The Florida Agency for Health Care Administration (AHCA) has revised its proposed overhaul of the Excellence in Home Health Award program, adopting many of the recommendations submitted by HCAF.

AHCA published a Notice of Change for Rule 59A-8.0248, Florida Administrative Code, on August 17. The revisions follow AHCA's May proposal to modernize the award criteria in accordance with House Bill 1353, legislation championed by HCAF and signed into law in 2025.

Overall, the revised proposal is more flexible and better recognizes the quality assurance programs, operational data, training, and improvement initiatives agencies already maintain.

Key Changes

For skilled-care agencies, AHCA replaced separate requirements addressing emergency care and hospital admissions and readmissions with a broader quality assurance standard. Agencies would document how they collect data on and evaluate at least three indicators involving care delivery, services, and operations. Those indicators must be used to improve outcomes and reduce unplanned emergency visits and hospitalizations.

For non-skilled agencies, AHCA removed the prescriptive requirement involving active listening, stress management, and social engagement. Agencies would instead evaluate at least three quality indicators related to personal care delivery, services, and operations, with the goal of improving outcomes involving activities of daily living and emotional wellness.

The revised proposal also clarifies what may qualify as an evidence-based practice. Acceptable documentation may include:

• Policies and procedures
• Quality assurance and performance-improvement activities
• Nationally recognized best practices
• Staff training programs
• Other documented quality-improvement initiatives

AHCA also broadened the innovation criteria to recognize operational improvements demonstrating advances in care delivery — not only the specific technologies and training programs listed in the original proposal. Innovative strategies may now address the patient or client “experience” as well as convenience and outcomes.

HCAF Recommendations Reflected in the Revision

The Notice of Change incorporates HCAF’s central recommendation that the award criteria be flexible enough to accommodate different agency types, service models, and existing quality systems.

AHCA closely followed HCAF’s recommendation to clarify evidence-based practices, substantially broadened the definition of innovation, and removed narrowly prescribed emotional-wellness activities for non-skilled agencies. The new quality-indicator framework should also allow providers to rely more heavily on existing operational data instead of creating separate processes solely for an award application.

Some concerns remain. AHCA retained the written 12-month adverse-event summary for skilled-care applicants, and the inspection-score methodology remains unchanged. The employee satisfaction requirement also continues to include a survey rather than expressly recognizing other feedback methods.

The Notice of Change is not a final adopted rule. HCAF will continue monitoring the rulemaking process and advocating for a practical, transparent award program that works for Florida’s home care provider community.

Additional information is available on AHCA’s rulemaking page.