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Item D09 D9 BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE Mayor Craig Cates,District 1 The Florida Keys Mayor Pro Tern Holly Merrill Raschein,District 5 Michelle Lincoln,District 2 James K.Scholl,District 3 David Rice,District 4 Board of County Commissioners Meeting July 19, 2023 Agenda Item Number: D9 2023-1191 BULK ITEM: Yes DEPARTMENT: Budget and Finance TIME APPROXIMATE: STAFF CONTACT: Tina Boan AGENDA ITEM WORDING: Approval of the Monroe County Designated Receiving System Plan for 2023-2026 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 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 corrected version of the Plan was ratified by the BOOC at its 3/17/21 meeting. PREVIOUS RELEVANT BOCC ACTION: March 17, 2021, agenda item C.11, the BOCC approved of the Monroe County Designated Receiving System Plan for 2021-2023. (Note: March 17 agenda item was a correction of the plan's cover sheet to read 2021-2023) 930 September 21, 2022, Item F.2, the BOCC adopted annual operating budget for FY2023; 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: N/A STAFF RECOMMENDATION: Approval DOCUMENTATION: 2023-2026 MC DRS Fla .pdf 2017-05-17 Agenda Item C.21 Attach ent.pdf FINANCIAL IMPACT: 931 Monroe County Designated Receiving System Plan In accordance with Florida Statute 394, Florida Mental Health Act Florida Statute 397, Hal S. Marchman Alcohol and Other Drug Services Act 2023-2026 Monroe County DRS Plan Updated May 2023 Page 1 of 27 932 Contents I. Background/Purpose:.............................................................................................................. 3 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 Template......................................................................................... 19 Attachment D—Sign In Sheet Monroe County Public Meeting .................................................. 27 Monroe County DRS Plan Updated May 2023 Page 2 of 27 933 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 assures the coordinated provision of emergency services for people in need of help for behavioral health disorders and supports a comprehensive behavioral system of care. 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 it 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- 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 substance use disorders, or co-occurring disorders. The central receiving facility shall be capable of assessment, evaluation, and triage or treatment or stabilization of persons with 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 linked by shared data systems, formal referral agreements, and cooperative arrangements for care coordination and case management. Each entry point shall be a designated receiving facility and shall, within existing resources, provide or arrange for necessary services following an initial assessment and evaluation. A tiered receiving system consists of multiple entry points, some of which offer only specialized or limited services. Each service provider shall be classified according to its capabilities as either a designated receiving facility or another type of service provider, 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. OR 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. Monroe County DRS Plan Updated May 2023 Page 3 of 27 934 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 providers shall be maintained and made available at all times to all first responders in the service area. IL Monroe County's Designated Receiving System (DRS) Monroe County's Designated Receiving System is best described as a centralized receiving system. 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 17.79 beds at these public receiving facilities — 9.79 are CSU beds and 8 are DETOX beds. The following are the number of funded beds at each facility, by type: • Guidance Care Center, Inc. —7.50 Adult CSU beds 8 DETOX beds • Lower Keys Medical Center—2.29 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 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 with the requirement in Senate Bill 12 to ensure that there is a"no wrong door"approach for acute care services. Thriving Mind held a public meeting in Monroe County for input and will continue to receive feedback from the stakeholders on the continued implementation of the Designated Receiving System through its community needs process. The sign in sheet for the public meeting can be found in Attachment D. 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. Individual is taken by Law Enforcement to the appropriate receiving facility, which is the centralized receiving system: The individual 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 individual that is picked up by law enforcement for a Baker Act/Marchman Act, etc. If the individual 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 appropriate receiving facility (public/private). If the appropriate receiving facility is a public receiving facility, then the individual will be screened for both behavioral health and financial eligibility (indigent vs.private pay). If that individual meets acute care criteria and there is capacity at that public receiving facility, then he/she will be accepted, stabilized and treated. Once the person is stabilized, if the individual is determined to be indigent, then the designated receiving facility will create a discharge plan, which includes a recommended level of care. The individual will also be screened Monroe County DRS Plan Updated May 2023 Page 4 of 27 935 for care coordination through Thriving Mind. If that individual meets criteria for care coordination, then a referral will 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. If it is determined that the individual meets acute care criteria, but the public receiving facility doesn't have capacity, then the public receiving facility will coordinate a transfer to another receiving facility that has capacity. It is important to note that if the individual is a Baker Act,then the law allows for the receiving facility to keep that individual as long as they do not go over 10% of their licensed bed capacity. However, if the individual is a Marchman Act,which does not allow for that flexibility and the Addiction Receiving Facility (ARF) is at licensed capacity, then the facility must provide a basic screening or triage sufficient to refer the person to the appropriate services and coordinate the transfer of that individual to another facility or hospital that has capacity. If it is determined (through the screening process) that the individual does not meet criteria for acute care,then the public receiving facility will determine the recommended level of care for that individual. 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 recommended level of care for that indigent individual is not actively managed by Thriving Mind, then the receiving facility will contact the Thriving Mind provider directly. Referrals will be made to best match the individuals with their needs and geographic preference. If no preference or specific needs are noted,then referrals are made on a rotating basis. All referrals that come through the centralized receiving system will be well documented and available for review at Thriving Mind. Individual is taken by Law Enforcement to the appropriate receiving facility, which is a private receiving facility: If the individual 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 appropriate receiving facility (public/private). If the 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 individual 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 determined that the individual is an indigent individual and meets acute care criteria, then a individual may be transferred to the centralized receiving system for continued acute care services and/or referral to lower level of care services. Individual is self-referred for any publicly funded service: If the individual is seeking publicly funded services, the individual can access care through the 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 individuals Monroe County DRS Plan Updated May 2023 Page 5 of 27 936 identified needs, the facility will make referrals accordingly including for acute care services if necessary. A Process Flow of the Centralized Receiving System is found in Attachment A. The Transportation plan that outlines how individuals needing acute care are transported can be found in Attachment B. III. Inventory of Participating Service Providers 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? Guidance Care CSU,Detox, Screening & Yes Yes Center, Inc. Assessment Lower Keys CSU Only No Yes Medical Center 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 Center, Inc. Assessment Lower Keys CSU Only No Yes Medical Center 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 May 2023 Page 6 of 27 937 Disorders/Co- Occurring? 