FDDC Capitol Update 7.3

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-----Original Message-----From: FDDC

Florida Developmental Disabilities Council, Inc.124 Marriott Drive, Suite 203, Tallahassee, FL 32301-2981Phone: / ~ Fax: ~ TDD / http://www.fddc.org/

This week is Children’s Week at the Capitol and Wednesday, April 2, 2008, is Autism Awareness Day. Facts about AutismDid you know?

1 in 150 children is diagnosed with autism 1 in 94 boys is on the autism spectrum 67 children are diagnosed per day A new case is diagnosed almost every 20 minutes More children will be diagnosed with autism this year than with AIDS, diabetes & cancer combined Autism is the fastest-growing serious developmental disability in the U.S. Autism costs the nation over $90 billion per year, a figure expected to double in the next decade Autism receives less than 5% of the research funding of many less prevalent childhood diseases Boys are four times more likely than girls to have autism There is no medical detection or cure for autism

Senate Bill 2654 by Senator Geller and House Bill 1291 by Representative Porth are bills called the Window of Opportunity Act because of the documented results of initiating therapies at an early age. The bills will:

Require health insurance plans to provide coverage for screening, diagnosis, intervention, and treatment of autism spectrum disorder in certain children. The bill prohibits an insurer from denying or refusing coverage or refusing to renew or reissue or terminate coverage based on a diagnosis of autism spectrum disorder. HB 1291 includes training provisions for child care personnel and procedures for early detection of Autism Spectrum Disorders. EFFECTIVE DATE: 01/01/2009.

SB 2654 has very good support in the Senate, however, HB 1291 has not yet been put on the agenda by Chairman Bean in the Healthcare Council. Please call or email

Chairman Bean and ask him to agenda this good bill and vote yes! Autism Speaks, the nation's largest autism advocacy organization, has undertaken a multi-state initiative to pass insurance coverage provisions for autism services. The 2008 initiative extends to Florida, California and Michigan. These are battleground states in the effort to compel commercial insurers to cover evidence-based, medically necessary therapies and services for individuals with autism.

Autism Speaks leadership began conversations with Governor Charlie Crist and key members of the Florida legislature in a bi-partisan effort to address the insurance coverage issue in Florida. According to the most recent Department of Education statistics, Florida ranks sixth in the United States in the number of children receiving services for autism.

Most states do not require private insurance companies to cover even essential autism treatments and services. In the absence of coverage, families often pay as much as they can out-ofpocket for services that can cost upwards of $50,000 per year. In the process, many risk their homes and the educations of their unaffected children – essentially mortgaging their entire futures. Autism Speaks, together with other autism advocacy groups, is working to change state insurance laws to require private health insurance policies to cover the diagnosis and treatment of autism spectrum disorders for individuals under the age of 21.

The insurance legislation supported by Autism Speaks specifically targets coverage of Applied Behavior Analysis (ABA) and other structured behavioral therapies, which are the most effective forms of treatment and have the best outcomes, both in human costs and in long-term economic benefits. Nationwide, few private insurance companies or other employee benefit plans cover Applied Behavior Analysis and other behavioral therapies. In fact, most insurance companies designate autism as a diagnostic exclusion, meaning that no autism-specific services are covered, even those that would be used to treat other conditions.

Agency for Persons with Disabilities Budget Update

This week the House Healthcare Council and the Senate Health and Human Services Committee unveiled their budget proposals

The proposed Senate budget for 2008-09 is $1.05 billion and the proposed House budget is $1.13 billion. The primary difference is that the House proposed $54 million dollars to replace nonrecurring funds provided for in 2007- 08 to help the agency avoid a deficit.

The Healthcare Council Chair, Representative Bean, commented that there may be challenges to the Tiered Waiver System legislated last year and expected to take effect later this year.

The Senate proposes a cap on Tier One or the most Medically Intensive individuals at $150,000 per person for a savings of 5.6 million dollars.

The largest reductions are the proposed 3% provider rate reduction in the House totaling $23 million and the 5.5% reduction in the Senate totaling $43 million. There is concern about the impact this may have on service availability and quality, particularly at the Senate level.

The most controversial budget decisions will not be reflected on the legislative budget proposals this year. The biggest issue is whether to allow a four tiered waiver system in its current form including proposed Rule language which will be Work-shopped on April 24, 2008.

The tiers are projected to provide a $120 million savings. Without these savings, the Agency will face a deficit in its Home and Community Based Serviceswaiver. Advocates are attempting to soften the impact of the tiers, particularly to individuals in the home. developmental disabilities in the family home.

SB 2654 - Relating to AutismSpectrum Disorder - GellerSummary-General Autism Spectrum Disorder; The "Window of Opportunity Act" would require health insurance plans to provide coverage for screening, diagnosis, intervention, and treatment of autism spectrum disorder in certain children. The bill prohibits an insurer from denying or refusing coverage or refusing to renew or reissue or terminate coverage based on a diagnosis of autism spectrum disorder. EFFECTIVE DATE: 01/01/2009.

