Week 6 – April 12, 2015
Florida House of Representatives Florida Senate
With only three weeks remaining until the end of the 2015 legislative session, there has been no movement on the budget. To add to the equation, the Governor changed his position on Medicaid expansion, thereby siding with House leadership in opposition and continuing the standoff over critical health-care funding. Conference committees which are normally appointed the week after the House and Senate pass their respective proposed budgets failed to be called to duty.
With little reason to think that the conflicts were about to end, legislators were already starting to plan for what happens if it all breaks down. Senate President Andy Gardiner, R-Orlando stated, “The Senate also shares the governor’s commitment to tax relief and record funding for education; however, if our state is forced to make up the difference of $2.2 billion in hospital funding, every area of our budget will be impacted…Moving forward the Senate will continue to advance the conservative, Florida-based, free-market (health) solutions we have proposed. We believe these innovative, bipartisan proposals can gain the approval of our federal partners, and we stand ready to meet with the House or Governor Scott at any time to discuss a way forward.”
Later, with no sign of any movement from any side on the impasse, the Senate reacted by postponing what would normally have been a routine confirmation of state Surgeon General John Armstrong after questioning him about his views on the coverage-expansion plan and receiving few answers. The Senate confirmation hearing of Agency for Health Care Administration Secretary Liz Dudek is planned for this Wednesday in the Senate Ethics and Elections Committee on Wednesday. Stay tuned.
Meanwhile, next week is a critical week, as all ears will be turned to Washington to hear the federal government’s expected response to Governor Scott’s request to notify the state if the $2.2 billion in Low Income Pool funding that pays for indigent care provided by hospitals will be forthcoming. Regardless, if conference committees do not begin their work next week, it will be extremely difficult, if not impossible, to craft a final budget and still allow for the constitutionally mandated 72 hour “cooling off” review period before it can be passed. Will legislators get called back into a special session later on?
On a happier note, next week is also Children’s Week at the Capitol, starting with the ceremonial hanging of the hands made by elementary school children across the state on Sunday. Can we join hands and work together?
EARLY LEARNING AND SCHOOL READINESS
Early Learning Health and Safety
After weeks of inaction, advocates were pleased to see that the Senate bill to increase health and safety standards at early learning facilities by the Senate Education PreK-12 Committee, SB 7006 will be heard in the Senate Appropriations Subcommittee on Health and Human Services on April 14. The House companion by the House Education Committee, CS/HB 7017 is awaiting action by the full House.
Care of Children
HB 11 by Rep. Ray Pilon (R-Sarasota) and SB 250 by Sen. Chris Smith (D-Ft. Lauderdale), Care of Children exempts certain membership organizations which are affiliated with national organizations, and do not provide child care as defined in FS s. 402.302, but rather provide afterschool care and juvenile delinquency prevention, from licensing requirements and minimum standards for child care facilities. The bill also provides for background screening requirements for organization employees under certain circumstances. After weeks of inaction due to fierce opposition to the exemption by some parties, SB 250 is scheduled to be heard in the Children, Families and Elder Affairs Committee on April 15.
The submission of these bills has fostered a healthy debate and the possible need to review the Florida Administrative Code rules for Child Care Licensing in order to more accurately define the differences between birth-to-five child care and afterschool programming for 6-12 year olds.
HEALTH AND WELLNESS
Newborn Health Screening
SB 632 by Sen. Rene Garcia (R-Hialeah) was passed unanimously by the Banking and Insurance Committee on April 7 and now heads to the full Appropriations Committee. The bill directs the Department of Health to establish requirements for newborn adrenoleukodystrophy, a test administered to newborns which identifies the presence of adrenoleukodystrophy, a disease of the central nervous system that is inherited as an X-linked recessive trait, and characterized by blindness, deafness, tonic spasms, and mental deterioration.
The House companion, HB 403 by Rep. Mike LaRosa (St. Cloud) is now awaiting action in the Health Care Appropriations Subcommittee.
