Membership, Advocacy & Political Investment: The Formula for Legislative Success
Influencing policy decisions that impact Florida’s home care industry requires more than good intentions — it takes year-round advocacy, trusted relationships, and strategic financial investment. At the core of this effort is HCAF, whose policy team works throughout the year to shape legislation and regulatory policy. This includes our retained lobbying firm, Continental Strategy, a powerhouse presence in Tallahassee that is funded entirely through HCAF membership dues. Their role is critical: opening doors, rattling cages when needed, and ensuring that the voice of home care is heard by state agencies, legislative leaders, and key lawmakers.
Complementing this work is the Home Care Political Action Committee (PAC) — a voluntary, non-profit, and non-partisan entity regulated by the Florida Division of Elections. While HCAF focuses on direct policy advocacy and regulatory engagement, the PAC raises and deploys funds to support candidates who are aligned with the interests of Florida’s home care community. Importantly, PAC contributions are separate from HCAF membership dues, providing an essential political tool to help elect — and re-elect — champions for home care in the Florida Legislature.
Together, HCAF’s policy expertise and the PAC’s targeted political investments have led to significant legislative victories: securing Medicaid reimbursement rate increases, expanding access to home- and community-based services (HCBS), defeating harmful proposals, and advancing regulatory reforms that promote operational flexibility for providers. From fighting to reduce waiting lists to eliminating barriers to caregiver employment, HCAF and the PAC work in tandem to advocate for policies that strengthen care delivery for both patients and providers.
The timeline below highlights key advocacy and policy achievements by year, demonstrating the lasting impact of HCAF’s efforts and the essential role of member and PAC support in shaping Florida’s home care future.
2013
- Secured a 10% Medicaid reimbursement rate increase for home health and private duty nursing (PDN) services ($9.3 million).
- Passed SB 1094 to reduce mandatory fines for home health agencies failing to file quarterly reports with AHCA, cutting penalties from $5,000 to $200 per day and exempting non-Medicare/Medicaid providers.
2014
- Secured a 5% Medicaid reimbursement rate increase for PDN services ($5.5 million).
- Secured a $12.6 million appropriation to reduce the long-term care waiver waiting list, expanding access to HCBS for 823 individuals.
- Passed HB 1179, exempting non-skilled, non-Medicare/Medicaid-participating home health agencies from accreditation requirements.
2015
- Passed HB 441, eliminating mandatory quarterly reporting requirements for home health agencies, saving providers millions in administrative costs.
- Passed SB 904, allowing home health agencies to operate related offices within a geographic service area without additional licenses.
2016
- Secured a 5% Medicaid reimbursement rate increase for PDN services ($7.7 million).
- Secured a $7.2 million appropriation to reduce the long-term care waiver waiting list by approximately 570 individuals.
2017
- Unanimously passed HB 6021, repealing the restriction on home health agencies with shared controlling interests operating within 10 miles of each other, expanding service flexibility.
2018
- Defeated SB 1362/HB 835, which sought to expand the Palm Beach County Caregiver ID Badge ordinance statewide. The proposal would have created new barriers to caregiver employment with duplicative, privacy-invasive requirements.
2019
Passed HB 23, establishing Florida's first comprehensive telehealth statute and setting the stage for expanded remote care delivery amid the coming pandemic.
2020
- Passed HB 607, a landmark workforce reform that expanded the scope of practice for direct care workers by authorizing registered nurses (RNs) to delegate specific tasks to home health aides and certified nursing assistants (CNAs). This policy shift was driven by the urgent need to address Florida’s growing home care workforce crisis by maximizing the skills of every available clinician and caregiver.The timing was historic: HB 607 passed on March 11, 2020 — the same day the World Health Organization declared COVID-19 a global pandemic. As the world braced for unprecedented health system strain, Florida acted decisively to empower more hands on the frontlines. The law has since proven essential in expanding access to care, reducing unnecessary hospitalizations, and improving patient outcomes across home-based settings.
- Secured a $30.2 million appropriation to reduce the iBudget waiver waiting list.
2021
- Defeated SB 634/HB 309, which proposed expanded Alzheimer’s disease and related disorders (ADRD) training mandates for long-term care providers. The bill would have required three hours of initial training and four hours annually for direct care workers, plus additional training for all staff.
2022
- Secured more than $600 million in Medicaid funding through a collaborative advocacy effort alongside other health care provider associations for reimbursement increases and the establishment of a $15 per hour minimum wage for direct care workers.
- Passed HB 469, expanding the scope of practice for direct care workers by allowing RNs to delegate additional tasks — mirroring what is currently permitted in assisted living facilities — helping address workforce shortages and improve care delivery in home- and community-based settings.
- Passed SB 7014, extending COVID-19 liability protections for health care providers and offering continued legal safeguards during ongoing public health challenges.
- Defeated SB 1572/HB 1507, which once again sought to impose expanded ADRD training requirements on long-term care providers.
2023
- Passed SB 2510, reforming Medicaid provider enrollment requirements to eliminate unnecessary red tape for certain providers, thereby reducing administrative costs and streamlining access to care.
- Successfully negotiated and passed HB 299, establishing balanced, no-cost online ADRD training requirements for long-term care providers — an advocacy win that replaced earlier, overly burdensome proposals.
- Passed HB 391, creating the Home Health Aide for Medically Fragile Children Program ("Family Home Health Aide") to bridge workforce gaps and provide specialized training pathways for family caregivers and direct care workers.
- Secured a $79.6 million appropriation to reduce the iBudget waiver waiting list.
- Secured a $5 million appropriation to expand Community Care for the Elderly and Home Care for the Elderly programs.
2024
- Unanimously passed HB 935, expanding Medicaid coverage to allow advanced practice registered nurses (APRNs) and physician assistants (PAs) to prescribe home health services. This legislation brings Florida into alignment with the federal CARES Act, providing permanent authorization for non-physician practitioners to certify Medicare and Medicaid home health care services.
- Championed provisions of SB 7016 (Live Healthy), including Florida’s participation in the speech-language pathology and audiology, and physical therapy licensure compacts. The legislation also allocated $19 million to the Linking Industry to Nursing Education (LINE) program, with an additional $5 million to expand access to private nursing schools — funding aimed at increasing the supply of licensed practical nurses (LPNs) and CNAs through targeted education grants.
- Secured a $29 million Medicaid reimbursement rate increase for PDN services to support recruitment and retention of skilled clinicians for medically complex patients.
- Obtained a $195.8 million appropriation to implement a uniform rate increase for all iBudget waiver providers, strengthening services for individuals with developmental disabilities.
2025
- Passed HB 1353, a major regulatory modernization allowing one administrator to oversee up to five commonly owned home health agencies, regardless of geographic service area — removing the outdated, arbitrary contiguous-county restriction. The bill also eliminates the requirement that admission, evaluation, and discharge visits be performed only by direct employees, enabling providers to use qualified contracted professionals to improve flexibility and access.It further revamps the Excellence in Home Health Program by requiring AHCA to distinguish award criteria between "skilled" and "non-skilled" agencies, streamline the application process, and ensure the designation is accessible and achievable — addressing why no provider has earned the award since its 2023 implementation.
- Passed SB 1156, strengthening the Home Health Aide for Medically Fragile Children Program ("Family Home Health Aide") by enhancing training standards, expanding provider eligibility, and exempting caregiver wages from Medicaid eligibility calculations.
- Passed SB 1490, directing AHCA to develop a comprehensive redesign plan for the Medicaid Model Waiver for children receiving PDN, with tiered service options and required input from families, providers, and Medicaid plans.