megan wall

Megan Wall, esq

Summary of the iBudget Rule Challenge Final Hearing before DOAH
7/9/13-7/11/13

Earlier this month, I attended the three day rule challenge hearing before the Division of Administrative Hearings (“DOAH), at which Holland & Knight attorneys Gigi Rollini, Karen Walker and Matthew Mears represented developmentally disabled consumers challenging the third version of proposed rules to implement the iBudget.  Like so many other consumers receiving services through Florida’s Developmentally Disability Services Waiver, all four Petitioners received significant proposed reductions under the iBudget further depleting their already inadequate funding.  Because this case impacts every Waiver consumer, I am summarizing what occurred for those who could not attend.

In response to the rule challenge, APD hired five private attorneys, in addition to two in-house lawyers. The team of seven lawyers had significant resources at their disposal to defend the rule.

In Florida, rule challenges are fast track cases meant to be heard within 30 days from the filing of the petition.  This hearing was scheduled the very first full week in July. The Holland & Knight lawyers fought hard (and succeeded) against APD’s attempts to delay the hearing. While it is difficult to go to a full-scale hearing so quickly, the Holland & Knight team was concerned that to give APD more time to prepare would drive up the expense of the case. Amazingly, despite the holiday weekend, the hearing began as originally scheduled, which was difficult but strategically important.

The case at its core is simple. The iBudget statute directs APD to set each client’s funding for services at an amount based on a statistically valid algorithm, and then consider if the person needs an increase to that amount because of extraordinary, one-time, temporary or changed needs.  Florida law prohibits APD from enacting rules that run contrary to, or expand the implementing statute. Despite these legal limitations, the evidence in the case showed that:

1.         APD used the algorithm only as a starting point for setting funding because, in APD’s own words, the algorithm APD designed produced “harsh results” for many. Because the algorithm does not result in an equitable allocation of the funds for DD waiver clients, APD created an elaborate and subjective “methodology” to decide whether or not to use the algorithm to set a client’s iBudget. This supplemental “methodology” treats some groups of people differently, even where clients in those groups have the exact same needs.  Most glaringly, APD’s “methodology” targets existing DD waiver clients and singles them out to receive lower budgets than a new client with identical needs. Given that the law requires an “equitable allocation” of funds based on “the client’s level of need,” the evidence showed at the hearing that APD’s actual system is not consistent with the system described in the iBudget statute.

2,         APD told the Florida Legislature that if it adopted an iBudget system for Florida, then 64% of existing Waiver clients would see an increase in their budgets as a result of the iBudget.   However, APD later made a “policy decision” that funding increases simply would not be given and the algorithm would be used only to reduce, not increase a client’s allocation of funds.

3.         Former University of Florida Professor Dr. McClave (an expert in statistics and econometrics who has written text books on these types of models and created successful Florida Medicaid models) reviewed and tested the APD algorithm and testified on behalf of the Petitioners that it was statistically unreliable, including that APD’s chosen algorithm had a margin of error of over 40%!  He said that this is not a model based on a valid statistics approach, and that the model was unacceptable in his field. He memorably testified that APD’s chosen model is as accurate as “throwing darts at a wall of numbers.”

4.         APD identified no specific legal authority that allowed it to implement the iBudget the way it is being done. APD could point to no legal authority to use a statistically unreliable algorithm, to reduce amounts determined by the algorithm, to use a “decision tree” process to reduce existing client’s budgets, to single out existing clients and assign them lower budgets, or to reduce budgets without any final rules at all.  Recognizing the shortcomings of its own position, APD admitted it asked the Florida Legislature in 2012 to change the iBudget statute to  conform to how APD was actually implementing the program.  The Legislature declined to make the revisions. Regardless, APD simply continued to implement the system using its system rather than one consistent with the statute.

5.         APD’s statistics expert (Dr. Niu), who designed the algorithm, testified that he did what his client (APD) asked him to do and he did his best.  He did not consider other state’s algorithms. His reason was that he did not need to because he “only relies on [him]self.”  He used a very few variables (about seven), and assumed he could drop out some variables (such as the entire physical status portion of the QSI) on the basis that other, similar variables (such as the behavioral status portion of the QSI) tended to measure about the same thing—not realizing that every DD client doesn’t have both physical and behavioral needs, or does not have them in equal force. The result—those with significant physical needs, but no significant behavioral needs, will get substantially lower budgets than those with equally costly behavioral needs.

