HB 0723

1
A bill to be entitled
2An act relating to foster care services; amending s.
320.19, F.S.; prohibiting certain members of a community
4alliance from receiving funds from the Department of
5Children and Family Services or a community-based care
6lead agency; amending s. 409.1671, F.S.; providing
7additional requirements for an eligible lead community-
8based provider to compete for a privatization project;
9requiring contracts with eligible lead community-based
10providers to include certain standards; revising
11requirements for the department's quality assurance
12program for privatized services; directing the Florida
13Coalition for Children, Inc., in consultation with the
14department, to develop a plan for a statewide risk pool
15for eligible lead community-based providers, their
16subcontractors, and certain providers that provide foster
17care and related services under contract with the
18department; deleting a requirement that the department
19develop a proposal; specifying the requirements of the
20plan; extending a plan submission deadline; revising the
21process for plan approval; directing the department to
22issue an interest-free loan upon approval of the plan;
23modifying the purposes of the community-based care risk
24pool; revising the purposes for which funding may be
25recommended to the Legislature; authorizing the risk pool
26to invest funds and retain interest; providing for
27payments upon a determination of insolvency; prohibiting
28payment of dividends to the risk pool members until
29repayment of the loan issued by the department and until
30the risk pool is actuarially sound and solvent; deleting a
31requirement for a performance bond; providing for the risk
32pool to be managed by the Florida Coalition for Children,
33Inc., or its designated contractor; specifying the manner
34in which nonmember entities may be authorized to contract
35with the department; authorizing the department to require
36a bond; providing an exemption from state travel policies
37for lead community-based providers and their
38subcontractors; providing an effective date.
39
40Be It Enacted by the Legislature of the State of Florida:
41
42     Section 1.  Subsection (6) of section 20.19, Florida
43Statutes, is amended to read:
44     20.19  Department of Children and Family Services.--There
45is created a Department of Children and Family Services.
46     (6)  COMMUNITY ALLIANCES.--
47     (a)  The department shall, in consultation with local
48communities, establish a community alliance of the stakeholders,
49community leaders, client representatives and funders of human
50services in each county to provide a focal point for community
51participation and governance of community-based services.  An
52alliance may cover more than one county when such arrangement is
53determined to provide for more effective representation.  The
54community alliance shall represent the diversity of the
55community.
56     (b)  The duties of the community alliance shall include,
57but not necessarily be limited to:
58     1.  Joint planning for resource utilization in the
59community, including resources appropriated to the department
60and any funds that local funding sources choose to provide.
61     2.  Needs assessment and establishment of community
62priorities for service delivery.
63     3.  Determining community outcome goals to supplement
64state-required outcomes.
65     4.  Serving as a catalyst for community resource
66development.
67     5.  Providing for community education and advocacy on
68issues related to delivery of services.
69     6.  Promoting prevention and early intervention services.
70     (c)  The department shall ensure, to the greatest extent
71possible, that the formation of each community alliance builds
72on the strengths of the existing community human services
73infrastructure.
74     (d)  The initial membership of the community alliance in a
75county shall be composed of the following:
76     1.  The district administrator.
77     2.  A representative from county government.
78     3.  A representative from the school district.
79     4.  A representative from the county United Way.
80     5.  A representative from the county sheriff's office.
81     6.  A representative from the circuit court corresponding
82to the county.
83     7.  A representative from the county children's board, if
84one exists.
85     (e)  At any time after the initial meeting of the community
86alliance, the community alliance shall adopt bylaws and may
87increase the membership of the alliance to include the state
88attorney for the judicial circuit in which the community
89alliance is located, or his or her designee, the public defender
90for the judicial circuit in which the community alliance is
91located, or his or her designee, and other individuals and
92organizations who represent funding organizations, are community
93leaders, have knowledge of community-based service issues, or
94otherwise represent perspectives that will enable them to
95accomplish the duties listed in paragraph (b), if, in the
96judgment of the alliance, such change is necessary to adequately
97represent the diversity of the population within the community
98alliance service districts.
99     (f)  A member of the community alliance, other than a
100member specified in paragraph (d), may not receive payment for
101contractual services from the department or a community-based
102care lead agency.
103     (g)(f)  Members of the community alliances shall serve
104without compensation, but are entitled to receive reimbursement
105for per diem and travel expenses, as provided in s. 112.061.
106Payment may also be authorized for preapproved child care
107expenses or lost wages for members who are consumers of the
108department's services and for preapproved child care expenses
109for other members who demonstrate hardship.
