Senate Bill sb1706c1

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    Florida Senate - 2004                           CS for SB 1706

    By the Committee on Children and Families; and Senators Wise
    and Webster




    300-2153-04

  1                      A bill to be entitled

  2         An act relating to specialty behavioral health

  3         care providers; requiring the Department of

  4         Children and Family Services to establish a

  5         demonstration project in District 4 in order to

  6         determine the benefits of developing a

  7         specialty behavioral health care provider to

  8         deliver behavioral health services to persons

  9         who reside in an assisted living facility that

10         holds a limited mental health license;

11         requiring the department to create an advisory

12         committee; defining the term "specialty

13         behavioral health provider"; providing the

14         requirements for the specialty behavioral

15         health care provider demonstration project;

16         providing that certain specialty behavioral

17         health care providers may seek and develop

18         cooperative agreements with administrators of

19         certain assisted living facilities; requiring

20         the Agency for Health Care Administration to

21         seek federal waivers to implement an

22         alternative prepaid behavioral health care plan

23         under certain conditions; requiring the

24         department to implement the demonstration

25         project by a specific date; providing for an

26         independent evaluation; requiring that a report

27         be submitted to the Legislature; providing an

28         effective date.

29  

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

31  

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1         Section 1.  Subsections (4), (5), (6), (7), (8), and

 2  (9) are added to section 394.4574, Florida Statutes, to read:

 3         394.4574  Department responsibilities for a mental

 4  health resident who resides in an assisted living facility

 5  that holds a limited mental health license.--

 6         (4)  The Department of Children and Family Services

 7  shall establish a demonstration project in the Department of

 8  Children and Family Services district 4 for the purpose of

 9  developing evidence-based practices in the delivery of

10  state-funded behavioral health care services and support

11  through the use of specialty behavioral health care providers

12  to persons who reside in assisted living facilities that hold

13  a limited mental health license. Participation in the program

14  of fee-for-service options is voluntary for Medicaid

15  recipients and recipients of state-funded services.

16         (5)(a)  The department shall create an advisory

17  committee to make recommendations to the Agency for Health

18  Care Administration and the Department of Children and Family

19  Services for the demonstration project that shall be developed

20  by the Department of Children and Family Services in

21  consultation with the Agency for Health Care Administration.

22  The advisory committee shall solicit input from stakeholders,

23  residents, facility administrators and advocates relative to

24  the standards, criteria, and array of services that will be

25  included.

26         (b)  The advisory committee membership shall include

27  local community partners that include residents, advocates,

28  private and publicly funded behavioral health care providers,

29  representatives of the Agency for Health Care Administration

30  and the Department of Children and Family Services, and local

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1  government facility administrators. Other representatives may

 2  include the following:

 3         1.  One person who is a member of the Florida

 4  Psychiatric Society, selected by the society;

 5         2.  One person who is a member of the Florida Council

 6  for Behavioral Health, selected by the council;

 7         3.  One person who is a member of the National Alliance

 8  for the Mentally Ill, selected by the state affiliate;

 9         4.  One person who is a member of the Florida Assisted

10  Living Affiliation, selected by the affiliation;

11         5.  One person who is a member of the local advocacy

12  council, selected by the local council; and

13         6.  A representative from the Advocacy Center for

14  Persons with Disabilities, selected by the advocacy center.

15         (c)  The advisory committee shall establish goals,

16  elect a chairman, and be governed by the latest edition of

17  Roberts Rules of Order.  The chairman shall direct the work of

18  the advisory committee and may appoint subcommittees as deemed

19  appropriate by the chairman.  In addition, the chairman shall

20  be responsible to ensure that minutes of meetings are kept and

21  community input is solicited.  The meetings shall convene upon

22  the call of the chairman.

23         (6)(a)  For the purposes of this demonstration project,

24  the term "specialty behavioral health provider" means a public

25  or private behavioral health care entity, provider, or

26  organization or coalition of providers that holds a contract

27  with the Department of Children and Family Services and can

28  offer a full array of state-funded behavioral health care

29  services to residents who live in state-licensed assisted

30  living facilities that hold a limited mental health license in

31  district 4.  The services that are provided on a

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1  fee-for-service basis shall be provided directly by the

 2  specialty behavioral health care provider.  The Department of

 3  Children and Family Services for the purpose of this

 4  demonstration project shall allow private providers the

 5  opportunity to seek a contract in order to compete and provide

 6  state-funded behavioral health care services.

 7         (b)  In constructing the requirements for the specialty

 8  behavioral health care provider demonstration project, the

 9  Agency for Health Care Administration and the Department of

10  Children and Family Services shall ensure that the providers

11  develop and implement a plan to ensure the provision of the

12  services and requirements as referenced under this section.

13  The demonstration project shall include requirements for

14  intensive case management services, provisions for on-call

15  case managers, and vocational support services, and include a

16  requirement for the development of evidence-based models and

17  practices in the delivery of community-based behavioral health

18  care services that includes strategies for reducing the

19  utilization of state-funded inpatient psychiatric care.  These

20  models should demonstrate new approaches and allow for maximum

21  input from consumers, family members, and facility

22  administrators. Services provided under the demonstration

23  project shall be fee-for-service and cost-neutral for the

24  Agency for Health Care Administration and for the Department

25  of Children and Family Services. The Department of Children

26  and Family Services in consultation with the Agency for Health

27  Care Administration shall use a request for information

28  process for the purpose of procurement and to ensure

29  competition and choice.

