Senate Bill sb2868

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    Florida Senate - 2007                                  SB 2868

    By the Committee on Children, Families, and Elder Affairs





    586-1468B-07

  1                      A bill to be entitled

  2         An act relating to mental health and substance

  3         abuse services; creating s. 394.4996, F.S.;

  4         authorizing the Department of Children and

  5         Family Services to establish facilities that

  6         provide services as an integrated adult mental

  7         health crisis stabilization unit and addictions

  8         receiving facility; requiring licensure;

  9         providing eligibility criteria for treatment

10         services; requiring the department to adopt

11         rules; amending s. 409.906, F.S.; eliminating

12         the requirement that providers of mental health

13         or substance abuse services must be under

14         contract with the department; amending s.

15         766.101, F.S.; adding the department as a

16         medical review committee to evaluate the

17         provision of mental health services provided in

18         certain facilities; providing an effective

19         date.

20  

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

22  

23         Section 1.  Section 394.4996, Florida Statutes, is

24  created to read:

25         394.4996  Integrated adult mental health crisis

26  stabilization and addictions receiving facilities.--

27         (1)  Beginning July 1, 2007, the Department of Children

28  and Family Services, in consultation with the Agency for

29  Health Care Administration, is authorized to establish

30  facilities that integrate services provided in an adult mental

31  health crisis stabilization unit with services provided in an

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    Florida Senate - 2007                                  SB 2868
    586-1468B-07




 1  addictions receiving facility. The facilities providing such

 2  integrated services shall be licensed as an adult crisis

 3  stabilization unit as provided under part IV, and shall meet

 4  all licensure requirements for such units.

 5         (2)  An integrated mental health crisis stabilization

 6  unit and addictions receiving facility may provide services

 7  under this section to adults, 18 years of age or older, who

 8  fall into one or more of the following categories:

 9         (a)  An adult meeting the requirements for voluntary

10  admission for mental health treatment under s. 394.4625.

11         (b)  An adult meeting the criteria for involuntary

12  examination for mental illness under s. 394.463.

13         (c)  An adult qualifying for voluntary admission for

14  substance abuse treatment under s. 397.601.

15         (d)  An adult meeting the criteria for involuntary

16  admission for substance abuse impairment under s. 397.675.

17         (3)  The department, in consultation with the agency,

18  shall adopt by rule standards that address eligibility

19  criteria; clinical procedures; staffing requirements;

20  operational, administrative, and financing requirements; and

21  the investigation of complaints. Standards that are

22  implemented specific to substance abuse treatment services

23  shall meet or exceed existing standards for addiction

24  receiving facilities.

25         Section 2.  Paragraph (a) of subsection (8) of section

26  409.906, Florida Statutes, is amended to read:

27         409.906  Optional Medicaid services.--Subject to

28  specific appropriations, the agency may make payments for

29  services which are optional to the state under Title XIX of

30  the Social Security Act and are furnished by Medicaid

31  providers to recipients who are determined to be eligible on

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    Florida Senate - 2007                                  SB 2868
    586-1468B-07




 1  the dates on which the services were provided. Any optional

 2  service that is provided shall be provided only when medically

 3  necessary and in accordance with state and federal law.

 4  Optional services rendered by providers in mobile units to

 5  Medicaid recipients may be restricted or prohibited by the

 6  agency. Nothing in this section shall be construed to prevent

 7  or limit the agency from adjusting fees, reimbursement rates,

 8  lengths of stay, number of visits, or number of services, or

 9  making any other adjustments necessary to comply with the

10  availability of moneys and any limitations or directions

11  provided for in the General Appropriations Act or chapter 216.

12  If necessary to safeguard the state's systems of providing

13  services to elderly and disabled persons and subject to the

14  notice and review provisions of s. 216.177, the Governor may

15  direct the Agency for Health Care Administration to amend the

16  Medicaid state plan to delete the optional Medicaid service

17  known as "Intermediate Care Facilities for the Developmentally

18  Disabled." Optional services may include:

19         (8)  COMMUNITY MENTAL HEALTH SERVICES.--

20         (a)  The agency may pay for rehabilitative services

21  provided to a recipient by a mental health or substance abuse

22  provider under contract with the agency or the Department of

23  Children and Family Services to provide such services.  Those

24  services which are psychiatric in nature shall be rendered or

25  recommended by a psychiatrist, and those services which are

26  medical in nature shall be rendered or recommended by a

27  physician or psychiatrist. The agency must develop a provider

28  enrollment process for community mental health providers which

29  bases provider enrollment on an assessment of service need.

30  The provider enrollment process shall be designed to control

31  costs, prevent fraud and abuse, consider provider expertise

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    Florida Senate - 2007                                  SB 2868
    586-1468B-07




 1  and capacity, and assess provider success in managing

 2  utilization of care and measuring treatment outcomes.

