Florida Senate - 2015                             CS for SB 7068
       
       
        
       By the Committees on Children, Families, and Elder Affairs; and
       Appropriations
       
       
       
       
       586-03410-15                                          20157068c1
    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 exclude 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, in consultation with the Agency for
   22         Health Care Administration, modify certain licensure
   23         rules and procedures; amending s. 394.9082, F.S.;
   24         revising Legislative findings and intent; redefining
   25         terms; requiring the managing entities, rather than
   26         the department, to develop and implement a plan with a
   27         certain purpose; requiring the regional network to
   28         offer access to certain services; requiring the plan
   29         to be developed in a certain manner; requiring the
   30         department to designate the regional network as a
   31         coordinated care organization after certain conditions
   32         are met; removing a provision providing legislative
   33         intent; requiring the department to contract with
   34         community-based managing entities for the development
   35         of 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; requiring the
   72         department and the Agency for Health Care
   73         Administration to make certain recommendations to the
   74         Governor and the Legislature by a specified date;
   75         providing requirements for a provider; amending s.
   76         409.967, F.S.; requiring that certain plans or
   77         contracts include specified requirements; amending s.
   78         409.973, F.S.; requiring each plan operating in the
   79         managed medical assistance program to work with the
   80         managing entity to establish specific organizational
   81         supports and service protocols; amending s. 409.975,
   82         F.S.; revising the categories from which the agency
   83         must determine which providers are essential Medicaid
   84         providers; repealing s. 394.4674, F.S., relating to a
   85         plan and report; repealing s. 394.4985, F.S., relating
   86         to districtwide information and referral network and
   87         implementation; repealing s. 394.657, F.S., relating
   88         to county planning councils or committees; repealing
   89         s. 394.745, F.S., relating to an annual report and
   90         compliance of providers under contract with the
   91         department; repealing s. 397.331, F.S., relating to
   92         definitions; repealing s. 397.333, F.S., relating to
   93         the Statewide Drug Policy Advisory Council; repealing
   94         s. 397.801, F.S., relating to substance abuse
   95         impairment coordination; repealing s. 397.811, F.S.,
   96         relating to juvenile substance abuse impairment
   97         coordination; repealing s. 397.821, F.S., relating to
   98         juvenile substance abuse impairment prevention and
   99         early intervention councils; repealing s. 397.901,
  100         F.S., relating to prototype juvenile addictions
  101         receiving facilities; repealing s. 397.93, F.S.,
  102         relating to children’s substance abuse services and
  103         target populations; repealing s. 397.94, F.S.,
  104         relating to children’s substance abuse services and
  105         the information and referral network; repealing s.
  106         397.951, F.S., relating to treatment and sanctions;
  107         repealing s. 397.97, F.S., relating to children’s
  108         substance abuse services and demonstration models;
  109         amending ss. 397.321, 397.98, 409.966, 943.031, and
  110         943.042, F.S.; conforming provisions and cross
  111         references to changes made by the act; reenacting ss.
  112         39.407(6)(a), 394.67(21), 394.674(1)(b), 394.676(1),
  113         409.1676(2)(c), and 409.1677(1)(b), F.S., relating to
  114         the term “suitable for residential treatment” or
  115         “suitability,” the term “residential treatment center
  116         for children and adolescents,” children’s mental
  117         health services, the indigent psychiatric medication
  118         program, and the term “serious behavioral problems,”
  119         respectively, to incorporate the amendment made to s.
  120         394.492, F.S., in references thereto; providing
  121         effective dates.
  122          
  123  Be It Enacted by the Legislature of the State of Florida:
  124  
  125         Section 1. Subsection (18) of section 394.455, Florida
  126  Statutes, is amended to read:
  127         394.455 Definitions.—As used in this part, unless the
  128  context clearly requires otherwise, the term:
  129         (18) “Mental illness” means an impairment of the mental or
  130  emotional processes that exercise conscious control of one’s
  131  actions or of the ability to perceive or understand reality,
  132  which impairment substantially interferes with the person’s
  133  ability to meet the ordinary demands of living. For the purposes
  134  of this part, the term does not include a developmental
  135  disability as defined in chapter 393, dementia, traumatic brain
  136  injuries, intoxication, or conditions manifested only by
  137  antisocial behavior or substance abuse impairment.
  138         Section 2. Subsections (1), (4), and (6) of section
  139  394.492, Florida Statutes, are amended to read:
  140         394.492 Definitions.—As used in ss. 394.490-394.497, the
  141  term:
  142         (1) “Adolescent” means a person who is at least 13 years of
  143  age but under 18 21 years of age.
  144         (4) “Child or adolescent at risk of emotional disturbance”
  145  means a person under 18 21 years of age who has an increased
  146  likelihood of becoming emotionally disturbed because of risk
  147  factors that include, but are not limited to:
  148         (a) Being homeless.
  149         (b) Having a family history of mental illness.
  150         (c) Being physically or sexually abused or neglected.
  151         (d) Abusing alcohol or other substances.
  152         (e) Being infected with human immunodeficiency virus (HIV).
  153         (f) Having a chronic and serious physical illness.
  154         (g) Having been exposed to domestic violence.
  155         (h) Having multiple out-of-home placements.
  156         (6) “Child or adolescent who has a serious emotional
  157  disturbance or mental illness” means a person under 18 21 years
  158  of age who:
  159         (a) Is diagnosed as having a mental, emotional, or
  160  behavioral disorder that meets one of the diagnostic categories
  161  specified in the most recent edition of the Diagnostic and
  162  Statistical Manual of Mental Disorders of the American
  163  Psychiatric Association; and
  164         (b) Exhibits behaviors that substantially interfere with or
  165  limit his or her role or ability to function in the family,
  166  school, or community, which behaviors are not considered to be a
  167  temporary response to a stressful situation.
  168  
  169  The term includes a child or adolescent who meets the criteria
  170  for involuntary placement under s. 394.467(1).
  171         Section 3. Section 394.761, Florida Statutes, is created to
  172  read:
  173         394.761 Revenue maximization.—The agency and the department
  174  shall develop a plan to obtain federal approval for increasing
  175  the availability of federal Medicaid funding for behavioral
  176  health care. Increased funding will be used to advance the goal
  177  of improved integration of behavioral health and primary care
  178  services through development and effective implementation of
  179  coordinated care organizations as described in s. 394.9082(3).
