Senate Bill sb0632c2

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    Florida Senate - 2002                     CS for CS for SB 632

    By the Committees on Appropriations; Children and Families;
    and Senator Peaden




    300-1889-02

  1                      A bill to be entitled

  2         An act relating to out-of-home care; repealing

  3         s. 39.521(5), F.S., relating to the mandatory

  4         assessment of specified children for placement

  5         in licensed residential group care; creating s.

  6         39.523, F.S.; prescribing procedures for the

  7         mandatory assessment of certain children for

  8         placement in licensed residential group care;

  9         providing for reports; providing for a

10         residential group care appropriations category

11         in the General Appropriations Act; providing

12         for funding increases to be appropriated in a

13         lump-sum category; specifying that the release

14         of certain funds is contingent on the approval

15         of a spending plan; prescribing elements of the

16         plan; authorizing one-time startup funding;

17         amending s. 39.407, F.S.; clarifying that the

18         Department of Children and Family Services may

19         place a child who is in its custody in a

20         residential treatment center without prior

21         approval of the court; amending s. 409.1671,

22         F.S.; providing intent that the Department of

23         Children and Family Services and the Department

24         of Juvenile Justice establish an interagency

25         agreement regarding referral to residential

26         group care facilities; specifying that a

27         residential group care facility must be

28         licensed as a child-caring agency; requiring

29         such facilities serving certain children to

30         meet specified staff qualifications and

31         Medicaid-provider criteria; redefining the term

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  1         "serious behavioral problems"; authorizing the

  2         department to adopt rules; specifying

  3         timeframes for initiating and for completing

  4         privatization of foster care and related

  5         services; providing for the establishment of a

  6         model comprehensive residential services

  7         program in specified counties; providing that

  8         community-based providers and subcontractors

  9         require employees to obtain bodily injury

10         liability insurance on personal automobiles;

11         providing certain immunity from liability when

12         transporting clients in privately owned

13         automobiles; directing the Department of

14         Children and Family Services to adopt written

15         policies and procedures for contract monitoring

16         of community-based providers; modifying the

17         requirement for community-based providers to

18         furnish information to the department;

19         modifying the conditions under which a provider

20         may close a case; modifying the requirements

21         concerning dual licensure of foster homes;

22         eliminating the authority for a risk pool;

23         requiring the development of a proposal for a

24         shared-earnings program; providing direction

25         for the development of the proposal; providing

26         for submission of the proposal to the

27         Legislative Budget Commission and for

28         submission to the Legislature under certain

29         conditions; expanding the program relating to

30         excess federal earnings and certain additional

31         state funds to additional entities; eliminating

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  1         a specified expiration for this program;

  2         requiring that the Legislature appropriate a

  3         lump sum in the Administered Funds Program each

  4         year for a specified purpose; specifying the

  5         type of bond that may be required; eliminating

  6         an obsolete review requirement; amending s.

  7         409.1676, F.S.; removing a reference to

  8         specific districts and regions of the

  9         department; amending s. 409.175, F.S.; defining

10         the term "family foster group home"; amending

11         s. 409.906, F.S.; expanding the authority for

12         the establishment of child welfare targeted

13         case management projects; eliminating reference

14         to a pilot project; eliminating the requirement

15         to report to the Child Welfare Estimating

16         Conference regarding targeted case management;

17         directing the Office of Program Policy Analysis

18         and Government Accountability, in consultation

19         with the Agency for Health Care Administration,

20         to conduct a review of the process for placing

21         children for residential mental health

22         treatment; providing for a report to the

23         Governor and Legislature; providing an

24         effective date.

25

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

27

28         Section 1.  Subsection (5) of section 39.521, Florida

29  Statutes, is repealed.

30         Section 2.  Section 39.523, Florida Statutes, is

31  created to read:

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  1         39.523  Placement in residential group care.--

  2         (1)  Except as provided in s. 39.407, any dependent

  3  child 11 years of age or older who has been in licensed family

  4  foster care for 6 months or longer and who is then moved more

  5  than once must be assessed for placement in licensed

  6  residential group care. The assessment procedures shall be

  7  conducted by the department or its agent and shall incorporate

  8  and address current and historical information from any

  9  psychological testing or evaluation that has occurred; current

10  and historical information from the guardian ad litem, if one

11  has been assigned; current and historical information from any

12  current therapist, teacher, or other professional who has

13  knowledge of the child and has worked with the child;

14  information regarding the placement of any siblings of the

15  child and the impact of the child's placement in residential

16  group care on the child's siblings; the circumstances

17  necessitating the moves of the child while in family foster

18  care and the recommendations of the former foster families, if

19  available; the status of the child's case plan and a

20  determination as to the impact of placing the child in

21  residential group care on the goals of the case plan; the age,

22  maturity, and desires of the child concerning placement; the

23  availability of any less restrictive, more family-like setting

24  for the child in which the foster parents have the necessary

25  training and skills for providing a suitable placement for the

26  child; and any other information concerning the availability

27  of suitable residential group care. If such placement is

28  determined to be appropriate as a result of this procedure,

29  the child must be placed in residential group care, if

30  available.

31

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  1         (2)  The results of the assessment described in

  2  subsection (1) and the actions taken as a result of the

  3  assessment must be included in the next judicial review of the

  4  child. At each subsequent judicial review, the court must be

  5  advised in writing of the status of the child's placement,

  6  with special reference regarding the stability of the

  7  placement and the permanency planning for the child.

  8         (3)  Any residential group care facility that receives

  9  children under the provisions of this subsection shall

10  establish special permanency teams dedicated to overcoming the

11  special permanency challenges presented by this population of

12  children. Each facility shall report to the department its

13  success in achieving permanency for children placed by the

14  department in its care at intervals that allow the current

15  information to be provided to the court at each judicial

16  review for the child.

17         (4)  This subsection does not prohibit the department

18  from assessing and placing children who do not meet the

19  criteria in subsection (1) in residential group care if such

20  placement is the most appropriate placement for such children.

21         (5)(a)  By December 1 of each year, the department

22  shall report to the Legislature on the placement of children

23  in licensed residential group care during the year, including

24  the criteria used to determine the placement of children, the

25  number of children who were evaluated for placement, the

26  number of children who were placed based upon the evaluation,

27  and the number of children who were not placed. The department

28  shall maintain data specifying the number of children who were

29  referred to licensed residential child care for whom placement

30  was unavailable and the counties in which such placement was

31  unavailable. The department shall include this data in its

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  1  report to the Legislature due on December 1, so that the

  2  Legislature may consider this information in developing the

  3  General Appropriations Act.

  4         (b)  As part of the report required in paragraph (a),

  5  the department shall also provide a detailed account of the

  6  expenditures incurred for "Special Categories: Grants and Aids

  7  - Residential Group Care" for the fiscal year immediately

  8  preceding the date of the report. This section of the report

  9  must include whatever supporting data is necessary to

10  demonstrate full compliance with paragraph (6)(c). The

11  document must present the information by district and must

12  specify, at a minimum, the number of additional beds, the

13  average rate per bed, the number of additional persons served,

14  and a description of the enhanced and expanded services

15  provided.

16         (6)(a)  The provisions of this section shall be

17  implemented to the extent of available appropriations

18  contained in the annual General Appropriations Act for such

19  purpose.

20         (b)  Each year, funds included in the General

21  Appropriations Act for Residential Group Care shall be

22  appropriated in a separately identified special category that

23  is designated in the act as "Special Categories: Grants and

24  Aids-Residential Group Care."

25         (c)  Each fiscal year, any funding increases to

26  "Special Categories: Grants and Aids.--Residential Group Care"

27  which are included in the General Appropriations Act shall be

28  appropriated in a lump-sum category as defined in s.

29  216.011(1)(aa). In accordance with s. 216.181(6)(a), the

30  Executive Office of the Governor shall require the department

31  to submit a spending plan that identifies the residential

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  1  group care bed capacity shortage throughout the state and

  2  proposes a distribution formula by district which addresses

  3  the reported deficiencies. The spending plan must have as its

  4  first priority the reduction or elimination of any bed

  5  shortage identified and must also provide for program

  6  enhancements to assure that residential group care programs

  7  meet a minimum level of expected performance and provide for

  8  expansion of the comprehensive residential group care services

  9  described in s. 409.1676. Annual appropriation increases

10  appropriated in the lump-sum appropriation must be used in

11  accordance with the provisions of the spending plan.

