Email from Florida Developmental Disabilities Council

February 2, 2024, Volume 24, Issue 4

The Florida House and Senate Are Finalizing Their Budgets

This year, the Florida Developmental Disabilities Council’s Le gislative Platform outlines the Council’s support of sustaining and expanding home- and community-based services(HCBS) for people with intellectual and developmental disabilities (I/DD).

In addition to supporting funding for more individuals with I/DD to receive home- and community-based services, the Council, along with other developmental disability advocates and partners, is recommending a uniform iBudget provider rate increase. The Senate’s Live Healthy program proposal in SB 7016 includes a 10% uniform rate increase for iBudget providers at $112,312,609. The House has a uniform proposal that is significantly less than the Senate’s proposal at $68,519,109. The House proposal is part of HB 1549.

What is unusual this year is that the legislature is crafting their budgets with some important budget items in bills. The House and Senate will finalize their individual budgets next week and then start the Budget Conference where they negotiate one final budget.

Another example of this is the recommendation of $38.8 million to expand iBudget waiver services to additional clients. This funding is expected to offer waiver services to individuals from pre-enrollment categories 3, 4, and 5. This funding is in SB 1758 and HB 1271 below.

The following are highlights from the initial House and Senate budget recommendations for individuals with I/DD (note the similarities and differences):

Senate budget highlights

Agency for Persons with Disabilities

• Pre-enrollment to waiver – $65 million to get as many people as possible off the waitlist (i.e., pre-enrollment list).

• Expansion of the Dual Diagnosis pilot program from last year – $4.9 million for the provision of a Dually Diagnosed Pilot Program in Broward, Orange, Hillsborough and Leon counties, to support individuals who are dually diagnosed with mental health challenges and developmental disabilities. This pilot includes training for mobile mental health treatment units, group home providers, parents and personnel support providers.

• Develop a new waiver called Adult Pathways - $300,000 for an actuarial study and planning geared toward creating a new waiver for young adults transitioning out of the school system that will have a limited selection of services. This study will determine a cap on overall expenditures.

• New forensic facility - $4 million to continue planning for a new forensic facility in Marianna to replace the existing facility at Florida State Hospital in Chattahoochee.

Agency for Health Care Administration

• Managed care pilot from last year - $48 million to support capitation payments for individuals enrolled in the pilot program for individuals with developmental disabilities. This pilot uses services from the iBudget waiver, the long-term care waiver and standard Medicaid that are offered through one managed care provider. The funding provides for 610 people in Miami-Dade and Monroe Counties. The pilot is currently under procurement. This budget request includes authority to enroll another 300 people in Hillsborough, Polk, Manatee, and Hardee Counties. The Agency for Persons with Disabilities shall determine eligibility for enrollment into the pilot.

• Early Intervention Services Rate Increase - $1.2 million

House budget highlights

Agency for Persons with Disabilities

• Expansion of the Dual Diagnosis pilot program from last year – $6.5 million for the provision of a Dually Diagnosed Pilot Program in Broward, Orange, Hillsborough and Leon counties, to support individuals who are dually diagnosed with mental health challenges and developmental disabilities. This pilot includes training for mobile mental health treatment units, group home providers, parents and support providers.

• Develop a new waiver called Adult Pathways - $800,000 for an actuarial study and planning geared toward creating a new waiver for young adults transitioning out of the school system that will have a limited selection of services. This study will determine a cap on overall expenditures.

• Managed Care Pilot - $ 29 million to transfer to AHCA to enroll individuals for participation in the AHCA Integrated Plan for Persons with Developmental Disabilities Pilot Program.

• Plans for a forensic facility - $6 million to continue planning for a new forensic facility in Marianna to replace the existing facility at Florida State Hospital in Chattahoochee. Also provides fixed capital outlay improvements, code corrections, life safety, and planning activities at the Developmentally Disabled Centers.