Actions03/13/08 SENATE Referred to Banking and Insurance; Health Policy; Health and Human Services Appropriations; 03/18/08 SENATE Favorable with CS by Banking and Insurance; 8 Yeas, 0 Nays03/20/08 SENATE Committee Substitute (C1) Filed

03/27/08 SENATE On Committee agenda - Health Policy, 04/01/08, 3:30 pm, 301 S

Compare BillHB 1291 - Relating to Autism Spectrum Disorder - Porth

This bill includes additional language that requires training provisions for child care personnel and procedures for early detection of Autism Spectrum Disorders. 03/07/08 HOUSE Referred to Healthcare Council; Policy & Budget Council 03/18/08 HOUSE Favorable with 1 Amendment by Health Innovation; 4 Yeas, 3 Nays

SB 2684 - Relating to OptionalPayments for Medical Assistance- Crist

Summary- Optional Payments for Medical Assistance; This bill provides for Medicaid eligibility for certain persons with disabilities under a Medicaid buy-in program, subject to specific federal authorization. This program would allow people withdisabilities to go back to work without fear of losing their Medicaid, as long as they share in paying for their Medicaid services.

Actions3/20/08 SENATE Referred to Health Policy; Children, Families and Elder Affairs and Health and Human Services Appropriations

Identical BillHB 1311 - Relating to Optional Payments for Medical Assistance - 03/07/08 HOUSE Referred to Healthcare Council; Policy & Budget 03/13/08 HOUSE Referred to Committee on Health Innovation by Healthcare Council

HB 739 - Relating to Guardian Advocates for Persons with Developmental Disabilities-AmblerSummary- Guardian Advocates for Persons with Developmental Disabilities: This bill provides a list of persons from which court must select a guardian advocate and provides that the guardian advocate need not be represented by an attorney. It revises requirements for petition seeking appointment of guardian advocate and modifies who may be appointed counsel to person with developmental disabilities. It also revises powers and duties of guardian advocate with respect to financial accounting requirements.

Actions02/06/08 HOUSE Referred to Healthcare Council; Policy & Budget Council03/04/08 HOUSE Favorable with 1 Amendment by Healthy Families; 9 Yeas, 0 Nays03/28/08 HOUSE on Council agenda -Healthcare Council, 04/01/08, 8:00 am, Hall

SimilarSB 688-Relating to Developmentally Disabled/Guardian Advocates - Crist01/09/08 SENATE Referred to Children, Families, and Elder Affairs; Judiciary; Health and Human Services Appropriations02/20/08 SENATE Favorable by Children, Families, and Elder Affairs; 7 Yeas, 0 Nays03/25/08 SENATE Favorable with CS by Judiciary; 10 Yeas, 0 Nays03/27/08 SENATE Committee Substitute (C1) Filed; Now in Health and Human Services Appropriations

SB 2028 - Relating to Disabled SchoolStudents/Discipline - Duetch Summary -Disabled School Students/Discipline [sPCC]-This bill requires the training of school personnel concerning procedures for safely restraining students with disabilities in an emergency. Prohibits school personnel from restraining a student with disabilities for a behavioral intervention or when the student is prone. The bill also provides for parental notification of incidents of restraint and provides for an outside review committee.

Actions02/27/08 SENATE Referred to Education Pre-K - 12; Children, Families, and Elder Affairs; EducationPre-K - 12 Appropriations

Identical BillHB 1139 - Relating to Discipline of Students with Disabilities by Bucher03/02/08 HOUSE Referred to Schools & Learning Council

HB 1319 - Relating to Medicaid Utilization Management Program - RobersonSummary -General Medicaid Utilization Management Program-The bill deletes the provision requiring the Agency for Healthcare Administration to develop and implement utilization management program for Medicaideligible recipients for management of occupational, physical, respiratory, & speech therapies. There currently are plans to put therapy services for children age 0-21 into for-profit managed care. This bill would terminate those plans.

Actions03/07/08 HOUSE Referred to Healthcare Council; Policy & Budget Council03/13/08 HOUSE Referred to Committee on Health Innovation by Healthcare Council

Identical BillsSB 2238 - Relating to Medicaid Utilization Management Program by 03/07/08 SENATE Referred to Health Policy; Health Regulation; Children, Families, and Elder Affairs; Health and Human Services Appropriations

HB 91 - Relating to Disability History and Awareness – Cosponsors: Galvano, Kendrick, Kriseman, Sachs, Skidmore, andZapataSummary -General Disability History and Awareness-This bill authorizes district school boards to designate "Disability History and Awareness Weeks" during the first 2 weeks in October each year. The bill provides for students in all K-12 public schools to be provided disability history and awareness instruction. Encourages state postsecondary institutions to conduct and promote activities related to disability history and awareness.

