Planning Ahead - Florida Developmental Disabilities Council

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Redesign Initiatives –A Brief OverviewIn February 2002 the Department of Children and Families, Developmental DisabilitiesProgram, now the Agency for Persons with Disabilities, began working with the Agencyfor Health Care Administration and stakeholders ~ individuals with developmental disabilities,their family members, service providers and other advocates ~ on a system of redesign of theHome & Community Based Waiver. That redesign addressed seven components:• appropriate assessment,• individual budgets,• flexible services,• fair and equitable rates,• a redefined role of support coordinators,• direct billing for providers, and• communication.The appropriate assessment developed for use by the Developmental Disabilities Program iscalled the Individual Cost Guidelines (ICG) and replaces the Florida Status Tracking Survey. It isa tool for predicting a person’s individualized costs and may only be administered by someonewho is trained and certified in its use. In September, 2003 the program began using this newtool which serves as the first step in the support planning process.The individual budget is based on the results of each person’s ICG, and is considered the secondstep in the support planning process. Using the individual’s needs identified on the ICG, andincorporating the standardized statewide rates for services, the state is able to approximateone’s individual budget. Another tool that was developed for use during this part of the processwas the Personal Budget Worksheet, which can be used to identify costs related to ALL needsand preferences for the person. It can serve as an aid during the planning and decision-makingprocess.A system of flexible services was proposed that would make it easier for individuals to movetheir approved cost plan dollars around and change services based on the changing needs oftheir lives. The 32 current waiver services were collapsed into eight broad categories of similarservices. The implementation of this component is still in the development stage.In July 2003 the Developmental Disabilities Program instituted a new statewide standardizedrate system for all Medicaid Waiver providers. The purpose of the rate system was to establishstatewide rate consistency and to accommodate current and long-term system funding needs.These new rates are driven by direct care staff salaries and provide multiple fixed rates withlimited exceptions.90Section 3, Helpful Attachments
Stakeholders requested a change in the responsibilities of waiver support coordinators so thatthey could increase assistance to individuals. Direct-provider billing allowed Medicaid Waiverproviders to submit invoices for payment directly to Medicaid. That change eliminated that taskfrom the responsibility of waiver support coordinators. With the introduction of standardizedrates, support coordinators no longer needed to be involved in rate negotiations.Another change in support coordination includes the creation of a limited support coordinationoption. Individuals who live with families can now opt for less support from the supportcoordinator. The agency has established a specific policy for limited support coordination. Ifyou feel you are interested in limited support coordination, you should thoroughly review andresearch this alternative and talk with your support coordinator or staff at the agency beforemaking this change.The final component of the system redesign is improved communication:• Regularly send E-Bulletins• Conduct district forums• Improve the DD website• Expand Choice Counseling to all individuals receiving services from the agency(previously only available to persons in ICFs)• Strengthen the role of the Family Care Councils, and• Implement web-based trainingThe Developmental Disabilities Program began regularly sending E-Bulletins to anyone interestedin keeping up with the changes and learning more about services and supports. Theirweb site was updated and expanded. It continues to be a source of up-to-date informationabout the program. The web-site address is www.apd.myflorida.com.The system redesign that began in 2002 was the beginning of changes that are meant to improvethe program for individuals with developmental disabilities. Following the 2003 legislativesession, the Consumer Directed Care Plus Waiver was approved by CMS as a Florida waiver.It allows Florida to continue the Robert Wood Johnson Consumer Direct Care pilot project andis open to individuals who were part of the experimental project and those who were participatingin the Choice and Control pilot. Further expansion of this waiver has not been determinedyet. During the 2004 session, the Florida Legislature expanded the Family SupportedLiving waiver and opened it to children, as well as adults. Five services are available through thiswaiver and it will be offered to people who are on the waiting list for services. In addition, theLegislature created the Agency for Persons with Disabilities. The new agency will take responsibilityfor the Developmental Disabilities Program and the Developmental Services Institutions(including the Mentally Retarded Defendant Program ((MRDP)) on October 1, 2004. A Blue RibbonTask Force was formed to address the many aspects of forming the Agency for Persons withDisabilities. The final report from this task force is available on the APD website. Users of thisguide are highly encouraged to visit the referenced web site for updates and changes.Section 3, Helpful Attachments91
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AcknowledgementsWe would like to th
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SECTION 1THE HANDBOOKDevelopmental
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in realizing goals and outcomes he
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• Identify agencies and organizat
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TO BE SURE YOU HAVE ACCESSED ALL AV
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CHAPTER THREEUsing Government Benef
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Property or assets mean real estate
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There is a special program for peop
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Department of Elder Affairs: The De
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Be sure to complete the application
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Most services provided to persons w
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CHAPTER FIVEAdvocating and Coordina
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family member receives services. De
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• Use the chain of command. If yo
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28ChooseYour family member may make
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7. Skilled Nursing HomeSkilled nurs
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There are now more opportunities fo
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If your family member really thinks
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pre-need directive. As the term ind
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Can the Living Will and the Health
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Page 50 and 51: LETTERS OF INTENTIn addition to hav
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Page 54 and 55: CHAPTER TENDealing WithHealth Care
Page 56 and 57: CHAPTER ELEVENCoping with Changes a
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Page 63 and 64: Senior CenterHomemakerPersonal Care
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Page 89 and 90: SECTION 3HELPFUL ATTACHMENTSDevelop
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Page 93 and 94: My Personal OutcomesWHO AM I?What g
Page 95: Bill Of RightsIn June of 1975 the G
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Planning Ahead - Florida Developmental Disabilities Council

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