HB 1429

1	A bill to be entitled
2	An act relating to substance abuse and mental health
3	services; amending s. 394.9082, F.S.; providing
4	legislative findings and intent; providing definitions;
5	establishing goals of the Department of Children and
6	Family Services with respect to the administration of
7	publicly funded substance abuse and mental health
8	services; providing and specifying responsibilities of the
9	department and of community-based network providers;
10	establishing community-based systems of care; providing
11	for rules; authorizing the implementation of community-
12	based networks by the department; establishing a process
13	for contracting with community-based networks; providing
14	an implementation schedule; specifying qualifying criteria
15	for certain community-based networks; specifying
16	management information system requirements; providing for
17	evaluations and reports; requiring the department to
18	contract with an independent entity to monitor and provide
19	technical assistance to networks; establishing an
20	Interagency Advisory Council on Substance Abuse and Mental
21	Health; providing for membership, meetings, and duties;
22	providing for rules; providing for implementation;
23	providing an effective date.
24
25	Be It Enacted by the Legislature of the State of Florida:
26
27	Section 1.  Section 394.9082, Florida Statutes, is amended
28	to read:
29	(Substantial rewording of section. See
30	s. 394.9082, F.S., for present text.)
31	394.9082  Community-based networks.--
32	(1)  LEGISLATIVE FINDINGS AND INTENT.--The Legislature
33	finds that substance abuse and mental health disorders
34	constitute major health problems for citizens of the state,
35	affecting an estimated 48 percent of the population and are a
36	major economic burden on public and private resources, and the
37	cost of treating these disorders has significantly increased the
38	economic demands placed on families, friends, and employers, as
39	well as the juvenile justice, criminal justice, child welfare,
40	health care, and economic assistance systems. The Legislature
41	finds that substance abuse and mental health disorders are best
42	treated by individually tailored regimens of treatment,
43	rehabilitation, and other supportive interventions and that
44	health care services are most effective when operated,
45	administered, and provided in the community in which the
46	consumer lives. The Legislature finds that outsourcing the
47	administration of publicly financed substance abuse and mental
48	health services to local community agencies through pilot
49	programs has been a significant achievement. The Legislature
50	finds that although the administration and financing of
51	substance abuse and mental health services has become more
52	effective over the past several decades in response to numerous
53	federal, state, and local initiatives, there has been a
54	proliferation of administrative entities at all levels of
55	government that have overlapping roles, responsibilities, and
56	jurisdictions and that the diffusion of administrative and
57	service delivery functions has negatively affected the
58	leadership of public substance abuse and mental health services
59	and diminished accountability for performance and treatment
60	outcomes. It has become increasingly difficult for local
61	providers of substance abuse and mental health services to
62	secure sufficient resources from multiple payors to meet
63	consumer and community needs, remain compliant with multiple and
64	changing contracting and monitoring standards and requirements,
65	adjust to varying performance standards, and meet disparate and
66	redundant reporting requirements. These demands reduce funds
67	available for services and make it more difficult to sustain
68	local systems of care for individuals in recovery. In order to
69	improve the efficiency and effectiveness of publicly financed
70	substance abuse and mental health services and enhance provider
71	performance and consumer outcomes, the Legislature has
72	authorized pilot programs to test models for outsourcing
73	administrative and service functions to local systems of care.
74	The Legislature finds that these pilot programs have resulted in
75	higher levels of consumer and family satisfaction; improved
76	provider accountability; expanded use of evidenced-based
77	practices and continuous quality improvement approaches to care;
78	more sophisticated and accessible information systems with
79	enhanced information management, analysis, and reporting
80	capabilities; and broader participation by consumers, families,
81	and community stakeholders in the development and enhancement of
82	local systems of care. The Legislature further finds that state
83	administrative costs may be reduced by integrating and
84	eliminating the duplication of monitoring, reporting, auditing,
85	outcome measurement, and other administrative functions carried
86	out by several state and local agencies that fund substance
87	abuse and mental health services. Therefore, it is the intent of
88	the Legislature to restructure the administration, management,
89	and financing of community-based substance abuse and mental
90	health services by authorizing the creation of and employing the
91	administrative and service delivery competencies of existing
92	community-based networks. These networks shall be designated by
93	the Department of Children and Family Services, which shall
94	ensure that the networks are qualified to administer local
95	systems of care; assume many state administrative
96	responsibilities; receive state and federal funds to purchase
97	care from a local network of providers; assume responsibility
98	for the disbursement of state and federal funds; ensure provider
99	accountability in the use of such funds; manage data collection
100	and information technology necessary to store, analyze, and
101	report cost, encounter, and performance outcome data; and
102	mobilize and engage consumers, families, community stakeholders,
103	local governments, and service providers in the design,
104	oversight, and continuous quality improvement processes
105	necessary to establish and manage locally responsive and
106	integrated systems of care.