12         (d)  Funds from "Special Categories: Grants and Aids -

13  Residential Group Care" may be used as one-time startup

14  funding for residential group care purposes that include, but

15  are not limited to, remodeling or renovation of existing

16  facilities, construction costs, leasing costs, purchase of

17  equipment and furniture, site development, and other necessary

18  and reasonable costs associated with the startup of facilities

19  or programs upon the recommendation of the lead

20  community-based provider if one exists and upon specific

21  approval of the terms and conditions by the secretary of the

22  department.

23         Section 3.  Subsection (5) of section 39.407, Florida

24  Statutes, is amended to read:

25         39.407  Medical, psychiatric, and psychological

26  examination and treatment of child; physical or mental

27  examination of parent or person requesting custody of child.--

28         (5)  Children who are in the legal custody of the

29  department may be placed by the department, without prior

30  approval of the court, in a residential treatment center

31  licensed under s. 394.875 or a hospital licensed under chapter

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  1  395 for residential mental health treatment only pursuant to

  2  this section or may be placed by the court in accordance with

  3  an order of involuntary examination or involuntary placement

  4  entered pursuant to s. 394.463 or s. 394.467. All children

  5  placed in a residential treatment program under this

  6  subsection must have a guardian ad litem appointed.

  7         (a)  As used in this subsection, the term:

  8         1.  "Residential treatment" means placement for

  9  observation, diagnosis, or treatment of an emotional

10  disturbance in a residential treatment center licensed under

11  s. 394.875 or a hospital licensed under chapter 395.

12         2.  "Least restrictive alternative" means the treatment

13  and conditions of treatment that, separately and in

14  combination, are no more intrusive or restrictive of freedom

15  than reasonably necessary to achieve a substantial therapeutic

16  benefit or to protect the child or adolescent or others from

17  physical injury.

18         3.  "Suitable for residential treatment" or

19  "suitability" means a determination concerning a child or

20  adolescent with an emotional disturbance as defined in s.

21  394.492(5) or a serious emotional disturbance as defined in s.

22  394.492(6) that each of the following criteria is met:

23         a.  The child requires residential treatment.

24         b.  The child is in need of a residential treatment

25  program and is expected to benefit from mental health

26  treatment.

27         c.  An appropriate, less restrictive alternative to

28  residential treatment is unavailable.

29         (b)  Whenever the department believes that a child in

30  its legal custody is emotionally disturbed and may need

31  residential treatment, an examination and suitability

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  1  assessment must be conducted by a qualified evaluator who is

  2  appointed by the Agency for Health Care Administration. This

  3  suitability assessment must be completed before the placement

  4  of the child in a residential treatment center for emotionally

  5  disturbed children and adolescents or a hospital. The

  6  qualified evaluator must be a psychiatrist or a psychologist

  7  licensed in Florida who has at least 3 years of experience in

  8  the diagnosis and treatment of serious emotional disturbances

  9  in children and adolescents and who has no actual or perceived

10  conflict of interest with any inpatient facility or

11  residential treatment center or program.

12         (c)  Before a child is admitted under this subsection,

13  the child shall be assessed for suitability for residential

14  treatment by a qualified evaluator who has conducted a

15  personal examination and assessment of the child and has made

16  written findings that:

17         1.  The child appears to have an emotional disturbance

18  serious enough to require residential treatment and is

19  reasonably likely to benefit from the treatment.

20         2.  The child has been provided with a clinically

21  appropriate explanation of the nature and purpose of the

22  treatment.

23         3.  All available modalities of treatment less

24  restrictive than residential treatment have been considered,

25  and a less restrictive alternative that would offer comparable

26  benefits to the child is unavailable.

27

28  A copy of the written findings of the evaluation and

29  suitability assessment must be provided to the department and

30  to the guardian ad litem, who shall have the opportunity to

31  discuss the findings with the evaluator.

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  1         (d)  Immediately upon placing a child in a residential

  2  treatment program under this section, the department must

  3  notify the guardian ad litem and the court having jurisdiction

  4  over the child and must provide the guardian ad litem and the

  5  court with a copy of the assessment by the qualified

  6  evaluator.

  7         (e)  Within 10 days after the admission of a child to a

  8  residential treatment program, the director of the residential

  9  treatment program or the director's designee must ensure that

10  an individualized plan of treatment has been prepared by the

11  program and has been explained to the child, to the

12  department, and to the guardian ad litem, and submitted to the

13  department. The child must be involved in the preparation of

14  the plan to the maximum feasible extent consistent with his or

15  her ability to understand and participate, and the guardian ad

16  litem and the child's foster parents must be involved to the

17  maximum extent consistent with the child's treatment needs.

18  The plan must include a preliminary plan for residential

19  treatment and aftercare upon completion of residential

20  treatment. The plan must include specific behavioral and

21  emotional goals against which the success of the residential

22  treatment may be measured. A copy of the plan must be provided

23  to the child, to the guardian ad litem, and to the department.

24         (f)  Within 30 days after admission, the residential

25  treatment program must review the appropriateness and

26  suitability of the child's placement in the program. The

27  residential treatment program must determine whether the child

28  is receiving benefit towards the treatment goals and whether

29  the child could be treated in a less restrictive treatment

30  program. The residential treatment program shall prepare a

31  written report of its findings and submit the report to the

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  1  guardian ad litem and to the department. The department must

  2  submit the report to the court. The report must include a

  3  discharge plan for the child. The residential treatment

  4  program must continue to evaluate the child's treatment

  5  progress every 30 days thereafter and must include its

  6  findings in a written report submitted to the department. The

  7  department may not reimburse a facility until the facility has

  8  submitted every written report that is due.

  9         (g)1.  The department must submit, at the beginning of

10  each month, to the court having jurisdiction over the child, a

11  written report regarding the child's progress towards

12  achieving the goals specified in the individualized plan of

13  treatment.

14         2.  The court must conduct a hearing to review the

15  status of the child's residential treatment plan no later than

16  3 months after the child's admission to the residential

17  treatment program. An independent review of the child's

18  progress towards achieving the goals and objectives of the

19  treatment plan must be completed by a qualified evaluator and

20  submitted to the court before its 3-month review.

21         3.  For any child in residential treatment at the time

22  a judicial review is held pursuant to s. 39.701, the child's

23  continued placement in residential treatment must be a subject

24  of the judicial review.

25         4.  If at any time the court determines that the child

26  is not suitable for continued residential treatment, the court

27  shall order the department to place the child in the least

28  restrictive setting that is best suited to meet his or her

29  needs.

30

31

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  1         (h)  After the initial 3-month review, the court must

  2  conduct a review of the child's residential treatment plan

  3  every 90 days.

  4         (i)  The department must adopt rules for implementing

  5  timeframes for the completion of suitability assessments by

  6  qualified evaluators and a procedure that includes timeframes

  7  for completing the 3-month independent review by the qualified

  8  evaluators of the child's progress towards achieving the goals

  9  and objectives of the treatment plan which review must be

10  submitted to the court. The Agency for Health Care

11  Administration must adopt rules for the registration of

12  qualified evaluators, the procedure for selecting the

13  evaluators to conduct the reviews required under this section,

14  and a reasonable, cost-efficient fee schedule for qualified

15  evaluators.

