Senate Bill 2108c1
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    Florida Senate - 2000                           CS for SB 2108
    By the Committee on Criminal Justice and Senator Brown-Waite
    307-1870-00
  1                      A bill to be entitled
  2         An act relating to health care of inmates in
  3         the state correctional system; providing
  4         legislative intent with respect to the
  5         Correctional Managed Health Care Pilot Program;
  6         creating the Correctional Managed Health Care
  7         Oversight Board to oversee the pilot program;
  8         providing for the membership of the board;
  9         providing duties of the board; providing for
10         meetings of the board; requiring that the board
11         inspect facilities operated under the pilot
12         program and report to the Governor and
13         Legislature; providing for expiration of the
14         board; establishing the Correctional Managed
15         Health Care Pilot Program; specifying the
16         correctional facilities to be included in the
17         pilot program; requiring the Department of
18         Corrections to contract with a private health
19         care vendor for the purpose of providing health
20         care services; providing procedures under which
21         the private vendor may deviate from procedures
22         or protocols adopted by the department;
23         providing for a criminal history check of
24         individuals employed by or contracting with the
25         health care vendor; providing that sovereign
26         immunity does not apply to any vendor
27         performing services under the pilot program;
28         requiring that the vendor and any subcontractor
29         indemnify the state and the department against
30         any liability; requiring that the population of
31         inmates served under the pilot program be
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1         similar to other inmates in the state
  2         correctional system; exempting the facilities
  3         under the pilot program from the direction of
  4         the State of Florida Correctional Medical
  5         Authority; providing for the prime vendor
  6         pharmaceutical contract to be available to the
  7         health care vendor operating the pilot program;
  8         providing an effective date.
  9
10  Be It Enacted by the Legislature of the State of Florida:
11
12         Section 1.  Legislative intent; Correctional Managed
13  Health Care Oversight Board; Correctional Managed Health Care
14  Pilot Program.--
15         (1)  It is the intent of the Legislature that the
16  delivery of inmate health care be accomplished in accordance
17  with the commonly accepted standards within the professional
18  health community at large; be provided at a level comparable
19  to a Medicaid-service level of care, enhanced to include
20  dental, mental health, and pharmacy programs that are at least
21  equivalent to the level of care provided by the Office of
22  Health Services of the Department of Corrections; and be
23  provided in the most cost-effective manner possible. It is
24  also the intent of the Legislature to reduce and control the
25  escalating costs of inmate health care by implementing, in a
26  pilot project, the managed health care approach described in
27  this section and specifically authorized in the 2000-2001
28  General Appropriations Act. In managing the contract for the
29  Correctional Managed Health Care Pilot Program contract, the
30  Department of Corrections shall safeguard the state's interest
31  in providing lawfully adequate health care to inmates.
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1         (2)  Upon the award of a contract, the Correctional
  2  Managed Health Care Oversight Board is created for the purpose
  3  of overseeing the implementation of the Correctional Managed
  4  Health Care Pilot Program. The board shall consist of seven
  5  members appointed by the Governor, one of whom must be
  6  employed by the Agency for Health Care Administration, and one
  7  of whom must be a certified public accountant who holds a
  8  valid license to practice in this state. The remaining members
  9  must be medical professionals and must include a physician, a
10  psychiatrist, a dentist, and a nurse, each of whom must hold a
11  valid license to practice their profession in this state. The
12  Governor shall designate one member to serve as the
13  chairperson. An employee of the Department of Corrections may
14  not be appointed to the board. Five members of the board shall
15  constitute a quorum. The members shall be appointed to terms
16  of 2 years each. A vacancy shall be filled in the same manner
17  as the original appointment and shall be for the remainder of
18  the unexpired term.
19         (a)  The purpose of the board is to assist in the
20  delivery of health care services for inmates in the Department
21  of Corrections by advising the Governor and the Legislature on
22  the status of the health care delivery system of the
23  Department of Corrections at the facilities participating in
24  the Correctional Managed Health Care Pilot Program; by
25  evaluating the provision of primary, convalescent, dental, and
26  mental health care and the management of costs consistent with
27  lawfully adequate care; and by assuring that lawfully adequate
28  standards of primary, convalescent, dental, and mental health
29  care for inmates are maintained. Deficiencies found by the
30  board to be life-threatening or otherwise serious shall be
31  immediately reported to the Secretary of Corrections and the
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1  private health care vendor performing the services under the
  2  Correctional Managed Health Care Pilot Program. The private
  3  health care vendor shall take immediate action to correct
  4  life-threatening or otherwise serious deficiencies identified
  5  by the board and, within 3 calendar days, file a written
  6  corrective action plan with the Secretary of Corrections, the
  7  department's contract manager, and the board which indicates
  8  the actions that will be taken to address the deficiencies.
  9         (b)  The board members shall not be compensated for
10  their services on the board, but are entitled to reimbursement
11  by the Department of Corrections for travel expenses, pursuant
12  to section 112.061, Florida Statutes, from funds appropriated
13  to the Department of Corrections. The department shall provide
14  necessary staff support to the board to enable the board to
15  fulfill its obligations.
16         (c)  The board shall meet at least once each quarter,
17  or often as necessary, for the purpose of carrying out its
18  responsibilities and evaluating the pilot program. The board
19  may adopt by-laws necessary for the board's operation.
20         (d)  The board shall inspect the facilities covered
21  under the pilot program at least once each year and shall
22  submit a report to the Governor, the President of the Senate,
23  and the Speaker of the House within 60 days after the
24  inspection.
25         (e)  The board shall address and resolve any request
26  for changes submitted by the private health care vendor under
27  paragraph (3)(b).
