Florida Senate - 2020 COMMITTEE AMENDMENT
Bill No. SB 82
Ì610520bÎ610520
LEGISLATIVE ACTION
Senate . House
.
.
.
.
.
—————————————————————————————————————————————————————————————————
—————————————————————————————————————————————————————————————————
Appropriations Subcommittee on Health and Human Services (Bean)
recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Present subsections (39) through (45) of section
6 393.063, Florida Statutes, are redesignated as subsections (40)
7 through (46), respectively, a new subsection (39) is added to
8 that section, and present subsection (41) of that section is
9 amended, to read:
10 393.063 Definitions.—For the purposes of this chapter, the
11 term:
12 (39) “Significant additional need” means an additional need
13 for medically necessary services which would place the health
14 and safety of the client, the client’s caregiver, or the public
15 in serious jeopardy if it is not met. The agency may only
16 provide additional funding after the determination of a client’s
17 initial allocation amount and after the qualified organization
18 has documented the availability of nonwaiver resources.
19 (42)(41) “Support coordinator” means an employee of a
20 qualified organization pursuant to s. 393.0663 a person who is
21 designated by the agency to assist individuals and families in
22 identifying their capacities, needs, and resources, as well as
23 finding and gaining access to necessary supports and services;
24 coordinating the delivery of supports and services; advocating
25 on behalf of the individual and family; maintaining relevant
26 records; and monitoring and evaluating the delivery of supports
27 and services to determine the extent to which they meet the
28 needs and expectations identified by the individual, family, and
29 others who participated in the development of the support plan.
30 Section 2. Subsection (2) of section 393.066, Florida
31 Statutes, is amended to read:
32 393.066 Community services and treatment.—
33 (2) Necessary services shall be purchased, rather than
34 provided directly by the agency, when the purchase of services
35 is more cost-efficient than providing them directly. All
36 purchased services must be approved by the agency. As a
37 condition of payment, persons or entities under contract with
38 the agency to provide services shall use agency data management
39 systems to document service provision to clients before billing
40 and must use the agency data management systems to bill for
41 services. Contracted persons and entities shall meet the minimum
42 hardware and software technical requirements established by the
43 agency for the use of such systems. Such persons or entities
44 shall also meet any requirements established by the agency for
45 training and professional development of staff providing direct
46 services to clients.
47 Section 3. Section 393.0661, Florida Statutes, is repealed.
48 Section 4. Section 393.0662, Florida Statutes, is amended
49 to read:
50 393.0662 Individual budgets for delivery of home and
51 community-based services; iBudget system established.—The
52 Legislature finds that improved financial management of the
53 existing home and community-based Medicaid waiver program is
54 necessary to avoid deficits that impede the provision of
55 services to individuals who are on the waiting list for
56 enrollment in the program. The Legislature further finds that
57 clients and their families should have greater flexibility to
58 choose the services that best allow them to live in their
59 community within the limits of an established budget. Therefore,
60 the Legislature intends that the agency, in consultation with
61 the Agency for Health Care Administration, shall manage the
62 service delivery system using individual budgets as the basis
63 for allocating the funds appropriated for the home and
64 community-based services Medicaid waiver program among eligible
65 enrolled clients. The service delivery system that uses
66 individual budgets shall be called the iBudget system.
67 (1) The agency shall administer an individual budget,
68 referred to as an iBudget, for each individual served by the
69 home and community-based services Medicaid waiver program. The
70 funds appropriated to the agency shall be allocated through the
71 iBudget system to eligible, Medicaid-enrolled clients. For the
72 iBudget system, eligible clients shall include individuals with
73 a developmental disability as defined in s. 393.063. The iBudget
74 system shall provide for: enhanced client choice within a
75 specified service package; appropriate assessment strategies; an
76 efficient consumer budgeting and billing process that includes
77 reconciliation and monitoring components; a role for support
78 coordinators that avoids potential conflicts of interest; a
79 flexible and streamlined service review process; and the
80 equitable allocation of available funds based on the client’s
81 level of need, as determined by the allocation methodology.
