HB 5011

1	A bill to be entitled
2	An act relating to foster care and related services;
3	amending s. 409.1671, F.S.; requiring the Department of
4	Children and Family Services to develop a statewide plan
5	for outsourcing foster care and related services; removing
6	certain plan requirements; removing an obsolete date;
7	authorizing the expenditure of certain funds; removing a
8	requirement to issue certain loans; removing certain
9	provisions relative to the sources of future funding;
10	making conforming changes; removing authority of the
11	Florida Coalition for Children, Inc., or its
12	subcontractors to manage certain risk pool funds;
13	authorizing the department to issue an interest-free loan
14	to the Florida Coalition for Children, Inc., to establish
15	a self-insurance program based on certain appropriations;
16	establishing a 3-year pilot program in Miami-Dade, Monroe,
17	and Broward Counties; providing for the transfer of
18	certain responsibilities from the Department of Children
19	and Family Services to specified community-based care lead
20	agencies; providing for funding the pilot program from
21	grants and federal funds; requiring that the department
22	enter into fixed-payment contracts; requiring that annual
23	financial statements regarding the pilot program be
24	provided to the Governor, the department, and the
25	Legislature; requiring that an independent arbitrator
26	resolve certain disputes related to contracts; requiring
27	that contract management and oversight be conducted by
28	third-party entities; providing an exemption from s.
29	287.057, F.S.; requiring such entities to submit reports
30	to the Governor and the Legislature; requiring that the
31	department, the lead agencies implementing the pilot
32	program, and the Agency for Health Care Administration
33	develop a plan for integrating certain Medicaid mental
34	health services; specifying that the annual evaluation
35	required in s. 409.1671, F.S., include an evaluation of
36	the pilot program; directing the Office of Program Policy
37	Analysis and Government Accountability and the Office of
38	the Auditor General to complete an evaluation of the pilot
39	program and to report to the Legislature; providing
40	effective dates.
41
42	Be It Enacted by the Legislature of the State of Florida:
43
44	Section 1.  Subsection (7) of section 409.1671, Florida
45	Statutes, is amended to read:
46	409.1671  Foster care and related services; outsourcing.--
47	(7)  The Florida Coalition for Children, Inc., in
48	consultation with the department, shall develop a plan, in
49	consultation with the Florida Coalition for Children, Inc.,
50	based on an independent actuarial study regarding the long-term
51	use and structure of a statewide community-based care risk pool
52	for the protection of eligible lead community-based providers,
53	their subcontractors, and providers of other social services who
54	contract directly with the department. The plan must also
55	outline strategies to maximize federal earnings as they relate
56	to the community-based care risk pool. At a minimum, the plan
57	must allow for the use of federal earnings received from child
58	welfare programs to be allocated to the community-based care
59	risk pool by the department, which earnings are determined by
60	the department to be in excess of the amount appropriated in the
61	General Appropriations Act. The plan must specify the necessary
62	steps to ensure the financial integrity and industry-standard
63	risk management practices of the community-based care risk pool
64	and the continued availability of funding from federal, state,
65	and local sources. The plan must also include recommendations
66	that permit the program to be available to entities of the
67	department providing child welfare services until full
68	conversion to community-based care takes place. The final plan
69	shall be submitted to the department and then to the Executive
70	Office of the Governor and the Legislative Budget Commission for
71	formal adoption before January 1, 2005. Upon approval of the
72	plan by all parties, the department is authorized to expend
73	funds from the community-based care risk pool pursuant to the
74	provisions of the plan shall issue an interest-free loan that is
75	secured by the cumulative contractual revenue of the community-
76	based care risk pool membership, and the amount of the loan
77	shall equal the amount appropriated by the Legislature for this
78	purpose. The plan shall provide for a governance structure that
79	assures the department the ability to oversee the operation of
80	the community-based care risk pool at least until this loan is
81	repaid in full.
82	(a)  The purposes for which the community-based care risk
83	pool shall be used include, but are not limited to:
84	1.  Significant changes in the number or composition of
85	clients eligible to receive services.
86	2.  Significant changes in the services that are eligible
87	for reimbursement.
