Medicaid Waiver News

2012-01-30T07:17:00.001-08:00

Helpline for Travelers with Disabilities. Click the link to see a new service from the TSA for travel. http://ping.fm/Kf726

TSA Helpline for Travelers with Disabilities

2012-01-30T07:14:00.001-08:00

TSA Helpline for Travelers with Disabilities

Please see the below links and press release regarding a new service from the TSA for travel.

http://www.tsa.gov/press/releases/2011/1222.shtm

http://www.tsa.gov/travelers/airtravel/disabilityandmedicalneeds/tsa_cares.shtm

The Transportation Security Administration (TSA) announced the launch of TSA Cares today, a new helpline number designed to assist travelers with disabilities and medical
conditions, prior to getting to the airport. Travelers may call TSA Cares toll free at 1-855-787 2227 prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint.

“TSA Cares provides passengers with disabilities and medical needs another resource to use before they fly, so they know what to expect when going through the screening process,” said TSA Administrator John Pistole. “This additional level of personal communication helps ensure that even those who do not travel often are aware of our screening policies before they arrive at the airport.”

Since its inception, TSA has provided information to all travelers through its TSA Contact Center and Customer Service Managers in airports nationwide. TSA Cares will serve as an additional, dedicated resource for passengers with disabilities, medical conditions or other circumstances or their loved ones who want to prepare for the screening process prior to flying.

When a passenger with a disability or medical condition calls TSA Cares, a representative will provide assistance, either with information about screening that is relevant to the passenger’s specific disability or medical condition, or the passenger may be referred to disability experts at TSA. TSA recommends that passengers call approximately 72 hours ahead of travel so that TSA Cares has the opportunity to coordinate checkpoint support with a TSA Customer Service Manager located at the airport when necessary.

Every person and item must be screened before entering the secure area of an airport and the manner in which the screening is conducted will depend on the passenger’s abilities and any specific equipment brought to the security checkpoint.

TSA strives to provide the highest level of security while ensuring that all passengers are treated with dignity and respect. The agency works regularly with a broad coalition of disability and medical condition advocacy groups to help understand their needs and adapt screening procedures accordingly. TSA holds quarterly meetings with this coalition to inform them about current training and screening procedures used in airports. TSA recently hosted a teleconference with members of these groups to announce the long-standing plans to implement TSA Cares for travelers and inform them of the upcoming launch.

All travelers may ask to speak to a TSA supervisor if questions about screening procedures arise while at the security checkpoint. The hours of operation for the TSA Cares helpline are Monday through Friday 9 a.m. – 9 p.m. EST, excluding federal holidays. After hours, travelers can find information about traveling with disabilities and medical needs on TSA’s website.

All travelers can contact TSA using Talk To TSA, a web-based tool that allows passengers to reach out to an airport Customer Service Manager directly, and the TSA Contact Center, 1 866-289-9673 and TSA-ContactCenter@dhs.gov, where travelers can ask questions, provide suggestions and file complaints. Travelers who are deaf or hard of hearing can use a relay service to contact TSA Cares or can e-mail TSA-ContactCenter@dhs.gov

2012-01-24T09:27:00.001-08:00

Local advocates & parents of disabled children met to voice their worries about Gov. Rick Scott's proposed budget cuts. http://ping.fm/6kbZO

Advocates for disabled worried about proposed budget cuts

2012-01-24T09:14:00.000-08:00

Advocates for disabled worried about proposed budget cuts

Local parents of disabled children met Monday to voice their worries about Gov. Rick Scott's proposed budget cuts, which some say will leave disabled Floridians without the help they need. About 40 parents and agency representatives who provide services to the disabled met at Goodwill Industries-Suncoast Inc. onWest Silver Springs Boulevard to voice concerns over insufficient funding for programs they say their children and clients need to live productive and meaningful lives.

Suzanne Sewell, president and CEO of the Florida Association of Rehabilitation, was the guest speaker. She is a lobbyist who represents organizations that work with disabled Floridians, including Goodwill.

Sewell warned that Scott's $66.4 billion budget proposes to slice nearly $38 million from Florida's Agency for Persons with Disabilities, leaving the agency with $772.5 million for the year beginning July 1.

Under Scott's proposal, if the agencymakes the cuts, it would receive an additional $24 million to help “restructure” the agency to improve efficiencies.
The agency spent $975 million last year providing services tomore than 30,000 people. That was $169 million over its budget. Scott had to release emergency funds to bridge the gap. It also was the third year in a row the agency spentmore than it was allocated.

Sewell encouraged those who attended the meeting to contact their legislators to object to the cuts. She said that while the Agency for Persons with Disabilities should stop spending more than it's allocated, its budget needed to be $870 million tomeet clients' needs.

“If it's not budgeted at $870 million, I think there are going to be catastrophic consequences,” she said. Sewell said that the $870 million spending is appropriate and reflects a substantial decrease compared with the $975 million the agency spent last year for services. The next step is for the Florida House and Senate to consider Scott's proposal. Some of the cuts stem from Scott's budget plan to spend an additional $1 billion for education this year.

Jean-MarieMoore, Goodwill's operations director for human services for a 10-county region, said her organization was bound to be affected if lawmakers approve Scott's proposals. Goodwill's services include adult training and supervised work programs. Goodwill subsidizes 40 percent of that cost through its sales.

“So instead of a person coming to adult day training five days a week, they'll be able to come three days a week, or two, or not at all,” she said. She estimates between 50 percent and 65 percent of families with disabled persons will see cuts to
their benefits. The Goodwill on Silver Springs Boulevard employs about 40 clients. Her Goodwill region has already closed two group homes during the past five years and cut its support living program.

Both Sewell and Moore, however, said it was too soon to predict just how Scott's cuts would affect specific programs. Sandy Dayton said her mentally disabled son, Tony, will likely be one of those people getting less help. The 27-year-old disabled man lives in a group home.

“When you have a child with a disability, you're in another world,” Dayton said.
Her son works at the Goodwill. The store's supervisor, Derek Arnold, said that if funding is cut, taxpayers will pay through other channels. “And if he's not here, perhaps he'll find other ways to … (spend their time),” Arnold said. “He can
land himself in trouble or (be) hurt. Someone's going to front the cost.”

Agency for Persons with Disabilities spokeswomanMelanie Etters said she didn't know of any proposed cuts, only about the $24 million additional money for restructuring.
Scott's recommended appropriations act for 2012-13 obtained by the Star-Banner, however, shows the cuts Sewell discussed Monday. Scott's deputy press secretary, Jackie Schultz, responded to the Star-Banner with an email. “Governor Scott is proposing savings as well as restructuring to get spending at APD under control,” she wrote. “By allocating funds and making some adjustments within the agency, it
should have a positive effect on getting the agency to operate within their budget to avoid future deficits and get people off of the waiting list.”

She went on to say, “Restructuring will take the form of consolidating services and standardizing rates. Governor Scott's recommendations suggest reducing the amount, scope and duration of certain services offered.”

By Fred HiersStaff writer
Contact Fred Hiers at fred.hiers@starbanner.comand

2012-01-23T10:22:00.001-08:00

Senator Negron won't take the easy way out to balance budget. How will it affect APD & Individuals with Disabilities. http://ping.fm/20X71

Senator Joe Negron won't take "the easy way out" to balance budget

2012-01-23T10:14:00.000-08:00

Sen. Joe Negron speaks at a press conference at the Capitol.

Gov. Rick Scott's proposed budget trimmed reimbursements to hospitals by $1.8 billion but there are growing signs that the Legislature is loathe to cut institutional providers that hard.

Sen. Joe Negron, chairman of the Senate Budget Subcommittee on Health and Human Services Appropriations, said on Thursday he's tired of "taking the easy way out" and doesn't plan on making flat across-the-board percentage cuts to facilities.

Though the Senate has not distributed any budget allocations Negron told his committee he is expecting to have to trim about $850 million from general revenue in the Health and Human Services budget that his committee will be working on next week.

The Palm City Republican said that traditionally there have been cuts to hospitals and nursing homes and hospice, all of which trickle down to reductions in managed care plans. He plans to avoid that at all costs this year.

"I'm going to be very resistant to just taking the easy way out," said Negron who continued,"There's a saying in the Bible, a laborer is worthy of his hire. And I really believe that."

Negron said the Legislature has "unilaterally" made cuts to hospitals, which have federal requirements to take care of the uninsured who show up at emergency rooms.

"At some point, it really gets to where we are almost demanding servitude for people who have contracts with the state. And all that does is shift cost to other people and I don't think that's responsible budgeting."

Sen. Don Gaetz, R-Destin, agreed with Negron saying "I don't have the stomach for assuming everything and everybody is providing equal value."

To avoid making reductions in reimbursement rates Negron compiled a nine-page list of programs that Florida Medicaid offers but isn't mandated to do so. The list also includes what he said are prevention and education program in the Agency for Health Care Administrations, the Department of Elder Affairs, the Department of Children and Families, Health and the Agency for Persons with Disabilities.

He distributed the list -- as well as accompanying budget language that explained the programs. For his part, Negron identified four programs on the list he would like to see eliminated, including privatizing AG Holley Tuberculosis Hospital, which Negron says is so old it looks like something out of a black-and-white movie.

Also included on the list were prevention programs at DOEA designed to keep people out of nursing homes, and mental health and substance abuse prevention programs.

"This isn't an academic exercise," Negron said, stressing that he doesn't want to reduce all the programs on the list, he just wants the committee to consider them all. " I want to force us to consider for today not having to cut reimbursement rates."

Scott's budget turns upside down hospital reimbursements by initiating rating bands for facilities, which would be a net reduction to hospitals of $1.8 billion. Scott defended the approach by saying that current reimbursements vary greatly even among hospitals that are located in the same area.

Negron said he's concerned that the general revenue savings -- or state share -- of the savings is just $388 million.

As an alternative to that approach Negron had Gaetz -- a former hospital administrator explain the concept of DRGs, diagnostic related groups.

DRGs are used in Medicare and pay based on the patient's diagnosis. Medicaid in Florida pays hospitals for its costs.

Gaetz said Florida could transition to a DRG system, but that Medicaid officials say it could take from three months to two years to initiate and as much as $3 million to actually implement.

Gaetz said a DRG system "begins to get at the inequities" in Medicaid reimbursements.

"It's simply is a way of identifying patients based on reason and paying hospital based on the complexity of what they do.,'' he said. "That, then, provides the hospitals with some norms."

Meanwhile in a memo to his members House Speaker Dean Cannon, R-Winter Park, said the House budget will continue to work toward a simplified hospital funding model, consistent with the Florida Medicaid reform enacted into law last year, recognizing that this effort will require more time-consuming, meticulous work and the investment of stakeholders. A state study of DRGs was included in last year’s sweeping Medicaid rewrite, that placed most Medicaid patients in Florida—from the cradle to the grave—into managed care.

Senate Minority Leader Nan Rich, D-Sunrise, expressed concerns with the cuts saying the committee is asked annually to make reduction. “I wish one year that we could look at some loopholes in our tax structure.”
Story by: thefloridacurrent.com - Reporter Christine Jordan Sexton can be reached at csexton@thefloridacurrent.com.

2012-01-21T08:36:00.001-08:00

New Definition of Autism Will Exclude Many, The definition of autism would reduce the rate the disorder is diagnosed. http://ping.fm/kjVuT

New Definition of Autism Will Exclude Many, Study Suggests

2012-01-21T08:30:00.000-08:00

New Definition of Autism Will Exclude Many, Study Suggests.

Proposed changes in the definition of autism would sharply reduce the skyrocketing rate at which the disorder is diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services, a new analysis suggests.

The definition is now being reassessed by an expert panel appointed by the American Psychiatric Association, which is completing work on the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, the first major revision in 17 years. The D.S.M., as the manual is known, is the standard reference for mental disorders, driving research, treatment and insurance decisions. Most experts expect that the new manual will narrow the criteria for autism; the question is how sharply.

The results of the new analysis are preliminary, but they offer the most drastic estimate of how tightening the criteria for autism could affect the rate of diagnosis. For years, many experts have privately contended that the vagueness of the current criteria for autism and related disorders like Asperger syndrome was contributing to the increase in the rate of diagnoses — which has ballooned to one child in 100, according to some estimates.

The psychiatrists’ association is wrestling with one of the most agonizing questions in mental health — where to draw the line between unusual and abnormal — and its decisions are sure to be wrenching for some families. At a time when school budgets for special education are stretched, the new diagnosis could herald more pitched battles. Tens of thousands of people receive state-backed services to help offset the disorders’ disabling effects, which include sometimes severe learning and social problems, and the diagnosis is in many ways central to their lives. Close networks of parents have bonded over common experiences with children; and the children, too, may grow to find a sense of their own identity in their struggle with the disorder.

The proposed changes would probably exclude people with a diagnosis who were higher functioning. “I’m very concerned about the change in diagnosis, because I wonder if my daughter would even qualify,” said Mary Meyer of Ramsey, N.J. A diagnosis of Asperger syndrome was crucial to helping her daughter, who is 37, gain access to services that have helped tremendously. “She’s on disability, which is partly based on the Asperger’s; and I’m hoping to get her into supportive housing, which also depends on her diagnosis.”

The new analysis, presented Thursday at a meeting of the Icelandic Medical Association, opens a debate about just how many people the proposed diagnosis would affect.

The changes would narrow the diagnosis so much that it could effectively end the autism surge, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine and an author of the new analysis of the proposal. “We would nip it in the bud.”

Experts working for the Psychiatric Association on the manual’s new definition — a group from which Dr. Volkmar resigned early on — strongly disagree about the proposed changes’ impact. “I don’t know how they’re getting those numbers,” Catherine Lord, a member of the task force working on the diagnosis, said about Dr. Volkmar’s report.

Previous projections have concluded that far fewer people would be excluded under the change, said Dr. Lord, director of the Institute for Brain Development, a joint project of NewYork-Presbyterian Hospital, Weill Medical College of Cornell University, Columbia University Medical Center and the New York Center for Autism.

Disagreement about the effect of the new definition will almost certainly increase scrutiny of the finer points of the psychiatric association’s changes to the manual. The revisions are about 90 percent complete and will be final by December, according to Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions.

At least a million children and adults have a diagnosis of autism or a related disorder, like Asperger syndrome or “pervasive developmental disorder, not otherwise specified,” also known as P.D.D.-N.O.S. People with Asperger’s or P.D.D.-N.O.S. endure some of the same social struggles as those with autism but do not meet the definition for the full-blown version. The proposed change would consolidate all three diagnoses under one category, autism spectrum disorder, eliminating Asperger syndrome and P.D.D.-N.O.S. from the manual. Under the current criteria, a person can qualify for the diagnosis by exhibiting 6 or more of 12 behaviors; under the proposed definition, the person would have to exhibit 3 deficits in social interaction and communication and at least 2 repetitive behaviors, a much narrower menu.

Dr. Kupfer said the changes were an attempt to clarify these variations and put them under one name. Some advocates have been concerned about the proposed changes.

“Our fear is that we are going to take a big step backward,” said Lori Shery, president of the Asperger Syndrome Education Network. “If clinicians say, ‘These kids don’t fit the criteria for an autism spectrum diagnosis,’ they are not going to get the supports and services they need, and they’re going to experience failure.”

Mark Roithmayr, president of the advocacy organization Autism Speaks, said that the proposed diagnosis should bring needed clarity but that the effect it would have on services was not yet clear. “We need to carefully monitor the impact of these diagnostic changes on access to services and ensure that no one is being denied the services they need,” Mr. Roithmayr said by e-mail. “Some treatments and services are driven solely by a person’s diagnosis, while other services may depend on other criteria such as age, I.Q. level or medical history.”

In the new analysis, Dr. Volkmar, along with Brian Reichow and James McPartland, both at Yale, used data from a large 1993 study that served as the basis for the current criteria. They focused on 372 children and adults who were among the highest functioning and found that overall, only 45 percent of them would qualify for the proposed autism spectrum diagnosis now under review.

The focus on a high-functioning group may have slightly exaggerated that percentage, the authors acknowledge. The likelihood of being left out under the new definition depended on the original diagnosis: about a quarter of those identified with classic autism in 1993 would not be so identified under the proposed criteria; about three-quarters of those with Asperger syndrome would not qualify; and 85 percent of those with P.D.D.-N.O.S. would not.

Dr. Volkmar presented the preliminary findings on Thursday. The researchers will publish a broader analysis, based on a larger and more representative sample of 1,000 cases, later this year. Dr. Volkmar said that although the proposed diagnosis would be for disorders on a spectrum and implies a broader net, it focuses tightly on “classically autistic” children on the more severe end of the scale. “The major impact here is on the more cognitively able,” he said.

Dr. Lord said that the study numbers are probably exaggerated because the research team relied on old data, collected by doctors who were not aware of what kinds of behaviors the proposed definition requires. “It’s not that the behaviors didn’t exist, but that they weren’t even asking about them — they wouldn’t show up at all in the data,” Dr. Lord said.

Dr. Volkmar acknowledged as much but said that problems transferring the data could not account for the large differences in rates.

2012-01-20T08:11:00.001-08:00

Health & human-services programs face hundreds of millions in cuts during 2012-13 fiscal year. Click to Read More. http://ping.fm/eo6Q2

health and human-services programs still likely face hundreds of millions of dollars in cuts during the upcoming 2012-13 fiscal year.

2012-01-20T08:07:00.000-08:00

health and human-services programs still likely face hundreds of millions of dollars in cuts during the upcoming 2012-13 fiscal year. As an indication, Senate Health and Human Services Appropriations Chairman Joe Negron, R-Stuart, said Thursday he will release an initial budget proposal next week and expects about $850 million in cuts.

"To me, this is just a rerun every year,'' said Senate Minority Leader Nan Rich, D-Weston, lamenting a series of reductions that have hit hospitals, nursing homes and other providers.

In offering his budget plan last month, Scott proposed major changes in Medicaid rates for hospitals. The changes would seek to end wide differences in payments to hospitals, while also reducing funding by about $1.7 billion.

But Speaker Dean Cannon, R-Winter Park, on Thursday released what are known as budget allocations --- numbers that indicate how much the House wants to spend in each area of government --- and appeared to make clear the House does not plan to go along with Scott's proposed cuts to hospitals..

In a memo, Cannon pointed to a plan that lawmakers passed last year to transform Medicaid into a statewide managed-care system. Though Cannon did not specifically mention Scott's proposal, the memo said the House wants to use the managed-care plan to change Medicaid funding for hospitals.

"The House will continue to work toward a simplified hospital funding model, consistent with the Florida Medicaid reform enacted into law last year, recognizing that this effort will require more time-consuming, meticulous work and the investment of stakeholders,'' Cannon's memo said.

Negron said the Senate will continue to study Scott's proposal, which involves grouping hospitals into 10 categories based on similar characteristics. New, more-standardized rates would be used for hospitals in each category.

But during a meeting of Negron's subcommittee Thursday, senators blasted the proposal because it would lead to deep cuts at safety-net facilities such as Jackson Memorial Hospital in Miami and the Shands hospitals in Gainesville and Jacksonville.

"I, for one, cannot be quiet and sit here and take these cuts,'' said Senate Health Regulation Chairman Rene Garcia, R-Hialeah.

Part of Scott's proposal was designed to free up money to help pay for a $1 billion increase in public-school funding. The House allocations also included such a school-funding increase --- a decision that Scott praised in a prepared statement issued later Thursday.

"Today's budget allocations put forward in the Florida House are exactly what Florida's teachers and students need to keep our schools on a path to success,'' Scott said.

House Appropriations Chairwoman Denise Grimsley, R-Sebring, said "almost every policy area" in the state budget would take some reductions, as the House looks to put more money into education.

Lawmakers have repeatedly cut health- and human-services funding during the past few years as they grappled with billions of dollars in budget shortfalls. As an example, hospital Medicaid rates were cut about $510 million last spring, while nursing home rates were cut about $187 million.

More details will become available next week, but it appears the House allocations leave a roughly $300 million gap in general-revenue funding for health- and human-services programs. The House proposal would increase spending on the programs by about $600 million, but that is about $300 million short of the amount needed to keep up with Medicaid caseloads and other costs.

