Florida Agency for Healthcare Administration Medicaid and Beneficiary Advisory Committee Application

Please complete the information below.
Personal Information
Please select the applicable memberships below.
Application Information
    
    Please indicate which provider type you represent:
  •     State or local advocacy groups or community-based organizations
  •     Primary care provider
  •     Specialty care provider
  •     Long-term care provider
  •     Primary care administrator
  •     Specialty care administrator
  •     Long-term care administrator
  •     Health Plan or Health Plan Associations
  •     Florida Health and Human Services Agencies (APD, DOH, DOEA, and DCF)
    
    Please indicate which beneficiary type you represent:
  •     Current Medicaid beneficiary
  •     Former Medicaid beneficiary
  •     Family members of Medicaid beneficiaries
  •     Unpaid caretakers of Medicaid beneficiaries
Are you representing the following?
  •     Yourself
  •     Association
  •     Industry Trade Group
Florida’s Government in the Sunshine Law, s. 286.011, F.S., commonly referred to as the Sunshine Law, provides a right of access to governmental proceedings of public boards or commissions at both the state and local levels. The law is equally applicable to elected and appointed boards, and applies to any gathering of two or more members of the same board to discuss some matter which will foreseeably come before that board for action.
Members-elect to such boards or commissions are also subject to the Sunshine Law, even though they have not yet taken office. There are three basic requirements of s. 286.011, F.S.:
  • (1) meetings of public boards or commissions must be open to the public;
  • (2) reasonable notice of such meetings must be given; and
  • (3) minutes of the meetings must be taken and promptly recorded.
The complete text of the Government in the Sunshine Law and related statutes may be found in Appendix B.
As such, please note that public meetings are subject to the Sunshine Law and that your name and any information you provide may be included in the meeting minutes, which are subject to public disclosure. The statement serves to inform individuals of the potential disclosure of their personal information and to allow them to make informed decisions about their participation.

By signing this document, I acknowledge reading, understanding, and agreeing to its contents.
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