Senate Bill 1660
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Florida Senate - 1998 SB 1660
By Senators Kurth, Myers, McKay, Brown-Waite, Turner, Klein
and Latvala
15-698B-98 See HB
1 A bill to be entitled
2 An act relating to children and families;
3 creating s. 383.145, F.S.; creating the Healthy
4 Families Florida program; providing legislative
5 findings and intent; providing purpose;
6 requiring integrated community-based delivery
7 of services; specifying program requirements;
8 providing responsibilities of the Department of
9 Health and the Department of Children and
10 Family Services; providing for development,
11 implementation, and administration of the
12 program; establishing the Healthy Families
13 Florida Statewide Board; specifying criteria
14 for community program grant funding; requiring
15 collaboration with existing community boards,
16 coalitions, providers, and planning groups;
17 authorizing contracts for training and
18 evaluation; providing for quality assurance;
19 providing for application for a federal waiver;
20 providing an effective date.
21
22 Be It Enacted by the Legislature of the State of Florida:
23
24 Section 1. Section 383.145, Florida Statutes, is
25 created to read:
26 383.145 The Healthy Families Florida program.--There
27 is created the Healthy Families Florida program, a voluntary
28 program for newborn children and their families.
29 (1) LEGISLATIVE FINDINGS AND INTENT.--
30 (a) The Legislature finds that family well-being is
31 critical to a child's health and development, that parenting
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 is a difficult responsibility, and that most of the assistance
2 available to Florida's families occurs after there is a
3 problem, and often provides "too little, too late." Research
4 has shown that comprehensive early home visitation programs
5 prevent child abuse, help develop positive parent-child
6 interactions, and help avoid future social problems. In
7 addition to addressing child abuse, such programs help to
8 ensure that families' social and medical needs are met and
9 that children are ready for success in school. The Legislature
10 finds that Florida needs broad implementation of such a
11 program to help identify families who need and desire
12 assistance in establishing healthy relationships and
13 environments for their children.
14 (b) It is the intent of the Legislature to establish
15 the Healthy Families Florida program as a collaborative effort
16 that builds on existing community-based home visiting and
17 family support resources and will not duplicate the existing
18 services. It is the further intent of the Legislature that
19 the program provide the needed intensity and duration of
20 services that extend beyond those available through Florida's
21 Healthy Start initiative. By creating a Healthy Families
22 Florida program, a major gap in the existing continuum of
23 early childhood prevention and assistance services will be
24 filled.
25 (2) PURPOSE.--The purpose of the program is to
26 strengthen families; promote healthy childhood growth and
27 development; improve childhood immunization rates and
28 well-child care; improve child health outcomes; improve school
29 readiness; increase family self-sufficiency; increase the
30 involvement of both parents with their children; and reduce
31 the incidence of child abuse and neglect, through a primary
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 prevention approach that offers home visits and linkages to
2 family supports for families and their newborn children and
3 continues until the children reach 5 years of age.
4 (3) DELIVERY OF SERVICES.--Service delivery under the
5 program shall be community-based and collaborative. Program
6 services shall be integrated and coordinated with services
7 provided under Florida's Healthy Start program and other home
8 visiting and family support service delivery systems currently
9 in place in Florida communities. Services shall be offered
10 with the intensity and duration required to prevent child
11 abuse and neglect and to improve child development and child
12 health outcomes.
13 (4) PROGRAM REQUIREMENTS.--The program shall provide
14 for intensive home visits and include the following critical
15 elements of the Healthy Families America model:
16 (a) Initiation of services. This element provides for:
17 1. Initiation of services prenatally or at birth.
18 2. Use of a standardized assessment tool to
19 systematically identify those families most in need of
20 services.
21 3. Offering services on a voluntary basis, and using
22 positive, persistent outreach efforts to build family trust.
23 4. Working with family members to identify strengths
24 and resources that can be mobilized to help resolve identified
25 family concerns.
