Amendments clarify definitions, address certification, update common licensing standards, clarify scope of practice, and clarify standards for prevention to align with current law and practice.

 

DEPARTMENT OF CHILDREN AND FAMILIES

Substance Abuse Program

RULE NOS.:RULE TITLES:

65D-30.002Definitions

65D-30.0031Certifications and Recognitions Required by Statute

65D-30.004Common Licensing Standards

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

65D-30.013Standards for Prevention

PURPOSE AND EFFECT: Amendments clarify definitions, address certification, update common licensing standards, clarify scope of practice, and clarify standards for prevention to align with current law and practice.

SUMMARY: Amendments include: 1) add definitions and remove unnecessary definitions; 2) specify the standards for developing and administering professional certification programs to certify peer specialists for organizations that desire recognition by the Department as a certifying organization for peer specialists; 3) updates background screening requirements; 4) allows APRN’s to act as a medical consultant for medical services; 5) amends provider requirements for recovery residence referrals; 6) specifies the services that may be rendered via telehealth; 7) add requirements regarding scope of practice and staff qualifications, including staff who are not licensed or certified as qualified professionals and who provide services specific to substance use, and peer specialists; 8) require providers to have on staff a certified prevention professional or individual who has successfully completed a specified federal training program; 9) remove references to universal indirect prevention services.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

A SERC has not been prepared.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: The Department used a checklist to conduct an economic analysis and determine if there is an adverse impact or regulatory costs associated with this rule that exceeds the criteria in section 120.541(2)(a), F.S. Based upon this analysis, the Department has determined that the proposed rule is not expected to require legislative ratification.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 397.321(5) F.S.

LAW IMPLEMENTED: 397.311, 397.321, 397.403, 397.4014, 397.4073, 397.4075, 397.410, 397.4103, 397.4104, 397.411, 397.417, 397.4871 F.S.

A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: January 5, 2023, 12:00 p.m.

PLACE: Join Zoom Meeting

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Meeting ID: 859 8643 3573

Passcode: 215548

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Meeting ID: 859 8643 3573

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Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: . If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Elizabeth Floyd. Elizabeth can be reached at [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65D-30.002 Definitions.

(1) through (3) No change.

(4) “Ancillary Services” as defined in section subsection 397.311(1), F.S.

(5) No change.

(6) “Authorized Agent of the Department” as defined in section subsection 397.311(2), F.S.

(7) No change.

(8) “Business Day” means a day in which the Department’s Office of Substance Abuse and Mental Health is operating for business Monday through Friday, between 8 a.m. and 5 p.m. (Eastern Standard Time).

(9) through (10)  No change.

(11) “Change or Transfer in Ownership” means, in addition to section 397.407(6), F.S.;

(a) through (c) No change.

(12) through (13)  No change.

(14) “Clinical Staff” means employees, independent contractors, and volunteers of a provider who are responsible for providing clinical services to individuals.

(15) No change.

(16) “Clinical Supervisor” as defined in section 397.311 F.S. means a person that manages personnel who provide direct clinical services, or a person who maintains lead responsibility for the overall coordination and provision of clinical services. A “Clinical Supervisor” shall meet the qualifications of a “Qualified Professional” as defined in subsection 397.311(34), F.S. For the purposes of this rule chapter a Clinical Director is considered a Clinical Supervisor.

(17) No change.

(18) “Component” or “Service Component” as defined in section 397.311 subsection 397.311(42), F.S. Each service component, except for Aftercare, is defined in section 397.311(26), F.S. Aftercare is defined above.

(a) “Addictions Receiving Facility” as defined in subsection 397.311(26), F.S.

(b) “Detoxification” as defined in subsection 397.311(26), F.S.

(c) “Intensive Inpatient Treatment” as defined in subsection 397.311(26), F.S.

(d) “Residential Treatment” as defined in subsection 397.311(26), F.S.

(e) “Day or Night Treatment with Community Housing” as defined in subsection 397.311(26), F.S.

(f) “Day or Night Treatment” as defined in subsection 397.311(26), F.S.

