CHAPTER 393

393.002 Transfer of Florida Developmental Disabilities Council as formerly created in this chapter to private nonprofit corporation. (1) The Governor, by executive order, shall designate a nonprofit corporation as the agency to receive federal funds to implement, on behalf of the State of Florida, Part B of the Developmental Disabilities Assistance and Bill of Rights Act under 42 U.S.C. ss. 6000 et seq., as amended by the United States Congress. The nonprofit corporation, to be known as the “Developmental Disabilities Council,” shall be the designated agency as provided by 42 U.S.C. s. 6021. (2) The executive order designating this nonprofit corporation shall include provisions for the governance and the organizational structure of the corporation consistent with 42 U.S.C. s. 6024(d)(2)(i). (3) The nonprofit corporation shall be organized pursuant to chapter 617 and shall possess all the powers granted by that chapter. All powers, duties and functions, records, property, and unexpended balances of appropriations, grants and donations, allocations, or any other funds or assets of the Florida Developmental Disabilities Council shall be transferred, together with title thereto, to the nonprofit corporation. (4) The designated nonprofit corporation is eligible to use the state communications system in accordance with s. 282.705(3). (5) Pursuant to the applicable provisions of chapter 284, the Division of Risk Management of the Department of Financial Services is authorized to insure this nonprofit corporation under the same general terms and conditions as the Florida Developmental Disabilities Council was insured in the Department of Children and Families by the division prior to the transfer of its functions authorized by this section. (6) All departments, officers, agencies, and institutions of the state shall cooperate with the designated corporation in the performance of its duties. (7) This nonprofit corporation shall make provisions for an annual postaudit of its financial accounts by an independent certified public accountant. The annual audit shall be submitted to the Executive Office of the Governor for review. (8) Copies of the aforementioned federal law, the state statute, and any executive orders establishing the Developmental Disabilities Council as a nonprofit corporation shall be made available by the corporation to anyone upon request. History. — s. 3, ch. 95-293; s. 31, ch. 99-5; s. 79, ch. 99-8; s. 412, ch. 2003-261; s. 33, ch. 2009-80; s. 70, ch. 2014-19. 393.062 Legislative findings and declaration of intent. The Legislature finds and declares that existing state programs for the treatment of individuals with developmental disabilities, which often unnecessarily place clients in institutions, are unreasonably costly, are ineffective in bringing the individual client to his or her maximum potential, and are in fact debilitating to many clients. A redirection in state treatment programs for individuals with developmental disabilities is necessary if any significant amelioration of the problems faced by such individuals is ever to take place. Such redirection should place primary emphasis on programs that prevent or reduce the severity of developmental disabilities. Further, the greatest priority shall be given to the development and implementation of community-based services that will enable individuals with developmental disabilities to achieve their greatest potential for independent and productive living, enable them to live in their own homes or in residences located in their own communities, and permit them to be diverted or removed from unnecessary institutional placements. This goal cannot be met without ensuring the availability of community residential opportunities in the residential areas of this state. The Legislature, therefore, declares that all persons with developmental disabilities who live in licensed community homes shall have a family living environment comparable to other Floridians and that such residences shall be considered and treated as a functional equivalent of a family unit and not as an institution, business, or boarding home. The Legislature further declares that, in developing community-based programs and services for individuals with developmental disabilities, private businesses, not-for-profit corporations, units of local government, and other organizations capable of providing needed services to clients in a cost-efficient manner shall be given preference in lieu of operation of programs directly by state agencies. Finally, it is the intent of the Legislature that all caretakers unrelated to individuals with developmental disabilities receiving care shall be of good moral character. History. — s. 1, ch. 77-335; s. 3, ch. 85-54; s. 6, ch. 89-308; s. 1, ch. 99-144; s. 9, ch. 2006-227. 393.063 Definitions. For the purposes of this chapter, the term: (1) “Adult day training” means a program of services which takes place in a nonresidential setting, separate from the home or facility in which the client resides, and is intended to support the participation of clients in meaningful and valued routines of the community. These services include, but are not limited to, the acquisition, retention, or improvement of self-help, socialization, and adaptive skills. (2) “Agency” means the Agency for Persons with Disabilities. (3) “Algorithm” means the mathematical formula used by the agency to calculate budget amounts for clients which uses variables that have statistically validated relationships to clients’ needs for services provided by the home and community-based services Medicaid waiver program. (4) “Allocation methodology” is the process used to determine a client’s iBudget by summing the amount generated by the algorithm, and, if applicable, any funding authorized by the agency for the client pursuant to s. 393.0662(1)(b). (5) “Autism” means a pervasive, neurologically based developmental disability of extended duration which causes severe learning, communication, and behavior disorders with age of onset during infancy or childhood. Individuals with autism exhibit impairment in reciprocal social interaction, impairment in verbal and nonverbal communication and imaginative ability, and a markedly restricted repertoire of activities and interests. (6) “Cerebral palsy” means a group of disabling symptoms of extended duration which results from damage to the developing brain that may occur before, during, or after birth and that results in the loss or impairment of control over voluntary muscles. For the purposes of this definition, cerebral palsy does not include those symptoms or impairments resulting solely from a stroke. (7) “Client” means any person determined eligible by the agency for services under this chapter. (8) “Client advocate” means a friend or relative of the client, or of the client’s immediate family, who advocates for the best interests of the client in any proceedings under this chapter in which the client or his or her family has the right or duty to participate. (9) “Comprehensive assessment” means the process used to determine eligibility for services under this chapter. (10) “Developmental disabilities center” means a state-owned and state-operated facility, formerly known as a “Sunland Center,” providing for the care, habilitation, and rehabilitation of clients with developmental disabilities. (11) “Developmental disability” means a disorder or syndrome that is attributable