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

  • From: Lighthouse of the Big Bend <lighthousebigbend@xxxxxxxxx>
  • To: tabi@xxxxxxxxxxxxx
  • Date: Wed, 8 Dec 2010 15:56:16 -0500

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
•       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 citizens.

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 command.

Reduce redundant administrative costs to include office space and
other such equipment.

 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

:• 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

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

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

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 moriitorexpenditures.
❖ 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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