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A bill to be entitled 1
An act relating to services for individuals with 2
developmental disabilities; amending s. 393.0662, 3
F.S.; requiring the Agency for Person with 4
Disabilities to provide a list of all qualified 5
organizations located within the region in which the 6
client resides and to post its quarterly 7
reconciliation reports on its website within specified 8
timeframes; amending s. 393.065, F.S.; requiring the 9
agency to participate in transition planning 10
activities and to post the total number of individuals 11
in each priority cat egory on its website; amending s. 12
393.502, F.S.; establishing the Statewide Family Care 13
Council; providing for the purpose, membership, and 14
duties of the council; requiring local family care 15
councils to report to the statewide council policy 16
changes and program recommendations in an annual 17
report; providing for appointments of local council 18
members; providing for the creation of family -led 19
nominating committees; providing duties of the agency 20
relating to the statewide council and local councils; 21
amending s. 409.972, F.S.; providing for a method of 22
voluntarily choosing to enroll in Medicaid managed 23
care; amending s. 409.9855, F.S.; revising 24
implementation and eligibility requirements of the 25
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pilot program for individuals with developmental 26
disabilities; provid ing for a method of voluntarily 27
choosing to enroll in the pilot program; requiring the 28
Agency for Persons with Disabilities to transmit to 29
the Agency for Health Care Administration weekly data 30
files of specified clients; requiring the Agency for 31
Health Care Administration to provide a call center 32
for specified purposes and to coordinate with the 33
Department of Children and Families and the Agency for 34
Persons with Disabilities to disseminate information 35
about the pilot program; revising pilot program 36
benefits; revising provider qualifications; requiring 37
participating plans to conduct an individualized 38
assessment of each enrollee within a specified 39
timeframe for certain purposes and to offer certain 40
services to such enrollees; requiring the Agency for 41
Health Care Administration to conduct monitoring and 42
evaluations and require corrective actions or payment 43
of penalties under certain circumstances; removing 44
coordination requirements for the agency when 45
submitting certain reports, establishing specified 46
measures, and conducting quality assurance monitoring 47
of the pilot program; revising specified dates for 48
submitting certain status reports; requiring the 49
Agency for Persons with Disabilities to contract for a 50
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specified study and provide to the Governor, the 51
President of the Senate, and the Speaker of the House 52
of Representatives a specified report by specified 53
date; providing an effective date. 54
55
Be It Enacted by the Legislature of the State of Florida: 56
57
Section 1. Subsections (5) and (14) of section 393.0662, 58
Florida Statutes, are amended to read: 59
393.0662 Individual budgets for delivery of home and 60
community-based services; iBudget system established. —The 61
Legislature finds that improved financial management of the 62
existing home and community -based Medicaid waiver program is 63
necessary to avoid deficits that impede the provision of 64
services to individuals who are on the waiting list for 65
enrollment in the program. The Legislature further finds that 66
clients and their families should have greater flexibility to 67
choose the services that best allow them to live in their 68
community within the limits of an established budget. Therefore, 69
the Legislature intends that the agency, in consultation with 70
the Agency for Health Care Administration, shall manage the 71
service delivery system using individual budgets as the basis 72
for allocating the funds appropriated for the home and 73
community-based services Medicaid waiver program among eligible 74
enrolled clients. The service delivery system that uses 75
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individual budgets shall be cal led the iBudget system. 76
(5) The agency shall ensure that clients and caregivers 77
have access to training and education that inform them about the 78
iBudget system and enhance their ability for self -direction. 79
Such training and education must be offered in a variety of 80
formats and, at a minimum, must address the policies and 81
processes of the iBudget system and the roles and 82
responsibilities of consumers, caregivers, waiver support 83
coordinators, providers, and the agency, and must provide 84
information to help t he client make decisions regarding the 85
iBudget system and examples of support and resources available 86
in the community. The agency shall, within 5 days after 87
enrollment, provide the client with a comprehensive and current 88
