Happy New Year!

Florida ARF Says Goodbye to 2005

As we reflect on the past year, we note the rehabilitation industry continues to evolve around the community based service system that so many of you represent.  State institutions continue to close their doors.  Landmark Training center is now a memory and Gulf Coast Center is in the process of depopulating.  Legislative support is at an all time high for disability service programs, but confidence in the administration that supports these programs is at an all time low.  Employment is the key word. 

Managed care is being pursued by the State for many Medicaid services.  The Developmental Services population, for the most part, remains “carved-out” from managed care demonstrations.   

Unfortunately, 2005 resulted in huge unspent surpluses and continued waiting lists for Medicaid Waivers.  A hard battle was fought to achieve a Cost of Living Adjustment (COLA) during the 2005 session, but at the final hour, the funding was redirected to increased utilization for current clients.  We still count this as a victory in that more individuals will receive needed services.

On the employment side, Florida ARF welcomed Bill Palmer as the new director of the Vocational Rehabilitation Program.   Florida ARF also hosted an Employment Forum on Responding to Market Place Changes and co-sponsored the President’s Job Fair with the Central Florida Employment Council and others.  This model can be used by community agencies to develop jobs for individuals with disabilities across the state and we hope to work with several community agencies to implement it in 2006.  The Employment Steering Committee was revived late in the year and you will see a flurry of activity during 2006.

Other significant Florida ARF achievements in 2005 included:

• Actively lobbied for and was instrumental in the appropriation of $22 million additional dollars in the Developmental Services program and $20 million additional dollars in the Vocational Rehabilitation program.  
• Developed a comprehensive grassroots advocacy campaign featuring local community agency involvement such as provider testimony at legislative hearings, legislative visits at community agency sites, and a legislative breakfast.
• Represented Florida ARF member interests on multiple groups such as the Employment Work Group, Interagency Quality Council, Blue Ribbon Task Force, Florida Rehabilitation Council, Provider Public Reporting, and others.
• Prevailed in a rule challenge on Developmental Services Home and Community Based Services rates.
• Represented Florida ARF member interests at multiple administrative rule hearings such as ICF/DD licensure and rates, the Developmental Services Handbook, Developmental Services Rates, Siting Rule, IQ Testing, and others. 
• Entered into a partnership with the Florida Disabled Outdoors Association to mutually promote our missions, and improved collaboration efforts with partners such ARC Florida, Family Care Council Family, Network on Disabilities, Autism Society and others.
• Coordinated a public relations campaign known as “Step-Up” to present the needs of individuals with developmental disabilities to lawmakers.
• United with other advocacy groups to help defeat legislative amendments to the Administrative Procedures Act that would have severely limited individuals’ rights to appeal Medicaid funded service reductions/denials.

Most recently, our lobby team was successful in protecting federal exemptions available through the Federal Fair Labor Standards Act.  Because of these efforts, the Florida Minimum Wage Act now acknowledges the same exemptions and this will benefit many individuals with disabilities who seek employment training and job placement opportunities.

As we welcome 2006, Florida ARF is leading the battle for legislative approval of  COLA this session.  The campaign has been designed and January 1 marks the COLA kickoff.  To ensure that you are connected into the campaign there will be a special link on the Florida ARF webpage, www.floridaarf.org and regular COLA calls.

There has never been a time when it is more critical for the industry to unite.  As we battle for the COLA, we cannot lose sight of Medicaid Reform which is now the law.  Please encourage your peers to work with us to address these issues.  Have a Happy New Year and let’s work together to win the COLA battle!

