FL
Florida House Bill H1103

Florida 2025 Regular Session

Florida House Bill H1103 Compare Versions

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1010 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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1414 A bill to be entitled 1
1515 An act relating to services for individuals with 2
1616 developmental disabilities; amending s. 393.0662, 3
17-F.S.; requiring the Agency for Person with 4
18-Disabilities to provide a list of all qualified 5
19-organizations located within the region in which the 6
20-client resides and to post its quarterly 7
21-reconciliation reports on its website within specified 8
22-timeframes; amending s. 393.065, F.S.; requiring the 9
23-agency to participate in transition planning 10
24-activities and to post the total number of individuals 11
25-in each priority cat egory on its website; amending s. 12
26-393.502, F.S.; establishing the Statewide Family Care 13
27-Council; providing for the purpose, membership, and 14
28-duties of the council; requiring local family care 15
29-councils to report to the statewide council policy 16
30-changes and program recommendations in an annual 17
31-report; providing for appointments of local council 18
32-members; providing for the creation of family -led 19
33-nominating committees; providing duties of the agency 20
34-relating to the statewide council and local councils; 21
35-amending s. 409.972, F.S.; providing for a method of 22
36-voluntarily choosing to enroll in Medicaid managed 23
37-care; amending s. 409.9855, F.S.; revising 24
38-implementation and eligibility requirements of the 25
17+F.S.; requiring the Agency for Persons with 4
18+Disabilities to post its quarterly reconciliation 5
19+reports on its website within a specified timeframe; 6
20+amending s. 393.065, F.S.; providing a requirement for 7
21+the online application system to allow an applicant to 8
22+apply for crisis enrollment; removing a requirement 9
23+for the agency to remove certain individuals from the 10
24+preenrollment categories under certain circumstanc es; 11
25+requiring the agency to participate in transition 12
26+planning activities and to post the total number of 13
27+individuals in each priority category on its website; 14
28+amending s. 393.502, F.S.; establishing the Statewide 15
29+Family Care Council; providing for the pur pose, 16
30+membership, and duties of the council; requiring local 17
31+family care councils to report to the statewide 18
32+council policy changes and program recommendations in 19
33+an annual report; providing for appointment of council 20
34+members; providing for the creation of family-led 21
35+nominating committees; providing duties of the agency 22
36+relating to the statewide council and local councils; 23
37+amending s. 409.9855, F.S.; revising implementation 24
38+and eligibility requirements of the pilot program for 25
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4747 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-pilot program for individuals with developmental 26
52-disabilities; provid ing for a method of voluntarily 27
53-choosing to enroll in the pilot program; requiring the 28
54-Agency for Persons with Disabilities to transmit to 29
55-the Agency for Health Care Administration weekly data 30
56-files of specified clients; requiring the Agency for 31
57-Health Care Administration to provide a call center 32
58-for specified purposes and to coordinate with the 33
59-Department of Children and Families and the Agency for 34
60-Persons with Disabilities to disseminate information 35
61-about the pilot program; revising pilot program 36
62-benefits; revising provider qualifications; requiring 37
63-participating plans to conduct an individualized 38
64-assessment of each enrollee within a specified 39
65-timeframe for certain purposes and to offer certain 40
66-services to such enrollees; requiring the Agency for 41
67-Health Care Administration to conduct monitoring and 42
68-evaluations and require corrective actions or payment 43
69-of penalties under certain circumstances; removing 44
70-coordination requirements for the agency when 45
71-submitting certain reports, establishing specified 46
72-measures, and conducting quality assurance monitoring 47
73-of the pilot program; revising specified dates for 48
74-submitting certain status reports; requiring the 49
75-Agency for Persons with Disabilities to contract for a 50
51+individuals with developmental disabilities; requiring 26
52+the Agency for Persons with Disabilities to transmit 27
53+to the Agency for Health Care Administration weekly 28
54+data files of specified clients; requiring the Agency 29
55+for Health Care Administration to provide a call 30
56+center for specified pu rposes and to coordinate with 31
57+the Department of Children and Families and the Agency 32
58+for Persons with Disabilities to disseminate 33
59+information about the pilot program; revising pilot 34
60+program benefits; revising provider qualifications; 35
61+requiring participatin g plans to conduct an 36
62+individualized assessment of each enrollee within a 37
63+specified timeframe for certain purposes and to offer 38
64+certain services to such enrollees; requiring the 39
65+Agency for Health Care Administration to conduct 40
66+monitoring and evaluations an d require corrective 41
67+actions or payment of penalties under certain 42
68+circumstances; removing coordination requirements for 43
69+the agency when submitting certain reports, 44
70+establishing specified measures, and conducting 45
71+quality assurance monitoring of the pilot p rogram; 46
72+revising dates for submitting certain status reports; 47
73+providing an effective date. 48
74+ 49
75+Be It Enacted by the Legislature of the State of Florida: 50
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8484 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-specified study and provide to the Governor, the 51
89-President of the Senate, and the Speaker of the House 52
90-of Representatives a specified report by specified 53
91-date; providing an effective date. 54
92- 55
93-Be It Enacted by the Legislature of the State of Florida: 56
94- 57
95- Section 1. Subsections (5) and (14) of section 393.0662, 58
96-Florida Statutes, are amended to read: 59
97- 393.0662 Individual budgets for delivery of home and 60
98-community-based services; iBudget system established. —The 61
99-Legislature finds that improved financial management of the 62
100-existing home and community -based Medicaid waiver program is 63
101-necessary to avoid deficits that impede the provision of 64
102-services to individuals who are on the waiting list for 65
103-enrollment in the program. The Legislature further finds that 66
104-clients and their families should have greater flexibility to 67
105-choose the services that best allow them to live in their 68
106-community within the limits of an established budget. Therefore, 69
107-the Legislature intends that the agency, in consultation with 70
108-the Agency for Health Care Administration, shall manage the 71
109-service delivery system using individual budgets as the basis 72
110-for allocating the funds appropriated for the home and 73
111-community-based services Medicaid waiver program among eligible 74
112-enrolled clients. The service delivery system that uses 75
88+ 51
89+ Section 1. Subsection (14) of section 393.0662, Florida 52
90+Statutes, is amended to read: 53
91+ 393.0662 Individual budgets for delivery of home and 54
92+community-based services; iBudget system established. —The 55
93+Legislature finds that improved financial management of the 56
94+existing home and community -based Medicaid waiver program is 57
95+necessary to avoid deficits that impede the provision of 58
96+services to individuals who are on the waiting list for 59
97+enrollment in the program. The Legislature further finds that 60
98+clients and their families should have greater flexibility to 61
99+choose the services that best allow them to live in their 62
100+community within the limits of an established budget. Therefore, 63
101+the Legislature intends that the agency, in consultation with 64
102+the Agency for Health Care Administration, shall manage the 65
103+service delivery system using individual budgets as the basis 66
104+for allocating the funds appropriated for the home and 67
105+community-based services Medicaid waiver program among eligible 68
106+enrolled clients. The service delivery system that uses 69
107+individual budgets shall be called the iBudget system. 70
108+ (14)(a) The agency, in consultation with the Agency for 71
109+Health Care Administration, shall provide a quarterly 72
110+reconciliation report of all home and community -based services 73
111+waiver expenditures from the Agency for Health Care 74
112+Administration's claims management system with service 75
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121121 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-individual budgets shall be cal led the iBudget system. 76
126- (5) The agency shall ensure that clients and caregivers 77
127-have access to training and education that inform them about the 78
128-iBudget system and enhance their ability for self -direction. 79
129-Such training and education must be offered in a variety of 80
130-formats and, at a minimum, must address the policies and 81
131-processes of the iBudget system and the roles and 82
132-responsibilities of consumers, caregivers, waiver support 83
133-coordinators, providers, and the agency, and must provide 84
134-information to help t he client make decisions regarding the 85
135-iBudget system and examples of support and resources available 86
136-in the community. The agency shall, within 5 days after 87
137-enrollment, provide the client with a comprehensive and current 88
138-written list of all qualified orga nizations located within the 89
139-region in which the client resides. 90
140- (14)(a) The agency, in consultation with the Agency for 91
141-Health Care Administration, shall provide a quarterly 92
142-reconciliation report of all home and community -based services 93
143-waiver expenditures from the Agency for Health Care 94
144-Administration's claims management system with service 95
