Item C16BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
.ter"
Louis LaTorre, Director/Social Services
Meeting Date: April 16, 2003 Division:__ Community Services
Bulk Item: Yes x No
Department: Social Services
AULIN 1A ITEM WORDING: Authorization to execute an Interim Assistance Reimbursement (IAR)
Agreement between Monroe County, the Social Security Administration and the State of Florida,
Department of Children and Families.
ITEM BACKGROUND: The State of Florida, Department of Children and Families first entered into
an Interim Assistance Reimbursement Agreement with the Secretary of Health and Human Services
(HHS) on November 3, 1975. Under this agreement the state serves only as a contractual
intermediary between HHS and participating counties. This Agreement enables the County to be
reimbursed for assistance rendered to a client prior to having all funds sent to the client that has been
approved for SSI.
PREVIOUS RELEVANT BOCC ACTION: The BOCC possibly approved Agreement in 1975,
copies not available.
CONTRACT/AGREEMENT CHANGES: A summary of the amendments to the Agreement is
attached.
STAFF RECOMMENDATIONS: Approval
TOTAL COST: N/A
COST TO COUNTY: N/A
REVENUE PRODUCING: Yes X No
BUDGETED: Yes N/A No
SOURCE OF FUNDS:Social Security (SSI)
AMOUNT (ESTIMATED FY O1/02 $64,260.10)
APPROVED BY: County Atty X O urchasing X Management v
DIVISION DIRECTOR APPROVAL: 0
1
Jame E alloc
DOCUMENTATION: Included X To Follow Not Required
DISPOSITION:
Revised 1/03
AGENDA ITEM #
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Social Security Administration
Contract with: and the State of Florida, Department of Effective Date:
Children and Families Expiration Date:
_Contract Purpose/Description:
This Agreement enables the County to be reimbursed for assistance rendered to a client prior to having all funds sent to
the client that has been approved for SSI.
Contract Manager: X4573 Social Services
(Louis LaTorre) (Ext.) (Department)
for BOCC meeting on 4/16/ 03 Agenda Deadline: 4 / 02 /03
CONTRACT COSTS
Total Dollar Value of Contract: $ N/A Current Year Portion: $ N/A
Budgeted ? Yes N/A No _ Account Codes: - -
Grant: $
County Match: N/A
ADDITIONAL COSTS
Estimated Ongoing Costs: $ N/A /yr. For:
(Not included in dollar value above)
I Division Director
I Risk Management
O.M.B./Purchasing
County Attorney
Comments:
(e.g. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Needed
Yes No
,,5////03
Date Out
1/l 1 /03
_3/28/03_
LORIDA DEPARTMENT OF i Jeb Bush
CHILDREN I - Governor
& FAMILIES
Jerry Regier
Secretary
RE: Interim Assistance Reimbursement (IAR) Agreement
Dear County Official:
The Social Security Administration is in the process of amending its Interim Assistance
Reimbursement Agreement with the state of Florida. As a result, we must advise you of
the changes and ask if your county wishes to continue to participate in this program. A new
Amended Agreement is enclosed for your review.
The State of Florida, Department of Children and Families, first entered into an Interim
Assistance Reimbursement Agreement with the Secretary of Health and Human Services
(HHS) on November 3, 1975. Under this Agreement, the state serves only as a
"contractual intermediary" between HHS and participating counties. Each participating
county has a direct working relationship with the Social Security Administration. Continued
participation in the program requires a county official's signature on the attached page. A
summary of amendments to the Agreement is attached.
In addition to the Agreement, the state is required to provide an updated listing of the
participating counties' contact information. If your county will continue to participate, please
review your county's information and submit any necessary corrections along with your
signed decision. Once all counties have responded to this office, we can update the State
Agreement and submit it to the Social Security Administration Regional Office in Atlanta.
We will send a copy of the signed Agreement to each of the participating counties.
Please return the Agreement to the attention of Virginia Hardcastle at your earliest
convenience, but no later than March 28 2002. If you have any questions regarding this
matter, please contact Lynn Raichelson at (850) 488-3274.
