August 2008


Don’t Get Tired of Doing Good

Galatians 6:9

 

Central Theme:  The church must continue to do good.

Introduction

       1.     Bob Mumford, formerly a famous preacher, once said that it always amazed him the people who were able to continue and grow in Jesus.

       2.     Usually, they weren’t the splashy people. 

       3.     He was careful of the people who always talked big. They didn’t seem to last long.

       4.     The people who grew strong in the Lord usually came and didn’t try to impress anyone or do important and big things.  They were, sometimes, shy.  Almost always they were people who didn’t impress him much

       5.     Have a member read Galatians 6:9. “Do not be weary in well-doing.”

 

       I.     I think this must be my life verse. Because people are always coming up and telling me, “Don’t get tired of doing good.”

 

              A. The point is important.

                   1.  You must learn to pace yourself

                   2.  Richard Stimson, founder of Special Gathering used to say to me all the time. “ Learn to pace yourself. Don’t try to do everything all at once.”

                   3.  People who are successful are the people who know how to pace themselves.

 

              B. Some tricks to learning how to pace yourself.

                   1.  Make yourself be patient and enjoy what you have.

                   2.  Take time off to smell the roses and enjoy God.

                   3.  Don’t be in a hurry to succeed.

                   4.  Accept your limitations.  We all have disabilities.  There are some  things that we won’t be able to do.

 

      II.     Dorcas was a woman who was always doing good.  She got sick and died and the people that she ministered to were the people who helped her.

 

Conclusion–Doing good is the most important thing we do for others.  Learn to be must be patient and gracious with each other and with yourself.

Yesterday, Steve, the man who experienced seizures during our Sunday program, died.  The day before I hand fed him his lunch and we laughed and joked with his mother.  Steve giggled at my silliness which only encouraged me to be sillier.

Today when he was put under anesthesia to have an MRI, his heart began to fade and they were never able to recover him.  The doctors say that he must have had an underlying heart condition that caused his death. 

Steve was 53, an old man in the years of a Downs person but none of us were ready for him to die.  He had not been sick in years.  He went to work every day.  He faithfully came to church.  He climbed the stairs.   I held his mother and sister and they wept.  As I got into the car to return to my home, I wanted to cry but I didn’t want to cry alone.  I called my sister who has a Special Gathering program in South Carolina.  We cried and laughed together, mingling the joy of his life with our pain of parting.  When I came home and saw my husband sitting in his wheelchair, we wept again.

Thank God for his comfort and release but, at times, life is too hard.

I received an e-mail for a young man from an country in Africa who wanted to know how he should prepare to do a ministry within the mentally challenged community.  He had read this blog about The Special Gathering which is a program designed to evangelise and disciple people who are developmentally disabled.  I realized that he would be working with limited resources and that he have many limitation regarding his education.  Here is my answer to him.  

Eric, 
Thank you for your email.  I would begin with studying your Bible and praying for God to help you begin.  Then I would try to gather some people (one or two would be perfect) who are mentally challenged from your church, town or city. Once you have gathered them, you will need to teach them.  I post a sermon on our blog each Sunday.  You should adapt it to fit your particular needs in Ghana.  You want to sing some simple songs (about five or six).  Ask for prayer requests, then take up an offering and have prayer.  Then you will preach, teach the sermon. 
 
I would then have a break, maybe have something very simple to eat.  Perhaps some one from your church would be willing to provide one cracker or cookie for each person, perhaps some simple fruit (mango).  Then after that I would go over the Bible lesson that you have taught in your sermon again.  I actually tell the story two more times.  Then I ask questions, in this way, I have the students tell each other the story one more time.  Then I use a practical question that helps them to apply the lesson to their lives. 
 
The model is very simple to follow and I know it will work.  Thanks for asking.  

The danger of writing a daily entry or column is that you begin to repeat yourself.  You understand, of course, because that’s what your wife does.  She tells the same story about your infamous missed touchdown or the prom or her mother-in-law again and again because it always gets a laugh.  Or she can depend on her audience to shed a tear at the appropriate places. 

This was my great fear in starting the Special Gathering Weblog.  That after two weeks, I would be telling the same things again and again.  Special Gathering is a ministry within the mentally challenged community.  We don’t do social work but classic ministry–evangelism and discipleship.  Over the past months, I’ve realized that I’m learning new things daily about our members and their disabilities and myself.  As an example, there was another emergency in our Melbourne program on Sunday. 

Steve, who doesn’t seizure, had two seizures just after ascending the stairs onto the second story of the educational building.  I wrote extensively about the episode that occurred several weeks ago regarding a seizure.  However, this time was different because the circumstances were altered.  When I called his mother, she told me to NOT call the ambulance.  His seizures had lasted 45 seconds and then 90 seconds.  Because he had never had a seizure, I think she believed that we were mistaken.  We didn’t call 911, as she instructed. 

Yet, once he had come out of the second seizure, two of us were inquiring about his condition.  As we were sitting on the floor with him, it became evident that he was sweating and his skin became extremely clammy.  He complained that his left arm was hurting him.  Of course, these are the classic symptoms of a heart attack.   Immediately, without consulting his mother again, I called 911 and explained the situation to them.  With heart attack or stroke symptoms, delay can be life threatening.  911 should always be called under these circumstances.   

Before his mother could arrive, the fire department was on the scene and the EMT’s were ready to transport him to the hospital.  His mother came within minutes of their arrival and she was more than willing to have the emergency medical team take him. 

As it turned out, he had not had a heart attack but he continued to have multiple seizures all during the day.  Though his mother is a retired nurse, it was a good thing that she allowed him to be transported because his next seizure was life threatening and she would have lost him had he not been under medical supervision. 