107	(2)  DEFINITIONS.--As used in this section, the term:
108	(a)  "Community-based network" means a provider-based
109	network that serves as an administering organization that offers
110	a full range of mental health and substance abuse services,
111	serves as a single point of accountability at the local level,
112	purchases mental health and substance abuse services, and is
113	responsible for the day-to-day planning for, administration of,
114	delivery of, and monitoring of mental health and substance abuse
115	services in communities in the state. The board of directors of
116	the network shall include substance abuse and mental health
117	service providers, including providers that only serve a
118	substance abusing or mentally ill population, as well as
119	consumers, family members, and other community stakeholders.
120	Community-based networks are provider owned and operated,
121	comprise not-for-profit safety net providers governed by
122	community boards that have traditionally contracted with the
123	department or enrolled as Medicaid providers, and are primarily
124	engaged in providing care to low-income consumers.
125	(b)  "Safety net provider" means a community substance
126	abuse or mental health service provider that is:
127	1.  Enrolled in the Medicaid program or contracts with the
128	department;
129	2.  Organizes and delivers a significant level of substance
130	abuse or mental health services to uninsured individuals,
131	Medicaid recipients, and other vulnerable populations;
132	3.  Offers specialized or essential substance abuse or
133	mental health services not generally provided by other local
134	agencies; and
135	4.  Has strong community ties.
136	(3)  GOALS.--The goal of the department while working with
137	community-based networks is to accomplish the restructuring of
138	the administration of publicly financed substance abuse and
139	mental health services using structural and service enhancements
140	that ensure the effective coordination, integration, and
141	management of publicly financed substance abuse and mental
142	health services that are cost effective, accessible, consumer-
143	oriented, and family-oriented and that achieve performance and
144	outcome measures established by the department. Other goals of
145	the restructured system include the following:
146	(a)  Promote the recovery and resiliency of individuals
147	served by public substance abuse and mental health treatment
148	services.
149	(b)  Identify and treat individuals with substance abuse
150	disorders and mental illnesses, including individuals who are at
151	high risk of poor outcomes or who are served by other systems of
152	care.
153	(c)  Improve state and local accountability regarding
154	access to and the quality, appropriateness, and cost-
155	effectiveness of substance abuse and mental health services.
156	(d)  Provide greater flexibility and assign responsibility
157	to local systems of care to:
158	1.  Test innovative strategies for the delivery and
159	financing of substance abuse and mental health services.
160	2.  Enhance individualized treatment and support services
161	for consumers.
162	3.  Promote the effective coordination of the multiple
163	health and human service providers and public and private payors
164	serving individuals with substance abuse disorders and mental
165	illnesses.
166	(e)  Improve the overall quality of substance abuse and
167	mental health services through the use of evidence-based and
168	best practice models by local systems of care.
169	(f)  Improve the coordination and integration of the
170	substance abuse and mental health service systems with other
171	systems, such as the physical health, housing, employment,
172	education, child welfare, emergency services, law enforcement,
173	and criminal justice systems.
174	(g)  Maximize the value of current resources, control the
175	cost of services without limiting the quality of care, and
176	increase the proportion of total funds spent on direct care.
177	(h)  Reduce unnecessary and burdensome regulatory barriers
178	to care.
179	(i)  Improve the collection, analysis, and dissemination of
180	substance abuse and mental health service data for planning,
181	performance measurement, and monitoring purposes and improve
182	departmental decisionmaking based on information collected by
183	the community-based networks that is disseminated and used by
184	the department through its data warehouse.
185	(j)  Promote the continuity of care for all children,
186	adolescents, and adults who receive services from the publicly
187	funded substance abuse and mental health service systems.
188	(k)  Improve public safety through the use of prevention,
189	early diagnosis, treatment, and diversionary programs and
190	enhanced system coordination.
191	(l)  Promote early diagnosis and treatment to enhance
192	recovery, prevent hospitalization, and avoid crises.
193	(m)  Assist community-based networks in improving the
194	assessment of local needs for substance abuse and mental health
195	services.
196	(n)  Promote the elimination of any ethnic, gender, and age
197	disparities in access to care.
198	(o)  Improve public understanding of the causes, effects,
199	and treatments of substance abuse and mental illness.
200	(p)  Improve access to safe, affordable, and permanent
201	housing.
202	(q)  Promote prevention programs and services.
