Aging and Disability Services

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1
An act relating to aging and disability services; 2
amending s. 409.979, F.S.; revising requirements for 3
Medicaid recipients to receive an offer for enrollment 4
for long-term care services; requiring the Department 5
of Elderly Affairs to maintain a statewide pre-6
enrollment list for certain services; requiring aging 7
and disability resource center personnel to place 8
individuals on certain lists; requiring certain staff 9
to administer rescreening under certain circumstances; 10
authorizing individuals who meet specified criteria to 11
enroll in the long-term care managed care program; 12
amending s. 409.983, F.S.; providing that the initial 13
assessment of an enrollee shall be reviewed or 14
performed by the Comprehensive Assessment and Review 15
for Long-term Care Services program; amending s. 16
430.04, F.S.; revising provisions relating to 17
intermediate measures taken against an area agency on 18
aging; creating s. 430.09, F.S.; providing 19
definitions; providing requirements for the 20
procurement of commodities or contractual services by 21
area agencies on aging; limiting the salary of the 22
chief executive officer and executive director of an 23
area agency on aging; providing construction; 24
requiring the department to impose certain penalties; 25

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amending s. 430.203, F.S.; revising the definitions of 26
the terms "community care service system" and "core 27
services"; amending s. 430.204, F.S.; authorizing an 28
area agency on aging to directly provide core services 29
under certain circumstances; amending s. 430.205, 30
F.S.; removing obsolete language; revising frequency 31
of inservice training for certain providers; requiring 32
certain elderly persons to be given priority 33
consideration for receiving certain services; amending 34
s. 430.2053, F.S.; redesignating aging resource 35
centers as aging and disability resource centers; 36
revising the purpose thereof; authorizing aging and 37
disability resource centers to place certain clients 38
on and release certain clients from pre-enrollment 39
lists; removing a requirement to convene a work group 40
for certain purposes; removing a requirement to 41
provide enrollment and coverage information to certain 42
individuals; requiring the aging and disability 43
resource center to receive a waiver to be the provider 44
of other direct services; revising the program to 45
which the department and the agency on aging may not 46
make payments; removing an eligibility requirement for 47
an area agency on aging to transition to an aging 48
resource center; revising the entity with which the 49
department may consult to develop capitation rates; 50

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amending s. 430.605, F.S.; revising certain subsidy 51
payments to include supplements to provide for food 52
and nutritional supplements and certain care; amending 53
s. 430.901, F.S.; conforming a provision to changes 54
made by the act; amending s. 744.2001, F.S.; revising 55
the required qualifications of the executive director 56
of the Office of Public and Professional Guardians; 57
amending s. 744.2003, F.S.; revising continuing 58
education requirements for a professional guardian; 59
amending ss. 744.2004 and 744.20041, F.S.; revising 60
disciplinary actions taken by the office; amending s. 61
744.2104, F.S.; providing certain authority for the 62
office in conducting certain investigations; amending 63
s. 744.3701, F.S.; requiring the clerk to disclose 64
confidential information to the department under 65
certain circumstances; requiring the department to 66
provide specified records to the Legislature by a 67
specified date; providing an effective date. 68
69
Be It Enacted by the Legislature of the State of Florida: 70
71
Section 1. Subsections (2) and (3) of section 409.979, 72
Florida Statutes, are amended to read: 73
409.979 Eligibility.— 74
(2) PRE-ENROLLMENT ENROLLMENT OFFERS.—Subject to the 75

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availability of funds, the Department of Elderly Affairs shall 76
make offers for enrollment to eligible individuals based on a 77
pre-enrollment list wait-list prioritization. Before making 78
enrollment offers, the agency and the Department of Elderly 79
Affairs shall determine that sufficient funds exist to support 80
additional enrollment into plans. 81
(a) A Medicaid recipient enrolled in one of the following 82
Medicaid home and community-based services waiver programs who 83
meets the eligibility criteria established in subsection (1) is 84
eligible to participate in the long-term care managed care 85
program and must be transitioned into the long-term care managed 86
care program by January 1, 2018: 87
1. Traumatic Brain and Spinal Cord Injury Waiver. 88
2. Adult Cystic Fibrosis Waiver. 89
3. Project AIDS Care Waiver. 90
(b) The agency shall seek federal approval to terminate 91
the Traumatic Brain and Spinal Cord Injury Waiver, the Adult 92
Cystic Fibrosis Waiver, and the Project AIDS Care Waiver once 93
all eligible Medicaid recipients have transitioned into the 94
long-term care managed care program. 95
(3) PRE-ENROLLMENT WAIT LIST, RELEASE, AND OFFER PROCESS.—96
The Department of Elderly Affairs shall maintain a statewide 97
pre-enrollment wait list for enrollment for home and community-98
based services through the long-term care managed care program. 99
(a) The Department of Elderly Affairs shall prioritize 100

