HB 5011

1
A bill to be entitled
2An act relating to foster care and related services;
3amending s. 409.1671, F.S.; removing provisions requiring
4the Department of Children and Family Services to develop
5a statewide plan for outsourcing foster care and related
6services; removing certain plan requirements; removing an
7obsolete date; removing a requirement to issue certain
8loans; requiring a community-based risk pool initiative
9for certain purposes; providing for the components of the
10initiative; establishing a risk pool peer review
11committee; requiring a report to the secretary of the
12department; authorizing expenditures from the risk pool
13under certain circumstances; providing for uses of the
14risk pool; removing certain provisions relating to the
15sources of future funding; making conforming changes;
16removing authority of the Florida Coalition for Children,
17Inc., or its subcontractors to manage certain risk pool
18funds; authorizing the department to issue an interest-
19free loan to the Florida Coalition for Children, Inc., to
20establish a self-insurance program based on certain
21appropriations; providing terms for repayment of the loan;
22establishing a 3-year pilot program in Miami-Dade, Monroe,
23and Broward Counties; providing for the transfer of
24certain responsibilities from the Department of Children
25and Family Services to specified community-based care lead
26agencies; requiring review of the proposed contract by the
27Chief Financial Officer by a certain date; providing for
28funding the pilot program from grants and federal funds;
29requiring that annual financial statements regarding the
30pilot program be provided to the Governor, the
31Legislature, the department, and certain local community-
32based care alliances; prohibiting the department from
33using certain funds; requiring that fiscal,
34administrative, and programmatic monitoring be conducted
35by third-party entities; requiring the department to fund
36the cost of the third-party monitoring; exempting the
37selection of the third-party entities from the provisions
38of s. 287.057, F.S., for a specified period of time;
39requiring such entities to submit reports to the Governor,
40the Legislature, and certain local community-based care
41alliances; defining "parties"; requiring that the
42department, the lead agencies implementing the pilot
43program, and the Agency for Health Care Administration
44develop a plan for integrating certain Medicaid health
45services; specifying that the annual evaluation required
46in s. 409.1671, F.S., include an evaluation of the pilot
47program; directing the Office of Program Policy Analysis
48and Government Accountability and the Office of the
49Auditor General to complete an evaluation of the pilot
50program and to report to the Legislature; providing for
51certain provisions to be included in the contract;
52requiring the department to enter into fixed-price
53contracts; authorizing increased contract payments under
54certain circumstances; requiring fiscal reporting and
55reconciliation; providing for certain expenditures by lead
56agencies; providing for a compliance supplement applicable
57to all community-based lead agencies; requiring the
58department to submit a plan by July 1, 2006, to the
59Governor and Legislature for the efficient use of
60resources; providing for distribution of savings resulting
61from the plan; providing for future repeal; providing
62effective dates.
63
64Be It Enacted by the Legislature of the State of Florida:
65
66     Section 1.  Subsection (7) of section 409.1671, Florida
67Statutes, is amended to read:
68     409.1671  Foster care and related services; outsourcing.--
69     (7)  The Florida Coalition for Children, Inc., in
70consultation with the department, shall develop a plan based on
71an independent actuarial study regarding the long-term use and
72structure of a statewide community-based care risk pool for the
73protection of eligible lead community-based providers, their
74subcontractors, and providers of other social services who
75contract directly with the department. The plan must also
76outline strategies to maximize federal earnings as they relate
77to the community-based care risk pool. At a minimum, the plan
78must allow for the use of federal earnings received from child
79welfare programs to be allocated to the community-based care
80risk pool by the department, which earnings are determined by
81the department to be in excess of the amount appropriated in the
82General Appropriations Act. The plan must specify the necessary
83steps to ensure the financial integrity and industry-standard
84risk management practices of the community-based care risk pool
85and the continued availability of funding from federal, state,
86and local sources. The plan must also include recommendations
87that permit the program to be available to entities of the
88department providing child welfare services until full
89conversion to community-based care takes place. The final plan
90shall be submitted to the department and then to the Executive
91Office of the Governor and the Legislative Budget Commission for
92formal adoption before January 1, 2005. Upon approval of the
93plan by all parties, the department shall issue an interest-free
94loan that is secured by the cumulative contractual revenue of
95the community-based care risk pool membership, and the amount of
96the loan shall equal the amount appropriated by the Legislature
97for this purpose. The plan shall provide for a governance
98structure that assures the department the ability to oversee the
99operation of the community-based care risk pool at least until
100this loan is repaid in full.
