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Legislative Link
A legislative update provided by the United Way of Florida
 
ISSUE 8                                                                                                 APRIL 24, 2015
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SagaContinuesThe Saga Continues
Last week's Legislative Link documented a series of events that put Republicans in the state Legislature at odds with one another.

The reason for the discord is that, simply put, the Senate has proposed a plan to expand healthcare to more than 800,000 Floridians plus draw down Low Income Pool (LIP) funds, totaling about $5 billion, and the House has refused to embrace the plan.

The discord and digging-in-of-positions by the House and the Senate intensified this week as session's end neared.

The bottom line is that next Friday the Legislature will not have next year's state budget completed and a special session will be called before July 1 - the beginning of the next state fiscal year - so the Legislature can create a budget as required by the Florida Constitution.
TurmoilContinuesWeek 8: The Turmoil Continues
This week, the House and Senate moved down their separate paths:
  • Tuesday the Senate Appropriations Committee discussed the rationale underlying its Florida Health Insurance Affordability Plan (CS/SB 7044), which addresses heath care expansion and the Low Income Pool (LIP) funding, and asked all Senators interested in participating to join the discussion and ask questions.
    • During the meeting, Amy Baker, the Legislature's chief economic expert, testified that the Senate's expansion plan would result in $1.2 billion in savings over the next five years.
  • At the same time the Senate Appropriations Committee was meeting, House Republicans met behind closed doors - guarded by a House aide to keep press and public out - to discuss healthcare expansion and LIP funding.
  • Former Senate President Don Gaetz pointed out that although officials knew a year ago of the need to submit it, Governor Scott's health care officials only submitted an application for LIP funding on Monday (April 20). Because Florida is required to hold a 30-day public comment period and the federal government must wait another 45 days before taking action, he noted that, "Even if everything goes well, the fact that nothing has happened puts us into the next fiscal year...Is that not the consequence of a year of malpractice?"
  • That same day, Governor Rick Scott released a statement requesting the Legislature pass a budget by next Friday's scheduled session end, or he will "call a Special Session to pass a continuation budget for critical services."
    • Governor Scott's statement noted that, "While we are pushing the federal healthcare department to continue the LIP program for low income Floridians, it is clear that the federal government is not planning to move quickly enough to help develop the FY 15-16 budget by May 1st." Senator Gaetz's statement (above) reflected that it had taken the feds more than six months to approve the last LIP program proposal.
    • Texas Governor Greg Abbott issued a statement Monday backing Governor Scott's lawsuit against the feds, reported in last week's Legislative Link. He said, "Texas will support Florida in its litigation against the federal government...Medicaid expansion is wrong for Texas. Florida's approach should be determined by Floridians, not coerced by federal bureaucrats."
    • Governor Scott's Agency for Health Care Administration has scheduled three, two-hour meetings in Orlando, Miami, and Tallahassee April 29, April 30, and May 1, respectively, to take public testimony on the LIP proposal.
  • On Wednesday, Governor Scott called several Senate Republicans to his office and reportedly threatened their priority issues with veto if they do not support his tax cuts, and provided a list of hospitals and their profit margins.
    • Senator Bill Galvano, R-Bradenton, was quoted as saying, "That doesn't help any more than a lawsuit does in negotiations with CMS," referring to Scott's decision last week to threaten suit against the federal government.
  • CMS also reported this week that, as it has already warned Florida and Texas, it notified Tennessee and Kansas that failing to expand Medicaid could jeopardize special funding to pay hospitals and doctors for treating the poor.
AmidTurmoilAmid Turmoil, A Ray of Hope?
Late yesterday, the Orlando Sentinel reported that House Speaker Steve Crisafulli announced he is floating a proposal to use $200 million in state funds to draw down $300 million in Medicaid funds to address the health care impasse in which the legislature is embroiled.

The House "finds" the money by reducing the House proposed education budget by $90 million, cut taxes by $78.5 million less than planned, and taking $50 million out of reserves.

This will be the first proposed (partial) solution to the issue the House will have put on the table this session and may open the door to negotiations that will ultimately resolve the impasse. The proposal does not include funding to expand healthcare access to 800,000 Floridians without health insurance, which is a key part of the Senate plan, but it would address part of the LIP problem.
TexttheParentHelp Child Language Skills: Text the Parent!
For years, researchers and practitioners have experimented with myriad ways to get parents to read to their children, among others, so children enter school with appropriate language skills. 

The problem has been most evident among low income children who are often leagues behind their more economically effluent classmates in terms of language skills, written and spoken.

