Florida Senate - 2015                   (PROPOSED BILL) SPB 7068
       
       
        
       FOR CONSIDERATION By the Committee on Appropriations
       
       
       
       
       
       576-02000A-15                                         20157068pb
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance abuse
    3         services; amending s. 394.455, F.S.; revising the
    4         definition of “mental illness” to include dementia and
    5         traumatic brain injuries; amending s. 394.492, F.S.;
    6         redefining the terms “adolescent” and “child or
    7         adolescent at risk of emotional disturbance”; creating
    8         s. 394.761, F.S.; requiring the Agency for Health Care
    9         Administration and the Department of Children and
   10         Families to develop a plan to obtain federal approval
   11         for increasing the availability of federal Medicaid
   12         funding for behavioral health care; establishing
   13         improved integration of behavioral health and primary
   14         care services through the development and effective
   15         implementation of coordinated care organizations as
   16         the primary goal of obtaining the additional funds;
   17         requiring the agency and the department to submit the
   18         written plan, which must include certain information,
   19         to the Legislature by a specified date; amending s.
   20         394.875, F.S.; requiring that, by a specified date,
   21         the department modify certain licensure rules and
   22         procedures; providing requirements for providers;
   23         amending s. 394.9082, F.S.; revising Legislative
   24         findings and intent; redefining terms; requiring the
   25         managing entities, rather than the department, to
   26         develop and implement a plan with a certain purpose;
   27         removing a provision providing legislative intent;
   28         requiring the department to contract with community
   29         based managing entities for the development of
   30         specified objectives; removing duties of the
   31         department, the secretary of the department, and
   32         managing entities; removing a provision regarding the
   33         requirement of funding the managing entity’s contract
   34         through departmental funds; removing legislative
   35         intent; requiring that the department’s contract with
   36         each managing entity be performance based; providing
   37         for scaled penalties and liquidated damages if a
   38         managing entity fails to perform after a reasonable
   39         opportunity for corrective action; requiring the plan
   40         for the coordination and integration of certain
   41         services to be developed in a certain manner and to
   42         incorporate certain models; providing requirements for
   43         the department when entering into contracts with a
   44         managing entity; requiring the department to consider
   45         specified factors when considering a new contractor;
   46         revising the goals of the coordinated care
   47         organization; requiring a coordinated care
   48         organization to consist of a comprehensive provider
   49         network that includes specified elements; requiring
   50         that specified treatment providers be initially
   51         included in the provider network; providing for
   52         continued participation in the provider network;
   53         revising the network management and administrative
   54         functions of the managing entities; requiring that the
   55         managing entity support network providers in certain
   56         ways; authorizing the managing entity to prioritize
   57         certain populations when necessary; requiring that, by
   58         a certain date, a managing entity’s governing board
   59         consist of a certain number of members selected by the
   60         managing entity in a specified manner; providing
   61         requirements for the governing board; removing
   62         departmental responsibilities; removing a reporting
   63         requirement; authorizing, rather than requiring, the
   64         department to adopt rules; creating s. 397.402, F.S.;
   65         requiring that the department modify certain licensure
   66         rules and procedures by a certain date; providing
   67         requirements for a provider; amending s. 397.427,
   68         F.S.; removing provisions requiring the department to
   69         determine the need for establishing providers of
   70         medication-assisted treatment services for opiate
   71         addiction; removing provisions requiring the
   72         department to adopt rules; amending s. 409.967, F.S.;
   73         requiring that certain plans or contracts include
   74         specified requirements; amending s. 409.973, F.S.;
   75         requiring each plan operating in the managed medical
   76         assistance program to work with the managing entity to
   77         establish specific organizational supports and service
   78         protocols; amending s. 409.975, F.S.; revising the
   79         categories from which the agency must determine which
   80         providers are essential Medicaid providers; repealing
   81         s. 394.4674, F.S., relating to a plan and report;
   82         repealing s. 394.4985, F.S., relating to districtwide
   83         information and referral network and implementation;
   84         repealing s. 394.657, F.S., relating to county
   85         planning councils or committees; repealing s. 394.745,
   86         F.S., relating to an annual report and compliance of
   87         providers under contract with department; repealing s.
   88         394.9084, F.S., relating to the Florida Self-Directed
   89         Care program; repealing s. 397.331, F.S., relating to
   90         definitions; repealing s. 397.333, F.S., relating to
   91         the Statewide Drug Policy Advisory Council; repealing
   92         s. 397.801, F.S., relating to substance abuse
   93         impairment coordination; repealing s. 397.811, F.S.,
   94         relating to juvenile substance abuse impairment
   95         coordination; repealing s. 397.821, F.S., relating to
   96         juvenile substance abuse impairment prevention and
   97         early intervention councils; repealing s. 397.901,
   98         F.S., relating to prototype juvenile addictions
   99         receiving facilities; repealing s. 397.93, F.S.,
  100         relating to children’s substance abuse services and
  101         target populations; repealing s. 397.94, F.S.,
  102         relating to children’s substance abuse services and
  103         the information and referral network; repealing s.
  104         397.951, F.S., relating to treatment and sanctions;
  105         repealing s. 397.97, F.S., relating to children’s
  106         substance abuse services and demonstration models;
  107         amending ss. 397.321, 397.98, 409.966, 943.031, and
  108         943.042, F.S.; conforming provisions and cross
  109         references to changes made by the act; reenacting ss.
  110         39.407(6)(a), 394.67(21), 394.674(1)(b), 394.676(1),
  111         409.1676(2)(c), and 409.1677(1)(b), F.S., relating to
  112         the term “suitable for residential treatment” or
  113         “suitability,” the term “residential treatment center
  114         for children and adolescents,” children’s mental
  115         health services, the indigent psychiatric medication
  116         program, and the term “serious behavioral problems,”
  117         respectively, to incorporate the amendment made to s.
  118         394.492, F.S., in references thereto; providing
  119         effective dates.
  120          
  121  Be It Enacted by the Legislature of the State of Florida:
  122  
  123         Section 1. Subsection (18) of section 394.455, Florida
  124  Statutes, is amended to read:
  125         394.455 Definitions.—As used in this part, unless the
  126  context clearly requires otherwise, the term:
  127         (18) “Mental illness” means an impairment of the mental or
  128  emotional processes that exercise conscious control of one’s
  129  actions or of the ability to perceive or understand reality,
  130  which impairment substantially interferes with the person’s
  131  ability to meet the ordinary demands of living. For the purposes
  132  of this part, the term does not include a developmental
  133  disability as defined in chapter 393, dementia, traumatic brain
  134  injuries, intoxication, or conditions manifested only by
  135  antisocial behavior or substance abuse impairment.
  136         Section 2. Subsections (1), (4), and (6) of section
  137  394.492, Florida Statutes, are amended to read:
  138         394.492 Definitions.—As used in ss. 394.490-394.497, the
  139  term:
  140         (1) “Adolescent” means a person who is at least 13 years of
  141  age but under 18 21 years of age.
  142         (4) “Child or adolescent at risk of emotional disturbance”
  143  means a person under 18 21 years of age who has an increased
  144  likelihood of becoming emotionally disturbed because of risk
  145  factors that include, but are not limited to:
  146         (a) Being homeless.
  147         (b) Having a family history of mental illness.
  148         (c) Being physically or sexually abused or neglected.
  149         (d) Abusing alcohol or other substances.
  150         (e) Being infected with human immunodeficiency virus (HIV).
  151         (f) Having a chronic and serious physical illness.
  152         (g) Having been exposed to domestic violence.
  153         (h) Having multiple out-of-home placements.
