Behavioral Assistant Services and Behavioral Assessment Restored!
The Florida Legislative Session is over and the restoration of behavioral services is a highlight. Providers and advocates for individuals with developmental disabilities found a way to increase revenue to pay for behavioral services. Intermediate Care Facilities for individuals with developmental disabilities (ICF/DD) Medicaid providers can contribute increased revenue toward Medicaid funding and draw down additional federal matching dollars by assessing quality assessment fees. Other states have used such fees to serve individuals in waiver programs. Florida stands to receive 10-13 million dollars in increased revenue by assessing a quality assessment fee which may be how the state will pay for behavioral assistant services and the Behavioral assessment service. Additional highlights that were included in the budget proviso language for the Agency for Persons with Disabilities (APD) included:
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The provision that the agency may expand enrollment in the Consumer Directed Care Plus Program by up to 2,500 individuals. Any savings generated from this expansion may be used to serve clients on the waiting list. -
Consolidating durable and consumable medical supplies purchasing, effective January 1, 2010.
Flexible Benefits Contingent on receiving required federal approvals, the Agency for Health Care Administration and APD may add a flexible benefit service to each Home and Community-Based Services Waiver administered by the agency. This service shall be self-directed and provide the choice to receive the flexible benefit service.The Fiscal Year 2009-10 amount of the service may not exceed 92 percent of the individual's total projected Fiscal Year 2009-10 expenditures for adult day training, companion services, respite care, supported employment, supported living coaching, and in-home support services.
An individual may not be authorized to receive simultaneously the flexible benefit service and any of the following services: adult day training, companion services, respite care, supported employment, and supported living coaching, or in-home support services.
The flexible benefit service may allow training for the individual or the person authorized to make decisions on behalf of the individual to ensure successful self-direction of flexible benefit services.
Also included in the proviso language is the shift to Individualized budgets; APD, in consultation with the Agency for Health Care Administration, shall develop a plan to establish individual budgets for individuals enrolled in the home and community- based services waivers. The plan shall provide for the following: - An equitable distribution of available resources among individuals based on an assessment process that includes client characteristics and a valid formal assessment instrument;
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Client choice of services and providers once the individual budget is determined; -
Any formulas necessary to predict resource needs and establish individual budgets; -
A recommended role for providers and support coordinators during the assessment process to avoid any potential conflicts of interest; -
A proposed schedule for implementation; and any suggested statutory revisions necessary to implement individual budgets.
The agency shall consider input from stakeholder groups, including self-advocates, family members, service providers, waiver support coordinators, and advocacy organizations in developing the plan. The plan shall be delivered to the Governor, the chair of the Senate Policy and Steering Committee on Ways and Means, and the chair of the House Full Appropriations Council on General Government and Healthcare no later than February 1, 2010.
SB 1660 Relating to Agency for Persons with Disabilities sponsor(s) by Peaden, Jr. CS Sponsors: Health and Human
HB 745 Relating to Prepaid Services for Parents of Children with Developmental Disabilities by Ford was added to this conforming bill. This language establishes a study group to determine the feasibility of creating a prepaid service plan for children with disabilities modeled after the Florida prepaid college plan. The prepaidservice plan would allow funds to be paid into a fund on behalf of a child and would be used for vouchers for services to help the child to transition into the workforce. See more on this study group below.
The Senate language that prioritizes the wait list was accepted with an implementation date of July 2010 to allow an extra year for participant and family input through the rule workshop and rule promulgation process.
04/09/09 SENATE Placed on Calendar, on second reading
Read Second Time; Read Third Time; Substituted for HB 5111; Passed (Vote: 116 Yeas / 0 Nays);
Compare Bills
HB 5111 - Relating to Agency for Persons with Disabilities by Human Services Appropriations Committee
04/17/09 HOUSE Read Third Time; Amendments Withdrawn (618901, 641877); Substituted for SB 1660; Laid on Table, Refer to SB 1660
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SB 242 Relating to Autism Spectrum Disorder Screening for Minors by Ring
In the Senate some of the Autism bills were combined by amendments to Senator Ring's Immunization bill SB 242. Senator Bennett offered several amendments that were accepted with the Senator's assurances that the concerns that were offered during public testimony would be seriously considered for inclusion in the final bill. The amendments that were added to Senator Ring's screening bill (below) include; - The elimination of organic or inorganic mercury in excess of 0.1microgram per milliliter in childhood vaccines.
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The right for formal clarification of the side effects etc. of childhood vaccines that are outlined by the Center for Disease Control. -
The right to choose an alternative vaccine schedule in consultation with a physician as long as vaccines are completed before school starts.
