| 1 | Representative(s) Galvano offered the following: |
| 2 |
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| 3 | Amendment (with title amendment) |
| 4 | Between lines 8 and 9, insert: |
| 5 | Section 1. Paragraph (f) of subsection (3) of section |
| 6 | 393.0661, Florida Statutes, is amended to read: |
| 7 | 393.0661 Home and community-based services delivery |
| 8 | system; comprehensive redesign.--The Legislature finds that the |
| 9 | home and community-based services delivery system for persons |
| 10 | with developmental disabilities and the availability of |
| 11 | appropriated funds are two of the critical elements in making |
| 12 | services available. Therefore, it is the intent of the |
| 13 | Legislature that the Agency for Persons with Disabilities shall |
| 14 | develop and implement a comprehensive redesign of the system. |
| 15 | (3) The Agency for Health Care Administration, in |
| 16 | consultation with the agency, shall seek federal approval and |
| 17 | implement a four-tiered waiver system to serve clients with |
| 18 | developmental disabilities in the developmental disabilities and |
| 19 | family and supported living waivers. The agency shall assign all |
| 20 | clients receiving services through the developmental |
| 21 | disabilities waiver to a tier based on a valid assessment |
| 22 | instrument, client characteristics, and other appropriate |
| 23 | assessment methods. All services covered under the current |
| 24 | developmental disabilities waiver shall be available to all |
| 25 | clients in all tiers where appropriate, except as otherwise |
| 26 | provided in this subsection or in the General Appropriations |
| 27 | Act. |
| 28 | (f) The agency shall seek federal waivers and amend |
| 29 | contracts as necessary to make changes to services defined in |
| 30 | federal waiver programs administered by the agency as follows: |
| 31 | 1. Supported living coaching services shall not exceed 20 |
| 32 | hours per month for persons who also receive in-home support |
| 33 | services. |
| 34 | 2. Limited support coordination services shall be the only |
| 35 | type of support coordination service provided to persons under |
| 36 | the age of 18 who live in the family home. |
| 37 | 3. Personal care assistance services shall be limited to |
| 38 | no more than 180 hours per calendar month and shall not include |
| 39 | rate modifiers. Additional hours may be authorized for persons |
| 40 | who have intensive physical, medical, or adaptive needs if such |
| 41 | hours are essential for avoiding institutionalization only if a |
| 42 | substantial change in circumstances occurs for the individual. |
| 43 | 4. Residential habilitation services shall be limited to 8 |
| 44 | hours per day. Additional hours may be authorized for persons |
| 45 | who have intensive medical or adaptive needs and if such hours |
| 46 | are essential for avoiding institutionalization, or for persons |
| 47 | who possess behavioral problems that are exceptional in |
| 48 | intensity, duration, or frequency and present a substantial risk |
| 49 | of harming themselves or others. This restriction shall be in |
| 50 | effect until the four-tiered waiver system is fully implemented. |
| 51 | 5. Chore Services, nonresidential support services, and |
| 52 | homemaker services shall be eliminated. The agency shall expand |
| 53 | the definition of in-home support services to enable the |
| 54 | provider of the service to include activities previously |
| 55 | provided in these eliminated services. |
| 56 | 6. Massage therapy and psychological assessment services |
| 57 | shall be eliminated. |
| 58 | 7. The agency shall conduct supplemental cost plan reviews |
| 59 | to verify the medical necessity of authorized services for plans |
| 60 | that have increased by more than 8 percent during either of the |
| 61 | 2 preceding fiscal years. |
| 62 | 8. The agency shall implement a consolidated residential |
| 63 | habilitation rate structure to increase savings to the state |
| 64 | through a more cost-effective payment method and establish |
| 65 | uniform rates for intensive behavioral residential habilitation |
| 66 | services. |
| 67 | 9. Pending federal approval, the agency is authorized to |
| 68 | extend current support plans for clients receiving services |
| 69 | under Medicaid waivers for 1 year beginning July 1, 2007, or |
| 70 | from the date approved, whichever is later. Clients who have a |
| 71 | substantial change in circumstances which threatens their health |
| 72 | and safety may be reassessed during this year in order to |
| 73 | determine the necessity for a change in their support plan. |
| 74 | Section 2. The following proviso associated with Specific |
| 75 | Appropriation 270 in chapter 2007-72, Laws of Florida, is |
| 76 | amended to read: |
| 77 |
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| 78 | Personal Care Assistance services shall be limited to no more |
| 79 | than 180 hours per calendar month and shall not include rate |
| 80 | modifiers. Additional hours may be authorized for persons who |
| 81 | have intensive physical, medical, or adaptive needs if such |
| 82 | hours are essential for avoiding institutionalization only if a |
| 83 | substantial change in circumstances occurs for the individual. |
| 84 |
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| 85 |
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| 86 | ======= T I T L E A M E N D M E N T ======= |
| 87 | Remove line 2 and insert: |
| 88 | An act relating to Medicaid; amending s. 393.0661, F.S.; |
| 89 | providing for additional hours to be authorized under the |
| 90 | personal care assistance services provided pursuant to a |
| 91 | federal waiver program and administered by the Agency for |
| 92 | Persons with Disabilities; amending a specified portion of |
| 93 | proviso in Specific Appropriation 270 in chapter 2007-72, |
| 94 | Laws of Florida; amending s. |