Senate Bill sb1276
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Florida Senate - 2002 SB 1276
By Senator Silver
38-1139A-02
1 A bill to be entitled
2 An act relating to access to health and human
3 services; creating s. 408.911, F.S.; providing
4 a short title; creating s. 408.912, F.S.;
5 providing legislative findings and intent with
6 respect to access to state-funded health
7 services; creating s. 408.913, F.S.; requiring
8 the Agency for Health Care Administration to
9 establish as a pilot project a comprehensive
10 health and human services eligibility access
11 system; establishing requirements for each
12 component of the system; creating s. 408.914,
13 F.S.; requiring the Agency for Health Care
14 Administration to phase in implementation of
15 the comprehensive health and human services
16 eligibility access system; specifying
17 timeframes for each implementation phase;
18 requiring that the agency submit a plan for
19 statewide implementation to the Governor and
20 Legislature; creating s. 408.915, F.S.;
21 requiring the Agency for Health Care
22 Administration to develop and implement a pilot
23 project to integrate eligibility determination
24 and information and referral services;
25 establishing requirements for the pilot
26 project; establishing requirements for
27 information and referral; specifying the scope
28 of the project; authorizing the agency to
29 request federal waivers; creating s. 408.916,
30 F.S.; establishing the Health Care Access
31 Steering Committee; providing for membership of
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Florida Senate - 2002 SB 1276
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1 the steering committee; providing duties;
2 establishing an expiration date for the
3 steering committee; creating s. 408.917, F.S.;
4 requiring an evaluation of the pilot project;
5 requiring a report to the Governor and
6 Legislature; specifying issues to be addressed
7 in the report; creating s. 408.918, F.S.;
8 authorizing the planning, development, and
9 implementation of the Florida 211 Network;
10 providing objectives for the Florida 211
11 Network; requiring the Agency for Health Care
12 Administration to establish criteria for
13 certification of information and referral
14 entities to participate in the Florida 211
15 Network; providing for revocation of 211
16 numbers from uncertified information and
17 referral entities; providing for assistance in
18 resolving disputes from the Public Service
19 Commission and the Federal Communications
20 Commission; providing an effective date.
21
22 Be It Enacted by the Legislature of the State of Florida:
23
24 Section 1. Section 408.911, Florida Statutes, is
25 created to read:
26 408.911 Short title.--Sections 408.911-408.918 may be
27 cited as the "Florida Health and Human Services Access Act."
28 Section 2. Section 408.912, Florida Statutes, is
29 created to read:
30 408.912 Legislative findings and intent.--
31 (1) The Legislature finds that:
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Florida Senate - 2002 SB 1276
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1 (a) Procedures for accessing state-funded health and
2 human services are fragmented, which can result in redundant,
3 incomplete, and inefficient service delivery;
4 (b) The process for determining eligibility for
5 state-funded health and human services is unnecessarily
6 cumbersome and complex, often requiring repeated visits to an
7 eligibility office to resolve questions regarding family
8 circumstances;
9 (c) Individuals and families who are eligible for
10 multiple state programs are confronted with multiple,
11 uncoordinated case managers and care plans;
12 (d) Information and referral entities provide a vital
13 service that informs, guides, directs, and links people to
14 appropriate local health and human services resources and
15 services;
16 (e) There is no comprehensive, statewide health and
17 human services information and referral system in this state
18 and no way for a person to easily determine the availability
19 of health and human services needed by an individual or
20 family, or the status of the eligibility of an individual or
21 family for such services;
22 (f) There are no consistent, statewide standards,
23 training, or criteria for technical support regarding
24 information on and referral for health and human services;
25 there are no consistent standards, criteria, or statutory
26 framework to guide appropriate sharing of information; and
27 there is duplicative management and funding of information and
28 referral systems and processes; and
29 (g) There is a demonstrated need for an
30 easy-to-remember, easy-to-use dialing code that will enable
31 persons in need, perhaps even critically so, to be directed to
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1 available community resources, and that the use of a single
2 dialing code, serving as a primary point of contact, will
3 simplify access to the services and resources of both the
4 government and the nonprofit community.
