Florida Senate - 2026                                    SB 1630
       
       
        
       By Senator Grall
       
       
       
       
       
       29-00734B-26                                          20261630__
    1                        A bill to be entitled                      
    2         An act relating to aging and disability services;
    3         amending s. 409.979, F.S.; deleting expired
    4         requirements for Medicaid recipients to receive an
    5         offer for enrollment for long-term care services;
    6         requiring the Department of Elderly Affairs to
    7         maintain a statewide pre-enrollment list, rather than
    8         a wait list, for certain services; requiring aging and
    9         disability resource center personnel to place on and
   10         release certain clients from the pre-enrollment lists;
   11         requiring certain staff to administer a rescreening
   12         under certain circumstances; deleting a requirement
   13         for the Comprehensive Assessment and Review for Long
   14         term Care Services (CARES) program to conduct
   15         prerelease assessments; requiring an aging and
   16         disability resource center to conduct a prerelease
   17         assessment; authorizing individuals who meet financial
   18         and medical eligibility criteria to enroll in the
   19         long-term care managed care program; conforming
   20         provisions to changes made by the act; amending s.
   21         409.983, F.S.; requiring the CARES program to review
   22         or perform the initial assessment of an enrollee’s
   23         level of care; amending s. 430.03, F.S.; revising the
   24         purposes of the department to include the provision of
   25         services for certain programs under certain
   26         circumstances; amending s. 430.04, F.S.; making a
   27         technical change; creating s. 430.09, F.S.; providing
   28         procurement requirements for area agencies on aging
   29         expenditures; prohibiting an administrative employee
   30         of an area agency on aging from receiving a specified
   31         salary amount; providing construction; amending s.
   32         430.203, F.S.; revising definitions; amending s.
   33         430.204, F.S.; deleting certain funding
   34         responsibilities of the department and certain
   35         entities; prohibiting the area agency on aging from
   36         directly providing core services; providing an
   37         exception; deleting the responsibility of provider
   38         agencies to collect and assess fees for certain
   39         services; amending s. 430.205, F.S.; deleting certain
   40         funding responsibilities of the department; deleting
   41         construction; revising frequency of inservice training
   42         for certain providers; authorizing high-risk
   43         vulnerable adults to be given priority consideration
   44         for receiving community-care-for-the-elderly services;
   45         replacing the term “primary consideration” with
   46         “priority consideration”; amending s. 430.2053, F.S.;
   47         renaming aging resource centers as aging and
   48         disability resource centers; revising the purpose and
   49         duties of such centers; authorizing aging and
   50         disability resource centers to place and release
   51         certain individuals on or from pre-enrollment lists;
   52         deleting a requirement for an aging and disability
   53         resource center to convene a work group for certain
   54         purposes; deleting a requirement for an aging and
   55         disability resource center to provide enrollment and
   56         coverage information to certain individuals; requiring
   57         the aging and disability resource center to receive a
   58         waiver to be the provider of certain direct services;
   59         revising the programs to which the department and the
   60         agency on aging may not make payments; deleting an
   61         eligibility requirement for an area agency on aging to
   62         transition to an aging resource center; revising whom
   63         the department may consult with to develop capitation
   64         rates; revising construction; conforming provisions to
   65         changes made by the act; amending s. 430.503, F.S.;
   66         deleting the responsibility of provider agencies to
   67         collect and assess fees for certain purposes; amending
   68         s. 430.605, F.S.; revising certain subsidy payments to
   69         include food and nutritional supplements; creating s.
   70         430.72, F.S.; providing the purpose of and legislative
   71         intent for the Florida Alzheimer’s Center of
   72         Excellence; defining terms; providing powers and
   73         duties of the center; providing eligibility
   74         requirements for services; amending s. 430.901, F.S.;
   75         conforming provisions to changes made by the act;
   76         amending s. 744.2003, F.S.; revising professional and
   77         public guardians’ continuing education requirements to
   78         specifically include Alzheimer’s disease and related
   79         dementias; amending ss. 744.2004 and 744.20041, F.S.;
   80         revising disciplinary actions; amending s. 744.2104,
   81         F.S.; providing powers for the Office of Public and
   82         Professional Guardians in conducting certain
   83         investigations; reenacting s. 110.501(4), F.S.,
   84         relating to definitions, to incorporate the amendment
   85         made to s. 430.204, F.S., in a reference thereto;
   86         reenacting s. 430.504, F.S., relating to
   87         confidentiality of information, to incorporate the
   88         amendment made to s. 430.503, F.S., in a reference
   89         thereto; reenacting s. 430.603, F.S., relating to home
   90         care for the elderly and rules, to incorporate the
   91         amendment made to s. 430.605, F.S., in a reference
   92         thereto; providing an effective date.
   93          
   94  Be It Enacted by the Legislature of the State of Florida:
   95  
   96         Section 1. Subsections (2) and (3) of section 409.979,
   97  Florida Statutes, are amended to read:
   98         409.979 Eligibility.—
   99         (2) PRE-ENROLLMENT ENROLLMENT OFFERS.—Subject to the
  100  availability of funds, the Department of Elderly Affairs shall
  101  make offers for enrollment to eligible individuals based on a
  102  pre-enrollment list wait-list prioritization. Before making
  103  enrollment offers, the agency and the Department of Elderly
  104  Affairs shall determine that sufficient funds exist to support
  105  additional enrollment into plans.
  106         (a) A Medicaid recipient enrolled in one of the following
  107  Medicaid home and community-based services waiver programs who
  108  meets the eligibility criteria established in subsection (1) is
  109  eligible to participate in the long-term care managed care
  110  program and must be transitioned into the long-term care managed
  111  care program by January 1, 2018:
  112         1. Traumatic Brain and Spinal Cord Injury Waiver.
  113         2. Adult Cystic Fibrosis Waiver.
  114         3. Project AIDS Care Waiver.
