Tag Archive for med waiver

Tallahassee – Disability Day

Thomas and I will be attending the annual Disability Day at the Capital on Monday and Tuesday of this week.  DD Day will be on Tuesday; however we will be up a day early so that we can meet with as many legislators as possible while we are in town.

As advocates and a self-advocates it is important to stay connected with our state legislators.  It is also important to be active on the national level.  However, I have found that as advocates we can be more effective at the state level.  The laws and budgets passed by the State of Florida directly and significantly impact the lives of persons living with disabilities here in our state.

I have been advocating in Tallahassee since Jeb Bush was governor.  I like to think that my efforts have had some level of success and have helped to make the lives of many Florida citizens better.

The issues have remained the same for as long as I have been doing this.  We need better employment opportunities and better transportation services.  These two often go hand in hand.  It is hard to find employment if you can not get to and from work.  Persons with disabilities have a high rate of unemployment.  Only 18% of people with disabilities are employed.

Every year we fight to keep the Early Steps program funded.  This is administered by Children’s Medical Services and is the Part C of the IDEA – Individuals with Disabilities Education Act.  They provide early intervention services for 0 to 3 and serve over 40,000 children in Florida.  History has shown that early intervention works.

The Med Waiver has been under funded for a decade or more.  We currently have over 20,000 people on the Med Waiver waiting list.  Every year we work to increase funding in an attempt to reduce the waiting list and continue to provide community services for those who so desperately need them.

Last session we saw and increase in funding and were able to remove over 1,000 individuals from the waiting list.  However, we still have a long way to go.

Every year the treatment of children with disabilities in our public schools is discussed.  In 2010 we had the first significant legislation protecting children from the abuse of seclusion and restraint in our public schools.  This year there is no legislation proposed so our children will remain vulnerable to abuse for another year.

Each year we fight the same battles.  Some years we make small steps and we celebrate our successes.  It is sad that advocates for the most vulnerable members of our society have to settle for small incremental successes.  However, that is the reality that over 20% of our citizens live with. That is the percent of people who have a disability.

This Tuesday, March 18 you should hear the squeaking of wheels in Tallahassee.  I hope that our legislators listen and appreciate how difficult it is for so many of our disabled citizens to make the trip to the Capital.  We want to be listened to, we want to be heard and we want to be taken seriously.

We will continue to keep squeaking our wheels for as long as it takes.

APD cuts services – what a great Christmas present for the disabled.

From a friend in south Florida comes this holiday message.

Karen R Wagner PhD, BCBA-D, LMHC
Behavior Services of Brevard, Inc/TheBehaviorAnalyst.com

“Just in time for the holidays, APD is in a big push to discontinue services.  Those of you who have been around for a while may recognize this from several years ago, when notifications of reductions went out on Christmas eve, so those who were on vacation could not respond until it was too late.  Blaming the local folks is probably unwarranted, they will be fired if they talk to anyone, and the mandates are coming from a higher source.  However, services are being cut without notification.  One of our consumers finally received official notification three weeks after funding ran out, after his mother exchanged several emails with the area office.  We have several consumers whose services were cut in the past few weeks without notification to the WSC, consumer, or ourselves, as providers.  It seems to be picking up speed, as I would guess the plan is to slash services by the end of the year.

It seems there are several other things to prevent a fair defense of necessary services.  APD has told WSCs that all documentation must be sent digitally, however, the email portal is abnormally small, so the digital files cannot be sent.  After sending several times, many WSCs have to split files into several smaller files, multiplying the probability of the documentation being lost in the flurry of activity.  Most of the requested documentation is already in the consumer’s files at APD, so the reasons for requesting the documentation are fuzzy at best.

APD seems to have discontinued the Notice of Intent to reduce or deny services, in favor of an “Agency Action”, which just tells you the services are cut.  Parents don’t seem to be getting these until after the service has been discontinued. Parents still only have 10 days from the receipt of the letter to respond.  Please contact your parent advocacy resources, parent group members, and most importantly, YOUR LEGISLATORS!

One thing to be aware of: Despite the gloomy financial forecasting, state funding has never come from real estate taxes, or unemployment funds, or local municipalities.  Most agencies, including APD have always been funded by Florida sales taxes and other sources, the income from which have not changed much in the past few years.  It is impossible to find accurate income figures state-wide.  So why are services being slashed to consumers?  This appears to be a created crisis, giving legislators an opportunity to cut “social welfare” programs.