16         Section 4.  Section 409.1671, Florida Statutes, is

17  amended to read:

18         409.1671  Foster care and related services;

19  privatization.--

20         (1)(a)  It is the intent of the Legislature that the

21  Department of Children and Family Services shall privatize the

22  provision of foster care and related services statewide. It is

23  further the Legislature's intent to encourage communities and

24  other stakeholders in the well-being of children to

25  participate in assuring that children are safe and

26  well-nurtured. However, while recognizing that some local

27  governments are presently funding portions of certain foster

28  care and related services programs and may choose to expand

29  such funding in the future, the Legislature does not intend by

30  its privatization of foster care and related services that any

31  county, municipality, or special district be required to

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  1  assist in funding programs that previously have been funded by

  2  the state. Nothing in this paragraph prohibits any county,

  3  municipality, or special district from future voluntary

  4  funding participation in foster care and related services. As

  5  used in this section, the term "privatize" means to contract

  6  with competent, community-based agencies. The department shall

  7  submit a plan to accomplish privatization statewide, through a

  8  competitive process, phased in over a 3-year period beginning

  9  January 1, 2000. This plan must be developed with local

10  community participation, including, but not limited to, input

11  from community-based providers that are currently under

12  contract with the department to furnish community-based foster

13  care and related services, and must include a methodology for

14  determining and transferring all available funds, including

15  federal funds that the provider is eligible for and agrees to

16  earn and that portion of general revenue funds which is

17  currently associated with the services that are being

18  furnished under contract. The methodology must provide for the

19  transfer of funds appropriated and budgeted for all services

20  and programs that have been incorporated into the project,

21  including all management, capital (including current furniture

22  and equipment), and administrative funds to accomplish the

23  transfer of these programs. This methodology must address

24  expected workload and at least the 3 previous years'

25  experience in expenses and workload. With respect to any

26  district or portion of a district in which privatization

27  cannot be accomplished within the 3-year timeframe, the

28  department must clearly state in its plan the reasons the

29  timeframe cannot be met and the efforts that should be made to

30  remediate the obstacles, which may include alternatives to

31  total privatization, such as public-private partnerships. As

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  1  used in this section, the term "related services" includes,

  2  but is not limited to, family preservation, independent

  3  living, emergency shelter, residential group care, foster

  4  care, therapeutic foster care, intensive residential

  5  treatment, foster care supervision, case management,

  6  postplacement supervision, permanent foster care, and family

  7  reunification. Unless otherwise provided for, beginning in

  8  fiscal year 1999-2000, either the state attorney or the Office

  9  of the Attorney General shall provide child welfare legal

10  services, pursuant to chapter 39 and other relevant

11  provisions, in Sarasota, Pinellas, Pasco, Broward, and Manatee

12  Counties.  Such legal services shall commence and be

13  effective, as soon as determined reasonably feasible by the

14  respective state attorney or the Office of the Attorney

15  General, after the privatization of associated programs and

16  child protective investigations has occurred.  When a private

17  nonprofit agency has received case management

18  responsibilities, transferred from the state under this

19  section, for a child who is sheltered or found to be dependent

20  and who is assigned to the care of the privatization project,

21  the agency may act as the child's guardian for the purpose of

22  registering the child in school if a parent or guardian of the

23  child is unavailable and his or her whereabouts cannot

24  reasonably be ascertained. The private nonprofit agency may

25  also seek emergency medical attention for such a child, but

26  only if a parent or guardian of the child is unavailable, his

27  or her whereabouts cannot reasonably be ascertained, and a

28  court order for such emergency medical services cannot be

29  obtained because of the severity of the emergency or because

30  it is after normal working hours. However, the provider may

31  not consent to sterilization, abortion, or termination of life

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  1  support. If a child's parents' rights have been terminated,

  2  the nonprofit agency shall act as guardian of the child in all

  3  circumstances.

  4         (b)  It is the intent of the Legislature that the

  5  department will continue to work towards full privatization by

  6  initiating the competitive-procurement process in each county

  7  by January 1, 2003. In order to provide for an adequate

  8  transition period to develop the necessary administrative and

  9  service-delivery capacity in each community, the full transfer

10  of all foster care and related services must be completed

11  statewide by December 31, 2004.

12         (c)(b)  As used in this section, the term "eligible

13  lead community-based provider" means a single agency with

14  which the department shall contract for the provision of child

15  protective services in a community that is no smaller than a

16  county. The secretary of the department may authorize more

17  than one eligible lead community-based provider within a

18  single county when to do so will result in more effective

19  delivery of foster care and related services. To compete for a

20  privatization project, such agency must have:

21         1.  The ability to coordinate, integrate, and manage

22  all child protective services in the designated community in

23  cooperation with child protective investigations.

24         2.  The ability to ensure continuity of care from entry

25  to exit for all children referred from the protective

26  investigation and court systems.

27         3.  The ability to provide directly, or contract for

28  through a local network of providers, all necessary child

29  protective services.

30         4.  The willingness to accept accountability for

31  meeting the outcomes and performance standards related to

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  1  child protective services established by the Legislature and

  2  the Federal Government.

  3         5.  The capability and the willingness to serve all

  4  children referred to it from the protective investigation and

  5  court systems, regardless of the level of funding allocated to

  6  the community by the state, provided all related funding is

  7  transferred.

  8         6.  The willingness to ensure that each individual who

  9  provides child protective services completes the training

10  required of child protective service workers by the Department

11  of Children and Family Services.

12         7.  The ability to maintain eligibility to receive all

13  federal child welfare funds, including Title IV-E and IV-A

14  funds, currently being used by the Department of Children and

15  Family Services.

16         (d)(c)1.  If attempts to competitively procure services

17  through an eligible lead community-based provider as defined

18  in paragraph (c)(b) do not produce a capable and willing

19  agency, the department shall develop a plan in collaboration

20  with the local community alliance. The plan must detail how

21  the community will continue to implement privatization, to be

22  accomplished by December 31, 2004 through competitively

23  procuring either the specific components of foster care and

24  related services or comprehensive services for defined

25  eligible populations of children and families from qualified

26  licensed agencies as part of its efforts to develop the local

27  capacity for a community-based system of coordinated care. The

28  plan must ensure local control over the management and

29  administration of the service provision in accordance with the

30  intent of this section and may include recognized best

31  business practices, including some form of public or private

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  1  partnerships. In the absence of a community alliance, the plan

  2  must be submitted to the President of the Senate and the

  3  Speaker of the House of Representatives for their comments.

  4         2.  The Legislature finds that the state has

  5  traditionally provided foster care services to children who

  6  have been the responsibility of the state. As such, foster

  7  children have not had the right to recover for injuries beyond

  8  the limitations specified in s. 768.28. The Legislature has

  9  determined that foster care and related services need to be

10  privatized pursuant to this section and that the provision of

11  such services is of paramount importance to the state. The

12  purpose for such privatization is to increase the level of

13  safety, security, and stability of children who are or become

14  the responsibility of the state. One of the components

15  necessary to secure a safe and stable environment for such

16  children is that private providers maintain liability

17  insurance. As such, insurance needs to be available and remain

18  available to nongovernmental foster care and related services

19  providers without the resources of such providers being

20  significantly reduced by the cost of maintaining such

21  insurance.

22         3.  The Legislature further finds that, by requiring

23  the following minimum levels of insurance, children in

24  privatized foster care and related services will gain

25  increased protection and rights of recovery in the event of

26  injury than provided for in s. 768.28.

27         (e)  In any county in which a service contract has not

28  been executed by December 31, 2004, the department shall

29  ensure access to a model comprehensive residential services

30  program as described in s. 409.1677 which, without imposing

31  undo financial, geographic, or other barriers, ensures

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  1  reasonable and appropriate participation by the family in the

  2  child's program.

  3         1.  In order to assure that the program is operational

  4  by December 31, 2004, the department must, by December 31,

  5  2003, begin the process of establishing access to a program in

  6  any county in which the department has not either entered into

  7  a transition contract or approved a community plan, as

  8  described in paragraph (d), which assures full privatization

  9  by the statutory deadline.

10         2.  The program must be procured through a competitive

11  process.

12         3.  The Legislature does not intend for the provisions

13  of this paragraph to substitute for the requirement that full

14  conversion to community-based care be accomplished.

