Florida Senate - 2015                                    SB 7068
       By the Committee on Appropriations
       576-02888-15                                          20157068__
    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         requiring the regional network to offer access to
   28         certain services; requiring the plan to be developed
   29         in a certain manner; requiring the department to
   30         designate the regional network as a coordinated care
   31         organization after certain conditions are met;
   32         removing a provision providing legislative intent;
   33         requiring the department to contract with community
   34         based managing entities for the development of
   35         specified objectives; removing duties of the
   36         department, the secretary of the department, and
   37         managing entities; removing a provision regarding the
   38         requirement of funding the managing entity’s contract
   39         through departmental funds; removing legislative
   40         intent; requiring that the department’s contract with
   41         each managing entity be performance based; providing
   42         for scaled penalties and liquidated damages if a
   43         managing entity fails to perform after a reasonable
   44         opportunity for corrective action; requiring the plan
   45         for the coordination and integration of certain
   46         services to be developed in a certain manner and to
   47         incorporate certain models; providing requirements for
   48         the department when entering into contracts with a
   49         managing entity; requiring the department to consider
   50         specified factors when considering a new contractor;
   51         revising the goals of the coordinated care
   52         organization; requiring a coordinated care
   53         organization to consist of a comprehensive provider
   54         network that includes specified elements; requiring
   55         that specified treatment providers be initially
   56         included in the provider network; providing for
   57         continued participation in the provider network;
   58         revising the network management and administrative
   59         functions of the managing entities; requiring that the
   60         managing entity support network providers in certain
   61         ways; authorizing the managing entity to prioritize
   62         certain populations when necessary; requiring that, by
   63         a certain date, a managing entity’s governing board
   64         consist of a certain number of members selected by the
   65         managing entity in a specified manner; providing
   66         requirements for the governing board; removing
   67         departmental responsibilities; removing a reporting
   68         requirement; authorizing, rather than requiring, the
   69         department to adopt rules; creating s. 397.402, F.S.;
   70         requiring that the department modify certain licensure
   71         rules and procedures by a certain date; providing
   72         requirements for a provider; amending s. 397.427,
   73         F.S.; removing provisions requiring the department to
   74         determine the need for establishing providers of
   75         medication-assisted treatment services for opiate
   76         addiction; removing provisions requiring the
   77         department to adopt rules; amending s. 409.967, F.S.;
   78         requiring that certain plans or contracts include
   79         specified requirements; amending s. 409.973, F.S.;
   80         requiring each plan operating in the managed medical
   81         assistance program to work with the managing entity to
   82         establish specific organizational supports and service
   83         protocols; amending s. 409.975, F.S.; revising the
   84         categories from which the agency must determine which
   85         providers are essential Medicaid providers; repealing
   86         s. 394.4674, F.S., relating to a plan and report;
   87         repealing s. 394.4985, F.S., relating to districtwide
   88         information and referral network and implementation;
   89         repealing s. 394.657, F.S., relating to county
   90         planning councils or committees; repealing s. 394.745,
   91         F.S., relating to an annual report and compliance of
   92         providers under contract with department; repealing s.
   93         394.9084, F.S., relating to the Florida Self-Directed
   94         Care program; repealing s. 397.331, F.S., relating to
   95         definitions; repealing s. 397.333, F.S., relating to
   96         the Statewide Drug Policy Advisory Council; repealing
   97         s. 397.801, F.S., relating to substance abuse
   98         impairment coordination; repealing s. 397.811, F.S.,
   99         relating to juvenile substance abuse impairment
  100         coordination; repealing s. 397.821, F.S., relating to
  101         juvenile substance abuse impairment prevention and
  102         early intervention councils; repealing s. 397.901,
  103         F.S., relating to prototype juvenile addictions
  104         receiving facilities; repealing s. 397.93, F.S.,
  105         relating to children’s substance abuse services and
  106         target populations; repealing s. 397.94, F.S.,
  107         relating to children’s substance abuse services and
  108         the information and referral network; repealing s.
  109         397.951, F.S., relating to treatment and sanctions;
  110         repealing s. 397.97, F.S., relating to children’s
  111         substance abuse services and demonstration models;
  112         amending ss. 397.321, 397.98, 409.966, 943.031, and
  113         943.042, F.S.; conforming provisions and cross
  114         references to changes made by the act; reenacting ss.
  115         39.407(6)(a), 394.67(21), 394.674(1)(b), 394.676(1),
  116         409.1676(2)(c), and 409.1677(1)(b), F.S., relating to
  117         the term “suitable for residential treatment” or
  118         “suitability,” the term “residential treatment center
  119         for children and adolescents,” children’s mental
  120         health services, the indigent psychiatric medication
  121         program, and the term “serious behavioral problems,”
  122         respectively, to incorporate the amendment made to s.
  123         394.492, F.S., in references thereto; providing
  124         effective dates.
  126  Be It Enacted by the Legislature of the State of Florida:
  128         Section 1. Subsection (18) of section 394.455, Florida
  129  Statutes, is amended to read:
  130         394.455 Definitions.—As used in this part, unless the
  131  context clearly requires otherwise, the term:
  132         (18) “Mental illness” means an impairment of the mental or
  133  emotional processes that exercise conscious control of one’s
  134  actions or of the ability to perceive or understand reality,
  135  which impairment substantially interferes with the person’s
  136  ability to meet the ordinary demands of living. For the purposes
  137  of this part, the term does not include a developmental
  138  disability as defined in chapter 393, dementia, traumatic brain
  139  injuries, intoxication, or conditions manifested only by
  140  antisocial behavior or substance abuse impairment.
  141         Section 2. Subsections (1), (4), and (6) of section
  142  394.492, Florida Statutes, are amended to read:
  143         394.492 Definitions.—As used in ss. 394.490-394.497, the
  144  term:
  145         (1) “Adolescent” means a person who is at least 13 years of
  146  age but under 18 21 years of age.
  147         (4) “Child or adolescent at risk of emotional disturbance”
  148  means a person under 18 21 years of age who has an increased
  149  likelihood of becoming emotionally disturbed because of risk
  150  factors that include, but are not limited to:
  151         (a) Being homeless.
  152         (b) Having a family history of mental illness.
  153         (c) Being physically or sexually abused or neglected.
  154         (d) Abusing alcohol or other substances.
  155         (e) Being infected with human immunodeficiency virus (HIV).
  156         (f) Having a chronic and serious physical illness.
  157         (g) Having been exposed to domestic violence.
  158         (h) Having multiple out-of-home placements.
  159         (6) “Child or adolescent who has a serious emotional
  160  disturbance or mental illness” means a person under 18 21 years
  161  of age who:
  162         (a) Is diagnosed as having a mental, emotional, or
  163  behavioral disorder that meets one of the diagnostic categories
  164  specified in the most recent edition of the Diagnostic and
  165  Statistical Manual of Mental Disorders of the American
  166  Psychiatric Association; and
  167         (b) Exhibits behaviors that substantially interfere with or
  168  limit his or her role or ability to function in the family,
  169  school, or community, which behaviors are not considered to be a
  170  temporary response to a stressful situation.
  172  The term includes a child or adolescent who meets the criteria
  173  for involuntary placement under s. 394.467(1).
  174         Section 3. Section 394.761, Florida Statutes, is created to
  175  read:
  176         394.761 Revenue maximization.—The agency and the department
  177  shall develop a plan to obtain federal approval for increasing
  178  the availability of federal Medicaid funding for behavioral
  179  health care. Increased funding will be used to advance the goal
  180  of improved integration of behavioral health and primary care
  181  services through development and effective implementation of
  182  coordinated care organizations as described in s. 394.9082(3).
