Document:

Exhibit 10.3

    

      Exhibit
        10.3

      Medicaid
        HMO Contract

       

      AHCA
        CONTRACT NO. FA521 AMENDMENT NO. 9

       

      THIS
        CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE
        ADMINISTRATION, hereinafter referred to as the "Agency" and HEALTHEASE OF
        FLORIDA, INC., hereinafter referred to as the "Vendor", is hereby amended
        as
        follows:

       

      1.
        Standard Contract, Section II.A, Contract Amount, the first sentence is hereby
        amended to now read:

       

      To
        pay
        for contracted services according to the conditions of Attachment I in an
        amount
        not to exceed
        $835,063,844.00
        (an
        increase of $1,513,414.00), subject to availability of funds.

       

      2.
        Attachment I, Section 10.5, Optional Services, is hereby deleted in its entirety
        and replaced with the following:

       

      10.5
        Optional Services

       

      The
        Plan
        shall offer the following services within all applicable Medicaid
        guidelines:

      
        	 	
                 

                Covered

              	
                 

                Not
                  Covered

              
	
                 

                Dental
                  Services

              	
                 

                ____________

              	
                 

                ___________

              
	
                 

                Transportation
                  Services

              	
                 

                _______X___

              	
                 

                ___________

              
	
                 

                Frail/Elderly
                  Program (in
                  accordance with Exhibit 110.4 of this contract)

              	
                 

                ____________

              	
                 

                _________

              

      

       

      3.
        Attachment I, Section 10.8.14, Transportation Services (optional), is hereby
        deleted in its entirety and replaced with the following:

       

      10.8.14
        Transportation Services (optional)

       

      a.
        Transportation Services are the arrangement and provision of an appropriate
        mode
        of transportation for Enrollees to receive medical care services. The Plan
        shall
        comply with the limitations and exclusions in the Medicaid Transportation
        Coverage, Limitations & Reimbursement Handbook (the "Transportation
        Handbook") except where compliance conflicts with the terms of this Contract.
        In
        no instance may the limitations or exclusions imposed by the Plan be more
        stringent than those specified in the Transportation Handbook. The Plan
        shall

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 1 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Medicaid
        HMO Contract

       

      offer
        Transportation Services free of charge and shall not charge Enrollees a co-pay
        for use of the Transportation Services. In providing Transportation Services,
        the Plan:

       

      1.
        Shall
        assure that providers of transportation are appropriately licensed and insured
        in accordance with the provisions of the Transportation Handbook;

       

      2.
        Must
        provide Transportation Services for all Enrollees seeking necessary Medicaid
        services;

       

      3.
        Shall
        be responsible for the cost of transporting an Enrollee from a nonparticipating
        facility or hospital to a Participating Facility or Hospital if the reason
        for
        transport is solely for the Plan's convenience, regardless of whether the
        Plan
        covers Medicaid Transportation Services; and

       

      4.
        Shall
        pay Transportation Services providers in accordance with the requirements
        set
        forth in this Contract,

       

      b.
        The
        Plan may delegate the provision of Transportation Services to a third
        party.

       

      1.
        The
        Plan shall provide a copy of the model Participating Transportation Subcontract
        to the Bureau of Managed Health Care in compliance with Section 70.0 of the
        Contract.

       

      2.
        The
        Plan may subcontract with more than one Transportation Services
        provider.

       

      3.
        The
        Plan shall maintain oversight of any third party providing Transportation
        Services on the Plan's behalf.

       

      c.
        The
        Plan shall provide the following non-emergency transportation, at a minimum,
        as
        part of its line of Transportation Services:*

       

      1.
        Ambulatory transportation;

       

      2.
        Long
        haul ambulatory transportation;

       

      3.
        Wheelchair transportation;

       

      4.
        Stretcher transportation;

       

      5.
        Multiload transportation;

       

      6.
        Mass
        transit transportation;

       

      '
        As
        defined in the Transportation Handbook.

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 2 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Medicaid
        HMO Contract

       

      7.
        Over-the-road bus;

       

      8.
        Over-the-road train;

       

      9.
        Private volunteer transportation;

       

      10.
        Escort services (including medical escort); and

       

      11.
        Commercial air carrier transportation. 

      d.
        The
        Plan shall provide the following encounter data on a quarterly
        basis:

       

      1.
        A call
        log broken down by month that includes the following information:

       

      (a)
        Number of calls received;

       

      (b)
        Average time required to answer a call;

       

      (c)
        Number of abandoned calls;

       

      (d)
        Percentage of calls that are abandoned;

       

      (e)
        Average abandonment time; and

       

      (f)
        Average call time.

       

      2.
        A
        listing of the total number of reservations of Transportation Services by
        month,
        level of service and percentage of level of service utilized, to include,
        but
        not be limited to, the following:

       

      (a)
        Ambulatory transportation;

       

      (b)
        Long
        haul ambulatory transportation;

       

      (c)
        Wheelchair transportation;

       

      (d)
        Stretcher transportation;

       

      (e)
        Ambulatory multiload transportation;

       

      (f)
        Wheelchair multiload transportation;

       

      (g)
        Mass
        transit pending transportation;

       

      (h)
        Mass
        transit transportation;

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 3 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (i)
        Mass
        transit transportation (Enrollee has pass); and

       

      (j)
        Mass
        transit transportation (sent pass to Enrollee).

       

      
        	 	
                3.

              	
                A
                  listing of the total number of authorized uses of Transportation
                  Services,
                  by month, level of service and percentage of level of service utilized,
                  to
                  include, but not be limited to, the
                  following:

              

      

       

      (a)
        Ambulatory transportation;

       

      (b)
        Long
        haul ambulatory transportation;

       

      (c)
        Wheelchair transportation;

       

      (d)
        Stretcher transportation;

       

      (e)
        Ambulatory multiload transportation;

       

      (f)
        Wheelchair multiload transportation;

       

      (g)
        Mass
        transit pending transportation;

       

      (h)
        Mass
        transit transportation;

       

      (i)
        Mass
        transit transportation (Enrollee has pass); and

       

      (j)
        Mass
        transit transportation (sent pass to Enrollee).

       

      4. A
        listing
        of the total number of canceled trips, by month, level of service and percentage
        of level of service utilized, to include, but not be limited to, the
        following:

       

      (a)
        Ambulatory transportation;

       

      (b)
        Long
        haul ambulatory transportation;

       

      (c)
        Wheelchair transportation;

       

      (d)
        Stretcher transportation;

       

      (e)
        Ambulatory multiload transportation;

       

      (f)
        Wheelchair multiload transportation;

       

      (g)
        Mass
        transit pending transportation;

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 4 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (h)
        Mass
        transit transportation;

       

      (i)
        Mass
        transit transportation (Enrollee has pass); and

       

      (j)
        Mass
        transit transportation (sent pass to Enrollee).

       

      
        	 	
                5.

              	
                A
                  listing of the total number of denied Transportation Services,
                  by month,
                  and a detailed description of why the Plan denied the Transportation
                  Service request.

              

      

       

      
        	 	
                6.

              	
                A
                  listing of the total number of authorized trips, by facility type,
                  for
                  each month and level of service.

              

      

       

      
        	 	
                7.

              	
                A
                  listing of the total number of Transportation Service claims and
                  payments,
                  by facility type, for each month and level of
                  service.

              

      

       

      e. Before
        providing Transportation Services, the Plan shall provide to the Bureau of
        Managed Health Care a copy of its policies and procedures relating to the
        following:

       

      1.
        How
        the Plan will determine eligibility for each Enrollee;

       

      2.
        The
        Plan's course of action as to how it will determine what type of

      transportation
        to provide to a particular Enrollee;

       

      3.
        The
        Plan's procedure for providing prior authorization to Enrollees requesting
        Transportation Services;

       

      4.
        The
        Plan's comprehensive employee training program to investigate potential
        fraud;

       

      5.
        How
        the Plan will review Participating Transportation Providers who demonstrate
        a
        pattern or practice of:

       

      (a)
        Falsified encounter or service reports;

       

      (b)
        Overstated reports or up-coded levels of service; and/or

       

      (c)
        Fraud
        or abuse.2

       

      6.
        How
        the Plan will review Participating Transportation Providers that:

       

      (a)
        Alter, falsify or destroy records prior to the end of the five (5) year records
        retention benchmark;

       

      2
        As
        defined in section 409.913, F.S., 2004.

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 5 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (b)
        Make
        false statements about credentials;

       

      (c)
        Misrepresent medical information to justify referrals;

       

      (d)
        Failed to provide scheduled transportation for Enrollees;

       

      (e)
        Charge Enrollees for covered services; and/or

       

      (f)
        Have
        committed, or been suspected of committing, fraud or abuse

      3

       

      
        	 	
                7.

              	
                How
                  the Plan will provide Transportation Services outside of the Plan's
                  service area.

              

      

       

      (a)
        The
        Plan shall state clearly the guidelines it will use in order to control costs
        when providing Transportation Services outside of the Plan's service
        area.

       

      f.
        The
        Plan shall report immediately, in writing to the Agency Contract Manager
        and the
        Medicaid Program Integrity Unit, any aspect of Transportation Service delivery,
        by any Transportation Services Provider, any adverse or untoward
        incident.4
        The Plan
        shall also report, immediately upon identification, in writing to the Agency
        Contract Manager and the Medicaid Program Integrity Unit, all instances of
        suspected Enrollee or Transportation Services Provider fraud or
        abuse.5

       

      1.
        The
        Plan shall file a written report with the Medicaid Program Integrity Unit
        and
        the Agency Contract Manager immediately upon the detection of a potentially
        or
        suspected fraudulent or abusive action by a Transportation Services Provider.
        At
        a minimum, the report must contain the name, tax identification number and
        contract information of the Transportation Services Provider and a description
        of the suspected fraudulent or abusive act. The report shall be in the form
        of a
        narrative.

       

      g.
        Insurance, Safety Requirements and Standards6

       

      1.
        The
        Plan shall ensure compliance with the minimum liability insurance requirement
        of
        $100,000 per person and $200,000 per incident for all transportation services
        purchased or provided for the transportation disadvantaged through the
        Plan.7
        The Plan
        shall indemnify and hold harmless the local. State, and federal governments
        and
        their entities and

       

      3
        As
        defined in section 409.913, F.S., 2004.

      4
        See
        section 641.55, F.S., 2004.

      5
        As
        defined in section 409.913, F.S., 2004.

      6
        Including, but not limited to, 41-2, F.A.C., 2004.

      7
        See
        section 768.28(5), F.S., 2004.

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 6 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      the
        Agency from any liabilities arising out of or due to an accident or negligence
        on the part of the Plan and/or all Participating Transportation Providers
        under
        contract to the Plan. The Plan may act as a Participating Transportation
        Provider, in which case it must follow all requirements set forth below for
        Participating Transportation Providers.

       

      2.
        The
        Plan, and all Participating Transportation Providers, shall ensure that all
        operations and services are in compliance with all federal and State safety
        requirements.8

       

      3.
        The
        Plan, and all Participating Transportation Providers, shall ensure continuing
        compliance with all applicable State or federal laws relating to drug
        testing.9

       

      4.
        The
        Plan and all Participating Transportation Providers shall adhere to the
        following standards, including, but not limited to, the following:

       

      (a)
        Drug
        and alcohol testing for safety sensitive job positions relating to the provision
        of Transportation Services regarding pre-employment, randomization,
        post-accident, and reasonable suspicion as required by the Federal Highway
        Administration and the Federal Transit Administration;

       

      (b)
        Use
        of child safety restraint devices, where the use of such devices would not
        interfere with the safety of a child (for example, a child in a
        wheelchair);

       

      (c)
        Enrollee property that can be carried by the passenger and/or driver, and
        can be
        stowed safely on the vehicle, shall be transported with the passenger at
        no
        additional charge. The driver shall provide transportation of the following
        items, as applicable, within the capabilities of the vehicle:

       

      (1)
        Wheelchairs;

       

      (2)
        Child
        seats;

       

      (3)
        Stretchers;

       

      (4)
        Secured oxygen;

       

      (5)
        Personal assistive devices; and/or

       

      (6)
        Intravenous devices.

       

      8
        Including, but not limited to, section 341.061(2)(a), Florida Statutes, and
        Chapter 14-90, F.A.C.

      9
        Including, but not limited to, to section 112.0455, Florida Statutes, 2004,
        Chapters 59A-24,41 U.S.C. 701, and 49 C.F.R., Parts 29 and 382.

