Senate Bill sb0632er

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  1

  2         An act relating to out-of-home care; repealing

  3         s. 39.521(5), F.S., relating to the mandatory

  4         assessment of specified children for placement

  5         in licensed residential group care; creating s.

  6         39.523, F.S.; prescribing procedures for the

  7         mandatory assessment of certain children for

  8         placement in licensed residential group care;

  9         providing for reports; providing for a

10         specialized residential group care services

11         appropriations category in the General

12         Appropriations Act; providing for funding

13         increases to be appropriated in a lump-sum

14         category; specifying that the release of

15         certain funds is contingent on the approval of

16         a spending plan; prescribing elements of the

17         plan; authorizing one-time startup funding;

18         amending s. 39.407, F.S.; clarifying that the

19         Department of Children and Family Services may

20         place a child who is in its custody in a

21         residential treatment center without prior

22         approval of the court; amending s. 409.1671,

23         F.S.; specifying timeframes for initiating and

24         for completing privatization of foster care and

25         related services; requiring cooperative

26         planning agreements between lead

27         community-based providers and Healthy Families

28         Florida lead agencies for certain purposes;

29         providing for the establishment of a model

30         comprehensive residential services program in

31         specified counties; providing that


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  1         community-based providers and subcontractors

  2         require employees to obtain bodily injury

  3         liability insurance on personal automobiles;

  4         providing certain immunity from liability when

  5         transporting clients in privately owned

  6         automobiles; directing the Department of

  7         Children and Family Services to adopt written

  8         policies and procedures for contract monitoring

  9         of community-based providers; modifying the

10         requirement for community-based providers to

11         furnish information to the department;

12         modifying the conditions under which a provider

13         may close a case; modifying the requirements

14         concerning dual licensure of foster homes;

15         authorizing the department to adopt rules;

16         eliminating the authority for a risk pool;

17         requiring the development of a proposal for a

18         statewide shared earnings program; providing

19         for use of excess federal earnings and certain

20         additional state funds for the development of

21         the proposal; providing for submission of the

22         proposal to the Legislative Budget Commission

23         and for submission to the Legislature under

24         certain conditions; requiring that the

25         Legislature appropriate a lump sum in the

26         Administered Funds Program each year for a

27         specified purpose; specifying the type of bond

28         that may be required; eliminating a specified

29         expiration for this program; eliminating an

30         obsolete review requirement; amending s.

31         409.1676, F.S.; providing intent that the


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  1         Department of Children and Family Services and

  2         the Department of Juvenile Justice establish an

  3         interagency agreement regarding referral to

  4         residential group care facilities; specifying

  5         that a residential group care facility must be

  6         licensed as a child-caring agency; requiring

  7         such facilities serving certain children to

  8         meet specified staff qualifications; redefining

  9         and adding terms; redefining the term "serious

10         behavioral problems"; authorizing the

11         department to adopt rules; removing a reference

12         to specific districts and regions of the

13         department; amending s. 409.175, F.S.;

14         conforming the definition of "family foster

15         home"; providing criteria for the number of

16         children placed in each family foster home;

17         providing for a comprehensive behavioral health

18         assessment of each child under certain

19         circumstances; requiring assessment of the

20         appropriateness of the number of children as a

21         condition of annual relicensure; correcting

22         cross references; amending s. 409.906, F.S.;

23         expanding the authority for the establishment

24         of child welfare targeted case management

25         projects; eliminating reference to a pilot

26         project; eliminating the requirement to report

27         to the Child Welfare Estimating Conference

28         regarding targeted case management; amending

29         ss. 393.0657, 402.3057, and 409.1757, F.S.;

30         correcting cross references; directing the

31         Office of Program Policy Analysis and


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  1         Government Accountability, in consultation with

  2         the Agency for Health Care Administration, to

  3         conduct a review of the process for placing

  4         children for residential mental health

  5         treatment; providing for a report to the

  6         Governor and Legislature; providing an

  7         effective date.

  8

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

10

11         Section 1.  Subsection (5) of section 39.521, Florida

12  Statutes, is repealed.

13         Section 2.  Section 39.523, Florida Statutes, is

14  created to read:

15         39.523  Placement in residential group care.--

16         (1)  Except as provided in s. 39.407, any dependent

17  child 11 years of age or older who has been in licensed family

18  foster care for 6 months or longer and who is then moved more

19  than once and who is a child with extraordinary needs as

20  defined in s. 409.1676 must be assessed for placement in

21  licensed residential group care. The assessment procedures

22  shall be conducted by the department or its agent and shall

23  incorporate and address current and historical information

24  from any psychological testing or evaluation that has

25  occurred; current and historical information from the guardian

26  ad litem, if one has been assigned; current and historical

27  information from any current therapist, teacher, or other

28  professional who has knowledge of the child and has worked

29  with the child; information regarding the placement of any

30  siblings of the child and the impact of the child's placement

31  in residential group care on the child's siblings; the


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  1  circumstances necessitating the moves of the child while in

  2  family foster care and the recommendations of the former

  3  foster families, if available; the status of the child's case

  4  plan and a determination as to the impact of placing the child

  5  in residential group care on the goals of the case plan; the

  6  age, maturity, and desires of the child concerning placement;

  7  the availability of any less restrictive, more family-like

  8  setting for the child in which the foster parents have the

  9  necessary training and skills for providing a suitable

10  placement for the child; and any other information concerning

11  the availability of suitable residential group care. If such

12  placement is determined to be appropriate as a result of this

13  procedure, the child must be placed in residential group care,

14  if available.

15         (2)  The results of the assessment described in

16  subsection (1) and the actions taken as a result of the

17  assessment must be included in the next judicial review of the

18  child. At each subsequent judicial review, the court must be

19  advised in writing of the status of the child's placement,

20  with special reference regarding the stability of the

21  placement and the permanency planning for the child.

22         (3)  Any residential group care facility that receives

23  children under the provisions of this subsection shall

24  establish special permanency teams dedicated to overcoming the

25  special permanency challenges presented by this population of

26  children. Each facility shall report to the department its

27  success in achieving permanency for children placed by the

28  department in its care at intervals that allow the current

29  information to be provided to the court at each judicial

30  review for the child.

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  1         (4)  This section does not prohibit the department from

  2  assessing and placing children who do not meet the criteria in

  3  subsection (1) in residential group care if such placement is

  4  the most appropriate placement for such children.

  5         (5)(a)  By December 1 of each year, the department

  6  shall report to the Legislature on the placement of children

  7  in licensed residential group care during the year, including

  8  the criteria used to determine the placement of children, the

  9  number of children who were evaluated for placement, the

10  number of children who were placed based upon the evaluation,

11  and the number of children who were not placed. The department

12  shall maintain data specifying the number of children who were

13  referred to licensed residential child care for whom placement

14  was unavailable and the counties in which such placement was

15  unavailable. The department shall include this data in its

16  report to the Legislature due on December 1, so that the

17  Legislature may consider this information in developing the

18  General Appropriations Act.

19         (b)  As part of the report required in paragraph (a),

20  the department shall also provide a detailed account of the

21  expenditures incurred for "Special Categories: Grants and Aids

22  - Specialized Residential Group Care Services" for the fiscal

23  year immediately preceding the date of the report. This

24  section of the report must include whatever supporting data is

25  necessary to demonstrate full compliance with paragraph

26  (6)(c). The document must present the information by district

27  and must specify, at a minimum, the number of additional beds,

28  the average rate per bed, the number of additional persons

29  served, and a description of the enhanced and expanded

30  services provided.

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  1         (6)(a)  The provisions of this section shall be

  2  implemented to the extent of available appropriations

  3  contained in the annual General Appropriations Act for such

  4  purpose.

  5         (b)  Each year, funds included in the General

  6  Appropriations Act for Enhanced Residential Group Care as

  7  provided for in s. 409.1676, shall be appropriated in a

  8  separately identified special category that is designated in

  9  the act as "Special Categories: Grants and Aids - Specialized

10  Residential Group Care Services."

11         (c)  Each fiscal year, all funding increases for

12  Enhanced Residential Group Care as provided in s. 409.1676,

13  which are included in the General Appropriations Act shall be

14  appropriated in a lump-sum category as defined in s.