Later that day, I relayed the incident to our Executive Director Richard Stimson.  “You must call 911 if there are symptoms of a heart attack,” he reassured me.  “You couldn’t wait for his mother.” 

Perhaps the greatest lesson I learned from this incident was how grateful I am for the continuing education I receive working with Special Gathering.  Each year, we repeat the First Aid Course.  We have annual teacher training that amplifies the importance of team work or emphasizes something regarding disabilities.  Having training from The Special Gathering manual has saved more than one life. 

Because we’ve had four unusual incidents in the past three weeks, I was curious and looked back in my files.  The last unusual incident form for our program was filed about three years ago.  Yet, in that time, I’ve had at least three health and safety training sessions.  I thank God for the provision made years ago to keep our staff and volunteers up to date regarding first aid issues. 

On second thought, perhaps repeating ourselves isn’t such a bad idea.  In fact, it can save lives.

When was the last emergency that you’ve had to handle?  When was your last emergency training event?

We all live with tensions in our lives.  There is the importance of play versus work; work versus family and friends.  We wrestle with maintaining a spiritual connection with the Lord while still being authentic people.  Eating healthy diets balanced with comfort foods that may soothe your feelings during stress.  There is the need for exercise coupled with the body recouping energy gained through rest, sleep and relaxation.  If we are healthy in body, mind and spirit, we have learned to balance each of the tensions in our lives which brings a harmonious hum to each day.

Tension versus Flexibility

Tension versus Flexibility

Within every ministry there are also tensions.  If you are the pastor of a nondisabled congregation, there is usually the tension between studying to teach and preach three to five messages a week and counseling and visitation.  If you are a youth pastor, there will be the tension between study and planning verses counseling and interacting in playful ministry with the youth under your care.  If you are a hospital chaplain, there is the tension between paperwork and praying with and for people who are in pain. 

For people who work with Special Gathering we actually face all of these minitry tension.  As a ministry within the disability community, our goal is to disciple and evangelise the mentally challenged community. In addition, there is the added and constant tension between advocacy and all the other concerns in our ministry bag.  We believe that advocacy is an important part of what we do and our weblog reflects that. Nevertheless, there is a struggle to bring balance, coupled with order.  As the tier letters are going out to our members, we think we must to inform and advise.  These letters will designated the amount of funding an individual will receive for the next year. However, should that take the place of daily devotion?  Maybe and maybe not.  We actually would like to strike a balance. 

Too many people will be left in the dark in this new Tier movement by the State.  These won’t be children with dedicated, activist parents who will wisely scream, yell and demand.  These will be the people who have been placed in the community whose parents are too old to fight or dead. They are the ones who’ve been dropped on their heads during our great social experiment called “independent living.”  I have been told of one client who had $90,000 of supports has been reduced to less than the $35,000 level.  How can that happen?

Yet, we can’t lose our connection with our real Provider and Friend, the Lord Jesus.  This is a time for prayer for our members in Florida and a time for each of us to work for an equitable balance within the State budget.  There is a budget crunch.  The only thing which will bring equity will be God’s hand of balance and love.  We access that grace through His mercy and by our prayers.

What are your members facing?  If not the Tier process, what about the financial stability in your state?

 Here are sample letters you will receive notifying you of your tier assignment.  Remember should you disagree with your placement, you have the right to appeal but it must be done within 10 days so that you can maintain the level of services you are now receiving.  The explanation of the appeal process is given after your letter.

Unfortunately, cut and pasting is somewhat unstable with WordPress blogs.  If you are in Tier 3 or 4, please see the last entry down.

Agency for Persons with Disabilities 

                           NOTICE OF IMPLEMENTATION OF CHANGES IN LAW FOR

TIER WAIVER ASSIGNMENT

EFFECTIVE OCTOBER 1, 2008

 

August 21, 2008

 RE:  Tier Assignment – Tier 1 Waiver

 We previously notified you that the Florida Legislature passed a law that requires the Agency for Persons with Disabilities (APD) to assign individuals receiving Medicaid waiver services to a four-tier waiver system.  The law requiring tier assignment is Section 393.0661, Florida Statutes (2007).  Rule 65G-4.0021 through 65G-4.0025, Florida Administrative Code, contains the criteria for tier assignment.

 

Effective October 1, 2008, you are assigned to Tier 1.  According to the agency’s records, this tier assignment does not require a change to your current waiver services.  You may wish to contact your Waiver Support Coordinator to verify this information.

Your due process hearing rights are described in the enclosed “Notice of Hearing Rights.”

 The Agency for Persons with Disabilities is committed to protecting your health and safety.  Additional information about the tier waivers can be found on the Agency’s website at http://apd.myflorida.com.  You may contact your Waiver Support Coordinator or the local Area APD office if you have questions or need assistance in completing a hearing request.

 Enclosure:  Notice of Hearing Rights  

Notice of Hearing Rights 

The agency tier assignment is an automatic action caused by a change in state law required by Section 393.0661, Florida Statutes (2007) and Agency Rules 65G-4.0021 through 65G-4.0025, Florida Administrative Code.  Therefore, if the only issue you raise is the change to the State law requiring the tier waiver system, your request for a hearing will be denied as authorized by 42 CFR 431.220.   

However, if you believe that the agency’s decision on your tier assignment is wrong, you may be entitled to an administrative hearing as provided in Sections 120.569 and 120.57, Florida Statutes (2007) and 42 CFR 431.220.  A hearing will only be granted if your hearing request states facts that demonstrate there was an error in your tier assignment.  Mediation is not available in this proceeding

 If the agency determines you have a right to hearing, you may represent yourself or use legal counsel, a relative, a friend, or other spokesperson in a hearing on this matter.  If you are not representing yourself, proof of guardianship or other documentation of your representative’s authority to act on your behalf is required with the request for hearing.