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- Occurring? Guidance Care CSU,Detox, Screening & Yes Yes Center, Inc. Assessment Involuntary Treatment for Mental Health Disorders 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 Center, Inc. Assessment Lower Keys CSU Only No Yes Medical Center Involuntary Treatment for Substance Use Disorders Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders/Co- Occurring? Monroe County DRS Plan Updated May 2023 Page 7 of 27 938 Guidance Care CSU,Detox, Screening & Yes Yes Center, Inc. Assessment IV. Designated Receiving System (DRS)Agreements Through Thriving Mind's Acute Care Data System, partners can share data and be aware of 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. A full description of the data functions can be found in Thriving Mind's Information Technology (IT) Plan and is available at ...thri:V.�t mind.2 . Network providers have individual contracts and executed Business Associate Agreements (BAAs) through their main contract with Thriving Mind which allows for data sharing and coordination of care. BAA Template can be found in Attachment C. Monroe County DRS Plan Updated May 2023 Page 8 of 27 939 Attachment A—Process Flow for Centralized Receiving System Monroe -Page Left Intentionally Blank- Monroe County DRS Plan Updated May 2023 Page 9 of 27 940 Monroe County DRS Plan Updated May 2023 Page 10 of 27 941 Wl]uan°oe 4"xauaoa�f�y CkNI.,'U� 5812 rep uires"no wrong Process jIoyv lor Carl;tfl°Gthl't;Cm„d door"for acute ca ra services. illerelvIng°INkste:m In lVki,IP81ri7i611! The process for LE'.will]remain .........�.��w the same so as to ell]minatte Transfers from other facilities Con Consumer picked up by Law distance traveled.In addition, Sumer Self-Referral Enforcement(bEj for Baker) the Bungle law enforcement (fads/prisons,courts,hospital` n^'w agency/ambulance would Marehlman Acts continue to fell o the �wwwwwwwww��wwwwwwww wwwwomma ° �,w�wwww�ww www �wwa. wwwwwwww�ww� � existing(as modified) Transpon[ation Plym„... the Can. ...o.� tcnteriaf screened pp .. ... _ Taken to or acute m y ............................. �� Taken to � Korb th Taken fts oes ucnsumeN^". CooYrallied nearest Private mee belts owl]health and ------- Receivin —_———. m, flnenctlal eligibility Receiving B Receiving "„ cereT FacilityCRF Facility Facility w"° Number of w admiss ons in FY 15 16 in r ,* Monroe County: ¢r° Yes 0 a Adult Mental Health: 1,680 Adept Substance Abuse: 428 01 Children�S Mental Health: 225 11100 Children'',Substance Abu— 151 or �p01 Meets Crteia�ay'"u�� ( Na i� H""'"u%u,,,r a,",rewp°" ems ns at% 4µ�r Acute Care7",rdl�'� m Facilty for �"'Po:"4C r 4 services If" "rare is ,a co�r", managed by os „aw1'1Vhat Is thdnr.„ry"n " Postdischarge,,consumer dm'f� r mended " SFBHN(SRT, could be referred to CRF or a" acorn m0�i. ""dye of caO11110 Residential, private provider for lower level vim,,,,,,,,,,,,,,,,, "'s","u contact SFBHN of care services C�'` . ... ........ ...�.. . . .....mm.......... ...................... T Yes oes the CR : managed b f or&7-caj ",o" "," naumer hcv'6 FBHN, H'M�capacity? N rC'�C� No provider suranc.of, pp"—'9rrC Yes 7 Y ource of n u iovider have "' 'a contact '"" "w ® �7 m 'Wr P Y„mr^ �, ' °w wa directly L—Rfer m� �vrwwIf, ....�.,�..�.�.�. ,u rivate Na ��+ oviderforCRF Consumer" Beginnung in Consumer 1anus ry2D17, transferred accepted Nuimber of new SF BHN Current SFBHYJ rc tourcutwavdrhabr:tr,,r lured into CRF there will be another Consumers in FY 15-16 real. dace CRF: (CSU/ avails ble that l]s receiving served in Monroe County: D ETOX elbleroindicate facility that 'C<tl, ""..... •""•. capacity at the has capacity. Adults: 1,347 DE GX- $ 7gi3,,b4"3 publicacute Claleren:3'14 Crisis Support- 5 104,27'7 care Racllities. "•••••'"""'"«••'" °°°° """°"°"°°°°"°"°""""°°"""°"°°°°°°°°'.. A,c,teunenl $ 258,267 Crisis Stay 'total dkvatable: :$1,8411,090 (3-'S days) (_atJ Ihtnded beds 10 92 All w"""wy Lffagend. " $e om rf"oes thou DrTOX funded Ihed 1.89 A'SA precommehnded �6risumer meek"^"r..m� Process what is the 10'w critenla for Care ru" Yes '';c Total funded beds 12.80* Mw d i 7 rr ww O ....... ...... level of care fth anon Eg r �°'+ Coordin °^^^•° w.( N T, Subpre ess *Note Thlsis subpectto change due to rate "sC enhancements Referral madeto SIFBHN's dC3ecision Add t eded to food CRF '+ No CC f}ept for hukage to 4"r Point 'w 's c r r g for c¢ cd volume.erpecurd for / "m w arnbulnurryser provider for CC services Potential A{d[ Cli 1 A. .ors 4 L r rF i21C1,1ll3 Conceml a15 a,e l8FFF $11.,OQ3 w wwww [AdIditionalInfto dt t f1 - 1Y fiC $140009 WOOuai7 v s I d F E, 9L 400 00 4h g Po 1 �f re w II be m. (.dr rail rev.rage `»L'1[d5 o p4etted at th CRF H—or,once a Start/End C)p 3t n F p? eg l2Q%,')- "135 r o Consumer is consumer goes to an SFBHN provider,they w WW Tot 1Ennt (2 discharged to a .111 receive a full ssessmcnt,which could a,,. n ) $L1J,,5+;4 ower Ievel of car, adjust the recommended level of care. // k'ufal rest for�I CRF 947,515 Ye/No voles/zov Monroe County DRS Plan Updated May 2023 Page 11 of 27 942 Attachment B — Transportation Plan Monroe Transportation Plan for Baker Act and Marchman Act Involuntary Examinations Department of Children and Families Circuit 16 (Monroe County) This transportation plan shall describe methods of transport to a facility within the designated receiving system for individuals subject to involuntary examination under the Baker Act s. 394.463 or involuntary admission under the Marchman Act s. 397.6772, s. 397.679, s. 397.6798, or s. 397.6811. 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 resources are available and as otherwise provided by law. Such persons shall be transported to an 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 person has a mental illness and because of his or her mental illness: 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 examination is necessary; and without care or treatment, the person is likely to suffer from neglect or refuse to care for himself or herself; such neglect or refusal poses a real and present threat of substantial harm to his or her well-being; and 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 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 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: 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 Monroe County DRS Plan Updated May 2023 Page 12 of 27 943 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 treatment, is likely to suffer from neglect or refuse to care for himself or herself; that such neglect 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. The law requires that each county shall designate a single law enforcement agency within the 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 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. The Monroe County Sherriff's Department and City of Key West Police Department provide transportation of individuals under the Baker Act and/or Marchman Act throughout Monroe County. 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, regardless of whether the hospital is a designated receiving facility or part of the centralized receiving system. Law enforcement should transport individuals under the Baker Act to the appropriate receiving facility. 