15  216.011(1)(aa). In accordance with s. 216.181(6)(a), the

16  Executive Office of the Governor shall require the department

17  to submit a spending plan that identifies the residential

18  group care bed capacity shortage throughout the state and

19  proposes a distribution formula by district which addresses

20  the reported deficiencies. The spending plan must have as its

21  first priority the reduction or elimination of any bed

22  shortage identified and must also provide for program

23  enhancements to ensure that residential group care programs

24  meet a minimum level of expected performance and provide for

25  expansion of the comprehensive residential group care services

26  described in s. 409.1676. Annual appropriation increases

27  appropriated in the lump-sum appropriation must be used in

28  accordance with the provisions of the spending plan.

29         (d)  Funds from "Special Categories: Grants and Aids -

30  Specialized Residential Group Care Services" may be used as

31  one-time startup funding for residential group care purposes


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  1  that include, but are not limited to, remodeling or renovation

  2  of existing facilities, construction costs, leasing costs,

  3  purchase of equipment and furniture, site development, and

  4  other necessary and reasonable costs associated with the

  5  startup of facilities or programs upon the recommendation of

  6  the lead community-based provider if one exists and upon

  7  specific approval of the terms and conditions by the secretary

  8  of the department.

  9         Section 3.  Subsection (5) of section 39.407, Florida

10  Statutes, is amended to read:

11         39.407  Medical, psychiatric, and psychological

12  examination and treatment of child; physical or mental

13  examination of parent or person requesting custody of child.--

14         (5)  Children who are in the legal custody of the

15  department may be placed by the department, without prior

16  approval of the court, in a residential treatment center

17  licensed under s. 394.875 or a hospital licensed under chapter

18  395 for residential mental health treatment only pursuant to

19  this section or may be placed by the court in accordance with

20  an order of involuntary examination or involuntary placement

21  entered pursuant to s. 394.463 or s. 394.467. All children

22  placed in a residential treatment program under this

23  subsection must have a guardian ad litem appointed.

24         (a)  As used in this subsection, the term:

25         1.  "Residential treatment" means placement for

26  observation, diagnosis, or treatment of an emotional

27  disturbance in a residential treatment center licensed under

28  s. 394.875 or a hospital licensed under chapter 395.

29         2.  "Least restrictive alternative" means the treatment

30  and conditions of treatment that, separately and in

31  combination, are no more intrusive or restrictive of freedom


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  1  than reasonably necessary to achieve a substantial therapeutic

  2  benefit or to protect the child or adolescent or others from

  3  physical injury.

  4         3.  "Suitable for residential treatment" or

  5  "suitability" means a determination concerning a child or

  6  adolescent with an emotional disturbance as defined in s.

  7  394.492(5) or a serious emotional disturbance as defined in s.

  8  394.492(6) that each of the following criteria is met:

  9         a.  The child requires residential treatment.

10         b.  The child is in need of a residential treatment

11  program and is expected to benefit from mental health

12  treatment.

13         c.  An appropriate, less restrictive alternative to

14  residential treatment is unavailable.

15         (b)  Whenever the department believes that a child in

16  its legal custody is emotionally disturbed and may need

17  residential treatment, an examination and suitability

18  assessment must be conducted by a qualified evaluator who is

19  appointed by the Agency for Health Care Administration. This

20  suitability assessment must be completed before the placement

21  of the child in a residential treatment center for emotionally

22  disturbed children and adolescents or a hospital. The

23  qualified evaluator must be a psychiatrist or a psychologist

24  licensed in Florida who has at least 3 years of experience in

25  the diagnosis and treatment of serious emotional disturbances

26  in children and adolescents and who has no actual or perceived

27  conflict of interest with any inpatient facility or

28  residential treatment center or program.

29         (c)  Before a child is admitted under this subsection,

30  the child shall be assessed for suitability for residential

31  treatment by a qualified evaluator who has conducted a


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  1  personal examination and assessment of the child and has made

  2  written findings that:

  3         1.  The child appears to have an emotional disturbance

  4  serious enough to require residential treatment and is

  5  reasonably likely to benefit from the treatment.

  6         2.  The child has been provided with a clinically

  7  appropriate explanation of the nature and purpose of the

  8  treatment.

  9         3.  All available modalities of treatment less

10  restrictive than residential treatment have been considered,

11  and a less restrictive alternative that would offer comparable

12  benefits to the child is unavailable.

13

14  A copy of the written findings of the evaluation and

15  suitability assessment must be provided to the department and

16  to the guardian ad litem, who shall have the opportunity to

17  discuss the findings with the evaluator.

18         (d)  Immediately upon placing a child in a residential

19  treatment program under this section, the department must

20  notify the guardian ad litem and the court having jurisdiction

21  over the child and must provide the guardian ad litem and the

22  court with a copy of the assessment by the qualified

23  evaluator.

24         (e)  Within 10 days after the admission of a child to a

25  residential treatment program, the director of the residential

26  treatment program or the director's designee must ensure that

27  an individualized plan of treatment has been prepared by the

28  program and has been explained to the child, to the

29  department, and to the guardian ad litem, and submitted to the

30  department. The child must be involved in the preparation of

31  the plan to the maximum feasible extent consistent with his or


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  1  her ability to understand and participate, and the guardian ad

  2  litem and the child's foster parents must be involved to the

  3  maximum extent consistent with the child's treatment needs.

  4  The plan must include a preliminary plan for residential

  5  treatment and aftercare upon completion of residential

  6  treatment. The plan must include specific behavioral and

  7  emotional goals against which the success of the residential

  8  treatment may be measured. A copy of the plan must be provided

  9  to the child, to the guardian ad litem, and to the department.

10         (f)  Within 30 days after admission, the residential

11  treatment program must review the appropriateness and

12  suitability of the child's placement in the program. The

13  residential treatment program must determine whether the child

14  is receiving benefit towards the treatment goals and whether

15  the child could be treated in a less restrictive treatment

16  program. The residential treatment program shall prepare a

17  written report of its findings and submit the report to the

18  guardian ad litem and to the department. The department must

19  submit the report to the court. The report must include a

20  discharge plan for the child. The residential treatment

21  program must continue to evaluate the child's treatment

22  progress every 30 days thereafter and must include its

23  findings in a written report submitted to the department. The

24  department may not reimburse a facility until the facility has

25  submitted every written report that is due.

26         (g)1.  The department must submit, at the beginning of

27  each month, to the court having jurisdiction over the child, a

28  written report regarding the child's progress towards

29  achieving the goals specified in the individualized plan of

30  treatment.

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  1         2.  The court must conduct a hearing to review the

  2  status of the child's residential treatment plan no later than

  3  3 months after the child's admission to the residential

  4  treatment program. An independent review of the child's

  5  progress towards achieving the goals and objectives of the

  6  treatment plan must be completed by a qualified evaluator and

  7  submitted to the court before its 3-month review.

  8         3.  For any child in residential treatment at the time

  9  a judicial review is held pursuant to s. 39.701, the child's

10  continued placement in residential treatment must be a subject

11  of the judicial review.

12         4.  If at any time the court determines that the child

13  is not suitable for continued residential treatment, the court

14  shall order the department to place the child in the least

15  restrictive setting that is best suited to meet his or her

16  needs.

17         (h)  After the initial 3-month review, the court must

18  conduct a review of the child's residential treatment plan

19  every 90 days.

20         (i)  The department must adopt rules for implementing

21  timeframes for the completion of suitability assessments by

22  qualified evaluators and a procedure that includes timeframes

23  for completing the 3-month independent review by the qualified

24  evaluators of the child's progress towards achieving the goals

25  and objectives of the treatment plan which review must be

26  submitted to the court. The Agency for Health Care

27  Administration must adopt rules for the registration of

28  qualified evaluators, the procedure for selecting the

29  evaluators to conduct the reviews required under this section,

30  and a reasonable, cost-efficient fee schedule for qualified

31  evaluators.


