Florida Senate - 2025                        COMMITTEE AMENDMENT
       Bill No. SB 1050
       
       
       
       
       
       
                                Ì643234ÆÎ643234                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/03/2025           .                                
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       The Committee on Children, Families, and Elder Affairs (Bradley)
       recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (14) of section 393.0662, Florida
    6  Statutes, is 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         (14)(a) The agency, in consultation with the Agency for
   25  Health Care Administration, shall provide a quarterly
   26  reconciliation report of all home and community-based services
   27  waiver expenditures from the Agency for Health Care
   28  Administration’s claims management system with service
   29  utilization from the Agency for Persons with Disabilities
   30  Allocation, Budget, and Contract Control system. The
   31  reconciliation report must be submitted to the Governor, the
   32  President of the Senate, and the Speaker of the House of
   33  Representatives no later than 30 days after the close of each
   34  quarter.
   35         (b)The agency shall post its quarterly reconciliation
   36  reports on its website, in a conspicuous location, no later than
   37  5 days after submitting the reports as required in this
   38  subsection.
   39         Section 2. Subsection (12) of section 393.065, Florida
   40  Statutes, is renumbered as subsection (13), paragraph (a) of
   41  subsection (1), paragraph (b) of subsection (5), and subsection
   42  (10) are amended, and a new subsection (12) is added to that
   43  section, to read:
   44         393.065 Application and eligibility determination.—
   45         (1)(a) The agency shall develop and implement an online
   46  application process that, at a minimum, supports paperless,
   47  electronic application submissions with immediate e-mail
   48  confirmation to each applicant to acknowledge receipt of
   49  application upon submission. The online application system must
   50  allow an applicant to review the status of a submitted
   51  application and respond to provide additional information. The
   52  online application must allow an applicant to apply for crisis
   53  enrollment.
   54         (5) Except as provided in subsections (6) and (7), if a
   55  client seeking enrollment in the developmental disabilities home
   56  and community-based services Medicaid waiver program meets the
   57  level of care requirement for an intermediate care facility for
   58  individuals with intellectual disabilities pursuant to 42 C.F.R.
   59  ss. 435.217(b)(1) and 440.150, the agency must assign the client
   60  to an appropriate preenrollment category pursuant to this
   61  subsection and must provide priority to clients waiting for
   62  waiver services in the following order:
   63         (b) Category 2, which includes clients in the preenrollment
   64  categories who are:
   65         1. From the child welfare system with an open case in the
   66  Department of Children and Families’ statewide automated child
   67  welfare information system and who are either:
   68         a. Transitioning out of the child welfare system into
   69  permanency; or
   70         b. At least 18 years but not yet 22 years of age and who
   71  need both waiver services and extended foster care services; or
   72         2. At least 18 years but not yet 22 years of age and who
   73  withdrew consent pursuant to s. 39.6251(5)(c) to remain in the
   74  extended foster care system.
   75  
   76  For individuals who are at least 18 years but not yet 22 years
   77  of age and who are eligible under sub-subparagraph 1.b., the
   78  agency must provide waiver services, including residential
   79  habilitation, and must actively participate in transition
   80  planning activities, including, but not limited to,
   81  individualized service coordination, case management support,
   82  and ensuring continuity of care pursuant to s. 39.6035. The
   83  community-based care lead agency must fund room and board at the
   84  rate established in s. 409.145(3) and provide case management
   85  and related services as defined in s. 409.986(3)(e). Individuals
   86  may receive both waiver services and services under s. 39.6251.
   87  Services may not duplicate services available through the
   88  Medicaid state plan.
   89  
   90  Within preenrollment categories 3, 4, 5, 6, and 7, the agency
   91  shall prioritize clients in the order of the date that the
   92  client is determined eligible for waiver services.
   93         (10) The client, the client’s guardian, or the client’s
   94  family must ensure that accurate, up-to-date contact information
   95  is provided to the agency at all times. Notwithstanding s.
   96  393.0651, the agency must send an annual letter requesting
   97  updated information from the client, the client’s guardian, or
   98  the client’s family. The agency must remove from the
   99  preenrollment categories any individual who cannot be located
  100  using the contact information provided to the agency, fails to
  101  meet eligibility requirements, or becomes domiciled outside the
  102  state.
  103         (12)To ensure transparency and timely access to
  104  information, the agency shall post on its website in a
  105  conspicuous location the total number of individuals in each
  106  priority category. The posted numbers shall reflect the current
  107  status of the preenrollment priority list and shall be updated
  108  at least every 5 days.
