1 | The Committee on Appropriations recommends the following: |
2 |
|
3 | Committee Substitute |
4 | Remove the entire bill and insert: |
5 | A bill to be entitled |
6 | An act relating to foster care services; amending s. |
7 | 20.19, F.S.; prohibiting certain members of a community |
8 | alliance from receiving funds from the Department of |
9 | Children and Family Services or a community-based care |
10 | lead agency; amending s. 409.1671, F.S.; providing |
11 | additional requirements for an eligible lead community- |
12 | based provider to compete for a privatization project; |
13 | requiring contracts with eligible lead community-based |
14 | providers to include certain standards; revising |
15 | requirements for the department's quality assurance |
16 | program for privatized services; directing the Florida |
17 | Coalition for Children, Inc., in consultation with the |
18 | department, to develop a plan for a statewide risk pool |
19 | for eligible lead community-based providers, their |
20 | subcontractors, and certain providers that provide foster |
21 | care and related services under contract with the |
22 | department; deleting a requirement that the department |
23 | develop a proposal; specifying the requirements of the |
24 | plan; extending a plan submission deadline; revising the |
25 | process for plan approval; directing the department to |
26 | issue an interest-free loan upon approval of the plan; |
27 | modifying the purposes of the community-based care risk |
28 | pool; revising the purposes for which funding may be |
29 | recommended to the Legislature; authorizing the risk pool |
30 | to invest funds and retain interest; providing for |
31 | payments upon a determination of insolvency; prohibiting |
32 | payment of dividends to the risk pool members until |
33 | repayment of the loan issued by the department and until |
34 | the risk pool is actuarially sound and solvent; deleting a |
35 | requirement for a performance bond; providing for the risk |
36 | pool to be managed by the Florida Coalition for Children, |
37 | Inc., or its designated contractor; specifying the manner |
38 | in which nonmember entities may be authorized to contract |
39 | with the department; authorizing the department to require |
40 | a bond; providing an exemption from state travel policies |
41 | for lead community-based providers and their |
42 | subcontractors; providing an effective date. |
43 |
|
44 | Be It Enacted by the Legislature of the State of Florida: |
45 |
|
46 | Section 1. Subsection (6) of section 20.19, Florida |
47 | Statutes, is amended to read: |
48 | 20.19 Department of Children and Family Services.--There |
49 | is created a Department of Children and Family Services. |
50 | (6) COMMUNITY ALLIANCES.-- |
51 | (a) The department shall, in consultation with local |
52 | communities, establish a community alliance of the stakeholders, |
53 | community leaders, client representatives and funders of human |
54 | services in each county to provide a focal point for community |
55 | participation and governance of community-based services. An |
56 | alliance may cover more than one county when such arrangement is |
57 | determined to provide for more effective representation. The |
58 | community alliance shall represent the diversity of the |
59 | community. |
60 | (b) The duties of the community alliance shall include, |
61 | but not necessarily be limited to: |
62 | 1. Joint planning for resource utilization in the |
63 | community, including resources appropriated to the department |
64 | and any funds that local funding sources choose to provide. |
65 | 2. Needs assessment and establishment of community |
66 | priorities for service delivery. |
67 | 3. Determining community outcome goals to supplement |
68 | state-required outcomes. |
69 | 4. Serving as a catalyst for community resource |
70 | development. |
71 | 5. Providing for community education and advocacy on |
72 | issues related to delivery of services. |
73 | 6. Promoting prevention and early intervention services. |
74 | (c) The department shall ensure, to the greatest extent |
75 | possible, that the formation of each community alliance builds |
76 | on the strengths of the existing community human services |
77 | infrastructure. |
78 | (d) The initial membership of the community alliance in a |
79 | county shall be composed of the following: |
80 | 1. The district administrator. |
81 | 2. A representative from county government. |
82 | 3. A representative from the school district. |
83 | 4. A representative from the county United Way. |
84 | 5. A representative from the county sheriff's office. |
85 | 6. A representative from the circuit court corresponding |
86 | to the county. |
87 | 7. A representative from the county children's board, if |
88 | one exists. |
89 | (e) At any time after the initial meeting of the community |
90 | alliance, the community alliance shall adopt bylaws and may |
91 | increase the membership of the alliance to include the state |
92 | attorney for the judicial circuit in which the community |
93 | alliance is located, or his or her designee, the public defender |