101     (a)  The department, in consultation with the Florida
102Coalition for Children, Inc., shall develop and implement a
103community-based care risk pool initiative to mitigate the
104financial risk to eligible lead community-based providers. This
105initiative shall include:
106     1.  A risk pool application and protocol developed by the
107department that outline submission criteria, including, but not
108limited to, financial and program management, descriptive data
109requirements, and timeframes for submission of applications.
110Requests for funding from risk pool applicants shall be based on
111relevant and verifiable service trends and changes that have
112occurred during the current fiscal year. The application shall
113confirm that expenditure of approved risk pool funds by the lead
114community-based provider shall be completed within the current
115fiscal year.
116     2.  A risk pool peer review committee, appointed by the
117secretary and consisting of department staff and representatives
118from at least three nonapplicant community-based care providers,
119that reviews and assesses all risk pool applications. Upon
120completion of each application review, the peer review committee
121shall report its findings and recommendations to the secretary
122providing, at a minimum, the following information:
123     a.  Justification for the specific funding amount required
124by the risk pool applicant based on current year service trend
125data, including validation that the applicant's financial need
126was caused by circumstances beyond the control of the lead
127agency management;
128     b.  Verification that the proposed use of risk pool funds
129meets at least one of the criteria in paragraph (c); and
130     c.  Evidence of technical assistance provided in an effort
131to avoid the need to access the risk pool and recommendations
132for technical assistance to the lead agency to ensure that risk
133pool funds are expended effectively and that the agency's need
134for future risk pool funding is diminished.
135     (b)  Upon approval by the secretary of a risk pool
136application, the department may request funds from the risk pool
137in accordance with s. 216.181(6)(a).
138     (c)(a)  The purposes for which the community-based care
139risk pool shall be used include, but are not limited to:
140     1.  Significant changes in the number or composition of
141clients eligible to receive services.
142     2.  Significant changes in the services that are eligible
143for reimbursement.
144     3.  Scheduled or unanticipated, but necessary, advances to
145providers or other cash-flow issues.
146     4.  Proposals to participate in optional Medicaid services
147or other federal grant opportunities.
148     5.  Appropriate incentive structures.
149     3.6.  Continuity of care in the event of failure,
150discontinuance of service, or financial misconduct by a lead
151agency.
152     7.  Payment for time-limited technical assistance and
153consultation to lead agencies in the event of serious
154performance or management problems.
155     8.  Payment for meeting all traditional and nontraditional
156insurance needs of eligible members.
157     4.9.  Significant changes in the mix of available funds.
158     (d)(b)  After approval of the plan in the 2004-2005 fiscal
159year and annually thereafter, The department may also request in
160its annual legislative budget request, and the Governor may
161recommend, that the funding necessary to carry out paragraph (c)
162(a) be appropriated to the department. Subsequent funding of the
163community-based care risk pool shall be supported by premiums
164assessed to members of the community-based care risk pool on a
165recurring basis. The community-based care risk pool may invest
166and retain interest earned on these funds. In addition, the
167department may request the allocation of transfer funds from to
168the community-based care risk pool in accordance with s.
169216.181(6)(a) as available in order to ensure an adequate
170funding level if the fund is declared to be insolvent and
171approval is granted by the Legislative Budget Commission. Such
172payments for insolvency shall be made only after a determination
173is made by the department or its actuary that all participants
174in the community-based care risk pool are current in their
175payments of premiums and that assessments have been made at an
176actuarially sound level. Such payments by participants in the
177community-based care risk pool may not exceed reasonable
178industry standards, as determined by the actuary. Funds Money
179from this pool fund may be used to match available federal
180dollars. Dividends or other payments, with the exception of
181legitimate claims, may not be paid to members of the community-
182based care risk pool until the loan issued by the department is
183repaid in full. Dividends or other payments, with the exception
184of legitimate claims and other purposes contained in the
185approved plan, may not be paid to members of the community-based
186care risk pool unless, at the time of distribution, the
187community-based care risk pool is deemed actuarially sound and
188solvent. Solvency shall be determined by an independent actuary
189contracted by the department. The plan shall be developed in
190consultation with the Office of Insurance Regulation.
