Florida 2023 Regular Session

Florida House Bill H1579 Compare Versions

Only one version of the bill is available at this time.

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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 developmental disability treatment 2
16	16	services; amending s. 393.065, F.S.; requiring the 3
17	17	Agency for Persons with Disabilities to make certain 4
18	18	eligibility determinations within specified time 5
19	19	periods; providing eligibility requirements for 6
20	20	applicants; requiring the agency to authorize 7
21	21	admission into an intermediate care facility; 8
22	22	providing requirements for such authorization; 9
23	23	deleting a provision requiring the agency to perform 10
24	24	specified assessments to determine level of need and 11
25	25	medical necessity for intermediate care facilities; 12
26	26	revising requirements for a client waiting for waiver 13
27	27	services; providing requirements for the home and 14
28	28	community-based services Medicaid waiver program; 15
29	29	providing an effective date. 16
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31	31	Be It Enacted by the Legisla ture of the State of Florida: 18
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33	33	Section 1. Subsections (6), (7), (8), (9), (10), and (11) 20
34	34	of section 393.065, Florida Statutes, are renumbered as 21
35	35	subsections (8), (9), (10), (12), (13), and (14), respectively, 22
36	36	subsections (1) through (5) are amended, an d new subsections 23
37	37	(2), (6), (7), and (11) are added to that section, to read: 24
38	38	393.065 Application and eligibility determination. — 25
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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	(1) Application for services shall be made in writing to 26
52	52	the agency, in the region service area in which the applicant 27
53	53	resides. The agency shall review each application and make an 28
54	54	applicant for eligibility determination within 45 days after the 29
55	55	date the application is signed for children under 6 years of age 30
56	56	and within 60 days after receipt of the date the application is 31
57	57	signed application for all other applicants . If an applicant is 32
58	58	requesting enrollment in the home and community -based services 33
59	59	Medicaid waiver program for individuals with developmental 34
60	60	disabilities deemed to be in crisis, as described in paragraph 35
61	61	(5)(a), at the time of the application, the agency shall 36
62	62	complete an eligibility determination within 45 days after 37
63	63	receipt of the signed application. 38
64	64	(a) If the agency determines additional documentation is 39
65	65	necessary to make a proper determination on an applicant 's 40
66	66	eligibility, the agency may request the additional documentation 41
67	67	from the applicant. 42
68	68	(b) When necessary to definitively identify individual 43
69	69	conditions or needs, the agency shall provide a comprehensive 44
70	70	assessment. 45
71	71	(c) If the agency requests addition al documentation from 46
72	72	the applicant or provides a comprehensive assessment, the 47
73	73	agency's eligibility determination must be completed within 90 48
74	74	days after receipt of the signed application Only applicants 49
75	75	whose domicile is in Florida are eligible for servic es. 50
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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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88	88	(2) In order to be eligible for services under this 51
89	89	chapter, the agency must determine that the applicant has met 52
90	90	all eligibility procedures and criteria found in rule, including 53
91	91	that the applicant has a developmental disability and is 54
92	92	domiciled in this state. Information accumulated by other 55
93	93	agencies, including professional reports and collateral data, 56
94	94	shall be considered in this process when available. 57
95	95	(2) In order to provide immediate services or crisis 58
96	96	intervention to applicants, the agency shal l arrange for 59
97	97	emergency eligibility determination, with a full eligibility 60
98	98	review to be accomplished within 45 days of the emergency 61
99	99	eligibility determination . 62
100	100	(3) The agency, or its designee, shall notify each 63
101	101	applicant, in writing, of its eligibility determination 64
102	102	decision. Any applicant or client determined by the agency to be 65
103	103	ineligible for services has the right to appeal this 66
104	104	determination decision pursuant to ss. 120.569 and 120.57. 67
105	105	(4) The agency must authorize admission into an 68
106	106	intermediate care facility for a developmentally disabled 69
107	107	individual. As a part of authorization, the agency, or its 70
108	108	designee, shall conduct an assessment to include medical 71
109	109	necessity and level of reimbursement shall assess the level of 72
110	110	need and medical necessity for pros pective residents of 73
111	111	intermediate care facilities for the developmentally disabled. 74
112	112	The agency may enter into an agreement with the Department of 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	Elderly Affairs for its Comprehensive Assessment and Review for 76
126	126	Long-Term-Care Services (CARES) program to con duct assessments 77
127	127	to determine the level of need and medical necessity for long -78
128	128	term-care services under this chapter. To the extent permissible 79
129	129	under federal law, the assessments shall be funded under Title 80
130	130	XIX of the Social Security Act . 81
131	131	(5) The agency shall assign any client that meets the 82
132	132	level of care requirements for an intermediate care facility for 83
133	133	individuals with intellectual disabilities pursuant to 42 C.F.R. 84
134	134	s. 435.217(b)(1) and 42 C.F.R. s. 440.150 to a waiting list and 85
135	135	provide priority to clients waiting for waiver services in the 86
136	136	following order: 87
137	137	(a) Category 1, which includes clients deemed to be in 88
138	138	crisis as described in rule, shall be given first priority in 89
