HB 1291

1	A bill to be entitled
2	An act relating to autism spectrum disorder; providing a
3	short title; amending s. 402.305, F.S.; including autism
4	spectrum disorder within training requirements for
5	personnel of child care facilities; providing application;
6	creating s. 627.6686, F.S.; providing definitions;
7	requiring health insurance plans to provide coverage for
8	screening, diagnosis, intervention, and treatment of
9	autism spectrum disorder in certain children; requiring a
10	treatment plan; prohibiting an insurer from denying or
11	refusing coverage or refusing to renew or reissue or
12	terminate coverage based on a diagnosis of autism spectrum
13	disorder; providing coverage limitations; providing
14	treatment plan requirements; limiting the frequency of
15	requests for updating a treatment plan; providing
16	eligibility requirements; providing a maximum benefit
17	limitation; providing for annual adjustments of the
18	maximum benefit limitation; providing construction;
19	requiring public institutions of higher education to
20	incorporate into educator certificate course curricula
21	certain recommendations of the Commissioner of Education
22	relating to autism awareness and teaching students who
23	have autism spectrum disorder; requiring the commissioner
24	to develop recommendations for certain instruction and
25	course curricula relating to autism spectrum disorder;
26	requiring the commissioner to submit such recommendations
27	to the State Board of Education and the Board of Governors
28	of the State University System; requiring the commissioner
29	to consult with the State Surgeon General and other
30	certain entities in developing such recommendations;
31	specifying requirements for such recommendations;
32	requiring the State Board of Education and the Board of
33	Governors of the State University System to adopt rules;
34	specifying implementation subject to legislative
35	appropriation; requiring the Department of Health, in
36	conjunction with the Department of Education, the
37	Department of Children and Family Services, the Agency for
38	Health Care Administration, and the Agency for Persons
39	with Disabilities, to establish a statewide system of
40	early autism spectrum disorder intervention services for
41	certain infants and toddlers; specifying system
42	requirements; requiring the department to establish an
43	Internet website for disseminating certain information;
44	requiring the State Surgeon General to adopt rules;
45	providing application; providing an effective date.
46
47	Be It Enacted by the Legislature of the State of Florida:
48
49	Section 1.  This act may be cited as the "Window of
50	Opportunity Act."
51	Section 2.  Paragraph (d) of subsection (2) of section
52	402.305, Florida Statutes, is amended to read:
53	402.305  Licensing standards; child care facilities.--
54	(2)  PERSONNEL.--Minimum standards for child care personnel
55	shall include minimum requirements as to:
56	(d)  Minimum training requirements for child care
57	personnel.
58	1.  Such minimum standards for training shall ensure that
59	all child care personnel take an approved 40-clock-hour
60	introductory course in child care, which course covers at least
61	the following topic areas:
62	a.  State and local rules and regulations which govern
63	child care.
64	b.  Health, safety, and nutrition.
65	c.  Identifying and reporting child abuse and neglect.
66	d.  Child development, including typical and atypical
67	language, cognitive, motor, social, and self-help skills
68	development.
69	e.  Observation of developmental behaviors, including using
70	a checklist or other similar observation tools and techniques to
71	determine the child's developmental age level.
72	f.  Specialized areas, including computer technology for
73	professional and classroom use and early literacy and language
74	development of children from birth to 5 years of age, as
75	determined by the department, for owner-operators and child care
76	personnel of a child care facility.
77	g.  Autism spectrum disorder.
78
79	Within 90 days after employment, child care personnel shall
80	begin training to meet the training requirements. Child care
81	personnel shall successfully complete such training within 1
82	year after the date on which the training began, as evidenced by
83	passage of a competency examination. Successful completion of
84	the 40-clock-hour introductory course shall articulate into
85	community college credit in early childhood education, pursuant
86	to ss. 1007.24 and 1007.25. Exemption from all or a portion of
87	the required training shall be granted to child care personnel
88	based upon educational credentials or passage of competency
89	examinations. Child care personnel possessing a 2-year degree or
90	higher that includes 6 college credit hours in early childhood
91	development or child growth and development, or a child
92	development associate credential or an equivalent state-approved
93	child development associate credential, or a child development
94	associate waiver certificate shall be automatically exempted
95	from the training requirements in sub-subparagraphs b., d., and
96	e.
