Date: January 31, 2020
Subject: Senate Bill 82 – Update
Good evening below is latest info as of Friday evening.
SB82 continues to move through the Florida Senate committees. On Tuesday it moved through the Senate Subcommittee for Health and Human Services. It was very apparent Senator Bean has been listening to his constituents around the State as the Bill was amended the day before the meeting. These changes aren’t perfect but definitely in a better direction. The new version moves us away from the privatization/managed care concept of two lowest bidding support coordination agencies in each region to agencies of 4 or more WSCs. The other big change relates to leaving the SAN process within APD Central office and not using an outside agency vendor.
As this Bill relates to Support Coordination, if it passes we will no longer have solo support coordinators or small agencies of 3 or less. The Bill will require waiver support coordinators to be employees of qualified waiver support coordination organizations. Specifically, agencies of 4 or more WSCs. The Bill addresses the responsibilities of “qualified organizations. Sen. Bean stressed this would be a gradual “not overnight” change. Giving the WSC a choice of either joining an existing agency or forming an agency of 4 or more. The Senator talked about a better delivery of service, accountability and a consistent approach to support coordination. This Bill will go into effect July 1st but giving WSCs an additional 6 months ( Jan 2021) to implement changes.
I had the opportunity to address the committee. ( in 60 seconds or less) Our concerns are as following:
Personal Supports should not be limited to 180 hrs. and to consider at least moving that # to 8 hrs a day with justifications.
Not limiting Supported Living to 20 hrs. (with example extenuating circumstances)
I stated that SCAF felt that this Bill was going in a positive direction compared to what we were looking at before the addendum. However, we wanted to point out that we did not think APD provider enrollment offices could handle the change within 6 months and that additional time would need to be given. It also pointed out that SCAF had reviewed the new requirements and felt that there was no reason why solo and small agencies currently in place couldn’t implement all the new requirements in this Bill and should be given the opportunity to do so. (I would have liked to addressed further and our issues with Res Hab but time was limited)
During public testimony, the committee heard from consumers, family members, and Support Coordinators from around the State. It was encouraging to see the support and hear consumers talk about the lifeline between consumer/WSC but in the end the committee passed SB82 with 9 YEAS and 1 NAY. Moving it to Senate Appropriations.
As for SCAF, we will provide the Senate with a strong response to SB82 stating that the current model for Support Coordination in the State of Florida is more than capable of meeting the new requirements as written in the Bill and should be allowed to continue. We also suggest that WSCs continue the conversation with consumers, families and providers. Discuss what is at stake for them with this bill. Is it Personal Supports, Supported Living, Res Hab. feel free to also address your concerns as it pertains to Support Coordination.
It would be wrong of us not to suggest that you start looking at your plan B. Do you see yourself working for an existing agency, forming an agency of your own? Whatever the direction this Bill takes, we hope SCAF will be able to give you some guidance and direction.
The last info we have pertains to Senate bill 1210 and matching House bill 807. Certification of Developmental Disabilities Services Personnel; Beginning on a specified date, requiring that all support coordinators and certain direct service providers obtain and maintain certification by a third-party credentialing entity; requiring the Agency for Persons with Disabilities to approve one or more third-party credentialing entities; providing for the review and appeal of decisions made by third-party credentialing entities, etc.
We have had discussion about this bill with APD back in November. We don’t know much yet, but as we hear things we will send out info.
As always, please feel free to reach out to us with questions, concerns or ideas. We have created a facebook page for ongoing group discussions. (Support Coordination Association of Florida) Please join.
In Solidarity
Laura Mohesky
Date: January 25, 2020
Subject: Senate Bill 82 – Update
Good evening Waiver Support Coordinators
Just wanted to touch base with you before the start of a new week. The Senate Appropriations Subcommittee on Health and Human Services will be meeting this Tuesday and again Wednesday to discuss and vote for SB82. It is imperative that we continue to encourage our consumers and families to reach out to this committee. At the bottom of this email are the Senators in this committee.
I also want to encourage you to take a look at a waiver petition that a coordinator from the Pensacola area set up. (thank you Pam Silva!) This petition is emailed to all Florida Senators when signatures reach certain increments. It is imperative this petition is signed by as many people as possible so the policy makers will know that although not everyone can go to Tallahassee to speak directly, they are aware of the changes and are opposed to this bill.
Below is the link,
I have sent this through text, email and Facebook to consumers, families, friends, providers. Lets get this moving!
I have heard of a few rally’s that are being planned around the State. If your area is doing something send us the info. We are more than happy to get the word out..
Thank you all
Laura Mohesky
Appropriations Subcommittee on Health and Human Services
Chair:
Vice Chair:
- Senator Lauren Book (D)
- Senator Manny Diaz, Jr. (R)
- Senator Gary M. Farmer, Jr. (D)
- Senator Anitere Flores (R)
- Senator Ed Hooper (R)
- Senator Kathleen Passidomo (R)
- Senator Kevin J. Rader (D)
- Senator Darryl Ervin Rouson (D)
Date: January 21, 2020
Subject: Senate Bill 82 – Update
Greetings WSC from around the State.
As you have heard SB 82 was presented at the Children, Families, and Elder Affairs committee on 01/15/2020. Many spoke against the Bill, including myself to the effects this Bill will have on consumers, WSC’s and providers. Unfortunately, the committee members voted favorably with a 5 yeas 2 nays vote moving this Bill forward.
So, what exactly will this Bill do:( just a recap for anyone not in the loop)
For starters, it will change the way Support Coordination is done. The Bill is proposing 2 or more agencies in each region. These agencies will have to bid for the contract. “LOWEST BIDDER” This will eliminate solo, small agencies and some of the larger agencies currently providing Support Coordination. Sen. Bean stated several times during his presentation that this would ensure consistency throughout the state.
Additional limitations:
Res Hab. Changes in the number of hours a day to 8. Res hab is a 24/7 service. It is unsure what this will do to current rates.
Supported Living: not to exceed 20 hrs a month
Personal Supports: limited to 180 hrs a month. ( additional hours may be authorized for persons with intensive physical, medical or adaptive needs IF such hours are essential for avoiding institutionalization.
SANS process: This Bill would move the approval process from APD to a 3rd party. This was one of the only things Barbara Palmer when asked felt they didn’t want to see happen with in this Bill. Director Palmer stated they would centralize the SAN process. I wouldn’t be surprised if we see this taken out.
So, what happens next? The Bill is now headed to the Senate Subcommittee on Health and Human Services. This committee meets again on 01/28/2020. The agenda is not out yet, but this is the next stop.
So, what can we do: Reach out to your consumers, families and providers. Explain what is at stake. Ask them to reach out to their Senator and others. They need to write/call/fax, visit with personal stories on how SB82 will personally affect them. The change to Support Coordination is MANAGED CARE case management. And once WSC are no longer working for consumers all other services are in jeopardy. Below are a few talking points to share:
Moving Support Coordination to the LOWEST BIDDER agencies will NOT guarantee saving the State money and it could cost more.
Lowest Bidder does NOT mean most qualified
Loss of Choice, Loss of Advocacy loss of current Support Coordinator.
Moving support coordinators to large agencies would make support coordinators less effective in advocating for individuals they serve. Support coordinators will no longer work for consumers/families but for an Agency with an APD agenda not a consumer’s agenda.
There is no guarantee that moving Support Coordination to two or three large agencies in each region will be a smooth transition. (files misplaced, services disrupted, delayed, consumers lost in the process)
There is also no guarantee that this is a better model. APD and the Senate need to explore all options. The State should conduct a REAL PILOT first. To not is just wrong!
Time is running out. The senators of the Health and Human Services committee needs to hear from our folks NOW. (especially before the 28th.) Below is a list of the Senators we need to be reaching out to.
In solidarity
Laura Mohesky
SCAF/CHAIR
Appropriations Subcommittee on Health and Human Services
Chair:
Vice Chair:
- Senator Lauren Book (D)
- Senator Manny Diaz, Jr. (R)
- Senator Gary M. Farmer, Jr. (D)
- Senator Anitere Flores (R)
- Senator Ed Hooper (R)
- Senator Kathleen Passidomo (R)
- Senator Kevin J. Rader (D)
- Senator Darryl Ervin Rouson (D)
Date: January 10, 2020
Subject: Senate Bill 82
Good morning Waiver Support Coordinators.
It has come to our attention that a Senate Bill was filed on 01/09/2020 By Senator Aaron Bean that will have significant impact on service of Support Coordination as we know. This Bill will require APD to competitively procure qualified organizations to provide Support Coordination.
As it reads: “The Agency shall competitively procure two or more qualified organizations to provide Support Coordination services. In awarding a contract to a qualified organization, the agency shall take into account price, quality and accessibility to these services”.
Additionally this Bill also addresses:
Changes to the SAN process with a qualified organization performing the medical necessity determination of SAN requests.
Seeking Federal approval to provide Consumer-Directed Options.
Requirement to use APD data management system for all billing.
Changes to Res Hab, Supported Living, and Personal Care Services.
Below is a description of the Bill along with a link for review.
GENERAL BILL by Bean
Individuals With Disabilities: Requiring persons and entities under contract with the Agency for Persons with Disabilities to use the agency data management systems to bill for services; revising criteria used by the agency to develop a client’s iBudget; requiring the Agency for Health Care Administration to seek federal approval to provide consumer-directed options; requiring the Agency for Persons with Disabilities to competitively procure qualified organizations to provide Support Coordination services, etc.
