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A legislative update provided by the United Way of Florida
 
ISSUE 7                                                                                                 APRIL 17, 2015
old and new capitol 
 2004 ScottRobinsonPhoto.com
ExtendedSpecialSessionExtended/Special Session Ahead
At this point in session, your Legislative Link usually reports on bills and conference committees, and occasionally we've reported on an apparent need for a special or extended session.

Although, as you can see in Bills Heard this Week below, there has been some action on bills this session, not much has happened, certainly not nearly as much as has usually happened seven weeks into session. In fact, with only two weeks left before the scheduled end of the regular session, 1,734 bills have been filed and a total of only 26 have passed both houses and gone to the Governor.

Because so much depends on money, the budget impasse on health care expansion and Low Income Pool Funding has put a virtual stop to most activity.

Even with so little having been accomplished, this week Senate and House leaders agreed that an extended or special session is going to be needed in order for the Legislature to finish the one job it is required by the Florida Constitution to do each year: pass a state budget.
RepublicansDisagreeRepublicans Disagree
While most stories about political controversy center around Ds vs. Rs, this session will be defined by the rift among the state's Republicans, whose leaders are as far apart on the session's most pivotal issue as the Ds and Rs have ever been on an issue.

In the last two weeks alone, a trip by two R Senators to DC compelled the R Governor to reverse his position on expanding health care access, R Senate leaders refused to confirm the R Governor's selection for Surgeon General, the incoming R House Speaker staged a rant the likes of which have not been seen in recent memory on the House floor against his R Senate colleagues (and, admittedly, our D President), the R Senate President issued a written explanation on the rightness of the Senate's health care position and, implicitly, the wrongness of the R House position, the R Senate President told the R Governor that the latter's desired tax cuts are "on the shelf," and R Senators questioned the R Governor's handling of health care negotiations with the feds.

It is often tougher to rule than to be the minority party.
AtWarWithFedsAt War with the Feds
This week, the federal Centers for Medicare and Medicaid Services (CMS) provided its decision on whether it will continue providing about $2 billion in Low Income Pool (LIP) funding to the state to pay for indigent care. It started a flurry of letters and, finally, a threat:
  • On Tuesday, CMS sent a letter to the Florida Agency for Health Care Administration (AHCA ) stating that, "Last year, CMS made clear that LIP would not continue in its current form " and that LIP funding "should not pay for costs that would be covered in a Medicaid expansion." The letter also noted that CMS is "...encouraged by the State Senate's interest in expanding Medicaid..."
  • That same day, six Republican members of Florida's Congressional delegation sent a letter to CMS claiming that "The LIP program...is in many ways separate and apart from any decision to expand Medicaid" and urging CMS to "...agree in principle to continue LIP funding..."
  • The next day, AHCA sent a letter to CMS stating that the CMS letter to AHCA had for the first time and inappropriately linked LIP funding to Medicaid expansion. It concluded that Medicaid expansion will force many low income Floridians, who have purchased health coverage in the open market under the Affordable Care Act, into the Medicaid "welfare and entitlement program". It also said that AHCA had "proposed multiple LIP models" and that "We hope the federal government receives our LIP amendment cordially..."
  • Finally, yesterday, a press release from the Governor's office proclaimed that "Governor Rick Scott announced that he will take legal action against President Obama's federal healthcare agency for stopping Low Income Pool (LIP) healthcare funds to Florida in order to force the state to take Legislative action to expand Medicaid under Obamacare."

No one knows where this state vs. feds issue will end. However, if it is not resolved in time for the Legislature to craft a 2015-2016 budget in time for the July 1 start of the next fiscal year, the House and Senate will be compelled to resolve their in-state differences. 

ALICEALICE and Healthcare

Accidents happen, and they can be devastating. If you are Asset Limited, Income Constrained, Employed, an accident might destroy not only your health, but your finances. Florida ranks near the bottom of the country in access to health insurance for children and adults. Healthcare debt is still the top cause of personal bankruptcy, and lack of preventative care leads to overwhelmed emergency rooms, higher healthcare costs, and even premature death. The United Way ALICE Report highlights the connections between individuals' health and the health of our economy and community.
EarlyLearningBillatRiskEarly Learning Bill at Risk?
Legislative leaders have said an extended or special session will be needed to complete their work.

If they merely extend, which appears unlikely at this time, bills still in the pipeline will be able to continue their paths to passage.

If, however, a special session is convened, bills that didn't pass during the regular session will have to be re-filed again for consideration during the special session. If history is any indication of the future, this will happen only with the highest priority House and Senate bills.

Scores of bills will likely be caught in limbo if the Legislature adjourns sine die on May 1 as scheduled, which appears likely at this time.