Actions09/17/07 HOUSE Referred to Schools & Learning Council; Policy & Budget Council01/24/08 HOUSE Referred to Committee on K-12 by Schools & Learning Council03/18/08 HOUSE Favorable with 1 Amendment by K-12; 8 Yeas, 1 Nay03/19/08 HOUSE Now in Schools & Learning Council

SimilarSB 856 - Relating to Disability History and Awareness Pilot Project - FasanoCS Sponsors: Children, Families, and Elder Affairs

Actions01/24/08 SENATE Referred to Education Pre-K - 12; Children, Families, and Elder Affairs; Education Pre-K - 12 Appropriations02/20/08 SENATE Favorable by Education Pre-K - 12; 5 Yeas, 0 Nays 03/19/08 SENATE Favorable with CS by Children, Families, and Elder Affairs; 7 Yeas, 0 Nays03/20/08 SENATE Committee Substitute (C1) Filed03/21/08 SENATE Now in Education Pre-K - 12 Appropriations

SB 1570 - Relating to Medicaid Managed Care Pilot Program - LynnSummary-General Medicaid Managed Care Pilot Program. This bill provides exceptions to mandatory enrollment in the Medicaid managed care pilot program and provides for expiration of such exceptions. The bill requires the Agency for Health Care Administration (AHCA) to take on additional powers, duties, and responsibilities with respect to the pilot program. This bill requires that AHCA provide Medicaid recipients with certain information, such as, planned standards for granting services in excess of the plan's service caps. The language states that” Persons with developmental disabilities as defined by s.393.063 (9), children found to be dependent pursuant to s. 39.01(14), persons with severe and persistent mental illness, and recipients who meet the institutional or "ICP" level of care required for Medicaid nursing home care or enrollment in a Medicaid home-based or community-based waiver are excluded from mandatory enrollment in the pilot program until the service delivery systems described in the current statute have been developed and evaluated for a period of at least 1 year and until the Legislature expressly authorizes their mandatory enrollment.

Actions02/21/08 SENATE Referred to Health Policy; Health Regulation; Children, Families, and Elder Affairs; Health and Human Services Appropriations03/19/08 SENATE Favorable with 4 Amendments by Health Policy; 7 Yeas, 0 Nays03/20/08 SENATE Now in Health Regulation

SB 366 - Relating to Elderly Persons and Disabled Adults/Abuse & Neglect - Margolis Cosponsors: Fasano, Bullard (L)Summary -General Elderly Persons and Disabled Adults/Abuse and Neglect This bill reclassifies the offense of aggravated abuse of an elderly person or disabled adult from a second-degree felony to a first-degree felony. This bill also requires certified law enforcement officers to complete training in identifying and investigating elder abuse and neglect before June 30, 2011.

Actions11/28/07 SENATE Referred to Criminal Justice; Children, Families, and Elder Affairs; Criminal and Civil Justice Appropriations02/06/08 SENATE Favorable by Criminal Justice; 9 Yeas, 0 Nays03/19/08 SENATE Favorable by Children, Families, and Elder Affairs; 7 Yeas, 0 Nays03/20/08 SENATE Now in Criminal and Civil Justice Appropriations

Identical billHB 233 - Relating to Elderly Persons and Disabled Adults - Cosponsors: Ambler, Heller, Holder, Porth, Sachs

Actions12/12/07 HOUSE Referred to Safety & Security Council; Policy & Budget Council02/06/08 HOUSE Favorable by Homeland Security & Public Safety; 7 Yeas, 0 Nays02/20/08 HOUSE Favorable by Safety & Security Council; 12 Yeas, 0 Nays; Now in Policy & Budget Council03/18/08 HOUSE Favorable by Policy & Budget Council; 32 Yeas, 0 Nays03/19/08 HOUSE Placed on Calendar, on second reading.

SB 788 - Relating to Transportation Disadvantaged/Services - by FasanoSummary - General Transportation Disadvantaged/Services –This bill revises the number of members required for a quorum at a meeting of the Commission for the Transportation Disadvantaged and revises responsibilities for the commission. The bill requires the commission to incur expenses for the purchase of advertisements, marketing services, and promotional items. The bill revises and creates duties and responsibilities for agencies that purchase transportation services for the transportation disadvantaged.

Actions01/24/08 SENATE Referred to Transportation; Community Affairs; Transportation and Economic Development Appropriations03/04/08 SENATE Favorable by Transportation; 7 Yeas, 0 Nays03/13/08 SENATE Favorable by Community Affairs; 9 Yeas, 0 Nays; Now in Transportation and Economic Development Appropriations03/24/08 SENATE Transportation and Economic Development Appropriations Meeting canceled, 03/24/08, 4:30 pm;On Committee agenda - Transportation and Economic Development Appropriations, 03/25/08, 3:00 pm, 309 C03/25/08 SENATE Temporarily postponed by Transportation and Economic Development Appropriations03/28/08 SENATE On Committee agenda - Transportation and Economic Development Appropriations, 04/02/08, 8:30 am, 309 C

Similar billHB 1175 - Relating to Transportation Disadvantaged Services - by Robaina

Actions03/05/08 HOUSE Referred to Healthcare Council; Policy & Budget Council03/13/08 HOUSE Referred to Committee on Health Innovation by Healthcare

Public Policy Staff Contact:Margaret J. Hooper,Public Policy Coordinatormargaretd@... or

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