Senate Bill sb1706c1
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Florida Senate - 2004 CS for SB 1706
By the Committee on Children and Families; and Senators Wise
and Webster
300-2153-04
1 A bill to be entitled
2 An act relating to specialty behavioral health
3 care providers; requiring the Department of
4 Children and Family Services to establish a
5 demonstration project in District 4 in order to
6 determine the benefits of developing a
7 specialty behavioral health care provider to
8 deliver behavioral health services to persons
9 who reside in an assisted living facility that
10 holds a limited mental health license;
11 requiring the department to create an advisory
12 committee; defining the term "specialty
13 behavioral health provider"; providing the
14 requirements for the specialty behavioral
15 health care provider demonstration project;
16 providing that certain specialty behavioral
17 health care providers may seek and develop
18 cooperative agreements with administrators of
19 certain assisted living facilities; requiring
20 the Agency for Health Care Administration to
21 seek federal waivers to implement an
22 alternative prepaid behavioral health care plan
23 under certain conditions; requiring the
24 department to implement the demonstration
25 project by a specific date; providing for an
26 independent evaluation; requiring that a report
27 be submitted to the Legislature; providing an
28 effective date.
29
30 Be It Enacted by the Legislature of the State of Florida:
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Florida Senate - 2004 CS for SB 1706
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1 Section 1. Subsections (4), (5), (6), (7), (8), and
2 (9) are added to section 394.4574, Florida Statutes, to read:
3 394.4574 Department responsibilities for a mental
4 health resident who resides in an assisted living facility
5 that holds a limited mental health license.--
6 (4) The Department of Children and Family Services
7 shall establish a demonstration project in the Department of
8 Children and Family Services district 4 for the purpose of
9 developing evidence-based practices in the delivery of
10 state-funded behavioral health care services and support
11 through the use of specialty behavioral health care providers
12 to persons who reside in assisted living facilities that hold
13 a limited mental health license. Participation in the program
14 of fee-for-service options is voluntary for Medicaid
15 recipients and recipients of state-funded services.
16 (5)(a) The department shall create an advisory
17 committee to make recommendations to the Agency for Health
18 Care Administration and the Department of Children and Family
19 Services for the demonstration project that shall be developed
20 by the Department of Children and Family Services in
21 consultation with the Agency for Health Care Administration.
22 The advisory committee shall solicit input from stakeholders,
23 residents, facility administrators and advocates relative to
24 the standards, criteria, and array of services that will be
25 included.
26 (b) The advisory committee membership shall include
27 local community partners that include residents, advocates,
28 private and publicly funded behavioral health care providers,
29 representatives of the Agency for Health Care Administration
30 and the Department of Children and Family Services, and local
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Florida Senate - 2004 CS for SB 1706
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1 government facility administrators. Other representatives may
2 include the following:
3 1. One person who is a member of the Florida
4 Psychiatric Society, selected by the society;
5 2. One person who is a member of the Florida Council
6 for Behavioral Health, selected by the council;
7 3. One person who is a member of the National Alliance
8 for the Mentally Ill, selected by the state affiliate;
9 4. One person who is a member of the Florida Assisted
10 Living Affiliation, selected by the affiliation;
11 5. One person who is a member of the local advocacy
12 council, selected by the local council; and
13 6. A representative from the Advocacy Center for
14 Persons with Disabilities, selected by the advocacy center.
15 (c) The advisory committee shall establish goals,
16 elect a chairman, and be governed by the latest edition of
17 Roberts Rules of Order. The chairman shall direct the work of
18 the advisory committee and may appoint subcommittees as deemed
19 appropriate by the chairman. In addition, the chairman shall
20 be responsible to ensure that minutes of meetings are kept and
21 community input is solicited. The meetings shall convene upon
22 the call of the chairman.
23 (6)(a) For the purposes of this demonstration project,
24 the term "specialty behavioral health provider" means a public
25 or private behavioral health care entity, provider, or
26 organization or coalition of providers that holds a contract
27 with the Department of Children and Family Services and can
28 offer a full array of state-funded behavioral health care
29 services to residents who live in state-licensed assisted
30 living facilities that hold a limited mental health license in
31 district 4. The services that are provided on a
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Florida Senate - 2004 CS for SB 1706
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1 fee-for-service basis shall be provided directly by the
2 specialty behavioral health care provider. The Department of
3 Children and Family Services for the purpose of this
4 demonstration project shall allow private providers the
5 opportunity to seek a contract in order to compete and provide
6 state-funded behavioral health care services.
7 (b) In constructing the requirements for the specialty
8 behavioral health care provider demonstration project, the
9 Agency for Health Care Administration and the Department of
10 Children and Family Services shall ensure that the providers
11 develop and implement a plan to ensure the provision of the
12 services and requirements as referenced under this section.
13 The demonstration project shall include requirements for
14 intensive case management services, provisions for on-call
15 case managers, and vocational support services, and include a
16 requirement for the development of evidence-based models and
17 practices in the delivery of community-based behavioral health
18 care services that includes strategies for reducing the
19 utilization of state-funded inpatient psychiatric care. These
20 models should demonstrate new approaches and allow for maximum
21 input from consumers, family members, and facility
22 administrators. Services provided under the demonstration
23 project shall be fee-for-service and cost-neutral for the
24 Agency for Health Care Administration and for the Department
25 of Children and Family Services. The Department of Children
26 and Family Services in consultation with the Agency for Health
27 Care Administration shall use a request for information
28 process for the purpose of procurement and to ensure
29 competition and choice.
