Issue 5 April 2, 2010

MID-Session KEY ISSUES

As the House and Senate considered and passed their respective 2010-2011 proposed state budgets this week, the session passed its halfway point. While there appears to be plenty of time to address the differences in the two budget proposals, other issues of great importance are also pending. Some of those the United Way of Florida will be focusing on during the second half of the session are:

Healthy Start – The ability of the state’s premier program that protects the health and welfare of pregnant women and at risk newborns would be significantly undermined by the House budget proposal to completely eliminate Healthy Start Coalitions and shift service dollars and responsibilities to local County Health Departments. The cut would save the state $4 million, but would result in loss of $32 million that the Coalitions leverage in additional community funds. Access to prenatal care through established provider networks will be negatively impacted and successful universal risk screening for pregnant women and infants will be jeopardized under the proposal.  In what would be a double whammy for low income pregnant women, the House budget reduces Medicaid eligibility for pregnant women from 185% of the federal poverty level to 150%, eliminating health coverage for 5,800 low-income pregnant women.

Children’s Services Councils – SB 1216 and HB 1227 would purge express voter intent contained in referenda creating Children’s Services Councils across the state and replace it with legislative intent. Voters expressly voted to allow their county commissions to put their CSC’s up for reconsideration on a local ballot any time their county commissions so desire. These bills would replace that intent by requiring that the CSC’s be put up for referendum every six years.

Healthy Families Florida – Healthy Families Florida is the state’s premier child abuse and neglect prevention program. Until last week, it was slated for total elimination in the Senate budget. Although the Senate has restored $27 million to the Healthy Families Florida budget, it is with one time, nonrecurring Medicaid funds that Congress is expected to vote on in the second or third week of April. Nonrecurring funds are better than none, but their use could subject this stellar program to being reduced or eliminated in 2011-2012, when the budget situation is expected to be worse than next year.

Affordable Housing – SB 262 and HB 665 remove the $243 million cap that was put on Affordable Housing Trust Funds in 2007, and provides for those trust funds to be used as intended – for Affordable Housing. The bills will also help thousands of Floridians renovate and improve existing properties so Florida's 300,000 empty-house-inventory can be sold-down and the construction industry - one of Florida’s main economic drivers – can get back on track.

Early Steps – We know that if young children are provided the supports and nurturing they need in their earliest years, they are much more likely to realize their full potential. The Early Steps Program provides almost 42,000 children at risk for and with developmental delays with services that often change their lives forever and reduce the need for expensive future state services. In order to continue to draw down millions of federal dollars to serve these children, the Senate needs an additional $4 million in their proposed budget, and the House an additional $600,000.

Medicaid Reform – Florida will spend about $19 billion– about one-in-four state budget dollars – on Medicaid next year, and Medicaid spending on the 2.7 million Floridians in the program accounts for about half of next year’s $3.2 billion budget shortfall. Consequently, Legislators are looking for ways to reduce Medicaid costs.

Numerous studies have been unable to document that Florida’s experiment with Medicaid reform has saved the state money, and all have documented more problems with quality and access to services in reform areas. All, that is, except one; one requested by the Legislature by a firm doing work for Medicaid HMOs that was released early this session. Not surprisingly, that study concluded the state could save $28 million next year and $100 million in future years if it expands Medicaid reform. As a result, the Senate budget bill includes expansion of Medicaid reform to an additional 19 counties, forcing about 250,000 Medicaid recipients into managed care.

The 19 counties targeted for the HMO move are those that have two or more managed care Medicaid plans already operating and are considered to have the capacity to serve a larger population. Among them are most Central Florida counties, including Orange, Seminole and Osceola, along with Miami-Dade, Hillsborough, Palm Beach and Pinellas counties. Already, about 1 million Florida Medicaid patients are treated through managed care.

The House will unveil its Medicaid reform proposal next week. While no one has yet seen it, incoming Speaker Dean Cannon has said the plan will include a design that does not require additional waivers from the federal government in the first year.

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Budgets Ready For Conference

The Senate passed its proposed $69.4 billion 2010-2011state budget on Wednesday and the House passed its $67.2 billion proposal on Thursday, both along party lines. The $2.2 billion difference is attributable to the Senate’s willingness to include $880 million in additional federal Medicaid money anticipated to pass Congress in mid-April, $412 million that would be available only if the Legislature approves a compact with the Seminole Tribe generated by allowing Las Vegas-style gambling at seven tribal casinos, and increasing local property taxes for education n 20+ counties. The House also includes deep cuts to schools, health programs and human services, particularly substance abuse, mental health and developmentally disabled programs. Both proposals include about $2.3 billion in federal stimulus money – the final installment of stimulus dollars that are propping up this year’s budget.

