Governor Ron DeSantis yesterday signed into law SB 1156, one of HCAF’s top legislative priorities of the 2025 session, marking a major victory for Florida’s most vulnerable pediatric patients and their families. The law takes effect immediately and enacts long-overdue reforms to the Home Health Aide for Medically Fragile Children program — also known as the Family Home Health Aide (FHHA) program.

With this action, Florida officially expands access to high-quality, family-delivered home care for children with complex medical needs. The bill passed unanimously in both chambers of the legislature and was among only 257 bills approved during the 2025 legislative session out of 1,959 bills filed (12.8%). HCAF is proud to report that both of our top legislative priorities were among them.

What the Law Does

SB 1156, sponsored by Senator Gayle Harrell (R-Stuart), and its companion, HB 1529, sponsored by Representative Chase Tramont (R-Orange Park), build on the foundation of HB 391 (2023) by enacting meaningful reforms to strengthen caregiver training, increase oversight, and expand access to care.

• Strengthens training standards for family caregivers by requiring:
  • A minimum of 75 hours of home health aide training in accordance with the federal Conditions of Participation (CoPs);
  • Child-specific instruction for advanced tasks, delivered by a registered nurse and delegated to the FHHA after demonstrating competency;
  • Ongoing training based on changes to the care plan;
  • Current CPR certification at all times.
• Enhances oversight through:
  • Annual assessments measuring caregiver satisfaction;
  • Tracking of adverse incidents and hospitalization rates;
  • Comparisons between outcomes for children served by aides versus nurses.
• Raises utilization limits from the previous cap to 12 hours per day, 40 hours per week, with exceptions allowed when medically necessary.
• Expands access by directing the Agency for Health Care Administration (AHCA) to submit federal waiver requests within 60 days (by August 22, 2025) to:
  • Exclude caregiver earnings when determining Medicaid eligibility for the child; and
  • Allow Medicaid pediatric specialty providers to participate in the FHHA program.

This legislative achievement is the result of months of advocacy by HCAF, our provider members, and families who bravely shared their stories. We are deeply grateful to Senator Harrell, Representative Tramont, and our champions in the legislature for their commitment to supporting home-based care and empowering families.

Additionally, this law will be a featured topic at HCAF’s HomeCareCon 36th Annual Conference & Trade Show on Friday, July 23, during the breakout session, "Mission Upgrade: Strengthening the Family Home Health Aide Program for Medically Fragile Children." The session will explore the full scope of the new law — including training mandates, oversight requirements, agency responsibilities, and federal alignment steps—providing attendees with practical insights to prepare for and implement these changes with confidence.

To further support providers, HCAF is developing a comprehensive training and policies and procedures toolkit tailored to the updated FHHA program. Stay tuned for its release in the coming weeks.

What Happens Next

With the law now in effect, AHCA must swiftly prepare and submit the required federal waiver requests to the Centers for Medicare & Medicaid Services (CMS). HCAF will remain closely engaged with the agency and provide updates to providers on the waiver process, implementation guidance, and opportunities to weigh in.

Help Us Keep the Momentum

This legislative win was made possible through our members' support, advocacy, and contributions to the Home Care Political Action Committee (PAC). To help fuel future victories, consider making a PAC contribution today and continue driving home care policy forward.

Click here to contribute.

Together, we’re making home care stronger — for every Floridian who needs it.