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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to mental health and substance abuse; 2
amending s. 394.494, F.S.; revising a requirement for 3
the Department of Children and Families relating to 4
certain performance outcomes and measures; amending s. 5
394.4955, F.S.; requiring managing entiti es to lead 6
the implementation of a coordinated system of care; 7
repealing s. 394.74, F.S., relating to contracts for 8
provision of local substance abuse and mental health 9
programs; repealing s. 394.75, F.S., relating to state 10
and district substance abuse and mental health plans; 11
repealing s. 394.76, F.S., relating to financing of 12
district programs and services; amending s. 394.9082, 13
F.S.; revising the definition of the term "managing 14
entity"; revising the duties of the department; 15
revising department requirem ents for, and 16
authorizations relating to, contracting with managing 17
entities; requiring the department to review such 18
assessments, in consultation with managing entity 19
representatives, for inclusion in the department's 20
legislative budget request; revising managing entity 21
duties; deleting a requirement for certain managing 22
entities to enter into a memoranda of understanding 23
relating to network accreditation and systems 24
coordination within a specified timeframe; revising 25
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the timeframe for annually submitting enhancement 26
plans; revising requirements relating to the acute 27
care services utilization database; amending ss. 28
394.4574, 394.493, and 394.674, F.S.; conforming 29
provisions to changes made by the act; reenacting ss. 30
394.9086(3)(a) and 394.9087(6), F.S., rel ating to the 31
Commission on Mental Health and Substance Abuse and 32
the Florida Veterans' Care Coordination Program, 33
respectively, to incorporate the amendments made to s. 34
394.9082, F.S., in references thereto; providing an 35
effective date. 36
37
Be It Enacted by the Legislature of the State of Florida: 38
39
Section 1. Subsection (2) of section 394.494, Florida 40
Statutes, is amended to read: 41
394.494 General performance outcomes for the child and 42
adolescent mental health treatment and support system. — 43
(2) Annually, pursuant to former s. 216.0166, the 44
department shall develop more specific performance outcomes and 45
performance measures to assess the performance of the child and 46
adolescent mental health treatment and support system in 47
achieving the intent of this section. 48
Section 2. Subsection (1) of section 394.4955, Florida 49
Statutes, is amended to read: 50
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394.4955 Coordinated system of care; child and adolescent 51
mental health treatment and support. — 52
(1) Pursuant to s. 394.9082(5)(d), each managing entity 53
shall lead the development and implementation of a plan that 54
promotes the development and effective implementation of a 55
coordinated system of care which integrates services provided 56
through providers funded by the state's child -serving systems 57
and facilitates access by children and adolescents, as resources 58
permit, to needed mental health treatment and services at any 59
point of entry regardless of the time of year, intensity, or 60
complexity of the need, and other systems with which such 61
children and adolescents are involved, as well as treatment and 62
services available through other systems for which they would 63
qualify. 64
Section 3. Section 394.74, Florida Statutes, is repealed. 65
Section 4. Section 394.75, Florida Statutes, is repealed. 66
Section 5. Section 394.76, Florida Statutes, is repealed. 67
Section 6. Paragraph (e) of subsection (2), paragraphs (b) 68
and (j) of subsection (4), paragraphs (b) and (l) of subsection 69
(5), paragraph (b) of subsection (6), and subsections (8) and 70
(10) of section 394.9082, Florida Statutes, are amended, and 71
paragraphs (n) and (o) are added to subsection (3) and paragraph 72
(v) is added to subsection (5) of that section, to read: 73
394.9082 Behavioral health managing entities. — 74
(2) DEFINITIONS.—As used in this section, the te rm: 75
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(e) "Managing entity" means a corporation : 76
1. Selected by and under contract with the department to 77
manage the daily operational delivery of behavioral health 78
services through a coordinated system of care that does not 79
provide therapeutic services; and 80
2. That is eligible to receive federal block grant 81
funding. 82
(3) DEPARTMENT DUTIES. —The department shall: 83
(n) Work with the managing entities and allow managing 84
entities to have direct input when reviewing expenditures to 85
determine funding of app ropriate services and reduce 86
administrative burdens. 87
(o) Complete a review of all reports submitted by managing 88
entities for the purpose of reducing administrative burdens by 89
