Florida Senate - 2005                      COMMITTEE AMENDMENT
    Bill No. SB 1852
                        Barcode 233660
                            CHAMBER ACTION
              Senate                               House
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       04/21/2005 09:20 AM         .                    
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11  The Committee on Health Care (Fasano) recommended the
12  following amendment:
13  
14         Senate Amendment (with title amendment) 
15         Delete everything after the enacting clause
16  
17  and insert:  
18         Section 1.  Section 409.91225, Florida Statutes, is
19  created to read:
20         409.91225  Requirements for residents who reside in an
21  assisted living facility that holds a limited mental health
22  license.--
23         (1)(a)  It is the intent of the Legislature to ensure
24  that each resident living in a licensed assisted living
25  facility that holds a limited mental health license receive
26  access to an adequate and appropriate array of state-funded
27  mental health services.
28         (b)  It is also the intent of the Legislature that the
29  array of state-funded mental health services promote recovery
30  by implementing best practices through cooperative agreements
31  between mental health providers and assisted living facilities
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Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 that hold a limited mental health license, by implementing the 2 community living support plans, and by complying with s. 3 394.4574. 4 (c) In addition, it is the intent of the Legislature 5 that the state ensure that a resident of an assisted living 6 facility not be displaced as a result of implementing any 7 managed care plan. 8 (2) Before implementing any managed care plan that 9 proposes to serve residents of assisted living facilities that 10 hold a limited mental health license, the agency must, within 11 existing resources, establish requirements for state-funded 12 mental health services that comply with the resident bill of 13 rights and meet the needs of the residents to ensure 14 appropriateness of placement in a licensed assisted living 15 facility that holds a limited mental health license. 16 (3) Any managed care plan implemented under this 17 section must incorporate certain required provisions in order 18 to provide state-funded mental health services to a resident 19 of an assisted living facility that holds a limited mental 20 health license. Each managed care plan must: 21 (a) Develop and implement a plan that complies with s. 22 394.4574 for providing state-funded mental health services. 23 (b) Ensure that each resident of an assisted living 24 facility that holds a limited mental health license has access 25 to therapeutic medications, including atypical psychotropic 26 medications, as directed by the resident's doctor. 27 (c) Ensure that each resident of an assisted living 28 facility that holds a limited mental health license has access 29 to state-funded primary care and mental health services 30 covered by the Medicaid program. 31 (d) Ensure access to club house programs for enrolled 2 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 residents of a licensed assisted living facility that holds a 2 limited mental health license. 3 (e) Ensure implementation of best practices that are 4 identified in the final report of the legislative workgroup on 5 best practices and limited mental health assisted living 6 facilities. 7 (f) Develop and implement an annual plan granting 8 access to adequate and appropriate health care for residents 9 of an assisted living facility that holds a limited mental 10 health license. The plan must be made available to the agency 11 and the Department of Children and Family Services and may be 12 used when evaluating contract performance. 13 (g) As permitted by contract and within available 14 funding, provide after-hours support during the evenings, 15 weekends, and holidays. 16 (h) Establish an assisted living facility advisory 17 subcommittee as part of the managed care advisory committee. 18 The subcommittee may review compliance with the community 19 living support plans for residents of an assisted living 20 facility that holds a limited mental health license, managed 21 care contractor compliance with s. 394.4574 and related 22 service-delivery requirements, and the implementation of best 23 practices that are identified by the legislative workgroup on 24 best practices and limited mental health assisted living 25 facilities. 26 Section 2. Subsections (4) and (5) are added to 27 section 394.4574, Florida Statutes, to read: 28 394.4574 Department responsibilities for a mental 29 health resident who resides in an assisted living facility 30 that holds a limited mental health license.-- 31 (4)(a) The department, within existing resources, shall 3 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 require each mental health service provider seeking to provide 2 state-funded behavioral health care services to residents of 3 an assisted living facility that holds a limited mental health 4 license to develop and implement a plan that demonstrates how 5 the mental health service provider plans to comply with this 6 section and other service-related provisions. The plan must be 7 prepared annually in consultation with the district program 8 supervisor of the substance abuse and mental health program 9 office and with the administrator of the assisted living 10 facility with whom the mental health service provider seeks to 11 form a cooperative agreement. 12 (b) Each mental health service provider seeking to 13 provide state-funded behavioral health care services to 14 residents of an assisted living facility that holds a limited 15 mental health license or who has a contract with the 16 department must: 17 1. Implement best practices that are identified by the 18 legislative workgroup on best practices and limited mental 19 health assisted living facilities within funds made available 20 by the department. 21 2. Establish or collaborate with an assisted living 22 facility advisory subcommittee as provided in chapter 409. The 23 advisory subcommittee shall review compliance of the mental 24 health provider with the community living support plans for 25 residents of an assisted living facility that holds a limited 26 mental health license, compliance with this section and 27 related service-delivery requirements, and the implementation 28 of best practices. 29 3. Provide access to state-funded behavioral health 30 care services as permitted by contract and available funding 31 for those residents who meet the eligibility criteria. 4 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 4. Provide access to substance abuse treatment 2 services and programs that address the need for ongoing 3 assessment, intervention, and after-hours support for the 4 residents of an assisted living facility that holds a limited 5 mental health license who are dually diagnosed and meet 6 eligibility criteria as determined by the department. 7 5. Provide access to club house programs and other 8 recovery-based supports that include supportive education and 9 supportive employment. 