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  1         Section 4.  Section 409.1671, Florida Statutes, is

  2  amended to read:

  3         409.1671  Foster care and related services;

  4  privatization.--

  5         (1)(a)  It is the intent of the Legislature that the

  6  Department of Children and Family Services shall privatize the

  7  provision of foster care and related services statewide. It is

  8  further the Legislature's intent to encourage communities and

  9  other stakeholders in the well-being of children to

10  participate in assuring that children are safe and

11  well-nurtured. However, while recognizing that some local

12  governments are presently funding portions of certain foster

13  care and related services programs and may choose to expand

14  such funding in the future, the Legislature does not intend by

15  its privatization of foster care and related services that any

16  county, municipality, or special district be required to

17  assist in funding programs that previously have been funded by

18  the state. Nothing in this paragraph prohibits any county,

19  municipality, or special district from future voluntary

20  funding participation in foster care and related services. As

21  used in this section, the term "privatize" means to contract

22  with competent, community-based agencies. The department shall

23  submit a plan to accomplish privatization statewide, through a

24  competitive process, phased in over a 3-year period beginning

25  January 1, 2000. This plan must be developed with local

26  community participation, including, but not limited to, input

27  from community-based providers that are currently under

28  contract with the department to furnish community-based foster

29  care and related services, and must include a methodology for

30  determining and transferring all available funds, including

31  federal funds that the provider is eligible for and agrees to


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  1  earn and that portion of general revenue funds which is

  2  currently associated with the services that are being

  3  furnished under contract. The methodology must provide for the

  4  transfer of funds appropriated and budgeted for all services

  5  and programs that have been incorporated into the project,

  6  including all management, capital (including current furniture

  7  and equipment), and administrative funds to accomplish the

  8  transfer of these programs. This methodology must address

  9  expected workload and at least the 3 previous years'

10  experience in expenses and workload. With respect to any

11  district or portion of a district in which privatization

12  cannot be accomplished within the 3-year timeframe, the

13  department must clearly state in its plan the reasons the

14  timeframe cannot be met and the efforts that should be made to

15  remediate the obstacles, which may include alternatives to

16  total privatization, such as public-private partnerships. As

17  used in this section, the term "related services" includes,

18  but is not limited to, family preservation, independent

19  living, emergency shelter, residential group care, foster

20  care, therapeutic foster care, intensive residential

21  treatment, foster care supervision, case management,

22  postplacement supervision, permanent foster care, and family

23  reunification. Unless otherwise provided for, beginning in

24  fiscal year 1999-2000, either the state attorney or the Office

25  of the Attorney General shall provide child welfare legal

26  services, pursuant to chapter 39 and other relevant

27  provisions, in Sarasota, Pinellas, Pasco, Broward, and Manatee

28  Counties.  Such legal services shall commence and be

29  effective, as soon as determined reasonably feasible by the

30  respective state attorney or the Office of the Attorney

31  General, after the privatization of associated programs and


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  1  child protective investigations has occurred.  When a private

  2  nonprofit agency has received case management

  3  responsibilities, transferred from the state under this

  4  section, for a child who is sheltered or found to be dependent

  5  and who is assigned to the care of the privatization project,

  6  the agency may act as the child's guardian for the purpose of

  7  registering the child in school if a parent or guardian of the

  8  child is unavailable and his or her whereabouts cannot

  9  reasonably be ascertained. The private nonprofit agency may

10  also seek emergency medical attention for such a child, but

11  only if a parent or guardian of the child is unavailable, his

12  or her whereabouts cannot reasonably be ascertained, and a

13  court order for such emergency medical services cannot be

14  obtained because of the severity of the emergency or because

15  it is after normal working hours. However, the provider may

16  not consent to sterilization, abortion, or termination of life

17  support. If a child's parents' rights have been terminated,

18  the nonprofit agency shall act as guardian of the child in all

19  circumstances.

20         (b)  It is the intent of the Legislature that the

21  department will continue to work towards full privatization by

22  initiating the competitive procurement process in each county

23  by January 1, 2003. In order to provide for an adequate

24  transition period to develop the necessary administrative and

25  service delivery capacity in each community, the full transfer

26  of all foster care and related services must be completed

27  statewide by December 31, 2004.

28         (c)(b)  As used in this section, the term "eligible

29  lead community-based provider" means a single agency with

30  which the department shall contract for the provision of child

31  protective services in a community that is no smaller than a


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  1  county. The secretary of the department may authorize more

  2  than one eligible lead community-based provider within a

  3  single county when to do so will result in more effective

  4  delivery of foster care and related services. To compete for a

  5  privatization project, such agency must have:

  6         1.  The ability to coordinate, integrate, and manage

  7  all child protective services in the designated community in

  8  cooperation with child protective investigations.

  9         2.  The ability to ensure continuity of care from entry

10  to exit for all children referred from the protective

11  investigation and court systems.

12         3.  The ability to provide directly, or contract for

13  through a local network of providers, all necessary child

14  protective services.

15         4.  The willingness to accept accountability for

16  meeting the outcomes and performance standards related to

17  child protective services established by the Legislature and

18  the Federal Government.

19         5.  The capability and the willingness to serve all

20  children referred to it from the protective investigation and

21  court systems, regardless of the level of funding allocated to

22  the community by the state, provided all related funding is

23  transferred.

24         6.  The willingness to ensure that each individual who

25  provides child protective services completes the training

26  required of child protective service workers by the Department

27  of Children and Family Services.

28         7.  The ability to maintain eligibility to receive all

29  federal child welfare funds, including Title IV-E and IV-A

30  funds, currently being used by the Department of Children and

31  Family Services.


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  1         8.  Written agreements with Healthy Families Florida

  2  lead entities in their community, pursuant to s. 409.153, to

  3  promote cooperative planning for the provision of prevention

  4  and intervention services.

  5         (d)(c)1.  If attempts to competitively procure services

  6  through an eligible lead community-based provider as defined

  7  in paragraph (c)(b) do not produce a capable and willing

  8  agency, the department shall develop a plan in collaboration

  9  with the local community alliance. The plan must detail how

10  the community will continue to implement privatization, to be

11  accomplished by December 31, 2004, through competitively

12  procuring either the specific components of foster care and

13  related services or comprehensive services for defined

14  eligible populations of children and families from qualified

15  licensed agencies as part of its efforts to develop the local

16  capacity for a community-based system of coordinated care. The

17  plan must ensure local control over the management and

18  administration of the service provision in accordance with the

19  intent of this section and may include recognized best

20  business practices, including some form of public or private

21  partnerships. In the absence of a community alliance, the plan

22  must be submitted to the President of the Senate and the

23  Speaker of the House of Representatives for their comments.

24         2.  The Legislature finds that the state has

25  traditionally provided foster care services to children who

26  have been the responsibility of the state. As such, foster

27  children have not had the right to recover for injuries beyond

28  the limitations specified in s. 768.28. The Legislature has

29  determined that foster care and related services need to be

30  privatized pursuant to this section and that the provision of

31  such services is of paramount importance to the state. The


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  1  purpose for such privatization is to increase the level of

  2  safety, security, and stability of children who are or become

  3  the responsibility of the state. One of the components

  4  necessary to secure a safe and stable environment for such

  5  children is that private providers maintain liability

  6  insurance. As such, insurance needs to be available and remain

  7  available to nongovernmental foster care and related services

  8  providers without the resources of such providers being

  9  significantly reduced by the cost of maintaining such

10  insurance.

11         3.  The Legislature further finds that, by requiring

12  the following minimum levels of insurance, children in

13  privatized foster care and related services will gain

14  increased protection and rights of recovery in the event of

15  injury than provided for in s. 768.28.

16         (e)  In any county in which a service contract has not

17  been executed by December 31, 2004, the department shall

18  ensure access to a model comprehensive residential services

19  program as described in s. 409.1677 which, without imposing

20  undue financial, geographic, or other barriers, ensures

21  reasonable and appropriate participation by the family in the

22  child's program.

23         1.  In order to ensure that the program is operational

24  by December 31, 2004, the department must, by December 31,

25  2003, begin the process of establishing access to a program in

26  any county in which the department has not either entered into

27  a transition contract or approved a community plan, as

28  described in paragraph (d), which ensures full privatization

29  by the statutory deadline.

30         2.  The program must be procured through a competitive

31  process.


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  1         3.  The Legislature does not intend for the provisions

  2  of this paragraph to substitute for the requirement that full

  3  conversion to community-based care be accomplished.