97	2.  The introductory course in child care shall stress, to
98	the extent possible, an interdisciplinary approach to the study
99	of children.
100	3.  The introductory course shall cover recognition and
101	prevention of shaken baby syndrome, prevention of sudden infant
102	death syndrome, recognition and care of infants and toddlers who
103	have autism spectrum disorder, and early childhood brain
104	development within the topic areas identified in this paragraph.
105	4.  On an annual basis in order to further their child care
106	skills and, if appropriate, administrative skills, child care
107	personnel who have fulfilled the requirements for the child care
108	training shall be required to take an additional 1 continuing
109	education unit of approved inservice training, or 10 clock hours
110	of equivalent training, as determined by the department.
111	5.  Child care personnel shall be required to complete 0.5
112	continuing education unit of approved training or 5 clock hours
113	of equivalent training, as determined by the department, in
114	early literacy and language development of children from birth
115	to 5 years of age one time. The year that this training is
116	completed, it shall fulfill the 0.5 continuing education unit or
117	5 clock hours of the annual training required in subparagraph 4.
118	6.  Procedures for ensuring the training of qualified child
119	care professionals to provide training of child care personnel,
120	including onsite training, shall be included in the minimum
121	standards. It is recommended that the state community child care
122	coordination agencies (central agencies) be contracted by the
123	department to coordinate such training when possible. Other
124	district educational resources, such as community colleges and
125	career programs, can be designated in such areas where central
126	agencies may not exist or are determined not to have the
127	capability to meet the coordination requirements set forth by
128	the department.
129	7.  Training requirements shall not apply to certain
130	occasional or part-time support staff, including, but not
131	limited to, swimming instructors, piano teachers, dance
132	instructors, and gymnastics instructors.
133	8.  The department shall evaluate or contract for an
134	evaluation for the general purpose of determining the status of
135	and means to improve staff training requirements and testing
136	procedures. The evaluation shall be conducted every 2 years. The
137	evaluation shall include, but not be limited to, determining the
138	availability, quality, scope, and sources of current staff
139	training; determining the need for specialty training; and
140	determining ways to increase inservice training and ways to
141	increase the accessibility, quality, and cost-effectiveness of
142	current and proposed staff training. The evaluation methodology
143	shall include a reliable and valid survey of child care
144	personnel.
145	9.  The child care operator shall be required to take basic
146	training in serving children with disabilities within 5 years
147	after employment, either as a part of the introductory training
148	or the annual 8 hours of inservice training.
149	Section 3.  Section 627.6686, Florida Statutes, is created
150	to read:
151	627.6686  Coverage for autism spectrum disorder required;
152	exception.--
153	(1)  As used in this section, the term:
154	(a)  "Applied behavior analysis" means the design,
155	implementation, and evaluation of environmental modifications,
156	using behavioral stimuli and consequences, to produce socially
157	significant improvement in human behavior, including, but not
158	limited to, the use of direct observation, measurement, and
159	functional analysis of the relations between environment and
160	behavior.
161	(b)  "Autism spectrum disorder" means any of the following
162	disorders as defined in the most recent edition of the
163	Diagnostic and Statistical Manual of Mental Disorders of the
164	American Psychiatric Association:
165	1.  Autistic disorder.
166	2.  Asperger's syndrome.
167	3.  Pervasive developmental disorder not otherwise
168	specified.
169	(c)  "Health insurance plan" means a group health insurance
170	policy or group health benefit plan offered by an insurer which
171	includes the state group insurance program provided under s.
172	110.123. The term does not include any health insurance plan
173	offered in the individual market, any health insurance plan that
174	is individually underwritten, or any health insurance plan
175	provided to a small employer.
176	(d)  "Insurer" means an insurer, health maintenance
177	organization, or any other entity providing health insurance
178	coverage which is licensed to engage in the business of
179	insurance in this state and is subject to insurance regulation.