written list of all qualified orga nizations located within the 89
region in which the client resides. 90
(14)(a) The agency, in consultation with the Agency for 91
Health Care Administration, shall provide a quarterly 92
reconciliation report of all home and community -based services 93
waiver expenditures from the Agency for Health Care 94
Administration's claims management system with service 95
utilization from the Agency for Persons with Disabilities 96
Allocation, Budget, and Contract Control system. The 97
reconciliation report must be submitted to the Governo r, the 98
President of the Senate, and the Speaker of the House of 99
Representatives no later than 30 days after the close of each 100
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quarter. 101
(b) The agency shall post its quarterly reconciliation 102
reports on its website, in a conspicuous location, no later than 103
5 days after submitting the reports as required in this 104
subsection. 105
Section 2. Subsection (12) of section 393.065, Florida 106
Statutes, is renumbered as subsection (13), paragraph (a) of 107
subsection (1), paragraph (b) of subsection (5), and subsection 108
(10) are amended, and a new subsection (12) is added to that 109
section, to read: 110
393.065 Application and eligibility determination. — 111
(1)(a) The agency shall develop and implement an online 112
application process that, at a minimum, supports paperless, 113
electronic application submissions with immediate e -mail 114
confirmation to each applicant to acknowledge receipt of 115
application upon submission. The online application system must 116
allow an applicant to review the status of a submitted 117
application and respond to prov ide additional information. The 118
online application must allow an applicant to apply for crisis 119
enrollment. 120
(5) Except as provided in subsections (6) and (7), if a 121
client seeking enrollment in the developmental disabilities home 122
and community-based services Medicaid waiver program meets the 123
level of care requirement for an intermediate care facility for 124
individuals with intellectual disabilities pursuant to 42 C.F.R. 125
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ss. 435.217(b)(1) and 440.150, the agency must assign the client 126
to an appropriate preenro llment category pursuant to this 127
subsection and must provide priority to clients waiting for 128
waiver services in the following order: 129
(b) Category 2, which includes clients in the 130
preenrollment categories who are: 131
1. From the child welfare system with a n open case in the 132
Department of Children and Families' statewide automated child 133
welfare information system and who are either: 134
a. Transitioning out of the child welfare system into 135
permanency; or 136
b. At least 18 years but not yet 22 years of age and who 137
need both waiver services and extended foster care services; or 138
2. At least 18 years but not yet 22 years of age and who 139
withdrew consent pursuant to s. 39.6251(5)(c) to remain in the 140
extended foster care system. 141
142
For individuals who are at least 18 years but not yet 22 years 143
of age and who are eligible under sub -subparagraph 1.b., the 144
agency must provide waiver services, including residential 145
habilitation, and must actively participate in transition 146
planning activities, including, but not limited to, 147
individualized service coordination, case management support, 148
and ensuring continuity of care pursuant to s. 39.6035. The 149
community-based care lead agency must fund room and board at the 150
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rate established in s. 409.145(3) and provide case management 151
and related services as defined in s. 409.986(3)(e). Individuals 152
may receive both waiver services and services under s. 39.6251. 153
Services may not duplicate services available through the 154
Medicaid state plan. 155
156
Within preenrollment categories 3, 4, 5, 6, and 7, th e agency 157
shall prioritize clients in the order of the date that the 158
client is determined eligible for waiver services. 159
(10) The client, the client's guardian, or the client's 160
family must ensure that accurate, up -to-date contact information 161
is provided to the agency at all times. Notwithstanding s. 162
393.0651, the agency must send an annual letter requesting 163
updated information from the client, the client's guardian, or 164
the client's family. The agency must remove from the 165
preenrollment categories any individ ual who cannot be located 166
using the contact information provided to the agency, fails to 167
meet eligibility requirements, or becomes domiciled outside the 168
state. 169
(12) To ensure transparency and timely access to 170
information, the agency shall post on its web site in a 171
conspicuous location the total number of individuals in each 172
priority category by county of residence. The posted numbers 173
shall reflect the current status of the preenrollment priority 174
list and shall be updated at least every 5 days. 175
