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More Cuts to Rates in Florida’s APD Budget

APD Continues Cost Containment Efforts

Tallahassee — On April 1, Agency for Persons with Disabilities (APD) will reduce the rates it pays for therapy assessments and all nursing services to the standard rate paid by the Medicaid State Plan. Currently, the APD Home and Community-Based Services Medicaid waiver pays higher rates for most of these services.

This rate change is the latest cost containment effort by APD to work toward bringing waiver expenses closer to the agency’s Legislative appropriation for the waiver.

The Legislature approved $810 million for APD’s Home and Community-Based Services Medicaid waiver for the 2011-12 state fiscal year that began on July 1. APD customers received $930 million worth of services last year.

While the agency is working to reduce Medicaid waiver expenditures, it is also looking for opportunities to increase waiver flexibility and equity for customers with the new iBudget Florida waiver. More than 3,000 APD customers in North Florida have transitioned to the new iBudget waiver which allows families to shift funding around to meet their current priorities.

APD annually serves more than 50,000 Floridians with developmental disabilities of autism, cerebral palsy, Down syndrome, intellectual disabilities, spina bifida, and Prader-Willi syndrome. The agency’s Medicaid waiver helps to support about 30,000 individuals with developmental disabilities so they may live and participate in their local communities. Those 30,000 people will all be transitioned to the new iBudget Florida waiver by July 2013.

For more information on iBudget, visit the website iBudgetFlorida.org.

For more information on the agency, call 1-866-APD-CARES or visit APDcares.org.


IPad Kiosks for Therap in Residential & Day Programs

Carolina Autism Supported Living Services in Charleston South Carolina has found a great way to use IPads in their group homes for documenting in Therap!  Here is a description and pictures from Phil Blevins, Executive Director:


“We used iPadWallBracket.com for the enclosure. There are many other sites with similar products but this seemed best for our purposes. We chose the enclosure that covers the “home” button. Then we installed a Kiosk program on the iPad. We chose Kiosk Pro from the Apple store. It’s free but there is a paid version with more features. We set the Therap login page as the start page and limited the kiosks browsing range to the therap domain. There are a few things I could note about setting it up if you ever want details.

We mounted the enclosure to a rolling laptop stand from Office Depot. Since it is plastic we chose not to drill holes in it but used a metal/plastic polymer adhesive to attach the enclosure.

We used iPads with WiFi instead of 3g so we have to make sure there is a working wireless router in the houses. And I’ve noticed that the iPad can’t handle the pop-up body image when entering skin/wound notes. But the staff person can still choose body parts from the drop-down menu. There may be other iPad quirks but we haven’t run into them yet.”
IPad Kiosks for Therap in Residential & Day Programs1      IPad Kiosks for Therap in Residential & Day Programs3  IPad Kiosks for Therap in Residential & Day Programs2

Therap National Conference – A Big Success!

Therap National Conference pic1In preparation for Therap Services pre-conference meetings on Monday, some of us came in early on Sunday to catch the Superbowl at a local Sports Bar-Redds, right across the street from the Met-Life Stadium where the Giants and Jets play!  It was sweet victory for New York and very exciting to be in the middle of it all!

We had a great conference with around 350 attendees, 3 days of over 35 sessions including: Basic to Advanced User sessions, Provider Organizations Special Topic sessions and Brainstorming with Therap Programmers! 

Therap National Conference pic2

Of course, being New York, we always take a trip to “The City” and what a great time of eating pizza, walking around Manhattan to look at the sites!  

Therap National Conference pic3

                           Therap National Conference pic4   Therap National Conference pic5

If you missed it, you can still get to one of our Regional Conferences this year.  Check out when we are coming to a town near you!


Florida APD: IBudgets To Roll-Out in Areas 1 & 2

For Immediate Release: Contact:

January 31, 2012 Melanie Mowry Etters
Communication Director
APD to Implement iBudget Formula
TALLAHASSEE — The Agency for Persons with Disabilities (APD) is announcing that it will
implement the final component of the iBudget Florida program for its customers in Northwest Florida
and the Big Bend area by April 1.
iBudget Florida is a new way to deliver Medicaid waiver services that has been approved by both
the Florida Legislature and the federal Centers for Medicare and Medicaid Services (CMS). It provides
Floridians with developmental disabilities in the Medicaid waiver program more flexibility in choosing
their services.
The April 1 transition will include APD customers living in Escambia, Santa Rosa, Okaloosa, Walton,
Bay, Gulf, Calhoun, Jackson, Washington, Holmes, Franklin, Leon, Wakulla, Gadsden, Liberty, Madison,
Taylor, and Jefferson counties, which comprise APD's areas 1 and 2.
APD customers in areas 1 and 2 have been using the iBudget Florida program since October 2011.
Customers in other areas of the state will be enrolled into the program later this year. An enrollment
schedule will be announced soon.
iBudget Florida is designed to make the funding process fair and equitable for all Medicaid waiver
customers. Waiver support coordinators will assist customers and their families in managing service
approvals and other aspects of the program using an online Web‐based system.
APD annually serves more than 50,000 Floridians with the developmental disabilities of autism,
cerebral palsy, Down syndrome, intellectual disabilities, spina bifida, and Prader‐Willi syndrome. For
more information on this program and the agency, visit iBudgetFlorida.org and APDcares.org or call tollfree
1‐866‐APD‐CARES (1‐866‐273‐2273).


