F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 1047 2024
1 A bill to be entitled
2 An act relating to home and community-based services
3 Medicaid waiver program; amending s. 393.065, F.S.;
4 requiring the Agency for Persons with Disabilities to
5 develop and implement an automated, electronic
6 application process for specified services; providing
7 requirements for the application process; requiring
8 the agency to provide an application in a printed form
9 or a portable document format under certain
10 circumstances; requiring the agency to make an
11 eligibility determination in a specified amount of
12 time for certain persons; authorizing the agency to
13 request additional documentation under certain
14 circumstances; providing requirements for such
15 request; requiring rulemaking; amending s. 393.0662,
16 F.S.; providing requirements for the Agency for Health
17 Care Administration when a client's iBudget is
18 established; requiring the agency within a specified
19 time period to ensure certain services that a client
20 has applied for have begun; requiring rulemaking;
21 amending ss. 393.0651, 409.9127, and s. 409.9855,
22 F.S.; conforming provisions to changes made by the
23 act; providing an effective date.
24
25 Be It Enacted by the Legislature of the State of Florida:
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HB 1047 2024
26
27 Section 1. Subsections (1) through (12) of section
28 393.065, Florida Statutes, are renumbered as subsections (2)
29 through (13), respectively, present subsections (1), (5), (6),
30 and (7), paragraph (a) of present subsection (8), and present
31 subsections (11) and (12) are amended, and a new subsection (1)
32 is added to that section, to read:
33 393.065 Application and eligibility determination. —
34 (1) As part of the agency's website, the agency shall
35 develop and implement an automated, electronic application
36 process. The application process shall, at a minimum, support:
37 (a) Electronic submissions.
38 (b) Automatic processing of each application.
39 (c) Immediate automatic e-mail confirmation to each
40 applicant with proof of filing along with a date and time stamp.
41 (d) Upon request, if the applicant does not have access to
42 electronic resources, the agency providing the applicant with
43 the application in printed form or in a portable document
44 format.
45 (2)(1) Application for services shall be made in writing to
46 the agency, in the region in which the applicant resides. The
47 agency shall review each application and make an eligibility
48 determination within 60 days after receipt of the signed
49 application. If, at the time of the application, an applicant is
50 requesting enrollment in the home and community-based services
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51 Medicaid waiver program for individuals with developmental
52 disabilities deemed to be in crisis, as described in paragraph
53 (6)(a) (5)(a), the agency shall complete an eligibility
54 determination within 45 days after receipt of the signed
55 application.
56 (a) If the agency determines additional documentation is
57 necessary to make an eligibility determination, the agency may
58 request the additional documentation from the applicant.
59 (b) When necessary to definitively identify individual
60 conditions or needs, the agency or its designee must provide a
61 comprehensive assessment.
62 (c) If the agency requests additional documentation from
63 the applicant or provides or arranges for a comprehensive
64 assessment, the agency's eligibility determination must be
65 completed within 90 days after receipt of the signed
66 application.
67 (d) If the applicant meets the criteria in paragraph
68 (7)(b), such applicant shall be deemed in crisis and the
69 following shall be required, regardless of age:
70 1. The agency shall review each application and make an
71 eligibility determination within 5 business days after receipt
72 of the signed application.
73 2. If, at the time of the application, the applicant is
74 requesting enrollment in the home and community-based services
75 Medicaid waiver program for individuals with developmental
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76 disabilities deemed to be in crisis, as described in paragraph
77 (7)(a), the agency shall complete an eligibility determination
78 within 15 calendar days after receipt of the signed application.
79 3. If the agency determines additional documentation is
80 necessary to make an eligibility determination, the agency may
81 request additional documentation from the applicant, but such
82 agency request may not prevent or delay services to the
83 applicant. When necessary to definitively identify individual
84 conditions or needs, the agency or its designee must provide a
85 comprehensive assessment.
86 4. If the agency requests additional documentation from
87 the applicant or provides or arranges for a comprehensive
88 assessment, the agency's eligibility determination must be
89 completed within 60 calendar days after receipt of the signed
90 application.
91 (6)(5) Except as provided in subsections (7) and (8) (6)
92 and (7), if a client seeking enrollment in the developmental
93 disabilities home and community-based services Medicaid waiver
94 program meets the level of care requirement for an intermediate
95 care facility for individuals with intellectual disabilities
96 pursuant to 42 C.F.R. ss. 435.217(b)(1) and 440.150, the agency
97 must assign the client to an appropriate preenrollment category
98 pursuant to this subsection and must provide priority to clients
99 waiting for waiver services in the following order:
100 (a) Category 1, which includes clients deemed to be in
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101 crisis as described in rule, must be given first priority in
102 moving from the preenrollment categories to the waiver.