  154         (6) “Child or adolescent who has a serious emotional
  155  disturbance or mental illness” means a person under 18 21 years
  156  of age who:
  157         (a) Is diagnosed as having a mental, emotional, or
  158  behavioral disorder that meets one of the diagnostic categories
  159  specified in the most recent edition of the Diagnostic and
  160  Statistical Manual of Mental Disorders of the American
  161  Psychiatric Association; and
  162         (b) Exhibits behaviors that substantially interfere with or
  163  limit his or her role or ability to function in the family,
  164  school, or community, which behaviors are not considered to be a
  165  temporary response to a stressful situation.
  166  
  167  The term includes a child or adolescent who meets the criteria
  168  for involuntary placement under s. 394.467(1).
  169         Section 3. Section 394.761, Florida Statutes, is created to
  170  read:
  171         394.761 Revenue maximization.—The agency and the department
  172  shall develop a plan to obtain federal approval for increasing
  173  the availability of federal Medicaid funding for behavioral
  174  health care. Increased funding will be used to advance the goal
  175  of improved integration of behavioral health and primary care
  176  services through development and effective implementation of
  177  coordinated care organizations as described in s. 394.9082(3).
  178  The agency and the department shall submit the written plan to
  179  the President of the Senate and the Speaker of the House of
  180  Representatives no later than November 1, 2015. The plan shall
  181  identify the amount of general revenue funding appropriated for
  182  mental health and substance abuse services which is eligible to
  183  be used as state Medicaid match. The plan must evaluate
  184  alternative uses of increased Medicaid funding, including
  185  expansion of Medicaid eligibility for the severely and
  186  persistently mentally ill; increased reimbursement rates for
  187  behavioral health services; adjustments to the capitation rate
  188  for Medicaid enrollees with chronic mental illness and substance
  189  use disorders; supplemental payments to mental health and
  190  substance abuse providers through a designated state health
  191  program or other mechanisms; and innovative programs for
  192  incentivizing improved outcomes for behavioral health
  193  conditions. The plan shall identify the advantages and
  194  disadvantages of each alternative and assess the potential of
  195  each for achieving improved integration of services. The plan
  196  shall identify the types of federal approvals necessary to
  197  implement each alternative and project a timeline for
  198  implementation.
  199         Section 4. Subsection (11) is added to section 394.875,
  200  Florida Statutes, to read:
  201         394.875 Crisis stabilization units, residential treatment
  202  facilities, and residential treatment centers for children and
  203  adolescents; authorized services; license required.—
  204         (11)No later than January 1, 2016, the department shall
  205  modify licensure rules and procedures to create an option for a
  206  single, consolidated license for a provider who offers multiple
  207  types of mental health and substance abuse services regulated
  208  under this chapter and chapter 397. Providers eligible for a
  209  consolidated license must operate these services through a
  210  single corporate entity and a unified management structure. Any
  211  provider serving adult and children must meet departmental
  212  standards for separate facilities and other requirements
  213  necessary to ensure children’s safety and promote therapeutic
  214  efficacy.
  215         Section 5. Effective upon this act becoming a law, section
  216  394.9082, Florida Statutes, is amended to read:
  217         394.9082 Behavioral health managing entities.—
  218         (1) LEGISLATIVE FINDINGS AND INTENT.—The Legislature finds
  219  that untreated behavioral health disorders constitute major
  220  health problems for residents of this state, are a major
  221  economic burden to the citizens of this state, and substantially
  222  increase demands on the state’s juvenile and adult criminal
  223  justice systems, the child welfare system, and health care
  224  systems. The Legislature finds that behavioral health disorders
  225  respond to appropriate treatment, rehabilitation, and supportive
  226  intervention. The Legislature finds that the state’s return on
  227  its it has made a substantial long-term investment in the
  228  funding of the community-based behavioral health prevention and
  229  treatment service systems and facilities can be enhanced by
  230  integration of these services with primary care in order to
  231  provide critical emergency, acute care, residential, outpatient,
  232  and rehabilitative and recovery-based services. The Legislature
  233  finds that local communities have also made substantial
  234  investments in behavioral health services, contracting with
  235  safety net providers who by mandate and mission provide
  236  specialized services to vulnerable and hard-to-serve populations
  237  and have strong ties to local public health and public safety
  238  agencies. The Legislature finds that a regional management
  239  structure for that places the responsibility for publicly
  240  financed behavioral health treatment and prevention services
  241  within a single private, nonprofit entity at the local level
  242  will improve promote improved access to care, promote service
  243  continuity, and provide for more efficient and effective
  244  delivery of substance abuse and mental health services. The
  245  Legislature finds that streamlining administrative processes
  246  will create cost efficiencies and provide flexibility to better
  247  match available services to consumers’ identified needs.
  248         (2) DEFINITIONS.—As used in this section, the term:
  249         (a) “Behavioral health services” means mental health
  250  services and substance abuse prevention and treatment services
  251  as defined in this chapter and chapter 397 which are provided
  252  using state and federal funds.
  253         (b) “Decisionmaking model” means a comprehensive management
  254  information system needed to answer the following management
  255  questions at the federal, state, regional, circuit, and local
  256  provider levels: who receives what services from which providers
  257  with what outcomes and at what costs?
  258         (b)(c) “Geographic area” means a county, circuit, regional,
  259  or a region as described in s. 409.966 multiregional area in
  260  this state.
  261         (c)(d) “Managing entity” means a corporation that is
  262  organized in this state, is designated or filed as a nonprofit
  263  organization under s. 501(c)(3) of the Internal Revenue Code,
  264  and is under contract to the department to manage the day-to-day
  265  operational delivery of behavioral health services as of July 1,
  266  2015 through an organized system of care.
  267         (e) “Provider networks” mean the direct service agencies
  268  that are under contract with a managing entity and that together
  269  constitute a comprehensive array of emergency, acute care,
  270  residential, outpatient, recovery support, and consumer support
  271  services.
  272         (3) COORDINATED CARE ORGANIZATIONS SERVICE DELIVERY
  273  STRATEGIES.—The department may work through managing entities
  274  shall to develop and implement a plan to create a coordinated
  275  regional network of behavioral health service providers which
  276  provides access to a comprehensive range of services and
  277  enhances continuity of care for service delivery strategies that
  278  will improve the coordination, integration, and management of
  279  the delivery of behavioral health services to people with who
  280  have mental illness or substance use disorders. It is the intent
  281  of the Legislature that a well-managed service delivery system
  282  will increase access for those in need of care, improve the
  283  coordination and continuity of care for vulnerable and high-risk
  284  populations, and redirect service dollars from restrictive care
  285  settings to community-based recovery services.
  286         (4) CONTRACT FOR SERVICES.—
  287         (a) The department must may contract for the purchase and
  288  management of behavioral health services with community-based
  289  managing entities for the development of a regional coordinated
  290  care organization, network management services, and the
  291  administrative functions defined in subsection (6). The
  292  department may require a managing entity to contract for
  293  specialized services that are not currently part of the managing
  294  entity’s network if the department determines that to do so is
  295  in the best interests of consumers of services. The secretary
  296  shall determine the schedule for phasing in contracts with
  297  managing entities. The managing entities shall, at a minimum, be
  298  accountable for the operational oversight of the delivery of
  299  behavioral health services funded by the department and for the
  300  collection and submission of the required data pertaining to
  301  these contracted services. A managing entity shall serve a
  302  geographic area designated by the department. The geographic
  303  area must be of sufficient size in population and have enough
  304  public funds for behavioral health services to allow for
  305  flexibility and maximum efficiency.
