The purpose and effect of these new rules is to set forth the process in which claimants may request and receive restitution within a reasonable timeframe for medical injury and/or property damage caused by a resident who ....

 

DEPARTMENT OF CHILDREN AND FAMILIES

Agency for Persons with Disabilities

RULE NOS.:RULE TITLES:

65G-15.001Definitions

65G-15.002Restitution Claims

PURPOSE AND EFFECT: The purpose and effect of these new rules is to set forth the process in which claimants may request and receive restitution within a reasonable timeframe for medical injury and/or property damage caused by a resident who the Agency for Persons with Disabilities ("Agency") is responsible for monitoring while that person is a resident at an Agency state institution or developmental disabilities center. These rules will implement and interpret statutory changes pursuant to chapter 2021-131, Laws of Florida.

SUMMARY: The State Institution Claims Program ("Program") will make restitution to any claimant who suffers property damages and/or direct medical expenses for injuries caused by patients, typically referred to as residents, under the Agency’s supervision at its’ state-run institutions. The Agency’s state-run institutions include Tacachale, Sunland Center, the Developmental Disabilities Defendant Program (“DDDP”), and Pathways. Claimants will complete the claim form, incorporated in 65G-15.002, F.A.C., after which the Agency will provide a timely response and resolution.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has been prepared by the Agency.

The SERC can be summarized by: rulemaking is required under chapter 2012-131, Laws of Florida; rulemaking is necessary to properly implement the State Institution Claims Program; without these rules the Agency would be acting pursuant to an unadopted rule; and given the statutory requirements, the Agency determined the rules do not have an adverse impact on economic growth, private sector job creation or employment, private sector investment, business competitiveness, productivity, or innovation, nor do they increase regulatory costs, including transactional costs, in excess of $200,000 in the aggregate within one year or in excess of $1 million in the aggregate within five years after the implementation of these rules.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A SERC Checklist and SERC were prepared by the Agency to determine the need for legislative ratification. Based on this information at the time of the analysis, summarized above, and pursuant to section 120.541, Florida Statutes, the rules will not require legislative ratification because costs will not be in excess of $1 million in the aggregate within 5 years after the implementation of the rules.

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.

RULEMAKING AUTHORITY: 402.181(3), 393.501(1), F.S.

LAW IMPLEMENTED: 402.181, F.S.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Nathan Koch, Deputy General Counsel, Agency for Persons with Disabilities, 4030 Esplanade Way, Suite 335, Tallahassee, FL 32399, [phone], [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65G-15.001 Definitions

(1) “Agency” means the Agency for Persons with Disabilities.

(2) “Claimant” means any person who submits a restitution claim alleging property damage and/or direct medical expenses for his or her injuries under section 402.181, Florida Statutes.

(3) “Health care” means services, supplies, and equipment that are necessary for the treatment of an injury to a person’s body.

(4) “Incident” means the same or similar event or occurrence in time.

(5) “Resident” means any individual of any developmental disability center or state institution under the supervision of the Agency, while such individual is living and receiving services at the center or institution. This includes Tacachale, Sunland Center, the Developmental Disabilities Defendant Program (“DDDP”), and Pathways.

(6) “Preponderance of the evidence” means the party bearing the burden of proof must present evidence which shows that the fact to be proven is more probable than not.

(7) “Repair cost” means the cost of services to restore a damaged asset to a condition that is as useful or productive as the asset was before the damage.

(8) “Replacement cost” means the cost of acquiring an asset that is of comparable value as the asset previously held.

(9) “Restitution” means recompense for injury or loss. Restitution includes any taxes, shipping, or other related costs necessary to be made whole.

(10) “Restitution claim” means any reimbursement claim resulting from property damages and/or direct medical expenses for injuries caused by a resident(s) that has not been restored or recompensed by any other source including but not limited to workers’ compensation, casualty and liability insurance, and health insurance.

Rulemaking Authority 402.181(3), 393.501(1), F.S. Law Implemented 402.181, F.S. History–New.

 

65G-15.002 Restitution Claims

(1) A claimant filing a restitution claim under section 402.181, Florida Statutes, has the burden to prove by a preponderance of the evidence:

(a) that the action(s) of a resident(s) is the direct cause of claimant’s property damages and/or direct medical expenses for injuries; and

(b) the monetary amounts of the claimant’s damages and/or expenses.

(2) Only one restitution claim can be submitted per claimant per incident.

(3) The maximum restitution amount per restitution claim may not exceed $1,000.00.

(4) Restitution claims must be submitted to the Agency using the State Institution Claims Program Form (“Claims Form”), APD Form 65G-15.002 A, effective _________, incorporated here by reference and available at _________.

(a) A complete Claims Form must be received by the Agency, in accordance with the instructions on the form, within 90 calendar days from the date of the incident that caused the property damage and/or medical injury.

(b) Any restitution claim received after 90 days of the incident must be denied.

(c) The Agency must adjudicate a restitution claim within 60 calendar days of receipt. The 60 days is tolled:

1. For 21 calendar days from the date the Agency issues a request for additional information to the claimant or claimant’s legal representative. If the Agency has not received the additional information within the 21 calendar days, the Agency will make a determination on the claim based solely upon the information available at that time.

2. Whenever a claimant makes a claim for restitution or compensation for the same incident which is not pursuant to section 402.181, Florida Statutes, for the period of time until such claim is resolved; the time for appeal, if any, has expired; and the Agency receives notice thereof from the claimant or the legal representative.

Rulemaking Authority 402.181(3), 393.501(1), F.S. Law Implemented 402.181, F.S. History–New.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Tom Rice

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Barbara Palmer

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: January 25, 2022

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: 10/28/2021