Florida Senate - 2024 SB 1758 By Senator Brodeur 10-00892C-24 20241758__ 1 A bill to be entitled 2 An act relating to individuals with disabilities; 3 amending s. 393.065, F.S.; requiring the Agency for 4 Persons with Disabilities to develop and implement an 5 online application process; specifying requirements 6 for the online application process; defining the term 7 complete application; revising timeframes within 8 which the agency must make eligibility determinations 9 for services; lowering the age that a caregiver must 10 be for an individual to be placed in a certain 11 preenrollment category; amending s. 393.0651, F.S.; 12 revising which types of clients are eligible for an 13 individual support plan; clarifying the timeframe 14 within which a family or individual support plan must 15 be developed; requiring waiver support coordinators to 16 inform the client or clients parent or guardian, as 17 appropriate, of certain information when developing or 18 reviewing the family or individual support plan; 19 providing appropriations; providing an effective date. 20 21 Be It Enacted by the Legislature of the State of Florida: 22 23 Section 1.Subsection (1) and paragraph (d) of subsection 24 (5) of section 393.065, Florida Statutes, are amended to read: 25 393.065Application and eligibility determination. 26 (1)(a)The agency shall develop and implement an online 27 application process that, at a minimum, supports paperless, 28 electronic application submissions with immediate e-mail 29 confirmation to each applicant to acknowledge receipt of 30 application upon submission. The online application system must 31 allow an applicant to review the status of a submitted 32 application and respond to provide additional information. 33 (b)The agency shall maintain access to a printable paper 34 application on its website and, upon request, must provide an 35 applicant with a printed paper application. Paper applications 36 may Application for services shall be submitted made in writing 37 to the agency, in the region in which the applicant resides. 38 (c)The agency must shall review each submitted application 39 in accordance with federal time standards and make an 40 eligibility determination within 60 days after receipt of the 41 signed application. If, at the time of the application, an 42 applicant is requesting enrollment in the home and community 43 based services Medicaid waiver program for individuals with 44 developmental disabilities deemed to be in crisis, as described 45 in paragraph (5)(a), the agency shall complete an eligibility 46 determination within 45 days after receipt of the signed 47 application. 48 (d)(a)If the agency determines additional documentation is 49 necessary to make an eligibility determination, the agency may 50 request the additional documentation from the applicant. 51 (e)(b)When necessary to definitively identify individual 52 conditions or needs, the agency or its designee must provide a 53 comprehensive assessment. 54 (c)If the agency requests additional documentation from 55 the applicant or provides or arranges for a comprehensive 56 assessment, the agencys eligibility determination must be 57 completed within 90 days after receipt of the signed 58 application. 59 (f)1.For purposes of this paragraph, the term complete 60 application means an application submitted to the agency which 61 is signed and dated by the applicant or an individual with legal 62 authority to apply for public benefits on behalf of the 63 applicant, is responsive on all parts of the application, and 64 contains documentation of a diagnosis. 65 2.If the applicant requesting enrollment in the home and 66 community-based services Medicaid waiver program for individuals 67 with developmental disabilities is deemed to be in crisis as 68 described in paragraph (5)(a), the agency must make an 69 eligibility determination within 15 calendar days after receipt 70 of a complete application. 71 3.If the applicant meets the criteria specified in 72 paragraph (5)(b), the agency must review and make an eligibility 73 determination as soon as practicable after receipt of a complete 74 application. 75 4.If the application meets the criteria specified in 76 paragraphs (5)(c)-(g), the agency shall make an eligibility 77 determination within 60 days after receipt of a complete 78 application. 79 (g)Any delays in the eligibility determination process, or 80 any tolling of the time standard until certain information or 81 actions have been completed, must be conveyed to the client as 82 soon as such delays are known through a verbal contact with the 83 client or the clients designated caregiver and confirmed by a 84 written notice of the delay, the anticipated length of delay, 85 and a contact person for the client. 86 (5)Except as provided in subsections (6) and (7), if a 87 client seeking enrollment in the developmental disabilities home 88 and community-based services Medicaid waiver program meets the 89 level of care requirement for an intermediate care facility for 90 individuals with intellectual disabilities pursuant to 42 C.F.R. 91 ss. 435.217(b)(1) and 440.150, the agency must assign the client 92 to an appropriate preenrollment category pursuant to this 93 subsection and must provide priority to clients waiting for 94 waiver services in the following order: 95 (d)Category 4, which includes, but is not required to be 96 limited to, clients whose caregivers are 60 70 years of age or 97 older and for whom a caregiver is required but no alternate 98 caregiver is available. 99 100 Within preenrollment categories 3, 4, 5, 6, and 7, the agency 101 shall prioritize clients in the order of the date that the 102 client is determined eligible for waiver services. 103 Section 2.Section 393.0651, Florida Statutes, is amended 104 to read: 105 393.0651Family or individual support plan.The agency 106 shall provide directly or contract for the development of a 107 family support plan for children ages 3 to 18 years of age and 108 an individual support plan for each client served by the home 109 and community-based services Medicaid waiver program under s. 110 393.0662. The client, if competent, the clients parent or 111 guardian, or, when appropriate, the client advocate, shall be 112 consulted in the development of the plan and shall receive a 113 copy of the plan. Each plan must include the most appropriate, 114 least restrictive, and most cost-beneficial environment for 115 accomplishment of the objectives for client progress and a 116 specification of all services authorized. The plan must include 117 provisions for the most appropriate level of care for the 118 client. Within the specification of needs and services for each 119 client, when residential care is necessary, the agency shall 120 move toward placement of clients in residential facilities based 121 within the clients community. The ultimate goal of each plan, 122 whenever possible, shall be to enable the client to live a 123 dignified life in the least restrictive setting, be that in the 124 home or in the community. The family or individual support plan 125 must be developed within 60 calendar days after the agency 126 determines the client eligible pursuant to s. 393.065(3). 