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. 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 Monroe County DRS Plan Updated May 2023 Page 13 of 27 944 emergency medical treatment, regardless of whether the hospital is a designated receiving facility or part of the centralized receiving system. Law enforcement should transport individuals (Adults and Minors) under the Marchman Act to the nearest Addiction Receiving Facility (ARF). A list of Monroe County designated ARFs 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. (Signature page follows) Monroe County DRS Plan Updated May 2023 Page 14 of 27 945 Monroe County Board of Commissioners Craig Cates, Mayor Date -Rest of Page Intentionally Left Blank- Monroe County DRS Plan Updated May 2023 Page 15 of 27 946 South Florida Behavioral Health Network d/b/a Thriving Mind South Florida John W. Newcomer, President & CEO Date -Rest of Page Intentionally Left Blank- Monroe County DRS Plan Updated May 2023 Page 16 of 27 947 Department of Children and Families Lourdes Dorado-Rubio, Interim Regional Director, Date Substance Abuse & Mental Health -Rest of Page Intentionally Left Blank- Monroe County DRS Plan Updated May 2023 Page 17 of 27 948 Appendix A Designated Receiving Facilities The following is a list of Monroe County facilities designated by the Florida 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 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 (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 to time as new facilities are designated and others are closed or have their designations removed. Guidance Care Center (ARF & Inpatient Detox) 3000 41 Street Ocean, Marathon 305-434-7660 Monroe County DRS Plan Updated May 2023 Page 18 of 27 949 Attachment C—Agreements Template 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"). 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"). A. SFBHN is deemed to be a Business Associate under the Prime Contract with the Florida 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 », 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 regulations pertaining to the access, use, disclosure, and management of Protected Health Information ("PHI") without limitation, PHI in an electronic format (EPHI). D. In the event that either Party (or both Parties) is a Program, as defined by the federal 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 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. E. The Associates intend to protect the privacy and provide for the security of patient information, including PHI, pursuant to this Agreement, and all in compliance with Applicable Law. Monroe County DRS Plan Updated May 2023 Page 19 of 27 950 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 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. 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, 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. 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 to the information that each Associate creates, maintains, receives from, or transmits on behalf of the other Associate. g. "Enforcement Rule" shall mean the Compliance and Enforcement Standards at 45 CFR Part 160. h. "HIPAA" meansthe Health Insurance Portabilityand Accountability Act of 1996("HIPAA"), Public Law No. 104-191, and any regulations promulgated thereunder. i. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, Enforcement, and 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. 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- 5 and 1320d-6. I. "Program" shall have the same meaning as given to such term in 42 CFR § 2.11. 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 May 2023 Page 20 of 27 951 Associate. n. "Required by Law"shall have the same meaning as given to such term in 45 CFR§ 164.103. o. "Secretary" shall mean the Secretary of the Department of Health and Human Services or his or her designee. P. "Security Rule" shall mean the Security Standards at 45 CFR Parts 160 and 162 and Parts 164, Subparts A and C. 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. 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. 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 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. Section 2. Permitted Uses and Disclosures of PHI. a. Uses and Disclosures of PHI. Except as otherwise limited in this Agreement, Associates 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 Underlying Agreements. b. Permitted Uses of PHI by Associates. Except as otherwise limited in this Agreement, 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 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 May 2023 Page 21 of 27 952 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. Section 3. Obligations and Activities of Associates(as Business Associates). Associates shall each comply with all obligations and requirements for Business Associates under Applicable Law with respect to PHI, and shall have the following obligations: 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 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. (iii) ((Legal Company Name »shall provide notification to SFBHN Privacy Officer and Contract Manager within twenty-four (24) hours of notification by the US Department of Health and Human Services of any investigations, compliance reviews or inquiries by the US Department of Health and Human Services concerning violations of HIPAA (Privacy, Security Breach). 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 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 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 May 2023 Page 22 of 27 953 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. 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 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 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 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 45 CFR §§ 164.524(c)(2)(ii) and (3)(ii) regarding an individual's request for an electronic copy of PHI. g. Amendment of PHI. Each Associate shall make any amendment(s) to PHI in a Designated Record Set that the other Associate directs or agrees to, pursuant to 45 CFR § 164.526, in a time and manner reasonably designated by the other Associate. h. Documentation of Disclosures. Each Associate agrees to document such disclosures of PHI 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 45 CFR § 164.528. i. Accounting of Disclosures. Each Associate agrees to provide to the other Associate, within 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 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 extent that the minimum necessary standard is applicable to the disclosure under 45 CFR § 164.502(b). k. Governmental Access to Records. Each Associate agrees to make its internal practices, 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. Monroe County DRS Plan Updated May 2023 Page 23 of 27 954 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 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) 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 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. , 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 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. C. Notification of Restrictions to Use or Disclosure of PHI. Each Associate shall notify the 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 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. d. Permissible Requests by Associates. Neither Associate shall request the other Associate 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 § 164.508 and 45 CFR § 164.514. Section 5. Term and Termination. a. Term. The term of this Agreement shall commence as of the Agreement Effective 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 Monroe County DRS Plan Updated May 2023 Page 24 of 27 955 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. 