82 (a) In developing each client’s iBudget, the agency shall
83 use the allocation methodology as defined in s. 393.063(4), in
84 conjunction with an assessment instrument that the agency deems
85 to be reliable and valid, including, but not limited to, the
86 agency’s Questionnaire for Situational Information. The
87 allocation methodology shall determine the amount of funds
88 allocated to a client’s iBudget.
89 (b) The agency may authorize additional funding based on a
90 client having one or more significant additional needs of the
91 following needs that cannot be accommodated within the funding
92 determined by the algorithm and having no other resources,
93 supports, or services available to meet the needs. Such
94 additional funding may be provided only after the determination
95 of a client’s initial allocation amount and after the qualified
96 organization has documented the availability of all nonwaiver
97 resources. Upon receipt of an incomplete request for significant
98 additional needs, the agency shall close the request.
99 (c) The agency shall centralize, within its headquarters
100 office, medical necessity determinations of requested services
101 made through the significant additional needs process. The
102 process must ensure consistent application of medical necessity
103 criteria. This process must provide opportunities for targeted
104 training, quality assurance, and inter-rater reliability. need:
105 1. An extraordinary need that would place the health and
106 safety of the client, the client’s caregiver, or the public in
107 immediate, serious jeopardy unless the increase is approved.
108 However, the presence of an extraordinary need in and of itself
109 does not warrant authorized funding by the agency. An
110 extraordinary need may include, but is not limited to:
111 a. A documented history of significant, potentially life
112 threatening behaviors, such as recent attempts at suicide,
113 arson, nonconsensual sexual behavior, or self-injurious behavior
114 requiring medical attention;
115 b. A complex medical condition that requires active
116 intervention by a licensed nurse on an ongoing basis that cannot
117 be taught or delegated to a nonlicensed person;
118 c. A chronic comorbid condition. As used in this
119 subparagraph, the term “comorbid condition” means a medical
120 condition existing simultaneously but independently with another
121 medical condition in a patient; or
122 d. A need for total physical assistance with activities
123 such as eating, bathing, toileting, grooming, and personal
124 hygiene.
125 2. A significant need for one-time or temporary support or
126 services that, if not provided, would place the health and
127 safety of the client, the client’s caregiver, or the public in
128 serious jeopardy. A significant need may include, but is not
129 limited to, the provision of environmental modifications,
130 durable medical equipment, services to address the temporary
131 loss of support from a caregiver, or special services or
132 treatment for a serious temporary condition when the service or
133 treatment is expected to ameliorate the underlying condition. As
134 used in this subparagraph, the term “temporary” means a period
135 of fewer than 12 continuous months. However, the presence of
136 such significant need for one-time or temporary supports or
137 services in and of itself does not warrant authorized funding by
138 the agency.
139 3. A significant increase in the need for services after
140 the beginning of the service plan year that would place the
141 health and safety of the client, the client’s caregiver, or the
142 public in serious jeopardy because of substantial changes in the
143 client’s circumstances, including, but not limited to, permanent
144 or long-term loss or incapacity of a caregiver, loss of services
145 authorized under the state Medicaid plan due to a change in age,
146 or a significant change in medical or functional status which
147 requires the provision of additional services on a permanent or
148 long-term basis that cannot be accommodated within the client’s
149 current iBudget. As used in this subparagraph, the term “long
150 term” means a period of 12 or more continuous months. However,
151 such significant increase in need for services of a permanent or
152 long-term nature in and of itself does not warrant authorized
153 funding by the agency.
154 4. A significant need for transportation services to a
155 waiver-funded adult day training program or to waiver-funded
156 employment services when such need cannot be accommodated within
157 a client’s iBudget as determined by the algorithm without
158 affecting the health and safety of the client, if public
159 transportation is not an option due to the unique needs of the
160 client or other transportation resources are not reasonably
161 available.
162
163 The agency shall reserve portions of the appropriation for the
164 home and community-based services Medicaid waiver program for
165 adjustments required pursuant to this paragraph and may use the
166 services of an independent actuary in determining the amount to
167 be reserved.
168 (d)(c) A client’s annual expenditures for home and
169 community-based Medicaid waiver services may not exceed the
170 limits of his or her iBudget. The total of all clients’
171 projected annual iBudget expenditures may not exceed the
172 agency’s appropriation for waiver services.
173 (2) The Agency for Health Care Administration, in
174 consultation with the agency, shall seek federal approval to
175 amend current waivers, request a new waiver, and amend contracts
176 as necessary to manage the iBudget system, improve services for
177 eligible and enrolled clients, and improve the delivery of
178 services through the home and community-based services Medicaid
179 waiver program and the Consumer-Directed Care Plus Program,
180 including, but not limited to, enrollees with a dual diagnosis
181 of a developmental disability and a mental health disorder.
182 (3) The agency must certify and document within each
183 client’s cost plan that the a client has used must use all
184 available services authorized under the state Medicaid plan,
185 school-based services, private insurance and other benefits, and
186 any other resources that may be available to the client before
187 using funds from his or her iBudget to pay for support and
188 services.
189 (4) Rates for any or all services established under rules
190 of the Agency for Health Care Administration must be designated
191 as the maximum rather than a fixed amount for individuals who
192 receive an iBudget, except for services specifically identified
193 in those rules that the agency determines are not appropriate
194 for negotiation, which may include, but are not limited to,
195 residential habilitation services.
196 (5) The agency shall ensure that clients and caregivers
197 have access to training and education that inform them about the
198 iBudget system and enhance their ability for self-direction.
199 Such training and education must be offered in a variety of
200 formats and, at a minimum, must address the policies and
201 processes of the iBudget system and the roles and
202 responsibilities of consumers, caregivers, waiver support
203 coordinators, providers, and the agency, and must provide
204 information to help the client make decisions regarding the
205 iBudget system and examples of support and resources available
206 in the community.
207 (6) The agency shall collect data to evaluate the
208 implementation and outcomes of the iBudget system.
209 (7) The Agency for Health Care Administration shall seek
210 federal approval to provide a consumer-directed option for
211 persons with developmental disabilities. The agency and the
212 Agency for Health Care Administration may adopt rules necessary
213 to administer this subsection.
214 (8) The Agency for Health Care Administration shall seek
215 federal waivers and amend contracts as necessary to make changes
216 to services defined in federal waiver programs as follows:
217 (a) Supported living coaching services may not exceed 20
218 hours per month for persons who also receive in-home support
219 services.
220 (b) Limited support coordination services are the only
221 support coordination services that may be provided to persons
222 under the age of 18 who live in the family home.
223 (c) Personal care assistance services are limited to 180
224 hours per calendar month and may not include rate modifiers.
225 Additional hours may be authorized for persons who have
226 intensive physical, medical, or adaptive needs if such hours
227 will prevent institutionalization.
228 (d) Residential habilitation services are limited to 8
229 hours per day. Additional hours may be authorized for persons
230 who have intensive medical or adaptive needs and if such hours
231 will prevent institutionalization, or for persons who possess
232 behavioral problems that are exceptional in intensity, duration,
233 or frequency and present a substantial risk of harm to
234 themselves or others.
235 (e) The agency shall conduct supplemental cost plan reviews
236 to verify the medical necessity of authorized services for plans
237 that have increased by more than 8 percent during either of the
238 2 preceding fiscal years.
239 (f) The agency shall implement a consolidated residential
240 habilitation rate structure to increase savings to the state
241 through a more cost-effective payment method and establish
242 uniform rates for intensive behavioral residential habilitation
243 services.
244 (g) The geographic differential for Miami-Dade, Broward,
245 and Palm Beach Counties for residential habilitation services
246 must be 7.5 percent.
247 (h) The geographic differential for Monroe County for
248 residential habilitation services must be 20 percent.
249 (9) The agency shall collect premiums or cost sharing
250 pursuant to s. 409.906(13)(c).
251 (10) This section or any related rule does not prevent or
252 limit the Agency for Health Care Administration, in consultation
253 with the agency, from adjusting fees, reimbursement rates,
254 lengths of stay, number of visits, or number of services, or
255 from limiting enrollment or making any other adjustment
256 necessary to comply with the availability of moneys and any
257 limitations or directions provided in the General Appropriations
258 Act.
259 (11) A provider of services rendered to persons with
260 developmental disabilities pursuant to a federally approved
261 waiver shall be reimbursed according to a rate methodology based
262 upon an analysis of the expenditure history and prospective
263 costs of providers participating in the waiver program, or under
264 any other methodology developed by the Agency for Health Care
265 Administration in consultation with the agency and approved by
266 the Federal Government in accordance with the waiver.
267 (12) The agency shall submit quarterly status reports to
268 the Executive Office of the Governor, the chair of the Senate
269 Appropriations Committee or its successor, and the chair of the
270 House Appropriations Committee or its successor containing all
271 of the following information:
272 (a) The financial status of home and community-based
273 services, including the number of enrolled individuals receiving
274 services through one or more programs.
275 (b) The number of individuals who have requested services
276 and who are not enrolled but who are receiving services through
277 one or more programs, with a description indicating the programs
278 from which the individual is receiving services.
279 (c) The number of individuals who have refused an offer of
280 services but who choose to remain on the list of individuals
281 waiting for services.
282 (d) The number of individuals who have requested services
283 but who are receiving no services.
284 (e) A frequency distribution indicating the length of time
285 individuals have been waiting for services.
286 (f) Information concerning the actual and projected costs
287 compared to the amount of the appropriation available to the
288 program and any projected surpluses or deficits.
289 (13) If at any time an analysis by the agency, in
290 consultation with the Agency for Health Care Administration,
291 indicates that the cost of services is expected to exceed the
292 amount appropriated, the agency shall submit a plan in
293 accordance with subsection (10) to the Executive Office of the
294 Governor, the chair of the Senate Appropriations Committee or
295 its successor, and the chair of the House Appropriations
296 Committee or its successor to remain within the amount
297 appropriated. The agency shall work with the Agency for Health
298 Care Administration to implement the plan so as to remain within
299 the appropriation.
300 (14) The agency, in consultation with the Agency for Health
301 Care Administration, shall provide a quarterly reconciliation
302 report of all home and community-based services waiver
303 expenditures from the Agency for Health Care Administration’s
304 claims management system with service utilization from the
305 Agency for Persons with Disabilities Allocation, Budget, and
306 Contract Control system. The reconciliation report shall be
307 submitted to the Governor, the President of the Senate, and the
308 Speaker of the House of Representatives no later than 30 days
309 after the close of each quarter.
310 (15)(7) The agency and the Agency for Health Care
311 Administration may adopt rules specifying the allocation
312 algorithm and methodology; criteria and processes for clients to
313 access reserved funds for significant additional needs
314 extraordinary needs, temporarily or permanently changed needs,
315 and one-time needs; and processes and requirements for selection
316 and review of services, development of support and cost plans,
317 and management of the iBudget system as needed to administer
318 this section.
319 Section 5. Section 393.0663, Florida Statutes, is created
320 to read:
321 393.0663 Support coordination; legislative intent;
322 qualified organizations; agency duties; due process;
323 rulemaking.—
324 (1) LEGISLATIVE INTENT.—To enable the state to provide a
325 systematic approach to service oversight for persons providing
326 care to individuals with developmental disabilities, it is the
327 intent of the Legislature that the agency work in collaboration
328 with relevant stakeholders to ensure that waiver support
329 coordinators have the knowledge, skills, and abilities necessary
330 to competently provide services to individuals with
331 developmental disabilities by requiring all support coordinators
332 to be employees of a qualified organization.
333 (2) QUALIFIED ORGANIZATIONS.—
334 (a) As used in this section, the term “qualified
335 organization” means an organization determined by the agency to
336 meet the requirements of this section and of the Developmental
337 Disabilities Individual Budgeting Waiver Services Coverage and
338 Limitations Handbook.
339 (b) The agency shall use qualified organizations for the
340 purpose of providing all support coordination services to
341 iBudget clients in this state. A qualified organization must:
342 1. Employ four or more support coordinators;
343 2. Maintain a professional code of ethics and a
344 disciplinary process that apply to all support coordinators
345 within the organization;
346 3. Comply with the agency’s cost containment initiatives;
347 4. Require support coordinators to ensure client budgets
348 are linked to levels of need;
349 5. Require support coordinators to perform all duties and
350 meet all standards related to support coordination as provided
351 in the Developmental Disabilities Individual Budgeting Waiver
352 Services Coverage and Limitations Handbook;
353 6. Prohibit dual employment of a support coordinator which
354 adversely impacts the support coordinator’s availability to
355 clients;
356 7. Educate clients and families regarding identifying and
357 preventing abuse, neglect, and exploitation;
358 8. Instruct clients and families on mandatory reporting
359 requirements for abuse, neglect, and exploitation;
360 9. Submit within established timeframes all required
361 documentation for requests for significant additional needs;
362 10. Require support coordinators to successfully complete
363 training and professional development approved by the agency;
364 11. Require support coordinators to pass a competency-based
365 assessment established by the agency; and
366 12. Implement a mentoring program approved by the agency
367 for support coordinators who have worked as a support
368 coordinator for less than 12 months.
369 (3) DUTIES OF THE AGENCY.—The agency shall:
370 (a) Require all qualified organizations to report to the
371 agency any violation of ethical or professional conduct by
372 support coordinators employed by the organization;
373 (b) Maintain a publicly accessible registry of all support
374 coordinators, including any history of ethical or disciplinary
375 violations; and
376 (c) Impose an immediate moratorium on new client
377 assignments, impose an administrative fine, require plans of
378 remediation, and terminate the Medicaid Waiver Services
379 Agreement of any qualified organization that is noncompliant
380 with applicable laws or rules.
381 (4) DUE PROCESS.—Any decision by the agency to take action
382 against a qualified organization as described in paragraph
383 (3)(c) is reviewable by the agency. Upon receiving an adverse
384 determination, the qualified organization may request an
385 administrative hearing pursuant to ss. 120.569 and 120.57(1)
386 within 30 days after completing any appeals process established
387 by the agency.
388 (5) RULEMAKING.—The agency may adopt rules to implement
389 this section.
390 Section 6. Subsection (6) is added to section 400.962,
391 Florida Statutes, to read:
392 400.962 License required; license application.—
393 (6) An applicant that has been granted a certificate-of
394 need exemption under s. 408.036(3)(o) must also demonstrate and
395 maintain compliance with the following criteria:
396 (a) The total number of beds per home within the facility
397 may not exceed eight, with each resident having his or her own
398 bedroom and bathroom. Each eight-bed home must be colocated on
399 the same property with two other eight-bed homes and must serve
400 individuals with severe maladaptive behaviors and co-occurring
401 psychiatric diagnoses.
402 (b) A minimum of 16 beds within the facility must be
403 designated for individuals with severe maladaptive behaviors who
404 have been assessed using the Agency for Persons with
405 Disabilities’ Global Behavioral Service Need Matrix with a score
406 of at least Level 3 and up to Level 6, or assessed using the
407 criteria deemed appropriate by the Agency for Health Care
408 Administration regarding the need for a specialized placement in
409 an intermediate care facility for the developmentally disabled.
410 (c) The applicant has not had a facility license denied,
411 revoked, or suspended within the 36 months preceding the request
412 for exemption.
413 (d) The applicant must have at least 10 years of experience
414 serving individuals with severe maladaptive behaviors in this
415 state.
416 (e) The applicant must implement a state-approved staff
417 training curriculum and monitoring requirements specific to the
418 individuals whose behaviors require higher intensity, frequency,
419 and duration of services.
420 (f) The applicant must make available medical and nursing
421 services 24 hours per day, 7 days per week.
422 (g) The applicant must demonstrate a history of using
423 interventions that are least restrictive and that follow a
424 behavioral hierarchy.
425 (h) The applicant must maintain a policy prohibiting the
426 use of mechanical restraints.
427 Section 7. Paragraph (o) is added to subsection (3) of
428 section 408.036, Florida Statutes, to read:
429 408.036 Projects subject to review; exemptions.—
430 (3) EXEMPTIONS.—Upon request, the following projects are
431 subject to exemption from subsection (1):
432 (o) For a new intermediate care facility for the
433 developmentally disabled as defined in s. 408.032 which has a
434 total of 24 beds, comprising three eight-bed homes, for use by
435 individuals exhibiting severe maladaptive behaviors and co
436 occurring psychiatric diagnoses requiring increased levels of
437 behavioral, medical, and therapeutic oversight. The facility
438 must not have had a license denied, revoked, or suspended within
439 the 36 months preceding the request for exemption and must have
440 at least 10 years of experience serving individuals with severe
441 maladaptive behaviors in this state. The agency may not grant an
442 additional exemption to a facility that has been granted an
443 exemption under this paragraph unless the facility has been
444 licensed and operational for a period of at least 2 years. The
445 exemption under this paragraph does not require a specific
446 legislative appropriation.
447 Section 8. Subsection (15) of section 409.906, Florida
448 Statutes, is amended to read:
449 409.906 Optional Medicaid services.—Subject to specific
450 appropriations, the agency may make payments for services which
451 are optional to the state under Title XIX of the Social Security
452 Act and are furnished by Medicaid providers to recipients who
453 are determined to be eligible on the dates on which the services
454 were provided. Any optional service that is provided shall be
455 provided only when medically necessary and in accordance with
456 state and federal law. Optional services rendered by providers
457 in mobile units to Medicaid recipients may be restricted or
458 prohibited by the agency. Nothing in this section shall be
459 construed to prevent or limit the agency from adjusting fees,
460 reimbursement rates, lengths of stay, number of visits, or
461 number of services, or making any other adjustments necessary to
462 comply with the availability of moneys and any limitations or
463 directions provided for in the General Appropriations Act or
464 chapter 216. If necessary to safeguard the state’s systems of
465 providing services to elderly and disabled persons and subject
466 to the notice and review provisions of s. 216.177, the Governor
467 may direct the Agency for Health Care Administration to amend
468 the Medicaid state plan to delete the optional Medicaid service
469 known as “Intermediate Care Facilities for the Developmentally
470 Disabled.” Optional services may include:
471 (15) INTERMEDIATE CARE FACILITY FOR THE DEVELOPMENTALLY
472 DISABLED SERVICES.—The agency may pay for health-related care
473 and services provided on a 24-hour-a-day basis by a facility
474 licensed and certified as a Medicaid Intermediate Care Facility
475 for the Developmentally Disabled, for a recipient who needs such
476 care because of a developmental disability. Payment shall not
477 include bed-hold days except in facilities with occupancy rates
478 of 95 percent or greater. The agency is authorized to seek any
479 federal waiver approvals to implement this policy. The agency
480 shall seek federal approval to implement a payment rate for
481 Medicaid intermediate care facilities serving individuals with
482 developmental disabilities, severe maladaptive behaviors, severe
483 maladaptive behaviors and co-occurring complex medical
484 conditions, or a dual diagnosis of developmental disability and
485 mental illness.
486 Section 9. Paragraph (d) of subsection (2) of section
487 1002.385, Florida Statutes, is amended to read:
488 1002.385 The Gardiner Scholarship.—
489 (2) DEFINITIONS.—As used in this section, the term:
490 (d) “Disability” means, for a 3- or 4-year-old child or for
491 a student in kindergarten to grade 12, autism spectrum disorder,
492 as defined in the Diagnostic and Statistical Manual of Mental
493 Disorders, Fifth Edition, published by the American Psychiatric
494 Association; cerebral palsy, as defined in s. 393.063(6); Down
495 syndrome, as defined in s. 393.063(15); an intellectual
496 disability, as defined in s. 393.063(24); Phelan-McDermid
497 syndrome, as defined in s. 393.063(28); Prader-Willi syndrome,
498 as defined in s. 393.063(29); spina bifida, as defined in s.
499 393.063(41) s. 393.063(40); being a high-risk child, as defined
500 in s. 393.063(23)(a); muscular dystrophy; Williams syndrome;
501 rare diseases which affect patient populations of fewer than
502 200,000 individuals in the United States, as defined by the
503 National Organization for Rare Disorders; anaphylaxis; deaf;
504 visually impaired; traumatic brain injured; hospital or
505 homebound; or identification as dual sensory impaired, as
506 defined by rules of the State Board of Education and evidenced
507 by reports from local school districts. The term “hospital or
508 homebound” includes a student who has a medically diagnosed
509 physical or psychiatric condition or illness, as defined by the
510 state board in rule, and who is confined to the home or hospital
511 for more than 6 months.
512 Section 10. This act shall take effect January 1, 2021.
513
514 ================= T I T L E A M E N D M E N T ================
515 And the title is amended as follows:
516 Delete everything before the enacting clause
517 and insert:
518 A bill to be entitled
519 An act relating to individuals with disabilities;
520 amending s. 393.063, F.S.; defining the term
521 “significant additional need”; revising the definition
522 of the term “support coordinator”; amending s.
523 393.066, F.S.; requiring persons and entities under
524 contract with the Agency for Persons with Disabilities
525 to use the agency data management systems to bill for
526 services; repealing s. 393.0661, F.S., relating to the
527 home and community-based services delivery system;
528 amending s. 393.0662, F.S.; revising criteria used by
529 the agency to develop a client’s iBudget; revising
530 criteria used by the agency to authorize additional
531 funding for certain clients; requiring the agency to
532 centralize medical necessity determinations of certain
533 services; requiring the agency to certify and document
534 the use of certain services before approving the
535 expenditure of certain funds; requiring the Agency for
536 Health Care Administration to seek federal approval to
537 provide consumer-directed options; authorizing the
538 Agency for Persons with Disabilities and the Agency
539 for Health Care Administration to adopt rules;
540 requiring the Agency for Health Care Administration to
541 seek federal waivers and amend contracts under certain
542 conditions; requiring the Agency for Persons with
543 Disabilities to collect premiums or cost sharing;
544 providing construction; providing for the
545 reimbursement of certain providers of services;
546 requiring the Agency for Persons with Disabilities to
547 submit quarterly status reports to the Executive
548 Office of the Governor, the chair of the Senate
549 Appropriations Committee, and the chair of the House
550 Appropriations Committee or their successors;
551 providing requirements for such reports; requiring the
552 Agency for Persons with Disabilities, in consultation
553 with the Agency for Health Care Administration, to
554 submit a certain plan to the Executive Office of the
555 Governor, the chair of the Senate Appropriations
556 Committee, and the chair of the House Appropriations
557 Committee under certain conditions; requiring the
558 agency to work with the Agency for Health Care
559 Administration to implement such plan; requiring the
560 Agency for Persons with Disabilities, in consultation
561 with the Agency for Health Care Administration, to
562 provide quarterly reconciliation reports to the
563 Governor and the Legislature within a specified
564 timeframe; revising rulemaking authority of the Agency
565 for Persons with Disabilities and the Agency for
566 Health Care Administration; creating s. 393.0663,
567 F.S.; providing legislative intent; defining the term
568 “qualified organization”; requiring the Agency for
569 Persons with Disabilities to use qualified
570 organizations to provide support coordination services
571 for certain clients; providing requirements for
572 qualified organizations; providing agency duties;
573 providing for the review and appeal of certain
574 decisions made by the agency; authorizing the agency
575 to adopt rules; amending s. 400.962, F.S.; requiring
576 certain facilities that have been granted a
577 certificate-of-need exemption to demonstrate and
578 maintain compliance with specified criteria; amending
579 s. 408.036, F.S.; providing an exemption from a
580 certificate-of-need requirement for certain
581 intermediate care facilities; prohibiting the Agency
582 for Health Care Administration from granting an
583 additional exemption to a facility unless a certain
584 condition is met; providing that a specific
585 legislative appropriation is not required for such
586 exemption; amending s. 409.906, F.S.; requiring the
587 agency to seek federal approval to implement certain
588 payment rates; amending s. 1002.385, F.S.; conforming
589 a cross-reference; providing an effective date.