Functions of Managing Entities

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Substance Abuse Program

RULE NO: RULE TITLE
65D-31.004: Functions of Managing Entities

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 35 No. 14, April 10, 2009 issue of the Florida Administrative Weekly.

65D-31.004 Functions of Managing Entities.

(1) System of care development and management. Managing entities must:

(a) Require must ensure that substance abuse and mental health services within their respective geographic areas to be coordinated and developed into an integrated network of assessable services which are and is responsive to the needs of persons in need of service and their families.

(b) Require must ensure substance abuse and mental health services to be are responsive to the needs of the community and community stakeholders including the courts, community agencies, law enforcement, child welfare agencies and others who are reliant on mental health and substance abuse services as essential to their success.

(c) Require the must ensure application of evidence-based practices by network providers through contracting requirements, program development and design, and the provision of training, technical assistance, and quality improvement activities.

(d) Develop effective and formal mechanisms for care management, continuity of care, least restrictive placement, and service coordination.

(e) through (2) (a) No change.

(b) The managing entity is required to contract only with agencies which when contracting with providers are to ensure that agencies are qualified and capable of providing quality client services. The managing entity will develop policies, procedures, and practices that require assure that network providers to comply are complying with applicable laws, rules, regulations, and contract requirements.

(c) The managing entity must require that, within available resources, ensure that, within available resources, a comprehensive system of care is available within their respective geographic area which that is accessible, co-occurring competent, and consists of a range of services that is responsive to the needs of persons receiving services and is responsive to the needs of the community.

(3)(a) through (3)(e) No change.

(f) Achieving efficiencies by the consolidation of provider operational functions. Examples include, but are not limited to, including, but not limited to, data collection and analysis, administrative efficiencies, and group purchasing.

(g) Reinvesting funds gained by efficiencies into the system of care after achieving departmentally approved reserves and necessary infrastructure development.

(4)(a) through (c) 2. a. No change.

b. The Department will establish plan requirements and timeframes for the submission of the annual business or operational plan.

c. through e. No change.

(5) Data Collection, Analysis, and Reporting.

(a) The Department, in collaboration with the managing entities shall design and implement a comprehensive behavioral health management information system to meet the minimum reporting requirements at the federal, state and local levels as follows. Each managing entity shall develop and maintain a database system, including data from agencies under contract with the managing entity. At the minimum, the managing entity’s database system shall provide information needed not only by the managing entity to address the management and clinical care needs of the local provider networks, but also by the department to meet the state and federal data reporting requirements. The Department shall collaborate with managing entities to develop business requirements, which managing entities will use to extract data required at the state and federal levels from their local database systems and to submit these data electronically into the Department’s central database system. Requirements will increase system access to users and ensure timely and accurate information. The Department shall use the central database system to provide non-confidential data accessible to all stakeholders, including managing entities, for planning, monitoring, evaluation, and research purposes.

(a) through (d) renumbered (b) through (e) No change.

(6) Continuous Quality Improvement.

(a) The managing entity will establish a clearly delineated continuous quality improvement program that provides for the meaningful involvement of managing entity personnel, provider organizations, consumers, and stakeholders. The program will:

(a)1. through 4. No change.

5. Require Insure that there are mechanisms that identify performance issues, conduct analysis of performance issues, develop appropriate interventions, and measure the effects of those interventions.

6. Review the results of quality assurance reviews, external monitoring, critical incidents, consumer complaints and grievances, and take steps to initiate improvement, including appropriate corrective actions and sanctions.

7. through 8. No change.

(b) 5. No change.

(7)(a) No change.

(b) The managing entity must require will ensure that all participating agencies have has a peer review process in place.

(c) through (10) No change.

Rulemaking Authority 394.9082(10) FS. Law Implemented 394.9082 FS. History–New_________.