  4         (f)(d)  Other than an entity to which s. 768.28

  5  applies, any eligible lead community-based provider, as

  6  defined in paragraph (c)(b), or its employees or officers,

  7  except as otherwise provided in paragraph (g)(e), must, as a

  8  part of its contract, obtain a minimum of $1 million per

  9  claim/$3 million per incident in general liability insurance

10  coverage. The eligible lead community-based provider must also

11  require that staff who transport client children and families

12  in their personal automobiles in order to carry out their job

13  responsibilities obtain minimum bodily injury liability

14  insurance in the amount of $100,000 per claim, $300,000 per

15  incident, on their personal automobiles. In any tort action

16  brought against such an eligible lead community-based provider

17  or employee, net economic damages shall be limited to $1

18  million per liability claim and $100,000 per automobile claim,

19  including, but not limited to, past and future medical

20  expenses, wage loss, and loss of earning capacity, offset by

21  any collateral source payment paid or payable. In any tort

22  action brought against such an eligible lead community-based

23  provider, noneconomic damages shall be limited to $200,000 per

24  claim. A claims bill may be brought on behalf of a claimant

25  pursuant to s. 768.28 for any amount exceeding the limits

26  specified in this paragraph. Any offset of collateral source

27  payments made as of the date of the settlement or judgment

28  shall be in accordance with s. 768.76. The lead

29  community-based provider shall not be liable in tort for the

30  acts or omissions of its subcontractors or the officers,

31  agents, or employees of its subcontractors.


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  1         (g)(e)  The liability of an eligible lead

  2  community-based provider described in this section shall be

  3  exclusive and in place of all other liability of such

  4  provider. The same immunities from liability enjoyed by such

  5  providers shall extend as well to each employee of the

  6  provider when such employee is acting in furtherance of the

  7  provider's business, including the transportation of clients

  8  served, as described in this subsection, in privately owned

  9  vehicles. Such immunities shall not be applicable to a

10  provider or an employee who acts in a culpably negligent

11  manner or with willful and wanton disregard or unprovoked

12  physical aggression when such acts result in injury or death

13  or such acts proximately cause such injury or death; nor shall

14  such immunities be applicable to employees of the same

15  provider when each is operating in the furtherance of the

16  provider's business, but they are assigned primarily to

17  unrelated works within private or public employment. The same

18  immunity provisions enjoyed by a provider shall also apply to

19  any sole proprietor, partner, corporate officer or director,

20  supervisor, or other person who in the course and scope of his

21  or her duties acts in a managerial or policymaking capacity

22  and the conduct that caused the alleged injury arose within

23  the course and scope of those managerial or policymaking

24  duties. Culpable negligence is defined as reckless

25  indifference or grossly careless disregard of human life.

26         (h)(f)  Any subcontractor of an eligible lead

27  community-based provider, as defined in paragraph (c)(b),

28  which is a direct provider of foster care and related services

29  to children and families, and its employees or officers,

30  except as otherwise provided in paragraph (g)(e), must, as a

31  part of its contract, obtain a minimum of $1 million per


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  1  claim/$3 million per incident in general liability insurance

  2  coverage. The subcontractor of an eligible lead

  3  community-based provider must also require that staff who

  4  transport client children and families in their personal

  5  automobiles in order to carry out their job responsibilities

  6  obtain minimum bodily injury liability insurance in the amount

  7  of $100,000 per claim, $300,000 per incident, on their

  8  personal automobiles. In any tort action brought against such

  9  subcontractor or employee, net economic damages shall be

10  limited to $1 million per liability claim and $100,000 per

11  automobile claim, including, but not limited to, past and

12  future medical expenses, wage loss, and loss of earning

13  capacity, offset by any collateral source payment paid or

14  payable. In any tort action brought against such

15  subcontractor, noneconomic damages shall be limited to

16  $200,000 per claim. A claims bill may be brought on behalf of

17  a claimant pursuant to s. 768.28 for any amount exceeding the

18  limits specified in this paragraph. Any offset of collateral

19  source payments made as of the date of the settlement or

20  judgment shall be in accordance with s. 768.76.

21         (i)(g)  The liability of a subcontractor of an eligible

22  lead community-based provider that is a direct provider of

23  foster care and related services as described in this section

24  shall be exclusive and in place of all other liability of such

25  provider. The same immunities from liability enjoyed by such

26  subcontractor provider shall extend as well to each employee

27  of the subcontractor when such employee is acting in

28  furtherance of the subcontractor's business, including the

29  transportation of clients served, as described in this

30  subsection, in privately owned vehicles. Such immunities shall

31  not be applicable to a subcontractor or an employee who acts


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  1  in a culpably negligent manner or with willful and wanton

  2  disregard or unprovoked physical aggression when such acts

  3  result in injury or death or such acts proximately cause such

  4  injury or death; nor shall such immunities be applicable to

  5  employees of the same subcontractor when each is operating in

  6  the furtherance of the subcontractor's business, but they are

  7  assigned primarily to unrelated works within private or public

  8  employment. The same immunity provisions enjoyed by a

  9  subcontractor shall also apply to any sole proprietor,

10  partner, corporate officer or director, supervisor, or other

11  person who in the course and scope of his or her duties acts

12  in a managerial or policymaking capacity and the conduct that

13  caused the alleged injury arose within the course and scope of

14  those managerial or policymaking duties. Culpable negligence

15  is defined as reckless indifference or grossly careless

16  disregard of human life.

17         (j)(h)  The Legislature is cognizant of the increasing

18  costs of goods and services each year and recognizes that

19  fixing a set amount of compensation actually has the effect of

20  a reduction in compensation each year. Accordingly, the

21  conditional limitations on damages in this section shall be

22  increased at the rate of 5 percent each year, prorated from

23  the effective date of this paragraph to the date at which

24  damages subject to such limitations are awarded by final

25  judgment or settlement.

26         (2)(a)  The department may contract for the delivery,

27  administration, or management of protective services, the

28  services specified in subsection (1) relating to foster care,

29  and other related services or programs, as appropriate. The

30  department shall retain responsibility for the quality of

31  contracted services and programs and shall ensure that


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  1  services are delivered in accordance with applicable federal

  2  and state statutes and regulations. The department must adopt

  3  written policies and procedures for monitoring the contract

  4  for delivery of services by lead community-based providers.

  5  These policies and procedures must, at a minimum, address the

  6  evaluation of fiscal accountability and program operations,

  7  including provider achievement of performance standards,

  8  provider monitoring of subcontractors, and timely followup of

  9  corrective actions for significant monitoring findings related

10  to providers and subcontractors. These policies and procedures

11  must also include provisions for reducing the duplication of

12  the department's program monitoring activities both internally

13  and with other agencies, to the extent possible. The

14  department's written procedures must ensure that the written

15  findings, conclusions, and recommendations from monitoring the

16  contract for services of lead community-based providers are

17  communicated to the director of the provider agency as

18  expeditiously as possible.

19         (b)  Persons employed by the department in the

20  provision of foster care and related services whose positions

21  are being privatized pursuant to this statute shall be given

22  hiring preference by the provider, if provider qualifications

23  are met.

24         (3)(a)  In order to help ensure a seamless child

25  protection system, the department shall ensure that contracts

26  entered into with community-based agencies pursuant to this

27  section include provisions for a case-transfer process to

28  determine the date that the community-based agency will

29  initiate the appropriate services for a child and family. This

30  case-transfer process must clearly identify the closure of the

31  protective investigation and the initiation of service


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  1  provision. At the point of case transfer, and at the

  2  conclusion of an investigation, the department must provide a

  3  complete summary of the findings of the investigation to the

  4  community-based agency.

  5         (b)  The contracts must also ensure that each

  6  community-based agency shall furnish information on its

  7  activities in all cases in client case records regular status

  8  reports of its cases to the department as specified in the

  9  contract. A provider may not discontinue services on any

10  voluntary case without prior written notification to the

11  department 30 days before planned case closure. If the

12  department disagrees with the recommended case closure date,

13  written notification to the provider must be provided before

14  the case closure date. without prior written notification to

15  the department. After discontinuing services to a child or a

16  child and family, the community-based agency must provide a

17  written case summary, including its assessment of the child

18  and family, to the department.

19         (c)  The contract between the department and

20  community-based agencies must include provisions that specify

21  the procedures to be used by the parties to resolve

22  differences in interpreting the contract or to resolve

23  disputes as to the adequacy of the parties' compliance with

24  their respective obligations under the contract.

25         (4)(a)  The department shall establish a quality

26  assurance program for privatized services. The quality

27  assurance program shall be based on standards established by a

28  national accrediting organization such as the Council on

29  Accreditation of Services for Families and Children, Inc.

30  (COA) or CARF--the Rehabilitation Accreditation Commission.