30 (c) For Medicaid-eligible residents that live in
31 assisted living facilities that hold a limited mental health
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1 license in district 4 and are enrolled in the MediPass program
2 under a "fee for service" arrangement for the provision of
3 Medicaid-funded behavioral health care services, the
4 Department of Children and Family Services and the Agency for
5 Health Care Administration shall allow any behavioral health
6 care provider in district 4 that meets the eligibility
7 requirements for this demonstration project to become a
8 "specialty behavioral health care" provider. This shall
9 include both nonprofit and private behavioral health care
10 providers, organizations, and entities or coalitions of
11 providers.
12 (d) Each eligible specialty behavioral health care
13 provider that is qualified under the requirements of the
14 demonstration project shall be permitted to seek and develop
15 cooperative agreements with administrators of assisted living
16 facilities that hold a limited mental health license in
17 district 4. The cooperative agreements shall be for a minimum
18 period of 1 year during the course of the demonstration
19 project and shall be binding on both parties for the duration
20 of the agreement. The cooperative agreements shall include
21 provisions that will serve to promote the development of
22 evidence-based practices and models as outlined in the
23 procurement document for the project. For the purposes of
24 this demonstration project, the provisions of the cooperative
25 agreement shall be focused on improving the coordination of
26 services, improved communication, detailed protocols that
27 relate to the supervision of the clinical needs of the
28 residents, and all other provisions currently required under
29 existing statute.
30 (7) If the Agency for Health Care Administration
31 implements a prepaid behavioral health care plan in district
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Florida Senate - 2004 CS for SB 1706
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1 4, the Agency for Health Care Administration shall seek
2 federal waivers to implement an alternative prepaid behavioral
3 health care plan in district 4 to demonstrate innovation and
4 to develop evidence-based practices that will improve the
5 coordination, satisfaction, and delivery of all state-funded
6 behavioral health care services to residents that live in
7 assisted living facilities located in district 4 that hold a
8 limited mental health license. The Agency for Health Care
9 Administration in developing the alternative prepaid program
10 for persons who reside in assisted living facilities that hold
11 a limited mental health license in district 4 shall include
12 provisions that ensure that the demonstration capitation rate
13 shall be based on no more than 90 percent of the historic
14 service utilization, and shall include all outpatient
15 state-funded behavioral health care services and inpatient
16 psychiatric services and shall exempt medications. The Agency
17 for Health Care Administration and the Department of Children
18 and Family Services shall also calculate a rate for the
19 non-Medicaid residents served in the demonstration area and
20 shall ensure that the capitation rate does not result in the
21 displacement of residents and is consistent with the
22 resident's right of access to adequate and appropriate health
23 care under s. 400.428.
24 (8) The district 4 demonstration project must be
25 implemented no later than January 1, 2005, and shall continue
26 for not less than 3 years following the date of
27 implementation.
28 (9) The Office of Program Policy Analysis and
29 Government Accountability shall conduct an evaluation of the
30 demonstration project. The evaluation must assess the
31 recidivism of residents from the assisted living facility that
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Florida Senate - 2004 CS for SB 1706
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1 holds a limited mental health license to the inpatient
2 hospital setting, improvement in resident behavioral health
3 outcomes, resident satisfaction with care, improvements in
4 program competencies and linkages, increased tenure of case
5 management relationships with residents, and implementation of
6 meaningful plans of recovery. Following the evaluation, the
7 office shall prepare a report and submit a copy to the
8 President of the Senate and the Speaker of the House of
9 Representatives by January 1, 2008.
10 Section 2. This act shall take effect July 1, 2004.
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Florida Senate - 2004 CS for SB 1706
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1 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
2 Senate Bill 1706
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* Deletes the requirement to select one exclusive specialty
5 behavioral health care services provider for the
demonstration project.
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* Specifies that participation in the fee-for-services
7 option is voluntary for Medicaid recipients and
recipients of state funded services who participate in
8 the demonstration project.
9 * Directs the Department of Children and Families (DCF or
the department) to create an advisory committee instead
10 of a board to make recommendations to the department and
the Agency for Health Care Administration (AHCA or the
11 agency) regarding the demonstration project and specifies
the membership of that committee.
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* Provides a definition for the term "specialty behavioral
13 health provider."
14 * Specifies the array of services that must be provided by
the "specialty behavioral health provider."
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* Specifies that the services provided under the
16 demonstration project are to be fee-for-service and cost
neutral to the department and AHCA.
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* Directs DCF and AHCA to allow any health care provider
18 meeting specified requirements to become a specialty
behavioral health care provider for the demonstration
19 project.
20 * Directs that the department utilize a request for
information process instead of a competitive bid process
21 to select specialty behavioral health care providers.
22 * Authorizes eligible specialty behavioral health care
providers to develop cooperative agreements with the
23 administrators of assisted living facilities holding a
limited mental health license and specifies requirements
24 for those cooperative agreements.
25 * Deletes the requirement that AHCA implement a capitated
payment arrangement with the specialty behavioral health
26 care provider if a managed care system is implemented in
District 4 and instead directs the agency to seek federal
27 waivers to implement an alternative behavioral health
care plan in District 4 if a pre-paid behavioral health
28 plan is implemented.
29 * Deletes the language authorizing the specialty behavioral
health care provider to identify medically necessary
30 services that must be provided by Medicaid.
31 * Directs the Office of Program Policy Analysis and
Government Accountability to conduct an evaluation of the
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Florida Senate - 2004 CS for SB 1706
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1 demonstration project and provide a report to the
Legislature instead of requiring the department to
2 contract for an independent evaluation.
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