Senate Bill sb2404

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    Florida Senate - 2003                                  SB 2404

    By Senator Lynn





    7-1600B-03

  1                      A bill to be entitled

  2         An act relating to substance abuse services;

  3         amending s. 394.74, F.S.; authorizing the

  4         Department of Children and Family Services to

  5         adopt by rule new payment methodologies and to

  6         eliminate unit-based methodologies for mental

  7         health and substance abuse services; amending

  8         s. 394.9082, F.S.; modifying the services for

  9         which a managing entity is accountable;

10         establishing data system requirements;

11         providing for establishment of a single

12         managing entity for the delivery of substance

13         abuse services to child protective services

14         recipients in specified districts of the

15         department; providing for a contract; requiring

16         certain information to be kept; providing for a

17         report; providing 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

24  abuse and mental health programs.--

25         (2)

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

27  department may use unit cost methods of payment in contracts

28  for purchasing mental health and substance abuse services. The

29  unit cost contracting system must account for those patient

30  fees that are paid on behalf of a specific client and those

31  that are earned and used by the provider for those services

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    Florida Senate - 2003                                  SB 2404
    7-1600B-03




 1  funded in whole or in part by the department. The department

 2  may use unit cost contracts while implementing through

 3  administrative rule fee-for-service, prepaid case rate, or

 4  prepaid capitation contract methodologies to purchase mental

 5  health and substance services. Fee-for-service, prepaid case

 6  rate, or prepaid capitation mechanisms may not be implemented

 7  statewide without the elimination of the unit cost method of

 8  payment.

 9         Section 2.  Paragraphs (a) and (d) of subsection (4) of

10  section 394.9082, Florida Statutes, are amended, present

11  subsection (8) of that section is renumbered as subsection

12  (9), and a new subsection (8) is added to that section, to

13  read:

14         394.9082  Behavioral health service delivery

15  strategies.--

16         (4)  CONTRACT FOR SERVICES.--

17         (a)  The Department of Children and Family Services and

18  the Agency for Health Care Administration may contract for the

19  provision or management of behavioral health services with a

20  managing entity in at least two geographic areas. Both the

21  Department of Children and Family Services and the Agency for

22  Health Care Administration must contract with the same

23  managing entity in any distinct geographic area where the

24  strategy operates. This managing entity shall be accountable

25  at a minimum for the delivery of behavioral health services

26  specified and funded by the department and the agency for

27  children, adolescents, and adults. The geographic area must be

28  of sufficient size in population and have enough public funds

29  for behavioral health services to allow for flexibility and

30  maximum efficiency. Notwithstanding the provisions of s.

31  409.912(3)(b)1. and 2., at least one service delivery strategy

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    Florida Senate - 2003                                  SB 2404
    7-1600B-03




 1  must be in one of the service districts in the catchment area

 2  of G. Pierce Wood Memorial Hospital.

 3         (d)  Under both strategies, the Department of Children

 4  and Family Services and the Agency for Health Care

 5  Administration may:

 6         1.  Establish benefit packages based on the level of

 7  severity of illness and level of client functioning;

 8         2.  Align and integrate procedure codes, standards, or

 9  other requirements if it is jointly determined that these

10  actions will simplify or improve client services and

11  efficiencies in service delivery;

12         3.  Use prepaid per capita and prepaid aggregate

13  fixed-sum payment methodologies; and

14         4.  Modify their current procedure codes to increase

15  clinical flexibility, encourage the use of the most effective

16  interventions, and support rehabilitative activities; and.

17         5.  Establish or develop data management and reporting

18  systems that promote efficient use of data by the service

19  delivery system. Data management and reporting systems must

20  address the management and clinical care needs of the service

21  providers and managing entities and provide information needed

22  by the department for required state and federal reporting. In

23  order to develop and test the application of new data systems,

24  a strategy implementation area is not required to provide

25  information that matches all current statewide reporting

26  requirements if the strategy's data systems include client

27  demographic, admission, discharge, enrollment, service events,

28  performance outcome information, and functional assessment.

29         (8)  EXPANSION IN DISTRICTS 4 AND 12.--The department

30  shall work with community agencies to establish a single

31  managing entity for districts 4 and 12 accountable for the

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    Florida Senate - 2003                                  SB 2404
    7-1600B-03




 1  delivery of substance abuse services to child protective

 2  services recipients in the two districts. The purpose of this

 3  strategy is to enhance the coordination of substance abuse

 4  services with community-based care agencies and the

 5  department. The department shall work with affected

 6  stakeholders to develop and implement a plan that allows the

 7  phase-in of services beginning with the delivery of substance

 8  abuse services, with phase-in of subsequent services agreed

 9  upon by the managing entity and authorized by the department,

10  providing the necessary technical assistance to assure

11  provider and district readiness for implementation. When a

12  single managing entity is established and meets readiness

13  requirements, the department may enter into a noncompetitive

14  contract with the entity. The department shall maintain

15  detailed information on the methodology used for selection and

16  a justification for the selection. Performance objectives

17  shall be developed which ensure that services that are

18  delivered directly affect and complement the child's

19  permanency plan. During the initial planning and

20  implementation phase of this project, the requirements in

21  subsections (6) and (7) are waived. Considering the critical

22  substance abuse problems experienced by many families in the

23  child protection system, the department shall initiate the

24  implementation of the substance abuse delivery component of

25  this program without delay and furnish status reports to the

26  appropriate substantive committees of the Senate and the House

27  of Representatives no later than February 29, 2004, and

28  February 28, 2005. The integration of all services agreed upon

29  by the managing entity and authorized by the department must

30  be completed within 2 years after project initiation. Ongoing

31  

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    Florida Senate - 2003                                  SB 2404
    7-1600B-03




 1  monitoring and evaluation of this strategy shall be conducted

 2  in accordance with subsection (9).

 3         Section 3.  This act shall take effect upon becoming a

 4  law.

 5  

 6            *****************************************

 7                          SENATE SUMMARY

 8    Authorizes the Department of Children and Family Services
      to adopt and eliminate methodologies relating to mental
 9    health and substance abuse services. Modifies
      responsibilities of managing entities. Requires data
10    management and reporting systems. Provides for the
      department to establish a single managing entity for the
11    delivery of substance abuse services to child protective
      services recipients in department districts 4 and 12.
12    Authorizes the department to enter a noncompetitive
      contract with an entity established and ready to provide
13    such services.

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