Amendment
Bill No. HB 5087
Amendment No. 903991
CHAMBER ACTION
Senate House
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1The Conference Committee on HB 5087 offered the following:
2
3     Conference Committee Amendment (with title amendment)
4     Remove everything after the enacting clause and insert:
5     Section 1.  Subsection (4) of section 393.0661, Florida
6Statutes, is renumbered as subsection (7), paragraphs (b) and
7(d) of subsection (3) are amended, present subsection (5) is
8renumbered as subsection (8) and amended, and new subsections
9(4), (5), and (6) are added to that section, to read:
10     393.0661  Home and community-based services delivery
11system; comprehensive redesign.--The Legislature finds that the
12home and community-based services delivery system for persons
13with developmental disabilities and the availability of
14appropriated funds are two of the critical elements in making
15services available. Therefore, it is the intent of the
16Legislature that the Agency for Persons with Disabilities shall
17develop and implement a comprehensive redesign of the system.
18     (3)  The Agency for Health Care Administration, in
19consultation with the agency, shall seek federal approval and
20implement a four-tiered waiver system to serve clients with
21developmental disabilities in the developmental disabilities and
22family and supported living waivers. The agency shall assign all
23clients receiving services through the developmental
24disabilities waiver to a tier based on a valid assessment
25instrument, client characteristics, and other appropriate
26assessment methods. All services covered under the current
27developmental disabilities waiver shall be available to all
28clients in all tiers where appropriate, except as otherwise
29provided in this subsection or in the General Appropriations
30Act.
31     (b)  Tier two shall be limited to clients whose service
32needs include a licensed residential facility and who are
33authorized to receive a moderate level of support for standard
34residential habilitation services or a minimal level of support
35for behavior focus greater than 5 hours per day in residential
36habilitation services or clients in supported living who receive
37greater than 6 hours a day of in-home support services. Total
38annual expenditures under tier two may not exceed $55,000 per
39client each year.
40     (d)  Tier four is the family and supported living waiver.
41Tier four shall include, but is not limited to, clients in
42independent or supported living situations and clients who live
43in their family home. An increase to the number of services
44available to clients in this tier shall not take effect prior to
45July 1, 2009 2008. Total annual expenditures under tier four may
46not exceed $14,792 per client each year.
47     (4)  Effective July 1, 2008, the geographic differential
48for Miami-Dade, Broward, and Palm Beach Counties for residential
49habilitation services shall be 7.5 percent. Effective July 1,
502009, the geographic differential for Miami-Dade, Broward, and
51Palm Beach Counties for residential habilitation services shall
52be 4.5 percent.
53     (5)  Effective July 1, 2008, the geographic differential
54for Monroe County for residential habilitation services shall be
5520 percent. Effective July 1, 2009, the geographic differential
56for Monroe County for residential habilitation services shall be
5715 percent. Effective July 1, 2010, the geographic differential
58for Monroe County for residential habilitation services shall be
5910 percent.
60     (6)  Effective January 1, 2009, and except as otherwise
61provided in this section, an individual served by the home and
62community-based services waiver or the family and supported
63living waiver funded through the Agency for Persons with
64Disabilities shall have his or her cost plan adjusted to reflect
65the amount of expenditures for the previous state fiscal year
66plus 5 percent if such amount is less than the individual's
67existing cost plan. The Agency for Persons with Disabilities
68shall use actual paid claims for services provided during the
69previous fiscal year that are submitted by October 31 to
70calculate the revised cost plan amount. If an individual was not
71served for the entire previous state fiscal year or there was
72any single change in the cost plan amount of more than 5 percent
73during the previous state fiscal year, the agency shall set the
74cost plan amount at an estimated annualized expenditure amount
75plus 5 percent. The agency shall estimate the annualized
76expenditure amount by calculating the average of monthly
77expenditures, beginning in the fourth month after the individual
78enrolled or the cost plan was changed by more than 5 percent and
79ending with August 31, 2008, and multiplying the average by 12.
80In the event that at least 3 months of actual expenditure data
81are not available to estimate annualized expenditures, the
82agency may not rebase a cost plan pursuant to this subsection.
83This subsection expires June 30, 2009, unless reenacted by the
84Legislature before that date.
85     (8)(5)  The Agency for Persons with Disabilities shall
86submit quarterly status reports to the Executive Office of the
87Governor, the chair of the Senate Ways and Means Committee or
88its successor, and the chair of the House Fiscal Council or its
89successor regarding the financial status of home and community-
90based services, including the number of enrolled individuals who
91are receiving services through one or more programs; the number
92of individuals who have requested services who are not enrolled
93but who are receiving services through one or more programs,
94with a description indicating the programs from which the
95individual is receiving services; the number of individuals who
96have refused an offer of services but who choose to remain on
97the list of individuals waiting for services; the number of
98individuals who have requested services but who are receiving no
99services; a frequency distribution indicating the length of time
100individuals have been waiting for services; and information
101concerning the actual and projected costs compared to the amount
102of the appropriation available to the program and any projected
103surpluses or deficits. If at any time an analysis by the agency,
104in consultation with the Agency for Health Care Administration,
105indicates that the cost of services is expected to exceed the
106amount appropriated, the agency shall submit a plan in
107accordance with subsection (7) (4) to the Executive Office of
108the Governor, the chair of the Senate Ways and Means Committee
109or its successor, and the chair of the House Fiscal Council or
110its successor to remain within the amount appropriated. The
111agency shall work with the Agency for Health Care Administration
112to implement the plan so as to remain within the appropriation.
113     Section 2.  Section 393.071, Florida Statutes, is amended
114to read:
115     393.071  Client fees.--The agency shall charge fees for
116services provided to clients in accordance with s. 402.33. All
117funds collected pursuant to this section shall be deposited in
118the Operations and Maintenance Trust Fund.
119     Section 3.  This act shall take effect July 1, 2008.
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T I T L E  A M E N D M E N T
124     Remove the entire title and insert:
125
A bill to be entitled
126An act relating to the Agency for Persons with
127Disabilities; amending s. 393.0661, F.S.; revising
128provisions relating to certain clients with developmental
129disabilities served under the four-tiered waiver system;
130providing for residential habilitation services;
131establishing geographic differential payments for Miami-
132Dade, Broward, Palm Beach, and Monroe Counties; providing
133effective dates for applicable payments; providing for
134rebasing cost plans based on actual expenditures for
135individuals served by home and community-based services or
136family and supported living waiver programs; extending the
137effective date for the provision of certain services;
138providing for future review and repeal of certain
139provisions; amending s. 393.071, F.S.; providing for
140deposit of client fees into the agency's Operations and
141Maintenance Trust Fund; providing an effective date.


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