203	(4)  SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES; DEPARTMENT
204	RESPONSIBILITIES.--
205	(a)  Upon the creation of community-based networks and the
206	privatization of the administration of local service delivery
207	and certain local administrative responsibilities, the
208	department shall re-emphasize its responsibility for addressing
209	broad systemic substance abuse and mental health service issues,
210	proposing enhancements to the publicly financed systems of care,
211	and transforming the substance abuse and mental health service
212	systems by ensuring the delivery of community-based care,
213	improving cost-effectiveness and outcomes, and implementing
214	model programs based on evidence-based practices.
215	(b)  The department shall provide for the availability of
216	and access to the services and supports necessary to meet the
217	substance abuse and mental health needs of individuals of all
218	ages who rely on publicly financed care, thereby enabling them
219	to live, work, and participate in their communities.
220	(c)  The principles guiding the department's administration
221	of publicly financed substance abuse and mental health programs
222	shall include:
223	1.  Enhancing system performance and cost-effectiveness.
224	2.  Increasing accountability for care by privatizing the
225	administration of local programs and service delivery through a
226	managed care system.
227	3.  Improving consumer outcomes using a recovery-based and
228	resiliency-based service delivery system.
229	4.  Ensuring quality of care by promoting the adoption of
230	evidence-based practices and model programs.
231	5.  Improving access to necessary care throughout the
232	state, promoting innovation and creativity in program design,
233	and ensuring that services are consumer oriented.
234	6.  Implementing the best available administrative
235	practices to support system operations that provide cost-
236	effective local services and supports and maximize service
237	outcomes.
238	7.  Controlling administrative costs and reducing
239	regulatory barriers while offering greater flexibility to
240	community-based networks and their providers.
241	8.  Establishing performance standards and outcome measures
242	and providing for periodic evaluations thereof.
243	9.  Improving collaboration and integration of multiagency
244	systems of care by promoting uniform program standards and
245	policies and integrating funding options across state agencies
246	and levels of government.
247	(d)  Substantive improvements in the administration of
248	departmental substance abuse and mental health programs and
249	improved performance and outcomes demand fundamental changes in
250	or enhancement of the roles and responsibilities of both the
251	department's headquarters, its district offices, and its
252	community-based networks.
253	(e)  To achieve these purposes and lead the transformation
254	of the state's substance abuse and mental health service
255	systems, the department shall:
256	1.  Provide overall system leadership, focusing on data-
257	based system oversight and ensuring system accountability,
258	enhancement, and protection of the state's substance abuse and
259	mental health safety net and safety net providers.
260	2.  Ensure the effective design, coordination, integration,
261	and management of public substance abuse and mental health
262	systems across state agencies and levels of government;
263	establish substance abuse and mental health policies and
264	procedures that include definitions of specific services,
265	standards, and limits regarding eligibility requirements to
266	receive services and priority services; determine and establish
267	program priorities; promote the use of evidenced-based and
268	promising practices through its facilities and community-based
269	networks; introduce innovative and model programs; establish
270	statewide systems of care for children and adults; design a
271	comprehensive array of recovery-based and resiliency-based
272	community substance abuse and mental health services; create
273	integrated treatment programs for individuals with co-occurring
274	disorders; develop and publish treatment and service standards;
275	and set standards for and designate centers of excellence.
276	3.  Develop and provide for a phased implementation, with
277	statewide implementation to be completed no later than June 30,
278	2011, of the full privatization of the local administration of
279	community-based substance abuse and mental health services;
280	implement a statewide, managed system of community substance
281	abuse and mental health care; contract on a county, circuit,
282	regional, or multiregional basis with community-based networks
283	that are owned and operated by providers as specified in this
284	section; streamline administrative and regulatory processes to
285	maximize the flexibility afforded to community-based networks
286	and their providers in meeting the needs of consumers; enter
287	into contracts with community-based networks; monitor contractor
288	program and fiscal performance; prepare reports on network
289	achievement of program and outcome measures; set performance
290	standards; provide technical assistance to and support the
291	efforts of community-based networks in developing innovative and
292	model substance abuse and mental health programs and services;
293	collaborate with the community-based networks in developing and
294	implementing a statewide quality assurance and quality
295	improvement program; ensure that network services are delivered
296	in accordance with applicable federal regulations and state law;
297	and develop and implement network reimbursement methods.
298	4.  Be responsible for the financial management and fiscal
299	integrity of publicly financed substance abuse and mental health
300	programs; monitor program expenditures and identify budget
301	trends and issues; expand financing options and opportunities;
302	promote the integration of state substance abuse and mental
303	health funding; and maximize other public and private sources of
304	program funding.
