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WaiverProvider.Com September 30, 2011

Is Your Support Plan Current And Correct?

All cost plans are being reviewed between now and November 15, 2011. If your need for services are not well documented, they could be eliminated or reduced. It’s very important that all documentation be sent up at the time of review. If your services are reduced or eliminated, you will have a chance for due process, but the judge will only be looking at what was actually submitted. You will not be allowed to give the judge more documentation during your hearing. Contact your support coordinator to learn more.

Minor Differences, That Are Not So Minor

Is Justification For Your Residential Habitation Rate Documented?

Minimal

$2195.48 Month

Moderate

$3294.48 Month

Self care/daily living tasks:

including physical assistance and mealtime intervention to eat safely, may require mealtime interventions and/or devices.

May require consistent verbal and physical help to complete self care/daily living tasks,

Requires substantial prompting and/or physical assistance to perform self-care/daily living activities.

May be totally dependent on staff for dressing/bathing. May require mealtime interventions and/or devices OR receives all nutrition through a gastrostomy or jejunostomy tube.

Toileting

May require scheduled toileting or use of incontinent briefs.

Incontinent of bowel or bladder. May require scheduled toileting or use of incontinent briefs.

Walking

Walks independently or independently uses a manual or power wheelchair.

Independently uses a powered wheelchair, may need assistance with a manual chair.

Transfer / Change Positions

· May require assistance to change positions.

· Needs physical assistance of one person to transfer or to change positions.

· May require assistance to change positions.

· Needs physical assistance of one person to transfer or to change position.

· Disability prevents sitting in an upright position, has limited positioning options.

Behavioral

· May exhibit behaviors that require formal and informal intervention;

· requires frequent prompts, instruction or redirection, some environmental modifications or restrictions on movement may be necessary.

· May exhibit behaviors that require frequent planned, informal and formal interventions.

· Assistance from others may be necessary to redirect the recipient. May require psychotropic medication for control of behavior. Self-injury or aggression towards others or property results in broken skin, major bruising/swelling or significant tissue damage requiring physician/nurse attention. May have threatened suicide in past 12 months. May have required use of reactive strategies 5 or more times per month in last 12 months. May routinely wear protective equipment to prevent injury from self-abusive behavior.

Physical

· Seizures: If has seizures, no interference with functional activities;

· May require medication for bowel elimination.

· May require a special diet. May require staff supervision to self-administer medications.

· Seizures: May have seizures that interfere with functional activities; receives 2 or more medications to control seizures.

· May require medication and daily management, including enemas, for bowel elimination.

· May be nutritionally at risk and require a physician/dietitian prescribed special diet.

· May have experienced a pressure sore requiring medical attention in the past 6 months.

See All Provider Rates

(888) 444-3331

WaiverProvider.Com

727-841-8943

*Information in our newsletters is provided by Clear Choice Web Solutions, Inc. which is not controlled or monitored by The Agency For Persons With Disabilities. The information provided in our newsletters has been submitted by support coordinators, waiver providers, and family members. Research has been done by Clear Choice Web Solutions. Inc. staff. We do our best to provide you with up to date and accurate information, however, always check with The Agency For Persons With Disabilities. You can call their Toll Free Number 1-866-APD-CARES or 1-866-273-2273 .

2011 All Rights Reservered | WaiverProvider.Com | 1.727.5841.8943

Here is the latest copy of  waiverprovider.com  newsletter.  If you don’t get your own copy, be sure to subscribe today.   

APD case action that led to a request for hearing.
Good information for anyone who requested a hearing.

 

Here is a link to view the sample letters:
Or copy this link into your browser https://acrobat.com/#d=gLQXKyxg9GmhoevPt7RFyw

Click here to read more about this story


PCA services for children with developmental disabilities are restored. Advocacy Center settles lawsuit with AHCA.

The State agreed to identify any person whose personal care assistant (PCA) services KePRO had reduced in the last twelve months, (through June 7, 2009) and to reinstate each person�s PCA services to the former level. The State further agreed to notify each individual that their hours were being reinstated and that their cases would be re-reviewed by KePRO (or any successor peer review organization). These notices will tell each recipient that if they believe their hours have not been reinstated, they can contact a specific person at AHCA.

If you receive notification of a reduction or termination of
personal care services from KePRO, please contact the
Advocacy Center for persons with disabilities, Inc.
850-488-9071 Toll Free: (800) 342-0823 TDD: (800) 346-4127

Click here to read more about this story


Announcing The Posting of 1115
Medicaid Waiver Extension Request

 

On June 30, 2010, the Agency submitted the 3-year waiver extension request to the Centers for Medicare and Medicaid Services as specified in SB 1484. The waiver extension request can be viewed at: http://ahca.myflorida.com/medicaid/medicaid_reform/index.shtml

Click here to read more about this story.


March with APD to Recognize the ADA

July 26 will mark the 20th Anniversary of the Americans with Disabilities Act (ADA) in the United States. In Florida, the public is invited to join the March for Opportunity in Tallahassee on Monday, July 26, to show their support for the ADA. Marchers should gather in the morning about 10 a.m. at Park Avenue and Monroe Street, with the walk beginning promptly at 10:30 a.m. Marchers will proceed down Monroe Street to the Capitol
Courtyard. A celebratory ceremony will begin at 11 a.m. in the Capitol
Courtyard with remarks from disability advocates and dignitaries.
The event is free and open to the public.

Click here to read more about this story.


AHCA pilot project will verify that home health
services are delivered to Medicaid recipients.

The Florida Agency for Health Care Administration (Agency) today announced the launch of the Telephonic Home Health Service Delivery Monitoring and Verification (DMV) pilot project in Miami-Dade County. This project will allow the Florida Medicaid program to verify that home health services were actually delivered to the Medicaid recipient.

�Reducing fraud is an important priority for our Medicaid program,� said Agency Secretary Thomas W. Arnold. �I am pleased that this project is underway, giving us one more tool to ensure that taxpayers� dollars are spent only on services actually provided to recipients.�

Click here to read more about this story.


Call to Advertise your company & be listed on our websites.
We want people to have a true choice.

WaiverProvider.ComSupportCoordinators.Com

FloridaGroupHome.ComFlorida UniteFloridaAutism.org

727-841-8943 or click the link Add My Company

 This is information received from WaiverProvider.com regarding the tiers:

TIER UPDATE… 

 

FYI–The judge has informed APD that the decision will not be made until
the first week of August.

Melanie Mowry Etters, APR, CPRC, CPM
Communications Director
Agency for Persons with Disabilities (APD)
4030 Esplanade Way, Suite 380
Tallahassee, FL 32399-0700
850-414-7551 Office or 488-4257
FAX 850-922-6456/SC 292-6456
 

Yesterday, July 28, a judge was supposed to give his decision on the Tier lawsuit that was brought forth by the
The Advocacy Center for Persons with Disabilities, Inc.
 
WaiverProvider.com has was told by Melanie Etters from APD Central office in Tallahassee FL. That the decision that was supposed to be made by a judge on 07/28/08 but has been postponed. Unless some other unforeseen problem arises, the Final Order should be issued the first of next week.