191     1.  Such funds shall constitute partial security for
192contract performance by lead agencies and shall be used to
193offset the need for a performance bond. Subject to the approval
194of the plan, the community-based care risk pool shall be managed
195by the Florida Coalition for Children, Inc., or the designated
196contractors of the Florida Coalition for Children, Inc.
197Nonmembers of the community-based care risk pool may continue to
198contract with the department but must provide a letter of credit
199equal to one-twelfth of the annual contract amount in lieu of
200membership in the community-based care risk pool.
201     2.  The department may separately require a bond to
202mitigate the financial consequences of potential acts of
203malfeasance, misfeasance, or criminal violations by the
204provider.
205     (e)  The department may issue an interest-free loan to the
206Florida Coalition for Children, Inc., for the purpose of
207creating a self-insurance program pursuant to law. The loan
208shall be secured by the cumulative contractual revenue of the
209community-based care lead agencies participating in the self-
210insurance program. The amount of the loan shall be in an amount
211equal to the amount appropriated by the Legislature for this
212purpose. The terms of the repayment of the loan shall be based
213on the economic viability of the self-insurance program.
214     Section 2.  Pilot project and financial issues.--
215     (1)  A 3-year pilot program is established for the
216community-based care lead agencies serving Miami-Dade, Monroe,
217and Broward Counties. This pilot program shall allow for the
218transfer of the current lead agency oversight responsibilities
219of the Department of Children and Family Services to independent
220entities and for funding the program through a grant that
221enhances funding flexibility. The pilot program shall expand the
222responsibilities and services provided by these lead agencies.
223     (2)  The Department of Children and Family Services shall
224enter into a 3-year contract with the designated community-based
225care lead agency serving Miami-Dade and Monroe Counties and with
226the designated community-based care lead agency serving Broward
227County, which have been established in accordance with s.
228409.1671, Florida Statutes. The department and the lead agencies
229in this pilot program shall submit to the Chief Financial
230Officer proposed contract language no later than June 1, 2006.
231The Chief Financial Officer shall review the contracts for
232sufficiency and respond to the parties no later than June 15,
2332006. This subsection shall take effect upon this act becoming a
234law.
235     (3)  The amount of federal Title IV-E funding allocated in
236each year of the 3-year pilot program shall be equal to the
237amount earned by each of the lead agencies and by the
238department's district or zone community-based care activities
239during the 2005-2006 fiscal year that is transitioned to the
240lead agencies as part of this pilot program. The lead agencies
241shall annually provide certified audited financial statements to
242the Governor, the Department of Children and Family Services,
243the appropriations committees of the Legislature, and the local
244community-based care alliances of Broward, Miami-Dade, and
245Monroe Counties. In implementing the pilot program, the
246department shall not use funds appropriated or allocated to
247community-based care lead agencies located outside of the pilot
248program area.
249     (4)  Fiscal monitoring, administrative monitoring, and
250programmatic monitoring shall be conducted by independent,
251nongovernmental third-party entities under contract with the
252department and shall be conducted in a manner jointly agreed to
253by the lead agencies and the department. The department shall
254fund the cost of contracting with these entities.
255Notwithstanding any other provision to the contrary, the pilot
256program may not be implemented until the parties have agreed to
257the selection of these entities and the manner in which they are
258to carry out their responsibilities. Such agreement must be
259reached by the parties no later than July 1, 2006. The selection
260of the third-party entities under this subsection shall be
261exempt from s. 287.057, Florida Statutes, from the effective
262date of this subsection through June 30, 2007. Fiscal oversight
263shall be conducted in a manner similar to the model used by the
264department during the 2005-2006 fiscal year in Miami-Dade and
265Monroe Counties. This subsection shall take effect upon this act
266becoming a law.