305	5.  Working with the community-based networks, design and
306	implement a quality assurance program to enhance the quality of
307	substance abuse and mental health services, improve program
308	performance and consumer outcomes, implement model and evidence-
309	based treatment practices, redirect service dollars from less
310	effective service models to model community-based services and
311	supports, and reward cost-effective programs, services, and care
312	patterns.
313	6.  Conduct comprehensive program planning and research;
314	conduct statewide needs assessments and maintain resource
315	inventories; identify treatment gaps and report those gaps to
316	the Legislature; disseminate information about the latest
317	substance abuse and mental health trends, issues, and research;
318	identify the need for and assist in the development of new
319	community substance abuse and mental health resources and
320	service models; and identify and act on systemic and structural
321	problems in the delivery and funding of substance abuse and
322	mental health systems.
323	7.  Based on data collected through the information systems
324	of the community-based networks, enhance agency transparency by
325	collecting and disseminating program data and information and
326	expanding public, provider, consumer, and other stakeholder
327	access to program information; assist community-based networks
328	in developing and implementing best available information
329	technology and management information systems; establish
330	performance standards and outcome measures; establish
331	information system requirements and data standards; and expand
332	data sharing among state and local agencies.
333	8.  Direct a program of statewide advocacy for consumers
334	and their families; establish and operate a consumer affairs
335	office and program; establish statewide public information and
336	educational programs; increase public awareness of substance
337	abuse and mental health issues; conduct a stigma reduction
338	campaign; expand citizen involvement in addressing state and
339	local substance abuse and mental health issues; expand
340	partnerships with consumers, families, and advocates; and
341	increase the availability of peer specialists, expand the use of
342	consumers in the workforce, and promote peer-based and consumer-
343	operated services.
344	9.  Fund and assist in the design and implementation of
345	staff development and training programs; conduct workforce
346	planning, including the completion of workforce needs
347	assessments by discipline and area of the state; develop a
348	statewide workforce plan and strategies; assist community-based
349	networks, colleges, and universities in enhancing staff
350	competencies and the knowledge base; and develop and implement
351	strategies for improving the recruitment and retention of a
352	qualified substance abuse and mental health workforce.
353	10.  Working with the community-based networks, enhance the
354	image and reputation of the public substance abuse and mental
355	health systems, programs, leadership, and management with
356	policymakers, consumers, providers, other stakeholders, and the
357	general public. The department shall also serve as the chief
358	liaison with federal, state, and local entities and other
359	stakeholders on substance abuse and mental health issues.
360	11.  Direct the district offices to focus their efforts on
361	conducting community and regional substance abuse and mental
362	health planning; completing local needs assessments; advocating
363	for consumers and their families; providing public and community
364	education; assessing local trends and issues; and advising the
365	department headquarters on local priorities.
366	12.  Prepare and submit to the Governor, the President of
367	the Senate, and the Speaker of the House of Representatives by
368	December 1 of each year an update to its annual strategic plan
369	and a report on its community-based network purchasing
370	specifications and the department's accomplishments and needs
371	relative to the purposes of this paragraph.
372	(5)  COMMUNITY-BASED SYSTEMS OF CARE; LEGISLATIVE INTENT.--
373	(a)  It is the intent of the Legislature that the
374	department privatize the administration of publicly financed
375	substance abuse and mental health services by contracting with a
376	single community-based network in a specified geographic area,
377	which may be a county, combination of counties, district,
378	combination of districts, region, or multiregion area according
379	to the discretion of the department and based on naturally
380	occurring market areas. In determining the geographic coverage
381	of a community-based network, the department shall also consider
382	the capacity to ensure that the principles of provider choice
383	and self-directed care can be realized and that economies of
384	scale are such that the desired cost efficiencies can be
385	achieved. The department's goal in managing services shall be
386	cost efficiency, not cost containment.
387	(b)  It is the intent of the Legislature that a substantial
388	portion of the funds currently allocated to departmental
389	district and regional offices for the management of contracted
390	substance abuse and mental health services be allocated to the
391	community-based networks for the administrative functions
392	reassigned from the department to the networks. These funds
393	shall to the extent possible support the administrative costs
394	associated with the network contractual responsibilities. The
395	department, working with the Louis de la Parte Florida Mental
396	Health Institute, shall identify the funds to be transferred by
397	December 31, 2008. Individuals currently employed by the
398	department to manage substance abuse and mental health services
399	whose positions are being privatized under this section shall be
400	given hiring preference by the network if the employee meets the
401	network's qualifications. For employees subsequently employed by
402	a network, years of service in such employment shall qualify as
403	years of service for purposes of the state retirement system.
