Issue #2 March 12, 2010

Revenue Estimates Slightly Up For 2010-2011

On March 9, the Revenue Estimating Conference met to project the amount of revenues Florida is anticipated to collect during the remainder of the 2009-2010 fiscal year and during the 2010-2011 fiscal year. The 19-member Conference, made up of fiscal analysts from the governor's office, Legislature and some economic-policy agencies, concluded that its December projectins are still pretty much on point, including its projection that next year will be the first year in three years that Florida can expect increased revenues. Through the remainder of this year, the Conference estimates that the state will receive $25.3 million more than originally projected in December (less than 0.2% increase) and for 2010-2011 expected revenues were increased by $56.1 million (less than 0.3% increase). Unfortunately, this slight increase in projected revenues does not even put a small dent in the projected $3 billion dollar deficit for 2010-2011.

The deficit is based on three factors: a reduction in federal stimulus funding of $924 million in Medicaid, an $842 million increase in Medicaid enrollment, and a loss of $778 million in ad valorem revenues from dropping property values, which fund Florida's public schools. The situation is not expected to improve next year, when the Legislative Budget Commission predicts we will have a $5 billion shortfall.

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FMAP: Budget Savior?

Last year, Congress temporarily increased the federal government’s share of Medicaid from 55 cents per Medicaid dollar to nearly 68 cents. This increase in the Federal Medical Assistance Percentage (FMAP) reduced Florida’s share from 45 cents to about 32 cents per dollar. While this may not sound like a huge amount, it means that if Congress does not extend the increase, which is set to expire December 31, the state will need an additional $1 billion to fund Medicaid. This has already been calculated into and is a part of the projected $3 billion budget deficit for next year. Governor Crist included the money in his proposed budget, but the House and Senate have not.
 

On Tuesday, the US Senate passed a companion bill to one that had already been passed by the US House, part of which extends the increased FMAP payment. The bill next goes to conference committee where the differences in the bills will be hashed out. It appears at his time there is a good likelihood the bill – and the FMAP continuation funding – will pass.
 

One of the biggest buzzes around the Florida Capital this week was the question of what the Legislature will do with the $1 billion, when and if it materializes. Unfortunately, it appears some/most of it will not be used to increase the pot of money available for health and human services. Speaker Cretul has stated his intent to put $1 billion into reserves to help off-set next year’s projected $5 billion deficit, and three members of the Senate Health and Human Services Appropriations Committee this week refused to sign a letter to Senate President Atwater urging him to use all of the money for health and human services. Advocates need to contact their legislative leaders and urge them to use the $1 billion as intended by Congress, to supplement funding for health and human services, not to supplant funding so it can be used for other state services.

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Senate Allocations Released

On Tuesday, Senate President Jeff Atwater told appropriations committees for each budget policy area how much money they would have for their respective areas. Generally, the House allocations which were released last week, provide $136 million more of general revenue for public schools, $316 million more for health care, and $147 million more than the Senate for criminal and civil justice. The biggest piece of the Senate allocation is $8.8 billion in recurring general revenue targeted to Pre-K-12 education spending, followed by $6.3 billion to health care. View the allocations.

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Florida Child Abuse Death Review Team Ignored

The Florida Child Abuse Death Review Team is a statewide group of experts that reviews the deaths of every child 18 years and younger who dies of abuse and neglect in the state. The team knows better than any other group why a child dies of abuse or neglect every 43 hours in Florida. The Team’s number one programmatic priority for reducing this horrendous number: Fully fund Healthy Families Florida. Why? Because Healthy Family Florida is 98% effective in preventing abuse and neglect. Also, unlike the vast majority of child abuse and neglect programs – and programs across the health and human services spectrum – we know it is 98% effective because it has been scrutinized by a rigorous five year third party evaluation.
 

On Thursday, the Florida Senate Health and Human Services Appropriations Committee tentatively agreed to cut all funding ($28 million) from Healthy Family Florida, basically eliminating the program. The reasons have not been made clear. Whether it is the tight budget, the lack of federal match, or the belief that such programs are not proper government functions, they do not justify elimination of the program.
 