15         (f)(d)  Other than an entity to which s. 768.28

16  applies, any eligible lead community-based provider, as

17  defined in paragraph (c)(b), or its employees or officers,

18  except as otherwise provided in paragraph (g)(e), must, as a

19  part of its contract, obtain a minimum of $1 million per

20  claim/$3 million per incident in general liability insurance

21  coverage. The eligible lead community-based provider must also

22  require that staff who transport client children and families

23  in their personal automobiles in order to carry out their job

24  responsibilities obtain minimum bodily injury liability

25  insurance in the amount of $100,000 per claim, $300,000 per

26  incident on their personal automobiles. In any tort action

27  brought against such an eligible lead community-based provider

28  or employee, net economic damages shall be limited to $1

29  million per liability claim and $100,000 per automobile claim,

30  including, but not limited to, past and future medical

31  expenses, wage loss, and loss of earning capacity, offset by

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  1  any collateral source payment paid or payable. In any tort

  2  action brought against such an eligible lead community-based

  3  provider, noneconomic damages shall be limited to $200,000 per

  4  claim. A claims bill may be brought on behalf of a claimant

  5  pursuant to s. 768.28 for any amount exceeding the limits

  6  specified in this paragraph. Any offset of collateral source

  7  payments made as of the date of the settlement or judgment

  8  shall be in accordance with s. 768.76. The lead

  9  community-based provider shall not be liable in tort for the

10  acts or omissions of its subcontractors or the officers,

11  agents, or employees of its subcontractors.

12         (g)(e)  The liability of an eligible lead

13  community-based provider described in this section shall be

14  exclusive and in place of all other liability of such

15  provider. The same immunities from liability enjoyed by such

16  providers shall extend as well to each employee of the

17  provider when such employee is acting in furtherance of the

18  provider's business, including the transportation of clients

19  served, as described in this subsection, in privately owned

20  vehicles. Such immunities shall not be applicable to a

21  provider or an employee who acts in a culpably negligent

22  manner or with willful and wanton disregard or unprovoked

23  physical aggression when such acts result in injury or death

24  or such acts proximately cause such injury or death; nor shall

25  such immunities be applicable to employees of the same

26  provider when each is operating in the furtherance of the

27  provider's business, but they are assigned primarily to

28  unrelated works within private or public employment. The same

29  immunity provisions enjoyed by a provider shall also apply to

30  any sole proprietor, partner, corporate officer or director,

31  supervisor, or other person who in the course and scope of his

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  1  or her duties acts in a managerial or policymaking capacity

  2  and the conduct that caused the alleged injury arose within

  3  the course and scope of those managerial or policymaking

  4  duties. Culpable negligence is defined as reckless

  5  indifference or grossly careless disregard of human life.

  6         (h)(f)  Any subcontractor of an eligible lead

  7  community-based provider, as defined in paragraph (c)(b),

  8  which is a direct provider of foster care and related services

  9  to children and families, and its employees or officers,

10  except as otherwise provided in paragraph (g)(e), must, as a

11  part of its contract, obtain a minimum of $1 million per

12  claim/$3 million per incident in general liability insurance

13  coverage. The subcontractor of an eligible lead

14  community-based provider must also require that staff who

15  transport client children and families in their personal

16  automobiles in order to carry out their job responsibilities

17  obtain minimum bodily injury liability insurance in the amount

18  of $100,000 per claim, $300,000 per incident on their personal

19  automobiles. In any tort action brought against such

20  subcontractor or employee, net economic damages shall be

21  limited to $1 million per liability claim and $100,000 per

22  automobile claim, including, but not limited to, past and

23  future medical expenses, wage loss, and loss of earning

24  capacity, offset by any collateral source payment paid or

25  payable. In any tort action brought against such

26  subcontractor, noneconomic damages shall be limited to

27  $200,000 per claim. A claims bill may be brought on behalf of

28  a claimant pursuant to s. 768.28 for any amount exceeding the

29  limits specified in this paragraph. Any offset of collateral

30  source payments made as of the date of the settlement or

31  judgment shall be in accordance with s. 768.76.

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  1         (i)(g)  The liability of a subcontractor of an eligible

  2  lead community-based provider that is a direct provider of

  3  foster care and related services as described in this section

  4  shall be exclusive and in place of all other liability of such

  5  provider. The same immunities from liability enjoyed by such

  6  subcontractor provider shall extend as well to each employee

  7  of the subcontractor when such employee is acting in

  8  furtherance of the subcontractor's business, including the

  9  transportation of clients served, as described in this

10  subsection, in privately owned vehicles. Such immunities shall

11  not be applicable to a subcontractor or an employee who acts

12  in a culpably negligent manner or with willful and wanton

13  disregard or unprovoked physical aggression when such acts

14  result in injury or death or such acts proximately cause such

15  injury or death; nor shall such immunities be applicable to

16  employees of the same subcontractor when each is operating in

17  the furtherance of the subcontractor's business, but they are

18  assigned primarily to unrelated works within private or public

19  employment. The same immunity provisions enjoyed by a

20  subcontractor shall also apply to any sole proprietor,

21  partner, corporate officer or director, supervisor, or other

22  person who in the course and scope of his or her duties acts

23  in a managerial or policymaking capacity and the conduct that

24  caused the alleged injury arose within the course and scope of

25  those managerial or policymaking duties. Culpable negligence

26  is defined as reckless indifference or grossly careless

27  disregard of human life.

28         (j)(h)  The Legislature is cognizant of the increasing

29  costs of goods and services each year and recognizes that

30  fixing a set amount of compensation actually has the effect of

31  a reduction in compensation each year. Accordingly, the

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  1  conditional limitations on damages in this section shall be

  2  increased at the rate of 5 percent each year, prorated from

  3  the effective date of this paragraph to the date at which

  4  damages subject to such limitations are awarded by final

  5  judgment or settlement.

  6         (2)(a)  The department may contract for the delivery,

  7  administration, or management of protective services, the

  8  services specified in subsection (1) relating to foster care,

  9  and other related services or programs, as appropriate. The

10  department shall retain responsibility for the quality of

11  contracted services and programs and shall ensure that

12  services are delivered in accordance with applicable federal

13  and state statutes and regulations. The department must adopt

14  written policies and procedures for monitoring the contract

15  for delivery of services by lead community-based providers.

16  These policies and procedures must, at a minimum, address the

17  evaluation of fiscal accountability and program operations,

18  including provider achievement of performance standards,

19  provider monitoring of subcontractors, and timely followup of

20  corrective actions for significant monitoring findings related

21  to providers and subcontractors. These policies and procedures

22  must also include provisions for reducing the duplication of

23  the department's program monitoring activities both internally

24  and with other agencies, to the extent possible. The

25  department's written procedures must assure that the written

26  findings, conclusions, and recommendations from monitoring the

27  contract for services of lead community-based providers are

28  communicated to the director of the provider agency as

29  expeditiously as possible.

30         (b)  Persons employed by the department in the

31  provision of foster care and related services whose positions

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  1  are being privatized pursuant to this statute shall be given

  2  hiring preference by the provider, if provider qualifications

  3  are met.

  4         (3)(a)  In order to help ensure a seamless child

  5  protection system, the department shall ensure that contracts

  6  entered into with community-based agencies pursuant to this

  7  section include provisions for a case-transfer process to

  8  determine the date that the community-based agency will

  9  initiate the appropriate services for a child and family. This

10  case-transfer process must clearly identify the closure of the

11  protective investigation and the initiation of service

12  provision. At the point of case transfer, and at the

13  conclusion of an investigation, the department must provide a

14  complete summary of the findings of the investigation to the

15  community-based agency.

16         (b)  The contracts must also ensure that each

17  community-based agency shall furnish information on its

18  activities in all cases in client case records regular status

19  reports of its cases to the department as specified in the

20  contract. A provider may not discontinue services on any

21  voluntary case without prior written notification to the

22  department 30 days before planned case closure. If the

23  department disagrees with the recommended case closure,

24  written notification to the provider must be provided before

25  the case-closure date. without prior written notification to

26  the department. After discontinuing services to a child or a

27  child and family, the community-based agency must provide a

28  written case summary, including its assessment of the child

29  and family, to the department.

30         (c)  The contract between the department and

31  community-based agencies must include provisions that specify

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  1  the procedures to be used by the parties to resolve

  2  differences in interpreting the contract or to resolve

  3  disputes as to the adequacy of the parties' compliance with

  4  their respective obligations under the contract.

