Senate Bill 1896
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1896
By Senator Silver
32-1070A-99 See HB
1 A bill to be entitled
2 An act relating to children and families;
3 creating the Families First program
4 demonstration project to provide home visiting
5 by nurses to first-time parents and their
6 infants, for a specified period; providing for
7 integration and coordination of services with
8 existing programs; providing for expected
9 outcomes and critical elements; providing for
10 specialized services; providing duty of the
11 Department of Health to develop, implement, and
12 administer the program; authorizing application
13 for a federal Medicaid waiver; specifying
14 criteria for implementation; providing an
15 effective date.
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17 Be It Enacted by the Legislature of the State of Florida:
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19 Section 1. Families First program.--
20 (1) CREATION.--There is hereby created the Families
21 First program for first-time parents and their newborns. This
22 program is a primary prevention approach that offers a
23 postdelivery birth facility visit, a home visit, and linkages
24 to family supports for families and their newborns. The goal
25 of the program is to reinforce parenting skills in order to
26 improve normal child development and child health outcomes.
27 This service delivery approach must be community-based,
28 collaborative, and nonduplicative with the intent of
29 integrating and coordinating services with Florida's Healthy
30 Start Initiative, Healthy Families Florida, and other home
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1896
32-1070A-99 See HB
1 visiting and family support service delivery systems already
2 in place in communities.
3 (2) EXPECTED OUTCOMES.--The Families First program is
4 designed to increase newborn care skills, to promote normal
5 child development, to improve rates of initiation of
6 immunizations and well-child-care utilization, to impart
7 information regarding planning for future pregnancies, and to
8 reduce unintentional injuries.
9 (3) CRITICAL ELEMENTS.--This program shall provide
10 home visiting using a nurse provider model. The Families
11 First program must:
12 (a) Begin with one postdelivery birth facility visit
13 and include one followup home visit within 14 days after
14 delivery.
15 (b) Provide visits with the consent of families.
16 (c) Offer information regarding available community
17 services ranging from minimum basic information to ongoing
18 services of an intensity and duration to meet the needs of
19 families and their newborns.
20 (d) Provide culturally competent services.
21 (e) Provide services that focus on supporting the
22 parent as well as supporting parent-child interaction and
23 normal child development for all children in the family.
24 (f) Link families to medical providers to ensure
25 optimal health and development, including timely
26 immunizations, well-child care that includes developmental
27 assessment and is consistent with the standards and
28 periodicity schedule recommended by the American Academy of
29 Pediatrics. If eligible for Medicaid, children are referred
30 for Early and Periodic Screening, Diagnosis, and Treatment
31 (EPSDT) now known as Child Health Check-Up.
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1896
32-1070A-99 See HB
1 (g) Select home visiting nurses because of their
2 interpersonal skills, their knowledge of community resources,
3 their willingness to work in or their experience working with
4 culturally diverse communities and families, and their job
5 skills.
6 (h) Ensure that home visiting nurses have core service
7 delivery competencies in areas such as: cultural diversity,
8 substance abuse, child abuse, domestic violence, parent-child
9 interaction models, normal child development,
10 substance-exposed infants and children, and health and social
11 services in their community.
12 (i) Ensure that home visiting nurses have preservice
13 and ongoing training specific to their role and have
14 supervision for assurance of quality and coordination with
15 other home visiting programs.
16 (4) SPECIAL CONSIDERATIONS.--The Families First
17 program shall incorporate: referral to specialized services
18 to accommodate for the needs of substance abusing families;
19 referral for ongoing risk reduction services for families with
20 risk factors that make them eligible for Healthy Start or
21 Healthy Families Florida; referral for other needs as
22 appropriate; and phone numbers to call for further assistance.
23 (5) IMPLEMENTATION.--The Department of Health shall
24 develop, implement, and administer a single-site demonstration
25 project for the Families First program by choosing a
26 collaborative site. Preference shall be given to a site with a
27 federal home visiting program or which has secured grant funds
28 to target the home visiting needs of newborns and their
29 families. The department shall:
30 (a) Work jointly with the Agency for Health Care
31 Administration to seek a federal waiver to secure matching
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1896
32-1070A-99 See HB
1 funds under Title XIX of the Social Security Act (Medicaid)
2 for the Families First program. The federal waiver
3 application shall include allowance to use new and existing
4 general revenue and local contributions. Families First
5 program services are not to be considered an entitlement under
6 this waiver.
7 (b) Implement the Families First program using the
8 criteria provided in this section.
9 (c) Implement the Families First program in
10 collaboration with local Healthy Start coalitions, Healthy
11 Families Florida, and family preservation and support planning
12 entities.
13 (6) The Families First program shall include the
14 following criteria for implementation:
15 (a) The program shall be integrated with Healthy Start
16 and other home visiting and family support programs.
17 (b) The program shall provide outcome and performance
18 data on the number of births, the number of families served,
19 the number of visits provided, the number of families refusing
20 visits, the relationship with other community home visiting
21 providers, and key health outcomes for the community to
22 include immunization initiation rates, injury rates, SIDS
23 deaths and other infant mortality rates, and other information
24 that the program deems to have been affected by the program.
25 (c) Services provided include a brief assessment of
26 strengths and needs, encouraging linkage to other
27 risk-reduction services as appropriate, anticipatory guidance,
28 and information on a range of topics, including brain
29 development, infant care, sleep position, child care provider
30 selection, parent-child interaction, home safety, and other
31 supportive skills.
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1896
32-1070A-99 See HB
1 (d) The department shall link with other statewide
2 home visiting evaluation projects to assess the demonstration
3 project, using the outcome and process data collected by the
4 project.
5 (e) Quality assurance and performance improvement must
6 be an integral part of the local program.
7 (7) Subject to specific appropriation, the Families
8 First demonstration project shall be implemented beginning
9 January 1, 2000. No part of this act shall be implemented
10 unless funding is appropriated therefor.
11 Section 2. This act shall take effect upon becoming a
12 law.
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15 HOUSE SUMMARY
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Creates the Families First program demonstration project,
17 under the Department of Health, to provide for home
visiting by nurses to first-time parents and their
18 newborns, for the purpose of strengthening families,
improving newborn care skills, promoting normal child
19 development, and improving child health outcomes.
Provides for integration with existing programs, such as
20 Healthy Start and Healthy Families Florida, and for links
to other family preservation and support services in the
21 community and to medical providers. Directs the
department to work with the Agency for Health Care
22 Administration to seek a federal waiver to utilize
Medicaid funding for the program. Provides for
23 implementation of the demonstration project beginning
January 1, 2000, if specific appropriation is provided.
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