  183  The agency and the department shall submit the written plan to
  184  the President of the Senate and the Speaker of the House of
  185  Representatives no later than November 1, 2015. The plan shall
  186  identify the amount of general revenue funding appropriated for
  187  mental health and substance abuse services which is eligible to
  188  be used as state Medicaid match. The plan must evaluate
  189  alternative uses of increased Medicaid funding, including
  190  expansion of Medicaid eligibility for the severely and
  191  persistently mentally ill; increased reimbursement rates for
  192  behavioral health services; adjustments to the capitation rate
  193  for Medicaid enrollees with chronic mental illness and substance
  194  use disorders; supplemental payments to mental health and
  195  substance abuse providers through a designated state health
  196  program or other mechanisms; and innovative programs for
  197  incentivizing improved outcomes for behavioral health
  198  conditions. The plan shall identify the advantages and
  199  disadvantages of each alternative and assess the potential of
  200  each for achieving improved integration of services. The plan
  201  shall identify the types of federal approvals necessary to
  202  implement each alternative and project a timeline for
  203  implementation.
  204         Section 4. Subsection (11) is added to section 394.875,
  205  Florida Statutes, to read:
  206         394.875 Crisis stabilization units, residential treatment
  207  facilities, and residential treatment centers for children and
  208  adolescents; authorized services; license required.—
  209         (11)No later than January 1, 2016, the department shall
  210  modify licensure rules and procedures to create an option for a
  211  single, consolidated license for a provider who offers multiple
  212  types of mental health and substance abuse services regulated
  213  under this chapter and chapter 397. Providers eligible for a
  214  consolidated license must operate these services through a
  215  single corporate entity and a unified management structure. Any
  216  provider serving adult and children must meet departmental
  217  standards for separate facilities and other requirements
  218  necessary to ensure children’s safety and promote therapeutic
  219  efficacy.
  220         Section 5. Effective upon this act becoming a law, section
  221  394.9082, Florida Statutes, is amended to read:
  222         394.9082 Behavioral health managing entities.—
  223         (1) LEGISLATIVE FINDINGS AND INTENT.—The Legislature finds
  224  that untreated behavioral health disorders constitute major
  225  health problems for residents of this state, are a major
  226  economic burden to the citizens of this state, and substantially
  227  increase demands on the state’s juvenile and adult criminal
  228  justice systems, the child welfare system, and health care
  229  systems. The Legislature finds that behavioral health disorders
  230  respond to appropriate treatment, rehabilitation, and supportive
  231  intervention. The Legislature finds that the state’s return on
  232  its it has made a substantial long-term investment in the
  233  funding of the community-based behavioral health prevention and
  234  treatment service systems and facilities can be enhanced by
  235  integration of these services with primary care in order to
  236  provide critical emergency, acute care, residential, outpatient,
  237  and rehabilitative and recovery-based services. The Legislature
  238  finds that local communities have also made substantial
  239  investments in behavioral health services, contracting with
  240  safety net providers who by mandate and mission provide
  241  specialized services to vulnerable and hard-to-serve populations
  242  and have strong ties to local public health and public safety
  243  agencies. The Legislature finds that a regional management
  244  structure for that places the responsibility for publicly
  245  financed behavioral health treatment and prevention services
  246  within a single private, nonprofit entity at the local level
  247  will improve promote improved access to care, promote service
  248  continuity, and provide for more efficient and effective
  249  delivery of substance abuse and mental health services. The
  250  Legislature finds that streamlining administrative processes
  251  will create cost efficiencies and provide flexibility to better
  252  match available services to consumers’ identified needs.
  253         (2) DEFINITIONS.—As used in this section, the term:
  254         (a) “Behavioral health services” means mental health
  255  services and substance abuse prevention and treatment services
  256  as defined in this chapter and chapter 397 which are provided
  257  using state and federal funds.
  258         (b) “Decisionmaking model” means a comprehensive management
  259  information system needed to answer the following management
  260  questions at the federal, state, regional, circuit, and local
  261  provider levels: who receives what services from which providers
  262  with what outcomes and at what costs?
  263         (b)(c) “Geographic area” means a county, circuit, regional,
  264  or a region as described in s. 409.966 multiregional area in
  265  this state.
  266         (c)(d) “Managing entity” means a corporation that is
  267  organized in this state, is designated or filed as a nonprofit
  268  organization under s. 501(c)(3) of the Internal Revenue Code,
  269  and is under contract to the department to manage the day-to-day
  270  operational delivery of behavioral health services as of July 1,
  271  2015 through an organized system of care.
  272         (e) “Provider networks” mean the direct service agencies
  273  that are under contract with a managing entity and that together
  274  constitute a comprehensive array of emergency, acute care,
  275  residential, outpatient, recovery support, and consumer support
  276  services.
  278  STRATEGIES.—The department may work through managing entities
  279  shall to develop and implement a plan to create a coordinated
  280  regional network of behavioral health service providers. The
  281  regional network must offer access to a comprehensive range of
  282  services and continuity of care for service delivery strategies
  283  that will improve the coordination, integration, and management
  284  of the delivery of behavioral health services to people with who
  285  have mental illness or substance use disorders. The plan must be
  286  developed through a collaborative process between the managing
  287  entity and providers in the region. The department shall
  288  designate the regional network as a coordinated care
  289  organization after the relationships, linkages, and interactions
  290  among network providers are formalized through written
  291  agreements that establish common protocols for intake and
  292  assessment, mechanisms for data sharing, joint operational
  293  procedures, and integrated care planning and case management. It
  294  is the intent of the Legislature that a well-managed service
  295  delivery system will increase access for those in need of care,
  296  improve the coordination and continuity of care for vulnerable
  297  and high-risk populations, and redirect service dollars from
  298  restrictive care settings to community-based recovery services.
  299         (4) CONTRACT FOR SERVICES.—
  300         (a) The department must may contract for the purchase and
  301  management of behavioral health services with community-based
  302  managing entities for the development of a regional coordinated
  303  care organization, network management services, and the
  304  administrative functions defined in subsection (6). The
  305  department may require a managing entity to contract for
  306  specialized services that are not currently part of the managing
  307  entity’s network if the department determines that to do so is
  308  in the best interests of consumers of services. The secretary
  309  shall determine the schedule for phasing in contracts with
  310  managing entities. The managing entities shall, at a minimum, be
  311  accountable for the operational oversight of the delivery of
  312  behavioral health services funded by the department and for the
  313  collection and submission of the required data pertaining to
  314  these contracted services. A managing entity shall serve a
  315  geographic area designated by the department. The geographic
  316  area must be of sufficient size in population and have enough
  317  public funds for behavioral health services to allow for
  318  flexibility and maximum efficiency.
  319         (b) The operating costs of the managing entity contract
  320  shall be funded through funds from the department and any
  321  savings and efficiencies achieved through the implementation of
  322  managing entities when realized by their participating provider
  323  network agencies. The department recognizes that managing
  324  entities will have infrastructure development costs during
  325  start-up so that any efficiencies to be realized by providers
  326  from consolidation of management functions, and the resulting
  327  savings, will not be achieved during the early years of
  328  operation. The department shall negotiate a reasonable and
  329  appropriate administrative cost rate with the managing entity.
