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The passing of Florida’s HB 391 has created new opportunities for family members to take an active role in the care of medically complex children. This legislation allows parents, guardians, and family members to provide personal care services to children who are eligible for private duty nursing, following completion of specialized training. In this FAQ section, we provide answers to common questions about the HB 391 ruling, including the training requirements, certification process, and program details. Explore below to learn more about how this ruling supports families caring for medically fragile children in Florida.

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What is the HB391 ruling?

In Florida, recent changes related to the HB 391 ruling have enabled family members to provide personal care services to medically complex pediatric patients who are eligible and approved for private duty nursing.

Who provides the training for this role, and what is the duration of the training program?

Under the HB 391 ruling and guidance from the Agency for Health Care Administration (AHCA), a parent, guardian, or family member may provide personal care services, provided they complete a minimum of 86 hours of an agency-approved training program developed in consultation with the Board of Nursing. A registered nurse will conduct the training and delegate instruction as appropriate.

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Could you specify the content covered in the training and any certification requirements that must be met upon completion?

According to the HB 391 training guidelines, the training is divided into several components.

  • Theoretical instruction consists of a minimum of 40 hours. It covers various aspects of patient care, including infection control, safety procedures, daily living support, strategies for interacting with cognitively impaired individuals, patient rights, and legal and ethical considerations.
  • Interactive instruction comprises a minimum of 20 hours focused on essential nursing skills, including maintaining basic hygiene, skin care, and pressure sore prevention. The curriculum also encompasses nutrition training, obtaining vital signs, safe lifting and positioning techniques, wound care, and various respiratory procedures. Additionally, other clinical skills will be covered, such as enteral care, which involves the administration of nutrition and medication directly into the gastrointestinal (GI) tract, as well as specific skills tailored to the needs of your potential patient.
  • Clinical instruction will provide hands-on competency training to ensure that home health aides possess the necessary skills and knowledge to deliver safe and effective patient care.
  • Medication Administration instruction will be additional training and must be approved and delegated by a licensed Registered Nurse for medication administration and medical error prevention.

HIV/AIDS Training and CardioPulmonary Resuscitation (CPR) certification will be required to obtain.

Each family home health aide is required to complete a total of 12 hours of in-service training annually, with the training to be renewed every 12 months throughout their employment with our agency.

Why doesn’t the Agency for Health Care Administration (AHCA) establish a waiver program that would exempt this income from consideration in determining Medicaid eligibility?

The Agency for Health Care Administration (AHCA) is required to adhere strictly to the language outlined in HB 391. The bill did not mandate the creation of a waiver specifically for this program. Our agency will monitor all developments related to this program and will promptly notify all employees of any updates or changes to the ruling as they occur. Regular communication will be provided through official channels to ensure that everyone remains informed.

When will the HB 391 program officially commence?

Our agency is currently awaiting guidance from the Agency for Health Care Administration (AHCA) as well as a comprehensive fee schedule from all participating health plans, which will include the appropriate billing codes for this newly implemented service. We anticipate that this information will establish the necessary framework for billing and reimbursement processes. We anticipate receiving further guidance from the Agency of Health Care Administration (AHCA) on October 1, 2024. This information will be critical for us to successfully and efficiently launch the program. Our team is committed to ensuring that all aspects of the implementation processes align with the ruling for HB 381.

If you have any questions or need more information on the HB391 program, contact us.