The Issue In this case, the Petitioners challenge the determination by the Respondent that Anastasia Rush, Ph.D. is an employee of the Baker County School Board based upon the Division of Retirement's determination that Dr. Rush is not an independent contractor. The issue is whether Dr. Rush should be a member of the Florida retirement system. This determination which turns upon whether she is an employee of the school district. Which turns upon whether or not she is, and was, an independent contractor providing professional services to the school board pursuant to contract.
Findings Of Fact The Board, in compliance with the statutory mandate requiring special education programs for emotionally-handicapped students, contracted with the Child Guidance Center, Inc., (CGC) to provide assessment and counseling of qualified students. See, Ex. A-B and Tr. 215-217. The Board obtained additional funding from grants to provide its students with these mandated special educational programs relating to mental health. See, Ex. E, F, G, H, and M. The Board contracts with neighboring school boards which are unable to afford their own programs and pay the Baker County Board to provide services to severely emotionally disturbed children in their counties as required by the statute. The Board's contracts with mental health specialists are dependent upon funding for special students from state monies allocated based upon the total number of students and upon grant money. See, Tr. 38 and 215-216. The Board has not established a permanent position for a health care professional to render clinical mental health services. See, Tr. 72 and 217. The Board has contracted for these professional services to severely emotionally handicapped students, as well as for the professional services of occupational therapists and physical therapists. See, Tr. 79. CGC, the first provider of services to emotionally-handicapped students, is a corporation whose business is providing mental health care. See, Tr. 29. The Board contracted annually with CGC beginning in 1982 to provide a specified number of hours of counseling for its qualifying students. See, Tr. 31-33. The number of hours stated in the contract with CGC varied according to the availability of funding and established a financial liability limit on the contract. Each contract between the Board and CGC was for the term of the school year and could be terminated by either party upon 30 days notice. See, Ex. B. The contracts between the Board and CGC provided that the services would be rendered in the Baker County public schools. See, Ex. B. CGC billed the Board for each hour of counseling provided by its employees. See, Ex. B. CGC did its billing and accounting on a quarterly basis and arranged with the Board to be paid on a quarterly basis for its convenience. See, Ex. B; Tr. 145-146. Dr. Rush was an employee of CGC and first began providing mental health services to the students of Baker County in the early 1980's. See, Tr. 142. Dr. Rush is a licensed psychologist specializing in child psychology. Dr. Rush received a graduate degree in psychiatric social work from the University of Athens, Greece, and received a Ph.D. in clinical psychology from the University of Florida. See, Tr. 140-141. Dr. Rush has worked in the field of mental health for approximately 20 years. Dr. Rush began her own practice while still working for CGC through Dr. Freeman under the name of Salisbury Counseling Clinic. See, Tr. 168-169 and 183. In 1990, Dr. Rush no longer wanted to be an employee of CGC and became an independent contractor with CGC. See, Tr. 146-147. Dr. Rush's private practice grew gradually and prior to 1991, she had resigned her employment with CGC, concentrating on her private practice. See, Tr. 146. In 1991, the Board cancelled its contract with CGC. See, Tr. 37-38. Wanda Walker, administrator of the special education programs, approached Dr. Rush and asked her if she would provide the mental health care as an independent contractor, as previously provided by CGC. See, Tr. 37-38. On August 16, 1991, the Board entered into two contracts with Dr. Rush to provide different types of mental health counseling to its students. See, Ex. A One contract between Dr. Rush and the Board provided that Dr. Rush would provide mental health services to the Board for at least nine hours per week, from which two hours would be committed to the special needs of the students in the Opportunity Program at Baker County High School. The contract services were for 37 weeks of the 1991-1992 school year. The cost of the service was $40.00 per hour, and Baker County agreed to pay Dr. Rush an amount not to exceed $14,460.00 for the service. The agreement required Dr. Rush to perform the services at Baker County public school sites, and provided that the mental health services should include psychological evaluations, classroom observations, participation as a member of the crisis intervention team, and