Natalie Kelly: Florida’s behavioral health safety net — a model of accountability, transparency

Florida has built a unique and effective safety net system to ensure uninsured and underinsured individuals receive critical behavioral health services. After the Parkland tragedy, the Legislature also tasked our safety net with implementing crisis response teams to assist anyone in need within 59 minutes.

Behavioral Health Managing Entities, acting as a Lead Agency under contract with the Department of Children and Families, work with more than 300 local providers statewide to offer local services, ranging from crisis intervention to long-term recovery support. Florida’s behavioral health safety net system serves more than 250,000 individuals annually.

These lead agencies operate as not-for-profits and provide the highest return on investment, with an administrative rate below 3.2%. This efficiency ensures that every taxpayer dollar is used effectively, with fiscal prudence and transparency.

Recently, Florida lawmakers introduced House Bill 633 and Senate Bill 1354, requiring the Department of Children and Families to subcontract operational and financial audits to evaluate which metrics and criteria best assess performance and outcomes. The bill would also standardize data requirements and reporting, increasing transparency for all stakeholders.

As CEO of Florida’s Association of Managing Entities, I can confidently affirm that our commitment to accountability and transparency is unwavering. Each Behavioral Health Managing Entity submits more than 65 reports annually to the Department of Children and Families, detailing business practices, contracting requirements, performance outcomes, and expenditures.

We commend Representative Koster and Senator Trumbull for their leadership and commitment to developing the behavioral health performance management system of the future.

Beyond financial accountability, Florida’s Behavioral Health Managing Entities focus on evidence-based best practices to maximize positive outcomes. In Fiscal Year 2023-2024, our network of providers achieved the following results:

• 98% of children in the Community Action Treatment (CAT) Teams were diverted from juvenile justice system involvement.
• 97% of children in the CAT program avoided placement in State Inpatient Psychiatric Programs.
• 96% of individuals enrolled in payor-level care coordination avoided costly crisis stabilization units, emergency rooms, and jails.
• Through Mobile Response Teams, 80% of individuals were diverted from Baker Act admissions, resulting in an estimated annual cost savings of $12.2 million for the state.

Behavioral Health Managing Entities are just one part of Florida’s vast and complex behavioral health system. Transparency and accountability must be extended to the entire behavioral health system of care, including private insurance and Florida’s Statewide Medicaid Managed Care Program, overseen by the Agency for Health Care Administration.

Behavioral Health Managing Entities and their network of providers are the safety net that cares for the state’s most vulnerable populations. We are dedicated to serving Floridians with complete transparency and accountability in the best way possible. We meet each community’s unique needs and help Floridians get back on their feet to live life to their fullest potential.

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Natalie Kelly is CEO of the Florida Association of Managing Entities.