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Section 3. Section 393.502, Florida Statutes, is amended 176
to read: 177
393.502 Family care councils. — 178
(1) CREATION AND PURPOSE OF STATEWIDE FAMILY CARE 179
COUNCIL.—There shall be established and located within each 180
service area of the agency a family care council. 181
(a) The Statewide Family Care Council is established to 182
connect local family care councils and facilitate direct 183
communication between local councils and the agency, with the 184
goal of enhancing the quality of and access to resources and 185
supports for individu als with developmental disabilities and 186
their families. 187
(b) The statewide council shall: 188
1. Review annual reports, policy proposals, and program 189
recommendations submitted by the local family care councils. 190
2. Advise the agency on statewide policies, programs, and 191
service delivery improvements based on the collective 192
recommendations of the local councils. 193
3. Identify systemic barriers to the effective delivery of 194
services and recommend solutions to address such barriers. 195
4. Foster collaboration an d the sharing of best practices 196
and available resources among local family care councils to 197
improve service delivery across regions. 198
5. Submit an annual report no later than December 1 of 199
each year to the Governor, the President of the Senate, the 200
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Speaker of the House of Representatives, and the agency. The 201
report shall include a summary of local council findings, policy 202
recommendations, and an assessment of the agency's actions in 203
response to previous recommendations of the local councils. 204
(c) The agency shall provide a written response within 60 205
days after receipt, including a detailed action plan outlining 206
steps taken or planned to address recommendations. The response 207
must specify whether recommendations will be implemented and 208
provide a timeline fo r implementation or include justification 209
if recommendations are not adopted. 210
(2) STATEWIDE FAMILY CARE COUNCIL MEMBERSHIP. — 211
(a) The statewide council shall consist of the following 212
members appointed by the Governor: 213
1. One representative from each of the local family care 214
councils, who must be a resident of the area served by that 215
local council. Among these representatives must be at least one 216
individual who is receiving waiver services from the agency 217
under s. 393.065 and at least one individual w ho is assigned to 218
a preenrollment category for waiver services under s. 393.065. 219
2. One individual representing an advocacy organization 220
representing individuals with disabilities. 221
3. One representative of a public or private entity that 222
provides services to individuals with developmental disabilities 223
that does not have a Medicaid waiver service contract with the 224
agency. 225
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(b) Employees of the agency or the Agency for Health Care 226
Administration are not eligible to serve on the statewide 227
council. 228
(3) STATEWIDE FAMILY CARE COUNCIL TERMS; VACANCIES. — 229
(a) Statewide council members shall be initially appointed 230
to staggered 2 and 4 year terms, with subsequent terms of 4 231
years. Members may be reappointed to one additional consecutive 232
term. 233
(b) A member who has served two consecutive terms shall 234
not be eligible to serve again until 12 months have elapsed 235
since ending service on the statewide council. 236
(c) Upon expiration of a term or in the case of any other 237
vacancy, the statewide council shall, by major ity vote, 238
recommend to the Governor for appointment at least one person 239
for each vacancy. 240
1. The Governor shall make an appointment within 45 days 241
after receiving a recommendation from the statewide council. If 242
the Governor fails to make an appointment for a member under 243
subsection (2), the chair of the local council may appoint a 244
member meeting the requirements of subsection (2) to act as the 245
statewide council representative for that local council until 246
the Governor makes an appointment. 247
2. If no member of a local council is willing and able to 248
serve on the statewide council, the Governor shall appoint an 249
individual from another local council to serve on the statewide 250
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council. 251
(4) STATEWIDE FAMILY CARE COUNCIL MEETINGS; ORGANIZATION. —252
The statewide council shall meet at least quarterly. The council 253
meetings may be held in person or via te leconference or other 254
electronic means. 255
(a) The Governor shall appoint the initial chair from 256
among the members of the statewide council. Subsequent chairs 257
shall be elected annually by a majority vote of the council. 258
(b) Members of the statewide counc il shall serve without 259
compensation but may be reimbursed for per diem and travel 260
expenses pursuant to s. 112.061. 261