consultations with teachers, guidance counselors and other appropriate school personnel. Dr. Rush submitted a statement of hours worked every two weeks, and was paid the contractual rate for each hour of professional services rendered. The contract provided that either party could terminate upon 30 days written notice. The other contract between the Board and Dr. Rush provided that Dr. Rush would provide mental health services to severely emotionally disturbed students in the Day Treatment Program at Southside Educational Center. This contract provided that Dr. Rush would provide case management, assessments and evaluations, consultation to school personnel, mental health services appropriate to the program, and direct the counseling services provided to Day Treatment Program students. The contract provided that Dr. Rush would provide for 10 hours of professional services per week for 37 weeks at a cost of $40.00 per hour not to exceed $14,550.00. The contract provided that Dr. Rush would submit a statement of hours worked every two weeks, and that the agreement could be terminated by either party upon 30 days written notice. On June 4, 1992, Dr. Rush entered into an agreement to provide professional services to the Board for the 1992-1993 school year. This contract duplicated the previous contract for nine hours per week of mental health services for 37 weeks in the 1992-1993 school year at a cost of $40.00 per hour not to exceed $14,460.00. The only significant change in this contract was that the contract covered the provision of services by Dr. Rush or her associate, Nancy Davie. On June 4, 1992, Dr. Rush entered into a contract with the Board to provide mental health services to severely emotionally disturbed students similar to the previous contract for the 1991-1992 school year. The contract for mental health services to severely emotionally disturbed students did not provide for the provision of these services by Nancy Davie. When the June 1992 contracts were executed, Dr. Rush had incorporated her professional practice; however, she entered into the contracts with the Board in her individual name. The Board was unaware of Dr. Rush's incorporation. Dr. Rush did not believe that there was a difference between contracting in her name or the name of her corporation; however, this contract was subsequently amended to indicate that her corporation was the contracting entity. See, Tr. 152-153, 189 and 190. Dr. Rush contracted with the Board in the name of her corporation, Protepon Counseling Center, in 1993. Dr. Rush maintained two offices, one in Jacksonville and one in Macclenny, where she held herself out to the public as a individual providing psychological counseling and where she conducted her professional business. Generally, Dr. Rush and her associates provided their services at the schools within the district; however, Dr. Rush maintained a professional office in Macclenny, Florida, and met with students and their parents at her professional office as necessary. See, Tr. 71. Both Dr. Rush and CGC provided services at the various schools within the district to alleviate the need to transport children and disrupt their schedules. Dr. Rush and her associates used the offices of guidance counsellors when at the various schools. See, Tr. 14 and 85. During the time that Dr. Rush has provided mental health services to the Board, Dr. Rush has provided her own tools for counseling and assessing students. She provides all of her own supplies. See, Tr. 88 and 297-298. Dr. Rush is not reimbursed for the use of her supplies or standardized tests. See, Tr. 211 Dr. Rush provides mental health counseling to private individuals and agencies, to include St. Johns River Hospital, the Center for Life Enrichment, Capp Care, Flamedco, Inc., and the Florida Medical Association Alternative Insurance Program. See, Tr. 160-165. Dr. Rush provides a profit sharing plan to her associates and maintains workers compensation insurance for her employees. See, Tr. 174 and 208. The contracts with the Board make up only a fraction of Dr. Rush's gross income from her professional practice. See, Ex. J(2); Tr. 169-170. Dr. Rush maintains her own retirement fund and has done so since she left CGC in 1991. See, Ex. J(3); Tr. 172-173. Neither the Board or Dr. Rush consider their relationship to be an employment relationship. See, Tr. 149 and 217. It was never the intent of Dr. Rush to be an employee of the Board or the Board's intent for Dr. Rush to be its employee. See, Tr. 149 and 181. Both Dr. Rush and the Board anticipated the continuation of the independent contractor relationship. The Board paid Dr. Rush for the services rendered by her and her associates from the special fund and not from a salary or payroll account. See, Ex. I. Every two weeks, Dr. Rush submitted statements of professional services rendered by her or her associates and charged the Board per hour for these services. See, Tr. 180-182. Dr. Rush