Of the United Way priority bills still in process, most important are the early learning bills that ensure if a child is in child care, the care is being provided in a healthy and safe environment.

CS/HB 7017 has passed its only committee of reference and is ready to be heard on the House Floor. Its Senate companion, CS/CS/SB 7006 has one more stop in the Appropriations Committee before heading to the floor. Read the analyses of the bills to see what they do by clicking on the bill numbers above.

Passage of one of these early learning bills sets the stage for addressing quality in early learning settings during the 2016 Session. If one does not pass, the health and safety issue addressed by the bills will be on the table again next session for the third year in a row delaying the quality discussion until 2017.

Early learning advocates have been waiting years to have the quality discussion. It is critically important, if we are going to ensure children in early learning programs receive the developmentally appropriate care they need to be ready to succeed in school when they begin, and to ensure Floridians are getting the bang for the taxpayer buck they deserve from the Legislature's investment in early learning.

During extended and special sessions, only priority bills are passed. Other bills must wait until the next regular session to begin the entire process again. Advocates are working hard to ensure the early learning bills are heard during the regular session, so Florida children need not wait another year to get the care they deserve in their early learning settings and taxpayers get the bang for the buck they deserve for their investment in early learning.  As this Legislative Link went to press, CS/CS/SB 7006 had been scheduled for hearing in the full Senate Appropriations Committee next Tuesday, April 21.
If winning isn't everything, why do they keep score?
-- Vince Lombardi
FloridaECCcrisisFlorida ECC Crisis
Early Childhood Caries (ECC) is a growing unmet health care crisis. According to the American Academy of Pediatric Dentistry's "The State of Little Teeth": 
  • 20 times more common than diabetes; 
  • 7 times more common than hay fever; and
  • 5 times more common than asthma.

Exacerbating the situation, only about 10 percent of practicing Florida dentists accept Medicaid-eligible patients and only about 10 percent of Medicaid eligible children under age six receive any dental care.

If not treated early, ECC can have life-long effects on health, well-being, and productivity. All efforts must be made to ensure all children receive the dental care they need in order to preserve their quality of life and Florida's workforce productivity. 

BillsHeardBILLS HEARD THIS WEEK
(Portions excerpted from Legislative staff analyses.)
MissingPersonsMissing Persons with Special Needs
CS/CS/CS/HB 69 creates the "Project Leo" pilot project in Baker, Columbia, Hamilton, and Suwannee Counties to provide personal devices to aid in search-and-rescue for persons with special needs in case of elopement.

"Elopement," which is defined as leaving an area without supervision or caregiver permission, is prevalent among persons with certain special needs and may expose them to dangerous situations. Individuals with Alzheimer's disease or with autism are two populations at higher risk to elope.

The project will be developed and administered by the Center for Autism and Related Disabilities at the University of Florida (CARD UF). The bill directs CARD UF to select participants on a first-come, first-served basis to receive a personal device to aid in search and rescue based on criteria it develops. Criteria must consider, at a minimum, the individual's risk of elopement. The number of participants will be determined based on available funding within the Center's existing resources.

Last Action: 4/14/15 HOUSE Placed on Calendar.
CivilCitationCivil Citation
Civil Citation Programs (CCPs) give law enforcement officers (LEO) an alternative to arresting youth who have committed non-serious delinquent acts. Under a CCP, a LEO has discretion to issue a civil citation to a juvenile who admits to having committed a first-time misdemeanor, assess not more than 50 community service hours, and require participation in intervention services appropriate to the identified needs of the juvenile.

