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©2004 ScottRobinsonPhoto.com |
 $4+ Billion Budget Divide |
On Thursday, the House and Senate appropriations committees passed their proposed budgets, setting the stage for a budget battle steeped in deep philosophical differences, as opposed to usually-easier-to-resolve mere funding differences. A $4.3 billion gulf between the proposed Senate budget (SB 2500) of $80.42 billion and the House proposal (HB 5001) of $76.14 billion is grounded almost entirely in the philosophical divide between Senators willing to draw down billions of federal dollars to pay for health care for millions of Floridians, and Representatives opposed to accepting the federal dollars.
While there are myriad differences between the proposed House and Senate budgets, the gap that is driving speculation there might need to be a special session is the $5 billion difference between the proposals for the Agency for Health Care Administration (AHCA), the state agency that administers Medicaid. The Senate funds AHCA at $27.8 billion and the House at $22.8 billion. The higher Senate allocation includes $2.8 billion in Medicaid expansion dollars and $2.3 billion in federal Low Income Pool (LIP) funds used to pay hospitals for care they provide to indigent patients.
Building the health care budget is more complicated than usual this year because the LIP program is set to end on June 30. The federal government has said it may be willing to approve a replacement program, but no deal has yet been reached.
Reaching consensus on the budget could require a special legislative session. With six weeks remaining in Session, House and Senate leaders say there is plenty of time to come to a budget agreement. Time will tell.
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| Health Care Expansion Going to Senate Floor |
A bill that accounts for more than half of the $5 billion separating the House and Senate budgets (SB 7044) passed its third committee this week and is headed to the Senate floor.
SB 7044 creates the Florida Health Insurance Affordability Exchange (FHIX). Intended as a private sector approach to addressing Medicaid expansion, it will draw down $2.8 billion in federal Medicaid expansion funds to provide health care coverage for 800,000 Floridians if it is accepted by the U.S. Centers for Medicare and Medicaid Services.
Among others, FHIX would offer vouchers to people between 22 percent and 100 percent of the federal poverty level to purchase health insurance with premiums ranging between $3 and $25 based on income. Eligibility to participate in FHIX includes mandated work requirements.
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| Early Steps: The First Steps to a Better Life | |
Last year, more than 40,000 Florida children received Early Steps services that will allow many to avoid a lifetime of diminished cognitive and/or physical function, and will allow taxpayers to avoid millions of dollars in unnecessary payments for special education classes and other public supports that would have been required without Early Steps.
Administered by the Department of Health, the program serves children birth to 36 months who have medical conditions such as Autism, Down Syndrome, Cerebral Palsy, hearing/vision impairment, as well as children with significant developmental delays. Each year, Early Steps helps these children achieve critical developmental milestones, starting them on a path toward achieving their full lifelong potential, and success at home, at school, and in life.
Increased referrals, increased enrollment, and increased caseloads have put a huge strain on the Early Steps system, threatening its ability to provide the services children need. The House proposed 2015-2016 budget does not include an increase for Early Steps, while the Senate budget includes a $3.3 million increase; a good start, but far below the $5 million needed to sustain this invaluable program. Read why the $5 million is so important in this paper prepared by the Florida Consortium of Advocates for Infants and Toddlers.
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ALICE has Food Issues!
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'Comfort' and 'food' go together so nicely, and yet for so many families this is not the case. Many ALICE households struggle to feed their families, but often do not qualify for SNAP (formerly Food Stamps) because they earn too much to qualify. Struggling families' quantity and quality of food impacts health and productivity for parents and children alike. SNAP is one of the fastest and most effective tools to slow a family's slide from being ALICE to being poor, yet there are many pressures to cut this assistance. The United Way ALICE Report highlights the trade-offs and costs hunger forces families and communities face.
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You can only be young once. But you can always be immature. -- Dave Barry
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| Mental Health System Reforms | |
This week, the Senate Appropriations Committee passed two bills that could significantly change the way mental health and substance abuse services are delivered and funded in Florida.