404	(c)  It is further the intent of the Legislature that by
405	January 1, 2011, a single point of access to integrated services
406	for publicly financed consumers of substance abuse and mental
407	health services shall be achieved through the implementation of
408	managed care contracts with community-based networks.
409	(d)  The department and the Agency for Health Care
410	Administration shall both execute contracts with community-based
411	networks to provide for the integration of funding for consumers
412	of departmental and Medicaid services. The department and the
413	agency shall jointly prepare and submit a plan to the
414	Legislature by December 1, 2008, to integrate funding sources to
415	better coordinate service delivery through a single entity in
416	each area of the state.
417	(e)  The community-based networks selected by the
418	department are recognized as independent vendors that may also
419	contract with public or private organizations to manage plans
420	and services operated by other organizations to increase their
421	cost effectiveness.
422	(f)  The department is authorized to adopt rules pursuant
423	to ss. 120.536(1) and 120.54 necessary to carry out the
424	provisions of this subsection, including any revisions to state
425	standards and processes for approval of departmental contracts.
426	(6)  SELECTION OF COMMUNITY-BASED NETWORKS.--
427	(a)  The Legislature recognizes that the state and local
428	communities have made substantial investments in local systems
429	of care that are composed of nonprofit, community-based
430	providers governed by community boards. These community-based
431	providers have the necessary expertise in serving departmental
432	consumers, have long-standing linkages with other community
433	agencies, and have successfully carried out statutorily
434	prescribed public social service, health, and safety functions
435	important to consumers, policymakers, and citizens of the state.
436	In several areas of the state, community substance abuse
437	treatment and mental health care service providers have already
438	demonstrated through pilot projects that they have the capacity
439	to manage care as described in this section and are achieving
440	good results in administering and providing substance abuse and
441	mental services on the local level.
442	(b)  During a 3-year implementation period beginning in the
443	2008-2009 fiscal year, the department shall contract with a
444	community-based network, in areas designated by the department,
445	that shall be responsible for the provision, administration, and
446	management of substance abuse and mental health services. The
447	department shall enter into a multiyear contract in the
448	designated areas with existing or newly formed community-based
449	networks. The department may contract on a sole-source basis
450	with entities that qualify as community-based networks as
451	described in subsection (8).
452	(c)  The department may enter into noncompetitive contracts
453	with existing community-based networks that meet the
454	qualifications specified under this subsection.
455	(7)  SCHEDULE FOR COMMUNITY-BASED NETWORK CONTRACTING.--
456	(a)  By March 1, 2009, the department shall initiate a
457	process that gives the community-based networks in districts 1,
458	4, 11, and 12 and in the Suncoast Region the opportunity to
459	contract with the department as a community-based network for
460	their respective service area. These established community-based
461	networks shall be given a minimum of 90 days after the
462	department publishes community-based network standards to
463	prepare an application for designation as the community-based
464	network for a specified geographic area. After review of the
465	application, if the department determines that the network's
466	application and prior contractual history meet the criteria
467	established in this section, the department shall enter into a
468	contract with the community-based network. If the department
469	determines additional changes are needed to comply with
470	departmental requirements, the network applicant shall be
471	notified of the standards and criteria that it fails to meet and
472	given a minimum of 90 days to meet these requirements in order
473	to enter into a contract with the department.
474	(b)  During the 2009-2010 fiscal year, in other areas of
475	the state where a single community-based network has formed with
476	the governance structure and ownership capabilities specified
477	for community-based networks under this section and which is
478	determined by the department to cover a sufficient geographical
479	area to achieve the necessary cost effectiveness, and there is
480	no competing network in the same area, the entity shall be given
481	the opportunity to contract as the community-based network for
482	that area, based on qualification and negotiation of a
483	noncompetitive contract as described in subsection (6). These
484	community-based networks shall be given a minimum of 90 days to
485	submit applications after the department notifies these
486	additional areas that it is accepting applications for
487	qualification as a community-based network. After reviewing an
488	application, if the department determines the network applicant
489	complies with the criteria specified in this section or meets
490	these requirements prior to execution of a contract, the
491	department shall enter into a contract with the network.
492	(c)  By the end of the 2010-2011 fiscal year, the
493	department shall have entered into contracts in any remaining
494	districts without a network and select the contractors through a
495	competitive procurement process.
496	(8)  QUALIFICATION OF ESTABLISHED SUBSTANCE ABUSE AND
497	MENTAL HEALTH COMMUNITY-BASED NETWORKS.--Based on standards
498	published by the department, a community-based network shall:
499	(a)  Be a nonprofit corporation under state law and s.
