Item C11 C.11
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County of Monroe
�y,4 ' ?, "tr, BOARD OF COUNTY COMMISSIONERS
Mayor Michelle Coldiron,District 2
�1 nff `_ll Mayor Pro Tem David Rice,District 4
-Ile Florida.Keys Craig Cates,District 1
Eddie Martinez,District 3
w Mike Forster,District 5
County Commission Meeting
March 17, 2021
Agenda Item Number: C.11
Agenda Item Summary #7904
BULK ITEM: Yes DEPARTMENT: Budget and Finance
TIME APPROXIMATE: STAFF CONTACT: Janet Gunderson (305) 292-4470
No
AGENDA ITEM WORDING: Ratification of previously approved Monroe County Designated
Receiving System plan which now has the corrected plan period of 1/1/21 to 12/31/23 on the cover
sheet of the plan document. The Guidance/Care Center and Lower Keys Medical Center provide
mental health & substance abuse services under this plan.
ITEM BACKGROUND: In 2016 Senate Bill 12 relating to mental health and substance abuse, was
approved,providing amendments to Florida Statute Chapter 394, Mental Health. Under F.S.
394.4573, counties along with the managing entity and community stakeholders were to plan a
designated receiving system. The initial plan was completed and implemented on July 1, 2017. On
March 2, 2017 South Florida Behavioral Health Network(SFBHN) held a Monroe County SB 12
Planning meeting with community members and providers (attendance roster attached). As a result
of the meeting an action plan for a Centralized Receiving System for Monroe County was
developed.
The Monroe County Designated Receiving System Plan (Plan) is brought before the Board for
approval and acceptance as prepared and presented by SFBHN/Thriving Minds South Florida, the
designated managing entity for Monroe County. The Plan was previously approved by the BOCC at
its 1/20/21 meeting, but the Plan and agenda item incorrectly stated that the Plan covered the period
of 1/1/21 through 12/31/20 and did not have a signature block for the Mayor to execute the Plan
document.
The Plan (attached)was presented by SFBHN/Thriving Minds South Florida for execution and with
the corrected period of l/l/21 to 12/31/23. Due to SFBHN/Thriving Minds South Florida's
submission deadline of the Plan, the Mayor executed the corrected Plan as noted in the now included
signature block and which also includes the corrected period of January 1, 2021 to December 31,
2023.
PREVIOUS RELEVANT BOCC ACTION: January 20, 2021, agenda item C.19, the BOCC
approved of the Monroe County Designated Receiving System Plan for 2021-2030. (Note: Today's
agenda item is a correction of the plan's cover sheet to read 2021-2023)
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C.11
September 16, 2020, Item H, the BOCC adopted annual operating budget for FY2021; Monroe
County annually provides required matching funds for substance abuse and mental health services.
May 17, 2017, Agenda Item No. C.21, the BOCC approved the Designated Receiving System plan
2017-2020, as designated by the Managing Entity for Monroe County, South Florida Behavioral
Health Network, for a centralized receiving system for Monroe County as required by Senate Bill 12
(Chapter 2016-241)
CONTRACT/AGREEMENT CHANGES:
No
STAFF RECOMMENDATION: Approve
DOCUMENTATION:
2021-01-20 Agenda Item
2021 - 2023 MC DRS Plan 2021 UPDATE REVISED SIGNED
FINANCIAL IMPACT:
Effective Date: 01/01/2021
Expiration Date: 12/31/2023
Total Dollar Value of Contract: N/A
Total Cost to County: $0
Current Year Portion: N/A
Budgeted: N/A
Source of Funds: N/A
CPI: No
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount: N/A
Grant: No
County Match: N/A
Insurance Required: N/A
Additional Details: N/A
N/A
REVIEWED BY:
Christine Limbert Completed 02/22/2021 11:04 AM
Christina Brickell Completed 02/22/2021 11:11 AM
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Liz Yongue Completed 02/26/2021 4:19 PM
Board of County Commissioners Pending 03/17/2021 9:00 AM
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County of Monroe rt BOARD OF COUNTY COMMISSIONERS
lYl Mayor Michelle Coldiron,District 2
Mayor Pro Tem David Rice,District 4
The Fl® da Keys Craig Cates,District 1
Eddie Martinez,District 3
Mike Forster,District 5
County Commission Meeting
January 20, 2021
Agenda Item Summary #7711
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BULK ITEM: Yes DEPARTMENT: Budget and Finance
TIME APPROXIMATE: STAFF CONTACT: Janet Gunderson (305)292-4470 CL
No
AGENDA ITEM WORDING: Approval of the Monroe County Designated Receiving System
Plan for 2021-2030 as presented by South Florida Behavioral Health Network, d.b.a. Thriving Mind >
South Florida, the designated Managing Entity for Monroe County and Miami/Dade County, for a
centralized receiving system for Monroe County as required by Senate Bill 12 (Chapter 2016-241).
ITEM BACKGROUND: In 2016 Senate Bill 12 relating to mental health and substance abuse, was
approved,providing amendments to Florida Statute Chapter 394, Mental Health. Under F.S.
394.4573, counties along with the managing entity and community stakeholders are to plan a
designated receiving system. The initial plan was completed and implemented on July 1, 2017. On c
March 2, 2017 South Florida Behavioral Health Network(SFBHN) held a Monroe County SB 12
Planning meeting with community members and providers (attendance roster attached). As a result
of the meeting an action plan for a Centralized Receiving System for Monroe County was
developed. Also attached is the Designated Receiving System Plan for 2017 —2020 and background
information including the March 2ad meeting agenda and the referenced statute. E
The Monroe County Designated Receiving System Plan before the Board for approval and
acceptance is prepared and presented by SFBHN/Thriving Minds South Florida, the designated
managing entity for Monroe County, and includes updates and covers the period of January 1, 2021 �C
to December 31, 2030.
PREVIOUS RELEVANT BOCC ACTION: Monroe County annually provides required matching N
funds for substance abuse and mental health services including transportation.
