Florida Administrative Code
64 - DEPARTMENT OF HEALTH
64I - Division of Health Access and Tobacco
Chapter 64I-5 - RURAL HEALTH NETWORKS
Section 64I-5.002 - Certification/Decertification of Rural Health Networks
Universal Citation: FL Admin Code R 64I-5.002
Current through Reg. 50, No. 187; September 24, 2024
(1) Network Certification Procedures. All applications by Phase I planning and development grant recipients for certification as eligible for Phase II operation grants shall be processed and reviewed as follows:
(a) An application for certification and two
copies shall be submitted using an Application for Rural Health Network
Certification and shall be sent to a requestor within one week of the
Department having received a written request.
(b) An application will be accepted by the
Department at any time during normal business hours (8:00 a.m. - 5:00 p.m.,
Eastern Time) and days (Monday - Friday) of the week, except for official state
holidays.
(c) There is no fee for
the submission of an application for certification.
(d) An application for certification must
contain the following information:
1.
Corporate information, including corporate name, address, telephone number,
contact person, date of incorporation, and a current certificate of status per
Section 607.0128, F.S.,
2. The name of the person filing the
application,
3. Articles of
incorporation, corporate bylaws, and applicable certificate from the Secretary
of State,
4. A list of the board of
directors, including name, address, telephone number, and affiliation category
(i.e., health care provider, health care consumer, representative of
government, representative of an employer, or representative of another
organization),
5. Name of all
board officers and their respective positions,
6. An organizational chart of the
applicant,
7. A copy of a network
provider membership application which contains a statement indicating the
provider agrees to comply with the provisions of Section
381.0406(4),
F.S.,
8. A detailed narrative
description of the network service area, a map of the network service area,
and, if the network service area contains only census tracts of a county, the
applicant must submit a copy of the most current U.S. Census Report that
defines the census tract as rural,
9. A list of the network provider members
that represent the minimum membership requirements set forth in Section
381.0406(3),
F.S., including the name, address, telephone number, license/certification
number, provider type (use professional or facility licensure designation), and
provider category (public health, primary care, emergency medical, acute
inpatient care, or other category),
10. A list of county public health units
participating in the network and a description of the network's direct patient
care services provided by the county public health units,
11. A detailed health care service delivery
plan adopted by the network board of directors for the delivery of the core
health care services described in Section
381.0406(12)(a),
F.S.; and,
12. A budget for the
next fiscal year utilizing the format in Application for Rural Health Network
Certification, the applicant must also provide a budget narrative, identifying
the source of funds and projected expenditures by type of
expenditure.
(e) The
application for certification must be signed by a board member, attesting to
the correctness of the application and the approval of the application by the
board of directors.
(f) The
following information and documents shall be available for review by the
Department certification team during regular business hours at the offices of
the applicant when the Department conducts an examination of the applicant for
certification:
1. A list of the network
provider members as defined in Sections
381.0406(2)(b) and
(13), F.S., including the name, address,
telephone number, license/certification number, provider type (use professional
or facility licensure designation), provider category (public health, primary
care, emergency medical, acute inpatient care, or other category), a list of
core network services provided in accordance with Section
381.0406(12)(a),
F.S., and a list of other network services provided by network providers in
accordance with Section
381.0406 (12)(a)1.-4., F.S.,
2. All current provider agreements
which include provider service responsibilities, agreements to accept all
patients referred to the provider by other network members, the extent to which
the providers will provide care to persons who lack health insurance or are
otherwise unable to pay for care, the procedures for the transfer and
maintenance of patient records, the transportation method to be used to
transport patients between providers, referral procedures, network procedures
for the transfer of patients to urban providers, and scheduling procedures,
3. All current contracts or
referral agreements the network has approved for tertiary care, specialty care,
and other services,
4. A
description of disease prevention and health promotion programs offered by the
network to rural residents,
5. A
copy of the protocol to coordinate and share patient records,
6. A copy of the procedures for maintaining,
and where applicable, increasing the number of points of entry through which
rural residents may enter the health care network within the rural health
network service area,
7. A copy of
the network's quality assurance plan and a copy of the procedure manual for the
network's quality assurance system as referenced in subsection
64I-5.001(7),
F.A.C. The quality assurance manual must contain the network's quality
assurance processes and procedures, names of staff, and procedures used to
monitor and evaluate the individual providers' quality assurance processes and
procedures. These procedures must show that the network or the providers in the
network are monitoring and evaluating patient's access to care,
8. A copy of the network's risk management
program, as referenced in subsection
64I-5.001(8),
F.A.C., which shall include measures to minimize the risk of injury and adverse
incidents to patients including risk management and risk prevention education
and training, and the procedures for monitoring the individual providers' risk
management systems for minimizing risk,
9. A description of the network's information
system, which will be utilized to measure the network's success in
accomplishing the following within the network service area:
a. Improving access to care,
b. Increasing the number of skilled health
professionals,
c. Developing more
efficient and effective uses of private and public resources,
d. Providing a continuum of quality health
services; and,
e. Increasing the
utilization of the statutory rural hospitals for appropriate health care
services.
