Florida Senate - 2023 SB 1016 By Senator Rouson 16-00534C-23 20231016__ 1 A bill to be entitled 2 An act relating to mental health and substance abuse; 3 amending s. 394.494, F.S.; revising a requirement for 4 the Department of Children and Families relating to 5 certain performance outcomes and measures; amending s. 6 394.4955, F.S.; requiring managing entities to lead 7 the implementation of a coordinated system of care; 8 repealing s. 394.74, F.S., relating to contracts for 9 provision of local substance abuse and mental health 10 programs; repealing s. 394.75, F.S., relating to state 11 and district substance abuse and mental health plans; 12 repealing s. 394.76, F.S., relating to financing of 13 district programs and services; amending s. 394.9082, 14 F.S.; revising the definition of the term managing 15 entity; revising the duties of the department; 16 revising department requirements for, and 17 authorizations relating to, contracting with managing 18 entities; requiring the department to review such 19 assessments, in consultation with managing entity 20 representatives, for inclusion in the departments 21 legislative budget request; revising managing entity 22 duties; deleting a requirement for certain managing 23 entities to enter into a memoranda of understanding 24 relating to network accreditation and systems 25 coordination within a specified timeframe; revising 26 the timeframe for annually submitting enhancement 27 plans; revising requirements relating to the acute 28 care services utilization database; amending ss. 29 394.4574, 394.493, and 394.674, F.S.; conforming 30 provisions to changes made by the act; reenacting ss. 31 394.9086(3)(a) and 394.9087(6), F.S., relating to the 32 Commission on Mental Health and Substance Abuse and 33 the Florida Veterans Care Coordination Program, 34 respectively, to incorporate the amendments made to s. 35 394.9082, F.S., in references thereto; providing an 36 effective date. 37 38 Be It Enacted by the Legislature of the State of Florida: 39 40 Section 1.Subsection (2) of section 394.494, Florida 41 Statutes, is amended to read: 42 394.494General performance outcomes for the child and 43 adolescent mental health treatment and support system. 44 (2)Annually, pursuant to former s. 216.0166, the 45 department shall develop more specific performance outcomes and 46 performance measures to assess the performance of the child and 47 adolescent mental health treatment and support system in 48 achieving the intent of this section. 49 Section 2.Subsection (1) of section 394.4955, Florida 50 Statutes, is amended to read: 51 394.4955Coordinated system of care; child and adolescent 52 mental health treatment and support. 53 (1)Pursuant to s. 394.9082(5)(d), each managing entity 54 shall lead the development and implementation of a plan that 55 promotes the development and effective implementation of a 56 coordinated system of care which integrates services provided 57 through providers funded by the states child-serving systems 58 and facilitates access by children and adolescents, as resources 59 permit, to needed mental health treatment and services at any 60 point of entry regardless of the time of year, intensity, or 61 complexity of the need, and other systems with which such 62 children and adolescents are involved, as well as treatment and 63 services available through other systems for which they would 64 qualify. 65 Section 3.Section 394.74, Florida Statutes, is repealed. 66 Section 4.Section 394.75, Florida Statutes, is repealed. 67 Section 5.Section 394.76, Florida Statutes, is repealed. 68 Section 6.Paragraph (e) of subsection (2), paragraphs (b) 69 and (j) of subsection (4), paragraphs (b) and (l) of subsection 70 (5), paragraph (b) of subsection (6), and subsections (8) and 71 (10) of section 394.9082, Florida Statutes, are amended, and 72 paragraphs (n) and (o) are added to subsection (3) and paragraph 73 (v) is added to subsection (5) of that section, to read: 74 394.9082Behavioral health managing entities. 75 (2)DEFINITIONS.As used in this section, the term: 76 (e)Managing entity means a corporation: 77 1.Selected by and under contract with the department to 78 manage the daily operational delivery of behavioral health 79 services through a coordinated system of care that does not 80 provide therapeutic services; and 81 2.That is eligible to receive federal block grant 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 appropriate 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 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 department 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 identifies 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 Legislature 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 entity 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 departments 124 legislative budget request. 