Senate Bill sb1724

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2001                                  SB 1724

    By Senator Klein





    28-1322-01                                              See HB

  1                      A bill to be entitled

  2         An act relating to children and families;

  3         creating s. 409.9072, F.S.; requiring the

  4         Agency for Health Care Administration to

  5         develop mechanisms for certification of local

  6         funds as state match for Medicaid projects, to

  7         maximize federal Title XIX funding for children

  8         and families; providing for return of funds to

  9         the generating districts and local entities;

10         requiring prior approval of local projects by

11         the agency and the Department of Children and

12         Family Services; specifying project

13         requirements; providing for modification of the

14         Medicaid state plan; providing for federal

15         waivers; providing responsibilities of the

16         agency and department with respect to

17         administrative and service costs, monitoring of

18         service delivery, and standards and quality of

19         care; providing a limitation on certain

20         administrative costs; requiring the department

21         to develop policies and procedures for

22         certification of local funds as state match for

23         foster care and related services projects, to

24         maximize federal Title IV-E funding for

25         services to eligible children; providing for

26         return of funds to the generating districts and

27         local entities; specifying project

28         requirements; providing a limitation on certain

29         administrative costs; providing for federal

30         waivers; authorizing the department and the

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    Florida Senate - 2001                                  SB 1724
    28-1322-01                                              See HB




  1         agency to adopt rules; requiring an annual

  2         report; providing an effective date.

  3

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

  5

  6         Section 1.  It is the intent of the Legislature to

  7  utilize local funding for Medicaid under Title XIX of the

  8  Social Security Act, as amended, and for foster care and

  9  related programs under Title IV-E of the Social Security Act,

10  as amended, to the fullest extent possible, so as to maximize

11  federal funding of such programs in the state. It is further

12  the intent of the Legislature that this act shall be

13  revenue-neutral with respect to state funds.

14         Section 2.  Section 409.9072, Florida Statutes, is

15  created to read:

16         409.9072  Certification of local match funding for

17  Medicaid and for foster care and related programs.--

18         (1)  The agency, in compliance with appropriate federal

19  authorities, shall develop mechanisms to allow for

20  certification of local match funds for covered Medicaid

21  services under Title XIX of the Social Security Act, as

22  amended.

23         (a)  The certification of match shall apply only to

24  services provided to children and their families who are

25  eligible under Medicaid and Medicaid expansion. Any federal

26  Medicaid reimbursement received as a result of local matched

27  funds generated at the district level shall be returned to the

28  district where those funds were generated, and the district

29  shall, by agreement, reimburse any local entities that have

30  provided funding that has generated the federal Medicaid

31  reimbursement received by the district.

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    Florida Senate - 2001                                  SB 1724
    28-1322-01                                              See HB




  1         (b)  Local projects seeking to provide Medicaid

  2  services to eligible children and their families must have

  3  prior approval by the Department of Children and Family

  4  Services and the agency in order to participate in any

  5  certification of match effort. A project must demonstrate that

  6  it has the clinical and administrative capability to provide

  7  Medicaid covered services and shall agree to:

  8         1.  Be responsible for checking with the state Medicaid

  9  office to verify that children and their families are eligible

10  at the time services are provided, but shall not be

11  responsible for any disallowances resulting from a subsequent

12  determination of ineligibility so long as eligibility was

13  verified at the time services were provided.

14         2.  Develop and maintain the financial records needed

15  to document the appropriate use of state and federal funds.

16         3.  Comply with all state and federal laws, rules,

17  regulations, and policies that regulate Medicaid services.

18         4.  Be responsible for reimbursing the cost of any

19  disallowance of federal funding previously provided to the

20  local project that results from failure of the local project

21  to comply with state or federal Medicaid laws, rules, or

22  regulations.

23         (c)  The agency and the department shall work with the

24  local projects to modify the Medicaid state plan and shall

25  seek and implement any federal waivers to ensure that all

26  Medicaid services are available to eligible clients of such

27  projects and to otherwise implement this subsection.

28         (d)  Projects may receive Medicaid reimbursement for

29  services on either a fee-for-service basis or a capitation

30  basis. The agency shall approve all capitation methodologies

31  and standards of care developed by the department. With the

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    Florida Senate - 2001                                  SB 1724
    28-1322-01                                              See HB




  1  agency's approval, the department shall develop provisions for

  2  monitoring service delivery, ensuring appropriate provider

  3  networks in accordance with s. 409.906, and analysis of

  4  administrative and service cost ratios.

