LeadingAge Florida Legislative Priorities

Medicaid Funding for Nursing Homes

LeadingAge Florida supports a temporary funding increase to support providers through unprecedented low occupancy and a workforce crisis.

On November 4, 2021, the Legislative Budget Commission authorized a temporary, nonrecurring rate increase to Florida Medicaid nursing homes to assist nursing homes dealing with staffing and occupancy challenges caused by the COVID-19 pandemic. There are nursing homes throughout the state that did not receive any assistance from this funding increase, even though these facilities are also experiencing the same financial challenges as other long-term care providers. LeadingAge Florida supports legislation to provide additional funding to those nursing homes.

HB 9031 by Rep. McFarland relating to Temporary Medicaid Nursing Home Funding allows for the providers who did not receive funding through the temporary rate increase to be eligible for additional Medicaid funding using an equitable formula.

We are working with the sponsor to get HB 9031 scheduled for a committee hearing. 

LeadingAge Florida supports the inflation and rate increases proposed through the Governor’s recommended budget that recognize the continuing growth in costs faced by nursing home providers and the application of the additional funds to both hold harmless and prospective payment rates.   

The Governor’s Freedom First Budget provides a 5% Medicaid reimbursement rate increase for nursing homes. This represents an increase of approximately $185 million over current funding levels.

LeadingAge Florida supports adjustments to the PPS rate setting methodology that prioritize funding to help address workforce challenges and ensure that nursing home rates are not reduced during this critical time. 

Any rate increases for Medicaid reimbursement should be allocated to the direct patient care component within the prospective payment system. The 5% Medicaid reimbursement rate increase provided in the Governor’s Freedom First Budget would provide an increase to the median percentage of cost reimbursed for direct patient care from 100% of the median to
125%.

Medicaid Funding for Assisted Living Facilities

LeadingAge Florida supports an increased Medicaid reimbursement rate for Assisted Living Facilities.

The Governor’s Freedom First Budget provides a 6% Medicaid reimbursement rate increase for assisted living facilities.

Workforce Shortage/Staffing Issues

LeadingAge Florida supports legislation that addresses the long-term care workforce crisis with solutions that help recruit, train and retain new workers.

The workforce shortage in long-term care is an ongoing challenge that has been exacerbated by the ongoing COVID-19 pandemic and the rapid spread of the omicron variant.  

Based on a survey of LeadingAge Florida members, 90% indicated staffing was a challenge and 75% indicated it was their number one concern.

SB 804 by Senator Albritton (R-Bartow) relating to Modernization of Nursing Home Facility Staffing makes changes to the minimum staffing standards in nursing homes including:

The bill also removes the moratorium on new admissions for failure to meet the minimum staffing requirements. Further, it applies the same definition of non-nursing direct care staff to the CCRC regulations relating to staff providing services in a nursing home and elsewhere on the campus.

LeadingAge Florida participated in a meeting this week held by Senator Albritton with stakeholders to try to address and resolve concerns with the legislation.  

HB 1239 by Rep. Melo (R-Naples) relating to Nursing Home Facility Staffing Requirements is a companion bill to SB 804 but is not identical. The house bill includes additional changes to increase the total hours of direct care from 3.6 hours per resident per day to 3.8. The bill also includes a minimum hourly requirement specifically for Certified Nursing Assistants of 1.8 hours per resident per day.

Dementia-related Staff Training Legislation

LeadingAge Florida supports legislation that provides standardized dementia-related staff training for providers of services to seniors at no cost to the provider.

During the 2021 Session, legislation supported by the Alzheimer’s Association was filed that would increase the amount of training and the staff required to complete the training related to dementia. The bill did not pass.

LeadingAge Florida has been working with a coalition of long-term care providers to develop an alternative proposal that provides uniformity of the training with requirements that are consistent among the different providers. The coalition and the Alzheimer’s Association are in ongoing negotiations to reach a compromise on the legislative proposals. Discussions continue on efforts to compromise on the few remaining issues.

SB 1572 by Sen. Baxley (R-Lady Lake)/HB 1507 by Rep. Byrd (R-Jacksonville Beach) relating to Dementia-related Staff Training create the Florida Alzheimer’s Disease and Dementia Training and Education Act creates or revises training requirements for all employees of nursing homes, home health agencies, hospices, ALFs, adult family-care homes, and adult day care centers, not just those who have direct contact with individuals with ADRD.