10 (5)(a) The department, in consultation with the 11 Department of Elderly Affairs and the Agency for Health Care 12 Administration, shall establish a workgroup to be entitled 13 Best Practices and Limited Mental Health Assisted Living 14 Facilities. 15 (b) The workgroup shall identify best practices 16 associated with implementing a state-funded behavioral health 17 care service system for residents of an assisted living 18 facility that holds a limited mental health license. The 19 workgroup shall also review the need for developing enhanced 20 services for residents that have additional needs due to 21 increasing medical needs or associated with aging. 22 (c) The workgroup shall consider various models or 23 proposals that would address the need to divert individuals 24 from more expensive institutional settings to residential 25 settings that are less restrictive. The workgroup shall also 26 review and, when appropriate, recommend changes to laws, 27 administrative rules, policies, and associated legislative 28 budget recommendations needed to implement the recommendations 29 of the workgroup. 30 (d) The workgroup members shall include, but are not 31 limited to, representatives from the department, the Agency 5 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 for Health Care Administration, the Department of Elderly 2 Affairs, the Department of Health, the Department of 3 Corrections, managed care providers or their representatives, 4 the Florida Council for Community Mental Health, the Florida 5 Psychiatric Society, Florida Coalition for Assisted Living and 6 Mental Health, the National Alliance for the Mentally Ill, the 7 Human Rights Advocacy Council, Americans with Disabilities Act 8 Working Group, and the Long-Term Care Ombudsman Council. 9 (e) The workgroup may request the Florida Mental 10 Health Institute to provide such research or analysis as the 11 workgroup may need to accomplish its tasks. 12 (f) The workgroup shall elect a chair who is not an 13 employee of the state. The workgroup shall hold meetings at 14 the call of the chair. The workgroup shall be administered by 15 staff of the department. The workgroup members shall each 16 serve at his or her own expense. 17 (g) The workgroup shall prepare a report and deliver a 18 copy of the report to the Governor, the President of the 19 Senate, and the Speaker of the House of Representatives no 20 later than January 5, 2006. 21 (h) The workgroup may continue to work until January 22 5, 2007. The workgroup shall submit a followup report to the 23 Governor and the Legislature on that date which includes 24 additional recommendations, issues that require further study, 25 the status of implementation of the workgroup's earlier 26 recommendations within state agencies, and the report's impact 27 on managed care plans and state-funded behavioral health care 28 services made available to residents of an assisted living 29 facility that holds a limited mental health license. 30 Section 3. The Agency for Health Care Administration 31 may seek the necessary federal waivers or approval to amend a 6 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 current 1915C waiver or other appropriate waiver for the 2 purpose of addressing the needs of individuals who reside in 3 an assisted living facility that holds a limited mental health 4 license. If the agency seeks to implement this authority, the 5 agency shall establish a workgroup to assist in the 6 preparation and development of the necessary amendment or 7 waiver request to provide input and information that is 8 relevant to the completion and successful approval of a 9 waiver, amendment, or other needed authorization. The 10 amendment, waiver, or other authorization that might be sought 11 under this authority must address the needs of certain 12 individuals who reside in an assisted living facility that 13 holds a limited mental health license. The amendment, waiver, 14 or other needed authorization must provide for a mechanism by 15 which those individuals with increased medical needs or need 16 for increased personal care services who are under the age of 17 65 and meet certain criteria would be eligible based on the 18 availability of funding for services that would enable these 19 residents to be retained in an assisted living facility that 20 holds a limited mental health license. The Office of Program 21 Policy Analysis and Government Accountability shall conduct an 22 evaluation of the amendment, waiver, or other needed 23 authorization requested under this section after the first 24 year of implementation. The evaluation must assess whether the 25 amendment, waiver, or other needed authorization and the 26 services provided have reduced, delayed, or otherwise improved 27 the ability of the assisted living facility to retain 28 individuals who otherwise would be homeless or at risk of 29 placement in a more restrictive setting. If the agency 30 implements the amendment, waiver, or other needed 31 authorization, it shall attempt to serve 400 individuals who 7 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 live in certain facilities that meet certain requirements. The 2 agency may consider implementation in the following counties: 3 Duval, Broward, Pasco, Sarasota, Nassau, Volusia, Miami-Dade, 4 Orange, Pinellas, and Hillsborough. The amendment, waiver, or 5 other needed authorization may not increase costs to the 6 Medicaid program and must demonstrate savings. 7 Section 4. This act shall take effect July 1, 2005. 8 9 10 ================ T I T L E A M E N D M E N T =============== 11 And the title is amended as follows: 12 Delete everything before the enacting clause 13 14 and insert: 15 A bill to be entitled 16 An act relating to specialty behavioral health 17 care providers; creating s. 409.91225, F.S.; 18 providing legislative intent relating to 19 providing state-funded mental health services 20 to residents of an assisted living facility 21 having a limited mental health license; 22 requiring the Agency for Health Care 23 Administration to establish standards before a 24 managed care plan may be approved; requiring 25 that a managed care plan designed to serve 26 residents of an assisted living facility having 27 a limited mental health license meet certain 28 specified requirements; amending s. 394.4574, 29 F.S.; requiring the Department of Children and 30 Family Services to ensure that each mental 31 health care provider has a plan demonstrating 8 10:23 AM 04/11/05 s1852d-he11-c7t
Florida Senate - 2005 COMMITTEE AMENDMENT Bill No. SB 1852 Barcode 233660 1 how it can provide mental health services to 2 residents of an assisted living facility having 3 a limited mental health license; requiring each 4 mental health service provider to adhere to 5 certain specified criteria; requiring the 6 department to establish a workgroup for best 7 practices; providing membership and duties; 8 requiring the workgroup to prepare a report for 9 the Governor and the Legislature; requiring the 10 agency to implement the waiver amendment; 11 prohibiting the waiver amendment from 12 increasing costs to the Medicaid program; 13 providing an effective date. 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 9 10:23 AM 04/11/05 s1852d-he11-c7t