(c) A majority of the members of the statewide council 262
shall constitute a quorum. 263
(5) LOCAL FAMILY CARE COUNCILS. —There is established a nd 264
located within each service area of the agency a local family 265
care council to work constructively with the agency, advise the 266
agency on local needs, identify gaps in services, and advocate 267
for individuals with developmental disabilities and their 268
families. 269
(6) LOCAL FAMILY CARE COUNCIL DUTIES. —The local family 270
care councils shall: 271
(a) Assist in providing information and conducting 272
outreach to individuals with developmental disabilities and 273
their families. 274
(b) Convene family listening sessions at least twice a 275
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year to gather input on local service delivery challenges. 276
(c) Hold a public forum every 6 months to solicit public 277
feedback concerning actions taken by the local family councils. 278
(d) Share information with other local family care 279
councils. 280
(e) Identify policy issues relevant to the community and 281
family support system in the region. 282
(f) Submit to the Statewide Family Care Council, no later 283
than September 1 of each year, an annual report detaili ng 284
proposed policy changes, program recommendations, and identified 285
service delivery challenges within its region. 286
(7)(2) LOCAL FAMILY CARE COUNCIL MEMBERSHIP.— 287
(a) Each local family care council shall consist of at 288
least 10 and no more than 15 members recommended by a majority 289
vote of the local family care council and appointed by the 290
Governor. 291
(b) At least three of the members of the council shall be 292
individuals receiving or waiting to receive services from the 293
agency. One such member shall be an in dividual who has been 294
receiving services within the 4 years before the date of 295
recommendation. The remainder of the council members shall be 296
parents, grandparents, guardians, or siblings of individuals who 297
have developmental disabilities and qualify for se rvices 298
pursuant to this chapter. For a grandparent to be a council 299
member, the grandchild's parent or legal guardian must consent 300
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to the appointment and report the consent to the agency. 301
(c) A person who is currently serving on another board or 302
council of the agency may not be appointed to a local family 303
care council. 304
(d) Employees of the agency or the Agency for Health Care 305
Administration are not eligible to serve on a local family care 306
council. 307
(e) Persons related by consanguinity or affinity within 308
the third degree shall not serve on the same local family care 309
council at the same time. 310
(f) A chair for the council shall be chosen by the council 311
members to serve for 1 year. A person may not serve no more than 312
four 1-year terms as chair. 313
(8)(3) LOCAL FAMILY CARE COUNCIL TERMS; VACANCIES.— 314
(a) Local family council members shall be appointed for a 315
3-year terms term, except as provided in subsection (11) (8), 316
and may be reappointed to one additional term. 317
(b) A member who has served two consecutive terms shall 318
not be eligible to serve again until 12 months have elapsed 319
since ending his or her service on the local council. 320
(c)1. Upon expiration of a term or in the case of any 321
other vacancy, the local council shall, by majority vote, 322
recommend to the Governor for appointment a person for each 323
vacancy based on recommendations received from the family -led 324
nominating committee described in paragraph (9)(a) . 325
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2. The Governor shall make an appointment within 45 days 326
after receiving a recommendation. If t he Governor fails to make 327
an appointment within 45 days, the local council shall, by 328
majority vote, select an interim appointment for each vacancy 329
from the panel of candidates recommended by the family -led 330
nomination committee. 331
(9)(4) LOCAL FAMILY CARE COUNCIL COMMITTEE APPOINTMENTS. — 332
(a) The chair of each local family care council shall 333
create, and appoint individuals receiving or waiting to receive 334
services from the agency and their relatives, to serve on a 335
family-led nominating committee. Members of the family-led 336
nominating council need not be members of the local council. The 337
family-led nominating committee shall nominate candidates for 338
vacant positions on the local family council. 339
(b) The chair of the local family care council may appoint 340
persons to serve on additional council committees. Such persons 341
may include current members of the council and former members of 342
the council and persons not eligible to serve on the council. 343
(10)(6) LOCAL FAMILY CARE COUNCIL MEETINGS.—Local council 344
members shall serve on a voluntary basis without payment for 345
their services but shall be reimbursed for per diem and travel 346
expenses as provided for in s. 112.061. Local councils The 347
