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A bill to be entitled

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An act relating to health care for children; creating the

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Universal Health Access Plan for Children; providing

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legislative findings; providing definitions relating to

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health care services for children; establishing a single,

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publicly funded statewide program to provide medically

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necessary health services for each child in the state

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without cost to the child or his or her family; requiring

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the Department of Health to administer the plan; directing

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the department to perform specified activities with

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respect to its responsibilities; requiring the department

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to report annually to the Governor and the Legislature;

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directing the department to adopt rules to administer the

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plan; authorizing the department to hold public hearings;

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providing an effective date.

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Be It Enacted by the Legislature of the State of Florida:

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     Section 1. Universal health care for children.--

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     (1) LEGISLATIVE FINDINGS.--

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     (a) The Legislature finds that one of the principal duties

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of government is to ensure the care, safety, and protection of

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children in an environment that fosters healthy social,

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emotional, intellectual, and physical development. To ensure a

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secure and safe environment, it is a paramount goal to promote

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the health and well-being of all children in this state.

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     (b) The Legislature further finds that most families are

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competent caregivers and providers for the health care needs of

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their children and that children achieve their greatest potential

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when families are able to support and nurture the health of their

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children in their own homes. Therefore, the Legislature finds

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that the policies and procedures relating to the health of

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children in this state must ensure that all children, regardless

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of their parents' income, have access to high-quality health

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care, without cost to the family or child.

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     (2) DEFINITIONS.--As used in this section, the term:

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     (a) "Child" means any person younger than 19 years of age.

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     (b) "Child with special health care needs" means a child

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whose serious or chronic physical or developmental condition

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requires extensive preventive and maintenance care beyond that

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required by typical healthy children. Health care utilization by

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such a child exceeds the statistically expected usage of the

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normal child adjusted for chronological age. These children often

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need complex care requiring multiple providers, rehabilitation

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services, and specialized equipment in a number of different

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settings.

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     (c) "Comprehensive health care services" means services,

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medical equipment, and supplies furnished by a provider,

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including, but not limited to, medical, surgical, and dental

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care; psychological, optometric, optic, chiropractic, podiatric,

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nursing, physical therapy, and pharmaceutical services; emergency

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services and care; health education, preventive medical,

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rehabilitative, and home health services; inpatient and

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outpatient hospital services; extended care; nursing home care;

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convalescent institutional care; technical and professional

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clinical pathology laboratory services; laboratory and ambulance

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services; appliances, drugs, medicines, and supplies; and any

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other care, service, or treatment of disease or correction of

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defects for children.

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     (d) "Department" means the Department of Health.

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     (e) "Emergency services and care" means medical screening,

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examination, and evaluation by a physician, or, to the extent

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permitted by applicable law, by other appropriate personnel under

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the supervision of a physician, to determine if an emergency

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medical condition exists and, if it does, the care, treatment, or

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surgery for a covered service by a physician necessary to relieve

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or eliminate the emergency medical condition, within the service

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capability of a hospital.

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     (f) "Family" means the group or the individuals caring for

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a child. The family includes a child who has a custodial parent

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or caretaker relative who resides in the same house or living

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unit or, in the case of a child whose disability of nonage has

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been removed under chapter 743, Florida Statutes, the child. The

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family may also include other individuals whose income and

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resources are considered in whole or in part in determining the

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eligibility of the child.

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     (g) "Health care provider" means a health care

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professional, health care facility, or entity licensed or

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certified to provide health services in this state which meets

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the criteria as established by the department.

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     (h) "Medically necessary" means the use of any medical

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treatment, service, equipment, or supply necessary to palliate

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the effects of a terminal condition or to prevent, diagnose,

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correct, cure, alleviate, or preclude deterioration of a

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condition that threatens life, causes pain or suffering, or

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results in illness or infirmity and which is:

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     1. Consistent with the symptom, diagnosis, and treatment of

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the child's condition;

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     2. Provided in accordance with generally accepted standards

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of medical practice;

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     3. Not primarily intended for the convenience of the child,

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the child's family, or the health care provider;

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     4. The most appropriate level of supply or service for the

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diagnosis and treatment of the child's condition; and

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     5. Approved by the appropriate medical body or health care

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specialty involved as effective, appropriate, and essential for

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the care and treatment of the child's condition.

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     (3) UNIVERSAL HEALTH ACCESS PLAN FOR CHILDREN.--The

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Universal Health Access Plan for Children is created for the

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purpose of providing a single, publicly funded statewide program

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to provide comprehensive health care services for all medically

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necessary health services for all children of the state without

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cost to the child or his or her family.

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     (4) RESPONSIBILITIES OF THE DEPARTMENT OF HEALTH.--

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     (a) The Department of Health shall:

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     1. Establish budget and reimbursement policy guidelines for

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the plan, recommend priorities for implementing comprehensive

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plans and budgets, and determine aggregate capital expenditures.

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     2. Establish fee schedules for health care providers.

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     3. Determine the medical standards for establishing the

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eligibility of children seeking comprehensive health care

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services from the plan based on medical priority.

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     4. Coordinate a comprehensive delivery system to enable

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children to take maximum advantage of all available funds.

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     5. Administer and implement the plan.

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     6. Study the most effective methods of providing

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comprehensive health care services to all children in this state,

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including children with special health care needs.

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     7. Serve as a provider and principal case manager for

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children with special health care needs.

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     8. Report annually to the Governor, the President of the

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Senate, and the Speaker of the House of Representatives on its

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activities and recommend any changes in health care law and

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funding to improve access to health care for the children of this

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state.

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     9. Disseminate, to health care providers and to the public,

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information concerning the plan and the children eligible to

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receive the comprehensive health care services under the plan.

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     10. Monitor, study, and evaluate the operation of the plan,

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including, but not limited to, the adequacy and quality of the

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comprehensive health care services furnished to children under

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the plan, the cost of each type of service, and the effectiveness

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of cost-containment measures under the plan.

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     11. Conduct necessary investigations and inquiries and

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compel the submission of information, documents, and records it

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considers necessary to carry out its duties under this section.

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     12. Conduct other activities the department considers

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necessary to carry out the purposes of this section.

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     13. Develop a plan of operation.

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     14. Adopt rules to administer the plan. The rules may

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include requirements for definitions of terms, program

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organization, and program description; responsibilities of

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clients; requirements for service applications, including

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required medical information; requirements for initial treatment

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and for continued treatment; billing and payment requirements for

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health care providers; requirements for qualification,

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appointments, verification, and emergency exceptions for health-

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professional consultants; general and diagnostic-specific

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standards for diagnostic and treatment facilities; and standards

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for the method of service delivery, including consultant

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services, respect-for-privacy considerations, examination

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requirements, family support plans, and clinic design.

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     (b) The department, after providing notice to families,

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health care providers, and others, may hold hearings in

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connection with any action that it proposes to take under this

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section.

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     Section 2.  This act shall take effect July 1, 2008.