reglab/statecodes huggingface dataset:
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.002 - Service Delivery

Current through Reg. 50, No. 138; July 16, 2024
(1) The Agency shall
				provide all clients with appropriate supports and services in accordance with
				their support plan. Implementation of this policy, however, is subject to
				availability of funds.
(2) Clients
				of the Agency shall be integrated within local communities to the greatest
				extent possible. To this end, generic and specialized community services rather
				than Agency services shall be used whenever this will serve the best interest
				of the client. For referral purposes, each area office shall have a current
				descriptive directory of community resources.
(3) Programs and services provided by or for
				the Agency shall adhere to the policies, standards and procedures specified and
				made reference to in this chapter. The Agency shall make every effort to ensure
				that services provided are of good quality and at least comparable to those
				provided to persons in the community without disabilities.
(4) Medicaid providers should be reminded
				that all contracts for programs and services provided to the Agency shall
				include any terms and requirements established in the Developmental
				Disabilities Waiver Services Coverage and Limitations Handbook as required by
				Rules  59G-13.083, and
				 65G-4.008,
				 65G-4.009,
				 65G-4.010,
				F.A.C.
Rulemaking Authority 373.13(4)(g)3.,
					 393.501(1) FS.
					 Law Implemented 373.13(4)(g)3.,
					 393.17
					 FS.
New 1-1-77, Formerly 10F-4.08, 10F-4.008,
					  65B-4.008, Amended
					 4-4-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0021 - Tier Waivers (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 10-20-08, Repealed
					 11-21-10.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0022 - Tier One Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 10-20-08, Repealed
					 11-21-10.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0023 - Tier Two Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 10-20-08, Amended 7-15-09, Repealed
					 11-21-10.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0024 - Tier Three Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 10-20-08, Repealed
					 11-21-10.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0025 - Tier Four Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 10-20-08, Repealed
					 11-21-10.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0026 - Tier Waivers (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 3-7-10, Amended 9-28-11, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0027 - Tier One Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 3-7-10, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0028 - Tier Two Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 3-7-10, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0029 - Tier Three Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 3-7-10, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.00291 - Tier Four Waiver (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.0661(3) FS.
					 Law Implemented 393.0661(3)
					 FS.
New 3-7-10, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.003 - Certification as a Behavior Analyst (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 393.13(4)(g)3.,
					 393.17 FS. Law Implemented
					 393.13,
					 393.17
					 FS.
New 9-23-96, Formerly 10F-4.024,
					  65B-4.024, Repealed
					 4-4-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.004 - Certification as an Associate Behavior Analyst (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 393.13(4)(g)3.,
					 393.17 FS. Law Implemented
					 393.13,
					 393.17
					 FS.
New 9-23-96, Formerly 10F-4.025,
					  65B-4.025, Repealed
					 4-4-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.005 - Renewal of Behavior Analysis Certification (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 393.13(4)(g)3.,
					 393.17 FS. Law Implemented
					 393.13,
					 393.17
					 FS.
New 9-23-96, Formerly 10F-4.026,
					  65B-4.026, Repealed
					 4-4-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.006 - Approved Continuing Education (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 393.13(4)(g)3.,
					 393.17 FS. Law Implemented
					 393.13,
					 393.17
					 FS.
New 9-23-96, Formerly 10F-4.027,
					  65B-4.028, Repealed
					 4-4-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.007 - Behavior Analysis Certification Fees (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 393.13(4)(g)3.,
					 393.17 FS. Law Implemented
					 393.17
					 FS.
New 9-23-96, Formerly 10F-4.028,
					  65B-4.027, Repealed
					 4-4-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.009 - Design, Implementation and Monitoring of Behavior Analysis Services

Current through Reg. 50, No. 138; July 16, 2024
(1) Providers of behavior analysis services
				shall provide services only as certified and as provided by law.
(2) All aspects of behavior analysis services
				shall be integrated with other relevant services and supports being provided to
				the client by the provider within the scope of authorized behavioral
				services.
(3) The selection of
				behavior analysis procedures and decisions by the provider to make
				environmental changes that obviate the need for the use of behavior change
				procedures shall be based upon information obtained through direct and indirect
				functional assessment or functional analysis designed to identify patterns of
				behavior and the functional relationships between the behavior or behaviors
				targeted for change and the environment. The assessment shall contain at
				minimum:
(a) Operational definitions of all
				behaviors targeted for change;
(b)
				Description of conditions under which the behavior is most likely and least
				likely to occur;
(c) Measures of
				current level of behavior targeted for change;
(d) Other relevant personal, social, medical,
				pharmacological or historical information that may impact on behavior targeted
				for change, if any;
(e) Putative
				functional relationships between targeted behavior and environment; and,
(f) Recommendations for procedures
				to decrease maladaptive behavior and increase relevant appropriate alternative
				behavior.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.010 - Behavior Analysis Services Approval

