This is a interesting analysis on what may be the future for mentally challenged persons in the State of Florida.  This is the response from a presentation of the iBudgets, the newest innovation from APD.

Thank you for the information on iBudgets.

I find myself hear the old Kenny Rogers song; you have to know when to hold them, know when to fold them, know when to walk away, know when to run…..

iBudget – Is that not what you get when you rebase whatever Tier you got stuck in?

Correct me if I am wrong but aren’t these really the issues that we are facing?

  1. Waiting list
  2. Limited money (shrinking money)
  3. Sustainability
  4. Equity

How do you determine “Equity?”

  1. Just those on the waiver?  Or for everyone?
  2. Equity for those on the waiting list?  If so, what does that mean?  Do we reduce what those on the waiver now are receiving so those on the waiting list can get something?  Do we prioritize who is not the waiver based on support needs?  The new prioritizing of waiting list put (I think) mentally challenged people who parents retire and move here higher on the list than people who were born here and been on the wait list for years.  For those on the waiver it appears that the funding (Tiers) level were more favorable for those who used the system and not favorable for those family that did not try to get the system to do everything.  You can have two mentally challenged persons who are exactly the same with just one difference.  One lives in a group home and one lives with their family.  The person in the group home is in a higher Tier.  Not because their needs are greater but because their family took advantage of the system funding the group home.
  3. What is fair?  Who decides?

Sustainability – What we are now doing is not sustainable.  We have to either get more money or cut services.  We get more money by either raising taxes or cutting spending somewhere else in the Sate Budget.  Does anyone think that is going to happen?  If so (back to the Kenny Rogers Song), we need to hold them.  We are living this year on stimulus money from the Feds that is not going to happen again. 

Sales taxes are down.  The State budget is shrinking.  Is a medical model sustainable?  At the second meeting of the Alternative Residential Option Work Group (which was held in Orlando) there were two things talked about that I think fit here:

  1. Derrick Dufresne talked about how Group Homes were demographically unsustainable.
  2. Life Share was presented as an option which was then labeled as foster care repackaged.  Before the waiver most people living in group homes were not receiving this funding we now call Res Hab.  I remember the fight about one group home in our area getting Res Hab.  The questions was asked again and again, why did only ARC group homes receive Res Hab in this county?

Limited Money – I am thinking we are at the beginning of the state saying, “we are not going to pay for that anymore.”  They have already done this with NRSS (just to name one program).  It is really what they are doing with the Tiers.  Who would have of ever thought whatever system was developed would not fund 5 days of meaningful day activity?  So if five days are not needed, why pay for five days for anyone?  Why pay for anyone to have any day program when there are people who need group homes?  What is fair (equity)?

Waiting List – For those on the waiver we do not think about this too much.  But at this time I think for every two people on the waive there is one person on the waiting list.  Those on the waiting list are more motivated because they are not receiving anything.  I hear these family saying it is not fair for those on the waiver to get everything and for us to get nothing. 

I also think there is a possibility that policy makers feel lied to.  They were told that the wavier would keep people in the community and be cheaper than putting them in institutions (ICF/MR).  With most of the people who first went on the wavier, families would have never considered putting their family member in an institutional setting. 

Policy makers were told that in the long run it would be cheaper because mentally challenged people would develop new skills, become more independent (hence cheaper) and develop community (natural) supports.  I am thinking this has not happened. 

Now the system has become unsustainable even in good financial times.  Remember when the crisis in APD budget first hit, we were not in a recession, to say nothing of the financial crisis our state and nation are in today.  I know many of my friends who are advocates feel we need to hold our ground and fight.  I think this is a fight we cannot win.

Richard Stimson

The Special Gathering

P.O. Box 685

Cocoa, Fl 32923

‘    321-632-0130

6 321-636-5821

+ rstimson@specialgatherings.com

        www.specialgatherings.com

Sent: Friday, November 06, 2009 9:41 PM
To: rstimson@specialgatherings.com;

Subject: APD – FCCF – iBudgetFlorida Power Point presentations

You all probably know about this…. I haven’t had a chance to read it yet.

Sent: Wednesday, November 04, 2009 9:49 PM
Subject: FCCF-iBudgetFlorida Power Point presentations

Hi All,

Attached please find the Power Point Presentations used to initiate the first meeting of the Stakeholders Work Group. 

Please set time aside to really go over these in detail.  Do not let the length put you off, it is good basic information we need to know.  Your understanding and input is valuable to this process and the positive outcomes that we hope to accomplish.  These PP slides introduce you to terms and language that will be important to know as this moves forward. 

Please feel free to contact Phil Pearson, Patty Houghland or myself, with questions and input.

We will have more to report at the FCCF meeting this month as well.

Hilary Brazzell, APD,  is spearheading this in depth study, and put a lot of effort into these as you will see.  She is doing an excellent job of assisting the group to understand and work to move this along to be ready for presentation to the Legislature in February.  She can be reached at hilary_brazzell@apd.state.fl.us  and really does want questions and constructive feedback from us.

I will follow up with some other readings that may assist you on iBudgets in a few days, and will also bring some additional information to the FCCF meeting as well, but thought the Power Points would be enough for right now. 

Thanks for all that you do,

Betty Kay Clements


FCCF Chairperson
352-753-1163
cbettykay@aol.com
Mission Statement:
The mission of the Family Care Council Florida
is to advocate, educate, and empower
individuals with developmental disabilities and
their families, partnering with the Agency for
Persons with Disabilities (APD), to bring quality
services to individuals for dignity and choice