Extension of COVID-19 Health Care Provider Liability Protections

LeadingAge Florida supports extension of the Covid-19 liability protections enacted in 2021.

LeadingAge Florida supported legislation passed during the 2021 Session and signed into law by Governor DeSantis providing reasonable, limited liability protections for long-term care providers for their extraordinary efforts to offer the best possible frontline care in an ever-changing environment. The law provides liability protections for both general businesses and health providers, and provides a one-year statute of limitations for COVID-19-related claims covered under the law.

SB 7014 by the Judiciary Committee relating to COVID-19-related Claims Against Health Care Providers extends the duration of liability protections from COVID-19 related claims against health care providers for 14 months, from March 29, 2022 to June 1, 2023. The bill has passed both of its committees of reference and has been placed on the Senate Special Order Calendar for January 19th. LeadingAge Florida expressed its support for the legislation in the committee.  

The Senate passed SB 7014 this week by a vote of 22-13.  The bill now moves to the House.

HB 7021, formerly PCB HHS 22-01, by the Health & Human Services Committee relating to Covid-19-related Claims Against Health Care Providers extends the application period to June 1, 2023. PCB HHS 22-01 passed the House HHS Committee on January 14th. LeadingAge Florida expressed its support for the legislation in committee.  HB 7021 has been referred to one committee, the Judiciary Committee.

Affordable Housing Trust Funds

As a member of the Florida Housing Coalition, LeadingAge Florida supports full funding of the Sadowski State and Local Housing Trust Fund with the recurring revenue based on the documentary stamp formula enacted in 2021.

Legislation was passed during the 2021 session and signed into law by Governor DeSantis providing that the Sadowski state and local housing trust fund revenues will be recurring and that there will be no more sweeps of the Sadowski trust fund for other purposes.  

The Governor’s Freedom First Budget includes $355.4 million in total funding for housing.

Activity on Bills Monitored by LeadingAge Florida

Nursing Homes

HB 539 by Rep. Trumbull (R-Panama City)/SB 1324 by Sen. Burgess (R-Zephyrhills) relating to Nursing Home Financial Reporting require nursing homes and their home offices to annually report audited financial experiences to AHCA’s Nursing Home Uniform Reporting System. Currently, nursing homes and home offices are submitting actual unaudited financial reports.

HB 539 passed its last committee of reference on January 11th and is on House calendar. SB 1324 has not yet been scheduled for a hearing.

HB 1237 by Rep. C. Smith (D-Winter Park)/SB 1596 by Sen. Gibson (D-Jacksonville) relating to Nursing Home Accountability require the establishment of a minimum loss ratio for nursing homes.  Nursing homes must spend at least 75% of their Medicaid revenue on direct and indirect patient care and 55% on direct patient care.  The bill also requires the nursing homes to post publically the maximum rates charged by public and private payers, a listing of owners, and contracts and agreements with related entities.

HB 1361 by Rep. Willhite (D-Wellington)/SB 1734 by Sen. Gibson (D-Jacksonville) relating to Resident Care in Nursing Home Facilities require a resident’s attending healthcare provider in a nursing home to consult with the resident’s personal physician; require a nursing home to provide specific information to a resident or legal representative and provide for a periodic review of the resident care plan, and post specific information on their website including daily reporting of the staff on duty, and other requirements.

Visitation

SB 988 by Sen. Garcia (R-Miami) relating to Patient Visitation Rights directs health-care providers to allow patients or residents to have visitors. If access needs to be restricted for health or safety concerns, the providers would have to develop alternate visitation protocols that allow visitation to the greatest extent possible while maintaining client health and safety. The bill passed its first committee of reference on January 13th.

SB 1724 by Sen. Harrell (R-Stuart) relating to Designation of Essential Caregivers for In-person Visitations provides residents in nursing homes, assisted living facilities, intermediate care facilities and other state-supported residential facilities the right to designate an essential caregiver. The facility may not prohibit in-person visitation by the essential caregiver.

HB 987 by Rep. Shoaf (R-Blountstown) relating to In-person Visitation by Essential Caregivers provides residents of residential facilities, developmental disabilities centers, direct service providers, nursing homes, or assisted living facilities the right to designate an essential caregiver for in-person visits.  

