SB 1156: Home Health Aide for Medically Fragile Children Program - Florida

S 1156 e1 → S 1156 er · 7 edits

MODERATE

This bill updates Florida's Home Health Aide for Medically Fragile Children program by establishing new training requirements, increasing minimum training hours from 76 to 85, raising the minimum Medicaid hourly rate to $25, and clarifying rules for when aides can work more than 40 hours per week. The changes aim to improve care quality, ensure adequate training for family caregivers, and provide financial support for those providing essential home care services.

Scope change

The bill expands the scope of the program by adding specific training topics (such as wound care, tracheostomy care, and enteral care) and clarifying the definition of a home health aide for medically fragile children to include a broader range of delegated tasks.

REQUIREMENT

Increased minimum training hours from 76 to 85 hours, with specific breakdowns including 40 hours of theoretical nursing instruction, 20 hours of skills training, and 16 hours of clinical training under nurse supervision.

Added specific training topics including measuring vital signs, safe lifting and positioning, wound care, portable oxygen use, tracheostomy care, enteral care, peripheral IV assistance, urinary catheterization, and ostomy care.

Clarified that the 40-hour weekly utilization cap can be exceeded when no other qualified provider is available, requiring justification and approval from the home health agency and managed care plan.

Added requirements for the agency to seek federal approval and waivers to allow Medicaid private duty nursing specialty providers to participate in the program and to disregard income earned under the program in Medicaid eligibility determinations.

Added annual assessment requirements to report caregiver satisfaction, adverse incident data, and hospitalization rates compared to traditional home health services.

FISCAL

Established a minimum Medicaid fee schedule rate of $25 per hour for home health agencies employing home health aides for medically fragile children.

DEFINITION

Expanded the definition of 'home health aide for medically fragile children' to include a comprehensive list of delegated tasks including data gathering, reporting abnormal signs, postmortem care, socialization, end-of-life care, and various medical procedures.

S 1156 c2 → S 1156 e1 · 6 edits

MODERATE

This bill updates Florida's Home Health Aide for Medically Fragile Children Program by expanding training requirements, adjusting fee schedules, and clarifying eligibility rules. The changes aim to improve care quality for medically fragile children while ensuring adequate compensation and federal compliance for home health agencies.

Scope change

The bill expands the program's scope by adding specific training topics (wound care, oxygen use, tracheostomy care, etc.) and allowing utilization caps to be exceeded with justification when no other qualified provider is available.

REQUIREMENT

Training requirements increased from 85 hours to include specific clinical training topics like wound care, portable oxygen use, tracheostomy care, enteral care, and urinary catheterization.

FISCAL

Medicaid fee schedule minimum rate set at $25 per hour with a utilization cap of 8 hours per day and 40 hours per week, though caps can be exceeded with justification.

ELIGIBILITY

Income earned by home health aides for medically fragile children is now disregarded in Medicaid eligibility determinations for low-income families.

DEFINITION

Definition of 'home health aide for medically fragile children' expanded to include specific delegated tasks like wound care, oxygen procedures, and tracheostomy care.

ENFORCEMENT

Added requirement for home health agencies to report adverse incidents within 48 hours to the agency and managed care plan.

TIMELINE

Agency required to seek federal approval and implement waivers within 60 days of the act becoming law.

S 1156 c1 → S 1156 c2 · 6 edits

MODERATE

This bill updates Florida's Home Health Aide for Medically Fragile Children program by strengthening training requirements, clarifying fee schedules, and adding new provisions for federal approval. The changes aim to improve care quality, ensure adequate staffing, and provide clearer guidelines for reimbursement and eligibility.

Scope change

The bill expands the scope by adding specific training requirements for HIV/AIDS and CPR certification, increasing the number of required training hours, and clarifying the utilization cap for services.

REQUIREMENT

Training requirements were revised to include HIV/AIDS training and CPR certification, with a total of 85 hours (40 hours theoretical, 20 hours skills, 16 hours clinical) instead of the previous 20 hours theoretical and 20 hours skills.

New requirements mandate that home health agencies provide training on HIV infections and AIDS and ensure each aide holds and maintains CPR certification.

FISCAL

The Medicaid fee schedule was updated to establish a minimum rate of $25 per hour with a utilization cap of 8 hours per day and 40 hours per week, with provisions for exceeding the cap when no other qualified provider is available.

DEFINITION

The definition of 'home health aide for medically fragile children' was expanded to include a comprehensive list of tasks delegated under chapter 464, including tracheostomy care, enteral care, and peripheral intravenous assistive activities.

TIMELINE

The effective date was changed from January 1, 2025 to upon becoming law, and the agency was given 60 days to seek federal approval and implement necessary rulemaking.

ENFORCEMENT

New provisions require the agency to seek federal approval and implement federal waivers and state plan amendments to allow Medicaid private duty nursing specialty providers to participate in the program and disregard income earned under the program for eligibility determinations.

S 1156 Filed → S 1156 c1 · 7 edits

MODERATE

This bill revises the Home Health Aide for Medically Fragile Children Program by clarifying training requirements, adjusting utilization caps, adding adverse incident reporting, and expanding federal approval requirements. The changes aim to improve program oversight, ensure caregiver competency, and allow income earned under the program to be excluded from Medicaid eligibility calculations.

Scope change

The bill expands the program's scope by adding adverse incident reporting requirements, clarifying training validation processes, and extending federal approval obligations to additional statutes (400.462 and 409.903).

REQUIREMENT

Training requirements now require competency validation by a registered nurse and documentation of training completion, with additional training required as care needs change.

Utilization cap revised from 12 hours per day to 8 hours per day and 40 hours per week, with provisions allowing exceptions when no other qualified provider is available.

Annual assessments must now include data on adverse incidents and compare hospitalization rates between children cared for by home health aides versus those cared for by registered or licensed practical nurses.

ENFORCEMENT

New requirement for home health agencies to report adverse incidents (death, brain/spinal damage, permanent disfigurement, fractures, neurological limitations, or law enforcement investigations) within 48 hours.

ELIGIBILITY

Income earned by home health aides for medically fragile children must be disregarded when determining eligibility for public assistance under s. 414.0252.

TIMELINE

Agency required to seek federal approval within 30 days of the act becoming law, with additional 60-day requirement for rulemaking implementation.

DEFINITION

Definition of home health aide for medically fragile children expanded to include specific delegated tasks under chapter 464.

Home Health Aide for Medically Fragile Children Program

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