Thank you in advance for your cooperation in this matter.
Sincerely,
Kim Brock
Acting Director
Economic Self -Sufficiency Services
Attachment
1317 Winewood Boulevard, Tallahassee, Florida 32399-0700
The Department of Children and Families is committed to working in partnership
With local communities to ensure safety. well-being and self-sufficiency for the people we serve.
LORIDA DEPARTMENT OF
--� CHILDREN
4" & FAMILIES
Supplemental Security Income
Agreement for Reimbursement under
Interim Assistance Reimbursement (IAR) Agreement
Between
The Department of Children and Families
And
Participating Florida Counties
Jeb Bush
Governor
Jerry Regier
Secretary
We have reviewed this letter and the revised drafted changes to the Social Security
Administration agreement.
MONROE
County
X Agrees to continue to participate in the Interim Assistance Program.
No longer will participate in the Interim Assistance Program.
Dixie M. Spehar
County Official (Print Name)
County Official (Signature)
Return to: Department of Children and Families
Economic Self -Sufficiency
1317 Winewood Boulevard, Building 3
Tallahassee, FI 32399
Attn: Virginia Hardcastle
April 16, 2003
Date
Mayor
Title
APPROVED AS TO F Rt'
AND LE L SUFFIC
BY
U`ANNE J TON
D 31_4
1317 Winewood Boulevard, Tallahassee, Florida 32399-0700
The Department of Children and Families is committed to working in partnership
with local communities to ensure safety, well-being and self-sufficiency for the people we serve.
FLORIDA — SSI Interim Assistance Participation—1/9/03
List of Political Subdivisions Using Manual Process
Brevard County Welfare
SSI Reimbursement
2725 St John's Street
Melbourne FL 32940-0000
10-40 (Brevard County)
[FL 6731
Broward County Social Services
SSI Reimbursement
The Government Center, Room 433A
115 S. Andrews Avenue
Ft Lauderdale, FL 33301-1802
10-50 (Broward County)
[FL 665]
Metro -Dade Community Services
III NW Ist Street, Suite 2130
Miami, FL 33128-1985
10-120 (Dade County)
[FL E991
Community Services Dept
SSI Reimbursement
900 Univ Blvd N, 9405
Jacksonville, FL 32211-5580
10-150 (Duval County)
[FL 6551
Glades County Welfare Department
SSI Reimbursement
P.O. Box 595
Moore Haven, FL 33471-0595
10-210 (Glades County)
[FL 6611
Highlands County Welfare
SSI Reimbursement
P.O. Box 1926
Sebring, FL 33871-I926
10-270 (Highlands County)
[FL B13]
Hendry County Welfare Department
SSI Reimbursement
710 East El Pasco Avenue
Clewiston, FL 33440-4705
10-250 (Hendry County)
[FL 6611
Indian River County Welfare
SSI Reimbursement
1840 25th Street
Vero Beach, FL 32960-3365
10-300 (Indian River County)
[FL B211
Monroe County Social Services
SSI Reimbursement
Key West, FL 33040-4M
10-430 (Monroe County)
[FL 6721
Department of Social Services
SSI Reimbursement
2100 E. Michigan Avenue
Orlando, FL 32806-4914
10-470 (Orange County)
[FL 6571
,Palm Beach County Welfare
Department
SSI Reimbursement
810 Datura Street
West Palm Beach, FL 33401-5204
10-490 (Palm Beach County)
[FL 6611
Department of social Services
SSl Reimbursement, Suite 1500
1100 Cleveland Street
Clearwater, FL 34615-4803
10-510 (Pinellas County)
[FL 257)
Division of Social Services and
Rehab., SSI Reimbursement
DRWR HSI1, P. O. Box 9005
Bartow, FL 33831-9005
10-520 (Polk County)
[FL 658]
Community Health and Human Ser
SSI Reimbursement
Suite 1110
Tampa, FL 33601-1 l l 0
10-280 (Hillsborough County)
[FT. 9491
JAR AGREEMENT/AUTHORIZATION AMENDMENTS
Preamble
• Revised to reflect that the Commissioner of Social Security is responsible for the
administration of the IAR program instead of the Secretary of the Department of
Health and Human Services.
