Agency for Health Care Administration Criminal Background Checks for Health Care Licensure

Agency for Health Care Administration Criminal Background Checks for Health Care Licensure Changes in the law, passed during the 2010 legislative session (Chapter Law 2010-114), significantly modifies the background screening and hiring process for many service providers regulated by a variety of state agencies including health care providers licensed by the Agency for Health Care Administration (Agency) under Chapter 408, Part II, Florida Statutes (F.S.). The following is a summary of changes to section 408.809 and Chapter 435, F.S. that apply to employees and contractors of health care providers licensed through the Agency for Health Care Administration. These changes are effective August 1, 2010. Provider/Facility Types Subject to Screening Facility/Service Type Owner / Administrator Financial Officer Employees and Contractors Providing Personal Care/ Services Directly to Clients Employees that have access to client property, funds or living areas Abortion Clinics Ambulatory Surgery Centers Birth Centers Clinical Laboratories Performing Non-waived Testing (including physician performed microscopic tests) Drug Free Workplace Multiphasic Health Testing Centers Organ Procurement Organizations, Tissue Banks, Eye Banks n/a n/a Adult Day Care Centers Adult Family Care Homes Assisted Living Facilities Health Care Service Pools Home Health Agencies Homemaker/Sitter/Companion Home Medical Equipment Providers Homes for Special Services Hospice Intermediate Care Facilities for the Developmentally Disabled ** Medicaid Contracted Facilities (excluding Adult Family Care Homes) Agency for Health Care Administration 1 August 14, 2010

Nurse Registries Nursing Homes Prescribed Pediatric Extended Care Transitional Living Facilities Community Mental Health Crisis Stabilization Units ** Residential Treatment Centers for Children and Adolescents ** Residential Treatment Facilities ** Short Term Residential Treatment Facilities ** (excludes Community Mental Health) (excludes Community Mental Health) (includes volunteers unless they work less than 10 hours/month as long as the volunteer is within the line of sight of an employee that has successfully completed a.) Health Care Clinics (includes owners with 5% or more interest in the clinic) Hospitals (only applies to staff working within mental health or psychiatric centers) -- Risk Managers -- -- -- ** These providers may request screenings to be reviewed through the Agency for Health Care Administration OR the Department of Children and Families Persons Required to be Screened Licensee if the licensee is an individual [Reference 408.809(1)(a)] Administrator or a similarly titled person who is responsible for the day-to-day operation of the provider. For example in a clinical laboratory, the Laboratory Director is the person designated with the day-to-day responsibilities of operation. [Reference 408.809(1)(b)] Financial officer or similarly titled individual who is responsible for the financial operation of the licensee or provider. [Reference 408.809(1)(c)] Controlling interests defined as the applicant or licensee; a person or entity that serves as an officer of, is on the board of directors of, or has a 5-percent or greater ownership interest in the applicant or licensee; or a person or entity that serves as an officer of, is on the board of directors of, or has a 5-percent or greater ownership interest in the management company or other entity, related or unrelated, with which the applicant or licensee contracts to manage the provider. The term does not include a voluntary board member - are required to meet background screening standards of 435.04 and may be required to be screened if the agency has reason to believe the person has been convicted of a disqualifying offense. [Reference 408.809(1)(d)] Provider personnel screening requirements are specified in the authorizing licensure statutes. The jobs and duties of persons who serve as employees or contractors must be evaluated independently to determine if they meet one of the definitions below. Agency for Health Care Administration 2 August 14, 2010

