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  Questions and Answers

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1.    What should I do if I am not happy with the provider or person that I am getting a support or service from?  

Answer:  First try to work out the problem you feel you have with the provider.  Complete the Personal Compass questions to help determine the issues.  If you feel you still cannot work out this problem, call your support coordinator about selecting a different provider.   Although choice of providers is up to you alone, you may still wish to receive options, recommendations or advice from people that know you best and/or from your support coordinator.


2.     What is the purpose behind the Medicaid Waiver program that I am a participant in? 

Answer: The Medicaid Waiver program’s purpose is to assist you with supports that will help you reach your chosen goals in effort to become more independent and more in control over your health, safety and life in general so that natural community supports eventually replace paid ones.


3.     What is all the talk about the three Es?

Answer:  Education, Experience and Exposure is what the three Es stands for.  Delmarva Foundation is a company under contract by the State of Florida to monitor the quality of all APD  Medicaid Waiver providers. Since 2005, they have been monitoring using the EEEs.  Basically Education means that a provider should be teaching you things that you need to know based upon your goals and preferences. Next, a provider should be exposing you to new ideas, concepts or activities that you may want to explore based on your known preferences.  Next a provider may facilitate a situation where you can experience an activity or idea based on your preferences.  The idea is that you will be educated on, exposed to and finally experience something new that you will then decide you like it or not. It is hoped that this will expand your possible available choices.  More about this in a powerpoint presentation I presented with my backup support coordinator in summer 2005.


4.     Who makes decisions for me?

Answer:  Unless you are a minor or have been declared legally incompetent and have a guardian, you make your own decisions not other people.  You are encouraged to make your own decisions about your healthcare, your goals, your daily activities, your friends, where you live, your level of community involvement and who will provide supports for you.


5.     What does Choice mean to me?

Answer: Choice means that you make the decisions that affect you.  You may want to ask what are your possible options and what are the pros and cons of each option before you make a choice.  If you make a bad choice, there will be results that you may not like.  You can also ask for advice or a recommendation if you  are not sure.


6.     What are the legal rights of a person with developmental disabilities? 

Answer:  See The Bill of Rights F.S. 393.13  Entire F.S. 393 governs APD Medicaid Waiver program.

              The right of dignity, privacy and humane care

              The right to religious freedom and practice

              The right to receive services in least restrictive setting

              The right to training with instruction in sex education, marriage, and family


              The right to social interaction and to participate in community activities.

              The right to physical exercise and recreational opportunities.

              The right to be free from harm, including unnecessary physical, chemical, or  

              mechanical restraint, isolation, excessive medication, abuse, or neglect.

              The right to consent to or refuse treatment.

              The unrestricted right to communication and visitation

              The right to personal possessions and effects

              The right to prompt and appropriate medical care and treatment

              The right to approved behavioral and leisure time activities

              The right to humane discipline

              The right physical examination prior to subjection to a treatment program to

              eliminate bizarre or unusual behaviors

              The right to minimum wage protection and fair compensation

              The right to a central record.

              The right to vote if eligible.

          SEE ALSO Americans with Disabilities Act

7.     What do I do if I suspect or experience abuse, neglect or exploitation?

      Answer:  Call the Abuse Registry  Hotline.  1800-96-ABUSE. 

          Ways to Report File an Abuse Report

      a. Phone  800 962-2873.
                b. Online, simply visit the Department of Children and Families Web site at    
                    http://www.state.fl.us/cf_web/ and click on the icon titled “Report Abuse Online.”

      c. Fax number, 1-800-914-0004, and
                d. Hearing or speech impaired  a TDD number, 1-800-453-5145, for the deaf, hard of hearing or
                    speech impaired are available to report instances of alleged abuse. 

8.     Should I have guardianship established and what types of legal mechanisms should I consider with an attorney?

Answer: See F.S. Chapter 744 Guardianship . This depends on several factors.  The support coordinator, physicians, attorney and other support team members along with family members can help provide recommendations here.  Since guardianship removes certain rights from the person with developmental disabilities, it should be used when a person is unable to make those important informed decisions on their own such as medical or financial decisions.  The MW program wishes to preserve as much of the many choices and decision making process to the individual as possible.  Important areas to consider when making this decision are: health, safety, legal and financial.  There are many types and levels of guardianships such as limited or full.  You might consider a coguardianship advocate which is cheaper in cost and allows some flexibility a lawyer has informed me. An attorney can explain and execute these many types for you should they become necessary.  If you do not have attorney or have limited resources to pay for one, you should contact the Florida Bar online Lawyer Referral Service or may call at them Lawyer Referral 1-800-342-8011.  If you cannot afford a lawyer, you might qualify for legal services.
The Community Legal Services of Mid-Florida, Inc. may be able to help in providing legal services. 
 407 841-7777.  I have listed 3 lawyers & phone below in ques#9 that you can call if you don't have your own lawyer. 