Current through Reg. 50, No. 138; July 16, 2024
(1) All written plans describing behavior
				analysis services consistent with subsection
				 65G-4.009(10),
				F.A.C., shall be submitted to the local review committee chairperson within
				five working days following implementation.
(2) All behavior analysis services designed
				to include restricted procedures or those services designed to address those
				actions of the individual which, without behavioral, physical, or chemical
				intervention can be expected to result in outcomes identified in subsection
				 65G-4.010(3),
				F.A.C., below and will be provided or supervised by a Certified Behavior
				Analyst as defined in subsection
				 65G-4.001(5),
				F.A.C., or a person licensed pursuant to Chapter 490 or 491, F.S.: In those
				cases where it is unclear whether behavior analysis services meet either
				criteria, the provider must contact the LRC chairperson to determine the need
				for LRC review.
(3) Written plans
				describing behavior analysis services must be submitted to the LRC chairperson,
				when:
(a) Behavior analysis services include
				restricted procedures such as:
1. The
				contingent delivery or removal of events to reduce the probability of
				occurrence of a problem behavior, including but not limited to: extinction or
				withholding of reinforcement for those behaviors referenced in paragraph
				 65G-4.010(3)(b),
				F.A.C., response blocking for more than 15 seconds, contingent exercise,
				restitutional overcorrection, positive practice overcorrection, time-out and
				response cost.
2. The removal of an
				aversive event contingent upon the display of a behavior targeted for increase,
				including but not limited to, Functional Communication Training using removal
				of demands or noise as a reinforcer, and desensitization programs.
3. Access to abundant amounts of an event or
				stimulus so that it loses potency as a reinforcer, and severely restricted
				access to an event or stimulus to increase its potency as a
				reinforce.
4. Behavioral protective
				devices, as defined in subsection
				 65G-8.001(4),
				F.A.C., and electronic devices for monitoring and signaling.
5. Dietary manipulations.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.011 - Determination of Intellectual Disability in Capital Felony Cases: Intelligence; Tests to be Administered

Current through Reg. 50, No. 138; July 16, 2024
(1) When a
				defendant convicted of a capital felony is suspected of having or determined to
				have intellectual disability, intelligence tests to determine intellectual
				functioning as specified below shall be administered by a qualified
				professional who is authorized in accordance with Florida Statutes to perform
				evaluations in Florida. The test shall consist of an individually administered
				evaluation, which is valid and reliable for the purpose of determining
				intelligence. The tests specified below shall be used.
(a) The Stanford-Binet Intelligence
				Scale.
(b) Wechsler Intelligence
				Scale.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.012 - Determination of Intellectual Disability: Intelligence Tests to Be Administered

Current through Reg. 50, No. 138; July 16, 2024
(1) For the
				purposes of chapters 393 and 916, F.S., the Stanford-Binet Intelligence Scale
				or the Wechsler Adult & Infant Intelligence Scale, administered by or under
				the direct supervision of a psychologist or school psychologist licensed under
				chapter 490, F.S., shall be used to determine intellectual disability and the
				level of intellectual functioning.
(2) Notwithstanding subsection (1), if, given
				the condition of the individual to be tested, the Stanford-Binet Intelligence
				Scale or the Wechsler Adult & Infant Intelligence Scale are not valid and
				reliable as determined by the person authorized to administer such tests as
				specified in subsection (1), an alternative test or evaluation procedure,
				administered and interpreted in conformance with instructions provided by the
				producer of the tests or evaluation materials, may be used. The results of the
				testing or evaluation must include reference to published validity and
				reliability data for the specified test or evaluation
				procedure.
Rulemaking Authority
					  393.063(38),
					 916.106,
					 393.501(1) FS.
					 Law Implemented 393.063(38),
					  916.106 FS.
New 6-13-06, Formerly
					  65B-4.033.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.014 - Eligibility for Agency Services - Definitions

