N.H. v. Agency for Persons With Disabilities

• Court: District Court of Appeal of Florida
• Decided: March 4, 2026
• Docket: 3D2025-1298
• Status: Published

Opinion

Third District Court of Appeal State of Florida

Opinion filed March 4, 2026. Not final until disposition of timely filed motion for rehearing.

________________

No. 3D25-1298 Lower Tribunal No. 24F-18985 ________________

N.H., Appellant,

vs.

Agency for Persons with Disabilities, Appellee.

An Appeal from the State of Florida, Department of Children and Families, Office of Appeal Hearings.

N.H., in proper person.

Erin W. Duncan, Chief Appellate Counsel (Tallahassee), for appellee.

Before FERNANDEZ, GORDO and GOODEN, JJ.

GORDO, J. N.H. appeals from a final order of the Florida Department of Children

and Families’ Office of Appeal Hearings, affirming a decision by the Agency

for Persons with Disabilities (“APD”) to deny her application for enrollment in

a Medicaid waiver program. We have jurisdiction. Fla. R. App. P.

9.030(b)(1)(C). We affirm.

I.

APD administers the iBudget Waiver Program 1 to provide long-term

care services to eligible individuals who prefer to receive services in their

homes or community settings rather than in institutional facilities.

N.H. was born on January 8, 1996. In March 2019, she applied for

enrollment in the iBudget Waiver Program under the eligibility categories of

autism and intellectual disability. APD denied N.H’s application, finding she

did not meet the eligibility criteria, which require a showing that her claimed

disabilities manifested before age eighteen. N.H. timely appealed the denial.

Following a hearing before the Office of Appeals Hearings, the hearing

officer entered a final order affirming APD’s determination that N.H. failed to

meet the eligibility criteria for autism or intellectual disability. N.H. did not

seek judicial review of that final order.

1 The iBudget Florida Waiver is a Medicaid program managed by APD that provides home and community-based services to eligible individuals with developmental disabilities.

2 Nearly five years later, in May 2024, N.H. submitted a second

application for enrollment in the iBudget Waiver Program under the same

eligibility categories—autism and intellectual disability. APD again denied

the application and determined that she was not eligible for the requested

services. N.H. appealed the second denial and requested a hearing.

During the second administrative hearing, APD moved to dismiss the

appeal on the grounds of administrative finality, arguing N.H. failed to provide

any new information material to the eligibility determination. The hearing

officer issued a final order dismissing the appeal, finding the issue presented

in the second proceeding—N.H.’s eligibility under the autism and intellectual

disability categories—was identical to the issue decided in the prior hearing,

which had been fully and fairly litigated. The officer concluded that N.H. had

failed to demonstrate any significant change in circumstances since the first

final order. This appeal followed.

II.

“We review an agency’s conclusions of law de novo and we review the

record to determine whether competent substantial evidence supports the

agency’s decision.” G.R. v. Agency for Perss. with Disabilities, 315 So. 3d

107, 108 (Fla. 3d DCA 2020). “In doing so, ‘we give no deference to agency

interpretations of statutes or rules.’” Id. (quoting A.C. v. Agency for Health

3 Care Admin., 322 So. 3d 1182, 1187 (Fla. 3d DCA 2019)). “In interpreting a

state statute or rule, a state court or an officer hearing an administrative

action pursuant to general law may not defer to an administrative agency’s

interpretation of such statute or rule, and must instead interpret such statute

or rule de novo.” Art. V, § 21, Fla. Const.

III.

N.H. argues her second application for services presented a materially

different issue and the hearing officer therefore improperly dismissed her

appeal.

The rule of administrative finality provides that “orders of administrative

agencies must eventually pass out of the agency’s control and become final

and no longer subject to modification.” Peoples Gas Sys., Inc. v. Mason,

187 So. 2d 335, 339 (Fla. 1966). “This rule assures that there will be a

terminal point in every proceeding at which the parties and the public may

rely on a decision of such an agency as being final and dispositive of the

rights and issues involved therein.” Id.

To overcome the doctrine of administrative finality, a subsequent

application must be supported by new facts, changed conditions, or

additional submissions material to the original agency determination. See

Fla. Power & Light Co. v. Beard, 626 So. 2d 660, 662 (Fla. 1993) (“[T]his

4 Court has recognized exceptions to the doctrine of administrative finality

based on a significant change of circumstances or a demonstrated public

interest.”). “A significant change in circumstances occurs when there has

been a change in the facts or circumstances that led to the original agency

decision.” M.N. v. Agency for Perss. with Disabilities, 395 So. 3d 231, 238

(Fla. 5th DCA 2024).

Here, the record shows N.H. sought identical relief in both

proceedings—a determination that she satisfies the statutory and regulatory

criteria for a developmental disability under the autism or intellectual

disability categories. 2 In each proceeding, however, N.H. failed to establish

a critical statutory requirement: manifestation of the claimed developmental

disability before the age of eighteen.3 Because N.H. did not demonstrate

2 A “developmental disability” must: (1) be attributable to a qualifying condition, including autism or intellectual disability; (2) manifest before age eighteen; and (3) constitute a substantial handicap reasonably be expected to continue indefinitely. § 393.063(11), Fla. Stat. “Intellectual disability” requires significantly subaverage intellectual functioning with concurrent adaptive deficits, manifesting before age eighteen. § 393.063(24), Fla. Stat. “Autism” is defined as a neurologically based developmental disability of extended duration with onset in infancy or childhood and characterized by significant impairments in social interaction, communication, and behavior. § 393.063(5), Fla. Stat. 3 While N.H. submitted two additional items of evidence—a clinical report and a physician’s note—neither provides new information establishing manifestation of a qualifying developmental disability before the age of eighteen.

5 any significant change in circumstances in her second Medicaid waiver

application, we find there is competent substantial evidence to support the

hearing officer’s findings. Accordingly, we are compelled to affirm. See

Pumphrey v. Dep’t of Child. & Fams., 292 So. 3d 1264, 1267 (Fla. 1st DCA

2020) (affirming dismissal of a subsequent Medicaid application where no

significant change in circumstances had been shown); M.M. v. Agency for

Health Care Admin., 337 So. 3d 449, 449 (Fla. 3d DCA 2022) (“We are not

free to substitute our judgment for that of a hearing officer, nor may we

reweigh the evidence presented at the administrative hearing. Our review is

limited to whether the hearing officer’s findings are supported by competent,

substantial evidence.”); J.J. v. Agency for Perss. with Disabilities, 174 So. 3d

372, 372 (Fla. 3d DCA 2014) (“We are prohibited by statute from substituting

our own judgment regarding the disputed facts when the administrative

findings are based on competent, substantial evidence.”).

Affirmed.