Bill Text: FL S1338 | 2015 | Regular Session | Introduced
Bill Title: Behavioral Health Services
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2015-05-01 - Died in Children, Families, and Elder Affairs [S1338 Detail]
Download: Florida-2015-S1338-Introduced.html
Florida Senate - 2015 SB 1338 By Senator Detert 28-01282-15 20151338__ 1 A bill to be entitled 2 An act relating to behavioral health services; 3 providing a short title; creating the Behavioral 4 Health Task Force within the Department of Children 5 and Families; specifying membership of the task force; 6 providing for reimbursement for per diem and travel 7 expenses; prescribing duties of the task force; 8 requiring the task force to submit a report to the 9 Governor and the Legislature by a specified date; 10 providing for staff support; creating s. 394.47892, 11 F.S.; authorizing counties to fund treatment-based 12 mental health court programs; providing legislative 13 intent; providing that pretrial program participation 14 is voluntary; specifying criteria that a court must 15 consider before sentencing a person to a 16 postadjudicatory treatment-based mental health court 17 program; requiring a judge presiding over a 18 postadjudicatory treatment-based mental health court 19 program to hear a violation of probation or community 20 control under certain circumstances; providing that 21 treatment-based mental health court programs may 22 include specified programs; requiring a judicial 23 circuit with a treatment-based mental health court 24 program to establish a coordinator position, subject 25 to annual appropriation by the Legislature; requiring 26 circuit courts to report specified data to the Office 27 of the State Courts Administrator; creating the 28 Florida Association of Mental Health Court 29 Professionals; specifying membership and duties of the 30 association; providing county funding requirements for 31 treatment-based mental health court programs; 32 authorizing the chief judge of a judicial circuit to 33 appoint an advisory committee for the treatment-based 34 mental health court program; specifying membership of 35 the committee; amending s. 394.656, F.S.; revising the 36 duties of the Criminal Justice, Mental Health, and 37 Substance Abuse Statewide Grant Review Committee; 38 requiring the Department of Children and Families to 39 appoint a grant selection committee; authorizing a 40 designated not-for-profit community provider to apply 41 for certain grants; providing an appropriation for the 42 Criminal Justice, Mental Health, and Substance Abuse 43 Reinvestment Grant Program; creating s. 394.9086, 44 F.S.; requiring the Department of Children and 45 Families to designate qualifying organizations as 46 community behavioral health centers; providing minimum 47 criteria for designation as a community behavioral 48 health center; requiring the department to adopt 49 rules; creating s. 394.9087, F.S.; establishing the 50 Behavioral Health Workforce Loan Forgiveness Program 51 within the department; providing eligibility 52 requirements; specifying limitations and requirements 53 with respect to loan repayment; authorizing the 54 department to adopt rules; providing appropriations 55 for the Behavioral Health Workforce Loan Forgiveness 56 Program; amending s. 409.906, F.S.; requiring the 57 Agency for Health Care Administration to implement a 58 prospective payment methodology for reimbursement 59 rates at community behavioral health centers; 60 directing the agency to require managed care plans and 61 fee-for-service providers to implement certain 62 measures with respect to the delivery of behavioral 63 health services; requiring the agency to submit a 64 federal waiver or state Medicaid plan amendment for 65 provision of health homes; specifying conditions for a 66 health home program; amending s. 409.967, F.S.; 67 revising contract requirements for managed care plans 68 under contract with the agency; requiring each managed 69 care plan to report annual spending on community 70 behavioral health services; requiring a managed care 71 plan to spend a threshold amount on direct community 72 behavioral health services; requiring a managed care 73 plan to reimburse the agency if community behavioral 74 health services spending does not reach the threshold 75 amount; amending ss. 29.004, 39.001, 39.507, 39.521, 76 409.975, and 921.0026, F.S.; conforming provisions to 77 changes made by the act; amending ss. 948.01 and 78 948.06, F.S.; conforming provisions relating to 79 probation and community control to reflect the 80 postadjudicatory treatment-based mental health court 81 program; requiring the agency to complete a study 82 regarding targeted case management services; 83 specifying requirements for the study; requiring the 84 agency to submit a report regarding the study to the 85 Legislature by a specified date; requiring the agency 86 to submit a planning grant application to the United 87 States Department of Health and Human Services; 88 providing appropriations; providing an effective date. 89 90 WHEREAS, Florida’s residents with mental illnesses and 91 substance abuse disorders are best able to recover and become 92 productive citizens when served in their own communities and 93 surrounded by family and natural support systems, and 94 WHEREAS, untreated mental illnesses and substance abuse 95 disorders place a burden on the health care and public safety 96 system, and 97 WHEREAS, research has demonstrated that the delivery of 98 behavioral health services to treat mental illnesses and 99 substance abuse disorders are cost-effective and efficient, and 100 WHEREAS, the Legislature intends to ensure greater access 101 to behavioral health services by promoting the high quality, 102 adequacy, and availability of these essential services, NOW, 103 THEREFORE, 104 105 Be It Enacted by the Legislature of the State of Florida: 106 107 Section 1. This act may be cited as the “Excellence in 108 Behavioral Health Act.” 109 Section 2. Behavioral Health Task Force.—The Behavioral 110 Health Task Force, a task force as defined in s. 20.03, Florida 111 Statutes, is created within the Department of Children and 112 Families. The task force is created for the express purpose of 113 recommending a plan for the delivery of comprehensive behavioral 114 health services to the residents of this state, which includes 115 short-term, mid-range, and long-term strategies to ensure the 116 availability of a comprehensive system to serve residents with 117 mental illnesses and substance abuse disorders. 118 (1) The task force shall consist of 23 members, as follows: 119 (a) One member from each of the following agencies, 120 appointed by the Governor: 121 1. The Executive Office of the Governor. 122 2. The Department of Children and Families. 123 3. The Agency for Health Care Administration. 124 4. The Department of Corrections. 125 5. The Department of Elderly Affairs. 126 6. The Agency for Persons with Disabilities. 127 7. The Department of Juvenile Justice. 128 (b) Two members of the Senate, one of whom shall be a 129 member of the minority party, appointed by the President of the 130 Senate. 131 (c) Two members of the House of Representatives, one of 132 whom shall be a member of the minority party, appointed by the 133 Speaker of the House of Representatives. 134 (d) Three members, one of whom shall be a circuit judge, 135 one of whom shall be a state attorney, and one of whom shall be 136 a public defender, appointed by the Chief Justice of the Supreme 137 Court. 