Employees that are expected to provide direct care or services or have access to client property, funds or living areas. [Reference 408.809 (1)(e)] Contractors expected to provide personal care or personal services directly to clients. Evidence of contractor screening may be retained by the contractor s employer or the licensees (provider). [408.809 (1)(e)] Other persons required under the authorizing statutes to be screening including the medical director and all health care practitioners for a licensed health care clinic (see chart for details). Volunteers for a mental health provider licensed under chapter 394, F.S. which includes Crisis Stabilization Units, Residential Treatment Facilities, and Residential Treatment Centers for Children and Adolescents, must undergo screening unless they work less than 10 hours/month and are within the line of sight of an employee that has successfully completed a. [Reference: 394.4572] Children under Age 18 - The law does not change based on the age of the employee/contractor. If a child under 18 years of age meets the definition of one of the positions above he/she must undergo the same screening as a person over age 18. All persons required to be screened must be screened and eligible before they are hired. Level of Screening Required is a fingerprint check of state and federal criminal history information conducted through the Florida Department of law Enforcement (FDLE) and Federal Bureau of Investigation (FBI). [Reference 435.04] Persons hired or initially contracting with a provider after August 1, 2010, must undergo background screening. Electronic Screening All screening requests must be submitted electronically. The Agency will no longer process Level 1 or screening requests or fees after July 31, 2010. Any Level 1 or screening request and fees submitted to the Agency s Background Screening Section after July 31, 2010 will be returned to the sender unprocessed. Forms of electronic screening : LiveScan device is a term used to describe the scanners used to directly capture fingerprints through a scanning function. Person being screened place their hands directly on the scanner for reading. Fingerprint scanning using a LiveScan device provides faster results and generally costs less that hard card scanning as there is less handling involved. LiveScan capture also produces a better quality print, so has a lower rejection rate of illegible prints (no ink smudging, etc). LiveScan options - There are several options for LiveScan capture including: LiveScan vendors approved to submit fingerprint requests through the Florida Department of Law Enforcement (FDLE). These vendors generally require advanced online reservations or appointments and charge a fee for use of the LiveScan in addition to the FDLE screening fee of $43.25. LiveScan devices are either available at specific locations or through mobile services where the vendor will either come to the provider location (based on certain volumes and fees) or another pre-arranged location. LiveScan vendors are independent businesses and each must be contacted in advance to determine fees, services and enrollment requirements. For more information regarding LiveScan vendors please see Florida LiveScan Vendor List for contact information locations and pricing on the Agency s Background Screening website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. You may also find a list of approved vendors in the state on the Florida Department of Law Enforcement s LiveScan Site: http://www.fdle.state.fl.us/content/getdoc/04833e12-3fc6-4c03-9993-379244e0da50/livescan.aspx. Agency for Health Care Administration 3 August 14, 2010

LiveScan devices (machines) may be purchased/leased by providers who wish to handle their own fingerprint capture. Several business offer machines (sale or lease) however, it is important to assure that any selection is approved for submission through FDLE and all requirements of fingerprint submission are met. For more information visit the FDLE LiveScan Site (link) or the AHCA Cogent contract (Option 1 or Option 2). Hard card scanning is a method of submitting a traditional fingerprint card where finger prints are rolled in ink onto an FBI fingerprint card. Cards may be converted to electronic by using a machine that scans the cards. There is typically a fee associated with rolling the prints as a high degree of skill is required to achieve the necessary quality. Hard cards for AHCA screening must be obtained from AHCA because they must include the pre-printed AHCA ORI# to assure results are returned to appropriately. You may request fingerprint cards at: BGScreen@ahca.myflorida.com. As of August 1, 2010, AHCA can no longer accept fingerprint hard cards for processing. Many LiveScan vendors (discussed above) also offer the ability to scan hard cards. Prices and service may vary. Please contact each vendor for details on services and fees. LiveScan Vendors There are many LiveScan sites available around the state from vendors listed on the FDLE site - some who offer mobile services for onsite screening. We have requested information from each of these vendors regarding their location, hours of operation, and fees and compiled a chart based on the information reported on the Background Screening Website. We will continue to update the chart as additional information is received. You may access the website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. LiveScan Vendor Requirements In addition to compliance with FDLE transmission requirements, the LiveScan sites will need the following information in order for AHCA to receive the results appropriately. If the vendor you choose does not have an online registration or appointment system we ask that you please use the Validation for LiveScan Vendors form available on the Background Screening website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. Failure to submit this information may result in the provider s inability to obtain screening results: Full Name Individual s Address Social Security Number Date of Birth Race Sex Height Weight AHCA # for provider/facility, or third party/contractor ** Employer Name Employer Address (address information should be separated by commas: street, city, state, zip) Please ensure the LiveScan site is using the following AHCA ORI # 922020Z for transmitting the prints to FDLE. ** The form requests the health care facility/provider AHCA #. Licensed health care providers may obtain the AHCA number at: http://www.floridahealthfinder.gov/facilitylocator/facloc.aspx : Select Search by Facility Type/Location Select your Facility/Provider Type in the drop down box (e.g. Assisted Living Facility) Type in your provider name and hit Search Select your provider from the list From the provider page, the AHCA Number is located in the second column of information. Agency for Health Care Administration 4 August 14, 2010

