More eyes will be on the Department of Health’s (DOH) handling and performance with Early Steps if the Florida Senate gets its way. The Senate is responding to outcries from parents and the advocacy community – including The Children’s Campaign – who brought the crisis forward and questioned DOH’s commitment to the program over a several year period.
Research shows that early intervention is crucial for children with developmental concerns. Prior to funding cuts in recent years, Florida’s Early Steps program served children at-risk of developmental delays to help provide necessary services when they would make the largest impact. Today, the program primarily serves children with “significant delays or an established medical condition that will likely result in a delay.”
DOH has a spotty record during its more recent administration when it comes to protecting and prioritizing children’s health. In October, Department of Health (DOH) Chief Operating Officer Jennifer Tschetter faced probing questions about the agency’s treatment of special-needs and medically needy children after thousands of children were screened out of Children’s Medical Services Network (CMS Network) into less expensive (for the state) Medicaid managed care. Last February, the size of the Early Steps administrative team was cut from 23 people to only five.
Additionally, the Early Steps providers have expressed difficulties in performing effectively or in a timely manner due to being overworked and under paid. Mary Alice Nye, chief legislative analyst from OPAGGA presented research findings to the Senate Children and Elder Affairs committee. The OPAGGA report showed that timeliness of services could be improved by focusing on contributing factors such as finding reliable transportation for appointments and caseloads. In interviews at Early Steps offices, OPPAGA learned caseloads were as high as 70 to 80 families per service coordinator.
The Senate committee is proposing SB 7034 in response. This bill will expand the duties of the DOH’s clearinghouse, create goals for the program and its 15 local offices, and require the creation of a statewide plan, accountability reports, and adherence to performance standards. Additionally, the bill will designate the Florida Interagency Coordinating Council for Infants and Toddlers as the statewide multiagency council and expand eligibility to all Florida newborns with a developmental disability.
The bill is an extension of the work pledged by Senate President Gardiner (R- Orlando) to focus services for those with disabilities. Senator Sobel says, “This bill is a step in the right direction.”
The support for Early Steps is a welcome change for a program that was a razor’s edge away from losing funding and was saved at the last second in budget negotiations. Even DOH appears to be on board, stating in a letter to Senator Sobel, “the sooner early intervention services are provided, the greater chance for a positive outcome for the child and family.”
Committee Advances “Child’s Best Hope Act”
A recent change to Florida’s law that was intended to shorten the path to permanency for children in the child welfare system has resulted in unintended consequences.
The goal was to encourage parents who did not believe that they could complete their case plan to start the path toward permanency by giving them a voice in where and with whom their child would ultimately end up.
Unfortunately, parents who are failing to complete their case plan are waiting until the last second to have a say in who will step in as guardian. Their choices often appear to be based on a desire to distance their child from the bond formed with their foster family, or to continue to allow parents to have a presence in their child’s life even if that is not in the best interest of the child.
SB 590 by Senator Detert (R- Venice), while allowing the court to consider the parent’s desire, would give judges the authority to decide what placement is in “the best interest of the child.” The bill also requires that parents are provided the option of moving towards a permanency goal of adoption while approving their case plan, rather than after it has been determined that reunification is not a viable option.
The bill, which is being referred to as the “Child’s Best Hope Act,” was heard in the Senate Children, Families, and Elder Affairs committee and passed unanimously.
Addressing the committee, Detert said that currently “even a parent who has murdered a spouse, committed egregious acts against their children or who wishes to punish a foster parent…can choose who their child should be placed with — without requiring the court to consider what is in the best interest of the child.”
In the meeting, members heard tearful testimony from foster parents who have witnessed the devastating consequences the current law has on foster children.
Over 4,600 people signed a petition which was circulated with the support of The Children’s Campaign to show support for the change in law to the “best interest standard.” According to Alan Abramowitz, executive director for the state’s Guardian ad Litem program, the current law, “negates the essential truth that blood doesn’t make a family, love does.”
The House companion, HB 673 by Representative Adkins (R- Fernandina Beach), was filed on 11/16.
