided under the original
bill; and
Revises the grandfather clause in the original bill to specify that a peer specialist
certified as of the bill’s effective date (July 1, 2022) is grandfathered in and
considered certified subject to compliance with minimum standards and requirements
needed for maintaining certification. These minimum standards and requirements are
developed by approved third-party credentialing entities under the bill.
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.