500	501(c)(3) of the United States Internal Revenue Code.
501	(b)  Have a network governance structure that includes
502	providers of substance abuse and mental health services, as
503	defined in this chapter and chapter 397, with community boards
504	of directors that include consumers and family members and other
505	representatives of community stakeholders.
506	(c)  Have submitted a business plan that includes network
507	program, financial, and operational plans.
508	(d)  Have provider networks that include a mix of
509	facilities and providers covering the entire range of substance
510	abuse and mental health services provided by the department,
511	including acute services, crisis services, residential care,
512	housing, recovery supports, and preventive services.
513	(e)  Provide evidence that all providers with current
514	contracts with the department in the same geographic area have
515	been offered a contract by the network.
516	(f)  Provide evidence of a recovery and resiliency based
517	service mission.
518	(g)  Through its network, offer self-directed and consumer-
519	and family-oriented care, such as clubhouses and drop-in
520	centers.
521	(h)  Demonstrate that program plans and operations reflect
522	the preferences and recommendations of consumers, families, and
523	community stakeholders.
524	(i)  Demonstrate that all providers under contract with the
525	network are using one of the department-approved standardized
526	assessment tools and that treatment plans are individualized
527	based on standardized assessments.
528	(j)  Have providers that employ individuals with substance
529	abuse disorders and mental illnesses and offer consumer-
530	orientated programs.
531	(k)  Offer criminal justice diversionary services that
532	comply with the criteria established for the Criminal Justice,
533	Mental Health, and Substance Abuse Reinvestment Grant Program.
534	(l)  Demonstrate sound financial management practices.
535	(m)  Have comprehensive quality assurance and quality
536	improvement programs.
537	(n)  Have operational performance and outcome measurement
538	systems.
539	(o)  Have a comprehensive, accessible information system
540	and data analysis capabilities that meet departmental standards.
541	(p)  Demonstrate well-established relationships with the
542	communities it serves and have written agreements with related
543	health and social service agencies and programs such as, at a
544	minimum, the child welfare-related, community-based care
545	agencies, hospitals and hospital emergency departments, other
546	health care providers, law enforcement agencies, drug courts and
547	mental health courts operating in the area, juvenile justice
548	agencies, and schools.
549	(q)  Promote the coordination of care for departmental and
550	Medicaid consumers.
551	(r)  Provide convenient and timely access to care.
552	(9)  COMMUNITY-BASED NETWORK RESPONSIBILITIES.--The
553	community-based networks shall be responsible for the following:
554	(a)  Working with consumers, families, advocates, and
555	referral agencies to identify community service needs.
556	(b)  Reorganizing or developing services to meet unmet
557	needs that are a priority.
558	(c)  Contracting with providers to build a comprehensive
559	service network with staff that meets credentialing standards,
560	retaining traditional providers that meet minimum standards, and
561	seeking to expand the range of consumer choices of services and
562	providers.
563	(d)  Establishing an organized and unified system of care
564	that will be easier for consumers to access and navigate.
565	(e)  Developing systems of care that ensure linkages with
566	other related systems, such as health care, child welfare,
567	criminal justice, law enforcement, public safety, emergency
568	services, education, economic assistance, elder services,
569	homeless programs, and other social service systems.
570	(f)  Ensuring that priority services are accessible
571	throughout the service area for each target population and that
572	linkages are in place so that consumers can move easily through
573	various levels of care.
574	(g)  Ensuring outreach to engage substance abusing and
575	mentally ill individuals who need care.
576	(h)  Establishing uniform clinical policies based on
577	evidence-based practices.
578	(i)  Monitoring provider services to measure compliance
579	with standards and contractual requirements.
580	(j)  Establishing provider training programs and provider
581	information exchange processes to support quality improvement.
582	(k)  Building an information management system capable of
583	integrating clinical, fiscal, and management data and reporting
584	uniform consumer level and aggregate data to support performance
585	measurement and quality improvement initiatives.
586	(l)  Promoting cost-effective and appropriate care through
587	the use of utilization management techniques with the goal that
588	the techniques will become internal to network provider
589	agencies.
590	(m)  Fostering innovation in service delivery and in
591	technology development among contracted agencies to increase
592	program efficiency and cost effectiveness.
593	(n)  Coordinating network activities with other local
594	organizations managing substance abuse and mental health care as
595	long as cost shifting does not occur.
596	(o)  Operating in the public interest by maximizing the
597	investment of public funds for the direct benefit of consumers,
598	maintaining a high level of consumer satisfaction, and
599	reinvesting savings in new community services.
