House Bill 3377c1

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    Florida House of Representatives - 1998             CS/HB 3377

        By the Committee on Family Law & Children and
    Representatives Frankel, Lynn, Thrasher, Ritchie, Morse,
    Bloom, Wise, Brennan, Bullard, Logan, Reddick, Turnbull,
    Mackenzie, Murman, Brown, Futch, Arnall, Merchant,
    (Additional Sponsors on Last Printed Page)


  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         Children and Family Services; providing for a

10         contract with The Ounce of Prevention Fund of

11         Florida for development, implementation, and

12         administration of the program; establishing the

13         Healthy Families Florida Advisory Committee and

14         providing duties; specifying criteria for

15         community program grant funding; requiring

16         collaboration with existing community boards,

17         coalitions, providers, and planning groups;

18         requiring contracts for evaluation; requiring

19         an annual report; authorizing contracts for

20         specified tasks and services; providing for

21         application for a federal waiver; providing an

22         effective date.

23

24  Be It Enacted by the Legislature of the State of Florida:

25

26         Section 1.  Section 383.145, Florida Statutes, is

27  created to read:

28         383.145  The Healthy Families Florida program.--There

29  is created within available resources the Healthy Families

30  Florida program, a voluntary program for newborn children and

31  their families.

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  1         (1)  LEGISLATIVE FINDINGS AND INTENT.--

  2         (a)  The Legislature finds that family well-being is

  3  critical to a child's health and development, that parenting

  4  is a difficult responsibility, and that most of the assistance

  5  available to Florida's families occurs after there is a

  6  problem, and often provides "too little, too late." Research

  7  has shown that comprehensive early home visitation programs

  8  prevent child abuse, help develop positive parent-child

  9  interactions, and help avoid future social problems. In

10  addition to addressing child abuse, such programs help to

11  ensure that families' social and medical needs are met and

12  that children are ready for success in school. The Legislature

13  finds that Florida needs broad implementation of such a

14  program to help identify families who need and desire

15  assistance in establishing healthy relationships and

16  environments for their children.

17         (b)  It is the intent of the Legislature to establish

18  the Healthy Families Florida program as a collaborative effort

19  that builds on existing community-based home visiting and

20  family support resources and will not duplicate the existing

21  services.  It is the further intent of the Legislature that

22  the program provide the needed intensity and duration of

23  services that extend beyond those available through Florida's

24  Healthy Start initiative. By creating a Healthy Families

25  Florida program, a major gap in the existing continuum of

26  early childhood prevention and assistance services will be

27  filled.

28         (2)  PURPOSE.--The purpose of the program is to

29  strengthen families; promote healthy childhood growth and

30  development; improve childhood immunization rates and

31  well-child care; improve child health outcomes; improve school

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  1  readiness; increase family self-sufficiency; increase the

  2  involvement of both parents with their children; and reduce

  3  the incidence of child abuse and neglect, through a primary

  4  prevention approach that offers home visits and linkages to

  5  family supports for families and their newborn children and

  6  continues until the children reach 5 years of age.

  7         (3)  DELIVERY OF SERVICES.--Service delivery under the

  8  program shall be community-based and collaborative. Program

  9  services shall be integrated and coordinated with services

10  provided under Florida's Healthy Start program and other home

11  visiting and family support service delivery systems currently

12  in place in Florida communities. Services shall be offered

13  with the intensity and duration required to prevent child

14  abuse and neglect and to improve child development and child

15  health outcomes.

16         (4)  PROGRAM REQUIREMENTS.--The program shall provide

17  for intensive home visits and include the following critical

18  elements of the Healthy Families America model:

19         (a)  Initiation of services. This element provides for:

20         1.  Initiation of services prenatally or at birth.

21         2.  Use of a standardized assessment tool to

22  systematically identify those families most in need of

23  services.

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:

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  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.

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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         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 services.

