N E W S     U P D A T E       January 2, 2012           Home
                              Click on Florida Senator / Representative for contact information                                                                                   News Update Archival (Past News items posted)

SB 1516 Senate bill as proposed makes numerous changes to APD services, how I budget is calculated,
funding issues including community resources explored first.  ADT and respite might be changed to not be considered
a "core service" which means it may no longer be available.

Senate Analysis of Bill and review in PDF format Click here.  
Actual Bill Text Click Here, then click on text.
Committee on Health Regulation will tenatively hear bill 1-31-12 @3:30p
Budget committee is last committee prior to going to Senate floor for vote.


APD Group Home Residents to contribute funds effective January 1, 2012.    Some APD residents residing in group homes will be paying a portion of any excessive funds they receive beginning on 1-1-12.   It will be called Residential Fee
Collection.  "Residential fee collection will require APD customers with federal benefits to help pay for their services
that they receive in a group home, foster care facility, residential habilitation center, or comprehensive transitional
education program".   Read the full article here > http://apdcares.org/news/news/2011/new-year.htm

Gov. Rick Scott recommends a larger APD budget eff 7-1-12 to help prevent past deficits.  If legislature adopts it, This would signify a step in the right direction.

IBudget.   Factors that determine your new budget and how formula is implemented.  Word doc here
Fall 2011 presentations by APD to legislature:   http://apd.myflorida.com/publications/legislative/

Want to exercise eat better?
The National Center on Physical Activity and Disability is offering a free, web-based physical activity and nutrition program for people with chronic health conditions, mobility impairments, and physical disabilities. By registering, you will gain exclusive access to exercise and nutrition experts who can provide you with personalized guidance along the way. To sign up anytime for NCPAD's 14-Week Program or for more information please visit http://www.ncpad.org/14weeks/?f=FL and click “join” in the upper right hand corner of the screen.  
To watch an advertisement about the 14-week program please visit http://www.youtube.com/watch?v=tf8bVWSDo4U.
If you have questions, contact a NCPAD 14-Week coach at 1-800-900-8086, ncpad@uic.edu, or via live chat.


New I Budget Website:  APD has a new website that provides details about the new IBudget eff 4-1-12 in District 7 (Orlando area)
APD is conducting comprehensive cost plan budget reviews currently to facilitate implementation.  As a result, some consumers may
experience a reduction or have room for an increase to their budget.  There will likely be another cut to all services in next few
months due to the APD budget shortfall.

APD sends cost cutting measures to Legislature / governor 9-1-11. APD presented to legislature on 9-1-11 several proposals on how it plans to cut the budget by 76+ million dollars.  The 22 page report is worth reading if you want to know the details of what services may get rate cuts and what APD recommends. 

The Agency for Persons with Disabilities (APD), in consultation with the Agency for Health Care Administration and other stakeholders, has met its legislative requirement by submitting a cost-containment report to the president of the Florida Senate, speaker of the House, and governor on September 1. The report analyzes more than two dozen options for controlling expenditures within the Home and Community-Based Services (HCBS) Developmental Disabilities waiver.  The Legislature approved $810 million for the HCBS waiver for the 2011-12 state fiscal year that began on July 1. APD customers received $930 million worth of services during the 2010-11 fiscal year.

To view the Cost-Containment Plan on APD’s website, visit http://apdcares.org/publications/legislative/docs/apd-cost-containment-plan-2011-2012.pdf.

 
Respite Care Pool Created, Cost plans cut by 50% eff 9-1-11 to help reduce APD budget since not enough budgeted for program.
 Basically if you currently receive respite care, your cost plan budget will be reduced by 50% eff 9-1-11.  APD discovered that 50% of the respite funds that are approved are not utilized by consumers.
 Since many times these funds are approved for emergencies or "just in case" we need them.  So a respite pool was created instead to allow for these unused hours to be utilizied if needed.
 APD notice about is published below:

 APD to Create Respite Pool

TALLAHASSEE - After reviewing the use of respite services with stakeholders, the Agency for Persons with Disabilities (APD) is adjusting how families will access the service. Beginning on September 1, APD will reserve 50 percent of respite service from all cost plans and put the hours into a respite pool. Families will be able to access all respite service hours that were previously approved in the individual’s cost plan, if needed.

The review of respite services showed that families traditionally use about half of their respite hours each year, and keep the other half on their cost plan as a safety net for unexpected emergencies. About $19 million dollars of respite services were not used last fiscal year. After discussions with stakeholders, the idea of creating a respite pool to assist families during emergencies won approval.