to intellectual disability, cerebral palsy, autism, spina bifida, Down syndrome, Phelan-McDermid syndrome, Prader-Willi syndrome, or Tatton-Brown-Rahman syndrome; that manifests before the age of 18; and that constitutes a substantial handicap that can reasonably be expected to continue indefinitely. (12) “Direct service provider” means a person 18 years of age or older who has direct face-to-face contact with a client while providing services to the client or has access to a client’s living areas or to a client’s funds or personal property. (13) “Direct-support professional” means a person paid to provide services directly to a client receiving home and community-based services to address activities of daily living or instrumental activities of daily living, behavioral supports, employment supports, or other services to promote community integration of the client. (14) “Domicile” means the place where a client legally resides and which is his or her permanent home. Domicile may be established as provided in s. 222.17. Domicile may not be established in Florida by a minor who has no parent domiciled in Florida, or by a minor who has no legal guardian domiciled in Florida, or by any alien not classified as a resident alien. (15) “Down syndrome” means a disorder caused by the presence of an extra chromosome 21. (16) “Express and informed consent” means consent voluntarily given in writing with sufficient knowledge and comprehension of the subject matter to enable the person giving consent to make a knowing decision without any element of force, fraud, deceit, duress, or other form of constraint or coercion. (17) “Family care program” means the program established in s. 393.068. (18) “Foster care facility” means a residential facility licensed under this chapter which provides a family living environment including supervision and care necessary to meet the physical, emotional, and social needs of its residents. The capacity of such a facility may not be more than three residents. (19) “Group home facility” means a residential facility licensed under this chapter which provides a family living environment including supervision and care necessary to meet the physical, emotional, and social needs of its residents. The capacity of such a facility shall be at least 4 but not more than 15 residents. (20) “Guardian” has the same meaning as in s. 744.102. (21) “Guardian advocate” means a person appointed by a written order of the court to represent a person with developmental disabilities under s. 393.12. (22) “Habilitation” means the process by which a client is assisted in acquiring and maintaining those life skills that enable the client to cope more effectively with the demands of his or her condition and environment and to raise the level of his or her physical, mental, and social efficiency. It includes, but is not limited to, programs of formal structured education and treatment. (23) “High-risk child” means, for the purposes of this chapter, a child from 3 to 5 years of age with one or more of the following characteristics: (a) A developmental delay in cognition, language, or physical development. (b) A child surviving a catastrophic infectious or traumatic illness known to be associated with developmental delay, when funds are specifically appropriated. (c) A child with a parent or guardian with developmental disabilities who requires assistance in meeting the child’s developmental needs. (d) A child who has a physical or genetic anomaly associated with developmental disability. (24) “Intellectual disability” means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior which manifests before the age of 18 and can reasonably be expected to continue indefinitely. For the purposes of this definition, the term: (a) “Adaptive behavior” means the effectiveness or degree with which an individual meets the standards of personal independence and social responsibility expected of his or her age, cultural group, and community. (b) “Significantly subaverage general intellectual functioning” means performance that is two or more standard deviations from the mean score on a standardized intelligence test specified in the rules of the agency. For purposes of the application of the criminal laws and procedural rules of this state to matters relating to pretrial, trial, sentencing, and any matters relating to the imposition and execution of the death penalty, the terms “intellectual disability” or “intellectually disabled” are interchangeable with and have the same meaning as the terms “mental retardation” or “retardation” and “mentally retarded” as defined in this section before July 1, 2013. (25) “Intermediate care facility for the developmentally disabled” means a residential facility licensed and certified under part VIII of chapter 400. (26) “Licensee” means an individual, a corporation, a partnership, a firm, an association, a governmental entity, or other entity that is issued a permit, registration, certificate, or license by the agency. The licensee is legally responsible for all aspects of the provider operation. (27) “Medical/dental services” means medically necessary services that are provided or ordered for a client by a person licensed under chapter 458, chapter 459, or chapter 466. Such services may include, but are not limited to, prescription drugs, specialized therapies, nursing supervision, hospitalization, dietary services, prosthetic devices, surgery, specialized equipment and supplies, adaptive equipment, and other services as required to prevent or alleviate a medical or dental condition. (28) “Personal care services” means individual assistance with or supervision of essential activities of daily living for self-care, including ambulation, bathing, dressing, eating, grooming, and toileting, and other similar services that are incidental to the care furnished and essential to the health, safety, and welfare of the client if no one else is available to perform those services. (29) “Phelan-McDermid syndrome” means a disorder caused by the loss of the terminal segment of the long arm of chromosome 22, which occurs near the end of the chromosome at a location designated q13.3, typically leading to developmental delay, intellectual disability, dolicocephaly, hypotonia, or absent or delayed speech. (30) “Prader-Willi syndrome” means an inherited condition typified by neonatal hypotonia with failure to thrive, hyperphagia or an excessive drive to eat which leads to obesity usually at 18 to 36 months of age, mild to moderate intellectual disability, hypogonadism, short stature, mild facial dysmorphism, and a characteristic neurobehavior. (31) “Relative” means an individual who is connected by affinity or consanguinity to the client and who is 18 years of age or older. (32) “Resident” means a person who has a developmental disability and resides at a residential facility, whether or not such person is a client of the agency. (33) “Residential facility” means a facility providing room and board and personal care for persons who have developmental disabilities. (34) “Residential habilitation” means supervision and training with the acquisition, retention, or improvement in skills related to activities of daily living, such as personal hygiene skills, homemaking skills, and the social and adaptive skills necessary to enable the individual to reside in the community. (35) “Residential habilitation center” means a community residential facility licensed