FLORIDA
2002 Legislation
In 2002, the Florida Legislature took a number of actions that affected long-term care, from addressing nursing home quality issues to creating a new long-term care policy agency and improving access to services through a statewide information and referral system and a simplified eligibility determination process.
Lawmakers continued to address nursing home staffing standards and liability issues as they had in several previous sessions. On the staffing front, the legislators prohibited union organizing activities by a nursing home employee during any period that the employee was included in staffing calculations to meet minimum staffing standards.
Lawmakers also followed up on the actions they took in 2001 to stabilize financial risk for nursing homes after a number of insurance companies threatened to pull out of the Florida market because of mounting lawsuits against nursing homes. In 2002, lawmakers expedited the availability of general and professional liability insurance for nursing homes by advancing $6 million to capitalize the risk retention group. The legislators also called for a report on the number of notices of intent to litigate received by each nursing home every month, the number of complaints filed each month, and information about the deficiencies cited in the complaints.
Another measure created the Florida Health and Human Services Access Act, which establishes a framework for improvements in access to information about available long-term care services. The legislation calls for the development of an information and referral system using the 211 telephone number, a simplified eligibility determination process, and development of coordinated care management for people with disabilities and their families. The Agency for Health Care Administration was directed to conduct a pilot project to determine the feasibility of integrating state-funded health care benefit eligibility determination with information and referral services.
The Legislature also:
- Directed the Department of Elder Affairs and the Agency for Health Care Administration to develop a model system to move all state-funded services for the elderly in one of the state's planning and service areas to a managed, integrated, long-term care delivery system under the direction of a single entity. All funding for services would be integrated into a single, per-person, per-month payment rate.
- Enacted the Florida Consumer-Directed Care Act, which requires the Agency for Health Care Administration to allow those enrolled in the Medicaid home and community-based waiver programs to direct their own care, if they are able to do so, or to designate an eligible representative. People enrolled in the program will be given a monthly budget allowance, based on their assessed functional needs.
- Established the Office of Long-Term Care Policy in the Department of Elder Affairs to evaluate, improve and coordinate the long-term care delivery system and to make recommendations to increase the availability of home and community-based services.
The new Office of Long-Term Care Policy has a 13-member Advisory Council, which issued its first report in February 2003. The Advisory Council recommended that a template be designed for evaluating all long-term care programs, using a uniform methodology across all components. The next step, the council said, would be an evaluation of the Medicaid waiver programs, to be followed by pilot projects and existing programs.
The council noted that fragmentation of long-term care programs and services would be a major focus for its work because similar services are provided by different programs; multiple state agencies are involved in repetitive or duplicative processes; some segments of the long-term care continuum, such as assisted living and hospice, have as many as four agencies overseeing a portion of their activities; and coordination among state agencies is limited. The report concluded that this fragmentation was the largest single policy issue facing the council.
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