SESSION WATCH
THE BILL ITSELF

SB 2518

Health

VERSION S 2518 Filed · BACK TO THE SUMMARY · OFFICIAL RECORD

underlined language is being added; struck language is being deleted. Line numbers are the Legislature's own — the same ones amendments cite.

Florida Senate - 2026 SB 2518 By the Committee on Appropriations 576-03004-26 20262518__
1 A bill to be entitled
2 An act relating to health; amending s. 216.136, F.S.;
3 requiring the Social Services Estimating Conference to
4 develop certain official information relating to the
5 pilot program for individuals with developmental
6 disabilities; amending s. 394.495, F.S.; authorizing
7 the Department of Children and Families, as authorized
8 by and consistent with appropriated funding, to
9 contract with a specified organization to provide
10 grief support services to help certain children and
11 youth; requiring that the services be provided at no
12 cost; authorizing the contracted organization to also
13 provide grief awareness training and outreach to local
14 schools and medical facilities under the contract;
15 amending s. 409.145, F.S.; revising the monthly room
16 and board rates the department is required to pay to
17 certain foster parents and caregivers; amending s.
18 409.1455, F.S.; renaming the Step into Success
19 Workforce Education and Internship Pilot Program as
20 the Step into Success Workforce Education and
21 Internship Program; deleting a provision limiting the
22 duration of the program; requiring the Office of
23 Continuing Care within the department to develop
24 certain cohorts within specified regions, to
25 collaborate with certain organizations to recruit
26 mentors and organizations, and to provide eligible
27 former foster youth with internship placement
28 opportunities; deleting a provision requiring that the
29 program be administered in a certain manner; deleting
30 obsolete language; requiring the office to develop
31 trauma-informed training for mentors of certain former
32 foster youth; providing requirements for the training;
33 authorizing the office to provide certain additional
34 trainings on mentorship of special populations;
35 revising the amount of monthly financial assistance
36 that the office provides to participating former
37 foster youth; requiring the office to assign
38 experienced staff to serve as program liaisons for a
39 specified purpose; revising qualifications to serve as
40 a mentor; authorizing the department to offer certain
41 training to mentors in subsequent years; authorizing
42 an employee who serves as a mentor to participate in
43 certain additional trainings; deleting a provision
44 authorizing the offset of a reduction in or loss of
45 certain benefits due to receipt of a Step into Success
46 stipend by an additional stipend payment; creating s.
47 409.1475, F.S.; providing legislative findings and
48 intent; creating the Foster and Family Support Grant
49 Program within the department; requiring the
50 department to award grants to not-for-profit, faith
51 based organizations for specified purposes; requiring
52 that the program emphasize certain support; specifying
53 authorized uses for awarded grant funds; requiring
54 grant recipients to submit reports to the department
55 in a format and at intervals prescribed by the
56 department; authorizing the department to adopt rules;
57 amending s. 409.908, F.S.; revising the parameters for
58 the prospective payment methodology used for
59 determining the Agency for Health Care
60 Administration’s long-term care reimbursement plan for
61 nursing home care; requiring the agency to consider
62 specified recommendations when revising its
63 methodology for calculating Quality Incentive Program
64 payments; requiring the agency to delay the effective
65 date of any changes to its methodology for a specified
66 timeframe; amending s. 409.9855, F.S.; requiring the
67 agency to collect and analyze certain data relating to
68 the pilot program for individuals with developmental
69 disabilities for a specified timeframe; requiring the
70 agency to report specified information to the Social
71 Services Estimating Conference; amending s. 409.990,
72 F.S.; revising the cumulative amount of unexpended
73 state funds that a community-based care lead agency
74 may carry forward to the next fiscal year; amending s.
75 414.56, F.S.; conforming a provision to changes made
76 by the act; reenacting ss. 39.5085(2)(d),
77 39.6225(5)(d), 393.065(5)(b), and 409.1451(2)(b),
78 F.S., relating to the Relative Caregiver Program, the
79 Guardianship Assistance Program, application and
80 eligibility determinations, and the Road-to
81 Independence Program, respectively, to incorporate the
82 amendment made to s. 409.145, F.S., in references
83 thereto; providing an effective date.
85 Be It Enacted by the Legislature of the State of Florida:
87 Section 1. Paragraph (c) is added to subsection (6) of
88 section 216.136, Florida Statutes, to read:
89 216.136 Consensus estimating conferences; duties and
90 principals.—
91 (6) SOCIAL SERVICES ESTIMATING CONFERENCE.—
92 (c) The Social Services Estimating Conference shall develop
93 official information relating to the pilot program for
94 individuals with developmental disabilities implemented pursuant
95 to s. 409.9855, including, but not limited to, data related to
96 enrollment, caseloads, utilization of services, program
97 expenditures, and any other information that the conference
98 determines necessary for the state planning and budgeting system
99 and to project future budgets and drawdown of federal matching
100 funds.
101 Section 2. Subsection (8) is added to section 394.495,
102 Florida Statutes, to read:
103 394.495 Child and adolescent mental health system of care;
104 programs and services.—
105 (8) As authorized by and consistent with funding
106 appropriated in the General Appropriations Act, the department
107 may contract with Valerie’s House, Inc., a nonprofit
108 organization exempt from taxation pursuant to s. 501(c)(3) of
109 the Internal Revenue Code, to provide grief support services to
110 help children and youth ages 4 to 19 who have experienced the
111 death of a parent or sibling. The services provided must be at
112 no cost to the bereaved child or his or her caregiver and may
113 include, but need not be limited to, grief support groups,
114 mentoring, individual grief counseling, financial crisis
115 support, and in-school support services. Valerie’s House, Inc.,
116 may also provide grief awareness training and outreach to local
117 schools and medical facilities under the contract.