  109         Section 3. Section 393.0664, Florida Statutes, is created
  110  to read:
  111         393.0664Adult Pathways Home and Community-based Services
  112  Medicaid waiver program.—
  113         (1)PROGRAM IMPLEMENTATION.—
  114         (a)The agency shall implement the Adult Pathways Home and
  115  Community-based Services Medicaid waiver program using a fee
  116  for-service model with an annual per-person funding cap to
  117  address the needs of clients with developmental disabilities as
  118  they transition into adulthood and achieve greater independence
  119  throughout their lifetimes.
  120         (b)The program is created to establish an additional
  121  pathway to provide necessary supports and services to clients
  122  and contain costs by maximizing the use of natural supports and
  123  community partnerships before turning to state resources to meet
  124  the needs of clients at the earliest possible time to prevent
  125  care crises and to positively influence outcomes relating to
  126  client health, safety, and well-being.
  127         (c)The agency, in partnership with the Agency for Health
  128  Care Administration, may seek federal approval through a state
  129  plan amendment or Medicaid waiver as necessary to implement the
  130  program. The Agency for Health Care Administration shall submit
  131  a request for any federal approval needed to implement the
  132  program by October 1, 2025.
  133         (2)VOLUNTARY ENROLLMENT; ELIGIBILITY; DISENROLLMENT.—
  134         (a)Participation in the program is voluntary and limited
  135  to the maximum number of enrollees authorized in the General
  136  Appropriations Act.
  137         (b)The agency shall approve a needs assessment methodology
  138  to determine functional, behavioral, and physical needs of
  139  prospective enrollees. The assessment methodology may be
  140  administered only by persons who have completed any training
  141  required by the agency for such purpose. If required, the agency
  142  must offer any such training.
  143         (c)To participate in the program, a client must meet all
  144  of the following criteria:
  145         1.Be eligible for Medicaid.
  146         2.Be eligible for a preenrollment category for Medicaid
  147  waiver services as provided in s. 393.065(5).
  148         3.Be 18 to 28 years of age at the time of enrollment and
  149  have attained a high school diploma or the equivalent.
  150         4.Meet the level of care required for home and community
  151  based services as identified in the federal approval for the
  152  program.
  153         (d)Enrollees may remain on the Adult Pathways waiver until
  154  the age of 32.
  155         (e)Participation in the program does not affect the status
  156  of current clients of the home and community-based services
  157  Medicaid waiver program under s. 393.0662 unless a client, or
  158  his or her legal representative, voluntarily disenrolls from
  159  that program.
  160         (f)Enrollees who voluntarily disenroll from the program
  161  must be allowed to return to the most appropriate preenrollment
  162  category for services under s. 393.065 based on a current needs
  163  assessment and the preenrollment category criteria.
  164         (3)ADULT PATHWAYS WAIVER SERVICES.—
  165         (a)The agency shall authorize covered services as
  166  specified in the Medicaid waiver which are medically necessary,
  167  including, but not limited to, any of the following:
  168         1.Adult day training.
  169         2.Companion services.
  170         3.Employment services.
  171         4.Personal supports.
  172         5.Prevocational services.
  173         6.Supported living coaching.
  174         7.Transportation.
  175         8.Care Coordination.
  176         (b)Services must be provided to enrollees in accordance
  177  with an individualized care plan, which must be evaluated and
  178  updated at least annually and as often as warranted by changes
  179  in the enrollee’s circumstances.
  180         (4)PROGRAM ADMINISTRATION AND EVALUATION.—
  181         (a)The agency shall begin enrollment upon federal approval
  182  of the Medicaid waiver, with coverage for enrollees becoming
  183  effective upon authorization and availability of sufficient
  184  state and federal funding and resources.
  185         (b)This section and any rules adopted pursuant thereto may
  186  not be construed to prevent or limit the agency, in consultation
  187  with the Agency for Health Care Administration, from adjusting
  188  fees, reimbursement rates, lengths of stay, number of visits, or
  189  number of services; limiting enrollment; or making any other
  190  adjustment necessary based upon funding and any limitations
  191  imposed or directions provided in the General Appropriations
  192  Act.
  193         (c)The agency, in consultation with the Agency for Health
  194  Care Administration, shall submit progress reports to the
  195  Governor, the President of the Senate, and the Speaker of the
  196  House of Representatives upon federal approval of the Medicaid
  197  waiver and throughout implementation of the program under the
  198  waiver. By July 1, 2026, the Agency for Persons with
  199  Disabilities shall submit a progress report on the
  200  administration of the program, including, but not limited to,
  201  all of the following:
  202         1.The number of enrollees in the program and other
  203  pertinent information on enrollment.
