Senate Bill sb0088c1

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    Florida Senate - 2002                             CS for SB 88

    By the Committee on Appropriations; and Senator Pruitt





    304-311G-02

  1                      A bill to be entitled

  2         An act relating to prevention and amelioration

  3         of learning problems and learning disabilities

  4         in young children; authorizing a demonstration

  5         program to be called Learning Gateway; creating

  6         a steering committee; providing for membership

  7         and appointment of steering committee members;

  8         establishing duties of the steering committee;

  9         authorizing demonstration projects in specified

10         counties; authorizing designated agencies to

11         provide confidential information to such

12         program; providing for funding; providing an

13         effective date.

14

15         WHEREAS, learning problems in children encompass all

16  areas of development and may affect cognition, communication,

17  attention, perception, behavior, and social, emotional,

18  sensory, and motor functioning, and

19         WHEREAS, recent advances in brain research show that

20  the greatest potential to influence a child's developing brain

21  exists during the early years of life and that the environment

22  sculpts the young child's brain as neurons form connections

23  and mature in response to stimulation and the environment, and

24         WHEREAS, strategies to successfully intervene and

25  instruct before children experience failure in the early

26  elementary grades are being tested within a variety of

27  demonstration research settings and are disseminated but are

28  not widely implemented in general practice, and

29         WHEREAS, parents are usually the best and most

30  important source of support for their children, but access to

31

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    Florida Senate - 2002                             CS for SB 88
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  1  information and services is often inconsistent and fragmented

  2  across the state, NOW, THEREFORE,

  3

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

  5

  6         Section 1.  Learning Gateway.--

  7         (1)  PROGRAM  GOALS.--The Legislature authorizes a

  8  3-year demonstration program, to be called the Learning

  9  Gateway, the purpose of which is to provide parents access to

10  information, referral, and services to lessen the effects of

11  learning disabilities in children from birth to age 9.

12  Parental consent shall be required for initial contact and

13  referral for evaluation and services provided through the

14  Learning Gateway. Each pilot program must design and test an

15  integrated, community-based system to help parents identify

16  learning problems and access early-education and intervention

17  services in order to minimize or prevent learning

18  disabilities. The Learning Gateway must be available to

19  parents in the settings where they and their children live,

20  work, seek care, or study. The goals of the Learning Gateway

21  are to:

22         (a)  Improve community awareness and education of

23  parents and practitioners about the warning signs or

24  precursors of learning problems and learning disabilities,

25  including disorders or delayed development in language,

26  attention, behavior, and social-emotional functioning,

27  including dyslexia and attention deficit hyperactivity

28  disorder, in children from birth through age 9.

29         (b)  Improve access for children who are experiencing

30  early learning problems and their families to appropriate

31

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  1  programs, services, and supports through improved outreach and

  2  referral processes among providers.

  3         (c)  Improve developmental monitoring and the

  4  availability to parents of appropriate screening resources,

  5  with emphasis on children from birth through age 9 who are at

  6  high risk of having learning problems.

  7         (d)  Improve the availability to parents of appropriate

  8  education and intervention programs, services, and supports to

  9  address learning problems and learning disabilities.

10         (e)  Identify gaps in the array of services and

11  supports so that an appropriate child-centered and

12  family-centered continuum of education and support would be

13  readily available in each community.

14         (f)  Improve accountability of the system through

15  improved planning, integration, and collaboration among

16  providers and through outcome measurement in collaboration

17  with parents.

18         (2)  LEARNING GATEWAY STEERING COMMITTEE.--

19         (a)  To ensure that parents of children with potential

20  learning problems and learning disabilities have access to the

21  appropriate necessary services and supports, an 18-member

22  steering committee is created.  The steering committee is

23  assigned to the Department of Education for administrative

24  purposes.

25         (b)  The duties of the Learning Gateway Steering

26  Committee are to provide policy development, consultation,

27  oversight, and support for the implementation of three

28  demonstration programs and to advise the agencies, the

29  Legislature, and the Governor on statewide implementation of

30  system components and issues and on strategies for continuing

31  improvement to the system.

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  1         (c)  The steering committee shall direct the

  2  administering agency of the Learning Gateway program to expend

  3  the funds appropriated for the steering committee's use to

  4  procure the products delineated in section 2 of this act

  5  through contracts or other means. The steering committee and

  6  the Learning Gateway pilot programs will provide information

  7  and referral for services but will not provide direct services

  8  to parents or children.

