Florida Senate - 2026                             CS for SB 1630
       
       
        
       By the Committee on Children, Families, and Elder Affairs; and
       Senator Grall
       
       
       
       
       586-02241-26                                          20261630c1
    1                        A bill to be entitled                      
    2         An act relating to aging and disability services;
    3         amending s. 409.979, F.S.; requiring the Department of
    4         Elderly Affairs to maintain a statewide pre-enrollment
    5         list, rather than a wait list, for certain services;
    6         deleting expired requirements for Medicaid recipients
    7         to receive an offer for enrollment for long-term care
    8         services; requiring aging and disability resource
    9         center personnel to place on and release certain
   10         clients from the pre-enrollment lists; requiring
   11         certain staff to administer a rescreening under
   12         certain circumstances; deleting a requirement for the
   13         Comprehensive Assessment and Review for Long-term Care
   14         Services (CARES) program to conduct prerelease
   15         assessments; requiring an aging and disability
   16         resource center to conduct a prerelease assessment;
   17         authorizing individuals who meet financial and medical
   18         eligibility criteria to enroll in the long-term care
   19         managed care program; conforming provisions to changes
   20         made by the act; amending s. 409.983, F.S.; requiring
   21         the CARES program to review or perform the initial
   22         assessment of an enrollee’s level of care; amending s.
   23         430.03, F.S.; revising the purposes of the department
   24         to include the provision of services for certain
   25         programs only under certain circumstances; amending s.
   26         430.04, F.S.; making a technical change; creating s.
   27         430.09, F.S.; providing procurement requirements for
   28         area agencies on aging; prohibiting an administrative
   29         employee of an area agency on aging from receiving a
   30         specified salary amount; providing construction;
   31         amending s. 430.203, F.S.; revising definitions;
   32         amending s. 430.204, F.S.; deleting certain funding
   33         responsibilities of the department and certain
   34         entities; prohibiting the area agency on aging from
   35         directly providing core services; providing
   36         exceptions; deleting the responsibility of provider
   37         agencies to collect and assess fees for certain
   38         services; amending s. 430.205, F.S.; deleting certain
   39         funding responsibilities of the department; deleting a
   40         provision providing construction; revising frequency
   41         of inservice training for certain providers; requiring
   42         that high-risk vulnerable adults be given priority
   43         consideration for receiving community-care-for-the
   44         elderly services; replacing the term “primary
   45         consideration” with “priority consideration”; amending
   46         s. 430.2053, F.S.; renaming aging resource centers as
   47         aging and disability resource centers; revising the
   48         purposes and duties of such centers; authorizing aging
   49         and disability resource centers to place on and
   50         release certain individuals from pre-enrollment lists;
   51         deleting a requirement for a work group to be
   52         convened; deleting a requirement to provide enrollment
   53         and coverage information to certain individuals;
   54         requiring the aging and disability resource center to
   55         receive a waiver from the department to be the
   56         provider of certain direct services; revising the
   57         services for which the department and an area agency
   58         on aging may not make payments; deleting an
   59         eligibility requirement for an area agency on aging to
   60         transition to an aging resource center; revising with
   61         whom the department may consult to develop capitation
   62         rates; revising construction; conforming provisions to
   63         changes made by the act; amending s. 430.503, F.S.;
   64         deleting the responsibility of provider agencies to
   65         collect and assess fees for certain purposes; amending
   66         s. 430.605, F.S.; revising certain subsidy payments to
   67         include food and nutritional supplements; creating s.
   68         430.72, F.S.; providing the purpose of and legislative
   69         intent for the Florida Alzheimer’s Center of
   70         Excellence; encouraging certain actions related to
   71         innovative and efficient program development; defining
   72         terms; providing powers and duties of the center;
   73         requiring the center to work with specified entities
   74         to ensure full use of state infrastructure;
   75         authorizing the center to provide direct services or
   76         contract for the provision of services; providing
   77         eligibility criteria for services; authorizing the
   78         center to provide assistance to persons meeting such
   79         criteria, subject to availability of funds and
   80         resources; amending s. 430.901, F.S.; conforming
   81         provisions to changes made by the act; amending s.
   82         744.2003, F.S.; revising professional and public
   83         guardians’ continuing education requirements to
   84         include Alzheimer’s disease and related dementias;
   85         amending ss. 744.2004 and 744.20041, F.S.; revising
   86         certain disciplinary actions and penalties; amending
   87         s. 744.2104, F.S.; authorizing the Office of Public
   88         and Professional Guardians to issue certain subpoenas
   89         to certain entities to compel the production of
   90         records in conducting certain investigations;
   91         authorizing the office to petition the court for a
   92         certain purpose under certain circumstances;
   93         reenacting s. 110.501(4), F.S., relating to
   94         definitions, to incorporate the amendment made to s.
   95         430.204, F.S., in a reference thereto; reenacting s.
   96         430.504, F.S., relating to confidentiality of
   97         information, to incorporate the amendment made to s.
   98         430.503, F.S., in a reference thereto; reenacting s.
   99         430.603, F.S., relating to home care for the elderly
  100         and rules, to incorporate the amendment made to s.
  101         430.605, F.S., in a reference thereto; providing an
  102         effective date.
  103          
  104  Be It Enacted by the Legislature of the State of Florida:
  105  
  106         Section 1. Subsections (2) and (3) of section 409.979,
  107  Florida Statutes, are amended to read:
  108         409.979 Eligibility.—
  109         (2) PRE-ENROLLMENT ENROLLMENT OFFERS.—Subject to the
  110  availability of funds, the Department of Elderly Affairs shall
  111  make offers for enrollment to eligible individuals based on a
  112  pre-enrollment list wait-list prioritization. Before making
  113  enrollment offers, the agency and the Department of Elderly
  114  Affairs shall determine that sufficient funds exist to support
  115  additional enrollment into plans.
