Florida Senate - 2016 COMMITTEE AMENDMENT Bill No. SB 998 Ì561784EÎ561784 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Gaetz) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 394.88, Florida Statutes, is created to 6 read: 7 394.88 Adolescent and child residential treatment 8 programs.— 9 (1) The purpose of an adolescent and child residential 10 treatment program is to offer room and board and to provide, or 11 arrange for the provision of, specialized treatment, specialized 12 therapies as defined in s. 393.063, and services for 13 rehabilitation or habilitation as defined in s. 393.063, for 14 adolescents and children with emotional, psychological, 15 developmental, or behavioral problems or disorders, or substance 16 abuse problems. In an adolescent and child residential treatment 17 program, adolescents and children are assisted in acquiring the 18 social and behavioral skills necessary for a healthy adjustment 19 to school, family life, and community. 20 (2) As used in this section, the term: 21 (a) “Adolescent and child residential treatment program” or 22 “program” means a privately owned and operated 24-hour group 23 living environment for four or more adolescents or children 24 unrelated to the owner or provider. 25 (b) “Program resident” or “resident” means an adolescent or 26 child at least 6 and no more than 18 years of age who enrolls 27 and participates in a program. 28 (3) An adolescent and child residential treatment program 29 must be licensed by the Agency for Health Care Administration in 30 accordance with part II of chapter 408. The department, in 31 consultation with the agency and the Agency for Persons with 32 Disabilities, shall establish by rule requirements for 33 licensure, administration, and operation of programs and program 34 facilities consistent with this section. 35 (4)(a) A program must employ a licensed psychiatrist or a 36 psychologist licensed under chapter 490 as the director of the 37 program. The director is responsible for the operation of the 38 program, the program facility, and the day-to-day supervision of 39 program residents. The director or a member of program staff 40 appointed by the director as his or her substitute must be 41 present at the program facility at all times. The director shall 42 maintain on site a current list of all program residents. 43 (b) Program staff must include, in addition to the 44 director, physicians licensed under chapter 458 or chapter 459, 45 psychologists licensed under chapter 490 or chapter 491, mental 46 health counselors licensed under chapter 491, or advanced 47 registered nurse practitioners licensed under part 1 of chapter 48 464 and certified under s. 464.012 who have been trained in 49 providing medical services and treatment to adolescents and 50 children to serve as professional program staff providing 51 treatment to residents. Such professional program staff must be 52 specifically trained in providing medical services and treatment 53 to adolescents and children diagnosed with mental health and 54 substance abuse problems and to residents with disabilities if 55 the program serves these populations. A program must have a 56 minimum of two such professional staff members on duty at all 57 times and must maintain a professional staff-to-resident ratio 58 of no less than 1 to 4 during awake hours. All program staff, 59 professional and non-professional, and all providers who may be 60 contracted to provide services to residents must undergo a level 61 2 background screening before engaging in any activity that 62 brings them into contact with a resident. The department may 63 establish by rule further staffing requirements to ensure 64 resident safety and service delivery consistent with this 65 section. 66 (5) A program must ensure that a treatment plan exists for 67 each resident. The treatment plan must be reviewed and signed at 68 the time a resident enrolls and periodically after enrollment, 69 as provided in the treatment plan, by the director of the 70 program and the resident’s parent or legal guardian. The 71 department may establish by rule further requirements relating 72 to the treatment and care of residents consistent with this 73 section. 74 (6) A program must maintain written documentation of 75 compliance with the following local requirements, as applicable: 76 (a) Zoning ordinances. 77 (b) Business license requirements. 78 (c) Building codes. 79 (d) Firesafety codes and standards. 80 (e) Health codes. 81 (f) Approval from appropriate governmental agencies for new 82 program services or increased consumer capacity. 83 84 A program facility that provides services to residents with 85 disabilities must be located where schools, churches, recreation 86 facilities, and other community facilities are available. The 87 department may establish by rule further requirements relating 88 to the program facility, including, but not limited to, interior 89 and exterior building dimensions, housing and kitchen standards, 90 meal plan guidelines, medication management, resident privacy 91 and accountability for his or her personal effects, and 92 cleanliness and safety standards, consistent with this section. 93 (7) A program must: 94 (a) Provide a curriculum approved by the Department of 95 Education to residents. A program that provides its own school 96 must be recognized and approved by the State Board of Education, 97 the Southern Association of Colleges and Schools, or another 98 educational accreditation organization. 99 (b) Conduct individual, group, couple, and family 100 counseling sessions or other appropriate treatment, including 101 skills development therapy, at least weekly, or more often if 102 required by a resident’s treatment plan. The program must 103 document the time, date, and nature of such services, including 104 the signature of the counselor providing them, in the individual 105 record for each resident. 106 Section 2. Section 394.89, Florida Statutes, is created to 107 read: 108 394.89 Adolescent and child outdoor programs.— 109 (1) The purpose of an adolescent and child outdoor program 110 is to offer wilderness hiking and camping experiences through 111 program field group activities and expeditions as a form of 112 rehabilitation and treatment for adolescents or children with 113 emotional, psychological, developmental, or behavioral problems 114 or disorders, or substance abuse problems. In an adolescent and 115 child outdoor program, adolescents and children are assisted in 116 acquiring the social and behavioral skills necessary for a 117 healthy adjustment to school, family life, and community. 