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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 A bill to be entitled An act relating to first-episode psychosis programs;
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 A bill to be entitled An act relating to coordinated specialty care programs;
defining the term "first-episode psychosis program";
defining the term "coordinated specialty care program";
revising the application criteria for the Criminal Justice, Mental Health, and Substance Abuse Reinvestment Grant Program to include support for first-episode psychosis programs;
revising the application criteria for the Criminal Justice, Mental Health, and Substance Abuse Reinvestment Grant Program to include support for coordinated specialty care programs;
requiring the Department of Children and Families to include specified information regarding first-episode psychosis programs in its annual assessment of behavioral health services;
requiring the Department of Children and Families to include specified information regarding coordinated specialty care programs in its annual assessment of behavioral health services;
providing a definition;
providing that a coordinated system of care includes coordinated specialty care programs;
providing that a coordinated system of care includes first-episode psychosis programs;
requiring coordinated specialty care programs to submit certain data to the department;
394.495, 394.496, 394.674, 394.9085, 409.972, 464.012, and 744.2007, F.S.;
39.407, 394.495, 394.496, 394.674, 394.74, 394.9085, 409.972, 464.012, and 744.2007, F.S.;
Subsections (17) through (48) of section 394.455, Florida Statutes, are renumbered as subsections (18) through (49), respectively, and a new subsection (17) is added to that section to read:
Subsections (10) through (48) of section 394.455, Florida Statutes, are renumbered as subsections (11) through (49), respectively, and a new subsection (10) is added Page 1 of 16 CODING:
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 394.455 Definitions.—As used in this part, the term:
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 to that section to read:
(17) "First-episode psychosis program" means an evidence- based program for individuals from 15 through 30 years of age who are experiencing the early indications of serious mental illness, especially symptoms of a first psychotic episode, and which includes, but is not limited to, intensive case management, individual or group therapy, supported employment, family education and supports, and the provision of appropriate psychotropic medication as needed.
394.455 Definitions.—As used in this part, the term:
(10) "Coordinated specialty care program" means an evidence-based program for individuals who are experiencing the early indications of serious mental illness, especially symptoms of a first psychotic episode, and which includes, but is not limited to, intensive case management, individual or group therapy, supported employment, family education and supports, and the provision of appropriate psychotropic medication as needed.
Subsections (10) through (24) of section 394.67, Florida Statutes, are renumbered as subsections (11) through (25), respectively, subsection (3) is amended, and a new subsection (10) is added to that section, to read:
Subsections (3) through (24) of section 394.67, Florida Statutes, are renumbered as subsections (4) through (25), respectively, present subsection (3) is amended, and a new subsection (3) is added to that section, to read:
(3) "Crisis services" means short-term evaluation, stabilization, and brief intervention services provided to a person who is experiencing an acute mental or emotional crisis, as defined in subsection (18) (17), or an acute substance abuse crisis, as defined in subsection (19) (18), to prevent further deterioration of the person's mental health.
(3) "Coordinated specialty care program" means an evidence-based program for individuals who are experiencing the early indications of serious mental illness, especially symptoms of a first psychotic episode, and which includes, but is not limited to, intensive case management, individual or group therapy, supported employment, family education and supports, and the provision of appropriate psychotropic medication as needed.
(4)(3) "Crisis services" means short-term evaluation, stabilization, and brief intervention services provided to a Page 2 of 16 CODING:
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 person who is experiencing an acute mental or emotional crisis, as defined in subsection (18) (17), or an acute substance abuse crisis, as defined in subsection (19) (18), to prevent further deterioration of the person's mental health.
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 (10) "First-episode psychosis program" means an evidence- based program for individuals from 15 through 30 years of age who are experiencing the early indications of serious mental illness, especially symptoms of a first psychotic episode, and which includes, but is not limited to, intensive case management, individual or group therapy, supported employment, family education and supports, and the provision of appropriate psychotropic medication as needed.
(b) The application criteria for a 3-year implementation or expansion grant shall require information from a county that Page 3 of 14 CODING:
(b) The application criteria for a 3-year implementation Page 3 of 16 CODING:
hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 demonstrates its completion of a well-established collaboration plan that includes public-private partnership models and the application of evidence-based practices.
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 or expansion grant shall require information from a county that demonstrates its completion of a well-established collaboration plan that includes public-private partnership models and the application of evidence-based practices.
First-episode psychosis programs.