Effective Date: 7/1/2020
Last Action: 1/9/2020 Senate – Referred to Children, Families, and Elder Affairs; Appropriations Subcommittee on Health and Human Services; Appropriations
Bill Text: Web Page | PDF
http://m.flsenate.gov/Bill/82/2020
This was not the REDESIGN APD submitted to the Governor in October. What we are now looking at is a form of Managed Care specifically in terms of Support Coordination. As for other services. Once you change the scope of Support Coordination, consumers and families can expect changes/reductions to other services that are currently approved and in place.
In the next few days SCAF will be reaching out to other Stakeholders around the State and develop talking points that you can share with your consumers, and families. We continue to suggest that you get involved. Educate your consumers, families, and providers on what is at stake during this Legislative session.
Please feel free to reach out to SCAF if you have additional questions.
Laura Mohesky
SCAF/CHAIR
Date: November 19, 2019
Subject:
Hello Waiver Support Coordinators,
Below is an update on what has been happening over the last month. Like all of you, the Board is busy between home visits, SAN requests, and of course dreaded Algorithms. So apologies for getting this out late.
On October 16th I attended the Senate Appropriations Subcommittee Meeting where Director Palmer and Secretary Mayhew laid out the plans for the Waiver Redesign. After the presentation, I, along with other Stakeholders, families and self-advocates were given the opportunity to speak. I asked our Senators to be our Fiscal Advocates and regardless of how we redesign this Waiver, it will still need to be funded better than it is now. We cannot continue being 50th in the Nation in how we take care of the most vulnerable citizens in our State. My takeaway from this meeting and after talking with several Stakeholders was that it appears APD has the support of the Senate Appropriations Subcommittee. However, they don’t know how they plan on funding this waiver.
I also got a chance before and after the meeting to talk with Director Palmer. She was happy to see the representation. We briefly talked about how she thinks things are going with the Redesign, she, like many others, feels that the concern lies with the House Health Care Appropriations Subcommittee. Remember it was the last Legislative Session that the House wanted to move the Waiver to Managed Care and the Senate did not have a matching bill. She encourages us to continue educating consumers, families and providers on importance of funding our waiver.
On November 8th I attended a meeting at Senator Rouson’s office (Senate Dem, St. Petersburg sits on the Appropriations Committee) which was arranged with the help of Gary Hartfield with Empower Florida. Senator Rouson had spent the day with ACHA Secretary Mary Mayhew. This meeting went well, and Secretary Mayhew listened to the concerns from the Stakeholders in attendance. I think she was enlightened by what we had to say and valued our input. She feels that Managed Care is not an option for our Waiver. I found it interesting to note she doesn’t think Managed Care is working for the other Waivers either. I was able to ask her several questions and my last question related to her thoughts on the Waiver as it currently stands and what she feels it needs to succeed or change. Her response was FUNDING.
The general feeling is that we are not out of the woods just yet. Like others, I have read the Governor is not convinced our Waiver should not be under Managed Care and we still have the concern with the House. For now, we will keep a close eye on when the House Health Care Appropriations Subcommittee will meet.
As for Support Coordination, we know that change is coming. As of recently a Senate Bill related to the certification of Support Coordination came out, Senate Bill 808. This Bill basically states that ALL Waiver Support Coordinators and certain direct Service Providers will maintain a certification by a 3rd party credentialing entity. WSC will be charged a “fee sufficient” to cover certain costs. The Certification means a professional credential awarded by an approved 3rd party credentialing entity. WSC will need to be able to demonstrate core competency in providing services to persons with developmental disabilities and adherence to established standards of professional ethics in the performance of their duties. The Bill, if passed is to take effect July 2021.
I spoke briefly to Director Palmer about the Bill and other WSC concerns this past Friday. Her belief is that this certification will provide professional development and help level the professionalism of Support Coordination. Currently, APD does not have a 3rd party credentialing entity in mind and Director Palmer was open to SCAF being part of the advisory committee.
Moving forward SCAF suggests all WSCs continue to educate their consumers, families and providers on what is at stake during this Legislative Session. Encourage them to call, write and meet with local Legislatures. It is very important to continue advocating for the Waiver and proper funding. As for SCAF, we plan to continue to meet with our Legislatures, attend committee meetings and get information out to our members as we hear it. We also hope to gather your input on how to improve Support Coordination.
As always please feel free to reach out to us.
Laura Mohesky
Chair
Date: October 3, 2019
Subject: Updates from Chair, Laura Mohesky on meeting with APD and AHCA
Good Evening,
By this time I hope you have had a chance to read the APD/AHCA Waiver Redesign. I was in attendance along with the major stakeholders and upper APD personnel to review the Redesign. Below is my take and the highlights of the meeting.
Director Palmer and Secretary Mary Mayhew (AHCA) led the meeting and highlighted sections of the Redesign. They made it clear there would be no reduction of service rates and both AHCA and APD agreed that Managed Care was not a good option for our folks. Therefore, Managed Care was not being recommended to the Governor.
APD is working with the Legislature to be a part of the SSEC (Social Services Estimating Conference).
There was discussion about the Algorithm and Director Palmer admitted it does not work and it is disruptive to families.
It was mentioned the Algorithm is not based on need.
Life Skills limitation: 1440 hours of Companion, Adult Day Training and Supported Employment. (and yes, they do realize the total does not compare to ADT 5 days a week, 6 hrs. a day). A reference about the 1440 limitation had been in place prior to iBudget.
Moving some costs from APD to AHCA which may include children aging out of the Medicaid State Plan, group homes: billing Medical Assisted Care through Medicaid.
Centralizing the SAN process (no regional middleman). Hiring additional qualified APD staff in Tally to review SANS.
The importance of a Needs Assessment (the next generation QSI) as a better tool to help justify consumer needs (compared to the Algorithm we now have).
The wait list and the importance of taking people off.
Cap: Individual cap for consumers with budgets over $205,000 a yr. (and looking closely at those budgets and services).
Support Coordination: The need for more training, certification and increased accountability. APD definitely wants to see change in SC. (Please review appendix F on the Redesign).
Both SCAF and ASCA have offered to be part of any form of “restructuring WSC”.
Director Palmer ended by saying Governor DeSantis wants a sustainable plan in place, which both AHCA and APD believe they have. She did stress this now goes into the hands of the Governor and the Legislature. She encouraged the room to continue to write and call Legislators making our voices heard for supporting and funding the Waiver and this redesign.
A time for questions and answers. I was able to ask 3 questions during this 1-hour meeting.
My first question was after hearing the Chair from Family Care talk about her son on the wait list and her concern if something were to happen to her (her son not having the ability to speak for himself). I asked how often does APD contact families on the wait list. Director Palmer said yearly. I questioned that as a WSC who recently received a case off the crisis list.
My second question was to Director Palmer: WSC are getting Algorithms monthly, if they don’t work are we going to continue receiving them and putting SANs in place? Director Palmer said yes until something else is put in its’ place as a tool to justify services.
My last question of the day (the elephant in room): I asked if they could just answer 3 simple questions that I would like to be able to share with my fellow WSCs around the state. (1) Is Support Coordination going to any type of Managed Care? (answer NO) (2) Will we see only a few WSC agencies in each region? (answer No) (3) Will we continue to have solo WSC? (answer YES).
As a WSC and your Chair, I have to admit I still have some concerns as this Redesign relates to the “restructuring” of SC. I have spoken with the Chair from ASCA and hopefully together we can work with APD to ensure the profession of SC continues to not only remain a core service in the waiver but that any form of restructuring improves the effectiveness of how we serve our consumers and increases the professionalism of SC.
One last note. If you’re not a current member of SCAF, I ask that you to carefully reconsider. SCAF is working hard on your behalf. If you take pride in this profession then join us in solidarity as we work to improve our relationship with APD, the stability of our employment, and most importantly that we continue to be the advocates for the consumers we serve. If you don’t want to join SCAF, at least consider joining the other SC association, ASCA (Association for Support Coordination Agencies). Either way, it benefits all of us.
Thank you
Laura Mohesky
Chair
Date: October 1, 2019
Subject: Final Redesign
Good Afternoon,
This morning, the iBudget Florida Waiver redesign plan has been posted on the APDCARES.ORG website.
http://apdcares.org/docs/Waiver%20Redesign%20Plan%20Final.pdf
SCAF Chair, Laura Mohesky will be attending a meeting in Tallahassee this afternoon with APD and other key stakeholders. We will share more information as we become more informed. SCAF board felt it was important to get this information out to you.
Sincerely,
Mary Schuh
SCAF/Secretary
Date: September 12, 2019
Subject: Talking Points
Good Afternoon,
The SCAF Board has put together the following simple “Talking Points” for you to share with your Consumers, Families and Providers.
1. The Medicaid (iBudget) Waiver has never been adequately funded – it falls into a deficit every year because it’s not funded properly. It is the most desired option for providing services. Properly FUND the Medicaid (iBudget) Waiver!
2. Attempts to cut cost and reduce services will not only jeopardize the health and safety of vulnerable people; it will also cost the State more in the long run.
3. The Core Service of Support Coordination (solo or agency) should never change. Support Coordination should never be an employee of APD, andSupport Coordination should never be part of managed care. Individuals on the Medicaid (iBudget) Wavier need choice and Support Coordinators to Advocate for their consumers best interest.
