Senate Bill 2388c1

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    Florida Senate - 1999                  CS for SB's 2388 & 1946

    By the Committee on Children and Families; and Senators
    Mitchell and Diaz-Balart




    300-1845A-99

  1                      A bill to be entitled

  2         An act relating to mental health and substance

  3         abuse services; amending s. 394.66, F.S.;

  4         conforming a reference to the renaming of a

  5         department; amending s. 394.74, F.S.;

  6         authorizing the Department of Children and

  7         Family Services to use unit cost methods of

  8         payments in contracts for mental health and

  9         substance abuse services; amending s. 394.78,

10         F.S.; directing the department to adopt certain

11         rules; establishing a commission on mental

12         health and substance abuse; providing

13         membership and duties; providing for an

14         advisory committee; providing for staff and

15         meetings; providing an effective date.

16

17  Be It Enacted by the Legislature of the State of Florida:

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19         Section 1.  Subsections (3) and (7) of section 394.66,

20  Florida Statutes, are amended to read:

21         394.66  Legislative intent with respect to alcohol,

22  drug abuse, and mental health services.--It is the intent of

23  the Legislature to:

24         (3)  Ensure that all activities of the Department of

25  Children Health and Family Rehabilitative Services and its

26  contractors are directed toward the coordination of planning

27  efforts in alcohol, drug abuse, and mental health treatment

28  services.

29         (7)  Include alcohol, drug abuse, and mental health

30  services as a component of the integrated service delivery

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1  system of the Department of Children Health and Family

  2  Rehabilitative Services.

  3         Section 2.  Subsection (2) of section 394.74, Florida

  4  Statutes, is amended to read:

  5         394.74  Contracts for provision of local alcohol, drug

  6  abuse, and mental health programs.--

  7         (2)(a)  Contracts for service shall be consistent with

  8  the approved district plan and the service priorities

  9  established in s. 394.75(4).

10         (b)  Notwithstanding s. 394.76(3)(a) and (c), the

11  department may use unit cost methods of payment in contracts

12  for purchasing mental health and substance abuse services. The

13  unit cost contracting system must through account for those

14  patient fees that are paid on behalf of a specific client and

15  those that are earned and used by the provider for those

16  services funded in whole or in part by the department.

17         (c)  The department may reimburse actual expenditures

18  for start-up contracts and fixed capital outlay contracts in

19  accordance with contract specifications.

20         Section 3.  Subsection (6) is added to section 394.78,

21  Florida Statutes, 1998 Supplement, to read:

22         394.78  Operation and administration; personnel

23  standards; procedures for audit and monitoring of service

24  providers; resolution of disputes.--

25         (6)  The department shall, by rule, establish standards

26  for contracting, budgeting, methods of payment, and the

27  accounting of patient fees that are earned on behalf of a

28  specific client.

29         Section 4.  Commission on Mental Health and Substance

30  Abuse.--

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1         (1)  FINDINGS.--The Legislature finds that:  major

  2  changes and improvements have occurred in how mental health

  3  and substance abuse care services are planned, purchased,

  4  delivered, coordinated, and accounted for; the management of

  5  the state's substance abuse and mental health services system

  6  delineated in part IV of chapter 394, Florida Statutes, has

  7  not been systematically reviewed and updated in over 15 years;

  8  and the management of the state-supported mental health and

  9  substance abuse system has not kept pace with improvements in

10  the field, thereby diminishing the potential efficacy of its

11  investment in mental health services and substance abuse

12  services. Therefore, it is the intent of the Legislature that

13  a systematic review of the overall management of the state's

14  mental health and substance abuse system be conducted and that

15  recommendations for updating part IV of chapter 394, Florida

16  Statutes, and other related statutes be formulated.

17         (2)  CREATION.--There is created, within the Executive

18  Office of the Governor, the Commission on Mental Health and

19  Substance Abuse.

20         (3)  DUTIES.--The duties of the Commission on Mental

21  Health and Substance Abuse include the following:

22         (a)  Conducting a review and evaluation of the

23  management and functioning of the existing publicly supported

24  mental health and substance abuse systems and services in the

25  Department of Children and Family Services, the Agency for

26  Health Care Administration, and all other departments which

27  administer mental health and substance abuse services. Such

28  review shall include, at a mimimum, a review of current goals

29  and objectives, current planning, services strategies,

30  coordination management, purchasing, contracting, financing,

31  local government funding responsibility, and accountability

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1  mechanisms. The commission shall coordinate its activities and

  2  recommendations with the Office of Drug Control.

  3         (b)  Addressing the unique mental health and substance

  4  abuse needs of older persons shall be an integral component of

  5  the duties of the commission as specified in paragraph (a).

  6         (c)  Addressing access to, and financing of, and scope

  7  of responsibility in the delivery of emergency behavioral

  8  health care services.

  9         (d)  Addressing the quality and effectiveness of

10  current mental health and substance abuse services delivery

11  systems, professional staffing and clinical structure of

12  services, roles and responsibilities of public and private

13  providers, such as community mental health centers, community

14  substance abuse agencies, hospitals, including emergency

15  services departments, law enforcement, and the judicial

16  system.

17         (e)  Addressing: priority population groups for

18  publicly funded mental health and substance abuse services; a

19  description of the comprehensive mental health and substance

20  abuse delivery systems; district mental health and substance

21  abuse needs assessment and planning activities; and local

22  government responsibilities for funding mental health and

23  substance abuse services.

24         (f)  Formulating recommendations to the Governor and

25  Legislature regarding the mission and objectives of

26  state-supported mental health and substance abuse services and

27  the planning, management, staffing, financing, contracting,

28  coordination, and accountability mechanisms which will best

29  foster the recommended mission and objectives.

30         (4)  MEMBERSHIP.--The commission shall be composed of

31  22 members.

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1         (a)  One member shall be a member of the Florida Senate

  2  and shall be appointed by the Senate President.

  3         (b)  One member shall be a member of the Florida House

  4  of Representatives and shall be appointed by the Speaker of

  5  the House of Representatives.

  6         (c)  One member shall be the Secretary of the

  7  Department of Children and Family Services or his or her

  8  designee.

  9         (d)  One member shall be the Director of the Agency for

10  Health Care Administration or his or her designee.

11         (e)  The following members shall be appointed by the

12  Governor:

13         1.  One consumer of publicly funded mental health or

14  substance abuse services.

15         2.  One family member of a consumer of publicly funded

16  mental health or substance abuse services.

17         3.  One representative of county government.

18         4.  One representative of the Florida Mental Health

19  Institute.

20         5.  One corporate employer of a corporation providing

21  mental health and substance abuse benefits to employees but

22  who is not in the business of providing mental health or

23  substance abuse services.

24         6.  One representative of an acute care hospital with

25  psychiatric beds or a mental health program.

26         7.  One representative of a community mental health

27  provider.

28         8.  One representative of a community substance abuse

29  provider.

30         9.  A licensed psychiatrist working within the mental

31  health or substance abuse delivery system.

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1         10.  A licensed psychologist working within the mental

  2  health or substance abuse delivery system.

  3         11.  Two other licensed mental health or substance

  4  abuse professionals.

  5         12.  An emergency room physician.

  6         13.  One representative of an insurer offering

  7  behavioral and physical health insurance benefits.

  8         14.  One representative of a specialty hospital

  9  licensed pursuant to chapter 395, Florida Statutes, providing

10  mental health care and addictive services.

11         15.  One representative from law enforcement.

12         16.  One representative from the judicial system.

13         17.  One representative of a child welfare agency

14  involved in the delivery of behavioral health services.

15         (5)  ADVISORY COMMITTEE.--The commission shall appoint

16  at least one advisory committee representative of all state

17  agencies involved in the delivery of mental health and

18  substance abuse services, and consumers, family members of

19  consumers, and current providers of public mental health or

20  substance abuse services.

21         (6)  STAFF.--The Executive Office of the Governor shall

22  appoint an executive director recommended by the commission,

23  who shall provide professional expertise and arrange for

24  required consultation, analysis, and secretarial and clerical

25  support for the commission. Additional staff support shall be

26  provided by the Department of Children and Family Services.

27         (7)  MEETINGS; REPORTS.--

28         (a)  The commission shall conduct its first meeting no

29  later than September 1999.

30         (b)  The commission shall meet as often as necessary to

31  fulfill its responsibilities.

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1         (c)  Committees shall be assigned as needed, composed

  2  of representatives of the commission and the advisory

  3  committee and employees of the involved state agencies.

  4         (d)  All commission meetings shall be open to the

  5  public and shall be held at various locations around the state

  6  to facilitate public participation.

  7         (e)  The commission shall elect a chairperson from

  8  among its members.

  9         (f)  The commission shall, as one of its first duties,

10  adopt rules of procedure, which shall, at a minimum, include a

11  requirement that the recommendations of the commission be

12  adopted by at least two-thirds of those commission members

13  present.

14         (g)  The commission shall submit an interim report to

15  the Governor, the President of the Senate, and the Speaker of

16  the House of Representatives no later than March 1, 2000.

17         (h)  A final report with recommendations, including any

18  modifications to current law, shall be submitted to the

19  Governor, the President of the Senate, and the Speaker of the

20  House of Representatives no later than December 1, 2000.

21         (i)  Authorization for the commission on Mental Health

22  and Substance Abuse expires effective May 15, 2001.

23         Section 5.  There is appropriated for each of fiscal

24  years 1999-2000 and 2000-2001 the sum of $75,000 from the

25  General Revenue Fund and $75,000 from administrative funds

26  available under Title XIX of the Social Security Act

27  (Medicaid), to the Executive Office of the Governor to fund

28  the Commission on Mental Health and Substance Abuse.

29         Section 6.  This act shall take effect upon becoming a

30  law.

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    Florida Senate - 1999                  CS for SB's 2388 & 1946
    300-1845A-99




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                    Senate Bills 2388 and 1946

  3

  4  SB 2388

  5  Removes the provision that unit cost contracting is effective
    through June 30, 2000.
  6
    Includes provisions for the department to propose statutory
  7  revisions to chapter 394, part IV, F.S., no later than October
    1, 2000.
  8
    Creates the Commission on Mental Health and Substance Abuse
  9  and specifies its membership and duties.

10  SB 1946

11  Removes the provision that unit cost contracting is effective
    through June 30, 2000.
12
    Deletes the provision that the Department of Children and
13  Family Services propose statutory revisions to part IV of
    Chapter 394, F.S., by December 1, 1999.
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    Creates the Commission on Mental Health and Substance Abuse
15  and specifies its membership and duties.

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