Florida SB 1026: Early Learning

Bill Text

1026 
Community Health Worker Services 
2025-12-30T03:22:26Z 
Authorizing the Agency for Health Care Administration to pay for specified community health worker services as an optional Medicaid service, subject to certain coverage requirements; defining the term “community health worker”; adding community health worker services to the list of Medicaid services authorized for reimbursement on a fee-for-service basis, etc. 
Original Filed Version 
2026 
S 
2026-07-01T00:00:00Z 
GB 
General Bill 
__ 

 Florida Senate - 2026 SB 1026 

 By Senator Rodriguez 

 40-01390-26 20261026__ 
 1 A bill to be entitled 
 2 An act relating to community health worker services; 
 3 amending s. 409.906, F.S.; authorizing the Agency for 
 4 Health Care Administration to pay for specified 
 5 community health worker services as an optional 
 6 Medicaid service, subject to certain coverage 
 7 requirements; defining the term “community health 
 8 worker”; requiring the agency to adopt rules; 
 9 authorizing the agency to seek federal approval; 
 10 amending s. 409.908, F.S.; adding community health 
 11 worker services to the list of Medicaid services 
 12 authorized for reimbursement on a fee-for-service 
 13 basis; amending s. 409.973, F.S.; adding community 
 14 health worker services to the list of minimum benefits 
 15 required to be covered by Medicaid managed care plans; 
 16 providing an effective date. 
 17 
 18 Be It Enacted by the Legislature of the State of Florida: 
 19 
 20 Section 1. Subsection (30) is added to section 409.906, 
 21 Florida Statutes, to read: 
 22 409.906 Optional Medicaid services.—Subject to specific 
 23 appropriations, the agency may make payments for services which 
 24 are optional to the state under Title XIX of the Social Security 
 25 Act and are furnished by Medicaid providers to recipients who 
 26 are determined to be eligible on the dates on which the services 
 27 were provided. Any optional service that is provided shall be 
 28 provided only when medically necessary and in accordance with 
 29 state and federal law. Optional services rendered by providers 
 30 in mobile units to Medicaid recipients may be restricted or 
 31 prohibited by the agency. Nothing in this section shall be 
 32 construed to prevent or limit the agency from adjusting fees, 
 33 reimbursement rates, lengths of stay, number of visits, or 
 34 number of services, or making any other adjustments necessary to 
 35 comply with the availability of moneys and any limitations or 
 36 directions provided for in the General Appropriations Act or 
 37 chapter 216. If necessary to safeguard the state’s systems of 
 38 providing services to elderly and disabled persons and subject 
 39 to the notice and review provisions of s. 216.177, the Governor 
 40 may direct the Agency for Health Care Administration to amend 
 41 the Medicaid state plan to delete the optional Medicaid service 
 42 known as “Intermediate Care Facilities for the Developmentally 
 43 Disabled.” Optional services may include: 
 44 (30) COMMUNITY HEALTH WORKERS.—The agency may pay for the 
 45 provision of community health worker services including, but not 
 46 limited to, health promotion, wellness coaching, and self 
 47 management education; cultural mediation; interpretation or 
 48 translation services; health system navigation; patient and 
 49 family advocacy; outreach before appointments, including 
 50 appointment reminders; outreach to ensure adherence to 
 51 treatments and medications; home visits; individual, community, 
 52 and environmental assessments; arranging transportation; making 
 53 connections to community resources or social services; and 
 54 providing care coordination and case management. 
 55 (a) As used in this subsection, the term “community health 
 56 worker” means a frontline public health worker who provides a 
 57 range of services addressing the health and social needs of the 
 58 community and is a trusted member of or has a close 
 59 understanding of the community he or she serves. The term 
 60 includes community health representatives, promotores de salud, 
 61 and workers of public or private community-based organizations. 
 62 (b) The agency shall adopt rules to implement this 
 63 subsection, including, but not limited to, rules establishing 
 64 eligible services provided by community health workers. 
 65 (c) The agency may seek federal approval necessary to 
 66 implement this subsection. 
 67 Section 2. Present paragraphs (c) through (u) of subsection 
 68 (3) of section 409.908, Florida Statutes, are redesignated as 
 69 paragraphs (d) through (v), respectively, and a new paragraph 
 70 (c) is added to that subsection, to read: 
 71 409.908 Reimbursement of Medicaid providers.—Subject to 
 72 specific appropriations, the agency shall reimburse Medicaid 
 73 providers, in accordance with state and federal law, according 
 74 to methodologies set forth in the rules of the agency and in 
 75 policy manuals a