  5         (4)(a)  The department shall establish a quality

  6  assurance program for privatized services. The quality

  7  assurance program shall be based on standards established by a

  8  national accrediting organization such as the Council on

  9  Accreditation of Services for Families and Children, Inc.

10  (COA) or CARF--the Rehabilitation Accreditation Commission.

11  The department may develop a request for proposal for such

12  oversight. This program must be developed and administered at

13  a statewide level. The Legislature intends that the department

14  be permitted to have limited flexibility to use funds for

15  improving quality assurance. To this end, effective January 1,

16  2000, the department may transfer up to 0.125 percent of the

17  total funds from categories used to pay for these

18  contractually provided services, but the total amount of such

19  transferred funds may not exceed $300,000 in any fiscal year.

20  When necessary, the department may establish, in accordance

21  with s. 216.177, additional positions that will be exclusively

22  devoted to these functions. Any positions required under this

23  paragraph may be established, notwithstanding ss.

24  216.262(1)(a) and 216.351. The department, in consultation

25  with the community-based agencies that are undertaking the

26  privatized projects, shall establish minimum thresholds for

27  each component of service, consistent with standards

28  established by the Legislature. Each program operated under

29  contract with a community-based agency must be evaluated

30  annually by the department. The department shall submit an

31  annual report regarding quality performance, outcome measure

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  1  attainment, and cost efficiency to the President of the

  2  Senate, the Speaker of the House of Representatives, the

  3  minority leader of each house of the Legislature, and the

  4  Governor no later than January 31 of each year for each

  5  project in operation during the preceding fiscal year.

  6         (b)  The department shall use these findings in making

  7  recommendations to the Governor and the Legislature for future

  8  program and funding priorities in the child welfare system.

  9         (5)(a)  The community-based agency must comply with

10  statutory requirements and agency rules in the provision of

11  contractual services. Each foster home, therapeutic foster

12  home, emergency shelter, or other placement facility operated

13  by the community-based agency or agencies must be licensed by

14  the Department of Children and Family Services under chapter

15  402 or this chapter. Each community-based agency must be

16  licensed as a child-caring or child-placing agency by the

17  department under this chapter. The department, in order to

18  eliminate or reduce the number of duplicate inspections by

19  various program offices, shall coordinate inspections required

20  pursuant to licensure of agencies under this section.

21         (b)  Substitute care providers who are licensed under

22  s. 409.175 and have contracted with a lead agency authorized

23  under this section shall also be authorized to provide

24  registered or licensed family day care under s. 402.313, if

25  consistent with federal law and if the home has met:

26         1.  the requirements of s. 402.313.; and

27         2.  The requirements of s. 402.281 and has received

28  Gold Seal Quality Care designation.

29         (c)  A dually licensed home under this section shall be

30  eligible to receive both an out-of-home care payment and a

31  subsidized child care payment for the same child pursuant to

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  1  federal law. The department may adopt administrative rules

  2  necessary to administer this paragraph the foster care board

  3  rate and the subsidized child care rate for the same child

  4  only if care is provided 24 hours a day. The subsidized child

  5  care rate shall be no more than the approved full-time rate.

  6         (6)  Beginning January 1, 1999, and continuing at least

  7  through June 30, 2000, the Department of Children and Family

  8  Services shall privatize all foster care and related services

  9  in district 5 while continuing to contract with the current

10  model programs in districts 1, 4, and 13, and in subdistrict

11  8A, and shall expand the subdistrict 8A pilot program to

12  incorporate Manatee County. Planning for the district 5

13  privatization shall be done by providers that are currently

14  under contract with the department for foster care and related

15  services and shall be done in consultation with the

16  department.  A lead provider of the district 5 program shall

17  be competitively selected, must demonstrate the ability to

18  provide necessary comprehensive services through a local

19  network of providers, and must meet criteria established in

20  this section. Contracts with organizations responsible for the

21  model programs must include the management and administration

22  of all privatized services specified in subsection (1).

23  However, the department may use funds for contract management

24  only after obtaining written approval from the Executive

25  Office of the Governor. The request for such approval must

26  include, but is not limited to, a statement of the proposed

27  amount of such funds and a description of the manner in which

28  such funds will be used. If the community-based organization

29  selected for a model program under this subsection is not a

30  Medicaid provider, the organization shall be issued a Medicaid

31  provider number pursuant to s. 409.907 for the provision of

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  1  services currently authorized under the state Medicaid plan to

  2  those children encompassed in this model and in a manner not

  3  to exceed the current level of state expenditure.

  4         (7)  The department, in consultation with existing lead

  5  agencies, shall develop a statewide proposal regarding the

  6  long-term use and structure of a shared-earnings program which

  7  addresses is authorized to establish and administer a risk

  8  pool to reduce the financial risk to eligible lead

  9  community-based providers resulting from unanticipated

10  caseload growth or from significant changes in client mixes or

11  services eligible for federal reimbursement. The

12  recommendations in the statewide proposal must also be

13  available to entities of the department until the conversion

14  to community-based care takes place. At a minimum, the

15  proposal must allow federal earnings received from child

16  welfare programs that are determined by the department to be

17  in excess of the amount appropriated in the General

18  Appropriations Act. These purposes include, but are not

19  limited to:

20         (a)  Significant changes in the number or composition

21  of clients eligible to receive services.

22         (b)  Significant changes in the services that are

23  eligible for reimbursement.

24         (c)  Significant changes in the availability of federal

25  funds.

26         (d)  Shortfalls in state funds available for eligible

27  or ineligible services.

28         (e)  Significant changes in the mix of available funds.

29         (f)  Scheduled or unanticipated, but necessary,

30  advances to providers or other cash-flow issues.

31

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  1         (g)  Proposals to participate in optional Medicaid

  2  services or other federal grant opportunities.

  3         (h)  Appropriate incentive structures.

  4         (i)  Continuity of care in the event of lead-agency

  5  failure, discontinuance of service, or financial misconduct.

  6

  7  The department shall further specify the necessary steps to

  8  ensure the financial integrity of these dollars and their

  9  continued availability on an ongoing basis. The final proposal

10  shall be submitted to the Legislative Budget Commission for

11  formal adoption before December 31, 2002. If the Legislative

12  Budget Commission refuses to concur with the adoption of the

13  proposal, the department shall present its proposal in the

14  form of recommended legislation to the President of the Senate

15  and the Speaker of the House of Representatives before the

16  commencement of the next legislative session. For fiscal year

17  2003-2004 and annually thereafter, the Department of Children

18  and Family Services may request, and the Governor may

19  recommend, the funding necessary to carry out paragraph (i),

20  in its legislative budget request from excess federal

21  earnings. The General Appropriations Act shall include any

22  funds appropriated for this purpose in a lump sum in the

23  Administered Funds Program, which funds constitute sufficient

24  and exclusive security for lead-agency contract performance,

25  and no other performance bond shall be required. The

26  department may require a bond to mitigate the financial

27  consequences of potential acts of malfeasance, misfeasance, or

28  criminal violations by the provider. Prior to the release of

29  any funds in the lump sum, the department shall submit a

30  detailed operational plan, which must identify the sources of

31  specific trust funds to be used. The release of the trust fund

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  1  shall be subject to the notice and review provisions of s.

  2  216.177. However, the release shall not require approval of

  3  the Legislative Budget Commission.

  4         (8)  Notwithstanding the provisions of s. 215.425, all

  5  documented federal funds earned for the current fiscal year by

  6  the department and community-based agencies which exceed the

  7  amount appropriated by the Legislature shall be distributed to

  8  all entities that contributed to the excess earnings based on

  9  a schedule and methodology developed by the department and

10  approved by the Executive Office of the Governor. Distribution

11  shall be pro rata based on total earnings and shall be made

12  only to those entities that contributed to excess earnings.