103 (b) Category 2, which includes clients in the
104 preenrollment categories who are:
105 1. From the child welfare system with an open case in the
106 Department of Children and Families' statewide automated child
107 welfare information system and who are either:
108 a. Transitioning out of the child welfare system into
109 permanency; or
110 b. At least 18 years but not yet 22 years of age and who
111 need both waiver services and extended foster care services; or
112 2. At least 18 years but not yet 22 years of age and who
113 withdrew consent pursuant to s. 39.6251(5)(c) to remain in the
114 extended foster care system.
115 For individuals who are at least 18 years but not yet 22 years
116 of age and who are eligible under sub-subparagraph 1.b., the
117 agency must provide waiver services, including residential
118 habilitation, and the community-based care lead agency must fund
119 room and board at the rate established in s. 409.145(3) and
120 provide case management and related services as defined in s.
121 409.986(3)(e). Individuals may receive both waiver services and
122 services under s. 39.6251. Services may not duplicate services
123 available through the Medicaid state plan.
124 (c) Category 3, which includes, but is not required to be
125 limited to, clients:
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126 1. Whose caregiver has a documented condition that is
127 expected to render the caregiver unable to provide care within
128 the next 12 months and for whom a caregiver is required but no
129 alternate caregiver is available;
130 2. At substantial risk of incarceration or court
131 commitment without supports;
132 3. Whose documented behaviors or physical needs place them
133 or their caregiver at risk of serious harm and other supports
134 are not currently available to alleviate the situation; or
135 4. Who are identified as ready for discharge within the
136 next year from a state mental health hospital or skilled nursing
137 facility and who require a caregiver but for whom no caregiver
138 is available or whose caregiver is unable to provide the care
139 needed.
140 (d) Category 4, which includes, but is not required to be
141 limited to, clients whose caregivers are 70 years of age or
142 older and for whom a caregiver is required but no alternate
143 caregiver is available.
144 (e) Category 5, which includes, but is not required to be
145 limited to, clients who are expected to graduate within the next
146 12 months from secondary school and need support to obtain a
147 meaningful day activity, maintain competitive employment, or
148 pursue an accredited program of postsecondary education to which
149 they have been accepted.
150 (f) Category 6, which includes clients 21 years of age or
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151 older who do not meet the criteria for category 1, category 2,
152 category 3, category 4, or category 5.
153 (g) Category 7, which includes clients younger than 21
154 years of age who do not meet the criteria for category 1,
155 category 2, category 3, or category 4.
156 Within preenrollment categories 3, 4, 5, 6, and 7, the agency
157 shall prioritize clients in the order of the date that the
158 client is determined eligible for waiver services.
159 (7)(6) The agency must allow an individual who meets the
160 eligibility requirements of subsection (3) (2) to receive home
161 and community-based services in this state if the individual's
162 parent or legal guardian is an active-duty military
163 servicemember and if, at the time of the servicemember's
164 transfer to this state, the individual was receiving home and
165 community-based services in another state.
166 (8)(7) The agency must allow an individual with a
167 diagnosis of Phelan-McDermid syndrome who meets the eligibility
168 requirements of subsection (3) (2) to receive home and
169 community-based services.
170 (9)(8) Only a client may be eligible for services under
171 the developmental disabilities home and community-based services
172 Medicaid waiver program. For a client to receive services under
173 the developmental disabilities home and community-based services
174 Medicaid waiver program, there must be available funding
175 pursuant to s. 393.0662 or through a legislative appropriation
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176 and the client must meet all of the following:
177 (a) The eligibility requirements of subsection (3) (2),
178 which must be confirmed by the agency.
179 (12)(a)(11)(a) The agency must provide the following
180 information to all applicants or their parents, legal guardians,
181 or family members:
182 1. A brief overview of the vocational rehabilitation
183 services offered through the Division of Vocational
184 Rehabilitation of the Department of Education, including a
185 hyperlink or website address that provides access to the
186 application for such services;
187 2. A brief overview of the Florida ABLE program as
188 established under s. 1009.986, including a hyperlink or website
189 address that provides access to the application for establishing
190 an ABLE account as defined in s. 1009.986(2);
191 3. A brief overview of the supplemental security income
192 benefits and social security disability income benefits
193 available under Title XVI of the Social Security Act, as
194 amended, including a hyperlink or website address that provides
195 access to the application for such benefits;
196 4. A statement indicating that the applicant's local
197 public school district may provide specialized instructional
198 services, including transition programs, for students with
199 special education needs;
200 5. A brief overview of programs and services funded
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201 through the Florida Center for Students with Unique Abilities,
202 including contact information for each state-approved Florida
203 Postsecondary Comprehensive Transition Program;
204 6. A brief overview of decisionmaking options for
205 individuals with disabilities, guardianship under chapter 744,
206 and alternatives to guardianship as defined in s. 744.334(1),
207 which may include contact information for organizations that the
208 agency believes would be helpful in assisting with such
209 decisions;
210 7. A brief overview of the referral tools made available
211 through the agency, including a hyperlink or website address
212 that provides access to such tools; and
213 8. A statement indicating that some waiver providers may
214 serve private-pay individuals.
215 (b) The agency must provide the information required in
216 paragra