March 2012


March 31
Florida Atlantic University
500 NW California Blvd., Port St. Lucie, FL
10 a.m. until 4:30 p.m.

Presented by
WaiverProvider.com– Family Care Council – FAU-CARD

We are pleased to present this opportunity for you to gain firsthand information from the Agency for Persons with Disabilities. APD Area 15 Administrator Gerry Driscoll will provide updates on current issues and future plans.

This free event is open to all families. Registration is not required. Come for all of the information and assistance. Then stay for the free lunch, refreshments, door prizes, dancing, and fun!

WaiverProvider.com will be telling families about resources on the Internet that may be of benefit.

The Area 15 Family Care Council will share information with families and accept new members.

Learn about Medicaid, Social Security, Vocational Rehabilitation, Centers for Independent Living, transition, guardianship, and more.

  • Agenda
  • 10 – 11 a.m. WaiverProvider.com, Area 15 FCC, & FAU-CARD
  • 11 a.m.–12 p.m. Breakout Sessions and Exhibitor Time
  • 12 – 1 p.m. Lunch and Exhibitor Time
  • 1 – 2 p.m. Breakout Sessions and Exhibitor Time
  • 2 – 2:30 p.m. Closing Remarks
  • 2:30 – 4:30 p.m. Dance with Live DJ Taking Requests, Door Prize Giveaways

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I spent the past few days in South Carolina with The Special Gathering program director.  During that time, I shadowed her during the week, observing the activities of that Special Gathering.  On Thursday afternoon, we went to a weekly Bible study.  This study is mainly attended by the Walterboro SpG leadership team.

I was impressed by several things.  First, each person is responsible to get to the study.  There were 13 people attending.  Five of their regular attendees were not present because their staff had planned a shopping trip to a larger, neighboring city.  Transportation is always an issue for people who are mentally challenged.  Perhaps, part of the success in their attendance is because they live in a small town.  However, when week-after-week the leadership team comes, it is an impressive achievement.

Second, the members of the class lead a lot of the discussing.  Their input was valuable and valued.  This was important and proved that these men and women were growing in the Lord.

Third, there was eager participation.  Each person gave valuable input but their enthusiasm was impressive.

Fourth, the class lasted for an hour and the members were attentive and responsive all during that time.  Almost everyone will tell you that a class that lasts this long is not wise within our community.  However, even after the class was dismissed, the members did not want to leave.  They continued to linger for another half hour.

While the circumstances of my program is different, I’m taking a new look at some of my tactics after spending time with the members of this program.

Have you ever visited another special needs program?  What were some of the things that impressed you?  What were the things you learned?

NOTE FROM LINDA HOWARD:  This email was sent to all Residential providers.  Essentially, it says that all third-party money received by people who live in residential facilities, must be given back to  APD.  Resident’s personal money must be turned over to the State as reimbursement for care.  Any remaining money will then be given to APD.  Shocking!  All personal money in excess of the amount needed for their care is to be sent to APD.  The State is now taking personal funds from people who are intellectually disabled!  This is an outrage!

Notice of Change/Withdrawal

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Agency for Persons with Disabilities

RULE NO.: RULE TITLE:
65G-2.016: Residential Fee Collection

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 37 No. 11, January 13, 2012 issue of the Florida Administrative Weekly.

65G-2.016 Residential Fee Collection

  • This rule applies to all clients, as defined in section 393.063, Florida Statutes, who are eighteen years of age or older, who receive residential habilitation services, and who live in a foster care facility, group home facility, residential habilitation center, or comprehensive transitional education program, licensed pursuant to section 393.067, Florida Statutes.
  • Definitions.  For the purposes of this rule, the following terms shall be defined as follows:
  • Agency. As defined in § 393.063, F.S
  • Benefit Payments. As defined in § 402.33, F.S.
  • Client.  As defined in § 393.063, F.S.,
  • Gross income.  For the purposes of this rule Gross income includes the sum of the client’s benefit payments and third party benefits less any deduction authorized in writing by the Social Security Administration or the Agency for Persons with Disabilities. Deductions may only be authorized by the Agency for Persons with Disabilities if the client is using benefit payments or third party benefits to offset a voluntary reduction in the client’s Medicaid Waiver services or if the benefit payments or third party benefits are used as a required payment, co-payment, or co-insurance for Medicaid services, including, but not limited to prescribed drugs. This term does not include the client’s earned income.

(b) Personal Needs Allowance.  A portion of the benefit payments and third party benefits that must be set aside and used for the direct benefit of the client. For purposes of this rule, a client’s personal needs allowance is $93.58 per month.

(c)  Residential Habilitation.  Supervision and specific training activities that assist the client to acquire, maintain or improve skills related to activities of daily living.  The service focuses on personal hygiene skills such as bathing and oral hygiene; homemaking skills such as food preparation, vacuuming and laundry; and on social and adaptive skills that enable the client to reside in the community.  This training is provided in accordance with a formal implementation plan, developed with direction from the client and reflects the client’s goal(s) from their current support plan.