under this chapter which provides habilitation services. The capacity of such a facility may not be fewer than nine residents. After October 1, 1989, new residential habilitation centers may not be licensed and the licensed capacity for any existing residential habilitation center may not be increased. (36) “Respite service” means appropriate, short-term, temporary care that is provided to a person who has a developmental disability in order to meet the planned or emergency needs of the person or the family or other direct service provider. (37) “Restraint” means a physical device, method, or drug used to control dangerous behavior. (a) A physical restraint is any manual method or physical or mechanical device, material, or equipment attached or adjacent to an individual’s body so that he or she cannot easily remove the restraint and which restricts freedom of movement or normal access to one’s body. (b) A drug used as a restraint is a medication used to control the person’s behavior or to restrict his or her freedom of movement and is not a standard treatment for the person’s medical or psychiatric condition. Physically holding a person during a procedure to forcibly administer psychotropic medication is a physical restraint. (c) Restraint does not include physical devices, such as orthopedically prescribed appliances, surgical dressings and bandages, supportive body bands, or other physical holding necessary for routine physical examinations and tests; for purposes of orthopedic, surgical, or other similar medical treatment; to provide support for the achievement of functional body position or proper balance; or to protect a person from falling out of bed. (38) “Seclusion” means the involuntary isolation of a person in a room or area from which the person is prevented from leaving. The prevention may be by physical barrier or by a staff member who is acting in a manner, or who is physically situated, so as to prevent the person from leaving the room or area. For the purposes of this chapter, the term does not mean isolation due to the medical condition or symptoms of the person. (39) “Self-determination” means an individual’s freedom to exercise the same rights as all other citizens, authority to exercise control over funds needed for one’s own support, including prioritizing these funds when necessary, responsibility for the wise use of public funds, and self-advocacy to speak and advocate for oneself in order to gain independence and ensure that individuals with a developmental disability are treated equally. (40) “Significant additional need” means an additional need for medically necessary services which would place the health and safety of the client, the client’s caregiver, or the public in serious jeopardy if it is not met. The term does not exclude services for an additional need that the client requires in order to remain in the least restrictive setting, including, but not limited to, employment services and transportation services. The agency may provide additional funding only after the determination of a client’s initial allocation amount and after the qualified organization has documented the availability of nonwaiver resources. (41) “Specialized therapies” means those treatments or activities prescribed by and provided by an appropriately trained, licensed, or certified professional or staff person and may include, but are not limited to, physical therapy, speech therapy, respiratory therapy, occupational therapy, behavior therapy, physical management services, and related specialized equipment and supplies. (42) “Spina bifida” means a medical diagnosis of spina bifida cystica or myelomeningocele. (43) “Support coordinator” means an employee of a qualified organization as provided in s. 393.0663 designated by the agency to assist individuals and families in identifying their capacities, needs, and resources, as well as finding and gaining access to necessary supports and services; coordinating the delivery of supports and services; advocating on behalf of the individual and family; maintaining relevant records; and monitoring and evaluating the delivery of supports and services to determine the extent to which they meet the needs and expectations identified by the individual, family, and others who participated in the development of the support plan. (44) “Supported employment” means employment located or provided in an integrated work setting, with earnings paid on a commensurate wage basis, and for which continued support is needed for job maintenance. (45) “Supported living” means a category of individually determined services designed and coordinated in such a manner as to provide assistance to adult clients who require ongoing supports to live as independently as possible in their own homes, to be integrated into the community, and to participate in community life to the fullest extent possible. (46) “Tatton-Brown-Rahman syndrome” means a disorder caused by a mutation in the DNMT3A gene typified by mild to severe intellectual disability, macrocephaly, stature and weight that is greater than or equal to two or more standard deviations above the mean for the person’s age and sex, and any of the following features presenting in infancy, childhood, or adolescence: (a) Mild facial dysmorphism. (b) Joint hypermobility. (c) Hypotonia. (d) Kyphoscoliosis. (e) Seizures. (f) Cryptorchidism. (g) Deficits in behavior. (h) Hematologic malignancies. (47) “Training” means a planned approach to assisting a client to attain or maintain his or her maximum potential and includes services ranging from sensory stimulation to instruction in skills for independent living and employment. (48) “Treatment” means the prevention, amelioration, or cure of a client’s physical and mental disabilities or illnesses. History. — s. 1, ch. 77-335; s. 1, ch. 79-148; s. 153, ch. 79-400; s. 3, ch. 81-23; s. 4, ch. 85-54; s. 1, ch. 85-147; s. 5, ch. 87-238; s. 5, ch. 88-398; s. 7, ch. 89-308; ss. 2, 4, ch. 89-339; s. 27, ch. 90-306; s. 1, ch. 90-333; s. 17, ch. 91-158; s. 3, ch. 94-154; s. 1045, ch. 95-148; s. 53, ch. 95-228; s. 1, ch. 95-293; s. 13, ch. 96-417; s. 23, ch. 98-171; s. 140, ch. 98-403; s. 80, ch. 99-8; s. 203, ch. 99-13; s. 3, ch. 2000-338; s. 35, ch. 2002-400; s. 7, ch. 2004-260; s. 71, ch. 2004-267; s. 15, ch. 2006-197; s. 10, ch. 2006-227; s. 2, ch. 2008-244; s. 2, ch. 2011-135; s. 9, ch. 2013-162; s. 6, ch. 2016-3; ss. 38, 39, 126, ch. 2016-62; ss. 11, 12, ch. 2016-65; s. 1, ch. 2016-140; s. 58, ch. 2019-3; s. 1, ch. 2020-71; s. 2, ch. 2023-273; s. 1, ch. 2025-111; s. 1, ch. 2026-129. 