The Issue Whether respondent should be required to repay $16,808 in CETA funds allegedly expended for unallowable purposes.
Findings Of Fact From October 1, 1978, to September 30, 1980, the audit period, the County implemented CETA grants of approximately $5,421,000. The Department's Division of Employment and Training, which serves as the state's prime sponsor under CETA, audited the County's records and disallowed certain expenditures. Those which remain in dispute are addressed below. (Testimony of Jessup, Flowers.) Wage and Fringe Benefits Paid to Kathryn Mabery. (CETA Subgrant Nos. 79MP-26-06-45-01 and 80ET-86-45-01-016, Title II-D) The Department contends that wage and fringe benefits, totaling $9,258, paid to participant Kathryn Mabery should be disallowed because she was not unemployed 15 out of the 20 weeks prior to her application, the Title II-D eligibility criteria of 20 CFR 675.5-5. On her August 13, 1979, application, Ms. Mabery indicated that she was last employed by Maryland Fried Chicken on May 13, 1979 2/ On August 15, 1979, the County correctly found her eligible for Title VI funding, which requires that an applicant be unemployed for at least ten out of 12 weeks prior to application. The County enrolled her as a clerical aide, with a starting date of August 20, 1979. But this was a CETA Title II-D position, not a Title VI position. She was thus paid, out of Title II-D funds, wages and fringe benefits totaling $9,258. In effect, on August 20, 1979, the County transferred Kathryn Mabery from the Title VI CETA program, for which she was eligible, to a Title II program, a program for which she was not eligible on August 15, 1979. (Testimony of Jessup, Flowers; P-1.) Wages and Fringe Benefits Paid to Edward Jackson. (CETA Subgrant No. 79MP-3C-06-45-01, Title IV) The Department contends that wages ($789) and fringe benefits ($44) totaling $833 paid to participant Edward Jackson should be disallowed because he was 13 years old at the time of enrollment. Participants in CETA Title IV programs must be between 14 and 21 years old at the time of enrollment. 20 CFR 676.6-10(b). The County, however, did not know he was 13--and thereby ineligible-- because both Edward Jackson and his mother signed eligibility applications which incorrectly stated he was 14 years old. He was subsequently enrolled in the CETA program, employed in the Mount Dora public works department, and paid a total of $833. The Department replies that Edward Jackson subsequently submitted to the County a student work permit (required for minors 12 through 15 years old) indicating his true age to be 13, and that the County failed to detect the discrepancy. Work permits, however, are a state requirement; they are not used to determine CETA eligibility. They were, in fact, issued after eligibility certification. When the County received them, they were routinely filed by clerical workers. The Department showed no duty on the part of the County to examine post-eligibility certification documents to confirm the initial eligibility determination. If the County had been aware of Jackson's true age, it would have immediately terminated him from the CETA program. His enrollment was not the result of a staff error or a failure to follow CETA eligibility procedures. It was attributable to falsification of eligibility certification documents by Edward Jackson and his mother. (Testimony of Jessup, Flowers; R-1.) Wages and Fringe Benefits Paid to Iola Bing. (CETA Subgrant Nos. 80ET-86-06-45-01-016 and 79MP-2U-06-45-01, Title II-D) The Department contends that wages ($5,196) and fringe benefits ($1,485) totaling $6,681 paid to participant Iola Bing should be disallowed because she did not meet the "Economically Disadvantaged" eligibility requirement of 20 CFR 675.5. Under that requirement, an applicant who receives "public assistance" is eligible. The County's intake staff determined that, since Ms. Bing was receiving Food Stamps, she satisfied the "public assistance" requirement. Federal and state CETA officials subsequently determined that Food Stamps were not "public assistance" within the meaning of CETA regulations. The Department seeks to retroactively apply that interpretation here. But the Department has not shown why Food Stamps should not, and cannot reasonably be considered "public assistance within the meaning of 20 CFR 675.5-5 and 676. No federal or state regulation has been cited which explicitly, or implicitly, disqualifies Food Stamps as public assistance." Neither has the Department shown that the County knew, or should have know, that Food Stamps were not "public assistance." Further, it appears that state officials may have advised County CETA workers that Food Stamps were a form of "public assistance." The Department has not shown, or even asserted, that any of the County's alleged errors were fraudulent; that the County, once it became aware of an ineligible participant or questioned activity, failed to take immediate corrective action; or that the County's eligibility determination procedures were inadequate or CETA management systems were not followed.
Recommendation Based on the foregoing, it is RECOMMENDED: That the County be required to repay the Department $9,258. DONE and RECOMMENDED this 23rd day of December, 1982, in Tallahassee, Leon County, Florida. R. L. CALEEN, JR. 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 23rd day of December, 1982.
The Issue Whether Petitioners, as members of the Florida Patient's Compensation Fund, are liable for additional assessments for Fund Years 1980-81 and 1981-82, as set forth in the Notice of Assessment filed on April 22, 1985. This proceeding arose as a result of petitions filed by two groups of hospitals contesting a Notice of Assessment issued by the Department of Insurance on April 22, 1985, based upon the certification by the Board of Governors of the Florida Patient's Compensation Fund to the Insurance Commissioner of a deficiency in the amount of money available to pay claims for the 1980-81 and 1981-82 fiscal Fund years. The proposed assessment seeks payment of the alleged deficiency in the total amount of $40,480,556.00 from health care providers who were members of the Fund during the Fund years in question, pursuant to Section 768.54, Florida Statutes. By Order, dated June 11, 1985, the two cases were consolidated into one proceeding, and the Florida Patient's Compensation Fund was granted intervention. Petitioners originally consisted of Southeast Volusia Hospital District and 58 other hospitals (Case No. 85-1650), and Tallahassee Memorial Regional Medical Center and 39 other hospitals (Case No. 85-1664). However, prior to final hearing, a majority of the hospitals from both groups voluntarily dismissed or otherwise withdrew their claims for relief in the proceeding. By Notice of Joinder, dated July 30, 1985, American Hospital, Northridge General Hospital and Pan American Hospital abandoned their claims in Case No. 85- 1650 and adopted the Amended Petition in Case No. 85-1664. As a result, the only remaining party of record in Case No. 85-1650 was St. Petersburg Osteopathic Hospital, Inc. which by Order, dated August 13, 1985, was ordered to show cause why it should not be dismissed as a party for failing to advise the Hearing Officer as to its status pursuant to Order dated July 12, 1985. No response to the Order to Show Cause having been received, it will be recommended herein that St. Petersburg osteopathic Hospital Inc. be dismissed as a party in Case No. 85-1650. Further, inasmuch as there are no longer any parties to that case, it will also be recommended for dismissal herein. By Prehearing Conference Order, dated July 11, 1985, Case No. 85-1664 was restyled to reflect Petitioners as Duval County Hospital Authority, et al. The parties remaining in Case No. 85-1664 at time of hearing were American Hospital of Miami, Inc., Duval County Hospital Authority, Gateway Community Hospital, Hialeah Hospital, Northshore Medical Center, Inc., Northridge General Hospital, Inc., Pan American Hospital, and St. Joseph's Hospital. By Prehearing Orders, dated July 11 and July 29, 1985, it was determined that questions concerning the setting or adequacy of base fees or additional fees, the statutory "cap" on physician assessments! the statutory cumulative "cap" on maintenance of the Fund per fiscal year, and the effect of payment limitations placed on the Fund by statute, were not properly at issue in this proceeding. However, one issue presented in the Amended Petition in Case No. 85-1664 as to whether the Fund has statutory authority to estimate reserves as a basis for an assessment was deemed to be an issue within the scope of this proceeding. The parties entered into a Prehearing Stipulation (Joint Exhibit 1), which included certain factual matters, subject to relevance, and the unresolved question of law as to whether the Fund and Department may include reserves on known claims other than those resolved by settlement or verdict in calculating the amount needed for assessments. At the final hearing, the parties stipulated that the Fund certification includes full credit for all previously noticed assessments, whether collected or not. They further stipulated as to the expertise of Charles Portero in claims handling and reserving practices. The parties also stipulated that there was no issue of fact as to the reasonableness of any individual claim reserve existing as of January 31, 1985, or included in the certification, except as to the Von Stetina claim. Testimony of Charles Portero concerning the Von Stetina claim was made confidential and the transcript of such testimony was extracted and submitted under seal pursuant to order of* *NOTE: Page 4 of the Recommended Order is omitted from the document on file with DOAH and, therefore, is not included in this research database. amount of the projected excess or insufficiency to the Insurance Commissioner with a request that he levy an assessment against Fund participants for that fiscal year. Petitioner hospitals were members of the Fund during one or more of Fund years 1980-81 and 1981-82 Each month, the Administrative Manager of the Fund follows a prescribed procedure to determine if an assessment is required for a particular Fund year, utilizing what is termed a "retrospective rating plan." The plan provides that assessments will not be levied in any year until