 Section 393.125(1)(c), Florida Statutes (2007), states that you must make your hearing request to the agency, in writing, within thirty (30) days of receiving this notice.

 Additionally, your hearing request must include the following information: 

1.      The name, address, and telephone number of the party making the request and the name, address and telephone number of the party’s counsel or representative upon whom service of pleadings and papers must be made;

2.      A statement that you are requesting an administrative hearing;

3.      A list of any facts and circumstances on which you rely to assert an error in your tier assignment,

4.      A reference to, or copy of, the agency tier assignment notice.

5.      A statement indicating the date you received your tier assignment notice, and  

6.      If someone is making the request for hearing on your behalf, a document, such as an Order Appointing Guardian or a written statement of authorization, establishing the representative’s authority to act on your behalf.

 

If you file your request within ten (10) days of receiving notice of your tier assignment, your services will continue at the existing level until the final decision on your request for hearing. 

 

To request a hearing mail or fax your completed request to:

Agency Clerk, Agency for Persons with Disabilities

4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

Facsimile – 850-410-0665

 You may contact your local APD office if you have questions or need assistance in completing a hearing request.  You may also view the Administrative Hearings Rights brochure located at http://apd.myflorida.com/customers/legal/docs/administrative-hearings-guide.pdf

 

Second Tier Letter–Under Cap

 

NOTICE OF IMPLEMENTATION OF CHANGES IN LAW FOR

TIER WAIVER ASSIGNMENT

EFFECTIVE OCTOBER 1, 2008

 

August 20, 2008

 

RE:  Tier Assignment – Tier 2 Waiver

 We previously notified you that the Florida Legislature passed a law that requires the Agency for Persons with Disabilities (APD) to assign individuals receiving Medicaid waiver services to a four-tier waiver system.  The law requiring tier assignment is Section 393.0661, Florida Statutes (2007).  Rule 65G-4.0021 through 65G-4.0025, Florida Administrative Code, contains the criteria for tier assignment.

 

Effective October 1, 2008, you are assigned to the Tier 2 waiver.  The annual spending limit for this tier is $55,000 a year.  According to our agency’s records, you currently receive services within this spending limit and there is no need to make any changes to your services.  You may wish to contact your Waiver Support Coordinator to verify this information.

 

The Agency for Persons with Disabilities is committed to protecting your health and safety.  Additional information about the tier waivers can be found on the Agency’s website at http://apd.myflorida.com.  You may also contact your Waiver Support Coordinator or your local Agency for Persons with Disabilities office if you have questions.

 

Your due process hearing rights are described in the enclosed “Notice of Hearing Rights.”

 

Tier 3 Letter-Under Cap

NOTICE OF IMPLEMENTATION OF CHANGES IN LAW FOR

TIER WAIVER ASSIGNMENT

EFFECTIVE OCTOBER 1, 2008

 

August 20, 2008

 

RE:  Tier Assignment – Tier 3 Waiver

 We previously notified you that the Florida Legislature passed a law that requires the Agency for Persons with Disabilities (APD) to assign individuals receiving Medicaid waiver services to a four-tier waiver system.  The law requiring tier assignment is Section 393.0661, Florida Statutes (2007).  Rule 65G-4.0021 through 65G-4.0025, Florida Administrative Code, contains the criteria for tier assignment.

 Effective October 1, 2008, you are assigned to the Tier 3 waiver.  The annual spending limit for this tier is $35,000 a year.  According to our agency’s records, you currently receive services within this spending limit and there is no need to make any changes to your services.  You may wish to contact your Waiver Support Coordinator to verify this information.

 The Agency for Persons with Disabilities is committed to protecting your health and safety.  Additional information about the tier waivers can be found on the Agency’s website at http://apd.myflorida.com.  You may also contact your Waiver Support Coordinator or your local Agency for Persons with Disabilities office if you have questions.

 Your due process hearing rights are described in the enclosed “Notice of Hearing Rights.”

 Enclosure:  Notice of Hearing Rights

  

Notice of Hearing Rights

 

The agency tier assignment is an automatic action caused by a change in state law required by Section 393.0661, Florida Statutes (2007) and Agency Rules 65G-4.0021 through 65G-4.0025, Florida Administrative Code.  Therefore, if the only issue you raise is the change to the State law requiring the tier waiver system, your request for a hearing will be denied as authorized by 42 CFR 431.220.   

 

However, if you believe that the agency’s decision on your tier assignment is wrong, you may be entitled to an administrative hearing as provided in Sections 120.569 and 120.57, Florida Statutes (2007) and 42 CFR 431.220.  A hearing will only be granted if your hearing request states facts that demonstrate there was an error in your tier assignment.  Mediation is not available in this proceeding

 

If the agency determines you have a right to hearing, you may represent yourself or use legal counsel, a relative, a friend, or other spokesperson in a hearing on this matter.  If you are not representing yourself, proof of guardianship or other documentation of your representative’s authority to act on your behalf is required with the request for hearing.

 

Section 393.125(1)(c), Florida Statutes (2007), states that you must make your hearing request to the agency, in writing, within thirty (30) days of receiving this notice.

 

Additionally, your hearing request must include the following information: 

1.      The name, address, and telephone number of the party making the request and the name, address and telephone number of the party’s counsel or representative upon whom service of pleadings and papers must be made;

2.      A statement that you are requesting an administrative hearing;

3.      A list of any facts and circumstances on which you rely to assert an error in your tier assignment,

4.      A reference to, or copy of, the agency tier assignment notice.

5.      A statement indicating the date you received your tier assignment notice, and  

6.      If someone is making the request for hearing on your behalf, a document, such as an Order Appointing Guardian or a written statement of authorization, establishing the representative’s authority to act on your behalf.