110     (h)(g)  Members of a community alliance are subject to the
111provisions of part III of chapter 112, the Code of Ethics for
112Public Officers and Employees.
113     (i)(h)  Actions taken by a community alliance must be
114consistent with department policy and state and federal laws,
115rules, and regulations.
116     (j)(i)  Alliance members shall annually submit a disclosure
117statement of services interests to the department's inspector
118general. Any member who has an interest in a matter under
119consideration by the alliance must abstain from voting on that
120matter.
121     (k)(j)  All alliance meetings are open to the public
122pursuant to s. 286.011 and the public records provision of s.
123119.07(1).
124     Section 2.  Paragraph (e) of subsection (1), paragraph (a)
125of subsection (4), and subsections (7) and (8) of section
126409.1671, Florida Statutes, as amended by section 27 of chapter
1272003-399, Laws of Florida, are amended, paragraph (e) is added
128to subsection (3) of said section, and subsection (10) is added
129to said section, to read:
130     409.1671  Foster care and related services;
131privatization.--
132     (1)
133     (e)  As used in this section, the term "eligible lead
134community-based provider" means a single agency with which the
135department shall contract for the provision of child protective
136services in a community that is no smaller than a county. The
137secretary of the department may authorize more than one eligible
138lead community-based provider within a single county when to do
139so will result in more effective delivery of foster care and
140related services. To compete for a privatization project, such
141agency must have:
142     1.  The ability to coordinate, integrate, and manage all
143child protective services in the designated community in
144cooperation with child protective investigations.
145     2.  The ability to ensure continuity of care from entry to
146exit for all children referred from the protective investigation
147and court systems.
148     3.  The ability to provide directly, or contract for
149through a local network of providers, all necessary child
150protective services. Such agency should directly provide no more
151than 35 percent of all child protective services provided.
152     4.  The willingness to accept accountability for meeting
153the outcomes and performance standards related to child
154protective services established by the Legislature and the
155Federal Government.
156     5.  The capability and the willingness to serve all
157children referred to it from the protective investigation and
158court systems, regardless of the level of funding allocated to
159the community by the state, provided all related funding is
160transferred.
161     6.  The willingness to ensure that each individual who
162provides child protective services completes the training
163required of child protective service workers by the Department
164of Children and Family Services.
165     7.  The ability to maintain eligibility to receive all
166federal child welfare funds, including Title IV-E and IV-A
167funds, currently being used by the Department of Children and
168Family Services.
169     8.  Written agreements with Healthy Families Florida lead
170entities in their community, pursuant to s. 409.153, to promote
171cooperative planning for the provision of prevention and
172intervention services.
173     9.  A board of directors, of which at least 51 percent of
174the membership is comprised of persons residing in this state.
175Of the state residents, at least 51 percent must also reside
176within the service area of the lead community-based provider.
177     (3)
178     (e)  Each contract with an eligible lead community-based
179provider must include all performance outcome measures that are
180established by the Legislature and that are under the control of
181the lead agency. The standards must be adjusted annually by
182contract amendment to enable the department to meet the
183legislatively established statewide standards.
184     (4)(a)  The department, in consultation with the community-
185based agencies that are undertaking the privatized projects,
186shall establish a quality assurance program for privatized
187services. The quality assurance program shall be based on
188standards established by the Adoption and Safe Families Act as
189well as by a national accrediting organization such as the
190Council on Accreditation of Services for Families and Children,
191Inc. (COA) or CARF--the Rehabilitation Accreditation Commission.
192The department may develop a request for proposal for such
193oversight. This program must be developed and administered at a
194statewide level. The Legislature intends that the department be
195permitted to have limited flexibility to use funds for improving
196quality assurance. To this end, the department may transfer up
197to 0.125 percent of the total funds from categories used to pay
198for these contractually provided services, but the total amount
199of such transferred funds may not exceed $300,000 in any fiscal
200year. When necessary, the department may establish, in
201accordance with s. 216.177, additional positions that will be
202exclusively devoted to these functions. Any positions required
203under this paragraph may be established, notwithstanding ss.
204216.262(1)(a) and 216.351. The department, in consultation with
205the community-based agencies that are undertaking the privatized
206projects, shall establish minimum thresholds for each component
207of service, consistent with standards established by the
208Legislature and the Federal Government. Each program operated
209under contract with a community-based agency must be evaluated
210annually by the department. The department shall, to the extent
211possible, use independent financial audits provided by the
212community-based care agency to eliminate or reduce the ongoing
213contract and administrative reviews conducted by the department.
