Florida Senate - 2024                                    SB 1758
       By Senator Brodeur
       10-00892C-24                                          20241758__
    1                        A bill to be entitled                      
    2         An act relating to individuals with disabilities;
    3         amending s. 393.065, F.S.; requiring the Agency for
    4         Persons with Disabilities to develop and implement an
    5         online application process; specifying requirements
    6         for the online application process; defining the term
    7         “complete application”; revising timeframes within
    8         which the agency must make eligibility determinations
    9         for services; lowering the age that a caregiver must
   10         be for an individual to be placed in a certain
   11         preenrollment category; amending s. 393.0651, F.S.;
   12         revising which types of clients are eligible for an
   13         individual support plan; clarifying the timeframe
   14         within which a family or individual support plan must
   15         be developed; requiring waiver support coordinators to
   16         inform the client or client’s parent or guardian, as
   17         appropriate, of certain information when developing or
   18         reviewing the family or individual support plan;
   19         providing appropriations; providing an effective date.
   21  Be It Enacted by the Legislature of the State of Florida:
   23         Section 1. Subsection (1) and paragraph (d) of subsection
   24  (5) of section 393.065, Florida Statutes, are amended to read:
   25         393.065 Application and eligibility determination.—
   26         (1)(a) The agency shall develop and implement an online
   27  application process that, at a minimum, supports paperless,
   28  electronic application submissions with immediate e-mail
   29  confirmation to each applicant to acknowledge receipt of
   30  application upon submission. The online application system must
   31  allow an applicant to review the status of a submitted
   32  application and respond to provide additional information.
   33         (b) The agency shall maintain access to a printable paper
   34  application on its website and, upon request, must provide an
   35  applicant with a printed paper application. Paper applications
   36  may Application for services shall be submitted made in writing
   37  to the agency, in the region in which the applicant resides.
   38         (c) The agency must shall review each submitted application
   39  in accordance with federal time standards and make an
   40  eligibility determination within 60 days after receipt of the
   41  signed application. If, at the time of the application, an
   42  applicant is requesting enrollment in the home and community
   43  based services Medicaid waiver program for individuals with
   44  developmental disabilities deemed to be in crisis, as described
   45  in paragraph (5)(a), the agency shall complete an eligibility
   46  determination within 45 days after receipt of the signed
   47  application.
   48         (d)(a) If the agency determines additional documentation is
   49  necessary to make an eligibility determination, the agency may
   50  request the additional documentation from the applicant.
   51         (e)(b) When necessary to definitively identify individual
   52  conditions or needs, the agency or its designee must provide a
   53  comprehensive assessment.
   54         (c) If the agency requests additional documentation from
   55  the applicant or provides or arranges for a comprehensive
   56  assessment, the agency’s eligibility determination must be
   57  completed within 90 days after receipt of the signed
   58  application.
   59         (f)1.For purposes of this paragraph, the term “complete
   60  application” means an application submitted to the agency which
   61  is signed and dated by the applicant or an individual with legal
   62  authority to apply for public benefits on behalf of the
   63  applicant, is responsive on all parts of the application, and
   64  contains documentation of a diagnosis.
   65         2.If the applicant requesting enrollment in the home and
   66  community-based services Medicaid waiver program for individuals
   67  with developmental disabilities is deemed to be in crisis as
   68  described in paragraph (5)(a), the agency must make an
   69  eligibility determination within 15 calendar days after receipt
   70  of a complete application.
   71         3.If the applicant meets the criteria specified in
   72  paragraph (5)(b), the agency must review and make an eligibility
   73  determination as soon as practicable after receipt of a complete
   74  application.
   75         4. If the application meets the criteria specified in
   76  paragraphs (5)(c)-(g), the agency shall make an eligibility
   77  determination within 60 days after receipt of a complete
   78  application.
   79         (g)Any delays in the eligibility determination process, or
   80  any tolling of the time standard until certain information or
   81  actions have been completed, must be conveyed to the client as
   82  soon as such delays are known through a verbal contact with the
   83  client or the client’s designated caregiver and confirmed by a
   84  written notice of the delay, the anticipated length of delay,
   85  and a contact person for the client.
   86         (5) Except as provided in subsections (6) and (7), if a
   87  client seeking enrollment in the developmental disabilities home
   88  and community-based services Medicaid waiver program meets the
   89  level of care requirement for an intermediate care facility for
   90  individuals with intellectual disabilities pursuant to 42 C.F.R.
   91  ss. 435.217(b)(1) and 440.150, the agency must assign the client
   92  to an appropriate preenrollment category pursuant to this
   93  subsection and must provide priority to clients waiting for
   94  waiver services in the following order:
   95         (d) Category 4, which includes, but is not required to be
   96  limited to, clients whose caregivers are 60 70 years of age or
   97  older and for whom a caregiver is required but no alternate
   98  caregiver is available.
  100  Within preenrollment categories 3, 4, 5, 6, and 7, the agency
  101  shall prioritize clients in the order of the date that the
  102  client is determined eligible for waiver services.
  103         Section 2. Section 393.0651, Florida Statutes, is amended
  104  to read:
  105         393.0651 Family or individual support plan.—The agency
  106  shall provide directly or contract for the development of a
  107  family support plan for children ages 3 to 18 years of age and
  108  an individual support plan for each client served by the home
  109  and community-based services Medicaid waiver program under s.