Community Services At Risk In Florida: Senate Bill 1516

Are you concerned about loosing community services for individuals with disabilities?

Senate Bill 1516 will have a hearing that will be held today at 3:30 p.m. by Senator Storms’ Committee.  This bill amends the DD Act.  For more information, you may go to the Florida ARF website, www.floridaarf.org,  grassroots page and click on the grassroots summary document on Saving DD Services.





Therap 2012.0 Released: Lots of New Features!


Therap 2012.0 Released!


We are now on version 2012.0 of the Therap Applications. We have worked relentlessly on getting the system up and running with lots of new and exciting features and updates. We hope to receive your valuable feedback on the new features.



Interview with APD Director, Mike Hansen

The Florida Current - Smartly Covering Florida Politics & Policy

Q&A with: Mike Hansen

By Christine Jordan Sexton, 01/06/2012 – 02:48 PM
Agency for Persons with Disabilities Director Mike Hanson. Photo Credit: Ana Goni-Lessan
Agency for Persons with Disabilities Director Mike Hanson. Photo Credit: Ana Goni-Lessan

Mike Hansen is the recently appointed director for the Agency for Persons with Disabilities.

An avid runner, Hansen, 59, worked in Miami-Dade County in the 1970s in the former Department of Health and Rehabilitative Services. He also worked at state agencies in Tallahassee before moving to the Legislature and then into the governor’s Office of Planning and Budgetingunder former Gov. Jeb Bush. Before being tapped by Gov. Rick Scott to lead APD, Hansen was theSenate Health and Human Services budget director. About 30,000 clients are served by APD Medicaid programs and Hansen — who has been at APD since the summer — says he has a spreadsheet in his office detailing who the clients are and the services they get. He looks at it regularly. He appears before the Senate Children, Families and Elder Affairs Committee this Thursday for a confirmation hearing.
You went from Senate staff director for the Health and Human Services budget to director of the Agency for Persons with Disabilities. How did that occur?

“I was approached over a period of time. It wasn’t a one-time deal.  People started talking to me from the governor’s office and started asking me questions. It was over a several months period of time which started during the session.  Of course in the position I was in, I did not want to really entertain an employment opportunity that could be construed that I made some decision in my previous job that would impact my decision. So the initial response was ‘I am not going to be interested in talking about this.’ Of course I was able to think about it over that period of time . …. In my line of work your position is good the day you are in it. You never know what tomorrow is going to bring. I am never in the habit of saying to someone ‘I would never consider doing that’ because who knows where you are going to be tomorrow? Who knows what you are going to have to deal with the next day? Who knows what the situation is going to be? As time went on, I had more time to think about it and the offer was very generous, very kind. It was ‘We need you to help us figure out how to make this agency work better.’ ”

Given the fact that the program is bigger than the appropriation — it’s a $900 million program with an $810 million budget — and it’s been bedeviled by budget crises, were you concerned about taking the position?

“Well, I did talk to the governor about that and basically said, ‘If you are going to evaluate me at the end of the first year as having brought the agency’s budget in line with the appropriation, I don’t feel like I can achieve that goal. So if that is your expectation, I am not the right guy for this job.’ I think I can make strides, I think I can move in the right direction, but I think it’s going to take longer than 12 months and I think there’s a lot of legwork that has to be done to figure out exactly what it would take to get there. If getting to that number means jeopardizing the health and safety of our clients, I’m not interested in getting to that number, and I know the governor is not interested in getting to that number, and I don’t think the Legislature is interested in getting to that number if that’s what it means.

“But there is a belief out there that money is being spent in a way that it can be more wisely spent and that is clearly my belief as well. We can do a better job of utilizing these resources. And that is what we are about trying to do and trying to figure out how we do that. If they

[the Scott administration] had told me to come in here and balance this budget no matter what, I would have told them, ‘I’m not interested,’ because I don’t think it can be done and it’s not the right thing to do. But that’s not what they asked me to do. They asked me to try to do the best job I could in figuring out are we using these resources as wisely as they can be used. And I’m certainly agreeable to do that and that’s exactly what we’re trying to do.”

To that end, the agency has taken a look at “core services.” What are core services? It has been somewhat controversial because core services differ from person to person. Where does this plan stand right now? 

“Obviously it has generated a lot of controversy — the notion of core services —  and we are planning to move away from core services because I think it was misconstrued. I think what our intention was, and how it was viewed, were two different things. And I don’t think that concept is a useful concept to move forward, so we are going to discontinue the use of the term.”

