Current through Reg. 48, No. 66; April 5, 2022
(1) "Agency" means the Agency for Persons
"Clearinghouse" means a database created and maintained by the Agency for
Health Care Administration that allows the results of criminal history checks
to be shared among specified agencies according to section 435.12, Florida
(3) "Code of
Ethics" means a set of values, standards, and principles to guide
decision-making and everyday professional conduct of Support Coordinators
employed by a Qualified Organization.
"Consultant" shall have the same meaning
as in the Consumer-Directed Care Plus Program Coverage, Limitations, and
Reimbursement Handbook ("CDC+ Handbook"), as adopted by Rule
Florida Administrative Code (F.A.C.).
(5) "Consumer-Directed Care Plus Program" or
"CDC+ Program" means a consumer-directed program that provides an alternative
to the Medicaid State Plan and the Home and Community-Based Services Medicaid
Waiver (also known as the iBudget Waiver). The CDC+ Program operates under the
authority of section 1915(j) of the Medicaid State Plan Amendment of the Social
Security Act and is governed by Title 42 of the Code of Federal Regulations,
Part 441, and sections
and (7), F.S.
"Corrective Action" means any act of
remediation that the Qualified Organization is required to complete in response
to any state or federal regulatory agency's or its representative's findings of
unacceptable performance, nonperformance, or noncompliance with the terms and
conditions of this chapter, Rules
through 4.0218, F.A.C. ("iBudget Rules"), Chapter 65G-10, F.A.C., section
393.0663, F.S., or the Developmental Disabilities Individual Budgeting Waiver
Services Coverage and Limitations Handbook.
(7) "Corrective Action Plan" means a plan
prepared by the Qualified Organization and approved by the Agency by which the
corrective action will be accomplished. A Corrective Action Plan has the same
meaning as a Plan of Remediation.
"Developmental Disabilities Individual
Budgeting Waiver Services Coverage and Limitations Handbook" or "iBudget
Handbook" refers to the handbook incorporated by reference in Rule
Florida Administrative Code.
"Home and Community Based Services Waiver" or "Waiver" means the Medicaid
waiver authorized by
of the federal
Social Security Act and Section
F.S., that provides Medicaid funding for home and community based services to
eligible persons with developmental disabilities who are eligible for Agency
services and who live at home or in a home-like setting.
"Home Region" means the Region in which
the applicant submitted its application to become a Qualified Organization and
where services will be rendered by the Qualified Organization, if approved. If
the applicant wishes to render services in multiple Regions, only one
application must be submitted to the Home Region as described in Rule
means the Agency's designated data management system as described in section
(a) For clients under the age of 18
years, the legal representative or health care surrogate appointed by the
Florida court to represent the child or anyone designated by the parent(s) of
the child to act on the parent(s)' behalf (e.g., due to military
(b) For clients age 18
years or older, the legal representative could be the client, anyone designated
by the client through a Power of Attorney or Durable Power of Attorney, a
medical proxy under chapter 765, F.S., or anyone appointed by a Florida court
as a guardian or guardian advocate under chapter 393 or 744, F.S.
(13) "Medicaid Waiver Services
Agreement" or "MWSA" means the contract between the Agency and providers of
Medicaid Waiver services to Agency clients, as defined in section
(14) "Mentee" means a person
employed by a Qualified Organization who is guided, advised, or trained by a
(15) "Mentor" means a
Support Coordinator employed and designated by a Qualified Organization who
uses his or her knowledge, skills, and experience to guide, advise, or train a
mentee employed by the same Qualified Organization.
(16) "Ombudsman" means the Agency's primary
point of contact for addressing issues of concern or unresolved issues
expressed by clients, legal representatives, providers, and other external
Organization" shall have the same meaning as in section
(18) "Quality Improvement
Organization" or "QIO" means a group of health quality experts, clinicians, and
consumers contracted with the Agency for Health Care Administration and
organized to improve the quality of care delivered to Agency clients.
(19) "Region" means one of six designated
local geographical areas served by the Agency. There are six regions across the
state of Florida: Northwest, Northeast, Central, Suncoast, Southeast, and
(20) "Regional Office"
means one of the Agency's offices serving a Region. The contact information for
each Regional Office is designated on the Agency's website.
(21) "Sexual Misconduct" shall have the same
meaning as in section
(22) "Support Coordinator"
shall have the same meaning as in section 393.063, F.S. and the CDC+
(23) "Waiver Support
Coordinator" refers to a Support Coordinator who assists clients enrolled on
the Medicaid Home and Community-Based Services Waiver.
(24) This Rule shall be reviewed, and if
necessary, renewed through the rulemaking process five years from the effective