4. Managed Care. Any form of Managed Care will have an impact on consumers and current services. Managed Care is a business, and it will not be profitable without reducing, eliminating and changing how our consumers receive service.
We encourage you to meet with your consumers and family members help them draft letters telling their stories to our legislators, explaining how any changes will affect them directly. These letters need to be sent to the Governor, Senate President, Speaker of the House and Senator Aaron Bean.
We also encourage you to educate and work with your providers. They have first-hand account of how vital these services are to the families. Make them aware of the redesign so they can also encourage their families to write letters or call the Governor, Senate President, Speaker of the House, Legislators and Senators
Here is how to find your Legislators: https://www.flsenate.gov/senators/find
Governor: Ron DeSantis
Office of the Governor
The Capitol
400 S. Monroe St.
Tallahassee, FL 32399-0001
850-717-9337
DeSantis.opengov@eog.myflorida.com
Senate President: Bill Galvano
District Office
1023 Manatee Ave. West Suite 201
Bradenton, LF 24205
941-741-3401
Tallahassee Office:
305 Senate Building
404 South Monroe Street
Tallahassee, FL 32399-1100
850-487-5021
galvano.bill@flsenate.gov
Representative: Jose R. Oliva
Speaker of the House
420 The Capitol
402 South Monroe Street
Tallahassee, FL 32399-1300
850-717-5110
jose.oliva@myfloridahouse.gov
https://www.myfloridahouse.gov/Sections/Representatives/contactmember.aspx?MemberId=4534
Home office:
3798 West 12th Avenue Suite A
Hialeah, FL 33012-4126
305-364-3114
SCAF is here for you but it will take ALL of us: Consumers, Families, WSCs, and Providers to save the Waiver as we know it. Keep in touch with us. Let us know what is happening in your area. We are aligning with other Stakeholders; Town Hall Meetings are taking place. Rallies are being organized during session.
Now is the time to get involved.
Sincerely,
Laura Mohesky
SCAF-Chair
September 11, 2019
Dear Members and prospective Members,
On behalf of the Board Members of SCAF, I am writing you to request your membership and membership renewals.
Support Coordination Association of Florida is a vital part of being a successful Support Coordinator now and in the future. We all know at times WSCs can feel alone and without a voice. SCAF is here to unify WSC as a professional association for the benefit of individuals with intellectual and developmental disabilities. SCAF is your professional network of colleagues. Your voice matters, we welcome and encourage both solos and agency WSCs to join.
Please find the attached Membership Application. The Membership Year is from July 2019-June 2020.
Thank you for your continued support.
Sincerely,
Gerda Mothersil
SCAF, Membership Chair
Click here for Membership form:
Membership Application
Date: August 28, 2019
Subject: Welcome the new Board and Redesign
SCAF Membership,
We would like to thank Tom Buddington for his years of dedication, leadership and hard work for SCAF. We are please to be re-starting SCAF and would like to welcome the new board members.
Laura Mohesky – Chair
Evelyn Rivera – Vice Chair
Mary Schuh – Secretary
Tara Downs – Treasurer
Gerda Mothersil – Member at Large
Shiphrah Mercado – Member at Large
Cristy Hitchcock – Member at Large
As you already know, APD is currently working on a Redesign of the Ibudget Waiver Program. SCAF has received a copy of the proposed Redesign. Here are the highlights:
-Possible rate reductions to all services except Res. Hab. (between 1-3%)
-ADT reduction in the number of levels, plans to implement two types of ADT – 1 track employment and 2nd track
Adult Day Care (2nd track being a lower rate)
-LSD Companion, Supported Employment and ADT not to exceed 1440 hours annually
-Personal Supports to revise the definition and exclude supervision. Requirement of hours beyond 12 to be in higher ratios (1:2 or 1:3). Limit to 180 hours per month unless the consumer requires total physical assistance that includes lifting and transfers, in at least three of the basic areas identified due to physical, medical or adaptive behavior. Additional hours over 180 hours may be requested for intensive physical, medical or adaptive needs when hours are essential to maintain health and medical status. Anyone who needs PS during sleep hours will need Doctor letter of medical necessity. PS max hours per day will be 16.
-Res Hab to reduce the number of levels and revise annual medical necessity to include a 3rd party recommendation. ICF for Intensive Behavior GH. (smaller ICF type homes under AHCA)
-Respite will be limited to 720/hours for ages 3-14 no changes for 15-20
Managed Care- Several options have been addressed:
1. Hybrid Managed Care Model through AHCA for medical services, APD to maintain Companion, ADT, Res Hab, etc.
2. Long Term Managed Care for all services (APD contract or AHCA administered)
-Waiver Support Coordination: APD contracts with a LIMITED number of agency(ies) regionally/statewide. APD to take back Support Coordination in the role of an FTE or Contract employee.
This is a DRAFT but it is in the direction that APD is heading into the new Legislative session. APD will submit the final report to the Senate President and Speaker of the House on 9/30/2019. This is the time to start educating consumer’s, families and providers what is at stake. We will be sending out talking points soon.
Please share this information with every WSC you know.
Thank you for your continued support.
Sincerely,
Laura Mohesky
SCAF Chair
Date: August 31, 2019
Subject: Statewide Emergency PreparednessGood afternoon WSCs and SCAF members.I have been participating in APD Statewide Emergency Operations calls since Friday evening. APD has been working with all stakeholders during this time to ensure the safety of our consumers. During the call this afternoon one of the ROM’s mentioned that they had not heard back from all WSC in the region on matters of health and safety of consumers.
I offered to send a message reminding WSCs to continue checking emails during this time. Respond back in an appropriate manner to all APD inquires. If you have an issue that needs resolution during this time and can’t reach APD, please feel free to contact me. I will reach out to the appropriate ROM.
Attaching info on Food Benefit assistance. (you should have received this email )
Thanks, and stay safe Florida
Laura Mohesky
SCAF/Chair
Lmohesky@cfl.rr.com
August 31, 2019
WSC ADVISORY #2019-039
FOOD ASSISTANCE UPDATE – ACTION REQUIRED
EFFECTIVE DATE: AUGUST 31, 2019
The Department of Children and Families (DCF) provided the information below on their
website regarding food assistance benefits in preparation for Hurricane Dorian. Waiver
Support Coordinators (WSCs) should ensure that individuals on their caseloads who utilize
food assistance benefits are aware of this information. “To assist families as they prepare
for Hurricane Dorian, DCF has been approved by the USDA to release September food
assistance benefits to all 67 counties.
Current customers who were scheduled to receive their benefits between September 1 and
September 14 will now be able to access benefits starting August 31 at noon. This is a early
release of regular benefits, not a distribution of additional funds.” More information
regarding food assistance programs can be found on the DCF Access Website at the
following link: https://www.myflorida.com/accessflorida/
DATE: August 26, 2019
SUBJECT: SCAF New Board Announcement
SCAF Membership,
It is with genuine pleasure that I introduce to you the new SCAF Board of Directors. These experienced and competent WSC’s have agreed to take over SCAF leadership. Their willingness to do so will ensure that your Association, and your voice, remains at the table on all matters pertaining to Waiver Support Coordination in the state of Florida. They are to be congratulated for taking on this sacrifice of time and talent and I hope that you will lend them your full support as you did me. All further communications will come from your new SCAF Board.
⚠️ SCAF Board of Directors Effective Immediately:
Laura Mokesky – Chair
Evelyn Rivera – Vice Chair
Mary Schuh – Secretary
Tara Downs – Treasurer
Gerda Mothersil – Member at Large
Shiphrah Mercado – Member at Large
Cristy Hitchcock – Member at Large
Again, warm appreciation and best wishes to the new SCAF Board in their work on behalf of Waiver Support Coordination in Florida.
Regards,
Tom Buddington, Past Chair
Support Coordination Association of Florida (SCAF)
_____________________________________________
Tom Buddington, Past-Chair
DATE: November 02, 2017
SUBJECT: SCAF Legislative Positions and Agenda Concerning Issues Relevant to Waiver Support
Coordination for the 2018 Legislative Year.
The Support Coordination Association of Florida (SCAF) believes it is important to make clear it’s position on legislative issues that affect iBudget Waiver Support Coordinators in Florida. SCAF is a large Association of Waiver Support Coordinators (WSC’s) representing both Solo and Agency Support Coordinator types with substantial membership in all geographic areas of the state. This document will make clear where SCAF stands on issues related to case management for persons with developmental disabilities for the coming legislative session.
On Waiver Support Coordination (Waiver Case Management)
We believe in the value of Waiver Support Coordination in all its current forms. This is a critical service provided
to persons with disabilities in Florida and must be fully supported in both solo and agency provider types to allow consumers sufficient choice of variants of this most essential service. We believe that this service must continue to be funded at it’s current level of funding with the current reimbursement rates in order to adequately and fairly compensate service providers of both types as they address the choices, needs, ‘health, safety, and well-being concerns of the consumers they serve.
On the Question of Provider Rates
SCAF understands that the funding scenario facing the Florida Legislature in the 2018 year is one of scarce funds. Funding priorities, particularly with regards to the issue of Waiver Provider Rates, must be carefully considered as a balance between those limited funds and the real need for provider rate increases for critical, ground-level services which are essential in achieving an acceptable quality of life for persons with developmental disabilities. SCAF does believe that there needs to be an additional rate increase for the following critical provider types in the coming year solely as specified and prioritized as follows:
1. Life Skills Development (LSD) (Companion) 2. Respite
3. Personal Supports
4. Adult Day Training
*SCAF is further clear that last year’s non-recurring 3% rate increase for the above-listed providers must be continued in the coming year.