 

If you file your request within ten (10) days of receiving notice of your tier assignment, your services will continue at the existing level until the final decision on your request for hearing. 

 

To request a hearing mail or fax your completed request to:

Agency Clerk, Agency for Persons with Disabilities

4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

Facsimile – 850-410-0665

 

You may contact your local APD office if you have questions or need assistance in completing a hearing request.  You may also view the Administrative Hearings Rights brochure located at http://apd.myflorida.com/customers/legal/docs/administrative-hearings-guide.pdf

 

 

 

 

 

Here are sample letters you will receive notifying you of your tier assignment.  Remember should you disagree with your placement, you have the right to appeal but it must be done within 10 days so that you can maintain the level of services you are now receiving.  The explanation of the appeal process is given after your letter.

Unfortunately, cut and pasting is somewhat unstable with WordPress blogs.  If you believe you will be in Tier 1 or 2, please see the next entry up.

NOTICE OF IMPLEMENTATION OF CHANGES IN LAW FOR

TIER WAIVER ASSIGNMENT

EFFECTIVE OCTOBER 1, 2008

 

August 20, 2008

 

RE:  Tier Assignment – Tier 3 Waiver

 

 

We previously notified you that the Florida Legislature passed a law that requires the Agency for Persons with Disabilities (APD) to assign individuals receiving Medicaid waiver services to a four-tier waiver system.  The law requiring tier assignment is Section 393.0661, Florida Statutes (2007).  Rule 65G-4.0021 through 65G-4.0025, Florida Administrative Code, contains the criteria for tier assignment.

 

Effective October 1, 2008, you are assigned to the Tier 3 waiver.  The annual spending limit for this tier is $35,000 a year.  According to our agency’s records, you currently receive services within this spending limit and there is no need to make any changes to your services.  You may wish to contact your Waiver Support Coordinator to verify this information.

 

The Agency for Persons with Disabilities is committed to protecting your health and safety.  Additional information about the tier waivers can be found on the Agency’s website at http://apd.myflorida.com.  You may also contact your Waiver Support Coordinator or your local Agency for Persons with Disabilities office if you have questions.

 

Your due process hearing rights are described in the enclosed “Notice of Hearing Rights.”

 

 

Enclosure:  Notice of Hearing Rights

 

 

Notice of Hearing Rights

 

The agency tier assignment is an automatic action caused by a change in state law required by Section 393.0661, Florida Statutes (2007) and Agency Rules 65G-4.0021 through 65G-4.0025, Florida Administrative Code.  Therefore, if the only issue you raise is the change to the State law requiring the tier waiver system, your request for a hearing will be denied as authorized by 42 CFR 431.220.   

 

However, if you believe that the agency’s decision on your tier assignment is wrong, you may be entitled to an administrative hearing as provided in Sections 120.569 and 120.57, Florida Statutes (2007) and 42 CFR 431.220.  A hearing will only be granted if your hearing request states facts that demonstrate there was an error in your tier assignment.  Mediation is not available in this proceeding

 

If the agency determines you have a right to hearing, you may represent yourself or use legal counsel, a relative, a friend, or other spokesperson in a hearing on this matter.  If you are not representing yourself, proof of guardianship or other documentation of your representative’s authority to act on your behalf is required with the request for hearing.

 

Section 393.125(1)(c), Florida Statutes (2007), states that you must make your hearing request to the agency, in writing, within thirty (30) days of receiving this notice.

 

Additionally, your hearing request must include the following information: 

1.      The name, address, and telephone number of the party making the request and the name, address and telephone number of the party’s counsel or representative upon whom service of pleadings and papers must be made;

2.      A statement that you are requesting an administrative hearing;

3.      A list of any facts and circumstances on which you rely to assert an error in your tier assignment,

4.      A reference to, or copy of, the agency tier assignment notice.

5.      A statement indicating the date you received your tier assignment notice, and  

6.      If someone is making the request for hearing on your behalf, a document, such as an Order Appointing Guardian or a written statement of authorization, establishing the representative’s authority to act on your behalf.

 

If you file your request within ten (10) days of receiving notice of your tier assignment, your services will continue at the existing level until the final decision on your request for hearing. 

 

To request a hearing mail or fax your completed request to:

Agency Clerk, Agency for Persons with Disabilities

4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

Facsimile – 850-410-0665

 

You may contact your local APD office if you have questions or need assistance in completing a hearing request.  You may also view the Administrative Hearings Rights brochure located at http://apd.myflorida.com/customers/legal/docs/administrative-hearings-guide.pdf

 

 

Tier 4 Letter 

 

NOTICE OF IMPLEMENTATION OF CHANGES IN LAW FOR

TIER WAIVER ASSIGNMENT

EFFECTIVE OCTOBER 1, 2008

 

August 20, 2008

 

Re: Tier Assignment – Tier 4 Waiver

 

We previously notified you that the Florida Legislature passed a law that requires the Agency for Persons with Disabilities (APD) to assign individuals receiving Medicaid waiver services to a four-tier waiver system.  The law requiring tier assignment is Section 393.0661, Florida Statutes (2007).  Rule 65G-4.0021 through 65G-4.0025, Florida Administrative Code, contains the criteria for tier assignment.

 

Effective October 1, 2008, you are assigned to the Tier 4 waiver.  The annual spending limit for this tier is $14,792 a year.  The following services are available on the Tier 4 waiver:

 

Adult Day Training

In Home Support Services

Behavior Analysis

Behavior Assistant

Personal Emergency Response System

Consumable Medical Supplies

Respite Care

Durable Medical Equipment

Supported Employment

Environmental Accessibility Adaptations

Supported Living Coaching

Waiver Support Coordination

Transportation

 

The following Developmental Disabilities waiver services are not available on Tier 4.  If you have been receiving any of these services, they will be terminated effective September 30, 2008.  For individuals enrolled in the Tier 4 waiver from the DD waiver, however, substitution of some of the above listed services can be made to meet your needs. 