Last November, the New York Times included an article entitled, "To Help Language Skills of Children, a Study Finds, Text Their Parents With Tips", highlighting a report released by the National Bureau of Economic Research suggesting that "mobile technology may offer a cheap and effective solution."

The study found that parents who received "literacy" texts on a regular basis were far more likely to report pointing out rhyming words or describing pictures in a book to their children than those who received general texts. In addition, the study children outpaced their peers in language skills and their parents were more involved in their schooling.
First the doctor told me the good news: I was going to have a disease named after me.
-- Steve Martin
SpecialSessionDilemmaSpecial Session Dilemma
Timing is not in the Legislature's favor.

Tuesday, Senate President Andy Gardiner released a statement saying that, "Despite the best efforts of the Senate to develop a Florida-based solution, at this time, there is no scenario under which we can complete a budget process that is open and transparent by May 1st."

The challenge the Legislature faces is that it must fulfill its constitutional mandate to create a state budget by July 1, the first day of the next fiscal year.

Here's the problem: Governor Scott's health care officials only submitted an application for LIP funding on Monday (April 20). Federal rules require Florida to hold a 30-day public comment period, and the federal government must wait another 45 days before taking action.

In other words, if the process works as quickly as it possibly can, which is itself doubtful, the soonest Florida will know if the LIP proposal will fly is 75 days from April 20. That date is July 3, two days after the Legislature must have the budget completed.

Of course, no one knows at this point what will happen in this topsy turvey political environment, but one thing is for sure: The timeframe could be an incredibly difficult hurdle to clear if the Legislature goes into special session awaiting word from the feds on LIP.
UWOFUnited Way of Florida: Support the Senate Healthcare Expansion Plan
On Thursday, after lengthy debate spanning several months, the United Way of Florida Board of Governors agreed to support the Senate's Florida Health Insurance Affordability Plan (CS/SB 7044).

Board members agreed that Florida is facing a health care crisis. The United Way press release noted that, at more than 800,000, the Sunshine State has the second highest number of uninsured residents in the country. Three out of four of these uninsured Floridians work full or part time and do not have access to affordable health insurance through their employers. They are veterans, moms and dads, and young people just entering the workforce.

They are part of the ALICE population who are Asset Limited, Income Constrained, Employed. The recently published United Way ALICE Report found that 45 percent of Florida's working families struggle to make ends meet and to afford basic necessities such as housing, food, transportation, childcare and health care. For these hardworking ALICE families a single crisis, often a health care emergency, can result in financial chaos.
EarlyLearningBillsMoveEarly Learning Bills Move
The session's two comprehensive early learning health and safety bills moved closer to final passage this week.

CS/CS/SB 7006 passed the Senate Appropriations Committee, its final committee reference, and is ready to go to the Senate Floor.

CS/HB 7017 was amended on the House floor and is positioned to be placed onto third reading (the final step where the Senate will actually vote it up or down).

The bills are substantially similar in that they both increase the health and safety standards and personnel requirements for Voluntary Prekindergarten Programs (VPK) programs and School Readiness programs. Among others, they both:
  • require licensure or, if the provider is a license-exempt faith-based provider or nonpublic school, a certificate of substantial compliance with specified child care licensing standards and submission to inspections by the Department of Children and Families (DCF);
  • require providers of child care and VPK to notify parents of disciplinary action and conspicuously post Class I violation citations and inspection reports that result in disciplinary action, on the premises; and
  • phase-in requirements that School Readiness and VPK personnel generally must be at least 18 years of age; hold a high school diploma or equivalent credential; and be trained in first aid, CPR, and age-appropriate practices.

The Senate bill was amended to remove provisions that would have allowed school districts and charter school governing boards to permit certain four-year-old children to attend kindergarten, and to remove DCF monitoring and inspection funding so the bill can pass without a fiscal impact. It is expected the $1.2 million for DCF will be addressed when the Legislature completes next year's budget.

I grew up with six brothers. That's how I learned to dance -- waiting for the bathroom.
-- Bob Hope
ChildProtectionBillChild Protection Bill Goes to Governor
Last year, the Legislature passed SB 1666, a comprehensive reform of the child welfare system. Among others, the bill addressed child protection teams (CPTs).

A CPT is a medically-directed, multi-disciplinary team that works with local sheriffs' offices and the Department of Children and Families (DCF) in cases of child abuse and neglect to supplement investigation activities. Child protection teams provide expertise in evaluating alleged child abuse and neglect, assess risk and protective factors, and provide recommendations for interventions to protect children.