  180  The agency and the department shall submit the written plan to
  181  the President of the Senate and the Speaker of the House of
  182  Representatives no later than November 1, 2015. The plan shall
  183  identify the amount of general revenue funding appropriated for
  184  mental health and substance abuse services which is eligible to
  185  be used as state Medicaid match. The plan must evaluate
  186  alternative uses of increased Medicaid funding, including
  187  expansion of Medicaid eligibility for the severely and
  188  persistently mentally ill; increased reimbursement rates for
  189  behavioral health services; adjustments to the capitation rate
  190  for Medicaid enrollees with chronic mental illness and substance
  191  use disorders; supplemental payments to mental health and
  192  substance abuse providers through a designated state health
  193  program or other mechanisms; and innovative programs for
  194  incentivizing improved outcomes for behavioral health
  195  conditions. The plan shall identify the advantages and
  196  disadvantages of each alternative and assess the potential of
  197  each for achieving improved integration of services. The plan
  198  shall identify the types of federal approvals necessary to
  199  implement each alternative and project a timeline for
  200  implementation.
  201         Section 4. Subsection (11) is added to section 394.875,
  202  Florida Statutes, to read:
  203         394.875 Crisis stabilization units, residential treatment
  204  facilities, and residential treatment centers for children and
  205  adolescents; authorized services; license required.—
  206         (11)No later than January 1, 2016, the department, in
  207  consultation with the agency, shall modify licensure rules and
  208  procedures to create an option for a single, consolidated
  209  license for a provider who offers multiple types of mental
  210  health and substance abuse services regulated under this chapter
  211  and chapter 397 pursuant to s. 397.402.
  212         Section 5. Effective upon this act becoming a law, section
  213  394.9082, Florida Statutes, is amended to read:
  214         394.9082 Behavioral health managing entities.—
  215         (1) LEGISLATIVE FINDINGS AND INTENT.—The Legislature finds
  216  that untreated behavioral health disorders constitute major
  217  health problems for residents of this state, are a major
  218  economic burden to the citizens of this state, and substantially
  219  increase demands on the state’s juvenile and adult criminal
  220  justice systems, the child welfare system, and health care
  221  systems. The Legislature finds that behavioral health disorders
  222  respond to appropriate treatment, rehabilitation, and supportive
  223  intervention. The Legislature finds that the state’s return on
  224  its it has made a substantial long-term investment in the
  225  funding of the community-based behavioral health prevention and
  226  treatment service systems and facilities can be enhanced by
  227  integration of these services with primary care in order to
  228  provide critical emergency, acute care, residential, outpatient,
  229  and rehabilitative and recovery-based services. The Legislature
  230  finds that local communities have also made substantial
  231  investments in behavioral health services, contracting with
  232  safety net providers who by mandate and mission provide
  233  specialized services to vulnerable and hard-to-serve populations
  234  and have strong ties to local public health and public safety
  235  agencies. The Legislature finds that a regional management
  236  structure for that places the responsibility for publicly
  237  financed behavioral health treatment and prevention services
  238  within a single private, nonprofit entity at the local level
  239  will improve promote improved access to care, promote service
  240  continuity, and provide for more efficient and effective
  241  delivery of substance abuse and mental health services. The
  242  Legislature finds that streamlining administrative processes
  243  will create cost efficiencies and provide flexibility to better
  244  match available services to consumers’ identified needs.
  245         (2) DEFINITIONS.—As used in this section, the term:
  246         (a) “Behavioral health services” means mental health
  247  services and substance abuse prevention and treatment services
  248  as defined in this chapter and chapter 397 which are provided
  249  using state and federal funds.
  250         (b) “Decisionmaking model” means a comprehensive management
  251  information system needed to answer the following management
  252  questions at the federal, state, regional, circuit, and local
  253  provider levels: who receives what services from which providers
  254  with what outcomes and at what costs?
  255         (b)(c) “Geographic area” means a county, circuit, regional,
  256  or a region as described in s. 409.966 multiregional area in
  257  this state.
  258         (c)(d) “Managing entity” means a corporation that is
  259  organized in this state, is designated or filed as a nonprofit
  260  organization under s. 501(c)(3) of the Internal Revenue Code,
  261  and is under contract to the department to manage the day-to-day
  262  operational delivery of behavioral health services as of July 1,
  263  2015 through an organized system of care.
  264         (e) “Provider networks” mean the direct service agencies
  265  that are under contract with a managing entity and that together
  266  constitute a comprehensive array of emergency, acute care,
  267  residential, outpatient, recovery support, and consumer support
  268  services.
  269         (3) COORDINATED CARE ORGANIZATIONS SERVICE DELIVERY
  270  STRATEGIES.—The department may work through managing entities
  271  shall to develop and implement a plan to create a coordinated
  272  regional network of behavioral health service providers. The
  273  regional network must offer access to a comprehensive range of
  274  services and continuity of care for service delivery strategies
  275  that will improve the coordination, integration, and management
  276  of the delivery of behavioral health services to people with who
  277  have mental illness or substance use disorders. The plan must be
  278  developed through a collaborative process between the managing
  279  entity and providers in the region. The department shall
  280  designate the regional network as a coordinated care
  281  organization after the relationships, linkages, and interactions
  282  among network providers are formalized through written
  283  agreements that establish common protocols for intake and
  284  assessment, mechanisms for data sharing, joint operational
  285  procedures, and integrated care planning and case management. It
  286  is the intent of the Legislature that a well-managed service
  287  delivery system will increase access for those in need of care,
  288  improve the coordination and continuity of care for vulnerable
  289  and high-risk populations, and redirect service dollars from
  290  restrictive care settings to community-based recovery services.
  291         (4) CONTRACT FOR SERVICES.—
  292         (a) The department must may contract for the purchase and
  293  management of behavioral health services with community-based
  294  managing entities for the development of a regional coordinated
  295  care organization, network management services, and the
  296  administrative functions defined in subsection (6). The
  297  department may require a managing entity to contract for
  298  specialized services that are not currently part of the managing
  299  entity’s network if the department determines that to do so is
  300  in the best interests of consumers of services. The secretary
  301  shall determine the schedule for phasing in contracts with
  302  managing entities. The managing entities shall, at a minimum, be
  303  accountable for the operational oversight of the delivery of
  304  behavioral health services funded by the department and for the
  305  collection and submission of the required data pertaining to
  306  these contracted services. A managing entity shall serve a
  307  geographic area designated by the department. The geographic
  308  area must be of sufficient size in population and have enough
  309  public funds for behavioral health services to allow for
  310  flexibility and maximum efficiency.
