The purpose and effect of these rule amendments is to clarify language regarding provider terminations, reductions, or suspensions of services to clients by providers and to clarify standards regarding retaliatory conduct.

 

DEPARTMENT OF CHILDREN AND FAMILIES

Agency for Persons with Disabilities

RULE NOS.:RULE TITLES:

65G-3.001Definitions

65G-3.002Criteria for Admissions and Services

65G-3.003Rules for Reduction of Services by the Provider

65G-3.004Rules for Suspension of Services by the Provider

65G-3.005Rules for Termination of Servies by the Provider

65G-3.006Retaliatory Conduct

PURPOSE AND EFFECT: The purpose and effect of these rule amendments is to clarify language regarding provider terminations, reductions, or suspensions of services to clients by providers and to clarify standards regarding retaliatory conduct.

SUBJECT AREA TO BE ADDRESSED: The subject to be addressed includes the provider termination, reduction, or suspension of services to clients and standards regarding retaliatory conduct.

RULEMAKING AUTHORITY: 393.125(2), 393.501(1)

LAW IMPLEMENTED: 393.125(2)

A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: October 10, 2018, 1:00 p.m.

PLACE: Agency for Persons with Disabilities, 4030 Esplanade Way, Room 301, Tallahassee, Florida 32399-0950

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 48 days before the workshop/meeting by contacting: Lisa Kuhlman, Agency for Persons with Disabilities, 4030 Esplanade Way, Tallahassee, Florida 32399-0950, [phone], [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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Lisa Kuhlman, Agency for Persons with Disabilities, 4030 Esplanade Way, Tallahassee, Florida 32399-0950, [phone], [e-mail]

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

 

Substantial rewording of Rule 65G-3.001, F.A.C. follows. See Florida Administrative Code for present text.

65G-3.001  Definitions.

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

(2) “Contract” means a formal written agreement between the provider and Agency and includes Medicaid Waiver Services Agreement.

(3) “Discrimination” means the unjust or prejudicial treatment of different categories of people.

(4) “Individual Representative” is defined in Rule 65G-4.0213(13), F.A.C.

(5) “Provider” means any individual, program, or facility that receives payment for the care, treatment, training, residence or habilitation of persons with developmental disabilities. A provider does not include:

(a) A spouse, family member or guardian with whom a person with developmental disabilities resides;

(b) A provider covered under the provisions of Part VIII of Chapter 400, F.S.; or

(c) Individuals or entities providing services to clients through the CDC+ program pursuant to s. 393._____, F.S. and Chapter 65G-____, F.A.C.

(6) “Reduction” means a decrease in the frequency, duration or intensity in the level of services, initiated by a non-residential provider that is not a result of faded or prescribed reductions that are part of service planning.

(7) “Retaliatory Conduct” means negative action against a client or client’s individual representative motivated by the desire to punish the client or the client’s individual representative.

(8) “Suspension” means an involuntary and temporary break in services in a non-residential program initiated by the provider. Suspension does not mean a break of services to a client by a service provider due to the unavailability of funds to the provider by the Agency.

(9) “Termination” means the involuntary, permanent discharge or discontinuation of services in a  program by the provider when such action is not included as part of the service planning process. Termination does not mean a discontinuation of services to a client by a service provider due to the unavailability of funds to the provider by the Agency.

(10) “Regional Office” means the Agency local office responsible for managing a specific geographical region.

Rulemaking Authority 393.125(2) FS. Law Implemented 393.0651, 393.067, 393.125(2) FS. History–New 12-10-91, Formerly 10F-8.026, 65B-8.026.

 

65G-3.002 Criteria for Admissions and Services.

Rulemaking Authority 393.125(2) FS. Law Implemented 393.125(2) FS. History–New 12-10-91, Formerly 10F-8.028, 65B-8.028,  Repealed ___________.

 

65G-3.003 Rules for Reduction of Services by the Provider.

Rulemaking Authority 393.125(2) FS. Law Implemented 393.125(2) FS. History–New 12-10-91, Formerly 10F-8.029, 65B-8.029,  Repealed ___________.

 

65G-3.004 Rules for Suspension of Services by the Provider.

Rulemaking Authority 393.125(2) FS. Law Implemented 393.125(2), 120 FS. History–New 12-10-91, Amended 5-19-93, Formerly 10F-8.030, 65B-8.030, Repealed __________.

 

Substantial rewording of Rule 65G-3.005, F.A.C. follows. See Florida Administrative Code for present text.

65G-3.005  Rules for Termination, Reduction, or Suspension of Services by the Provider.

(1) TERMINATIONS AND REDUCTIONS

(a) If a provider determines that he or she must terminate or reduce services the provider gives to a client, the Provider shall send written notice of intent to terminate or reduce services to the client and their individual representative, Regional Office, and the Support Coordinator by certified mail.  The provider may not terminate or reduce services until at least thirty calendar days after the receipt of the notification by the client, individual representative, Regional Office, and Support Coordinator. The provider shall send the required notice to the Regional Office and Support Coordinator via electronic mail in addition to the required certified mail.

