Florida Senate - 2025                             CS for SB 1354
       
       
        
       By the Committee on Children, Families, and Elder Affairs; and
       Senator Trumbull
       
       
       
       
       586-02853-25                                          20251354c1
    1                        A bill to be entitled                      
    2         An act relating to behavioral health managing
    3         entities; amending s. 394.9082, F.S.; requiring the
    4         Department of Children and Families to contract
    5         biennially for specified functions; requiring the
    6         department to contract for recommendations for certain
    7         transparency improvements; requiring the department to
    8         prepare and present to the Governor and Legislature a
    9         specified final report by a specified date; requiring
   10         managing entities to report required data to the
   11         department in a standardized electronic format;
   12         providing requirements for such format; requiring
   13         managing entities to electronically submit to the
   14         department certain documents in a specified format and
   15         with specified metadata; requiring managing entities
   16         to submit certain specific measures to the department;
   17         requiring the department to post and maintain such
   18         measures on its website by a specified date every
   19         month; requiring managing entities to report each
   20         measure using a standard methodology determined by the
   21         department; providing requirements for such measures;
   22         providing an effective date.
   23          
   24  Be It Enacted by the Legislature of the State of Florida:
   25  
   26         Section 1. Subsection (7) of section 394.9082, Florida
   27  Statutes, is amended, and paragraph (n) is added to subsection
   28  (3) and paragraphs (v) and (w) are added to subsection (5) of
   29  that section, to read:
   30         394.9082 Behavioral health managing entities.—
   31         (3) DEPARTMENT DUTIES.—The department shall:
   32         (n)1.Contract for all of the following:
   33         a.Biennial operational and financial audits of each
   34  managing entity to include all of the following:
   35         (I)A review of business practices, personnel, financial
   36  records, related parties, compensation, and other areas as
   37  determined by the department.
   38         (II)The services administered, the method of provider
   39  payment, expenditures, outcomes, and other information as
   40  determined by the department.
   41         (III)Referral patterns, including managing entity referral
   42  volume; provider referral assignments; services referred; length
   43  of time to obtain services; and key referral performance
   44  measures.
   45         (IV)Provider network adequacy and provider network
   46  participation in the department’s available bed platform, the
   47  Opioid Data Management System, the Agency for Health Care
   48  Administration Event Notification Service, and other department
   49  required provider data submissions.
   50         (V)Audits of each managing entity’s expenditures and
   51  claims. Such an audit must do both of the following:
   52         (A)Compare services administered through each managing
   53  entity, the outcomes of each managing entity’s expenditures,
   54  each managing entity’s Medicaid expenditures for behavioral
   55  health services, and any other information as determined by the
   56  department.
   57         (B)Analyze services funded by each managing entity
   58  rendered to individuals who are also Medicaid beneficiaries to,
   59  at a minimum, assess the extent to which managing entities are
   60  funding services that are also available as covered services
   61  under the Medicaid program.
   62         b.Recommendations to improve transparency of system
   63  performance, including, but not limited to, metrics and criteria
   64  used to measure each managing entity’s performance and patient
   65  and system outcomes, and the format and method to be used to
   66  collect and report necessary data and information.
   67         2.Prepare a report of the information gathered in
   68  subparagraph 1. and present the final report on or before
   69  December 1, 2025, to the Governor, the President of the Senate,
   70  and the Speaker of the House of Representatives.
   71         (5) MANAGING ENTITY DUTIES.—A managing entity shall:
   72         (v)Report all required data to the department in a
   73  standardized electronic format to ensure interoperability and to
   74  facilitate data analysis. The submission format must meet all of
   75  the following criteria:
   76         1.Provider payments must be reported using a standardized
   77  format for electronic data interchange that is used for health
   78  care claims processing.
   79         2.Information must be organized into discrete, machine
   80  readable data elements that allow for efficient processing and
   81  integration with other datasets.
   82         3.All data fields must comply with established protocols
   83  as specified by the department.
   84         4.The standardized format must be compatible with
   85  automated systems to enable the downloading, parsing, and
   86  combining of data with other sources for analysis.
   87         5.Submissions must pass validation checks to confirm
   88  adherence to the required data structure and format before the
   89  submission is accepted.
   90         (w)Submit to the department all documents that are
   91  required under contract for submission on a routine basis in an
   92  electronic format that allows for accurate text recognition and
   93  data extraction as specified by the department, which may
   94  include, but is not limited to, Portable Document Format or
   95  machine-readable text files. The documents must be accompanied
   96  by metadata containing key information that ensures proper
   97  organization, processing, and integration into the department’s
   98  systems. The required metadata must include, but is not limited
   99  to, all of the following elements:
  100         1.A descriptive and unique name for the document,
