64D-4.002. Definitions

For the purpose of this chapter, the words and phrases below are defined as follows:

(1) “ADAP Approved Plans” – insurance plans that will, at minimum, include pharmaceutical benefits for HIV antiretroviral medications; have at least one drug from each class of core antiretroviral; and are assessed for cost effectiveness. Cost effective is defined as the aggregate cost of paying for the health insurance option versus paying for the full cost for medications.

(2) “Federal Poverty Level” – the poverty income guidelines (effective January 2022) as published by the U.S. Department of Health and Human Services, which is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-14755.

(3) “Household Income” – income from all sources received by the applicant, the applicant’s spouse (if married), anyone who lives with the applicant who the applicant can claim as a dependent on their taxes, and anyone who lives with the applicant and claims the applicant as a dependent on their taxes.

(4) “Household Size” – the number of persons in an applicant’s household, which includes the applicant, the applicant’s spouse (if married), all persons the applicant could claim as dependents on their taxes, and anyone living with the applicant who could claim the applicant as a dependent on their taxes.

(5) “HIV/AIDS Patient Care Programs:”

(a) Ryan White Part B Consortia Program, a program authorized by 42 U.S.C. §300ff-23, that assesses the service needs of persons living with HIV/AIDS in an area that received Ryan White Part B funding, and secures providers to deliver the needed core medical and support services based on available funding;

(b) Ryan White Part B AIDS Drug Assistance Program, a program that provides medications to uninsured or underinsured individuals living with HIV/AIDS disease, authorized under 42 U.S.C. §300ff-26. Services are provided through the distribution of medications directly to eligible clients or by the purchase of health insurance that includes coverage for HIV/AIDS medications;

(c) ADAP Premium Plus Insurance Program, a component of ADAP designed to assist eligible clients, as defined in rule 64D-4.007, F.A.C., who have insurance and need assistance with premiums, copays, and/or deductibles;

(d) State Housing Opportunities for Persons with AIDS (HOPWA) Program, as defined by 24 C.F.R. Part 574 (04/01/13), a housing program, funded by the U.S. Department of Housing and Urban Development and administered by the state, that is intended to prevent the condition of homelessness from occurring to individuals or families living with HIV/AIDS; or if already homeless, to transition the individuals or families back into stable housing as soon as possible, as well as to create a strategy for long-term housing stability for persons living with HIV/AIDS. The program funds short-term rent, mortgage and utility assistance, permanent housing placement, transitional housing, resource identification and case management, and,

(e) HIV/AIDS patient care programs provided by the patient care networks, as defined in rule 64D-2.001, F.A.C., and county health departments as administered by the Florida Department of Health, Bureau of Communicable Diseases.

(6) “Low Income” – adjusted gross household income at or below 400 percent of the Federal Poverty Level. For HOPWA, low income means 80 percent of a county’s median income, as defined by the U.S. Department of Housing and Urban Development, County Income Limits 2022, effective April 18, 2022, which is incorporated by reference and is available at https://www.flrules.org/Gateway/reference.asp?No=Ref-14754.

(7) “Notice of Eligibility” – a document issued by the department, a Ryan White Part A program, or a contractor or subcontractor of either entity, that indicates an applicant/client meets the eligibility requirements to receive allowable Ryan White services, as stated in Rule 64D-4.003, F.A.C., and that lists, at a minimum, the applicant’s/client’s name, address, household size and income, which must meet the definition of low income.

Rulemaking Authority 381.0011(2), 381.003(2) FS. Law Implemented 381.0011, 381.003(1)(b) FS. History–New 1-23-07, Amended 8-31-07, 3-21-08, 10-27-08, 3-30-09, 7-4-16, 5-5-21, 10-12-22.