31  The department may develop a request for proposal for such


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  1  oversight. This program must be developed and administered at

  2  a statewide level. The Legislature intends that the department

  3  be permitted to have limited flexibility to use funds for

  4  improving quality assurance. To this end, effective January 1,

  5  2000, the department may transfer up to 0.125 percent of the

  6  total funds from categories used to pay for these

  7  contractually provided services, but the total amount of such

  8  transferred funds may not exceed $300,000 in any fiscal year.

  9  When necessary, the department may establish, in accordance

10  with s. 216.177, additional positions that will be exclusively

11  devoted to these functions. Any positions required under this

12  paragraph may be established, notwithstanding ss.

13  216.262(1)(a) and 216.351. The department, in consultation

14  with the community-based agencies that are undertaking the

15  privatized projects, shall establish minimum thresholds for

16  each component of service, consistent with standards

17  established by the Legislature. Each program operated under

18  contract with a community-based agency must be evaluated

19  annually by the department. The department shall submit an

20  annual report regarding quality performance, outcome measure

21  attainment, and cost efficiency to the President of the

22  Senate, the Speaker of the House of Representatives, the

23  minority leader of each house of the Legislature, and the

24  Governor no later than January 31 of each year for each

25  project in operation during the preceding fiscal year.

26         (b)  The department shall use these findings in making

27  recommendations to the Governor and the Legislature for future

28  program and funding priorities in the child welfare system.

29         (5)(a)  The community-based agency must comply with

30  statutory requirements and agency rules in the provision of

31  contractual services. Each foster home, therapeutic foster


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  1  home, emergency shelter, or other placement facility operated

  2  by the community-based agency or agencies must be licensed by

  3  the Department of Children and Family Services under chapter

  4  402 or this chapter. Each community-based agency must be

  5  licensed as a child-caring or child-placing agency by the

  6  department under this chapter. The department, in order to

  7  eliminate or reduce the number of duplicate inspections by

  8  various program offices, shall coordinate inspections required

  9  pursuant to licensure of agencies under this section.

10         (b)  Substitute care providers who are licensed under

11  s. 409.175 and have contracted with a lead agency authorized

12  under this section shall also be authorized to provide

13  registered or licensed family day care under s. 402.313, if

14  consistent with federal law and if the home has met:

15         1.  the requirements of s. 402.313.; and

16         2.  The requirements of s. 402.281 and has received

17  Gold Seal Quality Care designation.

18         (c)  A dually licensed home under this section shall be

19  eligible to receive both an out-of-home care payment and a

20  subsidized child care payment for the same child pursuant to

21  federal law. The department may adopt administrative rules

22  necessary to administer this paragraph the foster care board

23  rate and the subsidized child care rate for the same child

24  only if care is provided 24 hours a day. The subsidized child

25  care rate shall be no more than the approved full-time rate.

26         (6)  Beginning January 1, 1999, and continuing at least

27  through June 30, 2000, the Department of Children and Family

28  Services shall privatize all foster care and related services

29  in district 5 while continuing to contract with the current

30  model programs in districts 1, 4, and 13, and in subdistrict

31  8A, and shall expand the subdistrict 8A pilot program to


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  1  incorporate Manatee County. Planning for the district 5

  2  privatization shall be done by providers that are currently

  3  under contract with the department for foster care and related

  4  services and shall be done in consultation with the

  5  department.  A lead provider of the district 5 program shall

  6  be competitively selected, must demonstrate the ability to

  7  provide necessary comprehensive services through a local

  8  network of providers, and must meet criteria established in

  9  this section. Contracts with organizations responsible for the

10  model programs must include the management and administration

11  of all privatized services specified in subsection (1).

12  However, the department may use funds for contract management

13  only after obtaining written approval from the Executive

14  Office of the Governor. The request for such approval must

15  include, but is not limited to, a statement of the proposed

16  amount of such funds and a description of the manner in which

17  such funds will be used. If the community-based organization

18  selected for a model program under this subsection is not a

19  Medicaid provider, the organization shall be issued a Medicaid

20  provider number pursuant to s. 409.907 for the provision of

21  services currently authorized under the state Medicaid plan to

22  those children encompassed in this model and in a manner not

23  to exceed the current level of state expenditure.

24         (7)  The department, in consultation with existing lead

25  agencies, shall develop a proposal regarding the long-term use

26  and structure of a statewide shared earnings program which

27  addresses is authorized to establish and administer a risk

28  pool to reduce the financial risk to eligible lead

29  community-based providers resulting from unanticipated

30  caseload growth or from significant changes in client mixes or

31  services eligible for federal reimbursement. The


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  1  recommendations in the statewide proposal must also be

  2  available to entities of the department until the conversion

  3  to community-based care takes place. At a minimum, the

  4  proposal must allow for use of federal earnings received from

  5  child welfare programs, which earnings are determined by the

  6  department to be in excess of the amount appropriated in the

  7  General Appropriations Act, to be used for specific purposes.

  8  These purposes include, but are not limited to:

  9         (a)  Significant changes in the number or composition

10  of clients eligible to receive services.

11         (b)  Significant changes in the services that are

12  eligible for reimbursement.

13         (c)  Significant changes in the availability of federal

14  funds.

15         (d)  Shortfalls in state funds available for eligible

16  or ineligible services.

17         (e)  Significant changes in the mix of available funds.

18         (f)  Scheduled or unanticipated, but necessary,

19  advances to providers or other cash-flow issues.

20         (g)  Proposals to participate in optional Medicaid

21  services or other federal grant opportunities.

22         (h)  Appropriate incentive structures.

23         (i)  Continuity of care in the event of lead agency

24  failure, discontinuance of service, or financial misconduct.

25

26  The department shall further specify the necessary steps to

27  ensure the financial integrity of these dollars and their

28  continued availability on an ongoing basis. The final proposal

29  shall be submitted to the Legislative Budget Commission for

30  formal adoption before December 31, 2002. If the Legislative

31  Budget Commission refuses to concur with the adoption of the


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  1  proposal, the department shall present its proposal in the

  2  form of recommended legislation to the President of the Senate

  3  and the Speaker of the House of Representatives before the

  4  commencement of the next legislative session. For fiscal year

  5  2003-2004 and annually thereafter, the Department of Children

  6  and Family Services may request in its legislative budget

  7  request, and the Governor may recommend, the funding necessary

  8  to carry out paragraph (i) from excess federal earnings. The

  9  General Appropriations Act shall include any funds

10  appropriated for this purpose in a lump sum in the

11  Administered Funds Program, which funds constitute partial

12  security for lead agency contract performance. The department

13  shall use this appropriation to offset the need for a

14  performance bond for that year after a comparison of risk to

15  the funds available. In no event shall this performance bond

16  exceed 2.5 percent of the annual contract value. The

17  department may separately require a bond to mitigate the

18  financial consequences of potential acts of malfeasance,

19  misfeasance, or criminal violations by the provider. Prior to

20  the release of any funds in the lump sum, the department shall

21  submit a detailed operational plan, which must identify the

22  sources of specific trust funds to be used. The release of the

23  trust fund shall be subject to the notice and review

24  provisions of s. 216.177. However, the release shall not

25  require approval of the Legislative Budget Commission.

26         (8)  Notwithstanding the provisions of s. 215.425, all

27  documented federal funds earned for the current fiscal year by

28  the department and community-based agencies which exceed the

29  amount appropriated by the Legislature shall be distributed to

30  all entities that contributed to the excess earnings based on

31  a schedule and methodology developed by the department and


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  1  approved by the Executive Office of the Governor. Distribution

  2  shall be pro rata based on total earnings and shall be made

  3  only to those entities that contributed to excess earnings.

  4  Excess earnings of community-based agencies shall be used only

  5  in the service district in which they were earned. Additional

  6  state funds appropriated by the Legislature for

  7  community-based agencies or made available pursuant to the

  8  budgetary amendment process described in s. 216.177 shall be

  9  transferred to the community-based agencies. The department

10  shall amend a community-based agency's contract to permit

11  expenditure of the funds. The distribution program applies

12  only to entities that were under privatization contracts as of

13  July 1, 2002 1999. This program is authorized for a period of

14  3 years beginning July 1, 1999, and ending June 30, 2002. The

15  Office of Program Policy Analysis and Government

16  Accountability shall review this program and report to the

17  President of the Senate and the Speaker of the House of

18  Representatives by December 31, 2001. The review shall assess

19  the program to determine how the additional resources were

20  used, the number of additional clients served, the

21  improvements in quality of service attained, the performance

22  outcomes associated with the additional resources, and the

23  feasibility of continuing or expanding this program.