(g) “Intensive Outpatient Treatment” as defined in subsection 397.311(26), F.S.

(h) “Outpatient Treatment” as defined in subsection 397.311(26), F.S.

(i) “Aftercare” involves structured services provided to individuals who have completed an episode of treatment in a component and who are in need of continued observation and support to maintain recovery.

(j) “Intervention” as defined in subsection 397.311(26), F.S.

(k) “Prevention” as defined in subsection 397.311(26), F.S.

(l) “Medication-assisted treatment for opiate addiction” as defined in subsection 397.311(26), F.S.

(19) through (22) No change.

(23) “Credentialing entity” as defined in section subsection 397.311(10), F.S.

(24) No change.

(25) “Designate,” as used in this rule chapter, means the action taken by the Department to approve an Addictions Receiving Facility to provide screening, assessment, evaluation, and treatment to individuals found to be substance use impaired as described in section 397.675, F.S. and who meet the placement criteria for this component.

(26) through (28) are redesignated (25) through (27) No change.

(28)(29) “Direct Care Staff” means employees, independent contractors, and volunteers of a provider who provide direct services to individuals.

(30) through (32) are redesignated (29) through (31) No change.

(32)(33) “Indicated Prevention Services” has the same meaning as provided for the same term in 65E-14.021(4), subparagraph 65E-14.021(4)(v)1., F.A.C.

(34) through (36) are redesignated (33) through (35) No change.

(37) “Involuntary” means the status ascribed to a person who meets the criteria for admission under section 397.675, F.S.

(38) through (39) are redesignated (36) through (37) No change.

(40) “Medication Administration Record” or “MAR” means the chart maintained for each individual which records the medication information required by this rule chapter. Other information or documents pertinent to medication administration may be attached to the MAR.

(38)(41) “Medical Consultant” means a physician licensed under chapter 458 or 459, F.S., or an advanced practice registered nurse licensed under section 464, F.S., who has an agreement with a licensed provider to be available to consult on any medical services required by individuals involved in those licensed components.

(42) through (44) are redesignated (39) through (41) No change.

(45) “Medication Administration Record” or “MAR” means the chart maintained for each individual which records the medication administered to an individual as required by this rule chapter. Other information or documents pertinent to medication administration may be attached to the MAR.

(42)(46) “Medication Observation Record” or “MOR” means the chart maintained for each individual which records medication that is self-administered by an individual.

(47) “Medication Error” means medication that is administered or dispensed to an individual in a dose that is higher or lower, with greater or lesser frequency, or that is the wrong medication than that which is prescribed under a physician’s order.

(48) through (54) are redesignated (43) through (49) No change.

(50) “Peer Specialist” as defined in section 397.311 F.S.

(55) through (64) are redesignated (51) through (60) No change.

(61)(65) “Provider” or “Service Provider” as defined in section 397.311. means a public agency, a private for-profit or not-for-profit agency, a person who is in private practice, and a hospital, licensed under chapter 397, F.S., or exempt from licensure.

(66) through (67) are redesignated (62) through (63) No change.

(64) “Qualified Designee” or “Qualified Medical Designee” means a licensed medical health professional practicing within the scop of their training, education, and competence and identified by the Medical Director and in the provider’s wirtten medical protocols for the delegation of certain medical services, in accordance with 65D-30.004, F.A.C.

(65)(68) “Qualified Professional” as defined in section 397.311 subsection 397.311(34), F.S.

(66)(69) “Quality Assurance” means a formal method of evaluating the quality of care rendered by a provider and is used to promote and maintain an efficient and effective service delivery system. Quality assurance includes the use of a quality improvement process to prevent problems from occurring so that corrective efforts are not required.

(67) “Recovery Residence”  as defined in section 397.311, F.S.

(70) through (71) are redesignated (68) through (69) No change.

(70)(72) “Restraint” as defined in section 394.455(42) 394.455(41), F.S.

(71)(73) “Risk Factors” means those conditions affecting a group, individual, or defined geographic area that increase the likelihood of a substance use or substance abuse problem.