"That's the challenge we face every year with rising Medicaid rolls,'' Grimsley said.

The Senate has not released its allocations, but Negron was preparing Thursday to start making cuts. While he said he wants to continue studying Scott's proposal, he also said he wants to shield hospitals and nursing-homes from the types of across-the-board rate reductions they have faced in recent years.

But such an approach could lead to cuts in a wide range of other areas, such as substance-abuse and mental-health programs.

"I'm going to be very resistant to just doing the easy way out,'' Negron said.

Hospital and nursing-home industry officials said they hope lawmakers will take into consideration the deep cuts their facilities have sustained during the past few years. But they also were bracing for the possibility of more reductions.

"We hope they're minimal, but we certainly expect them,'' said Tony Marshall, a Florida Health Care Association official who closely follows Medicaid funding issues.

2012-01-19T14:30:00.001-08:00

Senate to move ahead with prison privatization. Could save 40 million. Sen. Alexander money saved could go to APD.http://ping.fm/y4tjQ

Prison privatization could help APD with 40 million.

2012-01-19T14:21:00.000-08:00

Senate to move ahead with prison privatization plan [Sen. Alexander: money
saved could go to APD]

TALLAHASSEE – A Senate panel opened the door Wednesday to give the Senate a
second shot at privatizing 29 prisons in South Florida and eliminate some
of the obstacles that led a Tallahassee judge to reject a similar plan this
summer.

The Senate Rules Committee, chaired by Sen. John Thrasher, R-St. Augustine,
gave the go ahead for the Senate to take up legislation that would
privatize correctional facilities in an 18-county South Florida region and
also a bill that revises requirements for the privatization process. The
second piece of legislation would drop a requirement that departments
looking at privatization create a business case for privatization prior to
the Legislature making the decision.

Last spring, lawmakers tucked the privatization plan into the budget
language, instead of debating it in a separate bill, making it easier to
pass and win Scott’s signature. Republican backers of the plan argued it
would save money for the nation’s third-largest prison system.

The Police Benevolent Association said that those promises were a sham and
that the state hadn’t even done a thorough enough analysis to even know how
much could be potentially saved. The group filed a lawsuit to undo the
plan, by arguing that lawmakers could not pass a privatization plan in the
budget language.

A judge agreed that privatization should be handled in a separate bill, not
in the budget. The judge also blasted the state for not doing a substantial
business analysis of how privatization would affect the state.

Matt Puckett, executive director of the Police Benevolent Association, said
stipulations such as the business case were in law to protect the state
from making a decision that was not advantageous to the state.

“I don’t know why we are undoing these changes now,” he said. “I think
these are put in place so we don’t make mistakes when we privatize.”
Senate Budget Chairman JD Alexander said the Legislature should be able to
decide whether to privatize if they believe it could save the state money
and allow other priorities to be funded.

“If we make a decision to save $40 million so we can spend on our prior,
like APD, I think is a legitimate budget decision,” he said.
The Senate meeting was only a preliminary vote to determine whether the
Senate should hold substantive hearings on the measure. Only two South
Florida lawmakers, Sen. Chris Smith, D-Fort Lauderdale, and Sen. Gwen
Margolis, D-Miami, objected to the bill going forward.

2012-01-10T15:53:00.001-08:00

APD Director Hansen will be presenting an update to the Health Care Appropriations Committee. 1-11-12 at 2:30pm. http://ping.fm/uE5SO

APD Director Hansen will be presenting an update to the Health Care Appropriations Committee

2012-01-10T15:50:00.000-08:00

APD Director Hansen will be presenting an update to the Health Care Appropriations Committee tomorrow at 2:30 PM (Wed. 1-11-12) Just posted today, thought you might be interested if able to watch

Packet is not up on the site at this time. If you can watch it, check our website for access :

Go to FCCF Website: www.FCCFlorida.org

(front page hit working with legislators) Go to link Florida House for the live video
or
go to Health Care Appropriations Committee, where you can get the packet when posted and at the top hit broadcast for live access at 2:30 PM

http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionId=70&CommitteeId=2599

Meeting Notices

Title Size Description view Jan 11 2012 2:30PM

Presentation on the Governor's Recommended Budget for FY 2012-13
Update on the Agency for Persons with Disabilities Medicaid Waiver Deficit
Update on Low Income Pool (LIP) Council Recommendations

For your convenience, the appearance request form on myfloridahouse.gov has been simplified. Before the meeting, please go to the web site and under the committee tab select our committee, then choose the appearance request form and follow the prompts. Please bring 2 copies of the form to the meeting and give to the administrative assistant

2012-01-09T08:54:00.001-08:00

APD News Clip -- Director Hansen interviewed.
http://ping.fm/4eLcr

APD News Clip -- Director Hansen interviewed

2012-01-09T08:44:00.000-08:00

Agency for Persons with Disabilities Director
Mike Hanson.

Mike Hansen is the recently appointed director for the Agency for Persons
with Disabilities.

An avid runner, Hansen, 59, worked in Miami-Dade County in the 1970s in the
former Department of Health and Rehabilitative Services. He also worked at
state agencies in Tallahassee before moving to the Legislature and then
into the governor's Office of Planning and Budgeting under former Gov. Jeb
Bush. Before being tapped by Gov. Rick Scott to lead APD, Hansen was the
Senate Health and Human Services budget director. About 30,000 clients are
served by APD Medicaid programs and Hansen -- who has been at APD since the
summer -- says he has a spreadsheet in his office detailing who the clients
are and the services they get. He looks at it regularly. He appears before
the Senate Children, Families and Elder Affairs Committee this Thursday for
a confirmation hearing.

He was brought to the agency to try to help rein in spending since APD has
had problems containing spending in its main programs. But Hansen says he
will not support changes that would result in clients being removed from
the community and placed in institutions. "That's the last thing I want to
do. I will not do that. They ain't paying me enough money. I will not do
that. Period. End of story. Forget about balancing the budget. I am not
going to participate in anything that would do that."

You went from Senate staff director for the Health and Human Services
budget to director of the Agency for Persons with Disabilities. How did
that occur?

"I was approached over a period of time. It wasn't a one-time deal. People
started talking to me from the governor's office and started asking me
questions. It was over a several months period of time which started during
the session. Of course in the position I was in, I did not want to really
entertain an employment opportunity that could be construed that I made
some decision in my previous job that would impact my decision. So the
initial response was 'I am not going to be interested in talking about
this.' Of course I was able to think about it over that period of time . ….
In my line of work your position is good the day you are in it. You never
know what tomorrow is going to bring. I am never in the habit of saying to
someone 'I would never consider doing that' because who knows where you are
going to be tomorrow? Who knows what you are going to have to deal with the
next day? Who knows what the situation is going to be? As time went on, I
had more time to think about it and the offer was very generous, very kind.
It was 'We need you to help us figure out how to make this agency work
better.' "

Given the fact that the program is bigger than the appropriation -- it's a
$900 million program with an $810 million budget -- and it's been bedeviled
by budget crises, were you concerned about taking the position?

"Well, I did talk to the governor about that and basically said, 'If you
are going to evaluate me at the end of the first year as having brought the
agency's budget in line with the appropriation, I don't feel like I can
achieve that goal. So if that is your expectation, I am not the right guy
for this job.' I think I can make strides, I think I can move in the right
direction, but I think it's going to take longer than 12 months and I think
there's a lot of legwork that has to be done to figure out exactly what it
would take to get there. If getting to that number means jeopardizing the
health and safety of our clients, I'm not interested in getting to that
number, and I know the governor is not interested in getting to that
number, and I don't think the Legislature is interested in getting to that
number if that's what it means.

"But there is a belief out there that money is being spent in a way that it
can be more wisely spent and that is clearly my belief as well. We can do a
better job of utilizing these resources. And that is what we are about
trying to do and trying to figure out how we do that. If they [the Scott
administration] had told me to come in here and balance this budget no
matter what, I would have told them, 'I'm not interested,' because I don't
think it can be done and it's not the right thing to do. But that's not
what they asked me to do. They asked me to try to do the best job I could
in figuring out are we using these resources as wisely as they can be used.
And I'm certainly agreeable to do that and that's exactly what we're trying
to do."

To that end, the agency has taken a look at "core services." What are core
services? It has been somewhat controversial because core services differ
from person to person. Where does this plan stand right now?

"Obviously it has generated a lot of controversy -- the notion of core
servicees -- and we are planning to move away from core services because I
think it was misconstrued. I think what our intention was, and how it was
viewed, were two different things. And I don't think that concept is a
useful concept to move forward, so we are going to discontinue the use of
the term."

Will you discontinue the use of the term but move on with the idea?

"Well, the idea is we have to find a way to correct budgets for
'extraordinary need,' that's the term used in the statute. We are trying to
figure out a way of coming up with a proxy for people who have
extraordinary needs. That's what we are looking at trying to figure out.
But the distinction I think you have to make is, it's one thing to
determine the amount of money someone needs to meet their extraordinary
needs. It's another thing to say, 'These are core services and these are
the only serves you can have access to.' We never were saying that and we
are not saying that now, but I think the use of the term led people to
believe we were saying that.

"We are moving forward with a definition of 'extraordinary need.' We are
trying to quantify that definition, but we don't want people to get
confused between the notion of extraordinary need and limits on how they
can spend their cost plan. Our clients are only going to benefit from the
concept of extraordinary need. No one is harmed. People are only benefitted
by that, and that's what I'll hope they will understand. The idea is we
want to make sure people have a safe place to live."

One month ago you said the approximate price tag of the ibudget (APD's new
system of budgeting that gives clients a set allocation of money but with
more flexibility on how to spend it) with the algorithm is about $870
million. Has that number changed?

"No, I think it is about that number. It would cost us a lot less than that
if we decided we don't want to care of 'extraordinary needs.' "

Are you asking the Legislature to change the mission statement of this
agency to bring it more in line with your appropriations?

Well, some bills are going to be filed. Until a bill is filed it's not a
public record so I don't want to speak. I think, and you've heard me
testify, that there may be some incongruence between [APD's mission
statement] and the actual amount of the appropriation. I think there could
be some tweaking to clarify those points."

Are you a cattle rancher?

"I am a person who enjoys living in the country. Growing up I lived in all
the big cities in the Northeast but my preference is the country. So I live
now on 52 acres in Wakulla County and I've got some cattle. I used to have
some hogs. I have chickens. I enjoy that life. I also grow a lot of trees.
So that's the other side of me. The non-work side of me. I'm like
[President] George Bush 43. On my days off or my vacations, I'm out there
working in the woods, clearing brush, building fences. Then there's the
other side of me, the reason I'm in Florida is I love the water. I have
boats and my other passion is fishing, spear fishing and cast netting. So
those are the things I do when i'm not doing this. It's a nice contrast."

2011-12-26T14:35:00.001-08:00

Report on how persons with disabilities are overmedicated, it's a huge problem that needs to be addessed. http://ping.fm/JuJbf

Overmedicating, it's a huge problem for persons with disabilities

2011-12-26T14:27:00.000-08:00

In Treating Disabled, Potent Drugs and Few Rules
DANNY HAKIM

Published: Thursday, December 22, 2011 at 4:30 a.m.

Something was happening to Katie Strignano.
After she was moved into a state-run group home, the 26-year-old woman, who is severely mentally retarded, started gaining weight, drooling, breaking out in pimples and pulling out her hair, leaving a bald spot the size of a softball on her head.

Her mother, Debra Strignano, suspected that someone had increased her daughter’s medication without her family’s consent.

When she asked for a copy of a consent form she had once signed for her daughter, she discovered it had been altered, tripling the daily dosage of Clonidine, which is used to control attention deficit disorder. The drug, and four others her daughter was taking, have myriad potential side effects, including rapid weight gain, skin rashes and drowsiness.

In response to questions from The New York Times, state officials said they would investigate how the consent form was changed and whether Katie Strignano was receiving the appropriate dose of medication.

“Everything with them is, let’s sedate the kid instead of trying to solve the problem,” Ms. Strignano said. “They want to dope her up; they want her to sit there like she doesn’t exist.”

Tens of thousands of powerful pills created to treat serious mental illnesses like schizophrenia are given to developmentally disabled people in the care of New York State every day.

But a review by The Times of previously unreleased records, as well as interviews with state employees, clinicians, family members and outside experts, reveals that the psychotropic medications, which alter the brain’s chemistry, are often dispensed sloppily, without rigorous or regular review, by general practitioners with little expertise in the area.

And low-level workers at state group homes are frequently given discretion to increase the medication “as needed,” despite their lack of significant training.

Psychologists who have worked inside the system describe a culture in which the drugs are used to control the disruptive behavior of the developmentally disabled — people with conditions like autism, Down syndrome and cerebral palsy — an approach increasingly discredited in the field.

The problem is that people with mental retardation, because of their condition and diminished intellectual capacity, commonly exhibit symptoms similar to those seen among people who have impulse control, anxiety or attention deficit disorders.

Psychiatrists and psychologists interviewed by The Times said those symptoms were best treated through therapy and one-on-one guidance of the developmentally disabled. But state records indicate that the doctors are often instead treating them with the psychotropic drugs, which do not address their underlying problems and can be harmful.

“It’s a mistake,” said Dr. Andrew Levitas, an associate professor of psychiatry at the University of Medicine and Dentistry of New Jersey who specializes in developmental disabilities. “Using antipsychotics to suppress behavior is an old practice used by people who aren’t acquainted with the advances in the field.”

The Times review found that 4 of the top 10 medications or supplements given to the developmentally disabled in the state are psychotropic, according to Medicaid records. In fact, developmentally disabled residents of group homes in New York are more likely to be given Ativan, an anti-anxiety drug that has a tranquilizing effect, than multivitamins, the records show.

Concern about drug use was one of the most frequently raised issues in inspection records reviewed by The Times; in the last five years, all nine state residential institutions for the developmentally disabled have been repeatedly cited by Health Department inspectors for failing to provide proper oversight of psychotropic drugs.

The drugs can have serious consequences. Risperdal, the second most frequently prescribed, was developed to treat psychotic disorders and has been approved for controlling aggression among people with autism. But its side effects can be extreme, including breast growth in adolescent boys, which in a small number of cases require mastectomies.

And even the use of the drugs to control behavior is questionable. A 2008 study published in the medical journal The Lancet found that psychotropic drugs like Risperdal were less effective at treating behavioral outbursts than placebos.

Dr. Roy Q. Sanders, who is the medical director of the Marcus Autism Center in Atlanta and has worked in New York, said, “I tell people all the time that the medications are really blunt tools when it comes to making substantial differences in behavior in developmentally disabled individuals.”

To be sure, the issue is a complicated one: developmentally disabled people are more likely than the general population to suffer from mental illness.

But the records examined by The Times show that some developmentally disabled residents received psychotropic drugs without ever getting a clear diagnosis of mental illness. Even among those who have a mental illness, the records indicate that the state’s use of the drugs can be overly aggressive.

During the last few months, as The Times has sought information about the state’s use of medications, the Office for People With Developmental Disabilities has acknowledged that there are problems, and began to develop sweeping guidelines for the use of medication. The new rules say medications “shall not be used for disciplinary purposes” or “as a substitute for supervision.”

“We know that less intrusive techniques work,” said Courtney Burke, commissioner of the Office for People With Developmental Disabilities, which oversees thousands of group homes and larger state facilities.

Ms. Burke said her agency was developing software to track the use of psychotropic drugs better and was creating a position, a chief of pharmacy, to oversee how drugs are used. New regulations, she added, would “help move the system to one that does not rely on medication or physical intervention.”

The Clinician’s View

Diana Valitutto, a former state psychologist, said she resigned from the Office for People With Developmental Disabilities in 2004 after concerns she raised about the use of psychotropic medications were ignored.

While she said she believed drugs were justified at times, she added, “from my experience, they don’t make genuine permanent changes in behavior, they simply control the client for the time being.”

State law says that “no medication shall be used for the convenience of staff” and that “special attention shall be given to those individuals receiving psychotropic medication.”

But oversight is limited. Although psychotropic drug use is supposed to be regularly reviewed, records show those reviews are seldom rigorous. The bar is higher in Massachusetts, for example, where state officials must have the approval of a judge to use drugs classified as antipsychotic.

“It’s worked well to protect people with mental health and cognitive impairments over the years,” said Marianne Meacham, general counsel at the Department of Developmental Services in Massachusetts. “It’s somewhat burdensome, but it’s definitely an important protection.”

In New York, Ms. Valitutto grew so worried about the overuse of drugs that she went to the Commission on Quality of Care and Advocacy for Persons With Disabilities, a state oversight agency, with examples of residents on what she believed were overly aggressive regimens of psychotropic medications.

“I saw people being medicated to control behavior to such a degree that to me it was obviously and clearly affecting their health, their safety, their quality of life, their ability to participate in the daily activities of living, and in some cases threatened their lives,” Ms. Valitutto said.

Ms. Valitutto said there was little consistency in how drugs were used: In central New York, she said, they were dispensed carefully and ethically. But that was not the case in the Albany area. A retired state psychologist who was approached independently by The Times vouched for Ms. Valitutto’s professionalism and offered a similar account, saying the residents in that region were often treated with multiple medications from the same class, a practice discouraged by the medical establishment.

“We would always go to drugs,” the psychologist said. “Once you get a client on a lot of medications, it’s hard to know what’s working and what’s not, and it’s hard to get them off.”

Read Entire Report

http://www.blueridgenow.com/article/20111222/ZNYT04/112223030/1016/opinion02?Title=In-Treating-Disabled-Potent-Drugs-and-Few-Rules

2011-12-26T09:16:00.001-08:00

Tallahassee Scrooges - Letter to the edeitor of Tampa bay online from Carol Novak. She calls Gov Rick Scott Gov Scrooge.http://ping.fm/RDd68

Tallahassee Scrooges - Letter to the edeitor of Tampa bay online from Carol Novak of Clearwater Fl

2011-12-26T09:10:00.000-08:00

Just a few weeks before Christmas, Gov. Rick Scott released his budget proposing another drastic reduction in funding for the Medicaid waiver that provides medically necessary services to vulnerable people with developmental disabilities.
Then, he had his director of the Agency for Persons with Disabilities announce two weeks ago that substantial cuts to consumers' services will begin in January in the area from Tampa Bay to Fort Myers.

If Gov. Scrooge has his way, up to 67 percent of Floridians with developmental disabilities will have essential services cut.

Even in this tough economy, Scott and most legislators lack the courage to cut even a little of the $300 million the state gives out each year to "double-dippers." On the other hand, it doesn't take any courage at all for them to cut funds for vulnerable people — something that Scott and the Legislature have done again and again.

Less than half of the funding for Medicaid waiver services is state money. The remainder is federal matching funds. At a time of high unemployment, these drastic cuts to waiver consumers' services will result in increased unemployment. I guess "Let's get to work" doesn't apply in the case of providing caregivers to vulnerable people whose lives depend on long-term care services.

Medicaid waiver services are the cheapest long-term care. Underfunding waiver services to people with developmental disabilities will ultimately force these vulnerable people into more costly long-term care settings.

This letter is from Carol Novak
of Clearwater Florida

2011-12-24T12:04:00.001-08:00

We're are once again resuming our White House monthly disability calls. In order to help keep you more informed. http://ping.fm/CgwiJ

Monthly Disability Calls.

2011-12-24T11:55:00.000-08:00

Hello Everyone,

We're once again resuming our monthly disability calls.

In order to help keep you more informed, we host these monthly calls to update you on various disability issues as well as to introduce you to persons who work on disability issues in the Federal government.

This call is open to everyone, and we strongly urge and ask that you distribute this email broadly to your networks and listservs so that everyone has the opportunity to learn this valuable information.

We will be addressing a number of issues during this next call since we have not had a call recently.

Also, we will begin answering the questions and issues many of you raised through disability.gov. So, dial in to hear if we answer your question or address your issue.

And, we will have some exciting announcements!

I would encourage you to call in about five minutes early due to the large volume of callers.

The conference call information is below.

Date of Call: 01/18/2012
Start Time: 2:00 PM Eastern (dial in 5 minutes early)
This call will probably last one and a half hour.
We will provide the dial in information and the link for captioning in another email in the first week of January so look for that email.
This call is off the record and not for press purposes.

