APD PROVIDERS / SUPPORT COORDINATORS JOINT MEETING Thursday, July 28, :30 A.M. 401 NW 2 ND AVENUE, SUITE N-1011, MIAMI, FL 33128

Transcription

1 APD PROVIDERS / SUPPORT COORDINATORS JOINT MEETING Thursday, July 28, :30 A.M. 401 NW 2 ND AVENUE, SUITE N-1011, MIAMI, FL AGENDA ITEM ISSUE / DISCUSSION ACTION / FOLLOW UP I. CALL TO ORDER Meeting began at 9:40am, Area Administrator Ms. Evelyn Alvarez welcomed everyone. Ms. Alvarez requested that all phones be silenced to avoid interruptions. Ms. Alvarez announced that Ms. Eleby is on leave and Montrese Albury and Maxine Johnson will be providing necessary updates. Managers were introduced, no new staff were introduced. No new providers were in attendance. Ms. Alvarez announced that she will need to excuse herself at about 10:45am from the meeting due to a schedule conflict with the weekly Area Administrator conference call and deferred to the Managers to proceed with the agenda. Guest Speaker: Rosa Maria Barbara, Chairperson Family Care Council Area 11 David New, Abilities Explosion 1

2 II. STATE / AREA AND APD UPDATE The Florida Legislature has mandated that APD bring its Medicaid waiver expenditure within appropriation. These rate changes are being made pursuant to APD s authority in section (7) Florida Statutes. This section authorizes the agency to adjust rates as necessary to comply with the availability of moneys provided in the General Appropriations Act. For more information about the Agency for Persons with Disabilities, please contact Evelyn Alvarez at (305) Law makers are requiring that APD submit a plan by September 1 on how it will reduce expenditures. The Legislature added a requirement in the law that waiver support coordinators and service providers must assist the agency in bringing service levels within appropriations. Increased oversight of individual cost plans Clear definition of the roles of providers and waiver support coordinators in monitoring those cost plans Use of generic and natural supports Reducing reliance on waiver funds CONTINUED STATE / AREA AND APD UPDATE APD is bringing together families, WSC providers to meet the Legislature s requirement to bring Medicaid waiver expenditures within appropriations. The One Team, Once Goal initiative will determine ways to trim waiver services requests by more than $300million over the next few months Voluntary cost plan reductions: Cost plan freeze: no increases to services unless determined to be in a crisis situation 4% provider rate reduction Companion Rate Adjustment- effective August 1, 2011, 2

3 the varying rates for companion services have been eliminated collapsing rates into a solo provider rate and an agency and geographical differential rate. Providers may serve up to three individuals at that rate. Effective July 1, 2011 the Agency will add Down Syndrome to: its list of developmental disabilities that it serves, although most people with Down Syndrome already qualify for waiver services. Budget Florida: On July 14 th APD announced its statewide implementation schedule for budget Florida. As you are aware I Budget Florida is a new way to deliver Medicaid waiver services that has been approved by both the Florida Legislature and the federal government. Budget Florida is designed to make the funding process fair and equitable for all Medicaid Waiver customers. It will provide more opportunities for customer to direct their own care. The new system will also allow the agency to have more financial predictability. Some of the customer benefits of budget are: Greater ability to choose services that matter to them, given their unique situation Greater flexibility for customers to respond to changing needs Reduced bureaucracy and red tape Support coordinators freed from paperwork to focus on providing help that makes an even greater difference Confidence that funding is fair compared to customers who are similarly situated. Reduced likelihood of policy changes that cause s significant disruption due to budget deficits. Security of a financially stable system that will be there to 3

4 serve customers down the road. Greater control over their lives. The schedule will begin in northern part of the state and will be effective October 1, This phase will cover 3261 individuals. The second phase is scheduled to begin December 1 it will effect 7745 customers. The third phase will start on February 1, 2012 affecting 9454 customers including Area 11 Miami Dade and Monroe County. The fourth and final phase will be implemented April 1, 2012 covering 9490 customers. For specific county information and as more information becomes available please visit APDcares.org Simultaneously with budget APD is also rolling out its customer central record online system throughout the state. This new system reduces paperwork for APD providers so they may focus more on serving customers. Temporary WSC Workload Reduction: June & July Governor Scott creates on July 26, 2011 by Executive Order Commission on Jobs for Floridians with Disabilities. Members to be announced in the next weeks. Lessons Learned & best practices: Provider travelling out of state with clients: New licensing rule will address providers travelling out of state with consumers. Recent incident narrative client travelled with provider out of town, client was competent adult and had a history of behavioral 4