  204         2.Service use.
  205         3.Average cost per enrollee.
  206         4.Outcomes and performance reporting relating to health,
  207  safety, and well-being of enrollees.
  208         Section 4. Section 393.502, Florida Statutes, is amended to
  209  read:
  210         393.502 Family care councils.—
  211         (1) CREATION AND PURPOSE OF STATEWIDE FAMILY CARE COUNCIL.
  212  There shall be established and located within each service area
  213  of the agency a family care council.
  214         (a)The Statewide Family Care Council is established to
  215  connect local family care councils and facilitate direct
  216  communication between local councils and the agency, with the
  217  goal of enhancing the quality of and access to resources and
  218  supports for individuals with developmental disabilities and
  219  their families.
  220         (b)The statewide council shall:
  221         1.Review annual reports, policy proposals, and program
  222  recommendations submitted by the local family care councils.
  223         2.Advise the agency on statewide policies, programs, and
  224  service delivery improvements based on the collective
  225  recommendations of the local councils.
  226         3.Identify systemic barriers to the effective delivery of
  227  services and recommend solutions to address such barriers.
  228         4.Foster collaboration and the sharing of best practices
  229  and available resources among local family care councils to
  230  improve service delivery across regions.
  231         5.Submit an annual report no later than December 1 of each
  232  year to the Governor, the President of the Senate, the Speaker
  233  of the House of Representatives, and the agency. The report
  234  shall include a summary of local council findings, policy
  235  recommendations, and an assessment of the agency’s actions in
  236  response to previous recommendations of the local councils.
  237         (c)The agency shall provide a written response within 60
  238  days after receipt, including a detailed action plan outlining
  239  steps taken or planned to address recommendations. The response
  240  must specify whether recommendations will be implemented and
  241  provide a timeline for implementation or include justification
  242  if recommendations are not adopted.
  243         (2)STATEWIDE FAMILY CARE COUNCIL MEMBERSHIP.—
  244         (a)The statewide council shall consist of the following
  245  members appointed by the Governor:
  246         1.One representative from each of the local family care
  247  councils, who must be a resident of the area served by that
  248  local council. Among these representatives must be at least one
  249  individual who is receiving waiver services from the agency
  250  under s. 393.065 and at least one individual who is assigned to
  251  a preenrollment category for waiver services under s. 393.065.
  252         2.One individual representing an advocacy organization
  253  representing individuals with disabilities.
  254         3.One representative of a public or private entity that
  255  provides services to individuals with developmental disabilities
  256  that does not have a Medicaid wavier service contract with the
  257  agency.
  258         (b)Employees of the agency or the Agency for Health Care
  259  Administration are not eligible to serve on the statewide
  260  council.
  261         (3)STATEWIDE FAMILY CARE COUNCIL TERMS; VACANCIES.—
  262         (a)Statewide council members shall be initially appointed
  263  to staggered 2 and 4 year terms, with subsequent terms of 4
  264  years. Members may be reappointed to one additional consecutive
  265  term.
  266         (b)A member who has served two consecutive terms shall not
  267  be eligible to serve again until at least 12 months have elapsed
  268  since ending service on the statewide council.
  269         (c)Upon expiration of a term or in the case of any other
  270  vacancy, the statewide council shall, by majority vote,
  271  recommend to the Governor for appointment at least one person
  272  for each vacancy.
  273         1.The Governor shall make an appointment within 45 days
  274  after receiving a recommendation from the statewide council. If
  275  the Governor fails to make an appointment for a member under
  276  subsection (2), the chair of the local council may appoint a
  277  member meeting the requirements of subsection (2) to act as the
  278  statewide council representative for that local council until
  279  the Governor makes an appointment.
  280         2.If no member of a local council is willing and able to
  281  serve on the statewide council, the Governor shall appoint an
  282  individual from another local council to serve on the statewide
  283  council.
  284         (4)STATEWIDE FAMILY CARE COUNCIL MEETINGS; ORGANIZATION.
  285  The statewide council shall meet at least quarterly. The council
  286  meetings may be held in person or via teleconference or other
  287  electronic means.
  288         (a)The Governor shall appoint the initial chair from among
  289  the members of the statewide council. Subsequent chairs shall be
  290  elected annually by a majority vote of the council.