(72)(74) “Seclusion” as defined in section 394.455(43) subsection 394.455(42), F.S.

(73)(75) “Selective Prevention Services” has the same meaning as provided for the same term in 65E-14.021(4), subparagraph 65E-14.021(4)(w)1., F.A.C.

(74)(76) “Services” means assistance that is provided to individuals and their support system (i.e., family, significant other, etc.), as indicated, in their efforts to reduce or eliminate substance use free, such as counseling, treatment planning, vocational activities, educational training, and recreational activities.

(75)(77) “Stabilization” as defined in section 397.311, subsection 397.311(45) F.S.

(78) through (81) are redesignated (76) through (79) No change.

(80)(82) “Telehealth” as defined in section 456.47(1)(a). means the mode of providing care, treatment, or services by a Florida qualified professional, as defined under subsection 397.311(34), F.S., within the scope of his or her practice, through the use of clinical and medical information exchanged from one site to another via electronic communication. Telehealth does not include the provision of health services only through an audio only telephone, email messages, text messages, facsimile transmission, U.S. mail or other parcel service, or any combination thereof.

(81)(83) “Transfer Summary” means a written justification of the circumstances of the transfer of an individual from one (1) component to another or from one (1) provider to another.

(82)(84) “Treatment” or “Clinical Treatment” as defined in section 397.311 paragraph 397.311(26)(a), F.S.

(83)(85) “Treatment Plan” as defined in section 397.311 subsection 397.311(49), F.S.

(84)(86) “Universal Direct Prevention Services” has the same meaning as provided for the same term in subparagraph 65E-14.021(4), 65E-14.021(4)(x)1., F.A.C.

(87) “Universal Indirect Prevention Services” has the same meaning as provided for the same term in subparagraph 65E-14.021(4)(y)1., F.A.C.

(88) through (89) are redesignated (85) through (86) No change.

Rulemaking Authority 397.321(5) FS. Law Implemented 397.311, 397.321(1), 397.410 FS. History–New 5-25-00, Amended 4-3-03, 12-12-05, 8-29-19. Amended ______________.

 

65D-30.0031 Certifications and Recognitions Required by Statute.

(1) Department Recognition of Accrediting Organizations.

(a) No change.

(b) Accrediting organizations that desire Department recognition shall submit a request in writing to the Director for the Office of Substance Abuse and Mental Health. The Director for the Office of Substance Abuse and Mental Health shall respond in writing to the organization’s chief executive officer denying or granting recognition. An organization must meet the following criteria in order to be granted recognition by the Department.

1. through 3. No change.

4. For the purposes of this rule, a service provider must hold a valid license for each service component type prior to seeking accreditation for substance use treatment services, as defined in subsection 65D-30.002(18) 65D-30.002(17), F.A.C.

5. No change.

(2) Department Recognition of Credentialing Entities.

(a) through (b) No change.

(c) The Department shall recognize one (1) or more credentialing entities as a certifying organization for peer specialists, in accordance with section 397.417, F.S. A list of Department recognized credentialing organizations for peer specialists can be found at the following link: http://www.myflfamilies.com/service-programs/licensing/samh/. An organization that desires recognition by the Department as a certifying organization for peer specialists shall request such approval in writing from the Department. Organizations seeking approval must demonstrate compliance with the following nationally recognized standards for developing and administering professional certification programs to certify peer specialists:

1. Core competencies required for certification of an individual as a peer specialist that include:

a. Advocacy,

b. Mentoring,

c. Recovery support,

d. Cultural and linguistic competence,

e. Motivational interviewing,

f. Vicarious trauma/Self-care,

g. Professional responsibility, and

h. Group facilitation skills.

2. Certification guidelines and requirements, including training requirements;

3. Ability to screen applicants;

4. Capacity to administer exams for certification at proctored test-taking sites, including policies for special accommodations in compliance with the Americans with Disabilities Act;

5. Established code of ethics;

6. Policies and procedures for investigation of complaints and corrective action against a certified peer specialist, which may include suspension and revocation of certification, and appeals;

7. Procedures for continuing education requirements for, and a process for, biennial certification renewal; and

8. Publicly available fee schedule and payment process for costs associated with certification, exam, recertification, and continuing education units.

