Pensacola Town Hall FAQ

1. How will APD help small agencies through the rate cuts?
1. First, there are not any rate cuts on the horizon
2. Second, join the Thriving Providers/Businesses Public Input Group that will brainstorm ideas for rate evaluation
2. Facility and Licensing – 65G2 is draft, when will rules be revised?
1. Cannot provide a date. Waiting on Office of Fiscal Accountability and Regulatory Reform (OFARR) decision for the licensing part.
2. For the regular licensing rule, we had a workshop in July and legal was submitting the final edits to OFARR (governor’s office) for approval before moving forward.  For the food safety part of the rule, the Joint Administrative Procedures (JAPSE) had more edits after the hearing, so we have to publish their changes for final public feedback.
3. We want providers to have higher educational standards; but, we cannot afford to hire those people.  We also want to have person centered planning.  How is APD going to help us?
1. APD understands the importance of hiring qualified providers.  Current education standards are defined in administrative rule, which includes the waiver handbook.  APD also understands the importance of person centered planning.  APD is currently working with the Agency for Healthcare Administration to finalize the iBudget Waiver Handbook rule.   As part of the rule promulgation process, the Agencies take comment and input from the public regarding the rules.  We welcome any specific recommendations from stakeholders with this process.  The proposed iBudget Waiver Handbook has requirements for person centered planning, which include the provider participating in and supporting the person-centered planning and implementation process for all consumers served through the waiver program.  Additionally, the proposed rule will require that upon enrollment, providers have policies and procedures in place for using a person-centered approach to identify individually determined goals and promote consumer choice.
4. People need to be out of institutions.  The level of staff needs to change in group homes so they know how to work with those that will be coming out of institutions.
1. APD strives to provide individuals with disabilities an array of living options, including community based settings.  For individuals leaving institutions and moving to APD licensed homes, the Agency would work with individual and their circle of supports to choose a placement that best meets their needs.  The Agency has materials available for individuals and their families who are making a transition into an APD licensed homes.   Attached are those materials to help with that process.
5. For Thriving Providers/Businesses Public Input Group – we need to figure out a way to help providers thrive. 
1. Trainings cannot be rubber stamped
2. Need consistency of documentation
3. On-line record keeping
6. For Employment Public Input Group – there are different levels of employability and APD needs to recognize that
7. iBudget was initially started in the Panhandle.  The state needs to go to the next step toward equality across the state.
1. iBudget has been implemented statewide as of July 1, 2013
8. Support Coordinators are paid the same rate as they were in 1995.  We need to build in cost of living increases, need to look at specific services needing more companions.
9. Mini-waiver – the beauty of the iBudget algorithm is that it acts like a mini-waiver for the 30,000 people that are on it.  How will APD implement a “mini-waiver”?  Are you going to run all of the people on the waitlist to see how much it will cost?
10. Last year there was a piece of legislation to start a pilot project for managed care.   There is a strong sentiment that we don’t want to go to managed care.
1. APD is already quasi-managed care.  We are staying within our budget, we are looking at best practices from other states, we are looking to possibly blend services that make sense blending, and we are going to start looking at what can be done for rural areas.
11. With current trends in health care, referring to the portability from state to state, is APD working on reciprocal agreements for persons with developmental disabilities with other states?
1. Medicaid waiver enrollment is not transferrable between states and is therefore not an issue with which APD is involved. Federal laws pertaining to the portability of health care services most commonly involve issues involving health insurance coverage (for medical services).   Such issues are currently addressed by the Agency for Health Care Administration.   Neither the Health Insurance Portability and Accountability Act (HIPAA) nor the Affordable Care Act address the issue of portability of Medicaid Home and Community-based Waiver services from state to state.   
12. Primary care visits have been limited to 2 per month.  Can we change this?
1. You will need to contact the Agency for Healthcare Administration since they regulate this.
13. What are the logistics of the committees?
1. Through phone conferencing.  You will have the option to either attend from your location, home or go to one of APD’s Regional or Field Offices to phone conference.
14. There is a concern about employers paying sub-minimum wage. 
1. Some of the town hall participant comments:
1. “If an employer has employees doing minimal duties, then it isn’t minimum wage work”
2. “It is wrong to expect all clients to be paid minimum wage if the employment is not competitive.”
3. “If an individual is working, no matter what the job, they should be paid minimum wage”
2. Director Palmer’s comment:
1. Maybe we can look at paying per job.  We will look at this in our Employment Committee.
3. Additional response: If an individual is working in the competitive workforce, the Department of Labor requires at least minimum wage. Less than minimum wage is allowed in sheltered workshop settings.
15.  Is there any way to guide individuals to have more meaningful days instead of just ADT’s?
1. Yes, Employment – we are working with the Florida Developmental Disabilities Council to implement legislation concerning an Employment 1st Policy.
2. Yes, we are looking at re-evaluating the Adult Day Training program model to expand options for various populations, including those of retirement age.
16. iBudget – If we want more services, we have to move hours around.  We don’t need to lose our independent skills; we need more hours for personal supports.
17. Does APD have the data on those individuals aging out of schools?
1. We currently do not keep data specifically on those individuals who are enrolled in school. Our estimates of when an individual is aging out of the school system are based on their age.
18. How can we get nutrition plans, exercise plans, recipes, etc…for health and wellness?
1. A Health and Wellness workgroup is currently meeting to discuss ways to address this very important issue.   To learn more about this workgroup (and for instructions on how to get involved), we invite you to visit our website at apdcares.org for more information.
19. Transportation – we would like to be able to transport our own folks.  We need transportation.  Can we look at changing transportation charges from routes to mileage?
1. A client’s family member (limited transportation provider) can provide transportation and be paid in rare situations.  There must be adequate justification as to why the relative is a paid vendor of the service, rather than a natural support.  They would be paid at the state mileage rate.  All other providers would have to an enrolled Medicaid waiver provider to provide transportation.  Usually, they bill per trip.  It is difficult in some situations to control costs when providers are allow to bill by the mile.