Florida Senate - 2026 SENATOR AMENDMENT
Bill No. HB 5301-E
Ì953056.Î953056
LEGISLATIVE ACTION
Senate . House
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Floor: 1/AD/2R .
05/12/2026 11:15 AM .
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Senator Trumbull moved the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Paragraph (c) is added to subsection (6) of
6 section 216.136, Florida Statutes, to read:
7 216.136 Consensus estimating conferences; duties and
8 principals.—
9 (6) SOCIAL SERVICES ESTIMATING CONFERENCE.—
10 (c) The Social Services Estimating Conference shall develop
11 official information relating to the pilot program for
12 individuals with developmental disabilities implemented pursuant
13 to s. 409.9855, including, but not limited to, data related to
14 enrollment, caseloads, utilization of services, program
15 expenditures, and any other information that the conference
16 determines necessary for the state planning and budgeting system
17 and to project future budgets and drawdown of federal matching
18 funds.
19 Section 2. Subsection (8) is added to section 394.495,
20 Florida Statutes, to read:
21 394.495 Child and adolescent mental health system of care;
22 programs and services.—
23 (8) As authorized by and consistent with funding
24 appropriated in the General Appropriations Act, the department
25 may contract with Valerie’s House, Inc., a nonprofit
26 organization exempt from taxation pursuant to s. 501(c)(3) of
27 the Internal Revenue Code, to provide grief support services to
28 help children and youth ages 4 to 19 who have experienced the
29 death of a parent or sibling. The services provided must be at
30 no cost to the bereaved child or his or her caregiver and may
31 include, but need not be limited to, grief support groups,
32 mentoring, individual grief counseling, financial crisis
33 support, and in-school support services. Valerie’s House, Inc.,
34 may also provide grief awareness training and outreach to local
35 schools and medical facilities under the contract.
36 Section 3. Subsection (3) of section 409.145, Florida
37 Statutes, is amended to read:
38 409.145 Care of children; “reasonable and prudent parent”
39 standard.—The child welfare system of the department shall
40 operate as a coordinated community-based system of care which
41 empowers all caregivers for children in foster care to provide
42 quality parenting, including approving or disapproving a child’s
43 participation in activities based on the caregiver’s assessment
44 using the “reasonable and prudent parent” standard.
45 (3) ROOM AND BOARD RATES.—
46 (a) Effective July 1, 2026 2022, room and board rates shall
47 be paid to foster parents, including relative and nonrelative
48 caregivers who are licensed as a level I child-specific foster
49 placement, and to relative and nonrelative caregivers who are
50 participating in the Relative Caregiver Program and receiving
51 payments pursuant to s. 39.5085(2)(d)1. or 2., as follows:
52
53 Monthly Room and Board Rate
54 0-5 YearsAge 6-12 YearsAge 13-21 YearsAge
55 $663.03 $517.94 $680.01 $531.21 $795.94 $621.77
56
57 (b) Each January, foster parents, including relative and
58 nonrelative caregivers who are licensed as a level I child
59 specific foster placement and relative and nonrelative
60 caregivers who are participating in the Relative Caregiver
61 Program and receiving payments pursuant to s. 39.5085(2)(d)1. or
62 2., shall receive an annual cost of living increase. The
63 department shall calculate the new room and board rate increase
64 equal to the percentage change in the Consumer Price Index for
65 All Urban Consumers, U.S. City Average, All Items, not
66 seasonally adjusted, or successor reports, for the preceding
67 December compared to the prior December as initially reported by
68 the United States Department of Labor, Bureau of Labor
69 Statistics. The department shall make available the adjusted
70 room and board rates annually.
71 (c) The amount of the monthly room and board rate may be
72 increased upon agreement among the department, the community
73 based care lead agency, and the foster parent.
74 (d) Effective July 1, 2022, community-based care lead
75 agencies providing care under contract with the department shall
76 pay a supplemental room and board payment to foster parents,
77 including relative and nonrelative caregivers who are licensed
78 as a level I child-specific foster placement and relative and
79 nonrelative caregivers who are participating in the Relative
80 Caregiver Program and receiving payments pursuant to s.
81 39.5085(2)(d)1. or 2., on a per-child basis, for providing
82 independent life skills and normalcy supports to children who
83 are 13 through 17 years of age placed in their care. The
84 supplemental payment must be paid monthly in addition to the
85 current monthly room and board rate payment. The supplemental
86 monthly payment shall be based on 10 percent of the monthly room
87 and board rate for children 13 through 21 years of age as
88 provided under this section and adjusted annually.
89 Section 4. Section 409.1455, Florida Statutes, is amended
90 to read:
91 409.1455 Step into Success Workforce Education and
92 Internship Pilot Program for foster youth and former foster
93 youth.—
94 (1) SHORT TITLE.—This section may be cited as the “Step
95 into Success Act.”
96 (2) CREATION.—The department shall establish the 3-year
97 Step into Success Workforce Education and Internship Pilot
98 Program to give eligible foster youth and former foster youth an
99 opportunity to learn and develop essential workforce and
100 professional skills, to transition from the custody of the
101 department to independent living, and to become better prepared
102 for an independent and successful future. The pilot program must
103 consist of an independent living professionalism and workforce
104 education component and, for youth who complete that component,
105 an onsite workforce training internship component. In
106 consultation with subject-matter experts and the community-based
107 care lead agencies, the office shall develop and administer the
108 pilot program for interested foster youth and former foster
109 youth; however, the department may contract with entities that
110 have demonstrable subject-matter expertise in the transition to
111 adulthood for foster youth, workforce training and preparedness,
112 professional skills, and related subjects to collaborate with
113 the office in the development and administration of the pilot
114 program. The independent living professionalism and workforce
115 education component of the program must culminate in a
116 certificate that allows a former foster youth to participate in
117 the onsite workforce training internship.