the cash available for paying claims in that membership year is down to 50 percent of the loss and expense reserves for all known losses. It further provides that the amount should be sufficient to create enough cash flow to pay known reserved claims for the year showing such deficit. In reviewing the Fund's monthly financial report of January 1, 1985, it was determined that a sufficient deficit existed to warrant the levy of an assessment. Thereafter, an outside audit of the Fund accounts was conducted and presented to the Fund Board for Certification. On March 25, 1985, the Florida Patient's Compensation Fund certified a deficiency to the Department in the following amounts: 1980-81 Membership Year $14,866,718.00 1981-82 Membership Year 25,613,838.00 TOTAL $40,480,556.00 This certification was authorized by the Board of Governors of the Florida Compensation Fund on March 19, 1985. An audit substantiating the need for the assessment was performed by Catledge, Sanders and Sanders, certified public accountants. On April 22, 1985, the Department of Insurance issued a Notice of Assessment for Fund years 1980-81 and 1981-82. Notice was published in Volume II, No. 8 at page 1907 of the Florida Administrative Weekly on May 3, 1985. The Notice of Assessment announced the Department's intent to levy and authorize the Fund to collect an assessment in the amount certified by the Fund ($40,480,556.00). The Notice of Assessment further provided that the assessment be divided among the various classes of health care providers for each year as follows: (i) Physicians and Surgeons 1980-81 1981-8 Class 1 0 0 Class 2 0 0 Class 3 0 0 (ii) Hospitals $14,754,672 $25,388,773 (iii) HMO 35,621 161,102 Ambulatory Surgical Centers 76,425 63,963 Professional Associations 0 0 The Department computed the portion of the assessments to be paid by the different classes of health care providers for all years in question based upon the "indicated rate method," modified to all5w for the statutory proscription against assessing certain health care providers more than "an amount equal to the fees originally paid by such health care provider." This is the same method utilized in five previous assessment proceedings and specifically approved by the Florida Supreme Court in Department of Insurance v. Southeast Volusia Hospital District, 438 So. 2d 815, 821 (Fla. 1983). The appropriateness of the procedure has not been placed at issue in this proceeding. The amounts of the assessments sought by the Fund, and described in the Notice of Assessment, were calculated by the Fund by using the following formula: Total fees paid for the Fund year + Investment Income attributable to the Fund year + Amounts previously noticed as assessments Expenses allocated to that Fund year Amount paid on claims for that Fund year Amount reserved for all known claims for that Fund year The Fund used the same procedure calculating the amount of this assessment as it used in the first five assessments. The Department used the same procedure and methodology (indicated rate method) in allocating the assessment among the various classes as it used in the first five assessments. The amount of the assessment is based on the amount needed to pay known claims. This amount needed to pay known claims includes the amount reserved as the estimated loss and expense payments. The Fund follows standard industry reserving practices, as modified in several respects by its particular needs and procedures. Each claim is assigned to a claims supervisor who obtains information concerning the claims incident from the primary insurance carrier. The initial reserve on a claim is based on a variety of factors, including the type of injury, potential damages, liability considerations, geographic location, and the particular attorney for the claimant. After a determination that a reserve is needed on the file, the claims supervisor makes an initial determination of the amount which is referred to the claims manager for approval. Final approval of the posted reserve lies in the hands of the Claims Committee of the Fund. The figure is usually fixed at a sum for which it is believed that the claim could be settled and the potential liability arising from a jury verdict. The necessity of obtaining approval of the Claims Committee for the initial reserve and any subsequent changes creates a certain amount of delay in obtaining such decisions. Changes may be effected in the reserve when injuries are found to be greater than anticipated, or because of the discovery of additional facts affecting potential liability. It is not unusual for a particular claim to be submitted three or four times to the Claims Committee before it is settled.
Findings Of Fact The following Findings of Fact are based on the evidence presented at the hearing: The parties stipulated to the reasonableness of all established claim reserves reflected in the current assessment sought by the Fund. However, Petitioners questioned the reasonableness of the Fund reserve on the Von Stetina claim which had been included in a previous assessment. Although it is questionable as to whether the adequacy of such a prior reserve should be addressed in a proceeding contesting a subsequent assessment, it is clear that the determination of a deficit necessarily involves deductions or credits for prior reserves in determining a current deficit. In any event, the Von Stetina reserve was established according to the standards practices of the Fund, and no evidence was presented by Petitioners to show that it was unreasonable or otherwise incorrect either on January 31, 1985, when it was determined that a sufficient deficit existed to warrant the levy of an assessment, or at the present time. The Von Stetina case is presently pending in the judicial process and, accordingly, there is no basis at the present time to reduce the previously established reserve. (Stipulation, Testimony of Portero) As heretofore found, the Fund includes a "claim" as a basis for an assessment as soon as a reserve for the claim is established. Petitioners presented the testimony of an accountant who expressed the opinion that the term "claim" as used in pertinent statutes should be restricted to final judgments or settlements against a health care provider in excess of the provider's primary coverage. This "cash basis" methodology would require the entry of a final judgment or settlement before the claim could be considered in determining whether a deficit exists for any particular Fund year. On the other hand, expert testimony from the Fund's Claims Manager shows that the definition of "claim" as used by the Fund is basically in accordance with the generally accepted meaning and usage of that term by the insurance industry. The reserving practices of the Fund are found to constitute a reasonable basis for arriving at the projected amounts required to meet the claims made against the Fund account for a particular fiscal year. (Testimony of Cherry,Portero) It is further found that the present assessment was prepared in accordance with standard procedures, that the amounts proposed to be levied as an assessment for each Fund year in question represent a deficiency in the Fund account for such years, and that the proposed allocations of such amounts among the specified health care providers are appropriate. (Respondent's Exhibits 1-7, Joint Exhibit 1- Stipulation, Testimony of Portero)
Recommendation In view of the foregoing, it is RECOMMENDED that a final order be issued by the Department of Insurance dismissing Case No. 85-1650, and levying assessments in accordance with the Notice of Assessment, dated April 22, 1985, for the Fund years specified therein. DONE and ENTERED this 15th day of October, 1985, in Tallahassee, Florida. THOMAS C. OLDHAM Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 Filed with the Clerk of the Division of Administrative Hearings this 15th day of October, 1985. APPENDIX PETITIONERS' PROPOSED FINDINGS OF FACT Paragraphs 1-7: Adopted by Stipulation (Joint Exhibit 1) in Findings of Fact 1-3, 5, 8. Paragraphs 8-10: These are conclusions of law and are therefore rejected as not being Proposed Findings of Fact. See Conclusions of Law in Recommended Order. Paragraph 11: Rejected as unsupported by the evidence. See Finding of Fact 10. Paragraph 12: Adopted in Finding of Fact 8. Paragraph 13: First sentence rejected as unsupported by evidence. Remainder adopted in Finding of Fact 10. Paragraph 14: Rejected as unsupported by the Evidence. (Confidential Portion) Paragraphs 1-6: Irrelevant and unnecessary except as set forth in Findings of Fact 9. RESPONDENT'S PROPOSED FINDINGS OF FACT Paragraphs 1, 3-10: Adopted in Findings of Fact 1-8. Paragraph 2: Rejected as Conclusion of Law rather than Finding of Fact. Paragraphs 11 & 12: Substantially adopted in Findings of Fact 9 Copies furnished: Honorable William Gunter Insurance Commissioner The Capitol Tallahassee, Florida 32301 William C. Owen and W. Douglas Hall, Esquires Carlton, Fields, Ward, Emmanuel, Smith, and Cutler Post Office Drawer 190 Tallahassee, Florida 32301 David A. Yon, Esquire Department of Insurance 413-B Larson Building Tallahassee, Florida 32301 Clay McGonagill 241 East Virginia Street Tallahassee, Florida 32301 St. Petersburg Osteopathic Hospital, Inc. 401 15th Street, North St. Petersburg, Florida Information Copy to Neil H. Butler, Cathi C. O'Halloran and Ben Wilkinson, Esquires, Pennington, Wilkinson, Dunlap, Butler & Gautier Post Office Box 13527 Tallahassee, Florida 32317-3527
