Senate Bill 1660c2
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Florida Senate - 1998 CS for CS for SB 1660
By the Committees on Governmental Reform and Oversight,
Children, Families and Seniors and Senators Kurth, Myers,
McKay, Brown-Waite, Turner, Klein, Latvala, Harris, Rossin and
Dyer
302-1911B-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; specifying criteria for community
13 program grant funding; requiring collaboration
14 with existing community boards, coalitions,
15 providers, and planning groups; authorizing
16 contracts for training and evaluation;
17 providing for quality assurance; establishing
18 the Healthy Families Florida Advisory
19 Committee; providing for application for a
20 federal waiver; providing an effective date.
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22 Be It Enacted by the Legislature of the State of Florida:
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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.--
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1 (a) The Legislature finds that family well-being is
2 critical to a child's health and development. Research has
3 shown that comprehensive early home visitation programs
4 prevent child abuse, help develop positive parent-child
5 interactions, and help avoid future social problems. In
6 addition to addressing child abuse, such programs help to
7 ensure that families' social and medical needs are met and
8 that children are ready for success in school. The Legislature
9 finds that Florida needs broad implementation of such a
10 program to help identify families who need and desire
11 assistance in establishing healthy relationships and
12 environments for their children.
13 (b) It is the intent of the Legislature to establish
14 the Healthy Families Florida program as a collaborative effort
15 that builds on existing community-based home visiting and
16 family support resources and will not duplicate the existing
17 services. It is the further intent of the Legislature that
18 the program provide the needed intensity and duration of
19 services that extend beyond those available through Florida's
20 Healthy Start initiative. By creating a Healthy Families
21 Florida program, a major gap in the existing continuum of
22 early childhood prevention and assistance services will be
23 filled.
24 (2) PURPOSE.--The purpose of the program is to
25 strengthen families; promote healthy childhood growth and
26 development; improve childhood immunization rates and
27 well-child care; improve child health outcomes; improve school
28 readiness; increase family self-sufficiency; increase the
29 involvement of both parents with their children; and reduce
30 the incidence of child abuse and neglect through a primary
31 prevention approach that offers home visits and linkages to
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1 family supports for families and their newborn children and
2 continues until the children reach 5 years of age.
3 (3) DELIVERY OF SERVICES.--Service delivery under the
4 program shall be community-based and collaborative. Program
5 services shall be integrated and coordinated with services
6 provided under Florida's Healthy Start program and other home
7 visiting and family support service delivery systems currently
8 in place in Florida communities. Services shall be offered
9 with the intensity and duration required to prevent child
10 abuse and neglect and to improve child development and child
11 health outcomes.
12 (4) PROGRAM REQUIREMENTS.--The program shall provide
13 for intensive home visits and include the following critical
14 elements:
15 (a) Initiation of services. This element provides for:
16 1. Initiation of services prenatally or at birth.
17 2. Use of a standardized assessment tool to
18 systematically identify those families most in need of
19 services. Voluntary participation in this assessment must be
20 clearly stated in the application and paperwork.
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.
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1 2. Providing services that are sensitive and
2 appropriate and that respect the cultural differences among
3 participants.
4 3. Providing services that focus on supporting parents
5 and families, encouraging the interaction of both parents with
6 their children, and enhancing the development of all children
7 in the family, including reading skills and school readiness.
8 4. Linking families to medical providers to ensure
9 optimal health and development of the children; timely
10 childhood immunizations; well-child care that provides for
11 developmental assessment and is consistent with the standards
12 and periodicity schedules of Medicaid and the American Academy
13 of Pediatrics; and additional services, as needed. Children
14 who are eligible for Medicaid shall be referred for Early
15 Periodic Screening, Diagnosis, and Treatment (EPSDT) services.
16 5. Providing families the opportunity to create
17 neighborhood support systems to address mutual concerns and
18 solve problems without external resources.
19 6. Incorporating specialized services to accommodate
20 the needs of families with substance abuse problems. Staff
21 trained in providing substance abuse services will work with
22 these families to meet their unique needs. Linkages will be
23 developed with existing community-based, substance-abuse
24 services.