24         (9)  Each district and subdistrict that participates in

25  the model program effort or any future privatization effort as

26  described in this section must thoroughly analyze and report

27  the complete direct and indirect costs of delivering these

28  services through the department and the full cost of

29  privatization, including the cost of monitoring and evaluating

30  the contracted services.

31


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  1         Section 5.  Section 409.1676, Florida Statutes, is

  2  amended to read:

  3         409.1676  Comprehensive residential group care services

  4  to children who have extraordinary needs.--

  5         (1)  It is the intent of the Legislature to provide

  6  comprehensive residential group care services, including

  7  residential care, case management, and other services, to

  8  children in the child protection system who have extraordinary

  9  needs, such as serious behavioral problems or having been

10  determined to be without the options of either reunification

11  with family or adoption. These services are to be provided in

12  a residential group care setting by a not-for-profit

13  corporation or a local government entity under a contract with

14  the Department of Children and Family Services or by a lead

15  agency as described in s. 409.1671. These contracts should be

16  designed to provide an identified number of children with

17  access to a full array of services for a fixed price. Further,

18  it is the intent of the Legislature that the Department of

19  Children and Family Services and the Department of Juvenile

20  Justice establish an interagency agreement by December 1,

21  2002, which describes respective agency responsibilities for

22  referral, placement, service provision, and service

23  coordination for dependent and delinquent youth who are

24  referred to these residential group care facilities. The

25  agreement must require interagency collaboration in the

26  development of terms, conditions, and performance outcomes for

27  residential group care contracts serving the youth referred

28  who have been adjudicated both dependent and delinquent.

29         (2)  As used in this section, the term:

30         (a)  "Child with extraordinary needs" means a dependent

31  child who has serious behavioral problems or who has been


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  1  determined to be without the options of either reunification

  2  with family or adoption.

  3         (b)(a)  "Residential group care" means a living

  4  environment for children who have been adjudicated dependent

  5  and are expected to be in foster care for at least 6 months

  6  with 24-hour-awake staff or live-in group home parents or

  7  staff. Each facility Beginning July 1, 2001, all facilities

  8  must be appropriately licensed in this state as a residential

  9  child caring agency as defined in s. 409.175(2)(j), and they

10  must be accredited by July 1, 2005. A residential group care

11  facility serving children having a serious behavioral problem

12  as defined in this section must have available staff or

13  contract personnel with the clinical expertise, credentials,

14  and training to provide services identified in subsection (4).

15         (c)(b)  "Serious behavioral problems" means behaviors

16  of children who have been assessed by a licensed

17  master's-level human-services professional to need at a

18  minimum intensive services but who do not meet the criteria of

19  s. 394.492(6) or (7). A child with an emotional disturbance as

20  defined in s. 394.492(5) or (6) may be served in residential

21  group care unless a determination is made by a mental health

22  professional that such a setting is inappropriate. A child

23  having a serious behavioral problem must have been determined

24  in the assessment to have at least one of the following risk

25  factors:

26         1.  An adjudication of delinquency and be on

27  conditional release status with the Department of Juvenile

28  Justice.

29         2.  A history of physical aggression or violent

30  behavior toward self or others, animals, or property within

31  the past year.


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  1         3.  A history of setting fires within the past year.

  2         4.  A history of multiple episodes of running away from

  3  home or placements within the past year.

  4         5.  A history of sexual aggression toward other youth.

  5         (3)  The department, in accordance with a specific

  6  appropriation for this program, shall contract with a

  7  not-for-profit corporation, a local government entity, or the

  8  lead agency that has been established in accordance with s.

  9  409.1671 for the performance of residential group care

10  services described in this section in, at a minimum, districts

11  4, 11, 12, and the Suncoast Region of the Department of

12  Children and Family Services and with a not-for-profit entity

13  serving children from multiple districts. A lead agency that

14  is currently providing residential care may provide this

15  service directly with the approval of the local community

16  alliance. The department or a lead agency may contract for

17  more than one site in a county if that is determined to be the

18  most effective way to achieve the goals set forth in this

19  section.

20         (4)  The lead agency, the contracted not-for-profit

21  corporation, or the local government entity is responsible for

22  a comprehensive assessment, residential care, transportation,

23  access to behavioral health services, recreational activities,

24  clothing, supplies, and miscellaneous expenses associated with

25  caring for these children; for necessary arrangement for or

26  provision of educational services; and for assuring necessary

27  and appropriate health and dental care.

28         (5)  The department may transfer all casework

29  responsibilities for children served under this program to the

30  entity that provides this service, including case management

31  and development and implementation of a case plan in


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  1  accordance with current standards for child protection

  2  services. When the department establishes this program in a

  3  community that has a lead agency as described in s. 409.1671,

  4  the casework responsibilities must be transferred to the lead

  5  agency.

  6         (6)  This section does not prohibit any provider of

  7  these services from appropriately billing Medicaid for

  8  services rendered, from contracting with a local school

  9  district for educational services, or from earning federal or

10  local funding for services provided, as long as two or more

11  funding sources do not pay for the same specific service that

12  has been provided to a child.

13         (7)  The lead agency, not-for-profit corporation, or

14  local government entity has the legal authority for children

15  served under this program, as provided in chapter 39 or this

16  chapter, as appropriate, to enroll the child in school, to

17  sign for a driver's license for the child, to cosign loans and

18  insurance for the child, to sign for medical treatment, and to

19  authorize other such activities.

20         (8)  The department shall provide technical assistance

21  as requested and contract management services.

22         (9)  The provisions of this section shall be

23  implemented to the extent of available appropriations

24  contained in the annual General Appropriations Act for such

25  purpose.

26         (10)  The department may adopt rules necessary to

27  administer this section.

28         Section 6.  Paragraph (e) of subsection (2) of section

29  409.175, Florida Statutes, is amended, present subsections (3)

30  through (15) of said section are renumbered as subsections (4)

31  through (16), respectively, present subsections (5), (8), (9),


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  1  and (11) are amended, and a new subsection (3) is added to

  2  said section, to read:

  3         409.175  Licensure of family foster homes, residential

  4  child-caring agencies, and child-placing agencies.--

  5         (2)  As used in this section, the term:

  6         (e)  "Family foster home" means a private residence in

  7  which children who are unattended by a parent or legal

  8  guardian are provided 24-hour care.  Such homes include

  9  emergency shelter family homes, family foster group homes, and

10  specialized foster homes for children with special needs.  A

11  person who cares for a child of a friend for a period not to

12  exceed 90 days, a relative who cares for a child and does not

13  receive reimbursement for such care from the state or federal

14  government, or an adoptive home which has been approved by the

15  department or by a licensed child-placing agency for children

16  placed for adoption is not considered a family foster home.

17         (3)(a)  The total number of children placed in each

18  family foster home shall be based on the recommendation of the

19  department, or the community-based care lead agency where one

20  is providing foster care and related services, based on the

21  needs of each child in care, the ability of the foster family

22  to meet the individual needs of each child, including any

23  adoptive or biological children living in the home, the amount

24  of safe physical plant space, the ratio of active and

25  appropriate adult supervision, and the background, experience,

26  and skill of the family foster parents.

27         (b)  If the total number of children in a family foster

28  home will exceed five, including the family's own children, a

29  comprehensive behavioral health assessment of each child to be

30  placed in the home must be completed prior to placement of any

31  additional children in the home. The comprehensive behavioral


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  1  health assessment must comply with Medicaid rules and

  2  regulations, assess and document the mental, physical, and

  3  psychosocial needs of the child, and recommend the maximum

  4  number of children in a family foster home that will allow the

  5  child's needs to be met.

  6         (c)  For any licensed family foster home, the

  7  appropriateness of the number of children in the home must be

  8  reassessed annually as part of the relicensure process. For a

  9  home with more than five children, if it is determined by the

10  licensure study at the time of relicensure that the total

11  number of children in the home is appropriate and that there

12  have been no substantive licensure violations and no

13  indications of child maltreatment or child-on-child sexual

14  abuse within the past 12 months, the relicensure of the home

15  shall not be denied based on the total number of children in

16  the home.

