Senate Bill sb1980

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    Florida Senate - 2002                                  SB 1980

    By Senator Silver





    38-1159-02

  1                      A bill to be entitled

  2         An act relating to children's health care;

  3         amending s. 624.91, F.S.; revising duties of

  4         the Florida Healthy Kids Corporation with

  5         respect to annual determination of

  6         participation in the Healthy Kids Program;

  7         creating s. 624.915, F.S.; prescribing duties

  8         of the corporation in establishing local match

  9         requirements; providing an effective date.

10

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

12

13         Section 1.  Subsection (1) and paragraph (b) of

14  subsection (4) of section 624.91, Florida Statutes, are

15  amended to read:

16         624.91  The Florida Healthy Kids Corporation Act.--

17         (1)  SHORT TITLE.--Sections 624.91-624.915 This section

18  may be cited as the "William G. 'Doc' Myers Healthy Kids

19  Corporation Act."

20         (4)  CORPORATION AUTHORIZATION, DUTIES, POWERS.--

21         (b)  The Florida Healthy Kids Corporation shall phase

22  in a program to:

23         1.  Organize school children groups to facilitate the

24  provision of comprehensive health insurance coverage to

25  children;

26         2.  Arrange for the collection of any family, local

27  contributions, or employer payment or premium, in an amount to

28  be determined by the board of directors, to provide for

29  payment of premiums for comprehensive insurance coverage and

30  for the actual or estimated administrative expenses;

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    Florida Senate - 2002                                  SB 1980
    38-1159-02




  1         3.  Establish the administrative and accounting

  2  procedures for the operation of the corporation;

  3         4.  Establish, with consultation from appropriate

  4  professional organizations, standards for preventive health

  5  services and providers and comprehensive insurance benefits

  6  appropriate to children; provided that such standards for

  7  rural areas shall not limit primary care providers to

  8  board-certified pediatricians;

  9         5.  Establish eligibility criteria which children must

10  meet in order to participate in the program;

11         6.  Establish procedures under which applicants to and

12  participants in the program may have grievances reviewed by an

13  impartial body and reported to the board of directors of the

14  corporation;

15         7.  Establish participation criteria and, if

16  appropriate, contract with an authorized insurer, health

17  maintenance organization, or insurance administrator to

18  provide administrative services to the corporation;

19         8.  Establish enrollment criteria which shall include

20  penalties or waiting periods of not fewer than 60 days for

21  reinstatement of coverage upon voluntary cancellation for

22  nonpayment of family premiums;

23         9.  If a space is available, establish a special open

24  enrollment period of 30 days' duration for any child who is

25  enrolled in Medicaid or Medikids if such child loses Medicaid

26  or Medikids eligibility and becomes eligible for the Florida

27  Healthy Kids program;

28         10.  Contract with authorized insurers or any provider

29  of health care services, meeting standards established by the

30  corporation, for the provision of comprehensive insurance

31  coverage to participants.  Such standards shall include

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    Florida Senate - 2002                                  SB 1980
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  1  criteria under which the corporation may contract with more

  2  than one provider of health care services in program sites.

  3  Health plans shall be selected through a competitive bid

  4  process. The selection of health plans shall be based

  5  primarily on quality criteria established by the board. The

  6  health plan selection criteria and scoring system, and the

  7  scoring results, shall be available upon request for

  8  inspection after the bids have been awarded;

  9         11.  Develop and implement a plan to publicize the

10  Florida Healthy Kids Corporation, the eligibility requirements

11  of the program, and the procedures for enrollment in the

12  program and to maintain public awareness of the corporation

13  and the program;

14         12.  Secure staff necessary to properly administer the

15  corporation. Staff costs shall be funded from state and local

16  matching funds and such other private or public funds as

17  become available. The board of directors shall determine the

18  number of staff members necessary to administer the

19  corporation;

20         13.  As appropriate, enter into contracts with local

21  school boards or other agencies to provide onsite information,

22  enrollment, and other services necessary to the operation of

23  the corporation;

24         14.  Provide a report on an annual basis to the

25  Governor, Insurance Commissioner, Commissioner of Education,

26  Senate President, Speaker of the House of Representatives, and

27  Minority Leaders of the Senate and the House of

28  Representatives;

29         15.  Annually determine the local match requirements

30  for each county under the formulas and procedure provided in

31  s. 624.915 Each fiscal year, establish a maximum number of

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    Florida Senate - 2002                                  SB 1980
    38-1159-02




  1  participants by county, on a statewide basis, who may enroll

  2  in the program without the benefit of local matching funds.

