Week 2 – March 15, 2015
The second week of session saw the arrival of many groups to the Capitol and bills moving rapidly through both chambers. Most notable was the passage of SB 7044, Health Insurance Affordability Exchange by the Senate Committee on Health Policy on March 10, to provide alternative affordable health care coverage to low-income, uninsured Floridians through private insurance. Overwhelming support for the bill came from the FL Hospital Association, Associated Industries of Florida, League of Women Voters, and the Safety Net Hospitals Alliance of Florida. Advocates testifying on the bill acknowledged that the bill was a good start to the conversation about Medicaid expansion. However, concerns were raised about barriers to utilization from tiered premium and work incentive requirements, as well as the automatic elimination of the Medically Needy Program upon passage of the law; and other provisions. These provisions will necessitate approval of a waiver fromthe federal U.S. Centers for Medicare and Medicaid Services. Several states that have submitted similar waivers have been denied by the agency. SB 7044 stipulates that if the Florida application is denied, the state will opt out of Medicaid Expansion.
Another noteworthy development this past week was the presentation by State Surgeon General Armstrong and his staff on the status of Children’s Medical Services (CMS) and the Early Steps Program on March 11 in the Senate Appropriations Subcommittee on Health and Human Services chaired by Senator Rene Garcia. Several committee members questioned Dr. Armstrong on the drastic staffing cuts from 22 to 7 employees to administer the Early Steps program at the state office and asked for assurances that this will not put Florida out of compliance with federal requirements.
For the upcoming week, both the House and Senate will begin deliberations on their respective budgets – the only duty of the Legislature prescribed in the Florida Constitution.
EARLY LEARNING AND SCHOOL READINESS
Early Learning Bills Released
A bill to increase health and safety standards at early learning facilities was filed by the House Education Committee, CS/HB 7017 and the Senate Education Pre-K-12 Committee, SB 7006.
Senate Bill 7006 was passed by the Senate Education Pre-K-12 Committee and the Senate Community Affairs Committee. Overall, both bills increase the health and safety standards and personnel requirements for Voluntary Prekindergarten Programs Education (VPK) and School Readiness programs. While the bills are substantively similar, an amendment by Sen. Wilton Simpson (R-Trilby) was added in the Senate Community Affairs Committee that would allow school districts to create policies permitting families to enroll four-year-olds in kindergarten if the child is 4 years of age by Sept. 1 of the school year and achieved certain academic and social standards. Currently, kindergarten serves five-year-olds. The next committee stop in the Senate is the Appropriations Committee on Health and Human Services.
CS/HB 7017 passed the Education Appropriations Subcommittee on Thursday, March 12 and now heads for a full House vote. In the House Education Appropriations Committee, Rep. O’Toole filed six amendments that were adopted:
Requires family child care homes to be licensed or registered with the Department of Children and Families. Defines training requirements for home operators. Requires completion of a health and safety checklist developed by the Department of Children and Families in conjunction with the statewide resource and referral program.
Technical edit related to the Inspector General for the Office of Early Learning.
Health and safety provisions for nonpublic schools.
Requires termination of a School Readiness provider contracts for Department of Children and Families’ sanctioned Class I violations.
Requires termination of a Voluntary Prekindergarten provider contracts for Department of Children and Families’ sanctioned Class I violations.
Retitles the Child Care Executive Partnership program to the Child Care Partnership program.
Clarifies that children’s services councils and government entities can contribute to the purchasing pool. Eliminates the requirement of a child care taskforce to implement the program locally. Reconstitutes board membership to five members, three appointed by the Governor, one by the House of Representatives and one by the Senate.
Rep. Mia Jones also filed one amendment that was adopted that requires that pre- and post-assessment data collected in the Voluntary Prekindergarten Education Program be used as part of the calculation of a provider’s readiness rate. The House and Senate bill differs in that the HB 7017 does not contain language regarding the enrollment of 4-year old children in Kindergarten.
Pre- and Post-Assessment for Voluntary Pre-Kindergarten Program
SB 518 by Sen. Audrey Gibson (D-Jacksonville) will revise provisions relating to calculation of the kindergarten readiness rate for Voluntary Prekindergarten Education Program providers and schools. It will also require the administration of a pre- and post-assessment of students based upon adopted performance standards. It requires the assessments to be administered by certain personnel and during certain time periods. Finally, it requires the Office of Early Learning to annually report to the State Board of Education certain student growth data. The bill passed the Senate Education Pre-K-12 Committee unanimously on March 11, 2015. It now heads to the Senate Appropriations Committee on Education chaired by Sen. Don Gaetz, the bill’s co-sponsor.