139	139	moving from the waiting list to the waiver. 90
140	140	(b) Category 2, which includes individuals on the waiting 91
141	141	list who are: 92
142	142	1. From the child welfare system with an open case in the 93
143	143	Department of Children and Families' statewide automated child 94
144	144	welfare information system and who are either: 95
145	145	a. Transitioning out of the child welfare system at the 96
146	146	finalization of an adoption, a reunification with family 97
147	147	members, a permanent placement with a relative, or a 98
148	148	guardianship with a nonrelative; or 99
149	149	b. At least 18 years but not yet 22 years of age and who 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	need both waiver servic es and extended foster care services; or 101
163	163	2. At least 18 years but not yet 22 years of age and who 102
164	164	withdrew consent pursuant to s. 39.6251(5)(c) to remain in the 103
165	165	extended foster care system. 104
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167	167	For individuals who are at least 18 years but not yet 22 years 106
168	168	of age and who are eligible under sub -subparagraph 1.b., the 107
169	169	agency shall provide waiver services, including residential 108
170	170	habilitation, and the community -based care lead agency shall 109
171	171	fund room and board at the rate established in s. 409.145(3) and 110
172	172	provide case management and related services as defined in s. 111
173	173	409.986(3)(e). Individuals may receive both waiver services and 112
174	174	services under s. 39.6251. Services may not duplicate services 113
175	175	available through the Medicaid state plan. 114
176	176	(c) Category 3, which includes, but is not required to be 115
177	177	limited to, clients: 116
178	178	1. Whose caregiver has a documented condition that is 117
179	179	expected to render the caregiver unable to provide care within 118
180	180	the next 12 months and for whom a caregiver is required but no 119
181	181	alternate caregiver is ava ilable; 120
182	182	2. At substantial risk of incarceration or court 121
183	183	commitment without supports; 122
184	184	3. Whose documented behaviors or physical needs place them 123
185	185	or their caregiver at risk of serious harm and other supports 124
186	186	are not currently available to alleviate the situation; or 125
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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	4. Who are identified as ready for discharge within the 126
200	200	next year from a state mental health hospital or skilled nursing 127
201	201	facility and who require a caregiver but for whom no caregiver 128
202	202	is available or whose caregiver is unable to provide the care 129
203	203	needed. 130
204	204	(d) Category 4, which includes, but is not required to be 131
205	205	limited to, clients whose caregivers are 70 years of age or 132
206	206	older and for whom a caregiver is required but no alternate 133
207	207	caregiver is available. 134
208	208	(e) Category 5, which includes, but is not required to be 135
209	209	limited to, clients who are expected to graduate within the next 136
210	210	12 months from secondary school and need support to obtain a 137
211	211	meaningful day activity, maintain competitive employment, or 138
212	212	pursue an accredited program of postsecondary e ducation to which 139
213	213	they have been accepted. 140
214	214	(f) Category 6, which includes clients 21 years of age or 141
215	215	older who do not meet the criteria for category 1, category 2, 142
216	216	category 3, category 4, or category 5. 143
217	217	(g) Category 7, which includes clients younger th an 21 144
218	218	years of age who do not meet the criteria for category 1, 145
219	219	category 2, category 3, or category 4. 146
220	220	(6) Within categories 3, 4, 5, and 6, and 7, the agency 147
221	221	shall maintain a waiting list of clients placed in the order of 148
222	222	the date that the client is det ermined eligible for waiver 149
223	223	services. 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	(7) The agency shall maintain a registration list of 151
237	237	clients who meet the level of care requirement for an 152
238	238	intermediate care facility for individuals with intellectual 153
239	239	disabilities pursuant to 42 C.F.R. s. 435.217(b) (1) and 42 154
240	240	C.F.R. s. 440.150 and who is: 155
241	241	(a) An individual under the age of 21 who is requesting 156
242	242	and not receiving waiver services and who is not assigned to 157
243	243	categories 1, 2, 3, 4, or 5; or 158
244	244	(b) An adult who resides in an institutional setting, 159
245	245	including, but not limited to, a penal institution, intermediate 160
246	246	care facility for the developmentally disabled, mental health 161
247	247	hospital, nursing home, or forensic facility run by the agency 162
248	248	pursuant to chapter 916. 163
249	249	(11) Only a client may be eligible for the hom e and 164
250	250	community-based services Medicaid waiver program. To receive 165
251	251	services under the home and community -based services Medicaid 166
252	252	waiver program, there must be available funding pursuant to s. 167
253	253	393.0662, or through a legislative appropriation, and the client 168
254	254	must meet all of the following: 169
255	255	(a) The eligibility criteria in subsection (2), which must 170
256	256	be confirmed by the agency. 171
257	257	(b) Eligibility requirements for the Florida Medicaid 172
258	258	program under Title XIX of the Social Security Act, as amended, 173
259	259	or the Supplemental Security Income program. 174
260	260	(c) The level of care requirements for an intermediate 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	care facility for individuals with developmental disabilities 176
274	274	pursuant to 42 C.F.R. s. 435.217(b)(1) and 42 C.F.R. s. 440.150. 177
275	275	(d) The requirements provided in the ap proved federal 178
276	276	waiver authorized under s. 1915(c) of the Social Security Act 179
277	277	and 42 C.F.R. s. 441.302. 180
278	278	Section 2. This act shall take effect July 1, 2023. 181