  115         (b) The agency shall seek federal approval to terminate the
  116  Traumatic Brain and Spinal Cord Injury Waiver, the Adult Cystic
  117  Fibrosis Waiver, and the Project AIDS Care Waiver once all
  118  eligible Medicaid recipients have transitioned into the long
  119  term care managed care program.
  120         (3) PRE-ENROLLMENT WAIT LIST, RELEASE, AND OFFER PROCESS.
  121  The Department of Elderly Affairs shall maintain a statewide
  122  pre-enrollment wait list for enrollment for home and community
  123  based services through the long-term care managed care program.
  124         (a) The Department of Elderly Affairs shall prioritize
  125  individuals for potential enrollment for home and community
  126  based services through the long-term care managed care program
  127  using a frailty-based screening tool that results in a priority
  128  score. The priority score is used to set an order for releasing
  129  individuals from the pre-enrollment wait list for potential
  130  enrollment in the long-term care managed care program. If
  131  capacity is limited for individuals with identical priority
  132  scores, the individual with the oldest date of placement on the
  133  pre-enrollment wait list shall receive priority for release.
  134         1. Pursuant to s. 430.2053, aging and disability resource
  135  center personnel certified by the Department of Elderly Affairs
  136  shall perform the screening for each individual requesting
  137  enrollment for home and community-based services through the
  138  long-term care managed care program. Aging and disability
  139  resource center personnel shall place on and release from the
  140  pre-enrollment lists clients eligible for the Alzheimer’s
  141  Disease Initiative or the Community Care for the Elderly, Home
  142  Care for the Elderly, or Statewide Medicaid Managed Care Long
  143  Term Care programs. The Department of Elderly Affairs shall
  144  request that the individual or the individual’s authorized
  145  representative provide alternate contact names and contact
  146  information.
  147         2. The individual requesting the long-term care services,
  148  or the individual’s authorized representative, must participate
  149  in an initial screening or rescreening for placement on the pre
  150  enrollment wait list. The screening or rescreening must be
  151  completed in its entirety before placement on the pre-enrollment
  152  wait list.
  153         3. Pursuant to s. 430.2053, staff authorized and certified
  154  by the Department of Elderly Affairs aging resource center
  155  personnel shall administer rescreening annually or upon
  156  notification of a significant change in an individual’s
  157  circumstances for an individual with a high priority score.
  158  Aging and disability resource center personnel may administer
  159  rescreening annually or upon notification of a significant
  160  change in an individual’s circumstances for an individual with a
  161  low priority score.
  162         4. The Department of Elderly Affairs shall adopt by rule a
  163  screening tool that generates the priority score and shall make
  164  publicly available on its website the specific methodology used
  165  to calculate an individual’s priority score.
  166         (b) Upon completion of the screening or rescreening
  167  process, the Department of Elderly Affairs shall notify the
  168  individual or the individual’s authorized representative that
  169  the individual has been placed on the pre-enrollment wait list,
  170  unless the individual has a low priority score. The Department
  171  of Elderly Affairs must maintain contact information for each
  172  individual with a low priority score for purposes of any future
  173  rescreening. Aging and disability resource center personnel
  174  shall inform individuals with low priority scores of community
  175  resources available to assist them and inform them that they may
  176  contact the aging and disability resource center for a new
  177  assessment at any time if they experience a change in
  178  circumstances.
  179         (c) If the Department of Elderly Affairs is unable to
  180  contact the individual or the individual’s authorized
  181  representative to schedule an initial screening or rescreening,
  182  and documents the actions taken to make such contact, it shall
  183  send a letter to the last documented address of the individual
  184  or the individual’s authorized representative. The letter must
  185  advise the individual or his or her authorized representative
  186  that he or she must contact the Department of Elderly Affairs
  187  within 30 calendar days after the date of the notice to schedule
  188  a screening or rescreening and must notify the individual that
  189  failure to complete the screening or rescreening will result in
  190  his or her termination from the screening process and the pre
  191  enrollment wait list.
  192         (d) After notification by the agency of available capacity,
  193  the CARES program shall conduct a prerelease assessment. The
  194  Department of Elderly Affairs shall release individuals from the
  195  pre-enrollment wait list based on the priority scoring process
  196  and prerelease assessment results. The aging and disability
  197  resource center shall conduct a prerelease assessment. Upon
  198  release, individuals who meet all financial and medical
  199  eligibility criteria may enroll in the long-term care managed
  200  care program.
  201         (e) The Department of Elderly Affairs may terminate an
  202  individual’s inclusion on the pre-enrollment wait list if the
  203  individual:
  204         1. Does not have a current priority score due to the
  205  individual’s action or inaction;
  206         2. Requests to be removed from the pre-enrollment wait
  207  list;
  208         3. Does not keep an appointment to complete the rescreening
  209  without scheduling another appointment and has not responded to
  210  three documented attempts by the Department of Elderly Affairs
  211  to contact the individual;
  212         4. Receives an offer to begin the eligibility determination
  213  process for the long-term care managed care program; or
  214         5. Begins receiving services through the long-term care
  215  managed care program.
  216  
  217  An individual whose inclusion on the pre-enrollment wait list is
  218  terminated must initiate a new request for placement on the pre
  219  enrollment wait list, and any previous priority considerations
  220  must be disregarded.
  221         (f) Notwithstanding this subsection, the following
  222  individuals are afforded priority enrollment for home and
  223  community-based services through the long-term care managed care
  224  program and do not have to complete the screening or pre
  225  enrollment list wait-list process if all other long-term care
  226  managed care program eligibility requirements are met:
  227         1. An individual who is 18, 19, or 20 years of age who has
  228  a chronic debilitating disease or condition of one or more
  229  physiological or organ systems which generally make the
  230  individual dependent upon 24-hour-per-day medical, nursing, or
  231  health supervision or intervention.
  232         2. A nursing facility resident who requests to transition
  233  into the community and who has resided in a Florida-licensed
  234  skilled nursing facility for at least 60 consecutive days.