The identical House companion, HB 483 by Rep. Mia Jones (D-Jacksonville) is awaiting a hearing in the House Subcommittee on Choice and Innovation. However, as noted, an amendment was adopted to CS/HB 7017 – the Early Learning bill in the House Education Appropriations Subcommittee relating to pre- and post-assessment for prekindergarten public and private providers.
HEALTH AND WELLNESS
Early Steps Program
Wednesday, March 11 – Senate Appropriations Subcommittee on Health and Human Services: Status Report on Children’s Medical Services and the Early Steps Program – State Surgeon General John H. Armstrong
The Early Steps Program, administered by the Florida Department of Health, provides critical services to approximately 43,000 children birth to 36 months with medical diagnoses such as Autism, Down Syndrome, Cerebral Palsy, and children with developmental delays. Last month, Early Steps providers were notified by the Department that $4.2 million would be cut from the remainder of the fiscal year’s budget. Legislative leaders voiced concerns that the proposed cuts will decimate direct services. DOH rescinded the cuts, but subsequently drastically cut program office staffing to reduce administrative/operating costs to nine percent. DOH commented that funds recouped from staff reduction will be funneled to direct services. However, Early Steps experts voiced concerns that the depth of the staff reductions (from 22 to 7) threatens the quality of services and programs, and could possibly jeopardize about $22 million of federal funding of the total $54 million program funding.
With the concerns raised by the Legislature and advocates, Dr. John Armstrong and Dr. Celeste Philip presented a slide presentation of the programs and services provided by Children’s Medical Services to the Senate Health and Human Services Appropriations Committee. The members and public testimony focused on the diminished staff to administer the statewide program. Under the new structure, more responsibilities will shift to local Early Steps providers for contract management and data reporting. Dr. Louis St. Petery, Executive Vice President for the Florida Academy of Pediatrics, also reported districts are already experiencing delays in services.
However, both DOH officials assured members of the committee that the steps taken would actually make the program stronger.
The Senate Committee will continue to monitor and work with the Department to ensure that there are no negative impacts on services from the program transitions and restructuring.
Florida KidCare Program
SB 294, sponsored by Sen. Rene Garcia ( R-Hialeah) that would allow children of legal immigrants, who have been residing in the United States less than five years to be insured under the Florida KidCare program, passed the Senate Appropriations Committee on Health and Human Services, on March 4, 2015 and is awaiting action in the full Senate Appropriations Committee. SB 294 extends Medicaid and Children’s Health Insurance Program (CHIP) eligibility to a “lawfully residing child” who meets other eligibility qualifications of Medicaid or CHIP. The federal programs permit states to cover those in a 5-year waiting period, if the state elects to do so. The bill defines “lawfully residing child” which conforms to the federal program eligibility requirements and deletes references to “qualified alien.” The bill specifies that the statutory changes do not extend Kidcare program eligibility or Medicaid eligibility to undocumented immigrants. The fiscal impact for the 2015-2016 fiscal year in recurring state General Revenue funds is $4.8 million.
The House companion, HB 829, by Rep. Mike La Rosa (R-St. Cloud) is still awaiting its first hearing in the House Health Innovation Subcommittee.
We need your help in one or more of the following ways:
Contact the bill sponsors and thank them for sponsoring this important legislation;
Contact your Senator and Representative and ask them to co-sponsor the bills; and
Contact the Chairs of the next committees of reference (Sen. Tom Lee and Rep. Ken Roberson) and let them know how important these bills are to you and ask that the bills be heard quickly.
Health Care Coverage Expansion
On March 10, 2015, the Senate Committee on Health Policy passed Senate Proposed Bill 7044 relating to Health Insurance Affordability Exchange. The bill creates the Florida Health Insurance Affordability Exchange Program or FHIX in the Agency for Health Care Administration. It provides patient rights and responsibilities; the development of a long-term reorganization plan, and the formation of the FHIX workgroup. It also removes certain Medicaid eligible persons from those for whom the agency may make payments for medical assistance and related services. The bill is scheduled to be heard in its second committee of reference, the Senate Appropriations Subcommittee on Health and Human Services next Tuesday, March 17, 2015.
