Issue 6 April 9, 2010

Voters Win on CSC Bill

On a tie vote, CS/HB 1227 died in the House Military & Local Affairs Policy Committee yesterday. The bill would have required the state’s Children’s Services Councils to be placed on referendum every six years, so local voters could decide whether to retain or retire them.

When CSCs were created by voters, the voters wanted to ensure daily accountability, so taxpayers would know how their hard-earned dollars are being spent. They also wanted the Councils to use their tax dollars for their intended purpose, to help children. So the voters put on the law books that they could at any time – tomorrow, next week, next year – put the Councils back up on referendum to determine if they should be retained or retired. They wanted this flexibility, so the CSCs wouldn’t have to regularly spend money on referendum costs, and so the Councils could strategically address long-term issues without being pushed and pulled by the politics of the moment. CS/HB 1227 and its companion CS/SB 1216 would have replaced that voter intent with the intent of the Legislature – to require that CSCs be placed on local referendums every six years.

The logic of the bill’s proponents – that the CSCs were created years ago and present-day voters should again be allowed to make the decision to retain or retire in order to ensure accountability – is fatally flawed because present-day voters have the ability every day under existing law – not just every six years – to call for a referendum. The Legislative intent actually would have watered down the voter’s intent. Yesterday, the voters won.

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Budget…Every Little Bit Helps

This week, the House, Senate, and Seminole Indian Tribe moved to finalize the Seminole Compact. The Compact will allow the Seminole Indian Tribe to significantly expand its gambling operations.  The $435 million to $438 million projected to be infused into next year's state budget through the Compact is no small peanuts, nor is the additional $1-$1.5 billion it is projected to generate for the state over the next five years. It goes a long way to addressing many recurring funding issues the State faces.

Finalizing the agreement is one of the two major dominoes that must fall before budget conferees are able to reconcile the $2.2 billion difference between the House’s $67.2 billion and the Senate’s $69.4 billion proposed 2010-2011 state budgets. The Senate included $435 million in its budget in anticipation of an agreement. The House did not.

Passage of the Seminole Compact and receipt of the anticipated $880 million in Medicaid funding – which it is hoped Congress passes shortly - will allow Governor Crist to show that the foundation upon which his proposed 2010-2011 budget was based did not deserve to be ignored and ridiculed as it was when it hit Legislators' desks in March.

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Great Week for Affordable Housing

Hundreds of affordable housing advocates and realtors converged on the Capitol to participate in Wednesday’s "Housing Day" rally and to show their support for affordable housing legislation that is moving through the House and Senate. Senator Bennett (CS/CS/SB 262) and Representative Aubuchon (CS/CS/HB 665) were recognized as champions for sponsoring the two bills that will remove the $243 million cap on affordable housing trust funds.  Hundreds of millions of dollars have been “swept” from these trust funds since the cap was implemented by the Legislature in 2006. “This bill not only seeks to improve the living conditions of Floridians, but also stimulates our economy, creates jobs and promotes economic growth,” said Senator Bennett, who is sponsoring the legislation in the Senate. “We really couldn’t ask for more in a single piece of legislation.” Read about bills below.

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House Medicaid Reform Plan Unveiled

On Monday, the House released its much-anticipated Medicaid reform expansion proposal. The next evening, the House Select Policy Council on Strategic and Economic Planning passed it. While it has some similarities to the Senate proposal, it is fundamentally different in its overall approach. Unlike the Senate proposal, which would expand the current 5-county reform area to an additional 19 counties, the House plan would divide the state into 6 geographic regions, with the first - Miami-Dade County – being added to the current reform areas in 2011, generating an estimated $40 million in savings next year. By 2015, all 2.7 million Medicaid patients would be in a managed care setting in one of the 6 regions. The 6 regions are:

 • Escambia County (Pensacola) to Madison County, just east of Tallahassee;
• Nassau County in the northeast corner of the state to Citrus County on the Gulf Coast;
• Tampa Bay area south to Lee County;
• Orlando metropolitan area and nearby areas of Central Florida;
• Broward, Palm Beach and rural counties in South Florida; and
• Miami-Dade, Collier and Monroe counties.