council shall meet at least six times per year. Meetings may be 348
held in person or by teleconference or other electronic means. 349
(7) PURPOSE.—The purpose of the local family care councils 350
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shall be to advise the agency, to develop a plan for the 351
delivery of family support services within the local area, and 352
to monitor the implementation and effectiveness of services and 353
support provided under the plan. The primary functions of the 354
local family care councils shall be to: 355
(a) Assist in providing information and outreach to 356
families. 357
(b) Review the effectiveness of serv ice programs and make 358
recommendations with respect to program implementation. 359
(c) Advise the agency with respect to policy issues 360
relevant to the community and family support system in the local 361
area. 362
(d) Meet and share information with other local fam ily 363
care councils. 364
(11)(8) NEW LOCAL FAMILY CARE COUNCILS.—When a local 365
family care council is established for the first time in a local 366
area, the Governor shall appoint the first four council members, 367
who shall serve 3-year terms. These members shall su bmit to the 368
Governor, within 90 days after their appointment, 369
recommendations for at least six additional members, selected by 370
majority vote. 371
(12)(9) FUNDING; FINANCIAL REVIEW. —The statewide and local 372
family care councils council may apply for, receive, and accept 373
grants, gifts, donations, bequests, and other payments from any 374
public or private entity or person. Each local council is 375
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subject to an annual financial review by staff assigned by the 376
agency. Each local council shall ex ercise care and prudence in 377
the expenditure of funds. The local family care councils shall 378
comply with state expenditure requirements. 379
(13)(5) TRAINING.— 380
(a) The agency, in consultation with the statewide and 381
local councils, shall establish and provide a training program 382
for local family care council members. Each local area shall 383
provide the training program when new persons are appointed to 384
the local council and at other times as the secretary deems 385
necessary. 386
(b) The training shall assist the counc il members to 387
understand the laws, rules, and policies applicable to their 388
duties and responsibilities. 389
(c) All persons newly appointed to the statewide or a 390
local council must complete this training within 90 days after 391
their appointment. A person who f ails to meet this requirement 392
is shall be considered to have resigned from the council. The 393
agency may make additional training available to council 394
members. 395
(14) DUTIES.—The agency shall publish on its website all 396
annual reports submitted by the local f amily care councils and 397
the Statewide Family Care Council within 15 days after receipt 398
of such reports in a designated and easily accessible section of 399
the website. 400
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(15) ADMINISTRATIVE SUPPORT. —The agency shall provide 401
administrative support to the state wide council and local 402
councils, including, but not limited to, staff assistance and 403
meeting facilities, within existing resources. 404
Section 4. Subsection (1) of section 409.972, Florida 405
Statutes, is amended to read: 406
409.972 Mandatory and voluntary en rollment.— 407
(1) The following Medicaid -eligible persons are exempt 408
from mandatory managed care enrollment required by s. 409.965, 409
and may voluntarily choose to participate in the managed medical 410
assistance program. These eligible persons must make an 411
affirmative choice before any enrollment action by the agency. 412
The agency may not automatically enroll these eligible persons. : 413
(a) Medicaid recipients who have other creditable health 414
care coverage, excluding Medicare. 415
(b) Medicaid recipients residing in residential commitment 416
facilities operated through the Department of Juvenile Justice 417
or a treatment facility as defined in s. 394.455. 418
(c) Persons eligible for refugee assistance. 419
(d) Medicaid recipients who are residents of a 420
developmental disability center, including Sunland Center in 421
Marianna and Tacachale in Gainesville. 422
(e) Medicaid recipients enrolled in the home and community 423
based services waiver pursuant to chapter 393, and Medicaid 424
recipients waiting for waiver services. 425
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(f) Medicaid recipients residing in a group home facility 426
licensed under chapter 393. 427
(g) Children receiving services in a prescribed pediatric 428
extended care center. 429
Section 5. Subsections (1), (2), (3), and (6) of section 430
409.9855, Florida Statutes, are amended to r ead: 431
409.9855 Pilot program for individuals with developmental 432
disabilities.— 433
(1) PILOT PROGRAM IMPLEMENTATION. — 434
(a) Using a managed care model, The agency shall implement 435