  291         (b)Members of the statewide council shall serve without
  292  compensation but may be reimbursed for per diem and travel
  293  expenses pursuant to s. 112.061.
  294         (c)A majority of the members of the statewide council
  295  shall constitute a quorum.
  296         (5)LOCAL FAMILY CARE COUNCILS.—There is established and
  297  located within each service area of the agency a local family
  298  care council to work constructively with the agency, advise the
  299  agency on local needs, identify gaps in services, and advocate
  300  for individuals with developmental disabilities and their
  301  families.
  302         (6)LOCAL FAMILY CARE COUNCIL DUTIES.—The local family care
  303  councils shall:
  304         (a)Assist in providing information and conducting outreach
  305  to individuals with developmental disabilities and their
  306  families.
  307         (b)Convene family listening sessions at least twice a year
  308  to gather input on local service delivery challenges.
  309         (c)Hold a public forum every 6 months to solicit public
  310  feedback concerning actions taken by the local family councils.
  311         (d)Share information with other local family care
  312  councils.
  313         (e)Identify policy issues relevant to the community and
  314  family support system in the region.
  315         (f)Submit to the Statewide Family Care Council, no later
  316  than September 1 of each year, an annual report detailing
  317  proposed policy changes, program recommendations, and identified
  318  service delivery challenges within its region.
  319         (7)(2)LOCAL FAMILY CARE COUNCIL MEMBERSHIP.—
  320         (a) Each local family care council shall consist of at
  321  least 10 and no more than 15 members recommended by a majority
  322  vote of the local family care council and appointed by the
  323  Governor.
  324         (b) At least three of the members of the council shall be
  325  individuals receiving or waiting to receive services from the
  326  agency. One such member shall be an individual who has been
  327  receiving services within the 4 years before the date of
  328  recommendation. The remainder of the council members shall be
  329  parents, grandparents, guardians, or siblings of individuals who
  330  have developmental disabilities and qualify for services
  331  pursuant to this chapter. For a grandparent to be a council
  332  member, the grandchild’s parent or legal guardian must consent
  333  to the appointment and report the consent to the agency.
  334         (c) A person who is currently serving on another board or
  335  council of the agency may not be appointed to a local family
  336  care council.
  337         (d) Employees of the agency or the Agency for Health Care
  338  Administration are not eligible to serve on a local family care
  339  council.
  340         (e) Persons related by consanguinity or affinity within the
  341  third degree shall not serve on the same local family care
  342  council at the same time.
  343         (f) A chair for the council shall be chosen by the council
  344  members to serve for 1 year. A person may not serve no more than
  345  four 1-year terms as chair.
  346         (8)(3)LOCAL FAMILY CARE COUNCIL TERMS; VACANCIES.—
  347         (a) Local family council members shall be appointed for a
  348  3-year terms term, except as provided in subsection (11) (8),
  349  and may be reappointed to one additional term.
  350         (b) A member who has served two consecutive terms shall not
  351  be eligible to serve again until 12 months have elapsed since
  352  ending his or her service on the local council.
  353         (c)1. Upon expiration of a term or in the case of any other
  354  vacancy, the local council shall, by majority vote, recommend to
  355  the Governor for appointment a person for each vacancy based on
  356  recommendations received from the family-led nominating
  357  committee described in paragraph (9)(a).
  358         2.The Governor shall make an appointment within 45 days
  359  after receiving a recommendation. If the Governor fails to make
  360  an appointment within 45 days the local council shall, by
  361  majority vote, may select an interim appointment for each
  362  vacancy from the panel of candidates recommended by the family
  363  led nominating committee.
  364         (9)(4)LOCAL FAMILY CARE COUNCIL COMMITTEE APPOINTMENTS.—
  365         (a)The chair of each local family care council shall
  366  create, and appoint individuals receiving or waiting to receive
  367  services from the agency and their relatives, to serve on a
  368  family-led nominating committee. Members of the family-led
  369  nominating council need not be members of the local council. The
  370  family-led nominating committee shall nominate candidates for
  371  vacant positions on the local family council.
  372         (b) The chair of the local family care council may appoint
  373  persons to serve on additional council committees. Such persons
  374  may include current members of the council and former members of
  375  the council and persons not eligible to serve on the council.
  376         (5) TRAINING.—
  377         (a) The agency, in consultation with the local councils,
  378  shall establish a training program for local family care council
  379  members. Each local area shall provide the training program when
  380  new persons are appointed to the local council and at other
  381  times as the secretary deems necessary.
  382         (b) The training shall assist the council members to
  383  understand the laws, rules, and policies applicable to their
  384  duties and responsibilities.