  330  The Legislature intends that reduced local and state contract
  331  management and other administrative duties passed on to the
  332  managing entity allows funds previously allocated for these
  333  purposes to be proportionately reduced and the savings used to
  334  purchase the administrative functions of the managing entity.
  335  Policies and procedures of the department for monitoring
  336  contracts with managing entities shall include provisions for
  337  eliminating duplication of the department’s and the managing
  338  entities’ contract management and other administrative
  339  activities in order to achieve the goals of cost-effectiveness
  340  and regulatory relief. To the maximum extent possible, provider
  341  monitoring activities shall be assigned to the managing entity.
  342         (c) The department’s contract with each managing entity
  343  must be a performance-based agreement requiring specific
  344  results, setting measureable performance standards and
  345  timelines, and identifying consequences for failure to timely
  346  plan and implement a regional, coordinated care organization.
  347  The consequences specified in the contract must correlate to a
  348  schedule of penalties, scaled to the nature and significance of
  349  the managing entity’s failure to perform, and must include
  350  liquidated damages. The contract must provide a reasonable
  351  opportunity for managing entities to implement corrective
  352  actions, but must require progress toward achievement of the
  353  performance standards identified in paragraph (e) Contracting
  354  and payment mechanisms for services must promote clinical and
  355  financial flexibility and responsiveness and must allow
  356  different categorical funds to be integrated at the point of
  357  service. The plan for coordination and integration of services
  358  required by subsection (3) shall be developed based on
  359  contracted service array must be determined by using public
  360  input and, needs assessment, and must incorporate promising,
  361  evidence-based and promising best practice models. The
  362  department may employ care management methodologies, prepaid
  363  capitation, and case rate or other methods of payment which
  364  promote flexibility, efficiency, and accountability.
  365         (d)The department shall establish a 3-year performance
  366  based contract with each managing entity on the next date of
  367  contract renewal after the effective date of this act. All
  368  managing entities must be operating under performance-based
  369  contracts by July 1, 2017. Managing entities with contracts
  370  subject to renewal on July 1, 2015, shall receive a contract
  371  renewal, if available, or a contract extension under s.
  372  287.057(12) until the performance-based contract can be
  373  developed.
  374         (e)The contract must identify performance standards that
  375  are critical to the implementation of a coordinated care
  376  organization. Failure to achieve these specific standards
  377  constitutes a disqualification of the entity resulting in a
  378  notice of termination, which is effective upon selection of a
  379  new contractor. If a managing entity is disqualified due to
  380  performance failure, the department shall issue an invitation to
  381  negotiate in order to select a new contractor. The new
  382  contractor must be a managing entity in another region, a
  383  Medicaid managed care organization operating in the same region,
  384  or a behavioral health specialty managed care organization. The
  385  department shall consider the input and recommendations of
  386  network providers in the selection of the new contractor. The
  387  invitation to negotiate shall specify the criteria and the
  388  relative weight of the criteria that will be used in selecting
  389  the new contractor. The department must consider all of the
  390  following factors:
  391         1.Experience serving persons with mental health and
  392  substance use disorders.
  393         2.Establishment of community partnerships with behavioral
  394  health providers.
  395         3.Demonstrated organizational capabilities for network
  396  management functions.
  397         4.Capability to integrate behavioral health with primary
  398  care services.
  399         (5) GOALS.—The primary goal of the coordinated care
  400  organization service delivery strategies is to improve outcomes
  401  for persons needing provide a design for an effective
  402  coordination, integration, and management approach for
  403  delivering effective behavioral health services to persons who
  404  are experiencing a mental health or substance abuse crisis, who
  405  have a disabling mental illness or a substance use or co
  406  occurring disorder, and require extended services in order to
  407  recover from their illness, or who need brief treatment or
  408  longer-term supportive interventions to avoid a crisis or
  409  disability. Other goals include:
  410         (a) Improving Accountability for measureable and
  411  transparent a local system of behavioral health care services to
  412  meet performance outcomes and standards through the use of
  413  reliable and timely data.
  414         (b) Enhancing the Continuity of care for all children,
  415  adolescents, and adults who receive services from the
  416  coordinated care organization enter the publicly funded
  417  behavioral health service system.
  418         (c) Value-based purchasing of behavioral health services
  419  that maximizes the return on investment to local, state, and
  420  federal funding sources Preserving the “safety net” of publicly
  421  funded behavioral health services and providers, and recognizing
  422  and ensuring continued local contributions to these services, by
  423  establishing locally designed and community-monitored systems of
  424  care.
  425         (d) Providing Early diagnosis and treatment interventions
  426  to enhance recovery and prevent hospitalization.
  427         (e) Regional service delivery systems that are responsive
  428  to Improving the assessment of local needs for behavioral health
  429  services.
  430         (f) Quality care that is provided using Improving the
  431  overall quality of behavioral health services through the use of
  432  evidence-based, best practice, and promising practice models.
  433         (g) Demonstrating improved service Integration of between
  434  behavioral health services programs and other programs, such as
  435  vocational rehabilitation, education, child welfare, primary
  436  health care, emergency services, juvenile justice, and criminal
  437  justice.
  438         (h) Providing for additional testing of creative and
  439  flexible strategies for financing behavioral health services to
  440  enhance individualized treatment and support services.
  441         (i) Promoting cost-effective quality care.
  442         (j) Working with the state to coordinate admissions and
  443  discharges from state civil and forensic hospitals and
  444  coordinating admissions and discharges from residential
  445  treatment centers.
  446         (k) Improving the integration, accessibility, and
  447  dissemination of behavioral health data for planning and
  448  monitoring purposes.
  449         (l) Promoting specialized behavioral health services to
  450  residents of assisted living facilities.
  451         (m) Working with the state and other stakeholders to reduce
  452  the admissions and the length of stay for dependent children in
  453  residential treatment centers.
  454         (n) Providing services to adults and children with co
  455  occurring disorders of mental illnesses and substance abuse
  456  problems.
  457         (o) Providing services to elder adults in crisis or at-risk
  458  for placement in a more restrictive setting due to a serious
  459  mental illness or substance abuse.
  460         (6) ESSENTIAL ELEMENTS.—It is the intent of the Legislature
  461  that the department may plan for and enter into contracts with
  462  managing entities to manage care in geographical areas
  463  throughout the state.
  464         (a) A coordinated care organization must consist of a
  465  comprehensive provider network that includes the following
  466  elements: The managing entity must demonstrate the ability of
  467  its network of providers to comply with the pertinent provisions
  468  of this chapter and chapter 397 and to ensure the provision of
  469  comprehensive behavioral health services. The network of
  470  providers must include, but need not be limited to, community
  471  mental health agencies, substance abuse treatment providers, and
  472  best practice consumer services providers.
  473         1.A centralized receiving facility or coordinated
  474  receiving system for persons needing evaluation pursuant to s.
  475  394.463 or s. 397.675.
  476         2.Crisis services, including mobile response teams and
  477  crisis stabilization units.
  478         3. Case management.
  479         4.Outpatient services.
  480         5. Residential services.
  481         6. Hospital inpatient care.
  482         7.Aftercare and other postdischarge services.
  483         8.Recovery support, including housing assistance and
  484  support for competitive employment, educational attainment,
  485  independent living skills development, family support and
  486  education, and wellness management and self-care.
  487         9.Medical services necessary for integration of behavioral
  488  health services with primary care.
  489         (b) The department shall terminate its mental health or
  490  substance abuse provider contracts for services to be provided
  491  by the managing entity at the same time it contracts with the
  492  managing entity.