26 (b) Service content. This element provides for:
27 1. Offering services over the long term and
28 intensively, with well-defined criteria for increasing or
29 decreasing the intensity of the service.
30 2. Providing culturally competent services.
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Florida Senate - 1998 SB 1660
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1 3. Providing services that focus on supporting parents
2 and families, encouraging the interaction of both parents with
3 their children, and enhancing the development of all children
4 in the family, including school readiness and educational
5 development.
6 4. Linking families to medical providers to ensure
7 optimal health and development of the children; timely
8 childhood immunizations; well-child care that provides for
9 developmental assessment and is consistent with the standards
10 and periodicity schedules of Medicaid and the American Academy
11 of Pediatrics; and additional services, as needed. Children
12 who are eligible for Medicaid shall be referred for Early
13 Periodic Screening, Diagnosis, and Treatment (EPSDT) services.
14 5. Providing families the opportunity to create
15 neighborhood support systems to address mutual concerns and
16 solve problems without external resources.
17 6. Incorporating specialized services to accommodate
18 the needs of families with substance abuse problems. Staff
19 trained in providing substance abuse services will work with
20 these families to meet their unique needs.
21 (c) Selection and training of service providers. This
22 element provides for:
23 1. Weighted caseloads of not greater than 25:1 overall
24 and 15:1 for intensive services, for staff providing home
25 visits, as specified in the Healthy Families America model.
26 2. Selecting home visit providers based on the
27 provider's interpersonal skills; knowledge of community
28 resources; willingness to work with, or experience working
29 with, culturally diverse communities and families; and job
30 skills.
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Florida Senate - 1998 SB 1660
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1 3. Ensuring that home visit providers have basic
2 training in areas including, but not limited to: cultural
3 competency, substance abuse, reporting child abuse, domestic
4 violence, drug-exposed infants, child development, services
5 available in the community, infant care and development, and
6 parenting.
7 4. Ensuring that home visit providers have preservice
8 and ongoing training that is specific to their job
9 requirements.
10 5. Ensuring that home visit providers receive ongoing
11 weekly reviews and direct and intensive supervision.
12 6. Ensuring that home visit providers are qualified
13 community-based private, not-for-profit, or public
14 organizations that are credentialed by, are in the process of
15 being credentialed by, or have been granted affiliation with
16 the Healthy Families America Initiative and have strong
17 community support and the social and fiscal capacity to
18 provide the service.
19 (5) HEALTHY FAMILIES FLORIDA ADVISORY COMMITTEE.--In
20 order to gain the efficiencies, advocacy, and broadbased
21 support of a public-private partnership, Healthy Families
22 Florida shall be developed, implemented, and administered by
23 The Ounce of Prevention Fund of Florida. The Department of
24 Children and Family Services shall be the conduit of funds
25 appropriated by the state to The Ounce of Prevention Fund of
26 Florida for Healthy Families Florida. The Department of
27 Children and Family Services shall contract with The Ounce of
28 Prevention Fund of Florida for purposes of developing,
29 implementing, and administering the Healthy Families Florida
30 program. There is created a Healthy Families Florida Advisory
31 Committee, which shall assist and advise The Ounce of
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 Prevention Fund of Florida and assure coordination and
