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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3	3	HB 1519 2023
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10	10	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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14	14	A bill to be entitled 1
15	15	An act relating to assisted care communities; amending 2
16	16	s. 409.908, F.S.; authorizing the Agency for Health 3
17	17	Care Administration to reimburse adult day care 4
18	18	services on a fee-for-service basis under the Medicaid 5
19	19	program; amending s. 429.41, F.S.; specifying 6
20	20	requirements for certain standards for assisted living 7
21	21	facilities the agency is required to adopt by rule; 8
22	22	creating s. 429.932, F.S.; providing a purpose; 9
23	23	requiring operators of adult day care centers to 10
24	24	annually complete specified continuing education; 11
25	25	providing requirements for the content and approval of 12
26	26	such continuing education courses; authorizing 13
27	27	approved courses to be offered in person and online; 14
28	28	providing requirements for courses completed online; 15
29	29	providing additional methods to satisfy the contin uing 16
30	30	education requirements; providing that compliance with 17
31	31	the continuing education requirements is a condition 18
32	32	precedent for licensure; authorizing the Department of 19
33	33	Elderly Affairs to grant an extension, not to exceed 1 20
34	34	year, for completion of the conti nuing education under 21
35	35	certain circumstances; requiring persons or entities 22
36	36	offering continuing education courses to submit 23
37	37	certain information to the department within a 24
38	38	specified timeframe; providing applicability; 25
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40	40	HB 1519 2023
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47	47	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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51	51	authorizing certain operators to request a waiver from 26
52	52	the continuing education requirements; prohibiting the 27
53	53	department from renewing the license of an adult day 28
54	54	care center under certain circumstances; providing an 29
55	55	exception; providing an effective date. 30
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57	57	Be It Enacted by the Legislature o f the State of Florida: 32
58	58	33
59	59	Section 1. Present paragraphs (a) through (u) of 34
60	60	subsection (3) of section 409.908, Florida Statutes, are 35
61	61	redesignated as paragraphs (b) through (v), respectively, a new 36
62	62	paragraph (a) is added to that subsection, and subsection (8) of 37
63	63	that section is amended, to read: 38
64	64	409.908 Reimbursement of Medicaid providers. —Subject to 39
65	65	specific appropriations, the agency shall reimburse Medicaid 40
66	66	providers, in accordance with state and federal law, according 41
67	67	to methodologies set forth in th e rules of the agency and in 42
68	68	policy manuals and handbooks incorporated by reference therein. 43
69	69	These methodologies may include fee schedules, reimbursement 44
70	70	methods based on cost reporting, negotiated fees, competitive 45
71	71	bidding pursuant to s. 287.057, and othe r mechanisms the agency 46
72	72	considers efficient and effective for purchasing services or 47
73	73	goods on behalf of recipients. If a provider is reimbursed based 48
74	74	on cost reporting and submits a cost report late and that cost 49
75	75	report would have been used to set a lower reimbursement rate 50
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82	82	hb1519-00
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84	84	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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86	86
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88	88	for a rate semester, then the provider's rate for that semester 51
89	89	shall be retroactively calculated using the new cost report, and 52
90	90	full payment at the recalculated rate shall be effected 53
91	91	retroactively. Medicare -granted extensions for filin g cost 54
92	92	reports, if applicable, shall also apply to Medicaid cost 55
93	93	reports. Payment for Medicaid compensable services made on 56
94	94	behalf of Medicaid-eligible persons is subject to the 57
95	95	availability of moneys and any limitations or directions 58
96	96	provided for in the G eneral Appropriations Act or chapter 216. 59
97	97	Further, nothing in this section shall be construed to prevent 60
98	98	or limit the agency from adjusting fees, reimbursement rates, 61
99	99	lengths of stay, number of visits, or number of services, or 62
100	100	making any other adjustments necessary to comply with the 63
101	101	availability of moneys and any limitations or directions 64
102	102	provided for in the General Appropriations Act, provided the 65
103	103	adjustment is consistent with legislative intent. 66
104	104	(3) Subject to any limitations or directions provided fo r 67
105	105	in the General Appropriations Act, the following Medicaid 68
106	106	services and goods may be reimbursed on a fee -for-service basis. 69
107	107	For each allowable service or goods furnished in accordance with 70
108	108	Medicaid rules, policy manuals, handbooks, and state and federal 71
109	109	law, the payment shall be the amount billed by the provider, the 72
110	110	provider's usual and customary charge, or the maximum allowable 73
111	111	fee established by the agency, whichever amount is less, with 74
112	112	the exception of those services or goods for which the agency 75
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121	121	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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125	125	makes payment using a methodology based on capitation rates, 76
126	126	average costs, or negotiated fees. 77
127	127	(a) Adult day care services. 78
128	128	(8) A provider of home -based or community-based services 79
129	129	rendered pursuant to a federally approved waiver shall be 80
130	130	reimbursed based on an established or negotiated rate for each 81
131	131	service, except that adult day care services shall be reimbursed 82
132	132	on a fee-for-service basis as provided in subsection (3) . These 83
133	133	rates shall be established according to an analysis of the 84
134	134	expenditure history a nd prospective budget developed by each 85
135	135	contract provider participating in the waiver program, or under 86
136	136	any other methodology adopted by the agency and approved by the 87
137	137	Federal Government in accordance with the waiver. Privately 88
138	138	owned and operated community -based residential facilities which 89
139	139	meet agency requirements and which formerly received Medicaid 90
140	140	reimbursement for the optional intermediate care facility for 91
141	141	the intellectually disabled service may participate in the 92
142	142	developmental services waiver as part of a home-and-community-93
143	143	based continuum of care for Medicaid recipients who receive 94
144	144	waiver services. 95
145	145	Section 2. Subsection (2) of section 429.41, Florida 96
146	146	Statutes, is amended to read: 97
147	147	429.41 Rules establishing standards. — 98