5 issues. During the travel client became physically aggressive towards providers and was hospitalized in a psychiatric facility for treatment. Client refused to travel back to Miami. Concerns: payment of medical expenses when out of state Medicaid may or may not cover, emergency Medicaid is not an option because of residency requirement not established; original state identification must be secure when travelling. Provider is responsible for the safe return of the client; the laws vary from state to state i.e. Baker Acts, guardianships, social services, reporting abuse (self neglect). Please assess the stability of clients when travelling and ensure that you have a plan in the event the individual decompensate. Providers are responsible for the safe return of clients. Attending Court Proceedings: When attending any court proceeding regarding one of your clients the expectation is that you will be prepared and knowledgeable of the facts of the case, services provided and supports and services available to your client. As a representative of APD by way of the WSA you are expected to communicate effectively articulately and have credibility. It is not uncommon for the dependency judges to call me from the bench or our Legal Counsel when they are not satisfied with one of our provider s performance. Client Central Record State Property: several incidents where providers have been negligent in the safe keeping of case files and as a result the files have been exposed to water damage and mold that have destroyed the case records and the history of the client that is irreplaceable. This practice is unacceptable all client central records must be maintained in a safe secured location that is not exposed to broken water heaters, car accidents, etc. Please govern you self accordingly. 5

6 III. MANAGER UPDATES Ms. Jackson mentioned, we must collectively work together to address the consumer needs via community/natural resources. We must look at ways to comply with our allocated money for the Agency and suggestions are needed. She also expressed to the audience that consumers/families are all to be involved with this process. All providers, but especially support coordinator are to read their s. Now is a critical time for information sharing and providers cannot afford to be lax. CDC+ 9/1/11 Purchasing Plans are due in by 8/10/11 to our office for 66 consumers that currently have companion services in their cost plan. Please remember to notify our office of consumers that will relocate outside of Area 11 or when a consumer will be moving to another state. Cost Plan Issues Just a reminder that the cost plan freeze is still in effect. Services that are being requested must have medical necessity determined. Additionally, service request must first be accommodated within the existing approved cost plan. This includes requests for respite services or any other service on the waiver. It is concerning that we are hearing from providers and some families that their support coordinator has told them that they are unfamiliar with this process. I have sent the out again to all providers this morning. Tier change notifications have been sent to several of you that were effective 7/26/11. We appreciate you updating those cost plans to ensure tier cap compliance. 6

7 As you are aware the companion rates have changed effective 8/1/11. All should have received the rates and other information via . Please realize that all rates for Dade County are now $1.71 per quarter hour for Independent providers and $2.28 per quarter hour for Agency providers. Ratios are still to be provided as previously indicated with these new rates. Staff are in the last stages of completing the ABC cost plan updates for the 8/1/11 companion service plans. We thank those of you that complied quickly by updating ABC accordingly. Support Coordinators please quickly issue service authorizations to providers. We anticipate completion today so please check ABC as soon as possible. Hearing Information and Hearing Withdrawals Support coordinators remember that if you are assisting your consumer/family with a hearing request that it must be received by APD within 10 days of the consumer/family receiving their letter. If this does not happen then the consumer's service will have to be reduced. ABC/Tier Issues Support coordinators please ensure the comment sections for services indicate the frequency/usage of the service correctly; there cannot be bulk numbers only. As a reminder, Crisis consumers that were enrolled over the past several months require a PSA packet for review. The Area 11 Office may have provided a temporary approval, but this does not justify the services for the entire upcoming 7/1/11 cost plan year. These are the consumers that were 7

8 enrolled as new waiver consumers. We are finding that support coordinators have not been following up to ensure this has been done. Inaccurate ABC demographics are a serious problem that we continue to notice with far too many support coordinators. Program components must be updated along with all other ABC demographic information as I have repeatedly advised all support coordinators. Handouts were provided. Cost plan adjustment service requests require the determination of medical necessity being made by our office. Support coordinators, you are still required to provide us with supporting documentation to justify the service request. Service money that is unused during the cost plan year cannot be moved forward so that the consumer can use more of that service at a later date as explained to Area Offices on a conference call yesterday. We anticipate further clarification from Central Office which will be shared with all. Support Plan/Case Note Issues QSI staff are in need of support plans, they will try to locate them first within our office but if not they will contact you. Please do not send them support plans that were NOT signed by the consumer/guardian. We need the complete support plan document that was approved by the consumer/guardian. Kindly send the items that have been requested of you as soon as possible. Additionally, QSI staff are reviewing services and may ask you for schedules or times when services are rendered please cooperate with them and provide the information. There are a few of you that were unprofessional towards them requesting this information from 8