  493         (b)(c) The managing entity shall ensure that its provider
  494  network shall initially include all is broadly conceived. All
  495  mental health or substance abuse treatment providers currently
  496  receiving public funds pursuant to this chapter or chapter 397.
  497  Continued participation in the network is subject to credentials
  498  and performance standards set by the managing entity and
  499  approved by the department under contract with the department
  500  shall be offered a contract by the managing entity.
  501         (c)(d) The network management and administrative functions
  502  of the department may contract with managing entities to provide
  503  the following core functions include:
  504         1. Financial management accountability.
  505         2. Allocation of funds to network providers in a manner
  506  that reflects the department’s strategic direction and plans.
  507         3. Provider monitoring to ensure compliance with federal
  508  and state laws, rules, and regulations.
  509         4. Data collection, reporting, and analysis.
  510         5. Information systems necessary for the delivery of
  511  coordinated care and integrated services Operational plans to
  512  implement objectives of the department’s strategic plan.
  513         6. Contract compliance.
  514         7. Performance measurement based on nationally recognized
  515  standards such as those developed by the National Quality Forum,
  516  the National Committee for Quality Assurance, or similar
  517  credible sources management.
  518         8. Collaboration with community stakeholders, including
  519  local government.
  520         9. System of care through network development.
  521         9.10. Consumer care coordination.
  522         10.11. Continuous quality improvement.
  523         12. Timely access to appropriate services.
  524         13. Cost-effectiveness and system improvements.
  525         14. Assistance in the development of the department’s
  526  strategic plan.
  527         15. Participation in community, circuit, regional, and
  528  state planning.
  529         11.16. Resource management and maximization, including
  530  pursuit of third-party payments and grant applications.
  531         12.17. Incentives for providers to improve quality and
  532  access.
  533         13.18. Liaison with consumers.
  534         14.19. Community needs assessment.
  535         15.20. Securing local matching funds.
  536         (d) The managing entity shall support network providers to
  537  offer comprehensive and coordinated care to all persons in need,
  538  but may develop a prioritization framework when necessary to
  539  make the best use of limited resources. Priority populations
  540  include:
  541         1. Individuals in crisis stabilization units who are on the
  542  waitlist for placement in a state treatment facility;
  543         2. Individuals in state treatment facilities on the
  544  waitlist for community care;
  545         3. Parents or caretakers with child welfare involvement;
  546         4. Individuals with multiple arrests and incarceration as a
  547  result of their behavioral health condition; and
  548         5. Individuals with behavioral health disorders and
  549  comorbidities consistent with the characteristics of patients in
  550  the region’s population of behavioral health service users who
  551  account for a disproportionately high percentage of service
  552  expenditures.
  553         (e) The managing entity shall ensure that written
  554  cooperative agreements are developed and implemented among the
  555  criminal and juvenile justice systems, the local community-based
  556  care network, and the local behavioral health providers in the
  557  geographic area which define strategies and alternatives for
  558  diverting people who have mental illness and substance abuse
  559  problems from the criminal justice system to the community.
  560  These agreements must also address the provision of appropriate
  561  services to persons who have behavioral health problems and
  562  leave the criminal justice system.
  563         (f) Managing entities must collect and submit data to the
  564  department regarding persons served, outcomes of persons served,
  565  and the costs of services provided through the department’s
  566  contract. The department shall evaluate managing entity services
  567  based on consumer-centered outcome measures that reflect
  568  national standards that can dependably be measured. The
  569  department shall work with managing entities to establish
  570  performance standards related to:
  571         1. The extent to which individuals in the community receive
  572  services.
  573         2. The improvement of quality of care for individuals
  574  served.
  575         3. The success of strategies to divert jail, prison, and
  576  forensic facility admissions.
  577         4. Consumer and family satisfaction.
  578         5. The satisfaction of key community constituents such as
  579  law enforcement agencies, juvenile justice agencies, the courts,
  580  the schools, local government entities, hospitals, and others as
  581  appropriate for the geographical area of the managing entity.
  582         (g) The Agency for Health Care Administration may establish
  583  a certified match program, which must be voluntary. Under a
  584  certified match program, reimbursement is limited to the federal
  585  Medicaid share to Medicaid-enrolled strategy participants. The
  586  agency may take no action to implement a certified match program
  587  unless the consultation provisions of chapter 216 have been met.
  588  The agency may seek federal waivers that are necessary to
  589  implement the behavioral health service delivery strategies.
  590         (7) MANAGING ENTITY REQUIREMENTS.—The department may adopt
  591  rules and contractual standards related to and a process for the
  592  qualification and operation of managing entities which are
  593  based, in part, on the following criteria:
  594         (a) As of December 31, 2015, a managing entity’s governing
  595  board governance structure shall consist of 15 members selected
  596  by the managing entity as follows: be representative and shall,
  597  at a minimum, include consumers and family members, appropriate
  598  community stakeholders and organizations, and providers of
  599  substance abuse and mental health services as defined in this
  600  chapter and chapter 397. If there are one or more private
  601  receiving facilities in the geographic coverage area of a
  602  managing entity, the managing entity shall have one
  603  representative for the private-receiving facilities as an ex
  604  officio member of its board of directors.
  605         1. Four representatives of consumers and their families,
  606  selected from nominations submitted by behavioral health service
  607  providers in the region.
  608         2. Two representatives of local governments in the region,
  609  selected from nominations submitted by county and municipal
  610  governments in the region.
  611         3. Two representatives of law enforcement, appointed by the
  612  Attorney General.
  613         4. Two representatives of employers in the region, selected
  614  from nominations submitted by Chambers of Commerce in the
  615  region.
  616         5. Two representatives of service providers involved with
  617  the child welfare system, appointed by the community-based care
  618  lead agency.
  619         6. Three representatives of health care professionals and
  620  health facilities in the region which are not under contract to
  621  the managing entity, selected from nominations submitted by
  622  local medical societies, hospitals, and other health care
  623  organizations in the region.
  624         (b) The managing entity must create a transparent process
  625  for nomination and selection of board members and must adopt a
  626  procedure for establishing staggered term limits which ensures
  627  that no individual serves more than 8 consecutive years on the
  628  governing board A managing entity that was originally formed
  629  primarily by substance abuse or mental health providers must
  630  present and demonstrate a detailed, consensus approach to
  631  expanding its provider network and governance to include both
  632  substance abuse and mental health providers.
  633         (c) A managing entity must submit a network management plan
  634  and budget in a form and manner determined by the department.
  635  The plan must detail the means for implementing the duties to be
  636  contracted to the managing entity and the efficiencies to be
  637  anticipated by the department as a result of executing the
  638  contract. The department may require modifications to the plan
  639  and must approve the plan before contracting with a managing
  640  entity. The department may contract with a managing entity that
  641  demonstrates readiness to assume core functions, and may
  642  continue to add functions and responsibilities to the managing
  643  entity’s contract over time as additional competencies are
  644  developed as identified in paragraph (g). Notwithstanding other
  645  provisions of this section, the department may continue and
  646  expand managing entity contracts if the department determines
  647  that the managing entity meets the requirements specified in
  648  this section.
  649         (d) Notwithstanding paragraphs (b) and (c), a managing
  650  entity that is currently a fully integrated system providing
  651  mental health and substance abuse services, Medicaid, and child
  652  welfare services is permitted to continue operating under its
  653  current governance structure as long as the managing entity can
  654  demonstrate to the department that consumers, other
  655  stakeholders, and network providers are included in the planning
  656  process.
