On February 18, 2026, the Home Care Association of Florida (HCAF) submitted formal comments to the Agency for Health Care Administration (AHCA) in response to its January 12, 2026, Notice of Proposed Rule amending Rules 59A-8.002, 59A-8.008, and 59A-8.0095, Florida Administrative Code.

The proposed amendments are intended to implement Chapter 2025-127, Laws of Florida (HB 1353) — HCAF’s 2025 priority legislation, passed unanimously by the Florida Legislature and signed into law by Governor Ron DeSantis.

At HCAF’s request, AHCA convened a rule workshop on February 17, 2026, to receive stakeholder feedback and allow for discussion of implementation and operational considerations prior to final adoption.

In its comments, HCAF expressed strong support for the policy objectives of HB 1353 — including expanded workforce flexibility and streamlined administrative operations — while urging AHCA to ensure that the final rule:

• Remains fully aligned with statutory authority;
• Avoids unintended workforce disruption;
• Provides clarity to promote consistent survey interpretation; and
• Includes reasonable and practical implementation timelines.

Below is a summary of the key concerns and recommendations HCAF submitted for AHCA's consideration.

Background: HB 1353

HB 1353 represents a major legislative victory for Florida’s home health provider community. The law:

• Allows a single administrator to oversee multiple agencies under common ownership;
• Expands the ability to use contracted clinicians for admissions, evaluations, and discharges; and
• Requires modernization of AHCA’s Excellence in Home Health program (under separate rulemaking)

The statute was designed to reduce administrative burdens, improve operational flexibility, and strengthen access to care statewide.

Summary of HCAF’s Comments

1. Effective Date and Transition Period

The proposed revisions — particularly those affecting home health aide documentation — do not clearly specify when changes would take effect.

• Our Recommendation: AHCA should clearly state the effective date and provide a reasonable transition period to allow agencies to update HR systems, onboarding procedures, policies, and vendor agreements. Immediate implementation would create widespread technical noncompliance.

2. Grandfathering of Existing Home Health Aides

The proposal expands documentation requirements for aide training records.

• Our Concern: Many aides completed training years ago under documentation standards that did not require detailed curriculum breakdowns or instructor qualification attestations. Retroactive application would make compliance impossible in many cases.
• Our Recommendation: Aides trained prior to the rule’s effective date should be deemed compliant based on documentation valid at the time of training. Agencies should not be required to reconstruct historical records.

3. Expanded Training Documentation Standards

The rule requires detailed documentation elements such as issuing entity information, topic-specific hour breakdowns, and instructor qualifications.

• Our Concern: It is unclear whether agencies must independently verify and maintain proof of an instructor’s nursing experience beyond a signed attestation. Without clarification, survey interpretation may vary widely.
• Our Recommendation: Clarify whether a registered nurse’s signature, credentials, and active license are sufficient to demonstrate compliance.

4. Advertising and Training Restrictions

The proposal includes restrictions prohibiting agencies from advertising that they offer home health aide training and limiting the ability to charge training fees.

• Our Concern: This creates a recruitment paradox. Agencies frequently hire individuals who are not yet trained and provide onboarding training. Prohibiting advertising that training will be provided may hinder workforce recruitment — particularly during ongoing staffing shortages. Notably, HB 1353 did not create new restrictions on training advertising or fees.
• Our Recommendation: Permit agencies to advertise that they are hiring aides and that training will be provided as part of employment onboarding. AHCA should also identify clear statutory authority for any fee prohibition.

5. Scope of Practice: “Monitoring” vs. “Observe and Report”

Certain provisions reference aides “monitoring” for signs of dehydration or changes in condition.

• Our Concern: Home health aides are unlicensed personnel. The term “monitoring” may imply clinical assessment, creating scope-of-practice confusion.
• Our Recommendation: Replace “monitoring” with “observe and report” to align with established aide responsibilities.

6. Specimen Collection Clarification

The proposal allows aides to collect urinary and stool specimens.

• Our Concern: The rule does not specify that collection must be non-invasive. Without clarification, this could be misinterpreted to allow catheter-based or invasive collection.
• Our Recommendation: Limit aide specimen collection authority to non-invasive methods only.

7. Toileting Assistance

Revisions to elimination task language remove a standalone reference to “toileting."

• Our Concern: Toileting is a core personal care function. Removing explicit language may create survey confusion.
• Our Recommendation: Confirm in rule text that assisting with toileting remains within aide scope.

8. Case Management Definition

The revised definition of “case management” includes assessment, care planning, coordination, supervision, and discharge functions.

• Our Concern: It is unclear whether this definition applies exclusively to licensed home health agencies. Broad interpretation could have regulatory implications for non-agency entities that use the term “case management” in non-clinical contexts.
• Our Recommendation: Clarify the applicability of the definition to prevent unintended regulatory consequences.

9. Delegated Patient-Specific Tasks

The rule permits aides to perform certain additional patient-specific activities when trained by a licensed health professional employee or contractor.

• Our Concern: There has historically been confusion regarding whether non-skilled agencies may utilize this delegation framework.
• Our Recommendation: Clarify whether the provision applies to both skilled and non-skilled agencies and specify documentation standards sufficient to demonstrate lawful delegation and competency validation.

Submit Your Comments to AHCA by Friday

AHCA is accepting written comments on the proposed rule amendments through 5:00 PM on Friday, February 20. HCAF strongly encourages members to submit feedback directly to AHCA — particularly if the proposed changes would impact your agency’s operations, workforce, or compliance systems.

Comments may be emailed to HQARULECOMMENTS@ahca.myflorida.com.

Direct provider input is critical, and specific examples and operational insight help ensure the final rule reflects real-world implementation considerations.

HCAF’s Ongoing Engagement

HCAF appreciates the member feedback that helped inform our comments and recommendations submitted to AHCA. Our comments are intended to ensure that implementation of HB 1353 remains faithful to legislative intent while protecting workforce stability and patient access to care.

We will continue working directly with AHCA leadership and rule staff as the process moves toward final adoption.