9 you. In reading support plans and in speaking with the consumer and/or their supports/group home providers it is clear that the consumer being depicted in the support plan is not accurate! Support coordinators, this cannot occur. Support plans are to be an accurate reflection of the consumer and the consumer's situation. Central Records must be returned to our office timely. Ms. Maxine Johnson reviewed this process with support coordinators. ibudget Again, providers must have valid addresses in order to be a budget provider. The system will be electronic. If you are not enrolled with your address, you cannot be a ibudget provider. Hurricane Season Just a reminder to you all, please ensure you have your plans up to date with contact information for your consumers especially consumers in supported living. Reactive Strategies Providers, you are again being reminded that reactive strategy reports are due by the 5th monthly to Dr. Wesolowski's attention and copy Dr. Molina on the reports. We have met with noncompliant providers and conducted a reactive strategies training with them. Reporting is not 9

10 optional it is mandated by law. Mr. Ryon notified all present that today, July 29, 2011 is the last day that the 2011 Gallery of Dreams exhibition will be displayed in the Rhode Building, South Tower lobby. All interested art lovers, particularly those present who support our customers should visit the south tower lobby after today s Provider Meeting in order to see the wonderful works on display. Mr. Ryon noted that this 3rd year of the exhibition was well received by everyone who visited and we look, hopefully, to continuing this exhibition in future years. Mr. Kirk Ryon noted that approximately 350 Delmarva Reviews have been completed so far this year. Of those 350 reviews, letters have been sent to approximately 200 providers requesting a plan of remediation. Of those 200 letters, provider agencies have only returned 50 Plans of Remediation. Mr. Ryon noted that those providers who have received a review and a letter requesting a Plan of Remediation but have not submitted a plan will be contacted by phone for follow-up. Mrs. Sharon Powell mentioned, today July 28 th, is world Hepatitis day. The theme is This is hepatitis... Know it. Confront it. Hepatitis affects everyone, everywhere. 1in 12 people worldwide are living with either chronic hepatitis B or C. This is higher than the prevalence of HIV or any cancer, yet awareness is low and the majority of those infected are unaware. The World Hepatitis Alliance hopes that World Hepatitis Day will prompt people to think about the huge scale of viral hepatitis infection globally, about whether they may be at risk (and if so, to get tested) and also about how to avoid 10

11 becoming infected. The long-term objective of the campaign is to prevent new infections and to deliver real improvements in health outcomes for people living with hepatitis B and C. In the UK health ministers are considering offering hepatitis B vaccine to children, by combining it with vaccines for other illnesses such as polio, whooping cough and tetanus. Hepatitis B is a virus which can cause liver cancer, liver disease and death. Prevention: The hepatitis B virus (HBV) is spread between people through contact with the blood or other body fluids (i.e. saliva, semen and vaginal fluid) of an infected person. The hepatitis C virus (HCV) is spread through direct contact with infected blood. Very rarely it may be passed on through other body fluids. According to the National Health Service hepatitis B is 100 times more infectious than HIV. Many people do not have any symptoms if they contract hepatitis B or C, although they can still transmit the viruses to others. The most common routes of infection are: Blood transfusions and blood products using unscreened blood Medical or dental interventions without adequate sterilization of equipment Mother to infant during childbirth Sharing equipment for injecting drugs Sharing straws, notes etc. for snorting cocaine Sharing razors, toothbrushes or other household articles Tattooing and body piercing if done using unsterilized equipment. 11

12 Persons with hepatitis should not be discriminated against or shun. Hepatitis is not spread by casual contact with someone that is infected. APD team wellness will be participating in the American Heart Association heart walk on October 29, 2011 at the Florida International University Modesto Modique campus. Even though the American heart association is not directly associated with APD, our consumers, friends and relatives and ourselves are impacted by heart disease in some way. We are asking you all to participate with our team by walking and or make a contribution to our team by going to the Miami Dade Heart walk.org website to sign up with our team to walk and or make a contribution. We are looking forward to your participation, we have 3 team leaders, and they are Ivonne Gonzalez waiver dept, Brenda Viera and I. If you have any question please do not hesitate to contact me at Ms. Montrese Albury mentioned on SUPPORTED EMPLOYMENT: The revised 2011 Florida minimum wage is $7.31. Please make sure all individuals employed are making that amount. TRAINING Supported employment classroom training will continue until December 31, 2011 with the new manual. Supported employment liaison will be scheduling classroom training once practicum is completed on August 29, The class schedule will placed on the statewide calendar. The online classes are available now at the APD website under supported employment training.net. 12