Findings Of Fact 1 In either April or May, 1983, HRS District III, Respondents in this case, advertised a request for proposals to operate a spouse abuse shelter in a subdistrict of HRS District III in accordance with the following schedule: The request for proposal (RFP) package was to be picked up by 5 p.m., May 20, 1983; the applicant was to notify HRS of its intent to submit a proposal by 5 p.m., May 20, 1983; and the proposal was to be filed with HRS no later than 5 p.m., June 3, 1983. The contract in question was for the period July 1, 1983 through June 30, 1984. Linda Tucker, President of the Petitioner's Board of Directors, found out about the solicitation from her Vice President, Alice Mulrooney, who had received word of it through an administrative letter sent to her in her capacity of an officer on the County Rape Council. Ms. Tucker and Ms. Mulrooney both telephonically spoke with Carol Laxton, the HRS official in Gainesville who was stewarding this solicitation. It was not clear which of the two spoke with her first. Ms. Tucker spoke with Ms. Laxton on May 20, 1983, and requested to be furnished with a copy of the RFP. Both Tucker and Mulrooney indicated they told Ms. Laxton that Petitioner was not yet incorporated. Both agree Ms. Laxton advised them the requirement for incorporation could be waived and that the proposal should be submitted anyway, including a letter from Petitioner's lawyer to the effect that the incorporation papers had been forwarded to the office of the Secretary of State. On May 25, 1983, Petitioner contacted representatives of the Hernando County Commission relative to county funding of at least a portion of that local source of matching funds required to make up at least 25 percent or the overall proposed operating budget as required by Florida Statutes and as set out in the proposal. At that time, Petitioner was advised that while the Commission supported the Petitioner's proposal in concept and fully hoped to lend its financial support, it could not officially do so until after the county's budget hearings were completed and it was determined that the requested funds were in fact available. A letter to this effect was submitted to Ms. Laxton by the Chairman of the Commission on June 7, 1983. In the interim, before the proposal was submitted, both Ms. Tucker and Ms. Mulrooney discussed this possible defect, as well, with Ms. Laxton. Again, both ladies contend Ms. Laxton advised them this criterion could be waived, as well. Petitioner submitted its proposal on time. However, at the time of submittal, the Petitioner was not in fact incorporated. The proposed corporate charter was forwarded to the Secretary of State on June 2, 1983 (a letter to this effect was sent the same day to Ms. Laxton by Petitioner's attorney), and approved on June 13, 1983. Also, at the time of submission, the proposal listed as budgeted resources donated land and two homes having a rental value of $4,800 per year as an in-kind resource, $182 as cash client contributions and $3,750 as a cash contribution by the Hernando County Commission. It is this last funding source that was committed in theory only and was not firm. Taken together, the three sources totaled $8,732, which would be slightly over 28 percent of the total yearly budget of $31,052. However, since the commitment from the County Commission was not firm and was contingent on funds being available, it could not be considered; and the remaining sum of $4,982 is only 16 percent of the budget. Ms. Laxton admits talking with both Tucker and Mulrooney on several occasions about the proposal and the difficulties they were having. They indicated to her they were having problems getting incorporated, but that their attorney was working on it. She admits telling them to send whatever they had, which included a status letter from their attorney. She also admits stating to them that some requirements of the RFP could be waived, but does not think incorporation was one and is sure she did not tell them the matching funds requirement could be waived. After hearing the evidence presented and considering it along with its relative probabilities and improbabilities, it is found that the Petitioner's representatives may have reasonably inferred the incorporation requirement could be waived. However, it is unlikely that Ms. Laxton would have even inferred anything as significant and sensitive as a matching fund requirement could be waived. If Ms. Tucker and Ms. Mulrooney inferred that from Ms. Laxton's comments, it was unfortunate, but in error. In fact, the County Commission did ultimately approve a commitment to Petitioner in the amount of $3,750. They have also received additional cash contributions of $2,300 and additional in-kind contributions of $5,000. None of these latter resources were in hand or firmly committed by the June 3, 1983 proposal submission deadline, however. At the present time, Petitioner is operating a shelter without Respondent's funds. They have requested assistance from the successful bidder, but have been turned down. There is, however, substantial but non-financial community support for Petitioner's operation.
Recommendation Based on the foregoing, it is RECOMMENDED: That Petitioner's protest be rejected. RECOMMENDED this 4th day of January, 1984, in Tallahassee, Florida. ARNOLD H. POLLOCK Hearing Officer Division of Administrative Hearings Department of Administration 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 4th day of January, 1984. COPIES FURNISHED: LINDA TREIMAN, ESQUIRE 11 NORTH MAIN STREET BROOKSVILLE, FLORIDA 33512 JAMES A. SAWYER, JR., ESQUIRE DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES 1000 N.E. 16TH AVENUE BUILDING H GAINESVILLE, FLORIDA 32601 MR. DAVID PINGREE SECRETARY DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES 1323 WINEWOOD BOULEVARD TALLAHASSEE, FLORIDA 32301
Findings Of Fact The Sarasota Retina Institute Research Foundation, Inc., (Petitioner) is a non-profit corporation exempt from federal income tax under Section 501(c)3 of the Internal Revenue Code. The Sarasota Retina Institute (SRI) is a private medical practice consisting of three practicing ophthalmologists. The three SRI ophthalmologists are on the seven-member board of directors of the Petitioner. Documents provided by the Petitioner indicate that SRI has been involved in medical clinical studies. Although the Petitioner asserts that it provides financial support for the studies, the evidence fails to support the assertion. The Petitioner's Articles of Incorporation state that it is organized for religious, charitable and educational purposes sufficient to qualify for federal tax exemption. The articles do not establish that the Petitioner was originally organized or is currently organized for scientific research. According to the Articles, the Petitioner's property is held for religious, charitable and educational purposes. The Petitioner's application for IRS exemption states that the activities of the Petitioner are to offer a "source of revenue for educational purposes and research purposes" in the field of human eye disease. The evidence offered at hearing is insufficient to establish that the funds of the Petitioner are being used for research purposes. The evidence indicates that majority of expenditures by the Petitioner are being made not for scientific purposes but, to cover travel and seminar expenses of the SRI ophthalmologists. The Petitioner's expenditures are insufficient to establish that the Foundation is a scientific organization.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Department of Revenue enter a Final Order denying the Petitioner's application for a Consumer's Certificate of Exemption. RECOMMENDED this 20th day of December, 1996, in Tallahassee, Florida. WILLIAM F. QUATTLEBAUM Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (904) 488-9675 SUNCOM 278-9675 Fax Filing (904) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 20th day of December, 1996. COPIES FURNISHED: Linda Lettera General Counsel Department of Revenue 204 Carlton Building Tallahassee, Florida 32399-0100 Larry Fuchs Executive Director Department of Revenue 104 Carlton Building Tallahassee, Florida 32399-0100 David P. Johnson, Esquire 2201 Ringling Boulevard, Suite 104 Sarasota, Florida 34237 Ruth Ann Smith Assistant General Counsel Department of Revenue Post Office Box 6668 Tallahassee, Florida 32314-6668
Findings Of Fact The Petitioner Florida Farmworker's Council, Inc., applied or funding under the Community Service Block Grant (CSBG) Program for the fiscal year beginning July 1, 1982, and ending June 30, 1983, with the Respondent Department of Community Affairs. Since the Respondent Department had recently assumed administration of the program from the federal government and neither rules nor funding information was available, the Department entered into an agreement with the Petitioner for interim funding covering a two-month period. The first month funding of $33,727.25 was released to the Petitioner subject to certain conditions. When the Department determined that the conditions were not fully met, the second month's funding was not released. Subsequently, as a result of various reviews, the Department determined that the original application was unacceptable, and a determination was made to withhold the remainder of the grant request totaling $370,999.75. An informal hearing was held in Fort Lauderdale, Florida, and resulted in a Final Order which gave the Petitioner an opportunity to resubmit its application with conditions. Following an exchange of correspondence and meetings between the parties, the Department agreed to fund the Council to the extent it operated a program in accordance with state and federal lab and pursuant to the program described in its application. A program review audit was conducted by the Department in June, 1983. In the audit is was concluded that while considerable funds were expended, the Petitioner's program activities were at a level which was unacceptable.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED: That a Final Order be entered by the Department denying the Petitioner's request for funding in the amount of $370,999.75, which represents eleven months of funding for fiscal year 1982-1983. DONE and ENTERED this 14th day of December, 1983, in Tallahassee, Florida. SHARYN L. SMITH Hearing Officer Division of Administrative Hearings Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 14 day of December, 1983. COPIES FURNISHED: W. George Allen, Esquire 116 Southeast Sixth Court Post Office Box 14738 Fort Lauderdale, Florida 33302 Mary Clark, Esquire General Counsel Department of Community Affairs 2571 Executive Center Circle, East Tallahassee, Florida 32301 John M. DeGrove, Secretary Department of Community Affairs 2571 Executive Center Circle, East Tallahassee, Florida 32301
The Issue Whether the Respondent, John Obrzut, should be terminated from his employment for reasons of incompetence and his alleged failure to advise the Superintendent of the Franklin County School District time and filing requirements under the above-cited Statute, because of failure to submit required monthly reports to the School Board as well as for unauthorized absences.
