Jim DeBeaugrine


Last week, Governor Charles Crist of Florida vetoed a scheduled 2.5 percent cut in the amount that providers who work within the mentally challenged community will be paid for their services.  However, Crist did not veto a 2.5 percent that the legislature passed in the amount of services that mentally challenged people can purchase.

At first, this was seen as a great victory for our community.  However, thoughtful providers and advocates are having second thoughts about the true benefits for consumers and for the people who labor to make their lives better.

Had both been vetoed, this would have been a win-win situation for providers and for people purchasing services or the consumer.  Using the analogy of the old-time company store, if you purchase all of your supplies from the company store and your salary is cut from $10 a week to $7.50, this is a problem.  Yet, if the prices in the company store are also cut by an equal amount, people purchasing goods in the store will not see a cut in what they receive.  Flour that was once $1 is now, $.75.  Therefore the purchaser does not see any decrease in what they can purchase.

A short-sighted view says that providers have won.  But is that really true?  Some providers and advocates are having second thought.  After all, if the company store is still selling flour for $1 and consumers only have $.75 to purchase that bag of flour, no amount of figuring will mean that the store owner will make the same amount of money at the end of the week.  Providers and consumers have received a cut, whether we like it or not. 

In this case, salaries of consumers were cut but the prices of what can be purchased in the company store was not cut.  Some providers are seeing this situation is almost as bad for them and certainly worse for the consumer.  If as a consumer, I have always had $10 to spend in the store and now I have only $7.50, I’m looking for some place to cut my expenses.

As a provider, I may be paid the same amount of money for an hour of physical therapy but the consumers I serve can only afford to purchase 45 minutes of therapy.  I am only going to be paid $.75 for my services.  As a provider, I have lost $.25. 

Governor Crist did not do a favor for the providers by vetoing this bill.  And, providers are gradually realizing that this was not a victory for them or for the consumers.  As they are doing the math, they are putting away the confetti and plans for a victory party!

As those involved in Christian ministry within the mentally challenged community, we must continue to pray for wisdom from our elected officials and the providers who work within our community

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This is the content of a letter sent from APD signed by Jim DeBeaugrine, Director, to Family Care Council.  It’s a bit of a smooze job.  However, I thought would want to read this.   For some odd reason, it would not copy directly, therefore, I had to type it into the post.  If you would like to give your own very positive feedback, please respond by phone at 866 273 2273 or online at http://apd.myflorida.com or wirte to Director Debeaugrine at 4030 Esplanade Way, Suite 380, Tallahassee, FL  32399 0950. 

October 19, 2009

Dear Family Care Council Members,

We have completed the last of our seven public meetings to share the news about APD’s new initiatives.  The feedback we received was very positive.  Consumers, families and providers especially appreciate the chance to ask questions, provide comments, and hear responses.  I also enjoyed the opportunity to speak directly with those we serve and those involved in making those services happen.  The family Care Councils’ involvement in helping to organize and publicize these meetings was key to their success and I am very grateful to you.

Agency staff is responding to the large number of questions asked at these meetings.  We will be posting these questions and resonses of general iterest on our website by early November.  Links will be e-mailed to you once they are posted.  However, we are responding individually to those questions which address personal situations.

Other feedback we received was taht attendees wanted more dtails about he initiative.s  As I mentionned during the meetings we are planning anouther round of events to share more information once the plan for individual budget (iBudget Florida) has been further developed.  We are tentatively planning those for January 2010.  In the meantime, we’ll be sharing information through out website.  Loook for more information on specific links in a future e-mail.

Again, thanks for your support of these recent meetings, and thanks for all you do to help those we serve,

Sincerely,

Jim DeBeaugrine

Director

“They are acting like spoiled children who haven’t gotten their way” was the interesting comment of an insider commenting on APD’s reaction to the court’s rejection of the Tiers.  I found Jim DeBeaugrine’s comments this week fascinating because he said nothing would change.  In other words, APD will disregard and ignore the courts.

What other agency would have the gall to disregard and ignore a federal court? 

On the other hand, the state is out of money and revenue is dropping as people are moving out of Florida.  As interested person said, “It doesn’t matter what the courts say.  APD will find some way to keep taking things away from those who need it most.” 

While the state is out of money and must find ways to cut corners, why does the most vulnerable population seem to be the people who must burden the brunt of the sacrifice?

