| 1 | The Health Care Appropriations Committee recommends the |
| 2 | following: |
| 3 |
|
| 4 | Council/Committee Substitute |
| 5 | Remove the entire bill and insert: |
| 6 | A bill to be entitled |
| 7 | An act relating to community behavioral health agencies; |
| 8 | creating s. 624.4624, F.S.; authorizing certain nonprofit |
| 9 | community mental health or substance abuse providers to |
| 10 | form a self-insurance fund for certain purposes; providing |
| 11 | operating requirements of the self-insurance fund; |
| 12 | providing certain application exceptions for such fund; |
| 13 | requiring certain funds to initially be organized and |
| 14 | operate as a commercial self-insurance fund for a time |
| 15 | certain; requiring certain self-insurance funds to comply |
| 16 | with certain annual financial statement requirements for a |
| 17 | time certain; proscribing certain self-insurance funds |
| 18 | from being considered insurers for certain purposes; |
| 19 | amending s. 768.28, F.S.; providing that certain providers |
| 20 | or vendors acting contractually on behalf of the |
| 21 | Department of Children and Family Services, and their |
| 22 | employees and agents, are agents of the state for purposes |
| 23 | of waiver of sovereign immunity in tort actions under |
| 24 | certain circumstances; requiring contracts to provide for |
| 25 | indemnification of the state by such agents for certain |
| 26 | liabilities up to certain limits; providing that such |
| 27 | persons are not employees or agents for purposes of |
| 28 | workers' compensation; restricting application; requiring |
| 29 | certain providers designated as agents of the state to |
| 30 | reimburse the state for certain costs; providing penalties |
| 31 | for noncompliance; providing for continuing liability for |
| 32 | certain amounts under certain circumstances; providing an |
| 33 | effective date. |
| 34 |
|
| 35 | Be It Enacted by the Legislature of the State of Florida: |
| 36 |
|
| 37 | Section 1. Section 624.4624, Florida Statutes, is created |
| 38 | to read: |
| 39 | 624.4624 Nonprofit community mental health and substance |
| 40 | abuse provider self-insurance fund.-- |
| 41 | (1) Notwithstanding any other provisions of law, any two |
| 42 | or more nonprofit community mental health or substance abuse |
| 43 | providers, which are members in good standing of a nonprofit |
| 44 | statewide association which has been in existence for at least |
| 45 | 10 years and is comprised of at least 50 community-based mental |
| 46 | health and substance abuse agencies which are primarily publicly |
| 47 | funded and located in this state, may form a self-insurance fund |
| 48 | for the purpose of pooling and spreading liabilities of its |
| 49 | group members in any property or casualty risk or surety |
| 50 | insurance or securing the payment of benefits under chapter 440, |
| 51 | provided the nonprofit community mental health and substance |
| 52 | abuse provider self-insurance fund created must: |
| 53 | (a) Have annual normal premiums in excess of $5 million. |
| 54 | (b) Maintain a continuing program of excess insurance |
| 55 | coverage and reserve evaluation to protect the financial |
| 56 | stability of the fund in an amount and manner determined by a |
| 57 | qualified and independent actuary. |
| 58 | (c) Submit to the office annually an audited fiscal year- |
| 59 | end financial statement by an independent certified public |
| 60 | accountant within 6 months after the end of the fiscal year. |
| 61 | (d) Have a governing body which is comprised entirely of |
| 62 | community mental health and substance abuse provider officials. |
| 63 | (2) A nonprofit community mental health and substance |
| 64 | abuse provider self-insurance fund that meets the requirements |
| 65 | of this section is not subject to s. 624.4621 and is not |
| 66 | required to file any report with the department under s. |
| 67 | 440.38(2)(b) required of group self-insurer funds qualified |
| 68 | under s. 624.4621. If any of the requirements of this section |
| 69 | are not met, the nonprofit mental health and substance abuse |
| 70 | provider self-insurance fund is subject to the requirements of |
| 71 | s. 624.4621. |
| 72 | (3)(a) Notwithstanding subsection (2), a nonprofit |
| 73 | community mental health and substance abuse provider self- |
| 74 | insurance fund created under this section after October 1, 2005, |
| 75 | shall initially be subject to the requirements of a commercial |
