Florida Senate - 2025 COMMITTEE AMENDMENT
Bill No. CS for SB 1050
Ì454718@Î454718
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
04/22/2025 .
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The Committee on Appropriations (Bradley) recommended the
following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Subsections (5) and (14) of section 393.0662,
6 Florida Statutes, are amended to read:
7 393.0662 Individual budgets for delivery of home and
8 community-based services; iBudget system established.—The
9 Legislature finds that improved financial management of the
10 existing home and community-based Medicaid waiver program is
11 necessary to avoid deficits that impede the provision of
12 services to individuals who are on the waiting list for
13 enrollment in the program. The Legislature further finds that
14 clients and their families should have greater flexibility to
15 choose the services that best allow them to live in their
16 community within the limits of an established budget. Therefore,
17 the Legislature intends that the agency, in consultation with
18 the Agency for Health Care Administration, shall manage the
19 service delivery system using individual budgets as the basis
20 for allocating the funds appropriated for the home and
21 community-based services Medicaid waiver program among eligible
22 enrolled clients. The service delivery system that uses
23 individual budgets shall be called the iBudget system.
24 (5) The agency shall ensure that clients and caregivers
25 have access to training and education that inform them about the
26 iBudget system and enhance their ability for self-direction.
27 Such training and education must be offered in a variety of
28 formats and, at a minimum, must address the policies and
29 processes of the iBudget system and the roles and
30 responsibilities of consumers, caregivers, waiver support
31 coordinators, providers, and the agency, and must provide
32 information to help the client make decisions regarding the
33 iBudget system and examples of support and resources available
34 in the community. The agency shall, within 5 days after
35 enrollment, provide the client with a comprehensive and current
36 written list of all qualified organizations located within the
37 region in which the client resides.
38 (14)(a) The agency, in consultation with the Agency for
39 Health Care Administration, shall provide a quarterly
40 reconciliation report of all home and community-based services
41 waiver expenditures from the Agency for Health Care
42 Administration’s claims management system with service
43 utilization from the Agency for Persons with Disabilities
44 Allocation, Budget, and Contract Control system. The
45 reconciliation report must be submitted to the Governor, the
46 President of the Senate, and the Speaker of the House of
47 Representatives no later than 30 days after the close of each
48 quarter.
49 (b) The agency shall post its quarterly reconciliation
50 reports on its website, in a conspicuous location, no later than
51 5 days after submitting the reports as required in this
52 subsection.
53 Section 2. Present subsection (12) of section 393.065,
54 Florida Statutes, is redesignated as subsection (13), a new
55 subsection (12) is added to that section, and paragraph (a) of
56 subsection (1), paragraph (b) of subsection (5), and subsection
57 (10) of that section are amended, to read:
58 393.065 Application and eligibility determination.—
59 (1)(a) The agency shall develop and implement an online
60 application process that, at a minimum, supports paperless,
61 electronic application submissions with immediate e-mail
62 confirmation to each applicant to acknowledge receipt of
63 application upon submission. The online application system must
64 allow an applicant to review the status of a submitted
65 application and respond to provide additional information. The
66 online application must allow an applicant to apply for crisis
67 enrollment.
68 (5) Except as provided in subsections (6) and (7), if a
69 client seeking enrollment in the developmental disabilities home
70 and community-based services Medicaid waiver program meets the
71 level of care requirement for an intermediate care facility for
72 individuals with intellectual disabilities pursuant to 42 C.F.R.
73 ss. 435.217(b)(1) and 440.150, the agency must assign the client
74 to an appropriate preenrollment category pursuant to this
75 subsection and must provide priority to clients waiting for
76 waiver services in the following order:
77 (b) Category 2, which includes clients in the preenrollment
78 categories who are:
79 1. From the child welfare system with an open case in the
80 Department of Children and Families’ statewide automated child
81 welfare information system and who are either:
82 a. Transitioning out of the child welfare system into
83 permanency; or
84 b. At least 18 years but not yet 22 years of age and who
85 need both waiver services and extended foster care services; or
86 2. At least 18 years but not yet 22 years of age and who
87 withdrew consent pursuant to s. 39.6251(5)(c) to remain in the
88 extended foster care system.
