Ahca AHCA Background Screening

The Division of Health Quality Assurance licenses, registers and regulates 29 health care provider types on the basis of Florida Statutes, Florida Administrative Codes and federal regulations governing Medicare and Medicaid if applicable. The majority of health care providers licensed by the Agency are required by law to conduct background screening for certain employment positions
including:

 

• The licensee, if an individual;
• The administrator or a similarly titled person who is responsible for the day-to-day operation of the provider;
• The financial officer or similarly titled individual who is responsible for the financial operation of the licensee or provider;
• A controlling interest if the Agency has reason to believe that such person has been convicted of any offense prohibited by section 435.04, F. S.;
• Any person employed or seeking employment with a licensee or provider who is expected to, or may require him or her to provide personal care or services directly to clients or have access to client funds, personal property or living areas; and
• Any person contracting with a licensee or provider whose responsibilities requires him or her to provide personal care or personal services directly to clients.

All screening results from requests processed through the Agency are reviewed by Agency staff to determine if the person screened is eligible to work pursuant to the requirements of Chapter 435, F. S. In 2009, legislation was passed that expanded the disqualifying offenses for health care employees to include financial crimes such as fraud, including Medicaid fraud, forgery and uttering a forged instrument. These additional disqualifying offenses are provided in section 408.809, F. S. Upon making an eligibility determination, Agency staff post the results in a database that licensed health care providers may access through a secured web site with an assigned user ID and password. Health care providers may use screening results conducted within the last five years, so this database avoids the costs of re-screening for persons that may change jobs.
Legislation passed in 2010 significantly modified the background screening process and hiring practices for many service providers regulated by a variety of state agencies including health care providers licensed by the Agency.

These changes included:
• The requirement for Level 2 fingerprint screening of the state (Florida Department of Law Enforcement) and national (Federal Bureau of Investigations) criminal history repositories for all positions required to undergo screening;
• Submission of fingerprints through electronic (LiveScan) devices;
• Five-year rescreening requirement; and
• Enhanced requirements for the Exemption from Disqualification.

 

This legislation brought a significant increase in the number of screenings conducted through the Agency. Prior to 2010, the Background Screening section processed an average of 65,000 screenings annually. In FY 2010-11, the section processed 209,012 screenings. Of those screenings, 44,076 had a criminal history record and 8,289 were determined to be not eligible for employment. Of the criminal history records reviewed since August 1, 2010, 27 individuals were disqualified due to Medicaid fraud.

 

If a person is determined to be not eligible for employment, section 435.07, F. S., contains guidelines for issuing an exemption from disqualification. A person applying for an exemption must meet certain criminal history criteria, demonstrate rehabilitation and meet other requirements. A granting of an exemption does not change a person’s criminal history record; it merely provides eligibility for employment.

In addition to screening activities, the Background Screening section also reviews news clips and other sources for information related to health care workers that have been arrested for a disqualifying criminal offense. If the individual was previously screened through the Agency, the reported incident is researched and if confirmed as a disqualifying offense, the individual’s screening status is changed to not eligible. The status change is reflected on the secure results website available to the providers and the employing health care provider is notified if the information is on record.

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