The Department of Health, Brain and Spinal Cord Injury Program is proposing some revisions to the current definitions section that will clarify some statutory terms. In addition, the section on eligibility and services is now in two sections. One ...

DEPARTMENT OF HEALTH
Division of Health Access and Tobacco

Rule No.: RULE TITLE
64I-1.001: Definitions
64I-1.002: Services
64I-1.003: Order of Selection
64I-1.005: Transitional Living Facility (TLF) Service Requirements
PURPOSE AND EFFECT: The Department of Health, Brain and Spinal Cord Injury Program is proposing some revisions to the current definitions section that will clarify some statutory terms. In addition, the section on eligibility and services is now in two sections. One section addresses eligibility, ineligibility and closure, with the majority of the language retained from the previous rule, and some changes to clarify the materials that can be used to open a new case for a person previously served by the program. The other section addresses services, with the prohibitive majority of the language retained for the original rule. Finally, a new section is added to address services provided by transitional living facilities.
SUMMARY: Proposed changes to Rule 64I-1.001, F.A.C., more precisely define “appropriate level of functioning in the community” to clarify this fundamental condition for case closure and confirm that the program does not purchase equipment that requires title. In addition, technical revisions to the rule are proposed to capitalize defined terms and to correct the name of the program. Proposed changes to Rule 64I-1.002, F.A.C., removes current language relating to services and will focus on eligibility for and closure from the Brain and Spinal Cord Injury Program. The proposed changes will assist the program in closing individuals’ cases that should be served by the state vocational rehabilitation program and will assist the program in determining eligibility for individuals who have previously received services from the program. Proposed Rule 64I-1.003, F.A.C., now contains the current language relating to services which define to whom services can be provided by the Department (See current Rule 64I-1.002, F.A.C.). Proposed Rule 64I-1.005, F.A.C., is new and confirms that transitional living facilities serve only those individuals who have sustained a brain or spinal cord injury as defined by Section 381.745, F.S., that transitional living facility services do not include long term care, and that transitional living facilities must obtain accreditation from the Commission on Accreditation of Rehabilitation Facilities prior to providing services.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 381.0011, 400.805 FS.
LAW IMPLEMENTED: 381.75, 381.76, 381.79, 400.805 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: Monday, November 15, 2010, 10:00 a.m.
PLACE: Department of Health, 4025 Esplanade Way, Room 301, Tallahassee, FL 32311
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Suzanne Kelly, Department of Health, Brain and Spinal Cord Injury Program, 4052 Bald Cypress Way, Tallahassee, Florida 32399; telephone: [phone]; Email address: [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Suzanne Kelly, Department of Health, Brain and Spinal Cord Injury Program, 4052 Bald Cypress Way, Tallahassee, Florida 32399; telephone: [phone]; Email address: [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TTD) or 1(800) 955-8770 (Voice).

THE FULL TEXT OF THE PROPOSED RULE IS:

64I-1.001 Definitions.

(1) Definitions for terms used in Sections 381.739-.79, F.S., and Rules 64I-1.001-.003, F.A.C. this rule, consistent with Section 381.745, F.S.

(a) Appropriate Level of Functioning in the Community: Maintaining oneself in a Ccommunity of one’s informed choosing by performing all activities of daily living, independently, or with support, but without the need for Sservices. A particular level of functioning in the Community is not an Appropriate Level of Functioning in the Community if the underlying activities of daily living:

1. Cannot be safely performed in a manner that is consistent with the Eligible Individual’s limitations; or

2. Are not financially supportable for the foreseeable future.

(b) No change.

(c) Legal Resident: An individual person who currently lives in Florida, has the present intent to remain in Florida indefinitely, and has lawful permanent presence in the United States of America.

(d) Medically Stable: The Aapplicant’s mental and physical health are sufficiently stable so that BSCIP can make a determination as to whether the Aapplicant is otherwise eligible for the General Program.

(e) No change.

(f) Reintegration into the Community: Maintaining oneself in a Ccommunity by performing all activities of daily living, independently, or with support, but without the need for Sservices.

(2) Additional definitions for terms used in Rules 64I-1.001-.003, F.A.C., this rule, consistent with Section 381.745, F.S.

(a) Applicant: An individual person requesting determination of eligibility for the General Program.

(b) Community: A location no more restrictive than an assisted living facility licensed under Chapter 429 400, Part III, F.S.

(c) Eligible Individual Person: An individual person determined eligible for the General Program.

(d) Equipment: For purposes of Section 381.79(1)(b), F.S., means personal property not required to be titled under state law and does not include fixtures to real property except as modifications to a residence.

(e)(d) General Program: The program for which eligibility is determined under Section 381.76, F.S.

(f)(e) Glasgow Coma Scale Score (Glasgow): The neurological assessment developed by G. Teasdale and B. Jennett Jennitte in “Assessment of Coma and Impaired Consciousness: A Practical Scale,” Lancet 1974; 22: 81-84. A copy of the Glasgow may be obtained from the Department of Health, Brain and Spinal Cord Injury Prevention Program, 4052 Bald Cypress Way, Bin #C-25, Tallahassee, Florida 32399-1744 and which is incorporated herein by reference.