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 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 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 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 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, defend, and hold harmless the other Associate (the "Indemnified Associate") from any and all claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs (including reasonable attorneys' and court fees and expenses) arising out of or related to any Breach or alleged Breach of Unsecured PHI created, received, maintained, transmitted, 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 indemnification does not cover any claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs resulting from the negligence or willful misconduct of the Indemnified Associate, or any of Indemnified Associate's employees, contractors, or agents (except Indemnifying Associate). This indemnification is contingent upon (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 May 2023 Page 25 of 27 956 the Substance Abuse Regulations, or any other Applicable Law means the section as in effect or 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. Section 9. Survival. The respective rights and obligations of the Parties under Section 5(c) and Section 6 of this Agreement shall survive the termination of the Agreement. Section 10. No Third Party Beneficiaries. Nothing express or implied in this Agreement is 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 meaning that permits the Parties to comply with Applicable Law. 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 any right or remedy in the future. Section 13. Severability. 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 IN WITNESS WHEREOF, the Parties hereto have duly executed this Agreement as of the Agreement Effective Date. Monroe County Board of Commissioners SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK, INC. SIGNED SIGNED BY: BY: NAME: Craig Cates NAME: John W. Newcomer TITLE: Mayor TITLE: President and CEO Date: Date: Federal Tax ID4 (or SSN): 59-6000747 Monroe County DRS Plan Updated May 2023 Page 26 of 27 957 Attachment D— Sign In Sheet Monroe County Public Meeting A// ke ""Ac i "J , (ALki 3L r iL (J Ile" 2 o A 70 �4 c"."'D a,vl(I 7r- 0 Monroe County DRS Plan Updated May 2023 Page 27 of 27 958 Monroe County Designated Receiving System Plan In accordance with Florida Statute 394, Florida Mental Health Act Florida Statute 397, Hal S. Marchman Alcohol and Other Drug Services Act 2017-2020 Monroe County DRS Plan Page 1 of 24 959 Contents I. Background/Purpose: ............................................................................................................. 3 II. 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............................................................................... 10 Attachment C—Agreements......................................................................................................... 15 Attachment D— Sign In Sheet Monroe County Public Meeting .................................................. 24 Monroe County DRS Plan Page 2 of 24 960 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 (the Managing Entity) have completed this Designated Receiving System (DRS) Plan. Implementation of this plan assures the coordinated provision of emergency services for people in need of help for behavioral health disorders and supports a comprehensive behavioral system of care. 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 it 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-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 substance use disorders, or co-occurring disorders. The central receiving facility shall be capable of assessment, evaluation, and triage or treatment or stabilization of persons with 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 linked by shared data systems, formal referral agreements, and cooperative arrangements for care coordination and case management. Each entry point shall be a designated receiving facility and shall, within existing resources, provide or arrange for necessary services following an initial assessment and evaluation. A tiered receiving system consists of multiple entry points, some of which offer only specialized or limited services. Each service provider shall be classified according to its capabilities as either a designated receiving facility or another type of service provider, 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. OR 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. Monroe County DRS Plan Page 3 of 24 961 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 providers shall be maintained and made available at all times to all first responders in the service area. II. Monroe County's Designated Receiving System (DRS) Monroe County's Designated Receiving System is best described as a centralized receiving system. In Monroe County, there are 2 designated receiving facilities which are both publicly funded (Guidance Care Center, Inc. and Lower Keys Medical Center). SFBHN currently funds a total of 12.80 beds at these public receiving facilities — 10.92 are CSU beds and 1.88 are DETOX beds. The following are the number of funded beds at each facility, by type: • Guidance Center Center, Inc. — 9.10 Adult CSU beds 1.88 DETOX beds • Lower Keys Medical Center— 1.82 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 attempts to maintain the current process for Baker Acts for law enforcement, so that they are transporting Baker Acts to the nearest most appropriate receiving facility (as is the case currently). This is consistent with the requirement in Senate Bill 12 to ensure that there is a "no wrong door" approach for acute care services. SFBHN held a public meeting in Monroe County for input and will continue to receive feedback from the stakeholders on the continued implementation of the Designated Receiving System through its community needs process. The sign in sheet for the public meeting can be found in Attachment D. SFBHN has identified the Guidance/Care Center as the provider that will be designated as the central receiving facility for the centralized receiving system, described above. Consumer is taken by Law Enforcement to the nearest receiving facility, which is the centralized receiving system: 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 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 he/she will be accepted, stabilized and treated. Once the person is stabilized, if the consumer is Monroe County DRS Plan Page 4 of 24 962 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 through SFBHN. If that consumer meets criteria for care coordination, then a referral will be made to SFBHN's Care Coordination Department. If the person does not meet criteria for care coordination, then a referral will be made to an SFBHN provider that has the recommended level of care within their treatment continuum. 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 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 SFBHN (Short-term Residential Treatment (SRT), Residential treatment), then SFBHN's Adult System of Care Department will be contacted in order to coordinate that referral. If the recommended level of care for that indigent consumer is not actively managed by SFBHN, then the receiving facility will contact the SFBHN provider directly. Referrals will be made to best match the consumers with their needs and geographic preference. If no preference or specific needs are noted, then referrals are made on a rotating basis. All referrals that come through the centralized receiving system will be well documented and will available for review to SFBHN. 