independent living


Here is a copy of the memo sent to service providers in Florida regarding three month 15 percent cuts:

APD

agency for  persons with disabilities

State of Florida 

MEMO TO ALL PROVIDERS OF DEVELOPMENTAL DISABILITIES

MEDICAID WAIVER SERVICES

March 31, 2011

 

TO:      All APD Providers  

FROM: Bryan Vaughan, ActingDirector

            Agency for Persons with Disabilities

RE: Changes to Developmental Disabilities Medicaid Waiver Service Rates

 The Agency has projected a budget deficit of more than $169 million dollars for the 2010-2011 fiscal year. Pursuant to the APD and AHCA’s authority in sections 393.0661(7) and (8), Florida Statutes, all provider rates in Rules 59G-13.081, 59G-13.082 and 59G-13.084 for Medicaid Waiver Services provided through the Developmental Disabilities Home and Community Based Waivers will be reduced by 15% for services provided between April 1, 2011, and June 30, 2011. In addition, solo/agency differentials will be eliminated. After June 30, 2011, these rate reductions may be revised pursuant to legislative action or agency rule.

These rates may be found on the Agency’s website and will be filed in an emergency rule. If you have a negotiated rate for intensive behavioral residential habilitation, transportation, or special medical home care services, your local area administrator will contact you in the near future with an addendum to your current waiver services agreement. 

These rate adjustments will be reflected in each client’s authorization for services. The rate adjustments do not reduce, modify, or terminate any currently authorized waiver services. APD will provide new service authorizations to all providers within 5 days of this memo. Until such time, this memo will serve as your authorization.

In these difficult economic times, the Agency for Persons with Disabilities appreciates your cooperation and thanks you for your service and dedication to individuals with developmental disabilities.

http://apdcares.org

Linda Howard’s note:  This is from an email I received this morning.  The first part of the entry contains comments  from Richard Stimson regarding the article.  I quoted the entire article but I also referenced it.  Go to the original article  to input your comments with the Miami Herald.

You know, it is like a horror movie, every time you think things have gotten as bad as they can, it gets worst.  This is the Miami Herald and they sound like they are supporting Governor Scott.

First statement in RED by Kingsley Ross – Is this saying agencies will stop providing services?  I got an email from another FARF person that said something similar.  It basically said at these rates services could not be provided in a safe way.

First statement in GREEN by Brian Burgess – Is this saying that these cuts are this bad because of what happen in the past?  I think so.  Also from reading the article it appears they blame all of the appeals too (see second part in GREEN).  I also find the word use of “neediest” interesting.  I do not think they are talking financially because all waiver clients are on Medicaid.  I think they are talking about a new way to prioritize who gets services.  What would that look like?  Folks in Group Homes?  What happens to those in supportive living?

First statement in PURPLE by Miami Herald – Makes it sound like Scott had no other choice.  He had to do this.  I would take this to mean that the paper thinks Scott is within his authority to do this as an Emergency Rule!

Linda Howard note:  This is an article is from the Miami Herald.  Here is the web address.  Go there to input your comments regarding this latest action:

 http://www.miamiherald.com/2011/03/30/2142265_gov-scott-to-call-for-deep-cuts.html#storylink=addthis

AGENCY FOR PERSONS WITH DISABILITIES

Gov. Scott to call for deep cuts at agency for disabled

A $170 million deficit in the agency that serves the most needy in Florida has left Gov. Rick Scott with a tough call.

By Marc Caputo

TALLAHASSEE — Due to a shockingly large deficit, Gov. Rick Scott is planning to invoke his emergency powers and make deep cuts to the rates charged by group homes and case workers who help the developmentally disabled.

Scott could announce a 15 percent rate cut as early as Thursday to close the $170 million budget gap in the Agency for Persons with Disabilities, according to lawmakers who were briefed Wednesday.

The deficit — which exceeds the agency’s spending authority by nearly 20 percent — is partly the legacy of lawsuits, poor planning by the Legislature and a nearly $20 million veto by Scott’s predecessor, Charlie Crist, who starved the program of savings when he refused to trim provider rates last summer.

SYSTEM SHUTDOWN

Those who provide services to the nearly 30,000 Floridians with cerebral palsy, autism and Down Syndrome said they aren’t concerned with the origin of the deficit as much as the effect of deep rate cuts.

“This would be a catastrophe,” said Kingsley Ross, an advocate and lobbyist for Sunrise Community, a Miami-based group home operator.

For the past three years, Ross said, providers have shouldered rate cuts. They’re now operating on the thinnest of margins.

“The system can’t take this,” Ross said. “Eventually, we will have to cut jobs and reduce services.”

Scott’s spokesman, Brian Burgess, said the governor doesn’t want to harm the developmentally disabled. However, he said the state has put off tough choices for too long and the bill is due.

Burgess said paring the budget now will put the state in a better position to pay future expenses on the neediest. “Yes it’s painful,” Burgess said. “But we’re trying to alleviate the pain long term.”

Florida has a constitutional requirement for a balanced budget, but federally created Medicaid-related entitlement programs can go into deficit from time to time if the number of recipients increases or costs for needed services rise.

