[rehab] proposal

Mon Dec 13 18:04:59 UTC 2010

What's the contact information for these people? RJ
----- Original Message ----- 
From: "Dick Davis" <ddavis at blindinc.org>
To: "'Rehabilitation Counselor Mailing List'" <rehab at nfbnet.org>
Sent: Monday, December 13, 2010 12:57 PM
Subject: Re: [rehab] proposal

Hi RJ,

I think you had better shoot a copy of this to Dr. Maurer, if you haven't
already.  I have seen the same b.s. used for years to justify umbrella
agencies, which never ever work.  Using Illinois, whose rehab system is the
pits, as an example shows how ignorant these people are.  When I ran
Minnesota State Services for the Blind, I saw the same kind of reasons given
for merging everything under Workforce Development.  When I was there, we
achieved 150 competitive closures in a year.  Now, under the new improved
system, they are lucky to accomplish half that.

I think what you wrote and sent me separately is a start, but lots more
needs to be done.  I suggest you contact Pearl Van Zandt and Carlos Servan
in Nebraska, since that is the most recent state to break out of an umbrella
and create a commission.  They did a nice job on it.  I'm sure they can give
you a lot of stuff that they submitted when they were working with the
politicians on it.

It is essential that you and the other people in Florida understand that all
this fluffy-wuffy stuff that they put in about the potential of disabled
people, the bucketload of jobs that will result, increased self-esteem,
opportunities, etc. is just a pack of lies.  If you read what you sent
closely, notice the focus on fiscal control, which is the real issue here,
not service, about which most bureaucrats could give a damn.

Dick Davis

-----Original Message-----
From: rehab-bounces at nfbnet.org [mailto:rehab-bounces at nfbnet.org] On Behalf
Of RJ Sandefur
Sent: Monday, December 13, 2010 11:25 AM
To: Rehabilitation Counselor Mailing List
Subject: [rehab] proposal

Here's what they're trying to do here in Florida.
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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