SPB 7068 requires the Agency for Health Care Administration and the Department of Children and Families (DCF) to develop a plan to apply for and obtain federal approval to increase Medicaid funding for behavioral health care.
To position the state for approval, the bill reorganizes behavioral health managing entities, which contract for publicly-funded mental health and substance abuse services, to create a coordinated care organization in each region of the state. The coordinated care organization would be a network of behavioral health care providers that offer a comprehensive range of services and that are capable of integrating behavioral health care and primary care.
The second bill (SPB 7070) deals primarily with involuntary commitment of individuals. Among others it provides that:
- an individual may be held under the Baker Act for an additional 48 hours beyond the current 72-hour time limit if a physician determines the individual would benefit from detoxification services;
- individuals who have been involuntarily admitted to a receiving facility or treatment facility within the immediate preceding 36 months may be ordered to involuntary outpatient placement; and
- individuals meeting specified criteria may be detained in a mental health or addictions receiving facility or a detoxification facility, with the condition that a court hearing on the involuntary inpatient placement must occur within five court working days after the petition is filed.
Lastly, the bill requires DCF to create a Forensic Hospital Diversion Pilot Program in Alachua, Escambia, Hillsborough and Miami-Dade Counties modeled after the Miami-Dade Forensic Alternative Center.
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Food Desert Bills Languish
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Food deserts are defined as urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food. Instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants and convenience stores that offer few healthy, affordable food options.
Lack of access to healthy foods contributes to poor diet and can lead to higher levels of obesity and other diet-related diseases, such as diabetes and heart disease. The U.S. Department of Agriculture estimates that 23.5 million people in America live in food deserts.
SB 610 and HB 1107 provide an income tax credit for grocery businesses that sell nutrient-dense food items in areas designated as food deserts. They define "nutrient dense foods" as foods with high levels of nutrients in relationship to the number of calories the food contains, and define the parameters for getting the tax credit.
The Senate bill has passed just one committee, on March 3, and the House bill has yet to be heard.
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The Sixties are now considered a historical period, just like the Roman Empire.
-- Dave Barry
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| Homelessness Has A Cost | |
The Council on Homelessness 2014 Report found that on any given night Florida has as many as 40,000 people living on the street or in emergency shelters. Although the data in the report is just a snapshot in time - the count was made on one day and one night in January 2014 - its findings remind us of the stark reality of homelessness in the Sunshine State.
That reality is a grim one for the people living it, but also an entirely different one for taxpayers. Another study
conducted last year by the Central Florida Regional Commission on Homelessness concluded that the average cost per homeless person, per year to taxpayers in Central Florida is $31,065. The report also found that taxpayer cost to provide supportive housing is only $10,051. Obviously the taxpayer reality could be reduced significantly by better funding of homeless programs.
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Newborn Adrenoleukodystrophy Screening
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Florida law directs the Department of Health (Department) to conduct newborn screenings for metabolic, hereditary, and congenital disorders that result in the significant impairment of health or intellect. The Florida Newborn Screening Program screens for 31 core conditions and 22 secondary conditions. In January, more than 21,000 newborns were screened under the current program.
CS/SB 632 directs the Department to add adrenoleukodystrophy (ADL) to the Newborn Screening Program. ALD is a genetic disorder that damages myelin, the sheath that surrounds the brain's neurons. It can cause behavioral changes such as abnormal withdrawal or aggression, memory loss, visual loss, learning disabilities, seizures, speech problems, swallowing difficulties, deafness, coordination issues, fatigue, and progressive dementia. Last Action: 3/23/15 SENATE Favorable with CS by Health Policy.