Current through Reg. 50, No. 138; July 16, 2024
(1) Autism means a condition which meets the
				requirements of section
				 393.063, F.S., that the
				condition is:
(a) Pervasive, meaning always
				present and without interruption;
(b) Neurologically based, meaning that the
				condition is not the result of physical impairment;
(c) A developmental disability with age of
				onset during infancy or childhood;
(d) With extended duration, meaning that the
				condition reasonably can be expected to continue indefinitely into the
				future;
(e) Causes severe learning
				disorders resulting in both severe communication disorders affecting both
				verbal and nonverbal skills, and severe behavior disorders. Autism is
				characterized by an individual evidencing at least six of the following twelve
				features from the following subparts 1 and 2, with at least one feature from
				subpart 2:
1. Severe communication disorders,
				which may include:
a. A delay in, or total
				lack of, the development of spoken language (not accompanied by an attempt to
				compensate through alternative modes of communication such as gesture or mime),
b. Stereotyped and repetitive use
				of language or idiosyncratic language,
c. For those applicants with speech, marked
				impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze,
				facial expression, body postures, and gestures to regulate social interaction,
d. Failure to develop peer
				relationships appropriate to developmental level,
e. A lack of spontaneous seeking to share
				enjoyment, interests, or achievements with other people (e.g., by a lack of
				showing, bringing, pointing out objects of interest, or achievements to
				others),
f. Lack of social or
				emotional reciprocity,
g. Marked
				impairment in the ability to initiate or sustain a conversation with others in
				individuals with adequate speech, or
h. Impaired imaginative ability evidenced by
				a lack of varied, spontaneous make-believe play or social imitative play
				appropriate to developmental level.
2. Severe behavior disorders, which are
				restricted, repetitive and stereotyped patterns of behavior, interests, and
				activities which may include:
a. Encompassing
				preoccupation with one or more stereotyped and restricted patterns of interest
				that is abnormal either in intensity or focus,
b. Apparently inflexible adherence to
				specific, nonfunctional routines or rituals,
c. Stereotyped and repetitive motor
				mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body
				movements), or
d. Persistent
				preoccupation with parts of objects.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.015 - Eligibility for Agency Services Criteria

Current through Reg. 50, No. 138; July 16, 2024
In order to be determined eligible for agency services the
				  applicant must:
(1) Be at least three
				years of age.
(2) Be a resident of
				and domiciled in the state of Florida in accordance with Sections
				 222.17(1) and
				(2), F.S. Domicile may not be established in
				Florida by a minor who has no parent domiciled in Florida, or by a minor who
				has no legal guardian domiciled in Florida, or by any alien not classified as a
				resident alien. Dependents of active duty military personnel stationed in the
				state of Florida are exempt from residency and domicile requirements.
(3) Have a confirmed diagnosis of one of the
				following developmental disabilities as defined in this these rules, Rules
				 65G-4.014, 4.015, 4.016 and
				4.017, F.A.C.:
(a) Autism;
(b) Cerebral palsy;
(c) Mental retardation or intellectual
				disability;
(d) Prader-Willi
				syndrome;
(e) Spina
				Bifida;
(f) Down
				Syndrome;
(g) Phelan-McDermid
				Syndrome, or
(h) Children between 3
				and 5 years of age who are at high risk of later diagnosis of one of the
				disabilities listed above. Such high-risk children shall not be placed on a
				preenrollment category for waiver services until a confirmed diagnosis of a
				qualifying disability is given.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.016 - Application Process

