We received an e-mail yesterday late in the evening regarding changes The Centers for Medicaid and Medicare Services (CMS) is proposing in regard to State Medicaid agencies.  While I am a neophyte, CMS appears to be the federal agency that manages funding allocations which are appropriated to the states.  CMS has proposed what would be equivalent to private insurance plans. 

Perhaps most important, CMS proposes 11 exemptions to needy populations that would probably cover most of our rider clientele.  Mike LaVoie, who has worked in the system for more than 30 years, writes, “In case, you missed this buried in some of the documents from Agency for Persons with Disabilities, pay particular attention to CMS recommendations cited in the email- from Department of Transportation to eliminate the requirement for Medicaid to provide transportation to and from Medicaid Services.  Needless to say, this could be devastating to the provision to transport to access Adult Day Training and Supported Employment services. “

LaVoie continues, “CMS suggestions that this could take years may be misleading as we all know, CMS has approved equally impactful decisions faster than that lately”

Lsia Bacot suggests that interested parties should comment by clicking onto this link:  http://www/regulations.gov/fdmspublic/component/main?main=SubmitComment&o=09000064803baf64

The comments should were due Monday, March 26, 2008 which is the day before this posting.  Everyone apologized about the short turnaround.  However, this was an important decision that was made public much too late for most people to react.

Here are a couple of the emails that were sent yesterday:

From: Mike

Sent: Monday, March 24, 2008 2:23 PM

Subject:FW: CMS Proposed Rule- Important

 Hey folks,In case you missed this buried in some of the documents from APD.Pay particular attention to CMS recommendations cited in the email from Dept of Transportation,to eliminate the requirement for Medicaid to provide transportation to and from Medicaid Services.Needless to say, this could be devastating to the provision of transport to access ADT and Supported Employment services.Suggestions that this could take years may be misleading as we all know CMS has appoved equally impactful decisions faster than that lately.Mike 

From: Johnson, Karen E.

Sent: Monday, March 24, 2008 9:06 AM

Subject:FW: CMS Proposed Rule- Important


—–Original Message—–
From: Mack, Heather@Career & Technical Education

Sent: Monday, March 24, 2008 8:58 AM

To: Johnson, Karen E.

Subject:FW: CMS Proposed Rule- Important

  Although many of us get these from Paula, I think there are many on our ICB list that do not.  Please forgive if this is redundant for you. HeatherHeather Mack, Special Populations
Career and Technical Education
2700 Judge Fran Jamieson Way
Viera, Florida  32940
321-633-1000 ext. 379

From:Davis, Paula [mailto:Paula.Davis@brevardcounty.us]
Sent: Monday, March 24, 2008 7:46 AM
To:Philip.Antos@vr.fldoe.org; pamela.ascanio@vr.fldoe.org; fairhousingbaade@bellsouth.net; tballard@fl.easterseals.com; fbarger@uwbrevard.org; Arthur_Barndt@dcf.state.fl.us; laura@d-s-i.com; patrick.blucker@patrick.af.mil; lbrannon@circlesofcare.org; mbrilley@job-link.net; sbunker@cfl.rr.com; scaporina@fl.easterseals.com; scash@cvicentralflorida.org; achestnut@brevardparks.com; dcooke@arc-brevard.org; Davis, Lacie; Sandra_Deveaux@doh.state.fl.us; kdilulio@arc-brevard.org; ldonoghue@211brevard.org; judy_dunning@apd.state.fl.us; Olga_Emgushov@doh.state.fl.us; texum@mail.ucf.edu; dezell@mail.ucf.edu; Betsy@Brevardbln.org; feldml@palmbayflorida.org; fertell@brevardcc.edu; cindyf@communityservicescouncil.org; llfowler@bellsouth.net; ceo@spacecoastredcross.org; giordja@hotmail.com; mgoff@rbhsinc.com; traci.griffin@vr.fldoe.org; lisa.gurri@health-first.org; mhalal@devereux.org; Christopher_Hale@doh.state.fl.us; pamelia_hamilton@doh.state.fl.us; thargrave@bacbrevard.com; rayfly42@bellsouth.net; eklausman@cfl.rr.com; llee@uwbrevard.org; dlee779@cfl.rr.com; Lewis, Eva@Exceptional Education; jim@ridescat.com; janlokay@aol.com; Lowe, Kathy; Mack, Heather@Career & Technical Education; fairhousingmiles@bellsouth.net; bmitchell@brevardparks.com; patricia.nellius@cbcbrevard.org; bohara319@aol.com; dolson@bacbrevard.com; paulillo@fit.edu; Denise_Porter@doh.state.fl.us; althea_puzio@doh.state.fl.us; Barbara_Ray@doh.state.fl.us; prosbury@dcf.state.fl.us; lovesgreen52@bellsouth.net; JSchiff@SpaceCoastEDC.org; kschillo@cocoabeachchamber.com; rseemer@etsfl.com; sshinn@sceic.com; angela_simonton@doh.state.fl.us; lverrysi@mail.ucf.edu; jcsmith@mail.ucf.edu; maria_stahl@doh.state.fl.us; rstimson@specialgatherings.com; dswartz8@cfl.rr.com; ntaback@brevardparks.com; Tolson, Sharon@Viera; maria.trieste@health-first.org; Marlene.A.Ulisky@SSA.gov; rv@cfl.rr.com; walkerw@spacey.net; jwatson@job-link.net; jwhitaker@circlesofcare.org; Wickham, Cindy@Viera; mwysocki@goodwillcfl.org; Davis, Paula; Becker, Brenda J; Becker, Jason L; Breslin, Brian R; Bryant, Stephanie L; Dettra, Samuel R; Ford, Suzanne; Golden, Ian J; Hansen, Christine; Harris, Tammy J; Herriott, Carl J; Holt, Leigh R; Howell, Cheryl; Ingalls, Joyce L; Joiner, Chenita M; Langan, Judy; Parks-Martin, Donna; Mcdonald, Michael E; Mcguffie, Glenn A; smosey@etsfl.com; Parks-Martin, Donna; Reich, Rosa M; Singleton, Lesley D; Spiller, Laverta; Urban, Sandra; Williams, Gay N; Wright, Pam

