Mar 12, 2014

The Agency for Persons with Disabilities (APD) Director Barbara Palmer. Was aked some important questions.

Barbara Palmer was appointed director of the Agency for Persons with Disabilities in August 2012, after serving as the agency's chief of staff for just under a year. Before that, she'd been assistant secretary for administration at the Department of Children and Families.

By then, Palmer had had a full career already. A pioneer in the development of programs for female athletes, she was among the first inductees into the Florida Women's Hall of Fame in 1982 due to her lobbying work on Title IX, the 1972 federal mandate to ensure equitable treatment of girls and women in school athletic programs.

Palmer earned her bachelor's and master's degrees from Florida State University. In 1977, she became the first director of women's athletics at FSU, which won five national championships and 226 All-American awards under her leadership. She then became FSU's associate vice-president for governmental relations, and director of the Division of Hotels and Restaurants at the Department of Business and Professional Regulation. For 15 years, she was president and CEO of Palmer, Musick & Associates, where she worked on issues such as athletics, education, mental health, health care and regulation before state and local governments.

The News Service of Florida has five questions for Barbara Palmer:

Q: Gov. Scott's budget has a lot of good news for your agency. Talk about that.

PALMER: Well, we're very excited. This is the second year in a row that the governor's recommended dollars to take people off the wait list.

As you probably know, we have thousands of people on the wait list. They all have different levels of need, but we've identified about 3,000 that need to come off as quickly as possible because they have critical needs. So last year we put a plan together, and the governor recommended $36 million and the Legislature funded that, and so we were able to take about 1,600 people off. So this year he asked what it would take to get the rest of them off that are in the critical-need category. So he is recommending $20 million, which we're very excited about. We're still running the numbers, but we believe that that's going to be enough to get the rest of those 3,000 off.

He also recommended some additional dollars for employment, which we're very excited about. ... I actually read and sign every crisis that comes up here. So I know the needs of these families, and they are very, very heart-wrenching in many cases. A lot of it, though, has to do with kids transitioning out of school. If they don't go on our waiver, somebody in that household has to quit their job.

So what we're focusing on for employment is that transition -- and that's not to say we don't want to help other people, because certainly we do. But we need to catch people at that point when they're really at the height of learning and they're excited about being part of a productive society instead of sitting home in front of a TV, really losing that self-esteem. Just like we all need. When we work, it makes you feel so much better about yourself.

And so we're excited about the money. Last year he gave us a half a million and the Legislature funded it. And we've spent all year trying to work on a sustainable system working with the school systems that will allow that transition. When a school identifies nine people graduating with special needs, for example, we want to know who's going on to higher education, who maybe already has a job, and what are the interests of the others, so that we can match them properly with the different businesses out there. So we're partnering with different businesses so we can match people. And this year the governor has put a million dollars in. So we're very excited. So that's the next step.

Q: What would it take to eliminate the entire waiting list? Could it ever happen?

PALMER: I think there always will be (a waiting list), but there are a lot of people that are on the wait list that really, at this point in time, are not urgent for services.

There are about 9,500 that are on our wait list that are under 21 that, if they're Medicaid-eligible right now, they would already get services through the Agency for Health Care Administration. So they're really not on our waiting list, but they are, because they know that when they turn 21, they're going to want to get our services. So that's an example.

But we also have people that -- I think they feel like they have to get on the waiting list. But we really don't provide services based on when somebody comes on. It's based on need. And so we have a whole formula for how we take people off the waiting list that the providers and stakeholders and individuals with disabilities and their families helped us design. This was not something we came up with ourselves. They helped us.

And it really is based on need, like caregiver aging out: People that are over 70 and have paid taxes all their lives, and they have needs; we need to help them. ...

Then we've got those that are absolutely just on the verge of crisis. And crisis for us is identified (as) an individual that is either a danger to themselves and others, or they're homeless. And that's what happens a lot with those that transition out of schools. So we're very attuned to this employment initiative, along with the wait list.

Q: How many people are using the iBudget now, and how is that going?

PALMER: We have about 29,000 people, around 29 to 30 (thousand), somewhere in there. And it's taken a year and a half to roll out completely, and we are extremely happy with the results.

We're in the middle of some lawsuits which, frankly, have created some workload issues for the people out in the field. It's unfortunate. However, for the most part, people are very excited about the iBudget because it gives them so much flexibility. Before, if they got their money, their money would come down for some type of specific service, or for the adult day training, or for transportation, and it was in categories and they had to spend it within that category. And if they didn't spend it, they lost it. So what the iBudget does is give them a lot of flexibility to use their money as they need. And you know, that's what we all do. We all have budgets. I have to save up if I have a crown, or something dental that's massive, or even an operation. So this gives them that kind of flexibility so they can plan, just like anyone.

Q: Is the Developmental Disabilities Home and Community Based Services Waiver operating within its budget now, after eight years of operating at a deficit?

PALMER: We ended this past year (2012-13) for the first time within our budget. And we're on our way this next year as well.

And I know there are a lot of people that wonder why we left some money on the table. And I want to address that, because I think it's very important that people understand that this agency has gotten in trouble over the years because they spent every penny they had, and then the next year as people's needs increased, they went into a deficit.

So it's very important that we do keep that cushion, so that the next year there is some room, because people's needs are going to change. They're going to change. They're going to get worse. They don't get better. And so we have to plan for that.

And so for the first time, because we were within our budget, we are doing some long-range planning. And in the category, for example, the caregiver aging out: Why should we start looking at age 60? Where do you want your child to be when you pass on? That's the big question everybody always asks. So let's help them plan with some of those things.

And the same thing with people with Alzheimer's. People are living longer, caregivers and the people we serve. And so we need to be planning for that. There's a lot of research to be done, and that's one of the areas where we're doing some long-range planning.

Q: What do you hope to accomplish at APD before you leave?

PALMER: Well, I feel like we've accomplished a lot already. But what I really would like to do is do this comprehensive study for the housing options, because I think that what we have right now is something that probably was built 20 years ago or more. And just because that's the way we did it 20 years doesn't make it right.

And I talked about dual diagnosis, and that's one that's very obvious. You can see that if you have somebody with severe mental challenges, and you put them in a house with somebody that doesn't, it would be a very, very difficult situation for people, especially people with developmental disabilities that don't understand that. So we have to make sure that whatever housing options we come up with are serving people with those needs.

And when I say that, I don't mean I want to put someone in a place and they stay there forever. We need intensive behavior types of therapies that are short-term, where we work with the person and then they get better. And so those are the kinds of things we're looking at.

We also need to be looking at the Alzheimer's, because this is something that is happening. What do you do? Do you support people aging in place? Well, if you do, and they're in a house where nobody else has Alzheimer's, how do you deal with that? Well, training, for one thing. And people coming in and working with the other people in the house to understand.

So we have to look at new ways to do the kinds of services we're doing, but doing it differently.