The proposed rule amendments update and add definitions used in the HIV/AIDS patient care programs, including updating the referenced federal poverty income guidelines and the county median income limits used to define “low ....

 

DEPARTMENT OF HEALTH

Division of Disease Control

RULE NOS.:RULE TITLES:

64D-4.002Definitions

64D-4.003Eligibility and Documentation Requirements

PURPOSE AND EFFECT: The proposed rule amendments update and add definitions used in the HIV/AIDS patient care programs, including updating the referenced federal poverty income guidelines and the county median income limits used to define “low income” for clients applying for HIV/AIDS patient care programs and clarifies the definitions of “household size” and “household income.” This rule change also allows Ryan White HIV/AIDS Program Part B providers to accept a notice of eligibility from a Ryan White HIV/AIDS Program Part A provider as documentation of a client meeting certain eligibility requirements to receive Part B services.

SUMMARY: The rule proposal updates the incorporated federal poverty level guidelines, and the county income limits which are used to determine eligibility HIV/AIDS patient care programs. This information is updated annually by the U.S. Department of Health and Human Services and the U.S. Department of Housing and Urban Development, making revision to this rule necessary. It also updates definitions for household income and size and adds a definition for notice of eligibility. The rule proposal also updates eligibility requirements for Florida’s Ryan White Part B HIV/AIDS programs.

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 not been prepared by the Agency.

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:

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: 381.0011(2), 381.003(2), FS

LAW IMPLEMENTED: 381.011, 381.003(1)(b), FS

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: Amber Pepe at [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64D-4.002 Definitions.

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

(1) No change.

(2) “Federal Poverty Level” – the poverty income guidelines (effective January 2022 2021) 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-XXXX https://www.flrules.org/Gateway/reference.asp?No=Ref-12883.

(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 and other adult persons living in the home, if they are included in the household size as defined in subsection (4), below.

(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. whose income is counted for purposes of determining the Federal Poverty Level. The number counted in household size includes the applicant, the applicant’s spouse (if married), and any adults who live with the applicant and:

(a) Claim the applicant as a dependent on a tax return, or

(b) Have legal custody of the applicant.

(5) No change.

(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, effective April 18, 2022 April 1, 2020, which is incorporated by reference and is available at https://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX https://www.flrules.org/Gateway/reference.asp?No=Ref-12884.

(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, 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,___.

 

64D-4.003 Eligibility and Documentation Requirements.

Only an individual seeking assistance, or their court-appointed representative, legal representative, or legal guardian seeking assistance on their behalf, may apply for services.

An applicant for HIV/AIDS patient care programs is eligible to be linked to services based on a preliminary positive HIV test result from a test approved by the Food and Drug Administration to determine the presence of HIV infection. For this rule, linkage to service is defined as referring the applicant to eligibility determination and counseling services and the scheduling of medical appointments. To receive services from an HIV/AIDS patient care program an applicant:

(1) through (5) No change

(6) Must not be currently institutionalized in a prison, jail, or other entity that is legally required to provide medical care and prescription medications.

(6)(7) Must have their eligibility confirmed recertified every 366 days six month or at shorter intervals if the client’s income or other factors change before the six-month period. The client must report any changes in his/her situation which impacts his/her eligibility status to the eligibility staff no later than 10 days after it is known.

The above items can be satisfied by providing a current Notice of Eligibility from a Ryan White Part A program.

Rulemaking Authority 381.0011(2), 381.003(2) FS. Law Implemented 381.0011, 381.003(1)(b) FS. History–New 1-23-07, Amended 10-27-08, 7-4-16,___.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Brandi Knight, HIV/AIDS Section Administrator

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Joseph A. Ladapo, MD, PhD, State Surgeon General

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: June 16, 2022

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: June 18, 2021