Workforce

HB 209 by Rep. Silvers (D-West Palm Beach)/SB 414 by Sen. Powell (D-West Palm Beach) relating to Family Caregiver Certified Nursing Assistant Program provide for the development of a program that trains a family member to provide personal care and assistance to a family member. The Board of Nursing and Agency for Health Care Administration are to develop the Family Caregiver Certified Nursing Assistant Program. A person completing the program is authorized to take the CNA examination and, upon passing, becomes eligible for certification as a CNA. The person must serve as a designated CNA for his or her relative under contract with a licensed nurse registry for a period of two years after which the CNA may practice in any setting authorized by law.  

SB 414 has passed its first committee of reference. HB 209 has not yet been scheduled for a committee hearing.  

Medication Administration

HB 413 by Rep. Snyder (R-Palm City)/SB 700 by (Sen. Burgess) relating to Delegation of Administration of Prescription Medications allow a registered nurse to delegate to a CNA or HHA medication administration to a patient of a nurse registry.  Under current law, a registered nurse is not authorized to delegate medication administration to a CNA or HHA for a patient of a nurse registry.

HB 413 was voted favorably in its first committee of reference on January 13th and is scheduled to be heard in its final committee of reference, the Health & Human Services Committee, on Monday, January 24th.  SB 700 has not yet been heard in committee.

SB 836 by Sen. Brodeur (R-Lake Mary)/HB 1403 by Rep. Buchanan (R-North Port) relating to Medication Technicians define a trained, unlicensed staff member in assisted living facilities as a “medication technician”, and add that medication technician training must address infection control, use of point-of-care devices, and communicating with case managers, among other requirements.

SB 836 was on the agenda in its first committee of reference this week, the Senate Health Policy Committee, but was temporarily postponed. HB 1403 has not been scheduled for a committee hearing.

HB 469 by Rep. Trabulsy (R-Fort Pierce)/SB 718 by Sen. Bradley (R-Orange Park) relating to Patient Care Health Care Facilities revise the home health agency laws to allow home health aides and CNAs to perform additional tasks in providing assistance to patients with self-administration of medication, similar to what is allowed in assisted living facilities.  Specifically, the bill allows a home health aide or CNA to provide assistance with: 

Telehealth

SB 312 by Sen Diaz (R-Hialeah Gardens)/HB 17 by Rep. Frabricio (R-Hialeah) relating to Telehealth remove a provision in the definition of “telehealth” that excludes audio-only telephone calls. The bills also amend a provision that, in practice, will allow a telehealth provider to issue a renewal prescription for a controlled substance listed in Schedule III, IV, or V of s. 893.03, F.S., through telehealth, within the scope of his or her practice, and in accordance with other state and federal laws. Currently, telehealth providers are prohibited from prescribing controlled substances through telehealth unless the prescription is for the treatment of a psychiatric disorder, inpatient treatment at a hospital, the treatment of a patient receiving hospice services, or the treatment of a resident in a nursing home facility. The legislation narrows this prohibition to the prescribing of only Schedule II controlled substances through telehealth, except under those specific circumstances. The bills add practices that were enacted during Covid’s inception that have proven to be beneficial for elderly and at-risk patients.

SB 312 has passed all committees of reference and is on the Senate Calendar. HB 17 has passed one committee of reference and is scheduled to be heard in the House Health & Human Services Committee on January 24th.

Alzheimer's Disease and Dementia-related Disorders

SB 806 by Sen. Perry (R-Gainesville)/HB 475 by Rep. Salzman (R-Pensacola) relating to Alzheimer’s Disease and Dementia-related Disorders Awareness establish the “Ramping up Education of Alzheimer’s Disease and Dementia for You (READY) Act.” The legislation requires the Department of Health (DOH), in collaboration with the Department of Elder Affairs (DOEA), to use existing, relevant public health and community outreach programs to develop and disseminate information to medical and osteopathic doctors and to nurses in order to educate them on and increase their understanding and awareness of Alzheimer’s disease and dementia-related disorders. DOH is directed to collaborate with other agencies and organizations to create a systematic approach to increasing public awareness of ADRD.

SB 806 has passed its first committee of reference. HB 475 has not yet scheduled for a committee hearing.

Appropriations

On December 9, 2021, Governor DeSantis released his Freedom First Budget. This week several committees received presentations on the Governor’s budget recommendations including House Appropriations, Senate Appropriations, and the Senate Appropriations Subcommittee on Health and Human Services. 

The Governor’s Freedom First Budget provides key funding to ensure the state’s most vulnerable population will continue to have access to the highest quality care, resources and services. The budget includes:

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