2011-12-20T14:10:00.001-08:00

Obama calls for home care worker wage reform, but some worry about cuts. This matters to providers in Florida. http://ping.fm/vxR9j

Obama calls for home care worker wage reform, but some worry about cuts

2011-12-20T14:07:00.000-08:00

The Obama administration announced Thursday it plans to extend minimum wage and overtime protection to more than 2 million workers who provide in-home care to frail and disabled people.

These home health and personal care aides give baths, dispense medicine, cook food and run errands — increasingly complex tasks in a fast-aging society. Many work for private agencies funded through public programs like Medicaid and Medicare.

But since 1974, the workers have been lumped in with babysitters as a class of "companions'' exempt from the Fair Labor Standards Act.

"As the home care business has changed over the years, the law hasn't changed to keep up,'' President Barack Obama said in a statement. "Employers are allowed to pay these workers less than minimum wage with no overtime. That's just wrong in this country.''

But some advocates for elderly and disabled people worry that higher labor costs could lead to cutbacks in service.

"This is a double-edged sword,'' said Sally Gronda, director of the Area Agency on Aging for Pinellas and Pasco County. "I support people getting a livable wage, but we have no extra money unless the Legislature gives us more money. The governor has kept all our programs at level funding and I want seniors to get service.''

The home care labor force is already one of largest but lowest paid in the country, according to the 2010 census. About 90 percent are women, and many have no health insurance.

Projections show the home care labor force growing to about 4.3 million by 2018, more than K-12 teachers, public safety employees, fast-food and cashier workers.

The change, which does not require the consent of Congress, would take effect next year after a public comment period. Its impact will vary from state to state and from employer to employer.

Florida had about 130,000 such workers in 2010, earning an average of $9.42 an hour, according to the Paraprofessional Healthcare Institute, a nonprofit advocacy group.

That compares to $12.73 an hour in New Jersey, the highest for home care workers, and the lowest of $8.15 in West Virginia.

Florida's minimum wage is $7.31 an hour — well below the average home care worker's pay. Still, the rule change has far-reaching effects by requiring overtime pay and hourly compensation for drive time to and from a client's home.

Alexis Garcia, 22, of St. Petersburg cares for Eric Biggs about 60 hours a week, seven days a week. Biggs, 51, has cerebral palsy. In the morning, she gets him out of bed and into a wheelchair, bathes and feeds him.

Then she dashes home to help care for her grandparents and her sister's two young boys. At 4:30 p.m., she heads back to Biggs' Kenneth City apartment for light housework, dinner and bedtime.

For this, Advantage Home Assisted Care of Largo, pays her about $8.50 an hour, without overtime. Florida's Agency for Persons with Disabilities reimburses Advantage about $14.04 to cover its overhead, but has been cutting back on coverage and reimbursement for five years, says Advantage's assistant administrator, Jennifer Finnen.

The state authorizes only 35 hours a week of care for Biggs.

"We know he needs 60 hours but we can't bill for it,'' Finnen says. So Advantage swallows the other 25 hours, losing money, she said.

If her company must pay overtime on top of that, "we just can't do it with Alexis anymore,'' Finnen said.

If the new rules happen, Garcia will be cut to 40 hours a week and Advantage will hire another aide to cover the other 20.

"That would really hurt me a lot,'' Garcia said. "I actually took on an extra 15 hours in February this year because I needed the extra money.''

She doubts she can make it up by working part-time at another agency. "Not a lot of other people have the flexibility I need,'' she said. "I watch my nephews.''

Working long hours without overtime risks burnout, said Deane Beebe, spokeswoman for the paraprofessional institute.

"The real issue with this industry is that it can't keep workers,'' Beebe said. "By taking this step, we are professionalizing this workforce in order to build it.''

The law would apply only to employees of companies, Beebe said, not to private arrangements.

Frank Stoker, president of Care Team Home Care of Tampa, welcomed the change.

His company already pays its workers $10 to $14 an hour with overtime, he said, but many of his competitors do not.

"This will take that unfair advantage out of this,'' Stoker said. "I don't care who you are, you should be paid properly.''
By Stephen Nohlgren

2011-12-16T18:36:00.001-08:00

Obama proposal prevents paying companions under minimum wage.http://ping.fm/9Fkwc

Obama proposal prevents paying companions under minimum wage.

2011-12-16T18:34:00.000-08:00

The White House Blog
By the Numbers: $21,000
Posted by Megan Slack on December 15, 2011 at 03:44 PM EST

Today President Obama announced a proposal that would ensure fair pay for the 1.79 million workers who provide critical in-home care services for the elderly and infirm. Because of the way the Fair Labor Standards Act is written, these workers are classified as “companions” and therefore exempt from minimum wage and overtime requirements, despite the fact many of them work up to 70 hours a week. The average salary for full-time, in-home care workers is just $21,000 a year.

When the exemption was established in 1974, it was meant to apply to casual babysitters and companions, not workers whose vocation was in-home care service. Now, as our population ages, the need for professional in-home care services is greater than ever. These workers should be paid fairly for their hard work and long hours and today’s proposed legislation changes would ensure that they are.

Approximately 92 percent of these workers are women, and a large number of them are their family’s breadwinners. Close to 40 percent rely on public benefits such as Medicaid and food stamps to make ends meet. Today’s proposed rule would expand minimum wage and overtime protections by ensuring that all home care workers employed by third parties, like staffing agencies, will receive protections along with workers who are privately employed.

Governor's budget on APD

2011-12-08T08:07:00.000-08:00

Some excerpts

SECTION 11. There is hereby appropriated $16,049,838 in recurring and
$20,650,162 in nonrecurring General Revenue and $20,377,393 in recurring
and $26,218,113 in nonrecurring Operations and Maintenance Trust Fund to
the Agency for Persons with Disabilities to cover the Fiscal Year
2011-12 Home and Community Based Services Waiver costs. This section
shall take effect upon becoming law.

251 SPECIAL CATEGORIES
HOME AND COMMUNITY BASED SERVICES WAIVER
FROM GENERAL REVENUE FUND . . . . . 327,108,667
FROM OPERATIONS AND MAINTENANCE
TRUST FUND . . . . . . . . . . . . 445,358,895
Funds in Specific Appropriation 251 reflect a reduction of $723,736
from the General Revenue Fund and $988,438 from the Operations and
Maintenance Trust Fund as a result of realigning the geographic
differential provider rates for residential habilitation services,
effective July 1, 2012. The differential rates shall be reset to 4.0
percent for each of the following counties: Broward, Palm Beach, Monroe,
Collier, and Lee. The geographic differential rate for Miami-Dade County
shall be eliminated. The agency shall amend provider contracts, cost
plans and rules as necessary to achieve this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $2,817,039
from the General Revenue Fund and $3,847,354 from the Operations and
Maintenance Trust Fund as a result of consolidating the number of
37
F_I_S_C_A_L_ _Y_E_A_R_ _2_0_1_2_-_1_3_ _G_O_V_E_R_N_O_R__’S_
_R_E_C_O_M_M_E_N_D_E_D_ _G_E_N_E_R_A_L_ _A_P_P_R_O_P_R_I_A_T_I_O_N_S_
_A_C_T__________
SECTION 3 - HUMAN SERVICES
prescribed residential habilitation levels from nine to four, effective
July 1, 2012. The agency shall amend provider contracts, cost plans and
rules as necessary to achieve this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $206,779
from the General Revenue Fund and $282,407 from the Operations and
Maintenance Trust Fund as a result of standardizing intensive behavioral
residential habilitation provider rates, effective July 1, 2012. The
agency shall amend provider contracts, cost plans and rules as necessary
to achieve this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $965,307
from the General Revenue Fund and $1,318,362 from the Operations and
Maintenance Trust Fund as a result of rolling back the exceptions to the
total per client annual expenditures limit for tier one, effective July
1, 2012. The agency shall amend provider contracts, cost plans and rules
as necessary to achieve this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $3,613,859
from the General Revenue Fund and $4,935,606 from the Operations and
Maintenance Trust Fund as a result of increasing solo provider rates 25
percent closer to agency provider rates, before rolling back agency
provider rate premiums altogether, effective July 1, 2012. The agency
shall amend provider contracts, cost plans and rules as necessary to
achieve this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $717,804
from the General Revenue Fund and $980,337 from the Operations and
Maintenance Trust Fund as a result of restricting residential
habilitation clients over the age of 21 to limited support coordination
for such services, effective July 1, 2012. The agency shall amend
provider contracts, cost plans and rules as necessary to achieve this
recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $520,095
from the General Revenue Fund and $710,317, from the Operations and
Maintenance Trust Fund as a result of prohibiting billing for behavior
assistant services rendered to clients who also receive residential
habilitation services, effective July 1, 2012. The agency shall amend
provider contracts, cost plans and rules as necessary to achieve this
recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $605,999
from the General Revenue Fund and $827,640 from the Operations and
Maintenance Trust Fund as a result of reestablishing nursing and therapy
provider rates at the same levels as identical services offered under
the Medicaid State Plan, effective July 1, 2012. The agency shall amend
provider contracts, cost plans and rules as necessary to achieve this
recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $362,244
from the General Revenue Fund and $494,733 from the Operations and
Maintenance Trust Fund as a result of prohibiting additional billing to
the day rate for in-home support services rendered to clients who are
not enrolled in tier one, effective July 1, 2012. The agency shall amend
provider contracts, cost plans and rules as necessary to achieve this
recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $1,067,410
from the General Revenue Fund and $1,457,809 from the Operations and
Maintenance Trust Fund as a result of deducting from waiver service
billings an amount equal to that in residential fees collected by
providers, effective July 1, 2012. The agency shall amend provider
contracts, cost plans and rules as necessary to achieve this recurring
reduction.
Funds in Specific Appropriation 251 reflect a reduction of $1,443,204
from the General Revenue Fund and $1,971,047 from the Operations and
Maintenance Trust Fund as a result of consolidating in-home support
services and personal care assistance into a single service category for
clients over the age of 21, effective July 1, 2012. The agency shall
amend provider contracts, cost plans and rules as necessary to achieve
this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $2,355,800
from the General Revenue Fund and $3,217,420 from the Operations and
Maintenance Trust Fund as a result of establishing a statewide client
cost plan review process to verify the continued necessity of authorized
38
F_I_S_C_A_L_ _Y_E_A_R_ _2_0_1_2_-_1_3_ _G_O_V_E_R_N_O_R__’S_
_R_E_C_O_M_M_E_N_D_E_D_ _G_E_N_E_R_A_L_ _A_P_P_R_O_P_R_I_A_T_I_O_N_S_
_A_C_T__________
SECTION 3 - HUMAN SERVICES
services, effective July 1, 2012. The agency shall amend provider
contracts, cost plans and rules as necessary to achieve this recurring
reduction.
Funds in Specific Appropriation 251 reflect a reduction of $383,710
from the General Revenue Fund and $524,050 from the Operations and
Maintenance Trust Fund as a result of establishing a statewide contract
for durable medical equipment and consumable medical supplies, effective
July 1, 2012. The agency shall amend provider contracts, cost plans and
rules as necessary to achieve this recurring reduction.
Funds in Specific Appropriation 251 reflect a reduction of $266,852
from the General Revenue Fund and $364,452 from the Operations and
Maintenance Trust Fund as a result of requiring premium payments or
other cost sharing by the parents of clients who are served by the
waiver and have an adjusted household income greater than 100 percent of
the federal poverty level, effective July 1, 2012. The agency shall
amend provider contracts, cost plans and rules as necessary to achieve
this recurring reduction.
254 QUALIFIED EXPENDITURE CATEGORY
HOME AND COMMUNITY BASED SERVICES WAIVER
RESTRUCTURING
FROM GENERAL REVENUE FUND . . . . . 10,000,000
FROM OPERATIONS AND MAINTENANCE
TRUST FUND . . . . . . . . . . . . 13,657,440
From the funds in Specific Appropriation 254, the recurring sum of
$10,000,000 from the General Revenue Fund and $13,657,440 from the
Operations and Maintenance Trust Fund is provided for the restructuring
of the Home and Community Based Services Waiver. Prior to the release of
these funds, the Agency must document implementation of the policies
outlined following Specific Appropriation 251. The agency is required to
submit a distribution plan for these funds for approval by the
Legislative Budget Commission, pursuant to the provisions of Chapter
216, Florida Statutes

2011-12-07T06:18:00.001-08:00

Disability groups pressure Medicaid to make a final decision to define what qualifies as community-based housing. http://ping.fm/g9ZXp

Disability Groups Urge Feds To Decide On Community Living

2011-12-07T06:14:00.000-08:00

By Michelle Diament | November 29, 2011

Months after the end of a public comment period, dozens of disability
advocacy groups are pressuring Medicaid to make a final decision on new
rules that would define what qualifies as community-based housing.

In a joint letter sent last week to officials at the Centers for Medicare
and Medicaid Services, nearly 100 advocacy groups asked the government
agency to “move swiftly” on a proposed regulation that would limit the
types of qualifying residences under Medicaid home and community-based
services waivers.

The proposal, issued in April, called for the exclusion of homes designed
exclusively for those with disabilities as well as residences with
“regimented meal and sleep times, limitations on visitors, lack of privacy
and other attributes that limit individual’s ability to engage freely in
the community.”

Medicaid officials say the proposed rules were prompted after they heard
reports of homes built on the sites of former institutions that were being
labeled “community-based.”

But months after the public comment period closed this summer, Medicaid
officials have not yet made a move to issue a final rule, which would be
necessary for the regulation to be implemented.

“Any delay is really unfortunate,” says Ari Ne’eman, president of the
Autistic Self Advocacy Network, and one of the organizers behind the
letter. “We’ve got 95 organizations from across the country on board here
and it seems pretty clear that the disability community stands solidly
behind a strong definition of home and community-based services.”

Nonetheless, the proposed rules are not without opposition. Among the
hundreds of public comments submitted to Medicaid were those from parents
who believe that their children would be best served by living in a
community of their peers with disabilities.

Medicaid officials say they have no specific timetable for issuing a final
regulation.

“We do not have a target date for final publication of the regulation but
finalizing it remains a priority,” wrote Alper Ozinal, a CMS spokesman, in
an e-mailed statement to Disability Scoop. “We received a substantial
number of public comments. While we are not surprised by the level of
public input…, we have considerable work to review, categorize, evaluate,
consider and respond to each comment, as required.”

(Embedded image moved to file: pic06334.jpg)
3 Comments (Open | Close)

3 Comments To "Disability Groups Urge Feds To Decide On Community Living"

#1 Comment By disabilitiesrightsadvocate On November 30, 2011 @ 9:25 am

While some people may have been able to convince themselves that these
consumers “would be best served by living in a community of their peers
with disabilities”, the actuality is that we are all peers; with or without
disabilities. The concept behind the most integrated setting set forth by
the Olmstead decision indicates that people with disabilities are more than
capable of living within the mainstream community and this would be
possible with proper supports and services. Individuals with disabilities
would most likely benefit more by living settings beyond group homes,
res-habs and other congregate settings that seemingly mirror the same
parameters of the outmoded institutions. Moreover, the community at large
has the most to gain by having individuals with disabilities living
independently and being integrated into mainstream residences. After all,
individuals with disabilities DO EXIST and have the same rights to
independence as anyone else.

#2 Comments By JR On December 2, 2011 @ 4:17 pm

The changes proposed by CMS last April would limit the use of Home and
Community Based Service Waivers to only those settings found acceptable,
not by the affected individuals, but by advocates following their own rigid
ideology. This ideology is a fantasy of many disability advocates that all
people, regardless of the nature or severity of their disabilities, can
live in “the community” without the specialized programs and settings that
so many rely on for their survival. This ideology is not grounded in the
law, the Supreme Court Olmstead decision, reality, or common sense.

The Supreme Court Olmstead decision supports choice, despite the fact that
it has been widely misinterpreted as a mandate to close all institutions:
“We emphasize that nothing in the ADA or its implementing regulations
condones termination of institutional settings for persons unable to handle
or benefit from community settings…Nor is there any federal requirement
that community-based treatment be imposed on patients who do not desire
it.” 119 S. Ct. at 2187.

Furthermore, the Olmstead decision does not comment specifically on or
mandate the closure of community-based programs or residential placements
of any particular size nor does it designate these programs as
institutional in nature and therefore discriminatory. Olmstead, and by
extension the Americans with Disabilities Act, gives no support to
eliminating or limiting access to settings that are “institution like”,
housing complexes that are “disability-specific” and “expressly designed
around an individual’s diagnosis”, if these services are appropriate to the
needs of the individual.

There are hundreds of thousands of people with disabilities on waiting
lists for services across the country and there is no shortage of ideas for
improving the lives of people with developmental disabilities. When CMS
deliberately and unnecessarily narrows the choice of options available
based on a misinterpretation of law and a questionable ideology, it becomes
an impediment to creating a system that can truly meet the needs of the
full range of people with developmental disabilities, especially for those
who are either not served at all or inadequately served by our current
system.

#3 Comment By kathyd On December 2, 2011 @ 6:57 pm

There is a very broad spectrum of needs represented by the part of our
population who have developmental disabilities. The point of a continuum of
care is to address the unique needs of individuals. Additionally, the
element of choice is legally mandated. The American Disabilities Act, as
well as the Supreme Court Olmstead decision which interprets it, very
specifically defines the right of choice of an institution as well as
“community.” For some, specialized communities can and do provide for
assisted independence in ways that living accommodations in the general
community cannot or does not. Given unlimited money, perhaps that would be
less often the case, but public funding must be stretched to meet the needs
of as many people as possible. I lived for years with the ideal that my
family member with profound id and extremely severe physical disabilities
would live happily in the general community. Truth? Our family was unable
to sustain the constant levels of attention that her conditions required
and, elsewhere in the general community, there proved not to be nearly
sufficient resources for her: financial, personal or professional. The care
that was available to her and others with such severe disabilities was so
pathetically sub-standard that it would never have been tolerated by CMS in
an institution. She now lives in a community of peers with disabilities.
Her choice of bedtime IS honored, her likes and dislikes ARE taken into
account and she is supported in choices that accommodate both. All of her
professional services are centrally located so she can have appointments
without yielding all the rest of the day to them. She does not have a job
in the general community, but then, that would be absurd, since her mental
age, while still progressing at age 62, is still not greater than 24
months. She does, however, enjoy a short bus ride to and from work 5 days a
week. And she DOES enjoy her supported workshop job of crushing cans, which
she does by hitting a big red button. She is delighted with the sound it
makes. Would she like to do something else instead? Other jobs have been
offered and she has tried them, but this is what she likes best. Where she
lives, in a shared home on a campus that is designed specifically to
accommodate the unique and varied needs of people with disabilities, she is
very happy and extremely well cared for. And, economy-of-scale works in
favor of keeping costs for such care lower than in small homes scattered
throughout the general community. Is this how everyone with disabilities
should be required to live? Absolutely not. Everyone should be allowed and
encouraged to exercise their right of choice and the CMS should leave bias
out of their rule-writing. Could her professional providers also serve
people who live off campus? Absolutely. Is there unused property on the
campus that could be developed for independent living by people with dd/id
in proximity to needed professional resources? Absolutely. Should anyone be
required to live there? No, of course not. Should people be allowed to
choose to live there? Absolutely. Lets let CHOICE really work and take
advantage of the benefits afforded by it.