  657         (d)(e) Managing entities shall operate in a transparent
  658  manner, providing public access to information, notice of
  659  meetings, and opportunities for broad public participation in
  660  decisionmaking. The managing entity’s network management plan
  661  must detail policies and procedures that ensure transparency.
  662         (e)(f) Before contracting with a managing entity, the
  663  department must perform an onsite readiness review of a managing
  664  entity to determine its operational capacity to satisfactorily
  665  perform the duties to be contracted.
  666         (f)(g) The department shall engage community stakeholders,
  667  including providers and managing entities under contract with
  668  the department, in the development of objective standards to
  669  measure the competencies of managing entities and their
  670  readiness to assume the responsibilities described in this
  671  section, and the outcomes to hold them accountable.
  672         (8) DEPARTMENT RESPONSIBILITIES.—With the introduction of
  673  managing entities to monitor department-contracted providers’
  674  day-to-day operations, the department and its regional and
  675  circuit offices will have increased ability to focus on broad
  676  systemic substance abuse and mental health issues. After the
  677  department enters into a managing entity contract in a
  678  geographic area, the regional and circuit offices of the
  679  department in that area shall direct their efforts primarily to
  680  monitoring the managing entity contract, including negotiation
  681  of system quality improvement goals each contract year, and
  682  review of the managing entity’s plans to execute department
  683  strategic plans; carrying out statutorily mandated licensure
  684  functions; conducting community and regional substance abuse and
  685  mental health planning; communicating to the department the
  686  local needs assessed by the managing entity; preparing
  687  department strategic plans; coordinating with other state and
  688  local agencies; assisting the department in assessing local
  689  trends and issues and advising departmental headquarters on
  690  local priorities; and providing leadership in disaster planning
  691  and preparation.
  692         (8)(9) FUNDING FOR MANAGING ENTITIES.—
  693         (a) A contract established between the department and a
  694  managing entity under this section shall be funded by general
  695  revenue, other applicable state funds, or applicable federal
  696  funding sources. A managing entity may carry forward documented
  697  unexpended state funds from one fiscal year to the next;
  698  however, the cumulative amount carried forward may not exceed 8
  699  percent of the total contract. Any unexpended state funds in
  700  excess of that percentage must be returned to the department.
  701  The funds carried forward may not be used in a way that would
  702  create increased recurring future obligations or for any program
  703  or service that is not currently authorized under the existing
  704  contract with the department. Expenditures of funds carried
  705  forward must be separately reported to the department. Any
  706  unexpended funds that remain at the end of the contract period
  707  shall be returned to the department. Funds carried forward may
  708  be retained through contract renewals and new procurements as
  709  long as the same managing entity is retained by the department.
  710         (b) The method of payment for a fixed-price contract with a
  711  managing entity must provide for a 2-month advance payment at
  712  the beginning of each fiscal year and equal monthly payments
  713  thereafter.
  714         (10) REPORTING.—Reports of the department’s activities,
  715  progress, and needs in achieving the goal of contracting with
  716  managing entities in each circuit and region statewide must be
  717  submitted to the appropriate substantive and appropriations
  718  committees in the Senate and the House of Representatives on
  719  January 1 and July 1 of each year until the full transition to
  720  managing entities has been accomplished statewide.
  721         (9)(11) RULES.—The department may shall adopt rules to
  722  administer this section and, as necessary, to further specify
  723  requirements of managing entities.
  724         Section 6. Section 397.402, Florida Statutes, is created to
  725  read:
  726         397.402 Single, consolidated license.—No later than January
  727  1, 2016, the department shall modify licensure rules and
  728  procedures to create an option for a single, consolidated
  729  license for a provider that offers multiple types of mental
  730  health and substance abuse services regulated under chapters 394
  731  and 397. Providers eligible for a consolidated license must
  732  operate these services through a single corporate entity and a
  733  unified management structure. Any provider serving both adults
  734  and children must meet departmental standards for separate
  735  facilities and other requirements necessary to ensure the safety
  736  of children and promote therapeutic efficacy.
  737         Section 7. Section 397.427, Florida Statutes, is amended,
  738  to read:
  739         397.427 Medication-assisted treatment service providers;
  740  rehabilitation program; needs assessment and provision of
  741  services; persons authorized to issue takeout medication;
  742  unlawful operation; penalty.—
  743         (1) Providers of medication-assisted treatment services for
  744  opiate addiction may not be licensed unless they provide
  745  supportive rehabilitation programs. Supportive rehabilitation
  746  programs include, but are not limited to, counseling, therapy,
  747  and vocational rehabilitation.
  748         (2) The department shall determine the need for
  749  establishing providers of medication-assisted treatment services
  750  for opiate addiction.
  751         (a) Providers of medication-assisted treatment services for
  752  opiate addiction may be established only in response to the
  753  department’s determination and publication of need for
  754  additional medication treatment services.
  755         (b) The department shall prescribe by rule the types of
  756  medication-assisted treatment services for opiate addiction for
  757  which it is necessary to conduct annual assessments of need. If
  758  needs assessment is required, the department shall annually
  759  conduct the assessment and publish a statement of findings which
  760  identifies each substate entity’s need.
  761         (c) Notwithstanding paragraphs (a) and (b), the license for
  762  medication-assisted treatment programs for opiate addiction
  763  licensed before October 1, 1990, may not be revoked solely
  764  because of the department’s determination concerning the need
  765  for medication-assisted treatment services for opiate addiction.
  766         (3) The department shall adopt rules necessary to
  767  administer this section, including, but not limited to, rules
  768  prescribing criteria and procedures for:
  769         (a) Determining the need for additional medication-assisted
  770  treatment services for opiate addiction.
  771         (b) Selecting providers for medication-assisted treatment
  772  services for opiate addiction when the number of responses to a
  773  publication of need exceeds the determined need.
  774         (c) Administering any federally required rules,
  775  regulations, or procedures.
  776         (2)(4) A service provider operating in violation of this
  777  section is subject to proceedings in accordance with this
  778  chapter to enjoin that unlawful operation.
  779         (3)(5) Notwithstanding s. 465.019(2), a physician
  780  assistant, a registered nurse, an advanced registered nurse
  781  practitioner, or a licensed practical nurse working for a
  782  licensed service provider may deliver takeout medication for
  783  opiate treatment to persons enrolled in a maintenance treatment
  784  program for medication-assisted treatment for opiate addiction
  785  if:
  786         (a) The medication-assisted treatment program for opiate
  787  addiction has an appropriate valid permit issued pursuant to
  788  rules adopted by the Board of Pharmacy;
  789         (b) The medication for treatment of opiate addiction has
  790  been delivered pursuant to a valid prescription written by the
  791  program’s physician licensed pursuant to chapter 458 or chapter
  792  459;
  793         (c) The medication for treatment of opiate addiction which
  794  is ordered appears on a formulary and is prepackaged and
  795  prelabeled with dosage instructions and distributed from a
  796  source authorized under chapter 499;
  797         (d) Each licensed provider adopts written protocols which
  798  provide for supervision of the physician assistant, registered
  799  nurse, advanced registered nurse practitioner, or licensed
  800  practical nurse by a physician licensed pursuant to chapter 458
  801  or chapter 459 and for the procedures by which patients’
  802  medications may be delivered by the physician assistant,
  803  registered nurse, advanced registered nurse practitioner, or
  804  licensed practical nurse. Such protocols shall be signed by the
  805  supervising physician and either the administering registered
  806  nurse, the advanced registered nurse practitioner, or the
  807  licensed practical nurse.