89
90 For individuals who are at least 18 years but not yet 22 years
91 of age and who are eligible under sub-subparagraph 1.b., the
92 agency must provide waiver services, including residential
93 habilitation, and must actively participate in transition
94 planning activities, including, but not limited to,
95 individualized service coordination, case management support,
96 and ensuring continuity of care pursuant to s. 39.6035. The
97 community-based care lead agency must fund room and board at the
98 rate established in s. 409.145(3) and provide case management
99 and related services as defined in s. 409.986(3)(e). Individuals
100 may receive both waiver services and services under s. 39.6251.
101 Services may not duplicate services available through the
102 Medicaid state plan.
103
104 Within preenrollment categories 3, 4, 5, 6, and 7, the agency
105 shall prioritize clients in the order of the date that the
106 client is determined eligible for waiver services.
107 (10) The client, the client’s guardian, or the client’s
108 family must ensure that accurate, up-to-date contact information
109 is provided to the agency at all times. Notwithstanding s.
110 393.0651, the agency must send an annual letter requesting
111 updated information from the client, the client’s guardian, or
112 the client’s family. The agency must remove from the
113 preenrollment categories any individual who cannot be located
114 using the contact information provided to the agency, fails to
115 meet eligibility requirements, or becomes domiciled outside the
116 state.
117 (12) To ensure transparency and timely access to
118 information, the agency shall post on its website in a
119 conspicuous location the total number of individuals in each
120 priority category by county of residence. The posted numbers
121 shall reflect the current status of the preenrollment priority
122 list and shall be updated at least every 5 days.
123 Section 3. Section 393.502, Florida Statutes, is reordered
124 and amended to read:
125 393.502 Family care councils.—
126 (1) CREATION AND PURPOSE OF STATEWIDE FAMILY CARE COUNCIL.
127 There shall be established and located within each service area
128 of the agency a family care council.
129 (a) The Statewide Family Care Council is established to
130 connect local family care councils and facilitate direct
131 communication between local councils and the agency, with the
132 goal of enhancing the quality of and access to resources and
133 supports for individuals with developmental disabilities and
134 their families.
135 (b) The statewide council shall:
136 1. Review annual reports, policy proposals, and program
137 recommendations submitted by the local family care councils.
138 2. Advise the agency on statewide policies, programs, and
139 service delivery improvements based on the collective
140 recommendations of the local councils.
141 3. Identify systemic barriers to the effective delivery of
142 services and recommend solutions to address such barriers.
143 4. Foster collaboration and the sharing of best practices
144 and available resources among local family care councils to
145 improve service delivery across regions.
146 5. Submit an annual report no later than December 1 of each
147 year to the Governor, the President of the Senate, the Speaker
148 of the House of Representatives, and the agency. The report must
149 include a summary of local council findings, policy
150 recommendations, and an assessment of the agency’s actions in
151 response to previous recommendations of the local councils.
152 (c) The agency shall provide a written response within 60
153 days after receipt, including a detailed action plan outlining
154 steps taken or planned to address recommendations. The response
155 must specify whether recommendations will be implemented and
156 provide a timeline for implementation or include justification
157 if recommendations are not adopted.
158 (2) STATEWIDE FAMILY CARE COUNCIL MEMBERSHIP.—
159 (a) The statewide council shall be composed of the
160 following members appointed by the Governor:
161 1. One representative from each of the local family care
162 councils, who must be a resident of the area served by that
163 local council. Among these representatives must be at least one
164 individual who is receiving waiver services from the agency
165 under s. 393.065 and at least one individual who is assigned to
166 a preenrollment category for waiver services under s. 393.065.
167 2. One representative of an advocacy organization
168 representing individuals with disabilities.
169 3. One representative of a public or private entity that
170 provides services to individuals with developmental disabilities
171 that does not have a Medicaid waiver service contract with the
172 agency.
173 (b) Employees of the agency or the Agency for Health Care
174 Administration are not eligible to serve on the statewide
175 council.
176 (3) STATEWIDE FAMILY CARE COUNCIL TERMS; VACANCIES.—
177 (a) Statewide council members shall be initially appointed
178 to staggered 2- and 4- year terms, with subsequent terms of 4
179 years. Members may be reappointed to one additional consecutive
180 term.
