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) Must have a positive test result from a test approved by the Food and Drug Administration to determine the presence of HIV infection.

(2) Must be living in Florida which may be documented by providing one of the following: current state or local Florida photo identification; utility bill, with name and street address; housing, rental or mortgage agreement in client’s name; recent school records; bank statement, with name and street address; letter from person with whom the client resides; property tax receipt or W-2 form for previous year; unemployment document with street address; current voter registration card; official correspondence, postmarked in last 3 months; prison records, if recently released; current documentation from the Florida Medicaid Managed Information System (FLMMIS) or the Medical Eligibility Verification System (MEVSNET) showing that the client is currently receiving Medicaid or assistance from the Supplemental Nutritional Assistance Program (SNAP), formally known as food stamps; Florida Department of Corrections offender search website photo print out; or a Declaration of Domicile, as per section 222.17, F.S. If homeless: a statement from the shelter in which the client resides or visits; physical observation of location of residence by eligibility staff; a written statement from the client describing living circumstances may be used, signed and dated by the client. Eligibility staff may provide assistance with writing the statement; or a statement from a social service agency attesting to the homeless status of the client.

(3) Cannot be receiving the same services or be eligible to participate in local, state, or federal programs where the same type service is provided or available.

(4) Must have low-income.

(5) Must submit a completed and signed Application to Receive Allowable Services for HIV/AIDS Patient Care Programs, DH 150-884 (08/2014), which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-06962, be willing to cooperate with eligibility staff during the eligibility process, and comply with the Rights and Responsibilities stated in the application.

(6) Must have their eligibility confirmed every 366 days or at shorter intervals if the client’s income or other factors change.

The above items can be satisified 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, 10-12-22.