  808         (e) Each licensed service provider maintains and has
  809  available for inspection by representatives of the Board of
  810  Pharmacy all medical records and patient care protocols,
  811  including records of medications delivered to patients, in
  812  accordance with the board.
  813         (4)(6) The department shall also determine the need for
  814  establishing medication-assisted treatment for substance use
  815  disorders other than opiate dependence. Service providers within
  816  the publicly funded system shall be funded for provision of
  817  these services based on the availability of funds.
  818         (5)(7) Service providers that provide medication-assisted
  819  treatment for substance abuse other than opiate dependence shall
  820  provide counseling services in conjunction with medication
  821  assisted treatment.
  822         (6)(8) The department shall adopt rules necessary to
  823  administer medication-assisted treatment services, including,
  824  but not limited to, rules prescribing criteria and procedures
  825  for:
  826         (a) Determining the need for medication-assisted treatment
  827  services within the publicly funded system.
  828         (b) Selecting medication-assisted service providers within
  829  the publicly funded system.
  830         (c) Administering any federally required rules,
  831  regulations, or procedures related to the provision of
  832  medication-assisted treatment.
  833         (7)(9) A physician assistant, a registered nurse, an
  834  advanced registered nurse practitioner, or a licensed practical
  835  nurse working for a licensed service provider may deliver
  836  medication as prescribed by rule if:
  837         (a) The service provider is authorized to provide
  838  medication-assisted treatment;
  839         (b) The medication has been administered pursuant to a
  840  valid prescription written by the program’s physician who is
  841  licensed under chapter 458 or chapter 459; and
  842         (c) The medication ordered appears on a formulary or meets
  843  federal requirements for medication-assisted treatment.
  844         (8)(10) Each licensed service provider that provides
  845  medication-assisted treatment must adopt written protocols as
  846  specified by the department and in accordance with federally
  847  required rules, regulations, or procedures. The protocol shall
  848  provide for the supervision of the physician assistant,
  849  registered nurse, advanced registered nurse practitioner, or
  850  licensed practical nurse working under the supervision of a
  851  physician who is licensed under chapter 458 or chapter 459. The
  852  protocol must specify how the medication will be used in
  853  conjunction with counseling or psychosocial treatment and that
  854  the services provided will be included on the treatment plan.
  855  The protocol must specify the procedures by which medication
  856  assisted treatment may be administered by the physician
  857  assistant, registered nurse, advanced registered nurse
  858  practitioner, or licensed practical nurse. These protocols shall
  859  be signed by the supervising physician and the administering
  860  physician assistant, registered nurse, advanced registered nurse
  861  practitioner, or licensed practical nurse.
  862         (9)(11) Each licensed service provider shall maintain and
  863  have available for inspection by representatives of the Board of
  864  Pharmacy all medical records and protocols, including records of
  865  medications delivered to individuals in accordance with rules of
  866  the board.
  867         Section 8. Present paragraphs (d) through (m) of subsection
  868  (2) of section 409.967, Florida Statutes, are redesignated as
  869  paragraphs (e) through (n), respectively, and a new paragraph
  870  (d) is added to that subsection, to read:
  871         409.967 Managed care plan accountability.—
  872         (2) The agency shall establish such contract requirements
  873  as are necessary for the operation of the statewide managed care
  874  program. In addition to any other provisions the agency may deem
  875  necessary, the contract must require:
  876         (d) Quality care.—Managed care plans shall provide, or
  877  contract for the provision of, care coordination to facilitate
  878  the appropriate delivery of behavioral health care services in
  879  the least restrictive setting with treatment and recovery
  880  capabilities that address the needs of the patient. Services
  881  shall be provided in a manner that integrates behavioral health
  882  services and primary care. Plans shall be required to achieve
  883  specific behavioral health outcome standards, established by the
  884  agency in consultation with the Department of Children and
  885  Families.
  886         Section 9. Subsection (5) is added to section 409.973,
  887  Florida Statutes, to read:
  888         409.973 Benefits.—
  890  operating in the managed medical assistance program shall work
  891  with the managing entity in its service area to establish
  892  specific organizational supports and service protocols that
  893  enhance the integration and coordination of primary care and
  894  behavioral health services for Medicaid recipients. Progress in
  895  this initiative will be measured using the integration framework
  896  and core measures developed by the Agency for Healthcare
  897  Research and Quality.
  898         Section 10. Paragraph (a) of subsection (1) of section
  899  409.975, Florida Statutes, is amended to read:
  900         409.975 Managed care plan accountability.—In addition to
  901  the requirements of s. 409.967, plans and providers
  902  participating in the managed medical assistance program shall
  903  comply with the requirements of this section.
  904         (1) PROVIDER NETWORKS.—Managed care plans must develop and
  905  maintain provider networks that meet the medical needs of their
  906  enrollees in accordance with standards established pursuant to
  907  s. 409.967(2)(c). Except as provided in this section, managed
  908  care plans may limit the providers in their networks based on
  909  credentials, quality indicators, and price.
  910         (a) Plans must include all providers in the region that are
  911  classified by the agency as essential Medicaid providers, unless
  912  the agency approves, in writing, an alternative arrangement for
  913  securing the types of services offered by the essential
  914  providers. Providers are essential for serving Medicaid
  915  enrollees if they offer services that are not available from any
  916  other provider within a reasonable access standard, or if they
  917  provided a substantial share of the total units of a particular
  918  service used by Medicaid patients within the region during the
  919  last 3 years and the combined capacity of other service
  920  providers in the region is insufficient to meet the total needs
  921  of the Medicaid patients. The agency may not classify physicians
  922  and other practitioners as essential providers. The agency, at a
  923  minimum, shall determine which providers in the following
  924  categories are essential Medicaid providers:
  925         1. Federally qualified health centers.
  926         2. Statutory teaching hospitals as defined in s.
  927  408.07(45).
  928         3. Hospitals that are trauma centers as defined in s.
  929  395.4001(14).
  930         4. Hospitals located at least 25 miles from any other
  931  hospital with similar services.
  932         5. Publicly funded behavioral health service providers.
  934  Managed care plans that have not contracted with all essential
  935  providers in the region as of the first date of recipient
  936  enrollment, or with whom an essential provider has terminated
  937  its contract, must negotiate in good faith with such essential
  938  providers for 1 year or until an agreement is reached, whichever
  939  is first. Payments for services rendered by a nonparticipating
  940  essential provider shall be made at the applicable Medicaid rate
  941  as of the first day of the contract between the agency and the
  942  plan. A rate schedule for all essential providers shall be
  943  attached to the contract between the agency and the plan. After
  944  1 year, managed care plans that are unable to contract with
  945  essential providers shall notify the agency and propose an
  946  alternative arrangement for securing the essential services for
  947  Medicaid enrollees. The arrangement must rely on contracts with
  948  other participating providers, regardless of whether those
  949  providers are located within the same region as the
  950  nonparticipating essential service provider. If the alternative
  951  arrangement is approved by the agency, payments to
  952  nonparticipating essential providers after the date of the
  953  agency’s approval shall equal 90 percent of the applicable
  954  Medicaid rate. If the alternative arrangement is not approved by
  955  the agency, payment to nonparticipating essential providers
  956  shall equal 110 percent of the applicable Medicaid rate.
  957         Section 11. Section 394.4674, Florida Statutes, is
  958  repealed.
