The Florida Agency for Health Care Administration (AHCA) has finalized rulemaking updates to Rule 59A-8.008, Florida Administrative Code, formally codifying expanded workforce flexibility for home health agencies following passage of House Bill 1353 during the 2025 Florida Legislative Session.

The revised rule now explicitly allows agencies to utilize contracted clinicians to perform case management functions. Specifically, in cases requiring nursing services, case management may be performed by a licensed registered nurse (RN) who is either a direct employee of the agency or under contract with the agency.

Signed into law by Governor Ron DeSantis, HB 1353 was HCAF’s top legislative priority last year. The bill passed unanimously through both chambers of the Florida Legislature and included several reforms designed to reduce administrative burdens and improve operational efficiency for home health agencies.

What This Means for Providers

The finalized rule provides clear regulatory support for the use of contracted clinicians in case management and other core functions, removing ambiguity that previously created operational constraints.

Providers should take this opportunity to:

• Evaluate staffing models and identify opportunities to incorporate contracted clinicians
• Update policies and procedures to reflect the revised rule language
• Ensure contracts, oversight, and documentation practices align with compliance expectations
• Train clinical and administrative teams on appropriate implementation

As with any regulatory change, agencies remain responsible for ensuring quality of care, coordination, and compliance with all applicable requirements.

Important Medicare Considerations

Despite the expanded flexibility under Florida law, Medicare-certified home health agencies must continue complying with applicable federal Conditions of Participation (CoPs).

Federal regulations require Medicare-certified agencies to provide at least one qualifying service directly through agency employees rather than contracted personnel. As a result, agencies that designate nursing as their employee-provided service may not utilize contracted RNs for nursing case management functions tied to that federal requirement.

Providers should carefully evaluate both state and federal requirements when implementing staffing changes under the revised rule.

Advocacy in Action — and What Comes Next

This achievement underscores the impact of a unified home care voice in Tallahassee. HCAF’s ability to secure and implement meaningful policy reforms is driven by the engagement of its members and the support of the Home Care Political Action Committee (PAC).

With the 2026 elections approaching and the 2027 Legislative Session on the horizon, HCAF will continue advocating for reforms that reduce administrative burdens, strengthen the workforce pipeline, and support sustainable, high-quality care in the home.

This victory demonstrates what coordinated advocacy can accomplish — but continued progress depends on maintaining a strong presence at the Capitol.

To help support future legislative and regulatory victories, providers are encouraged to contribute to the Home Care PAC.

Click here to contribute today!