As of October 2014, CCPs were operational in 59 of Florida's 67 counties.  CS/CS/CS/HB 99 amends current law to:
  • authorize a law enforcement officer to issue a warning or inform the juvenile's parent when a juvenile admits to having committed a misdemeanor;
  • give the officer discretion to issue a civil citation or require participation in a similar diversion program if he or she decides not to issue a warning or notify the juvenile's parents;
  • give the officer discretion to arrest the juvenile (If an arrest is made the LEO must provide written documentation as to why an arrest was warranted); and 
  • allow a juvenile to participate in the civil citation program for a total of three separate misdemeanor offenses.
Last Action: 4/16/15 HOUSE Placed on Calendar.
AdoptionFosterCareAdoption and Foster Care
CS/HB 7013 makes three additions to statutes to improve the adoption of children from foster care: The bill:
  • creates a program to advance the permanency, stability, and well-being of children in the child welfare system by awarding incentive payments to community-based care lead agencies (CBC's) for achieving specified adoption performance standards. The new adoption incentive program would require DCF to conduct a baseline assessment of CBC adoption performance regarding such factors as the length of time children have been waiting for adoption; the length of time to complete an adoption; and feedback from prospective adoptive families, adoptive families, adoptees, children within the child welfare system, and stakeholders. The bill requires DCF to then establish measurable outcome targets for performance by each CBC and negotiate incentive payments to be paid to CBC's upon meeting these targets.
  • re-creates a program to provide an additional adoption benefit of either $5,000 or $10,000, depending on whether the adopted child has special needs described in statute, for qualifying employees of state agencies who adopt a child from the child welfare system. The program was originally created in 2000 and provided employee adoption benefits until it was repealed in 2010.
  • requires the Governor to select and recognize one or more individuals, families, or entities that have made significant contributions to the adoption of children from foster care each year.
Among others, the bill also:
  • provides that maintaining a foster child in his or her current educational setting is a priority, unless it is not in the best interests of the child;
  • specifies that homeschooling is an educational option for foster children;
  • requires the CBC to contact the adoptive family by telephone one year after the adoption's finalization to offer post-adoption assistance; and
  • specifies that state employee adoptions that are completed on or after July 1, 2015, are eligible for cash benefits.
Last Action: 4/14/15 Enrolled.
DentalCareDental Care - Dentists
Only 27.4 percent of low income Floridians have access to dental care. CS/CS/SB 606 requires the Department of Health to develop and implement a Dental Care Access Account Initiative to benefit Florida licensed dentists employed by public health programs or committed to opening private practices capable of serving at least 1,200 patients in an area designated as a dental health professional shortage area (HPSA) or a medically under-served area.

Florida currently has 220 designated dental HPSAs, which have only enough dentists to serve 17 percent of the population living within them. For 2012, it is estimated that 853 additional dentists were required to meet the total need. This puts Florida among the states with the highest proportion of their populations that are deemed under-served.

Last Action: 4/14/15 Placed on Third Reading.
HumanTraffickingHuman Trafficking
CS/SB 534 seeks to heighten public awareness regarding human trafficking in the State of Florida. The bill:
  • requires the Attorney General to develop specifications for the form and content of human trafficking public awareness signs;
  • directs the Florida Department of Transportation (FDOT) to display the signs in every rest area and welcome center in the state; and
  • requires 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 also imposes a civil penalty of $500 for a first offense and $1,000 for a second or subsequent offense.

Last Action: 4/14/15 SENATE Placed on Third Reading.
MentalHealthMental Health and Substance Abuse Services
CS/HB 7119 makes changes to the statewide system of safety-net prevention, treatment, and recovery services for substance abuse and mental health (SAMH) administered by the Department of Children and Families (DCF).

DCF currently contracts with seven managing entities that in turn contract with local service providers to deliver SAMH services. The bill updates statutes that provided DCF initial authority and guidance for transitioning to the managing entity system. The bill makes changes to providing services and enhances operation of this outsourced approach by:
  • allowing managed behavioral health organizations to bid for managing entity contracts when fewer than two bids are received;
  • requiring care coordination, specifying services that shall be provided within available resources, and prioritizing the populations served;
  • requiring DCF to develop performance standards that measure improvement in a community's behavioral health and in specified individuals' functioning or progress toward recovery;
  • specifying members for managing entities' governing boards, and requiring managed behavioral health organizations serving as managing entities to have advisory boards with that membership;
  • allowing managing entities flexibility in shaping their provider network, while requiring a system for publicizing opportunities to join, and evaluating providers for participation;
  • deleting obsolete statutes regarding the transition to the managing entity system;
  • specifying that managing entities may apply for Criminal Justice, Mental Health, and Substance Abuse Reinvestment grants in the same way as non-profit organizations;
  • amending the definition of "managed behavioral health organizations" to limit them to managed care organizations under contract with the Medicaid managed medical assistance program and to managed behavioral health organizations;
  • adding children involved in the child welfare system who are not in out-of-home care to the list of groups prioritized to receive care coordination;
  • requiring improved coordination of behavioral health and primary care services through the development and effective implementation of coordinated care organizations; and
  • adding family members and other interested parties as parties authorized to petition the court for the appointment of a guardian advocate to consent to treatment when the individual is not competent to do so.
Last Action: 4/14/15 HOUSE Placed on Calendar.
InvolExamMinorsInvoluntary Examinations of Minors
CS/SB 954 requires a public school's principal, or his or her designee, to notify a student's parent or guardian if the student is removed from the school, school transportation, or a school-sponsored activity for an involuntary examination. The bill also provides notification requirements for receiving facilities that hold minor patients for involuntary examination.

The bill allows the school principal, or his or her designee, and the receiving facility each to delay notification by up to 24 hours if there is suspected abuse, abandonment, or neglect and delay has been deemed to be in the student's or minor patient's best interest. Delay in notification may occur only after a report of suspected abuse, abandonment, or neglect is submitted to the Department of Children and Families' central abuse hotline.

