HB 0493

1	A bill to be entitled
2	An act relating to mental health care services; creating
3	s. 409.91225, F.S.; directing the Agency for Health Care
4	Administration, in cooperation with the Department of
5	Children and Family Services, to develop a pilot program
6	in district 10 for a mental health care provider service
7	network to deliver mental health care services as a form
8	of managed care under the MediPass program; providing
9	legislative intent; providing powers, duties, and
10	responsibilities of the agency under the program;
11	directing the agency to determine the medical and
12	financial eligibility standards for individuals seeking
13	services from the program and the criteria for mental
14	health care providers to participate in the program;
15	providing for agreements with other governmental programs
16	and institutions; providing for oversight; providing
17	rulemaking authority; requiring a report to the Governor
18	and Legislature; providing an effective date.
19
20	Be It Enacted by the Legislature of the State of Florida:
21
22	Section 1.  Section 409.91225, Florida Statutes, is created
23	to read:
24	409.91225  Mental Health Care Provider Service Network
25	pilot program.--
26	(1)  The Agency for Health Care Administration, in
27	cooperation with the Department of Children and Family Services,
28	shall develop a pilot program in the department's service
29	district 10 to deliver mental health care services as a form of
30	managed care under the MediPass program.
31	(2)  The Legislature intends that the Mental Health Care
32	Provider Service Network pilot program:
33	(a)  Provide to persons with mental health care needs a
34	family-centered, comprehensive, and coordinated managed system
35	of mental health care.
36	(b)  Provide essential preventive, evaluative, and early
37	intervention services for persons at risk for or having mental
38	health care needs in order to prevent or reduce the occurrence,
39	severity, duration, and disabling aspects of mental, emotional,
40	and behavioral disorders.
41	(3)  The Agency for Health Care Administration shall have
42	the following powers, duties, and responsibilities with respect
43	to the Mental Health Care Provider Service Network pilot
44	program:
45	(a)  To provide or contract for the provision of mental
46	health care services to eligible individuals.
47	(b)  To determine the medical and financial eligibility
48	standards for the program and to determine the medical and
49	financial eligibility of individuals seeking mental health care
50	services from the program.
51	(c)  To recommend priorities for the implementation of
52	comprehensive plans and budgets.
53	(d)  To coordinate a comprehensive delivery system for
54	eligible individuals to take maximum advantage of all available
55	funds.
56	(e)  To promote, establish, and coordinate programs
57	relating to mental health care services in cooperation with
58	other public and private agencies and to coordinate funding of
59	mental health care programs with federal, state, or local mental
60	health care funding mechanisms.
61	(f)  To initiate, coordinate, and request review of
62	applications to federal and state agencies for funds, services,
63	or commodities relating to mental health care programs.
64	(g)  To sponsor or promote grants for projects, programs,
65	educational activities, or research in the field of mental
66	health care, with an emphasis on early diagnosis and treatment.
67	(h)  To oversee and operate the program.
68	(i)  To establish reimbursement mechanisms for the program.
69	(j)  To establish program standards and credentialing
70	requirements for mental health care providers and mental health
71	care services.
72	(k)  To monitor the provision of mental health care
73	services in the program, including the utilization and quality
74	of mental health care services.
75	(l)  To establish and operate a grievance resolution
76	process for participants and mental health care providers.
77	(m)  To maintain integrity in the program.
78	(n)  To establish the criteria to designate mental health
79	care providers to participate in the program. The agency shall
80	follow, whenever available, national guidelines for selecting
81	mental health care providers.
82	(o)  To establish mental health care provider agreements
83	for participation in the program.
84	(p)  To require that all mental health care providers under
85	contract with the program be duly licensed in the state, if such
86	licensure is available, and meet other criteria as may be
87	established by the agency.
88	(q)  To initiate agreements with other state or local
89	governmental programs or institutions for the coordination of
90	mental health care to eligible individuals receiving services
91	from such programs or institutions.
92	(r)  To operate a system to oversee the activities of
93	program participants, mental health care providers, and their
94	representatives in order to prevent fraudulent or abusive
95	behavior, overutilization or duplicative utilization, and
96	neglect of participants and to recover overpayments as
97	appropriate. For the purposes of this paragraph, the terms
98	"abuse" and "fraud" have the meanings provided in s. 409.913.
99	The agency shall refer incidents of suspected fraud, abuse, and
100	overutilization and duplicative utilization to the appropriate
101	regulatory agency.
102	(4)  The Agency for Health Care Administration shall adopt
103	rules pursuant to ss. 120.536(1) and 120.54 to implement and
104	administer the Mental Health Care Provider Service Network pilot
105	program as provided in this section.
106	Section 2.  The Agency for Health Care Administration shall
107	prepare an evaluation of the Mental Health Care Provider Service
108	Network pilot program created under section 409.91225, Florida
109	Statutes, including recommendations for the future of the
110	program, and submit the report to the Governor, the President of
111	the Senate, and the Speaker of the House of Representatives
112	before the convening of the next regular session of the
113	Legislature.
114	Section 3.  This act shall take effect July 1, 2005.

CODING: Words stricken are deletions; words underlined are additions.