identifying obsolete, duplicative, and uninformative reports. 90
(4) CONTRACT WITH MANAGING ENTITIES. — 91
(b) The department may shall issue an invitation to 92
negotiate under s. 287.057 to select an organization to serve as 93
a managing entity. If the department does not receive a 94
responsive bid receives fewer than two responsive bids to the 95
solicitation, the department may shall reissue the solicitation 96
and managed behavioral health organizations shall be eligible to 97
bid and be awarded a contract , notwithstanding the federal block 98
grant eligibility requirement . 99
(j) By June 30, 2019, If all other contract requirements 100
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and performance standards are substantially met and the 101
department determines that a managing entity has maintained 102
under contract as of July 1, 2016, has received network 103
accreditation pursuant to subsection (6), the depart ment may 104
continue its contract with the managing entity for as long as 105
the managing entity meets its contractual and performance 106
requirements up to, but not exceeding, 5 years, including any 107
and all renewals and extensions. Thereafter, the department must 108
issue a competitive solicitation pursuant to paragraph (b) . 109
(5) MANAGING ENTITY DUTIES. —A managing entity shall: 110
(b) Conduct a community behavioral health care needs 111
assessment every 3 years in the geographic area served by the 112
managing entity which id entifies needs by subregion. The process 113
for conducting the needs assessment shall include an opportunity 114
for public participation. The assessment shall include, at a 115
minimum, the information the department needs for its annual 116
report to the Governor and L egislature pursuant to s. 394.4573. 117
The assessment shall also include a list and descriptions of any 118
gaps in the arrays of services for children or adolescents 119
identified pursuant to s. 394.4955 and recommendations for 120
addressing such gaps. The managing en tity shall provide the 121
needs assessment to the department. The department, in 122
consultation with the managing entity representatives, shall 123
review such assessments for inclusion in the department's 124
legislative budget request. 125
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(l) Work collaboratively with public receiving facilities 126
and licensed housing providers to establish a network of 127
licensed housing resources for mental health consumers that will 128
prevent and reduce readmissions to public receiving facilities. 129
(v) Collaborate with county emergency o peration centers to 130
identify organizations that ensure access to and coordinate 131
delivery of behavioral health services to responders and 132
survivors and survivor's family members of a public emergency as 133
critical public health infrastructure. 134
(6) NETWORK ACCREDITATION AND SYSTEMS COORDINATION 135
AGREEMENTS.— 136
(b) If no accreditations are available or deemed 137
acceptable pursuant to paragraph (a) which address coordination 138
between the provider network and major systems and programs with 139
which the provider networ k interacts, each managing entity shall 140
enter into memoranda of understanding which details mechanisms 141
for communication and coordination. The managing entity shall 142
enter into such memoranda with any community -based care lead 143
agencies, circuit courts, coun ty courts, sheriffs' offices, 144
offices of the public defender, offices of criminal conflict and 145
civil regional counsel, Medicaid managed medical assistance 146
plans, and homeless coalitions in its service area. Each 147
managing entity under contract on July 1, 20 16, shall enter into 148
such memoranda by June 30, 2017, and each managing entity under 149
contract after July 1, 2016, shall enter into such memoranda 150
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within 1 year after its contract execution date. 151
(8) ENHANCEMENT PLANS. —By June September 1 of each year, 152
beginning in 2017, each managing entity shall develop and submit 153
to the department a description of strategies for enhancing 154
services and addressing three to five priority needs in the 155
service area. The planning process sponsored by the managing 156
entity shall include consumers and their families, community -157
based care lead agencies, local governments, law enforcement 158
agencies, service providers, community partners and other 159
stakeholders. Each strategy must be described in detail and 160
accompanied by an implementa tion plan that specifies action 161
steps, identifies responsible parties, and delineates specific 162
services that would be purchased, projected costs, the projected 163
number of individuals that would be served, and the estimated 164
benefits of the services. The department shall consider 165
enhancement plans submitted by the managing entities in the 166
department's legislative budget request All or parts of these 167
