Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

[Guest guest]

Ven, can you please supply the link to the PCB 10-03 you site below. I have searched both the House and Senate PCBs and there are none that are related to HMO's for medwaiver. I also went to the site for the Policy Council on Strategic & Economic Planning and there is no staff analysis or draft proposals there of any pending PCB re this topic. I am just trying to see what the proposed bill actually says. Is this to implement the new 1915(i) waiver that has been authorized (already) ........ it did not seem in development that the new waiver "usurped" 1915© waivers that are specifically for people with developmental disabilities. Where are you getting your information? Let me know when you can. Thanks so much. Lucille Pivinski

[Guest guest]

Ven, okay, finally found it, posted on the House website tonight. This actually represents a huge overhaul in the entire Medicaid system. It represents "new" statutory authority for implementing a Managed Care system for everyone receiving anything through Medicaid except those actually in DD large institutions.

Even the Intermediate Care facilities (considered institutional level of care) would be going into Managed Care. The levels of care do seem to track the Tier assignments (plus one level for ICF)........so 5 levels.

It is hard to believe that this will actually be enacted in one huge overhaul like this ............encompassing nursing home for elderly, ALFs, group homes, supported living, people on CDC+, dual eligibles, on and on. Even with all the phased in/over time pieces (the DD waiver folks would see implementation in 2014-2015)......this could potentially (probably) involve a huge disruption in service delivery. Also, I am surprised the Legislators would be going this way since I thought the experiments with managed care for Medicaid didn't actually produce significant savings. I could be wrong on this. Also, with respect to people with DD, I can't imagine how plans that are supposed to be person-centered and individualized can be implemented by an HMO. And then there are the well know problems with access and quality with HMOs that pay as little as possible to providers in order to preserve their profits. All in all, sounds like a bad idea. Maybe a very bad idea. Here is the proposed Bill.........it is PCB SPCSEP 10-03

http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?PublicationType=Committees & CommitteeId=2546 & Session=2010 & DocumentType=Proposed%20Committee%20Bills%20(PCBs) & FileName=PCB%20SPCSEP%2010-03.pdf

Two, additional comments:

(1) if you are on the waitlist for home and community based services, don't think this legislation does anything for you. We who are at zero funding (40% of eligible individuals receive zero.......that is how big the wait list has gotten) at the implementation date .....cannot access the Long-Term Care Program, which is where the waiver services are "covered services". Waitlist continues to mean Zero.

(2) maybe the well funded FDDC and Advocacy Center and Florida Center for Inclusive Communities should have been paying attention to this issue and not spending a substantial amount of their time and efforts (and taxpayer money) running about Tallahassee lobbying against parent driven bills which would permit optional quality residential opportunities to people with developmental disabilities. As usual, the FDDC, in particular, is both on the wrong side of what they do get involved in and missing in action on things they should be involved in. Where are all their Alerts on this issue??

Ven, can you please supply the link to the PCB 10-03 you site below. I have searched both the House and Senate PCBs and there are none that are related to HMO's for medwaiver. I also went to the site for the Policy Council on Strategic & Economic Planning and there is no staff analysis or draft proposals there of any pending PCB re this topic. I am just trying to see what the proposed bill actually says. Is this to implement the new 1915(i) waiver that has been authorized (already) ........ it did not seem in development that the new waiver "usurped" 1915© waivers that are specifically for people with developmental disabilities. Where are you getting your information? Let me know when you can. Thanks so much. Lucille Pivinski

[Guest guest]

Ven, okay, finally found it, posted on the House website tonight. This actually represents a huge overhaul in the entire Medicaid system. It represents "new" statutory authority for implementing a Managed Care system for everyone receiving anything through Medicaid except those actually in DD large institutions.

Even the Intermediate Care facilities (considered institutional level of care) would be going into Managed Care. The levels of care do seem to track the Tier assignments (plus one level for ICF)........so 5 levels.