On December 19, 2005, the Florida ARF Children’s Forum met via teleconference to review the Association’s intended legislative position regarding transfer of the Early Intervention program from the Department of Health to the Agency for Persons with Disabilities (APD), or other agencies such as the Department of Education.  The general consensus of the group was that support to move the Early Intervention Program to the APD or other agencies does not exist.  However, Forum members have asked other members to review the proposal (see attached notes) and if sufficient reason can be identified to support the transfer, the Children’s Forum will revisit the issue.  Questions or comments may be forwarded to Suzanne Sewell at ssewell@floridaarf.org

• Florida Inclusion Alliance Coordinator Invites Comments on Performance Plans 
  
  (Tallahassee, FL  December 28, 2005)  Kathryn Kamiya, the Florida Inclusion Alliance Coordinator, has invited public comments on IDEA Part B and C Plans to ensure that the plans appropriately reflect inclusion principles.  According to Kamiya, the Florida Department of Health is the lead agency for IDEA, Part C, which provides for early intervention services for children in natural environments, and the Florida Department of Education is the lead agency for IDEA, Part B, which addresses services in the least restrictive environment.  Each agency has been working to develop a draft state performance plan and Florida's plans are due January 31, 2006.  If you wish to participate in the review and comment phase for the plans, please go HERE.
   
• IDEA 2004 Act Demos Announced
  
  (Washington, D.C.  December 21, 2005)  John H. Hager, Assistant Secretary of the Office of Special Education and Rehabilitative Services (OSERS), U.S. Department of Education, invites you to submit comments regarding proposed requirements and selection criteria for the Paperwork Waiver Demonstration Program and the Multiyear Individualized Education Program (IEP) Demonstration Program.  Read more...

• Spectrum Training Systems Announces Training Slots Still Available for January Training
  
  (Tallahassee, FL December 31, 2005) Spectrum Training Systems has asked that we share that training slots are still available on a training session called “Behavioral Strategies, Medication and Public Safety for Autism Spectrum Disorder".  The session is scheduled for January 9-10, 2006, in Orlando Florida.  Read more...
   
• US To Boost Test Exemptions For Disabled
  
  (Boston Globe - December 14, 2005)   The US Department of Education plans to triple the number of disabled students that schools can partially exempt from annual tests required under the No Child Left Behind law.  Schools had been allowed to exclude about 10 percent of an estimated 6.5 million children with disabilities who qualify for special education services. The new rule would excuse another 20 percent of students, or about 1.3 million individuals.  Read more...
   

• GAO Reports about Education
  
  (Washington, D.C.  December 14, 2005)   Today, the Government Accountability Office (GAO) released correspondence on the Individuals with Disabilities Education Act indicating: “Education Should Provide Additional Guidance to Help States Smoothly Transition Children to Preschool” (GAO-06-26).  The full correspondence can be viewed  HERE; Highlights can be viewed  HERE

HMO-Medicaid caution is wise

(Tallahassee, FL  December 29, 2005)  Typically, Issues Forum Breaking News does not feature newspaper editorials.  (The www.floridaarf.org. website contains current industry related articles that can be accessed.)  However, the Herald Tribune recently published an editorial that expresses the sentiments of many of our members regarding Medicaid Reform and the events that occurred during the Special Session.  Therefore, we are sharing the article with you:

"Lost in the stunning, historic and extremely welcome action of the Legislature to ban all ‘freebies’ from lobbyists were the thoughtful and courageous actions by two of our own state legislators regarding health care."

One of the main reasons the governor called the recent special legislative session was to speed up the process whereby all Medicaid recipients would be enrolled in HMOs. He specifically wanted steps in the process to be controlled by his state agency heads.

Throughout the spring session of the Legislature and now this special session, it has been state Senator Lisa Carlton of Sarasota County who led the effort to move cautiously with pilot HMO-Medicaid projects. Her rationale: Before plunging in, let's make sure this really will save Medicaid dollars without jeopardizing needed care.

In the House, it was a freshman legislator -- Representative Paige Kreegel of Punta Gorda -- who helped assure a deliberative approach. At a time when support for giving control of the HMO-Medicaid expansion to agency heads seemed imminent, Representative Kreegel stood up and supported an amendment that would require the Legislature itself to approve each step in the expansion process. It took courage to go against his own leadership, but he did it.

What finally passed was a process of pilot projects, carefully developed and evaluated, with the Legislature controlling any expansion.

We should thank Senator Carlton and Representative Kreegel.”   TC, Port Charlotte

The above position reflects the concern several advocacy agency representatives expressed during our November Legislative Platform Summit meeting and will ensure that the State uses a deliberative approach before proceeding with Medicaid managed care expansion.