181 (b) A member who has served two consecutive terms is not
182 eligible to serve again until at least 12 months have elapsed
183 since ending service on the statewide council.
184 (c) Upon expiration of a term or in the case of any other
185 vacancy, the statewide council shall, by majority vote,
186 recommend to the Governor for appointment at least one person
187 for each vacancy.
188 1. The Governor shall make an appointment within 45 days
189 after receiving a recommendation from the statewide council. If
190 the Governor fails to make an appointment for a member under
191 subsection (2), the chair of the local council may appoint a
192 member meeting the requirements of subsection (2) to act as the
193 statewide council representative for that local council until
194 the Governor makes an appointment.
195 2. If no member of a local council is willing and able to
196 serve on the statewide council, the Governor shall appoint an
197 individual from another local council to serve on the statewide
198 council.
199 (4) STATEWIDE FAMILY CARE COUNCIL MEETINGS; ORGANIZATION.
200 The statewide council shall meet at least quarterly. The council
201 meetings may be held in person or through teleconference or
202 other electronic means.
203 (a) The Governor shall appoint the initial chair from among
204 the members of the statewide council. Subsequent chairs shall be
205 elected annually by a majority vote of the council.
206 (b) Members of the statewide council shall serve without
207 compensation but may be reimbursed for per diem and travel
208 expenses pursuant to s. 112.061.
209 (c) A majority of the members of the statewide council
210 constitutes a quorum.
211 (5) LOCAL FAMILY CARE COUNCILS.—There is established and
212 located within each service area of the agency a local family
213 care council to work constructively with the agency, advise the
214 agency on local needs, identify gaps in services, and advocate
215 for individuals with developmental disabilities and their
216 families.
217 (6) LOCAL FAMILY CARE COUNCIL DUTIES.—The local family care
218 councils shall:
219 (a) Assist in providing information and conducting outreach
220 to individuals with developmental disabilities and their
221 families.
222 (b) Convene family listening sessions at least twice a year
223 to gather input on local service delivery challenges.
224 (c) Hold a public forum every 6 months to solicit public
225 feedback concerning actions taken by the local family councils.
226 (d) Share information with other local family care
227 councils.
228 (e) Identify policy issues relevant to the community and
229 family support system in the region.
230 (f) Submit to the Statewide Family Care Council, no later
231 than September 1 of each year, an annual report detailing
232 proposed policy changes, program recommendations, and identified
233 service delivery challenges within its region.
234 (7)(2) LOCAL FAMILY CARE COUNCIL MEMBERSHIP.—
235 (a) Each local family care council shall consist of at
236 least 10 and no more than 15 members recommended by a majority
237 vote of the local family care council and appointed by the
238 Governor.
239 (b) At least three of the members of the council shall be
240 individuals receiving or waiting to receive services from the
241 agency. One such member shall be an individual who has been
242 receiving services within the 4 years before the date of
243 recommendation. The remainder of the council members shall be
244 parents, grandparents, guardians, or siblings of individuals who
245 have developmental disabilities and qualify for services
246 pursuant to this chapter. For a grandparent to be a council
247 member, the grandchild’s parent or legal guardian must consent
248 to the appointment and report the consent to the agency.
249 (c) A person who is currently serving on another board or
250 council of the agency may not be appointed to a local family
251 care council.
252 (d) Employees of the agency or the Agency for Health Care
253 Administration are not eligible to serve on a local family care
254 council.
255 (e) Persons related by consanguinity or affinity within the
256 third degree may shall not serve on the same local family care
257 council at the same time.
258 (f) A chair for the council shall be chosen by the council
259 members to serve for 1 year. A person may not serve no more than
260 four 1-year terms as chair.
261 (8)(3) LOCAL FAMILY CARE COUNCIL TERMS; VACANCIES.—
262 (a) Local family council members shall be appointed for a
263 3-year terms term, except as provided in subsection (11) (8),
264 and may be reappointed to one additional term.
265 (b) A member who has served two consecutive terms is shall
266 not be eligible to serve again until 12 months have elapsed
267 since ending his or her service on the local council.
