HB 1327

CS

CHAMBER ACTION

1	The Health Care Appropriations Committee recommends the
2	following:
3
4	Council/Committee Substitute
5	Remove the entire bill and insert:
6	A bill to be entitled
7	An act relating to transition services for adolescents and
8	young adults with disabilities; creating the Jacksonville
9	Health and Transition Services Pilot Program; assigning
10	the program for administrative purposes to the Children's
11	Medical Services program in the Department of Health;
12	providing purposes of the pilot program; providing for the
13	development of collaborative partnerships with certain
14	entities; delineating the target population; describing
15	participating service providers and the services that they
16	are to provide; providing for the design and
17	implementation of a comprehensive evaluation of the pilot
18	program; providing a contingent effective date.
19
20	Be It Enacted by the Legislature of the State of Florida:
21
22	Section 1.  Jacksonville Health and Transition Services
23	Pilot Program; creation; purposes; participating agencies and
24	services provided; evaluation.--
25	(1)  The Jacksonville Health and Transition Services Pilot
26	Program is created for the purpose of assisting adolescents and
27	young adults who have special needs relating to health care and
28	educational and vocational services in making a smooth
29	transition from the child health care and educational system to
30	the adult health care system and to employment. For
31	administrative purposes, the pilot program is located in the
32	Children's Medical Services program in the Department of Health.
33	(2)  The pilot program, in consultation with the Children's
34	Medical Services program in the Department of Health, shall
35	develop collaborative partnerships with the public and private
36	entities specified in this section to administer and implement
37	the pilot program. Participation in the program by such entities
38	is voluntary. However, an entity that participates in the
39	program must comply with the requirements of this section.
40	(3)  The Department of Internal Medicine and the Department
41	of Pediatrics at the University of Florida Jacksonville, in
42	collaboration with Children's Medical Services and community
43	partners, including, but not limited to, ARC Jacksonville, Hope
44	Haven Children's Clinic and Family Center, the Spina Bifida
45	Association, and the Down Syndrome Association, shall develop
46	the pilot program. The primary care clinic for the program shall
47	be located in the Ambulatory Care Center on the University of
48	Florida/Shands Jacksonville campus.
49	(4)  The target population for the pilot program comprises
50	adolescents and young adults with disabilities who are between
51	14 and 25 years of age, inclusive, reside in the North Central
52	area of Children's Medical Services of the Department of Health,
53	have chronic health-related or developmental conditions, and
54	could benefit from such a program. All children in the
55	Children's Medical Services State Child Health Insurance Program
56	(SCHIP), Medicaid, and Safety Net (Children's Medical Services),
57	as well as referrals from the Nemours Children's Clinic, the
58	Duval County School District, general pediatricians, and other
59	health care providers, shall be assessed for eligibility to
60	enroll in the program.
61	(5)  Upon intake into the program, participants shall be
62	offered an assessment of their development and educational and
63	vocational achievement. The pilot program shall work with
64	participants and their families to plan for transition to
65	college or to programs for adult educational and vocational
66	rehabilitation. The program shall work with local school
67	systems, community colleges, technical centers, and community-
68	based agencies to provide vocational counseling and training.
69	The pilot program shall develop partnerships with community-
70	based agencies as listed in subsection (3) to support
71	comprehensive transition planning and educational and vocational
72	counseling services.
73	(6)  The pilot program shall include:
74	(a)  A primary-care clinic in the Ambulatory Care Center on
75	the University of Florida/Shands Jacksonville campus, which
76	shall be staffed by a multidisciplinary team that includes a
77	pediatrician and an internist, a nurse care coordinator, a
78	transition specialist, and insurance specialists.
79	(b)  A network of adult medical and surgical specialists
80	from the community and from the University of Florida
81	Jacksonville Health Care System who agree to treat the special
82	needs of the adolescents and young adults who are being served
83	in the pilot program.
84	(c)  Comprehensive intake-evaluation and transition-
85	planning services for adolescents and young adults and their
86	families that cover health care planning, assessment of
87	educational needs, vocational preparation, referral to
88	habilitative support services, assistance in securing insurance,
89	and coordination of services across these areas.
90	(d)  Coordination and collaboration with other agencies
91	that are involved in providing services to adolescents and young
92	adults who have special health care needs, including ARC
93	Jacksonville, Hope Haven Children's Clinic and Family Center,