On the Question of Disaster Planning
SCAF believes that the existing tool and format APD Disaster Plan should be amended to be more practical in chaotic extreme events and, further, that it be required that the Disaster Plan be included in the Support Plan of all iBudget Waiver consumers. This is an essential informational tool that will be used for sharing consumer plans and safety supports with support systems during extreme events. SCAF stands ready to assist key players in the development of an upgraded Disaster Plan.
On the Question of the Waitlist
SCAF supports taking as many currently-unserved persons with disabilities as is fiscally feasible off the waitlist.
*We support Agency for Persons with Disabilities (APD)’s position that 900 individuals be removed from the waitlist as a minimum number.
Support Coordination Association of Florida (SCAF) at the direction of the SCAF Executive Committee
[SCAF form version 07/01/2017]
FEMA Info on Resources menu for guidebook download. Reimburses for housing & related disaster expenses.
Food Assistance Replacement Request Form- English, Spanish, Hatian versions
-Used to replace spoiled food stuffs that were purchased during Irma with SNAP.
See Resources menu for form download.
Please note our email address: SCAofFlorida@gmail.com
DATE: July 03, 2017
SUBJECT: Message from the Chair 07/03/2017
As the new SCAF Chair, I just wanted to take a quick moment to thank you for your membership and the opportunity to serve as your Chair for the next 2 years starting this month. I very much look forward to working for you in this capacity along with the rest of the elected SCAF Board. Having worked with this board for the past 2 years, let me say that it is truly is an honor to work for you and with this group of individuals. You have a very hard-working Board who are committed to serve the interests of all WSC’s in the state, not for pay but out of passion for this work, on behalf of the developmentally disabled served by the Waiver in Florida.
In addition to myself, the following are the current slate of SCAF Board members:
- Laura Mohesky – Laura will be serving her 2nd term as SCAF Vice-Chair
- Tara Downs – serving a second term as SCAF Treasurer
- Rita McKeown – continuing to serve as SCAF Parliamentarian
- Kelly Alvarez – we warmly welcome Kelly to the Board as the new SCAF Secretary
On behalf of the entire SCAF Board I would also like to take this opportunity to thank our Past Chair, David Alexander, for his decades of faithful and tireless service to the consumers he served and to all of us for being an instrumental part of this Association’s birth and development. We all look forward to continuing to work with him in the coming years as he serves as our first Past Chair. SCAF would not exist if it were not for David’s dream of an Association that represented all Waiver Support Coordinators.
I hope you have a happy and safe holiday.
Regards,
Tom Buddington, SCAF Chair
DATE: June 29, 2017
SUBJECT: Florida Medicaid Health Care Alert 06/29/2017
SCAF Members – Please see notice from AHCA below:
Provider Type(s): ALL
Delay in Payment to Florida’s Medicaid Providers
During the first week in July 2017, the Florida Department of Financial Services will be performing the annual close out of the state fiscal year. The Florida Accounting Information Resource (FLAIR) system will be offline until Wednesday, July 5, 2017. Due to the timing of this mandatory process, the Agency for Health Care Administration will delay payments to Medicaid Providers until Monday, July 10, 2017.
Please note that the “Payment Issue Date” on the remittance advice and all other generated information will remain Wednesday, July 5, 2017.
This is a one-time delay with the regular Thursday payment schedule returning on July 13, 2017.
If you need assistance or have questions about provider payments please contact the Medicaid Provider Enrollment Call Center at 1-800-289-7799, Option 4
DATE: June 22, 2017
SUBJECT: 2017 SCAF Membership Renewal and Dues Notice
SCAF Members
Your renewed membership (or 1st time membership) is critical in ensuring we remain a major player at the table of every significant conversation that affects what we do and are passionate about.
The past year, your association has been very hard at work for all Waiver Support Coordinators in Florida. Some examples of our efforts include:
1. iBudget SAN System – SCAF became directly involved in addressing concerns and advocating for improvements to the system.
2. SCAF participated in a monthly schedule of conference calls with APD Tallahassee leadership to ensure the needs of all WSC’s were addressed and to provide a ’street level’ perspective on our work as key decisions were being made. SCAF additionally worked on the following issues:
a. working on creating a better working relationship for WSCs with APD Tally and Regional
b. the Algorithm – worked to clarify roll-out and obtain a workable lead-time for WSC’s to address. Communicated impact of new algorithm on WSC’s and their recipients.
3. Training held in Orlando late Sept. and Oct.
a. initiated by SCAF
b. paid for by APD
4. Our Ticket System
a. allows members to send questions to us which we address with researched, authoritative answers
b. Ticket issues may address concerns happening on the regional level or statewide level
c. Through this member complaint/concern system, SCAF has on numerous occasions intervened directly on behalf of individual SCAF members in need.
5. SCAF has built a solid, productive working relationship with numerous stakeholders throughout the state.
6. APD is sending WSC Advisories directly to SCAF so we can distribute to members and ensure rapid communication of important issues to everyone.
7. Fiscal Year Cost Plan Exercise – SCAF partnered directly with APD Tallahassee to ensure the rate change and 17-18 Fiscal Year project came off smoothly (including advocating for an emergency procedure for Consultants to follow for Cost Plan changes during the ‘lock-down period.’)
8. SCAF successfully advocated during the last Legislative Session for a direct care service provider rate increase over other possible uses for the limited funds that were available.
9. SCAF reached out to its membership for nominations to the SCAF Board to allow members to participate in deciding on the leadership of their association and elections were held.
10. SCAF attends APD stakeholder meetings in Tallahassee.
We look forward to your continued support. Please send your $50.00 membership fee to the SCAF P.O. Box [Support Coordination Association of Florida | P.O. Box 561357 | Rockledge, FL 32956-1357] in order to continue your membership and to continue receiving SCAF Member Info Messages. NEW THIS YEAR: If you renew your membership for three (3) years at once you will receive a 10% discount ($135.00 total for all 3 years)
*Beginning August 01, 2017, only registered, paying SCAF members will receive member support (access to the member complaint/help system wherein we will assist you directly with issues you may experience with APD or other parties) and Member InfoBlasts. July 2017 will be a grace period for all.
So send your renewals in and continue to be members in a truly beneficial WSC association.
Highest Regards,
The Support Coordination Association of Florida (SCAF) Board of Directors.
DATE: June 06, 2017
SUBJECT: New Provider Rates Posted to SCAF Website
SCAF Members,
SCAF has received a copy of the new Provider Rates which will be effective for 07/01/2017 for the following Services:
– Life Skills Development (LSD) Adult Day Training
– Personal Supports
– LPN level skilled nursing and Respite Skilled Nursing – Residential Habilitation – all levels and types
– Supported Employment
A link to the new rates is posted on the SCAF Website. Click on the link and you will be able to download a copy of the rate table.
http://scaof.com/FY2017_2018_Rate_Increases_FINAL_2.pdf
*SCAF urges you to complete your FY 17-18 Cost Plans as soon as possible. The sooner you get this project completed the more time APD Consultants will have time to review and approve your caseload’s cost plans in time for the system shut-down and rate change implementation on 06/12/17. **REMEMBER: Cost Plans can not be in PENDING status for this exercise.
DATE: June 6, 2017
SUBJECT: Provider rate changes
Effective July 1, 2017, rate changes for certain services will be utilized and automatically inserted into existing iBudgets prior to this date.
Here is the new rate table. http://scaof.com/FY2017_2018_Rate_Increases_FINAL_2.pdf
DATE: May 31, 2017
SUBJECT: IMPORTANT Bulletin Concerning FY 17-18 Cost Plan Exercise
SCAF Members,
The SCAF Board would like to advise that we have been in communication with APD Tallahassee concerning this year’s Fiscal Year Cost Plan exercise. As you are aware, this year’s exercise will have the added challenge of a 2 week Cost Plan ‘lock-down’ period necessitated by Rate coding for the provider rate increase. APD will be increasing budgets for recipients based on the rate increases and annualize Cost Plans accordingly. This will be for the following services:
– Life Skills Development (LSD) Adult Day Training
– Personal Supports
– LPN level skilled nursing and Respite Skilled Nursing
– Residential Habilitation – all levels and types
– Supported Employment
*Note that of these services, the increase (which as of this date has not been signed by the Governor and therefore the exact rate increase amount is not known) for Skilled Nursing is permanent (recurring). All of the other afore-mentioned services will have to be re-visited during the next legislative session (they are not recurring).
SCAF has been reassured by APD Tallahassee that APD Consultants will be given a procedure to follow for cases of Cost Plan changes necessary due to emergencies during the Cost Plan system lock-down.
SCAF would like to advise it’s membership to make sure you have the most current version of their caseload’s recipients’ Cost Plans downloaded in the event it would be necessary to demonstrate previous-approved amounts. In past similar exercises it has proven very helpful to be able to demonstrate the number of units of a particular service that were previously approved during a rate change exercise and iBudget does not at this time save Cost Plan ‘version histories.’
Concerning Service Authorization(s) – we addressed concerns that these will be late for the rate change-affected services. APD Tallahassee will be addressing this problem by issuing a Provider Advisory to providers informing them that Service Authorization(s) for the affected services, after the rate changes occur, will not be available until 06/26/17. *APD has informed SCAF that providers will be informed via the advisory that WSC’s will have until 07/15/2017 to issue the affected Service Authorization(s).