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 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. Consumer is self-referred for any publically funded service: Monroe County DRS Plan Page 5 of 24 963 If the consumer is seeking publically funded services, the consumer can access care through the 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 identified needs, the facility will make referrals accordingly including for acute care services if necessary. A Process Flow of the Centralized Receiving System is found in Attachment A. The Transportation plan that outlines how consumers needing acute care are transported can be found in Attachment B. HI. Inventory of Participating Service Providers 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? Guidance Care CSU, Detox, Screening Yes -pending Yes Center, Inc. & Assessment Lower Keys CSU Only No Yes Medical Center 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 -pending Yes Center, Inc. & Assessment Lower Keys CSU Only No Yes Medical Center Triage Centers for Mental Health Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental Monroe County DRS Plan Page 6 of 24 964 accept DRS Health Patients? Disorders/Co- Occurring? Guidance Care Yes - pending Yes - pending Yes Center, Inc. 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- Occurring? Guidance Care CSU, Detox, Screening Yes -pending Yes Center, Inc. & Assessment Involuntary Treatment for Mental Health Disorders 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 -pending Yes Center, Inc. & Assessment Lower Keys CSU Only No Yes Medical Center Involuntary Treatment for Substance Use Disorders Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders/Co- Occurring? Monroe County DRS Plan Page 7 of 24 965 Guidance Care CSU, Detox, Screening Yes -pending Yes Center, Inc. & Assessment EMEEMEEEEEMMMMMMMMMMMM= IV. Designated Receiving System (DRS)Agreements Through SFBHN's Acute Care Data System partners can share data and be aware of available beds in the Centralized Receiving System. SFBHN has been working with Knight Software (KIS) to expand the current service data system to fully integrate Utilization Management, Acute Care reporting and Financial Reporting into one, cohesive application. The KIS Integrated Solution 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. The first phase of the new KIS Utilization Management system was implemented effective March 1, 2016. The system is currently capturing adult screening and assessment data. The second phase of referral and bed management is currently in development. The KIS Integrated Solution will allow providers within the network to enroll consumers, record clinical and other psychosocial history, coordinate their care through management of referrals and shared access to the clinical information, and document the outcomes of care. A full description of the data functions can be found in SFBHN's Information Technology (IT) Plan and is available at : : ...:sly"?.h.L. ��:� . Network providers have individual contracts and executed Business Associate Agreements (BAAs)through their main contract with SFBHN which allows for data sharing and coordination of care. Providers collaborate with SFBHN and each other to ensure consumers are linked to services. Agreements can be found in Attachment C. Monroe County DRS Plan Page 8 of 24 966 Attachment A—Process Flow for Centralized Receiving System Monroe -Page Left Intentionally Blank- Monroe County DRS Plan Page 9 of 24 967 tlNlonrne CwaaMtly CYNI.'d.,,,� 587.2req�u'vres2'no wrong PtWrt,w,n Rovta 1'w ICI W i auV9laWid door°for acu[ecareserv9ces. Ri Ceiv' IITs SF°ulerit in ° ;a Ohll"a;;pt!", The proses for LE.1111 remain Nmvwwwwww� ww anwwwww wwww� wwu�W�,�. the same so as to eliminate Consumer picked up by Law distance traveled In.add'.ition, (1r,antipfre" from other fac.ilitles the single lawenforce.ment Consumer Self-Referral Enforcement(LE}for baker/ s,mv'°" (jails/prisons,courts,ho5pltals) � agency/ambulr—would m � Northman Acts continue[o fnluow the wwwwwwwwwwwwwwwwwwwwwwwww www wwwwwww wwwwwwwwwwwwww. existing(as modified) Trasportakion PI a eWuo Taken ffo Taken to Taken to "u uoes the consumd't"',, Consumer screened for both Centralized nearest Private meet criteria for acute`S$ behavl'orat heath and --—-_ ____ _ _--„..._— financial eligilbilty Receiving R 'suing Receiving s'hnvs care? er FacilityCRF Faa611ty Facility Numbe7of new admissions in FN 15-16 in Monroe County'i Jr ' Adult Mental Health. 1,680 wp Adult Substance Abuse: 428 Children's Mental HeaBtfu 225 r 00 Children's Substance Abuse: 151 d;We"oMeeks Ce'kenar'yMyi„, r No remainsa€•' 'tlWiy,or Acute Care7T�k ,,,,,p ,,,„�,e facility for S'aWt W40 rvicee „c, if level of care is m _ ,,o4+hat is th°d^,,,s managed by Post discharge,aonsu'mer m( esommended r„„ypt SF'HN IS"' could be referred to CRT or "°"4sgI of car ^, Residential), private provider for lower level s conCacC SFBHN <-11,11-11// ..... .,.,.,� ., . af care�servi,ce,s.",,,,,,,,,�,.,,,,� Yes a if level of re care is not Consumer havds"d J e*"a wy managed by ry insurance/ocher Yes v' Y„y"'Lloes the CR�'wst // SFBHN, Yes t provider �':— Na J contact �1 p capacity? %� pmvlder ",', S�miu. �X ,rr r W directly N dam."w..wM.�. w nmu /�" Refer to / No private L }:" provider ......... ......o, .. ......... �........ 1,11, „.»„✓ an CRF Consumer' Ir,,, ginning ins Consumer "' �° accepted ua ry aot7, transferred Number of new SFBHN W re will be Cut rent SFBHN rQuum re: evadable to lurid into CRF to another consumers un FY 1546 t:RFrsilrime data{'CSU/ ilable that dsI receiving served in Monroe County: OETIDX) able to indicate facility that :(7AI. p1,294,9113 `"'" • capacity t the has capacity Adults: 1,347 DE I UX 18b,643 ppublice"te Clutter,314 ::Caisiis Support- $ 194,27`7 care facilities. Assonrmora $ 258,267 TottaI Ave ila bfe: $1„841.,0W Crisis Stay (3-'5 daps) Cis tl funded beds 1092 AI ns�u;7""'O�oNrmkk�� Legend; """ UE I(32 tunded beul.:1 88 ASA P ha sis the , d mar meek„W � Process - -what amendcd criteria for Care t�i. Yes Total funded beds. 1,2.80* recam _._�__ ..,,... m fion as'm 1 level ofsare '� „p ,,, *Note.This is subject khan a duce to rate r Caordina t d"@, (CC)vms`i° .. Subprocess 1 g � enhancements Referral made to SFBHN's °'6ecsion h add t needed mf d CriF No CC De{rt forlinkaga to W.m*Pa[wit a"°'k cr i 4 r nrd v.luo rcaxFtacrud inn n a bit>rc y ser provider for CC services ""` " '"" ""'"" °��"''"" Potential ai1t IClin IA ,urvr� I/FiE, $21C1CM, Cancernl F us 1 8 F IL $1.1)AC3 Additi nl fa.' LM 6 p F'lonr ors l R riL 47>a Cl the screaning fnr level of Cara will be "" v r d t P YI r 9)"alpp ", t„rn ,sll nu..-age 7,?8 G47ri a„........ completed at the CRF.However,ante a Start/EndW�^ dpe at g Lxpe sl2kM�} S f?4 G75 Consumer is c discharged to a consumer goes.to an SFRHN iprovider,they c receiveafuVN sessment.which,muhd Tr ralE rig g6HJy ,1,1 J,8S4 werlevet afcar adlastthe recommended level ofcare. � mow"' �. Ye/N. t Total C.at War LCRIF S 1947,515 nalua/zov �l Monroe County DRS Plan Page 10 of 24 968 Attachment B— Transportation Plan Monroe Transportation Plan for Baker Act and Marchman Act Involuntary Examinations Department of Children and Families Circuit 16 (Monroe County) This transportation plan shall describe methods of transport to a facility within the designated receiving system for individuals subject to involuntary examination under the Baker Act s. 394.463 or involuntary admission under the Marchman Act s. 397.6772, s. 397.679, s. 397.6798, or s. 397.6811. 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 resources are available and as otherwise provided by law. Such persons shall be transported to an 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 person has a mental illness and because of his or her mental illness: 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 examination is necessary; and without care or treatment, the person is likely to suffer from neglect or refuse to care for himself or herself, such neglect or refusal poses a real and present threat of substantial harm to his or her well-being; and 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 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 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: 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 Monroe County DRS Plan Page 11 of 24 969 without care or treatment, is likely to suffer from neglect or refuse to care for himself or herself, that such neglect 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. The law requires that each county shall designate a single law enforcement agency within the 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 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. 