HB 0723

CS

CHAMBER ACTION

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.

CODING: Words stricken are deletions; words underlined are additions.