Rulemaking Authority 397.321(5) FS. Law Implemented 397.321(6), (15), 397.403, 397.417, 397.4871 FS. History–New 8-29-19, Amended_____.

 

65D-30.004 Common Licensing Standards.

(1) Operating Procedures. Providers shall demonstrate organizational capability required by section 397.403(1) paragraph 65D-30.0036(1)(e), F.A.C., through a written, indexed system of policies and procedures that are descriptive of services, and the population served. Administrative and clinical services must align with current best practices as defined in subsection 65D-30.002(7), F.A.C. All staff shall have a working knowledge of the operating procedures. These operating procedures shall be submitted with new applications and applications for new components to be available for review by the Department at any time.

(2) No change.

(3) Provider Governance and Management.

(a) Governing Body. Any provider that applies for a license, shall be a legally constituted entity. Providers that are government-based and providers that are for-profit and not-for-profit, as defined in section 397.311, F.S., shall have a governing body that shall set policy for the provider. The governing body shall maintain a record of all meetings where business is conducted relative to provider operations. These records shall be available for review by the Department department.

(b) Insurance Coverage. Regarding In regard to liability insurance coverage, providers shall assess the potential risks associated with the delivery of services to determine the amount of coverage necessary and shall purchase policies accordingly.

(c) Chief Executive Officer. A chief executive officer shall be appointed. If the entity is operated by a governing board, the governing body shall appoint a chief executive officer. The qualifications and experience required for the position of chief executive officer shall be defined in the provider’s operating procedures. Documentation shall be available from the governing body providing evidence that a background screening has been completed in accordance with chapters 397 and 435, F.S., and there is no evidence of a disqualifying offense. Providers shall notify the regional office in writing within 24 hours when a new chief executive officer is appointed.

(d) (Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services and are exempt from the requirements in this paragraph. Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of subsection (3). this paragraph.)

(4) Personnel Policies. Personnel policies shall clearly address recruitment and selection of prospective employees, promotion and termination of staff, code of ethical conduct, sexual harassment, confidentiality of individual records, attendance and leave, employee grievance, non-discrimination, abuse reporting procedures, and the orientation of staff to the agency’s universal infection control procedures. The code of ethical conduct shall prohibit employees and volunteers from engaging in sexual activity with individuals receiving services for a minimum of two (2) years after the last professional contact with the individual. Providers shall also have a drug-free workplace policy for employees and prospective employees.

(a) Personnel Records. Records on all personnel shall be maintained. Each personnel record shall contain:

1. through 6. No change.

7. Documentation of required staff training (Inmate Substance Abuse Programs operated by the Department of Corrections are exempt from the provisions of this subparagraph).

8. Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services, and Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of sub-paragraph (a)7.

(b) Background Screening Requirements of Staff.

1. Providers shall ensure compliance with background screening in accordance with section 397.4073, F.S.

2. Providers shall ensure that peer specialists are screened in accordance with section 397.417, F.S.

3. Individuals subject to screening in this subsection shall be re-screened within five (5) years from the date of their last screening results and every five (5) years thereafter. At the time of the initial screening, and with every re-screening, an Affidavit of Good Moral Character, form CF 1649, (April 2021), which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, shall be submitted by individuals who are subject to level 2 background screenings.

4. Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services, and Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of sub-paragraph 3., unless the service provider personnel have direct contact with unmarried inmates under the age of 18 or with inmates who are intellectually disabled, pursuant to section 397.4073(1)(e), F.S.