145-utilization from the Agency for Persons with Disabilities 96
146-Allocation, Budget, and Contract Control system. The 97
147-reconciliation report must be submitted to the Governo r, the 98
148-President of the Senate, and the Speaker of the House of 99
149-Representatives no later than 30 days after the close of each 100
125+utilization from the Agency for Persons with Disabilities 76
126+Allocation, Budget, and Contract Control system. The 77
127+reconciliation report must be submitted to the Governor, the 78
128+President of the Senate, and the Speaker of the House of 79
129+Representatives no later tha n 30 days after the close of each 80
130+quarter. 81
131+ (b) The agency shall post its quarterly reconciliation 82
132+reports on its website, in a conspicuous location, no later than 83
133+5 days after submitting the reports as required in this 84
134+subsection. 85
135+ Section 2. Subsecti on (12) of section 393.065, Florida 86
136+Statutes, is renumbered as subsection (13), paragraph (a) of 87
137+subsection (1), paragraph (b) of subsection (5), and subsection 88
138+(10) are amended, and a new subsection (12) is added to that 89
139+section, to read: 90
140+ 393.065 Application and eligibility determination. — 91
141+ (1)(a) The agency shall develop and implement an online 92
142+application process that, at a minimum, supports paperless, 93
143+electronic application submissions with immediate e -mail 94
144+confirmation to each applicant to acknowled ge receipt of 95
145+application upon submission. The online application system must 96
146+allow an applicant to review the status of a submitted 97
147+application and respond to provide additional information. The 98
148+online application must allow an applicant to apply for cris is 99
149+enrollment. 100
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158158 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-quarter. 101
163- (b) The agency shall post its quarterly reconciliation 102
164-reports on its website, in a conspicuous location, no later than 103
165-5 days after submitting the reports as required in this 104
166-subsection. 105
167- Section 2. Subsection (12) of section 393.065, Florida 106
168-Statutes, is renumbered as subsection (13), paragraph (a) of 107
169-subsection (1), paragraph (b) of subsection (5), and subsection 108
170-(10) are amended, and a new subsection (12) is added to that 109
171-section, to read: 110
172- 393.065 Application and eligibility determination. — 111
173- (1)(a) The agency shall develop and implement an online 112
174-application process that, at a minimum, supports paperless, 113
175-electronic application submissions with immediate e -mail 114
176-confirmation to each applicant to acknowledge receipt of 115
177-application upon submission. The online application system must 116
178-allow an applicant to review the status of a submitted 117
179-application and respond to prov ide additional information. The 118
180-online application must allow an applicant to apply for crisis 119
181-enrollment. 120
182- (5) Except as provided in subsections (6) and (7), if a 121
183-client seeking enrollment in the developmental disabilities home 122
184-and community-based services Medicaid waiver program meets the 123
185-level of care requirement for an intermediate care facility for 124
186-individuals with intellectual disabilities pursuant to 42 C.F.R. 125
162+ (5) Except as provided in subsections (6) and (7), if a 101
163+client seeking enrollment in the developmental disabilities home 102
164+and community-based services Medicaid waiver program meets the 103
165+level of care requirement for an intermediate care faci lity for 104
166+individuals with intellectual disabilities pursuant to 42 C.F.R. 105
167+ss. 435.217(b)(1) and 440.150, the agency must assign the client 106
168+to an appropriate preenrollment category pursuant to this 107
169+subsection and must provide priority to clients waiting for 108
170+waiver services in the following order: 109
171+ (b) Category 2, which includes clients in the 110
172+preenrollment categories who are: 111
173+ 1. From the child welfare system with an open case in the 112
174+Department of Children and Families' statewide automated child 113
175+welfare information system and who are either: 114
176+ a. Transitioning out of the child welfare system into 115
177+permanency; or 116
178+ b. At least 18 years but not yet 22 years of age and who 117
179+need both waiver services and extended foster care services; or 118
180+ 2. At least 18 years bu t not yet 22 years of age and who 119
181+withdrew consent pursuant to s. 39.6251(5)(c) to remain in the 120
182+extended foster care system. 121
183+ 122
184+For individuals who are at least 18 years but not yet 22 years 123
185+of age and who are eligible under sub -subparagraph 1.b., the 124
186+agency must provide waiver services, including residential 125
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195195 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-ss. 435.217(b)(1) and 440.150, the agency must assign the client 126
200-to an appropriate preenro llment category pursuant to this 127
201-subsection and must provide priority to clients waiting for 128
202-waiver services in the following order: 129
203- (b) Category 2, which includes clients in the 130
204-preenrollment categories who are: 131
205- 1. From the child welfare system with a n open case in the 132
206-Department of Children and Families' statewide automated child 133
207-welfare information system and who are either: 134
208- a. Transitioning out of the child welfare system into 135
209-permanency; or 136
210- b. At least 18 years but not yet 22 years of age and who 137
211-need both waiver services and extended foster care services; or 138
212- 2. At least 18 years but not yet 22 years of age and who 139
213-withdrew consent pursuant to s. 39.6251(5)(c) to remain in the 140
214-extended foster care system. 141
215- 142
216-For individuals who are at least 18 years but not yet 22 years 143
217-of age and who are eligible under sub -subparagraph 1.b., the 144
218-agency must provide waiver services, including residential 145
219-habilitation, and must actively participate in transition 146
220-planning activities, including, but not limited to, 147
221-individualized service coordination, case management support, 148
222-and ensuring continuity of care pursuant to s. 39.6035. The 149
223-community-based care lead agency must fund room and board at the 150
199+habilitation, and must actively participate in transition 126
200+planning activities, including, but not limited to, 127
201+individualized service coordination, case management support, 128
202+and ensuring continuity of care pursuant to s. 39.6035. The 129
203+community-based care lead agency must fund room and board at the 130
204+rate established in s. 409.145(3 ) and provide case management 131
205+and related services as defined in s. 409.986(3)(e). Individuals 132
206+may receive both waiver services and services under s. 39.6251. 133
207+Services may not duplicate services available through the 134
208+Medicaid state plan. 135
209+ 136
210+Within preenrollment categories 3, 4, 5, 6, and 7, the agency 137
211+shall prioritize clients in the order of the date that the 138
212+client is determined eligible for waiver services. 139
213+ (10) The client, the client's guardian, or the client's 140
214+family must ensure that accurate, up -to-date contact information 141
215+is provided to the agency at all times. Notwithstanding s. 142
216+393.0651, the agency must send an annual letter requesting 143
217+updated information from the client, the client's guardian, or 144
218+the client's family. The agency must remove from the 145
219+preenrollment categories any individual who cannot be located 146
220+using the contact information provided to the agency, fails to 147
221+meet eligibility requirements, or becomes domiciled outside the 148
222+state. 149
223+ (12) To ensure transparency and timely access to 150
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232232 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-rate established in s. 409.145(3) and provide case management 151
237-and related services as defined in s. 409.986(3)(e). Individuals 152
238-may receive both waiver services and services under s. 39.6251. 153
239-Services may not duplicate services available through the 154
240-Medicaid state plan. 155
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242-Within preenrollment categories 3, 4, 5, 6, and 7, th e agency 157
243-shall prioritize clients in the order of the date that the 158
244-client is determined eligible for waiver services. 159
245- (10) The client, the client's guardian, or the client's 160
246-family must ensure that accurate, up -to-date contact information 161
247-is provided to the agency at all times. Notwithstanding s. 162
248-393.0651, the agency must send an annual letter requesting 163
249-updated information from the client, the client's guardian, or 164
250-the client's family. The agency must remove from the 165
251-preenrollment categories any individ ual who cannot be located 166
252-using the contact information provided to the agency, fails to 167
253-meet eligibility requirements, or becomes domiciled outside the 168
254-state. 169
255- (12) To ensure transparency and timely access to 170
256-information, the agency shall post on its web site in a 171
257-conspicuous location the total number of individuals in each 172
258-priority category by county of residence. The posted numbers 173
259-shall reflect the current status of the preenrollment priority 174
260-list and shall be updated at least every 5 days. 175
236+information, the agency shall post on its website in a 151
237+conspicuous location the total number of individuals in each 152
238+priority category. The posted numbers shall reflect the current 153
239+status of the preenrollment priority list and shall be updated 154
240+at least every 5 days. 155
241+ Section 3. Section 393.502, Florida Statutes, is amended 156
242+to read: 157
243+ 393.502 Family care councils. — 158
244+ (1) CREATION AND PURPOSE OF STATEWIDE FAMILY CARE 159
245+COUNCIL.—There shall be established and located within each 160