The Legislature estimated that next year the entire state budget will have a $3.75 billion shortfall. So lawmakers are trimming programs.

Troubled by the deficit in the Agency for Persons with Disabilities, Scott ordered an inquiry. The results of the investigation are scheduled to be released Thursday.

RECIPE FOR DISASTER

The Legislature tried to cut the program for the developmentally disabled last year, but Gov. Crist refused. He vetoed a 2.5 percent provider rate reduction.

Meantime, lawmakers didn’t budget enough money for the program to account for the fact that thousands of recipients had sued to block a system of service reductions and cuts to the program.

When times were flush five years ago, legislators expanded the rolls of the Medicaid program by about 5,000 — a move that brought cheers from advocates for the disabled. They had fretted that about 15,000 developmentally-disabled people were on a waiting list but unable to receive services.

But the waiting list has only grown. Medical costs have increased. But state tax collections plummeted and then flat-lined.

Add all those factors together, and the deficit in the $850 million program for the developmentally disabled is about $170 million, according to the Florida House’s proposed budget. The budget proposes to fix this year’s deficit by shifting money from special accounts. But the Senate offers no such solution, leaving Gov. Scott few choices. Neither he nor his fellow Republicans want to raise taxes to fill the deficit.

Scott’s proposal to reduce rates by 15 percent should save about $34 million. The rest of the deficit would be plugged by shifting agency money and reducing the rates of South Florida providers who get slightly higher reimbursements.

Sen. Joe Negron, a Stuart Republican who chairs the Senate’s health budget committee, and Rep. Matt Hudson, chairman of the House health budget committee, said they were briefed on the plan and support Scott.

 To record your input with the Miami Herald, please go to:  http://www.miamiherald.com/2011/03/30/2142265_gov-scott-to-call-for-deep-cuts.html#storylink=addthis

Much Ado about Nothing

Genesis 2:7 and 8

Central Theme:  God‘s greatest prize was made from dirt.

Introduction–Okay here we go again with grandbaby stories.  I went to visit my granddaugter who is 18 months old now.  She can say, “Grandmother and cracker.”  She knows what she wants and how to get it with a smile and a kiss.  Can you imagine that this little baby is a growing, thriving bundle of dirt.  Show a bag of dirt.  Have a member read Genesis 2:7 and 8.

       I.     God took the most common thing on earth, dirt, and fashioned his most prize possession, people. 

          A. When we look at the great achievements of the universe, they have all been accomplished by some bundle of dirt. 

          B. The greatest acts of love, compassion and tenderness, all come from some salt-water moistened lump of dirt.

          C. I’ve brought a picture of a great work of art, skillfully and brilliantly fashioned by dirt hands.           

      II.     We should understand our origins to fully understand ourselves.

              A. I‘m not talking about our family background. 

              1.  We need to understand that God made us from dirt.

              2.  Even science agrees with the fact that we are made from dirt.

              3.  What science cannot understand is God’s love for me as he fashioned Adam and Eve into humanity

              4.  Abstract thought cannot grasp a Creator God who loved us enough to let us have freewill that would turn and curse and revile our Creator.

              5.  Thinking people cannot grasp this God who made a way for me to be redeemed by the shed blood of his Son.

          B. God loved the dirt he had fashioned so much that He knew that only if he became dirt himself could he bring these dirty creature to himself.

              1.  He gave us everything to become like us–dirt.

Conclusion–I am dirt but because of Jesus, I am clean dirt.

Today, I was reminded by Os Hillman the truth and importance  of Exodus 16:4.  “Then the Lord said to Moses, ‘I will cause food to fall like rain from the sky for all of you.  Every day the people must go out and gather what they need for that day.  I want to see if the people will do what I teach them'” (New Century Version).

When God takes us into the wilderness, we find that we must depend totally on the Lord.  Imagine, no way to purchase steak or after-school snacks.  No grocery stores, 7-11 stores.  No farms, plowing or harvest.  No orange groves.  No Macy’s to purchase a new Christmas sweater or shoe stores to satisfy our inherited shoe genes. 

The wilderness always means that we are dependent on the Lord, totally and completely. 

The reason I was impressed by this verse, however, wasn’t because of my dependence–though it is vital for my spiritual growth.  It is because of the mentally challenged community.  Often when I speak and teach about depending on the Lord, I see from our members’ smiles and other expressions of understanding that this is a principle they understand and accept.  Even our lower functioning members comprehend this dogma. 

The mentally challenged community are people who are totally dependent on others.  There are very few things that they can do completely on their own.  Even when they are gifted in one area, like Michael, our members may be captured by emotions and stresses they cannot understand, much less explain to others. 

Over the years, I’ve come to know and love Michael because of his sweet, giving spirit.  I’ve also come to appreciate and depend on his talents and giftings.  Nevertheless, there are times that Michael slips into an agonizing funk.  Trying to probe and examine him, only makes his pain more extreme.  As talented as Michael is, he is not completely verbal.  Perhaps he does not even know what brings on his pain.  Everyone who knows him has learned to leave him alone and to allow him to work out his emotional crisis.  Only God can deliver him from his hurts and suffering and it takes time.