127 (1)The agency shall develop and specify by rule the core 128 components of support plans. 129 (2)The family or individual support plan shall be 130 integrated with the individual education plan (IEP) for all 131 clients who are public school students entitled to a free 132 appropriate public education under the Individuals with 133 Disabilities Education Act, I.D.E.A., as amended. The family or 134 individual support plan and IEP must be implemented to maximize 135 the attainment of educational and habilitation goals. 136 (a)If the IEP for a student enrolled in a public school 137 program indicates placement in a public or private residential 138 program is necessary to provide special education and related 139 services to a client, the local education agency must provide 140 for the costs of that service in accordance with the 141 requirements of the Individuals with Disabilities Education Act, 142 I.D.E.A., as amended. This does not preclude local education 143 agencies and the agency from sharing the residential service 144 costs of students who are clients and require residential 145 placement. 146 (b)For clients who are entering or exiting the school 147 system, an interdepartmental staffing team composed of 148 representatives of the agency and the local school system shall 149 develop a written transitional living and training plan with the 150 participation of the client or with the parent or guardian of 151 the client, or the client advocate, as appropriate. 152 (3)Each family or individual support plan shall be 153 facilitated through case management designed solely to advance 154 the individual needs of the client. 155 (4)In the development of the family or individual support 156 plan, a client advocate may be appointed by the support planning 157 team for a client who is a minor or for a client who is not 158 capable of express and informed consent when: 159 (a)The parent or guardian cannot be identified; 160 (b)The whereabouts of the parent or guardian cannot be 161 discovered; or 162 (c)The state is the only legal representative of the 163 client. 164 165 Such appointment may not be construed to extend the powers of 166 the client advocate to include any of those powers delegated by 167 law to a legal guardian. 168 (5)The agency shall place a client in the most appropriate 169 and least restrictive, and cost-beneficial, residential facility 170 according to his or her individual support plan. The client, if 171 competent, the clients parent or guardian, or, when 172 appropriate, the client advocate, and the administrator of the 173 facility to which placement is proposed shall be consulted in 174 determining the appropriate placement for the client. 175 Considerations for placement shall be made in the following 176 order: 177 (a)Clients own home or the home of a family member or 178 direct service provider. 179 (b)Foster care facility. 180 (c)Group home facility. 181 (d)Intermediate care facility for the developmentally 182 disabled. 183 (e)Other facilities licensed by the agency which offer 184 special programs for people with developmental disabilities. 185 (f)Developmental disabilities center. 186 (6)In developing a clients annual family or individual 187 support plan, the individual or family with the assistance of 188 the support planning team shall identify measurable objectives 189 for client progress and shall specify a time period expected for 190 achievement of each objective. 191 (7)The individual, family, and support coordinator shall 192 review progress in achieving the objectives specified in each 193 clients family or individual support plan, and shall revise the 194 plan annually, following consultation with the client, if 195 competent, or with the parent or guardian of the client, or, 196 when appropriate, the client advocate. The agency or designated 197 contractor shall annually report in writing to the client, if 198 competent, or to the parent or guardian of the client, or to the 199 client advocate, when appropriate, with respect to the clients 200 habilitative and medical progress. 201 (8)Any client, or any parent of a minor client, or 202 guardian, authorized guardian advocate, or client advocate for a 203 client, who is substantially affected by the clients initial 204 family or individual support plan, or the annual review thereof, 205 shall have the right to file a notice to challenge the decision 206 pursuant to ss. 120.569 and 120.57. Notice of such right to 207 appeal shall be included in all support plans provided by the 208 agency. 209 (9)When developing or reviewing a clients family or 210 individual support plan, the waiver support coordinator shall 211 inform the client, the clients parent or guardian, or, when 212 appropriate, the client advocate about the consumer-directed 213 care program established under s. 409.221. 214 Section 3.For the 2024-2025 fiscal year, the sum of 215 $16,562,703 in recurring funds from the General Revenue Fund and 216 $22,289,520 in recurring funds from the Operations and 217 Maintenance Trust Fund are appropriated in the Home and 218 Community Based Services Waiver category to the Agency for 219 Persons with Disabilities to offer waiver services to the 220 greatest number of individuals permissible under the 221 appropriation from preenrollment categories 3, 4, and 5, 222 including individuals whose caregiver is age 60 or older in 223 category 4, as provided in s. 393.065, Florida Statutes, as 224 amended by this act. For the 2024-2025 fiscal year, the sum of 225 $38,852,223 in recurring funds from the Medical Care Trust Fund 226 is appropriated in the Home and Community Based Services Waiver 227 category to the Agency for Health Care Administration to 228 establish budget authority for Medicaid services. 229 Section 4.This act shall take effect July 1, 2024.