Coordinated specialty care programs.
reports.—On or before December 1 of each year, the department shall submit to the Governor, the President of the Senate, and the Speaker of the House of Representatives an assessment of the behavioral health services in this state.
reports.—On or before December 1 of each year, the department shall submit to the Governor, the President of the Senate, and the Speaker of the House of Representatives an Page 4 of 16 CODING:
The Page 4 of 14 CODING:
hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 assessment shall consider, at a minimum, the extent to which designated receiving systems function as no-wrong-door models, the availability of treatment and recovery services that use recovery-oriented and peer-involved approaches, the availability of less-restrictive services, and the use of evidence-informed practices.
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 assessment of the behavioral health services in this state.
The assessment shall also consider the availability of and access to first-episode psychosis programs and identify any gaps in the availability of and access to such programs in the state.
The assessment shall consider, at a minimum, the extent to which designated receiving systems function as no-wrong-door models, the availability of treatment and recovery services that use recovery-oriented and peer-involved approaches, the availability of less-restrictive services, and the use of evidence-informed practices.
The assessment shall also consider the availability of and access to coordinated specialty care programs and identify any gaps in the availability of and access to such programs in the state, and shall include the data submitted to the department under paragraph (2)(n).
Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures.
Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange Page 5 of 16 CODING:
The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to Page 5 of 14 CODING:
hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 improve outcomes among priority populations.
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 procedures.
The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations.
(d) "First-episode psychosis program" means an evidence- based program for individuals from 15 through 30 years of age who are experiencing the early indications of serious mental illness, especially symptoms of a first psychotic episode, and which includes, but is not limited to, intensive case management, individual or group therapy, supported employment, family education and supports, and the provision of appropriate psychotropic medication as needed.
(d) "No-wrong-door model" means a model for the delivery of acute care services to persons who have mental health or substance use disorders, or both, which optimizes access to care, regardless of the entry point to the behavioral health care system.
(e)(d) "No-wrong-door model" means a model for the delivery of acute care services to persons who have mental health or substance use disorders, or both, which optimizes access to care, regardless of the entry point to the behavioral health care system.
(2) The essential elements of a coordinated system of care include:
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(a) Community interventions, such as prevention, primary care for behavioral health needs, therapeutic and supportive services, crisis response services, and diversion programs.
(b) A designated receiving system that consists of one or Page 6 of 16 CODING:
hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 (2) The essential elements of a coordinated system of care include:
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 more facilities serving a defined geographic area and responsible for assessment and evaluation, both voluntary and involuntary, and treatment or triage of patients who have a mental health or substance use disorder, or co-occurring disorders.
(a) Community interventions, such as prevention, primary care for behavioral health needs, therapeutic and supportive services, crisis response services, and diversion programs.
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(b) A designated receiving system that consists of one or more facilities serving a defined geographic area and responsible for assessment and evaluation, both voluntary and involuntary, and treatment or triage of patients who have a mental health or substance use disorder, or co-occurring disorders.
To the extent permitted by available resources, the Page 7 of 14 CODING:
To the extent permitted by available resources, the designated receiving system shall function as a no-wrong-door model.
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 designated receiving system shall function as a no-wrong-door model.
A central receiving system that consists of a designated central receiving facility that serves as a single entry point for persons with mental health or substance use disorders, or co-occurring disorders.
A central receiving system that consists of a Page 7 of 16 CODING:
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 designated central receiving facility that serves as a single entry point for persons with mental health or substance use disorders, or co-occurring disorders.
All Page 8 of 14 CODING:
All participating service providers shall, within existing resources, be linked by methods to share data, formal referral agreements, and cooperative arrangements for care coordination and case management.
An accurate inventory of the participating service providers Page 8 of 16 CODING:
hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 participating service providers shall, within existing resources, be linked by methods to share data, formal referral agreements, and cooperative arrangements for care coordination and case management.
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 which specifies the capabilities and limitations of each provider and its ability to accept patients under the designated receiving system agreements and the transportation plan developed pursuant to this section shall be maintained and made available at all times to all first responders in the service area.
An accurate inventory of the participating service providers which specifies the capabilities and limitations of each provider and its ability to accept patients under the designated receiving system agreements and the transportation plan developed pursuant to this section shall be maintained and made available at all times to all first responders in the service area.
(f) Care coordination that involves coordination with other local systems and entities, public and private, which are Page 9 of 14 CODING:
(f) Care coordination that involves coordination with other local systems and entities, public and private, which are involved with the individual, such as primary care, child welfare, behavioral health care, and criminal and juvenile justice organizations.
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 involved with the individual, such as primary care, child welfare, behavioral health care, and criminal and juvenile justice organizations.
(j) Aftercare and other postdischarge services.
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 (j) Aftercare and other postdischarge services.
