Andrew Powell
The Senate has unanimously passed a measure that aims to ensure that behavioral health services are delivered more efficiently.
Panama City Republican Sen. Jay Trumbull presented the bill (SB 1354), which was swapped out for its House companion (HB 633) sponsored by Tampa Republican Rep. Traci Koster. The House approved that bill last week, making its next stop the Governor’s Office.
Trumbull said the bill would enhance transparency and accountability of behavioral health managing entities by requiring regular audits.
“We cannot manage what we do not measure, and this is a great opportunity for the state to understand where our dollars are going and how we can better manage outcomes,” Trumbull said.
St. Petersburg Democratic Sen. Darryl Rouson thanked Trumbull for the legislation.
“Everything that we fund, that we send money, should be accountable and transparent with how it operates,” Rouson said.
Natalie Kelly, CEO of the Florida Association of Managing Entities said her group welcomes the change.
“We applaud the Florida Legislature for passing legislation championing additional transparency within Florida’s behavioral health safety net system, which will show the return on investment of taxpayer dollars achieved by the Managing Entities,” Kelly said.
“On behalf of Florida’s seven Behavioral Health Managing Entities, which oversee the system, we welcome all measures to provide Floridians with the transparency and accountability they deserve so they can see the return on investment of their taxpayer dollars.”
Under the bill, the Department of Children and Families (DCF) would contract for operational and financial audits of managing entities and would analyze the data provided.
Audits would need to include a review of business practices, personnel, financial records, compensation, services administered, the method of provider payment, expenditures, outcomes, referral patterns and referral volume, provider referral assignments, and key performance measures.
Provider network participation information for DCF’s available bed platform, the Opioid Management System, and the Agency for Health Care Administration Event Notification Service would be required for audits, as well as information on provider network adequacy.
Managing entities would be required to compare administered services with outcomes of expenditures and add them into each audit of the entity’s expenditures and claims, including any Medicaid funding used for behavioral health services.
Claims paid by each managing entity for Medicaid recipients would need to be analyzed and include recommendations to improve the transparency of the system’s performance based on metrics and criteria. Performance standards would be established by both DCF and the managing entities.
DCF and managing entities would further work together to outline success strategies that would avoid admission from acute levels of care, jails, prisons and forensic facilities. These strategies also include ways to integrate behavioral health services within the child welfare system and addressing housing needs of individuals released from a facility who are homeless.
Managing entities would be required to report the numbers and percentages of high utilizers, individuals who receive outpatient services for behavioral health services, and emergency room visits.
Information on the number of individuals able to schedule an appointment within 24 hours, wait times, the incidence of medication errors in treatment plans, rate of readmission, and the number of adverse incidents such as self-harm in both in-patient and outpatient settings would also be reported.