118 Section 3. Subsection (3) of section 409.145, Florida
119 Statutes, is amended to read:
120 409.145 Care of children; “reasonable and prudent parent”
121 standard.—The child welfare system of the department shall
122 operate as a coordinated community-based system of care which
123 empowers all caregivers for children in foster care to provide
124 quality parenting, including approving or disapproving a child’s
125 participation in activities based on the caregiver’s assessment
126 using the “reasonable and prudent parent” standard.
127 (3) ROOM AND BOARD RATES.—
128 (a) Effective July 1, 2026 2022 , room and board rates shall
129 be paid to foster parents, including relative and nonrelative
130 caregivers who are licensed as a level I child-specific foster
131 placement, and to relative and nonrelative caregivers who are
132 participating in the Relative Caregiver Program and receiving
133 payments pursuant to s. 39.5085(2)(d)1. or 2., as follows:
135 Monthly Room and Board Rate
136 0-5 YearsAge 6-12 YearsAge 13-21 YearsAge
137 $663.03 $517.94 $680.01 $531.21 $795.94 $621.77
138 (b) Each January, foster parents, including relative and
139 nonrelative caregivers who are licensed as a level I child
140 specific foster placement and relative and nonrelative
141 caregivers who are participating in the Relative Caregiver
142 Program and receiving payments pursuant to s. 39.5085(2)(d)1. or
143 2., shall receive an annual cost of living increase. The
144 department shall calculate the new room and board rate increase
145 equal to the percentage change in the Consumer Price Index for
146 All Urban Consumers, U.S. City Average, All Items, not
147 seasonally adjusted, or successor reports, for the preceding
148 December compared to the prior December as initially reported by
149 the United States Department of Labor, Bureau of Labor
150 Statistics. The department shall make available the adjusted
151 room and board rates annually.
152 (c) The amount of the monthly room and board rate may be
153 increased upon agreement among the department, the community
154 based care lead agency, and the foster parent.
155 (d) Effective July 1, 2022, community-based care lead
156 agencies providing care under contract with the department shall
157 pay a supplemental room and board payment to foster parents,
158 including relative and nonrelative caregivers who are licensed
159 as a level I child-specific foster placement and relative and
160 nonrelative caregivers who are participating in the Relative
161 Caregiver Program and receiving payments pursuant to s.
162 39.5085(2)(d)1. or 2., on a per-child basis, for providing
163 independent life skills and normalcy supports to children who
164 are 13 through 17 years of age placed in their care. The
165 supplemental payment must be paid monthly in addition to the
166 current monthly room and board rate payment. The supplemental
167 monthly payment shall be based on 10 percent of the monthly room
168 and board rate for children 13 through 21 years of age as
169 provided under this section and adjusted annually.
170 Section 4. Section 409.1455, Florida Statutes, is amended
171 to read:
172 409.1455 Step into Success Workforce Education and
173 Internship Pilot Program for foster youth and former foster
174 youth.—
175 (1) SHORT TITLE.—This section may be cited as the “Step
176 into Success Act.”
177 (2) CREATION.—The department shall establish the 3-year
178 Step into Success Workforce Education and Internship Pilot
179 Program to give eligible foster youth and former foster youth an
180 opportunity to learn and develop essential workforce and
181 professional skills, to transition from the custody of the
182 department to independent living, and to become better prepared
183 for an independent and successful future. The pilot program must
184 consist of an independent living professionalism and workforce
185 education component and, for youth who complete that component,
186 an onsite workforce training internship component. In
187 consultation with subject-matter experts and the community-based
188 care lead agencies, the office shall develop and administer the
189 pilot program for interested foster youth and former foster
190 youth; however, the department may contract with entities that
191 have demonstrable subject-matter expertise in the transition to
192 adulthood for foster youth, workforce training and preparedness,
193 professional skills, and related subjects to collaborate with
194 the office in the development and administration of the pilot
195 program. The independent living professionalism and workforce
196 education component of the program must culminate in a
197 certificate that allows a former foster youth to participate in
198 the onsite workforce training internship.
199 (3) DEFINITIONS.—For purposes of this section, the term:
200 (a) “Community-based care lead agency” has the same meaning
201 as in s. 409.986(3).
202 (b) “Former foster youth” means an individual 18 years of
203 age or older but younger than 26 years of age who is currently
204 or was previously placed in licensed care, excluding Level I
205 licensed placements pursuant to s. 409.175(5)(a)1., for at least
206 60 days within this state.
207 (c) “Foster youth” means an individual older than 16 years
208 of age but younger than 18 years of age who is currently in
209 licensed care, excluding Level I licensed placements pursuant to
210 s. 409.175(5)(a)1.
211 (d) “Office” means the department’s Office of Continuing
212 Care.
213 (e) “Participating organization” means a state agency, a
214 corporation under chapter 607 or chapter 617, or another
215 relevant entity that has agreed to collaborate with the office
216 in the development and implementation of a trauma-informed
217 onsite workforce training internship program pursuant to
218 subsections (6) and (7).
219 (4) REQUIREMENTS OF THE DEPARTMENT AND OFFICE.—The
220 department shall establish and the office shall develop and
221 administer the pilot program for eligible foster youth and
222 former foster youth. The office shall do all of the following:
223 (a) Develop eligible foster youth and former foster youth
224 cohorts within the department’s regions.
225 (b) Collaborate with local chambers of commerce and recruit
226 mentors and organizations within the department’s regions,
227 emphasizing recruitment of mentors and organizations in the
228 following counties:
229 1. Duval.
230 2. Escambia.
231 3. Hillsborough.
232 4. Palm Beach.
233 5. Polk.
234 (c) Provide eligible former foster youth with a variety of
235 internship placement opportunities, including by connecting
236 existing third-party mentorship organizations that focus on
237 former foster youth with eligible former foster youth who have
238 an interest in such organizations’ programs The pilot program
239 must be administered as part of an eligible foster youth’s
240 regular transition planning under s. 39.6035 or as a post
241 transition service for eligible former foster youth. The office
242 must begin the professionalism and workforce education component
243 of the program on or before January 1, 2024, and the onsite
244 workforce training internship component of the program on or
245 before July 1, 2024 .