(d) Room and Board Payment. Reimbursement to the operators of facilities or programs licensed pursuant to section 393.067, Florida Statutes, to cover the cost of providing food and shelter to Agency clients who also receive residential habilitation services in accordance with Chapter 65G-2 of the Florida Administrative Code. For purposes of this rule, a client’s room and board payment is $543.42 per month.

(e) Third party benefits. As defined in §402.33, F.S.

  • Room and Board Payment Rates. Providers serving clients who receive residential habilitation services within a facility licensed pursuant to section 393.067, Florida Statutes, will receive a room and board payment which is dependent upon the amount of benefit payments and third party benefits the client receives.
  • Payments to Providers:

The room and board payment is calculated by subtracting a personal needs allowance ($93.58 per month) from the client’s monthly benefit payments and third party benefits. The room and board ($543.42) payment is then subtracted from the remaining total. If any benefit payments or third party benefits remain after subtracting the personal needs allowance and room and board payment, the remaining balance shall be subject to the provisions in Section (5) below. 

  • Fees assessed for Residential Habilitation services:
  • If a client receives residential habilitation services in a facility licensed pursuant to section 393.067, Florida Statutes, and the client’s monthly gross income exceeds the client’s personal needs allowance and the client’s room and board payment, the client must send the excess gross income to the Agency for Persons with Disabilities.
  • Payments made pursuant to subsection (5)(a) must be sent to the local APD area office by the 15th day of the month after receipt of the third party benefit payments.  If the 15th of the month falls on a weekend, state holiday, or national holiday, then the payment due date will be the next business day immediately thereafter. Checks or money orders should be made payable to Agency for Persons with Disabilities (or APD).   Individuals or organizations serving as the representative payee for multiple clients may submit a single check or money order to the Agency each month.
  • Clients or representative payees for clients shall submit an accounting for any deductions in the calculation of the fees assessed pursuant to this subsection.
  • Mandatory Monthly Reports to the Agency.
  • Every client or representative payee for a client, including a facility or program licensed pursuant to section 393.067, Florida Statutes, must report to the appropriate APD area office by the 15th day of the month. The report must include a calculation for each client that includes:If the monthly report described in this subsection indicates that a fee should be assessed to the client’s third party benefits pursuant to subsection (5) of this rule, the client or representative payee for the client must also include a payment of the assessed fee with the monthly report.
    • The total gross income that the client receives;
    • The amount to be subtracted for payment of the client’s room and board and for the client’s personal needs allowances;
    • The total amount owed to the provider pursuant to subsection (4) of this rule or the total amount of the fee assessed pursuant to subsection (5) of this rule.
  • If the 15th day of the month falls on a weekend, state holiday, or national holiday, then the payment due date will be the next business day immediately thereafter.
  • Review of Assessed Fees
  • Substantially affected individuals may request a review the fees assessed upon their gross income by submitting a request for review to the applicable area office. The client or responsible party must notify the agency, in writing, of the request for review of the fee assessed, and must submit any receipts, tax records, bills, certified statements or other documentation needed to substantiate the request for a review of the fee.
  • If the substantially affected individuals still disagree with the fees assessed upon their third party benefit payments after their request for review, they may request an administrative hearing pursuant to section 393.125, Florida Statutes.

Rulemaking Authority 393.501(1) and 402.33, FS. Law Implemented 402.33, FS. History-New , Amended . 


ImageEach year, Special Gathering of Indian River partners with the Brevard County Rec Department to provide special events.  This Saturday, we will be taking a group of SpG members to SeaWorld, an amusement park in Orlando.  These trips are a great time of fellowship and growth.

I’m responsible for 34 people who will be attending.  I’m not supervising these people; but I am gathering their information and helping to get their tickets.

However, I find several things that I cannot understand.  First, I go over my list of people who are attending several times.  I keep a complete and thorough list.  Every person gives me their money and I record the amount they gave me.  I don’t let anyone get away with not paying.  Yet, I, occasionally, manage to have less money that I should have.  Usually, it is only a few dollars so it isn’t a financial burden.  It is a source of frustration though.

ImageMy questions is:  Where does that $3 go?  Is there a hole in an envelop somewhere? Have I lost my ability to count?  This week I’ve gathered the money for the 34 tickets and I face the same dilemma.

Perhaps, it is like the proverbial sock that disappears in the short journey when transferring from the dirty clothes hamper to the dryer.  My problem is not the amount of money that disappears but WHERE has it gone?

Do you have any answers?  Does this ever happen to you?  Is this a sign of stress?  Perhaps, there is a simple explanation.  Can you help?

When Sally met Matthew, she said she loved him from the first.  Of course, Sally had never had a man give her any attention all of her 30 years.  A petite blonde, she had lived in a small town in North Carolina.  Her parents had protected her to the point that she wasn’t even able to go to a sheltered workshop to work.  Then tragic events brought her to our county to live with a distant relative that she had only met one time.

