Florida Senate - 2025 SB 1062 By Senator Rodriguez 40-01561-25 20251062__ 1 A bill to be entitled 2 An act relating to adult day care centers; amending s. 3 409.908, F.S.; excepting certain adult day care 4 services from certain established or negotiated 5 Medicaid reimbursement rates; providing for 6 reimbursement of adult day care services pursuant to a 7 tiered payment system; defining the term “tiered 8 payment system”; specifying requirements and rates of 9 reimbursement for tier I and tier II adult day care 10 centers; providing for annual adjustments of the 11 reimbursement rates; providing for reimbursement of 12 direct transportation services; creating s. 429.916, 13 F.S.; providing a purpose; requiring adult day care 14 center operators to annually complete an 8-hour 15 continuing education course approved by the Department 16 of Elderly Affairs; authorizing the department to 17 approve additional providers for such course; 18 specifying requirements for the course; providing that 19 the course may be offered in person or online; 20 requiring operators who complete the course online to 21 obtain a minimum passing score on a department 22 approved online exam; providing an exemption from the 23 exam requirement if the course is completed in person; 24 providing that classroom hours spent teaching an 25 approved course or lecturing at an approved seminar 26 may be counted toward fulfilling an operator’s 27 continuing education requirements; requiring providers 28 of the continuing education courses to furnish 29 specified information to the department within a 30 specified timeframe; requiring operator compliance 31 with continuing education requirements as a condition 32 precedent to the licensure of an adult day care 33 center; authorizing the department to grant an 34 extension for completion of continuing education 35 requirements for good cause shown; requiring the 36 department to grant a waiver of the continuing 37 education requirements for operators in active duty 38 military service upon submission of certain 39 documentation; prohibiting the department from 40 renewing an adult day care center’s license until the 41 center’s operator has completed the continuing 42 education requirements, with exceptions; providing an 43 effective date. 44 45 Be It Enacted by the Legislature of the State of Florida: 46 47 Section 1. Subsection (8) of section 409.908, Florida 48 Statutes, is amended to read: 49 409.908 Reimbursement of Medicaid providers.—Subject to 50 specific appropriations, the agency shall reimburse Medicaid 51 providers, in accordance with state and federal law, according 52 to methodologies set forth in the rules of the agency and in 53 policy manuals and handbooks incorporated by reference therein. 54 These methodologies may include fee schedules, reimbursement 55 methods based on cost reporting, negotiated fees, competitive 56 bidding pursuant to s. 287.057, and other mechanisms the agency 57 considers efficient and effective for purchasing services or 58 goods on behalf of recipients. If a provider is reimbursed based 59 on cost reporting and submits a cost report late and that cost 60 report would have been used to set a lower reimbursement rate 61 for a rate semester, then the provider’s rate for that semester 62 shall be retroactively calculated using the new cost report, and 63 full payment at the recalculated rate shall be effected 64 retroactively. Medicare-granted extensions for filing cost 65 reports, if applicable, shall also apply to Medicaid cost 66 reports. Payment for Medicaid compensable services made on 67 behalf of Medicaid-eligible persons is subject to the 68 availability of moneys and any limitations or directions 69 provided for in the General Appropriations Act or chapter 216. 70 Further, nothing in this section shall be construed to prevent 71 or limit the agency from adjusting fees, reimbursement rates, 72 lengths of stay, number of visits, or number of services, or 73 making any other adjustments necessary to comply with the 74 availability of moneys and any limitations or directions 75 provided for in the General Appropriations Act, provided the 76 adjustment is consistent with legislative intent. 77 (8)(a) Except as otherwise provided in paragraph (b), a 78 provider of home-based or community-based services rendered 79 pursuant to a federally approved waiver shall be reimbursed 80 based on an established or negotiated rate for each service. 81 These rates shall be established according to an analysis of the 82 expenditure history and prospective budget developed by each 83 contract provider participating in the waiver program, or under 84 any other methodology adopted by the agency and approved by the 85 Federal Government in accordance with the waiver. Privately 86 owned and operated community-based residential facilities which 87 meet agency requirements and which formerly received Medicaid 88 reimbursement for the optional intermediate care facility for 89 the intellectually disabled service may participate in the 90 developmental services waiver as part of a home-and-community 91 based continuum of care for Medicaid recipients who receive 92 waiver services. 93 (b) A provider of adult day care services rendered pursuant 94 to a federally approved waiver must be reimbursed pursuant to a 95 tiered payment system. As used in this paragraph, the term 96 “tiered payment system” means a two-tiered payment model that 97 categorizes an adult day care center based on the center’s 98 quality of care, facilities, compliance with established 99 standards, and level of provided services. 