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Resolution 115-1976 RESOLUTION NO~15_l976 'iillEREAS, the Board of County Commissioners of Monroe County, Florida, through its County Social Services Department, has been rendering certain services to indigent citizens of Monroe County, Florida, under the direction of said Board of County COlnmissioners, and WHEREAS, in order to facilitate the operation of said service department, said Board of County Commissioners desires to adopt rules and regulations and guidelines for providing social services through said social services department, now, therefore, BE IT RESOLVED BY THE BOARD OF COUNTY CO~ft1ISSIONERS OF MONROE COUNTY, FLORIDA, that it hereby adopts the following rules and regulations for the administration and rendering of social services for the indigents of Monroe County, Florida. GENERAL PURPOSE OF THE DEPARTMENT SECTION 125.01 (4) FLORIDA STATUTES, IMPOSES UPON THE COUNTIES TO HAVE CARE AND PROVIDE FOR THE POOR AND INDIGENT PEOPLE OF THE COUNTY. ARTICLE 13, SECTION 3, OF THE CONSTITUTION OF 1885, \>JHICH IS NOW A STATUTE, READS IN PART: "THE RESPECTIVE COUNTIES OF THE STATE SHALL PROVIDE IN THE MANNER PRESCRIBED BY LAW FOR THOSE OF THE INHABITANTS 1mO, BY REASON OF AGE, INFIID1ITY OR MISFORTUNE, MAY HAVE CLAIMS UPON THE AID AND SY~ATHY OF SOCIETY. . ." HISTORICALLY, THE COUNTY'S RESPONSIBILITY IS VIE\'TED AS CARING FOR AND SUPPORTING NEEDY PERSONS FROM ~NHOM THE STATE, CHAPTER 409, GENERAL STATUTES, HAS ~1ADE NO SPECIAL PROVISION, THE NATURE AND EXTENT OF RESPONSIBILITY RELATES REALISTICALLY TO THE NUMBER OF ELIGIBLE APPLICANTS, THE EXTENT OF NEED OF EACH ELIGIBLE APPLICANT AND TO BUDGETARY AVAILABILITY; CONTINUING EFFORTS ARE MADE TO PROVIDE THE MAXIMUM ASSISTANCE POSSIBLE TO MEET THE MINI- MUM NEEDS CONSISTENT WITH HEALTH AND DECENCY STANDARDS; AT THE SAME TIME, THE RIGHT TO ASSISTANCE CARRIES WITH IT THE DEFINITE RESPONSIBILITY FOR MAXIMUM SELF-SUPPORT, ~1AXIMUM SELF-DIRECTION AND ACTIVE PARTICIPATION IN PLANS FOR REHABILITATION. -2- RULES AND REGULATIONS FOR THE ADMINISTRATION OF THE MONROE COUNTY SOCIAL SERVICES DEPARTMENT THIS IS A COUNTY WELFARE AGENCY THAT OFFERS EMERGENCY OR TEMPORARY ASSISTANCE BASICALLY FOR AGED AND DISABLED INDIVIDUALS WHILE ASSISTANCE OF A MORE PERMANENT NATURE IS PENDING. AN APPLI- CANT RECEIVING ASSISTANCE FROM OTHER PUBLIC ASSISTANCE PROGRAMS IS INELIGIBLE FOR COUNTY ASSISTANCE, UNLESS A SPECIFIC REQUIREMENT EXISTS THAT IS OF AN EMERGENCY NATURE AND NOT OTHERWISE AVAILABLE. HOUSEHOLDS WITH CHILDREN CAN BE CONSIDERED FOR ASSISTANCE IF AN EXTENUATING CIRCm.ffiTANCE BEYOND THEIR CONTROL EXISTS AND CAN BE VERIFIED BY THE DEPARTMENT. 1. Eligibility: The vendor payment services hereinafter set forth will be available to those individuals eligible for county assistance. Eligiblity will be based on the following in- come guidelines: INCOME GUIDELINES Number of Household Monthly Income Annual Income 1 2 3 4 5 6 7 8 9 10 $208.33 $291.66 $333.33 $375.00 $416.66 $458.33 $500.00 $541.66 $583.33 $625.00 $2500.00 $3500.00 $4000.00 $4500.00 $5000.00 $5500.00 $6000.00 $6500.00 $7000.00 $7500.00 Any cases not coming within the above income guidelines, the Director may recommend approval of said eligibility for approval by the Board of County Commissioners of Monroe County, Florida. 2, Services to be Delivered or Rendered to Indigents: a. Food & Dietary - Emergency Food order for no more than three days to be provided by participating local grocery stores. b. Shelter - Emergency payment of rent for exten- sively disabled or aged individuals who are not receiving assistance from any other agency. AN EXTENSIVE DISABILITY IS DEFINED AS ANY MEDICAL OR PSYCHIATRIC CONDITION WHICH HAS OR WILL INCAPACITATE -3- THE APPLICANT FOR AT LEAST 6 WEEKS. APPLICANTS MUST FURNISH THE DEPARTMENT WITH WRITTEN VERIFICATION FROM A DOCTOR TO ESTABLISH THEIR DISABILITY STATUS. AN AGED INDIVIDUAL IS DEFINED AS ANY PERSON OVER THE AGE OF 60. AGE MUST BE VERIFIED BY EITHER PROPER IDENTIFICATION, DOCUMENTS, OR BY CONTACTING OTHER PUBLIC AGENCIES SUCH AS THE SOCIAL SECURITY ADMINISTRATION. c. Utilities - Emergency payment of utilities (electricity, water, and cooking fuel) for extensively disabled or aged individuals who are not receiving assistance from any other agency. d. Clothing - Emergency clothing for households or individuals who are victims of disasters. e. Transportation - Transportation to be provided by public transportation. THE DEPARTMENT WILL PROVIDE A ONE-WAY NON-REFUNDABLE BUS TICKET ONLY TO THE NEAREST COUNTY. AN EXCEPTION TO THIS POLICY CAN BE MADE TO PROVIDE TRANSPORTATION TO A FURTHER DESTINATION BASED ON VERIFIED NEED AND EXTENUATING CIRCUMSTANCES IN A CASE. f. Pauper Burials - Burial services provided by participating funeral homes for verified paupers for the sum of $175.00 for each burial. IN CASES OF UNCLAIMED DECEDENTS A RELEASE FROM THE SHERIFF'S DEPARTMENT MUST BE OBTAINED BEFORE THE DEPARTMENT WILL APPROVE A COUNTY PAUPER BURIAL. REIMBURSEMENT TO THE COUNTY FOR BURIAL EXPENSES WILL BE SOUGHT THROUGH THE SOCIAL SECURITY ADMINISTRATION FOR ANY DECEDENT ~ffiO MAY BE ELIGIBLE FOR THE LUMP-SUM DEATH BENEFIT. g. Physicians Services - Medical treatment for CHRONIC OR EMERGENCY MEDICAL CONDITIONS to be provided by local participating physicians who accept payment based on 80% of their customary charges for county indigents. THE FOLLOWING CONDITIONS CAN BE CONSIDERED: 1. BLEEDING 2. HIGH FEVER 3. VOMITING 4. SEVERE PAIN 5. BROKEN BONES 6. SEVERELY ILL -4- h. Drugs - Purchase of prescriptioned medications on a monthly basis for aged and disabled individuals and temporary assistance for medicines where the individual's circumstances justifies the expenditure. THE DEPARTl1ENT CAN ALLOW UP TO A $25.00 MONTHLY MEDICINE ALLOWANCE AT PARTICIPATING DRUGSTORES TO APPLICANTS ELIGIBLE FOR THIS SERVICE. A LARGER ALLOWANCE FOR MEDI- CINE CAN BE CONSIDERED IF NEED AND EXTENUATING CIRCUMSTANCES CAN BE VERIFIED. HOWEVER, LARGER ALLOWANCES OF THIS NATURE WILL ONLY BE APPROVED ON A ONE MONTH OR TEMPORARY BASIS. i. Medical Supplies - Purchase of medical supplies such as bandages, dressings, syringes, etc. which are not included as prescriptioned medication for county indigents. j. Out-Patient Services - payment for out-patient treatment at participating local hospitals such as emergency room services, x-ray and laboratory services for eligible individuals. k. Ambulance Payment for ambulance services pro- vided by local participating ambulance c~mpanies for county indi- gents such as transfers to nursing homes and emergency ambulance services to treatment centers. 