Managed Care Training

(Tallahassee, FL  December 30, 2005)   A training session on how Medicaid managed care will affect the community agency industry is being offered on January 25, 2006.  The need for the training was discussed at the Florida ARF September quarterly meeting and in response to your request, Florida ARF has partnered with ARC Florida to assist in sponsorship of a one-day session. The training will be conducted by Health Management Associates (HMA) and is available for agency administrators represented by ARC Florida and Florida ARF.  It will be held in Altamonte Springs, FL in conjunction with an ARC Florida meeting.  The registration fee is $75 per person prior to January 13, 2006, and $100 after that date.   See attached registration form.

Community Supports Announcements:

• Kaiser Commission Reviews Florida Medicaid Reform
  
  (Tallahassee, FL  December 30, 2005)  The Kaiser Commission has reviewed Florida’s Medicaid Reform Proposal and published a four-page summary of the request.  The review is one of the more succinct summaries we have seen.  Read more...
   
• Working with Providers in the Home Document Recommended
  
  (Tallahassee, FL  December 22, 2005) The State of Arizona has developed a tool kit for individuals and families to use when they employ their own in-home providers. This document was discussed at the last Interagency Quality Council (IQC) meeting and was described as being very easy to follow and straightforward.  Read more... 
   
• Public Reporting Work Group Develops Feedback Survey
  
  (Tallahassee FL  December 30, 2005)  In 2005, a multi-agency work group led by the Delmarva Foundation and the Agency for Persons with Disabilities developed a web based system to report performance and demographic information on providers serving individuals with developmental disabilities.  Available information includes provider compliance scores for agencies receiving funding through two Medicaid Waivers (Home and Community Based Services and Family and Supported Living).  The webpage, known as The Florida Developmental Disabilities Resources Website, is a public reporting resource for individuals with developmental disabilities who live in or are moving to Florida.  The site may be viewed HERE.   In December 2005, the Work Group developed a draft feedback survey for the public reporting website and a copy is attached.  If you have feedback or suggestions regarding this survey instrument, please forward your comments so we may share them with the work group.  Read more...
    
• Agency for Persons with Disabilities Shares Resources from Quarterly IQC Meeting
  
  (Tallahassee, FL  December 21, 2005)  Linda Mabile from the Agency for Persons with Disabilities has shared the following information and links presented at the last Interagency Quality Council (IQC) meeting.  These should give you a good idea what other states are doing regarding quality assurance.

www.hcbs.org/files/28/1377/QFramework.pdf
www.hsdspd.utah.gov/docs/support_book_mr.pdf   
www.hsdspd.utah.gov/selfadmin_mentalforms.htm
www.ddmhs.state.vt.us/docs/ds/ddsGuideforPeopleSelfManaging2004.pdf
www.vcu.edu/partnership/choice.htm
www.hsri.org/docs/QF_MA_DMR_QA_Report_FINA 2002and03.doc

• Participants for Citizens' Health Care Working Group Meeting
  
  (Winter Park, FL  December 21, 2005)  The Winter Park Health Foundation is seeking Participants for a Citizens' Health Care Working Group Meeting on January 24, 2006.  Space is limited!  Read more...
   
• American Congress of Community Supports and Employment Services (ACCSES) Reviews Appropriations Bill
  
  (Washington, D.C.  December 22, 2005)   Marc Kilmer from ACCSES forwarded a concise summary of two final appropriations bills (Defense and Labor-HHS-Education).  The summary was prepared by Peter Thomas of the law firm Powers, Pyles, Sutter and Verville.  According to Thomas, “Following several days of tense floor debate and closed-door negotiations, the Senate approved late Wednesday evening the two remaining Appropriations bills for fiscal year (FY) 2006 – Labor-Health and Humans Services-Education and Defense, and adjourned for the year.  After a short procedural session in the House Thursday afternoon, both bills now await the President’s signature.”  Read more...
   