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 7 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (d)
        Vehicle transfer points shall provide shelter, security, and safety of
        Enrollees;

       

      (e)
        Maintain inside all vehicles copies of the Plan's toll free phone number
        for
        Enrollee complaints;

       

      (f)
        The
        interior of all vehicles shall be free from dirt, grime, oil, trash, torn
        upholstery, damaged or broken seats, protruding metal or other objects or
        materials which could soil items placed in the vehicle or provide discomfort
        for
        Enrollees;

       

      (g)
        Maintain a passenger/trip database for each Enrollee transported by the
        Plan/Participating Transportation Provider;

       

      (h)
        Ensure adequate seating for paratransit services for each Enrollee and escort,
        child, or personal care attendant, and shall ensure that the vehicle does
        not
        transport more passengers than the registered passenger seating capacity
        in a
        vehicle at any time;

       

      (i)
        Ensure adequate seating space for transit services for each Enrollee and
        escort,
        child, or personal care attendant, and shall ensure that transit vehicles
        provide adequate seating or standing space to each rider, and shall ensure
        that
        the vehicle does not transport more passengers than the registered passenger
        seating or standing capacity in a vehicle at any time;

       

      (j)
        Drivers for paratransit services shall identify themselves by name and company
        in a manner that is conducive to communications with the specific passenger,
        upon pickup of each Enrollee, group of Enrollees, or representative, guardian,
        or associate of the Enrollee, except in situations where the driver regularly
        transports the Enrollee on a recurring basis;

       

      (k)
        Each
        driver must have photo identification that is viewable by the passenger.
        Name
        patches, inscriptions or badges that affix to driver clothing are acceptable.
        For transit services, the driver photo identification shall be in a conspicuous
        location in the vehicle;

       

      (1)
        The
        paratransit driver shall provide the Enrollee with boarding assistance, if
        necessary or requested, to the seating portion of the vehicle. The boarding
        assistance shall include, but not be limited to, opening the vehicle door,
        fastening the seat belt or utilization of wheel chair securement devices,
        storage of mobility assistive devices and closing the vehicle door. In the
        door-through-door

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 8 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      paratransit
        service category, the driver shall open and close doors to buildings, except
        in
        situations in which assistance in opening and/or closing building doors would
        not be safe for passengers remaining on the vehicle. The driver shall provide
        assisted access in a dignified manner. Drivers may not assist wheelchair
        passengers up or down more than one (1) step, unless it can be performed
        safely
        as determined by the Enrollee, guardian, and driver;

       

      (m)
        Smoking, eating and drinking are prohibited in any vehicle, except in cases
        in
        which, as a Medical Necessity, the Enrollee requires fluids or sustenance
        during
        transport;

       

      (n)
        Ensure that all vehicles are equipped with two-way communications, in good
        working order and audible to the driver at all times, by which to communicate
        with the Transportation Services hub or base of operations;

       

      (o)
        Ensure that all vehicles have working air conditioners and heaters. The Plan
        shall ensure that all vehicles that do not have a working air conditioner
        or
        heater are removed from the vehicle pool and scheduled for repair or
        replacement;

       

      (p)
        Develop and implement a first aid policy and cardiopulmonary resuscitation
        policy;

       

      (q)
        Ensure that all drivers providing Transportation Services undergo a background
        screening;

       

      (r)
        Establish Enrollee pick-up windows and communicate these windows to
        Participating Transportation Providers and Enrollees;

       

      (s)
        Establish a minimum 24-hour advanced notification policy to obtain
        Transportation Services. The Plan shall communicate said policy to Participating
        Transportation Providers and Enrollees;

       

      (t)
        Establish a performance measure to evaluate the safety of the Transportation
        Services provided by Participating Transportation Providers. The Plan shall
        report the results of the evaluation to the Agency on August 15th
        of each
        year;

       

      (u)
        Establish a performance measure to evaluate the reliability of the vehicles
        utilized by Participating Transportation Providers. The Plan shall report
        the
        results of the evaluation to the Agency on August 15th
        of each
        year; and

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 9 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

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        HMO Contract

       

      (v)
        Establish a performance measure to evaluate the quality of service provided
        by a
        Participating Transportation Provider. The Plan shall report the results
        of the
        evaluation to the Agency on August 15th
        of each
        year.

       

      (h.)
        Operational Standards10
        - Each
        Plan shall implement, or ensure that each Participating Transportation Provider
        has implemented, policies and procedures that, at a minimum, comply with
        the
        following:

       

      1.
        Address the following safety elements and requirements:

       

      (a)
        Safety policies and responsibilities;

       

      (b)
        Vehicle and equipment standards and procurement criteria;

       

      (c)
        Operational standards and procedures;

       

      (d)
        Vehicle driver and employee selection;

       

      (e)
        Driving requirements;

       

      (f)
        Vehicle driver and employee training;

       

      (g)
        Vehicle maintenance;

       

      (h)
        Investigations of events described under Section 10.8-14.h-7, Transportation
        Services, below;

       

      (i)
        Hazard identification and resolution;

       

      (j)
        Equipment for transporting wheelchairs;

       

      (k)
        Safety data acquisition and analysis;

       

      (1)
        Safety standards for private contract vehicle transit system(s) that provide(s)
        transportation services for compensation as a result of a contractual agreement
        with the vehicle transit system.

       

      2.
        Shall
        submit an annual safety certification to the Agency verifying the
        following:

       

      (a)
        Adoption of policies and procedures that, at a minimum, establish standard
        set
        forth in this Section; and

       

      10
        For
        reference, see 14-90, F.A.C., 2004.

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 10 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

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      (b)
        The
        Plan/Participating Transportation Provider is in full compliance with the
        policies and procedures relating to Transportation Services, and that it
        has
        performed annual safety inspections on all vehicles operated by the
        Plan/Participating Transportation Provider, by persons meeting the requirements
        set forth in Section 10.8.14.h.6, below.

       

      3.
        The
        Plan shall suspend immediately a Participating Transportation Provider if,
        at
        any time, continued use of that Participating Transportation Provider, is
        unsafe
        for passenger service or poses a potential danger to public safety.

       

      4.
        Address the following security requirements:

       

      (a)
        Security policies, goals, and objectives;

       

      (b)
        Organization, roles, and responsibilities;

       

      (c)
        Emergency management processes and procedures for mitigation,

      preparedness,
        response, and recovery;

       

      (d)
        Procedures for investigation of any event involving a vehicle, or taking
        place
        on vehicle transit system controlled property, resulting in a fatality, injury,
        or property damage as discussed in Section 10.8.14.h.7, below;

       

      (e)
        Procedures for the establishment of interfaces with emergency response
        organizations;

       

      (f)
        Employee security and threat awareness training programs;

       

      (g)
        Conduct and participate in emergency preparedness drills and exercises;
        and

       

      (h)
        Security requirements for Participating Transportation Providers that provide
        Transportation Services for compensation as a result of a contractual agreement
        with the Plan/Participating Transportation Provider.

       

      5.
        Shall
        establish criteria and procedures for selection, qualification, and training
        of
        all drivers. The criteria shall include, at a minimum, the
        following:

       

      (a)
        Driver qualifications and background checks with minimum hiring
        standards;

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 11 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

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      (b)
        Driving and criminal background checks for all new drivers;

       

      (c)
        Verification and documentation of valid driver licenses for all employees
        who
        drive vehicles;

       

      (d)
        Training and testing to demonstrate and ensure adequate skills and capabilities
        to safely operate each type of vehicle or vehicle combination before driving
        unsupervised;

       

      (e)
        At a
        minimum, drivers shall be given explicit instructional and procedural training
        and testing in the following areas:

       

      (1)
        Plans/Participating Transportation Provider safety and operational policies
        and
        procedures;

       

      (2)
        Operational vehicle and equipment inspections;

       

      (3)
        Vehicle equipment familiarization;

       

      (4)
        Basic
        operations and maneuvering;

       

      (5)
        Boarding and alighting passengers;

       

      (6)
        Operation of wheelchair lift and other special equipment and driving
        conditions;

       

      (7)
        Defensive driving;

       

      (8)
        Passenger assistance and securement;

       

      (9)
        Handling of emergencies and security threats; and

       

      (10)
        Security and threat awareness.

       

      (f)
        Shall
        provide written operational and safety procedures to all vehicle drivers
        before
        the drivers are allowed to drive unsupervised. These procedures and instructions
        shall address, at a minimum, the following:

       

      (1)
        Communication and handling of unsafe conditions, security threats, and
        emergencies;

       

      (2)
        Familiarization and operation of safety and emergency equipment, wheelchair
        lift
        equipment, and restraining devices;

      and

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 12 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

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      (3)
        Application and compliance with applicable federal and State rules and
        regulations.l}

       

      (g)
        Shall
        maintain the following records for at least five (5) years:

       

      (1)
        Records of vehicle driver background checks and qualifications;

       

      (2)
        Detailed descriptions of training administered and completed by each vehicle
        driver;

       

      (3)
        A
        record of each vehicle driver's duty status, which shall include total days
        worked, on-duty hours, driving hours and time of reporting on- and off-duty
        each
        day; and

       

      (4)
        Any
        documents required to be prepared by this Contract.

       

      (h)
        Shall
        establish a drug-free workplace policy statement12
        and a
        substance abuse management and testing program;13
        and

       

      (i)
        Shall
        require that drivers write and submit a daily vehicle inspection report,
        i

       

      6.
        Shall
        establish a maintenance policy and procedures for preventative and routine
        maintenance for all vehicles. The maintenance policy and procedures shall
        ensure, at a minimum, that:

       

      (a)
        All
        vehicles, all parts and accessories on such vehicles, and any additional
        parts
        and accessories which may affect the safety of vehicle operation, including
        frame and frame assemblies, suspension systems, axles and attaching parts,
        wheels and rims, and steering systems, are regularly and systematically
        inspected, maintained and lubricated in accordance with the standards developed
        and established according to the vehicle manufacturer's recommendations and
        requirements;

       

      (b)
        That
        a recording and tracking system is established for the types of inspections,
        maintenance, and lubrication intervals, including the date or mileage when
        these
        services are due. Required maintenance inspections shall be more comprehensive
        than daily inspections performed by the driver;

       

      "
        The
        provisions in Sections !0.8.14.h.5(e) and (f), above, shall not apply to
        personnel licensed and authorized by the Plan/Participating

      Transportation
        Provider to drive, move, or road test a vehicle in order to perform repairs
        or
        maintenance services where it has been determined

      that
        such
        temporary operation does not create an unsafe operating condition or create
        a
        hazard to public safety.

      12
        In
        accordance with 49 C.F.R. Part 29.

      11
        In
        accordance with 49 C.F.R. Parts 40 and 655, October 1,2004.

      14
        Pursuant
        to Rule 14-90.006, F.A.C.

       

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      (c)
        That
        proper preventive maintenance is performed when on all

      vehicles;
        and

       

      (d)
        That
        the Plan/Participating Transportation Provider maintain and provide written
        documentation of preventive maintenance, regular maintenance, inspections,
        lubrication, and repairs performed for each vehicle under their control.
        Such
        records shall be maintained by the Plan/Participating Transportation Provider
        for at least five (5) years and include, at a minimum, the following
        information:

       

      (1)
        Identification of the vehicle, including make, model, and license number
        or
        other means of positive identification and ownership;

       

      (2)
        Date,
        mileage, and type of inspection, maintenance, lubrication, or repair
        performed;

       

      (3)
        Date,
        mileage, and description of each inspection, maintenance, and lubrication
        intervals performed;

       

      (4)
        If
        not owned by the Plan/Participating Transportation Provider, the name of
        any
        person or lessor furnishing any vehicle; and

       

      (5)
        The
        name and address of any entity or contractor performing an inspection,
        maintenance, lubrication, or repair.

       

      7.
        The
        Plan/Participating Transportation Provider shall investigate, or cause to
        be
        investigated, any event involving a vehicle or taking place on
        Plan/Participating Transportation Provider controlled property resulting
        in a
        fatality, injury, or property damage as follows:

       

      (a)
        A
        fatality, where an individual is confirmed dead, within three (3) days of
        a
        Transportation Services related event, excluding suicides and deaths from
        illnesses. The Plan must file detailed report of the incident with the Agency
        within ten (10) days of the event;15

       

      (b)
        Injuries requiring immediate medical attention away from the scene for two
        (2)
        or more individuals;

       

      (c)
        Property damage to Plan/Participating Transportation Provider vehicles, other
        Plan/Participating Transportation Provider property or facilities, or any
        other
        property, except the Plan/Participating

       

      15
        See
        section 641.55(6), F.S., 2004.

       

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      Transportation
        Provider shall have the discretion to investigate events resulting in property
        damage totaling less than $1,000;

       

      (d)
        Evacuation of a vehicle due where there is imminent danger to passengers
        on the
        vehicle, excluding evacuations due to vehicle operation issues;

       

      (e)
        Each
        investigation shall be documented in a final report that includes a description
        of investigation activities, identified causal factors and a corrective action
        plan;

       

      (1)
        Each
        corrective action plan shall identify the action to be taken by the
        Plan/Participating Transportation Provider and the schedule for its
        implementation; and

       

      (2)
        The
        Plan/Participating Transportation Provider must monitor and track the
        implementation of each corrective action plan.

       

      (f)
        The
        Plan/Participating Transportation Provider shall maintain all investigation
        reports, corrective action plans, and related supporting documentation for
        a
        minimum of five (5) years from the date of completion of the
        investigation.

       

      i.
        Medical Examinations for Drivers - The Plan/Participating Transportation
        Provider shall establish medical examination requirements for all applicants
        for
        driver positions and for existing drivers. The medical examination requirements
        shall include a pre-employment examination for applicants, an examination
        at
        least once every two (2) years for existing drivers, and a return to duty
        examination for any driver prior to returning to duty after having been off
        duty
        for thirty (30) or more days due to an illness, medical condition, or
        injury.