was paid for each hour of service which she or her associates provided, and was not paid a salary or reimbursed or compensated for travel costs or supplies. See, Ex. I; Tr. 297 The statements do not indicate whether Dr. Rush or one of her associates provided the service to the Board. The Board never paid any of Dr. Rush's associates. See, Tr. 43-44, 106 and 107. Dr. Rush's associates have always been paid by Dr. Rush. See, Tr. 151-152. The Board never deducted withholding taxes from its payments to Dr. Rush. See, Ex. I. Dr. Rush paid her own social security tax. See, Tr. 207. Dr. Rush was paid by the Board as she is paid by all of her clients at the agreed-upon hourly rate for her professional counseling services. See, Ex. I; Tr. 182. In making its determination, the Division of Retirement relied upon the answers provided by Dr. Rush and Wanda Walker to a questionnaire sent out by the Division of Retirement. See, Ex. O. Both Dr. Rush and Ms. Walker answered the questionnaire without help from legal counsel and without understanding its purpose or legal implications. See, Tr. 77-79, 82, and 176. Dr. Rush provided an annual orientation to new personnel and students; however, she did not take any training program required by the Board during the period of these contracts. The answers provided by Dr. Rush and Ms. Walker were ambiguous regarding the fact that the annual orientation in which Dr. Rush participated was provided by Dr. Rush to Board employees. See, Ex. O; Tr. 70, 88-89, and 178-179. Using the school calendar, Dr. Rush prepared a schedule calendar indicating the dates, times, and school locations at which she or her associates would provide professional services under the contract with the Board. See, Tr. 178. See, Tr. 45-48, and Ex. D. Pursuant to their contract, Dr. Rush provided professional services for the Board at the times and dates when students were attending school. See, Ex. C. Dr. Rush set her own schedule within the confines of the school day and the school year. The purpose of the calendar schedule was to alert teachers as to Dr. Rush's availability at particular schools. See, Tr. 85. Dr. Rush and her associates did not check in with a supervisor at the various schools. Dr. Rush called Ms. Walker, who notified the appropriate school when a new counsellor would be going to that school. See, Tr. 121-122. This practice was designed for security reasons to let the school know for security reasons that a new individual would be providing services. Dr. Rush was available if there was an emergency. When paged, Dr. Rush called the school and determined from the facts if it was necessary for her or one of her associates to respond. See, Tr. 131 and 297. Dr. Rush was not subject to being summoned by Board employees, but exercised her professional judgment about the by of response which was necessary. See, Tr. 131 and 297. Dr. Rush and her associates evaluated students and recorded the results of their testing and observations. They participated as part of the multidisciplinary team required by law to assess special education students and prepare their educational programs. In this regard, the reports of Dr. Rush and her associates were expressions of their professional expert opinion. See, Tr. 66. It was the experience and expertise of Dr. Rush and her associates which the Board sought in contracting with Dr. Rush. The Board did not direct Dr. Rush's counseling of students. See, Tr. 81-87. Dr. Rush and her associates conducted their counseling without any control from the Board. See, Tr. 83-84 and 227.
Recommendation Having considered the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that Dr. Rush be treated as an independent contractor and denied participation in the Florida Retirement System. DONE AND ENTERED this 12th day of January, 1994, in Tallahassee, Florida. STEPHEN F. DEAN Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 12th day of January, 1994. APPENDIX TO RECOMMENDED ORDER CASE NO. 93-3378 Both parties submitted proposed findings which were read and considered. Contrary to the Division's rules, Baker County did not number its findings and did not limit them to short statements of fact. Therefore, although most of its findings were adopted in the order originally presented, it is virtually impossible to identify which of the findings were adopted. In order to assist those attempting to determine which facts were adopted, and which were rejected and why, the numbers listed under the Recommended Order column below reference the paragraphs in the Recommended Order which contain the findings suggested by the Division, or the alternative findings suggested by Baker County which the Hearing Officer determined were based upon the more credible evidence. It is readily apparent when the reason is stated for rejecting the proposed findings. Retirement's Findings Recommended Order Paragraphs 1-3 1,2,3,6,7,13 Paragraph 4 14 Paragraph 5,6 19 Paragraph 7 Rejected