  116         (a) A Medicaid recipient enrolled in one of the following
  117  Medicaid home and community-based services waiver programs who
  118  meets the eligibility criteria established in subsection (1) is
  119  eligible to participate in the long-term care managed care
  120  program and must be transitioned into the long-term care managed
  121  care program by January 1, 2018:
  122         1. Traumatic Brain and Spinal Cord Injury Waiver.
  123         2. Adult Cystic Fibrosis Waiver.
  124         3. Project AIDS Care Waiver.
  125         (b) The agency shall seek federal approval to terminate the
  126  Traumatic Brain and Spinal Cord Injury Waiver, the Adult Cystic
  127  Fibrosis Waiver, and the Project AIDS Care Waiver once all
  128  eligible Medicaid recipients have transitioned into the long
  129  term care managed care program.
  130         (3) PRE-ENROLLMENT WAIT LIST, RELEASE, AND OFFER PROCESS.
  131  The Department of Elderly Affairs shall maintain a statewide
  132  pre-enrollment wait list for enrollment for home and community
  133  based services through the long-term care managed care program.
  134         (a) The Department of Elderly Affairs shall prioritize
  135  individuals for potential enrollment for home and community
  136  based services through the long-term care managed care program
  137  using a frailty-based screening tool that results in a priority
  138  score. The priority score is used to set an order for releasing
  139  individuals from the pre-enrollment wait list for potential
  140  enrollment in the long-term care managed care program. If
  141  capacity is limited for individuals with identical priority
  142  scores, the individual with the oldest date of placement on the
  143  pre-enrollment wait list shall receive priority for release.
  144         1. Pursuant to s. 430.2053, aging and disability resource
  145  center personnel certified by the Department of Elderly Affairs
  146  shall perform the screening for each individual requesting
  147  enrollment for home and community-based services through the
  148  long-term care managed care program. Aging and disability
  149  resource center personnel shall place on and release from the
  150  pre-enrollment lists clients eligible for the Alzheimer’s
  151  Disease Initiative or the Community Care for the Elderly, Home
  152  Care for the Elderly, or Statewide Medicaid Managed Care Long
  153  Term Care programs. The Department of Elderly Affairs shall
  154  request that the individual or the individual’s authorized
  155  representative provide alternate contact names and contact
  156  information.
  157         2. The individual requesting the long-term care services,
  158  or the individual’s authorized representative, must participate
  159  in an initial screening or rescreening for placement on the pre
  160  enrollment wait list. The screening or rescreening must be
  161  completed in its entirety before placement on the pre-enrollment
  162  wait list.
  163         3. Pursuant to s. 430.2053, staff authorized and certified
  164  by the Department of Elderly Affairs aging resource center
  165  personnel shall administer rescreening annually or upon
  166  notification of a significant change in an individual’s
  167  circumstances for an individual with a high priority score.
  168  Aging and disability resource center personnel may administer
  169  rescreening annually or upon notification of a significant
  170  change in an individual’s circumstances for an individual with a
  171  low priority score.
  172         4. The Department of Elderly Affairs shall adopt by rule a
  173  screening tool that generates the priority score and shall make
  174  publicly available on its website the specific methodology used
  175  to calculate an individual’s priority score.
  176         (b) Upon completion of the screening or rescreening
  177  process, the Department of Elderly Affairs shall notify the
  178  individual or the individual’s authorized representative that
  179  the individual has been placed on the pre-enrollment wait list,
  180  unless the individual has a low priority score. The Department
  181  of Elderly Affairs must maintain contact information for each
  182  individual with a low priority score for purposes of any future
  183  rescreening. Aging and disability resource center personnel
  184  shall inform individuals with low priority scores of community
  185  resources available to assist them and inform them that they may
  186  contact the aging and disability resource center for a new
  187  assessment at any time if they experience a change in
  188  circumstances.
  189         (c) If the Department of Elderly Affairs is unable to
  190  contact the individual or the individual’s authorized
  191  representative to schedule an initial screening or rescreening,
  192  and documents the actions taken to make such contact, it shall
  193  send a letter to the last documented address of the individual
  194  or the individual’s authorized representative. The letter must
  195  advise the individual or his or her authorized representative
  196  that he or she must contact the Department of Elderly Affairs
  197  within 30 calendar days after the date of the notice to schedule
  198  a screening or rescreening and must notify the individual that
  199  failure to complete the screening or rescreening will result in
  200  his or her termination from the screening process and the pre
  201  enrollment wait list.
  202         (d) After notification by the agency of available capacity,
  203  the CARES program shall conduct a prerelease assessment. The
  204  Department of Elderly Affairs shall release individuals from the
  205  pre-enrollment wait list based on the priority scoring process
  206  and prerelease assessment results. The aging and disability
  207  resource center shall conduct a prerelease assessment. Upon
  208  release, individuals who meet all financial and medical
  209  eligibility criteria may enroll in the long-term care managed
  210  care program.
  211         (e) The Department of Elderly Affairs may terminate an
  212  individual’s inclusion on the pre-enrollment wait list if the
  213  individual:
  214         1. Does not have a current priority score due to the
  215  individual’s action or inaction;
  216         2. Requests to be removed from the pre-enrollment wait
  217  list;
  218         3. Does not keep an appointment to complete the rescreening
  219  without scheduling another appointment and has not responded to
  220  three documented attempts by the Department of Elderly Affairs
  221  to contact the individual;
  222         4. Receives an offer to begin the eligibility determination
  223  process for the long-term care managed care program; or
  224         5. Begins receiving services through the long-term care
  225  managed care program.
  226  
  227  An individual whose inclusion on the pre-enrollment wait list is
  228  terminated must initiate a new request for placement on the pre
  229  enrollment wait list, and any previous priority considerations
  230  must be disregarded.
  231         (f) Notwithstanding this subsection, the following
  232  individuals are afforded priority enrollment for home and
  233  community-based services through the long-term care managed care
  234  program and do not have to complete the screening or pre
  235  enrollment list wait-list process if all other long-term care
  236  managed care program eligibility requirements are met:
  237         1. An individual who is 18, 19, or 20 years of age who has
  238  a chronic debilitating disease or condition of one or more
  239  physiological or organ systems which generally make the
  240  individual dependent upon 24-hour-per-day medical, nursing, or
  241  health supervision or intervention.