Current through Reg. 50, No. 138; July 16, 2024
(1) Application for
				services from the agency shall be made by submitting an application by hand
				delivery, U.S. Postal Service, or facsimile to the agency office in the service
				area where the applicant resides. The Application for Services (Form 10-007,
				2007), is available on the agency website at
www.APD.myflorida.com
,
http://www.apd.myflorida.com/customers/application/
or by contacting the agency. The application is available in English and
				Spanish and is hereby incorporated by reference,
http://www.flrules.org/Gateway/reference.asp?No=Ref-01203
.
(2) Upon receipt of a completed, signed, and
				dated Application for Services, the area agency staff shall review the
				application and supporting documentation and, within 45 days for children under
				the age of 6 and 60 days for individuals 6 years of age and older, shall notify
				the applicant of the final determination of eligibility for agency services. If
				requests for collateral information or additional evaluations are necessary to
				determine eligibility, the time may be extended for no more than an additional
				ninety (90) days.
(3) If an
				applicant is unable to produce an existing evaluation that establishes
				eligibility or if there is concern that the information provided is inaccurate,
				incorrect, or incomplete, the agency area office will be responsible for
				obtaining an evaluation to establish eligibility. Professional diagnoses under
				Rule  65G-4.017, F.A.C., must document
				all criteria for eligibility as set forth in Rules
				 65G-4.014 -.017, F.A.C. The
				evaluation process includes only those assessments necessary to determine
				eligibility that were administered by a person qualified to administer the
				instrument(s).
(4) When the
				eligibility determination is complete, the agency area office shall notify the
				applicant in writing within five (5) business days of the decision. If the
				applicant is determined ineligible for agency services, the agency area office
				shall notify the applicant of the right to appeal the decision in accordance
				with Chapter 120, F.S.
(5) If the
				applicant is determined to be ineligible to receive services from the agency,
				the agency area office shall offer suggestions regarding other programs,
				agencies, or services for which the applicant may be eligible.
(6) If a category of covered conditions in
				this rule is not also covered by the state's Medicaid developmental
				disabilities waiver (DD waiver) at the time an individual is determined to be
				eligible, those individuals will be placed on a preenrollment category and may
				be provided services funded through general revenue allocations or sources
				other than the DD Waiver.
Rulemaking Authority
					 393.065(10),
					 393.066(8),
					 393.501 FS. Law Implemented
					 393.065,
					 393.066
					 FS.
New 5-16-12.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.017 - Establishing Eligibility

Current through Reg. 50, No. 138; July 16, 2024
(1) Establishing
				Eligibility - Autism. A diagnosis of autism, as defined by Rule
				 65G-4.014, F.A.C., may only be
				made by one or more of the following who has specific training and experience
				in making such diagnosis:
(a) A
				Florida-licensed psychiatrist;
(b)
				A Florida-licensed psychologist;
(c) A board-certified pediatric neurologist
				who is qualified by training and experience to make a diagnosis of
				autism;
(d) A board-certified
				developmental pediatrician, or
(e)
				Collateral information received from another state may be accepted if the
				evaluator is licensed through the same credentials required for licensure in
				Florida for the professions listed in paragraph (1)(a),
				above.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0210 - Definitions (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.0662
					 FS.
New 10-2-13, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0211 - General Provisions (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.0662
					 FS.
New 10-2-13, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0212 - Establishing the Final iBudget Allocation Amount (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.0662
					 FS.
New 10-2-13, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0213 - Definitions

Current through Reg. 50, No. 138; July 16, 2024
For the purposes of this chapter, the term:
(1) "Agency" means the Agency for Persons
				with Disabilities.
(2) "Allocation
				Algorithm" means the mathematical formula based upon statistically validated
				relationships between client characteristics (variables) and the client's level
				of need for services provided through the Waiver as set forth in Rule
				 65G-4.0214, F.A.C., and as
				provided in Section  393.0662(1)(a),
				F.S.
(3) "Allocation Algorithm
				Amount" means the result of the Allocation Algorithm apportioned according to
				available funding.
(4) "Amount
				Implementation Meeting Worksheet" or "AIM Worksheet" means a form used by the
				Agency for new Waiver enrollees, and upon recalculation of a client's
				algorithm, to:
(a) Communicate a client's
				Allocation Algorithm Amount;
(b)
				Identify proposed services based upon the Allocation Algorithm Amount;
				and
(c) Identify additional
				services, if any, should the client or their legal representative feel that any
				Significant Additional Needs of the client cannot be met within the Allocation
				Algorithm Amount. The Amount Implementation Meeting Worksheet - APD Form
				 65G-4.0213 A, effective 7-1-21,
				is hereby adopted and incorporated by reference, and is available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-12459
.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0214 - Allocation Algorithm