138 (e) The Insurance Consumer Advocate. 139 (f) Two members appointed by the president of the Florida 140 Association of Health Plans. 141 (g) One member appointed by the executive director of the 142 Florida Alcohol and Drug Abuse Association. 143 (h) One member appointed by the president of the Florida 144 Council for Community Mental Health. 145 (i) One member appointed by the Florida Association of 146 Managing Entities. 147 (j) One sheriff appointed by the executive director of the 148 Florida Sheriffs Association. 149 (k) One consumer member appointed by the program director 150 of the National Alliance on Mental Illness Florida. 151 (l) One consumer member appointed by Floridians for 152 Recovery. 153 (2) Members of the task force shall serve without 154 compensation. Per diem and travel expenses for each member shall 155 be the responsibility of the member’s sponsoring agency or 156 organization; however, the consumer members appointed to the 157 task force are entitled to reimbursement for per diem and travel 158 expenses from the Department of Children and Families, pursuant 159 to s. 112.061, Florida Statutes. 160 (3) The task force shall prepare a comprehensive State 161 Strategic Behavioral Health Plan, which must address the 162 following items: 163 (a) Evaluate whether current funding for the treatment of 164 mental illnesses and substance abuse treatment services in this 165 state is adequate. 166 (b) Evaluate whether the current size of the state’s 167 behavioral health workforce meets current demand. 168 (c) Propose funding mechanisms that maximize available 169 funding through federal, state, and local sources. 170 (d) Develop strategies to streamline funding strategies for 171 behavioral health services, including how to eliminate 172 unnecessary legislative, regulatory, and other bureaucratic 173 barriers that impede efforts to efficiently deliver behavioral 174 health services. 175 (e) Develop measures necessary to promote the formation of 176 a network of community-based treatment providers to facilitate 177 greater accessibility to cost-effective care and prevent persons 178 with mental illnesses or substance abuse disorders from 179 homelessness, imprisonment, or seeking care in hospital 180 emergency rooms. 181 (f) Develop strategies for interagency coordination between 182 the criminal justice system and the mental health and substance 183 abuse treatment system. 184 (g) Provide a proposal for a comprehensive data collection 185 system that measures patients served, services delivered, 186 treatment outcomes, and the cost-effectiveness of care. 187 (h) Assess and report on the state’s current progress in 188 implementing the federal Paul Wellstone and Pete Domenici Mental 189 Health Parity and Addiction Equity Act of 2008, 29 U.S.C. s. 190 1185a, and propose any strategy necessary to assist in the 191 implementation. 192 (i) Evaluate the need and potential placement of a 193 specialized mental health and substance abuse agency within 194 state government. 195 (4) The task force shall submit a report of its findings 196 and recommendations to the Governor, the President of the 197 Senate, and the Speaker of the House of Representatives by June 198 30, 2016. Upon submission of the report, the task force shall 199 expire. 200 (5) The Department of Children and Families shall provide 201 the task force with staff necessary to assist the task force in 202 the performance of its duties. 203 Section 3. Section 394.47892, Florida Statutes, is created 204 to read: 205 394.47892 Treatment-based mental health court programs.— 206 (1) Each county may fund a treatment-based mental health 207 court program under which persons in the justice system assessed 208 with a mental illness will be processed in such a manner as to 209 appropriately address the severity of the identified mental 210 health problem through treatment services tailored to the 211 individual needs of the participant. The Legislature intends to 212 encourage the Department of Corrections, the Department of 213 Children and Families, the Department of Juvenile Justice, the 214 Department of Health, the Department of Law Enforcement, the 215 Department of Education, and such agencies, local governments, 216 law enforcement agencies, other interested public or private 217 sources, and individuals to support the creation and 218 establishment of these problem-solving court programs. 219 Participation in the treatment-based mental health court 220 programs does not divest any public or private agency of its 221 responsibility for a child or adult, but enables these agencies 222 to better meet their needs through shared responsibility and 223 resources. 224 (2) Entry into a pretrial treatment-based mental health 225 court program is voluntary. 226 (3)(a) Entry into a postadjudicatory treatment-based mental 227 health court program as a condition of probation or community 228 control pursuant to s. 948.01 or s. 948.06 must be based upon 229 the sentencing court’s assessment of the defendant’s criminal 230 history, mental health screening outcome, amenability to the 231 services of the program, and total sentence points; the 232 recommendation of the state attorney and the victim, if any; and 233 the defendant’s agreement to enter the program. 234 (b) An offender who is sentenced to a postadjudicatory 235 treatment-based mental health court program and who, while a 236 mental health court participant, is the subject of a violation 237 of probation or community control under s. 948.06 shall have the 238 violation of probation or community control heard by the judge 239 presiding over the postadjudicatory treatment-based mental 240 health court program. After a hearing on or admission of the 241 violation, the judge shall dispose of any such violation as he 242 or she deems appropriate if the resulting sentence or conditions 243 are lawful. 244 (4) Treatment-based mental health court programs may 245 include pretrial intervention programs as provided in s. 948.08, 246 treatment-based mental health court programs authorized in 247 chapter 39, postadjudicatory programs as provided in ss. 948.01 248 and 948.06, and review of the status of compliance or 249 noncompliance of sentenced offenders in a treatment-based mental 250 health court program. 251 (5)(a) Contingent upon an annual appropriation by the 252 Legislature, each judicial circuit with a treatment-based mental 253 health court program shall establish, at a minimum, one 254 coordinator position for the treatment-based mental health court 255 program within the state courts system to coordinate the 256 responsibilities of the participating agencies and service 257 providers. Each coordinator shall provide direct support to the 258 treatment-based mental health court program by providing 259 coordination between the multidisciplinary team and the 260 judiciary, providing case management, monitoring compliance of 261 the participants in the program with court requirements, and 262 providing program evaluation and accountability. 263 (b) Each judicial circuit shall report sufficient client 264 level and programmatic data to the Office of the State Courts 265 Administrator annually for purposes of program evaluation. 