 3  Providers will be selected through a competitive procurement

 4  or selective contracting process. In addition to other

 5  community mental health providers, the agency shall consider

 6  for enrollment of mental health programs licensed under

 7  chapter 395 and group practices licensed under chapter 458,

 8  chapter 459, chapter 490, or chapter 491. The agency is also

 9  authorized to continue operation of its behavioral health

10  utilization management program and may develop new services if

11  these actions are necessary to ensure savings from the

12  implementation of the utilization management system. The

13  agency shall coordinate the implementation of this enrollment

14  process with the Department of Children and Family Services

15  and the Department of Juvenile Justice. The substance abuse

16  and mental health program of the Department of Children and

17  Family Services shall participate with the agency in the

18  assessment of service needs and program development. The

19  agency is authorized to utilize diagnostic criteria in setting

20  reimbursement rates, to preauthorize certain high-cost or

21  highly utilized services, to limit or eliminate coverage for

22  certain services, or to make any other adjustments necessary

23  to comply with any limitations or directions provided for in

24  the General Appropriations Act.

25         Section 3.  Subsection (1) of section 766.101, Florida

26  Statutes, is amended to read:

27         766.101  Medical review committee, immunity from

28  liability.--

29         (1)  As used in this section:

30         (a)  The term "medical review committee" or "committee"

31  means:

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    Florida Senate - 2007                                  SB 2868
    586-1468B-07




 1         1.a.  A committee of a hospital or ambulatory surgical

 2  center licensed under chapter 395 or a health maintenance

 3  organization certificated under part I of chapter 641;,

 4         b.  A committee of a physician-hospital organization, a

 5  provider-sponsored organization, or an integrated delivery

 6  system;,

 7         c.  A committee of a state or local professional

 8  society of health care providers;,

 9         d.  A committee of a medical staff of a licensed

10  hospital or nursing home, provided the medical staff operates

11  pursuant to written bylaws that have been approved by the

12  governing board of the hospital or nursing home;,

13         e.  A committee of the Department of Corrections or the

14  Correctional Medical Authority as created under s. 945.602, or

15  employees, agents, or consultants of either the department or

16  the authority or both;,

17         f.  A committee of a professional service corporation

18  formed under chapter 621 or a corporation organized under

19  chapter 607 or chapter 617, which is formed and operated for

20  the practice of medicine as defined in s. 458.305(3), and

21  which has at least 25 health care providers who routinely

22  provide health care services directly to patients;,

23         g.  A committee of employees, agents, or consultants of

24  the Department of Children and Family Services conducting peer

25  review, utilization review, and mortality review of mental

26  health treatment services provided to persons served under

27  chapter 394;

28         h.g.  A committee of a mental health treatment facility

29  licensed under chapter 394 or a community mental health center

30  as defined in s. 394.907, provided the quality assurance

31  

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    Florida Senate - 2007                                  SB 2868
    586-1468B-07




 1  program operates pursuant to the guidelines which have been

 2  approved by the governing board of the agency;,

 3         i.h.  A committee of a substance abuse treatment and

 4  education prevention program licensed under chapter 397

 5  provided the quality assurance program operates pursuant to

 6  the guidelines which have been approved by the governing board

 7  of the agency;,

 8         j.i.  A peer review or utilization review committee

 9  organized under chapter 440;,

10         k.j.  A committee of the Department of Health, a county

11  health department, healthy start coalition, or certified rural

12  health network, when reviewing quality of care, or employees

13  of these entities when reviewing mortality records;, or

14         l.k.  A continuous quality improvement committee of a

15  pharmacy licensed pursuant to chapter 465,

16  

17  which committee is formed to evaluate and improve the quality

18  of health care rendered by providers of health service or to

19  determine that health services rendered were professionally

20  indicated or were performed in compliance with the applicable

21  standard of care or that the cost of health care rendered was

22  considered reasonable by the providers of professional health

23  services in the area; or

24         2.  A committee of an insurer, self-insurer, or joint

25  underwriting association of medical malpractice insurance, or

26  other persons conducting review under s. 766.106.

27         (b)  The term "health care providers" means physicians

28  licensed under chapter 458, osteopathic physicians licensed

29  under chapter 459, podiatric physicians licensed under chapter

30  461, optometrists licensed under chapter 463, dentists

31  licensed under chapter 466, chiropractic physicians licensed

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    Florida Senate - 2007                                  SB 2868
    586-1468B-07




 1  under chapter 460, pharmacists licensed under chapter 465, or

 2  hospitals or ambulatory surgical centers licensed under

 3  chapter 395, community mental health center as defined in s.

 4  394.455, or a facility licensed under s. 394.875.

 5         Section 4.  This act shall take effect upon becoming a

 6  law.

 7  

 8            *****************************************

 9                          SENATE SUMMARY

10    The bill addresses the provision of mental health and
      substance abuse services by the Department of Children
11    and Family Services. Provides for the establishment of
      facilities that provide integrated adult mental health
12    crisis stabilization and addictions receiving facility
      services. Requires the licensure of such facilities by
13    the Agency for Health Care Administration. Provides
      eligibility criteria for persons served by the
14    facilities. Requires the department to adopt rules
      establishing standards and procedures to regulate such
15    facilities. Eliminates the requirement that mental health
      or substance abuse providers be under contract with the
16    department. Adds the department as a medical review
      committee to evaluate the provision of mental health
17    services provided in certain facilities.

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