118 (3) DEFINITIONS.—For purposes of this section, the term:
119 (a) “Community-based care lead agency” has the same meaning
120 as in s. 409.986(3).
121 (b) “Former foster youth” means an individual 18 years of
122 age or older but younger than 26 years of age who is currently
123 or was previously placed in licensed care, excluding Level I
124 licensed placements pursuant to s. 409.175(5)(a)1., for at least
125 60 days within this state.
126 (c) “Foster youth” means an individual older than 16 years
127 of age but younger than 18 years of age who is currently in
128 licensed care, excluding Level I licensed placements pursuant to
129 s. 409.175(5)(a)1.
130 (d) “Office” means the department’s Office of Continuing
131 Care.
132 (e) “Participating organization” means a state agency, a
133 corporation under chapter 607 or chapter 617, or another
134 relevant entity that has agreed to collaborate with the office
135 in the development and implementation of a trauma-informed
136 onsite workforce training internship program pursuant to
137 subsections (6) and (7).
138 (4) REQUIREMENTS OF THE DEPARTMENT AND OFFICE.—The
139 department shall establish and the office shall develop and
140 administer the pilot program for eligible foster youth and
141 former foster youth. The office shall do all of the following:
142 (a) Develop eligible foster youth and former foster youth
143 cohorts within the department’s regions.
144 (b) Collaborate with local chambers of commerce and recruit
145 mentors and organizations within the department’s regions,
146 emphasizing recruitment of mentors and organizations in the
147 following counties:
148 1. Duval.
149 2. Escambia.
150 3. Hillsborough.
151 4. Palm Beach.
152 5. Polk.
153 (c) Provide eligible former foster youth with a variety of
154 internship placement opportunities, including by connecting
155 existing third-party mentorship organizations that focus on
156 former foster youth with eligible former foster youth who have
157 an interest in such organizations’ programs The pilot program
158 must be administered as part of an eligible foster youth’s
159 regular transition planning under s. 39.6035 or as a post
160 transition service for eligible former foster youth. The office
161 must begin the professionalism and workforce education component
162 of the program on or before January 1, 2024, and the onsite
163 workforce training internship component of the program on or
164 before July 1, 2024.
165 (5) INDEPENDENT LIVING PROFESSIONALISM AND WORKFORCE
166 EDUCATION COMPONENT REQUIREMENTS.—The office shall do all of the
167 following in connection with the independent living
168 professionalism and workforce education component for eligible
169 foster youth and former foster youth:
170 (a) Designate and ensure that the number of qualified staff
171 is sufficient to implement and administer the component, which
172 may be part of a larger independent living or life skills
173 training program if the larger program meets the requirements of
174 this subsection.
175 (b) Develop all workshops, presentations, and curricula for
176 the component, including, but not limited to, all written
177 educational and training materials for foster youth and former
178 foster youth. Resources may include, but are not limited to,
179 workshops and materials to assist with preparing résumés, mock
180 interviews, experiential training, and assistance with securing
181 an internship or employment. The office must review and update
182 these materials as necessary. The training materials must
183 address, but are not limited to, the following:
184 1. Interview skills;
185 2. Professionalism;
186 3. Teamwork;
187 4. Leadership;
188 5. Problem solving; and
189 6. Conflict resolution in the workplace.
190 (c) Require that the training provided be in addition to
191 any other life skills or employment training required by law.
192 The training may be developed or administered by the department,
193 community-based care lead agencies, or the lead agencies’
194 subcontracted providers, or in collaboration with colleges or
195 universities or other nonprofit organizations in the community
196 with workforce education and training resources.
197 (d) Provide relevant written materials from the component
198 and any relevant tools developed to ensure participants’
199 successful transition to internships to all participating
200 organizations that offer workforce training internship
201 opportunities.
202 (e) Provide materials to inform eligible foster youth and
203 former foster youth of the program, the requirements for
204 participation, and contact information for enrollment. The
205 community-based care lead agencies shall ensure that any
206 subcontracted providers that directly serve youth receive this
207 information.
208 (f) Advertise and promote the availability of the education
209 and internship program to engage as many eligible foster youth
210 and former foster youth as possible.
211 (g) Assess the career interests of each eligible foster
212 youth and former foster youth who expresses interest in
213 participating in the program and determine the most appropriate
214 internship and post-internship opportunities for that youth
215 based on his or her expressed interests.
216 (6) ONSITE WORKFORCE TRAINING INTERNSHIP COMPONENT
217 REQUIREMENTS.—The office shall do all of the following in
218 connection with the onsite workforce training internship program
219 for eligible former foster youth:
220 (a) Develop processes and procedures to implement a trauma
221 informed onsite workforce training internship component. The
222 processes and procedures of the internship component must be
223 designed so that they can be replicated and scaled to meet
224 various organizational structures and sizes. The component must
225 include:
226 1. Recruitment of agencies, corporations, and other
227 entities to host interns as participating organizations;
228 2. Assisting participating organizations with mentor
229 recruitment, training, and matching;
230 3. Mentor-led performance reviews, including a review of
231 the intern’s work product, professionalism, time management,
232 communication style, and stress-management strategies;
233 4. Daily mentorship and coaching on topics such as:
234 a. Professionalism;
235 b. Teamwork;
236 c. Leadership;
237 d. Problem solving; and
238 e. Conflict resolution in the workplace;
239 5. Development of opportunities for interns to become
240 employees of the participating organization; and
241 6. Reporting requirements specified in subsection (11).
242 (b) Develop a minimum of 1 hour of required trauma-informed
243 training for mentors to satisfy the requirements of sub
244 subparagraph (7)(b)1.e. Such training must include interactive
245 or experiential components, such as role-playing, scenario
246 discussion, or case studies. The office may provide at least
247 four additional 1-hour trainings on mentorship of special
248 populations as optional training opportunities, which must be
249 asynchronous and accessible to mentors online at their
250 convenience, and must inform participating organizations of
251 these optional training opportunities teach the skills necessary
252 to engage with participating eligible former foster youth.