266 Client-level data include primary offenses that resulted in the 267 mental health court referral or sentence, treatment compliance, 268 completion status and reasons for failure to complete, offenses 269 committed during treatment and the sanctions imposed, frequency 270 of court appearances, and units of service. Programmatic data 271 include referral and screening procedures, eligibility criteria, 272 type and duration of treatment offered, and residential 273 treatment resources. 274 (6) The Florida Association of Mental Health Court 275 Professionals is created. 276 (a) The membership of the association may consist of 277 treatment-based mental health, mental health, and veterans court 278 program practitioners who comprise the multidisciplinary 279 treatment-based mental health court program team, including, but 280 not limited to, judges, state attorneys, defense counsel, 281 treatment-based mental health court program coordinators, 282 probation officers, law enforcement officers, community 283 representatives, members of the academic community, and 284 treatment professionals. Membership in the association shall be 285 voluntary. 286 (b) The association shall annually elect a chair who shall 287 solicit recommendations from members on issues relating to the 288 expansion, operation, and institutionalization of treatment 289 based mental health court programs. The chair is responsible for 290 providing on or before October 1 of each year the association’s 291 recommendations and an annual report to the appropriate Supreme 292 Court committee or to the appropriate personnel of the Office of 293 the State Courts Administrator. 294 (7) If a county chooses to fund a treatment-based mental 295 health court program, the county must secure funding from 296 sources other than the state for those costs not otherwise 297 assumed by the state pursuant to s. 29.004. However, this 298 subsection does not preclude counties from using treatment and 299 other service funding provided through state executive branch 300 agencies. Counties may provide, by interlocal agreement, for the 301 collective funding of these programs. 302 (8) The chief judge of each judicial circuit may appoint an 303 advisory committee for the treatment-based mental health court 304 program. The committee shall be composed of the chief judge, or 305 his or her designee, who shall serve as chair; the judge of the 306 treatment-based mental health court program, if not otherwise 307 designated by the chief judge as his or her designee; the state 308 attorney, or his or her designee; the public defender, or his or 309 her designee; the treatment-based mental health court program 310 coordinators; community representatives; treatment 311 representatives; and any other persons the chair deems 312 appropriate. 313 Section 4. Section 394.656, Florida Statutes, is amended to 314 read: 315 394.656 Criminal Justice, Mental Health, and Substance 316 Abuse Reinvestment Grant Program.— 317 (1) There is created within the Department of Children and 318 Families the Criminal Justice, Mental Health, and Substance 319 Abuse Reinvestment Grant Program. The purpose of the program is 320 to provide funding to counties with which they can plan, 321 implement, or expand initiatives that increase public safety, 322 avert increased spending on criminal justice, and improve the 323 accessibility and effectiveness of treatment services for adults 324 and juveniles who have a mental illness, substance abuse 325 disorder, or co-occurring mental health and substance abuse 326 disorders and who are in, or at risk of entering, the criminal 327 or juvenile justice systems. 328 (2) The department shall establish a Criminal Justice, 329 Mental Health, and Substance Abuse Statewide Grant Review 330 Committee. The committee shall include: 331 (a) One representative of the Department of Children and 332 Families; 333 (b) One representative of the Department of Corrections; 334 (c) One representative of the Department of Juvenile 335 Justice; 336 (d) One representative of the Department of Elderly 337 Affairs; and 338 (e) One representative of the Office of the State Courts 339 Administrator. 340 341 The committee shall serve as the lead body to study policy and 342 funding issues to help reduce the impact of persons with mental 343 illnesses and substance abuse disorders on communities and the 344 court system and foster coordination between executive agencies, 345 the court system, local governments, and law enforcement 346 agencies. The committee shall advise the department in selecting 347 priorities for applying and reviewing grants and investing 348 awarded grant moneys. The department, to the extent possible, 349 shall appoint a grant selection committee that has expertise in 350 the content areas relating to the grantsTo the extent possible,351the members of the committee shall have expertise in grant352writing, grant reviewing, and grant application scoring. 353 (3)(a) A county or a designated not-for-profit community 354 provider may apply for a 1-year planning grant or a 3-year 355 implementation or expansion grant. The purpose of the grants is 356 to demonstrate that investment in treatment efforts related to 357 mental illness, substance abuse disorders, or co-occurring 358 mental health and substance abuse disorders results in a reduced 359 demand on the resources of the judicial, corrections, juvenile 360 detention, and health and social services systems. 361 (b) To be eligible to receive a 1-year planning grant or a 362 3-year implementation or expansion grant, ana countyapplicant 363 must have acountyplanning council or committee that is in 364 compliance with the membership requirements set forth in this 365 section. 366 (4) The grant review committee shall notify the Department 367 of Children and Families in writing of the names of the 368 applicants who have been selected by the committee to receive a 369 grant. Contingent upon the availability of funds and upon 370 notification by the review committee of those applicants 371 approved to receive planning, implementation, or expansion 372 grants, the Department of Children and Families may transfer 373 funds appropriated for the grant program to an approved 374 applicantany county awarded a grant. 375 Section 5. For the 2015-2016 fiscal year, there is 376 appropriated the sum of $9 million in recurring funds from the 377 General Revenue Fund to the Department of Children and Families 378 for the purpose of funding the Criminal Justice, Mental Health, 379 and Substance Abuse Reinvestment Grant Program established in s. 380 394.656, Florida Statutes. 381 Section 6. Section 394.9086, Florida Statutes, is created 382 to read: 383 394.9086 Community behavioral health centers.— 384 (1) The department shall designate qualifying community 385 behavioral health organizations as community behavioral health 386 centers. The department, in conjunction with the Agency for 387 Health Care Administration, shall establish criteria that must 388 be met by a community behavioral health organization in order to 389 receive designation as a community behavioral health center. 390 (2) In order to be designated as a community behavioral 391 health center, a community behavioral health organization, at a 392 minimum, must: 393 (a) Provide services at locations that ensure availability 394 and accessibility to services in a manner that preserves human 395 dignity and ensures continuity of care. 396 (b) Deliver services in a mode appropriate for the center’s 397 target population. 