Findings Of Fact On May 6, 1985, the Respondent entered into an employment contract with the Franklin County School Board for employment in the position of Finance Officer and Business Manager. The contract's term continued through June 30, 1986, with a commencing date of July 1, 1985. The contract provided for a probationary status for Respondent. The Respondent was provided with a copy of the job description for the Finance Officer/Business Manager position he accepted and contracted for at the time of his employment. That job description established that the individual directly responsible to the Superintendent and the School Board for all activities concerned with the financial operations of the school system was the Finance Officer/Business Manager, Dr. Obrzut. Superintendent Gloria Tucker interviewed Dr. Obrzut for this position and was especially concerned that he understand the duties he would have in that office because the School Board was experiencing financial difficulties at that time, primarily related to the disheveled condition of its records for the past several fiscal years due at least in part to previous mismanagement by those with Dr. Obrzut's responsibilities. The Respondent was informed that it would be necessary for him, as Finance Officer, to reconstruct portions of those records. Dr. Obrzut did not inquire regarding the specific status of the records during the time of his employment interview and once he became employed he found the problem to be considerably worse than he had expected. Ms. Tucker informed the Respondent that his duties would include keeping her advised of the "TRIM Bill" time requirements in order to meet the budget publication date of July 25, 1985, as required by that law. His job description also required him to prepare a monthly financial statement showing receipts, disbursements and the balance of funds available in the district budget. Additionally, on June 24, 1985, after he was hired, the Respondent was given the various task assignments, in writing, from the Superintendent. These involved: (1) gathering necessary data and preparing the budget amendment for the June 27, 1985 School Board meeting; (2) develop with Mr. Johnson's help the baseline data that would establish the "time-line" for reconciliation of the 1982-1983 and 1983-1984 budgets, which was one of the Respondent's two major priorities for June and July of 1985 because, given the disarray of its financial records, the Board had an immediate necessity to know what cash reserves it truly had on hand; (3) set up a time schedule concerning when final reports were due on each federal and State project and when that information would be available to the Superintendent, as well as to give the Superintendent a written report as to how the "time-line" would operate during July and August of 1985. (4) The Respondent was required to set up a written time schedule as when Department of Education reports were due so that no reports would be filed late. Assignment number 5 involved reviewing the requirements for budget preparation as stated in the law regarding time requirements (i.e. the "TRIM Bill"). The Respondent was to directly contact the County property appraiser concerning when tax millage information from his office would be ready for the budgeting process. The Respondent's past employment history involved various clerical, accounting and financial analyst positions for most of the last two decades, as well as substantial periods of time spent obtaining graduate degrees. His longest period of employment was four years with the Department of Transportation, where he supervised a clerical unit with a number of employees reporting to him. Prior to his employment with the Franklin County School Board, he had no experience as the overall supervisor of financial operations of any agency of government or a private enterprise. He had no experience with school finance procedures established under Chapter 237, Florida Statutes. On June 24, 1985, the Respondent was given the assignment involving task number 5 mentioned above, whereby he was to review the requirements for budget preparation as stated in the above- cited Statute regarding time requirements. He contacted the property appraiser concerning when the Superintendent and the Board might expect tax millage information from his office required for the budget process. The Respondent was also verbally instructed by the Superintendent at this same time to keep her informed of all specific dates required by the law concerning budget events. In the course of these verbal instructions, the Superintendent advised Dr. Obrzut that she was especially concerned about this because this was her first time to be involved in the budgeting process as a Superintendent of Schools. On June 25, 1985, Dr. Obrzut advised the Superintendent that he had called the Franklin County property appraiser's office and it provided him no information on the requirements for the budget process at that time, in the form of the tax millage information, but he expected advice from them on this subject on June 27, 1985. He also advised the Superintendent at this time that he expected to receive a planning document, with the time requirements for the budgeting process, in the mail from the Department of Education and also expected to receive a copy of it personally at a school financial officer's meeting in Tampa. Dr. Obrzut reviewed Section 200.065, Florida Statutes (the "TRIM Bill"), as requested by the Superintendent, but his testimony establishes that he has no recollection of making any notes or recollection concerning the sequence of events required by the Statute as deadlines in the budget preparation process. In any event, the Respondent had no further communication with the Superintendent concerning the budget time requirements. He subsequently learned that a copy of the planning document would also be mailed to the Superintendent and therefore simply assumed she would monitor the State's various budget planning event time requirements herself. He took no further steps to advise her of the various critical time deadlines. In fact, no one in the Franklin County School District administration was monitoring the budget time schedule of events because the Superintendent, whom the financial officer, Dr. Obrzut, directly reported to, was relying on Obrzut to do this. This fact, however, was discovered accidentally by Mr. David Johnson, a contract certified public accountant, who was performing an audit of the internal accounts of the various district schools. Mr. Johnson was meeting with the Superintendent concerning matters about the internal audit on a Wednesday in July 1985, when he inquired of her as to the status of the district's advertising of its forthcoming budget, as required by law. The Superintendent advised him that Dr. Obrzut was monitoring the schedule of events and deadlines concerning the budget preparation and advertising process. Mr. Johnson thereupon visited Dr. Obrzut at his office and retrieved from him the planning document that Obrzut had received from the Department of Education. Mr. Johnson informed the Superintendent that the budget must be completed and ready for advertising prior to the following Tuesday. This was the first time the Superintendent had learned of the immediately impending deadline for budget advertising as required by the above Statute. The Franklin County School District employees responsible for preparation of the budget then had to work through the entire weekend that ensued in order to timely complete the budget in time for the advertising deadline on Tuesday. The testimony of the Superintendent as well as Mr. Johnson, who has extensive experience in the field of educational finance and was accepted as an expert in that field, established that had that deadline been missed the Franklin County School District would have lost approximately $500,000 in tax revenues needed to fund its $3,000,000 operating budget. Dr. Obrzut acknowledged that he was responsible for ensuring that the federal cash advance reports were sent to the Department of Education in a timely fashion in order to ensure the continuous flow of funds to the district for the district's federally funded projects. He established that he prepared one of these reports himself and delegated the task of preparing the September 1985 report to one of his subordinate employees, Donna Ward. He admitted he did not monitor her work and ensure that the report was timely filed and did not learn of the fact that it had not been filed until the Superintendent informed him of that fact at the time she informed him she would recommend his dismissal. The report was delinquent at that time and the district had already ceased to receive federal funds because of that delinquency. David Johnson was accepted as an expert witness in the areas of accounting and Florida school finance. He worked for the Office of the Auditor General for three years and then spent several years in the capacity of a school Finance Officer. He is a certified public accountant and currently operates an accounting firm that renders accounting assistance to four school districts in Florida. Additionally, he serves as chairman of the Walton County School Board. Mr. Johnson was retained to assist Dr. Obrzut in reconstructing the ledgers and records for the fiscal years 1982- 83 and 1983-84. He was also asked to school Dr. Obrzut in the legal and regulatory requirements and accounting procedures attendant to the peculiarities of Florida school finance. Mr. Johnson established that he had great difficulty explaining to Dr. Obrzut the nuances and peculiarities of the Florida school finance law, reporting requirements and accounting procedures. He spent more than one full day in attempting to explain these duties of Dr. Obrzut's position to him. Dr. Obrzut would indicate that he understood, but later conversation revealed that he did not in fact understand what had been explained to him. Further, Dr. Obrzut showed a penchant for discussing tangential or even unrelated matters with great Verbosity during Mr. Johnson's attempts to explain his financial duties to him. This may have frustrated Dr. Obrzut's opportunity to understand the explanation of his financial duties and the requirements of his position and doubtless frustrated Mr. Johnson's efforts to explain them. In any event, Mr. Johnson established that, based upon his association with Dr. Obrzut over a period of several months, that Dr. Obrzut did not possess the knowledge and skills necessary to enable him to serve as a School District Finance Officer, even in view of his educational degrees in the areas of finance. This opinion was unrebutted.
