Florida Senate - 2025 SB 1156
By Senator Harrell
31-01398B-25 20251156__
1 A bill to be entitled
2 An act relating to the home health aide for medically
3 fragile children program; amending s. 400.4765, F.S.;
4 revising the training requirements for family
5 caregivers participating in the program; specifying
6 that services provided by a home health aide for a
7 medically fragile child may not exceed a specified
8 percentage of the total annual hours authorized for
9 private duty nursing services for that child; revising
10 requirements for the Medicaid fee schedule for home
11 health aides for medically fragile children; requiring
12 the Agency for Health Care Administration, within a
13 specified timeframe, to seek federal approval to
14 implement specified practices under the program;
15 amending s. 400.54, F.S.; requiring Medicaid managed
16 care plans to provide certain data to the agency as
17 part of an annual assessment of the home health aide
18 for medically fragile children program; revising
19 requirements for such assessment; providing a
20 directive to the Division of Law Revision; providing
21 an effective date.
22
23 Be It Enacted by the Legislature of the State of Florida:
24
25 Section 1. Paragraph (a) of subsection (3) and subsection
26 (9) of section 400.4765, Florida Statutes, are amended, and
27 subsection (10) is added to that section, to read:
28 400.4765 Home health aide for medically fragile children
29 program.—
30 (3) TRAINING.—
31 (a) The agency, in consultation with the Board of Nursing,
32 shall approve home health aide for medically fragile children
33 training programs developed by home health agencies in
34 accordance with 42 C.F.R. ss. 483.151-483.154 and 484.80 to
35 train family caregivers as home health aides for medically
36 fragile children to increase the health care provider workforce
37 and to authorize persons to provide trained nursing services as
38 delegated by a registered nurse to eligible relatives. The
39 program must include consist of at least 85 hours of training,
40 including, but need not be limited to, all of the following:
41 1. A minimum of 20 40 hours of theoretical instruction in
42 nursing, including, but not limited to, instruction on all of
43 the following:
44 a. Person-centered care.
45 b. Communication and interpersonal skills.
46 c. Infection control.
47 d. Safety and emergency procedures.
48 e. Assistance with activities of daily living.
49 f. Mental health and social service needs.
50 g. Care of cognitively impaired individuals.
51 h. Basic restorative care and rehabilitation.
52 i. Patient rights and confidentiality of personal
53 information and medical records.
54 j. Relevant legal and ethical issues.
55
56 Such instruction must be offered in various formats, and any
57 interactive instruction must be provided during various times of
58 the day.
59 2. Up to A minimum of 20 hours of skills training on basic
60 nursing skills, tailored to the child’s care needs as specified
61 in the ordering provider’s plan of care, which may include
62 training on the following topics, as applicable including, but
63 not limited to:
64 a. Hygiene, grooming, and toileting.
65 b. Skin care and pressure sore prevention.
66 c. Nutrition and hydration.
67 d. Measuring vital signs, height, and weight.
68 e. Safe lifting, positioning, and moving of patients.
69 f. Wound care.
70 g. Portable Oxygen use and safety and other respiratory
71 procedures.
72 h. Tracheostomy care.
73 i. Enteral care and therapy.
74 j. Peripheral Intravenous assistive activities and
75 alternative feeding methods.
76 k. Urinary catheterization and care and ostomy care.
77 3. Up to At least 16 hours of clinical training related to
78 the specific needs of the eligible relative, under direct
79 supervision of a licensed registered nurse.
80 4. Training concerning HIV infections and AIDS. and is
81 required to obtain and maintain
82 5. Obtaining and maintaining a current certificate in
83 cardiopulmonary resuscitation.
84 (9) FEE SCHEDULE.—The agency shall modify any state
85 Medicaid plans and implement any federal waivers necessary to
86 implement this section and shall establish a Medicaid fee
87 schedule for home health agencies employing a home health aide
88 for medically fragile children at a minimum rate of $25 per hour
89 with a utilization cap of no more than 12 8 hours per day per
90 medically fragile child. If a home health aide for medically
91 fragile children works more than 40 hours per week,
92 justification must be provided as to why there is no other
93 qualified provider available, and the request must be approved
94 by the home health agency and the managed care plan.
95 (10) FEDERAL APPROVAL.—Within 30 days after this act
96 becomes a law, the agency shall seek federal approval through
97 any necessary Medicaid waiver or state plan amendment to:
98 (a) Allow Medicaid private duty nursing specialty providers
99 and home health services providers to participate in and receive
100 reimbursement for services rendered under the program.
101 (b) Establish that the income earned under the program by a
102 home health aide for medically fragile children must be
103 disregarded in eligibility considerations for public assistance
104 as defined in s. 414.0252.
105 Section 2. Section 400.54, Florida Statutes, is amended to
106 read:
107 400.54 Annual assessment of the home health aide for
108 medically fragile children program.—The agency shall conduct an
109 annual assessment of the home health aide for medically fragile
110 children program. The assessment must report caregiver
111 satisfaction with the program and, identify additional support
112 that may be needed by the home health aide for medically fragile
113 children. The managed care plan shall provide to the agency the
114 data necessary to, and assess the rate and extent of
115 hospitalization of children in home health services who are
116 attended by a home health aide for medically fragile children
117 compared to those in home health services provided by a
118 registered nurse or licensed practical nurse without a home
119 health aide for medically fragile children. The agency shall
120 include in the assessment data on any adverse incident occurring
121 under the care of a home health aide for medically fragile
122 children. By January 1 of each year, beginning January 1, 2025,
123 the agency shall report its findings to the Governor, the
124 President of the Senate, and the Speaker of the House of
125 Representatives.
126 Section 3. The Division of Law Revision is directed to
127 replace the phrase “this act becomes a law” wherever it occurs
128 in this act with the date this act becomes a law.
129 Section 4. This act shall take effect upon becoming a law.