Apr 2, 2012

Residential Fee Collection FAQs

Residential Fee Collection FAQs

Who will this impact?

o Residential Fee Collection will only apply to agency clients who are adults (18 or above) living in an APD- licensed facility whose residential care is funded through a room and board payment.

Which Federal Benefits will be taken into consideration?

o As defined in Section 402.33, F.S., the term “benefit payments” refer to 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 (such as SSI and SSDI, for example)
o Please contact the appropriate area APD office for questions about specific benefit payments and their applicability to the residential fee collection initiative.

What is considered “excess” cash benefits?

o The term "excess" refers to the amount left over from a benefit payment after the personal needs allowance, room and board payment, federally approved exclusions, and other exclusions described within the proposed rule is subtracted from the benefit payment(s). Any remaining money is considered “excess” and should be remitted to APD.

 Example: If a beneficiary received $800 in benefits, the personal needs allowance of $93.58 would be deducted. This leaves $706.42. Next, the room and board payment of ($543.42) is deducted, leaving a balance of $163.00. Assuming that no other exclusions apply, the balance would be remitted to the agency to offset the state-funded care in the group home.

What money is excluded?

 The following federal benefit amounts are not subject to residential fee collection:
(1) benefits which were specifically excluded (in writing) by the Social Security Administration,
(2) benefits which were used as a required payment, co-payment, or co-insurance for Medicaid or Medicare services, including but not limited to prescribed drugs, or
(3) benefits which were used to offset a voluntary reduction in a client’s Medicaid waiver services.

All exclusion requests must include evidence of payments (such as receipts, for example) for the actual services rendered.

Please contact the appropriate area APD office for questions about specific benefit payments and their applicability to the residential fee collection initiative.

Will the fee change the rate at which group homes receive room and board?

o No. The room and board rate will still remain the same.

If the individual has already received the January, February, or March SSI checks, will APD require clients to submit additional fees for those months?

No. The first fees will be due on May 15, 2012 (from any federal benefits received beginning on April 1, 2012). Fees will be due to APD on the 15 of every month following the month in which the benefit payments are received.

Does the fee impact the individuals “allowance”?

o No. APD currently utilizes one of the highest personal needs allowances in Florida (at $93.58). This amount will not change as a result of this initiative.

If I am paying privately for a Medicaid waiver service with the excess cash benefits, will that money now be due to APD?

o Possibly. If an individual voluntarily chose to reduce or eliminate a Medicaid waiver service (which he or she was previously authorized to receive), then such funds would not be subject to residential fee collection. However, if those waiver services were reduced or eliminated through an Agency-initiated action, then those funds would be subject to collection. Please contact the appropriate area APD office with questions about any excess funds (used to pay for Medicaid waiver services) in order to determine whether or not such funds are subject to collection.

o APD will require a client or representative payee to provide the local area office with proof of payment for a service if the client claims an exclusion or deduction from residential fee collection.

What gives APD the authority to collect excess benefits from the Federal government if APD is a state agency?

o APD utilized the statutory authority provided under s. 402.33, Florida Statutes in order to pursue the collection of fees to help offset the cost of residential services for APD clients.