This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0485c.HCA
DATE: 3/29/2023
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 485 Veterans' Services and Recognition
SPONSOR(S): Health Care Appropriations Subcommittee, Salzman and others
TIED BILLS: IDEN./SIM. BILLS: SB 824
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Local Administration, Federal Affairs & Special
Districts Subcommittee
18 Y, 0 N Mwakyanjala Darden
2) Health Care Appropriations Subcommittee 15 Y, 0 N, As CS Aderibigbe Clark
3) Health & Human Services Committee
SUMMARY ANALYSIS
The Florida Department of Veterans’ Affairs (FDVA) operates a network of nine state veterans’ homes and
provides statewide outreach to connect veterans with services, benefits and support. FDVA offers benefits and
services in the fields of health care, mental health and substance abuse, claims support, education,
employment, housing, burial benefits, and legal assistance. The U.S. Department of Veterans’ Affairs (VA) is
principally responsible for the delivery of health care services to veterans.
Boards of county commissioners and governing bodies of municipalities may employ veteran service officers
and prescribe their duties, compensation, and terms of employment.
Adult day health care is a program established by the VA with the goal of allowing veterans to have a place
during the day for social activities, peer support, companionship, and recreation. The program is intended for
veterans who need help with activities of daily living, who are isolated, or whose caregiver is experiencing
burden. State law recognizes adult day care centers. However, facilities that operate under the federal
government or any agency thereof are exempt from current state law pertaining to adult day care centers and
regulation by the Agency for Health Care Administration.
The bill creates the Division of Long-term Care (division) within FDVA. The division is to oversee the
operations of veterans’ adult day health care programs. The bill provides that the executive director of FDVA
(director) shall appoint operators who will be responsible for the overall operation of each operator’s state
authorized veterans’ adult day health care program. The director may designate contractors responsible for the
operations of an adult day health care program authorized under federal law to perform the same duties as
operators. Eligible veterans who are residents of the state and have a service-connected disability will have
priority admittance.
The bill also revises eligibility requirements of county and city veteran service officers and designates the week
of November 11 of each year as “Veterans Week.”
The fiscal impact to state government is indeterminate as federal reimbursement is available for each program
participant; however, the participant number is unknown. There are costs associated with starting a program
but the FDVA estimates these will be absorbed within existing resources. See Fiscal Analysis.
The bill has an effective date of July 1, 2023. STORAGE NAME: h0485c.HCA PAGE: 2
DATE: 3/29/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Florida Department of Veterans’ Affairs
The Florida Department of Veterans’ Affairs (FDVA) is a nearly 1,500-member constitutionally
chartered
1
department with a budget of $171 million for FY 2022-2023.
2
FDVA operates a network of
nine state veterans’ homes and provides statewide outreach to connect veterans with services,
benefits, and support.
3
FDVA offers benefits and services in the fields of health care, mental health and
substance abuse, claims support, education, employment, housing, burial benefits, and legal
assistance.
4
Health Care
The U.S. Department of Veterans’ Affairs (VA) is principally responsible for the delivery of health care
services to veterans.
5
Eligibility for hospital, nursing home, and domiciliary care depends on a number
of factors. Veterans qualify for specified health care services depending on disability status, time of
service, active duty status during service, toxic exposure during service, annual income, or the need for
support.
6
Veteran Service Officers
Boards of county commissioners and governing bodies of municipalities may employ veteran service
officers and prescribe their duties, compensation, and terms of employment.
7
A veteran service officer
must be a veteran who served as a member of the U.S. Armed Forces during a period of war,
8
served
at least 18 months’ active duty in the Armed Forces, and be separated from such service under
honorable conditions.
9
Legal Holidays and Observances
State law provides designations for legal holidays and special observances. Depending on the
holiday or special observance, certain actions may be required to be performed for the
commemoration or observance of the date, day, or month. There are 21 legal holidays
10
established in law and 36 special observances.
11
1
Art. IV, s. 11, Fla. Const.
2
Ch. 2022-156, Laws of Fla., pg. 141.
3
Florida Department of Veterans Affairs, Florida Department of Veterans’ Affairs – Our Vision and Mission, available at
https://www.floridavets.org/leadership/ (last visited on Mar. 12, 2023).