On Wednesday, the Senate passed legislation fine tuning last year's bill. Among others, CS/CS/HB 1055:
  • requires the Statewide Medical Director for Child Protection be a physician who is board certified in pediatrics with a subspecialty certification in child abuse from the American Board of Pediatrics;
  • requires each medical director to be a physician either board certified in pediatrics with a subspecialty certification in child abuse from the American Board of Pediatrics or credentialed by a third-party entity within four years from the date of employment or, if currently employed, within four years of July 1, 2015;
  • requires medical personnel participating on a child protection team to successfully complete the required CPT training curriculum; and
  • provides that the critical incident rapid response team must include a child protection team medical director.

The bill is on its way to the Governor's desk for his signature.


Another key child protection bill refining last year's legislation is poised to be heard by the full Senate. Read about CS/SB 7078 in Bills Heard This Week, below. 

GlimmerofHopeGlimmer of Hope for KidCare
Florida KidCare is the state's health insurance program for uninsured children in families with incomes up to 200 percent of the federal poverty level.

When first implemented, federal law required that lawfully residing immigrant children wait five years before they could participate in the KidCare program. However, in 2009 Congress revised the law to allow states to eliminate the five year waiting period.

Florida has not eliminated the waiting period and, as a result, approximately 20,000 immigrant children who are lawfully residing in Florida must wait five years before they can participate in the program and receive the health care they need. The cost to the state for providing coverage for these children is estimated to be $14 million.

The Senate bill that would eliminate the waiting period (SB 294) has passed two of its three referenced committees and its House companion (HB 829) has never been heard.

This much-needed legislation - which advocates have tried to get passed for years - is likely dead for the session. But this week a powerful senator, Rene Garcia who is the Senate bill sponsor and Chair of the Appropriations Subcommittee on Health and Human Services, vowed that he will try to secure funding to eliminate the waiting period when the appropriations process kicks back into gear.
ERPoorKidsER: Poor Kids' Dentist Office
According to George Washington University, in 2012 Florida ranked 50th nationally in the percentage (18.8 percent) of Medicaid-covered children who received preventive dental services (dental cleaning or application of dental sealants).

This is an expensive proposition for Florida taxpayers and health insurance policy holders.

That same year, The Florida Public Health Institute reports
12,976 Medicaid-covered children with oral health problems visited emergency rooms, costing $11.3 million dollars. More than half of these children (7,234) were five years old or younger, accounting for almost $5 million of those ER costs.
BillsHeardBILLS HEARD THIS WEEK
(Portions excerpted from Legislative staff analyses.)
BullyingBullying and Harassment Policies in Schools
In 2008, the Florida Legislature passed legislation prohibiting bullying and harassment of any student or employee of a public K-12 educational institution.

CS/SB 530 requires periodic revision of a school district's anti-bullying and harassment policy, modifies the information that must be contained in the policy, and requires schools to implement the policy. Among others, the bill requires that:
  • school districts revise anti-bullying and harassment policies every three years;
  • schools implement school district anti-bullying and harassment policies; and
  • school district anti-bullying and harassment policies:
    • make reporting of bullying or harassment mandatory; and
    • include a list of bullying prevention and intervention programs authorized by the school district to provide instruction to students, parents, teachers, school administrators, counseling staff, and school volunteers on identifying, preventing, and responding to bullying or harassment.
Last Action: 4/22/15 SENATE Favorable with CS by Fiscal Policy.
ConsumerProtectionConsumer Protection - Refunds
CS/CS/SB 726 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, among others, 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: 4/23/15 SENATE Placed on Calendar.
ChildWelfareChild Welfare
Last year, in response to extraordinary investigative reporting by the Miami Herald, revealing that 477 Florida children had died or been killed while in the child welfare system over the previous five years, the Florida Legislature passed CS/SB 1666.

The bill made a number of changes to state law intended to improve investigation of and subsequent response to allegations of abuse or neglect. Among the changes, were creation of the Critical Incident Rapid Response Team (CIRRT), expansion of the number and types of cases reviewed through the Child Abuse Death Review (CADR) process, and creation of the Florida Institute for Child Welfare (FICW).

This session, CS/SB 7078, which refines last year's bill, is poised to go to the Senate Floor. Among others, the bill:
  • clarifies the roles of state and local review committees in the CADR process and imposes specific reporting requirements to address the increased volume of cases reviewed through the CADR process and better align it with the newly-created CIRRT process;
  • permits the Secretary of Department of Children and Families (DCF) to deploy CIRRTs in response to other child deaths in addition to those with verified abuse and neglect in the last 12 months;
  • requires more frequent reviews and reports by the CIRRT advisory committee;
  • requires a multi-agency staffing be convened for cases of alleged medical neglect, clarifying that the staffing shall be convened only if medical neglect is substantiated by the child protection team;
  • permits specialty plans to continue to serve children in custody of DCF under certain conditions; and 
  • implements FICW interim report recommendations by clarifying legislative intent to prioritize evidence-based and trauma-informed services.
Last Action: 4/23/15 SENATE Third Reading.
CombatVeteransServices for Combat Veterans and Their Families
CS/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.

