Safety Net
Health Care
TANF
WIC
reemployment assistance
unemployment
medicaid
SNAP
coronavirus
COVID-19 policy response
SNAC
By
Anne Swerlick
|
By
Cindy Huddleston
|
March 23, 2020

Policy Recommendations for Strengthening Florida’s Safety Net In Response to COVID-19

The needs of families with low income must be a priority as the state decides what steps it will take to lessen the effects of COVID-19. On March 24th, 44 organizations signed on to a letter authored by Florida Policy Institute to Governor DeSantis urging him to adopt the below 47 policy changes to bolster the state's safety net. Download the letter at the bottom of this page.

Florida should adopt proactive COVID-19 policies to protect families who rely on safety net programs to avoid hunger, stay well, and make ends meet, such as the Supplemental Nutrition Assistance Program (SNAP), Medicaid, Temporary Assistance for Needy Families (TANF), Reemployment Assistance (RA), and the Special Nutrition Program for Women, Infants, and Children (WIC).

DCF-Administered Safety Net Programs

  • Develop a plan to serve Floridians confined to their homes who are unable to use a computer. DCF announced on March 18, 2020, that it was closing public access to brick-and-mortar storefronts due to coronavirus. Because 10 percent of people apply for safety net benefits in person, DCF recommends that those Floridians use drop-boxes at the Department’s storefront locations to turn in their applications. However, all seniors and persons with significant medical conditions, many of whom do not have internet access or a computer, have been advised to stay home. While DCF may be allowing phone interviews, we are unaware that people can apply by phone. If phone interviews are an option, the public should be advised on how to apply by phone.  If not, we encourage DCF to begin to employ telephone applications or develop a focused plan to serve seniors and persons with disabilities who do not have access to computers or the internet during the pandemic.

Supplemental Nutrition Assistance Program 

Florida’s Supplemental Nutrition Assistance Program (SNAP) provides families with low income with assistance to put food on the table.

