APD Tiers News Stories

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FYI……._______LAWMAKER SAYS NEW TIER SYSTEM NEEDS CONTINUING REVIEWBy KATHLEEN HAUGHNEYTHE NEWS SERVICE OF FLORIDATHE CAPITAL, TALLAHASSEE, Dec. 15, 2008... A lawmaker who helped spearhead a controversial change to the system that provides money for people with disabilities said Monday that the issue may need to be revisited by the Legislature.Rep. Bill Galvano, R-Bradenton, told the News Service that he and other lawmakers should examine how reforms they implemented last legislative session are affecting Floridians and the Agency for Persons with Disabilities, which administers aid to families across the state.Last year, the Legislature created a system of tiers to categorize the financial needs of people with disabilities with a goal of saving money - the agency has been operating under a deficit - and a hope of providing services for some of the 17,000 people with disabilities waiting for some form of financial help.Galvano said the Legislature tried to take “more of a scalpel approach instead of doing a chopping block approach.â€But the move was met by an outcry from families and disability advocates who said the tier system would greatly harm families who depend on state assistance for costly care programs. Without those programs, many families say they couldn’t keep their children out of institutions.Some families said their assistance would be cut in half, severely limiting the amount of care their children or siblings could receive.Bill , a 70-year-old Lantana resident, said his son Ross lives in a group home, but can do little for himself. He is wheelchair-bound and cannot feed himself without making a mess.“It's not that easy,†said. “He makes a mess so we have to cover him with a bib.â€Ross , 42, was put into the second tier, which means he can receive no more than $55,000 per year from the state for his care. His father said this will enable him to stay in a group home, but the family will be unable to afford to send Ross to adult day care or for some of his other therapies. said Ross will be “withering away because of lack of therapy and withering away mentally because of lack of challenges.â€'s family was one of about 5,000 families who appealed their tier assignments made by the Agency for Persons with Disabilities. Those who appealed within 10 days of receiving their assignments were permitted to keep their current level of service.However, only 700 of the 5,000 have been granted hearings before the state to determine if their tier assignment should be changed. Those denied hearings are allowed to appeal that decision before a final order is issued from the department.A spokeswoman for the department said that 1,800 people who appealed their tier assignments had not been adversely affected by the decision and therefore were not granted hearings. Applicants are still being notified of their appeal status.The department spokeswoman, Mowry Etters, said the agency originally thought it could save $41 million through the implementation of the tier system.However, with the number of appeals, it is unclear how much that number will change. Etters said the department must wait for the resolution of the hearings to evaluate how much money they could save and how many people could be taken off the waiting list.“Whether the tiers will actually save any amount or some amount in between... we don't know yet,†Etters said.Galvano said that the complications of the issue are something both he and the Healthy Families Committee, which he formerly chaired, need to examine.The agency's fiscal situation and the waiting list, he said, are something that cannot be ignored. But, he said he also acknowledges the challenges some Floridians currently receiving assistance are facing because of the cuts they are seeing in their state aid.“You can't just reform something and say 'OK we reformed it and we're done,'†Galvano said. “I can't stress enough how important this issue is and we have to find that balance, and at the same time if we can't begin to draw people down off the wait list, that's a big problem too.â€--END--12/15/08Illuminating the Sunshine Statehttp://www.newsserviceflorida.com_____________________Gainesville SunNew funding formula for disabled generates controversyBy Jim RossStaff WriterPublished: Sunday, December 14, 2008 at 6:01 a.m. Budget cuts - especially government budget cuts - are constantly in the news these days. Some cuts are quite visible: A busy road doesn't get repaired or widened; some government employees lose their jobs; universities restrict enrollment.Other government cuts don't get nearly as much attention. The results are evident only behind closed doors. But the burden can be severe for those affected.Exhibit A in the latter category might be Florida's Home and Community-Based Waiver program for the developmentally disabled. The name is bureaucratic, but the goal couldn't be more simple: helping developmentally disabled people to live at home or in the community instead of an institution.To make this happen, the program pays for everything from adult diapers to transportation to in-home companions and care assistants.But now, hoping to save $41 million per year, the state has installed a controversial funding formula that reduces help for 7,500 of the program's 31,000 clients.Advocates fear that the developmentally disabled won't get the help they desperately need, and that some clients might be pushed, by financial necessity, from their homes or group homes into institutions."The reality is, there's only so much money," said Mowry Etters, communications director for the state Agency for Persons with Disabilities.True enough. But the state is "balancing the budget on the backs of Florida's most vulnerable citizens," countered