• ANCOR Reviews Reconciliation Bill by Suellen Galbraith
  
  (Washington, D.C.  December 31, 2005)  ANCOR indicates their earlier analysis of the Reconciliation Bill remains essentially unchanged and that the House has to vote on the bill again because of slight modifications to the Senate bill.  These modifications do not change the conference report on reconciliation itself.  The House will vote again, but is not scheduled to be back in session until late January 2006.  ANCOR indicates the next step is to get more House members to vote against the Reconciliation Bill when it comes back to that chamber with the Senate modifications.
  
  (Washington, D.C.  December 20, 2005)  House members received the 775-page budget document at 1:00 a.m. December 19, 2005, before voting by dawn on the final bill.  Many people think the conference report does not do as much harm as original House budget--wrong.  See worst provisions and side-by-side attachments.  Remember, the conference report deleted the big savings from Medicare by eliminating the cuts to the stablization fund that is no longer needed to get managed care Medicare drug plans involved.  The conference report totally goes back on the Senate vote not to harm beneficiaries by including unlimited co-pays and unlimited premiums for children and some people with disabilities.  See the New Center on Budget Report on Budget  http://www.cbpp.org/12-20-05bud.pdf
   
• DSPA Warns House-Passed Budget Reconciliation Conference Agreement Bad for Persons with Disabilities; Calls on Senate to Reject the Bill
   
  (Washington, D.C.  December 19, 2005) – The Disability Service Providers of American (DSPA) today warned that the Budget Reconciliation bill pending before Congress is harmful to persons with disabilities. The reconciliation package includes nearly $35 billion in cuts over the next five years.   Read more...

• Agency for Persons with Disabilities Presents Employment Opportunities Strategy
  
  (Tallahassee, FL  December 30, 2005)   On November 7, 2005, Agency for Persons with Disabilities (APD) Director Shelly Brantley presented before a joint conference between the National Conference for the Center for the Workers with Disabilities and the National Association of State Medicaid Directors.  Brantley’s presentation described Florida’s employment strategies for individuals with developmental disabilities and a press release is available that summarizes the information shared and how the Agency intends to achieve its employment goals.  Read more...
   

• APD-Approved Live Training in Supported Employment

  (Tallahassee, FL December 31, 2005) We have received notification from TRN-FL Supported Employment [Dale Dileo] that several training slots have been released for a live 3-day training in Supported Employment that will be held in Pensacola on January 10-12, 2006. The training is targeted for Pensacola area stakeholders, but has extra capacity. The slots will be filled on a first come, first serve basis. There is no fee for this training, but attendees must travel at their own expense. Registration is due January 5, 2006. Questions may be directed to Tara Thompson: tthompson@fmhi.usf.edu. 813-974-4581 To download the registration go to: http://www.flse.net/PNSflyer.doc

• WIA, Rehabilitation Act Legislation Unlikely this Year  By Brandon Macsata, Managing Partner, The Macsata-Kornegay Group, Inc.
  
  (Washington, D.C. December 31, 2005) Congress adjourned the First Session of the 109th Congress without passing legislation reauthorizing the Workforce Investment & Rehabilitation Acts.  It had been reported that the Senate was poised to bring the “Workforce Investment Act Amendments of 2005” (S.1021) to the floor for a vote, followed by the appointment of a conference committee to reconcile differences with the House-passed bill.  Both Acts are still authorized under the 1998 law under a Continuing Resolution.  Read more...
   
• Assistant Secretary W. Roy Grizzard, Jr. Addresses Employers at the EARN/Monster.com Inaugural Strategic Workforce Symposium
  
  On November 16, 2005, the Employer Assistance & Recruiting Network (EARN) and Monster.com joined forces to host the first ever Strategic Workforce Symposium in Washington, DC. More than 50 human resource managers and diversity officers from public and private organizations across the nation attended the event to explore strategies for fostering a corporate culture inclusive of people with disabilities.
  
  Dr. Grizzard, who leads the Office of Disability Employment Policy spoke of the importance of corporate leadership in the recruiting, hiring, retention, and advancement of persons with disabilities Other distinguished speakers included the past President and CEO of the Society for Human Resource Management (SHRM), and representatives from Microsoft, Inc., Manpower, Inc, and the Job Accommodation Network (JAN). Monster.com provides online recruitment services. Both JAN and EARN are services of the Office of Disability Employment Policy.  Go to EARN website.