This is a statement sent out by the Family Care Council:

Statement by APD Director Jim DeBeaugrine on Court Decision on Tier Rule

Tallahassee – Today the First District Court of Appeals issued a ruling determining the tier waiver rule to be invalid.

APD will thoroughly review the opinion issued by the First District Court of Appeals to determine which options will best preserve the benefits of our customers. Options include seeking rehearing, appealing to the Florida Supreme Court, and an internal review of the rule.

“The top priorities of the Agency for Persons with Disabilities are the health and safety of the people we serve. We will continue to try to meet the needs of our customers while adhering to the mandatory requirements of the tier waiver statute,” said Agency for Persons with Disabilities Director Jim DeBeaugrine.

The agency annually serves about 35,000 Floridians with developmental disabilities of mental retardation, autism, cerebral palsy, spina bifida, and Prader-Willi syndrome. For more information on the agency, call 1-866-APD-CARES or visit www.APDCares.org.

This is an article that came from The Tampa Tribune.  Because Ms. Dolinski said it much better than I could, I’ve reprinted her entire article.

By CATHERINE DOLINSKI | The Tampa Tribune

Published: July 3, 2009

TALLAHASSEE – Last fall, 5,555 Floridians with developmental disabilities and their families appealed spending cuts or other changes to the services they receive through a state Medicaid program.

The state Agency for Persons with Disabilities granted formal hearings in only 771 of those cases. So far, only one family has prevailed in its case.

That worries Yvonne Mason, of Seffner, who is awaiting an August hearing to appeal a 42-percent cut in funding for services and care of her adult son, Sean. “That’s disheartening,” she said. “I would have expected better numbers.”

Sean, Mason’s 39-year-old son who lives with her, has been diagnosed with autism, schizophrenia and intellectual disabilities. His mother, who is 70 and suffered a minor stroke four years ago, said she may not be able to continue caring for him if the state refuses to raise Sean’s spending level.

“I think I have a very good case,  but seeing this, you feel like you can’t fight City Hall,” she said. “I hear they have excellent lawyers.”

From the disability agency’s perspective, the low number of successful appeals only proves it is doing its job.

House and Senate lawmakers directed the agency in 2007 to divide beneficiaries of the Home and Community Based Services program into spending tiers, based on their needs and circumstances. The agency was facing a deficit of about $155 million at the time, and lawmakers passed the tough new reforms in an effort to bring the disability agency’s wallowing budget back into balance. On Thursday, preliminary estimates showed the deficit hovering around $12 million due to a variety of cost-cutting measures.

The 2007 legislation provided for an appeals process for beneficiaries to challenge their tier assignments “ but only to determine whether or not APD implemented the Legislature’s mandate correctly.”

APD director Jim DeBeaugrine said he understands why families may feel discouraged by the low success rate of appeals. “But it’s an indication that we have been very, very careful,” he said. “We have double-checked everywhere there’s even been a hint that there may be something wrong. I told our employees and our legal staff that we’re not going to take anything to a hearing unless we’re completely convinced we’ve done it right.”

That’s cold comfort for parents like Mason, who fear what the agency’s spending cuts mean for their children. But a closer look at the appeals process may offer more hope.

Of the 771 appeals that APD approved for review, 621 have not even reached the Division of Administrative Hearings yet. That’s because APD relies largely on lawyers in the Attorney General’s office to represent them at the hearings, and their capacity to process the requests has been limited. To date, only 60 hearings have been held, and hearing officers have released findings in only 14 of those cases so far.

Meanwhile, APD is preparing to notify 175 beneficiaries that the agency has reassigned them to new spending tiers. The agency expects that many of those families will drop their appeals as a result.

Attorneys for APD also noted that of the initial 5,555 challenges from families, 455 were dropped “ in most cases, prior to the agency determining which merited hearings. APD attorney John Newton said that half of all people who filed appeals would not actually have experienced a cut in services, because their tier assignment actually covered what they were already spending.

Rep. Juan Zapata, who chairs the House Human Services budget committee, blamed the volume of initial appeals largely on “scare tactics” by providers like fearing loss of income. The program covers a wide range of services to help with beneficiaries and families with daily life, from regulating diet and monitoring medication to bathing and housekeeping.

“Every time we put cost containment in the process, we get a lot of pushback from providers; they scare the families,” said Zapata, R-Miami.

But eventually, Zapata said, a more consumer-directed approach may provide a better long-term solution.