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. 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, regardless of whether the hospital is a designated receiving facility or part of the centralized receiving system. Law enforcement should transport consumers meeting the requirements for an involuntary examination under the Baker Act to the nearest receiving facility, unless the consumer is an inmate, at which time, law enforcement should transport the consumer directly to the Central Receiving Facility (Guidance Care Center, Inc.). 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. 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. Monroe County DRS Plan Page 12 of 24 970 Law enforcement should transport consumers (Adults and Minors) under the Marchman Act to the nearest Addiction Receiving Facility. 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. Monroe County DRS Plan Page 13 of 24 971 Appendix A Designated Receiving Facilities The following is a list of Monroe County psychiatric facilities designated by the Florida 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 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 (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 to time as new facilities are designated and others are closed or have their designations removed. Guidance Care Center (ARF & Inpatient Detox) 3000 41 Street Ocean, Marathon 305-434-7660 Monroe County DRS Plan Page 14 of 24 972 Attachment C—Agreements 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 "Party" or "Associate" and collectively the "Parties" or the "Associates"). The Effective Date of this Agreement shall be July 1, 2016 ("Agreement Effective Date"). RECITALS A. SFBHN and «LegalCompanyName », 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"). A. SFBHN is deemed to be a Business Associate under the Prime Contract with the Florida 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 », 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 regulations pertaining to the access, use, disclosure, and management of Protected Health Information ("PHI") without limitation, PHI in an electronic format (EPHI). D. In the event that either Party (or both Parties) is a Program, as defined by the federal 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 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. E. The Associates intend to protect the privacy and provide for the security of patient information, including PHI, pursuant to this Agreement, and all in compliance with Applicable Law. Monroe County DRS Plan Page 15 of 24 973 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 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. 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, 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. 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 to the information that each Associate creates, maintains, receives from, or transmits on behalf of the other Associate. g. "Enforcement Rule" shall mean the Compliance and Enforcement Standards at 45 CFR Part 160. h. "HIPAA" means the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Public Law No. 104-191, and any regulations promulgated thereunder. i. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, Enforcement, and 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. 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-5 and 1320d-6. Monroe County DRS Plan Page 16 of 24 974 I. "Program" shall have the same meaning as given to such term in 42 CFR § 2.11. 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 Associate. n. "Required by Law" shall have the same meaning as given to such term in 45 CFR § 164.103. o. "Secretary" shall mean the Secretary of the Department of Health and Human Services or his or her designee. p. "Security Rule" shall mean the Security Standards at 45 CFR Parts 160 and 162 and Parts 164, Subparts A and C. 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. 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. 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 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. Section 2. Permitted Uses and Disclosures of PHI. a. Uses and Disclosures of PHI. Except as otherwise limited in this Agreement, Associates 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 Underlying Agreements. b. Permitted Uses of PHI by Associates. Except as otherwise limited in this Agreement, 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 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 Monroe County DRS Plan Page 17 of 24 975 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 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. Section 3. Obligations and Activities of Associates (as Business Associates). Associates shall each comply with all obligations and requirements for Business Associates under Applicable Law with respect to PHI, and shall have the following obligations: 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 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. (iii) «LegalCompanyName » shall provide notification to SFBHN Privacy Officer and Contract Manager within twenty-four (24) hours of notification by the US Department of Health and Human Services of any investigations, compliance reviews or inquiries by the US Department of Health and Human Services concerning violations of HIPAA (Privacy, Security Breach). C. Data Breach Notification. No later than four (4) business days following any breach affecting 500 or more individuals , 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 notification requirements set forth in the Prime Contract, 45 C.F.R. §§ 164.400, et seq., Monroe County DRS Plan Page 18 of 24 976 and in s. 501.171, F.S. Associates, as applicable, at its own cost, shall notice affected parties no later 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. 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. 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 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 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 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 45 CFR §§ 164.524(c)(2)(ii) and (3)(ii) regarding an individual's request for an electronic copy of PHI. g. Amendment of PHI. Each Associate shall make any amendment(s) to PHI in a Designated Record Set that the other Associate directs or agrees to, pursuant to 45 CFR § 164.526, in a time and manner reasonably designated by the other Associate. h. Documentation of Disclosures. Each Associate agrees to document such disclosures of PHI 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 45 CFR § 164.528. i. Accounting of Disclosures. Each Associate agrees to provide to the other Associate, within 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 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 extent that the minimum necessary standard is applicable to the disclosure under 45 CFR § 164.502(b). Monroe County DRS Plan Page 19 of 24 977 k. Governmental Access to Records. Each Associate agrees to make its internal practices, 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. 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 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) 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 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. , 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 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. C. Notification of Restrictions to Use or Disclosure of PHI. Each Associate shall notify the 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 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. d. Permissible Requests bV Associates. Neither Associate shall request the other Associate 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 Monroe County DRS Plan Page 20 of 24 978 Rule regarding marketing, fundraising and research located at Sections 45 CFR § 164.501, 45 CFR § 164.508 and 45 CFR § 164.514. Section 5. Term and Termination. a. Term. The term of this Agreement shall commence as of the Agreement Effective 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 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. 