House Bill 2091
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Florida House of Representatives - 1999 HB 2091
By the Committee on Children & Families and Representative
Murman
1 A bill to be entitled
2 An act relating to child welfare; amending s.
3 216.136, F.S.; revising duties of the Child
4 Welfare System Estimating Conference; amending
5 s. 409.1671, F.S.; revising requirements
6 relating to the plan for privatization of
7 foster care and related services; requiring
8 community-based agencies providing foster care
9 and related services under contract with the
10 Department of Children and Family Services to
11 obtain certain liability insurance coverage;
12 requiring such coverage for such agencies'
13 subcontractors; providing limitations on tort
14 actions; providing exclusiveness of liability;
15 providing a hiring preference for certain state
16 employees whose positions are privatized;
17 revising timeframe for an annual report;
18 authorizing certain substitute care providers
19 to provide family day care services; providing
20 reimbursement eligibility for dually licensed
21 providers; continuing privatized foster care
22 and related services in district 5 of the
23 department for a specified period; providing
24 for distribution, transfer, and use of certain
25 excess or additional funds for foster care and
26 related services provided under contract with
27 the department; amending s. 409.175, F.S.;
28 providing for state insurance coverage for
29 persons who own or operate family foster care
30 homes for community-based agencies providing
31 foster care under contract with the department;
1
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1 amending s. 409.912, F.S.; authorizing the
2 Agency for Health Care Administration to
3 contract with community-based agencies for
4 services to Medicaid recipients; requiring a
5 waiver from the federal Health Care Finance
6 Administration; providing the form of payment
7 for such services; providing for establishment
8 of a targeted case management program;
9 providing funding limitations; providing an
10 effective date.
11
12 Be It Enacted by the Legislature of the State of Florida:
13
14 Section 1. Paragraph (a) of subsection (8) of section
15 216.136, Florida Statutes, 1998 Supplement, is amended to
16 read:
17 216.136 Consensus estimating conferences; duties and
18 principals.--
19 (8) CHILD WELFARE SYSTEM ESTIMATING CONFERENCE.--
20 (a) Duties.--The Child Welfare System Estimating
21 Conference shall develop such official the following
22 information relating to the child welfare system of the state,
23 including forecasts of child welfare caseloads, as the
24 conference determines is needed for the state planning and
25 budgeting system. Such official information may include, but
26 not be limited to:
27 1. Estimates and projections of the number of initial
28 and additional reports of child abuse, abandonment, or neglect
29 made to the central abuse hotline maintained by the Department
30 of Children and Family Services as established in s.
31 39.201(4).
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1 2. Estimates and projections of the number of children
2 who are alleged to be victims of child abuse, abandonment, or
3 neglect and are in need of emergency shelter, protective
4 services, family reunification, foster care, residential group
5 care, adoptive services, or other appropriate care placement
6 in a shelter.
7
8 In addition, the conference shall develop other official
9 information relating to the child welfare system of the state
10 which the conference determines is needed for the state
11 planning and budgeting system. The Department of Children and
12 Family Services shall provide information on the child welfare
13 system requested by the Child Welfare System Estimating
14 Conference, or individual conference principals, in a timely
15 manner.