May 17, 2017, Agenda Item No. C.21, the BOCC approved the Designated Receiving System plan
2017-2020, as designated by the Managing Entity for Monroe County, South Florida Behavioral
Health Network, for a centralized receiving system for Monroe County as required by Senate Bill 12
(Chapter 2016-241)
CONTRACT/AGREEMENT CHANGES:
No
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STAFF RECOMMENDATION: Approval
DOCUMENTATION:
2021 -2030 MC DRS Plan_2021 UPDATE
2017-05-17 Agenda Item C.21 Attachment
FINANCIAL IMPACT: N
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Effective Date: 01/01/2021
Expiration Date: 12/31/2030
Total Dollar Value of Contract: N/A
Total Cost to County: $0
Current Year Portion: N/A
Budgeted: N/A
Source of Funds: N/A
CPI: No a
Indirect Costs: No
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount:
Grant: No
County Match: N/A
Insurance Required: N/A
Additional Details:
None. --
REVIEWED BY: a
Christine Limbert Completed 12/31/2020 10:19 AM
Christina Brickell Completed 01/05/2021 12:44 PM
Liz Yongue Completed 01/05/2021 12:46 PM
Board of County Commissioners Completed 01/20/2021 9:00 AM
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Monroe County
Designated Receiving System Plan
In accordance with
Florida Statute 3 94, Florida Mental Health Act N
Florida Statute 397, Hal S. Marchman Alcohol and
Other Drug Services Act
2021-2023
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Monroe County DRS Plan/Updated December 2020 Page 1 of 26
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Contents
I. Background/Purpose:.............................................................................................................. 3
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IL Monroe County's Designated Receiving System (DRS)........................................................ 4
III. Inventory of Participating Service Providers.......................................................................... 6
IV. Designated Receiving System (DRS) Agreements ................................................................ 8
Attachment A—Process Flow for Centralized Receiving System Monroe.................................... 9
Attachment B —Transportation Plan Monroe............................................................................... 11
Attachment C —Agreements......................................................................................................... 18
Attachment D—Sign In Sheet Monroe County Public Meeting .................................................. 26
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Monroe County DRS Plan/Updated December 2020 Page 2 of 26
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I. Background/Purpose:
In accordance with the changes promulgated by Senate Bill 12 to Florida Statute 394 (Florida
Mental Health Act, commonly referred to as the"Baker Act"), and Florida Statute 397 (commonly
referred to as the Marchman Act), Monroe County in collaboration with South Florida Behavioral
Health Network, Inc. dba Thriving Mind South Florida (Thriving Mind), the Managing Entity,
have completed this Designated Receiving System (DRS) Plan. Implementation of this plan E
assures the coordinated provision of emergency services for people in need of help for behavioral E
health disorders and supports a comprehensive behavioral system of care.
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This DRS Plan describes how the community shall ensure the provision of the "No Wrong Door
Model" defined in FS 394.4573. This description includes the organization of the DRS and how its
responds to individual needs and integrates services among various providers.
The designated receiving system may be organized in any manner which functions as a no-wrong- 2
door model. Such models include, but are not limited to:
A central receiving system is identified as a system that consists of a designated central ,
receiving facility that serves as a single-entry point for persons with mental health or r_
substance use disorders, or co-occurring disorders. The central receiving facility shall be 2
capable of assessment, evaluation, and triage or treatment or stabilization of persons with 2
mental health or substance use disorders, or co-occurring disorders.
A coordinated receiving system as a system that consists of multiple entry points that are
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linked by shared data systems, formal referral agreements, and cooperative arrangements z
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for care coordination and case management. Each entry point shall be a designated ®i
receiving facility and shall, within existing resources, provide or arrange for necessary w
services following an initial assessment and evaluation. v)
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A tiered receiving system consists of multiple entry points, some of which offer only Wi
specialized or limited services. Each service provider shall be classified according to its LU
capabilities as either a designated receiving facility or another type of service provider,
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such as a triage center, a licensed detoxification facility, or an access center. 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.
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The DRS may be organized in any manner that functions as a No-Wrong-Door Model that
responds to individual needs and integrates the services of various providers.
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Monroe County DRS Plan/Updated December 2020 Page 3 of 26
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The County and the Managing Entity shall review and update, as necessary, the designated
receiving system at least once every 3 years. An accurate inventory of the participating service
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providers shall be maintained and made available at all times to all first responders in the service
area.
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IL Monroe County's Designated Receiving System (DRS) E
Monroe County's Designated Receiving System is best described as a centralized receiving
system. v)
In Monroe County, there are 2 designated receiving facilities which are both publicly funded
(Guidance/Care Center, Inc. and Lower Keys Medical Center).
Thriving Mind currently funds a total of 16.2 beds at these public receiving facilities—11 are CSU
beds and 5.20 are DETOX beds. The following are the number of funded beds at each facility, by
type:
• Guidance/Care Center, Inc. —8.01 Adult CSU beds 0
5.20 DETOX beds
• Lower Keys Medical Center—2.99 Adult CSU beds
*Note: Contract bed totals are subject to change due to rate enhancements.
The County's approach to develop the designated receiving system for Monroe County is one that
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attempts to maintain the current process for Baker Acts for law enforcement, so that they are
transporting Baker Acts to the nearest receiving facility (as is the case currently). This is consistent v)l
with the requirement in Senate Bill 12 to ensure that there is a"no wrong door"approach for acute w
care services. Thriving Mind held a public meeting in Monroe County for input and will continue v)
to receive feedback from the stakeholders on the continued implementation of the Designated LU
Receiving System through its community needs process. The sign in sheet for the public meeting LU
can be found in Attachment D. CL
Thriving Mind has identified the Guidance/Care Center as the provider that will be designated as
the centralized receiving facility for the centralized receiving system, described above. N
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Consumer is taken by Law Enforcement to the nearest receiving facility, which is the
centralized receiving system: �-
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The consumer can be referred to the centralized receiving system through multiple entry points: as
a transfer from other facilities (such as jails/prisons, courts or hospitals), as a self-referral, as a
consumer that is picked up by law enforcement for a Baker Act/Marchman Act, etc. If the
consumer is referred to the centralized receiving system because he/she is picked up by law N
enforcement as a result of a Baker Act, then he/she is taken to the nearest receiving facility
(public/private). If the nearest receiving facility is a public receiving facility, then the consumer
will be screened for both behavioral health and financial eligibility (indigent vs. private pay). If
that consumer meets acute care criteria and there is capacity at that public receiving facility, then E
he/she will be accepted, stabilized and treated. Once the person is stabilized, if the consumer is
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determined to be indigent,then the designated receiving facility will create a discharge plan,which
includes a recommended level of care. The consumer will also be screened for care coordination
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through Thriving Mind. If that consumer meets criteria for care coordination, then a referral will
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be made to Thriving Mind's Care Coordination Department. If the person does not meet criteria
for care coordination, then a referral will be made to a Thriving Mind provider that has the
recommended level of care within their treatment continuum. C-
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If it is determined that the consumer meets acute care criteria, but the public receiving facility
doesn't have capacity, then the public receiving facility will coordinate a transfer to another v)
receiving facility that has capacity. It is important to note that if the consumer is a Baker Act,then
the law allows for the receiving facility to keep that consumer as long as they do not go over 10%
of their licensed bed capacity. However, if the consumer is a Marchman Act,which does not allow
for that flexibility should the receiving facility be at licensed capacity, then the receiving facility
must coordinate the transfer of that consumer to another public receiving facility and/or hospital
that has capacity.'