If the elimination stands, thousands of children will be subject to abuse and neglect, likely resulting in the state having to spend many more times the cost of HFF on issues relating to school failure, mental illness, juvenile justice, corrections, lost productively, and more. Not to mention the emotional and physical toll it will take on the victims over the course of thier lives.  Please let your legislators know today that Healthy Families Florida funding must be maintained at current levels. For more information, visit the Healthy Families Florida website.

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School Readiness and VPK Hit Hard

The House and Senate Committees responsible for the School Readiness Program and VPK budgets released their proposed cuts for the 2010-2011 fiscal year this week. It is not a pretty picture. Here are the proposed cuts and the number of children impacted:
 

School Readiness Program:
 

 VPK Program:

These cuts and reductions in per student allocations will result in fewer children receiving the care and nurturing they need in their earliest years, fewer children being ready for school, parents not able to work because they have no care for their children, higher unemployment , and reduced overall economic activity and productivity. Based on the proposed House cuts to School Readiness, the overall cost to the state is $54 mill-$99 mill in increased unemployment benefits, Medicaid, Food Stamps, and temporary cash assistance, not to mention the longer term costs associated with school failure and family dysfunction……….Please call your legislators today and urge them to maintain funding at least at this year’s levels.

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Elder Services at Risk

Some of the most vital, cost saving prevention programs for children, families, elders, and the developmentally disabled are at risk this year. The Legislature faces a daunting task as it tries to address a $3 billion shortfall. Since raising new revenues is not – at this time – on the table, the only other alternative is to cut services. Next week, your Legislative Link will highlight some of the proposed cuts to elder and disability issues. In the mean time, please read about the benefits of services provided by the Florida Aging Network highlighted by the Claude Pepper Foundation scholar in residence, Larry Polivka, Ph.D., as printed in the Lakeland Ledger on Monday.

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HMOization of Medicaid?

As legislators attempt to rein in skyrocketing Medicaid costs, one alternative to the traditional fee for service system has been moving more Medicaid patients into HMOs. With about an $18 billion budget, Medicaid covers 2.7 million Floridians (expected to grow another 5% next year) and pays for more than half the births in the state, provides care to about 25% of Florida’s children, and pays for 63% of the state’s nursing home care. 

On Thursday, the Senate Health and Human Services Appropriations Committee unveiled a proposal to start requiring Medicaid recipients in 19 counties to enroll in managed-care plans during the next year, with additional counties to be added over the following 18 months.

Is requiring Medicaid patients to get their care through HMOs a wise decision that will result in better care and save money? Bob Sharpe, President & CEO of the Florida Council for Community Mental Health and past Florida Medicaid Director provided his views about expanding Medicaid HMOs in Chain Reaction, the newsletter of Florida Chain , which is a statewide network organizations dedicated to improving the health of all Floridians by promoting sustainable access to affordable, effective health care. 
 

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Medicaid Waiver for Alzheimer’s to Sunset

In 1993, the Florida Legislature created the Medicare Alzheimer’s Waiver (MAP), which provides 11 essential services to people suffering from the disease to delay or avoid institutionalization. Florida has the largest population of Alzheimer's patients in the nation and the waiver allows Medicaid to pay for community-based care for Alzheimer's patients in the state. Unfortunately, the MAP is due to sunset in May. Although the program is only available in four counties, Broward, Miami-Dade, Palm Beach and Pinellas, it is the type of program that we know saves money and preserves the quality of life for the people receiving its services. To learn more about the MAP and what you can do to help with its reauthorization, visit the Alzheimer’s Community Care website at http://www.alzcare.org/AlzMedicaidWaiver.

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Florida Prosperity Caucus Meets

On Wednesday, Representative Alan Williams convened the inaugural meeting of the Florida Prosperity Caucus (FPC). Supported by the Florida Prosperity Partnership, the United Way and others, the caucus will focus on supporting collaborations across the state that are focused on providing life enhancing services to Floridians, particularly those that improve financial management skills. The caucus will also address public policy issues relating to consumer protection from predatory lending, restructuring public benefit asset limits to more appropriate levels, and expanding access to quality, culturally competent health care.
 

