“Planning Our Future” All Ages May 9, 2015 Wildwood, Florida Barbara Palmer Director Rick Scott Governor

2 2 Arthur Barndt has more than 10 years working directly with people with Intellectual Disabilities and children in crisis and an additional 10 years with Florida ’ s Agency for Persons with Disabilities. Barndt is dedicated to seeing people with disabilities living, working and learning in their communities. A graduate of Kutztown University of Pennsylvania with a Bachelor of Arts degree in Speech Communications, Barndt is also a certified Project Management Professional, a certified Community Work Incentive Coordinator and a certified supported employment trainer Arthur Barndt PMP® iBudget Manager with the Office of Programs

3 3 o Legislative o Strategic Plan Goals o Questionnaire Situational Information (QSI ) o iBudget Waiver o Person-Centered Planning

4 4 Legislative Director Barbara Palmer was reappointed May 2015 by Governor Rick Scott

5 5 Legislative Director Barbara Palmer met with the Chair of House Appropriations, Chairs of both Senate and House Health Care Appropriations

6 6 Legislative And many other key leaders, totaling 52 legislative members during the 2015 Legislative Session, sharing APD’s goals and vision for the future

7 7 Legislative Governor Scott and the Legislature have provided $56 million to enroll new people from the waiting list

8 8 Legislative Because of Governor Scott’s recommendation and the Legislature’s approval, our agency has been able to offer waiver enrollment to more than 2,800 people with critical needs during the past two years

9 9 Legislative We are hopeful the Legislature will support Governor Scott’s budget recommendation for $8 million to move more than 400 people with critical needs from the waiting list to the Medicaid waiver next fiscal year

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LIVING LEARNING WORKING 2015 Strategic Plan Agency for Persons with Disabilities “Planning Our Future” Your own footer

12 Strategic Plan Goals Manage Agency Budget within Fiscal Allocation Deploy a client-data-management system (CDMS) Develop strategies to access program services for children through the Children and Youth Cabinet

13 Strategic Plan Goals Improve Management and Oversight of Agency and Provider Services People with developmental disabilities live in the most integrated setting that is safe and appropriate for their level of care Adhere to the new Home and Community-Based Services transition plan requirement established by the Center for Medicaid and Medicare Services (CMS)

14 Strategic Plan Goals Improve Access to Community-Based Services, Treatment and Residential Options Develop a service model and rate for individuals with dual mental health diagnoses and intensive behaviors Improve service delivery to individuals whose family caregivers are aging and have dementia

15 Strategic Plan Goals Increase the Number of Individuals with Developmental Disabilities in the Workforce Develop a systematic approach for job placement, customized employment, or a career path Expand the Employment Enhancement program to serve people on the waiting list annually

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17 Questionnaire on Situational information(QSI) What is a QSI? The QSI is the Agency’s approved functional needs assessment The assessment tool was determined valid and reliable by the University of South Florida and the Human Services Research Institute

18 Questionnaire on Situational information(QSI) Purpose of the QSI Gather key information about a person’s life situation over the last 12 months Plan for supports and services to meet the needs of the individual for the next 12 months

19 Questionnaire on Situational information(QSI) Frequency of the QSI Conducted every three years for all consumers, and Upon request from consumer, parent, or legal guardian

20 Questionnaire on Situational information(QSI) Frequency of the QSI Re-administered to identify any possible changes in levels of support in the event that an individual experiences a major life change (such as moving from one residential setting to another, major changes in caregivers or major health changes)

21 Questionnaire on Situational information(QSI) QSI Staff  65 certified APD staff administer the QSI full time  46 additional APD staff certified to administer the QSI as adjunct duty  Requires annual recertification

22 Questionnaire on Situational information(QSI) Face-to-Face Interview Must include the person being assessed Encouraged to invite anyone familiar with capabilities and life situation

23 Questionnaire on Situational information(QSI) Face-to-Face Interview Must include the person being assessed Encouraged to invite anyone familiar with capabilities and life situation

24 Questionnaire on Situational information(QSI) Face-to-Face Interview WSC must attend if the individual being assessed requests Legal representative must be contacted for consent, but participation is not mandatory

25 Questionnaire on Situational information(QSI) QSI Information APD website View, print, or download the QSI Version 4.0

26 Questionnaire on Situational information(QSI) QSI Information Review frequently asked questions about the QSI View, print, or download the QSI and You brochure in English or Spanish

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28 iBudget Handbook How services are to be administered Qualifications for providers Requirements Public Meetings held during past 2 years

29 iBudget Algorithm How money is allocated to each consumer for their individual budget Currently under revision Public meetings held since December, 2014

30 iBudget Current Algorithm Age (under 21, over 21) Living setting (family home, supported living/independent living, group home, residential habilitation center) QSI Functional and Behavioral Sum of Scores of all questions Additional QSI questions Question 18 = transferring Question 20 = maintain hygiene Question 23 = self-protect

31 Living Setting FH =Family Home Live2ILSL = Independent and Supported living Live2RH1 =Residential Habilitation (Standard) and Live-in) Proposed Tentative Algorithm

32 Age Ages:3 – 21 Ages:21 – 30 Ages:31+ n) Proposed Tentative Algorithm

33 Bum=Behavior Sum FHFSum =Family Home Functional Sum SLFSum =Supported Living/Independent Living Functional Sum SLBSum = Supported/Independent Living Behavior Sum Proposed Tentative Algorithm

34 Q16=Functional Status, Eating Q18=Functional Status, Transfers Q20=Functional Status, Hygiene Q21=Functional Status, Dressing Q23=Functional Status, Self-protection Proposed Tentative Algorithm

35 Q28=Behavior Status, Inappropriate Sexual Behavior Q33=Physical Status, Injury to the Person Caused by Aggression toward Others or Property Proposed Tentative Algorithm

36 Q34=Physical Status, Use of Mechanical Restraints or Protective Equipment for Maladaptive Behavior Q36=Physical Status, Use of Psychotropic Medications Q43=Physical Status, Treatments including Nursing Proposed Tentative Algorithm

37 Multiple R – Squared for proposed tentative model after removing 9.40% outliers (2,410 consumers): “R-square” Proposed Tentative Algorithm

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39 Person-Centered Planning is a planning approach based on the individual’s perspective rather than that of a program or resource to identify supports and services to meet needs Person-Centered Planning involves the individuals receiving services and the significant people in their lives Person-Centered Planning

40 Goals and outcomes that are important to the individual are identified, along with the supports needed to achieve them Currently, WSCs are required to use a person-centered planning approach in the support plan and cost plan development process. Providers are required to implement person-centered supports and services Person Centered Planning

41 New federal HCBS Rules layout specific requirements of a person-centered planning process. These include: items related to who participates in the process; ensuring no conflicts of interest; cultural considerations; goal and risk factor identification; choices in where to live; activities and services; etc. Stakeholders recommend training for individuals, families, and providers regarding person-centered planning requirements Person-Centered Planning

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43 Arthur Barndt PMP® iBudget Manager with the Office of Programs Thank You