RULE NO.: RULE TITLE:
58A-1.010Program Forms
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 39, No. 38, February 25, 2013 issue of the Florida Administrative Register. The changes are in response to input received at a public hearing held on the proposed rule on March 19, 2013 in Tallahassee, Florida. No additional hearings were requested pursuant to Section 120.54(3)(c)1., F.S. The Department considered the testimony of the parties at the hearings, as well as suggestions made by the Joint Administrative Procedures Committee, and determined that the following changes are appropriate. At the suggestion of the Joint Administrative Procedures Committee, and in response to public input received, DOEA Forms 701A, 701B, 701C, 701S, and 701T were amended to address technical issues, as well as to include a notice on each form explaining the Department’s authority and purpose for collecting social security numbers, in compliance with Section 119.071(5)(a)2.a., Florida Statutes.
Rules 58A-1.010, F.A.C., is amended to read:
58A-1.010 Program Forms.
The following forms shall be used for programs regulated by this chapter. These forms are hereby incorporated by reference, and are available from the Department of Elder Affairs, 4040 Esplanade Avenue, Tallahassee, Florida 32399-7000.
(1) For purposes of assessment:
(a) DOEA Form 701A, Department of Elder Affairs Condensed Assessment, April February 2013.
(b) DOEA Form 701B, Department of Elder Affairs Comprehensive Assessment, April February 2013.
(c) DOEA Form 701C, Department of Elder Affairs Congregate Meals Assessment, April February 2013.
(d) DOEA Form 701S, Department of Elder Affairs Screening Form, April February 2013.
(e) DOEA Form 701T, Department of Elder Affairs Non-Community Placement CARES Mini Assessment, April February 2013.
(2) For purposes of documenting planned services of care, a case management agency must develop a care plan format that includes at least the following information:
(a) Client name and identification number;
(b) Case management agency name and identification number;
(c) Client’s assessed service needs;
(d) Types, units, frequency and duration of planned DOEA and non-DOEA services;
(e) The provider and associated costs of each planned service;
(f) Initiation, revision and termination dates of the care plan;
(g) An acknowledgement that the client or client’s representative is involved in the development of the care plan; and
(h) Client or representative and case manager signatures and date of signatures.
Proposed Effective Date is July 1, 2013.
Rulemaking Authority 430.08, 430.101 FS. Law Implemented 20.41, 430.101, 430.04 FS. History–New 8-20-00, Amended 8-6-01, 9-24-08, 7-1-13.