  311         (b) The operating costs of the managing entity contract
  312  shall be funded through funds from the department and any
  313  savings and efficiencies achieved through the implementation of
  314  managing entities when realized by their participating provider
  315  network agencies. The department recognizes that managing
  316  entities will have infrastructure development costs during
  317  start-up so that any efficiencies to be realized by providers
  318  from consolidation of management functions, and the resulting
  319  savings, will not be achieved during the early years of
  320  operation. The department shall negotiate a reasonable and
  321  appropriate administrative cost rate with the managing entity.
  322  The Legislature intends that reduced local and state contract
  323  management and other administrative duties passed on to the
  324  managing entity allows funds previously allocated for these
  325  purposes to be proportionately reduced and the savings used to
  326  purchase the administrative functions of the managing entity.
  327  Policies and procedures of the department for monitoring
  328  contracts with managing entities shall include provisions for
  329  eliminating duplication of the department’s and the managing
  330  entities’ contract management and other administrative
  331  activities in order to achieve the goals of cost-effectiveness
  332  and regulatory relief. To the maximum extent possible, provider
  333  monitoring activities shall be assigned to the managing entity.
  334         (c) The contract with each managing entity must be
  335  performance-based and contain specific results, measureable
  336  performance standards and timelines, and identify penalties for
  337  failure to timely plan and implement a regional, coordinated
  338  care organization, to meet other specific performance standards,
  339  including financial management, or other contractual
  340  requirements. The contract must have a schedule of penalties
  341  scaled to the nature and significance of the managing entity’s
  342  failure to perform. Such penalties may include, but are not
  343  limited to, a corrective action plan, liquidated damages, or
  344  termination of the contract. The contract must provide a
  345  reasonable opportunity for managing entities to implement
  346  corrective actions, but must require progress toward achievement
  347  of the performance standards identified in paragraph (e)
  348  Contracting and payment mechanisms for services must promote
  349  clinical and financial flexibility and responsiveness and must
  350  allow different categorical funds to be integrated at the point
  351  of service. The plan for coordination and integration of
  352  services required by subsection (3) shall be developed based on
  353  contracted service array must be determined by using public
  354  input and, needs assessment, and must incorporate promising,
  355  evidence-based and promising best practice models. The
  356  department may employ care management methodologies, prepaid
  357  capitation, and case rate or other methods of payment which
  358  promote flexibility, efficiency, and accountability.
  359         (d)The department shall establish a 3-year performance
  360  based contract with each managing entity by July 1, 2017. For
  361  managing entities selected after the effective date of this act,
  362  the department shall use a performance-based contract that meets
  363  the requirements of this section. For managing entities with
  364  contracts subject to renewal on or before July 1, 2015, the
  365  department may renew, or if available, extend a contract under
  366  s. 287.057(12), but contracts with such managing entities must
  367  meet the requirements of this section by July 1, 2017.
  368         (e)If the department terminates a contract with a managing
  369  entity due to failure to establish a coordinated care
  370  organization or meet other contractual requirements, the
  371  department must issue an invitation to negotiate in order to
  372  select a new managing entity. The new managing entity must be
  373  either a managing entity in another region, a Medicaid managed
  374  care organization operating in the same region, a behavioral
  375  health organization contracted with a Medicaid managed care
  376  organization operating in the same region, or a behavioral
  377  health specialty managed care organization established pursuant
  378  to part IV of chapter 409. The department shall consider the
  379  input and recommendations of network providers in the selection
  380  of the new contractor. The invitation to negotiate shall specify
  381  the criteria and the relative weight of the criteria that will
  382  be used in selecting the new contractor. The department must
  383  consider all of the following factors:
  384         1.Experience serving persons with mental health and
  385  substance use disorders.
  386         2.Establishment of community partnerships with behavioral
  387  health providers.
  388         3.Demonstrated organizational capabilities for network
  389  management functions.
  390         4.Capability to integrate behavioral health with primary
  391  care services.
  392         (5) GOALS.—The primary goal of the coordinated care
  393  organization service delivery strategies is to improve outcomes
  394  for persons needing provide a design for an effective
  395  coordination, integration, and management approach for
  396  delivering effective behavioral health services to persons who
  397  are experiencing a mental health or substance abuse crisis, who
  398  have a disabling mental illness or a substance use or co
  399  occurring disorder, and require extended services in order to
  400  recover from their illness, or who need brief treatment or
  401  longer-term supportive interventions to avoid a crisis or
  402  disability. Other goals include:
  403         (a) Improving Accountability for measureable and
  404  transparent a local system of behavioral health care services to
  405  meet performance outcomes and standards through the use of
  406  reliable and timely data.
  407         (b) Enhancing the Continuity of care for all children,
  408  adolescents, and adults who receive services from the
  409  coordinated care organization enter the publicly funded
  410  behavioral health service system.
  411         (c) Value-based purchasing of behavioral health services
  412  that maximizes the return on investment to local, state, and
  413  federal funding sources Preserving the “safety net” of publicly
  414  funded behavioral health services and providers, and recognizing
  415  and ensuring continued local contributions to these services, by
  416  establishing locally designed and community-monitored systems of
  417  care.
  418         (d) Providing Early diagnosis and treatment interventions
  419  to enhance recovery and prevent hospitalization.
  420         (e) Regional service delivery systems that are responsive
  421  to Improving the assessment of local needs for behavioral health
  422  services.
  423         (f) Quality care that is provided using Improving the
  424  overall quality of behavioral health services through the use of
  425  evidence-based, best practice, and promising practice models.
  426         (g) Demonstrating improved service Integration of between
  427  behavioral health services programs and other programs, such as
  428  vocational rehabilitation, education, child welfare, primary
  429  health care, emergency services, juvenile justice, and criminal
  430  justice.
  431         (h) Providing for additional testing of creative and
  432  flexible strategies for financing behavioral health services to
  433  enhance individualized treatment and support services.
  434         (i) Promoting cost-effective quality care.
  435         (j) Working with the state to coordinate admissions and
  436  discharges from state civil and forensic hospitals and
  437  coordinating admissions and discharges from residential
  438  treatment centers.
  439         (k) Improving the integration, accessibility, and
  440  dissemination of behavioral health data for planning and
  441  monitoring purposes.
  442         (l) Promoting specialized behavioral health services to
  443  residents of assisted living facilities.
  444         (m) Working with the state and other stakeholders to reduce
  445  the admissions and the length of stay for dependent children in
  446  residential treatment centers.
  447         (n) Providing services to adults and children with co
  448  occurring disorders of mental illnesses and substance abuse
  449  problems.
  450         (o) Providing services to elder adults in crisis or at-risk
  451  for placement in a more restrictive setting due to a serious
  452  mental illness or substance abuse.