Republican leaders have long sought to eliminate the fee for services payment method Medicaid has used since it was implemented 40 years ago. They claim it provides incentives for health care providers to perform unnecessary services that will jack up their fees. Under a managed care system, a set fee is paid regardless of the amount of services provided. This approach, embraced by both the House and Senate proposals, is intended to reduce the cost of the $19 billion program. Another provision intended to ensure that Medicaid funds are used for services is a requirement in both bills that HMOs and provider networks spend at least 85% of the money on medical services and direct care management. If they don't, they will be fined.

At the House Council meeting, every human service advocate asking to testify was opposed to the bill.  In particular, hospitals and doctors contend the legislation will make it harder to find doctors to work in emergency rooms and that they will be forced to work with HMOs without being able to negotiate better care for their patients (because the state contract with the HMOs will set the standards), hospice and elder groups oppose it because of the requirement for long term care to be included, and disabilities groups oppose it because they have seen significant reductions in service in the last few years and this portends yet another, for a population whose needs are significantly underfunded to begin with.

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VPK and School Readiness Funding Promoted

Florida’s Voluntary Pre-Kindergarten Program is struggling to attain the high quality status that voters explicitly demanded when they created the program in the Florida Constitution. Even so, the Senate’s proposed 2010-2011 budget cuts the program by more than $30 million, a $255 dollar cut per child for a reduction of nearly 10%.

Agency for Workforce Innovation Director Cynthia Lorenzo, who oversees the school readiness and VPK budgets, has worked hard to ensure these critically important services are funded appropriately. She articulates her reasons in a letter to the editor published last week in the Lakeland Ledger. Read the article.

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Bills, Bills, Bills

This week and last were the most frenetic weeks of the 2010 session, as scores of bills worked their way through the committee process at a dizzying pace. This being the last week for committee hearings, legislators knew that if their bills weren’t heard and passed by week's end, they would likely die this session.

True to form, as has always occurred but become more common-place in recent years, fundamentally important and extremely complex legislation was unveiled this week – Medicaid reform expansion (read article above) – with only three weeks left to analyze and make substantive changes to it. The strategy of unveiling such comprehensive legislation has gained popularity in recent years as legislative leaders have figured out that it provides an opportunity for quickly passing their priority bills; bills that, if required to go through the regular committee process, might get bogged down due to their complexity and due to significant opposition that would have time to coalesce to fight them. Even though the House Medicaid reform bill was released only about 24 hours before it was heard on Tuesday, there was a room full of advocates prepared to testify. All opposed the bill.

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BILLS HEARD THIS WEEK

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HB 91 – Adult Protective Services

On Tuesday, the House Health & Family Services Policy Council passed committee substitute for HB 91. Among others, the bill replaces the terms, “disabled adults”, and “elderly persons” with the term “vulnerable adult”. It requires that the central abuse hotline 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. The bill also clarifies that the Department of Children and Families may file a petition to determine incapacity in adult protective proceedings, and has access to Department of Highway Safety and Motor Vehicles records for use in conducting protective investigations. Read the bill.  

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SB 146 – Senior Services Special Districts

On Tuesday, the Senate Health and Human Service Appropriations Committee temporarily passed SB 146, which would authorize counties to create by ordinance an independent special district to provide senior services throughout the county. The special districts could also levy property taxes to fund those services if the majority of voters in the county approved doing so. The bill provides the membership of the governing council, powers and duties of the council, and reporting requirements. Read the bill.

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SB 214 – Autism Spectrum Disorder

CS/CS/CS SB 214 requires a physician to screen a minor for autism spectrum disorder (ASD) in accordance with the America Academy of Pediatrics’ Guidelines when the parents or legal guardian of the minor believes the minor exhibits symptoms of ASD. Based on a determination of medical necessity, the physician must refer the minor for additional ASD screening or inform the parent of other available screening options. The bill expands the current autism coverage mandate in Florida law to include treatment for developmental disabilities.