All owners, chief financial officers, chief executive officers, and clinical supervisors of service providers are subject to level 2 background screening and local background screening as provided under chapters 435 and 397, F.S. All service provider personnel, and volunteers who have direct contact with children receiving services or with adults with intellectual disabilities receiving services are subject to level 2 background screening as provided under chapter 435, and section 397.4073, F.S. In addition, individuals shall be re-screened within five (5) years from the date of their last screening and shall include a local background screening. Re-screening shall include a level 2 screening in accordance with chapter 435, F.S. Service provider personnel who request an exemption from disqualification must submit the request within 30 days after being notified of the disqualification. If five (5) years or more have elapsed since the most recent disqualifying offense, service provider personnel may work with adults who have substance use disorders under the supervision of a qualified professional until the Department makes a final determination regarding the request for an exemption from disqualification. (Personnel operating directly with local correctional agency or authority, Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections or the Department of Management Services are exempt from the requirements in this paragraph, unless they have direct contact with unmarried inmates under the age of 18 or with inmates who are intellectually disabled.)

(c) A person who is disqualified pursuant to the background screening conducted in paragraph (4)(b) of this rule may request an exemption from disqualification pursuant to section 435.07, F.S. or, if applicable, section 397.4073(4)(b), F.S.

(d)(c) Employment History Checks and Reference Checks of References. The chief executive officer or designee, such as human resources staff, shall assess employment history checks and reference checks of references for each employee who has direct contact with children receiving services or intellectually disabled adults who are intellectually disabled receiving services.

(5) No change.

(6) Medical Director. Providers licensed to operate This requirement applies to addictions receiving facilities, detoxification, intensive inpatient treatment, residential treatment, and methadone and medication-assisted treatment for opioid use disorder shall have a medical director addiction. Providers shall designate a medical director who shall oversee all medical services. The medical director’s responsibilities shall be clearly described.

(a) through (c) No change.

(d) A medical director may not serve in that capacity for more than a maximum of the indicated number of individuals for the treatment types listed below:

1. through 6. No change.

7. Methadone medication-assisted treatment for opioid use disorder Medication and methadone maintenance treatment – a cumulative total of 1,745 individuals at any given time.

(e) through (f) No change.

(g) In cases where a provider operates treatment components that are not identified in this subsection, the provider shall have access to a physician or APRN through a written agreement who will be available to consult on any medical services required by individuals involved in those components. Physicians or APRN’s serving as a medical consultant shall adhere to all requirements and restrictions as described for medical directors in this chapter.

(h) A medical director or medical consultant in violation of any of the requirements set forth in chapter 65D-30, F.A.C., or chapter 397, F.S., is permanently barred from being employed by or contracting with a service provider licensed under chapter 65D-30, F.A.C.

(7) Medical Services.

(a) No change.

(b) The medical protocols shall also include:

1. The manner in which certain medical functions may be delegated to appropriate licensed practitioners Advanced Registered Nurse Practitioners and Physician’s Assistants in those instances where these practitioners are utilized as part of the clinical staff;

2. through 4. No change.

(c) Supervision of self-administration of medication may be provided, including at the community housing location, under the following conditions:

1. No change.

2. Individuals must receive prescription medication in accordance to the prescriptions of appropriate licensed practitioners qualified physicians, as required by law;

3. through 4. No change.

(d) No change.

(e) Emergency Medical Services. All licensed providers shall describe the manner in which medical emergencies shall be addressed. (Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections or the Department of Management Services are exempt from the requirements of subsection 65D-30.004(7), F.A.C. Juvenile Justice Commitment Programs and detention facilities operated by or under contract with the Department of Juvenile Justice are exempt from the requirements of this subsection.)

(f) Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services, and Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of subsection (7).

(8) State Approval Regarding Prescription Medication. In instances where the provider utilizes prescription medication, medications shall be purchased, handled, dispensed, administered, and stored in compliance with the State of Florida Board of Pharmacy requirements for facilities which hold Modified Class II Institutional Permits and in accordance with chapter 465, F.S. This shall be implemented in consultation with a state-licensed consultant pharmacist and approved by the medical director. The provider shall ensure that policies implementing this subsection are reviewed and signed and dated annually by a state-licensed consultant pharmacist. (Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, the Department of Juvenile Justice, or the Department of Management Services are exempt from the requirements of this subsection.)