2011-12-05T09:45:00.001-08:00

APD to charge people with disabilities for their care.
http://ping.fm/tmE97

APD to charge people with disabilities for their care

2011-12-05T09:42:00.000-08:00

TALLAHASSEE, FL (wfsu) - "Those who have, will have to pay at least a
little." That's the essence of a new Florida rule that takes effect the
first of the year. It will require some people who have disabilities to
turn over any excess income they have to help pay for the services they
receive. Tom Flanigan reports there are still those who believe the new
rule will impose too much of a hardship.
It was the last of two public hearings on the new rule at the Tallahassee
headquarters of the Agency for Persons with Disabilities, commonly referred
to by its acronym "APD". Agency Attorney Jonathan Grab urged the conference
room audience to be open and honest with their input.
"Any language, particularly specific language, that you guys can help us
with and provide as suggestions any citations I mean basically that's part
of why we're here today to get your input and your assistance with this
process."
The focus of the hearing is a new rule that essentially imposes a means
requirement on certain people who have disabilities. They are among the
thirty-thousand Floridians with developmental disabilities who are cared
for in group homes, foster care facilities, residential rehab centers or
comprehensive transitional education programs. Today, the total cost of
that care is provided under something called the "Home and Community-Based
Services Medicaid Waiver."
But after January first, that will no longer be the case for some eight
thousand of those clients. That's because any income they receive over a
living allowance of just over ninety-three dollars, will be sent to APD to
help defray the cost of the service they receive. Agency Deputy Director
Charles Ball says it's the only way to deal with a harsh reality.
"If you look at the global situation with the APD budget that we have, the
history of the last fiscal year is spending about $120 million more on a
population of individuals than the Florida Legislature has provided funding
for."
At the same time, Ball says, there is a waiting list of some
twenty-thousand clients to get into the program. The new rule, he says,
will help plug the budget gap by around eight million dollars. The
requirement to send APD anything deemed "excess income" upsets Sandy
Dayton. She and her husband have a 21-year-old son who has a developmental
disability.
"In reality, because we have worked very hard and we will die one day and
that extra money gives us a sense of security to know that my son will get
extra Social Security because of our hard work but we're gonna give it to
you."
Dayton ended her questions and concerns with a single statement:
"Yes, this is all legal, but is it moral? Just asking."
Stacey Ricketts has concerns, moral and otherwise, too. She's director of
operations for the Threshold Center for Autism in Winter Park and is
responsible for thirty-two residential clients and one in-home client. One
of these clients is 51-year-old "WC" and Ricketts says the new rule would
be particularly hurtful to him and his family. That's because WC's parents
pay his premium for a pre-paid burial plan, which is considered income
under the new rule.
"He gets more than most people do, but his parents want him to be buried
with them. They are elderly; we help them administer his stuff. If you
apply what you're saying in this rule, he's going to be $10,000 in the hole
in 2012. So what am I going to go to his parents and say, I'm sorry. He
can't be buried with you.'"
And Ricketts says service providers like hers could even be in danger of
having to shut down because of the new rule.
"It does cost more than the legislature understands to care for people with
these kinds of disabilities. They need to be educated. So it goes beyond
APD. Maybe APD needs to take the stance of trying to educate them how much
does it really cost to care for an individual?"
But that education will have to wait for the next legislative session. The
new fee collection rule, with whatever minor tweaks are made, takes effect
the first day of 2012.
Tom Flanigan, Florida Public Radio/WFSU-FM (2011-12-02)

2011-12-01T08:16:00.001-08:00

Verifying Medicaid Recipient Eligibility Training Teleconference. December 14, 2011 from 2:00 p.m. - 3:00 p.m http://ping.fm/VyAsX

Verifying Medicaid Recipient Eligibility Training Teleconference

2011-12-01T08:13:00.000-08:00

Health Care Alerts & Provider Alerts Messages
November 2011

Provider Type(s): All

Provider Training:

December 14, 2011 from 2:00 p.m. - 3:00 p.m., Eastern Standard Time

Verifying Medicaid Recipient Eligibility training will be held Wednesday,
December 14, 2011 from 2:00 p.m. - 3:00 p.m., Eastern Standard Time.

Medicaid providers are invited to participate. The training will be
performed via teleconference. To join the teleconference training,
please dial 1 (888) 808-6959 and at the prompt enter the conference code:
3054466900.

You don't need to register or reserve space. Just call at the designated
time.

The training will follow a PowerPoint presentation found at
http://ahca.myflorida.com/Medicaid/e-library/index.shtml. To download
the presentation to view during the teleconference, click on the Upcoming
Training and Schedules tab, then right click on the picture of the
presentation, choose "Save Target" and save a copy of the presentation to
your computer. You may also click on the picture of the presentation and
view it online.

Please have a copy of the PowerPoint presentation available before the
teleconference so you can follow along.

Any questions can be emailed prior to or during the teleconference to:
elibrarytraining@ahca.myflorida.com. If you have any questions about the
teleconferences, please contact the: elibrarytraining@ahca.myflorida.com.

2011-12-01T07:29:00.001-08:00

APD holds another rule hearing December 2, on residential fee collection. http://ping.fm/p2paZ

APD Holds another Rule Hearing

2011-12-01T07:25:00.000-08:00

APD Holds Rule Hearing

TALLAHASSEE — Agency for Persons with Disabilities (APD) will

host another rule development workshop in Tallahassee on Friday,

December 2, on residential fee collection.

The meeting will be held at the APD Central Office, 4030

Esplanade Way, in Conference Room 301 from 9 until 11 a.m. Comments

will be taken from the public during the meeting to develop the rule

for residential fee collection.

Residential fee collection will require individuals who have

income to help pay for the services they receive in a group home,

foster care facility, residential habilitation center, or

comprehensive transitional education program. APD customers will

still receive a monthly personal needs allowance before turning

excess income over to help pay for their services.

2011-11-30T01:07:00.001-08:00

Upcoming APD cost-containment plans and cuts. http://ping.fm/eV6MS

APD cost-containment plans, upcoming

2011-11-30T01:05:00.000-08:00

APD Announces Schedule

TALLAHASSEE — Agency for Persons with Disabilities (APD) Director Mike Hansen presented an update on the agency’s cost-containment efforts today to the House of Representatives Health Care Appropriations Subcommittee.

The Legislature approved $810 million for APD’s Medicaid waiver for the 2011-12 state fiscal year that began on July 1. APD customers received $930 million worth of services last year. The agency has been working to bring its waiver expenditures within the Legislative appropriation this fiscal year. The agency is also looking for opportunities to increase waiver flexibility and equity for customers, while continuing to protect their health and safety.

Earlier this month, APD shared five cost-containment initiatives with various legislative committees that would reduce APD’s waiver obligations. The director was asked to bring back a proposed timeline for implementing the changes. The timeframes may be contingent on developing new rules or federal approval from the Centers for Medicare and Medicaid Services (CMS).

At today’s meeting, Hansen announced plans to standardize payment rates for intensive behavior residential habilitation beginning January 1, 2012. Also on that same date, the agency will begin collecting fees from APD customers who have income to offset some of their costs of living in a group home.

APD plans to reduce the rates it pays for therapy assessments and all nursing services to the standard rate paid by the Medicaid State Plan beginning April 1, 2012. Currently, the APD Medicaid waiver pays higher rates for most of these services.

Also on the same date, APD will reduce the difference it pays between solo providers and agencies for waiver services to no more than 20 percent. Currently, those rates may differ up to 43 percent.

There was no timeline announced today for implementing cost sharing for parents who have children on the Medicaid waiver. APD is working with the Agency for Health Care Administration on this issue. The change to the waiver requires federal approval.

After pursuing these cost-containment initiatives to APD’s Medicaid waiver, the agency expects to realize more than $14 million in reduced expenditures on an annual basis.

The agency annually serves about 35,000 Floridians with developmental disabilities of mental retardation, autism, cerebral palsy, spina bifida, and Prader-Willi syndrome. For more information on the agency, call 1-866-APD-CAREs or visit http://apdcares.org.

2011-11-29T08:23:00.001-08:00

Crime Against Persons with Disabilities, 2008-2010 - Statistical Tables. http://ping.fm/Ha8yz

Crime Against Persons with Disabilities, 2008-2010 - Statistical Tables

2011-11-29T08:19:00.000-08:00

October 13, 2011 NCJ 235777

Presents estimates of nonfatal violent victimization (rape, sexual assault, robbery, aggravated and simple assault) against persons age 12 or older with disabilities, from 2008 to 2010. Findings are based on the National Crime Victimization Survey (NCVS). The report compares the victimization of persons with and without disabilities, types of disabilities, and victim and crime characteristics using population estimates based on the Census Bureau's American Community Survey (ACS). Data are presented on victim and crime characteristics of persons with and without disabilities, including distributions by age, race and sex; offender weapon possession; victim injuries; and reporting to the police.

Highlights include the following:

Persons age 12 or older who had disabilities experienced an estimated 567,000 nonfatal violent crimes in 2010.
In 2010, the age-adjusted violent victimization rate for persons with disabilities (28 violent victimizations per 1,000) was almost twice the rate among persons without disabilities (15 violent victimizations per 1,000).
In 2010, for both males and females the age-adjusted rate of violent crime was greater for those with disabilities than the rate against those without disabilities. The rate for males with disabilities was 23 per 1,000, compared to 16 per 1,000 for males without disabilities; for females with disabilities the rate was 26 per 1,000, compared to 15 per 1,000 for females without disabilities.
for more information go to - http://bjs.gov/index.cfm?ty=pbdetail&iid=2238

2011-11-28T10:35:00.001-08:00

Need to advertise a job opening? We reach thousands in the home healthcare field. Call Aaron Nangle (727) 841-8943 for advertising options.

2011-11-28T10:21:00.001-08:00

Company looking for support coordinator with experience in the Tampa Bay area - cases are in Hernando County- Call (352) 279-4337.

2011-11-23T07:58:00.001-08:00

Free autism screenings for children. http://ping.fm/6PZfL

Free autism screenings for children

2011-11-23T07:56:00.001-08:00

The Children's Hospital of Southwest Florida, in partnership with the Ronald McDonald House Charities of Southwest Florida, offers a free monthly autism spectrum disorder screening for toddlers 18 months to five years of age.

The next screening will be held Nov. 18 from 9:30 a.m. to 2 p.m. at the Cape Coral Library, 921 SW 39th Terrace, Cape Coral (rescheduled from Nov. 4)

The following month, a screening will be held on Dec. 2 from 9:30 a.m. to 2 p.m. at The Family Health Center, 2256 Heitman Street, Fort Myers.

It is estimated that one in every 150 children is diagnosed with some form of Autism Spectrum Disorder, making it more common than childhood cancer, juvenile diabetes and pediatric AIDS combined, health officials say.

Medical consultants for the project stress that an early diagnosis can make a vast difference for toddlers and their families. They say early intensive behavioral intervention can make an immense difference not just in the development of the child, but in their families as well.

The ASD screening is conducted by the Neurosciences Center at The Children's Hospital, under the guidance of pediatric neurologist Dr. Jose Colon. The screenings are administered by an advanced registered nurse practitioner, who has extensive training and experience in typical child development and developmental disorders.

A physician referral is not required. To schedule a screening, call 239-343-6838.

2011-11-21T07:37:00.001-08:00

Circle K Presents Check for $332,000 to United Cerebral Palsy They have contributed more than $1 million to UCP in 2011 http://ping.fm/Qw8ET

Circle K Presents Check for $332,000 to United Cerebral Palsy

2011-11-21T07:34:00.000-08:00

Circle K Presents Check for $332,000 to United Cerebral Palsy
Retailer has contributed more than $1 million to UCP in 2011; receives group's highest honor
CSP Daily News | November 21, 2011 TAMPA, Fla.-- From its FishStix event, an annual golf and fishing tournament, as well as from funds raised through canister donations throughout the year, Circle K presented a check for $332,000 to United Cerebral Palsy (UCP). The donation brings the convenience store chain's total contribution to UCP to more than $1 million in 2011.

The check presentation ceremony included Circle K and UCP executives from the Florida affiliates that benefit from Circle K donations, representatives from UCP's national office in Washington, D.C., and Circle K executives, regional operations directors and store managers.

Darrell Davis, who was appointed vice president of Circle K's Florida region in Spring 2011, welcomed everyone to the ceremony: "At its heart, Circle K is a group of committed individuals who care deeply for the communities where we operate. For more than three decades, our partnership with UCP has been one of the most important outlets for Circle K to give back to the people we serve. We look forward to strengthening our ongoing relationship with UCP and are extremely proud to play a role in providing a life without limits for people with disabilities."

Leaders from several UCP Florida affiliates remarked on the incredible impact Circle K's partnership has had on the work they do every day. Summing them up, Craig Byrd, executive director of UCP of East Central Florida, said, "In these trying economic times, you hear every day how the government is able to do less and less for the people in the most need in our community. We really rely on our community partnership with Circle K to help us continue to provide services that are so critical to hundreds of people with disabilities."

When Circle K Corp. purchased the UtoteM chain of convenience stores in 1984, management adopted UCP as the company's designated charity. Today, UCP remains Circle K's charity of choice in the Florida and Gulf regions. Circle K stands as UCP's largest corporate sponsor, having raised more than $40 million over the life of the partnership through coin collection canisters at retail sites and with special events like golf tournaments, casual days, bake sales and car washes.

Circle K and UCP have launched two new campaigns. Since September 1, the "Adopt a Child/Adopt a Life" campaign helps to celebrate and promote the tremendous difference that Circle K has made in communities across Florida. Unlike the earlier coin collection campaigns, each Circle K store now features the story and photo of a UCP client that lives in the region that that particular store serves. Circle K customers donating at the register now know they are supporting those in their immediate community.

This type of targeted campaign that ties donors to outcomes is designed to trumpet the good work of Circle K as a community partner and good corporate citizen. At the same time, it will raise public awareness of UCP and the services it provides to people with disabilities, and raise crucial funds that will change their lives for the better.

Beginning November 2 and running through the holiday season, Circle K patrons will have the opportunity to purchase a "star" that includes coupons for in-store use on select products. The star will be hung throughout the stores to raise awareness of Circle K's support of UCP, visualize the incredible impact that individuals can have on the lives of people with disabilities in their communities, and encourage other customers to support as well.

"We're excited to herald Circle K's deep philanthropy by showing people in the communities where a Circle K is doing business that their donations are impacting real lives in the towns and cities where donations are being collected," said Michael Hill, UCP's senior vice president for external affairs. "In this way, we shine a spotlight on the radical difference that Circle K is making in the lives of people with a spectrum of disabilities."

UCP presented Circle K with its Chair Award--its highest honor--during the 2011 UCP Annual Conference in recognition of its efforts. UCP presented the 2011 Chair Award to Jason Broussard, vice president of the Circle K Gulf Coast Region, and to Davis.

Bruce Merlin Fried, chair of UCP's national board of trustees, said it was an easy decision to honor Circle K. "We know that Circle K's philanthropic efforts make significant contributions in the communities where they have a presence, but for UCP, Circle K has been a central part of advancing the civil rights movement for people with disabilities. Few companies can claim that level of impact. We applaud Circle K for not only transforming lives but making a long-term commitment to UCP."

Stephen Bennett, president and CEO of UCP, said, "Corporate partnerships can have a dramatic impact on the work of organizations like UCP. But the partnership with Circle K goes beyond a partnership; it has literally been a cornerstone experience for thousands of Circle K employees for decades and the efforts of those employees have forever changed the lives of thousands of people with disabilities around the nation."

UCP educates, advocates and provides support services to ensure a life without limits for people with a spectrum of disabilities.

Laval, Quebec-based Alimentation Couche-Tard Inc., with annual revenues of more than $15,8 billion, has a c-store network of more than 5,800 stores. These stores--under three main brands, Couche-Tard, Mac's and Circle K--are located across 10 provinces of Canada in three geographic markets (East, Center and West), and across 43 American states and the District of Columbia in eight major markets (Great Lakes, Midwest, Southeast, Florida, Gulf, Arizona, West Coast, Southwest).

2011-11-14T20:43:00.001-08:00

People with disabilities finding it hard to secure employment. Some finding success opening their own business. http://ping.fm/OGK57

2011-11-14T20:38:00.000-08:00

For those with disabilities, a new entrepreneurial spirit
November 12, 2011By Kate Santich, Orlando Sentinel

If you think the job market is tough for the able-bodied, consider the case for those with disabilities.
In Florida, estimates of the jobless rate among disabled, working-age adults — including large numbers of young, severely injured soldiers returning to civilian life — run as high as 50 percent.
To address the problem, nonprofit organizations and government agencies recently have begun pushing an option that many with disabilities may have once thought unlikely: becoming entrepreneurs.

"We're seeing a major influx of people saying, 'What I really want is to start my own business,' " said Rogue Gallart, president of the Central Florida Disability Chamber, a nonprofit created in 2009. "We work with clients across the board to help them write their business plans and then assist them in finding the funding they need.
"Essentially, we're a business incubator."
With expert advice and grant money available for startups, the chamber already has helped write 17 business plans and has 20 more in the works. As the only organization of its kind in the state — and one of the few in the country — it now handles referrals from throughout Florida.
Businesses run the gamut from Internet-based companies to street-corner food carts to construction companies.
"They are wonderful," said Ayla Topgul, an expert seamstress and designer. After more than 40 years in the industry, she couldn't find work because shoulder, back and foot problems limited her mobility — and her job options.
"I am happy now."
Topgul lost her home and car during the years she spent trying to get someone else to hire her. Turned down on her initial application for federal disability payments — a relatively common occurrence — Topgul didn't bother appealing.
"What she really wanted was to work," said her daughter, Aydan Topgul. "She said to me, 'What am I supposed to do? I can't just sit around all day.' And she can't. She always has to be doing something."
The 63-year-old Topgul went first to Workforce Central Florida, which sent her to the state's Division of Vocational Rehabilitation, which ultimately referred her to the Central Florida Disability Chamber. There, the two-person staff analyzed her notion of starting her own business, wrote a business plan, secured a state grant of $85,000 for industrial sewing machines and other startup costs, and helped her find a storefront.
Opened last year, Angora Design Studio in Winter Park is still trying to make a name for itself, and it is just now at the break-even point. But Ayla Topgul is thrilled.
"I know I do good work for people," she said, pointing out meticulous alterations, handmade lace and a series of custom and intricate wedding gowns. Adds her daughter: "If you show her a picture, she can make it."
Keys to success
Family support is often critical to the success of a business venture, Gallart said. New businesses typically lack the means to hire outsiders, so having someone who will either pitch in for free — or help with living expenses while the entrepreneur is building a customer base — can be the difference between making and breaking a young enterprise.
Although the chamber's track record is too short to be definitive, so far about 95 percent of the businesses launched are still open.

Peter Schoemann, a Central Florida attorney who created a National Chamber of Commerce for Persons With Disabilities before realizing the issue needed a more localized approach, said Gallart's organization is "a fantastic place." In fact, his group is now getting requests from New York; Washington, D.C.; and Texas to replicate the Central Florida model.
But entrepreneurship is not for the faint of heart, he cautions.
"You have to have willpower," he said. "It's one thing to have a good idea. It's another to be willing to put in the effort 24-7 to run your own business."
And for those receiving government disability payments, there is a strong disincentive, Schoemann said.
"It blows my mind the way the current system is set up: The moment you earn more than the ridiculously low income allowed, you're going to risk getting kicked off. Yet that's long before a new business owner can make enough money to survive."
'More determined'
On the flip side, Schoemann said, many entrepreneurs with disabilities are more determined than their typical able-bodied counterparts. Often, they've spent years — or even a lifetime — overcoming barriers.
For Bill Miller, a 35-year-old Lake County quadriplegic, the inability to walk, sit up, move his arms or take care of his own physical needs has only magnified his drive to succeed. Injured in a freakish fall at age 20, he belatedly returned to college online, completed a bachelor's degree in business administration with a 4.0 grade-point average and is now working on his master's degree in entrepreneurship.

In the process, using a voice-activated computer, he also has worked as a movie reviewer for a Leesburg newspaper and helped to invent and market the IKAN Bowler — a wheelchair-mounted device that allows quadriplegics to bowl. The invention, pronounced "I can," empowers even those who navigate with a sip-and-puff mouthpiece to aim and release a bowling ball, giving them a rare recreational outlet and much-needed fun.
"Right now it's an extremely tough market, and this is not a low-cost product," Miller said of the 30-pound bowler, which sells for $699. "Right before the recession hit, we were just starting to turn a profit."

