12-001168MPI Agency For Health Care Administration vs. Matanzas Group Home Status: Closed Recommended Order on Monday, December 3, 2012.

Summary: Petitioner proved, by clear and convincing evidence, that Respondent committed all violations alleged in Sanction Letter. Recommend fine of $7,000.00

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Petitioner, )

)

vs. ) Case No. 12 - 1168MPI

)

MATANZAS GROUP HOME, )

)

Respondent. )

)

RECOMMENDED OR DER

Pursuant to notice, a hearing was cond ucted in this case

pursuant to s ections 120.569 and 120.57(1), Florida Statutes

(201 2 ) 1 / , before Cathy M. Sellers , a n Administrative Law Judge of

the Division of Administrative Hearings, on September 24, 201 2 ,

by video t eleconference at sites in Lauderdale Lakes and

Tallahassee, Florida.

APPEARANCES

For Petitioner: Rachic A. Wilson , Esquire

Agency for Health Care Administration

Office of the General Counsel

2727 Mahan Drive, Mail Station 3

Tallahassee, Florida 32399

For Respondent: Laura Quirantes

Matanzas Group Home, Inc.

4801 Southwest 201st Terrace

Southwest Ranches, Florida 33332

STATEMENT OF THE ISSUE S

The issues in this case are : (1) W hether Respondent

violated section 409.913, Florida Statutes, by f ailing to have

documentation evidencing the receipt of current Zero Tolerance

training in three employees ' files; failing to have

document ation showing that one employee has a high school

diploma or equivalent ; failing to have documentation of an

implementation plan in one consumer ' s file; failing to have

documentation of quarterly summaries in one consumer ' s file; and

failing to have writte n policies and procedures addressing the

staff training plan and specifying how pre - service and in -

service activities will be carried out, including HIV/AIDS

training, cardiopulmonary resuscitation training, and all other

training mandated pursuant to sect ion 381.0035 ; and (2) if so,

the penalty that should be imposed.

PRELIMINARY STATEMENT

On February 22, 2011, Petitioner issued a Sanction Letter

charging Respondent with violating section 409.913 by failing to

have certain required documentation in it s employee and consumer

files, and seeking to impose a fine pursuant to Florida

Administrative Code Rule 59G - 9.070. Respondent timely requested

an administrative hearing, and Petitioner referred the

proceeding to the Division of Administrative Hearings fo r

assignment of an Administrative Law Judge and conduct of a

hearing pursuant to sections 120.569 and 120.57(1) to dispute

the allegations in the Sanction Letter .

The final hearing initially was set for June 18 and 19,

2012, but pursuant to Respondent ' s request, the final hearing

was continued until September 10, 2012. Due to a scheduling

conflict, the final hearing was rescheduled until September 24,

2012.

At the final hearing, Petitioner presented the testimony of

Ms. Gina Selwitz and offered Petiti oner ' s Exhibits 1 through 13,

which were admitted into evidence without objection. Respondent

presented the testimony of Amarilys Gomez and Laura Quirantes and

offered Respondent ' s Exhibits 1 through 4, which were admitted

into evidence over objection.

T he one - volume Transcript was filed on October 11, 2012.

Petitioner timely filed its Proposed Recommended Order on

October 22, 2012, and Respondent filed its Proposed Recommended

Order on October 23, 2012; both were duly considered in preparing

this Recom mended Order.

FINDINGS OF FACT

I. The Parties and Medicaid Provider Agreement

1. Petitioner is the state agency responsible for

administering the Florida Medicaid Program 2 / pursuant to chapter

409. Petitioner ' s duties include operating a program to ov ersee

the activities of Medicaid recipients, providers , and their

representatives to ensure that fraudulent and abusive behavior

and neglect of recipients occur to the minimum extent possible,

and to recover overpayments and impose sanctions as appropriate .

§ 409.913(1), Fla. Stat. To that end, Petitioner is authorized

to conduct investigations of Medicaid providers to determine

compliance with the Medicaid program. § 409.913(2), Fla. Stat.