Last Action: 4/14/15 SENATE Retained on Special Order Calendar.
HousingforHomelessHousing for the Homeless
CS/CS/SB 1500 makes numerous changes to laws related to housing for individuals and families who are homeless. The bill amends the State Apartment Incentive Loan (SAIL) Program, to remove the difference in the percentage of available funds that must be reserved between specified tenant groups. It requires the State Office on Homelessness to establish a task force to make recommendations related to the implementation of a statewide Homeless Management Information System (HMIS). The bill requires that expenditures of leveraged funds or resources be permitted only for eligible activities committed on one project which have not been used as leverage or match for another project.

The bill also expresses legislative intent to encourage homeless continuums of care to adopt the Rapid Re-Housing approach to preventing homelessness for individuals and families who do not require the intense level of supports provided in the Permanent Supportive Housing model and requires Rapid Re-Housing to be added to the components of a continuum of care plan.

Last Action: 4/14/15 SENATE Favorable with CS by Appropriations Subcommittee on Transportation, Tourism, and Economic Development.
GuardiansforDevelopDisabledGuardians for Developmentally Disabled Dependent Children
CS/CS/HB 437 creates a framework for identifying and appointing guardians for developmentally disabled children who may require decision-making assistance beyond their 18th birthday. It also authorizes guardianship courts to exercise jurisdiction over dependent children nearing their 18th birthday to appoint guardian advocates, limited guardians, and plenary guardians. The bill:
  • requires the court to conduct an annual review of the continued necessity of a guardianship for young adults in extended foster care who already have a guardian;
  • requires the Department of Children and Families (DCF) to develop an updated case plan for any child who may require the assistance of a guardian;
  • requires that upon a judge's finding, no less restrictive decision-making assistance will meet the child's needs;
  • requires DCF to complete a report and identify individuals who are willing to serve as a guardian advocate or as a plenary or limited guardian;
  • provides that proceedings for appointment of a guardian may be initiated in a separate proceeding in guardianship court within 180 days of the child's 17th birthday;
  • requires that a minor who is 17 and one-half years of age and is subject to guardianship proceedings must receive all the due process rights of an adult; and
  • allows the child's parents to remain the child's natural guardians unless the parents' rights have been terminated or the dependency or guardianship court determines it is not in the child's best interest.
Last Action: 4/16/15 HOUSE Passed.
PublicRecordsHumanTraffickingPublic Records/Human Trafficking Victims
HB 467 expands the types of criminal intelligence and criminal investigative information that is confidential and exempt from public records to include:
  • information that reveals the identity of a person under the age of 18 who is the victim of human trafficking;
  • information that may reveal the identity of a person who is the victim of human trafficking for commercial sexual activity; and
  • a photograph, videotape, or image of any part of the body of a victim of human trafficking involving commercial sexual activity.
Last Action: 4/16/15 HOUSE Passed.
PublicRecordsVictimsPublic Records/Victims of Sexual Exploitation
HB 469 creates public record exemptions for information about the location of safe houses, safe foster homes, other residential facilities serving child victims of sexual exploitation, and residential facilities serving adult victims of human trafficking involving commercial sexual activity. The bill provides that the information regarding the location of these facilities that is held by an agency is confidential and exempt from public record requirements. However, the bill allows this information to be provided to any agency in order to maintain health and safety standards and to address emergency situations.

Last Action: 4/16/15 HOUSE Passed.
MentalHealthSubstanceAbuseMental Health and Substance Abuse
CS/SB 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; 
  • a Nonviolent Offender Reentry Program be created to divert nonviolent offenders with substance abuse impairment from serving lengthy sentences through a partial service of sentence and referral to a reentry program;
  • substance abuse evaluations be added to evaluations that may be performed by a receiving facility within 24 hours after arrival of an individual in need of intervention and adds substance abuse professionals to the list of professionals who may evaluate the individual;
  • law enforcement officers notify the nearest relative of a minor taken into protective custody that the minor has been taken into protective custody;
  • a public school principal or the principal's designee, including those at charter schools, to immediately notify a student's parent, guardian, guardian advocate, or caregiver if a student is transferred from the school to a receiving facility for an involuntary examination, unless a report has been provided to the child abuse hotline, in which case notification may be delayed for up to 24 hours; and
  • receiving facilities immediately notify, and repeatedly attempt to notify until contact is successful, a minor's parent, guardian, caregiver, or guardian advocate, in person, by phone, or by electronic communication, unless a report has been provided to the child abuse hotline, in which case notification may be delayed for up to 24 hours.
Last Action: 4/16/15 SENATE Favorable with CS by Appropriations.
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We didn't lose the game; we just ran out of time.
-- Vince Lombardi
 
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