16 Section 2. Paragraph (a) of subsection (1),
17 subsections (2), (4), and (5), and paragraph (a) of subsection
18 (3) of section 409.1671, Florida Statutes, 1998 Supplement,
19 are amended, paragraphs (c) through (h) are added to
20 subsection (1), and subsection (7) is added to said section,
21 to read:
22 409.1671 Foster care and related services;
23 privatization.--
24 (1)(a) It is the intent of the Legislature that the
25 Department of Children and Family Services shall privatize the
26 provision of foster care and related services statewide. As
27 used in this section, the term "privatize" means to contract
28 with competent, community-based agencies. The department
29 shall submit a plan to accomplish privatization statewide,
30 through a competitive process, phased in over a 3-year period
31 beginning January 1, 2000. This plan is to be submitted by
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1 July 1, 1999, to the President of the Senate, the Speaker of
2 the House of Representatives, the Governor, and the minority
3 leaders of both houses. This plan must be developed with local
4 community participation, including, but not limited to, input
5 from the district health and human services board and
6 community-based providers that are currently under contract
7 with the department to furnish community-based foster care and
8 related services, and must include a methodology for
9 determining and transferring all available funds, including
10 federal funds that the provider is eligible for and agrees to
11 earn and that portion of general revenue funds which is
12 currently associated with the services that are being
13 furnished under contract. The methodology must provide for the
14 transfer of funds appropriated and budgeted for all services
15 and programs that have been incorporated into the project,
16 including all management, capital (including current furniture
17 and equipment), and administrative funds to accomplish the
18 transfer of these programs. This methodology must address
19 expected workload and at least the 3 previous years'
20 experience in expenses and workload. With respect to any
21 district or portion of a district in which privatization
22 cannot be accomplished within the 3-year timeframe, the
23 department must clearly state in its plan the reasons the
24 timeframe cannot be met and the efforts that should be made to
25 remediate the obstacles, which may include alternatives to
26 total privatization, such as public-private partnerships. As
27 used in this section, the term "related services" means family
28 preservation, independent living, emergency shelter,
29 residential group care, foster care, therapeutic foster care,
30 intensive residential treatment, foster care supervision, case
31 management, postplacement supervision, permanent foster care,
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1 adoption, and family reunification. Unless otherwise provided
2 for, beginning in fiscal year 1999-2000, either the state
3 attorney or the Office of the Attorney General shall provide
4 child welfare legal services, pursuant to chapter 39 and other
5 relevant provisions, in Sarasota, Pinellas, Pasco, and Manatee
6 Counties. Such legal services shall commence and be
7 effective, as soon as determined reasonably feasible by the
8 respective state attorney or the Office of the Attorney
9 General, after the privatization of associated programs and
10 child protective investigations has occurred. When a private
11 nonprofit agency has received case management
12 responsibilities, transferred from the state under this
13 section, for a child who is sheltered or found to be dependent
14 and who is assigned to the care of the privatization project,
15 the agency may act as the child's guardian for the purpose of
16 registering the child in school if a parent or guardian of the
17 child is unavailable and his or her whereabouts cannot
18 reasonably be ascertained. The private nonprofit agency may
19 also seek emergency medical attention for such a child, but
20 only if a parent or guardian of the child is unavailable, his
21 or her whereabouts cannot reasonably be ascertained, and a
22 court order for such emergency medical services cannot be
23 obtained because of the severity of the emergency or because
24 it is after normal working hours. However, the provider may
25 not consent to sterilization, abortion, or termination of life
26 support. If a child's parents' rights have been terminated,
27 the nonprofit agency shall act as guardian of the child in all
28 circumstances.
29 (c) Any community-based agency that provides foster
30 care and related services to children and families under
31 contract with the department pursuant to this section must, as
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1 a part of its contract, obtain general liability insurance
2 coverage. Any tort action brought against an eligible lead
3 community-based provider shall be limited to net economic
4 damages, including, but not limited to, past and future
5 medical expenses, wage loss, and loss of earning capacity,
6 offset by any collateral source payments paid. Any offset of
7 collateral source payments made as of the date of the
8 settlement or judgment shall be in accordance with s. 768.76.
9 The state shall hold harmless the private providers for
10 noneconomic damages over $200,000 pursuant to s. 768.28.
11 (d) The liability of an eligible lead community-based
12 provider prescribed in this section shall be exclusive and in
13 place of all other liability of such provider. The same
14 immunities from liability enjoyed by such providers shall
15 extend as well to each employee of the provider when such
16 employee is acting in furtherance of the provider's business.
17 Such immunities shall not be applicable to a provider or an
18 employee who acts in a culpably negligent manner or with
19 unprovoked physical aggression when such acts result in injury
20 or death or such acts proximately cause such injury or death,
21 nor shall such immunities be applicable to employees of the
22 same provider when each is operating in the furtherance of the
23 provider's business, but they are assigned primarily to
24 unrelated works within private or public employment. The same
25 immunity provisions enjoyed by a provider shall also apply to
26 any sole proprietor, partner, corporate officer or director,
27 supervisor, or other person who in the course and scope of his
28 or her duties acts in a managerial or policymaking capacity
29 and the conduct which caused the alleged injury arose within
30 the course and scope of said managerial or policymaking duties
31 and was not a violation of a law, whether or not a violation
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1 was charged, for which the maximum penalty which may be
2 imposed does not exceed 60 days' imprisonment as set forth in
3 s. 775.082.