  385         (c) All persons appointed to a local council must complete
  386  this training within 90 days after their appointment. A person
  387  who fails to meet this requirement shall be considered to have
  388  resigned from the council.
  389         (10)(6)LOCAL FAMILY CARE COUNCIL MEETINGS.—Local council
  390  members shall serve on a voluntary basis without payment for
  391  their services but shall be reimbursed for per diem and travel
  392  expenses as provided for in s. 112.061. Local councils The
  393  council shall meet at least six times per year. Meetings may be
  394  held in person or by teleconference or other electronic means.
  395         (7)PURPOSE.—The purpose of the local family care councils
  396  shall be to advise the agency, to develop a plan for the
  397  delivery of family support services within the local area, and
  398  to monitor the implementation and effectiveness of services and
  399  support provided under the plan. The primary functions of the
  400  local family care councils shall be to:
  401         (a)Assist in providing information and outreach to
  402  families.
  403         (b)Review the effectiveness of service programs and make
  404  recommendations with respect to program implementation.
  405         (c)Advise the agency with respect to policy issues
  406  relevant to the community and family support system in the local
  407  area.
  408         (d)Meet and share information with other local family care
  409  councils.
  410         (11)(8) NEW LOCAL FAMILY CARE COUNCILS.—When a local family
  411  care council is established for the first time in a local area,
  412  the Governor shall appoint the first four council members, who
  413  shall serve 3-year terms. These members shall submit to the
  414  Governor, within 90 days after their appointment,
  415  recommendations for at least six additional members, selected by
  416  majority vote.
  417         (12)(9) FUNDING; FINANCIAL REVIEW.—The statewide and local
  418  family care councils council may apply for, receive, and accept
  419  grants, gifts, donations, bequests, and other payments from any
  420  public or private entity or person. Each local council is
  421  subject to an annual financial review by staff assigned by the
  422  agency. Each local council shall exercise care and prudence in
  423  the expenditure of funds. The local family care councils shall
  424  comply with state expenditure requirements.
  425         (13)TRAINING.—
  426         (a)The agency, in consultation with the statewide and
  427  local councils, shall establish and provide a training program
  428  for council members.
  429         (b)The training shall assist the council members to
  430  understand the laws, rules, and policies applicable to their
  431  duties and responsibilities.
  432         (c)All persons newly appointed to the statewide or a local
  433  council must complete this training within 90 days after their
  434  appointment. A person who fails to meet this requirement is
  435  considered to have resigned from the council. The agency may
  436  make additional training available to council members.
  437         (14)DUTIES.—The agency shall publish on its website all
  438  annual reports submitted by the local care councils and the
  439  Statewide Family Care Council within 15 days after receipt of
  440  such reports in a designated and easily accessible section of
  441  the website.
  442         (15)ADMINISTRATIVE SUPPORT.—The agency shall provide
  443  administrative support to the statewide council and local
  444  councils, including, but not limited to, staff assistance and
  445  meeting facilities, within existing resources.
  446         Section 5. Subsections (1), (2), (3), and (6) of section
  447  409.9855, Florida Statutes, are amended to read:
  448         409.9855 Pilot program for individuals with developmental
  449  disabilities.—
  450         (1) PILOT PROGRAM IMPLEMENTATION.—
  451         (a) Using a managed care model, The agency shall implement
  452  a pilot program for individuals with developmental disabilities
  453  in Statewide Medicaid Managed Care Regions D and I to provide
  454  coverage of comprehensive services using a managed care model.
  455  The agency may seek federal approval through a state plan
  456  amendment or Medicaid waiver as necessary to implement the pilot
  457  program.
  458         (b) The agency shall administer the pilot program pursuant
  459  to s. 409.903 and as a component of the Statewide Medicaid
  460  Managed Care model established by this section. Unless otherwise
  461  specified, ss. 409.961-409.969 apply to the pilot program. The
  462  agency may seek federal approval through a state plan amendment
  463  or Medicaid waiver as necessary to implement the pilot program.
  464  The agency shall submit a request for any federal approval
  465  needed to implement the pilot program by September 1, 2023.
  466         (c)Pursuant to s. 409.963, the agency shall administer the
  467  pilot program in consultation with the Agency for Persons with
  468  Disabilities.
  469         (c)(d) The agency shall make capitated payments to managed
  470  care organizations for comprehensive coverage, including managed
  471  medical assistance benefits and long-term care under this part
  472  and community-based services described in s. 393.066(3) and
  473  approved through the state’s home and community-based services
  474  Medicaid waiver program for individuals with developmental
  475  disabilities. Unless otherwise specified, ss. 409.961-409.969
  476  apply to the pilot program.
