Florida 2023 Regular Session

Florida House Bill H1519 Compare Versions

Only one version of the bill is available at this time.
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1010 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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1414 A bill to be entitled 1
1515 An act relating to assisted care communities; amending 2
1616 s. 409.908, F.S.; authorizing the Agency for Health 3
1717 Care Administration to reimburse adult day care 4
1818 services on a fee-for-service basis under the Medicaid 5
1919 program; amending s. 429.41, F.S.; specifying 6
2020 requirements for certain standards for assisted living 7
2121 facilities the agency is required to adopt by rule; 8
2222 creating s. 429.932, F.S.; providing a purpose; 9
2323 requiring operators of adult day care centers to 10
2424 annually complete specified continuing education; 11
2525 providing requirements for the content and approval of 12
2626 such continuing education courses; authorizing 13
2727 approved courses to be offered in person and online; 14
2828 providing requirements for courses completed online; 15
2929 providing additional methods to satisfy the contin uing 16
3030 education requirements; providing that compliance with 17
3131 the continuing education requirements is a condition 18
3232 precedent for licensure; authorizing the Department of 19
3333 Elderly Affairs to grant an extension, not to exceed 1 20
3434 year, for completion of the conti nuing education under 21
3535 certain circumstances; requiring persons or entities 22
3636 offering continuing education courses to submit 23
3737 certain information to the department within a 24
3838 specified timeframe; providing applicability; 25
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4747 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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5151 authorizing certain operators to request a waiver from 26
5252 the continuing education requirements; prohibiting the 27
5353 department from renewing the license of an adult day 28
5454 care center under certain circumstances; providing an 29
5555 exception; providing an effective date. 30
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5757 Be It Enacted by the Legislature o f the State of Florida: 32
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5959 Section 1. Present paragraphs (a) through (u) of 34
6060 subsection (3) of section 409.908, Florida Statutes, are 35
6161 redesignated as paragraphs (b) through (v), respectively, a new 36
6262 paragraph (a) is added to that subsection, and subsection (8) of 37
6363 that section is amended, to read: 38
6464 409.908 Reimbursement of Medicaid providers. —Subject to 39
6565 specific appropriations, the agency shall reimburse Medicaid 40
6666 providers, in accordance with state and federal law, according 41
6767 to methodologies set forth in th e rules of the agency and in 42
6868 policy manuals and handbooks incorporated by reference therein. 43
6969 These methodologies may include fee schedules, reimbursement 44
7070 methods based on cost reporting, negotiated fees, competitive 45
7171 bidding pursuant to s. 287.057, and othe r mechanisms the agency 46
7272 considers efficient and effective for purchasing services or 47
7373 goods on behalf of recipients. If a provider is reimbursed based 48
7474 on cost reporting and submits a cost report late and that cost 49
7575 report would have been used to set a lower reimbursement rate 50
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8484 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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8888 for a rate semester, then the provider's rate for that semester 51
8989 shall be retroactively calculated using the new cost report, and 52
9090 full payment at the recalculated rate shall be effected 53
9191 retroactively. Medicare -granted extensions for filin g cost 54
9292 reports, if applicable, shall also apply to Medicaid cost 55
9393 reports. Payment for Medicaid compensable services made on 56
9494 behalf of Medicaid-eligible persons is subject to the 57
9595 availability of moneys and any limitations or directions 58
9696 provided for in the G eneral Appropriations Act or chapter 216. 59
9797 Further, nothing in this section shall be construed to prevent 60
9898 or limit the agency from adjusting fees, reimbursement rates, 61
9999 lengths of stay, number of visits, or number of services, or 62
100100 making any other adjustments necessary to comply with the 63
101101 availability of moneys and any limitations or directions 64
102102 provided for in the General Appropriations Act, provided the 65
103103 adjustment is consistent with legislative intent. 66
104104 (3) Subject to any limitations or directions provided fo r 67
105105 in the General Appropriations Act, the following Medicaid 68
106106 services and goods may be reimbursed on a fee -for-service basis. 69
107107 For each allowable service or goods furnished in accordance with 70
108108 Medicaid rules, policy manuals, handbooks, and state and federal 71
109109 law, the payment shall be the amount billed by the provider, the 72
110110 provider's usual and customary charge, or the maximum allowable 73
111111 fee established by the agency, whichever amount is less, with 74
112112 the exception of those services or goods for which the agency 75
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121121 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125125 makes payment using a methodology based on capitation rates, 76
126126 average costs, or negotiated fees. 77
127127 (a) Adult day care services. 78
128128 (8) A provider of home -based or community-based services 79
129129 rendered pursuant to a federally approved waiver shall be 80
130130 reimbursed based on an established or negotiated rate for each 81
131131 service, except that adult day care services shall be reimbursed 82
132132 on a fee-for-service basis as provided in subsection (3) . These 83
133133 rates shall be established according to an analysis of the 84
134134 expenditure history a nd prospective budget developed by each 85
135135 contract provider participating in the waiver program, or under 86
136136 any other methodology adopted by the agency and approved by the 87
137137 Federal Government in accordance with the waiver. Privately 88
138138 owned and operated community -based residential facilities which 89
139139 meet agency requirements and which formerly received Medicaid 90
140140 reimbursement for the optional intermediate care facility for 91
141141 the intellectually disabled service may participate in the 92
142142 developmental services waiver as part of a home-and-community-93
143143 based continuum of care for Medicaid recipients who receive 94
144144 waiver services. 95
145145 Section 2. Subsection (2) of section 429.41, Florida 96
146146 Statutes, is amended to read: 97
147147 429.41 Rules establishing standards. — 98
148148 (2) In adopting any rules pursuant to this part, the 99
