The Marjory Stoneman Douglas High School Public Safety Commission Report

A memorial garden for the 17 people killed in the Feb. 14, 2018, mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla.

The Marjory Stoneman Douglas High School Public Safety Commission released their state mandated 2nd report of findings and recommendations to a comprehensive approach to identifying and addressing issues presented by the tragedy that occurred at Marjory Stoneman Douglas High School in Parkland, Florid

The Marjory Stoneman Douglas High School Public Safety Commission- within the Florida Department of Law Enforcement-was established during the 2018 legislative session. The Commission was formed to specifically analyze information from the school shooting and other mass violence incidents in the state and address recommendations and system improvements.

FBHA staff overview of the full report as it relates to the mental health allocation, mental health services for children, threat assessment teams and juvenile detention may be read here.

Read the full Commission Report

The Office of Program Policy Analysis and Government Accountability (OPPAGA)

OPPAGA released their report regarding CSU bed payments that was mandated in the 2019 Appropriations Act Implementing bill November 1. The OPPAGA findings conclude that the state’s Acute Care Services Utilization (ACSU) Database cannot accurately report final payment sources or final amounts paid to providers and does not accurately represent actual bed utilization by payer source. The report indicates that due to duplication, missing data, and quality errors, the FASAMS ACSU results on bed days should be viewed cautiously.  The report also points out high utilization of crisis beds for state funded beds (97% to 99% DCF funded) in FY 2019/20, exemplifying the need for recurring, stable funding. 

Read the full OPPAGA Report

DCF Notice of Change to Rule 65D 30

The Department of Children and Families recently released the second Notice of Change/Withdrawl to the proposed rewrite of Rule 65D -30. The Notice of Change modifies some of the initial proposed rewrite as well as in the first Notice of Change. Here is the history of rule promulgation on this rule. The most recent release is a much smaller document than the previous two, indicating that the Department is beginning to “close out” some of the proposed items. To date, a Public Workshop has not been scheduled. Meanwhile, the Department adopted the final rule regarding Methadone Maintenance, along with the Fiscal Year 2018-19 Methadone Needs Assessment. However, if you have any questions, comments, or concerns, please feel free to contact Sally Cunningham (sally@fccmh.org). Here are two documents prepared by the association. The first document is a spreadsheet that outlines each change, and when the change was made, along with comments made by members of the association. The second document summarizes the second Notice of Change.

65D30 Rule Comments

65D30 Key Provisions to Changes in Rewrite

Regulatory Updates: June

Department of Education

Rule/Title: 6A-1.094121 Mental and Emotional Health Education

Purpose and Effect: To establish minimum hours of required instruction related to mental and emotional health education for grades 6-12 students and to establish procedures for school districts to document the instruction.

The preliminary text of the proposed rule development is not currently available.

Department of Children and Families

Rule/Title: 65D30.014 Methadone and Methadone Maintenance
We have heard the agency is very close to final adoption of the rules relating to methadone. Stay tuned…..

Low Income Pool for Central Receiving Systems Update

OBHA Staff

Good News! The final milestone to implement the Low Income Pool (LIP) for Behavioral Health providers was reached on April 17 when AHCA received approval from federal CMS on the Revised Funding Methodology Document (RFMD) that includes Behavioral Health providers (central receiving systems) in Florida’s LIP.   AHCA has already initiated the invoicing process and providers are expected to receive payment before June 30.  We are excited to have the opportunity to demonstrate the positive impact this will have on the system of care statewide.

This lengthy process began over three years ago with the hiring and collaboration of Health Management Consultants (HMA) on revenue maximization language. At the conclusion of the 2018 session (March) LIP proviso was agreed upon and accepted by the legislature, written into the GAA, and signed by the Governor. AHCA had to submit the 1115 Waiver Amendment and obtain CMS approval. Then One BH staff worked to get a state budget amendment passed by the Joint Legislative Budget Commission after the CMS approval.  Finally AHCA received the RFMD approval by CMS to implement the behavioral health LIP payments in April.

CMS Updates on Efforts to Address Opioid Epidemic

The Medicare Administrative Contractors (MACs) under the Centers for Medicare and Medicaid Services (CMS) recently mailed letters to all Medicare fee-for-service providers to outline federal agency efforts to reduce opioid misuse by Medicare enrollees, including:

  • Providing guidance on co-prescribing Naloxone
  • Implementing new Medicare Part D opioid policies
  • Promoting a range of safe and effective pain treatments

Also released by CMS in February was an expanded version of the Opioid Prescribing Mapping Tool, which includes current data to effectively address the opioid epidemic across the country. The goal is to better inform local prevention and treatment efforts, particularly in rural communities hard hit by the opioid crisis.

New to this tool is data on opioid prescribing through Medicaid, along with the capability to make geographic comparisons of Medicare Part D opioid prescribing rates over time for urban and rural communities.

The full text of the press release can be found here: CMS Press Release (issued February 22).

DCF Clarification on Serving Individuals from Out of State in Outpatient Detox

On March 13, the Department of Children and Families (DCF) issued a policy clarification regarding Outpatient Detox and Day or Night with Community Housing services. In the clarification memo, DCF reported that some outpatient detox providers are serving individuals from out of state who do not have family support, as required in Section 65D-30.006(3), FAC. Additionally, DCF has become aware of instances where individuals are receiving treatment services (assistance with medications) while living in day or night treatment with community housing program, in violation of 65D-30.008(1), FAC.

In response to these violations, DCF is requiring all outpatient detox providers to eliminate the practice of admitting individuals from out of state who do not have local family support to monitor their compliance. Additionally, day or night community housing providers may not accept individuals who are receiving detox services. (link to memo)