  101  following any naming conventions prescribed by the department.
  102         2.The date the document is uploaded.
  103         3.A predefined classification indicating the nature or
  104  category of the document.
  105         4.Any relevant identifiers, such as application numbers,
  106  case numbers, or tracking codes, as specified by the department.
  107         5.The name, contact information, and any other required
  108  identification number, which may include, but is not limited to,
  109  a contract, license, or registration number, of the person or
  110  organization submitting the document.
  111         6.Any other metadata fields as prescribed by the
  112  department to facilitate accurate processing and analysis.
  113         (7) PERFORMANCE MEASUREMENT AND ACCOUNTABILITY.—
  114         (a) Managing entities shall collect and submit data to the
  115  department regarding persons served, outcomes of persons served,
  116  costs of services provided through the department’s contract,
  117  and other data as required by the department. The department
  118  shall evaluate managing entity performance and the overall
  119  progress made by the managing entity, together with other
  120  systems, in meeting the community’s behavioral health needs,
  121  based on consumer-centered outcome measures that reflect
  122  national standards, if possible, that can be accurately
  123  measured. The department shall work with managing entities to
  124  establish performance standards, including, but not limited to:
  125         1.(a) The extent to which individuals in the community
  126  receive services, including, but not limited to, parents or
  127  caregivers involved in the child welfare system who need
  128  behavioral health services.
  129         2.(b) The improvement in the overall behavioral health of a
  130  community.
  131         3.(c) The improvement in functioning or progress in the
  132  recovery of individuals served by the managing entity, as
  133  determined using person-centered measures tailored to the
  134  population.
  135         4.(d) The success of strategies to:
  136         a.1. Divert admissions from acute levels of care, jails,
  137  prisons, and forensic facilities as measured by, at a minimum,
  138  the total number and percentage of clients who, during a
  139  specified period, experience multiple admissions to acute levels
  140  of care, jails, prisons, or forensic facilities;
  141         b.2. Integrate behavioral health services with the child
  142  welfare system; and
  143         c.3. Address the housing needs of individuals being
  144  released from public receiving facilities who are homeless.
  145         5.(e) Consumer and family satisfaction.
  146         6.(f) The level of engagement of key community
  147  constituencies, such as law enforcement agencies, community
  148  based care lead agencies, juvenile justice agencies, the courts,
  149  school districts, local government entities, hospitals, and
  150  other organizations, as appropriate, for the geographical
  151  service area of the managing entity.
  152         (b)Managing entities must submit specific measures to the
  153  department regarding individual outcomes and system functioning,
  154  which the department must post to, and maintain on, its website
  155  by the 15th of every month. The posted measures must reflect
  156  performance for the previous calendar month. Each managing
  157  entity must report each measure using a standard methodology
  158  determined by the department and submit the data to the
  159  department by the deadline specified by the department. The
  160  measures shall include data from individuals served by each
  161  managing entity for services funded by the managing entity, to
  162  the extent feasible and appropriate. The measures shall be
  163  reported and posted stratified by, at a minimum, whether the
  164  individual is a child or an adult and whether the individual is
  165  a Medicaid recipient. Such measures shall include, at a minimum,
  166  all of the following:
  167         1.The number and percentage of individuals who are high
  168  utilizers of crisis behavioral health services.
  169         2.The number and percentage of individuals referred to
  170  outpatient behavioral health services after their discharge from
  171  a receiving or treatment facility, an emergency department under
  172  this chapter, or an inpatient or residential licensed service
  173  component under chapter 397 and who begin receiving such
  174  services within 7 days after discharge.
  175         3.The average wait time for initial appointments for
  176  behavioral health services, categorized by the type of service.
  177         4.The number and percentage of individuals with
  178  significant behavioral health symptoms who are seeking urgent
  179  but noncrisis acute care and who are scheduled to be seen by a
  180  provider within 1 business day after initial contact with the
  181  provider.
  182         5.The number and percentage of emergency department visits
  183  per capita for behavioral health-related issues.
  184         6.The incidence of medication errors.
  185         7.The number and percentage of adverse incidents,
  186  including, but not limited to, self-harm, occurring during
  187  inpatient and outpatient behavioral health services.
  188         8.The number and percentage of individuals with co
  189  occurring conditions who receive integrated care.
  190         9.The number and percentage of individuals discharged from
  191  a receiving or treatment facility under this chapter or an
  192  inpatient or residential licensed service component under
  193  chapter 397 who successfully transition to ongoing services at
  194  the appropriate level of care.
  195         10.The rate of readmissions to emergency departments due
  196  to behavioral health issues or to crisis stabilization units,
  197  addictions receiving facilities, or other inpatient levels of
  198  care under this chapter and chapter 397 within 30 days after
  199  discharge from inpatient or outpatient behavioral health
  200  services.
  201         11.The average length of stay for inpatient behavioral
  202  health services.
  203         Section 2. This act shall take effect July 1, 2025.