  235         3. An individual who is referred by the Department of
  236  Children and Families pursuant to the Adult Protective Services
  237  Act, ss. 415.101-415.113, as high risk and who is placed in an
  238  assisted living facility temporarily funded by the Department of
  239  Children and Families.
  240         (g) The Department of Elderly Affairs and the agency may
  241  adopt rules to implement this subsection.
  242         Section 2. Subsection (4) of section 409.983, Florida
  243  Statutes, is amended to read:
  244         409.983 Long-term care managed care plan payment.—In
  245  addition to the payment provisions of s. 409.968, the agency
  246  shall provide payment to plans in the long-term care managed
  247  care program pursuant to this section.
  248         (4) The initial assessment of an enrollee’s level of care
  249  shall be reviewed or performed made by the Comprehensive
  250  Assessment and Review for Long-Term Care Services (CARES)
  251  program, which shall assign the recipient into one of the
  252  following levels of care:
  253         (a) Level of care 1 consists of recipients residing in or
  254  who must be placed in a nursing home.
  255         (b) Level of care 2 consists of recipients at imminent risk
  256  of nursing home placement, as evidenced by the need for the
  257  constant availability of routine medical and nursing treatment
  258  and care, and who require extensive health-related care and
  259  services because of mental or physical incapacitation.
  260         (c) Level of care 3 consists of recipients at imminent risk
  261  of nursing home placement, as evidenced by the need for the
  262  constant availability of routine medical and nursing treatment
  263  and care, who have a limited need for health-related care and
  264  services and are mildly medically or physically incapacitated.
  265  
  266  The agency shall periodically adjust payment rates to account
  267  for changes in the level of care profile for each managed care
  268  plan based on encounter data.
  269         Section 3. Subsection (7) of section 430.03, Florida
  270  Statutes, is amended to read:
  271         430.03 Purposes.—The purposes of the Department of Elderly
  272  Affairs are to:
  273         (7) Oversee implementation of federally funded and state
  274  funded programs and services for the state’s elderly population.
  275  The department may provide direct services for the Community
  276  Care for the Elderly Program, Home Care for the Elderly Program,
  277  and Alzheimer’s Disease Initiative only in the event of a state
  278  of emergency or in the event a contracted service provider or
  279  subcontractor is unable to provide services.
  280         Section 4. Present paragraph (g) of subsection (2) of
  281  section 430.04, Florida Statutes, is redesignated as paragraph
  282  (h), a new paragraph (g) is added to that subsection, and
  283  paragraph (f) of that subsection is amended to read:
  284         430.04 Duties and responsibilities of the Department of
  285  Elderly Affairs.—The Department of Elderly Affairs shall:
  286         (2) Be responsible for ensuring that each area agency on
  287  aging operates in a manner to ensure that the elderly of this
  288  state receive the best services possible. The department shall
  289  rescind designation of an area agency on aging or take
  290  intermediate measures against the agency, including corrective
  291  action, unannounced special monitoring, temporary assumption of
  292  operation of one or more programs by the department, placement
  293  on probationary status, imposing a moratorium on agency action,
  294  imposing financial penalties for nonperformance, or other
  295  administrative action pursuant to chapter 120, if the department
  296  finds that:
  297         (f) The agency has failed to properly determine client
  298  eligibility as defined by the department.
  299         (g)The agency has failed to or efficiently manage program
  300  budgets.
  301         Section 5. Section 430.09, Florida Statutes, is created to
  302  read:
  303         430.09 Area agencies on aging expenditures.—
  304         (1)The procurement of commodities or contractual services
  305  by an area agency on aging and its subcontractors must comply
  306  with applicable state and federal law and follow all
  307  regulations.
  308         (a) In accordance with s. 287.017(2), area agencies on
  309  aging shall competitively procure all contracts.
  310         (b) The department shall impose financial consequences, as
  311  established by the department and incorporated into the
  312  contract, for noncompliance with applicable local, state, or
  313  federal law for the procurement of commodities or contractual
  314  services.
  315         (2) An administrative employee of an area agency on aging
  316  may not receive a salary in excess of 150 percent of the annual
  317  salary paid to the secretary of the Department of Elderly
  318  Affairs from state-appropriated funds, or from state
  319  appropriated federal funds. This limitation applies regardless
  320  of the number of contracts an area agency on aging may execute
  321  with the department. This subsection does not prohibit any party
  322  from providing compensation that is not from state funds to an
  323  area agency on aging administrative employee.
  324         Section 6. Subsections (3) and (5) and paragraph (c) of
  325  subsection (9) of section 430.203, Florida Statutes, are amended
  326  to read:
  327         430.203 Community care for the elderly; definitions.—As
  328  used in ss. 430.201-430.207, the term:
  329         (3) “Community care service system” means a service network
  330  comprising a variety of home-delivered services, day care
  331  services, and other basic services, hereinafter referred to as
  332  “core services,” for functionally impaired elderly persons which
  333  are provided by or through a designated single lead agency by
  334  the area agency on aging. Its purpose is to provide a continuum
  335  of care encompassing a full range of preventive, maintenance,
  336  and restorative services for functionally impaired elderly
  337  persons.
  338         (5) “Core services” means a variety of home-delivered
  339  services, day care services, and other basic services that may
  340  be provided by several entities. Core services are those
  341  services that are most needed to prevent unnecessary
  342  institutionalization. The area agency on aging shall not
  343  directly provide core services.
  344         (9) “Lead agency” means an agency designated at least once
  345  every 6 years by an area agency on aging as the result of a
  346  competitive procurement conducted through a request for
  347  proposal.
  348         (c) In each community care service system, the lead agency
  349  must be given the authority and responsibility to coordinate
  350  some or all of the services, either directly or through
  351  subcontracts, for functionally impaired elderly persons. These
  352  services must include case management, homemaker and chore
  353  services, respite care, adult day care, personal care services,
  354  home-delivered meals, counseling, information and referral, and
  355  emergency home repair services. The lead agency must compile
  356  community care statistics and monitor, when applicable,
  357  subcontracts with agencies providing core services.