Article I, Scope
• Revised to clarify that an individual must have been paid both an SSI dollar
amount and an IAR dollar amount for a state to receive reimbursement for a
month(s).
Article II B.
• Revised to clarify that the Commissioner of Social Security has the discretion to
determine what constitutes a State for IAE jurisdictional purposes.
Article II E.
Revised to clarify that the interim period for initial claims begins with the month
following the month in which the individual filed an application for benefits.
Article II G.
Revised to cover the processing of IAR cases involving situations where the
Commissioner is required by law to control the release of retroactive SSI
payments; e.g., installment and/or dedicated account cases.
Article III A.
• Modified to allow States to designate a financial institution to receive their IAR
payments when feasible for SSA and the States.
Article IV A.
Revised to require States to:
Notify the Commissioner within thirty (30) calendar days of the date the individual
signed the authorization. If a State fails to do so, the authorization will no longer
be binding on the individual or the State. This requirement is intended to assure
that an IAR State acts on the authorization in a reasonably prompt manner. In
such situations, SSA field offices will release the retroactive payment to the
individual through applicable payment processing procedures. To recover IAR
money in these situations, the State may, without any SSA involvement, pursue
recovery of such money. (This change was made at the request of regional
office staffs that have noted that some State offices frequently withhold sending
an authorization to SSA for several months, )
Forward the IAR accounting form to SSA within 15 working days of a follow-up
request by SSA to receive an IAR payment for situations in which the
Commissioner is required by law to restrict the manner in which the retroactive
SSI payment may be paid to an individual. The State's failure to comply with this
requirement will result in the release of the entire retroactive payment to the
individual. In such instances, States may pursue recovery for the IAR payment
from the individual. However, SSA will not be a party to the State's recovery
efforts.
Article V
Changed to. -
Cover the processing of IAR accounting forms for situations in which Law
requires the Commissioner to restrict the manner in which the residual amount of
a retroactive SSI payment may be paid to the individual.
• Afford the States and the Commissioner the flexibility of using an accounting
form that may vary from standard IAR accounting forms provided, so long as the
variant form meets SSA processing requirements.
Article VI
• Revised to simplify and expedite the disputes process by removing the
Departmental Appeals Board level from the process and allowing the
Commissioner to settle the dispute(s).
New Model IAR Authorization
• New format uses a question and answer approach designed to walk the
individual and the State through the IAR process.
• States have the flexibility of using a single form for both initial claims and post -
eligibility events instead of using a separate authorization for each event.
• The language changes contained in the new authorizations conform to the
proposed model agreement.
• SSA suggests that the format used in the New Model IAR Authorization be used
for your next revision.
0 SSA must approve revisions in your IAR authorizations prior to implementation.
SUPPLEMENTAL SECURITY INCOME FOR THE
AGE, BLIND, AND DISABLED
Agreement for Reimbursetaent to State
for Interim Assistance Payments
Pursuant to Section 1631(g)
Of the Social Security Act
Between
The Commissioner of the Social Security Achinistration
and
The State of Florida
The Commissioner of the Social Security Administration,
hereina;ter referred to as the "Commissioner," and the State of
Florida, hereinafter referred to as the "State,
" for the
of ensuring the availability of assistance to meet basic needsso
applicants for benefits under the supplemental security income f
(SSI) program, title XVI of the Social Security Act
to the following: , hereby agree
g e
ARTICLE I
SCOPE
'This Agreement covers reimbursement by the Commissioner to the
State for assistance furnished b
the to
(a.) the months their SSI applicationsSaree endindividuals during
during the months -their SSI benefits have beensuspendeding andbor
terminated, if said individuals are subsequently found to be
eligible for SSI payment of benefits for those months.
a State may be reimbursed only for months duringr
the However,
described in (a.) or (b.) above in which the individualwass
both an SSI dollar amount payment and an interim pai
(1Ad
erim assistance
dollar amount payment. ( )
ARTICLE II
DEFINITIONS
For purposes of this Agreement. -
A. The term "Commissioner" means the Commissioner of the Social
Security Administration (SSA) or his/her delegate.