Miller sees his future in teaching, both online and in a classroom. And his ultimate goal, he said, "is to be a contributing member of society. I don't want to be supported by taxpayers."
VA joins effort
Toward that end, the Department of Veterans Affairs also is pushing an agenda of self-employment for its disabled veterans. The National Science Foundation recently awarded a three-year, $100,000 grant to Maitland-based Blue Orb Inc., parent company of the keyless-computer-keyboard maker orbiTouch. The device allows those without fine-motor dexterity in their hands to easily navigate a desktop computer.
Partnering with the VA, orbiTouch is enlisting veterans and others with disabilities to foster their entry into the world of entrepreneurship.
For 42-year-old Rodney Cruce of Orlando, a service-disabled veteran, the efforts can't come quickly enough. After more than two decades in the Army and deployments in Afghanistan and Iraq, he left in 2009 and soon discovered he lacked the connections and networking in civilian life to quickly grow his business, On Point Saliency.
The security and crisis-management company, which trains business personnel planning to travel or operate overseas, has impressive credentials and expertise. But Cruce still struggles to get face time with corporate decision-makers.
"Part of it is the recession," said Cruce, a former Army commander. "But that [lack of connections] really has been the hardest part.
"I don't want anybody to think I'm asking for a handout — because I'm not — but I just want to be as successful in the civilian sector as I was in the military."

ksantich@tribune.com or 407-420-5503

Florida Unites - Be Part Of The Solution

2011-11-14T10:17:00.000-08:00

Florida Unites - Be Part Of The Solution

2011-11-11T07:37:00.001-08:00

For disabled adults a question about where to live. Without adequate funding the provider funding system is in jeopardy.http://ping.fm/kSfTa

For disabled adults, a question about where to live

2011-11-11T07:28:00.000-08:00

For disabled adults, a question about where to live

John Cavanaugh who lives in a group home for people with various intellectual disabilities in Trumbull, Conn. hugs his sister goodbye after she stopped by for a visit on Friday October 21, 2011. This particular group home is private and run by the Kennedy Center which is based in Trumbull.

"Without adequate funding, the private provider funding system is in jeopardy," said Martin Schwartz, president of the Kennedy Center, a private facility in Trumbull. "I would feel extremely unfortunate if funding were to become not adequate for continued viability. Then the state will have one solution, to provide all services directly through the state at much greater cost."

State employees at the sole remaining institution in Southbury run by the state, by contract, cannot be laid off even as the number of clients decreases. The staff is, instead, redeployed to other state facilities. No new admissions have been allowed to the institution since 1986 and the remaining clients are slowly being placed in smaller residential settings or die. A 2011 labor agreement also prohibits broad layoffs for the next four years.

When the second-to-last remaining institution in Mansfield was closed in 1978, the labor contract mandated state employees had to remain employed in the same geographical area.

WORKING TOGETHER
Some families are coming up with their own solution for adults housing for relatives with intellectually disabilities.

In Fairfield County, a group of about eight families are exploring independently finding a house for their children to live in. One of the mothers recently reached out to Cathy Petrone to see if Matt could be a part of the group.

The benefit, Petrone was told, is that parents could share the costs of the house and the care instead of trying to cover it all on their own. They would still need some level of state assistance, however.

"We're in the very beginning, infant stages," Cathy Petrone said. "We're a bunch of parents talking to each other. We're trying to figure out, are our kids compatible? And how would this run? We're hoping for state reimbursement. It's a complicated financial picture."

This independent model has worked in Westchester County, N.Y., and also other parts of Connecticut. The Cottage in Ridgefield, for example, was opened in 2004 after a group of parents came together in 1999. A little more than half of the funding for the six-person home came from the state.

But Petrone said Matthew's caseworker told her money for similar projects has gotten extremely tight.

While the Petrone family is making plans for Matthew, many parents aren't aware of the challenges in finding care for their children with disabilities.

"The people on the waiting list are identified," Glomb said. "The scary thing is, if you look at statistics for developmental disability and the number of people we know about, it becomes pretty clear there are large numbers of people out there who aren't accounted for. There are still aging parents out there who haven't thought about it yet. They do not realize this is going to befall them sooner or later."
by ctpost.com Vinti Singh, Staff Writer

2011-11-08T11:14:00.001-08:00

John Ross runs ALF homes despite reports of abuse, rapes, & deaths of his residents. Task force wants law to ban him.http://ping.fm/Goulh

Time to ban ALF caregivers who abuse, state is told

2011-11-08T10:57:00.000-08:00

Time to ban ALF caregivers who abuse, state is told
By Carol Marbin Miller and Michael Sallah The Miami Herald

Florida disability administrators are recommending a ban on caregivers who have harmed residents living in ALFs.
By Carol Marbin Miller and Michael Sallah
cmarbin@MiamiHerald.com
When a mentally ill resident of the Hillandale assisted living facility left the home before dawn in August 2007, administrator John Ross instructed a caregiver not to search for him until the next day’s staff arrived. By then it was too late: the man, Co Dang, was struck by a car and killed.
Elder abuse investigators put the blame for Co’s death partly on Ross, saying the administrator had left him in harm’s way by failing to act.
But the Department of Children & Families’ finding had no consequence: Ross was allowed to continue running the Pasco County ALF, and one other, for another four years while the home racked up dozens of new violations. Ross continues to run the home even as the state seeks to close it.
Now, the leaders of Florida’s disabilities agency are recommending that administrators or caregivers who are held responsible for the abuse or neglect of a resident be permanently barred from working at an ALF.
That’s the way the law used to be, but it was changed. Current law states that “information in the central abuse hotline may not be used for employment screening.”
The proposal is a key recommendation before members of a special task force that is looking for ways to improve conditions at the state’s roughly 2,960 ALFs, many of them in South Florida. The work group will hold its final meetings Monday and Tuesday at Florida International University’s main campus in Miami.
The task force, whose members were appointed by Gov. Rick Scott, was formed in response to a series of stories, called Neglected to Death, in The Miami Herald last May. The reports said state healthcare regulators had allowed scores of homes to stay open , even go unpunished altogether, for sometimes severe violations of state law.
The state Agency for Persons with Disabilities submitted several recommendations to the work group, some of them prompted by their frustrations over Hillandale, which housed many clients of the agency. The disabilities agency went so far as to cut all funding to Hillandale under a program that sets aside Medicaid dollars to encourage disabled people to live in community settings. But the cutoff had no effect as a separate government entity, the Agency for Health Care Administrators, continued to both fund Hillandale and allow it to remain open.
“I was dumbfounded,” Jim de Beaugrine, former director of the disabilities agency, said of his reaction when administrators realized Ross was allowed to continue running an ALF for disabled people after he was held responsible for the death of a resident. “It was shocking.”
“If they are that callous, they should be barred from working with [residents] further. The past is the best predictor of the future when it comes to behavior.”
Disability administrators also are recommending that lawmakers require healthcare inspectors to report suspicions of abuse or neglect at an ALF to the state’s abuse hotline, and to allow the healthcare agency to use DCF’s abuse database to “pursue sanctions” against homes that repeatedly are held responsible for mistreating residents. The disabilities agency proposes that the AHCA be allowed to deny, revoke or suspend the license of an ALF if the owner is named in a verified abuse report.
What’s more, the disabilities agency would like the healthcare agency to change its rules to prohibit ALF staffers from working directly with vulnerable residents while an adult-abuse investigator is looking into allegations of abuse or neglect.
Current law “allows for the verified perpetrators of abuse, neglect or financial exploitation to continue working with vulnerable populations as long as none of those cases subsequently results in prosecution and conviction,” agency leaders wrote. Bentley Lipscomb, a former secretary of the Department of Elder Affairs, said only about 3 percent of elder abuse or neglect cases referred to state’s attorneys offices are ever prosecuted.
Ross, who still operates Hillandale, said ALF owners will vigorously fight any change to state law that allows regulators to use the state’s confidential abuse registry to screen employees. Ross said it would be unfair to screen caregivers based on reports to which they do not have access. “DCF never said anything to me about that case whatsoever,” he said.
The Florida Assisted Living Association “would never let that fly,” Ross said, referring to the state’s ranking industry group.
Hillandale is not the only home that employed, or was run by, caregivers found directly responsible for the death or neglect of an elderly or disabled Floridian. The Herald found scores of cases in which an employee or administrator was the subject of a report that investigators “verified” as a case of abuse or neglect. In many cases, the caregivers remained on staff, even after they were caught beating, starving or illegally restraining vulnerable residents.
DCF put the blame squarely on three caregivers in the death of Magdalena Marrone. Staff failed to give her life-saving heart medication for four days in 2009 — and then gave her the wrong drugs on the day she died.
An assistant administrator who lost track of her medical charts and two nurses were named in the 82-year-old woman’s death at Emeritus at Crossing Pointe, an Orlando home that’s now an independent living facility.
Authorities could not say how many times Co Dang had run away from Hillandale; a state report says “the staff did not document or log an incident report in such instances.” But one staff member suggested Co had left the home at least eight times, and the Pasco Sheriff’s Office reported returning him to the ALF at least twice.
Nevertheless, when the lone caregiver supervising 17 residents called Ross before dawn on Aug. 21, 2007 to report that Co was missing, Ross, investigators said, instructed the staffer “to just wait until day shift staff arrived and they could look for him.”
Ross insists neither he nor the home did anything wrong: “You cannot lock someone into an ALF; you can’t do that,” Ross said Friday. “The client has rights.”
But Lipscomb, the former elder affairs secretary, said the state has no business operating an abuse registry if caregivers found to have committed egregious abuse or neglect are allowed to continue working with elders.
“It’s just a waste of taxpayer dollars,” Lipscomb said.
The father of a 27-year-old woman whom police say was raped by a caregiver at Hillandale last May said he and his wife would have looked elsewhere for a home for their disabled daughter had they known about the administrator’s record.
“We would not have even considered it,” said the 61-year-old Safety Harbor resident, who is not being identified to protect the privacy of his daughter. “No one in their right mind would.”
“So much could have been prevented had that law been in effect,” the man added. Read more: http://www.miamiherald.com/2011/11/06/v-fullstory/2487752/time-to-ban-alf-caregivers-who.html#ixzz1d8rnrLz1

2011-11-07T08:21:00.001-08:00

AHCA - Florida Medicaid - Statewide Prepaid Dental Health Plan Website Launch is now up and going.
http://ping.fm/bhwwP

Statewide Prepaid Dental Health Plan Website Launch

2011-11-07T08:13:00.000-08:00

FLORIDA MEDICAID

A Division of the Agency for Health Care Administration

Statewide Prepaid Dental Health Plan (PDHP)November 2011
Statewide Prepaid Dental Health Plan Website Launch

The new website for the Medicaid Statewide Prepaid Dental Health Plan has been launched. Please visit www.AHCA.MyFlorida.com/MedicaidPDHP.

Please send any questions to: StatewidePDHP@AHCA.MyFlorida.com.

2011-11-06T14:47:00.001-08:00

IBudget Florida was designed to meet needs of disabled, but 22 percent will lose half their allocations for services.http://ping.fm/Up0IP

Fla. Senate ponders cuts for developmentally disabled

2011-11-06T14:44:00.001-08:00

TALLAHASSEE, Fla. -
A Senate committee Thursday encouraged Mike Hansen, director of the Florida Agency for Persons with Disabilities, in his quest to trim spending at the chronically cash-strapped agency although his plan will likely result in major service cuts for APD clients.Hansen told the Senate Committee on Children, Families and Elder Affairs that more than half the 30,000 Floridians who receive services via a Medicaid waiver would see reductions under the iBudget plan, which uses a formula to determine how much each client gets, and that 22 percent would lose half their allocations.I know its hard to determine the difference between what someone needs and what they want, he said, but were trying to figure out a way to do that.APD has a $10.5 million deficit for the 2010-11 fiscal year, and is also trying to find tens of millions of dollars in savings to balance this year's budget. The transition to the new plan began Oct. 1 in the Panhandle and Big Bend regions, and APD hopes to take it statewide by July.Lawmakers were generally enthusiastic, citing the agencys long history of shortfalls, and Sen. Nancy Detert, R-Venice, called iBudgets a more realistic approach than in the past.I dont think we ever gave [APD] enough money to run the program properly, she said, so youre setting them up for failure. Lets be a little more honest about budgeting needs, and maybe they can then stay within their budget.Sen. Ronda Storms, R-Brandon and the committee chairwoman, agreed. "Tolerance is very low for needing more money from the appropriations people because it seems that, from the Legislatures perspective, no matter how much we allocate, we will always need more money [for APD]."Storms also said she wanted committee members to look at the cuts as a way to avoid managed care, "which I think is a really serious threatmuch, much worse for the population."Using a visual display titled Hard Choices, Hansen gave examples of which plans would apply to which clients. Only core services defined as those necessary to maintain health and safety would qualify for funding.But Senate Democratic Leader Nan Rich, D-Weston, said cuts to services such as Adult Day Training would erode the clients quality of life and should be preserved where possible."I just dont believe people can sit in their homes all day long," she said. "Its so counter-productive to trying to get people to be self-sufficient. Somehow we have got to find a way for people who need that to be able to have that service."No one expected the cuts to go over well."I know we will be sued," Storms said."Anybody who gets a cut of 40 percent or more, were going to be hearing from those folks in our home district," said Detert.Hansen noted that when APD shifted its service delivery system to its previous "tier" system, which also capped individual budgets according to a formula, 6,000 clients demanded fair hearings."So as we do this," he said of iBudgets, "we expect numerous fair hearings."He said the formula has not been finalized and that recipients would have some flexibility in how they spend their allocations."Im a lot more optimistic this year," Detert said, "because theres more honesty and truth-telling in the building than Ive seen in years."
Copyright 2011 by The News Service of Florida. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

2011-11-03T07:47:00.001-07:00

Story by Ross O’Banion, Executive Director of Angels Unaware, Inc. Death by a thousand cuts & they just keep coming. http://ping.fm/eYIIo

2011-11-03T07:43:00.001-07:00

Adding sales tax to items you buy online could help the agency for persons with disabilities avoid more cuts.http://ping.fm/kXwjX

Adding sales tax to items you buy online could help the agency for persons with disabilities avoid more cuts.

2011-11-03T07:41:00.000-07:00

No leadership on shortfall
By TBO.COM Published: November 02, 2011
Once again, Florida state government is facing a major budget deficit — as much as $2 billion next year. And once again, the Republican majority in Tallahassee — Senate President Mike Haridopolos especially — is showing little leadership in solving the fiscal crisis.
While there is no avoiding painful budget cuts, no effort is being made to also find reasonable revenue sources without punishing taxpayers.
Haridopolos, R-Merritt Island, refuses to consider collecting sales taxes on online purchases — despite the urging of the Florida Chamber of Commerce, which has made this a top goal, and rightfully so.
Based on Haridipolos' recent comments, we wonder whether he even understands the online sales tax issue. A sampling:
"I think we have made a pretty firm statement as far as sales taxes are concerned or tax increases, that there would not be an increase," he told reporters.
And this: "If there were any (revenue) adjustments, we'd have to see an equal reduction somewhere else."
Say what?
It's wrong to portray the collection of sales taxes on Internet purchases as a tax increase. This is all about enforcing the state's 6 percent sales tax, which online merchants and customers are avoiding but local bricks-and-mortar merchants have to pay or else risk fines or jail.
And to say, as Haridopolos did, that such a move would violate the Legislature's "no new tax" pledge is silly. This is the same head-in-the-sand approach that other lawmakers have employed when responsible leaders have suggested reviewing Florida's outdated sales tax exemptions, which unduly favor certain businesses.
Fortunately, Rep. Will Weatherford, a Wesley Chapel Republican slated to be the next House speaker, has a different view. Weatherford supports collecting sales taxes on online purchases as long as the seller has a "physical presence" in Florida. And that's a start.
Collecting sales taxes on online purchases, which Weatherford says also would require action by Congress, is not a new tax or a tax increase. It's a matter of fairness.
As Mark Wilson, the chamber president, explains: "If you go down to your local small businesses and you purchase something, they are required to pay the sales taxes. We believe the same thing should apply to online retailers, whether they are Amazon, whether they are in Florida or not."
Yet, the Legislature has refused to take steps to start collecting this much-needed revenue. In 2012 alone, according to the chamber, the state could take in as much as $1.48 billion . Instead, Haridopolos says the anticipated budget deficit would be handled by more cuts to services, which already have been cut to the bone in many areas.
Consider the plight of many clients of the Agency for Persons with Disabilities. The Home and Community-Based Services Waiver program, which helps many clients stay with their families and out of institutions, is woefully underfunded. People who need help the most are being hurt — including those who cannot speak or take care of themselves. Likewise, many service providers are struggling due to rate cuts.
For 2007-08, for example, the Legislature appropriated $958 million for the program. Funding for 2010-11 was reduced to $930 million, while last session lawmakers approved a bigger drop, to $810 million, forcing yet more cutbacks that can be devastating to families.
Collecting the sales taxes due on online sales could easily fill this gap and restore the program's funding to needed levels, as well as put a big dent in the budget deficit.
Florida's tax structure should be consistent and equitable. Internet sales tax collection would level the playing field for local business and generate funding for the developmentally disabled. It might even eventually allow additional tax cuts. But Tallahassee leaders, terrified of even uttering tax reform, would rather cling to the status quo than pursue a change that would surely help Florida's businesses and its most vulnerable citizens.

From Ross O’Banion - DEATH BY A THOUSAND CUTS

2011-11-03T07:35:00.000-07:00

Ross O’Banion, Executive Director of Angels Unaware, Inc.
DEATH BY A THOUSAND CUTS – THEY JUST KEEP COMING
The Scott administration and APD has announced yet another round of cuts aimed at consumers and providers. According to their words the agency been working to bring its waiver expenditures within the legislative appropriations this year. The agency is also looking for opportunities to increase waiver flexibility and equity for consumers while continuing to protect their health and safety. The net effect has been little or no response to consumer needs (including health issues), the growth of wait-ing lists, lowering the quality of services and the consumer‘s quality of life.

This month APD published its five cost containment ideas and, as you are reading this, is rushing these to the various legislative sub-committee for approval and a time-table for implementation. To read the entire plan click here. Here are their five con-tainment ideas:

1. Standardize payment rates for intensive behavior residential habilitation starting 1/1/2011.
2. Collection of fees (co-payments) from APD consumers who have income to offset some of their costs of living in a group home.
3. Reduction of the rates it pays for therapy assessments and all nursing services to the standard rate paid by the Medicaid State Plan starting 4/1/2012.
4. Reduction of the difference it pays between solo providers and agencies for waiver services to no more than 20% by 4/1/2012.

There is no timeline announced for implementing cost sharing for parents who have children on the Medicaid Waiver. APD and AHCA are working jointly on this issue.
There is also a Long Range Program Plan for APD. This is the plan that ADP is giving to legislators to consider. It is important that you read and understand these plans. If implemented, they will directly affect you and your families. Click here to read the entire plan. Parents, relatives, advocates and friends need to contact your legislative delegation immediately and tell them no more cuts. (Click here for contact informa-tion.) Providers of services have been barely hanging on for the last few years. The legislature and Governor Scott needs to be looking for ways to increase or hold rates stable while a reliable source of revenue is developed. Our web site has some talking points with comments on each topic that may help you. We suggest that you read these before speaking with your legislator. Click here to view these talking points.

Your lack of action will result in loss of services because there will not be providers in business to provide these services. It is time to cut APD (state employees), support coordination and any other position in the state of Florida ‘food chain’ that does not provide direct daily physical ‘hands on’ assistance to our consumers. Eliminate excessive rules and over-site mountains of paperwork. As Governor Scott is bragging about job creation in Florida perhaps it is time to have him look at saving jobs that agencies like Angels Unaware, Inc. create to provide daily ‗hands on‘ services. In the 33 years I have had the privilege being the Executive Direc-tor I have never once seen and APD employee change a diaper, feed a consumer, take a consumer to a day program, a doctor‘s appointment or church.

2011-10-31T06:47:00.001-07:00

Florida wants to return a $35.7 million grant. Rep. Matt Hudson says Florida doesn’t need the money. http://ping.fm/1snKm

Florida wants to return a $35.7 million grant. Rep. Matt Hudson says Florida doesn’t need the money

2011-10-31T06:41:00.000-07:00

By Kimberly Vlach -

Florida Republican lawmakers are proud there are no denials in transitioning people out of nursing homes.