  306         (b) The operating costs of the managing entity contract
  307  shall be funded through funds from the department and any
  308  savings and efficiencies achieved through the implementation of
  309  managing entities when realized by their participating provider
  310  network agencies. The department recognizes that managing
  311  entities will have infrastructure development costs during
  312  start-up so that any efficiencies to be realized by providers
  313  from consolidation of management functions, and the resulting
  314  savings, will not be achieved during the early years of
  315  operation. The department shall negotiate a reasonable and
  316  appropriate administrative cost rate with the managing entity.
  317  The Legislature intends that reduced local and state contract
  318  management and other administrative duties passed on to the
  319  managing entity allows funds previously allocated for these
  320  purposes to be proportionately reduced and the savings used to
  321  purchase the administrative functions of the managing entity.
  322  Policies and procedures of the department for monitoring
  323  contracts with managing entities shall include provisions for
  324  eliminating duplication of the department’s and the managing
  325  entities’ contract management and other administrative
  326  activities in order to achieve the goals of cost-effectiveness
  327  and regulatory relief. To the maximum extent possible, provider
  328  monitoring activities shall be assigned to the managing entity.
  329         (c) The department’s contract with each managing entity
  330  must be a performance-based agreement requiring specific
  331  results, setting measureable performance standards and
  332  timelines, and identifying consequences for failure to timely
  333  plan and implement a regional, coordinated care organization.
  334  The consequences specified in the contract must correlate to a
  335  schedule of penalties, scaled to the nature and significance of
  336  the managing entity’s failure to perform, and must include
  337  liquidated damages. The contract must provide a reasonable
  338  opportunity for managing entities to implement corrective
  339  actions, but must require progress toward achievement of the
  340  performance standards identified in paragraph (e) Contracting
  341  and payment mechanisms for services must promote clinical and
  342  financial flexibility and responsiveness and must allow
  343  different categorical funds to be integrated at the point of
  344  service. The plan for coordination and integration of services
  345  required by subsection (3) shall be developed based on
  346  contracted service array must be determined by using public
  347  input and, needs assessment, and must incorporate promising,
  348  evidence-based and promising best practice models. The
  349  department may employ care management methodologies, prepaid
  350  capitation, and case rate or other methods of payment which
  351  promote flexibility, efficiency, and accountability.
  352         (d)The department shall establish a 3-year performance
  353  based contract with each managing entity on the next date of
  354  contract renewal after the effective date of this act. All
  355  managing entities must be operating under performance-based
  356  contracts by July 1, 2017. Managing entities with contracts
  357  subject to renewal on July 1, 2015, shall receive a contract
  358  renewal, if available, or a contract extension under s.
  359  287.057(12) until the performance-based contract can be
  360  developed.
  361         (e)The contract must identify performance standards that
  362  are critical to the implementation of a coordinated care
  363  organization. Failure to achieve these specific standards
  364  constitutes a disqualification of the entity resulting in a
  365  notice of termination, which is effective upon selection of a
  366  new contractor. If a managing entity is disqualified due to
  367  performance failure, the department shall issue an invitation to
  368  negotiate in order to select a new contractor. The new
  369  contractor must be a managing entity in another region, a
  370  Medicaid managed care organization operating in the same region,
  371  or a behavioral health specialty managed care organization. The
  372  department shall consider the input and recommendations of
  373  network providers in the selection of the new contractor. The
  374  invitation to negotiate shall specify the criteria and the
  375  relative weight of the criteria that will be used in selecting
  376  the new contractor. The department must consider all of the
  377  following factors:
  378         1.Experience serving persons with mental health and
  379  substance use disorders.
  380         2.Establishment of community partnerships with behavioral
  381  health providers.
  382         3.Demonstrated organizational capabilities for network
  383  management functions.
  384         4.Capability to integrate behavioral health with primary
  385  care services.
  386         (5) GOALS.—The primary goal of the coordinated care
  387  organization service delivery strategies is to improve outcomes
  388  for persons needing provide a design for an effective
  389  coordination, integration, and management approach for
  390  delivering effective behavioral health services to persons who
  391  are experiencing a mental health or substance abuse crisis, who
  392  have a disabling mental illness or a substance use or co
  393  occurring disorder, and require extended services in order to
  394  recover from their illness, or who need brief treatment or
  395  longer-term supportive interventions to avoid a crisis or
  396  disability. Other goals include:
  397         (a) Improving Accountability for measureable and
  398  transparent a local system of behavioral health care services to
  399  meet performance outcomes and standards through the use of
  400  reliable and timely data.
  401         (b) Enhancing the Continuity of care for all children,
  402  adolescents, and adults who receive services from the
  403  coordinated care organization enter the publicly funded
  404  behavioral health service system.
  405         (c) Value-based purchasing of behavioral health services
  406  that maximizes the return on investment to local, state, and
  407  federal funding sources Preserving the “safety net” of publicly
  408  funded behavioral health services and providers, and recognizing
  409  and ensuring continued local contributions to these services, by
  410  establishing locally designed and community-monitored systems of
  411  care.
  412         (d) Providing Early diagnosis and treatment interventions
  413  to enhance recovery and prevent hospitalization.
  414         (e) Regional service delivery systems that are responsive
  415  to Improving the assessment of local needs for behavioral health
  416  services.
  417         (f) Quality care that is provided using Improving the
  418  overall quality of behavioral health services through the use of
  419  evidence-based, best practice, and promising practice models.
  420         (g) Demonstrating improved service Integration of between
  421  behavioral health services programs and other programs, such as
  422  vocational rehabilitation, education, child welfare, primary
  423  health care, emergency services, juvenile justice, and criminal
  424  justice.
  425         (h) Providing for additional testing of creative and
  426  flexible strategies for financing behavioral health services to
  427  enhance individualized treatment and support services.
  428         (i) Promoting cost-effective quality care.
  429         (j) Working with the state to coordinate admissions and
  430  discharges from state civil and forensic hospitals and
  431  coordinating admissions and discharges from residential
  432  treatment centers.
  433         (k) Improving the integration, accessibility, and
  434  dissemination of behavioral health data for planning and
  435  monitoring purposes.
  436         (l) Promoting specialized behavioral health services to
  437  residents of assisted living facilities.
  438         (m) Working with the state and other stakeholders to reduce
  439  the admissions and the length of stay for dependent children in
  440  residential treatment centers.
  441         (n) Providing services to adults and children with co
  442  occurring disorders of mental illnesses and substance abuse
  443  problems.
  444         (o) Providing services to elder adults in crisis or at-risk
  445  for placement in a more restrictive setting due to a serious
  446  mental illness or substance abuse.
  447         (6) ESSENTIAL ELEMENTS.—It is the intent of the Legislature
  448  that the department may plan for and enter into contracts with
  449  managing entities to manage care in geographical areas
  450  throughout the state.
  451         (a) A coordinated care organization must consist of a
  452  comprehensive provider network that includes the following
  453  elements: The managing entity must demonstrate the ability of
  454  its network of providers to comply with the pertinent provisions
  455  of this chapter and chapter 397 and to ensure the provision of
  456  comprehensive behavioral health services. The network of
  457  providers must include, but need not be limited to, community
  458  mental health agencies, substance abuse treatment providers, and
  459  best practice consumer services providers.
  460         1.A centralized receiving facility or coordinated
  461  receiving system for persons needing evaluation pursuant to s.
  462  394.463 or s. 397.675.
  463         2.Crisis services, including mobile response teams and
  464  crisis stabilization units.
  465         3. Case management.
  466         4.Outpatient services.
  467         5. Residential services.
  468         6. Hospital inpatient care.
