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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Florida House of Representatives - 1998 CS/HB 3377
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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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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
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