Current through Reg. 50, No. 138; July 16, 2024
(1) To establish the
				Allocation Algorithm Amount for any client who has not previously had a QSI
				assessment, a QSI assessment must be completed prior to calculating the
				Allocation Algorithm Amount under subsection (2).
(a) The QSI assessor shall arrange for a face
				to face meeting with the client and, if available, the client's legal
				representative. The WSC shall attend the face to face meeting with consent of
				the client or the client's legal representative. If the client or the client's
				legal representative is not capable of fully responding to all of the
				assessment questions, at least one participant with day-to-day knowledge of the
				client's care should participate.
(b) A copy of the completed QSI evaluation
				and scores shall be provided to the client and WSC.
(c) Upon receiving QSI results if the client
				or his or her legal representative identifies an error in the QSI results the
				WSC shall notify the Agency in writing setting forth the details of the error.
				At any time, the client or WSC can prepare a statement to be maintained in
				client's Central File identifying any concerns with the QSI assessment score or
				responses. If any error is identified in the QSI assessment the Agency shall
				review the error to determine if any adjustments are needed. The Agency shall
				inform the WSC of the result of the review and provide a revised Allocation
				Algorithm Amount, if appropriate, within 15 working days of notification of the
				error. The WSC shall in turn notify the client or the client's
				representative.
(d) The client or
				WSC may request a reassessment any time there has been a significant change in
				circumstance or condition that would impact any of the questions used as
				variables in the algorithm determination. The Agency shall arrange for a
				reassessment at the earliest possible time in accordance with the
				circumstances, complete the reassessment, and notify the client and WSC of the
				results within 60 days of the request for reassessment. This section shall not
				be construed to require the Agency to wait for the completion of a QSI in order
				to address an emergency situation of the client.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0215 - General Provisions

Current through Reg. 50, No. 138; July 16, 2024
(1) Medical
				necessity alone is not sufficient to authorize a service under the Waiver; in
				addition:
(a) With the assistance of the WSC,
				the client must utilize all available State Plan Medicaid services,
				school-based services, private insurance, natural supports, and any other
				resources that may be available to the client before expending funds from the
				client's iBudget Amount for support or services. As an example, State Plan
				Medicaid services for children under the age of 21 typically include personal
				care assistance, therapies, consumable medical supplies, medical services, and
				nursing;
(b) The services must be
				within Waiver coverages and limitations; and
(c) The cost of the services must be within
				the Allocation Algorithm Amount unless there is a significant additional need
				demonstrated.
Failure to meet the above criteria shall result in a denial
				  of a request for additional funding.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0216 - Establishment of the iBudget Amount

Current through Reg. 50, No. 138; July 16, 2024
(1)
				The iBudget Amount for a client shall be the Allocation Algorithm Amount, as
				provided in Rule  65G-4.0214, F.A.C., plus any
				approved Significant Additional Needs funding as provided in Rule
				 65G-4.0218, F.A.C.
(2) The Agency will determine the iBudget
				Amount consistent with the criteria and limitations contained in the following
				provisions: Sections  409.906 and
				 393.0662, F.S.; and Rules
				 59G-13.080,
				 59G-13.081, and
				 59G-13.070, F.A.C.
(3) Significant Additional Needs Review:
(a) The first time the Allocation Algorithm
				Amount is calculated, the WSC will discuss the Allocation Algorithm Amount with
				the client, and, if available, the client's legal representative and, if
				available and applicable, the client advocate, in order to determine if the
				client has any Significant Additional Needs.
(b) The WSC shall discuss the services
				requested with the client or the client's legal representative, and, if
				available and applicable, the client advocate.
(c) The Agency will conduct a Client Review
				to determine whether services requested meet health and safety needs and waiver
				coverage and limitations. The AIM Worksheet must be completed as part of the
				Client Review and submitted to the Agency within 30 days of receipt of the new
				Allocation Algorithm Amount.
(d)
				The Agency will issue a decision of the iBudget Amount within 30 days of
				receipt of the AIM Worksheet. The client and his or her legal representative
				will be advised of the Agency's decision for the amount of the client's final
				iBudget Amount within 30 days.
1. If
				additional documentation is requested, the deadline for the Agency's response
				shall be extended to 60 days following the receipt of the original
				request.
2. The Verification of
				Available Services form is a material part of the request form. Failure to
				include the Verification of Available Services form is a basis for
				denial.
(e) The Agency
				shall approve an increase to the iBudget Amount if additional funding is
				required to meet the Significant Additional Needs subject to the provisions of
				the iBudget Rules. The Agency, upon completion of its review shall notify in
				writing the client, the WSC and the client advocate, if any, of its
				decision.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0217 - iBudget Cost Plan