The bill also requires health insurers and HMO’s to provide direct access to one appropriate specialist for the diagnosis of ASD or other developmental disability. The bill also mandates health insurance policies and health maintenance organizations to provide at least three visits per policy year for the screening, evaluation of, or diagnosis of ASD or other developmental disabilities. The bill was passed by the Senate Governmental Oversight and Accountability Committee on Tuesday. Read the bill.

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SB 262/HB 665 – Affordable Housing

On Tuesday, the Senate Finance and Tax Committee passed CS/CS/SB 262 and on Wednesday the House Economic Development & Community Affairs Policy Council passed CS/CS/HB 665. Both bills would repeal the $243 million cap that the 2006 Legislature put on state and local affordable housing trust funds. Legislators appear ready to pass the bills this year and target the trust funds to improvements on existing housing, resulting in the creation of nearly 15,000 Florida jobs and over $1.4 billion in economic activity. This will also draw down the inventory of over 300,000 empty houses that are on the market in Florida. Until the inventory is significantly reduced, experts predict that new construction will not rebound, and new construction has historically been one of the main drivers of Florida’s economy. As one of the 25 members of the Sadowski Coalition which has worked to remove the cap for years, the United Way of Florida supports this legislation. Read CS/CS/SB 262.   Read CS/CS/HB 665.  

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SB 316 – Booster Seats

Car crashes are the leading cause of child death. Current Florida law requires children three years of age or younger to be secured in a baby seat when riding in a car. Unfortunately, children older than three, who may be too big to fit in a car seat, are often secured in the car by a regular seatbelt. Because of their height and or weight, these children are subject to serious injury (primarily liver, spleen and spinal cord injury) and even death because the seatbelt does not fit appropriately. Booster seats have been shown to reduce serious injury by 59% for these children.

CS/CS/SB 316, which was passed the Criminal Justice Committee on Tuesday, requires the operator of a motor vehicle who is transporting a child who is 7 years of age or younger and is less than 4'9" to protect the child by properly using a crash tested, federally approved child restraint device. The bill specifies the device must be appropriate for the height and weight of the child, and may include a vehicle manufacturer’s integrated child seat, a separate child’s safety seat, or a child booster seat. Under the provisions of the bill, motorists will no longer be permitted to transport children age 4-7 years old with only a safety belt used as protection.

An infraction will be a moving violation punishable by a fine of $60.00 plus court costs and add-ons, and by assessment of three points against the driver’s license. The requirement to use a booster seat does not apply to a person who is transporting a child age 4-7 if the person is transporting the child gratuitously in response to a declared emergency or immediate emergency involving the child or transporting a child whose medical condition necessitates an exception. Lastly, the bill requires courts to dismiss a charge against the driver for a first violation upon proof of purchase of a federally approved child restraint device. The bill was passed by the Senate Transportation and Economic Development Appropriations Committee on Tuesday. Read the bill.

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SB 476 – Medicaid Behavioral Health Care Services

SB 476 requires funds returned to the Agency for Health Care Administration from behavioral health plans that do not spend at least 80% of their capitation rate on behavioral health care services, as required by law, to be deposited in the Medical Care Trust Fund and reallocated to community behavioral health providers in the network of the plan making repayments. The providers must then use the funds for any Medicaid-allowable community behavioral health and case management services. The Senate Children, Families, and Elder Affairs Committee passed the bill on Wednesday. Read the bill.

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SB 580 – Alzheimer's Disease

In Florida, more than 435,000 elders currently suffer from Alzheimer’s disease. As baby boomers age, that number will swell considerably. Alzheimer’s is the 7th leading cause of death in the nation and the 5th leading cause of death for those over age 65. In 2005, Florida had the third highest number of deaths due to the disease in the country. CS/SB 580, which was passed by the Senate Health and Human Services Appropriations Committee on Tuesday, would establish a program to educate the public regarding screening for memory impairment, and would authorize the Department of Elder Affairs to support programs providing information and memory screening and memory screening services. Read the bill.