a pilot program for individuals with developmental disabilities 436
in Statewide Medicaid Managed Care Regions D and I to provide 437
coverage of comprehensive services using a managed care model. 438
The agency may seek federal approval through a state plan 439
amendment or Medicaid waiver as necessary to implement the pilot 440
program. 441
(b) The agency shall administer the pilot program pursuant 442
to s. 409.963 and as a component of the Statewide Medicaid 443
Managed Care model established by this part. Unless otherwise 444
specified, ss. 409.961 -409.969 apply to the pilot program. The 445
agency may seek federal approval through a state plan amendment 446
or Medicaid waiver as necessary to implement the pilot program. 447
The agency shall submit a request for any federal approval 448
needed to implement the pilot program by September 1, 2023. 449
(c) Pursuant to s. 409.963, the agency shall administer 450
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the pilot program in consultation with the Agency for Persons 451
with Disabilities. 452
(c)(d) The agency shall make capitated payments to managed 453
care organizations for comprehensive coverage, including managed 454
medical assistance benefits and long -term care under this part 455
and community-based services described in s. 393.066(3) and 456
approved through the state's home and community -based services 457
Medicaid waiver program for individuals with developmental 458
disabilities. Unless otherwise specified, ss. 409.961 -409.969 459
apply to the pilot program . 460
(e) The agency shall evaluate the feasibility of statewide 461
implementation of the capitated managed care model used by the 462
pilot program to serve individuals with devel opmental 463
disabilities. 464
(2) ELIGIBILITY; VOLUNTARY ENROLLMENT; DISENROLLMENT. — 465
(a) Participation in the pilot program is voluntary and 466
limited to the maximum number of enrollees specified in the 467
General Appropriations Act. An individual must make an 468
affirmative choice before any enrollment action by the agency. 469
The agency may not automatically enroll eligible individuals. 470
(b) To be eligible for enrollment in the pilot program, an 471
individual must: 472
(b) The Agency for Persons with Disabilities shall ap prove 473
a needs assessment methodology to determine functional, 474
behavioral, and physical needs of prospective enrollees. The 475
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assessment methodology may be administered by persons who have 476
completed such training as may be offered by the agency. 477
Eligibility to participate in the pilot program is determined 478
based on all of the following criteria: 479
1. Be Medicaid eligible. 480
1. Whether the individual is eligible for Medicaid. 481
2. Be Whether the individual is 18 years of age or older . 482
3. Have a developmental disability as defined in s. 483
393.063. 484
4. Be placed in any preenrollment category for individual 485
budget waiver services under chapter 393 and reside in Statewide 486
Medicaid Managed Care Regions D or I; effective October 1, 2025, 487
be placed in any preenrollmen t category for individual budget 488
waiver services under chapter 393 regardless of region; or, 489
effective July 1, 2026, be enrolled in the individual budget 490
waiver services program under chapter 393 or in the long -term 491
care managed care program under this par t regardless of region 492
and is on the waiting list for individual budget waiver services 493
under chapter 393 and assigned to one of categories 1 through 6 494
as specified in s. 393.065(5) . 495
3. Whether the individual resides in a pilot program 496
region. 497
(c) The agency shall enroll individuals in the pilot 498
program based on verification that the individual has met the 499
criteria in paragraph (b). 500
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1. The Agency for Persons with Disabilities shall transmit 501
to the agency weekly data files of clients enrolled in the 502
Medicaid home and community -based services waiver program under 503
chapter 393 and clients in preenrollment categories pursuant to 504
s. 393.065. The agency shall maintain a record of individuals 505
with developmental disabilities who may be eligible for the 506
pilot program using this data, Medicaid enrollment data 507
transmitted by the Department of Children and Families, and any 508
available collateral data. 509
2. The agency shall determine and administer the process 510
for enrollment. A needs assessment conducted by the Agency for 511
Persons with Disabilities is not required for enrollment. The 512
agency shall notify individuals with developmental disabilities 513
of the opportunity to voluntarily enroll in the pilot program 514
and explain the benefits available through the pilot program, 515
the process for enrollment, and the procedures for 516
disenrollment, including the requirement for continued coverage 517
after disenrollment pursuant to paragraph (d). 518
3. The agency shall provide a call center staffed by 519