393.064 Care navigation. (1) Within available resources, the agency shall offer to clients and their caregivers care navigation services for voluntary participation at the time of application and as part of any eligibility or renewal review. The goals of care navigation are to create a seamless network of community resources and supports for the client and the client’s family as a whole to support a client in daily living, community integration, and achievement of individual goals. Care navigation services must involve assessing client needs and developing and implementing care plans, including, but not limited to, connecting a client to resources and supports. At a minimum, a care plan must address immediate, intermediate, and long-term needs and goals to promote and increase well-being and opportunities for education, employment, social engagement, community integration, and caregiver support. For a client who is a public school student entitled to a free appropriate public education under the Individuals with Disabilities Education Act (IDEA), as amended, the care plan must be integrated with the student’s individual education plan (IEP). The care plan and IEP must be implemented to maximize the attainment of educational and habilitation goals. (2) Services provided by the agency must include services to high-risk children from 3 to 5 years of age, and their families, to meet the intent of chapter 411. Except for services for children from birth to age 3 years which are the responsibility of the Division of Children’s Medical Services in the Department of Health or part H of the Individuals with Disabilities Education Act, such services may include: (a) Individual evaluations or assessments necessary to diagnose a developmental disability or high-risk condition and to determine appropriate, individual family and support services. (b) Early intervention services, including developmental training and specialized therapies. (c) Support services, such as respite care, parent education and training, parent-to-parent counseling, homemaker services, and other services which allow families to maintain and provide quality care to children in their homes. (3) Other agencies of state government shall cooperate with and assist the agency, within available resources, in implementing programs which have the potential to prevent, or reduce the severity of, developmental disabilities and shall consider the findings and recommendations of the agency in developing and implementing agency programs and formulating agency budget requests. (4) There is created at the developmental disabilities center in Gainesville a research and education unit. Such unit shall be named the Raymond C. Philips Research and Education Unit. The functions of such unit shall include: (a) Research into the etiology of developmental disabilities. (b) Ensuring that new knowledge is rapidly disseminated throughout the agency. (c) Diagnosis of unusual conditions and syndromes associated with developmental disabilities in clients identified throughout developmental disabilities programs. (d) Evaluation of families of clients with developmental disabilities of genetic origin in order to provide them with genetic counseling aimed at preventing the recurrence of the disorder in other family members. (e) Ensuring that health professionals in the developmental disabilities center at Gainesville have access to information systems that will allow them to remain updated on newer knowledge and maintain their postgraduate education standards. (f) Enhancing staff training for professionals throughout the agency in the areas of genetics and developmental disabilities. History. — s. 1, ch. 77-335; s. 92, ch. 79-164; ss. 1, 2, ch. 79-367; s. 5, ch. 82-213; s. 45, ch. 83-218; s. 8, ch. 89-308; s. 4, ch. 94-154; s. 81, ch. 99-8; s. 46, ch. 2000-139; s. 13, ch. 2000-153; s. 72, ch. 2004-267; s. 51, ch. 2004-350; s. 11, ch. 2006-227; s. 3, ch. 2008-244; s. 1, ch. 2024-14. Note. — Consolidation of s. 393.064 and former s. 393.20. 393.065 Application and eligibility determination. (1)(a) The agency shall develop and implement an online application process that, at a minimum, supports paperless, electronic application submissions with immediate e-mail confirmation to each applicant to acknowledge receipt of application upon submission. The online application system must allow an applicant to review the status of a submitted application and respond to provide additional information. The online application must allow an applicant to apply for crisis enrollment. (b) The agency shall maintain access to a printable paper application on its website and, upon request, must provide an applicant with a printed paper application. Paper applications may be submitted in writing to the agency in the region in which the applicant resides, sent to a central or regional address through regular United States mail, or faxed to a central or regional confidential fax number. The agency shall acknowledge receipt of all applications it receives, regardless of the manner of submission, with an immediate receipt confirmation provided in the same manner in which the application was received, unless the applicant has designated an alternative preferred method of communication on the submitted application. (c) The agency must review each submitted application in accordance with federal time standards. 1. If the agency determines additional documentation is necessary to make an eligibility determination, the agency may request the additional documentation from the applicant. 2. When necessary to definitively identify individual conditions or needs, the agency or its designee must provide a comprehensive assessment. (d)1. For purposes of this paragraph, the term “complete application” means an application submitted to the agency which is signed and dated by the applicant or an individual with legal authority to apply for public benefits on behalf of the applicant, is responsive on all parts of the application, and contains documentation of a diagnosis. 2. If the applicant requesting enrollment in the home and community-based services Medicaid waiver program for individuals with developmental disabilities is deemed to be in crisis as described in paragraph (5)(a), the agency must make an eligibility determination within 15 calendar days after receipt of a complete application. 3. If the applicant meets the criteria specified in paragraph (5)(b), the agency must review and make an eligibility determination as soon as practicable after receipt of a complete application. 4. If the application meets any of the criteria specified in paragraphs (5)(c)-(g), the agency must make an eligibility determination within 60 days after receipt of a complete application. (e) Any delays in the eligibility determination process, or any tolling of the time standard until certain information or actions have been completed, must be conveyed to the client as soon as such delays are known through verbal contact with the client or the client’s designated caregiver and confirmed by a written notice of the delay, the anticipated length of delay, and a contact person for the client. (2) In order to be eligible for services under this chapter, the agency must determine that the applicant has met all eligibility requirements in rule, including having a developmental disability and being domiciled in this state. Information accumulated by other agencies, including professional reports and collateral data, shall be considered in this process when available. (3) The agency or its designee shall notify each applicant, in writing, of its eligibility determination. Any applicant or client determined by the agency to be ineligible for services has the right to appeal this determination pursuant to ss. 120.569 and 120.57. (4) Before admission to an intermediate care facility for individuals with intellectual disabilities and to ensure that the setting is the least restrictive to meet the individual’s needs, the agency must authorize admission pursuant to this subsection. As part of the authorization, the agency or its designee must conduct a comprehensive assessment that includes medical necessity, level of care, and level of reimbursement. (5) Except as provided in subsections (6) and (7), if a client seeking enrollment in the