253 (c) Provide assistance to eligible foster youth and former
254 foster youth interested in participating in the internship
255 component, including, but not limited to, identifying and
256 monitoring internship opportunities, being knowledgeable of the
257 training and skills needed to match eligible foster youth and
258 former foster youth with appropriate internships, and assisting
259 eligible foster youth and former foster youth with applying for
260 post-internship employment opportunities.
261 (d) Publicize specific internship positions in an easily
262 accessible manner and inform eligible foster youth and former
263 foster youth of where to locate such information.
264 (e) Provide a participating former foster youth with
265 financial assistance in the amount of $1,717 $1,517 monthly and
266 develop a process and schedule for the distribution of payments
267 to former foster youth participating in the component, subject
268 to the availability of funds.
269 (f) Distribute funds appropriated for the compensation of
270 mentors who are participating in the component as provided in
271 paragraph (7)(b).
272 (g) By May 1, 2024, provide to the Board of Governors and
273 the State Board of Education all relevant internship information
274 necessary to support the award of postsecondary credit or career
275 education clock hours for internship positions held by former
276 foster youth participating in the onsite workforce training
277 internship component.
278 (h) Develop and conduct follow-up surveys with:
279 1. Former foster youth within 3 months after their
280 internship start date to ensure successful transition into the
281 work environment and to gather feedback on how to improve the
282 experience for future participants.
283 2. Mentors assigned to participating former foster youth.
284 Such data must be collected by October 1, 2024, and by October 1
285 annually thereafter, for inclusion in the independent living
286 services annual report.
287 3. Any other persons the office deems relevant for purposes
288 of continued improvement of the internship component.
289 (i) Assign experienced staff to serve as program liaisons
290 who are available for mentors to contact whenever the mentors
291 need to debrief or have questions concerning a former foster
292 youth.
293 (7) REQUIREMENTS FOR PARTICIPATING ORGANIZATIONS.—Each
294 organization participating in the onsite workforce training
295 internship component shall:
296 (a) Collaborate with the office to implement a trauma
297 informed approach to mentoring and training former foster youth.
298 (b) Recruit employees to serve as mentors for former foster
299 youth interning with such organizations.
300 1. To serve as a mentor, an employee must:
301 a. Have worked in his or her career field or area for the
302 participating organization for at least 1 year;
303 b. Have experience relevant to the job and task
304 responsibilities of the intern;
305 c. Sign a monthly hour statement for the intern;
306 d. Allocate at least 1 hour per month to conduct mentor-led
307 performance reviews, to include a review of the intern’s work
308 product, professionalism, time management, communication style,
309 and stress-management strategies; and
310 e. Complete a minimum of 1 hour of trauma-informed training
311 to gain and maintain skills critical for successfully engaging
312 former foster youth. Before being matched with a former foster
313 youth, the employee must complete a 1-hour training that covers
314 core topics, including, but not limited to:
315 (I) Understanding trauma and its impacts.
316 (II) Recognizing and responding to trauma-related
317 behaviors.
318 (III) De-escalation strategies and crisis response.
319 (IV) Boundaries and mentor self-care.
320 (V) Communication skills.
321
322 The department may offer a 1-hour training to review topics
323 covered by the training required under this sub-subparagraph
324 every subsequent year that the employee chooses to serve as a
325 mentor.
326 2. Subject to available funding, an employee who serves as
327 a mentor and receives the required trauma-informed training is
328 eligible for a maximum payment of $1,200 per intern per fiscal
329 year, to be issued as a $100 monthly payment for every month of
330 service as a mentor.
331 3. An employee may serve as a mentor for a maximum of three
332 interns at one time and may not receive more than $3,600 in
333 compensation per fiscal year for serving as a mentor. Any time
334 spent serving as a mentor to an intern under this section counts
335 toward the minimum service required for eligibility for payments
336 pursuant to subparagraph 2. and this subparagraph.
337 4. An employee who serves as a mentor may participate in
338 additional trainings on the mentorship of special populations as
339 made available by the office.
340 (c) When necessary, have a discussion with an intern’s
341 assigned mentor, the participating organization’s internship
342 program liaison, and the office about the creation of a
343 corrective action plan to address issues related to the intern’s
344 professionalism, work product, or performance and, if
345 applicable, after giving the intern a reasonable opportunity to
346 comply with the corrective action plan, document the intern’s
347 failure to do so before discharging him or her.
348 (d) Provide relevant feedback to the office at least
349 annually for the office to comply with paragraph (6)(h).
350 (e) Collaborate with the department to provide any
351 requested information necessary to prepare the annual report
352 required under subsection (11).
353 (8) TIME LIMITATIONS FOR PARTICIPATION.—A former foster
354 youth who obtains an internship with a participating
355 organization may participate in the internship component for no
356 more than 1 year, calculated as 12 monthly stipend periods. The
357 year begins on his or her start date with a participating
358 organization. A former foster youth may intern under the
359 internship program with more than one participating
360 organization, but may not intern with more than one
361 participating organization at the same time. A participating
362 organization may hire the intern as an employee, but the hiring
363 of a former foster youth may not be for an internship under this
364 section.
365 (9) AWARD OF POSTSECONDARY CREDIT.—The Board of Governors
366 and the State Board of Education shall adopt regulations and
367 rules, respectively, to award postsecondary credit or career
368 education clock hours for eligible former foster youth
369 participating in the internship component pursuant to subsection
370 (4). The regulations and rules must include procedures for the
371 award of postsecondary credit or career education clock hours,
372 including, but not limited to, equivalency and alignment of the
373 internship component with appropriate postsecondary courses and
374 course descriptions.
