Florida Administrative Code
65 - DEPARTMENT OF CHILDREN AND FAMILIES
65E - Mental Health Program
Chapter 65E-14 - COMMUNITY SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES - FINANCIAL RULES
Section 65E-14.018 - Sliding Fee Scale

(a) The service provider shall make a determination of ability to pay in accordance with the sliding fee scale for all individuals seeking substance abuse or mental health services. Payment of fees shall not be a pre-requisite to treatment or the receipt of services. The sliding fee scale shall not apply to services provided under the following Covered Services as defined in Rule 65E-14.021. F.A.C:

(b) It is not the intent of this rule to prohibit or regulate the collection of fees on behalf of an individual from third party payers and commercial insurers such as Workers' Compensation, TRICARE, Medicaid, or Medicare. However, service providers shall make every reasonable effort to identify and collect benefits from third party payers for services rendered to eligible individuals.

(c) For the purposes of this rule, household income is defined by I.R.C. §36B(d)(2) (1986), https://www.flrules.org/Gateway/reference.asp?No=Ref-04195, with exceptions pursuant to 42 CFR § 435.603(e), October 1, 2012, https://www.flrules.org/Gateway/reference.asp?No=Ref-04196, hereby incorporated by reference, copies of which may be obtained from the Office of Substance Abuse and Mental Health, 1317 Winewood Blvd., Building 6, Tallahassee, Florida 32399-0700.

(a) Each service provider shall develop a sliding fee scale, that is updated annually, in conjunction with the Federal Poverty Guidelines, and applies to individuals receiving services that are paid for by state, federal, or local matching funds.

(b) The service provider shall request a sliding fee payment from persons not eligible for Medicaid or receiving services ineligible under Medicaid; and whose household income is less than 150 percent of the federal poverty income guidelines in accordance with Section 409.9081, F.S. Nominal co-payments for the following substance abuse and mental health services shall apply:

(c) The service provider shall require persons meeting the criteria listed below to contribute to their treatment costs consistent with the provisions of Section 409.212, F.S.:

(a) Parents of minors, when the minor has been permanently committed to the department and parental rights have been permanently terminated, or

(b) Parents of a minor, when the minor has requested and is receiving services without parental consent.

(a) Each service provider shall develop a uniform schedule of discounts and sliding fee scale, as specified in Section 394.674(4)(a), F.S.

(b) The uniform schedule of discounts shall be based on household income, financial assets and family size, as declared by the person or the person's guardian, relative to the family's percent of poverty level.

(c) The percent of poverty level shall be calculated by dividing the household income by the U.S. Department of Health and Human Services Annual Update of the Health and Human Services Poverty Guidelines. The poverty guidelines establish poverty income levels for various family sizes.

(d) The total charges to an individual shall not exceed 5% of gross household income.

(e) Nothing in this rule shall prevent a service provider from further discounting or writing off charges individually or in the aggregate.

(f) An individual's failure to make payment under a provider's sliding fee scale shall not prevent the individual from receiving services.