developmental disabilities home and community-based services Medicaid waiver program meets the level of care requirement for an intermediate care facility for individuals with intellectual disabilities pursuant to 42 C.F.R. ss. 435.217(b)(1) and 440.150, the agency must assign the client to an appropriate preenrollment category pursuant to this subsection and must provide priority to clients waiting for waiver services in the following order: (a) Category 1, which includes clients deemed to be in crisis as described in rule, must be given first priority in moving from the preenrollment categories to the waiver. (b) Category 2, which includes clients in the preenrollment categories who are: 1. From the child welfare system with an open case in the Department of Children and Families’ statewide automated child welfare information system and who are either: a. Transitioning out of the child welfare system into permanency; or b. At least 18 years but not yet 22 years of age and who need both waiver services and extended foster care services; or 2. At least 18 years but not yet 22 years of age and who withdrew consent pursuant to s. 39.6251(5)(c) to remain in the extended foster care system. For individuals who are at least 18 years but not yet 22 years of age and who are eligible under sub-subparagraph 1.b., the agency must provide waiver services, including residential habilitation, and must actively participate in transition planning activities, including, but not limited to, individualized service coordination, case management support, and ensuring continuity of care pursuant to s. 39.6035. The community-based care lead agency must fund room and board at the rate established in s. 409.145(3) and provide case management and related services as defined in s. 409.986(3)(f). Individuals may receive both waiver services and services under s. 39.6251. Services may not duplicate services available through the Medicaid state plan. (c) Category 3, which includes, but is not required to be limited to, clients: 1. Whose caregiver has a documented condition that is expected to render the caregiver unable to provide care within the next 12 months and for whom a caregiver is required but no alternate caregiver is available; 2. At substantial risk of incarceration or court commitment without supports; 3. Whose documented behaviors or physical needs place them or their caregiver at risk of serious harm and other supports are not currently available to alleviate the situation; or 4. Who are identified as ready for discharge within the next year from a state mental health hospital or skilled nursing facility and who require a caregiver but for whom no caregiver is available or whose caregiver is unable to provide the care needed. (d) Category 4, which includes, but is not required to be limited to, clients whose caregivers are 60 years of age or older and for whom a caregiver is required but no alternate caregiver is available. (e) Category 5, which includes, but is not required to be limited to, clients who are expected to graduate within the next 12 months from secondary school and need support to obtain a meaningful day activity, maintain competitive employment, or pursue an accredited program of postsecondary education to which they have been accepted. (f) Category 6, which includes clients 21 years of age or older who do not meet the criteria for category 1, category 2, category 3, category 4, or category 5. (g) Category 7, which includes clients younger than 21 years of age who do not meet the criteria for category 1, category 2, category 3, or category 4. Within preenrollment categories 3, 4, 5, 6, and 7, the agency shall prioritize clients in the order of the date that the client is determined eligible for waiver services. (6) The agency must allow an individual who meets the eligibility requirements of subsection (2) to receive home and community-based services in this state if the individual’s parent or legal guardian is an active-duty military servicemember and if, at the time of the servicemember’s transfer to this state, the individual was receiving home and community-based services in another state. (7) The agency must allow an individual with a diagnosis of Phelan-McDermid syndrome who meets the eligibility requirements of subsection (2) to receive home and community-based services. (8) Only a client may be eligible for services under the developmental disabilities home and community-based services Medicaid waiver program. For a client to receive services under the developmental disabilities home and community-based services Medicaid waiver program, there must be available funding pursuant to s. 393.0662 or through a legislative appropriation and the client must meet all of the following: (a) The eligibility requirements of subsection (2), which must be confirmed by the agency. (b) The eligibility requirements for the Florida Medicaid program under Title XIX of the Social Security Act, as amended, or the Supplemental Security Income program. (c) The level of care requirements for an intermediate care facility for individuals with developmental disabilities pursuant to 42 C.F.R. ss. 435.217(b)(1) and 440.150. (d) The requirements provided in the approved federal waiver authorized pursuant to s. 1915(c) of the Social Security Act and 42 C.F.R. s. 441.302. (9) Agency action that selects individuals to receive waiver services pursuant to this section does not establish a right to a hearing or an administrative proceeding under chapter 120 for individuals remaining in the preenrollment categories. (10) The client, the client’s guardian, or the client’s family must ensure that accurate, up-to-date contact information is provided to the agency at all times. Notwithstanding s. 393.0651, the agency must send an annual letter requesting updated information from the client, the client’s guardian, or the client’s family. (11)(a) The agency must provide the following information to all applicants or their parents, legal guardians, or family members: 1. A brief overview of the vocational rehabilitation services offered through the Division of Vocational Rehabilitation of the Department of Education, including a hyperlink or website address that provides access to the application for such services; 2. A brief overview of the Florida ABLE program as established under s. 1009.986, including a hyperlink or website address that provides access to the application for establishing an ABLE account as defined in s. 1009.986(2); 3. A brief overview of the supplemental security income benefits and social security disability income benefits available under Title XVI of the Social Security Act, as amended, including a hyperlink or website address that provides access to the application for such benefits; 4. A statement indicating that the applicant’s local public school district may provide specialized instructional services, including transition programs, for students with special education needs; 5. A brief overview of programs and services funded through the Florida Center for Students with Unique Abilities, including contact information for each state-approved Florida Postsecondary Comprehensive Transition Program; 6. A brief overview of decisionmaking options for individuals with disabilities, guardianship under chapter 744, and alternatives to guardianship as defined in s. 744.334(1), which may include contact information for organizations that the agency believes would be