Florida Senate - 2020                        COMMITTEE AMENDMENT
       Bill No. SPB 7012
       
       
       
       
       
       
                                Ì181950&Î181950                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                                       .                                
                                       .                                
                                       .                                
                                       .                                
                                       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       The Committee on Children, Families, and Elder Affairs
       (Mayfield) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 413 - 697
    4  and insert:
    5         Section 8. Effective January 1, 2021, paragraph (b) of
    6  subsection (8) of section 627.6675, Florida Statutes, is amended
    7  to read:
    8         627.6675 Conversion on termination of eligibility.—Subject
    9  to all of the provisions of this section, a group policy
   10  delivered or issued for delivery in this state by an insurer or
   11  nonprofit health care services plan that provides, on an
   12  expense-incurred basis, hospital, surgical, or major medical
   13  expense insurance, or any combination of these coverages, shall
   14  provide that an employee or member whose insurance under the
   15  group policy has been terminated for any reason, including
   16  discontinuance of the group policy in its entirety or with
   17  respect to an insured class, and who has been continuously
   18  insured under the group policy, and under any group policy
   19  providing similar benefits that the terminated group policy
   20  replaced, for at least 3 months immediately prior to
   21  termination, shall be entitled to have issued to him or her by
   22  the insurer a policy or certificate of health insurance,
   23  referred to in this section as a “converted policy.” A group
   24  insurer may meet the requirements of this section by contracting
   25  with another insurer, authorized in this state, to issue an
   26  individual converted policy, which policy has been approved by
   27  the office under s. 627.410. An employee or member shall not be
   28  entitled to a converted policy if termination of his or her
   29  insurance under the group policy occurred because he or she
   30  failed to pay any required contribution, or because any
   31  discontinued group coverage was replaced by similar group
   32  coverage within 31 days after discontinuance.
   33         (8) BENEFITS OFFERED.—
   34         (b) An insurer shall offer the benefits specified in s.
   35  627.4193 s. 627.668 and the benefits specified in s. 627.669 if
   36  those benefits were provided in the group plan.
   37         Section 9. Effective January 1, 2021, section 627.668,
   38  Florida Statutes, is transferred, renumbered as section
   39  627.4193, Florida Statutes, and amended to read:
   40         627.4193 627.668Requirements for mental health and
   41  substance use disorder benefits; reporting requirements Optional
   42  coverage for mental and nervous disorders required; exception.—
   43         (1) Every insurer issuing, delivering, or issuing for
   44  delivery comprehensive major medical individual or, health
   45  maintenance organization, and nonprofit hospital and medical
   46  service plan corporation transacting group health insurance
   47  policies or providing prepaid health care in this state must
   48  comply with the federal Paul Wellstone and Pete Domenici Mental
   49  Health Parity and Addiction Equity Act of 2008 (MHPAEA) and any
   50  regulations relating to MHPAEA, including, but not limited to,
   51  45 C.F.R. s. 146.136, 45 C.F.R. s. 147.160, and 45 C.F.R. s.
   52  156.115(a)(3); and must provide shall make available to the
   53  policyholder as part of the application, for an appropriate
   54  additional premium under a group hospital and medical expense
   55  incurred insurance policy, under a group prepaid health care
   56  contract, and under a group hospital and medical service plan
   57  contract, the benefits or level of benefits specified in
   58  subsection (2) for the medically necessary care and treatment of
   59  mental and nervous disorders, including substance use disorders,
   60  as described defined in the Diagnostic and Statistical Manual of
   61  Mental Disorders, Fifth Edition, published by standard
   62  nomenclature of the American Psychiatric Association, subject to
   63  the right of the applicant for a group policy or contract to
   64  select any alternative benefits or level of benefits as may be
   65  offered by the insurer, health maintenance organization, or
   66  service plan corporation provided that, if alternate inpatient,
   67  outpatient, or partial hospitalization benefits are selected,
   68  such benefits shall not be less than the level of benefits
   69  required under paragraph (2)(a), paragraph (2)(b), or paragraph
   70  (2)(c), respectively.