  • Use phone interviews. Federal law gives DCF flexibility to substitute phone interviews for face-to-face interviews for all SNAP applicants. We encourage DCF, who already uses telephone interviews for many applicants, to substitute phone interviews across the board for households able and willing to be interviewed by phone. We also suggest that interviews be temporarily waived for families without adequate cell phone data.
  • Extend certification periods to the maximum extent possible and ease or delay verification of eligibility factors not required by law to be verified. Many families in Florida who are eligible for SNAP lose their benefits due to red tape, particularly at recertification, even though they cannot make ends meet. Because it is more important than ever that struggling families be able to establish eligibility and continue to receive assistance for as long as they are in need, we suggest that DCF not only extend certification periods but also ease or delay verification requirements during the pandemic.  
  • Suspend work requirements. Currently, Florida operates a mandatory work program for SNAP recipients who are considered to be Able Bodied Adults Without Dependents (ABAWDs). Under that program, SNAP recipients who are not exempt must participate in work activities or lose their assistance as a sanction. Further, ABAWDs who voluntarily quit employment or reduce hours of employment without good cause also face reduction or termination of their assistance. Until social distancing guidelines are relaxed and employers are able to stay open for normal business hours, we encourage DCF to take steps to suspend SNAP work and voluntary quit requirements  so that families can continue to participate in SNAP uninterrupted and without risk to the health of themselves, members of their households, or those in their communities. No sanctions for failure to meet SNAP E&T or work requirements should be imposed during the pandemic.
  • Place a moratorium on time limits. Florida currently imposes SNAP time limits state-wide for all ABAWDs. Under these time limits, ABAWDs cannot receive SNAP for more than three months in a 36-month period unless they work or are in a work activity for an average of 80 hours per month. We ask that DCF institute a moratorium on time limits during the pandemic.  ABAWDs, many of whom face enormous barriers to employment in normal circumstances, will encounter even greater barriers during the COVID-19 emergency due to social distancing and the inevitable economic downturn from this public health crisis.
  • Consider ways to ensure that college students can establish eligibility during the pandemic. Ordinarily, students who are enrolled in college or other institutions of higher education at least half time are not eligible for SNAP. Because college closures impact the ability of many students to access food, DCF should think about ways to extend eligibility to students who have been unable to qualify in the past.
  • Reinforce good cause exemptions. For individuals unable to meet SNAP work or voluntary quit requirements due to COVID-19,  we urge the State of Florida to reinforce its good cause policies for coronavirus circumstances beyond the participant’s control, and provide a directive to staff about the importance of screening for good cause. 
  • Implement pilot programs for ordering groceries online. USDA allows states, including Alabama,  to operate a pilot program for SNAP recipients to purchase groceries online using their EBT card. To minimize social interaction during the pandemic, we urge the State of Florida to develop such a program.
  • Expand good cause for COVID-19-related noncooperation with child support. The SNAP program requires that applicants cooperate with Florida’s child support enforcement unit (CSEU) as a condition of receiving food assistance unless good cause exists. The State of Florida should expand the definition of good cause to specify that noncooperation due to the impact of coronavirus constitutes good cause. If cooperation would require personal interaction, we urge the state to explore a moratorium on such activities in order to comply with federal social distancing guidelines as well as to protect families, staff, and the communities in which they live from spreading coronavirus.
  • Automatically supplement the SNAP allotments of participating families. To respond to the profound economic impact of COVID-19 on low-income families, we urge DCF to automatically supplement SNAP allotments up to the maximum for families of the household’s size. We request ask that this supplement be in addition to the allotment that the household already receives.
  • Broaden expedited service eligibility. Families impacted by COVID-19, especially those losing jobs or experiencing significant cut in work hours, may not necessarily meet current expedited service criteria but still be in desperate need of help putting food on the table. We urge DCF to broaden expedited service criteria during the pandemic to meet the emergency food needs of affected families.
  • Determine financial eligibility based on expected income.  Because so many Floridians have been informed that they will lose jobs or have their hours at work reduced, we urge DCF to determine eligibility based on their expected income.
  • Implement a Disaster SNAP (D-SNAP) program as soon as permissible under federal law. Although we urge DCF to institute a D-SNAP program when possible, we encourage the Department to ensure that families are screened for regular SNAP.
  • Issue SNAP for school-aged children who would otherwise receive free or reduced-price school meals. Given the urgent need of families losing income during the pandemic, we urge the state to set benefits for each child at a level that is more than the value of meals at the free rate, assume that all school-age children in households receiving SNAP benefits also receive free school meals, and provide this issuance in addition to any other supplement that current recipients receive.
  • Temporarily allow purchases of hot foods. After disasters, USDA often waives the prohibition on using SNAP benefits to purchase prepared hot foods. In light of  food shortages on grocery store shelves in Florida, we ask that DCF obtain such a waiver from USDA for this pandemic.


Temporary Assistance for Needy Families (TANF)

The Temporary Assistance for Needy Families (TANF) program provides temporary cash assistance to families with very low income, many of whom are facing an unexpected crisis such as loss of a job, divorce, death of a breadwinner, or health crisis.

