65G-14.001. Definitions

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

(2) “Clearinghouse” means a database created and maintained by the Agency for Health Care Administration that allows the results of criminal history checks to be shared among specified agencies according to Section 435.12, Florida Statutes (F.S.).

(3) “Code of Ethics” means a set of values, standards, and principles to guide decision-making and everyday professional conduct of Support Coordinators employed by a Qualified Organization.

(4) “Consultant” shall have the same meaning as in the Consumer-Directed Care Plus Program Coverage, Limitations, and Reimbursement Handbook (“CDC+ Handbook”), as adopted by Rule 59G-13.088, Florida Administrative Code (F.A.C.).

(5) “Consumer-Directed Care Plus Program” or “CDC+ Program” means a consumer-directed program that provides an alternative to the Medicaid State Plan and the Home and Community-Based Services Medicaid Waiver (also known as the iBudget Waiver). The CDC+ Program operates under the authority of section 1915(j) of the Medicaid State Plan Amendment of the Social Security Act and is governed by Title 42 of the Code of Federal Regulations, Part 441, and Sections 409.221 and 393.0662(2) and (7), F.S.

(6) “Corrective Action” means any act of remediation that the Qualified Organization is required to complete in response to any state or federal regulatory agency’s or its representative’s findings of unacceptable performance, nonperformance, or noncompliance with the terms and conditions of this chapter, Rules 65G-4.0213 through 4.0218, F.A.C. (“iBudget Rules”), Chapter 65G-10, F.A.C., Section 393.0663, F.S., or the Developmental Disabilities Individual Budgeting Waiver Services Coverage and Limitations Handbook.

(7) “Corrective Action Plan” means a plan prepared by the Qualified Organization and approved by the Agency by which the corrective action will be accomplished. A Corrective Action Plan has the same meaning as a Plan of Remediation.

(8) “Developmental Disabilities Individual Budgeting Waiver Services Coverage and Limitations Handbook” or “iBudget Handbook” refers to the handbook incorporated by reference in Rule 59G-13.070, F.A.C.

(9) “Employee” means a person who works in the service of an employer, the Qualified Organization, in a relationship in which the employer has the right to control the details of his or her job performance, as opposed to an independent contractor.

(10) “Home and Community Based Services Waiver” or “Waiver” means the Medicaid waiver authorized by 42 U.S.C. 1396n(c) of the federal Social Security Act and Section 409.906, F.S., that provides Medicaid funding for home and community based services to eligible persons with developmental disabilities who are eligible for Agency services and who live at home or in a home-like setting.

(11) “Home Region” means the Region in which the applicant submitted its application to become a Qualified Organization and where services will be rendered by the Qualified Organization, if approved. If the applicant wishes to render services in multiple Regions, only one application must be submitted to the Home Region as described in Rule 65G-14.002, F.A.C.

(12) “iConnect” means the Agency’s designated data management system as described in Section 393.066(2), F.S.

(13) “Legal Representative” means:

(a) For clients under the age of 18 years, the legal representative or health care surrogate appointed by the Florida court to represent the child or anyone designated by the parent(s) of the child to act on the parent(s)’ behalf (e.g., due to military absence).

(b) For clients age 18 years or older, the legal representative could be the client, anyone designated by the client through a Power of Attorney or Durable Power of Attorney, a medical proxy under Chapter 765, F.S., or anyone appointed by a Florida court as a guardian or guardian advocate under Chapter 393 or 744, F.S.

(14) “Medicaid Waiver Services Agreement” or “MWSA” means the voluntary contract as described in Section 409.907, F.S., between the Agency and providers of Medicaid Waiver services to Agency clients, as defined in Section 393.063(7), F.S.

(15) “Mentee” means a person employed by a Qualified Organization who is guided, advised, or trained by a mentor.

(16) “Mentor” means a Support Coordinator employed and designated by a Qualified Organization who uses his or her knowledge, skills, and experience to guide, advise, or train a mentee employed by the same Qualified Organization.

(17) “Ombudsman” means the Agency’s primary point of contact for addressing issues of concern or unresolved issues expressed by clients, legal representatives, providers, and other external stakeholders.

(18) “Qualified Organization” shall have the same meaning as in Section 393.0663(2), F.S.

(19) “Quality Improvement Organization” or “QIO” means a group of health quality experts, clinicians, and consumers contracted with the Agency for Health Care Administration and organized to improve the quality of care delivered to Agency clients.

(20) “Region” means one of six designated local geographical areas served by the Agency. There are six regions across the state of Florida: Northwest, Northeast, Central, Suncoast, Southeast, and Southern.

(21) “Regional Office” means one of the Agency’s offices serving a Region. The contact information for each Regional Office is designated on the Agency’s website.

(22) “Sexual Misconduct” shall have the same meaning as in Section 393.135, F.S.

(23) “Support Coordinator” shall have the same meaning as in Section 393.063, F.S. and the CDC+ Handbook.

(24) “Waiver Support Coordinator” refers to a Support Coordinator who assists clients enrolled on the Medicaid Home and Community-Based Services Waiver.

(25) This rule shall be reviewed, and if necessary, renewed through the rulemaking process five years from the effective date.

Rulemaking Authority 393.0662, 393.0663, 393.501 FS. Law Implemented 393.063, 393.0662, 393.0663 FS. History–New 7-1-21, Amended 10-25-22.