Senate Bill sb2840

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    Florida Senate - 2007                                  SB 2840

    By Senator Wise





    5-1323-07                                               See HB

  1                      A bill to be entitled

  2         An act relating to the Florida Self-Directed

  3         Care program; amending s. 394.9084, F.S.;

  4         requiring the Department of Children and Family

  5         Services to offer the program in districts that

  6         provide certain mental health services;

  7         providing legislative intent with regard to

  8         funding; requiring an independent financial

  9         agent to pay for certain services; defining the

10         term "independent financial agent"; authorizing

11         transfer of certain funds; providing rulemaking

12         authority; requiring an annual evaluation of

13         the program; revising provisions relating to

14         expenditures for conducting an evaluation;

15         deleting the expiration date of the program;

16         providing an effective date.

17  

18  Be It Enacted by the Legislature of the State of Florida:

19  

20         Section 1.  Section 394.9084, Florida Statutes, is

21  amended to read:

22         394.9084  Florida Self-Directed Care program.--

23         (1)  The Department of Children and Family Services, in

24  cooperation with the Agency for Health Care Administration,

25  shall offer the Florida Self-Directed Care program, may

26  develop a client-directed and choice-based program, in all

27  pilot project in district 4 and three other districts that to

28  provide mental health treatment and support services to adults

29  who have a serious mental illness. The department may also

30  develop and implement a client-directed and choice-based pilot

31  project in one district to provide mental health treatment and

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    Florida Senate - 2007                                  SB 2840
    5-1323-07                                               See HB




 1  support services for children with a serious emotional

 2  disturbance who live at home. If established, any staff who

 3  work with children must be screened under s. 435.04. The

 4  department projects shall implement a payment mechanism model

 5  in which each client controls the money that is available for

 6  that participant's client's mental health treatment and

 7  support services. It is the intent of the Legislature that any

 8  new or existing applicable funding shall be made available to

 9  allow individuals to choose to participate in this program.

10  The department shall establish interagency cooperative

11  agreements and work with the agency, the division, and the

12  Social Security Administration to implement and administer the

13  Florida Self-Directed Care program.

14         (2)  To be eligible for enrollment in the Florida

15  Self-Directed Care program, a person must be an adult with a

16  severe and persistent mental illness.

17         (3)  The Florida Self-Directed Care program has four

18  subcomponents:

19         (a)  Department mental health services, which include

20  community mental health outpatient, community support, and

21  case management services funded through the department. This

22  subcomponent excludes Florida Assertive Community Treatment

23  (FACT) services for adults; residential services; and

24  emergency stabilization services, including crisis

25  stabilization units, short-term residential treatment, and

26  inpatient services.

27         (b)  Agency mental health services, which include

28  community mental health services and mental health targeted

29  case management services reimbursed by Medicaid.

30  

31  

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    Florida Senate - 2007                                  SB 2840
    5-1323-07                                               See HB




 1         (c)  Vocational rehabilitation, which includes funds

 2  available for an eligible participant as provided by the

 3  Rehabilitation Act of 1973, 29 U.S.C. chapter 16, as amended.

 4         (d)  Social Security Administration.

 5         (4)  The independent financial agent managing entity

 6  shall pay for the cost-efficient community-based services the

 7  participant selects to meet his or her mental health care and

 8  vocational rehabilitation needs and goals as identified on his

 9  or her recovery plan. For purposes of this section, the term

10  "independent financial agent" means a third-party

11  administrator, as defined in s. 409.901(26), that does not

12  provide mental health services.

13         (5)(a)  The department shall take all necessary action

14  to ensure state compliance with federal regulations. The

15  agency, in collaboration with the department, shall

16  expeditiously seek federal Medicaid waivers, and the

17  department shall expeditiously seek any available Supplemental

18  Security Administration waivers under s. 1110(b) of the

19  federal Social Security Act; and the division, in

20  collaboration with the department, shall expeditiously seek

21  federal approval to participate in the Florida Self-Directed

22  Care program. No later than June 30, 2008 2005, the

23  department, the agency, and the division shall amend and

24  update their strategic and state plans to reflect

25  participation in the projects, including intent to seek

26  federal approval to provide cashout options for eligible

27  services for participants in the projects.

28         (b)  The department may apply for and use any funds

29  from private, state, and federal grants provided for

30  self-directed care, voucher, and self-determination programs,

31  

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    Florida Senate - 2007                                  SB 2840
    5-1323-07                                               See HB




 1  including those providing substance abuse and mental health

 2  care.

 3         (6)  The department, the agency, and the division may

 4  transfer funds to the independent financial agent managing

 5  entity.

 6         (7)  The department, the agency, and the division shall

 7  have rulemaking authority pursuant to ss. 120.536(1) and

 8  120.54 to implement the provisions of this section. These

 9  rules shall be for the purpose of enhancing choice in and

10  control over the purchased mental health and vocational

11  rehabilitative services accessed by Florida Self-Directed Care

12  program participants.

13         (8)  The department and the agency shall will complete

14  a memorandum of agreement to delineate management roles for

15  operation of the Florida Self-Directed Care program.

16         (9)  The department, the agency, and the division shall

17  each, on an ongoing basis, review and assess the

18  implementation of the Florida Self-Directed Care program.

19         (a)  The department shall will implement an annual

20  evaluation of the program and shall will include

21  recommendations for improvements in the program.

22         (b)  At a minimum, the evaluation must compare between

23  program participants and nonparticipants:

24         1.  Re-hospitalization rates.

25         2.  Levels of satisfaction.

26         3.  Service utilization rates.

27         4.  Residential stability.

28         5.  Levels of community integration and interaction.

29         (c)  The evaluation must assess evaluate adherence to

30  the Centers for Medicare and Medicaid self-direction

31  requirements, including:

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    Florida Senate - 2007                                  SB 2840
    5-1323-07                                               See HB




 1         1.  Person-centered planning.

 2         2.  Individual budgets.

 3         3.  Availability of independently brokered services

 4  from recovery coaches and quality advocates.

 5         4.  Access to the program by all who are eligible to

 6  enroll.

 7         5.  Participant safety and program incident management

 8  planning.

 9         6.  An independently mediated grievance process.

10         (d)  The evaluation must assess the economic

11  self-sufficiency of the program participants, including the

12  number of Individual Development Accounts.

13         (e)  The evaluation must assess any adverse incidents

14  resulting from the Florida Self-Directed Care program,

15  including consumer grievances, conflicts of interest, and

16  patterns of self-referral by licensed professions.

17  

18  The department is authorized to spend up to $100,000 to pay

19  for the evaluation. If the agency and the department obtain a

20  federal waiver, the evaluation will be used to determine

21  effectiveness.

22         (10)  This section expires July 1, 2008.

23         Section 2.  This act shall take effect July 1, 2007.

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