Florida Administrative Code

The hearing is a formal proceeding and shall be conducted pursuant to these rules. At the request of the petitioner, the hearing may be conducted as an informal proceeding pursuant to Section 120.57(2), F.S. (1) For programs other than Supplemental Nutrition Assistance Program (S…

(1) A person may be represented by an attorney, or other qualified representative or may appear on their own behalf. (2) The hearing shall be attended by a representative of the Department. Rulemaking Authority 409.285 FS. Law Implemented 409.285 FS. History-New 5-17-78, Amended …

(1) The hearings officer may grant a continuance of the hearing pursuant to Rule 28-106.210, F.A.C., or upon stipulation of all parties of record and the consent of the hearings officer. (2) In appeals related to the Supplemental Nutrition Assistance Program (SNAP), the household…

(1) The burden of proof, except where otherwise required by statutes, is on the party asserting the affirmative of an issue. The burden is upon the Department when the Department takes action which would reduce or terminate the benefits or payments being received by the recipient…

Abandonment may be deemed to have occurred if the appellant, without good cause therefor, fails to appear by himself/herself or an authorized representative at the hearing scheduled for such appellant. If good cause is shown, the appeal will no longer be considered abandoned and …

(1) Orders issued by the hearings officers of the Office of Appeal Hearings of the Department of Children and Families are final orders and shall be implemented immediately. (2) The Final Order shall be based exclusively on evidence and other materials introduced at the hearing o…

(1) Federal Regulation 45 C.F.R. 233.20(a)(13) requires the Department to recover overpayments of the Temporary Assistance of Needy Families (TANF) Program. Rule 65A-1.900, F.A.C., provides the method and procedures to be used by the Department to implement 45 C.F.R. 233.20(a)(13…

(1) The hearings officer of the Office of Appeal Hearings shall conduct intentional program violation disqualification hearings. These hearings shall be conducted in accordance with regulations published by the United States Department of Agriculture, Food and Nutrition Service i…

The following terms and phrases when used in this rule and in the interpretation thereof, shall have the meaning ascribed to them as follows: (1) "Client" - means any person receiving services, or who is determined eligible to receive services, provided by the department. (2) "De…

(1) The interest accruing on client funds is the property of the individual client and must be used or conserved for the personal use or benefit of that client. Similarly, when service charges or other fees are charged to the fund, the individual clients whose monies comprise the…

(1) Purpose. The purpose of this rule is to implement the provisions of section 402.73(1), F.S., and to provide procedures for the imposition of financial penalties upon providers that fail to comply with a department request for corrective action. (2) Definitions. For the purpos…

(1) Client Trust Fund. An account established by the department for the purpose of accepting and administering in trust any money or other property received for personal use or benefit of a client; such as parent contributions, benefit payments, and interest. (2) Cost of Service.…

Rulemaking Authority 402.33(2), (9)(a), (10) FS. Law Implemented 402.33 FS. History-New 1-23-85, Formerly 10-6.11, Amended 3-29-89, Formerly 10-6.011, Repealed 9-30-18.

Liability for fees begins on the first day that services are provided and terminates at the end of the next to the last day that services are provided to the client. (1) The following shall be liable for the payment of fees for services or reimbursement for the cost of services: …

The following parties shall not be liable for the payment of fees: (1) Indigents whose only sources of income are from state and federal aid. For purposes of this rule, income from state or federal aid shall be defined as cash assistance or cash equivalent benefits based on an in…

Rulemaking Authority 402.33(4) FS. Law Implemented 402.33 FS. History-New 1-23-85, Formerly 10-6.14, 10-6.014, Repealed 9-30-18.

(1) The client or responsible party will complete and return to the department the Financial Information form (CF Form 280, effective September 2018), which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-10017, will be completed …

The cost of services, as defined in subsection 65-6.010(4), F.A.C., is the maximum amount which a payor shall be charged, unless ordered by a court. Payment of fees shall not be a prerequisite to receiving services. (1) First and second party payors shall be charged a fee not in …

(1) Fees shall not be assessed on wages which are below the minimum hourly wage under the Federal Fair Labor Standards Act. (2) Clients who are employed while in residential care may keep monthly earnings of up to $100. Of the remaining amount of earnings, the client may keep one…

For clients in residential care, a personal allowance shall be set aside from benefit payments for the personal needs of the client. The representative payee is responsible for maintaining and administering the client's personal allowance for the benefit of the client. This allow…

(1) Upon submission of the financial information required by this chapter, or the court order for clients in short term placement, the department shall compute the fee according to the fee formula as found in rule 65-6.020, F.A.C., or fee schedule as found in subsection (3), or a…

(1) For purposes of this rule, the following definitions shall apply: (a) Disposable Income. Net income less fixed domestic expenses and other allowable deductions. (b) Fixed Domestic Expenses. Basic household expenses which are deducted from net income in the fee formula: 1. Ren…

(1) When a client applies for services, the client or responsible party shall be informed of the department's fee collection policy. (2) The department shall determine the fee assessment based on the client's or responsible party's ability to pay and on the availability of benefi…

(1) A client or responsible party may request a review of the fee if they do not agree with the assessment. (2) The Regional Managing Director or Facility Administrator shall appoint, at a minimum, three members to a review committee. The Regional Managing Director or Facility Ad…

(1) An account is considered delinquent when a charge for fees remains unpaid for 61 days from the date the charge was made to the account. (2) The department shall charge interest on amounts which remain unpaid for over 6 months from the date the amount was charged to the accoun…

(1) A responsible party whose residence is out of state shall be requested by the department to apply for interstate transfer of the client. This requirement does not apply to a foster care client's responsible party. (2) If the responsible party applies for interstate transfer o…

Rulemaking Authority 402.17 FS. Law Implemented 402.17 FS. History-New 1-27-86, Amended 4-27-93, Formerly 10-6.025, Repealed 9-30-18.