9.     What are some of the types of final planning areas I should review and decide on?

Answer:  You should consult your spiritual, legal, medical and / or family as necessary before making a decision on all of the below issues.

a. Should decide if you want to have a health surrogate which could make medical decisions if / when you are not able.  You must be legally competent and be able to understand to give this "informed consent" to someone else to make health decisions for you should you not be able to do so yourself in the future.  A sample form is located at: CLICK HERE TO GET PDF FORM      CLICK HERE TO GET IT IN WORD FORMAT

b. Should decide if you want to donate any organs after you die.  Organ donation process click here.

c. Should decide if you want a DNR order in place.  You must be legally competent and be able to understand the serious consequences of this decision and be able to give "informed consent". Many hospitals have this form.  You may wish to consult your spiritual, legal, medical and family before making a decision on this.  

d. Should decide if you need to establish a Special Needs Trust to protect against losing your Medicaid and MW benefits if your inherit money or assets.  Consult your lawyer about this or one that has done these type of trusts before. If you don’t know or have a lawyer, two I am aware of but cannot officially endorse are:

1. Law Offices of Hoyt & Bryan, LLC  in Oviedo, FL (407) 977-8080   http://www.hoytbryan.com/  or contact Frank Nisi Jr., PA
(407) 622-2550 located at:  587 Lake Howell Rd, Maitland, FL 32751 or  Giles & Robinson, P.A. of Orlando, FL. (407) 425-3591

You may wish to contact the Orange County Bar Association at 407 422-4551 or at  http://orangecountybar.org/  Seminole county Bar Association at 407 834-1660 or at http://www.scbalas.com/ or the Florida Bar at 850 561-5600 or at http://www.floridabar.org

e. Should decide any funeral preferences you may have such as service, church, pastor, cremation vs. burial etc.  The largest local (West Orlando) cemetery is:  Woodlawn Memorial Park 407 293-1361 their website is at:  www.DignityMemorial.com   Prepaid plans are available and a good use of any excess funds that need to be spent so Medicaid benefits are not lost.  Be sure to notify Medicaid though if a plan is purchased so it will be excluded from your asset limit.  

 Note:  To make some of these above choices happen, it may require an attorney or completion of official documents. This is only general information provided to my clients to explore some options and things to consider before making any decisions. These are not all the options or choices, just some important ones.  You may need a specialist who knows more details in healthcare, legal, financial or funeral business.  They then can help you to get your choices realized and what necessary actions are needed on your part.


    10.  Where can I find a physician to use that specializes in a particular field of concern?   

       Answer:  The American Medical Association has a member physician’s search engine you can use at: 
http://webapps.ama-assn.org/doctorfinder/disclaimer.jsp  Many of the local hospitals also have their
        own referral service you can use.  The two largest local hospitals are: Orlando Regional Medical Center         
        http://www.orlandoregional.org/  and the Florida Hospital  http://www.flhosp.org/  You should ask if
        the physician accepts Medicaid or Medicare depending on your coverage. The HCBS Medicaid Waiver
        program only pays for certain prior-approved therapies and some prior approved dental services that
        have been determined to be medically necessary. 


11. Where can I find more information and get social service referrals in Orange or Seminole counties?
      Answer:  The
2-1-1 Community Resource Directory is an excellent start.  This comprehensive directory is a wonderful resource of community organizations and services.  A hardbound copy can be requested / purchased at 407 849-2364 Dr Nelson Ying Center 1940 Traylor Blvd. Orlando, FL  32804 Fax 407 244-2902.  Not all of these resources are related or appropriate for persons with developmental disabilities but many are. The helpline is 407 839-4357 (HELP).   

12. What do I do if I am interested in registering to vote in the election?

     Answer:  You can complete the
Florida Voter Registration Application*(.pdf). You can also use this form to: "CHANGE NAME OR ADDRESS • REPLACE YOUR DEFACED, LOST, OR STOLEN VOTER INFORMATION CARD • REGISTER WITH A POLITICAL PARTY OR CHANGE PARTY AFFILIATION • UPDATE YOUR SIGNATURE." It lists requirements such as being a US citizen, Florida resident, at least 18 years old, not now be adjudicated mentally incapacitated with respect to voting in Florida or any other state, Not have been convicted of a felony in Florida, or any other state, without your civil rights having been restored. A photo ID and last 4 digits of Social Security are helpful to have.

       To register in Orange County call: 407 836-2070 119 W Kaley Ave Orlando 32801 or internet at:    
To register in Seminole County call: 407 708-7700; 1500 E Airport Blvd Sanford, FL 32773 or at: 

    APD and / or Support Coordinators can inquire if you wish to register by using
           "Voter Registration Preference Form"*(.pdf)
  In Chapter 97.032 of the Florida Statutes, "The Florida Voter Registration Act,"  APD is considered a named voter registration agency
(97.058). As such, the expectations of the statute to offer assistance to register to vote for APD adult clients who are of legal age and competency applies to both area offices and institutions."

*You need adobe reader   Adobe Reader for Windows if you don't have, to read .PDF files. 


