Florida Senate - 2018 SB 2506
By the Committee on Appropriations
1 A bill to be entitled
2 An act relating to health care; amending s. 381.915,
3 F.S.; increasing the number of years that a cancer
4 center may participate in Tier 3 of the Florida
5 Consortium of National Cancer Institute Centers
6 Program; increasing the number of years after
7 qualification that a certain Tier 3 cancer center may
8 pursue specified NCI designations; amending s.
9 409.908, F.S.; removing the Agency for Health Care
10 Administration’s authority to establish an alternative
11 methodology to the DRG-based prospective payment
12 system to set reimbursement rates for Class III
13 psychiatric hospitals; revising parameters relating to
14 the prospective payment methodology for the
15 reimbursement of Medicaid providers to be implemented
16 for rate setting purposes; requiring the agency to
17 establish prospective payment reimbursement rates for
18 nursing home services as provided in this act and in
19 the General Appropriations Act; conforming provisions
20 to changes made by the act; amending s. 409.9082,
21 F.S.; authorizing the agency to seek certain remedies
22 from any nursing home facility provider that fails to
23 report its total number of resident days monthly,
24 including the imposition of a specified fine; amending
25 s. 409.9083, F.S.; authorizing the agency to seek
26 certain remedies from any intermediate care facility
27 for the developmentally disabled provider that fails
28 to report its total number of resident days monthly,
29 including the imposition of a specified fine; amending
30 s. 409.909, F.S.; revising the definition of the term
31 “qualifying institution” to include certain licensed
32 substance abuse treatment facilities for purposes of
33 the Statewide Medicaid Residency Program; amending s.
34 409.968, F.S.; revising the rate-setting methodology
35 used in the reimbursement of Class III psychiatric
36 hospitals; amending s. 409.906, F.S.; conforming a
37 cross-reference; requiring the agency to seek
38 authorization from the federal Centers for Medicare
39 and Medicaid Services to modify the period of
40 retroactive Medicaid eligibility in a manner that
41 ensures that the modification becomes effective by a
42 certain date; requiring the agency to contract with a
43 nonprofit organization in Miami-Dade County, which
44 must meet certain requirements, to be a site for the
45 Program for All-inclusive Care for the Elderly (PACE),
46 subject to federal approval of the application site;
47 requiring the nonprofit organization to provide PACE
48 services to frail elders in Miami-Dade County;
49 requiring the agency, in consultation with the
50 Department of Elderly Affairs, to approve up to a
51 certain number of initial enrollees in PACE at the new
52 site, subject to an appropriation; providing effective
55 Be It Enacted by the Legislature of the State of Florida:
57 Section 1. Paragraph (c) of subsection (4) of section
58 381.915, Florida Statutes, is amended to read:
59 381.915 Florida Consortium of National Cancer Institute
60 Centers Program.—
61 (4) Tier designations and corresponding weights within the
62 Florida Consortium of National Cancer Institute Centers Program
63 are as follows:
64 (c) Tier 3: Florida-based cancer centers seeking
65 designation as either a NCI-designated cancer center or NCI
66 designated comprehensive cancer center, which shall be weighted
67 at 1.0.
68 1. A cancer center shall meet the following minimum
69 criteria to be considered eligible for Tier 3 designation in any
70 given fiscal year:
71 a. Conducting cancer-related basic scientific research and
72 cancer-related population scientific research;
73 b. Offering and providing the full range of diagnostic and
74 treatment services on site, as determined by the Commission on
75 Cancer of the American College of Surgeons;
76 c. Hosting or conducting cancer-related interventional
77 clinical trials that are registered with the NCI’s Clinical
78 Trials Reporting Program;
79 d. Offering degree-granting programs or affiliating with
80 universities through degree-granting programs accredited or
81 approved by a nationally recognized agency and offered through
82 the center or through the center in conjunction with another
83 institution accredited by the Commission on Colleges of the
84 Southern Association of Colleges and Schools;
85 e. Providing training to clinical trainees, medical
86 trainees accredited by the Accreditation Council for Graduate
87 Medical Education or the American Osteopathic Association, and
88 postdoctoral fellows recently awarded a doctorate degree; and
89 f. Having more than $5 million in annual direct costs
90 associated with their total NCI peer-reviewed grant funding.
91 2. The General Appropriations Act or accompanying
92 legislation may limit the number of cancer centers which shall
93 receive Tier 3 designations or provide additional criteria for
94 such designation.
95 3. A cancer center’s participation in Tier 3 shall be
96 limited to 6
97 4. A cancer center that qualifies as a designated Tier 3
98 center under the criteria provided in subparagraph 1. by July 1,
99 2014, is authorized to pursue NCI designation as a cancer center
100 or a comprehensive cancer center for 6 5 years after
102 Section 2. Paragraph (a) of subsection (1) of section
103 409.908, Florida Statutes, is amended to read:
104 409.908 Reimbursement of Medicaid providers.—Subject to
105 specific appropriations, the agency shall reimburse Medicaid
106 providers, in accordance with state and federal law, according
107 to methodologies set forth in the rules of the agency and in
108 policy manuals and handbooks incorporated by reference therein.
109 These methodologies may include fee schedules, reimbursement
110 methods based on cost reporting, negotiated fees, competitive
111 bidding pursuant to s. 287.057, and other mechanisms the agency
112 considers efficient and effective for purchasing services or
113 goods on behalf of recipients. If a provider is reimbursed based
114 on cost reporting and submits a cost report late and that cost
115 report would have been used to set a lower reimbursement rate
116 for a rate semester, then the provider’s rate for that semester
117 shall be retroactively calculated using the new cost report, and
118 full payment at the recalculated rate shall be effected
119 retroactively. Medicare-granted extensions for filing cost
120 reports, if applicable, shall also apply to Medicaid cost
121 reports. Payment for Medicaid compensable services made on
122 behalf of Medicaid eligible persons is subject to the
123 availability of moneys and any limitations or directions
124 provided for in the General Appropriations Act or chapter 216.
125 Further, nothing in this section shall be construed to prevent
126 or limit the agency from adjusting fees, reimbursement rates,
127 lengths of stay, number of visits, or number of services, or
128 making any other adjustments necessary to comply with the
129 availability of moneys and any limitations or directions
130 provided for in the General Appropriations Act, provided the
131 adjustment is consistent with legislative intent.
132 (1) Reimbursement to hospitals licensed under part I of
133 chapter 395 must be made prospectively or on the basis of
135 (a) Reimbursement for inpatient care is limited as provided
136 in s. 409.905(5), except as otherwise provided in this
138 1. If authorized by the General Appropriations Act, the
139 agency may modify reimbursement for specific types of services
140 or diagnoses, recipient ages, and hospital provider types.
141 2. The agency may establish an alternative methodology to
142 the DRG-based prospective payment system to set reimbursement
143 rates for:
144 a. State-owned psychiatric hospitals.
145 b. Newborn hearing screening services.
146 c. Transplant services for which the agency has established
147 a global fee.
148 d. Recipients who have tuberculosis that is resistant to
149 therapy who are in need of long-term, hospital-based treatment
150 pursuant to s. 392.62.
151 e. Class III psychiatric hospitals.
152 3. The agency shall modify reimbursement according to other
153 methodologies recognized in the General Appropriations Act.
155 The agency may receive funds from state entities, including, but
156 not limited to, the Department of Health, local governments, and
157 other local political subdivisions, for the purpose of making
158 special exception payments, including federal matching funds,
159 through the Medicaid inpatient reimbursement methodologies.
160 Funds received for this purpose shall be separately accounted
161 for and may not be commingled with other state or local funds in
162 any manner. The agency may certify all local governmental funds
163 used as state match under Title XIX of the Social Security Act,
164 to the extent and in the manner authorized under the General
165 Appropriations Act and pursuant to an agreement between the
166 agency and the local governmental entity. In order for the
167 agency to certify such local governmental funds, a local
168 governmental entity must submit a final, executed letter of
169 agreement to the agency, which must be received by October 1 of
170 each fiscal year and provide the total amount of local
171 governmental funds authorized by the entity for that fiscal year
172 under this paragraph, paragraph (b), or the General
173 Appropriations Act. The local governmental entity shall use a
174 certification form prescribed by the agency. At a minimum, the
175 certification form must identify the amount being certified and
176 describe the relationship between the certifying local
177 governmental entity and the local health care provider. The
178 agency shall prepare an annual statement of impact which
179 documents the specific activities undertaken during the previous
180 fiscal year pursuant to this paragraph, to be submitted to the
181 Legislature annually by January 1.
182 Section 3. Effective October 1, 2018, subsection (2) of
183 section 409.908, Florida Statutes, as amended by section 8 of
184 chapter 2017-129, Laws of Florida, is amended to read:
185 Section 8. Effective October 1, 2018, subsection (2) of
186 section 409.908, Florida Statutes, is amended to read:
187 409.908 Reimbursement of Medicaid providers.—Subject to
188 specific appropriations, the agency shall reimburse Medicaid
189 providers, in accordance with state and federal law, according
190 to methodologies set forth in the rules of the agency and in
191 policy manuals and handbooks incorporated by reference therein.
192 These methodologies may include fee schedules, reimbursement
193 methods based on cost reporting, negotiated fees, competitive
194 bidding pursuant to s. 287.057, and other mechanisms the agency
195 considers efficient and effective for purchasing services or
196 goods on behalf of recipients. If a provider is reimbursed based
197 on cost reporting and submits a cost report late and that cost
198 report would have been used to set a lower reimbursement rate
199 for a rate semester, then the provider’s rate for that semester
200 shall be retroactively calculated using the new cost report, and
201 full payment at the recalculated rate shall be effected
202 retroactively. Medicare-granted extensions for filing cost
203 reports, if applicable, shall also apply to Medicaid cost
204 reports. Payment for Medicaid compensable services made on
205 behalf of Medicaid eligible persons is subject to the
206 availability of moneys and any limitations or directions
207 provided for in the General Appropriations Act or chapter 216.
208 Further, nothing in this section shall be construed to prevent
209 or limit the agency from adjusting fees, reimbursement rates,
210 lengths of stay, number of visits, or number of services, or
211 making any other adjustments necessary to comply with the
212 availability of moneys and any limitations or directions
213 provided for in the General Appropriations Act, provided the
214 adjustment is consistent with legislative intent.
215 (2)(a)1. Reimbursement to nursing homes licensed under part
216 II of chapter 400 and state-owned-and-operated intermediate care
217 facilities for the developmentally disabled licensed under part
218 VIII of chapter 400 must be made prospectively.
219 2. Unless otherwise limited or directed in the General
220 Appropriations Act, reimbursement to hospitals licensed under
221 part I of chapter 395 for the provision of swing-bed nursing
222 home services must be made on the basis of the average statewide
223 nursing home payment, and reimbursement to a hospital licensed
224 under part I of chapter 395 for the provision of skilled nursing
225 services must be made on the basis of the average nursing home
226 payment for those services in the county in which the hospital
227 is located. When a hospital is located in a county that does not
228 have any community nursing homes, reimbursement shall be
229 determined by averaging the nursing home payments in counties
230 that surround the county in which the hospital is located.
231 Reimbursement to hospitals, including Medicaid payment of
232 Medicare copayments, for skilled nursing services shall be
233 limited to 30 days, unless a prior authorization has been
234 obtained from the agency. Medicaid reimbursement may be extended
235 by the agency beyond 30 days, and approval must be based upon
236 verification by the patient’s physician that the patient
237 requires short-term rehabilitative and recuperative services
238 only, in which case an extension of no more than 15 days may be
239 approved. Reimbursement to a hospital licensed under part I of
240 chapter 395 for the temporary provision of skilled nursing
241 services to nursing home residents who have been displaced as
242 the result of a natural disaster or other emergency may not
243 exceed the average county nursing home payment for those
244 services in the county in which the hospital is located and is
245 limited to the period of time which the agency considers
246 necessary for continued placement of the nursing home residents
247 in the hospital.
248 (b) Subject to any limitations or directions in the General
249 Appropriations Act, the agency shall establish and implement a
250 state Title XIX Long-Term Care Reimbursement Plan for nursing
251 home care in order to provide care and services in conformance
252 with the applicable state and federal laws, rules, regulations,
253 and quality and safety standards and to ensure that individuals
254 eligible for medical assistance have reasonable geographic
255 access to such care.
256 1. The agency shall amend the long-term care reimbursement
257 plan and cost reporting system to create direct care and
258 indirect care subcomponents of the patient care component of the
259 per diem rate. These two subcomponents together shall equal the
260 patient care component of the per diem rate. Separate prices
261 shall be calculated for each patient care subcomponent,
262 initially based on the September 2016 rate setting cost reports
263 and subsequently based on the most recently audited cost report
264 used during a rebasing year. The direct care subcomponent of the
265 per diem rate for any providers still being reimbursed on a cost
266 basis shall be limited by the cost-based class ceiling, and the
267 indirect care subcomponent may be limited by the lower of the
268 cost-based class ceiling, the target rate class ceiling, or the
269 individual provider target. The ceilings and targets apply only
270 to providers being reimbursed on a cost-based system. Effective
271 October 1, 2018, a prospective payment methodology shall be
272 implemented for rate setting purposes with the following
274 a. Peer Groups, including:
275 (I) North-SMMC Regions 1-9, less Palm Beach and Okeechobee
276 Counties; and
277 (II) South-SMMC Regions 10-11, plus Palm Beach and
278 Okeechobee Counties.
279 b. Percentage of Median Costs based on the cost reports
280 used for September 2016 rate setting:
281 (I) Direct Care Costs....................105 100 percent.
