Senate Bill 2108c1

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    Florida Senate - 2000                           CS for SB 2108

    By the Committee on Criminal Justice and Senator Brown-Waite





    307-1870-00

  1                      A bill to be entitled

  2         An act relating to health care of inmates in

  3         the state correctional system; providing

  4         legislative intent with respect to the

  5         Correctional Managed Health Care Pilot Program;

  6         creating the Correctional Managed Health Care

  7         Oversight Board to oversee the pilot program;

  8         providing for the membership of the board;

  9         providing duties of the board; providing for

10         meetings of the board; requiring that the board

11         inspect facilities operated under the pilot

12         program and report to the Governor and

13         Legislature; providing for expiration of the

14         board; establishing the Correctional Managed

15         Health Care Pilot Program; specifying the

16         correctional facilities to be included in the

17         pilot program; requiring the Department of

18         Corrections to contract with a private health

19         care vendor for the purpose of providing health

20         care services; providing procedures under which

21         the private vendor may deviate from procedures

22         or protocols adopted by the department;

23         providing for a criminal history check of

24         individuals employed by or contracting with the

25         health care vendor; providing that sovereign

26         immunity does not apply to any vendor

27         performing services under the pilot program;

28         requiring that the vendor and any subcontractor

29         indemnify the state and the department against

30         any liability; requiring that the population of

31         inmates served under the pilot program be

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1         similar to other inmates in the state

  2         correctional system; exempting the facilities

  3         under the pilot program from the direction of

  4         the State of Florida Correctional Medical

  5         Authority; providing for the prime vendor

  6         pharmaceutical contract to be available to the

  7         health care vendor operating the pilot program;

  8         providing an effective date.

  9

10  Be It Enacted by the Legislature of the State of Florida:

11

12         Section 1.  Legislative intent; Correctional Managed

13  Health Care Oversight Board; Correctional Managed Health Care

14  Pilot Program.--

15         (1)  It is the intent of the Legislature that the

16  delivery of inmate health care be accomplished in accordance

17  with the commonly accepted standards within the professional

18  health community at large; be provided at a level comparable

19  to a Medicaid-service level of care, enhanced to include

20  dental, mental health, and pharmacy programs that are at least

21  equivalent to the level of care provided by the Office of

22  Health Services of the Department of Corrections; and be

23  provided in the most cost-effective manner possible. It is

24  also the intent of the Legislature to reduce and control the

25  escalating costs of inmate health care by implementing, in a

26  pilot project, the managed health care approach described in

27  this section and specifically authorized in the 2000-2001

28  General Appropriations Act. In managing the contract for the

29  Correctional Managed Health Care Pilot Program contract, the

30  Department of Corrections shall safeguard the state's interest

31  in providing lawfully adequate health care to inmates.

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1         (2)  Upon the award of a contract, the Correctional

  2  Managed Health Care Oversight Board is created for the purpose

  3  of overseeing the implementation of the Correctional Managed

  4  Health Care Pilot Program. The board shall consist of seven

  5  members appointed by the Governor, one of whom must be

  6  employed by the Agency for Health Care Administration, and one

  7  of whom must be a certified public accountant who holds a

  8  valid license to practice in this state. The remaining members

  9  must be medical professionals and must include a physician, a

10  psychiatrist, a dentist, and a nurse, each of whom must hold a

11  valid license to practice their profession in this state. The

12  Governor shall designate one member to serve as the

13  chairperson. An employee of the Department of Corrections may

14  not be appointed to the board. Five members of the board shall

15  constitute a quorum. The members shall be appointed to terms

16  of 2 years each. A vacancy shall be filled in the same manner

17  as the original appointment and shall be for the remainder of

18  the unexpired term.

19         (a)  The purpose of the board is to assist in the

20  delivery of health care services for inmates in the Department

21  of Corrections by advising the Governor and the Legislature on

22  the status of the health care delivery system of the

23  Department of Corrections at the facilities participating in

24  the Correctional Managed Health Care Pilot Program; by

25  evaluating the provision of primary, convalescent, dental, and

26  mental health care and the management of costs consistent with

27  lawfully adequate care; and by assuring that lawfully adequate

28  standards of primary, convalescent, dental, and mental health

29  care for inmates are maintained. Deficiencies found by the

30  board to be life-threatening or otherwise serious shall be

31  immediately reported to the Secretary of Corrections and the

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1  private health care vendor performing the services under the

  2  Correctional Managed Health Care Pilot Program. The private

  3  health care vendor shall take immediate action to correct

  4  life-threatening or otherwise serious deficiencies identified

  5  by the board and, within 3 calendar days, file a written

  6  corrective action plan with the Secretary of Corrections, the

  7  department's contract manager, and the board which indicates

  8  the actions that will be taken to address the deficiencies.

  9         (b)  The board members shall not be compensated for

10  their services on the board, but are entitled to reimbursement

11  by the Department of Corrections for travel expenses, pursuant

12  to section 112.061, Florida Statutes, from funds appropriated

13  to the Department of Corrections. The department shall provide

14  necessary staff support to the board to enable the board to

15  fulfill its obligations.

16         (c)  The board shall meet at least once each quarter,

17  or often as necessary, for the purpose of carrying out its

18  responsibilities and evaluating the pilot program. The board

19  may adopt by-laws necessary for the board's operation.

20         (d)  The board shall inspect the facilities covered

21  under the pilot program at least once each year and shall

22  submit a report to the Governor, the President of the Senate,

23  and the Speaker of the House within 60 days after the

24  inspection.

25         (e)  The board shall address and resolve any request

26  for changes submitted by the private health care vendor under

27  paragraph (3)(b).