Also, it was shocking to learn that Dr. Niu “meant to do testing” to ensure the validity of the model, but then just did not get around to performing the type of testing necessary to ensure the validity of the model.  He did no testing against other years’ budgets (as is commonly done in statistics, apparently), or “log” method testing (as is typically done in statistics, apparently, when the model is a budget allocation or distribution model).  This was the case even though Dr. Niu has done a much simpler distribution model for the Florida Department of Transportation, and he did do “log” method testing for that model.

Dr. Niu also had no response to the UF Professor’s testimony that the algorithm was not statistically valid.  In fact, he said complimentary things about the other expert, Dr. McClave, and hoped his model “would get better over time.”

NoteAPD testified that it will analyze each client’s iBudget every 12 months to determine what further cuts can be made.  When APD decides it is appropriate, it may (or may not) re-run the inaccurate algorithm in any year it wants.  Under the proposed rules, APD has authority to use the proposed subjective methods in the rule to further reduce client services at its discretion. However, for future years, the processes which permit increases for extraordinary, one-time, temporary and changed needs will no longer be available to the person whose services are being reduced.  Of course, if the algorithm dictates an increase for a DD client, APD will still have the ability to find that award is “really just not medically necessary,” since APD continues to be the sole determiner of what is and what is not medically necessary.

APD’s arguments in response to Petitioners’ case were as follows: We worked really hard on this system; the Tier system has expired and, if this new system is thrown out, APD cannot return to the Tier system; we did our best; we do have authority to do what we did (without specific reference to any law or statute); and, mainly, the Florida Legislature is very happy with APD because APD has substantially cut the cost of the DD waiver program with APD’s interpretation of the iBudget system!  In fact, APD testified that the Legislature “rewarded” APD as a “thank you” for doing such a good job with two additional appropriations totaling $60 million, which APD used internally and to bring people off the waitlist.  [The judge asked if APD should have put that into the iBudget calculations and reappropriated the money to the existing DD clients, and APD said no; the Judge asked if APD had re-run the algorithm since APD first did it (one time) based upon each years’ new appropriation, and APD said, “No, and we are not going to.”]

And, finally, there was the real client example offered at the hearing: An amazing and articulate father of a DD 26-year-old came in and told his son’s story—with a 20 IQ, he lives in a home inherited by his father, which permits his son and two other DD clients to have extremely reduced rent.  All need 24-hour supervision, which they can barely piece together between the three of them—with less and less money each year, less and less of a rate of payment each year.  And, now, all three have been given iBudget reduction notices (his son’s, alone, is an over $8,000 reduction under iBudget).  They were barely making it since their budget is already to the bone (even with the father’s substantial assistance). With the cuts now proposed, there is no hope and nowhere for them to live, except an institution were these cuts to be implemented.

With that, the story of this proposed iBudget system was told.  The agency admitted it was not following the statute to implement the system and the model being used cannot be shown to be statistically reliable.  They agreed that cuts may continue each year. Even if every client could bring into an individual hearing an expert statistician to object to algorithm used to calculate the proposed reduction, the DCF Fair Hearing Officers lack the authority to find the rules invalid. Only DOAH has that authority.  Thus, the reason why this case is before DOAH for a decision, and why it is so crucial a test case.

A decision will be issued around the end of August or early September.  The lawyers for the Petitioners agreed to file this case without sufficient cash in hand on the hope that once the DD community knew the truth about the proposed iBudget system, they would join together to support efforts to compel APD to use an algorithm that is statistically reliable  and a process that follows the law. The Petitioners’ lawyers brought this David and Goliath case, did it in an unbelievably short period of time and, as a result, kept the costs to a bare minimum ($225,000).  Our team, led by Gigi Rollini, presented a clear, articulate, and persuasive case.  And, now, we have to pay her!  [And did I mention that in addition to APD’s seven attorneys and the work they all created, there was also surprise evidence sent by APD at 8:30 am the final day of trial, and surprise witnesses on the final day of witness disclosure—less than one week before hearing—including an expert APD brought in at the last minute and paid $85,000 for his service. And despite the additional work and expense tied to this surprise witness, he ultimately did not even testify because he had nothing to say after hearing Dr. McClave.]

