Senate Bill sb1852
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
By Senator Wise
5-741B-05
1 A bill to be entitled
2 An act relating to specialty behavioral health
3 care providers; amending s. 394.4574, F.S.;
4 authorizing the Agency for Health Care
5 Administration to establish a demonstration
6 project in certain counties in order to
7 determine the benefits of developing a
8 specialty behavioral health care provider to
9 deliver behavioral health services to persons
10 who reside in an assisted living facility that
11 holds a limited mental health license;
12 authorizing the agency to create an advisory
13 committee; defining the term "specialty
14 behavioral health care provider"; providing the
15 requirements for the specialty behavioral
16 health care provider demonstration project;
17 providing that certain specialty behavioral
18 health care providers may seek and develop
19 cooperative agreements with administrators of
20 certain assisted living facilities; authorizing
21 the agency to seek federal waivers to implement
22 an alternative prepaid behavioral health care
23 plan under certain conditions; authorizing the
24 agency to implement the demonstration project
25 and the advisory committee to complete work;
26 providing for an independent evaluation;
27 requiring that a report be submitted to the
28 Legislature; authorizing the agency to seek a
29 waiver or approval for an amendment to a waiver
30 for the purpose of addressing needs of
31 individuals who reside in certain assisted
1
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 living facilities; requiring the agency to
2 establish a workgroup for the purpose of
3 preparing an amendment to a waiver; providing
4 requirements for the amendment; requiring the
5 Office of Program Policy Analysis and
6 Government Accountability to conduct an
7 evaluation; requiring the agency to implement
8 the waiver amendment; prohibiting the waiver
9 amendment from increasing costs to the Medicaid
10 program; providing an effective date.
11
12 Be It Enacted by the Legislature of the State of Florida:
13
14 Section 1. Subsections (4), (5), (6), (7), (8), (9),
15 and (10) are added to section 394.4574, Florida Statutes, to
16 read:
17 394.4574 Department responsibilities for a mental
18 health resident who resides in an assisted living facility
19 that holds a limited mental health license.--
20 (4) The Agency for Health Care Administration may
21 establish a demonstration project within Duval, Nassau, Pasco,
22 Pinellas, Lee, Volusia, Putnam, Charlotte, Hillsborough, Dade,
23 Sarasota, Broward, Brevard, Orange, Santa Rosa, Collier, and
24 Palm Beach Counties for the purpose of developing
25 evidence-based practices in the delivery of state-funded
26 behavioral health care services and support through the use of
27 specialty behavioral health care providers to persons who
28 reside in assisted living facilities that hold a limited
29 mental health license.
30 (5)(a) The agency may create an advisory committee to
31 make recommendations to the Agency for Health Care
2
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 Administration and the Department of Children and Family
2 Services for the demonstration project that may be developed
3 by the Agency for Health Care Administration, in consultation
4 with the Department of Children and Families Services. The
5 advisory committee shall solicit input from stakeholders,
6 residents, facility administrators, and advocates relative to
7 standards, criteria, and the array of services that will be
8 included.
9 (b) The members of the advisory committee shall
10 include local community partners, including residents,
11 advocates, private and publicly funded behavioral health care
12 providers, representatives of the Agency for Health Care
13 Administration and the Department of Children and Family
14 Services, and facility administrators selected by the agency.
15 Other representatives may include the following:
16 1. One person who is a member of the Florida
17 Psychiatric Society, selected by the society;
18 2. One person who is a member of the Florida Council
19 for Behavioral Health, selected by the council;
20 3. One person who is a member of the National Alliance
21 for the Mentally Ill, selected by the state affiliate;
22 4. One person who is a member of the Florida Assisted
23 Living Affiliation, selected by the affiliation; and
24 5. One person who is a member of the local advocacy
25 council, selected by the local council.
26
27 Each member or representative on the advisory committee must
28 serve at his or her own expense.
29 (c) The advisory committee shall establish goals,
30 elect a chairperson, and be governed by the latest edition of
31 Roberts Rules of Order. The chairperson shall direct the work
3
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 of the advisory committee and may appoint subcommittees as
2 deemed appropriate by the chairperson. In addition, the
3 chairperson shall be responsible for ensuring that minutes of
4 meetings are kept and community input is solicited. The
5 meetings shall convene upon the call of the chairperson.
6 (6)(a) For the purposes of this demonstration project,
7 the term "specialty behavioral health care provider" means a
8 public or private behavioral health care entity, provider, or
9 organization or coalition of providers which holds a contract
10 with the Department of Children and Family Services and can
11 offer a full array of state-funded behavioral health care
12 services to residents who live in state-licensed assisted
13 living facilities that hold a limited mental health license in
14 the counties of Duval, Nassau, Pasco, Pinellas, Lee, Volusia,
15 Putnam, Charlotte, Hillsborough, Dade, Sarasota, Broward,
16 Brevard, Orange, Santa Rosa, Collier, or Palm Beach. The
17 services that are provided on a fee-for-service basis shall be
18 provided directly by the specialty behavioral health care
19 provider. For the purpose of this demonstration project, the
20 Department of Children and Family Services shall allow private
21 providers the opportunity to seek a contract with the
22 department in order to compete and provide state-funded
23 behavioral health care services.