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| School Safety |
SB180 would allow certain school district employees or volunteers, licensed to carry concealed weapons, to carry a concealed firearm on school property. In addition to being licensed to carry concealed weapons, the person must also be:
- an honorably discharged military veteran with no firearm-related disciplinary infraction;
- an active-duty member of the military, National Guard, or reserves, with no firearm-related disciplinary infraction; or
- a law enforcement officer in good standing or a former officer who has retired or terminated employment in good standing and not during the course of an internal investigation.
The school district employees or volunteers who meet the criteria are called "school safety designees" in the bill.
Last Action: 3/23/14 SENATE Favorable by Criminal Justice.
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| Human Trafficking |
CS/SB 534 and SB 1106 seek to heighten public awareness regarding human trafficking in the State of Florida. The bills:
- require the Attorney General to develop specifications for the form and content of human trafficking public awareness signs;
- direct the Florida Department of Transportation (FDOT) to display the signs in every rest area and welcome center in the state; and
- require businesses such as strip clubs, airports, bus stations, truck stops and emergency rooms to display the signs near the public entrance of the establishment or in another conspicuous location clearly visible to both the public and employees of the establishment.
The bill imposes a civil penalty of $500 for a first offense and $1,000 for a second or subsequent offense.
Last Action SB 534: 3/24/15 SENATE Favorable with CS by Criminal Justice.
Last Action SB 1106: 3/23/15 SENATE Favorable by Criminal Justice.
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| Public Records/Identity of a Victim/Human Trafficking Offense |
SB 1108 expands the current public records exemption for certain criminal intelligence and criminal investigative information to include identifying information of a child victim of human trafficking for labor or services, as well as any victim of human trafficking for commercial sexual activity.
Last Action: 3/23/15 SENATE Favorable by Criminal Justice.
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| Employment Opportunities for Persons with Disabilities |
CS/HB 1083 requires development and implementation of an interagency cooperative agreement among 10 state agencies and organizations. The agreement must, among others:
- establish commitment by state leadership to maximize resources and coordination to improve employment outcomes for individuals with disabilities;
- develop strategic goals and benchmarks to assist state agencies and organizations in implementing the agreement;
- identify financing and contracting methods to help prioritize employment for individuals with disabilities by state agencies and organizations;
- establish training methods to better integrate persons with disabilities into the workforce;
- ensure collaborative efforts between agencies;
- promote service innovations to better assist individuals with disabilities in the workplace; and
- identify accountability measures to ensure sustainability of the agreement.
Last Action: 3/24/14 HOUSE Favorable with CS by Government Operations Subcommittee. Read first time.
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| Closing the Gap Grant Program |
SB 94 expands the list of priority health areas under the "Closing the Gap" grant program to include sickle cell disease. The Closing the Gap grant program provides funding for activities designed to reduce racial and ethnic health disparities in priority health areas.
Last Action: 3/24/15 SENATE Passed.
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| Services for Veterans and Their Families |
CS/HB 1193 creates the Florida Veterans' Care Coordination Program (the Program) within the Department of Children and Families (DCF) to provide dedicated behavioral healthcare referral services through Florida's 211 Network. The bill requires DCF to designate "care coordination teams" to implement the Program statewide, and to provide peer support, suicide assessment, and treatment and resource coordination. In addition to the requirement for services, the bill requires the Program team to track and follow up with callers and advertise the Program.
The bill requires the Program to provide a number of services, including:
- telephonic peer support;
- crisis intervention;
- communication of information and referral resources;
- treatment coordination, including follow-up care;
- suicide assessment;
- promotion of safety and wellness of veterans and their families, including continuous safety planning and support;
- resource coordination, including data analysis, to ensure acceptance, enrollment, and attendance by veterans and their families in VA programs and services and community-based programs and services; and
- immediate needs assessments, including safety planning.
In addition to the requirement for services, the bill also requires the Program team to take certain actions. The term "program team" is not defined in the bill. The Program team must:
- track the number of requests from callers who are veterans or family members of veterans;
- follow-up with callers to determine whether they have acted on referrals or received the needed assistance, or if additional referrals or advocacy are needed;
- develop communication strategies (media promotions, public service announcements, print and Internet stories, community presentations) to inform veterans and their families about available services; and
- document all calls and capture all data to improve outreach to veterans and their families.
