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House Bill 3377

Florida House of Representatives - 1998 HB 3377 By Representatives Frankel, Lynn, Thrasher, Ritchie, Morse, Bloom, Wise, Brennan, Bullard, Logan, Reddick, Turnbull, Mackenzie, Murman, Brown, Futch, Arnall, Merchant, Dawson-White, Casey and Jones 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 for rules; providing an effective 21 date. 22 23 Be It Enacted by the Legislature of the State of Florida: 24 25 Section 1. Section 383.145, Florida Statutes, is 26 created to read: 27 383.145 The Healthy Families Florida program.--There 28 is created the Healthy Families Florida program, a voluntary 29 program for newborn children and their families. 30 (1) LEGISLATIVE FINDINGS AND INTENT.-- 31 1 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-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 House of Representatives - 1998 HB 3377 115-175B-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. 23 3. Offering services on a voluntary basis, and using 24 positive, persistent outreach efforts to build family trust. 25 4. Working with family members to identify strengths 26 and resources that can be mobilized to help resolve identified 27 family concerns. 28 (b) Service content. This element provides for: 29 1. Offering services over the long term and 30 intensively, with well-defined criteria for increasing or 31 decreasing the intensity of the service. 3 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 1 2. Providing culturally competent services. 2 3. Providing services that focus on supporting parents 3 and families, encouraging the interaction of both parents with 4 their children, and enhancing the development of all children 5 in the family. 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. 31 4 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 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, and services available in the 5 community. 6 4. Ensuring that home visit providers have preservice 7 and ongoing training that is specific to their job 8 requirements. 9 5. Ensuring that home visit providers receive ongoing 10 weekly reviews and direct and intensive supervision. 11 (5) HEALTHY FAMILIES FLORIDA STATEWIDE BOARD.--The 12 program shall be developed, implemented, and administered by 13 the Department of Health and the Department of Children and 14 Family Services, or their designees, in cooperation with other 15 appropriate state agencies and public and private 16 organizations. For this purpose, there is created a Healthy 17 Families Florida Statewide Board of Directors composed of the 18 Secretary of Health, the Secretary of Children and Family 19 Services, and 11 members from other state agencies and public 20 and private organizations, one of whom shall be a parent 21 representative. The board shall be co-chaired by the Secretary 22 of Health and the Secretary of Children and Family Services. 23 The members shall be jointly appointed by the Secretary of 24 Health and the Secretary of Children and Family Services. The 25 board shall also be responsible for defining the scope of the 26 program, awarding grants to communities to implement the 27 program, and evaluating the program's progress toward 28 achieving measurable outcomes. The Department of Health and 29 the Department of Children and Family Services shall provide 30 clerical and staff support as may be reasonably needed by the 31 board for the proper performance of its duties, including, but 5 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 1 not limited to, program development, technical assistance, and 2 program monitoring. In the event of any statutory change to 3 the structure or organization of the Department of Health or 4 the Department of Children and Family Services, the board 5 shall be reconstituted for purposes of implementing this 6 section, replacing the original board member with the head of 7 the new department or agency having the same or similar 8 functions. 9 (6) IMPLEMENTATION.--The Department of Health and the 10 Department of Children and Family Services, or their 11 designees, shall: 12 (a) Implement a community-based Healthy Families 13 Florida program using the criteria provided in this section. 14 (b) Award community grants and determine requirements 15 for local matching funds using a weighted criteria based on 16 population demographics, factors associated with child abuse 17 and neglect, and other criteria developed by the Healthy 18 Families Florida Statewide Board. 19 (c) Require the following selection criteria for grant 20 funding: 21 1. Each community must select the local lead planning 22 and implementation entity for the Healthy Families program. 23 Existing boards, coalitions, planning groups, and consumers 24 shall be involved in selecting the lead entity. These groups 25 shall include, but are not limited to, the following, if 26 locally established: Healthy Start coalitions, local healthy 27 families steering committees, family preservation and support 28 planning entities, health and human services boards, 29 children's services councils, Head Start boards, 30 prekindergarten early intervention councils, community child 31 care coordinating agencies, school advisory councils, 6 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 1 substance abuse and mental health services boards, and 2 juvenile justice councils. 