13  Excess earnings of community-based agencies shall be used only

14  in the service district in which they were earned. Additional

15  state funds appropriated by the Legislature for

16  community-based agencies or made available pursuant to the

17  budgetary amendment process described in s. 216.177 shall be

18  transferred to the community-based agencies. The department

19  shall amend a community-based agency's contract to permit

20  expenditure of the funds. The distribution program applies

21  only to entities that were under privatization contracts as of

22  July 1, 2002 1999. This program is authorized for a period of

23  3 years beginning July 1, 1999, and ending June 30, 2002. The

24  Office of Program Policy Analysis and Government

25  Accountability shall review this program and report to the

26  President of the Senate and the Speaker of the House of

27  Representatives by December 31, 2001. The review shall assess

28  the program to determine how the additional resources were

29  used, the number of additional clients served, the

30  improvements in quality of service attained, the performance

31

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  1  outcomes associated with the additional resources, and the

  2  feasibility of continuing or expanding this program.

  3         (9)  Each district and subdistrict that participates in

  4  the model program effort or any future privatization effort as

  5  described in this section must thoroughly analyze and report

  6  the complete direct and indirect costs of delivering these

  7  services through the department and the full cost of

  8  privatization, including the cost of monitoring and evaluating

  9  the contracted services.

10         Section 5.  Section 409.1676, Florida Statutes, is

11  amended to read:

12         409.1676  Comprehensive residential group care services

13  to children who have extraordinary needs.--

14         (1)  It is the intent of the Legislature to provide

15  comprehensive residential group care services, including

16  residential care, case management, and other services, to

17  children in the child protection system who have extraordinary

18  needs, such as serious behavioral problems or having been

19  determined to be without the options of either reunification

20  with family or adoption. These services are to be provided in

21  a residential group care setting by a not-for-profit

22  corporation or a local government entity under a contract with

23  the Department of Children and Family Services or by a lead

24  agency as described in s. 409.1671. These contracts should be

25  designed to provide an identified number of children with

26  access to a full array of services for a fixed price. Further,

27  it is the intent of the Legislature that the Department of

28  Children and Family Services and the Department of Juvenile

29  Justice establish an interagency agreement by December 1,

30  2002, which describes respective agency responsibilities for

31  referral, placement, service provision, and service

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  1  coordination for dependent and delinquent youth who are

  2  referred to these residential group care facilities. The

  3  agreement must require interagency collaboration in the

  4  development of terms, conditions, and performance outcomes for

  5  residential group care contracts serving the youth referred

  6  who have been adjudicated both dependent and delinquent.

  7         (2)  As used in this section, the term:

  8         (a)  "Residential group care" means a living

  9  environment for children who have been adjudicated dependent

10  and are expected to be in foster care for at least 6 months

11  with 24-hour-awake staff or live-in group home parents or

12  staff. Each facility Beginning July 1, 2001, all facilities

13  must be appropriately licensed in this state as a residential

14  child caring agency as defined in s. 409.175(2)(j), and they

15  must be accredited by July 1, 2005. A residential group care

16  facility serving children having a serious behavioral problem

17  as defined in this section must have available staff or

18  contract personnel with the clinical expertise, credentials,

19  and training to provide services identified in s. 409.1671(4)

20  and must be a qualified Medicaid provider for Behavioral

21  Health Overlay Services (BHOS).

22         (b)  "Serious behavioral problems" means behaviors of

23  children who have been assessed by a licensed master's-level

24  human-services professional to need at a minimum intensive

25  services but who do not meet the criteria of s. 394.492(6) or

26  (7). A child with an emotional disturbance as defined in s.

27  394.492(5) may be served in residential group care unless a

28  determination is made by a mental health professional that

29  such a setting is inappropriate. A child having a serious

30  behavioral problem must have been determined in the assessment

31  to have at least one of the following risk factors:

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  1         1.  An adjudication of delinquency and be on

  2  conditional release status with the Department of Juvenile

  3  Justice.

  4         2.  A history of physical aggression or violent

  5  behavior toward self or others, animals, or property within

  6  the past year.

  7         3.  A history of setting fires within the past year.

  8         4.  A history of multiple episodes of running away from

  9  home or placements within the past year.

10         5.  A history of sexual aggression toward other youth.

11         (3)  The department, in accordance with a specific

12  appropriation for this program, shall contract with a

13  not-for-profit corporation, a local government entity, or the

14  lead agency that has been established in accordance with s.

15  409.1671 for the performance of residential group care

16  services described in this section in, at a minimum, districts

17  4, 11, 12, and the Suncoast Region of the Department of

18  Children and Family Services and with a not-for-profit entity

19  serving children from multiple districts. A lead agency that

20  is currently providing residential care may provide this

21  service directly with the approval of the local community

22  alliance. The department or a lead agency may contract for

23  more than one site in a county if that is determined to be the

24  most effective way to achieve the goals set forth in this

25  section.

26         (4)  The lead agency, the contracted not-for-profit

27  corporation, or the local government entity is responsible for

28  a comprehensive assessment, residential care, transportation,

29  behavioral health services, recreational activities, clothing,

30  supplies, and miscellaneous expenses associated with caring

31  for these children; for necessary arrangement for or provision

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  1  of educational services; and for assuring necessary and

  2  appropriate health and dental care.

  3         (5)  The department may transfer all casework

  4  responsibilities for children served under this program to the

  5  entity that provides this service, including case management

  6  and development and implementation of a case plan in

  7  accordance with current standards for child protection

  8  services. When the department establishes this program in a

  9  community that has a lead agency as described in s. 409.1671,

10  the casework responsibilities must be transferred to the lead

11  agency.

12         (6)  This section does not prohibit any provider of

13  these services from appropriately billing Medicaid for

14  services rendered, from contracting with a local school

15  district for educational services, or from earning federal or

16  local funding for services provided, as long as two or more

17  funding sources do not pay for the same specific service that

18  has been provided to a child.

19         (7)  The lead agency, not-for-profit corporation, or

20  local government entity has the legal authority for children

21  served under this program, as provided in chapter 39 or this

22  chapter, as appropriate, to enroll the child in school, to

23  sign for a driver's license for the child, to cosign loans and

24  insurance for the child, to sign for medical treatment, and to

25  authorize other such activities.

26         (8)  The department shall provide technical assistance

27  as requested and contract management services.

28         (9)  The provisions of this section shall be

29  implemented to the extent of available appropriations

30  contained in the annual General Appropriations Act for such

31  purpose.

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  1         (10)  The department may adopt rules necessary to

  2  administer this section.

  3         Section 6.  Subsections (2) and (5) of section 409.175,

  4  Florida Statutes, are amended to read:

  5         409.175  Licensure of family foster homes, residential

  6  child-caring agencies, and child-placing agencies.--

  7         (2)  As used in this section, the term:

  8         (a)  "Agency" means a residential child-caring agency

  9  or a child-placing agency.

10         (b)  "Boarding school" means a school which is

11  registered with the Department of Education as a school.  Its

12  program must follow established school schedules, with holiday

13  breaks and summer recesses in accordance with other public and

14  private school programs.  The children in residence must

15  customarily return to their family homes or legal guardians

16  during school breaks and must not be in residence year-round,

17  except that this provision does not apply to foreign students.

18  The parents of these children retain custody and planning and

19  financial responsibility.

20         (c)  "Child" means any unmarried person under the age

21  of 18 years.

22         (d)  "Child-placing agency" means any person,

23  corporation, or agency, public or private, other than the

24  parent or legal guardian of the child or an intermediary

25  acting pursuant to chapter 63, that receives a child for

26  placement and places or arranges for the placement of a child

27  in a family foster home, residential child-caring agency, or

28  adoptive home.

29         (e)  "Family foster home" means a private residence in

30  which children who are unattended by a parent or legal

31  guardian are provided 24-hour care.  Such homes include

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  1  emergency shelter family homes, family foster group homes, and

  2  specialized foster homes for children with special needs.  A

  3  person who cares for a child of a friend for a period not to

  4  exceed 90 days, a relative who cares for a child and does not

  5  receive reimbursement for such care from the state or federal

  6  government, or an adoptive home which has been approved by the

  7  department or by a licensed child-placing agency for children

  8  placed for adoption is not considered a family foster home.

