30651726, 64DER26-5 - Florida Administrative Rules, Law, Code, Register

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Notice: 30651726

Notice of Emergency Rule

Department:

DEPARTMENT OF HEALTH

Division:

Division of Disease Control

Overview

RULE:

64DER26-5

Eligibility and Documentation Requirements (Superseded by 64DER26-8)

SPECIFIC REASONS FOR FINDING AN IMMEDIATE DANGER TO THE PUBLIC HEALTH, SAFETY OR WELFARE:

The Ryan White Grant program is a voluntary federal program that issues grant monies to states for HIV/AIDS prevention and treatment.  There is no state statute compelling the Department to participate in that grant program nor is there any federal requirement that the Department participate.  The Department has, however, applied for the grant as part of the Department’s broad authority to implement programs and policies that provide for the prevention and control of communicable diseases.  See § 381.0011, Fla. Stat.  Specifically, the Department has broad authority and discretion to determine which programs, if any, to implement (and the contours of those programs) for the prevention and control of human immunodeficiency virus infection and acquired immune deficiency syndrome. See § 381.003, Fla. Stat.  
That authority and discretion have been exercised, in part, by applying for and administering a federal grant program to provide certain medications to low-income individuals with HIV/AIDS.  The program, as implemented by the Department includes, among other things, direct dispense medication and the payment of insurance premiums for full healthcare coverage (not just limited to medication) to certain individuals who qualify under the Department’s program parameters.  The health insurance has been acquired and provided through the Affordable Care Act (ACA) marketplace exchange.   
The federal government implemented enhanced subsidies in 2021 that helped maintain ACA insurance premiums at a certain level.  The federal government ended those enhanced subsidies for ACA insurance premiums in 2025.  As a result, ACA insurance costs have increased by almost double.  Concurrently, the federal government has not increased Ryan White Grant funding to offset the ACA insurance cost increases. 
The Department is allotted a finite sum of money under the Ryan White Grant and a much smaller amount of state dollars is allocated yearly by the legislature for this program.  Under the program eligibility and program parameters as they existed under Chapter 64D-4, Florida Administrative Code, the Department would not have sufficient funds through the 2026 calendar year, such that it could have to terminate all services to all eligible persons.  Approximately 32,000 persons with HIV/AIDS could lose access to some or all medications as a result.  
As a result, the Department initiated rulemaking to amend its rules and also adopted Emergency Rules 64DER26-1, 64DER26-2, and 64DER26-3 (Emergency Rules), after concluding that the exhausting of funds would create an immediate danger to the public health, safety, or welfare because without any continued medication, the viral loads in 32,000 infected persons could elevate and could facilitate transmission of HIV within the state.  Accordingly, the Department attempted by emergency rule to mitigate that situation and ensure the greatest number of people can receive some direct dispense medication within the constraints of available funding, which is the baseline federal requirement under the grant. 
In anticipation of the allocation of additional funding on or before April 1, this emergency rule adjusts program requirements to serve the greatest number of persons within budgetary limitations.

REASON FOR CONCLUDING THAT THE PROCEDURE IS FAIR UNDER THE CIRCUMSTANCES:

The program parameters are set by existing rules.  The federal enhanced subsidies for ACA insurance ended late 2025.  The Department is engaged in non-emergency rulemaking procedures to ensure public participation in the rulemaking process.  Due to the rapidly evolving nature of the status of the program and in order to be able to serve the greatest number of people, there is no other feasible mechanism under the Administrative Procedure Act to revise the existing program parameters other than an emergency rule that modifies existing rules and supersedes Emergency Rule 64DER26-2.

SUMMARY:

These updates will clarify eligibility and documentation requirements for individuals who wish to apply for assistance from HIV/AIDS Patient Care Programs and the HOPWA Program and includes updates to the application. It will also provide that an individual may confirm eligibility up to 45 days prior to expiration of their Notice to Eligibility to avoid a lapse in eligibility.

THE PERSON TO BE CONTACTED REGARDING THE EMERGENCY RULE IS:

Amber Pepe at amber.pepe@flhealth.gov or (850)901-6953.

PRINT PUBLISH DATE:

3/16/2026 Vol. 52/51

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=64DER26-5&PDate=3/16/2026&Section=4

REFERENCE MATERIALS:

Ref-06962 DH 150-884

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