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A bill to be entitled

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An act relating to the home and community-based services

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delivery system; amending s. 393.0661, F.S.; providing

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that the total annual expenditures under tier one for

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services to clients with developmental disabilities may

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not exceed $150,000 per client per year; limiting tier two

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services to clients whose service needs include a licensed

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residential facility and who have authorization for a

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moderate level of support for standard residential

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habilitation services or authorization for a minimal level

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of support for behavior focus residential habilitation

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services; delaying the applicability of provisions

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governing services provided under tier four; providing an

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effective date.

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Be It Enacted by the Legislature of the State of Florida:

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     Section 1.  Paragraphs (a), (b), and (d) of subsection (3)

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of section 393.0661, Florida Statutes, are amended to read:

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     393.0661  Home and community-based services delivery system;

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comprehensive redesign.--The Legislature finds that the home and

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community-based services delivery system for persons with

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developmental disabilities and the availability of appropriated

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funds are two of the critical elements in making services

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available. Therefore, it is the intent of the Legislature that

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the Agency for Persons with Disabilities shall develop and

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implement a comprehensive redesign of the system.

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     (3)  The Agency for Health Care Administration, in

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consultation with the agency, shall seek federal approval and

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implement a four-tiered waiver system to serve clients with

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developmental disabilities in the developmental disabilities and

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family and supported living waivers. The agency shall assign all

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clients receiving services through the developmental disabilities

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waiver to a tier based on a valid assessment instrument, client

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characteristics, and other appropriate assessment methods. All

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services covered under the current developmental disabilities

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waiver shall be available to all clients in all tiers where

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appropriate, except as otherwise provided in this subsection or

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in the General Appropriations Act.

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     (a)  Tier one shall be limited to clients who have service

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needs that cannot be met in tier two, three, or four for

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intensive medical or adaptive needs and that are essential for

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avoiding institutionalization, or who possess behavioral problems

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that are exceptional in intensity, duration, or frequency and

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present a substantial risk of harm to themselves or others. Total

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annual expenditures under tier one may not exceed $150,000 per

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client per year.

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     (b)  Tier two shall be limited to clients whose service

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needs include a licensed residential facility and who have

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authorization for a moderate level of support for standard

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residential habilitation services or authorization for a minimal

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level of support for behavior focus residential habilitation

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services greater than 5 hours per day in residential habilitation

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services or clients in supported living who receive greater than

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6 hours a day of in-home support services. Total annual

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expenditures under tier two may not exceed $55,000 per client

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each year.

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     (d)  Tier four is the family and supported living waiver.

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Tier four shall include, but is not limited to, clients in

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independent or supported living situations and clients who live

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in their family home. An increase to the number of services

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available to clients in this tier shall not take effect before

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July 1, 2009 prior to July 1, 2008. Total annual expenditures

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under tier four may not exceed $14,792 per client each year.

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     Section 2.  This act shall take effect July 1, 2008.