There is no House companion to the proposed Senate bill. House Speaker Steve Crisafulli (R-Merritt Island) has reiterated his chamber’s continued opposition to Medicaid Expansion.
Newborn Health Screening
SB 632 by Sen. Rene Garcia (R-Hialeah) 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 bill also provides certain insurance and managed care coverage; provides an exemption; and provides for documentation of objections to screening by the parent or legal guardian. The bill has yet to be heard in its first committee, the Senate Committee on Health Policy.
The House companion, HB 403 by Rep. Mike La Rosa (St. Cloud), is scheduled for consideration in the House Subcommittee on Health Quality on Monday, March 16, 2015.
Dental Program for Medicaid Eligible Children
HB 601 related to a statewide Prepaid Dental Program for Medicaid-eligible Children sponsored by Rep. MaryLynn Magar (R-Hobe Sound) was heard in the House Health Innovation Subcommittee on March 10, 2015, and FAILED on a tie vote. The bill was proposed as a way of providing increased dental services to children, but opposed by managed care health plan providers that alleged that with only 8 months of the statewide Medicaid Managed Care system rollout, the bill could lead to other services being ‘carved out’ of the comprehensive managed care system.
The Senate companion SB 350 by Sen. Anitere Flores (R-Miami) has yet to be heard in its first committee, the Senate Committee on Health Policy.
SB 610 by Sen. Dwight Bullard (D-Miami) passed the Senate Agriculture Committee unanimously on March 2, 2015 and currently awaits action in the Senate Finance and Tax Committee. The bill provides an income tax credit for grocery businesses that sell nutrient-dense food items in areas designated as food deserts. It provides definitions, sets forth eligibility and application requirements, and establishes the amount of credit. The bill allows the Department of Revenue (DOR), in consultation with the Department of Agriculture and Consumer Services (DACS), to adopt rules to administer the program. It requires DOR and DACS to review the program after 3 years for the purpose of recommending to the legislature whether it should be continued or eliminated. It provides criminal and administrative penalties for fraudulently claiming tax credits.
The House companion, HB 1107 by Rep. Larry Lee (D-Ft. Pierce) is awaiting committee references.
On Thursday, March 12, 2015, bill sponsors, business, and faith-based leaders held a Press Conference at the Capitol to create awareness of food deserts in high poverty and minority areas that contribute to infant mortality, low-birth rates, and obesity. The bills will provide access to nutrient rich food to address preventable diseases.
CS/HB 545 Telehealthby Rep. W. Travis Cummings (R-Orange Park) and Rep. Mia Jones (D-Jacksonville) passed the House Health Quality Subcommittee unanimously on March 11, 2015 and now heads to the House Health Care Appropriations Subcommittee.
CS/SB 478 by Sen. Aaron Bean (R-Jacksonville) and Sen. Arthenia Joyner (D-Tampa defines telehealth services and telehealth provider. 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. The bill is awaiting a hearing in the Senate Apppropriations Subcommittee on Health and Human Services.
Stakeholders are encouraged about the bills’ passage this year with the recent support of the powerful Florida Medical Association (FMA). The bills which could extend care for school based efforts, authorize an emergency medical technician, a paramedic, or a health care practitioner to provide telemedicine services to a patient who is a resident of this state; and, requires telemedicine services to be covered by specified Medicaid programs in the same manner as services provided to a recipient in person.
Guardian for Dependent Children who are Developmentally Disabled or Incapacitated
SB 496 by Senator Detert (R-Venice) passed unanimously in the Senate Judiciary Committee on March 10, 2015, and is awaiting action in its final committee of reference, Senate Appropriations Committee. The bill creates a framework for identifying and appointing guardian advocates, limited guardians, and plenary guardians for developmentally disabled children who may require decision-making assistance beyond their 18th birthday. The bill:
Requires an annual review of the continued necessity of guardianship for young adults in extended foster care who already have a guardian advocate or guardian;
Requires development of an updated case plan for any child who may require the assistance of a guardian advocate, limited guardian, or plenary guardian;
Provides that upon a judge’s finding that no less restrictive decision-making assistance will meet the child’s needs:
Provides that a minor who is 17 and one-half years of age and is subject to guardianship proceedings must receive all the due process rights of an adult; and
Provides that a child’s parents are considered to be the child’s natural guardians, unless the dependency or guardianship court determines it is not in the child’s best interest or the parents’ rights have been terminated.