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individuals for potential enrollment for home and community-101
based services through the long-term care managed care program 102
using a frailty-based screening tool that results in a priority 103
score. The priority score is used to set an order for releasing 104
individuals from the pre-enrollment wait list for potential 105
enrollment in the long-term care managed care program. If 106
capacity is limited for individuals with identical priority 107
scores, the individual with the oldest date of placement on the 108
pre-enrollment wait list shall receive priority for release. 109
1. Pursuant to s. 430.2053, aging and disability resource 110
center personnel certified by the Department of Elderly Affairs 111
shall perform the screening for each individual requesting 112
enrollment for home and community-based services through the 113
long-term care managed care program. Aging and disability 114
resource center personnel shall place on and release from the 115
pre-enrollment lists clients eligible for the Alzheimer's 116
Disease Initiative, community care for the elderly, home care 117
for the elderly, and the Statewide Medicaid Managed Care Long-118
term Care program. The Department of Elderly Affairs shall 119
request that the individual or the individual's authorized 120
representative provide alternate contact names and contact 121
information. 122
2. The individual requesting the long-term care services, 123
or the individual's authorized representative, must participate 124
in an initial screening or rescreening for placement on the pre-125

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enrollment wait list. The screening or rescreening must be 126
completed in its entirety before placement on the pre-enrollment 127
wait list. 128
3. Pursuant to s. 430.2053, staff authorized and certified 129
by the Department of Elderly Affairs aging resource center 130
personnel shall administer rescreening annually or upon 131
notification of a significant change in an individual's 132
circumstances for an individual with a high priority score. 133
Aging and disability resource center personnel may administer 134
rescreening annually or upon notification of a significant 135
change in an individual's circumstances for an individual with a 136
low priority score. 137
4. The Department of Elderly Affairs shall adopt by rule a 138
screening tool that generates the priority score and shall make 139
publicly available on its website the specific methodology used 140
to calculate an individual's priority score. 141
(b) Upon completion of the screening or rescreening 142
process, the Department of Elderly Affairs shall notify the 143
individual or the individual's authorized representative that 144
the individual has been placed on the pre-enrollment wait list, 145
unless the individual has a low priority score. The Department 146
of Elderly Affairs must maintain contact information for each 147
individual with a low priority score for purposes of any future 148
rescreening. Aging and disability resource center personnel 149
shall inform individuals with low priority scores of community 150

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resources available to assist them and inform them that they may 151
contact the aging and disability resource center for a new 152
assessment at any time if they experience a change in 153
circumstances. 154
(c) If the Department of Elderly Affairs is unable to 155
contact the individual or the individual's authorized 156
representative to schedule an initial screening or rescreening, 157
and documents the actions taken to make such contact, it shall 158
send a letter to the last documented address of the individual 159
or the individual's authorized representative. The letter must 160
advise the individual or his or her authorized representative 161
that he or she must contact the Department of Elderly Affairs 162
within 30 calendar days after the date of the notice to schedule 163
a screening or rescreening and must notify the individual that 164
failure to complete the screening or rescreening will result in 165
his or her termination from the screening process and the pre-166
enrollment wait list. 167
(d) After notification by the agency of available 168
capacity, the Department of Elderly Affairs CARES program shall 169
release individuals from the pre-enrollment list based on the 170
priority scoring process. The aging and disability resource 171
center shall conduct a prerelease assessment. The Department of 172
Elderly Affairs shall release individuals from the wait list 173
based on the priority scoring process and prerelease assessment 174
results. Upon release, individuals who meet all financial and 175

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medical eligibility criteria may enroll in the long-term care 176
managed care program. 177
(e) The Department of Elderly Affairs may terminate an 178
individual's inclusion on the pre-enrollment wait list if the 179
individual: 180
1. Does not have a current priority score due to the 181
individual's action or inaction; 182
2. Requests to be removed from the pre-enrollment wait 183
list; 184
3. Does not keep an appointment to complete the 185
rescreening without scheduling another appointment and has not 186
responded to three documented attempts by the Department of 187
Elderly Affairs to contact the individual; 188
4. Receives an offer to begin the eligibility 189
determination process for the long-term care managed care 190
program; or 191
5. Begins receiving services through the long-term care 192
managed care program. 193
194
An individual whose inclusion on the pre-enrollment wait list is 195
terminated must initiate a new request for placement on the pre-196
enrollment wait list, and any previous priority considerations 197
must be disregarded. 198
(f) Notwithstanding this subsection, the following 199
individuals are afforded priority enrollment for home and 200