       

      1.
        Medical examinations may be
        performed and recorded according to qualification standards adopted by the
        Plan/Participating Transportation Provider, provided the medical examination
        qualification standards adopted by the Plan/Participating Transportation
        Provider meet or exceed those provided in Department Form Number 725-030-11,
        Medical Examination Report for Bus Transit System Driver, Rev. 07/05, hereby
        incorporated by reference.16

       

      2.
        Medical examinations shall be performed by a Doctor of Medicine or Osteopathy,
        a
        PA or ARNP licensed or certified by the State of Florida. The examination
        shall
        be conducted in person, and not via the Internet. If medical examinations
        are
        performed by a PA or ARNP, they must be

       

      16
        Copies
        of Form Number 725-030-11 are available from the Florida Department of
        Transportation, Public Transit Office, 605 Suwannee Street, Mail Station
        26,
        Tallahassee, Florida 32399-0450 or on-line at
        www.dot.state.fl.us/transit.

       

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      performed
        under the supervision or review of a Doctor of Medicine or

      Osteopathy.

       

      (a)
        An
        ophthalmologist or optometrist licensed by the State of Florida may perform
        as
        much of the examination as pertains to visual acuity, field of vision and
        color
        recognition.

       

      (b)
        Upon
        completion of the examination, the examining medical professional shall
        complete, sign, and date the medical examination report.

       

      3.
        The
        Plan/Participating Transportation Provider shall have on file proof of medical
        examination, i.e., a completed and signed medical examination report for
        each
        driver, dated within the past 24 months. Medical examination reports of employee
        drivers shall be maintained by the Plan/Participating Transportation Provider
        for a minimum of five (5) years from the date of the examination.

       

      j.
        Operational and Driving Requirements

       

      1.
        The
        Plan/Participating Transportation Provider shall not permit a driver to drive
        a
        vehicle when such driver's license has been suspended, canceled or revoked.
        The
        Plan/Participating Transportation Provider shall require a driver who receives
        a
        notice that his or her license to operate a motor vehicle has been suspended,
        canceled, or revoked notify his or her employer of the contents of the notice
        immediately, and no later than the end of the business day following the
        day he
        or she received the notice.

       

      2.
        At all
        times, the Plan/Participating Transportation Provider shall operate vehicles
        in
        compliance with applicable traffic regulations, ordinances and laws of the
        jurisdiction in which they are being operated.

       

      3.
        The
        Plan/Participating Transportation Provider shall not permit or require a
        driver
        to drive more than twelve (12) hours in any one 24-hour period, or drive
        after
        having been on duty for sixteen (16) hours in any one 24-hour period. The
        Plan/Participating Transportation Provider shall not permit a driver to drive
        until the driver fulfills the requirement of a minimum eight (8) consecutive
        hours off-duty. A driver's work period shall begin from the time he or she
        first
        reports for duty to his or her employer. A driver is permitted to exceed
        his or
        her regulated hours in order to reach a regularly established relief or dispatch
        point, provided the additional driving time does not exceed one (1)
        hour.

       

      4.
        The
        Plan/Participating Transportation Provider shall not permit or require a
        driver
        to be on duty more than 72 hours in any period of seven (7) consecutive days;
        however, 24 consecutive hours off-duty shall constitute

       

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      the
        end
        of any such period of seven (7) consecutive days. The Plan/Participating
        Transportation Provider shall ensure that a driver who has reached the maximum
        72 hours of on-duty time during the seven (7) consecutive days has a minimum
        of
        24 consecutive hours off-duty before returning to on-duty status.

       

      5.
        A
        driver is permitted to drive for more than the regulated hours for safety
        and
        protection of the public due to conditions such as adverse weather, disaster,
        security threat, a road or traffic condition, medical emergency or an
        accident.

       

      6.
        The
        Plan/Participating Transportation Provider shall not permit or require any
        driver to drive when his or her ability is impaired, or likely to be impaired,
        by fatigue, illness, or other causes, as to make it unsafe for the driver
        to
        begin or continue driving.

       

      7.
        The
        Plan/Participating Transportation Provider shall require pre-operational
        or
        daily inspection of all vehicles and reporting of all defects and deficiencies
        likely to affect safe operation or cause mechanical malfunctions.

       

      (a)
        The
        Plan/Participating Transportation Provider shall maintain a log detailing
        a
        daily inspection or test of the following parts and devices to ascertain
        that
        they are in safe condition and in good working order:

       

      (1)
        Service brakes;

       

      (2)
        Parking brakes;

       

      (3)
        Tires
        and wheels;

       

      (4)
        Steering;

       

      (5)
        Horn;

       

      (6)
        Lighting devices;

       

      (7)
        Windshield wipers;

       

      (8)
        Rear
        vision mirrors;

       

      (9)
        Passenger doors and seats;

       

      (10)
        Exhaust system;

       

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      (11)
        Equipment for transporting wheelchairs; and

       

      (12)
        Safety, security, and emergency equipment.

       

      (b)
        The
        Plan/Participating Transportation Provider shall review daily inspection
        reports
        and document corrective actions taken as a result of any deficiencies identified
        by any inspections.

       

      (c)
        The
        Plan/Participating Transportation Provider shall retain records of all
        inspections and any corrective action documentation for five (5)
        years.

       

      8.
        The
        driver shall not operate a vehicle with passenger doors in the open position
        when passengers are aboard. The driver shall not open the vehicle's doors
        until
        the vehicle comes to a complete stop. The Plan/Participating Transportation
        Provider shall not operate a vehicle with inoperable passenger doors with
        passengers aboard, except to move the vehicle to a safe location.

       

      9.
        During
        darkness, interior lighting and lighting in stepwells on vehicles shall be
        sufficient for passengers to enter and exit safely.

       

      10.
        Passenger(s) shall not be permitted in the stepwell(s) of any vehicle, while
        the
        vehicle is in motion, or to occupy an area forward of the standee
        line.

       

      11.
        Passenger(s) shall not be permitted to stand on or in vehicles not designed
        and
        constructed for that purpose.

       

      12.
        The
        Plan/Participating Transportation Provider shall not refuel vehicles in a
        closed
        building. The Plan/Participating Transportation Provider shall minimize the
        number of times a vehicle shall refuel when passengers are onboard.

       

      13.
        The
        Plan/Participating Transportation Provider shall require the driver to be
        properly secured to the driver's seat with a restraining belt at all times
        while
        the vehicle is in motion.

       

      14.
        The
        driver shall not leave vehicles unattended with passenger(s) aboard for longer
        than five (5) minutes. The Plan/Participating Transportation Provider shall
        ensure that the driver sets the parking or holding brake any time the vehicle
        is
        left unattended.

       

      15.
        The
        Plan/Participating Transportation Provider shall not leave vehicles unattended
        in an unsafe condition with passenger(s) aboard at any time.

       

      k.
        Vehicle Equipment Standards and Procurement
        Criteria

       

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      1.
        The
        Plan/Participating Transportation Provider shall ensure that vehicles procured
        and operated meet the following requirements, at a minimum:

       

      (a)
        The
        capability and strength to carry the maximum allowed load and not exceed
        the
        manufacturer's gross vehicle weight rating (GVWR), gross axle weighting,
        or tire
        rating;

      (b)
        Structural integrity that mitigates or minimizes the adverse effects of
        collisions; and

       

      (c)
        Federal Motor Vehicle Safety Standards (FMVSS), 49 C.F.R. Part 571, Sections
        102, 103, 104, 105, 108, 207, 209, 210, 217, 220, 221, 225, 302, 403, and
        404,
        October 1, 2004, are hereby incorporated by reference.

       

      2.
        Proof
        of strength and structural integrity tests on new vehicles procured shall
        be
        submitted by manufacturers or the Plan/Participating Transportation Providers
        to
        the Department of Transportation.17

       

      3.
        The
        Plan/Participating Transportation Provider shall ensure that every vehicle
        operated in this State in connection with this Contract shall be equipped
        as
        follows:

       

      (a)
        Mirrors - There must be at least two (2) exterior rear vision mirrors, one
        (1)
        at each side. The mirrors shall be firmly attached to the outside of the
        vehicle
        and so located as to reflect to the driver a view to the rear along both
        sides
        of the vehicle.

       

      (1)
        Each
        exterior rear vision mirror, on Type I buses shall have a minimum reflective
        surface of 50 square inches and the right (curbside) mirror shall be located
        on
        the bus so that the lowest part of the mirror and its mounting is a minimum
        80
        inches above the ground. All Type I buses shall be equipped with an inside
        rear
        vision mirror capable of giving the driver a clear view of seated or standing
        passengers. Buses having a passenger exit door that is located inconveniently
        for the driver's visual control shall be equipped with additional interior
        mirror(s), enabling the driver to view the passenger exit door. The exterior
        right (curbside) rear vision mirror and its mounting on Type I buses may
        be
        located lower than 80 inches from the ground, provided such buses are used
        exclusively for paratransit services.

       

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      (2)
        In
        lieu of interior mirrors, trailer buses and articulated buses may be equipped
        with closed circuit video systems or adult monitors in voice control with
        the
        driver.

       

      (b)
        Wiring and Battery - Electrical wiring shall be maintained so as not to come
        in
        contact with moving parts, or heated surfaces, or be subject to chafing or
        abrasion which may cause insulation to become worn.

       

      (1)
        Every
        Type I bus manufactured on or after February 7, 1988, shall be equipped with
        a
        storage battery(ies) electrical power main disconnect switch. The disconnect
        switch shall be practicably located in an accessible location adjacent to
        or
        near to the battery(ies) and be legibly and permanently marked for
        identification.

       

      (2)
        Every
        storage battery on each public-sector bus shall be mounted with proper
        retainment devices in a compartment which provides adequate ventilation and
        drainage.

       

      (c)
        Brake
        Interlock Systems - All Type I buses having a rear exit door shall be equipped
        with a rear exit door/brake interlock that automatically applies the brake(s)
        upon driver activation of the rear exit door to the open position. Interlock
        brake application shall remain activated until deactivation by the driver
        and
        the rear exit door returns to the closed position. The rear exit door interlock
        on such buses shall be equipped with an identified override switch enabling
        emergency release of the interlock function, which shall not be located within
        reach of the seated driver. Air pressure application to the brake(s) during
        interlock operation, on buses equipped with rear exit door/brake interlock,
        shall be regulated at the original equipment manufacturer's
        specifications.

       

      4.
        Standee Line and Warning - Every vehicle designed and constructed to allow
        standees shall be plainly marked with a line of contrasting color at least
        two
        (2) inches wide or be equipped with some other means to indicate that any
        passenger is prohibited from occupying a space forward of a perpendicular
        plane
        drawn through the rear of the driver's seat and perpendicular to the
        longitudinal axis of the vehicle. A sign shall be posted at or near the front
        of
        the vehicle stating that it is a violation for a vehicle to be operated with
        passengers occupying an area forward of the line.

       

      5.
        Handrails and Stanchions - Every vehicle designed and constructed to allow
        standees shall be equipped with overhead grab rails for standee passengers.
        Overhead grab rails shall be continuous, except for a gap at

       

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      the
        rear
        exit door, and terminate into vertical stanchions or turn up into a

      ceiling
        fastener.

       

      (a)
        Every
        Type I and Type II bus designed for carrying more than sixteen (16) passengers
        shall be equipped with grab handles, stanchions, or bars at least ten (10)
        inches long and installed to permit safe on-board circulation, seating and
        standing assistance, and boarding and unloading by elderly and handicapped
        persons. Type I buses shall be equipped with a safety bar and panel directly
        behind each entry and exit stepwell.

       

      6.
        Flooring, Steps, and Thresholds - Flooring, steps, and thresholds on all
        vehicles shall have slip resistant surfaces without protruding or sharp edges,
        lips, or overhangs, to prevent tripping hazards. All step edges and thresholds
        shall have a band of color(s) running the full width of the step or edge
        which
        contrasts with the step tread and riser, either light-on-dark or
        dark-on-light.

       

      7
        Doors -
        Power activated doors on all vehicles shall be equipped with a manual device
        designed to release door closing pressure.

       

      8.
        Emergency Exits - All vehicles shall have an emergency exit door, or in lieu
        thereof, shall be provided with emergency escape push-out windows. Each
        emergency escape window shall be in a form of a parallelogram with dimensions
        of
        not less than 18" by 24", and each shall contain an area of not less than
        432
        square inches. There shall be a sufficient number of such push-out or kick-out
        windows in each vehicle to provide a total escape area equivalent to 67 square
        inches per seat, including the driver's seat.

       

      (a)
        No
        less than forty percent (40%) of the total escape area shall be on one (1)
        side
        of the vehicle. Emergency escape kick-out or push-out windows and emergency
        exit
        doors shall be conspicuously marked by a sign or light and shall always be
        kept
        in good working order so that they may be readily opened in an
        emergency.

       

      (b)
        All
        such windows and doors shall not be obstructed by bars or other such means
        located either inside or outside so as to hinder escape. Vehicles equipped
        with
        an auxiliary door for emergency exit shall be equipped with an audible alarm
        and
        light indicating to the driver when a door is ajar or opened while the engine
        is
        running.

       

      (c)
        Supplemental security locks operable by a key are prohibited on emergency
        exit
        doors unless these security locks are equipped and

       

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      connected
        with an ignition interlock system or an audio visual alarm located in the
        driver's compartment. Any supplemental security lock system used on emergency
        exits shall be kept unlocked whenever a vehicle is in operation.

       

      9.
        Tires
        and Wheels - Tires shall be properly inflated in accordance with

      manufacturer's
        recommendations.

       

      (a)
        No
        vehicle shall be operated with a tread groove pattern depth:

       

      (1)
        Less
        than 4/32 (1/8) of an inch, measured at any point on a major tread groove
        for
        tires on the steering axle of all vehicles. The measurements shall not be
        made
        where tie bars, humps, or fillets are located.