5 (2) It is, therefore, the intent of the Legislature to
6 establish a pilot project to demonstrate the feasibility of
7 combining the easy access to information provided by a
8 comprehensive information and referral service with a
9 streamlined and simplified approach to determining eligibility
10 for state-funded health care and, if feasible, other human
11 services. It is the intent of the Legislature that the state
12 agencies that provide health and human services develop
13 coordinated care management for individuals and families with
14 multiple needs. It is the intent of the Legislature that a
15 comprehensive information and referral system for health and
16 human services be developed in the state. It is further the
17 intent of the Legislature to establish a governing body to
18 guide the implementation of the pilot project and make
19 recommendations to the Legislature for expanding the pilot
20 project to other areas of the state.
21 Section 3. Section 408.913, Florida Statutes, is
22 created to read:
23 408.913 Comprehensive Health and Human Services
24 Eligibility Access System.--
25 (1) The Agency for Health Care Administration shall
26 develop a comprehensive, automated system for access to health
27 care services. This system shall, to the greatest extent
28 possible, use the capacity of existing automated systems so as
29 to maximize the benefit of investments already made in
30 information technology and minimize additional costs.
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1 (2) The benefit-eligibility component of the system
2 shall include simplified access through coordination with
3 information and referral telephone systems. This does not
4 preclude use of other methods of application, including
5 mail-in applications, office visits, or on-line applications
6 via the Internet. The eligibility component of the system
7 shall include:
8 (a) Improved access to eligibility-status information.
9 (b) Development and sharing of information with
10 eligible individuals and families regarding choices available
11 to them for using health care services.
12 (3) The state agencies providing the medical,
13 clinical, and related health care support services for special
14 populations, including frail elders, adults with disabilities,
15 and children with special needs shall develop systems for
16 these populations which integrate and coordinate care and
17 improved communication. These systems must include development
18 of standard protocols for care planning and assessment, a
19 focus on family involvement, and methods to communicate across
20 systems, including automated methods, in order to improve
21 integration and coordination of services.
22 Section 4. Section 408.914, Florida Statutes, is
23 created to read:
24 408.914 Phased implementation plan.--The Agency for
25 Health Care Administration, in consultation with the Health
26 Care Access Steering Committee created in s. 408.916, shall
27 phase in the implementation of the Comprehensive Health and
28 Human Services Eligibility Access System.
29 (1) The first phase of implementation shall be a pilot
30 project in one or more contiguous counties to demonstrate the
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1 feasibility of integrating eligibility determination for
2 health care services with information and referral services.
3 (2) Upon demonstration of the feasibility of the first
4 phase of implementation, and subject to appropriation of any
5 necessary resources, the steering committee shall develop a
6 detailed implementation plan for the care-management component
7 of the system. The implementation plan must include the
8 steering committee's recommendation of one or more state
9 agencies that should be designated to implement the
10 case-management component of the system.
11 (3) Options for further implementation of the system
12 may include a phased implementation of the eligibility
13 component in additional sites before implementing the
14 remaining components of the system or may include
15 implementation of the care management and service system
16 components along with the eligibility components.
17 (4) The Agency for Health Care Administration, in
18 consultation with the steering committee, shall complete
19 analysis of the initial pilot project by November 1, 2003, and
20 by January 1, 2004, shall submit a plan to the Governor, the
21 President of the Senate, and the Speaker of the House of
22 Representatives for statewide implementation of all components
23 of the system, if warranted. This plan must also include
24 recommendations for incorporating additional public assistance
25 and human services programs into the Comprehensive Health and
26 Human Services Eligibility Access System.
27 Section 5. Section 408.915, Florida Statutes, is
28 created to read:
29 408.915 Eligibility pilot project.--The Agency for
30 Health Care Administration, in consultation with the steering
31 committee established in s. 408.916, shall develop and
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1 implement a pilot project to integrate the determination of
2 eligibility for health care services with information and
3 referral services.
4 (1) The pilot project shall operate in one or more
5 contiguous counties, as selected by the agency in consultation
6 with the steering committee.