Please contribute now to help us to meet our $125,000 goal!  To get there, we are asking that you consider donating at least at the $10,000 level.  We also specially thank those increasing this to the $20,000 level—we could not do this without you!

Please be a part of the solution!  There are two easy ways to contribute to the APD iBudget Proposed Rule Challenge:

(1)       Checks may be made out to Holland & Knight LLP, and sent to ATTN:  Gigi Rollini, Post Office Drawer 810, Tallahassee, Florida32302; or

(2)          Payment by wire transfer to:

Wells Fargo Bank N.A.

420 Montgomery Street

San Francisco, CA 94104-1207

ABA # 121000248

Account # 2090002390441

For Credit to: Holland & Knight, LLP

Please indicate “APD iBudget Proposed Rule Challenge” as the Beneficiary Reference in the wire.

Thank you!

–Megan Wall, Managing Attorney, St. Johns County Legal Aid

Announcement From

The Florida Developmental Disabilities Council

WEBINAR: Understanding Asset Building & Public Benefits for People with Disabilities in Florida

Visit our Website 

This series consists of two 90-minute installments and will give participants a basic understanding of many benefit programs offered by local, state and federal governments, many of which have applications and rules that change often and can be confusing. Sharon Brent, Director of Training & Technical Support at National Disability Institute will conduct the training sessions.

After participating in this series, you will have a better understanding of:

  • Public benefits and differences of programs under Social Security – SSI & SSDI.
  • The value and effect of how earned income (wages) and unearned income affect cash and medical benefits for both programs.
  • Work Incentives and which benefit program they apply to, when to use them & the value they offer when applied.
  • The difference between Medicaid & Medicare rules and the value when individuals earn income.
  • Available information from the SSA website & other important web resources for updates and continuous learning.

Who should participate in this two-part series?

  • SSI and/or SSDI beneficiaries who work or want to work
  • Parents & family members of SSI & SSDI beneficiaries who work or want to work
  • Direct service professionals who work with a SSI or SSDI beneficiary who earns or wants to earn income
  • Vocational rehabilitation managers & staff serving people with disabilities who work or want to work
  • School-to-work transition staff
  • Anyone interested in learning more about public benefits and the interaction between benefits, employment and asset building

THIS IS A TWO-PART SERIES. Participants must attend both sessions – access to the September 24th session will be given only to those who attend the September 10th session. REGISTER NOW!

This webinar is presented by:

MEETING INFORMATION

Date: September 10 & 24, 2012

Visit our Website


Time: 1:30 to 3:00 PM Eastern


Captioning will be provided during this webinar. If you use a screen reader and would like a copy of the powerpoint presentation ahead of time, please contact Katie Metz.

Visit our Website


 

Barbara Palmer to Lead Agency for Persons with Disabilities

Today, Governor Rick Scott named Barbara Palmer as director of the Agency for Persons with Disabilities, effective August 22, 2012.

She has served as the agency’s chief of staff since 2011.  “Throughout her distinguished career, Barbara has been widely recognized for her leadership and advocacy work on behalf of individuals seeking equal opportunities, and she has demonstrated that same high energy on behalf of Floridians with disabilities,” Governor Scott said.  “The agency and the customers it serves will benefit from her broad range of experience and expertise.”

Previously, Palmer served as assistant secretary for administration with the Florida Department of Children and Families from 2009 to 2011. Among her private-sector experience, she was president and CEO of Palmer, Musick and Associates from 1993 to 2009 and CEO of Illuminactive Multimedia Inc. from 1995 to 1997.

She served as director of the division of hotels and restaurants within the Florida Department of Business and Professional Regulation from 1989 to 1991. At Florida State University, she was associate vice president for governmental relations from 1985 to 1989 and director of women’s intercollegiate athletics from 1977 to 1985.