If it is determined (through the screening process) that the consumer does not meet criteria for
acute care,then the public receiving facility will determine the recommended level of care for that
consumer. If the recommended level of care is one that is actively managed by Thriving Mind
(Short-term Residential Treatment (SRT), Residential treatment), then Thriving Mind's Adult
System of Care Department will be contacted in order to coordinate that referral_ If the c�
recommended level of care for that indigent consumer is not actively managed by Thriving Mind,
then the receiving facility will contact the Thriving Mind provider directly. Referrals will be made z
to best match the consumers with their needs and geographic preference. If no preference or 0
specific needs are noted,then referrals are made on a rotating basis.All referrals that come through aLU
the centralized receiving system will be well documented and will be available for review to U)
Thriving Mind. LU
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Consumer is taken by Law Enforcement to the nearest receiving facility, which is a private
receiving facility:
If the consumer is referred to the centralized receiving system because he/she is picked up by law
enforcement as a result of a Baker Act, then he/she is taken to the nearest receiving facility
(public/private). If the nearest receiving facility is a private receiving facility, then he/she will be
screened to determine if he/she meets acute care criteria.If he/she meets criteria,then the consumer
will remain at the private receiving facility and will be stabilized and treated. A discharge plan
will be made by the private receiving facility, which includes a recommended level of care. If it is
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determined that the consumer is an indigent consumer and meets acute care criteria, then a
consumer may be transferred to the centralized receiving system for continued acute care services
and/or referral to lower level of care services.
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Consumer is self-referred for any publicly funded service:
If the consumer is seeking publicly funded services, the consumer can access care through the a
centralized receiving facility. The centralized receiving facility has satellite offices throughout
Monroe County which allows for screening and level of care assessment. Based on the consumers
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identified needs, the facility will make referrals accordingly including for acute care services if
necessary.
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A Process Flow of the Centralized Receiving System is found in Attachment A. The N
Transportation plan that outlines how consumers needing acute care are transported can be found
in Attachment B. CL
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III. Inventory of Participating Service Providers U'
Voluntary Assessment and Evaluation Facilities
Facility Capabilities/Limitations Does the facility Substance Use
have agreements to Disorders/Mental
accept DRS Health
Patients? Disorders/Co-
Occurring?
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Guidance Care CSU,Detox, Screening & Yes Yes o
Center, Inc. Assessment
Lower Keys CSU Only No Yes
Medical Center
"REME' 'KIN M' ' U)
Involuntary Assessment and Evaluation Facilities
Facility Capabilities/Limitations Does the facility Substance Use
have agreements to Disorders/Mental
accept DRS Health
Patients? Disorders/Co-
Occurring?
Guidance Care CSU,Detox, Screening & Yes Yes
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Center, Inc. Assessment
Lower Keys CSU Only No Yes
Medical Center
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Triage Centers for Mental Health
Facility Capabilities/Limitations Does the facility Substance Use
have agreements to Disorders/Mental
accept DRS Health
Patients?
Monroe County DRS Plan/Updated December 2020 Page 6 of 26
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Disorders/Co-
Occurring? "'
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Guidance Care CSU,Detox, Screening & Yes Yes
Center, Inc. Assessment
Lower Keys CSU Only No Yes
Medical Center
Triage Centers for Substance Use Disorders
Facility Capabilities/Limitations Does the facility Substance Use
have agreements to Disorders/Mental
accept DRS Health
Patients? Disorders/Co- u
Occurring?
Guidance Care CSU,Detox, Screening& Yes Yes
Center, Inc. Assessment
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Involuntary Treatment for Mental Health Disorders
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Facility Capabilities/Limitations Does the facility Substance Use
have agreements to Disorders/Mental
accept DRS Health v)
Patients? Disorders/Co-
Occurring? i
Guidance Care CSU,Detox, Screening & Yes Yes
Center, Inc. Assessment
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Lower Keys CSU Only No Yes
Medical Center
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Involuntary Treatment for Substance Use Disorders c�
Facility Capabilities/Limitations Does the facility Substance Use
have agreements to Disorders/Mental
accept DRS Health
Patients? Disorders/Co- N
Occurring?
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Guidance Care CSU,Detox, Screening & Yes Yes
Center, Inc. Assessment
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IV. Designated Receiving System (DRS)Agreements
Through Thriving Mind's Acute Care Data System, partners can share data and be aware of U),
available beds in the coordinated receiving system. The system provides real-time bed availability
that is fed into the Thriving Mind web-site.
Thriving Mind has been working with Knight Software to expand the current service data system -�
to fully integrate Acute Care and Financial Reporting into one, cohesive application. The Knight
Integrated Solution (KIS) has been developed with the goal to improve the clinical and
psychosocial outcomes of stakeholders within the mental healthcare system by providing a system
for securely sharing clinical and psychosocial information across authorized healthcare providers
to facilitate coordination of care and improve outcomes. r_
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A full description of the data functions can be found in Thriving Mind's Information Technology Q
(IT)Plan and is available at www.thrivingnaind.or�.
Network providers have individual contracts and executed Business Associate Agreements
(BAAs) through their main contract with Thriving Mind which allows for data sharing and 0
coordination of care. v)
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Agreements can be found in Attachment C.
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Monroe County DRS Plan/Updated December 2020 Page 8 of 26
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Attachment A—Process Flow for Centralized Receiving System Monroe
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Monroe County DRS Plan/Updated December 2020 Page 9 of 26
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Monroe.Cassrrt' ONLY SB12 requires"no wrong
ri o flS '}�s Ceinluratized door"for acute care services.
f4vk8 w::Y;:$[kb q The process for LE wily remain CD
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.m°'rn.- -. � -- -- -• the same spas to eliminate
} distance t a eled In add tion, T—
f Consumer picked up by Law
Tra nsfers from other facilities' :r the single law enforcement
Consumer Self-Referral i Enforcement(LE)for Baker/
(jails/prisons,courts,hospitals) n agency/ambulance would CD
Marchman Acts continue to followthe CV
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Transportation PI �
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Taken to "�''�w' `°
C screened ffar both Taken to F F,,.1}oej the cansumzYw<,.