4 (e) Any subcontractor of an eligible lead
5 community-based agency that provides foster care and related
6 services to children and families under contract with the
7 department pursuant to this section must, as a part of its
8 subcontract, be covered under a general liability insurance
9 policy. Any tort action brought against a subcontractor of an
10 eligible lead community-based provider which is a direct
11 provider of foster care and related services shall be limited
12 to net economic damages, including, but not limited to, past
13 and future medical expenses, wage loss, and loss of earning
14 capacity, offset by any collateral source payments paid. Any
15 offset of collateral source payments made as of the date of
16 the settlement or judgment shall be in accordance with s.
17 768.76. The state shall hold harmless the private providers
18 for noneconomic damages over $200,000 pursuant to s. 768.28.
19 (f) The liability of a subcontractor of an eligible
20 lead community-based provider which is a direct provider of
21 foster care and related services as prescribed in this section
22 shall be exclusive and in place of all other liability of such
23 provider. The same immunities from liability enjoyed by such
24 subcontractor provider shall extend as well to each employee
25 of the subcontractor when such employee is acting in
26 furtherance of the subcontractor's business. Such immunities
27 shall not be applicable to a subcontractor or an employee who
28 acts in a culpably negligent manner or with unprovoked
29 physical aggression when such acts result in injury or death
30 or such acts proximately cause such injury or death, nor shall
31 such immunities be applicable to employees of the same
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1 subcontractor when each is operating in the furtherance of the
2 subcontractor's business, but they are assigned primarily to
3 unrelated works within private or public employment. The same
4 immunity provisions enjoyed by a subcontractor shall also
5 apply to any sole proprietor, partner, corporate officer or
6 director, supervisor, or other person who in the course and
7 scope of his or her duties acts in a managerial or
8 policymaking capacity and the conduct which caused the alleged
9 injury arose within the course and scope of said managerial or
10 policymaking duties and was not a violation of a law, whether
11 or not a violation was charged, for which the maximum penalty
12 which may be imposed does not exceed 60 days' imprisonment as
13 set forth in s. 775.082.
14 (g) The Legislature is cognizant of the increasing
15 costs of goods and services each year and recognizes that
16 fixing a set amount of compensation actually has the effect of
17 a reduction in compensation each year. Accordingly, the
18 conditional limitation on noneconomic damages in this section
19 shall be increased at the rate of 5 percent each year,
20 prorated from the effective date of this paragraph to the date
21 at which noneconomic damages subject to such limitation are
22 awarded by final judgment or settlement.
23 (h) If any paragraph, sentence, clause, phrase, or
24 word of this subsection is for any reason held or declared to
25 be unconstitutional, invalid, inoperative, ineffective,
26 inapplicable, or void, such invalidity or unconstitutionality
27 shall not affect the portions of this subsection not so held
28 to be unconstitutional, void, invalid, or ineffective, or
29 affect the application of this subsection to other
30 circumstances not so held to be invalid, it being the express
31 legislative intent that any such unconstitutional, illegal,
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1 invalid, ineffective, inapplicable, or void portion or
2 portions of this subsection did not induce its passage, and
3 that without the inclusion of any such unconstitutional,
4 illegal, invalid, ineffective, or void portions of this
5 subsection, the Legislature would have enacted the valid and
6 constitutional portions thereof.
7 (2)(a) The department may contract for the delivery,
8 administration, or management of protective services, the
9 services specified in subsection (1) relating to foster care,
10 and other related services or programs, as appropriate. The
11 department shall retain responsibility for the quality of
12 contracted services and programs and shall ensure that
13 services are delivered in accordance with applicable federal
14 and state statutes, rules, and regulations.
15 (b) Persons employed by the department in the
16 provision of foster care and related services whose positions
17 are privatized pursuant to this section shall be given hiring
18 preference by the provider, if provider qualifications are
19 met.
20 (3)(a) The department shall establish a quality
21 assurance program for privatized services. The quality
22 assurance program may be performed by a national accrediting
23 organization such as the Council on Accreditation of Services
24 for Families and Children, Inc. (COA) or the Council on
25 Accreditation of Rehabilitation Facilities (CARF). The
26 department shall develop a request for proposal for such
27 oversight. This program must be developed and administered at
28 a statewide level. The Legislature intends that the department
29 be permitted to have limited flexibility to use funds for
30 improving quality assurance. To this end, effective January 1,
31 2000, the department may transfer up to 0.125 percent of the
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1 total funds from categories used to pay for these
2 contractually provided services, but the total amount of such
3 transferred funds may not exceed $300,000 in any fiscal year.
