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The Florida Statutes

The 1998 Florida Statutes

Title XXIX
PUBLIC HEALTH
Chapter 402
Health And Human Services: Miscellaneous Provisions
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402.33  Department authority to charge fees for services provided.--

(1)  As used in this section, the term:

(a)  "Benefit payments" means cash payments from retirement, survivors, or disability insurance or from supplemental security income programs, and includes, but is not limited to, payments from social security, railroad retirement, and the United States Department of Veterans Affairs.

(b)  "Client" means any natural person receiving services provided by the department, including supervision, care, and maintenance, but not as a licensee subject to regulation by the department for purposes of licensure.

(c)  "Department" means the 1Department of Health and Rehabilitative Services.

(d)  "Fee collections" means all fees collected by the department for services provided to clients.

(e)  "Representative payee" means an individual or entity which acts on behalf of a client as the receiver of any or all benefits owing to the client.

(f)  "Responsible party" means any person legally responsible for the financial support of the client and may include a minor client's natural or adoptive parent, a client's spouse, and an estate or trust established for the financial support of a client, but not a payor of third-party benefits.

(g)  "State and federal aid" means cash assistance or cash equivalent benefits based on an individual's proof of financial need, including, but not limited to, temporary assistance under the WAGES Program and food stamps.

(h)  "Third-party benefits" means moneys received by or owing to a client or responsible party because of the client's need for or receipt of services such as those provided by the department. Such benefits include, but are not limited to, benefits from insurers, Medicare, and workers' compensation.

(2)  The department, in accordance with rules established by it, shall either charge, assess, or collect, or cause to be charged, assessed, or collected, fees for any service it provides to its clients either directly or through its agencies or contractors, except for:

(a)  Diagnosis and evaluation procedures necessary to determine the client's eligibility and need for services provided by the department;

(b)  Customary and routine information and referral services;

(c)  Educational services provided in lieu of public education;

(d)  Specific services exempted by law from fee assessment;

(e)  Emergency shelter or emergency detention care and custody prior to a detention hearing under chapter 39;

(f)  Specific classes or types of services provided in programs funded by grants, donations, or contracts that prohibit charging fees;

(g)  Developmental services provided under chapter 393 to any person who is determined to be eligible for such services by the department and whose earned income falls below the federal Health and Human Services Poverty Guidelines, unless such fees are collected from third-party benefits and benefit payments; or

(h)  Any type of service for which the department determines that the net estimated revenue from such fees after deducting any loss of funds from federal grants occasioned by such fees will be less than the estimated cost to charge and collect such fees.

Fees, other than third-party benefits and benefit payments, may not be charged for services provided to indigents whose only sources of income are from state and federal aid. In addition, fees may not be charged parents of a minor client for services requested by the minor without parental consent or for services provided a minor client who has been permanently committed to the care and custody of the department with parental rights permanently severed. However, lack of parental consent does not preclude the charging of fees established under chapter 39. The department may not require a client who is receiving wages which are below the minimum wage under the federal Fair Labor Standards Act to pay fees from such wages. Voluntary payments for services must be encouraged.

(3)  Fees not specifically set elsewhere by statute shall be reasonably related to the cost of providing the service but may not exceed the average cost of the service, and the client receiving or benefiting from the service or the client's responsible party shall be liable for any such fee assessed. The department may actively assist a client or his or her responsible party in obtaining any financial benefits he or she is entitled to by law, or as the beneficiary of a trust, annuity, retirement fund, or insurance contract. Designation of payee or assignment of benefits shall comply with rules adopted by the department. The department may serve as the representative payee in receiving such benefits for the client or responsible party and shall use such benefits received to reduce the client's or responsible party's liability for fees assessed. Before reducing such liability, the department shall provide for the client's incidental personal expenses allowed by departmental rule and shall bill any insurer or other payor of third-party benefits who may be obligated by contract or law to provide, or to participate in the cost of providing, the service or services to the client for which the fees have been assessed.

(4)  The department shall:

(a)  At least annually, determine or establish the cost of providing services for which charges will be made. A determination of this cost shall be made within 90 days of the effective date of this act.

(b)  Annually review uniform criteria for determining ability to pay, or to participate in, the cost of service.

(5)  The payment of charges shall not be a prerequisite to treatment or care.

(6)(a)  The department may not require a client or responsible party to pay fees it may assess that exceed the client's or responsible party's ability to pay. Such ability to pay shall be based upon the income of the client or responsible party, including any inheritance or bequests he or she may receive, and shall be determined according to uniform criteria and rules adopted by the department, unless the amount of the fee is specifically established by statute. The department shall assess the effects upon clients, responsible parties, services, and revenues of determining the ability to pay based upon:

1.  The client's or responsible party's gross income, the number of persons dependent on that income, and the number of such persons who are clients; and

2.  The client's or responsible party's income less fixed domestic expenses, including a maximum amount of expenses as set forth by the department for each category of domestic expense so that any expenditures by the client or responsible party which exceed the maximum allowed will not be deducted from gross income for the purpose of determining ability to pay.