  453         (6) ESSENTIAL ELEMENTS.—It is the intent of the Legislature
  454  that the department may plan for and enter into contracts with
  455  managing entities to manage care in geographical areas
  456  throughout the state.
  457         (a) A coordinated care organization must consist of a
  458  comprehensive network of providers working together to offer a
  459  patient-centered system of care which provides or arranges for
  460  the following elements: The managing entity must demonstrate the
  461  ability of its network of providers to comply with the pertinent
  462  provisions of this chapter and chapter 397 and to ensure the
  463  provision of comprehensive behavioral health services. The
  464  network of providers must include, but need not be limited to,
  465  community mental health agencies, substance abuse treatment
  466  providers, and best practice consumer services providers.
  467         1.A centralized receiving facility or coordinated
  468  receiving system for persons needing evaluation pursuant to s.
  469  394.463 or s. 397.675.
  470         2.Crisis services, including mobile response teams and
  471  crisis stabilization units.
  472         3. Case management.
  473         4.Outpatient services.
  474         5. Residential services.
  475         6. Hospital inpatient care.
  476         7.Aftercare and other postdischarge services.
  477         8.Recovery support, including housing assistance and
  478  support for competitive employment, educational attainment,
  479  independent living skills development, family support and
  480  education, and wellness management and self-care.
  481         9.Medical services necessary for integration of behavioral
  482  health services with primary care.
  483         10. Prevention and outreach services.
  484         11. Medication assisted treatment.
  485         12. Detoxification services.
  486         (b) The department shall terminate its mental health or
  487  substance abuse provider contracts for services to be provided
  488  by the managing entity at the same time it contracts with the
  489  managing entity.
  490         (b)(c) The managing entity shall ensure that its provider
  491  network shall initially include all is broadly conceived. All
  492  mental health or substance abuse treatment providers currently
  493  receiving public funds pursuant to this chapter or chapter 397.
  494  Continued participation in the network is subject to credentials
  495  and performance standards set by the managing entity and
  496  approved by the department under contract with the department
  497  shall be offered a contract by the managing entity.
  498         (c)(d) The network management and administrative functions
  499  of the department may contract with managing entities to provide
  500  the following core functions include:
  501         1. Financial management accountability.
  502         2. Allocation of funds to network providers in a manner
  503  that reflects the department’s strategic direction and plans.
  504         3. Provider monitoring to ensure compliance with federal
  505  and state laws, rules, and regulations.
  506         4. Data collection, reporting, and analysis.
  507         5. Information systems necessary for the delivery of
  508  coordinated care and integrated services Operational plans to
  509  implement objectives of the department’s strategic plan.
  510         6. Contract compliance.
  511         7. Performance measurement based on nationally recognized
  512  standards such as those developed by the National Quality Forum,
  513  the National Committee for Quality Assurance, or similar
  514  credible sources management.
  515         8. Collaboration with community stakeholders, including
  516  local government.
  517         9. System of care through network development.
  518         9.10. Consumer care coordination.
  519         10.11. Continuous quality improvement.
  520         12. Timely access to appropriate services.
  521         13. Cost-effectiveness and system improvements.
  522         14. Assistance in the development of the department’s
  523  strategic plan.
  524         15. Participation in community, circuit, regional, and
  525  state planning.
  526         11.16. Resource management and maximization, including
  527  pursuit of third-party payments and grant applications.
  528         12.17. Incentives for providers to improve quality and
  529  access.
  530         13.18. Liaison with consumers.
  531         14.19. Community needs assessment.
  532         15.20. Securing local matching funds.
  533         (d) The managing entity shall support network providers to
  534  offer comprehensive and coordinated care to all persons in need,
  535  but may develop a prioritization framework when necessary to
  536  make the best use of limited resources. Priority populations
  537  include:
  538         1. Individuals in crisis stabilization units who are on the
  539  waitlist for placement in a state treatment facility;
  540         2. Individuals in state treatment facilities on the
  541  waitlist for community care;
  542         3. Parents or caretakers with child welfare involvement;
  543         4. Individuals with multiple arrests and incarceration as a
  544  result of their behavioral health condition; and
  545         5. Individuals with behavioral health disorders and
  546  comorbidities consistent with the characteristics of patients in
  547  the region’s population of behavioral health service users who
  548  account for a disproportionately high percentage of service
  549  expenditures.
  550         (e) The managing entity shall ensure that written
  551  cooperative agreements are developed and implemented among the
  552  criminal and juvenile justice systems, the local community-based
  553  care network, and the local behavioral health providers in the
  554  geographic area which define strategies and alternatives for
  555  diverting people who have mental illness and substance abuse
  556  problems from the criminal justice system to the community.
  557  These agreements must also address the provision of appropriate
  558  services to persons who have behavioral health problems and
  559  leave the criminal justice system.
  560         (f) Managing entities must collect and submit data to the
  561  department regarding persons served, outcomes of persons served,
  562  and the costs of services provided through the department’s
  563  contract. The managing entity must use a unique identifier
  564  developed by the department for each person served. All
  565  providers under contract with the managing entity shall use the
  566  unique identifier in order to coordinate care and the delivery
  567  of services by January 1, 2016. The department shall evaluate
  568  managing entity services based on consumer-centered outcome
  569  measures that reflect national standards that can dependably be
  570  measured. The department shall work with managing entities to
  571  establish performance standards related to:
  572         1. The extent to which individuals in the community receive
  573  services.
  574         2. The improvement of quality of care for individuals
  575  served.
  576         3. The success of strategies to divert jail, prison, and
  577  forensic facility admissions.
  578         4. Consumer and family satisfaction.
  579         5. The satisfaction of key community constituents such as
  580  law enforcement agencies, juvenile justice agencies, the courts,
  581  the schools, local government entities, hospitals, and others as
  582  appropriate for the geographical area of the managing entity.
  583         (g) The Agency for Health Care Administration may establish
  584  a certified match program, which must be voluntary. Under a
  585  certified match program, reimbursement is limited to the federal
  586  Medicaid share to Medicaid-enrolled strategy participants. The
  587  agency may take no action to implement a certified match program
  588  unless the consultation provisions of chapter 216 have been met.
  589  The agency may seek federal waivers that are necessary to
  590  implement the behavioral health service delivery strategies.
