(1) LEGISLATIVE FINDINGS AND INTENT.The home health aide for medically fragile children program is hereby established in response to the existing national health care provider shortage and the impact that the shortage has on medically fragile children and the family caregivers. This program is created to decrease the hospitalization and institutionalization of medically fragile children, reduce state expenditures, and provide an opportunity for a family caregiver to receive training and gainful employment.
(2) ELIGIBILITY REQUIREMENTS.A home health agency may employ as a home health aide for medically fragile children any person 18 years of age or older who meets all of the following requirements. A person must:

(a) Be a family caregiver of an eligible relative.

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Terms Used In Florida Statutes 400.4765

  • Agency: means the Agency for Health Care Administration. See Florida Statutes 400.462
  • Approved training program: means a course of training approved by the agency, in consultation with the Board of Nursing, to train a family caregiver as a home health aide for medically fragile children. See Florida Statutes 400.462
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Department: means the Department of Children and Families. See Florida Statutes 400.462
  • Eligible relative: means a patient 21 years of age or younger who has an underlying physical, mental, or cognitive impairment that prevents him or her from safely living independently, is eligible to receive skilled care or respite care services under the Medicaid program, and is related to his or her family caregiver. See Florida Statutes 400.462
  • Family caregiver: means a person who provides or intends to provide significant personal care to an eligible relative. See Florida Statutes 400.462
  • Fraud: Intentional deception resulting in injury to another.
  • Home health agency: means a person that provides one or more home health services. See Florida Statutes 400.462
  • Home health aide: means a person who is trained or qualified, as provided by rule, and who provides hands-on personal care, performs simple procedures as an extension of therapy or nursing services, assists in ambulation or exercises, assists in administering medications as permitted in rule and for which the person has received training established by the agency under this part, or performs tasks delegated to him or her under chapter 464. See Florida Statutes 400.462
  • Home health aide for medically fragile children: means a family caregiver who meets the qualifications specified in this part and who performs tasks delegated to him or her under chapter 464 while caring for an eligible relative, and provides care relating to activities of daily living, including those associated with personal care; maintaining mobility; nutrition and hydration; toileting and elimination; assistive devices; safety and cleanliness; data gathering; reporting abnormal signs and symptoms; postmortem care; patient socialization and reality orientation; end-of-life care; cardiopulmonary resuscitation and emergency care; residents' or patients' rights; documentation of services performed; infection control; safety and emergency procedures; hygiene, grooming, skin care, and pressure sore prevention; wound care; portable oxygen use and safety and other respiratory procedures; tracheostomy care; enteral care and therapy; peripheral intravenous assistive activities and alternative feeding methods; and any other tasks delegated to the family caregiver under chapter 464. See Florida Statutes 400.462
  • person: includes individuals, children, firms, associations, joint adventures, partnerships, estates, trusts, business trusts, syndicates, fiduciaries, corporations, and all other groups or combinations. See Florida Statutes 1.01
  • Personal care: means assistance to a patient in the activities of daily living, such as dressing, bathing, eating, or personal hygiene, and assistance in physical transfer, ambulation, and in administering medications as permitted by rule. See Florida Statutes 400.462
(b) Demonstrate a minimum competency to read and write.
(c) Complete an approved training program as set forth in this section or have graduated from an accredited prelicensure nursing education program and is waiting to take the state licensing exam.
(d) Successfully pass the required background screening pursuant to s. 400.215. If the person has successfully passed the required background screening pursuant to s. 400.215 or s. 408.809 within 90 days before applying for a certificate to practice and the person’s background screening results are not retained in the clearinghouse created under s. 435.12, the agency shall waive the requirement that the applicant successfully pass an additional background screening pursuant to s. 400.215.
(3) TRAINING.

(a) The agency, in consultation with the Board of Nursing, shall approve home health aide for medically fragile children training programs developed by home health agencies in accordance with 42 C.F.R. § ss. 483.151483.154 and 484.80 to train family caregivers as home health aides for medically fragile children to increase the health care provider workforce and to authorize persons to provide trained nursing services as delegated by a registered nurse to eligible relatives. The program must consist of at least 85 hours of training, including, but not limited to, all of the following:

1. A minimum of 40 hours of theoretical instruction in nursing, including, but not limited to, instruction on all of the following:

a. Person-centered care.
b. Communication and interpersonal skills.
c. Infection control.
d. Safety and emergency procedures.
e. Assistance with activities of daily living.
f. Mental health and social service needs.
g. Care of cognitively impaired individuals.
h. Basic restorative care and rehabilitation.
i. Patient rights and confidentiality of personal information and medical records.
j. Relevant legal and ethical issues.

Such instruction must be offered in various formats, and any interactive instruction must be provided during various times of the day.

2. A minimum of 20 hours of skills training on basic nursing skills, including, but not limited to:

a. Hygiene, grooming, and toileting.
b. Skin care and pressure sore prevention.
c. Nutrition and hydration.
d. Measuring vital signs, height, and weight.
e. Safe lifting, positioning, and moving of patients.
f. Wound care.
g. Portable oxygen use and safety and other respiratory procedures.
h. Tracheostomy care.
i. Enteral care and therapy.
j. Peripheral intravenous assistive activities and alternative feeding methods.
k. Urinary catheterization and ostomy care.
3. At least 16 hours of clinical training under direct supervision of a licensed registered nurse.
4. Training concerning HIV infections and AIDS and is required to obtain and maintain a current certificate in cardiopulmonary resuscitation.
(b) If a home health aide for medically fragile children allows 24 consecutive months to pass without providing any personal care related services for an eligible relative, the family caregiver must complete an approved training program before providing personal care related services as a home health aide for medically fragile children.
(4) EMPLOYMENT.A home health agency that employs a home health aide for medically fragile children must ensure that the home health aide for medically fragile children completes 12 hours of inservice training during each 12-month period as a condition of employment. The training concerning HIV infections and AIDS and the cardiopulmonary training may count toward meeting the 12 hours of inservice training. The home health agency shall maintain documentation demonstrating compliance with this subsection.
(5) LIABILITY.If a home health agency terminates or denies employment to a home health aide for medically fragile children who fails to maintain the requirements of this part or whose name appears on a criminal screening report of the Department of Law Enforcement, the home health agency is not civilly liable for such termination and a cause of action may not be brought against the home health agency for damages. There may not be any monetary liability on the part of, and a cause of action for damages may not arise against, any licensed facility or its governing board or members thereof, medical staff, disciplinary board, agents, investigators, witnesses, employees, or any other person for any action taken in good faith, without intentional fraud, to comply with this part.
(6) CONFIDENTIALITY.A home health agency, or an agent thereof, may not use criminal records or juvenile records relating to vulnerable adults for any purpose other than determining if the person meets the requirements of this part. The agency shall maintain the confidentiality of any such records and information it obtains which are confidential and exempt from s. 119.07(1) and Fla. Const. Art. I, § 24(a).
(7) SERVICES.Services provided by a home health aide for medically fragile children must reduce an eligible relative’s private duty nursing service hours. Such services may not be provided concurrently with any private duty nursing service.
(8) RULES.The agency, in consultation with the Board of Nursing, may adopt rules to implement this section.
(9) FEE SCHEDULE.The agency shall modify any state Medicaid plans and implement any federal waivers necessary to implement this section and shall establish a Medicaid fee schedule for home health agencies employing a home health aide for medically fragile children at $25 per hour with a utilization cap of no more than 8 hours per day.