Medwaiver also has a sizable federal matching component, and based on recent figures, the “deficit” numbers seem to exclude the contributing federal match dollars, artificially inflating the shortfall. However, since the budget was set by the legislators, and has been shrinking every year, “shortfall” seems to be a misnomer.

Spread the word to consumers, families and advocates to check their mail, PO boxes, the consumer’s mail (if they live independently), or anywhere else the consumer may receive mail.  Requests for reconsiderations and hearings may need to be sent during the holidays.  Wish there was better news.”

Enjoy your Holy Days and keep squeaking those wheels.  We need to make enough noise – we need to be heard.

APD Statement on Governor’s Proposed Budget

From our friend Aaron Nangel.

Statement on Governor’s Budget Proposal by  Agency for Persons with Disabilities Director Mike Hansen.

The Agency for Persons with Disabilities (APD) is very pleased with Governor Scott’s budget proposal released recently.

The governor has once again shown that being fiscally responsible does not mean lessening our commitment to the state’s most vulnerable citizens, said APD Director Mike Hansen.

This budget proposal increases recurring General Revenue funding by $26 million to meet the needs of the 30,000 Floridians with developmental disabilities currently receiving services under the Home and Community-Based Services (HCBS) Medicaid waiver.

Also included is $83 million in additional funding to cover the current projected shortfall in waiver funding, said Hansen. “The governor’s proposal also requires the agency to tighten its belt and find greater efficiencies by reducing positions and funding for administration,” said Hansen.

See the Governor’s budget proposal.

Note there is no mention of the Wait List.

We can never stop squeaking our wheels.


19,000 Or More Florida Disabled on Med Waiver Waiting List

Headline from an online news source.

19,000 reported on Florida Developmental Disabilities (DD) waiting list.

This is not news or anything new.  The disabled have been under served for many years.  Under served is a polite way to the say that the State of Florida is ignoring the needs of the disabled. By their actions it is evident that Florida and its legislators would prefer the disabled just disappear – go away – stop existing and stop being such a problem.

19,000 is a large number to ignore and leave with no services.

What the State of Florida – What Rick Scott – What the Legislature – do not realize is that they will not go away.  They will keep drawing attention to the needs of the most vulnerable citizens in Florida.

One day and I hope it is soon – the citizens of Florida will insist that the disabled no longer be ignored.

In the meantime we will keep squeaking our wheels.  They can not ignore us forever.


APD Director Mike Hansen Updates on APD Budget

From our friend and fellow advocate Aaron Nangle of WaiverProvider.com.

APD Director Mike Hansen Gave Updates on APD budget at House committee meeting.

On November 15, APD Director Michael Hansen made a presentation to the House Health Care Appropriations Subcommittee on actions the agency is taking to bring its Medicaid waiver within appropriations.
He talks in depth about how APD is working hard to get the budget under control. I do hope many of you took the time to see this meeting. I do have to say in my opinion Mr Hansen did let our legislators know they are not providing us with enough funds to provide the proper care that people need. He let them know that the waiver needs another 1,000,000.00 Also that the cuts and funding is all up to them to control.
He talked about how some cost plans will be cut in half. “Yes cut in half” He talked about people only having core services and not non core services. It is important for you to know what they are and how it will affect you.
As you look at the slide shows you will see information on what Mr. Hanson went over with the legislators at this meeting. If you do not agree with what you see and what is happening it is up to each and every one of you to call, write and go see all of your representatives. Let them know your thoughts and opinions. Tell them how this will affect you and your families health, safety and well being.
Aaron and all advocates – keep us informed and keep squeaking your wheels.

Florida Face to Face Interview with APD Director Mike Hansen

Florida Face to Face Interview with APD Director Mike Hansen


No More Cuts –

From Tallahassee – Florida Senate ponders cuts for developmentally disabled.

No more cuts. The disabled are already shouldering more than their share of budget cuts.

Read the full story.


Left Behind Children and Adults with Disabilities Who Have No Services

Mike Coonan is the President of Left Behind in the USA.  He fights a very tough battle to help children and adults with disabilities receive the services necessary for them to live a full and rewarding life.

