Managing Entity Implementation and Transition

The Northeast Region contracted with a Managing Entity on July 1, 2012, to administer substance abuse and mental health funds and services. The managing entity structure is expected to increase access to care, improve coordination and continuity of care, and redirect service dollars from restrictive care settings to more community-based recovery services.

a. Procurement

The Managing Entity will develop and implement a plan for competitive procurement of all substance abuse and mental health services; this will bring anticipated cost savings and improved quality of care. Competitive procurement will be completed within the first two (2) years of the Managing Entity contract implementation.

b. Service Provision/Scope of Service

The following are the ten core functions of the Managing Entity in the Northeast Region:

Function 1. System of Care Development and Maintenance: The Managing Entity shall develop and manage substance abuse and mental health services into an integrated network of services that are accessible and responsive to individuals in need of such services, along with their families and community Stakeholders.

Function 2. Utilization Management: Utilization Management plan must include methods to reduce, manage, and eliminate waitlists, promote co-occurring services, and ensure appropriate access to substance abuse and mental health crisis intervention, support and stabilization across the life-span.

Function 3. Network/Subcontract Management: The Managing Entity shall manage the Subcontractor network, at a minimum, through the following means: enforcement and monitoring of access standards and management of the system of care, web registration, subcontractor performance monitoring, background screening verification, onsite annual audits and evaluation of all new subcontractors prior to service delivery.

Function 4. Continuous Quality Improvement: The Managing Entity shall maintain a Continuous Quality Improvement (CQI) program which shall include use of outcomes for Individuals Served, Stakeholder satisfaction data, complaint tracking and resolution, as well as the level of staff commitment for this function. This program shall follow a systems approach to reporting, analyzing, and tracking critical incidents related to Individuals Served, community Stakeholder, employees, and family and consumer groups.

Function 5. Technical Assistance/Training: The Managing Entity shall develop and implement a plan for technical assistance and training, including using the relationship between emerging trends in the behavioral health field, monitoring finding, training, clinical supervision, and the CQI program.

Function 6. Data Collection, Reporting and Analysis: The Managing Entity shall implement the performance measure and data collection improvement plans developed by the Managing Entity and approved by the Department. These plans describe improvements for performance measurement and the data collection system based on state performance and outcome measures and the federally-mandated National Outcome Measures and describe approaches to future integration of appropriate data among SAMHIS, Safe Family Network, and Automated Community Connection to Economic Self- Sufficiency data systems operated by the Department.

Function 7. Financial Management: The Managing Entity shall ensure sound fiscal stability of its Subcontractors and ensure revenues and expenditures are budgeted and accounted for in state-designated cost centers for substance abuse and mental health services.

Function 8. Planning: The Managing Entity shall work with the Department to provide performance, utilization, assessment of the System of Care, and other network information for the Department’s Substance Abuse and Mental Health Services Plan, and annual update thereof, and to provide appropriate information for the Department’s Long Range Program Plan and its Annual Business plan.

Function 9. Board Development and Governance: The Managing Entity shall

maintain a strong organization and governance structure, with clear lines of authority across all levels of the service network to the county level.

Function 10. Disaster Planning and Responsiveness: The Managing Entity shall work collaboratively with the Department for disaster planning and preparation to

involvement with community based disaster plans.

c. Integration of Substance Abuse and Mental Health and Child Welfare

The Managing Entity will work with the Community Based Care Agencies and the Departments Child Welfare staff to ensure a prompt and family center scope of substance abuse and mental health service to families involved in the child welfare system. These families should be served with minimal waiting, with evidence based programs and in a trauma informed system of care.

3. Conclusion

The Northeast Region SAMH Program Office will continue to work with the Managing Entity to ensure a successful and seamless transition for the behavioral health clients served in our area. Cost savings, due to decreased administrative rates through utilization management, will be used to continually improve and expand services in our area. This, along with continuous quality improvement, will increase the capacity for our system of care and improve outcomes for clients and their families.

Substance Abuse and Mental Health Program 1. Organizational Profile/Program Description

a. Location & Counties Served

Until February 1, 2013, the Southeast Region's (SER) service area includes two (2) counties in southeast Florida. The Region includes Circuits 15 and 17, comprised by the urban and rural counties of Broward and Palm Beach, with a population of approximately 2.8 million. (As of February 1, 2013, the Southeast Region will also include Circuit 19, comprised of St. Lucie, Martin, Okeechobee and Indian River.) In Fiscal Year 2012-13, the Region served over 50,000 individuals in Adult Mental Health, Children's Mental Health and Adult and Children's Substance Abuse.

The Region recently entered into negotiations for two (2) Managing to administer approximately $92 million in funds and services in the Region. Preparing for implementation, the Region has worked diligently with both groups and their Boards. At the same time, the Region has lost many of its staff.

This narrative reflects a Regional, rather than Circuit-based, approach to services in the Southeast. Most staff are housed in the Regional office in Fort Lauderdale, but travel to both counties and effective February 1, to all six (6) counties. We are the only Region to have two separate Managing Entity contracts, with full responsibility for both.

b. Staffing (OPS & FTEs)

The chart below reflects staffing as of February, 2013, and indicates positions vacant pending hiring.

Number of Employees

Program FTE OPS TOTAL

Substance Abuse 5 3 8

Mental Health 3 2.5 5.5

Total 8 5.5 13.5

c. Types of Services Provided and Number Served i. Substance Abuse

SA Initiatives PREVENTION

 Circuit 17 developed a Comprehensive Community Prevention System to coordinate and enhance prevention services in the Circuit. The Circuit contracted with the Broward County Commission on Substance Abuse as the Lead Agency to accomplish the five (5) steps of the Center for Substance Abuse Prevention’s Strategic Prevention Framework: