Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. PCS (366342) for SB 7054
       
       
       
       
       
       
                                Ì500696CÎ500696                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/03/2016           .                                
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       The Committee on Appropriations (Garcia) recommended the
       following:
       
    1         Senate Amendment 
    2  
    3         Delete lines 495 - 578
    4  and insert:
    5         (b) The allocation methodology shall determine provide the
    6  algorithm that determines the amount of funds allocated to a
    7  client’s iBudget.
    8         (b) The agency may authorize funding approve an increase in
    9  the amount of funds allocated, as determined by the algorithm,
   10  based on a the client having one or more of the following needs
   11  that cannot be accommodated within the funding as determined by
   12  the algorithm and having no other resources, supports, or
   13  services available to meet the need:
   14         1. An extraordinary need that would place the health and
   15  safety of the client, the client’s caregiver, or the public in
   16  immediate, serious jeopardy unless the increase is approved.
   17  However, the presence of an extraordinary need in and of itself
   18  does not warrant authorized funding by the agency. An
   19  extraordinary need may include, but is not limited to:
   20         a. The loss of or a change in the client’s caregiver
   21  arrangement or a documented need based on a medical, behavioral,
   22  or psychological assessment;
   23         b.a. A documented history of significant, potentially life
   24  threatening behaviors, such as recent attempts at suicide,
   25  arson, nonconsensual sexual behavior, or self-injurious behavior
   26  requiring medical attention;
   27         c.b. A complex medical condition that requires active
   28  intervention by a licensed nurse on an ongoing basis that cannot
   29  be taught or delegated to a nonlicensed person;
   30         d.c. A chronic comorbid condition. As used in this
   31  subparagraph, the term “comorbid condition” means a medical
   32  condition existing simultaneously but independently with another
   33  medical condition in a patient; or
   34         e.d. A need for total physical assistance with activities
   35  such as eating, bathing, toileting, grooming, and personal
   36  hygiene.
   37  
   38  However, the presence of an extraordinary need alone does not
   39  warrant an increase in the amount of funds allocated to a
   40  client’s iBudget as determined by the algorithm.
   41         2. A significant need for one-time or temporary support or
   42  services that, if not provided, would place the health and
   43  safety of the client, the client’s caregiver, or the public in
   44  serious jeopardy, unless the increase is approved. A significant
   45  need may include, but is not limited to, the provision of
   46  environmental modifications, durable medical equipment, services
   47  to address the temporary loss of support from a caregiver, or
   48  special services or treatment for a serious temporary condition
   49  when the service or treatment is expected to ameliorate the
   50  underlying condition. As used in this subparagraph, the term
   51  “temporary” means a period of fewer than 12 continuous months.
   52  However, the presence of such significant need for one-time or
   53  temporary supports or services alone does not in and of itself
   54  warrant authorized funding by the agency an increase in the
   55  amount of funds allocated to a client’s iBudget as determined by
   56  the algorithm.
   57         3. A significant increase in the need for services after
   58  the beginning of the service plan year which that would place
   59  the health and safety of the client, the client’s caregiver, or
   60  the public in serious jeopardy because of substantial changes in
   61  the client’s circumstances, including, but not limited to,
   62  permanent or long-term loss or incapacity of a caregiver, loss
   63  of services authorized under the state Medicaid plan due to a
   64  change in age, or a significant change in medical or functional
   65  status which requires the provision of additional services on a
   66  permanent or long-term basis that cannot be accommodated within
   67  the client’s current iBudget. As used in this subparagraph, the
   68  term “long-term” means a period of 12 or more continuous months.
   69  However, such significant increase in need for services of a
   70  permanent or long-term nature alone does not in and of itself
   71  warrant authorized funding by the agency warrant an increase in
   72  the amount of funds allocated to a client’s iBudget as
   73  determined by the algorithm.
   74         4. A significant need for transportation services to a
   75  waiver-funded adult day training program or to waiver-funded
   76  employment services when such need cannot be accommodated within
   77  a client’s iBudget as determined by the algorithm without
   78  affecting the health and safety of the client, when public
   79  transportation is not an option due to the unique needs of the
   80  client, or when other transportation resources are not
   81  reasonably available.
   82  
   83  The agency shall reserve portions of the appropriation for the
   84  home and community-based services Medicaid waiver program for
   85  adjustments required pursuant to this paragraph and may use the
   86  services of an independent actuary in determining the amount of
   87  the portions to be reserved.
   88         (c) A client’s iBudget shall be the total of the amount