398 (c) Provide services to one or more specialized 399 populations, including, but not limited to, children and 400 families at risk of or exiting the child welfare system due to 401 mental illness or a substance abuse disorder, senior citizens 402 with severe mental illnesses or substance abuse disorders, or 403 adults and juveniles at risk of entering the criminal justice 404 system. 405 (d) Provide individuals with a choice of effective service 406 options for treatment. 407 (e) Employ clinical staff with multidisciplinary experience 408 and cultural and linguistic competencies. 409 (f) Provide services, subject to a center’s capability and 410 available funding, to any individual residing or employed in the 411 center’s service area regardless of his or her ability to pay 412 for such services. 413 (g) Provide, directly or through contract to the extent 414 covered, to an adult enrolled in the state Medicaid plan 415 authorized under Title XIX of the Social Security Act, 42 U.S.C. 416 s. 1396 et seq., or a child receiving early and periodic 417 screening, diagnostic, and treatment services authorized under 418 42 U.S.C. 1396d, the following services: 419 1. Screening, assessment, and diagnosis, including risk 420 assessment. 421 2. Treatment planning, including risk assessment and crisis 422 planning, which focuses on the individual. 423 3. Outpatient mental health and substance abuse services, 424 including screening, assessment, diagnosis, psychotherapy, 425 medication management, and integrated evidence-based treatment 426 for mental illness and substance abuse. 427 4. Crisis mental health services, including 24-hour mobile 428 crisis teams, emergency crisis intervention services, and crisis 429 stabilization. 430 5. Targeted case management services designed to assist 431 individuals in gaining access to needed medical, social, 432 educational, and other services; applying for supplemental 433 security income; or any other benefit to which they may be 434 entitled. 435 6. Psychiatric rehabilitation services, including, but not 436 limited to, assertive community treatment, family psychology 437 education, disability self-management, supported employment, 438 supported housing services, and therapeutic foster care 439 services. 440 7. Counseling, including family and peer support services. 441 8. Outpatient screening and monitoring of key health 442 indicators and health risk factors, including, but not limited 443 to, diabetes, hypertension, cardiovascular disease, body mass 444 index, blood pressure, blood-glucose levels, and lipid profiles. 445 (h) Maintain partnerships and, if possible, enter into 446 contractual agreements with: 447 1. Federally qualified health centers. 448 2. Inpatient psychiatric facilities and substance abuse 449 detoxification, post-detoxification transitional services, and 450 residential programs. 451 3. Facilities that provide adult and youth peer support and 452 counseling services. 453 4. Facilities that provide family support services for 454 families of children with serious mental illnesses or substance 455 abuse disorders. 456 5. Providers of primary care services. 457 6. Providers of outreach services, including translation 458 services and transportation services. 459 7. Providers of other health and wellness services, 460 including tobacco cessation services. 461 (i) Provide outreach, to the extent feasible, to encourage 462 individuals who may benefit from receiving behavioral healthcare 463 to participate in services provided by a community behavioral 464 health center. 465 (3) The department shall adopt rules to implement and 466 administer this section. 467 Section 7. Section 394.9087, Florida Statutes, is created 468 to read: 469 394.9087 Behavioral Health Workforce Loan Forgiveness 470 Program.— 471 (1) The Behavioral Health Workforce Loan Forgiveness 472 Program is established within the department. The purpose of the 473 program is to increase employment and retention among qualified 474 personnel employed at substance abuse treatment providers or 475 community behavioral health centers where critical workforce 476 shortages exist by making repayments toward loans received by 477 applicants through federal or state programs or commercial 478 lending institutions for the support of pursuing postsecondary 479 study in the behavioral health field. 480 (2) To be eligible for the program, an applicant must: 481 (a) Have graduated from an accredited or approved 482 postsecondary degree program in counseling, psychology, or 483 social work. 484 (b) Be employed as a qualified professional, as defined in 485 s. 397.311, at a licensed substance abuse treatment provider or 486 community behavioral health center. 487 (3) Only loans to pay the costs of tuition, books, fees, 488 and living expenses shall be covered by the program. 489 (4) All participants in the program must remain employed by 490 a substance abuse treatment provider or community behavioral 491 health center for a period of 4 years after completion of a 492 qualifying postsecondary degree. If employment ends before the 493 4-year period has concluded, the benefit shall be repaid 494 according to a pro rata calculation based on the number of years 495 of service. 496 (5) From the funds available, the department may make loan 497 principal payments of up to $3,000 each calendar year for up to 498 4 years on behalf of a participant in the program. All payments 499 are contingent upon the proof of the participant’s continued 500 employment at a qualifying provider or center and shall be made 501 directly to the holder of the loan. The state is not responsible 502 for the collection of any interest charges or other remaining 503 balance on the loan. In the event that the designated providers 504 or centers are changed, a participant shall continue to be 505 eligible for loan forgiveness as long as he or she continues to 506 work at the provider or center for which the original loan 507 repayment was made and otherwise meets all conditions of 508 eligibility. 509 (6) Applications must be reviewed on a quarterly basis, and 510 applicant rewards shall be based on the financial need of the 511 applicant. 512 (7) The department may adopt rules to administer this 513 section. 514 Section 8. Beginning in the 2015-2016 fiscal year and each 515 year thereafter through the 2020-2021 fiscal year, the sum of 516 $450,000 in recurring funds is appropriated from the General 517 Revenue Fund to the Department of Children and Families for the 518 purpose of funding the Behavioral Health Workforce Loan 519 Forgiveness Program as created in s. 394.9087, Florida Statutes. 520 Section 9. Paragraphs (c), (d), and (e) are added to 521 subsection (8) of section 409.906, Florida Statutes, to read: 522 409.906 Optional Medicaid services.—Subject to specific 523 appropriations, the agency may make payments for services which 524 are optional to the state under Title XIX of the Social Security 525 Act and are furnished by Medicaid providers to recipients who 526 are determined to be eligible on the dates on which the services 527 were provided. Any optional service that is provided shall be 528 provided only when medically necessary and in accordance with 529 state and federal law. Optional services rendered by providers 530 in mobile units to Medicaid recipients may be restricted or 531 prohibited by the agency. Nothing in this section shall be 532 construed to prevent or limit the agency from adjusting fees, 533 reimbursement rates, lengths of stay, number of visits, or 534 number of services, or making any other adjustments necessary to 535 comply with the availability of moneys and any limitations or 536 directions provided for in the General Appropriations Act or 537 chapter 216. If necessary to safeguard the state’s systems of 538 providing services to elderly and disabled persons and subject 539 to the notice and review provisions of s. 216.177, the Governor 540 may direct the Agency for Health Care Administration to amend 541 the Medicaid state plan to delete the optional Medicaid service 542 known as “Intermediate Care Facilities for the Developmentally 543 Disabled.” Optional services may include: 544 (8) COMMUNITY MENTAL HEALTH SERVICES.