After several years, the relative was overwhelmed with the responsibilities of a young woman with Downs Syndrome.  She turned to a local agency for help.  Sally was able to obtain a placement in a group home.  Within a few months, Sally was moved into an apartment.  Matthew lived in the apartment across the hall from Sally.  He was an experienced young man who understood how to win Sally’s heart.

Unfortunately, Matthew was the victim of abuse in his family.  Therefore, he proceeded to abuse Sally, beating her badly after their sexual encounters.  Because Matthew was also a mentally challenged individual and Sally refused to press charges against the man she loved, Matthew was never arrested or paid any price for his brutal beatings.

It is a well-known psychological fact that victims of abuse become abusers.  While we hate to admit it, this fact is true within the mentally challenged community, also.  While the story of Sally and Matthew is ugly and rare, it is true.  Perhaps the blame rests on the professional community, who believed that the indisputable principle of choice was more important than safety.  Perhaps it was the fault of APD who encourages the placement of people into apartments, whether they are ready for that move or not.

It would seem obvious that Sally wasn’t prepared to handle Matthew’s advances.  Yet, she wasn’t moved from the apartment complex or given the kind of protection that she needed.  Perhaps, it is the fault of politicians, who can’t seem to find the money to provide funding for our most vulnerable citizen.  Perhaps it is the fault of an entire society who discount the value of mentally challenged people.

Perhaps, there are too many people who cling to a faulty and unsafe philosophy to point fingers to any one set of people.  Could it be that there are so many problems involved in the system that there is no good solution?  This is why we at The Special Gathering, a ministry within the mentally challenged community, must advocate for the community we serve.  Richard Stimson, the Executive Director of Special Gathering, has said, “A shepherd protects his sheep.  Therefore, advocacy must be a part of pastoral care.”

What do you think is the responsibility of a specialized ministry in regard to advocacy?  Even though Sally wasn’t a member of Special Gathering, did we still have an obligation to advocate for her?  What could be done for Sally, since she didn’t want any help?

Specialgathering's Weblog

Last week we started learning new music at The Special Gathering Vero and Melbourne choirs.   I am the director of two of the six choirs at Special Gathering.  Our choirs sing in local churches and during our chapel services.  Our purpose in traveling to other congregations is to educate the church to the spiritual needs of people who are mentally challenged.  

Trying to keep the choirs more interested in the newer music we will learn, I let them choose the new songs.  Because our members memorize the music, it takes a bit longer to teach them the words and melody.  Therefore I begin about three or four months before they will preform the songs.  This new music contains the songs we’ll be singing in the summer and fall.

During the time we were going over the new selections, Anna kept wandering away in her mind.  Lucy and Nancy were nodding off.  Only Sheila was awake and perky during…

View original post 625 more words

On Saturday, I learned that a member of the mentally challenged community had suffered a brain hemorrhage and had been placed on life support.  The decision was made to disconnect her from life support that afternoon while we were in the middle of our Special Gathering program.  Phone calls from grieving staff who had worked with her most of her life came quickly into my phone.  Because we were having Special Gathering at the time that things were progressing, I could have been in a bit of a dilemma.

However, the Vero supervisor, Diane, immediately understood and she filled in the vacuum this emergency created.  She continued the program without missing a beat.  This is the second time that a pending death has happened during our Special Gathering program.  While I would not consider leaving our members, there are several things that can be put into place.

  1. Training in advance is perhaps the most vital key.  Because of the emphasis on health and safety that has been put into place at Special Gathering, I knew that the staff understood the importance of keeping our members in their normal routine and carrying the load while I was a bit out-of-pocket.
  2. Cell phones are perhaps a program directors greatest ally during a crisis situation.  Standing far enough away from our members so that they can not hear a deeply personal and private conversation, I can still be in view of SpG members and observant staff.
  3. Choosing the right staff may seem obvious; but there is no doubt that it is an issue that needs to be reviewed often. Careful staffing selection is the key but that is a different issue for a different day.
  4.  I’m learning that not everyone can supervise or improvise.  Both are needed during a crisis situation by the person who is in charge of supervision.
  5. Keep your composure at all times.  If you and your supervisor remain calm, your members will be calm.  There should be time for weeping; but while walking through the valley of the shadow of death, it a time for peace and calm, not drama and chaos.
  6. Pray freely with people to whom you are speaking.  Don’t be afraid to ask, “May I pray with you?”  During personal crises, we all can become overwhelmed with a feeling of helplessness.  Counter that feeling with a confidence in God’s ability to make every circumstance right.
  7. Assure the people on the phone that you will come as quickly as possible.  I had a van route to do.  Therefore, I could not get to the hospital even after our program ended.  I explained to the people who needed to know what my afternoon process should be so that there would be no misunderstanding.

Perhaps the most important thing you bring to the table is your relationship and confidence in the Lord.  What are some of the things you have learning during crisis, especially a death, during your program?

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