Current through Reg. 50, No. 187; September 24, 2024
(1) Each Qualified Organization must develop,
maintain, and enforce a professional code of ethics applicable to all Support
Coordinators within the organization. Failure to develop, maintain, or enforce
a professional code of ethics shall constitute grounds for the Agency to deny
approval of or take disciplinary action against the Qualified
Organization.
(2) The code of
ethics must include:
(a) Provisions addressing
how the Qualified Organization will prevent and avoid actual and perceived
conflicts of interest among its Support Coordinators, which must prohibit each
Support Coordinator from:
1. Being the legal
representative, applying to be the legal representative, or being affiliated
with an organization or person who is the legal representative of a client
served by the Qualified Organization;
2. Being the legal representative or
representative payee for any benefits received by a client served by the
Qualified Organization nor assume control of a client's finances or assume
possession of a client's checkbook, investments, or cash;
3. Rendering support coordination services to
a client who is a family member;
4.
Unduly influencing paid services on behalf of a client from a service provider
who is a family member of the Support Coordinator or any employee of the
Qualified Organization;
5.
Providing any waiver service other than support coordination and CDC+
consultant services;
6. Being a
subsidiary of or being directly or indirectly controlled by persons or
organizations providing waiver services within the state of Florida, other than
support coordination and related administrative activities to clients who
receive services from the Agency;
7. Requesting or receiving financial
compensation from family members of clients; and
8. Providing assistance to a client on
completion of the Support Coordinator Client Satisfaction
Survey.
(b) Provisions
mandating every Support Coordinator to promote client choice as described in
the iBudget Handbook, including freedom to direct service planning and choose a
provider from all available providers;
(c) Provisions addressing how the Qualified
Organization will ensure that clients' rights under Section
393.13, F.S., are protected,
including reporting known or suspected abuse, neglect, exploitation, and sexual
misconduct;
(d) Provisions
encouraging fairness, integrity, and civility, including providing honest and
accurate information verbally and in writing, being available for clients,
timely responding to communications from clients and Agency staff, and
cooperating and collaborating with others involved in client care;
(e) Provisions requiring Support Coordinators
to counsel clients and, if applicable, the client's legal representative
regarding covered services and that covered services will only be approved if
they are individualized, specific, consistent with the client's needs, and not
in excess of the client's needs;
(f) Provisions requiring Support Coordinators
to explore all services available through local, state, and federal government
and non-government programs or services, including the Medicaid State Plan;
school-based services; private insurance; natural supports; and community
supports, prior to requesting Waiver funds on behalf of the client, which may
be evidenced by denial letters, coverage policies, case notes, and other
documentation;
(g) Provisions
requiring Support Coordinators to only pursue Waiver services for clients that
the Support Coordinator believes address the capacities, needs, and resources
of their clients and are not available through other resources or funding
sources, which the Support Coordinator must indicate on the Verification of
Available Services Form incorporated by reference in Rule
65G-4.0213, F.A.C.;
(h) Provisions requiring confidentiality and
privacy of client information;
(i)
Provisions prohibiting Support Coordinators from misrepresenting their
affiliation with the Agency; and
(j) Provisions addressing Support Coordinator
duties and responsibilities described in Chapter 393, F.S., and the iBudget
Handbook, including:
1. Ensuring Significant
Additional Needs requests are complete and accurate when submitted;
2. Assisting clients and, if applicable,
legal representatives obtain services through the Medicaid state
plan;
3. Participating in meetings
required by the Agency;
4.
Participating in meetings coordinating services on behalf of the
client;
5. Assisting clients and,
if applicable, their legal representative with the process for addressing
client complaints and grievances regarding possible service delivery
issues;
6. Coordinating in the
preparation and planning for natural disasters, including ensuring each client
has a personal disaster plan and monitoring the status of each client,
including providing information on available resources during and after a
natural disaster; and
7. Updating
service authorizations in iConnect to reflect the current, approved level of
service(s) and providing the updated service authorizations to
providers.
(3)
The Qualified Organization must make the approved code of ethics available to
all its employed Support Coordinators and must review the code of ethics to
each client or, if applicable, client's legal representative on an annual basis
or immediately upon request.
(4)
Upon discovering that a Support Coordinator has violated the code of ethics,
the Qualified Organization must send a report to the Agency as described in
Rule 65G-14.003, F.A.C.
(5) This rule shall be reviewed, and if
necessary, renewed through the rulemaking process five years from the effective
date.
Rulemaking Authority
393.0662 (7),
(15),
393.0663(5),
393.501(1) FS.
Law Implemented 393.0662,
393.0663(2)-(3),
393.063 FS.
New 7-1-21.