268 (c)1. Upon expiration of a term or in the case of any other
269 vacancy, the local council shall, by majority vote, recommend to
270 the Governor for appointment a person for each vacancy based on
271 recommendations received from the family-led nominating
272 committee described in paragraph (9)(a).
273 2. The Governor shall make an appointment within 45 days
274 after receiving a recommendation. If the Governor fails to make
275 an appointment within 45 days, the local council shall, by
276 majority vote, select an interim appointment for each vacancy
277 from the panel of candidates recommended by the family-led
278 nominating committee.
279 (9)(4) LOCAL FAMILY CARE COUNCIL COMMITTEE APPOINTMENTS.—
280 (a) The chair of each local family care council shall
281 create, and appoint individuals receiving or waiting to receive
282 services from the agency and their relatives, to serve on a
283 family-led nominating committee. Members of the family-led
284 nominating council need not be members of the local council. The
285 family-led nominating committee shall nominate candidates for
286 vacant positions on the local family council.
287 (b) The chair of the local family care council may appoint
288 persons to serve on additional council committees. Such persons
289 may include current members of the council and former members of
290 the council and persons not eligible to serve on the council.
291 (13)(5) TRAINING.—
292 (a) The agency, in consultation with the statewide and
293 local councils, shall establish and provide a training program
294 for local family care council members. Each local area shall
295 provide the training program when new persons are appointed to
296 the local council and at other times as the secretary deems
297 necessary.
298 (b) The training shall assist the council members to
299 understand the laws, rules, and policies applicable to their
300 duties and responsibilities.
301 (c) All persons newly appointed to the statewide or a local
302 council must complete this training within 90 days after their
303 appointment. A person who fails to meet this requirement is
304 shall be considered to have resigned from the council. The
305 agency may make additional training available to council
306 members.
307 (10)(6) LOCAL FAMILY CARE COUNCIL MEETINGS.—Local council
308 members shall serve on a voluntary basis without payment for
309 their services but shall be reimbursed for per diem and travel
310 expenses as provided for in s. 112.061. Local councils The
311 council shall meet at least six times per year. Meetings may be
312 held in person or by teleconference or other electronic means.
313 (7) PURPOSE.—The purpose of the local family care councils
314 shall be to advise the agency, to develop a plan for the
315 delivery of family support services within the local area, and
316 to monitor the implementation and effectiveness of services and
317 support provided under the plan. The primary functions of the
318 local family care councils shall be to:
319 (a) Assist in providing information and outreach to
320 families.
321 (b) Review the effectiveness of service programs and make
322 recommendations with respect to program implementation.
323 (c) Advise the agency with respect to policy issues
324 relevant to the community and family support system in the local
325 area.
326 (d) Meet and share information with other local family care
327 councils.
328 (11)(8) NEW LOCAL FAMILY CARE COUNCILS.—When a local family
329 care council is established for the first time in a local area,
330 the Governor shall appoint the first four council members, who
331 shall serve 3-year terms. These members shall submit to the
332 Governor, within 90 days after their appointment,
333 recommendations for at least six additional members, selected by
334 majority vote.
335 (12)(9) FUNDING; FINANCIAL REVIEW.—The statewide and local
336 family care councils council may apply for, receive, and accept
337 grants, gifts, donations, bequests, and other payments from any
338 public or private entity or person. Each local council is
339 subject to an annual financial review by staff assigned by the
340 agency. Each local council shall exercise care and prudence in
341 the expenditure of funds. The local family care councils shall
342 comply with state expenditure requirements.
343 (14) DUTIES.—The agency shall publish on its website all
344 annual reports submitted by the local family care councils and
345 the Statewide Family Care Council within 15 days after receipt
346 of such reports in a designated and easily accessible section of
347 the website.
348 (15) ADMINISTRATIVE SUPPORT.—The agency shall provide
349 administrative support to the statewide council and local
350 councils, including, but not limited to, staff assistance and
351 meeting facilities, within existing resources.