94 | for the judicial circuit in which the community alliance is |
95 | located, or his or her designee, and other individuals and |
96 | organizations who represent funding organizations, are community |
97 | leaders, have knowledge of community-based service issues, or |
98 | otherwise represent perspectives that will enable them to |
99 | accomplish the duties listed in paragraph (b), if, in the |
100 | judgment of the alliance, such change is necessary to adequately |
101 | represent the diversity of the population within the community |
102 | alliance service districts. |
103 | (f) A member of the community alliance, other than a |
104 | member specified in paragraph (d), may not receive payment for |
105 | contractual services from the department or a community-based |
106 | care lead agency. |
107 | (g)(f) Members of the community alliances shall serve |
108 | without compensation, but are entitled to receive reimbursement |
109 | for per diem and travel expenses, as provided in s. 112.061. |
110 | Payment may also be authorized for preapproved child care |
111 | expenses or lost wages for members who are consumers of the |
112 | department's services and for preapproved child care expenses |
113 | for other members who demonstrate hardship. |
114 | (h)(g) Members of a community alliance are subject to the |
115 | provisions of part III of chapter 112, the Code of Ethics for |
116 | Public Officers and Employees. |
117 | (i)(h) Actions taken by a community alliance must be |
118 | consistent with department policy and state and federal laws, |
119 | rules, and regulations. |
120 | (j)(i) Alliance members shall annually submit a disclosure |
121 | statement of services interests to the department's inspector |
122 | general. Any member who has an interest in a matter under |
123 | consideration by the alliance must abstain from voting on that |
124 | matter. |
125 | (k)(j) All alliance meetings are open to the public |
126 | pursuant to s. 286.011 and the public records provision of s. |
127 | 119.07(1). |
128 | Section 2. Paragraph (e) of subsection (1), paragraph (a) |
129 | of subsection (4), and subsections (7) and (8) of section |
130 | 409.1671, Florida Statutes, as amended by section 27 of chapter |
131 | 2003-399, Laws of Florida, are amended, paragraph (e) is added |
132 | to subsection (3) of said section, and subsection (10) is added |
133 | to said section, to read: |
134 | 409.1671 Foster care and related services; |
135 | privatization.-- |
136 | (1) |
137 | (e) As used in this section, the term "eligible lead |
138 | community-based provider" means a single agency with which the |
139 | department shall contract for the provision of child protective |
140 | services in a community that is no smaller than a county. The |
141 | secretary of the department may authorize more than one eligible |
142 | lead community-based provider within a single county when to do |
143 | so will result in more effective delivery of foster care and |
144 | related services. To compete for a privatization project, such |
145 | agency must have: |
146 | 1. The ability to coordinate, integrate, and manage all |
147 | child protective services in the designated community in |
148 | cooperation with child protective investigations. |
149 | 2. The ability to ensure continuity of care from entry to |
150 | exit for all children referred from the protective investigation |
151 | and court systems. |
152 | 3. The ability to provide directly, or contract for |
153 | through a local network of providers, all necessary child |
154 | protective services. Such agency should directly provide no more |
155 | than 35 percent of all child protective services provided. |
156 | 4. The willingness to accept accountability for meeting |
157 | the outcomes and performance standards related to child |
158 | protective services established by the Legislature and the |
159 | Federal Government. |
160 | 5. The capability and the willingness to serve all |
161 | children referred to it from the protective investigation and |
162 | court systems, regardless of the level of funding allocated to |
163 | the community by the state, provided all related funding is |
164 | transferred. |
165 | 6. The willingness to ensure that each individual who |
166 | provides child protective services completes the training |
167 | required of child protective service workers by the Department |
168 | of Children and Family Services. |
169 | 7. The ability to maintain eligibility to receive all |
170 | federal child welfare funds, including Title IV-E and IV-A |
171 | funds, currently being used by the Department of Children and |
172 | Family Services. |
173 | 8. Written agreements with Healthy Families Florida lead |
174 | entities in their community, pursuant to s. 409.153, to promote |
175 | cooperative planning for the provision of prevention and |
176 | intervention services. |
177 | 9. A board of directors, of which at least 51 percent of |
178 | the membership is comprised of persons residing in this state. |
179 | Of the state residents, at least 51 percent must also reside |
