Senate Bill 1660c1
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
By the Committee on Children, Families and Seniors and
Senators Kurth, Myers, McKay, Brown-Waite, Turner, Klein,
Latvala, Harris, Rossin and Dyer
300-1773A-98
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 within available resources the Healthy Families
28 Florida program, a voluntary program for newborn children and
29 their families.
30 (1) LEGISLATIVE FINDINGS AND INTENT.--
31
1
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 (a) The Legislature finds that family well-being is
2 critical to a child's health and development, that parenting
3 is a difficult responsibility, and that most of the assistance
4 available to Florida's families occurs after there is a
5 problem, and often provides "too little, too late." Research
6 has shown that comprehensive early home visitation programs
7 prevent child abuse, help develop positive parent-child
8 interactions, and help avoid future social problems. In
9 addition to addressing child abuse, such programs help to
10 ensure that families' social and medical needs are met and
11 that children are ready for success in school. The Legislature
12 finds that Florida needs broad implementation of such a
13 program to help identify families who need and desire
14 assistance in establishing healthy relationships and
15 environments for their children.
16 (b) It is the intent of the Legislature to establish
17 the Healthy Families Florida program as a collaborative effort
18 that builds on existing community-based home visiting and
19 family support resources and will not duplicate the existing
20 services. It is the further intent of the Legislature that
21 the program provide the needed intensity and duration of
22 services that extend beyond those available through Florida's
23 Healthy Start initiative. By creating a Healthy Families
24 Florida program, a major gap in the existing continuum of
25 early childhood prevention and assistance services will be
26 filled.
27 (2) PURPOSE.--The purpose of the program is to
28 strengthen families; promote healthy childhood growth and
29 development; improve childhood immunization rates and
30 well-child care; improve child health outcomes; improve school
31 readiness; increase family self-sufficiency; increase the
2
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 involvement of both parents with their children; and reduce
2 the incidence of child abuse and neglect, through a primary
3 prevention approach that offers home visits and linkages to
4 family supports for families and their newborn children and
5 continues until the children reach 5 years of age.
6 (3) DELIVERY OF SERVICES.--Service delivery under the
7 program shall be community-based and collaborative. Program
8 services shall be integrated and coordinated with services
9 provided under Florida's Healthy Start program and other home
10 visiting and family support service delivery systems currently
11 in place in Florida communities. Services shall be offered
12 with the intensity and duration required to prevent child
13 abuse and neglect and to improve child development and child
14 health outcomes.
15 (4) PROGRAM REQUIREMENTS.--The program shall provide
16 for intensive home visits and include the following critical
17 elements of the Healthy Families America model:
18 (a) Initiation of services. This element provides for:
19 1. Initiation of services prenatally or at birth.
20 2. Use of a standardized assessment tool to
21 systematically identify those families most in need of
22 services. Voluntary participation in this assessment must be
23 clearly stated in the application and paperwork.
24 3. Offering services on a voluntary basis, and using
25 positive, persistent outreach efforts to build family trust.
26 4. Working with family members to identify strengths
27 and resources that can be mobilized to help resolve identified
28 family concerns.
29 (b) Service content. This element provides for:
30
31
3
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 1. Offering services over the long term and
2 intensively, with well-defined criteria for increasing or
3 decreasing the intensity of the service.
4 2. Providing culturally competent services.
5 3. Providing services that focus on supporting parents
6 and families, encouraging the interaction of both parents with
7 their children, and enhancing the development of all children
8 in the family, including reading skills and school readiness.
9 4. Linking families to medical providers to ensure
10 optimal health and development of the children; timely
11 childhood immunizations; well-child care that provides for
12 developmental assessment and is consistent with the standards
13 and periodicity schedules of Medicaid and the American Academy
14 of Pediatrics; and additional services, as needed. Children
15 who are eligible for Medicaid shall be referred for Early
16 Periodic Screening, Diagnosis, and Treatment (EPSDT) services.
17 5. Providing families the opportunity to create
18 neighborhood support systems to address mutual concerns and
19 solve problems without external resources.
20 6. Incorporating specialized services to accommodate
21 the needs of families with substance abuse problems. Staff
22 trained in providing substance abuse services will work with
23 these families to meet their unique needs. Linkages will be
24 developed with existing community-based substance-abuse
25 services.
26 (c) Selection and training of service providers. This
27 element provides for:
28 1. Weighted caseloads of not greater than 25:1 overall
29 and 15:1 for intensive services, for staff providing home
30 visits, as specified in the Healthy Families America model.
31
4
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 2. Selecting home visit providers based on the
2 provider's interpersonal skills; knowledge of community
3 resources; willingness to work with, or experience working
4 with, culturally diverse communities and families; and job
5 skills.
