HB 1397 2003
1	A bill to be entitled
2	An act relating to substance abuse services; amending s.
3	394.74, F.S.; authorizing the Department of Children and
4	Family Services to adopt by rule new payment methodologies
5	and to eliminate unit-based methodologies for mental
6	health and substance abuse services; amending s. 394.9082,
7	F.S.; modifying the services for which a managing entity
8	is accountable; establishing data system requirements;
9	providing for establishment of a single managing entity
10	for the delivery of substance abuse services to child
11	protective services recipients in specified districts of
12	the department; providing for a contract; requiring
13	certain information to be kept; providing for a report;
14	amending s. 394.9083, F.S.; directing the department to
15	develop and present to the Legislature an implementation
16	plan with respect to behavioral health services; providing
17	an effective date.
18
19	Be It Enacted by the Legislature of the State of Florida:
20
21	Section 1. Paragraph (b) of subsection (2) of section
22	394.74, Florida Statutes, is amended to read:
23	394.74 Contracts for provision of local substance abuse
24	and mental health programs.--
25	(2)
26	(b) Notwithstanding s. 394.76(3)(a) and (c), the
27	department may implement through administrative rule fee-for-
28	service, prepaid case rate, or prepaid capitation contract
29	payment methodologies to purchase mental health and substance
30	abuse services. Fee-for-service or prepaid capitation mechanisms
31	may not be implemented without the elimination of the unit cost
32	method of payment.use unit cost methods of payment in contracts
33	for purchasing mental health and substance abuse services. The
34	unit cost contracting system must account for those patient fees
35	that are paid on behalf of a specific client and those that are
36	earned and used by the provider for those services funded in
37	whole or in part by the department.
38	Section 2. Paragraphs (a) and (d) of subsection (4) of
39	section 394.9082, Florida Statutes, are amended, present
40	subsection (8) of that section is renumbered as subsection (9),
41	and a new subsection (8) is added to that section, to read:
42	394.9082 Behavioral health service delivery strategies.--
43	(4) CONTRACT FOR SERVICES.--
44	(a) The Department of Children and Family Services and the
45	Agency for Health Care Administration may contract for the
46	provision or management of behavioral health services with a
47	managing entity in at least two geographic areas. Both the
48	Department of Children and Family Services and the Agency for
49	Health Care Administration must contract with the same managing
50	entity in any distinct geographic area where the strategy
51	operates. This managing entity shall be accountable at a minimum
52	for the delivery of all behavioral health services specified and
53	funded by the department and the agency which are provided to
54	Medipass recipientsfor children, adolescents, and adults. The
55	geographic area must be of sufficient size in population and
56	have enough public funds for behavioral health services to allow
57	for flexibility and maximum efficiency. Notwithstanding the
58	provisions of s. 409.912(3)(b)1. and 2., at least one service
59	delivery strategy must be in one of the service districts in the
60	catchment area of G. Pierce Wood Memorial Hospital.
61	(d) Under both strategies, the Department of Children and
62	Family Services and the Agency for Health Care Administration
63	may:
64	1. Establish benefit packages based on the level of
65	severity of illness and level of client functioning;
66	2. Align and integrate procedure codes, standards, or
67	other requirements if it is jointly determined that these
68	actions will simplify or improve client services and
69	efficiencies in service delivery;
70	3. Use prepaid per capita and prepaid aggregate fixed-sum
71	payment methodologies; and
72	4. Modify their current procedure codes to increase
73	clinical flexibility, encourage the use of the most effective
74	interventions, and support rehabilitative activities; and.
75	5. Establish or develop data management and reporting
76	systems that promote efficient use of data by the service
77	delivery system. Data management and reporting systems must
78	address the management and clinical care needs of the service
79	providers and managing entities and provide information needed
80	by the department for required state and federal reporting. In
81	order to develop and test the application of new data systems, a
82	strategy implementation area is not required to provide
83	information that matches all current statewide reporting
84	requirements if the strategy's data systems include client
85	demographic, admission, discharge, enrollment, service events,
86	and performance outcome information.
87	(8) EXPANSION IN DISTRICTS 4 AND 12.--The department shall
88	work with community agencies to establish a single managing
89	entity for districts 4 and 12 accountable for the delivery of
90	substance abuse services to child protective services recipients
91	in the two districts. The purpose of this strategy is to enhance
92	the coordination of substance abuse services with community-
93	based care agencies and the department. The department shall
94	work with affected stakeholders to develop and implement a plan
95	that allows the phase-in of services beginning with the delivery
96	of substance abuse services, with phase-in of subsequent
97	services agreed upon by the managing entity and authorized by
98	the department, providing the necessary technical assistance to
99	assure provider and district readiness for implementation. When
100	a single managing entity is established and meets readiness
101	requirements, the department may enter into a noncompetitive
102	contract with the entity. The department shall maintain detailed
103	information on the methodology used for selection and a
104	justification for the selection. Performance objectives shall be
105	developed which ensure that services that are delivered directly
106	affect and complement the child's permanency plan. During the
107	initial planning and implementation phase of this project, the
108	requirements in subsections (6) and(7) are waived. Considering
109	the critical substance abuse problems experienced by many
110	families in the child protection system, the department shall
111	initiate the implementation of the substance abuse delivery
112	component of this program without delay and furnish status
113	reports to the appropriate substantive committees of the Senate
114	and the House of Representatives no later than February 29,
115	2004, and February 28, 2005. The integration of all services
116	agreed upon by the managing entity and authorized by the
117	department must be completed within 2 years after project
118	initiation. Ongoing monitoring and evaluation of this strategy
119	shall be conducted in accordance with subsection(9).
120	Section 3. Subsection (2) of section 394.9083, Florida
121	Statutes, is amended to read:
122	394.9083 Behavioral Health Services Integration
123	Workgroup.--
124	(2) Based upon the report provided by the Behavioral
125	Health Services Integration Workgroup as well as the performance
126	of the strategy areas, the department shall, in cooperation with
127	community providers, develop an implementation plan to
128	systematically initiate successful behavioral health service
129	strategies across the state. Implementation and monitoring for a
130	given strategy shall be conducted in accordance with s. 394.9083
131	unless an incremental approach to implementation has been
132	jointly agreed upon in writing by the department and the
133	identified managing entity. The full integration of behavioral
134	health strategies must be addressed in the plan if an
135	incremental approach is proposed. The statewide implementation
136	plan shall be presented to the appropriate substantive
137	committees by February 29, 2004, with a subsequent status report
138	to be provided by February 28, 2005.The Behavioral Health
139	Services Integration Workgroup shall submit a report to the
140	Governor, the President of the Senate, and the Speaker of the
141	House of Representatives by January 1, 2002, regarding the
142	Workgroup's progress toward achieving the goals specified in
143	subsection (1).
144	Section 4. This act shall take effect upon becoming a law.