375 (10) CONDITIONS OF PARTICIPATION IN THE INTERNSHIP
376 COMPONENT.—
377 (a) To become a participant in the internship component of
378 the program, the applicant must be a foster youth or a former
379 foster youth as those terms are defined in subsection (3) at the
380 time such youth applies for an internship position with a
381 participating organization. A foster youth or former foster
382 youth who has completed the training component with the
383 department may apply for a position with a participating
384 organization but may not begin an internship until attaining the
385 age of 18 years.
386 (b) If offered an internship, a former foster youth must be
387 classified as an intern and must work 80 hours per month to be
388 eligible for the stipend payment.
389 (c) A former foster youth must spend any stipend funds
390 specified for clothing on clothing that is in compliance with
391 the dress code requirements of the participating organization
392 with which the former foster youth is interning. Notwithstanding
393 any limitation on funds provided to purchase clothing, the
394 former foster youth must comply with any dress code requirements
395 of the participating organization with which he or she is
396 interning.
397 (d) Stipend money earned pursuant to the internship
398 component may not be considered earned income for purposes of
399 computing eligibility for federal or state benefits, including,
400 but not limited to, the Supplemental Nutrition Assistance
401 Program, a housing choice assistance voucher program, the
402 Temporary Cash Assistance Program, the Medicaid program, or the
403 school readiness program. Notwithstanding this paragraph, any
404 reduction in the amount of benefits or loss of benefits due to
405 receipt of the Step into Success stipend may be offset by an
406 additional stipend payment equal to the value of the maximum
407 benefit amount for a single person allowed under the
408 Supplemental Nutrition Assistance Program.
409 (e) A former foster youth may, at the discretion of a
410 postsecondary educational institution within this state in which
411 such youth is enrolled, earn postsecondary credit or career
412 education clock hours for work performed as an intern under the
413 internship component. Postsecondary credit and career education
414 clock hours earned for work performed under the internship
415 component may be in addition to any compensation earned for the
416 same work performed under the internship component and may be
417 awarded for completion of all or any part of the internship
418 component. Participating organizations shall cooperate with
419 postsecondary educational institutions to provide any
420 information about internship positions which is necessary to
421 enable the institutions to determine whether to grant the
422 participating former foster youth postsecondary credit or career
423 education clock hours toward his or her degree.
424 (f) A former foster youth who accepts an internship with a
425 participating organization pursuant to this section may only be
426 discharged from the internship component after the participating
427 organization engages the intern’s assigned mentor and the
428 participating organization’s internship program staff to assist
429 the intern in performing the duties of the internship. Before
430 discharging the former foster youth, the participating
431 organization must also document the intern’s failure to comply
432 with a corrective action plan after being given a reasonable
433 opportunity to do so.
434 (11) REPORT.—The department shall include a section on the
435 Step into Success Workforce Education and Internship Pilot
436 Program in the independent living annual report prepared
437 pursuant to s. 409.1451(6) which includes, but is not limited
438 to, all of the following:
439 (a) Whether the pilot program is in compliance with this
440 section, and if not, barriers to compliance.
441 (b) A list of participating organizations and the number of
442 interns.
443 (c) A summary of recruitment efforts to increase the number
444 of participating organizations.
445 (d) A summary of the feedback and surveys received pursuant
446 to paragraph (6)(h) from participating former foster youth,
447 mentors, and others who have participated in the pilot program.
448 (e) Recommendations, if any, for actions necessary to
449 improve the quality, effectiveness, and outcomes of the pilot
450 program.
451 (f) Employment outcomes of former foster youth who
452 participated in the pilot program, including employment status
453 after completion of the program, whether he or she is employed
454 by the participating organization in which he or she interned or
455 by another entity, and job description and salary information,
456 if available.
457 (12) RULEMAKING.—The department shall adopt rules to
458 implement this section.
459 Section 5. Section 409.1475, Florida Statutes, is created
460 to read:
461 409.1475 Foster and Family Support Grant Program.—
462 (1) The Legislature recognizes that children and families
463 thrive when caregivers are engaged, supported, and equipped to
464 meet their responsibilities. It is the intent of the Legislature
465 to strengthen community-based support that promotes stable
466 caregiving relationships, responsible parenting, and improved
467 outcomes for vulnerable children. Therefore, the Foster and
468 Family Support Grant Program is created within the department.
469 (2) The department shall award grants to not-for-profit,
470 faith-based organizations to support their efforts in the
471 recruitment of foster and adoptive families through faith-based
472 organizations and strengthening local capacity to support
473 foster, adoptive, and kinship families and families caring for
474 vulnerable children in underserved and rural communities. The
475 program shall emphasize sustained, community-based support
476 beyond initial licensure or training in order to improve
477 caregiver retention and outcomes for children.
478 (3) Awarded grant funds must be used to provide education,
479 resources, training, and technical assistance to eligible faith
480 based organizations involved in foster care, adoption, and
481 family preservation activities and to support the development of
482 trauma-informed, community-based support systems for families
483 throughout the caregiving continuum. Allowable uses of funds
484 include, but are not limited to:
485 (a) Outreach and recruitment activities to increase the
486 number of licensed foster and adoptive families;
487 (b) Training and support for organizations and volunteers
488 assisting foster, adoptive, and kinship families and families;
489 (c) Trauma-informed training, coaching, and counseling
490 services for caregivers, families, and individuals involved in
491 supporting children in out-of-home care or at risk of entry into
492 care;
493 (d) Program support and other activities to strengthen
494 local capacities to support foster, adoptive, and kinship
495 families and families;
496 (e) Expansion of foster parent training initiatives
497 designed to improve caregiver engagement, retention, and
498 placement stability;
499 (f) Development of volunteer-based wraparound support
500 services for foster and adoptive families, including kinship
501 caregivers;
502 (g) Assistance with essential family needs for families
503 actively fostering, adopting, or pursuing licensure, consistent
504 with federal and state law; and
505 (h) Ongoing family mentoring and peer support to promote
506 placement stability, permanency, and family well-being.