(a) All providers purchasing, dispensing, handling, administering, storing, or observing self-administration of medications shall adhere to best practices, state and federal regulations.

(b) Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services, and Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of subsection (8).

(9) Universal Infection Control. Providers licensed to operate This requirement applies to addictions receiving facilities, detoxification, intensive inpatient treatment, residential treatment, day or night treatment with community housing, day or night treatment, intensive outpatient treatment, outpatient treatment, and medication-assisted treatment for opioid addiction shall implement an exposure control plan and universal infection control services.

(a) No change.

(b) Required Services. The following Universal Infection Control Services shall be provided:

1. through 2. No change.

3. Reporting of communicable diseases to the Department of Health in accordance with sections 381.0031 and 384.25, F.S.

(Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections or Department of Management Services are exempt from the requirements of this subsection but shall provide such services as required by chapter 945, F.S., titled Department of Corrections. Juvenile Justice Commitment Programs and detention facilities operated by or under contract with the Department of Juvenile Justice are exempt from the requirements of this subsection but shall provide such services as required in the policies, standards, and contractual conditions established by the Department of Juvenile Justice.)

(c) Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services, and Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of subsection (9).

(10) Universal Infection Control Education Requirements for Employees and Individuals. Providers shall meet the educational requirements for HIV and AIDS pursuant to section 381.0035, F.S., and all infection prevention and control educational activities shall be documented. Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, or the Department of Management Services, and Juvenile Justice Commitment Programs and detention facilities operated by the Department of Juvenile Justice, are exempt from the requirements of this subsection. (Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, the Department of Juvenile Justice, or the Department of Management Services are exempt from the requirements of this subsection but shall provide such services as required in the policies, standards, and contractual conditions established by the Department of Juvenile Justice.)

(11) Meals. Providers licensed to operate addictions receiving facilities, inpatient detoxification, intensive inpatient treatment, and residential treatment shall provide at At least three (3) meals per calendar day shall be provided to individuals in addictions receiving facilities, inpatient detoxification, intensive inpatient treatment, and residential treatment. In addition, at least one (1) snack shall be provided each day. Providers licensed to operate For day or night treatment with community housing and day or night treatment, the provider shall make arrangements to serve a meal to individuals involved in services a minimum of five (5) hours at any one time. Individuals with special dietary needs shall be reasonably accommodated. Under no circumstances may food be withheld for disciplinary reasons. The provider shall document and ensure that nutrition and dietary plans are reviewed and approved by a dietitian/nutritionist licensed under section 468.509, F.S., at least annually. If the provider contracts with a third party for food services, a copy of the provider’s contract with the company and the company’s current health inspection shall be provided to the Department upon application and renewal. (Inmate Substance Abuse Programs operated by or under contract with the Department of Corrections, the Department of Juvenile Justice, or the Department of Management Services are exempt from the requirements of this subsection but shall provide such services as required in the policies, standards, and contractual conditions established by the respective department.)

(12) Verbal De-escalation. Providers licensed to operate This applies to all components except for with the exception of universal direct and indirect prevention services. Providers shall have written policies and procedures of the specific verbal de-escalation technique(s) to be used. Direct care staff shall be trained in verbal de-escalation techniques as required in paragraph 65D-30.0046(1)(b), F.A.C. The provider shall provide proof to the Department that affected staff have completed training in those techniques.

(13) Compulsory School Attendance for Minors. Providers which admit juveniles between the ages of 6 and 16 shall comply with chapter 1003, Part III 232, F.S., entitled School Attendance Compulsory School Attendance; Child Welfare.

(14) through (16) No change.

(17) Critical Incident Reporting pursuant Pursuant to paragraph 397.4103(2)(f), F.S.

(a) through (b) No change.

(18) No change.

(19) Certified Recovery Residence Referrals. Providers shall comply with the statutory requirements established in sections 397.4104 and section 397.4873, F.S., regarding referrals to and admissions from certified recovery residences.