  477         (e)The agency shall evaluate the feasibility of statewide
  478  implementation of the capitated managed care model used by the
  479  pilot program to serve individuals with developmental
  480  disabilities.
  481         (2) ELIGIBILITY; VOLUNTARY ENROLLMENT; DISENROLLMENT.—
  482         (a) Participation in the pilot program is voluntary and
  483  limited to the maximum number of enrollees specified in the
  484  General Appropriations Act.
  485         (b)To be eligible for enrollment in the pilot program, an
  486  individual must:
  487         (b)The Agency for Persons with Disabilities shall approve
  488  a needs assessment methodology to determine functional,
  489  behavioral, and physical needs of prospective enrollees. The
  490  assessment methodology may be administered by persons who have
  491  completed such training as may be offered by the agency.
  492  Eligibility to participate in the pilot program is determined
  493  based on all of the following criteria:
  494         1.Be Medicaid eligible.
  495         1.Whether the individual is eligible for Medicaid.
  496         2. Be Whether the individual is 18 years of age or older.
  497         3.Have a developmental disability as defined in s. 393.063.
  498         4. Be placed in any preenrollment category for individual
  499  budget waiver services under chapter 393 and reside in Statewide
  500  Medicaid Managed Care Regions D or I; effective October 1, 2025,
  501  be placed in any preenrollment category for individual budget
  502  waiver services under chapter 393 regardless of region; or,
  503  effective July 1, 2026, be enrolled in the individual budget
  504  waiver services program under chapter 393 or in the long-term
  505  care managed care program under this part regardless of region
  506  and is on the waiting list for individual budget waiver services
  507  under chapter 393 and assigned to one of categories 1 through 6
  508  as specified in s. 393.065(5).
  509         3. Whether the individual resides in a pilot program
  510  region.
  511         (c) The agency shall enroll individuals in the pilot
  512  program based on verification that the individual has met the
  513  criteria in paragraph (b).
  514         1. The Agency for Persons with Disabilities shall transmit
  515  to the agency weekly data files of clients enrolled in the
  516  Medicaid home and community-based services waiver program under
  517  chapter 393 and clients in preenrollment categories pursuant to
  518  s. 393.065. The agency shall maintain a record of individuals
  519  with developmental disabilities who may be eligible for the
  520  pilot program using this data, Medicaid enrollment data
  521  transmitted by the Department of Children and Families, and any
  522  available collateral data.
  523         2. The agency shall determine and administer the process
  524  for enrollment. A needs assessment conducted by the Agency for
  525  Persons with Disabilities is not required for enrollment. The
  526  agency shall notify individuals with developmental disabilities
  527  of the opportunity to voluntarily enroll in the pilot program
  528  and explain the benefits available through the pilot program,
  529  the process for enrollment, and the procedures for
  530  disenrollment, including the requirement for continued coverage
  531  after disenrollment pursuant to paragraph (d).
  532         3. The agency shall provide a call center staffed by agents
  533  trained to assist individuals with developmental disabilities
  534  and their families in learning about and enrolling in the pilot
  535  program.
  536         4. The agency shall coordinate with the Department of
  537  Children and Families and the Agency for Persons with
  538  Disabilities to develop partnerships with community-based
  539  organizations to disseminate information about the pilot program
  540  to providers of covered services and potential enrollees.
  541         (d) Notwithstanding any provisions of s. 393.065 to the
  542  contrary, an enrollee must be afforded an opportunity to enroll
  543  in any appropriate existing Medicaid waiver program if any of
  544  the following conditions occur:
  545         1. At any point during the operation of the pilot program,
  546  an enrollee declares an intent to voluntarily disenroll,
  547  provided that he or she has been covered for the entire previous
  548  plan year by the pilot program.
  549         2. The agency determines the enrollee has a good cause
  550  reason to disenroll.
  551         3. The pilot program ceases to operate.
  552  
  553  Such enrollees must receive an individualized transition plan to
  554  assist him or her in accessing sufficient services and supports
  555  for the enrollee’s safety, well-being, and continuity of care.
  556         (3) PILOT PROGRAM BENEFITS.—
  557         (a) Plans participating in the pilot program must, at a
  558  minimum, cover the following:
  559         1. All benefits included in s. 409.973.
  560         2. All benefits included in s. 409.98.