       

      (2)
        Less
        than 2/32 (1/16) of an inch, measured at any point on a major tread groove
        for
        all other tires of all vehicles. The measurements shall not be made where
        tie
        bars, humps, or

      fillets
        are located.

       

      (b)
        The
        Plan/Participating Transportation Provider shall not operate any vehicle
        with
        recapped, regrooved, or retreaded tires on the steering axle.

       

      (c)
        Wheels shall be visibly free from cracks and distortion and shall not have
        missing, cracked, or broken mounting lugs.

       

      10.
        Suspension - The suspension system of all vehicles, including springs, air
        bags,
        and all other suspension parts as applicable, shall be free from cracks,
        leaks,
        or any other defect which would or may cause its impairment or failure to
        function properly.

       

      11.
        Steering and Front Axle - The steering system of all vehicles shall have
        no
        indication of leaks which would or may cause its impairment to-function
        properly, and shall be free from cracks and excessive wear of components
        that
        would or may cause excessive free play or loose motion in the steering system
        or
        above normal effort in steering control.

       

      12.
        Seat
        Belts - Every vehicle shall be equipped with an adjustable driver's restraining
        belt in compliance with the requirements ofFMVSS 209, "Seat Belt
        Assemblies"19
        and
        FMVSS 210, "Seat Belt Assembly Anchorages."20

       

      "See
        49
        C.F.R. 571.209,2004. 20
        See 49
        C.F.R. 571.210,2004.

       

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      13.
        Safety Equipment - Every vehicle shall be equipped with one (1) fully charged
        dry chemical or carbon dioxide fire extinguisher, having at least a 1A:BC
        rating
        and bearing the label of Underwriter's Laboratory, Inc.

       

      (a)
        Each
        fire extinguisher shall be securely mounted on the vehicle in a conspicuous
        place or a clearly marked compartment and be readily accessible.

       

      (b)
        Each
        fire extinguisher shall be maintained in efficient operating condition and
        equipped with some means of determining if it is fully charged.

       

      (c)
        Every
        Type I bus shall be equipped with portable red reflector warning
        devices.21

       

      

      14.
        Vehicles used for the purpose of transporting individuals with disabilities
        shall meet the requirements set forth in 49 C.F.R. Part 38, October 1, 2004,
        hereby incorporated by reference, and the following:

       

      (a)
        Installation of a wheelchair lift or ramp shall not cause the manufacturer's
        GVWR, gross axle weight rating, or tire rating to be exceeded.

       

      (b)
        Except in locations within 3 1/2 inches of the vehicle floor, all readily
        accessible exposed edges or other hazardous protrusions of parts of wheelchair
        lift assemblies or ramps that are located in the passenger compartment shall
        be
        padded with energy absorbing material to mitigate injury in normal use and
        in
        case of a collision. This requirement shall also apply to parts of the vehicle
        associated with the operation of the lift or ramp.

       

      (c)
        The
        controls for operating the lift shall be at a location where the driver or
        lift
        attendant has a full view, unobstructed by passengers, of the lift platform,
        its
        entrance and exit, and the wheelchair passenger, either directly or with
        partial
        assistance of-mirrors. Lifts located entirely to the rear of the driver's
        seat
        shall not be operable from the driver's seat, but shall have an override
        control
        at the driver's position that can be activated to prevent the lift from being
        operated by the other controls (except for emergency manual operation upon
        power
        failure).

       

      (d)
        The
        installation of the wheelchair lift or ramp and its controls and the method
        of
        attachment in the vehicle body or chassis shall not diminish the structural
        integrity of the vehicle nor cause a hazardous imbalance of the vehicle.
        No part
        of the assembly, when installed and stowed, shall extend laterally beyond
        the

       

      21
        See
        section 316.300, F.S., 2004.

       

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      normal
        side contour of the vehicle or vertically beyond the lowest part of the rim
        of
        the wheel closest to the lift.

       

      (e)
        Each
        wheelchair lift or ramp assembly shall be legibly and permanently marked
        by the
        manufacturer or installer with the following minimum information:

      (1)
        The
        manufacturer's name and address;

      (2)
        The
        month and year of manufacture; and

      (3)
        A
        certificate that the wheelchair lift or ramp securement devices, and their
        installation, conform to State of Florida requirements applicable to accessible
        vehicles.

       

      15.
        Wheelchair lifts, ramps, securement devices, and restraints shall be inspected
        and maintained as required in this Section, above. Instructions for normal
        and
        emergency operation of the lift or ramp shall be carried or displayed in
        every
        vehicle.

       

      1.
        Vehicle Safety Inspections

       

      1.
        The
        Plan/Participating Transportation Provider shall require that all vehicles
        be
        inspected in accordance with the vehicle inspection procedures set forth
        above.

       

      2.
        It is
        the Plan's/Participating Transportation Provider's responsibility to ensure
        that
        each individual performing a vehicle safety inspection is qualified as
        follows:

       

      (a)
        Understands the requirements set forth in 14-90, F.A.C., 2004 and can identify
        defective components;

       

      (b)
        Is
        knowledgeable of, and has mastered the methods, procedures, tools, and equipment
        used when performing an inspection; and

       

      (c)
        Has
        at least one (1) year of training and/or experience as a mechanic or inspector
        in a vehicle maintenance program and has sufficient general knowledge of
        vehicles owned and operated by the Plan/Participating Transportation Provider
        to
        recognize deficiencies or mechanical defects.

       

      3.
        The
        Plan/Participating Transportation Provider shall ensure that each vehicle
        receiving a safety inspection is checked for compliance with the safety devices
        and equipment requirements as referenced or specified above. Specific operable
        equipment and devices include the following:

       

      (a) Horn;

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 24 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (b)
        Windshield wipers;

       

      (c)
        Mirrors;

       

      (d)
        Wiring and battery(ies);

       

      (e)
        Service and parking brakes;

       

      (f)
        Warning devices;

       

      (g)
        Directional signals;

       

      (h)
        Hazard warning signals;

       

      (i)
        Lighting systems and signaling devices;

       

      (j)
        Handrails and stanchions;

       

      (k)
        Standee line and warning;

       

      (1)
        Doors
        and interlock devices;

       

      (m)
        Stepwells and flooring;

       

      (n)
        Emergency exits;

       

      (o)
        Tires
        and wheels;

       

      (p)
        Suspension system;

       

      (q)
        Steering system;

       

      (r)
        Exhaust system;

       

      (s)
        Seat
        belts;

      (t)
        Safety equipment; and (u) Equipment for transporting wheelchairs.

       

      4.
        A
        safety inspection report shall be prepared by the individual(s) performing
        the
        inspection which shall include the following:

       

      (a)
        Identification of the individual(s) performing the inspection;

      (b)
        Identification of the Plan/Participating Transportation Provider operating
        the
        vehicle;

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 25 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMD Contract

       

      (c)
        The
        date of the inspection;

      (d)
        Identification of the vehicle inspected;

      (e)
        Identification of the equipment and devices inspected including the
        identification of equipment and devices found deficient or defective;
        and

      (f)
        Identification of corrective action(s) for deficient or defective items and
        date(s) of completion of corrective action(s).

       

      5.
        Records of annual safety inspections and documentation of any required
        corrective actions shall be retained for compliance review a minimum of five
        (5)
        years by the Plan/Participating Transportation Provider.

       

      m.
        Certification - Each Plan/Participating Transportation Provider shall submit
        to
        the Bureau of Managed Health Care an annual safety and security certification
        in
        accordance with 14-90.10, F.A.C., 2004 and shall submit in the format set
        forth
        in 14-90.10 and 14-90.12, F.A.C., 2004.

       

      n.
        The
        Plan shall report the following by August 15th
        of each
        year:

       

      (1)
        The
        estimated number of one-way passenger trips to be provided during the coming
        fiscal year in the following categories:22

       

      (a)
        Ambulatory transportation;

       

      (b)
        Long
        haul ambulatory transportation;

       

      (c)
        Wheelchair transportation;

       

      (d)
        Stretcher transportation;

       

      (e)
        Ambulatory multiload transportation;

       

      (f)
        Wheelchair multiload transportation;

       

      (g)
        Mass
        transit pending transportation;

       

      (h)
        Mass
        transit transportation;

       

      (i)
        Mass
        transit transportation (Enrollee has pass); and

       

      (j)
        Mass
        transit transportation (sent pass to Enrollee).

       

      (2)
        The
        actual amount of funds expended and the total number of trips provided during
        the previous fiscal year; and

       

      22
        As
        defined in the Transportation Handbook.

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 26 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      (3)
        The
        operating financial statistics for the previous fiscal year.

       

      o.
        Shall
        provide the total number of vehicles in each category, other than public
        transportation, that will serve each County as well as a provider directory
        for
        all Transportation Services."

       

      4.
        Attachment VIII, Estimated 2005-2006 Rates; Not for use unless approved by
        CMS,
        is hereby deleted in its entirety and replaced with Attachment VIII-A, 2005/2006
        Medicaid HMO Capitation Rates.

       

      5.
        Attachment I, Section 90.0, Payment and Authorized Enrollment Levels, Tables
        2
        and 3, are hereby deleted in their entirety and replaced with the
        following:

       

      Capitation
        Rates

       

      A.
        General Capitation Rates (Attachment VIII-A, Table I):

       

      Area
        1 Counties: Escambia, Santa Rosa

       

      County   Provider
        Number

      Escambia  015019314
        Santa Rosa   015019331

       

      Area
        4 Counties: Duval, Volusia

       

      County   Provider
        Number

      Volusia
           015019335

       

      Area
        9 Counties: Martin, Palm Beach

       

      County   Provider
        Number

      Martin   015019324
        Palm Beach   015019339

       

      Area
        10 Counties: Broward

       

      County   Provider
        Number

      Broward
          015019337

       

      B.
        General Capitation Rates plus Mental Health Rates (Attachment VIII-A, Table
        4):

       

      Area
        2 Counties: Madison, Wakulla, Calhoun, Liberty, Gadsden,
        Leon,

      Jefferson
        

      

      County   Provider
        Number

      Jefferson  015019318
        Madison  015019322

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 27 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Medicaid
        HMO Contract

      

      Wakulla   015019336

      Calhoun   015019340

      Liberty   015019342

      Gadsden     015019315

      Leon    015019320

       

      Area
        3 Counties: Citrus, Lake, Marion, Putnam

       

      County   Provider
        Number

      Citrus   015019309
        Lake   015019319
        Marion   015019323
        Putnam   015019329

       

      Area
        5 Counties: Pasco, Pinellas

       

      County
          Provider
        Number

      Pasco
          015019302
        Pinellas   015019303

       

      Area
        6 Counties: Manatee, Polk, Highlands

       

      County   Provider
        Number

      Manatee
          015019301
        Polk   015019304
        Highlands  015019317

       

      Area
        7 Counties: Brevard

       

      County   Provider
        Number

      Brevard
          015019308

       

      Area
        8 Counties: Sarasota

       

      County   Provider
        Number

      Sarasota
          015019332

       

      Area
        11 Counties: Dade

       

      County   Provider
        Number 

      Dade
          015019338

       

      REMAINDER
        OF PAGE INTENTIONALLY LEFT BLANK

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 28 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMO Contract

       

      C.
        General Capitation Rates plus Mental Health Rates and Transportation Rates
        (Attachment VIII-A, Table 6):

       

      Area
        4 Counties: Duval

       

      County   Provider
        Number

      Duval
          015019313

       

      Area
        6 Counties: Hillsborough

       

      County
           Provider
        Number

      Hillsborough
          015019300

       

      Area
        7 Counties: Orange, Osceola, Seminole

       

      County   Provider
        Number

      Orange
          015019327
        Osceola   015019328
        Seminole   015019333

       

      Notwithstanding
        the payment amounts which may be computed with the above rate table, the
        sum of
        total capitation payments under this contract shall not exceed the total
        contract amount of
        $835,063,844.00
        (an
        increase of $1,513,414.00), expressed on page seven of this
        contract.

       

      6.
        This
        Amendment shall have an effective date of December 1, 2005, or the date on
        which
        both parties execute the Amendment, whichever is later.

       

      All
        provisions in the Contract and any attachments thereto in conflict with this
        amendment shall be and are hereby changed to conform with this
        amendment.

       

      All
        provisions not in conflict with this Amendment are still in effect and are
        to be
        performed at the level specified in the Contract.

       

      This
        Amendment, and all its attachments are hereby made part of the
        Contract.

       

      This
        Amendment can not be executed unless all previous amendments to this Contract
        have been fully executed.

       

      REMAINDER
        OF PAGE INTENTIONALLY LEFT BLANK

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 29 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      Medicaid
        HMD Contract

       

      IN
        WITNESS WHEREOF,
        the
        Parties have caused this 33 page Amendment (including all attachments, if
        any)
        to be executed by their duly authorized officials.