It is hard to believe that this will actually be enacted in one huge overhaul like this ............encompassing nursing home for elderly, ALFs, group homes, supported living, people on CDC+, dual eligibles, on and on. Even with all the phased in/over time pieces (the DD waiver folks would see implementation in 2014-2015)......this could potentially (probably) involve a huge disruption in service delivery. Also, I am surprised the Legislators would be going this way since I thought the experiments with managed care for Medicaid didn't actually produce significant savings. I could be wrong on this. Also, with respect to people with DD, I can't imagine how plans that are supposed to be person-centered and individualized can be implemented by an HMO. And then there are the well know problems with access and quality with HMOs that pay as little as possible to providers in order to preserve their profits. All in all, sounds like a bad idea. Maybe a very bad idea. Here is the proposed Bill.........it is PCB SPCSEP 10-03

http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?PublicationType=Committees & CommitteeId=2546 & Session=2010 & DocumentType=Proposed%20Committee%20Bills%20(PCBs) & FileName=PCB%20SPCSEP%2010-03.pdf

Two, additional comments:

(1) if you are on the waitlist for home and community based services, don't think this legislation does anything for you. We who are at zero funding (40% of eligible individuals receive zero.......that is how big the wait list has gotten) at the implementation date .....cannot access the Long-Term Care Program, which is where the waiver services are "covered services". Waitlist continues to mean Zero.

(2) maybe the well funded FDDC and Advocacy Center and Florida Center for Inclusive Communities should have been paying attention to this issue and not spending a substantial amount of their time and efforts (and taxpayer money) running about Tallahassee lobbying against parent driven bills which would permit optional quality residential opportunities to people with developmental disabilities. As usual, the FDDC, in particular, is both on the wrong side of what they do get involved in and missing in action on things they should be involved in. Where are all their Alerts on this issue??

Ven, can you please supply the link to the PCB 10-03 you site below. I have searched both the House and Senate PCBs and there are none that are related to HMO's for medwaiver. I also went to the site for the Policy Council on Strategic & Economic Planning and there is no staff analysis or draft proposals there of any pending PCB re this topic. I am just trying to see what the proposed bill actually says. Is this to implement the new 1915(i) waiver that has been authorized (already) ........ it did not seem in development that the new waiver "usurped" 1915© waivers that are specifically for people with developmental disabilities. Where are you getting your information? Let me know when you can. Thanks so much. Lucille Pivinski

[Guest guest]

P.S...........if you go to the document and you think your head is going to explode (it is 61 pages), you might want to scroll down to the section that specifically provides for managed care for people with Developmental Disabilities. It starts at Line 1355 and runs to the end of the document.

[Guest guest]

Lucille:

I attached the section of the bill that pertains to DD. It appears to me that they are intentionally keeping it under the radar, thus the difficulty to find anything on it. If you want the entire bill, I can send it but it is 188 pages.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter

Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

Ven, can you please supply the link to the PCB 10-03 you site below. I have searched both the House and Senate PCBs and there are none that are related to HMO's for medwaiver. I also went to the site for the Policy Council on Strategic & Economic Planning and there is no staff analysis or draft proposals there of any pending PCB re this topic. I am just trying to see what the proposed bill actually says. Is this to implement the new 1915(i) waiver that has been authorized (already) ........ it did not seem in development that the new waiver "usurped" 1915© waivers that are specifically for people with developmental disabilities. Where are you getting your information? Let me know when you can. Thanks so much. Lucille Pivinski

1 of 1 File(s)

DD Svrs in CP_House_H2010SPCSEP_10_03.pdf

[Guest guest]

Lucille:

I attached the section of the bill that pertains to DD. It appears to me that they are intentionally keeping it under the radar, thus the difficulty to find anything on it. If you want the entire bill, I can send it but it is 188 pages.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter

Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

Ven, can you please supply the link to the PCB 10-03 you site below. I have searched both the House and Senate PCBs and there are none that are related to HMO's for medwaiver. I also went to the site for the Policy Council on Strategic & Economic Planning and there is no staff analysis or draft proposals there of any pending PCB re this topic. I am just trying to see what the proposed bill actually says. Is this to implement the new 1915(i) waiver that has been authorized (already) ........ it did not seem in development that the new waiver "usurped" 1915© waivers that are specifically for people with developmental disabilities. Where are you getting your information? Let me know when you can. Thanks so much. Lucille Pivinski

1 of 1 File(s)

DD Svrs in CP_House_H2010SPCSEP_10_03.pdf

[Guest guest]

Lucille:

I attached the section of the bill that pertains to DD. It appears to me that they are intentionally keeping it under the radar, thus the difficulty to find anything on it. If you want the entire bill, I can send it but it is 188 pages.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter

Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

Ven, can you please supply the link to the PCB 10-03 you site below. I have searched both the House and Senate PCBs and there are none that are related to HMO's for medwaiver. I also went to the site for the Policy Council on Strategic & Economic Planning and there is no staff analysis or draft proposals there of any pending PCB re this topic. I am just trying to see what the proposed bill actually says. Is this to implement the new 1915(i) waiver that has been authorized (already) ........ it did not seem in development that the new waiver "usurped" 1915© waivers that are specifically for people with developmental disabilities. Where are you getting your information? Let me know when you can. Thanks so much. Lucille Pivinski

1 of 1 File(s)

DD Svrs in CP_House_H2010SPCSEP_10_03.pdf

[Guest guest]

I just sent the section that pertains to our population. I know what I originally sent was lengthy, but it has all the pertinent info in it. I wanted the subject line to say what the intent was and have impact so people would read it. That is why it says HMO's to run Med waiver.

The bottom line is this is not going to be less costly to implement. The savings is going to come out of our kids/adults cost plans. The state is off the hook and private industry will be running it as a business. Choice is gone, support coordination gone, needs based services gone. It is criminal what they are proposing.

I agree it is a VERY BAD IDEA. I have given up trying to figure out what the legislature is doing every day. The fact that the House is not willing to carve out our population is really bad. This is driven by the powers that be that have ties to insurance industry. Carol Gormley (House staff) is one of the key people who wrote it. I have been told it is a done deal. The scary thing is with it affecting all of Medicaid, you would think other organizations (besides DD) would be screaming too. We must get to the Senate and let them know how devastating this will be. We also need to flood the Governor's office with calls. I will get the phone number to call for the Governor and send out soon.

I think they want to get rid of APD because of all the law suits and hearings and this is a way they can accomplish this. Basically, we will have no recourse.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter

Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

P.S...........if you go to the document and you think your head is going to explode (it is 61 pages), you might want to scroll down to the section that specifically provides for managed care for people with Developmental Disabilities. It starts at Line 1355 and runs to the end of the document.

[Guest guest]

I just sent the section that pertains to our population. I know what I originally sent was lengthy, but it has all the pertinent info in it. I wanted the subject line to say what the intent was and have impact so people would read it. That is why it says HMO's to run Med waiver.

The bottom line is this is not going to be less costly to implement. The savings is going to come out of our kids/adults cost plans. The state is off the hook and private industry will be running it as a business. Choice is gone, support coordination gone, needs based services gone. It is criminal what they are proposing.

I agree it is a VERY BAD IDEA. I have given up trying to figure out what the legislature is doing every day. The fact that the House is not willing to carve out our population is really bad. This is driven by the powers that be that have ties to insurance industry. Carol Gormley (House staff) is one of the key people who wrote it. I have been told it is a done deal. The scary thing is with it affecting all of Medicaid, you would think other organizations (besides DD) would be screaming too. We must get to the Senate and let them know how devastating this will be. We also need to flood the Governor's office with calls. I will get the phone number to call for the Governor and send out soon.

I think they want to get rid of APD because of all the law suits and hearings and this is a way they can accomplish this. Basically, we will have no recourse.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter

Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

P.S...........if you go to the document and you think your head is going to explode (it is 61 pages), you might want to scroll down to the section that specifically provides for managed care for people with Developmental Disabilities. It starts at Line 1355 and runs to the end of the document.

[Guest guest]

I just sent the section that pertains to our population. I know what I originally sent was lengthy, but it has all the pertinent info in it. I wanted the subject line to say what the intent was and have impact so people would read it. That is why it says HMO's to run Med waiver.

The bottom line is this is not going to be less costly to implement. The savings is going to come out of our kids/adults cost plans. The state is off the hook and private industry will be running it as a business. Choice is gone, support coordination gone, needs based services gone. It is criminal what they are proposing.

I agree it is a VERY BAD IDEA. I have given up trying to figure out what the legislature is doing every day. The fact that the House is not willing to carve out our population is really bad. This is driven by the powers that be that have ties to insurance industry. Carol Gormley (House staff) is one of the key people who wrote it. I have been told it is a done deal. The scary thing is with it affecting all of Medicaid, you would think other organizations (besides DD) would be screaming too. We must get to the Senate and let them know how devastating this will be. We also need to flood the Governor's office with calls. I will get the phone number to call for the Governor and send out soon.

I think they want to get rid of APD because of all the law suits and hearings and this is a way they can accomplish this. Basically, we will have no recourse.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter

Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING

P.S...........if you go to the document and you think your head is going to explode (it is 61 pages), you might want to scroll down to the section that specifically provides for managed care for people with Developmental Disabilities. It starts at Line 1355 and runs to the end of the document.