  959         Section 12. Section 394.4985, Florida Statutes, is
  960  repealed.
  961         Section 13. Section 394.657, Florida Statutes, is repealed.
  962         Section 14. Section 394.745, Florida Statutes, is repealed.
  963         Section 15. Section 394.9084, Florida Statutes, is
  964  repealed.
  965         Section 16. Section 397.331, Florida Statutes, is repealed.
  966         Section 17. Section 397.333, Florida Statutes, is repealed.
  967         Section 18. Section 397.801, Florida Statutes, is repealed.
  968         Section 19. Section 397.811, Florida Statutes, is repealed.
  969         Section 20. Section 397.821, Florida Statutes, is repealed.
  970         Section 21. Section 397.901, Florida Statutes, is repealed.
  971         Section 22. Section 397.93, Florida Statutes, is repealed.
  972         Section 23. Section 397.94, Florida Statutes, is repealed.
  973         Section 24. Section 397.951, Florida Statutes, is repealed.
  974         Section 25. Section 397.97, Florida Statutes, is repealed.
  975         Section 26. Subsection (15) of section 397.321, Florida
  976  Statutes, is amended to read:
  977         397.321 Duties of the department.—The department shall:
  978         (15) Appoint a substance abuse impairment coordinator to
  979  represent the department in efforts initiated by the statewide
  980  substance abuse impairment prevention and treatment coordinator
  981  established in s. 397.801 and to assist the statewide
  982  coordinator in fulfilling the responsibilities of that position.
  983         Section 27. Subsection (1) of section 397.98, Florida
  984  Statutes, is amended to read:
  985         397.98 Children’s substance abuse services; utilization
  986  management.—
  987         (1) Utilization management shall be an integral part of
  988  each Children’s Network of Care Demonstration Model as described
  989  under s. 397.97. The utilization management process shall
  990  include procedures for analyzing the allocation and use of
  991  resources by the purchasing agent. Such procedures shall
  992  include:
  993         (a) Monitoring the appropriateness of admissions to
  994  residential services or other levels of care as determined by
  995  the department.
  996         (b) Monitoring the duration of care.
  997         (c) Developing profiles of network providers which describe
  998  their patterns of delivering care.
  999         (d) Authorizing care for high-cost services.
 1000         Section 28. Paragraph (e) of subsection (3) of section
 1001  409.966, Florida Statutes, is amended to read:
 1002         409.966 Eligible plans; selection.—
 1004         (e) To ensure managed care plan participation in Regions 1
 1005  and 2, the agency shall award an additional contract to each
 1006  plan with a contract award in Region 1 or Region 2. Such
 1007  contract shall be in any other region in which the plan
 1008  submitted a responsive bid and negotiates a rate acceptable to
 1009  the agency. If a plan that is awarded an additional contract
 1010  pursuant to this paragraph is subject to penalties pursuant to
 1011  s. 409.967(2)(i) s. 409.967(2)(h) for activities in Region 1 or
 1012  Region 2, the additional contract is automatically terminated
 1013  180 days after the imposition of the penalties. The plan must
 1014  reimburse the agency for the cost of enrollment changes and
 1015  other transition activities.
 1016         Section 29. Paragraph (a) of subsection (5) of section
 1017  943.031, Florida Statutes, is amended to read:
 1018         943.031 Florida Violent Crime and Drug Control Council.—
 1019         (5) DUTIES OF COUNCIL.—Subject to funding provided to the
 1020  department by the Legislature, the council shall provide advice
 1021  and make recommendations, as necessary, to the executive
 1022  director of the department.
 1023         (a) The council may advise the executive director on the
 1024  feasibility of undertaking initiatives which include, but are
 1025  not limited to, the following:
 1026         1. Establishing a program that provides grants to criminal
 1027  justice agencies that develop and implement effective violent
 1028  crime prevention and investigative programs and which provides
 1029  grants to law enforcement agencies for the purpose of drug
 1030  control, criminal gang, and illicit money laundering
 1031  investigative efforts or task force efforts that are determined
 1032  by the council to significantly contribute to achieving the
 1033  state’s goal of reducing drug-related crime, that represent
 1034  significant criminal gang investigative efforts, that represent
 1035  a significant illicit money laundering investigative effort, or
 1036  that otherwise significantly support statewide strategies
 1037  developed by the Statewide Drug Policy Advisory Council
 1038  established under s. 397.333, subject to the limitations
 1039  provided in this section. The grant program may include an
 1040  innovations grant program to provide startup funding for new
 1041  initiatives by local and state law enforcement agencies to
 1042  combat violent crime or to implement drug control, criminal
 1043  gang, or illicit money laundering investigative efforts or task
 1044  force efforts by law enforcement agencies, including, but not
 1045  limited to, initiatives such as:
 1046         a. Providing enhanced community-oriented policing.
 1047         b. Providing additional undercover officers and other
 1048  investigative officers to assist with violent crime
 1049  investigations in emergency situations.
 1050         c. Providing funding for multiagency or statewide drug
 1051  control, criminal gang, or illicit money laundering
 1052  investigative efforts or task force efforts that cannot be
 1053  reasonably funded completely by alternative sources and that
 1054  significantly contribute to achieving the state’s goal of
 1055  reducing drug-related crime, that represent significant criminal
 1056  gang 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         2. Expanding the use of automated biometric identification
 1062  systems at the state and local levels.
 1063         3. Identifying methods to prevent violent crime.
 1064         4. Identifying methods to enhance multiagency or statewide
 1065  drug control, criminal gang, or illicit money laundering
 1066  investigative efforts or task force efforts that significantly
 1067  contribute to achieving the state’s goal of reducing drug
 1068  related crime, that represent significant criminal gang
 1069  investigative efforts, that represent a significant illicit
 1070  money laundering investigative effort, or that otherwise
 1071  significantly support statewide strategies developed by the
 1072  Statewide Drug Policy Advisory Council established under s.
 1073  397.333.
 1074         5. Enhancing criminal justice training programs that
 1075  address violent crime, drug control, illicit money laundering
 1076  investigative techniques, or efforts to control and eliminate
 1077  criminal gangs.
 1078         6. Developing and promoting crime prevention services and
 1079  educational programs that serve the public, including, but not
 1080  limited to:
 1081         a. Enhanced victim and witness counseling services that
 1082  also provide crisis intervention, information referral,
 1083  transportation, and emergency financial assistance.
 1084         b. A well-publicized rewards program for the apprehension
 1085  and conviction of criminals who perpetrate violent crimes.
 1086         7. Enhancing information sharing and assistance in the
 1087  criminal justice community by expanding the use of community
 1088  partnerships and community policing programs. Such expansion may
 1089  include the use of civilian employees or volunteers to relieve
 1090  law enforcement officers of clerical work in order to enable the
 1091  officers to concentrate on street visibility within the
 1092  community.
 1093         Section 30. Subsection (1) of section 943.042, Florida
 1094  Statutes, is amended to read:
 1095         943.042 Violent Crime Investigative Emergency and Drug
 1096  Control Strategy Implementation Account.—
 1097         (1) There is created a Violent Crime Investigative
 1098  Emergency and Drug Control Strategy Implementation Account
 1099  within the Department of Law Enforcement Operating Trust Fund.