CS/SB 478 by Sen. Aaron Bean (R-Jacksonville) and Sen. Arthenia Joyner (D-Tampa) which defines telehealth services and telehealth provider is scheduled to be heard in the Appropriations Subcommittee on Health and Human Services on April 14. CS/SB 478 establishes that the standard of care for a telehealth service is the same as the standard of care for a health professional providing in-person services. A telehealth provider is not required to research the patient’s medical history or conduct a physical examination if the telehealth provider conducts an evaluation sufficient to diagnose and treat the patient. Additionally, a telehealth provider must document health care services in the patient’s medical record under the same standard as for in-person care. The bill specifies that a non-physician telehealth provider who is using telehealth and acting within the relevant scope of practice is not practicing medicine without a license. The bill prohibits a telehealth provider from prescribing lenses, spectacles, eyeglasses, contact lenses, or other optical lenses based solely on the use of computer controlled device through telehealth. Additionally, controlled substances may not be prescribed through telehealth for chronic nonmalignant pain. However, this provision does not preclude a physician from using telehealth to order a controlled substance for an inpatient in a hospital or for a hospice patient.
CS/HB 545 Telehealth by Rep. W. Travis Cummings (R-Orange Park) and Rep. Mia Jones (D-Jacksonville) was unanimously passed by the House Health Quality Subcommittee, and is awaiting action in the House Health and Human Services Committee.
Child Abuse Death Review (CADR)
The House Health and Human Services Committee unanimously passed HB 7121 by The Children, Families and Seniors Subcommittee and Rep. Gayle Harrell (R-Stuart) on April 9 relating to child welfare. The bill addresses issues related to implementation of landmark child welfare reform legislation – SB 1666 that passed in 2014.
HB 7121 addresses the increased volume of cases reviewed through the Child Abuse Death Review (CADR) process and better aligns it with the newly created Critical Incident Rapid Response Team (CIRRT) process, clarifies the roles of the two types of committees within the CADR process, and imposes specific reporting requirements. It also permits the Secretary of DCF to deploy CIRRTs in response to other child deaths, in addition to those with verified abuse and neglect in the last 12 months. Further, the bill requires more frequent reviews and reports by the CIRRT advisory committee. The bill also requires multi-agency staffing to be convened for cases of alleged medical neglect, clarifying that the staffing shall be convened only if medical neglect is substantiated by the child protection team. In addition, HB 7121 implements the Florida Institute for Child Welfare Report (FICW) interim report recommendations by clarifying legislative intent to prioritize evidence-based and trauma-informed services.
The Senate companion, SB 7078 is awaiting action in the Senate Fiscal Policy Committee.
Mental Health and Substance Abuse
SB 7068 has been placed on the Calendar for April 14 for full Senate action. The bill would change the way mental-health and substance-abuse services are administered, coordinate them with primary health care, and seek to increase Medicaid funding for them.
“The bill will lead to more continuity and less fragmentation of services,” Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said in a prepared statement. “People suffering from mental illness and substance abuse will receive more effective treatment, and the service delivery system will be more accountable to the taxpayers who fund these important efforts.”
HB 7119 by the Children, Families, and Seniors Subcommittee passed the Health and Human Services Committee unanimously on April 9. The bill makes changes to the statewide system of safety-net prevention, treatment, and recovery services for substance abuse and mental health (SAMH) administered by the Department of Children and Families (DCF). An amendment was added to make the bill similar to SB 7068. There was much discussion during the meeting on the creation of ‘coordinated care organization’ under this bill.
DCF currently contracts with seven managing entities that in turn contract with local service providers to deliver SAMH services. The bill updates statutes that provided DCF initial authority and guidance for transitioning to the managing entity system. The bill makes changes to providing services and enhances operation of this outsourced approach by:
Allowing managed behavioral health organizations to bid for managing entity contracts when fewer than two bids are received;
Requiring care coordination, specifying to services that shall be provided within available resources, and prioritizing the populations served;
Requiring DCF to develop performance standards that measure improvement in a community’s behavioral health and in specified individuals’ functioning or progress toward recovery;
Specifying members for managing entities’ governing boards, and requiring managed behavioral health organizations serving as managing entities to have advisory boards with that membership;
Allowing managing entities flexibility in shaping their provider network while requiring a system for publicizing opportunities to join and evaluating providers for participation; and
Deleting obsolete statutes regarding the transition to the managing entity system.
The bill requires DCF to contract for a study of the safety-net system, with an interim and final report submitted on specified topics. The bill also requires DCF and the Agency for Health Care Administration to report on options for increasing the availability of federal Medicaid SAMH services. Most legislators are in support of the overall reforms, but some have questioned the need to make the system for-profit which Chair Harrell says would empower and incentivize Managing Entities to serve the population more appropriately.