 

Adult Dental

Companion

Dietitian

Medication Review

Occupational Therapy

Personal Care Assistance

Physical Therapy

Private Duty Nursing

Residential Habilitation

Residential Nursing

Respiratory Therapy

Skilled Nursing

Special Medical Home Care

Specialized Mental Health

Speech Therapy

 

 

In creating the new four-tier waiver system, the Legislature required client choice in selecting waiver services.  You current cost plan may exceed the spending limit for Tier 4, or you may receive one or more services that are no longer available to you.  APD encourages you to immediately contact your Waiver Support Coordinator to discuss information about your tier assignment and cost plan.  APD is supplying your Waiver Support Coordinator with information on how to assist you in choosing services to adjust your current approved plan to comply with the statutory limits of Tier 4. Your Waiver Support Coordinator can assist you in choosing the services that are most important to you and adjusting your plan to stay within the $14,792 annual limit.

 

If your cost plan exceeds $14,792 or you receive services that are being terminated, your cost plan must be revised and submitted to the Area Office by your Waiver Support Coordinator no later than September 10, 2008.  Your waiver support coordinator must submit the adjusted cost plan to the APD area office for review and final approval. 

 

If you are under 21 years old and approved for personal care assistance services, these services will remain available to you, but they will not be paid through an APD waiver.  Thus, when adjusting your cost plan to bring it within your annual limit, the cost of personal care assistance services will not be included in the calculation.

 

Your due process hearing rights are described in the enclosed “Notice of Hearing Rights.”

 

           The Agency for Persons with Disabilities is committed to protecting your health and safety.  Additional information about the Tier Waivers can be found on the Agency’s website at http://apd.myflorida.com.  You may also contact your Waiver Support Coordinator or the local Area Agency for Persons with Disabilities office if you have questions or need assistance in completing a hearing request.

 

Enclosure:  Notice of Hearing Rights

Notice of Hearing Rights

 

The agency tier assignment is an automatic action caused by a change in state law required by Section 393.0661, Florida Statutes (2007) and Agency Rules 65G-4.0021 through 65G-4.0025, Florida Administrative Code.  Therefore, if the only issue you raise is the change to the State law requiring the tier waiver system, your request for a hearing will be denied as authorized by 42 CFR 431.220.   

 

However, if you believe that the agency’s decision on your tier assignment is wrong, you may be entitled to an administrative hearing as provided in Sections 120.569 and 120.57, Florida Statutes (2007) and 42 CFR 431.220.  A hearing will only be granted if your hearing request states facts that demonstrate there was an error in your tier assignment.  Mediation is not available in this proceeding

 

If the agency determines you have a right to hearing, you may represent yourself or use legal counsel, a relative, a friend, or other spokesperson in a hearing on this matter.  If you are not representing yourself, proof of guardianship or other documentation of your representative’s authority to act on your behalf is required with the request for hearing.

 

Section 393.125(1)(c), Florida Statutes (2007), states that you must make your hearing request to the agency, in writing, within thirty (30) days of receiving this notice.

 

Additionally, your hearing request must include the following information: 

1.      The name, address, and telephone number of the party making the request and the name, address and telephone number of the party’s counsel or representative upon whom service of pleadings and papers must be made;

2.      A statement that you are requesting an administrative hearing;

3.      A list of any facts and circumstances on which you rely to assert an error in your tier assignment,

4.      A reference to, or copy of, the agency tier assignment notice.

5.      A statement indicating the date you received your tier assignment notice, and  

6.      If someone is making the request for hearing on your behalf, a document, such as an Order Appointing Guardian or a written statement of authorization, establishing the representative’s authority to act on your behalf.

 

If you file your request within ten (10) days of receiving notice of your tier assignment, your services will continue at the existing level until the final decision on your request for hearing. 

 

To request a hearing mail or fax your completed request to:

Agency Clerk, Agency for Persons with Disabilities

4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

Facsimile – 850-410-0665

 

You may contact your local APD office if you have questions or need assistance in completing a hearing request.  You may also view the Administrative Hearings Rights brochure located at http://apd.myflorida.com/customers/legal/docs/administrative-hearings-guide.pdf

 

Ready or Not--Here I come

Ready or Not--Here I come

I love change and moving furniture and being involved in a dynamic organization like The Special Gathering that is constantly looking for ways to make things better and improve.  As a ministry within the developmentally disabled community, there are a myriad of things to learn and experience.  Each day must be a new beginning and adventure.  Though our mission remains focused on discipleship and evangelism, the way we do things is open to discussion and growth.  This brings me a lot of pleasure.

However, there is a down side to change.  That comes when you are asked to change at the last minute and you ain’t prepared.  That was the opportunity we had on Sunday and it turned into an exciting adventure.  First United Methodist Church of Melbourne, our gracious host church in South Brevard, was having a wonderful celebration with all the ministries of the church participating.  Because we must catch our buses to go home, it was decided that we would not have our choir sing or attend the worship service. 

Yet, during preparation for our worship service, we were approached by the pastor and he asked that our choir sing at the beginning of the joint worship service.  “Sing the song you were practicing a few minutes ago.  It sounded great,” the Senior Pastor, John Denmark, requested.  My concern was that the choir had only sung that song about five or six times.   I don’t mean that we had practiced it during six rehearsals.  I mean that we had only sung this song a total of five, maybe six, times.

Singing a new song after so few rehearsals would be a feat for any choir but our members are developmentally delayed.  It seemed impossible.  However, the choir was more than game. “They can’t sing.  They aren’t wearing their uniform,” was heard from several naysayers.  I admit that Stuart’s shorts weren’t appealing to me.  Yet, it was a celebration and this is Florida where semi-formal wear always means clean jeans. 