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 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 contrary. 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 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 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 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, defend, and hold harmless the other Associate (the "Indemnified Associate") from any and all claims, losses, liabilities, damages,judgments, fees, expenses, awards, civil monetary penalties, and costs (including reasonable attorneys' and court fees and expenses) arising out of or related to any Breach or alleged Breach of Unsecured PHI created, received, maintained, transmitted, 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 indemnification does not cover any claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs resulting from the negligence or willful misconduct of the Indemnified Associate, or any of Indemnified Associate's employees, contractors, or agents (except Indemnifying Associate). This indemnification is contingent upon (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 Monroe County DRS Plan Page 21 of 24 979 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, the Substance Abuse Regulations, or any other Applicable Law means the section as in effect or 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. Section 9. Survival. The respective rights and obligations of the Parties under Section 5(c) and Section 6 of this Agreement shall survive the termination of the Agreement. Section 10. No Third Party Beneficiaries. Nothing express or implied in this Agreement is 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 meaning that permits the Parties to comply with Applicable Law. 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 any right or remedy in the future. Section 13. Severability. 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 IN WITNESS WHEREOF, the Parties hereto have duly executed this Agreement as of the Agreement Effective Date. «Legal_Company_Name_» SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK, INC. SIGNED SIGNED BY: BY: NAME: «ContractSigner» NAME: John W. Dow Monroe County DRS Plan Page 22 of 24 980 TITLE: ((Signer Title>> TITLE: President and CEO Date: Date: Federal Tax ID# (or SSN): «Fed ID» Monroe County DRS Plan Page 23 of 24 981 Attachment D— Sign In Sheet Monroe County Public Meeting vt 4117 5, SJV,,raT ov' 0 6",I % 4 cl, �-i 6, ' ��•.6`��' ��'ry�*s'w I:,w�.� �f,w�'�'� � � �4w�'dF��;,, ww �q C4 17", Z- Monroe County DRS Plan Page 24 of 24 982 '102South Florida Behavioral � Health Network, Inc. Monroe County SB 12 Planning Meeting Thursday, March 2, 2017 Morning Session—(9:00am) AGENDA (SFBHN Staff: John, Steve, Laura, Betty, Carol, Joanna) 1. Welcome and Introductions 2. Review of Senate Bill (SB) 12 3. Centralized Receiving Facility (CRF) Proposal 4. Transportation Plan Discussions 5. Care Coordination Activities 6. Follow-up Activities 7. Adjournment Monroe County Housing Planning Meeting Thursday, March 2, 2017 Afternoon AGENDA (SFBHN Staff: Maria) 1. Welcome and Introductions 2. Review of Housing Needs in Monroe County 3. Site Visits of Housing Providers (Samuel's House, AIDS Help, De Poo) 4. Follow-up Activities 5. Adjournment Monroe County Provider Visits Friday, March 3, 2017 AGENDA (SFBHN Staff: Betty, Carol, Joanna, Maria) 9:00am—Volunteers of America 10:00am—Florida Keys Outreach Coalition (FKOC) 11:30 am—Guidance Care Center (GCC) CSU Marathon 983 Statutes & Constitution :View Statutes : Online Sunshine Page l of 3 Select Year: 201 fi v Go The 2016 Florida Statutes Title XXIX Cha ter 394 View Entire Chapter PUBLIC HEALTH MENTAL HEALTH 394.4573 Coordinated system of care; annual assessment; essential elements; measures of performance; system improvement grants; 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. 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 department's assessment shall consider, at a minimum, the needs assessments conducted by the managing entities pursuant to s. 394.9082(5). Beginning in 2017, the department shall compile and include in the report all plans submitted by managing entities pursuant to s. 394.9082(8) and the department's evaluation of each plan. (1) As used in this section: (a) "Care coordination" means the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure service linkage. Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures. The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations. (b) "Case management" means those direct services provided to a client in order to assess his or her needs, plan or arrange services, coordinate service providers, link the service system to a client, monitor service delivery, and evaluate patient outcomes to ensure the client is receiving the appropriate services. (c) "Coordinated system of care" means the full array of behavioral and related services in a region or community offered by all service providers, whether participating under contract with the managing entity or by another method of community partnership or mutual agreement. (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: (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 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. htt /'www.le state.fl.us/STATUTES/index.cfm?A mode=Dis la „Statute&Search St... 3/28/2017 984 P� g• PP,�„ P Y ��, Statutes & Constitution :View Statutes : Online Sunshine Page 2 of 3 1. A county or several counties shalt plan the designated receiving system using a process that includes the managing entity and is open to participation by individuals with behavioral health needs and their families, service providers, law enforcement agencies, and other parties. The county or counties, in collaboration with the managing entity, shall document the designated receiving system through written memoranda of agreement or other binding arrangements. The county or counties and the managing entity shalt complete the plan and implement the designated receiving system by July 1, 2017, and the county or counties and the managing entity shalt review and update, as necessary, the designated receiving system at least once every 3 years. 2. To the extent permitted by available resources, the designated receiving system shall function as a no-wrong-door model. The designated receiving system may be organized in any manner which functions as a no-wrong-door model that responds to individual needs and integrates services among various providers. Such models include, but are not limited to: a. 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. The central receiving facility shall be capable of assessment, evaluation, and triage or treatment or stabilization of persons with mentat health or substance use disorders, or co-occurring disorders. b. A coordinated receiving system that consists of multiple entry points that are linked by shared data systems, formal referral agreements, and cooperative arrangements for care coordination and case management. Each entry point shall be a designated receiving facility and shall, within existing resources, provide or arrange for necessary services following an initial assessment and evaluation. c. A tiered receiving system that consists of multiple entry points, some of which offer only specialized or limited services. Each service provider shalt be classified according to its capabilities as either a designated receiving facility or another type of service provider, such as a triage center, a licensed detoxification facility, or an access center. All participating service providers shad, within existing resources, be linked by methods to share data, format referral agreements, and cooperative arrangements for care coordination and case management. 