The Substance Abuse and Mental Health Program is governed by Chs. 394 and 397, Florida Statutes, and develops the standards of quality care for prevention, treatment, and recovery services. The department is statutorily responsible for licensure and regulation of substance use disorder treatment services, and designation of addiction and Baker Act receiving facilities.

The Department of Children and Families does not directly provide community-based behavioral health services. Instead, it contracts for the delivery of services through seven managing entities. The managing entities are responsible for the planning, implementation, administration, monitoring, data collection and reporting, and analysis for behavioral health care in their regions. Managing entities contract with local network service providers for the provision of prevention, treatment, and recovery support services. Managing entities also work to create linkages among various services and systems, including juvenile justice and adult criminal justice, child welfare, housing services, homeless systems of care, and health.

The programs provided services for 580,634 individuals in Fiscal Year 2018-19; 276,885 adults and 303,749 children.

• Mental Health Services for Adults
  • Assessment determines the services, supports, and level of care needed.
  • Crisis Support is outpatient services available 24 hours per day, seven days per week for crisis intervention or to provide emergency care.
  • Crisis Stabilization is an acute care service, offered 24 hours per day, seven days per week, which provides brief, intensive mental health residential treatment services. This service meets the needs of individuals who are experiencing an acute crisis and who, in the absence of a suitable alternative, would require hospitalization.
  • Florida Assertive Community Treatment (FACT) teams, in an effort to promote independent, integrated living for individuals with severe and persistent psychiatric disorders, provide a 24-hours-per-day, seven-days-per-week multidisciplinary approach to deliver comprehensive care to people where they live, work or go to school, and spend their leisure time.
  • In-Home and On-Site Services are therapeutic services and supports provided in non-mental health provider settings such as nursing homes, assisted living facilities, residences, schools, detention centers, commitment settings, foster homes, and other community settings.
  • Inpatient Services provide intensive treatment to individuals exhibiting violent behaviors, suicidal behaviors, and other severe disturbances due to a mental illness. These services are provided in general hospitals or psychiatric specialty hospitals.
  • Residential Treatment provides supervision 24 hours per day, seven days per week and include structured rehabilitation-oriented group facilities that house persons who have significant deficits in independent living skills and need extensive support and supervision. Residential treatment includes short-term residential treatment and adult group homes for those requiring longer lengths of stay.
  • Outpatient Services provide a therapeutic environment that is designed to improve the functioning, or prevent further deterioration, of persons with mental health and/or substance abuse problems. Outpatient services are usually provided on a regularly scheduled basis by appointment, with arrangements made for non-scheduled visits during times of increased stress or crisis.
   
• Mental Health Services for Children provides funding for in-home and community based outpatient services, crisis services, and residential treatment including services at psychiatric residential treatment facilities, therapeutic foster care homes, and therapeutic group homes provided through joint Medicaid and Mental Health Program contracts with behavioral health managed entities and providers).

• Juvenile Incompetent to Proceed Program provides competency restoration services to juveniles who have been charged with a felony prior to their 18th birthday and do not have the ability to participate in legal proceedings due to their mental illness, mental retardation, or autism. The goal is to provide assessment, evaluation and intensive competency restoration services to allow the juvenile to return to court and proceed with their court proceedings. Competency restoration services are available in both the community and in a secure residential setting.  

• Substance Abuse Services for Adults and Children
• Prevention services are designed to preclude, forestall, or impede the development of substance abuse problems, primarily for youth, through increasing public awareness and education, community-based processes and evidence-based practices.
• Detoxification services use medical and clinical procedures to assist individuals in their efforts to withdraw from the physiological and psychological effects of substance abuse and may occur in a residential or outpatient setting.
• Treatment services include an array of assessment, counseling, case management, and support provided in residential and non-residential (outpatient) settings for individuals and their families who have lost their abilities to control the substance use on their own and require formal, structured intervention and support. Services include various levels of residential, outpatient, and recovery support based on the severity of the addiction.
• Recovery Support services are offered during and following treatment to further assist individuals in their development of the knowledge and skills necessary to maintain their recovery. Services include transitional housing, life skills training, parenting skills, and peer-based individual and group counseling.

