Florida Regulations 65G-4.0214: Allocation Algorithm
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(1) To establish the Allocation Algorithm Amount for any client who has not previously had a QSI assessment, a QSI assessment must be completed prior to calculating the Allocation Algorithm Amount under subsection (2).
(b) A copy of the completed QSI evaluation and scores shall be provided to the client and WSC.
(c) Upon receiving QSI results if the client or his or her legal representative identifies an error in the QSI results the WSC shall notify the Agency in writing setting forth the details of the error. At any time, the client or WSC can prepare a statement to be maintained in client’s Central File identifying any concerns with the QSI assessment score or responses. If any error is identified in the QSI assessment the Agency shall review the error to determine if any adjustments are needed. The Agency shall inform the WSC of the result of the review and provide a revised Allocation Algorithm Amount, if appropriate, within 15 working days of notification of the error. The WSC shall in turn notify the client or the client’s representative.
(d) The client or WSC may request a reassessment any time there has been a significant change in circumstance or condition that would impact any of the questions used as variables in the algorithm determination. The Agency shall arrange for a reassessment at the earliest possible time in accordance with the circumstances, complete the reassessment, and notify the client and WSC of the results within 60 days of the request for reassessment. This section shall not be construed to require the Agency to wait for the completion of a QSI in order to address an emergency situation of the client.
(2) To calculate the Allocation Algorithm for each client, the following weighted values, as applicable, shall be summed, and the resulting total then squared:
(a) The base value for all clients, 27.5720;
(b) If the client is age 21 to 30, 47.8473;
(c) If the client is age 31 or older, 48.9634;
(d) If the client resides in supported or independent living, or the client resides in a licensed facility and does not receive residential habilitation services, 35.8220;
(e) If the client resides in a licensed residential facility that is designated to provide Standard or Live-In residential habilitation services, 90.6294;
(f) If the client resides in a licensed residential facility with a Behavior Focus designation, 131.7576;
(g) If the client resides in a licensed residential facility with an Intensive Behavior designation, 209.4558;
(h) If the client resides in a licensed residential facility that is a Comprehensive Transitional Education Program or provides Special Medical Home Care, 267.0995;
(i) The sum of the scores on the client questions in the QSI Behavioral Status Subscale (Questions 25-30), multiplied by 0.4954;
(j) If the client resides in the family home, the sum of the scores on the client questions in the QSI Functional Status Subscale (Questions 14-24), multiplied by 0.6349;
(k) If the client resides in supported or independent living, the sum of the scores on the client questions in the QSI Functional Status Subscale (Questions 14-24), multiplied by 2.0529;
(l) If the client resides in supported or independent living, the sum of the scores on the client questions in the QSI Behavioral Status Subscale (Questions 25-30), multiplied by 1.4501;
(m) The client’s score on QSI Question 16, multiplied by 2.4984;
(n) The client’s score on QSI Question 18, multiplied by 5.8537;
(o) The client’s score on QSI Question 20, multiplied by 2.6772;
(p) The client’s score on QSI Question 21, multiplied by 2.7878;
(q) The client’s score on QSI Question 23, multiplied by 6.3555;
(r) The client’s score on QSI Question 28, multiplied by 2.2803;
(s) The client’s score on QSI Question 33, multiplied by 1.2233;
(t) The client’s score on QSI Question 34, multiplied by 2.1764;
(u) The client’s score on QSI Question 36, multiplied by 2.6734; and
(v) The client’s score on QSI Question 43, multiplied by 1.9304.
(3) The squared result of the sum of the applicable values of paragraphs (2)(a) through (v), above, then apportioned according to available funding, is the client’s Allocation Algorithm Amount.
(4) This rule shall be reviewed, and if necessary, renewed through the rulemaking process five years from the effective date.
Rulemaking Authority 393.501(1), 393.0662 FS. Law Implemented 393.063, 393.0662 FS. History-New 7-7-16, Amended 7-1-21.
