Week 8 – March 4, 2016
KIDCARE PASSES HOUSE! EXPUNCTION ON WAY! CHAIRS TAKE OVER BUDGET CONFERENCE
With roughly one week to go until the end of session, HB 89 – Kidcare by Rep. Jose Felix Diaz was passed by the full House on a unanimous vote of 118:0 on Thursday. Advocates have been working on the bill since 2009. Rep. Diaz (R-Miami) explained that “Today we put our kids first…preventive services promote health for a lifetime..” Members rose to applaud Rep. Diaz, and loud clapping arose from the gallery and floor ensued as Speaker Crisafulli stepped down from the well to personally congratulate Rep. Diaz. Dozens of members gathered around and asked to be listed as co-sponsors to the bill, totaling 40 co-sponsors to date. The bill now moves to the Senate where SB 248 by Senator Rene Garcia will be heard next week.
Late Thursday afternoon the final piece of the package to expunge juvenile records completed its journey in the legislature as the confidentiality bill was passed on the Senate floor and will be on its way to the Governor’s desk soon. The expunction bill is already on the Governor’s desk. Much appreciation to Senators Detert and Soto, and to Reps. Sprowls, Latvala and Fitzenhagen.
Budget conference commenced last Friday evening, with negotiations among the various committees taking place throughout the weekend. On Sunday negotiations on education spending broke down, and the entire education budget was ‘bumped up’ to budget chairs Richard Corcoran (R-Lutz) and Tom Lee (R-Brandon). According to the News Service of Florida “House negotiators working on the education proposal rejected a complicated Senate offer that would have closed out several but not all of the remaining issues between the two chambers. The only area of agreement between the two sides on education is a plan to keep property owners from seeing increases in their local education tax bills despite rising property values.” The other committees completed their work by the night of Monday, February 29, and the remaining unresolved issues were ‘bumped up’ to the budget chairs to resolve.
Budget chairs met on Thursday night to start hammering out the remaining differences in the budget in anticipation of having the budget completed by Tuesday, March 8 to allow for the constitutional requirement of a 72-hour cooling-off period before the final vote on the budget, if the session is to end on time March 11. The General Government and Health and Human Services budget offers were accepted by both chambers, leaving Criminal Justice and Education to be resolved. Lee and Corcoran also issued a new version of the model for $607 million in hospital funding through a program known as the Low Income Pool. The two said it was aimed at clarifying for health-care facilities what could be expected from the new plan more than it being about making any substantial changes.
With revenues down by $400 million, there is much speculation on whether the Governor will line item veto more issues than he did last session or veto the entire budget. The Governor’s priority issues have not as of yet been fully realized, including the tax incentives for Enterprise Florida, $1 billion in tax cuts, the Seminole gaming compact, and the confirmation of his Surgeon General for the Secretary of the Department of Health.
The Senate confirmation of the Department of Health (DOH) Surgeon General, Dr. John Armstrong, was again postponed by the Senate Ethics and Elections Committee on March 1. However, on March 2, Senate President Andy Gardiner announced that he was considering bringing the Surgeon General John Armstrong’s nomination to the Senate floor, a move aimed at breaking the logjam over the agency head’s future.
EARLY LEARNING AND SCHOOL READINESS
Early Learning – Child Care Development Block Grant
SB 1166 relating to education funding by Sen. Don Gaetz (R-Destin) is scheduled to be taken up by the Senate on March 4 and ready for final passage next week. The bill provides for the drawdown of federal block grant funding for subsidized child care, and directs the Office of Early Learning to develop (through rule making) quality standards for publicly-funded child care, including appropriate group size requirements. The bill also includes language relating to background screening and criminal background checks of child care personnel. SB 2502, the Implementing Bill for the 2016-2017 General Appropriations Act also includes language on child care block grant reauthorization which was substituted for HB 5003, Implementing the 2016-2017 Appropriations Act.
Voluntary Prekindergarten Eligibility
CS/SB 524, relating to Education has become a vehicle for several education issues. The amended bill now includes language that revises the eligibility for the Voluntary Prekindergarten Education Program to include 5 year olds along with the program’s intended 4 year olds. Each child would still only be eligible for a one-time participation, but parents would be able to determine whether to enroll children at age 4 or 5. The proposed change does contemplate age limits by setting a hard date of ineligibility for children turning 6 before Feb 1. This would limit the eligible population to the children that would be younger 5-year-olds that may not be developmentally ready for kindergarten. Sen. Don Gaetz (R-Destin) in his presentation stated that the language is a ‘one-year deferment from the program.’ The language of CS/SB 524 was initially scheduled to be amended to CS/HB 7043 relating to Education by Rep. Erik Fresen (R-Miami) on March 3 but was temporarily postponed. House members and a number of advocates remain concerned about changing the terms of statute related to the constitutional amendment for four year olds given high quality standards have not yet been fully realized.
