Bill Amendment: FL S1758 | 2024 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Individuals with Disabilities
Status: 2024-03-22 - Chapter No. 2024-14 [S1758 Detail]
Download: Florida-2024-S1758-Senate_Committee_Amendment_931526.html
Bill Title: Individuals with Disabilities
Status: 2024-03-22 - Chapter No. 2024-14 [S1758 Detail]
Download: Florida-2024-S1758-Senate_Committee_Amendment_931526.html
Florida Senate - 2024 COMMITTEE AMENDMENT Bill No. SB 1758 Ì931526)Î931526 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Children, Families, and Elder Affairs (Brodeur) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 393.064, Florida Statutes, is amended to 6 read: 7 393.064 Care navigationPrevention.— 8 (1) Within available resources, the agency shall offer to 9 clients and their caregivers care navigation services for 10 voluntary participation at the time of application and as part 11 of any eligibility or renewal review. The goals of care 12 navigation are to create a seamless network of community 13 resources and supports for the client and the client’s family as 14 a whole to support a client in daily living, community 15 integration, and achievement of individual goals. Care 16 navigation services must involve assessing client needs and 17 developing and implementing care plans, including, but not 18 limited to, connecting a client to resources and supports. At a 19 minimum, a care plan must address immediate, intermediate, and 20 long-term needs and goals to promote and increase well-being and 21 opportunities for education, employment, social engagement, 22 community integration, and caregiver support. For a client who 23 is a public school student entitled to a free appropriate public 24 education under the Individuals with Disabilities Education Act, 25 I.D.E.A., as amended, the care plan must be integrated with the 26 student’s individual education plan (IEP). The care plan and IEP 27 must be implemented to maximize the attainment of educational 28 and habilitation goalsgive priority to the development,29planning, and implementation of programs which have the30potential to prevent, correct, cure, or reduce the severity of31developmental disabilities. The agency shall direct an32interagency and interprogram effort for the continued33development of a prevention plan and program. The agency shall34identify, through demonstration projects, through program35evaluation, and through monitoring of programs and projects36conducted outside of the agency, any medical, social, economic,37or educational methods, techniques, or procedures that have the38potential to effectively ameliorate, correct, or cure39developmental disabilities. The agency shall determine the costs40and benefits that would be associated with such prevention41efforts and shall implement, or recommend the implementation of,42those methods, techniques, or procedures which are found likely43to be cost-beneficial. 44 (2)PreventionServices provided by the agency mustshall45 include services to high-risk children from 3 to 5 years of age, 46 and their families, to meet the intent of chapter 411. Except 47 for services for children from birth to age 3 years which are 48 the responsibility of the Division of Children’s Medical 49 Services in the Department of Health or part H of the 50 Individuals with Disabilities Education Act, such services may 51 include: 52 (a) Individual evaluations or assessments necessary to 53 diagnose a developmental disability or high-risk condition and 54 to determine appropriate, individual family and support 55 services. 56 (b) Early intervention services, including developmental 57 training and specialized therapies. 58 (c) Support services, such as respite care, parent 59 education and training, parent-to-parent counseling, homemaker 60 services, and other services which allow families to maintain 61 and provide quality care to children in their homes. 62 (3) Other agencies of state government shall cooperate with 63 and assist the agency, within available resources, in 64 implementing programs which have the potential to prevent, or 65 reduce the severity of, developmental disabilities and shall 66 consider the findings and recommendations of the agency in 67 developing and implementing agency programs and formulating 68 agency budget requests. 69 (4) There is created at the developmental disabilities 70 center in Gainesville a research and education unit. Such unit 71 shall be named the Raymond C. Philips Research and Education 72 Unit. The functions of such unit shall include: 73 (a) Research into the etiology of developmental 74 disabilities. 75 (b) Ensuring that new knowledge is rapidly disseminated 76 throughout the agency. 77 (c) Diagnosis of unusual conditions and syndromes 78 associated with developmental disabilities in clients identified 79 throughout developmental disabilities programs. 80 (d) Evaluation of families of clients with developmental 81 disabilities of genetic origin in order to provide them with 82 genetic counseling aimed at preventing the recurrence of the 83 disorder in other family members. 84 (e) Ensuring that health professionals in the developmental 85 disabilities center at Gainesville have access to information 86 systems that will allow them to remain updated on newer 87 knowledge and maintain their postgraduate education standards. 88 (f) Enhancing staff training for professionals throughout 89 the agency in the areas of genetics and developmental 90 disabilities. 