However, just because there’s no one on the state waiting list, it doesn’t mean there aren’t people who can come out.

Many people are healthy enough to leave the nursing home and continue their care at home – but end up trapped because state programs don’t fund certain costs that transitions may require, like a moving van.

In comes federal officials who awarded Florida $35.7 million in a program called Money Follows the Person, covering those gaps left by the state. But the state refuses to use those dollars.

The $35.7 million Money Follows the Person grant could help even more people transition out of nursing homes. In August, HealthyState.org reported on how the MFP grant would help even more people transition out of nursing homes.

The state Agency for Health Care Administration estimates that over 1,700 elders and disabled adults over the five-year period of the grant. A person eligible for MFP funding would receive a maximum $3,000 reimbursement for expenses such as: an apartment application, utility and phone deposits, moving expenses, certain medical equipment not covered by the state, etc. A person under age 60 would be allowed to transition into an assisted living facility under the MFP program.

However, Rep. Matt Hudson (R-Naples), a member of the Legislative Budget Commission which decides what state agencies are allowed to spend, says he voted against using the MFP grant because Florida doesn’t need the money.

“There’s not a single person who’s requested to be transferred out of a nursing home that hasn’t had that opportunity to do so,” says Hudson.

According to the office of the Speaker of the House, Florida serves over 103,000 people each year through state waiver programs while serving about 73,000 people in nursing home facilities.

“Since 2009, no nursing home resident has been denied the opportunity to transition to a waiver program due to any limits on the waiver slots available,” adds Katie Betta, spokeswoman for Speaker Dean Cannon.

While that may be true, there are many more people who can’t apply for the state transition program in the first place, says Gary Martoccio, a case worker for Self Reliance, Inc., a non-profit organization that transitions people out of nursing homes.

That’s because they don’t have enough money to move into a new place, says Martoccio.

Many In Florida’s Nursing Homes Are Trapped

“In one way, they’re not denied, but where are they going to go?” he points out.

Keep in mind that most nursing home patients who are receiving state aid will have exhausted all their assets because of the exorbitant costs of nursing homes.

“A high percentage of our residents don’t have anywhere to go, so we identify them a home or an apartment,” Martoccio explains. “OK, so now they don’t have the application fee. They don’t have first month, security [deposit] – so that’s holding them back. So something as simple as that. But it’s very difficult for them to come up with the funds, and it’s so important.”

Gov. Rick Scott and AHCA are reviewing whether or not to return to the Legislative Budget Commission in January to ask for the release of funds.

This reporter can be reached at kvlach@wusf.org.

2011-10-30T19:19:00.001-07:00

Competition is fierce among private companies offering the Medicare Advantage managed-care option. http://ping.fm/ZWO18

competition is fierce among private companies offering the Medicare Advantage managed-care option

2011-10-30T19:11:00.000-07:00

Former Tampa Bay anchors return to TV as Medicare insurance pitchmen
By Eric Deggans, Times TV/Media Critic
In Print: Friday, October 28, 2011

For 30 years, Bob Hite helped TV audiences digest the news of the day as one of the Tampa Bay area's most-watched local television newsmen.

But his latest TV job is something new: hosting a half-hour infomercial touting the merits of a Florida insurance company's Medicare Advantage plan.

The onetime anchor, who retired from Tampa NBC affiliate WFLA-Ch. 8 in 2007, plugs his decades of experience as a journalist in the "special broadcast" for Optimum Health Care, a locally based company that administers Medicare benefits.

"As a news anchor and photojournalist, I've spent over 40 years researching and reporting stories I felt were important to improve people's lives," Hite says early in the program. "Nothing is more important than helping people … to better understand the (Medicare) system."

Enrollment for the government health insurance program for seniors and disabled people began this month, and the competition is fierce among private companies offering the Medicare Advantage managed-care option.

Should a journalist, even one who has been retired from local TV news for nearly four years, leverage the credibility he developed as an objective, independent reporter to tout one insurance company for pay?

Hite, 63, sees no problem with his first on-camera infomercial since leaving WFLA. "I think it's clear to anyone what I'm doing; anyone who knows me from my days as a newsman knows I've been retired for years," he said, speaking by telephone from his home in Southwest Colorado. "The only products we take on are products I believe in. And I have to have total script control."

The blurring of lines between advertising and journalism still makes some TV news experts uneasy.

"It is really awkward and uncomfortable," said Deborah Potter, a former CBS and CNN correspondent now serving as executive director for Newslab a training center based in Washington, D.C. "You can't tell (retired) people to pass up an opportunity. But transparency is key; if there's the potential for confusion in the viewers' mind, that's troubling."

Hite isn't alone. Former WTVT-Ch. 13 anchor Frank Robertson, who left the station in 2009 after nearly 21 years, appears in a different ad for Optimum, sitting behind what looks like an anchor desk trading lines with a woman who looks like a co-anchor.

"That's probably why I do get selected for so many spots; they do feel I have some credibility," said Robertson, who also has voiced ads for a local chiropractic practice and a medical security device. "I do feel, once you've established yourself as a commercial spokesperson, you can't go back. You're not the news guy anymore."

The company plans to air Hite's half-hour infomercial about 200 times through early December; Robertson's ad could air up to 500 times, placed in local newscasts when seniors are likely watching, said Joe Vessio, head of sales and marketing for Freedom Health Care and Optimum.

"I don't think they would lend their image or their name to a product they didn't believe in," Vessio said of Hite and Robertson. "That's what I would say to some of the skeptics. If we weren't a credible company, they wouldn't be working with us."

Private health care companies are filling local TV stations and newspapers with ads asking eligible people to allow them to provide their Medicare benefits before enrollment ends Dec. 7.

Experts say the decision is personal and specific, because each company offers different features and perks. A plan that is inexpensive for one consumer, because of the drugs they take, could be costly for a person with different prescriptions.

"All these ads are terribly confusing for people," said Charles Franckle, a retired economist who works as a volunteer counselor through the state-funded SHINE program (Serving Health Insurance Needs of Elders). "All of them are just touting the advantages and none of the disadvantages."

Ren Scott has heard such criticism before. He spent nearly 20 years as a TV anchor in New York, Philadelphia and at WFTS-Ch. 28 in Tampa before founding his own marketing and video production company in Tampa. Now he hires former anchors such as Hite (whom he also represents as an agent), Robertson and former WFTS sports anchor Al Keck to voice commercials and infomercials his company scripts and films.

"I have journalists in my office weekly saying salaries are down, I don't feel stable, what can I do?" said Scott, who developed Hite's infomercial for Optimum.

"The reality is, the news business and a lot of the things they're calling journalism, it's not journalism," added Scott, who touts his company's success in raising funds for charity. "I am doing more good in delivering important messages now than I ever did covering fires and murders."

Hite sees his endorsements as an extension of the behind-the-scenes video work he does through his company Kinship Productions. "Telling stories through moving picture is my hobby, and I've been lucky enough to make a living doing it," he said. "I have these skills I've developed over the years; it's nice to be able to use them."

Eric Deggans can be reached at deggans@sptimes.com or (727) 893-8521. Blog: Tampabay.com/blogs/media. Twitter: @Deggans.

2011-10-27T08:11:00.001-07:00

Under Gov. Rick Scott's new law, teacher in trouble and faces stiff fines for helping her students register to vote. http://ping.fm/231xE

Promoting civic involvement shouldn't be a crime

2011-10-27T08:05:00.000-07:00

St. Petersburg Times-

In an effort to provide a hands-on lesson in civic responsibility, New Smyrna Beach High School teacher Jill Cicciarelli simply wanted to register 50 of her students to vote. But what began as a routine exercise in democracy could result in Cicciarelli facing thousands of dollars in fines for violating a new state law that needlessly complicates voter registration. In their zeal to suppress the vote to gain a political advantage, Gov. Rick Scott and the Republican-controlled Florida Legislature have made it a crime for high school teachers to help students register to vote and prepare them for a life of civic engagement.

Cicciarelli preregistered 50 17-year-old students to vote at the start of the school year. But those registration forms ran afoul of Florida's new election law, which requires third parties who sign up new voters to register with the state and submit new voter application forms within 48 hours. The new rules, including an additional provision that forces some voters who change their address to cast a provisional ballot, are so onerous that even the Florida League of Women Voters has decided to suspend its voter registration efforts.

Because she was on maternity leave earlier this year, the Volusia County educator wasn't aware of the changes. While the teacher could merely receive a warning for her seditious conduct, Cicciarelli faces a potential fine of $50 for each application she improperly processed and up to a $1,000 fine for her role as an unregistered third party agent of record. That's some expensive civics lesson.

Republican lawmakers and the Scott administration disingenuously defend the new law as an effort to thwart voter fraud. But the real fraud here is the Legislature's effort to suppress voting by creating an unmanageable maze of bureaucracy, making it almost impossible for third party groups to sign up voters and reducing the window for Floridians to cast a ballot. There is no evidence of systemic voter fraud in Florida.

Many county elections supervisors, along with U.S. Sen. Bill Nelson, have called on Scott and the Legislature to repeal or revamp this regressive, egregiously partisan election law. For the sake of Jill Cicciarelli and her students, a young person's first experience in citizenship should not consist of being denied an opportunity to register to vote and seeing the teacher charged with a crime for promoting democracy.

2011-10-27T00:48:00.001-07:00

Free Dental Day Lakeland Florida November 18, 2011
http://ping.fm/fe6nh

Free Dental Day Lakeland Florida November 18, 2011

2011-10-27T00:46:00.000-07:00

Free Dental Day Lakeland Florida November 18, 2011
November 18th, 2011 - November 18th, 2011
607 S. Missouri Ave
Lakeland, FL - 33815
863-709-4254

On November 18, 2011 there will be a free dental clinic in Lakeland Florida at the office of Midtown Dental. This free dental clinic is being done in partnership with Midtown Dental, Polk County Health Department and the Polk County Medical Reserve Corps.

In order to be approved for this day of free dental you must sign up at Midtown Dental, 607 S Missouri Ave, Lakeland, FL on October 28, 2011, from 9am - 1pm.

This clinic is for people who cannot afford dental care on their own. Bring a driver's license or picture id to register.

Services to be provided at the clinic include: Dental exams, dental x-rays, dental cleanings, up to two fillings or three extractions.

2011-10-26T14:38:00.001-07:00

Getting Out the (Disabled) Vote The Arc helps clients exercise their constitutional right.
http://ping.fm/B45Wb

Getting Out the (Disabled) Vote The Arc helps clients exercise their constitutional right

2011-10-26T14:35:00.000-07:00

Jenny Joslyn is a model citizen: a tax-paying, working-class 30-something woman who embraces her right to engage politically. She has voted in every election since her 18th birthday. She is also intellectually disabled, one of thousands of Idahoans who require assistance for life skills. But it is her citizenship that she said defines her on Election Day.

"I think it's important for everybody to vote," said Joslyn. "I would ask anyone why they don't vote."

Her voting record is the very definition of independence, casting votes in previous elections for presidents Bill Clinton, George W. Bush and Barack Obama.

"I really liked Obama's ideas in 2008," said Joslyn. "I think he's doing OK, but I know that the economy is very difficult for him right now."

Like many American voters, the economy is a touchstone issue for Joslyn. She works four days a week, cleaning rooms at the Super 8 Hotel near the Boise Airport. She secured the job through The Arc, which has assisted thousands of the disabled since 1956.

"We serve approximately 600 individuals a year," said Nicole Lang, who has worked at the Boise-based Arc for 14 years, the past five as its director of programs. "Our current participants are as young as 18 and as old as 75."

Through her years of overseeing programs, including developmental therapy and vocational training, Lang has seen countless instances of challenge and success, but nothing surprised her more than what occurred during the 2008 presidential election.

"It was unlike anything I had experienced before. It was amazing," said Lang. "The best example I can give you is a 45-year-old woman with a disability who comes to The Arc on a regular basis. She comes from a very strict family with very strict political beliefs. Well, she wanted to vote for a candidate her family didn't approve of. At times, she ended up in tears after some pretty emotional political debates. She did her best to understand the issues and she made her choice. Her family certainly didn't agree with her, but her candidate won. It was the most empowering thing I've ever seen."

That woman wasn't alone. In fact, according to the U.S. Census, more disabled adults participated in the 2008 presidential election than any time in the nation's history.

"I was at the national Arc convention a couple of weeks ago, and this was a very hot topic," said Lang. "In 2008, 14.9 million people with disabilities voted--more than 3.9 million more than had voted in the previous presidential election."

For Lang and her colleagues, the message was clear.

"We've got to make sure people with intellectual and developmental disabilities are aware that, No. 1, they have a right to vote," said Lang. "We need to show them how to register and explain their rights."

The law is clear--the United States Constitution and the Americans with Disabilities Act guarantees a person with a mental disability the right to vote. That person can ask for help from any person he or she chooses. While some states have struggled with the issue when courts have tried to rule that a person is not competent to vote, Idaho has never had any such challenge. In fact, if a state chooses to impose a voter-competence requirement, that requirement must be applied to all voters. It cannot single out a particular group of voters, such as people who are the subject of guardianship proceedings.

Marjorie Cashbaugh requires guardianship. Due to her diagnoses of mental retardation and cerebral palsy, she depends primarily on her mother. But Marjorie is not to be underestimated.

"I'm getting to be pretty good at my math, and my cooking is good, too," said Cashbaugh, 26, who has been going to The Arc for two years, working on her life skills.

"I'm not registered to vote at the moment but I really want to do it," said Cashbaugh. "I think I'm going to ask the staff here [at The Arc] to help me. I've been talking to a number of my friends and my mother about the issues. I have a lot of friends who have disabilities and they need to be respected. They need an advocate."

Robert Burge has several advocates at The Arc. The 44-year-old suffered a severe brain injury when he was hit by a truck at the age of 4. Today, he is a janitor for three businesses: The Arc, American Linen Supply, and The Boys and Girls Clubs. Burge is a gentle giant, with a football-player-size build and an ear-to-ear smile.

Three years ago, Burge told the staff at The Arc that he was interested in voting.

"They told me how to vote but they didn't tell me who to vote for," said Burge, who admitted that the whole process was a challenge. "It was really difficult for me to see who to vote for, getting to the voting place and signing all the papers. But I'm really glad I did it."

Lang said coaching someone with a disability on how the electoral process works can't be confused with coaching them on how to vote.

"We're going to continue to do this very carefully," said Lang. "It's a very delicate balance, but we're going to do the best we can."

2011-10-26T11:48:00.001-07:00

"Lives Worth Living", a history of the treatment and rights of persons with disabilities. Thursday 10pm ET, on PBS http://ping.fm/6aaS4

Lives Worth Living

2011-10-26T11:45:00.000-07:00

People with disabilities are one of the largest minorities in the United States. But for most of American history, they occupied a sub-class of millions without access to everyday things most citizens take for granted: schools, apartment buildings, public transportation, and more. Some were forcibly sterilized under state laws. Others were committed to horrifying institutions where they were left and forgotten.

After World War II, however, things began to change, thanks to a small group of determined people with an unwavering determination to live their lives like anyone else, and to liberate all disabled Americans of the limitations their government refused to accommodate.

Lives Worth Living traces the development of consciousness of these pioneers who realized that in order to change the world they needed to work together. Through demonstrations and inside legislative battles, the disability rights community secured equal civil rights for all people with disabilities. Thanks to their efforts, tens of millions of people's lives have been changed.

This film is an oral history, told by the movement's mythical heroes themselves, and illustrated through the use of rare archival footage. The story features Fred Fay, who suffered a spinal cord injury at age 17 in 1961, and simply refused to be relegated to life’s sidelines just because he couldn’t walk. He fought tirelessly for decades for equal rights, access, and opportunity for the disabled, including advocating for programs allowing the disabled to live independently. (Fred died August 20, 2011; the film is dedicated to him.) Also featured is Ed Roberts, who founded the independent living movement in Berkeley and is also considered a father of the disability rights movement.

Echoing footage of Martin Luther King marching in Selma, we see protestors climb from wheelchairs and drag themselves courageously up courthouse steps; we watch as quadriplegic activists maneuver their chairs in front of public buses that are not equipped to accommodate them.

The film ends with the dramatic battle for the Americans with Disabilities Act, one of the most important pieces of civil rights legislation in America's history. The thousands of individuals who came together to change attitudes and laws demonstrated the power of humanity, cooperation, and self-determination, and what can be accomplished against seemingly insurmountable obstacles.

MORE- http://www.pbs.org/independentlens/lives-worth-living/film.html

2011-10-26T02:32:00.001-07:00

Ever wanted to take a peek inside the friendliest group homes in Florida? We list 47 homes, most with slide shows. http://ping.fm/Jn2HZ

2011-10-25T09:28:00.001-07:00

Son 'shocked' parents accused of holding disabled persons captive, calls it a 'misunderstanding'
http://ping.fm/76f4C

Son 'shocked' parents accused of holding captives, calls it a 'misunderstanding'

2011-10-25T09:25:00.000-07:00

The son of two of four people charged with imprisoning four mentally disabled adults in the basement boiler room of a Philadelphia apartment building called his parents "loving and caring" on Monday, adding he is "shocked" by their arrest.

Three of the suspects -- Linda Ann Weston, 51; Gregory Thomas, 47, and Eddie Wright, 49 -- had status hearings Monday, but none were in court. Afterward, Weston's attorney George S. Yacoubian Jr. said their next court date, a preliminary hearing, is set for December 19.

They face several charges including criminal conspiracy, aggravated assault, kidnapping, criminal trespass, unlawful restraint and false imprisonment after the landlord of the apartment building found the four people locked in the 15-foot-by-6-foot room with no food and only a bucket for a toilet, police said. Weston is the accused ringleader of the group, according to police.

A fourth suspect -- Jean McIntosh, Weston's daughter -- faces similar counts, but was charged a few days after the first three. A hearing in McIntosh's case is scheduled for Wednesday, according to court records.

Gregory Thomas Jr., who several months ago moved back to Philadelphia from Florida, son of Weston and Thomas, conceded to CNN on Monday that he "felt a little out of the loop."

That said, the 18-year-old aspiring boxer insisted the case against his parents was "a real big misunderstanding."

"I don't think they're guilty," the younger Thomas said. "I just hope they get the facts straight, before they make a decision in court."

Police have said the suspects may have been holding seven other people, including Weston's 19-year-old niece and six children. Police believe two of the children, ages 2 and 5, may belong to Tamara Breeden, one of the four adults rescued from the sub-basement.

Gregory Thomas Jr. said that he considered some of the mentally disabled adults living with his parents as "family," adding that he believed they were fed and not locked in their rooms. He claimed, for example, that he had gone to the movies with one of the mentally disabled men, and said his mother would give them Christmas presents and treat them to holiday dinners.

"Everything seemed normal," the younger Thomas said. "No one had to ask for anything."

Weston, according to her son, "tried to do a lot to help -- sometimes, I think, she did too much, that she cannot handle." He also said he felt she "had the wrong people around," but called it "shocking" that she and his father were arrested.

2011-10-25T09:23:00.001-07:00

Support system for disabled Floridians at 'breaking point'
http://ping.fm/nGSs7

Support system for disabled Floridians at 'breaking point'

2011-10-25T09:22:00.001-07:00

By RENEÉ VALLETUTTI | Special to The Tampa Tribune
Published: October 25, 2011

Over the past several years, individuals with developmental disabilities and their families have endured extensive reductions and elimination of needed services due to funding cuts to the Florida Agency for Persons with Disabilities' Developmental Disabilities Home and Community Based Services Waiver budget. The Florida Developmental Disabilities Council believes that funding for the waiver cannot sustain any further reductions without seriously jeopardizing both the health and safety of individuals with developmental disabilities who rely on these services and the basic infrastructure of the waiver system.

Currently, many individuals with developmental disabilities and their families are not receiving the services they need to find employment and get help with their daily living activities, which allows them to become or remain independent and have a life in the community like their peers without disabilities.

Each year since 2007, with the exception of 2009-10, there have been reductions in funding implemented through either provider rate reductions, reduction in tier caps and/or imposition of other service limitations. The annual appropriation for the waiver has gone from $958 million in 2007-2008 to $810 million for 2011-2012.

