STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

GEORGE TSISMANAKIS, )

)

Petitioner, )

)

vs. ) CASE NO. 86-0937

)

DEPARTMENT OF HEALTH AND )

REHABILITATIVE SERVICES, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, this cause was heard on October 16 and 17, 1986, in Orlando, Florida, before Diane A. Grubbs, a hearing officer of the Division of Administrative Hearings.

APPEARANCES

For Petitioner: George Tsismanakis, pro se

403 N.W. 2nd Avenue Okeechobee, Florida 33472

For Respondent: R. Bruce McKibben, Jr., Esquire

Assistant General Counsel Department of Health and

Rehabilitative Services 1323 Winewood Boulevard

Tallahassee, Florida 32399-0700

ISSUE

Whether petitioner should pass the Level III Behavior Management Certification examination given by the Department of Health and Rehabilitative Services (HRS) on June 28, 1985.

BACKGROUND

On February 7, 1986, petitioner filed a request for an administrative hearing pursuant to Section 120.57(1), Florida Statutes. The petition alleged that on February 1, 1986, petitioner received written notice that he had obtained a failing grade of 64 on the Level III Certification examination given June 28, 1985, and that the passing grade was 68. By his petition, petitioner protested the grade and also requested an opportunity to review his examination. The petition alleged, generally, that the training provided by HRS did not sufficiently correlate with the examination and that the conditions under which the test was given were very poor. On March 18, 1986, the matter was referred to the Division of Administrative Hearings for further proceedings.

On April 14, 1986, this cause was consolidated with the case of Juanita Kasper v. Department of Health and Rehabilitative Services, Case No. 86-0934. However, prior to hearing, Ms. Kasper voluntarily dismissed her petition, and Case No. 86-0934 was closed.

On July 21, 1986, a protective order was entered which limited disclosure of the examination questions and answers that would be made available to petitioner through discovery. Further, to maintain confidentiality of the examination questions it was agreed at hearing that petitioner's exhibits 1, 1B, and 16 would be sealed, along with those portions of the transcript referring to specific examination questions, specifically Volume III and Volume IV of the transcript.

Prior to the hearing the parties filed a prehearing stipulation setting forth the parties' statement of the case, the facts that were not in dispute, and the issues the parties perceived needed to be resolved at hearing. In addition to the prehearing stipulation, at the hearing the respondent stipulated that the petitioner had standing to challenge the failing score he received on the examination.

The cause was heard on petitioner's second Amended Petition filed October 6, 1986, in which the ultimate relief sought was a finding that petitioner earned a passing grade on the certification examination and issuance to petitioner of certification in behavior programing.

At the hearing petitioner presented the testimony of Dr. Jacob Beard, an expert in measurements and testing; Ms. Ludwika A. Goodson, the owner of Instructional System Design, Inc., and an expert in instructional design and criterion referenced testing; Ms. Sheryl Shepherd, an individual who took the training provided by HRS; Mr. David Rodriquez, Client Services Program Administrator with the Developmental Services Program Office of HRS; Dr. Gerald

1. Shock, Senior Behavioral Analyst, Developmental Services Program Office; and Dr. James M. Johnston, an expert in psychology and behavior analysis.

   Petitioner also testified on his own behalf. The respondent presented the testimony of Dr. Jacob G. Beard and Dr. James Johnston. Petitioner's exhibits 1 through 14 and 16 through 18 were admitted into evidence. The respondent did not offer any exhibits.

   
   

   Both parties have filed proposed recommended orders, and a ruling on each of the proposed findings of fact has been made in the appendix to this order.

   
   

   FINDINGS OF FACT ESTABLISHMENT OF THE PROGRAM

   1. The Developmental Services Program Office in HRS is the office responsible for the Behavior Management Certification examination. The concept of a certification exam arose out of a commitment to improve and to increase the capabilities of the people who were providing behavioral programs to developmentally disabled people in Florida. In December of 1982 or January of 1983, HRS contracted with Instructional System Design, Inc., to design an examination that would ensure that the persons who passed the examination were persons who possessed proficiency and competency in the field of behavioral management or behavior analysis. Instructional System Design, Inc., also was to design and prepare a curriculum guide that would aid individuals in becoming proficient in behavior management. However, the examination was designed first and then the curriculum guide was prepared to cover the major content areas

      which were reflected in the examination. The Behavior Analysis Curriculum Guide had not been completed before petitioner took the examination, which was the first time the examination was offered. At that time, the curriculum guide was still in draft form.

      
      

      PREPARATION OF THE TEST

      
      

   2. The model used for constructing this examination was a domain referenced test model. Items are included which assess every competency. Ms. Goodson, the president of Instructional System Design, Inc., and designer of the examination, assembled an interdisciplinary team which included representatives of HRS and experts in the field of behavioral psychology. Specific competency areas, or content domains, were determined and arranged in competency clusters on the examination. For example, Competency Cluster #1 has to do with making legal and ethical decisions about when to intervene. Competency Cluster #3 relates to observing and recording behavior, and Competency Cluster #6 involves the application of behavioral procedures. The number of questions in each cluster relates to the number of tasks, or subtopics, within the particular competency area. The purpose of designing a test in this manner is to make sure that a question is included in the test that will evaluate proficiency in each defined competency and task within the competency.

      
      

   3. The content standard was established by the interdisciplinary committee. It was agreed that the minimum standard would be that the content would have to be included in two widely used textbooks and not successfully refuted in any other textbook. This minimum standard was designed to overcome any biases that may exist in any one particular form of training.

      
      

   4. Two forms of the examination were prepared, Form A and Form B. However, each form was prepared to assess the same competencies. For example, question 2-1 on Form A was designed to assess the same competency and task as question 2-1 on Form B. HRS requested that two forms of the examination be prepared.

      
      

   5. After the first draft of the examination had been prepared, and content experts reviewed and made revisions to the questions, a field review of the examination was conducted. Thirteen different reviewers were asked 28 questions about each test item. One of the 28 questions was the correct answer, and the other 27 questions asked other information about the particular question. The other 27 questions were asked to ensure that each test question was valid, that the question was clear, and that it was representative of the competency area that it was attempting to assess. None of the field reviewers reviewed all 156 questions, but all questions were reviewed. The examination was not field- tested by actually giving the entire exam to a small group of people because it was felt that it would be impractical to get 15 to 20 people to voluntarily submit to this rigorous an examination for the purpose of field-testing without getting certification. Field review appeared to be more practical and provided more information about the validity of each item.

      
      

   6. Since there appeared to be no reason to weigh any particular item, so that some items would count more than others, it was agreed that each item would count as one point. It also was determined that more than one person would score the examination to provide a double-check on the scoring process. Since some of the examination questions were essay questions, it was determined that the scorers would be experts in the field with the capabilities to assess the

      answer given using the standards set forth in the answer key as a guideline. If the two scorers disagreed on the correctness of an answer, the scorers would confer with each other to resolve the difference.

      
      

      TEST ANALYSIS

      
      

   7. After the first administration of the examination in June of 1985, Dr. Beard, a professor at Florida State University and an expert in testing, conducted a test analysis. Dr. Beard took the data, the indication of whether the items were right or wrong, coded them onto computer records, and computed a large number of statistical items. He computed the P-value of each item, the proportion that answered each item correctly. He computed the points by serial correlation between each item and the total scores. He also computed the frequency distribution of scores, means, standard deviations, and other descriptive statistics of the scores. After this was done, Dr. Beard determined that the two forms of the test differed in difficulty. He therefore applied an equating or calibrating procedure to adjust the difficulty of one form to that of the other. In other words, although each exam form was designed to test the same knowledge and skills, unintended differences in test difficulty from form to form gave an advantage to people taking the easier form. Therefore, it was necessary to convert the scores obtained on one form to the units on the other form, a process called test equating. Form A was the easier form; and therefore, the raw scores on Form A were equated to the scores on Form B.

      
      

   8. The test analysis also revealed that certain of the test items did not have desirable measurement properties. In any test, some items discriminate better between those who have a large amount of the knowledge being tested and those who do not have. An item that does not discriminate well will show a negative discrimination index. An item showing a negative discrimination index detracts from the measurement properties of the test. Therefore items that have negative discrimination indices should not be included in scoring an examination unless the elimination of the items would destroy the content validity of the examination.

      
      

   9. Out of the 156 questions on this examination, 31 of the items had a negative discrimination index. Because the elimination of these items did not affect the content validity of the exam, the 31 questions were eliminated. The elimination of these negative indicators did not affect the validity of the exam, and the inclusion of any negative indicator in an examination detracts from the reliability of the exam.