Below are bills the Council is supporting or tracking. Keep in mind that bills usually must pass through three or four committees before getting to the House or Senate chambers. Once in a chamber, bills are read three times before final passage and then sent to the other chamber for acceptance to end up with one bill to send to the Governor.

Please click on bill links to track a bill’s full journey through the process to date.

Important Bills to Watch

HB 73 - Supported Decision-Making Authority by Koster, Tant

Summary

This bill requires the court to consider the needs and abilities of persons with a developmental disability when determining whether to appoint a guardian advocate or a guardian. The bill creates a new type of power of attorney, termed a supported decision-making agreement (SDM agreement). The “supporter” in an SDM agreement would provide information, recommendations, and assistance to the eligible individual in making decisions and exercising his or her rights, but the supporter does not have any authority to make any binding decisions for or on behalf of the individual. The SDM agreement limits the supporter’s authority to only be able to obtain information on behalf of the principal, and assist the principal in communicating with third parties, including conveying the principal's communications, decisions, and directions to third parties on behalf of the principal.

When capacity is in question, HB 73 also permits the examining committee, which determines incapacity, to allow a person to assist with communication with the individual with a disability when requested by the court-appointed counsel for the alleged incapacitated person.

The final order addressing the level of guardianship or decision-making option selected must address why a less restrictive level of care was not selected instead of a more restrictive choice.

The bill adds SDM agreements to the list of alternative methods for parental involvement in educational decision making which an IEP team must share with the parent during the process of developing a transition plan for a student with a disability. The Council is supporting this bill.

Identical Bill

SB 0446 - Supported Decision-Making Authority by Simon

SB 212 - Medicaid Buy-In by Gruters

Summary

This bill would require the Agency for Health Care Administration to establish and implement a Medicaid buy-in program for individuals with disabilities who are 18 to 64 years of age and whose incomes exceed the maximum income eligibility level for initial enrollment to obtain coverage for medical assistance under the Medicaid program. The Medicaid buy-in program must provide full Medicaid benefits to eligible individuals and limit any premiums or cost sharing to a certain percentage of an individual’s income, as determined by the agency and requires the agency to seek federal waiver approval or submit any necessary state plan amendments by October 2024.

The Council supported this bill; however, it appears to have died for this session with the withdrawal of HB 567.

Withdrawn

HB 313 - Transparency for Autism-Related Services by Plascencia

Summary

The bill defines “manifests" and “onset" to mean the display or disclosure of characteristic signs or symptoms of an illness for use in determining Autism Spectrum Disorders and eligibility in general for the iBudget waiver.

The bill would direct the agency or its designee to notify each applicant, in writing, of its individualized eligibility determination, including any specific criteria the applicant has not met from the agency's eligibility criteria described in rule. The Council is supporting this bill.

Identical Bill

SB 0550 - Transparency for Autism-Related Services by Rouson

SB 794 - Medicaid Managed Care Plan Performance Metrics by Harrell

Summary

The bill would require Medicaid managed care plans to submit performance metrics monthly to the Agency for Health Care Administration. The bill would also require the agency to contract to develop and display on its public website a dashboard containing these monthly performance metrics; and the bill would require the agency to create a quarterly report on the metrics obtained. The Council is supporting this bill.

HB 77 - Recovery of Damages in Claims for Medical Negligence by Roach

Summary

This bill removes a provision that prohibits parents of an adult child from recovering damages in medical negligence suits. For example, some parents of children with disabilities have lost children to death through possible medical negligence and the law currently offers no ability for parents to seek damages for their adult children even if they have disabilities. In addition to removing this provision, SB 446 and HB 129 add that damages can be sought for medical negligence of a resident living in a facility. SB 248 adds that such recoveries are contingent upon certain findings or determinations by the Agency for Health Care Administration or the Department of Health. The Council is tracking these bills.