Florida has relied heavily on the family to support individuals with developmental disabilities. More than 70 percent of individuals live with their family compared to the national average of 57 percent. Findings resulting from 24 focus groups held across the state in 2009 involving individuals with developmental disabilities and their families reported increased stress and dwindling capacity to continue providing supports at home. Now, with the additional stress of the downturn in Florida's economy, Florida's system that relies on support offered through family households will be stretched to the breaking point.

The Florida Developmental Disabilities Council recognizes that the Agency for Persons with Disabilities must strengthen the fiscal and operational controls of the waiver to ensure that waiver spending is within the legislative appropriation. These controls can be achieved without shifting the waiver into private managed care, as has been considered. The individualized budget (iBudget) program approved by the Legislature in 2010 and 2011 is designed to contain and predict costs and, in turn, strengthen the agency's fiscal and operational controls.

Reneé Valletutti chairs the Florida Developmental Disabilities Council.

2011-10-24T14:27:00.001-07:00

AHCA monitors assisted living facilities 1x every 2 yrs. Lawmakers try to limit volunteers who check homes for abuse.http://ping.fm/F4eQk

AHCA only monitors assisted living facilities 1x every 2 years. Now key lawmakers are trying to limit volunteers who check troubled homes for abuse a

2011-10-24T13:52:00.000-07:00

Florida curtails effort to police ALFs
By Carol Marbin Miller and Michael Sallah The Miami Herald
Under fire from some lawmakers and healthcare industry leaders, Florida’s struggling elder ombudsman program now has turned on itself.

Read more: http://www.miamiherald.com/2011/10/22/2467414/ombudsman-program-in-grave-condition.html#ixzz1bjcDulUL

By Carol Marbin Miller and Michael Sallah
cmarbin@MiamiHerald.com
When elder advocate Diane Carpenter entered Our Golden Home in 2008, she found an elderly woman languishing in a recliner, soaked in her own urine.

After ordering an aide to put clean clothes on the woman, Carpenter, a supervisor with the state’s volunteer ombudsman program, heard muffled cries from the rear of the Hialeah assisted-living facility. “Help me, help me,” a man pleaded.

Curled in a fetal position, the man was burning with fever.

Carpenter ordered caregivers to call an ambulance. They refused. She then threatened to call the state’s elder abuse hotline. When paramedics finally rushed the man to a nearby hospital, they had little time to spare: He had already lapsed into life-threatening renal failure.

Three years later, the program that Carpenter represents also is in grave condition.

Under attack by powerful industry groups, the once celebrated program launched during the Great Society legislation of the 1960s has been hit by a wave of resignations and firings that have left it reeling over the past year. Amid the turmoil, federal regulators blasted the state last month for allowing political meddling to cripple the advocacy group.

Just six months ago, key lawmakers wanted to do away with the group’s ability to perform yearly inspections of nursing homes and assisted-living facilities — the program’s key mission — even as its corps of trained volunteers was turning up a record number of abuse and neglect cases in ALFs across the state.

Created as an advocacy group for frail residents in long-term care homes, the program now finds many of its veterans at odds with their new leader, Jim Crochet — a longtime state administrator recommended by industry leaders. They say he is trying to diminish their roles as protectors of vulnerable adults to appease the industry.

“People just don’t understand how important these people are,” said David Gillespie, former manager of the Broward ombudsman office. “The volunteers are responsible for saving countless lives, and for improving the lives of countless others.”

Internally, nearly a dozen employees and volunteers have resigned or been fired as Crochet launched an overhaul of the agency after his appointment in April.

“We are going through a paradigm shift and it is difficult for some who have been ingrained in the old way,” Crochet said in an August email to a top administrator of the Agency for Health Care Administration, the state’s nursing home and ALF regulator. “Unfortunately, that shift may require that some folks will leave the program.”

The new approach, Crochet acknowledged, has infuriated both volunteers and paid administrators, many of whom are fleeing. When an AHCA administrator wished him “good luck’’ in a May 17 email following his appointment, he replied: “I’ll surely need it with the reception I received by the council,” a reference to the group that meets regularly to set policy and discuss issues.

Crochet’s shift in philosophy comes as ALF industry heads, several lawmakers and even AHCA leaders have mounted their own campaigns to weaken the program.

Earlier this year, state Rep. Matt Hudson, a Naples Republican, pushed legislation that would have eliminated the program’s ability to perform annual “assessments,” or inspections, of facilities — retaining authority only to evaluate complaints. Lawmakers and industry leaders had complained bitterly that ombudsmen were duplicating the role of AHCA, and AHCA inspectors had complained repeatedly of “interference” from the volunteers.

The legislation failed. But no matter; Crochet introduced a new tool that will have a similar result. A new inspection form, and the guide that explains it, allows volunteers only to interview residents, not to observe ALF conditions as a whole.

“Jim Crochet met with Representative Hudson, who supports the program’s resident advocacy, but not regulatory involvement,” the minutes of a July 5 statewide ombudsman meeting state.

At a meeting of the South Miami-Dade Ombudsman Council last week, Don Hering, the program’s director of field operations, called the new form a “capitulation” that was necessary for the program to survive: “Some legislators were trying to shut the program down,” Hering said. “They were going to reduce our budget.”

Program administrators, Hering said, were getting “pressure” from lawmakers to stop behaving as regulators.

Hering encouraged the Miami volunteers to fight the new inspection form. “Please don’t take this lying down,” he said, “because it’s not going to go away.” But he also encouraged the Miami group to accept some of the changes, “instead of worrying about whether the legislators are going to take pot shots at us.”

The changes come as the lead regulator of long-term care homes, AHCA, is under intense pressure for failing to shut down dozens of troubled assisted-living facilities, allowing the worst offenders to stay open over the years, according to a Miami Herald investigation.

While the ombudsman program found that abuse and neglect cases had doubled in ALFs over the past five years, AHCA was cutting back on its own inspections by 33 percent, records show.

And while AHCA has been forced to make fewer visits to homes, veteran ombudsmen say the new assessment form will hamstring their ability to inspect a host of conditions that for decades have been within their power, especially in turning up decrepit conditions: rodents, ants, roaches, the stench of urine and feces in rooms, leaking roofs, piles of dirty laundry that molder for days; filthy floors and bathrooms; rotten produce, and expired milk and canned goods.

The new form has prompted a backlash among volunteers, who say the approach is fundamentally flawed because at many ALFs, residents — particularly those with mental illness or disabilities — are fearful of retaliation or too impaired to communicate. In fact, The Herald found 292 cases in the past decade in which an ALF resident told an ombudsman that they were too afraid of reprisal to talk.

South Miami-Dade volunteer Bill Hearne, who represents the area on a statewide council, said he frequently uncovers physical and emotional abuse of residents, medication errors and poor living conditions during facility inspections — and fears such violations will go undetected under the new system.

During one ALF inspection, for example, Hearne watched in horror as a caregiver screamed at an elderly man with Parkinson’s disease who spilled his soup on the table because the neurological disorder made it difficult for the man to use his spoon. “How would you like it if somebody spoke to your granddad like that?” Hearne asked. “It hurt the man, and he began to cry. I went over and I touched him; I held his hand. I came this close to crying.”

During an inspection of Bilmar Gardens by the Broward County ombudsman last year, volunteers turned up a host of violations, including filthy and decrepit conditions that prompted the immediate removal of 14 residents. “Willful neglect,” wrote David Gillespie, manager of the Broward office. “Living environment is detrimental to their dignity, health and well being.”

Though AHCA had turned up enough violations in prior years to shut down the home, it didn’t do so — even allowing the facility to operate without a valid license until reaching a settlement in 2006. Since then, it turned up 44 more violations, but it wasn’t until the ombudsman program called fire inspectors last year that AHCA took action to close the home.

“Bilmar Gardens would still be open today if not for the ombudsman program,” said Gillespie, who resigned his job recently to work for the city of Orlando.

Differences between AHCA and local ombudsmen also erupted two years ago when AHCA refused to shut down the troubled Munne Center, a Miami-Dade facility where a 71-year-old woman suffering from Alzheimer’s disease was raped and other residents were found languishing with life-threatening conditions.

At one point, Hering threatened to hold a news conference to expose the state’s failure to act, but AHCA arranged a settlement with the home in 2009. In the ensuing years, however, conditions grew worse. Munne was finally shut down last month, following a scathing, 63-page report that uncovered a litany of violations: poor training of key employees, a failure to hospitalize residents with life-threatening pressure sores, scorching temperatures inside the building, foul odors, filthy bathrooms, stained floors and broken furniture, and the home’s habitual inability to keep track of its residents.

During another inspection in Miami-Dade, Hearne said he found an elder had just been beaten up by another resident. No caregiver was in sight, and the ALF owner was at work elsewhere, unable to return to the facility.

“We find these things out,” Hearne said. “AHCA does not see it, and we will not find it under the new policies and procedures going into effect.”

Volunteer Joel Beyer drew applause from other South Miami-Dade council members last week when he attacked the new form: Residents, he said, “need us.”

In an interview with The Herald, Crochet dismissed the criticism, saying the overwhelming majority of volunteers throughout the state had “embraced” the new assessment process, and the Miami area represented but a small pocket of resistance.

“That may be what you’re hearing in Miami,” Crochet said in the interview, “but I can tell you that is not going on across the board.”

But other councils have complained, as well.

In his comments to the Miami group last week, Hering acknowledged that the new assessment had become a bone of contention everywhere as he criss-crossed the state visiting local councils. “The argument I hear across the board is ‘we don’t need to capitulate to the guys or gals who are after us,’ ” he said.

And in September, the Broward County Ombudsman Council drafted its own recommended assessment guide, which included a laundry list of items to inspect, including the safety of cleaning supplies, swollen or dented canned goods, evidence of roaches and rodents, medication carts, and the cleanliness of bathrooms and kitchens. The outline also encourages inspectors to look for signs of life-threatening pressure sores, bruises or other injuries, insect bits and rashes among residents.

“Members were appreciative that the assessment is resident-centered,” the council wrote, “however, it was felt that there were areas of resident health and safety that the residents themselves would not be in position to be aware of unless or until tragedy strikes. These areas have been included in past assessments and have frequently uncovered egregious conditions that could impact resident health and/or safety.”

Crochet insists the program has as many, if not more, volunteers than when he took office in May, and takes issue with the suggestion made by Miami council members that the program’s new direction has led to a spate of firings and resignations. The firings, in particular, sparked criticism from members of the state Senate’s Children, Families and Elder Affairs Committee, who grilled the Department of Elder Affairs secretary at a meeting earlier this month.

One South Miami-Dade volunteer, Teresita Mestre, resigned in the middle of last week’s council meeting, eliciting an audible gasp. Mestre said she became an elder advocate after seeing her father treated poorly at an ALF — at one point, she discovered caregivers had simply put a second diaper on her dad rather than clean him up. But changes in the ombudsman program, she said, will leave it crippled.

“Some people are afraid to speak up to you because of retaliation,” she said of the requirement that volunteers only investigate what residents tell them. “Even caregivers are afraid to speak to you.”

“We are not respected anymore,” Mestre added.

State Sen. Eleanor Sobel, a Hollywood Democrat who as vice chair of the Health Regulation Committee is helping draft a brill overhauling ALF oversight, said the program’s woes go far deeper than a lack of respect.

Sobel said she is infuriated by the criticism of a volunteer corps “that should be recognized as heroes, and instead, they are being attacked.

“There’s a gag order on them,” she said. “This is not a totalitarian state.”

Read more: http://www.miamiherald.com/2011/10/22/2467414_p4/ombudsman-program-in-grave-condition.html#ixzz1bjjFhV74

Read more: http://www.miamiherald.com/2011/10/22/2467414_p3/ombudsman-program-in-grave-condition.html#ixzz1bjh3hZID

Read more: http://www.miamiherald.com/2011/10/22/2467414_p2/ombudsman-program-in-grave-condition.html#ixzz1bjccrvYG

Read more: http://www.miamiherald.com/2011/10/22/2467414/ombudsman-program-in-grave-condition.html#ixzz1bjc6HDWH

2011-10-24T05:58:00.001-07:00

Our latest newsletter- this one is a special edition just for caregivers, providers, and support coordinators. http://ping.fm/dQQmA

2011-10-21T16:27:00.001-07:00

Best Buddies is always is looking for people to serve as “buddies” to persons with developmental disabilities.http://ping.fm/zwoOr

2011-10-21T16:24:00.000-07:00

Best Buddies is always is looking for people to serve as “buddies” to adults and children with intellectual and developmental disabilities.
Founded in 1989 by Anthony Kennedy Shriver, Best Buddies is now an international organization with almost 1,500 chapters connected to middle schools, high schools, and colleges.

In addition to pairing volunteers with disabled students, Best Buddies also has programs that match up volunteers with disabled adults in the corporate, civic and online worlds to provide the extra support and friendship to spur them toward success.

Best Buddies Florida also has a volunteer corps known as its Circle of Friends, who serve on planning committees for events, assist local chapters with fund-raising, and help promote the nonprofit in the community.

A Best Buddies volunteer must be at least 18 years old. Depending on the role for which you’re interested in volunteering, you may have to fill out a volunteer application.

Learn more about the local program and its needs http://www.bestbuddies.org/

Those interested can contact Program Supervisor Justin Hickman at JustinHickman@bestbuddies.org

2011-10-21T03:36:00.001-07:00

Persons who report Medicaid fraud may be entitled to a reward up to 25 percent of the amount recovered. http://ping.fm/naHyQ

Persons who report Medicaid fraud may be entitled to a reward for their information up to 25 percent of the amount recovered,

2011-10-21T03:33:00.000-07:00

Not all providers commit fraud but all Floridians can help by identifying those who do. Persons who report Medicaid fraud may be entitled to a reward for their information up to 25 percent of the amount recovered, or a maximum of $500,000 per case, if the case results in a fine, penalty or a forfeiture of property. Tips about suspected fraud can be reported by calling the Attorney General’s Fraud Hotline at 1-866-966-7226 or the Agency’s Consumer Call Center at 1-888-419-3456. Communication initiatives are in progress, including a mailing to Medicaid recipients, to heighten awareness and encourage recipients to report fraud. Citizens may also report fraud online by visiting our Web site, http://click.icptrack.com/icp/relay.php?r=12353917&msgid=218447&act=52BP&c=227375&admin=0&destination=http%3A%2F%2Fwww.ahca.myflorida.com%2F and clicking the “Report Fraud” button. We hope you’ll use these brochures and posters to help us promote this effort.
Agency Highlights
The Florida Medicaid program is fortunate that a vast majority of its providers are honest and provide high-quality care. Unfortunately, the few bad players create a need for bold efforts. We are committed to working with our partners to fight those who cheat Florida taxpayers and hope you will join us in this effort.
The number one priority in our state Medicaid program is to ensure our limited resources are spent on health care services for our state’s most vulnerable citizens who need care. Now more than ever, a team effort is vital to success in combating health care fraud statewide and stopping providers and others who cheat taxpayers. Both the Medicare and Medicaid programs are working hard to find and eliminate waste, fraud and abuse and to ensure scarce health care resources are spent appropriately. While the Medicare program is administered and funded by the federal government’s Centers for Medicare and Medicaid Services, Florida’s Medicaid program is operated by the state Agency for Health Care Administration (Agency) and funded with state and federal dollars. By working together, we are taking strong steps to curb health care fraud in Florida.
For example, after identifying alarming numbers of claims for home health aide services in the Miami-Dade area in 2008, our Florida Medicaid Program Integrity staff embarked on an effort to find those home health agencies billing for services never delivered to Medicaid patients. In March and October 2009, we formed teams with investigators and trained medical personnel from the Agency, the state Department of Health and the federal Centers for Medicare and Medicaid Services, and we conducted major sweeps of Miami-Dade County home health agencies. Together, we interviewed hundreds of recipients and prescribing physicians and found some home health agencies billed for services not delivered or not medically necessary. As a result of these field investigations and audits over the past two years, Medicaid home health services claims dropped by over $10 million in state fiscal year 2008-09.
We are strengthening this important effort with the 2009 passage of Senate Bill 1986. This new law increases standards home health agencies must meet before receiving Medicaid payments, adds penalties and provides new authority to impose sanctions and to suspend or revoke licenses of those who cheat the system. When the Agency suspects a provider has committed fraud, referrals go to the Florida Attorney General’s Medicaid Fraud Control Unit and the Florida Department of Law Enforcement to pursue criminal and/or civil actions if the allegations are found to be true. Actions regarding licensure are handled by related licensing entities in our Agency and at the Department of Health.
In 2010, Florida Medicaid staff will begin new outreach efforts to verify Medicaid patients do, in fact, have a condition requiring home health services. The Agency is on track to inspect all of the approximately 360 home health agencies that provide services to Medicaid recipients in Miami-Dade County and randomly selected agencies statewide. And, by June 2010, a new technology pilot program will be introduced allowing the Medicaid program to verify that home health services were actually delivered to the patient. At the same time, our Medicaid Program Integrity staff will continue to carefully scrutinize the data available to us to identify unusual trends and opportunities to stop the bad players in Florida’s Medicaid system throughout the state.

2011-10-21T02:57:00.001-07:00

Check out our help wanted section- including 2 companies now hiring support coordinators. http://ping.fm/mokG3

2011-10-20T19:29:00.001-07:00

Family of disabled man found in basement speaks
http://ping.fm/CW8Qt

Family of disabled man found in basement speaks

2011-10-20T19:25:00.000-07:00

Family of man found in basement speaks
Knowles was missing for three years
Updated: Tuesday, 18 Oct 2011, 9:04 AM EDTPublished : Monday, 17 Oct 2011, 10:35 PM EDT
NORFOLK, Va. (WAVY) - October 17 was the day a Norfolk family had longed to have for many years.
Herbert Knowles went missing three years ago. "One day he didn't come home and it was unlike him," Tiffany Davis, Knowles' niece, said. "He would come here everyday to eat. He would talk to my grandmother and if he didn't come he always called."
On Monday, his family found out where he had been all those years, but the details about his disappearance were horrifying. Knowles, 40, was one of the four disabled adults found locked in the sub-basement of a Philadelphia apartment.
"The way they describe him, as if he was some kind of animal," Davis said. "You got him chained in the basement. All the lights are out. There are buckets for him to use the bathroom."
Police said the building's landlord discovered a woman and three men in the locked room when he went into the building's basement. Police said all four have the mental capacity of 10-year-olds.
"We never knew he was out of the area," Davis added. "Even when he was here, we really didn't know where he was."
Knowles' family said three years ago he moved in with a girlfriend and her mother, Linda Weston. That was the last time they saw him, until they saw a picture of Knowles taken from a Philadelphia hospital bed.
"Still a smile on his face after all he went through," Davis said.
Weston along with two other men are now behind bars. Police say they were keeping the three men and one woman captive to steal their Social Security and disability checks. They may have done the same thing to victims in Florida, Virginia and Texas.
Weston, 51, was also convicted of murder in 1981 when she starved a man to death in a closet of her Philadelphia home.
"It's going to be very emotional," Davis added. "My grandmother always prayed he would come home...the prayers obviously worked."
Knowles' family now only looks to the future. It was three years of birthdays and holidays missed, but soon they know he'll be back home where he belongs.
"It's going to be great, because that's what we need as a family," Davis said. "He's a part of our family. He always has been a part of our family. Nobody ever forgot him."

2011-10-20T07:32:00.001-07:00

APD attorney Nathan J. Dygart Arrested in underage sex sting. Melanie Etters from APD said Dygart was fired on Monday. http://ping.fm/2B0tv

APD attorney arrested in underage sex sting

2011-10-20T07:21:00.000-07:00

Tallahassee, Florida -- Thirty-five men, 25 of whom are from Tallahassee, were arrested over the last week in an extensive underage sex sting where the men allegedly solicited sex in online forums with people they thought were teenage girls.

Mug Shot Gallery: Suspects arrested in underage sex sting

The sting is considered the most successful operation in Florida history, based on the number of arrests, police said. Those arrested include a youth baseball and football coach employed by the city of Tallahassee, a corrections officer for Florida Department of Corrections and an attorney for the Agency for Person with Disabilities.