Third Party entities and health care contractors must register with the Agency s Background Screening Section to obtain the AHCA #. See instructions for registration in the section: AHCA Background Screening Results Website Validation for LiveScan Vendor Form The Validation for LiveScan Vendors form is available on the Background Screening Website to provide the required information to the vendor. Since most vendors require this information be submitted at the time the person is preregistering for the screening (for example with online registration), the Validation form is not required to be presented at the LiveScan location if the information is submitted as part of the vendor's preregistration process. The purpose of this form is solely to assure the necessary information is submitted with the fingerprint submission. Cost of Screening FDLE charges $43.25 for a background screen ($24.00 for the state portion and $19.25 for the national portion). The additional cost of electronic screening varies based on the vendor chosen. Total cost = $43.25 + electronic print processing fee The cost of the screening may be borne by the licensee or the person fingerprinted. [Reference 408.809(2)] AHCA Screening Process Overview Providers send their employees, potential employees, or contractors to a LiveScan vendor for fingerprinting it is critical that the fingerprint submission is accompanied by the required information for the person screened (see LiveScan Vendor Requirements above). Failure to submit this information may result in the provider s inability to obtain screening results. Once prints are successfully submitted, FDLE will check the state criminal history repository for records and the FBI will check national criminal history systems for information. Allow 2-3 business days for FDLE/FBI processing and submission of results to AHCA. Once complete, FDLE electronically sends results to AHCA where data is brought into the AHCA Background Screening Database (BGS Database). AHCA staff review the results and determine if any disqualifying criminal offenses exist. If the person has disqualifying offenses, he/she is recorded in the AHCA Background Screening Database as Not Eligible, if no disqualifying offenses exist they are recorded as Eligible. The results of the screening are posted immediately to the Agency s Background Screening Results Website. Please allow 2-3 business days for AHCA processing. Therefore, total processing time is generally 5-7 business days from the date prints are submitted to FDLE. screening records are confidential and may not be shared with anyone other than the individual that was screened. If a criminal record is incomplete, AHCA will contact the person screened through certified mail (based on the address submitted to FDLE) for additional information, which will delay the processing of the screening. The employer (AHCA provider/facility) should contact the person screened if delays exist. If fingerprints are rejected by FDLE/FBI, AHCA will send the person screened a certified letter directing them to return to the same vendor with a copy of the letter they received. The letter includes their TCR number. This number lets the vendor know that the first set of prints were rejected and to submit a second set of prints at no charge. The vendor must allow the person to submit a second set of fingerprints to FDLE at no additional cost. If the certified letter is not signed for after 30 days, a second letter will be sent out by regular mail. AHCA Background Screening Results Website The Agency s Background Screening Results Website provides direct access electronic screening results to licensed providers and registered third party vendors and health care contractors. This website enables users to search criminal history screening results of persons required to be screened for licensure and potential employees/contractors screened Agency for Health Care Administration 5 August 14, 2010