Will you discontinue the use of the term but move on with the idea?

“Well, the idea is we have to find a way to correct budgets for ‘extraordinary need,’ that’s the term used in the statute. We are trying to figure out a way of coming up with a proxy for people who have extraordinary needs. That’s what we are looking at trying to figure out. But the distinction I think you have to make is, it’s one thing to determine the amount of money someone needs to meet their extraordinary needs. It’s another thing to say, ‘These are core services and these are the only serves you can have access to.’ We never were saying that and we are not saying that now, but I think the use of the term led people to believe we were saying that.

“We are moving forward with a definition of ‘extraordinary need.’ We are trying to quantify that definition, but we don’t want people to get confused between the notion of extraordinary need and limits on how they can spend their cost plan. Our clients are only going to benefit from the concept of extraordinary need. No one is harmed. People are only benefitted by that, and that’s what I’ll hope they will understand.  The idea is we want to make sure people have a safe place to live.”

One month ago you said the approximate price tag of the ibudget (APD’s new system of budgeting that gives clients a set allocation of money but with more flexibility on how to spend it) with the algorithm is about $870 million. Has that number changed?

“No, I think it is about that number. It would cost us a lot less than that if we decided we don’t want to care of ‘extraordinary needs.’ ”

Are you asking the Legislature to change the mission statement of this agency to bring it more in line with your appropriations?

Well, some bills are going to be filed. Until a bill is filed it’s not a public record so I don’t want to speak. I think, and you’ve heard me testify, that there may be some incongruence between [APD’s mission statement] and the actual amount of the appropriation. I think there could be some tweaking to clarify those points.”

Are you a cattle rancher?

“I am a person who enjoys living in the country. Growing up I lived in all the big cities in the Northeast but my preference is the country. So I live now on 52 acres in Wakulla County and I’ve got some cattle. I used to have some hogs. I have chickens. I enjoy that life. I also grow a lot of trees. So that’s the other side of me. The non-work side of me. I’m like [President] George Bush 43. On my days off or my vacations, I’m out there working in the woods, clearing brush, building fences. Then there’s the other side of me, the reason I’m in Florida is I love the water. I have boats and my other passion is fishing, spear fishing and cast netting. So those are the things I do when i’m not doing this. It’s a nice contrast.”

Reporter Christine Jordan Sexton can be reached at csexton@thefloridacurrent.com.

Reporter Travis Pillow contributed to this story. Travis Pillow can be reached at tpillow@thefloridacurrent.com

Florida Medicaid 5010 Implementation

Therap is 5010 Compliant:

Therap 5010 Support

Click Here for More Information

Better Health Care for All Floridians

A Division of the Agency for Health Care Administration

Health Care Alerts & Provider Alerts Messages
December 2011

Provider Type(s): All

Reminder – Florida Medicaid 5010 Implementation Schedule

The FMMIS will be frozen from 8:00 p.m. January 1, 2012 until 4:00 a.m. January 2, 2012 for inbound transactions.

4010 versions of X12 transactions will no longer be accepted after 8:00 p.m. January 1, 2012.

Please disregard the following if you or your billing partner have already converted to X12 5010 for outbound X12 transactions before December 30, 2011.

If you have not converted to 5010 before December 30, 2011 you will receive X12 Outbound batch and or real-time for 820, 834, 835, 271, 277, 277U transactions as follows:

  • Transactions submitted to the FMMIS before January 3, 2012 will be provided on the outbound transaction in the current 4010 X12 version.
  • Transactions submitted to the FMMIS after January 2, 2012 will be provided on the outbound transaction in new 5010 X12 version.


Contact Your Legislator

Go To FDDC Website for a review of the iBudget and  to send your feedback to your Legislator


Significant budget cuts to the developmentally disabled will be made with the implementation of the iBudget.


Therap Regional Conference: Therap & CCHIT, Kissimmee, Florida, December 6-7, 2011

This week we will be in Kissimmee, Florida to hold our first Florida Regional Conference.  There are currently over 25 organizations and approximately 80 individuals registered.   In addition to usual training intensive sessions, there will be a number of sessions on nationally significant topics such as CCHIT and the meaningful use of Electronic Health Records (EHR).

Session highlights will include:

A close look at Therap’s Health Tracking modules for appointments, seizures, lab tests, vital signs, and medication histories

Introduction to Therap Medication Administration Records (MAR)

Therap Individual Service Plans (ISP)

Hands on training on different Therap modules including Therap GERs (incident reports), Time Tracking, Secure Communications and Training Management

A close look at Therap electronic billing, service authorizations and claim tracking

Advanced Training on Provider Administration, Super Roles and Caseloads

Conference Agenda and Additional Information:

Therap Regional Conference: Therap & CCHIT, Kissimmee, Florida, December 6-7, 2011