352 Section 4. Subsection (1) of section 409.972, Florida
353 Statutes, is amended to read:
354 409.972 Mandatory and voluntary enrollment.—
355 (1) The following Medicaid-eligible persons listed in
356 paragraphs (a) through (g) are exempt from mandatory managed
357 care enrollment required by s. 409.965, and may voluntarily
358 choose to participate in the managed medical assistance program.
359 These eligible persons must make an affirmative choice before
360 any enrollment action by the agency. The agency may not
361 automatically enroll these eligible persons.:
362 (a) Medicaid recipients who have other creditable health
363 care coverage, excluding Medicare.
364 (b) Medicaid recipients residing in residential commitment
365 facilities operated through the Department of Juvenile Justice
366 or a treatment facility as defined in s. 394.455.
367 (c) Persons eligible for refugee assistance.
368 (d) Medicaid recipients who are residents of a
369 developmental disability center, including Sunland Center in
370 Marianna and Tacachale in Gainesville.
371 (e) Medicaid recipients enrolled in the home and community
372 based services waiver pursuant to chapter 393, and Medicaid
373 recipients waiting for waiver services.
374 (f) Medicaid recipients residing in a group home facility
375 licensed under chapter 393.
376 (g) Children receiving services in a prescribed pediatric
377 extended care center.
378 Section 5. Subsections (1), (2), (3), and (6) of section
379 409.9855, Florida Statutes, are amended to read:
380 409.9855 Pilot program for individuals with developmental
381 disabilities.—
382 (1) PILOT PROGRAM IMPLEMENTATION.—
383 (a) Using a managed care model, The agency shall implement
384 a pilot program for individuals with developmental disabilities
385 in Statewide Medicaid Managed Care Regions D and I to provide
386 coverage of comprehensive services using a managed care model.
387 The agency may seek federal approval through a state plan
388 amendment or Medicaid waiver as necessary to implement the pilot
389 program.
390 (b) The agency shall administer the pilot program pursuant
391 to s. 409.963 and as a component of the Statewide Medicaid
392 Managed Care model established by this part. Unless otherwise
393 specified, ss. 409.961-409.969 apply to the pilot program. The
394 agency may seek federal approval through a state plan amendment
395 or Medicaid waiver as necessary to implement the pilot program.
396 The agency shall submit a request for any federal approval
397 needed to implement the pilot program by September 1, 2023.
398 (c) Pursuant to s. 409.963, the agency shall administer the
399 pilot program in consultation with the Agency for Persons with
400 Disabilities.
401 (d) The agency shall make capitated payments to managed
402 care organizations for comprehensive coverage, including managed
403 medical assistance benefits and long-term care under this part
404 and community-based services described in s. 393.066(3) and
405 approved through the state’s home and community-based services
406 Medicaid waiver program for individuals with developmental
407 disabilities. Unless otherwise specified, ss. 409.961-409.969
408 apply to the pilot program.
409 (e) The agency shall evaluate the feasibility of statewide
410 implementation of the capitated managed care model used by the
411 pilot program to serve individuals with developmental
412 disabilities.
413 (2) ELIGIBILITY; VOLUNTARY ENROLLMENT; DISENROLLMENT.—
414 (a) Participation in the pilot program is voluntary and
415 limited to the maximum number of enrollees specified in the
416 General Appropriations Act. An individual must make an
417 affirmative choice before any enrollment action by the agency.
418 The agency may not automatically enroll eligible individuals.
419 (b) To be eligible for enrollment in the pilot program, an
420 individual must The Agency for Persons with Disabilities shall
421 approve a needs assessment methodology to determine functional,
422 behavioral, and physical needs of prospective enrollees. The
423 assessment methodology may be administered by persons who have
424 completed such training as may be offered by the agency.
425 Eligibility to participate in the pilot program is determined
426 based on all of the following criteria:
427 1. Be Medicaid eligible Whether the individual is eligible
428 for Medicaid.
429 2. Be Whether the individual is 18 years of age or older.
430 3. Have a developmental disability as defined in s.
431 393.063.