— 545 (c) The agency shall implement a prospective payment 546 methodology for establishing reimbursement rates for mental 547 health services rendered at a community behavioral health center 548 designated pursuant to s. 394.9086. The methodology shall 549 provide for reimbursement of reasonable actual costs incurred by 550 a community behavioral health center in delivering its services 551 as determined by the agency. 552 (d) The agency shall require managed care plans or other 553 fee-for-service providers to implement cost-based, cost 554 effective, and efficient methods for the delivery of behavioral 555 health services. 556 (e) The agency shall submit a federal waiver or a state 557 Medicaid plan amendment for the provision of health homes for 558 individuals with chronic conditions, including those with severe 559 mental illnesses or substance use disorders, as authorized under 560 42 U.S.C. s. 1396w-4. The waiver or plan amendment shall allow 561 for a health home services provider to be reimbursed for the 562 delivery of primary care services and other core services. The 563 agency shall direct managed care plans to incorporate providers 564 with health homes into their network and reimburse the health 565 home services providers for any services delivered. 566 1. To be eligible for inclusion in a health home program, a 567 Medicaid beneficiary must have at least two chronic health 568 conditions; one chronic health condition and be at risk of 569 having a second chronic health condition; or one serious and 570 persistent mental health condition. 571 2. A health home must meet standards developed by the Joint 572 Commission or the Commission on Accreditation of Rehabilitation 573 Facilities and be a behavioral health organization that provides 574 screening, evaluation, crisis intervention, medication 575 management, psychosocial treatment and rehabilitation, care 576 management, and community integration and support services 577 designed to assist individuals in addressing their behavioral 578 health care needs. In addition, a health home must: 579 a. Embody a recovery-focused model of care that respects 580 and promotes independence and recovery. 581 b. Promote healthy lifestyles and provide prevention and 582 education services that focus on wellness and self-care. 583 c. Ensure access to and coordinate care across prevention, 584 primary care, and specialty health care services. 585 d. Monitor critical health indicators. 586 e. Support individuals in the self-management of chronic 587 health conditions. 588 f. Coordinate and monitor emergency room visits and 589 hospitalizations, including participation in transition and 590 discharge planning and followup. 591 Section 10. Paragraph (c) of subsection (2) of section 592 409.967, Florida Statutes, is amended to read: 593 409.967 Managed care plan accountability.— 594 (2) The agency shall establish such contract requirements 595 as are necessary for the operation of the statewide managed care 596 program. In addition to any other provisions the agency may deem 597 necessary, the contract must require: 598 (c) Access.— 599 1. The agency shall establish specific standards for the 600 number, type, and regional distribution of providers in managed 601 care plan networks to ensure access to care for both adults and 602 children. Each plan must maintain a regionwide network of 603 providers in sufficient numbers to meet the access standards for 604 specific medical services for all recipients enrolled in the 605 plan. The exclusive use of mail-order pharmacies may not be 606 sufficient to meet network access standards. Consistent with the 607 standards established by the agency, provider networks may 608 include providers located outside the region. A plan may 609 contract with a new hospital facility before the date the 610 hospital becomes operational if the hospital has commenced 611 construction, will be licensed and operational by January 1, 612 2013, and a final order has issued in any civil or 613 administrative challenge. Each plan shall establish and maintain 614 an accurate and complete electronic database of contracted 615 providers, including information about licensure or 616 registration, locations and hours of operation, specialty 617 credentials and other certifications, specific performance 618 indicators, and such other information as the agency deems 619 necessary. The database must be available online to both the 620 agency and the public and have the capability to compare the 621 availability of providers to network adequacy standards and to 622 accept and display feedback from each provider’s patients. Each 623 plan shall submit quarterly reports to the agency identifying 624 the number of enrollees assigned to each primary care provider. 625 2. Each managed care plan must publish any prescribed drug 626 formulary or preferred drug list on the plan’s website in a 627 manner that is accessible to and searchable by enrollees and 628 providers. The plan must update the list within 24 hours after 629 making a change. Each plan must ensure that the prior 630 authorization process for prescribed drugs is readily accessible 631 to health care providers, including posting appropriate contact 632 information on its website and providing timely responses to 633 providers. For Medicaid recipients diagnosed with hemophilia who 634 have been prescribed anti-hemophilic-factor replacement 635 products, the agency shall provide for those products and 636 hemophilia overlay services through the agency’s hemophilia 637 disease management program. 638 3. Managed care plans, and their fiscal agents or 639 intermediaries, must accept prior authorization requests for any 640 service electronically. 641 4. Managed care plans serving children in the care and 642 custody of the Department of Children and Families must maintain 643 complete medical, dental, and behavioral health encounter 644 information and participate in making such information available 645 to the department or the applicable contracted community-based 646 care lead agency for use in providing comprehensive and 647 coordinated case management. The agency and the department shall 648 establish an interagency agreement to provide guidance for the 649 format, confidentiality, recipient, scope, and method of 650 information to be made available and the deadlines for 651 submission of the data. The scope of information available to 652 the department shall be the data that managed care plans are 653 required to submit to the agency. The agency shall determine the 654 plan’s compliance with standards for access to medical, dental, 655 and behavioral health services; the use of medications; and 656 followup on all medically necessary services recommended as a 657 result of early and periodic screening, diagnosis, and 658 treatment. 