507 (4) Grant recipients must submit reports to the department
508 in a format and at intervals, at least annually, as prescribed
509 by the department.
510 (5) The department may adopt rules to implement this
511 section.
512 Section 6. Upon the expiration and reversion of the
513 amendments made to s. 409.908, Florida Statutes, pursuant to
514 section 26 of chapter 2025-199, Laws of Florida, paragraph (b)
515 of subsection (2) of section 409.908, Florida Statutes, is
516 amended to read:
517 409.908 Reimbursement of Medicaid providers.—Subject to
518 specific appropriations, the agency shall reimburse Medicaid
519 providers, in accordance with state and federal law, according
520 to methodologies set forth in the rules of the agency and in
521 policy manuals and handbooks incorporated by reference therein.
522 These methodologies may include fee schedules, reimbursement
523 methods based on cost reporting, negotiated fees, competitive
524 bidding pursuant to s. 287.057, and other mechanisms the agency
525 considers efficient and effective for purchasing services or
526 goods on behalf of recipients. If a provider is reimbursed based
527 on cost reporting and submits a cost report late and that cost
528 report would have been used to set a lower reimbursement rate
529 for a rate semester, then the provider’s rate for that semester
530 shall be retroactively calculated using the new cost report, and
531 full payment at the recalculated rate shall be effected
532 retroactively. Medicare-granted extensions for filing cost
533 reports, if applicable, shall also apply to Medicaid cost
534 reports. Payment for Medicaid compensable services made on
535 behalf of Medicaid-eligible persons is subject to the
536 availability of moneys and any limitations or directions
537 provided for in the General Appropriations Act or chapter 216.
538 Further, nothing in this section shall be construed to prevent
539 or limit the agency from adjusting fees, reimbursement rates,
540 lengths of stay, number of visits, or number of services, or
541 making any other adjustments necessary to comply with the
542 availability of moneys and any limitations or directions
543 provided for in the General Appropriations Act, provided the
544 adjustment is consistent with legislative intent.
545 (2)
546 (b) Subject to any limitations or directions in the General
547 Appropriations Act, the agency shall establish and implement a
548 state Title XIX Long-Term Care Reimbursement Plan for nursing
549 home care in order to provide care and services in conformance
550 with the applicable state and federal laws, rules, regulations,
551 and quality and safety standards and to ensure that individuals
552 eligible for medical assistance have reasonable geographic
553 access to such care.
554 1. The agency shall amend the long-term care reimbursement
555 plan and cost reporting system to create direct care and
556 indirect care subcomponents of the patient care component of the
557 per diem rate. These two subcomponents together shall equal the
558 patient care component of the per diem rate. Separate prices
559 shall be calculated for each patient care subcomponent,
560 initially based on the September 2016 rate setting cost reports
561 and subsequently based on the most recently audited cost report
562 used during a rebasing year. The direct care subcomponent of the
563 per diem rate for any providers still being reimbursed on a cost
564 basis shall be limited by the cost-based class ceiling, and the
565 indirect care subcomponent may be limited by the lower of the
566 cost-based class ceiling, the target rate class ceiling, or the
567 individual provider target. The ceilings and targets apply only
568 to providers being reimbursed on a cost-based system. Effective
569 October 1, 2018, a prospective payment methodology shall be
570 implemented for rate setting purposes with the following
571 parameters:
572 a. Peer Groups, including:
573 (I) North-SMMC Regions 1-9, less Palm Beach and Okeechobee
574 Counties; and
575 (II) South-SMMC Regions 10-11, plus Palm Beach and
576 Okeechobee Counties.
577 b. Percentage of Median Costs based on the cost reports
578 used for September 2016 rate setting:
579 (I) Direct Care Costs........................100 percent.
580 (II) Indirect Care Costs......................92 percent.
581 (III) Operating Costs.........................86 percent.
582 c. Floors:
583 (I) Direct Care Component.....................95 percent.
584 (II) Indirect Care Component................92.5 percent.
585 (III) Operating Component...........................None.
586 d. Pass-through Payments..................Real Estate and
587 ...............................................Personal Property
588 ...................................Taxes and Property Insurance.
589 e. Quality Incentive Program Payment
590 Pool...............................14.77 10 percent of September
591 .......................................2016 non-property related
592 ................................payments of included facilities.
593 f. Quality Score Threshold to Qualify for Quality Incentive
594 Payment.......33 percent of all available points in the Medicaid
595 Quality Incentive Program 20th
596 ..............................percentile of included facilities.
597 g. Fair Rental Value System Payment Parameters:
598 (I) Building Value per Square Foot based on 2018 RS Means.
599 (II) Land Valuation...10 percent of Gross Building value.
600 (III) Facility Square Footage......Actual Square Footage.
601 (IV) Movable Equipment Allowance..........$8,000 per bed.
602 (V) Obsolescence Factor......................1.5 percent.
603 (VI) Fair Rental Rate of Return................8 percent.
604 (VII) Minimum Occupancy.......................90 percent.
605 (VIII) Maximum Facility Age.....................40 years.
606 (IX) Minimum Square Footage per Bed..................350.
607 (X) Maximum Square Footage for Bed...................500.
608 (XI) Minimum Cost of a renovation/replacements$500 per bed.
609 h. Ventilator Supplemental payment of $200 per Medicaid day
610 of 40,000 ventilator Medicaid days per fiscal year.
611 2. The agency shall revise its methodology for calculating
612 Quality Incentive Program payments to:
613 a. Include the results of consumer satisfaction surveys
614 conducted pursuant to s. 400.0225 as a measure of nursing home
615 quality. The agency shall so revise the methodology after the
616 surveys have been in effect for an amount of time the agency
617 deems sufficient for statistical and scientific validity as a
618 meaningful quality measure that may be incorporated into the
619 methodology.