       

      

      
        	
                 

                WELL
                  CARE HMO, INC. D/B/A STAYWELL HEALTH PLAN OF FLORIDA

                SIGNED

                BY:/s/
                  Todd S. Farha

                NAME:
                  Todd
                  S. Farha 

                TITLE:
                  President
                  & CEO

                DATE:
                  12/2/05

              	
                 

                STATE
                  OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION

                SIGNED
                  

                BY:
                  [ILLEGIBLE]

                NAME:
                  Alan
                  Levine

                TITLE:
                  Secretary 

                DATE:12/6/05

              

      

       

      

       

      List
        of
        attachments included as part of this Amendment:

       

      Specify

      Type_______  Number  Description    ____________

      Attachment VIII-A 2005/2006
        Medicaid HMO Capitation Rates (3 pages)

       

      REMAINDER
        OF PAGE INTENTIONALLY LEFT BLANK

       

      

       

      AHCA
        Contract No. FA521, Amendment No. 9, Page 30 of 30

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      ATTACHMENT
        VIII-A 2005/2006 MEDICAID HMO CAPITATION RATES

      By
        Area , Age and Eligibility Category Effective from July 1, 2005 thru June
        30,
        2006

      
        	
                TABLE
                  1

              
	
                 

                General
                  Rates: Effect from July 1, 05 - Dec 31, 05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                SSI-AB

              	
                 

                SSI-B

              	
                 

                SSI-AB

              
	
                 

                Area

              	
                 

                THMO

                 

                +2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                BTHMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  (14-20)

              	
                 

                AGE
                  (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male
                  

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                856.85

              	
                 

                169.63

              	
                 

                82.99

              	
                 

                52.45

              	
                 

                116.16

              	
                 

                58.88

              	
                 

                223.51

              	
                 

                144.11

              	
                 

                299.66

              	
                 

                8,379.19

              	
                 

                1,456.18

              	
                 

                373.32

              	
                 

                192.70

              	
                 

                211.00

              	
                 

                636.93

              	
                 

                598.84

              	
                 

                359.76

              	
                 

                314.95

              	
                 

                219.52

              	
                 

                213.89

              	
                 

                77.80

              	
                 

                67.94

              
	
                02

              	
                856.85

              	
                169.63

              	
                82.99

              	
                52.45

              	
                116.16

              	
                58.88

              	
                223.51

              	
                144.11

              	
                299.66

              	
                8,379.19

              	
                1,456.18

              	
                373.32

              	
                192.70

              	
                211.00

              	
                636.93

              	
                598.84

              	
                359.76

              	
                314.95

              	
                219.52

              	
                213.89

              	
                77.80

              	
                67.94

              
	
                03

              	
                956.50

              	
                190.36

              	
                93.47

              	
                59.66

              	
                130.82

              	
                66.71

              	
                252.75

              	
                163.57

              	
                340.95

              	
                8,796.55

              	
                1,536.62

              	
                394.23

              	
                205.64

              	
                225.15

              	
                679.21

              	
                639.39

              	
                347.95

              	
                292.11

              	
                203.81

              	
                229.06

              	
                75.70

              	
                66.16

              
	
                04

              	
                877.98

              	
                175.54

              	
                86.37

              	
                55.47

              	
                120.97

              	
                62.05

              	
                234,40

              	
                152.22

              	
                317.36

              	
                8,571.85

              	
                1,495.58

              	
                383.99

              	
                199.57

              	
                218.39

              	
                659.82

              	
                620.93

              	
                333.59

              	
                294.49

              	
                205.57

              	
                207.10

              	
                77.20

              	
                67.39

              
	
                05

              	
                919.97

              	
                183.42

              	
                90.13

              	
                57.68

              	
                126.15

              	
                64.46

              	
                244.02

              	
                158.18

              	
                329.69

              	
                9,248.01

              	
                1,615.40

              	
                414.34

              	
                216.54

              	
                236.27

              	
                713.54

              	
                671.88

              	
                327.76

              	
                311,44

              	
                217.30

              	
                209.72

              	
                74.11

              	
                64.73

              
	
                06

              	
                839.89

              	
                168.12

              	
                82.82

              	
                53.24

              	
                115.99

              	
                59.56

              	
                224.94

              	
                146.07

              	
                305.02

              	
                8,536.48

              	
                1,494.27

              	
                383.60

              	
                201.12

              	
                219.94

              	
                663,51

              	
                624.96

              	
                318.14

              	
                283,93

              	
                198.16

              	
                200.02

              	
                68.93

              	
                60.15

              
	
                 

                07

              	
                 

                894.04

              	
                 

                178.56

              	
                 

                87.80

              	
                 

                56.33

              	
                 

                122.97

              	
                 

                63.04

              	
                 

                238.18

              	
                 

                154.51

              	
                 

                322.34

              	
                 

                8,976.51

              	
                 

                1,573.97

              	
                 

                404.51

              	
                 

                212.74

              	
                 

                232.25

              	
                 

                701.12

              	
                 

                661.11

              	
                 

                308.90

              	
                 

                284.51

              	
                 

                198.54

              	
                 

                199.32

              	
                 

                72.42

              	
                 

                63.26

              
	
                 

                08

              	
                 

                785.52

              	
                 

                156.85

              	
                 

                77.12

              	
                 

                49.44

              	
                 

                107.94

              	
                 

                55.29

              	
                 

                209.14

              	
                 

                135.62

              	
                 

                282.90

              	
                 

                8,247.93

              	
                 

                1440.20

              	
                 

                369.54

              	
                 

                192.51

              	
                 

                211.13

              	
                 

                636.41

              	
                 

                599.00

              	
                 

                306.59

              	
                 

                288.63

              	
                 

                201.43

              	
                 

                185.30

              	
                 

                69.18

              	
                 

                60.36

              
	
                 

                09

              	
                 

                850.65

              	
                 

                169.56

              	
                 

                83.32

              	
                 

                53.28

              	
                 

                116.63

              	
                 

                59.62

              	
                 

                225.69

              	
                 

                146.30

              	
                 

                304.86

              	
                 

                9,123.67

              	
                 

                1,599.06

              	
                 

                410.92

              	
                 

                216.11

              	
                 

                235.92

              	
                 

                711.70

              	
                 

                670.95

              	
                 

                288.69
                  

              	
                 

                317.25

              	
                 

                221.58

              	
                 

                179.44

              	
                 

                76.11

              	
                 

                66.48

              
	
                 

                10

              	
                 

                854.17

              	
                 

                170.86

              	
                 

                84.11

              	
                 

                54.07

              	
                 

                117.82

              	
                 

                60.56

              	
                 

                228.53

              	
                 

                148.48

              	
                 

                309.80

              	
                 

                11,134.67

              	
                 

                1,955.18

              	
                 

                502.14

              	
                 

                264.85

              	
                 

                289.15

              	
                 

                873.08

              	
                 

                823.33

              	
                 

                316.19

              	
                 

                341.03

              	
                 

                238.55

              	
                 

                205.90

              	
                 

                81.99

              	
                 

                71.59

              
	
                 

                11

              	
                 

                1,110.67

              	
                 

                220.94

              	
                 

                108.54

              	
                 

                69.08

              	
                 

                151.73

              	
                 

                77.37

              	
                 

                293.07

              	
                 

                189.70

              	
                 

                395.11

              	
                 

                12,135.43

              	
                 

                2,122.04

              	
                 

                545.24

              	
                 

                284.82

              	
                 

                311.87

              	
                 

                940.58

              	
                 

                885.79

              	
                 

                450.68
                  

              	
                 

                420.85

              	
                 

                294.28

              	
                 

                269.25

              	
                 

                112.55

              	
                 

                98.31

              
	
                TABLE
                  2

              
	
                 

                General
                  + Transportation Rates: Effect from July 1, 05 - Dec 31,
                  05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                 

                Female

              	
                 

                Male

              	
                 

                Female

              	
                 

                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                859.90

              	
                 

                170.76

              	
                 

                83.89

              	
                 

                53.10

              	
                 

                117.81

              	
                 

                59.91

              	
                 

                226.17

              	
                 

                145.81

              	
                 

                302.65

              	
                 

                8,391.86

              	
                 

                1,468.01

              	
                 

                380.72

              	
                 

                194.81

              	
                 

                214.04

              	
                 

                651.77

              	
                 

                609.36

              	
                 

                374.05

              	
                 

                331.44

              	
                 

                226.36

              	
                 

                228.18

              	
                 

                94.29

              	
                 

                74.78

              
	
                02
                  

              	
                859.90

              	
                170.76

              	
                83.89

              	
                53.10

              	
                117.81

              	
                59.91

              	
                226.17

              	
                145.81

              	
                302.65

              	
                8,391.86

              	
                1,468.01

              	
                380.72

              	
                194.81

              	
                214.84

              	
                651.77

              	
                609.36

              	
                374.05

              	
                331.44

              	
                226.36

              	
                228.18

              	
                94.29

              	
                74.78

              
	
                 

                03
                  

              	
                 

                959.98

              	
                 

                191.66

              	
                 

                94.50

              	
                 

                60.41

              	
                 

                132.70

              	
                 

                67.88

              	
                 

                255.80

              	
                 

                165.52

              	
                 

                344.37

              	
                 

                8,811.87

              	
                 

                1,550.92

              	
                 

                403.17

              	
                 

                208.19

              	
                 

                229.78

              	
                 

                697.16

              	
                 

                652.10

              	
                 

                358.59

              	
                 

                315.51

              	
                 

                213.51

              	
                 

                239.70

              	
                 

                99.10

              	
                 

                75.86

              
	
                04

              	
                880.32

              	
                176.41

              	
                87.06

              	
                55.97

              	
                122.24

              	
                62.84

              	
                236.45

              	
                153.53

              	
                319.66

              	
                8,588.73

              	
                1,511.34

              	
                393.86

              	
                202.38

              	
                223.50
                  

              	
                679.61
                  

              	
                634.95
                  

              	
                340.18

              	
                317.93
                  

              	
                215.29

              	
                213.69
                  

              	
                100.64
                  

              	
                77.11

              
	
                 

                05
                  

              	
                 

                922.10

              	
                 

                184.21

              	
                 

                90.76

              	
                 

                58.14

              	
                 

                127.30

              	
                 

                65.18

              	
                 

                245.89

              	
                 

                159.37

              	
                 

                331.78

              	
                 

                9,257.23

              	
                 

                1,624.00
                  

              	
                 

                419.72
                  

              	
                 

                218.07

              	
                 

                239.06

              	
                 

                724.34

              	
                 

                679.53

              	
                 

                333.32
                  

              	
                 

                325.59

              	
                 

                223.17

              	
                 

                215.28

              	
                 

                88.26

              	
                 

                70.60
                  

              
	
                06

              	
                842.31

              	
                169.02

              	
                83.53

              	
                53.75

              	
                117.30

              	
                60.38

              	
                227.06

              	
                147.42

              	
                307.40

              	
                8,546.96

              	
                1,504.05

              	
                389.72

              	
                202.87

              	
                223.11

              	
                675.78

              	
                633.65

              	
                322.90

              	
                298.45

              	
                204.18

              	
                204.78

              	
                83.45

              	
                66.17

              
	
                07
                  

              	
                895.75

              	
                179.20

              	
                88.31

              	
                56.70

              	
                123.90

              	
                63.62

              	
                239.68

              	
                155.47

              	
                324.02

              	
                8,987.84

              	
                1,584.55

              	
                411.12

              	
                214.63

              	
                235.67

              	
                714.39

              	
                670.51

              	
                314.35

              	
                301.66

              	
                205.65

              	
                204.77

              	
                89.57

              	
                70.37

              
	
                08
                  

              	
                788.64

              	
                158.01

              	
                78.04

              	
                50.11

              	
                109.62

              	
                56.34

              	
                211.86

              	
                137.36

              	
                285.97

              	
                8.259.67

              	
                1,451.16

              	
                376.39

              	
                194.46

              	
                214.68

              	
                650.16

              	
                608.74

              	
                316.39

              	
                304.12

              	
                207.85

              	
                195.10

              	
                84.67

              	
                66.78

              
	
                 

                09
                  

              	
                 

                853.54

              	
                 

                170.64

              	
                 

                84.18

              	
                 

                53.90

              	
                 

                118.18

              	
                 

                60.59

              	
                 

                228.21

              	
                 

                147.91

              	
                 

                307.69

              	
                 

                9,136.00

              	
                 

                1,610.58

              	
                 

                418.13

              	
                 

                218.16

              	
                 

                239.64

              	
                 

                726.15

              	
                 

                681.19

              	
                 

                293.10

              	
                 

                336.49

              	
                 

                229.56

              	
                 

                183.85

              	
                 

                95.35

              	
                 

                74.46

              
	
                 

                10
                  

              	
                 

                856.36

              	
                 

                171.67

              	
                 

                84.76

              	
                 

                54.54

              	
                 

                119.01

              	
                 

                61.30

              	
                 

                230.45

              	
                 

                149.70

              	
                 

                311.95

              	
                 

                11,151.24

              	
                 

                1,9070.64

              	
                 

                511.81

              	
                 

                267.61

              	
                 

                294.16

              	
                 

                892.47

              	
                 

                837.08
                  

              	
                 

                322.46
                  

              	
                 

                363.21
                  

              	
                 

                247.75
                  

              	
                 

                212.17
                  

              	
                 

                104.17
                  

              	
                 

                80.79
                  

              
	
                 

                11

              	
                 

                1,112.08

              	
                 

                221.47

              	
                 

                108.96

              	
                 

                69.38

              	
                 

                152.49

              	
                 

                77.84

              	
                 

                294.30

              	
                 

                190.48

              	
                 

                369.50

              	
                 

                12,145.44

              	
                 

                2,131.38

              	
                 

                551.08

              	
                 

                286.49

              	
                 

                314.89

              	
                 

                952.30

              	
                 

                894.10

              	
                 

                455.34

              	
                 

                433.96

              	
                 

                299.72

              	
                 