659 5. Each managed care plan must report its annual direct 660 care spending on community behavioral health services and 661 inpatient behavioral health services and the proportion of 662 direct care spending on behavioral health services in relation 663 to other health services. The agency shall include in all plan 664 contracts a provision requiring that each managed care plan 665 spend at least 85 percent of its behavioral health capitation on 666 direct community behavioral health services. If a plan spends 667 less than 85 percent of its behavioral health capitation on 668 direct community behavioral health services, the difference 669 shall be returned to the agency. 670 Section 11. Paragraph (e) is added to subsection (10) of 671 section 29.004, Florida Statutes, to read: 672 29.004 State courts system.—For purposes of implementing s. 673 14, Art. V of the State Constitution, the elements of the state 674 courts system to be provided from state revenues appropriated by 675 general law are as follows: 676 (10) Case management. Case management includes: 677 (e) Service referral, coordination, monitoring, and 678 tracking for treatment-based mental health court programs under 679 s. 394.47892. 680 681 Case management may not include costs associated with the 682 application of therapeutic jurisprudence principles by the 683 courts. Case management also may not include case intake and 684 records management conducted by the clerk of court. 685 Section 12. Subsection (6) of section 39.001, Florida 686 Statutes, is amended to read: 687 39.001 Purposes and intent; personnel standards and 688 screening.— 689 (6) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES.— 690 (a) The Legislature recognizes that early referral and 691 comprehensive treatment can help combat mental illness and 692 substance abuse in families and that treatment is cost 693 effective. 694 (b) The Legislature establishes the following goals for the 695 state related to mental illness and substance abuse treatment 696 services in the dependency process: 697 1. To ensure the safety of children. 698 2. To prevent and remediate the consequences of mental 699 illness and substance abuse on families involved in protective 700 supervision or foster care and reduce mental illness and 701 substance abuse, including alcohol abuse, for families who are 702 at risk of being involved in protective supervision or foster 703 care. 704 3. To expedite permanency for children and reunify healthy, 705 intact families, when appropriate. 706 4. To support families in recovery. 707 (c) The Legislature finds that children in the care of the 708 state’s dependency system need appropriate health care services, 709 that the impact of mental illness and substance abuse on health 710 indicates the need for health care services to include mental 711 health and substance abuse services to children and parents 712 where appropriate, and that it is in the state’s best interest 713 that such children be provided the services they need to enable 714 them to become and remain independent of state care. In order to 715 provide these services, the state’s dependency system must have 716 the ability to identify and provide appropriate intervention and 717 treatment for children with personal or family-related mental 718 illness and substance abuse problems. 719 (d) It is the intent of the Legislature to encourage the 720 use of the mental health court program model established by s. 721 394.47892 and the drug court program model established by s. 722 397.334 and authorize courts to assess children and persons who 723 have custody or are requesting custody of children where good 724 cause is shown to identify and address mental illness and 725 substance abuse problems as the court deems appropriate at every 726 stage of the dependency process. Participation in treatment, 727 including a treatment-based mental health court program or a 728 treatment-based drug court program, may be required by the court 729 following adjudication. Participation in assessment and 730 treatment prior to adjudication shall be voluntary, except as 731 provided in s. 39.407(16). 732 (e) It is therefore the purpose of the Legislature to 733 provide authority for the state to contract with mental health 734 service providers and community substance abuse treatment 735 providers for the development and operation of specialized 736 support and overlay services for the dependency system, which 737 will be fully implemented and used as resources permit. 738 (f) Participation in a treatment-based mental health court 739 program or athetreatment-based drug court program does not 740 divest any public or private agency of its responsibility for a 741 child or adult, but is intended to enable these agencies to 742 better meet their needs through shared responsibility and 743 resources. 744 Section 13. Subsection (10) of section 39.507, Florida 745 Statutes, is amended to read: 746 39.507 Adjudicatory hearings; orders of adjudication.— 747 (10) After an adjudication of dependency, or a finding of 748 dependency where adjudication is withheld, the court may order a 749 person who has custody or is requesting custody of the child to 750 submit to a mental health or substance abuse assessment or 751 evaluation. The assessment or evaluation must be administered by 752 a qualified professional, as defined in s. 397.311. The court 753 may also require such person to participate in and comply with 754 treatment and services identified as necessary, including, when 755 appropriate and available, participation in and compliance with 756 a treatment-based mental health court program established under 757 s. 394.47892 or a treatment-based drug court program established 758 under s. 397.334. In addition to supervision by the department, 759 the court, including the treatment-based mental health court 760 program or the treatment-based drug court program, may oversee 761 the progress and compliance with treatment by a person who has 762 custody or is requesting custody of the child. The court may 763 impose appropriate available sanctions for noncompliance upon a 764 person who has custody or is requesting custody of the child or 765 make a finding of noncompliance for consideration in determining 766 whether an alternative placement of the child is in the child’s 767 best interests. Any order entered under this subsection may be 768 made only upon good cause shown. This subsection does not 769 authorize placement of a child with a person seeking custody, 770 other than the parent or legal custodian, who requires mental 771 health or substance abuse treatment. 772 Section 14. Paragraph (b) of subsection (1) of section 773 39.521, Florida Statutes, is amended to read: 774 39.521 Disposition hearings; powers of disposition.— 775 (1) A disposition hearing shall be conducted by the court, 776 if the court finds that the facts alleged in the petition for 777 dependency were proven in the adjudicatory hearing, or if the 778 parents or legal custodians have consented to the finding of 779 dependency or admitted the allegations in the petition, have 780 failed to appear for the arraignment hearing after proper 781 notice, or have not been located despite a diligent search 782 having been conducted. 783 (b) When any child is adjudicated by a court to be 784 dependent, the court having jurisdiction of the child has the 785 power by order to: 786 1. Require the parent and, when appropriate, the legal 787 custodian and the child to participate in treatment and services 788 identified as necessary. The court may require the person who 789 has custody or who is requesting custody of the child to submit 790 to a mental health or substance abuse assessment or evaluation. 