  591         (7) MANAGING ENTITY REQUIREMENTS.—The department may adopt
  592  rules and contractual standards related to and a process for the
  593  qualification and operation of managing entities which are
  594  based, in part, on the following criteria:
  595         (a) As of December 31, 2015, the department shall verify
  596  that each a managing entity’s governing board meets the
  597  requirements of this section. governance structure shall be
  598  representative and shall, at a minimum, include consumers and
  599  family members, appropriate community stakeholders and
  600  organizations, and providers of substance abuse and mental
  601  health services as defined in this chapter and chapter 397. If
  602  there are one or more private-receiving facilities in the
  603  geographic coverage area of a managing entity, the managing
  604  entity shall have one representative for the private-receiving
  605  facilities as an ex officio member of its board of directors.
  606         1. The composition of the board shall be broadly
  607  representative of the community and include consumers and family
  608  members, community organizations that do not contract with the
  609  managing entity, local governments, area law enforcement
  610  agencies, business leaders, local providers of child welfare
  611  services, health care professionals, and representatives of
  612  health care facilities.
  613         2. The managing entity must establish a technical advisory
  614  panel consisting of providers of mental health and substance
  615  abuse services that selects at least one member to serve as an
  616  ex officio member of the governing board.
  617         (b) The managing entity must create a transparent process
  618  for nomination and selection of board members and must adopt a
  619  procedure for establishing staggered term limits which ensures
  620  that no individual serves more than 8 consecutive years on the
  621  governing board A managing entity that was originally formed
  622  primarily by substance abuse or mental health providers must
  623  present and demonstrate a detailed, consensus approach to
  624  expanding its provider network and governance to include both
  625  substance abuse and mental health providers.
  626         (c) A managing entity must submit a network management plan
  627  and budget in a form and manner determined by the department.
  628  The plan must detail the means for implementing the duties to be
  629  contracted to the managing entity and the efficiencies to be
  630  anticipated by the department as a result of executing the
  631  contract. The department may require modifications to the plan
  632  and must approve the plan before contracting with a managing
  633  entity. The department may contract with a managing entity that
  634  demonstrates readiness to assume core functions, and may
  635  continue to add functions and responsibilities to the managing
  636  entity’s contract over time as additional competencies are
  637  developed as identified in paragraph (g). Notwithstanding other
  638  provisions of this section, the department may continue and
  639  expand managing entity contracts if the department determines
  640  that the managing entity meets the requirements specified in
  641  this section.
  642         (d) Notwithstanding paragraphs (b) and (c), a managing
  643  entity that is currently a fully integrated system providing
  644  mental health and substance abuse services, Medicaid, and child
  645  welfare services is permitted to continue operating under its
  646  current governance structure as long as the managing entity can
  647  demonstrate to the department that consumers, other
  648  stakeholders, and network providers are included in the planning
  649  process.
  650         (d)(e) Managing entities shall operate in a transparent
  651  manner, providing public access to information, notice of
  652  meetings, and opportunities for broad public participation in
  653  decisionmaking. The managing entity’s network management plan
  654  must detail policies and procedures that ensure transparency.
  655         (e)(f) Before contracting with a managing entity, the
  656  department must perform an onsite readiness review of a managing
  657  entity to determine its operational capacity to satisfactorily
  658  perform the duties to be contracted.
  659         (f)(g) The department shall engage community stakeholders,
  660  including providers and managing entities under contract with
  661  the department, in the development of objective standards to
  662  measure the competencies of managing entities and their
  663  readiness to assume the responsibilities described in this
  664  section, and the outcomes to hold them accountable.
  665         (8) DEPARTMENT RESPONSIBILITIES.—With the introduction of
  666  managing entities to monitor department-contracted providers’
  667  day-to-day operations, the department and its regional and
  668  circuit offices will have increased ability to focus on broad
  669  systemic substance abuse and mental health issues. After the
  670  department enters into a managing entity contract in a
  671  geographic area, the regional and circuit offices of the
  672  department in that area shall direct their efforts primarily to
  673  monitoring the managing entity contract, including negotiation
  674  of system quality improvement goals each contract year, and
  675  review of the managing entity’s plans to execute department
  676  strategic plans; carrying out statutorily mandated licensure
  677  functions; conducting community and regional substance abuse and
  678  mental health planning; communicating to the department the
  679  local needs assessed by the managing entity; preparing
  680  department strategic plans; coordinating with other state and
  681  local agencies; assisting the department in assessing local
  682  trends and issues and advising departmental headquarters on
  683  local priorities; and providing leadership in disaster planning
  684  and preparation.
  685         (8)(9) FUNDING FOR MANAGING ENTITIES.—
  686         (a) A contract established between the department and a
  687  managing entity under this section shall be funded by general
  688  revenue, other applicable state funds, or applicable federal
  689  funding sources. A managing entity may carry forward documented
  690  unexpended state funds from one fiscal year to the next;
  691  however, the cumulative amount carried forward may not exceed 8
  692  percent of the total contract. Any unexpended state funds in
  693  excess of that percentage must be returned to the department.
  694  The funds carried forward may not be used in a way that would
  695  create increased recurring future obligations or for any program
  696  or service that is not currently authorized under the existing
  697  contract with the department. Expenditures of funds carried
  698  forward must be separately reported to the department. Any
  699  unexpended funds that remain at the end of the contract period
  700  shall be returned to the department. Funds carried forward may
  701  be retained through contract renewals and new procurements as
  702  long as the same managing entity is retained by the department.
  703         (b) The method of payment for a fixed-price contract with a
  704  managing entity must provide for a 2-month advance payment at
  705  the beginning of each fiscal year and equal monthly payments
  706  thereafter.
  707         (10) REPORTING.—Reports of the department’s activities,
  708  progress, and needs in achieving the goal of contracting with
  709  managing entities in each circuit and region statewide must be
  710  submitted to the appropriate substantive and appropriations
  711  committees in the Senate and the House of Representatives on
  712  January 1 and July 1 of each year until the full transition to
  713  managing entities has been accomplished statewide.
  714         (9)(11) RULES.—The department may shall adopt rules to
  715  administer this section and, as necessary, to further specify
  716  requirements of managing entities.