25 (c) Selection and training of service providers. This
26 element provides for:
27 1. Weighted caseloads of not greater than 25:1 overall
28 and 15:1 for intensive services for staff providing home
29 visits. The establishment of weighted caseloads may take into
30 consideration the Healthy Families America model.
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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 (5) IMPLEMENTATION.--In order to gain the
18 efficiencies, advocacy, and broadbased support of a
19 public-private partnership, the Department of Children and
20 Family Services shall contract with a private nonprofit
21 corporation that is incorporated to identify, fund, support,
22 and evaluate programs and community initiatives to improve the
23 development and life outcomes of children and to preserve and
24 strengthen families, with a primary emphasis on prevention.
25 The corporation must be registered, incorporated, organized,
26 and operated in compliance with chapter 617, and shall not be
27 a unit or entity of state government. This contract with the
28 private nonprofit corporation must provide for the
29 development, implementation, and administration of the Healthy
30 Families Florida program. This contract must be
31 performance-based, including at a minimum the performance
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1 standards adopted by the Legislature, and must cover the
2 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 private nonprofit corporation 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 recommended by the advisory
14 committee. Matching funds may be in-kind or cash as determined
15 by the advisory committee with the approval of the private
16 nonprofit corporation's board of directors.
17 (c) Develop a plan of implementation to equitably
18 distribute funds.
19 (d) Require that the following criteria be used in
20 selecting recipients of grant funds:
21 1. Each community must have a community-based lead
22 entity for planning and implementing the Healthy Families
23 Florida program. This lead entity must demonstrate the
24 support, integration, and collaboration of existing boards,
25 coalitions, planning groups, business, and consumers. These
26 groups must include, but need not be limited to, the
27 following, if locally established: Healthy Start coalitions,
28 local healthy families steering committees, Success by Six,
29 family preservation and support planning entities, health and
30 human services boards, children's services councils, Head
31 Start boards, prekindergarten early intervention councils,
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1 community child care coordinating agencies, school advisory
2 councils, substance abuse and mental health services boards,
3 juvenile justice councils, civic groups, business, and other
4 nonprofit organizations.
5 2. Preference for grant awards must be given to
6 existing community-based entities that have broad
7 representation and have the fiscal and administrative capacity
8 to implement the program.
9 3. Those community-based entities that are currently
10 providing intensive home visiting services and that meet the
11 criteria set forth in this section must be given preference,
12 during fiscal year 1998-1999, for grant awards to fully serve
13 their designated service area.
14 4. The Healthy Families Florida program must
15 complement and coordinate with Healthy Start and other home
16 visiting and family support programs.
17 5. One application per designated service delivery
18 area is to be submitted. A designated service area may be a
19 county, any area within a county, or contiguous counties.
20 6. Each successful grant applicant must agree to be
21 credentialed as directed by the private nonprofit
22 corporation's board of directors. Credentialing must be based
23 on the applicant's capacity to provide the critical elements
24 of Healthy Families Florida as defined in paragraphs
25 (4)(a)-(c). To continue qualifying for funding under this
26 section, an entity must achieve these credentials within the
27 specified deadlines articulated by the private nonprofit
28 corporation and must maintain the credentials in good standing
29 for the duration of program operation.
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1 7. Each applicant must agree to use a standardized
2 assessment tool approved by the private nonprofit
3 corporation's board of directors.
4 8. Each applicant must agree to provide outcome and
5 performance data in the format and at the frequency specified
6 by the private nonprofit corporation's board of directors.
7 9. Each applicant must identify local resources
8 available for implementation.
9 10. Local assessment and planning for the program must
10 be collaborative and must include representatives from the
11 entities listed in subparagraph 1., if locally established.
12 During the planning phase, these entities, and others as
13 appropriate, shall participate in: a strength-based community
14 assessment process that identifies existing home visiting and
15 family support services and uses existing needs assessments;
16 the grant application and the development of a local
17 implementation plan for service delivery; and the
18 determination and identification of local funds and resources
19 that will support the implementation of the program.
20 11. Each applicant must show evidence that consumers
21 and families have been involved in the planning and
22 development of the grant application and support the Healthy
23 Families Florida program in the designated service area
24 identified in the grant application.
25 12. Implementation design must include service
26 delivery strategies that, when appropriate, involve both
27 parents when they have shared parental responsibility,
28 regardless of residential custody arrangements.
