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The Florida Senate

2025 Florida Statutes

Title XXIX PUBLIC HEALTH
Chapter 400 NURSING HOMES AND RELATED HEALTH CARE FACILITIES Entire Chapter
SECTION 4765
Home health aide for medically fragile children program.
F.S. 400.4765
400.4765 Home health aide for medically fragile children program.—
(1) LEGISLATIVE FINDINGS AND INTENT.—The home health aide for medically fragile children program is hereby established in response to the existing national health care provider shortage and the impact that the shortage has on medically fragile children and the family caregivers. This program is created to decrease the hospitalization and institutionalization of medically fragile children, reduce state expenditures, and provide an opportunity for a family caregiver to receive training and gainful employment.
(2) ELIGIBILITY REQUIREMENTS.—A home health agency may employ as a home health aide for medically fragile children any person 18 years of age or older who meets all of the following requirements. A person must:
(a) Be a family caregiver of an eligible relative.
(b) Demonstrate a minimum competency to read and write.
(c) Complete an approved training program as set forth in this section or have graduated from an accredited prelicensure nursing education program and is waiting to take the state licensing exam.
(d) Successfully pass the required background screening pursuant to s. 400.215. If the person has successfully passed the required background screening pursuant to s. 400.215 or s. 408.809 within 90 days before applying for a certificate to practice and the person’s background screening results are not retained in the clearinghouse created under s. 435.12, the agency shall waive the requirement that the applicant successfully pass an additional background screening pursuant to s. 400.215.
(3) TRAINING.—
(a) Before providing services to an eligible relative, a home health aide for medically fragile children must complete an agency-approved training program. The employing home health agency must provide validation of competency by a registered nurse, and maintain documentation of training completion and competency validation. The employing home health agency must provide additional training and competency validation as the medically fragile child’s care needs change, consistent with any changes to the plan of care. The employing home health agency must provide training on HIV infections and AIDS and must ensure that each home health aide for medically fragile children holds and maintains a certification in cardiopulmonary resuscitation.
(b) The agency, in consultation with the Board of Nursing, shall approve home health aide for medically fragile children training programs developed by home health agencies in accordance with 42 C.F.R. ss. 483.151-483.154 and 484.80 to train family caregivers as home health aides for medically fragile children to increase the health care provider workforce and to authorize persons to provide trained nursing services as delegated by a registered nurse to eligible relatives. The training programs must consist of at least 76 hours of training, including, but not limited to, all of the following:
1. Successful completion of at least 40 hours of home health aide training pursuant to s. 400.497.
2. A minimum of 20 hours of skills training on basic nursing skills tailored to the child’s individualized care needs as specified in the ordering provider’s plan of care, which may include training on the following topics, as applicable:
a. Hygiene, grooming, and toileting.
b. Skin care and pressure sore prevention.
c. Nutrition and hydration.
d. Measuring vital signs, height, and weight.
e. Safe lifting, positioning, and moving of patients.
f. Wound care.
g. Oxygen use and safety and other respiratory procedures.
h. Tracheostomy care.
i. Enteral care and therapy.
j. Intravenous assistive activities and alternative feeding methods.
k. Urinary catheterization and care and ostomy care.
3. At least 16 hours of clinical training related to the specific needs of an eligible relative and provided under direct supervision of a licensed registered nurse.
4. Training concerning HIV infections.
5. Cardiopulmonary resuscitation training, evidenced by obtaining and maintaining a current certificate in cardiopulmonary resuscitation.
(c) If a home health aide for medically fragile children allows 24 consecutive months to pass without providing any personal care related services for an eligible relative, the family caregiver must complete an approved training program before providing personal care related services as a home health aide for medically fragile children.
(4) EMPLOYMENT.—A home health agency that employs a home health aide for medically fragile children must ensure that the home health aide for medically fragile children completes 12 hours of inservice training during each 12-month period as a condition of employment. The training concerning HIV infections and AIDS and the cardiopulmonary training may count toward meeting the 12 hours of inservice training. The home health agency shall maintain documentation demonstrating compliance with this subsection.
(5) LIABILITY.—If a home health agency terminates or denies employment to a home health aide for medically fragile children who fails to maintain the requirements of this part or whose name appears on a criminal screening report of the Department of Law Enforcement, the home health agency is not civilly liable for such termination and a cause of action may not be brought against the home health agency for damages. There may not be any monetary liability on the part of, and a cause of action for damages may not arise against, any licensed facility or its governing board or members thereof, medical staff, disciplinary board, agents, investigators, witnesses, employees, or any other person for any action taken in good faith, without intentional fraud, to comply with this part.
(6) CONFIDENTIALITY.—A home health agency, or an agent thereof, may not use criminal records or juvenile records relating to vulnerable adults for any purpose other than determining if the person meets the requirements of this part. The agency shall maintain the confidentiality of any such records and information it obtains which are confidential and exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution.
(7) SERVICES.—Services provided by a home health aide for medically fragile children must reduce an eligible relative’s private duty nursing service hours. Such services may not be provided concurrently with any private duty nursing service.
(8) RULES.—The agency, in consultation with the Board of Nursing, may adopt rules to implement this section.
(9) FEE SCHEDULE.—The agency shall modify any state Medicaid plans and implement any federal waivers necessary to implement this section and shall establish a Medicaid fee schedule for home health agencies employing a home health aide for medically fragile children at minimum rate of $25 per hour with a utilization cap of no more than 12 hours per day and 40 hours per week, per medically fragile child. The utilization cap of 40 hours per week, per recipient may be exceeded; however, justification must be provided as to why there is no other qualified provider available, and the request must be approved by the home health agency and the managed care plan.
1(10) FEDERAL APPROVAL.—The agency shall seek necessary federal approval, including seeking the appropriate federal waiver, to:
(a) Allow Medicaid private duty nursing specialty providers and home health services providers to participate in and receive reimbursement for services rendered under this program.
(b) Provide that the income earned under this program by a home health aide for medically fragile children is disregarded in Medicaid eligibility determinations.
History.—s. 4, ch. 2023-183; s. 2, ch. 2025-171.
1Note.—Section 5, ch. 2025-171, provides that “[w]ithin 60 days after this act becomes law, the Agency for Health Care Administration shall make all necessary requests and submissions to obtain federal approval to implement this act amending s. 409.903, Florida Statutes, and initiate any necessary rulemaking to implement the provisions of this act amending s. 400.4765, Florida Statutes.”