(a) The QSI assessor shall arrange for a face to face meeting with the client and, if available, the client’s legal representative. The WSC shall attend the face to face meeting with consent of the client or the client’s legal representative. If the client or the client’s legal representative is not capable of fully responding to all of the assessment questions, at least one participant with day-to-day knowledge of the client’s care should participate.
(b) A copy of the completed QSI evaluation and scores shall be provided to the client and WSC.
(c) Upon receiving QSI results if the client or his or her legal representative identifies an error in the QSI results the WSC shall notify the Agency in writing setting forth the details of the error. At any time, the client or WSC can prepare a statement to be maintained in client’s Central File identifying any concerns with the QSI assessment score or responses. If any error is identified in the QSI assessment the Agency shall review the error to determine if any adjustments are needed. The Agency shall inform the WSC of the result of the review and provide a revised Allocation Algorithm Amount, if appropriate, within 15 working days of notification of the error. The WSC shall in turn notify the client or the client’s representative.
(d) The client or WSC may request a reassessment any time there has been a significant change in circumstance or condition that would impact any of the questions used as variables in the algorithm determination. The Agency shall arrange for a reassessment at the earliest possible time in accordance with the circumstances, complete the reassessment, and notify the client and WSC of the results within 60 days of the request for reassessment. This section shall not be construed to require the Agency to wait for the completion of a QSI in order to address an emergency situation of the client.
(2) To calculate the Allocation Algorithm for each client, the following weighted values, as applicable, shall be summed, and the resulting total then squared:
(a) The base value for all clients, 27.5720;
(b) If the client is age 21 to 30, 47.8473;
(c) If the client is age 31 or older, 48.9634;
(d) If the client resides in supported or independent living, or the client resides in a licensed facility and does not receive residential habilitation services, 35.8220;
(e) If the client resides in a licensed residential facility that is designated to provide Standard or Live-In residential habilitation services, 90.6294;
(f) If the client resides in a licensed residential facility with a Behavior Focus designation, 131.7576;
(g) If the client resides in a licensed residential facility with an Intensive Behavior designation, 209.4558;
(h) If the client resides in a licensed residential facility that is a Comprehensive Transitional Education Program or provides Special Medical Home Care, 267.0995;
(i) The sum of the scores on the client questions in the QSI Behavioral Status Subscale (Questions 25-30), multiplied by 0.4954;
(j) If the client resides in the family home, the sum of the scores on the client questions in the QSI Functional Status Subscale (Questions 14-24), multiplied by 0.6349;
(k) If the client resides in supported or independent living, the sum of the scores on the client questions in the QSI Functional Status Subscale (Questions 14-24), multiplied by 2.0529;
(l) If the client resides in supported or independent living, the sum of the scores on the client questions in the QSI Behavioral Status Subscale (Questions 25-30), multiplied by 1.4501;
(m) The client’s score on QSI Question 16, multiplied by 2.4984;
(n) The client’s score on QSI Question 18, multiplied by 5.8537;
(o) The client’s score on QSI Question 20, multiplied by 2.6772;
(p) The client’s score on QSI Question 21, multiplied by 2.7878;
(q) The client’s score on QSI Question 23, multiplied by 6.3555;
(r) The client’s score on QSI Question 28, multiplied by 2.2803;
(s) The client’s score on QSI Question 33, multiplied by 1.2233;
(t) The client’s score on QSI Question 34, multiplied by 2.1764;
(u) The client’s score on QSI Question 36, multiplied by 2.6734; and
(v) The client’s score on QSI Question 43, multiplied by 1.9304.
(3) The squared result of the sum of the applicable values of paragraphs (2)(a) through (v), above, then apportioned according to available funding, is the client’s Allocation Algorithm Amount.
(4) This rule shall be reviewed, and if necessary, renewed through the rulemaking process five years from the effective date.
Rulemaking Authority 393.501(1), 393.0662 FS. Law Implemented 393.063, 393.0662 FS. History-New 7-7-16, Amended 7-1-21.