Recommendation Having considered the foregoing Findings of Fact, the Conclusions of Law, the evidence of record, the candor and demeanor of the witnesses, and the pleadings and arguments of the parties, it is, therefore RECOMMENDED that the Respondent John Obrzut be terminated from his position of employment with the School Board of Franklin County. DONE and ENTERED this 19th day of December, 1986 in Tallahassee, Florida. P. MICHAEL RUFF Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 19th day of December, 1986. APPENDIX TO RECOMMENDED ORDER, CASE NO. 86-1775 Petitioner's Proposed Findings of Fact: Accepted. Accepted. Accepted. Accepted. Accepted. Accepted. Accepted. Respondent's Proposed Findings of Fact: Accepted. Accepted. Accepted. Accepted. Accepted, but not for the material import sought to be conveyed. Rejected as to its overall import as not in accordance with the greater weight of the testimony and evidence presented. Accepted to the extent that the Petitioner failed to present evidence of any unauthorized absences, but the remainder of this proposed finding is rejected as not comporting with the greater weight of the material evidence presented. Rejected as not in accordance with the greater weight of the evidence and testimony presented, except that the record does not reflect that he ever received any written reprimand or warning. Accepted. COPIES FURNISHED: Van P. Russell, Esquire WATKINS & RUSSELL 41 Commerce Street Apalachicola, Florida 32320 Edward S. Stafman, Esquire 317 East Park Avenue Tallahassee, Florida 32301 Honorable Ralph D. Turlington Commissioner of Education The Capitol Tallahassee, Florida 32301 Judith Brechner, Esquire General Counsel Department of Education Knott Building Tallahassee, Florida 32301 Gloria H. Tucker, Superintendent Franklin County School District 155 Avenue E Apalachicola, Florida 32320
The Issue Whether Petitioner's September 29, 1993, claim (Claim No. 34092993) for reimbursement of expenses for medical services rendered in 1992 should be denied on the ground that said claim was not timely filed with Department of Management Services, Division of State Employees' Insurance (hereinafter referred to as the "Department")?
Findings Of Fact Based upon the evidence adduced at hearing, and the record as a whole, the following Findings of Fact are made: Petitioner is now, and has been at all times material to the instant case, a participant in the State of Florida Flexible Benefits Plan (hereinafter referred to as the "Plan") with an established Medical Reimbursement Account. The following were among the medical expenses incurred by Petitioner and members of her immediate family during the 1992 calendar year: DATE TYPE OF SERVICE AMOUNT 6/29/92 Dental $70.00 7/9/92 Dental $310.00 7/11/92 Endodontic $450.00 7/17/92 Optical $266.75 7/22/92 Dental $500.00 7/27/92 Optical $84.70 8/19/92 Optical $416.50 12/29/92 Dental $210.00 In August of 1992, Hurricane Andrew ravaged parts of South Florida. Petitioner's residence was extensively damaged by the storm. Most of the contents of the residence, including medical records and receipts, were destroyed. Petitioner and her family were forced to vacate the premises. They packed their remaining belongings and moved to another location in Dade County, with the intention of returning to their home once the damage to the structure had been repaired. As of the date of the hearing in this case, all of the necessary repairs to the home had yet to be made and therefore the family had not moved back in. Petitioner and the other members of her family were among those residents of South Florida whose lives were significantly disrupted by the hurricane and the destruction and devastation it caused In the aftermath of the hurricane, Petitioner directed her energies toward obtaining a return to normalcy in her life. Although she realized that there were medical expense reimbursement claims that she needed to file with the Department, filing these claims was not a priority of hers. She focused her attention on other matters that she considered to be more deserving of her time given her situation. In January or February of 1993, Petitioner telephoned the Department to inquire if extensions of time for filing reimbursement claims were being given to Plan participants, such as herself, who were still suffering from the consequences of Hurricane Andrew. The person to whom Petitioner spoke advised her that such extensions were indeed being given. Based upon what she had been told by this Department representative, Petitioner reasonably believed that she would be able to file reimbursement claims for 1992 medical expenses after March 1, 1993, without having these claims rejected on the ground that they had been untimely filed. She therefore felt that there was no urgency with respect to the filing of these claims and she acted accordingly. Shortly after gathering all of the supporting documentation she believed she needed, 1 Petitioner, on September 29, 1993, filed a claim with the Department requesting that she be reimbursed from her Medical Reimbursement Account for the medical expenses enumerated in Finding of Fact 2 of this Recommended Order. The Department designated the claim as Claim No. 34092993. Petitioner also sought reimbursement, through the filing of this claim, of certain medical expenses incurred in 1993, including $140.00 for dental work that Petitioner had inadvertently indicated on the claim form had been performed in July of 1992. The work had actually been done in July of 1993. By letter dated October 8, 1993, the Department advised Petitioner that "[o]nly expenses for services rendered during the January 1, 1993 through December 31, 1993 plan year are eligible for reimbursement" and that "[s]ince [her] 1992 expense does not fall within this plan year, it is not reimbursable." Petitioner responded to this advisement by sending the following letter, dated November 28, 1993, to the Department: This is a petition or application requesting a formal hearing on my Claim #34092993 for Payment/Reimbursement for expenses incurred during my period of coverage for 1992. This Claim was denied. My Name is: Luretha F. Lucky My Address is: 10430 S.W. 162nd Terrace (temporary) Miami, Florida 33157 My permanent address is: 10361 S.W. 139th Street Miami, Florida 33176 I am employed at Florida International University, Miami, Florida 33199. I filed my claim late because my home was severely damaged when hit [b]y Hurricane Andrew, August 24, 1992. In addition, the content[s] in my home w[ere] destroyed, therefore, it took awhile for me to collect documentation for my claim from medical personnel. Also, I had to move and the few items saved were packed away. Lastly, I called the Department of Management Services, Division of State Employees' Insurance to inform them of what had happened to me and asked if . . . they were providing extensions on submitting claims. I was told they were. My mistake was not asking and recording the name of the person with whom I spoke. As you can see from my temporary address, I am still not back in my home! In fact we just settled (with the assistance of the Insurance Commissioner's Office) with our insurance company to complete the work on our home. We had to request an extension on filing our income tax for 1992. This past year has been an awful experience for us, and I do hope you will provide me a hearing on my reimbursement. My Claim # is: 34092993. The decision that my claim was denied was received by regular mail. Thank you very much for considering my request.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is hereby: RECOMMENDED that the Department enter a final order finding Petitioner's September 29, 1993, claim (Claim No. 34092993) for reimbursement of expenses for medical services rendered in 1992 to have been timely filed and therefore subject to consideration on its merits. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 15th day of April, 1994. STUART M. LERNER Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings 15th day of April, 1994.
The Issue Whether Petitioner is entitled to receive attorney's fees and costs from Respondent pursuant to Section 57.111, Florida Statutes.