We have been assured that if you have opted to complete the entire year of your recipients’ Fiscal Year Cost Plans, the rate changes will apply to the entire year and you will not have to re-enter Q’s 2 through 4.
Please notify your Region Office / Consultant as soon as you detect a Cost Plan error so that it can be corrected in a timely manner.
Please let SCAF know of any issues or problems you are having by directing them to the SCAF email address and thank you.
DATE: May 11, 2017
SUBJECT: IMPORTANT Bulletin Concerning FY 17-18 Cost Plan Exercise
SCAF Members,
We would like to advise the General Membership that we have been getting reports from various parts of the state that, with regards to the Fiscal Year Cost Plan exercise this year, they are being told they are only allowed to enter the 1st Quarter. We are also getting reports that Waiver Support Coordinators are being warned that if they have entered a full year’s, the plans will be deleted.
SCAF has made contact with the APD Central Program Office and obtained immediate clarification and remedy. Please be advised that the APD Central Program Office is completely supportive of entering either just Q1 or the entire Cost Plan at the Waiver Support Coordinator’s discretion and this was their intent from the beginning. Central Program Office reiterated to us that their aim is to make this project easier, not create obstacles, and we thank them for their responsiveness and immediate assistance.
Please contact us if any of you are having any further difficulties. This is the reason we exist as an Association.
DATE: April 05, 2017
SUBJECT: SCAF Update on APD Legislative Agenda 04/04/2017
SCAF Membership,
There are significant developments occurring this year in the 2017-2018 Legislative Session. SCAF feels that it is essential that it’s membership, the Florida House and Senate, APD, and any other involved parties be clear concerning our position as an Association.
SCAF has become aware that the other Support Coordination Association in Florida (ASCA – Association of Support Coordination Agencies) has been lobbying the Florida Legislature for a rate increase for Waiver Support Coordination providers that meet the criteria for agency designation. It is also our understanding that a current proposal exists which involves utilization of funds that were designated for reduction of the Waiver waitlist.
It is SCAF’s position that this is fundamentally wrong. As we are all aware, reimbursement rates for Waiver providers of all types continues to be inadequate at this time. However, it is undeniable that of all provider types, direct care providers such as Personal Supports and Life Skills Development 1 (Companion) are in critical need of compensation at an equitable rate, a condition which currently does not exist.
We will continue as an Association to push for fair reimbursement rates for Waiver Support Coordination. However, given the limited funding available as we understand the present situation, SCAF is firmly advocating for improvement to the reimbursement rates for Personal Supports and Life Skills Development (LSD 1) Companion as priority targets for funding increases for the 17-18 Fiscal Year. We feel any other approach or priorities would be fundamentally unfair. We are all aware that these two specific services are critical ground-level services to our recipients and families and at the current rates for these services it is increasingly difficult to obtain and retain staff.
SCAF is also gravely concerned about the status of the waitlist. We have seen no significant reduction to this waitlist of individuals desperately waiting for services.
SCAF, serving both agency and solo WSC providers, wishes to be clear that rather than supporting an increase to the reimbursement rate for Waiver Support Coordination agency or solo provider types, given the current funding atmosphere, rate improvement priorities should focus on direct care supports and the waitlist.
DATE: March 14, 2017
SUBJECT: New Board Members Needed
SCAF Members,
The Executive Board of the Association has met in both January and February of this year and as one of our agenda items we have discussed the need for Board members to take over our positions as of July 2017. Board members serve a two year term and our terms will be expiring as of June of this year.
As the current Chair of the Association, I am sending this memo out to apprise the membership of the fact that the Board is seeking those among the membership who would be interested in serving on the Board starting in July. As the Chair I am asking that if you would like to have the responsibility of serving on our Board you contact me with your resume. This may simply be an email letting me know how long you have been a WSC and your current work as one.
SCAF has been very instrumental in working with APD Tallahassee in making some changes in policies and procedures during the past two years. We are currently involved in supporting the need for a major change in the implementation of the Algorithm. This project is overwhelming for WSCs and the need for it to have been done is being looked into at this time.
If you are interested in a position on the Board please contact me at dalexanderwsc@gmail.com.
Respectfully,
David Alexander
Chair, SCAF
DATE: March 14, 2017
SUBJECT: SCAF Update on APD Legislative Agenda 03/14/2017
WSC’s,
Vice Chair Laura Mohesky represented SCAF at the APD Stakeholder Meeting in Tally on Feb 23, 2017. Topics discussed were:
Carlton Palms Transition Plans
Provider Development
Governor Scotts Proposed Budget
APD Legislative Priorities
Below are the FY 2017-18 Budget Recommendations APD Issues
Continue Waiver Provider Rates for USDOL
- Continues rates provided to enable providers to meed USDOL requirement to pay minimum wage to direct care providers
Increase Waiver Rates for Nursing Services
- Effect will be to increase Waiver rate to meet the Medicaid State Plan rate.
New Waiver Intensive Behavior Models
- Implement new residential models to serve individuals with extreme behaviors in community-based settings.
Staff Augmentation
- Provides additional staff to ensure the health and safety of clients.
Client Data Management System
- Continue implementation to provide centralized client records and electronic visit verification (ECC) to reduce Medicaid fraud, waste, and abuse.
Employment and Internship Supports
- Will provide Supported Employment and supported internship services for individuals on the waiting list who have indicated that they want to go to work.
Additional Funding to Serve Remaining Individuals with Critical Needs on the Waiting List
- Funds are provided to transition approximately 700 individuals with critical needs remaining on the waiting list to home and community based services. *Amount represents half of the $15 million estimated cost because individuals do not use there entire Cost Plans in the first year.
DATE: November 18, 2016
SUBJECT: Information Referral Concerning Implantation of the New Algorithm WSC’s,
WSC’s,
Concerning implementation of changes to the algorithm and the resultant changes to consumer Cost Plans, SCAF wanted to post an information advisory to the membership.
SCAF advises that WSC’s proceed with caution when requesting the new algorithms as well as scheduling and developing the AIM’s.
SCAF worked with APD in suggesting timelines for providing the algorithms to WSC’s and it was agreed that these would be sent out 60 days prior to Support Plan effective dates, suggesting that a WSC would have 60 days to coordinate and develop the AIM and get it to APD.
What we did not know at the time was that 65G-4.0216 FAC (the rule that governs the algorithm change) states that “The AIM Worksheet form APD 2015-01 must be completed as part of the Individual Review and submitted to the Agency within 30 days of receipt of the new Allocation Algorithm Amount.”
What this statement is saying is that you actually have 30 days from the date you receive the new Algorithm Cost Plan amount to complete and submit the AIM Worksheet, not 60 days. APD might be willing to overlook this deadline discrepancy, but if the case should go to an appeal it is questionable that a judge would do so. This could mean that you have automatically lost the case due to non-compliance with Florida Administrative Code. In any case, it represents for the consumer entering Due Process with a potential legal handicap.
Caution is also advised when requesting algorithms for any consumer. We have had SCAF members requesting their algorithms early (in some cases requesting their entire case load’s algorithms in an effort to be efficient and pro-active). If 65G-4.0216 were enforced this technically would mean that you would have 30 days to do all of your caseload’s AIM Worksheets.
One final note: SCAF has clarified with APD Tallahassee that the new (i.e., next year’s) Support Plan (17-18 year) does not have to be completed and submitted at the time of submission of the AIM as a part of the new algorithm’s implementation; the current Support Plan with any updates to it that may have occurred during the year is sufficient along with any supplemental and supporting documentation related to services and funding currently being received. APD intended it to be a convenience to allow the new Support Plan and the algorithm AIM to be done at the same time but this is not a requirement. WSC’s still follow the guidelines outlined for doing the new year’s Support Plan. If doing the AIM with the consumer separately, turning in the current Support Plan is sufficient.
SCAF is interested in helping the WSC through this process. We are always wanting to hear from our membership.
FIRST ANNUAL SUPPORT COORDINATION ASSOCIATION of FLORIDA MEETING & APD CONFERENCE – Friday September 30, 2016
Location:
Renaissance Orlando at SeaWorld 6677 Sea Harbor Drive
Orlando, Florida 32821-8092 407-351-5555
DATE: September 26, 2016
SUBJECT: SCAF Annual Meeting Notification
Dear SCAF Members,
On Friday the 30th of this month, SCAF will be having its first annual membership meeting. This will be held after the meeting that APD, SCAF and ASCAF are presenting that day. Their day will go from 9:00 am until 3:00 pm. We will meet immediately after they finish. ASCAF plans to do the same. APD is going to check and see if the hotel has dividers in the large room that we will all meet in that can be closed to allow each group to have a space for our respective meetings. The meeting will not go for more than an hour. I look forward to meeting those of our membership that are in attendance as do the other Board members.
David Alexander, Chair
DATE: September 16, 2016
SUBJECT: APD – WSC Conference Notice INVITATION Agenda
Dear SCAF Members,
As the Chair of Support Coordination Association of Florida, I would like to encourage you to attend this meeting. This is hopefully going to be the beginning of a new working relationship with APD. Barbara Palmer is committed to bringing us all together to better serve the population that we all work with in our respective positions.