helpful in assisting with such decisions; 7. A brief overview of the referral tools made available through the agency, including a hyperlink or website address that provides access to such tools; and 8. A statement indicating that some waiver providers may serve private-pay individuals. (b) The agency must provide the information required in paragraph (a) in writing to an applicant or his or her parent, legal guardian, or family member along with a written disclosure statement in substantially the following form: DISCLOSURE STATEMENT Each program and service has its own eligibility requirements. By providing the information specified in section 393.065(11)(a), Florida Statutes, the agency does not guarantee an applicant’s eligibility for or enrollment in any program or service. (c) The agency must also publish the information required in paragraph (a) and the disclosure statement in paragraph (b) on its website, and must provide that information and statement annually to each client placed in the preenrollment categories or to the parent, legal guardian, or family member of such client. (12) To ensure transparency and timely access to information, the agency shall post on its website in a conspicuous location the total number of individuals in each priority category by county of residence. The posted numbers shall reflect the current status of the preenrollment priority list and shall be updated at least every 5 days. (13) The agency and the Agency for Health Care Administration may adopt rules specifying application procedures, criteria associated with the preenrollment categories, procedures for administering the preenrollment, including tools for prioritizing waiver enrollment within preenrollment categories, and eligibility requirements as needed to administer this section. History. — s. 1, ch. 77-335; s. 42, ch. 83-218; s. 7, ch. 88-398; s. 5, ch. 94-154; s. 120, ch. 96-410; s. 82, ch. 99-8; s. 2, ch. 99-144; s. 100, ch. 2004-267; s. 13, ch. 2006-227; s. 1, ch. 2009-56; s. 71, ch. 2014-19; ss. 40, 41, 126, ch. 2016-62; s. 13, ch. 2016-65; s. 3, ch. 2016-140; s. 16, ch. 2018-111; s. 16, ch. 2020-138; s. 1, ch. 2021-100; s. 4, ch. 2022-68; s. 3, ch. 2023-273; s. 2, ch. 2024-14; s. 2, ch. 2025-130; s. 28, ch. 2026-236. 393.0651 Family or individual support plan. The agency shall provide directly or contract for the development of a family support plan for children ages 3 to 18 years of age and an individual support plan for each client served by the home and community-based services Medicaid waiver program under s. 393.0662. The client, if competent, the client’s parent or guardian, or, when appropriate, the client advocate, shall be consulted in the development of the plan and shall receive a copy of the plan. Each plan must include the most appropriate, least restrictive, and most cost-beneficial environment for accomplishment of the objectives for client progress and a specification of all services authorized. The plan must include provisions for the most appropriate level of care for the client. Within the specification of needs and services for each client, when residential care is necessary, the agency shall move toward placement of clients in residential facilities based within the client’s community. The ultimate goal of each plan, whenever possible, shall be to enable the client to live a dignified life in the least restrictive setting, be that in the home or in the community. The family or individual support plan must be developed within 60 calendar days after the agency determines the client eligible pursuant to s. 393.065(3). (1) The agency shall develop and specify by rule the core components of support plans. (2) The family or individual support plan shall be integrated with the individual education plan (IEP) for all clients who are public school students entitled to a free appropriate public education under the Individuals with Disabilities Education Act (IDEA), as amended. The family or individual support plan and IEP must be implemented to maximize the attainment of educational and habilitation goals. (a) If the IEP for a student enrolled in a public school program indicates placement in a public or private residential program is necessary to provide special education and related services to a client, the local education agency must provide for the costs of that service in accordance with the requirements of the Individuals with Disabilities Education Act (IDEA), as amended. This does not preclude local education agencies and the agency from sharing the residential service costs of students who are clients and require residential placement. (b) For clients who are entering or exiting the school system, an interdepartmental staffing team composed of representatives of the agency and the local school system shall develop a written transitional living and training plan with the participation of the client or with the parent or guardian of the client, or the client advocate, as appropriate. (3) Each family or individual support plan shall be facilitated through case management designed solely to advance the individual needs of the client. (4) In the development of the family or individual support plan, a client advocate may be appointed by the support planning team for a client who is a minor or for a client who is not capable of express and informed consent when: (a) The parent or guardian cannot be identified; (b) The whereabouts of the parent or guardian cannot be discovered; or (c) The state is the only legal representative of the client. Such appointment may not be construed to extend the powers of the client advocate to include any of those powers delegated by law to a legal guardian. (5) The agency shall place a client in the most appropriate and least restrictive, and cost-beneficial, residential facility according to his or her individual support plan. The client, if competent, the client’s parent or guardian, or, when appropriate, the client advocate, and the administrator of the facility to which placement is proposed shall be consulted in determining the appropriate placement for the client. Considerations for placement shall be made in the following order: (a) Client’s own home or the home of a family member or direct service provider. (b) Foster care facility. (c) Group home facility. (d) Intermediate care facility for the developmentally disabled. (e) Other facilities licensed by the agency which offer special programs for people with developmental disabilities. (f) Developmental disabilities center. (6) In developing a client’s annual family or individual support plan, the individual or family with the assistance of the support planning team shall identify measurable objectives for client progress and shall specify a time period expected for achievement of each objective. (7) The individual, family, and support coordinator shall review progress in achieving the objectives specified in each client’s family or individual support plan, and shall revise the plan annually, following consultation with the client, if competent, or with the parent or guardian of the client, or, when appropriate, the client advocate. The agency or designated contractor shall annually report in writing to the client, if competent, or to the parent or guardian of the client, or to the client advocate, when appropriate, with respect to the client’s habilitative and medical progress. (8) Any client, or any parent of a minor client, or guardian, authorized guardian advocate, or client advocate for a client, who is substantially affected by the client’s initial family or individual support plan, or the annual review thereof, shall have the right to file a notice to challenge the decision pursuant to ss. 120.569 and 120.57. Notice of such right to appeal shall be included in all support plans provided by the agency. (9) When developing or reviewing a client’s family or individual support plan, the waiver support coordinator shall inform the client, the client’s parent or guardian, or, when appropriate, the client advocate about the consumer-directed care program established under s. 409.221. History. — s. 10, ch. 89-308; s. 3, ch. 89-339; s. 6, ch. 94-154; s. 1046, ch. 95-148; s. 121, ch. 96-410; s. 101, ch. 2004-267; s. 14, ch. 2006-227; s. 4, ch. 2008-244; s. 4, ch. 2023-273; s. 3, ch. 2024-14. 