B. The term "State" for purposes of an IA agreement means a 2
State of the United States, the District of Columbia, or the
Northern Mariana Islands. For all other purposes (for
example, payment, appeals, notices) State also means an
entity that the Commissioner deems to be a political
subdivision and that such political subdivision is
administratively feasible to include for participation in
the interim assistance reimbursement (IAR) program.
political subdivision of the State of Florida admiThe
nis
this IA agreement is the Department of Children an
tering
d Families
C. The term "Act" means the Social Security Act.
D. The term "benefits" means supplemental security income
benefits under title XVI of the Act and any State
supplementary payments under section 1616 thereof, or
mandatory minimum supplementary payments under section 212
of Public Law 93-66, which the Commissioner makes on behalf
of the State (or political subdivision thereof).
E. The term "interim assistance" (IA) means assistance
furnished to the individual or on behalf of the individual,
financed totally from State and/or local funds, for meeting
basic needs and furnished (1) during the period beginning
with the month following the month in which the individual
filed an application for benefits, for which he/she was
found eligible to receive benefits, and ending with (and
including) the month the individual's benefits began, and
(2) during the period beginning with the day the
individual's benefits were reinstated after a period of
suspense or termination, and ending with (and including) the
month the individual's benefits were resumed.
F. The terms "initial claims" and "initial posteligibility
payment" mean the first payment with respect to the IA
period discussed in E. above, but does not include any
emergency advance payments authorized under section
1631 (a) (4) (A) of the Act, any presumptive
disability/blindness payment authorized under section
1631 (a) (4) (B) , or any immediate payments authorized under
section 1631 (a) (1) .
G. The phrase "amount equal to the amount of initial a
initial posteligibility payment available to the Sta eent as Ior
A
reimbursement" means that portion of the initial (or initial
posteligibility) payment that the State can claim as
reimbursement. In certain situations, the Commissioner is
required by the Act to control the release of an
individual's retroactive payment. In these situations, if
SSA were to release the initial payment or initial
posteligibility to the State and the State released a
residual amount to the individual, the individual might be
paid in a manner contrary to the Act. To prevent this, when
SSA identifies such a situation, 5SA will ask the State to
determine the amount it is entitled to be reimbursed, and
SSA will then release that amount to the State.
H. The term "Supplemental Security Income Program" means the
Federal assistance program under title XVI of the Social
Security Act.
I. The term "authorization" means the form used b
obtain an SSI applicant's written permission forthe theState to
Commissioner to withhold the individual's initial payment or
initial posteligibility payment and send such
ent to
State. This form must include the language specified in the
Article IV, Paragraph A and be approved by the State and
Commissioner.
J. The term "protective filing" means a written Statement by an
individual indicating an intent to claim SSI benefits
received at an SSA office or another Federal or State office
designated by the Commissioner to receive applications on
behalf of the Commissioner, or by a person so authorized.
For purposes of this Agreement, the term protective filing
is limited to the written authorization defined in Article
II, Paragraph I.
ARTICLE III
FUNCTIONS TO BE PERFOPJaM BY THE CotoISSIONER
The Commissioner shall:
A. Send to the State or the State'a
cial
institution (when feasible for bo�h parties) siqnated �the�initial
State
paymenasoIA1reimburnitial sement"asg1defined in A
y payment available to the
le II,
paragraphs F. and G., in situations where the cCommissioner
is required to control the release of the individual's
retroactive payment) for any such individual for whom a
signed copy of an authorization, as defined in Article II,
Paragraph I., has been received by the Commissioner, orb a
Federal or State office designated by the Commissiy
receive applications, oner to
prior to the date of payment.
B. Provide information to the State in order to assist the
State in complying with the terms of the Agreement.