[Guest guest]

This whole thing is just so frustrating and sad for our children. My own son, who has CP doesn't even have Medicaid because it was taken away because..."I earned too much"!!He's been on the Medwaiver "waiting list" for about 5yrs now.He was on his father's insurance plan, but he was laid off @ the end of February, so...my son has NO insurance right now!!We're waiting for healthy kids, but when we called Thursday for a status, they couldn't even find the app. We had to fill it out again resend it...WHAT???What a joke!!!I can just imagine all the horrible things that are going to be experienced with the passing of this issue.Sent on the Now Network™ from my Sprint® BlackBerryFrom: vsequenzia@...Date: Sat, 10 Apr 2010 08:51:20 -0400To: <sList >Subject: Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING I just sent the section that pertains to our population. I know what I originally sent was lengthy, but it has all the pertinent info in it. I wanted the subject line to say what the intent was and have impact so people would read it. That is why it says HMO's to run Med waiver. The bottom line is this is not going to be less costly to implement. The savings is going to come out of our kids/adults cost plans. The state is off the hook and private industry will be running it as a business. Choice is gone, support coordination gone, needs based services gone. It is criminal what they are proposing. I agree it is a VERY BAD IDEA. I have given up trying to figure out what the legislature is doing every day. The fact that the House is not willing to carve out our population is really bad. This is driven by the powers that be that have ties to insurance industry. Carol Gormley (House staff) is one of the key people who wrote it. I have been told it is a done deal. The scary thing is with it affecting all of Medicaid, you would think other organizations (besides DD) would be screaming too. We must get to the Senate and let them know how devastating this will be. We also need to flood the Governor's office with calls. I will get the phone number to call for the Governor and send out soon. I think they want to get rid of APD because of all the law suits and hearings and this is a way they can accomplish this. Basically, we will have no recourse. Regards, Ven Sequenzia President Autism Society of America State of Florida Chapter Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING P.S...........if you go to the document and you think your head is going to explode (it is 61 pages), you might want to scroll down to the section that specifically provides for managed care for people with Developmental Disabilities. It starts at Line 1355 and runs to the end of the document.

[Guest guest]

This whole thing is just so frustrating and sad for our children. My own son, who has CP doesn't even have Medicaid because it was taken away because..."I earned too much"!!He's been on the Medwaiver "waiting list" for about 5yrs now.He was on his father's insurance plan, but he was laid off @ the end of February, so...my son has NO insurance right now!!We're waiting for healthy kids, but when we called Thursday for a status, they couldn't even find the app. We had to fill it out again resend it...WHAT???What a joke!!!I can just imagine all the horrible things that are going to be experienced with the passing of this issue.Sent on the Now Network™ from my Sprint® BlackBerryFrom: vsequenzia@...Date: Sat, 10 Apr 2010 08:51:20 -0400To: <sList >Subject: Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING I just sent the section that pertains to our population. I know what I originally sent was lengthy, but it has all the pertinent info in it. I wanted the subject line to say what the intent was and have impact so people would read it. That is why it says HMO's to run Med waiver. The bottom line is this is not going to be less costly to implement. The savings is going to come out of our kids/adults cost plans. The state is off the hook and private industry will be running it as a business. Choice is gone, support coordination gone, needs based services gone. It is criminal what they are proposing. I agree it is a VERY BAD IDEA. I have given up trying to figure out what the legislature is doing every day. The fact that the House is not willing to carve out our population is really bad. This is driven by the powers that be that have ties to insurance industry. Carol Gormley (House staff) is one of the key people who wrote it. I have been told it is a done deal. The scary thing is with it affecting all of Medicaid, you would think other organizations (besides DD) would be screaming too. We must get to the Senate and let them know how devastating this will be. We also need to flood the Governor's office with calls. I will get the phone number to call for the Governor and send out soon. I think they want to get rid of APD because of all the law suits and hearings and this is a way they can accomplish this. Basically, we will have no recourse. Regards, Ven Sequenzia President Autism Society of America State of Florida Chapter Re: URGENT! - HMO'S TO RUN MEDWAIVER - WILL BE DEVASTATING P.S...........if you go to the document and you think your head is going to explode (it is 61 pages), you might want to scroll down to the section that specifically provides for managed care for people with Developmental Disabilities. It starts at Line 1355 and runs to the end of the document.