SB 7070 by the Judiciary Committee passed the Appropriations Committee favorably on April 7. The bill integrates provisions of the Marchman Act, which provides for a comprehensive continuum of accessible and quality substance abuse prevention, intervention, clinical treatment, and recovery support services, into the Florida Mental Health Act, more commonly known as the Baker Act. The bill provides that an individual may be held for an additional 48 hours beyond the current 72-hour time limit if a physician determines the individual would benefit from detoxification services. Under the bill, individuals that have been involuntarily admitted to a receiving facility or treatment facility within the immediate preceding 36 months may be ordered to involuntary outpatient placement. Individuals that meet specified criteria may be detained in a mental health, an addictions receiving facility or a detoxification facility. A court hearing on the involuntary inpatient placement must occur within five court working days after the petition is filed. The Department of Children and Families (DCF) is directed to create a Forensic Hospital Diversion Pilot Program in Alachua, Escambia, Hillsborough and Miami-Dade counties which is to be modeled after the Miami-Dade Forensic Alternative Center.
SB 1106 Relating to Human Trafficking by Sen. Anitere Flores (R-Miami) was unanimously passed by the Appropriations Subcommittee on Criminal and Civil Justice on April 8 and now heads to full Appropriations.
Adoption and Foster Care
HB 7013 by Rep. Jason Brodeur (R-Sanford) was heard on April 8 in the full Senate and will be placed on third reading on April 14. The bill creates a program to advance the permanency, stability, and well-being of children in the child welfare system by awarding incentive payments to community-based care lead agencies (CBC’s) for achieving specified adoption performance standards. CBC’s provide adoption-related services in the state pursuant to contracts with the Department of Children and Families (DCF). The bill allows home-schooling of adopted children and removes a statutory prohibition against adoption by same sex couples.
However, due to loud opposition from some groups, CS/HB 7111 by the Judiciary Committee and Health and Human Services Committee and Rep. Jason Brodeur (R-Sanford) was drafted and passed by the full House unanimously on April 9. The bill now heads to the Senate. The bill provides what it referred to as “conscience protection” for private agencies whose “religious or moral convictions” do not permit the children in their care to be adopted by same sex couples. The bill is in response to passage of HB 7013 relating to adoption of foster children that included language repealing the current ban on adoption by same-sex couples. There is no Senate companion to the bill. However, during the Senate debate on SB 320 on adoption by Senator Don Gaetz (R-Destin) which was heard by the full Senate on April 8, Sen. Kelli Stargel (R-Lakeland) proposed an amendment to reinsert the prohibition against same sex couple adoption. The amendment failed. Another amendment that also failed would have added the provisions of HB 7111 – the conscience protection language to the Senate bill.
SB 378 by Sen. Rene Garcia (R-Hialeah) is expected to be heard on the Senate floor on April 14. The bill expands juvenile civil citation by allowing law enforcement to issue a civil citation to youth who have committed a second or subsequent misdemeanor. Civil citation is presently only available to youth who admit to committing a first-time misdemeanor. In addition, law enforcement will be authorized to issue a simple warning to the youth and inform the youth’s parents of the misdemeanor. CS/SB 378 also states that if an arrest is made, law enforcement must provide written documentation as to why the arrest is warranted. A floor amendment has been filed on the bill by Sen. Audrey Gibson to cap the numbers of allowable citations to 3.
The House companion HB 99 sponsored by Rep. Gwyndolen Clarke-Reed (D-Pompano Beach), is scheduled to be heard in the House Judiciary Committee on April 14.
Criminal Information of Juveniles
CS/SB 1082 by Sen. Thad Altman (R-Cape Canaveral) was voted favorably on a 4:2 vote in the Appropriations Subcommittee on Criminal and Civil Justice on April 8, and now heads to the full Appropriations Committee. The bill substantially amends Florida’s current methods for transferring a juvenile to adult court for criminal prosecution. These transfer methods are indictment and direct file. The bill also amends current provisions requiring the court to impose juvenile and adult sanctions upon juveniles transferred to adult court. The bill allows a juvenile who is transferred by direct file to request a court hearing in writing to determine whether he or she will remain in adult court. Unlike current law, the bill never requires the court to impose adult sanctions but rather allows the option for lesser offenses and requires consideration of additional criteria the court must consider when determining whether juvenile or adult sanctions are appropriate including the juvenile’s maturity and mental capacity, the effect of familial or peer pressure, the juvenile’s home and family environment, and history of abuse, abandonment or neglect, as well as whether the Department of Corrections has appropriate facilities or programs for the juvenile. The House companion, HB 783 by Rep. Katie Edwards (R-Sunrise is awaiting action in the Justice Appropriations Subcommittee.