Current through Reg. 50, No. 138; July 16, 2024
(1) When a client's
				iBudget Amount is determined, the WSC must submit a cost plan proposal, which
				includes a completed Verification of Available Services form
,
that reflects the specific Waiver services and supports (paid and unpaid) that
				will assist the client to achieve identified goals, and the provider of those
				services and supports, including natural supports. The cost plan proposal is
				derived from person-centered planning. The Verification of Available Services
				form is a material part of the cost plan proposal. Failure to include the
				Verification of Available Services form will result in a denial of the cost
				plan.
(2) The WSC shall provide
				documentation for requested services as specified in Section C of the WSC Cost
				Plan and Significant Additional Needs Job Aid to document medical necessity and
				compliance with Handbook coverage and limitations.
(3) Each client's proposed iBudget cost plan
				shall be reviewed and approved by the Agency in conformance with the iBudget
				Rules and the Handbook. Any conflict between the Handbook and these iBudget
				Rules shall be resolved in favor of these rules.
(4) For a client to begin receiving a
				specific Waiver service, that service must have been listed in an Approved Cost
				Plan and the service authorization must have been issued to the provider prior
				to the delivery of service.
(5)
				Clients must budget their funds so that their needs are met throughout the plan
				year. All clients shall allocate iBudget funding each month for Waiver support
				coordination services, which is a required service under the Waiver.
(6) This rule shall be reviewed, and if
				necessary, renewed through the rulemaking process five years from the effective
				date.
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.063,
					 393.0662,
					 409.906
					 FS.
New 7-7-16, Amended
					 7-1-21.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.0218 - Significant Additional Need Funding

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Supplemental funding for Significant Additional Needs (SANs) may be of a
				one-time, temporary, or long-term in nature.
(2) The presence of a significant additional
				need or significant change in condition or circumstance alone does not warrant
				an increase in the amount of funds allocated to a client's iBudget as
				determined by the algorithm.
(3) A
				client's annual expenditures for home and community-based services Medicaid
				Waiver services may not exceed the limits of his or her iBudget. The total of
				all clients' projected annual iBudget expenditures may not exceed the Agency's
				appropriation for Waiver services.
(4) SANs can only be approved after the
				determination of a client's initial allocation amount and after the WSC has
				documented the availability of non-Waiver resources on the Verification of
				Available Services form. Nothing in this section prohibits the authorization of
				emergency services on a temporary basis through the Agency. Requests for SANs
				require:
(a) The client to have a significant
				additional need as defined in this chapter; and
(b) A significant additional need cannot be
				created by failing to maintain sufficient funds to cover services previously
				authorized in accordance with subsections
				 65G-4.0215(2) and
				(5), F.A.C.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.022 - iBudget Cost Plan Development and Approval (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.0662
					 FS.
New 10-2-13, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.024 - Cost Plan Changes (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.0662
					 FS.
New 10-2-13, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-4 - SERVICE DELIVERY PRACTICE AND PROCEDURE › Section 65G-4.027 - Cost Plan Funding and Review (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 393.501(1),
					 393.0662 FS. Law Implemented
					 393.0662
					 FS.
New 10-2-13, Repealed
					 1-19-16.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.001 - Definitions

Current through Reg. 50, No. 138; July 16, 2024
(1) "Community supported living arrangements
				(CSLA)" means a Medicaid state plan optional service. The following services
				are available through CSLA funding:
(a)
				Supported living coaching;
(b)
				Personal assistance; and,
(c)
				Environmental modifications.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.002 - Eligibility for Services

Current through Reg. 50, No. 138; July 16, 2024
(1) All persons
				eighteen years of age or older who have developmental disabilities, reside
				within the state of Florida and are clients of the Agency shall be eligible for
				supported living services.
(2)
				Individuals must be Medicaid recipients in order to receive supported living
				services through the CSLA Medicaid state plan option. Services shall not be
				provided simultaneously to an individual through CSLA and the Developmental
				Disabilities Home and Community-Based Services Waiver.
(3) Persons who are clients of the Agency and
				who wish to receive supported living services shall make a request for such
				services through their support coordinator.
(4) Persons who are not clients of the Agency
				must first make application for determination of eligibility for developmental
				disability services. They may concurrently request supported living
				services.
(5) Supported living
				services must be authorized by an individual's support plan. A preliminary
				determination of the individual's support requirements to reside in supported
				living shall be made as part of the individual support plan
				process.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.003,
					  65B-5.003.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.003 - Planning for Supported Living Services