The budget is the only bill the Legislature is constitutionally required to pass each year. In a normal year, the remaining time in session would be more than enough to iron out the differences between the two proposals and pass the final budget, usually on the last day of session. However, this year the negotiations will be largely on hold until mid-April when Congress is expected to pass the bill which includes the $880 million included in the Senate budget. If Congress fails to pass the increased Medicaid funding before the end of session, Legislators will be scrambling to get their business done as fast as possible so they can hit the campaign trail. All 120 House seats and 20 of the 40 Senate seats are up for election in November.

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School Readiness and PreK Budgets

Thanks to an amendment that was made on the Senate floor on Wednesday, school readiness funding in both proposed budgets is in good shape for next year – about the same as this year.

However, while the proposed 2010-2011 House budget only contains a minimal (1%) cut to the PreK program, the Senate budget cuts the program by more than $30 million, a $255 dollar cut per child for a reduction of nearly 10%.

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Volunteer Month Begins

April is Florida Volunteer Month, and this year’s theme is “Florida Needs YOU … VOLUNTEER!” Sponsored by the Governor’s Commission on Volunteerism and Community Service (Volunteer Florida), April is the month each year when we celebrate the volunteers that improve lives and communities across the state and encourage Floridians who have not discovered the joys of volunteering to join the volunteer movement. Visit the Volunteer Florida website  to find out more the Governor’s Commission, and visit the Florida Volunteer Month website  and download the customizable Florida Volunteer Month Toolkit. Use it to promote volunteerism in your community!

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Pinwheels for Prevention Campaign Launched

Last Friday, the Florida Department of Children and Families, the Ounce of Prevention Fund of Florida and Prevent Child Abuse Florida launched the Pinwheels for Prevention campaign.

Pinwheels for Prevention is a national campaign to engage individuals and communities in actions that prevent child abuse and neglect before it ever begins. As part of the Campaign, community coordinators will be planting 16,000 pinwheels throughout Florida and distributing resources on healthy child development to parents and child advocates. To find out more about Pinwheels for Prevention and preventing child abuse and neglect in your community, call the Florida Parent HelpLine at 1-800-FLA-LOVE or visit the Ounce of Prevention website at www.ounce.org.

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Housing Day Rally Next Wednesday

On Wednesday, April 7, 2010 at 12:45 p.m. the annual Housing Day Rally will be held on the back steps of the Old Capitol Building (facing the new Capitol). The Sadowski Coalition is hosting the a press conference to thank legislators for support of repealing the cap on the state and local housing trust funds (Senate Bill 262 and House Bill 665 ) and to call upon lawmakers to use housing trust fund money for housing.

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BILLS HEARD THIS WEEK

Including bills heard last Friday after Legislative Link hit the wire.

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HB 7 – Coverage For Mental and Nervous Disorders

On Tuesday, the House Health Care Regulation Committee passed HB 7. The bill requires health insurers, health maintenance organizations, and nonprofit hospital and medical service plan corporations to make mental and nervous disorder services available to policy holders for an additional premium. However, the services do not have to be the same as for those offered for physical illness; Florida mandates mental and nervous disorder coverage, but does not mandate parity of coverage. The bill imposes a mandated health insurance offering for the care and treatment of schizophrenia, psychotic disorders, mood disorders, anxiety disorders, substance abuse disorders, eating disorders, and childhood ADD/ADHD at full parity with coverage offered for physical illness. The bill maintains the partial parity of current law with respect to all other mental disorders. Read the bill.

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HB 91 – Adult Protective Services

Last Friday the House Health Care Appropriations Committee passed CS/HB 91. The bill amends several statutory provisions relating to adult protective services. Among others, the bill:

• Replaces the terms “disabled adults” and “elderly persons” with the term “vulnerable adult;”
• Defines “activities of daily living” to conform with the same definition relating to adult family-care homes;
• Provides that the central abuse hotline must transfer to the appropriate county sheriff’s office reports of known or suspected abuse of a vulnerable adult involving a person other than a relative, caregiver, or household member;
• Specifies that the Department of Children and Families (DCF) may file a petition to determine incapacity in adult protective proceedings; and
• Provides DCF with access to records of the Department of Highway Safety and Motor Vehicles for use in conducting protective investigations.

Read the bill.

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HB 813 – Juvenile Justice Facilities and Programs

The House Criminal and Civil Justice Appropriations Committee has passed HB 813. The bill is intended to improve the quality and delivery of health care services to children in the juvenile justice system.

Among others, the bill defines “ordinary medical care” as meaning medical procedures that are administered or performed on a routine basis and include, but are not limited to, inoculations, physical examinations, remedial treatment for minor illnesses and injuries, preventive services, medical management, chronic disease detection and treatment, and other medical procedures that are administered or performed on a routine basis and do not involve hospitalization, surgery, use of general anesthesia, or the provision of psychotropic medications for which a separate court order, power of attorney, or informed consent is required. The bill requires the Department of Juvenile Justice to adopt rules for ordinary medical care, mental health services, substance abuse treatment services, and developmental disability services and to coordinate its rule making effort with the Department of Children and Families and the Agency for Persons with Disabilities. The term “ordinary medical care” is defined. Read the bill.