214The department may suggest additional items to be included in
215such independent financial audits to meet the department's
216needs. Should the department determine that such independent
217financial audits are inadequate, then other audits, as
218necessary, may be conducted by the department. Nothing herein
219shall abrogate the requirements of s. 215.97. The department
220shall submit an annual report regarding quality performance,
221outcome measure attainment, and cost efficiency to the President
222of the Senate, the Speaker of the House of Representatives, the
223minority leader of each house of the Legislature, and the
224Governor no later than January 31 of each year for each project
225in operation during the preceding fiscal year.
226     (7)  The Florida Coalition for Children, Inc., in
227consultation with the department, shall develop a plan based on
228an independent actuarial study regarding the long-term use and
229structure of a statewide community-based care risk pool for the
230protection of eligible lead community-based providers, their
231subcontractors, and providers of other social services who
232contract directly with the department. The plan must also
233outline strategies to maximize federal earnings as they relate
234to the community-based care risk pool. At a minimum, the plan
235must allow for the use of federal earnings received from child
236welfare programs to be allocated to the community-based care
237risk pool by the department, which earnings are determined by
238the department to be in excess of the amount appropriated in the
239General Appropriations Act. The plan must specify the necessary
240steps to ensure the financial integrity and industry-standard
241risk management practices of the community-based care risk pool
242and the continued availability of funding from federal, state,
243and local sources. The plan must also include recommendations
244that permit the program to be available to entities of the
245department providing child welfare services until full
246conversion to community-based care takes place. The final plan
247shall be submitted to the department and the Office of Insurance
248Regulation and then to the Executive Office of the Governor and
249the Legislative Budget Commission for formal adoption before
250January 1, 2005. Upon approval of the plan by all parties, the
251department shall issue an interest-free loan that is secured by
252the cumulative contractual revenue of the community-based care
253risk pool membership, and the amount of the loan shall equal the
254amount appropriated by the Legislature for this purpose. The
255plan shall provide for a governance structure that assures the
256department the ability to oversee the operation of the
257community-based care risk pool at least until this loan is
258repaid in full.
259     (a)  The purposes for which the community-based care risk
260pool shall be used include, but are not limited to:
261     1.  Significant changes in the number or composition of
262clients eligible to receive services.
263     2.  Significant changes in the services that are eligible
264for reimbursement.
265     3.  Scheduled or unanticipated, but necessary, advances to
266providers or other cash-flow issues.
267     4.  Proposals to participate in optional Medicaid services
268or other federal grant opportunities.
269     5.  Appropriate incentive structures.
270     6.  Continuity of care in the event of failure,
271discontinuance of service, or financial misconduct by a lead
272agency.
273     7.  Payment for time-limited technical assistance and
274consultation to lead agencies in the event of serious
275performance or management problems.
276     8.  Payment for meeting all traditional and nontraditional
277insurance needs of eligible members.
278     9.  Significant changes in the mix of available funds.
279     (b)  After approval of the plan in the 2004-2005 fiscal
280year and annually thereafter, the department may also request in
281its annual legislative budget request, and the Governor may
282recommend, that the funding necessary to carry out the purposes
283described in paragraph (a) be appropriated to the department.
284Subsequent funding of the community-based care risk pool shall
285be supported by premiums assessed to members of the community-
286based care risk pool on a recurring basis. The community-based
287care risk pool may invest and retain interest earned on these
288funds. In addition, the department may transfer funds to the
289community-based care risk pool as available in order to ensure
290an adequate funding level if the fund is declared to be
291insolvent and approval is granted by the Legislative Budget
292Commission. Such payments for insolvency shall be made only
293after a determination is made by the department or its actuary
294that all members of the community-based care risk pool are
295current in their payments of premiums and that assessments have
296been made at an actuarially sound level. Such payments by
297members of the community-based care risk pool may not exceed
298reasonable industry standards, as determined by the actuary.
299Moneys from this fund may be used to match available federal
300dollars. Dividends or other payments, with the exception of
301legitimate claims, may not be paid to members of the community-
302based care risk pool until the loan issued by the department is
303repaid in full. Dividends or other payments, with the exception
304of legitimate claims and other purposes contained in the
305approved plan, may not be paid to members of the community-based
306care risk pool unless, at the time of distribution, the
307community-based care risk pool is deemed actuarially sound and
308solvent. Solvency shall be determined by an independent actuary
309contracted by the department. The Office of Insurance Regulation
310must approve the determination of solvency by the independent
311actuary before the department may accept the recommendation of
312the independent actuary.