Centralized nearest T meet criteria for ac m
b haoral health and ----.._-- —_------
Receiving Receiving 'Fn, care?financial eligibility a"Facility Facilit CftF
Number of new admissions in FY 15-16 in
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..Monroe County:
Yes
Adult Mental Health: 1,680
Adult Substance Abuse: 428
Children's Mental Health: 225
Children's Substance Abuse: 151
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Consumes
„fir"Mes" ten. No remains at
"razor Acute Ca refit .._ ,� Facility for
' services
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re isbseflVhatisth ��, y Post discharge,consumere ded i T, could be referred to CRF or°adgv f r # l), private provider for lower level
HN of ea re services
If level of 43oes t�
£ care is not Fts .mar havf' �1 k�
managed By -0 insurarncelother ")-9�j Yes
yfJoes the Cfi FTM�ana SFBHN, �source�oi�.r'' �
provider have contact
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t 7 ° provider
��capacity.�,."
_ya'- directly U)
Refer to
No r�Y private
provider pis
s~ ari CRF LL
Consumer €beg nn4ng m Consumer ��
accepted Ii ua ry 2b17, transferred Numher of new SF BHN
there"111be to another Curry ntSFBH N resour ces ass dable to frmd
into CRF 1_tiTe data consum s in FY 15-16 CRF:
(CSU/ avalltiuc that is receiving served in Monroe County:
D ETOX) able m indicate facility that CS II- $1,294,903 CL
capacity at the has capacity Adults: 1,347 DETOX- 5 183,b43
publicacute Chilcrem 314 Crisis Support- $ 104,277
care iacllities.
Asst-,snrer,t- s a5a,:�s7 tV
Total Available: $3,841,ra9t1
Crisis Stay
(3-5 days)
CSU funded beds- 10.92 AMH
Legend: CL
Fr''Uoes thit,,
DETOX funded 2reds 1.88 ASA
Post-d harge, faGq nSumer un.4 r f Process
W_}1at 1,end
recommended f�'"N criterSa for Care ``'ri" Yes ,ay Total funded brads 12.8'0*
? t' Coordination t
level of care.
�(CC)?ya° Subproczss *Note:Tfiis is suhpest fa change due to rate
;F9,. enhancements
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• ', Referral made to SFBHN's "�3acision.°x Add t I edad t f d"fiF �
No CC 6ept,for linkage to -,r._Paint a `' screen ngy or i xcraaamI vo{umt,nxpecved for N
provider for CC services ""a.�Y arr,6ulam�y sac Ices, r
-- - --- - --- Add t I Cl' I Reseors A 2 FTEs $216,013
F IS e -e 8 FTEs $112108
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D h ee Planners 28 FTEs $140000 N
err 23 FTEs $92,400
Th g for f car.w II be . On call coverage 5138,605 `F
pl tad at tha CRF_H r oneea
"Oestart/End ope a g E pe e f2C1 1 $1.S.a05
Consumer is consum r goes ko an SFBHN provider,they �
discharged to a w II receive a full assessment,which could — To al Fnnge[20 i $110 884
dower level of ca rr adjust the recommended level of care. Total Coat foci CRP $ 942,515
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Attachment B—Transportation Plan Monroe
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Transportation Plan for Baker Act and Marchman Act Involuntary Examinations
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Department of Children and Families
Circuit 16(Monroe County) a.
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This transportation plan shall describe methods of transport to a facility within the designated
receiving system for individuals subjectto involuntary examination under the Baker Act s. 394.463 v)
or involuntary admission under the Marchman Act s. 397.6772, s. 397.679, s. 397.6798, or s.
397.6811. E
When any law enforcement officer has custody of a person based on either noncriminal or minor -�
criminal behavior that meets the statutory guidelines for involuntary examination pursuant to s.
394.463, the law enforcement officer shall transport the person to the appropriate facility within
the designated receiving system pursuant to a transportation plan or an exception or to the nearest
receiving facility if neither apply. Persons who meet the statutory guidelines for involuntary
admission pursuant to s. 397.675 may also be transported by law enforcement officers to the extent r_
resources are available and as otherwise provided by law. Such persons shall be transported to an 2
appropriate facility within the designated receiving system pursuant to a transportation plan or an
exception or to the nearest facility if neither apply.
The Florida Mental Health Act, usually referred to as "The Baker Act," states that a person may
be taken to a receiving facility for involuntary examination if there is reason to believe that the z
person has a mental illness and because of his or her mental illness: Ui
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The person has refused voluntary examination after conscientious explanation and disclosure of
the purpose of the examination; or the person is unable to determine for himself or herself whether w
examination is necessary; and without care or treatment,the person is likely to suffer from neglect Wi
or refuse to care for himself or herself, such neglect or refusal poses a real and present threat of LU
substantial harm to his or her well-being; and it is not apparent that such harm may be avoided
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through the help of willing family members or friends or the provision of other services; or there
is a substantial likelihood that without care or treatment the person will cause serious bodily harm
to himself or herself or others in the near future, as evidenced by recent behavior.
The Marchman Act is the Florida Substance Abuse Impairment Act which requires that a person CL
who meets the criteria for involuntary admission if there is good faith reason to believe that the
person is substance abuse impaired or has a co-occurring mental health disorder and, because of
such impairment or disorder:
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Has lost the power of self-control with respect to substance abuse; and is in need of substance
abuse services and, by reason of substance abuse impairment, his or her judgment has been so
impaired that he or she is incapable of appreciating his or her need for such services and of making
a rational decision in that regard, although mere refusal to receive such services does not constitute
evidence of lack of judgment with respect to his or her need for such services; or without care or E
treatment, is likely to suffer from neglect or refuse to care for himself or herself, that such neglect
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or refusal poses a real and present threat of substantial harm to his or her well-being; and that it is
not apparent that such harm may be avoided through the help of willing family members or friends
or the provision of other services, or there is substantial likelihood that the person has inflicted, or
threatened to or attempted to inflict, or, unless admitted, is likely to inflict, physical harm on
himself, herself, or another.
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The law requires that each county shall designate a single law enforcement agency within the E
county, or portions thereof,to take a person into custody upon the entry of an ex parte order or the
execution of a certificate for involuntary examination by an authorized professional and to v)
transport that person to the appropriate facility within the designated receiving system pursuant to
this transportation plan.