282 (II) Indirect Care Costs......................92 percent.
283 (III) Operating Costs.........................86 percent.
284 c. Floors:
285 (I) Direct Care Component.....................95 percent.
286 (II) Indirect Care Component................92.5 percent.
287 (III) Operating Component...........................None.
288 d. Pass-through PaymentsReal Estate and Personal Property
289 Taxes and Property Insurance.
290 e. Quality Incentive Program Payment Pool7.5 6 percent of
291 September 2016 non-property related payments of included
293 f. Quality Score Threshold to Quality for Quality Incentive
294 Payment..................20th percentile of included facilities.
295 g. Fair Rental Value System Payment Parameters:
296 (I) Building Value per Square Foot based on 2018 RS Means.
297 (II) Land Valuation...10 percent of Gross Building value.
298 (III) Facility Square Footage......Actual Square Footage.
299 (IV) Moveable Equipment Allowance.........$8,000 per bed.
300 (V) Obsolescence Factor......................1.5 percent.
301 (VI) Fair Rental Rate of Return................8 percent.
302 (VII) Minimum Occupancy.......................90 percent.
303 (VIII) Maximum Facility Age.....................40 years.
304 (IX) Minimum Square Footage per Bed..................350.
305 (X) Maximum Square Footage for Bed...................500.
306 (XI) Minimum Cost of a renovation/replacements$500 per bed.
307 h. Ventilator Supplemental payment of $200 per Medicaid day
308 of 40,000 ventilator Medicaid days per fiscal year.
309 2. The direct care subcomponent shall include salaries and
310 benefits of direct care staff providing nursing services
311 including registered nurses, licensed practical nurses, and
312 certified nursing assistants who deliver care directly to
313 residents in the nursing home facility, allowable therapy costs,
314 and dietary costs. This excludes nursing administration, staff
315 development, the staffing coordinator, and the administrative
316 portion of the minimum data set and care plan coordinators. The
317 direct care subcomponent also includes medically necessary
318 dental care, vision care, hearing care, and podiatric care.
319 3. All other patient care costs shall be included in the
320 indirect care cost subcomponent of the patient care per diem
321 rate, including complex medical equipment, medical supplies, and
322 other allowable ancillary costs. Costs may not be allocated
323 directly or indirectly to the direct care subcomponent from a
324 home office or management company.
325 4. On July 1 of each year, the agency shall report to the
326 Legislature direct and indirect care costs, including average
327 direct and indirect care costs per resident per facility and
328 direct care and indirect care salaries and benefits per category
329 of staff member per facility.
330 5. Every fourth year, the agency shall rebase nursing home
331 prospective payment rates to reflect changes in cost based on
332 the most recently audited cost report for each participating
334 6. A direct care supplemental payment may be made to
335 providers whose direct care hours per patient day are above the
336 80th percentile and who provide Medicaid services to a larger
337 percentage of Medicaid patients than the state average.
338 7. For the period beginning on October 1, 2018, and ending
339 on September 30, 2021, the agency shall reimburse providers the
340 greater of their September 2016 cost-based rate or their
341 prospective payment rate. Effective October 1, 2021, the agency
342 shall reimburse providers the greater of 95 percent of their
343 cost-based rate or their rebased prospective payment rate, using
344 the most recently audited cost report for each facility. This
345 subparagraph shall expire September 30, 2023.