620 b. During the next rebasing for the Quality Incentive
621 Program, consider implementing the recommendations proposed in
622 sections 3.1.2-3.1.5 of the Study of Nursing Home Quality
623 Incentive Programs Final Report that was prepared by Guidehouse,
624 Inc., and presented to the agency on December 22, 2025.
625 c. Delay the effective date of any change made to its
626 methodology or scoring due to rebasing for 1 year after any
627 recalculations have been completed and the scores have been made
628 available to the public.
629 3. The direct care subcomponent shall include salaries and
630 benefits of direct care staff providing nursing services
631 including registered nurses, licensed practical nurses, and
632 certified nursing assistants who deliver care directly to
633 residents in the nursing home facility, allowable therapy costs,
634 and dietary costs. This excludes nursing administration, staff
635 development, the staffing coordinator, and the administrative
636 portion of the minimum data set and care plan coordinators. The
637 direct care subcomponent also includes medically necessary
638 dental care, vision care, hearing care, and podiatric care.
639 4. All other patient care costs shall be included in the
640 indirect care cost subcomponent of the patient care per diem
641 rate, including complex medical equipment, medical supplies, and
642 other allowable ancillary costs. Costs may not be allocated
643 directly or indirectly to the direct care subcomponent from a
644 home office or management company.
645 5. On July 1 of each year, the agency shall report to the
646 Legislature direct and indirect care costs, including average
647 direct and indirect care costs per resident per facility and
648 direct care and indirect care salaries and benefits per category
649 of staff member per facility.
650 6. Every fourth year, the agency shall rebase nursing home
651 prospective payment rates to reflect changes in cost based on
652 the most recently audited cost report for each participating
653 provider.
654 7. A direct care supplemental payment may be made to
655 providers whose direct care hours per patient day are above the
656 80th percentile and who provide Medicaid services to a larger
657 percentage of Medicaid patients than the state average.
658 8. Pediatric, Florida Department of Veterans Affairs, and
659 government-owned facilities are exempt from the pricing model
660 established in this subsection and shall remain on a cost-based
661 prospective payment system. Effective October 1, 2018, the
662 agency shall set rates for all facilities remaining on a cost
663 based prospective payment system using each facility’s most
664 recently audited cost report, eliminating retroactive
665 settlements.
666 9. By October 1, 2025, and each year thereafter, the agency
667 shall submit to the Governor, the President of the Senate, and
668 the Speaker of the House of Representatives a report on each
669 Quality Incentive Program payment made pursuant to sub
670 subparagraph 1.e. The report must, at a minimum, include all of
671 the following information:
672 a. The name of each facility that received a Quality
673 Incentive Program payment and the dollar amount of such payment
674 each facility received.
675 b. The total number of quality incentive metric points
676 awarded by the agency to each facility and the number of points
677 awarded by the agency for each individual quality metric
678 measured.
679 c. An examination of any trends in the improvement of the
680 quality of care provided to nursing home residents which may be
681 attributable to incentive payments received under the Quality
682 Incentive Program. The agency shall include examination of
683 trends both for the program as a whole as well as for each
684 individual quality metric used by the agency to award program
685 payments.
686
687 It is the intent of the Legislature that the reimbursement plan
688 achieve the goal of providing access to health care for nursing
689 home residents who require large amounts of care while
690 encouraging diversion services as an alternative to nursing home
691 care for residents who can be served within the community. The
692 agency shall base the establishment of any maximum rate of
693 payment, whether overall or component, on the available moneys
694 as provided for in the General Appropriations Act. The agency
695 may base the maximum rate of payment on the results of
696 scientifically valid analysis and conclusions derived from
697 objective statistical data pertinent to the particular maximum
698 rate of payment. The agency shall base the rates of payments in
699 accordance with the minimum wage requirements as provided in the
700 General Appropriations Act.
701 Section 7. Paragraph (d) is added to subsection (6) of
702 section 409.9855, Florida Statutes, to read:
703 409.9855 Pilot program for individuals with developmental
704 disabilities.—
705 (6) PROGRAM IMPLEMENTATION AND EVALUATION.—
706 (d) The agency shall collect and analyze data needed to
707 project program enrollment costs, current and projected
708 caseloads, utilization, and current and projected expenditures
709 for the next 3 years. The agency shall report caseload and
710 expenditure data and trends and any other information requested
711 by the Social Services Estimating Conference in accordance with
712 chapter 216.
713 Section 8. Subsection (5) of section 409.990, Florida
714 Statutes, is amended to read:
715 409.990 Funding for lead agencies.—A contract established
716 between the department and a lead agency must be funded by a
717 grant of general revenue, other applicable state funds, or
718 applicable federal funding sources.
719 (5) A lead agency may carry forward documented unexpended
720 state funds from one fiscal year to the next; however, the
721 cumulative amount carried forward may not exceed 8 percent of
722 the annual amount of the total contract. Any unexpended state
723 funds in excess of that percentage must be returned to the
724 department.
725 (a) The funds carried forward may not be used in any way
726 that would create increased recurring future obligations, and
727 such funds may not be used for any type of program or service
728 that is not currently authorized by the existing contract with
729 the department.
730 (b) Expenditures of funds carried forward must be
731 separately reported to the department.
732 (c) Any unexpended funds that remain at the end of the
733 contract period shall be returned to the department.
734 (d) Funds carried forward may be retained through any
735 contract renewals and any new procurements as long as the same
736 lead agency is retained by the department.
737 Section 9. Subsection (5) of section 414.56, Florida
738 Statutes, is amended to read:
739 414.56 Office of Continuing Care.—The department shall
740 establish an Office of Continuing Care to ensure young adults
741 who age out of the foster care system between 18 and 21 years of
742 age, or 22 years of age with a documented disability, have a
743 point of contact until the young adult reaches the age of 26 in
744 order to receive ongoing support and care coordination needed to
745 achieve self-sufficiency. Duties of the office include, but are
746 not limited to:
747 (5) Developing and administering the Step into Success
748 Workforce Education and Internship Pilot Program for foster
749 youth and former foster youth as required under s. 409.1455.