   71         (2) Under individual or group policies described in
   72  subsection (1) or contracts, inpatient hospital benefits,
   73  partial hospitalization benefits, and outpatient benefits
   74  consisting of durational limits, dollar amounts, deductibles,
   75  and coinsurance factors may not be provided in a manner that is
   76  more restrictive than medical and surgical benefits, and limits
   77  on the scope or duration of treatments which are not expressed
   78  numerically, also known as nonquantitative treatment
   79  limitations, must be provided in a manner that is comparable and
   80  may not be applied more stringently than limits on medical and
   81  surgical benefits, in accordance with 45 C.F.R. s.
   82  146.136(c)(2), (3), and (4) shall not be less favorable than for
   83  physical illness generally, except that:
   84         (a) Inpatient benefits may be limited to not less than 30
   85  days per benefit year as defined in the policy or contract. If
   86  inpatient hospital benefits are provided beyond 30 days per
   87  benefit year, the durational limits, dollar amounts, and
   88  coinsurance factors thereto need not be the same as applicable
   89  to physical illness generally.
   90         (b) Outpatient benefits may be limited to $1,000 for
   91  consultations with a licensed physician, a psychologist licensed
   92  pursuant to chapter 490, a mental health counselor licensed
   93  pursuant to chapter 491, a marriage and family therapist
   94  licensed pursuant to chapter 491, and a clinical social worker
   95  licensed pursuant to chapter 491. If benefits are provided
   96  beyond the $1,000 per benefit year, the durational limits,
   97  dollar amounts, and coinsurance factors thereof need not be the
   98  same as applicable to physical illness generally.
   99         (c) Partial hospitalization benefits shall be provided
  100  under the direction of a licensed physician. For purposes of
  101  this part, the term “partial hospitalization services” is
  102  defined as those services offered by a program that is
  103  accredited by an accrediting organization whose standards
  104  incorporate comparable regulations required by this state.
  105  Alcohol rehabilitation programs accredited by an accrediting
  106  organization whose standards incorporate comparable regulations
  107  required by this state or approved by the state and licensed
  108  drug abuse rehabilitation programs shall also be qualified
  109  providers under this section. In a given benefit year, if
  110  partial hospitalization services or a combination of inpatient
  111  and partial hospitalization are used, the total benefits paid
  112  for all such services may not exceed the cost of 30 days after
  113  inpatient hospitalization for psychiatric services, including
  114  physician fees, which prevail in the community in which the
  115  partial hospitalization services are rendered. If partial
  116  hospitalization services benefits are provided beyond the limits
  117  set forth in this paragraph, the durational limits, dollar
  118  amounts, and coinsurance factors thereof need not be the same as
  119  those applicable to physical illness generally.
  120         (3) Insurers must maintain strict confidentiality regarding
  121  psychiatric and psychotherapeutic records submitted to an
  122  insurer for the purpose of reviewing a claim for benefits
  123  payable under this section. These records submitted to an
  124  insurer are subject to the limitations of s. 456.057, relating
  125  to the furnishing of patient records.
  126         (4)Every insurer shall submit an annual affidavit
  127  attesting to compliance with the applicable provisions of the
  128  MHPAEA.
  129         (5)The office shall implement and enforce applicable
  130  provisions of MHPAEA and federal guidance or regulations
  131  relating to MHPAEA, including, but not limited to, 45 C.F.R. s.
  132  146.136, 45 C.F.R. s. 147.160, and 45 C.F.R. s. 156.115(a)(3),
  133  and this section.
  134         (6)The Financial Services Commission may adopt rules to
  135  implement this section.
  136         Section 10. Subsection (4) is added to section 627.669,
  137  Florida Statutes, to read:
  138         627.669 Optional coverage required for substance abuse
  139  impaired persons; exception.—
  140         (4) This section is repealed January 1, 2021.
  141         Section 11. Effective January 1, 2021, present subsection
  142  (17) of section 627.6699, Florida Statutes, is redesignated as
  143  subsection (18), and a new subsection (17) is added to that
  144  section, to read:
  145         627.6699 Employee Health Care Access Act.—
  146         (17) MENTAL HEALTH AND SUBSTANCE ABUSE BENEFITS.—A health
  147  benefit plan that provides coverage to employees of a small
  148  employer is subject to s. 627.4193.