246 (5) INDEPENDENT LIVING PROFESSIONALISM AND WORKFORCE
247 EDUCATION COMPONENT REQUIREMENTS.—The office shall do all of the
248 following in connection with the independent living
249 professionalism and workforce education component for eligible
250 foster youth and former foster youth:
251 (a) Designate and ensure that the number of qualified staff
252 is sufficient to implement and administer the component, which
253 may be part of a larger independent living or life skills
254 training program if the larger program meets the requirements of
255 this subsection.
256 (b) Develop all workshops, presentations, and curricula for
257 the component, including, but not limited to, all written
258 educational and training materials for foster youth and former
259 foster youth. Resources may include, but are not limited to,
260 workshops and materials to assist with preparing résumés, mock
261 interviews, experiential training, and assistance with securing
262 an internship or employment. The office must review and update
263 these materials as necessary. The training materials must
264 address, but are not limited to, the following:
265 1. Interview skills;
266 2. Professionalism;
267 3. Teamwork;
268 4. Leadership;
269 5. Problem solving; and
270 6. Conflict resolution in the workplace.
271 (c) Require that the training provided be in addition to
272 any other life skills or employment training required by law.
273 The training may be developed or administered by the department,
274 community-based care lead agencies, or the lead agencies’
275 subcontracted providers, or in collaboration with colleges or
276 universities or other nonprofit organizations in the community
277 with workforce education and training resources.
278 (d) Provide relevant written materials from the component
279 and any relevant tools developed to ensure participants’
280 successful transition to internships to all participating
281 organizations that offer workforce training internship
282 opportunities.
283 (e) Provide materials to inform eligible foster youth and
284 former foster youth of the program, the requirements for
285 participation, and contact information for enrollment. The
286 community-based care lead agencies shall ensure that any
287 subcontracted providers that directly serve youth receive this
288 information.
289 (f) Advertise and promote the availability of the education
290 and internship program to engage as many eligible foster youth
291 and former foster youth as possible.
292 (g) Assess the career interests of each eligible foster
293 youth and former foster youth who expresses interest in
294 participating in the program and determine the most appropriate
295 internship and post-internship opportunities for that youth
296 based on his or her expressed interests.
297 (6) ONSITE WORKFORCE TRAINING INTERNSHIP COMPONENT
298 REQUIREMENTS.—The office shall do all of the following in
299 connection with the onsite workforce training internship program
300 for eligible former foster youth:
301 (a) Develop processes and procedures to implement a trauma
302 informed onsite workforce training internship component. The
303 processes and procedures of the internship component must be
304 designed so that they can be replicated and scaled to meet
305 various organizational structures and sizes. The component must
306 include:
307 1. Recruitment of agencies, corporations, and other
308 entities to host interns as participating organizations;
309 2. Assisting participating organizations with mentor
310 recruitment, training, and matching;
311 3. Mentor-led performance reviews, including a review of
312 the intern’s work product, professionalism, time management,
313 communication style, and stress-management strategies;
314 4. Daily mentorship and coaching on topics such as:
315 a. Professionalism;
316 b. Teamwork;
317 c. Leadership;
318 d. Problem solving; and
319 e. Conflict resolution in the workplace;
320 5. Development of opportunities for interns to become
321 employees of the participating organization; and
322 6. Reporting requirements specified in subsection (11).
323 (b) Develop a minimum of 1 hour of required trauma-informed
324 training for mentors to satisfy the requirements of sub
325 subparagraph (7)(b)1.e. Such training must include interactive
326 or experiential components, such as role-playing, scenario
327 discussion, or case studies. The office may provide at least
328 four additional 1-hour trainings on mentorship of special
329 populations as optional training opportunities, which must be
330 asynchronous and accessible to mentors online at their
331 convenience, and must inform participating organizations of
332 these optional training opportunities teach the skills necessary
333 to engage with participating eligible former foster youth .
334 (c) Provide assistance to eligible foster youth and former
335 foster youth interested in participating in the internship
336 component, including, but not limited to, identifying and
337 monitoring internship opportunities, being knowledgeable of the
338 training and skills needed to match eligible foster youth and
339 former foster youth with appropriate internships, and assisting
340 eligible foster youth and former foster youth with applying for
341 post-internship employment opportunities.
342 (d) Publicize specific internship positions in an easily
343 accessible manner and inform eligible foster youth and former
344 foster youth of where to locate such information.
345 (e) Provide a participating former foster youth with
346 financial assistance in the amount of $1,717 $1,517 monthly and
347 develop a process and schedule for the distribution of payments
348 to former foster youth participating in the component, subject
349 to the availability of funds.
350 (f) Distribute funds appropriated for the compensation of
351 mentors who are participating in the component as provided in
352 paragraph (7)(b).
353 (g) By May 1, 2024, provide to the Board of Governors and
354 the State Board of Education all relevant internship information
355 necessary to support the award of postsecondary credit or career
356 education clock hours for internship positions held by former
357 foster youth participating in the onsite workforce training
358 internship component.
359 (h) Develop and conduct follow-up surveys with:
360 1. Former foster youth within 3 months after their
361 internship start date to ensure successful transition into the
362 work environment and to gather feedback on how to improve the
363 experience for future participants.
364 2. Mentors assigned to participating former foster youth.
365 Such data must be collected by October 1, 2024, and by October 1
366 annually thereafter, for inclusion in the independent living
367 services annual report.
368 3. Any other persons the office deems relevant for purposes
369 of continued improvement of the internship component.
370 (i) Assign experienced staff to serve as program liaisons
371 who are available for mentors to contact whenever the mentors
372 need to debrief or have questions concerning a former foster
373 youth.