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community-based services through the long-term care managed care 201
program and do not have to complete the screening or pre-202
enrollment list wait-list process if all other long-term care 203
managed care program eligibility requirements are met: 204
1. An individual who is 18, 19, or 20 years of age who has 205
a chronic debilitating disease or condition of one or more 206
physiological or organ systems which generally make the 207
individual dependent upon 24-hour-per-day medical, nursing, or 208
health supervision or intervention. 209
2. A nursing facility resident who requests to transition 210
into the community and who has resided in a Florida-licensed 211
skilled nursing facility for at least 60 consecutive days. 212
3. An individual who is referred by the Department of 213
Children and Families pursuant to the Adult Protective Services 214
Act, ss. 415.101-415.113, as high risk and who is placed in an 215
assisted living facility temporarily funded by the Department of 216
Children and Families. 217
(g) The Department of Elderly Affairs and the agency may 218
adopt rules to implement this subsection. 219
Section 2. Subsection (4) of section 409.983, Florida 220
Statutes, is amended to read: 221
409.983 Long-term care managed care plan payment.—In 222
addition to the payment provisions of s. 409.968, the agency 223
shall provide payment to plans in the long-term care managed 224
care program pursuant to this section. 225

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(4) The initial assessment of an enrollee's level of care 226
shall be reviewed or performed made by the Comprehensive 227
Assessment and Review for Long-Term Care Services (CARES) 228
program, which shall assign the recipient into one of the 229
following levels of care: 230
(a) Level of care 1 consists of recipients residing in or 231
who must be placed in a nursing home. 232
(b) Level of care 2 consists of recipients at imminent 233
risk of nursing home placement, as evidenced by the need for the 234
constant availability of routine medical and nursing treatment 235
and care, and who require extensive health-related care and 236
services because of mental or physical incapacitation. 237
(c) Level of care 3 consists of recipients at imminent 238
risk of nursing home placement, as evidenced by the need for the 239
constant availability of routine medical and nursing treatment 240
and care, who have a limited need for health-related care and 241
services and are mildly medically or physically incapacitated. 242
243
The agency shall periodically adjust payment rates to account 244
for changes in the level of care profile for each managed care 245
plan based on encounter data. 246
Section 3. Subsection (2) of section 430.04, Florida 247
Statutes, is amended to read: 248
430.04 Duties and responsibilities of the Department of 249
Elderly Affairs.—The Department of Elderly Affairs shall: 250

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(2) Be responsible for ensuring that each area agency on 251
aging operates in a manner to ensure that the elderly of this 252
state receive the best services possible. The department shall 253
rescind designation of an area agency on aging or take 254
intermediate measures against the agency, including corrective 255
action, unannounced special monitoring, temporary assumption of 256
operation of one or more programs by the department, placement 257
on probationary status, imposing a moratorium on agency action, 258
imposing financial penalties for nonperformance, or other 259
administrative action pursuant to chapter 120, if the department 260
finds that: 261
(a) An intentional or negligent act of the agency has 262
materially affected the health, welfare, or safety of clients, 263
or substantially and negatively affected the operation of an 264
aging services program. 265
(b) The agency lacks financial stability sufficient to 266
meet contractual obligations or that contractual funds have been 267
misappropriated. 268
(c) The agency has committed multiple or repeated 269
violations of legal and regulatory requirements or department 270
standards. 271
(d) The agency has failed to continue the provision or 272
expansion of services after the declaration of a state of 273
emergency. 274
(e) The agency has exceeded its authority or otherwise 275

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failed to adhere to the terms of its contract with the 276
department or has exceeded its authority or otherwise failed to 277
adhere to the provisions specifically provided by statute or 278
rule adopted by the department. 279
(f) The agency has failed to properly determine client 280
eligibility as defined by the department. 281
(g) The agency has failed to or efficiently manage program 282
budgets. 283
(h)(g) The agency has failed to implement and maintain a 284
department-approved client grievance resolution procedure. 285
Section 4. Section 430.09, Florida Statutes, is created to 286
read: 287
430.09 Area agencies on aging expenditures.— 288
(1) As used in this section, the term: 289
(a) "Commodity" means any of the various supplies, 290
materials, goods, merchandise, food, equipment, information 291
technology, and other personal property purchased, leased, or 292
otherwise contracted for by an area agency on aging. 293
(b) "Competitive solicitation" means the process of 294
requesting and receiving two or more sealed bids, proposals, or 295
replies submitted by responsive vendors in accordance with the 296
terms of a competitive process, regardless of the method of 297
procurement. 298
(c) "Contractual services" means the rendering by a 299
contractor of its time and effort rather than the furnishing of 300