17         (6)(5)(a)  An application for a license shall be made

18  on forms provided, and in the manner prescribed, by the

19  department. The department shall make a determination as to

20  the good moral character of the applicant based upon

21  screening.

22         (b)  Upon application, the department shall conduct a

23  licensing study based on its licensing rules; shall inspect

24  the home or the agency and the records, including financial

25  records, of the agency; and shall interview the applicant.

26  The department may authorize a licensed child-placing agency

27  to conduct the licensing study of a family foster home to be

28  used exclusively by that agency and to verify to the

29  department that the home meets the licensing requirements

30  established by the department.  Upon certification by a

31  licensed child-placing agency that a family foster home meets


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  1  the licensing requirements, the department shall issue the

  2  license.

  3         (c)  A licensed family foster home, child-placing

  4  agency, or residential child-caring agency which applies for

  5  renewal of its license shall submit to the department a list

  6  of personnel who have worked on a continuous basis at the

  7  applicant family foster home or agency since submitting

  8  fingerprints to the department, identifying those for whom a

  9  written assurance of compliance was provided by the department

10  and identifying those personnel who have recently begun

11  working at the family foster home or agency and are awaiting

12  the results of the required fingerprint check, along with the

13  date of the submission of those fingerprints for processing.

14  The department shall by rule determine the frequency of

15  requests to the Department of Law Enforcement to run state

16  criminal records checks for such personnel except for those

17  personnel awaiting the results of initial fingerprint checks

18  for employment at the applicant family foster home or agency.

19         (d)1.  The department may pursue other remedies

20  provided in this section in addition to denial or revocation

21  of a license for failure to comply with the screening

22  requirements.  The disciplinary actions determination to be

23  made by the department and the procedure for hearing for

24  applicants and licensees shall be in accordance with chapter

25  120.

26         2.  When the department has reasonable cause to believe

27  that grounds for denial or termination of employment exist, it

28  shall notify, in writing, the applicant, licensee, or summer

29  or recreation camp, and the personnel affected, stating the

30  specific record which indicates noncompliance with the

31  screening requirements.


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  1         3.  Procedures established for hearing under chapter

  2  120 shall be available to the applicant, licensee, summer day

  3  camp, or summer 24-hour camp, and affected personnel, in order

  4  to present evidence relating either to the accuracy of the

  5  basis for exclusion or to the denial of an exemption from

  6  disqualification.

  7         4.  Refusal on the part of an applicant to dismiss

  8  personnel who have been found not to be in compliance with the

  9  requirements for good moral character of personnel shall

10  result in automatic denial or revocation of license in

11  addition to any other remedies provided in this section which

12  may be pursued by the department.

13         (e)  At the request of the department, the local county

14  health department shall inspect a home or agency according to

15  the licensing rules promulgated by the department.  Inspection

16  reports shall be furnished to the department within 30 days of

17  the request. Such an inspection shall only be required when

18  called for by the licensing agency.

19         (f)  All residential child-caring agencies must meet

20  firesafety standards for such agencies adopted by the Division

21  of State Fire Marshal of the Department of Insurance and must

22  be inspected annually.  At the request of the department,

23  firesafety inspections shall be conducted by the Division of

24  State Fire Marshal or a local fire department official who has

25  been certified by the division as having completed the

26  training requirements for persons inspecting such agencies.

27  Inspection reports shall be furnished to the department within

28  30 days of a request.

29         (g)  In the licensing process, the licensing staff of

30  the department shall provide consultation on request.

31


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  1         (h)  Upon determination that the applicant meets the

  2  state minimum licensing requirements, the department shall

  3  issue a license without charge to a specific person or agency

  4  at a specific location. A license may be issued if all the

  5  screening materials have been timely submitted; however, a

  6  license may not be issued or renewed if any person at the home

  7  or agency has failed the required screening. The license is

  8  nontransferable. A copy of the license shall be displayed in a

  9  conspicuous place. Except as provided in paragraph (j), the

10  license is valid for 1 year from the date of issuance, unless

11  the license is suspended or revoked by the department or is

12  voluntarily surrendered by the licensee. The license is the

13  property of the department.

14         (i)  A license issued for the operation of a family

15  foster home or agency, unless sooner suspended, revoked, or

16  voluntarily returned, will expire automatically 1 year from

17  the date of issuance except as provided in paragraph (j).

18  Ninety days prior to the expiration date, an application for

19  renewal shall be submitted to the department by a licensee who

20  wishes to have the license renewed.  A license shall be

21  renewed upon the filing of an application on forms furnished

22  by the department if the applicant has first met the

23  requirements established under this section and the rules

24  promulgated hereunder.

25         (j)  Except for a family foster group home having a

26  licensed capacity for more than five children, the department

27  may issue a license that is valid for longer than 1 year but

28  no longer than 3 years to a family foster home that:

29         1.  Has maintained a license with the department as a

30  family foster home for at least the 3 previous consecutive

31  years;


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  1         2.  Remains in good standing with the department; and

  2         3.  Has not been the subject of a report of child abuse

  3  or neglect with any findings of maltreatment.

  4

  5  A family foster home that has been issued a license valid for

  6  longer than 1 year must be monitored and visited as frequently

  7  as one that has been issued a 1-year license. The department

  8  reserves the right to reduce a licensure period to 1 year at

  9  any time.

10         (k)  The department may not license summer day camps or

11  summer 24-hour camps.  However, the department shall have

12  access to the personnel records of such facilities to ensure

13  compliance with the screening requirements.

14         (9)(8)(a)  The department may deny, suspend, or revoke

15  a license.

16         (b)  Any of the following actions by a home or agency

17  or its personnel is a ground for denial, suspension, or

18  revocation of a license:

19         1.  An intentional or negligent act materially

20  affecting the health or safety of children in the home or

21  agency.

22         2.  A violation of the provisions of this section or of

23  licensing rules promulgated pursuant to this section.

24         3.  Noncompliance with the requirements for good moral

25  character as specified in paragraph (5)(4)(a).

26         4.  Failure to dismiss personnel found in noncompliance

27  with requirements for good moral character.

28         (10)(9)(a)  The department may institute injunctive

29  proceedings in a court of competent jurisdiction to:

30

31


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  1         1.  Enforce the provisions of this section or any

  2  license requirement, rule, or order issued or entered into

  3  pursuant thereto; or

  4         2.  Terminate the operation of an agency in which any

  5  of the following conditions exist:

  6         a.  The licensee has failed to take preventive or

  7  corrective measures in accordance with any order of the

  8  department to maintain conformity with licensing requirements.

  9         b.  There is a violation of any of the provisions of

10  this section, or of any licensing requirement promulgated

11  pursuant to this section, which violation threatens harm to

12  any child or which constitutes an emergency requiring

13  immediate action.

14         3.  Terminate the operation of a summer day camp or

15  summer 24-hour camp providing care for children when such camp

16  has willfully and knowingly refused to comply with the

17  screening requirements for personnel or has refused to

18  terminate the employment of personnel found to be in

19  noncompliance with the requirements for good moral character

20  as determined in paragraph (5)(4)(a).

21         (b)  If the department finds, within 30 days after

22  written notification by registered mail of the requirement for

23  licensure, that a person or agency continues to care for or to

24  place children without a license or, within 30 days after

25  written notification by registered mail of the requirement for

26  screening of personnel and compliance with paragraph (5)(4)(a)

27  for the hiring and continued employment of personnel, that a

28  summer day camp or summer 24-hour camp continues to provide

29  care for children without complying, the department shall

30  notify the appropriate state attorney of the violation of law

31  and, if necessary, shall institute a civil suit to enjoin the


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  1  person or agency from continuing the placement or care of

  2  children or to enjoin the summer day camp or summer 24-hour

  3  camp from continuing the care of children.

  4         (c)  Such injunctive relief may be temporary or

  5  permanent.

  6         (12)(11)(a)  It is unlawful for any person or agency

  7  to:

  8         1.  Provide continuing full-time care for or to receive

  9  or place a child apart from her or his parents in a

10  residential group care facility, family foster home, or

11  adoptive home without a valid license issued by the department

12  if such license is required by subsection (5)(4); or

13         2.  Make a willful or intentional misstatement on any

14  license application or other document required to be filed in

15  connection with an application for a license.