432 4. Be placed in any preenrollment category for individual
433 budget waiver services under chapter 393 and reside in Statewide
434 Medicaid Managed Care Regions D or I; effective October 1, 2025,
435 be placed in any preenrollment category for individual budget
436 waiver services under chapter 393, regardless of region; or,
437 effective July 1, 2026, be enrolled in the individual budget
438 waiver services program under chapter 393 or in the long-term
439 care managed care program under this part, regardless of region
440 and is on the waiting list for individual budget waiver services
441 under chapter 393 and assigned to one of categories 1 through 6
442 as specified in s. 393.065(5).
443 3. Whether the individual resides in a pilot program
444 region.
445 (c) The agency shall enroll individuals in the pilot
446 program based on verification that the individual has met the
447 criteria in paragraph (b).
448 1. The Agency for Persons with Disabilities shall transmit
449 to the agency weekly data files of clients enrolled in the
450 Medicaid home and community-based services waiver program under
451 chapter 393 and clients in preenrollment categories pursuant to
452 s. 393.065. The agency shall maintain a record of individuals
453 with developmental disabilities who may be eligible for the
454 pilot program using this data, Medicaid enrollment data
455 transmitted by the Department of Children and Families, and any
456 available collateral data.
457 2. The agency shall determine and administer the process
458 for enrollment. A needs assessment conducted by the Agency for
459 Persons with Disabilities is not required for enrollment. The
460 agency shall notify individuals with developmental disabilities
461 of the opportunity to voluntarily enroll in the pilot program
462 and explain the benefits available through the pilot program,
463 the process for enrollment, and the procedures for
464 disenrollment, including the requirement for continued coverage
465 after disenrollment pursuant to paragraph (d).
466 3. The agency shall provide a call center staffed by agents
467 trained to assist individuals with developmental disabilities
468 and their families in learning about and enrolling in the pilot
469 program.
470 4. The agency shall coordinate with the Department of
471 Children and Families and the Agency for Persons with
472 Disabilities to develop partnerships with community-based
473 organizations to disseminate information about the pilot program
474 to providers of covered services and potential enrollees.
475 (d) Notwithstanding any provisions of s. 393.065 to the
476 contrary, an enrollee must be afforded an opportunity to enroll
477 in any appropriate existing Medicaid waiver program if any of
478 the following conditions occur:
479 1. At any point during the operation of the pilot program,
480 an enrollee declares an intent to voluntarily disenroll,
481 provided that he or she has been covered for the entire previous
482 plan year by the pilot program.
483 2. The agency determines the enrollee has a good cause
484 reason to disenroll.
485 3. The pilot program ceases to operate.
486
487 Such enrollees must receive an individualized transition plan to
488 assist him or her in accessing sufficient services and supports
489 for the enrollee’s safety, well-being, and continuity of care.
490 (3) PILOT PROGRAM BENEFITS.—
491 (a) Plans participating in the pilot program must, at a
492 minimum, cover the following:
493 1. All benefits included in s. 409.973.
494 2. All benefits included in s. 409.98.
495 3. All benefits included in s. 393.066(3).
496 4. Any additional benefits negotiated by the agency
497 pursuant to paragraph (4)(b), and all of the following:
498 a. Adult day training.
499 b. Behavior analysis services.
500 c. Behavior assistant services.
501 d. Companion services.
502 e. Consumable medical supplies.
503 f. Dietitian services.
504 g. Durable medical equipment and supplies.
505 h. Environmental accessibility adaptations.
506 i. Occupational therapy.
507 j. Personal emergency response systems.
508 k. Personal supports.
509 l. Physical therapy.
510 m. Prevocational services.
511 n. Private duty nursing.
512 o. Residential habilitation, including the following
513 levels:
514 (I) Standard level.
515 (II) Behavior-focused level.
516 (III) Intensive-behavior level.
517 (IV) Enhanced intensive-behavior level.
518 p. Residential nursing services.
519 q. Respiratory therapy.
520 r. Respite care.
521 s. Skilled nursing.
522 t. Specialized medical home care.
523 u. Specialized mental health counseling.
524 v. Speech therapy.
525 w. Support coordination.
526 x. Supported employment.
527 y. Supported living coaching.
528 z. Transportation.