4
Florida Department of Veterans Affairs, Benefits & Services, available at https://www.floridavets.org/benefits-services/ (last visited on
Mar. 12, 2023).
5
Florida Department of Veterans Affairs, Health Care, available at https://www.floridavets.org/benefits-services/health-care/ (last visited
on Mar. 12, 2023).
6
38 U.S.C. s. 1710.
7
S. 292.11, F.S.
8
Period of war is defined as the Spanish-American War, the Mexican border period, World War I, World War II, the Korean conflict, the
Vietnam era, the Persian Gulf War, and the period beginning on the date of any declaration of war by the Congress and ending on the
date prescribed by Presidential proclamation or concurrent resolution of the Congress. 38 U.S.C. s. 101(11).
9
S. 292.11(1), F.S.
10
S. 683.01, F.S.
11
Ss. 683.04 - 683.3341, F.S. STORAGE NAME: h0485c.HCA PAGE: 3
DATE: 3/29/2023
Adult Day Care Centers
Adult day care centers provide therapeutic services and activities for adults in a non-institutional
setting.
12
Participants may utilize a variety of services offered during any part of a day totaling less than
24 hours. Basic services provided by adult day care centers include leisure activities, self-care training,
nutritional services, and respite care.
13
These facilities are licensed by the Agency for Health Care
Administration.
14
However, facilities that operate under the federal government or any agency thereof
are exempt from the current state law pertaining to adult day care centers.
15
The VA’s Adult Day Health Care Program (Program) was established by the VA with the goal of
allowing veterans to have a place during the day for social activities, peer support, companionship, and
recreation.
16
The Program is intended for veterans who need help with activities of daily living, those
who are isolated, or whose caregiver is experiencing burden. Health services such as care from
nurses, therapists, social workers, and others may also be provided. The Program may be provided at
VA medical centers, state Veterans Homes, or through community organizations. In order to receive a
federal grant or grant funding for an adult day health care program, the state must meet the following
specific, federal requirements:
If an adult day health care program is located within a nursing home, domiciliary, or other care
facility, the adult health care program must have its own separate designated space during
operational hours.
The indoor space for the adult day health care program must be at least 100 sq. ft. per
participant including office space for staff and must be 60 sq. ft. per participant excluding office
space for staff.
Each program will need to design and partition its space to meet its own needs but must make
available certain federally-mandated functional areas.
17
Furnishings must be available for all participants, including functional furniture appropriate to the
participants’ needs.
18
Effect of Proposed Changes
The bill creates the Division of Long-term Care (division) within FDVA. The division is to oversee the
operations of veterans’ adult day health care programs. The bill provides that the executive director of
FDVA (director) shall appoint operators who will be responsible for the overall operation of each
operator’s state authorized veterans’ adult day health care program. The director may designate
contractors responsible for the operations of an adult day health care entity authorized under federal
law to perform the same duties as operators.
While the bill provides that the operator shall determine eligibility of the applicants for admission into an
adult day health care program, the bill also provides general eligibility requirements and an admittance
priority. In order to be eligible for the program, a person must:
Be a veteran as defined by state law;
Need adult day health care;
Be a resident of the state at the time of application for admission to the program;
Not owe money to FDVA for services rendered during any previous stay at a department facility;
Have applied for all financial assistance reasonably available through governmental sources;
and
Have been approved as eligible for care and treatment by the VA.
12
S. 429.901(3), F.S.
13
Id.
14
S. 429.903, F.S.
15
S. 429.905, F.S.
16
U.S. Department of Veterans Affairs, Adult Day Health Care, available at
https://www.va.gov/geriatrics/pages/Adult_Day_Health_Care.asp (last visited Mar. 12, 2023).
17
For the list of federally mandated functional areas, see 38 C.F.R. s. 59.160(c)(1)-(11).
18
38 C.F.R. s. 59.160. STORAGE NAME: h0485c.HCA PAGE: 4
DATE: 3/29/2023
The bill provides that an operator may waive the residency requirement for an applicant as long as the
veteran would be otherwise eligible under the requirements listed above and the applicant is a disaster
evacuee of a state that is under a declared state of emergency.