Among others, the bill requires DCF to:
  • consult with the Florida Alliance of Information and Referral Services instead of the Agency for Health Care Administration (AHCA) to develop the Program;
  • contract with the managing entities to enter into agreements with the Florida 211 Network participants to provide services under the Program; and
  • provide a report on the Program's implementation to the Governor, President of the Senate, and Speaker of the House of Representatives by December 15, 2016, using data provided to DCF by the Florida 211 Network participants.
The bill also:
  • limits program services to combat veterans and their families; and
  • provides a $2,000,155 recurring General Revenue appropriation to DCF to implement the program.
Last Action: 4/22/15 HOUSE passed; Received by SENATE.
FSECCFlorida State Employees' Charitable Campaign
SB 694 provides an exception to the requirement that state officers and employees designate a charitable organization to receive their contributions from the Florida State Employees' Charitable Campaign (FSECC) made during participation in a special event. The bill allows state officers and employees to contribute undesignated funds to the FSECC as part of a campaign event, and direct the fiscal agent to direct undesignated contributions to participating charitable organizations in proportion to all designated FSECC contributions received by that organization.

The bill eliminates the requirement that local steering committees be established in each fiscal agent area. It also eliminate the additional eligibility requirements for an independent unaffiliated agency, national agency, and international service agency.

Last Action: 4/22/15 Enrolled.
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 CARD UF existing resources.

Last Action: 4/22/15 HOUSE Passed; Received by the SENATE.
RestitutionRestitution for Juvenile Offenses
CS/CS/HB 235 expands the authority of courts 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.

The bill 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:
  • 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: 4/22/15 HOUSE Passed; Received by the SENATE.
CivilCitationCivil Citation
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: 4/23/15 SENATE Third Reading.
NonprofitDonorProtectionNonprofit and Donor Protection
CS/CS/SB 1446 makes confidential and exempt criminal or civil intelligence or investigative information provided to or by another state or federal agency as part of a joint or multi-agency examination or investigation if the information is confidential or exempt under the regulations or laws of the state or federal agency that provides the information. The Department of Agriculture and Consumer Services (DACS) will be able to obtain, use and release the information that is confidential or exempt under the laws or regulations of the state or federal source of information in accordance with conditions imposed by agreements DACS enters into with the other state or governmental entity.

Simply put, the bill will allow DACS to provide information to and receive information from other investigative agencies (ex. FBI, IRS, etc.), and that information is not subject to Florida's public records/Sunshine laws.

Last Action: 4/14/15 SENATE Third Reading.
DentalCareDental Care
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: 4/22/15 SENATE Passed; HOUSE In messages.
HumanTraffickingHuman Trafficking
CS/CS/HB 369 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: SENATE CS passed as amended; HOUSE In returning messages.
InvolExamMinorsInvoluntary Examination of Minors
CS/SB 954 requires a public school 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 the 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: 4/23/15 SENATE CS passed as amended; HOUSE In messages.
GuardianAppointmentGuardian Appointment: Aging Out
Under current law, when a minor with developmental disabilities or with some level of incapacity ages out of the foster care system at age 18, a gap exists between the time he or she turns 18 years old and the time when a guardian can be appointed. Because of this gap, many young adults have suffered as a result of making bad decisions, and at least one has died.

Two separate issues create this gap. First, there is no procedure within the dependency system to identify adults willing to serve as guardians for these minors as they reach age 18 years of age. Second, probate courts that have the jurisdiction to appoint guardians after a person turns 18 cannot begin the process until after the child turns 18, and the process can take months. It is during these months that problems and deadly mistakes have been made.

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 an annual review of the continued necessity of a guardianship for young adults in extended foster care who already have a guardian advocate or guardian;
  • requires development of an updated case plan for any child who may require the assistance of a guardian advocate, limited guardian, or plenary guardian;
  • provides that upon a judge's finding that no less restrictive decision-making assistance will meet the child's needs;
  • requires the Department of Children and Families (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 advocate, plenary guardian, or limited guardian may be initiated in a separate proceeding in guardianship court within 180 days of the child's 17th birthday;
  • provides 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
  • provides that a child's parents are considered to be the child's natural guardians, unless the dependency or guardianship court determines it is not in the child's best interest or the parents' rights have been terminated.
Last Action: 4/22/15 SENATE Passed; HOUSE In returning messages.
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