Representative Williams is chairing the Coalition and already 15 legislators – on both sides of the aisle – have joined. Representative Saunders, Geraldine Thompson, Steinberg, Braynon, and Pafford joined Wednesday’s meeting. The United Way applauds the vision and commitment of all Legislators who have joined the Coalition. Their recognition of the opportunities we have to help many Floridians “learn how to fish” will result in a better quality of life for individuals, families, and communities across the state.
 

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Census: More Dollars for Florida?

Many of the largest funding streams coming from the federal government to Florida are based on population and demographic figures generated every 10 years by the census. On Monday the Census Bureau began mailing advance letters to about 120 million addresses nationwide in an effort to boost census mail-back rates and avoid costs associated with door-to-door visits; for every 1 percent increase in households that respond by mail, taxpayers save about $85 million in costs associated with door-to-door census efforts. The letters urge recipients to complete the 10-question census form when it arrives and to return it in an accompanying prepaid envelope. It is very important that you, your friends, family, colleagues, and the people your organization serves respond to this and other census inquiries. Billions of dollars in federal aid to Florida in coming years are at stake. To find out more about what you can do to ensure an accurate census this year, visit the US Census Bureau.

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BILLS HEARD THIS WEEK

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SCR 10 – Balanced Federal Budget

Senate Concurrent Resolution 10 calls upon Congress to convene a Constitutional convention to propose amendments to the U.S. Constitution to require the federal government to achieve and maintain a balanced federal budget and to limit the ability of the federal government to require states to expend funds. The resolution passed the Senate Judiciary Committee on Tuesday. Read Bill. 

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HB 91 – Adult Protective Services

On Tuesday the House Public Safety and Domestic Security Policy Committee, the committee substitute for HB 91. Among others, the bill replaces the terms, “disabled adults”, and “elderly persons” with the term “vulnerable adult”. It requires that the central abuse hotline transfer to the appropriate county sheriff’s office reports of known or suspected abuse of a vulnerable adult involving a person other than a relative, caregiver, or household member. The bill also clarifies that the Department of Children and Families may file a petition to determine incapacity in adult protective proceedings, and has access to Department of  Highway Safety and Motor Vehicles records for use in conducting protective investigations.   Read Bill. 

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CS/SB 214 – Autism Spectrum Disorder

SB 214 requires a physician to refer a minor whose parents suspect the minor has an autism spectrum disorder (ASD) to an appropriate specialist for screening, evaluation, or diagnosis. The bill requires health insurers and HMO’s to provide direct access to an appropriate specialist for the diagnosis of ASD. The bill also mandates health insurance policies and health maintenance organizations to provide at least three visits per policy year for the screening, evaluation of, or diagnosis of ASD. The bill was passed by the Senate Health Regulation Committee on Tuesday. Read Bill. 

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CS/CS/SB 316 – Booster Seats

Car crashes are the leading cause of child death.  Current Florida law requires children 3 years of age or younger to be secured within a baby seat when riding in a car. Unfortunately, children older than 3 who may be too big to fit in a car seat are often times secured in the car by a regular seatbelt.  Because of their height and or weight, these children are subject to serious injury (primarily liver, spleen and spinal cord injury) and even death because the seatbelt does not fit appropriately. Booster seats have been shown to reduce serious injury by 59% for these children.

CS/SB 316, which was passed the Criminal Justice Committee on Tuesday, requires the operator of a motor vehicle who is transporting a child who is 7 years of age or younger and is less than 4'9" to protect the child by properly using a crash tested, federally approved child restraint device. The bill specifies the device must be appropriate for the height and weight of the child, and may include a vehicle manufacturer’s integrated child seat, a separate child’s safety seat, or a child booster seat. Under the provisions of the bill, motorists will no longer be permitted to transport children age 4-7 years old with only a safety belt used as protection. An infraction will be a moving violation punishable by a fine of $60.00 plus court costs and add-ons, and by assessment of three points against the driver’s license. The requirement to use a booster seat does not apply to a person who is transporting a child age 4-7 if the person is transporting the child gratuitously in response to a declared emergency or immediate emergency involving the child or transporting a child whose medical condition necessitates an exception. Lastly the bill requires courts to dismiss a charge against the driver for a first violation upon proof of purchase of a federally approved child restraint device. The bill was passed by the Criminal Justice Committee on Tuesday. Read Bill.
 