374 (7) REQUIREMENTS FOR PARTICIPATING ORGANIZATIONS.—Each
375 organization participating in the onsite workforce training
376 internship component shall:
377 (a) Collaborate with the office to implement a trauma
378 informed approach to mentoring and training former foster youth.
379 (b) Recruit employees to serve as mentors for former foster
380 youth interning with such organizations.
381 1. To serve as a mentor, an employee must:
382 a. Have worked in his or her career field or area for the
383 participating organization for at least 1 year;
384 b. Have experience relevant to the job and task
385 responsibilities of the intern;
386 c. Sign a monthly hour statement for the intern;
387 d. Allocate at least 1 hour per month to conduct mentor-led
388 performance reviews, to include a review of the intern’s work
389 product, professionalism, time management, communication style,
390 and stress-management strategies; and
391 e. Complete a minimum of 1 hour of trauma-informed training
392 to gain and maintain skills critical for successfully engaging
393 former foster youth. Before being matched with a former foster
394 youth, the employee must complete a 1-hour training that covers
395 core topics, including, but not limited to:
396 (I) Understanding trauma and its impacts.
397 (II) Recognizing and responding to trauma-related
398 behaviors.
399 (III) De-escalation strategies and crisis response.
400 (IV) Boundaries and mentor self-care.
401 (V) Communication skills.
403 The department may offer a 1-hour training to review topics
404 covered by the training required under this sub-subparagraph
405 every subsequent year that the employee chooses to serve as a
406 mentor.
407 2. Subject to available funding, an employee who serves as
408 a mentor and receives the required trauma-informed training is
409 eligible for a maximum payment of $1,200 per intern per fiscal
410 year, to be issued as a $100 monthly payment for every month of
411 service as a mentor.
412 3. An employee may serve as a mentor for a maximum of three
413 interns at one time and may not receive more than $3,600 in
414 compensation per fiscal year for serving as a mentor. Any time
415 spent serving as a mentor to an intern under this section counts
416 toward the minimum service required for eligibility for payments
417 pursuant to subparagraph 2. and this subparagraph.
418 4. An employee who serves as a mentor may participate in
419 additional trainings on the mentorship of special populations as
420 made available by the office.
421 (c) When necessary, have a discussion with an intern’s
422 assigned mentor, the participating organization’s internship
423 program liaison, and the office about the creation of a
424 corrective action plan to address issues related to the intern’s
425 professionalism, work product, or performance and, if
426 applicable, after giving the intern a reasonable opportunity to
427 comply with the corrective action plan, document the intern’s
428 failure to do so before discharging him or her.
429 (d) Provide relevant feedback to the office at least
430 annually for the office to comply with paragraph (6)(h).
431 (e) Collaborate with the department to provide any
432 requested information necessary to prepare the annual report
433 required under subsection (11).
434 (8) TIME LIMITATIONS FOR PARTICIPATION.—A former foster
435 youth who obtains an internship with a participating
436 organization may participate in the internship component for no
437 more than 1 year, calculated as 12 monthly stipend periods. The
438 year begins on his or her start date with a participating
439 organization. A former foster youth may intern under the
440 internship program with more than one participating
441 organization, but may not intern with more than one
442 participating organization at the same time. A participating
443 organization may hire the intern as an employee, but the hiring
444 of a former foster youth may not be for an internship under this
445 section.
446 (9) AWARD OF POSTSECONDARY CREDIT.—The Board of Governors
447 and the State Board of Education shall adopt regulations and
448 rules, respectively, to award postsecondary credit or career
449 education clock hours for eligible former foster youth
450 participating in the internship component pursuant to subsection
451 (4). The regulations and rules must include procedures for the
452 award of postsecondary credit or career education clock hours,
453 including, but not limited to, equivalency and alignment of the
454 internship component with appropriate postsecondary courses and
455 course descriptions.
456 (10) CONDITIONS OF PARTICIPATION IN THE INTERNSHIP
457 COMPONENT.—
458 (a) To become a participant in the internship component of
459 the program, the applicant must be a foster youth or a former
460 foster youth as those terms are defined in subsection (3) at the
461 time such youth applies for an internship position with a
462 participating organization. A foster youth or former foster
463 youth who has completed the training component with the
464 department may apply for a position with a participating
465 organization but may not begin an internship until attaining the
466 age of 18 years.
467 (b) If offered an internship, a former foster youth must be
468 classified as an intern and must work 80 hours per month to be
469 eligible for the stipend payment.
470 (c) A former foster youth must spend any stipend funds
471 specified for clothing on clothing that is in compliance with
472 the dress code requirements of the participating organization
473 with which the former foster youth is interning. Notwithstanding
474 any limitation on funds provided to purchase clothing, the
475 former foster youth must comply with any dress code requirements
476 of the participating organization with which he or she is
477 interning.
478 (d) Stipend money earned pursuant to the internship
479 component may not be considered earned income for purposes of
480 computing eligibility for federal or state benefits, including,
481 but not limited to, the Supplemental Nutrition Assistance
482 Program, a housing choice assistance voucher program, the
483 Temporary Cash Assistance Program, the Medicaid program, or the
484 school readiness program. Notwithstanding this paragraph, any
485 reduction in the amount of benefits or loss of benefits due to
486 receipt of the Step into Success stipend may be offset by an
487 additional stipend payment equal to the value of the maximum
488 benefit amount for a single person allowed under the
489 Supplemental Nutrition Assistance Program.
490 (e) A former foster youth may, at the discretion of a
491 postsecondary educational institution within this state in which
492 such youth is enrolled, earn postsecondary credit or career
493 education clock hours for work performed as an intern under the
494 internship component. Postsecondary credit and career education
495 clock hours earned for work performed under the internship
496 component may be in addition to any compensation earned for the
497 same work performed under the internship component and may be
498 awarded for completion of all or any part of the internship
499 component. Participating organizations shall cooperate with
500 postsecondary educational institutions to provide any
501 information about internship positions which is necessary to
502 enable the institutions to determine whether to grant the
503 participating former foster youth postsecondary credit or career
504 education clock hours toward his or her degree.