2. At all times relevant to this proceeding, Respondent

was an enrolled Medicaid provider 3 / providing residential

rehabilitation and companion care services to the

developmentally disabled pursuant to a valid Medicaid Provider

Agreement ( " MPA " ) with Petitioner. 4 /

3. The MPA establishes the terms and conditions o f an

enrolled provider ' s participation in the Medicaid program. A

key condition is that the provider agrees to comply with all

federal, state, and local laws, including rules, regulations,

an d statements of policy applicable to the Medicaid program,

inclu ding the Medicaid Handbooks. The Florida Medicaid

Developmental Disabilities Waiver Services Coverage and

Limitations Handbook , dated November 2010 ( " Disabilities

Handbook " ), and the Florida Medicaid Provider General Handbook,

dated July 2008 ( " General Ha ndbook " ), are among the laws and

policies applicable to this proceeding.

II. Petitioner ' s Inspection of Respondent ' s Facility

4 . On September 27, 2011, Ms. Gina Selwitz, an Inspector

Specialist with Petitioner ' s Bureau of Medicaid Program

Integrity ( " MPI " ) , 5 / along with another employee of Respondent ' s

Bureau of MPI and a representative from the United States

Department of Health and Human Services Centers for Medicare and

Medicaid Services, conducted a site inspection at Respondent ' s

facility , to det ermine Respondent ' s compliance with applicable

Medicaid Program requirements . In the course of the inspection,

Ms. Selwitz and the other inspect ion team members review ed

Respondent ' s employee records and recipient files for compliance

with applicable Medi caid program requi rements . They

contemporaneously documented their findings on checklists .

5. While at the facility, Ms. Selwitz hand - delivere d a

demand letter with an attached provider questionnaire form and a

Certification of Completeness form to Res pondent . The letter

stated in pertinent part:

Pursuant to Section 409 .913, Florida

Statutes ( " F.S. " ), this is official notice

that the Agency requests that documentation

for services paid by the Florida Medicaid

program to the above provider number. Th e

Medicaid - related records to substantiate

billing for the recipients identified on the

enclosed printout are due within fifteen

(15) calendar days of our receipt of this

notification. In addition, please complete

the attached questionnaire and submit it

along with the copies of the Medicaid -

related records. Please submit the

documentation and the attached Certification

of Completeness of Records to the Agency

within this timeframe ....

6. Respondent signed a form acknowledgi ng receipt of the

demand let ter . Respondent completed and signed the provider

questionnaire and the Certification of Completeness form and

submitted them, along with the requested records, to Petitioner.

By signing the Certification of Completeness form, Respondent

verified that th e records it provided were true and correct

copies of all requested information. Petitioner received the

records and completed forms on October 4, 2011.

7 . After the inspection was completed, Ms. Selwitz

reviewed the checklists prepared during the in spection and

determined that the following was missing from Respondent's

files: (1) Documentation showing current Zero Tolerance

training missing from employee file s of Respondent ' s employees

L .Q., A.G., and A.H. ; (2) Documentation showing receipt of a

high school diploma missing from the file of L.Q.; (3)

Documentation of an implementation plan in the consumer file for

A.G. - A.; (4) Documentation of quarterly summaries in the

consumer file for L.G.; and (5) Written policies and procedures

addressing t he staff training plan and specifying how pre -

service and in - service activities will be carried out, including

HIV/AIDS training, C.P.R. training, and all other training

mandated pursuant to section 381.0035.

8 . On February 22, 2011, Petitioner sent Re spondent a

Sanction Letter specifically identifying these deficiencies,

stating that the deficiencies constitute violat ions of federal

and state Medicaid laws, and imposing a total fine of $7,000.00 .

III. Findings Regarding Alleged Violations

A. Zero To lerance Training

9 . Ms. Selwitz testified that the inspection of

Respondent's facility revealed that documentation evidencing the

receipt of current Zero Tolerance training was missing from the

employee files for A.G., A.H., and L.Q. Her testimony was

supported by the inspection checklist prepared at the time of

the inspection, indicating that L.Q. ' s and A.H. ' s employee file s

did not contain documentation showing that they had received

Zero Tolerance training, and that the A.G. ' s Zero Tolerance

training had expired. 6 /

10 . At hearing, Respondent conceded that A.G. ' s Zero

Tolerance training had expired .