  • Increase TANF benefit levels. Even before having to buy additional disinfectants, medical supplies, and non-perishable goods, many families participating in TANF struggle each month to meet all of their basic needs. The Florida Legislature should revisit TANF benefit levels through the lens of disaster recovery. Until lawmakers raise TANF benefits, thousands of Floridians will be unable to take adequate precautions against the spread of coronavirus, or in the wake of any other disaster.
  • Create special coronavirus programs. The State of Florida should create COVID-19-specific programs for relief.  Florida has about $16 million in unspent TANF funds as of 2019. With bars and restaurants shutting or cutting hours, rank-and-file hospitality workers need innovative relief based on their unique circumstances. In newly created programs, Florida has the flexibility to waive asset tests and impose broad income guidelines, such as serving families with income under 200 percent of the federal poverty line.
  • Suspend mandatory work requirements. The TANF program requires that most able-bodied recipients participate in work activities or face sanction (loss of benefits). As with our recommendations for suspension of SNAP E&T, we suggest that DCF suspend mandatory TANF work requirements, at least until social distancing guidelines are relaxed and employers are able to stay open during normal business hours. This will allow families to continue to participate in TANF without interruption and without risking the health of their families or others in their communities.
  • Use phone interviews. We encourage DCF, who already uses telephone interviews for many TANF applicants, to substitute phone interviews across the board for households able and willing to be interviewed by phone. We also suggest that interviews be temporarily waived for families without adequate cell phone data.
  • Suspend all requirements that require in-person interaction. The TANF program imposes many requirements that may entail in-person interaction with staff of state agencies (e.g., child support cooperation).  Until Florida develops the capacity to offer telephone or video certification appointments, we urge the state to impose a moratorium on such activities in order to comply with federal social distancing guidelines as well as to protect families, staff, and the communities in which they live from spreading coronavirus.
  • Expand good cause for COVID-19-related noncooperation with child support. The TANF program requires that caregivers cooperate with child support enforcement as a condition of receiving assistance unless good cause exists.  The State of Florida should expand the definition of good cause to specify that noncooperation due to the impact of coronavirus constitutes good cause.
  • Impose a moratorium on Learnfare. In Florida, parents must attend a school conference each semester in order to continue to get assistance. In light of school closures, the state should issue guidance explicitly halting Learnfare requirements during the pandemic.
  • Harness the existing transitional assistance program for the pandemic. Florida’s TANF program provides one-time, short-term assistance for applicants in specified situations who do not need ongoing assistance but have an unexpected emergency that requires immediate assistance. DCF should issue guidance explaining ways in which its existing transitional assistance programs can be used in coronavirus-related circumstances to assist families in need.
  • Place a moratorium on work sanctions. No sanctions for failure to meet TANF work requirements should be imposed during the pandemic under a blanket good cause exemption.
  • Determine financial eligibility based on expected income.  Because so many Floridians have been informed that they will lose jobs or have their hours at work reduced, we urge DCF to determine eligibility based on their expected income.
  • Increase time limits. Ordinarily, adults in Florida can receive TANF assistance for no more than 48 cumulative months, unless they meet the criteria for an exemption due to barriers and limited employment prospects. This is more stringent than federal law, which allows up to 60 months of assistance. We ask that lawmakers increase the number of months that participants impacted by COVID-19 can receive assistance and urge DCF to redefine criteria to consider COVID-19 barriers.
  • Extend review periods and ease or delay verification of eligibility factors not required by law to be verified.  Currently, DCF requires that families receiving TANF be reviewed at frequent intervals in order to continue to receive assistance. Many families in Florida who are eligible for TANF lose their benefits during these reviews due to red tape even though they are no better off. Because it is more important than ever that struggling families be able to establish eligibility and continue to receive assistance for as long as they are in need, we suggest that DCF extend review periods and also ease or delay verification requirements during the pandemic. 

Reemployment Assistance

Reemployment Assistance (RA) (also referred to as Unemployment Compensation) provides temporary benefits to Floridians who lose their job through no fault of their own.  As businesses shut down or reduce hours, RA will be an important part of the safety net to help workers, families, and communities respond to job loss due to COVID-19. 

  • Address Florida’s low RA recipiency rate. Florida’s RA recipiency rate (percentage of total unemployed receiving benefits) is consistently one of the worst in the country. This signals a system that, in the best of times, is inadequate to take care of workers who lose jobs through no fault of their own. We believe that one of the state’s most important priorities should be to immediately explore ways to make RA accessible to out-of-work Floridians so that, as the pandemic plays out, systems will be in place to accommodate an influx of workers out of jobs.
  • Waive work-search requirements. Florida requires out-of-work applicants for RA to document that they have conducted five work search contacts per week. We urge Florida to waive work search requirements, especially considering the impact of the pandemic on businesses and their ability to operate at capacity. Further, while many qualifying work searches can take place online, not every claimant has access to technology to complete work search remotely. As a result, many claimants will be unable to conduct work search without violating federal guidelines limiting social interaction and putting themselves, their families, and their communities at risk.
  • Waive the waiting period.  In Florida, claimants for RA have a one-week wait period that they must serve out before getting benefits. This requirement should be waived during the COVID-19 pandemic so that assistance for Floridians who have lost jobs due to the pandemic get the immediate assistance they need to keep their families afloat.
  • Expand the definition of “good cause” to include quitting. In Florida’s RA program, persons who quit jobs without good cause are ineligible to collect RA. However, the pandemic will impact the ability of Floridians to work for a variety of reasons that may not strictly be considered good cause. We applaud DEO’s COVID-19 policy defining good cause to include being quarantined by a medical professional or a government agency as well as caring for an immediate family member who is diagnosed with COVID-19. However, the State of Florida should expand the definition of good cause to include those self-quarantined under federal guidelines, quitting work that violates health and safety standards, and quitting work to care for a quarantined family member.