180 | within the service area of the lead community-based provider. |
181 | (3) |
182 | (e) Each contract with an eligible lead community-based |
183 | provider must include all performance outcome measures that are |
184 | established by the Legislature and that are under the control of |
185 | the lead agency. The standards must be adjusted annually by |
186 | contract amendment to enable the department to meet the |
187 | legislatively established statewide standards. |
188 | (4)(a) The department, in consultation with the community- |
189 | based agencies that are undertaking the privatized projects, |
190 | shall establish a quality assurance program for privatized |
191 | services. The quality assurance program shall be based on |
192 | standards established by the Adoption and Safe Families Act as |
193 | well as by a national accrediting organization such as the |
194 | Council on Accreditation of Services for Families and Children, |
195 | Inc. (COA) or CARF--the Rehabilitation Accreditation Commission. |
196 | The department may develop a request for proposal for such |
197 | oversight. This program must be developed and administered at a |
198 | statewide level. The Legislature intends that the department be |
199 | permitted to have limited flexibility to use funds for improving |
200 | quality assurance. To this end, the department may transfer up |
201 | to 0.125 percent of the total funds from categories used to pay |
202 | for these contractually provided services, but the total amount |
203 | of such transferred funds may not exceed $300,000 in any fiscal |
204 | year. When necessary, the department may establish, in |
205 | accordance with s. 216.177, additional positions that will be |
206 | exclusively devoted to these functions. Any positions required |
207 | under this paragraph may be established, notwithstanding ss. |
208 | 216.262(1)(a) and 216.351. The department, in consultation with |
209 | the community-based agencies that are undertaking the privatized |
210 | projects, shall establish minimum thresholds for each component |
211 | of service, consistent with standards established by the |
212 | Legislature and the Federal Government. Each program operated |
213 | under contract with a community-based agency must be evaluated |
214 | annually by the department. The department shall, to the extent |
215 | possible, use independent financial audits provided by the |
216 | community-based care agency to eliminate or reduce the ongoing |
217 | contract and administrative reviews conducted by the department. |
218 | The department may suggest additional items to be included in |
219 | such independent financial audits to meet the department's |
220 | needs. Should the department determine that such independent |
221 | financial audits are inadequate, then other audits, as |
222 | necessary, may be conducted by the department. Nothing herein |
223 | shall abrogate the requirements of s. 215.97. The department |
224 | shall submit an annual report regarding quality performance, |
225 | outcome measure attainment, and cost efficiency to the President |
226 | of the Senate, the Speaker of the House of Representatives, the |
227 | minority leader of each house of the Legislature, and the |
228 | Governor no later than January 31 of each year for each project |
229 | in operation during the preceding fiscal year. |
230 | (7) The Florida Coalition for Children, Inc., in |
231 | consultation with the department, shall develop a plan based on |
232 | an independent actuarial study regarding the long-term use and |
233 | structure of a statewide community-based care risk pool for the |
234 | protection of eligible lead community-based providers, their |
235 | subcontractors, and providers of other social services who |
236 | contract directly with the department. The plan must also |
237 | outline strategies to maximize federal earnings as they relate |
238 | to the community-based care risk pool. At a minimum, the plan |
239 | must allow for the use of federal earnings received from child |
240 | welfare programs to be allocated to the community-based care |
241 | risk pool by the department, which earnings are determined by |
242 | the department to be in excess of the amount appropriated in the |
243 | General Appropriations Act. The plan must specify the necessary |
244 | steps to ensure the financial integrity and industry-standard |
245 | risk management practices of the community-based care risk pool |
246 | and the continued availability of funding from federal, state, |
247 | and local sources. The plan must also include recommendations |
248 | that permit the program to be available to entities of the |
249 | department providing child welfare services until full |
250 | conversion to community-based care takes place. The final plan |
251 | shall be submitted to the department and the Office of Insurance |
252 | Regulation and then to the Executive Office of the Governor and |
253 | the Legislative Budget Commission for formal adoption before |
254 | January 1, 2005. Upon approval of the plan by all parties, the |