  717         Section 6. Section 397.402, Florida Statutes, is created to
  718  read:
  719         397.402 Single, consolidated license.—No later than January
  720  1, 2016, the department, in consultation with the Agency for
  721  Health Care Administration, shall modify licensure rules and
  722  procedures to create an option for a single, consolidated
  723  license for a provider that offers multiple types of mental
  724  health and substance abuse services regulated under this chapter
  725  and chapter 394. Providers eligible for a consolidated license
  726  must operate these services through a single corporate entity
  727  and a unified management structure. Any provider serving both
  728  adults and children must meet department standards for separate
  729  facilities and other requirements necessary to ensure the safety
  730  of children and promote therapeutic efficacy. The department and
  731  the Agency for Health Care Administration shall recommend to the
  732  Governor, the President of the Senate, and the Speaker of the
  733  House of Representatives any revisions to the Florida Statutes
  734  needed to further implement the intent of this section by
  735  December 1, 2015.
  736         Section 7. Present paragraphs (d) through (m) of subsection
  737  (2) of section 409.967, Florida Statutes, are redesignated as
  738  paragraphs (e) through (n), respectively, and a new paragraph
  739  (d) is added to that subsection, to read:
  740         409.967 Managed care plan accountability.—
  741         (2) The agency shall establish such contract requirements
  742  as are necessary for the operation of the statewide managed care
  743  program. In addition to any other provisions the agency may deem
  744  necessary, the contract must require:
  745         (d) Quality care.—Managed care plans shall provide, or
  746  contract for the provision of, care coordination to facilitate
  747  the appropriate delivery of behavioral health care services in
  748  the least restrictive setting with treatment and recovery
  749  capabilities that address the needs of the patient. Services
  750  shall be provided in a manner that integrates behavioral health
  751  services and primary care. Plans shall be required to achieve
  752  specific behavioral health outcome standards, established by the
  753  agency in consultation with the Department of Children and
  754  Families.
  755         Section 8. Subsection (5) is added to section 409.973,
  756  Florida Statutes, to read:
  757         409.973 Benefits.—
  758         (5) INTEGRATED BEHAVIORAL HEALTH INITIATIVE.—Each plan
  759  operating in the managed medical assistance program shall work
  760  with the managing entity in its service area to establish
  761  specific organizational supports and service protocols that
  762  enhance the integration and coordination of primary care and
  763  behavioral health services for Medicaid recipients. Progress in
  764  this initiative will be measured using the integration framework
  765  and core measures developed by the Agency for Healthcare
  766  Research and Quality.
  767         Section 9. Paragraph (a) of subsection (1) of section
  768  409.975, Florida Statutes, is amended to read:
  769         409.975 Managed care plan accountability.—In addition to
  770  the requirements of s. 409.967, plans and providers
  771  participating in the managed medical assistance program shall
  772  comply with the requirements of this section.
  773         (1) PROVIDER NETWORKS.—Managed care plans must develop and
  774  maintain provider networks that meet the medical needs of their
  775  enrollees in accordance with standards established pursuant to
  776  s. 409.967(2)(c). Except as provided in this section, managed
  777  care plans may limit the providers in their networks based on
  778  credentials, quality indicators, and price.
  779         (a) Plans must include all providers in the region that are
  780  classified by the agency as essential Medicaid providers, unless
  781  the agency approves, in writing, an alternative arrangement for
  782  securing the types of services offered by the essential
  783  providers. Providers are essential for serving Medicaid
  784  enrollees if they offer services that are not available from any
  785  other provider within a reasonable access standard, or if they
  786  provided a substantial share of the total units of a particular
  787  service used by Medicaid patients within the region during the
  788  last 3 years and the combined capacity of other service
  789  providers in the region is insufficient to meet the total needs
  790  of the Medicaid patients. The agency may not classify physicians
  791  and other practitioners as essential providers. The agency, at a
  792  minimum, shall determine which providers in the following
  793  categories are essential Medicaid providers:
  794         1. Federally qualified health centers.
  795         2. Statutory teaching hospitals as defined in s.
  796  408.07(45).
  797         3. Hospitals that are trauma centers as defined in s.
  798  395.4001(14).
  799         4. Hospitals located at least 25 miles from any other
  800  hospital with similar services.
  801         5. Publicly funded behavioral health service providers.
  802  
  803  Managed care plans that have not contracted with all essential
  804  providers in the region as of the first date of recipient
  805  enrollment, or with whom an essential provider has terminated
  806  its contract, must negotiate in good faith with such essential
  807  providers for 1 year or until an agreement is reached, whichever
  808  is first. Payments for services rendered by a nonparticipating
  809  essential provider shall be made at the applicable Medicaid rate
  810  as of the first day of the contract between the agency and the
  811  plan. A rate schedule for all essential providers shall be
  812  attached to the contract between the agency and the plan. After
  813  1 year, managed care plans that are unable to contract with
  814  essential providers shall notify the agency and propose an
  815  alternative arrangement for securing the essential services for
  816  Medicaid enrollees. The arrangement must rely on contracts with
  817  other participating providers, regardless of whether those
  818  providers are located within the same region as the
  819  nonparticipating essential service provider. If the alternative
  820  arrangement is approved by the agency, payments to
  821  nonparticipating essential providers after the date of the
  822  agency’s approval shall equal 90 percent of the applicable
  823  Medicaid rate. If the alternative arrangement is not approved by
  824  the agency, payment to nonparticipating essential providers
  825  shall equal 110 percent of the applicable Medicaid rate.
  826         Section 10. Section 394.4674, Florida Statutes, is
  827  repealed.
  828         Section 11. Section 394.4985, Florida Statutes, is
  829  repealed.
  830         Section 12. Section 394.657, Florida Statutes, is repealed.
  831         Section 13. Section 394.745, Florida Statutes, is repealed.
  832         Section 14. Section 397.331, Florida Statutes, is repealed.
  833         Section 15. Section 397.333, Florida Statutes, is repealed.
  834         Section 16. Section 397.801, Florida Statutes, is repealed.
  835         Section 17. Section 397.811, Florida Statutes, is repealed.
  836         Section 18. Section 397.821, Florida Statutes, is repealed.
  837         Section 19. Section 397.901, Florida Statutes, is repealed.
  838         Section 20. Section 397.93, Florida Statutes, is repealed.
  839         Section 21. Section 397.94, Florida Statutes, is repealed.
  840         Section 22. Section 397.951, Florida Statutes, is repealed.
  841         Section 23. Section 397.97, Florida Statutes, is repealed.
  842         Section 24. Subsection (15) of section 397.321, Florida
  843  Statutes, is amended to read:
  844         397.321 Duties of the department.—The department shall:
  845         (15) Appoint a substance abuse impairment coordinator to
  846  represent the department in efforts initiated by the statewide
  847  substance abuse impairment prevention and treatment coordinator
  848  established in s. 397.801 and to assist the statewide
  849  coordinator in fulfilling the responsibilities of that position.
  850         Section 25. Subsection (1) of section 397.98, Florida
  851  Statutes, is amended to read:
  852         397.98 Children’s substance abuse services; utilization
  853  management.—
  854         (1) Utilization management shall be an integral part of
  855  each Children’s Network of Care Demonstration Model as described
  856  under s. 397.97. The utilization management process shall
  857  include procedures for analyzing the allocation and use of
  858  resources by the purchasing agent. Such procedures shall
  859  include:
  860         (a) Monitoring the appropriateness of admissions to
  861  residential services or other levels of care as determined by
  862  the department.