118 (2) As used in this section, the term: 119 (a) “Adolescent and child outdoor program” or “program” 120 means a privately owned and operated 24-hour group wilderness 121 hiking and camping experience for four or more adolescents or 122 children unrelated to the owner or provider. A program may be 123 established independently or as an adjunct and subsidiary of an 124 adolescent and child residential treatment program established 125 pursuant to s. 394.88. 126 (b) “Program participant” or “participant” means an 127 adolescent or child at least 6 and no more than 18 years of age 128 who enrolls and participates in a program. The term does not 129 include the parent or contracting agent that enrolls the 130 adolescent or child in the program. 131 (3)(a) An adolescent and child outdoor program must be 132 licensed by the Agency for Health Care Administration in 133 accordance with part II of chapter 408. The department, in 134 consultation with the agency and the Agency for Persons with 135 Disabilities, shall establish by rule requirements for 136 licensure, administration, and operation of programs consistent 137 with this section. All local, state, and federal regulations and 138 professional licensing requirements must be met by a program as 139 a condition of licensure by the agency. The agency must review 140 and approve a program’s training plan specifying the program’s 141 goals and methodologies. The training plan must include 142 provisions governing a participant’s conduct and the 143 consequences for his or her conduct while enrolled in the 144 program. 145 (b) A program must provide an educational component 146 approved by the Department of Education to a participant who is 147 absent from his or her school or educational setting for more 148 than 30 days. Before enrolling a participant, the program 149 supervisor must coordinate with the local school board to 150 provide an educational component as part of the participant’s 151 program experience. To offer educational credit to participants, 152 the program must be recognized and approved by the State Board 153 of Education. 154 (4)(a) A program must employ a licensed psychiatrist or a 155 psychologist licensed under chapter 490 as its program 156 supervisor. The program supervisor is responsible for and has 157 authority over the policies and activities of the program. The 158 program supervisor shall coordinate office and support services, 159 supervise the operations of the program, and ensure that all 160 program staff are adequately trained. The program supervisor 161 shall maintain on file at all times enrollment records of all 162 participants and a current list of participants, including each 163 participant’s group field activity or expedition and his or her 164 geographic location. The list must be updated every 24 hours. 165 The program supervisor must develop and sign a written plan for 166 each group field activity and expedition. Plans must not expose 167 participants to unreasonable risks. 168 (b) Each group field activity or expedition must have field 169 staff working directly with the participants. A program must 170 have field support staff members who are responsible for the 171 delivery of supplies to the field, mail delivery, 172 communications, and first aid support. 173 (c) Each program must provide its participants access to a 174 multidisciplinary team of licensed health care providers and 175 licensed mental health counselors who have been trained in 176 providing medical services and treatment to adolescents and 177 children and which includes, at a minimum, the following: 178 1. A physician licensed under chapter 458 or chapter 459. 179 2. At least one of the following: 180 a. A psychologist licensed under chapter 490 or chapter 181 491. 182 b. A licensed clinical social worker. 183 c. A mental health counselor licensed under chapter 491. 184 d. A licensed marriage and family therapist. 185 e. A certified school counselor. 186 (d) All program staff, professional and non-professional, 187 and all providers who may be contracted to provide services to 188 participants must undergo a level 2 background screening before 189 engaging in any activity that brings them into contact with a 190 participant. The department may establish by rule further 191 staffing requirements consistent with this section. 192 Section 3. This act shall take effect July 1, 2016. 193 194 ================= T I T L E A M E N D M E N T ================ 195 And the title is amended as follows: 196 Delete everything before the enacting clause 197 and insert: 198 A bill to be entitled 199 An act relating to adolescent and child treatment 200 programs; creating s. 394.88, F.S.; providing purpose 201 of adolescent and child residential treatment 202 programs; defining terms; requiring licensure by the 203 Agency for Health Care Administration; requiring the 204 Department of Children and Families to adopt rules for 205 the licensure, administration, and operation of 206 programs and program facilities; providing staffing 207 requirements; requiring a treatment plan for each 208 resident; requiring a review of treatment plans; 209 requiring written documentation of compliance with 210 certain local requirements; providing location 211 requirements for program facilities under certain 212 circumstances; authorizing the department to establish 213 certain requirements; requiring a program to provide a 214 curriculum; requiring a program to conduct certain 215 counseling sessions; creating s. 394.89, F.S.; 216 providing purpose of adolescent and child outdoor 217 programs; defining terms; requiring licensure by the 218 agency; requiring the department to adopt rules for 219 the licensure, administration, and operation of 220 programs; providing regulations and licensing 221 requirements for programs; providing administrative 222 requirements for programs; requiring programs to have 223 an educational component approved by the Department of 224 Education under certain circumstances; providing 225 requirements and qualifications for program staff; 226 requiring the program supervisor to maintain a current 227 list and enrollment records of all participants; 228 requiring program supervisors to develop a written 229 plan for each field group activity and expedition; 230 providing an effective date.