Issue 7 April 16, 2010

Budget on Hold

It was anticipated that the Conferees who will resolve the differences between the $69.4 billion Senate and the $67.2 billion House proposed 2010-2011 state budgets would be named this week. As this Legislative Link went to wire, they had not. One of the major hold-ups has been the failure of Congress to pass legislation that would send at least $800 million in Medicaid funding to Florida. As recently as last week, there was optimism in Washington and elsewhere that the legislation would be passed soon. However, as this week progressed it appeared less-and-less likely that it will be passed in time to be plugged into next year’s budget. Session is scheduled to end two weeks from today, on April 30.

Failure of Congress to act puts Florida legislators in a real bind. The House refused to include the anticipated Medicaid money in its budget. The Senate did, contributing in large part to the fact that its budget is $2.2 billion larger than the House’s.

The $880 million in Medicaid money the Senate included allowed it to provide hundreds of millions of dollars to maintain state coverage for 20,000 transplant patients and others with catastrophic illness covered through the Medically Needy program, and another 24,000 older and disabled Floridians living below the poverty line and receiving care through the Meds A/D program. The money also allowed the Senate to back-off its plan to eliminate the Healthy Families program, to increase mental health funding by an additional $85.6 million, and to fund many more programs. In contrast, the House proposal cuts public school spending by $52-per-student, eliminates state dollars for Everglades restoration and the Florida Forever land-buying program, and reduces a range of health programs. 

It is now anticipated the Conferees will be named as soon as later today or over the weekend. Because it is an election year and the Senate proposal has created higher expectations for funding, it will be interesting to see if the House becomes more willing to include the future-anticipated Medicaid funds in the final budget.

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Medicaid Reform Set for House Vote Next Week

The House considered its far-reaching Medicaid reform package on Thursday, adopting some amendments to address physician and hospital concerns, but leaving many questions still unanswered, along with many concerns. The bill – which fundamentally restructures the $19 billion program has received less than 30 hours of consideration in the House and was never considered by the health care committees or appropriations committees. It would result in all 2.7 million Medicaid patients being in managed care by 2015. We’ll include an overview of the legislation in next week’s Legislative Link.

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Children’s Week Highlights Children’s Issues

More than 2,000 advocates, parents, children, teachers, child care providers, child welfare providers, juvenile justice representatives, and others convened in Tallahassee this week to forcefully show their support for children. All children, age 0-18. Participants – including dozens of youth who exemplify the best of what our future state’s leaders can be – spent the week raising legislators’ awareness of the critical issues impacting children and their families.

Many thanks to the state leaders who participated and supported 2010 Children’s Week – and the children and families of our state – including: Governor Charlie Crist, Lt. Governor Jeff Kottkamp, Senator Nan Rich, CFO Alex Sink, DCF Secretary George Sheldon, past Attorney General Bob Butterworth, Florida Supreme Court Justice Ricky Polston, Florida Chief Child Advocate Jim Kallinger, Major General George Norwood, DJJ Secretary Frank Peterman, Florida Surgeon General Ana Viamonte Ros, AWI Director Cynthia Lorenzo, Bishop Tim Whitaker and all of the wonderful Children’s Week Sponsors and Partners who made the week a reality.

Children’s Week was particularly honored to present the annual Chiles Advocacy Award to long time child advocate Dick Batchelor, who has supported Florida’s children and families in myriad ways over many years. His commitment, energy, and vision – and the positive impact he has had on millions of Florida children and families – is a shining example to all of us aspiring to improve the lives of our children and their families.

Kudos also to the four inaugural winners of the Children’s Week Community Innovation Awards, sponsored by the United Way of Florida and the Lawton Chiles Foundation. The Awards were presented to communities that embrace collaboration by working across multiple sectors and providers to address problems facing children 0-18 and their families. The Awards recognize communities that are pursuing systemic change by collaboratively endeavoring to mesh programs and funding to address critical issues facing children and families.