C. Perform such other functions as may be required by the terms
of this Agreement.
ARTICLE IV
FUNCTIONS TO BE PERFORMED By THE STATE
The State shall:
A. For political subdivisions of a State that the Commissioner
deems to be administratively feasible to include for
participation in the IAR program based on scope and size,
obtain a written, signed, and dated authorization for the
reimbursement of IA (models attached hereto at Appendix A),
for each individual who has received or will receive IA, and
whose initial payment or initial posteligibility payment or
amount equal to the amount of the initial payment or initial
posteligibility payment available to the State as IA is to
be sent to the State or the State's designated financial
institution pursuant to Article III, Paragraph A and
furnish a copy of the authorization or notify the
Commissioner of the receipt and date of receipt of the
authorization (in the case of an automated State). The
authorization form must, at a minimum, provide language that
advises the individual that:
1. For initial SSI claims, the period for the life of the
authorization is one (1) calendar year if the
individual does not apply for SSI within the one year
period. The one year period begins with the date SSA
receives the signed authorization (in the case of a
manual State) or the date that the State notifies SSA
by an automated system that it has received a signed
authorization (in the case of an automated State) and
ends one calendar year later. In addition, if the
State does not notify the Commissioner within thirty
(30) calendar days of the date the individual signed
the authorization, the authorization is not binding on
the applicant. (This condition is intended to assure
that the State acts on the authorization in a
reasonably prompt manner.) However, if the individual
applies for SSI before the end of the one 5
the authorization period or has alreadyapplied year life of
before the period for the life of the authorization SSI
begins, the period for the life of the authorization
will be extended beyond the one year period, until such
time as:
The Commissioner makes the first payment of
retroactive SSI benefits on the individual's
claim; or
The Commissioner makes a final determination on
the claim and no timely request for review is
filed; or
The State and the individual agree to terminate
the authorization.
If one of the events listed above occurs before the
expiration of the one-year calendar period, the
authorization will cease to be in force as of the date
of the occurrence of such an event.
2. For initial posteligibility cases, the period for the
life of the authorization is one (1) calendar year.
The one year period begins with the date SSA receives
the signed authorization (in the case of a manual
State) or the date that the State notifies SSA by an
automated system that it has received a signed
authorization (in the case of an automated State) and
ends one calendar year later. In addition, if the
State does not notify the Commissioner within thirty
(30) calendar days of the date the individual signed
the authorization, the authorization is not binding on
the applicant. (This condition is intended to assure
that the State acts on the authorization in a
reasonably prompt manner.). The life of the
authorization will remain in effect for that one year
period, or until the end of the maximum period
permitted under regulations at Subpart N of 20 CFR 416
within which to request administrative or judicial
review of the Commissioner's determination to suspend
or terminate the individual's SSI benefits, whichever
period of time is longer, unless the individual files a
request within the time for such review, or one of the
following events occurs earlier, in which case the
authorization will cease to have effect as of the date
Of such event:
The Commissioner makes the first posteligibility
payment of retroactive SSI benefits following the
suspension or termination of the individual'6 benefits; or s
The Commissioner makes a final determination on
the claim and no timely request for review is
filed; or
The State and the individual agree to terminate
the authorization.
If one of the events listed above occurs before the
expiration of the one-year calendar period, the
authorization will cease to be in force as of the date
of the occurrence of such event.
3. After deducting from the individual's initial payment
or payment received from the Commissioner an amount
sufficient to reimburse the State for IA paid the
individual, the State shall promptly provide to the
individual a written notice (copy attached hereto at
Appendix B) explaining the amount of the initial
payment or payment it received from the Commissioner
and the excess amount (if any) due the
individual and shall pay the excess amount
1
such individual within ten (10) working daysofathe to
date of the receipt of said payment from the
Commissioner.
4• The State shall complete and return an SSA accounting
form to a designated SSA office within 30 calendar days
of the date SSA forwarded such form to the State.