Special Nutrition Program for Women, Infants, and Children (WIC)

WIC is a federally funded program that provides healthy food and one-on-one nutrition counseling not only to pregnant, breastfeeding, and non-breastfeeding postpartum mothers with low income, but also to infants and children under the age of five at nutritional risk.

  • Maximize ability to waive physical presence requirements. Under federal rules, WIC applicants must physically report to the WIC office when they are first certified and at each certification. To accommodate families, states have discretion to adopt certain exemptions, such as for some children of working parents. While Florida has opted to adopt most of the permissible exemptions, it does not exempt children of working parents. During the pandemic, Florida should exercise its discretion to limit physical presence requirements to the maximum extent allowed by law.
  • Maximize flexibility in food choice and minimum stocking requirements. Florida’s WIC program should allow shoppers in stores with reduced stock to make substitutions for missing items.
  • Obtain waiver to allow WIC participants to spend their next month’s benefits early. Allowing participants early access to benefits is a safeguard against the real possibility of grocery stores running out of food or a WIC participant being unexpectedly quarantined. 
  • Seek a waiver to extend certification periods. Until WIC develops the capacity to offer telephone or video certification appointments, we urge Florida to keep issuing benefits under extended certification periods. 

Medicaid/KidCare

Medicaid and KidCare provide vital health care coverage to more than 4 million Floridians. We appreciate the steps the state has already taken through its section 1135 waiver to give providers more flexibility to meet the COVID-19 testing and treatment needs of their patients. However, there are numerous additional flexibilities provided under federal law that are essential for extending coverage to more people, making it easier for people to enroll and stay enrolled and get the care they need. Moreover, since Florida's 1135 waiver was granted, Congress has passed the Families First Coronavirus Response Act, which will require immediate state policy changes, such as the cessation of Medicaid terminations. 

  • Ensure access to COVID-19 evaluation, testing and treatment for all. This should be provided at no cost, regardless of insurance or immigration status. This is key to protecting the overall public health of our state and country.
  • Expand Medicaid coverage for adults with income up to 138% of poverty. More than 800,000 low income uninsured Floridians are currently excluded from Medicaid coverage. In addition, thousands of Floridians with low income are losing jobs and employer-sponsored health coverage at the very moment when access to health care is critical for themselves and their families.
  • Immediately enroll applicants who are eligible based on the information they provide on their applications.  Needed verification can be obtained after enrollment.  
  • Maximize the use of presumptive eligibility by allowing additional "qualified entities" such as social services agencies to temporarily enroll clients when they seek assistance.
  • Verify income through electronic data sources whenever possible. If electronic data aren't reasonably compatible with the information the applicant provides, accept a reasonable explanation (e.g., the employer closed due to the public health emergency).
  • For income that cannot be verified electronically, accept an applicant's information on a case-by-case basis.  Obtaining or submitting documents will be difficult for applicants due to employer and other office closures.
  • Suspend Medicaid/KidCare eligibility terminations and renewals for all beneficiaries until the threat of the epidemic has passed. During this time, the State of Florida should minimize the burden on beneficiaries and keep people covered.
  • Suspend periodic eligibility checks. This should include quarterly wage checks. The state should also avoid acting on mid-year checks, to reduce extra paperwork for beneficiaries and state workers and prevent potential termination of coverage for people who remain eligible. Many people who had jobs may no longer have them or may be working reduced hours.
  • Restore retroactive Medicaid eligibility for seniors, persons with disabilities and non-pregnant adults. Without this coverage people suddenly becoming gravely ill due to COVID-19 face enormous medical debt and possible bankruptcy. The increased federal match under the federal disaster package will more than cover the cost.  
  • Temporarily increase provider payments for Medicaid patients in long-term care. For patients in nursing facilities and other institutional settings or for those receiving home and community- based care increased payments can help to provide enhanced care, including additional nursing assistance to deal with intensive patient needs.
  • Ensure that if/when a vaccine becomes available, coverage is required for all eligible children under Medicaid’s early and periodic screening, diagnosis, and treatment benefit, as well as for all Medicaid-enrolled adults.