Troy Strawder, a service provider for the developmentally disabled.In the red For years, many of the program's clients received whatever services were deemed medically necessary. Gainesville resident Braddy, 25, who is autistic and mentally retarded, lives in her family's home and will receive about $55,000 worth of help this year."She can never be left alone," Janice Braddy said of her daughter. A personal care assistant stays with Braddy when her mother goes to work.Through the years, as the number of clients increased statewide, spending soared. In one recent year, the "Med waiver," as the program is known, ran a deficit exceeding $100 million.To stanch the red ink, the Legislature created a "tier" system. Each client was assigned a level, from 1 to 4, depending on needs and living situations.Tier 1 clients have no annual financial cap for services. Tier 4 has the most restrictive cap at $14,792 per year. The other caps are in between.Some clients, facing a spending ceiling for the first time, formally objected. But except for some cases that are pending appeal, the new system is up and running.Making due The Braddy case is among those still in limbo. Janice Braddy walks on egg shells every time she checks the mail for a notification letter.The state put in Tier 3, with an annual spending cap of $35,000 - $20,000 below what Janice Braddy expects to spend this year. is one of about 7,500 of the program's 31,000 clients who are "adversely affected" - in other words, with a cap below what they have been spending.Janice Braddy wants Tier 2, with a $55,000 cap. If she put her daughter in a group home, that would happen."I'm being punished because I'm keeping my daughter at home ... where she is happy," Braddy said.If the appeal fails, Braddy said she will "make do with what I have." She hopes there will be enough money to pay for a caretaker during work hours.Braddy's health insurance covers only medical matters, not the companion and respite care her daughter requires."It (the new tier system) is not going to impact me as much as others," Janice Braddy said. She has a good job in administration at the University of Florida's College of Dentistry and is set to graduate from UF next year with a business administration degree.Other clients aren't as fortunate.Making matters worse? Each client's needs are reviewed at length on at least an annual basis, and only services deemed medically necessary are arranged, said Sylvia W. , public policy coordinator for the statewide Advocacy Center for Persons with Disabilities Inc."These services are not extra services," she said.Cuts might well lead to medical and behavioral problems and, eventually, put clients at risk of being institutionalized - an option that in most cases would be less ideal for the client and much more expensive for taxpayers, said. (A local example of an institutional setting is Tacachale, a residential intermediate care facility.)The state Agency for Persons with Disabilities hastens to note that it has scrutinized each client's case and even enlisted legal help from other state agencies to review appeal requests."Our agency would never want to take any action that would unfairly affect our customers," agency director Jim DeBeaugrine said in prepared remarks.Regardless, the complaints continue - and not just from clients and advocates. Some service providers also object to what's happening.Troy Strawder is CEO of the Advocacy Resource Center in Ocala, a nonprofit agency that operates eight group homes for 52 clients. He said providers like his agency are getting less reimbursement today than they did eight years ago, even though expenses - everything from fuel to utility costs - have increased.He said the tier system is just making matters worse: The low pay rate is now coupled with restrictions on the quantity of services clients are allowed to receive.Strawder said leaders of the Agency for Persons with Disabilities haven't lobbied hard enough for state money and have led frustrated lawmakers to impose cuts such as the new tier system.Of the Advocacy Resource Center's 52 clients, 12 got tier assignments that would cut their funding significantly. Appeals are pending.Tough budget times , from Advocacy Center for Persons with Disabilities complains that only 700 of the 5,000 clients who sought a hearing on their tier assignments were granted hearings. She said government should freeze any cuts until the effects on clients are properly measured.At this point, only one thing seems certain: The funding situation might not get better anytime soon.Earlier this month, the state Senate met to discuss Florida's $2.14 billion budget deficit. State economists have reduced their general revenue estimates for the current year by $1.4 billion and for next year by $2.3 billion.Advocates understand the budget realities. Some, like , said Florida needs to beef up its revenue streams before it slashes vital services."The measure of a society," Strawder said, "is how we treat our most vulnerable people."Sylvia W. , J.D.Public Policy Coordinator2728 Centerview Drive, Suite 102Tallahassee, FL 32301 x 208 (Fax)sylviasadvocacycenter (DOT) orgwww.advocacycenter.org “The Advocacy Center’s mission is to advance the quality of life, dignity, equality, self-determination, and freedom of choice of persons with disabilities through collaboration, education, advocacy, as well as legal and legislative strategies." This email message, including any attachment(s), may be confidential and/or privileged, and is intended strictly for the designated recipient(s). If you are not the intended recipient(s) of this email message, you should immediately notify the sender by responding to this message, and delete the message from your system. 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