600	(p)  Consolidating the management functions of network
601	providers, as much as possible, in order to reduce costs and
602	maximize funding for direct services and promoting the
603	economical use of limited resources through measures such as
604	group purchasing.
605	(q)  Routinely evaluating network services based on
606	consumer-centered outcome measures that reflect national and
607	state standards and the recommendations of stakeholders,
608	including community agencies, consumers, and their families.
609	(r)  Monitoring network providers and ensuring that
610	monitoring results are used to improve both direct services and
611	administrative practices.
612	(s)  Working with consumers, advocates, and referral
613	agencies to identify community service needs.
614	(10)  MANAGEMENT INFORMATION SYSTEMS REQUIREMENTS.--
615	(a)  The Legislature finds that the information systems
616	supporting departmental substance abuse and mental health
617	programs are insufficient to meet service reporting and
618	performance and outcome measurement goals. To support the
619	conversion of substance abuse and mental health service delivery
620	and financing to community-based networks, the department shall
621	coordinate the development and implementation of common
622	information system requirements and system linkages across
623	community-based networks. The department shall establish a data
624	warehouse using the data contained in community-based network
625	information systems. The substance abuse and mental health
626	management information systems implemented by community-based
627	networks shall provide, at a minimum, an integrated service
628	delivery information system to capture information about
629	individuals served through community-based networks, including
630	comprehensive consumer, provider, clinical, demographic,
631	performance, outcome, and financial information for all of the
632	substance abuse and mental health programs administered by the
633	networks.
634	(b)1.  Community-based network management information
635	systems shall be designed to promote efficient and effective use
636	of resources and ensure network accountability. The system shall
637	contain, at a minimum, that information essential for ongoing
638	administration of service delivery, monitoring, and outcome
639	measurement systems and for the purpose of making management
640	decisions.
641	2.  The department shall aggregate, on a quarterly and an
642	annual basis, data provided by the management information
643	systems maintained by the community-based networks into
644	descriptive and statistical reports that shall be disseminated
645	through quarterly and annual reports and placed on Internet
646	websites for use by interested parties and shall be disseminated
647	to the appropriate substantive and appropriations committees of
648	the House of Representatives and the Senate.
649	3.  The department shall provide a data warehouse for
650	storage of nonconfidential data that shall be accessible to
651	stakeholders for planning, monitoring, evaluation, and research
652	purposes.
653	(c)  The department shall provide an annual report on the
654	planning and performance of the information system as executed
655	by the department and the community-based networks to the
656	appropriate substantive and appropriations committees of the
657	House of Representatives and the Senate. In developing system
658	requirements, the department shall consider and report on the
659	availability of, and the costs associated with using, existing
660	community-based network computer systems, including associated
661	hardware and software, or computer systems that are operational
662	in other states to meet the requirements of this subsection. The
663	department shall also consider and report on the compatibility
664	of existing systems and software with the development of an
665	integrated management information system across community-based
666	networks. The report to the House of Representatives and the
667	Senate shall be submitted no later than December 1 of each year.
668	(d)  In conjunction with the community-based networks, the
669	department shall develop its information system to track the
670	participation of consumers in substance abuse or mental health
671	programs on a timely basis and the extent to which the consumer
672	is involved with other systems of care, such as criminal
673	justice, housing, and education, and share this data with
674	community-based networks.
675	(11)  DEPARTMENTAL CONTRACTING, MONITORING, AND EVALUATION
676	OF COMMUNITY-BASED NETWORKS.--
677	(a)  The department shall set contract and program
678	standards for community-based service networks in accordance
679	with the requirements of this section.
680	(b)  The department shall adopt written policies and
681	procedures for monitoring contracts with community-based
682	networks. The contract monitoring shall be carried out by a
683	single contract monitoring unit located within the substance
684	abuse and mental health central program office of the
685	department.
686	(c)  These policies and procedures shall:
687	1.  Address the evaluation of fiscal accountability and
688	program operations, including achievement of performance
689	standards, network monitoring of subcontractors, and timely
690	followup on monitoring findings.
691	2.  Include provisions for eliminating any duplication of
692	the monitoring activities of the department and the community-
693	based networks.
694
695	The department shall recognize the national accreditation of
696	networks and their providers in determining the extent of
697	departmental monitoring required.
698	(d)  The services of community-based networks contracting
699	with the department must be evaluated annually by the
700	department. The department shall use independent audits of both
701	financial and service records provided by the network to
702	eliminate or significantly reduce contract and administrative
703	reviews conducted by the department. The department may suggest
704	additional items to be included in such independent audits to
705	meet departmental needs.
