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Linda Seegraves April 20, 2012. Purpose. The primary mission of the agency is to support persons with developmental disabilities in living, learning, and working, in all aspects of community life. Service Models.
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Linda Seegraves April 20, 2012
Purpose • The primary mission of the agency is to support persons with developmental disabilities in living, learning, and working, in all aspects of community life.
Service Models • Developmental Disability Waiver, formerly known as the Home and Community Based Services Waiver (HCBS) • Tier 1 – $150,000 (with some exceptions) • Tier 2 – Capped at $53,625 of services • Tier 3 – Capped at $34.250 of services • Tier 4 – Capped at $14,422 of services • Consumer Directed Care (CDC) • Waiting List / General Revenue Funding • Institutional Care • I-Budget – NEW! More on that later
Disabilities eligible for APD under Chapter 393.063 of the Florida Statutes • Intellectual Disability (MR) • Down Syndrome (new in 2011) • Cerebral Palsy • Autism • Spina Bifida • Prader-Willi Syndrome • High Risk
Other Eligibility Requirements • Age 3 or above • Resident of Florida - A minor cannot establish residency • Legal resident of United States • Prove identity (Social Security card, Birth certificate, Permanent Resident card)
Medicaid Waiver Eligibility • Be an APD customer living in the community • Be offered a slot on the Medicaid waiver • Be eligible for Medicaid • IQ of 59 or less or • IQ of 60-69 with a secondary condition or severe functional limitations in 3 major life areas or • Primary diagnosis of autism, cerebral palsy, spina bifida or Prader-Willi syndrome and substantial limitations in 3 major life areas
Major Life Areas • Self care • Understanding and use of language • Learning • Mobility • Self direction • Capacity for independent living
Waiver Services The waiver provides: • Medically necessary medical & dental services • Medically necessary supplies & equipment • Assistance to secure a safe place to live • Transportation to access necessary services • Assistance to participate in a meaningful day activity. • See brochure for specific services
Process to Make a Referral for Application to APD • Call, write, fax, email or visit the APD office: Agency for Persons with Disabilities 305 East Drive, Suite L W. Melbourne, FL 32904 321-409-6518 • Be prepared to provide individual’s name, address, phone number, SSN, DOB, suspected disability • Application packet will be mailed to the family or guardian and it needs to be mailed back to APD
Application Packet • Instructions • Application for APD - Applications must be signed by the adult consumer or, if a minor, by the legal guardian • Collateral information request forms (request for records documenting a person’s disability) • Bill of Rights of Persons who are Developmentally Disabled • HIPPA forms • Informational pamphlets
Application Process • Referrals are kept open for 30 days • When a completed application packet is returned, an eligibility decision should be made within 60 days, or 45 days for children under 6 • Written documentation of the individual’s disability prior to age 18 is required • Psychological evaluations and adaptive testing are used to determine eligibility for ID and Autism • Medical records are used to determine eligibility for Down Syndrome, Cerebral Palsy, Spina Bifida and Prader-Willi
Wait List • As of July 1, 2011 there were 20,372 persons statewide on the waitlist • Wait list order is by date determined eligible - so the earlier individuals apply, the better.
Brevard County Numbers As of July 1, 2011, in Brevard County there were: • Persons receiving services through a waiver – 722 • Persons on the waitlist – 590
Waitlist Priority Categories • Old system – first come, first served • New system – 7 categories broadly based on urgency of need for services • Cat 1 – Those in a crisis • Cat 2 – Children in the foster care system • Cat 3 – Pre-Crisis • Cat 4 – Those whose caregiver is over the age of 70 and there is no other caregiver available
Waitlist Priority Categories – con’t • Cat 5 – Those who will be finishing school in the next 12 months and need assistance in finding a job or continuing their education • Cat 6 – Everyone else over the age of 21 • Cat 7 – Everyone else under the age of 21
Crisis Application • Individuals on the waitlist can be given priority for enrollment on the waiver if they are in a crisis situation which is defined as being – • 1) a danger to themselves or other, or • 2) homeless or • 3) in a situation where the caregiver is unable to continue to provide care Waitlist consumers need to call their caseworker in our office to request a crisis application
Other Important Things To Keep In Mind • Records prior to age 18 are extremely important. If individuals apply while still in school, it is easy to get records. • Brevard County Schools only keep cum records for five years after an ESE student finishes school. Then those records are destroyed and can never be recovered. Parents should be urged to keep their own records.
Other Important Things To Keep In Mind • Circumstances change so even if an individual is not in need of services at this time, it is still good to get on the waitlist NOW. • APD’s crisis process is slow. It is not emergency services. Brevard CARES does a better job of providing emergency services to families.
More Information http://apd.myflorida.com/publications/ • Supports & Services • Understanding Waiver Tiers • Manners That Matter