(g)(f) Rancho Los Amigos Scale, revised (Rancho): A cognitive functioning scale to determine the level or severity of a brain injury based on observations of the patient’s response to external stimuli. Original Scale co-authored by Chris Hagen, Ph.D., Danese Malkmus, M.A., Patricia Durham, M.A., Communication Disorders Service, Rancho Los Amigos Hospital, 1972. Revised 11/15/74 by Danese Malkmus, M.A., and Kathryn Stenderup, O.T.R. Revised scale 1997 by Chris Hagen. A copy of the Rancho may be obtained from the Department of Health, Brain and Spinal Cord Injury Prevention Program, 4052 Bald Cypress Way, Bin #C-25, Tallahassee, Florida 32399-1744 and which is incorporated herein by reference.

(h)(g) Services: Services provided by the General Program.

Rulemaking Specific Authority 381.0011 FS. Law Implemented 381.76 FS. History–New 5-9-05, Amended 10-31-05,________.

 

(Substantial rewording of Rule 64I-1.002 follows. See Florida Administrative Code for present text.)

64I-1.002 Ineligibility, Eligibility and Closure Services.

(1) An Applicant shall be determined ineligible for the General Program if the Applicant:

(a) Is determined eligible for the state vocational rehabilitations program funded under the Rehabilitation Act of 1973, as amended;

(b) Does not require Services to achieve Reintegration into the Community;

(c) Is below Rancho 4 or otherwise is not reasonably expected to achieve Reintegration into the Community through Services; or

(d) Is otherwise categorically ineligible under the statutory criteria.

(2) An Eligible Individual’s case shall be closed if the Eligible Individual is:

(a) Determined eligible for the state vocational rehabilitations program funded under the Rehabilitation Act of 1973, as amended;

(b) At an Appropriate Level of Functioning in the Community; or

(c) Not reasonably expected to return to an Appropriate Level of Functioning in the Community through Services.

(3) Prior closure does not prevent an individual from becoming an Applicant.

(4) Applicants previously closed under paragraph (2)(b) for not more than twelve months prior to again becoming an Applicant shall be:

(a) Presumed to satisfy Sections 381.76(1)(a)-(d), F.S.; and

(b) Presumed to satisfy Section 381.76(1)(e), F.S., if the specific required Services:

1. Are needed to achieve an Appropriate Level of Functioning in the Community;

2. Were not provided previously; and

3. Are not available or in sufficient supply from any other resource.

Rulemaking Specific Authority 381.0011 FS. Law Implemented 381.76 FS. History–New 10-31-05, Amended________

 

64I-1.003 Services.

(1) All Services must be directed specifically to an individual Applicant or Eligible Individual by prior authorization of the General Program.

(2) Services can be delivered for an Applicant only to the extent necessary to determine eligibility for the General Program and for an Eligible Individual only to the extent necessary to achieve subsection 64I-1.002(2), F.A.C. closure.

(3) Services do not include:

(a) Upgrading, replacement or maintenance of a durable medical device;

(b) Funding for consumables (those items for which the very act of using destroys their further use), except in support of Services, and then for no more than twenty four (24) months beginning with the first time such funding is authorized;

(c) Any required by a change in circumstances not directly related to the Applicant or Eligible Individual’s brain or spinal cord injury and capable of repetition throughout their life. Examples of changes in circumstances capable of repetition include moving to another location, obtaining a vehicle or, except in the case of an individual below the age of eighteen, the loss of a caregiver; or

(d) Any requiring approval under federal law, such as human subject research.

Rulemaking Authority 381.0011 FS. Law Implemented 381.79 FS. History–New________.

 

64I-1.005 Transitional Living Facility (TLF) Services.

(1) Services:

(a) No entity can deliver TLF services without complying with this rule and before receiving a TLF license from the Agency for Health Care Administration under Section 400.805, F.S.;

(b) TLF services are solely for persons who have sustained brain or spinal cord injury as defined in Section 381.745(2), F.S.;

(c) TLF services do not include services as an appropriate discharge site;

(d) No entity can deliver services as a TLF except upon obtaining and maintaining Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation for actions taken or intended to be taken under a TLF license. CARF may be reached via: the internet www.carf.org; telephone, [phone] or toll-free [phone]; fax, [phone]; and by mail CARF-CCAC, 1730 Rhode Island Avenue N.W., Suite 209, Washington, DC 20036, USA.

PROPOSED EFFECTIVE DATE: June 1, 2011 for Rule 64I-1.005.

Rulemaking Authority 381.0011, 400.805 FS. Law Implemented 381.75, 400.805 FS. History–New________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Thom DeLilla, Bureau Chief, Brain and Spinal Cord Injury Program
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Ana M. Viamonte Ros, M.D., M.P.H., State Surgeon General
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 4, 2010
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: August 15, 2008, September 26, 2008 and June 26, 2009