  469         7.Aftercare and other postdischarge services.
  470         8.Recovery support, including housing assistance and
  471  support for competitive employment, educational attainment,
  472  independent living skills development, family support and
  473  education, and wellness management and self-care.
  474         9.Medical services necessary for integration of behavioral
  475  health services with primary care.
  476         (b) The department shall terminate its mental health or
  477  substance abuse provider contracts for services to be provided
  478  by the managing entity at the same time it contracts with the
  479  managing entity.
  480         (b)(c) The managing entity shall ensure that its provider
  481  network shall initially include all is broadly conceived. All
  482  mental health or substance abuse treatment providers currently
  483  receiving public funds pursuant to this chapter or chapter 397.
  484  Continued participation in the network is subject to credentials
  485  and performance standards set by the managing entity and
  486  approved by the department under contract with the department
  487  shall be offered a contract by the managing entity.
  488         (c)(d) The network management and administrative functions
  489  of the department may contract with managing entities to provide
  490  the following core functions include:
  491         1. Financial management accountability.
  492         2. Allocation of funds to network providers in a manner
  493  that reflects the department’s strategic direction and plans.
  494         3. Provider monitoring to ensure compliance with federal
  495  and state laws, rules, and regulations.
  496         4. Data collection, reporting, and analysis.
  497         5. Information systems necessary for the delivery of
  498  coordinated care and integrated services Operational plans to
  499  implement objectives of the department’s strategic plan.
  500         6. Contract compliance.
  501         7. Performance measurement based on nationally recognized
  502  standards such as those developed by the National Quality Forum,
  503  the National Committee for Quality Assurance, or similar
  504  credible sources management.
  505         8. Collaboration with community stakeholders, including
  506  local government.
  507         9. System of care through network development.
  508         9.10. Consumer care coordination.
  509         10.11. Continuous quality improvement.
  510         12. Timely access to appropriate services.
  511         13. Cost-effectiveness and system improvements.
  512         14. Assistance in the development of the department’s
  513  strategic plan.
  514         15. Participation in community, circuit, regional, and
  515  state planning.
  516         11.16. Resource management and maximization, including
  517  pursuit of third-party payments and grant applications.
  518         12.17. Incentives for providers to improve quality and
  519  access.
  520         13.18. Liaison with consumers.
  521         14.19. Community needs assessment.
  522         15.20. Securing local matching funds.
  523         (d) The managing entity shall support network providers to
  524  offer comprehensive and coordinated care to all persons in need,
  525  but may develop a prioritization framework when necessary to
  526  make the best use of limited resources. Priority populations
  527  include:
  528         1. Individuals in crisis stabilization units who are on the
  529  waitlist for placement in a state treatment facility;
  530         2. Individuals in state treatment facilities on the
  531  waitlist for community care;
  532         3. Parents or caretakers with child welfare involvement;
  533         4. Individuals with multiple arrests and incarceration as a
  534  result of their behavioral health condition; and
  535         5. Individuals with behavioral health disorders and
  536  comorbidities consistent with the characteristics of patients in
  537  the region’s population of behavioral health service users who
  538  account for a disproportionately high percentage of service
  539  expenditures.
  540         (e) The managing entity shall ensure that written
  541  cooperative agreements are developed and implemented among the
  542  criminal and juvenile justice systems, the local community-based
  543  care network, and the local behavioral health providers in the
  544  geographic area which define strategies and alternatives for
  545  diverting people who have mental illness and substance abuse
  546  problems from the criminal justice system to the community.
  547  These agreements must also address the provision of appropriate
  548  services to persons who have behavioral health problems and
  549  leave the criminal justice system.
  550         (f) Managing entities must collect and submit data to the
  551  department regarding persons served, outcomes of persons served,
  552  and the costs of services provided through the department’s
  553  contract. The department shall evaluate managing entity services
  554  based on consumer-centered outcome measures that reflect
  555  national standards that can dependably be measured. The
  556  department shall work with managing entities to establish
  557  performance standards related to:
  558         1. The extent to which individuals in the community receive
  559  services.
  560         2. The improvement of quality of care for individuals
  561  served.
  562         3. The success of strategies to divert jail, prison, and
  563  forensic facility admissions.
  564         4. Consumer and family satisfaction.
  565         5. The satisfaction of key community constituents such as
  566  law enforcement agencies, juvenile justice agencies, the courts,
  567  the schools, local government entities, hospitals, and others as
  568  appropriate for the geographical area of the managing entity.
  569         (g) The Agency for Health Care Administration may establish
  570  a certified match program, which must be voluntary. Under a
  571  certified match program, reimbursement is limited to the federal
  572  Medicaid share to Medicaid-enrolled strategy participants. The
  573  agency may take no action to implement a certified match program
  574  unless the consultation provisions of chapter 216 have been met.
  575  The agency may seek federal waivers that are necessary to
  576  implement the behavioral health service delivery strategies.
  577         (7) MANAGING ENTITY REQUIREMENTS.—The department may adopt
  578  rules and contractual standards related to and a process for the
  579  qualification and operation of managing entities which are
  580  based, in part, on the following criteria:
  581         (a) As of December 31, 2015, a managing entity’s governing
  582  board governance structure shall consist of 15 members selected
  583  by the managing entity as follows: be representative and shall,
  584  at a minimum, include consumers and family members, appropriate
  585  community stakeholders and organizations, and providers of
  586  substance abuse and mental health services as defined in this
  587  chapter and chapter 397. If there are one or more private
  588  receiving facilities in the geographic coverage area of a
  589  managing entity, the managing entity shall have one
  590  representative for the private-receiving facilities as an ex
  591  officio member of its board of directors.
  592         1. Four representatives of consumers and their families,
  593  selected from nominations submitted by behavioral health service
  594  providers in the region.
  595         2. Two representatives of local governments in the region,
  596  selected from nominations submitted by county and municipal
  597  governments in the region.
  598         3. Two representatives of law enforcement, appointed by the
  599  Attorney General.
  600         4. Two representatives of employers in the region, selected
  601  from nominations submitted by Chambers of Commerce in the
  602  region.
  603         5. Two representatives of service providers involved with
  604  the child welfare system, appointed by the community-based care
  605  lead agency.
  606         6. Three representatives of health care professionals and
  607  health facilities in the region which are not under contract to
  608  the managing entity, selected from nominations submitted by
  609  local medical societies, hospitals, and other health care
  610  organizations in the region.
  611         (b) The managing entity must create a transparent process
  612  for nomination and selection of board members and must adopt a
  613  procedure for establishing staggered term limits which ensures
  614  that no individual serves more than 8 consecutive years on the
  615  governing board A managing entity that was originally formed
  616  primarily by substance abuse or mental health providers must
  617  present and demonstrate a detailed, consensus approach to
  618  expanding its provider network and governance to include both
  619  substance abuse and mental health providers.
  620         (c) A managing entity must submit a network management plan
  621  and budget in a form and manner determined by the department.
  622  The plan must detail the means for implementing the duties to be
  623  contracted to the managing entity and the efficiencies to be
  624  anticipated by the department as a result of executing the
  625  contract. The department may require modifications to the plan
  626  and must approve the plan before contracting with a managing
  627  entity. The department may contract with a managing entity that
  628  demonstrates readiness to assume core functions, and may
  629  continue to add functions and responsibilities to the managing
  630  entity’s contract over time as additional competencies are
  631  developed as identified in paragraph (g). Notwithstanding other
  632  provisions of this section, the department may continue and
  633  expand managing entity contracts if the department determines
  634  that the managing entity meets the requirements specified in
  635  this section.