At DeBeaugrine’s urging, lawmakers inserted language in the 2009-2010 budget directing APD to devise a new system that would customize individual budgets for each beneficiary, based on his or her particular circumstances. Families, most likely in consultation with a professional support coordinator, would decide for themselves the best way to spend the money. Lawmakers have asked APD to submit the new proposal by Feb.1, 2010.

“We’ll be putting the individual, as much as possible, in charge of their own lives, making their own decisions.” said DeBeaugrine, adding that, In time, it might replace the tier system altogether.

“After putting people through all of this?” Mason asked. “But he’s right, I do think this is the only way to go. It makes perfect sense; anyone can relate to that, customizing it to the person. I think DeBeaugrine is the only person who makes any sense.”

Reporter Catherine Dolinski can be reached at (850) 222-8382.

Advocacy Center Files Lawsuit on Behalf of Individuals with Developmental Disabilities

Lawsuit Seeks to Preserve Rights to a Hearing to Determine Level of Medicaid Funding for Services Provided Through the Home and Community Based Waiver


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A lawsuit has been filed by the Advocacy Center for Persons with Disabilities, Inc. ( Advocacy Center ) in the Circuit Court in and for the 2nd Judicial Circuit in Tallahassee , Florida against the Agency for Persons with Disabilities (APD). The lawsuit is titled Lyons v. Agency for Persons with Disabilities, Case No. 2009-CA 0144 and has been assigned to Judge John C. Cooper.

Plaintiffs are William Layton Lyons, Francesca Correa, John Bodack and the Advocacy Center . The Advocacy Center is a non-profit corporation authorized by federal law to pursue legal, administrative, and other remedies for individuals with disabilities in Florida . APD is the state agency charged with the administration of home and community based waiver services for individuals with developmental disabilities.

The lawsuit alleges that cuts to the funding levels for home and community based services for individuals with developmental disabilities will cause Plaintiffs and thousands of others to experience immediate irreparable harm. The lawsuit also alleges that Plaintiffs and thousands of others have been denied their right to a hearing in violation of chapter 120 of the Florida Statutes.

Approximately 3600 individuals, for whom APD has cut funding levels, have requested and been denied access to a hearing. Because of these funding level cuts, plaintiffs face a loss of essential medically necessary services. Individuals’ health, safety and community life depend on services such as behavior analysis and support, transportation, personal care, assistance with meals and hygiene, supplies such as formula and adult diapers, dental care, residential habilitation, and other essential services. Funding for these services is not available elsewhere. Plaintiffs seek to preserve their right to a hearing pursuant to chapter 120, Florida Statutes to determine if APD erroneously reduced their funding allotment.

The Plaintiffs are individuals who exemplify the immediate harm faced by thousands of other individuals with developmental disabilities. Mr. Lyons is a 33-year-old who requires 24-hour daily care and lives with his parents. Mr. Lyons has severe cognitive and motor disabilities from meningitis contracted as an infant. Ms. Correa is a 19-year-old woman who, because of severe autism, functions like a young child. Ms. Correa lives with family, but requires continuous supervision and is facing a substantial cut but no access to a hearing, while her twin sister, who also has severe autism, will be given a hearing to dispute her funding cut. Mr. Bodack is a 27-year-old man who was born with a benign brain tumor that impairs his functional abilities. With the help of services he receives now, he works 25 hours a week at Dairy Queen. He faces the loss of services essential to his continued ability to contribute to the community through his job and other activities.

The Advocacy Center maintains that placing the burden of reducing APD funding deficits on the backs of Florida ‘s citizens with developmental disabilities is harmful to Florida ‘s most vulnerable citizens, as well as fiscally shortsighted. Florida ranks extremely low nationwide in per person funding for home and community based services for individuals with developmental disabilities.

Here is a comment I received from an OT.  I thought she deserved her own post.  Thanks Jo Wryals for your update from Miami.  This is a scary time. 

I am an occupational therapist who provides services to clients in their home or community setting. I have already lost 20% of my clients and stand to lose another 70% if appeals are denied. My clients are those who are in the most need for services.

My reality is I, also, have a mortgage to pay.

I understand the need to balance the budget but I believe the pain of cuts should be across the board. Once again, the poor, disabled and elderly are the hardest hit. A day program in North Miami notified staff today they were closing their program within 4 weeks. Another program in Miami will cut their work program in half plus lay off 4-7 staff persons. The bad news continues on a daily basis.

Jo Wryals, OTR
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