  358         Section 7. Subsections (1), (4), (5), and (8) of section
  359  430.204, Florida Statutes, are amended to read:
  360         430.204 Community-care-for-the-elderly core services;
  361  departmental powers and duties.—
  362         (1)(a) The department shall fund, through each area agency
  363  on aging, at least one community care service system the primary
  364  purpose of which is the prevention of unnecessary
  365  institutionalization of functionally impaired elderly persons
  366  through the provision of community-based core services. Whenever
  367  feasible, an area agency on aging shall be the contracting
  368  agency of preference to engage only in the planning and funding
  369  of community-care-for-the-elderly core services for functionally
  370  impaired elderly persons.
  371         (b) The department shall fund, through each area agency on
  372  aging in each county as defined in s. 125.011(1), more than one
  373  community care service system the primary purpose of which is
  374  the prevention of unnecessary institutionalization of
  375  functionally impaired elderly persons through the provision of
  376  community-based core services.
  377         (4) The department or contracting agency shall contract for
  378  the provision of the core services required by a community care
  379  service area. The area agency on aging may not directly provide
  380  core services unless the designated lead agency is unable to
  381  perform its duties and the department approves.
  382         (5) Entities contracting to provide core services under ss.
  383  430.201-430.207 must provide a minimum of 10 percent of the
  384  funding necessary for the support of project operations. In-kind
  385  contributions, whether materials, commodities, transportation,
  386  office space, other types of facilities, or personal services,
  387  and contributions of money or services from functionally
  388  impaired elderly persons may be evaluated and counted as part or
  389  all of the required local funding.
  390         (8) Provider agencies are responsible for the collection of
  391  fees for services in accordance with rules adopted by the
  392  department. Provider agencies shall assess fees for services
  393  rendered in accordance with those rules. To help pay for
  394  services received from community care for the elderly, a
  395  functionally impaired elderly person shall be assessed a fee
  396  based on an overall ability to pay. The fee to be assessed shall
  397  be fixed according to a schedule established by the department
  398  in cooperation with area agencies, lead agencies, and service
  399  providers.
  400         Section 8. Subsections (1), (2), and (4) and paragraph (a)
  401  of subsection (5) of section 430.205, Florida Statutes, are
  402  amended to read:
  403         430.205 Community care service system.—
  404         (1)(a) The department, through the area agency on aging,
  405  shall fund in each planning and service area at least one
  406  community care service system that provides case management and
  407  other in-home and community services as needed to help the older
  408  person maintain independence and prevent or delay more costly
  409  institutional care.
  410         (b) The department shall fund, through the area agency on
  411  aging in each county as defined in s. 125.011(1), more than one
  412  community care service system that provides case management and
  413  other in-home and community services as needed to help elderly
  414  persons maintain independence and prevent or delay more costly
  415  institutional care.
  416         (2) Core services and other support services may be
  417  furnished by public or private agencies or organizations. Each
  418  community care service system must be under the direction of a
  419  lead agency that coordinates the activities of individual
  420  contracting agencies providing community-care-for-the-elderly
  421  services. When practicable, the activities of a community care
  422  service area may be directed from a multiservice senior center,
  423  as defined in s. 430.901, and coordinated with other services
  424  offered therein. This subsection does not require programs in
  425  existence prior to the effective date of this act to be
  426  relocated.
  427         (4) A preservice and annual inservice training program for
  428  community-care-for-the-elderly service providers and staff may
  429  be designed and implemented to help assure the delivery of
  430  quality services. The department shall specify in rules the
  431  training standards and requirements for the community-care-for
  432  the-elderly service providers and staff. Training must be
  433  sufficient to ensure that quality services are provided to
  434  clients and that appropriate skills are developed to conduct the
  435  program.
  436         (5) Any person who has been classified as a functionally
  437  impaired elderly person is eligible to receive community-care
  438  for-the-elderly core services.
  439         (a) Those elderly persons who are determined by protective
  440  investigations to be high risk vulnerable adults in need of
  441  services, pursuant to s. 415.104(3)(b), or to be victims of
  442  abuse, neglect, or exploitation who are in need of immediate
  443  services to prevent further harm and are referred by the adult
  444  protective services program, shall be given priority primary
  445  consideration for receiving community-care-for-the-elderly
  446  services. As used in this paragraph, the termpriority primary
  447  consideration” means that an assessment and services must
  448  commence within 72 hours after referral to the department or as
  449  established in accordance with department contracts by local
  450  protocols developed between department service providers and the
  451  adult protective services program. Regardless, a community-care
  452  for-the-elderly services provider may dispute a referral under
  453  this paragraph by requesting that adult protective services
  454  negotiate the referral placement of, and the services to be
  455  provided to, a vulnerable adult or victim of abuse, neglect, or
  456  exploitation. If an agreement cannot be reached with adult
  457  protective services for modification of the referral decision,
  458  the determination by adult protective services shall prevail.
  459         Section 9. Section 430.2053, Florida Statutes, is amended
  460  to read:
  461         430.2053 Aging and disability resource centers.—
  462         (1) The department, in consultation with the Agency for
  463  Health Care Administration and the Department of Children and
  464  Families, shall develop pilot projects for aging and disability
  465  resource centers.
  466         (2) The purposes of an aging and disability resource center
  467  shall be:
  468         (a) To provide Florida’s elders, adults with disabilities,
  469  and their families with a locally focused, coordinated approach
  470  to integrating information and referral for all available
  471  services for persons elders with the eligibility determination
  472  entities for state and federally funded long-term-care services.
  473         (b) To provide for easier access to long-term-care services
  474  by Florida’s elders, adults with disabilities, and their
  475  families by creating multiple access points to the long-term
  476  care network that flow through one established entity with wide
  477  community recognition.