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The following organizations support the recommendations listed above:

Florida Policy Institute

Alianza for Progress

Allegany Franciscan Ministries

Alliance for Public Schools

Broward for Progress

Catalyst Miami

Catholic Charities of Central Florida

Central Florida Jobs with Justice

Community Justice Project

Dream Defenders

Faith in Public Life

Farmworker's Self-Help

Florida Center for Fiscal and Economic Policy

Florida Children's Council

Florida Health Justice Project

Florida Impact to End Hunger

Florida Institute for Health Innovation

Florida Parent Teacher Association (PTA)

Florida Voices for Health

Florida’s Children First

Hubbell Farms

Huddle in the Harbor, Inc.

Ju’Coby Pittman-White Harvest Farm at Clara White

League of Women Voters of Florida

LULAC Florida

Lupus and Allied Diseases Association, Inc.

Miami Workers Center

Miami-Dade County Commissioner, District 8

Miami Freedom Project

National Association of Social Workers - Florida

National Lawyers Guild, South Florida Chapter

New Florida Majority

North Florida Educational Development Corporation

Opportunity For All Floridians

Organize Florida

ParentsTogether

Pinellas Juvenile Welfare Board

Progress Florida Education Institute

QLatinx

Second Harvest Food Bank of Central Florida

Slow Food First Coast

SPLC Action Fund

The Common Ground Project

Treasure Coast Food Bank

United Way of Broward County

USF Florida Covering Kids and Families



Re-employment Assistance (RA)

American Rescue Plan Act Changes. The American Rescue Plan Act of 2021 extended PEUC and PUA benefits through the week ending September 6, 2021. It also increased the maximum duration of PEUC benefits ($300 a week) to 53 weeks and the maximum duration of PUA to 79 weeks. Although PEUC and PUA did not end until September 6, 2021, Florida withdrew from the Federal Pandemic Unemployment Compensation Program (FPUC) effective June 26, 2021. FPUC provided persons who were out of work due to COVID-19 with an additional $300 a week in unemployment insurance.

Reemployment Assistance weeks reverted to 12 effective January 1, 2022. DEO determines the maximum number of weeks available to RA claimants based on a statutory formula that looks at the average unemployment rate for the most recent third calendar year quarter (i.e., July, August, and September). Based on the downturn in unemployment, the maximum number of weeks for RA reverted to 12 effective January 1, 2022.

RA work-search and work registration requirements reinstated on May 30, 2021. Persons filing an application for RA benefits beginning March 15, 2020, are not required to complete work registration in Employ Florida through May 29, 2021. In addition, work search requirements for individuals requesting benefits for the weeks beginning March 15, 2020, were also reinstated on May 30, 2021.

RA biweekly reporting requirements reinstated. Although previously waived, biweekly reporting was reinstated effective May 10, 2020. DEO’s guide to claiming weeks is here.

Mobile app deployed. DEO has deployed a mobile app for RA applications.

‍DEO announces extended benefits. DEO announced implementation of Extended Benefits (EB).

Resources and guidance. For a list of resources and guidance from the United States Department of Labor on unemployment insurance and COVID-19, go here.

For DEO’s “Reemployment Assistance Frequently Asked Questions and Additional Resources,” updated 12/30/2020, go here.

For DEO’s latest claims data, go here.

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Department of Children and Families (DCF) Multi-Program Policies

DCF opens offices. DCF has reopened its brick-and-mortar storefronts, which were previously closed  due to coronavirus.

DCF adds call center numbers. DCF has added a call center number for Monday through Friday, from 7 a.m. to 6 p.m. Call center numbers now include 850-300-4323, 866-762-2237, or TTY 1-800-955-8771.

Certification periods extended by 6 months only through August 2020. Certification periods for cash, food and medical assistance were extended by 6 months for individuals and families scheduled to recertify in April through August  2020. FNS’ approval of the SNAP extension for August is here.  However, effective September 1, 2020, SNAP, TANF and Medicaid recertifications have been reinstated, although DCF says that no one will lose Medicaid due to recertification.

‍DCF allows phone interviews. Phone interviews are now being used for TANF cash and SNAP food assistance.

