The Agency for Health Care Administration (AHCA) has published a proposed amendment to Rule 59A-8.0099, Florida Administrative Code, which governs the minimum training requirements for home health aides for medically fragile children, commonly referred to as family home health aides. The proposal implements statutory changes enacted through SB 1156 (Chapter 2025-171, Laws of Florida) and would revise both training standards and data reporting requirements for home health agencies.

The proposed rule reflects AHCA’s effort to strengthen pediatric-specific training, reinforce competency validation, and formalize adverse incident and data reporting for agencies serving medically fragile children.

Key Proposed Changes and Their Impact

AHCA proposes restructuring the training curriculum by reducing total required hours from 86 to 76, while more clearly separating foundational aide training from pediatric-specific instruction and clinical competency validation.

Under the proposal, training would include standard home health aide foundational coursework, pediatric-specific theoretical instruction, in-person pediatric skills training, and on-site clinical competency validation with a medically fragile child under the supervision of a registered nurse (RN).

The curriculum would continue to address complex conditions such as respiratory disorders (including ventilators and tracheostomies), neurological and cardiac conditions, enteral feeding systems, ostomies, mobility supports, emergency response procedures, and developmental disabilities.

Importantly, even when coursework is completed online or through hybrid formats, the proposed rule would require in-person skills demonstration and RN-validated competency.

Strengthened RN Oversight

The proposal reinforces that:

• Aides for medically fragile children are employees of the home health agency
• All tasks must be delegated and supervised by an RN
• Training and competency validation must be conducted directly by qualified RNs — not under general supervision

This further formalizes the RN’s central role in pediatric oversight, delegation, and ongoing competency assessment.

Expanded Medication Administration Training (With Safeguards)

The proposal maintains RN-delegated medication administration authority while requiring additional route-specific medication training, clear RN instruction and supervision, and continued prohibition on controlled substances.

These provisions align increased pediatric complexity with stricter training expectations.

New Reporting Requirements

AHCA also proposes new compliance obligations, including mandatory adverse incident reporting within 48 hours through its electronic reporting system, as well as annual service data reporting on pediatric services provided and agency activity related to medically fragile children, due each year by November 1. Agencies that fail to submit the required reports could face financial penalties of up to $500.

Public Workshop and Comment Period

AHCA will hold a public rule workshop on Thursday, February 19, 2026, at 2:00 PM ET at AHCA headquarters:

2727 Mahan Drive
Building 3, Conference Room B
Tallahassee, FL 32308

Stakeholders may also participate remotely by calling (888) 585-9008 and entering conference room number 998-518-088#.

Written comments can be submitted online through the Florida Department of State website or via email to HQARuleComments@ahca.myflorida.com by February 12, 2026.

Bottom Line

This proposed rule would significantly expand training structure, RN oversight, and reporting obligations for home health agencies serving medically fragile children. While intended to strengthen pediatric safety and competency, it would also introduce new operational and compliance responsibilities for providers.

HCAF is closely reviewing the proposed language — particularly the revised training framework, competency validation requirements, and new reporting mandates — and will be submitting formal comments to AHCA.

Please share your feedback with Kyle Simon, Senior Director of Policy, Advocacy & Communications, at ksimon@homecarefla.org by Wednesday, February 4, 2026.