  478         (3) The duties of an aging and disability resource center
  479  are to:
  480         (a) Develop referral agreements with local community
  481  service organizations, such as senior centers, existing elder
  482  service providers, volunteer associations, and other similar
  483  organizations, to better assist clients who do not need or do
  484  not wish to enroll in programs funded by the department or the
  485  agency. The referral agreements must also include a protocol,
  486  developed and approved by the department, which provides
  487  specific actions that an aging and disability resource center
  488  and local community service organizations must take when a
  489  person or a person’s an elder or an elder’s representative
  490  seeking information on long-term-care services contacts a local
  491  community service organization before prior to contacting the
  492  aging and disability resource center. The protocol shall be
  493  designed to ensure that persons elders and their families are
  494  able to access information and services in the most efficient
  495  and least cumbersome manner possible.
  496         (b) Provide an initial screening of all clients who request
  497  long-term-care services to determine whether the person would be
  498  most appropriately served through any combination of federally
  499  funded programs, state-funded programs, locally funded or
  500  community volunteer programs, or private funding for services.
  501         (c) Determine eligibility for the programs and services
  502  listed in subsection (9) for persons residing within the
  503  geographic area served by the aging and disability resource
  504  center and determine a priority ranking for services which is
  505  based upon the potential recipient’s frailty level and
  506  likelihood of institutional placement without such services.
  507         (d) Place on and release from the pre-enrollment lists
  508  clients eligible for the Alzheimer’s Disease Initiative or the
  509  Community Care for the Elderly, Home Care for the Elderly, or
  510  Statewide Medicaid Managed Care Long-term Care programs.
  511         (e) Manage the availability of financial resources for the
  512  programs and services listed in subsection (9) for persons
  513  residing within the geographic area served by the aging and
  514  disability resource center.
  515         (f)(e) When financial resources become available, refer a
  516  client to the most appropriate entity to begin receiving
  517  services. The aging and disability resource center shall make
  518  referrals to lead agencies for service provision that ensure
  519  that persons individuals who are vulnerable adults in need of
  520  services pursuant to s. 415.104(3)(b), or who are victims of
  521  abuse, neglect, or exploitation in need of immediate services to
  522  prevent further harm and are referred by the adult protective
  523  services program, are given priority primary consideration for
  524  receiving community-care-for-the-elderly services in compliance
  525  with the requirements of s. 430.205(5)(a) and that other
  526  referrals for services are in compliance with s. 430.205(5)(b).
  527         (f) Convene a work group to advise in the planning,
  528  implementation, and evaluation of the aging resource center. The
  529  work group shall be comprised of representatives of local
  530  service providers, Alzheimer’s Association chapters, housing
  531  authorities, social service organizations, advocacy groups,
  532  representatives of clients receiving services through the aging
  533  resource center, and any other persons or groups as determined
  534  by the department. The aging resource center, in consultation
  535  with the work group, must develop annual program improvement
  536  plans that shall be submitted to the department for
  537  consideration. The department shall review each annual
  538  improvement plan and make recommendations on how to implement
  539  the components of the plan.
  540         (g) Enhance the existing area agency on aging in each
  541  planning and service area by integrating, either physically or
  542  virtually, the staff and services of the area agency on aging
  543  with the staff of the department’s local CARES Medicaid
  544  preadmission screening unit and a sufficient number of staff
  545  from the Department of Children and Families’ Economic Self
  546  Sufficiency Unit necessary to determine the financial
  547  eligibility for all persons age 60 and older residing within the
  548  area served by the aging and disability resource center that are
  549  seeking Medicaid services, Supplemental Security Income, and
  550  food assistance.
  551         (h) Assist clients who request long-term care services in
  552  being evaluated for eligibility for enrollment in the Medicaid
  553  long-term care managed care program as eligible plans become
  554  available in each of the regions pursuant to s. 409.981(2).
  555         (i) Provide enrollment and coverage information to Medicaid
  556  managed long-term care enrollees as qualified plans become
  557  available in each of the regions pursuant to s. 409.981(2).
  558         (j) Assist Medicaid recipients enrolled in the Medicaid
  559  long-term care managed care program with informally resolving
  560  grievances with a managed care network and assist Medicaid
  561  recipients in accessing the managed care network’s formal
  562  grievance process as eligible plans become available in each of
  563  the regions defined in s. 409.981(2).
  564         (4) The department shall select the entities to become
  565  aging and disability resource centers based on each entity’s
  566  readiness and ability to perform the duties listed in subsection
  567  (3) and the entity’s:
  568         (a) Expertise in the needs of each target population the
  569  center proposes to serve and a thorough knowledge of the
  570  providers that serve these populations.
  571         (b) Strong connections to service providers, volunteer
  572  agencies, and community institutions.
  573         (c) Expertise in information and referral activities.
  574         (d) Knowledge of long-term-care resources, including
  575  resources designed to provide services in the least restrictive
  576  setting.
  577         (e) Financial solvency and stability.
  578         (f) Ability to collect, monitor, and analyze data in a
  579  timely and accurate manner, along with systems that meet the
  580  department’s standards.
  581         (g) Commitment to adequate staffing by qualified personnel
  582  to effectively perform all functions.
  583         (h) Ability to meet all performance standards established
  584  by the department.
  585         (5) The aging and disability resource center shall have a
  586  governing body which shall be the same entity described in s.
  587  20.41(7), and an executive director who may be the same person
  588  as described in s. 20.41(7). The governing body shall annually
  589  evaluate the performance of the executive director.
  590         (6) The aging and disability resource center may not be a
  591  provider of direct services other than information and referral
  592  services, outreach, and screening, and intake. The aging and
  593  disability resource center must receive a waiver from the
  594  department to be the provider of any other direct services.
