Upjohn Healthcare Services, Inc. v. Department of Health & Rehabilitative Services

9 Fla. Supp. 2d 196
CourtState of Florida Division of Administrative Hearings
DecidedOctober 25, 1984
DocketCase No. 83-335R
StatusPublished

This text of 9 Fla. Supp. 2d 196 (Upjohn Healthcare Services, Inc. v. Department of Health & Rehabilitative Services) is published on Counsel Stack Legal Research, covering State of Florida Division of Administrative Hearings primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Upjohn Healthcare Services, Inc. v. Department of Health & Rehabilitative Services, 9 Fla. Supp. 2d 196 (Fla. Super. Ct. 1984).

Opinion

OPINION

DIANE D. TREMOR, Hearing Officer.

Pursuant to notice, an administrative hearing was held before Diane D. Tremor, Hearing Officer with the Division of Administrative Hearing, on May 10 and 11, 1984, in Tallahassee, Florida. This case was consolidated for hearing purposes with the cases of Upjohn Healthcare Services, Inc., v. Department of Health and Rehabilitative Services, [197]*197DOAH Case Number 83-3059, and Department of Health and Rehabilitative Services v. Upjohn Healthcare Services, Inc., DOAH Case Number 83-3248, which are the subject of a separate Recommended Order. The instant proceeding was brought pursuant to Section 120.56, Florida Statutes, and challenges the validity of certain “rules” as embodied in the following documents, copies of which are attached to this order:

(1) An April 7, 1982 memorandum by Gary Clarke, Deputy Assistant Secretary for Health Planning and Development, with attached legal opinion dated March 9, 1982, by James Barclay (“the Clarke memorandum” and “the Barclay opinion”),

(2) The Home Health Planning Review Matrix (“the matrix”),

(3) The April 8, 1983 “OPLC Policy Letter No. 33-83” by Jay Kassack, Director of the Office of Licensure and Certification (“the Kassack policy letter”).

INTRODUCTION

This rule-challenge proceeding was consolidated for hearing purposes with two other cases involving the application of the challenged statements to Upjohn Healthcare Services, Inc. (Upjohn). Case No. 83-3059 challenges the Department of Health and Rehabilitative Services’ denial of Upjohn’s application to add to its Marion County license to operate a home health care agency the adjoining counties of Sumter, Citrus and Lake. Case No. 83-3248 emanates from an Administrative Complaint seeking revocation of, or other disciplinary action against, Upjohn’s Marion County license on the ground that Upjohn is providing home health services in Citrus and/or Lake Counties without a license.

In support of its position in each of the three cases, Upjohn offered the testimony of Dr. Frank A. Sloan, accepted as an expert in the field of economics as applied to home health care agencies; Wilford “Bill” Madsen, a Regional Manager for Upjohn; and R. Warren Dacus, accepted as an expert in the area of health planning. The depositions of Ray Chambis, Gary Clarke, Thomas F. Porter, Nat Ward and Marjorie Turnbull, taken in connection with another proceeding, were received into evidence, as were the depositions of Ms. Turnbull and Jay Kassack taken for the purposes of these proceedings. Upjohn’s Exhibits 1 through 53, 55, 57, 58, 64 through 73 and 85 through 88 were received into evidence.

Testifying on behalf of HRS were Eugene Nelson, the Administrator of HRS’s Office of Community Medical Facilities, who was accepted as [198]*198an expert in health planning; Carol Gormley, the Executive Director of the North Central Florida Health Planning Council; and John Adams, a License Supervisor with HRS’s Office of Licensure and Certification. Testifying by way of deposition were Phyllis Jean Beiro and Kathleen J. Maher. The deposition of Thomas J. Konrad, taken in another proceeding, was also received into evidence, as were HRS’s Exhibits 1 through 11.

Subsequent to the hearing, the parties submitted proposed findings of fact and proposed conclusions of law. To the extent that the parties’ proposed findings are not contained herein, they are rejected as being either not supported by competent substantial evidence, irrelevant or immaterial to the issues in dispute or as constituting legal conclusions as opposed to factual findings.

FINDINGS OF FACT

Upon consideration of the oral and documentary evidence adduced at the hearing, as well as the parties’ stipulated facts, the following facts relevant to this rule-challenge proceeding are found:

(1) Upjohn operates a number of home health agencies throughout the State of Florida, as well as in other states.

(2) Prior to 1975, a . patient served by a proprietary home health agency could not obtain reimbursement under the Medicare program. Such agencies were not able to obtain a Medicare “provider number” unless they were licensed under State law. In 1975, the Legislature enacted the Home Health Services Act, Chapter 400, Part III, Florida Statutes, providing for the licensure of proprietary home health agencies. On July 1, 1977, the “establishment of a new home health agency” became one of the projects subject to Certificate of Need review. HRS’s rules pertaining to Certificate of Need review were amended in October of 1977, to include the “establishment of a new home health agency or a new subunit of an agency” as projects subject to review. During the rule adoption process, HRS specifically considered the suggestion that expansions of service areas by existing home health agencies without new facilities be subject to Certificate of Need review. This suggestion was rejected on the belief that such a requirement was not statutorily authorized.

(3) Prior to 1982, officials within the Office of Community Medical Facilities (OCMF), the office responsible for the Certificate of Need program, generally took the position that the mere geographical expansion of services by an existing certificated and licensed home health agency did not require further Certificate of Need review as long [199]*199as additional physical facilities were not contemplated. The Office of Licensure and Certification (OLC) did, on occasion, require home health agencies to build new offices if it was found that an agency was geographically overextending itself in terms of appropriate supervision or quality of care concerns. In January of 1980, the Director of OLC took the position that petitioner’s licensed Marion County home health agency could not provide services to Citrus County residents without applying for and obtaining a Certificate of Need, and thereafter having its license extended to operate in Citrus County.

(4) In September of 1981, Upjohn was informed by the OCMF that a Certificate of Need was not required for the provision of home health services from its Jacksonville, Duval County, office to patients residing in Nassau, Baker or St. Johns Counties, as long as subunits or other physical facilities were not opened in those counties. The above four counties were all located within the same health service area.

(5) Thereafter, in October of 1981, Upjohn requested advice from the OLC as to whether it could provide services from its Broward County office to patients in Palm Beach County. Noting that it was the understanding of the OLC that a Certificate of Need would be required to authorize any expansion of home health services, the OLC referred Upjohn’s request to the OCMF. The matter was thereafter referred to the HRS legal staff. James M. Barclay, an attorney with the Office of Health Planning and Development, issued Legal Opinion 82-2 on the issue of whether a Certificate of Need was required before a home health agency, licensed to operate in certain counties within a health service area, could provide services to additional counties within the same health service area. It was Mr. Barclay’s opinion that a licensed home health agency could provide services to additional counties within the same health service area without an additional Certificate of Need.

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Bluebook (online)
9 Fla. Supp. 2d 196, Counsel Stack Legal Research, https://law.counselstack.com/opinion/upjohn-healthcare-services-inc-v-department-of-health-rehabilitative-fladivadminhrg-1984.