Respite services are used when the primary caregiver is unavailable to help the person with a disability due to illness, vacation, or other situations.

Families should contact their waiver support coordinator to learn more about this service adjustment. During the year, the waiver support coordinator will handle requests to access the respite pool. Also, APD has been working to develop free respite resources for families in some areas.

The Florida Legislature has mandated that APD bring its Medicaid waiver expenditures within its appropriation. The Legislature approved $810 million for the Home and Community-based Services (HCBS) waiver for the 2011-12 state fiscal year that began on July 1. APD customers received $930 million worth of services during the 2010-11 fiscal year.

For more information on the agency, call 1-866-APD-CARES or visit APDcares.org.

I Budget UPDATE:
The Agency for Persons with Disabilities (APD) announced its statewide implementation schedule for iBudget Florida. iBudget Florida is a new way to deliver Medicaid waiver services that has been approved by both the Florida Legislature and the federal government.

Simultaneously with iBudget Florida, APD is rolling out its customer central record online system throughout the state. This new system reduces paperwork for APD providers so they may focus more on serving the customer. APD annually serves more than 50,000 Floridians with developmental disabilities of autism, cerebral palsy, Down syndrome, intellectual disabilities, spina bifida, and Prader-Willi syndrome.

 The agency’s Medicaid waiver supports about 30,000 Floridians with developmental disabilities so they may live and participate in their local community. Those 30,000 people will all transition to iBudget Florida over the next 10 months.

The final phase is scheduled to be implemented on April 1, 2012, covering 9,490 customers in Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee, Union, Baker,
Duval, St. Johns, Nassau, Brevard, Orange, Osceola, Seminole, Flagler, Volusia, Citrus, Hernando, Lake, Marion, and Sumter counties.

As more information becomes available about iBudget, it will be posted on the agency’s website at APDcares.org. iBudget Florida is designed to make the funding process fair and equitable for all Medicaid waiver customers. It will provide for more opportunities for customers to direct their own care. The new system
will also allow the agency to have more financial predictability.

      Some of the customer benefits of iBudget are:

     · Greater ability to choose services that matter to them, given their unique situations.
     · Greater flexibility for customers to respond to changing needs.
     · Reduced bureaucracy and “red tape.”
     · Support coordinators freed from paperwork to focus on providing help that makes an even greater difference.
     · Confidence that funding is fair compared to other customers who are similarly situated.
     · Reduced likelihood of policy changes that cause significant disruption due to budget deficits.
     · Security of a financially stable system that will be there to serve customers down the road.
     · Greater control over their lives.
      

APD ACTING DIRECTOR INTERViEW JUNE 27, 2011 - 40 minutes on You Tube        

    BUDGET UPDATE:

    -4% RATE cut for all APD MW funded providers.
    -15% reduction taken 4-1 to 4-15-11 on services
    -APD is still millions in deficit for fiscal year 2011-12
    -Support Coordinators job description modified by APD to require them to ask families to voluntarily cut or eliminate MW funded supports.
    -Support Coordinators job expanded to give more emphasis/refer to natural, community and generic supports and resources (free instead of using MW $)
    -APD implemented a budget freeze effective 3-1-11. This means no increases in funded services unless you reduce 1 service to transfer $ to new one.
    Until the revenues increase in the state budget, APD budget will continue to remain extremely tight which means no increases will be the norm and even
     reductions may become typical throughout the year to balance the budget.
   
     Managed Care for APD: 
     No HMO Managed Care for APD program.   But managed care HMOs will be required for healthcare 1-2012 to 7-2012 approximately.
     APD has 3 years to prove to the Legislature that it can balance its budget to prevent an HMO managed care model from happening.
     Senate held strong despite the House pushing HMOs for our 50,000 DD citizens. 
    They heard their voices. Democracy still works.
     Thanks for all of you that took the time to write, call, visit your senator or representative.  It made a difference.

               May 6th 2011 decided the HMO fate of APD.  There will be none, at least from this session.   
          
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 www.FloridaUnitedForChoice.com   It is a grassroots effort to prevent HMOs from taking over APD and your services.  T

I Budgets are coming in late 2011 or 2012. Being tested in Tallahassee area office currently. See powepoint presentation about IBudget here.

 NCI is National Core Indicators:  Florida recently joined over 27 other member states to join resources to improve measures to improve quality of delivered
services to Floridians with developmental disabilities.  See learning center, terms here.  What are the actually indicators? click here for word doc.
 