125 (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 operation centers to 130 identify organizations that ensure access to and coordinate 131 delivery of behavioral health services to responders and 132 survivors and survivors 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 acceptable 137 pursuant to paragraph (a) which address coordination between the 138 provider network and major systems and programs with which the 139 provider network interacts, each managing entity shall enter 140 into memoranda of understanding which details mechanisms for 141 communication and coordination. The managing entity shall enter 142 into such memoranda with any community-based care lead agencies, 143 circuit courts, county courts, sheriffs offices, offices of the 144 public defender, offices of criminal conflict and civil regional 145 counsel, Medicaid managed medical assistance plans, and homeless 146 coalitions in its service area. Each managing entity under 147 contract on July 1, 2016, shall enter into such memoranda by 148 June 30, 2017, and each managing entity under contract after 149 July 1, 2016, shall enter into such memoranda within 1 year 150 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 implementation 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 departments legislative budget request All or parts of these 167 enhancement plans may be included in the departments 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 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 protocols to 181 be used for data collection, storage, transmittal, and analysis. 182 The standards and protocols shall allow for compatibility of 183 data and data transmittal between public receiving facilities, 184 detoxification facilities, addictions receiving facilities, 185 managing entities, and the department for the implementation, 186 and to meet the requirements, of this subsection. 187 (b)A managing entity shall require providers specified in 188 paragraph (a) to submit data, in real time or at least daily, to 189 the managing entity for: 190 1.All admissions and discharges of clients receiving 191 public receiving facility services who qualify as indigent, as 192 defined in s. 394.4787. 193 2.All admissions and discharges of clients receiving 194 substance abuse services in an addictions receiving facility or 195 detoxification facility pursuant to parts IV and V of chapter 196 397 who qualify as indigent. 197 3.The current active census of total licensed beds, the 198 number of beds purchased by the department, the number of 199 clients qualifying as indigent occupying those beds, and the 200 total number of unoccupied licensed beds, regardless of funding. 201 (c)A managing entity shall require providers specified in 202 paragraph (a) to submit data, on a monthly basis, to the 203 managing entity which aggregates the daily data submitted under 204 paragraph (b). The managing entity shall reconcile the data in 205 the monthly submission to the data received by the managing 206 entity under paragraph (b) to check for consistency. If the 207 monthly aggregate data submitted by a provider under this 208 paragraph are inconsistent with the daily data submitted under 209 paragraph (b), the managing entity shall consult with the 210 provider to make corrections necessary to ensure accurate data. 211 (d)A managing entity shall require providers specified in 212 paragraph (a) within its provider network to submit data, on an 213 annual basis, to the managing entity which aggregates the data 214 submitted and reconciled under paragraph (c). The managing 215 entity shall reconcile the data in the annual submission to the 216 data received and reconciled by the managing entity under 217 paragraph (c) to check for consistency. If the annual aggregate 218 data submitted by a provider under this paragraph are 219 inconsistent with the data received and reconciled under 220 paragraph (c), the managing entity shall consult with the 221 provider to make corrections necessary to ensure accurate data. 222 (e)After ensuring the accuracy of data pursuant to 223 paragraphs (c) and (d), the managing entity shall submit the 224 data to the department on a monthly and an annual basis. The 225 department shall create a statewide database for the data 226 described under paragraph (b) and submitted under this paragraph 227 for the purpose of analyzing the use of publicly funded crisis 228 stabilization services and detoxification and addictions 229 receiving services provided on a statewide and an individual 230 provider basis. 231 (f)The department shall post on its website, by facility, 232 the data collected pursuant to this subsection and update such 233 posting monthly. 234 Section 7.Subsection (3) of section 394.4574, Florida 235 Statutes, is amended to read: 236 394.4574Responsibilities for coordination of services for 237 a mental health resident who resides in an assisted living 238 facility that holds a limited mental health license. 