  561         3. All benefits included in s. 393.066(3).
  562         4. Any additional benefits negotiated by the agency
  563  pursuant to paragraph (4)(b), and all of the following:
  564         a. Adult day training.
  565         b. Behavior analysis services.
  566         c. Behavior assistant services.
  567         d. Companion services.
  568         e. Consumable medical supplies.
  569         f. Dietitian services.
  570         g. Durable medical equipment and supplies.
  571         h. Environmental accessibility adaptations.
  572         i. Occupational therapy.
  573         j. Personal emergency response systems.
  574         k. Personal supports.
  575         l. Physical therapy.
  576         m. Prevocational services.
  577         n. Private duty nursing.
  578         o. Residential habilitation, including the following
  579  levels:
  580         (I) Standard level.
  581         (II) Behavior-focused level.
  582         (III) Intensive-behavior level.
  583         (IV) Enhanced intensive-behavior level.
  584         p. Residential nursing services.
  585         q. Respiratory therapy.
  586         r. Respite care.
  587         s. Skilled nursing.
  588         t. Specialized medical home care.
  589         u. Specialized mental health counseling.
  590         v. Speech therapy.
  591         w. Support coordination.
  592         x. Supported employment.
  593         y. Supported living coaching.
  594         z. Transportation.
  595         (b) All providers of the benefits services listed under
  596  paragraph (a) must meet the provider qualifications established
  597  by the agency for the Medicaid long-term care managed care
  598  program under this section. If no such qualifications apply to a
  599  specific benefit or provider type, the provider must meet the
  600  provider qualifications established by the Agency for Persons
  601  with Disabilities for the individual budget waiver services
  602  program under chapter 393 outlined in the Florida Medicaid
  603  Developmental Disabilities Individual Budgeting Waiver Services
  604  Coverage and Limitations Handbook as adopted by reference in
  605  rule 59G-13.070, Florida Administrative Code.
  606         (c) Support coordination services must maximize the use of
  607  natural supports and community partnerships.
  608         (d) The plans participating in the pilot program must
  609  provide all categories of benefits through a single, integrated
  610  model of care.
  611         (e) Participating plans must provide benefits services must
  612  be provided to enrollees in accordance with an individualized
  613  care plan which is evaluated and updated at least quarterly and
  614  as warranted by changes in an enrollee’s circumstances.
  615  Participating plans must conduct an individualized assessment of
  616  each enrollee within 5 days after enrollment to determine the
  617  enrollee’s functional, behavioral, and physical needs. The
  618  assessment method or instrument must be approved by the agency.
  619         (f) Participating plans must offer a consumer-directed
  620  services option in accordance with s. 409.221.
  621         (6) PROGRAM IMPLEMENTATION AND EVALUATION.—
  622         (a) The agency shall conduct monitoring and evaluations and
  623  require corrective actions or payment of penalties as may be
  624  necessary to secure compliance with contractual requirements,
  625  consistent with its obligations under this section, including,
  626  but not limited to, compliance with provider network standards,
  627  financial accountability, performance standards, health care
  628  quality improvement systems, and program integrity select
  629  participating plans and begin enrollment no later than January
  630  31, 2024, with coverage for enrollees becoming effective upon
  631  authorization and availability of sufficient state and federal
  632  resources.
  633         (b) Upon implementation of the program, the agency, in
  634  consultation with the Agency for Persons with Disabilities,
  635  shall conduct audits of the selected plans’ implementation of
  636  person-centered planning.
  637         (b)(c) The agency, in consultation with the Agency for
  638  Persons with Disabilities, shall submit progress reports to the
  639  Governor, the President of the Senate, and the Speaker of the
  640  House of Representatives upon the federal approval,
  641  implementation, and operation of the pilot program, as follows:
  642         1. By August 30, 2025 December 31, 2023, a status report on
  643  progress made toward federal approval of the waiver or waiver
  644  amendment needed to implement the pilot program.
  645         2. By December 31, 2025 2024, a status report on
  646  implementation of the pilot program.
  647         3. By December 31, 2025, and annually thereafter, a status
  648  report on the operation of the pilot program, including, but not
  649  limited to, all of the following:
  650         a. Program enrollment, including the number and
  651  demographics of enrollees.
  652         b. Any complaints received.
  653         c. Access to approved services.