24         (5)  HEALTHY FAMILIES FLORIDA ADVISORY COMMITTEE.--In

25  order to gain the efficiencies, advocacy, and broad-based

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 shall

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  1  contract with The Ounce of Prevention Fund of Florida for

  2  purposes of developing, implementing, and administering the

  3  Healthy Families Florida program. There is created a Healthy

  4  Families Florida Advisory Committee, which shall assist and

  5  advise The Ounce of Prevention Fund of Florida and assure

  6  coordination and collaboration with appropriate state agencies

  7  and public and private organizations. The advisory committee

  8  shall operate under the auspices of the Board of Directors of

  9  The Ounce of Prevention Fund of Florida. The duties of the

10  advisory committee include developing measurable outcomes

11  consistent with the established outcomes of the Healthy

12  Families America Initiative, reviewing grant applications and

13  recommending grant awards under this section to the Board of

14  Directors of The Ounce of Prevention Fund of Florida, defining

15  the scope of this program, and generally advising The Ounce of

16  Prevention Fund of Florida on the development, implementation,

17  and administration of this program. The Board of Directors of

18  The Ounce of Prevention Fund of Florida has the final approval

19  of grant awards and contracts but may consider only those

20  applicants recommended by the advisory committee. The advisory

21  committee shall consist of nine members, including the

22  Secretary of Children and Family Services or the secretary's

23  designee, the Secretary of Health or the secretary's designee,

24  one representative of TEAM Florida, one representative of the

25  Florida Coalition of Healthy Start Coalitions, two active

26  board members of The Ounce of Prevention Fund of Florida, and

27  two community representatives who have direct experience and

28  significant knowledge of the Healthy Families program, one of

29  whom is to be appointed by the President of the Senate and one

30  of whom is to be appointed by the Speaker of the House of

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  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 cover

  7  the expenditure of all funds appropriated for Healthy Families

  8  Florida other than funds appropriated to the department for a

  9  contract manager and for expenses incident to that position.

10  The Ounce of Prevention Fund of Florida under this contractual

11  agreement shall:

12         (a)  Using the criteria set forth in this section,

13  implement a community-based Healthy Families Florida program.

14         (b)  Award community grants and determine requirements

15  for matching funds. Community grants must be awarded in

16  accordance with weighted criteria based on population

17  demographics, factors associated with child abuse and neglect,

18  and other appropriate criteria developed by Healthy Families

19  America or the advisory committee. Matching funds may be

20  in-kind or cash as determined by the advisory committee with

21  the approval of the Board of Directors of The Ounce of

22  Prevention Fund of Florida.

23         (c)  Develop a plan of implementation to equitably

24  distribute funds.

25         (d)  Require that the following criteria be used in

26  selecting recipients of grant funds:

27         1.  Each community must have a community-based lead

28  entity for planning and implementing the Healthy Families

29  program. This lead entity must demonstrate the support,

30  integration, and collaboration of existing boards, coalitions,

31  planning groups, businesses, and consumers. These groups must

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  1  include, but need not be limited to, the following, if locally

  2  established: Healthy Start coalitions, local healthy families

  3  steering committees, Success by Six, family preservation and

  4  support planning entities, health and human services boards,

  5  children's services councils, Head Start boards,

  6  prekindergarten early intervention councils, community child

  7  care coordinating agencies, school advisory councils,

  8  substance abuse and mental health services boards, juvenile

  9  justice councils, civic groups, businesses, and other

10  nonprofit organizations.

11         2.  Preference for grant awards must be given to

12  existing community-based entities that have broad

13  representation and have the fiscal and administrative capacity

14  to implement the program.

15         3.  Those community-based entities that have been

16  granted affiliation with the Healthy Families America

17  Initiative by the National Committee to Prevent Child Abuse or

18  have been trained by the Healthy Families America Initiative

19  prior to July 1, 1998, and that meet the criteria set forth in

20  this section must be given preference, during fiscal year

21  1998-1999, for grant awards to fully serve their designated

22  service area.

23         4.  The Healthy Families Florida program must

24  complement and coordinate with Healthy Start and other home

25  visiting and family support programs.

26         5.  One application per designated service delivery

27  area is to be approved. A designated service area is a county.

28  However, the advisory committee, with the approval of the

29  Board of Directors of The Ounce of Prevention Fund of Florida,

30  may grant a waiver of the designated service area which

31  results in reducing or enlarging the designated service area

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  1  as long as all other criteria set forth in this section are

  2  met and there remains only one Healthy Families Florida

  3  provider within the new designated service area.