791 The assessment or evaluation must be administered by a qualified 792 professional, as defined in s. 397.311. The court may also 793 require such person to participate in and comply with treatment 794 and services identified as necessary, including, when 795 appropriate and available, participation in and compliance with 796 a treatment-based mental health court program established under 797 s. 394.47892 or a treatment-based drug court program established 798 under s. 397.334. In addition to supervision by the department, 799 the court, including the treatment-based mental health court 800 program or the treatment-based drug court program, may oversee 801 the progress and compliance with treatment by a person who has 802 custody or is requesting custody of the child. The court may 803 impose appropriate available sanctions for noncompliance upon a 804 person who has custody or is requesting custody of the child or 805 make a finding of noncompliance for consideration in determining 806 whether an alternative placement of the child is in the child’s 807 best interests. Any order entered under this subparagraph may be 808 made only upon good cause shown. This subparagraph does not 809 authorize placement of a child with a person seeking custody of 810 the child, other than the child’s parent or legal custodian, who 811 requires mental health or substance abuse treatment. 812 2. Require, if the court deems necessary, the parties to 813 participate in dependency mediation. 814 3. Require placement of the child either under the 815 protective supervision of an authorized agent of the department 816 in the home of one or both of the child’s parents or in the home 817 of a relative of the child or another adult approved by the 818 court, or in the custody of the department. Protective 819 supervision continues until the court terminates it or until the 820 child reaches the age of 18, whichever date is first. Protective 821 supervision shall be terminated by the court whenever the court 822 determines that permanency has been achieved for the child, 823 whether with a parent, another relative, or a legal custodian, 824 and that protective supervision is no longer needed. The 825 termination of supervision may be with or without retaining 826 jurisdiction, at the court’s discretion, and shall in either 827 case be considered a permanency option for the child. The order 828 terminating supervision by the department shall set forth the 829 powers of the custodian of the child and shall include the 830 powers ordinarily granted to a guardian of the person of a minor 831 unless otherwise specified. Upon the court’s termination of 832 supervision by the department, no further judicial reviews are 833 required, so long as permanency has been established for the 834 child. 835 Section 15. Paragraph (a) of subsection (1) of section 836 409.975, Florida Statutes, is amended to read: 837 409.975 Managed care plan accountability.—In addition to 838 the requirements of s. 409.967, plans and providers 839 participating in the managed medical assistance program shall 840 comply with the requirements of this section. 841 (1) PROVIDER NETWORKS.—Managed care plans must develop and 842 maintain provider networks that meet the medical needs of their 843 enrollees in accordance with standards established pursuant to 844 s. 409.967(2)(c). Except as provided in this section, managed 845 care plans may limit the providers in their networks based on 846 credentials, quality indicators, and price. 847 (a) Plans must include all providers in the region which 848thatare classified by the agency as essential Medicaid 849 providers, unless the agency approves, in writing, an 850 alternative arrangement for securing the types of services 851 offered by the essential providers. Providers are essential for 852 serving Medicaid enrollees if they offer services that are not 853 available from any other provider within a reasonable access 854 standard, or if they provided a substantial share of the total 855 units of a particular service used by Medicaid patients within 856 the region during the last 3 years and the combined capacity of 857 other service providers in the region is insufficient to meet 858 the total needs of the Medicaid patients. The agency may not 859 classify physicians and other practitioners as essential 860 providers. The agency, at a minimum, shall determine which 861 providers in the following categories are essential Medicaid 862 providers: 863 1. Federally qualified health centers. 864 2. Statutory teaching hospitals as defined in s. 865 408.07(45). 866 3. Hospitals that are trauma centers as defined in s. 867 395.4001(14). 868 4. Hospitals located at least 25 miles from any other 869 hospital with similar services. 870 5. Community behavioral health centers as provided in s. 871 394.9086. 872 873 Managed care plans that have not contracted with all essential 874 providers in the region as of the first date of recipient 875 enrollment, or with whom an essential provider has terminated 876 its contract, must negotiate in good faith with such essential 877 providers for 1 year or until an agreement is reached, whichever 878 is first. Payments for services rendered by a nonparticipating 879 essential provider shall be made at the applicable Medicaid rate 880 as of the first day of the contract between the agency and the 881 plan. A rate schedule for all essential providers shall be 882 attached to the contract between the agency and the plan. After 883 1 year, managed care plans that are unable to contract with 884 essential providers shall notify the agency and propose an 885 alternative arrangement for securing the essential services for 886 Medicaid enrollees. The arrangement must rely on contracts with 887 other participating providers, regardless of whether those 888 providers are located within the same region as the 889 nonparticipating essential service provider. If the alternative 890 arrangement is approved by the agency, payments to 891 nonparticipating essential providers after the date of the 892 agency’s approval shall equal 90 percent of the applicable 893 Medicaid rate. If the alternative arrangement is not approved by 894 the agency, payment to nonparticipating essential providers 895 shall equal 110 percent of the applicable Medicaid rate. 896 Section 16. Paragraph (m) of subsection (2) of section 897 921.0026, Florida Statutes, is amended to read: 898 921.0026 Mitigating circumstances.—This section applies to 899 any felony offense, except any capital felony, committed on or 900 after October 1, 1998. 901 (2) Mitigating circumstances under which a departure from 902 the lowest permissible sentence is reasonably justified include, 903 but are not limited to: 904 (m) The defendant’s offense is a nonviolent felony, the 905 defendant’s Criminal Punishment Code scoresheet total sentence 906 points under s. 921.0024 are 60 points or fewer, and the court 907 determines that the defendant is amenable to the services of a 908 postadjudicatory treatment-based drug court program or a 909 postadjudicatory treatment-based mental health court program and 910 is otherwise qualified to participate in the program as part of 911 the sentence. For purposes of this paragraph, the term 912 “nonviolent felony” has the same meaning as provided in s. 913 948.08(6). 