  9         1.  "Family Foster Group Home" means a licensed private

10  family home occupied by a married couple or individual who has

11  demonstrated the interest and special qualifications to care

12  for preadolescent and adolescent children, including the

13  family's own children. The family foster group home parent

14  must be able to work in close cooperation with the department

15  and the child placing agency. The licensed capacity of each

16  home shall be based on the recommendation of the child placing

17  agency based on the needs of each child in care, the ability

18  of the foster family to meet the individual needs of each

19  child including any adoptive or biological children living in

20  the home, the amount of safe physical plant space, the ratio

21  of active and appropriate adult supervision, and the

22  background experience and skill of the family foster parents.

23         a.  If there are more than five children in a family

24  foster group home including the family's own children, there

25  must be an assessment completed by the child placing agency

26  documented in the licensure file, determining that the home

27  can appropriately meet the needs of all children living in the

28  home. The appropriateness of the number of children in that

29  home must be reassessed annually as part of the relicensure

30  process.

31

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  1         b.  In each family foster group home, a plan to address

  2  supervision appropriate to the needs of all children living in

  3  the home must be developed and approved by the child placing

  4  agency. The plan may or may not include the requirement for

  5  24-hour-awake supervision, depending on the needs of the

  6  children in the home.

  7         c.  In a family foster group home, at least one parent

  8  must be a full time foster parent having no employment

  9  commitment outside the home.

10         (f)  "License" means "license" as defined in s.

11  120.52(9). A license under this section is issued to a family

12  foster home or other facility and is not a professional

13  license of any individual.  Receipt of a license under this

14  section shall not create a property right in the recipient. A

15  license under this act is a public trust and a privilege, and

16  is not an entitlement. This privilege must guide the finder of

17  fact or trier of law at any administrative proceeding or court

18  action initiated by the department.

19         (g)  "Operator" means any onsite person ultimately

20  responsible for the overall operation of a child-placing

21  agency, family foster home, or residential child-caring

22  agency, whether or not she or he is the owner or administrator

23  of such an agency or home.

24         (h)  "Owner" means the person who is licensed to

25  operate the child-placing agency, family foster home, or

26  residential child-caring agency.

27         (i)  "Personnel" means all owners, operators,

28  employees, and volunteers working in a child-placing agency,

29  family foster home, or residential child-caring agency who may

30  be employed by or do volunteer work for a person, corporation,

31  or agency which holds a license as a child-placing agency or a

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  1  residential child-caring agency, but the term does not include

  2  those who do not work on the premises where child care is

  3  furnished and either have no direct contact with a child or

  4  have no contact with a child outside of the presence of the

  5  child's parent or guardian.  For purposes of screening, the

  6  term shall include any member, over the age of 12 years, of

  7  the family of the owner or operator or any person other than a

  8  client, over the age of 12 years, residing with the owner or

  9  operator if the agency or family foster home is located in or

10  adjacent to the home of the owner or operator or if the family

11  member of, or person residing with, the owner or operator has

12  any direct contact with the children. Members of the family of

13  the owner or operator, or persons residing with the owner or

14  operator, who are between the ages of 12 years and 18 years

15  shall not be required to be fingerprinted, but shall be

16  screened for delinquency records. For purposes of screening,

17  the term "personnel" shall also include owners, operators,

18  employees, and volunteers working in summer day camps, or

19  summer 24-hour camps providing care for children.  A volunteer

20  who assists on an intermittent basis for less than 40 hours

21  per month shall not be included in the term "personnel" for

22  the purposes of screening, provided that the volunteer is

23  under direct and constant supervision by persons who meet the

24  personnel requirements of this section.

25         (j)  "Residential child-caring agency" means any

26  person, corporation, or agency, public or private, other than

27  the child's parent or legal guardian, that provides staffed

28  24-hour care for children in facilities maintained for that

29  purpose, regardless of whether operated for profit or whether

30  a fee is charged.  Such residential child-caring agencies

31  include, but are not limited to, maternity homes, runaway

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  1  shelters, group homes that are administered by an agency,

  2  emergency shelters that are not in private residences, and

  3  wilderness camps.  Residential child-caring agencies do not

  4  include hospitals, boarding schools, summer or recreation

  5  camps, nursing homes, or facilities operated by a governmental

  6  agency for the training, treatment, or secure care of

  7  delinquent youth, or facilities licensed under s. 393.067 or

  8  s. 394.875 or chapter 397.

  9         (k)  "Screening" means the act of assessing the

10  background of personnel and includes, but is not limited to,

11  employment history checks as provided in chapter 435, using

12  the level 2 standards for screening set forth in that chapter.

13  Screening for employees and volunteers in summer day camps and

14  summer 24-hour camps and screening for all volunteers included

15  under the definition of "personnel" shall be conducted as

16  provided in chapter 435, using the level 1 standards set forth

17  in that chapter.

18         (l)  "Summer day camp" means recreational, educational,

19  and other enrichment programs operated during summer vacations

20  for children who are 5 years of age on or before September 1

21  and older.

22         (m)  "Summer 24-hour camp" means recreational,

23  educational, and other enrichment programs operated on a

24  24-hour basis during summer vacation for children who are 5

25  years of age on or before September 1 and older, that are not

26  exclusively educational.

27         (5)(a)  An application for a license shall be made on

28  forms provided, and in the manner prescribed, by the

29  department. The department shall make a determination as to

30  the good moral character of the applicant based upon

31  screening.

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  1         (b)  Upon application, the department shall conduct a

  2  licensing study based on its licensing rules; shall inspect

  3  the home or the agency and the records, including financial

  4  records, of the agency; and shall interview the applicant.

  5  The department may authorize a licensed child-placing agency

  6  to conduct the licensing study of a family foster home to be

  7  used exclusively by that agency and to verify to the

  8  department that the home meets the licensing requirements

  9  established by the department.  Upon certification by a

10  licensed child-placing agency that a family foster home meets

11  the licensing requirements, the department shall issue the

12  license.

13         (c)  A licensed family foster home, child-placing

14  agency, or residential child-caring agency which applies for

15  renewal of its license shall submit to the department a list

16  of personnel who have worked on a continuous basis at the

17  applicant family foster home or agency since submitting

18  fingerprints to the department, identifying those for whom a

19  written assurance of compliance was provided by the department

20  and identifying those personnel who have recently begun

21  working at the family foster home or agency and are awaiting

22  the results of the required fingerprint check, along with the

23  date of the submission of those fingerprints for processing.

24  The department shall by rule determine the frequency of

25  requests to the Department of Law Enforcement to run state

26  criminal records checks for such personnel except for those

27  personnel awaiting the results of initial fingerprint checks

28  for employment at the applicant family foster home or agency.

29         (d)1.  The department may pursue other remedies

30  provided in this section in addition to denial or revocation

31  of a license for failure to comply with the screening

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  1  requirements.  The disciplinary actions determination to be

  2  made by the department and the procedure for hearing for

  3  applicants and licensees shall be in accordance with chapter

  4  120.

  5         2.  When the department has reasonable cause to believe

  6  that grounds for denial or termination of employment exist, it

  7  shall notify, in writing, the applicant, licensee, or summer

  8  or recreation camp, and the personnel affected, stating the

  9  specific record which indicates noncompliance with the

10  screening requirements.

11         3.  Procedures established for hearing under chapter

12  120 shall be available to the applicant, licensee, summer day

13  camp, or summer 24-hour camp, and affected personnel, in order

14  to present evidence relating either to the accuracy of the

15  basis for exclusion or to the denial of an exemption from

16  disqualification.

17         4.  Refusal on the part of an applicant to dismiss

18  personnel who have been found not to be in compliance with the

19  requirements for good moral character of personnel shall

20  result in automatic denial or revocation of license in

21  addition to any other remedies provided in this section which

22  may be pursued by the department.

23         (e)  At the request of the department, the local county

24  health department shall inspect a home or agency according to

25  the licensing rules promulgated by the department.  Inspection

26  reports shall be furnished to the department within 30 days of

27  the request. Such an inspection shall only be required when

28  called for by the licensing agency.

29         (f)  All residential child-caring agencies must meet

30  firesafety standards for such agencies adopted by the Division

31  of State Fire Marshal of the Department of Insurance and must

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  1  be inspected annually.  At the request of the department,

  2  firesafety inspections shall be conducted by the Division of

  3  State Fire Marshal or a local fire department official who has

  4  been certified by the division as having completed the

  5  training requirements for persons inspecting such agencies.

