Senate Bill sb7084pb

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084

    FOR CONSIDERATION By the Committee on Children, Families, and
    Elder Affairs




    586-1468A-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 substance

  8         abuse addiction receiving facility; requiring

  9         licensure; providing eligibility criteria for

10         treatment services; requiring the department to

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

12         eliminating the requirement that providers of

13         mental health or substance abuse services must

14         be under contract with the department; amending

15         s. 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 substance abuse addiction receiving

27  facilities.--

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

29  and Family Services, in consultation with the Agency for

30  Health Care Administration, is authorized to establish

31  facilities that integrate services provided in an adult mental

                                  1

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






    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084
    586-1468A-07




 1  health crisis stabilization unit with services provided in a

 2  substance abuse addiction receiving facility. The facilities

 3  providing such integrated services shall be licensed as an

 4  adult crisis stabilization unit as provided under part IV, and

 5  shall meet all licensure requirements for such units.

 6         (2)  An integrated mental health crisis stabilization

 7  unit and substance abuse addiction receiving facility may

 8  provide services under this section to adults, 18 years of age

 9  or older, who fall into one or more of the following

10  categories:

11         (a)  An adult meeting the requirements for voluntary

12  admission for mental health treatment under s. 394.4625.

13         (b)  An adult meeting the criteria for involuntary

14  examination for mental illness under s. 394.463.

15         (c)  An adult qualifying for voluntary admission for

16  substance abuse treatment under s. 397.601.

17         (d)  An adult meeting the criteria for involuntary

18  admission for substance abuse impairment under s. 397.675.

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

20  shall adopt by rule standards that address eligibility

21  criteria; clinical procedures; staffing requirements;

22  operational, administrative, and financing requirements; and

23  the investigation of complaints. Standards that are

24  implemented specific to substance abuse treatment services

25  shall meet or exceed existing standards for addiction

26  receiving facilities.

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

28  409.906, Florida Statutes, is amended to read:

29         409.906  Optional Medicaid services.--Subject to

30  specific appropriations, the agency may make payments for

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

                                  2

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






    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084
    586-1468A-07




 1  the Social Security Act and are furnished by Medicaid

 2  providers to recipients who are determined to be eligible on

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

 4  service that is provided shall be provided only when medically

 5  necessary and in accordance with state and federal law.

 6  Optional services rendered by providers in mobile units to

 7  Medicaid recipients may be restricted or prohibited by the

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

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

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

11  making any other adjustments necessary to comply with the

12  availability of moneys and any limitations or directions

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

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

15  services to elderly and disabled persons and subject to the

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

17  direct the Agency for Health Care Administration to amend the

18  Medicaid state plan to delete the optional Medicaid service

19  known as "Intermediate Care Facilities for the Developmentally

20  Disabled." Optional services may include:

21         (8)  COMMUNITY MENTAL HEALTH SERVICES.--

22         (a)  The agency may pay for rehabilitative services

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

24  provider under contract with the agency or the Department of

25  Children and Family Services to provide such services.  Those

26  services which are psychiatric in nature shall be rendered or

27  recommended by a psychiatrist, and those services which are

28  medical in nature shall be rendered or recommended by a

29  physician or psychiatrist. The agency must develop a provider

30  enrollment process for community mental health providers which

31  bases provider enrollment on an assessment of service need.

                                  3

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






    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084
    586-1468A-07




 1  The provider enrollment process shall be designed to control

 2  costs, prevent fraud and abuse, consider provider expertise

 3  and capacity, and assess provider success in managing

 4  utilization of care and measuring treatment outcomes.

 5  Providers will be selected through a competitive procurement

 6  or selective contracting process. In addition to other

 7  community mental health providers, the agency shall consider

 8  for enrollment of mental health programs licensed under

 9  chapter 395 and group practices licensed under chapter 458,

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

11  authorized to continue operation of its behavioral health

12  utilization management program and may develop new services if

13  these actions are necessary to ensure savings from the

14  implementation of the utilization management system. The

15  agency shall coordinate the implementation of this enrollment

16  process with the Department of Children and Family Services

17  and the Department of Juvenile Justice. The agency is

18  authorized to utilize diagnostic criteria in setting

19  reimbursement rates, to preauthorize certain high-cost or

20  highly utilized services, to limit or eliminate coverage for

21  certain services, or to make any other adjustments necessary

22  to comply with any limitations or directions provided for in

23  the General Appropriations Act.

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

25  Statutes, is amended to read:

26         766.101  Medical review committee, immunity from

27  liability.--

28         (1)  As used in this section:

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

30  means:

31  

                                  4

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






    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084
    586-1468A-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  

                                  5

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






    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084
    586-1468A-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

                                  6

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






    Florida Senate - 2007   (PROPOSED COMMITTEE BILL)     SPB 7084
    586-1468A-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 substance abuse addiction
      receiving facility services. Requires the licensure of
13    such facilities by the Agency for Health Care
      Administration. Provides eligibility criteria for persons
14    served by the facilities. Requires the department to
      adopt rules establishing standards and procedures to
15    regulate such facilities. Eliminates the requirement that
      mental health or substance abuse providers be under
16    contract with the department. Adds the department as a
      medical review committee to evaluate the provision of
17    mental health services provided in certain facilities.

18  

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

                                  7

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