Nationally recognized for her efforts to secure passage of Title IX and ensure equity in sports for women in school athletic programs, Palmer was inducted into the Florida Women’s Hall of Fame in 1982. In the 1970’s, Palmer began her career as executive director and vice president of IMPACT Enterprises Inc., a company serving individuals with developmental, mental and physical disabilities transitioning from institutional settings to community placements. She received bachelor’s and master’s degrees from Florida State University.

The current director, Mike Hansen, has accepted a position with the Florida Senate. With more than 30 years of experience with health and human services policy and budgeting, Hansen has spent the past year working to continue increased efficiencies at the agency with the goal of balancing the agency’s budget and ensuring the continuation of services to Florida’s persons with disabilities.

“Mike’s extensive experience with Medicaid services and budgeting have been a tremendous help as we continue to work to ensure the availability of services to one of Florida’s most vulnerable populations,”  Governor Scott said. “I wish him all the best in his future endeavors.”

APD Communications Wants Your Opinion

The Communications Office of the Agency for Persons with Disabilities wants to ensure that it is meeting the communication needs of all its stakeholders which include employees, customers, and providers.

The Communications Office is responsible for all agency media relations, program marketing, brochures, posters, the Champion newsletter, websites, displays, constituent correspondence, agency customer service inquiries, Disability Employment Awareness Month activities, presentations, and other related activities.

Let APD know what you think!

Please spend two minutes completing this online survey (https://wwwsurveymonkey.com/s/APDComm) to help APD improve it’s communication with you.

Dykes v. Dudek Settlement Agreement Summary

On July 2, 2012, the Dykes v. Dudek lawsuit was settled. Under the settlementagreement the Agency for Persons with Disabilities (APD) and the Agency for Health Care Administration (AHCA) will engage in the activities described in this Settlement Agreement Summary. The agreement addresses five key areas:

  • Residents of ICF/DDs and Nursing Homes
  • Crisis
  • Individual Family Support (IFS) Funds
  • Waitlist Strategic Planning Workgroup
  • Employment

Visit our Newsroom to read the

Settlement Agreement Summary.

Thanks to guest columnist and Executive Director of Special Gathering, Richard Stimson for this article

Many people within the mentally challenged community are receiving phone calls about the iBudgets.  This is a new thing from the Agency for Persons with Disabilities (APD).

One of the major differences is that APD may ask you to give up some money.  Perhaps they want you to give up $3,000 from your home-care services for which they will pay.  Under the iBudget, you can say back to them, “What about $1,000?  What if you give me $1,000, instead of $3,000?”  Then you must wait to see what APD says.

APD calls this a negotiation.  You will still be able to appeal; but APD is hoping they can find an amount you can agree to give up through these negotiation.  If you ask for an appeal, it will mean that you might win your appeal and you will get everything for which you have asked.  However, if you lose, then you will get nothing.

I have been to two of these negotiations.  These meetings feel like buying a car.  When you want to purchase a car, once you get a price from the sales person, you can ask for a lower price.  Then the sales person has to go and get their boss to sign off on the amount.

I really do not have any good advice.  If you just say, “No,” to the cuts and decide to appeal them it is all or nothing.  You may want to negotiate with APD and try to get something rather than chance getting nothing.

EmployME First Forum

You are invited to participate in a discussion about community employment for people with intellectual and developmental disabilities in Florida. Join us for a presentation on the Florida
Developmental Disabilities Council’s EmployME First project, a project to develop ways to increase access to community employment for people with intellectual and developmental disabilities.  Participants will have the opportunity to ask questions about the project and provide feedback on the current state of employment for people with IDD in Florida.

