HB 7041

1	A bill to be entitled
2	An act relating to the Florida Self-Directed Care program;
3	amending s. 394.9084, F.S.; authorizing the Department of
4	Children and Family Services to expand the program
5	statewide; requiring the department to implement a payment
6	mechanism for mental health treatment and support
7	services; defining the term "fiscal intermediary";
8	providing for the duties of the fiscal intermediary;
9	permitting the fiscal intermediary to receive funds on
10	behalf of participants; requiring an evaluation by the
11	Office of Program Policy Analysis and Government
12	Accountability by a certain date; providing evaluation
13	criteria; deleting provisions relating to the evaluation
14	of the original pilot program; deleting the expiration
15	date of the program; providing an effective date.
16
17	Be It Enacted by the Legislature of the State of Florida:
18
19	Section 1.  Subsections (1), (4), (6), (8), (9), and (10)
20	of section 394.9084, Florida Statutes, are amended to read:
21	394.9084  Florida Self-Directed Care program.--
22	(1)  The Department of Children and Family Services, in
23	cooperation with the Agency for Health Care Administration, may
24	provide develop a client-directed and choice-based Florida Self-
25	Directed Care program in all department service districts, in
26	addition to the pilot projects established project in district 4
27	and district 8, three other districts to provide mental health
28	treatment and support services to adults who have a serious
29	mental illness. The department may also develop and implement a
30	client-directed and choice-based pilot project in one district
31	to provide mental health treatment and support services for
32	children with a serious emotional disturbance who live at home.
33	If established, any staff who work with children must be
34	screened under s. 435.04. The department projects shall
35	implement a payment mechanism model in which each client
36	controls the money that is available for that client's mental
37	health treatment and support services. The department shall
38	establish interagency cooperative agreements and work with the
39	agency, the Division of Vocational Rehabilitation, and the
40	Social Security Administration to implement and administer the
41	Florida Self-Directed Care program.
42	(4)  The fiscal intermediary managing entity shall pay for
43	the cost-efficient community-based services the participant
44	selects to meet his or her mental health care and vocational
45	rehabilitation needs and goals as identified on his or her
46	recovery plan. For purposes of this section, the term "fiscal
47	intermediary" means an entity approved by the department that
48	helps the client manage his or her budget allowance, retains the
49	funds, processes employment information, if any, and tax
50	information, reviews records to ensure correctness, and writes
51	paychecks to providers.
52	(6)  The department, the agency, and the division may
53	transfer funds to the fiscal intermediary managing entity.
54	(8)  The department and the agency shall will complete a
55	memorandum of agreement to delineate management roles for
56	operation of the Florida Self-Directed Care program.
57	(9)  By December 31, 2009, the Office of Program Policy
58	Analysis and Government Accountability shall evaluate the
59	effectiveness The department, the agency, and the division shall
60	each, on an ongoing basis, review and assess the implementation
61	of the Florida Self-Directed Care program. The evaluation shall
62	include an assessment of participant choice and access to
63	services, cost savings, coordination and quality of care,
64	adherence to principles of self-directed care, barriers to
65	implementation, progress toward expansion of the program
66	statewide, and recommendations for improvement in the program.
67	(a)  The department will implement an evaluation of the
68	program and will include recommendations for improvements in the
69	program.
70	(b)  At a minimum, the evaluation must compare between
71	program participants and nonparticipants:
72	1.  Re-hospitalization rates.
73	2.  Levels of satisfaction.
74	3.  Service utilization rates.
75	4.  Residential stability.
76	5.  Levels of community integration and interaction.
77	(c)  The evaluation must evaluate adherence to the Centers
78	for Medicare and Medicaid self-direction requirements,
79	including:
80	1.  Person-centered planning.
81	2.  Individual budgets.
82	3.  Availability of independently brokered services from
83	recovery coaches and quality advocates.
84	4.  Access to the program by all who are eligible to
85	enroll.
86	5.  Participant safety and program incident management
87	planning.
88	6.  An independently mediated grievance process.
89	(d)  The evaluation must assess the economic self-
90	sufficiency of the program participants, including the number of
91	Individual Development Accounts.
92	(e)  The evaluation must assess any adverse incidents
93	resulting from the Florida Self-Directed Care, including
94	consumer grievances, conflicts of interest, and patterns of
95	self-referral by licensed professions.
96
97	The department is authorized to spend up to $100,000 to pay for
98	the evaluation. If the agency and the department obtain a
99	federal waiver, the evaluation will be used to determine
100	effectiveness.
101	(10)  This section expires July 1, 2008.
102	Section 2.  This act shall take effect July 1, 2008.

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