246+service area of the agency a family care council. 161
247+ (a) The Statewide Family Care Council is established to 162
248+connect local family care councils and facilitate direct 163
249+communication between local councils and the agency, with the 164
250+goal of enhancing the quality of and access to resources and 165
251+supports for individuals with developmental disabilities and 166
252+their families. 167
253+ (b) The statewide council shall: 168
254+ 1. Review annual reports, policy proposals, and program 169
255+recommendations submitted by the local family care councils. 170
256+ 2. Advise the agency on statewi de policies, programs, and 171
257+service delivery improvements based on the collective 172
258+recommendations of the local councils. 173
259+ 3. Identify systemic barriers to the effective delivery of 174
260+services and recommend solutions to address such barriers. 175
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269269 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- Section 3. Section 393.502, Florida Statutes, is amended 176
274-to read: 177
275- 393.502 Family care councils. — 178
276- (1) CREATION AND PURPOSE OF STATEWIDE FAMILY CARE 179
277-COUNCIL.—There shall be established and located within each 180
278-service area of the agency a family care council. 181
279- (a) The Statewide Family Care Council is established to 182
280-connect local family care councils and facilitate direct 183
281-communication between local councils and the agency, with the 184
282-goal of enhancing the quality of and access to resources and 185
283-supports for individu als with developmental disabilities and 186
284-their families. 187
285- (b) The statewide council shall: 188
286- 1. Review annual reports, policy proposals, and program 189
287-recommendations submitted by the local family care councils. 190
288- 2. Advise the agency on statewide policies, programs, and 191
289-service delivery improvements based on the collective 192
290-recommendations of the local councils. 193
291- 3. Identify systemic barriers to the effective delivery of 194
292-services and recommend solutions to address such barriers. 195
293- 4. Foster collaboration an d the sharing of best practices 196
294-and available resources among local family care councils to 197
295-improve service delivery across regions. 198
296- 5. Submit an annual report no later than December 1 of 199
297-each year to the Governor, the President of the Senate, the 200
273+ 4. Foster collaboration and the sharing of best practices 176
274+and available resources among local family care councils to 177
275+improve service delivery across regions. 178
276+ 5. Submit an annual report no later than December 1 of 179
277+each year to the Governor, the President of the Senat e, the 180
278+Speaker of the House of Representatives, and the agency. The 181
279+report shall include a summary of local council findings, policy 182
280+recommendations, and an assessment of the agency's actions in 183
281+response to previous recommendations of the local councils. 184
282+ (c) The agency shall provide a written response within 60 185
283+days after receipt, including a detailed action plan outlining 186
284+steps taken or planned to address recommendations. The response 187
285+must specify whether recommendations will be implemented and 188
286+provide a timeline for implementation or include justification 189
287+if recommendations are not adopted. 190
288+ (2) STATEWIDE FAMILY CARE COUNCIL MEMBERSHIP. — 191
289+ (a) The statewide council shall consist of the following 192
290+members appointed by the Governor: 193
291+ 1. One representative from each of the local family care 194
292+councils, who must be a resident of the area served by that 195
293+local council. Among these representatives must be at least one 196
294+individual who is receiving waiver services from the agency 197
295+under s. 393.065 and at least one individual who is assigned to 198
296+a preenrollment category for waiver services under s. 393.065. 199
297+ 2. One individual representing an advocacy organization 200
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310-Speaker of the House of Representatives, and the agency. The 201
311-report shall include a summary of local council findings, policy 202
312-recommendations, and an assessment of the agency's actions in 203
313-response to previous recommendations of the local councils. 204
314- (c) The agency shall provide a written response within 60 205
315-days after receipt, including a detailed action plan outlining 206
316-steps taken or planned to address recommendations. The response 207
317-must specify whether recommendations will be implemented and 208
318-provide a timeline fo r implementation or include justification 209
319-if recommendations are not adopted. 210
320- (2) STATEWIDE FAMILY CARE COUNCIL MEMBERSHIP. — 211
321- (a) The statewide council shall consist of the following 212
322-members appointed by the Governor: 213
323- 1. One representative from each of the local family care 214
324-councils, who must be a resident of the area served by that 215
325-local council. Among these representatives must be at least one 216
326-individual who is receiving waiver services from the agency 217
327-under s. 393.065 and at least one individual w ho is assigned to 218
328-a preenrollment category for waiver services under s. 393.065. 219
329- 2. One individual representing an advocacy organization 220
330-representing individuals with disabilities. 221
331- 3. One representative of a public or private entity that 222
332-provides services to individuals with developmental disabilities 223
333-that does not have a Medicaid waiver service contract with the 224
334-agency. 225
310+representing individuals with disabilities. 201
311+ 3. One representative of a public or private entity that 202
312+provides services to individuals with developmental disabilities 203
313+that does not have a Medicaid wavier service contract with the 204
314+agency. 205
315+ (b) Employees of the agency or the Agency for Health Care 206
316+Administration are not eligible to serve on the statewide 207
317+council. 208
318+ (3) STATEWIDE FAMILY CARE COUNCIL TERMS; VACANCIES. — 209
319+ (a) Statewide council members shall be initially appointed 210
320+to staggered 2 and 4 year terms, with subsequent terms of 4 211
321+years. Members may be reappointed to one additional consecutive 212
322+term. 213
323+ (b) A member who has served two consecutive terms shall 214
324+not be eligible to serve again until at least 12 months have 215
325+elapsed since ending service on the statewide council. 216
326+ (c) Upon expiration of a term or in the case of any other 217
327+vacancy, the statewide council shall, by majority vote, 218
328+recommend to the Governor for appointment at least one person 219
329+for each vacancy. 220
330+ 1. The Governor shall make an appointment within 45 days 221
331+after receiving a recommendation from the statewide council. If 222
332+the Governor fails t o make an appointment for a member under 223
333+subsection (2), the chair of the local council may appoint a 224
334+member meeting the requirements of subsection (2) to act as the 225
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341-hb1103-02-c2
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343343 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
344344
345345
346346
347- (b) Employees of the agency or the Agency for Health Care 226
348-Administration are not eligible to serve on the statewide 227
349-council. 228
350- (3) STATEWIDE FAMILY CARE COUNCIL TERMS; VACANCIES. — 229
351- (a) Statewide council members shall be initially appointed 230
352-to staggered 2 and 4 year terms, with subsequent terms of 4 231
353-years. Members may be reappointed to one additional consecutive 232
354-term. 233
355- (b) A member who has served two consecutive terms shall 234
356-not be eligible to serve again until 12 months have elapsed 235
357-since ending service on the statewide council. 236
358- (c) Upon expiration of a term or in the case of any other 237
359-vacancy, the statewide council shall, by major ity vote, 238
360-recommend to the Governor for appointment at least one person 239
361-for each vacancy. 240
362- 1. The Governor shall make an appointment within 45 days 241
363-after receiving a recommendation from the statewide council. If 242
364-the Governor fails to make an appointment for a member under 243
365-subsection (2), the chair of the local council may appoint a 244
366-member meeting the requirements of subsection (2) to act as the 245
367-statewide council representative for that local council until 246
368-the Governor makes an appointment. 247
369- 2. If no member of a local council is willing and able to 248
370-serve on the statewide council, the Governor shall appoint an 249
371-individual from another local council to serve on the statewide 250
347+statewide council representative for that local council until 226
348+the Governor makes an appoin tment. 227
349+ 2. If no member of a local council is willing and able to 228
350+serve on the statewide council, the Governor shall appoint an 229
351+individual from another local council to serve on the statewide 230
352+council. 231
353+ (4) STATEWIDE FAMILY CARE COUNCIL MEETINGS; ORGANIZATION. —232
354+The statewide council shall meet at least quarterly. The council 233
355+meetings may be held in person or via teleconference or other 234
356+electronic means. 235
357+ (a) The Governor shall appoint the initial chair from 236
358+among the members of the statewide council. Subsequent chairs 237
359+shall be elected annually by a majority vote of the council. 238
360+ (b) Members of the statewide council shall serve without 239
361+compensation but may be reimbursed for per diem and travel 240
362+expenses pursuant to s. 112.061. 241
363+ (c) A majority of the members of the statewide council 242
364+shall constitute a quorum. 243
365+ (5) LOCAL FAMILY CARE COUNCILS. —There is established and 244
366+located within each service area of the agency a local family 245
367+care council to work constr uctively with the agency, advise the 246
368+agency on local needs, identify gaps in services, and advocate 247