 1100  The account shall be used to provide emergency supplemental
 1101  funds to:
 1102         (a) State and local law enforcement agencies that are
 1103  involved in complex and lengthy violent crime investigations, or
 1104  matching funding to multiagency or statewide drug control or
 1105  illicit money laundering investigative efforts or task force
 1106  efforts that significantly contribute to achieving the state’s
 1107  goal of reducing drug-related crime, that represent a
 1108  significant illicit money laundering investigative effort, or
 1109  that otherwise significantly support statewide strategies
 1110  developed by the Statewide Drug Policy Advisory Council
 1111  established under s. 397.333;
 1112         (b) State and local law enforcement agencies that are
 1113  involved in violent crime investigations which constitute a
 1114  significant emergency within the state; or
 1115         (c) Counties that demonstrate a significant hardship or an
 1116  inability to cover extraordinary expenses associated with a
 1117  violent crime trial.
 1118         Section 31. For the purpose of incorporating the amendment
 1119  made by this act to section 394.492, Florida Statutes, in a
 1120  reference thereto, paragraph (a) of subsection (6) of section
 1121  39.407, Florida Statutes, is reenacted to read:
 1122         39.407 Medical, psychiatric, and psychological examination
 1123  and treatment of child; physical, mental, or substance abuse
 1124  examination of person with or requesting child custody.—
 1125         (6) Children who are in the legal custody of the department
 1126  may be placed by the department, without prior approval of the
 1127  court, in a residential treatment center licensed under s.
 1128  394.875 or a hospital licensed under chapter 395 for residential
 1129  mental health treatment only pursuant to this section or may be
 1130  placed by the court in accordance with an order of involuntary
 1131  examination or involuntary placement entered pursuant to s.
 1132  394.463 or s. 394.467. All children placed in a residential
 1133  treatment program under this subsection must have a guardian ad
 1134  litem appointed.
 1135         (a) As used in this subsection, the term:
 1136         1. “Residential treatment” means placement for observation,
 1137  diagnosis, or treatment of an emotional disturbance in a
 1138  residential treatment center licensed under s. 394.875 or a
 1139  hospital licensed under chapter 395.
 1140         2. “Least restrictive alternative” means the treatment and
 1141  conditions of treatment that, separately and in combination, are
 1142  no more intrusive or restrictive of freedom than reasonably
 1143  necessary to achieve a substantial therapeutic benefit or to
 1144  protect the child or adolescent or others from physical injury.
 1145         3. “Suitable for residential treatment” or “suitability”
 1146  means a determination concerning a child or adolescent with an
 1147  emotional disturbance as defined in s. 394.492(5) or a serious
 1148  emotional disturbance as defined in s. 394.492(6) that each of
 1149  the following criteria is met:
 1150         a. The child requires residential treatment.
 1151         b. The child is in need of a residential treatment program
 1152  and is expected to benefit from mental health treatment.
 1153         c. An appropriate, less restrictive alternative to
 1154  residential treatment is unavailable.
 1155         Section 32. For the purpose of incorporating the amendment
 1156  made by this act to section 394.492, Florida Statutes, in a
 1157  reference thereto, subsection (21) of section 394.67, Florida
 1158  Statutes, is reenacted to read:
 1159         394.67 Definitions.—As used in this part, the term:
 1160         (21) “Residential treatment center for children and
 1161  adolescents” means a 24-hour residential program, including a
 1162  therapeutic group home, which provides mental health services to
 1163  emotionally disturbed children or adolescents as defined in s.
 1164  394.492(5) or (6) and which is a private for-profit or not-for
 1165  profit corporation licensed by the agency which offers a variety
 1166  of treatment modalities in a more restrictive setting.
 1167         Section 33. For the purpose of incorporating the amendment
 1168  made by this act to section 394.492, Florida Statutes, in a
 1169  reference thereto, paragraph (b) of subsection (1) of section
 1170  394.674, Florida Statutes, is reenacted to read:
 1171         394.674 Eligibility for publicly funded substance abuse and
 1172  mental health services; fee collection requirements.—
 1173         (1) To be eligible to receive substance abuse and mental
 1174  health services funded by the department, an individual must be
 1175  a member of at least one of the department’s priority
 1176  populations approved by the Legislature. The priority
 1177  populations include:
 1178         (b) For children’s mental health services:
 1179         1. Children who are at risk of emotional disturbance as
 1180  defined in s. 394.492(4).
 1181         2. Children who have an emotional disturbance as defined in
 1182  s. 394.492(5).
 1183         3. Children who have a serious emotional disturbance as
 1184  defined in s. 394.492(6).
 1185         4. Children diagnosed as having a co-occurring substance
 1186  abuse and emotional disturbance or serious emotional
 1187  disturbance.
 1188         Section 34. For the purpose of incorporating the amendment
 1189  made by this act to section 394.492, Florida Statutes, in a
 1190  reference thereto, subsection (1) of section 394.676, Florida
 1191  Statutes, is reenacted to read:
 1192         394.676 Indigent psychiatric medication program.—
 1193         (1) Within legislative appropriations, the department may
 1194  establish the indigent psychiatric medication program to
 1195  purchase psychiatric medications for persons as defined in s.
 1196  394.492(5) or (6) or pursuant to s. 394.674(1), who do not
 1197  reside in a state mental health treatment facility or an
 1198  inpatient unit.
 1199         Section 35. For the purpose of incorporating the amendment
 1200  made by this act to section 394.492, Florida Statutes, in a
 1201  reference thereto, paragraph (c) of subsection (2) of section
 1202  409.1676, Florida Statutes, is reenacted to read:
 1203         409.1676 Comprehensive residential group care services to
 1204  children who have extraordinary needs.—
 1205         (2) As used in this section, the term:
 1206         (c) “Serious behavioral problems” means behaviors of
 1207  children who have been assessed by a licensed master’s-level
 1208  human-services professional to need at a minimum intensive
 1209  services but who do not meet the criteria of s. 394.492(7). A
 1210  child with an emotional disturbance as defined in s. 394.492(5)
 1211  or (6) may be served in residential group care unless a
 1212  determination is made by a mental health professional that such
 1213  a setting is inappropriate. A child having a serious behavioral
 1214  problem must have been determined in the assessment to have at
 1215  least one of the following risk factors:
 1216         1. An adjudication of delinquency and be on conditional
 1217  release status with the Department of Juvenile Justice.
 1218         2. A history of physical aggression or violent behavior
 1219  toward self or others, animals, or property within the past
 1220  year.
 1221         3. A history of setting fires within the past year.
 1222         4. A history of multiple episodes of running away from home
 1223  or placements within the past year.
 1224         5. A history of sexual aggression toward other youth.
 1225         Section 36. For the purpose of incorporating the amendment
 1226  made by this act to section 394.492, Florida Statutes, in a
 1227  reference thereto, paragraph (b) of subsection (1) of section
 1228  409.1677, Florida Statutes, is reenacted to read:
 1229         409.1677 Model comprehensive residential services
 1230  programs.—
 1231         (1) As used in this section, the term:
 1232         (b) “Serious behavioral problems” means behaviors of
 1233  children who have been assessed by a licensed master’s-level
 1234  human-services professional to need at a minimum intensive
 1235  services but who do not meet the criteria of s. 394.492(6) or
 1236  (7). A child with an emotional disturbance as defined in s.
 1237  394.492(5) may be served in residential group care unless a
 1238  determination is made by a mental health professional that such
 1239  a setting is inappropriate.
 1240         Section 37. Except as otherwise expressly provided in this
 1241  act and except for this section, which shall take effect upon
 1242  this act becoming a law, this act shall take effect July 1,
 1243  2015.