David Alexander
————————————————————————————————–
Statewide Waiver Support Coordinator Meeting
Making a Difference Every Day
You are invited to join the Agency for Persons with Disabilities (APD) in Orlando on September 30 for critical dialogue to enhance services to individuals with developmental disabilities. Network with state and regional APD leadership and earn 6 in-service training hours.
“Waiver Support Coordinators are the vital link between our valuable APD customers and the community. Please join me at this event.”
Renaissance Orlando at SeaWorld 6677 Sea Harbor Drive
Orlando, Florida 32821-8092 407-351-5555
APD Director Barbara Palmer
September 30 Registration sign in and lunch fee: 8:30 – 9 a.m. Meeting from 9 a.m. – 3 p.m.
Interactive panels and group discussions on challenges and solutions:
• DCF foster care
• Medically fragile individuals
• Intensive behavioral services
• Accessing Medicaid State Plan services
• iBudget handbook
• Navigating the SANs online system
• Implementing the new iBudget algorithm
• Young adults aging out of Medicaid State Plan
To book a hotel room at a discounted rate go to: https://resweb.passkey.com/go/romwaiver
Please feel free to bring your own beverages and snacks RSVP to apd.info@apdcares.org
DATE: September 13, 2016
SUBJECT: APD – WSC Conference Notice
Dear SCAF Members,
This is the latest information we have from APD. We apologize about the late notice but we ourselves just received this last week. See below.
From: Kim Tillery
Subject: FW: Save the Date: ROM/WSC Meetings September 29-30, 2016
Date: September 8, 2016 at 10:31:08 AM EDT
Good Morning!
I am sending this on behalf of Karen as she is currently at an offsite meeting. We are sending this to the Regional Operations Managers for forwarding to their WSC listserv as well, but you may want to send out too just to make sure everyone is covered.
Please note that we have secured a location! We apologize that it has taken so long; the storm put us a little behind!
Please plan to attend the WSC meeting on September 30, 2016.
Friday, September 30, 2016 from 9:00AM-5:00PM, we will be holding a meeting with waiver support coordinators from around the state. Please bring your regional waiver liaison if possible.
Renaissance Orlando at Seaworld
6677 Sea Harbor Drive
Orlando, Florida 32821
http://www.marriott.com/hotels/travel/mcosr-renaissance-orlando-at-seaworld/
The hotel is $120 per night. Please reference the APD meeting when making reservations.
Please send your region’s WSC’s the information about the statewide meeting on Friday so they that can save the date and make hotel reservations as necessary.
You will receive additional information (to include the agendas) very soon. Please make your hotel reservations as soon as possible.
More to come. We look forward to seeing you there!
Thank you!
DATE: August 09, 2016
SUBJECT: Information Gathering from SCAF Membership on new iBudget SAN System
SCAF Members,
The SCAF Executive Committee will be meeting with Tallahassee APD next week and will be addressing issues and concerns pertaining to the new iBudget SAN system. While we believe that this system has components to it that are superior to the system and method of submitting SAN’s we were previously using, we are aware that there are issues with the new system. We would like your feedback (good and bad) concerning this new system. We will present this information to APD on the 16th of this month. Some issues we are aware of:
1. Initial indications are that many APD Consultants have not been properly trained in the new system and are unable to locate documents uploaded to the iBudget SAN system.
2. As a result of #1, APD Consultants are beginning to routinely request documents that were submitted (again), thereby extending their time-frame for approval from 30 days to 60 days. This we believe is unfair to the consumers we serve and it is unwarrented.
3. WSC’s did not receive proper training in the new SAN iBudget system and are therefore uncomfortable utilizing it. SCAF believes that although there is an instruction guide and interactive PowerPoint guide on APD’s website, that there should nonetheless be an actual training on this new system that also allows for a question/answer opportunity.
4. There is no known reliable way to copy the screen showing submitted documents in order to retain proof that the documents were submitted. (*And once removed from the SAN system there is no way to prove as a WSC that you submitted anything.)
**SCAF would like to you send an email to the SCAF Email Address (SCAofFlorida@gmail.com) and let us know of any issues or concerns you have experienced. We are committed to addressing problems and having them corrected. Please get us your comments by 08/15/2016 and thank you. We remain committed to advocating for your needs.
Regards,
Support Coordination Association of Florida
DATE: July 19, 2016
SUBJECT: InfoBlast to WSC’s Concerning SCAF Phone Conference with APD Tallahassee
SCAF Members,
We would like to update our Membership concerning SCAF’s participation in a conference call with APD Tallahassee management which occurred on 07/18/16. It was a productive meeting. During this conference call we were able to share our concerns about system and design problems which affect the work of the WSC. Further, APD frankly shared their concerns about issues they are seeing and what their hopes for improvement are both in terms of Waiver Support Coordinator activities and teamwork building. We are enthusiastic and hopeful that these communications (to occur monthly) will continue to build a more effective bridge between WSC’s and APD. The issues needing to be worked on are topics of ongoing conversation.
The following is a summary of this Conference Call:
🔸 The algorithm – This is what we know at this time. APD is currently hoping to implement use of the new algorithm in September of this year at the time of the recipient’s Support Plan annual submission. APD stated that they will provide a 60 day advance notice prior to a change to the recipient’s Cost Plan taking place. It was noted that if a change was needed to a recipient’s Cost Plan (for example if there was a decrease under the new algorithm) an AIM Sheet would need to be completed and submitted by the WSC along with the Support Plan justifying the increase in disagreement with the new algorithm amount. Please note that changes to the algorithm were authorized by 65G-4.0213 FAC (with considerations and emphasis being given to recipient and caregiver age, living settings, and questions in the QSI).
🔸 CDC – APD is encouraging Waiver Support Coordinator (WSC)’s to become CDC consultants. It was noted that there are simply not enough CDC Consultants. To that end APD is developing a survey targeted at Waiver Support Coordinators (WSC)’s in effort to determine why they have not expressed an interest in becoming CDC consultants. APD reports that they average 35-43 new CDC consumer applications per month and there are not enough CDC consultants to take the cases. SCAF encourages WSC’s to complete the survey.
🔸 Person-Centered Issue – APD stated that they conducted a survey among consumers and guardians (utilizing NCI data) on provider choice and options. They are stating that their data is showing that consumers are not being given choices of services, providers, and social roles in the community. It is not completely understood how large the sample was or to what degree issues such as lack of available providers or provider resistance to providing services for USDOL-affected services play a part and this is being looked at. It was additionally noted concerning the possible DELMARVA sample source for this issue, there is a question as to how much provider choice counseling as mandated in the iBudget Handbook is actually occurring but not being properly documented. The bottom line for SCAF is that the Association certainly encourages members to offer choice routinely throughout the year and to be certain to document it. This is a Person-Centered issue of importance.
🔸 WSC MENTORING PROGRAM – SCAF continues to work on this product as a pilot project. It is in the formative stages with work set to take place on it in earnest in the coming weeks. We are open to input from all key players including APD and certainly SCAF Members and will be soliciting this in the coming weeks as the pilot unfolds. SCAF’s investment in this is to enhance the level of Support Coordination provided, particularly to struggling WSC’s. We are very excited about this effort.
🔸 Updating of APD critical information databases and timelines: SCAF would like to remind it’s members of the following guideline from the iBudget Waiver Handbook:
🏮 NEW HANDBOOK REG: Waiver support coordinators will make updates to client data in the ABC system (ACLM5 screen) for supported employment services:
• Working but not receiving supported employment services – Update required quarterly
• Working and receiving supported employment services – Update required monthly
• Not working and receiving supported employment services – Update required monthly, with
justification as to why a job had not been found
• Not working and not receiving supported employment services – Update required quarterly
*Here is a ready category guide to follow in updating your ABC Screens:
1. Not working and not receiving supported employment services
Update required quarterly
CONSUMERS (List):
🚦STATUS: [📆UPDATED: ]
2. Not working and receiving supported employment services
Update required monthly, with justification as to why a job had not been found
CONSUMERS (List):
🚦STATUS: [📆UPDATED: ]
3. Working but not receiving supported employment services
Update required quarterly
CONSUMERS (List):
-🚦STATUS: [📆UPDATED: ]
4. WORKING AND RECEIVING SUPPORTED EMPLOYMENT SERVICES
Update required monthly
CONSUMERS (List):
🚦STATUS: [📆UPDATED: ]
🔸 Carlton Palms Update – provider development continues. There are 16 clients ready to go. Regions are working with providers that meet the criteria to work with these folks.
🔸 Orlando – WSC Meeting in Orlando – We are waiting on a date for final confirmation of parameters of Orlando meeting. As soon as we know more we will send out another Member InfoBlast.
That’s all for now. Let us know of any issues or concerns you may have. We are here for you. We are for WSC’s.
DATE: July 14, 2016
SUBJECT: InfoBlast to WSC’s Concerning SCAF Meeting with APD Tallahassee
Dear Waiver Support Coordinators,
The Support Coordination Association of Florida (SCAF) Board would like to update you on some important events that took place involving the Association this week. SCAF attended a series of meetings with top level APD management in Tallahassee on Monday (07/11/16). These meetings were both positive and productive. These encounters with APD are representative of an ongoing and serious effort to develop a close, productive and constructive relationship between APD and SCAF. Our aim continues to be enhancing communication between SCAF and key APD decision makers. We are using this relationship to confront and address problems WSC’s face every day in their efforts to coordinate supports and services for their caseloads. We understand these issues because we ourselves are WSC’s and we are hearing from our Membership on a weekly basis. Standard operating procedure for us as a Board is to keep our membership informed of our activities on their behalf.