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HB 747 – Treatment of Students with Diabetes

The House Education Policy Council passed CS/CS/HB 747 on Wednesday. The bill prohibits school districts from restricting the assignment of students who have diabetes to particular schools because of their diabetes, because the schools do not have full-time nurses, or because the schools do not have trained diabetes personnel. The bill permits diabetic students whose parents or physicians provide written authorization to carry diabetic supplies and equipment on their person and attend to the management and care of their diabetes while in school, participating in school sponsored events, or in transit to or from school or school sponsored events to the extent authorized by the parent and physician and within the parameters set forth by the State Board of Education. Lastly, the State Board of Education, in cooperation with the Department of Health, is required to adopt rules for the management and care of diabetes by students in schools that must include provisions to protect the safety of all students from the misuse or abuse of diabetic supplies or equipment. Read the bill.

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HB 813 – Juvenile Justice Facilities and Programs

HB 813 is intended to improve the quality and delivery of services in the juvenile justice system. The bill defines “ordinary medical care” (which had not been previously defined) as medical procedures that are administered or performed on a routine basis and include, but are not limited to, inoculations, physical examinations, preventive services, and other medical procedures administered or performed on a routine basis that do not involve hospitalization, surgery, use of general anesthesia, or use of psychotropic medications. 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 efforts with the Department of Children and Families and the Agency for Persons with Disabilities. The bill was passed unanimously by the House Criminal & Civil Justice Policy Council on Tuesday. Read the bill.

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SB 842 – Prevent Child Sexual Abuse

CS/SB 842 requires the Department of Highway Safety and Motor Vehicles to include a $1 check-off for a voluntary contribution to Prevent Child Sexual Abuse on motor vehicle registration applications and renewals, driver’s licenses and applications for driver’s licenses, duplicate driver’s licenses, and license renewals, among others. Driver’s license applications and renewals currently include voluntary $1.00 check-off contributions for Prevent Blindness Florida, the Florida Council of the Blind, the Hearing Research Institute, Family First, and Stop Heart Disease. CS/SB 842 was passed by the Senate Health and Human Services Appropriations Committee on Tuesday. Read the bill.

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HB 923 – Homelessness

HB 923 was passed by the House Health & Family Services Policy Council on Tuesday. The bill creates and revises multiple sections of Florida law relating to homelessness, including:

• Authorizes the ability of drivers to make $1.00 voluntary contributions to aid the homeless on their applications and renewal forms for motor vehicle registrations and driver’s licenses ;
• Replaces the existing Emergency Financial Assistance For Housing Program with a Homeless Prevention Grant Program administered by local homeless continuums of care to provide emergency financial assistance to families facing the loss of their current home due to financial or other crisis;
• Limits the amount a lead agency may spend on administrative costs under a Prevention Grant; and
• Eliminates the Housing First Program.

Read the bill.

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SB 1072 – Juvenile Justice

On Tuesday, the Senate Criminal and Civil Justice Appropriations Committee passed CS/SB 1072. The bill makes a number of changes to juvenile justice laws, along with conforming changes to other relevant statutes including the “Children and Families In Need of Services” (CINS/FINS) statute and the “Comprehensive Child and Adolescent Mental Health Services Act” in an effort to enhance services for youth in the Juvenile Justice system. Among others, the bill:

• Encourages the diversion of youth nine years of age or younger who are found by a court to pose no danger to the community and are unlikely to recidivate back into supervision;
• Expands the definition of “child in need of services” and “family in need to services” to allow those youth to be served by the CINS/FINS network;
• Promotes the use of restorative justice practices to support victims of juvenile delinquency;
• Adds counties, municipalities, and the Department of Juvenile Justice to the specified entities that are encouraged to create pre-arrest or post-arrest diversion programs for youth nine years of age or younger and youth who are first time misdemeanants;
• Prohibits a youth nine years of age or younger from being placed in secure detention unless the youth has been charged with a capital felony, a life felony, or a felony of the first degree; and
• Requires the DJJ to create the Disproportionate Minority Contact Task Force as a way to address minority over-representation in the Juvenile Justice system.

Read the bill.  

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SB 1216 – Children's Services Councils

On Wednesday, the Senate Community Affairs Committee passed CS/SB 1216, which would require that Florida's Children's Services Councils be placed on the local referenda every six years.  On Thursday, the House Military & Local Affairs Policy Committee killed the identical companion bill, CS/HB 1227 by a tie vote.  Read the bill. 

