Talking Points on Budget and Session

· Although Governor Crist’s recommendation for full funding of the deficit in the agency’s Developmental Disabilities Home and Community-Based Service waiver was not supported, the Agency for Persons with Disabilities is pleased that the legislature provided $114 million to cover some of the expected deficit. This represents a nearly 15 percent increase in the waiver over last year’s funding and a nine percent increase in the agency’s overall budget.

· The agency will begin work immediately to implement the changes to the waiver that take effect on July 1. Some of the changes will require federal government approval including creating two additional waivers with varying caps.

· Several elements in the final budget were taken from the agency’s plan to reduce the projected waiver deficit. APD worked with its stakeholders to develop the plan.

· None of the adjustments will cause someone to be institutionalized. There are safeguards in place to ensure that all needed basic supports will be provided to anyone currently receiving waiver services.

· There is no indication these changes will result in the closure of facilities such as group homes.

· The agency recognizes that changes in the waivers will impact all stakeholders. These adjustments are necessary to address the deficit and hopefully to begin serving people waiting for services.

Legislative changes to the waiver program will include:

· Chore, Non-residential Support Services, and Homemaker Services will be eliminated. However, the definition of In-Home Support Services will be expanded to include activities previously provided in the eliminated services.

· Massage Therapy and IQ Testing (Psychological Assessments) will be eliminated.

· Supported Living Coaching will be limited to no more than 20 hours a month for persons who also receive in-home support services.

· Support Coordination to all persons under the age of 18 who live in the family home will be limited.

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· Personal Care Attendants shall be limited to 180 hours a month. Additional hours may be authorized only if there is a substantial change in circumstances.

· Residential Habilitation Services will be limited to no more than 8 hours a day. Additional hours may be authorized for persons who have intensive medical, adaptive, or behavioral needs. (In effect until 4 tier system implemented.)

· Cost Plan reviews will be conducted for all plans that have increased by more than eight percent during the past two years.

· Residential Habilitation rate structure will be consolidated.

· Intensive Behavioral Residential Habilitation services will have uniform rates.

· Current support plans will be extended for one year beginning July 1, 2007, pending federal approval.

· Crisis clients will be served from funding available through attrition.

· Support plan submitted by Waiver Support Coordinators that are not in compliance with the Agency’s rules, policies, and procedures will be resolved.

In addition to the changes listed above, the Agency for Health Care Administration in consultation with APD is required to seek federal approval and implement a four-tiered waiver system. The new waiver system calls for waiver clients to be assigned to one of four “tiers”, based on an assessment of their needs, according to the following criteria:

· Tier 1 – Current DD waiver: Limited to individuals with intensive medical, behavioral and adaptive needs that cannot be met in other tiers.

· Tier 2 – Capped at $55,000: Limited to clients whose service needs include a licensed residential facility and greater than 5 hours a day of Residential Habilitation as well as clients in supported living who receive more than 6 hours of in-home support services

· Tier 3 – Capped at $35,000: Will include all individuals who do not fall into tier 1 or tier 2.

· Tier 4 – Current Family and Supported Living waiver with a cap of nearly $15,000. Additional services may be added to this tier after July 1, 2008.

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