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APD Waiver Redesign Email Responses APD Waiver Redesign Email Responses # Email Responses To APD: Our names are Robert and Mary Hensley and we have been medwaiver physical therapists for The Agency for Persons with Disabilities for over 20 years. We are sorry that we were unable to attend today's meeting in Tallahassee to provide our input. We are writing to emphasize the importance of Physical Therapy as a vital service in the medwaiver program. Please remember the name of this agency "Agency for Person's with Disabilities." The clients of this important state agency often have serious and severe physical disabilities that require the specific and unique knowledge, attention and treatment from a Florida licensed Physical Therapist. It truly is a matter of the "Health and Safety" of the client. Through no other funding source will the client be able to receive the ongoing, specific services that the medwaiver Physical Therapist is able to provide, such as wheelchair evaluations, wheelchair repairs and use of an EasyStander device. Besides strengthening exercises, stretching exercises, and gait training (among other things), the clients of APD often need specialized adaptive equipment (like the EasyStander device and others) and manual or power wheelchairs for their independent mobility. To receive these wheelchairs, it requires a specific wheelchair evaluations from a Florida licensed?? Physical Therapist and a certified wheelchair vendor. This can be very time consuming.?? A Medicare or Medicaid therapist generally does not have the time or experience to do such an evaluation. The client will be unable to receive a customized and individualized?? wheelchair that their disability requires. Also, when existing wheelchairs need minor repairs, the medwaiver therapist will often do these repairs while another therapist will not. It can also take weeks or months to get a wheelchair vendor to come and do minor repairs and it also requires a doctor's prescription for them to do the repairs. Without the use of these individualized wheelchairs, many med waiver clients will be home bound or bed bound and unable to access their community. Most clients who do receive Physical Therapy under the medwaiver program only receive about 1 hour of Physical Therapy per week. (And reimbursement rates are actually LOWER now than they were 20 years ago!)?? Physical Therapy is not a major expense to the program, yet provides a much needed and often underutilized service. Please just ask the clients who receive Physical Therapy. It is therefore very important that Physical Therapy be maintained as a service for those with physical disabilities under this program. Sincerely, Robert Hensley and Mary Hensley Hensley 1 [email protected] Physical Therapy Services Elizabeth, as a permanent disabled person why are my I-budget benefits subjected to a reduction when I have permanent personal care NEEDS? Thank you for 45 CFR 164.514(b)(2)(i) 2 45 CFR 164.514(b)(2)(i) presenting my question. Hi I am 45 CFR 164.514(b)(2)(i) a mother/legal guardian of a 27 year old med waiver recipient who has been on med waiver for many years since before their was a waiting list. Today I find myself once again wondering what services the state is trying to cut out now or even lessen. Im in panic mode! I’m almost 50 years old and disabled myself and have multiple services (nursing, personal supports, support coordination, medical supplies , etc..) that are provided by med waiver to ensure my son the proper care he needs to continue to live and thrive in the family home and be comfortable and safe in his community and home. Without any one of his services he is at risk for institutionalization. In the past they have tried to say group homes were less expensive, but this is not where he wants to live and also they have had him on state wide search for placement in the past ( not that I wanted him to be but they said in order to keep my services I had to have him on it as it was the least expensive situation. But in saying that he was on one so to ensure to keep my services and every group home that APD sent his info to refused him because the nature of his size being 6’7 and 342lbs , wheelchair bound and drop seizures daily. So in saying that I have to have my services to ensure his care and safety. The state gave group home choices for picking their individuals, but they failed to realize some individuals have more severe issues than others and that has allowed for discrimination on my son due to his condition. As a mother I hope to pass before my child , but what will happen to him then ? Group homes won’t choose him and services keep being cut , my fear he will be institutionalized and that is not right. Please help us in keeping our services and prioritizing and taking consideration a category he fits in. Thank you 45 CFR 164.514(b)(2)(i) Please speak this in the webinar as I am not a 3 45 CFR 164.514(b)(2)(i) speaker I get to emotional As per the US Census Bureau, Florida is the fastest growing state in the nation. As our population with and without disabilities ages and increases, FL's no-state- income-tax model cannot support the growing demands made on the APD & Medicaid by those who are in need of services. Just as the DOE receives some 4 [email protected] funds from the FL Lottery, we need a .01 cent/penny tax on luxury or tourism related goods or services. Annette Lizardo Parent Advocate & Attorney APD Waiver Redesign Email Responses There needs to be more supervision over support coordinators/consultants who are happy to receive the money they are entitled to for the job they are doing, but fail to provide the necessary assistance to their clients. Ignoring phone calls, email, texts, failing to follow through, not showing up for appointments, pushing the limits of the relationship to see how far they can get without the client complaining, and failing to communicate so that they are wasting time. These problems may be due to overload, poor management skills, lack of training....a variety of issues, but the bottom line is the client is always affected. APD needs to monitor the people who represent them and that's not being done. The answer I get is we have so many families and we are a big county (Palm Beach)....so what's the answer??? Also, autism has needs that are different than other clients and this needs to be addressed because it is not. Families will be devastated by the cutting of funds especially because APD needs to improve their system so that money is not wasted on consultants who are getting paid but not providing the services they are being paid to do - and no one is supervising what they are doing. Teresa Badillo Researcher/Writer 5 [email protected] www.epidemicanswers.org www.theautismexchange.com https://autismresearchcoalition.org/ Boca Raton, Fl 561 289-6750 [email protected] Dear Governor Desantis, My name is 45 CFR 164.514(b)(2)(i) and I am the proud parent of45 CFR 164.514(b)(2)(i) , a beautiful, bright, creative, autistic young boy of age 8. Autism brings a lot of challenges to Josiah as well as to our family. Many people do not realize how much effort goes into completing simple tasks independently for children who are on the spectrum. Anything from getting dressed, taking a bath, or brushing teeth requires the assistance of a caregiver. Therefore, it becomes extremely challenging to take care of a non verbal autistic child who cannot express his needs, desires or concerns. Furthermore, it becomes very challenging to provide optimal care to his siblings while tending to his everyday needs. It is because of this reason that I implore you to please consider keeping the Medicaid Waiver active so that parents such as myself can continue to receive assistance for our wonderful children with special needs. The waiver has been instrumental in providing families the much needed assistance in ABA therapy and respite care which goes a long way towards providing hope to our children with special needs. Our children did not ask to be born with these unique set of challenges, and they by no means intentionally desire to make life more challenging for parents. They are trying in their own little way to cope with their disabilities and flourish as individuals just as any other child would desire. However, this is a difficult journey for them as they battle daily to overcome the challenges that come with their disabilities. Let's help our children to not only survive but thrive as all human beings desire to do by doing all we can to the necessary assistance provided through the Medicaid Waiver. 6 45 CFR 164.514(b)(2)(i) I thank you for your time and consideration, 45 CFR 164.514(b)(2)(i) APD Waiver Redesign Email Responses , g p , g y y p g concur with many of speakers at the event and on the the webinar discussion, that *total managed care for the APD program would be a detriment to the clients that we serve. WSCs are a very integral part of ensuring our clients health, safety and overall well-being. However, some services on the APD program could be handled under managed care. Here are my suggestions on how to make some cost effective changes to the APD Program. **Managed Care for BCBA & Medical Services-Although Support Coordination, Group Homes and Direct Care Providers should not be under Managed Care, I do feel some services should be considered for managed care to cut costs and streamline quality and efficiency of services.
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