      
      

      CUT-OFF SCORE COMMITTEE

      
      

   10. The passing score on the examination was determined by a cut-off score committee. The committee was composed of a group of individuals representing practitioners, clients, and persons involved in the administration of the examination. The committee was given statistical information concerning the exam. The committee discussed the consequences of setting too high a passing score and the consequences of setting too low a score. Establishing a passing score by a committee that is aware of both the content of the examination and the impact of choosing a particular score is an acceptable method for determining a passing grade on an examination.

       
       

   11. After a complete review of the examination and consideration of the statistical information, each member of the committee wrote down a recommended passing score. There was a wide variation in the recommended passing scores. However, after further discussion a consensus was reached, and the ultimate cut-

       off score voted upon was approved unanimously. The cut-off score was set at 86 out of 125 items, or 68.8 percent. Thirty-three percent of the people taking the examination passed it.

       
       

       PETITIONER'S EXAMINATION

       
       

   12. Out of the original 156 questions on the examination, petitioner was scored with having answered 105 questions correctly. Of the 31 items eliminated, petitioner answered 21 correctly and missed 10. Of the 125 items which HRS counted on the examination, petitioner answered 84 correctly.

       However, petitioner took Form A of the exam, and petitioner's raw score of 84 on Form A was the equivalent to a score of 80 on Form B. Therefore, petitioner's equated score was 80. To pass the examination, petitioner would have to have received at least six more points.

       
       

   13. The deletion of the 31 items from the test served to make the test more reliable. However, had the 31 items not been deleted from the test, petitioner would have gotten the identical percentage of correct answers as he did after the elimination of these items. Therefore, the deletion of the items did not adversely affect the petitioner.

       
       

   14. The equating of scores is an acceptable testing procedure and adds to the fairness of the test. However, even if petitioner's score had not been equated, he would not have passed the exam. Further, if petitioner's score had not been equated, the scores of the other 49 individuals who took Form A also would not have been equated. This would have raised all of those raw scores and could have resulted in a higher cut-off score being chosen.

       
       

   15. Because the elimination of negative indicators and the equating of scores on two different forms of an exam are both acceptable-testing procedures, petitioner's contention that he should pass the exam must be based upon a showing that he answered correctly at least six of the questions that he was scored as missing.

       
       

       PETITIONER'S EXAMINATION ANSWERS

       
       

   16. Petitioner's exam was graded by Dr. James Johnston and Dr. Standler. Dr. Standler and Dr. Johnston initially disagreed on only four of the answers given by petitioner on the essay questions. However, there was no evidence presented concerning whether the disagreement on the four questions was resolved adversely to petitioner.

       
       

   17. Although petitioner did not designate in his petition the specific questions he was challenging, at the hearing the following question numbers were mentioned: 2-6, 3-3, 3-7, 4-1, 4-11, 5-4, 5-10, 5-11, 6-6, 6-7, 6-46, 6-48, 9- 2, and 10-8. Dr. James Johnston was the only expert in behavior analysis to testify, and he was called as a witness by both petitioner and respondent.

       
       

       Question 2-6

       
       

   18. Question 2-6 requested that the examinee write a functional response definition for the given situation. A functional response definition considers only the effect of the behavior. Petitioner's answer was incorrect because he included in his answer where the behavior occurred, when it occurred, and how it occurred. Therefore, petitioner did not write the functional response definition.

       Question 3-3

       
       

   19. The only evidence presented as to this question was that petitioner's response, C, was incorrect and that the correct answer was answer A.

       
       

       Question 3-7

       
       

   20. Dr. Johnston agreed with the petitioner that if one defined "interval recording" as meaning "whole interval recording" there would not be a proper answer to question 3-7. However, the question did not use the term "whole interval recording." Therefore a correct answer was provided in the choices. On his exam petitioner wrote the following note:

       
       

       Our instructor used the term "interval" in time sampling synonymously with the term whole interval only. None of the answers provided are thus appropriate, since none apply to whole intervals. Alternative C is given as answer because it applies to momen- tary time sampling whereas A + B are partial time sampling. . . .

       
       

       Dr. Johnston explained that the use of "whole interval time sampling" as a term is improper since it is the mixture of two different procedures. Time sampling is one procedure, often in the form of momentary time sampling. An interval recording, partial or whole, is a totally different procedure. The question asked the best method for obtaining interval recording data. Petitioner did not correctly answer the question.