28         (f)  An affirmative vote of the majority of the quorum

29  is necessary for the board to take any action.

30         (g)  The board shall exist until all objectives are

31  achieved, but not later than January 31, 2004.

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1         (3)(a)  The Correctional Managed Health Care Pilot

  2  Program is established for the purpose of providing inmate

  3  health care, including primary, convalescent, dental, and

  4  mental health care, to inmates housed by the Department of

  5  Corrections at the prisons located in the region designated by

  6  the department as Region IV on March 1, 2000. The pilot

  7  program shall:

  8         1.  Commence with a contract awarded to a private

  9  health care vendor by the Department of Corrections, at the

10  department's discretion. The private health care vendor shall

11  provide services to inmates, except inmates housed in

12  institutions authorized under chapter 957, Florida Statutes,

13  at a level that is comparable to the level of care provided

14  under Medicaid. In addition, services shall be enhanced to

15  include dental, mental health, and pharmacy programs that are

16  at least equivalent to the level of care provided by the

17  Office of Health Services of the Department of Corrections.

18  The contract for the pilot project shall be terminated no

19  later than December 31, 2003.

20         2.  Maintain lawfully adequate levels of inmate health

21  care and provide access to health care while achieving

22  substantial cost savings.

23         3.  Adhere to the health care procedures, health care

24  plans, health service bulletins, and treatment protocols

25  relating to the provision of inmate health care services

26  adopted by the Department of Corrections.

27         (b)  If there is a need to deviate from the procedures,

28  plans, bulletins, or protocols adopted by the Department of

29  Corrections, the private health care vendor shall file a

30  request for change with the chairperson of the Correctional

31  Managed Health Care Oversight Board which states the reasons

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1  for the request for change and the alternative protocol the

  2  pilot program would implement, if approved, and shall submit

  3  an affidavit from a local health care provider which attests

  4  to the fact that the alternative protocol is commonly accepted

  5  within the professional health community at large. The

  6  chairperson of the Correctional Managed Health Care Oversight

  7  Board shall promptly assemble a quorum to review the request

  8  for change and submit a recommendation to the Secretary of

  9  Corrections to approve or deny the request. All documentation

10  considered by the board shall be provided to the Secretary of

11  Corrections for a final decision.

12         (c)  The private health care vendor shall provide the

13  names, addresses, and social security numbers and, upon

14  request, a complete set of fingerprints taken by an authorized

15  law enforcement agency, of all individuals who will be

16  employed by, or contracting with, the vendor within the

17  state's correctional system for the purpose of a background

18  check. The Department of Law Enforcement may accept such

19  fingerprints for the purpose of conducting a statewide and

20  national criminal history check and, to the extent provided by

21  law, to exchange state, multistate, and federal criminal

22  history records with the Department of Corrections.

23         (d)  The Department of Corrections shall provide

24  training to the private health care vendor, any

25  subcontractors, and their respective employees with regard to

26  security requirements to be maintained by the vendor,

27  subcontractor, or employees while working within the state's

28  correctional system.

29         (4)  Section 768.28(10)(a), Florida Statutes, does not

30  apply to any vendor performing services under the Correctional

31  Managed Health Care Pilot Program. The vendor entering into a

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1  contract under this section is liable in tort with respect to

  2  the care of inmates under the Correctional Managed Health Care

  3  Pilot Program and for any breach of contract. Sovereign

  4  immunity may not be raised by a vendor, subcontractor, or

  5  employee of the vendor or subcontractor, or by the insurer of

  6  the vendor, subcontractor, or employee on their behalf, as a

  7  defense in any action arising out of the performance of any

  8  service under the terms of any contract entered under this

  9  section or as a defense in tort, or any other application,

10  with respect to the care of inmates and for any breach of

11  contract.

12         (5)  Each primary vendor or subcontractor entering into

13  an agreement under this section shall defend and indemnify the

14  state and the Department of Corrections, including their

15  officials, employees and agents, against any claim, loss,

16  damage, cost, charge, or expense arising out of any act,

17  action, neglect, or omission by the vendor or its agents or

18  employees during the performance of the contract, whether

19  direct or indirect, including, but not limited to, any tort or

20  civil rights liability. Proof of satisfactory insurance is

21  required in the request for proposal and resulting contract,

22  if any is awarded. The vendor shall provide a performance bond

23  in an amount to be specified in the request for proposal.

24         (6)(a)  The population of inmates housed in

25  correctional facilities within which the Correctional Managed

26  Health Care Pilot Program is operated shall be of a

27  substantially similar composition as those inmates who are

28  housed in similar facilities in the remainder of the state

29  correctional system with respect to their overall health, age,

30  mental health, and dental requirements.

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    Florida Senate - 2000                           CS for SB 2108
    307-1870-00




  1         (b)  Section 945.603, Florida Statutes, does not apply

  2  to the correctional facilities within which the pilot program

  3  is operated and such facilities are not subject to direction

  4  by the State of Florida Correctional Medical Authority.

  5         (7)  The prime vendor pharmaceutical contract of the

  6  state shall be available to the private health care vendor

  7  selected to operate the Correctional Managed Health Care Pilot

  8  Program. However, the private health care vendor is not

  9  required to use the state's prime vendor pharmaceutical

10  contract.

11         Section 2.  This act shall take effect upon becoming a

12  law.

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14          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
15                         Senate Bill 2108

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17  The CS defines a pilot project, authorized by proviso language
    in the Senate Budget 2000-2001, which would allow the
18  Department of Corrections to contract with a private health
    care vendor to deliver inmate health services in one Region
19  for a specified period of time. The CS creates an oversight
    board to report to the Legislature and Governor on the
20  implementation and success of the pilot program.

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