agents trained to assist individuals wit h developmental 520
disabilities and their families in learning about and enrolling 521
in the pilot program. 522
4. The agency shall coordinate with the Department of 523
Children and Families and the Agency for Persons with 524
Disabilities to develop partnerships with co mmunity-based 525
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organizations to disseminate information about the pilot program 526
to providers of covered services and potential enrollees. 527
(d) Notwithstanding any provisions of s. 393.065 to the 528
contrary, an enrollee must be afforded an opportunity to enro ll 529
in any appropriate existing Medicaid waiver program if any of 530
the following conditions occur: 531
1. At any point during the operation of the pilot program, 532
an enrollee declares an intent to voluntarily disenroll, 533
provided that he or she has been covered for the entire previous 534
plan year by the pilot program. 535
2. The agency determines the enrollee has a good cause 536
reason to disenroll. 537
3. The pilot program ceases to operate. 538
539
Such enrollees must receive an individualized transition plan to 540
assist him or her in accessing sufficient services and supports 541
for the enrollee's safety, well -being, and continuity of care. 542
(3) PILOT PROGRAM BENEFITS. — 543
(a) Plans participating in the pilot program must, at a 544
minimum, cover the following: 545
1. All benefits includ ed in s. 409.973. 546
2. All benefits included in s. 409.98. 547
3. All benefits included in s. 393.066(3) . 548
4. Any additional benefits negotiated by the agency 549
pursuant to paragraph (4)(b) , and all of the following: 550
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a. Adult day training . 551
b. Behavior analysis services. 552
c. Behavior assistant services. 553
d. Companion services. 554
e. Consumable medical supplies. 555
f. Dietitian services. 556
g. Durable medical equipment and supplies. 557
h. Environmental accessibility adaptations. 558
i. Occupational therapy. 559
j. Personal emergency response systems. 560
k. Personal supports. 561
l. Physical therapy. 562
m. Prevocational services. 563
n. Private duty nursing. 564
o. Residential habilitation, including the following 565
levels: 566
(I) Standard level. 567
(II) Behavior-focused level. 568
(III) Intensive-behavior level. 569
(IV) Enhanced intensive -behavior level. 570
p. Residential nursing services. 571
q. Respiratory therapy. 572
r. Respite care. 573
s. Skilled nursing. 574
t. Specialized medical home care. 575
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u. Specialized mental health counsel ing. 576
v. Speech therapy. 577
w. Support coordination. 578
x. Supported employment. 579
y. Supported living coaching. 580
z. Transportation. 581
(b) All providers of the benefits services listed under 582
paragraph (a) must meet the provider qualifications established 583
by the agency for the Medicaid long -term care managed care 584
program under this section. If no such qualifications apply to a 585
specific benefit or provider type, the provider must meet the 586
provider qualifications established by the Agency for Persons 587
with Disabilities for the individual budget waiver services 588
program under chapter 393 outlined in the Florida Medicaid 589
Developmental Disabilities Individual Budgeting Waiver Services 590
Coverage and Limitations Handbook as adopted by reference in 591
rule 59G-13.070, Florida Administrative Code . 592
(c) Support coordination services must maximize the use of 593
natural supports and community partnerships. 594
(d) The plans participating in the pilot program must 595
provide all categories of benefits through a single, integrated 596
model of care. 597
(e) Participating plans must provide benefits services 598
must be provided to enrollees in accordance with an 599
individualized care plan which is evaluated and updated at least 600
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quarterly and as warranted by changes in an enrollee's 601
circumstances. Participating plans must conduct an 602
individualized assessment of each enrollee within 5 days after 603
enrollment to determine the enrollee's functional, behavioral, 604
and physical needs. The assessment method or instrument must be 605
approved by the agency. 606
(f) Participating plans must offer a consumer -directed 607
services option in accordance with s. 409.221. 608
(6) PROGRAM IMPLEMENTATION AND EVALUATION. — 609
(a) The agency shall conduct monitoring and evaluations 610
and require corrective actions or payment of penalties as may be 611
necessary to secure compliance with contractual requirements, 612
consistent with its obligations under this section, including, 613
but not limited to, compliance with provider network standards, 614
financial accountability, performance standards, health c are 615
quality improvement systems, and program integrity select 616
participating plans and begin enrollment no later than January 617
31, 2024, with coverage for enrollees becoming effective upon 618
