[Nfbf-l] The proposal

Tue Dec 14 01:52:50 UTC 2010

RJ, I thought your proposal was very good.  I also had another idea I 
thought I would throw out here to see waht everyone thinks.

As previously stated by many, lumping all disabilities together would 
definitely not be a good idea, for any disability, especially blindness. 
Therefore, obviously, we are going to have to convince the powers at be, why 
this is not a good idea.

Many folks have already stated their disapproval, and that's a good thing. 
perhaps we may want to consider another tactic to try and promote 
understanding of why so many are against this action.

Since most of these powers at be are sighted, perhaps an approach that one 
might consider would be to put ourselves on their playing field by 
presenting another scenario that they themselves can relate to, that 
parallels our point.  Then, perhaps they will understand where we are coming 
from.  So far, I myself can not think of anything, but maybe someone else 
out here can, so, lets all give this some thought, and see what we can come 
up with that will prove our point.

Just putting my two sense in!!

----- Original Message ----- 
From: "RJ Sandefur" <joltingjacksandefur at gmail.com>
To: "NFB of Florida Internet Mailing List" <nfbf-l at nfbnet.org>
Sent: Monday, December 13, 2010 12:18 PM
Subject: [Nfbf-l] The proposal

Guys, I spoke with bryan Von this morning on the telaphone, and He's hearing 
you loud and clear, but he strongly feels what he's doing is in our best 
interest. He knows the NFBF isn't standing down.
Here's the proposal in its intirity, for those who don't know what's going 
on.
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.

  a.. 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 lifecycle.

  a.. This department can have one point of entry with a standardized 
application, eligibility criteria, provider qualifications, and provider 
rates for all services and programs.

  a.. Creation of new jobs in the areas of community - 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:

  a.. Agency for Healthcare Administration (AHCA), the
  b.. Department of Health (DOH), the
  c.. Department of Children and Families (DCF), the
  d.. Department of Elder Affairs(CARES), the
  e.. Department of Education (Vocational Rehabilitation and Division of 
Blind Services), and
  f..  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.

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

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

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

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

Ø  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.

v  The department will maximize existing resources, such as using the 
Clearinghouse on Disability Information to:

Ø  Maintain one website for all information on disabilities.

Ø  Operate a single toll-free phone number with accessibility built into the 
system.

Ø  Have a dedicated information referral system that not only serves 
consumers, but providers and other state agencies.

v  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.

v  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.

v  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.

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

v  Serve consumers and providers will be served in a timelier and more 
consistent manner statewide.

Ø  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.

Ø  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.

Ø  The Legislature will only need to deal with one budget to fund all the 
waivers.

Ø  The processes for being placed on a wait list will be standardized 
throughout all the individual waivers.

Ø  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.

Consolidation

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

v  A coordinated waiver program would require fewer administrative staff, 
intake and referral staff, provider enrollment staff and fiscal staff to 
monitor expenditures.

v  There would be a reduction in allocated office space, expenses, and 
equipment allocations for personnel due to consolidation into one agency.

v  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.

v  Consolidating multiple call-centers for consumers and providers would 
still allow calls to be channeled from one line directly to the appropriate 
waiver specialist.

Creation of Private Sector Jobs

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 he/she 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.

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