4 When necessary, the department may establish, in accordance
5 with s. 216.177, additional positions that will be exclusively
6 devoted to these functions. Any positions required under this
7 paragraph may be established, notwithstanding ss.
8 216.262(1)(a) and 216.351. The department, in consultation
9 with the community-based agencies that are undertaking the
10 privatized projects, shall establish minimum thresholds for
11 each component of service, consistent with standards
12 established by the Legislature. Each program operated under
13 contract with a community-based agency must be evaluated
14 annually by the department. The department shall submit an
15 annual report regarding quality performance, outcome measure
16 attainment, and cost efficiency to the President of the
17 Senate, the Speaker of the House of Representatives, the
18 minority leader of each house of the Legislature, and the
19 Governor no later than November 30 January 31 of each year for
20 each project in operation during the preceding fiscal year.
21 (4)(a) The community-based agency must comply with
22 statutory requirements and agency rules in the provision of
23 contractual services. Each foster home, therapeutic foster
24 home, emergency shelter, or other placement facility operated
25 by the community-based agency or agencies must be licensed by
26 the Department of Children and Family Services under chapter
27 402 or this chapter. Each community-based agency must be
28 licensed as a child-caring or child-placing agency by the
29 department under this chapter. The department, in order to
30 eliminate or reduce the number of duplicate inspections by
31
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1 various program offices, shall coordinate inspections required
2 pursuant to licensure of agencies under this section.
3 (b) Substitute care providers licensed under s.
4 409.175 and contracted with a lead agency authorized under
5 this section shall also be authorized to provide registered or
6 licensed family day care under s. 402.313, provided that:
7 1. The home has met the requirements of s. 402.313.
8 2. The home has met the requirements of s. 402.281 and
9 has received Gold Seal Quality Care designation.
10 (c) A dually licensed home under this subsection shall
11 be eligible to receive both the foster care board rate and the
12 subsidized child care rate for the same child only if care is
13 provided 24 hours per day. The subsidized child care rate
14 shall be no more than the approved full-time rate.
15 (5) Beginning January 1, 1999, and continuing at least
16 through June 30, 2000 December 31, 1999, the Department of
17 Children and Family Services shall privatize all foster care
18 and related services in district 5 and shall expand the
19 privatization for the care model in district 12 while
20 continuing to contract with the current model programs in
21 districts 1, 4, and 13, and in subdistrict 8A, and shall
22 expand the subdistrict 8A pilot program to incorporate Manatee
23 County. Planning for the district 5 privatization shall be
24 done by providers that are currently under contract with the
25 department for foster care and related services and shall be
26 done in consultation with the department. A lead provider of
27 the district 5 program shall be competitively selected, must
28 demonstrate the ability to provide necessary comprehensive
29 services through a local network of providers, and must meet
30 criteria established in this section. Contracts with
31 organizations responsible for the model programs must include
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1 the management and administration of all privatized services
2 specified in subsection (1). However, the department may use
3 funds for contract management only after obtaining written
4 approval from the Executive Office of the Governor. The
5 request for such approval must include, but is not limited to,
6 a statement of the proposed amount of such funds and a
7 description of the manner in which such funds will be used. If
8 the community-based organization selected for a model program
9 under this subsection is not a Medicaid provider, the
10 organization shall be issued a Medicaid provider number
11 pursuant to s. 409.907 for the provision of services currently
12 authorized under the state Medicaid plan to those children
13 encompassed in this model and in a manner not to exceed the
14 current level of state expenditure.
15 (7) Notwithstanding the provisions of s. 215.425, all
16 documented federal funds earned for the current fiscal year by
17 the department and community-based agencies that exceed the
18 amount appropriated by the Legislature shall be distributed
19 based on a schedule and methodology developed by the
20 department and approved by the Executive Office of the
21 Governor. Additional state funds appropriated by the
22 Legislature for community-based agencies or made available
23 pursuant to the budgetary amendment process described in s.
24 216.177 shall be transferred to the community-based agencies.
25 The community-based agencies shall use any such funds made
26 available under this subsection for the sole purpose of
27 providing child welfare services. The department shall amend a
28 community-based agency's contract to permit expenditure of
29 these funds.
