Fla. Admin. Code Ann. R. 65G-4.0216 - Establishment of the iBudget Amount

(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.

(4) After the iBudget Amount is established, if a client remains in the same living setting and experiences a significant change in condition or circumstances where the proposed needs cannot be met within the current iBudget Amount, the WSC shall request services through the significant additional needs process without the calculation of a new algorithm or the completion of the AIM Worksheet.

(5) iBudget Amounts are pro-rated as appropriate based on the length of time remaining in the fiscal year.

(6) The Agency shall ensure that the sum of all clients' projected expenditures do not exceed the Agency's annual appropriation.

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

Notes

Fla. Admin. Code Ann. R. 65G-4.0216

Rulemaking Authority 393.501(1), 393.0662 FS. Law Implemented 393.063, 393.0662, 409.906 FS.

Adopted by Florida Register Volume 42, Number 120, June 21, 2016 effective 7/7/2016, Amended by Florida Register Volume 47, Number 012, January 20, 2021 effective 7/1/2021.

New 7-7-16, Amended 7-1-21.