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SB 1356 – Transitional Services for Youth

On Wednesday, the Senate Judiciary Committee passed SB 1356, addressing provision of transition to adulthood services to older youth who are in the custody 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 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 he or she is participating in the transition to adulthood program. Read the bill.

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SB 2014 – School Readiness and VPK

On Tuesday, the Senate Education Pre-K12 Committee passed CS/SB 2014 and on Wednesday, the Senate Children, Families, and Elder Affairs Committee also passed it.

The bill addresses numerous provisions in the school readiness and VPK programs. Among others, it removes flexibility from Early Learning Coalitions (ELCs) to address the unique circumstances of the communities they serve by requiring the Agency for Workforce Innovation (AWI) to adopt specific support service strategies for implementing program requirements, and ELC’s must amend their school readiness plans to conform to AWI’s adopted strategies. The bill expands AWI’s rule making authority to administer the program and directs the Governor to designate AWI as the lead agency for administering the Federal Childcare and Development Fund - the primary funding source for the School Readiness program. The bill requires that AWI adopt and ELC’s use a standard contract for contracting with School Readiness providers. Among others, the bill also increases the statutory limit on the number of ELCs from 30 to 31 and eliminates provisions exempting certain counties from the limit. The bill revises the membership of ELC boards, subjects ELCs to AWI adopted procurement procedures (rather than those for state agencies), eliminates provisions requiring certain ELC’s to hire fiscal agents, and requires AWI to review ELC School Readiness plans every two years rather than annually. The bill also prohibits ELC’s from imposing unauthorized requirements on providers that do not participate in school readiness programs or receive state and federal funding and eliminates ELC discretion to establish priorities based on local factors. Read the bill.  

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SB 2038 – Medicaid Buy-In Program

The Senate Children, Families, and Elder Affairs Committee passed CS/SB 2038 on Wednesday. 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 2120 – Cadmium in Children’s Products

Cadmium is an odorless, silver-white, blue-tinged malleable metal or grayish-white power that has been used for commercial purposes since the end of the 19th century. While today, cadmium is predominately used for batteries, it has also been used in paint pigments, alloys, electro plating and coating, and stabilizers for plastics. Numerous studies have found cadmium to be cancer causing. It is also linked to other health problems. Breathing high levels of cadmium can severely damage the lungs and eating food or drinking water with very high levels of cadmium severely irritates the stomach, leading to vomiting and diarrhea. Long term exposure to lower levels of cadmium in air, food, or water leads to a build up of cadmium in the kidneys and possible kidney disease.

On Wednesday, the Senate Commerce Committee passed CS/SB 2120. The bill provides that a person may not use or apply cadmium in excess of 75 parts per million on the surface or underlying material of a child’s jewelry, toy, or child care article sold in Florida. If such a person, who is not an individual consumer, knowingly and intentionally commits an act prohibited by the bill, he or she commits a felony. Read the bill.  

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SB 2396 – Persons with Disabilities

The Senate Governmental Oversight and Accountability Committee passed SB 2396 on Tuesday. The bill 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 for violating the rights and privileges of a person with developmental disabilities. The bill also creates the Floridians with Disabilities Act, statutorily adopts the Federal Americans with Disabilities Act of 1990 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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SB 2596 – Smoking in Vehicles with Minor Passengers

SB 2596, which was passed by the Senate Transportation Committee on Wednesday, creates a new noncriminal traffic infraction by prohibiting a person who is operating or in actual physical control of a motor vehicle from smoking or allowing another passenger to smoke if a minor under the age of 16 is also in the vehicle. The infraction is committed regardless of whether the motor vehicle is operating or parked. The bill permits an officer to issue a warning in lieu of a citation, and to issue materials relating to the dangers of smoking in a vehicle with children present. Lastly, the bill provides for secondary enforcement of the infraction, and creates a $100 “enhanced penalty” for all non-moving and moving violations that are committed when operating a motor vehicle while a person in the motor vehicle is smoking and a minor is present. Read the bill.

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