Christine Jordan Sexton
A new $10.5 million long-term care facility for people with developmental disabilities will be built in Madison County in the next 18 months.
The Agency for Health Care Administration announced that Sunrise Community, Inc. is taking advantage of a 2020 law championed by Sen. Gayle Harrell and Rep. Colleen Burton that allows it to build an ICFDD, or intermediate care facility for the developmentally disabled, without obtaining a “certificate of need,” or CON.
AHCA did not immediately provide Florida Politics with Sunrise Community’s application for the CON exemption. The application provides project details such as costs, timelines and services that will be provided.
But the law requires that three separate “homes,” each with eight beds, be built on the ICFDD campus. The beds must be reserved for individuals who require increased levels of behavioral, medical and therapeutic oversight because of severe maladaptive behavior.
In Florida, new ICFDD beds and new nursing home beds — both of which generally rely on Medicaid for reimbursement — usually require a CON, as do new hospice beds.
There are four CON “batching cycles” annually where CON applications are competitively reviewed by Florida health care regulators. Two batching cycles are for hospice services and two cycles are for nursing homes and ICFDD beds.
Each batching cycle begins with the state determining and publishing the “need” for new services across the state. Providers interested in offering the services must submit a letter of intent to the state 30 days before the CON application is due.
Although letters of intent are not binding, they are required. The state publishes the letters, which allow entities to get a glimpse at their potential competition. If the provider wants to move ahead, they are required to submit a CON application to the state.
State regulators review the applications and make preliminary decisions on which providers would be granted CONs.
The agency’s decisions, though, are not final. The decisions can be — and often are — challenged in the Division of Administrative Hearings.
Sunrise, though, took advantage of a temporary CON exemption for certain ICFDD beds that the Legislature passed in 2020 at its behest.
The exemption applies only to entities that have had at least 10 years of experience serving people in Florida with severe maladaptive behaviors. Additionally, only providers that have had a clean record for three years can apply for the exemption.
The exemption is valid for 18 months, which means providers must have construction underway within that time. The law allows the agency to extend the timeframe for providers that can demonstrate that the project is being delayed due to litigation or regulatory or permitting issues.
Lawmakers also agreed to limit to three the number of CON exemptions that could be approved. They also agreed the law should expire on July 1, 2022, unless the Legislature agreed to extend it. They did not.
A review of CON-exempt projects in Fiscal Year 2020-21 and Fiscal Year 2021-22 shows that, to date, the May 6 Sunrise application for new beds in Madison County is the only ICFDD project that has been granted the exemption.