  149         Section 12. Effective January 1, 2021, subsection (9) is
  150  added to section 641.26, Florida Statutes, to read:
  151         641.26 Annual and quarterly reports.—
  152         (9) Every health maintenance organization issuing,
  153  delivering, or issuing for delivery contracts providing
  154  comprehensive major medical coverage shall annually submit an
  155  affidavit to the office attesting to compliance with the
  156  requirements of s. 627.4193. The office may adopt rules to
  157  implement this subsection.
  158         Section 13. Effective January 1, 2021, subsection (48) is
  159  added to section 641.31, Florida Statutes, to read:
  160         641.31 Health maintenance contracts.—
  161         (48) All health maintenance contracts that provide
  162  comprehensive medical coverage must comply with the coverage
  163  provisions of s. 627.4193. The commission may adopt rules to
  164  implement this subsection.
  165         Section 14. Section 786.1516, Florida Statutes, is created
  166  to read:
  167         786.1516 Immunity for providing assistance in a suicide
  168  emergency.—
  169         (1) As used in this section, the term:
  170         (a) “Emergency care” means assistance or advice offered to
  171  avoid, mitigate, or attempt to mitigate the effects of a suicide
  172  emergency.
  173         (b) “Suicide emergency” means an occurrence that reasonably
  174  indicates an individual is at risk of dying or attempting to die
  175  by suicide.
  176         (2) A person who provides emergency care at or near the
  177  scene of a suicide emergency, gratuitously and in good faith, is
  178  not liable for any civil damages or penalties as a result of any
  179  act or omission by the person providing the emergency care
  180  unless the person is grossly negligent or caused the suicide
  181  emergency.
  182         Section 15. Present subsection (28) of section 1002.33,
  183  Florida Statutes, is redesignated as subsection (29), and a new
  184  subsection (28) is added to that section, to read:
  185         1002.33 Charter schools.—
  186         (28) CONTINUING EDUCATION AND INSERVICE TRAINING FOR YOUTH
  187  SUICIDE AWARENESS AND PREVENTION.—
  188         (a) By October 1, 2020, every charter school must:
  189         1. Incorporate 2 hours of training offered pursuant to s.
  190  1012.583. The training must be included in the existing
  191  continuing education or inservice training requirements for
  192  instructional personnel and may not add to the total hours
  193  currently required by the department. Every charter school must
  194  require all instructional personnel to participate.
  195         2. Have at least two school-based staff members certified
  196  or otherwise deemed competent in the use of a suicide screening
  197  instrument approved under s. 1012.583(1) and have a policy to
  198  use such suicide risk screening instrument to evaluate a
  199  student’s suicide risk before requesting the initiation of, or
  200  initiating, an involuntary examination due to concerns about
  201  that student’s suicide risk.
  202         (b) Every charter school must report its compliance with
  203  this subsection to the department.
  204         Section 16. Subsections (2) and (3) of section 1012.583,
  205  Florida Statutes, are amended to read:
  206         1012.583 Continuing education and inservice training for
  207  youth suicide awareness and prevention.—
  208         (2) By October 1, 2020, every public school must A school
  209  shall be considered a “Suicide Prevention Certified School” if
  210  it:
  211         (a) Incorporate Incorporates 2 hours of training offered
  212  pursuant to this section. The training must be included in the
  213  existing continuing education or inservice training requirements
  214  for instructional personnel and may not add to the total hours
  215  currently required by the department. Every public school A
  216  school that chooses to participate in the training must require
  217  all instructional personnel to participate.
  218         (b) Have Has at least two school-based staff members
  219  certified or otherwise deemed competent in the use of a suicide
  220  screening instrument approved under subsection (1) and have has
  221  a policy to use such suicide risk screening instrument to
  222  evaluate a student’s suicide risk before requesting the
  223  initiation of, or initiating, an involuntary examination due to
  224  concerns about that student’s suicide risk.