369+for individuals with developmental disabilities and their 248
370+families. 249
371+ (6) LOCAL FAMILY CARE COUNCIL DUTIES. —The local family 250
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380380 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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384-council. 251
385- (4) STATEWIDE FAMILY CARE COUNCIL MEETINGS; ORGANIZATION. —252
386-The statewide council shall meet at least quarterly. The council 253
387-meetings may be held in person or via te leconference or other 254
388-electronic means. 255
389- (a) The Governor shall appoint the initial chair from 256
390-among the members of the statewide council. Subsequent chairs 257
391-shall be elected annually by a majority vote of the council. 258
392- (b) Members of the statewide counc il shall serve without 259
393-compensation but may be reimbursed for per diem and travel 260
394-expenses pursuant to s. 112.061. 261
395- (c) A majority of the members of the statewide council 262
396-shall constitute a quorum. 263
397- (5) LOCAL FAMILY CARE COUNCILS. —There is established a nd 264
398-located within each service area of the agency a local family 265
399-care council to work constructively with the agency, advise the 266
400-agency on local needs, identify gaps in services, and advocate 267
401-for individuals with developmental disabilities and their 268
402-families. 269
403- (6) LOCAL FAMILY CARE COUNCIL DUTIES. —The local family 270
404-care councils shall: 271
405- (a) Assist in providing information and conducting 272
406-outreach to individuals with developmental disabilities and 273
407-their families. 274
408- (b) Convene family listening sessions at least twice a 275
384+care councils shall: 251
385+ (a) Assist in providing information and conducting 252
386+outreach to individuals with developmental disabilities and 253
387+their families. 254
388+ (b) Convene family listening sessions at least twice a 255
389+year to gather input on local service delivery challenges. 256
390+ (c) Hold a public forum every 6 months to solicit public 257
391+feedback concerning actions taken by the local family councils. 258
392+ (d) Share information with other local family care 259
393+councils. 260
394+ (e) Identify policy issues relevant to the community and 261
395+family support system in the region. 262
396+ (f) Submit to the Statewide Family Care Council, no later 263
397+than September 1 of each year, an annual report detailing 264
398+proposed policy changes, program recommendations, and identified 265
399+service delivery challenges within its region. 266
400+ (7)(2) LOCAL FAMILY CARE COUNCIL MEMBERSHIP.— 267
401+ (a) Each local family care council shall consist of at 268
402+least 10 and no more than 15 members recommended by a majority 269
403+vote of the local family care council and appointed by the 270
404+Governor. 271
405+ (b) At least three of the members of the council shall be 272
406+individuals receiving or waiting to receive services from the 273
407+agency. One such member shall be an individual who has been 274
408+receiving services within the 4 years before the date of 275
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417417 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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421-year to gather input on local service delivery challenges. 276
422- (c) Hold a public forum every 6 months to solicit public 277
423-feedback concerning actions taken by the local family councils. 278
424- (d) Share information with other local family care 279
425-councils. 280
426- (e) Identify policy issues relevant to the community and 281
427-family support system in the region. 282
428- (f) Submit to the Statewide Family Care Council, no later 283
429-than September 1 of each year, an annual report detaili ng 284
430-proposed policy changes, program recommendations, and identified 285
431-service delivery challenges within its region. 286
432- (7)(2) LOCAL FAMILY CARE COUNCIL MEMBERSHIP.— 287
433- (a) Each local family care council shall consist of at 288
434-least 10 and no more than 15 members recommended by a majority 289
435-vote of the local family care council and appointed by the 290
436-Governor. 291
437- (b) At least three of the members of the council shall be 292
438-individuals receiving or waiting to receive services from the 293
439-agency. One such member shall be an in dividual who has been 294
440-receiving services within the 4 years before the date of 295
441-recommendation. The remainder of the council members shall be 296
442-parents, grandparents, guardians, or siblings of individuals who 297
443-have developmental disabilities and qualify for se rvices 298
444-pursuant to this chapter. For a grandparent to be a council 299
445-member, the grandchild's parent or legal guardian must consent 300
421+recommendation. The remainder of the council members shall be 276
422+parents, grandparents, guardians, or siblings of individuals who 277
423+have developmental disabilities and qualify for services 278
424+pursuant to this chapter. For a grandparent to be a council 279
425+member, the grandchild's parent or legal guardian must consent 280
426+to the appointment and report the consent to the agency. 281
427+ (c) A person who is currently serving on another board or 282
428+council of the agency may not be appointed to a local family 283
429+care council. 284
430+ (d) Employees of the agency or the Agency for Health Care 285
431+Administration are not eligible to serve on a local family care 286
432+council. 287
433+ (e) Persons related by consanguinity or affinity within 288
434+the third degree shall not serve on the same local family care 289
435+council at the same time. 290
436+ (f) A chair for the council shall be cho sen by the council 291
437+members to serve for 1 year. A person may not serve no more than 292
438+four 1-year terms as chair. 293
439+ (8)(3) LOCAL FAMILY CARE COUNCIL TERMS; VACANCIES.— 294
440+ (a) Local family council members shall be appointed for a 295
441+3-year terms term, except as provided in subsection (11) (8), 296
442+and may be reappointed to one additional term. 297
443+ (b) A member who has served two consecutive terms shall 298
444+not be eligible to serve again until 12 months have elapsed 299
445+since ending his or her service on the local council. 300
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454454 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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457457
458-to the appointment and report the consent to the agency. 301
459- (c) A person who is currently serving on another board or 302
460-council of the agency may not be appointed to a local family 303
461-care council. 304
462- (d) Employees of the agency or the Agency for Health Care 305
463-Administration are not eligible to serve on a local family care 306
464-council. 307
465- (e) Persons related by consanguinity or affinity within 308
466-the third degree shall not serve on the same local family care 309
467-council at the same time. 310
468- (f) A chair for the council shall be chosen by the council 311
469-members to serve for 1 year. A person may not serve no more than 312
470-four 1-year terms as chair. 313
471- (8)(3) LOCAL FAMILY CARE COUNCIL TERMS; VACANCIES.— 314
472- (a) Local family council members shall be appointed for a 315
473-3-year terms term, except as provided in subsection (11) (8), 316
474-and may be reappointed to one additional term. 317
475- (b) A member who has served two consecutive terms shall 318
476-not be eligible to serve again until 12 months have elapsed 319
477-since ending his or her service on the local council. 320
478- (c)1. Upon expiration of a term or in the case of any 321
479-other vacancy, the local council shall, by majority vote, 322
480-recommend to the Governor for appointment a person for each 323
481-vacancy based on recommendations received from the family -led 324
482-nominating committee described in paragraph (9)(a) . 325
458+ (c)1. Upon expiration of a term or in the case of any 301
459+other vacancy, the local council shall, by majority vote, 302
460+recommend to the Governor for appointment a person for each 303
461+vacancy based on recommendations received from the family -led 304
462+nominating committee desc ribed in paragraph (9)(a) . 305
463+ 2. The Governor shall make an appointment within 45 days 306
464+after receiving a recommendation. 307
465+ (9)(4) LOCAL FAMILY CARE COUNCIL COMMITTEE APPOINTMENTS. — 308
466+ (a) The chair of each local family care council shall 309
467+create, and appoint individuals receiving or waiting to receive 310
468+services from the agency and their relatives, to serve on a 311
469+family-led nominating committee. Members of the family -led 312
470+nominating council need not be members of the local council. The 313
471+family-led nominating commit tee shall nominate candidates for 314
472+vacant positions on the local family council. 315
473+ (b) The chair of the local family care council may appoint 316
474+persons to serve on additional council committees. Such persons 317
475+may include current members of the council and former members of 318
476+the council and persons not eligible to serve on the council. 319
477+ (10)(6) LOCAL FAMILY CARE COUNCIL MEETINGS.—Local council 320
478+members shall serve on a voluntary basis without payment for 321
479+their services but shall be reimbursed for per diem and tra vel 322
480+expenses as provided for in s. 112.061. Local councils The 323
481+council shall meet at least six times per year. Meetings may be 324
482+held in person or by teleconference or other electronic means. 325
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491491 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
492492
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495- 2. The Governor shall make an appointment within 45 days 326
496-after receiving a recommendation. If t he Governor fails to make 327
497-an appointment within 45 days, the local council shall, by 328
498-majority vote, select an interim appointment for each vacancy 329
499-from the panel of candidates recommended by the family -led 330
500-nomination committee. 331