1. In-patient Hospital Services - Payment for emer- gency or urgent hospitalization at participating local or out-of- county hospitals for county indigents. HOSPITALIZATION SERVICES IS PROVIDED FOR THE ACUTELY ILL OR INJURED PERSON WITH AN URGENT ILLNESS WHO MAY RESPOND TO SHORT-TERM REMEDIAL TREATMENT, THE POST- PONEMENT OF WHICH MAY CONSTITUTE A HAZARD TO THE PATIENT'S LIFE OR WOULD CAUSE UNDUE SUFFERING. THE DEPARTMENT WILL INITIALLY APPROVE A MAXIMUM HOSPITAL STAY OF 15 DAYS AT THE CURRENT MEDICAID PER DIEM RATE OR ACCORDING TO COUNTY CONTRACT. FURTHER EXTENSION FOR HOSPITALIZATION CAN BE CONSIDERED UPON PROPER VERIFICATION OF THE MEDICAL NECESSITY FOR SUCH AN EXTENDED PERIOD. ANY CASE REQUIRING MORE THAN 30 DAYS IN-PATIENT CARE WITHIN A 12 MONTH PERIOD WILL BE SUBJECT TO PRIOR APPROVAL BY THE BOARD OF COUNTY COMMISSIONERS. THOSE CERTIFIED FOR MEDICARE OR MEDICAID ARE EXCLUDED FROM THIS -5- PROGRAM INASMUCH AS THE COUNTY IS ALREADY CONTRIBUTING TO THE STATE'S MEDICAID PROGRfu~. m. Nursing Home Care - Payment for nursing home care at an extended care center for individuals not entitled to Medicaid Assistance and who cannot afford the entire cost of nursing home care. THE DEPARTMENT WILL APPROVE rOUNTY PAYMENT TO NURSING HOME AT THE STATE APPROVED MEDICAID RATE. FAMILY CONTRIBUTIONS AND OTHER RE- SOURCES, WHEN AVAILABLE WILL BE EXHAUSTED BEFORE COUNTY PAYMENT WILL BE CONSIDERED. 3. Regulations and Guidelines for Qualified Indigents: , a. The Monroe County Social Services Department shall supervise the administration of the general assistance pro- gram in the County of Monroe, rendering emergency and/or temporary services while assistance of a more permanent nature is pending. The Department shall also be responsible for the cooperation and close coordination with other agencies; defining and determining the basic needs of clients; and making every effort to adequately correct such needs. General supervision shall be provided by the Social Services Director. Full use of existing public service agencies and private agencies will be exhausted before county funds are expended. The social services listed herein are offered to individuals who are determined eligible by the Department according to their income and ability to pay by taking the person's family circumstances into consideration. VERIFICATION OF INDIGENCY WILL BE EXERCISED WITH TACT AND WITHOUT OFFENDING THE APPLICANT. THE PURPOSE OF THIS DEPART- MENT WILL ALWAYS BE TO ASSIST THE COMMUNITY BY PROVIDING SERVICES TO THOSE CITIZENS THEREIN WHO ARE IN NEED. b. Individuals who are eligible based on the income standards passed by the Board of County Commissioners will be authorized for vendor payment services. There may be unusual cir- cumstances in which case the Director may use his or her discretion in giving one-time emergency assistance subject to approval by