The bill establishes the following admittance priority for eligible veterans:
Residents of the state.
Veterans who have a service-connected disability as determined by the VA or were discharged
or released from military service for disability incurred or aggravated in the line of duty and the
disability is the condition for which adult day health care is needed.
Veterans who have a non-service-connected disability and is unable to defray the expense of
adult day health care and so states under oath before a notary public or other officer authorized
to administer an oath.
Operators are authorized to admit veterans who have sufficient means to fund their own support but
who would otherwise be eligible for admittance if the program has available room.
The bill requires a program under the division to be open to audit and inspection by the Auditor General
and the Office of Program Policy Analysis and Government Accountability. The bill grants rulemaking
authority to the operator and the director to adopt rules necessary for the proper administration of the
program, including rules to preserve order and enforce discipline in the program. The rules must
conform as nearly as possible to the rules and regulations for comparable facilities of the VA.
The bill revises the eligibility requirement of county and city veteran service officers to provide that any
veteran as defined by state law may serve as a veteran service officer.
The bill designates the week of November 11 of each year “Veterans Week.” The governor is
authorized to issue a proclamation during Veterans Week and may call public officials, schools, private
organizations, and residents of the state to commemorate Veterans Week and servicemembers.
B. SECTION DIRECTORY:
Section 1: Amends s. 20.37, F.S., creating the Division of Long-term Care within the Florida
Department of Veterans’ Affairs.
Section 2: Amends s. 292.11, F.S., revising the definition for county and city veteran service
officers.
Section 3: Creates part III of ch. 296, F.S., to be cited as the “Veteran’s Adult Day Health Care of
Florida Act.,” providing for the establishment of basic standards for the operation of
veterans’ adult day health care programs.
Section 4: Creates s. 683.1475, F.S., designating the week of November 11 of each year as
“Veterans Week.”
Section 5: Provides that the bill will take effect July 1, 2023.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT: STORAGE NAME: h0485c.HCA PAGE: 5
DATE: 3/29/2023
1. Revenues:
The FDVA will receive a federal reimbursement for each eligible participant in the adult day care
program. At this time, it is unknown how quickly the program will be established and how many
participants will be served. Once federal reimbursement revenues are received, the funds will be
deposited into the Operations and Maintenance Trust Fund within the department. The FDVA will
need to request spending authority from the Legislature to expend any of the revenues received.
See Fiscal Comments.
2. Expenditures:
The FDVA will experience startup costs, such as licensure application through AHCA, renovation
expenses, and increases in liability insurance within the Veterans’ Nursing Homes division for the
establishment of the adult day care program. The FDVA anticipates these startup costs will be
minor and can be absorbed within existing resources. Additionally, the FDVA expects that the
overall operation of the adult day care program will be performed by contractors and will have no
increase in state personnel expenditures.
See Fiscal Comments.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
Qualifying private contractors that are currently providing services in other settings may now be eligible
to be designated as operators.
D. FISCAL COMMENTS:
The bill authorizes FDVA to operate, or contract with third parties to operate, adult day care programs.
These programs may increase expenditures by FDVA but may also be offset by funds received from
VA for the program.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not Applicable. This bill does not appear to require counties or municipalities to spend funds or take
action requiring the expenditures of funds; reduce the authority that counties or municipalities have
to raise revenues in the aggregate; or reduce the percentage of state tax shared with counties or
municipalities.
2. Other:
None.
B. RULE-MAKING AUTHORITY: STORAGE NAME: h0485c.HCA PAGE: 6
DATE: 3/29/2023
The bill grants rulemaking authority to the operator and the director to adopt rules necessary for the
administration of the program, including rules to preserve order and enforce discipline in the program.
The rules must conform as nearly as possible to the rules and regulations for comparable facilities of
the VA.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
On March 29, 2023, the Health Care Appropriations Subcommittee adopted an amendment and
reported the bill favorably as a committee substitute. The amendment designates the week beginning
with the Sunday preceding November 11 of each year as “Veterans Week” or if November 11 falls on a
Sunday, “Veterans Week” begins on that day.
The bill analysis is drafted to the committee substitute as adopted by the Health Care Appropriations
Subcommittee.