JONATHAN HUGHES

v.

AGENCY FOR PERSONS WITH DISABILITIES

PER CURIAM.

Jonathan Hughes appeals the Agency for Persons with Disabilities’ (“Agency”) decision to reallocate his service hours. Hughes receives services under the Individual Budgeting Home and Community-Based Services Medicaid Waiver Program (“iBudget Waiver”).

Hughes has profound and life-long disabilities, including cerebral palsy and spastic tetraplegia. Hughes receives full-time, professional care. Though he has significant needs, he runs a micro-business that operates vending machines, participates in community groups, and advocates for the interests of others living with disabilities.

In October 2020, the Agency notified Hughes that his service hours were being reallocated. He would still receive full-time, 24/7 care, but the allocation of the hours would change. Of particular concern to Hughes was the number of hours allocated to Supported Living Coaching (“SLC”) services. The Agency reduced and reallocated some of Hughes’ SLC hours to Personal Support Services (“PCA”). The iBudget Waiver program permits recipients to hire their own service providers and set the compensation rates. § 393.0662, Fla. Stat. (2020). The Agency approves the service hours for a recipient and sets out a budget. Id. The recipient then uses the budgeted funds to manage his or her needs. Id. All providers rendering iBudget Waiver services must comply with the provisions of the Florida Medicaid Developmental Disabilities Individual Budgeting Waiver Services Coverage and Limitations Handbook, September 2020 (“Handbook”) as incorporated by Fla. Admin. Code Rule 59G-13.070.

Hughes disputed the Agency’s decision and a telephonic hearing was held. At the hearing, an Agency representative testified that Hughes’ hours were reallocated because the overlap between the SLC and PCA categories resulted in duplicative services. Hughes’ mother also testified. She explained that Hughes requires the same level of SLC hours he previously received because of his medical conditions. Hughes argued that the Agency did not comply with the person-centered plan of care requirement under Fla. Admin. Code R. 65G-4.0213(17).

The hearing officer’s final order affirmed the Agency’s reallocation of service hours. The final order agreed with the Agency that many of Hughes’ services could be handled by PCA rather than SLC.

On appeal, Hughes argues the hearing officer misinterpreted the Handbook rules on SLC and PCA tasks. The Agency repeats its argument that the services were duplicative and that it correctly reallocated the type of service hours.

According to the Handbook, SLC provides services [that] can include assistance with locating appropriate housing; the acquisition, retention, or improvement of skills related to activities of daily living (e.g., personal hygiene and grooming); household chores; meal preparation; shopping; personal finances; and the social and adaptive skills necessary to enable recipients to reside on their own.

Handbook, pg. 2-70.

PCA provides assistance and training to the recipient in activities of daily living, such as eating, bathing, dressing, personal hygiene, and preparation of meals. When specified in the support plan, this service can also include heavy household chores to make the home safer, such as washing floors, windows and walls; tacking down loose rugs and tiles; or moving heavy items or furniture. Services also include non-medical care, and supervision . . . . Personal supports in supported living are also designated to teach the recipient about home-related responsibilities.

Handbook, pg. 2-40.

By the definitions in the Handbook, it is clear that some of the SLC service hours provided to Hughes could be recategorized as PCA services, specifically meal preparation, household chores, and personal hygiene. While SLCs have higher qualification requirements and can provide more services than a PCA, the Agency’s finding was not that Hughes was not entitled to any SLC hours, only that some SLC hours could be reduced and replaced by PCA hours.

Hughes also argues his SANs, or Significant Additional Needs, justify additional funding pursuant to section 393.0662(1)(b), Fla. Stat. Funding may be authorized “based on a client having one or more of the following needs that cannot be accommodated within the funding determined by the algorithm and having no other resources, supports, or services available to meet the need.” § 393.0662(1)(b), Fla. Stat. Hughes does have SANs and adequately established qualifying conditions under section 393.0662(1)(b)(1)(c–d), Fla. Stat. However, Hughes did not show that his SANs required an increase in SLC hours.

The final order was supported by competent, substantial evidence. The hearing officer entered detailed and comprehensive findings of fact based on the documents and testimony received at the hearing. The hearing officer found that Hughes’ previous SLC services had included household needs, buying groceries, preparing his meals, and supervising his mealtimes, buying cleaning supplies, changing lightbulbs, batteries, and air conditioning filters, cleaning his wheelchair, and taking Hughes to meetings and managing his business. The hearing officer was correct to find that each of these tasks are covered under the PCA definition. The Agency’s representative gave clear testimony regarding the services received by Hughes, the billing rates, and the language in the Handbook.

Because we find no error in the hearing officer’s determinations or the final order on appeal, we affirm.

AFFIRMED. ROWE, C.J., and JAY and LONG, JJ., concur. _____________________________