  110  393.0662. The client, if competent, the client’s parent or
  111  guardian, or, when appropriate, the client advocate, shall be
  112  consulted in the development of the plan and shall receive a
  113  copy of the plan. Each plan must include the most appropriate,
  114  least restrictive, and most cost-beneficial environment for
  115  accomplishment of the objectives for client progress and a
  116  specification of all services authorized. The plan must include
  117  provisions for the most appropriate level of care for the
  118  client. Within the specification of needs and services for each
  119  client, when residential care is necessary, the agency shall
  120  move toward placement of clients in residential facilities based
  121  within the client’s community. The ultimate goal of each plan,
  122  whenever possible, shall be to enable the client to live a
  123  dignified life in the least restrictive setting, be that in the
  124  home or in the community. The family or individual support plan
  125  must be developed within 60 calendar days after the agency
  126  determines the client eligible pursuant to s. 393.065(3).
  127         (1) The agency shall develop and specify by rule the core
  128  components of support plans.
  129         (2) The family or individual support plan shall be
  130  integrated with the individual education plan (IEP) for all
  131  clients who are public school students entitled to a free
  132  appropriate public education under the Individuals with
  133  Disabilities Education Act, I.D.E.A., as amended. The family or
  134  individual support plan and IEP must be implemented to maximize
  135  the attainment of educational and habilitation goals.
  136         (a) If the IEP for a student enrolled in a public school
  137  program indicates placement in a public or private residential
  138  program is necessary to provide special education and related
  139  services to a client, the local education agency must provide
  140  for the costs of that service in accordance with the
  141  requirements of the Individuals with Disabilities Education Act,
  142  I.D.E.A., as amended. This does not preclude local education
  143  agencies and the agency from sharing the residential service
  144  costs of students who are clients and require residential
  145  placement.
  146         (b) For clients who are entering or exiting the school
  147  system, an interdepartmental staffing team composed of
  148  representatives of the agency and the local school system shall
  149  develop a written transitional living and training plan with the
  150  participation of the client or with the parent or guardian of
  151  the client, or the client advocate, as appropriate.
  152         (3) Each family or individual support plan shall be
  153  facilitated through case management designed solely to advance
  154  the individual needs of the client.
  155         (4) In the development of the family or individual support
  156  plan, a client advocate may be appointed by the support planning
  157  team for a client who is a minor or for a client who is not
  158  capable of express and informed consent when:
  159         (a) The parent or guardian cannot be identified;
  160         (b) The whereabouts of the parent or guardian cannot be
  161  discovered; or
  162         (c) The state is the only legal representative of the
  163  client.
  165  Such appointment may not be construed to extend the powers of
  166  the client advocate to include any of those powers delegated by
  167  law to a legal guardian.
  168         (5) The agency shall place a client in the most appropriate
  169  and least restrictive, and cost-beneficial, residential facility
  170  according to his or her individual support plan. The client, if
  171  competent, the client’s parent or guardian, or, when
  172  appropriate, the client advocate, and the administrator of the
  173  facility to which placement is proposed shall be consulted in
  174  determining the appropriate placement for the client.
  175  Considerations for placement shall be made in the following
  176  order:
  177         (a) Client’s own home or the home of a family member or
  178  direct service provider.
  179         (b) Foster care facility.
  180         (c) Group home facility.
  181         (d) Intermediate care facility for the developmentally
  182  disabled.
  183         (e) Other facilities licensed by the agency which offer
  184  special programs for people with developmental disabilities.
  185         (f) Developmental disabilities center.
  186         (6) In developing a client’s annual family or individual
  187  support plan, the individual or family with the assistance of
  188  the support planning team shall identify measurable objectives
  189  for client progress and shall specify a time period expected for
  190  achievement of each objective.
  191         (7) The individual, family, and support coordinator shall
  192  review progress in achieving the objectives specified in each
  193  client’s family or individual support plan, and shall revise the
  194  plan annually, following consultation with the client, if
  195  competent, or with the parent or guardian of the client, or,
  196  when appropriate, the client advocate. The agency or designated
  197  contractor shall annually report in writing to the client, if
  198  competent, or to the parent or guardian of the client, or to the
  199  client advocate, when appropriate, with respect to the client’s
  200  habilitative and medical progress.
  201         (8) Any client, or any parent of a minor client, or
  202  guardian, authorized guardian advocate, or client advocate for a
  203  client, who is substantially affected by the client’s initial
  204  family or individual support plan, or the annual review thereof,
  205  shall have the right to file a notice to challenge the decision
  206  pursuant to ss. 120.569 and 120.57. Notice of such right to
  207  appeal shall be included in all support plans provided by the
  208  agency.
  209         (9)When developing or reviewing a client’s family or
  210  individual support plan, the waiver support coordinator shall
  211  inform the client, the client’s parent or guardian, or, when
  212  appropriate, the client advocate about the consumer-directed
  213  care program established under s. 409.221.
  214         Section 3. For the 2024-2025 fiscal year, the sum of
  215  $16,562,703 in recurring funds from the General Revenue Fund and
  216  $22,289,520 in recurring funds from the Operations and
  217  Maintenance Trust Fund are appropriated in the Home and
  218  Community Based Services Waiver category to the Agency for
  219  Persons with Disabilities to offer waiver services to the
  220  greatest number of individuals permissible under the
  221  appropriation from preenrollment categories 3, 4, and 5,
  222  including individuals whose caregiver is age 60 or older in
  223  category 4, as provided in s. 393.065, Florida Statutes, as
  224  amended by this act. For the 2024-2025 fiscal year, the sum of
  225  $38,852,223 in recurring funds from the Medical Care Trust Fund
  226  is appropriated in the Home and Community Based Services Waiver
  227  category to the Agency for Health Care Administration to
  228  establish budget authority for Medicaid services.
  229         Section 4. This act shall take effect July 1, 2024.