  9         (d)  The steering committee must include parents,

10  service providers, and representatives of the disciplines

11  relevant to diagnosis of and intervention in early learning

12  problems. The Governor shall appoint one member from the

13  private sector who has expertise in communications, management

14  or service provision, one member who has expertise in

15  children's vision, one member who has expertise in learning

16  disabilities, one member who has expertise in audiology, one

17  member who is a parent of a child eligible for services by the

18  Learning Gateway, and one provider of related diagnostic and

19  intervention services. The President of the Senate shall

20  appoint one member from the private sector who has expertise

21  in communications, management or service provision, one member

22  who has expertise in emergent literacy, one member who has

23  expertise in pediatrics, one member who has expertise in brain

24  development, one member who is a parent of a child eligible

25  for services by the Learning Gateway, and one member who is a

26  provider of related diagnostic and intervention services. The

27  Speaker of the House of Representatives shall appoint one

28  member from the private sector who has expertise in

29  communications, management or service provision, one member

30  who has expertise in environmental health and allergies, one

31  member who has expertise in children's nutrition, one member

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  1  who has expertise in family medicine, one parent of a child

  2  eligible for services by the Learning Gateway, and one member

  3  who is a school psychologist providing diagnostic and

  4  intervention services.

  5         (e)  To support and facilitate system improvements, the

  6  steering committee must consult with representatives from the

  7  Department of Education, the Department of Health, the Florida

  8  Partnership for School Readiness, the Department of Children

  9  and Family Services, the Agency for Health Care

10  Administration, the Department of Juvenile Justice, and the

11  Department of Corrections and the director of the Learning

12  Development and Evaluation Center of Florida Agricultural and

13  Mechanical University.

14         (f)  Steering committee appointments must be made, and

15  the committee must hold its first meeting, within 90 days

16  after this act takes effect. Steering committee members shall

17  be appointed to serve a term of 3 years. The Governor shall

18  designate the chairman of the steering committee.

19         (g)  Steering committee members shall not receive

20  compensation for their services, but may receive reimbursement

21  for travel expenses incurred under section 112.061, Florida

22  Statutes.

23         (3)  LEARNING GATEWAY DEMONSTRATION PROJECTS.--

24         (a)  Within 90 days after its initial meeting, the

25  Learning Gateway Steering Committee shall accept proposals

26  from interagency consortia in Orange, Manatee, and St. Lucie

27  counties which comprise public and private providers,

28  community agencies, business representatives, and the local

29  school board in each county to serve as demonstration sites

30  for design and development of a system that addresses the

31  requirements in section 2 of this act. If there is no proposal

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  1  from one of the designated counties, the steering committee

  2  may select another county to serve as a demonstration site by

  3  majority vote.

  4         (b)  The proposals for demonstration projects must

  5  provide a comprehensive and detailed description of the system

  6  of care. The description of the proposed system of care must

  7  clearly indicate the point of access for parents, integration

  8  of services, linkages of providers, and additional array of

  9  services required to address the needs of children and

10  families.

11         (c)  The demonstration projects should ensure that the

12  system of care appropriately includes existing services to the

13  fullest extent possible and should determine additional

14  programs, services, and supports that would be necessary to

15  implement the requirements of this act.

16         (d)  The projects, in conjunction with the steering

17  committee, shall determine what portion of the system can be

18  funded using existing funds, demonstration funds provided by

19  this act, and other available private and community funds.

20         (e)  The demonstration projects shall recommend to the

21  steering committee the linking or combining of some or all of

22  the local planning bodies, including school readiness

23  coalitions, Healthy Start coalitions, Part C advisory

24  councils, Department of Children and Family Services community

25  alliances, and other boards or councils that have a primary

26  focus on services for children from birth to age 9, to the

27  extent allowed by federal regulations, if such changes would

28  improve coordination and reduce unnecessary duplication of

29  effort.

30         (f)  Demonstration projects shall use public and

31  private partnerships, partnerships with faith-based

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  1  organizations, and volunteers, as appropriate, to enhance

  2  accomplishment of the goals of the system.