180	(2)  A health insurance plan shall provide coverage for
181	well-baby and well-child screening for diagnosing the presence
182	of autism spectrum disorder and the intervention and treatment
183	of autism spectrum disorder through speech therapy, occupational
184	therapy, physical therapy, applied behavior analysis, treatment
185	by a psychiatrist or psychologist, and any other necessary
186	medical care. Coverage provided under this section is limited to
187	treatment that is prescribed by the insured's treating medical
188	physician in accordance with a treatment plan. With regards to a
189	health insurance plan, an insurer may not deny or refuse to
190	issue coverage for, refuse to contract with, or refuse to renew
191	or reissue or otherwise terminate or restrict coverage for an
192	individual because the individual is diagnosed as having autism
193	spectrum disorder.
194	(3)  The coverage required pursuant to subsection (2) may
195	not be subject to dollar limits, deductibles, or coinsurance
196	provisions that are less favorable to an insured than the dollar
197	limits, deductibles, or coinsurance provisions that apply to
198	physical illnesses that are generally covered under the health
199	insurance plan, except as otherwise provided for in subsection
200	(5). The coverage required in subsection (2) may not be denied
201	on the basis that provided services are habilitative in nature.
202	The coverage may not be subject to any limits on the number of
203	visits an insured may make to a service provider. However, the
204	coverage required pursuant to subsection (2) may be subject to
205	other general exclusions and limitations of the insurer's policy
206	or plan, including, but not limited to, coordination of
207	benefits, participating provider requirements, restrictions on
208	services provided by family or household members, and
209	utilization review of health care services, including the review
210	of medical necessity, case management, and other managed care
211	provisions.
212	(4)  The treatment plan required pursuant to subsection (2)
213	must include all elements necessary for the health insurance
214	plan to appropriately pay claims. These elements include, but
215	are not limited to, a diagnosis, the proposed treatment by type,
216	the frequency and duration of treatment, the anticipated
217	outcomes stated as goals, the frequency by which the treatment
218	plan will be updated, and the treating medical doctor's
219	signature. A health insurance plan may request an updated
220	treatment plan only once every 6 months from the treating
221	medical doctor for purposes of reviewing medical necessity
222	unless the health insurance plan and the treating medical doctor
223	agree that a more frequent review is necessary due to emerging
224	clinical circumstances.
225	(5)  To be eligible for benefits and coverage under this
226	section, an individual must be diagnosed as having autistic
227	spectrum disorder at 8 years of age or younger. The benefits and
228	coverage provided pursuant to this section shall be provided to
229	any eligible person younger than 18 years of age or to any
230	eligible person 18 years of age or older who is in high school.
231	Coverage for applied behavior analysis is subject to a maximum
232	benefit of $36,000 per year. Beginning January 1, 2010, this
233	maximum benefit shall be adjusted annually on January 1 of each
234	calendar year to reflect any change from the previous year in
235	the medical component of the then current Consumer Price Index,
236	All Urban Consumers, as published by the United States
237	Department of Labor's Bureau of Labor Statistics.
238	(6)  This section may not be construed as limiting benefits
239	and coverage otherwise available to an insured under a health
240	insurance plan.
241	Section 4.  (1)  Beginning with the 2008-2009 school year,
242	each public institution of higher education offering coursework
243	for educator certification required under s. 1012.56, Florida
244	Statutes, shall incorporate into existing course curricula the
245	recommendations developed by the Commissioner of Education
246	pursuant to subsection (2) concerning instruction in autism
247	spectrum disorder and other developmental disabilities awareness
248	and methods of teaching students who have autism spectrum
249	disorder and other developmental disabilities.
250	(2)(a)  The Commissioner of Education shall develop
251	recommendations for instruction in awareness of autism spectrum
252	disorder and other developmental disabilities and methods of
253	teaching students who have autism spectrum disorder and other
254	developmental disabilities for educator certification programs
255	in accordance with subsection (1) and shall submit the
256	recommendations to the State Board of Education and the Board of
257	Governors of the State University System. In developing the
258	recommendations, the commissioner shall consult with the State
259	Surgeon General and representatives from entities that promote
260	awareness about autism spectrum disorder and other developmental
261	disabilities and provide programs and services to people who
262	have autism spectrum disorder and other developmental
263	disabilities, including, but not limited to, regional autism
264	centers established under s. 1004.55, Florida Statutes, and
265	representatives of the education community in this state.