(a) Pursuant to section 397.4873, F.S., all All providers shall maintain an active referral log of each individual referred to a recovery residence. The log shall include the individual’s name being referred or accepted, name and address of the certified recovery residence, signature of the employee making the referral, and date of the referral. The log shall be made available for review by the Department. (Service Providers under contract with the Managing Entities are exempt from this requirement.)

(b) Pursuant to section 397.4104(1), F.S., all providers shall maintain an updated record of recovery residence referrals in the Department’s statewide electronic system specific to licensure.

(20) Telehealth Services.

(a) Providers shall maintain policies and Prior to initiating services utilizing telehealth, providers shall submit detailed procedures outlining how they will provide services through telehealth which services they intend to provide as described in paragraph 65D-30.0036(1), F.A.C. 65D-30.003(1)(l), F.A.C.

(b) Providers delivering services through telehealth shall provide the service to the same extent the service would be delivered if provided through an in-person service delivery with a provider.

(c) Providers delivering any services by telehealth are responsible for the quality of the equipment and technology employed. and Providers are responsible for its safe use. Providers utilizing telehealth equipment and technology must be able to meet or exceed the prevailing standard of care. Service providers must meet the following additional requirements:

(a) through (b) are redesignated (d) through (e) No change.

(c) Clinical screenings, assessments, medication management, and counseling are the only services allowable through telehealth; and

(d) Telehealth services must be provided within the state of Florida except for those licensed for outpatient, intervention, and prevention.

(21) through (22) No change.

Rulemaking Authority 397.321(5) FS. Law Implemented 397.321, 397.4014, 397.4073, 397.4075, 397.410, 397.4103, 397.4104, 397.411 FS. History–New 5-25-00, Amended 4-3-03, 12-12-05, 8-29-19. Amended ________________.

 

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) through (c) No change.

(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. through 3. No change.

4. Rights of individuals served; and

5. No change.

(e) through (i) No change. 

(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 qualified professional. 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 all staff. All staff must provide services within the scope of their professional licensure or certification, training, and competence in accordance with applicable clinical protocols.

(4) Scope of Practice for staff who provide services specific to substance use but who are not licensed or certified as qualified professionals.

(a) The scope of practice is more limited for certain staff working for providers licensed under this Chapter who do not meet the definition of a qualified professional. This staff is comprised of:

1. Bachelor’s or master’s degree level practitioners. Practitioners 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 (a related human services field is one in which major course work includes the study of human behavior and development);

2. Registered interns for marriage and family therapy, clinical social work, and mental health counseling;

3. Certified addiction counselors who are certified by the Florida Certification Board; and

4. Certified behavioral health technicians who are certified by the Florida Certification Board.

(b)  The staff listed in subsection (4)(a) of this rule shall be directly supervised by a qualified professional.

(c) When providing services specific to substance use, the staff listed in subsection (4)(a) of this rule are limited to the following tasks:

1. Screening,

2. Psychosocial assessment,

3. Treatment planning,

4. Referral and linkage,

5. Service coordination,

6. Consultation,

7. Continuing assessment and treatment plan reviews,

8. Recovery support services,

9. Crisis intervention,

10. Individual, family, and community education,

11. Documentation of progress,

12.Any other tasks permitted in these rules and appropriate to that licensable component, and

13. Supportive counseling.

(d) Individual and family therapy may only be provided by master’s degree level practitioners and registered interns, and student interns seeking their master’s degree from an accredited university. 

(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.

(3) Scope of Practice. Staff not licensed under chapter 458, 459, 464, 490 or 491, F.S., providing services specific to substance use 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. Staff must provide services within the scope of their professional licensure certification; or training and competence in applicable clinical protocols.