2 collaboration with appropriate state agencies and public and
3 private organizations. The advisory committee shall operate
4 under the auspices of The Ounce of Prevention Fund of Florida
5 Board of Directors. The duties of the advisory committee
6 include developing measurable outcomes consistent with the
7 established outcomes of Healthy Families America, reviewing
8 grant applications and recommending grant awards under this
9 section to the Board of Directors of The Ounce of Prevention
10 Fund of Florida, defining the scope of this program, and
11 generally advising The Ounce of Prevention Fund of Florida on
12 the development, implementation, and administration of this
13 program. The Board of Directors of The Ounce of Prevention
14 Fund of Florida has the final approval of grant awards and
15 contracts but may consider only those applicants recommended
16 by the advisory committee. The advisory committee shall
17 consist of nine members, including the Secretary of Children
18 and Family Services or the secretary's designee, the Secretary
19 of Health or the secretary's designee, one representative of
20 TEAM Florida, one representative of the Florida Coalition of
21 Healthy Start Coalitions, two active board members of The
22 Ounce of Prevention Fund of Florida, and two community
23 representatives who have direct experience and significant
24 knowledge of the Healthy Families program, one of whom is to
25 be appointed by the President of the Senate and one of whom is
26 to be appointed by the Speaker of the House of
27 Representatives, and one representative of the Family Source,
28 Inc.
29 (6) IMPLEMENTATION.--The Department of Children and
30 Family Services shall contract with The Ounce of Prevention
31 Fund of Florida to develop, implement, and maintain the
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Florida Senate - 1998 SB 1660
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1 Healthy Families Florida programs. This contract must cover
2 the expenditure of all funds appropriated for Healthy Families
3 Florida other than funds appropriated to the department for a
4 contract manager and for expenses incident to that position.
5 The Ounce of Prevention Fund of Florida under this contractual
6 agreement shall:
7 (a) Using the criteria set forth in this section,
8 implement a community-based Healthy Families Florida program.
9 (b) Award community grants and determine requirements
10 for matching funds. Community grants must be awarded in
11 accordance with weighted criteria based on population
12 demographics, factors associated with child abuse and neglect,
13 and other appropriate criteria developed by the Healthy
14 Families America or the advisory committee. Matching funds may
15 be in-kind or cash as determined by the advisory committee
16 with the approval of The Ounce of Prevention Fund of Florida
17 Board of Directors.
18 (c) Develop a plan of implementation to equitably
19 distribute funds.
20 (d) Require that the following criteria be used in
21 selecting recipients of grant funds:
22 1. Each community must have a community-based lead
23 entity for planning and implementing the Healthy Families
24 program. This lead entity must demonstrate the support,
25 integration, and collaboration of existing boards, coalitions,
26 planning groups, business, and consumers. These groups must
27 include, but need not be limited to, the following, if locally
28 established: Healthy Start coalitions, local healthy families
29 steering committees, Success by Six, family preservation and
30 support planning entities, health and human services boards,
31 children's services councils, Head Start boards,
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 prekindergarten early intervention councils, community child
2 care coordinating agencies, school advisory councils,
3 substance abuse and mental health services boards, juvenile
4 justice councils, civic groups, business, and other nonprofit
5 organizations.
6 2. Preference for grant awards must be given to
7 existing community-based entities that have broad
8 representation and have the fiscal and administrative capacity
9 to implement the program.
10 3. Those community-based entities that have been
11 granted affiliation with the Healthy Families America
12 Initiative by the National Committee to Prevent Child Abuse or
13 have been trained by the Healthy Families America Initiative
14 before July 1, 1998, and that meet the criteria set forth in
15 this section must be given preference, during fiscal year
16 1998-1999, for grant awards to fully serve their designated
17 service area.
18 4. The Healthy Families Florida program must
19 complement and be integrated with Healthy Start and other home
20 visiting and family support programs.
21 5. One application per designated service delivery
22 area is to be approved. A designated service area is a county.
23 However, the advisory committee, with the approval of the
24 Board of Directors of The Ounce of Prevention Fund of Florida,
25 may grant a waiver of the designated service area which
26 results in reducing or enlarging the designated service area
27 as long as all other criteria set forth in this section are
28 met and there remains only one Healthy Families Florida
29 provider within the new designated service area.
30 6. Each successful grant applicant must seek to be
31 credentialed by Healthy Families of America. To continue
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 qualifying for funding under this section, an entity must
2 achieve these credentials within the specified deadlines
3 articulated by Healthy Families America and must maintain the
4 credentials in good standing for the duration of program
5 operation.