6 3. Ensuring that home visit providers have basic
7 training in areas including, but not limited to: cultural
8 competency, substance abuse, reporting child abuse, domestic
9 violence, drug-exposed infants, child development, services
10 available in the community, infant care and development, and
11 parenting.
12 4. Ensuring that home visit providers have preservice
13 and ongoing training that is specific to their job
14 requirements.
15 5. Ensuring that home visit providers receive ongoing
16 weekly reviews and direct and intensive supervision.
17 6. Ensuring that home visit providers are qualified
18 community-based private, not-for-profit, or public
19 organizations that are credentialed by, are in the process of
20 being credentialed by, or have been granted affiliation with
21 the Healthy Families America Initiative and have strong
22 community support and the social and fiscal capacity to
23 provide the service.
24 (5) HEALTHY FAMILIES FLORIDA ADVISORY COMMITTEE.--In
25 order to gain the efficiencies, advocacy, and broadbased
26 support of a public-private partnership, Healthy Families
27 Florida shall be developed, implemented, and administered by
28 The Ounce of Prevention Fund of Florida. The Department of
29 Children and Family Services shall be the conduit of funds
30 appropriated by the state to The Ounce of Prevention Fund of
31 Florida for Healthy Families Florida. The Department of
5
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 Children and Family Services shall contract with The Ounce of
2 Prevention Fund of Florida for purposes of developing,
3 implementing, and administering the Healthy Families Florida
4 program. There is created a Healthy Families Florida Advisory
5 Committee, which shall assist and advise The Ounce of
6 Prevention Fund of Florida and assure coordination and
7 collaboration with appropriate state agencies and public and
8 private organizations. The advisory committee shall operate
9 under the auspices of The Ounce of Prevention Fund of Florida
10 Board of Directors. The duties of the advisory committee
11 include developing measurable outcomes consistent with the
12 established outcomes of Healthy Families America, reviewing
13 grant applications and recommending grant awards under this
14 section to the Board of Directors of The Ounce of Prevention
15 Fund of Florida, defining the scope of this program, and
16 generally advising The Ounce of Prevention Fund of Florida on
17 the development, implementation, and administration of this
18 program. The Board of Directors of The Ounce of Prevention
19 Fund of Florida has the final approval of grant awards and
20 contracts but may consider only those applicants recommended
21 by the advisory committee. The advisory committee shall
22 consist of nine members, including the Secretary of Children
23 and Family Services or the secretary's designee, the Secretary
24 of Health or the secretary's designee, one representative of
25 TEAM Florida, one representative of the Florida Coalition of
26 Healthy Start Coalitions, two active board members of The
27 Ounce of Prevention Fund of Florida, and two community
28 representatives who have direct experience and significant
29 knowledge of the Healthy Families program, one of whom is to
30 be appointed by the President of the Senate and one of whom is
31 to be appointed by the Speaker of the House of
6
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 Representatives, and one representative of the Family Source,
2 Inc.
3 (6) IMPLEMENTATION.--The Department of Children and
4 Family Services shall contract with The Ounce of Prevention
5 Fund of Florida to develop, implement, and maintain the
6 Healthy Families Florida programs. This contract must be
7 performance-based, including at a minimum the performance
8 standards adopted by the Legislature, and must cover the
9 expenditure of all funds appropriated for Healthy Families
10 Florida other than funds appropriated to the department for a
11 contract manager and for expenses incident to that position.
12 The Ounce of Prevention Fund of Florida under this contractual
13 agreement shall:
14 (a) Using the criteria set forth in this section,
15 implement a community-based Healthy Families Florida program.
16 (b) Award community grants and determine requirements
17 for matching funds. Community grants must be awarded in
18 accordance with weighted criteria based on population
19 demographics, factors associated with child abuse and neglect,
20 and other appropriate criteria developed by the Healthy
21 Families America or the advisory committee. Matching funds may
22 be in-kind or cash as determined by the advisory committee
23 with the approval of The Ounce of Prevention Fund of Florida
24 Board of Directors.
25 (c) Develop a plan of implementation to equitably
26 distribute funds.
27 (d) Require that the following criteria be used in
28 selecting recipients of grant funds:
29 1. Each community must have a community-based lead
30 entity for planning and implementing the Healthy Families
31 program. This lead entity must demonstrate the support,
7
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 integration, and collaboration of existing boards, coalitions,
2 planning groups, business, and consumers. These groups must
3 include, but need not be limited to, the following, if locally
4 established: Healthy Start coalitions, local healthy families
5 steering committees, Success by Six, family preservation and
6 support planning entities, health and human services boards,
7 children's services councils, Head Start boards,
8 prekindergarten early intervention councils, community child
9 care coordinating agencies, school advisory councils,
10 substance abuse and mental health services boards, juvenile
11 justice councils, civic groups, business, and other nonprofit
12 organizations.