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specific commodities. The term applies only to those services 301
rendered by individuals and firms that are independent 302
contractors, and such services may include, but are not limited 303
to, evaluations; consultations; maintenance; accounting; 304
security; management systems; management consulting; educational 305
training programs; research and development studies or reports 306
on the findings of consultants engaged thereunder; and 307
professional, technical, and social services. 308
(2) The procurement of commodities or contractual services 309
in excess of $35,000 by an area agency on aging is subject to 310
the competitive solicitation process. Any competitive 311
solicitation shall be made available simultaneously to all 312
vendors, must include the time and date for the receipt of bids, 313
proposals, or replies and of the public opening, and must 314
include all contractual terms and conditions applicable to the 315
procurement, including the criteria to be used in determining 316
acceptability and relative merit of the bid, proposal, or reply. 317
(3) The chief executive officer or the executive director 318
of an area agency on aging may not receive a salary in excess of 319
150 percent of the annual salary paid to the Secretary of 320
Elderly Affairs from state and federal funds. This limitation 321
applies regardless of the number of contracts an area agency on 322
aging holds with the department. This subsection does not 323
prohibit any party from providing cash that is not from 324
appropriated state funds to the chief executive officer or the 325

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executive director of an area agency on aging. 326
(4) The department must impose financial penalties or 327
sanctions, as established by the department and incorporated 328
into the contract, for noncompliance with this section. 329
Section 5. Subsections (3) and (5) of section 430.203, 330
Florida Statutes, are amended to read: 331
430.203 Community care for the elderly; definitions.—As 332
used in ss. 430.201-430.207, the term: 333
(3) "Community care service system" means a service 334
network comprising a variety of home-delivered services, day 335
care services, and other basic services, hereinafter referred to 336
as "core services," for functionally impaired elderly persons 337
which are provided by or through a single lead agency designated 338
by the area agency on aging. Its purpose is to provide a 339
continuum of care encompassing a full range of preventive, 340
maintenance, and restorative services for functionally impaired 341
elderly persons. 342
(5) "Core services" means a variety of home-delivered 343
services, day care services, and other basic services that may 344
be provided by several entities. Core services are those 345
services that are most needed to prevent unnecessary 346
institutionalization. The area agency on aging shall not 347
directly provide core services. 348
Section 6. Subsection (4) of section 430.204, Florida 349
Statutes, is amended to read: 350

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430.204 Community-care-for-the-elderly core services; 351
departmental powers and duties.— 352
(4)(a) The department or contracting agency shall contract 353
for the provision of the core services required by a community 354
care service area. 355
(b) The area agency on aging may only directly provide 356
core services if the designated lead agency is unable to perform 357
its duties and the department approves. 358
Section 7. Subsections (2) and (4) and paragraph (a) of 359
subsection (5) of section 430.205, Florida Statutes, are amended 360
to read: 361
430.205 Community care service system.— 362
(2) Core services and other support services may be 363
furnished by public or private agencies or organizations. Each 364
community care service system must be under the direction of a 365
lead agency that coordinates the activities of individual 366
contracting agencies providing community-care-for-the-elderly 367
services. When practicable, the activities of a community care 368
service area may be directed from a multiservice senior center, 369
as defined in s. 430.901, and coordinated with other services 370
offered therein. This subsection does not require programs in 371
existence prior to the effective date of this act to be 372
relocated. 373
(4) A preservice and annual inservice training program for 374
community-care-for-the-elderly service providers and staff may 375

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be designed and implemented to help assure the delivery of 376
quality services. The department shall specify in rules the 377
training standards and requirements for the community-care-for-378
the-elderly service providers and staff. Training must be 379
sufficient to ensure that quality services are provided to 380
clients and that appropriate skills are developed to conduct the 381
program. 382
(5) Any person who has been classified as a functionally 383
impaired elderly person is eligible to receive community-care-384
for-the-elderly core services. 385
(a) Those elderly persons who are determined by protective 386
investigations to be high-risk vulnerable adults in need of 387
services, pursuant to s. 415.104(3)(b), or to be high-risk 388
victims of abuse, neglect, or exploitation who are in need of 389
immediate services to prevent further harm and are referred by 390
the adult protective services program, shall be given priority 391
primary consideration for receiving community-care-for-the-392
elderly services. As used in this paragraph, "priority primary 393
consideration" means that an assessment and services must 394
commence within 72 hours after referral to the department or as 395
established in accordance with department contracts by local 396
protocols developed between department service providers and the 397
adult protective services program. Regardless, a community-care-398
for-the-elderly services provider may dispute a referral under 399
this paragraph by requesting that adult protective services 400