  242         2. A nursing facility resident who requests to transition
  243  into the community and who has resided in a Florida-licensed
  244  skilled nursing facility for at least 60 consecutive days.
  245         3. An individual who is referred by the Department of
  246  Children and Families pursuant to the Adult Protective Services
  247  Act, ss. 415.101-415.113, as high risk and who is placed in an
  248  assisted living facility temporarily funded by the Department of
  249  Children and Families.
  250         (g) The Department of Elderly Affairs and the agency may
  251  adopt rules to implement this subsection.
  252         Section 2. Subsection (4) of section 409.983, Florida
  253  Statutes, is amended to read:
  254         409.983 Long-term care managed care plan payment.—In
  255  addition to the payment provisions of s. 409.968, the agency
  256  shall provide payment to plans in the long-term care managed
  257  care program pursuant to this section.
  258         (4) The initial assessment of an enrollee’s level of care
  259  shall be reviewed or performed made by the Comprehensive
  260  Assessment and Review for Long-Term Care Services (CARES)
  261  program, which shall assign the recipient into one of the
  262  following levels of care:
  263         (a) Level of care 1 consists of recipients residing in or
  264  who must be placed in a nursing home.
  265         (b) Level of care 2 consists of recipients at imminent risk
  266  of nursing home placement, as evidenced by the need for the
  267  constant availability of routine medical and nursing treatment
  268  and care, and who require extensive health-related care and
  269  services because of mental or physical incapacitation.
  270         (c) Level of care 3 consists of recipients at imminent risk
  271  of nursing home placement, as evidenced by the need for the
  272  constant availability of routine medical and nursing treatment
  273  and care, who have a limited need for health-related care and
  274  services and are mildly medically or physically incapacitated.
  275  
  276  The agency shall periodically adjust payment rates to account
  277  for changes in the level of care profile for each managed care
  278  plan based on encounter data.
  279         Section 3. Subsection (7) of section 430.03, Florida
  280  Statutes, is amended to read:
  281         430.03 Purposes.—The purposes of the Department of Elderly
  282  Affairs are to:
  283         (7) Oversee implementation of federally funded and state
  284  funded programs and services for the state’s elderly population.
  285  The department may provide direct services for the Community
  286  Care for the Elderly Program, Home Care for the Elderly Program,
  287  and the Alzheimer’s Disease Initiative only in the event of a
  288  state of emergency or in the event a contracted service provider
  289  or subcontractor is unable to provide services.
  290         Section 4. Present paragraph (g) of subsection (2) of
  291  section 430.04, Florida Statutes, is redesignated as paragraph
  292  (h), a new paragraph (g) is added to that subsection, and
  293  paragraph (f) of that subsection is amended to read:
  294         430.04 Duties and responsibilities of the Department of
  295  Elderly Affairs.—The Department of Elderly Affairs shall:
  296         (2) Be responsible for ensuring that each area agency on
  297  aging operates in a manner to ensure that the elderly of this
  298  state receive the best services possible. The department shall
  299  rescind designation of an area agency on aging or take
  300  intermediate measures against the agency, including corrective
  301  action, unannounced special monitoring, temporary assumption of
  302  operation of one or more programs by the department, placement
  303  on probationary status, imposing a moratorium on agency action,
  304  imposing financial penalties for nonperformance, or other
  305  administrative action pursuant to chapter 120, if the department
  306  finds that:
  307         (f) The agency has failed to properly determine client
  308  eligibility as defined by the department.
  309         (g)The agency has failed to or efficiently manage program
  310  budgets.
  311         Section 5. Section 430.09, Florida Statutes, is created to
  312  read:
  313         430.09 Area agencies on aging expenditures.—
  314         (1)The procurement of commodities or contractual services
  315  by an area agency on aging and its subcontractors must comply
  316  with applicable state and federal law and follow all
  317  regulations.
  318         (a) Area agencies on aging shall competitively procure all
  319  contracts in excess of $35,000.
  320         (b) The department shall impose financial consequences, as
  321  established by the department and incorporated into the
  322  contract, for noncompliance with applicable local, state, or
  323  federal law for the procurement of commodities or contractual
  324  services.
  325         (2) An administrative employee of an area agency on aging
  326  may not receive a salary in excess of 150 percent of the annual
  327  salary paid to the secretary of the Department of Elderly
  328  Affairs from state-appropriated funds or from state-appropriated
  329  federal funds. This limitation applies regardless of the number
  330  of contracts an area agency on aging may execute with the
  331  department. This subsection does not prohibit any party from
  332  providing compensation that is not from state funds to an area
  333  agency on aging administrative employee.
  334         Section 6. Subsections (3) and (5) and paragraph (c) of
  335  subsection (9) of section 430.203, Florida Statutes, are amended
  336  to read:
  337         430.203 Community care for the elderly; definitions.—As
  338  used in ss. 430.201-430.207, the term:
  339         (3) “Community care service system” means a service network
  340  comprising a variety of home-delivered services, day care
  341  services, and other basic services, hereinafter referred to as
  342  “core services,” for functionally impaired elderly persons which
  343  are provided by or through a designated single lead agency by
  344  the area agency on aging. Its purpose is to provide a continuum
  345  of care encompassing a full range of preventive, maintenance,
  346  and restorative services for functionally impaired elderly
  347  persons.
  348         (5) “Core services” means a variety of home-delivered
  349  services, day care services, and other basic services that may
  350  be provided by several entities. Core services are those
  351  services that are most needed to prevent unnecessary
  352  institutionalization. The area agency on aging shall not
  353  directly provide core services.
  354         (9) “Lead agency” means an agency designated at least once
  355  every 6 years by an area agency on aging as the result of a
  356  competitive procurement conducted through a request for
  357  proposal.