  Terms Explained

Home                 These are only a few of the key terms used.


1. Choice – You alone select and decide on things that affect you.(unless a minor or declared incompetent)


2. EEE Education, Experience and Exposure concepts that promote independence and expand available choices based on new preferences. See #3 under questions and answers section for more info.


3. Natural supports:  A non-paid community support. This may be a friend or family member. One of the central themes of the Medicaid Waiver program, is that as you become more a part of your community and gain social roles, that natural supports will eventually replace paid supports.


4. Supported Employment: An employment coach that assists you in a community job.  Acts as a liaison between your employer and the employee-consumer and assists in promoting job stability with training.


5. Supported Living: Living in your own apartment with or without a roommate exercising more independence and having more responsibilities than say in a group home.  A  SL coach that trains and assists you to become more independent and more responsible in day to day activities.


6. Support Plan:  Identifies your preferences and goals. Support Coordinator assembles this document
    based upon your preferences and choices for supports.


7. IPP or IEP:  Individual program or education plan. IPP is written by a provider whom you selected to
    give you supports necessary to reach your chosen goals. IEP is written by a school. Both plans list
    the individual steps required that will hopefully lead up to reaching your desired goals.


8. Cost plan: All the costs associated with the supports of providers necessary to reach your goals. This
     must be submitted to Maximus or APS Healthcare for review and approval.  Specific documentation is
     required from each provider.  If documentation is not given to the support coordinator or is inadequate,
     delay or denial of a service could likely happen.

9. ICG:  Individual Cost Guidelines:  Established 2003 assessment to determine maximum funding levels allowed based upon your needs in various areas identified. Assessment is conducted every 3 years by support coordinator whom is certified to administer assessment. ICG has been tied up in court and so no $ limits have been established as first thought.  However, each MW service does have it's own individual
maximum limits that will be approved for funding.


10. Person Centered approach: All providers should be working towards reaching your goals, not
      what someone else thinks you should be working on.  The focus is on your wants and desires for goals.


11. Outcome Based  The amount of success in a provider’s effort in part is based upon the outcome or result of the change or improvement or progress you actually made towards your goals.  This assumes that you did your part and made effort towards the goal as well as the provider making an effort.  In other words, Outcome Based is determined by what results or progress was made on a given goal.


 12. POMPersonal Outcome Measures.  Twenty plus areas that help to measure what areas you have supports in and which you need supports in. Which are important to you and which are not.  This is helpful in planning for your support plan goals. Your support coordinator asks you these questions which include areas such as choosing where you live and work and if you have the best healthcare available, if you have privacy and enough social roles or friends.  These outcome measures have gained importance in determining what supports are missing and needed, based on the importance given by the consumer to an outcome area or goal.  Delmarva Foundation randomly conducts POM interviews with APD consumers as a part of the WSC review process.


13. Independence / Self-sufficiency:  This is one of the central goals that the Medicaid Waiver program wants you to obtain so that you can be more in control over your own life and make more and better decisions by having more choices and less paid supports.


14. Health and Safety:  These two areas are very important to the Medicaid Waiver program.  Depending on who helps you in your living and work situation, you may get some assistance in these areas to maximize your health and reduce your risks and improve your safety issues.  Your support coordinator may also assist in obtaining supports for you as necessary or requested. You or someone that advocates for you should let your provider of supports know whether you feel you have adequate health care provisions and whether you feel there are any safety concerns.  If you have residential supports, this provider will normally help ensure your health and safety needs.  

15. National Core Indicators: (NCI) This is an assessment tool utilized by several states in the U.S.A. to measure quality of services and life outcomes of persons with developmental
disabilities.  Each member state can share their resources and knowledge to compare and contrast the results of their state to other states. 
Here is the
main home page of the National Core Indicators for more detailed information.  The NCI has basically replaced the Personal Outcome Measures (POM) since it incorporates
many of the same measures and has similar purpose to improve quality outcomes.
Their goal is to develop a systematic approach to performance and outcome measurement in order to
 improve  program performance. 



  Multi-Media Presentations


   Power Point Presentation(s)       

       PowerPoint Presentation:  Health, Safety & EEE PowerPoint >Click to view, Right mouse click
       "back" to stop presentation. (don't need powerpoint to view)



       Webcast presentation: Medicare Prescription Drug Program Webcast >Click to view (72 minutes)
(broadband Windows media player)


       Medicare Part D - Rx

       Website Guide To Medicare Part D Prescription Drug Coverage:  Click Here, excellent reference
Prepared by Disability Policy Collaboration , a partnership between The Arc and United Cerebral Palsy,
       Washington, DC



  Training Opportunities



APD District 7 has many training opportunities available throughout the year. Many are open to families or providers. Family Care Council and Family Cafe other groups also have trainings available.

    Delmarva Foundation also offers training on their Florida website.  Have online training modules that can accessed by anyone. Click on this link for training:  http://www.dfmc-florida.org/training_information/index.htm



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