149149 agency shall make distinct standards for facilities based upon 100
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158158 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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162162 facility size; the types of care provided; the physical and 101
163163 mental capabilities and needs of residents; the type, frequency, 102
164164 and amount of services and care offered; and the staffing 103
165165 characteristics of the facility. Rules developed pursuant to 104
166166 this section may not restrict the use of shared staffing and 105
167167 shared programming in facilities that are part of retirement 106
168168 communities that provide multiple levels of care and ot herwise 107
169169 meet the requirements of law and rule. If a continuing care 108
170170 facility licensed under chapter 651 or a retirement community 109
171171 offering multiple levels of care licenses a building or part of 110
172172 a building designated for independent living for assisted 111
173173 living, staffing requirements established in rule apply only to 112
174174 residents who receive personal, limited nursing, or extended 113
175175 congregate care services under this part. Such facilities shall 114
176176 retain a log listing the names and unit number for residents 115
177177 receiving these services. The log must be available to surveyors 116
178178 upon request. The agency shall adopt by rule separate and 117
179179 distinct standards for facilities with 16 or fewer beds and for 118
180180 facilities with 17 or more beds ; however, minimum staffing 119
181181 standards for facili ties with 6 or fewer beds may not exceed 168 120
182182 hours per week. The standards for facilities with 16 or fewer 121
183183 beds must be appropriate for a noninstitutional residential 122
184184 environment; however, the structure may not be more than two 123
185185 stories in height and all pe rsons who cannot exit the facility 124
186186 unassisted in an emergency must reside on the first floor. The 125
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195195 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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199199 agency may make other distinctions among types of facilities as 126
200200 necessary to enforce this part. When Where appropriate, the 127
201201 agency shall offer alternate solut ions for complying with 128
202202 established standards, based on distinctions made by the agency 129
203203 relative to the physical characteristics of facilities and the 130
204204 types of care offered. 131
205205 Section 3. Section 429.932, Florida Statutes, is created 132
206206 to read: 133
207207 429.932 Continuing education requirements. — 134
208208 (1) The purpose of this section is to establish 135
209209 requirements and standards for continuing education courses for 136
210210 an operator handling the day -to-day operations of an adult day 137
211211 care center licensed under this part. 138
212212 (2) In addition to any existing adult day care center 139
213213 staff training requirements required under this part or by 140
214214 department rule, each operator must complete at least 8 hours of 141
215215 continuing education each calendar year, which must include 1 142
216216 hour of training in e ach of the following topic areas: 143
217217 (a) Compliance with requirements of the Agency for Health 144
218218 Care Administration. 145
219219 (b) Alzheimer's disease and related disorders. 146
220220 (c) State and local comprehensive emergency management 147
221221 plans. 148
222222 (d) Anti-fraud laws and regulations. 149
223223 (e) Nonemergency medical transportation. 150
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232232 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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236236 (f) Daily management of facility operations. 151
237237 (g) Staff compliance. 152
238238 (h) The Health Insurance Portability and Accountability 153
239239 Act and related requirements. 154
240240 (3) The continuing education courses mu st be developed and 155
241241 offered by the Florida Adult Day Services Association and 156
242242 approved by the department. Courses may also be provided by any 157
243243 other educational provider approved by the department. 158
244244 (4) Approved courses may be offered in person or online. 159
245245 Upon completion of an online course, an operator must pass an 160
246246 online department-approved exam with a minimum score of 80 161
247247 percent or higher. An operator attending an in -person course is 162
248248 exempt from the exam requirement. An individual teaching an 163
249249 approved course or lecturing at an approved seminar and 164
250250 attending the entire course or seminar qualifies for the same 165
251251 number of classroom hours as would be granted to a person taking 166
252252 and successfully completing such course or seminar. Such credit 167
253253 is limited to the nu mber of hours actually taught by the 168
254254 individual unless he or she attends the entire course or 169
255255 seminar. 170
256256 (5) Compliance with the continuing education requirements 171
257257 of this section is a condition precedent to the issuance, 172
258258 continuation, reinstatement, or ren ewal of an operator's adult 173
259259 day care center license subject to this part. However, for good 174
260260 cause shown, the department may grant the operator an extension 175
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269269 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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273273 of time, not to exceed 1 year, to complete the continuing 176
274274 education required under this section. 177
275275 (6) Each person or entity offering a course for continuing 178
276276 education credit under this section must submit to the 179
277277 department, within 30 days after completion of the course, in a 180
278278 form satisfactory to the department or its designee, a roster 181
279279 including the adult day care license number and the name of the 182
280280 operator who successfully completed such course and is 183
281281 requesting credit. 184
282282 (7) Except as otherwise provided in this section, this 185
283283 section applies to all operators handling the day -to-day 186
284284 operations of adult d ay care centers licensed under this part. 187
285285 Operators who are unable to comply with the continuing education 188
286286 requirements due to active duty in the military may submit a 189
287287 written request for a waiver to the department. 190
288288 (8) Unless the operator has been grant ed an extension or a 191
289289 waiver by the department, the department may not renew the 192
290290 license of an adult day care center whose operator has failed to 193
291291 complete the continuing education required under this section 194
292292 until such time as the operator completes such co ntinuing 195
293293 education. 196
294294 Section 4. This act shall take effect July 1, 2023. 197