91 Section 2. Subsection (1) and paragraph (d) of subsection 92 (5) of section 393.065, Florida Statutes, are amended to read: 93 393.065 Application and eligibility determination.— 94 (1)(a) The agency shall develop and implement an online 95 application process that, at a minimum, supports paperless, 96 electronic application submissions with immediate e-mail 97 confirmation to each applicant to acknowledge receipt of 98 application upon submission. The online application system must 99 allow an applicant to review the status of a submitted 100 application and respond to provide additional information. 101 (b) The agency shall maintain access to a printable paper 102 application on its website and, upon request, must provide an 103 applicant with a printed paper application. Paper applications 104 mayApplication for services shallbe submittedmadein writing 105 to the agency, in the region in which the applicant resides. 106 (c) The agency mustshallreview each submitted application 107 in accordance with federal time standardsand make an108eligibility determination within 60 days after receipt of the109signed application. If, at the time of the application, an110applicant is requesting enrollment in the home and community111based services Medicaid waiver program for individuals with112developmental disabilities deemed to be in crisis, as described113in paragraph (5)(a), the agency shall complete an eligibility114determination within 45 days after receipt of the signed115application. 116 1.(a)If the agency determines additional documentation is 117 necessary to make an eligibility determination, the agency may 118 request the additional documentation from the applicant. 119 2.(b)When necessary to definitively identify individual 120 conditions or needs, the agency or its designee must provide a 121 comprehensive assessment. 122(c) If the agency requests additional documentation from123the applicant or provides or arranges for a comprehensive124assessment, the agency’s eligibility determination must be125completed within 90 days after receipt of the signed126application.127 (d)1. For purposes of this paragraph, the term “complete 128 application” means an application submitted to the agency which 129 is signed and dated by the applicant or an individual with legal 130 authority to apply for public benefits on behalf of the 131 applicant, is responsive on all parts of the application, and 132 contains documentation of a diagnosis. 133 2. If the applicant requesting enrollment in the home and 134 community-based services Medicaid waiver program for individuals 135 with developmental disabilities is deemed to be in crisis as 136 described in paragraph (5)(a), the agency must make an 137 eligibility determination within 15 calendar days after receipt 138 of a complete application. 139 3. If the applicant meets the criteria specified in 140 paragraph (5)(b), the agency must review and make an eligibility 141 determination as soon as practicable after receipt of a complete 142 application. 143 4. If the application meets any of the criteria specified 144 in paragraphs (5)(c)-(g), the agency shall make an eligibility 145 determination within 60 days after receipt of a complete 146 application. 147 (e) Any delays in the eligibility determination process, or 148 any tolling of the time standard until certain information or 149 actions have been completed, must be conveyed to the client as 150 soon as such delays are known through verbal contact with the 151 client or the client’s designated caregiver and confirmed by a 152 written notice of the delay, the anticipated length of delay, 153 and a contact person for the client. 154 (5) Except as provided in subsections (6) and (7), if a 155 client seeking enrollment in the developmental disabilities home 156 and community-based services Medicaid waiver program meets the 157 level of care requirement for an intermediate care facility for 158 individuals with intellectual disabilities pursuant to 42 C.F.R. 159 ss. 435.217(b)(1) and 440.150, the agency must assign the client 160 to an appropriate preenrollment category pursuant to this 161 subsection and must provide priority to clients waiting for 162 waiver services in the following order: 163 (d) Category 4, which includes, but is not required to be 164 limited to, clients whose caregivers are 6070years of age or 165 older and for whom a caregiver is required but no alternate 166 caregiver is available. 167 168 Within preenrollment categories 3, 4, 5, 6, and 7, the agency 169 shall prioritize clients in the order of the date that the 170 client is determined eligible for waiver services. 171 Section 3. Section 393.0651, Florida Statutes, is amended 172 to read: 173 393.0651 Family or individual support plan.