Traditionally, a new year begins with resolutions – ways to make lives healthier, better, more fulfilling – many involve health. People are resolving to eat better, exercise more, visit the doctor regularly, or pay better attention to getting and staying healthy. Health and its impact on Florida’s children is no exception and has been in the spotlight. In the final week of 2014, federal Judge Adalberto Jordan found that Florida did not comply with parts of Medicaid law which led to lack of access to care for many children enrolled in Medicaid.
Specifically, the opinion detailed: low reimbursement payments to doctors, issues with getting treatment from specialists, children being improperly terminated from the program, lack of available dental care, and reduction of state effort to sign up eligible children. Remedies will be decided in a future phase of the case.
The State is arguing that the program has changed and should be judged on the current version rather than the model in place when the case was filed. State officials are referring to the Medicaid overhaul which now enrolls almost all beneficiaries in managed care plans.
Lack of appropriate coverage for children under Medicaid is not the only issue facing Florida’s health care system. The state has forfeited approximately $51billion because it failed to expand Medicaid, and ranks 51st among the states and the District of Columbia in per capita funding received from the Affordable Care Act, having forfeiting at least $300 million in tax revenue.
A coalition of business and health care groups are making the case that Medicaid expansion would save the state and employers money. They are promoting “A Healthy Florida Works”. According to the coalition, the program is essentially a compromise between last year’s House and Senate proposals to cover an additional million uninsured Floridians, but it is more like a true expansion of the state’s existing privatized Medicaid program.
According to the Baker Institute Policy Report from the James A. Baker III Institute for Public Policy of Rice University, not only does research show that insurance to low income pregnant women and children increased spending on other consumer goods by approximately $800 per family, but lifetime health capital lost due to lack of child health insurance is $15,572 for each male and $11,646 for each female.
The report states that “lack of insurance coverage for children leads to poorer health in childhood, greater rates of avoidable hospitalizations, and higher childhood mortality,” and “better health in childhood has been linked in adulthood to higher incomes, higher wealth, more weeks worked, and a higher growth rate in income.”
In a presentation to the Senate Agriculture Committee, Robin Safley, Director of the Division of Food, Nutrition, and Wellness presented on Florida’s Roadmap to Living Healthy program. It’s a new way of looking at information about health and nutrition in Florida. The data can help find and serve children who are hungry, especially during the summer months when they lose meals provided in school. The data is providing information about proper diet and nutrition and their combined impact on a child’s life. The program is a first step to addressing the root causes of hunger and keeping children from going without.
Discussion on health will continue well into the New Year. Hopefully, unlike most resolutions that go by the wayside, keeping Florida’s children healthy will continue to be a priority.
Governor Scott Begins Second Term
Governor Rick Scott’s 2015 inaugural speech was an echo of the vision he has touted for the past four years: cutting taxes, creating jobs, and education improvement. He pledged to “cut another $1 billion in taxes in the next two years and roll back the business tax while permanently eliminating the tax on manufacturing equipment,” while Florida remains 45th in percent of children with health insurance, and 44th in child food security.
Florida is also 41st in per pupil spending in education. As Governor Scott begins to roll out his 2015-16 recommended budget, he has announced a proposed increase of $842.5 million in funding for K-12 public schools and a per pupil funding increase of $126 (total $7,176). The recommended per pupil funding is $50 higher than the highest level found in 2007-08, and approximately $1,100 lower than the national average.
When Governor Scott’s recommended budget is released in the coming weeks, it will be interesting to see how he intends to reconcile his tax plan with the vast unmet needs of the state. What will be included? What will be left out? We will report the full details in upcoming publications.
The Department of Children and Families presented at both the Senate Children, Families & Elder Affairs and Health and Human Service Committees for the first committee week of 2015. Presentations included an update on the budget increase to support the reform of last Session, and a review of areas of focus and the impact of the policy change.
The presentation in the HHS committee was very number heavy – resulting in a spirited interaction between Sen Sobel (D- Hollywood) and Geoffrey Becker, Assistant Secretary for Administration. Sen. Sobel wanted to be certain she understood where the new dollars were going and requested paperwork to back up the presentation.
In his presentation to the Children, Families and Elder Affairs committee, which appeared to be well received, DCF Secretary Mike Carroll focused on the website which tracks child deaths in Florida and stated that reducing child fatalities was the number one priority of the Department. It wasn’t completely clear, however, how many of the new child protective investigator positions have been filled, when subtracting the continuing turnover among frontline staff from the new hires.
Carroll also said that “real fundamental changes need to be made” in reference to mental health. Senator Garcia (R – Hialeah) agreed, stating, “It’s a serious problem not only this state but the nation is facing.”
Helping Minors Provide Proof of Sexual Abuse
Last month, the Florida Supreme Court overturned the child sexual abuse conviction of Richard McDade on the grounds that the secretly recorded evidence provided by his 16-year old stepdaughter, should not have been allowed at the trial. Florida law explicitly bans the use of secret recordings as evidence.
Child sex abuse is often difficult to prove. There may not be any physical evidence, and when a parent is the perpetrator they can prevent the victim from getting help. That’s what happened in the McDade case: the victim had reported the abuse to her mother and other caregivers for years without anyone believing her. The recording was her tool to prove what she had been saying all along.
Rep. Jared Moskowitz (D-Coral Springs) is proposing a bill that will help abuse victims get a chance at justice. HB 131 will create an exception to the current law so that secret recordings could be used in child sexual abuse prosecutions. This bill will allow children to provide proof needed to protect themselves.
Other Filed Legislation…
There is a marked downturn of legislation being filed concerning children. Last Session at this time, more than 55 bills had been filed. So far this year there are about 25. This is due in large part to late committee assignments and the pace is expected to pick up.
Here is a brief sampling of currently filed legislation:
Children with Disabilities:
HB 23 by Rep. Janet Cruiz (D-Tampa) requires physicians to refer minors to appropriate specialists for screening for autism spectrum disorder and it requires certain insurers & HMOs to provide direct patient access to specialists for screening, evaluation, and diagnosis of autism spectrum disorder. HB 23 is currently in the Health Innovation Subcommittee.
HB 153 by Rep. Larry Lee Jr. (D-Fort Pierce) requires the Office of Early Learning to establish a pilot project in St. Lucie County to assist low-income, at-risk children in developing emergent literacy skills. Last session, this bill passed the House but not the Senate. HB 153 bill is currently in the House Choice and Innovation Subcommittee.
HB 99 filed by Rep. Gwyndolen Clarke-Reed (D-Pompano Beach) requires that a law enforcement officer, upon making contact with a first-time juvenile offender who admits having committed a misdemeanor, issue a civil citation in certain circumstances. This bill was submitted on 12/12/14, and has yet to be referenced to a committee.