11. With respect to A.H., at hearing Respondent provided a

document purporting to be an unofficial transcript from

Tallahassee Community College sh owing that Respondent had

completed Zero Tolerance in 2010, so that her training was

current. However, Respondent acknowledged that this

documentation was not in A.H. ' s employee file at the time of

Petitioner ' s inspection.

12. With respect to L.Q., Re spondent claims that

documentation showing her current Zero Tolerance training was ,

in fact, present in her employee file, and that Petitioner ' s

inspection team overlooked the documentation. Respondent noted

that Delmarva 7 / had inspected the facility appr oximately 15 days

before Petitioner ' s inspection, and claimed that Delmarva ' s

report did not show Zero Tolerance documentation deficiencies

for L.Q. ' s file. Respondent argues that this shows that that

the Zero Tolerance documentation was present in L.Q. ' s file when

Petitioner inspected the facility and Petitioner ' s inspection

team simply overlooked it. In support, Respondent provided a

document purported to be the Delmarva inspection report.

1 3 . The persuasive evidence establishes that Respondent

viol ated the requirement to maintain documentation of current

Zero Tolerance Training in the employee files of A.G., A.H., and

L.Q . At hearing, Respondent conceded that A.G. ' s Zero Tolerance

training had expired and that A.H. ' s employee file did not

contain t he required Zero Tolerance Training documentation at

the time Petitioner conducted its inspection. Further, Ms.

Selwitz credibly testified that L.Q. ' s employee file did not

contain the required Zero Tolerance training information, and

her testimony was bu ttressed by the contemporaneously - prepared

inspection checklists . Respondent did not provide persuasive

evidence to the contrary . 8 / Accordingly, it is determined that

Respondent violate Medicaid laws, rules, regulations, and

policies by failing to have Z ero Tolerance training

documentation in the employee files for A.G., A.H., and L.Q.

B. Educational Level Documentation for L.Q.

1 4 . Ms. Selwitz testified that during the inspection, the

team determined that documentation was missing from L.Q. ' s

employee file showing that she possessed the required level

educational training ÏÏ i.e., a high school diploma or

equivalent 9 / ÏÏ to serve as direct care staff providing residential

rehabilitation services. Ms. Selwitz ' s testimony was supported

by the inspection che cklist , which expressly not ed the lack of

high school diploma or general educational development

( " G.E.D. " ) in L.Q. ' s file and that a copy of L.Q. ' s application

for employment with Respondent stated that she had not graduated

from high school.

1 5 . At hearing, L.Q ., a director and employee of

Respondent, testified on behalf of Respondent , and Respondent

offered for admission into evidence a document purported to be

L.Q. ' s application for employment with Respondent . The

application stated that Responden t had graduated from high

school. L.Q testified that this application was completed in

2006 when she started working with Respondent , but subsequently

testified that she graduated from high school in 2008 . Her

testimony was inconsistent with, and undercu t the veracity o f,

the document Respondent offered to show that L.Q. met the

educational training level requirement . Furthermore, even if

L.Q. satisfied the applicable educational training requirements,

Respondent did not provide credible evidence to over come

Petitioner ' s showing that the required documentation showing

that training was not in L.Q. ' s file when Petitioner inspected

Respondent ' s facility. Accordingly, the credible, persuasive

evidence establishes that Respondent violated Medicaid laws,

rule s, regulations, and policies by failing to have

documentation of L.Q. ' s educational status in her employee file.

C. Inclusion of Implementation Plan in Consumer File

1 6 . Ms. Selwitz testified that the inspection also showed

that a current Implementatio n Plan was not included in A.G. - A. ' s

consumer file , and her testimony was supported by the

Residential Rehabilitation Services checklist that Petitioner ' s

team completed at the time of the inspection . Respondent did

not offer any testimony or other eviden ce to the contrary .

Accordingly, Petitioner established that Respondent violated

applicable Medicaid laws , rules, regulations, and policies by

failing to have in its file s a copy of the current

Implementation Plan for consumer A.G. - A.

D. Quarterly Summa ry Documentation in Consumer File

17 . Ms. Selwitz testified that Petitioner ' s inspection

also revealed that Respondent failed to include a quarterly

summar y in L.G. ' s consumer file documenting her progress , and

this testimony was supported by the inspe ction checklists. At

hearing, Respondent conceded this violation. Accordingly,

Petitioner demonstrated that Respondent violated applicable

Medicaid laws , rules, regulations, and policies by failing to

have a quarterly summary in L.G. ' s consumer file.