Leslie is a committed Christian who would be singing the solo for this song in the Christmas play where we intended to sing it for the first time.  Leslie’s smile is amazing and her willingness to cooperate is legendary.  But Leslie’s voice has such a narrow range that most people would call her a monotone.  I found that this song matched the few notes she is able to sing.  However, did I go so far as let her sing during the opening of a celebration with about 1,500 people?  My decision was yes.  And no one was disappointed, especially Leslie.  The tenderness and compassion displayed in her facial expression and especially in her eyes told the listening congregation that this young woman loves Jesus with all her heart. 

I was so proud of our choir but I was especially excited for Leslie.  Excellence is vital in a performance but love is much more important.  Leslie has a terminal disease and we could lose her any moment.  I’m so pleased that 1,500 people could see and witness her desire to please her savior. 

Ready or not–we came and we sang and I’m so happy we did.

Has there been a time that you stepped out when you didn’t feel prepared?  What were the results?

Photo by Volar

Yes, the Howard family sat on our home with Fay beating us up from Monday morning until Thursday.  Living two blocks from the ocean, she just languished over our small beach town and whipped and blew and stomped and spit.  She pulled into the ocean and came back with her tail-end bumping and knocking us some more. 

Thanks to the wonderful renovations and hurricane hardening done by Able House Construction and the owner Brad Shea, our home was hurricane ready and we suffered no damage to our house.  We did end up with a room-sized bougainvillea in our pool; but that was minor compared to previous hurricane damage inflicted to our home.

I had written two blog entries anticipating that our electricity would go out.  Well, other than a couple of minutes here and there, we didn’t lose our electricity but we did lose our telephone connection from Wednesday until late Saturday.  I am still on dial up; therefore, we had no Internet connection.  However, our phone is back and so am I.

I had a great conversation with Steve, a choir member and deacon at Special Gathering, on our way to chapel program this morning.  Special Gathering is a ministry within the mentally challenged community.  We have Bible studies and chapel services for our members, emphasizing discipleship and evangelism.  Steve and I decided that we weren’t ready for retirement.  We are too mean and grumpy having to stay at home and do nothing but house work.  Steve groused, “I missed going to work.”  And I agreed with a irritated groan. 

Without my Internet connection, there was so many things I couldn’t do.  As a small ministry, we find that the Internet allows us to do many things that would be impossible otherwise.  It was wonderful to have Fay gone.  The only problem is that I now have more work to do than I can accomplish because I lost a full week.  Some people can’t be satisfied.

What about you?  Have you had a week that nothing was accomplished only to realize that you were left with an avalanche of tasks to accomplish?  How did you get everything done?

 This is an e-mail I received explaining your right to appeal your Tier Placement.  It also gives your great information regarding how and why to start the process.  As always when I cut and paste, I never know what the format will turn out to be but the information is what is needed more than a pretty entry.  Thanks for your patience.

Advocacy Center for Persons with Disabilities, Inc.
 Your Rights Regarding The Implementation Of The

APD Tier System: Challenging Tier Placements

In 2007, the Florida Legislature amended section 393.0661, Florida Statutes, to implement a four-tiered waiver system to serve clients with developmental disabilities in the DD and Family and Supported Living Waivers. APD published a set of proposed rules to implement the tiers and held a public hearing on April 24, 2008. Four waiver recipients, Southern Legal Counsel and the Advocacy Center for Persons with Disabilities, Inc., filed a challenge to the proposed rules: 

 

BACKGROUND

 

Moreland vs. APD, DOAH case number 08-2199RP. The hearing on the proposed rule challenge was held on June 24 and 25.

CONCLUSION OF THE CHALLENGE TO THE PROPOSED RULES

On August 6, 2008, the Administrative Law Judge issued the Final Order in the case finding the proposed rules valid. APD may now finalize and implement the proposed rules.

WHAT YOU SHOULD DO NOW

APD will send out individual notices informing you of your tier assignment. In the notice, APD will include information about your rights to challenge the tier assignment and about working with your support coordinator to choose the services that are most important to you to stay within the limits of your tier assignment. At the time that you receive your notice, if the tier assignment significantly affects the services you are receiving you may challenge the assignment.

If you challenge the tier assignments, services cannot be reduced until the hearing process is concluded.

APD has posted information on its website, http://apd.myflorida.com concerning the procedures they will use to implement the tier system.

YOUR RIGHTS

TO CHALLENGE YOUR TIER ASSIGNMENT BY REQUESTING AN ADMINISTRATIVE HEARING; and

TO HAVE YOUR SERVICES CONTINUE IF YOU REQUEST AN ADMINISTRATIVE HEARING WITHIN 10 DAYS.

2

DECISION TO CHALLENGE TIER ASSIGNMENTS

Some things you should consider in making the decision whether to challenge the tier assignment are:

You may challenge

the tier placement  on the basis that it does not meet your needs. You will have to show that you qualify for another tier.

 

If your tier assignment does not make a significant difference in the services you are receiving, challenging the tier assignments may not be indicated and/or successful.

 

DECISION TO CHALLENGE TIER ASSIGNMENTS

Some things you should consider in making the decision whether to challenge the tier assignment are:

You may challenge

the tier placement  on the basis that it does not meet your needs. You will have to show that you qualify for another tier.

 

 

 

 

If your tier assignment does not make a significant difference in the services you are receiving, challenging the tier assignments may not be indicated and/or successful.

 

When and if you receive a Notice of Tier Assignment, you have the right:  

 

 

Some things you should consider in making the decision whether to challenge the tier assignment are:

You may challenge the tier placement  on the basis that it does not meet your needs. You will have to show that you qualify for another tier.