04/21/09 SENATE temporarily postponed by Policy & Steering Committee on Ways and Means
05/11/09 SENATE Died in Policy & Steering Committee on Ways and Means
Companion Bill
HB 0033 - Relating to Childhood Vaccinations by Ambler
05/08/09 HOUSE Died in PreK-12 Policy Committee
***************************** SB 308 - Relating to Developmental Disabilities by Ring CS Sponsors: Health Regulation Committee, Banking and Insurance Committee
Summary
This bill requires that a physician refer a minor to an appropriate specialist for screening for autism spectrum disorder or other developmental disability and inform the parent or legal guardian of the right to direct access to that specialist under certain circumstances. Requires certain insurers and HMOs to provide direct patient access to an appropriate specialist for screening, evaluation of, or diagnosis for autism spectrum disorder, etc. EFFECTIVE DATE: 07/01/2009.
04/24/09 SENATE Withdrawn from Policy & Steering Committee on Ways and Means; Placed on Calendar, on second reading; Placed on Special Order Calendar for 04/28/09
05/11/09 HOUSE Died in Committee on Insurance, Business, & Financial Affairs Policy (after being referred back to this committee).
Compare Bills
HB 0089 - Relating to Autism by Precourt
05/08/09 HOUSE Died in Insurance, Business & Financial Affairs Policy Committee
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SB 2314 - Relating to Affordable Housing/Persons with Special Needs by Wise
Summary
This bill provides criteria relating to the distribution of proceeds from the excise tax on documents to increase housing accessibility for persons with special needs. The bill also provides additional policy guidelines under the state housing strategy for the development of programs for housing production or rehabilitation. The bill includes persons with special needs as a tenant group for specified purposes of the State Apartment Incentive Loan Program, etc. EFFECTIVE DATE: 07/01/2009.
05/11/09 SENATE Died in Committee on Finance and Tax
Compare Bills
HB 1009 - Relating to Affordable Housing by Roberson (Y)
05/01/09 HOUSE
Indefinitely postponed and withdrawn from consideration
******************************* HB 353 by Porth
Relating to McKay Scholarships for Students with Disabilities
Summary This bill authorizes students who receive certain services under the Voluntary Pre- Kindergarten Program to receive the John M. McKay Scholarship. This bill deletes the requirement that a student must have spent the prior school year in attendance at a Florida school.
The bill provides certain rights and requires information explaining the rights and responsibilities that parents, guardians and teachers have when they make certain decisions. The bill requires DOE to recommend training for school personnel in procedures for safe restraint of students. The bill also requires a private school to refund scholarship payment under certain circumstances and permits students to receive scholarship services at locations other than a private school's site under specified conditions.
Alternative Sites for Instruction and Services - A student eligible for a scholarship under this section, including a student with autism spectrum disorder who participates in the program for students who are homebound or hospitalized, may receive regular and direct instruction and services from a private school at a site other than the school's physical location if the following criteria are met: - The student's parent provides a notarized statement from the medical doctor or psychologist treating the student's disability which certifies that the student's welfare or the welfare of other students in the classroom will be jeopardized if the student is required to regularly attend class at the school's physical location. The notarized statement must be:
- Annually provided to the department at least 60 days prior to the date of the first scholarship payment for each school year.
- Based on an annual review of the student's disability by the student's medical doctor or psychologist.
This bill was referred to the following committees in the House on 2/6/09:
PreK-12 Policy Committee;
Education Policy Council;
Full Appropriations Council on Education and Economic Development
05/08/09 HOUSE Died in PreK-12 Policy Committee
Companion Bill in the Senate;
SB 2478 by Gardiner
05/11/09 SENATE Died in Committee on Education Pre-K - 12
SB 1124 - Relating to Community Residential Homes by Altman Cosponsors: Deutch, Sobel
Summary This bill defines the term "planned residential community."
The bill provides that community residential homes that have six or fewer residents and are located within a planned residential community not be required to obtain local government approval regardless of their proximity to each other.
The concern for advocates who oppose this bill is that it opens up the option of congregate living as a licensed living opportunity for individuals with developmental disabilities. Advocates believe this option could lead to a return to segregated living that resembles many of the institutions that were closed in the last few decades.
There is also the assertion that this would be an inappropriate use of the Developmental Disability Home and Community Based Waiver funding, a waiver that is intended for inclusive community living.
On the other hand, the bill's proponents feel that they have a right to choose this option, have compared it to living in a golf community, and see these planned residential communities as safe alternatives that will provide the individuals living there with more social opportunities and activities.
EFFECTIVE DATE: 07/01/2009.
04/29/09 HOUSE Substituted for HB 0371; Amendment(s) pending; Temporarily Postponed on Second Reading; Placed on Unfinished Business
05/11/09 HOUSE Died on Calendar
Identical bill HB 371 by Stargel Cosponsors: McKeel and CS Sponsors: Military & Local Affairs Policy Committee
04/29/09 HOUSE Read Second Time; Substituted for SB 1124; Laid on Table, Refer to SB 1124
SB 2480 - Relating to Schools/Students with Disabilities/Restraint by Gardiner -Cosponsors: Fasano
Summary This bill prohibits school personnel from manually physically restraining a student with disabilities. The bill provides an exception in emergency cases when there is an imminent and significant threat to the physical safety of the student or others. The bill prohibits mechanical restraint, prone restraint, and requires parental notification.