       
       

       Question 4-1

       
       

   21. Question 4-1 may have been a question that was deleted; however, the only competent evidence presented was that petitioner's answer was incorrect.

       
       

       Question 4-11

       
       

   22. There was no competent evidence presented to establish that petitioner answered question 4-11 correctly. Petitioner argued that he correctly displayed the data on the graph provided because he assumed that one of the days was a "no chance" day. When "no chance" day occurs, the data points on either side should not be connected by a line. However, the question did not indicate that the day was a no chance day.

       
       

       Question 5-4

       
       

   23. Question 5-4 asked which inference was the most reasonable to be made based on the graph that was provided. Petitioner chose the answer, "The data indicate it would be appropriate to begin the treatment phase on the fifth-day." The correct answer was, "Baseline data should continue to be collected until more representative data are obtained." This answer was the correct choice because there were only four observations reflected on the graph. Four observations are too few, even if the fluctuation in the behavior recorded is not a large fluctuation.

       
       

       Question 5-10

   24. Petitioner simply read the graph incorrectly on this question. The question referred to the duration of the behavior. On a six-cycle chart, a standard behavior chart, duration is plotted on the right-hand axis, not the left-hand axis. On the left side the values get larger going up the scale, but on the right side the values get larger going down the scale. When measuring duration of behavior, if the data points on the chart go in a downward direction it would show that the duration is increasing. The correct answer was not given by the petitioner because he thought the duration was decreasing.

       
       

       Question 5-11

       
       

   25. Although petitioner did not give the best answer to question 5-11, the answer recognized in the answer key as the correct answer is also incorrect. Although this question was a flawed question, and therefore should have been deleted prior to scoring, petitioner cannot be credited with a correct answer on the question, since his answer was not the best of the three answers given. In other words, although the answer on the answer key was wrong, petitioner's answer was also wrong. This question simply should not be considered in determining the scoring.

       
       

       Question 6-4

       
       

   26. Question 6-4 provided a situation and then asked the question, "What is happening according to the social learning model? The key feature of the social learning theory is "cognitive mediation." Because cognitive mediation is the centerpiece of the social learning theory, petitioner's failure to mention it showed that he did not explain the situation in terms of the social learning theory.

       
       

       Question 6-7

       
       

   27. Question 6-7 presented a situation and required that the examinee write "at least two prerequisites that should be established so that the client can maximally benefit from behavioral intervention." Petitioner gave one prerequisite that was correct. However, petitioner did not answer correctly the second prerequisite. The second prerequisite given by petitioner, that the client "will perform simple tasks when instructed to do so," does not address specifically the situation provided. The situation refers to the client being so restless that she runs around the room and rarely stays in her seat long enough to be taught. A prerequisite that must be established so that the client can maximally benefit from the behavior intervention is that the client hold still long enough so the training can proceed. Since this is an important and obvious prerequisite for training, petitioner's answer is incorrect.

       
       

       Question 6-46

       
       

   28. Question 6-46 provides the following situation:

       
       

       The teacher wants to keep Sybil on task during class, but Sybil is so restless in the classroom setting on that spring afternoon she is not getting much work done.

       
       

       The question asks, "How could you use negative reinforcement to increase the client's behavior?" Petitioner answered the question by stating; "Nag Sybil until she terminates the aversive stimulus by doing her work (staying on task)."

   29. Negative reinforcement occurs when you have an aversive stimulus present and the response terminates the aversive stimulus. From the information given in this question, which information is to be used in answering the question, one should know that an aversive stimulus is present. Since the aversive stimulus is present, the teacher does not have to arrange an aversive stimulus. From the information given, the appropriate negative reinforcement procedure is to tell Sybil that she can leave class, the aversive stimulus, when she does her work. Petitioner's answer requires the teacher to add an aversive stimulus to the situation. Further, petitioner's response pairs the aversive stimulus with the teacher, which should be avoided.

       
       

   30. Petitioner argues in his proposed recommended order that it might be considered irresponsible and dangerous to let a child leave the classroom where she would be unsupervised. As a practical matter, this may be true. However, there is nothing in the situation given indicating that if Sybil left the classroom she would be unsupervised. Further, petitioner's answer on the exam did not reflect this concern. From petitioner's answer, it is not apparent that petitioner was aware that an aversive stimulus was already present. Therefore, petitioner's response was not a correct answer.