However, for situations in which the Commissioner is
required by law to restrict the manner in which the
residual -amount of retroactive SSI payments may be paid
to the individual, the State shall complete and return
the SSA accounting form to a designated SSA office
within 10 working days of the date SSA forwarded the
form to the State. If a State does not forward the
accounting form to SSA within 10 working days of the
date it was forwarded or transmitted to the State, SSA
will forward the State.a follow-up request for the
completion and return of that form. If a State fails
to return the form to the designated SSA office within
15 working days of the follow-up request, SSA will
release the retroactive amount to the individual
through its applicable processing procedures to protect
the individual from hardship that may arise from the
State's failure to comply with SSA's IAR processing
requirements. In these situations, the State may
choose to ask the individual for any IAR the State may
be due. However, the Commissioner will not be a party
to or responsible for participating in the State's 7
efforts to recover any IAR due the State under these
circumstances.
5.
Such individual shall have the right to a he
the State respecting any matter for which the
ring from
individual believes he or she has been a
action taken by the State under section g631(g) by
Act." (g) of the
B. The State may receive on the Commissioner's behalf, the
authorization as an intent b
benefits (a protective filing) the individual to claim SSI
subdivisions within the State)asoidentifr all iedtinaa
this Agreement. appendix C of
C. Political subdivisions of the State listed in Appendix C
that use a manual process will forward the authorizations
th- Commissioner within thin
obtaining the authorizations and3shall iretain copies of to
authorizations in accordance with the provisions
days of
VIII. P isions of Article
h
D. Political subdivisions of the State listed in Appendix D
that use an automated process will forward via an automated
data processing method acceptable both to the Commissioner
and the State information: such authorization and (2) (1) that the State has received
the date that the State and the
claimant signed the authorization.
forwarded to the Commissioner within
This information will be
days of matching the applicant's thirty (30) calendar
general assistance eligibility firecord on the State's
record and the State shall retain copies Ofpsuchng SSI
authorizations in accordance with the provisions of Article
VIII.
E. For situations in which the Commissioner is not required b
law to restrict the manner in which the residual amount of
retroactive SSI y
payments may be paid to the individual:
1• Deduct from the initial
Payment or posteligibilty
Payment received from the Commissioner, with respect to
an individual, an amount sufficient as reimbursement
for IA furnished on behalf of such individual in months
during which the individual was found eligible for SSI
from the first month in which such individual was found
eligible for SSI benefits, and ending with and '
including the month payment of such individual's SSI
benefits began and/or from the day of the month such
individual's payment of SSI benefits were subsequently
reinstated after a period of suspense or termination,
2.
F.
and ending with and including the month such
individual's SSI benefits were resumed.
Pay any residual amount of the initial payment or
initial posteligibility payment received from the
Commissioner to the individual within
days from the date the State receives the initiorking
payment or initial posteligibility payment. a
For situations
to restrict the
retroactive SSI
in which the Commissioner is required by law
manner in which the residual amount of
Payments may be paid to the individual:
Inform the Commissioner, according to Article V,
Paragraph B, of the amount of reimbursement claimed for
IA the State furnished on behalf of such individual in
months during which the individual was found eligible
for SSI, from the first month in which such individual
was found eligible for SSI benefits, and ending with
and including the month payment of such individual's
SSI benefits began, and/or from the day of the month
such individual's payment of SSI benefits were
subsequently reinstated after a period of suspense or
termination, and ending with and including the month
such individual's SSI benefits were resumed.
G. Provide to the individual within
ten the date the State receives the initial0)payment O days from
posteligibility payment a written notice e explaining:
1. The amount of the initial payment or initial
posteligibility payment received from the Commissioner
for IA;
2. The excess amount (if any) due the individual; and
3. The opportunity for a hearing with respect to any
action taken by the State pursuant to the
implementation of this Agreement by which the
individual believes he or she has been aggrieved.
If an individual dies after executing an authorization but
before receiving the written notice and payment of the
excess amount required by the preceding sentence, the State
shall, within the prescribed time limit, provide such
explanation and pay such balance to the Commissioner rather
than to anyone else on behalf of the individual.