  358         (c) In each community care service system, the lead agency
  359  must be given the authority and responsibility to coordinate
  360  some or all of the services, either directly or through
  361  subcontracts, for functionally impaired elderly persons. These
  362  services must include case management, homemaker and chore
  363  services, respite care, adult day care, personal care services,
  364  home-delivered meals, counseling, information and referral, and
  365  emergency home repair services. The lead agency must compile
  366  community care statistics and monitor, when applicable,
  367  subcontracts with agencies providing core services.
  368         Section 7. Subsections (1), (4), (5), and (8) of section
  369  430.204, Florida Statutes, are amended to read:
  370         430.204 Community-care-for-the-elderly core services;
  371  departmental powers and duties.—
  372         (1)(a) The department shall fund, through each area agency
  373  on aging, at least one community care service system the primary
  374  purpose of which is the prevention of unnecessary
  375  institutionalization of functionally impaired elderly persons
  376  through the provision of community-based core services. Whenever
  377  feasible, an area agency on aging shall be the contracting
  378  agency of preference to engage only in the planning and funding
  379  of community-care-for-the-elderly core services for functionally
  380  impaired elderly persons.
  381         (b) The department shall fund, through each area agency on
  382  aging in each county as defined in s. 125.011(1), more than one
  383  community care service system the primary purpose of which is
  384  the prevention of unnecessary institutionalization of
  385  functionally impaired elderly persons through the provision of
  386  community-based core services.
  387         (4) The department or contracting agency shall contract for
  388  the provision of the core services required by a community care
  389  service area. The area agency on aging may not directly provide
  390  core services unless the designated lead agency is unable to
  391  perform its duties or in the event of a state of emergency and
  392  the department approves.
  393         (5) Entities contracting to provide core services under ss.
  394  430.201-430.207 must provide a minimum of 10 percent of the
  395  funding necessary for the support of project operations. In-kind
  396  contributions, whether materials, commodities, transportation,
  397  office space, other types of facilities, or personal services,
  398  and contributions of money or services from functionally
  399  impaired elderly persons may be evaluated and counted as part or
  400  all of the required local funding.
  401         (8) Provider agencies are responsible for the collection of
  402  fees for services in accordance with rules adopted by the
  403  department. Provider agencies shall assess fees for services
  404  rendered in accordance with those rules. To help pay for
  405  services received from community care for the elderly, a
  406  functionally impaired elderly person shall be assessed a fee
  407  based on an overall ability to pay. The fee to be assessed shall
  408  be fixed according to a schedule established by the department
  409  in cooperation with area agencies, lead agencies, and service
  410  providers.
  411         Section 8. Subsections (1), (2), and (4) and paragraph (a)
  412  of subsection (5) of section 430.205, Florida Statutes, are
  413  amended to read:
  414         430.205 Community care service system.—
  415         (1)(a) The department, through the area agency on aging,
  416  shall fund in each planning and service area at least one
  417  community care service system that provides case management and
  418  other in-home and community services as needed to help the older
  419  person maintain independence and prevent or delay more costly
  420  institutional care.
  421         (b) The department shall fund, through the area agency on
  422  aging in each county as defined in s. 125.011(1), more than one
  423  community care service system that provides case management and
  424  other in-home and community services as needed to help elderly
  425  persons maintain independence and prevent or delay more costly
  426  institutional care.
  427         (2) Core services and other support services may be
  428  furnished by public or private agencies or organizations. Each
  429  community care service system must be under the direction of a
  430  lead agency that coordinates the activities of individual
  431  contracting agencies providing community-care-for-the-elderly
  432  services. When practicable, the activities of a community care
  433  service area may be directed from a multiservice senior center,
  434  as defined in s. 430.901, and coordinated with other services
  435  offered therein. This subsection does not require programs in
  436  existence prior to the effective date of this act to be
  437  relocated.
  438         (4) A preservice and annual inservice training program for
  439  community-care-for-the-elderly service providers and staff may
  440  be designed and implemented to help assure the delivery of
  441  quality services. The department shall specify in rules the
  442  training standards and requirements for the community-care-for
  443  the-elderly service providers and staff. Training must be
  444  sufficient to ensure that quality services are provided to
  445  clients and that appropriate skills are developed to conduct the
  446  program.
  447         (5) Any person who has been classified as a functionally
  448  impaired elderly person is eligible to receive community-care
  449  for-the-elderly core services.
  450         (a) Those elderly persons who are determined by protective
  451  investigations to be high risk vulnerable adults in need of
  452  services, pursuant to s. 415.104(3)(b), or to be victims of
  453  abuse, neglect, or exploitation who are in need of immediate
  454  services to prevent further harm and are referred by the adult
  455  protective services program, shall be given priority primary
  456  consideration for receiving community-care-for-the-elderly
  457  services. As used in this paragraph, the termpriority primary
  458  consideration” means that an assessment and services must
  459  commence within 72 hours after referral to the department or as
  460  established in accordance with department contracts by local
  461  protocols developed between department service providers and the
  462  adult protective services program. Regardless, a community-care
  463  for-the-elderly services provider may dispute a referral under
  464  this paragraph by requesting that adult protective services
  465  negotiate the referral placement of, and the services to be
  466  provided to, a vulnerable adult or victim of abuse, neglect, or
  467  exploitation. If an agreement cannot be reached with adult
  468  protective services for modification of the referral decision,
  469  the determination by adult protective services shall prevail.
  470         Section 9. Section 430.2053, Florida Statutes, is amended
  471  to read:
  472         430.2053 Aging and disability resource centers.—
  473         (1) The department, in consultation with the Agency for
  474  Health Care Administration and the Department of Children and
  475  Families, shall develop pilot projects for aging and disability
  476  resource centers.
  477         (2) The purposes of an aging and disability resource center
  478  are shall be:
  479         (a) To provide Florida’s elders, adults with disabilities,
  480  and their families with a locally focused, coordinated approach
  481  to integrating information and referral for all available
  482  services for persons elders with the eligibility determination
  483  entities for state and federally funded long-term-care services.