The law enforcement agency may decline to transport the person to a receiving facility only if: -�
a. The jurisdiction designated by the county has contracted on an annual basis with an
emergency medical transport service or private transport company for
transportation of persons to receiving facilities pursuant to this section at the sole
cost of the county; and
b. The law enforcement agency and the emergency medical transport service or
private transport company agree that the continued presence of law enforcement °
personnel is not necessary for the safety of the person or others. Q
The Monroe County Sherriff's Department and City of Key West Police Department provide --
transportation of consumers under the Baker Act and/or Marchman Act throughout Monroe
County. z
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Monroe County Transportation Plan guidelines for Baker Act:
If a law enforcement officer believes that a person has an emergency medical condition as defined
in s. 395.002,the person should be first transported to a hospital for emergency medical treatment, w
regardless of whether the hospital is a designated receiving facility or part of the centralized Wi
receiving system. LU
Law enforcement should transport consumers under the Baker Act to the nearest receiving facility.
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A list of Monroe County designated receiving facilities that can provide medical examination and
treatment of persons for whom an involuntary examination has been initiated under the Baker Act
can be found in Appendix A. c-
v)
Monroe County Transportation Plan guidelines for Marchman Act:
If a law enforcement officer believes that a person has an emergency medical condition as defined
in s. 395.002,the person should be first transported to a hospital for emergency medical treatment,
regardless of whether the hospital is a designated receiving facility or part of the centralized
receiving system.
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Law enforcement should transport consumers (Adults and Minors)under the Marchman Act to the
nearest Addiction Receiving Facility. E
Monroe County DRS Plan/Updated December 2020 Page 12 of 26
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C.11.b
A list of Monroe County designated receiving facilities that can provide medical examination and
treatment of persons for whom an involuntary examination has been initiated under the Marchman
Act can be found in Appendix A.
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(Signature page follows)
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Monroe County DRS Plan/Updated December 2020 Page 13 of 26
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C.11.b
Monroe County Board of Commissioners
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Michelle Coldiron, Mayer Date
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Monroe County DRs PlanJUpduted December 2020 Page 14 of26
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C.11.b
South Florida Behavioral Health Network d/b/a Thriving Mind South Florida
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John W. Newcomer, President& CEO Date
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-Rest of Page Intentionally Left Blank-
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Monroe County DRS Plan/Updated December 2020 Page 15 of 26
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C.11.b
Department of Children and Families
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Karen Annunziato, Regional Director, Substance Abuse & Mental Health Date
a.
-Rest of Page Intentionally Left Blank-
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Monroe County DRS Plan/Updated December 2020 Page 16 of 26
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C.11.b
Appendix ACD
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Designated Receiving Facilities
The following is a list of Monroe County psychiatric facilities designated by the Florida N
Department of Children and Families to receive and hold persons with mental illness for
involuntary examination and short-term treatment. This list is subject to change from time to C.
time as new facilities are designated and others are closed or have their designations
removed.
Public Receiving Facilities >
Guidance Care Center
3000 41 Street Ocean, Marathon
305-434-7660
Lower Fl. Keys Health System (DePoo Hospital),
1200 Kennedy Drive
Key West, Florida 33040 0
(305) 294-5531
Addiction Receiving Facilities
The following is a list of Monroe County Addiction Receiving Facilities (ARFs)designated by the
Florida Department of Children and Families to receive and hold persons under a Marchman Act
for involuntary examination and short-term treatment. This list is subject to change from time z
to time as new facilities are designated and others are closed or have their designations 2
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removed.
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Guidance Care Center (ARF & Inpatient Detox)
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3000 41 Street Ocean, Marathon W1
305-434-7660 LU
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Monroe County DRS Plan/Updated December 2020 Page 17 of 26
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C.11.b
Attachment C—Agreements
N
BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement("Agreement") is entered into by and between South
Florida Behavioral Health Network. Inc., ("SFBHN") and «Legal Company Name »
(individually each a "Parry" or "Associate" and collectively the "Parties" or the "Associates").
The Effective Date of this Agreement shall be July 1, 2016 ("Agreement Effective Date"). E
RECITALS
A. SFBHN and ((Legal Company Name », are each deemed to be Covered Entities under >
the Health Insurance Portability and Accountability Act ("HIPAA") and may, from time to
time, each act as a Business Associate on behalf of the other to provide services in
accordance with one or more agreements (the "Underlying Agreements"). 2
A. SFBHN is deemed to be a Business Associate under the Prime Contract with the Florida .N
Department of Children and Families and obligated to comply with HIPAA, the HITECH
Act, and any regulations promulgated thereunder, with respect to the PHI it creates,
maintains, receives, or transmits on behalf of((Legal Company Name ».
B. ((Legal Company Name » acknowledges that all provisions, terms and conditions, or
amendments, addendum, changes or revisions applicable to the
((Legal Company Name » made subsequent to the initial execution of the Prime
Contract, (Contract entered into between the Florida Department of Children and
Families) and SFBHN, not in conflict with this Business Associate Agreement shall be
binding upon the ((Legal Company Name », and the ((Legal Company Name », ®i
agrees to comply with same. The Prime Contract is incorporated by reference in this
Business Associate Agreement.
C. The Associates both acknowledge that they are each obligated to comply with the Privacy
Rule, the Security Rule, the Breach Notification Rule, the Health Information Technology
for Economic and Clinical Health ("HITECH") Act, s. 501.171, F.S., and other laws and CL
regulations pertaining to the access, use, disclosure, and management of Protected
Health Information ("PHI") without limitation, PHI in an electronic format (EPHI). `V
N
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D. In the event that either Party (or both Parties) is a Program, as defined by the federal
CL
regulations governing the Confidentiality of Alcohol and Drug Abuse Patient Records, at
42 CFR Part 2 (the "Substance Abuse Regulations"), the Underlying Agreements may also
require each of the Parties to create, receive, transmit, or maintain patient information c)
on behalf of the other that is subject to the Substance Abuse Regulations. As such, the
Associates further acknowledge that they are each obligated to comply with those
regulations, with respect to a Program's patient information.
N
E. The Associates intend to protect the privacy and provide for the security of patient N
information, including PHI, pursuant to this Agreement, and all in compliance with
Applicable Law.