as contrary to more detailed descriptions of the contracts at issue. Paragraph 8,9 20,21,22 Paragraph 10 Irrelevant. Paragraph 11 As indicated in the Conclusions, there is no issue concerning the fact that employees of school boards are qualified for membership in the retirement system. The issue is whether Dr. Rush was an employee. Paragraph 12,13,14 23,24,25,49,50 Paragraph 15 26,32,34 Paragraph 16 The differences in the terms of the board's contracts with CGC and Dr. Rush are not relevant. Paragraph 17 1,53,54 Paragraph 18 48,49 Paragraph 19 37-44 Paragraph 20-23 2-4,37-44. The manner in which some non-instructional staff are paid is irrelevant. Paragraph 24 26,28-31 Paragraph 25 45-47 Paragraph 26 51,52 Paragraph 27-28 53 paragraph 29 26,28 Paragraph 30,31 25 Paragraph 32,33 Irrelevant argument. COPIES FURNISHED: A.J. McMullian, III, Director Division of Retirement Cedars Executive Center, Bldg. C 2639 North Monroe Street Tallahassee, FL 32399-1560 Sylvan Strickland, General Counsel Department of Management Services Knight Building, Suite 309 2737 Centerview Drive Tallahassee, FL 32399-0950 John W. Caven, Jr., Esquire Claire M. Merrigan, Esquire CAVEN, CLARK, RAY & TUCKER, P.A. 3306 Independent Square Jacksonville, FL 32202 Jodi B. Jennings, Esquire Assistant General Counsel Florida Division of Retirement Cedars Executive Center, Bldg. C 2639 North Monroe Street Tallahassee, FL 32399-1560 William H. Linder, Secretary Department of Management Services 309 Knight Building 2737 Centerview Drive Tallahassee, FL 32399-0950
The Issue The issues in this case are whether Respondent violated Subsection 458.331(1)(s), Florida Statutes (2009),1 and, if so, what discipline should be imposed.
Findings Of Fact The Department is the state agency charged with regulating the practice of medicine in Florida pursuant to Chapters 456 and 458 and Section 20.43, Florida Statutes. At all times material to this Administrative Complaint, Dr. Campbell was a licensed physician in the State of Florida, having been issued license number ME 34315. Dr. Campbell has suffered two motor vehicle accidents which resulted in closed-head injuries and has sustained damage to his brain resulting from hypoxia from cervical spine surgery. He has some residual effects from his injuries such as some word-finding problems, a tendency to cry easily, trouble with his dexterity, and taking longer than normal to make a point. He takes medications for his brain injuries, including Exelon and Muvigil. In or around January of 2005, Dr. Campbell self- contacted Professional Resource Network (PRN), which is the impaired practitioner’s program for the Board of Medicine pursuant to Section 456.076, Florida Statutes. PRN is a program that monitors the evaluation, care, and treatment of impaired healthcare professionals. PRN oversees random drug screens and provides for the exchange of information between treatment providers and the Department for the protection of the public. In or around November 2005, it was concluded that Dr. Campbell’s then-current cognitive abilities were sufficient to practice medicine safely based on completing the Special Purpose Examination (SPEX). The SPEX is a computerized, multiple-choice examination of current knowledge used by state medical boards to re-examine a licensed or previously-licensed physician’s ongoing level of basic medical knowledge. In or around April of 2006, Dr. Campbell entered into a licensure-long PRN contract, which included the involvement of a psychiatrist. In or around December of 2006, the Agency for Health Care Administration (AHCA) performed a site visit regarding Dr. Campbell’s participation in the LLC Medipass Program. Medipass (Medicaid Provider Access System) is a primary care case management program for Medicaid beneficiaries developed and administered by Florida Medicaid. Florida NetPass LLC provides clinical, pharmaceutical, diagnostic, and financial information for patients to their physicians. It also provides service network services, plan administration, utilization management, credentialing of members, data analysis and reporting, and preferred drug list education services. By letter dated December 5, 2006, Dr. Campbell was advised by Health Network One, Inc. (HN1), of the immediate termination of his Primary Care Services Agreement with HS1 Medical Management, Inc. The basis for the termination of the contract was the site review conducted in December 2006, which led clinical staff to conclude that Dr. Campbell was not mentally competent to practice medicine at that time and that the continuation of the agreement would have a negative effect on the patients’ care. The termination of the contract meant that Dr. Campbell could not provide services to Florida NetPass, MediPass beneficiaries. On April 10, 2007, AHCA advised Dr. Campbell that it was terminating his Medicaid Provider Agreement. In July 2009, PRN sent Dr. Campbell a letter requesting that he provide an update