  • Pensacola July 11, 2012 11:00am-1:00pm
  • J. Earle Bowden Building Conference Room
  • 1 120 Church St.
  • Pensacola, FL 32502
  • Jacksonville Friday, July 13, 2012 1:00-3:00pm
  • APD office 3631 Hodges Blvd. Building B
  • Jacksonville, FL 32224
  • Orlando Tuesday, July 24, 2012 2:00-4:00pm
  • Goodwill Industries of Central Florida
  • 7531 S. Orange Blossom Trail
  • Orlando, FL 32809
  • Sarasota, Wednesday, July 25, 2012 11:00 am-1:00pm
  • Selby Public Library 1331 First Street
  • Sarasota, FL 34236
  • Ft. Lauderdale Thursday, July 26 2:00-4:00pm
  • Workforce One/ Broward County
  • 6301 NW 5th Way, Suite 3000
  • Fort Lauderdale, FL 33309

Please RSVP at www.iciget.it/emf
Space is limited so please register early!

APD’s New Regional Offices Take Effect

APD will now refer to regional offices instead of area offices. That’s because the APD’s new system of regions took effect on July 1. To help you get a handle on all this, here is an easy guide to the new regions and the former areas they contain:

  • Northwest Region – Areas 1 and 2 except Madison and Taylor counties
  • Northeast Region – Areas 3, 4, and 12, plus Madison and Taylor counties
  • Central Region – Areas 7, 13, 14, and 15
  • Suncoast Region – Suncoast Area (23) and Area 8
  • Southeast Region – Areas 9 and 10
  • Southern Region – Area 11

Also, you can view the agency’s Regional Map, which shows the new regions and lists all of the counties within them.

Click on the link or paste the link into your browser to see the map.

http://apdcares.org/champion/2012/july/july/map.htm

The new APD regional directors are:

  • Lynne Daw for the Northwest Region
  • Gayle Granger for the Northeast Region
  • Merari Perez for the Central Region
  • Geri Williams for the Suncoast Region
  • Gerry Driscoll for the Southeast Region
  • Evelyn Alvarez for the Southern Region

APD Regional Directors and Strategic Planning

On May 8 and 9, the six new regional directors for the Agency for Persons with Disabilities (APD) met in Tallahassee to begin planning for the restructuring of the APD offices throughout the state.

APD Director Mike Hansen kicked off the meeting. Several program areas presented updates to the regional directors to ensure that they were aware of the latest information.

The new APD regional directors are:

  • Lynne Daw for the Northwest Region
  • Gayle Granger for the Northeast Region
  • Merari Perez for the Central Region
  • Geri Williams for the Suncoast Region
  • Gerry Driscoll for the Southeast Region
  • Evelyn Alvarez for the Southern Region

Following the regional planning meeting, the regional directors joined the rest of the agency for an APD Strategic Plan webinar. Each team leader presented an update on the activities that have occurred as part of the team’s strategic objective.

 

_____________________________________

 

Webinar for CDC+ Personal Care Services Transition

This transition will affect CDC+ consumers under the age of 21 who wish to obtain PCA service via Medicaid State Plan AND self-direct the approved PCA funds via their CDC+ monthly budget. Consultants who serve these consumers are encouraged to attend one of the scheduled Webinars.

For more information call your local APD area office or contact Alexandra Weimorts CDC+ Director

Consumer Directed Care Plus Services

Agency for Persons with Disabilities

Phone: 850/414-6609 Fax: 850/414-7761

Blackberry: 850/274-1230

Areas 9 & 10
June 14, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm

Area 11
July 10, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm
July 19, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm

Areas 1 & 2
August 7, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm
August 16, 2012
Representative Training 10am – 12pm

Consultant Training 1pm – 3pm

Areas 4, 12 & 13
September 4, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm
September 13, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm

Areas 8 & 23
October 2, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm
October 11, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm

Areas 3, 7, 14 & 15
November 8, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm
November 13, 2012
Representative Training 10am – 12pm
Consultant Training 1pm – 3pm

 

This is part of the newsletter MedWaiver sent by Aaron Nangle. Go to their website to voice your opinion.

APD Communications Wants Your Opinion

The Communications Office of the Agency for Persons with Disabilities wants to ensure that it is meeting the communication needs of all its stakeholders which include employees, customers, and providers.

The Communications Office is responsible for all agency media relations, program marketing, brochures, posters, the Champion newsletter, websites, displays, constituent correspondence, agency customer service inquiries, Disability Employment Awareness Month activities, presentations, and other related activities.

Let APD know what you think!