If your tier assignment does not make a significant difference in the services you are receiving, challenging the tier assignments may not be indicated and/or successful.

 

If you are the parent of a minor child living at home, your services should not change and should continue under state plan Medicaid. Personal Care Assistance services for minors will continue as a Medicaid state plan service. You may want to proceed to challenge the tier assignment only if there are waiver specific services that exceed the tier limitations. APD has indicated that it will review the petitions to determine initially whether it had made a mistake on the assignment prior to forwarding the petition to the Division of Administrative Hearings.

 

WHERE TO GET HELP

The Advocacy Center for Persons with Disabilities, Inc., http://www.advocacycenter.org has instructions available to assist you regarding filing a petition and the hearing process. It is in the form of a manual and is entitled “When They Don’t Play Fair, Level the Playing Field.”

Three Rivers Legal Services, http://www.trls.org.

Southern Legal Counsel, 352-271-8890

Florida Legal Services, http://www.floridalegal.org/

Jacksonville Area Legal Aid, 904-356-8371

Advocacy Center, CARES team, 850-488-9071, 1-800-342-0823

 

 

 

 

I have a check list:

  • Water
  • First Aid kit
  • canned goods/snacks
  • ice
  • dry ice, if possible
  • gasoline for the generator
  • clothes and personal items for evacuation
  • one item you think you can’t live without
  • family photos
  • bills and financial information
  • candles and matches, flashlights and batteries
  • kerosene for the lanterns

I also include a few things that I wouldn’t allow myself to have in ordinary times, like gooey, yummy treats that will throw my system out of whack for a couple of hours.

However, my greatest concern isn’t what I will do in a hurricane.  It isn’t even how I’ll take care of my physically frail husband because we deal with his disability everyday and we have a plan. 

What about the most vulnerable in our communities?

What about the most vulnerable in our communities?

My concerns is what will happen to the members of The Special Gathering, a ministry within the disability community.  We do chapel services and Bible studies for persons who are developmentally delayed.  They remain a vulnerable population. 

The members who are in group homes or with their families are of minimal concern. Eric will mutter and studder, fume and prance; but in the end his parents will take him to a safe place and he will be calmed.  No.  It is the people who have been placed in apartments in this great inclusive social experiment that give me sleepness nights. 

It is Saul who believes everything that his self-proclaimed, “hair-brained” companion tells him.  Saul believes that taking his companion’s 195 pound Rockwilder dog would be a better pet for him than a cat.  Even though he’s job requires him to be gone all day and he lives in a small one bedroom apartment with no lawn.  Why would he believe this?  Because she told him it would be a good idea; and she can no longer take responsiblity for the dog.    

It is Katy who lives in her own house and does weekly trips to the hospital emergency room with fantom or self-inflicted pain to get attention and more pain-killing drugs.  I feel a responsiblity to the married couple who no longer comes to SpG but whose supported living coach makes emergency trips to visit her children in NC during each hurricane disaster. 

It is during times of tragedy that I wonder into what kind of social-action plan have we thrown the mentally challenged community?  Where are the helps when they seem to be needed most? 

Do you have any answers to these questions?  Is your state prepared for the disasters that hit every community in regard to people who are most vulnerable?

My son, a retired major in the Air Force, often talks about not falling into a victim mentality.  There is no doubt in my mind that this is an essential element when you want to be successful and you have a disability.  One thing that deeply impressed me about Frank Howard when I first met him was that even though he had an extremely awkward gait, there was nothing pitiful about this young man.  I was so impressed that I later married him. 

After 46 years of marriage, I find he maintains a determined spirit that he won’t pity himself because of his disability.  While his health is failing by inches each day, he resists the temptation to feel sorry for himself.

The victim mentality manifests itself in many different ways.  First, there is self-pity.  Of course, everyone falls into the pit of pity in occasion but this is different.  It is a permanent odor that screams, “Look at me!  I’m different.  My life is worse than everyone else!”

Second, there is a sense of entitlement.  Perhaps it manifests itself in expecting favors without feeling that you need to return them.  Helen was a helper at one of the churches where I held a position.  She was a volunteer and I gladly picked her up and took her home on the days she worked.  We went out to lunch and I usually paid for her meal. 

Helen had never driven a car.  One day as I drove her home, we got into a conversation about how hard it was for her to get rides now that her husband was dead.  “You could ride the bus,” I offered to her. 

“Are you kidding me?  They charge 50 cents every time you ride.  It would be a dollar for me to get anywhere I wanted to go.”

“Well,” I said innocently, “you have to pay your friends more than that when they pick you up to take you places.”

She lifted her head and raised her hand in a rather emphatic gesture, “I don’t pay anyone anything to give me a ride,” she said.  “It’s bad enough that I don’t have a car.  I would never pay for a ride.  I need my money.”

“But your friends are elderly and retired the same as you,” I ignorantly pursued the subject jumping carelessly into the lion’s den.

With great fierceness, she raised her voice and spoke slowly as though I had suddenly become hard of understanding, “They are rich enough to afford a car.  They can carry me when I need a ride.” 

For the rest of the ride, this small elderly lady worked over my clock with a hard bristled brush.  I don’t remember her arguments.  I do remember the blistering hurt I felt when she slammed the door as she exited the car.

Her argument in short was “I’m a victim.  I’m entitled.”  And she didn’t have a disability.  She had simply never learned to drive an automobile.

Third, is a growing resentment when people don’t perform to my expectations. One day I called the Space Coast Area Transit main office for some information.  Because we work closely with the transportation system, I’ve come to know the people in the office pretty well.  Today, one of the leads was frustrated.  “What’s wrong?” I asked.