enhancement plans may be included in the department's annual 168
budget requests submitted to the Legislature . 169
(10) ACUTE CARE SERVICES UTILIZATION DATABASE. —The 170
department shall develop, implement, and maintain standards 171
under which a managing entity shall collect utilization data 172
from all contracted public receiving facilities situated within 173
its geographical service area and all detoxification and 174
addictions receiving facilities under contract with the managing 175
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entity. As used in this subsection, the term "public receiving 176
facility" means an entity that meets the licensure requirements 177
of, and is designated by, the department to operate as a public 178
receiving facility under s. 394.875 and that is operating as a 179
licensed crisis stabilization unit. 180
(a) The department shall develop standards and protoc ols 181
to be used for data collection, storage, transmittal, and 182
analysis. The standards and protocols shall allow for 183
compatibility of data and data transmittal between public 184
receiving facilities, detoxification facilities, addictions 185
receiving facilities, managing entities, and the department for 186
the implementation, and to meet the requirements, of this 187
subsection. 188
(b) A managing entity shall require providers specified in 189
paragraph (a) to submit data, in real time or at least daily, to 190
the managing entity for: 191
1. All admissions and discharges of clients receiving 192
public receiving facility services who qualify as indigent, as 193
defined in s. 394.4787. 194
2. All admissions and discharges of clients receiving 195
substance abuse services in an addictions receivin g facility or 196
detoxification facility pursuant to parts IV and V of chapter 197
397 who qualify as indigent. 198
3. The current active census of total licensed beds, the 199
number of beds purchased by the department, the number of 200
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clients qualifying as indigent occ upying those beds, and the 201
total number of unoccupied licensed beds, regardless of funding. 202
(c) A managing entity shall require providers specified in 203
paragraph (a) to submit data, on a monthly basis, to the 204
managing entity which aggregates the daily dat a submitted under 205
paragraph (b). The managing entity shall reconcile the data in 206
the monthly submission to the data received by the managing 207
entity under paragraph (b) to check for consistency. If the 208
monthly aggregate data submitted by a provider under th is 209
paragraph are inconsistent with the daily data submitted under 210
paragraph (b), the managing entity shall consult with the 211
provider to make corrections necessary to ensure accurate data. 212
(d) A managing entity shall require providers specified in 213
paragraph (a) within its provider network to submit data, on an 214
annual basis, to the managing entity which aggregates the data 215
submitted and reconciled under paragraph (c). The managing 216
entity shall reconcile the data in the annual submission to the 217
data received and reconciled by the managing entity under 218
paragraph (c) to check for consistency. If the annual aggregate 219
data submitted by a provider under this paragraph are 220
inconsistent with the data received and reconciled under 221
paragraph (c), the managing entity s hall consult with the 222
provider to make corrections necessary to ensure accurate data. 223
(e) After ensuring the accuracy of data pursuant to 224
paragraphs (c) and (d), the managing entity shall submit the 225
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data to the department on a monthly and an annual basis . The 226
department shall create a statewide database for the data 227
described under paragraph (b) and submitted under this paragraph 228
for the purpose of analyzing the use of publicly funded crisis 229
stabilization services and detoxification and addictions 230
receiving services provided on a statewide and an individual 231
provider basis. 232
(f) The department shall post on its website, by facility, 233
the data collected pursuant to this subsection and update such 234
posting monthly. 235
Section 7. Subsection (3) of section 394. 4574, Florida 236
Statutes, is amended to read: 237
394.4574 Responsibilities for coordination of services for 238
a mental health resident who resides in an assisted living 239
facility that holds a limited mental health license. — 240
(3) The Secretary of Children and Fa milies, in 241
consultation with the Agency for Health Care Administration, 242
shall require each district administrator to develop, with 243
community input, a detailed annual plan that demonstrates how 244
the district will ensure the provision of state -funded mental 245
health and substance abuse treatment services to residents of 246
assisted living facilities that hold a limited mental health 247
