Amendment
Bill No. 5003C
Amendment No. 307737
CHAMBER ACTION
Senate House
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1Representative(s) Galvano offered the following:
2
3     Amendment (with title amendment)
4     Between lines 280 and 281, insert:
5     Section 13.  Paragraph (f) of subsection (3) of section
6393.0661, Florida Statutes, is amended to read:
7     393.0661  Home and community-based services delivery
8system; comprehensive redesign.--The Legislature finds that the
9home and community-based services delivery system for persons
10with developmental disabilities and the availability of
11appropriated funds are two of the critical elements in making
12services available. Therefore, it is the intent of the
13Legislature that the Agency for Persons with Disabilities shall
14develop and implement a comprehensive redesign of the system.
15     (3)  The Agency for Health Care Administration, in
16consultation with the agency, shall seek federal approval and
17implement a four-tiered waiver system to serve clients with
18developmental disabilities in the developmental disabilities and
19family and supported living waivers. The agency shall assign all
20clients receiving services through the developmental
21disabilities waiver to a tier based on a valid assessment
22instrument, client characteristics, and other appropriate
23assessment methods. All services covered under the current
24developmental disabilities waiver shall be available to all
25clients in all tiers where appropriate, except as otherwise
26provided in this subsection or in the General Appropriations
27Act.
28     (f)  The agency shall seek federal waivers and amend
29contracts as necessary to make changes to services defined in
30federal waiver programs administered by the agency as follows:
31     1.  Supported living coaching services shall not exceed 20
32hours per month for persons who also receive in-home support
33services.
34     2.  Limited support coordination services shall be the only
35type of support coordination service provided to persons under
36the age of 18 who live in the family home.
37     3.  Personal care assistance services shall be limited to
38no more than 180 hours per calendar month and shall not include
39rate modifiers. Additional hours may be authorized for persons
40who have intensive physical, medical, or adaptive needs and if
41such hours are essential for avoiding institutionalization only
42if a substantial change in circumstances occurs for the
43individual.
44     4.  Residential habilitation services shall be limited to 8
45hours per day. Additional hours may be authorized for persons
46who have intensive medical or adaptive needs and if such hours
47are essential for avoiding institutionalization, or for persons
48who possess behavioral problems that are exceptional in
49intensity, duration, or frequency and present a substantial risk
50of harming themselves or others. This restriction shall be in
51effect until the four-tiered waiver system is fully implemented.
52     5.  Chore Services, nonresidential support services, and
53homemaker services shall be eliminated. The agency shall expand
54the definition of in-home support services to enable the
55provider of the service to include activities previously
56provided in these eliminated services.
57     6.  Massage therapy and psychological assessment services
58shall be eliminated.
59     7.  The agency shall conduct supplemental cost plan reviews
60to verify the medical necessity of authorized services for plans
61that have increased by more than 8 percent during either of the
622 preceding fiscal years.
63     8.  The agency shall implement a consolidated residential
64habilitation rate structure to increase savings to the state
65through a more cost-effective payment method and establish
66uniform rates for intensive behavioral residential habilitation
67services.
68     9.  Pending federal approval, the agency is authorized to
69extend current support plans for clients receiving services
70under Medicaid waivers for 1 year beginning July 1, 2007, or
71from the date approved, whichever is later. Clients who have a
72substantial change in circumstances which threatens their health
73and safety may be reassessed during this year in order to
74determine the necessity for a change in their support plan.
75     Section 14.  The following proviso language associated with
76Specific Appropriation 270 in chapter 2007-72, Laws of Florida,
77is amended to read:
78
79Personal Care Assistance services shall be limited to no more
80than 180 hours per calendar month and shall not include rate
81modifiers. Additional hours may be authorized for persons who
82have intensive physical, medical, or adaptive needs and if such
83hours are essential for avoiding institutionalization only if a
84substantial change in circumstances occurs for the individual.
85
86======= T I T L E  A M E N D M E N T =======
87     Between lines 21 and 22, insert:
88amending s. 393.0661, F.S.; providing for additional hours to be
89authorized under the personal care assistance services provided
90pursuant to a federal waiver program and administered by the
91Agency for Persons with Disabilities; amending proviso language
92contained in Specific Appropriation 270 in chapter 2007-72, Laws
93of Florida, to conform;


CODING: Words stricken are deletions; words underlined are additions.