CODING: Words stricken are deletions; words underlined are additions.House Bill 1965e1
HB 1965, First Engrossed
1 A bill to be entitled
2 An act relating to health care; creating s.
3 154.501, F.S.; creating the "Primary Care for
4 Children and Families Challenge Grant Act";
5 creating s. 154.502, F.S.; providing
6 legislative findings and intent; creating s.
7 154.503, F.S.; providing for the creation and
8 administration of the Primary Care for Children
9 and Families Challenge Grant Program; creating
10 s. 154.504, F.S.; providing for eligibility and
11 benefits; creating s. 154.505, F.S.; providing
12 an application process and requirements;
13 authorizing contracts for health care services;
14 creating s. 154.506, F.S.; providing for
15 primary care for children and families
16 challenge grant awards; providing for local
17 matching funds; requiring a study and a report;
18 directing the Agency for Health Care
19 Administration to seek federal waivers;
20 repealing s. 766.1115(12), F.S., relating to
21 expiration of the Access to Health Care Act;
22 providing an effective date.
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24 Be It Enacted by the Legislature of the State of Florida:
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26 Section 1. Section 154.501, Florida Statutes, is
27 created to read:
28 154.501 Short title.--Sections 154.501-154.506 may be
29 cited as the "Primary Care for Children and Families Challenge
30 Grant Act."
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HB 1965, First Engrossed
1 Section 2. Section 154.502, Florida Statutes, is
2 created to read:
3 154.502 Legislative findings and intent.--
4 (1) The Legislature finds that, despite significant
5 state investments in health care programs, millions of
6 low-income Floridians, many of them families with children,
7 continue to lack access to basic health care. The Legislature
8 finds that local solutions to health care problems can have a
9 dramatic and positive effect on the health status of children
10 and families. Local governments are better equipped to
11 identify the health care needs of the children and families in
12 their communities, mobilize the community to donate time and
13 services to help their neighbors, and organize health care
14 providers to provide health services to needy children and
15 families.
16 (2) It is the intent of the Legislature to provide
17 matching funds to Florida counties in the form of primary care
18 for children and families challenge grants to stimulate the
19 development of coordinated primary health care delivery
20 systems for low-income, children and families. Further, it is
21 the intent of the Legislature to foster the development of
22 coordinated primary health care delivery systems which
23 emphasize volunteerism, cooperation, and broad-based
24 participation by public and private health care providers.
25 Finally, it is the intent of the Legislature that the Primary
26 Care for Children and Families Challenge Grant Program
27 function as a partnership between state and local governments
28 and private sector health care providers.
29 Section 3. Section 154.503, Florida Statutes, is
30 created to read:
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HB 1965, First Engrossed
1 154.503 Primary Care for Children and Families
2 Challenge Grant Program; creation; administration.--
3 (1) Effective July 1, 1997, there is created the
4 Primary Care for Children and Families Challenge Grant Program
5 to be administered by the Department of Health.
6 (2) The department shall:
7 (a) Publicize the availability of funds and the method
8 by which a county or counties may submit a primary care for
9 children and families challenge grant application.
10 (b) Develop a quality assurance process to monitor the
11 quality of health services provided under ss. 154.501-154.506.
12 (c) Provide technical assistance, as requested, to
13 primary care for children and families challenge grant
14 recipients.
15 (d) Develop uniform data reporting requirements for
16 primary care for children and families challenge grant
17 recipients, for the purpose of evaluating the performance of
18 the projects.
19 (e) Coordinate with the primary care program developed
20 pursuant to s. 154.011, the Florida Healthy Kids Corporation
21 program created in s. 624.91, the school health services
22 program created in ss. 402.32 and 402.321, the Healthy
23 Communities, Healthy People Program created in s. 408.604, and
24 the volunteer health care provider program developed pursuant
25 to s. 766.1115.
26 (3) A primary care for children and families challenge
27 grant shall be in effect for 1 year and may be renewed for
28 additional years upon application to and approval by the
29 department, subject to meeting quality standards and outcomes,
30 and subject to the availability of funds.
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HB 1965, First Engrossed
1 (4) The department is authorized to adopt rules
2 necessary to implement ss. 154.501-154.506.
3 Section 4. Section 154.504, Florida Statutes, is
4 created to read:
5 154.504 Eligibility and benefits.--
6 (1) Any county or counties may apply for a primary
7 care for children and families challenge grant to provide
8 primary health care services to children and families with
9 incomes of up to 150 percent of the federal poverty level.
10 Participants shall pay no monthly premium for participation,
11 but shall be required to pay a copayment at the time a service
12 is provided. Copayments may be paid from sources other than
13 the participant, including, but not limited to, the child's or
14 parent's employer, or other private sources.
15 (2) Nothing in this section shall prevent counties
16 with populations less than 100,000, based on the annual
17 estimates produced by the Population Program of the University
18 of Florida Bureau of Economic and Business Research, from
19 submitting a multi-county application for a primary care for
20 children and families challenge grant to jointly administer
21 and operate a coordinated multi-county primary care for
22 children and families program under ss. 154.501-154.506.
23 However, when such counties submit a joint application, the
24 application shall clearly identify one lead county with
25 respect to program accountability and administration.
26 (3) Each county or group of counties submitting an
27 application to participate in the Primary Care for Children
28 and Families Challenge Grant Program shall develop a schedule
29 of benefits and services appropriate for the population to be
30 served. However, at a minimum, such benefits must cover
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HB 1965, First Engrossed
1 preventive and primary care services and include a
2 coordination mechanism for limited inpatient hospital care.