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1 Section 3. Paragraph (a) of subsection (14) of section
2 409.175, Florida Statutes, 1998 Supplement, is amended to
3 read:
4 409.175 Licensure of family foster homes, residential
5 child-caring agencies, and child-placing agencies.--
6 (14)(a) The Division of Risk Management of the
7 Department of Insurance shall provide coverage through the
8 Department of Children and Family Services to any person who
9 owns or operates a family foster home solely for the
10 Department of Children and Family Services, or who owns or
11 operates a family foster home solely for a community-based
12 agency providing foster care under s. 409.1671, and who is
13 licensed to provide family foster home care in her or his
14 place of residence. The coverage shall be provided from the
15 general liability account of the Florida Casualty Insurance
16 Risk Management Trust Fund, and the coverage shall be primary.
17 The coverage is limited to general liability claims arising
18 from the provision of family foster home care pursuant to an
19 agreement with the department and pursuant to guidelines
20 established through policy, rule, or statute. Coverage shall
21 be limited as provided in ss. 284.38 and 284.385, and the
22 exclusions set forth therein, together with other exclusions
23 as may be set forth in the certificate of coverage issued by
24 the trust fund, shall apply. A person covered under the
25 general liability account pursuant to this subsection shall
26 immediately notify the Division of Risk Management of the
27 Department of Insurance of any potential or actual claim.
28 Section 4. Paragraph (e) is added to subsection (3) of
29 section 409.912, Florida Statutes, 1998 Supplement, to read:
30 409.912 Cost-effective purchasing of health care.--The
31 agency shall purchase goods and services for Medicaid
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1 recipients in the most cost-effective manner consistent with
2 the delivery of quality medical care. The agency shall
3 maximize the use of prepaid per capita and prepaid aggregate
4 fixed-sum basis services when appropriate and other
5 alternative service delivery and reimbursement methodologies,
6 including competitive bidding pursuant to s. 287.057, designed
7 to facilitate the cost-effective purchase of a case-managed
8 continuum of care. The agency shall also require providers to
9 minimize the exposure of recipients to the need for acute
10 inpatient, custodial, and other institutional care and the
11 inappropriate or unnecessary use of high-cost services.
12 (3) The agency may contract with:
13 (e) A community-based agency that meets Medicaid
14 provider enrollment criteria and provides behavioral health
15 care to Medicaid recipients through a community-based child
16 welfare project approved by and under contract with the
17 Department of Children and Family Services and authorized
18 under s. 409.1671. The agency must obtain a waiver from the
19 federal Health Care Finance Administration pursuant to
20 paragraph (d) to implement these services. Payments for
21 services may be made on a prepaid capitation, fee-for-service,
22 or fixed-sum basis. The community-based entity may provide
23 such prepaid services either directly or through formal
24 arrangements with other qualified providers. Further, the
25 Agency for Health Care Administration is authorized to
26 establish a targeted case management program within those
27 counties included in the community-based child welfare project
28 approved by the Department of Children and Family Services and
29 authorized under s. 409.1671. The general revenue required
30 match for these services is limited to those funds available
31
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1 for match and contained within the contracted funds for
2 covered services with the lead agency.
3 Section 5. This act shall take effect upon becoming a
4 law.
5
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7 HOUSE SUMMARY
8
Revises duties of the Child Welfare System Estimating
9 Conference. Revises requirements relating to the plan for
privatization of foster care and related services.
10 Requires community-based agencies contracting with the
Department of Children and Family Services to provide
11 such services to obtain certain liability insurance
coverage and requires coverage of subcontractors.
12 Provides limitations on tort actions. Provides
exclusiveness of liability. Provides a hiring preference
13 for certain state employees whose positions are
privatized. Authorizes substitute care providers which
14 meet described requirements to provide family day care
services, and provides reimbursement eligibility for such
15 dually licensed providers. Continues a program of
privatized foster care and related services in district 5
16 of the department until June 30, 2000. Provides for
distribution, transfer, and use of certain excess or
17 additional funds for foster care and related services
provided under contract with the department. Authorizes
18 the Agency for Health Care Administration to contract
with community-based agencies for services for Medicaid
19 recipients, subject to a waiver from the federal Health
Care Finance Administration. Provides for a targeted case
20 management program within such contract area and provides
certain funding limitations for such contracts. See bill
21 for details.
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