88	3.  Scheduled or unanticipated, but necessary, advances to
89	providers or other cash-flow issues.
90	4.  Proposals to participate in optional Medicaid services
91	or other federal grant opportunities.
92	5.  Appropriate incentive structures.
93	6.  Continuity of care in the event of failure,
94	discontinuance of service, or financial misconduct by a lead
95	agency.
96	7.  Payment for time-limited technical assistance and
97	consultation to lead agencies in the event of serious
98	performance or management problems.
99	8.  Payment for meeting all traditional and nontraditional
100	insurance needs of eligible members.
101	9.  Significant changes in the mix of available funds.
102	(b)  After approval of the plan in the 2004-2005 fiscal
103	year and annually thereafter, the department may also request in
104	its annual legislative budget request, and the Governor may
105	recommend, that the funding necessary to carry out paragraph (a)
106	be appropriated to the department. Subsequent funding of the
107	community-based care risk pool shall be supported by premiums
108	assessed to members of the community-based care risk pool on a
109	recurring basis. The community-based care risk pool may invest
110	and retain interest earned on these funds. In addition, the
111	department may transfer funds to the community-based care risk
112	pool as available in order to ensure an adequate funding level
113	if the fund is declared to be insolvent and approval is granted
114	by the Legislative Budget Commission. Such payments for
115	insolvency shall be made only after a determination is made by
116	the department or its actuary that all participants in the
117	community-based care risk pool are current in their payments of
118	premiums and that assessments have been made at an actuarially
119	sound level. Such payments by participants in the community-
120	based care risk pool may not exceed reasonable industry
121	standards, as determined by the actuary. Money from this fund
122	may be used to match available federal dollars. Dividends or
123	other payments, with the exception of legitimate claims, may not
124	be paid to members of the community-based care risk pool until
125	the loan issued by the department is repaid in full. Dividends
126	or other payments, with the exception of legitimate claims and
127	other purposes contained in the approved plan, may not be paid
128	to members of the community-based care risk pool unless, at the
129	time of distribution, the community-based care risk pool is
130	deemed actuarially sound and solvent. Solvency shall be
131	determined by an independent actuary contracted by the
132	department. The plan shall be developed in consultation with the
133	Office of Insurance Regulation.
134	1.  Such funds shall constitute partial security for
135	contract performance by lead agencies and shall be used to
136	offset the need for a performance bond. Subject to the approval
137	of the plan, the community-based care risk pool shall be managed
138	by the Florida Coalition for Children, Inc., or the designated
139	contractors of the Florida Coalition for Children, Inc.
140	Nonmembers of the community-based care risk pool may continue to
141	contract with the department but must provide a letter of credit
142	equal to one-twelfth of the annual contract amount in lieu of
143	membership in the community-based care risk pool.
144	2.  The department may separately require a bond to
145	mitigate the financial consequences of potential acts of
146	malfeasance, misfeasance, or criminal violations by the
147	provider.
148	(c)  The department may issue an interest-free loan to the
149	Florida Coalition for Children, Inc., for the purpose of
150	creating a self-insurance program. The loan shall be secured by
151	the cumulative contractual revenue of the community-based care
152	lead agencies participating in the self-insurance program. The
153	amount of the loan shall be in an amount equal to the amount
154	appropriated by the Legislature for this purpose.
155	Section 2.  Effective upon this act becoming a law:
156	(1)  A 3-year pilot program is established for the
157	community-based care lead agencies serving Miami-Dade, Monroe,
158	and Broward Counties. This pilot program shall allow for the
159	transfer of the current lead agency oversight responsibilities
160	of the Department of Children and Family Services to independent
161	agents and for funding the program through a grant that enhances
162	funding flexibility. The pilot program shall expand the
163	responsibilities and services provided by these lead agencies.