  484         (b) To provide for easier access to long-term-care services
  485  by Florida’s elders, adults with disabilities, and their
  486  families by creating multiple access points to the long-term
  487  care network that flow through one established entity with wide
  488  community recognition.
  489         (3) The duties of an aging and disability resource center
  490  are to:
  491         (a) Develop referral agreements with local community
  492  service organizations, such as senior centers, existing elder
  493  service providers, volunteer associations, and other similar
  494  organizations, to better assist clients who do not need or do
  495  not wish to enroll in programs funded by the department or the
  496  agency. The referral agreements must also include a protocol,
  497  developed and approved by the department, which provides
  498  specific actions that an aging and disability resource center
  499  and local community service organizations must take when a
  500  person or a person’s an elder or an elder’s representative
  501  seeking information on long-term-care services contacts a local
  502  community service organization before prior to contacting the
  503  aging and disability resource center. The protocol shall be
  504  designed to ensure that persons elders and their families are
  505  able to access information and services in the most efficient
  506  and least cumbersome manner possible.
  507         (b) Provide an initial screening of all clients who request
  508  long-term-care services to determine whether the person would be
  509  most appropriately served through any combination of federally
  510  funded programs, state-funded programs, locally funded or
  511  community volunteer programs, or private funding for services.
  512         (c) Determine eligibility for the programs and services
  513  listed in subsection (9) for persons residing within the
  514  geographic area served by the aging and disability resource
  515  center and determine a priority ranking for services which is
  516  based upon the potential recipient’s frailty level and
  517  likelihood of institutional placement without such services.
  518         (d) Place on and release from the pre-enrollment lists
  519  clients eligible for the Alzheimer’s Disease Initiative or the
  520  Community Care for the Elderly, Home Care for the Elderly, or
  521  Statewide Medicaid Managed Care Long-term Care programs.
  522         (e) Manage the availability of financial resources for the
  523  programs and services listed in subsection (9) for persons
  524  residing within the geographic area served by the aging and
  525  disability resource center.
  526         (f)(e) When financial resources become available, refer a
  527  client to the most appropriate entity to begin receiving
  528  services. The aging and disability resource center shall make
  529  referrals to lead agencies for service provision that ensure
  530  that persons individuals who are vulnerable adults in need of
  531  services pursuant to s. 415.104(3)(b), or who are victims of
  532  abuse, neglect, or exploitation in need of immediate services to
  533  prevent further harm and are referred by the adult protective
  534  services program, are given priority primary consideration for
  535  receiving community-care-for-the-elderly services in compliance
  536  with the requirements of s. 430.205(5)(a) and that other
  537  referrals for services are in compliance with s. 430.205(5)(b).
  538         (f) Convene a work group to advise in the planning,
  539  implementation, and evaluation of the aging resource center. The
  540  work group shall be comprised of representatives of local
  541  service providers, Alzheimer’s Association chapters, housing
  542  authorities, social service organizations, advocacy groups,
  543  representatives of clients receiving services through the aging
  544  resource center, and any other persons or groups as determined
  545  by the department. The aging resource center, in consultation
  546  with the work group, must develop annual program improvement
  547  plans that shall be submitted to the department for
  548  consideration. The department shall review each annual
  549  improvement plan and make recommendations on how to implement
  550  the components of the plan.
  551         (g) Enhance the existing area agency on aging in each
  552  planning and service area by integrating, either physically or
  553  virtually, the staff and services of the area agency on aging
  554  with the staff of the department’s local CARES Medicaid
  555  preadmission screening unit and a sufficient number of staff
  556  from the Department of Children and Families’ Economic Self
  557  Sufficiency Unit necessary to determine the financial
  558  eligibility for all persons age 60 and older residing within the
  559  area served by the aging and disability resource center that are
  560  seeking Medicaid services, Supplemental Security Income, and
  561  food assistance.
  562         (h) Assist clients who request long-term care services in
  563  being evaluated for eligibility for enrollment in the Medicaid
  564  long-term care managed care program as eligible plans become
  565  available in each of the regions pursuant to s. 409.981(2).
  566         (i) Provide enrollment and coverage information to Medicaid
  567  managed long-term care enrollees as qualified plans become
  568  available in each of the regions pursuant to s. 409.981(2).
  569         (j) Assist Medicaid recipients enrolled in the Medicaid
  570  long-term care managed care program with informally resolving
  571  grievances with a managed care network and assist Medicaid
  572  recipients in accessing the managed care network’s formal
  573  grievance process as eligible plans become available in each of
  574  the regions defined in s. 409.981(2).
  575         (4) The department shall select the entities to become
  576  aging and disability resource centers based on each entity’s
  577  readiness and ability to perform the duties listed in subsection
  578  (3) and the entity’s:
  579         (a) Expertise in the needs of each target population the
  580  center proposes to serve and a thorough knowledge of the
  581  providers that serve these populations.
  582         (b) Strong connections to service providers, volunteer
  583  agencies, and community institutions.
  584         (c) Expertise in information and referral activities.
  585         (d) Knowledge of long-term-care resources, including
  586  resources designed to provide services in the least restrictive
  587  setting.
  588         (e) Financial solvency and stability.
  589         (f) Ability to collect, monitor, and analyze data in a
  590  timely and accurate manner, along with systems that meet the
  591  department’s standards.
  592         (g) Commitment to adequate staffing by qualified personnel
  593  to effectively perform all functions.
  594         (h) Ability to meet all performance standards established
  595  by the department.
  596         (5) The aging and disability resource center shall have a
  597  governing body which shall be the same entity described in s.
  598  20.41(7), and an executive director who may be the same person
  599  as described in s. 20.41(7). The governing body shall annually
  600  evaluate the performance of the executive director.
  601         (6) The aging and disability resource center may not be a
  602  provider of direct services other than information and referral
  603  services, outreach, and screening, and intake. The aging and
  604  disability resource center must receive a waiver from the
  605  department to be the provider of any other direct services.