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HB 1061 – Suicide Prevention Education

The House PreK-12 Appropriations Committee passed CS/CS/HB 1061 last Friday. Among others, the bill revises the membership of the Suicide Prevention Coordinating Council and amends district school board duties relating to student discipline and school safety to require each school board, beginning next school year, to provide access to suicide prevention educational resources to all instructional and administrative as part of the school district’s professional development system. School boards must use resources approved by the Statewide Office of Suicide Prevention. Read the bill.

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SB 1356 – Transitional Services For Youth

Last Friday the Senate Criminal Justice Committee passed SB 1356, addressing provision of transition to adulthood services to older youth who are in the custody of, or under the supervision of, the Department of Juvenile Justice (DJJ). The bill requires that transitional services must be part of an overall plan leading to the total independence of the child from DJJ supervision, and specifies requirements of the overall plan. The bill also provides that youth who are adjudicated delinquent and who are in legal custody of the Department of Children and Family Services (DCF) are eligible to receive DCF’s independent living transition services. The adjudication of delinquency may not be considered, by itself, as disqualifying criteria for eligibility in DCF’s Independent Living Program. Lastly, the bill permits the court to retain jurisdiction for a year beyond the child’s 19th birthday if they are participating in the transition to adulthood program. Read the bill.

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SB 1520 – Background Screening

CS/SB 1520 was full house on Thursday. The bill substantially rewrites the requirements and procedures for background screening of persons and businesses that deal with vulnerable populations; children, the elderly and disabled. Among others, the bill:

• Provides that no person required to be screened may begin work until the screening has been completed;
• Requires all fingerprints be submitted electronically by July 1, 2012;
• Increases all level one screening to level two screening for persons working with vulnerable populations;
• Requires that volunteers working with vulnerable populations undergo a level two background screening;
• Adds career offenders, sexual offenders, and sexual predators to those individuals who may never apply for an exemption from disqualification.

The bill significantly increases the number of people who will need to undergo background screening prior to working with vulnerable persons. It will also require screening to be done using level two standards instead of level one. Level one screening simply requires a name check against the state records while level two screening requires a fingerprint search against state and national records. Level one costs $24.00 and level two costs $43.25. By increasing the cost in the number of persons subject to screening there will be an impact on employers and employees. Senate staff has anticipated that in most cases, the fees will be passed onto the employee. Read the bill.   The House Companion bill, CS/HB 7069 passed the House Policy Council on Tuesday. Read the bill.

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SB 2038 – Medicaid Buy-In Program

The Senate Health Regulation Committee has passed CS/SB 2038. The bill establishes new Medicaid “buy-in” coverage for working disabled individuals ages 16 through 64 who would be eligible for Supplemental Security Income if their earnings equal to 250% of the Federal Poverty Level (FPL) are disregarded, and unearned income does not exceed 88% of the FPL. A participant would be charged a premium based on a sliding scale once his or her earned income exceeds 100% of the FPL. The bill designates the Agency for Health Care Administration as the agency responsible for establishing and administering the Medicaid buy-in program, and provides the Department of Children and Family Services with authority to adopt rules for determining eligibility. The Medicaid buy-in program is subject to federal authorization and the availability of state and federal funds, and the bill directs ACHA to seek amendments to existing Medicaid waivers that service persons with disabilities to allow eligible individuals to participate in the program. Read the bill.

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SB 2244 – Independent Living Transition Services

The Senate Children, Families, and Elder Affairs Committee has passed SB 2244. The bill requires the Auditor General to perform an operational audit of the Independent Living Transition Services Program administered by the Department of Children and Family Services (DCF). The audit must examine provision of pre-independent living services, life skill services, subsidized independent living services, aftercare support services, the Road- to-Independence- Program and transitional support services by the Department and its lead agencies and providers. The bill also requires the Office of Program Policy Analysis and Government Accountability (OPPAGA) to evaluate the Independent Living Transition Services Program, including how the department and lead agencies plan, design, deliver, and oversee the program. Both the audit and the OPPAGA study are to be released by January 15, 2011. Read the bill.

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SB 2396 – Persons With Disabilities

The Senate Judiciary Committee has passed SB 2396 which amends Florida’s Bill of Rights for Persons with Developmental Disabilities to recognize that persons with development disabilities have a right to be free from abuse and negligence, regardless of the setting. The bill clarifies that entities as well as individuals may be liable to a person for violating the rights and privileges of a person with developmental disabilities. The bill also creates the Floridian with Disabilities Act, statutorily adopts the Federal Americans with Disabilities Act of 1990 and as amended in 2008, and provides for civil and administrative remedies for alleged violations of the Floridians with Disabilities Act. Read the bill.

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