255 | department shall issue an interest-free loan that is secured by |
256 | the cumulative contractual revenue of the community-based care |
257 | risk pool membership, and the amount of the loan shall equal the |
258 | amount appropriated by the Legislature for this purpose. The |
259 | plan shall provide for a governance structure that assures the |
260 | department the ability to oversee the operation of the |
261 | community-based care risk pool at least until this loan is |
262 | repaid in full. |
263 | (a) The purposes for which the community-based care risk |
264 | pool shall be used include, but are not limited to: |
265 | 1. Significant changes in the number or composition of |
266 | clients eligible to receive services. |
267 | 2. Significant changes in the services that are eligible |
268 | for reimbursement. |
269 | 3. Scheduled or unanticipated, but necessary, advances to |
270 | providers or other cash-flow issues. |
271 | 4. Proposals to participate in optional Medicaid services |
272 | or other federal grant opportunities. |
273 | 5. Appropriate incentive structures. |
274 | 6. Continuity of care in the event of failure, |
275 | discontinuance of service, or financial misconduct by a lead |
276 | agency. |
277 | 7. Payment for time-limited technical assistance and |
278 | consultation to lead agencies in the event of serious |
279 | performance or management problems. |
280 | 8. Payment for meeting all traditional and nontraditional |
281 | insurance needs of eligible members. |
282 | 9. Significant changes in the mix of available funds. |
283 | (b) After approval of the plan in the 2004-2005 fiscal |
284 | year and annually thereafter, the department may also request in |
285 | its annual legislative budget request, and the Governor may |
286 | recommend, that the funding necessary to carry out the purposes |
287 | described in paragraph (a) be appropriated to the department. |
288 | Subsequent funding of the community-based care risk pool shall |
289 | be supported by premiums assessed to members of the community- |
290 | based care risk pool on a recurring basis. The community-based |
291 | care risk pool may invest and retain interest earned on these |
292 | funds. In addition, the department may transfer funds to the |
293 | community-based care risk pool as available in order to ensure |
294 | an adequate funding level if the fund is declared to be |
295 | insolvent and approval is granted by the Legislative Budget |
296 | Commission. Such payments for insolvency shall be made only |
297 | after a determination is made by the department or its actuary |
298 | that all members of the community-based care risk pool are |
299 | current in their payments of premiums and that assessments have |
300 | been made at an actuarially sound level. Such payments by |
301 | members of the community-based care risk pool may not exceed |
302 | reasonable industry standards, as determined by the actuary. |
303 | Moneys from this fund may be used to match available federal |
304 | dollars. Dividends or other payments, with the exception of |
305 | legitimate claims, may not be paid to members of the community- |
306 | based care risk pool until the loan issued by the department is |
307 | repaid in full. Dividends or other payments, with the exception |
308 | of legitimate claims and other purposes contained in the |
309 | approved plan, may not be paid to members of the community-based |
310 | care risk pool unless, at the time of distribution, the |
311 | community-based care risk pool is deemed actuarially sound and |
312 | solvent. Solvency shall be determined by an independent actuary |
313 | contracted by the department. The Office of Insurance Regulation |
314 | must approve the determination of solvency by the independent |
315 | actuary before the department may accept the recommendation of |
316 | the independent actuary. |
317 | 1. Appropriated funds shall constitute partial security |
318 | for contract performance by lead agencies and shall be used to |
319 | offset the need for a performance bond. Subject to the approval |
320 | of the plan, the community-based care risk pool shall be managed |
321 | by the Florida Coalition for Children, Inc., or the designated |
322 | contractors of the Florida Coalition for Children, Inc. |
323 | Nonmembers of the community-based care risk pool may continue to |
324 | contract with the department but must provide a letter of credit |
325 | equal to one-twelfth of the annual contract amount in lieu of |
326 | membership in the community-based care risk pool. |
327 | 2. The department may separately require a bond to |
328 | mitigate the financial consequences of potential acts of |
329 | malfeasance or misfeasance or criminal violations by the |
330 | provider. The department, in consultation with existing lead |
331 | agencies, shall develop a proposal regarding the long-term use |
332 | and structure of a statewide shared earnings program which |
333 | addresses the financial risk to eligible lead community-based |
334 | providers resulting from unanticipated caseload growth or from |