from his psychiatrist, Ann Tyson, M.D. (Dr. Tyson). An update was provided in October 2009 by Dr. Tyson, who concluded that Dr. Campbell’s diagnosis and/or medication at that time did not affect his ability to practice medicine. In October 2009, PRN notified Dr. Campbell that it was necessary for him to get new neuropsychological testing done. Dr. Campbell did not have the funds to get the testing done at that time. In December 2009, Dr. Campbell saw Dano A. Leli, Ph.D. (Dr. Leli), for a neuropsychological evaluation. Dr. Leli credibly concluded as follows: Based on all of the findings contained in this neuropsychological evaluation coupled with the information provided in the available records, Dr. [Campbell] does not appear to be safe to practice his profession as a physician. This conclusion is based on his above-described neuro-cognitive and motor deficits; poor impulse control, emotional lability, lack of respect for interpersonal boundaries, poor stress tolerance, impaired interpersonal reasoning, judgment, planning, and problem-solving skills; lack of insight to how his various disorders are affecting his professional behavior; and his seeming difficulty in receiving any type of constructive feedback designed to help him alter his behavior in a more adaptive fashion. In his deposition, Dr. Leli credibly testified that it was his opinion that Dr. Campbell was not safe to practice medicine at this time. Dr. Campbell has difficulty with interpersonal space. For example, he continued to unintentionally kick the test examiner under the table during his evaluation testing. He also rested his hands unusually close to the examiner’s hands to the extent that it made the examiner uncomfortable. Dr. Campbell did not recognize that he needed to keep boundaries between them. A physician needs to be able to maintain personal boundaries with his patients. Dr. Campbell’s inability to maintain appropriate personal boundaries adversely affects his ability to practice medicine. Dr. Campbell demonstrated poor impulse control and poor stress tolerance during his neuropsychological evaluation. He swore frequently during the testing and had loud verbal temper outbursts. A physician needs to be able to keep his emotions in check when he is seeing patients; otherwise, a physician cannot effectively respond to his patients. During the evaluation, Dr. Campbell told Dr. Leli that he was impulsive and that he cares for his patients too much. Dr. Campbell told Dr. Leli that if he had a patient who was experiencing a heart attack that he would take the patient to the hospital in his personal car rather than call 911 for an ambulance and paramedics. When Dr. Leli asked Dr. Campbell whether Dr. Campbell understood the liability of doing that or the danger to the patient, Dr. Campbell replied that he would still take the patient to the hospital himself. Dr. Campbell’s poor impulse control and poor judgment adversely affect his ability to practice medicine. Dr. Campbell has difficulty in judgment, planning, and problem solving. During the evaluation process, Dr. Campbell kept excusing himself to go to a nearby vending machine to get soft drinks. He went so many times, that the evaluator finally told him to go to a convenience store and purchase as many soft drinks as he needed so that they could finish the testing without the interruptions. Additionally, Dr. Campbell had difficulty in using the vending machine. He tried to put a dollar bill in the machine, but the machine would not take the bill. Dr. Campbell went back to the evaluator, got change, and went back to the vending machine. Dr. Campbell did not seem to know what to do with the coins. Finally, the evaluator told him to put the coins in the machine. A physician needs to be able to plan and problem solve in dealing with patients. Dr. Campbell’s difficulties in these areas adversely affect his ability to practice medicine. Dr. Campbell demonstrated difficulty with motor skills during the evaluation. He was given a test in which he was to tap a key similar to a telegraph key with his finger. He was unable to tap the key with his finger; instead, he placed his whole hand on the key. Dr. Campbell told Dr. Leli that he was having difficulties with his fine motor skills, particularly with his left upper extremity. Dr. Campbell also relayed that he was having tremors in both upper extremities. A physician needs to have fine motor skills in order to touch his patients and make evaluations as well as to use mechanical devices. Dr. Campbell’s difficulties with motor skills adversely affect his ability to practice medicine. Dr. Campbell does not understand how his behavior is affecting other people. During the evaluation, Dr. Campbell began to explain to the examiner a diagnosis of diabetes. After he explained the process, which included the drawing of diagrams, Dr. Campbell asked the examiner to reiterate to him what he had just explained, as if he were trying to