                273.91

              	
                 

                125.66

              	
                 

                103.75

              
	
                TABLE
                  3

              	 
	
                 

                General
                  + Dental Rates: Effect from July 1, 05 - Dec 31, 05 Effect from
                  Jan 1, 06
                  - June 30, 06

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE

                 

                (65-)

              	
                 

                AGE

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                856.85

              	
                 

                169.64

              	
                 

                85.68

              	
                 

                57.82

              	
                 

                122.00

              	
                 

                63.64

              	
                 

                224.53

              	
                 

                144.95

              	
                 

                300.28

              	
                 

                8,379.19

              	
                 

                1,456.20

              	
                 

                375.81

              	
                 

                196.65

              	
                 

                214.57

              	
                 

                636.22

              	
                 

                599.71

              	
                 

                359.86

              	
                 

                315.91

              	
                 

                219.89

              	
                 

                213.99

              	
                 

                78.76

              	
                 

                68.31

              
	
                02
                  

              	
                856.85

              	
                169.64

              	
                85.68

              	
                57.82

              	
                122.00

              	
                63.64

              	
                224.53

              	
                144.95

              	
                300.28

              	
                8,379.19

              	
                1,456.20

              	
                375.81

              	
                196.65

              	
                214.57

              	
                636.22

              	
                599.71

              	
                359.86

              	
                315.91

              	
                219.89

              	
                213.99

              	
                78.76

              	
                68.31

              
	
                03
                  

              	
                956.50

              	
                190.37

              	
                96.77

              	
                66.24

              	
                137.98

              	
                72.54

              	
                256.08

              	
                166.32

              	
                342.99

              	
                8,796.55

              	
                1.536.65

              	
                397.67

              	
                211.11

              	
                230.10

              	
                681.91

              	
                641.21

              	
                349.31

              	
                294.26

              	
                204.63

              	
                230.42

              	
                77.85

              	
                66.98

              
	
                04
                  

              	
                877.98

              	
                175.55

              	
                88.68

              	
                60.09

              	
                125.99

              	
                66.14

              	
                237.63

              	
                154.89

              	
                319.33

              	
                8,571.85

              	
                1,495.60

              	
                386.54

              	
                203.61

              	
                222.05

              	
                662.50

              	
                622.74

              	
                334.80

              	
                296.81

              	
                206.45

              	
                208.31

              	
                79.52

              	
                68.27

              
	
                05
                  

              	
                919.98

              	
                183.44

              	
                93.94

              	
                65.28

              	
                134.42

              	
                71.19

              	
                254.18

              	
                166.58

              	
                335.91

              	
                9,248.01

              	
                1,615.44

              	
                419.19

              	
                224.23

              	
                243.23

              	
                719.05

              	
                675.60

              	
                332.66

              	
                317.69

              	
                219.69

              	
                214.62

              	
                80.36

              	
                67.12

              
	
                06
                  

              	
                839.89

              	
                168.13

              	
                85.94

              	
                59.43

              	
                122.74

              	
                65,05

              	
                231.04

              	
                151.11

              	
                308.75

              	
                8,536.48

              	
                1,494.30

              	
                387.15

              	
                206.75

              	
                225.03

              	
                668.52

              	
                628.34

              	
                320.73

              	
                288.82

              	
                200.03

              	
                202.61

              	
                73.82

              	
                62.02

              
	
                07
                  

              	
                894.04

              	
                178.57

              	
                90.51

              	
                61.74

              	
                128.85

              	
                67.83

              	
                243.93

              	
                159.26

              	
                325.86

              	
                8,976.51

              	
                1,574.00

              	
                407.86

              	
                218.05

              	
                237.05

              	
                704.74

              	
                663.55

              	
                310.08

              	
                287.80

              	
                199.80

              	
                200.50

              	
                75.71

              	
                64.52

              
	
                08
                  

              	
                785.52

              	
                156.86

              	
                79.85

              	
                54.89

              	
                113.87

              	
                60.13

              	
                214.88

              	
                140.36

              	
                286.42

              	
                8,247.93

              	
                1,440.22

              	
                372.40

              	
                197.06

              	
                215.24

              	
                641.03

              	
                602.12

              	
                309.05

              	
                292.56

              	
                202.94

              	
                187.76

              	
                73.11

              	
                61.87

              
	
                09
                  

              	
                850.66

              	
                169.58

              	
                86.89

              	
                60.40

              	
                124.38

              	
                65.93

              	
                229.41

              	
                149.37

              	
                307.13

              	
                9,123.67

              	
                1,599.08

              	
                414.10

              	
                221.16

              	
                240.49

              	
                714.60

              	
                672.91

              	
                289.96

              	
                319.90

              	
                222.59

              	
                180.71

              	
                78.76

              	
                67.49

              
	
                10
                  

              	
                854.17

              	
                170.87

              	
                87.29

              	
                60.43

              	
                124.73

              	
                66.19

              	
                231.56

              	
                150.99

              	
                311.65

              	
                11,134.67

              	
                1,955.21

              	
                506.08

              	
                271.11

              	
                294.81

              	
                876.08

              	
                825.36

              	
                317.65

              	
                344.02

              	
                239.70

              	
                207.36

              	
                84.98

              	
                72.74

              
	
                11
                  

              	
                1,110.68

              	
                220.96

              	
                112.49

              	
                76.96

              	
                160.31

              	
                84.36

              	
                296.12

              	
                192.22

              	
                396.97

              	
                12,135.43

              	
                2,122.07

              	
                549.62

              	
                291.76

              	
                318.15

              	
                943.63

              	
                887.85

              	
                452.12

              	
                423.86

              	
                295.43

              	
                270.69

              	
                115.56

              	
                99.46

              

      

      

      AHCA
        Contract No. FA521, Attachment VIII-A, Page 1 of 3

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      

      
        	
                TABLE
                  4

              
	
                 

                General
                  + Mental Health Rates: Effect from July 1, 05 - Dec 31,
                  05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                SSI-AB

              	
                 

                SSI-B

              	
                 

                SSI-AB

              
	
                 

                Area

              	
                 

                THMO

                 

                +2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                BTHMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  (14-20)

              	
                 

                AGE
                  (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male
                  

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                856.86

              	
                 

                169.64

              	
                 

                84.58

              	
                 

                64.23

              	
                 

                128.66

              	
                 

                71.38

              	
                 

                227.66

              	
                 

                148.26

              	
                 

                303.38

              	
                 

                8,379.21

              	
                 

                1,456.20

              	
                 

                384.40

              	
                 

                263.28

              	
                 

                284.40

              	
                 

                732.06

              	
                 

                631.82

              	
                 

                367.49

              	
                 

                331.54

              	
                 

                236.11

              	
                 

                221.62

              	
                 

                94.39

              	
                 

                84.53

              
	
                02

              	
                856.87

              	
                169.65

              	
                85.36

              	
                69.25

              	
                128.93

              	
                71.65

              	
                226.56

              	
                147.16

              	
                302.78

              	
                8,379.20

              	
                1,456.19

              	
                388.93

              	
                278.27

              	
                264.36

              	
                690.25

              	
                621.15

              	
                380.79

              	
                328.39

              	
                232.96

              	
                234.92

              	
                91.24

              	
                81.38

              
	
                03

              	
                956.51

              	
                190.37

              	
                94.52

              	
                67.12

              	
                136.49

              	
                72.38

              	
                254.10

              	
                164.92

              	
                342.33

              	
                8,796.56

              	
                1,536.63

              	
                401.17

              	
                243.67

              	
                248.87

              	
                702.91

              	
                649.30

              	
                356.54

              	
                299.65

              	
                211.35

              	
                237.65

              	
                83.24

              	
                73.70

              
	
                04

              	
                877.99

              	
                175.55

              	
                87.56

              	
                63.92

              	
                127.39

              	
                68.47

              	
                235.93

              	
                153.75

              	
                318.93

              	
                8,571.86

              	
                1,495.59

              	
                394.00

              	
                354.46

              	
                252.62

              	
                694.02

              	
                635.24

              	
                342.17

              	
                311.96

              	
                223.04

              	
                215.68

              	
                94.67

              	
                84.86

              
	
                05

              	
                919.98

              	
                183.43

              	
                91.15

              	
                64.87

              	
                131.62

              	
                69.93

              	
                245.33

              	
                159.49

              	
                331.03

              	
                9,248.02

              	
                1,615.41

              	
                420.86

              	
                252.27

              	
                258.55

              	
                735.80

              	
                681.19

              	
                332.63

              	
                321.24

              	
                227.10

              	
                214.59

              	
                83.91

              	
                74.53

              
	
                06

              	
                839.91

              	
                168.14

              	
                84.80

              	
                67.94

              	
                131.59

              	
                75.16

              	
                230.12

              	
                151.25

              	
                309.66

              	
                8,536.50

              	
                1,494.29

              	
                393.28

              	
                262.75

              	
                284.04

              	
                746.59

              	
                653.76

              	
                319.38

              	
                288.23

              	
                202.46

              	
                201.26

              	
                73.23

              	
                64.45

              
	
                 

                07

              	
                 

                894.05

              	
                 

                178.57

              	
                 

                89.54

              	
                 

                68.64

              	
                 

                132.32

              	
                 

                72.39

              	
                 

                240.41

              	
                 

                156.74

              	
                 

                324.62

              	
                 

                8,976.52

              	
                 

                1,573.98

              	
                 

                414.04

              	
                 

                264.97

              	
                 

                264.82

              	
                 

                733.66

              	
                 

                674.72

              	
                 

                312.78

              	
                 

                269.22

              	
                 

                210.25

              	
                 

                203.20

              	
                 

                84.13

              	
                 

                74.97

              
	
                 

                08

              	
                 

                785.53

              	
                 

                156.86

              	
                 

                78.13

              	
                 

                56.61

              	
                 

                113.39

              	
                 

                60.74

              	
                 

                210.44

              	
                 

                136.92

              	
                 

                284.23

              	
                 

                8,247.94

              	
                 

                1,440.21

              	
                 

                376.25

              	
                 

                229.28

              	
                 

                234.06

              	
                 

                659.32

              	
                 

                608.59

              	
                 

                313.20

              	
                 

                297.40

              	
                 

                210.20

              	
                 

                191.91

              	
                 

                77.95

              	
                 

                69.13

              
	
                 

                09

              	
                 

                850.66

              	
                 

                169.57

              	
                 

                84.45

              	
                 

                61.30

              	
                 

                122.72

              	
                 

                65.71

              	
                 

                227.14

              	
                 

                147.75

              	
                 

                306.35

              	
                 

                9,123.68

              	
                 

                1,599.07

              	
                 

                417.49

              	
                 

                252.14

              	
                 

                258.39

              	
                 

                734.15

              	
                 

                680.34

              	
                 

                292.37

              	
                 

                328.87

              	
                 

                233.20

              	
                 

                183.12

              	
                 

                87.73

              	
                 

                78.10

              
	
                 

                10

              	
                 

                854.19

              	
                 

                170.88

              	
                 

                86.07

              	
                 

                67.92

              	
                 

                128.34

              	
                 

                71.08

              	
                 

                231.04

              	
                 

                150.99

              	
                 

                312.37

              	
                 

                11,134.68

              	
                 

                1,955.19

              	
                 

                510.16

              	
                 

                308.82

              	
                 

                316.57

              	
                 

                900.47

              	
                 

                834.79

              	
                 

                319.50

              	
                 

                346.90

              	
                 

                244.42

              	
                 

                209.21

              	
                 

                87.86

              	
                 

                77.46

              
	
                 

                11

              	
                 

                1,110.68

              	
                 

                220.95

              	
                 

                110.34

              	
                 

                81.84

              	
                 

                161.42

              	
                 

                87.06

              	
                 

                295.39

              	
                 

                192.02

              	
                 

                397.48

              	
                 

                12,135.44

              	
                 

                2,122.05

              	
                 

                554.29

              	
                 

                334.42

              	
                 

                342.80

              	
                 

                971.48

              	
                 

                898.72

              	
                 

                457.65

              	
                 

                426.65

              	
                 

                300.08

              	
                 

                276.22

              	
                 

                118.35

              	
                 

                104.11

              
	
                TABLE
                  5

              
	
                 

                General
                  + Mental Health + Dental Rates: Effect from July 1, 05 - Dec 31,
                  05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+

                 

                2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                 

                Female

              	
                 

                Male

              	
                 

                Female

              	
                 

                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                856.86

              	
                 

                169.65

              	
                 

                87.27

              	
                 

                69.60

              	
                 

                134.50

              	
                 

                76.14

              	
                 

                228.68

              	
                 

                149.10

              	
                 

                304.00

              	
                 

                8,379.21

              	
                 

                1,456.22

              	
                 

                386.89

              	
                 

                267.23

              	
                 

                287.97

              	
                 

                733.35

              	
                 

                632.69

              	
                 

                367.59

              	
                 

                332.50

              	
                 

                236.48

              	
                 

                221.72

              	
                 

                95.35

              	
                 

                84.90

              
	
                02

              	
                856.87

              	
                169.66

              	
                88.05

              	
                74.62

              	
                134.77

              	
                76.41

              	
                227.58

              	
                148.00

              	
                303.40

              	
                8,379.20

              	
                1,456.21

              	
                391.42

              	
                282.22

              	
                267.93

              	
                691.54

              	
                622.02

              	
                380.89

              	
                329.35

              	
                233.33

              	
                235.05

              	
                92.20

              	
                81.75

              
	