6 7. Each applicant must agree to use the Kempe Family
7 Stress Checklist or other standardized assessment tool
8 consistent with the Healthy Families America credentialing
9 standards and approved by the advisory committee.
10 8. Each applicant must agree to provide outcome and
11 performance data in the format and at the frequency specified
12 by The Ounce of Prevention Fund of Florida.
13 9. Each applicant must identify local resources
14 available for implementation.
15 10. Local assessment and planning for the program must
16 be collaborative and must include representatives from the
17 entities listed in subparagraph 1., if locally established.
18 During the planning phase, these entities, and others as
19 appropriate, shall participate in: a strength-based community
20 assessment process that identifies existing home visiting and
21 family support services and uses existing needs assessments;
22 the grant application and the development of a local
23 implementation plan for service delivery; and the
24 determination and identification of local funds and resources
25 that will support the implementation of the program.
26 11. Each applicant must show evidence that consumers
27 and families have been involved in the planning and
28 development of the grant application and support the Healthy
29 Families Florida program in the designated service area
30 identified in the grant application.
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 12. Implementation design must include service
2 delivery strategies that, when appropriate, involve both
3 parents when they have shared parental responsibility,
4 regardless of residential custody arrangements.
5 13. Each community must develop mechanisms to refer
6 at-risk children between the ages of 4 months and 3 years, who
7 were not identified before the age of 4 months, for other
8 intervention services available in the community.
9 (e) Evaluate and approve the grant applications and
10 the local implementation plans for service delivery.
11 (f) Coordinate service delivery with Healthy Start
12 care coordination.
13 (g) Identify qualified trainers and training
14 opportunities that will assure adequate opportunities for
15 grantees and their communities to provide preservice and
16 inservice training. Funds for training may be incorporated
17 into the grants.
18 (h) Contract with evaluators to develop and implement
19 an evaluation design for the program.
20 (i) Provide for ongoing technical assistance and
21 coordination to each community-based program.
22 (j) Develop and implement a quality assurance and
23 improvement process for the program.
24 (k) Evaluate the progress of the program and provide
25 an annual report regarding the progress and achievement of
26 designated outcomes to the Governor, the President of the
27 Senate, the Speaker of the House of Representatives, and other
28 vested parties.
29
30 The Ounce of Prevention Fund of Florida may subcontract the
31 performance of tasks or services described in this section.
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Florida Senate - 1998 SB 1660
15-698B-98 See HB
1 (7) WAIVER.--The Department of Health and the
2 Department of Children and Family Services shall work jointly
3 with the Agency for Health Care Administration to seek a
4 federal waiver to secure Title XIX matching funds for the
5 Healthy Families Florida program. The waiver application shall
6 include allowance to use new and existing general revenue and
7 local contributions. Healthy Families Florida program services
8 shall not be considered an entitlement under this waiver.
9 Section 2. This act shall take effect July 1, 1998.
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12 LEGISLATIVE SUMMARY
13 Creates the Healthy Families Florida program, a voluntary
program to promote the health of newborns and their
14 families. Provides for integration with existing
community-based family support service delivery systems.
15 Specifies requirements relating to initiation and content
of services and selection and training of service
16 providers. Provides for development, implementation, and
administration of the program through The Ounce of
17 Prevention Fund of Florida, under contract with the
Department of Children and Family Services, and the
18 Healthy Families Florida Advisory Committee established
under this act. Provides for locally matched grants.
19 Specifies criteria for community program grant funding.
Requires collaboration with existing community boards,
20 coalitions, providers, and planning groups. Authorizes
contracts for training and evaluation. Provides for
21 quality assurance. Requires the Department of Health, the
Department of Children and Family Services, and the
22 Agency for Health Care Administration to seek a federal
waiver to secure federal matching funds. Provides that
23 the program is not an entitlement.
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