authorization and availability of sufficient state and federal 619
resources. 620
(b) Upon implementation of the program, the agency, in 621
consultation with the Agency for Persons with Disabilities, 622
shall conduct audits of the selected plans' implementation of 623
person-centered planning. 624
(b)(c) The agency, in consultation wit h the Agency for 625
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Persons with Disabilities, shall submit progress reports to the 626
Governor, the President of the Senate, and the Speaker of the 627
House of Representatives upon the federal approval, 628
implementation, and operation of the pilot program, as follow s: 629
1. By August 30, 2025 December 31, 2023, a status report 630
on progress made toward federal approval of the waiver or waiver 631
amendment needed to implement the pilot program. 632
2. By December 31, 2025 2024, a status report on 633
implementation of the pilot p rogram. 634
3. By December 31, 2025, and annually thereafter, a status 635
report on the operation of the pilot program, including, but not 636
limited to, all of the following: 637
a. Program enrollment, including the number and 638
demographics of enrollees. 639
b. Any complaints received. 640
c. Access to approved services. 641
(c)(d) The agency, in consultation with the Agency for 642
Persons with Disabilities, shall establish specific measures of 643
access, quality, and costs of the pilot program. The agency may 644
contract with an independent evaluator to conduct such 645
evaluation. The evaluation must include assessments of cost 646
savings; consumer education, choice, and access to services; 647
plans for future capacity and the enrollment of new Medicaid 648
providers; coordination of care; pers on-centered planning and 649
person-centered well-being outcomes; health and quality -of-life 650
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outcomes; and quality of care by each eligibility category and 651
managed care plan in each pilot program site. The evaluation 652
must describe any administrative or legal b arriers to the 653
implementation and operation of the pilot program in each 654
region. 655
1. The agency, in consultation with the Agency for Persons 656
with Disabilities, shall conduct quality assurance monitoring of 657
the pilot program to include client satisfaction with services, 658
client health and safety outcomes, client well -being outcomes, 659
and service delivery in accordance with the client's care plan. 660
2. The agency shall submit the results of the evaluation 661
to the Governor, the President of the Senate, and the S peaker of 662
the House of Representatives by October 1, 2029. 663
Section 6. (1) The agency shall contract for a study to 664
review, evaluate, and identify recommendations regarding the 665
algorithm required under s. 393.0662, Florida Statutes. The 666
individual contractor must possess or, if the contractor is a 667
firm must include at least one lead team member who possesses, a 668
doctorate in statistics and advanced knowledge of the 669
development and selection of multiple linear regression models. 670
The study must, at a minim um, assess the performance of the 671
current algorithm used by the agency and determine whether a 672
different algorithm would better meet the requirements of that 673
section. In conducting this assessment and determination, at a 674
minimum, the study must also review the fit of recent 675
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expenditure data to the current algorithm, determine and refine 676
dependent and independent variables, develop and apply a method 677
for identifying and removing outliers, develop alternative 678
algorithms using multiple linear regression, test the accuracy 679
and reliability of the algorithms, provide recommendations for 680
improving accuracy and reliability, recommend an algorithm for 681
use by the agency, assess the robustness of the recommended 682
algorithm, and provide suggestions for improving any reco mmended 683
alternative algorithm, if appropriate. The study must also 684
consider whether any waiver services that are not currently 685
funded through the algorithm can be funded through the current 686
algorithm or an alternative algorithm, and the impact of doing 687
so on that algorithm's fit and effectiveness. The study must 688
present for any recommended alternative algorithm, at a minimum, 689
the estimated number and percent of waiver enrollees who would 690
require supplemental funding under s. 393.0662(1)(b), Florida 691
Statutes, compared to the current algorithm; and the number and 692
percent of waiver enrollees whose budgets are estimated to 693
increase or decrease, categorized by level of increase or 694
decrease, age, living setting, and current total individual 695
budget amount. 696
(2) The agency shall report to the Governor, the President 697
of the Senate, and the Speaker of the House of Representatives 698
findings and recommendations by November 15, 2025. 699
Section 7. This act shall take effect July 1, 2025. 700