529 (b) All providers of the benefits services listed under
530 paragraph (a) must meet the provider qualifications established
531 by the agency for the Medicaid long-term care managed care
532 program under this section. If no such qualifications apply to a
533 specific benefit or provider type, the provider must meet the
534 provider qualifications established by the Agency for Persons
535 with Disabilities for the individual budget waiver services
536 program under chapter 393 outlined in the Florida Medicaid
537 Developmental Disabilities Individual Budgeting Waiver Services
538 Coverage and Limitations Handbook as adopted by reference in
539 rule 59G-13.070, Florida Administrative Code.
540 (c) Support coordination services must maximize the use of
541 natural supports and community partnerships.
542 (d) The plans participating in the pilot program must
543 provide all categories of benefits through a single, integrated
544 model of care.
545 (e) Participating plans must provide benefits services must
546 be provided to enrollees in accordance with an individualized
547 care plan which is evaluated and updated at least quarterly and
548 as warranted by changes in an enrollee’s circumstances.
549 Participating plans must conduct an individualized assessment of
550 each enrollee within 5 days after enrollment to determine the
551 enrollee’s functional, behavioral, and physical needs. The
552 assessment method or instrument must be approved by the agency.
553 (f) Participating plans must offer a consumer-directed
554 services option in accordance with s. 409.221.
555 (6) PROGRAM IMPLEMENTATION AND EVALUATION.—
556 (a) The agency shall conduct monitoring and evaluations and
557 require corrective actions or payment of penalties as may be
558 necessary to secure compliance with contractual requirements,
559 consistent with its obligations under this section, including,
560 but not limited to, compliance with provider network standards,
561 financial accountability, performance standards, health care
562 quality improvement systems, and program integrity select
563 participating plans and begin enrollment no later than January
564 31, 2024, with coverage for enrollees becoming effective upon
565 authorization and availability of sufficient state and federal
566 resources.
567 (b) Upon implementation of the program, the agency, in
568 consultation with the Agency for Persons with Disabilities,
569 shall conduct audits of the selected plans’ implementation of
570 person-centered planning.
571 (b)(c) The agency, in consultation with the Agency for
572 Persons with Disabilities, shall submit progress reports to the
573 Governor, the President of the Senate, and the Speaker of the
574 House of Representatives upon the federal approval,
575 implementation, and operation of the pilot program, as follows:
576 1. By August 30, 2025 December 31, 2023, a status report on
577 progress made toward federal approval of the waiver or waiver
578 amendment needed to implement the pilot program.
579 2. By December 31, 2025 2024, a status report on
580 implementation of the pilot program.
581 3. By December 31, 2025, and annually thereafter, a status
582 report on the operation of the pilot program, including, but not
583 limited to, all of the following:
584 a. Program enrollment, including the number and
585 demographics of enrollees.
586 b. Any complaints received.
587 c. Access to approved services.
588 (c)(d) The agency, in consultation with the Agency for
589 Persons with Disabilities, shall establish specific measures of
590 access, quality, and costs of the pilot program. The agency may
591 contract with an independent evaluator to conduct such
592 evaluation. The evaluation must include assessments of cost
593 savings; consumer education, choice, and access to services;
594 plans for future capacity and the enrollment of new Medicaid
595 providers; coordination of care; person-centered planning and
596 person-centered well-being outcomes; health and quality-of-life
597 outcomes; and quality of care by each eligibility category and
598 managed care plan in each pilot program site. The evaluation
599 must describe any administrative or legal barriers to the
600 implementation and operation of the pilot program in each
601 region.
602 1. The agency, in consultation with the Agency for Persons
603 with Disabilities, shall conduct quality assurance monitoring of
604 the pilot program to include client satisfaction with services,
605 client health and safety outcomes, client well-being outcomes,
606 and service delivery in accordance with the client’s care plan.
607 2. The agency shall submit the results of the evaluation to
608 the Governor, the President of the Senate, and the Speaker of
609 the House of Representatives by October 1, 2029.
610 Section 6. (1) The Agency for Persons with Disabilities
611 shall contract for a study to review, evaluate, and identify
612 recommendations regarding the algorithm required under s.