346 8. Pediatric, Florida Department of Veterans Affairs, and
347 government-owned facilities are exempt from the pricing model
348 established in this subsection and shall remain on a cost-based
349 prospective payment system. Effective October 1, 2018, the
350 agency shall set rates for all facilities remaining on a cost
351 based prospective payment system using each facility’s most
352 recently audited cost report, eliminating retroactive
355 It is the intent of the Legislature that the reimbursement plan
356 achieve the goal of providing access to health care for nursing
357 home residents who require large amounts of care while
358 encouraging diversion services as an alternative to nursing home
359 care for residents who can be served within the community. The
360 agency shall base the establishment of any maximum rate of
361 payment, whether overall or component, on the available moneys
362 as provided for in the General Appropriations Act. The agency
363 may base the maximum rate of payment on the results of
364 scientifically valid analysis and conclusions derived from
365 objective statistical data pertinent to the particular maximum
366 rate of payment.
367 Section 4. Effective October 1, 2018, subsection (23) of
368 section 409.908, Florida Statutes, is amended to read:
369 409.908 Reimbursement of Medicaid providers.—Subject to
370 specific appropriations, the agency shall reimburse Medicaid
371 providers, in accordance with state and federal law, according
372 to methodologies set forth in the rules of the agency and in
373 policy manuals and handbooks incorporated by reference therein.
374 These methodologies may include fee schedules, reimbursement
375 methods based on cost reporting, negotiated fees, competitive
376 bidding pursuant to s. 287.057, and other mechanisms the agency
377 considers efficient and effective for purchasing services or
378 goods on behalf of recipients. If a provider is reimbursed based
379 on cost reporting and submits a cost report late and that cost
380 report would have been used to set a lower reimbursement rate
381 for a rate semester, then the provider’s rate for that semester
382 shall be retroactively calculated using the new cost report, and
383 full payment at the recalculated rate shall be effected
384 retroactively. Medicare-granted extensions for filing cost
385 reports, if applicable, shall also apply to Medicaid cost
386 reports. Payment for Medicaid compensable services made on
387 behalf of Medicaid eligible persons is subject to the
388 availability of moneys and any limitations or directions
389 provided for in the General Appropriations Act or chapter 216.
390 Further, nothing in this section shall be construed to prevent
391 or limit the agency from adjusting fees, reimbursement rates,
392 lengths of stay, number of visits, or number of services, or
393 making any other adjustments necessary to comply with the
394 availability of moneys and any limitations or directions
395 provided for in the General Appropriations Act, provided the
396 adjustment is consistent with legislative intent.
397 (23)(a) The agency shall establish rates at a level that
398 ensures no increase in statewide expenditures resulting from a
399 change in unit costs for county health departments effective
400 July 1, 2011. Reimbursement rates shall be as provided in the
401 General Appropriations Act.
402 (b)1. Base rate reimbursement for inpatient services under
403 a diagnosis-related group payment methodology shall be provided
404 in the General Appropriations Act.
405 2. (c) Base rate reimbursement for outpatient services under
406 an enhanced ambulatory payment group methodology shall be
407 provided in the General Appropriations Act.
408 3. Prospective payment system reimbursement for nursing
409 home services shall be as provided in subsection (2) and in the
410 General Appropriations Act
411 (d) Thi s subsection applies to the following provider
413 1. Nursing homes.
414 2. County health departments.
415 (e) The agency shall apply the effect of this subsection to
416 the reimbursement rates for nursing home diversion programs.
417 Section 5. Subsection (7) of section 409.9082, Florida
418 Statutes, is amended to read:
419 409.9082 Quality assessment on nursing home facility
420 providers; exemptions; purpose; federal approval required;
422 (7) The agency may seek any of the following remedies for
423 failure of any nursing home facility provider to report its
424 total number of resident days monthly or to pay its assessment
426 (a) Withholding any medical assistance reimbursement
427 payments until such time as the assessment amount is recovered;
428 (b) Suspension or revocation of the nursing home facility
429 license; and
430 (c) Imposition of a fine of up to $1,000 per day for each
431 offense delinquent payment, not to exceed the amount of the
433 Section 6. Subsection (6) of section 409.9083, Florida
434 Statutes, is amended to read:
435 409.9083 Quality assessment on privately operated
436 intermediate care facilities for the developmentally disabled;
437 exemptions; purpose; federal approval required; remedies.—
438 (6) The agency may seek any of the following remedies for
439 failure of any ICF/DD provider to report its total number of
440 resident days monthly or to timely pay its assessment:
441 (a) Withholding any medical assistance reimbursement
442 payments until the assessment amount is recovered.
443 (b) Suspending or revoking the facility’s license.