A
E. Comply with such other rules as the -Commissioner finds 9
necessary to achieve efficient a4l effective administration
Of IAR procedures and to carry ou
Program. t the purposes of the SSI
I. Perform such other functions as may be required by the terms
of this Agreement.
ARTICLE v
ACCOUNTING REPORTS
A. For situations in which the Commissioner is not required by
law to restrict the manner in which the residual amount of
retroactive SSI payments may be paid to the individual:
1• The State shall submit a report on Form SSA-8125 or
other SSA approved accounting form for each initial
payment and posteligibility payment received from the
Commissioner within thirty (30) calendar days from the
date the State received such payment.
2. The report shall account to the Commissioner (on an
individual case basis) for the total IA paid, the total
amount of the initial payment or posteligibility
payment received by the State (for such individual),
the amount retained by the State as reimbursement, the
amount (i-f any) due the individual, and the date said
amount (if any) was sent to the individual.
B. For situations in which the Commissioner is
to restrict the manner in which the residual
retroactive SSI payments may be paid to the
1.
2.
required by law
amount of
individual:
The State shall submit a claim on Form SSA-8125-F6 or
other SSA approved accounting form for each report of a
pending initial payment and posteligibilit
received from the Commissioner within y Payment
clays from the date the State receives such (report 10) king
The report shall account to the Commissioner (on an
individual case basis) for the total IA paid to the
individual and the amount of reimbursement claimed by
the State for IA furnished on behalf of such individual
in months for which the individual was found eligible
to receive SSI or SSI benefits were subsequently 10
reinstated after a period of suspense or termination.
C. The aggregate of all reports referred to in Paragraphs A.
and B. above received by the Commissioner in each fiscal
year shall constitute the State's report for such fiscal
year.
ARTICLE VI
RESOLUTION OF DISPUTES
A. If SSA and the State are unable to agree on any item in
dispute arising under this Agreement, the State may request
the Commissioner of Social Security to make a determination.
Within 90 days from the receipt of such request, the
Commissioner of Social Security, or his/her designee, shall
make a determination in writing with a full explanation
thereof, or provide written notification of the reason such
determination cannot be made, what further information or
action by the parties may be required, and within what time
period a determination is expected to be made. This
determination shall be final and conclusive. Pending the
decision of the Commissioner, the State and the Commissioner
shall proceed diligently with performance of this Agreement.
B. Nothing in this Agreement shall be construed to waive the
State's right to seek judicial review by a court of
competent jurisdiction of both findings of fact and
conclusion of law contained in the Commissioner's decision,
or to enforce its rights under this Agreement by any
available remedy. Nothing in this Agreement shall be
construed as waiving the Commissioner's rights to assert
lack of jurisdiction with respect to any suit brought under
this Agreement, or to enforce the Commissioner's rights
under this Agreement by available remedies.
ARTICLE VII
ADN'NISTRATIVE COSTS
Neither the State nor the Commissioner, in performing their
functions and duties under this Agreement, shall pay to the
other, any costs of administration incurred by the other.
11
ARTICLE VIII
EXAMINATION AND RETENTION OF RECORDS
A. The State agrees that the Commissioner and the Comp tr
General of the United States (including their duly°ller
authorized representatives) have access to and the right to
examine any pertinent books, documents, papers, and records
of the State for purposes of verifying transactions with
respect to matters covered by this Agreement.
B. The State shall retain each authorization it receives (or a'
COPY thereof) for a total of three (3) years from the date
lsaid authorization is signed and for such longer period as
i required for completion or resolution of the audits,
litigation, or other actions involving such records of which
the State has actual notice and which are commenced before
the end of the three (3Y year period.
C. The State shall retain a copy of each Form SSA-8125
8125-F6, or other SSA a SSA -
for three 3 approved accounting form it completes
( ) years from the end of the Federal fiscal year
for which the form pertains.
D. The State shall retain a copy of each written notice
furnished to an individual as set forth in Article IV,
Paragraph G. for three (3) years from *the end of the Federal
fiscal year for which the notice pertains.
