Program Purpose and Goals
This program allows family caregivers to:
- Become employed by licensed home health agencies
- Provide delegated home health aide services
- Support medically fragile children receiving Medicaid PDN services
This program is intended to:
- Expand access to care for medically fragile children
- Help stabilize families facing nursing shortages
- Reduce unnecessary hospitalizations
- Reduce institutionalization
- Improve continuity of care in the home
- Supplement authorized PDN services
Child Eligibility Requirements
To participate the child must:
- Be under age 21
- Be medically fragile
- Be eligible for Medicaid
- Be receiving Medicaid PDN services
This program specifically targets high-acuity pediatric Medicaid recipients, children requiring substantial home-based nursing support.
Family Caregiver Eligibility
Eligible caregivers include:
- Family members
- Legal guardians
- Caretaker relatives
Participants must:
- Be at least 18 years old
- Read and write at a basic level
- Pass a Level 2 background screening
- Complete required training and competency validations
- Be employed by a licensed participating home health agency
Training Requirements Overview
AHCA has finalized the Medicaid Family Home Health Aide for Medically Fragile Children program minimum training requirements. They were filed on 5/11/26 and made effective on 5/31/26. They were originally created through HB 391 in 2023, expanded and strengthened through SB 1156 in 2025, and then implemented through Rule 59A-8.0099, F.A.C.
The finalized rule requires:
- 40 hours of basic home health aide training
- 20 hours of pediatric medically fragile skills training
- 16 hours of clinical competency validation
Emphasis on:
- Pediatric safety
- Competency validation
- RN oversight
- Standardized statewide requirements
Caregivers must also complete a one-time HIV education within 30 days of employment and CPR certification.
The 20 Hours of Pediatric Medically Fragile Skills Training
Training must be:
- In person
- Tailored to the child’s individualized plan of care
- Conducted by qualified pediatric RN
The 16 Hours of Clinical Competency Validation
Requirements:
- Hands on validation
- Conducted with an actual patient
- Direct supervision by qualified pediatric RN
- In-person demonstration of all required skills
Caregivers must achieve 100% proficiency before independently providing services. Ongoing competency validation must occur within 90 days of training completion and renewed annually.
Any change in physician orders may require new delegation, additional competency review, and updated validation documentation.
Medication Administration Requirements
In addition to the standard 6 hours of medication administration training is required under Rule 59A-8.0097, caregivers must complete 4 additional hours of specialized pediatric medication administration training.
Training includes administration involving:
- Enteral feeding tubes
- Crushed medications
- Rectal medications
- Subcutaneous injections
- Intradermal injections
- Intramuscular injections
- Inhaled medications administered through a tracheostomy
Medicaid Eligibility Development
The Florida Agency for Health Care Administration (AHCA) has shared an important update regarding the AMFC (Family Home Health Aide/FHHA) Income Disregard.
Families who are currently participating in, or enrolling in, the AMFC program are encouraged to complete the linked Income Disregard Form and email it to hqw.access.esshq@myflfamilies.com. Doing so may help protect their Medicaid eligibility.
We’re sharing this information to help ensure our families are aware of this opportunity. Atlantic Care Services is not involved in the Medicaid or SSI eligibility process and cannot provide guidance on securing benefits.
Please refer to the linked Income Disregard Form and AHCA website below for complete instructions, additional information, and submission details.