Juvenile Criminal History Record Expungement
HB 7103 by the Criminal Justice Subcommittee and Rep. Sharon Pritchett (D-Miramar) was passed by the House State Affairs Committee on April 2 and now heads to the Judiciary Committee on April 14. The bill specifies that all records obtained under ch. 985, F.S., as a result of a juvenile being involved in the juvenile justice system, are confidential. However, s. 985.04(2), F.S., creates exceptions if the juvenile is:
Taken into custody for a violation of law which, if committed by an adult, would be a felony;
Found by a court to have committed three or more violations of law which, if committed by an adult, would be misdemeanors; or
Transferred to the adult system.
The Senate companion, CS/SB 1316 by Criminal Justice and Sen. Darren Soto (D-Kissimmee) is awaiting action in the Appropriations Subcommittee on Criminal and Civil Justice although that committee no longer appears to be meeting. The final committee reference, Appropriations was removed.
OTHER BILLS AFFECTING CHILDREN
Bills that would allow some individuals to carry guns at public schools and college campuses face an uncertain future in the Legislature.
SB 176, a bill sponsored by Sen. Greg Evers, R-Baker that would allow concealed carry permit holders to bring firearms on university grounds, is scheduled to come before the Senate Judiciary Committee, but committee chair Sen. Miguel Diaz de La Portilla, R-Miami, stating that he had polled members of the Senate and found weak support for the bill, still has not decided whether to hear the bill at the panel’s final meeting Wednesday, April 15.
However, Rep. Greg Steube, R-Sarasota, House sponsor of both bills, said he and Evers are still seeking ways to bring the bills to the Senate floor. NRA lobbyist Marion Hammer also isn’t ready to concede defeat, stating in an email that “nothing is dead until sine die.”
CS/HB 19 by Rep. Greg Steube (R-Sarasota) was passed by the House Judiciary Committee on a 12:3 vote on April 2, and now heads for full House action. The bill allows school superintendents, upon approval of the district school board, to create a school safety designee program through which the school superintendent may designate one or more individuals to carry a concealed weapon or firearm on school property. Weapons or firearms may only be carried in a concealed manner, and must be on the individual’s person at all times while he/she is performing official school duties. The bill:
Requires school safety designees to possess a concealed weapon license.
Establishes criteria and training requirements which school safety designees must meet.
Requires a level 2 background screening for school safety designees who have not already had a level 2 background screening by the school board, and authorizes each school superintendent to require additional background screenings and mental health screenings for all school safety designees.
Requires district school board policies and procedures for emergencies and emergency drills to include active shooter and hostage situations, to be developed in consultation with a local law enforcement agency.
Requires each district school superintendent to provide recommendations to improve school safety and security to the first responding local law enforcement agency.
Requires school districts and private schools to allow first-responding law enforcement agencies to tour school campuses once every three years. Any recommendations relating to school safety and emergency issues based on a campus tour must be documented by the district or private school.
Specifies that a district school board may commission one or more school safety officers on each school campus.
Specifies that the required training will be created and defined by the Criminal Justice Standards and Training Commission which is administered by the Florida Department of Law Enforcement (FDLE).
The Senate companion, SB 180 by Sen. Greg Evers (R-Pensacola) is scheduled to be heard in the Senate Education Pre-K-12 Committee on April 15. However, this bill may also be in trouble. Senate Education Pre-K-12 Committee chaired by Sen.John Legg, R-Lutz, temporarily postponed the bill last month.