505 (f) A former foster youth who accepts an internship with a
506 participating organization pursuant to this section may only be
507 discharged from the internship component after the participating
508 organization engages the intern’s assigned mentor and the
509 participating organization’s internship program staff to assist
510 the intern in performing the duties of the internship. Before
511 discharging the former foster youth, the participating
512 organization must also document the intern’s failure to comply
513 with a corrective action plan after being given a reasonable
514 opportunity to do so.
515 (11) REPORT.—The department shall include a section on the
516 Step into Success Workforce Education and Internship Pilot
517 Program in the independent living annual report prepared
518 pursuant to s. 409.1451(6) which includes, but is not limited
519 to, all of the following:
520 (a) Whether the pilot program is in compliance with this
521 section, and if not, barriers to compliance.
522 (b) A list of participating organizations and the number of
523 interns.
524 (c) A summary of recruitment efforts to increase the number
525 of participating organizations.
526 (d) A summary of the feedback and surveys received pursuant
527 to paragraph (6)(h) from participating former foster youth,
528 mentors, and others who have participated in the pilot program.
529 (e) Recommendations, if any, for actions necessary to
530 improve the quality, effectiveness, and outcomes of the pilot
531 program.
532 (f) Employment outcomes of former foster youth who
533 participated in the pilot program, including employment status
534 after completion of the program, whether he or she is employed
535 by the participating organization in which he or she interned or
536 by another entity, and job description and salary information,
537 if available.
538 (12) RULEMAKING.—The department shall adopt rules to
539 implement this section.
540 Section 5. Section 409.1475, Florida Statutes, is created
541 to read:
542 409.1475 Foster and Family Support Grant Program.—
543 (1) The Legislature recognizes that children and families
544 thrive when caregivers are engaged, supported, and equipped to
545 meet their responsibilities. It is the intent of the Legislature
546 to strengthen community-based support that promotes stable
547 caregiving relationships, responsible parenting, and improved
548 outcomes for vulnerable children. Therefore, the Foster and
549 Family Support Grant Program is created within the department.
550 (2) The department shall award grants to not-for-profit,
551 faith-based organizations to support their efforts in the
552 recruitment of foster and adoptive families through faith-based
553 organizations and strengthening local capacity to support
554 foster, adoptive, and kinship families and families caring for
555 vulnerable children in underserved and rural communities. The
556 program shall emphasize sustained, community-based support
557 beyond initial licensure or training in order to improve
558 caregiver retention and outcomes for children.
559 (3) Awarded grant funds must be used to provide education,
560 resources, training, and technical assistance to eligible faith
561 based organizations involved in foster care, adoption, and
562 family preservation activities and to support the development of
563 trauma-informed, community-based support systems for families
564 throughout the caregiving continuum. Allowable uses of funds
565 include, but are not limited to:
566 (a) Outreach and recruitment activities to increase the
567 number of licensed foster and adoptive families;
568 (b) Training and support for organizations and volunteers
569 assisting foster, adoptive, and kinship families and families;
570 (c) Trauma-informed training, coaching, and counseling
571 services for caregivers, families, and individuals involved in
572 supporting children in out-of-home care or at risk of entry into
573 care;
574 (d) Program support and other activities to strengthen
575 local capacities to support foster, adoptive, and kinship
576 families and families.
577 (e) Expansion of foster parent training initiatives
578 designed to improve caregiver engagement, retention, and
579 placement stability;
580 (f) Development of volunteer-based wraparound support
581 services for foster and adoptive families, including kinship
582 caregivers;
583 (g) Assistance with essential family needs for families
584 actively fostering, adopting, or pursuing licensure, consistent
585 with federal and state law; and
586 (h) Ongoing family mentoring and peer support to promote
587 placement stability, permanency, and family well-being.
588 (4) Grant recipients must submit reports to the department
589 in a format and at intervals, at least annually, as prescribed
590 by the department.
591 (5) The department may adopt rules to implement this
592 section.
593 Section 6. Upon the expiration and reversion of the
594 amendments made to s. 409.908, Florida Statutes, pursuant to
595 section 26 of chapter 2025-199, Laws of Florida, paragraph (b)
596 of subsection (2) of section 409.908, Florida Statutes, is
597 amended to read:
598 409.908 Reimbursement of Medicaid providers.—Subject to
599 specific appropriations, the agency shall reimburse Medicaid
600 providers, in accordance with state and federal law, according
601 to methodologies set forth in the rules of the agency and in
602 policy manuals and handbooks incorporated by reference therein.
603 These methodologies may include fee schedules, reimbursement
604 methods based on cost reporting, negotiated fees, competitive
605 bidding pursuant to s. 287.057, and other mechanisms the agency
606 considers efficient and effective for purchasing services or
607 goods on behalf of recipients. If a provider is reimbursed based
608 on cost reporting and submits a cost report late and that cost
609 report would have been used to set a lower reimbursement rate
610 for a rate semester, then the provider’s rate for that semester
611 shall be retroactively calculated using the new cost report, and
612 full payment at the recalculated rate shall be effected
613 retroactively. Medicare-granted extensions for filing cost
614 reports, if applicable, shall also apply to Medicaid cost
615 reports. Payment for Medicaid compensable services made on
616 behalf of Medicaid-eligible persons is subject to the
617 availability of moneys and any limitations or directions
618 provided for in the General Appropriations Act or chapter 216.
619 Further, nothing in this section shall be construed to prevent
620 or limit the agency from adjusting fees, reimbursement rates,
621 lengths of stay, number of visits, or number of services, or
622 making any other adjustments necessary to comply with the
623 availability of moneys and any limitations or directions
624 provided for in the General Appropriations Act, provided the
625 adjustment is consistent with legislative intent.