266	(b)  The Commissioner of Education shall develop
267	recommendations to incorporate autism spectrum disorder and
268	other developmental disabilities awareness instruction and
269	methods of teaching students who have autism spectrum disorder
270	and other developmental disabilities for teacher and
271	paraprofessional in-service and other training programs, where
272	appropriate, and shall submit the recommendations to the State
273	Board Education and the Board of Governors of the State
274	University System. In developing the recommendations, the
275	commissioner shall consult with the State Surgeon General,
276	representatives from entities that promote awareness about
277	autism and other developmental disabilities and provide programs
278	and services to people who have autism and other developmental
279	disabilities, including representatives of the education
280	community in this state.
281	(c)  The recommendations developed by the Commissioner of
282	Education pursuant to paragraphs (a) and (b) shall address:
283	1.  Characteristics of students who have autism spectrum
284	disorder and other developmental disabilities.
285	2.  Curriculum planning, curricular and instructional
286	modifications, adaptations, and specialized strategies and
287	techniques.
288	3.  Assistive technology.
289	4.  Inclusive educational practices, including
290	collaborative partnerships.
291	(3)  The State Board of Education and the Board of
292	Governors of the State University System, based upon the
293	recommendations developed by the Commissioner of Education
294	pursuant to subsection (2), shall adopt rules pursuant to ss.
295	120.536(1) and 120.54, Florida Statutes, necessary to implement
296	this section.
297	(4)  Implementation of this section is subject to an
298	appropriation by the Legislature.
299	Section 5.  (1)  The Department of Health, in conjunction
300	with the Department of Education, the Department of Children and
301	Family Services, the Agency for Health Care Administration, and
302	the Agency for Persons with Disabilities, shall establish a
303	statewide system of early intervention services for eligible
304	infants and toddlers from birth to age 2, inclusive, who have
305	physical, cognitive, communication, social or emotional, and
306	adaptive developmental delays or disabilities in accordance with
307	Part H of the Individuals with Disabilities Education Act, 20
308	U.S.C. ss. 1471 et seq.
309	(2)  The early intervention program in the Department of
310	Health established pursuant to subsection (1) shall provide for
311	addressing the specific needs of children who have autism
312	spectrum disorders and their families. Such activities shall
313	include, but not be limited to:
314	(a)  Developing, in consultation with autism experts and
315	advocates, including, but not limited to, regional autism
316	centers established under s. 1004.55, Florida Statutes,
317	guidelines for health care professionals to use in evaluating
318	infants and toddlers living in this state for autism spectrum
319	disorder and to ensure the timely referral by health care
320	professionals of infants and toddlers who are identified as
321	having autism spectrum disorder or suspected of being on the
322	autism spectrum to the early intervention program in order to
323	provide appropriate services to those infants and toddlers as
324	early as possible.
325	(b)  Referring affected children who are identified as
326	having autism spectrum disorder or suspected of being on the
327	autism spectrum and their families to schools and agencies,
328	including community, consumer, and parent-based agencies, and
329	organizations and other programs mandated by Part C of the
330	Individuals with Disabilities Education Act, 20 U.S.C. ss. 1431
331	et seq., which offer programs specifically designed to meet the
332	unique needs of children who have autism spectrum disorder.
333	(c)  Collecting data on statewide autism spectrum disorder
334	screening, diagnosis, and intervention programs and systems that
335	can be used for applied research, program evaluation, and policy
336	development.
337	(d)  Disseminating information on the screening, diagnosis,
338	intervention, treatment, and medical care of individuals who
339	have autism spectrum disorder to health care professionals and
340	the public.
341	(3)  The Department of Health shall establish an Internet
342	website to comply with the requirements of paragraph (2)(d).
343	(4)  The State Surgeon General shall adopt rules pursuant
344	to ss. 120.536(1) and 120.54, Florida Statutes, to administer
345	this section.
346	Section 6.  This act shall take effect January 1, 2009, and
347	applies to health insurance policies or plans issued, renewed,
348	entered into, or delivered on or after that date.

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