HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 1 of 8
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
A bill to be entitled 1
An act relating to developmental disability treatment 2
services; amending s. 393.065, F.S.; requiring the 3
Agency for Persons with Disabilities to make certain 4
eligibility determinations within specified time 5
periods; providing eligibility requirements for 6
applicants; requiring the agency to authorize 7
admission into an intermediate care facility; 8
providing requirements for such authorization; 9
deleting a provision requiring the agency to perform 10
specified assessments to determine level of need and 11
medical necessity for intermediate care facilities; 12
revising requirements for a client waiting for waiver 13
services; providing requirements for the home and 14
community-based services Medicaid waiver program; 15
providing an effective date. 16
17
Be It Enacted by the Legisla ture of the State of Florida: 18
19
Section 1. Subsections (6), (7), (8), (9), (10), and (11) 20
of section 393.065, Florida Statutes, are renumbered as 21
subsections (8), (9), (10), (12), (13), and (14), respectively, 22
subsections (1) through (5) are amended, an d new subsections 23
(2), (6), (7), and (11) are added to that section, to read: 24
393.065 Application and eligibility determination. — 25
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 2 of 8
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
(1) Application for services shall be made in writing to 26
the agency, in the region service area in which the applicant 27
resides. The agency shall review each application and make an 28
applicant for eligibility determination within 45 days after the 29
date the application is signed for children under 6 years of age 30
and within 60 days after receipt of the date the application is 31
signed application for all other applicants . If an applicant is 32
requesting enrollment in the home and community -based services 33
Medicaid waiver program for individuals with developmental 34
disabilities deemed to be in crisis, as described in paragraph 35
(5)(a), at the time of the application, the agency shall 36
complete an eligibility determination within 45 days after 37
receipt of the signed application. 38
(a) If the agency determines additional documentation is 39
necessary to make a proper determination on an applicant 's 40
eligibility, the agency may request the additional documentation 41
from the applicant. 42
(b) When necessary to definitively identify individual 43
conditions or needs, the agency shall provide a comprehensive 44
assessment. 45
(c) If the agency requests addition al documentation from 46
the applicant or provides a comprehensive assessment, the 47
agency's eligibility determination must be completed within 90 48
days after receipt of the signed application Only applicants 49
whose domicile is in Florida are eligible for servic es. 50
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 3 of 8
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
(2) In order to be eligible for services under this 51
chapter, the agency must determine that the applicant has met 52
all eligibility procedures and criteria found in rule, including 53
that the applicant has a developmental disability and is 54
domiciled in this state. Information accumulated by other 55
agencies, including professional reports and collateral data, 56
shall be considered in this process when available. 57
(2) In order to provide immediate services or crisis 58
intervention to applicants, the agency shal l arrange for 59
emergency eligibility determination, with a full eligibility 60
review to be accomplished within 45 days of the emergency 61
eligibility determination . 62
(3) The agency, or its designee, shall notify each 63
applicant, in writing, of its eligibility determination 64
decision. Any applicant or client determined by the agency to be 65
ineligible for services has the right to appeal this 66
determination decision pursuant to ss. 120.569 and 120.57. 67
(4) The agency must authorize admission into an 68
intermediate care facility for a developmentally disabled 69
individual. As a part of authorization, the agency, or its 70
designee, shall conduct an assessment to include medical 71
necessity and level of reimbursement shall assess the level of 72
need and medical necessity for pros pective residents of 73
intermediate care facilities for the developmentally disabled. 74
The agency may enter into an agreement with the Department of 75
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 4 of 8
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
Elderly Affairs for its Comprehensive Assessment and Review for 76
Long-Term-Care Services (CARES) program to con duct assessments 77
to determine the level of need and medical necessity for long -78
term-care services under this chapter. To the extent permissible 79
under federal law, the assessments shall be funded under Title 80
XIX of the Social Security Act . 81
(5) The agency shall assign any client that meets the 82
level of care requirements for an intermediate care facility for 83
individuals with intellectual disabilities pursuant to 42 C.F.R. 84
s. 435.217(b)(1) and 42 C.F.R. s. 440.150 to a waiting list and 85
provide priority to clients waiting for waiver services in the 86
following order: 87
(a) Category 1, which includes clients deemed to be in 88
crisis as described in rule, shall be given first priority in 89
moving from the waiting list to the waiver. 90