  636         (d) Notwithstanding paragraphs (b) and (c), a managing
  637  entity that is currently a fully integrated system providing
  638  mental health and substance abuse services, Medicaid, and child
  639  welfare services is permitted to continue operating under its
  640  current governance structure as long as the managing entity can
  641  demonstrate to the department that consumers, other
  642  stakeholders, and network providers are included in the planning
  643  process.
  644         (d)(e) Managing entities shall operate in a transparent
  645  manner, providing public access to information, notice of
  646  meetings, and opportunities for broad public participation in
  647  decisionmaking. The managing entity’s network management plan
  648  must detail policies and procedures that ensure transparency.
  649         (e)(f) Before contracting with a managing entity, the
  650  department must perform an onsite readiness review of a managing
  651  entity to determine its operational capacity to satisfactorily
  652  perform the duties to be contracted.
  653         (f)(g) The department shall engage community stakeholders,
  654  including providers and managing entities under contract with
  655  the department, in the development of objective standards to
  656  measure the competencies of managing entities and their
  657  readiness to assume the responsibilities described in this
  658  section, and the outcomes to hold them accountable.
  659         (8) DEPARTMENT RESPONSIBILITIES.—With the introduction of
  660  managing entities to monitor department-contracted providers’
  661  day-to-day operations, the department and its regional and
  662  circuit offices will have increased ability to focus on broad
  663  systemic substance abuse and mental health issues. After the
  664  department enters into a managing entity contract in a
  665  geographic area, the regional and circuit offices of the
  666  department in that area shall direct their efforts primarily to
  667  monitoring the managing entity contract, including negotiation
  668  of system quality improvement goals each contract year, and
  669  review of the managing entity’s plans to execute department
  670  strategic plans; carrying out statutorily mandated licensure
  671  functions; conducting community and regional substance abuse and
  672  mental health planning; communicating to the department the
  673  local needs assessed by the managing entity; preparing
  674  department strategic plans; coordinating with other state and
  675  local agencies; assisting the department in assessing local
  676  trends and issues and advising departmental headquarters on
  677  local priorities; and providing leadership in disaster planning
  678  and preparation.
  679         (8)(9) FUNDING FOR MANAGING ENTITIES.—
  680         (a) A contract established between the department and a
  681  managing entity under this section shall be funded by general
  682  revenue, other applicable state funds, or applicable federal
  683  funding sources. A managing entity may carry forward documented
  684  unexpended state funds from one fiscal year to the next;
  685  however, the cumulative amount carried forward may not exceed 8
  686  percent of the total contract. Any unexpended state funds in
  687  excess of that percentage must be returned to the department.
  688  The funds carried forward may not be used in a way that would
  689  create increased recurring future obligations or for any program
  690  or service that is not currently authorized under the existing
  691  contract with the department. Expenditures of funds carried
  692  forward must be separately reported to the department. Any
  693  unexpended funds that remain at the end of the contract period
  694  shall be returned to the department. Funds carried forward may
  695  be retained through contract renewals and new procurements as
  696  long as the same managing entity is retained by the department.
  697         (b) The method of payment for a fixed-price contract with a
  698  managing entity must provide for a 2-month advance payment at
  699  the beginning of each fiscal year and equal monthly payments
  700  thereafter.
  701         (10) REPORTING.—Reports of the department’s activities,
  702  progress, and needs in achieving the goal of contracting with
  703  managing entities in each circuit and region statewide must be
  704  submitted to the appropriate substantive and appropriations
  705  committees in the Senate and the House of Representatives on
  706  January 1 and July 1 of each year until the full transition to
  707  managing entities has been accomplished statewide.
  708         (9)(11) RULES.—The department may shall adopt rules to
  709  administer this section and, as necessary, to further specify
  710  requirements of managing entities.
  711         Section 6. Section 397.402, Florida Statutes, is created to
  712  read:
  713         397.402 Single, consolidated license.—No later than January
  714  1, 2016, the department shall modify licensure rules and
  715  procedures to create an option for a single, consolidated
  716  license for a provider that offers multiple types of mental
  717  health and substance abuse services regulated under chapters 394
  718  and 397. Providers eligible for a consolidated license must
  719  operate these services through a single corporate entity and a
  720  unified management structure. Any provider serving both adults
  721  and children must meet departmental standards for separate
  722  facilities and other requirements necessary to ensure the safety
  723  of children and promote therapeutic efficacy.
  724         Section 7. Section 397.427, Florida Statutes, is amended,
  725  to read:
  726         397.427 Medication-assisted treatment service providers;
  727  rehabilitation program; needs assessment and provision of
  728  services; persons authorized to issue takeout medication;
  729  unlawful operation; penalty.—
  730         (1) Providers of medication-assisted treatment services for
  731  opiate addiction may not be licensed unless they provide
  732  supportive rehabilitation programs. Supportive rehabilitation
  733  programs include, but are not limited to, counseling, therapy,
  734  and vocational rehabilitation.
  735         (2) The department shall determine the need for
  736  establishing providers of medication-assisted treatment services
  737  for opiate addiction.
  738         (a) Providers of medication-assisted treatment services for
  739  opiate addiction may be established only in response to the
  740  department’s determination and publication of need for
  741  additional medication treatment services.
  742         (b) The department shall prescribe by rule the types of
  743  medication-assisted treatment services for opiate addiction for
  744  which it is necessary to conduct annual assessments of need. If
  745  needs assessment is required, the department shall annually
  746  conduct the assessment and publish a statement of findings which
  747  identifies each substate entity’s need.
  748         (c) Notwithstanding paragraphs (a) and (b), the license for
  749  medication-assisted treatment programs for opiate addiction
  750  licensed before October 1, 1990, may not be revoked solely
  751  because of the department’s determination concerning the need
  752  for medication-assisted treatment services for opiate addiction.
  753         (3) The department shall adopt rules necessary to
  754  administer this section, including, but not limited to, rules
  755  prescribing criteria and procedures for:
  756         (a) Determining the need for additional medication-assisted
  757  treatment services for opiate addiction.
  758         (b) Selecting providers for medication-assisted treatment
  759  services for opiate addiction when the number of responses to a
  760  publication of need exceeds the determined need.
  761         (c) Administering any federally required rules,
  762  regulations, or procedures.
  763         (2)(4) A service provider operating in violation of this
  764  section is subject to proceedings in accordance with this
  765  chapter to enjoin that unlawful operation.
  766         (3)(5) Notwithstanding s. 465.019(2), a physician
  767  assistant, a registered nurse, an advanced registered nurse
  768  practitioner, or a licensed practical nurse working for a
  769  licensed service provider may deliver takeout medication for
  770  opiate treatment to persons enrolled in a maintenance treatment
  771  program for medication-assisted treatment for opiate addiction
  772  if:
  773         (a) The medication-assisted treatment program for opiate
  774  addiction has an appropriate valid permit issued pursuant to
  775  rules adopted by the Board of Pharmacy;
  776         (b) The medication for treatment of opiate addiction has
  777  been delivered pursuant to a valid prescription written by the
  778  program’s physician licensed pursuant to chapter 458 or chapter
  779  459;
  780         (c) The medication for treatment of opiate addiction which
  781  is ordered appears on a formulary and is prepackaged and
  782  prelabeled with dosage instructions and distributed from a
  783  source authorized under chapter 499;
  784         (d) Each licensed provider adopts written protocols which
  785  provide for supervision of the physician assistant, registered
  786  nurse, advanced registered nurse practitioner, or licensed
  787  practical nurse by a physician licensed pursuant to chapter 458
  788  or chapter 459 and for the procedures by which patients’
  789  medications may be delivered by the physician assistant,
  790  registered nurse, advanced registered nurse practitioner, or
  791  licensed practical nurse. Such protocols shall be signed by the
  792  supervising physician and either the administering registered
  793  nurse, the advanced registered nurse practitioner, or the
  794  licensed practical nurse.
