A report commissioned by the Agency for Health Care Administration (AHCA), dated August 1, 2024, provides an in-depth analysis of challenges and recommendations concerning Private Duty Nursing (PDN) services in Florida. Funded by a $150,000 appropriation from the 2024 Florida Legislature, this comprehensive document has been submitted to Governor Ron DeSantis and the chairs of both the Senate and House of Representatives Appropriations Committees.

The findings highlight critical issues including workforce shortages, the financial sustainability of PDN providers, and the need for improved access to care for medically fragile children and adults. The report emphasizes that current Medicaid reimbursement rates are insufficient to cover rising care costs, leading to provider closures and reduced availability of essential services. It calls for policymakers to consider changes to increase Medicaid reimbursement rates, support workforce development, and ensure timely and adequate care for Medicaid recipients.

To address these challenges, the report explores three options for adjusting payments for home health services:

1. Adjustment Based on Patient Acuity: This option considers increasing rates based on the severity of the patient’s condition, which requires more intensive and resource-heavy care.
2. Adjustment Based on Geographical Location: This method explores adjusting payments according to the cost of living and operational expenses in different regions.
3. Combination of Patient Acuity and Geographical Location: This approach offers a comprehensive strategy that integrates both patient acuity and regional cost variations.

These options are presented for consideration by policymakers, offering a range of potential strategies to enhance Medicaid reimbursement rates and improve the sustainability of PDN services across Florida. HCAF plans to use these insights and recommendations in our advocacy efforts to secure a Medicaid rate increase during the 2025 legislative session. We will present these findings to lawmakers, highlighting the urgent need for thoughtful exploration of these options to better support providers and ensure equitable access to quality care across the state.