Mandatory work requirements suspended only through May 2021. Under a directive from Governor DeSantis to waive work requirements for safety net programs, DCF  waived work requirements for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) through May 2021. To do this, DCF explains that it partnered with the Department of Economic Opportunity to apply “good cause” statewide for TANF and SNAP recipients who would otherwise be subject to participation in mandatory work requirements as a condition of receiving those benefits. Through May 2021, persons who were sanctioned in the past due to work requirements will be able to reapply and participate in SNAP or TANF again.
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Work requirements were reinstated effective June 1, 2021.

Supplemental Nutrition Assistance Program (SNAP)

Emergency allotments (EA) ended. DCF automatically supplemented SNAP allotments of current recipients up to the maximum for a household’s size for July 2021. However, EA was discontinued beginning August 1, 2021.

The SNAP benefits increase by 15 percent ended in October 2021. Floridians who participate in SNAP to put food on the table will receive a temporary 15 percent supplement to SNAP under COVID relief passed by Congress and extended by the American Rescue Plan Act through September 2021.

FNS permanently increases SNAP through revamp of the Thrifty Food Plan. Effective October 2021, FNS has mandated a permanent increase to SNAP through a revamp of the Thrifty Food Plan. DCF says that the increase amounts to about 6% for Floridians.

Time limits suspended. SNAP time limits are suspended during the COVID-19 public health emergency. No one in Florida should be barred from SNAP due to time limits, even if they exhausted their time limit in the past.

Florida granted waiver to allow families to purchase groceries online. DCF has been granted a federal waiver to permit the State of Florida to launch a pilot project statewide effective April 21, 2020, that allows families to purchase groceries online with their Electronic Benefit Transfer (EBT) card instead of going into stores.

  • At present, participating retailers are Walmart, Amazon, Aldi, BJ’s Wholesale Club, and Publix. DCF cautions, however, that EBT cards cannot be used for delivery fees.

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Medicaid

No Medicaid terminations from March 2020 through the end of the federal public health emergency. The national public health emergency has existed since January 27, 2020 and has been renewed by the Secretary of the U.S. Department of Health & Human Services in 90-day increments since that time. The most recent renewal is effective January 16, 2022.

On March 31, 2020, AHCA alerted providers and DCF posted on the ACCESS website that:

  • No Medicaid recipient will lose Medicaid eligibility during the COVID-19 public health emergency (unless the individual is no longer a state resident or request voluntary termination); under the newly enacted Families First Coronavirus Response Act, a state is prohibited from ending coverage for recipients enrolled as of March 18th for the duration of the public health emergency if the state opts to obtain an enhanced federal Medicaid match.
  • AHCA is working to notify recipients who may have received a termination notice in the month of March that their benefits will be reinstated.
  • An FAQ released by federal CMS provides some examples of Medicaid eligibility groups  protected under these "no termination" requirements including: former foster care youth aging out when they turn 26; youth aging out of children's eligibility when they turn 19; individuals who become ineligible for SSI; individuals no longer qualifying for Qualified Medicare Benefits (QMB). In a May 5, 2020 update, CMS states that this “no termination” requirement also applies to medically needy individuals determined eligible during the public health emergency even if they do not continue to meet their monthly share of cost in subsequent months. This protection extends through the last day of the month the public health emergency ends.  
  • On October 28, 2020, federal CMS issued a new interim final rule weakening the continuous coverage, “no termination” requirement. In states like Florida that have opted to cover full benefits for lawfully residing children in the first 5 years after entry into the United States, once they turn 18, states are now required to limit their coverage to emergency services.  In addition, states are now permitted to reduce optional benefits such as dental coverage or increase cost-sharing such as requiring nursing home residents to contribute more to their costs of care. But in Florida this type of change would require the Legislature to amend state Medicaid law.  

Redetermination/recertification times are reinstated. As of October 1, 2020 AHCA's website is alerting recipients that the Department of Children and Families is now mailing letters for case reviews to check if a household is still eligible for Medicaid and/or Medically Needy. AHCA is urging people receiving these letters to take steps now to re-apply. But note, Medicaid coverage will not end during the COVID-19 Public Health Emergency. In January 2021 DCF conducted one-year “automated renewals” for people whose sole income is social security and SSI and are enrolled in an SSI-related Medicaid program (e.g., MEDS/AD,  Medically Needy and Medicare Savings Programs). People getting VA income were not included in the automated renewal.