—The agency 174 shall provide directly or contract for the development of a 175 family support plan for children ages 3 to 18 years of age and 176 an individual support plan for each client served by the home 177 and community-based services Medicaid waiver program under s. 178 393.0662. The client, if competent, the client’s parent or 179 guardian, or, when appropriate, the client advocate, shall be 180 consulted in the development of the plan and shall receive a 181 copy of the plan. Each plan must include the most appropriate, 182 least restrictive, and most cost-beneficial environment for 183 accomplishment of the objectives for client progress and a 184 specification of all services authorized. The plan must include 185 provisions for the most appropriate level of care for the 186 client. Within the specification of needs and services for each 187 client, when residential care is necessary, the agency shall 188 move toward placement of clients in residential facilities based 189 within the client’s community. The ultimate goal of each plan, 190 whenever possible, shall be to enable the client to live a 191 dignified life in the least restrictive setting, be that in the 192 home or in the community. The family or individual support plan 193 must be developed within 60 calendar days after the agency 194 determines the client eligible pursuant to s. 393.065(3). 195 (1) The agency shall develop and specify by rule the core 196 components of support plans. 197 (2) The family or individual support plan shall be 198 integrated with the individual education plan (IEP) for all 199 clients who are public school students entitled to a free 200 appropriate public education under the Individuals with 201 Disabilities Education Act, I.D.E.A., as amended. The family or 202 individual support plan and IEP must be implemented to maximize 203 the attainment of educational and habilitation goals. 204 (a) If the IEP for a student enrolled in a public school 205 program indicates placement in a public or private residential 206 program is necessary to provide special education and related 207 services to a client, the local education agency must provide 208 for the costs of that service in accordance with the 209 requirements of the Individuals with Disabilities Education Act, 210 I.D.E.A., as amended. This does not preclude local education 211 agencies and the agency from sharing the residential service 212 costs of students who are clients and require residential 213 placement. 214 (b) For clients who are entering or exiting the school 215 system, an interdepartmental staffing team composed of 216 representatives of the agency and the local school system shall 217 develop a written transitional living and training plan with the 218 participation of the client or with the parent or guardian of 219 the client, or the client advocate, as appropriate. 220 (3) Each family or individual support plan shall be 221 facilitated through case management designed solely to advance 222 the individual needs of the client. 223 (4) In the development of the family or individual support 224 plan, a client advocate may be appointed by the support planning 225 team for a client who is a minor or for a client who is not 226 capable of express and informed consent when: 227 (a) The parent or guardian cannot be identified; 228 (b) The whereabouts of the parent or guardian cannot be 229 discovered; or 230 (c) The state is the only legal representative of the 231 client. 232 233 Such appointment may not be construed to extend the powers of 234 the client advocate to include any of those powers delegated by 235 law to a legal guardian. 236 (5) The agency shall place a client in the most appropriate 237 and least restrictive, and cost-beneficial, residential facility 238 according to his or her individual support plan. The client, if 239 competent, the client’s parent or guardian, or, when 240 appropriate, the client advocate, and the administrator of the 241 facility to which placement is proposed shall be consulted in 242 determining the appropriate placement for the client. 243 Considerations for placement shall be made in the following 244 order: 245 (a) Client’s own home or the home of a family member or 246 direct service provider. 247 (b) Foster care facility. 248 (c) Group home facility. 249 (d) Intermediate care facility for the developmentally 250 disabled. 251 (e) Other facilities licensed by the agency which offer 252 special programs for people with developmental disabilities. 253 (f) Developmental disabilities center. 254 (6) In developing a client’s annual family or individual 255 support plan, the individual or family with the assistance of 256 the support planning team shall identify measurable objectives 257 for client progress and shall specify a time period expected for 258 achievement of each objective. 259 (7) The individual, family, and support coordinator shall 260 review progress in achieving the objectives specified in each 261 client’s family or individual support plan, and shall revise the 262 plan annually, following consultation with the client, if 263 competent, or with the parent or guardian of the client, or, 264 when appropriate, the client advocate. The agency or designated 265 contractor shall annually report in writing to the client, if 266 competent, or to the parent or guardian of the client, or to the 267 client advocate, when appropriate, with respect to the client’s 268 habilitative and medical progress. 269 (8) Any client, or any parent of a minor client, or 270 guardian, authorized guardian advocate, or client advocate for a 271 client, who is substantially affected by the client’s initial 272 family or individual support plan, or the annual review thereof, 273 shall have the right to file a notice to challenge the decision 274 pursuant to ss. 120.569 and 120.57. Notice of such right to 275 appeal shall be included in all support plans provided by the 276 agency. 