Senate Bill sb1346c1

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2001                           CS for SB 1346

    By the Committee on Children and Families; and Senator
    Saunders




    300-1663-01

  1                      A bill to be entitled

  2         An act relating to behavioral health care

  3         service; amending s. 394.66, F.S.; providing

  4         legislative intent; creating s. 394.741, F.S.;

  5         requiring the Agency for Health Care

  6         Administration and the Department of Children

  7         and Family Services to accept accreditation in

  8         lieu of its administrative and program

  9         monitoring under certain circumstances;

10         amending s. 394.90, F.S.; requiring the Agency

11         for Health Care Administration to accept

12         accreditation in lieu of its onsite licensure

13         reviews; amending s. 397.411, F.S.; requiring

14         the Department of Children and Family Services

15         to accept accreditation in lieu of its onsite

16         licensure reviews; amending s. 397.403, F.S.;

17         conforming provisions; providing an effective

18         date.

19

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

21

22         Section 1.  Subsections (13) and (14) are added to

23  section 394.66, Florida Statutes, to read:

24         394.66  Legislative intent with respect to substance

25  abuse and mental health services.--It is the intent of the

26  Legislature to:

27         (13)  Promote best practices and the highest quality of

28  care in contacted alcohol, drug abuse, and mental health

29  services through achievement of national accreditation.

30         (14)  Ensure that the state agencies, licensing and

31  monitoring contracted providers, perform in the most

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1  cost-efficient and effective manner with limited duplication

  2  and disruption to organizations providing services.

  3         Section 2.  Section 394.741, Florida Statutes, is

  4  created to read:

  5         394.741  Accreditation requirements for providers of

  6  behavioral health care services.--

  7         (1)  As used in this section, the term "behavioral

  8  health care services" means mental health and substance abuse

  9  treatment services.

10         (2)  Notwithstanding any provision of law to the

11  contrary, accreditation shall be accepted by the agency and

12  department in lieu of the agency's and department's facility

13  licensure on-site review requirements and shall be accepted as

14  a substitute for the department's administrative and program

15  monitoring requirements, except as required by subsections (3)

16  and (4):

17         (a)  Any organization from which the department

18  purchases behavioral health care services that is accredited

19  by the Joint Commission on Accreditation of Healthcare

20  Organizations or the Council on Accreditation for Children and

21  Family Services, or have those services that are being

22  purchased by the department accredited by CARF--the

23  Rehabilitation Accreditation Commission.

24         (b)  Any mental health facility licensed by the agency

25  or any substance abuse component licensed by the department

26  that is accredited by the Joint Commission on Accreditation of

27  Healthcare Organizations, CARF--the Rehabilitation

28  Accreditation Commission or the Council on Accreditation of

29  Children and Family Services.

30         (c)  Any network of providers from which the department

31  or the agency purchase behavioral health care services

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1  accredited by the Joint Commission on Accreditation of

  2  Healthcare Organizations, CARF--the Rehabilitation

  3  Accreditation Commission, the Council on Accreditation of

  4  Children and Family Services, or the National Committee for

  5  Quality Assurance. A provider organization, which is part of

  6  an accredited network, is afforded the same rights under this

  7  part.

  8         (3)  For mental health services, the department and the

  9  agency may adopt rules that establish:

10         (a)  Additional standards for monitoring and licensing

11  accredited programs and facilities that the department and the

12  agency have determined are not specifically and distinctly

13  covered by the accreditation standards and processes. These

14  standards and the associated monitoring must not duplicate the

15  standards and processes already covered by the accrediting

16  bodies.

17         (b)  An on-site monitoring process between 24 months

18  and 36 months after accreditation for non-residential

19  facilities to assure that accredited organizations exempt from

20  licensing and monitoring activities under this part continue

21  to comply with critical standards.

22         (c)  An on-site monitoring process between 12 months

23  and 24 months after accreditation for residential facilities

24  to assure that accredited organizations exempt from licensing

25  and monitoring activities under this part continue to comply

26  with critical standards.

27         (4)  For substance abuse services, the department shall

28  conduct full licensure inspections every three years and shall

29  develop in rule criteria which would justify more frequent

30  inspections.

31

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1         (5)  The department and the agency shall be given

  2  access to all accreditation reports, corrective action plans,

  3  and performance data submitted to the accrediting

  4  organizations. When major deficiencies, as defined by the

  5  accrediting organization, are identified through the

  6  accreditation process, the department and the agency may

  7  perform followup monitoring to assure that such deficiencies

  8  are corrected and that the corrections are sustained over

  9  time. Proof of compliance with fire and health safety

10  standards will be submitted as required by rule.

11         (6)  The department or agency, by accepting the survey

12  or inspection of an accrediting organization, does not forfeit

13  its rights to perform inspections at any time, including

14  contract monitoring to ensure that deliverables are provided

15  in accordance with the contract.

16         (7)  The department and the agency shall report to the

17  Legislature by January 1, 2003 on the viability of mandating

18  all organizations under contract with the department for the

19  provision of behavioral healthcare services, or licensed by

20  the agency or department to be accredited. The department and

21  the agency shall also report to the Legislature by January 1,

22  2003 on the viability of privatizing all licensure and

23  monitoring functions through an accrediting organization.

24         (8)  The accreditation requirements of this section

25  shall apply to contracted organizations that are already

26  accredited immediately upon becoming law.