164	(2)  The Department of Children and Family Services shall
165	enter into a 3-year contract with the designated community-based
166	care lead agency serving Miami-Dade and Monroe Counties and with
167	the designated community-based care lead agency serving Broward
168	County, which have been established in accordance with s.
169	409.1671, Florida Statutes. The contracts must be fixed-payment
170	contracts funded in 36 equal monthly installments. The first 2
171	months shall be paid in advance, and the contract must contain
172	the elements outlined in this section. The initial 2-month
173	advance payment is due July 10, 2006. The contracts shall be
174	funded by general revenue through a grant and by federal Title
175	IV-E funding and other federal funding sources. The amount of
176	federal Title IV-E funding allocated in each year of the 3-year
177	pilot program shall be equal to the amount earned by each of the
178	lead agencies during the 2005-2006 fiscal year. The state shall
179	be held harmless for any shortfall caused by the lead agencies'
180	inability to earn the allocated Title IV-E funding, and each
181	lead agency's contract shall be increased in accordance with any
182	federal overearnings. Funding in excess of the contracted
183	amounts for the lead agencies shall be available only in the
184	event of additional specific legislative appropriations for
185	services provided under s. 409.1671, Florida Statutes; an
186	increase in the population of children served that exceeds 3
187	percent of the population of children served on June 15, 2005,
188	by either lead agency; or unforeseen catastrophic events as
189	determined by the Governor and funded by the Legislature. The
190	lead agencies shall annually provide certified audited financial
191	statements to the Governor, the Department of Children and
192	Family Services, and the appropriations committees of the
193	Legislature. All other required fiscal reporting shall be
194	determined by the independent fiscal monitors selected by the
195	parties. For purposes of this section, the term "parties" means
196	the two lead agencies implementing this pilot program and the
197	Department of Children and Family Services. In order to
198	facilitate and expedite the execution of this section, the
199	parties shall engage an independent arbitrator for purposes of
200	dispute resolution, including any disputes related to the form
201	and substance of the contract to execute the pilot program, with
202	an award of fees and costs to the prevailing party. The
203	arbitrator's role shall be limited to selecting which party's
204	position is more reasonable.
205	(3)  Contract management, fiscal oversight, and
206	programmatic oversight shall be conducted by independent,
207	nongovernmental third-party entities under contract to the
208	department and shall be conducted in a manner jointly agreed to
209	by the lead agencies and the department. The cost of contracting
210	with these independent entities shall be funded by the
211	department. Notwithstanding any other provision to the contrary,
212	the pilot program may not be implemented until the parties have
213	agreed to the selection of these entities and the manner in
214	which they are to carry out their responsibilities. Such
215	agreement must be reached by the parties no later than July 1,
216	2006. The selection of the entities for purposes of compliance
217	with this subsection shall be exempt from the provisions of s.
218	287.057, Florida Statutes. Fiscal oversight shall be conducted
219	in a manner similar to the model used by the department during
220	the 2005-2006 fiscal year in Miami-Dade and Monroe Counties. In
221	order to be able to compare the performance of the pilot
222	program's lead agencies with that of other lead agencies, the
223	programmatic performance of the pilot program's lead agencies
224	shall be measured and monitored by outcome measures contained in
225	their contracts with the department that are in effect on the
226	effective date of this section. The independent entities shall
227	submit their reports directly to the Governor, the President of
228	the Senate, and the Speaker of the House of Representatives.
229	(4)  The department and the lead agencies implementing the
230	pilot program shall develop an implementation plan with the
231	Agency for Health Care Administration regarding the pending
232	Medicaid mental health reform for the purpose of implementing a
233	local reform model that allows for the integration of services
234	in the current systems of care.
235	(5)  The annual evaluation required by s. 409.1671(4)(a),
236	Florida Statutes, shall include an evaluation of the pilot
237	program described in this act that compares performance and
238	fiscal management of the community-based care lead agencies in
239	the pilot program to those that are not in the pilot program. In
240	addition, the Office of Program Policy Analysis and Government
241	Accountability and the Office of the Auditor General shall
242	jointly complete an evaluation of the pilot program and provide
243	an interim report to the President of the Senate and the Speaker
244	of the House of Representatives no later than February 1, 2008,
245	and a final report no later than February 1, 2009.
246	Section 3.  Except as otherwise expressly provided in this
247	act, this act shall take effect July 1, 2006.

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