  863         (b) Monitoring the duration of care.
  864         (c) Developing profiles of network providers which describe
  865  their patterns of delivering care.
  866         (d) Authorizing care for high-cost services.
  867         Section 26. Paragraph (e) of subsection (3) of section
  868  409.966, Florida Statutes, is amended to read:
  869         409.966 Eligible plans; selection.—
  870         (3) QUALITY SELECTION CRITERIA.—
  871         (e) To ensure managed care plan participation in Regions 1
  872  and 2, the agency shall award an additional contract to each
  873  plan with a contract award in Region 1 or Region 2. Such
  874  contract shall be in any other region in which the plan
  875  submitted a responsive bid and negotiates a rate acceptable to
  876  the agency. If a plan that is awarded an additional contract
  877  pursuant to this paragraph is subject to penalties pursuant to
  878  s. 409.967(2)(i) s. 409.967(2)(h) for activities in Region 1 or
  879  Region 2, the additional contract is automatically terminated
  880  180 days after the imposition of the penalties. The plan must
  881  reimburse the agency for the cost of enrollment changes and
  882  other transition activities.
  883         Section 27. Paragraph (a) of subsection (5) of section
  884  943.031, Florida Statutes, is amended to read:
  885         943.031 Florida Violent Crime and Drug Control Council.—
  886         (5) DUTIES OF COUNCIL.—Subject to funding provided to the
  887  department by the Legislature, the council shall provide advice
  888  and make recommendations, as necessary, to the executive
  889  director of the department.
  890         (a) The council may advise the executive director on the
  891  feasibility of undertaking initiatives which include, but are
  892  not limited to, the following:
  893         1. Establishing a program that provides grants to criminal
  894  justice agencies that develop and implement effective violent
  895  crime prevention and investigative programs and which provides
  896  grants to law enforcement agencies for the purpose of drug
  897  control, criminal gang, and illicit money laundering
  898  investigative efforts or task force efforts that are determined
  899  by the council to significantly contribute to achieving the
  900  state’s goal of reducing drug-related crime, that represent
  901  significant criminal gang investigative efforts, that represent
  902  a significant illicit money laundering investigative effort, or
  903  that otherwise significantly support statewide strategies
  904  developed by the Statewide Drug Policy Advisory Council
  905  established under s. 397.333, subject to the limitations
  906  provided in this section. The grant program may include an
  907  innovations grant program to provide startup funding for new
  908  initiatives by local and state law enforcement agencies to
  909  combat violent crime or to implement drug control, criminal
  910  gang, or illicit money laundering investigative efforts or task
  911  force efforts by law enforcement agencies, including, but not
  912  limited to, initiatives such as:
  913         a. Providing enhanced community-oriented policing.
  914         b. Providing additional undercover officers and other
  915  investigative officers to assist with violent crime
  916  investigations in emergency situations.
  917         c. Providing funding for multiagency or statewide drug
  918  control, criminal gang, or illicit money laundering
  919  investigative efforts or task force efforts that cannot be
  920  reasonably funded completely by alternative sources and that
  921  significantly contribute to achieving the state’s goal of
  922  reducing drug-related crime, that represent significant criminal
  923  gang investigative efforts, that represent a significant illicit
  924  money laundering investigative effort, or that otherwise
  925  significantly support statewide strategies developed by the
  926  Statewide Drug Policy Advisory Council established under s.
  927  397.333.
  928         2. Expanding the use of automated biometric identification
  929  systems at the state and local levels.
  930         3. Identifying methods to prevent violent crime.
  931         4. Identifying methods to enhance multiagency or statewide
  932  drug control, criminal gang, or illicit money laundering
  933  investigative efforts or task force efforts that significantly
  934  contribute to achieving the state’s goal of reducing drug
  935  related crime, that represent significant criminal gang
  936  investigative efforts, that represent a significant illicit
  937  money laundering investigative effort, or that otherwise
  938  significantly support statewide strategies developed by the
  939  Statewide Drug Policy Advisory Council established under s.
  940  397.333.
  941         5. Enhancing criminal justice training programs that
  942  address violent crime, drug control, illicit money laundering
  943  investigative techniques, or efforts to control and eliminate
  944  criminal gangs.
  945         6. Developing and promoting crime prevention services and
  946  educational programs that serve the public, including, but not
  947  limited to:
  948         a. Enhanced victim and witness counseling services that
  949  also provide crisis intervention, information referral,
  950  transportation, and emergency financial assistance.
  951         b. A well-publicized rewards program for the apprehension
  952  and conviction of criminals who perpetrate violent crimes.
  953         7. Enhancing information sharing and assistance in the
  954  criminal justice community by expanding the use of community
  955  partnerships and community policing programs. Such expansion may
  956  include the use of civilian employees or volunteers to relieve
  957  law enforcement officers of clerical work in order to enable the
  958  officers to concentrate on street visibility within the
  959  community.
  960         Section 28. Subsection (1) of section 943.042, Florida
  961  Statutes, is amended to read:
  962         943.042 Violent Crime Investigative Emergency and Drug
  963  Control Strategy Implementation Account.—
  964         (1) There is created a Violent Crime Investigative
  965  Emergency and Drug Control Strategy Implementation Account
  966  within the Department of Law Enforcement Operating Trust Fund.
  967  The account shall be used to provide emergency supplemental
  968  funds to:
  969         (a) State and local law enforcement agencies that are
  970  involved in complex and lengthy violent crime investigations, or
  971  matching funding to multiagency or statewide drug control or
  972  illicit money laundering investigative efforts or task force
  973  efforts that significantly contribute to achieving the state’s
  974  goal of reducing drug-related crime, that represent a
  975  significant illicit money laundering investigative effort, or
  976  that otherwise significantly support statewide strategies
  977  developed by the Statewide Drug Policy Advisory Council
  978  established under s. 397.333;
  979         (b) State and local law enforcement agencies that are
  980  involved in violent crime investigations which constitute a
  981  significant emergency within the state; or
  982         (c) Counties that demonstrate a significant hardship or an
  983  inability to cover extraordinary expenses associated with a
  984  violent crime trial.