Current through Reg. 50, No. 138; July 16, 2024
(1) An
				individual's desire and willingness to participate in supported living shall be
				considered as part of the support planning process, and supported living
				services shall be authorized by the support plan when requested by the
				individual or the individual's guardian.
(2) The support plans of individuals in
				supported living are facilitated by the support coordinator and shall address
				the following with regard to supported living services:
(a) Frequency of supported living coaching
				services and specific areas of support required by the individual to live in
				his or her own home and participate in the local community;
(b) An explanation of the individual's need
				for the services;
(c) The person or
				agency responsible for providing the services;
(d) When services will be provided;
(e) The methodology that will be used to
				provide the services;
(f) How the
				individual can access supported living coaching services 24 hours a day for
				emergency assistance;
(g) How
				natural and generic supports available through family, friends, neighbors, and
				the community at large will be included in the support process;
(h) What supports are in place to meet the
				home and community safety needs of the individual;
(i) A financial profile that includes an
				accountable strategy for assisting the individual in money management, when
				requested by the individual or the individual's guardian; and,
(j) The outcomes the individual wishes to
				achieve during the next year.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.004 - Selection of Housing

Current through Reg. 50, No. 138; July 16, 2024
(1) The individual
				shall select a home available for lease or sale to any member of the community
				based on the individual's own choice and personal financial resources with
				assistance from the supported living coaching provider as needed.
(2) The following criteria identify an
				eligible supported living setting:
(a) The
				name of the individual appears on the lease or mortgage either singularly, with
				a roommate, or with a guarantor;
(b) Neither the supported living provider nor
				the immediate family of the supported living provider shall serve as landlord
				or have any interest in the ownership of the housing unit; and,
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.005 - Selection of Providers by Participants

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Individuals may choose from among the available providers within the area.
				Every effort shall be made to ensure that the individual receives services from
				the provider of his or her choice. Eligible individuals who wish to receive
				services through the Medicaid CSLA state plan option must choose from among the
				available CSLA providers.
(2) The
				individual's support coordinator shall provide information to the individual
				verbally and in writing concerning the philosophy and scope of services
				available from each supported living provider and shall assist the individual
				as needed in the screening and selection of a provider.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.004,
					 65B-11.004.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.006 - Ongoing Monitoring by Support Coordinator

Current through Reg. 50, No. 138; July 16, 2024
(1) The individual's support coordinator
				shall have at least monthly telephone contact with the individual to monitor
				the individual's health and well-being. This call may be initiated by the
				support coordinator or the individual.
(2) When telephone contact is not possible, a
				face-to-face visit shall be made.
(3) The individual's support coordinator
				shall conduct a quarterly home visit to ensure that supported living services
				are being carried out in accordance with the support plan. This visit shall be
				scheduled at a mutually convenient time and shall not be unannounced. The
				supported living coach shall also attend unless the individual requests
				otherwise.
(4) In addition to
				reviewing supported living services, the support coordinator shall review the
				updated housing survey and the individual's need for a financial subsidy or
				adjustment of current subsidy at the time of the quarterly home visit. If the
				supported living coaching provider is acting as fiscal agent for the
				individual, bank statements and any other financial records shall be reviewed
				by the support coordinator at the time of the quarterly home
				visit.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.009,
					 65B-11.009.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.007 - Individual Survey Activities

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				individual shall be asked at least annually to complete a survey that addresses
				his or her satisfaction with service delivery and the extent to which the
				individual's desired outcomes identified in Rule
				 65G-5.003, F.A.C., have been
				achieved.
(2) If the individual
				desires or needs assistance to complete the survey, he or she shall be asked to
				identify a person or persons to assist on a volunteer basis in reviewing the
				supports and services that the individual has received.
(3) The survey process shall be distinct from
				the support planning process; however, the individual may choose to include
				some or all of the persons who assist the individual in support
				planning.
(4) Persons who are
				selected by the individual to assist in the survey process may be family
				members, friends, or neighbors of the individual; however, paid staff providing
				direct supported living services to an individual may not assist in survey
				activities for that individual.
(5)
				The results of the survey shall be reported to the staff person designated by
				the area office who will follow up on any concerns raised.
(6) The area office shall forward results of
				individual survey activities to the Agency's central office for submission to
				the state supported living services monitoring board.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.008,
					 65B-5.008.