335 | significant changes in client mixes or services eligible for |
336 | federal reimbursement. The recommendations in the statewide |
337 | proposal must also be available to entities of the department |
338 | until the conversion to community-based care takes place. At a |
339 | minimum, the proposal must allow for use of federal earnings |
340 | received from child welfare programs, which earnings are |
341 | determined by the department to be in excess of the amount |
342 | appropriated in the General Appropriations Act, to be used for |
343 | specific purposes. These purposes include, but are not limited |
344 | to: |
345 | (a) Significant changes in the number or composition of |
346 | clients eligible to receive services. |
347 | (b) Significant changes in the services that are eligible |
348 | for reimbursement. |
349 | (c) Significant changes in the availability of federal |
350 | funds. |
351 | (d) Shortfalls in state funds available for eligible or |
352 | ineligible services. |
353 | (e) Significant changes in the mix of available funds. |
354 | (f) Scheduled or unanticipated, but necessary, advances to |
355 | providers or other cash-flow issues. |
356 | (g) Proposals to participate in optional Medicaid services |
357 | or other federal grant opportunities. |
358 | (h) Appropriate incentive structures. |
359 | (i) Continuity of care in the event of lead agency |
360 | failure, discontinuance of service, or financial misconduct. |
361 |
|
362 | The department shall further specify the necessary steps to |
363 | ensure the financial integrity of these dollars and their |
364 | continued availability on an ongoing basis. The final proposal |
365 | shall be submitted to the Legislative Budget Commission for |
366 | formal adoption before December 31, 2002. If the Legislative |
367 | Budget Commission refuses to concur with the adoption of the |
368 | proposal, the department shall present its proposal in the form |
369 | of recommended legislation to the President of the Senate and |
370 | the Speaker of the House of Representatives before the |
371 | commencement of the next legislative session. For fiscal year |
372 | 2003-2004 and annually thereafter, the Department of Children |
373 | and Family Services may request in its legislative budget |
374 | request, and the Governor may recommend, the funding necessary |
375 | to carry out paragraph (i) from excess federal earnings. The |
376 | General Appropriations Act shall include any funds appropriated |
377 | for this purpose in a lump sum in the Administered Funds |
378 | Program, which funds constitute partial security for lead agency |
379 | contract performance. The department shall use this |
380 | appropriation to offset the need for a performance bond for that |
381 | year after a comparison of risk to the funds available. In no |
382 | event shall this performance bond exceed 2.5 percent of the |
383 | annual contract value. The department may separately require a |
384 | bond to mitigate the financial consequences of potential acts of |
385 | malfeasance, misfeasance, or criminal violations by the |
386 | provider. Prior to the release of any funds in the lump sum, the |
387 | department shall submit a detailed operational plan, which must |
388 | identify the sources of specific trust funds to be used. The |
389 | release of the trust fund shall be subject to the notice and |
390 | review provisions of s. 216.177. However, the release shall not |
391 | require approval of the Legislative Budget Commission. |
392 | (8) Notwithstanding the provisions of s. 215.425, all |
393 | documented federal funds earned for the current fiscal year by |
394 | the department and community-based agencies which exceed the |
395 | amount appropriated by the Legislature shall be distributed to |
396 | all entities that contributed to the excess earnings based on a |
397 | schedule and methodology developed by the department and |
398 | approved by the Executive Office of the Governor. Distribution |
399 | shall be pro rata based on total earnings and shall be made only |
400 | to those entities that contributed to excess earnings. Excess |
401 | earnings of community-based agencies shall be used only in the |
402 | service district in which they were earned. Additional state |
403 | funds appropriated by the Legislature for community-based |
404 | agencies or made available pursuant to the budgetary amendment |
405 | process described in s. 216.177 shall be transferred to the |
406 | community-based agencies. The department shall amend a |
407 | community-based agency's contract to permit expenditure of the |
408 | funds. The distribution program applies only to entities that |
409 | were under privatization contracts as of July 1, 2002. |
410 | (10) The lead community-based providers and their |
411 | subcontractors shall be exempt from state travel policies as set |
412 | forth in s. 112.061(3)(a) for their travel expenses incurred in |
413 | order to comply with the requirements of this section. |
414 | Section 3. This act shall take effect July 1, 2004. |