       
       

       Question 6-48

       
       

   31. Question 6-48 asks, "How can target behavior be strengthened?" Petitioner chose the alternative, "By making all reinforcing activities for the client contingent on the performance of the target behavior." This answer is unwise and incorrect because it refers to all the reinforcing activities for a client. All the reinforcing activities include a variety of different activities and stimuli that are reinforcing for any particular individual. To try to bring all these together, or make them contingent on the particular behavior, would probably be impossible. Although "increasing the frequency of reinforcement short of satiation" does not mention a contingency, the definition of reinforcement means that there is a contingency between a behavior and some following consequence. Therefore, the latter alternative is the best answer, and petitioner's answer is incorrect.

       
       

       Question 9-2

       
       

   32. Question 9-2 provided a situation and asked, "How can you use the AB design to evaluate the behavioral treatment." The examinee was informed that his answer must explain what to do and how to do it. One of the hallmark requirements of an AB design is that behavior is measured until it is stable and a representative picture of what is happening in that phase is obtained. Petitioner's answer did not reflect that data be collected until a stable and representative picture is obtained, and therefore his answer was incorrect.

       
       

       Question 10-8

       
       

   33. Question 10-8 set forth a situation involving the staff at a facility. The situation explained that staff members were dissatisfied with the working conditions and complained that raises, work schedules and special privileges were made on the basis of whom the supervisor liked rather than on staff performance. The question asked how the supervision and management system could be changed to make it more effective. The question stated that the answer should explain how the examinee would determine the effectiveness of staff performance and what types of consequences might be provided for performance. Although respondent's answer reflected certain positive reinforcers to use for appropriate performance, petitioner mentioned no negative consequences for a

       poor performance. Although petitioner mentioned evaluations, by stating "if the measuring instrument to evaluate performance is sufficiently detailed there are likely to be far less disputes regarding evaluations," petitioner does not mention having regular evaluations of the staff. Because petitioner did not include any negative consequences for poor performance, and did not mention regular evaluations as a means of determining the effectiveness of staff performance, petitioner's answer is incorrect.

       
       

       TRAINING PROVIDED BY HRS

       
       

   34. Prior to taking the examination, petitioner attended training classes conducted by Mr. Stelios Chimonides, an employee of HRS. The training classes were provided by HRS as a means by which practitioners could prepare for the certification examination. However, the training provided by HRS did not cover all the competency areas covered on the exam. Further, Mr. Chimonides used certain terms in training that were not identical to the terms used on the exam. However, the examination was not designed to test the information learned in the HRS training session. The examination was designed to test the practitioner's competency in the field of behavior management. Thus, the quality and thoroughness of the training provided by HRS through Mr. Chimonides is not relevant in determining whether petitioner should pass the exam and be certified by HRS. Further, petitioner did not establish that any of the correct answers on the examination were in conflict with the information provided during training.

       
       

       CONCLUSION

       
       

   35. The evidence presented at the hearing was not sufficient to establish that petitioner should have passed the certification examination. There was no evidence presented that the deletion of questions and the equating of scores were unacceptable testing procedures. Petitioner presented no competent evidence to establish that his answers on the challenged items were correct. Petitioner did establish that question #5-11 was flawed and should not have been included in the scoring. However, the elimination of this item would not cause petitioner to obtain a passing score. Indeed, even if it were determined that petitioner should receive a correct answer for that question, petitioner would not obtain a passing score.

       
       

       CONCLUSIONS OF LAW

       
       

   36. The Division of Administrative Hearings has jurisdiction over the parties to and the subject matter of this proceeding. Section 120.57(1), Florida Statutes.

       
       

   37. The relief sought by the petitioner in this case is a determination that petitioner passed the certification examination and that he be granted Level III Behavior Analysis certification. Petitioner has the burden to establish that he should pass the examination and be certified. Petitioner simply has not carried this burden. In his proposed recommended order, petitioner argues that he could not afford to pay expert witnesses to come to the hearing and notes that all of the HRS witnesses were individuals who were directly or indirectly paid by HRS. Petitioner overlooks the fact that all of HRS's witnesses were petitioner's witnesses also. The only expert in behavior analysis who testified was Dr. Johnston. He was initially called as petitioner's witness. Petitioner recognized Dr. Johnston's expertise in the field of behavior analysis. Simply put, Dr. Johnston's testimony did not, on the whole, support petitioner's contention that he answered the challenged

questions correctly. Further, the other evidence provided by petitioner also did not establish that petitioner's answers were correct.

