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Tax Reform.
It is critical that Florida develop a stable revenue stream that is
adequate to meet the needs of the state’s diverse and growing population.
Resource limitations are evident throughout the human services
delivery system in Sarasota County and affect every one of the Community
Alliance’s priorities for FY 2004. The
Alliance supports meaningful tax reform at the state level that will provide
sufficient revenues to meet the community’s needs.
Our preference is that the Legislature and Governor enact legislation
that would require a mandatory review of state sales tax exemptions.
If the Legislature does not take action on its own initiative, the
Community Alliance intends to vigorously support the Constitutional
Amendment referendum proposed by Floridians Against Inequities in Rates
(FAIR). In addition, the
Community Alliance urges the Legislature to enact legislation imposing a
state sales tax on internet sales.
Update: Tax reform was not addressed during the session and is still a
pending issue. The Community Alliance may now wish to take a formal
position supporting the proposed constitutional amendment.
Devolution/Unfunded
Mandates.
The Community Alliance continues to oppose any legislation that would
shift responsibility for human service programs from the state to the local
government level that does not include a corresponding transfer of funds to
local governments or other new mandates on local governments for which funds
are not provided by the state. A
prime example of such an unfunded mandate is the proposal in the
Governor’s Budget Recommendation for FY 2004 to shift to county
governments the costs of operating the state’s juvenile justice detention
facilities (see below). The
Community Alliance supports the legislative agenda of the Florida
Association of Counties and its affiliated groups on the issue of unfunded
mandates.
Update:
The DJJ cost shift to the counties passed. The impact to Sarasota County
will be $1.1 million.
Elimination
of KidCare Program Waiting Lists.
The Community Alliance supports full funding of Florida’s KidCare
Program to eliminate all waiting lists statewide, permit year-round open
enrollment, and continue funding for program outreach.
Federal funds already made available to the state for this purpose
should be utilized immediately to begin enrolling children who have been
placed on the waiting list since enrollment was capped last year [statewide,
the waiting list has now grown to over 100,000 children, with 2,000-3,000
children being added each week; in Sarasota County, the waiting list had
grown to 1,519 children by February 20, 2004].
The Alliance opposes provisions in SB 2000 and/or HB 1073 which would
limit open enrollment to only two 30-day periods each year; would eliminate
the policy of keeping a waiting list; would eliminate any capacity for
program outreach; and would change the policy for dental coverage to be
permissive rather than mandatory. Most
importantly, the Alliance opposes any policy change which would deem
ineligible for KidCare any child whose parent has access to employer-based
health insurance without taking into consideration the family’s ability to
afford the insurance premiums for that coverage.
Update: Legislation passed which removed children who were on the waiting
list as of March 12; however, the KidCare program no longer keeps a waiting
list of applicants for the program. There will be two open enrollments per
year if funds are available. The next open enrollment will be held in the
Spring of 2005 as the decision has already been made that funds are not
available for the September 2004 open enrollment.
Replacement/Restoration of Funding
for Substance Abuse Services.
The Florida
Legislature utilized $20 milliion in non-recurring federal block grant funds
to fund community-based substance abuse prevention and treatment services
through the Department of Children and Families in the FY 2003-04 budget.
These funds represented the full federal block grant trust fund
balance and will not be available for FY 2004-05.
As a result, these funds must be replaced with General Revenue funds
in the coming year simply to maintain the current level of
services—otherwise, an estimated 6,000 individuals will lose services.
Similarly, the Legislature cut $7.5 million in funds from the
Department of Corrections’ FY 2003-04 budget for substance abuse treatment
programs. This cut in
residential treatment capacity directly impacted Sarasota County, with an
estimated 25 offenders forced to remain in jail and unable to receive
substance abuse treatment services offered through First Step of
Sarasota’s “Choices” program. The
Community Alliance supports the full replacement of the $20 million in
non-recurring federal funds to maintain the current level of community-based
substance abuse prevention and treatment services and restoration of the
$7.5 million cut in funding for residential treatment programs.
The Governor’s Budget Recommendation for FY 2004 includes $17.8
million to replace the non-recurring federal funds and $4.1 million to
restore the previous cuts in funding for residential treatment programs.
Update: A total of $17.5 million ($8.5 million to support the criminal
justice system and drug courts and $9 million as a lump sum) in nonrecurring
funds have been replaced with a significant amount of recurring state
general revenue. In addition, $5,027,099 in recurring general revenue was
provided for Adult Substance Abuse Prevention, Evaluation and Treatment
Service.
Additional Funding for Crisis
Stabilization Unit Beds.
Last year the Community Alliance conducted an analysis of Sarasota
County’s acute care system and subsequently established an Acute Care
System Task Force to implement the recommendations arising from the study.
Although many of the report’s recommendations address the need to
better coordinate the elements of the community’s acute care system, it
also confirmed that the County’s designated Baker Act public receiving
facility is running over capacity virtually every day.
As a result, indigent patients are being diverted to private
receiving facilities in both Sarasota and surrounding counties.