the Board of County Commissioners. -6- c. APPLICANTS REQUESTING THE LISTED SOCIAL SERVICES FROM THE DEPARTMENT MUST BE WILLING TO COMPLETE AN APPLICATION AND BE INTERVIEWED BY ONE OF THE DEPARTMENT'S SOCIAL WORKERS. Appli- cants must be willing to verify all income and show written medical proof of any disability which would make them unable to work. If they are able to wor~ they must be registered at the Florida State Employment Service, and be actively seeking employment. ACTIVELY SEEKING EMPLOYMENT IS DEFINED AS A PERSON WHO CHECKS IN AT LEAST ONCE A WEEK WITH THE EMPLOYMENT SERVICE AND WHO DOES NOT REFUSE ANY EMPLOYMENT THAT THEY ARE PHYSICALLY AND MENTALLY ABLE TO PERFORM WHICH WOULD ENABLE THEM TO PROVIDE FOR THEIR OWN BASIC NEEDS. IN- ABILITY TO FIND WORK DOES NOT MAKE A PERSON UNEMPLOYABLE. THE DE- PARTMENT IS ABLE TO HELP THE EMPLOYABLE PERSON TO A LIMITED DEGREE ONLY IN HARDSHIP AND EMERGENCY SITUATIONS (PERSONS WHO ARE UNEMPLOYED THROUGH NO FAULT OF THEIR OWN AND NOT ELIGIBLE FOR OTHER ASSISTANCE) COUNTY ASSISTANCE ~~Y NOT BE RENDERED TO THE FOLLOWING EMPLOYED OR EMPLOYABLE PERSONS OR FAMILY SITUATION: 1. HUSBAND EMPLOYED, IN THE HOME, BUT NOT PROPERLY SUPPORTING, 2. HUSBAND DESERTED THE FAMILY, WIFE ADEQUATELY EMPLOYED. 3. HUSBAND ILL, WIFE ADEQUATELY EMPLOYED, OR EMPLOYABLE. 4, HUSBAND IN THE COMMUNITY AND/OR CONTRIBUTING TO HIS FAMILY. 5. LEFT JOB FOR REASONS OTHER THAN ILLNESS OR ACCIDENT. The fact that an individual is unemployed does not make them eligible for assistance. APPLICANTS MUST BE ABLE TO VERIFY THEIR PLACE OF RESIDENCE AND LIVING SITUATION BY: EITHER SHOWING A RENT RECEIPT OR STATEMENT FROM LANDLORD OR HEAD OF THE HOUSEHOLD. d. Applicants must sign medical, financial and re- imbursement agreement forms. }lliDICAL AND FINANCIAL RELEASES ARE NECESSARY TO VERIFY AN APPLICANT'S DISABILITY AND FINANCIAL STATUS. THE REIMBURSEMENT AGREEMENT HILL INCLUDE A DESK REVIEH WITHIN 30 DAYS -7- AFTER ASSISTANCE IS TENDERED TO THE APPLICANT BY THE ASSIGNED SOCIAL WORKER TO ASSESS AN APPLICANT'S PRESENT OR FUTURE ABILITY TO REPAY THE COUNTY FOR FINANCIAL ASSISTANCE GRANTED. DISABLED OR AGED RECIPIENTS LIVING ON FIXED INCOMES WILL BE EXCLUDED FROM THE DEPARTMENT I S RE IMBURSEMENT PROCEDURE. e. APPLICANTS MUST SHOW PROPER PERSONAL IDENTIFI- CATION SUCH AS SOCIAL SECURITY CARD, DRIVER'S LICENSE, VOTER REGISTRATION, OR OTHER FORMS OF IDENTIFICATION. f. All applicants requesting medical or hospital assistance will be screened by the Department and if eligible, given an authorization form for county payment. MEDICAL SERVICES WILL BE PROVIDED ON A LIMITED EMERGENCY BASIS UNTIL FURTHER MEDICAL ASSIS- TANCE CAN BE OBTAINED FROM ANOTHER PUBLIC ASSISTANCE OR PRIVATE AGENCY. g. When physicians services or out-patient services are approved the applicant will be charged a fee according to their income and ability to pay, These fees will be determined according to the following fee classification schedule: CLASS A NO CHARGE CLASS B $1. 