Lakeland Town Hall FAQ

1. What is the 1.5 M EVV (Electronic Visit Verification) and Client Record?
1. APD is working to develop an electronic system to keep our records of clients and providers. Currently, it is largely a manual paper process. This electronic technology solution, called the Client Data Management System (CDMS) will have a component that will allow the agency to verify providers are visiting clients according to a set plan. This electronic visit verification will help improve services to clients and ensure money isn’t being paid to providers who don’t complete their visits as required.
2. Rates cut by 40% for behavior services in 2011, what are we going to do about this? Why can’t a flag be put in system when Medicaid is turned off and if needed just turn back on?
1. Behavioral services is a broad category and is often thought to include behavior analysis, behavior assistant, behavior focused Residential Habilitation (Res Hab) and intensive behavioral Res Hab.  However, in late 2011 standard rates for IB Res Hab were established and effectively implemented January 1, 2012.  For some providers this meant a reduction ranging from 4% to 25%, while some providers actually gained an increase from 4% to 31%.  This fundamentally was the result of the same IB budget allocation being redistributed based upon rate standardization, with those providers taking a cut whose rates were negotiated later and at a higher rates than those who opened earlier and negotiated at a much lower rate.  Unless the legislature infuses additional dollars into the APD budget for the purpose of rate increases, it is unlikely that those funds lost will be restored.  However, there are now far fewer rates, and they are based upon a rating of an individual’s level of need.
3. Why can’t a flag be put in system when Medicaid is turned off and if needed just turn back on?
1.  Individuals who experience a lapse in receipt of Medicaid funded services (due to withdrawal from the program, extended hospitalization, a temporary move out of state, incarceration, etc.) are eligible for up to 12 months to re-establish funding and services without having to reapply for the Waiver.
4. Consumers that have Medicaid are being contacted by companies who offer more than HMO (Wellcare). Then, if they sign up, they are taken off the waiver and they lose those services. If this happens, APD typically back dates the payment. How can we get these companies to understand what happens if they lose Medicaid benefits? Why is this happening? Should there be another step before this happens? Is this happening all over?
1. The Florida Legislature has directed the Agency for Health care Administration (AHCA) to create the Statewide Medicaid Managed Care Program.  AHCA has already begun to transition recipients into the program and anticipates that it will be available in all areas by October 1, 2014
2. Individuals on the Developmental Disabilities Home and Community Based Services Waiver and those on the Waitlist are not required but may choose to enroll in the Medicaid Managed Care Program.  If a recipient does transition into a Medicaid Managed Care Program, they will no longer receive Waiver Services.  
3. Medicaid Managed Care Programs are not supposed to solicit Medicaid recipients. If this has happened and if you have signed up for a Medicaid Managed Care Program in error, call the Toll-free Medicaid number for Managed Care: 1-877-711-3662 and ask to be disenrolled. Inform them that you are on the Developmental Disabilities Home and Community Based Services Waiver or on the Waitlist.   
5. iBudget is awesome; however, for some people we serve it does not fit them
1. Public transportation (too expensive) and not allowed/provided by iBudget
1. Individuals can purchase bus passes through iBudget.  Bus passes are far less expensive than purchasing transportation by the trip. With bus passes, individuals can go to their waiver services and access the community via the public transportation system. 
2. Need different services to fit different customers
1. The services available through iBudget are designed to benefit and meet the needs of each individual.  Although waiver services cannot address all the needs an individual might have, health and safety needs have priority during the service selection process.  APD continually reviews its array of services offered to its customers in order to improve service delivery. 
3. What do we do for students leaving school that go home because there aren’t on the waiver?
1. Students leaving school and are not on the waiver can sometimes receive services in their area through APD general revenue funding.  The level and duration of services vary due to regional-specific funding. In some cases, these individuals can receive waiver services through crisis enrollment. Individuals and their families are encouraged to contact Vocational Rehabilitation and other community resources for assistance.
4. We need to see what this group of people need
1. Individuals leaving school and are not on the waiver are assigned a support coordinator to assist them with identifying their needs, accessing community services, services via general revenue and crisis enrollment, if applicable.
5. APD spends a lot of money for services that are not effective
1. APD continually reviews its array of services to improve effectiveness and address the needs of individuals.  Although some services are more expensive and harder to match the specific needs of individuals, with iBudget, the delivery of services in general has been more cost-effective while adding flexibility for those receiving services.  Providing effective services will remain a high priority for APD in the future.