13 DMD Disability Mentoring Day/Disability Awareness Month in October is not a one day event. It can occur through out the month or year. Please keep in mind that it is coming up and it gives individuals the opportunity to gain valuable work experience. PASS Please contact the supported employment liaison if you have any individuals who need to utilize any of the Social Security Work Incentives to help them pay for supported employment services. Mrs. Maria Springer mentioned, Good Morning please allow me to clarify on the information that Mrs. Rosa Maria Barbara of FCC shared with you about the Provider Expo 2011 happening this Saturday. It will take place on the Miami Fair grounds at the Grand Ball Room, we recommend that you please share with the families that this is an outing, they will have a dance and food after the presentations. On August 3 rd we will be having the UM Job Readiness Symposium for our Waitlist consumers. This event is being provided by UM with the assistance of AmeriCorps for our waitlist consumers who have graduated from High school and are now in process of seeking employment. The Units have started doing Bi-annual visits to the waitlist consumers that are residing in ALF s. GR Units continue to assist our waitlist consumers with Community resources, and assist them in completing Crisis Tools when appropriate. The Area 11 APD- AmeriCorps will be coming to an end on August 31 st. It has been a great experience and our waitlist 13

14 consumers have been offered a variety of recreational and voluntary opportunities. IMPORTANT: OUR ON-CALL PHONE NUMBER IS IV. ADJOURMENT ATTENDANCE: Soraya Lopez, Regina Linases, Kenneth, Maureen Winter, Frank Perez, Cynthia Giron, Janice Thurston, Shawntisha Mcconn, Gisel Prado, Rusty Toronsess, Anthony Spicer, Joan Lee, Yadi Flores, Neftali Pervas, Yitzhak Rivero, Jamie Levin, Evet Johnson, Albert Duclair, Tatiana Cortez, Laura Notice, Gloria Rose, Portia James, Josephina Livington, Yvon Maxwell, Audrey Lawrence, Marlon Medina, Saimary Rivero, Edna Arroyo, Angela Wilson, Monica Martinez, Rosa Maria Barbara, Joseph Mazagua, Katena Broussard, Altheon Martin, Sabrina Altidor, Pedro Herman, Rene Gomez, Xiomara Elsabals, Gladys Minino, Maribel Galvin, Susan Best-Rodrgiuguz, Laronda Smith, Aleyia Cunningham, Judith Rodriguez, Amnuel Achong, Luis Rodriguez, Rebeca Freeman, Estrella Granda, Laura Vinen, Gloria Fortune, Argeo Rodriguez, Michel Gonzalez, Marina Hernandez, Tammie Martin, Tamara Rodriguerz, Vernonica Oliver, Jorge Villavan, Agusto Aday, Sarah Cartaya, Clara Romero, Cynthia Gay, Daylin Talavera, Miriam Fernandez, Dora Guzman, Murie Cuadro, Roberto Cuadro, Lissset Rulan, Maria Zaldinar, Isis Espino, Annie Dickson, Penny Schueneman, Carlos Rocha, Karen Knoblock, Annette Lens, Ally Jalice, Andres Pachecho, Kathreen Childs, Carmen Suarez, Patricia Garcia Monts, Monique Vincent, Patrick Blane, Yolette Brown, Raquel Lotero, Luz Ortiz, Mable Burger, Argeo Rodriguez, Kristine Foncseca, Martha Khan, Martha Robina, Darlene Thomas, Joanna Brown, Pascaue Malette, Annie Bethel, Ella Mayo, Natalia Laver, Mary Coldwell, Brenda Lampson, Melissa Mitchell, Jeantte Williams, Timothy Paulk, Frank Thomas, Tredra, Monique Miller, Mariana Abraham, Milagros Aniceto, Crisitina Schwarz, Lesly Dewbeau-Charles, Aracely Montano, Annita Machado, Derrick Harley, Yoslaine Otero, Brenda Lowe, Ana Vazquez, Cherie, O Green, Maria Lacayo, Kenol Pierre, Laura Vivent, Xiomara Benavides, Tammie Martin, Velma Fulger. 14