Subject:FW: CMS Proposed Rule- Important

 FYI – regards M-NET 

PaulaPaula C. DavisHuman Services Planner IIBrevard County Housing and Human Services2725 Judge Fran Jamieson Way, Suite B103Viera, Florida  32940 321-633-2076paula.davis@brevardcounty.us 
Disclaimer: “This e-mail is for information purposes only and does not necessarily reflect the views of the Brevard County Board of County Commissioners nor Brevard County Housing and the Human Services Department.”

From:Bacot, Lisa M. [mailto:Lisa.Bacot@dot.state.fl.us]
Sent: Thursday, March 20, 2008 4:25 PM
To:CO-CTD Staff
Subject:CMS Proposed Rule- Important
Importance: High

 TO:  Entire TD Distribution List 

The Centers for Medicaid and Medicare Services (CMS) has issued a proposed rule relating to allowing State Medicaid agencies the opportunity to create benchmark packages that would be equivalent to private insurance plans.  We appreciate that CMS is looking outside the box, however, one of the proposed plans in this rule is to allow Medicaid agencies the opportunity to “relieve States of the responsibility to assure transportation to and from providers.”  Before a state could act on this (if it becomes final rule), the state plan would have to be adjusted, so it would be a year or two down the road.  In addition,  CMS proposes 11 exemptions to needy populations that would probably cover most of our rider clientele.   Regardless, it does have the potential of making very significant changes to Medicaid Transportation services to certain clients. If you do want to comment, please click on this link:  http://www.regulations.gov/fdmspublic/component/main?main=SubmitComment&o=09000064803baf64  You can then enter your contact information in and either type in your comments or revise the attached sample letter and upload it into the system.  Comments are due Monday, March 24, 2008.  I apologize for the short turnaround.  I do not have a copy of CTAA’s response, but when I get it, I will send it to you. Thank you.  Lisa M. BacotExecutive DirectorFlorida Commission for the Transportation Disadvantaged605Suwannee Street, MS 49Tallahassee, FL 32399-0450lisa.bacot@dot.state.fl.usDirect Line (850) 410-5711Toll Free (800) 983-2435TTY (850) 410-5708Florida Relay System Dial 711 (Florida Only)FAX (850) 410-5752www.dot.state.fl.us/ctd  

At The Special Gathering, we have chapel programs.  That is our main thrust and mission.  We evangelize and disciple people who are mentally challenged.  We often say that our members learn on a third or fourth grade level.  They are stuck socially in junior high but they have all the need and concerns of any other adult. 

Those concerns can be terribly confusing to our members and their families.  Therefore, we also do advocacy and teach self-advocacy.  One of the main issues facing our members is transportation. 

In our mobile society, transportation is a large issue in every household.  We take for granted that the second largest expense a family will have is our automobiles and the costs associated with them.  However, our members do not drive.  Therefore, other than mom and dad who are usually still transporting, public transportation is the only option for people who are intellectually disadvantaged.

 In the state of Florida, the transportation systems are operated on a county-by-county basis.  This means that some transit systems are good and some are not necessarily the best.  In Brevard, Space Coast Area Transit (SCAT) is a national, award-winning transit provider but there are a lot of obstacles they face.  With the recent budget cuts in Florida, everything will be effected, including transportation. 

I am enclosing an e-mail I received from the Commissioner of Transportation.  You may be interested in responding to it. 

TO: ALL INTERESTED PARTIES Many of you have been instrumental in the Commission’s legislative efforts for Medicaid Non-Emergency Transportation and the TD Program over the past few years.  Your efforts have not gone un-noticed or un-appreciated.   This  past year has been an extremely dynamic one concerning Medicaid NET Services.  The Commission is supporting legislation this year to update Chapter 427 F.S. with the addition of language that clarifies the requirement for any agency to go outside of the coordinated transportation system.   We are having a meeting to update and brief those of you that are interested in helping to support the Commission’s legislative efforts this year.  The meeting is February 18th, at 3:30pm at the Commission’s office in Tallahassee. If you can not attend the meeting the conference call number is, ,  888-808-6959 and the conference code is  34767.  Please let us know if you are able to participate in the meeting, need directions, or any additional information.   Thank you in advance for your continued support of the TD Program.  We look forward to working with you. Thanks- Laurie Revell, M.S.WLegislative AffairsCommission for the Transportation Disadvantaged605 Suwannee Street, MS-49Tallahassee, Fl 32399 (850)410-5704   e-mail  laurie.revell@dot.state.fl.us