750 Section 10. For the purpose of incorporating the amendment
751 made by this act to section 409.145, Florida Statutes, in a
752 reference thereto, paragraph (d) of subsection (2) of section
753 39.5085, Florida Statutes, is reenacted to read:
754 39.5085 Relative Caregiver Program.—
755 (2)
756 (d)1. Relatives or nonrelatives who have a child placed
757 with them in out-of-home care and who have obtained licensure as
758 a child-specific level I foster placement, regardless of whether
759 a court has found the child to be dependent, shall receive a
760 monthly payment in accordance with s. 409.145(3) from the date
761 the child is placed in out-of-home care with his or her
762 relatives or with nonrelatives until the child achieves
763 permanency as determined by the court pursuant to s. 39.621.
764 2. Relatives or nonrelatives who have a child who has been
765 found to be dependent placed with them in out-of-home care shall
766 receive a monthly payment at a rate equal to the rate
767 established in s. 409.145(3) for licensed foster parents,
768 regardless of whether the relatives or nonrelatives have
769 obtained a child-specific level I foster license, from the date
770 the child is found to be dependent or from the date the child is
771 placed with them in out-of-home care, whichever is later, for a
772 period of no more than 6 months or until the child achieves
773 permanency as determined by the court pursuant to s. 39.621,
774 whichever occurs first.
775 3. Relatives or nonrelatives who have a child who has been
776 found to be dependent placed with them in out-of-home care and
777 who have not obtained a child-specific level I foster license
778 within 6 months from the date of such placement shall receive a
779 monthly payment in an amount determined by department rule from
780 6 months after the date the child is found to be dependent or
781 from 6 months after the child is placed with them in out-of-home
782 care, whichever is later, until the relatives or nonrelatives
783 obtain a child-specific level I foster license or until the
784 child achieves permanency as determined by the court pursuant to
785 s. 39.621, whichever occurs first. The monthly payment amount
786 paid to relatives or nonrelatives pursuant to this subparagraph
787 must be less than the monthly payment amount provided to a
788 participant enrolled in the Guardianship Assistance Program
789 pursuant to s. 39.6225.
790 4. Relatives or nonrelatives who have a child placed in
791 their care by permanent guardianship pursuant to s. 39.6221, in
792 a permanent placement with a fit and willing relative pursuant
793 to s. 39.6231, or under former s. 39.622 if the placement was
794 made before July 1, 2006, and who are not enrolled in the
795 Guardianship Assistance Program pursuant to s. 39.6225 shall
796 receive a monthly payment in an amount determined by department
797 rule which must be less than the monthly payment amount provided
798 to a participant enrolled in the Guardianship Assistance Program
799 under s. 39.6225.
800 Section 11. For the purpose of incorporating the amendment
801 made by this act to section 409.145, Florida Statutes, in a
802 reference thereto, paragraph (d) of subsection (5) of section
803 39.6225, Florida Statutes, is reenacted to read:
804 39.6225 Guardianship Assistance Program.—
805 (5) A guardian with an application approved pursuant to
806 subsection (2) who is caring for a child placed with the
807 guardian by the court pursuant to this part may receive
808 guardianship assistance payments based on the following
809 criteria:
810 (d) The department shall provide guardianship assistance
811 payments in the amount of $4,000 annually, paid on a monthly
812 basis, or in an amount other than $4,000 annually as determined
813 by the guardian and the department and memorialized in a written
814 agreement between the guardian and the department. The agreement
815 shall take into consideration the circumstances of the guardian
816 and the needs of the child. Changes may not be made without the
817 concurrence of the guardian. However, the amount of the monthly
818 payment may not exceed the foster care maintenance payment that
819 would have been paid during the same period if the child had
820 been in licensed care at his or her designated level of care at
821 the rate established in s. 409.145(3).
822 Section 12. For the purpose of incorporating the amendment
823 made by this act to section 409.145, Florida Statutes, in a
824 reference thereto, paragraph (b) of subsection (5) of section
825 393.065, Florida Statutes, is reenacted to read:
826 393.065 Application and eligibility determination.—
827 (5) Except as provided in subsections (6) and (7), if a
828 client seeking enrollment in the developmental disabilities home
829 and community-based services Medicaid waiver program meets the
830 level of care requirement for an intermediate care facility for
831 individuals with intellectual disabilities pursuant to 42 C.F.R.
832 ss. 435.217(b)(1) and 440.150, the agency must assign the client
833 to an appropriate preenrollment category pursuant to this
834 subsection and must provide priority to clients waiting for
835 waiver services in the following order:
836 (b) Category 2, which includes clients in the preenrollment
837 categories who are:
838 1. From the child welfare system with an open case in the
839 Department of Children and Families’ statewide automated child
840 welfare information system and who are either:
841 a. Transitioning out of the child welfare system into
842 permanency; or
843 b. At least 18 years but not yet 22 years of age and who
844 need both waiver services and extended foster care services; or
845 2. At least 18 years but not yet 22 years of age and who
846 withdrew consent pursuant to s. 39.6251(5)(c) to remain in the
847 extended foster care system.
848
849 For individuals who are at least 18 years but not yet 22 years
850 of age and who are eligible under sub-subparagraph 1.b., the
851 agency must provide waiver services, including residential
852 habilitation, and must actively participate in transition
853 planning activities, including, but not limited to,
854 individualized service coordination, case management support,
855 and ensuring continuity of care pursuant to s. 39.6035. The
856 community-based care lead agency must fund room and board at the
857 rate established in s. 409.145(3) and provide case management
858 and related services as defined in s. 409.986(3)(e). Individuals
859 may receive both waiver services and services under s. 39.6251.