E. Written Policies and Procedures Addressing Staff Training

18 . At hearing, Respondent conceded that at the time of

the inspection, it f ailed to have written policies and

procedures addressing the staff training plan and specifying how

pre - service and i n - service activities will be carried out,

including HIV/AIDS training, C.P.R. training, and all other

training mandated pursuant to section 381.0035. Accordingly, it

is determined that Respondent violated applicable Medicaid laws ,

rules, regulations, and policies by failing to maintain this

required documentation.

CONCLUSIONS OF LAW

19 . The Division of Administrative Hearings has

jurisdiction over the parties to, and subject matter of, this

proceeding pursuant to sections 120.569, 120.57(1), and

409.913 (31).

2 0 . In this proceeding, Pet itioner alleges that

Respondent, by failing to have specified documentation in its

employee and consumer files, violated federal and state Medicaid

laws, rules, and policies . Petitioner seeks to impose

administrative fin es for these violations. To prevail,

Petitioner must prove the alleged violations by clear and

convincing evidence. Dep ' t of Banking & Fin., Div. of Secs. &

Investor Prot. v. Osborne Stern, Inc. , 670 So. 2d 932, 935 (Fla.

1996); Ferris v. Turlington , 510 So. 2d 292, 294 (Fla. 1987).

Clear and convincing evidence requires that:

the evidence must be found to be credible;

the facts to which the witnesses testify

must be distinctly remembered; the testimony

must be precise and explicit and the

witnesses must be lacking in confusion as to

the facts in issue. The evidence must be of

such weight that it produces in the mind of

the trier of fact a firm belief or

conviction, without hesitancy, as to the

truth of the allegations sought to be

established.

Slomowit z v. Walker , 429 So. 2d 797, 800 (Fla. 4th DCA 1983).

2 1 . Section 409.913(9) provides in pertinent part:

A Medicaid provider shall retain medical,

professional, financial, and business

records pertaining to services and goods

furnished to a Medicaid reci pient and billed

to Medicaid for a period of 5 years after

the date of furnishing such services or

goods. The agency may investigate, review,

or analyze such records, which must be made

available during normal business hours

. . .. The provider is respo nsible for

furnishing to the agency, and keeping the

agency informed of the location of, the

provider ' s Medicaid - related records.

2 2 . Section 409.913(15), in pertinent part, authorizes

Petitioner to seek remedies provided by law if:

(b) The provider has failed to make

available or has refused access to Medicaid -

related records to an auditor, investigator,

or other authorized employee or agent of the

agency, the Attorney General, a state

attorney, or the Federal Government;

(c) The prov ider has not furnished or has

failed to make available such Medicaid -

related records as the agency has found

necessary to determine whether Medicaid

payments are or were due and the amounts

thereof;

* * *

(e) The provider is not in compliance with

p rovisions of Medicaid provider publications

that have been adopted by reference as rules

in the Florida Administrative Code; with

provisions of state or federal laws, rules,

or regulations; with provisions of the

provider agreement between the agency and

t he provider; or with certifications found

on claim forms or on transmittal forms for

electronically submitted claims that are

submitted by the provider or authorized

representative, as such provisions apply to

the Medicaid program.

23 . Section 409.913(1 6)(c) authorizes Petitioner to impose

a fine of up to $5,000 .00 for each violation described in

section 409.913(15).

24 . Florida Administrative Code Rule 59G - 9.070(3)(q)

defines a " violation " as any " omission or act " contrary to the

Medicaid laws. Rule 59G - 9.070(3)(h) defines an " [o]ffense " as

the violations contained in an audit report. Rule 59G -

9.070(7)(e) provides for a fine of $1000 .00 per violation, if a

first offense, for a failure to comply with Medicaid laws.

25 . Florida Administrative Code Rule 59G - 5.020(1 )

incorporates the General Handbook ' s record keeping requirements .

The General Handbook provides in pertinent part:

Medicaid requires that the provider retain

all business records as defined in 59G -

1.010(3), F.A.C., medical - related record s as

defined in 59G - 1.010(154), F.A.C., and

medical records as defined in 59G -

1.010(160), F.A.C., on all services provided

to a Medicaid recipient.