  6  Inspection reports shall be furnished to the department within

  7  30 days of a request.

  8         (g)  In the licensing process, the licensing staff of

  9  the department shall provide consultation on request.

10         (h)  Upon determination that the applicant meets the

11  state minimum licensing requirements, the department shall

12  issue a license without charge to a specific person or agency

13  at a specific location. A license may be issued if all the

14  screening materials have been timely submitted; however, a

15  license may not be issued or renewed if any person at the home

16  or agency has failed the required screening. The license is

17  nontransferable. A copy of the license shall be displayed in a

18  conspicuous place. Except as provided in paragraph (j), the

19  license is valid for 1 year from the date of issuance, unless

20  the license is suspended or revoked by the department or is

21  voluntarily surrendered by the licensee. The license is the

22  property of the department.

23         (i)  A license issued for the operation of a family

24  foster home or agency, unless sooner suspended, revoked, or

25  voluntarily returned, will expire automatically 1 year from

26  the date of issuance except as provided in paragraph (j).

27  Ninety days prior to the expiration date, an application for

28  renewal shall be submitted to the department by a licensee who

29  wishes to have the license renewed.  A license shall be

30  renewed upon the filing of an application on forms furnished

31  by the department if the applicant has first met the

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  1  requirements established under this section and the rules

  2  promulgated hereunder.

  3         (j)  Except for a family foster group home having a

  4  licensed capacity for more than five children, the department

  5  may issue a license that is valid for longer than 1 year but

  6  no longer than 3 years to a family foster home that:

  7         1.  Has maintained a license with the department as a

  8  family foster home for at least the 3 previous consecutive

  9  years;

10         2.  Remains in good standing with the department; and

11         3.  Has not been the subject of a report of child abuse

12  or neglect with any findings of maltreatment.

13

14  A family foster home that has been issued a license valid for

15  longer than 1 year must be monitored and visited as frequently

16  as one that has been issued a 1-year license. The department

17  reserves the right to reduce a licensure period to 1 year at

18  any time.

19         (k)  The department may not license summer day camps or

20  summer 24-hour camps.  However, the department shall have

21  access to the personnel records of such facilities to ensure

22  compliance with the screening requirements.

23         Section 7.  Subsection (24) of section 409.906, Florida

24  Statutes, is amended to read:

25         409.906  Optional Medicaid services.--Subject to

26  specific appropriations, the agency may make payments for

27  services which are optional to the state under Title XIX of

28  the Social Security Act and are furnished by Medicaid

29  providers to recipients who are determined to be eligible on

30  the dates on which the services were provided.  Any optional

31  service that is provided shall be provided only when medically

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  1  necessary and in accordance with state and federal law.

  2  Optional services rendered by providers in mobile units to

  3  Medicaid recipients may be restricted or prohibited by the

  4  agency. Nothing in this section shall be construed to prevent

  5  or limit the agency from adjusting fees, reimbursement rates,

  6  lengths of stay, number of visits, or number of services, or

  7  making any other adjustments necessary to comply with the

  8  availability of moneys and any limitations or directions

  9  provided for in the General Appropriations Act or chapter 216.

10  If necessary to safeguard the state's systems of providing

11  services to elderly and disabled persons and subject to the

12  notice and review provisions of s. 216.177, the Governor may

13  direct the Agency for Health Care Administration to amend the

14  Medicaid state plan to delete the optional Medicaid service

15  known as "Intermediate Care Facilities for the Developmentally

16  Disabled."  Optional services may include:

17         (24)  CHILD-WELFARE-TARGETED CASE MANAGEMENT.--The

18  Agency for Health Care Administration, in consultation with

19  the Department of Children and Family Services, may establish

20  a targeted case-management pilot project in those counties

21  identified by the Department of Children and Family Services

22  and for all counties with a the community-based child welfare

23  project in Sarasota and Manatee counties, as authorized under

24  s. 409.1671, which have been specifically approved by the

25  department. These projects shall be established for the

26  purpose of determining the impact of targeted case management

27  on the child welfare program and the earnings from the child

28  welfare program. Results of targeted case management the pilot

29  projects shall be reported to the Child Welfare Estimating

30  Conference and the Social Services Estimating Conference

31  established under s. 216.136. The number of projects may not

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  1  be increased until requested by the Department of Children and

  2  Family Services, recommended by the Child Welfare Estimating

  3  Conference and the Social Services Estimating Conference, and

  4  approved by the Legislature. The covered group of individuals

  5  who are eligible to receive targeted case management include

  6  children who are eligible for Medicaid; who are between the

  7  ages of birth through 21; and who are under protective

  8  supervision or postplacement supervision, under foster-care

  9  supervision, or in shelter care or foster care. The number of

10  individuals who are eligible to receive targeted case

11  management shall be limited to the number for whom the

12  Department of Children and Family Services has available

13  matching funds to cover the costs. The general revenue funds

14  required to match the funds for services provided by the

15  community-based child welfare projects are limited to funds

16  available for services described under s. 409.1671. The

17  Department of Children and Family Services may transfer the

18  general revenue matching funds as billed by the Agency for

19  Health Care Administration.

20         Section 8.  The Office of Program Policy Analysis and

21  Government Accountability, in consultation with the Department

22  of Children and Family Services and the Agency for Health Care

23  Administration, shall conduct a review of the process for

24  placing children for residential mental health treatment as

25  specified in section 39.407(5), Florida Statutes. This review

26  is to be used to determine whether changes are needed in this

27  process. The integrity of the examination process that is

28  intended to assure that only a child with an emotional

29  disturbance or a serious emotional disturbance is placed in a

30  residential mental health facility and to assure that a child

31  who is diagnosed with an emotional disturbance or a serious

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  1  emotional disturbance receives the most appropriate mental

  2  health treatment in the least-restrictive setting must be

  3  maintained. The review shall analyze and make recommendations

  4  relative to issues pertinent to the process such as the number

  5  of children who are assessed and the outcomes of the

  6  assessments, the costs associated with the suitability

  7  assessments based on geographic differentials, delays in

  8  receiving appropriate mental health treatment services in both

  9  residential and nonresidential settings which can be

10  attributed to the assessment process, and the need to expand

11  the mental health professional groups who may conduct the

12  suitability assessment. The Department of Children and Family

13  Services shall submit a report of its findings and any

14  proposed changes to substantive law to the Office of the

15  Governor, the President of the Senate, and the Speaker of the

16  House of Representatives by January 1, 2003.

17         Section 9.  This act shall take effect July 1, 2002.

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  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                            CS/SB 632

  3

  4  Amends s. 39.407, F.S., to clarify that children who are in
    the legal custody of the Department of Children and Family
  5  Services may be placed in residential treatment by the
    department without prior court approval.
  6
    Authorizes the department to ensure access to a model program
  7  for children in any county that is not fully privatized by the
    statutory deadline rather than requiring that a separate model
  8  program be established in each of those counties.

  9  Modifies the amendment to s. 409.1676, F.S., by targeting
    residential group care facilities on youth with certain
10  behavioral risk factors; requesting the Departments of
    Children and Family Services and Juvenile Justice to develop
11  an interagency agreement regarding youth in residential group
    care; specifying that residential group care facilities must
12  be licensed as child-caring agencies and, if caring for youth
    with serious behavioral problems, must have staff with certain
13  expertise and be qualified Medicaid providers for Behavioral
    Health Overlay Services(BHOS); and authorizing the Department
14  of Children and Family Services to adopt rules.

15  Specifies that, beginning FY 2003-2004, funds appropriated by
    the Legislature to protect the department against the failure
16  of a community-based lead agency must be appropriated in a
    lump sum in the Administered Funds Program and that these
17  funds constitute sufficient security for lead agency
    performance; authorizes the department to require a bond for
18  malfeasance, misfeasance, or criminal violations; requires an
    operational plan from the department prior to the release of
19  the lump sum and specifies that its release is subject to s.
    216.177, F.S., except that approval of the Legislative Budget
20  Commission is not required.

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