501- (9)(4) LOCAL FAMILY CARE COUNCIL COMMITTEE APPOINTMENTS. — 332
502- (a) The chair of each local family care council shall 333
503-create, and appoint individuals receiving or waiting to receive 334
504-services from the agency and their relatives, to serve on a 335
505-family-led nominating committee. Members of the family-led 336
506-nominating council need not be members of the local council. The 337
507-family-led nominating committee shall nominate candidates for 338
508-vacant positions on the local family council. 339
509- (b) The chair of the local family care council may appoint 340
510-persons to serve on additional council committees. Such persons 341
511-may include current members of the council and former members of 342
512-the council and persons not eligible to serve on the council. 343
513- (10)(6) LOCAL FAMILY CARE COUNCIL MEETINGS.—Local council 344
514-members shall serve on a voluntary basis without payment for 345
515-their services but shall be reimbursed for per diem and travel 346
516-expenses as provided for in s. 112.061. Local councils The 347
517-council shall meet at least six times per year. Meetings may be 348
518-held in person or by teleconference or other electronic means. 349
519- (7) PURPOSE.—The purpose of the local family care councils 350
495+ (7) PURPOSE.—The purpose of the local family care councils 326
496+shall be to advise the agency, to develop a plan for the 327
497+delivery of family support services within the local area, and 328
498+to monitor the implementation and effectiveness of services and 329
499+support provided under the plan. The primary functions of the 330
500+local family care councils shall be to: 331
501+ (a) Assist in providing information and outreach to 332
502+families. 333
503+ (b) Review the effectiveness of service programs and make 334
504+recommendations with respect to program implementation. 335
505+ (c) Advise the agency with respect to policy issues 336
506+relevant to the community and family support system in the local 337
507+area. 338
508+ (d) Meet and share information with other local family 339
509+care councils. 340
510+ (11)(8) NEW LOCAL FAMILY CARE COUNCILS.—When a local 341
511+family care council is established for the first ti me in a local 342
512+area, the Governor shall appoint the first four council members, 343
513+who shall serve 3-year terms. These members shall submit to the 344
514+Governor, within 90 days after their appointment, 345
515+recommendations for at least six additional members, selected b y 346
516+majority vote. 347
517+ (12)(9) FUNDING; FINANCIAL REVIEW. —The statewide and local 348
518+family care councils council may apply for, receive, and accept 349
519+grants, gifts, donations, bequests, and other payments from any 350
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528528 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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532-shall be to advise the agency, to develop a plan for the 351
533-delivery of family support services within the local area, and 352
534-to monitor the implementation and effectiveness of services and 353
535-support provided under the plan. The primary functions of the 354
536-local family care councils shall be to: 355
537- (a) Assist in providing information and outreach to 356
538-families. 357
539- (b) Review the effectiveness of serv ice programs and make 358
540-recommendations with respect to program implementation. 359
541- (c) Advise the agency with respect to policy issues 360
542-relevant to the community and family support system in the local 361
543-area. 362
544- (d) Meet and share information with other local fam ily 363
545-care councils. 364
546- (11)(8) NEW LOCAL FAMILY CARE COUNCILS.—When a local 365
547-family care council is established for the first time in a local 366
548-area, the Governor shall appoint the first four council members, 367
549-who shall serve 3-year terms. These members shall su bmit to the 368
550-Governor, within 90 days after their appointment, 369
551-recommendations for at least six additional members, selected by 370
552-majority vote. 371
553- (12)(9) FUNDING; FINANCIAL REVIEW. —The statewide and local 372
554-family care councils council may apply for, receive, and accept 373
555-grants, gifts, donations, bequests, and other payments from any 374
556-public or private entity or person. Each local council is 375
532+public or private entity or person. Each local council is 351
533+subject to an annual financial review by staff assigned by the 352
534+agency. Each local council shall exercise care and prudence in 353
535+the expenditure of funds. The local family care councils shall 354
536+comply with state expenditure requirements. 355
537+ (13)(5) TRAINING.— 356
538+ (a) The agency, in consultation with the statewide and 357
539+local councils, shall establish and provide a training program 358
540+for local family care council members. Each local area shall 359
541+provide the training program when new persons are appointed to 360
542+the local council and at other times as the secretary deems 361
543+necessary. 362
544+ (b) The training shall assist the council members to 363
545+understand the laws, rules, and policies applicable to their 364
546+duties and responsibilities. 365
547+ (c) All persons newly appointed to the statewide or a 366
548+local council must complete this training within 90 days after 367
549+their appointment. A person who fails to meet this requirement 368
550+is shall be considered to have resigned from the council. The 369
551+agency may make additional training available to counci l 370
552+members. 371
553+ (14) DUTIES.—The agency shall publish on its website all 372
554+annual reports submitted by the local care councils and the 373
555+Statewide Family Care Council within 15 days after receipt of 374
556+such reports in a designated and easily accessible section of 375
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565565 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
566566
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569-subject to an annual financial review by staff assigned by the 376
570-agency. Each local council shall ex ercise care and prudence in 377
571-the expenditure of funds. The local family care councils shall 378
572-comply with state expenditure requirements. 379
573- (13)(5) TRAINING.— 380
574- (a) The agency, in consultation with the statewide and 381
575-local councils, shall establish and provide a training program 382
576-for local family care council members. Each local area shall 383
577-provide the training program when new persons are appointed to 384
578-the local council and at other times as the secretary deems 385
579-necessary. 386
580- (b) The training shall assist the counc il members to 387
581-understand the laws, rules, and policies applicable to their 388
582-duties and responsibilities. 389
583- (c) All persons newly appointed to the statewide or a 390
584-local council must complete this training within 90 days after 391
585-their appointment. A person who f ails to meet this requirement 392
586-is shall be considered to have resigned from the council. The 393
587-agency may make additional training available to council 394
588-members. 395
589- (14) DUTIES.—The agency shall publish on its website all 396
590-annual reports submitted by the local f amily care councils and 397
591-the Statewide Family Care Council within 15 days after receipt 398
592-of such reports in a designated and easily accessible section of 399
593-the website. 400
569+the website. 376
570+ (15) ADMINISTRATIVE SUPPORT. —The agency shall provide 377
571+administrative support to the statewide council and local 378
572+councils, including, but not limited to, staff assistance and 379
573+meeting facilities, within existing resources. 380
574+ Section 4. Subsections (1), (2), (3), and (6) of section 381
575+409.9855, Florida Statutes, are amended to read: 382
576+ 409.9855 Pilot program for individuals with developmental 383
577+disabilities.— 384
578+ (1) PILOT PROGRAM IMPLEMENTATION. — 385
579+ (a) Using a managed care model, The agency shall imple ment 386
580+a pilot program for individuals with developmental disabilities 387
581+in Statewide Medicaid Managed Care Regions D and I to provide 388
582+coverage of comprehensive services using a managed care model. 389
583+The agency may seek federal approval through a state plan 390
584+amendment or Medicaid waiver as necessary to implement the pilot 391
585+program. 392
586+ (b) The agency shall administer the pilot program pursuant 393
587+to s. 409.903 and as a component of the Statewide Medicaid 394
588+Managed Care model established by this section. Unless otherwise 395
589+specified, ss. 409.961 -409.969 apply to the pilot program. The 396
590+agency may seek federal approval through a state plan amendment 397
591+or Medicaid waiver as necessary to implement the pilot program. 398
592+The agency shall submit a request for any federal approval 399
593+needed to implement the pilot program by September 1, 2023. 400
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602602 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
603603
604604
605605
606- (15) ADMINISTRATIVE SUPPORT. —The agency shall provide 401
607-administrative support to the state wide council and local 402
608-councils, including, but not limited to, staff assistance and 403
609-meeting facilities, within existing resources. 404
610- Section 4. Subsection (1) of section 409.972, Florida 405
611-Statutes, is amended to read: 406
612- 409.972 Mandatory and voluntary en rollment.— 407
613- (1) The following Medicaid -eligible persons are exempt 408
614-from mandatory managed care enrollment required by s. 409.965, 409
615-and may voluntarily choose to participate in the managed medical 410
616-assistance program. These eligible persons must make an 411
617-affirmative choice before any enrollment action by the agency. 412
618-The agency may not automatically enroll these eligible persons. : 413
619- (a) Medicaid recipients who have other creditable health 414
620-care coverage, excluding Medicare. 415
621- (b) Medicaid recipients residing in residential commitment 416
622-facilities operated through the Department of Juvenile Justice 417