  606         (7) The aging and disability resource center must agree to
  607  allow the department to review any financial information the
  608  department determines is necessary for monitoring or reporting
  609  purposes, including financial relationships.
  610         (8) The duties and responsibilities of the community care
  611  for the elderly lead agencies within each area served by an
  612  aging and disability resource center shall be to:
  613         (a) Develop strong community partnerships to maximize the
  614  use of community resources for the purpose of assisting persons
  615  elders to remain in their community settings for as long as it
  616  is safely possible.
  617         (b) Conduct comprehensive assessments of clients that have
  618  been determined eligible and develop a care plan consistent with
  619  established protocols that ensures that the unique needs of each
  620  client are met.
  621         (9) The services to be administered through the aging and
  622  disability resource center shall include those funded by the
  623  following programs:
  624         (a) Community care for the elderly.
  625         (b) Home care for the elderly.
  626         (c) Contracted services.
  627         (d) Alzheimer’s Disease Initiative.
  628         (e) Older Americans Act.
  629         (10) The department shall, before prior to designation of
  630  an aging and disability resource center, develop by rule
  631  operational and quality assurance standards and outcome measures
  632  to ensure that clients receiving services through all long-term
  633  care programs administered through an aging and disability
  634  resource center are receiving the appropriate care they require
  635  and that contractors and subcontractors are adhering to the
  636  terms of their contracts and are acting in the best interests of
  637  the clients they are serving, consistent with the intent of the
  638  Legislature to reduce the use of and cost of nursing home care.
  639  The department shall by rule provide operating procedures for
  640  aging and disability resource centers, which shall include:
  641         (a) Minimum standards for financial operation, including
  642  audit procedures.
  643         (b) Procedures for monitoring and sanctioning of service
  644  providers.
  645         (c) Minimum standards for technology utilized by the aging
  646  and disability resource center.
  647         (d) Minimum staff requirements which shall ensure that the
  648  aging and disability resource center employs sufficient quality
  649  and quantity of staff to adequately meet the needs of the elders
  650  residing within the area served by the aging and disability
  651  resource center.
  652         (e) Minimum accessibility standards, including hours of
  653  operation.
  654         (f) Minimum oversight standards for the governing body of
  655  the aging and disability resource center to ensure its
  656  continuous involvement in, and accountability for, all matters
  657  related to the development, implementation, staffing,
  658  administration, and operations of the aging and disability
  659  resource center.
  660         (g) Minimum education and experience requirements for
  661  executive directors and other executive staff positions of aging
  662  and disability resource centers.
  663         (h) Minimum requirements regarding any executive staff
  664  positions that the aging and disability resource center must
  665  employ and minimum requirements that a candidate must meet in
  666  order to be eligible for appointment to such positions.
  667         (11) In an area in which the department has designated an
  668  area agency on aging as an aging and disability resource center,
  669  the department and the agency may shall not make payments for
  670  the services listed in subsection (9) and the Statewide Medicaid
  671  Managed Care Long-term Care Program Long-Term Care Community
  672  Diversion Project for such persons who were not screened and
  673  enrolled through the aging and disability resource center. The
  674  department shall cease making payments for recipients in
  675  eligible plans as eligible plans become available in each of the
  676  regions defined in s. 409.981(2).
  677         (12) Each aging and disability resource center shall enter
  678  into a memorandum of understanding with the department for
  679  collaboration with the CARES unit staff. The memorandum of
  680  understanding shall outline the staff person responsible for
  681  each function and shall provide the staffing levels necessary to
  682  carry out the functions of the aging and disability resource
  683  center.
  684         (13) Each aging and disability resource center shall enter
  685  into a memorandum of understanding with the Department of
  686  Children and Families for collaboration with the Economic Self
  687  Sufficiency Unit staff. The memorandum of understanding shall
  688  outline which staff persons are responsible for which functions
  689  and shall provide the staffing levels necessary to carry out the
  690  functions of the aging and disability resource center.
  691         (14) If any of the state activities described in this
  692  section are outsourced, either in part or in whole, the contract
  693  executing the outsourcing shall mandate that the contractor or
  694  its subcontractors shall, either physically or virtually,
  695  execute the provisions of the memorandum of understanding
  696  instead of the state entity whose function the contractor or
  697  subcontractor now performs.
  698         (15)(a)In order to be eligible to begin transitioning to
  699  an aging resource center, an area agency on aging board must
  700  ensure that the area agency on aging which it oversees meets all
  701  of the minimum requirements set by law and in rule.
  702         (16)(a)Once an aging resource center is operational, The
  703  department, in consultation with the aging and disability
  704  resource center agency, may develop capitation rates for any of
  705  the programs administered through the agency aging resource
  706  center. Capitation rates for programs shall be based on the
  707  historical cost experience of the state in providing those same
  708  services to the population age 60 or older residing within each
  709  area served by an aging and disability resource center. Each
  710  capitated rate may vary by geographic area as determined by the
  711  department.
  712         (b) The department and the agency may determine for each
  713  area served by an aging and disability resource center whether
  714  it is appropriate, consistent with federal and state laws and
  715  regulations, to develop and pay separate capitated rates for
  716  each program administered through the aging and disability
  717  resource center or to develop and pay capitated rates for
  718  service packages which include more than one program or service
  719  administered through the aging and disability resource center.
  720         (c) Once capitation rates have been developed and certified
  721  as actuarially sound, the department and the agency may pay
  722  service providers the capitated rates for services when
  723  appropriate.
  724         (d) The department, in consultation with the agency, shall
  725  annually reevaluate and recertify the capitation rates,
  726  adjusting forward to account for inflation, programmatic
  727  changes.
  728         (16)(17) This section does shall not be construed to allow
  729  an aging and disability resource center to restrict, manage, or
  730  impede the local fundraising activities of service providers.