3 2. When selecting the local lead planning and 4 implementation entity for Healthy Families Florida, each 5 community shall give preference to existing entities that have 6 broad representation and have the fiscal and administrative 7 capacity to implement the program. 8 3. The Healthy Families Florida program must build on 9 and be integrated with Healthy Start and other home visiting 10 and family support programs and must target geographic areas 11 at high risk of child abuse and neglect. 12 4. One application per designated service delivery 13 area shall be submitted for approval. 14 5. Each applicant community must agree to seek 15 national Healthy Families America credentialing within 2 years 16 after implementing the program. 17 6. Each applicant community must agree to use the 18 Kempe Family Stress Checklist or other standardized assessment 19 tool approved by the Healthy Families Florida Statewide Board. 20 7. Each applicant community must agree to provide 21 outcome and performance data in the format and at the 22 frequency specified by the board. 23 8. Each applicant community must identify local 24 resources available for implementation. 25 9. Local assessment and planning for the program must 26 be collaborative and include representatives from the entities 27 listed in subparagraph 1., if locally established. During the 28 planning phase, these entities, and others as appropriate, 29 shall participate in: a strength-based community assessment 30 process that identifies existing home visiting and family 31 support services and uses existing needs assessments; the 7 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 1 grant application and the development of a local 2 implementation plan for service delivery; and the 3 determination and identification of local funds and resources 4 that will support the implementation of the program. 5 10. Each community must show evidence that consumers 6 and families have been involved in the planning and 7 development of the grant application and support the Healthy 8 Families Florida program in the targeted area identified in 9 the grant application. 10 11. Implementation design must include service 11 delivery strategies that, when appropriate, involve both 12 parents who have shared parental responsibility, regardless of 13 residential custody arrangements. 14 12. Each community must develop mechanisms to refer 15 at-risk children ages 4 to 36 months, who were not identified 16 before age 4 months, for other intervention services available 17 in the community. 18 (d) Evaluate and approve the grant applications and 19 the local implementation plans for service delivery. 20 (e) Enhance the Healthy Start postnatal risk 21 screening, to include factors associated with child abuse and 22 neglect. 23 (f) Coordinate service delivery with Healthy Start 24 care coordination, as specified in the service delivery plans 25 of the Healthy Start coalitions. 26 (g) Contract with providers to establish a statewide 27 training program and to develop and provide preservice and 28 inservice training and ongoing technical assistance to each 29 community-based program. 30 (h) Contract with evaluators to develop and implement 31 an evaluation design for the program. 8 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 1 (i) Develop and implement a quality assurance and 2 improvement process for the program. 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. Healthy Families Florida program services 10 shall not be considered an entitlement under this waiver. 11 (8) RULES.--The Department of Health, with the 12 concurrence of the Department of Children and Family Services, 13 may adopt rules to implement the program. These rules may 14 include criteria for provider selection, provisions for 15 provider contracts and reimbursement provisions for data 16 collection and reporting, and requirements for program design, 17 program services, staff qualifications, service delivery, and 18 state and local agency coordination. 19 Section 2. This act shall take effect July l of the 20 year in which enacted. 21 22 23 24 25 26 27 28 29 30 31 9 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1998 HB 3377 115-175B-98 1 ***************************************** 2 HOUSE SUMMARY 3 Creates the Healthy Families Florida program, a voluntary 4 program to promote the health of newborns and their families. Provides for integration with existing 5 community-based family support service delivery systems. Specifies requirements relating to initiation and content 6 of services and selection and training of service providers. Provides for development, implementation, and 7 administration of the program under the Department of Health, the Department of Children and Family Services, 8 and the Healthy Families Florida Statewide Board established pursuant to the act. Provides for locally 9 matched grants. Specifies criteria for community program grant funding. Requires collaboration with existing 10 community boards, coalitions, providers, and planning groups. Authorizes contracts for training and evaluation. 11 Provides for quality assurance. Requires the departments and agency to seek a federal waiver to secure federal 12 matching funds. Provides that the program is not an entitlement. Provides for rules. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 10