Historical Background of the Need for the Florida Health and Human Services Board.

In 1969 the Florida Legislature established the Florida Department of Health and Rehabilitative Services (HRS). Its legal basis is described in Chapter 20.19, F.S. The secretary of HRS was appointed by the governor and confirmed by Senate. The secretary served at the pleasure of the governor.

 

The duties of HRS were to administer State programs relating to adult corrections, youth services, mental health, alcoholic rehabilitation, retardation, vocational rehabilitation, blind services, family services, public health, crippled children, tuberculosis, pest control, community hospitals and medical facilities, public welfare, and aging.

As Florida’s population grew rapidly, some broadminded and farsighted, legislators saw the need for local citizen input into planning and evaluating the wide range of services that were being offered by the then massive Department of Health and Rehabilitative Services

In 1992 the Florida Legislature established within each of the fifteen administrative districts of the department a district health and human services board.( 20.19(7), F.S.). The duties of the district health and human services boards were to help the district administrators plan and evaluate the services offered in their local area by doing needs assessment and expressing local priorities.

In addition to those duties related directly to services within each district, the health and human services board served as the search committee when a vacancy occurred in the office of district administrator. The replacement was then appointed by the Secretary of the Department.

At that same time, 1992, the legislature also established a Statewide Health and Human Services Board, analogous to the previously existent statewide Board of Health, The new statewide board was described as follows in FS 20.19: STATEWIDE HEALTH AND HUMAN SERVICES BOARD.--There is created the Statewide Health and Human Services Board consisting of the chairs of the district health and human services boards or their designees. The statewide board shall meet at least twice annually and as needed, upon the call of the secretary. The statewide board shall advise the secretary on statewide issues and identify barriers to and opportunities for effective and efficient local service delivery and the integration of health and family services. Each member attending these meetings is entitled to receive reimbursement for per diem and travel expenses as provided in s. 112.061.

The members of the health and human services boards were selected as follows: After screening by a broadly representative local Nominee Qualifications Review Committee, the members were appointed, the majority by their local County Commissions and a few by the Governor to assure representation of minorities, etc.

As mentioned, the Statewide Health and Human Services Board was composed of representatives of each of the district boards, and the Statewide Board obviously advised the Secretary.

During the last decade of the twentieth century, the department in partnership with these boards (district and statewide) were trying to improve a very complex and seriously under-funded system of prevention and care for those who are often referred to as “our most vulnerable citizens,” children at risk of abuse, neglect, and delinquency, and adults at risk of disabilities, substance abuse, mental and emotional illness, poor health and, of course, poverty.  

In a series of assaults that prevented the natural development of a good system that might have better protected thousands of children and adults, the Florida Legislature broke up the Department of Health and Rehabilitative Services, separated out juvenile services, then child support enforcement, then health services, then children’s medical services, and still underfunded what was left under the label Children and Family Services.

In 1996 the Florida Legislature passed a stringent welfare reform act (WAGES) that forced single mothers to go to work, leaving their children in the care of others. In 1998, the Florida Legislature passed a sweeping "Privatization of Foster Care and Related Services Act.” The next year they passed a 1999 "glitch" bill intended to correct some of the worst of the 1998 act, but still put little money into services for children and families.

The 2000 Florida Legislature passed more bills, changing the word "privatization" into the phrase "community based child welfare," and, worst of all eliminated the watchdog health and human services boards, replacing them with "community alliances," forcing still another unfunded mandate on local communities, and reorganizing the remains of the Department of Children and Families into "regions" quite removed from local communities. That same 2000 Florida Legislature reorganized the WAGES programs into Work Force Florida, focusing sharply on employment statistics while weakening the social aspects of welfare reform. They also reduced the funds intended for prevention of juvenile delinquency and put those funds, instead, into more incarceration facilities.

So far, all this change has been chaotic, dismantling service systems before replacements are developed. With the Health and Human Services Board eliminated, there has been no voice calling attention to the problems this makes for a whole range of services.

The extremely unstable situation in the Department of Children and Families needs our vigilant attention. The problems are exacerbated in the Tampa Bay or Sun Coast area because under a poorly planned reorganization, districts 5, 6, and part of 8 were reorganized into the Suncoast Region. Much of the staff was completely demoralized, leading to very high turnover. The Employee Feedback system that used to operate in District 6 under the watchful eye of the Health and Human Services Board is inoperative, probably because employees are now afraid to offer any feedback. Managers and administrators are working under extremely unfavorable conditions, with no job security. With the Health and Human Services Board gone, there is no mechanism for public involvement. District Administrators used to think of the Health and Human Services Board as their local "board of directors," but now the administrators work only for the Secretary, and the 2000 legislation made them accountable only to the secretary who serves, still, at the pleasure of the governor.

The 2000 legislation contained another dreadful "unfunded mandate," in telling the County Commission, the School Board, the Judicial District, the Sheriff, and the Children’s Council in each county where they exist that they must form a "Community Alliance" and that those alliances were to do all the things that the Health and Human Services Board used to do. In most counties, these busy officers seem to have taken the worst possible approach to this mandate – rather than complain and get the matter adjusted, they simply have not done the job. So, the ones who suffer are the children and families of our Florida communities.

In January of 2015 many Floridians celebrated to learn that Florida surpassed New York in population growth. At the same time, the Florida Health and Human Services Board learned, without celebration that Texas  passed Florida on per capita spending on human services, leaving us, you guessed it, as dead last in the nation!

The decline in Florida’s funding of health and human services is illustrated clearly in a graph produced in early 2015 by the association of managing entities <http://www.fhhsb.org/GraphFLSAMHspending2000-2013.pdf>

Notable also is Florida’s failure to provide health insurance to cover large numbers of children and families eligible for the federally funded Medicaid/CHIP programs.  Those health and human services boards, both the district boards and the statewide board, would not have permitted that to happen!

 

--Document originally drafted in 2001 by Alvin Wolfe, last edited in 2015. Alvin W. Wolfe, Chair, Florida Health and Human Services Board, Inc., 17920 Burnside Road, Lutz, 33549 (813) 949-4673. Email: fhhsb@tampabay.rr.com.