Senate bill seeks additional federal Medicaid dollars for mental health and substance abuse programs

The Senate has proposed a tandem of bills that, combined, would transform Florida’s mental health and substance abuse laws as well as increase the amount of federal Medicaid money used fund the programs.
The Senate Appropriations Subcommittee on Health and Human services will discuss two bills — released late Friday — at its March 16 meeting. The proposed bills do not not have bill numbers because they are drafts. They are contained in the committee’s meeting package.
The first bill, among other things, requires the Department of Children and Families and the Agency for Health Care Administration to submit to the Legislature no later than Nov. 1 a plan to to increase federal Medicaid dollars for mental health and substance abuse and to show the pros and cons of targeting the increased dollars at, among other things:
  • expanding Medicaid access for the the “severely and persistently” mentally ill;
  • increasing the rates managed care plans are paid for treating those with chronic mental illness or substance abuse disorders; and
  • creating a designated health program or other mechanism to drawn down supplemental Medicaid payments

The 43-page bill also alters the managing care entities that contract with the Department of Children and Families placing into law specific requirements for their governing boards. It also deletes a requirement that managing care entities be nonprofit organization.

Moreover, the bill requires makes several changes to the Statewide Medicaid Managed Care program to incorporate mental health services, including adding publicly funded community mental health services providers to the to the list of “essential Medicaid providers” meaning they must be included on managed care plans networks.

Medicaid managed care plans will be required to provide behavioral health care services in the least restrictive setting with treatment and recovery capabilities that best serve the patient. The managed care plans also will be required to work with the managing entity in the service area to establish organizational supports and protocols to meet the goals.

The 43-page bill also requires by Jan. 1, 2016 the Department of Children and Families to modify licensure rules to create an option for a single, consolidated license for a provider that offers multiple types of mental health and substance abuse services.

The second draft is a 113-page bill that, among other things, adds substance abuse to department’s list of ailments DCF should plan to reduce and updates the state’s laws on voluntary and involuntary admissions to treatment receiving facilities and detoxification centers.

The bill creates a Forensic Hospital Diversion Pilot Program to serve those with mental health or mental  health and substance abuse disorders who are admitted to or at risk of entering state forensic mental health treatment facilities, prisons, jails, or civil mental health treatment facilities.

The program is created to provide competency restoration and community re-integration services in locked residential treatment facilities. The pilot program will operate in Alachua, Escambia, Hillsborough and Miami-Dade counties. The program must be initiated within existing resources and is limited to people who are 18 and older; charged with a second or third degree felony; have been adjudicated incompetent to stand trial and do not have a “significant history” of violent criminal offenses and would be admitted to a state mental health treatment facility if not for the pilot program.

Mike Hansen, President and CEO of Alliance for Community Mental Health Centers, said the tandem of bills make significant changes to the state’s mental health and substance abuse programs.

“This is transformational,” said Hansen. “This is the first time mental health services have had a complete review since the 1970s.”

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


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