30         (c)  For Medicaid-eligible residents that live in

31  assisted living facilities that hold a limited mental health

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1  license in district 4 and are enrolled in the MediPass program

 2  under a "fee for service" arrangement for the provision of

 3  Medicaid-funded behavioral health care services, the

 4  Department of Children and Family Services and the Agency for

 5  Health Care Administration shall allow any behavioral health

 6  care provider in district 4 that meets the eligibility

 7  requirements for this demonstration project to become a

 8  "specialty behavioral health care" provider. This shall

 9  include both nonprofit and private behavioral health care

10  providers, organizations, and entities or coalitions of

11  providers.

12         (d)  Each eligible specialty behavioral health care

13  provider that is qualified under the requirements of the

14  demonstration project shall be permitted to seek and develop

15  cooperative agreements with administrators of assisted living

16  facilities that hold a limited mental health license in

17  district 4.  The cooperative agreements shall be for a minimum

18  period of 1 year during the course of the demonstration

19  project and shall be binding on both parties for the duration

20  of the agreement.  The cooperative agreements shall include

21  provisions that will serve to promote the development of

22  evidence-based practices and models as outlined in the

23  procurement document for the project.  For the purposes of

24  this demonstration project, the provisions of the cooperative

25  agreement shall be focused on improving the coordination of

26  services, improved communication, detailed protocols that

27  relate to the supervision of the clinical needs of the

28  residents, and all other provisions currently required under

29  existing statute.

30         (7)  If the Agency for Health Care Administration

31  implements a prepaid behavioral health care plan in district

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1  4, the Agency for Health Care Administration shall seek

 2  federal waivers to implement an alternative prepaid behavioral

 3  health care plan in district 4 to demonstrate innovation and

 4  to develop evidence-based practices that will improve the

 5  coordination, satisfaction, and delivery of all state-funded

 6  behavioral health care services to residents that live in

 7  assisted living facilities located in district 4 that hold a

 8  limited mental health license. The Agency for Health Care

 9  Administration in developing the alternative prepaid program

10  for persons who reside in assisted living facilities that hold

11  a limited mental health license in district 4 shall include

12  provisions that ensure that the demonstration capitation rate

13  shall be based on no more than 90 percent of the historic

14  service utilization, and shall include all outpatient

15  state-funded behavioral health care services and inpatient

16  psychiatric services and shall exempt medications. The Agency

17  for Health Care Administration and the Department of Children

18  and Family Services shall also calculate a rate for the

19  non-Medicaid residents served in the demonstration area and

20  shall ensure that the capitation rate does not result in the

21  displacement of residents and is consistent with the

22  resident's right of access to adequate and appropriate health

23  care under s. 400.428.

24         (8)  The district 4 demonstration project must be

25  implemented no later than January 1, 2005, and shall continue

26  for not less than 3 years following the date of

27  implementation.

28         (9)  The Office of Program Policy Analysis and

29  Government Accountability shall conduct an evaluation of the

30  demonstration project. The evaluation must assess the

31  recidivism of residents from the assisted living facility that

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1  holds a limited mental health license to the inpatient

 2  hospital setting, improvement in resident behavioral health

 3  outcomes, resident satisfaction with care, improvements in

 4  program competencies and linkages, increased tenure of case

 5  management relationships with residents, and implementation of

 6  meaningful plans of recovery.  Following the evaluation, the

 7  office shall prepare a report and submit a copy to the

 8  President of the Senate and the Speaker of the House of

 9  Representatives by January 1, 2008.

10         Section 2.  This act shall take effect July 1, 2004.

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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 1706

 3                                 

 4  
    *    Deletes the requirement to select one exclusive specialty
 5       behavioral health care services provider for the
         demonstration project.
 6  
    *    Specifies that participation in the fee-for-services
 7       option is voluntary for Medicaid recipients and
         recipients of state funded services who participate in
 8       the demonstration project.

 9  *    Directs the Department of Children and Families (DCF or
         the department) to create an advisory committee instead
10       of a board to make recommendations to the department and
         the Agency for Health Care Administration (AHCA or the
11       agency) regarding the demonstration project and specifies
         the membership of that committee.
12  
    *    Provides a definition for the term "specialty behavioral
13       health provider."

14  *    Specifies the array of services that must be provided by
         the "specialty behavioral health provider."
15  
    *    Specifies that the services provided under the
16       demonstration project are to be fee-for-service and cost
         neutral to the department and AHCA.
17  
    *    Directs DCF and AHCA to allow any health care provider
18       meeting specified requirements to become a specialty
         behavioral health care provider for the demonstration
19       project.

20  *    Directs that the department utilize a request for
         information process instead of a competitive bid process
21       to select specialty behavioral health care providers.

22  *    Authorizes eligible specialty behavioral health care
         providers to develop cooperative agreements with the
23       administrators of assisted living facilities holding a
         limited mental health license and specifies requirements
24       for those cooperative agreements.

25  *    Deletes the requirement that AHCA implement a capitated
         payment arrangement with the specialty behavioral health
26       care provider if a managed care system is implemented in
         District 4 and instead directs the agency to seek federal
27       waivers to implement an alternative behavioral health
         care plan in District 4 if a pre-paid behavioral health
28       plan is implemented.

29  *    Deletes the language authorizing the specialty behavioral
         health care provider to identify medically necessary
30       services that must be provided by Medicaid.

31  *    Directs the Office of Program Policy Analysis and
         Government Accountability to conduct an evaluation of the
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    Florida Senate - 2004                           CS for SB 1706
    300-2153-04




 1       demonstration project and provide a report to the
         Legislature instead of requiring the department to
 2       contract for an independent evaluation.

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