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.