The following is a brief synopsis of what happened in Tallahassee between APD and SCAF this week.
SCAF Meeting with Karen Hagan, APD Chief of Staff
We met with Karen and discussed having a 2-day meeting between APD and Waiver Support Coordinators to take place in Orlando. This is currently planned for either late September or early October this year. SCAF is working with APD along with ASCA (Association of Support Coordination Agencies) to set this meeting up and develop its components and it will involve a free flow of communication between top level APD management and WSC’s. Barbara Palmer will be in attendance as will all of the ROM’s (APD Region Managers). This meeting is for any and all WSC’s in the state and it will be a great opportunity for you to talk directly to APD at the level where decisions are made.
The SCAF Board will be there and we will hold a ‘meet and greet.’ This will be an excellent opportunity for you to speak directly with the Association’s Board of Directors and we are eager to shake your hand, hear your concerns and needs, and get to know you.
Some other exciting specifics of this meeting:
• This meeting will be FREE OF CHARGE. APD is going to pay for all costs.
• There will be NO vendors – this is an encounter meant strictly for APD and WSC’s.
• There will be training which will count towards your yearly CEU requirement. SCAF along with ASCA will be assisting with Training. We are working with APD to identify topics and design training that will be truly useful to the hard-working Waiver Support Coordinator.
• This meeting is FOR EVERYONE, Waiver Support Coordinators who are members of an association or not.
Carlton Palms Transition Planning Meeting
SCAF was present and participated in the meeting to develop plans to close Carlton Palms and transition the residents currently living in this setting back to their home Regions. This meeting included (in addition to representatives from the APD Central Office) FARF, ARC of Florida, the DD Council, Disability Rights, and the Family Care Council. In this meeting Barbara Palmer and her staff outlined the transition of Carlton Palms consumers to other settings and elicited suggestions that would result in an effective transition for them to a safe alternative setting. Some specifics of this meeting:
• APD has put together teams to complete this project. As part of this effort they are engaging in provider development which includes searching out and identifying providers that will effectively provide the supports and services that these behaviorally intense, medically fragile, forensic, and dually-diagnosed consumers will need in new settings.
• SCAF was instrumental in this meeting in ensuring that the Waiver Support Coordinator perspective was brought into the conversation including budget/Cost Plan issues (to ensure adequate funding would be in place), addressing the need for immediate and effective medical, behavioral, and ancillary supports being identified and in place BEFORE the consumers move, and that a variety of health and safety concerns will be pro-actively addressed in addition to other case management issues we identified. *SCAF IS WORKING TO ENSURE THAT THERE WILL BE AN EFFECTIVE PROTOCOL FOR WSC’s to follow for this and we are designing and proposing our own for their possible use. We want a WSC who has the opportunity to work with a Carlton Palms consumer to have a ready tool to use when these intense and high-need consumers ‘hit the pavement’ in their new settings.
• APD has not gotten to the point of deciding how they will crosswalk with WSC’s at this point. There will be more meetings to come and we have been invited as an association to be a part of this process.
• 2019 was identified as the target year for Carlton Palms to close, though Ms. Palmer stated that it was her hope that the transition would be completed before this date.
Meeting with Barbara Palmer and her Key Staff:
SCAF went over our Member Concern Ticket System – this is our mechanism for SCAF Members to communicate their issues and WSC related problems and to get direct help from the Association. We noted that any and all member complaints are accepted and looked into with a response and meaningful communication from a SCAF Board member to the WSC that made the complaint or registered a concern. (*SCAF Members – remember, all you have to do is send an email to the SCAF email address (SCAofFlorida@gmail.com) with your concern or complaint and we will make it an issue for us through this ticket tracking system – you WILL NOT fall through the cracks.)
We additionally addressed the following items in this meeting:
1. The issue of Cost Plans being deleted during the Fiscal Year Cost Plan exercise was addressed. We confronted APD about it happening and again requested that technical issues causing it be identified and corrected. We were emphatic that this caused a massive amount of time waisted for the Waiver Support Coordinators affected.
2. Cost Plans being reduced during the 16-17 Fiscal Year Cost Plan exercise.We informed APD Tallahassee that Cost Plans were reduced during the Fiscal Year Cost Plan exercise, that a number of WSC’s were instructed to “make the new budgets work,” and we were clear that these needed to be corrected or Due Process offered to the consumers affected.
3. The hostile working relationship which exists between WSC’s and APD (with examples being given) was raised and confronted. *We will be meeting again with APD to continue this problem-solving effort and keep you posted. We are very aware that this is an ongoing problem and it is SCAF’s position that it is unacceptable. We are committed to working this issue until we see changes.
4. Cost Plan approval requests and Service Change Requests. WE ARE ASKING FOR APD TO PROVIDE US WITH A COPY OF THE OFFICIAL PROCESS THEY ARE FOLLOWING CONCERNING TIME-LINES FOR RESPONDING TO AND APPROVING SERVICE CHANGE AND COST PLAN APPROVAL REQUESTS. When we get this we will review it against 65G-4 FAC and then respond. We will get the results of this effort out to the SCAF Membership.
Some final pieces of information for you:
• APD wanted to remind us that they are actively posting their ‘Advisories’ to the APD Website. *Recall that this is the communication, complaint, and problem resolution system APD is using to identify global system problems along with their suggested resolution(s).
• SCAF and APD Tallahassee staff are now committed to MONTHLY conference calls. We intend to make full use of our frequent communication with APD management to the benefit of the SCAF Membership.
• ⚠️*THE ALGORITHM HAS BEEN CHANGED. The algorithm has been changed and will be applied when the next new annual Support Plan date for a consumer occurs. ⚡️Be advised that this could result in Cost Plan changes. *SCAF would like to remind all WSC’s that Due Process/Fair Hearing Rights fully apply here to any reductions to a consumer’s Cost Plan. We have templates for filing appeals available for SCAF Members and can and will share these upon request through a simple email. *Simply send an email to the SCAF email address and we will provide you with the template.
That’s all for now. Again, the meetings were productive and constructive and we really are excited about the road map for future real dialogue and problem-solving. SCAF membership now covers every geographic region of Florida and we have a substantial membership base that is growing. We highly encourage you to join us if you are not already a member and enjoy the full benefits of membership of a truly hard-working and exciting WSC Association. Send an email to the SCAF email address (SCAofFlorida@gmail.com) and we will send you an application promptly.
DATE: June 10, 2016
SUBJECT: SCAF – APD Joint Communique Concerning Conference Call on 16-17 Fiscal Year Cost Plan Issues
SCAF Members:
*This can be regarded as a joint SCAF – APD communique.
The Chair, Vice-Chair, and Secretary of the Support Coordination Association of Florida Board of Directors participated in a conference call on June 09 with Denise Arnold, Cheryl Smith, Lorenna Fulcher, and Michael Sauve of APD. The purpose of this call was to address concerns and issues raised by SCAF members pertaining to the Fiscal Year 16-17 Cost Plan exercise, addressing concerns raised by WSC’s throughout the State. A few additional issues were addressed in this conference call as well.
Fiscal Year Cost Plan-related issues and concerns reported by Waiver Support Coordinators to SCAF were addressed in a constructive problem-solving meeting.
• Completed and Submitted Cost Plans being deleted by the iBudget system during this exercise – It was agreed that this was unfortunate and APD expresses their regret and notes that it was not their intention to waste or misuse Waiver Support Coordinators’ time during this exercise. *A positive development related to this was that it was agreed that SCAF and APD would have a mutual work session prior to the implementation of the next Fiscal Year Cost Plan exercise to collaborate on streamlining the process and minimizing the possibilities of future ‘glitches,’ bringing together the knowledge of system issues that APD brings and the knowledge of ‘field-level experience’ that SCAF Waiver Support Coordinator’s bring to the process.
• APD Consultants modifying and/or reducing Cost Plans during the Fiscal Year Cost Plan exercise – APD management was clear that this was not permitted and was not condoned by APD. The Central Office requests that instances of this activity be reported to the Deputy Regional Administrator of the Region involved. APD wanted to be clear on this: the Fiscal Year Cost Plan exercise was NOT an opportunity to revise a Cost Plan. It was agreed that if there were changes during the Cost Plan year between flexible-use services that have become permanent, an explanation from the WSC clarifying the situation (an email or phone call would be sufficient), no CPAW or additional processes would be required (provided no increases were being attempted or requested). If the Agency wished to challenge the Medical Necessity of an approved service it would issue a Notice of Intent (NOI) and follow legal due process procedures. Again, transgressions of this sort should be reported to the Deputy Regional Administrator of the respective Region and it will be addressed accordingly.
• APD Regions requiring use of a CPAW or modified version of same before approving a Cost Plan during the Fiscal Year Cost Plan exercise – This is not something implemented by the Central Office and is not and should not be required. *The intent of the Fiscal Year Cost Plan exercise is simply to continue what was approved in the previous Cost Plan year. This is to be a straight-forward ‘copy-paste’ exercise wherein last year’s Support Plan-supported Cost Plan is continued into the 16-17 Cost Plan Fiscal Year. If a review of medical necessity is initiated by the Agency it would properly be done as a separate exercise. APD has the legal right to review the ongoing medical necessity of supports and services, however, this is not to be a part of the annual Fiscal Year Cost Plan exercise and use of any form of a CPAW other than the original used to approve services in the previous Cost Plan year is not authorized. Please report variations to this to the Deputy Regional Administrator of your Region.
