The Department intends to amend rules 65A-2.022-.023, .032, and .036, F.A.C., to incorporate non-English forms and update Optional State Supplementation program financial standards for Medicaid recipients.

 

DEPARTMENT OF CHILDREN AND FAMILIES

Economic Self-Sufficiency Program

RULE NOS.:RULE TITLES:

65A-2.022Rights and Responsibilities

65A-2.023Application and Determination of Eligibility

65A-2.032Optional State Supplementation Eligibility Criteria

65A-2.036Optional State Supplementation Base Provider Rates and Program Standards

PURPOSE AND EFFECT: The Department intends to amend rules 65A-2.022-.023, .032, and .036, F.A.C., to incorporate non-English forms and update Optional State Supplementation program financial standards for Medicaid recipients.

SUMMARY: The amendments accomplish the following: 1) Incorporate non-English versions of forms; and 2) Update monthly income standards and monthly base provider rates for Assisted Living Facilities (ALFs), Adult Family Care Homes (AFCHs), and Mental Health Residential Treatment Facilities (MHRTFs).

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: The Department used a checklist to conduct an economic analysis and determine if there is an adverse impact or regulatory costs associated with this rule that exceeds the criteria in section 120.541(2)(a), F.S. Based upon this analysis, the Department has determined that the proposed rule is not expected to require legislative ratification.

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: 409.212(7), 429.67(8) F.S.

LAW IMPLEMENTED: 409.212, 429.67(8), 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: Jodi Abramowitz. Jodi can be reached at [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65A-2.022 Rights and Responsibilities.

(1) Any individual has the right to apply for Optional State Supplementation (OSS) and, if found eligible according to these rules and Section 409.212, F.S., to receive an established monthly payment. The OSS payment is made to assist Iindividuals residing in Assisted Living Facilities (ALF) and Adult Family Care Homes (AFCH) are  eligible to to receive OSS payments to assist with the cost of room and board. Optional State Supplementation payments are made to Iindividuals residing in facilities covered by subsection 65A-2.032(7), F.A.C., and within the coverage groups specified in subsections 65A-2.033(1) through (4), F.A.C., are also eligible to receive OSS payments. Additionally, the Optional State Supplementation payment is made to assist individuals residing in those Mental Health Residential Treatment Facilities (MHRTFs) that are enrolled as qualified Medicaid providers of Assistive Care Services (ACS) with the Agency for Health Care Administration (AHCA) are eligible to receive OSS payments to assist with room and board. The OSS payments are made to Iindividuals residing in MHRTFs that are not enrolled as qualified Medicaid providers of ACS by AHCA, and for the individuals covered under subsections 65A-2.033(3) and (4), F.A.C., are eligible for OSS payments that are is inclusive of room, board and personal care. The individual’s use of the personal needs allowance is not restricted.

(2) An authorized representative as defined in subsection 65A-1.203(9), F.A.C., may be designated to act on behalf of the individual in any matter pertaining to the individual’s OSS eligibility. Designation may be made by the individual, or a person knowledgeable of the individual’s affairs may be self-designated as the individual’s representative. The authorized representative may be identified on the Appointment of a Designated Representative, CF-ES 2505, 07/2013, http://www.flrules.org/Gateway/reference.asp?No=Ref-03155, incorporated by reference. The following non-English versions of the Appointment of a Designated Representative form are incorporated by reference: CF-ES 2505H (Creole), 07/2013, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, and CF-ES 2505S (Spanish), 07/2013, available athttp://www.flrules.org/Gateway/reference.asp?No=Ref-XXX.

(3) No change.

(4) The Department is responsible for determining eligibilty within the required time standard in accordance with  providing prompt action in accordance with subsections 65A-2.023(1) and (2), F.A.C., equitable treatment in accordance with Rules 65A-1.204 and 65A-2.031, F.A.C., and timely notification in accordance with subsection 65A-2.023(2), F.A.C., of any decision regarding an individual’s payment or eligibility status.

(5) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

(5) Copies of the form incorporated by reference in this rule are available from the Economic Self-Sufficiency Headquarters Office, 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700 or on the Department’s website at http://www.dcf.state.fl.us/dcfforms/Search/DCFFormSearch.aspx.

Rulemaking Authority 409.212(7) FS. Law Implemented 409.212 FS. History–New 1-1-77, Formerly 10C-2.22, 10C-2.022, Amended 12-16-01, 5-14-02. 10-2-13. Amended___

65A-2.023 Application and Determination of Eligibility.

(1) An individual applying to receive an Optional State Supplementation (OSS) payment must submit an ACCESS Florida Application, CF-ES 2337, 08/2016 11/2011, incorporated by reference in Rule 65A-1.205, F.A.C. Once the completed, dated and signed application is received, and date stamped as received by the Department, the application process begins.