The substance abuse program serves adolescents and adults affected by substance misuse, abuse, or dependence.

The mental health program services are focused on

• adults in crisis; people with serious, disabling, or potentially disabling mental illnesses who live in the community and who cannot otherwise access mental health care; and certain people with serious mental illnesses who get involved with the criminal justice system; and
• children and adolescents who are experiencing an acute mental or emotional crisis; who have a serious emotional disturbance or mental illness; who have an emotional disturbance; who are at risk of emotional disturbance; and who are incompetent to proceed to a delinquency hearing due to their mental illness, intellectual disability, or autism.

Each of the program's client groups has performance measures and standards included in the department's Long Range Program Plan that provide an indication of the program's success in meeting needs. For example, 77% of children successfully completed substance abuse treatment services, above the legislative standard of 48% for Fiscal Year 2018-19. The following table shows selected performance measures for the program.  

Program Performance in Fiscal Year 2018-19
Measure	Performance
Percentage of adults with serious mental illness who are competitively employed	36%
Percentage of school days seriously emotionally disturbed children attended	87%
Percentage of children with emotional disturbance with improved functioning	66%
Percentage of children with serious emotional disturbance with improved functioning	61%
Percentage of adults who successfully complete substance abuse treatment services	55%
Source: Long Range Program Plan, Department of Children and Families.

 

Sixty-five percent of funding for community mental health and substance abuse is general revenue funds.

Children's Mental Health. Chapter 2020-107, Laws of Florida, requires the development of plans promoting a coordinated system of care for children's mental health services. It requires the Department of Children and Families (DCF) and the Agency for Health Care Administration (AHCA) to identify children, adolescents, and young adults age 25 and under who are the highest users of crisis stabilization services, jointly submit a quarterly report to the Legislature during Fiscal Years 2020-21 and 2021-22 on the actions taken by both agencies to better serve these individuals. The bill also includes certain provisions for DCF and behavioral health managing entities (MEs) to provide crisis response services through mobile response teams. 

Substance Abuse Services. Chapter 2020-38, Laws of Florida, addresses individuals who have experienced substance abuse treatment, as well as recovery residence service providers, who have been disqualified from employment following a failed background screening by requiring the Department of Children and Families to provide exemptions from employment disqualification for certain offenses. The bill condenses several background screening sections of Ch. 397, Florida Statutes, into a single set of requirements. The bill also modifies patient-brokering laws to exempt discounts, waivers of payment, or payments not prohibited by the federal anti-kickback statute or regulations. The bill also applies such exemptions to all payment methods used by federal health care programs, and provides that patient-brokering constitutes a first-degree misdemeanor.

Substance Abuse and Mental Health. Chapter 2020-39, Laws of Florida, makes several changes relating to suicide prevention and substance abuse and mental health services. The law broadens the scope and duties of the Statewide Office of Suicide Prevention by requiring it to coordinate education and training curricula on suicide prevention efforts for veterans and service members. The law also creates the First Responders Suicide Deterrence Task Force to assist in the reduction of suicide rates of first responders. Additionally, the law broadens the scope and duties of the Suicide Prevention Coordinating Council by requiring the Council to make recommendations on the implementation of evidence-based mental health programs and suicide risk identification training and adds five new members to the Council. The law makes additional changes to facility requirements, contracting requirements between DCF and managing entities, and requirements for county jails.

The Acute Care Services Utilization Database Meets Statutory Requirements; Limitations Exist for Certain Types of Analyses, Report 19-12, November 2019

Other Reports
The Auditor General reports on department operations are located on its website.

Websites of Interest
Department of Children and Families, Get Help
Substance Abuse and Mental Health Services Administration
National Institute on Drug Abuse
National Institutes of Mental Health

Performance Information
Performance measures and standards for the department may be found in its Long Range Program Plan and Planning and Performance Measures, which reports the department's performance on external and internal measures for its various programs. The measures allow the user to view performance at both a statewide and geographic region level.

Chapters 394 and 397, and s. 20.19, Florida Statutes.

Substance Abuse and Mental Health Program

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