28         (f)  An affirmative vote of the majority of the quorum
29  is necessary for the board to take any action.
30         (g)  The board shall exist until all objectives are
31  achieved, but not later than January 31, 2004.
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1         (3)(a)  The Correctional Managed Health Care Pilot
  2  Program is established for the purpose of providing inmate
  3  health care, including primary, convalescent, dental, and
  4  mental health care, to inmates housed by the Department of
  5  Corrections at the prisons located in the region designated by
  6  the department as Region IV on March 1, 2000. The pilot
  7  program shall:
  8         1.  Commence with a contract awarded to a private
  9  health care vendor by the Department of Corrections, at the
10  department's discretion. The private health care vendor shall
11  provide services to inmates, except inmates housed in
12  institutions authorized under chapter 957, Florida Statutes,
13  at a level that is comparable to the level of care provided
14  under Medicaid. In addition, services shall be enhanced to
15  include dental, mental health, and pharmacy programs that are
16  at least equivalent to the level of care provided by the
17  Office of Health Services of the Department of Corrections.
18  The contract for the pilot project shall be terminated no
19  later than December 31, 2003.
20         2.  Maintain lawfully adequate levels of inmate health
21  care and provide access to health care while achieving
22  substantial cost savings.
23         3.  Adhere to the health care procedures, health care
24  plans, health service bulletins, and treatment protocols
25  relating to the provision of inmate health care services
26  adopted by the Department of Corrections.
27         (b)  If there is a need to deviate from the procedures,
28  plans, bulletins, or protocols adopted by the Department of
29  Corrections, the private health care vendor shall file a
30  request for change with the chairperson of the Correctional
31  Managed Health Care Oversight Board which states the reasons
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1  for the request for change and the alternative protocol the
  2  pilot program would implement, if approved, and shall submit
  3  an affidavit from a local health care provider which attests
  4  to the fact that the alternative protocol is commonly accepted
  5  within the professional health community at large. The
  6  chairperson of the Correctional Managed Health Care Oversight
  7  Board shall promptly assemble a quorum to review the request
  8  for change and submit a recommendation to the Secretary of
  9  Corrections to approve or deny the request. All documentation
10  considered by the board shall be provided to the Secretary of
11  Corrections for a final decision.
12         (c)  The private health care vendor shall provide the
13  names, addresses, and social security numbers and, upon
14  request, a complete set of fingerprints taken by an authorized
15  law enforcement agency, of all individuals who will be
16  employed by, or contracting with, the vendor within the
17  state's correctional system for the purpose of a background
18  check. The Department of Law Enforcement may accept such
19  fingerprints for the purpose of conducting a statewide and
20  national criminal history check and, to the extent provided by
21  law, to exchange state, multistate, and federal criminal
22  history records with the Department of Corrections.
23         (d)  The Department of Corrections shall provide
24  training to the private health care vendor, any
25  subcontractors, and their respective employees with regard to
26  security requirements to be maintained by the vendor,
27  subcontractor, or employees while working within the state's
28  correctional system.
29         (4)  Section 768.28(10)(a), Florida Statutes, does not
30  apply to any vendor performing services under the Correctional
31  Managed Health Care Pilot Program. The vendor entering into a
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1  contract under this section is liable in tort with respect to
  2  the care of inmates under the Correctional Managed Health Care
  3  Pilot Program and for any breach of contract. Sovereign
  4  immunity may not be raised by a vendor, subcontractor, or
  5  employee of the vendor or subcontractor, or by the insurer of
  6  the vendor, subcontractor, or employee on their behalf, as a
  7  defense in any action arising out of the performance of any
  8  service under the terms of any contract entered under this
  9  section or as a defense in tort, or any other application,
10  with respect to the care of inmates and for any breach of
11  contract.
12         (5)  Each primary vendor or subcontractor entering into
13  an agreement under this section shall defend and indemnify the
14  state and the Department of Corrections, including their
15  officials, employees and agents, against any claim, loss,
16  damage, cost, charge, or expense arising out of any act,
17  action, neglect, or omission by the vendor or its agents or
18  employees during the performance of the contract, whether
19  direct or indirect, including, but not limited to, any tort or
20  civil rights liability. Proof of satisfactory insurance is
21  required in the request for proposal and resulting contract,
22  if any is awarded. The vendor shall provide a performance bond
23  in an amount to be specified in the request for proposal.
24         (6)(a)  The population of inmates housed in
25  correctional facilities within which the Correctional Managed
26  Health Care Pilot Program is operated shall be of a
27  substantially similar composition as those inmates who are
28  housed in similar facilities in the remainder of the state
29  correctional system with respect to their overall health, age,
30  mental health, and dental requirements.
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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00
  1         (b)  Section 945.603, Florida Statutes, does not apply
  2  to the correctional facilities within which the pilot program
  3  is operated and such facilities are not subject to direction
  4  by the State of Florida Correctional Medical Authority.
  5         (7)  The prime vendor pharmaceutical contract of the
  6  state shall be available to the private health care vendor
  7  selected to operate the Correctional Managed Health Care Pilot
  8  Program. However, the private health care vendor is not
  9  required to use the state's prime vendor pharmaceutical
10  contract.
11         Section 2.  This act shall take effect upon becoming a
12  law.
13
14          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
15                         Senate Bill 2108
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17  The CS defines a pilot project, authorized by proviso language
    in the Senate Budget 2000-2001, which would allow the
18  Department of Corrections to contract with a private health
    care vendor to deliver inmate health services in one Region
19  for a specified period of time. The CS creates an oversight
    board to report to the Legislature and Governor on the
20  implementation and success of the pilot program.
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