(b) Category 2, which includes individuals on the waiting 91
list who are: 92
1. From the child welfare system with an open case in the 93
Department of Children and Families' statewide automated child 94
welfare information system and who are either: 95
a. Transitioning out of the child welfare system at the 96
finalization of an adoption, a reunification with family 97
members, a permanent placement with a relative, or a 98
guardianship with a nonrelative; or 99
b. At least 18 years but not yet 22 years of age and who 100
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 5 of 8
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
need both waiver servic es and extended foster care services; or 101
2. At least 18 years but not yet 22 years of age and who 102
withdrew consent pursuant to s. 39.6251(5)(c) to remain in the 103
extended foster care system. 104
105
For individuals who are at least 18 years but not yet 22 years 106
of age and who are eligible under sub -subparagraph 1.b., the 107
agency shall provide waiver services, including residential 108
habilitation, and the community -based care lead agency shall 109
fund room and board at the rate established in s. 409.145(3) and 110
provide case management and related services as defined in s. 111
409.986(3)(e). Individuals may receive both waiver services and 112
services under s. 39.6251. Services may not duplicate services 113
available through the Medicaid state plan. 114
(c) Category 3, which includes, but is not required to be 115
limited to, clients: 116
1. Whose caregiver has a documented condition that is 117
expected to render the caregiver unable to provide care within 118
the next 12 months and for whom a caregiver is required but no 119
alternate caregiver is ava ilable; 120
2. At substantial risk of incarceration or court 121
commitment without supports; 122
3. Whose documented behaviors or physical needs place them 123
or their caregiver at risk of serious harm and other supports 124
are not currently available to alleviate the situation; or 125
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 6 of 8
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
4. Who are identified as ready for discharge within the 126
next year from a state mental health hospital or skilled nursing 127
facility and who require a caregiver but for whom no caregiver 128
is available or whose caregiver is unable to provide the care 129
needed. 130
(d) Category 4, which includes, but is not required to be 131
limited to, clients whose caregivers are 70 years of age or 132
older and for whom a caregiver is required but no alternate 133
caregiver is available. 134
(e) Category 5, which includes, but is not required to be 135
limited to, clients who are expected to graduate within the next 136
12 months from secondary school and need support to obtain a 137
meaningful day activity, maintain competitive employment, or 138
pursue an accredited program of postsecondary e ducation to which 139
they have been accepted. 140
(f) Category 6, which includes clients 21 years of age or 141
older who do not meet the criteria for category 1, category 2, 142
category 3, category 4, or category 5. 143
(g) Category 7, which includes clients younger th an 21 144
years of age who do not meet the criteria for category 1, 145
category 2, category 3, or category 4. 146
(6) Within categories 3, 4, 5, and 6, and 7, the agency 147
shall maintain a waiting list of clients placed in the order of 148
the date that the client is det ermined eligible for waiver 149
services. 150
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 7 of 8
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
(7) The agency shall maintain a registration list of 151
clients who meet the level of care requirement for an 152
intermediate care facility for individuals with intellectual 153
disabilities pursuant to 42 C.F.R. s. 435.217(b) (1) and 42 154
C.F.R. s. 440.150 and who is: 155
(a) An individual under the age of 21 who is requesting 156
and not receiving waiver services and who is not assigned to 157
categories 1, 2, 3, 4, or 5; or 158
(b) An adult who resides in an institutional setting, 159
including, but not limited to, a penal institution, intermediate 160
care facility for the developmentally disabled, mental health 161
hospital, nursing home, or forensic facility run by the agency 162
pursuant to chapter 916. 163
(11) Only a client may be eligible for the hom e and 164
community-based services Medicaid waiver program. To receive 165
services under the home and community -based services Medicaid 166
waiver program, there must be available funding pursuant to s. 167
393.0662, or through a legislative appropriation, and the client 168
must meet all of the following: 169
(a) The eligibility criteria in subsection (2), which must 170
be confirmed by the agency. 171
(b) Eligibility requirements for the Florida Medicaid 172
program under Title XIX of the Social Security Act, as amended, 173
or the Supplemental Security Income program. 174
(c) The level of care requirements for an intermediate 175
HB 1579 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1579-00
Page 8 of 8
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
care facility for individuals with developmental disabilities 176
pursuant to 42 C.F.R. s. 435.217(b)(1) and 42 C.F.R. s. 440.150. 177
(d) The requirements provided in the ap proved federal 178
waiver authorized under s. 1915(c) of the Social Security Act 179
and 42 C.F.R. s. 441.302. 180
Section 2. This act shall take effect July 1, 2023. 181