Frank, one of my closest friends, has an off-the-charts IQ.  Interestingly, he suffers from the same type of funk.  Even though he is extremely verbal, he is not able to explain why or how these awful fits of gloom come on him.  Like Michael, only God can release him from these times of hurtful suffering. 

This morning I was reminded of Michael and so many other members who must totally depend on the Lord.  Simple tasks, like buying groceries, are overwhelming ordeals without the help of another person.  Daily, practical living leaves them grasping for someone else’s assistance.  Their times of acute pain, however, are days that we must all allow God to do His supernatural work releasing them from their hurts and anxiety. 

“Isn’t there anything I can do to help Michael?”  I asked his caregiver, yesterday over lunch. 

“Pray.  You know our members all respond to prayer” was her wise answer.

All of us wander through the wilderness.  All of us share times of perplexing uncertainty when we must totally depend on the Lord.  Perhaps we can learn from our members during these anxious times of distress.  They are veterans of this lonely, foreboding place.  They understand God’s leading and grace in ways I only wish I could comprehend.

This is an article from The Florida Transit Advocate, on-line newsletter published by the Florida Public Transit Association.

An important election is coming up in November.  Our Governor, a U.S. Senate seat, all of Florida’s 27 U.S. House Seats, most of our state Legislature, and a plethora of local positions are being put to the voters. Citizens in Hillsborough and Polk Counties will be asked to vote on ballot initiatives (see stories at the bottom left of this page).wes pic

Florida transit is at a crossroads. It’s up to voters like us to determine whether Florida is at a Renaissance or whether transit will slide backwards with budget cuts. Never before have so many Floridians, on both sides of the aisle, come to realize the need for strong, functioning transit systems in our urban areas. As someone who represents the interests of public transit in our Legislature every year, I can vouch that your voice will be heard in the halls of Tallahassee. I urge each of you to make sure that your positions on transit are made clear at the ballot box. I also invite you to urge your friends to subscribe to this newsletter, the larger our base, the more we will be heard.

Wes Watson,  Executive Director, 
Florida Public Transportation Association

I was asked to write a eulogy for a dear and close friend who died last week.  I wanted to share with you a portion of it.  She worked for years as a full-time volunteer in the school system with all children.  She did stage productions, taking great joy to never exclude children with disabilities.  To her, all children had a special need for an abundance of love.

While we don’t ever admit it, there is something wonderful about death, that final passage of life. Because people–the survivror–are forced to stop. We stop to remember. We brace our hoe under their armpit and take off their hats. Slowly, we wipe our brows and listen and embrace the rambling noise of memories. And for a brief moment in time, we allow ourselves to rejoice in the past. We are lost something in the 70’s, our sense of tradition. But tradition is more than a processional or which side of the lectern the piano should be placed. Tradition is embodied in the story–the story of our faith. Even more, Christian tradition is embodied in the story of the Faithful.

Jesus said at the last supper, “Do this to remember me.” Memory is an essential part of the Judeo-Christian heritage. The Passover is a ritual of remembering. The Jewish people were taught to remember God’s miraculous salvation interruptions that occur in our everyday lives. But somehow we refuse to allow time to remember. Our lives are wrapped tightly in the present and future. Even our older generations, don’t take the time to remember…or we don’t take the time to listen.

But death abruptly unwraps the cocoons of our present and our future and we come to a screeching halt as the noise of the past slaps us in the face. The only thing John’s family, friends and I have left are our memories of him.

Several times a week, I sit in pastor’s meetings in at least three counties.  The closer the friendships, the more frankly the pastors speak about their concerns and problems.  During some sessions, I leave thanking God that I am working with people who have disabilities.  The members of Special Gathering are men and women with obvious flaws but hearts that desire to follow the Lord.

 Author Jan Karon uses a wonderful term to describe the fictitious church in one of her books–“hungry and imperfect.”  One of the main characters says that the reason that she loves the new church is because it is filled with people who are “hungry and imperfect.”  I’ve read no better description than this to describe the members of Special Gathering.

The imperfections are obvious.  No mere crooked noses or small feet here.  Their reasoning and intellectual abilities are reduced.  Too often, their bodies have suffered some type of developmental difficulties, leaving them physically impaired. 

Yet, these are people who are hungry.  They sit listening intently.  Of course, Mike holds the hand of his girlfriend during the sermon; but he rarely blinks throughout the entire discourse.  He is intent to learn more about his Savior.  With a bit of encouragement, John asks excellent questions.  He struggles to get the correct answer to questions asked  during our Bible study.  Windy, Mary and Laura all desire to know God in a more perfect way. 

Paraphrasing an unknown author, God comes into the darkest most imperfect rooms of our hearts and there He seeks to set up his home.  Cleansing, perfecting and loving us into his perfection and wholeness.  Worshipping with folks who are “hungry and imperfect” I’ve found there is no better place where we,  his children, can find a resting, growing place?

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