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negotiate the referral placement of, and the services to be 401
provided to, a vulnerable adult or victim of abuse, neglect, or 402
exploitation. If an agreement cannot be reached with adult 403
protective services for modification of the referral decision, 404
the determination by adult protective services shall prevail. 405
Section 8. Section 430.2053, Florida Statutes, is amended 406
to read: 407
430.2053 Aging and disability resource centers.— 408
(1) The department, in consultation with the Agency for 409
Health Care Administration and the Department of Children and 410
Families, shall develop pilot projects for aging and disability 411
resource centers. 412
(2) The purposes of an aging and disability resource 413
center shall be: 414
(a) To provide Florida's elders, adults with disabilities, 415
and their families with a locally focused, coordinated approach 416
to integrating information and referral for all available 417
services for persons elders with the eligibility determination 418
entities for state and federally funded long-term-care services. 419
(b) To provide for easier access to long-term-care 420
services by Florida's elders, adults with disabilities, and 421
their families by creating multiple access points to the long-422
term-care network that flow through one established entity with 423
wide community recognition. 424
(3) The duties of an aging and disability resource center 425

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are to: 426
(a) Develop referral agreements with local community 427
service organizations, such as senior centers, existing elder 428
service providers, volunteer associations, and other similar 429
organizations, to better assist clients who do not need or do 430
not wish to enroll in programs funded by the department or the 431
agency. The referral agreements must also include a protocol, 432
developed and approved by the department, which provides 433
specific actions that an aging and disability resource center 434
and local community service organizations must take when a 435
person or a person's an elder or an elder's representative 436
seeking information on long-term-care services contacts a local 437
community service organization before prior to contacting the 438
aging and disability resource center. The protocol shall be 439
designed to ensure that persons elders and their families are 440
able to access information and services in the most efficient 441
and least cumbersome manner possible. 442
(b) Provide an initial screening of all clients who 443
request long-term-care services to determine whether the person 444
would be most appropriately served through any combination of 445
federally funded programs, state-funded programs, locally funded 446
or community volunteer programs, or private funding for 447
services. 448
(c) Determine eligibility for the programs and services 449
listed in subsection (9) for persons residing within the 450

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geographic area served by the aging and disability resource 451
center and determine a priority ranking for services which is 452
based upon the potential recipient's frailty level and 453
likelihood of institutional placement without such services. 454
(d) Place on and release from the pre-enrollment lists 455
clients eligible for the Alzheimer's Disease Initiative, 456
community care for the elderly, home care for the elderly, and 457
the Statewide Medicaid Managed Care Long-term Care program. 458
(e)(d) Manage the availability of financial resources for 459
the programs and services listed in subsection (9) for persons 460
residing within the geographic area served by the aging and 461
disability resource center. 462
(f)(e) When financial resources become available, refer a 463
client to the most appropriate entity to begin receiving 464
services. The aging and disability resource center shall make 465
referrals to lead agencies for service provision that ensure 466
that persons individuals who are vulnerable adults in need of 467
services pursuant to s. 415.104(3)(b), or who are victims of 468
abuse, neglect, or exploitation in need of immediate services to 469
prevent further harm and are referred by the adult protective 470
services program, are given priority primary consideration for 471
receiving community-care-for-the-elderly services in compliance 472
with the requirements of s. 430.205(5)(a) and that other 473
referrals for services are in compliance with s. 430.205(5)(b). 474
(f) Convene a work group to advise in the planning, 475

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implementation, and evaluation of the aging resource center. The 476
work group shall be comprised of representatives of local 477
service providers, Alzheimer's Association chapters, housing 478
authorities, social service organizations, advocacy groups, 479
representatives of clients receiving services through the aging 480
resource center, and any other persons or groups as determined 481
by the department. The aging resource center, in consultation 482
with the work group, must develop annual program improvement 483
plans that shall be submitted to the department for 484
consideration. The department shall review each annual 485
improvement plan and make recommendations on how to implement 486
the components of the plan. 487
(g) Enhance the existing area agency on aging in each 488
planning and service area by integrating, either physically or 489
virtually, the staff and services of the area agency on aging 490
with the staff of the department's local CARES Medicaid 491
preadmission screening unit and a sufficient number of staff 492
from the Department of Children and Families' Economic Self-493
Sufficiency Unit necessary to determine the financial 494
eligibility for all persons age 60 and older residing within the 495
area served by the aging and disability resource center that are 496
seeking Medicaid services, Supplemental Security Income, and 497
food assistance. 498
(h) Assist clients who request long-term care services in 499
being evaluated for eligibility for enrollment in the Medicaid 500