Extended application time. Effective with applications filed in February 2020, the time for submitting documentation required to process an application is extended for 120 days from the date of the application and eligibility will still be effective the first day of the month the application was received. Effective July 1, 2021, this policy has been rescinded. Medicaid applications submitted on or after July 1, 2021 may be denied on the 30th day after application or the day after verification information is due. Applications filed prior to July 1, will be allowed 120 days to provide requested verification to establish Medicaid eligibility.

‍Exclusion of additional unemployment payments in determining eligibility. The $600/week of additional unemployment insurance payments under the CARES Act will not be counted as income in determining Medicaid eligibility. (However, these payments will be counted as income in determining marketplace subsidy calculations.)

Coverage of Medicaid services during the state of emergency

  • Coverage of all medically necessary services to COVID-19 testing and treatment.
  • Waiver of limits on services that must be exceeded to maintain the health and safety of recipients diagnosed with COVID-19 or when necessary to maintain a recipient safely in their home
  • Waiver of prior authorization requirements for hospital, physician, advanced practice registered nursing, physician assistant, home health services and durable medical equipment and supplies. As of June 19, 2020, AHCA reinstated prior authorization requirements for all of these services.
  • Waiver of copayments for all services
  • Waiver of limits on early prescription refills, except for controlled substances
  • Coverage of a 90-day supply of maintenance prescriptions when available at the pharmacy
  • Reimbursement of out-of-state providers providing medically necessary services to Florida Medicaid beneficiaries. As of July 1, 2021, the availability of provider “provisional enrollment” for in-state and out-of-state providers will end.
  • Delay of fair hearings only in those instances when the recipient is continuing to receive services pending the outcome of the hearing

COVID-19 Vaccines for Medicaid Enrollees. In an executive order published March 16, 2021 Governor DeSantis revised the vaccine distribution plan, which applies to the general public including Medicaid enrollees, to lower the age requirement to 40 effective March 29, 2021 and then effective April 5, 2021 all Floridians are eligible to receive any COVID-19 vaccination approved by the Food and Drug Administration.

Medicaid enrollees eligible to receive the vaccine may visit myvaccine.fl.gov to find a location distributing the vaccine and to schedule an appointment.

On March 12, 2021, AHCA published instructions for Medicaid enrollees on how to obtain Medicaid transportation once they have scheduled an appointment for a vaccine. AHCA states: "Florida Medicaid will take you to get the COVID-19 vaccine at no cost. All you need to do is set up a time to get your vaccine. Next, let your Medicaid plan know you need a ride and they will take care of the rest. If you are not enrolled in a plan, call the Medicaid Helpline at 1-877-254-1055 to find out the name and phone number for a transportation service."

The state has also recently launched a new email system to help bring COVID-19 vaccines to homebound seniors. Seniors will be able to sign up to have the vaccine come to them by emailing a request to HomeboundVaccine@em.myflorida.com.

AHCA has posted Medicaid Alerts and FAQs providing more detail on Medicaid service changes in response to COVID-19. They address a wide range of topics including, but not limited to: telemedicine guidance for medical, behavioral health, and early intervention services providers; long-term care provider network flexibilities allowing more types of providers to deliver specified long term care services; and continuity of care for adult day care center enrollees during the time these centers are closed.

AHCA is loosening coverage restrictions for behavioral health services. Effective May 5, 2020, all prior authorization requirements for mental health or substance use disorder treatment are waived and service limitations (frequency and duration) are lifted. For behavioral analysis services, current authorizations will be extended through an "administrative approval process" which does not require providers to reassess beneficiaries currently getting services. Effective July 1, 2021 service limits will be reinstated for behavioral health services and effective July 15, 2021 Medicaid prior authorization requirements will be reinstated for behavioral health services.

Per a May 29, 2020 provider alert, during the state of emergency AHCA will be reimbursing providers for telemedicine well-child visits provided to children older than 24 months through age 20. Providers are directed to actively work to schedule follow-up in-person visits to administer immunizations and other physical components of the exam which cannot be accomplished through telemedicine.  