Juvenile Record Bills on the Move
This past week, several bills backed by The Children’s Campaign that create crucial reforms within the juvenile justice system continued to move through the committee process. HB 147 sponsored by Representative Chris Latvala (R – Clearwater), provides for the expunction of non-violent, non-habitual juvenile offenders’ criminal histories after a specified period was unanimously passed in the House Justice Appropriations subcommittee on Wednesday. Its companion bill, SB 386 sponsored by Senator Detert (R – Sarasota), was previously passed in the Criminal Justice subcommittee and is now scheduled to be heard in the Appropriations Subcommittee on Criminal and Civil Justice.
HB 293 sponsored by Representative Pritchett (D – Miramar), which will strengthen confidentially standards for juvenile offenders, passed unanimously in the Criminal Justice Subcommittee. It is now headed to the Subcommittee on Government Operations. Its companion bill, SB 700 sponsored by Senator Sotto (D – Kissimmee), has been filed and referred to the subcommittee on Criminal Justice.
Florida’s Childcare Facilities at Risk of Losing Millions in Federal Funds
Last Wednesday, the House Education Committee heard discussion about Florida’s compliance with the Child Care Development Block Grant (CCDBG). The CCDBG allocates $369 million in federal matching dollars for a $98 million investment from the state to programs that provide childcare services for low-income family members who work, train for work, attend school, or whose children receive or need protective services. These federal funds are at risk of ending if Florida does not make necessary standards changes to bring them into compliance with the updated federal law.
Legislation that would have addressed these issues has moved through the process in previous years, but ultimately failed due to special interests attaching their agendas to the legislation. The bill focuses on the areas where Florida is out of compliance, including employee screening requirements, health and safety checklist, training requirements, and monitoring and inspection.
The bill as yet unnumbered seems to be on track to pass through the process quickly. That is important because as of now, families earning just under $20,000 a year would be spending about 50% of their income on childcare without childcare readiness help. The grants provided to income-eligible families, reduce this rate to just 7%. Over 224,000 children attend childcare with assistance from the CCDBG.
Expanded Coverage to Legally Residing Children Has Yet to Be Heard in House
HB 89 was referred to the Health Innovation, Health Care Appropriations and Health & Human Services committees in September but has yet to be scheduled to be heard. If the pattern continues, it would be a repeat of last year’s legislative session, in which the bill completed the path through the Senate but died in the House.
The Senate version, SB 248, is moving smoothly. Introduced by Senator Garcia (R – Hialeah) for the fifth time, the bill would provide medical assistance funding for redefined “lawfully residing children” within the state. If passed, SB 248 will benefit the private sector and the state’s citizens by reducing uncompensated health care costs that are either shouldered by providers and/or passed onto the public.
Foster Care Under the House Spotlight
The now two session long debate about children in foster care and group homes is simmering again. Last Wednesday, the Children Families and Elder Affairs subcommittee heard testimony and listened to a series of presentations about child welfare and out-of-home care by the Legislature’s Office of Program Policy Analysis and Government Accountability (OPPAGA) and Florida’s Children First.
The number of kids entering foster care is slowly increasing, up now to about 22,000 after years of decline. Many attribute the increase to child welfare law changes and continued response to the investigative reports by the Miami Herald about hundreds of children who died despite their previous contact with the Department of Children and Families (DCF).
Of the children currently within the foster care system, 55 percent reside with relatives or family friends, 28 percent are in family foster homes, 7 percent are in group care and 3 percent are in therapeutic foster care. The remaining children reside in residential treatment, emergency shelters or hospitals, or they have run away from their placements. As the strain on the system intensifies, lawmakers are studying placement options with an eye toward improving outcomes and fiscal impacts.
Former foster child Nell Smith grew up within the system and lived in a group home for most of her time in foster care. Commenting on her personal experience, she told the committee that group homes work better for some children, and that family homes are not the best fit for every child. She believes that group homes helped her to foster different kinds of relationships with mentors and adults that were very beneficial as she grew into adulthood.
Also brought forward was the low reimbursement rate to foster families who receive only $15 daily. Representative Hager (R – Delray Beach) articulates, “anyone who has raised children … would understand that $15 is wholly insufficient.”
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