  595         (7) The aging and disability resource center must agree to
  596  allow the department to review any financial information the
  597  department determines is necessary for monitoring or reporting
  598  purposes, including financial relationships.
  599         (8) The duties and responsibilities of the community care
  600  for the elderly lead agencies within each area served by an
  601  aging and disability resource center shall be to:
  602         (a) Develop strong community partnerships to maximize the
  603  use of community resources for the purpose of assisting persons
  604  elders to remain in their community settings for as long as it
  605  is safely possible.
  606         (b) Conduct comprehensive assessments of clients that have
  607  been determined eligible and develop a care plan consistent with
  608  established protocols that ensures that the unique needs of each
  609  client are met.
  610         (9) The services to be administered through the aging and
  611  disability resource center shall include those funded by the
  612  following programs:
  613         (a) Community care for the elderly.
  614         (b) Home care for the elderly.
  615         (c) Contracted services.
  616         (d) Alzheimer’s disease initiative.
  617         (e) Older Americans Act.
  618         (10) The department shall, before prior to designation of
  619  an aging and disability resource center, develop by rule
  620  operational and quality assurance standards and outcome measures
  621  to ensure that clients receiving services through all long-term
  622  care programs administered through an aging and disability
  623  resource center are receiving the appropriate care they require
  624  and that contractors and subcontractors are adhering to the
  625  terms of their contracts and are acting in the best interests of
  626  the clients they are serving, consistent with the intent of the
  627  Legislature to reduce the use of and cost of nursing home care.
  628  The department shall by rule provide operating procedures for
  629  aging and disability resource centers, which shall include:
  630         (a) Minimum standards for financial operation, including
  631  audit procedures.
  632         (b) Procedures for monitoring and sanctioning of service
  633  providers.
  634         (c) Minimum standards for technology utilized by the aging
  635  and disability resource center.
  636         (d) Minimum staff requirements which shall ensure that the
  637  aging and disability resource center employs sufficient quality
  638  and quantity of staff to adequately meet the needs of the elders
  639  residing within the area served by the aging and disability
  640  resource center.
  641         (e) Minimum accessibility standards, including hours of
  642  operation.
  643         (f) Minimum oversight standards for the governing body of
  644  the aging and disability resource center to ensure its
  645  continuous involvement in, and accountability for, all matters
  646  related to the development, implementation, staffing,
  647  administration, and operations of the aging and disability
  648  resource center.
  649         (g) Minimum education and experience requirements for
  650  executive directors and other executive staff positions of aging
  651  and disability resource centers.
  652         (h) Minimum requirements regarding any executive staff
  653  positions that the aging and disability resource center must
  654  employ and minimum requirements that a candidate must meet in
  655  order to be eligible for appointment to such positions.
  656         (11) In an area in which the department has designated an
  657  area agency on aging as an aging and disability resource center,
  658  the department and the agency may shall not make payments for
  659  the services listed in subsection (9) and the Statewide Medicaid
  660  Managed Care Long-term Care Program Long-Term Care Community
  661  Diversion Project for such persons who were not screened and
  662  enrolled through the aging and disability resource center. The
  663  department shall cease making payments for recipients in
  664  eligible plans as eligible plans become available in each of the
  665  regions defined in s. 409.981(2).
  666         (12) Each aging and disability resource center shall enter
  667  into a memorandum of understanding with the department for
  668  collaboration with the CARES unit staff. The memorandum of
  669  understanding shall outline the staff person responsible for
  670  each function and shall provide the staffing levels necessary to
  671  carry out the functions of the aging and disability resource
  672  center.
  673         (13) Each aging and disability resource center shall enter
  674  into a memorandum of understanding with the Department of
  675  Children and Families for collaboration with the Economic Self
  676  Sufficiency Unit staff. The memorandum of understanding shall
  677  outline which staff persons are responsible for which functions
  678  and shall provide the staffing levels necessary to carry out the
  679  functions of the aging and disability resource center.
  680         (14) If any of the state activities described in this
  681  section are outsourced, either in part or in whole, the contract
  682  executing the outsourcing shall mandate that the contractor or
  683  its subcontractors shall, either physically or virtually,
  684  execute the provisions of the memorandum of understanding
  685  instead of the state entity whose function the contractor or
  686  subcontractor now performs.
  687         (15)(a)In order to be eligible to begin transitioning to
  688  an aging resource center, an area agency on aging board must
  689  ensure that the area agency on aging which it oversees meets all
  690  of the minimum requirements set by law and in rule.
  691         (16)(a)Once an aging resource center is operational, The
  692  department, in consultation with the aging and disability
  693  resource center agency, may develop capitation rates for any of
  694  the programs administered through the agency aging resource
  695  center. Capitation rates for programs shall be based on the
  696  historical cost experience of the state in providing those same
  697  services to the population age 60 or older residing within each
  698  area served by an aging and disability resource center. Each
  699  capitated rate may vary by geographic area as determined by the
  700  department.
  701         (b) The department and the agency may determine for each
  702  area served by an aging and disability resource center whether
  703  it is appropriate, consistent with federal and state laws and
  704  regulations, to develop and pay separate capitated rates for
  705  each program administered through the aging and disability
  706  resource center or to develop and pay capitated rates for
  707  service packages which include more than one program or service
  708  administered through the aging and disability resource center.
  709         (c) Once capitation rates have been developed and certified
  710  as actuarially sound, the department and the agency may pay
  711  service providers the capitated rates for services when
  712  appropriate.
  713         (d) The department, in consultation with the agency, shall
  714  annually reevaluate and recertify the capitation rates,
  715  adjusting forward to account for inflation, programmatic
  716  changes.
  717         (16)(17) This section does shall not be construed to allow
  718  an aging and disability resource center to restrict, manage, or
  719  impede the local fundraising activities of service providers.
  720         Section 10. Section 430.503, Florida Statutes, is amended
  721  to read:
  722         430.503 Alzheimer’s Disease Initiative; short title fees
  723  and administrative expense.—
  724         (1) Sections 430.501-430.504 may be cited as the
  725  “Alzheimer’s Disease Initiative.”