626 (2)
627 (b) Subject to any limitations or directions in the General
628 Appropriations Act, the agency shall establish and implement a
629 state Title XIX Long-Term Care Reimbursement Plan for nursing
630 home care in order to provide care and services in conformance
631 with the applicable state and federal laws, rules, regulations,
632 and quality and safety standards and to ensure that individuals
633 eligible for medical assistance have reasonable geographic
634 access to such care.
635 1. The agency shall amend the long-term care reimbursement
636 plan and cost reporting system to create direct care and
637 indirect care subcomponents of the patient care component of the
638 per diem rate. These two subcomponents together shall equal the
639 patient care component of the per diem rate. Separate prices
640 shall be calculated for each patient care subcomponent,
641 initially based on the September 2016 rate setting cost reports
642 and subsequently based on the most recently audited cost report
643 used during a rebasing year. The direct care subcomponent of the
644 per diem rate for any providers still being reimbursed on a cost
645 basis shall be limited by the cost-based class ceiling, and the
646 indirect care subcomponent may be limited by the lower of the
647 cost-based class ceiling, the target rate class ceiling, or the
648 individual provider target. The ceilings and targets apply only
649 to providers being reimbursed on a cost-based system. Effective
650 October 1, 2018, a prospective payment methodology shall be
651 implemented for rate setting purposes with the following
652 parameters:
653 a. Peer Groups, including:
654 (I) North-SMMC Regions 1-9, less Palm Beach and Okeechobee
655 Counties; and
656 (II) South-SMMC Regions 10-11, plus Palm Beach and
657 Okeechobee Counties.
658 b. Percentage of Median Costs based on the cost reports
659 used for September 2016 rate setting:
660 (I) Direct Care Costs........................100 percent.
661 (II) Indirect Care Costs......................92 percent.
662 (III) Operating Costs.........................86 percent.
663 c. Floors:
664 (I) Direct Care Component.....................95 percent.
665 (II) Indirect Care Component................92.5 percent.
666 (III) Operating Component...........................None.
667 d. Pass-through Payments..................Real Estate and
668 ...............................................Personal Property
669 ...................................Taxes and Property Insurance.
670 e. Quality Incentive Program Payment
671 Pool............................... 14.77 10 percent of September
672 .......................................2016 non-property related
673 ................................payments of included facilities.
674 f. Quality Score Threshold to Qualify for Quality Incentive
675 Payment....... 33 percent of all available points in the Medicaid
676 Quality Incentive Program 20th
677 ..............................percentile of included facilities .
678 g. Fair Rental Value System Payment Parameters:
679 (I) Building Value per Square Foot based on 2018 RS Means.
680 (II) Land Valuation...10 percent of Gross Building value.
681 (III) Facility Square Footage......Actual Square Footage.
682 (IV) Movable Equipment Allowance..........$8,000 per bed.
683 (V) Obsolescence Factor......................1.5 percent.
684 (VI) Fair Rental Rate of Return................8 percent.
685 (VII) Minimum Occupancy.......................90 percent.
686 (VIII) Maximum Facility Age.....................40 years.
687 (IX) Minimum Square Footage per Bed..................350.
688 (X) Maximum Square Footage for Bed...................500.
689 (XI) Minimum Cost of a renovation/replacements$500 per bed.
690 h. Ventilator Supplemental payment of $200 per Medicaid day
691 of 40,000 ventilator Medicaid days per fiscal year.
692 2. The agency shall revise its methodology for calculating
693 Quality Incentive Program payments to :
694 a. Include the results of consumer satisfaction surveys
695 conducted pursuant to s. 400.0225 as a measure of nursing home
696 quality. The agency shall so revise the methodology after the
697 surveys have been in effect for an amount of time the agency
698 deems sufficient for statistical and scientific validity as a
699 meaningful quality measure that may be incorporated into the
700 methodology.
701 b. During the next rebasing for the Quality Incentive
702 Program, consider implementing the recommendations proposed in
703 sections 3.1.2-3.1.5 of the Study of Nursing Home Quality
704 Incentive Programs Final Report that was prepared by Guidehouse,
705 Inc., and presented to the agency on December 22, 2025.
706 c. Delay the effective date of any change made to its
707 methodology or scoring due to rebasing for 1 year after any
708 recalculations have been completed and the scores have been made
709 available to the public.
710 3. The direct care subcomponent shall include salaries and
711 benefits of direct care staff providing nursing services
712 including registered nurses, licensed practical nurses, and
713 certified nursing assistants who deliver care directly to
714 residents in the nursing home facility, allowable therapy costs,
715 and dietary costs. This excludes nursing administration, staff
716 development, the staffing coordinator, and the administrative
717 portion of the minimum data set and care plan coordinators. The
718 direct care subcomponent also includes medically necessary
719 dental care, vision care, hearing care, and podiatric care.
720 4. All other patient care costs shall be included in the
721 indirect care cost subcomponent of the patient care per diem
722 rate, including complex medical equipment, medical supplies, and
723 other allowable ancillary costs. Costs may not be allocated
724 directly or indirectly to the direct care subcomponent from a
725 home office or management company.
726 5. On July 1 of each year, the agency shall report to the
727 Legislature direct and indirect care costs, including average
728 direct and indirect care costs per resident per facility and
729 direct care and indirect care salaries and benefits per category
730 of staff member per facility.
731 6. Every fourth year, the agency shall rebase nursing home
732 prospective payment rates to reflect changes in cost based on
733 the most recently audited cost report for each participating
734 provider.
735 7. A direct care supplemental payment may be made to
736 providers whose direct care hours per patient day are above the
737 80th percentile and who provide Medicaid services to a larger
738 percentage of Medicaid patients than the state average.
