HOUSE AMENDMENT
                                                  Bill No. HB 1799
    Amendment No. 2 (for drafter's use only)
                            CHAMBER ACTION
              Senate                               House
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11  The Council for Healthy Communities offered the following:
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13         Amendment (with title amendment) 
14         On page 5, between lines 8 and 9 of the bill
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16  insert:  
17         Section 3.  Subsections (13) and (14) are added to
18  section 394.66, Florida Statutes, to read:
19         394.66  Legislative intent with respect to substance
20  abuse and mental health services.--It is the intent of the
21  Legislature to:
22         (13)  Promote best practices and the highest quality of
23  care in contracted alcohol, drug abuse, and mental health
24  services through achievement of national accreditation.
25         (14)  Ensure that the state agencies licensing and
26  monitoring contracted providers perform in the most
27  cost-efficient and effective manner with limited duplication
28  and disruption to organizations providing services.
29         Section 4.  Section 394.741, Florida Statutes, is
30  created to read:
31         394.741  Accreditation requirements for providers of
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    File original & 9 copies    04/18/01                          
    hcf0003                     09:12 am         01799-hcc -521503

HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 behavioral health care services.-- 2 (1) As used in this section, the term "behavioral 3 health care services" means mental health and substance abuse 4 treatment services. 5 (2) Notwithstanding any provision of law to the 6 contrary, accreditation of the following shall be accepted by 7 the agency and department in lieu of the agency's and 8 department's facility licensure onsite review requirements and 9 shall be accepted as a substitute for the department's 10 administrative and program monitoring requirements, except as 11 required by subsection (3): 12 (a) Any organization from which the department 13 purchases behavioral health care services that is accredited 14 by the Joint Commission on Accreditation of Health Care 15 Organizations or the Council on Accreditation for Children and 16 Family Services; or which has those services that are being 17 purchased by the department accredited by CARF--the 18 Rehabilitation Accreditation Commission. 19 (b) Any mental health facility licensed by the agency 20 or any substance abuse component licensed by the department 21 that is accredited by the Joint Commission on Accreditation of 22 Health Care Organizations, CARF--the Rehabilitation 23 Accreditation Commission, or the Council on Accreditation of 24 Children and Family Services. 25 (c) Any network of providers from which the department 26 or the agency purchases behavioral health care services 27 accredited by the Joint Commission on Accreditation of Health 28 Care Organizations, CARF--the Rehabilitation Accreditation 29 Commission, the Council on Accreditation of Children and 30 Family Services, or the National Committee for Quality 31 Assurance. A provider organization which is part of an 2 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503
HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 accredited network is afforded the same rights under this 2 part. 3 (3) The department and the agency may adopt rules that 4 establish: 5 (a) Additional standards for monitoring and licensing 6 accredited programs and facilities that the department and the 7 agency have determined are not specifically and distinctly 8 covered by the accreditation standards and processes. These 9 standards and the associated monitoring must not duplicate the 10 standards and processes already covered by the accrediting 11 bodies. 12 (b) An onsite monitoring process between 24 months and 13 36 months after accreditation for nonresidential facilities to 14 assure that accredited organizations exempt from licensing and 15 monitoring activities under this part continue to comply with 16 critical standards. 17 (c) An onsite monitoring process between 12 months and 18 24 months after accreditation for residential facilities to 19 assure that accredited organizations exempt from licensing and 20 monitoring activities under this part continue to comply with 21 critical standards. 22 (4) The department and the agency shall be given 23 access to all accreditation reports, corrective action plans, 24 and performance data submitted to the accrediting 25 organizations. When major deficiencies, as defined by the 26 accrediting organization, are identified through the 27 accreditation process, the department and the agency may 28 perform followup monitoring to assure that such deficiencies 29 are corrected and that the corrections are sustained over 30 time. 31 (5) The department or the agency, by accepting the 3 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503
HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 survey or inspection of an accrediting organization, does not 2 forfeit its right to perform inspections at any time, 3 including contract monitoring to ensure that deliverables are 4 provided in accordance with the contract. 5 (6) The department and the agency shall report to the 6 Legislature by January 1, 2003, on the viability of mandating 7 all organizations under contract with the department for the 8 provision of behavioral health care services, or licensed by 9 the department or the agency, to be accredited. The department 10 and the agency shall also report to the Legislature by January 11 1, 2003, on the viability of privatizing all licensure and 12 monitoring functions through an accrediting organization. 13 (7) The accreditation requirements of this section 14 shall apply to contracted organizations that are already 15 accredited immediately upon becoming law. 16 Section 5. Subsection (5) of section 394.90, Florida 17 Statutes, is amended to read: 18 394.90 Inspection; right of entry; records.-- 19 (5)(a) The agency shall may accept, in lieu of its own 20 inspections for licensure, the survey or inspection of an 21 accrediting organization, if the provider is accredited 22 according to the provisions of s. 394.741 and the agency 23 receives the report of the accrediting organization. The 24 department, in consultation with the agency, shall develop, 25 and adopt by rule, specific criteria for assuring that the 26 accrediting organization has specific standards and experience 27 related to the program area being licensed, specific criteria 28 for accepting the standards and survey methodologies of an 29 accrediting organization, delineations of the obligations of 30 accrediting organizations to assure adherence to those 31 standards, criteria for receiving, accepting and maintaining 4 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503
HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 the confidentiality of the survey and corrective action 2 reports, and allowance for the agency's participation in 3 surveys. 4 (b) The agency shall conduct compliance investigations 5 and sample validation inspections to evaluate the inspection 6 process of accrediting organizations to ensure minimum 7 standards are maintained as provided in Florida statute and 8 rule. The agency may conduct a lifesafety inspection in 9 calendar years in which an accrediting organization survey is 10 not conducted and shall conduct a full state inspection, 11 including a lifesafety inspection, if an accrediting 12 organization survey has not been conducted within the previous 13 36 months. The agency, by accepting the survey or inspection 14 of an accrediting organization, does not forfeit its right to 15 perform inspections. 16 Section 6. Subsection (3) of section 397.403, Florida 17 Statutes, is amended to read: 18 397.403 License application.-- 19 (3) The department shall accept proof of accreditation 20 by CARF--the Rehabilitation Accreditation Commission on 21 Accreditation of Rehabilitation Facilities (CARF) or the Joint 22 Commission on Accreditation of Health Care Organizations 23 (JCAHCO), or through any other nationally recognized 24 certification process that is acceptable to the department and 25 meets the minimum licensure requirements under this chapter, 26 in lieu of requiring the applicant to submit the information 27 required by paragraphs (1)(a)-(c). 28 Section 7. Subsection (2) of section 397.411, Florida 29 Statutes, is amended to read: 30 397.411 Inspection; right of entry; records.-- 31 (2)(a) The department shall may accept, in lieu of its 5 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503
HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 own inspections for licensure, the survey or inspection of an 2 accrediting organization, if the provider is accredited 3 according to the provisions of s. 394.741 and the department 4 receives the report of the accrediting organization. The 5 department shall develop, and adopt by rule, specific criteria 6 for assuring that the accrediting organization has specific 7 standards and experience related to the program area being 8 licensed; specific criteria for accepting the standards and 9 survey methodologies of an accrediting organization; 10 delineations of the obligations of accrediting organizations 11 to assure adherence to those standards; criteria for 12 receiving, accepting, and maintaining the confidentiality of 13 the survey and corrective action reports; and allowance for 14 the department's participation in surveys. 15 (b) The department shall conduct compliance 16 investigations and sample validation inspections to evaluate 17 the inspection process of accrediting organizations to ensure 18 minimum standards are maintained as provided in Florida 19 statute and rule. The department may conduct a fire, safety, 20 and health inspection in calendar years in which an 21 accrediting organization survey is not conducted and shall 22 conduct a full state inspection, including a lifesafety 23 inspection, if an accrediting organization survey has not been 24 conducted within the previous 36 months. The department, by 25 accepting the survey or inspection of an accrediting 26 organization, does not forfeit its right to perform 27 inspections. 28 29 30 ================ T I T L E A M E N D M E N T =============== 31 And the title is amended as follows: 6 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503
HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 On page 1, line 20 2 3 insert after the semicolon: 4 amending s. 394.66, F.S.; providing legislative 5 intent relating to the accreditation and 6 cost-efficiency of substance abuse and mental 7 health service providers; creating s. 394.741, 8 F.S., relating to accreditation requirements 9 for providers of behavioral health care 10 services; defining the term "behavioral health 11 care services"; requiring the accreditation of 12 certain entities to be accepted in lieu of 13 licensure, administrative, and program 14 monitoring requirements; authorizing the 15 adoption of rules; requiring that the 16 Department of Children and Family Services and 17 the Agency for Health Care Administration be 18 allowed access to all accreditation reports, 19 corrective action plans, and performance data 20 submitted to accrediting organizations; 21 authorizing followup monitoring by the 22 department and the agency if major deficiencies 23 are identified through the accreditation 24 process; preserving the right of the department 25 and agency to perform inspections, including 26 contract monitoring; requiring the department 27 and the agency to report to the Legislature on 28 the viability of mandating accreditation and 29 privatizing licensure and monitoring functions; 30 specifying that the accreditation requirements 31 of s. 394.741, F.S., apply to contracted 7 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503
HOUSE AMENDMENT Bill No. HB 1799 Amendment No. 2 (for drafter's use only) 1 organizations that are already accredited; 2 amending s. 394.90, F.S., relating to substance 3 abuse and mental health services; revising 4 provisions relating to licensure, 5 accreditation, and inspection of facilities, to 6 conform; providing a cross reference; amending 7 s. 397.411, F.S., relating to substance abuse 8 service providers; revising provisions relating 9 to licensure, accreditation, and inspection of 10 facilities, to conform; providing a cross 11 reference; amending ss. 397.403; revising the 12 name of the Commission on Accreditation of 13 Rehabilitation Facilities; 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 8 File original & 9 copies 04/18/01 hcf0003 09:12 am 01799-hcc -521503