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 shalt be maintained and made available at all times to all first responders in the service area. (c) Transportation in accordance with a plan developed under s. 394.462. (d) Crisis services, including mobile response teams, crisis stabilization units, addiction receiving facilities, and detoxification facilities. (e) Case management. Each case manager or person directly supervising a case manager who provides Medicaid-funded targeted case management services shall hold a valid certification from a department-approved credentialing entity as defined in s. 397.311(9) by July 1, 2017, and, thereafter, within 6 months after hire. (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. (g) Outpatient services. (h) Residential services. (i) Hospital inpatient care. (j) Aftercare and other postdischarge services. http://www.leg.state.fl.us/STATUTES/index.cfm?App,_mode:=Display,,Statute&Search,"-St... 3/28/2017 985 Statutes & Constitution :View Statutes : Online Sunshine Page 3 of 3 (k) Medication-assisted treatment and medication management. (1) Recovery support, including, but not limited to, support for competitive employment, educational attainment, independent living skills development, family support and education, wellness management and self-care, and assistance in obtaining housing that meets the individual's needs. Such housing may include mental health residential treatment facilities, Limited mental health assisted living facilities, adult family care homes, and supportive housing. Housing provided using state funds must provide a safe and decent environment free from abuse and neglect. (m) Care plans shall assign specific responsibility for initial and ongoing evaluation of the supervision and support needs of the individual and the identification of housing that meets such needs. For purposes of this paragraph, the term "supervision" means oversight of and assistance with compliance with the clinical aspects of an individual's care plan. (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. Such a grant must be awarded through a performance-based contract that Links payments to the documented and measurable achievement of system improvements. History.--ss, 3, 4, 5, ch. 80-384; s. 5,ch. 84-285;s. 1, ch.89-211; s. 5, ch. 96-169;s. 100, ch. 2010-102;s. 5,ch. 2016- 241. Copyright 0 1995-2017 The Florida Legislature - —Privacy Statement - Contact Us http://www.leg.state.fl.us/STATUTES/index.cfm?App,,_jnode:-Display,_,Statute&Search"-St... 3/28/2017 986 THE FLORIDA SENATE 2016 SUMMARY OF LEGISLATION PASSED Committee on Children, Families, And Elder Affairs CS/SB 12 — Mental Health and Substance Abuse by Appropriations Committee and Senators Garcia, Galvano and Ring The bill addresses Florida's system for the delivery of behavioral health services. The bill provides for mental health services for children,parents, and others seeking custody of children involved in dependency court proceedings. The bill identifies the components of a coordinated system of care to be provided for individuals with mental illness or substance use disorder and defines a"No Wrong Door" model for accessing care. The Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF) are directed to modify licensure requirements through the rulemaking process if possible, to create an option for a single, consolidated license to provide both mental health and substance use disorder services. For modifications requiring statutory revisions, the agency and the department shall produce a plan for consolidation to the Legislature by November 1, 2016. Additionally, by December 31, 2016, AHCA and DCF are directed to develop a plan to increase federal funding for behavioral health care; compile detailed documentation of the cost and reimbursements for Medicaid covered services provided to Medicaid eligible individuals by providers of behavioral health care services. If the report provides clear and convincing evidence that Medicaid reimbursements are less than the costs of providing services, the agency and the department shall request additional trust fund authority necessary to draw down Medicaid funds as a match for the documented general revenue expenditures supporting covered services delivered to eligible individuals. To more closely align the Baker Act(mental illness) and Marchman Act(substance abuse), the bill modifies the legal procedures and timelines, as well as processes for assessment, evaluation, and provision of services. The duties and responsibilities of DCF are revised for the contract and oversight of the managing entities'. The duties and responsibilities of the managing entities are also revised. The new duties include, among others, the requirement to conduct a community behavioral health care needs assessment every three years in the geographic area served by the managing entity; determine the optimal array of services to meet the needs identified in the needs assessment and develop strategies to divert people with mental illness or substance use disorder from the criminal justice system and collaborate with the Department of Juvenile Justice and the state court system to integrate behavioral health services with the child welfare system. 1 See s.394.9082,F.S.A managing entity is a not-for-profit corporation organized in Florida which is under contract with DCF on a regional basis to manage the day-to-day operational delivery of behavioral health services through an organized system of care and a network of providers who are contracted with the managing entity to provide a comprehensive array of emergency,acute care,residential,outpatient,recovery support,and consumer support services related to behavioral health. This surmnary is provided for infonnation only and does not represent the opinion of any Senator,Senate Officer,or Senate Office. CS/SB 12 Page: 1 987 Committee on Children, Families, 2016 Summary of Legislation Passed And Elder Affairs By September 1 of each year, beginning in 2017, each managing entity is required to develop and submit a plan to the department describing the strategies for enhancing services and addressing three to five priority needs in the service area. The plans must be developed with input from consumers and their families, local governments, local law enforcement agencies, and other stakeholders. The department is directed to update the crisis stabilization services utilization database. The database is renamed the acute care services utilization database. Managing entities are required to collect utilization data from all public receiving facilities situated within its geographical service area and all detoxification and addictions receiving facilities under contract with the managing entity. The bill allows a crisis stabilization unit, a short-term residential treatment facility, or an integrated adult mental health crisis stabilization and addictions receiving facility that is collocated with a centralized receiving facility to be in a multi-story building and may be authorized on floors other than the ground floor. The department is to develop certain forms to be used by law enforcement for use when a person is taken into custody under chapter 397. The department is also to develop a website and post standard forms to be used to file a petition for involuntary admission under the Marchman Act. The bill has a fiscal impact of$400,000 in nonrecurring funds from the Operations and Maintenance Trust Fund to DCF for the purpose of modifying the existing crisis stabilization database to collect and analyze data and information pursuant to s. 397.321, F.S. If approved by the Governor, these provisions take effect July 1, 2016 Vote: Senate 38-0; House 118-1 This surmnary is provided for infonnation only and does not represent the opinion of any Senator,Senate Officer,or Senate Office. CS/SB 12 Page: 2 988