Findings Of Fact On June 24, 1994, Dolly Davis, Insurance Specialist at the Department's Daytona Beach Service Office, sent a letter to Mary Russo, Examiner, Bureau of Specialty Insurers, which brought to the Department's attention that Capital was utilizing a billing service disclosure form in conjunction with its standard premium financing agreement to collect a charge for a supplemental product, allegedly in violation of Sections 627.8405 and 627.838, Florida Statutes. On August 25, 1994, Al Willis, Bureau Chief, Bureau of Specialty Insurance, sent a memorandum to Dennis Silverman, Legal Services, in which Mr. Willis requested the Division of Legal Services to issue an immediate final order to revoke Capital's license to transact premium financing or to fine Capital for allegedly violating Sections 627.8405 and 627.838, Florida Statutes. Mr. Willis explained in the memorandum that the Department became aware of the alleged violations through examinations of Ace Auto Insurance and Accountable Auto-Star, both of which were believed to be affiliated with Capital. On August 30, 1994, the Department issued its Notice of Intent to Non-Renew Capital National's license. The Department stated in the Notice that the Department had obtained evidence that Capital was financing automobile club memberships in violation of Section 627.8405, Florida Statutes, and was utilizing a form in conjunction with its premium finance agreement which had not been approved by the Department in violation of Section 627.838, Florida Statutes. The case was referred to the Division of Administrative Hearings for an administrative hearing. The parties agreed to submit memoranda of law and proposed recommended orders based on stipulated facts in lieu of an evidentiary hearing. The parties agreed that the sole issue to be determined by the administrative law judge was whether Capital was financing the purchase of automobile club memberships in violation of Section 627.8405, Florida Statutes. The parties stipulated that the billing service disclosure form used by Capital is executed on the same day the premium finance agreement is executed, and the billing disclosure form is physically a separate document from the premium finance agreement. On January 8, 1996, the administrative law judge entered a Recommended Order, concluding that although the billing service disclosure form was part of the premium finance agreement, Capital was not financing automobile club memberships and, therefore, was not in violation of Section 627.8405, Florida Statutes. On February 15, 1996, the Department issued a declaratory statement, In the Matter of Just Premium Finance, Inc., Case No. 12412-95-C-JAB, in which the Department took the position that Section 627.8405, Florida Statutes, prohibits as financing a premium finance company's collection of a charge for the purchase of a supplemental product, despite the fact that the premium company does not advance any funds or charge a rate of interest for performing the service. On March 1, 1996, the Department entered a final order concluding that Capital was financing automobile club memberships in violation of Section 627.8405, Florida Statutes. Capital appealed the final order to the Third District Court of Appeal, Capital National Financial Corporation v. Department of Insurance and Treasurer, Case No. 96-0826. On November 6, 1996, the Department issued a Report of Examination for Dome Premium Finance Company, in which the Department noted that Dome was engaging in activities prohibited by Section 627.8405, Florida Statutes, by utilizing a separate billing disclosure form for the payment of supplemental products. On November 18, 1996, the Department sent a letter to Richard Perry, President of Perry and Company, in which the Department requested confirmation that all companies managed or serviced by Perry and Company had terminated the practice of using separate consumer finance agreements. On January 12, 1997, Mr. Perry verified that all companies managed or serviced by Perry and Company had terminated this practice. Perry and Company manages and/or services the following premium finance companies: Freedom Premium Finance Corporation; Equity Premium, Inc.; Puritan Budget Plan, Inc.; and Gibraltar Budget Plan, Inc. Capital National was the only premium finance company to challenge the Department's interpretation of Section 627.8405, Florida Statutes, and thus, it was the only premium finance company to receive a Notice of Intent to Non-Renew its license. The Notice of Intent to Non-Renew was used for the first time against Capital and has never been used again. On March 12, 1997, the Third District Court of Appeal reversed the Department's final order, finding that Capital was not financing automobile club membership under Section 627.8405, Florida Statutes. On April 29, 1997, pursuant to the Third District Court of Appeal's Mandate, the Department issued an amended final order consistent with the Appellate Court's decision. Capital incurred total attorney's fees of $23,010 and costs of $2,024 in defending against the Department's Notice of Intent not to renew Capital's premium finance license. The Department has agreed that the fees and costs are reasonable. Capital is domiciled in the State of Florida. Currently Capital has ten employees. Since its inception, Capital has never had more than 15 employees.
Conclusions Having reviewed the Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review dated March 13, 2013 (Ex. 1), and the Administrative Law Judge’s Order Granting Respondent’s Motion to Relinquish Jurisdiction and Dismiss Case As Moot (Ex. 2), the Agency for Health Care Administration finds concludes as follows: 1. The license of the Licensee/Transferor, License Number 5799, was revoked by Final Order dated March 8, 2013. 2. The change of ownership application filed by the Petitioner/Transferee is moot because the Licensee no longer has a license. 3. The Petitioner’s change of ownership application is therefore withdrawn from further review in accordance with the Administrative Law Judge’s order. ORDERED in Tallahassee, Florida, on this 23 day of _ Marly , 2014. Sel retary th-Care Administration
Other Judicial Opinions A party that is adversely affected by this Final Order is entitled to seek judicial review which shall be instituted by filing one copy of a notice of appeal with the agency clerk of AHCA, and a second copy, along with filing fee as prescribed by law, with the District Court of Appeal in the appellate district where the agency maintains its headquarters or where a party resides. Review of proceedings shall be conducted in accordance with the Florida appellate rules. The notice of appeal must be filed within 30 days of rendition of the order to be reviewed. Filed March 31, 2014 3:56 PM Division of Administative Hearings CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy offhis Final Order was served on the below- named persons/entities by the method designated on this .$/-day of Space , 2014. Richard J. Shoop, Agency Cler Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Telephone (850) 412-3630 Jan Mills Shaddrick Haston, Unit Manager Facilities Intake Unit Licensure Unit Agency for Health Care Administration Agency for Health Care Administration (Electronic Mail) (Electronic Mail) John E. Bradley, Assistant General Counsel Arlene Mayo-Davis, Field Office Manager Office of the General Counsel Local Field Office Agency for Health Care Administration Agency for Health Care Administration (Electronic Mail) (Electronic Mail) Honorable June C. McKinney Administrative Law Judge Division of Administrative Hearings (Electronic Filing) Bernard P. Coniff, Esquire Counsel for Special Care, Inc. 760 Ponce De Leon, Suite. 101 Coral Gables, Florida 33134 (U.S. Mail) HORIDA AGENCY FOR HEALTH CARE ADMINSTRATION Pa RICK SCOTT ELIZABETH DUDEK GOVERNOR Better Health Care for all Floridians SECRETARY 1c, (OP 2% March 13, 2013 my wk eS CERTIFIED MAIL Bernard P. Coniff, Esq. Wilfred Braceras Special Care, Inc. 760 Ponce De Leon, Ste. 101 Coral Gables, Florida 33134 cense Number: 5799 Po} 300 LE 2°) Fy Certified Article Number 756 9008 9111 6923 4301 SENDERS RECORD NOTICE OF INTENT TO DEEM APPLICATION INCOMPLETE AND ENE EY DERM APPLICATION INCOMPLETE AND WITHDRAWN FROM FURTHER REVIEW Dear Sir/s: Your change of ownership (CHOW) application for a license is deemed incomplete and withdrawn from further consideration pursuant to Section 408.806(3)(b), Florida Statutes (F.S.), which states that “Requested information omitted from an application for licensure, license renewal, or change of ownership, other than an inspection, must be filed with the agency within 21 days after the agency’s request for omitted information or the application shall be deemed incomplete and shall be withdrawn from further consideration and the fees shall be forfeited’. You were notified by correspondence dated 01/18/2013 to provide further information addressing identified apparent errors or omissions within twenty-one days from the receipt of the Agency’s correspondence. Our records indicate you received this correspondence by certified mail on 01/24/2013. The requested information was reviewed by the Agency. However, your application is deemed incomplete and withdrawn from further consideration, The outstanding issues remaining for licensure are: Proof of Financial Ability To Operate Conclusion: The applicant has not met the following Statutory filing requirements for proof of financial ability to operate: ¢ The applicant failed to provide independent evidence that the funds necessary for startup costs, working capital, and contingency financing exist and will be available as needed as required under Section 408.810(8), Florida Statutes. Analysis: Staff reviewed the documents submitted by the applicant to demonstrate proof of financial ability to operate. Due to errors and omissions in the filing, staff is unable to evaluate the applicant’s financial ability to operate. Proof of Funding: The applicant did not provide adequate proof of ability to fund start-up costs, working capital, and required