10. A copy of
marketing materials to be used by the network to recruit health care providers
and inform the general public of the services to be offered by the network,
11. Documentation that identifies
the activities the network has undertaken or will undertake to recruit and
retain health care providers.
(2) Network Certification Application Review Procedures.
(a) The Department of Health,
Office of Rural Health shall review all applications in the context of the
review criteria specified in Section 381.0406, F.S., and Chapter 64I-5,
F.A.C.
(b) Applications shall be
reviewed according to the following timetable:
1. Completeness Review.
a. Within 15 calendar days after the
application is received, the Department shall determine whether the application
is complete.
b. An application
shall not be deemed complete by the Department unless all information required
by statute and rule has been submitted by the applicant.
c. If the application is deemed incomplete by
the Department, the Department shall request, by certified mail, specific
information necessary for the application to be deemed complete.
d. If an applicant does not provide to the
Department the specific additional information within 21 days of receipt of the
Department's request, the application shall be deemed withdrawn from
consideration.
e. Subsequent to an
application being deemed complete by the Department, no further application
information or amendment will be accepted by the Department.
f. The Department of Health will, within 7
days of declaring the application complete, request the Office of Rural Health
to have the appropriate office review team contact the applicant and establish
an appropriate time for an on-site visit to verify that the applicant has in
its offices the information identified in paragraph
64I-5.002(1)(f),
F.A.C.
g. The Department shall
issue a report within 60 calendar days from the date the application(s) is
deemed complete.
(3) Issuance or Denial of Certification.
(a) The Department shall notify the applicant
by certified mail of the approval or denial of the network certification within
60 calendar days from the date the application was deemed complete. The
Department shall publish its notice of approval or denial decision in the
Florida Administrative Weekly within 14 calendar days after a letter of
approval or denial has been issued.
(b) The network certification shall be signed
by the State Surgeon General or his designee and shall become effective on the
date when signed. Network certification shall remain valid unless it is
decertified by the Department.
(c)
If the Department's decision is to deny an application, the applicant must
request an administrative hearing within 21 days after the publication of the
Department's decision in the Florida Administrative Weekly of the letter of
denial of the network certification. If no hearing is timely requested, the
Department's decision shall become the final order of the Department.
(d) If a request for an administrative
hearing is timely filed and a final order is subsequently entered which grants
network certification, a network certification shall be signed by the State
Surgeon General or his designee. Network certification shall be effective on
the date when the final order is filed in the Office of the Agency
Clerk.
(4) Decertification Procedures.
(a) Upon receipt
of a written complaint or the discovery of evidence that a certified network
has failed to meet the requirements of this rule, the Department shall notify
the network, in writing, by certified mail, of such complaint or evidence and
request a response to the complaint, in writing. The notice shall contain
either a copy of the complaint or the evidence.
(b) A network shall respond to a Department
notice of alleged failure to meet certification criteria within 25 days of
receipt.
(c) Within 30 days after
receipt of a network's documentation of compliance with the applicable
certification criteria, the Department of Health shall review the applicable
documentation, and notify the network, in writing by certified mail whether the
network is in compliance with the applicable rules and regulations.
(d) Within 60 days of receiving a notice from
the Department that the network fails to meet certification criteria, a network
must provide documentation to the Department which demonstrates that the
network has taken the necessary steps to come into compliance with applicable
certification criteria.