94	Nemours Children's Clinic, the Duval County School District, the
95	juvenile justice system, family support services, the foster
96	care program of the Department of Children and Family Services,
97	faith-based community programs, and the Duval County Health
98	Department.
99	(e)  Ongoing evaluation of patient satisfaction, disease
100	self-management, and success in taking steps toward employment
101	and health-related quality of life and other health-related
102	outcomes.
103	(f)  Services that support the intellectual development and
104	educational and vocational preparation of adolescents and young
105	adults with disabilities who are enrolled in the program.
106	(7)  Participating agencies and the health and social
107	services that they shall provide include:
108	(a)  The Department of Internal Medicine at the University
109	of Florida Jacksonville, which shall:
110	1.  Provide a primary care physician who shall serve as the
111	co-medical director of the pilot program.
112	2.  Work with both medical and surgical specialty services
113	to facilitate specialty referrals of patients.
114	3.  Provide administrative support to the pilot program,
115	including, but not limited to, supervision of clinic staff,
116	scheduling, and billing.
117	4.  Allot clinic space for a multidisciplinary transition
118	clinic, which shall initially operate at least once a week and
119	shall expand as the demand increases.
120	5.  Assign nursing and support staff to the clinic,
121	including staff to implement an appointment system.
122	6.  Maintain medical records and charts under the
123	University of Florida/Shands Health Care System.
124	7.  Make efforts to ensure that adolescents and young
125	adults with disabilities participating in the pilot program,
126	regardless of their funding source, shall continue to receive
127	health care services, including primary and specialty outpatient
128	medical services, medications, and laboratory services, until
129	they reach their 26th birthday.
130	(b)  The Department of Pediatrics at the University of
131	Florida Jacksonville, which shall:
132	1.  Provide a primary care pediatrician who shall serve as
133	the co-medical director of the pilot program.
134	2.  Work with pediatric specialty physicians to facilitate
135	the transfer of adolescents and young adults with disabilities
136	from pediatric health care specialists to adult health care
137	specialists. The Department of Pediatrics shall contact
138	pediatric specialists and determine what activities or supports
139	are needed to transfer patients from pediatric specialty care to
140	adult specialty care, such as the transfer of medical records
141	and the provision of educational programs for adult specialists.
142	3.  Encourage participation by the subspecialty pediatric
143	physicians through the development of transition programs within
144	each specialty area to prepare patients and their families for
145	participation in the pilot program.
146	4.  Identify and refer adolescents and young adults and
147	their families who are candidates for the pilot program.
148	(c)  The Nemours Children's Clinic, which shall:
149	1.  Encourage participation by the subspecialty pediatric
150	physicians through the development of transition programs within
151	each specialty area to prepare adolescents and young adults with
152	disabilities and their families for participation in the pilot
153	program.
154	2.  Identify and refer adolescents and young adults and
155	their families who are candidates for the pilot program.
156	3.  Provide in-kind support for care coordination and
157	specialized transitional services.
158	(d)  The Institute for Health, Policy and Evaluation
159	Research within the Duval County Health Department, which shall
160	provide the design and implementation of a comprehensive
161	evaluation of the pilot program that includes an assessment of
162	the service-oriented process and patient and family-oriented
163	outcome measures. The Institute for Health, Policy and
164	Evaluation Research shall also conduct a longitudinal study to
165	determine whether the adolescents and young adults with
166	disabilities who participate in this pilot program are more
167	successful than the adolescents and young adults with
168	disabilities who are not associated with the program but receive
169	assistance with vocational rehabilitation only.
170	(e)  Hope Haven Children's Clinic and Family Center,
171	Nemours Children's Clinic, ARC Jacksonville, the Duval County
172	School District, the Florida Community College of Jacksonville,
173	the Division of Vocational Rehabilitation of the Department of
174	Education, and other groups, which shall develop a comprehensive
175	educational and vocational transition program that shall be
176	offered to adolescents and young adults with disabilities in the
177	program. The transition specialists in these agencies shall
178	identify, to the greatest extent feasible, all adolescents and
179	young adults with disabilities in the district and refer them to
180	the program.
181	Section 2.  This act shall take effect July 1, 2006, only
182	if a specific appropriation to the Department of Health to fund
183	the provisions of this act is made in the General Appropriations
184	Act for fiscal year 2006-2007.

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