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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  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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  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.

  7

  8            *****************************************

  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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