(2) Applications are processed and the eligibility decision is made in accordance with the standards in Rule 65A-1.205, F.A.C., with the exception that the ACCESS Florida Application is the application for the OSS Program. The individual is notified  noticed of the eligibility decision by a Notice of Case Action, CF-ES 2235, 02/2012, http://www.flrules.org/Gateway/reference.asp?No=Ref-01205, incorporated by reference.  The following non-English versions of the Notice of Case Action are incorporated by reference: CF-ES 2235H (Creole), 02/2012, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, and CF-ES 2235S (Spanish), 02/2012, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX.

(3) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

(3) Copies of materials incorporated by reference are available from the Economic Self-Sufficiency Headquarters Office, 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700, or on the Department’s website at http://www.dcf.state.fl.us/dcfforms/Search/DCFFormSearch.aspx.

Rulemaking Authority 409.212(7) FS. Law Implemented 409.212 FS. History–New 1-1-77, Formerly 10C-2.23, Amended 2-9-88, Formerly 10C-2.023, Amended 12-16-01, 6-4-12. Amended____

65A-2.032 Optional State Supplementation Eligibility Criteria.

(1) through (6) No change.

(7) An eligible individual must be living in a licensed Assisted Living Facility as defined in Section 429.02(5), F.S.; a licensed Adult Family Care Home as defined in Section 429.65(2), F.S.; or a licensed Mental Health Residential Treatment Facility as defined in Section 394.67(23)(22), F.S. Additionally, the facility must meet the individual’s needs based on objective medical and social evaluations and care plans, in accordance with Chapter 59A-36, 59A-37, 58A-5, 58A-14 or 65E-4, F.A.C., respectively.

(8) Pursuant to Section 429.67(8), F.S., the Department of Children and Families will refer residents who receive Optional State Supplementation (OSS) to adult family care homes by providing the resident with the Adult Family Care Home Referral Notice, CF-ES 2202, 08/2009, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX.  The following non-English versions of the Adult Family Care Home Referral Notice are incorporated by reference: CF-ES 2202H (Creole), 08/2009, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, and CF-ES 2202S (Spanish), 08/2009, http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX.

(9) When appropriated OSS funding is insufficient to meet fiscal demands, a proportional reduction will be applied to OSS payments, but shall not affect maintenance of effort required per 42 U.S.C. §1382g.

(10) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

(10) Copies of the form incorporated by reference in this rule are available from the Economic Self-Sufficiency Headquarters Office at 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700 or on the Department’s website at http://www.dcf.state.fl.us/dcfforms/Search/DCFFormSearch.aspx.

Rulemaking Authority 409.212(7), 429.67(8) FS. Law Implemented 409.212, 429.67(8) FS. History–New 1-1-77, Amended 9-29-81, 10-31-83, Formerly 10C-2.32, Amended 9-30-86, Formerly 10C-2.032, Amended 12-16-01, 2-25-10. Amended___

65A-2.036 Optional State Supplementation Base Provider Rates and Program Standards.

(1) through (2) No change.

(3) Optional State Supplementation Program Financial Standards. Optional State Supplementation Program financial standards are subject to Florida legislative appropriations and federal cost-of-living adjustments.

(a) The monthly income eligibility standard for residents of Assisted Living Facilities (ALFs), Adult Family Care Homes (AFCHs) and, except as specified in paragraph (b), below, Mental Health Residential Treatment Facilities (MHRTFs) is $872.40 $861.40.

(b) The monthly income eligibility standard for residents of MHRTFs that do not meet the criteria for enrollment as qualified Medicaid providers of Assistive Care Services (ACS), and for individuals with coverage under subsections 65A-2.033(3) and (4), F.A.C., is $979.00 $968.00.

(c) No change.

(4) Optional State Supplementation Base Provider Rates. Optional State Supplementation base provider rates are subject to Florida legislative appropriations and federal cost-of-living adjustments.

(a) For ALFs, AFCHs and, except as specified in paragraph (b), below, MHRTFs, the monthly base provider rate is $872.40 $807.40 and is inclusive of room and board only.

(b) For MHRTFs that do not meet the criteria for enrollment as qualified Medicaid providers of ACS, and for the individuals covered under subsections 65A-2.033(3) and (4), F.A.C., the monthly base provider rate is $979.00 $968.00 and is inclusive of room, board and personal care.

(5) through (8) No change.

(9) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process five years from the effective date.

Rulemaking Authority 409.212(7) FS. Law Implemented 409.212 FS. History–New 1-1-77, Amended 9-27-79, 10-7-80, 9-29-81, 9-29-82, 10-31-83, 11-28-83, 9-30-84, 10-1-85, Formerly 10C-2.36, Amended 1-1-87, 2-9-88, 11-6-88, 2-16-89, 3-1-90, 1-27-91, 2-19-95, Formerly 10C-2.036, Amended 1-27-99, 12-16-01, 5-14-02, 11-26-18, 6-30-19, 6-11-20 Amended______

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Suzanne Fauci

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Shevaun L. Harris

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: July 26, 2021

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: August 3, 2021