444 (c) Imposing a fine of up to $1,000 per day for each
445 offense delinquent payment, not to exceed the amount of the
447 Section 7. Paragraph (c) of subsection (2) of section
448 409.909, Florida Statutes, is amended to read:
449 409.909 Statewide Medicaid Residency Program.—
450 (2) On or before September 15 of each year, the agency
451 shall calculate an allocation fraction to be used for
452 distributing funds to participating hospitals and to qualifying
453 institutions as defined in paragraph (c). On or before the final
454 business day of each quarter of a state fiscal year, the agency
455 shall distribute to each participating hospital one-fourth of
456 that hospital’s annual allocation calculated under subsection
457 (4). The allocation fraction for each participating hospital is
458 based on the hospital’s number of full-time equivalent residents
459 and the amount of its Medicaid payments. As used in this
460 section, the term:
461 (c) “Qualifying institution” means a federally Qualified
462 Health Center holding an Accreditation Council for Graduate
463 Medical Education institutional accreditation or a substance
464 abuse treatment facility licensed under chapter 397 which has
465 housed residents and fellows since 2013.
466 Section 8. Present subsections (4) and (5) of section
467 409.968, Florida Statutes, are redesignated as subsections (5)
468 and (6), respectively, and a new subsection (4) is added to that
469 section, to read:
470 409.968 Managed care plan payments.—
471 (4) Reimbursement for Class III psychiatric hospitals is
472 not defined by the agency’s inpatient hospital APR-DRG
473 compensation methodology and must be established using the
474 federal Centers for Medicare and Medicaid Services prospective
475 payment system pricing methodology or be limited to compensation
476 amounts agreed to by the plan and the hospital.
477 Section 9. Paragraph (d) of subsection (13) of section
478 409.906, Florida Statutes, is amended to read:
479 409.906 Optional Medicaid services.—Subject to specific
480 appropriations, the agency may make payments for services which
481 are optional to the state under Title XIX of the Social Security
482 Act and are furnished by Medicaid providers to recipients who
483 are determined to be eligible on the dates on which the services
484 were provided. Any optional service that is provided shall be
485 provided only when medically necessary and in accordance with
486 state and federal law. Optional services rendered by providers
487 in mobile units to Medicaid recipients may be restricted or
488 prohibited by the agency. Nothing in this section shall be
489 construed to prevent or limit the agency from adjusting fees,
490 reimbursement rates, lengths of stay, number of visits, or
491 number of services, or making any other adjustments necessary to
492 comply with the availability of moneys and any limitations or
493 directions provided for in the General Appropriations Act or
494 chapter 216. If necessary to safeguard the state’s systems of
495 providing services to elderly and disabled persons and subject
496 to the notice and review provisions of s. 216.177, the Governor
497 may direct the Agency for Health Care Administration to amend
498 the Medicaid state plan to delete the optional Medicaid service
499 known as “Intermediate Care Facilities for the Developmentally
500 Disabled.” Optional services may include:
501 (13) HOME AND COMMUNITY-BASED SERVICES.—
502 (d) The agency shall seek federal approval to pay for
503 flexible services for persons with severe mental illness or
504 substance use disorders, including, but not limited to,
505 temporary housing assistance. Payments may be made as enhanced
506 capitation rates or incentive payments to managed care plans
507 that meet the requirements of s. 409.968(5) s. 409.968(4).
508 Section 10. The Agency for Health Care Administration shall
509 seek authorization from the federal Centers for Medicare and
510 Medicaid Services to modify the period of retroactive Medicaid
511 eligibility from 90 days to 30 days in a manner that ensures
512 that the modification becomes effective on July 1, 2018.
513 Section 11. Effective July 1, 2018, and subject to federal
514 approval of the application to be a site for the Program of All
515 inclusive Care for the Elderly (PACE), the Agency for Health
516 Care Administration shall contract with an additional nonprofit
517 organization to serve individuals and families in Miami-Dade
518 County. The nonprofit organization must have a history of
519 serving primarily the Hispanic population by providing primary
520 care services, nutrition, meals, and adult day care to the
521 senior population. The nonprofit organization shall leverage
522 existing community-based care providers and health care
523 organizations to provide PACE services to frail elders who
524 reside in Miami-Dade County. The organization is exempt from the
525 requirements of chapter 641, Florida Statutes. The agency, in
526 consultation with the Department of Elderly Affairs and subject
527 to an appropriation, shall approve up to 250 initial enrollees
528 in the PACE site established by this organization to serve frail
529 elders who reside in Miami-Dade County.
530 Section 12. Except as expressly provided in this act, this
531 act shall take effect upon becoming a law.