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Behavioral Health Overlay Services (BHOS) in child welfare settings include mental health, substance abuse and supportive services designed to meet the behavioral health treatment needs of recipients placed in the care of a Medicaid-enrolled, certified residential group-care organization. These organizations are under contract with the Department of Children and Families (DCF), child welfare and community based care organizations. Since 1998, the service has been approved for a rate of $32.75 per day. BHOS provider organizations must meet stringent requirements established by the Agency for Health Care Administration (AHCA) for staff levels, policies and procedures, and training in order to be approved and certified as a BHOS provider. Children’s Home Society of Florida and other providers meet the behavioral needs of youth more effectively and reduce more costly treatment programs by using BHOS. Since 1998, the rate of reimbursement for organizations has continued at $32.75 a day and can be billed for seven days a week. The rate and number of statewide available beds has also remained the same since 1997; the number of slots throughout the state is 1,417. BHOS is unique and serves a unique population of youth by providing individual and group therapy and behavior management services when a child needs it. The wrap-around services provided through BHOS allow staff to truly treat the child at the time of need, rather than waiting until an appointment is available. Instead of only receiving one hour of individual therapy a day (per the Medicaid plan), youth can receive services that best meet their needs.
Early Steps is administered by Children's Medical Services (CMS) within the Department of Health in accordance with the Individuals with Disabilities Education Act (IDEA), Part C. The Early Steps program serves Florida’s infants and toddlers from birth to 3 years old who have a developmental delay or a condition that places them at risk for developmental delay, by providing early intervention services and supports intended to improve a child’s chances to develop to full potential by achieving developmental milestones. These milestones are essential to develop a child’s ability to learn, speak, and move at critical periods that research shows leads to optimal abilities later in life. Services are provided in the context of everyday relationships, activities and places.
The waiver proposal was developed jointly by the Department of Children and Families (DCF) and its community based care lead agencies and was approved by the U.S. Department of Health and Human Services' Administration for Children and Families (ACF) in April 2006. Florida is the only state in the nation to receive the waiver for Title IV-E; California has two counties that participate. The waiver allows federal foster care funds to be used for any child welfare purpose rather than being restricted solely to funding out-of-home care, as generally required under federal law. Thus, it enables funds to be used for a wide variety of child welfare services including prevention, intensive in-home services to keep children safe in their own homes, reunification and foster care. Prior to the waiver, Florida could only use IV-E monies for services to children already removed from their homes. Pre-waiver, the IV-E formula essentially created a disincentive to reunifying children with their families and to keeping children from ever entering the foster care system. The 2006 waiver agreement stipulated that Florida must meet a consistent funding commitment to children’s services and, by complying, would receive an annual 3% return; this commitment was capped using the number of children in care at the time of signing. Since 2006, Florida has made great progress in reducing the number of children in care but still receives steady funding from the federal government due to the waiver’s annual 3% return. The waiver was set to expire September 30, 2011; however, with much advocacy and support from Florida’s DCF, community based care lead agencies and child welfare providers from around the state, the U.S. Department of Health and Human Services Administration on Children and Families (HHS ACF) recognized the accomplishments and issued a temporary extension of Florida’s waiver until July 31, 2012.
Child Protection Teams are administered by Children's Medical Services (CMS) within the Department of Health. The Child Protection Team program operates on the premise that child abuse and neglect is a multifaceted problem requiring multidisciplinary evaluation. Child Protection Teams save lives and improve the well-being and health of Florida’s children by providing expertise in evaluating alleged maltreatments of child abuse and neglect, assessing risk and protective factors, and providing recommendations for interventions to protect children.