The public charge rule will not be applied to immigrants’ use of Medicaid benefits for COVID-19 testing and treatment.

Coverage of home and community-based waiver services (HCBS) - In response to the public emergency, Florida obtained approval from the federal government to make changes in HCBS waiver programs, including the Long Term Care and Developmental Disabilities programs. The changes are effective retroactively from January 27, 2020 to January 26, 2021. Details can be found here. They include, but are not limited to:

  • permitting virtual evaluations, assessments and care planning meetings in lieu of face to face meetings and use of electronic signatures;
  • lifting service limits in order to address health and welfare issues of enrollees;
  • adjusting service prior authorization requirements;
  • temporarily expanding the settings where services can be provided;  
  • allowing payments for support services provided to enrollees in hospital or short- term institutional settings; and
  • prohibiting visitors in certain residential settings to minimize the spread of infection.

Note on COVID-19 testing, treatment, and vaccines for the uninsured. Florida has not opted to receive 100 percent federal Medicaid funding for COVID-19 testing of people without health insurance. Under the 2021 American Rescue Plan Act this option has been expanded to cover COVID-19 treatment and vaccines for the uninsured as well. Since the state has not taken up this option Floridians must look to an uneven patchwork of free testing, treatment, and vaccine resources scattered around the state. AHCA advises that uninsured people may receive free testing from their county health department or a federally qualified health center and that “many communities provide testing for free for individuals who do not have insurance. Please [click here] to find a test site in your area. Uninsured individuals should ask before the test whether testing is free of charge." There are no state agency instructions on where uninsured people can receive free treatment. However, more information on possible sources for free treatment is available here.

Residency proof no longer required at some vaccine sites, “paving the way for migrants.” - On April 29, 2021 Surgeon General Rivkees issued a new public health advisory specifying that COVID-19 vaccines are available to “a Florida resident” or someone “who is present in Florida for the purpose of providing goods or services for the benefits of residents and visitors of the State of Florida.” This new policy applies to all state-run and federally supported vaccination sites. It rescinds an advisory issued in January that had restricted vaccinations to people who could show proof of Florida residency

2021 unemployment compensation claimants can access free or reduced cost health insurance through the ACA marketplace. The Affordable Care Act (ACA) Marketplace was re-opened in February 2021 to give people who need health insurance a new “special enrollment" opportunity to get covered. The 2021 American Rescue Plan eliminated or vastly reduced premiums for many people with low or moderate incomes.

Starting July 1, 2021, people who received or have been approved for unemployment compensation for any week beginning in 2021 can access free or reduced cost comprehensive health insurance plans through the ACA marketplace. This benefit is available regardless of someone's current income. To get this benefit, people must enroll in the marketplace no later than August 15, 2021. For help with enrollment, contact Covering Florida at 877-813-9115.

Child Nutrition Programs

School children in distance learning still eligible for free or reduced cost meals. Students in distance learning for  2020-21 can still receive school meals through the National School Lunch Program if they are eligible. The student or parent/guardian may pick up meals at the school but should contact their school for more information.

For a list of current child nutrition program waivers for Florida from USDA, go here.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Congress allows increased fruit and vegetable benefits. At present, WIC provides $9 for children and $11 for women monthly for fruits and vegetables. The American Rescue Plan Act makes funding available for a four-month increase in the benefit of up to $35 monthly, if a state chooses to do so.

DOH attains waiver allowing remote issuance: Department of Health (DOH) obtained a waiver of the requirement that participants pick up their EBT cards in person at recertification or during nutritional education appointments.

‍WIC participants allowed to substitute certain food. Under a waiver from USDA, WIC participants in Florida are allowed to substitute milk of any available fat content and whole wheat or whole grain bread in package sizes up to 24 oz. when 16 oz. packages are unavailable.

‍USDA waived physical presence requirements: Although the scope and logistics are unclear at this time, USDA has given DOH permission to waive the requirement that persons be physically present at each certification or recertification determination in order to determine eligibility under the program through May 31, 2020.

USDA extends certification periods through May 31, 2020, for some participants.

For a list of current WIC waivers for Florida from USDA, go here.


Temporary Assistance for Needy Families (TANF)

HHS provides guidance. HHS has issued guidance on the flexibilities in TANF to respond to COVID-19.

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