Identical Bills

SB 0310 - Recovery of Damages in Claims for Medical Negligence by Martin

SB 0248 - Medical Negligence by Yarborough

SB 0442 - Damages Recoverable in Wrongful Death Actions by Book

HB 341 - Designation of a Diagnosis on Motor Vehicle Registrations by Salzman

Summary

This bill authorizes motor vehicle owners or registrants to designate on his or her application form for motor vehicle registration that he or she has been diagnosed with, or is the parent or legal guardian of child or ward who has been diagnosed with, a developmental disability or psychiatric disorder and authorizes removal of such designation upon request. The Council is tracking this bill.

Identical Bills

SB 0288 - Designation of a Certain Diagnosis on Motor Vehicle Registrations by Rodriguez

SB 1758 - Home- and Community-Based Services Medicaid Waiver Program by Brodeur

Summary

This bill requires the Agency for Persons with Disabilities (APD) to develop and implement an automated, electronic application process for crisis services and therefore deleting the requirement that application for services be made to the agency in the region in which the applicant resides. The bill specifies that applicants meeting crisis criteria are deemed to be in crisis regardless of the applicant’s age. The bill requires the agency to make eligibility determination in a specified amount of time for clients in crisis. The bill also requires APD to educate new waiver recipients about the Consumer Directed Care Plus waiver.SB 1758 also includes the following provisions. First, the bill reduces the age requirement of a client’s caregiver in Pre-Enrollment Category 4 from 70 years of age to 60 years of age or older. This will allow a higher number of individuals to be included in Category 4 of the pre-enrollment prioritization list. Second, $16,562,703 in recurring funds from the General Revenue fund and $22,289,520 in recurring funds from the Operations and Maintenance Trust Fund are appropriated to the APD in the Home- and Community-Based Services Waiver category. These funds are appropriated to offer waiver services to the greatest number of individuals permissible under the appropriation from Pre-Enrollment Categories 3, 4, and 5, including individuals whose caregivers are age 60 or older in Category 4. The Council is supporting this bill.

Identical Bill

HB 1271 - Individuals with Disabilities by Buchanan

SB 1170 - Home- and Community-Based Services Medicaid Waiver Program by Bradley

HB 829 - Autism Spectrum Disorder Training for Law Enforcement Officers by Stark

Summary

This bill provides requirements for training officers for interacting with individuals with autism spectrum disorder. The bill requires the Criminal Justice Standards and Training Commission to adopt rules requiring such training as part of continued employment training for officers. The Council is supporting this bill.

HB 439 - Corporal Punishment Bill by Waldron, Cosponsors: Beltran, Gottlieb

Summary

This bill requires charter schools to comply with corporal punishment laws and removes provisions authorizing teachers to administer corporal punishment. The bill provides duties and responsibilities for principals relating to corporal punishment. The bill requires notification be provided to parents and prohibits the use of corporal punishment on students with an Individual Education Plan, 504 plan, Exceptional students as defined in s. 1003.01(9), homeless students and students in alternative schools. Finally, the bill specifies reporting requirements. The Council is supporting this bill.

Identical Bill

SB 1318 - Corporal Punishment by Thompson

SB 1578 - Student Elopement by Torres, Jr.

Summary

The bill requires public schools to create a School Staff Assistance for Emergencies (SAFE) Team and a school elopement plan. The bill specifies the membership and responsibilities of the SAFE Team. The bill would require the SAFE Team to create student-specific elopement quick reference guides for certain students and requires public schools to annually submit their plans to the district school board. The Council is supporting this bill.

Identical Bill

HB 1395 - Student Elopement by Eskamani

SB 832 - Employment of Individuals with Disabilities by Calatayud

Summary

This bill requires the collection and sharing of data between multiple agencies for the interagency cooperative agreement under the Employment First Act and requires the Office of Reimagining Education and Career Help to issue an annual statewide report by a specified date each year.

This bill is important to the Council, because we initiated the Employment First Act. The Council is supporting this bill.

Identical Bill

HB 1137 - Employment of Individuals with Disabilities by Redondo

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