(b)  The department is authorized to require financial information from a client or his or her responsible party, in order to determine the client's or responsible party's ability to pay, including the source of current or potential income or benefits that might be available to pay the cost of services provided or assets that may be available to assure payment of the fees. If the required information is not furnished within a time period established by departmental rule, the department may enter suit to enforce the requirement or may bill the client or responsible party for the full cost of services, less reimbursements from third-party payors for such services. The department shall verify such financial information in accordance with the most economical uniform procedures. If the cost of services, less recoveries from third-party payors, exceeds the client's or responsible party's ability to pay, the department shall reduce the client's or responsible party's liability for fees assessed to an amount not in excess of the amount which the client or responsible party has been determined to be able to pay.

(7)(a)  The department shall by rule establish procedures for clients or responsible parties to request a review of assessed fees. Further, the department shall advise such clients or responsible parties of the criteria which are used to make determinations on requests for reduction or waiver of fees.

(b)  If the department denies a request for a fee reduction or waiver, it shall inform the client or responsible party of his or her right to appeal the decision pursuant to the provisions of chapter 120.

(8)(a)  Unpaid fees for services provided by the department to a client constitute a lien on any property owned by the client or the client's responsible party which property is not exempt by s. 4, Art. X of the State Constitution. If fees are not paid within 6 months after they are billed, the department shall charge interest on the unpaid balance at a rate equal to the average rate of interest earned by the State Treasury on state funds deposited in commercial banks as reported by the Treasurer for the previous year. The department is authorized to negotiate and settle any delinquent account, and to charge off any delinquent account even though the claim of the department may be against the client, a responsible party, or a payor of third-party benefits, either directly for the department or as a fiduciary for the client or responsible party.

(b)  If negotiation and settlement cannot be effected within a time period established by its rules, and if charging off the account is not appropriate, the department shall, if it is cost-effective to do so, file the lien for the unpaid fees for recordation by the clerk of the circuit court in such county or counties which the department determines to be in the best interest of the state. Services for which fees were charged shall constitute a claim against the client, the client's responsible party, or any insurer obligated to pay for the services provided. Such liens and claims shall be enforced on behalf of the state by the department. Liens and claims upon recordation with the clerk of the circuit court shall be continuing obligations until 3 years after the demise of the client or the client's responsible party, unless satisfied earlier.

(c)  Upon the death of a person against whom the department has a claim, the department shall file such caveats as are in the best interest of the state. If the department effects recovery, the fund from which the filing fee for the caveat was paid shall be reimbursed.

2(9)(a)  The department should exert every lawful and reasonable effort to collect all delinquent and unpaid fees for services and to maximize the recovery of fees.

(b)  In collecting delinquent or unpaid fees, the department may employ the services of a collection agency. The collection agency must be registered and in good standing under chapter 559. The department may pay a collection agency from any amount collected under the claim a fee that the department and the agency have agreed upon, or may authorize the agency to deduct the fee from the amount collected.

(10)(a)  Upon August 12, 1983, the department shall begin an orderly review of all services provided clients to assure that fees now assessed conform to the provisions of this section. Additional service fees, when and if required, shall be established according to a time schedule and financial plan.

(b)  Unless otherwise specified by the Legislature, fee collections, including third-party reimbursements, in excess of fee-supported appropriations may be used in conformance with the provisions of chapter 216 to fund nonrecurring expenditures for direct client services and to fund administrative costs of improving the fee collection program of the department. No more than one-sixth of the amount of collections in excess of the amount of appropriations may be used to fund such improvements to the program. Priority consideration for the expenditure of excess collections shall be given to those districts and programs most responsible for the excess. A plan for the use of excess collections not spent in the fiscal year in which collected shall be subject to approval by the Executive Office of the Governor within 90 days from the end of the state fiscal year in which the excess occurs.

History.--ss. 1, 2, 3, 4, 5, 6, ch. 75-190; s. 1, ch. 76-210; s. 1, ch. 77-174; s. 10, ch. 83-230; s. 51, ch. 85-81; s. 2, ch. 85-187; s. 84, ch. 86-220; s. 45, ch. 87-225; s. 1, ch. 87-377; s. 1, ch. 93-72; s. 20, ch. 93-268; s. 814, ch. 95-148; s. 42, ch. 95-418; s. 82, ch. 96-175; s. 2, ch. 96-235; s. 4, ch. 96-407; s. 67, ch. 97-100.

1Note.--The Department of Health and Rehabilitative Services was redesignated as the Department of Children and Family Services by s. 5, ch. 96-403, and the Department of Health was created by s. 8, ch. 96-403.

2Note.--Section 1, ch. 96-235, provides that "[i]t is the intent of the Legislature that the 1Department of Health and Rehabilitative Services be accountable and deliver services in an efficient and effective manner. The Legislature recognizes that the power of the 1Department of Health and Rehabilitative Services to collect delinquent and unpaid fees should be augmented by creating additional mechanisms to ensure timely collection of moneys that are due the state. In order to render resources more immediately available to meet the needs of the department's clients, it is the legislative intent that the collection mechanisms provided in section 402.33(9), Florida Statutes, be in addition to, not in lieu of, existing collection mechanisms."