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long-term care managed care program as eligible plans become 501
available in each of the regions pursuant to s. 409.981(2). 502
(i) Provide enrollment and coverage information to 503
Medicaid managed long-term care enrollees as qualified plans 504
become available in each of the regions pursuant to s. 505
409.981(2). 506
(i)(j) Assist Medicaid recipients enrolled in the Medicaid 507
long-term care managed care program with informally resolving 508
grievances with a managed care network and assist Medicaid 509
recipients in accessing the managed care network's formal 510
grievance process as eligible plans become available in each of 511
the regions defined in s. 409.981(2). 512
(4) The department shall select the entities to become 513
aging and disability resource centers based on each entity's 514
readiness and ability to perform the duties listed in subsection 515
(3) and the entity's: 516
(a) Expertise in the needs of each target population the 517
center proposes to serve and a thorough knowledge of the 518
providers that serve these populations. 519
(b) Strong connections to service providers, volunteer 520
agencies, and community institutions. 521
(c) Expertise in information and referral activities. 522
(d) Knowledge of long-term-care resources, including 523
resources designed to provide services in the least restrictive 524
setting. 525

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(e) Financial solvency and stability. 526
(f) Ability to collect, monitor, and analyze data in a 527
timely and accurate manner, along with systems that meet the 528
department's standards. 529
(g) Commitment to adequate staffing by qualified personnel 530
to effectively perform all functions. 531
(h) Ability to meet all performance standards established 532
by the department. 533
(5) The aging and disability resource center shall have a 534
governing body which shall be the same entity described in s. 535
20.41(7), and an executive director who may be the same person 536
as described in s. 20.41(7). The governing body shall annually 537
evaluate the performance of the executive director. 538
(6) The aging and disability resource center may not be a 539
provider of direct services other than information and referral 540
services, outreach, and screening, and intake. The aging and 541
disability resource center must receive a waiver from the 542
department to be the provider of any other direct services. 543
(7) The aging and disability resource center must agree to 544
allow the department to review any financial information the 545
department determines is necessary for monitoring or reporting 546
purposes, including financial relationships. 547
(8) The duties and responsibilities of the community care 548
for the elderly lead agencies within each area served by an 549
aging and disability resource center shall be to: 550

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(a) Develop strong community partnerships to maximize the 551
use of community resources for the purpose of assisting persons 552
elders to remain in their community settings for as long as it 553
is safely possible. 554
(b) Conduct comprehensive assessments of clients that have 555
been determined eligible and develop a care plan consistent with 556
established protocols that ensures that the unique needs of each 557
client are met. 558
(9) The services to be administered through the aging and 559
disability resource center shall include those funded by the 560
following programs: 561
(a) Community care for the elderly. 562
(b) Home care for the elderly. 563
(c) Contracted services. 564
(d) Alzheimer's disease initiative. 565
(e) Older Americans Act. 566
(10) The department shall, before prior to designation of 567
an aging and disability resource center, develop by rule 568
operational and quality assurance standards and outcome measures 569
to ensure that clients receiving services through all long-term-570
care programs administered through an aging and disability 571
resource center are receiving the appropriate care they require 572
and that contractors and subcontractors are adhering to the 573
terms of their contracts and are acting in the best interests of 574
the clients they are serving, consistent with the intent of the 575

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Legislature to reduce the use of and cost of nursing home care. 576
The department shall by rule provide operating procedures for 577
aging and disability resource centers, which shall include: 578
(a) Minimum standards for financial operation, including 579
audit procedures. 580
(b) Procedures for monitoring and sanctioning of service 581
providers. 582
(c) Minimum standards for technology utilized by the aging 583
and disability resource center. 584
(d) Minimum staff requirements which shall ensure that the 585
aging and disability resource center employs sufficient quality 586
and quantity of staff to adequately meet the needs of the elders 587
residing within the area served by the aging and disability 588
resource center. 589
(e) Minimum accessibility standards, including hours of 590
operation. 591
(f) Minimum oversight standards for the governing body of 592
the aging and disability resource center to ensure its 593
continuous involvement in, and accountability for, all matters 594
related to the development, implementation, staffing, 595
administration, and operations of the aging and disability 596
resource center. 597
(g) Minimum education and experience requirements for 598
executive directors and other executive staff positions of aging 599
and disability resource centers. 600