7 (2) The pilot project shall focus on developing, to
8 the maximum extent possible, a process for eligibility
9 application which:
10 (a) Uses a single uniform electronic application
11 process, but permits applying for health services through
12 various entry points, including information and referral
13 providers, state agency program personnel or contracted
14 providers, the mail, or the Internet;
15 (b) Is linked to a shared database that will have the
16 capability to sort or store information by families as well as
17 individuals;
18 (c) Permits electronic input and storage of data and
19 electronic verification and exchange of information;
20 (d) Is compliant with the federal Health Insurance
21 Portability and Accountability Act, as well as all other
22 applicable state and federal confidentiality requirements; and
23 (e) Includes an initial screening component for
24 referring applicants to other health and human services
25 programs provided through state agencies, including programs
26 addressing developmental delays, developmental disabilities,
27 chronic physical illness, mental health needs, substance abuse
28 needs, elder and aging needs, and other health care needs.
29 (3) The information and referral provider in the site
30 selected as the pilot project shall, at a minimum:
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1 (a) Execute a memorandum of understanding with the
2 local community volunteer placement centers;
3 (b) Implement, or be in the process of implementing, a
4 shared, web-based, information and eligibility database with
5 community health providers and funders;
6 (c) Provide comprehensive information and referral
7 services 24 hours per day, 7 days per week;
8 (d) Agree, in writing, to become accredited within 3
9 years by a nationally recognized information and referral
10 accrediting agency;
11 (e) Execute a memorandum of understanding with 911 and
12 other emergency response agencies in the pilot area;
13 (f) Implement policies and structured training to
14 effectively respond to crisis calls or obtain accreditation by
15 a nationally recognized mental health or crisis accrediting
16 agency;
17 (g) Obtain teletypewriter and multi-language
18 accessibility, either on-site or through a translation
19 service;
20 (h) Develop resources to support and publicize
21 information and referral services and provide ongoing
22 education to the public on the availability of such services;
23 and
24 (i) Provide periodic reports to the Governor, the
25 President of the Senate, and the Speaker of the House of
26 Representatives on the use of the information and referral
27 system and on measures that demonstrate the effectiveness and
28 efficiency of the information and referral services provided.
29 (4) The pilot project shall include eligibility
30 determinations for the following programs:
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1 (a) Medicaid under Title XIX of the Social Security
2 Act.
3 (b) Medikids as created in s. 409.8132.
4 (c) Florida Healthy Kids as described in s. 624.91 and
5 within eligibility guidelines provided in s. 409.814.
6 (d) Eligibility for Florida Kidcare services outside
7 of the scope of Title XIX or Title XXI of the Social Security
8 Act as provided in s. 409.814.
9 (e) State and local publicly funded health and social
10 services programs as determined appropriate by the steering
11 committee.
12 (5) If the Secretary of Health Care Administration, in
13 consultation with the steering committee established in s.
14 408.916, determines that it would facilitate operation of the
15 pilot project to obtain federal waiver authority, the agency
16 shall request such waiver authority from the appropriate
17 federal agency.
18 Section 6. Section 408.916, Florida Statutes, is
19 created to read:
20 408.916 Steering committee.--In order to guide the
21 implementation of the pilot project, there is created a Health
22 Care Access Steering Committee.
23 (1) The steering committee shall be composed of the
24 following members:
25 (a) The Secretary of Health Care Administration.
26 (b) The Secretary of Children and Family Services.
27 (c) The Secretary of Elderly Affairs.
28 (d) The Secretary of Health.
29 (e) A representative of the Florida Alliance of
30 Information and Referral Services.
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1 (2) The steering committee may designate additional ad
2 hoc members or technical advisors as the committee finds is
3 appropriate.
4 (3) The Secretary of Health Care Administration shall
5 be the chairperson of the steering committee.
6 (4) The steering committee shall provide oversight to
7 the ongoing implementation of the pilot project, provide
8 consultation and guidance on matters of policy, and provide
9 oversight to the evaluation of the pilot project.