The Award winners were:
• Healthy Jacksonville Childhood Obesity Prevention Coalition
• Quality Counts – Palm Beach County’s Quality Rating Improvement System
• Arnold Palmer Hospital for Children-Teen Xpress Program
• Kinship Service Network of Pinellas County

To find out more about Children’s Week, visit the Children’s Week website.

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BILLS HEARD THIS WEEK

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SB 182 – Coverage for Mental and Nervous Disorders

SB 182 expands the benefits that insurers and health maintenance organizations are required to offer to small and large group policy holders (i.e. employers) for mental, nervous, and substance-related disorders. The bill provides that the benefit limits for schizophrenia, psychotic disorders, mood disorders, anxiety disorders, substance abuse disorders, eating disorders, and childhood ADD/ADHD may not be more restrictive than the treatment limitations and cost-sharing requirements under the plan that are applicable to physical illness and conditions. It requires that, for mental health disorders not specified above, the coverage would not be less favorable than for a physical illness. The bill also allows an opt-out to a group health plan if the application of this law causes an increase of plan costs of more than 2%. The bill was passed by the Senate Banking and Insurance Committee on Tuesday. Read the bill.

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SB 194 – Injunctions for Protection/Violations

SB 194 was passed the by Senate Criminal and Civil Justice Appropriations Committee on Tuesday. The bill creates additional ways a person can violate an injunction for protection against repeat violence, sexual violence, or dating violence by making it identical to the ways a person can violate an injunction for protection against domestic violence. Read the bill.

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SB 336 – Adult Protective Services

On Tuesday, the Senate Health and Human Services Appropriations Committee passed CS/SB 336. The bill amends the legislative intent of the Adult Protective Services Act, replacing the terms “disabled adults” and “elderly adults” with the term “vulnerable adult”. The bill provides that the central abuse hotline operated by the Department of Children and Families (DCF) must be operated in such a manner as to enable DCF to immediately transfer reports of abuse involving possible responsible parties other than the vulnerable adults’ relative, caregiver, or household member, to the appropriate county sheriff’s office. The bill also authorizes DCF to file a petition to determine incapacity in adult protective proceedings. Read the bill.

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SB 506 – Crimes Against Homeless Persons

On Tuesday, the Senate Criminal and Civil Justice Appropriations Committee passed SB 506. The bill amends Florida’s Hate Crime Statute to reclassify “Homeless Status” as a hate crime if prejudice based on the homeless status of a victim is evidenced. Read the bill.

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HB 747 - Care of Public School Students with Diabetes

On Thursday, the House passed HB 747, which requires the Department of Education in partnership with several other groups, including the Florida Association of School Nurses, to develop guidelines for training school employees in the care of students with diabetes. School districts will also be required to annually provide training that is commensurate with a school employee’s role in working with students with diabetes. Training will include, among others, instruction in:

• Recognizing and treating hyperglycemia and hypoglycemia;
• Understanding the appropriate actions to take when blood glucose levels are outside target ranges;
• Understanding prescriber instructions concerning diabetes medication, drug dosage, frequency, and manner of administration;
• Performing fingerstick blood glucose checks and ketone checks and recording the results;
• Administering insulin and glucagon; and
• Understanding how to perform basic insulin pump functions.

Read the bill. 

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CS/SB 834 – Child Care Facilities

CS/SB 834 amends the definition of family daycare home and large family child care home to require that household children be included in the household capacity calculation of licensed family daycare homes and large family child care homes, whether on the premises or on a field trip with children enrolled in child care. The bill also requires persons advertising or publishing an advertisement for a child care facility, family daycare home or large family child care home to include in the advertisement the state or local agency license number or registration number of the facility or home. The bill was passed by the Senate Community Affairs Committee on Wednesday. Read the bill.

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SB 1216 – Relating to Children’s Services

CS/CS/SB 1216 requires that Florida’s Children’s Services Councils be brought up on local referendum every six years. The bill passed the Senate Finance and Tax Committee on Tuesday. Read the bill.