3 Section 5. Section 154.505, Florida Statutes, is
4 created to read:
5 154.505 Proposals; application process; minimum
6 requirements.--
7 (1) Any county or counties which desire to receive
8 state funding under ss. 154.501-154.506 shall submit an
9 application to the department. The department shall develop
10 an application process for the Primary Care for Children and
11 Families Challenge Grant Program.
12 (2) Applications shall be competitively reviewed by an
13 independent panel appointed by the secretary of the
14 department. This panel shall determine the relative weight
15 for scoring and evaluating each of the following elements to
16 be used in the evaluation process:
17 (a) The target population to be served.
18 (b) The health benefits to be provided.
19 (c) The proposed service network, including specific
20 health care providers and health care facilities that will
21 participate in the service network on a paid or voluntary
22 basis.
23 (d) The methods that will be used to measure
24 cost-effectiveness.
25 (e) How patient and provider satisfaction will be
26 measured.
27 (f) The proposed internal quality assurance process.
28 (g) Projected health status outcomes.
29 (h) The way in which data to measure the
30 cost-effectiveness, outcomes, and overall performance of the
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HB 1965, First Engrossed
1 program will be collected, including a description of the
2 proposed information system.
3 (i) All local resources, including cash, in-kind,
4 voluntary, or other resources, that will be dedicated to the
5 proposal.
6 (3) Preference shall be given to proposals which:
7 (a) Exceed the minimum local contribution requirements
8 specified in s. 154.506.
9 (b) Demonstrate broad-based local support for the
10 project, including, but not limited to, agreements to
11 participate in the service network, letters of endorsement, or
12 other forms of support.
13 (c) Demonstrate a high degree of participation by
14 health care providers on a free or volunteer basis, or through
15 financial contributions. This may include participation by
16 publicly or privately funded health care providers, such as,
17 hospitals, county health departments, community health
18 centers, or rural health clinics, in the service network.
19 (d) Are submitted by counties with a high proportion
20 of children and families living in poverty and with poor
21 health status indicators.
22 (e) Demonstrate coordinated service delivery with
23 existing publicly financed health care programs, including
24 those programs specified in s. 154.503(2)(e).
25 (4) Nothing in ss. 154.501-154.506 shall prevent a
26 county or group of counties from contracting for the provision
27 of health care services. A service network may include, but
28 need not be limited to, special health care districts, county
29 health departments, federally qualified health centers,
30 community health centers, and rural health clinics.
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HB 1965, First Engrossed
1 Section 6. Section 154.506, Florida Statutes, is
2 created to read:
3 154.506 Primary care for children and families
4 challenge grant awards.--
5 (1) Primary care for children and families challenge
6 grants shall be awarded on a matching basis. The county or
7 counties shall provide $1 in local matching funds for each $2
8 grant payment made by the state. Except as provided in
9 subsection (2), up to 50 percent of the county match may be
10 in-kind in the form of free hospital and physician services.
11 However, a county shall not supplant the value of donated
12 services in fiscal year 1996 as documented in the volunteer
13 health care provider program annual report. The department
14 shall develop a methodology for determining the value of an
15 in-kind match. Any third party reimbursement and all fees
16 collected shall not be considered local match or in-kind
17 contributions. Fifty percent of the local match shall be in
18 the form of cash.
19 (2) A small county with a population of no more than
20 50,000 may provide the required local matching funds entirely
21 through an in-kind contribution as long as the new system of
22 care produces an increase in patients served or services
23 delivered, or both.
24 (3) Grant awards shall be based on a county's
25 population size, or each individual county's size in a group
26 of counties, and other factors, in an amount as determined by
27 the department. However, for fiscal year 1997-98, no fewer
28 than four grants shall be awarded.
29 (4) Children and families eligible for other state and
30 federally financed health care programs shall exhaust all
31 health care benefits funded through those programs prior to
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HB 1965, First Engrossed
1 receiving health services through the primary care for
2 children and families challenge grant. A program funded under
3 this act may bill for third party reimbursement for services
4 provided.
5 (5) Implementation of the Primary Care for Children
6 and Families Challenge Grant Program shall be subject to the
7 allocation of a specific appropriation in the General
8 Appropriations Act.
9 Section 7. (1) It is the intent of the Legislature
10 that there be an evaluation of the various health care
11 programs serving children and families.
12 (2) The Agency for Health Care Administration, in
13 conjunction with the Department of Health, shall evaluate the
14 cost benefits, program effectiveness, and quality outcomes
15 associated with a service delivery model versus an insurance
16 coverage model. The evaluation shall account for program
17 differences with regard to eligibility coverages, benefits,
18 population differences, and other factors that may affect
19 program operations. This evaluation shall include, but not
20 be limited to, Medicaid, the Primary Care for Children and
21 Families Challenge Grant Program, the Children's Medical
22 Services alternative service network, and the Florida Healthy
23 Kids Corporation program. The agency shall submit a report of
24 its findings to the Legislature and the Governor by January 1,
25 1999.
26 Section 8. The Agency for Health Care Administration,
27 working jointly with the Department of Health and the Florida
28 Healthy Kids Corporation, is directed to seek federal waivers
29 to secure Title XIX matching funds for the Florida Healthy
30 Kids program and the Primary Care for Children and Families
31 Challenge Grant. The federal waiver application shall seek
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HB 1965, First Engrossed
1 Medicaid matching funds for all general revenue, family
2 contributions, and local contributions. The number of persons
3 supported with federal matching funds under the Florida
4 Healthy Kids Corporation shall not exceed the number annually
5 specified in the General Appropriations Act.
6 Section 9. Effective June 30, 1997, subsection (12) of
7 section 766.1115, Florida Statutes, as created by section 1 of
8 chapter 92-278, Laws of Florida, is hereby repealed.
9 Section 10. This act shall take effect upon becoming a
10 law.
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