65D-30.0046. Staff Training, Qualifications, and Scope of Practice

(1) Staff Training. Providers shall develop and implement a staff development plan. At least one (1) staff member with skill in developing staff training plans shall be assigned the responsibility of ensuring that staff development activities are implemented.

(a) The staff development plan must be reviewed at least annually through the quality assurance program and revised as needed. The plan must be signed and dated.

(b) All required training activities shall be documented and accessible for Department review, including the date, duration, topic, name(s) of participants, and name(s) of the trainer or training organization.

(c) New staff orientation. Within six (6) months of the hiring date, employees must complete the following trainings:

1. A two (2) hour educational course on HIV/AIDS as required by Section 381.0035, F.S.

2. Overdose prevention training which must be renewed biennially. The training shall include, at a minimum, information about:

a. Risk factors for overdose;

b. Overdose recognition and response; and

c. Naloxone, the medication that reverses opioid overdose, including how to use Naloxone and the importance of individuals at risk of opioid overdose and their friends and family having access to Naloxone.

3. Training in incident reporting procedures and requirements in accordance with subsection 65D-30.004(17), F.A.C., the affirmative duty requirements and protections of Chapter 415, F.S., and Title V of the Americans with Disabilities Act.

4. For direct care staff working in component services identified in subsection 65D-30.004(12), F.A.C., two (2) hours of training in verbal de-escalation techniques and two (2) hours annually thereafter.

5. Staff performing nursing support functions must be trained in those services prior to performing that function.

6. For all direct care staff, training and certification in cardiopulmonary resuscitation (CPR) and first aid. Staff must maintain CPR and first aid certification, and a copy of the valid certificate must be filed in the personnel record.

(d) General Training Requirements. All staff and volunteers who provide direct care or prevention services shall participate in a minimum of 10 hours of documented training per year related to their duties and responsibilities. This includes training conducted annually in the following areas:

1. Prevention and control of infection in inpatient and residential settings;

2. Fire prevention, life safety, and disaster preparedness;

3. Safety awareness program;

4. Rights of individuals served; and

5. Federal law, 42 CFR, Part 2, and Sections 397.334(10), 397.501(7), 397.752, F.S. applicable state laws regarding confidentiality.

(e) In instances where an individual has received the requisite training as required in paragraphs (1)(c) and (d) during the year prior to employment by a provider, that individual will have met the training requirements. This provision applies only if the individual is able to produce documentation that the training was completed and that such training was provided by persons who or organizations that are qualified to provide such training

(f) Special Training Requirements for Clinical Staff. All new clinical staff who work at least 20 hours per week or more must receive 12 hours of competency-based training related to substance use disorder treatment and recovery within the first year.

(g) Special Training Requirements for Prevention. In addition to paragraphs (1)(c) and (d), new staff providing prevention services shall receive 12 hours basic training in science-based prevention within the first year of employment.

(h) Medication Administration Training Requirements. Training is required before personnel may supervise the self-administration of medication. At least two and a half (2.5) hours of training is required which may be conducted only by licensed practical nurses, licensed registered nurses or advanced practice registered nurses. Personnel responsible for training must certify by signed document or certificate the competency of unlicensed staff to supervise the self-administration of medication. Proof of training shall be documented in the personnel file and shall be completed prior to implementing the supervision of self-administration of medication.

(i) In addition to the requirements of paragraph (h), self-administration of medication training must include step-by-step procedures, covering, at a minimum, the following subjects:

1. Safe storage, handling, and disposal of medications;

2. Comprehensive understanding of and compliance with medication instructions on a prescription label, a healthcare practitioner’s order, and proper completion of medication observation record (MOR) form;

3. The medical indications and purposes for commonly used medications, their common side effects, and symptoms of adverse reactions;

4. The proper administration of oral, transdermal, ophthalmic, otic, rectal, inhaled or topical medications;

5. Safety and sanitation practices while administering medication;

6. Medication administration documentation and record keeping requirements;

7. Medical errors and medical error reporting;

8. Determinations of need for medication administration assistance and informed consent requirements;

9. Procedural arrangements for individuals who require medication offsite; and

10. Validation requirements.

(2) Clinical Supervision. A qualified professional shall supervise clinical services, as permitted within the scope of their qualifications. In addition, all licensed and unlicensed staff shall be supervised by a clinical supervisor. In the case of medical services, medical staff may provide supervision within the scope of their license. Supervisors shall conduct regular reviews of work performed by subordinate employees. Clinical supervision may include supervisory participation in treatment planning meetings, staff meetings, observation of group sessions and private feedback sessions with personnel. The date, duration, and content of supervisory sessions shall be clearly documented for staff in each licensed component and made available for Department review.

(3) Scope of Practice for Clinical Staff. Clinical staff who are not qualified professionals providing services specific to substance use disorders are limited to the following tasks unless otherwise specified in this rule:

(a) Screening;

(b) Psychosocial assessment;

(c) Treatment planning;

(d) Referral;

(e) Service coordination;

(f) Consultation;

(g) Continuing assessment and treatment plan reviews;

(h) Recovery support services;

(i) Crisis intervention;

(j) Individual, family, and community education;

(k) Documentation of progress;

(l) Any other tasks permitted in these rules and appropriate to that licensable component; and

(m) Counseling, including;

1. Individual counseling;

2. Group counseling; and

3. Counseling with families, couples, and significant others.

(4) Staff Qualifications.

(a) Staff must provide services within the scope of their professional licensure certification or training and competence in applicable clinical protocols.

(b) Bachelor’s or master’s degree level clinical staff must hold a degree from an accredited university or college with a major in counseling, social work, psychology, nursing, rehabilitation, special education, health education, or a related human services field.

(5) Scope of Practice for staff who are peer specialists who provide services specific to substance use disorder treatment.

(a) Peer specialists providing Department-funded peer support services shall be certified by a peer specialist credentialing organization that is recognized by the Department, or the peer specialists shall be working towards certification for up to one year.

(b) Peer specialists may provide the following services: 

1. Referral and linkage,

2. Service coordination,

3. Recovery support services,

4. Facilitation of recovery group meetings, excluding twelve-step meetings and therapeutic or clinical group counseling sessions,

5. Non-clinical crisis support,

6. Individual, family, and community education,

7. Outreach,

8. Recovery goal setting and planning assistance,

9. Advocacy,

10. Documentation of recovery plan progress, and

11. Participation in treatment team planning and process.

Rulemaking Authority 397.321(5) FS. Law Implemented 397.321, 397.410 FS. History–New 8-29-19, Amended 7-20-23.