  3  Thereafter, the corporation may establish local matching

  4  requirements for supplemental participation in the program.

  5  The corporation may vary local matching requirements and

  6  enrollment by county depending on factors which may influence

  7  the generation of local match, including, but not limited to,

  8  population density, per capita income, existing local tax

  9  effort, and other factors. The corporation also may accept

10  in-kind match in lieu of cash for the local match requirement

11  to the extent allowed by Title XXI of the Social Security Act;

12  and

13         16.  Establish eligibility criteria, premium and

14  cost-sharing requirements, and benefit packages which conform

15  to the provisions of the Florida Kidcare program, as created

16  in ss. 409.810-409.820.

17         Section 2.  Section 624.915, Florida Statutes, is

18  created to read:

19         624.915  Local match requirement.--

20         (1)  By May 1st of each year, the Florida Healthy Kids

21  Corporation established in s. 624.91 shall determine the local

22  match requirement for each county and provide written

23  notification to each county of the amount to be remitted to

24  the corporation for the following fiscal year.

25         (a)  The corporation shall first annually establish a

26  nonmatch enrollment allocation per county which does not

27  require any local matching funds. For the purpose of

28  determining the nonmatch enrollment allocation, each county

29  shall be assigned to one of three tiers based on the county's

30  population of children, using the most recently released

31  federal census data. Enrollment slots shall be allocated to

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    Florida Senate - 2002                                  SB 1980
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  1  each tier; however, no county shall receive fewer than 500

  2  slots. Enrollment slots shall not be reserved for any

  3  particular county, and unused slots may be redistributed by

  4  the corporation to accommodate increased enrollment in other

  5  counties.

  6         (b)  The corporation shall then determine the county's

  7  local match percentage rate. For the purpose of determining

  8  the local match percentage rate, each county shall be assigned

  9  to one of three tiers based on the county's economic census in

10  the year of the most recently released federal census data.

11  The local match percentage rate for the lowest tier shall be

12  greater than zero but not more than 5 percent, and it shall be

13  no greater than 15 percent for the highest tier.

14         (c)  The corporation shall then calculate the local

15  match requirement for each county as the total annual

16  consideration paid by the corporation for the county's total

17  enrollee insurance premiums for the prior fiscal year, less

18  the value of the premiums for the county's nonmatch enrollment

19  for the same year, multiplied by the county's local match

20  percentage rate. The resulting local match requirement for

21  each county shall not be less than zero, but it may be no more

22  than the county paid in fiscal year 2000-2001.

23         (2)  A county that disputes its tier assignment may

24  file a written grievance with the corporation for review by

25  the corporation's board of directors. The board's decision

26  shall be final and not subject to further review.

27         (3)  The corporation's board of directors shall

28  determine the timing and method for payment of the required

29  local match to the corporation. For purposes of meeting the

30  local match requirement, at least 90 percent of the county's

31  local match requirement must be eligible to match federal

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    Florida Senate - 2002                                  SB 1980
    38-1159-02




  1  Title XXI funds. Local matching funds must be in the form of

  2  cash. In-kind contributions will not be accepted for purposes

  3  of being in compliance with a county's local match

  4  requirement.

  5         (4)  The corporation shall notify the Senate President,

  6  the Speaker of the House of Representatives, the Governor, and

  7  the Department of Banking and Finance of any county not

  8  meeting its local match requirement. The Department of Banking

  9  and Finance shall withhold from cigarette tax receipts or any

10  other funds to be distributed to counties an amount equal to

11  the county's local match share that has not been remitted

12  within 60 days after billing and forward such amount to the

13  corporation.

14         Section 3.  This act shall take effect upon becoming a

15  law.

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17            *****************************************

18                          SENATE SUMMARY

19    Prescribes duties of the Florida Healthy Kids Corporation
      in annually establishing local match requirements for
20    county participation in the Healthy Kids program.

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