educate the examiner. The explanation of diabetes was inappropriate in the context of an evaluation setting, and Dr. Campbell did not appear to know that it was inappropriate. The test results of the evaluation demonstrated that Dr. Campbell’s visual-motor intellectual abilities were significantly declined when compared to functioning on at least a high average level prior to his injuries. He showed a significant decline on tests of visual concentration and attention. He also had difficulties with auditory processing. Dr. Campbell was given a verbal memory test of stories. He would read a story and then would immediately relate the contents of the story. Thirty minutes after reading the story, he would be asked to relate the contents of the story again. Dr. Campbell was average on immediate retrieval, but was borderline impaired on delayed retrieval. This memory problem would adversely affect his care of patients if he cannot recall what the patient has told him within 30 minutes of the conversation with the patient. Dr. Campbell demonstrated difficulties in paying attention to fine visual detail. This impairment adversely relates to the practice of medicine because a physician has to examine a patient’s body and pay attention to fine detail in order to properly evaluate the patient. Dr. Campbell demonstrated some persecutory thinking during his evaluation, where he perceives that people, who are not out to get him, are trying to hurt him. Such thinking can adversely affect his ability to practice medicine because he could easily misperceive an interaction between him and a patient causing him to lose his clinical demeanor and clinical efficacy. In January 2010, Dr. Campbell advised Jerome Gropper, M.D., who was Dr. Campbell’s case manager at PRN, that he had had neuropsychological testing done in December 2009. This was the first time that Dr. Gropper had heard that Dr. Campbell had been tested. Dr. Gropper asked Dr. Campbell to send him a copy of the test results. During January 2010, Dr. Campbell also advised Dr. Gropper that on the way to the testing in December 2009 that he had fallen, had hurt his back, and had taken some Lyrica. The effects of the Lyrica caused him not to be able to finish the test, and he had to come back later to finish the test. On the way home from the first testing he banged up his car. Another time he had taken Lyrica and had made a left hand turn on a red light and had stopped at a green light. Dr. Campbell was required to keep PRN apprised of all the medications that he was taking, and he had failed to do so before taking the Lyrica. Dr. Gropper asked Dr. Campbell if he had a prescription for Lyrica, Dr. Campbell said that he did. When questioned about the prescription, Dr. Campbell became upset and started yelling. Dr. Campbell also told Dr. Gropper that the reason that he had been upset during the site visit in December 2006 was because he had taken Neurontin for back pain, and he had an adverse reaction to the drug. Dr. Gropper asked Dr. Campbell to send a copy of the prescription for Lyrica to PRN. When PRN received a copy of the prescription, it was learned that the medication had been prescribed in 2006. Dr. Gropper considered the taking of a three-year-old prescription to be self-medicating. By letter dated February 12, 2010, Judy S. Rivenbark, M.D., the acting medical director of PRN, notified Dr. Campbell that his monitoring contract with PRN was terminated and that his case would be referred to the Department for further action. By letter dated February 16, 2010, Dr. Rivenbark advised the Department that Dr. Campbell had failed to progress in the PRN program and that PRN was unable to say whether Dr. Campbell was able to practice with reasonable skill and safety. Dr. Tyson has been Dr. Campbell’s psychiatrist since 2007. When asked on deposition whether Dr. Campbell was competent to practice medicine, she replied: I don’t know that. I think there are problems that have been magnified by this process, and I think that, given [Dr. Campbell’s] strengths, that [he] should be given a chance to practice medicine. And I think the only way that will happen is if [he] practice [sic] under the supervision of someone. When asked if it was her opinion that Dr. Campbell could practice safely without the supervision of another physician, Dr. Tyson replied, “I don’t think that I should assume, at this point, that he could practice safely without supervision, no.”
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a final order be entering finding that Dr. Campbell has violated Subsection 458.331(1)(s), Florida Statutes, and suspending his license indefinitely until Dr. Campbell is able to demonstrate the ability to practice with reasonable skill and safety, followed by probation. DONE AND ENTERED this 28th day of July, 2010, in Tallahassee, Leon County, Florida. S SUSAN B. HARRELL 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 28th day of July, 2010.