239 (3)The Secretary of Children and Families, in consultation 240 with the Agency for Health Care Administration, shall require 241 each district administrator to develop, with community input, a 242 detailed annual plan that demonstrates how the district will 243 ensure the provision of state-funded mental health and substance 244 abuse treatment services to residents of assisted living 245 facilities that hold a limited mental health license. This plan 246 must be consistent with the substance abuse and mental health 247 district plan developed pursuant to s. 394.75 and must address 248 case management services; access to consumer-operated drop-in 249 centers; access to services during evenings, weekends, and 250 holidays; supervision of the clinical needs of the residents; 251 and access to emergency psychiatric care. 252 Section 8.Subsection (3) of section 394.493, Florida 253 Statutes, is amended to read: 254 394.493Target populations for child and adolescent mental 255 health services funded through the department. 256 (3)Each child or adolescent who meets the target 257 population criteria of this section shall be served to the 258 extent possible within available resources and consistent with 259 the portion of the district substance abuse and mental health 260 plan specified in s. 394.75 which pertains to child and 261 adolescent mental health services. 262 Section 9.Subsection (5) of section 394.674, Florida 263 Statutes, is amended to read: 264 394.674Eligibility for publicly funded substance abuse and 265 mental health services; fee collection requirements. 266 (5)A person who meets the eligibility criteria in 267 subsection (1) shall be served in accordance with the 268 appropriate district substance abuse and mental health services 269 plan specified in s. 394.75 and within available resources. 270 Section 10.For the purpose of incorporating the amendments 271 made by this act to section 394.9082, Florida Statutes, in a 272 reference thereto, paragraph (a) of subsection (3) of section 273 394.9086, Florida Statutes, is reenacted to read: 274 394.9086Commission on Mental Health and Substance Abuse. 275 (3)MEMBERSHIP; TERM LIMITS; MEETINGS. 276 (a)The commission shall be composed of 19 members as 277 follows: 278 1.A member of the Senate, appointed by the President of 279 the Senate. 280 2.A member of the House of Representatives, appointed by 281 the Speaker of the House of Representatives. 282 3.The Secretary of Children and Families or his or her 283 designee. 284 4.The Secretary of the Agency for Health Care 285 Administration or his or her designee. 286 5.A person living with a mental health disorder, appointed 287 by the President of the Senate. 288 6.A family member of a consumer of publicly funded mental 289 health services, appointed by the President of the Senate. 290 7.A representative of the Louis de la Parte Florida Mental 291 Health Institute within the University of South Florida, 292 appointed by the President of the Senate. 293 8.A representative of a county school district, appointed 294 by the President of the Senate. 295 9.A representative of mental health courts, appointed by 296 the Governor. 297 10.A representative of a treatment facility, as defined in 298 s. 394.455, appointed by the Speaker of the House of 299 Representatives. 300 11.A representative of a managing entity, as defined in s. 301 394.9082(2), appointed by the Speaker of the House of 302 Representatives. 303 12.A representative of a community substance abuse 304 provider, appointed by the Speaker of the House of 305 Representatives. 306 13.A psychiatrist licensed under chapter 458 or chapter 307 459 practicing within the mental health delivery system, 308 appointed by the Speaker of the House of Representatives. 309 14.A psychologist licensed under chapter 490 practicing 310 within the mental health delivery system, appointed by the 311 Governor. 312 15.A mental health professional licensed under chapter 313 491, appointed by the Governor. 314 16.An emergency room physician, appointed by the Governor. 315 17.A representative from the field of law enforcement, 316 appointed by the Governor. 317 18.A representative from the criminal justice system, 318 appointed by the Governor. 319 19.A representative of a child welfare agency involved in 320 the delivery of behavioral health services, appointed by the 321 Governor. 322 Section 11.For the purpose of incorporating the amendments 323 made by this act to section 394.9082, Florida Statutes, in a 324 reference thereto, subsection (6) of section 394.9087, Florida 325 Statutes, is reenacted to read: 326 394.9087Florida Veterans Care Coordination Program. 327 (6)Florida 211 Network participants in the Florida 328 Veterans Care Coordination Program shall maintain a database of 329 veteran-specific services available in the communities served by 330 the programs. The Department of Veterans Affairs and its 331 selected contractor shall work with managing entities as defined 332 in s. 394.9082(2) to educate service providers about the Florida 333 Veterans Support Line and the Florida Veterans Care 334 Coordination Program. 335 Section 12.This act shall take effect July 1, 2023.