  3         (g)  Addressing system components delineated in section

  4  2 of this act, each demonstration project proposal must

  5  include, at a minimum:

  6         1.  Protocols for requiring and receiving parental

  7  consent for Learning Gateway services.

  8         2.  A method for establishing communication with

  9  parents and coordination and planning processes within the

10  community.

11         3.  Action steps for making appropriate linkages to

12  existing services within the community.

13         4.  Procedures to determine gaps in services and

14  identify appropriate providers.

15         5.  A lead agency to serve as the system access point,

16  or gateway.

17         (h)  As authorized under the budget authority of the

18  Department of Education, demonstration projects,

19  representative of the diversity of the communities in this

20  state, shall be established in Manatee, Orange, and St. Lucie

21  counties as local Learning Gateway sites and shall be

22  authorized to hire staff, establish office space, and contract

23  for administrative services as needed to implement the project

24  within the budget designated by the Legislature.

25         (i)  The steering committee must approve, deny, or

26  conditionally approve a Learning Gateway proposal within 60

27  days after receipt of the proposal. If a proposal is

28  conditionally approved, the steering committee must assist the

29  Learning Gateway applicant to correct deficiencies in the

30  proposal by December 1, 2002. Funds must be available to a

31  pilot program 15 days after final approval of its proposal by

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  1  the steering committee. Funds must be available to all pilot

  2  programs by January 1, 2003.

  3         Section 2.  Components of the Learning Gateway.--

  4         (1)  The Learning Gateway system consists of the

  5  following components:

  6         (a)  Community education strategies and family-oriented

  7  access.--

  8         1.  Each local demonstration project shall establish

  9  the system access point, or gateway, by which parents can

10  receive information about available appropriate services.  An

11  existing public or private agency or provider or new provider

12  may serve as the system gateway.  The local Learning Gateway

13  should provide parents and caretakers with a single point of

14  access for screening, assessment, and referral for services

15  for children from birth through age 9.  The demonstration

16  projects have the budgetary authority to hire appropriate

17  personnel to perform administrative functions. These staff

18  members must be knowledgeable about child development, early

19  identification of learning problems and learning disabilities,

20  family service planning, and services in the local area.  Each

21  demonstration project must arrange for the following services

22  to be provided by existing service systems:

23         a.  Conducting intake with families.

24         b.  Conducting appropriate screening or referral for

25  such services.

26         c.  Conducting needs/strengths-based family assessment.

27         d.  Developing family resource plans.

28         e.  Making referrals for needed services and assisting

29  families in the application process.

30         f.  Providing service coordination as needed by

31  families.

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  1         g.  Assisting families in establishing a medical home.

  2         h.  Conducting case management and transition planning

  3  as necessary.

  4         i.  Monitoring performance of service providers against

  5  appropriate standards.

  6         2.  The Learning Gateway Steering Committee and

  7  demonstration projects shall designate a central information

  8  and referral access phone number for parents in each pilot

  9  community. This centralized phone number should be used to

10  increase public awareness and to improve access to local

11  supports and services for children from birth through age 9

12  and their families.  The number should be highly publicized as

13  the primary source of information on services for young

14  children.  The telephone staff should be trained and supported

15  to offer accurate and complete information and to make

16  appropriate referrals to existing public and private community

17  agencies.

18         3.  In collaboration with local resources such as

19  Healthy Start, the demonstration projects shall develop

20  strategies for offering hospital visits or home visits by

21  trained staff to new mothers. The Learning Gateway Steering

22  Committee shall provide technical assistance to local

23  demonstration projects in developing brochures and other

24  materials to be distributed to parents of newborns.

25         4.  In collaboration with other local resources, the

26  demonstration projects shall develop public awareness

27  strategies to disseminate information about developmental

28  milestones, precursors of learning problems and other

29  developmental delays, and the service system that is

30  available.  The information should target parents of children

31  from birth through age 9 and should be distributed to parents,

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  1  health care providers, and caregivers of children from birth

  2  through age 9.  A variety of media should be used as

  3  appropriate, such as print, television, radio, and a

  4  community-based internet web site, as well as opportunities

  5  such as those presented by parent visits to physicians for

  6  well-child check-ups.  The Learning Gateway Steering Committee

  7  shall provide technical assistance to the local demonstration

  8  projects in developing and distributing educational materials

  9  and information.