contingency funding as required by Section 408.810(8), Florida Statutes. : The inter-office omissions letter dated January 18, 2013, raised the following issues: 2727 Mahan Drive,MS#30 Tallahassee, Florida 32308 Visit AHCA online at ahca.myflorida.com CYHIBIT 1 Mr. Braceras * BOYNTON BEACH ASSIS. LIVING FACILITY Page 2 03/13/2013 CHOW Purchase Price The applicant did not indicate the purchase price on Schedule 1. In addition, the applicant did not provide documentation of the purchase (purchase agreement, bill of sale, etc.) and did not provide proof of available funding to complete the purchase transaction. Please provide supporting documentation indicating the availability of funds to complete the purchase. Proof may include account statements of the purchaser prior to purchase. If the purchase has already been completed (an executed bill of sale exists) please provide documentation of the transfer of funds including canceled checks, and or electronic funds transfer receipts. if the applicant borrowed any of the funds for the purchase from an institution or individual, please disclose the amount borrowed, the identity of the lender, and documentation supporting the loan. While the applicant did indicate a purchase price of $30,000, it again did not provide proof of CHOW price, potentially significantly understating its. funding requirement. Working Capital, and Contingency Financing Working capital as defined on Schedule 1 as the largest cumulative cash need from year one or two, from Schedule 7, Projected Cash Flow Statement, Line 21 of the application. In its application, the agency listed its largest cumulative cash need as $0. However, the correct figure, according to the applicants’ Schedule 7, as filed, is $62,182. In addition to providing funding for start-up costs and working capital requirement, all applicants are required by law to provide for contingency financing. Contingency financing as defined in Section 400.471(2}(e), Florida Statutes, and applies to all agency licensure and requires an applicant’s access to contingency financing in addition to funding anticipated cash flows. The purpose of contingency financing is to provide funding for unanticipated, extraordinary occurrences that the applicant cannot project. The contingency financing should cover at least one-month’s average operating expense over the first year of operations. This funding should be in addition to the funding for working capital and Start-up cost on Schedule 1. On Schedule 1, the applicant calculated its contingency funding requirement as $0. However, based on the financial projections in the application, the total annual operating expense in year one is $1,240,565; therefore, one month’s average operating expense would be $103,380. Note: the amounts above are based on the application as filed. The amounts may change due to the financial and application omissions in this notice. Together, the combined total working capital, and contingency funding requirement for the applicant is $165,562, as filed. In its initial application, the applicant did not complete the working capital or contingency funding components of the minimum funding requirement calculation. The only amount listed were pre- opening costs of $66,375. In its response to omissions, the applicant included those omitted items and adjusted pre-opening costs, which appears to have incorrectly contained the purchase price instead of it being listed separately. Because the applicant did not provide any documentation proving the purchase had been completed, and confirming the purchase price, the purchase price must be added to the minimum funding requirement. Mr. Braceras BOYNTON BEACH ASSIS. .O LIVING FACILITY Page 3 03/13/2013 As a result, the minimum funding requirement, as filed in its omission response, is $213,965 ($60,000 purchase price + $50,780 working capital + $103,185 contingency funding). Insufficient Proof of Funding The applicant did not indicate any source of funds on Schedule 1, and did not provide any supporting documentation as evidence that any required financing exist and are available for immediate use, as directed in the instructions to Schedule 1. Failure to provide proof of ability to fund the minimum funding requirement will result in denial of the application. Pursuant to Schedule 1 instructions, please provide independent, certifiable documentation of the existence and availability of these funds, Examples of documents that support funding include: * copies of current bank statements for accounts owned by the proposed agency, * letters of commitment from a bank or other independent lending source, * or a copy of a line of credit agreement indicating credit line and available credit and any restrictions, * parent company audited financial statements (Note: unaudited financial statements will not be considered as proof of funding ability). In addition, if submitting more than one document as Support for funding, attach a Separate schedule that clearly lists each item, including: Name of the financial institution Cutoff (balance) date Last four digits of the account/identification number Ending balance For a line of credit, along with the above, provide total credit line and available credit Note: any parent company or personal funds pledged to the applicant must meet the above criteria and the owner of the funds must provide a binding letter of financial commitment pledging the funds to the applicant. Note: already paid pre-opening costs being claimed must be supported by paid invoices, receipts, etc. All receipts must be accompanied by a separate schedule prepared in an orderly fashion that recaps the nature of the expenditure, amount, and that ultimately ties to the amount claimed as pre-paid expense on Schedule 1. Receipts received alone, without an orderly analysis attached will not be considered as @ source of funding. As its source of funds the applicant provided bank statements proving $143,760 (one statement indicating $4,916, and the second indicating a balance of $138,844). In addition, the applicant included a copy of a check in the amount of $30,000. Staff is unsure of the nature and relevance of the check as no explanation was given for it. However, the funding shortfall is $70,205 and even if the $30,000 check were proof of some prepaid costs, the minimum funding requirement would still be under funded by $40,205. : Since the proven funding is less than the required funding the applicant has not met the provisions of Section 408.810(8), Florida Statutes, and has not proven the financial ability to operate. Mr. Braceras BOYNTON BEACH ASSIS._D LIVING FACILITY Page 4 03/13/2013 Residential Group Care Inspection Report (DOH Form 4029 Please provide a copy of this report from your county health department. The report must be satisfactory and have a current date. EXPLANATION OF RIGHTS Pursuant to Section 120.569, ES, you have the right to request an administrative hearing. In order to obtain a formal proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S., your request for an administrative hearing must conform to the requirements in Section 28- 106.201, Florida Administrative Code (F.A.C), and must state the material facts you dispute. SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS. Sincerely, Shaddrick Haston, Manage) Assisted Living Unit SH/Pottere ce: Agency Clerk, Mail Stop 3 Legal Intake Unit, Mail Stop 3 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS SPECIAL CARE, INC., Petitioner, vs. Case No. 13-1450 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. ORDER GRANTING RESPONDENT’S MOTION TO RELINQUISH JUR[ISDIC]TION AND DISMISS CASE AS MOOT Respondent's Motion to Relinquish Jurfisdic]tion and Dismiss Case as Moot ("Motion") came before the undersigned on June 10, 2013, in which the Agency for Health Care Administration ("Respondent" or “ACHA") asserted that there are no disputed material facts before the undersigned in this matter. ACHA contends that license number 5799, which Special Care, Inc.,*/ is seeking with its change of ownership application, has been revoked by final agency action. Respondent further contends that since license number 5799 ceases to exist, all collateral matters regarding the license are moot, including sufficiency of an application for Petitioner, which is the issue before the undersigned. On June 17, 2013, Special Care, Inc. filed Petitioner's Objection to Respondent's Motion to Relinquish Jurisdiction and Dismiss Case as Moot ("Response"). In the Response, Petitioner did not dispute the material facts of Respondent's Motion stated in paragraphs two through six. Petitioner only alleged duress by Respondent as the reason for Petitioner's submission of a change of ownership application instead of an initial licensure application. After careful consideration of the pleadings, and there being no disputed issues of material fact to be resolved by the Division of Administrative Hearings since Petitioner's change of ownership application is moot because license number 5799 does not exist, it is, therefore, EXHIBIT 2 ORDERED that: 1. The Motion is granted. 2. The final hearing scheduled for July 10, 2013, is canceled. 3. Jurisdiction is relinquished to the Agency for Health Care Administration for entry of a final order. The file of the Division of Administrative Hearings is closed. DONE AND ORDERED this 19th day of June, 2013, in Tallahassee, Leon County, Florida. COHN, JUNE C. McKINNEY Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 19th day of June, 2013.
The Issue The issues in this protest are, first, whether Respondent clearly erred in determining that Petitioner's application for funding, which had failed to include all of the required financial information concerning its "non-corporation" lender, was ineligible for consideration due to a material, nonwaivable deviation from the specifications of the solicitation; if Petitioner's application was not, in fact, materially nonresponsive, then it will be necessary to decide whether Respondent should exercise its discretion to waive the minor irregularity in Petitioner's application.