24 (b) In constructing the requirements for the specialty
25 behavioral health care provider demonstration project, the
26 Agency for Health Care Administration and the Department of
27 Children and Family Services shall ensure that the providers
28 develop and implement a plan to ensure the provision of the
29 services and requirements referenced under this section. The
30 demonstration project shall include requirements for intensive
31 case-management services, provisions for on-call case
4
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 managers, and vocational support services, and shall include a
2 requirement for the development of evidence-based models and
3 practices in the delivery of community-based behavioral health
4 care services which include strategies for reducing the use of
5 state-funded inpatient psychiatric care. These models should
6 demonstrate new approaches and allow for maximum input from
7 consumers, family members, and facility administrators.
8 Services provided under the demonstration project shall be
9 provided on a fee-for-service basis for residents who are not
10 eligible for Medicaid and must be cost-neutral for the Agency
11 for Health Care Administration and for the Department of
12 Children and Family Services. The Agency for Health Care
13 Administration, in consultation with the Department of
14 Children and Family Services, shall use a
15 request-for-information process for the purpose of procurement
16 and to ensure competition and choice.
17 (c) For Medicaid-eligible residents who live in
18 assisted living facilities that hold a limited mental health
19 license in the counties of Duval, Nassau, Pasco, Pinellas,
20 Lee, Volusia, Putnam, Charlotte, Hillsborough, Dade, Sarasota,
21 Broward, Brevard, Orange, Santa Rosa, Collier, or Palm Beach
22 and are enrolled in the MediPass program under a
23 fee-for-service arrangement for the provision of
24 Medicaid-funded behavioral health care services, the
25 Department of Children and Family Services and the Agency for
26 Health Care Administration shall allow any behavioral health
27 care provider in the counties referenced under this section
28 which meets the eligibility requirements for this
29 demonstration project to become a specialty behavioral health
30 care provider, including a nonprofit or private behavioral
31
5
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 health care provider, organization, or entity or coalition of
2 providers.
3 (d) Each eligible specialty behavioral health care
4 provider that is qualified under the requirements of the
5 demonstration project may seek and develop cooperative
6 agreements with administrators of assisted living facilities
7 that hold a limited mental health license in the counties of
8 Duval, Nassau, Pasco, Pinellas, Lee, Volusia, Putnam,
9 Charlotte, Hillsborough, Dade, Sarasota, Broward, Brevard,
10 Orange, Santa Rosa, Collier, or Palm Beach. The cooperative
11 agreement shall be for a minimum of 1 year during the course
12 of the demonstration project and shall be binding on both
13 parties for the duration of the agreement. The cooperative
14 agreement must include provisions that promote the development
15 of evidence-based practices and models as outlined in the
16 procurement document for the project. For the purposes of this
17 demonstration project, the provisions of the cooperative
18 agreement shall be focused on improving the coordination of
19 services, improved communication, detailed protocols that
20 relate to the supervision of the clinical needs of the
21 residents, and all other provisions required by law.
22 (7) If the Agency for Health Care Administration
23 implements a prepaid behavioral health care plan in the
24 counties of Duval, Nassau, Pasco, Pinellas, Lee, Volusia,
25 Putnam, Charlotte, Hillsborough, Dade, Sarasota, Broward,
26 Brevard, Orange, Santa Rosa, Collier, or Palm Beach, the
27 Agency for Health Care Administration may seek federal waivers
28 to implement an alternative prepaid behavioral health care
29 plan in the counties of Duval, Nassau, Pasco, Pinellas, Lee,
30 Volusia, Putnam, Charlotte, Hillsborough, Dade, Sarasota,
31 Broward, Brevard, Orange, Santa Rosa, Collier, or Palm Beach
6
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 in order to demonstrate innovation and develop evidence-based
2 practices that will improve the coordination, satisfaction,
3 and delivery of all state-funded behavioral health care
4 services to residents that live in assisted living facilities
5 that hold a limited mental health license. The Agency for
6 Health Care Administration, in developing the alternative
7 prepaid program for persons who reside in assisted living
8 facilities that hold a limited mental health license in the
9 counties of Duval, Nassau, Pasco, Pinellas, Lee, Volusia,
10 Putnam, Charlotte, Hillsborough, Dade, Sarasota, Broward,
11 Brevard, Orange, Santa Rosa, Collier, or Palm Beach, shall
12 include provisions that ensure that the demonstration
13 capitation rate is based on no more than 90 percent of the
14 historic service utilization from the fee-for-service base,
15 shall include all outpatient state-funded behavioral health
16 care services and inpatient psychiatric services and shall
17 exempt medications. The Department of Children and Family
18 Services shall calculate a rate for the nonMedicaid residents
19 served in the demonstration area and shall ensure that the
20 capitation rate does not result in the displacement of
21 residents and is consistent with each resident's right of
22 access to adequate and appropriate health care under s.
