Tag Archive for budget cuts

Yet More Cuts and Reductions to the APD Budget In Florida

www.waiverprovider.com

Our friend Aaron Nangle of waiverprovider.com has provided information on the Draft Plan for APD’s HCBS Waiver – Home and Community Based Services Waiver Expenditure Reductions.

These will impact all persons with disabilities in Florida.

Publish Standardized IB Rates for future with lower rates retained, expected savings $1,549,764 standardizing rates based on individual Rate Rule needs rather than negotiated contracts required. This Rate Matrix is in development. Savings dependent on effective date.

  Eliminate Res Hab quarter hour as other options available for in home supports. $917,290 Eliminates the quarter hour unit, as it is usually used in their own home, Would need Rate rule change. This may increase IHSS use, reducing service array.

Fee Collection by Residential providers, estimate $8,401,147 Form would be created to calculate recipient responsibility to be deducted from Waiver service bills, monthly surplus frozen or swept by service, Would need method developed and procedures to monitor, would be late in year before implementation.

 12.5% required match as State share, savings not determined, This would leverage current spending to decrease GR effort and would need long term research with AHCA and CMMS and unknown if local effort applicable.

Core Service models– savings not determined, would limit waiver services to only those services considered core to prevent institutionalization, Would need Waiver amendment.

 Service Limits-not determined, would reduce service limits for each Waiver service and would be limited to only essential elements within the budget.

 Limit individual cost plan to not greater than average ICF/DD estimate of $3,300,000 savings and some thought it could be up to as much as a possible 17 million realized if limited, Alternative supports would be necessary for adversely impacted clients. Would need Waiver Amendment.

Three days of blogging just listing the cuts.  And who knows if they are done.

Keep squeaking those wheels on your wheelchairs.  We need to draw attention to the cuts and to those who receive no services and are left behind.

More APD Cuts and Reductions in Florida

www.waiverprovider.com

Our friend Aaron Nangle of waiverprovider.com has provided information on the Draft Plan for APD’s HCBS Waiver – Home and Community Based Services Waiver Expenditure Reductions.

These will impact all persons with disabilities in Florida.

Collapse Behavior Analyst rate from level 1-2, estimate of $2,580,874 Rate for level 2 is $50 per hour for solo and agency is 20% above on an average, this would need a Handbook and Rate Rule change. Currently behavior analyst rates are based solely on years of experience not client need or outcomes.

Rate reductions to Medicaid State Plan nursing and therapies assessments. savings with an estimate of $ 1,530,476 Would need a Rate rule change that is currently being sought.

  Res Hab reduction of rate levels from 9-4 with savings expected of  $21,113,087 This would need redefinition of level of supports and associated rates as well as revision of staffing levels in the handbook, Would need Handbook and Rate Rule change- APD is seeking provider input for alternative savings.

Collapse IHSS quarter hour above live in rate, expected savings $2,714,937 Would delete use of quarter hour above the day rate and use QSI 1,2,3 and eliminate IHSS 1/4 hr. above day rate. Rationale is that Individuals with level of need 1,2,3, do not require additional supports beyond a daily rate for IHSS.

Utilization management of behavioral services possible ? $3,000,000  6 month increment with reapplication and approval required after each increment: declining hours based on matrix scores and the Implementing of on site reviews for continued stay in intensive behavioral programs. Additional utilization reviews ongoing to match services to level of need of client.

More reductions on our next blog.  Remember to keep squeaking those wheelchairs.

APD Proposed Cuts and Changes to Budget In Florida

 

www.waiverprovider.com

 

Our friend Aaron Nangle of waiverprovider.com has provided information on the Draft Plan for APD’s HCBS Waiver – Home and Community Based Services Waiver Expenditure Reductions.

These will impact all persons with disabilities in Florida.


Consideration to Move Specialized Mental Health Therapy to Medicaid State Plan (adults) Detail: remove expenditure from waiver through

amendment for the long term because service is provided by DCF/AHCA Savings Expected would be about $1,395,703 This would need Handbook change, Rate Rule change, Waiver Amendment. While waiting for waiver amendment, case by case transition of services to Medicaid State Plan. Waiver would be amended this Fiscal Year

 Moving Skilled nursing to Medicaid State Plan(adults) Savings expected would be $1,615,650Remove expenditure from waiver and do waiver amendment for the long term because skilled nursing is provided by MSP Would need Handbook change, Rate Rule change, Waiver Amendment. While waiting for waiver amendment, case by  case transition of services to MSP. Waiver will be amended this FY.

 Rate adjustment for all ADT recipients and reduce burdensome regulations. Savings TBD Would need Handbook change, Rate Rule change with reduced paperwork and regulation, looking for alternative savings in this category.

Eliminate Behavior Assistant services with ResHab and ADT ? $5,000,000. savings, Would need Handbook change for clarifying policy, Rationale: Behavior Assistance services are duplicative of the services and training provided in Res Hab and ADT.

Agency Rate premium set to a maximum of 20% above solo rates for all services with agency rates, Savings expected $3,712,169 Currently there is a range of 5% to 45% over solo rates as agency premium. This would need a Rate rule change. currently rate premiums vary fro 5% to 42% depending on the service category.

More proposed reductions in our next blog.  Remember the squeaky wheelchair gets noticed.