“I’m just not able to cope today with the anger of some of the people who call making demands that public transportation can’t provide,” she said on the verge of tears.  While SCAT isn’t perfect, it is public transportation and they can’t fulfill all the desires of people needing a ride. 

More than rides, there may be a dissatisfaction with group homes, job placements, companions, paid state workers and professional staff.  Of course, there is plenty to become disgruntled about.  Yet, festering resentment only feeds the victim mentality.

Self-pity, a sense of entitlement and festering resentment will turn any person into a hateful shrew.  Of course, persons with disabilities aren’t the only people who can become entrapped in this vicious cycle of unhappiness.  Parents, caregivers, professionals, and, yes, ministers must guard our hearts against the unrelenting horror of a victim mentality. 

Guarding our hearts from the poisonous trickles of seeping self-pity may the main and most effective way to keep ahead of the pain victimhood generates.  Prayer, meditation on God’s word and fellowship with people who will be honest seem to be the ways that I’ve seen others escape.

What about you?  What are some of the ways you’ve seen this cycle hurt people you know?  Do you find that people with disabilities are more prone to this cycle? Or have you found them less like to fall prey to the victim mentality?

 Let My People Go

Third Week in August 2008

Call to Worship: I have seen the misery of My people in Egypt.  Exodus 3:7

The Lord is near all who call out to Him.  Psalm 145:18

Over the past few days, I’ve been caught up in the controversy regarding the movie, Tropic Thunder.  I‘m told that there are many offensive references to a important group of people.  The mentally challenged community is spoken of in offensive ways. It reminds me the struggles of the blacks in the South in the 1950’s.  It also reminds me of another group of people who were living under great oppression.  Moses was ready to talk to Pharaoh about having God’s people leave Egypt.  Things are about to get bad.  Have a member read, Psalm 145:18.

 

     I.     Egypt has had a nation of slaves for more than 400 years.  They like having slaves.  They like having Israel in their country.  However, that is about to change.

            A. Moses went to Pharaoh and told him that God wanted to people to leave the country for a few days to worship him.  Pharaoh refused.

            B. He made life much harder for the Israelites.  There would be no straw for bricks.  The people didn’t understand why their life was getting so much worse when Moses promised God was going to deliver them from Egypt.

 

II. I love children and teenagers.  I even loved my children and my teenagers.  But I know that the teen years are transition times.  Teens are unhappy and they make everyone unhappy.  But by the time, it is time for them to leave, everyone is ready for that to happen.

 

A.   This was kind of like it was in Egypt.  Things were getting worse for the Israelites.

B.    And things were about to much, much worse for the Egyptians.

C.   By the time they were ready to leave, everyone would be happy they were going.

 

    III. What about you?  Have you gone through a hard times?  Have you been unhappy?

            A. Maybe God is getting ready to make a change in your life.

            B. It could be time to pray for God’s wisdom for your life.

            C. There are times that we are like teenagers and everything makes us unhappy.

            D. Usually it not anyone else’s fault but we need to talk to God and find out what he wants us to do now.

Conclusion:  Moses and Pharaoh were about to get into a war of words and deeds–and God was going to win.  Remember, God always wins because he is God.  Life will be better if you just yield to him and obey.

 

 

 

 

 

 

 

 

 

During lunch with four pastors, a volunteer and a teenager who all work with people who are mentally challenged, the question was asked, “Should we go and see the movie Tropic Thunder?”  In case, you don’t know, I have been told–because I haven’t seen the film–that this a movie that contains some demeaning and even profane references to persons who are developmentally delayed.  It takes the degrading term “retard” to a new low.

 After a brief discussion of the movie and the pros and cons about viewing the movie, one of the teenagers who was sitting at the table asked, “Why would you even want to go and see that?

Perhaps the greatest problem with this kind of thing is that you want to be current and relevant.  In fact, won’t your opinions be dismissed if you don’t spend the time and actually see film?  Doesn’t being able to speak with authority mean that you must know what you are talking about and doesn’t that also mean that you must see the movie?

Balancing on the other foot, paying to see the movie only promotes the profits, encouraging other movie makers to copy-cat the experience.  “Sure it was a controversial movie but look how much money they made” could become the rationale for more of the same.

I happen to agree with the teenager at the table.  However, there would be great satisfaction in going to the movie, then walking out and asking for my money back.  Yet, if this is my plan and purpose, isn’t that a bit deceitful?   

As it often does in a free flow of ideas, the conversation morphed into one pastor telling about a private Christian school in Florida that had a contest at lunch time called “Retard of the Day.”  This contest was to humiliate the misbehaving students and help control them during this rowdy time.  I think, as a group, we left the lunch table with the disturbing realization that there seems to be no good way to handle this issue.  We were also smacked in the face with the understanding that abuse is allowed–even in Christian circles–in regard to this population and the mental health population that would not be allowed with any other sub-cultures. 

However, I was so grateful that these important people in our culture aren’t being warehoused and ignored.  I was raised in the South.  I remember the days when the mantra of the white population was “they don’t care and they don’t know any better.”  We found out in technicolor reality that we were acutely wrong and things began to change.  The South of today is not perfect by any means in regard to race relations; but so much better than the South of the ’50’s.  Yet, blacks and whites will tell you that it has taken years of pain and suffering on all sides to reach where we are. 

I didn’t march in any demonstrations to make things better.  But I did reach out and touch my brothers and sisters of color who lived in the South and love them.  I did voice my opinion in mixed company.  I did monitor the use of offensive words to insure they weren’t used by me or my children.  

Perhaps the movie, Tropic Thunder has given the mentally challenged community a resounding slap that will back fire into society as a whole.  Perhaps professionals and pastor will stop ignoring the offenses and begin to speak out and reach out in love and grace.  We can only pray that this will happen.

How do you plan on handling this offensive piece of Hollywood cinema?

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