16         (b)  It is unlawful for any person, agency, summer day

17  camp, or summer 24-hour camp providing care for children to:

18         1.  Willfully or intentionally fail to comply with the

19  requirements for the screening of personnel or the dismissal

20  of personnel found not to be in compliance with the

21  requirements for good moral character as specified in

22  paragraph (5)(4)(a).

23         2.  Use information from the criminal records obtained

24  under this section for any purpose other than screening a

25  person for employment as specified in this section or to

26  release such information to any other person for any purpose

27  other than screening for employment as specified in this

28  section.

29         (c)  It is unlawful for any person, agency, summer day

30  camp, or summer 24-hour camp providing care for children to

31  use information from the juvenile records of any person


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  1  obtained under this section for any purpose other than

  2  screening for employment as specified in this section or to

  3  release information from such records to any other person for

  4  any purpose other than screening for employment as specified

  5  in this section.

  6         (d)1.  A first violation of paragraph (a) or paragraph

  7  (b) is a misdemeanor of the first degree, punishable as

  8  provided in s. 775.082 or s. 775.083.

  9         2.  A second or subsequent violation of paragraph (a)

10  or paragraph (b) is a felony of the third degree, punishable

11  as provided in s. 775.082 or s. 775.083.

12         3.  A violation of paragraph (c) is a felony of the

13  third degree, punishable as provided in s. 775.082, s.

14  775.083, or s. 775.084.

15         Section 7.  Subsection (24) of section 409.906, Florida

16  Statutes, is amended to read:

17         409.906  Optional Medicaid services.--Subject to

18  specific appropriations, the agency may make payments for

19  services which are optional to the state under Title XIX of

20  the Social Security Act and are furnished by Medicaid

21  providers to recipients who are determined to be eligible on

22  the dates on which the services were provided.  Any optional

23  service that is provided shall be provided only when medically

24  necessary and in accordance with state and federal law.

25  Optional services rendered by providers in mobile units to

26  Medicaid recipients may be restricted or prohibited by the

27  agency. Nothing in this section shall be construed to prevent

28  or limit the agency from adjusting fees, reimbursement rates,

29  lengths of stay, number of visits, or number of services, or

30  making any other adjustments necessary to comply with the

31  availability of moneys and any limitations or directions


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  1  provided for in the General Appropriations Act or chapter 216.

  2  If necessary to safeguard the state's systems of providing

  3  services to elderly and disabled persons and subject to the

  4  notice and review provisions of s. 216.177, the Governor may

  5  direct the Agency for Health Care Administration to amend the

  6  Medicaid state plan to delete the optional Medicaid service

  7  known as "Intermediate Care Facilities for the Developmentally

  8  Disabled."  Optional services may include:

  9         (24)  CHILD-WELFARE-TARGETED CASE MANAGEMENT.--The

10  Agency for Health Care Administration, in consultation with

11  the Department of Children and Family Services, may establish

12  a targeted case-management pilot project in those counties

13  identified by the Department of Children and Family Services

14  and for all counties with a the community-based child welfare

15  project in Sarasota and Manatee counties, as authorized under

16  s. 409.1671, which have been specifically approved by the

17  department. These projects shall be established for the

18  purpose of determining the impact of targeted case management

19  on the child welfare program and the earnings from the child

20  welfare program. Results of targeted case management the pilot

21  projects shall be reported to the Child Welfare Estimating

22  Conference and the Social Services Estimating Conference

23  established under s. 216.136. The number of projects may not

24  be increased until requested by the Department of Children and

25  Family Services, recommended by the Child Welfare Estimating

26  Conference and the Social Services Estimating Conference, and

27  approved by the Legislature. The covered group of individuals

28  who are eligible to receive targeted case management include

29  children who are eligible for Medicaid; who are between the

30  ages of birth through 21; and who are under protective

31  supervision or postplacement supervision, under foster-care


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  1  supervision, or in shelter care or foster care. The number of

  2  individuals who are eligible to receive targeted case

  3  management shall be limited to the number for whom the

  4  Department of Children and Family Services has available

  5  matching funds to cover the costs. The general revenue funds

  6  required to match the funds for services provided by the

  7  community-based child welfare projects are limited to funds

  8  available for services described under s. 409.1671. The

  9  Department of Children and Family Services may transfer the

10  general revenue matching funds as billed by the Agency for

11  Health Care Administration.

12         Section 8.  Section 393.0657, Florida Statutes, is

13  amended to read:

14         393.0657  Persons not required to be refingerprinted or

15  rescreened.--Any provision of law to the contrary

16  notwithstanding, human resource personnel who have been

17  fingerprinted or screened pursuant to chapters 393, 394, 397,

18  402, and 409, and teachers who have been fingerprinted

19  pursuant to chapter 231, who have not been unemployed for more

20  than 90 days thereafter, and who under the penalty of perjury

21  attest to the completion of such fingerprinting or screening

22  and to compliance with the provisions of this section and the

23  standards for good moral character as contained in such

24  provisions as ss. 110.1127(3), 393.0655(1), 394.457(6),

25  397.451, 402.305(2), and 409.175(5)(4), shall not be required

26  to be refingerprinted or rescreened in order to comply with

27  any direct service provider screening or fingerprinting

28  requirements.

29         Section 9.  Section 402.3057, Florida Statutes, is

30  amended to read:

31


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  1         402.3057  Persons not required to be refingerprinted or

  2  rescreened.--Any provision of law to the contrary

  3  notwithstanding, human resource personnel who have been

  4  fingerprinted or screened pursuant to chapters 393, 394, 397,

  5  402, and 409, and teachers and noninstructional personnel who

  6  have been fingerprinted pursuant to chapter 231, who have not

  7  been unemployed for more than 90 days thereafter, and who

  8  under the penalty of perjury attest to the completion of such

  9  fingerprinting or screening and to compliance with the

10  provisions of this section and the standards for good moral

11  character as contained in such provisions as ss. 110.1127(3),

12  393.0655(1), 394.457(6), 397.451, 402.305(2), and

13  409.175(5)(4), shall not be required to be refingerprinted or

14  rescreened in order to comply with any caretaker screening or

15  fingerprinting requirements.

16         Section 10.  Section 409.1757, Florida Statutes, is

17  amended to read:

18         409.1757  Persons not required to be refingerprinted or

19  rescreened.--Any provision of law to the contrary

20  notwithstanding, human resource personnel who have been

21  fingerprinted or screened pursuant to chapters 393, 394, 397,

22  402, and this chapter, and teachers who have been

23  fingerprinted pursuant to chapter 231, who have not been

24  unemployed for more than 90 days thereafter, and who under the

25  penalty of perjury attest to the completion of such

26  fingerprinting or screening and to compliance with the

27  provisions of this section and the standards for good moral

28  character as contained in such provisions as ss. 110.1127(3),

29  393.0655(1), 394.457(6), 397.451, 402.305(2), and

30  409.175(5)(4), shall not be required to be refingerprinted or

31


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  1  rescreened in order to comply with any caretaker screening or

  2  fingerprinting requirements.

  3         Section 11.  The Office of Program Policy Analysis and

  4  Government Accountability, in consultation with the Department

  5  of Children and Family Services and the Agency for Health Care

  6  Administration, shall conduct a review of the process for

  7  placing children for residential mental health treatment as

  8  specified in section 39.407(5), Florida Statutes. This review

  9  is to be used to determine whether changes are needed in this

10  process. The integrity of the examination process that is

11  intended to ensure that only a child with an emotional

12  disturbance or a serious emotional disturbance is placed in a

13  residential mental health facility and to ensure that a child

14  who is diagnosed with an emotional disturbance or a serious

15  emotional disturbance receives the most appropriate mental

16  health treatment in the least restrictive setting must be

17  maintained. The review shall analyze and make recommendations

18  relative to issues pertinent to the process such as the number

19  of children who are assessed and the outcomes of the

20  assessments, the costs associated with the suitability

21  assessments based on geographic differentials, delays in

22  receiving appropriate mental health treatment services in both

23  residential and nonresidential settings which can be

24  attributed to the assessment process, and the need to expand

25  the mental health professional groups who may conduct the

26  suitability assessment. The Office of Program Policy Analysis

27  and Government Accountability shall submit a report of its

28  findings and any proposed changes to substantive law to the

29  Executive Office of the Governor, the President of the Senate,

30  and the Speaker of the House of Representatives by January 1,

31  2003.


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  1         Section 12.  This act shall take effect July 1, 2002.

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