03/12/09 SENATE Referred to Education Pre-K - 12; Education Pre-K - 12 Appropriations
Never Heard in Committee
Identical Bills
HB 1449 - Relating to Use of Restraint and Seclusion on Students with Disabilities in Public Schools by Sachs
05/01/09 HOUSE Indefinitely postponed and withdrawn from consideration
SB 642 Relating to Autism License Plates and Autism Programs
By Altman
Summary This bill creates an Autism license plate and provides for distribution of use fees received from sale of these plates; the renewal of registration would include language permitting voluntary contribution to the Autism License Plate Fund.
The fee for the Autism license plate will be $25.The proceeds from the license plate annual use fee shall be distributed to Achievement and Rehabilitation Centers, Inc., to fund service programs for autism and related disabilities throughout the state and to operate and establish programs to support individuals with autism and related disabilities through direct services, evaluation, training, and awareness.
Achievement and Rehabilitation Centers, Inc. shall establish an Autism Services Grant Council that shall provide grants from available Autism license plate proceeds to nonprofit organizations for direct services and programs for individuals with autism and related disabilities and their families.
Consideration for participation in such services and programs shall be given to applicants who are children or adults with autism and related disabilities and their families and shall include those who are on the Agency for Persons with Disabilities waiting lists for services. Achievement and Rehabilitation Centers, Inc., shall also establish an Autism License Plate Fund.
Thirty-five percent of the proceeds from the annual use fee shall be used to establish and operate programs to support individuals with autism and related disabilities and their families through direct services, evaluation, training, and awareness in the state.
The Center for Autism and Related Disabilities at the University of Miami shall receive 15 percent of the proceeds from the annual use fee for distribution, as determined appropriate by the director of that center, to the seven regional autism centers. The regional centers shall use the proceeds to support the services they provide.
The remaining proceeds from the annual use fee shall be available to the Autism Services Grant Council for grants to nonprofit organizations to operate direct services programs for individuals with autism and related disabilities and their families and for marketing the Autism license plate. Effective Date: July 1, 2009.
05/01/09 SENATE Temporarily Postponed on Third Reading
The Autism license plate bill language was added to conforming language during the last day of budget conference meetings!
SB 348 - Relating to Medicaid Buy-in Program/Persons with Disabilities - 2009 by Crist
Summary The original bill provided for Medicaid eligibility for certain persons with disabilities under a Medicaid buy-in program, subject to specific federal authorization. The proposed Work Incentive Medicaid Coverage program would continue to offer Medicaid coverage to people with disabilities who are working. Once they enrolled in the program they would have the opportunity to earn more and save more than the allowable limits for regular Medicaid and still retain their health care coverage through the State's Medicaid Program.
This bill was changed to form a workgroup to hammer out more details on how to implement this program.
The group would have required that the four relevant state agencies sit down and work on the best way to implement this program in Florida.
The bill passed through two Committees in the Senate and was withdrawn from one committee. The bill was never heard on the House side.
EFFECTIVE DATE: 07/01/2009.
Filed
03/23/09 SENATE Reference to Health and Human Services Appropriations removed; remaining reference: Policy & Steering Committee on Ways and Means; Now in Policy & Steering Committee on Ways and Means
Similar HB 0529 - Relating to Optional Payments for Medical Assistance by Planas
05/01/09 HOUSE Indefinitely postponed and withdrawn from consideration
HB 745 - Relating to Prepaid Services for Parents of Children with Developmental Disabilities -
By Ford
Summary This bill establishes a study group to determine the feasibility of creating a prepaid service plan for children with disabilities modeled after the Florida prepaid college plan. The prepaidservice plan would allow funds to be paid into a fund on behalf of a child and would be used for vouchers for services to help the child to transition into the workforce. In addition, the bill specifies membership of the study group to include members of the legislature, the directors of the Agency for Persons With Disabilities (APD), the Division of Vocational Rehabilitation (DVR or division), and the State Board of Administration (SBA), the executive director of Arc of Florida (ARC/Florida), the chairperson of the Family Care Council/Florida, and a parent representative from a local Family Care Council. The bill provides that administrative support for the study group will be provided by APD and requires the study group to submit a final report to the Legislature no later than January 29, 2010, and that the study group will be abolished upon submission of the final report. The final report will address services for which a voucher could be used, financial requirements, qualifications of service providers and steps necessary to qualify this plan for a federal waiver program that would allow for federal financial participation. It is anticipated there will be an indeterminate, but insignificant, fiscal impact for travel expenses of the study group; provides for per diem & travel expenses for members; requires study group topresent final report to Legislature. Effective Date: July 1, 2009
04/27/09 HOUSE Read Third Time; Passed (Vote: 118 Yeas / 0 Nays); In Senate Messages
Identical Bills
SB 1278 - Relating to Children with Disabilities/Prepaid Service Plan by Altman
Added to the conforming bill SB 1660 in the budget conference period! |