Please spend two minutes completing this online survey (https://wwwsurveymonkey.com/s/APDComm) to help APD improve it’s communication with you.

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 . 


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

For information about the event or to reserve a table for your company,
please contact WaiverProvider.com’s Aaron Nangle or Richard Lilliston 
at (813) 610-8511 or Email: stlucieexpo@yahoo.com.

Action Alert – SB 1516

The Florida Senate Health Regulation Committee is about to take up SB1516 which will substantially alter how services are prioritized and individual consumer iBudget allocations are decided.  The bill was amended this week but key issues were not resolved.  The bill is scheduled be heard as early as Tuesday January 31st.

Background:    Sen. Joe Negron filed SB 1516 on behalf of the Agency for Persons with Disabilities (APD) earlier this year.  This bill changes APD’s responsibilities for services to those related primarily to health and safety.  As filed, the bill limits APD’s responsibility for quality of life to individuals living in its two major state institutions. What this means in terms of iBudget allocations is that an individual’s need for funds excludes any need for adult day training, transportation, respite care, dental care, companion services and several others.  With this methodology, people would have to choose what to give up if they wanted any of these services or find another way of funding them.

While there is no House companion, this is a very dangerous bill.  APDs strategy is to get this bill passed through the appropriations process which could happen even without a House version of the bill. 

Action Needed:  Contact your Senators and tell them (in your own words) what it would mean if you had to give up any of these services.  If your Senator is on the Health Regulation Committee ask them to vote against this bill.  Below are the members of the Health Regulation Committee.

______________________________

Miguel Diaz de la Portilla – Miami Florida

(305) 643-7200 & (850) 487-5109

portilla.miguel.web@flsenate.gov

________________________________________

Mike Fasano – New Port Richey Florida

 (727) 848-5885 & (850) 487-5062

 

fasano.mike.web@flsenate.gov

__________________________________

 Don Gaetz – Destin Florida

 (850) 897-5747 & (850) 487-5009

gaetz.don.web@flsenate.gov

_______________________________________

Rena Garcia – Hialeah Florida

305-364-3100 & 850-487-5106

garcia.rene.web@flsenate.gov

_______________________________________

Dennis Jones – Seminole Florida

(727) 549-6411 & (850) 487-5065

jones.dennis.web@flsenate.gov

_______________________________________

Jim Norman – Tampa Florida

(813) 265-6260 & (850) 487-5068

norman.jim.web@flsenate.gov

_______________________________________

Eleanor Sobel – Hollywood Florida

(954) 924-3693 & (850) 487-5097

sobel.eleanor.web@flsenate.gov

Each year in Florida, there are threats of budget cuts to the services of people who are mentally challenged.  More and more, these cuts are a reality.  These are lean times everywhere.  Many states are broke or going broke.

While it appears that other budget items either stay the same or they are increased, the intellectually disabled community received the projected cuts.  Placing blame does little good.  However, we have learned that being proactive does help, especially if the advocacy is done by self-advocates.

Last year, a group of self-advocates traveled several times during the legislative session to petition the legislators to stop the proposed changes and cuts.  While walking the halls of the Senate office building, these men and women “bumped into” the president of the Senate.  They asked for an appointment to speak with him and got one.  Some are saying their advocacy made the difference in legislation being altered in the favor of the consumer.

Last evening, several people who are involved in Special Gathering from a couple of states met for dinner.  One of the SpG volunteers also heads an agency.  “We only get paid for three days of rehab now for Jill and others.  Therefore, we have to be pretty creative with the days for which we are paid.  The other days have to be even more creative,” she said, laughing.  However, I have seen the toll this financial strain has taken on the agency and their employees.

This agency is determined to not enter a “survival mode” mentality.  However, other agencies who work with our population have had to simply find ways to exist.   The uncertainty of funding does play on the minds of people who are mentally challenged.  They are aware of the pending difficulties.

In dealing with our members, it may be good to give them continual reassurance that God has a plan and that He will protect us if we remain faithful to Him.  This will be reinforced and believed, if we truly believe that our stability doesn’t come from the government or even the value of the dollar but from a gracious God who loves us.