267     (5)  To compare the performance of the pilot program's lead
268agencies with that of other lead agencies, the programmatic
269performance of the pilot program's lead agencies shall be
270measured and monitored by outcome measures contained in their
271contracts with the department that are in effect on the
272effective date of this section and other outcomes designed to
273best determine the quality of performance of the lead agencies
274and developed by the parties in conjunction with the
275independent, nongovernmental third-party entities as part of the
276agreement on programmatic monitoring. The independent entities
277shall submit their reports directly to the Governor, the
278President of the Senate, the Speaker of the House of
279Representatives, and the community-based care alliances of
280Broward, Miami-Dade, and Monroe Counties.
281     (6)  For purposes of this section, the term "parties" means
282the two lead agencies implementing this pilot program and the
283Department of Children and Family Services.
284     (7)  The department and the lead agencies implementing the
285pilot program shall develop an implementation plan with the
286Agency for Health Care Administration regarding the pending
287Medicaid mental health reform for the purpose of implementing a
288local model that allows for the integration of behavioral health
289and physical health with the local child welfare systems of
290care.
291     (8)  The annual evaluation required by s. 409.1671(4)(a),
292Florida Statutes, shall include an evaluation of the pilot
293program described in this section that compares performance and
294fiscal management of the community-based care lead agencies in
295the pilot program to those that are not in the pilot program. In
296addition, the Office of Program Policy Analysis and Government
297Accountability and the Office of the Auditor General shall
298jointly complete an evaluation of the pilot program and provide
299an interim report to the President of the Senate and the Speaker
300of the House of Representatives no later than February 1, 2008,
301and a final report no later than February 1, 2009.
302     (9)  The provisions of this subsection shall be included in
303the contracts with the lead agencies in the pilot program and
304may be implemented with other community-based care lead agencies
305established under s. 409.1671, Florida Statutes. The contracts
306must be fixed-price funded in 36 equal monthly installments. The
307first 2 months shall be paid in advance on July 10, 2006. The
308contracts shall be funded by a grant of general revenue and by
309applicable federal funding sources. The lead agencies are
310responsible for documenting federal earnings, and federal
311earnings not documented shall be returned to the department.
312Notwithstanding s. 409.1671(8), Florida Statutes, the lead
313agencies' annual contract amounts may be increased by excess
314federal earnings in accordance with s. 216.181(11), Florida
315Statutes. Monthly reporting requirements shall be limited to
316only the reports required to support monthly federal expenditure
317reporting and statutorily restricted state expenditures as
318defined in the lead agencies' approved cost allocation plan.
319Quarterly reconciliation shall be required from the
320participating lead agencies. All other required fiscal reporting
321shall be determined by the independent fiscal monitors.
322Notwithstanding any other provision of law, the following lead
323agency expenditures are permissible: staff cellular telephone
324allowances; contracts requiring deferred payments and
325maintenance agreements; security deposits for office leases;
326related professional membership dues and professional state
327license fees; food and refreshment; promotional materials; and
328costs associated with fundraising personnel either employed or
329contracted with by the lead agency.
330     (10)  The department, in consultation with the Department
331of Financial Services, shall develop a compliance supplement for
332the state financial assistance regarding flexibility of
333allowable expenditures in accordance with s. 215.97, Florida
334Statutes, which shall be applicable to all community-based lead
335agencies.
336     (11)  The department shall submit a plan to the Executive
337Office of the Governor, the chair of the Senate Ways and Means
338Committee, and the chair of the House of Representatives Fiscal
339Council describing the most efficient use of resources relating
340to community-based care in the district administration and the
341program management and compliance budget entities. Any cost
342savings achieved as a result of this plan shall be distributed
343to the lead agencies by a methodology described in the plan. The
344department's plan shall be submitted no later than July 1, 2006.
345This subsection shall take effect upon this act becoming a law.
346     (12)  This section is repealed July 1, 2009.
347     Section 3.  Except as otherwise expressly provided in this
348act and except for this section, which shall take effect upon
349this act becoming a law, this act shall take effect July 1,
3502006.


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