Last Action: 3/24/14 HOUSE Favorable with CS by Children, Families & Seniors Subcommittee.
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| Consumer Protection - Refunds |
HB 793 requires retail sales establishments to grant a refund within three days after the date of purchase for goods costing more than $1,000 if returned by a consumer who has been adjudicated incapacitated or who has documentation from a physician of a medical condition that causes the consumer to lack sufficient understanding or capacity to make reasonable decisions concerning his or her person or property.
Last Action: 3/24/14 HOUSE Favorable by Business & Professions Subcommittee.
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| Florida ABLE Act |
CS/SB 642 creates the Florida Achieving a Better Life Experience Act (the Florida ABLE Act). The Florida ABLE Act establishes the Florida ABLE program, which would assist individuals with disabilities save money without losing their eligibility for state and federal benefits, and thereby providing a pathway for economic independence and a better quality of life.
Under the Florida ABLE program, individuals with disabled family members and others can contribute funds to a tax-exempt ABLE account without affecting the disabled individual's eligibility for state and federal benefits, such as SSI and Medicaid. Those funds can be used for qualified disability expenses that include education, housing, transportation, employment support, health, prevention, wellness, financial, and legal expenses, and other expenses authorized through federal regulations. Funds placed in the ABLE program would supplement, rather than supplant, benefits provided through state and federal programs, earnings, and other sources.
Last Action: 3/26/15 SENATE Second reading.
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| Restitution for Juvenile Offenses |
SB 312 expands the authority of the court to order restitution when a child is found to have committed a delinquent act, regardless of whether the child is adjudicated delinquent or adjudication is withheld.
It requires, rather than authorizes, the child and the child's parent or guardian, to pay restitution when the court has determined that restitution is appropriate. It also authorizes the court to do the following:
- set up a payment plan if the child and the parents or guardians are unable to pay the restitution in one lump-sum payment;
- absolve the parent or guardian of any liability for restitution if after a hearing, the court finds that the current offense is the child's first referral and the parent or guardian has made diligent and good faith efforts to prevent the child from engaging in delinquent acts, or the victim entitled to restitution is the child's parent or guardian; and
- make both of the child's parents or guardians responsible for restitution, regardless of whether one parent or guardian has sole parental responsibility.
Last Action: 3/26/15 SENATE Favorable with CS by Children, Families and Elder Affairs.
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| Juvenile Justice |
CS/SB 378 expands juvenile civil citation by allowing law enforcement to issue a civil citation to youth who have committed a second or subsequent misdemeanor. Civil citation is presently only available to youth who admit to committing a first-time misdemeanor.
In addition, law enforcement will be authorized to issue a simple warning to the youth, inform the youth's parents of the misdemeanor, issue a civil citation or require participation in a similar diversion program under the bill. The bill also states that if an arrest is made, law enforcement must provide written documentation as to why the arrest is warranted.
Last Action: 3/26/15 SENATE Favorable by Children, Families and Elder Affairs.
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| Individuals with Disabilities | |
CS/CS/SB 1246 creates the Florida Unique Abilities Partner program to recognize business entities that employ individuals with disabilities, contribute to organizations that support the independence of individuals with disabilities, or establish programs that contribute to the independence of individuals with disabilities.
Among others, the bill requires the Department of Economic Opportunity (DEO) to maintain a website that provides the public with a list containing the name of every business that has been designated as a Florida Unique Abilities Partner, and businesses with the designation must be identified on the EmployFlorida Marketplace system.
Last Action: 3/26/15 SENATE Favorable with CS by Fiscal Policy.
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People who drink to drown their sorrow should be told that sorrow knows how to swim. -- Ann Landers
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