Rules 6A-25.011, 6A-25.012, 6A-25.013, 6A-25.014, 6A-25.015, 6A-25-016, 6A-25.017, and 6A-25.018, are amended to read:
6A-25.011 Division Determinations, Review Procedures.
(3)(e) The ALJ shall issue a Recommended Order based on Federal and Florida law. The Florida Commissioner of Education shall review the Recommended Order and the parties’ Exceptions to the Recommended Order, if any, and, pursuant to Section 120.57, Florida Statutes, issue a Final Order. The Commissioner may not overturn or modify the ALJ’s Recommended Order except as provided in Section 120.57(l), Florida Statutes.
Rulemaking Authority 413.22 FS. Law Implemented 413.24, 413.28, 413.30, 413.731 FS. History–Formerly 38J-1.006, New________.
6A-25.012 Confidentiality and Release of Consumer Information/Records.
(1)(a) The division shall accept additional information for inclusion in the case record to the extent it determines such information to be reasonably material to providing or not providing rehabilitation services to the applicant or individual.
Rulemaking Authority 413.22 FS. Law Implemented 257.36(6), 413.24, 413.28, 413.30, 413.341 FS. History–New________.
6A-25.013 Physical and Mental Restoration Services.
(3) Dental services. Dental services may be provided to an individual if the individual’s dental condition is a substantial impediment to employment; is slowly progressive; is contributing significantly to the complication of another physical condition,; and that condition constitutes a substantial vocational impediment.
(a)1. When the dental condition creates toxicity and causes physical symptoms in other systems of the body. This determination must be made by an internist and treatment approved by the division’s medical consultant.; or
(5)(a) The individual must provide documented evidence of vocational impairments that exist at the time of request.;
(b) An individual requesting bariatric surgery as an elective procedure must provide records of nutritional counseling and attempt at weight loss with a balanced diet (may be through a weight loss program or in consultation with a nutritionist or doctor) for at least one (1) year prior to the division’s considering sponsoring bariatric surgery. The division may assist with the costs of counseling and weekly fees for weight loss programs.;
(c) The individual must submit to psychological evaluation and therapeutic counseling, if recommended, regarding the individual’s current psychological status, expectations about the surgery, and ability to maintain the extreme dietary discipline required after surgery.;
(d) The individual must provide documentation from a doctor that the individual can safely undergo the surgery and be expected to return to employment.; and
Rulemaking Authority 413.22 FS. Law Implemented 413.24, 413.28, 413.30, 413.731 FS. History–New________.
6A-25.014 Vocational and Other Training Services.
(5) If an individual has to retake a course due to a failing grade and/or fails to attend the appropriate number of classes and the failure to attend was within the individual’s control, the division shall have no obligation to pay for the student’s retaking of the course.
Rulemaking Authority 413.22 FS. Law Implemented 413.24, 413.28, 413.30, 413.32, 413.731 FS. History–New________.
6A-25.015 Building Modifications.
(2)(d)1. No other resident or person typically present is available or physically capable of assisting or carrying the individual to safety.; or
(j) Prior to the authorization of any building modifications, the counselor and individual will obtain all necessary approvals from the property owner, homeowner’s associations, and/or any persons with an interest in such variances for the property.
Rulemaking Authority 413.22 FS. Law Implemented 413.24, 413.28, 413.731 FS. History–New________.
6A-25.016 Rehabilitation Technology Services.
Rulemaking Authority 413.22 FS. Law Implemented 413.24, 413.28, 413.30, 413.731 FS. History–New________.
6A-25.017 Case Closure.
(1) A case shall be closed when the individual has achieved an meaningful employment outcome, is determined ineligible, is not available, declines further service, or when the individual's actions or inactions materially interfere with providing services.
(2)(d) Determined to have achieved and maintained an meaningful employment outcome for at least ninety (90) days.
Rulemaking Authority 413.22 FS. Law Implemented 413.24, 413.28, 413.30, 413.371, 413.401, 413.731 FS. History–Formerly 38J-1.007, New_________.
6A-25.018 Recovery From Third Parties.
(7) If a third party policy only partially pays or a co-payment deductible must be paid, the division may supplement the third party payment or the co-payment deductible. The supplement to third party insurance or co-payment/deductible must be documented by the insurance carrier or vendor and the division shall not authorize an amount in excess of the division's maximum allowed fee.
(7)(8) If a vendor will not accept Medicaid or Medicare, the division may pay the vendor for services and recover from Medicaid.
(8)(9) Under special circumstances, where undue financial hardship would result to the individual, the division may consider, in its sole discretion, whether to seek reimbursement or to seek reimbursement for less than all of such funds expended. Under such circumstances, the division shall consider the following factors in determining whether to seek less than full or no reimbursement:
(9)(10) The division shall have the sole discretion, after consideration of such factors, to reduce or waive any claims the division may have under Section 413.445, Florida Statutes.