(b) Upon receipt of the notice from the provider, the Support Coordinator shall:

i. Evaluate the circumstances that led to the proposed termination or reduction,

ii. Determine what actions, if any, should be taken to resolve the situation,

iii. Immediately assist the client or the client’s individual representative in locating an alternate provider if resolution is not acceptable to the client or provider or otherwise not possible, and

iv. Update the client’s support plan, cost plan and relevant service authorizations accordingly. 

(c) At the request of the client or the client’s individual representative, the Support Coordinator shall arrange a meeting with the provider and client or the client’s individual representative, to offer any recommendations to  the client and provider in an effort to resolve the concerns that led to the issuance of the notice of intent to terminate or reduce service.  The meeting must be arranged within 5 calendar days of the client’s or the individual representative’s request for the meeting.

(d)  The Support Coordinator shall contact the Regional Office immediately if the client and the client’s individual representative need assistance in locating an alternate provider at least 25 days prior to the effective date of termination or reduction in services. The Regional Office will assist the client and the client’s individual representative in meeting the client’s needs.

(e) If the termination is for services provided in a licensed residential facility, the Regional Office shall immediately work with the client’s Support Coordinator to assist the client or the client’s individual representative in choosing an alternate place to live.

(f)  If the client or the client’s individual representative selects an individual or entity to render the services who is not qualified to be that client’s provider, the Regional Office shall issue a notice to deny  the client’s selection of provider choice within 30 calendar days of the client’s notification to the Regional Office.  The notice shall identify any alternate providers or service options for the client and include an explanation of the client’s administrative hearing rights pursuant to ss. 393.125, 120.569, and 120.57, F.S.

(2) SUSPENSIONS

(a) Emergency Suspension: A service provider may immediately suspend services provided to a client in a non-residential program when the behavior of the client constitutes an immediate danger to health, safety, or welfare of the client, another recipient of the provider’s services, the provider, or a third party.  If a service provider immediately suspends a client’s services for this reason, the provider shall give written notice of immediate suspension to the client, the client’s individual representative, the client’s Support Coordinator, and Regional Office at the time of the suspension or immediately thereafter, detailing reasons for the suspension. 

(b) Other Suspension: A service provider may immediately suspend services provided to a client in a non-residential program when the client’s behavior interferes with services provided to other recipients of the provider’s services.  If a service provider initiates a suspension for this reason, the service provider shall provide written notice of immediate suspension from a non-residential program to the client, the client’s individual representative, the client’s Support Coordinator, and the Regional Office at the time of the suspension or immeiately thereafter, detailing reasons for the suspension.

1. This type of suspension shall not exceed 3 service days. 

2. If the client is not on the iBudget Waiver pursuant to s. 393.0662, F.S., notification is only required to be given by the provider to the Regional Office, the client or the client’s individual’s representative.               

(c) The Support Coordinator will ensure that appropriate service coverage is available during the time of suspension and update the support plan, cost plan, and relevant service authorizations accordingly. The Support Coordinator shall contact the Regional office immediately if assistance is needed in securing alternate services or providers. The Regional Office will assist the client and the client’s individual representative in meeting the client’s needs.

(3) This rule does not apply to fading or other reduction of care set forth in the client’s plan of care.

Rulemaking Authority 393.125(2) FS. Law Implemented 393.125(2) FS. History–New 12-10-91, Amended 5-19-93, Formerly 10F-8.031, 65B-8.031.

 

Substantial rewording of Rule 65G-3.006, F.A.C. follows. See Florida Administrative Code for present text.

65G-3.006 Discrimination and Retaliatory Conduct.

(1) Service providers are prohibited from:

(a) Taking any action that qualifies as illegal discrimination against any client receiving services in the receipt of those services. 

(b) Prejudicing the future provision of appropriate services when the client, or the client’s individual representative, attempts to advocate with the Agency, a government entity, or advocacy organization for desired services.

(c) Taking any action that qualifies as retaliatory conduct againt a client or the client’s individual representative if either has complained about the service provider to the Agency, a governmental entity or  advocacy organization, or any other individual or entity.

(2) In cases where retaliatory or illegal discriminatory conduct by the service provider, as described within this section, is determined by the Agency, the Agency, at its discretion, may initiate action against the service provider’s license, contract with the Agency, or Medicaid Waiver Services Agreement, in accordance with the provisions of applicable state law and administrative rules.

Rulemaking Authority 393.125(2) FS. Law Implemented 393.125(2) FS. History–New 12-10-91, Amended 5-19-93, Formerly 10F-8.033, 65B-8.033