00 CLASS C $2.00 CLASS D $3.00 CLASS E $4.00 CLASS F $5.00 CLASS A: CLASS B: No. of Household Annual Income No. of Household Annual Income 1 $2500.00 1 $3000.00 2 $3500.00 2 $4000.00 3 $4000.00 3 $4500.00 4 $4500.00 4 $5000.00 5 $5000.00 5 $5500.00 6 $5500.00 6 $6000.00 7 $6000.00 7 $6500.00 8 $6500.00 8 $7000.00 9 $7000.00 9 $7500.00 10 $7500.00 10 $8000.00 -8- CLASS C: CLASS D: No. of Household Annual Income No, of Household Annual Income 1 $3500.00 1 $4000.00 2 $4500.00 2 $5000.00 3 $5000.00 3 $5500.00 4 $5500.00 4 $6000.00 5 $6000.00 5 $6500.00 6 $6500.00 6 $7000.00 7 $7000.00 7 $7500.00 8 $7500.00 8 $8000.00 9 $8000.00 9 $8500.00 10 $8500.00 10 $9000.00 CLASS E: CLASS F: No. of Household Annual Income No. of Household Annual Income 1 $4500.00 1 $5000.00 2 $5500.00 2 $6000.00 3 $6000.00 3 $6500.00 4 $6500.00 4 $7000.00 5 $7000.00 5 $7500.00 6 $7500.00 6 $8000.00 7 $8000,00 7 $8500.00 8 $8500.00 8 $9000.00 9 $9000.00 9 $9500.00 10 $9500.00 10 $10000.00 h. The Department will collect the appropriate fee from the applicants being referred to doctors and hospitals as county indigents and turn it over to the County Finance Department. This money will be put back into the Out-Patient Account to help defray the cost to the County. i. The applicants may choose the doctor of his/her choice from any of the participating physicians. j. All information given by the applicants will be held in strictest confidence. In most cases a home visit will be done before assistance is granted. The home visit will be made to verify the home situation and to assist the applicants in making better use of their own resources. k. ASSETS INCLUDING REAL PROPERTY - AN APPLICANT FOR ASSISTANCE MAY OWN TO TO $750.00 MAXIMUM IN REAL OR PEP~ONAL VALUE IF HE HAS NO DEPENDENTS AND UP TO $1500.00 MAXIMUM WITH DE- PENDENTS. AN APPLICANT MAY OWN CASH VALUE LIFE INSURANCE OR BURIAL INSURANCE UP TO $750.00. HOMESTEAD EVALUATION IS EXCLUDED IN DE- TERMINING ELIGIBILITY. -9- 1. ANY APPLICANT WHO IS DISSATISFIED WITH THE DE- CISION RENDERED BY THE DEPARTMENT, HAS THE RIGHT TO REQUEST A RE- VIEW OF THEIR CASE BY THE SOCIAL SERVICES DIRECTOR. THIS REVIEW WILL BE DONE WITHIN 5 WORKING DAYS AFTER THE REQUEST IS RECEIVED FROM THE APPLICANT. IF THE DIRECTOR'S REVIEW DOES NOT RESOLVE THE APPLICANT'S COMPLAINT, THE APPLICANT THEN HAS THE RIGHT TO REQUEST A FAIR HEARING. FAIR HEARING PROCEDURE WITHIN TEN DAYS AFTER A COMPLAINT IS RECEIVED FROM A CLIENT, A HEARING WILL BE HELD IN THE COUNTY SOCIAL SERVICES OFFICE. THE PURPOSE OF THIS HEARING WILL BE TO ALLOW THE CLIENT A FAIR OPPOR- TUNITY TO VOICE HIS/HER COMPLAINT BEFORE A HEARINGS COMMITTEE. THIS COMMITTEE WILL CONSIST OF THE COUNTY SOCIAL WORKER ASSIGNED TO THE CASE, THE DIRECTOR OF THE MONROE COUNTY SOCIAL SERVICES DEPARTMENT, AND ONE COUNTY COMMISSIONER. THE FINAL DECISION WILL BE REACHED BY THE HEARINGS COMMITTEE IN ACCORD WITH THE FLORIDA STATUTES AND COUNTY RESOLUTION GOVERNING THE COUNTY SOCIAL SERVICES DEPARTMENT. BE IT FURTHER RESOLVED BY SAID BOARD that social services heretofore rendered by the Board of County Commissioners of Monroe County, Florida, through its Social Services Department be and the same are hereby ratified and confirmed. DATED July 13, 1976. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY" FLORIDA By c (Seal) Attest :j // ~ (.. .4P/ ~/ce-2~> -.' ... Clerk