  985         Section 29. For the purpose of incorporating the amendment
  986  made by this act to section 394.492, Florida Statutes, in a
  987  reference thereto, paragraph (a) of subsection (6) of section
  988  39.407, Florida Statutes, is reenacted to read:
  989         39.407 Medical, psychiatric, and psychological examination
  990  and treatment of child; physical, mental, or substance abuse
  991  examination of person with or requesting child custody.—
  992         (6) Children who are in the legal custody of the department
  993  may be placed by the department, without prior approval of the
  994  court, in a residential treatment center licensed under s.
  995  394.875 or a hospital licensed under chapter 395 for residential
  996  mental health treatment only pursuant to this section or may be
  997  placed by the court in accordance with an order of involuntary
  998  examination or involuntary placement entered pursuant to s.
  999  394.463 or s. 394.467. All children placed in a residential
 1000  treatment program under this subsection must have a guardian ad
 1001  litem appointed.
 1002         (a) As used in this subsection, the term:
 1003         1. “Residential treatment” means placement for observation,
 1004  diagnosis, or treatment of an emotional disturbance in a
 1005  residential treatment center licensed under s. 394.875 or a
 1006  hospital licensed under chapter 395.
 1007         2. “Least restrictive alternative” means the treatment and
 1008  conditions of treatment that, separately and in combination, are
 1009  no more intrusive or restrictive of freedom than reasonably
 1010  necessary to achieve a substantial therapeutic benefit or to
 1011  protect the child or adolescent or others from physical injury.
 1012         3. “Suitable for residential treatment” or “suitability”
 1013  means a determination concerning a child or adolescent with an
 1014  emotional disturbance as defined in s. 394.492(5) or a serious
 1015  emotional disturbance as defined in s. 394.492(6) that each of
 1016  the following criteria is met:
 1017         a. The child requires residential treatment.
 1018         b. The child is in need of a residential treatment program
 1019  and is expected to benefit from mental health treatment.
 1020         c. An appropriate, less restrictive alternative to
 1021  residential treatment is unavailable.
 1022         Section 30. For the purpose of incorporating the amendment
 1023  made by this act to section 394.492, Florida Statutes, in a
 1024  reference thereto, subsection (21) of section 394.67, Florida
 1025  Statutes, is reenacted to read:
 1026         394.67 Definitions.—As used in this part, the term:
 1027         (21) “Residential treatment center for children and
 1028  adolescents” means a 24-hour residential program, including a
 1029  therapeutic group home, which provides mental health services to
 1030  emotionally disturbed children or adolescents as defined in s.
 1031  394.492(5) or (6) and which is a private for-profit or not-for
 1032  profit corporation licensed by the agency which offers a variety
 1033  of treatment modalities in a more restrictive setting.
 1034         Section 31. For the purpose of incorporating the amendment
 1035  made by this act to section 394.492, Florida Statutes, in a
 1036  reference thereto, paragraph (b) of subsection (1) of section
 1037  394.674, Florida Statutes, is reenacted to read:
 1038         394.674 Eligibility for publicly funded substance abuse and
 1039  mental health services; fee collection requirements.—
 1040         (1) To be eligible to receive substance abuse and mental
 1041  health services funded by the department, an individual must be
 1042  a member of at least one of the department’s priority
 1043  populations approved by the Legislature. The priority
 1044  populations include:
 1045         (b) For children’s mental health services:
 1046         1. Children who are at risk of emotional disturbance as
 1047  defined in s. 394.492(4).
 1048         2. Children who have an emotional disturbance as defined in
 1049  s. 394.492(5).
 1050         3. Children who have a serious emotional disturbance as
 1051  defined in s. 394.492(6).
 1052         4. Children diagnosed as having a co-occurring substance
 1053  abuse and emotional disturbance or serious emotional
 1054  disturbance.
 1055         Section 32. For the purpose of incorporating the amendment
 1056  made by this act to section 394.492, Florida Statutes, in a
 1057  reference thereto, subsection (1) of section 394.676, Florida
 1058  Statutes, is reenacted to read:
 1059         394.676 Indigent psychiatric medication program.—
 1060         (1) Within legislative appropriations, the department may
 1061  establish the indigent psychiatric medication program to
 1062  purchase psychiatric medications for persons as defined in s.
 1063  394.492(5) or (6) or pursuant to s. 394.674(1), who do not
 1064  reside in a state mental health treatment facility or an
 1065  inpatient unit.
 1066         Section 33. For the purpose of incorporating the amendment
 1067  made by this act to section 394.492, Florida Statutes, in a
 1068  reference thereto, paragraph (c) of subsection (2) of section
 1069  409.1676, Florida Statutes, is reenacted to read:
 1070         409.1676 Comprehensive residential group care services to
 1071  children who have extraordinary needs.—
 1072         (2) As used in this section, the term:
 1073         (c) “Serious behavioral problems” means behaviors of
 1074  children who have been assessed by a licensed master’s-level
 1075  human-services professional to need at a minimum intensive
 1076  services but who do not meet the criteria of s. 394.492(7). A
 1077  child with an emotional disturbance as defined in s. 394.492(5)
 1078  or (6) may be served in residential group care unless a
 1079  determination is made by a mental health professional that such
 1080  a setting is inappropriate. A child having a serious behavioral
 1081  problem must have been determined in the assessment to have at
 1082  least one of the following risk factors:
 1083         1. An adjudication of delinquency and be on conditional
 1084  release status with the Department of Juvenile Justice.
 1085         2. A history of physical aggression or violent behavior
 1086  toward self or others, animals, or property within the past
 1087  year.
 1088         3. A history of setting fires within the past year.
 1089         4. A history of multiple episodes of running away from home
 1090  or placements within the past year.
 1091         5. A history of sexual aggression toward other youth.
 1092         Section 34. For the purpose of incorporating the amendment
 1093  made by this act to section 394.492, Florida Statutes, in a
 1094  reference thereto, paragraph (b) of subsection (1) of section
 1095  409.1677, Florida Statutes, is reenacted to read:
 1096         409.1677 Model comprehensive residential services
 1097  programs.—
 1098         (1) As used in this section, the term:
 1099         (b) “Serious behavioral problems” means behaviors of
 1100  children who have been assessed by a licensed master’s-level
 1101  human-services professional to need at a minimum intensive
 1102  services but who do not meet the criteria of s. 394.492(6) or
 1103  (7). A child with an emotional disturbance as defined in s.
 1104  394.492(5) may be served in residential group care unless a
 1105  determination is made by a mental health professional that such
 1106  a setting is inappropriate.
 1107         Section 35. Except as otherwise expressly provided in this
 1108  act and except for this section, which shall take effect upon
 1109  this act becoming a law, this act shall take effect July 1,
 1110  2015.