277 (9) When developing or reviewing a client’s family or 278 individual support plan, the waiver support coordinator shall 279 inform the client, the client’s parent or guardian, or, when 280 appropriate, the client advocate about the consumer-directed 281 care program established under s. 409.221. 282 Section 4. For the 2024-2025 fiscal year, the sum of 283 $16,562,703 in recurring funds from the General Revenue Fund and 284 $22,289,520 in recurring funds from the Operations and 285 Maintenance Trust Fund are appropriated in the Home and 286 Community Based Services Waiver category to the Agency for 287 Persons with Disabilities to offer waiver services to the 288 greatest number of individuals permissible under the 289 appropriation from preenrollment categories 3, 4, and 5, 290 including individuals whose caregiver is age 60 or older in 291 category 4, as provided in s. 393.065, Florida Statutes, as 292 amended by this act. 293 Section 5. The Agency for Health Care Administration and 294 the Agency for Persons with Disabilities, in consultation with 295 other stakeholders, shall jointly develop a comprehensive plan 296 for the administration, finance, and delivery of home and 297 community-based services through a new home and community-based 298 services Medicaid waiver program. The waiver program shall be 299 for clients transitioning into adulthood and shall be designed 300 to prevent future crisis enrollment into the waiver program 301 authorized under s. 393.0662, Florida Statutes. The Agency for 302 Health Care Administration is authorized to contract with 303 necessary experts to assist in developing the plan. The Agency 304 for Health Care Administration must submit a report to the 305 Governor, the President of the Senate, and the Speaker of the 306 House of Representatives by December 1, 2024, addressing, at a 307 minimum, all of the following: 308 (1) The purpose, rationale, and expected benefits of the 309 new waiver program. 310 (2) The proposed eligibility criteria for clients and 311 service packages to be offered through the new waiver program. 312 (3) A proposed implementation plan and timeline, including 313 recommendations for the number of clients to be served by the 314 new waiver program at initial implementation, changes over time, 315 and any per-client benefit caps. 316 (4) Proposals for how clients will transition onto and off 317 of the new waiver, including, but not limited to, transitions 318 between this new waiver and the waiver established under s. 319 393.0662, Florida Statutes. 320 (5) The fiscal impact for the implementation year and 321 projections for the subsequent 5 years, determined on an 322 actuarially sound basis. 323 (6) An analysis of the availability of services that would 324 be offered under the new waiver program and recommendations to 325 increase availability of such services, if necessary. 326 (7) A list of all stakeholders, public and private, who 327 were consulted or contacted as part of developing the plan for 328 the new waiver program. 329 Section 6. This act shall take effect July 1, 2024. 330 331 ================= T I T L E A M E N D M E N T ================ 332 And the title is amended as follows: 333 Delete everything before the enacting clause 334 and insert: 335 A bill to be entitled 336 An act relating to individuals with disabilities; 337 amending s. 393.064, F.S.; revising provisions related 338 to programs and services provided by the Agency for 339 Persons with Disabilities; requiring the agency, 340 within available resources, to offer voluntary 341 participation care navigation services to clients and 342 their caregivers at specified times; specifying goals 343 and requirements for such care navigation services; 344 specifying requirements for care plans; requiring the 345 integration of care plans with any individual 346 education plans of clients; specifying requirements 347 for such integration; amending s. 393.065, F.S.; 348 requiring the agency to develop and implement an 349 online application process; specifying requirements 350 for the online application process; defining the term 351 “complete application”; revising timeframes within 352 which the agency must make eligibility determinations 353 for services; lowering the age that a caregiver must 354 be for an individual to be placed in a certain 355 preenrollment category; amending s. 393.0651, F.S.; 356 revising which types of clients are eligible for an 357 individual support plan; clarifying the timeframe 358 within which a family or individual support plan must 359 be developed; requiring waiver support coordinators to 360 inform the client, client’s parent or guardian, or 361 client’s advocate, as appropriate, of certain 362 information when developing or reviewing the family or 363 individual support plan; providing appropriations; 364 requiring the Agency for Health Care Administration 365 and the Agency for Persons with Disabilities, in 366 consultation with other stakeholders, to jointly 367 develop a comprehensive plan for the administration, 368 finance, and delivery of home and community-based 369 services through a new home and community-based 370 services Medicaid waiver program; providing 371 requirements for the waiver program; authorizing the 372 Agency for Health Care Administration to contract with 373 necessary experts to assist in developing the plan; 374 requiring the Agency for Health Care Administration to 375 submit a specified report to the Governor and the 376 Legislature by a specified date; providing an 377 effective date.