[tabi] Re: Gov Scott's Transition Team may be thinking about if one agency should serve all disabilities...

  • From: "Joe Plummer" <joeplummer@xxxxxxx>
  • To: <tabi@xxxxxxxxxxxxx>
  • Date: Wed, 8 Dec 2010 18:19:15 -0500

This is the worst idea I heard of yet. This is aim at one thing and one
thing only that is cutting jobs out. This is also going to make waiting
lines extremely long and lots of red tape. It will have people that is in a
job that have no idea what we need and are going thru. I have try to tell
you all that there Is terrible times coming to Florida and especially the
old, helpless the very young and the disable and the handicap. We are now
going to be treated like a charity case like someone standing in line for a
bowl of soup. We the blind community is going to need medical care say for
our eyes and if you are depending on the blind services to do it you are
going to have to wait fro ever to get the help. If you need a screen reader
to keep your job you will lose the job before you get the screen reader
approved. You just wait and see we are going to go backwards 100 years
before it is over. In my opinion this is the worst thing that could happen
to us just about.

Joe Plummer (JP)
-----Original Message-----
From: tabi-bounce@xxxxxxxxxxxxx [mailto:tabi-bounce@xxxxxxxxxxxxx] On Behalf
Of Lighthouse of the Big Bend
Sent: Wednesday, December 08, 2010 3:56 PM
To: tabi@xxxxxxxxxxxxx
Subject: [tabi] Gov Scott's Transition Team may be thinking about if one
agency should serve all disabilities...

Consumer groups of the Blind/VI may want to get involved, as it looks like
Gov Scott's Transition Team may be thinking about whether one agency should
serve everyone with disabilities...

Single Department Concept
A New Service Delivery System for the 21St Century

The purpose of this proposal is to illustrate a method by which Florida can
create a single, efficient, consumer driven and community
-- based service delivery system to provide services to the over 6 million
persons with disabilities in Florida. The ultimate goal is to reduce
administrative costs and increase access to services and service dollars;
create a more efficient, fraud resistant billing system and create an
economic stimulus creating new private sector jobs.
.       Combining all of the programs and services for persons With
disabilities, including the Florida Medicaid Waiver programs, under one
department`-. will enable the State to move precious resources to actual
service delivery for persons with:.disabilities and seniors across the
disability spectrum and Recycle.
.       This department can have one point of entry with a standardized
application, eligibility criteria, provider qualifications, and provider
rates for all services and programs.
.       Creation of new jobs in the areas of core munity - based service
delivery and fraud prevention methods. This would mean the recruitment of
new entrepreneurial minded providers into the system statewide.
To accomplish this goal, certain units can be removed from current
departments and placed in the new departmental structure. Personnel
requirements will then be determined, based on the overall organization.
Departments effected:
.       Agency for Healthcare Administration (AHCA), the
.       Department of Health (DOH), the
.       Department of Children and Families (DCF), the
.       Department of Eider Affairs(CARES), the
.       Department of Education (Vocational Rehabilitation and Division of
Blind Services), and
.       The Agency for"Persons with Disabilities
As this new department is being physically formed, a new philosophy will
also be nurtured. A philosophy of ingenuity, creativity, and an
entrepreneurial spirit, where employees are encouraged to think "outside of
the box" to solve the problems we will face in the coming years. We must
encourage unique, public - private partnerships at every level, in order to
maximize our precious resources. This includes private entity investment
into not only service provision but employment opportunities for persons
with disabilities. It is only through this "rebirth" of the physical and
philosophical can we have a department that is truly responsive to our

In Florida, every day over 6 million persons, with identified or
self-reported disabilities study, live, play, and work. The vast majority of
persons with disabilities can secure and maintain full or part -- time
competitive employment. They exhibit more courage and fortitude daily than
some people do in a lifetime. These Floridians do not want a hand out but a
hand up, a chance to maximize their individual independence and to be as
included in their community as they wish, This untapped resource of ready
and willing potential employees should not be ignored.

Having all disability programs and services, including Medicaid Waivers
located within one department, will:

Streamline the application, eligibility, and acceptance process for
consumers and providers.