The rate of 3rd grade students performing below grade level in reading has consistently exceeded 40 percent over the past several years. SB 1068 attempts to address this situation by expanding public school reading requirements relating to interventions and instructional supports, teacher certification and training, and school improvement and accountability. The bill was amended to: require the use of data from the statewide kindergarten readiness screening to identify students in need of reading interventions and supports; authorize the use of alternative pre- and post-assessments aligned to the performance standards adopted by the Office of Early Learning for the Voluntary Prekindergarten (VPK); and, to authorize VPK or School Readiness providers to continue offering services during the pendency of an appeal of termination, if such termination if not an emergency termination or a termination for fraud. SB 1068 is awaiting action in Appropriations that is not scheduled to meet again.
The House companion, CS/CS/HB 7021 by Rep. Janet Adkins (R-Fernandina Beach) is scheduled to be taken up for full House consideration on March 4, and scheduled for final passage next week.
Child Care Personnel
CS/HB 1125 by the Children, Families, and Seniors Subcommittee and Rep. Charles McBurney (R-Jacksonville) prohibits the Department of Children and Families (DCF) from granting exemptions for employment to child care personnel who have been identified as a sex offender, or convicted of a felony or violent misdemeanor. The bill passed the House on March 2 on a vote of 116:0. The Senate companion, SB 1420 by Sen. Aaron Bean (R-Jacksonville) was substituted for CS/HB 1125 on March 4, and is scheduled for a final Senate vote next week.
HEALTH AND WELLNESS
Florida KidCare Program
HB 89 by Rep. Jose Diaz (R-Miami) that would allow children of lawfully residing immigrants, who have been living in the United States less than five years to be insured under the Florida KidCare program passed the House on March 3 on a vote of 118:0. HB 89 extends Children’s Health Insurance Program (CHIP) and Medicaid eligibility to a “lawfully residing child” who meets other eligibility qualifications of the program. The bill specifies that the statutory changes do not extend KidCare eligibility to undocumented immigrants. The Senate companion, SB 248 by Sen. Rene Garcia (R-Miami) is awaiting a hearing in the full Senate Appropriations Committee which is not scheduled to meet again. However, SB 2508, the Health Care Services budget conforming bill includes similar language which was substituted for HB 5101 – the Medicaid bill. Budget negotiators over the weekend agreed to include $28.8 million, mostly federal money, and a small amount from family premiums (no state general revenue)in the proposed 2016-17 budget to fund the program.
Early Steps Program
The language in SB 7034 by Children, Families, and Elder Affairs was amended to CS/HB 7053, the Child Care Development Block Grant bill. The bill is now awaiting action by the full House. The Early Steps portion of the bill renames the “Infants and Toddlers Early Intervention Program” as the “Early Steps Program,” sets accountability standards, and revises requirements for the Department of Health (DOH) to maintain a clearinghouse of information for parents and health care providers on developmental evaluation and early intervention programs. The bill also requires the development of an individual family support plan for each child served in the program, and expands eligibility to serve additional children.
TAKE ACTION: Please contact your House members and urge them to request that Early Steps legislation be passed as soon as possible.
SB 7087 by the Select Committee on Affordable Healthcare Access and Rep. Chris Sprowls (R-Clearwater) that provides practice standards and registration requirements to provide telehealth services in Florida passed the House on March 2 on a vote of 114:3. The bill now heads to the Senate. A similar bill, CS/SB 1686 by Sen. Aaron Bean (R-Jacksonville) was substituted for HB 7087, amended, and returned to the House on March 3. The bill now creates a taskforce to compile and analyze certain data and conduct a comparative analysis of health insurance coverage available for telehealth services and for in-person treatment, and requires the task force to submit a report to the Governor and Legislature by June 30, 2017.
Prepaid Dental Plans
The Senate companion, SB 994 by Sen. Joe Negron (R-Palm City) is scheduled to be taken up by the Senate on March 4 and final passage early next week. The bill removes dental services from the list of minimum benefits that Managed Medical Assistance (MMA) plans must provide, effective March 1, 2019. Instead, effective July 1, 2017, AHCA must implement a statewide Prepaid Dental Health Plan (PDHP) program for children and adults, and begin enrollment by March 1, 2019. AHCA must contract with at least two licensed dental managed care providers through a competitive procurement process to provide dental benefits. AHCA is authorized to seek any necessary state plan amendment or federal waivers to implement the statewide PDHP program. The bill requires AHCA to prepare a comprehensive report on dental services which must examine the effectiveness of the managed care plans in providing dental care, improving access to dental care and dental health, and achieving satisfactory outcomes for recipients and providers. The bill authorizes the Legislature to use the findings of the report to establish the scope of minimum benefits under the MMA program for future procurements of eligible plans; specifically, the Legislature may use the findings of the report to determine whether dental benefits should be benefits under the MMA program or be provided separately. HB 819 by Rep. Jose Felix Diaz (R-Miami) passed the House on February 24 on a vote of 100:15.