27         Section 3.  Subsection (5) of section 394.90, Florida

28  Statutes, is amended to read:

29         394.90  Inspection; right of entry; records.--

30         (5)(a)  The agency shall may accept, in lieu of its own

31  inspections for licensure, the survey or inspection of an

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1  accrediting organization, if the provider is accredited

  2  according to the provisions of s. 394.741 and the agency

  3  receives the report of the accrediting organization. The

  4  department, in consultation with the agency, shall develop,

  5  and adopt by rule, specific criteria for assuring that the

  6  accrediting organization has specific standards and experience

  7  related to the program area being licensed, specific criteria

  8  for accepting the standards and survey methodologies of an

  9  accrediting organization, delineations of the obligations of

10  accrediting organizations to assure adherence to those

11  standards, criteria for receiving, accepting and maintaining

12  the confidentiality of the survey and corrective action

13  reports, and allowance for the agency's participation in

14  surveys.

15         (b)  The agency shall conduct compliance investigations

16  and sample validation inspections to evaluate the inspection

17  process of accrediting organizations to ensure minimum

18  standards are maintained as provided in Florida statute and

19  rule. The agency may conduct a lifesafety inspection in

20  calendar years in which an accrediting organization survey is

21  not conducted and shall conduct a full state inspection,

22  including a lifesafety inspection, if an accrediting

23  organization survey has not been conducted within the previous

24  36 months.  The agency, by accepting the survey or inspection

25  of an accrediting organization, does not forfeit its right to

26  perform inspections.

27         Section 4.  Subsection (2) of section 397.411, Florida

28  Statutes, is amended to read:

29         397.411  Inspection; right of entry; records.--

30         (2)(a)  The department shall may accept, in lieu of its

31  own inspections for licensure, the survey or inspection of an

                                  5

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1  accrediting organization, if the provider is accredited

  2  according to the provisions of s. 394.741 and the department

  3  receives the report of the accrediting organization. The

  4  department shall develop, and adopt by rule, specific criteria

  5  for assuring that the accrediting organization has specific

  6  standards and experience related to the program area being

  7  licensed; specific criteria for accepting the standards and

  8  survey methodologies of an accrediting organization;

  9  delineations of the obligations of accrediting organizations

10  to assure adherence to those standards; criteria for

11  receiving, accepting, and maintaining the confidentiality of

12  the survey and corrective action reports; and allowance for

13  the department's participation in surveys.

14         (b)  The department shall conduct compliance

15  investigations and sample validation inspections to evaluate

16  the inspection process of accrediting organizations to ensure

17  minimum standards are maintained as provided in Florida

18  statute and rule. The department may conduct a fire, safety,

19  and health inspection in calendar years in which an

20  accrediting organization survey is not conducted and shall

21  conduct a full state inspection, including a lifesafety

22  inspection, if an accrediting organization survey has not been

23  conducted within the previous 36 months.  The department, by

24  accepting the survey or inspection of an accrediting

25  organization, does not forfeit its right to perform

26  inspections.

27         Section 5.  Subsection (3) of section 397.403, Florida

28  Statutes, is amended to read:

29         397.403  License application.--

30         (3)  The department shall accept proof of accreditation

31  by CARF--the Rehabilitation Accreditation Commission on

                                  6

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1  Accreditation of Rehabilitation Facilities (CARF) or the Joint

  2  Commission on Accreditation of Health Care Organizations

  3  (JCAHCO), or through any other nationally recognized

  4  certification process that is acceptable to the department and

  5  meets the minimum licensure requirements under this chapter,

  6  in lieu of requiring the applicant to submit the information

  7  required by paragraphs (1)(a)-(c).

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

  9  law.

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

                                  7

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2001                           CS for SB 1346
    300-1663-01




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 1346

  3

  4  Removes the requirement that organizations that are licensed
    by the Agency for Health Care Administration and under
  5  contract with the Department of Children and Family Services
    or the Agency for Health Care Administration to provide
  6  behavioral health services or participates in the Medicaid
    community mental health services or targeted case management
  7  program be accredited no later than July 1, 2006.

  8  Adds the Council on Accreditation of Children and Family
    Services as an accreditation body acceptable for mental health
  9  facilities licensed by the Agency for Health Care
    Administration or a substance abuse component licensed by the
10  Department of Children and Family Services.

11  Adds the National Committee for Quality Assurance as an
    accreditation body acceptable for any network of providers
12  from which the Department of Children and Family Services or
    the Agency for Health Care Administration purchases behavioral
13  health services.

14  Specifies that the Department of Children and Family Services
    and the Agency for Health Care Administration may adopt rules
15  for:

16       -      Establishing additional standards that are not
                specifically and distinctly covered by the
17              accreditation standards and processes.

18       -      Identifying an onsite monitoring process to occur
                after the accreditation survey for non-residential
19              and residential facilities.

20  Requires that the Department of Children and Family Services
    study the viability of mandating the accreditation of all
21  behavioral health organizations under contract with the
    department or licensed by the Agency for Health Care
22  Administration and to include this review in its report to the
    Legislature.
23
    Changes the date from March 1, 2003, to January 1, 2003, for
24  the Department of Children and Family Services and the Agency
    for Health Care Administration to submit a report to the
25  Legislature on: 1) the viability of mandating accreditation of
    all organizations under contract with the department or
26  licensed by the department or agency, and 2) the
    practicability of privatizing all licensure and monitoring
27  functions through an accrediting organization.

28

29

30

31

                                  8

CODING: Words stricken are deletions; words underlined are additions.