Eliminate the "silo" effect, bringing all state organizations working with
persons with disabilities under one organizational plan and chain of

Reduce redundant administrative costs to include office space and other such

 Create new private sector opportunities for persons who become disabled as
adults. Require anyone wishing to file for federal disability programs to
register with Vocational Rehabilitation. Begin early working with the person
focusing on ways to maximize his/her abilities. in many cases, it may be
possible for the person with the disability to emerge with a better, more
lucrative career.

The department will maximize existing resources, such as using the
Clearinghouse on Disability Information to:
Maintain one website for all information on disabilities.
Operate a single toll-free phone number with accessibility built into the
system. Have a dedicated information referral system that not only serves
consumers, but providers and other state agencies.

? Allow the department to standardize the processes to determine eligibility
(one assessment instrument), provider qualifications and enrollment, service
limitations, rates of pay, nursing home transition initiatives, etc.

? Reduce or maintain turnaround time in billing to enable providers to
receive pay for services in a timely fashion, while cutting down on
potential fraud.

Through a coordinated, functional needs based system, all individuals with
disabilities will have their needs assessed and identified by a Global
Assessment with a single Case Plan.

Bryan F. Vaughan, MS Executive Director Commission on Disabilities

1217/2010       Page 2 of 4

.:. Adapt the existing iBudget algorithm across the disabilities spectrum to
ensure a consistent and efficient distribution of scarce resources.

:. Serve consumers and providers will be served in a timelier and more
consistent manner statewide.
One standardized assessment instrument to determine risk of
institutionalization and eligibility for waiver services would ensure
services are provided to those most in need and would reduce the number of
individuals currently on wait lists for the various waivers.
Provider qualifications and rate of pay will be consistent and allow them to
serve all populations without having to apply to work with multiple waivers
and organizations. The Legislature will only need to deal with one budget to
fund all the waivers. The processes for being placed on a wait list will be
standardized throughout all the individual waivers.
Funding for community-based, long-term care services would be more equitable
for each of the disability groups competing for limited resources.

Note: Some agencies may be reluctant' to relinquish administration of their
waiver programs. Consumers and providers currently being served by the
various waivers may be impacted if service limitations and rates of pay are
standardized. Use of the iBudget algorithm will ensure a person's needs are
met in an effective manner. Some individual disability groups may be
concerned about any change in the current structure which can be mitigated
through an appropriate public information program.
Evidence to Support Single Department

The states of Illinois and Vermont have already gone to the single entity
system with good results. Real Choice Systems Change Grant Program, Third
Year Report: Progress and Challenges of the FY 2002 and FY 2003 Grantees:
(October 1, 2003 -- September 30, 2004) Final Report.

The Governor's Commission on Disabilities, along with personnel from the
effected departments, advocates, and providers could work towards the
planning, development, and implementation of this single department.

Planning & Timeline
Planning could begin to consolidate all programs and services, including
waivers under one department in the 2010 - 2011 fiscal year, with
implementation occurring in an on-going basis. Full consolidation could take
until the 2011 -- 2012 fiscal year.
Estimated Potential Savings
? A coordinated waiver program would require fewer administrative staff,
intake and referral staff, provider enrollment staff and fiscal staff to
? There would be a reduction in allocated office space, expenses;, and
equipment allocations for personnel due to consolidation into one agency.
Multiple websites dedicated to the various waivers would be reduced.to>one.
This would also create a more user friendly, accessible system of delivering
information. **g Consolidating multiple call-centers for consumers and
providers would still allow calls to be channeled from one line directly to
the appropriate waiver specialist.

Florida currently has a great need for more community - based service
providers. Partnerships with Colleges of Business at our State Universities,
as well as the Chamber of Commerce for Persons with Disabilities, can
promote an entrepreneurial effort to create these small provider businesses.

To reduce fraud, a "call and verify" system can be included as part of the
billing cycle. When a provider bills the department, a random verification
system will identify a consumer to be called and asked if helshe has
received the items or services as billed. This process will help prevent
discrepancies and false claims as are potential risks under the current
system. The department can either decide to use one or multiple verifying
agencies. This can be performed by workers from home (enabling persons with
disabilities, seniors, or others who are transportation
disadvantaged) or a central location.

Lighthouse of the Big Bend
Guiding People Through Vision Loss
3071 Highland Oaks Terrace
Tallahassee, FL 32301
(850) 942-3658
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