Mental Health and Substance Abuse
SB 12 by Sen. Rene Garcia (R-Hialeah) that addresses Florida’s system for the delivery of behavioral health services is scheduled to be considered on March 4 and scheduled for final passage next week. The bill provides for mental health services for children, parents, and others seeking custody of children involved in dependency court proceedings. The bill creates a coordinated system of care to be provided either by a community or a region for those suffering from mental illness or substance use disorder through a “No Wrong Door” system of single access points. The Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF) are directed to modify licensure requirements to create an option for a single, consolidated license to provide both mental health and substance use disorder services.
Although there is no additional state funding provided, the AHCA and the DCF are directed to develop a plan to increase federal funding for behavioral health care. To the extent possible, the bill aligns the legal processes, timelines, and processes for assessment, evaluation, and receipt of available services of the Baker Act (mental illness) and Marchman Act (substance abuse) to assist individuals in recovery, and reduce readmission to the system. The duties and responsibilities of the DCF are also revised to set performance measures and standards for managing entities and to allow the agency to enter into contracts with managing entities that support efficient and effective administration of the behavioral health system, as well as to ensure accountability for performance.
CS/HB 7097 by the House Children and Families Subcommittee and Representatives Harrell, Peters and Pilon is scheduled to be taken up on March 4, and scheduled for final passage next week . A similar bill, SB 1336 by Sen. Jack Latvala (R-Clearwater) is awaiting action in the Appropriations Committee which is not scheduled to meet again this session.
Dental Program for Medicaid Eligible Children
SB 580 by Sen. Denise Grimsley (R-Sebring) passed the Senate on March 2 on a vote of 38:0 and was sent to the House. CS/SB 580 authorizes the Agency for Health Care Administration (AHCA) to reimburse a health access setting under the Medicaid program for remedial dental services (remedial tasks) delivered by a dental hygienist when provided to a Medicaid recipient younger than 21 years of age. Remedial tasks are defined as intra-oral tasks that do not create unalterable changes in the mouth or contiguous structures, are reversible, and do not expose the patient to increased risks.
The House companion, CS/HB 595, by Rep. Rene Plasencia (R-Orlando) is awaiting action by the full House.
Direct Primary Care
CS/CS/SB 132 by Sen. Denise Grimsley (R-Sebring) that creates a new section of Florida Statutes related to the application of the Florida Insurance Code for direct primary care agreements is awaiting Senate consideration. The language of CS/CS/SB 132 was amended to CS/SB 212 by Sen. Don Gaetz (R-Destin) relating to Ambulatory Surgical Centers and is awaiting full Senate action. The bill provides that a direct primary care agreement is not insurance and is not subject to the Florida Insurance Code. The bill defines the terms, “direct primary care agreement,” “primary care provider,” and “primary care service,” and specifies certain provisions that must be included in a direct primary care agreement.
The House companion, CS/CS/HB 37 by Rep. Fred Costello (R-Port Orange) passed the House on March 2 on a vote of 116:0.
CS/CS/HB 139 by Rep. W. Travis Cummings (R-Orange Park) requires the Department of Health (DOH) to develop and implement a dental care access account initiative to benefit dentists employed by a public health program or committed to opening a private practice capable of serving at least 1,200 patients in a dental health professional shortage area or medically underserved area. The bill passed the House on March 2 on a vote of 117:0. The bill requires DOH to implement an electronic benefits transfer system enabling selected dentists to spend awarded funds on:
The Senate companion, SB 234 by Sen. Don Gaetz (R-Destin) is awaiting Senate action.
Healthy Food Financing – Food Deserts
CS/SB 760, by Sen. Aaron Bean (R-Jacksonville) is scheduled to be taken up for consideration on March 4 and ready for final passage next week. The bill directs the Department of Agriculture and Consumer Services (DACS) to establish a program to provide financing to retailers to construct, rehabilitate, or expand grocery stores in underserved communities in low- and moderate-income areas.
The House companion CS/HB 153 by Rep. David Santiago (R-Deltona) passed the House on March 3 on a vote of 118:0 . The bill now goes to the Senate.
Child Welfare System
HB 599 by Rep. Neil Combee (R-Auburndale) and Rep. Gayle Harrell (R-Stuart) passed the House on March 2 on a vote of 119:0 and was substituted for CS/SB 7018.