623-or a treatment facility as defined in s. 394.455. 418
624- (c) Persons eligible for refugee assistance. 419
625- (d) Medicaid recipients who are residents of a 420
626-developmental disability center, including Sunland Center in 421
627-Marianna and Tacachale in Gainesville. 422
628- (e) Medicaid recipients enrolled in the home and community 423
629-based services waiver pursuant to chapter 393, and Medicaid 424
630-recipients waiting for waiver services. 425
606+ (c) Pursuant to s. 409.963, the agency shall administer 401
607+the pilot program in consultation with the Agency for Persons 402
608+with Disabilities. 403
609+ (c)(d) The agency shall make capitated payments to managed 404
610+care organizations for comprehensive coverage, including managed 405
611+medical assistance benefits and long -term care under this part 406
612+and community-based services described in s. 393.066(3) and 407
613+approved through the state's home and community -based services 408
614+Medicaid waiver program for individuals with developmental 409
615+disabilities. Unless otherwise specified, ss. 409.961 -409.969 410
616+apply to the pilot program . 411
617+ (e) The agency shall evaluate the feasibility of statewide 412
618+implementation of the capitated managed care model use d by the 413
619+pilot program to serve individuals with developmental 414
620+disabilities. 415
621+ (2) ELIGIBILITY; VOLUNTARY ENROLLMENT; DISENROLLMENT. — 416
622+ (a) Participation in the pilot program is voluntary and 417
623+limited to the maximum number of enrollees specified in the 418
624+General Appropriations Act. 419
625+ (b) To be eligible for enrollment in the pilot program, an 420
626+individual must: 421
627+ (b) The Agency for Persons with Disabilities shall approve 422
628+a needs assessment methodology to determine functional, 423
629+behavioral, and physical needs of pr ospective enrollees. The 424
630+assessment methodology may be administered by persons who have 425
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639639 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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643- (f) Medicaid recipients residing in a group home facility 426
644-licensed under chapter 393. 427
645- (g) Children receiving services in a prescribed pediatric 428
646-extended care center. 429
647- Section 5. Subsections (1), (2), (3), and (6) of section 430
648-409.9855, Florida Statutes, are amended to r ead: 431
649- 409.9855 Pilot program for individuals with developmental 432
650-disabilities.— 433
651- (1) PILOT PROGRAM IMPLEMENTATION. — 434
652- (a) Using a managed care model, The agency shall implement 435
653-a pilot program for individuals with developmental disabilities 436
654-in Statewide Medicaid Managed Care Regions D and I to provide 437
655-coverage of comprehensive services using a managed care model. 438
656-The agency may seek federal approval through a state plan 439
657-amendment or Medicaid waiver as necessary to implement the pilot 440
658-program. 441
659- (b) The agency shall administer the pilot program pursuant 442
660-to s. 409.963 and as a component of the Statewide Medicaid 443
661-Managed Care model established by this part. Unless otherwise 444
662-specified, ss. 409.961 -409.969 apply to the pilot program. The 445
663-agency may seek federal approval through a state plan amendment 446
664-or Medicaid waiver as necessary to implement the pilot program. 447
665-The agency shall submit a request for any federal approval 448
666-needed to implement the pilot program by September 1, 2023. 449
667- (c) Pursuant to s. 409.963, the agency shall administer 450
643+completed such training as may be offered by the agency. 426
644+Eligibility to participate in the pilot program is determined 427
645+based on all of the following criteria: 428
646+ 1. Be Medicaid eligible. 429
647+ 1. Whether the individual is eligible for Medicaid. 430
648+ 2. Be Whether the individual is 18 years of age or older . 431
649+ 3. Have a developmental disability as defined in s. 432
650+393.063. 433
651+ 4. Be placed in any preenrollment category for individual 434
652+budget waiver services under chapter 393 and reside in Statewide 435
653+Medicaid Managed Care Regions D or I; effective October 1, 2025, 436
654+be placed in any preenrollment category for individual budget 437
655+waiver services under chapter 393 regardless of region; or, 438
656+effective July 1, 2026, be enrolled in the individual budget 439
657+waiver services program under chapter 393 or in the long -term 440
658+care managed care program under this part regardless of region 441
659+and is on the waiting list for individual budget waiver services 442
660+under chapter 393 and assigned to one of categories 1 through 6 443
661+as specified in s. 393.065(5) . 444
662+ 3. Whether the individual resides in a pilot program 445
663+region. 446
664+ (c) The agency shall enroll individuals in the pilot 447
665+program based on verification that the individual has met the 448
666+criteria in paragraph (b). 449
667+ 1. The Agency for Persons with Disabilities shall transmit 450
668668
669-CS/CS/HB 1103 2025
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674-hb1103-02-c2
675-Page 19 of 28
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675+Page 19 of 25
676676 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
677677
678678
679679
680-the pilot program in consultation with the Agency for Persons 451
681-with Disabilities. 452
682- (c)(d) The agency shall make capitated payments to managed 453
683-care organizations for comprehensive coverage, including managed 454
684-medical assistance benefits and long -term care under this part 455
685-and community-based services described in s. 393.066(3) and 456
686-approved through the state's home and community -based services 457
687-Medicaid waiver program for individuals with developmental 458
688-disabilities. Unless otherwise specified, ss. 409.961 -409.969 459
689-apply to the pilot program . 460
690- (e) The agency shall evaluate the feasibility of statewide 461
691-implementation of the capitated managed care model used by the 462
692-pilot program to serve individuals with devel opmental 463
693-disabilities. 464
694- (2) ELIGIBILITY; VOLUNTARY ENROLLMENT; DISENROLLMENT. — 465
695- (a) Participation in the pilot program is voluntary and 466
696-limited to the maximum number of enrollees specified in the 467
697-General Appropriations Act. An individual must make an 468
698-affirmative choice before any enrollment action by the agency. 469
699-The agency may not automatically enroll eligible individuals. 470
700- (b) To be eligible for enrollment in the pilot program, an 471
701-individual must: 472
702- (b) The Agency for Persons with Disabilities shall ap prove 473
703-a needs assessment methodology to determine functional, 474
704-behavioral, and physical needs of prospective enrollees. The 475
680+to the agency weekly data files of clients enrolled in the 451
681+Medicaid home and community -based services waiver program under 452
682+chapter 393 and clients in preenroll ment categories pursuant to 453
683+s. 393.065. The agency shall maintain a record of individuals 454
684+with developmental disabilities who may be eligible for the 455
685+pilot program using this data, Medicaid enrollment data 456
686+transmitted by the Department of Children and Fami lies, and any 457
687+available collateral data. 458
688+ 2. The agency shall determine and administer the process 459
689+for enrollment. A needs assessment conducted by the Agency for 460
690+Persons with Disabilities is not required for enrollment. The 461
691+agency shall notify individuals with developmental disabilities 462
692+of the opportunity to voluntarily enroll in the pilot program 463
693+and explain the benefits available through the pilot program, 464
694+the process for enrollment, and the procedures for 465
695+disenrollment, including the requirement for con tinued coverage 466
696+after disenrollment pursuant to paragraph (d). 467
697+ 3. The agency shall provide a call center staffed by 468
698+agents trained to assist individuals with developmental 469
699+disabilities and their families in learning about and enrolling 470
700+in the pilot program. 471
701+ 4. The agency shall coordinate with the Department of 472
702+Children and Families and the Agency for Persons with 473
703+Disabilities to develop partnerships with community -based 474
704+organizations to disseminate information about the pilot program 475
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713713 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
714714
715715
716716
717-assessment methodology may be administered by persons who have 476
718-completed such training as may be offered by the agency. 477
719-Eligibility to participate in the pilot program is determined 478
720-based on all of the following criteria: 479
721- 1. Be Medicaid eligible. 480
722- 1. Whether the individual is eligible for Medicaid. 481
723- 2. Be Whether the individual is 18 years of age or older . 482
724- 3. Have a developmental disability as defined in s. 483
725-393.063. 484
726- 4. Be placed in any preenrollment category for individual 485
727-budget waiver services under chapter 393 and reside in Statewide 486
728-Medicaid Managed Care Regions D or I; effective October 1, 2025, 487
729-be placed in any preenrollmen t category for individual budget 488
730-waiver services under chapter 393 regardless of region; or, 489
731-effective July 1, 2026, be enrolled in the individual budget 490
732-waiver services program under chapter 393 or in the long -term 491
733-care managed care program under this par t regardless of region 492
734-and is on the waiting list for individual budget waiver services 493
735-under chapter 393 and assigned to one of categories 1 through 6 494
736-as specified in s. 393.065(5) . 495
737- 3. Whether the individual resides in a pilot program 496
738-region. 497
739- (c) The agency shall enroll individuals in the pilot 498
740-program based on verification that the individual has met the 499
741-criteria in paragraph (b). 500
717+to providers of covered services and potential enrollees. 476
718+ (d) Notwithstanding any provisions of s. 393.065 to the 477