* * *

Right to Review Records

Authorized state and federal agencies and

their authorized representat ives ma y audit

or examine a provider ' s or facility ' s

records. This examination includes all

records the agency finds necessary to

determine whether Medicaid payments amounts

were or are due. This requirement applies

to the provider ' s records for which th e

provider is the custodian. The provider

must give authorized state and federal

agencies and their authorized

representatives access to all Medicaid

patient records and to other information

that cannot be separated from Medicaid -

related records.

* * *

At the time of the request , all records must

be provided regardless of the media format

on which the original records are retained

by the provider. All Medicaid records must

be reproduced onto paper copies.

* * *

Incomplete Records

Providers wh o are not in compliance with the

Medicaid documentation and record retention

policies described in this chapter may be

subject to administrative sanctions and

recoupment of Medicaid payments. Medicaid

payments for services that lack required

documentation or appropriate signatures will

be recouped.

General Handbook, Record Keeping

Requirements, 2 - 55 Î 2 - 57 (emphasis added) .

26. Rule 59G - 1.010(30) defines " business records " in

pertinent part as:

documents related to the administrative or

commercial ac tivities of a provider, as

contrasted with medical or professional

activities. Business records made available

to Medicaid must be dated and legible.

Business records include, as applicable

. . . personnel . . . documents, all

administrative or commerci al records that

are customarily prepared or acquired and are

customarily retained by the provider, and

administrative or commercial records that

are required by statute or rule to be

prepared or acquired and retained by the

provider. Records may be on pap er, magnetic

material, film or other media.

2 7 . Florida Administrative Code Rule 59G - 1.010(154)

defines " Medicaid - related records " as:

records that relate to the provider ' s

business or profession and to a Medicaid

recipient. Medicaid - related records include

records related to non - Medicaid customers,

clients, or patients, to the extent that the

documentation is shown by the department to

be necessary to determine a provider ' s

entitlement to payments under the Medicaid

program.

2 8 . The DD Waiver Ha ndbook, Appendix A, page A - 1, requires

Petitioner and APD to establish performance standards for all

contracted recipient services and service provision quality in

the delivery of contracted Medicaid waiver services. The terms

and conditions by which deve lopmentally disabled services

providers are bound are based, in part, on the Core Assurances.

The DD Waiver Handbook, Appendix A, page A - 10, requires

providers and their employees to receive training in Core

Assurances topics, including Zero Tolerance and HIV/AIDS; to

document this training ; and to keep proof of training on file

and accessible so that it is available for compliance monitoring

and review.

2 9 . The DD Waiver Handbook, Appendix A, page A - 10, section

2.1(H), requires Medicaid direct service p roviders to complete

the APD - developed Zero Tolerance Training course before

providing direct care services, and to complete further training

at least once every three years. Providers and their employees

must receive training in Zero Tolerance, document this training,

and keep proof of training on file and accessible so that it is

available for compliance monitoring and review.

30. The DD Waiver Handbook addresses qualifications

required for residential rehabilitation providers, stating in

pertinent par t:

Direct care staff providing residential

rehabilitation services must be at least 18

years of age and have a high school diploma

or equivalent and one year of experience

working in a medical, psychiatric, nursing

or child care setting or in working with

persons who have a developmental disability.

College, vocational, or technical training

equal to 30 semester hours, 45 quarter

hours, or 720 classroom hours can substitute

for the required experience.

3 1 . The DD Waiver Handbook, as part of its reimbur sement

and monitoring documentation requirements, mandates that

providers maintain copies of individual implementation plans for

consumers and m aintain quarterly summaries documenting consumer

progress .

3 2 . The DD Waiver Handbook , Appendix A, also requi res

providers to train staff in, among other things, cardiopulmonary

resuscitation, infection control techniques, and prevention and

management of HIV/AIDS, and other areas set forth in section

381.0035, and to develop and maintain written procedures and

p olicies that address staff training and specify how staff

training will be carried out. The DD Handbook specifies that

proof of annual or required updated training must be maintained

on file for review.