                03

              	
                 

                956.51

              	
                 

                190.38

              	
                 

                97.82

              	
                 

                73.70

              	
                 

                143.65

              	
                 

                78.21

              	
                 

                257.43

              	
                 

                167.67

              	
                 

                344.37

              	
                 

                8,796.56

              	
                 

                1,536.66

              	
                 

                404.61

              	
                 

                249.14

              	
                 

                253.82

              	
                 

                705.61

              	
                 

                651.12

              	
                 

                357.90

              	
                 

                301.80

              	
                 

                212.17

              	
                 

                239.01

              	
                 

                85.39

              	
                 

                74.52

              
	
                04

              	
                877.99

              	
                175.56

              	
                89.87

              	
                68.54

              	
                132.41

              	
                72.56

              	
                239.16

              	
                156.42

              	
                320.90

              	
                8,571.86

              	
                1,495.61

              	
                396.55

              	
                258.50

              	
                256.28

              	
                696.70

              	
                637.05

              	
                343.38

              	
                314.28

              	
                223.92

              	
                216.89

              	
                96.99

              	
                85.74

              
	
                05

              	
                 

                919.99

              	
                 

                183.45

              	
                 

                94.96

              	
                 

                72.47

              	
                 

                139.89

              	
                 

                76.66

              	
                 

                255.49

              	
                 

                167.89

              	
                 

                337.25

              	
                 

                9,248.02

              	
                 

                1,615.45

              	
                 

                425.71

              	
                 

                259.96

              	
                 

                265.51

              	
                 

                741.31

              	
                 

                684.91

              	
                 

                337.53

              	
                 

                927.49

              	
                 

                229.49

              	
                 

                219.49

              	
                 

                90.16

              	
                 

                76.92

              
	
                06

              	
                839.91

              	
                168.15

              	
                87.92

              	
                74.13

              	
                138.34

              	
                80.65

              	
                236.22

              	
                156.29

              	
                313.39

              	
                8,536.50

              	
                1,494.32

              	
                396.83

              	
                268.38

              	
                289.13

              	
                751.60

              	
                657.14

              	
                321.97

              	
                293.12

              	
                204.33

              	
                203.85

              	
                78.12

              	
                66.32

              
	
                 

                07

              	
                894.05

              	
                178.58

              	
                92.25

              	
                74.05

              	
                138.20

              	
                77.18

              	
                246.16

              	
                161.49

              	
                328.14

              	
                8,976.52

              	
                1,574.01

              	
                417.39

              	
                270.28

              	
                269.62

              	
                737.28

              	
                677.16

              	
                313.96

              	
                299.51

              	
                211.51

              	
                204.38

              	
                87.42

              	
                76.23

              
	
                 

                08

              	
                785.53

              	
                156.87

              	
                80.86

              	
                62.06

              	
                119.32

              	
                65.58

              	
                216.18

              	
                141.66

              	
                287.75

              	
                8,247.94

              	
                1,440.23

              	
                379.11

              	
                233.83

              	
                238.17

              	
                663.94

              	
                611.71

              	
                315.66

              	
                301.33

              	
                211.71

              	
                194.37

              	
                81.88

              	
                70.64

              
	
                 

                09

              	
                 

                850.67

              	
                 

                169.59

              	
                 

                88.02

              	
                 

                68.42

              	
                 

                130.47

              	
                 

                72.02

              	
                 

                230.86

              	
                 

                150.82

              	
                 

                308.62

              	
                 

                9,123.68

              	
                 

                1,599.09

              	
                 

                420.67

              	
                 

                257.19

              	
                 

                262.96

              	
                 

                737.05

              	
                 

                682.30

              	
                 

                293.64

              	
                 

                331.52

              	
                 

                234.21

              	
                 

                184.39

              	
                 

                90.38

              	
                 

                79.11

              
	
                 

                10

              	
                 

                854.19

              	
                 

                170.89

              	
                 

                89.25

              	
                 

                74.28

              	
                 

                135.25

              	
                 

                76.71

              	
                 

                234.07

              	
                 

                153.50

              	
                 

                314.22

              	
                 

                11,134.68

              	
                 

                1,955.22

              	
                 

                514.10

              	
                 

                315.08

              	
                 

                322.23

              	
                 

                903.47

              	
                 

                836.82

              	
                 

                320.96

              	
                 

                349.89

              	
                 

                245.57

              	
                 

                210.67

              	
                 

                91.85

              	
                 

                78.61

              
	
                 

                11

              	
                 

                1,110.69

              	
                 

                220.97

              	
                 

                114.29

              	
                 

                89.72

              	
                 

                170.00

              	
                 

                94.05

              	
                 

                298.44

              	
                 

                194.54

              	
                 

                399.34

              	
                 

                12,135.44

              	
                 

                2,122.08

              	
                 

                558.67

              	
                 

                341.36

              	
                 

                349.08

              	
                 

                974.53

              	
                 

                900.78

              	
                 

                459.09

              	
                 

                429.66

              	
                 

                301.23

              	
                 

                277.66

              	
                 

                121.36

              	
                 

                105.26

              
	
                TABLE
                  6

              	 
	
                 

                General
                  + Mental Health + Transportation Rates: Effect from July 1, 05
                  - Dec 31,
                  05 Effect from Jan 1, 06 - June 30, 06

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+

                 

                2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE

                 

                (65-)

              	
                 

                AGE

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                859.91

              	
                 

                170.77

              	
                 

                85.48

              	
                 

                64.88

              	
                 

                130.31

              	
                 

                72.41

              	
                 

                230.32

              	
                 

                149.96

              	
                 

                306.37

              	
                 

                8,391.88

              	
                 

                1,468.03

              	
                 

                319.80

              	
                 

                265.39

              	
                 

                288.24

              	
                 

                746.90

              	
                 

                642.34

              	
                 

                381.78

              	
                 

                348.03

              	
                 

                242.95

              	
                 

                235.91

              	
                 

                110.88

              	
                 

                91.37

              
	
                02
                  

              	
                859.92

              	
                170.78

              	
                86.26

              	
                69.90

              	
                130.58

              	
                72.68

              	
                229.22

              	
                148.86

              	
                305.77

              	
                8,391.87

              	
                1,468.02

              	
                396.33

              	
                280.38

              	
                268.20

              	
                705.09

              	
                631.67

              	
                395.08

              	
                344.88

              	
                239.80

              	
                249.21

              	
                107.73

              	
                88.22

              
	
                03
                  

              	
                959.99

              	
                191.67

              	
                95.55

              	
                67.87

              	
                138.37

              	
                73.55

              	
                257.15

              	
                166.87

              	
                345.75

              	
                8,811.88

              	
                1,550.93

              	
                410.11

              	
                246.22

              	
                253.50

              	
                720.86

              	
                662.01

              	
                367.18

              	
                323.05

              	
                221.05

              	
                248.29

              	
                106.64

              	
                83.40

              
	
                04
                  

              	
                880.33

              	
                176.42

              	
                88.25

              	
                64.42

              	
                128.66

              	
                69.26

              	
                237.98

              	
                155.06

              	
                321.23

              	
                8,588.74

              	
                1,511.35

              	
                403.87

              	
                257.27

              	
                257.73

              	
                713.81

              	
                649.26

              	
                348.76

              	
                335.40

              	
                232.76

              	
                222.27

              	
                118.11

              	
                94.58

              
	
                05
                  

              	
                922.11

              	
                184.22

              	
                91.78

              	
                65.33

              	
                132.77

              	
                70.65

              	
                247.20

              	
                160.68

              	
                333.12

              	
                9,257.24

              	
                1,624.01

              	
                426.24

              	
                253.80

              	
                261.34

              	
                746.60

              	
                688.84

              	
                338.19

              	
                335.39

              	
                232.97

              	
                220.15

              	
                98.06

              	
                80.40

              
	
                06
                  

              	
                842.33

              	
                169.04

              	
                85.51

              	
                68.45

              	
                132.90

              	
                75.98

              	
                232.24

              	
                152.60

              	
                312.04

              	
                8,546.98

              	
                1,504.07

              	
                399.40

              	
                264.50

              	
                287.21

              	
                758.86

              	
                662.45

              	
                324.14

              	
                302.75

              	
                208.48

              	
                206.02

              	
                87.75

              	
                70.47

              
	
                07
                  

              	
                895.76

              	
                179.21

              	
                90.05

              	
                69.01

              	
                133.25

              	
                72.97

              	
                241.91

              	
                157.70

              	
                326.30

              	
                8,987.85

              	
                1,584.56

              	
                420.65

              	
                266.86

              	
                268.24

              	
                746.93

              	
                684.12

              	
                318.23

              	
                313.37

              	
                217.36

              	
                208.65

              	
                101.28

              	
                82.08

              
	
                08
                  

              	
                788.65

              	
                158.02

              	
                79.05

              	
                57.28

              	
                115.07

              	
                61.79

              	
                213.16

              	
                138.66

              	
                287.30

              	
                8,259.68

              	
                1,451.17

              	
                383.10

              	
                231.23

              	
                237.61

              	
                673.07

              	
                618.33

              	
                323.00

              	
                312.89

              	
                216.62

              	
                201.71

              	
                93.44

              	
                75.55

              
	
                09
                  

              	
                853.55

              	
                170.65

              	
                85.31

              	
                61.92

              	
                124.27

              	
                66.68

              	
                229.66

              	
                149.36

              	
                309.18

              	
                9,136.01

              	
                1,610.59

              	
                424.70

              	
                254.19

              	
                262.11

              	
                748.60

              	
                690.58

              	
                296.78

              	
                348.11

              	
                241.18

              	
                187.53

              	
                106.97

              	
                86.08

              
	
                10
                  

              	
                856.38

              	
                171.69

              	
                86.72

              	
                68.39

              	
                129.53

              	
                71.82

              	
                232.96

              	
                152.21

              	
                314.52

              	
                11,151.25

              	
                1,970.65

              	
                519.83

              	
                311.58

              	
                321.58

              	
                919.86

              	
                848.54

              	
                325.77

              	
                369.08

              	
                253.62

              	
                215.48

              	
                110.04

              	
                86.66

              
	
                11
                  

              	
                1,112.09

              	
                221.48

              	
                110.76

              	
                82.14

              	
                162.18

              	
                87.53

              	
                296.62

              	
                192.80

              	
                398.87

              	
                12,145.45

              	
                2,131.39

              	
                560.13

              	
                336.09

              	
                345.82

              	
                983.20

              	
                907.03

              	
                462.31

              	
                439.76

              	
                305.52

              	
                280.88

              	
                131.46

              	
                109.55

              

      

      

      AHCA
        Contract No. FA521, Attachment VIII-A, Page 2 of 3

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      
        	
                TABLE
                  7

              
	
                 

                General
                  + Dental + Transportation Rates: Effect from July 1, 05 - Dec 31,
                  05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                SSI-AB

              	
                 

                SSI-B

              	
                 

                SSI-AB

              
	
                 

                Area

              	
                 

                THMO

                 

                +2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                BTHMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  (14-20)

              	
                 

                AGE
                  (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                Female

              	
                Male
                  

              	
                Female

              	
                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01

              	
                 

                859.90

              	
                 

                170.77

              	
                 

                86.58

              	
                 

                58.47

              	
                 

                123.65

              	
                 

                64.67

              	
                 

                227.19

              	
                 

                146.65

              	
                 

                303.27

              	
                 

                8,391.86

              	
                 

                1,468.03

              	
                 

                383.21

              	
                 

                198.76

              	
                 

                218.41

              	
                 

                653.06

              	
                 

                610.23

              	
                 

                374.15

              	
                 

                332.40

              	
                 

                226.73

              	
                 

                228.28

              	
                 

                95.25

              	
                 

                75.15

              
	
                02

              	
                859.90

              	
                170.77

              	
                86.58

              	
                58.47

              	
                123.65

              	
                64.67

              	
                227.19

              	
                146.65

              	
                303.27

              	
                8,391.86

              	
                1,468.03

              	
                383.21

              	
                198.76

              	
                218.41

              	
                653.06

              	
                610.23

              	
                374.15

              	
                332.40

              	
                226.73

              	
                228.28

              	
                95.25

              	
                75.15

              
	
                03

              	
                959.98

              	
                191.67

              	
                97.80

              	
                66.99

              	
                139.86

              	
                73.71

              	
                259.13

              	
                168.27

              	
                346.41

              	
                8,811.87

              	
                1,550.95

              	
                406.61

              	
                213.66

              	
                234.73

              	
                699.86

              	
                653.92

              	
                359.95

              	
                317.66

              	
                214.33

              	
                241.06

              	
                101.25

              	
                76.68

              
	
                04

              	
                880.32

              	
                176.42

              	
                86.37

              	
                60.59

              	
                127.26

              	
                66.93

              	
                239.68

              	
                156.20

              	
                321.63

              	
                8,588.73

              	
                1,511.36

              	
                396.41

              	
                206.42

              	
                227.16

              	
                682.29

              	
                636.76

              	
                341.39

              	
                320.25

              	
                216.17

              	
                214.90

              	
                102.96

              	
                77.99

              
	
                05

              	
                922.11

              	
                184.23

              	
                94.57

              	
                65.74

              	
                135.57

              	
                71.91

              	
                256.05

              	
                167.77

              	
                338.00

              	
                9,257.23

              	
                1,624.04

              	
                424.57

              	
                225.76

              	
                246.02

              	
                729.85

              	
                683.25

              	
                338.22

              	
                331.84

              	
                225.56

              	
                220.18

              	
                94.51

              	
                72.99

              
	