  726         (2) Provider agencies are responsible for the collection of
  727  fees for services in accordance with rules adopted by the
  728  department. Provider agencies shall assess fees for services
  729  rendered in accordance with those rules. To help pay for
  730  services received pursuant to the Alzheimer’s Disease
  731  Initiative, a functionally impaired elderly person shall be
  732  assessed a fee based on an overall ability to pay. The fee to be
  733  assessed shall be fixed according to a schedule to be
  734  established by the department. Services of specified value may
  735  be accepted in lieu of a fee. The fee schedule shall be
  736  developed in cooperation with the Alzheimer’s Disease Advisory
  737  Committee, area agencies on aging, and service providers.
  738         Section 11. Subsection (3) of section 430.605, Florida
  739  Statutes, is amended to read:
  740         430.605 Subsidy payments.—The department shall develop a
  741  schedule of subsidy payments to be made to persons providing
  742  home care, and to providers of goods and services, for certain
  743  eligible elderly persons. Payments must be based on the
  744  financial status of the person receiving care. Payments must
  745  include, but need not be limited to:
  746         (3) When necessary, special supplements to provide for any
  747  goods and services, including food and nutritional supplements,
  748  and specialized care required to maintain the health, safety,
  749  and well-being of the elderly person. Extraordinary medical,
  750  dental, or pharmaceutical expenses may be paid as a special
  751  supplement.
  752         Section 12. Section 430.72, Florida Statutes, is created to
  753  read:
  754         430.72 Florida Alzheimer’s Center of Excellence.—
  755         (1) PURPOSE AND INTENT.—
  756         (a)The purpose of this section is to assist and support
  757  persons with Alzheimer’s disease or related forms of dementia
  758  and their caregivers by connecting them with resources in their
  759  communities. The Legislature intends to create a holistic care
  760  model for persons with Alzheimer’s disease or related forms of
  761  dementia and their caregivers to address two primary goals:
  762         1. To allow Floridians living with Alzheimer’s disease or
  763  related forms of dementia to age in place.
  764         2. To empower family caregivers to improve their own well
  765  being.
  766         (b) The development of innovative approaches to program
  767  management, staff training, and service delivery which have an
  768  impact on cost-avoidance, cost-effectiveness, and program
  769  efficiency is encouraged.
  770         (2) DEFINITIONS.—As used in this section, the term:
  771         (a) “Center” means the Florida Alzheimer’s Center of
  772  Excellence.
  773         (b) “Department” means the Department of Elderly Affairs.
  774         (3) POWERS AND DUTIES.—
  775         (a) There is created within the department the Florida
  776  Alzheimer’s Center of Excellence, which shall be responsible for
  777  improving the quality of care for persons living with
  778  Alzheimer’s disease or related forms of dementia and improved
  779  quality of life for family caregivers.
  780         (b) The center shall aim to address, at a minimum, all of
  781  the following:
  782         1. Early and accurate diagnosis.
  783         2. Caregiver health.
  784         3. Improved access to care.
  785         4. Health care use costs.
  786         5. Strengthening a dementia-capable workforce.
  787         6. Underreporting of Alzheimer’s disease and related forms
  788  of dementia.
  789         7. Disparities in access to dementia care.
  790         (c) The center shall provide caregivers access to services,
  791  including, but not limited to, all of the following:
  792         1. Care consultation.
  793         2. Support groups.
  794         3. Education and training programs.
  795         4. Caregiver support services such as:
  796         a. Caregiver companions.
  797         b. Caregiver wellness programs.
  798         c. Care support teams.
  799         d. Technology-based services.
  800         e. Coordinating or monitoring care and services.
  801         f. Assistance in obtaining diagnosis or prognosis of
  802  dementia.
  803         g. Assistance in obtaining end-of-life care.
  804         h. Assistance connecting to resources for medical care.
  805         i. Assistance with planning for current or future care.
  806         j. Guidance for coping with relationship changes for
  807  persons with dementia and their caregivers.
  808         k. Skills for communicating with persons with dementia.
  809         l. Understanding or managing behavioral symptoms of
  810  dementia.
  811         (d) The center shall work with area agencies on aging; the
  812  Alzheimer’s Disease Advisory Committee; the Alzheimer’s Disease
  813  Initiative, including the state-funded memory disorder clinics;
  814  the Dementia Care and Cure Initiative; universities; hospitals;
  815  and other available community resources to ensure full use of
  816  the state’s infrastructure.
  817         (e) As necessary to fulfill its duties under this section,
  818  the center may provide direct services or contract for the
  819  provision of services.
  820         (4) ELIGIBILITY FOR SERVICES.—
  821         (a) Persons seeking assistance from the center must meet
  822  all of the following criteria to be eligible for services:
  823         1. At least one person in the household is a caregiver for
  824  a person who has been diagnosed with, or is suspected of having,
  825  Alzheimer’s disease or a related form of dementia.
  826         2. The caregiver or person diagnosed with, or suspected of
  827  having, Alzheimer’s disease or a related form of dementia is a
  828  resident of this state.
  829         3. Have the goal of providing in-home care for the person
  830  who has been diagnosed with, or is suspected of having,
  831  Alzheimer’s disease or a related form of dementia.
  832         (b) If the person seeking assistance meets the criteria in
  833  paragraph (a), the center may provide assistance to the
  834  caregiving family, subject to the availability of funds and
  835  resources.
  836         Section 13. Subsection (2) of section 430.901, Florida
  837  Statutes, is amended to read:
  838         430.901 Multiservice senior center; definition; purpose.—A
  839  “multiservice senior center” is:
  840         (2) An entity that may partner with an aging and disability
  841  resource center to provide for easier access to long-term care
  842  services by seniors and their families who reside within the
  843  local community.