  5         (e)  Projects which operate on a fee-for-service basis

  6  may assign a qualified organization to serve as a gatekeeper,

  7  which may be responsible for the authorization of all services

  8  for children enrolled in the project. With the approval of the

  9  agency, the department shall develop quality-of-care standards

10  for the providers who deliver these services. The project may

11  also provide case management services to coordinate care and

12  linkages with Medicaid providers and other agencies.

13         (f)  The agency, prior to distribution of funds under

14  paragraph (a), may deduct its actual administrative costs for

15  implementing and monitoring the local match certification

16  program, but in no event may such administrative costs exceed

17  5 percent of the total funding to be provided to local

18  entities under paragraph (a).

19         (2)  The Department of Children and Family Services, in

20  compliance with appropriate federal authorities, shall develop

21  policies and procedures to allow for certification of local

22  funds that have been publicly appropriated or generated in

23  other ways for foster care and related services to eligible

24  children under Title IV-E of the Social Security Act, as

25  amended.

26         (a)  Any federal Title IV-E reimbursement received as a

27  result of matching funds generated at the district level shall

28  be returned to the district that generated those funds, and

29  the district shall, by agreement, reimburse any local entities

30  that have provided funding that has generated the federal

31  Title IV-E reimbursement received by the district.

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    Florida Senate - 2001                                  SB 1724
    28-1322-01                                              See HB




  1         (b)  In order to receive any reimbursement under this

  2  subsection, any entity, other than the department, providing

  3  local funds for Title IV-E services must demonstrate that it

  4  has the capability of providing such services and shall agree

  5  to:

  6         1.  Be responsible for verifying that children and

  7  their families are eligible for Title IV-E services at the

  8  time services are provided, but shall not be responsible for

  9  any disallowances resulting from a subsequent determination of

10  ineligibility so long as eligibility was verified at the time

11  services were provided.

12         2.  Develop and maintain the financial records needed

13  to document the appropriate use of federal funds.

14         3.  Comply with all state and federal laws, rules,

15  regulations, and policies that regulate Title IV-E services.

16         4.  Be responsible for reimbursing the cost of any

17  disallowance of federal funding previously provided to the

18  local entity that results from failure of the local entity to

19  comply with state or federal Title IV-E laws, rules, or

20  regulations.

21         (c)  The department, prior to distribution of funds

22  under paragraph (a), may deduct its actual administrative

23  costs for implementing and monitoring the local match

24  certification program, but in no event may such administrative

25  costs exceed 5 percent of the total funding to be provided to

26  local entities under paragraph (a).

27         (d)  The department shall seek and implement any

28  federal waivers necessary to implement this subsection.

29         (3)  The department and the agency are authorized to

30  adopt rules to implement this section.

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    Florida Senate - 2001                                  SB 1724
    28-1322-01                                              See HB




  1         (4)  The department and the agency shall annually

  2  prepare a report, to be submitted to the President of the

  3  Senate, the Speaker of the House of Representatives, and the

  4  chairs of the appropriate substantive and fiscal committees of

  5  each chamber of the Legislature no later than January 1,

  6  documenting the specific activities undertaken during the

  7  previous fiscal year pursuant to this section.

  8         Section 3.  This act shall take effect July 1, 2001.

  9

10            *****************************************

11                          HOUSE SUMMARY

12
      Requires the Agency for Health Care Administration to
13    develop mechanisms for certification of local funds as
      state match for Medicaid projects, to maximize federal
14    Title XIX funding for children and families. Provides for
      return of funds to the generating districts and local
15    entities. Requires prior approval of local projects by
      the agency and the Department of Children and Family
16    Services. Specifies project requirements. Provides for
      modification of the Medicaid state plan. Authorizes the
17    agency and department to seek and implement federal
      waivers. Provides responsibilities of the agency and
18    department with respect to administrative and service
      costs, monitoring of service delivery, and standards and
19    quality of care. Provides a 5-percent limit on project
      administrative costs to be retained by the agency.
20    Requires the department to develop policies and
      procedures for certification of local funds as state
21    match for foster care and related services projects, to
      maximize federal funding for services to eligible
22    children under Title IV-E of the Social Security Act.
      Provides for return of funds to the generating districts
23    and local entities. Specifies project requirements.
      Provides a 5-percent limit on project administrative
24    costs to be retained by the department. Authorizes the
      department to seek and implement federal waivers.
25    Authorizes the department and the agency to adopt rules.
      Requires an annual report to the Governor and
26    Legislature.

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