When beds are not available at these facilities, the overflow of
patients ends up in Sarasota Memorial Hospital’s emergency room
(compromising the hospital’s ability to provide acute medical care) or in
the county jail. Based on the
Department of Children and Families’ own formula for determining a
community’s needed capacity for crisis stabilization unit beds, Sarasota
County was short 3.5 beds—even before the closing of G. Pierce Wood
Memorial Hospital in 2002 and the closing last year of Bons Secours
Hospital’s private receiving facility, both of which have increased demand
for CSU services. The Community
Alliance supports increased funding for additional CSU beds in Sarasota
County, as well as an increase in DCF’s per diem reimbursement rate
for CSU services. The
Governor’s Budget Recommendation for FY 2004 includes $14 million for 235
additional CSU beds statewide, but none of these funds are targeted for
DCF’s SunCoast Region which includes Sarasota County.
Update: No additional funding was received.
Increased Funding for the Community
Care for the Elderly Program.
The state’s
Community Care for the Elderly (CCE) Program, funded through the Department
of Elder Affairs and administered locally by Senior Friendship Centers,
provides an array of services—including care management; homemaker,
personal care, and respite services; and adult day care services—designed
to support “aging in place” and keep frail elders out of institutional
care and in their homes and neighborhoods with family and friends.
Payment for services is on a state-mandated sliding fee scale, with
all co-payments utilized to expand service provision, and a 10% local match
is also raised to help fund the program.
The CCE Program has received insufficient funding increases in recent
years to enable it to keep pace with the rapidly escalating rate of older
Floridians in need of such services: a
recent statewide waiting list for CCE Program services listed 16,817 frail
elders. In Sarasota County,
where the population aged 75+ has grown by 34% over the past decade—making
Sarasota the “oldest” county in the nation with a population over
200,000—there was a waiting list of 423 persons for CCE Program services
in November, 2003. During the
same period, the population aged 85+ grew by 53% in Sarasota County.
In many respects, Sarasota County is “ground zero” for the Aging
of America. As such, the
Community Alliance strongly supports an increase of at least 5% in the state
funding for the CCE Program. The
Governor’s Budget Recommendation for FY 2004 proposes no increase in
funding for the CCE Program.
Update: No additional funding was received.
Cost Shift for Operation
of Juvenile Detention Centers.
The Governor’s Budget Recommendation for FY 2004 proposes to shift the
cost of operating the state’s 25 juvenile justice detention centers to
county governments. According
to the Department of Juvenile Justice, the state would withhold county
revenue sharing dollars based on the actual cost of housing the county’s
youth held in predisposition detention.
The state would continue to operate the facilities, but the counties
would pay the bill: $90 million statewide, $1.1 million for Sarasota County.
The Community Alliance strongly opposes this unfunded mandate.
Update: The DJJ cost shift to the counties passed. The impact to Sarasota
County will be $1.1 million.
Increased Funding
for the Healthy Start Program.
The state’s Healthy Start
Program, funded through the Department of Health and administered locally by
Healthy Start Coalitions, provides an array of services to at-risk mothers
and their babies designed to ensure healthy pregnancies and improve birth
outcomes. Although often
heralded as the shining star in Florida’s health crown, the Healthy Start
Program has received insufficient funding increases in recent years to
enable it to keep pace with the increasing number of women seeking care:
it is estimated that today only 30% of the need for Healthy Start
services is being met. Moreover,
the cost of providing services has continued to increase without
corresponding increases in funding levels. As a result, fewer persons are being served, and this has
been reflected in rising statewide infant mortality rates since 2001.
The Community Alliance supports a $9.5 million increase in state
funding for the Healthy Start Program, which would draw down an additional
$5.5 million in federal Medicaid funds and enable an additional 24,0000
women to be served statewide. The Governor’s Budget Recommendation for FY 2004 proposes
no increase in funding for the Healthy Start Program.
Update: No additional funding was
received.
Continuation Funding for
Mothers and Infants Program. First Step of Sarasota’s
Mothers and Infants Program was created in 1995 to address the growing issue
of drug-exposed newborns. Funded
initially through the Department of Children and Families, the program
provides residential treatment in a safe, secure environment for pregnant,
substance abusing women with a goal of healthy, live births with no drug
presence in the newborns. While
awaiting the birth of their babies, women in the program receive intensive
treatment for their addiction as well as vocational training and classes in
parenting and daily living skills designed to ensure a successful reentry
into the community with stable housing and employment.
The program has been remarkably successful, with 100% of the 123
babies born to program participants being drug-free at delivery.
Last year, the Mothers and Infants Program was awarded a “Best
Practices Award” by the Florida Alcohol and Drug Abuse Association.
The program’s annual operating budget is approximately $600,000,
serving 18-20 clients with an average length of stay of eight months.
DCF funding for the program was lost in FY 2002 when Sarasota County
was shifted from District 8 to the SunCoast Region.
The program was able to secure continuation funding that year as a
special project funded through the Department of Health.
Last year, however, the Department of Health determined that the
program was not consistent with the agency’s core mission and reduced its
funding by 50% for FY 2003. Sarasota
County Government and the DCF SunCoast Region stepped in and awarded
“one-time” contracts to First Step of Sarasota to enable the
organization to continue the program. For
FY 2004, however, neither DCF nor DOH has included funds in its budget for
the Mothers and Infants Program. Given
the demonstrated results of this program and its strong benefit/cost ratio,
the Community Alliance supports the restoration of state funding for the
program as a legislative priority in FY 2004.
Update:
First Step of Sarasota will receive $500,000 to fund the Mothers and Infants
Program.
Additional
Legislative Updates:
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