23 400.428.
24 (8) The demonstration project may be implemented by
25 the Agency for Health Care Administration at the direction of
26 the agency Secretary. When the Secretary of Health Care
27 Administration authorizes implementation of the demonstration
28 project, the project shall continue for at least 3 years
29 following the date of implementation. The advisory committee
30 shall complete its work at the end of the 3-year period.
31
7
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 (9) The Office of Program Policy Analysis and
2 Government Accountability shall conduct an evaluation of the
3 demonstration project at the end of the first year and a
4 review at the end of the 3-year period. The evaluation must
5 assess the recidivism of residents from each assisted living
6 facility that holds a limited mental health license to the
7 inpatient hospital setting, improvement in resident behavioral
8 health outcomes, resident satisfaction with care, improvements
9 in program competencies and linkages, increased tenure of
10 case-management relationships with residents, and
11 implementation of meaningful plans of recovery. Following the
12 evaluation and review, the office shall prepare a report and
13 submit a copy to the President of the Senate and the Speaker
14 of the House of Representatives in a timely manner.
15 (10) The Agency for Health Care Administration may
16 seek the necessary federal waivers or approval to amend a
17 current waiver for the purpose of addressing the needs of
18 individuals who reside in an assisted living facility that
19 holds a limited mental health license. The agency shall
20 establish a workgroup to assist in the preparation and
21 development of the amendment to the waiver to provide input
22 and information relevant to the completion and successful
23 submission of an amendment. The amendment must address the
24 needs of certain individuals that reside in state-licensed
25 assisted living facilities that hold a limited mental health
26 license. The amendment must provide for a mechanism by which
27 those individuals having increased medical needs who are under
28 the age of 65 and meet certain criteria would be eligible
29 based on the availability of funding for additional services
30 that would enable these individuals to remain as a resident in
31 an assisted living facility that holds a limited mental health
8
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 license. The Office of Program Policy Analysis and Government
2 Accountability shall conduct an evaluation of the waiver
3 amendment after the first year of implementation. The
4 evaluation shall assess whether the amendment to the waiver
5 and the services provided have reduced, delayed, or otherwise
6 improved the ability of the assisted living facility to
7 retrain individuals who otherwise would have been homeless or
8 placed in an institutional setting. The agency shall implement
9 the waiver and serve 400 individuals who meet the criteria and
10 reside in an assisted living facility that holds a limited
11 mental health license in the counties of Duval, Nassau, Pasco,
12 Sarasota, Putnam, Volusia, Dade, Charlotte, Santa Rosa,
13 Collier, Palm Beach, or Lee. The agency shall implement the
14 waiver amendment upon approval from appropriate federal
15 agencies and access to available funding. The waiver amendment
16 may not increase costs to the Medicaid program and must
17 demonstrate savings.
18 Section 2. This act shall take effect July 1, 2005.
19
20
21
22
23
24
25
26
27
28
29
30
31
9
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2005 SB 1852
5-741B-05
1 *****************************************
2 SENATE SUMMARY
3 Authorizes the Agency for Health Care Administration to
establish a demonstration project in certain counties in
4 order to determine the benefits of developing a specialty
behavioral health care provider to deliver behavioral
5 health services to persons who reside in an assisted
living facility that holds a limited mental health
6 license. Authorizes the agency to create an advisory
committee. Provides the requirements for the specialty
7 behavioral health care provider demonstration project.
Provides that certain specialty behavioral health care
8 providers may seek and develop cooperative agreements
with administrators of certain assisted living
9 facilities. Authorizes the agency to seek federal waivers
to implement an alternative prepaid behavioral health
10 care plan under certain conditions. Authorizes the agency
to implement the demonstration project and the advisory
11 committee to complete work by a specific date. Requires
that a report be submitted to the Legislature. Authorizes
12 the agency to seek a waiver or approval for an amendment
to a waiver for the purpose of addressing needs of
13 individuals who reside in certain assisted living
facilities. Requires the agency to establish a workgroup
14 for the purpose of preparing an amendment to a waiver.
Requires the Office of Program Policy Analysis and
15 Government Accountability to conduct an evaluation.
Prohibits the waiver amendment from increasing costs to
16 the Medicaid program.
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
10
CODING: Words stricken are deletions; words underlined are additions.