This is a letter we received from the Family Care Council.  Interesting!

Family Care Council

Agency for Persons with Disabilities

Patty Houghland, Chairperson 


April 24, 2008

Family Care Council Florida wants to go on record with the following comments on the TIER rule:

We did not have input to the Tiers and do not believe they serve individuals with developmental disabilities well. We recognize, however, that they are in statute and at this time are to be implemented. We believe an individual budget based on a valid assessment is a preferred method of controlling cost and encourage the APD to work to that end. Since that is not what we have at this point in time, and we must work with these TIERS, the FCCF comments are as follows.

Page 2-“65G-4.0021 TIER Waivers (3)-The total billings in any quarter of the state’s fiscal year for any service a client is authorized to receive shall not exceed twenty-five percent (25%) of the total annual cost plan budget for that service.” Family Care Council Florida objects to this provision. We believe it will have many unintentional consequences such as:

• Ensure that individuals will spend all of their funding in the cost plan. It is the practice of use it or lose it.

• Prohibit one-time expenditures because it would all occur within one quarter.

• DME and technology tools would be prohibitive because you would have to spread the cost throughout the fiscal year and a vendor would not be inclined to do that

• Penalize individuals and families as life issues occur.

This restriction assumes the lives of individuals with disabilities happen in quarters, which is ridiculous of course. Dental emergencies, acute illness of an individual or caregiver, equipment needs, or let’s look at respite as a service. A family planning a special vacation that does not include their individual with a disability could only use one quarter of the respite time they have in the plan. That seriously limits what the family is able to do. They would have to ask for increased respite for the year in order to have enough available for spending in one quarter to cover the vacation for that year. This would give the individual a lot more respite than needed and may take away from another necessary service. It penalizes the individual or the family needlessly due to rule that allows only ¼ at a time. We see no benefit to this provision, but we do see a lot of unintended negative