29 13. Each applicant must identify mechanisms, programs,
30 and services in the designated service-delivery area to refer
31 at-risk children between the ages of 4 months and 3 years, who
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1 were not identified before the age of 4 months, for other
2 intervention services available in the community.
3 (e) Evaluate and approve the grant applications and
4 the local implementation plans for service delivery.
5 (f) Work with the Department of Health and the
6 advisory committee to develop a single, integrated screening
7 and assessment process for Healthy Families Florida and
8 Healthy Start and referrals to other family supports by July
9 1, 2000.
10 (g) Coordinate service delivery with Healthy Start
11 care coordination.
12 (h) Contract to develop and implement preservice and
13 inservice training. Funds for inservice training may be
14 incorporated into the grants.
15 (i) Contract to develop and implement an evaluation
16 design for the program.
17 (j) Provide for ongoing technical assistance and
18 coordination to each community-based program.
19 (k) Develop and implement a quality assurance and
20 improvement process for the program.
21 (l) Evaluate the progress of the program and provide
22 an annual report regarding the progress and achievement of
23 designated outcomes to the Governor, the President of the
24 Senate, the Speaker of the House of Representatives, and other
25 vested parties.
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27 The private nonprofit corporation may subcontract the
28 performance of tasks or services described in this subsection.
29 (6) HEALTHY FAMILIES FLORIDA ADVISORY
30 COMMITTEE.--There is created a Healthy Families Florida
31 Advisory Committee, which shall assist and advise the private
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1 nonprofit corporation 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 private nonprofit corporation's
5 board of directors. The responsibilities of the advisory
6 committee include developing measurable outcomes consistent
7 with the department's performance-based budget, outcomes,
8 measures, and standards; reviewing grant applications and
9 recommending grant awards under this section to the board of
10 directors of the private nonprofit corporation; defining the
11 scope of this program; and generally advising the private
12 nonprofit corporation on the development, implementation, and
13 administration of this program. The board of directors of the
14 private nonprofit corporation has the final approval of grant
15 awards and contracts but may consider only those applicants
16 recommended by the advisory committee. The advisory committee
17 shall consist of eleven members, including the Secretary of
18 Children and Family Services or the secretary's designee, the
19 Secretary of Health or the secretary's designee, one
20 representative of the department's Interagency Workgroup for
21 Children and Families, one representative of the Florida
22 Association of Healthy Start Coalitions, two active board
23 members of the private nonprofit corporation, two community
24 representatives who have direct experience and significant
25 knowledge of the Healthy Families Florida program, two
26 representatives from the business community, and one consumer
27 representative who has direct experience with the Healthy
28 Families Florida program. The President of the Senate shall
29 appoint one community representative and one business
30 representative. The Speaker of the House of Representatives
31 shall appoint one community representative and one business
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1 representative. The Governor shall appoint the consumer
2 representative.
3 (7) WAIVER.--The Department of Health and the
4 Department of Children and Family Services shall work jointly
5 with the Agency for Health Care Administration to seek a
6 federal waiver to secure Title XIX matching funds for the
7 Healthy Families Florida program. The waiver application shall
8 include allowance to use new and existing general revenue and
9 local contributions. The Department of Children and Family
10 Services and the Agency for Health Care Administration may not
11 implement the federal waiver unless the waiver permits the
12 state to limit enrollment or the amount, duration, and scope
13 of services to ensure that expenditures will not exceed funds
14 appropriated by the Legislature or available from local
15 sources.
16 Section 2. This act shall take effect July 1, 1998.
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18 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
19 CS/SB 1660
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21 CS/CS/SB 1660 deletes specific reference to the Ounce of
Prevention Fund of Florida as the corporation determined to be
22 the exclusive contract vendor for Healthy Families Florida.
Instead, a general reference to a private, nonprofit
23 corporation is provided which leaves the contract discretion
to the Secretary of the Department of Children and Families.
24 The advisory board is made purely advisory so that its duties
are not intrusive of the operating responsibilities of the
25 corporation's board of directors. The advisory board is
increased in size from nine to eleven members. There is
26 specific rather than general reference to credentialing
requirements so as to eliminate ambiguities as to what is
27 required of designated providers.
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