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(h) Minimum requirements regarding any executive staff 601
positions that the aging and disability resource center must 602
employ and minimum requirements that a candidate must meet in 603
order to be eligible for appointment to such positions. 604
(11) In an area in which the department has designated an 605
area agency on aging as an aging and disability resource center, 606
the department and the agency may shall not make payments for 607
the services listed in subsection (9) and the Statewide Medicaid 608
Managed Care Long-term Care program Long-Term Care Community 609
Diversion Project for such persons who were not screened and 610
enrolled through the aging and disability resource center. The 611
department shall cease making payments for recipients in 612
eligible plans as eligible plans become available in each of the 613
regions defined in s. 409.981(2). 614
(12) Each aging and disability resource center shall enter 615
into a memorandum of understanding with the department for 616
collaboration with the CARES unit staff. The memorandum of 617
understanding shall outline the staff person responsible for 618
each function and shall provide the staffing levels necessary to 619
carry out the functions of the aging and disability resource 620
center. 621
(13) Each aging and disability resource center shall enter 622
into a memorandum of understanding with the Department of 623
Children and Families for collaboration with the Economic Self-624
Sufficiency Unit staff. The memorandum of understanding shall 625

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outline which staff persons are responsible for which functions 626
and shall provide the staffing levels necessary to carry out the 627
functions of the aging and disability resource center. 628
(14) If any of the state activities described in this 629
section are outsourced, either in part or in whole, the contract 630
executing the outsourcing shall mandate that the contractor or 631
its subcontractors shall, either physically or virtually, 632
execute the provisions of the memorandum of understanding 633
instead of the state entity whose function the contractor or 634
subcontractor now performs. 635
(15) In order to be eligible to begin transitioning to an 636
aging resource center, an area agency on aging board must ensure 637
that the area agency on aging which it oversees meets all of the 638
minimum requirements set by law and in rule. 639
(15)(a)(16)(a) Once an aging resource center is 640
operational, The department, in consultation with the aging and 641
disability resource center agency, may develop capitation rates 642
for any of the programs administered through the agency aging 643
resource center. Capitation rates for programs shall be based on 644
the historical cost experience of the state in providing those 645
same services to the population age 60 or older residing within 646
each area served by an aging and disability resource center. 647
Each capitated rate may vary by geographic area as determined by 648
the department. 649
(b) The department and the agency may determine for each 650

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area served by an aging and disability resource center whether 651
it is appropriate, consistent with federal and state laws and 652
regulations, to develop and pay separate capitated rates for 653
each program administered through the aging and disability 654
resource center or to develop and pay capitated rates for 655
service packages which include more than one program or service 656
administered through the aging and disability resource center. 657
(c) Once capitation rates have been developed and 658
certified as actuarially sound, the department and the agency 659
may pay service providers the capitated rates for services when 660
appropriate. 661
(d) The department, in consultation with the agency, shall 662
annually reevaluate and recertify the capitation rates, 663
adjusting forward to account for inflation, programmatic 664
changes. 665
(16)(17) This section does shall not be construed to allow 666
an aging and disability resource center to restrict, manage, or 667
impede the local fundraising activities of service providers. 668
Section 9. Subsection (3) of section 430.605, Florida 669
Statutes, is amended to read: 670
430.605 Subsidy payments.—The department shall develop a 671
schedule of subsidy payments to be made to persons providing 672
home care, and to providers of goods and services, for certain 673
eligible elderly persons. Payments must be based on the 674
financial status of the person receiving care. Payments must 675

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include, but need not be limited to: 676
(3) When necessary, special supplements to provide for any 677
goods and services, food and nutritional supplements, and 678
specialized care required to maintain the health, safety, and 679
well-being of the elderly person. Extraordinary medical, dental, 680
or pharmaceutical expenses may be paid as a special supplement. 681
Section 10. Subsection (2) of section 430.901, Florida 682
Statutes, is amended to read: 683
430.901 Multiservice senior center; definition; purpose.—A 684
"multiservice senior center" is: 685
(2) An entity that may partner with an aging and 686
disability resource center to provide for easier access to long-687
term care services by seniors and their families who reside 688
within the local community. 689
Section 11. Subsection (1) and paragraph (e) of subsection 690
(2) of section 744.2001, Florida Statutes, are amended to read: 691
744.2001 Office of Public and Professional Guardians.—692
There is created the Office of Public and Professional Guardians 693
within the Department of Elderly Affairs. 694
(1) The Secretary of Elderly Affairs shall appoint the 695
executive director, who shall be the head of the Office of 696
Public and Professional Guardians. The executive director must 697
be a member of The Florida Bar, knowledgeable of guardianship 698
law and of the social services available to meet the needs of 699
incapacitated persons, shall serve on a full-time basis, and 700