SB 7018 by Sen. Nancy Detert (R-Venice) was then substituted for CS/HB 599 and scheduled for final passage on March 4. The bill requires DCF, in collaboration with certain stakeholders, to develop a continuum of care for children in the child welfare system. This continuum of care must be a complete range of placement options, programs, and services for children served by, or at risk of being served by, the dependency system. The continuum of care requires a quality rating system for residential group care, as well as an annual report.
The bill creates a new section of law that requires an initial assessment when a child has been determined to need out-of-home placement to aid in identification of placement and help determine any services needed. The bill also requires an in-depth assessment to be completed for each child placed in out-of-home care, to supplement the initial assessment and further determine service and placement needs.
The bill creates permanency teams that are required to review out-of-home placements for certain children who have historically faced barriers to permanency. The bill also outlines the intervention services to be provided by lead agencies.
After final passage in the Senate, the bill will be sent to the House where it is expected to be amended again next week.
Child Protection Teams (CATs)
SB 670, by Sen. Don Gaetz (R-Destin) was considered by the Senate on March 3 and scheduled for a final vote on March 4. The bill applies immunity from personal liability in certain actions to any member of a child protection (CPT) team, in certain circumstances. As a result, CPT members may not be held personally liable for torts committed in such capacity; instead the state may be held liable up to the limits established under the state’s statutory waiver of sovereign immunity. A child protection team (CPT) is a medically directed, multidisciplinary team of professionals contracted by the Children’s Medical Services (CMS) Program in the Department of Health (DOH). CPTs supplement the child protective investigation activities of local sheriffs’ offices and the Department of Children and Families (DCF) in cases of child abuse, abandonment, and neglect. CPTs provide expertise in evaluating alleged child abuse and neglect, assessing risk and protective factors, and providing recommendations for interventions to protect children and to enhance a caregiver’s capacity to provide a safer environment when possible. HB 715 by Rep. Gayle Harrell is awaiting action in the House Appropriations Committee which is not scheduled to meet again.
Adoption and Foster Care
CS/CS/SB 590 by Sen. Nancy Detert (R-Venice) revises the circumstances under which an adoption consent is valid, binding, and enforceable. The bill was substituted for HB 673 and passed by the House on March 2 on a vote of 119:0. The bill also requires the court to consider a child’s best interest when changing a placement rather than the appropriateness of the placement. The bill requires courts in all dependency proceedings to advise the parent who is a party to the case at the arraignment hearing of the right to participate in a private adoption plan. The House companion, CS/HB 673 by Rep. Janet Adkins (R-Fernandina Beach) was substituted for CS/CS/SB 590 and passed the House on March 2 .
CS/SB 860 by Sen. Nancy Detert (R-Venice) designates the second week of February of each year as “Foster Family Appreciation Week.” The House companion, HB 657 by Rep. Ben Albritton (R-Bartow) was substituted for CS/SB 860 and passed by the house on March 2 on a vote of 118:1.
Civil Citations and Diversion Programs
HB 7085 by the House Criminal Justice Subcommittee and Rep. Carlos Trujillo (R-Doral) relating to juvenile civil citation and similar diversion programs is awaiting action in the Judiciary Committee which is not scheduled to meet again for this session. The bill requires the establishment of civil citation or similar diversion programs for juveniles; provides definitions; and, specifies program eligibility, participation, and implementation requirements. A similar bill, SB 408 by Sen. Thad Altman (R-Cape Canaveral) was voted favorably in the Rules Committee on February 29. The bills have met strong objection by members of law enforcement who do not want their hands tied through a hard requirement to use civil citations in all instances.
Confidentiality of Juvenile Records
SB 700 by Sen. Darren Soto (D-Kissimmee) that specifies that certain confidential information obtained under chapter 985, F.S., relating to juvenile justice, is exempt from public records requirements was substituted for HB 293 by Rep. Sharon Pritchett (D-Miramar) and passed by the Senate on March 3 on a vote of 38:0.
OTHER BILLS AFFECTING CHILDREN
CS/SB 784 by Senator Anitere Flores (R-Miami) was substituted for CS/CS/HB 545 by Rep. Ross Spano (R-Riverview) passed and presented to the Governor on March 1 who must act on this bill by March 8. The bill addresses human trafficking and offenses that are often associated with human trafficking by:
Ad Valorem Taxation
CS/SB 766 by Sen. Anitere Flores (R-Miami) which makes several changes related to the Value Adjustment Board (VAB) process is scheduled to be heard in the Appropriations Committee on March 1. The bill:
The bill also makes permanent the ability of a school district to levy 75 percent of a school district’s most recent prior period funding adjustment millage in the event that the final tax roll is delayed for longer than one year.
The House companion, CS/CS/HB 499 by Rep. Bryan Avila (R-Hialeah) was passed by the House on March 3 on a vote of 117:0.
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