613 393.0662, Florida Statutes. The individual contractor must
614 possess, or, if the contractor is a firm, must include at least
615 one lead team member who possesses, a doctorate in statistics
616 and advanced knowledge of the development and selection of
617 multiple linear regression models. The study must, at a minimum,
618 assess the performance of the current algorithm used by the
619 agency and determine whether a different algorithm would better
620 meet the requirements of that section. In conducting this
621 assessment and determination, at a minimum, the study must also
622 review the fit of recent expenditure data to the current
623 algorithm, determine and refine dependent and independent
624 variables, develop and apply a method for identifying and
625 removing outliers, develop alternative algorithms using multiple
626 linear regression, test the accuracy and reliability of the
627 algorithms, provide recommendations for improving accuracy and
628 reliability, recommend an algorithm for use by the agency,
629 assess the robustness of the recommended algorithm, and provide
630 suggestions for improving any recommended alternative algorithm,
631 if appropriate. The study must also consider whether any waiver
632 services that are not currently funded through the algorithm can
633 be funded through the current algorithm or an alternative
634 algorithm, and the impact of doing so on that algorithm’s fit
635 and effectiveness. The study must present for any recommended
636 alternative algorithm, at a minimum, the estimated number and
637 percent of waiver enrollees who would require supplemental
638 funding under s. 393.0662(1)(b), Florida Statutes, compared to
639 the current algorithm; and the number and percent of waiver
640 enrollees whose budgets are estimated to increase or decrease,
641 categorized by level of increase or decrease, age, living
642 setting, and current total individual budget amount.
643 (2) The agency shall report to the Governor, the President
644 of the Senate, and the Speaker of the House of Representatives
645 findings and recommendations by November 15, 2025.
646 Section 7. This act shall take effect July 1, 2025.
647
648 ================= T I T L E A M E N D M E N T ================
649 And the title is amended as follows:
650 Delete everything before the enacting clause
651 and insert:
652 A bill to be entitled
653 An act relating to services for individuals with
654 developmental disabilities; amending s. 393.0662,
655 F.S.; requiring the Agency for Persons with
656 Disabilities to provide a list of all qualified
657 organizations located within the region in which the
658 client resides and to post its quarterly
659 reconciliation reports on its website within a
660 specified timeframe; amending s. 393.065, F.S.;
661 requiring online applications to include application
662 for crisis enrollment; requiring the agency to
663 participate in transition planning activities and to
664 post the total number of individuals in each priority
665 category on its website; reordering and amending s.
666 393.502, F.S.; establishing the Statewide Family Care
667 Council; providing for the purpose, membership, and
668 duties of the council; providing for appointment of
669 local council members; providing for the creation of
670 family-led nominating committees; requiring local
671 family care councils to report to the statewide
672 council policy changes and program recommendations in
673 an annual report; providing duties of the agency
674 relating to the statewide council and local councils;
675 amending s. 409.972, F.S.; requiring certain Medicaid
676 eligible persons to take certain actions before
677 enrollment; prohibiting the agency from automatically
678 enrolling such persons; amending s. 409.9855, F.S.;
679 revising implementation and eligibility requirements
680 of the pilot program for individuals with
681 developmental disabilities; providing for a method of
682 voluntarily choosing to enroll in the pilot program;
683 requiring the agency to transmit to the Agency for
684 Health Care Administration weekly data files of
685 specified clients; requiring the Agency for Health
686 Care Administration to provide a call center for
687 specified purposes and to coordinate with the
688 Department of Children and Families and the Agency for
689 Persons with Disabilities to disseminate information
690 about the pilot program; revising pilot program
691 benefits; revising provider qualifications; requiring
692 participating plans to conduct an individualized
693 assessment of each enrollee within a specified
694 timeframe for certain purposes and to offer certain
695 services to such enrollees; requiring the Agency for
696 Health Care Administration to conduct monitoring and
697 evaluations and require corrective actions or payment
698 of penalties under certain circumstances; removing
699 coordination requirements for the agency when
700 submitting certain reports, establishing specified
701 measures, and conducting quality assurance monitoring
702 of the pilot program; revising the dates by which the
703 Agency for Persons with Disabilities shall submit
704 progress reports to the Governor and Legislature;
705 requiring the Agency for Persons with Disabilities to
706 contract for a specified study and provide to the
707 Governor and the Legislature a specified report by
708 specified date; providing an effective date.