3 3 . The MPA states in section (5), " Provider

R espo nsibilities, " that the Medicaid provider must: " (b) Keep,

maintain, and make available in a systematic and orderly manner

all medical and Medicaid - related records as AHCA requires for a

period of at least five (5) years. " Additionally, section (3)

of the MPA, entitled " Compliance, " requires Medicaid providers

to comply with local, state, and federal laws, rules,

regulations, and policy statements applicable to the Medicaid

program, including the Medicaid Provider handbooks issued by

Petitioner.

3 4 . For the reasons set forth in the Findings of Fact,

Petitioner demonstrate d , by clear and convincing evidence, that

Respondent violated the foregoing statutes, rules, regulations,

Medicaid Handbook provisions, and MPA provisions . Accordingly,

Petitioner demons trate d , by clear and convincing evidence, that

Respondent violated federal and state Medicaid laws as charged

in the Sanction Letter dated February 22 , 2012.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions

of Law, it is hereby R EC OMMENDED that the Agency for Health Care

Administration enter a Final Order determining that Respondent

violate d federal and state Medicaid laws as charged in the

February 22, 2012 Sanction Letter, and imposing a fine of

$7,000.00.

D ONE AND ENTERED thi s 3rd day of Dec ember , 20 12 , in

Tallahassee, Leon County, Florida.

S

__________________________________

CATHY M. SELLERS

Administrative Law Judge

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399 - 3 060

(850) 488 - 9675

Fax Filing (850) 921 - 6847

www.doah.state.fl.us

Filed with the Clerk of the

Division of Administrative Hearings

this 3rd day of Dec ember , 20 1 2 .

ENDNOTE S

1 / All references are to 2012 Florida Statutes.

2 / The Medicaid Program is the federal - state medical assistance

program authorized by Title XIX of the Federal Social Securi ty

Act, pursuant to which the State of Florida provides medical

goods and services to eligible indigent recipients. See 42

U.S.C. § 1396(a) and 42 C.F.R. Parts 400, 430 - 455 ; see also §§

409.901(13) - (14), Fla. Stat.

3 / Respondent operates its group home u nder AHCA Provider License

No. 230977 and APD Provider License No. 10 - 2619.

4 / To become enrolled as a Medicaid provider for the

developmentally disabled in Florida, a provider applies with

Petitioner and the Agency for Persons with Disabilities ( " APD " ).

Upon approv al for enrollment in the Medicaid program, the

provider enters into the MPA with Petitioner.

5 / MPI is the entity charged with ensuring the integrity of

Florida's Medicaid Program. Among other statutory duties, MPI

oversees the activities of Medicaid providers; conducts reviews,

investigations, and audits of Medicaid providers; and imposes

sanctions on Medicaid providers for Medicaid program violations.

6 / Zero Tolerance training is required to be completed at least

once every three years. See Florida Medicaid Developmental

Disabilities Waiver Services Coverage and Limitations Handbook,

November 2010, Appendix A, section 2.1.

7 / Delmarva is an organization under contract with APD to review

providers that render services to the developmen tally disabled

through the Development Disabilities Waiver Program.

8 / The document purported to be the Delmarva inspection report

was unauthenticated and therefore c ould not be verified as being

a true and accurate copy of that report. Moreover, it is not

relevant to this proceeding because it would only address

documentation in Respondent ' s files on the date Delmarva

conducted its inspection ÏÏ not on the date Petiti oner conducted

its inspection.

9 / See Florida Medicaid Development al Disabilities Waiver

Services Coverage and Limitations Handbook, November 2010, page

1 - 24.

COPIES FURNISHED :

Rachic A. Wilson, Esquire

Agency for Health Care Administ ration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308

Amarilys Gomez

Matanzas Group Home

4801 Southwest 201st Terrace

Southwest Ranches, Florida 33332

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308

Stuart Williams, General Counsel

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308

Elizabeth Dudek, Secretary

Agency for Health Care Administration

Mail Stop 1

2727 Mahan Dr ive

Tallahassee, Florida 32308

N OTICE OF RIGHT TO SU BMIT EXCEPTIONS

All parties have the right to submit written exceptions within

15 days from the date of this Recommended Order. Any exceptions

to this Recommended Order should be filed with the agenc y that

will issue the Final Order in this case.