through the Agency and the Department of Health. These are the only two state agencies whose results will be reported on this site. Each licensed provider will receive a user code upon licensure to access the system, and must complete a User Agreement. New licensure applicants will receive an account by mail, once their initial license application is received by the Agency. Third Party Screening Entities and Health Care Contractors may also submit screenings and review screening results processed through the Agency. To gain access to the system, Third Party Screening Entities and Contractors must register with AHCA to obtain a AHCA #. Send a request by fax, mail, or email on company letterhead to the Background Screening section at 2727 Mahan Drive, MS 40, Tallahassee, FL 32308, fax # (850)487-0470, or email BGScreen@ahca.myflorida.com. Please include a phone number or email address in the request. You will be contacted once the account is set up and given your AHCA #. Once you receive this number you will be able to log into the Agency s secure website and complete a user agreement. We have received a large number of screening results from LiveScan vendors submitted since August 2, 2010, that do not contain a Social Security Number for the person who was screened. Without the Social Security Number we cannot post the screening results in the AHCA Background Screening Results Website. If you have checked the AHCA Background Screening Results Website and are unable to find screening results of a LiveScan screening submitted more than 7 days ago, the Social Security Number may be missing. To correct, please fax the Names, Dates of Birth and Social Security Numbers for each missing screening result to: (850) 487-0470. Results will be corrected and posted to the AHCA Background Screening Results Website. Please be sure that all screening candidates provide their Social Security Numbers at the time their prints are scanned. Prior Screening Conducted by another Agency or AHCA Proof of compliance with level 2 screening standards for the following state agencies is satisfactory compliance with screening for AHCA if the screening is less than five years old, the final screening determination is provided, the person has not been unemployed for more than 90 days (type of employment is not specified), and the person signs the Affidavit of Compliance (form 3100-0008, August 2010) [Reference 408.809(2)]. This form is available on our website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. State agencies include: Agency for Health Care Administration - including Licensure and Medicaid Department of Health Agency for Persons with Disabilities Department of Children and Families Department of Financial Services The following provider types may submit screening requests for review by the Agency OR the Department of Children and Families; different fees may apply [Reference: 394.4572]: Crisis Stabilization Units Residential Treatment Facilities for Adolescents and Children Residential Treatment Facilities Short Term Residential Programs Persons seeking employment in one of these provider types that is disqualified from employment due to their background screenings and are seeking an Exemption from Disqualification must submit the appropriate application to the agency that reviewed the screening results. Employees and Contractors Employed before August 1, 2010 Every employee/contractor must attest to meeting the requirements of this chapter and agreeing to inform the employer immediately if arrested for any of the disqualifying offenses while employed by the employer. [Section 435.05(2)]. The Agency for Health Care Administration 6 August 14, 2010

attestation must be maintained in the employee s personnel file. You may use the Affidavit of Compliance with Background Screening (AHCA Form 3100-0008, August 2010) to satisfy the attestation requirement. This form is available on our website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. If an employer becomes aware that an employee/contractor has been arrested for a disqualifying offense, the employer must remove the employee/contractor from contact with any vulnerable person that places the employee/contractor in a role that requires background screening until the arrest is resolved in a way that the employer determines that the employee/contractor is still eligible for employment/contracting under this chapter. [Section 435.06(2)(b)] Rescreening All persons subject to screening will be required to be rescreened every five years. Initial rescreening must be conducted by July 31, 2015 or sooner if AHCA develops rules to stagger the rescreening schedule. [Reference 408.809(3)] Existing employees or contractors with prior Level 1 screening: Persons affiliated (hired or contracting with) a provider before August 1, 2010, who have already been screened under Level 1 (state only) are not required to immediately be rescreened under as long as they remain with the same provider. They must be rescreened by July 31, 2015 or sooner if required by rules. [Reference 408.809(3)] Criminal Offenses Disqualifying criminal offenses are listed in 408.809(4) and 435.04. If a person is found to have a new disqualifying offense, or is arrested for any of these offenses, he/she is not eligible to work in a position that requires screening unless an exemption is granted. [Reference 408.809(4) and 435.04, 435.05] Existing employees or contractors screened, qualified and hired before August 1, 2010, that have a disqualifying offense revealed during a rescreening that was not disqualifying at the time of the prior screening, may continue to work, if the employer agrees, while applying for an exemption from disqualification as long as the employee/contractor is eligible to apply for an exemption and the application is received by the appropriate agency within 30 days after receipt of the rescreening results. This provision does not apply to staff hired before August 1, 2010 who have never been screened. [Reference 408.809(4)] Criminal History Reports Criminal history reports must be complete to render a decision. If a report is missing the disposition of an arrest for a disqualifying offense(s) the person screened will be notified by certified mail to obtain additional information from the arresting jurisdiction. To correct information on a criminal history report for a offense that occurred in Florida, contact the Florida Department of Law Enforcement. Eligibility Determinations The Agency will review all screening results and a determination of Eligible or Not Eligible will be posted on our secure website. Notifications by mail will no longer be available. The website will also indicate if the individual has applied for or has a decision for an Exemption from Disqualification. Providers may access the screening results through the Agency s secure website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/logon.shtml. The new law added additional disqualifying criminal offenses (includes luring and enticing a child; voyeurism, video voyeurism; and unlawful sexual activity with certain minors). A health care provider may not hire a new employee or contract with a person until a final screening determination of Eligible has been made or the individual is Not Eligible but has been granted an Exemption from Disqualification from Agency for Health Care Administration 7 August 14, 2010