Monroe County DRS Plan/Updated December 2020 Page 18 of 26
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C.11.b
F. The Parties acknowledge that this Agreement supplements and amends each of the
Underlying Agreements only with respect to the creation, use, or disclosure of patient `V
information, including PHI. Except as so supplemented or amended, the terms of the
Underlying Agreements shall govern the matters addressed in this Agreement and in
each of the Underlying Agreements.
CL
NOW,THEREFORE, in consideration of the mutual promises below, the Parties agree as follows:
Section 1. Definitions. Capitalized terms used in this Agreement and not otherwise defined
herein shall have the meanings set forth in the HIPAA Rules, which definitions are incorporated
in this Agreement by reference. Capitalized terms used in this Agreement are defined as follows:
a. "Applicable Law" means HIPAA, the HITECH Act, and all regulations issued thereunder, as
well as the Substance Abuse Regulations and any other applicable federal and state law.
b. "Breach" shall have the meaning given to such term under the Breach Notification Rule, N
including, but not limited to, 45 CFR § 164.402.
c. "Breach Notification Rule" shall mean the Breach Notification Standards at 45 CFR Parts
160 and 164. —
d. "Business Associate" shall have the same meaning as given to such term in 45 CFR §
160.103.
e. "Covered Entity" shall have the same meaning as given to such term in 45 CFR § 160.103.
LU
f. "Electronic Protected Health Information"or"ePHI" shall have the meaning given to such
term under the HIPAA Rules, including, but not limited to, 45 CFR § 160.103, as applied ®i
to the information that each Associate creates, maintains, receives from, or transmits on LU
behalf of the other Associate.
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g. "Enforcement Rule" shall mean the Compliance and Enforcement Standards at 45 CFR Wi
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Part 160.
h. "HIPAA" meansthe Health Insurance Portabilityand Accountability Act of 1996("HIPAA"), CL
Public Law No. 104-191, and any regulations promulgated thereunder.
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i. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, Enforcement, and NI
Transaction Rules at 45 CFR Parts 160, 162, and 164.
j. "HITECH Act" means the Health Information Technology for Economic and Clinical Health
("HITECH") Act, Public Law No. 111-005, and any regulations promulgated thereunder.
c)
k. "Privacy Rule" shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR Parts 160 and 162 and Part 164, Subparts A and E, 42 U.S.C. 1320d-
CD
5 and 1320d-6. `V
I. "Program" shall have the same meaning as given to such term in 42 CFR § 2.11. CD
m. "Protected Health Information" or"PHI" shall have the same meaning given to such term
under the HIPAA Rules, including, but not limited to, 45 CFR § 160.103, as applied to the
information created or received by each Associate from, or on behalf of, the other
Monroe County DRS Plan/Updated December 2020 Page 19 of 26
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C.11.b
Associate.
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n. "Required by Law"shall have the same meaning as given to such term in 45 CFR§ 164.103. cv
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o. "Secretary" shall mean the Secretary of the Department of Health and Human Services or cv
his or her designee.
CL
P. "Security Rule" shall mean the Security Standards at 45 CFR Parts 160 and 162 and Parts
164, Subparts A and C. y
q. "Subcontractor" shall have the same meaning as given to such term in 45 CFR § 160.103.
r. "Substance Abuse Regulations" shall mean the Confidentiality of Alcohol and Drug Abuse
Patient Records regulations, at 42 CFR Part 2. a
s. Transaction"shall have the same meaning given to such term under the Transaction Rule,
including, but not limited to, 45 CFR § 160.103.
t. "Transaction Rule" shall mean the Standards for Electronic Transactions at 45 CFR Parts
160 and 162.
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u. "Unsecured PHI" shall have the same meaning given to such term, as "unsecured —
protected health information," under the Breach Notification Rule, including but not Q
limited to, 45 CFR § 164.402, as applied to the information created or received by each
Associate from, or on behalf of, the other Associate. W
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Section 2. Permitted Uses and Disclosures of PHI.
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a. Uses and Disclosures of PHI. Except as otherwise limited in this Agreement, Associates
LU
may each use or disclose PHI received from or created on behalf of the other Associate only to
perform such functions, activities, or services for, or on behalf of, each other pursuant to the
LU
Underlying Agreements. W i
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b. Permitted Uses of PHI by Associates. Except as otherwise limited in this Agreement, CL
Associates may each use the PHI received from or created on behalf of the other Associate (i) for
their respective proper management and administration, (ii) to carry out their respective legal
responsibilities; and (iii) for Data Aggregation purposes for the Health Care Operations of the i
other Associate. Associates may use PHI to create de-identified health information, in
accordance with the HIPAA Rules at 45 CFR § 164.514, and may use such de-identified health
information.
C. Permitted Disclosures of PHI by Associates. Except as otherwise limited in this Agreement,
Associates may each disclose PHI (i)for their proper management and administration; (ii)to carry
out their respective legal responsibilities; (iii) as Required by Law; and (iv) for Data Aggregation
purposes for the Health Care Operations of the other Associate. If an Associate intends to
disclose PHI to a third party, prior to making any such disclosure, such Associate shall first obtain,
(i) reasonable written assurances from such third party that PHI will be held confidential in a
manner that is consistent with the terms of this Agreement and will only be used or disclosed as
Required by Law or for the purposes for which it was disclosed to such third party, and (ii) a
written agreement from such third party to notify Associate of any breaches of confidentiality of
Monroe County DRS Plan/Updated December 2020 Page 20 of 26
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C.11.b
the PHI, to the extent it has obtained knowledge of such breach, without unreasonable delay,
and in any event within sufficient time to meet any breach notification requirements under the
HIPAA Rules. n'
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Section 3. Obligations and Activities of Associates(as Business Associates). Associates shall each cV
comply with all obligations and requirements for Business Associates under Applicable Law with
respect to PHI, and shall have the following obligations: CL
a. Appropriate Safeguards. Associates shall each implement administrative, physical, and
technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and
availability of PHI, in accordance with 45 CFR § 164.308, physical safeguards as set forth at 45
CFR § 164.310, and technical safeguards as set forth at 45 CFR § 164.312; including, policies and
procedures regarding the protection of PHI and/or ePHI set forth at 45 CFR § 164.316 and the
provisions of training on such policies and procedures to applicable employees, subcontractors,
independent contractors, and volunteers, that reasonably and appropriately protect the
confidentiality, integrity, and availability of the PHI and/or ePHI that the Provider creates,
receives, maintains or transmits.