  731         Section 10. Section 430.503, Florida Statutes, is amended
  732  to read:
  733         430.503 Alzheimer’s Disease Initiative; short title fees
  734  and administrative expense.—
  735         (1) Sections 430.501-430.504 may be cited as the
  736  “Alzheimer’s Disease Initiative.”
  737         (2) Provider agencies are responsible for the collection of
  738  fees for services in accordance with rules adopted by the
  739  department. Provider agencies shall assess fees for services
  740  rendered in accordance with those rules. To help pay for
  741  services received pursuant to the Alzheimer’s Disease
  742  Initiative, a functionally impaired elderly person shall be
  743  assessed a fee based on an overall ability to pay. The fee to be
  744  assessed shall be fixed according to a schedule to be
  745  established by the department. Services of specified value may
  746  be accepted in lieu of a fee. The fee schedule shall be
  747  developed in cooperation with the Alzheimer’s Disease Advisory
  748  Committee, area agencies on aging, and service providers.
  749         Section 11. Subsection (3) of section 430.605, Florida
  750  Statutes, is amended to read:
  751         430.605 Subsidy payments.—The department shall develop a
  752  schedule of subsidy payments to be made to persons providing
  753  home care, and to providers of goods and services, for certain
  754  eligible elderly persons. Payments must be based on the
  755  financial status of the person receiving care. Payments must
  756  include, but need not be limited to:
  757         (3) When necessary, special supplements to provide for any
  758  goods and services, including food and nutritional supplements,
  759  and specialized care required to maintain the health, safety,
  760  and well-being of the elderly person. Extraordinary medical,
  761  dental, or pharmaceutical expenses may be paid as a special
  762  supplement.
  763         Section 12. Section 430.72, Florida Statutes, is created to
  764  read:
  765         430.72 Florida Alzheimer’s Center of Excellence.—
  766         (1) PURPOSE AND INTENT.—
  767         (a)The purpose of this section is to assist and support
  768  persons with Alzheimer’s disease or related forms of dementia
  769  and their caregivers by connecting them with resources in their
  770  communities. The Legislature intends to create a holistic care
  771  model for persons with Alzheimer’s disease or related forms of
  772  dementia and their caregivers to address two primary goals:
  773         1. To allow Floridians living with Alzheimer’s disease or
  774  related forms of dementia to age in place.
  775         2. To empower family caregivers to improve their own well
  776  being.
  777         (b) The development of innovative approaches to program
  778  management, staff training, and service delivery which have an
  779  impact on cost-avoidance, cost-effectiveness, and program
  780  efficiency is encouraged.
  781         (2) DEFINITIONS.—As used in this section, the term:
  782         (a) “Center” means the Florida Alzheimer’s Center of
  783  Excellence.
  784         (b) “Department” means the Department of Elderly Affairs.
  785         (3) POWERS AND DUTIES.—
  786         (a) There is created within the department the Florida
  787  Alzheimer’s Center of Excellence, which shall be responsible for
  788  improving the quality of care for persons living with
  789  Alzheimer’s disease or related forms of dementia and improved
  790  quality of life for family caregivers.
  791         (b) The center shall aim to address, at a minimum, all of
  792  the following:
  793         1. Early and accurate diagnosis.
  794         2. Caregiver health.
  795         3. Improved access to care.
  796         4. Health care use costs.
  797         5. Strengthening a dementia-capable workforce.
  798         6. Underreporting of Alzheimer’s disease and related forms
  799  of dementia.
  800         7. Disparities in access to dementia care.
  801         (c) The center shall provide caregivers access to services,
  802  including, but not limited to, all of the following:
  803         1. Care consultation.
  804         2. Support groups.
  805         3. Education and training programs.
  806         4. Caregiver support services such as:
  807         a. Caregiver companions.
  808         b. Caregiver wellness programs.
  809         c. Care support teams.
  810         d. Technology-based services.
  811         e. Coordinating or monitoring care and services.
  812         f. Assistance in obtaining diagnosis or prognosis of
  813  dementia.
  814         g. Assistance in obtaining end-of-life care.
  815         h. Assistance connecting to resources for medical care.
  816         i. Assistance with planning for current or future care.
  817         j. Guidance for coping with relationship changes for
  818  persons with dementia and their caregivers.
  819         k. Skills for communicating with persons with dementia.
  820         l. Understanding or managing behavioral symptoms of
  821  dementia.
  822         (d) The center shall work with area agencies on aging; the
  823  Alzheimer’s Disease Advisory Committee; the Alzheimer’s Disease
  824  Initiative, including the state-funded memory disorder clinics;
  825  the Dementia Care and Cure Initiative; universities; hospitals;
  826  and other available community resources to ensure full use of
  827  the state’s infrastructure.
  828         (e) As necessary to fulfill its duties under this section,
  829  the center may provide direct services or contract for the
  830  provision of services.
  831         (4) ELIGIBILITY FOR SERVICES.—
  832         (a) Persons seeking assistance from the center must meet
  833  all of the following criteria to be eligible for services:
  834         1. At least one person in the household is a caregiver for
  835  a person who has been diagnosed with, or is suspected of having,
  836  Alzheimer’s disease or a related form of dementia.
  837         2. The caregiver or person diagnosed with, or suspected of
  838  having, Alzheimer’s disease or a related form of dementia is a
  839  resident of this state.
  840         3. Have the goal of providing in-home care for the person
  841  who has been diagnosed with, or is suspected of having,
  842  Alzheimer’s disease or a related form of dementia.
  843         (b) If the person seeking assistance meets the criteria in
  844  paragraph (a), the center may provide assistance to the
  845  caregiving family, subject to the availability of funds and
  846  resources.
  847         Section 13. Subsection (2) of section 430.901, Florida
  848  Statutes, is amended to read:
  849         430.901 Multiservice senior center; definition; purpose.—A
  850  “multiservice senior center” is:
  851         (2) An entity that may partner with an aging and disability
  852  resource center to provide for easier access to long-term care
  853  services by seniors and their families who reside within the
  854  local community.