  225         (3) Every public school A school that meets the criteria in
  226  subsection (2) must report its compliance with this section to
  227  the department. The department shall keep an updated record of
  228  all Suicide Prevention Certified Schools and shall post the list
  229  of these schools on the department’s website. Each school shall
  230  also post on its own website whether it is a Suicide Prevention
  231  Certified School, and each school district shall post on its
  232  district website a list of the Suicide Prevention Certified
  233  Schools in that district.
  234         Section 17. Paragraphs (a) and (c) of subsection (3) of
  235  section 394.495, Florida Statutes, are amended to read:
  236         394.495 Child and adolescent mental health system of care;
  237  programs and services.—
  238         (3) Assessments must be performed by:
  239         (a) A professional as defined in s. 394.455(5), (7), (33)
  240  (32), (36) (35), or (37) (36);
  241         (c) A person who is under the direct supervision of a
  242  qualified professional as defined in s. 394.455(5), (7), (33)
  243  (32), (36) (35), or (37) (36) or a professional licensed under
  244  chapter 491.
  245         Section 18. Subsection (5) of section 394.496, Florida
  246  Statutes, is amended to read:
  247         394.496 Service planning.—
  248         (5) A professional as defined in s. 394.455(5), (7), (33)
  249  (32), (36) (35), or (37) (36) or a professional licensed under
  250  chapter 491 must be included among those persons developing the
  251  services plan.
  252         Section 19. Subsection (6) of section 394.9085, Florida
  253  Statutes, is amended to read:
  254         394.9085 Behavioral provider liability.—
  255         (6) For purposes of this section, the terms “detoxification
  256  services,” “addictions receiving facility,” and “receiving
  257  facility” have the same meanings as those provided in ss.
  258  397.311(26)(a)4., 397.311(26)(a)1., and 394.455(40) 394.455(39),
  259  respectively.
  260         Section 20. Paragraph (b) of subsection (1) of section
  261  409.972, Florida Statutes, is amended to read:
  262         409.972 Mandatory and voluntary enrollment.—
  263         (1) The following Medicaid-eligible persons are exempt from
  264  mandatory managed care enrollment required by s. 409.965, and
  265  may voluntarily choose to participate in the managed medical
  266  assistance program:
  267         (b) Medicaid recipients residing in residential commitment
  268  facilities operated through the Department of Juvenile Justice
  269  or a treatment facility as defined in s. 394.455(47).
  270         Section 21. Paragraph (e) of subsection (4) of section
  271  464.012, Florida Statutes, is amended to read:
  272         464.012 Licensure of advanced practice registered nurses;
  273  fees; controlled substance prescribing.—
  274         (4) In addition to the general functions specified in
  275  subsection (3), an advanced practice registered nurse may
  276  perform the following acts within his or her specialty:
  277         (e) A psychiatric nurse, who meets the requirements in s.
  278  394.455(36) s. 394.455(35), within the framework of an
  279  established protocol with a psychiatrist, may prescribe
  280  psychotropic controlled substances for the treatment of mental
  281  disorders.
  282         Section 22. Subsection (7) of section 744.2007, Florida
  283  Statutes, is amended to read:
  284         744.2007 Powers and duties.—
  285         (7) A public guardian may not commit a ward to a treatment
  286  facility, as defined in s. 394.455(47), without an involuntary
  287  placement proceeding as provided by law.
  288         Section 23. The Office of Program Policy Analysis and
  289  Government Accountability shall perform a review of suicide
  290  prevention programs and efforts made by other states and make
  291  recommendations on their applicability to this state. The office
  292  shall submit a report containing the findings and
  293  recommendations to the President of the Senate and the Speaker
  294  of the House of Representatives by January 1, 2021.
  295         Section 24. Except as otherwise expressly provided in this
  296  act, this act shall take effect July 1, 2020.
  297  
  298  ================= T I T L E  A M E N D M E N T ================
  299  And the title is amended as follows:
  300         Delete line 77
  301  and insert:
  302         specified date; providing effective dates.