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.

16

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

18

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.

13

14            *****************************************

15                          HOUSE SUMMARY

16
      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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