RECOMMENDATION

Based on the foregoing findings of fact and conclusions of law, it is recommended that a final order be entered finding that petitioner did not pass the Behavior Management Certification Examination given on June 28, 1985, and that petitioner's request to be certified be denied.

DONE and ORDERED this 29th day of May 1987, in Tallahassee, Florida.

DIANE A. GRUBBS

Hearing Officer

Division of Administrative Hearings The Oakland Building

2009 Apalachee Parkway

Tallahassee, Florida 32301

(904)488-9675

Filed with the Clerk of the Division of Administrative Hearings this day of May 1987.

APPENDIX

The following constitute my rulings, by paragraph, of the parties' proposed findings of fact.

Petitioner's Proposed Findings of Fact

1-2. Accepted to the degree relevant in paragraph 12.

1. Accepted to the degree relevant in paragraph 7.

2. Accepted, in that the items were deleted as explained in paragraph 8, the remainder is rejected in that petitioner's statement does not correctly explain a negative discrimination index.

3. Accepted that Dr. Beard's analysis was a statistical one in paragraph 7 and 8.

4. Accepted as stated in paragraph 5.

5. Accepted in paragraph 7.

6. Rejected as irrelevant.

9-10. Accepted to the degree set forth in paragraph 5.

1. Rejected in that all of HRS's witnesses were petitioner's witnesses.

2. Accepted generally in paragraph 1.

13-14. Accepted as stated in paragraphs 2 and 9.

15-23. Rejected as irrelevant or not appropriate findings of fact; however, accept that test was not based on Chimonides' training in paragraph 34.

24-25. Accepted generally in paragraphs 15 and 17.

26-29. Accepted in part and rejected in part in paragraph 20. Witness Shepherd did state that "interval recording" was not used as a synonym for "partial interval time sampling." This is consistent with Dr. Johnston's testimony which indicated time sampling is a totally different procedure from an interval recording, either partial or whole.

30-34. Accepted in part and rejected in part as stated in paragraph 23.

1. Rejected as irrelevant.

2. Rejected by contrary findings.

37-40. Accepted in part and rejected in part as stated in paragraph 25.

45. Accepted in part and rejected in part in paragraph 26. 46-48. Accepted in part and rejected in part in paragraph 27.

49-54. Accepted in part and rejected in part in paragraphs 28-30. 55-56. Accepted in part and rejected in part in paragraph 31.

57-62. Accepted in part and rejected in part in paragraph 33.

63. Rejected by contrary finding in paragraph 35.

Respondent's Proposed Findings of Fact

1. Accepted as stated in paragraph 16.

2. Accepted in paragraph 15 and 35.

3. Accepted generally in paragraphs 12-14.

4. Rejected as specific finding as unnecessary, but accepted as true.

5. Rejected as cumulative.

6-8. Accepted to the degree relevant in paragraphs 1 and 2.

1. Accepted in paragraphs 2 and 5.

2. Rejected as irrelevant and not supported by competent substantial evidence.

11-12. Accepted generally in paragraphs 8 and 9.

1. Rejected as cumulative.

2. Rejected as specific finding of fact as unnecessary, but accepted as true.

3. Accepted in paragraph 11.

16-17. Accepted as stated in paragraph 12.

1. Accepted as stated in paragraph 17.

2. Rejected as cumulative.

20-21. Rejected as not findings of fact.

COPIES FURNISHED:

George Tsismanakis, pro se

403 N.W. 2nd Avenue Okeechobee, Florida 33472

Gregory L. Coler, Secretary

Department of Health and Rehabilitative Services 1323 Winewood Boulevard

Tallahassee, Florida 32399-0700

Paul V. Smith, Esquire Assistant General Counsel Department of Health and

Rehabilitative Services 1323 Winewood Boulevard

Tallahassee, Florida 32399-0700

John Miller, Acting General Counsel

Department of Health and Rehabilitative Services 1323 Winewood Boulevard

Tallahassee, Florida 32399-0700

Docket for Case No: 86-000937

Orders for Case No: 86-000937