license. This plan must be consistent with the substance abuse 248
and mental health district plan developed pursuant to s. 394.75 249
and must address case management services; access to consumer -250
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operated drop-in centers; access to services during evenings, 251
weekends, and holidays; supervision of the clinical needs of the 252
residents; and access to emergency psychiatric care. 253
Section 8. Subsection (3) of section 394.493, Florida 254
Statutes, is amended to read: 255
394.493 Target populations for child and adolescent mental 256
health services funded through the department. — 257
(3) Each child or adolescent who meets the target 258
population criteria of this section shall be served to the 259
extent possible within available resources and consistent with 260
the portion of the district substance abuse and mental health 261
plan specified in s. 394.75 which pertains to child and 262
adolescent mental health services . 263
Section 9. Subsection (5) of section 394.674, Florida 264
Statutes, is amended to read: 265
394.674 Eligibility for publicly funded substance abuse 266
and mental health services; fee collection requirements. — 267
(5) A person who meets the eligibility criteria in 268
subsection (1) shall be served in accordance with the 269
appropriate district substance abuse and mental health services 270
plan specified in s. 394.75 and within available resources. 271
Section 10. For the purpose of incorporating the 272
amendments made by this act to section 394.9082, Florida 273
Statutes, in a reference thereto, paragraph (a) of subsection 274
(3) of section 394.9086, Florida Statutes, is reenacted to read: 275
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394.9086 Commission on Mental Health and Substance Abuse. — 276
(3) MEMBERSHIP; TERM LIMITS; MEETING S.— 277
(a) The commission shall be composed of 19 members as 278
follows: 279
1. A member of the Senate, appointed by the President of 280
the Senate. 281
2. A member of the House of Representatives, appointed by 282
the Speaker of the House of Representatives. 283
3. The Secretary of Children and Families or his or her 284
designee. 285
4. The Secretary of the Agency for Health Care 286
Administration or his or her designee. 287
5. A person living with a mental health disorder, 288
appointed by the President of the Senate. 289
6. A family member of a consumer of publicly funded mental 290
health services, appointed by the President of the Senate. 291
7. A representative of the Louis de la Parte Florida 292
Mental Health Institute within the University of South Florida, 293
appointed by the President of the Senate. 294
8. A representative of a county school district, appointed 295
by the President of the Senate. 296
9. A representative of mental health courts, appointed by 297
the Governor. 298
10. A representative of a treatment facility, as defined 299
in s. 394.455, appoint ed by the Speaker of the House of 300
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Representatives. 301
11. A representative of a managing entity, as defined in 302
s. 394.9082(2), appointed by the Speaker of the House of 303
Representatives. 304
12. A representative of a community substance abuse 305
provider, appointed by the Speaker of the House of 306
Representatives. 307
13. A psychiatrist licensed under chapter 458 or chapter 308
459 practicing within the mental health delivery system, 309
appointed by the Speaker of the House of Representatives. 310
14. A psychologist licensed un der chapter 490 practicing 311
within the mental health delivery system, appointed by the 312
Governor. 313
15. A mental health professional licensed under chapter 314
491, appointed by the Governor. 315
16. An emergency room physician, appointed by the 316
Governor. 317
17. A representative from the field of law enforcement, 318
appointed by the Governor. 319
18. A representative from the criminal justice system, 320
appointed by the Governor. 321
19. A representative of a child welfare agency involved in 322
the delivery of behavioral health services, appointed by the 323
Governor. 324
Section 11. For the purpose of incorporating the 325
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amendments made by this act to section 394.9082, Florida 326
Statutes, in a reference thereto, subsection (6) of section 327
394.9087, Florida Statutes, is reenacted to read: 328
394.9087 Florida Veterans' Care Coordination Program. — 329
(6) Florida 211 Network participants in the Florida 330
Veterans' Care Coordination Program shall maintain a database of 331
veteran-specific services available in the communities served by 332
the programs. The Department of Veterans' Affairs and its 333
selected contractor shall work with managing entities as defined 334
in s. 394.9082(2) to educate service providers about the Florida 335
Veterans Support Line and the Florida Veterans' Care 336
Coordination Program. 337
Section 12. This act shall take effect July 1, 2023. 338