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SB 1234 – Child Care Facility/Licensing Standards

On Tuesday, the Senate Health and Human Services Appropriations Committee passed CS/CS/SB 1234. The bill creates minimum requirements for licensure of child care facilities relating to window blinds and other window coverings, and prohibits the use of certain types of window blinds and window coverings that pose a risk of strangulation to young children. The bill also requires child care facilities to properly retrofit existing window blinds, window coverings, pull cords and inner cords by January 1, 2011. Read the bill.

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SB 1382 – Child Care Facilities

On Tuesday, the Senate Heath and Human Services Appropriations Committee passed CS/CS/SB 1382.  Among others, the bill revises minimum standards for child care personnel by increasing the minimum age for child care personnel to 18.  It also requires the child care personnel to hold a high school or high school equivalency diploma, and requiring that for every 28 children in a licensed child care facility – beginning with the first child – that at least one staff hold a current credential. Read the bill.

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CS/SB 1520 – Background Screening

CS/CS/SB 1520 was passed by the Senate Health and Human Services Committee on Tuesday. 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; and
• 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 and 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.

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SB 2014 – School Readiness and VPK

On Tuesday, the Senate Transportation and Economic Development Appropriations Committee passed CS/CS/CS/SB 2014.
The bill addresses numerous provisions in the School Readiness and VPK programs. Among others, it requires the Agency for Workforce Innovation (AWI) to adopt specific support service strategies for implementing program requirements, and Early Learning Coalitions (ELCs) 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 2192 - Prepaid Developmental Disabilities Savings Program

SB 2192 creates the Prepaid Developmental Disabilities Savings Program, a program very similar to the College Prepaid Tuition Program, only for children with disabilities. The bill authorizes a Florida resident parent or grandparent, or a non-residential, non-custodial parent to enter into a prepaid contract plan for his or her child or grandchild who has a developmental disability and who is under the age of 22. The investment plan authorized by the bill allows a benefactor to deposit funds on behalf of a qualified beneficiary/disabled child into a non-guaranteed fund provided by the Florida Prepaid College Board. The principal and interest accruing during the lifetime of the plan may be used to assist the benefactor after age 22 with college and other future needs. The Senate Governmental Oversight and Accountability Committee passed SB 2192 on Wednesday. Read the bill.

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SB 2244 – Independent Living Transition Services Program

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 Families (DCF). The audit must include examination of the provision of the pre-independent living services, life skills services, subsidized independent living services, after care support services, the Road-To-Independence Program, and transitional support services by DCF and its lead agencies and providers. The bill also requires the Office of Program Policy Analysis and Government Accountability to evaluate the Independent Living Transition Services Program, including how the department and lead agencies plan, design, deliver, and oversee the program. The two studies are to be completed and reported by January 15, 2011. Read the bill.

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SB 2654 – Homelessness

The Senate Transportation Committee passed SB 2654 on Tuesday. The bill authorizes a voluntary check-off option of $1 to aid the homeless to be added to vehicle registration forms, driver’s license applications, and initial and renewal applications. Read the bill.

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SB 2718 – Children/Out-of-home Placement/Psychotropic Drugs

On Tuesday, the Senate Judiciary Committee passed CS/CS/SB 2718. The bill makes a number of changes to current law relating to psychotropic medication and children in out-of-home placements. Among others, it:

• Provides that every child placed in out-of-home care be provided a comprehensive behavioral health assessment;
• Provides for an appointment of a Guardian Ad Litem (GAL) for every child who is being prescribed a psychotropic medication and provides duties and responsibilities of the GAL;
• Requires creation of a mental health treatment plan for children in out-of-home care who need mental health services;
• Provides procedures to follow for the administration of psychotropic medication to a child in out-of-home care when parental consent has not been obtained and before court authorization has been obtained;
• Requires a court finding and compelling governmental interest before administering psychotropic medications to certain children; and
• Prohibits children in the custody of the Department of Children and Families from participating in clinical trials involving psychotropic medications.

Read the bill. 

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