the Agency or the Department of Health (if seeking employment in a position that requires professional licensure or certification through the Department). Each employee/contractor required to undergo screening must attest upon hiring that they meet the requirements for employment and agree to inform the employer immediately if arrested for any disqualifying offense. This form must be kept in the employee s personnel file. You may find the Affidavit of Compliance with Background Screening (AHCA Form 3100-0008, August 2010) [Reference 408.809(2)]. This form is available on our website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. If an employee/contractor has an arrest for a disqualifying offense and is awaiting sentencing he/she is Not Eligible to work until there is a final court disposition and the individual is determined by the Agency to be eligible. Exemptions from Disqualification Requests for exemption from disqualification due to a criminal history may be submitted using the application form available on our website. An Application for Exemption from Disqualification AHCA Form 3110-0019, August 2010, and instructions may be downloaded from the Agency s website at: http://ahca.myflorida.com/mchq/long_term_care/background_screening/exemption.shtml. A person is not eligible to apply for an Exemption from Disqualification until: He/she has been lawfully released from confinement, probation or other sanction for a disqualifying misdemeanor criminal offense; At least 3 years after he/she has been lawfully released from confinement, probation or other sanction for a disqualifying felony criminal offense. Persons designated as sexual predators, sexual offenders or career offenders are not eligible for an Exemption from Disqualification. The Agency will review applications and make decisions for Exemptions for unlicensed personnel working for a health care provider and the Department of Health will review applications and make decisions for licensed and certified personnel as long as that person is working in the scope of his or her license or certification. Please allow 30 days for a decision from the date a complete application is submitted. Compliance Evidence of screening must be retained in the personnel files for those screened. Contractor screening may be retained either by the employer or the licensee where the contractor provides contract services. Given the significant changes to processes brought on by these new laws and recent developments indicating fewer than expected LiveScan locations available on August 1, we want to ensure that challenges in the initial implementation of this new law will not interfere with the delivery of necessary care and services to those who receive health care in Florida. Therefore, during the initial implementation of this new law, deficient practice will be determined based on providers good faith efforts to comply with the law. Providers making a good faith effort to comply will not be sanctioned. Providers must document their efforts to comply with the law. Contact Information Please visit our website for important information regarding new background screening requirements including how to submit fingerprints electronically, a list of LiveScan vendors in the state updated daily with new locations, and instructions to request an exemption from disqualification due to a criminal history. Our website is www.ahca.myflorida.com select Providers, then select Background Screening on the top right column, or http://ahca.myflorida.com/mchq/long_term_care/background_screening/index.shtml. Agency for Health Care Administration 8 August 14, 2010

If you have any questions please contact the Background Screening section at 850-412-4503 or email BGscreen@ahca.myflorida.com Please direct questions regarding licensure issues to the appropriate licensure unit. Long Term Care Unit (850) 412-4303 Nursing Homes, ICF/DDs, Prescribed Pediatric Extended Care Centers, Transitional Living Facilities, Homes for Special Services Hospitals & Outpatient Services Unit (850) 412-4549 Abortion Clinics, Ambulatory Surgery Centers, Birth Centers, Crisis Stabilization Units, Hospitals, Organ Procurement Organizations, Tissue Banks, Eye Banks, Residential Treatment Facilities, Utilization Review Health Care Clinic Unit (850) 412-4404 Home Care Unit (850) 412-4403 Home Health Agencies, Homemaker, Sitter, Companion Agencies, Home Medical Equipment Providers, Hospice, Nurse Registries, Health Care Services Pools Assisted Living Unit (850) 412-4304 Adult Day Care Centers, Adult Family Care Homes, Assisted Living Facilities Laboratory Unit (850) 412-4500 Drug Free Workplace, Multiphasic Health Testing Centers, Organ and Tissue Programs, Clinical Laboratories Agency for Health Care Administration 9 August 14, 2010