914 Section 17. Subsection (8) is added to section 948.01, 915 Florida Statutes, to read: 916 948.01 When court may place defendant on probation or into 917 community control.— 918 (8)(a) Notwithstanding s. 921.0024 and effective for 919 offenses committed on or after July 1, 2015, the sentencing 920 court may place the defendant into a postadjudicatory treatment 921 based mental health court program if the defendant’s Criminal 922 Punishment Code scoresheet total sentence points under s. 923 921.0024 are 60 points or fewer, the offense is a nonviolent 924 felony, the defendant is amenable to mental health treatment, 925 and the defendant is otherwise qualified under s. 394.47892(3). 926 The satisfactory completion of the program must be a condition 927 of the defendant’s probation or community control. As used in 928 this subsection, the term “nonviolent felony” means a third 929 degree felony violation under chapter 810 or any other felony 930 offense that is not a forcible felony as defined in s. 776.08. 931 (b) The defendant must be fully advised of the purpose of 932 the program, and the defendant must agree to enter the program. 933 The original sentencing court shall relinquish jurisdiction of 934 the defendant’s case to the postadjudicatory treatment-based 935 mental health court program until the defendant is no longer 936 active in the program, the case is returned to the sentencing 937 court due to the defendant’s termination from the program for 938 failure to comply with the terms of the program, or the 939 defendant’s sentence is completed. 940 Section 18. Paragraph (j) is added to subsection (2) of 941 section 948.06, Florida Statutes, to read: 942 948.06 Violation of probation or community control; 943 revocation; modification; continuance; failure to pay 944 restitution or cost of supervision.— 945 (2) 946 (j)1. Notwithstanding s. 921.0024 and effective for 947 offenses committed on or after July 1, 2015, the court may order 948 the defendant to successfully complete a postadjudicatory 949 treatment-based mental health court program if: 950 a. The court finds or the offender admits that the offender 951 has violated his or her community control or probation; 952 b. The offender’s Criminal Punishment Code scoresheet total 953 sentence points under s. 921.0024 are 60 points or fewer after 954 including points for the violation; 955 c. The underlying offense is a nonviolent felony. As used 956 in this subsection, the term “nonviolent felony” means a third 957 degree felony violation under chapter 810 or any other felony 958 offense that is not a forcible felony as defined in s. 776.08; 959 d. The court determines that the offender is amenable to 960 the services of a postadjudicatory treatment-based mental health 961 court program; 962 e. The court has explained the purpose of the program to 963 the offender and the offender has agreed to participate; and 964 f. The offender is otherwise qualified to participate in 965 the program under s. 394.47892(3). 966 2. After the court orders the modification of community 967 control or probation, the original sentencing court shall 968 relinquish jurisdiction of the offender’s case to the 969 postadjudicatory treatment-based mental health court program 970 until the offender is no longer active in the program, the case 971 is returned to the sentencing court due to the offender’s 972 termination from the program for failure to comply with the 973 terms of the program, or the offender’s sentence is completed. 974 Section 19. The Agency for Health Care Administration shall 975 complete a study to examine the feasibility, and any associated 976 costs and benefits, of including persons with substance abuse 977 disorders as a target population for targeted case management 978 services. Such case management services must be comprehensive 979 services that include face-to-face interaction with the 980 recipient; coordination of services for the recipient and the 981 recipient’s family members; and access to community-based 982 supports such as housing and community recovery supports. Such 983 services may not be duplicative of care coordination available 984 through the statewide Medicaid managed care program. For 985 purposes of the study, the term “target population” means 986 individuals with a substance abuse disorder who are pregnant or 987 have a child younger than 8 years of age, who have a comorbid 988 behavioral or physical health condition, or whose treatment is 989 complicated by factors such as transient housing, homelessness, 990 or multiple admissions to treatment. The study must address how 991 case management services can reduce the need for Medicaid-funded 992 services such as inpatient detoxification and multiple 993 hospitalizations, improve family stability and avoid negative 994 consequences for young children, and reduce the cost of physical 995 health care for persons with comorbid conditions, and how 996 reductions in health care costs can reduce the financial impact 997 of such services on this state. The study must also provide an 998 estimate of the amount of state and federal funds needed to add 999 targeted case management services for persons with substance 1000 abuse disorders to the state Medicaid plan while accounting for 1001 potential financial offsets. In completing the study, the agency 1002 shall collaborate with the Department of Children and Families 1003 and the Florida Alcohol and Drug Abuse Association. The agency 1004 shall submit a report detailing the findings of the study to the 1005 President of the Senate and the Speaker of the House of 1006 Representatives by February 1, 2016. 1007 Section 20. (1) The Agency for Health Care Administration 1008 shall apply to the United States Department of Health and Human 1009 Services for a planning grant and any other subsequent grant 1010 programs that become available through s. 203 of the federal 1011 Protecting Access to Medicare Act of 2014, Pub. L. No. 113-93, 1012 and that create opportunity to improve access to community 1013 mental health services while improving Medicaid reimbursement 1014 rates for such services. The agency shall collaborate with the 1015 Department of Children and Families in preparing the state’s 1016 planning grant application for submission. 1017 (2) For the 2015-2016 fiscal year, there is appropriated 1018 the sum of $189,000 in nonrecurring funds from the General 1019 Revenue Fund and the sum of $189,000 in nonrecurring funds from 1020 the Medical Care Trust Fund to the Agency for Health Care 1021 Administration for the purpose of assisting the agency with the 1022 preparation of the state’s planning grant application. 1023 Section 21. For the 2015-2016 fiscal year, there is 1024 appropriated the sum of $44,520,498 in nonrecurring funds from 1025 the General Revenue Fund and the sum of $65,569,754 in 1026 nonrecurring funds from the Medical Care Trust Fund to the 1027 Agency for Health Care Administration for the purpose of 1028 increasing Medicaid reimbursement rates for behavioral health 1029 services providers to the actual cost of providing such 1030 services. The agency shall amend each contract with a Medicaid 1031 managed care plan to include a provision that requires the plan 1032 to pass such reimbursement rate increases directly to behavioral 1033 health services providers. 1034 Section 22. This act shall take effect July 1, 2015.