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shall personally, or through a representative of the office, 701
carry out the purposes and functions of the Office of Public and 702
Professional Guardians in accordance with state and federal law. 703
The executive director shall serve at the pleasure of and report 704
to the secretary. 705
(2) The executive director shall, within available 706
resources: 707
(e) Produce and make available information about 708
alternatives to and types of guardianship for dissemination by 709
area agencies on aging as defined in s. 430.203 and aging and 710
disability resource centers as described in s. 430.2053. 711
Section 12. Subsection (3) of section 744.2003, Florida 712
Statutes, is amended to read: 713
744.2003 Regulation of professional guardians; 714
application; bond required; educational requirements.— 715
(3) Each professional guardian as defined in s. 716
744.102(17) and public guardian must receive a minimum of 40 717
hours of instruction and training. Each professional guardian 718
must receive a minimum of 30 hours of continuing education every 719
2 calendar years after the year in which the initial 40-hour 720
educational requirement is met. The required continuing 721
education must include at least 2 hours on fiduciary 722
responsibilities; 2 hours on professional ethics; 1 hour on 723
advance directives; 1 hour on Alzheimer's disease and related 724
disorders; 3 hours on abuse, neglect, and exploitation; and 3 4 725

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hours on guardianship law. The instruction and education must be 726
completed through a course approved or offered by the Office of 727
Public and Professional Guardians. The expenses incurred to 728
satisfy the educational requirements prescribed in this section 729
may not be paid with the assets of any ward. This subsection 730
does not apply to any attorney licensed to practice law in this 731
state or an institution acting as guardian under s. 744.2002(7). 732
Section 13. Subsection (2) of section 744.2004, Florida 733
Statutes, is amended to read: 734
744.2004 Complaints; disciplinary proceedings; penalties; 735
enforcement.— 736
(2) The Office of Public and Professional Guardians shall 737
establish disciplinary proceedings, conduct hearings, and take 738
administrative action pursuant to chapter 120. Disciplinary 739
actions may include, but are not limited to, requiring a 740
professional guardian to participate in additional educational 741
courses provided or approved by the Office of Public and 742
Professional Guardians, imposing additional monitoring by the 743
Office of Public and Professional Guardians of the guardianships 744
to which the professional guardian is appointed, imposing a 745
fine, and suspension or revocation of a professional guardian's 746
registration. 747
Section 14. Paragraph (f) of subsection (2) of section 748
744.20041, Florida Statutes, is redesignated as paragraph (g), 749
and a new paragraph (f) is added to that subsection to read: 750

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744.20041 Grounds for discipline; penalties; enforcement.— 751
(2) When the Office of Public and Professional Guardians 752
finds a professional guardian guilty of violating subsection 753
(1), it may enter an order imposing one or more of the following 754
penalties: 755
(f) Requirement that the professional guardian pay a fine, 756
not to exceed $500 per violation. 757
Section 15. Subsection (2) of section 744.2104, Florida 758
Statutes, is renumbered as subsection (4), and new subsections 759
(2) and (3) are added to that section to read: 760
744.2104 Access to records by the Office of Public and 761
Professional Guardians; confidentiality.— 762
(2) In conducting an investigation, the Office of Public 763
and Professional Guardians may issue subpoenas duces tecum to 764
financial institutions, insurance companies, the ward's 765
caregivers, any facility at which the ward resides or has 766
resided, and the professional guardian or employees to compel 767
the production of records relevant to the investigation 768
conducted by the office. 769
(3) If there is substantial noncompliance with a subpoena 770
duces tecum issued by the office, the office may petition the 771
court in the county in which the person resides or has resided 772
or his place of business for an order requiring the person to 773
produce such records as specified in the subpoena duces tecum. 774
Section 16. Subsection (4) of section 744.3701, Florida 775

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Statutes, is amended to read: 776
744.3701 Confidentiality.— 777
(4) The clerk may disclose confidential information to the 778
Department of Children and Families, the Department of Elderly 779
Affairs, or law enforcement agencies for other purposes as 780
provided by court order. 781
Section 17. Consistent with s. 11.0431(2), Florida 782
Statutes, the Department of Elderly Affairs shall submit all of 783
the following unredacted Office of Public and Professional 784
Guardians records to the President of the Senate and the Speaker 785
of the House of Representatives by August 1, 2026: 786
(1) For all complaints received during calendar year 2025 787
that were dismissed pursuant to s. 744.2004(1)(f), Florida 788
Statutes: 789
(a) The original complaint. 790
(b) The final investigation report. 791
(c) The dismissal letter issued to the complainant and 792
guardian as required by s. 744.2004(1)(g), Florida Statutes. 793
(2) For all complaints received during calendar year 2025 794
that resulted in the issuance of a letter of concern, notice of 795
noncompliance, or other written cautionary communication 796
concerning the complaint that was not a dismissal letter sent 797
pursuant to s. 744.2004(1)(g), Florida Statutes: 798
(a) The original complaint. 799
(b) The final investigation report. 800

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(c) The letter of concern, notice of noncompliance, or 801
other written communication or notice provided to the guardian. 802
(d) The letter or notice provided to the complainant. 803
Section 18. This act shall take effect July 1, 2026. 804