Associates shall take immediate steps to limit or avoid recurrence of any security breach and take
any other action pertaining to such unauthorized access or disclosure required by applicable
federal and state laws and regulations regardless of any actions taken by SFBHN or The Florida
Department of Children and Families.
b. Reporting of Improper Use or Disclosure.
(i) Each Associate shall report to the other Associate, in writing, any use or
disclosure of PHI not provided for by this Agreement, including any Breach of Unsecured PHI or
any Security Incident of which it becomes aware as required at 45 CFR 164.410, and any security
incident of which it becomes aware.
(ii) ((Legal Company Name » shall provide notification to SFBHN Security i
Officer, Privacy Officer and Contract Manager as soon as possible, but no later than four (4)
business days following the determination of any breach or potential breach of personal and
confidential data. CL
(iii) ((Legal Company Name_ ))shall provide notification to SFBHN Privacy Officer N
and Contract Manager within twenty-four (24) hours of notification by the US Department of i
Health and Human Services of any investigations, compliance reviews or inquiries by the US
CL
Department of Health and Human Services concerning violations of HIPAA (Privacy, Security
Breach).
c)
C. Data Breach Notification. No later than four (4) business days following any breach
affecting 500 or more individual, either Associate shall provide to the other, in writing the
elements as required by s. 501.171, F.S. to permit SFBHN to comply with the HIPAA Breach `V
notification requirements set forth in the Prime Contract, 45 C.F.R. §§ 164.400, et seq., and in
s. 501.171, F.S. Associates, as applicable, at its own cost, shall notice affected parties no later cv
than thirty (30) days following the determination of any breach or potential breach of personal
or confidential data as provided in § 817.5681, Fla. Stat. Following a HIPAA Breach (Privacy,
Security Breach), each Associate will have a continuing duty to inform the other Associate of new
and material information learned regarding the HIPAA Breach.
Monroe County DRS Plan/Updated December 2020 Page 21 of 26
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C.11.b
d. Mitigation Procedures. Each Associate agrees to mitigate, to the extent practicable, any
harmful effect that is known to it of a use or disclosure of PHI by such Associate in violation of
the requirements of this Agreement, or the HIPAA Rules. N
N
e. Subcontractors and Agents. Each Associate shall ensure that any agent, including a
Subcontractor, to whom it provides PHI, agrees (in writing) to the same restrictions and CL
conditions that apply through this Agreement to such Associate with respect to such PHI.
Associates shall implement and maintain sanctions against agents and Subcontractors that
violate such restrictions and conditions, and shall attempt to mitigate the effects of any such
violation. Each Associate and their Subcontractors and Agents are directly liable under the civil
and criminal enforcement provisions set forth at Section 13404 of the HITECH Act and section 45
CFR § 164.500 and 164.502(E) of the Privacy Rule (42 U.S.C. 1320d-5 and 1320d-6), as amended,
for failure to comply with the safeguards, policies and procedures requirements and any
guidance issued by the Secretary of Health and Human Services with respect to such
requirements
f. Access to PHI. Each Associate agrees to provide access to PHI in a Designated Record Set
to the other Associate or, as directed by the other Associate, to an Individual, at the written c
request of the other Associate within a reasonable time and manner,sufficient to allow the other
Associate to meet the requirements of 45 CFR § 164.524. Each Associate agrees to disclose PHI Q
in electronic format to the other Associate or, as directed by the other Associate, to an Individual
or an Individual's designee, as may be necessary to satisfy the other Associate's obligations under W
45 CFR §§ 164.524(c)(2)(ii) and (3)(ii) regarding an individual's request for an electronic copy of
PHI. LU
g. Amendment of PHI. Each Associate shall make any amendment(s) to PHI in a Designated ®I
Record Set that the other Associate directs or agrees to, pursuant to 45 CFR § 164.526, in a time LU
and manner reasonably designated by the other Associate.
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h. Documentation of Disclosures. Each Associate agrees to document such disclosures of PHI i
LU
and information related to such disclosures as would be required for the other Associate to
respond to a request by an Individual for an accounting of disclosures of PHI in accordance with
CL
45 CFR § 164.528.
N
i. Accounting of Disclosures. Each Associate agrees to provide to the other Associate, within i
thirty(30) business days, information collected in accordance with Section 3(f)of this Agreement,
sufficient to permit the other Associate to respond to a request by an Individual, or on behalf of CL
an Individual, for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528.
j. Minimum Necessary. Each Associate shall request, use, and disclose only the minimum
amount of PHI necessary to accomplish the purpose of the request, use, or disclosure to the
CN
extent that the minimum necessary standard is applicable to the disclosure under 45 CFR § CD
N
164.502(b).
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k. Governmental Access to Records. Each Associate agrees to make its internal practices, N
books, and records relating to the use and disclosure of PHI received from the other Associate,
or created on behalf of the other Associate, available to the Secretary for purposes of
determining either or both Associates' compliance with the HIPAA Rules.
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C.11.b
I. Standard Transactions. If an Associate conducts, in whole or in part, any Transactions
electronically on behalf of the other Associate, such Associate shall comply with the applicable
requirements of 45 CFR Part 162 and shall require that any agents or Subcontractors that n'
perform, in whole or in part, such Transactions on its behalf, agree in writing to comply with such
requirements. Such Associate will not enter into any trading partner agreement in connection
with conducting Standard Transactions on behalf of the other Associate: (i) that changes the
definition, data condition, or use of a data element or segment in a Standard Transaction; (ii) CL
adds any data element or segment to the maximum defined data set; (iii) uses any code or data
element that is marked as "not used" in the Standard Transaction's implementation specification
or is not in the Standard Transaction's implementation specification; or(iv) changes the meaning
or intent of the Standard Transaction's implementation specification.
m. Qualified Service Organization Agreement. In the event that either Associate (or both
Associates) is a Program, as defined by the Substance Abuse Regulations, each Associate agrees
to provide the services, as described in the Underlying Agreements, and further(i) acknowledges
that in receiving, storing, processing, or otherwise dealing with any information from a Program
about the patients in the Program, it is fully bound by the provisions of the Substance Abuse
Regulations; and (ii) agrees to resist in judicial proceedings any effort to obtain access to
information pertaining to such patients otherwise than as expressly provided for in the Substance c
Abuse Regulations.
Section 4. Obligations of Associates (as Covered Entities).
a. Notice of Privacy Practices. Each Associate shall notify the other Associate of any
limitation(s) in its notice of privacy practices, under 45 CFR § 164.520 and under s. 501.171, F.S. LU
to the extent that such limitation(s) may affect the other Associate's use or disclosure of PHI.
b. Notification of Changes Regarding Individual Permission. Each Associate shall notify the
LU
other Associate of any changes in, or revocation of, permission by an Individual to use or disclose
PHI, to the extent that such changes may affect the other Associate's use or disclosure of PHI.