| 76 | fund under s. 624.4621 and, for the first 5 years of its |
| 77 | existence, shall be subject to all the requirements applied to |
| 78 | commercial self-insurance funds or to group self-insurance |
| 79 | funds, respectively. |
| 80 | (b)1. A nonprofit community mental health and substance |
| 81 | abuse provider self-insurance fund formed after January 1, 2006, |
| 82 | shall, for its first 5 fiscal years, file with the office full |
| 83 | and true statements of its financial condition, transactions, |
| 84 | and affairs. An annual statement covering the preceding fiscal |
| 85 | year shall be filed within 60 days after the end of the fund's |
| 86 | fiscal year and quarterly statements shall be filed within 45 |
| 87 | days after each such date. The office may, for good cause, grant |
| 88 | an extension of time for filing an annual or quarterly |
| 89 | statement. The statements shall contain information generally |
| 90 | included in insurers' financial statements prepared in |
| 91 | accordance with generally accepted insurance accounting |
| 92 | principles and practices and in a form generally used by |
| 93 | insurers for financial statements, sworn to by at least two |
| 94 | executive officers of the self-insurance fund. The form for |
| 95 | financial statements shall be the form currently approved by the |
| 96 | National Association of Insurance Commissioners for use by |
| 97 | property and casualty insurers. |
| 98 | 2. Each annual statement shall contain a statement of |
| 99 | opinion on loss and loss adjustment expense reserves made by a |
| 100 | member of the American Academy of Actuaries. Workpapers in |
| 101 | support of the statement of opinion must be provided to the |
| 102 | office upon request. |
| 103 | Section 2. No self-insurance fund created under this act |
| 104 | shall be deemed to be or considered to be an insurer for any |
| 105 | purpose under chapter 631, Florida Statutes. |
| 106 | Section 3. Subsection (21) is added to section 768.28, |
| 107 | Florida Statutes, to read: |
| 108 | 768.28 Waiver of sovereign immunity in tort actions; |
| 109 | recovery limits; limitation on attorney fees; statute of |
| 110 | limitations; exclusions; indemnification; risk management |
| 111 | programs.-- |
| 112 | (21)(a) Solely with respect to services to individuals in |
| 113 | need of detoxification and services through an addictions |
| 114 | receiving facility under chapter 397 or mental health services |
| 115 | under chapter 394, providers or vendors, or any of their |
| 116 | employees or agents, that have contractually agreed to act on |
| 117 | behalf of the state as agents of the Department of Children and |
| 118 | Family Services to provide such services are agents of the state |
| 119 | for purposes of this section while acting within the scope of |
| 120 | and pursuant to guidelines established in the contract or by |
| 121 | rule. A contract must provide for the indemnification of the |
| 122 | state by the agent for any liabilities incurred up to the limits |
| 123 | set out in this chapter. |
| 124 | (b) This subsection does not designate a person who |
| 125 | provides contracted services to the Department of Children and |
| 126 | Family Services as an employee or agent of the state for |
| 127 | purposes of chapter 440. |
| 128 | (c) This subsection does not provide any immunity to, or |
| 129 | limitation on liability for, any person or entity which provides |
| 130 | services to an individual who is paying or being reimbursed for |
| 131 | that service in any amount or who is insured for that service. |
| 132 | (d) Any person or entity designated as an agent of the |
| 133 | state pursuant to this subsection shall reimburse the state for |
| 134 | the actual costs of defending any claim and for any amounts paid |
| 135 | by the state in payment of a settlement or judgment arising out |
| 136 | of the claim up to the limits of liability set forth in this |
| 137 | section. Any person or entity who fails to reimburse the state |
| 138 | as required shall be subject to license revocation and shall be |
| 139 | responsible for all subsequent payments by the state in |
| 140 | resolving the underlying cause of action, including any amounts |
| 141 | paid pursuant to a claims bill, and for all costs and attorney |
| 142 | fees incurred by the state in recovering the original |
| 143 | reimbursement amount due and the subsequent payments owed. |
| 144 | Section 4. This act shall take effect July 1, 2005. |