  795         (e) Each licensed service provider maintains and has
  796  available for inspection by representatives of the Board of
  797  Pharmacy all medical records and patient care protocols,
  798  including records of medications delivered to patients, in
  799  accordance with the board.
  800         (4)(6) The department shall also determine the need for
  801  establishing medication-assisted treatment for substance use
  802  disorders other than opiate dependence. Service providers within
  803  the publicly funded system shall be funded for provision of
  804  these services based on the availability of funds.
  805         (5)(7) Service providers that provide medication-assisted
  806  treatment for substance abuse other than opiate dependence shall
  807  provide counseling services in conjunction with medication
  808  assisted treatment.
  809         (6)(8) The department shall adopt rules necessary to
  810  administer medication-assisted treatment services, including,
  811  but not limited to, rules prescribing criteria and procedures
  812  for:
  813         (a) Determining the need for medication-assisted treatment
  814  services within the publicly funded system.
  815         (b) Selecting medication-assisted service providers within
  816  the publicly funded system.
  817         (c) Administering any federally required rules,
  818  regulations, or procedures related to the provision of
  819  medication-assisted treatment.
  820         (7)(9) A physician assistant, a registered nurse, an
  821  advanced registered nurse practitioner, or a licensed practical
  822  nurse working for a licensed service provider may deliver
  823  medication as prescribed by rule if:
  824         (a) The service provider is authorized to provide
  825  medication-assisted treatment;
  826         (b) The medication has been administered pursuant to a
  827  valid prescription written by the program’s physician who is
  828  licensed under chapter 458 or chapter 459; and
  829         (c) The medication ordered appears on a formulary or meets
  830  federal requirements for medication-assisted treatment.
  831         (8)(10) Each licensed service provider that provides
  832  medication-assisted treatment must adopt written protocols as
  833  specified by the department and in accordance with federally
  834  required rules, regulations, or procedures. The protocol shall
  835  provide for the supervision of the physician assistant,
  836  registered nurse, advanced registered nurse practitioner, or
  837  licensed practical nurse working under the supervision of a
  838  physician who is licensed under chapter 458 or chapter 459. The
  839  protocol must specify how the medication will be used in
  840  conjunction with counseling or psychosocial treatment and that
  841  the services provided will be included on the treatment plan.
  842  The protocol must specify the procedures by which medication
  843  assisted treatment may be administered by the physician
  844  assistant, registered nurse, advanced registered nurse
  845  practitioner, or licensed practical nurse. These protocols shall
  846  be signed by the supervising physician and the administering
  847  physician assistant, registered nurse, advanced registered nurse
  848  practitioner, or licensed practical nurse.
  849         (9)(11) Each licensed service provider shall maintain and
  850  have available for inspection by representatives of the Board of
  851  Pharmacy all medical records and protocols, including records of
  852  medications delivered to individuals in accordance with rules of
  853  the board.
  854         Section 8. Present paragraphs (d) through (m) of subsection
  855  (2) of section 409.967, Florida Statutes, are redesignated as
  856  paragraphs (e) through (n), respectively, and a new paragraph
  857  (d) is added to that subsection, to read:
  858         409.967 Managed care plan accountability.—
  859         (2) The agency shall establish such contract requirements
  860  as are necessary for the operation of the statewide managed care
  861  program. In addition to any other provisions the agency may deem
  862  necessary, the contract must require:
  863         (d) Quality care.—Managed care plans shall provide, or
  864  contract for the provision of, care coordination to facilitate
  865  the appropriate delivery of behavioral health care services in
  866  the least restrictive setting with treatment and recovery
  867  capabilities that address the needs of the patient. Services
  868  shall be provided in a manner that integrates behavioral health
  869  services and primary care. Plans shall be required to achieve
  870  specific behavioral health outcome standards, established by the
  871  agency in consultation with the Department of Children and
  872  Families.
  873         Section 9. Subsection (5) is added to section 409.973,
  874  Florida Statutes, to read:
  875         409.973 Benefits.—
  876         (5) INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan
  877  operating in the managed medical assistance program shall work
  878  with the managing entity in its service area to establish
  879  specific organizational supports and service protocols that
  880  enhance the integration and coordination of primary care and
  881  behavioral health services for Medicaid recipients. Progress in
  882  this initiative will be measured using the integration framework
  883  and core measures developed by the Agency for Healthcare
  884  Research and Quality.
  885         Section 10. Paragraph (a) of subsection (1) of section
  886  409.975, Florida Statutes, is amended to read:
  887         409.975 Managed care plan accountability.—In addition to
  888  the requirements of s. 409.967, plans and providers
  889  participating in the managed medical assistance program shall
  890  comply with the requirements of this section.
  891         (1) PROVIDER NETWORKS.—Managed care plans must develop and
  892  maintain provider networks that meet the medical needs of their
  893  enrollees in accordance with standards established pursuant to
  894  s. 409.967(2)(c). Except as provided in this section, managed
  895  care plans may limit the providers in their networks based on
  896  credentials, quality indicators, and price.
  897         (a) Plans must include all providers in the region that are
  898  classified by the agency as essential Medicaid providers, unless
  899  the agency approves, in writing, an alternative arrangement for
  900  securing the types of services offered by the essential
  901  providers. Providers are essential for serving Medicaid
  902  enrollees if they offer services that are not available from any
  903  other provider within a reasonable access standard, or if they
  904  provided a substantial share of the total units of a particular
  905  service used by Medicaid patients within the region during the
  906  last 3 years and the combined capacity of other service
  907  providers in the region is insufficient to meet the total needs
  908  of the Medicaid patients. The agency may not classify physicians
  909  and other practitioners as essential providers. The agency, at a
  910  minimum, shall determine which providers in the following
  911  categories are essential Medicaid providers:
  912         1. Federally qualified health centers.
  913         2. Statutory teaching hospitals as defined in s.
  914  408.07(45).
  915         3. Hospitals that are trauma centers as defined in s.
  916  395.4001(14).
  917         4. Hospitals located at least 25 miles from any other
  918  hospital with similar services.
  919         5. Publicly funded behavioral health service providers.
  920  
  921  Managed care plans that have not contracted with all essential
  922  providers in the region as of the first date of recipient
  923  enrollment, or with whom an essential provider has terminated
  924  its contract, must negotiate in good faith with such essential
  925  providers for 1 year or until an agreement is reached, whichever
  926  is first. Payments for services rendered by a nonparticipating
  927  essential provider shall be made at the applicable Medicaid rate
  928  as of the first day of the contract between the agency and the
  929  plan. A rate schedule for all essential providers shall be
  930  attached to the contract between the agency and the plan. After
  931  1 year, managed care plans that are unable to contract with
  932  essential providers shall notify the agency and propose an
  933  alternative arrangement for securing the essential services for
  934  Medicaid enrollees. The arrangement must rely on contracts with
  935  other participating providers, regardless of whether those
  936  providers are located within the same region as the
  937  nonparticipating essential service provider. If the alternative
  938  arrangement is approved by the agency, payments to
  939  nonparticipating essential providers after the date of the
  940  agency’s approval shall equal 90 percent of the applicable
  941  Medicaid rate. If the alternative arrangement is not approved by
  942  the agency, payment to nonparticipating essential providers
  943  shall equal 110 percent of the applicable Medicaid rate.