313     1.  Appropriated funds shall constitute partial security
314for contract performance by lead agencies and shall be used to
315offset the need for a performance bond. Subject to the approval
316of the plan, the community-based care risk pool shall be managed
317by the Florida Coalition for Children, Inc., or the designated
318contractors of the Florida Coalition for Children, Inc.
319Nonmembers of the community-based care risk pool may continue to
320contract with the department but must provide a letter of credit
321equal to one-twelfth of the annual contract amount in lieu of
322membership in the community-based care risk pool.
323     2.  The department may separately require a bond to
324mitigate the financial consequences of potential acts of
325malfeasance or misfeasance or criminal violations by the
326provider. The department, in consultation with existing lead
327agencies, shall develop a proposal regarding the long-term use
328and structure of a statewide shared earnings program which
329addresses the financial risk to eligible lead community-based
330providers resulting from unanticipated caseload growth or from
331significant changes in client mixes or services eligible for
332federal reimbursement. The recommendations in the statewide
333proposal must also be available to entities of the department
334until the conversion to community-based care takes place. At a
335minimum, the proposal must allow for use of federal earnings
336received from child welfare programs, which earnings are
337determined by the department to be in excess of the amount
338appropriated in the General Appropriations Act, to be used for
339specific purposes. These purposes include, but are not limited
340to:
341     (a)  Significant changes in the number or composition of
342clients eligible to receive services.
343     (b)  Significant changes in the services that are eligible
344for reimbursement.
345     (c)  Significant changes in the availability of federal
346funds.
347     (d)  Shortfalls in state funds available for eligible or
348ineligible services.
349     (e)  Significant changes in the mix of available funds.
350     (f)  Scheduled or unanticipated, but necessary, advances to
351providers or other cash-flow issues.
352     (g)  Proposals to participate in optional Medicaid services
353or other federal grant opportunities.
354     (h)  Appropriate incentive structures.
355     (i)  Continuity of care in the event of lead agency
356failure, discontinuance of service, or financial misconduct.
357
358The department shall further specify the necessary steps to
359ensure the financial integrity of these dollars and their
360continued availability on an ongoing basis. The final proposal
361shall be submitted to the Legislative Budget Commission for
362formal adoption before December 31, 2002. If the Legislative
363Budget Commission refuses to concur with the adoption of the
364proposal, the department shall present its proposal in the form
365of recommended legislation to the President of the Senate and
366the Speaker of the House of Representatives before the
367commencement of the next legislative session. For fiscal year
3682003-2004 and annually thereafter, the Department of Children
369and Family Services may request in its legislative budget
370request, and the Governor may recommend, the funding necessary
371to carry out paragraph (i) from excess federal earnings. The
372General Appropriations Act shall include any funds appropriated
373for this purpose in a lump sum in the Administered Funds
374Program, which funds constitute partial security for lead agency
375contract performance. The department shall use this
376appropriation to offset the need for a performance bond for that
377year after a comparison of risk to the funds available. In no
378event shall this performance bond exceed 2.5 percent of the
379annual contract value. The department may separately require a
380bond to mitigate the financial consequences of potential acts of
381malfeasance, misfeasance, or criminal violations by the
382provider. Prior to the release of any funds in the lump sum, the
383department shall submit a detailed operational plan, which must
384identify the sources of specific trust funds to be used. The
385release of the trust fund shall be subject to the notice and
386review provisions of s. 216.177. However, the release shall not
387require approval of the Legislative Budget Commission.
388     (8)  Notwithstanding the provisions of s. 215.425, all
389documented federal funds earned for the current fiscal year by
390the department and community-based agencies which exceed the
391amount appropriated by the Legislature shall be distributed to
392all entities that contributed to the excess earnings based on a
393schedule and methodology developed by the department and
394approved by the Executive Office of the Governor. Distribution
395shall be pro rata based on total earnings and shall be made only
396to those entities that contributed to excess earnings. Excess
397earnings of community-based agencies shall be used only in the
398service district in which they were earned. Additional state
399funds appropriated by the Legislature for community-based
400agencies or made available pursuant to the budgetary amendment
401process described in s. 216.177 shall be transferred to the
402community-based agencies. The department shall amend a
403community-based agency's contract to permit expenditure of the
404funds. The distribution program applies only to entities that
405were under privatization contracts as of July 1, 2002.
406     (10)  The lead community-based providers and their
407subcontractors shall be exempt from state travel policies as set
408forth in s. 112.061(3)(a) for their travel expenses incurred in
409order to comply with the requirements of this section.
410     Section 3.  This act shall take effect July 1, 2004.


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