(e) Should
the Department determine that the network still does not meet the applicable
certification criteria, the Department shall file an administrative complaint
decertifying the network, reciting the factual basis for the decertification of
the network.
(f) The network must
file a request for hearing within 21 days of receipt of the decertification
notice in accordance with Chapter 120, F.S.
(g) If the network is decertified by final
order, the decertified network shall return, within 60 days of receipt of the
decertification notice, the full amount of any unused Phase II operational
funds, if any grant funds were received, as of the date of receipt of the
decertification letter, accompanied by the network's financial records for the
Phase II grant period prior to decertification.
(5) Monitoring Procedures. The Department of Health shall monitor certified rural health networks for compliance with the conditions of certification. Any certified network found by the Department to be in noncompliance with conditions of certification is subject to decertification of its certification. Compliance with the following requirements will be part of the monitoring process of the Department:
(a) Each certified network shall submit to
the Department an annual statement attesting that it is in compliance with the
criteria in this rule. The first annual statement shall be submitted after the
date of certification and annually on that date the following years.
(b) Each certified network shall maintain a
current file which includes all documentation required for certification,
including copies of all provider agreements. This file shall be available for
inspection by the Department and by the public during the regular business
hours of the network.
(6) Modification of a Certification. Any certified network desiring modification of its certification shall submit a written request to the Department documenting good cause for modification. Examples of good cause include, but are not limited to:
(a) Changes in the rural health
network's service area; and,
(b)
Changes in the network's ability to provide optional
services.
(7) Public Access to Rural Health Network Certification Records.
(a) Any individual wishing to examine rural
health network certification records will make an appointment with the
librarian of the Office of Rural Health.
(b) No more than one network file may be
examined at a time and must be returned to the Office of Rural Health before
another file may be obtained.
(c)
No file may be removed from the Department's premises.
(d) All files are to be picked up from the
Office of Rural Health and returned to the office after examination.
(e) The hours during which records are
available are as follows:
1. Visitors will be
permitted to examine and copy files during normal working hours between 8:30
a.m. and 4:30 p.m., Monday through Friday.
2. Visitors are prohibited access to the file
room and no files are to be removed from the Office of Rural
Health.
(f) Procedures
governing copying are as follows:
1. Copying
of certification records will be done on the copy machines in the Office of
Health Policy.
2. Each individual
must complete a Request for Public Records, each time copies are made. The
form, which will be provided by the Office of Rural Health, must be completed
in its entirety giving both the beginning and ending auditron numbers and the
total copies made.
3. Office of
Rural Health staff will not copy files for the public.
4. No person may unbind or unstaple
certification-related documents while reviewing or copying records.
5. Materials must be refiled in the same
sequential order as found.
(g) Procedures governing information listings
are as follows:
1. The Department will
maintain listings of rural health network certification information for
purposes of identifying specific files.
2. These listings are available to the public
for inspection, without an appointment, at any time between 8:00 a.m. and 5:00
p.m., Monday through Friday, during normal business hours.
3. A fee will be charged for record access as
follows:
a. The charge for copies produced
will be $.15 per page plus the file retrieval fee.
b. A file retrieval fee will be charged for
each individual request to review a rural health network certification file.
The file retrieval fee is $3.00 per file.
c. A certification copy fee of $3.00 will be
charged for certification of copies of each rural health network certification
file by the office librarian.
d.
Any person who fails to pay the charges at the time of copying will not be
allowed to take the copied documents with them.
e. The person will not be allowed to copy any
other rural health network documents until the charges are paid in
full.
4. Computer
searches and computer generated reports of rural health network certification
data will be available upon written request for a fee as determined below.
a. Charges will be determined based upon
staff time required to generate the report, mailing charges, plus a standard
computer usage charge of $10.00.
b.
Charges for computer printouts or data diskettes must be paid at the time the
reports are requested.
Rulemaking Authority 381.0406(17) FS. Law Implemented 381.0406(16) FS.
New 1-29-95, Amended 8-18-96, Formerly 59F-1.005.
Disclaimer: These regulations may not be the most recent version. Florida may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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