Rulemaking Authority 402.17 FS. Law Implemented 402.17 FS. History-New 1-27-86, Amended 4-27-93, Formerly 10-6.026, Repealed 9-30-18.

(1) When the department determines that a client should be placed in a program which requires financial eligibility and the client is income eligible, but exceeds the program's resource limitation, the department may apply excess resources in the Client Trust Fund to the cost of …

Except as otherwise provided within, the following definitions apply to this chapter. (1) Public Assistance: Food Assistance, Temporary Cash Assistance, Medicaid, Refugee Assistance, Optional State Supplementation. (2) Economic Self-Sufficiency (ESS): The entity within the Depart…

(1) An individual has the right to apply for assistance, to have eligibility determined, and if found eligible, to receive benefits. The applicant for or recipient of public assistance must assume the responsibility of furnishing information, documentation and verification needed…

(1) The individual completes and submits a Department application for public assistance using either the ACCESS Florida Application, CF-ES 2337, 08/2016, incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-11698, or an ACCESS Florida We…

(1) The automatic Lifeline service enrollment process is an electronic interface between the Department and the Public Service Commission. Applicants and recipients can indicate their interest in receiving Lifeline service within the ACCESS Florida Web Application, CF-ES 2353, 09…

(1) The individual whose needs are included must meet the citizenship and noncitizen status established in: P.L. 104-193, The Personal Responsibility and Work Opportunity Reconciliation Act of 1996; P.L. 105-33, the Balanced Budget Act of 1997; P.L. 105-185, the Agricultural Rese…

(1) To be eligible for public assistance, the individual must either provide the social security number (SSN) when known for each person whose needs are included in the assistance group or SFU or, apply for a SSN for each individual who either does not have a number assigned or w…

(1) Specific policies concerning assets vary by program and are found in federal statutes and regulations and Florida Statutes. (2) Any individual who has the legal ability to dispose of an interest in an asset owns the asset. (3) Once the individual's ownership interest of an as…

The following forms are used for Public Assistance Programs to provide applicants and recipients with required notice of the agency's and client's rights and responsibilities and other necessary program information. These forms are hereby incorporated by reference. (1) Forms that…

(1) Food Assistance Program case processing is done in accordance with the eligibility determination process in Rule 65A-1.205, F.A.C., and in 7 C.F.R. § 271.2, 273.1 - 273.18, 273.24 and 273.25. (2) Responsible Member is defined as any member of the Standard Filing Unit (SFU) ca…

(1) Rounding Income and Expenses. With the exception of the benefit reduction, cents resulting from budget calculations are retained at each level in determining the assistance group's (AGs) food assistance benefits. The benefit reduction is rounded up to the next whole dollar. (…

(1) The Food Assistance Employment and Training (E&T) Program is administered in accordance with the requirements of 7 C.F.R. §273.7, P.L. 104-193, The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and P.L. 107-171, Food Stamp Reauthorization Act of 200…

As used in Rules 65A-1.701 through 65A-1.716, F.A.C., the following terms have the following meanings unless a different meaning is given: (1) Adoption Subsidy: A monthly payment to assist adoptive parents in caring for an adopted child who has been determined to meet the eligibi…

(1) Date of Eligibility. Eligibility for Medicaid begins the first day of a month if an individual was eligible any time during the month, except as provided below: (a) Presumptive Eligibility for Pregnant Women (PEPW). The period of presumptive eligibility for pregnant women beg…

The Department determines eligibility for mandatory and optional Medicaid coverage groups for individuals, families and children described in "The Patient Protection and Affordable Care Act", under "The Health Care and Education Reconciliation Act 2010", Section 1931 of the Socia…

(1) Public assistance staff determine eligibility for Family-Related Medicaid in accordance with Rules 65A-1.703, 65A-1.705 and 65A-1.707, F.A.C., at the time of the initial application and annually thereafter and when a change potentially affecting eligibility is reported. (2) T…

(1) The Family-Related Medicaid technical eligibility factors. (a) The age criteria for children is specified in Rule 65A-1.703, F.A.C. (b) The individual must be a resident of Florida as required by subsection 1902(a)(16) of the Social Security Act. Individuals who are physicall…

The standards set forth in Rule 65A-1.716, F.A.C., are used to determine an individual's needs for Family-related Medicaid. Rulemaking Authority 409.919 FS. Law Implemented 409.903, 409.904, 409.919 FS. History-New 10-8-97, Amended 2-15-01.

(1) The Department uses the Modified Adjusted Gross Income (MAGI) based budgeting methodologies as defined in 26 U.S.C. 36B(d)(2)(B) to determine the financial eligibility of individuals applying for Medicaid. Resources are not considered as part of the eligibility determination …