719+contrary, an enrollee must be afforded an opportunity to enroll 478
720+in any appropriate existing Medicaid waiver program if any of 479
721+the following conditions occur: 480
722+ 1. At any point during the operation of the pilot program, 481
723+an enrollee declares an intent to voluntarily disenroll, 482
724+provided that he or she has been covered for the entire previous 483
725+plan year by the pilot program. 484
726+ 2. The agency determines the enrollee ha s a good cause 485
727+reason to disenroll. 486
728+ 3. The pilot program ceases to operate. 487
729+ 488
730+Such enrollees must receive an individualized transition plan to 489
731+assist him or her in accessing sufficient services and supports 490
732+for the enrollee's safety, well -being, and continuity of care. 491
733+ (3) PILOT PROGRAM BENEFITS. — 492
734+ (a) Plans participating in the pilot program must, at a 493
735+minimum, cover the following: 494
736+ 1. All benefits included in s. 409.973. 495
737+ 2. All benefits included in s. 409.98. 496
738+ 3. All benefits included in s. 393.06 6(3). 497
739+ 4. Any additional benefits negotiated by the agency 498
740+pursuant to paragraph (4)(b) , and all of the following: 499
741+ a. Adult day training . 500
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750750 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
751751
752752
753753
754- 1. The Agency for Persons with Disabilities shall transmit 501
755-to the agency weekly data files of clients enrolled in the 502
756-Medicaid home and community -based services waiver program under 503
757-chapter 393 and clients in preenrollment categories pursuant to 504
758-s. 393.065. The agency shall maintain a record of individuals 505
759-with developmental disabilities who may be eligible for the 506
760-pilot program using this data, Medicaid enrollment data 507
761-transmitted by the Department of Children and Families, and any 508
762-available collateral data. 509
763- 2. The agency shall determine and administer the process 510
764-for enrollment. A needs assessment conducted by the Agency for 511
765-Persons with Disabilities is not required for enrollment. The 512
766-agency shall notify individuals with developmental disabilities 513
767-of the opportunity to voluntarily enroll in the pilot program 514
768-and explain the benefits available through the pilot program, 515
769-the process for enrollment, and the procedures for 516
770-disenrollment, including the requirement for continued coverage 517
771-after disenrollment pursuant to paragraph (d). 518
772- 3. The agency shall provide a call center staffed by 519
773-agents trained to assist individuals wit h developmental 520
774-disabilities and their families in learning about and enrolling 521
775-in the pilot program. 522
776- 4. The agency shall coordinate with the Department of 523
777-Children and Families and the Agency for Persons with 524
778-Disabilities to develop partnerships with co mmunity-based 525
754+ b. Behavior analysis services. 501
755+ c. Behavior assistant services. 502
756+ d. Companion services. 503
757+ e. Consumable medical supplies. 504
758+ f. Dietitian services. 505
759+ g. Durable medical equipment and supplies. 506
760+ h. Environmental accessibility adaptations. 507
761+ i. Occupational therapy. 508
762+ j. Personal emergency response systems. 509
763+ k. Personal supports. 510
764+ l. Physical therapy. 511
765+ m. Prevocational services. 512
766+ n. Private duty nursing. 513
767+ o. Residential habilitation, including the following 514
768+levels: 515
769+ (I) Standard level. 516
770+ (II) Behavior-focused level. 517
771+ (III) Intensive-behavior level. 518
772+ (IV) Enhanced intensive -behavior level. 519
773+ p. Residential nursing services. 520
774+ q. Respiratory therapy. 521
775+ r. Respite care. 522
776+ s. Skilled nursing. 523
777+ t. Specialized medical home care. 524
778+ u. Specialized mental health counseling. 525
779779
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787787 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
788788
789789
790790
791-organizations to disseminate information about the pilot program 526
792-to providers of covered services and potential enrollees. 527
793- (d) Notwithstanding any provisions of s. 393.065 to the 528
794-contrary, an enrollee must be afforded an opportunity to enro ll 529
795-in any appropriate existing Medicaid waiver program if any of 530
796-the following conditions occur: 531
797- 1. At any point during the operation of the pilot program, 532
798-an enrollee declares an intent to voluntarily disenroll, 533
799-provided that he or she has been covered for the entire previous 534
800-plan year by the pilot program. 535
801- 2. The agency determines the enrollee has a good cause 536
802-reason to disenroll. 537
803- 3. The pilot program ceases to operate. 538
804- 539
805-Such enrollees must receive an individualized transition plan to 540
806-assist him or her in accessing sufficient services and supports 541
807-for the enrollee's safety, well -being, and continuity of care. 542
808- (3) PILOT PROGRAM BENEFITS. — 543
809- (a) Plans participating in the pilot program must, at a 544
810-minimum, cover the following: 545
811- 1. All benefits includ ed in s. 409.973. 546
812- 2. All benefits included in s. 409.98. 547
813- 3. All benefits included in s. 393.066(3) . 548
814- 4. Any additional benefits negotiated by the agency 549
815-pursuant to paragraph (4)(b) , and all of the following: 550
791+ v. Speech therapy. 526
792+ w. Support coordination. 527
793+ x. Supported employment. 528
794+ y. Supported living coaching. 529
795+ z. Transportation. 530
796+ (b) All providers of the benefits services listed under 531
797+paragraph (a) must meet the provider qualifications established 532
798+by the agency for the Medicaid long -term care managed care 533
799+program under this section. If no s uch qualifications apply to a 534
800+specific benefit or provider type, the provider must meet the 535
801+provider qualifications established by the Agency for Persons 536
802+with Disabilities for the individual budget waiver services 537
803+program under chapter 393 outlined in the Florida Medicaid 538
804+Developmental Disabilities Individual Budgeting Waiver Services 539
805+Coverage and Limitations Handbook as adopted by reference in 540
806+rule 59G-13.070, Florida Administrative Code . 541
807+ (c) Support coordination services must maximize the use of 542
808+natural supports and community partnerships. 543
809+ (d) The plans participating in the pilot program must 544
810+provide all categories of benefits through a single, integrated 545
811+model of care. 546
812+ (e) Participating plans must provide benefits services 547
813+must be provided to enrollees in accordance with an 548
814+individualized care plan which is evaluated and updated at least 549
815+quarterly and as warranted by changes in an enrollee's 550
816816
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824824 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
825825
826826
827827
828- a. Adult day training . 551
829- b. Behavior analysis services. 552
830- c. Behavior assistant services. 553
831- d. Companion services. 554
832- e. Consumable medical supplies. 555
833- f. Dietitian services. 556
834- g. Durable medical equipment and supplies. 557
835- h. Environmental accessibility adaptations. 558
836- i. Occupational therapy. 559
837- j. Personal emergency response systems. 560
838- k. Personal supports. 561
839- l. Physical therapy. 562
840- m. Prevocational services. 563
841- n. Private duty nursing. 564
842- o. Residential habilitation, including the following 565
843-levels: 566
844- (I) Standard level. 567
845- (II) Behavior-focused level. 568
846- (III) Intensive-behavior level. 569
847- (IV) Enhanced intensive -behavior level. 570
848- p. Residential nursing services. 571
849- q. Respiratory therapy. 572
850- r. Respite care. 573
851- s. Skilled nursing. 574
852- t. Specialized medical home care. 575
828+circumstances. Participating plans must conduct an 551
829+individualized assessment of each enrollee within 5 days af ter 552
830+enrollment to determine the enrollee's functional, behavioral, 553
831+and physical needs. The assessment method or instrument must be 554
832+approved by the agency. 555
833+ (f) Participating plans must offer a consumer -directed 556
834+services option in accordance with s. 409.22 1. 557
835+ (6) PROGRAM IMPLEMENTATION AND EVALUATION. — 558
836+ (a) The agency shall conduct monitoring and evaluations 559
837+and require corrective actions or payment of penalties as may be 560
838+necessary to secure compliance with contractual requirements, 561
839+consistent with its ob ligations under this section, including, 562
840+but not limited to, compliance with provider network standards, 563
841+financial accountability, performance standards, health care 564
842+quality improvement systems, and program integrity select 565
843+participating plans and begin en rollment no later than January 566
844+31, 2024, with coverage for enrollees becoming effective upon 567
845+authorization and availability of sufficient state and federal 568
846+resources. 569
847+ (b) Upon implementation of the program, the agency, in 570
848+consultation with the Agency for Persons with Disabilities, 571
849+shall conduct audits of the selected plans' implementation of 572
850+person-centered planning. 573
851+ (b)(c) The agency, in consultation with the Agency for 574
852+Persons with Disabilities, shall submit progress reports to the 575
853853
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861861 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
862862
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864864
865- u. Specialized mental health counsel ing. 576
866- v. Speech therapy. 577
867- w. Support coordination. 578
868- x. Supported employment. 579
869- y. Supported living coaching. 580
870- z. Transportation. 581
871- (b) All providers of the benefits services listed under 582
872-paragraph (a) must meet the provider qualifications established 583
873-by the agency for the Medicaid long -term care managed care 584
874-program under this section. If no such qualifications apply to a 585