Findings Of Fact Respondent Florida Housing Finance Corporation ("FHFC") is a statutorily created, public corporation whose mission is to dispense financial assistance intended to create affordable housing opportunities in the state of Florida. On January 22, 2016, FHFC issued Request for Applications 2016-101 (the "RFA"), whose full title——"Home Financing to Be Used for Rental Developments in Rural Areas"—— generally describes the developments for which FHFC expects to lend approximately $15 million available through the HOME Investment Partnerships Program. The loans are to be made on a competitive basis to selected applicants proposing to construct affordable housing in accordance with the specifications of the RFA, FHFC's generally applicable standards, and all other governing laws. Applications were due on February 25, 2016. Applicants were required to submit a completed and executed application, together with all applicable attachments. One part of the application, which is relevant to the instant dispute, comprised a multipage Development Cost Pro Forma ("Pro Forma"). To complete the Pro Forma, applicants needed to itemize their projected development costs and disclose the sources and amounts of their anticipating funding, the total of which was supposed to equal or exceed expected costs. The RFA divided lenders into two mutually exclusive classes: (a) Regulated Mortgage Lenders, a category which consists essentially of standard banks and credit unions whose operations are overseen by state or federal agencies that regulate financial institutions; and (b) all other lenders, referred to in the RFA as "Non-Corporation" sources. If an applicant chose to rely upon Non-Corporation funding for its project, then it was required under the RFA to provide evidence of the lender's ability to fund the loan, including the lender's financial statements. The failure to submit sufficient evidence of a Non-Corporation lender's wherewithal to finance the project constituted grounds for FHFC not to count that lender as a funding source, which might create a funding shortfall that would render the applicant ineligible. FHFC received nine applications in response to the RFA, including that of Petitioner National Development Foundation, Inc. ("NDF"), an Oviedo-based, Florida corporation that builds affordable housing. In accordance with the RFA, FHFC selected a review committee to evaluate, score, and rank the nine applications. NDF proposed to obtain a first mortgage loan from Neighborhood Lending Partners, Inc. ("NLPI"), to provide both construction and permanent financing for a 30-unit apartment complex to be developed in Macclenny, Florida. NLPI is a multi- bank lending consortium that provides financing to developers of affordable housing. Although NLPI is not a Regulated Mortgage Lender, its member banks are in that category. Nevertheless, it is undisputed that NLPI is a Non-Corporation lender for purposes of the RFA under consideration. Consequently, NDF was required to submit evidence of NLPI's ability to fund the mortgage loan. NDF provided a detailed Term Sheet from NLPI, which described the proposed financing. NDF did not, however, provide NLPI's financial statements with its application. There is no dispute that NDF's application did not strictly conform to the RFA's specifications in this regard. As will be seen, the most hotly contested issue here is whether this deficiency constitutes a nonwaivable material deviation or, rather, a minor irregularity which could be waived at FHFC's discretion. FHFC's review committee determined that, because NLPI did not meet the definition of a Regulated Mortgage Lender, and because NDF had failed to provide the necessary evidence of NLPI's ability to fund, NDF's proposed Non-Corporation funding should not be counted, which effectively removed essential first mortgage financing from NDF's Pro Forma, creating a disqualifying funding shortfall for the applicant. As a result, the committee deemed NDF's application ineligible for lack of financing. At its meeting on May 6, 2016, FHFC's Board of Directors (the "Board"), as urged by its staff, approved the review committee's recommendations with regard to the distribution of funds being allocated under the RFA, including the recommendation to reject NDF's application as ineligible to receive funding. No discussion was had concerning the relative materiality of NDF's failure to provide evidence of NLPI's ability to fund. The Board's action, however, strongly implies that it believed the defect was a nonwaivable material deviation, which is how, in this proceeding, FHFC currently characterizes the deficiency. The question of whether the Board clearly erred in determining that NDF's application was materially nonresponsive is made more complicated by the undisputed fact that, during the meeting on May 6 at which NDF's application was rejected, the Board voted to award funds being made available under a separate program to an applicant (Grove Pointe) whose application had the very same deficiency as NDF's. The material facts of that case, in brief, are that Grove Pointe applied under RFA 2016-104 (the "SAIL RFA") for State Apartment Incentive Loan funding. Grove Pointe was the only applicant. The SAIL RFA required documentation of a Non-Corporation lender's ability to finance, just as did the RFA in this case. Like NDF, Grove Pointe submitted a mortgage loan proposal from NLPI, but failed to provide the consortium's financial statements. The review committee accordingly declined to count the funds Grove Pointe expected to borrow from NLPI, thereby creating a funding shortfall which, in the committee's view, rendered Grove Pointe ineligible for an award. In short, Grove Pointe and NDF ended up in the same situation, for the same reason, after the respective review committees had completed their assigned tasks. At the Board meeting, however, the two similarly situated applicants' fortunes diverged, as staff recommended that the Board offer funding to Grove Pointe on the condition that, within 21 days after the meeting, Grove Pointe cure the deficiency in its application by submitting acceptable evidence of NLPI's ability to provide financing. The Board adopted this recommendation, tacitly waiving the irregularity in Grove Pointe's application (the "Grove Pointe Decision"). The rationale for the Grove Pointe Decision is not entirely clear. When a variance exists between the response to a competitive solicitation and the specifications of the request, the agency must, as a threshold matter, determine whether the variance is a "material deviation" or a "minor irregularity." This is because a material deviation cannot be waived; a response suffering from a material deviation is fatally flawed and must be rejected. If the agency determines, as a matter of ultimate fact, that the deviation is material, therefore, the inquiry is over. If, however, the agency determines that the deviation is not material, but rather is merely a minor irregularity, then it must make another decision, namely whether to waive the minor irregularity, which requires the exercise of discretion. In making the Grove Pointe Decision, the Board did not explicitly decide the threshold question, and even here, in this proceeding, FHFC has not plainly taken an unequivocal position as to whether, in its view, Grove Pointe's failure to provide NLPI's financial statements was a material deviation or a minor irregularity. Careful examination of the Grove Pointe Decision is necessary to assess the strength of NDF's position, which relies heavily upon that "precedent." That is, NDF argues that considerations of consistency and fairness (sometimes called administrative stare decisis) require FHFC to follow the Grove Pointe Decision, which NDF believes is on all fours, in determining NDF's substantial interests. Simply put, it is NDF's contention that FHFC, having approved Grove Pointe's identically defective application, must likewise approve NDF for funding. For its part, FHFC argues that the Grove Pointe Decision is distinguishable and hence inapposite. (Notably, FHFC does not suggest that the decision to fund Grove Pointe was incorrect and should be disregarded for that reason.) Because the parties disagree as to what the Board "held" in the other case, it is important to ascertain the reasoning behind the Grove Pointe Decision. The record shows that the Grove Pointe Decision was taken on three grounds——although one was arguably something of an afterthought, and the others are really two sides of the same coin. The interrelated reasons boil down to the fact that because Grove Pointe was the sole applicant, FHFC could fund Grove Pointe, despite its ineligibility, without having to deny any other applicant's request for funding. Grove Pointe's win, in other words, was not someone else's loss——not, at least, someone identifiable. The absence of other applicants led FHFC to conclude that awarding funding to Grove Pointe would not give the developer a "competitive advantage" over other applicants. Thus, one basis for the Grove Pointe Decision was the supposed lack of a competitive advantage. That there was more funding available than could be awarded to all the applicants——or to the one applicant, as it happened——also prompted FHFC to invoke the "Returned Allocation provision" in the SAIL RFA, which stated as follows: Funding that becomes available after the Board takes action on the Committee's recommendations, due to an Applicant withdrawing its Application, an Applicant declining its Invitation to enter credit underwriting, or an Applicant's inability to satisfy a requirement outlined in this RFA, will be distributed as approved by the Board. Putting aside whether this language actually applies under the circumstances facing FHFC at the time, the reasons for the agency's reliance on the Returned Allocation provision focused, again, on the fact that Grove Pointe was the only applicant, which meant that there was lots of leftover money to distribute, and no one to complain if Grove Pointe received funding, so FHFC might as well get the deal done with the applicant it had, notwithstanding Grove Pointe's apparent ineligibility. The no competitive advantage/unallocated balance grounds can be summed up as the "no harm, no foul" rationale, which, ultimately, provided the principal justification for the Grove Pointe Decision. Notice, however, that this rule applies equally to the waiver of any variance, whether a material deviation or a minor irregularity, for the determinative factor is not the significance of the variance, but rather on how its waiver actually——i.e., not in theory, but in fact——would affect competitors.1/ As mentioned, FHFC has never clearly articulated its determination regarding the materiality of the Grove Pointe application's deficiency, leaving open two possibilities: (a) FHFC believes it has the authority to waive a material deviation where doing so results in "no harm"; or (b) FHFC believes that a variance which, if waived, would result in "no harm" is, for that reason, a minor irregularity that, in the exercise of sound discretion, should be waived. Either of these, therefore, could be considered the rule of the Grove Pointe Decision. The third basis for funding Grove Pointe, which the Board considered but arguably did not view as essential, was FHFC's favorable experience with NLPI, whose ability to provide financing had been proven in past projects, and whose financial statements FHFC had reviewed within the preceding 17 months. FHFC, in other words, was already familiar with the fact of NLPI's fiscal health despite Grove Pointe and NDF's failure to provide evidence thereof. NDF interprets the Grove Pointe Decision as standing for the proposition that the failure to provide financial statements for NLPI is a minor irregularity that should be waived because FHFC knows from experience that NLPI is able to fund mortgage loans.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Florida Housing Finance Corporation enter a final order (i) determining that NDF's failure to include with its application evidence of NLPI's ability to lend funds to NDF constitutes a minor irregularity and (ii) waiving the minor irregularity on the condition that NDF supply the missing information within 21 days after the entry of the final order; or, alternatively, stating the facts and circumstances upon which its discretionary decision not to waive the minor irregularity has been based, so that the outcome will not appear to be arbitrary or capricious, and also to enable a reviewing court to determine whether or not the agency's discretion was abused. DONE AND ENTERED this 18th day of July, 2016, in Tallahassee, Leon County, Florida. S JOHN G. VAN LANINGHAM Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 18th day of July, 2016.