(a) The scope of practice limitations listed in subsection (3) apply to the following unlicensed staff who must work directly under the supervision of a qualified professional:

1. Bachelor’s or master’s degree level practitioners. Practitioners 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;

2. Registered marriage and family therapy, clinical social work, and mental health counseling interns;

3. Certified master’s degree level addiction professionals who are certified by the Florida Certification Board;

4. Certified addictions professionals who are certified by the Florida Certification Board;

5. Certified addiction counselors who are certified by the Florida Certification Board.

(b) Certified recovery peer specialists and specialist or certified recovery support specialists who are certified by the Florida Certification Board may provide all services listed in subsection (3) of this rule, except counseling listed in paragraph (3)(l), under the supervision of a qualified professional or a certified recovery peer specialist with a minimum of three (3) years of experience providing recovery support services to individuals with substance use disorders. Recovery support specialists and recovery peer specialists are allowed one year from the date of their employment to obtain certification through the Florida Certification Board.

Rulemaking Authority 397.321(5) FS. Law Implemented 397.321, 397.410 FS. History–New 8-29-19. Amended____________.

 

65D-30.013 Standards for Prevention.

Prevention includes activities and strategies that are used to preclude the development of substance use problems. In addition to rule 65D-30.004, F.A.C., the following standards apply to prevention.

(1) Categories of Prevention. For the purpose of these rules, prevention services are categorized as indicated, selective, or universal direct, or universal indirect, as defined in paragraphs 65E-14.021(4)(v)-(x)(y), F.A.C., incorporated by reference, and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-10900. While the Department covers universal indirect as a prevention service under rule 65E-14.021, F.A.C., this service is not regulated under this rule.

(a)  Indicated prevention services are provided to at-risk individuals who are identified as having minimal but detectable signs or symptoms foreshadowing mental health or substance use disorders. Target recipients of indicated prevention services are at-risk individuals who do not meet clinical criteria for mental health or substance use disorders. Indicated prevention services are designed to preclude, forestall, or impede the development of mental health or substance use abuse disorders.

(b) Selective prevention services are provided to a population subgroup whose risk of developing mental health or substance use disorders is higher than average. Target recipients of selective prevention services do not meet clinical criteria for mental health or substance use disorders. Selective prevention services are designed to preclude, forestall, or impede the development of mental health or substance use disorders.

(c) Universal direct prevention services are provided to the general public or a whole population that has not been identified on the basis of individual risk. These services are designed to preclude, forestall, or impede the development of mental health or substance use disorders. Universal direct services directly serve an identifiable group of participants who have not been identified on the basis of individual risk. These services include interventions involving interpersonal and ongoing or repeated contacts such as curricula, programs, and classes.

(2) No change.

(3) General Requirements.

(a) Staffing Patterns. Providers shall delineate reporting relationships and staff supervision. This delineation shall include a description of staff qualifications, including educational background and experience regarding the substance use prevention field. Providers shall have at least one (1) qualified prevention professional on staff who is:

1. A Certified Prevention Professional under the Florida Certification Board; or

2. A Certified Prevention Specialist under the International Certification & Reciprocity Consortium; or

3. A Qualified Professional with at least one year of experience in the delivery of prevention services.

(b) No change.

(c) Referral. Providers shall have a plan for assessing the appropriateness of prevention services and conditions for referral to other services. The plan shall include a current directory of locally available substance abuse services and other human services for referral of prevention program participants, or prospective participants.

(4) Requirements for Providers of Universal Direct and Universal Indirect Prevention Services.

(a) Program Description. Providers of universal direct and universal indirect prevention services shall describe the prevention services that will be available. This description shall include:

1. through 5. No change.

(b) Activity Logs for Providers of Universal Direct and Universal Indirect Prevention Services. Providers shall collect and maintain records of all universal direct and universal indirect prevention services, including the following:

1. through 7. No change.

(5) Requirements for Providers of Selective Prevention Services.

(a) No change.

(b) Activity Logs for Providers of Selective Prevention Services. Providers shall collect and maintain records of all universal direct and universal indirect prevention services, including the following:

1. through 7. No change.

(6) No change.

Rulemaking Authority 397.321(5) FS. Law Implemented 397.311(26), 397.321, 397.410 FS. History–New 5-25-00, Amended 4-3-03, 8-29-19. Amended ______________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: William Hardin, Heather Allman

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Shevaun L. Harris

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 28, 2022

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: October 31, 2022