100 1. To be reimbursed as a tier I center, an adult day care 101 center must meet the basic requirements for a licensed adult day 102 care center under part III of chapter 429, but the adult day 103 care center need not provide specialized Alzheimer’s services as 104 specified in s. 429.918. The reimbursement rate for a tier I 105 center is the greater of the minimum rate per day set by the 106 United States Department of Veterans Affairs for adult day care 107 services or $90 per day. The reimbursement rate must be adjusted 108 on January 1 of each year. The adjustment may not exceed the 109 lesser of 3 percent or the increase in the Consumer Price Index 110 for All Urban Consumers, Southeast Region. 111 2. To be reimbursed as a tier II center, an adult day care 112 center must meet all the requirements of a tier I center and be 113 designated as a specialized Alzheimer’s services adult day care 114 center as provided in s. 429.918. The reimbursement rate for a 115 tier II center is the greater of the rate per day set by the 116 United States Department of Veterans Affairs for adult day care 117 services plus 30 percent or $110 per day. The reimbursement rate 118 must be adjusted on January 1 of each year. The adjustment may 119 not exceed the lesser of 3 percent or the increase in the 120 Consumer Price Index for All Urban Consumers, Southeast Region. 121 3. An adult day care center that provides transportation 122 services to a participant must be reimbursed for such services 123 at the rate paid by the applicable managed care organization to 124 a contracted nonemergency medical transportation vendor or, if 125 the adult day care center directly contracts with a nonemergency 126 medical transportation vendor of a managed care plan, the rate 127 paid by the contracted nonemergency medical transportation 128 vendor to its nonemergency medical transportation provider. 129 Section 2. Section 429.916, Florida Statutes, is created to 130 read: 131 429.916 Continuing education requirements for operators.— 132 (1) The purpose of this section is to establish 133 requirements and standards for continuing education courses for 134 operators managing the day-to-day operations of adult day care 135 centers in this state. 136 (2) In addition to any existing adult day care center staff 137 training required under this part or by department rule, an 138 operator must annually complete an 8-hour continuing education 139 course developed and offered by the Florida Adult Day Services 140 Association and approved by the department. The department may 141 approve additional educational providers to offer the course. 142 The content of the continuing education course must include 1 143 hour of training on each of the following topics: 144 (a) Compliance with requirements imposed by the agency. 145 (b) Alzheimer’s disease and related disorders. 146 (c) The state comprehensive emergency management plan. 147 (d) Combatting fraud, abuse, and neglect. 148 (e) Nonemergency medical transportation. 149 (f) Daily management training. 150 (g) Staff compliance with the participant care standards 151 adopted by the agency in rule 59A-16.103, Florida Administrative 152 Code. 153 (h) Compliance with the Health Insurance Portability and 154 Accountability Act. 155 (3) The department-approved continuing education course may 156 be offered in person or online. Upon completion of an online 157 course, an operator must pass a department-approved online exam 158 with a minimum score of 80 percent. An operator who attends the 159 course in person is exempt from the exam requirement. An 160 operator teaching an approved course of instruction or lecturing 161 at any approved seminar and attending the entire course or 162 seminar qualifies for the same number of classroom hours as 163 would be granted to a person taking and successfully completing 164 such course or seminar. Credit is limited to the number of hours 165 actually taught unless a person attends the entire course or 166 seminar. 167 (4) A person or an entity providing a course for continuing 168 education credit must furnish, within 30 days after completion 169 of the course, in a form satisfactory to the department or its 170 designee, a roster showing the adult day care center’s license 171 number and the names of the operators who successfully completed 172 such course and are requesting credit. 173 (5)(a) An operator’s compliance with the continuing 174 education requirements of this section is a condition precedent 175 to the issuance, continuation, reinstatement, or renewal of any 176 adult day care center license subject to this part. The 177 department may, for good cause shown, grant an operator an 178 extension of up to 1 year to complete the required continuing 179 education. An operator who is unable to comply with the 180 continuing education requirements of this section due to active 181 duty in the military must be granted a waiver by the department 182 upon submission of a waiver request and documentation of his or 183 her active duty status. 184 (b) Unless it has granted an operator an extension or a 185 waiver under paragraph (a), the department may not issue a 186 renewal license to an adult day care center until its operator 187 meets the requirements of this section. 188 Section 3. This act shall take effect July 1, 2025.