  654         (c)(d) The agency, in consultation with the Agency for
  655  Persons with Disabilities, shall establish specific measures of
  656  access, quality, and costs of the pilot program. The agency may
  657  contract with an independent evaluator to conduct such
  658  evaluation. The evaluation must include assessments of cost
  659  savings; consumer education, choice, and access to services;
  660  plans for future capacity and the enrollment of new Medicaid
  661  providers; coordination of care; person-centered planning and
  662  person-centered well-being outcomes; health and quality-of-life
  663  outcomes; and quality of care by each eligibility category and
  664  managed care plan in each pilot program site. The evaluation
  665  must describe any administrative or legal barriers to the
  666  implementation and operation of the pilot program in each
  667  region.
  668         1. The agency, in consultation with the Agency for Persons
  669  with Disabilities, shall conduct quality assurance monitoring of
  670  the pilot program to include client satisfaction with services,
  671  client health and safety outcomes, client well-being outcomes,
  672  and service delivery in accordance with the client’s care plan.
  673         2. The agency shall submit the results of the evaluation to
  674  the Governor, the President of the Senate, and the Speaker of
  675  the House of Representatives by October 1, 2029.
  676         Section 6. This act shall take effect July 1, 2025.
  677  
  678  ================= T I T L E  A M E N D M E N T ================
  679  And the title is amended as follows:
  680         Delete everything before the enacting clause
  681  and insert:
  682                        A bill to be entitled                      
  683         An act relating to services for individuals with
  684         developmental disabilities; amending s. 393.0662,
  685         F.S.; requiring the Agency for Persons with
  686         Disabilities to post its quarterly reconciliation
  687         reports on its website within a specified timeframe;
  688         amending s. 393.065, F.S.; providing a requirement for
  689         the online application system to allow an applicant to
  690         apply for crisis enrollment; removing a requirement
  691         for the agency to remove certain individuals from the
  692         preenrollment categories under certain circumstances;
  693         requiring the agency to participate in transition
  694         planning activities and to post the total number of
  695         individuals in each priority category on its website;
  696         creating s. 393.0664, F.S.; requiring the agency to
  697         implement a specified Medicaid waiver program to
  698         address the needs of certain clients; providing the
  699         purpose of the program; authorizing the agency, in
  700         partnership with the Agency for Health Care
  701         Administration, to seek federal approval through a
  702         state plan amendment or Medicaid waiver to implement
  703         the program by a specified date; providing voluntary
  704         enrollment, eligibility, and disenrollment
  705         requirements; requiring the agency to approve a needs
  706         assessment methodology; providing that only persons
  707         trained by the agency may administer the methodology;
  708         requiring the agency to offer such training; requiring
  709         the agency to authorize certain covered services
  710         specified in the Medicaid waiver; providing
  711         requirements for such services; requiring the agency
  712         to begin enrollment in the program upon federal
  713         approval; providing construction; requiring the
  714         agency, in consultation with the Agency for Health
  715         Care Administration, to submit progress reports to the
  716         Governor and the Legislature upon federal approval and
  717         throughout implementation of the program; requiring
  718         the agency to submit, by a specified date, a progress
  719         report on the administration of the program;
  720         specifying requirements for the report; amending s.
  721         393.502, F.S.; establishing the Statewide Family Care
  722         Council; providing for the purpose, membership, and
  723         duties of the council; requiring local family care
  724         councils to report to the statewide council policy
  725         changes and program recommendations in an annual
  726         report; providing for appointment of council members;
  727         providing for the creation of family-led nominating
  728         committees; providing duties of the agency relating to
  729         the statewide council and local councils; amending s.
  730         409.9855, F.S.; revising implementation and
  731         eligibility requirements of the pilot program for
  732         individuals with developmental disabilities; requiring
  733         the Agency for Persons with Disabilities to transmit
  734         to the Agency for Health Care Administration weekly
  735         data files of specified clients; requiring the Agency
  736         for Health Care Administration to provide a call
  737         center for specified purposes and to coordinate with
  738         the Department of Children and Families and the Agency
  739         for Persons with Disabilities to disseminate
  740         information about the pilot program; revising pilot
  741         program benefits; revising provider qualifications;
  742         requiring participating plans to conduct an
  743         individualized assessment of each enrollee within a
  744         specified timeframe for certain purposes and to offer
  745         certain services to such enrollees; requiring the
  746         Agency for Health Care Administration to conduct
  747         monitoring and evaluations and require corrective
  748         actions or payment of penalties under certain
  749         circumstances; removing coordination requirements for
  750         the agency when submitting certain reports,
  751         establishing specified measures, and conducting
  752         quality assurance monitoring of the pilot program;
  753         revising dates for submitting certain status reports;
  754         providing an effective date.