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(n) Coordinated specialty care programs.
Such programs must submit deidentified data regarding the historical and current use of marijuana by individuals who are served by such programs to the department for inclusion in the assessment of behavioral health services as required in this section.
(3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific Page 10 of 16 CODING:
hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 (n) First-episode psychosis programs.
hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 appropriation by the Legislature, the department may award system improvement grants to managing entities based on a detailed plan to enhance services in accordance with the no- wrong-door model as defined in subsection (1) and to address specific needs identified in the assessment prepared by the department pursuant to this section.
(3) SYSTEM IMPROVEMENT GRANTS.—Subject to a specific appropriation by the Legislature, the department may award system improvement grants to managing entities based on a detailed plan to enhance services in accordance with the no- wrong-door model as defined in subsection (1) and to address specific needs identified in the assessment prepared by the department pursuant to this section.
Paragraph (a) of subsection (3) of section 39.407, Florida Statutes, is amended to read:
39.407 Medical, psychiatric, and psychological examination and treatment of child;
physical, mental, or substance abuse examination of person with or requesting child custody.— (3)(a)1.
Except as otherwise provided in subparagraph (b)1.
or paragraph (e), before the department provides psychotropic medications to a child in its custody, the prescribing physician or a psychiatric nurse, as defined in s.
394.455, shall attempt to obtain express and informed consent, as defined in s.
394.455(16) s.
394.455(15) and as described in s.
394.459(3)(a), from the child's parent or legal guardian.
The department must take steps necessary to facilitate the inclusion of the parent in the child's consultation with the physician or psychiatric nurse, as defined in s.
394.455.
However, if the parental rights of the parent have been terminated, the parent's Page 11 of 16 CODING:
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 location or identity is unknown or cannot reasonably be ascertained, or the parent declines to give express and informed consent, the department may, after consultation with the prescribing physician or psychiatric nurse, as defined in s.
394.455, seek court authorization to provide the psychotropic medications to the child.
Unless parental rights have been terminated and if it is possible to do so, the department shall continue to involve the parent in the decisionmaking process regarding the provision of psychotropic medications.
If, at any time, a parent whose parental rights have not been terminated provides express and informed consent to the provision of a psychotropic medication, the requirements of this section that the department seek court authorization do not apply to that medication until such time as the parent no longer consents.
2.
Any time the department seeks a medical evaluation to determine the need to initiate or continue a psychotropic medication for a child, the department must provide to the evaluating physician or psychiatric nurse, as defined in s.
394.455, all pertinent medical information known to the department concerning that child.
Section 6.
(a) A professional as defined in s.
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 (a) A professional as defined in s.
Section 6.
Section 7.
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394.496 Service planning.— (5) A professional as defined in s.
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 394.496 Service planning.— (5) A professional as defined in s.
Section 7.
Section 8.
Adults who have severe and persistent mental illness, as designated by the department using criteria that include severity of diagnosis, duration of the mental illness, ability to independently perform activities of daily living, and receipt of disability income for a psychiatric condition.
Adults who have severe and persistent mental illness, Page 13 of 16 CODING:
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 as designated by the department using criteria that include severity of diagnosis, duration of the mental illness, ability to independently perform activities of daily living, and receipt of disability income for a psychiatric condition.
Persons deemed incompetent to proceed or not guilty by Page 12 of 14 CODING:
Persons deemed incompetent to proceed or not guilty by reason of insanity under chapter 916.
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 reason of insanity under chapter 916.
Section 8.
Section 9.
Paragraph (a) of subsection (3) of section 394.74, Florida Statutes, is amended to read:
394.74 Contracts for provision of local substance abuse and mental health programs.— (3) Contracts shall include, but are not limited to:
(a) A provision that, within the limits of available resources, substance abuse and mental health crisis services, as defined in s.
394.67(4) s.
394.67(3), shall be available to any individual residing or employed within the service area, regardless of ability to pay for such services, current or past Page 14 of 16 CODING:
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 health condition, or any other factor;
Section 10.
Section 9.
Section 11.
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Section 12.
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hb0577-00 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S HB 577 2020 Section 10.
controlled substance prescribing.— (4) In addition to the general functions specified in subsection (3), an advanced practice registered nurse may perform the following acts within his or her specialty:
controlled substance prescribing.— (4) In addition to the general functions specified in Page 15 of 16 CODING:
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hb0577-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 577 2020 subsection (3), an advanced practice registered nurse may perform the following acts within his or her specialty:
Section 11.
Section 13.
Section 12.
Section 14.
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hb0577-00
hb0577-01-c1
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