10         a.  Public awareness strategies targeting parents of

11  children from birth through age 5 shall be designed to provide

12  information to public and private preschool programs,

13  childcare providers, pediatricians, parents, and local

14  businesses and organizations. These strategies should include

15  information on the school readiness performance standards for

16  kindergarten adopted by the School Readiness Partnership

17  Board.

18         b.  Public awareness strategies targeting parents of

19  children from ages 6 through 9 must be designed to disseminate

20  training materials and brochures to parents and public and

21  private school personnel, and must be coordinated with the

22  local school board and the appropriate school advisory

23  committees in the demonstration projects.  The materials

24  should contain information on state and district proficiency

25  levels for grades K-3.

26         (b)  Screening and developmental monitoring.--

27         1.  In coordination with the Partnership for School

28  Readiness, the Department of Education, and the Florida

29  Pediatric Society, and using information learned from the

30  local demonstration projects, the Learning Gateway Steering

31  Committee shall establish guidelines for screening children

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  1  from birth through age 9.  The guidelines should incorporate

  2  recent research on the indicators most likely to predict early

  3  learning problems, mild developmental delays, child-specific

  4  precursors of school failure, and other related developmental

  5  indicators in the domains of cognition; communication;

  6  attention; perception; behavior; and social, emotional,

  7  sensory, and motor functioning.

  8         2.  Based on the guidelines established by the steering

  9  committee and in cooperation with the Florida Pediatric

10  Society, the steering committee shall adopt a comprehensive

11  checklist for child healthcare checkups and a corresponding

12  training package for physicians and other medical personnel in

13  implementing more effective screening for precursors of

14  learning problems, learning disabilities, and mild

15  developmental delays.

16         3.  Using the screening guidelines developed by the

17  steering committee, local demonstration projects should engage

18  local physicians and other medical professionals in enhancing

19  the screening opportunities presented by immunization visits

20  and other well-child appointments, in accordance with the

21  American Academy of Pediatrics Periodicity Schedule.

22         4.  Using the screening guidelines developed by the

23  steering committee, the demonstration projects shall develop

24  strategies to increase early identification of precursors to

25  learning problems and learning disabilities through providing

26  parents the option of improved screening and referral

27  practices within public and private early care and education

28  programs and K-3 public and private school settings.

29  Strategies may include training and technical assistance teams

30  to assist program providers and teachers. The program shall

31  collaborate appropriately with the school readiness

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  1  coalitions, local school boards, and other community resources

  2  in arranging training and technical assistance for early

  3  identification and screening with parental consent.

  4         5.  The demonstration project shall work with

  5  appropriate local entities to reduce the duplication of

  6  cross-agency screening in each demonstration project area.

  7  Demonstration projects shall provide opportunities for public

  8  and private providers of screening and assessment at each age

  9  level to meet periodically to identify gaps or duplication of

10  efforts in screening practices.

11         6.  Based on technical assistance and support provided

12  by the steering committee and in conjunction with the school

13  readiness coalitions and other appropriate entities,

14  demonstration projects shall develop a system to log the

15  number of children screened, assessed, and referred for

16  services.  After development and testing, tracking should be

17  supported by a standard electronic data system for screening

18  and assessment information.

19         7.  In conjunction with the technical assistance of the

20  steering committee, demonstration projects shall develop a

21  system for targeted screening.  The projects should conduct a

22  needs assessment of existing services and programs where

23  targeted screening programs should be offered. Based on the

24  results of the needs assessment, the project shall develop

25  procedures within the demonstration community whereby periodic

26  developmental screening could be offered to parents of

27  children from birth through age 9 who are served by state

28  intervention programs or whose parents or caregivers are in

29  state intervention programs. Intervention programs for

30  children, parents, and caregivers include those administered

31  or funded by the:

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  1         a.  Agency for Health Care Administration;

  2         b.  Department of Children and Family Services;

  3         c.  Department of Corrections and other criminal

  4  justice programs;

  5         d.  Department of Education;

  6         e.  Department of Health; and

  7         f.  Department of Juvenile Justice.

  8         8.  When results of screening suggest developmental

  9  problems, potential learning problems, or learning

10  disabilities, the intervention program shall inform the

11  child's parent of the results of the screening and shall offer

12  to refer the child to the Learning Gateway for coordination of

13  further assessment. If the parent chooses to have further

14  assessment, the Learning Gateway shall make referrals to the

15  appropriate entities within the service system.