739 8. Pediatric, Florida Department of Veterans Affairs, and
740 government-owned facilities are exempt from the pricing model
741 established in this subsection and shall remain on a cost-based
742 prospective payment system. Effective October 1, 2018, the
743 agency shall set rates for all facilities remaining on a cost
744 based prospective payment system using each facility’s most
745 recently audited cost report, eliminating retroactive
746 settlements.
747 9. By October 1, 2025, and each year thereafter, the agency
748 shall submit to the Governor, the President of the Senate, and
749 the Speaker of the House of Representatives a report on each
750 Quality Incentive Program payment made pursuant to sub
751 subparagraph 1.e. The report must, at a minimum, include all of
752 the following information:
753 a. The name of each facility that received a Quality
754 Incentive Program payment and the dollar amount of such payment
755 each facility received.
756 b. The total number of quality incentive metric points
757 awarded by the agency to each facility and the number of points
758 awarded by the agency for each individual quality metric
759 measured.
760 c. An examination of any trends in the improvement of the
761 quality of care provided to nursing home residents which may be
762 attributable to incentive payments received under the Quality
763 Incentive Program. The agency shall include examination of
764 trends both for the program as a whole as well as for each
765 individual quality metric used by the agency to award program
766 payments.
768 It is the intent of the Legislature that the reimbursement plan
769 achieve the goal of providing access to health care for nursing
770 home residents who require large amounts of care while
771 encouraging diversion services as an alternative to nursing home
772 care for residents who can be served within the community. The
773 agency shall base the establishment of any maximum rate of
774 payment, whether overall or component, on the available moneys
775 as provided for in the General Appropriations Act. The agency
776 may base the maximum rate of payment on the results of
777 scientifically valid analysis and conclusions derived from
778 objective statistical data pertinent to the particular maximum
779 rate of payment. The agency shall base the rates of payments in
780 accordance with the minimum wage requirements as provided in the
781 General Appropriations Act.
782 Section 7. Paragraph (d) is added to subsection (6) of
783 section 409.9855, Florida Statutes, to read:
784 409.9855 Pilot program for individuals with developmental
785 disabilities.—
786 (6) PROGRAM IMPLEMENTATION AND EVALUATION.—
787 (d) The agency shall collect and analyze data needed to
788 project program enrollment costs, current and projected
789 caseloads, utilization, and current and projected expenditures
790 for the next 3 years. The agency shall report caseload and
791 expenditure data and trends and any other information requested
792 by the Social Services Estimating Conference in accordance with
793 chapter 216.
794 Section 8. Subsection (5) of section 409.990, Florida
795 Statutes, is amended to read:
796 409.990 Funding for lead agencies.—A contract established
797 between the department and a lead agency must be funded by a
798 grant of general revenue, other applicable state funds, or
799 applicable federal funding sources.
800 (5) A lead agency may carry forward documented unexpended
801 state funds from one fiscal year to the next; however, the
802 cumulative amount carried forward may not exceed 8 percent of
803 the annual amount of the total contract. Any unexpended state
804 funds in excess of that percentage must be returned to the
805 department.
806 (a) The funds carried forward may not be used in any way
807 that would create increased recurring future obligations, and
808 such funds may not be used for any type of program or service
809 that is not currently authorized by the existing contract with
810 the department.
811 (b) Expenditures of funds carried forward must be
812 separately reported to the department.
813 (c) Any unexpended funds that remain at the end of the
814 contract period shall be returned to the department.
815 (d) Funds carried forward may be retained through any
816 contract renewals and any new procurements as long as the same
817 lead agency is retained by the department.
818 Section 9. Subsection (5) of section 414.56, Florida
819 Statutes, is amended to read:
820 414.56 Office of Continuing Care.—The department shall
821 establish an Office of Continuing Care to ensure young adults
822 who age out of the foster care system between 18 and 21 years of
823 age, or 22 years of age with a documented disability, have a
824 point of contact until the young adult reaches the age of 26 in
825 order to receive ongoing support and care coordination needed to
826 achieve self-sufficiency. Duties of the office include, but are
827 not limited to:
828 (5) Developing and administering the Step into Success
829 Workforce Education and Internship Pilot Program for foster
830 youth and former foster youth as required under s. 409.1455.
831 Section 10. For the purpose of incorporating the amendment
832 made by this act to section 409.145, Florida Statutes, in a
833 reference thereto, paragraph (d) of subsection (2) of section
834 39.5085, Florida Statutes, is reenacted to read:
835 39.5085 Relative Caregiver Program.—
836 (2)
837 (d)1. Relatives or nonrelatives who have a child placed
838 with them in out-of-home care and who have obtained licensure as
839 a child-specific level I foster placement, regardless of whether
840 a court has found the child to be dependent, shall receive a
841 monthly payment in accordance with s. 409.145(3) from the date
842 the child is placed in out-of-home care with his or her
843 relatives or with nonrelatives until the child achieves
844 permanency as determined by the court pursuant to s. 39.621.
845 2. Relatives or nonrelatives who have a child who has been
846 found to be dependent placed with them in out-of-home care shall
847 receive a monthly payment at a rate equal to the rate
848 established in s. 409.145(3) for licensed foster parents,
849 regardless of whether the relatives or nonrelatives have
850 obtained a child-specific level I foster license, from the date
851 the child is found to be dependent or from the date the child is
852 placed with them in out-of-home care, whichever is later, for a
853 period of no more than 6 months or until the child achieves
854 permanency as determined by the court pursuant to s. 39.621,
855 whichever occurs first.
856 3. Relatives or nonrelatives who have a child who has been
857 found to be dependent placed with them in out-of-home care and
858 who have not obtained a child-specific level I foster license
859 within 6 months from the date of such placement shall receive a
860 monthly payment in an amount determined by department rule from
861 6 months after the date the child is found to be dependent or
862 from 6 months after the child is placed with them in out-of-home
863 care, whichever is later, until the relatives or nonrelatives
864 obtain a child-specific level I foster license or until the
865 child achieves permanency as determined by the court pursuant to
866 s. 39.621, whichever occurs first. The monthly payment amount
867 paid to relatives or nonrelatives pursuant to this subparagraph
868 must be less than the monthly payment amount provided to a
869 participant enrolled in the Guardianship Assistance Program
870 pursuant to s. 39.6225.