OTHER BILLS OF INTEREST
Value Adjustment Boards
CS/HB 695 – Ad Valorem Taxation by Rep. Bryan Avila (R-Hialeah) was passed by the House Appropriations Committee on April 7 and now heads for full Floor action. Several amendments were considered that made the following changes to the Committee Substitute CS/HB 695:
Added to the definition of “common element” in s. 193.0235, F.S., property located within the same county as a subdivision and used for at least 10 years exclusively for the benefit of lot owners within the subdivision;
Waived the June 1 deadline to certify the assessment roll after all VAB hearings for any county where the VAB petitions increase by more than 10 percent from the prior year;
Delayed the applicability of the June 1 deadline to begin with the 2017 tax rolls;
Made drafting changes to clarify who can represent taxpayers before the VAB and to clarify the evidence exchange procedures;
Provided the property appraiser is not required to provide comparable property records cards if they are available online from the property appraiser;
Removed the proposed requirement that the property appraiser provide a copy of the form documenting value adjustments of the property pursuant to those factors described in s. 193.011(8), F.S.;
Removed the proposed evidence exchange rule that failure by either party to timely comply with the evidence exchange provisions results in the exclusion from consideration by the VAB of any evidence that was requested in writing and not timely provided;
Allowed interest accrual when the property appraiser and the property owner reach a settlement prior to a VAB hearing;
Removed the proposed “good cause” restriction on petitioners rescheduling of a VAB hearing, and added the requirement that the clerk notify the petitioner of any rescheduled hearing 15 days before the rescheduled date (instead of usual 25 days);
Provided that the chairman on the VAB will be elected by the members of the VAB;
Removed the proposed requirement that written decisions of the VAB must include checklist forms, as prescribed by the DOR;
Removed the proposed DOR authority to do a review of the VAB process in counties where 10,000 or more petitions are filed;
Specified terms that must be included in a contract to perform an examine or audit of tax exemptions claimed on assessment rolls;
Clarified the notification on TRIM notices that property owners may challenge the assessed value of their property.
This committee substitute may be a county or municipality mandate requiring a two-thirds vote of the membership of the House. Please click here to see the most recent staff analysis for a complete description of the committee substitute and fiscal impact.
SB 972 by Sen. Anitere Flores (R-Miami) relating to Value Adjustment Boards (VAB) proceedings passed the Senate Finance and Tax Committee on March 31, and now heads to the full Appropriations Committee. The bill makes several changes to VAB proceedings:
Requires a petition to the VAB to be signed by the taxpayer, or be accompanied by the taxpayer’s written authorization for representation, which is only valid for one tax year.
Limits representation of taxpayers before the VAB to certain professionals.
Requires the property appraiser to notify the petitioner when the property record card is available online.
Limits a petitioner’s ability to reschedule a hearing to a single instance and for good cause only.
Changes the rate of interest for overpayments and underpayments from 12 percent to the prime rate.
Allows district school boards and district county commissions to audit VAB expenses.
Requires all VAB petitions to be resolved by the June 1 following the assessment year.
Establishes an enhanced review process by which the Department of Revenue may conduct a review of VAB proceedings for counties that receive 10,000 or more petitions in any one tax year.
The Revenue Estimating Conference has determined that this bill will have an indeterminate positive impact on local government (school district, county, municipal and special taxing district) revenues and will allow for more budget predictability on the part of such local governments.
The Children’s Health Insurance Program (CHIP)
On Thursday, March 26 the US House of Representatives passed the Sustainable Growth Rate (SGR) Children’s Health Insurance Program/Maternal Infant Early Childhood Home Visitation (CHIP/MIECHV) Legislation on a vote of 392-37. The compromise extends the current CHIP and MIECHV programs for two years, with no harmful changes to CHIP as proposed by the Hatch-Upton-Pitts proposal. Further, the bill includes NO harmful offsets to Medicaid, CHIP or the ACA in the package, good news for kids. The bill will be heard by the Senate next week when Senators return from recess.
Call your Senate members immediately and urge them to support the renewal of CHIP and Home Visitation funding.
April is Child Abuse Prevention Month
April is Child Abuse Prevention Month, and Pinwheels for Prevention, a national campaign creating a community-wide commitment to healthy child development, launched its annual awareness campaign in partnership with Prevent Child Abuse Florida (PCA Florida), the Ounce of Prevention Fund of Florida and the Florida Department of Children and Families. First Lady Ann Scott joined leaders at the Capital on the morning of April 10 and met with people on the second floor rotunda for pictures and breakfast. Lady Scott says putting an end to child abuse is something she’s always been passionate about.
Wear Blue Day is part of the statewide Pinwheels for Prevention campaign.
To help draw attention to and encourage involvement in child abuse prevention efforts, visit the Ounce of Prevention’s PCA and Pinwheels for Prevention websites.