860 Services may not duplicate services available through the
861 Medicaid state plan.
862
863 Within preenrollment categories 3, 4, 5, 6, and 7, the agency
864 shall prioritize clients in the order of the date that the
865 client is determined eligible for waiver services.
866 Section 13. For the purpose of incorporating the amendment
867 made by this act to section 409.145, Florida Statutes, in a
868 reference thereto, paragraph (b) of subsection (2) of section
869 409.1451, Florida Statutes, is reenacted to read:
870 409.1451 The Road-to-Independence Program.—
871 (2) POSTSECONDARY EDUCATION SERVICES AND SUPPORT.—
872 (b) The amount of the financial assistance shall be as
873 follows:
874 1. For a young adult who does not remain in foster care and
875 is attending a postsecondary school as provided in s. 1009.533,
876 the amount is $1,720 monthly.
877 2. For a young adult who remains in foster care, is
878 attending a postsecondary school, as provided in s. 1009.533,
879 and continues to reside in a licensed foster home, the amount is
880 the established room and board rate for foster parents. This
881 takes the place of the payment provided for in s. 409.145(3).
882 3. For a young adult who remains in foster care, but
883 temporarily resides away from a licensed foster home for
884 purposes of attending a postsecondary school as provided in s.
885 1009.533, the amount is $1,720 monthly. This takes the place of
886 the payment provided for in s. 409.145(3).
887 4. For a young adult who remains in foster care, is
888 attending a postsecondary school as provided in s. 1009.533, and
889 continues to reside in a licensed group home, the amount is
890 negotiated between the community-based care lead agency and the
891 licensed group home provider.
892 5. For a young adult who remains in foster care, but
893 temporarily resides away from a licensed group home for purposes
894 of attending a postsecondary school as provided in s. 1009.533,
895 the amount is $1,720 monthly. This takes the place of a
896 negotiated room and board rate.
897 6. A young adult is eligible to receive financial
898 assistance during the months when he or she is enrolled in a
899 postsecondary educational institution.
900 Section 14. This act shall take effect July 1, 2026.
901
902 ================= T I T L E A M E N D M E N T ================
903 And the title is amended as follows:
904 Delete everything before the enacting clause
905 and insert:
906 A bill to be entitled
907 An act relating to health; amending s. 216.136, F.S.;
908 requiring the Social Services Estimating Conference to
909 develop certain official information relating to the
910 pilot program for individuals with developmental
911 disabilities; amending s. 394.495, F.S.; authorizing
912 the Department of Children and Families, as authorized
913 by and consistent with appropriated funding, to
914 contract with a specified organization to provide
915 grief support services to help certain children and
916 youth; requiring that the services be provided at no
917 cost; authorizing the contracted organization to also
918 provide grief awareness training and outreach to local
919 schools and medical facilities under the contract;
920 amending s. 409.145, F.S.; revising the monthly room
921 and board rates the department is required to pay to
922 certain foster parents and caregivers; amending s.
923 409.1455, F.S.; renaming the Step into Success
924 Workforce Education and Internship Pilot Program as
925 the Step into Success Workforce Education and
926 Internship Program; deleting a provision limiting the
927 duration of the program; requiring the Office of
928 Continuing Care within the department to develop
929 certain cohorts within specified regions, to
930 collaborate with certain organizations to recruit
931 mentors and organizations, and to provide eligible
932 former foster youth with internship placement
933 opportunities; deleting a provision requiring that the
934 program be administered in a certain manner; deleting
935 obsolete language; requiring the office to develop
936 trauma-informed training for mentors of certain former
937 foster youth; providing requirements for the training;
938 authorizing the office to provide certain additional
939 trainings on mentorship of special populations;
940 revising the amount of monthly financial assistance
941 that the office provides to participating former
942 foster youth; requiring the office to assign
943 experienced staff to serve as program liaisons for a
944 specified purpose; revising qualifications to serve as
945 a mentor; authorizing the department to offer certain
946 training to mentors in subsequent years; authorizing
947 an employee who serves as a mentor to participate in
948 certain additional trainings; deleting a provision
949 authorizing the offset of a reduction in or loss of
950 certain benefits due to receipt of a Step into Success
951 stipend by an additional stipend payment; creating s.
952 409.1475, F.S.; providing legislative findings and
953 intent; creating the Foster and Family Support Grant
954 Program within the department; requiring the
955 department to award grants to not-for-profit, faith
956 based organizations for specified purposes; requiring
957 that the program emphasize certain support; specifying
958 authorized uses for awarded grant funds; requiring
959 grant recipients to submit reports to the department
960 in a format and at intervals prescribed by the
961 department; authorizing the department to adopt rules;
962 amending s. 409.908, F.S.; revising the parameters for
963 the prospective payment methodology used for
964 determining the Agency for Health Care
965 Administration’s long-term care reimbursement plan for
966 nursing home care; requiring the agency to consider
967 specified recommendations when revising its
968 methodology for calculating Quality Incentive Program
969 payments; requiring the agency to delay the effective
970 date of any changes to its methodology for a specified
971 timeframe; amending s. 409.9855, F.S.; requiring the
972 agency to collect and analyze certain data relating to
973 the pilot program for individuals with developmental
974 disabilities for a specified timeframe; requiring the
975 agency to report specified information to the Social
976 Services Estimating Conference; amending s. 409.990,
977 F.S.; revising the cumulative amount of unexpended
978 state funds that a community-based care lead agency
979 may carry forward to the next fiscal year; amending s.
980 414.56, F.S.; conforming a provision to changes made
981 by the act; reenacting ss. 39.5085(2)(d),
982 39.6225(5)(d), 393.065(5)(b), and 409.1451(2)(b),
983 F.S., relating to the Relative Caregiver Program, the
984 Guardianship Assistance Program, application and
985 eligibility determinations, and the Road-to
986 Independence Program, respectively, to incorporate the
987 amendment made to s. 409.145, F.S., in references
988 thereto; providing an effective date.