Unfortunately he fights a battle that may never end and that he may never win.  However, despite this, he continues to fight on.

Currently nearly 400,000 disabled Americans live marginalized lives because they do not receive services that would help them live on their own, work or get out into the community.

His organizations opening statement is:

Left Behind in the USA is a non-profit organizations representing families whose child/loved one with autism, cerebral palsy, mental retardation/intellectual disability and related Developmental Disability is on Medicaid Waiver waiting lists. We are dedicated to educating and empowering families on the Medicaid Waiver waiting list.

Keep fighting the fight and keep providing a voice for those who have no voice.  You are not alone.

Keep squeaking your wheels – they will have to pay attention.

Florida – APD Announces A Schedule of Cuts

From Aaron Nangle of WaiverProvider.com

October 19, 2011

Director Mike Hansen presented an update on the agency’s cost-containment efforts today to the House of Representatives Health Care Appropriations Subcommittee.

The Legislature approved $810 million for APD’s Medicaid waiver for the 2011-12 state fiscal year that began on July 1. APD customers received $930 million worth of services last year.

The agency has been working to bring its waiver expenditures within the Legislative appropriation this fiscal year. The agency is also looking for opportunities to increase waiver flexibility and equity for customers, while continuing to protect their health and safety.

Earlier this month, APD shared five cost containment
initiatives with various legislative committees that would reduce APD’s waiver obligations. The director was asked to bring back a proposed timeline for implementing the changes.

The timeframes may be contingent on developing new rules or federal approval from the Centers for Medicare and Medicaid Services (CMS).

At today’s meeting, Hansen announced plans to standardize payment rates for intensive behavior residential habilitation beginning January 1, 2012. Also on that same date, the agency will begin collecting fees from APD customers who have income to offset some of their costs of living in a group home.

APD plans to reduce the rates it pays for therapy assessments and all nursing services to the standard rate paid by the Medicaid State Plan beginning April 1, 2012.  Currently, the APD Medicaid waiver pays higher rates for most of these services.

Also on the same date, APD will reduce the difference it pays between solo providers and agencies for waiver services to no more than 20 percent. Currently, those rates may differ up to 43 percent.

There was no timeline announced today for implementing cost sharing for parents who have children on the Medicaid waiver. APD is working with the Agency for Health Care Administration on this issue.

The change to the waiver requires federal approval.

After pursuing these cost-containment initiatives to APD’s Medicaid waiver, the agency expects to realize more than $14 million in reduced expenditures on an annual basis. 


Keep raising your voices and squeaking your wheels.  We can not let those who are them most vulnerable suffer from these cuts.

Disability Rights of Florida Sues State Ove Med Waiver Wait List

This is the text of a letter from Philip Pearson, Vice Chairperson, FCC12

Families waiting for the Medicaid Waiver, You may or may not know this, but Disability Rights of Florida (previously known as the advocacy center) has filed a lawsuit against the state of Florida on behalf of families on the waiting list for Medicaid Waiver services. Although there are named plaintiffs, we are all included, as this is a class action lawsuit. You do not need to sign up to be a part of the class.

While at a recent Family Care Council Florida meeting, the Disability Rights Senior Attorney, Amanda Heystek, talked about the need to have families contact Disability Rights Florida to provide contact information. We, FCC representatives suggested that we could send a letter to wait list families to ask them to do this. Here are Amanda’s words:

Disability Rights Florida is engaged in a lawsuit regarding the waitlist for home and community based services through the Developmental Disabilities Waiver. Disability Rights Florida would like to hear directly from those on the waitlist. Please fill out the survey on the link provided.
You can fax, mail or email your survey to Disability Rights Florida. By filling out the survey you are only agreeing to be contacted by our staff for further inquiry as to your needs and purpose for registering on the waitlist.
If you have computer and web access, please go fill out the questionnaire.

Download the short survey, fill it out and send it in to
Amanda Heystek
Disability Rights Florida
2728 Centerview Drive, Suite 102
Tallahassee, Florida 32301
If you don’t have access, please contact disability rights directly to provide them your information. If you would like more information about the lawsuit, please contact:
Sylvia W. Smith, Director of Legislative and Public Affairs
850-488-9071 ext 9725


We need to end the wait list and get our citizens with disabilities services.

Keep squeaking those wheels.