148	148	(2) In adopting any rules pursuant to this part, the 99
149	149	agency shall make distinct standards for facilities based upon 100
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158	158	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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162	162	facility size; the types of care provided; the physical and 101
163	163	mental capabilities and needs of residents; the type, frequency, 102
164	164	and amount of services and care offered; and the staffing 103
165	165	characteristics of the facility. Rules developed pursuant to 104
166	166	this section may not restrict the use of shared staffing and 105
167	167	shared programming in facilities that are part of retirement 106
168	168	communities that provide multiple levels of care and ot herwise 107
169	169	meet the requirements of law and rule. If a continuing care 108
170	170	facility licensed under chapter 651 or a retirement community 109
171	171	offering multiple levels of care licenses a building or part of 110
172	172	a building designated for independent living for assisted 111
173	173	living, staffing requirements established in rule apply only to 112
174	174	residents who receive personal, limited nursing, or extended 113
175	175	congregate care services under this part. Such facilities shall 114
176	176	retain a log listing the names and unit number for residents 115
177	177	receiving these services. The log must be available to surveyors 116
178	178	upon request. The agency shall adopt by rule separate and 117
179	179	distinct standards for facilities with 16 or fewer beds and for 118
180	180	facilities with 17 or more beds ; however, minimum staffing 119
181	181	standards for facili ties with 6 or fewer beds may not exceed 168 120
182	182	hours per week. The standards for facilities with 16 or fewer 121
183	183	beds must be appropriate for a noninstitutional residential 122
184	184	environment; however, the structure may not be more than two 123
185	185	stories in height and all pe rsons who cannot exit the facility 124
186	186	unassisted in an emergency must reside on the first floor. The 125
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193	193	hb1519-00
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195	195	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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199	199	agency may make other distinctions among types of facilities as 126
200	200	necessary to enforce this part. When Where appropriate, the 127
201	201	agency shall offer alternate solut ions for complying with 128
202	202	established standards, based on distinctions made by the agency 129
203	203	relative to the physical characteristics of facilities and the 130
204	204	types of care offered. 131
205	205	Section 3. Section 429.932, Florida Statutes, is created 132
206	206	to read: 133
207	207	429.932 Continuing education requirements. — 134
208	208	(1) The purpose of this section is to establish 135
209	209	requirements and standards for continuing education courses for 136
210	210	an operator handling the day -to-day operations of an adult day 137
211	211	care center licensed under this part. 138
212	212	(2) In addition to any existing adult day care center 139
213	213	staff training requirements required under this part or by 140
214	214	department rule, each operator must complete at least 8 hours of 141
215	215	continuing education each calendar year, which must include 1 142
216	216	hour of training in e ach of the following topic areas: 143
217	217	(a) Compliance with requirements of the Agency for Health 144
218	218	Care Administration. 145
219	219	(b) Alzheimer's disease and related disorders. 146
220	220	(c) State and local comprehensive emergency management 147
221	221	plans. 148
222	222	(d) Anti-fraud laws and regulations. 149
223	223	(e) Nonemergency medical transportation. 150
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232	232	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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236	236	(f) Daily management of facility operations. 151
237	237	(g) Staff compliance. 152
238	238	(h) The Health Insurance Portability and Accountability 153
239	239	Act and related requirements. 154
240	240	(3) The continuing education courses mu st be developed and 155
241	241	offered by the Florida Adult Day Services Association and 156
242	242	approved by the department. Courses may also be provided by any 157
243	243	other educational provider approved by the department. 158
244	244	(4) Approved courses may be offered in person or online. 159
245	245	Upon completion of an online course, an operator must pass an 160
246	246	online department-approved exam with a minimum score of 80 161
247	247	percent or higher. An operator attending an in -person course is 162
248	248	exempt from the exam requirement. An individual teaching an 163
249	249	approved course or lecturing at an approved seminar and 164
250	250	attending the entire course or seminar qualifies for the same 165
251	251	number of classroom hours as would be granted to a person taking 166
252	252	and successfully completing such course or seminar. Such credit 167
253	253	is limited to the nu mber of hours actually taught by the 168
254	254	individual unless he or she attends the entire course or 169
255	255	seminar. 170
256	256	(5) Compliance with the continuing education requirements 171
257	257	of this section is a condition precedent to the issuance, 172
258	258	continuation, reinstatement, or ren ewal of an operator's adult 173
259	259	day care center license subject to this part. However, for good 174
260	260	cause shown, the department may grant the operator an extension 175
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269	269	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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273	273	of time, not to exceed 1 year, to complete the continuing 176
274	274	education required under this section. 177
275	275	(6) Each person or entity offering a course for continuing 178
276	276	education credit under this section must submit to the 179
277	277	department, within 30 days after completion of the course, in a 180
278	278	form satisfactory to the department or its designee, a roster 181
279	279	including the adult day care license number and the name of the 182
280	280	operator who successfully completed such course and is 183
281	281	requesting credit. 184
282	282	(7) Except as otherwise provided in this section, this 185
283	283	section applies to all operators handling the day -to-day 186
284	284	operations of adult d ay care centers licensed under this part. 187
285	285	Operators who are unable to comply with the continuing education 188
286	286	requirements due to active duty in the military may submit a 189
287	287	written request for a waiver to the department. 190
288	288	(8) Unless the operator has been grant ed an extension or a 191
289	289	waiver by the department, the department may not renew the 192
290	290	license of an adult day care center whose operator has failed to 193
291	291	complete the continuing education required under this section 194
292	292	until such time as the operator completes such co ntinuing 195
293	293	education. 196
294	294	Section 4. This act shall take effect July 1, 2023. 197