  944         Section 11. Section 394.4674, Florida Statutes, is
  945  repealed.
  946         Section 12. Section 394.4985, Florida Statutes, is
  947  repealed.
  948         Section 13. Section 394.657, Florida Statutes, is repealed.
  949         Section 14. Section 394.745, Florida Statutes, is repealed.
  950         Section 15. Section 394.9084, Florida Statutes, is
  951  repealed.
  952         Section 16. Section 397.331, Florida Statutes, is repealed.
  953         Section 17. Section 397.333, Florida Statutes, is repealed.
  954         Section 18. Section 397.801, Florida Statutes, is repealed.
  955         Section 19. Section 397.811, Florida Statutes, is repealed.
  956         Section 20. Section 397.821, Florida Statutes, is repealed.
  957         Section 21. Section 397.901, Florida Statutes, is repealed.
  958         Section 22. Section 397.93, Florida Statutes, is repealed.
  959         Section 23. Section 397.94, Florida Statutes, is repealed.
  960         Section 24. Section 397.951, Florida Statutes, is repealed.
  961         Section 25. Section 397.97, Florida Statutes, is repealed.
  962         Section 26. Subsection (15) of section 397.321, Florida
  963  Statutes, is amended to read:
  964         397.321 Duties of the department.—The department shall:
  965         (15) Appoint a substance abuse impairment coordinator to
  966  represent the department in efforts initiated by the statewide
  967  substance abuse impairment prevention and treatment coordinator
  968  established in s. 397.801 and to assist the statewide
  969  coordinator in fulfilling the responsibilities of that position.
  970         Section 27. Subsection (1) of section 397.98, Florida
  971  Statutes, is amended to read:
  972         397.98 Children’s substance abuse services; utilization
  973  management.—
  974         (1) Utilization management shall be an integral part of
  975  each Children’s Network of Care Demonstration Model as described
  976  under s. 397.97. The utilization management process shall
  977  include procedures for analyzing the allocation and use of
  978  resources by the purchasing agent. Such procedures shall
  979  include:
  980         (a) Monitoring the appropriateness of admissions to
  981  residential services or other levels of care as determined by
  982  the department.
  983         (b) Monitoring the duration of care.
  984         (c) Developing profiles of network providers which describe
  985  their patterns of delivering care.
  986         (d) Authorizing care for high-cost services.
  987         Section 28. Paragraph (e) of subsection (3) of section
  988  409.966, Florida Statutes, is amended to read:
  989         409.966 Eligible plans; selection.—
  990         (3) QUALITY SELECTION CRITERIA.—
  991         (e) To ensure managed care plan participation in Regions 1
  992  and 2, the agency shall award an additional contract to each
  993  plan with a contract award in Region 1 or Region 2. Such
  994  contract shall be in any other region in which the plan
  995  submitted a responsive bid and negotiates a rate acceptable to
  996  the agency. If a plan that is awarded an additional contract
  997  pursuant to this paragraph is subject to penalties pursuant to
  998  s. 409.967(2)(i) s. 409.967(2)(h) for activities in Region 1 or
  999  Region 2, the additional contract is automatically terminated
 1000  180 days after the imposition of the penalties. The plan must
 1001  reimburse the agency for the cost of enrollment changes and
 1002  other transition activities.
 1003         Section 29. Paragraph (a) of subsection (5) of section
 1004  943.031, Florida Statutes, is amended to read:
 1005         943.031 Florida Violent Crime and Drug Control Council.—
 1006         (5) DUTIES OF COUNCIL.—Subject to funding provided to the
 1007  department by the Legislature, the council shall provide advice
 1008  and make recommendations, as necessary, to the executive
 1009  director of the department.
 1010         (a) The council may advise the executive director on the
 1011  feasibility of undertaking initiatives which include, but are
 1012  not limited to, the following:
 1013         1. Establishing a program that provides grants to criminal
 1014  justice agencies that develop and implement effective violent
 1015  crime prevention and investigative programs and which provides
 1016  grants to law enforcement agencies for the purpose of drug
 1017  control, criminal gang, and illicit money laundering
 1018  investigative efforts or task force efforts that are determined
 1019  by the council to significantly contribute to achieving the
 1020  state’s goal of reducing drug-related crime, that represent
 1021  significant criminal gang investigative efforts, that represent
 1022  a significant illicit money laundering investigative effort, or
 1023  that otherwise significantly support statewide strategies
 1024  developed by the Statewide Drug Policy Advisory Council
 1025  established under s. 397.333, subject to the limitations
 1026  provided in this section. The grant program may include an
 1027  innovations grant program to provide startup funding for new
 1028  initiatives by local and state law enforcement agencies to
 1029  combat violent crime or to implement drug control, criminal
 1030  gang, or illicit money laundering investigative efforts or task
 1031  force efforts by law enforcement agencies, including, but not
 1032  limited to, initiatives such as:
 1033         a. Providing enhanced community-oriented policing.
 1034         b. Providing additional undercover officers and other
 1035  investigative officers to assist with violent crime
 1036  investigations in emergency situations.
 1037         c. Providing funding for multiagency or statewide drug
 1038  control, criminal gang, or illicit money laundering
 1039  investigative efforts or task force efforts that cannot be
 1040  reasonably funded completely by alternative sources and that
 1041  significantly contribute to achieving the state’s goal of
 1042  reducing drug-related crime, that represent significant criminal
 1043  gang investigative efforts, that represent a significant illicit
 1044  money laundering investigative effort, or that otherwise
 1045  significantly support statewide strategies developed by the
 1046  Statewide Drug Policy Advisory Council established under s.
 1047  397.333.
 1048         2. Expanding the use of automated biometric identification
 1049  systems at the state and local levels.
 1050         3. Identifying methods to prevent violent crime.
 1051         4. Identifying methods to enhance multiagency or statewide
 1052  drug control, criminal gang, or illicit money laundering
 1053  investigative efforts or task force efforts that significantly
 1054  contribute to achieving the state’s goal of reducing drug
 1055  related crime, that represent significant criminal gang
 1056  investigative efforts, that represent a significant illicit
 1057  money laundering investigative effort, or that otherwise
 1058  significantly support statewide strategies developed by the
 1059  Statewide Drug Policy Advisory Council established under s.
 1060  397.333.
 1061         5. Enhancing criminal justice training programs that
 1062  address violent crime, drug control, illicit money laundering
 1063  investigative techniques, or efforts to control and eliminate
 1064  criminal gangs.
 1065         6. Developing and promoting crime prevention services and
 1066  educational programs that serve the public, including, but not
 1067  limited to:
 1068         a. Enhanced victim and witness counseling services that
 1069  also provide crisis intervention, information referral,
 1070  transportation, and emergency financial assistance.
 1071         b. A well-publicized rewards program for the apprehension
 1072  and conviction of criminals who perpetrate violent crimes.
 1073         7. Enhancing information sharing and assistance in the
 1074  criminal justice community by expanding the use of community
 1075  partnerships and community policing programs. Such expansion may
 1076  include the use of civilian employees or volunteers to relieve
 1077  law enforcement officers of clerical work in order to enable the
 1078  officers to concentrate on street visibility within the
 1079  community.
 1080         Section 30. Subsection (1) of section 943.042, Florida
 1081  Statutes, is amended to read:
 1082         943.042 Violent Crime Investigative Emergency and Drug
 1083  Control Strategy Implementation Account.—
 1084         (1) There is created a Violent Crime Investigative
 1085  Emergency and Drug Control Strategy Implementation Account
 1086  within the Department of Law Enforcement Operating Trust Fund.