10 (5) The steering committee shall complete its
11 activities by June 30, 2004, and the authorization for the
12 steering committee ends on that date.
13 Section 7. Section 408.917, Florida Statutes, is
14 created to read:
15 408.917 Evaluation of the pilot project.--The Agency
16 for Health Care Administration, in consultation with the
17 steering committee, shall conduct or contract for an
18 evaluation of the pilot project under the guidance and
19 oversight of the steering committee. The agency shall ensure
20 that the evaluation is submitted to the Governor and
21 Legislature by June 30, 2004. The evaluation report must
22 address at least the following questions:
23 (1) What has been the impact of the pilot project on
24 improving access to the process of determining eligibility?
25 (2) Based on the experience of the pilot project, what
26 is the projected cost of statewide implementation?
27 (3) What has been the impact of the pilot project on
28 the caseload trends in publicly funded programs and what is
29 the projected impact of statewide implementation?
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1 (4) How has the implementation of the pilot project
2 affected customer satisfaction with access to eligibility
3 determination for state-funded health services?
4 (5) Does the experience of the pilot project support
5 continued expansion of the concept?
6 (6) What changes or modifications to the concepts of
7 the pilot project are recommended for future sites?
8 Section 8. Section 408.918, Florida Statutes, is
9 created to read:
10 408.918 Florida 211 Network; uniform certification
11 requirements.--
12 (1) The Legislature authorizes the planning,
13 development, and, subject to appropriations, the
14 implementation of a statewide Florida 211 Network, which shall
15 serve as the single point of coordination for information and
16 referral for health and human services. The objectives for
17 establishing the Florida 211 Network shall be to:
18 (a) Provide comprehensive and cost-effective access to
19 health and human services information.
20 (b) Improve access to accurate information by
21 simplifying and enhancing state and local health and human
22 services information and referral systems and by fostering
23 collaboration among information and referral systems.
24 (c) Electronically connect local information and
25 referral systems to each other, to service providers, and to
26 consumers of information and referral services.
27 (d) Establish and promote standards for data
28 collection and for distributing information among state and
29 local organizations.
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1 (e) Promote the use of a common dialing access code
2 and the visibility and public awareness of the availability of
3 information and referral services.
4 (f) Provide a management and administrative structure
5 to support the Florida 211 Network and establish technical
6 assistance, training, and support programs for information and
7 referral-service programs.
8 (g) Test methods for integrating information and
9 referral services with local and state health and human
10 services programs and for consolidating and streamlining
11 eligibility and case-management processes.
12 (h) Provide access to standardized, comprehensive data
13 to assist in identifying gaps and needs in health and human
14 services programs.
15 (i) Provide a unified systems plan with a developed
16 platform, taxonomy, and standards for data management and
17 access.
18 (2) In order to participate in the Florida 211
19 Network, a provider of information and referral services must
20 be certified by the Agency for Health Care Administration. The
21 agency shall develop criteria for certification, as
22 recommended by the Florida Alliance of Information and
23 Referral Services, and shall adopt the criteria as
24 administrative rules.
25 (a) If any provider of information and referral
26 services or other entity leases a 211 number from a local
27 exchange company and is not certified by the agency, the
28 agency shall, after consultation with the local exchange
29 company and the Public Service Commission, request that the
30 Federal Communications Commission direct the local exchange
31 company to revoke the use of the 211 number.
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1 (b) The agency shall seek the assistance and guidance
2 of the Public Service Commission and the Federal
3 Communications Commission in resolving any disputes arising
4 over jurisdiction related to 211 numbers.
5 Section 9. This act shall take effect upon becoming a
6 law.
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9 SENATE SUMMARY
10 Creates the Florida Health and Human Services Access Act.
Requires the Agency for Health Care Administration to
11 establish the Comprehensive Health and Human Services
Eligibility Access System. Requires that the agency begin
12 with a pilot project and phase in implementation of the
system. Establishes the Health Care Access Steering
13 Committee to guide implementation of the pilot project.
Provides for the creation of the Florida 211 Network to
14 serve as a single point of coordination for information
and referral for health and human services. (See bill for
15 details.)
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