16         9.  The local Learning Gateway shall provide for

17  followup contact to all families whose children have been

18  found ineligible for services under Part B or Part C of the

19  IDEA to inform them of other services available in the county.

20         10.  Notwithstanding any law to the contrary, each

21  agency participating in the Learning Gateway is authorized to

22  provide to a Learning Gateway program confidential information

23  exempt from disclosure under chapter 119, Florida Statutes,

24  regarding a developmental screening on any child participating

25  in the Learning Gateway who is or has been the subject of a

26  developmental screening within the jurisdiction of each

27  agency.

28         (c)  Early education, services and supports.--

29         1.  The demonstration projects shall develop a

30  conceptual model system of care that builds upon, integrates,

31  and fills the gaps in existing services.  The model shall

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  1  indicate how qualified providers of family-based or

  2  center-based interventions or public and private school

  3  personnel may offer services in a manner consistent with the

  4  standards established by their profession and by the standards

  5  and criteria adopted by the steering committee and consistent

  6  with effective and proven strategies.  The specific services

  7  and supports may include:

  8         a.  High-quality early education and care programs.

  9         b.  Assistance to parents and other caregivers, such as

10  home-based modeling programs for parents and play programs to

11  provide peer interactions.

12         c.  Speech and language therapy that is

13  age-appropriate.

14         d.  Parent education and training.

15         e.  Comprehensive medical screening and referral with

16  biomedical interventions as necessary.

17         f.  Referral as needed for family therapy, other mental

18  health services, and treatment programs.

19         g.  Family support services as necessary.

20         h.  Therapy for learning differences in reading and

21  math, and attention to subject material for children in grades

22  K-3.

23         i.  Referral for Part B or Part C services as required.

24         j.  Expanded access to community-based services for

25  parents.

26         k.  Parental choice in the provision of services by

27  public and private providers.

28

29  The model shall include a statement of the cost of

30  implementing the model.

31

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  1         2.  Demonstration projects shall develop strategies to

  2  increase the use of appropriate intervention practices with

  3  children who have learning problems and learning disabilities

  4  within public and private early care and education programs

  5  and K-3 public and private school settings.  Strategies may

  6  include training and technical assistance teams.  Intervention

  7  must be coordinated and must focus on providing effective

  8  supports to children and their families within their regular

  9  education and community environment.  These strategies must

10  incorporate, as appropriate, school and district activities

11  related to the student's academic improvement plan and must

12  provide parents with greater access to community-based

13  services that should be available beyond the traditional

14  school day. Academic expectations for public school students

15  in grades K-3 must be based upon the local school board's

16  adopted proficiency levels.  When appropriate, school

17  personnel shall consult with the local Learning Gateway to

18  identify other community resources for supporting the child

19  and the family.

20         3.  The steering committee, in cooperation with the

21  Department of Children and Family Services, the Department of

22  Education, and the Florida Partnership for School Readiness,

23  shall identify the elements of an effective research-based

24  curriculum for early care and education programs.

25         4.  The steering committee, in conjunction with the

26  demonstration projects, shall develop processes for

27  identifying and sharing promising practices and shall showcase

28  these programs and practices at a dissemination conference.

29         5.  The steering committee shall establish processes

30  for facilitating state and local providers' ready access to

31  information and training concerning effective instructional

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  1  and behavioral practices and interventions based on advances

  2  in the field and for encouraging researchers to regularly

  3  guide practitioners in designing and implementing

  4  research-based practices. The steering committee shall assist

  5  the demonstration projects in conducting a conference for

  6  participants in the three demonstration projects for the

  7  dissemination of information on best practices and new

  8  insights about early identification, education, and

  9  intervention for children from birth through age 9. The

10  conference should be established so that continuing education

11  credits may be awarded to medical professionals, teachers, and

12  others for whom this is an incentive.

13         6.  Demonstration projects shall investigate and may

14  recommend to the steering committee more effective resource

15  allocation and flexible funding strategies if such strategies

16  are in the best interest of the children and families in the

17  community.  The Department of Education and other relevant

18  agencies shall assist the demonstration projects in securing

19  state and federal waivers as appropriate.