875-specific benefit or provider type, the provider must meet the 586
876-provider qualifications established by the Agency for Persons 587
877-with Disabilities for the individual budget waiver services 588
878-program under chapter 393 outlined in the Florida Medicaid 589
879-Developmental Disabilities Individual Budgeting Waiver Services 590
880-Coverage and Limitations Handbook as adopted by reference in 591
881-rule 59G-13.070, Florida Administrative Code . 592
882- (c) Support coordination services must maximize the use of 593
883-natural supports and community partnerships. 594
884- (d) The plans participating in the pilot program must 595
885-provide all categories of benefits through a single, integrated 596
886-model of care. 597
887- (e) Participating plans must provide benefits services 598
888-must be provided to enrollees in accordance with an 599
889-individualized care plan which is evaluated and updated at least 600
865+Governor, the President of the Senate, and the Speaker of the 576
866+House of Representatives upon the federal approval, 577
867+implementation, and operation of the pilot program, as follows: 578
868+ 1. By August 30, 2025 December 31, 2023, a status report 579
869+on progress made toward federal approval of the waiver or waiver 580
870+amendment needed to implement the pilot program. 581
871+ 2. By December 31, 2025 2024, a status report on 582
872+implementation of the pilot program. 583
873+ 3. By December 31, 2025, and annually thereafter, a status 584
874+report on the operation of the pilot program, including, but not 585
875+limited to, all of the following: 586
876+ a. Program enrollment, including the number and 587
877+demographics of enrollees. 588
878+ b. Any complaints received. 589
879+ c. Access to approved services. 590
880+ (c)(d) The agency, in consultation wit h the Agency for 591
881+Persons with Disabilities, shall establish specific measures of 592
882+access, quality, and costs of the pilot program. The agency may 593
883+contract with an independent evaluator to conduct such 594
884+evaluation. The evaluation must include assessments of c ost 595
885+savings; consumer education, choice, and access to services; 596
886+plans for future capacity and the enrollment of new Medicaid 597
887+providers; coordination of care; person -centered planning and 598
888+person-centered well-being outcomes; health and quality -of-life 599
889+outcomes; and quality of care by each eligibility category and 600
890890
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898898 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
899899
900900
901901
902-quarterly and as warranted by changes in an enrollee's 601
903-circumstances. Participating plans must conduct an 602
904-individualized assessment of each enrollee within 5 days after 603
905-enrollment to determine the enrollee's functional, behavioral, 604
906-and physical needs. The assessment method or instrument must be 605
907-approved by the agency. 606
908- (f) Participating plans must offer a consumer -directed 607
909-services option in accordance with s. 409.221. 608
910- (6) PROGRAM IMPLEMENTATION AND EVALUATION. — 609
911- (a) The agency shall conduct monitoring and evaluations 610
912-and require corrective actions or payment of penalties as may be 611
913-necessary to secure compliance with contractual requirements, 612
914-consistent with its obligations under this section, including, 613
915-but not limited to, compliance with provider network standards, 614
916-financial accountability, performance standards, health c are 615
917-quality improvement systems, and program integrity select 616
918-participating plans and begin enrollment no later than January 617
919-31, 2024, with coverage for enrollees becoming effective upon 618
920-authorization and availability of sufficient state and federal 619
921-resources. 620
922- (b) Upon implementation of the program, the agency, in 621
923-consultation with the Agency for Persons with Disabilities, 622
924-shall conduct audits of the selected plans' implementation of 623
925-person-centered planning. 624
926- (b)(c) The agency, in consultation wit h the Agency for 625
927-
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935-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
936-
937-
938-
939-Persons with Disabilities, shall submit progress reports to the 626
940-Governor, the President of the Senate, and the Speaker of the 627
941-House of Representatives upon the federal approval, 628
942-implementation, and operation of the pilot program, as follow s: 629
943- 1. By August 30, 2025 December 31, 2023, a status report 630
944-on progress made toward federal approval of the waiver or waiver 631
945-amendment needed to implement the pilot program. 632
946- 2. By December 31, 2025 2024, a status report on 633
947-implementation of the pilot p rogram. 634
948- 3. By December 31, 2025, and annually thereafter, a status 635
949-report on the operation of the pilot program, including, but not 636
950-limited to, all of the following: 637
951- a. Program enrollment, including the number and 638
952-demographics of enrollees. 639
953- b. Any complaints received. 640
954- c. Access to approved services. 641
955- (c)(d) The agency, in consultation with the Agency for 642
956-Persons with Disabilities, shall establish specific measures of 643
957-access, quality, and costs of the pilot program. The agency may 644
958-contract with an independent evaluator to conduct such 645
959-evaluation. The evaluation must include assessments of cost 646
960-savings; consumer education, choice, and access to services; 647
961-plans for future capacity and the enrollment of new Medicaid 648
962-providers; coordination of care; pers on-centered planning and 649
963-person-centered well-being outcomes; health and quality -of-life 650
964-
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972-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
973-
974-
975-
976-outcomes; and quality of care by each eligibility category and 651
977-managed care plan in each pilot program site. The evaluation 652
978-must describe any administrative or legal b arriers to the 653
979-implementation and operation of the pilot program in each 654
980-region. 655
981- 1. The agency, in consultation with the Agency for Persons 656
982-with Disabilities, shall conduct quality assurance monitoring of 657
983-the pilot program to include client satisfaction with services, 658
984-client health and safety outcomes, client well -being outcomes, 659
985-and service delivery in accordance with the client's care plan. 660
986- 2. The agency shall submit the results of the evaluation 661
987-to the Governor, the President of the Senate, and the S peaker of 662
988-the House of Representatives by October 1, 2029. 663
989- Section 6. (1) The agency shall contract for a study to 664
990-review, evaluate, and identify recommendations regarding the 665
991-algorithm required under s. 393.0662, Florida Statutes. The 666
992-individual contractor must possess or, if the contractor is a 667
993-firm must include at least one lead team member who possesses, a 668
994-doctorate in statistics and advanced knowledge of the 669
995-development and selection of multiple linear regression models. 670
996-The study must, at a minim um, assess the performance of the 671
997-current algorithm used by the agency and determine whether a 672
998-different algorithm would better meet the requirements of that 673
999-section. In conducting this assessment and determination, at a 674
1000-minimum, the study must also review the fit of recent 675
1001-
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1009-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
1010-
1011-
1012-
1013-expenditure data to the current algorithm, determine and refine 676
1014-dependent and independent variables, develop and apply a method 677
1015-for identifying and removing outliers, develop alternative 678
1016-algorithms using multiple linear regression, test the accuracy 679
1017-and reliability of the algorithms, provide recommendations for 680
1018-improving accuracy and reliability, recommend an algorithm for 681
1019-use by the agency, assess the robustness of the recommended 682
1020-algorithm, and provide suggestions for improving any reco mmended 683
1021-alternative algorithm, if appropriate. The study must also 684
1022-consider whether any waiver services that are not currently 685
1023-funded through the algorithm can be funded through the current 686
1024-algorithm or an alternative algorithm, and the impact of doing 687
1025-so on that algorithm's fit and effectiveness. The study must 688
1026-present for any recommended alternative algorithm, at a minimum, 689
1027-the estimated number and percent of waiver enrollees who would 690
1028-require supplemental funding under s. 393.0662(1)(b), Florida 691
1029-Statutes, compared to the current algorithm; and the number and 692
1030-percent of waiver enrollees whose budgets are estimated to 693
1031-increase or decrease, categorized by level of increase or 694
1032-decrease, age, living setting, and current total individual 695
1033-budget amount. 696
1034- (2) The agency shall report to the Governor, the President 697
1035-of the Senate, and the Speaker of the House of Representatives 698
1036-findings and recommendations by November 15, 2025. 699
1037- Section 7. This act shall take effect July 1, 2025. 700
902+managed care plan in each pilot program site. The evaluation 601
903+must describe any administrative or legal barriers to the 602
904+implementation and operation of the pilot program in each 603
905+region. 604
906+ 1. The agency, in consultation with the Agency for Persons 605
907+with Disabilities, shall conduct quality assurance monitoring of 606
908+the pilot program to include client satisfaction with services, 607
909+client health and safety outcomes, client well -being outcomes, 608
910+and service delivery in accordance with the client's care plan. 609
911+ 2. The agency shall submit the results of the evaluation 610
912+to the Governor, the President of the Senate, and the Speaker of 611
913+the House of Representatives by October 1, 2029. 612
914+ Section 5. This act shall take effect July 1, 2025. 613