393.0654 Direct service providers; private sector services. It is not a violation of s. 112.313(7) for a direct service provider who is employed by the agency to own, operate, or work in a private facility that is a service provider under contract with the agency if: (1) The employee does not have any role in the agency’s placement recommendations or the client’s decisionmaking process regarding placement; (2) The direct service provider’s employment with the agency does not compromise the ability of the client to make a voluntary choice among private providers for services; (3) The employee’s employment outside the agency does not create a conflict with the employee’s public duties and does not impede the full and faithful discharge of the employee’s duties as assigned by the agency; and (4) The service provider discloses the dual employment or ownership status to the agency and all clients within the provider’s care. The disclosure must be given to the agency, the client, and the client’s guardian or guardian advocate, if appropriate. History. — s. 15, ch. 2006-227. 393.0655 Screening of direct service providers. (1) MINIMUM STANDARDS. — The agency shall require level 2 employment screening pursuant to chapter 435 for direct service providers who are unrelated to their clients, including support coordinators, and all employees of residential facilities or adult day training programs licensed under this chapter and any other persons, including volunteers, who provide care or services, who have access to a client’s living areas, or who have access to a client’s funds or personal property. Background screening must include employment history checks as provided in s. 435.03(1) and local criminal records checks through local law enforcement agencies. (a) A volunteer who assists on an intermittent basis for less than 10 hours per month does not have to be screened if a person who meets the screening requirement of this section is always present and has the volunteer within his or her line of sight. (b) Licensed physicians, nurses, or other professionals licensed and regulated by the Department of Health are not subject to background screening pursuant to this section if they are providing a service that is within their scope of licensed practice. (c) A person selected by the family or the individual with developmental disabilities and paid by the family or the individual to provide supports or services is not required to have a background screening under this section. (d) Persons 12 years of age or older, including family members, residing with a direct services provider who provides services to clients in his or her own place of residence are subject to background screening; however, such persons who are 12 to 18 years of age shall be screened for delinquency records only. (2) EXEMPTIONS FROM DISQUALIFICATION. — The agency may grant exemptions from disqualification from working with children or adults with developmental disabilities only as provided in s. 435.07. (3) PAYMENT FOR PROCESSING OF FINGERPRINTS AND STATE CRIMINAL RECORDS CHECKS. — The costs of processing fingerprints and the state criminal records checks shall be borne by the employer or by the employee or individual who is being screened. (4) TERMINATION; HEARINGS PROVIDED. — (a) The agency shall deny, suspend, terminate, or revoke a license, certification, rate agreement, purchase order, or contract, or pursue other remedies provided in s. 393.0673, s. 393.0675, or s. 393.0678 in addition to or in lieu of denial, suspension, termination, or revocation for failure to comply with this section. (b) When the agency has reasonable cause to believe that grounds for denial or termination of employment exist, it shall notify, in writing, the employer and the person affected, stating the specific record that indicates noncompliance with the standards in this section. (c) The procedures established for hearing under chapter 120 shall be available to the employer and the person affected in order to present evidence relating either to the accuracy of the basis of exclusion or to the denial of an exemption from disqualification. (d) Refusal on the part of an employer to dismiss a manager, supervisor, or direct service provider who has been found to be in noncompliance with standards of this section shall result in automatic denial, termination, or revocation of the license or certification, rate agreement, purchase order, or contract, in addition to any other remedies pursued by the agency. (5) DISQUALIFYING OFFENSES. — The background screening conducted under this section must ensure that, in addition to the disqualifying offenses listed in s. 435.04, no person subject to the provisions of this section has an arrest awaiting final disposition for, has been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to, or has been adjudicated delinquent and the record has not been sealed or expunged for, any offense prohibited under any of the following provisions of state law or similar law of another jurisdiction: (a) Any authorizing statutes, if the offense was a felony. (b) This chapter, if the offense was a felony. (c) Section 409.920, relating to Medicaid provider fraud. (d) Section 409.9201, relating to Medicaid fraud. (e) Section 817.034, relating to fraudulent acts through mail, wire, radio, electromagnetic, photoelectronic, or photooptical systems. (f) Section 817.234, relating to false and fraudulent insurance claims. (g) Section 817.505, relating to patient brokering. (h) Section 817.568, relating to criminal use of personal identification information. (i) Section 817.60, relating to obtaining a credit card through fraudulent means. (j) Section 817.61, relating to fraudulent use of credit cards, if the offense was a felony. (k) Section 831.01, relating to forgery. (l) Section 831.02, relating to uttering forged instruments. (m) Section 831.07, relating to forging bank bills, checks, drafts, or promissory notes. (n) Section 831.09, relating to uttering forged bank bills, checks, drafts, or promissory notes. History. — s. 5, ch. 85-54; s. 6, ch. 87-238; s. 2, ch. 90-225; s. 25, ch. 90-347; s. 6, ch. 91-33; s. 21, ch. 91-57; s. 88, ch. 91-221; s. 10, ch. 93-156; s. 18, ch. 94-134; s. 18, ch. 94-135; s. 7, ch. 94-154; s. 1047, ch. 95-148; s. 14, ch. 95-152; s. 12, ch. 95-158; s. 35, ch. 95-228; s. 123, ch. 95-418; s. 7, ch. 96-268; s. 206, ch. 96-406; s. 73, ch. 2004-267; s. 52, ch. 2005-2; s. 16, ch. 2006-227; s. 4, ch. 2010-114; s. 5, ch. 2023-273; s. 2, ch. 2026-129. 