Adoption and Foster Care
HB 7013 by Rep. Jason Brodeur (R-Sanford) and the House Health & Human Services Committee, relating to Adoption and Foster Care, passed the full House on March 11, 2015. 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 new adoption incentive program would require DCF to conduct a baseline assessment of CBC adoption performance regarding such factors as the length of time children have been waiting for adoption; the length of time to complete an adoption; and feedback from prospective adoptive families, adoptive families, adoptees, children within the child welfare system, and stakeholders. The bill requires DCF to then establish measurable outcome targets for performance by each CBC and negotiate incentive payments to be paid to CBC’s upon meeting these targets. The bill also re-creates a program to provide an additional adoption benefit of either $5,000 or $10,000, depending on whether the adopted child has special needs described in statute, for qualifying employees of state agencies who adopt a child from the child welfare system. The program originally created in 2000, provided employee adoption benefits until it was repealed in 2010. Currently the Office of Adoption and Child Protection (Office) in the Executive Office of the Governor works to promote adoption, support adoptive families, and advance child abuse prevention through a variety of means, including participating in events to recognize and celebrate adoptive families and adopted children. The bill requires the Governor to select and recognize one or more individuals, families, or entities that have made significant contributions to the adoption of children from foster care each year.
On March 10, there were several floor amendments added to the bill that passed:
An amendment dealing with post-adoption assistance by Rep. Brodeur
An amendment allowing a community-based care lead agency’s subcontractors that provide adoption services into the program, subject to review by DCF by Rep. Brodeur
An amendment removing a statutory prohibition against adoption by same sex couples by Rep. Richardson, (D-Miami Beach). A substitute amendment was offered by Rep. Gaetz, (R-Fort Walton Beach) dealing with home-schooling adopted children including the language on adoption by same sex couples.
On March 11, 2015, House members voted 68-50 to approve HB 7013. Opponents of the bill did not support the provisions allowing community-based lead agencies to provide adoption services and allowing foster children to be eligible for home schooling. Rep. Baxley (R-Ocala) said he was challenged by the provision regarding gay adoption but supported other provisions of the bill that will result in children being placed in permanent homes.
The Senate companion, SB 320 by Senator Don Gaetz (R-Destin), passed the Senate Committee on Fiscal Policy unanimously on March 5, 2015 and is awaiting passage by the full Senate. The Senate bill appropriates $10 million of recurring general revenue to fund and administer the programs created under the bill.
Children in Out-of-Home Care
SB 940 by Sen. Nancy Detert (R-Venice) relates to children in out-of-home care. The bill removes provisions requiring the Department of Children and Families to develop, implement, and administer a coordinated community-based system of care for children directed toward specified goals. It authorizes children of certain ages to be placed in a residential group home setting using a shift-care model only under specified circumstances. It further requires DCF to develop a proposal for a continuum of care for children in out-of-home care. The bill was passed unanimously by the Senate Committee on Children, Families, and Elder Affairs on March 12, 2015 and now heads to the Senate Appropriations Subcommittee on Health and Human Services. Prior to hearing the bill, the Committee heard a presentation (.pdf) from Jennifer Johnson, Staff Director, Health and Human Services, OPPAGA, on their review of Foster Care Group Homes. During public testimony, the committee heard testimony from members of Florida Youth Shine on their experiences in group homes.
To date, there is no House companion to this bill.
HB 467 by Rep. Ross Spano (R-Riverview), “Relating to Public Records/Human Trafficking Victims,” passed favorably in the House Subcommittee on Governmental Operations on March 11, 2015 and now heads to the House Judiciary Committee.
SB 378 by Sen. Rene Garcia (R-Hialeah) and Sen. Audrey Gibson (D-Jacksonville) relating to Juvenile Justice, authorizes a law enforcement officer to issue a warning to a juvenile who admits having committed a misdemeanor or to inform the child’s parent or guardian of the child’s infraction; requires a law enforcement officer who does not exercise one of these options to issue a civil citation or require participation in a similar diversion program; provides that, in exceptional situations, a law enforcement officer may arrest a first-time misdemeanor offender in the interest of protecting public safety. In addition, law enforcement will be authorized to issue a simple warning to the youth or inform the youth’s parents of the misdemeanor, as well as issue a civil citation or require participation in a similar diversion program under the bill. The bill also states that if an arrest is made, law enforcement must provide written documentation as to why the arrest is warranted. The bill passed unanimously in the Senate Criminal Justice Committee on March 10, 2015 as a Committee Substitute and now heads to Senate Committee on Children, Families and Elder Affairs. To date, there is no House companion to the bill.