                06

              	
                842.31

              	
                169.03

              	
                86.65

              	
                59.94

              	
                124.05

              	
                65.87

              	
                233.16

              	
                152.46

              	
                311.13

              	
                8,546.96

              	
                1,504.08

              	
                393.27

              	
                208.50

              	
                228.20

              	
                680.79

              	
                637.03

              	
                325.49

              	
                303.40

              	
                206.05

              	
                207.37

              	
                88.34

              	
                68.04

              
	
                 

                07

              	
                 

                895.75

              	
                 

                179.21

              	
                 

                91.02

              	
                 

                62.11

              	
                 

                129.78

              	
                 

                68.41

              	
                 

                245.43

              	
                 

                160.22

              	
                 

                327.54

              	
                 

                8,987.84

              	
                 

                1,584.58

              	
                 

                414.47

              	
                 

                219.94

              	
                 

                240.47

              	
                 

                718.01

              	
                 

                672.95

              	
                 

                315.53

              	
                 

                304.95

              	
                 

                206.91

              	
                 

                205.95

              	
                 

                92.86

              	
                 

                71.63

              
	
                 

                08

              	
                 

                788.64

              	
                 

                158.02

              	
                 

                80.77

              	
                 

                55.56

              	
                 

                115.55

              	
                 

                61.18

              	
                 

                217.60

              	
                 

                142.10

              	
                 

                289.49

              	
                 

                8,259.67

              	
                 

                1,451.18

              	
                 

                379.25

              	
                 

                199.01

              	
                 

                218.79

              	
                 

                654.78

              	
                 

                611.86

              	
                 

                318.85

              	
                 

                308.05

              	
                 

                209.36

              	
                 

                197.56

              	
                 

                88.60

              	
                 

                68.29

              
	
                 

                09

              	
                 

                853.55

              	
                 

                170.66

              	
                 

                87.75

              	
                 

                61.02

              	
                 

                125.93

              	
                 

                66.90

              	
                 

                231.93

              	
                 

                150.98

              	
                 

                309.96

              	
                 

                9,136.00

              	
                 

                1,610.60

              	
                 

                421.31

              	
                 

                223.21

              	
                 

                244.21

              	
                 

                729.05

              	
                 

                683.15

              	
                 

                294.37

              	
                 

                339.14

              	
                 

                230.57

              	
                 

                185.12

              	
                 

                98.00

              	
                 

                75.47

              
	
                 

                10

              	
                 

                856.36

              	
                 

                171.68

              	
                 

                87.94

              	
                 

                60.90

              	
                 

                125.92

              	
                 

                66.93

              	
                 

                233.48

              	
                 

                152.21

              	
                 

                313.80

              	
                 

                11,151.24

              	
                 

                1,970.67

              	
                 

                515.75

              	
                 

                273.87

              	
                 

                299.82

              	
                 

                895.47

              	
                 

                839.11

              	
                 

                323.92

              	
                 

                336.20

              	
                 

                248.90

              	
                 

                213.63

              	
                 

                107.18

              	
                 

                81.94

              
	
                 

                11

              	
                 

                1,112.09

              	
                 

                221.49

              	
                 

                112.91

              	
                 

                77.26

              	
                 

                161.07

              	
                 

                84.83

              	
                 

                297.35

              	
                 

                193.00

              	
                 

                398.36

              	
                 

                12,145.44

              	
                 

                2,131.41

              	
                 

                555.46

              	
                 

                293.43

              	
                 

                321.17

              	
                 

                955.35

              	
                 

                896.16

              	
                 

                456.78

              	
                 

                436.97

              	
                 

                300.87

              	
                 

                275.35

              	
                 

                128.67

              	
                 

                104.90

              
	
                TABLE
                  8

              
	
                 

                General
                  + Mental Health + Transportation + Dental Rates: Effect from July
                  1, 05 -
                  Dec 31, 05

              	
                 

                Effect
                  from Jan 1, 06 - June 30, 06

              
	 	
                 

                TANF

              	
                 

                SSI-NO
                  MEDICARE

              	
                 

                SSI-B

              	
                 

                 

                SSI-AB

              	
                 

                SSI-B

              	
                SSI-AB

              
	
                 

                Area

              	
                 

                THMO+2MO

              	
                 

                3MO-

                 

                11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE

                 

                (14-20)

                 

                 

              	
                 

                AGE

                 

                (21-54)

                 

              	
                 

                AGE

                 

                (55+)

              	
                 

                THMO+2MO

              	
                 

                3MO-11MO

              	
                 

                AGE
                  

                 

                (1-5)

              	
                 

                AGE
                  

                 

                (6-13)

              	
                 

                AGE
                  

                 

                (14-20)

              	
                 

                AGE

                 

                (21-54)

              	
                 

                AGE

                 

                (55+)

              	 	
                 

                AGE
                  

                 

                (65-)

              	
                 

                AGE
                  

                 

                (65+)

              	 	
                 

                AGE
                  (65-)

              	
                 

                AGE
                  (65+)

              
	 	 	 	 	 	
                 

                Female

              	
                 

                Male

              	
                 

                Female

              	
                 

                Male

              	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
                 

                01
                  

              	
                 

                859.91

              	
                 

                170.78

              	
                 

                88.17

              	
                 

                70.25

              	
                 

                136.15

              	
                 

                77.17

              	
                 

                231.34

              	
                 

                150.80

              	
                 

                306.99

              	
                 

                8,391.88

              	
                 

                1,468.05

              	
                 

                394.29

              	
                 

                269.34

              	
                 

                291.81

              	
                 

                748.19

              	
                 

                643.21

              	
                 

                381.88

              	
                 

                348.99

              	
                 

                243.32

              	
                 

                236.01

              	
                 

                111.84

              	
                 

                91.74

              
	
                02
                  

              	
                859.91

              	
                170.79

              	
                88.95

              	
                75.27

              	
                136.42

              	
                77.44

              	
                230.24

              	
                149.70

              	
                306.39

              	
                8,391.87

              	
                1,
                  468.04

              	
                398.82

              	
                284.33

              	
                271.77

              	
                706.38

              	
                632.54

              	
                395.18

              	
                345.84

              	
                240.17

              	
                249.31

              	
                108.69

              	
                88.59

              
	
                 

                03
                  

              	
                 

                959.99

              	
                 

                191.68

              	
                 

                98.85

              	
                 

                74.45

              	
                 

                145.53

              	
                 

                79.38

              	
                 

                260.48

              	
                 

                169.62

              	
                 

                347.79

              	
                 

                8,811.88

              	
                 

                1,550.96

              	
                 

                413.55

              	
                 

                251.69

              	
                 

                258.45

              	
                 

                723.56

              	
                 

                663.83

              	
                 

                368.54

              	
                 

                325.20

              	
                 

                221.87

              	
                 

                249.65

              	
                 

                108.79

              	
                 

                84.22

              
	
                04

              	
                880.33

              	
                176.43

              	
                90.56

              	
                69.04

              	
                133.68

              	
                73.35

              	
                241.21

              	
                157.73

              	
                323.20

              	
                8,588.74

              	
                1,511.37

              	
                406.42

              	
                261.31

              	
                261.39

              	
                716.49

              	
                651.07

              	
                349.97

              	
                337.72

              	
                233.64

              	
                223.48

              	
                120.43

              	
                95.46

              
	
                 

                05
                  

              	
                 

                922.12

              	
                 

                184.24

              	
                 

                95.59

              	
                 

                72.93

              	
                 

                141.04

              	
                 

                77.38

              	
                 

                257.36

              	
                 

                169.08

              	
                 

                339.34

              	
                 

                9,257.24

              	
                 

                1,624.05

              	
                 

                431.09

              	
                 

                261.49

              	
                 

                268.30

              	
                 

                752.11

              	
                 

                692.56

              	
                 

                343.09

              	
                 

                341.64

              	
                 

                235.36

              	
                 

                225.05

              	
                 

                104.31

              	
                 

                82.79

              
	
                06

              	
                842.33

              	
                169.05

              	
                88.63

              	
                74.64

              	
                139.65

              	
                81.47

              	
                238.34

              	
                157.64

              	
                315.77

              	
                8,564.98

              	
                1,504.10

              	
                402.95

              	
                270.13

              	
                292.30

              	
                763.87

              	
                665.83

              	
                326.73

              	
                307.64

              	
                210.35

              	
                208.61

              	
                92.64

              	
                72.34

              
	
                07
                  

              	
                895.76

              	
                179.22

              	
                92.76

              	
                74.42

              	
                139.13

              	
                77.78

              	
                247.66

              	
                162.45

              	
                329.82

              	
                8,987.85

              	
                1,584.59

              	
                424.00

              	
                272.17

              	
                273.04

              	
                750.55

              	
                686.56

              	
                319.41

              	
                316.66

              	
                218.62

              	
                209.83

              	
                104.57

              	
                83.34

              
	
                08
                  

              	
                788.65

              	
                158.03

              	
                81.78

              	
                62.73

              	
                121.00

              	
                66.63

              	
                218.90

              	
                134.40

              	
                290.82

              	
                8,259.68

              	
                1,451.19

              	
                385.96

              	
                235.78

              	
                241.72

              	
                677.69

              	
                621.45

              	
                325.46

              	
                316.82

              	
                218.13

              	
                204.17

              	
                97.37

              	
                77.06

              
	
                 

                09
                  

              	
                 

                853.56

              	
                 

                170.67

              	
                 

                88.88

              	
                 

                69.04

              	
                 

                132.02

              	
                 

                72.99

              	
                 

                233.38

              	
                 

                152.43

              	
                 

                311.45

              	
                 

                9,136.01

              	
                 

                1,610.61

              	
                 

                427.88

              	
                 

                259.24

              	
                 

                266.68

              	
                 

                751.50

              	
                 

                692.54

              	
                 

                298.05

              	
                 

                350.76

              	
                 

                242.19

              	
                 

                188.80

              	
                 

                109.62

              	
                 

                87.09

              
	
                 

                10
                  

              	
                 

                856.38

              	
                 

                171.70

              	
                 

                89.90

              	
                 

                74.75

              	
                 

                136.44

              	
                 

                77.45

              	
                 

                235.99

              	
                 

                154.72

              	
                 

                316.37

              	
                 

                11,151.25

              	
                 

                1,970.68

              	
                 

                523.77

              	
                 

                317.84

              	
                 

                327.24

              	
                 

                922.86

              	
                 

                850.57

              	
                 

                327.23

              	
                 

                372.07

              	
                 

                254.77

              	
                 

                216.94

              	
                 

                113.03

              	
                 

                87.81

              
	
                 

                11

              	
                 

                1,112.10

              	
                 

                221.50

              	
                 

                114.71

              	
                 

                90.02

              	
                 

                170.76

              	
                 

                94.52

              	
                 

                299.67

              	
                 

                195.32

              	
                 

                400.73

              	
                 

                12,145.45

              	
                 

                2,131.42

              	
                 

                564.51

              	
                 

                343.03

              	
                 

                352.10

              	
                 

                986.25

              	
                 

                909.09

              	
                 

                463.75

              	
                 

                442.77

              	
                 

                306.67

              	
                 

                282.32

              	
                 

                134.47

              	
                 

                110.70

              

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      

      AHCA
        Contract No. FA521, Attachment VIII-A, Page 3 of 3Exhibit
      4.2

    

    CERTIFICATE
      OF AMENDMENT TO

    AMENDED
      AND RESTATED CERTIFICATE OF INCORPORATION

    

    OF

    

    DOR
      BIOPHARMA, INC.

    

    

    It
      is
      hereby certified that:

    

    1.
      The
      name of the corporation (hereinafter called the “Corporation”) is: DOR
      BioPharma, Inc.

    

    2.
      The
      Amended and Restated Certificate of Incorporation, as amended, of the
      Corporation is hereby further amended by striking out the first introductory
      paragraphs of Article IV thereof, and by substituting in lieu thereof, the
      following new introductory paragraphs: 

    

    “The
      total number of shares of capital stock of all classes which the Corporation
      shall have authority to issue is one hundred fifty-five million (155,000,000)
      shares, of which one hundred fifty million (150,000,000) shares, of par value
      of
      $.001 per share, shall be of a class designated “Common Stock,” four million six
      hundred thousand (4,600,000) shares, of a par value of $.001 per share, shall
      be
      of a class designated “Preferred Stock,” two hundred thousand (200,000) shares,
      of a par value of $.05 per share, shall be of a class designated “Series B
      Convertible Preferred Stock,” and two hundred thousand (200,000) shares, of a
      par value of $.05 per share, shall be of a class designated “Series C
      Convertible Preferred Stock.

    

    The
      designations, powers, preferences, privileges, and relative, participating,
      option, or other special rights and qualifications, limitations or restrictions
      of the above classes of capital stock shall be as follows:”

    

    3.
      The
      Amendment of the Certificate of Incorporation herein certified has been duly
      adopted in accordance with the provisions of Section 242 of the General
      Corporation Law of the State of Delaware.

    

    Signed
      on
      December 29, 2005.

    

    

    

    /s/
      Evan Myrianthopoulos____

    Name: Evan
      Myrianthopoulos

    Title: Chief
      Financial Officer

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00095-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00095-of-00352.parquet"}]]