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CS/CS/SB 532 – Domestic Violence Centers/Food Services Inspections

The Senate Children, Families, and Elder Affairs Committees passed CS/CS/SB 532 on Tuesday. The bill requires the Department of Health to inspect certified domestic violence centers and group care facilities that are licensed by the Department of Children and Family Services for compliance with food safety rules that apply to community-based residential facilities having five or fewer residents, regardless of the number of actual residents. The bill further provides that a certified domestic violence center that only provides food for it residents is not a food service establishment for purposes of restaurant regulations. Read Bill.

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HB 627 – Transitional Services for Youth

HB 627 permits the Department of Juvenile Justice (DJJ) to provide transition to adulthood services to youth in DJJ’s custody or supervision. Designed to increase a youth’s ability to live independently and become a self-sufficient adult, the services include; accessing a youth’s skills and abilities to live independently and become self-sufficient; developing a list of activities and responsibilities to be incorporated into the youths written case plan; providing information related to Social Security insurance benefits and public assistance; and to contract for transition to adult services, including residential services and assistance that allow the child to live independently of the daily care and supervision of an adult. The bill requires that transition to adulthood services must be part of an overall plan leaving to total independence of the child from DJJ’s supervision. Lastly, the bill also provides that youth who are judicated delinquent and who are in the legal custody of the Department of Children and Families are eligible to receive DCF’s independent living transitions services. The bill was passed by the House Public Safety and Domestic Policy Committee on Tuesday. Read Bill.  The Senate Companion bill, SB 1356 was passed by the Senate Children, Families and Elder Affairs Committee on Tuesday.  Read Bill.

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CS/SB 834 – Child Care Facilities

CS/SB 834 amends the definition of family daycare home and large family child care home to require that household children be included in the household capacity calculation of licensed family daycare homes and large family child care homes, whether on the premises or on a field trip with children enrolled in child care. The bill also requires persons advertising or publishing an advertisement for a child care facility, family daycare home or large family child care home to include in the advertisement the state or local agency license number or registration number of the facility or home. The bill was passed by the Senate Children, Families and Elder Affairs Committee on Tuesday. Read Bill.

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HB 923 – Homelessness

HB 923 was passed by the House Health Care Services Policy Committee on Tuesday. The bill creates and revises multiple sections of Florida law relating to homelessness including:
 

• Authorizes the ability of drivers to make $1.00 voluntary contributions to aid the homeless on thier applications and renewal forms for motor vehicle registrations and driver’s licenses ;
• Replaces the existing Emergency Financial Assistance For Housing Program with a Homeless Prevention Grant Program administered by local homeless continuums of care to provide emergency financial assistance to families facing the loss of their current home due to financial or other crisis;
• Limits the amount a lead agency may spend on administrative costs under a Prevention Grant; and
• Eliminates the Housing First Program.
Read Bill.
 

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CS/SB 1520 – Background Screening

CS/SB 1520 was passed the Senate Children, Families and Elder Affairs Committee on Tuesday.  The bill substantially rewrites the requirements and procedures for background screening of persons and businesses that deal with vulnerable populations; children, the elderly and disabled.  Among others, the bill:
 

• Provides that no person required to be screened may begin work until the screening has been completed;
• Requires all fingerprints be submitted electronically by July 1, 2012;
• Increases all level one screening to level two screening for persons working with vulnerable populations;
• Requires that volunteers working with vulnerable populations undergo a level two background screening;
• Adds career offenders, sexual offenders, and sexual predators to those individuals who may never apply for an exemption from disqualification.

The bill significantly increases the number of people who will need to undergo background screening prior to working with vulnerable persons. It will also require screening to be done using level two standards instead of level one.  Level one screening simply requires a name check against the state records while level two screening requires a fingerprint search against state and national records.  Level one costs $24.00 and level two costs $43.25. By increasing the cost in the number of persons subject to screening there will be an impact on employers and employees. Senate staff has anticipated that in most cases, the fees will be passed onto the employee.  Read Bill.   The House Companion bill, CS/HB 7069 passed the House Policy Council on Tuesday. Read Bill.

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