  4         6.  Each successful grant applicant must seek to be

  5  credentialed by the Healthy Families America Initiative. To

  6  continue qualifying for funding under this section, an entity

  7  must achieve these credentials within the specified deadlines

  8  articulated by the Healthy Families America Initiative and

  9  must maintain the credentials in good standing for the

10  duration of program operation.

11         7.  Each applicant must agree to use a standardized

12  assessment tool consistent with the credentialing standards of

13  the Healthy Families America Initiative and approved by the

14  advisory committee.

15         8.  Each applicant must agree to provide outcome and

16  performance data in the format and at the frequency specified

17  by The Ounce of Prevention Fund of Florida.

18         9.  Each applicant must identify local resources

19  available for implementation.

20         10.  Local assessment and planning for the program must

21  be collaborative and must include representatives from the

22  entities listed in subparagraph 1., if locally established.

23  During the planning phase, these entities, and others as

24  appropriate, shall participate in: a strength-based community

25  assessment process that identifies existing home visiting and

26  family support services and uses existing needs assessments;

27  the grant application and the development of a local

28  implementation plan for service delivery; and the

29  determination and identification of local funds and resources

30  that will support the implementation of the program.

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  1         11.  Each applicant must show evidence that consumers

  2  and families have been involved in the planning and

  3  development of the grant application and support the Healthy

  4  Families Florida program in the designated service area

  5  identified in the grant application.

  6         12.  Implementation design must include service

  7  delivery strategies that, when appropriate, involve both

  8  parents when they have shared parental responsibility,

  9  regardless of residential custody arrangements.

10         13.  Each community must develop mechanisms to identify

11  and refer at-risk children between the ages of 4 months and 3

12  years, who were not identified before the age of 4 months, for

13  other intervention services available in the community.

14         (e)  Evaluate and approve the grant applications and

15  the local implementation plans for service delivery.

16         (f)  Coordinate service delivery with Healthy Start

17  care coordination.

18         (g)  Identify qualified trainers and training

19  opportunities that will assure adequate opportunities for

20  grantees and their communities to provide preservice and

21  inservice training. Funds for training may be incorporated

22  into the grants.

23         (h)  Contract with evaluators to develop and implement

24  an evaluation design for the program.

25         (i)  Provide for ongoing technical assistance and

26  coordination to each community-based program.

27         (j)  Develop and implement a quality assurance and

28  improvement process for the program.

29         (k)  Evaluate the progress of the program and provide

30  an annual report regarding the progress and achievement of

31  designated outcomes to the Governor, the President of the

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  1  Senate, the Speaker of the House of Representatives, and other

  2  vested parties.

  3

  4  The Ounce of Prevention Fund of Florida may subcontract the

  5  performance of tasks or services described in this section.

  6         (7)  WAIVER.--The Department of Health and the

  7  Department of Children and Family Services shall work jointly

  8  with the Agency for Health Care Administration to seek a

  9  federal waiver to secure Title XIX matching funds for the

10  Healthy Families Florida program. The waiver application shall

11  include allowance to use new and existing general revenue and

12  local contributions. Healthy Families Florida program services

13  shall not be considered an entitlement under this waiver.

14         Section 2.  This act shall take effect July 1 of the

15  year in which enacted.

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19

20                       ADDITIONAL SPONSORS

21
    Dawson-White, Casey, Jones, Fasano, Healey, Hafner, Jacobs,
22
    Crist, Roberts-Burke, Chestnut, Wasserman Schultz, Fischer,
23
    Ritter, Lawson, Bush, D. Prewitt, Silver, Miller, Horan, Hill,
24
    Dennis, Rayson, Kosmas, Betancourt, Cosgrove, Flanagan, Crow,
25
    Ogles, Bainter, Stafford, Albright, Effman, Sanderson,
26
    Westbrook, Boyd, Spratt, Tamargo, Byrd, Kelly, Wallace,
27
    Burroughs, Trovillion, Villalobos, Culp, Livingston, Saunders,
28
    Wiles and Peaden
29

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