  855         Section 14. Subsection (3) of section 744.2003, Florida
  856  Statutes, is amended to read:
  857         744.2003 Regulation of professional guardians; application;
  858  bond required; educational requirements.—
  859         (3) Each professional guardian as defined in s. 744.102(17)
  860  and public guardian must receive a minimum of 40 hours of
  861  instruction and training. Each professional guardian must
  862  receive a minimum of 30 hours of continuing education every 2
  863  calendar years after the year in which the initial 40-hour
  864  educational requirement is met. The required continuing
  865  education must include at least 2 hours on fiduciary
  866  responsibilities; 2 hours on professional ethics; 1 hour on
  867  advance directives; 1 hour on Alzheimer’s disease and related
  868  dementias; 3 hours on abuse, neglect, and exploitation; and 3 4
  869  hours on guardianship law. The instruction and education must be
  870  completed through a course approved or offered by the Office of
  871  Public and Professional Guardians. The expenses incurred to
  872  satisfy the educational requirements prescribed in this section
  873  may not be paid with the assets of any ward. This subsection
  874  does not apply to any attorney licensed to practice law in this
  875  state or an institution acting as guardian under s. 744.2002(7).
  876         Section 15. Subsection (2) of section 744.2004, Florida
  877  Statutes, is amended to read:
  878         744.2004 Complaints; disciplinary proceedings; penalties;
  879  enforcement.—
  880         (2) The Office of Public and Professional Guardians shall
  881  establish disciplinary proceedings, conduct hearings, and take
  882  administrative action pursuant to chapter 120. Disciplinary
  883  actions may include, but are not limited to, requiring a
  884  professional guardian to participate in additional educational
  885  courses provided or approved by the Office of Public and
  886  Professional Guardians, imposing additional monitoring by the
  887  Office of Public and Professional Guardians, imposing a fine
  888  office of the guardianships to which the professional guardian
  889  is appointed, and suspension or revocation of a professional
  890  guardian’s registration.
  891         Section 16. Paragraph (g) is added to subsection (2) of
  892  section 744.20041, Florida Statutes, to read:
  893         744.20041 Grounds for discipline; penalties; enforcement.—
  894         (2) When the Office of Public and Professional Guardians
  895  finds a professional guardian guilty of violating subsection
  896  (1), it may enter an order imposing one or more of the following
  897  penalties:
  898         (g)Requirement that the professional guardian pay a fine,
  899  not to exceed $500 per violation.
  900         Section 17. Present subsection (2) of section 744.2104,
  901  Florida Statutes, is redesignated as subsection (4), and a new
  902  subsection (2) and subsection (3) are added to that section, to
  903  read:
  904         744.2104 Access to records by the Office of Public and
  905  Professional Guardians; confidentiality.—
  906         (2)In conducting an investigation, the Office of Public
  907  and Professional Guardians may issue subpoenas duces tecum to
  908  financial institutions, insurance companies, the ward’s
  909  caregivers, any facility in which the ward is residing or has
  910  resided, and the facility’s professional guardians or employees
  911  to compel the production of records relevant to the
  912  investigation conducted by the office.
  913         (3)If there is substantial noncompliance with a subpoena
  914  duces tecum issued by the Office of Public and Professional
  915  Guardians, the office may petition the court in the county in
  916  which the noncompliant person resides or has her or his place of
  917  business for an order requiring the person to produce such
  918  records as specified in the subpoena duces tecum.
  919         Section 18. For the purpose of incorporating the amendment
  920  made by this act to section 430.204, Florida Statutes, in a
  921  reference thereto, subsection (4) of section 110.501, Florida
  922  Statutes, is reenacted to read:
  923         110.501 Definitions.—As used in this act:
  924         (4) “Volunteer” means any person who, of his or her own
  925  free will, provides goods or services, or conveys an interest in
  926  or otherwise consents to the use of real property pursuant to
  927  chapter 260, to any state department or agency, or nonprofit
  928  organization, with no monetary or material compensation. A
  929  person registered and serving in Older American Volunteer
  930  Programs authorized by the Domestic Volunteer Service Act of
  931  1973, as amended (Pub. L. No. 93-113), shall also be defined as
  932  a volunteer and shall incur no civil liability as provided by s.
  933  768.1355. A volunteer shall be eligible for payment of volunteer
  934  benefits as specified in Pub. L. No. 93-113, this section, and
  935  s. 430.204.
  936         Section 19. For the purpose of incorporating the amendment
  937  made by this act to section 430.503, Florida Statutes, in a
  938  reference thereto, section 430.504, Florida Statutes, is
  939  reenacted to read:
  940         430.504 Confidentiality of information.—Information about
  941  clients of programs created or funded under s. 430.501 or s.
  942  430.503 which is received through files, reports, inspections,
  943  or otherwise, by the department or by authorized departmental
  944  employees, by persons who volunteer services, or by persons who
  945  provide services to clients of programs created or funded under
  946  s. 430.501 or s. 430.503 through contracts with the department
  947  is confidential and exempt from the provisions of s. 119.07(1).
  948  Such information may not be disclosed publicly in such a manner
  949  as to identify a person who receives services under s. 430.501
  950  or s. 430.503, unless that person or that person’s legal
  951  guardian provides written consent.
  952         Section 20. For the purpose of incorporating the amendment
  953  made by this act to section 430.605, Florida Statutes, in a
  954  reference thereto, section 430.603, Florida Statutes, is
  955  reenacted to read:
  956         430.603 Home care for the elderly; rules.—The department
  957  shall by rule establish minimum standards and procedures for the
  958  provision of home care for the elderly and for the approval of
  959  persons seeking to provide such care. Any person who is approved
  960  to provide care, goods, or services for an elderly person shall
  961  be eligible for the subsidy payments described in s. 430.605.
  962  However, the home care for the elderly program must be operated
  963  within the funds appropriated by the Legislature.
  964         Section 21. This act shall take effect July 1, 2026.