"This investigation has revealed a disturbing number of individuals who have been actively targeting children in this community," Sheriff Larry Campbell said. "Law enforcement cannot do what parents can do to keep children safe from online predators."

According to the National Center for Missing and Exploited Children, there are 3,668 cases reported to the center's tip line every week involving child sexual exploitation.

Online predators can be savvy, but parents and children can take steps to learn how to avoid being a potential victim and learn about red flags.

Mike Phillips, assistant special agent-in-charge for the Florida Department of Law Enforcement, said filtering and monitoring software for home computers is an effective tool. He also said talking to children is vital and parents need to be aware of what children are seeing and experiencing online.

"It's their job to protect their kids and part of that is knowing what your kids are doing," Phillips said, although he cautions parents not to panic. "You don't have to be looking over their shoulder every day. But just keep up with what they are doing."

Leslie Reinhard, 28, mother of three children ages 12, 4 and 2, said she doesn't allow her oldest son to surf the Internet unsupervised.

But she was stunned after reading breaking news posted on The Tallahassee Democrat that her son's baseball coach, Carlos Stephens, was among those arrested.

Reinhard called Stephens "nice" and "an incredible coach," but said she was alarmed by the allegations.

Stephens, 28, has been a city employee since September 2005, said Dee Crumpler, director of the city's Parks, Recreation and Neighborhood Affairs Department.

He was a referee for adult flag football and baseball. He also coached boys baseball ages 11-12 in the Spring 2010-2011 season for the Cal Ripkin Baseball League at Capital Park on Tram Road.

Crumpler said he immediately suspended Stephens without pay Tuesday and he is moving forward with terminating Stephens.

"When I first heard about it, as a parent of teenage daughters, I was sickened," Crumpler said of the sex sting arrests. "It's unfortunate, but we have 1,200 employees in our department ... We do everything we can to prevent that."

Stephens passed all background and drug checks when he was first hired. However, in 2008 he failed a drug test when he tested positive for marijuana.

Per city policy, Stephens had to sit out for a year if he wanted to work for the city again. He was required to participate in the city's employee assistance program and drug counseling. He returned to the city in August 2009.

Nathan J. Dygart, 29, another man arrested in the sting, held a temporary position as an attorney in the general counsel's office for the Agency for Persons with Disabilities for the last five months. According to Melanie Etters, spokeswoman for the agency, Dygart was fired on Monday.

"He no longer has access to our building or databases," she said. "Our IT people will do a review of his computer."
Brantley Hill, 21, works as a corrections officer for the Florida Department Corrections. It has not yet been reported if he has been suspended or terminated.

The arrests were made as a part of Operation Tallyop by the North Florida Internet Crimes Against Children Task Force. The group is made up of officers from FDLE, the Leon County Sheriff's Office, Tallahassee Police Department, the U.S. Marshal Service, Immigration and Customs Enforcement, St. Johns County Sheriff's Office and the Alachua County Sheriff's Office.

"This is the most successful ICAC operation to date in Florida," said Tallahassee Police Chief Dennis Jones. "It could not have been accomplished without everyone working together to meet the common goal of ridding the streets of these predators."

According to Jones, there were about 40 police officers working at any given time throughout the week and arrests peaked at eight in one day.

Assistant State Attorney Stefanie Walters said the men, if convicted, could face up to 15 years in prison for traveling to meet a minor for sex and up to five years in prison for online solicitation.

Desiree Stennett and TaMaryn Waters, the Tallahassee Democrat

2011-10-19T07:52:00.001-07:00

Today watch a live update from APD Director Mike Hansen to the Health Care Appropriations Subcommittee at 1:30 PM http://ping.fm/FIOHn

update from APD Director Mike Hansen to the Health Care Appropriations Subcommittee at 1:30 PM today

2011-10-19T07:42:00.000-07:00

Today there will be an update from Director Hansen on the Corrective Action Plan to the Health Care Appropriations Subcommittee at 1:30 PM Wednesday Oct. 19, 2011

It can be viewed by going to http://www.fccflorida.org/ and hitting the hot link under working with the Legislature, there is a link for the House live and one for the Senate live.
If you go to Florida Online Sunshine and hit the link to the House or Senate and then committees, you can get the agendas and packets once they are available.
Below is the link that has all APD presentations to the legislature in Sept. and Oct so far.

http://apd.myflorida.com/publications/legislative/index.htm#requests

As much as possible, we really need to be paying close attention to what is going on in these legislative committee meetings, watching these or listening to podcasts available assists the perspective and familiarizes us with those who will be making decisions that affect so many lives. It can help us be more effective in our outreach efforts.

2011-10-18T10:12:00.001-07:00

Ability Explosion will commence on October 19 at the Miami Beach Convention Center
http://ping.fm/42ptz

Ability Explosion will commence on October 19 at the Miami Beach Convention Center

2011-10-18T10:09:00.000-07:00

ABILITY EXPLOSION is a weeklong series of special events held in historic Miami Beach and created for the enjoyment of the entire community. From "Lights Out Miami" (A Dining in the dark experience) to the 5k Run, our mission is to celebrate the ABILITIES of people living with Disabilities, encourage their acceptance by the community at large and promote innovations that will improve their lives.

“Ability Explosion” is a weeklong series of events held in Miami Beach meant to highlight to the abilities of persons with disabilities to the entire surrounding community.

The Ability Explosion Blastoff and Disability Mentoring Day Kickoff
will commence on October 19 at the Miami Beach Convention Center, Hall D. During this time, a ceremonial event will take place, between 9:00 and 10:00 a.m, recognizing APD with a proclamation to APD and citations of this year’s mentors participating in DMD through APD.

Directly following that, there will be a resource and technology fair in which various community service providers, including APD, will be available to community participants for information, referral and outreach.

You are all invited to attend at times convenient to you. This may provide impetus for your participation as an exhibitor next year.
You may recall that the President and Founder of “Ability Explosion”, David New, presented at a recent Providers’ Meeting.

For more information, you may visit:

www.abilityexplosion.org

2011-10-17T20:10:00.001-07:00

Vast scheme —to steal the monthly Social Security disability checks of disabled people- 4 found in basement. http://ping.fm/7YRgu

People held in Philly house say they were abused

2011-10-17T20:00:00.000-07:00

October 17, 2011 7:57 PM PrintText People held in Philly house say they were abused

(AP) PHILADELPHIA - The landlord of the apartment building at first thought a circuit breaker had tripped when he went to the basement Saturday and found all the lights were out. Then he realized all six bulbs had been removed, and he heard dogs barking inside a boiler room, its door chained shut.

He removed the chain, stepped into the dank, foul-smelling room and lifted a pile of blankets. Several sets of human eyes stared back at him.

Turgut Gozleveli had stumbled upon four mentally disabled adults, all weak and malnourished, and one chained to the boiler.

He may have also stumbled upon a vast scheme — stretching from Philadelphia to Norfolk, Virginia; West Palm Beach, Florida, and Texas — to steal the monthly Social Security disability checks of defenseless and vulnerable people, authorities said.

Philadelphia police on Saturday arrested three adults staying in an apartment upstairs, including the person accused of being the ringleader, Linda Ann Weston, who had been convicted of murder in a 1981 starvation death.

Detectives also found dozens of identity cards, power-of-attorney forms and other documents in the apartment, suggesting the theft scheme involved more than just the four captives.

"Without a doubt. This is just the beginning of this investigation," Lt. Ray Evers said Monday. "We think she's been doing this for quite some time."

How long, how much money the scheme brought in, how the disabled were deceived and how many people in all were victimized are still unclear, investigators said. The FBI has joined the investigation.

Weston, 51, was charged with kidnapping, false imprisonment and other offenses, with bail set at $2.5 million. Also arrested and jailed were the man she described as her boyfriend, 50-year-old Eddie "the Reverend Ed" Wright, and 47-year-old Gregory Thomas.

"Talk about preying on the weak and weary," Evers said. "You can't get any lower than this person."

As of Monday, the defendants did not appear to have lawyers. They couldn't be reached for contact in jail.

The victims, a woman and three men, were found in a crawlspace that reeked of urine and was too shallow for an adult to stand up. There were mattresses and blankets, but the only food found was a container of orange juice. The adults shared their space with three dogs.

Gozleveli called police, suspecting they were squatters, then watched as officers and ambulance workers helped them up the steps to the street in a working-class section of the city's Tacony neighborhood.

The victims, ages 29 to 41, had the mental capacity of 10-year-olds, along with some physical disabilities, authorities said. One could barely see.

Three of them — Tamara Breeden, Derwin McLemire and Herbert Knowles — told KYW-TV on Monday that they were mistreated by Weston, Wright and Thomas.

Breeden, 29, told the TV station that she was hit on her head and showed where she said some of her teeth were knocked out.

McLemire, 41, said he met Weston through an online dating service and tried to escape but didn't get away "so they got me."

Knowles, 40, was shackled to the boiler and said he was hit by one of the two men arrested with Weston.

Neighbors said the defendants and the basement captives had arrived in an SUV from West Palm Beach, Florida, about two weeks ago, though it does not appear the victims spent the entire time in the basement.

Danyell "Nicky" Tisdale, a neighborhood resident, said that about a week ago a man and a woman and four mentally disabled adults held a yard sale, selling piles of shoes, jackets and other clothing on the sidewalk.

Since the arrests, police have slowly and patiently been trying to elicit information from the captives. All four were treated at hospitals and placed with social service agencies.

Breeden had been reported missing by her family in Philadelphia in 2005, police said. One of the men also is from Philadelphia, and a second, McLemire, is from North Carolina. Their relatives were contacted. Police were having trouble finding family members for Knowles.

According to an investigative report obtained by The Associated Press, Knowles was reported missing in Norfolk, Virginia, in December 2008 after a mental health case worker couldn't reach him and family members failed to hear from him. The report described him as "slightly mentally retarded."

The case worker reported that Knowles' Social Security checks were going to a Philadelphia address. The report said Philadelphia police went by the address and were told no one there had ever heard of Knowles.

Knowles' government benefits were stopped after his mail was forwarded to Philadelphia, but Weston took him to a Philadelphia social service agency in 2008 and showed identification, and the checks resumed, Norfolk police said.

Norfolk police spokesman Chris Amos said police did not continue looking for Knowles because as an adult he was under no obligation to report to his case worker.

"It's not illegal to be missing," Amos said. "A lot of people are missing by choice."

Scam artists can get control of a disabled person's checks by visiting the Social Security office with the victim, who then designates the other person to receive the payments, said Nora J. Baladerian, a clinical psychologist in Los Angeles and advocate for people with disabilities.

Only if there is a report of suspected abuse would social service agencies enter the picture, she said.

In Florida, Weston and Thomas appeared to live with several disabled adults, including a man and woman who had bruises on their faces, neighbors in a poor section of West Palm Beach said. The woman also had what looked like a large burn mark on her face, neighbor Ronald Bass said.

He said that he often heard yelling, apparently from the disabled women, and that police frequently went to the house.

Another neighbor, Sadie Pollard, said she saw bruised lips and other facial injuries on the disabled people but was told they had been fighting with each other.

Weston was convicted of murder and voluntary manslaughter in the death of her sister's boyfriend. According to news accounts, Weston and her sister beat him and locked him in a closet because he refused to support the unborn child he had fathered. He died of starvation weeks later.

It was unclear from court records whether Weston served any prison time.

Gozleveli, the landlord who discovered the victims, freed the man chained to the boiler.

"He was just watching me when I cut the chain," Gozleveli said. "I asked them what they are doing here and how they got in. There was no communication. I asked questions, and I don't get any answers."

Philadelphia police Commissioner Charles Ramsey said: "This case is going to be going on for a while. We don't know how far it will extend."

2011-10-17T05:12:00.001-07:00

Exploitation of disabled is becoming common- A prime target, receiving monthly benefits without well checkshttp://ping.fm/EbGzR

2011-10-17T05:03:00.001-07:00

Exploitation like this of disabled is becoming common- A prime target, receiving monthly benefits without well checkshttp://ping.fm/gDNxo

Philly's Terrified Basement Prisoners

2011-10-17T04:46:00.000-07:00

Philly's Terrified Basement Prisoners
Oct 16, 2011 4:56 PM EDT Four mentally disabled adults were found chained up and horrifically abused in a Philadelphia basement. Jeff Deeney on the "caretakers" accused of putting them there—and why the system failed.

A shocking discovery on a weathered but quiet stretch of Longshore Avenue in the working-class Tacony neighborhood shook Philadelphia on Saturday afternoon: four cognitively impaired disabled adults were found malnourished, chained to a water heater, and locked behind a steel door in a filthy 15-by-15-foot closet in the basement of an apartment complex.

The details of the story are still taking shape. The four adults and their “caretakers”—charged with kidnapping, aggravated assault, and various other crimes—arrived in the city by way of Florida just a few weeks ago, but lived in Texas prior to that. What brought them to Philadelphia is still unclear, but one of them, 50-year-old Linda Westen, is a convicted murderer. They are suspected of financially exploiting their captives for the meager $674 per month they received in government benefits. The quartet of disabled adults have reportedly since received medical care at a nearby hospital and been sent to a local shelter, where they are receiving social services.

Neighbors were stunned to learn of the nauseating crimes taking place on their street. Danielle Tisdale, the block captain who lives a couple doors down from what has now been dubbed the “hell house” in the local media, says Longshore Avenue is a tightknit community where neighbors take care of each other.

“We look out for people around here," says Tisdale. "Kids, the elderly—f it snows or in the summer when it’s real hot we make sure everyone has what they need. Nobody would have thought something like this could happen around here.”

A woman who gave her name as Nancy says she’s lived in the small two-story apartment building where the disabled adults were discovered since March and never suspected that anything was awry.

“This is a quiet building, you could hear a pin drop in here. We heard nothing, no screams, no banging, nothing. There weren’t any bad smells, we had no idea. It wasn’t like no Jeffrey Dahmer or Gary Heidnik situation.”

Nancy said she was aware the building had a basement, but nobody had a reason to use it.

“Nobody ever went in the basement. It’s like a storage area, with no washers or dryers or nothing. I can’t really say I ever had a reason to be down there.” She noted that Westen and her alleged partners in crime lived on the second floor next to her, and had no reason to access the basement, either.

But neighborhood kids, for their part, say they had their suspicions. They described one of the accused male captors as a “creepy guy in a tan trenchcoat” who once followed one of the block's little girls to her school.

The central question of how a crew of criminals could have transported four disabled adults across multiple state lines and kept them chained in a basement for weeks without raising an eyebrow requires a look at state standards for protecting those with disabilities. Both the states of Florida and Texas have Adult Protective Services programs whose missions specifically include stopping anyone who is “misusing the resources of an elderly or disabled person for personal or monetary benefit. This includes taking Social Security or SSI (Supplemental Security Income) checks, abusing a joint checking account, and taking property and other resources.”

But it’s unclear whether these agencies had any contact with the four disabled adults before they were dragged to Philadelphia by their kidnappers. Many states have regulations regarding interstate travel for the disabled in order ensure their safety and that their basic needs are being met, but only for those receiving state-funded services. Westen and the other alleged kidnappers may have prevented the state from having any contact with their victims, knowing that contact with state agencies would bring more scrutiny.

Pennsylvania, for its part, only voted for an Adult Protective Services Act in April of this year, and the new Act remains an unfunded mandate. The state’s Department of Welfare has proposed no new regulations that would define what Adult Protective Services will consist of, or who will be contracted to administer them, in the months since the law passed.

Block captain Tisdale says that an anonymous Adult Protective Services emergency hotline would have come in handy in reporting Westen to authorities. She says that the previous weekend Longshore Avenue had a flea market and Westen was there, verbally abusing one of the cognitively impaired adults being kept in the basement in view of all the neighbors.
“We said to each other, ‘That’s a grown man, why is she talking so disrespectful to him?’ I would definitely say the way she was treating him was abusive.”

Without an investigative hotline to call, Tisdale did what she thought was best, telling the landlord who manages the property. It was Tisdale’s call that prompted the landlord to search the basement, where he found the four adults covered in bedsores and living in filthy close quarters.

Neighborhood kids described one of the accused male captors as a “creepy guy in a tan trenchcoat” who once followed one of the block's little girls to her school.
Bethany Canver is a licensed social worker who provides supports coordination for disabled people in Philadelphia. Her clients are typically profoundly impaired; many are nonverbal, having conditions like cerebral palsy and progressive multiple sclerosis. Her clients are also poor, often living in Philadelphia’s most violent neighborhoods, and some are disabled as a result of gunshot wounds or other violent trauma. Canver’s job is about as close to Adult Protective Services as Philadelphia gets at the moment. She navigates the city doing home visits, meeting with attendant caregivers, and confirming the health and safety of her clients. She says that, unfortunately, exploitation of disabled adults is a common event.

“This case is particularly extreme; however, exploitation and abuse are rampant. In general, the disabled folks are vulnerable to exploitation, in part because of the nature of their impairment. For example, if you’re nonverbal, intellectually impaired, medically fragile, or have trouble with decision making, you’re going to need assistance with some parts of day-to-day life. And unfortunately caregivers don’t always have the best interest of people with disabilities at heart. I think a lot of that has to do with the fact that direct care services are provided by nonprofessionalized workers who are not only doing stressful, draining work, but also only making like $9 an hour. It shouldn’t come as a surprise that financial exploitations happens with all these factors in the mix.”

She gives a common example of the kind of low-level theft that corrupt caretakers casually engage in, and are rarely punished for, that has a major impact on the life quality of disabled adults.

“For instance, a consumer of mine had an attendant who works for a state-funded attendant care agency steal her SEPTA Trailpass worth $127. My consumer uses her Trailpass for therapeutic swimming sessions, grocery shopping, visiting friends and family, and she lives on fixed SSI income. She doesn’t have an extra $127 laying around to replace it, so for the rest of the month she was stuck at home.”

Canver says that state bureaucrats can be unhelpful when disabled people try to report such instances of exploitation, and with no sanctions coming from the state for professional malfeasance, corrupt care workers are able to float from job to job, stealing at will, and not suffering any consequences.

For now, at least, one criminal group of abusive disabled-adult exploiters of has been taken off the streets, and the residents of Longshore Avenue are recovering from the shock of finding the nightmarish scene in their midst.

“This is sad, it’s beyond sad,” says alleged kidnapper Linda Westen’s neighbor Nancy. “Our hearts and our prayers go out to the victims.”

Like The Daily Beast on Facebook and follow us on Twitter for updates all day long.

Jeff Deeney is a social worker and freelance writer from Philadelphia. He works with felony drug offenders in the criminal-justice system and writes about urban poverty and drug culture.

For inquiries, please contact The Daily Beast at editorial@thedailybeast.com.

2011-10-16T12:00:00.001-07:00

Janitor finds mentally disabled people chained in basement- http://ping.fm/Yv3ja

Janitor finds mentally disabled people chained in basement

2011-10-16T11:58:00.000-07:00

Janitor finds mentally disabled people chained in basement; 3 arrestedBy the CNN Wire Staff
updated 11:28 AM EST, Sun October 16, 2011

Philadelphia (CNN) -- Three suspects accused of chaining mentally disabled people and stealing their Social Security checks were arrested in Philadelphia.

They were arrested Friday after a janitor doing checks at a building found four victims -- a 29-year-old woman, and three men, ages 31, 35 and 31 -- locked up in a basement boiler room at a Philadelphia residence, said Lt. Ray Evers, a police spokesman. The janitor released the four and called police.

Authorities believe the victims had been trapped in the tiny room for up to a week. Evers said they suffered from bed sores and "injuries that are very, very hard to describe."

Evers said the group had moved a year ago from Texas to Florida, before traveling to Philadelphia around October 4.

Police have not named the suspects -- two men, ages 51 and 41, and a 50-year-old woman who is believed to have orchestrated the check-stealing scheme.

"They'll be charged with pretty much everything we can find in the crimes code ... from aggravated assault to kidnapping to false imprisonment," Evers said. "You name it, we're going to stick it on them."

The suspects are also accused of human trafficking -- an allegation the FBI is investigating.