65A-2.022. Rights and Responsibilities

(1) Any individual has the right to apply for Optional State Supplementation (OSS) and, if found eligible according to these rules and Section 409.212, F.S., to receive an established monthly payment. Individuals residing in Assisted Living Facilities (ALF) and Adult Family Care Homes (AFCH) are eligible to receive OSS payments to assist with the cost of room and board. Individuals residing in facilities covered by subsection 65A-2.032(7), F.A.C., and within the coverage groups specified in subsections 65A-2.033(1) through (4), F.A.C., are also eligible to receive OSS payments. Additionally, individuals residing in Mental Health Residential Treatment Facilities (MHRTFs) enrolled as qualified Medicaid providers of Assistive Care Services (ACS) with the Agency for Health Care Administration (AHCA) are eligible to receive OSS payments to assist with room and board. Individuals residing in MHRTFs that are not enrolled as qualified Medicaid providers of ACS by AHCA, under subsections 65A-2.033(3) and (4), F.A.C., are eligible for OSS payments that are inclusive of room, board and personal care. The individual’s use of the personal needs allowance is not restricted.

(2) An authorized representative as defined in subsection 65A-1.203(9), F.A.C., may be designated to act on behalf of the individual in any matter pertaining to the individual’s OSS eligibility. Designation may be made by the individual, or a person knowledgeable of the individual’s affairs may be self-designated as the individual’s representative. The authorized representative may be identified on the Appointment of a Designated Representative, CF-ES 2505, 07/2013, http://www.flrules.org/Gateway/reference.asp?No=Ref-03155, incorporated by reference. The following non-English versions of the Appointment of a Designated Representative form are incorporated by reference: CF-ES 2505H (Creole), 07/2013, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-13629, and CF-ES 2505S (Spanish), 07/2013, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-13630.

(3) The individual is responsible for providing all facts necessary to establish initial and continuing eligibility. The individual is also responsible to notify the Department of any changes in circumstances that could affect their eligibility within ten days of the date of the change.

(4) The Department is responsible for determining eligibilty within the required time standard in accordance with subsections 65A-2.023(1) and (2), F.A.C., equitable treatment in accordance with Rules 65A-1.204 and 65A-2.031, F.A.C., and timely notification in accordance with subsection 65A-2.023(2), F.A.C., of any decision regarding an individual’s payment or eligibility status.

(5) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

Rulemaking Authority 409.212(7) FS. Law Implemented 409.212 FS. History–New 1-1-77, Formerly 10C-2.22, 10C-2.022, Amended 12-16-01, 5-14-02, 10-2-13, 10-26-21.