ARTICLE IX
CONFIDENT'AL NATURE AND LIMITATION
ON USE OF INFORMATION AND RECORDS
A. The purpose of this Article is to set forth the
rocedures
for safeguarding the confidentiality of IAR dataexchanged
between the Commissioner and the State, and imposing
limitations on the use of that data. IAR data includes the
authorization form as defined in Article II, Paragraph I.;
the automated data that the State transmits or sends to the
Commissioner pursuant to' Article IV, Paragraphs C. and D.•
the notice provided to individuals Para ra h G.- pursuant to Article IV,
g P , the Form SSA-8125, SSA-8125-F6, or other SSA
approved accounting form completed by the State
Article V.; and any other information provided touthe aState
by the Commissioner pursuant to Article III, Paragraph B.
F. The Commissioner will adopt P
that it will us th P Policies and procedur
C.
la
E.
e e IAR data obtained from the Stateounderre
this Agreement only for purposes of carrying out this
Agreement and will disclose such data onlyas
tted
Federal law (e.g., 42 U.S.C. subsection 1306(a), 5 U.S. by
dC.
subsections 552 and 552a, animplementing regulations20 CFR
Part 401).
The State will adopt policies and
eto ensure
it will use the IAR data obtained from theeCommissionerthat
under this Agreement only for purposes of carrying out this
Agreement and will disclose such data for other purposes
only with the prior approval.of the Commissioner.
T�e following minimum safeguards will be afforded by the
Commissioner and the State to IAR data exchanged under er this
1. Access to the data will be restricted to only those
authorized employees and officials who need it to
perform their official duties in connection with the
intended use of the data;
2. The data will be stored in an area that is physically
safe from access by unauthorized persons during duty
hours as well as nonduty hours or when not in use;
3. The data will be processed under the immediate
supervision and control of authorized personnel in a
manner which will protect the confidentiality of the
data, and in such a way
ized er
cannot retrieve the data tbytmeans tOfrcomputerSO
terminal or other means; and remote
4• All personnel who will have access to the data will be
advised of the confidential nature of the information,
the safeguards required to Protect "the information and
the sanctions for noncompliance with those safeguards
contained in the applicable Federal and State statutes.
In d
a dition, the Commissioner reserves the right to make
onsite inspections or to make other provision
that adequate safeguards are being maintained• to ensure
12
ARTICLE X
13
TERMS OF AGREEIENT
This Agreement shall begin on March 1, 2002 and will be
automatically renewed for successive periods of one (1) year
thereafter (commencing on October 1st of each such year), unless
the State or the Commissioner gives written notice not to renew
at least thirty (30) days before the end of the then current
period.
ARTICLE XI
TERMINATION AND MODIFICATION OF AGRE.MEM
A. The State or the Commissioner may terminate this Agreement
at any time upon thirty (30) days written notice to the
other party.
B. This Agreement may be modified in writing at any time by
mutual consent of the parties hereto.
C. If this Agreement is terminated in any manner (includin
nonrenewal), the accounting requirements described in g
Article V shall continue to apply for all initial payments
and posteligibility payments received by the State from the
Commissioner prior to such termination.
D. If this Agreement is terminated by either party, the
Commissioner and the State agree that all cases for which
the State has obtained an authorization as required by
Article IV, Paragraph A., shall be processed in accordance
with the provisions of this Agreement.
14
J
In Witness whereof, the parties hereby execute this Agreement
this day of
2002.
COMMISSIONER OF
SOCIAL SECURITY
BY:
Myrtle S. Habersham
Regional Commissioner
Atlanta
(TITLE)(TITLE)
State of Florida
BY
I,
of t e State o certify that I an the Attorney Gen eral*5
who signed this Agreementtontbe a
of said State; andwthathe/shhen the
aut orize to enter into agreements of this nature on behalfeofs
the State and that there is authority under the laws of the State
of Florida to carry out all the functions to be performed by the
State as provided herein and comply with the terms of this
Agreement.
Signature of Counsel
*Or legal counsel for the State Agency