Charging Youths as Adults in Criminal Proceedings
HB 783 by Rep. Katie Edwards (R-Sunrise) relates to youths charged as adults in criminal proceedings. The bill is scheduled for a hearing in the House Subcommittee on Criminal Justice on March 16, 2015. The bill specifies offenses that allow state attorneys to file information for specified juvenile offenders. The bill:
Prohibits filing information for juveniles with certain conditions;
Specifies effects of direct file;
Prohibits certain juvenile offenders from being transferred to adult court;
Requires the Department of Juvenile Justice (DJJ) to collect specified data & make report;
Specifies minimum age for indictment of juvenile for certain offenses;
Prohibits certain juvenile offenders from being transferred to adult court; deletes provisions relating to sentencing of juveniles as adults for certain offenses;
Revises provisions relating to transfer of other pending felony charges when child has been indicted;
Revises factors to be considered in determining whether to impose juvenile or adult sanctions for violations of law by juvenile;
Requires court to consider specified reports in hearing on such sentencing;
Revises provisions relating to sentencing alternatives.
The Senate companion, SB 1082 by Sen.Thad Altman (R-Cape Canaveral) is awaiting hearing in the Senate Committee on Criminal Justice.
PERSONS WITH DISABILITIES
Students with Disabilities
On Thursday, March 12, 2015, the House Education Committee workshopped their proposed bill on Personal Learning Scholarship Accounts. Rep. Michael Bileca (R-Miami) provided a Section-by-Section of the Personal Learning Scholarship Account (.pdf) summary.
OTHER BILLS AFFECTING CHILDREN
Children and Youth Cabinet
HB 55 by Rep. Gayle Harrell (R-Stuart) relating to the Children and Youth Cabinet, passed the House Choice and Innovation Subcommittee unanimously on March 3, 2015 and was reported favorably by the House Health and Human Services Committee on March 12, 2015. The bill now heads to the House Education Committee.
The Florida Children and Youth Cabinet (Cabinet) consists of the Governor and 14 members. These members include the Secretary of the Department of Children and Families, the Secretary of Juvenile Justice, the Director of the Agency for Persons with Disabilities, the Director of the Office of Early Learning, the State Surgeon General, the Secretary of Health Care Administration, the Commissioner of Education, the Director of the Statewide Guardian Ad Litem Office, the Director of the Office of Child Abuse Prevention, and five members appointed by the Governor who represent children and youth advocacy organizations. The bill creates one additional Cabinet position to be held by a superintendent of schools who is appointed by the Governor.
The Senate companion, SB 878 by Sen. Bill Montford (D-Quincy) was also reported favorably as a Committee Substitute by the Senate Committee on Children, Families and Elder Affairs on March 12, 2015 and now heads to the Senate Education PreK-12 Committee.
The Children’s Health Insurance Program (CHIP)
The beloved bipartisan Children’s Health Insurance Program (CHIP) created in 1997 that gave rise to state programs such as Florida KidCare is authorized until 2019, but its funds must be renewed in September of this year. The good news is there seems to be bipartisan agreement on the Hill on the need to extend CHIP funding, and perhaps even a desire on the part of congressional leadership to get this done quickly. Bills that have been filed in both the House and Senate (SR 522 and HR 919) call for a swift and relatively clean four-year renewal of CHIP. However, there is an alternative draft bill brewing which could limit the program in several ways, including allowing states to impose up to a 12 month waiting period for CHIP (currently they may not impose longer that a 90 day wait). Call your Congressional members immediately and urge them to push for a clean, four year renewal of CHIP funding.
Children’s Week – April 12-17
Children’s Week Children’s Week www.childrensweek.org brings together many non-profits at the Captiol under “One Voice” to support children’s issues and advocate for the full spectrum of children’s services and needs. Local coordinators also plan and implement various events in their communities to symbolize the unity of Florida’s statewide child advocacy efforts.
Children’s Week has also unified more than 200 community events and activities statewide, bringing thousands of parents, children, legislators, professionals, community leaders and concerned citizens together to share valuable knowledge and information about children’s issues in each community across the state.