871 4. Relatives or nonrelatives who have a child placed in
872 their care by permanent guardianship pursuant to s. 39.6221, in
873 a permanent placement with a fit and willing relative pursuant
874 to s. 39.6231, or under former s. 39.622 if the placement was
875 made before July 1, 2006, and who are not enrolled in the
876 Guardianship Assistance Program pursuant to s. 39.6225 shall
877 receive a monthly payment in an amount determined by department
878 rule which must be less than the monthly payment amount provided
879 to a participant enrolled in the Guardianship Assistance Program
880 under s. 39.6225.
881 Section 11. For the purpose of incorporating the amendment
882 made by this act to section 409.145, Florida Statutes, in a
883 reference thereto, paragraph (d) of subsection (5) of section
884 39.6225, Florida Statutes, is reenacted to read:
885 39.6225 Guardianship Assistance Program.—
886 (5) A guardian with an application approved pursuant to
887 subsection (2) who is caring for a child placed with the
888 guardian by the court pursuant to this part may receive
889 guardianship assistance payments based on the following
890 criteria:
891 (d) The department shall provide guardianship assistance
892 payments in the amount of $4,000 annually, paid on a monthly
893 basis, or in an amount other than $4,000 annually as determined
894 by the guardian and the department and memorialized in a written
895 agreement between the guardian and the department. The agreement
896 shall take into consideration the circumstances of the guardian
897 and the needs of the child. Changes may not be made without the
898 concurrence of the guardian. However, the amount of the monthly
899 payment may not exceed the foster care maintenance payment that
900 would have been paid during the same period if the child had
901 been in licensed care at his or her designated level of care at
902 the rate established in s. 409.145(3).
903 Section 12. For the purpose of incorporating the amendment
904 made by this act to section 409.145, Florida Statutes, in a
905 reference thereto, paragraph (b) of subsection (5) of section
906 393.065, Florida Statutes, is reenacted to read:
907 393.065 Application and eligibility determination.—
908 (5) Except as provided in subsections (6) and (7), if a
909 client seeking enrollment in the developmental disabilities home
910 and community-based services Medicaid waiver program meets the
911 level of care requirement for an intermediate care facility for
912 individuals with intellectual disabilities pursuant to 42 C.F.R.
913 ss. 435.217(b)(1) and 440.150, the agency must assign the client
914 to an appropriate preenrollment category pursuant to this
915 subsection and must provide priority to clients waiting for
916 waiver services in the following order:
917 (b) Category 2, which includes clients in the preenrollment
918 categories who are:
919 1. From the child welfare system with an open case in the
920 Department of Children and Families’ statewide automated child
921 welfare information system and who are either:
922 a. Transitioning out of the child welfare system into
923 permanency; or
924 b. At least 18 years but not yet 22 years of age and who
925 need both waiver services and extended foster care services; or
926 2. At least 18 years but not yet 22 years of age and who
927 withdrew consent pursuant to s. 39.6251(5)(c) to remain in the
928 extended foster care system.
930 For individuals who are at least 18 years but not yet 22 years
931 of age and who are eligible under sub-subparagraph 1.b., the
932 agency must provide waiver services, including residential
933 habilitation, and must actively participate in transition
934 planning activities, including, but not limited to,
935 individualized service coordination, case management support,
936 and ensuring continuity of care pursuant to s. 39.6035. The
937 community-based care lead agency must fund room and board at the
938 rate established in s. 409.145(3) and provide case management
939 and related services as defined in s. 409.986(3)(e). Individuals
940 may receive both waiver services and services under s. 39.6251.
941 Services may not duplicate services available through the
942 Medicaid state plan.
944 Within preenrollment categories 3, 4, 5, 6, and 7, the agency
945 shall prioritize clients in the order of the date that the
946 client is determined eligible for waiver services.
947 Section 13. For the purpose of incorporating the amendment
948 made by this act to section 409.145, Florida Statutes, in a
949 reference thereto, paragraph (b) of subsection (2) of section
950 409.1451, Florida Statutes, is reenacted to read:
951 409.1451 The Road-to-Independence Program.—
952 (2) POSTSECONDARY EDUCATION SERVICES AND SUPPORT.—
953 (b) The amount of the financial assistance shall be as
954 follows:
955 1. For a young adult who does not remain in foster care and
956 is attending a postsecondary school as provided in s. 1009.533,
957 the amount is $1,720 monthly.
958 2. For a young adult who remains in foster care, is
959 attending a postsecondary school, as provided in s. 1009.533,
960 and continues to reside in a licensed foster home, the amount is
961 the established room and board rate for foster parents. This
962 takes the place of the payment provided for in s. 409.145(3).
963 3. For a young adult who remains in foster care, but
964 temporarily resides away from a licensed foster home for
965 purposes of attending a postsecondary school as provided in s.
966 1009.533, the amount is $1,720 monthly. This takes the place of
967 the payment provided for in s. 409.145(3).
968 4. For a young adult who remains in foster care, is
969 attending a postsecondary school as provided in s. 1009.533, and
970 continues to reside in a licensed group home, the amount is
971 negotiated between the community-based care lead agency and the
972 licensed group home provider.
973 5. For a young adult who remains in foster care, but
974 temporarily resides away from a licensed group home for purposes
975 of attending a postsecondary school as provided in s. 1009.533,
976 the amount is $1,720 monthly. This takes the place of a
977 negotiated room and board rate.
978 6. A young adult is eligible to receive financial
979 assistance during the months when he or she is enrolled in a
980 postsecondary educational institution.
981 Section 14. This act shall take effect July 1, 2026.