• APD Consultants Modifying the Comments Section of Service Plans – APD continues to request that whenever appropriate, specific comments be entered into the ‘Comment Section’ of Service Plans. The comment section is intended to be a helpful guide to providers in making clear to those providers authorized service usage patterns when that is necessary. Consultants should not be arbitrarily entering comments on their own, rather, should be dialoguing with the involved WSC when questions about clarity arise. *The Waiver Support Coordinator (WSC) and not the APD Consultant should enter comments in the Service Plan Comments Section.
• iBudget System Maintenance During Critical Phases of the Fiscal Year Cost Plan Exercise – This is considered to be an unfortunate but necessary activity during the process as it involves loading a sub-set of special condition Cost Plans (recent SAN Cost Plans for example). Some of the timing just couldn’t be helped. APD networks with their ‘IT’ department to minimize the impact of the Fiscal Year Cost Plan exercise and it is their intent to continue to do so. SCAF’s intent is that the timing of system maintenance be looked at again during the proposed workgroup meeting with APD for the 17-18 Fiscal Year.
SCAF raised the concern that forms are updated and posted to the APD website with no notice being provided to Waiver Support Coordinators. *A recent example of this is the posting of the 04/21/2016 version of the iBudget Waiver Eligibility Sheet. SCAF requested that a ‘Version Alert’ be sent out to WSC’s. If SCAF is alerted of a new form it will rapidly communicate the information to its membership. The Waiver Eligibility Sheet is critical as use of an outdated version could result in financial penalties for the Waiver Support Coordinator. APD stated that the new Eligibility form will not be enforceable until 07/01/2016 (the date the statute addressing new eligibility criteria takes effect). APD will communicate this information to Delmarva to ensure there are no issues.
Supported Living Global Re-Assessment – SCAF members have reported that the Frequency/Intensity/Duration of Supported Living currently approved was being re-assessed for Medical Necessity. A medical necessity determination is not part of the fiscal year continuation of cost plans. However, for any waiver service, the Agency may make a medical necessity decision throughout the year, including, but not limited to at the time of the annual Support Plan, when changes are requested, or other appropriate times.
Support Coordination Association of Florida
Letters from the Chair
DATE: September 10, 2015
SUBJECT: Waiver Support Coordinator/Agency for Persons with Disabilities Forum
Dear SCAF members and Potential members:
Yesterday Board members of SCAF attended a forum sponsored by The Association for Support Coordination Agencies (ASCA) in conjunction with Barbara Palmer and the Regional office staff of APD.
It was without a doubt the best meeting I’ve attended in my almost 20 years of working as a WSC. It was also the first time I’ve personally met Barbara Palmer and I found her to be very down to earth and truly seeking to bridge the gap between WSCs and her staff. She opened up the session with her vision for APD which is to truly get us into a TEAM work approach.
The meeting was from 9:00 – 12:00. After it was over Barbara said that she plans to do this at least two times a year but it will be for not less than a six hour day as it is too difficult to cover all that needs to be talked about in 3 hours. She had required that all of her Regional Directors be present as well as a good representation from her Tallahassee staff.
There were four categories that were laid out for topics of discussion during the course of the meeting. Number one was Key Issues of Support Coordination. This covered three Topics, A. Meeting the Needs of Children on the Waiver. It was discussed that a child is not “half a client.” There needs to be a closer look at their rate as we could/should be more effective in leading the way for children from school through to adulthood. Topic B. Person-Centered Case Management – Getting Back to Basics dealt with issues such as developing a new support plan that allows for talking about the person without having to be so negative in order to justify the service. Making the QSI more usable to the actual Support Plan process was discussed. And, Topic C. Delmarva. At this time some of this area will be looked at after they come into compliance with the new iBudget Handbook. Ways to make this a more realistic experience for us were discussed.
The second category Communication Panel Discussion was a discussion by the APD Regional Operations Managers. They presented a new flow chart on how communication between APD Tallahassee, the Regional offices and WSCs will take place. It is a two way system whereby they are developing WSC ADVISORY memos. As things come up that we need to be aware of a memo will be sent out to them and they will forward it to 0us via email. We will in turn have a time frame in which we can respond to it. This might be a policy change or just a notice of something coming up. We will now have it in writing across the State.
The third category – Planning for the Future dealt with “Elevating the Professional Level of SC Services.” This area focused on how we as WSCs can work to elevate the level of professionalism ourselves. Some thoughts were to have peer review committees to work with a provider who is struggling to provide this person/agency assistance in how to provide a higher quality level of services. The second topic in this area was “Identifying Training Needs & Options for Support Coordinators.” You will find that the new handbook addresses changes in our required annual trainings. I will be starting to serve on the training committee in Tallahassee as of this writing as Barbara has invited me to do so.
The fourth category “Development of Electronic Records” did not get the time for much discussion as the day passed too fast. We are now allowed to save our work electronically as laid out in the new Handbook.
We all came away from the meeting feeling like it was a breath of fresh air ready for change to happen. Barbara gave me an opportunity to speak on behalf of the new Support Coordination Association of Florida and she let us know that she welcomes our presence and is looking forward to working with us in the future.
There was some discussion about ‘why two Associations?’ and Janice Phillips clarified why she serves only agencies in a limited capacity. I discussed the reasons as to why we started this new Association — to give a voice to the solo providers and agencies that are not a part of ASCA. We certainly plan to work in a cooperative fashion with each other as we move forward and pledged to do so whenever possible.
I personally on behalf of the Association want to thank each of you who have joined the Support Coordination Association of Florida. We are growing and will continue to do so. I wish to encourage those of you who have been thinking about joining to please do so. WE want our voice in Tallahassee to be as strong of a representation as possible.
I would also encourage you to make sure that you attend any of the upcoming meetings that APD has as a follow up to this one. I left knowing that changes are to come that will be for the better of our system.
Respectfully,
David Alexander, Chair
SCAF
DATE: September 01, 2015
To: SCAF members and potential members
From: David Alexander, Chair SCAF
Greetings to all:
I am sending out this memo to let you know that your Board of Directors is at work. We have just completed setting up the positions for Chapter Directors of each region in Florida. As the positions here are filled it will give us the ability to give and receive information as we move forward with Association duties. The Executive Board
of the Association will be interviewing prospective individuals to serve as our Chapter Directors. There will be eight positions serving on the Board of Directors as we are following the regional breakout of the State according to Medicaid’s guidelines for APD. The individuals will have full voting rights on the Board and be our primary
means of communication between the Board and membership.
The Board members will be attending a forum in Orlando on the 9th of September. This is a meeting that is sponsored by Support Coordination Agencies (this is the other WSC Association in Florida) with APD Director Barbara Palmer as the keynote speaker. She will be talking about planning for the future of Support Coordination. It is also an opportunity to thank Ms. Palmer for the rate adjustment received July 1, 2015 that was supported by her. Thanks will also be expressed by SCAF to Janice Phillips for her lobbying efforts in this
rate adjustment.
As the Chair, I am working to get speaking engagements set up with the Regional/Area offices during your monthly meeting time so that I may personally address with you the need for your taking a stand and joining the Association. We need each other to give a voice in Tallahassee with APD and the State Legislature. Contact has already been made with APD Tallahassee and SCAF will be represented at the table with APD as meetings
come up where we need to have a voice. We are having a steady growth in membership but I am personally asking that each of you who have not already done so please consider joining with us to provide a much stronger voice in Tallahassee for the needs of those
we serve. We also want to give voice to making the work of a WSC a respected and valued position within Florida. This is one of Barbara Palmer’s topics for discussion at the Orlando meeting this month – “Elevating the professional level of SC services.”
Please fill out the attached registration form and join with us as we build for the future of WSC. Membership dues are only $50 yearly. Those who have already joined, we thank you for your support.
Respectfully,
David Alexander, Chair
Support Coordination Association of Florida
Cc. Attachments: Select above menu, membership > application
DATE: July 14, 2015
Dear Waiver Support Coordinators:
We are excited to inform you of the new State Association for Support Coordinators, the This long-needed Association has been formed to give a voice to Support Coordinators in the State of Florida. The Association has as its primary mission the promotion of the highest standards of professional conduct for support coordinators, to advance the cause of professional respect for this service, and to enable the effectiveness of this service model by means of legislation, regulation, and policy advocacy through a unified voice as a professional association for the benefit of individuals with intellectual and developmental disabilities in the State of Florida.
Membership is open to any Waiver Support Coordinator – Agency or Solo Provider. An agency may join with a single vote for general membership votes regardless of the number of employees or contracted employees. An employee or contracted employee of an agency may join as a solo member of the Association with the right to vote separate from the agency. Solo providers who are Certified Waiver Support Coordinators who join will be given the right to be a voting member.
To join with us just fill out the attached membership application and email it to the Association Secretary, Tom Buddington, at . *Mail the $50.00 annual membership application fee separately to: SUPPORT COORDINATION ASSOCATION OF FLORIDA, P.O. Box 561357; Rockledge FL 32956-1357, or simply print-out and complete the application and send it to the same address along with your $50.00 Annual Membership fee.
Thank you! We sincerely look forward to representing you.
Respectfully,
David Alexander, Chair
Website Administrator: George Andrew, MPA
This new website is in progress and will include an operational blog in the future. Being beta tested currently.