Tier 1 = $120,000 (not yet implemented by APD but legislatively passed into law 2010)
Tier 2 =$53,625,
Tier 3 = $34,125
Tier 4 =14,422.

Effective 7-1-11. Since ALL provider rates are going down by 4%, the overall budget will decrease and some cuts were necessary.  But if ADT / transportation was
reduced some, either by illness, camp or vacation / holiday time with family may help accommodate this service reduction.

1. IBudgets: (Individual Budgeting) -   More details click on > Questions and Answers 
      - APD presented IBudget to Florida Legislature in February 2010.  
    - Determines MW budget funding levels via QSI, living situation, age etc
      - Consumers with similar needs will receive similar funding levels as well as consumers with greater needs receive greater funding.
      - Gives more flexibility with services and consumer involvement in spending
    -APD not yet sharing IBudget algorithm which is really the essence of what criteria will determine consumers new budget (as of 3-9-10)
   
  2. Flexible Benefit Service:
    - Is optional for enrolled MW consumers
     - Uses Medicaid providers
     - ADT, companion, respite, I.H.S., SEmployment, SLiving
     - Budgets must take a 8% cut to be a part of
     - Option might begin in future per APD

3. New Quality Assurance / Person Centered Planning system:
   -Uses national core indicators
    - Fewer forms
    - Complete forms online
    - Issue service authorizations electronically
  - Emphasizes the consumer abilities

4.  Funding for Dental service
    - For Tier 4:
     - Currently if you are in tier 4, dental is not an allowed service under MW funding.

Questions to Ponder and needed changes to our program
    - When will the IBudget take the place of current tier system and will it be fair?
     - When will the annual rebasing of cost plan budgets be ended since rebasing process costs more money to conduct by APD / WSCs than they save
        as well as not being very fair to many of our consumers?  If it is not ended, when will date for rebasing be changed from around thanksgiving /
        xmas to earlier say in September?   This is the only time many WSCs and APD employees take time off with their families and friends. Basic fairness.
    - When will APD and all of it's certified MW providers utilize a more efficient business model and become fully digital? Currently many providers
       still snail mail volumes of papers to support coordinators (I get 110 pages/month from 1 provider) or APD each month to document their activities/
       services when they could send a digital file such as a pdf file instead. All the major email services are encrypted already or at least a CD disk could
       be mailed out instead.  This change would save everyone time / money and would make data retrieval very fast.  Very few items need to be originals
       such as birth certificates, legal docs. SS card etc. but even these can be scanned from an original for safe  storage and quick retrieval.  
     - When will providers not be required to send monthly bill invoices to WSC since they no longer do the provider billings and providers are responsible
        for and should maintain their OWN documentation for billing purposes?  Why does the WSC need a copy still? ABC lists out providers bills if needed.
     - Since natural and community supports are being emphasized to ease budgetary pressures, two community contacts should substitute for a FF and secondary
       contact for up to two months in a row. So third month back to required face to face for those that currently require FF each month, unless health/safety.
       This change would promote natural and community contacts and promote budgetary cuts when free supports could take over.
     - Eliminate Delmarva monitoring and replace it by state APD employees to conduct monitoring using a digital approach saving millions each year.
     - Providers with years of experience and excellent reputations with good monitoring scores or excellent satisfaction surveys, monitor every 3 yrs instead of yearly
     - Reduce annual 24 hrs to 12 required training for WSCs since doctors only require this amount.  Rates continue to be cut and workloads increased.
     - Encourage and solicit ideas and efficient cutting edge business practices for providers and APD instead of out dated costly approaches.
       Ask the top providers in each district and APD veterans what other improvements / suggestions they would make to our program.  
    

QSI consumer interviews will eventually effect budget tier assignments based upon this assessment of need determining fund / tier category.  There will also be follow up interviews to validate these QSI interviews called SIS. Call support coordinator if unsure about. 
 
If you are assigned tier 4, certain services such as companion, dental and mental health counseling
are NOT covered on this "Family and Supported Living Waiver" you are transferring to within APD. 
I might be able to transfer companion to "in home supports" if your current provider offers this under
this new waiver.

Tier 4 only pays for: ADT, Beh Analysis / Assistant, CMS, EAA, DME, in home supports, pers emerg
response, respite, SE, S.Lvg coaching, transp, and Waiver support coord.  So if your service is not listed
here and you have been assigned to tier 4, then the service ended on 10-14-08.  These new tiers were effective on 10-15-08. these will be eliminated once the Ibudget
takes over.

 If I am your support coordinator, please email, snail mail or fax me.  GeoAndrew@aol.com or 407 246-1874 fax. 



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