706	(e)  A departmental contract with a community-based network
707	shall include provisions that specify the procedures to be used
708	by the parties to resolve differences in interpreting the
709	contract or to resolve disputes as to the adequacy of the
710	parties' compliance with their respective obligations under the
711	contract.
712	(f)  The departmental contract shall ensure payment to the
713	network for reasonable administrative costs and reasonable
714	funding for the cost of delivering services. The department
715	shall redirect savings in departmental administrative costs to
716	community-based networks.
717	(g)  The department shall establish network performance
718	measures, performance benchmarks and standards, and consumer-
719	outcome measures and standards. Each contract with a community-
720	based network must include performance and consumer outcome
721	measures that are adjusted annually to enable the department to
722	meet its system performance and consumer-outcome standards.
723	(h)  The department shall collaborate with community-based
724	networks in developing standards for and implementing a quality
725	assurance and improvement program, including the use of pay-for-
726	performance incentives.
727	(i)  The department shall ensure that network services are
728	delivered in accordance with applicable federal regulations and
729	state law.
730	(j)  The department shall provide technical assistance to
731	and support the efforts of the community-based networks to
732	develop innovative and model substance abuse and mental health
733	programs and services.
734	(k)  The department, in order to eliminate or significantly
735	reduce the number of duplicate inspections by various entities,
736	shall coordinate inspections required pursuant to licensure of
737	agencies required under part II of chapter 408.
738	(12)  MONITORING THE REDESIGN OF THE SUBSTANCE ABUSE AND
739	MENTAL HEALTH SYSTEM.--
740	(a)  The department shall contract with the Louis de la
741	Parte Florida Mental Health Institute to monitor and provide
742	technical assistance to community-based networks; assist in
743	developing network standards, qualification criteria, and
744	contracts; identify administrative funds eligible for transfer
745	to community-based networks; develop information system
746	requirements; set performance and consumer outcome measures;
747	conduct stakeholder surveys during the transition process; and
748	identify best and promising practices.
749	(b)  Reports of these activities and reviews shall be
750	submitted to the appropriate substantive and appropriations
751	committees in the House of Representatives and the Senate by
752	March 1 and September 1 of each year until full transition to
753	community-based management has been accomplished statewide,
754	except that the first report must be submitted by February 1,
755	2009, and address all readiness activities undertaken through
756	November 30, 2008. The perspectives of all participants in this
757	review process must be included in each report.
758	(13)  INTERAGENCY ADVISORY COUNCIL ON SUBSTANCE ABUSE AND
759	MENTAL HEALTH.--
760	(a)  The Executive Office of the Governor shall establish
761	an Interagency Advisory Council on Substance Abuse and Mental
762	Health, the members of which shall advise the department as the
763	single state authority for the provision of publicly financed
764	services.
765	(b)  The council shall be composed of the secretaries of
766	the Agency for Health Care Administration, the Agency for
767	Workforce Innovation, the Department of Corrections, the
768	Department of Elderly Affairs, the Department of Health, the
769	Department of Juvenile Justice, and the Department of Law
770	Enforcement, or their designees; the Attorney General or his or
771	her representative; the Commissioner of Education or his or her
772	representative; and a representative of the Office of Drug
773	Control.
774	(c)  The council shall meet at least quarterly to develop a
775	plan for improving the coordination and integration of substance
776	abuse and mental health programs administered by various state
777	agencies. The plan shall address coordination of consumer
778	eligibility, funded services, contract specifications,
779	performance and outcome measures and procedures, joint or
780	collaborative purchasing, and an integrated data system for
781	performance reporting in order to maximize cost-effective
782	provision of services, agency performance, and consumer
783	outcomes. Each council member shall propose plans and a schedule
784	for the transition of state agency contracting to a common
785	contracting entity or otherwise promote collaborative purchasing
786	using integrated funding approaches so that available state and
787	federal funds are matched to consumer needs by the community-
788	based networks. The plan shall be submitted to the Governor by
789	December 1, 2009.
790	(14)  RULES.--The department shall develop and adopt rules
791	pursuant to ss. 120.536(1) and 120.54 to implement this section
792	only to the extent necessary to further specify requirements of
793	community-based networks and other changes required by this
794	section. The department shall involve providers, community-based
795	networks, and other stakeholders in the development of
796	administrative rules.
797	(15)  AGENCY FLEXIBILITY.--Notwithstanding any other
798	provisions of law or administrative rule, the Department of
799	Financial Services and the Department of Management Services
800	shall provide the Department of Children and Family Services
801	with the flexibility needed to implement this section.
802	Section 2.  This act shall take effect upon becoming a law.

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