13 2. Preference for grant awards must be given to
14 existing community-based entities that have broad
15 representation and have the fiscal and administrative capacity
16 to implement the program.
17 3. Those community-based entities that have been
18 granted affiliation with the Healthy Families America
19 Initiative by the National Committee to Prevent Child Abuse or
20 have been trained by the Healthy Families America Initiative
21 before July 1, 1998, and that meet the criteria set forth in
22 this section must be given preference, during fiscal year
23 1998-1999, for grant awards to fully serve their designated
24 service area.
25 4. The Healthy Families Florida program must
26 complement and coordinate with Healthy Start and other home
27 visiting and family support programs.
28 5. One application per designated service delivery
29 area is to be approved. A designated service area is a county.
30 However, the advisory committee, with the approval of the
31 Board of Directors of The Ounce of Prevention Fund of Florida,
8
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 may grant a waiver of the designated service area which
2 results in reducing or enlarging the designated service area
3 as long as all other criteria set forth in this section are
4 met and there remains only one Healthy Families Florida
5 provider within the new designated service area.
6 6. Each successful grant applicant must seek to be
7 credentialed by Healthy Families of America. To continue
8 qualifying for funding under this section, an entity must
9 achieve these credentials within the specified deadlines
10 articulated by Healthy Families America and must maintain the
11 credentials in good standing for the duration of program
12 operation.
13 7. Each applicant must agree to use a standardized
14 assessment tool consistent with the Healthy Families America
15 credentialing standards and approved by the advisory
16 committee.
17 8. Each applicant must agree to provide outcome and
18 performance data in the format and at the frequency specified
19 by The Ounce of Prevention Fund of Florida.
20 9. Each applicant must identify local resources
21 available for implementation.
22 10. Local assessment and planning for the program must
23 be collaborative and must include representatives from the
24 entities listed in subparagraph 1., if locally established.
25 During the planning phase, these entities, and others as
26 appropriate, shall participate in: a strength-based community
27 assessment process that identifies existing home visiting and
28 family support services and uses existing needs assessments;
29 the grant application and the development of a local
30 implementation plan for service delivery; and the
31
9
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 determination and identification of local funds and resources
2 that will support the implementation of the program.
3 11. Each applicant must show evidence that consumers
4 and families have been involved in the planning and
5 development of the grant application and support the Healthy
6 Families Florida program in the designated service area
7 identified in the grant application.
8 12. Implementation design must include service
9 delivery strategies that, when appropriate, involve both
10 parents when they have shared parental responsibility,
11 regardless of residential custody arrangements.
12 13. Each community must develop mechanisms to identify
13 and refer at-risk children between the ages of 4 months and 3
14 years, who were not identified before the age of 4 months, for
15 other intervention services available in the community.
16 (e) Evaluate and approve the grant applications and
17 the local implementation plans for service delivery.
18 (f) Coordinate service delivery with Healthy Start
19 care coordination.
20 (g) Identify qualified trainers and training
21 opportunities that will assure adequate opportunities for
22 grantees and their communities to provide preservice and
23 inservice training. Funds for training may be incorporated
24 into the grants.
25 (h) Contract with evaluators to develop and implement
26 an evaluation design for the program.
27 (i) Provide for ongoing technical assistance and
28 coordination to each community-based program.
29 (j) Develop and implement a quality assurance and
30 improvement process for the program.
31
10
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 (k) Evaluate the progress of the program and provide
2 an annual report regarding the progress and achievement of
3 designated outcomes to the Governor, the President of the
4 Senate, the Speaker of the House of Representatives, and other
5 vested parties.
6
7 The Ounce of Prevention Fund of Florida may subcontract the
8 performance of tasks or services described in this section.
9 (7) WAIVER.--The Department of Health and the
10 Department of Children and Family Services shall work jointly
11 with the Agency for Health Care Administration to seek a
12 federal waiver to secure Title XIX matching funds for the
13 Healthy Families Florida program. The waiver application shall
14 include allowance to use new and existing general revenue and
15 local contributions. The Department of Children and Family
16 Services and the Agency for Health Care Administration may not
17 implement the federal waiver unless the waiver permits the
18 state to limit enrollment or the amount, duration, and scope
19 of services to ensure that expenditures will not exceed funds
20 appropriated by the Legislature or available from local
21 sources.
22 Section 2. This act shall take effect July 1, 1998.
23
24
25
26
27
28
29
30
31
11
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 CS for SB 1660
300-1773A-98
1 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
2 Senate Bill 1660
3
4
- Specifies that the Healthy Families Program is created
5 within available resources.
6 - Requires that services to families with substance abuse
problems be linked with existing community-based
7 substance abuse services.
8 - Removes the requirement that the Kempe Family Stress
Clinic Checklist be used as the standardized assessment
9 tool in the criteria for selecting recipients of grant
funds.
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
12