6. There are 3 young ladies that want to live together in an unlicensed medical home but APD will not let them. They are on the waiting list and almost to crisis stage. Why won’t APD let these ladies live together?
1. If any of these ladies are experiencing a crisis situation or if their health and safety is at risk in any way, we urge you to contact your local APD office immediately for assistance.   
2. It is difficult to answer the question completely without additional details regarding this situation. However, we can tell you that APD staff are required to abide by Chapter 429 of the Florida Statutes. This law requires that any facility providing housing, meals, and personal services (such as medication administration) for a period exceeding 24 hours to one or more adults (who are not relatives of the owner or administrator) must be licensed by the State of Florida. Operating such a home without a license is classified as a third degree felony.     
7. How will money be distributed/how much for each individual moving from waitlist to waiver?
1. We anticipate 2 or 3 waves
2. First group coming off are those with highest need
3.  The Agency for Persons with Disabilities (APD) looked at the QSI scores, QSI addendum scores that were given by individuals, families, and/or legal representatives, and the individuals’ waitlist category to determine the individuals with the most critical situations and the highest need. Individuals that met the criteria outlined by the legislature were ranked. APD has already sent out the first round of waiver offers. The individuals target allocation is based on the iBudget algorithm. An individual review is completed for each person enrolling on the waiver. As a result of the individual review and algorithm, there is no set distribution amount and everyone’s iBudget amount will be unique to their situation and need.
4. The individuals that have declined Waiver enrollment, or those with a smaller cost plan than projected, will allow monies to be available for future offers. APD is currently analyzing the remaining funds and preparing for the next round of Waiver offers to be complete.
5. If you feel that you or the individual you care for has an outdated QSI or an incomplete QSI addendum, please contact your local APD Regional Office.  
8. Possible for local APD offices to allow people to go in and use computers for Community Resource Directory?
1. If a customer has limited computer or internet access at home, they should contact their Support Coordinator. The support coordinators can assist individuals looking for services in their communities. If someone would like a hard copy of the resources in their area, APD can print out a copy for them, and they can pick it up at the area office.
9. We need more dental.
1. Legislator’s gave Arc of Florida 2M to study dental and they have identified dentists around the state
2. You can get free services at Tacachale in Gainesville. The ARC of Florida is a 501c 3) nonprofit charity that serves individuals with intellectual and developmental disabilities. They have identified dentists around the state to provide services to our respected population. Also, they have received special appropriation from the Florida Legislature to provide preventative and acute dental services for individuals with intellectual and developmental disabilities. The program that they are operating to provide dental services has an application and approval process that takes a minimum of 3 months. For additional information regarding the program or to apply for the program, please contact the ARC of Florida at 1-800-226-1155.
3. Tacachale is an APD run facility. There is an operating dental clinic on the facility campus. Services provided at the dental clinic are not free. If an individual is on the waiver, the services will need to be paid by the individual’s waiver allocation (iBudget amount). If the individual interested in dental services at the dental clinic on the Tacachale Campus is on the APD waitlist and has Medicaid, Medicaid will pay for dental services at the Medicaid Rate. If the individual is on the APD Waitlist and does not have Medicaid, services that are provided will be expected to be paid privately at the Medicaid Service Rate(s).
10. Have there been outreaches done to dentists?
1. Yes. The ARC of Florida has identified dentist around the state that are able to provide service. APD has open discussions with dentist in Florida and are currently in contract with several dentist to provide dental services to individuals with intellectual and developmental disabilities.
1. What is the timeframe for the Invitation to Negotiate (ITN)?
1. APD is currently working to complete the Invitation to Negotiate ITN and anticipates a release date the first of October.
2. WSC requires 4 year degree – can we have leniency in qualifications for this position?
1. The minimum qualifications for Waiver Support Coordinators are specified in Rule 59G of the Florida Administrative Code.  This is an Agency for Healthcare Administration Rule and also known as the Waiver Coverage and Limitations Handbook.  Changes can be made to these qualifications through the rule promulgation process. Additional information on the rule change process can be found at https://www.flrules.org/Default.asp.  This requirement has been in place for quite some time due to Waiver Support Coordinators being responsible for providing professional level oversight and coordination of consumer services that are tied to their health and well-being.