LU
C. Notification of Restrictions to Use or Disclosure of PHI. Each Associate shall notify the LU
other Associate of any restriction(s) imposed on the use or disclosure of PHI that such Associate
has agreed to or is obligated to support in accordance with 45 CFR § 164.522, to the extent that CL
such restriction may affect the other Associate's use or disclosure of PHI. The other Associate
agrees to abide by such restriction to the extent applicable and provided that it is made aware of
the restriction in a reasonable and timely manner. i
d. Permissible Requests by Associates. Neither Associate shall request the other Associate CL
to use or disclose PHI in any manner that would not be permissible under Applicable Law if done
by such Associate, except as permitted under this Agreement.
e. Marketing, Fundraising and Research. Each Associate shall follow guidance in the HIPAA
Rule regarding marketing, fundraising and research located at Sections 45 CFR § 164.501, 45 CFR `CD
V
§ 164.508 and 45 CFR § 164.514.
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Section 5. Term and Termination. cV
a. Term. The term of this Agreement shall commence as of the Agreement Effective E
Date and shall terminate when all of the PHI provided by each Associate to the other Associate
is destroyed or returned, or, if it is infeasible to return or destroy the PHI, protections are
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Packet Pg.463
C.11.b
extended to such information, in accordance with Section 5(c), or when one party gives the other
fifteen (15) calendar days notification of termination in writing to the other party or such time
as mutually agreed upon by both parties.
N
b. Termination for Cause. A breach by either Associate of any provision set forth in Sections
2, 3 or 4 of this Agreement may, in the sole discretion of the other Associate, be deemed to
constitute a material breach of this Agreement if such breach is not cured,or a plan is not enacted CL
to enable a cure, within thirty (30) business days of receiving written notice from the non-
breaching Associate. Upon occurrence of such material breach,the non-breaching Associate may
immediately terminate this Agreement, notwithstanding any provision in this Agreement to the
contra ry.
C. Effect of Termination.
(i) Except as provided in paragraph (ii) of this Section 5(c), upon termination
of this Agreement for any reason, each Associate shall return or destroy all PHI received from the
other Associate, or created or received by each Associate on behalf of the other Associate, and N
shall retain no copies of the PHI. Each Associate agrees to impose the same obligations to return
or destroy PHI, in writing, on each of its Subcontractors or agents to the extent they are or may
be expected to come into possession of such PHI.
(ii) In the event that an Associate determines that returning or destroying the Q
said PHI is infeasible, such Associate shall provide notification of the conditions that make return
or destruction infeasible to the other Associate and shall extend the protections of this
Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that
LU
make the return or destruction infeasible, for so long as such Associate maintains such PHI.
Section 6. Indemnification. Each Associate (the "Indemnifying Associate") will indemnify, ®I
defend, and hold harmless the other Associate (the "Indemnified Associate") from any and all LU
claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties,
LU
and costs (including reasonable attorneys' and court fees and expenses) arising out of or related W i
to any Breach or alleged Breach of Unsecured PHI created, received, maintained, transmitted, LU
LU
or otherwise used by the Indemnifying Associate and arising from the Indemnifying Associate's
breach, or failure to perform pursuant to this Agreement (collectively, a "Claim"). This CL
indemnification does not cover any claims, losses, liabilities, damages, judgments, fees,
expenses, awards, civil monetary penalties, and costs resulting from the negligence or willful i
misconduct of the Indemnified Associate, or any of Indemnified Associate's employees,
contractors, or agents (except Indemnifying Associate). This indemnification is contingent upon CL
(i) Indemnified Associate giving prompt written notice to Indemnifying Associate of any Claim
for which indemnification is sought, and (ii) Indemnified Associate giving Indemnifying Associate
sole control of the defense, including selection of counsel, and related settlement negotiations
regarding the Claim, except that Indemnifying Associate will not enter into a final settlement
involving discharge of any claims against Indemnified Associate without Indemnified Associate's
prior consent. Indemnified Associate may participate in the defense of any Claim at Indemnified
Associate's own cost. Indemnified Associate agrees that it will assist and cooperate in the
defense and related settlement of the Claim, at its expense, as the Indemnifying Associate may
reasonably request.
Section 7. Regulatory References. A reference in this Agreement to a section in the HIPAA Rules,
Monroe County DRS Plan/Updated December 2020 Page 24 of 26
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the Substance Abuse Regulations, or any other Applicable Law means the section as in effect or
N
as amended, and for which compliance is required by either or both Associates.
Section 8. Amendment. The Parties agree to take such action to amend this Agreement from
time to time as is necessary for both to comply with Applicable Law. Such amendment shall be
in writing and signed by both the Parties. CL
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Section 9. Survival. The respective rights and obligations of the Parties under Section 5(c) and 0)
Section 6 of this Agreement shall survive the termination of the Agreement.
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Section 10. No Third Party Beneficiaries, Nothing express or implied in this Agreement is S
.2:
intended to confer, nor shall anything herein confer, upon any person other than the Parties and
their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever.
Section 11. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a 2
meaning that permits the Parties to comply with Applicable Law,
2M
Section 12. Waiver. No delay or omission by either Party to exercise any right or remedy under
this Agreement will be construed to be either acquiescence or the waiver of the ability to exercise 0
any right or remedy in the future. r-
.2
Section 13. SeverabilLty. In the event any part or parts of this Agreement are held to be
unenforceable,the remainder of this Agreement shall continue in effect.
Section, 14. Governing Law. This Agreement shall be governed by the laws of Florida
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IN WITNESS WHEREOF, the Parties hereto, have duly executed this Agreement as of the 0
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Agreement Effective Date.
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Monroe County Board of Commissioners SOUTH FLORIDA BEHAVIORAL HEALTH
NETWORK, INC.
CL
SIGNED SIGNED
BY: BY: N
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NAME: Michelle Coldiron NAME: John W. Newcomer CL
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TITLE: Mayor TITLE: President and CEO L)
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Date: Ln Date: CD
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Federal Tax ID4 (or SSN): 59-6000747
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CD
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Monroe,County DR S Plan/Updated December 2020 Page 25 of 26
1 Packet Pg. 465
C.11.b
Attachment D—Sign In Sheet Monroe County Public Meeting
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