The Agency for Health Care Administration (AHCA) is holding a workshop on Thursday, January 11, 2024, to create a new rule within Chapter 59A-8, F.A.C., addressing home health aides for medically fragile children. The proposed rule aims to implement the provisions of HB 391 (LOF 2023-183) and establish comprehensive training guidelines for home health aides, along with data reporting requirements for home health agencies.

Background

The Home Health Aide for Medically Fragile Children Program was established by the Florida Legislature in 2023 through the passage of HB 391. The program's purpose is to provide family caregivers with the opportunity to receive training and gain employment while caring for medically fragile children.

According to the law, a family caregiver can receive Medicaid reimbursement for care provided to a relative who is 21 years old or younger with an underlying physical, mental, or cognitive impairment and is eligible for skilled care or respite care services. The home health aide for medically fragile children must be employed by or under contract with a home health agency.

As part of the law, AHCA is required to establish a fee schedule that provides reimbursement for family caregivers at a rate of $25 per hour for up to eight (8) hours per day.

When delegated by a registered nurse (RN), a home health aide for medically fragile children is authorized to perform certain tasks, including medication administration, activities of daily living, maintaining mobility, nutrition, hydration, and maintaining safety and cleanliness. As part of the law, home health aide for medically fragile children services must result in a reduction in the number of private duty nursing (PDN) service hours provided to eligible recipients. In addition, the law prohibits a home health aide for medically fragile children from duplicating private duty nursing services provided to eligible recipients.

The law protects home health agencies from civil liability for terminating or refusing employment of home health aides for medically fragile children who fail to comply with regulations or whose names appear on a criminal screening report issued by the Department of Law Enforcement (FDLE).

Event Details

• Rule Number: 59A-8.0099
• Rule Title: Home Health Aides for Medically Fragile Children
• Date and Time: Thursday, January 11, 2024, 2:00-3:00 PM ET
• Location: Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, FL 32308, Building 2, Conference Room F
• Virtual Participation: Dial the Open Voice conference line at (888) 585-9008, and enter conference room number 998-518-088#

Workshop Agenda

1. Welcome/Opening Remarks
2. Introductory Statement
3. Public Comments
4. Closing Remarks

Draft Rule Highlights

The proposed rule outlines the following key points:

• Eligibility and Training: Licensed home health agencies accepting Medicaid may train and employ individuals 18 or older as home health aides for medically fragile children who meet specific eligibility criteria and complete required training.
• Supervision and Responsibilities: Eligible home health aides for medically fragile children must adhere to the standards set in Rule 59A-8.0095, F.A.C., and work under the supervision of an RN. The RN must conduct supervisory visits every 30 days.
• Medication Administration: Home health aides for medically fragile children may administer medications under the delegation of an RN after completing additional medication training. The rule specifies the types of medications and the necessary training.
• Training Curriculum: The proposed curriculum involves a minimum of 86 hours of training and validation, emphasizing theoretical instruction, skills training, and clinical competency.
• Validation and Revalidation: Home health aides for medically fragile children must undergo validation by an RN within 90 days of completing training, achieving 100% proficiency. Validations expire after one year, requiring revalidation within 60 days before expiration.
• Annual Program Assessment and Data Reporting: Licensed home health agencies employing home health aides for medically fragile children must submit data on caregiver satisfaction, hospitalization rates, and program support needs annually by November 1. Home health agencies failing to submit required information may face fines of up to $50 per day, not exceeding $500.

This workshop represents a crucial step towards enhancing the quality of care for medically fragile children, and stakeholders are encouraged to participate actively in the discussion.

HCAF is in the process of analyzing the draft rule and will submit comments on behalf of the Medicaid home health provider community in advance of the upcoming workshop.