 1087  The account shall be used to provide emergency supplemental
 1088  funds to:
 1089         (a) State and local law enforcement agencies that are
 1090  involved in complex and lengthy violent crime investigations, or
 1091  matching funding to multiagency or statewide drug control or
 1092  illicit money laundering investigative efforts or task force
 1093  efforts that significantly contribute to achieving the state’s
 1094  goal of reducing drug-related crime, that represent a
 1095  significant illicit money laundering investigative effort, or
 1096  that otherwise significantly support statewide strategies
 1097  developed by the Statewide Drug Policy Advisory Council
 1098  established under s. 397.333;
 1099         (b) State and local law enforcement agencies that are
 1100  involved in violent crime investigations which constitute a
 1101  significant emergency within the state; or
 1102         (c) Counties that demonstrate a significant hardship or an
 1103  inability to cover extraordinary expenses associated with a
 1104  violent crime trial.
 1105         Section 31. For the purpose of incorporating the amendment
 1106  made by this act to section 394.492, Florida Statutes, in a
 1107  reference thereto, paragraph (a) of subsection (6) of section
 1108  39.407, Florida Statutes, is reenacted to read:
 1109         39.407 Medical, psychiatric, and psychological examination
 1110  and treatment of child; physical, mental, or substance abuse
 1111  examination of person with or requesting child custody.—
 1112         (6) Children who are in the legal custody of the department
 1113  may be placed by the department, without prior approval of the
 1114  court, in a residential treatment center licensed under s.
 1115  394.875 or a hospital licensed under chapter 395 for residential
 1116  mental health treatment only pursuant to this section or may be
 1117  placed by the court in accordance with an order of involuntary
 1118  examination or involuntary placement entered pursuant to s.
 1119  394.463 or s. 394.467. All children placed in a residential
 1120  treatment program under this subsection must have a guardian ad
 1121  litem appointed.
 1122         (a) As used in this subsection, the term:
 1123         1. “Residential treatment” means placement for observation,
 1124  diagnosis, or treatment of an emotional disturbance in a
 1125  residential treatment center licensed under s. 394.875 or a
 1126  hospital licensed under chapter 395.
 1127         2. “Least restrictive alternative” means the treatment and
 1128  conditions of treatment that, separately and in combination, are
 1129  no more intrusive or restrictive of freedom than reasonably
 1130  necessary to achieve a substantial therapeutic benefit or to
 1131  protect the child or adolescent or others from physical injury.
 1132         3. “Suitable for residential treatment” or “suitability”
 1133  means a determination concerning a child or adolescent with an
 1134  emotional disturbance as defined in s. 394.492(5) or a serious
 1135  emotional disturbance as defined in s. 394.492(6) that each of
 1136  the following criteria is met:
 1137         a. The child requires residential treatment.
 1138         b. The child is in need of a residential treatment program
 1139  and is expected to benefit from mental health treatment.
 1140         c. An appropriate, less restrictive alternative to
 1141  residential treatment is unavailable.
 1142         Section 32. For the purpose of incorporating the amendment
 1143  made by this act to section 394.492, Florida Statutes, in a
 1144  reference thereto, subsection (21) of section 394.67, Florida
 1145  Statutes, is reenacted to read:
 1146         394.67 Definitions.—As used in this part, the term:
 1147         (21) “Residential treatment center for children and
 1148  adolescents” means a 24-hour residential program, including a
 1149  therapeutic group home, which provides mental health services to
 1150  emotionally disturbed children or adolescents as defined in s.
 1151  394.492(5) or (6) and which is a private for-profit or not-for
 1152  profit corporation licensed by the agency which offers a variety
 1153  of treatment modalities in a more restrictive setting.
 1154         Section 33. For the purpose of incorporating the amendment
 1155  made by this act to section 394.492, Florida Statutes, in a
 1156  reference thereto, paragraph (b) of subsection (1) of section
 1157  394.674, Florida Statutes, is reenacted to read:
 1158         394.674 Eligibility for publicly funded substance abuse and
 1159  mental health services; fee collection requirements.—
 1160         (1) To be eligible to receive substance abuse and mental
 1161  health services funded by the department, an individual must be
 1162  a member of at least one of the department’s priority
 1163  populations approved by the Legislature. The priority
 1164  populations include:
 1165         (b) For children’s mental health services:
 1166         1. Children who are at risk of emotional disturbance as
 1167  defined in s. 394.492(4).
 1168         2. Children who have an emotional disturbance as defined in
 1169  s. 394.492(5).
 1170         3. Children who have a serious emotional disturbance as
 1171  defined in s. 394.492(6).
 1172         4. Children diagnosed as having a co-occurring substance
 1173  abuse and emotional disturbance or serious emotional
 1174  disturbance.
 1175         Section 34. For the purpose of incorporating the amendment
 1176  made by this act to section 394.492, Florida Statutes, in a
 1177  reference thereto, subsection (1) of section 394.676, Florida
 1178  Statutes, is reenacted to read:
 1179         394.676 Indigent psychiatric medication program.—
 1180         (1) Within legislative appropriations, the department may
 1181  establish the indigent psychiatric medication program to
 1182  purchase psychiatric medications for persons as defined in s.
 1183  394.492(5) or (6) or pursuant to s. 394.674(1), who do not
 1184  reside in a state mental health treatment facility or an
 1185  inpatient unit.
 1186         Section 35. For the purpose of incorporating the amendment
 1187  made by this act to section 394.492, Florida Statutes, in a
 1188  reference thereto, paragraph (c) of subsection (2) of section
 1189  409.1676, Florida Statutes, is reenacted to read:
 1190         409.1676 Comprehensive residential group care services to
 1191  children who have extraordinary needs.—
 1192         (2) As used in this section, the term:
 1193         (c) “Serious behavioral problems” means behaviors of
 1194  children who have been assessed by a licensed master’s-level
 1195  human-services professional to need at a minimum intensive
 1196  services but who do not meet the criteria of s. 394.492(7). A
 1197  child with an emotional disturbance as defined in s. 394.492(5)
 1198  or (6) may be served in residential group care unless a
 1199  determination is made by a mental health professional that such
 1200  a setting is inappropriate. A child having a serious behavioral
 1201  problem must have been determined in the assessment to have at
 1202  least one of the following risk factors:
 1203         1. An adjudication of delinquency and be on conditional
 1204  release status with the Department of Juvenile Justice.
 1205         2. A history of physical aggression or violent behavior
 1206  toward self or others, animals, or property within the past
 1207  year.
 1208         3. A history of setting fires within the past year.
 1209         4. A history of multiple episodes of running away from home
 1210  or placements within the past year.
 1211         5. A history of sexual aggression toward other youth.
 1212         Section 36. For the purpose of incorporating the amendment
 1213  made by this act to section 394.492, Florida Statutes, in a
 1214  reference thereto, paragraph (b) of subsection (1) of section
 1215  409.1677, Florida Statutes, is reenacted to read:
 1216         409.1677 Model comprehensive residential services
 1217  programs.—
 1218         (1) As used in this section, the term:
 1219         (b) “Serious behavioral problems” means behaviors of
 1220  children who have been assessed by a licensed master’s-level
 1221  human-services professional to need at a minimum intensive
 1222  services but who do not meet the criteria of s. 394.492(6) or
 1223  (7). A child with an emotional disturbance as defined in s.
 1224  394.492(5) may be served in residential group care unless a
 1225  determination is made by a mental health professional that such
 1226  a setting is inappropriate.
 1227         Section 37. Except as otherwise expressly provided in this
 1228  act and except for this section, which shall take effect upon
 1229  this act becoming a law, this act shall take effect July 1,
 1230  2015.