Florida Senate - 2025 SB 1156 By Senator Harrell 31-01398B-25 20251156__ 1 A bill to be entitled 2 An act relating to the home health aide for medically 3 fragile children program; amending s. 400.4765, F.S.; 4 revising the training requirements for family 5 caregivers participating in the program; specifying 6 that services provided by a home health aide for a 7 medically fragile child may not exceed a specified 8 percentage of the total annual hours authorized for 9 private duty nursing services for that child; revising 10 requirements for the Medicaid fee schedule for home 11 health aides for medically fragile children; requiring 12 the Agency for Health Care Administration, within a 13 specified timeframe, to seek federal approval to 14 implement specified practices under the program; 15 amending s. 400.54, F.S.; requiring Medicaid managed 16 care plans to provide certain data to the agency as 17 part of an annual assessment of the home health aide 18 for medically fragile children program; revising 19 requirements for such assessment; providing a 20 directive to the Division of Law Revision; providing 21 an effective date. 22 23 Be It Enacted by the Legislature of the State of Florida: 24 25 Section 1.Paragraph (a) of subsection (3) and subsection 26 (9) of section 400.4765, Florida Statutes, are amended, and 27 subsection (10) is added to that section, to read: 28 400.4765Home health aide for medically fragile children 29 program. 30 (3)TRAINING. 31 (a)The agency, in consultation with the Board of Nursing, 32 shall approve home health aide for medically fragile children 33 training programs developed by home health agencies in 34 accordance with 42 C.F.R. ss. 483.151-483.154 and 484.80 to 35 train family caregivers as home health aides for medically 36 fragile children to increase the health care provider workforce 37 and to authorize persons to provide trained nursing services as 38 delegated by a registered nurse to eligible relatives. The 39 program must include consist of at least 85 hours of training, 40 including, but need not be limited to, all of the following: 41 1.A minimum of 20 40 hours of theoretical instruction in 42 nursing, including, but not limited to, instruction on all of 43 the following: 44 a.Person-centered care. 45 b.Communication and interpersonal skills. 46 c.Infection control. 47 d.Safety and emergency procedures. 48 e.Assistance with activities of daily living. 49 f.Mental health and social service needs. 50 g.Care of cognitively impaired individuals. 51 h.Basic restorative care and rehabilitation. 52 i.Patient rights and confidentiality of personal 53 information and medical records. 54 j.Relevant legal and ethical issues. 55 56 Such instruction must be offered in various formats, and any 57 interactive instruction must be provided during various times of 58 the day. 59 2.Up to A minimum of 20 hours of skills training on basic 60 nursing skills, tailored to the childs care needs as specified 61 in the ordering providers plan of care, which may include 62 training on the following topics, as applicable including, but 63 not limited to: 64 a.Hygiene, grooming, and toileting. 65 b.Skin care and pressure sore prevention. 66 c.Nutrition and hydration. 67 d.Measuring vital signs, height, and weight. 68 e.Safe lifting, positioning, and moving of patients. 69 f.Wound care. 70 g.Portable Oxygen use and safety and other respiratory 71 procedures. 72 h.Tracheostomy care. 73 i.Enteral care and therapy. 74 j.Peripheral Intravenous assistive activities and 75 alternative feeding methods. 76 k.Urinary catheterization and care and ostomy care. 77 3.Up to At least 16 hours of clinical training related to 78 the specific needs of the eligible relative, under direct 79 supervision of a licensed registered nurse. 80 4.Training concerning HIV infections and AIDS. and is 81 required to obtain and maintain 82 5.Obtaining and maintaining a current certificate in 83 cardiopulmonary resuscitation. 84 (9)FEE SCHEDULE.The agency shall modify any state 85 Medicaid plans and implement any federal waivers necessary to 86 implement this section and shall establish a Medicaid fee 87 schedule for home health agencies employing a home health aide 88 for medically fragile children at a minimum rate of $25 per hour 89 with a utilization cap of no more than 12 8 hours per day per 90 medically fragile child. If a home health aide for medically 91 fragile children works more than 40 hours per week, 92 justification must be provided as to why there is no other 93 qualified provider available, and the request must be approved 94 by the home health agency and the managed care plan. 95 (10)FEDERAL APPROVAL.Within 30 days after this act 96 becomes a law, the agency shall seek federal approval through 97 any necessary Medicaid waiver or state plan amendment to: 98 (a)Allow Medicaid private duty nursing specialty providers 99 and home health services providers to participate in and receive 100 reimbursement for services rendered under the program. 101 (b)Establish that the income earned under the program by a 102 home health aide for medically fragile children must be 103 disregarded in eligibility considerations for public assistance 104 as defined in s. 414.0252. 105 Section 2.Section 400.54, Florida Statutes, is amended to 106 read: 107 400.54Annual assessment of the home health aide for 108 medically fragile children program.The agency shall conduct an 109 annual assessment of the home health aide for medically fragile 110 children program. The assessment must report caregiver 111 satisfaction with the program and, identify additional support 112 that may be needed by the home health aide for medically fragile 113 children. The managed care plan shall provide to the agency the 114 data necessary to, and assess the rate and extent of 115 hospitalization of children in home health services who are 116 attended by a home health aide for medically fragile children 117 compared to those in home health services provided by a 118 registered nurse or licensed practical nurse without a home 119 health aide for medically fragile children. The agency shall 120 include in the assessment data on any adverse incident occurring 121 under the care of a home health aide for medically fragile 122 children. By January 1 of each year, beginning January 1, 2025, 123 the agency shall report its findings to the Governor, the 124 President of the Senate, and the Speaker of the House of 125 Representatives. 126 Section 3.The Division of Law Revision is directed to 127 replace the phrase this act becomes a law wherever it occurs 128 in this act with the date this act becomes a law. 129 Section 4.This act shall take effect upon becoming a law.