20         Section 3.  Accountability.--

21         (1)  The steering committee shall provide information

22  to the School Readiness Estimating Conference and the

23  Enrollment Conference for Public Schools regarding estimates

24  of the population of children from birth through age 9 who are

25  at risk of learning problems and learning disabilities.

26         (2)  The steering committee, in conjunction with the

27  demonstration projects, shall develop accountability

28  mechanisms to ensure that the demonstration programs are

29  effective and that resources are used as efficiently as

30  possible. Accountability should be addressed through a

31  multilevel evaluation system, including measurement of

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  1  outcomes and operational indicators. Measurable outcomes must

  2  be developed to address improved child development, improved

  3  child health, and success in school.  Indicators of system

  4  improvements must be developed to address quality of programs

  5  and integration of services. Agency monitoring of programs

  6  shall include a review of child and family outcomes and system

  7  effectiveness indicators with a specific focus on elimination

  8  of unnecessary duplication of planning, screening, and

  9  services.

10         (3)  The steering committee shall oversee a formative

11  evaluation of the project during implementation, including

12  reporting short-term outcomes and system improvements.  By

13  January 2005, the steering committee shall make

14  recommendations to the Governor, the President of the Senate,

15  the Speaker of the House of Representatives, and the

16  Commissioner of Education related to the merits of expansion

17  of the demonstration projects.

18         (4)  By January 1, 2005, the steering committee, in

19  conjunction with the demonstration projects, shall develop a

20  model county-level strategic plan to formalize the goals,

21  objectives, strategies, and intended outcomes of the

22  comprehensive system, and to support the integration and

23  efficient delivery of all services and supports for parents of

24  children from birth through age 9 who have learning problems

25  or learning disabilities. The model county-level strategic

26  plan must include, but need not be limited to, strategies to:

27         (a)  Establish a system whereby parents can access

28  information about learning problems in young children and

29  receive services at their discretion;

30         (b)  Improve early identification of those who are at

31  risk for learning problems and learning disabilities;

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  1         (c)  Provide access to an appropriate array of services

  2  within the child's natural environment or regular classroom

  3  setting or specialized training in other settings;

  4         (d)  Improve and coordinate screening for children from

  5  birth through age 9;

  6         (e)  Improve and coordinate services for children from

  7  birth through age 9;

  8         (f)  Address training of professionals in effectively

  9  identifying factors, across all domains, which place children

10  from birth through age 9 at risk of school failure and in

11  appropriate interventions for the learning differences;

12         (g)  Provide appropriate support to families;

13         (h)  Share best practices with caregivers and referral

14  sources;

15         (i)  Address resource needs of the assessment and

16  intervention system; and

17         (j)  Address development of implementation plans to

18  establish protocols for requiring and receiving parental

19  consent for services; to identify action steps, responsible

20  parties, and implementation schedules; and to ensure

21  appropriate alignment with agency strategic plans.

22         Section 4.  The Legislature shall appropriate a sum of

23  money to fund the demonstration programs and shall authorize

24  selected communities to blend funding from existing programs

25  to the extent that this is advantageous to the community and

26  is consistent with federal requirements.

27         Section 5.  This act shall take effect upon becoming a

28  law.

29

30

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2002                             CS for SB 88
    304-311G-02




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                          Senate Bill 88

  3

  4  Parental consent is required for all Learning Gateway
    activities. Pilot programs may provide information and
  5  referral but may not provide direct services.  There will not
    be automatic referral of high-risk newborns to the Learning
  6  Gateway and the Learning Gateway is not provided access to
    student records under s. 228.093, F.S. Also tests will not be
  7  added to the infant screening program in the pilot counties.

  8  Agencies participating in the Learning Gateway are authorized
    to provide to the Learning Gateway information regarding a
  9  developmental screening on any child participating in the
    Learning Gateway who has been the subject of a developmental
10  screening within the jurisdiction of that agency. The broader
    authority for agencies to share records is deleted.
11
    The steering committee is reduced from 23 to 18 members and
12  membership is revised.  By January, the steering committee, in
    conjunction with the pilot programs, must develop a model
13  county-level strategic plan to support the integration and
    efficient delivery of services and supports
14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

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CODING: Words stricken are deletions; words underlined are additions.