  844         Section 14. Subsection (3) of section 744.2003, Florida
  845  Statutes, is amended to read:
  846         744.2003 Regulation of professional guardians; application;
  847  bond required; educational requirements.—
  848         (3) Each professional guardian as defined in s. 744.102(17)
  849  and public guardian must receive a minimum of 40 hours of
  850  instruction and training. Each professional guardian must
  851  receive a minimum of 30 hours of continuing education every 2
  852  calendar years after the year in which the initial 40-hour
  853  educational requirement is met. The required continuing
  854  education must include at least 2 hours on fiduciary
  855  responsibilities; 2 hours on professional ethics; 1 hour on
  856  advance directives; 1 hour on Alzheimer’s disease and related
  857  dementias; 3 hours on abuse, neglect, and exploitation; and 3 4
  858  hours on guardianship law. The instruction and education must be
  859  completed through a course approved or offered by the Office of
  860  Public and Professional Guardians. The expenses incurred to
  861  satisfy the educational requirements prescribed in this section
  862  may not be paid with the assets of any ward. This subsection
  863  does not apply to any attorney licensed to practice law in this
  864  state or an institution acting as guardian under s. 744.2002(7).
  865         Section 15. Subsection (2) of section 744.2004, Florida
  866  Statutes, is amended to read:
  867         744.2004 Complaints; disciplinary proceedings; penalties;
  868  enforcement.—
  869         (2) The Office of Public and Professional Guardians shall
  870  establish disciplinary proceedings, conduct hearings, and take
  871  administrative action pursuant to chapter 120. Disciplinary
  872  actions may include, but are not limited to, requiring a
  873  professional guardian to participate in additional educational
  874  courses provided or approved by the Office of Public and
  875  Professional Guardians, imposing additional monitoring by the
  876  Office of Public and Professional Guardians, imposing a fine
  877  office of the guardianships to which the professional guardian
  878  is appointed, and suspension or revocation of a professional
  879  guardian’s registration.
  880         Section 16. Paragraph (g) is added to subsection (2) of
  881  section 744.20041, Florida Statutes, to read:
  882         744.20041 Grounds for discipline; penalties; enforcement.—
  883         (2) When the Office of Public and Professional Guardians
  884  finds a professional guardian guilty of violating subsection
  885  (1), it may enter an order imposing one or more of the following
  886  penalties:
  887         (g)Requirement that the professional guardian pay a fine,
  888  not to exceed $500 per violation.
  889         Section 17. Present subsection (2) of section 744.2104,
  890  Florida Statutes, is redesignated as subsection (4), and a new
  891  subsection (2) and subsection (3) are added to that section, to
  892  read:
  893         744.2104 Access to records by the Office of Public and
  894  Professional Guardians; confidentiality.—
  895         (2)In conducting an investigation, the Office of Public
  896  and Professional Guardians may issue subpoenas duces tecum to
  897  financial institutions, insurance companies, the ward’s
  898  caregivers, any facility in which the ward is residing or has
  899  resided, and the facility’s professional guardians or employees
  900  to compel the production of records relevant to the
  901  investigation conducted by the office.
  902         (3)If there is substantial noncompliance with a subpoena
  903  duces tecum issued by the Office of Public and Professional
  904  Guardians, the office may petition the court in the county in
  905  which the noncompliant person resides or has her or his place of
  906  business for an order requiring the person to produce such
  907  records as specified in the subpoena duces tecum.
  908         Section 18. For the purpose of incorporating the amendment
  909  made by this act to section 430.204, Florida Statutes, in a
  910  reference thereto, subsection (4) of section 110.501, Florida
  911  Statutes, is reenacted to read:
  912         110.501 Definitions.—As used in this act:
  913         (4) “Volunteer” means any person who, of his or her own
  914  free will, provides goods or services, or conveys an interest in
  915  or otherwise consents to the use of real property pursuant to
  916  chapter 260, to any state department or agency, or nonprofit
  917  organization, with no monetary or material compensation. A
  918  person registered and serving in Older American Volunteer
  919  Programs authorized by the Domestic Volunteer Service Act of
  920  1973, as amended (Pub. L. No. 93-113), shall also be defined as
  921  a volunteer and shall incur no civil liability as provided by s.
  922  768.1355. A volunteer shall be eligible for payment of volunteer
  923  benefits as specified in Pub. L. No. 93-113, this section, and
  924  s. 430.204.
  925         Section 19. For the purpose of incorporating the amendment
  926  made by this act to section 430.503, Florida Statutes, in a
  927  reference thereto, section 430.504, Florida Statutes, is
  928  reenacted to read:
  929         430.504 Confidentiality of information.—Information about
  930  clients of programs created or funded under s. 430.501 or s.
  931  430.503 which is received through files, reports, inspections,
  932  or otherwise, by the department or by authorized departmental
  933  employees, by persons who volunteer services, or by persons who
  934  provide services to clients of programs created or funded under
  935  s. 430.501 or s. 430.503 through contracts with the department
  936  is confidential and exempt from the provisions of s. 119.07(1).
  937  Such information may not be disclosed publicly in such a manner
  938  as to identify a person who receives services under s. 430.501
  939  or s. 430.503, unless that person or that person’s legal
  940  guardian provides written consent.
  941         Section 20. For the purpose of incorporating the amendment
  942  made by this act to section 430.605, Florida Statutes, in a
  943  reference thereto, section 430.603, Florida Statutes, is
  944  reenacted to read:
  945         430.603 Home care for the elderly; rules.—The department
  946  shall by rule establish minimum standards and procedures for the
  947  provision of home care for the elderly and for the approval of
  948  persons seeking to provide such care. Any person who is approved
  949  to provide care, goods, or services for an elderly person shall
  950  be eligible for the subsidy payments described in s. 430.605.
  951  However, the home care for the elderly program must be operated
  952  within the funds appropriated by the Legislature.
  953         Section 21. This act shall take effect July 1, 2026.