393.0657 Persons not required to be refingerprinted or rescreened. Persons who have undergone any portion of the background screening required under s. 393.0655 within the last 12 months are not required to repeat such screening in order to comply with the screening requirements if such persons have not been unemployed for more than 90 consecutive days since that screening occurred. Such persons are responsible for providing documentation of the screening and shall undergo screening for any remaining background screening requirements that have never been conducted or have not been completed within the last 12 months. History. — s. 1, ch. 87-128; s. 1, ch. 87-141; s. 22, ch. 93-39; s. 8, ch. 94-154; s. 8, ch. 2002-219; s. 979, ch. 2002-387; s. 40, ch. 2004-5; s. 17, ch. 2006-227; s. 5, ch. 2008-244. 393.066 Community services and treatment. (1) The agency shall plan, develop, organize, and implement its programs of services and treatment for persons with developmental disabilities to allow clients to live as independently as possible in their own homes or communities and to achieve productive lives as close to normal as possible. All elements of community-based services shall be made available, and eligibility for these services shall be consistent across the state. 1 (2) Necessary services shall be purchased, rather than provided directly by the agency, when the purchase of services is more cost-efficient than providing them directly. All purchased services must be approved by the agency. As a condition of payment and before billing, persons or entities under contract with the agency to provide services shall use agency data management systems to document service provision to clients or shall maintain such information in its own data management system and electronically transmit it to the agency data management system in an industry standard electronic format designated by the agency. The agency may not require training on the use of agency data management systems by persons or entities that choose to maintain data in their own data management system, provided that they electronically transmit required information in a format and frequency designated by the agency. Contracted persons and entities shall meet the minimum hardware and software technical requirements established by the agency for the use of such systems. Such persons or entities shall also meet any requirements established by the agency for training and professional development of staff providing direct services to clients. (3) Community-based services that are medically necessary to prevent institutionalization shall, to the extent of available resources, include: (a) Adult day training services. (b) Family care services. (c) Guardian advocate referral services. (d) Medical/dental services, except that medical services shall not be provided to clients with spina bifida except as specifically appropriated by the Legislature. (e) Parent training. (f) Personal care services. (g) Recreation. (h) Residential facility services. (i) Respite services. (j) Social services. (k) Specialized therapies. (l) Supported employment. (m) Supported living. (n) Training, including behavioral analysis services. (o) Transportation. (p) Other habilitative and rehabilitative services as needed. (4) The agency shall utilize the services of private businesses, not-for-profit organizations, and units of local government whenever such services are more cost-efficient than such services provided directly by the department, including arrangements for provision of residential facilities. (5) In order to improve the potential for utilization of more cost-effective, community-based residential facilities, the agency shall promote the statewide development of day habilitation services for clients who live with a direct service provider in a community-based residential facility and who do not require 24-hour-a-day care in a hospital or other health care institution, but who may, in the absence of day habilitation services, require admission to a developmental disabilities center. Each day service facility shall provide a protective physical environment for clients, ensure that direct service providers meet minimum screening standards as required in s. 393.0655, make available to all day habilitation service participants at least one meal on each day of operation, provide facilities to enable participants to obtain needed rest while attending the program, as appropriate, and provide social and educational activities designed to stimulate interest and provide socialization skills. (6) To promote independence and productivity, the agency shall provide supports and services, within available resources, to assist clients enrolled in Medicaid waivers who choose to pursue gainful employment. (7) For the purpose of making needed community-based residential facilities available at the least possible cost to the state, the agency is authorized to lease privately owned residential facilities under long-term rental agreements, if such rental agreements are projected to be less costly to the state over the useful life of the facility than state purchase or state construction of such a facility. (8) The agency may adopt rules providing definitions, eligibility criteria, and procedures for the purchase of services provided pursuant to this section. (9) The agency shall utilize a monthly reimbursement rate, developed by the Agency for Health Care Administration in consultation with the agency, for Life Skills Development Level 3 and Level 4 services. The monthly reimbursement rate shall apply to services for clients who receive at least 80 hours of such services during a calendar month. For clients who receive less than 80 hours of services during a calendar month, providers shall be reimbursed using an hourly reimbursement rate. History. — s. 1, ch. 77-335; s. 2, ch. 80-174; s. 43, ch. 83-218; s. 15, ch. 84-226; s. 6, ch. 85-54; s. 2, ch. 85-147; s. 10, ch. 86-220; s. 7, ch. 87-238; s. 11, ch. 89-308; s. 18, ch. 91-158; s. 4, ch. 92-174; ss. 2, 3, ch. 93-143; s. 9, ch. 93-200; s. 5, ch. 93-267; s. 9, ch. 94-154; s. 1, ch. 98-152; s. 83, ch. 99-8; s. 3, ch. 99-144; s. 74, ch. 2004-267; s. 18, ch. 2006-227; s. 6, ch. 2008-244; s. 4, ch. 2016-140; s. 2, ch. 2020-71; s. 24, ch. 2021-51; ss. 31, 32, ch. 2025-199; ss. 44, 45, ch. 2026-233; s. 4, ch. 2026-236. 1 Note. — A. Section 44, ch. 2026-233, reenacted subsection (2) “[i]n order to implement Specific Appropriations 250, 254, and 267 of the 2026-2027 General Appropriations Act.” B. Section 45, ch. 2026-233, provides that “[t]he text of s. 393.066(2), Florida Statutes, as carried forward from chapter 2025-199, Laws of Florida, by this act, expires July 1, 2027, and the text of that subsection shall revert to that in existence on June 30, 2025, except that any amendments to such text enacted other than by this act shall be preserved and continue to operate to the extent that such amendments are not dependent upon the portions of text which expire pursuant to this section.” Effective July 1, 2027, subsection (2), as amended by s. 45, ch. 2026-233, will read: (2) Necessary services shall be purchased, rather than provided directly by the agency, when the purchase of services is more cost-efficient than providing them directly. All purchased services must be approved by the agency. As a condition of payment and before billing, persons or entities under contract with the agency to provide services shall use agency data management systems to document service provision to