Senate Bill sb1524

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2005                                  SB 1524

    By Senators Rich and Dawson





    34-1139A-05                                         See HB 493

  1                      A bill to be entitled

  2         An act relating to mental health care services;

  3         creating s. 409.91225, F.S.; directing the

  4         Agency for Health Care Administration, in

  5         cooperation with the Department of Children and

  6         Family Services, to develop a pilot program in

  7         district 10 for a mental health care provider

  8         service network to deliver mental health care

  9         services as a form of managed care under the

10         MediPass program; providing legislative intent;

11         providing powers, duties, and responsibilities

12         of the agency under the program; directing the

13         agency to determine the medical and financial

14         eligibility standards for individuals seeking

15         services from the program and the criteria for

16         mental health care providers to participate in

17         the program; providing for agreements with

18         other governmental programs and institutions;

19         providing for oversight; providing rulemaking

20         authority; requiring a report to the Governor

21         and Legislature; providing an effective date.

22  

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

24  

25         Section 1.  Section 409.91225, Florida Statutes, is

26  created to read:

27         409.91225  Mental Health Care Provider Service Network

28  pilot program.--

29         (1)  The Agency for Health Care Administration, in

30  cooperation with the Department of Children and Family

31  Services, shall develop a pilot program in the department's

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    Florida Senate - 2005                                  SB 1524
    34-1139A-05                                         See HB 493




 1  service district 10 to deliver mental health care services as

 2  a form of managed care under the MediPass program.

 3         (2)  The Legislature intends that the Mental Health

 4  Care Provider Service Network pilot program:

 5         (a)  Provide to persons with mental health care needs a

 6  family-centered, comprehensive, and coordinated managed system

 7  of mental health care.

 8         (b)  Provide essential preventive, evaluative, and

 9  early intervention services for persons at risk for or having

10  mental health care needs in order to prevent or reduce the

11  occurrence, severity, duration, and disabling aspects of

12  mental, emotional, and behavioral disorders.

13         (3)  The Agency for Health Care Administration shall

14  have the following powers, duties, and responsibilities with

15  respect to the Mental Health Care Provider Service Network

16  pilot program:

17         (a)  To provide or contract for the provision of mental

18  health care services to eligible individuals.

19         (b)  To determine the medical and financial eligibility

20  standards for the program and to determine the medical and

21  financial eligibility of individuals seeking mental health

22  care services from the program.

23         (c)  To recommend priorities for the implementation of

24  comprehensive plans and budgets.

25         (d)  To coordinate a comprehensive delivery system for

26  eligible individuals to take maximum advantage of all

27  available funds.

28         (e)  To promote, establish, and coordinate programs

29  relating to mental health care services in cooperation with

30  other public and private agencies and to coordinate funding of

31  

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    Florida Senate - 2005                                  SB 1524
    34-1139A-05                                         See HB 493




 1  mental health care programs with federal, state, or local

 2  mental health care funding mechanisms.

 3         (f)  To initiate, coordinate, and request review of

 4  applications to federal and state agencies for funds,

 5  services, or commodities relating to mental health care

 6  programs.

 7         (g)  To sponsor or promote grants for projects,

 8  programs, educational activities, or research in the field of

 9  mental health care, with an emphasis on early diagnosis and

10  treatment.

11         (h)  To oversee and operate the program.

12         (i)  To establish reimbursement mechanisms for the

13  program.

14         (j)  To establish program standards and credentialing

15  requirements for mental health care providers and mental

16  health care services.

17         (k)  To monitor the provision of mental health care

18  services in the program, including the utilization and quality

19  of mental health care services.

20         (l)  To establish and operate a grievance resolution

21  process for participants and mental health care providers.

22         (m)  To maintain integrity in the program.

23         (n)  To establish the criteria to designate mental

24  health care providers to participate in the program. The

25  agency shall follow, whenever available, national guidelines

26  for selecting mental health care providers.

27         (o)  To establish mental health care provider

28  agreements for participation in the program.

29         (p)  To require that all mental health care providers

30  under contract with the program be duly licensed in the state,

31  

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2005                                  SB 1524
    34-1139A-05                                         See HB 493




 1  if such licensure is available, and meet other criteria as may

 2  be established by the agency.

 3         (q)  To initiate agreements with other state or local

 4  governmental programs or institutions for the coordination of

 5  mental health care to eligible individuals receiving services

 6  from such programs or institutions.

 7         (r)  To operate a system to oversee the activities of

 8  program participants, mental health care providers, and their

 9  representatives in order to prevent fraudulent or abusive

10  behavior, overutilization or duplicative utilization, and

11  neglect of participants and to recover overpayments as

12  appropriate. For the purposes of this paragraph, the terms

13  "abuse" and "fraud" have the meanings provided in s. 409.913.

14  The agency shall refer incidents of suspected fraud, abuse,

15  and overutilization and duplicative utilization to the

16  appropriate regulatory agency.

17         (4)  The Agency for Health Care Administration shall

18  adopt rules pursuant to ss. 120.536(1) and 120.54 to implement

19  and administer the Mental Health Care Provider Service Network

20  pilot program as provided in this section.

21         Section 2.  The Agency for Health Care Administration

22  shall prepare an evaluation of the Mental Health Care Provider

23  Service Network pilot program created under section 409.91225,

24  Florida Statutes, including recommendations for the future of

25  the program, and submit the report to the Governor, the

26  President of the Senate, and the Speaker of the House of

27  Representatives before the convening of the next regular

28  session of the Legislature.

29         Section 3.  This act shall take effect July 1, 2005.

30  

31  

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