DOL Homecare Rule Webinar



The Department of Labor (DOL) published a Final Rule on October 1, 2013 extending minimum wage and overtime pay protections under the Fair Labor Standards Act (FLSA) to most home care workers (who may have job titles such as home health aide or personal care assistant) who provide essential assistance to people with disabilities and older adults.  On August 21, 2015, the U.S. Court of Appeals for the D.C. Circuit issued a decision upholding the Final Rule.  On Friday, September 18th from 2:00-3:00pm Eastern Time, senior leadership from the U.S. Department of Labor’s Wage and Hour Division and Office of the Solicitor will hold a webinar to discuss the Home Care Final Rule.  Presenters will provide an overview of the Final Rule as well as the Department’s guidance regarding joint employment in domestic service employment under the FLSA and the application of the FLSA to shared living programs.  Our comments will address questions we have received from states, including about the home care litigation.


Please click  to register for the webinar.

Once you register, you will receive an email with the information you need to access the webinar.


There will be a question and answer period after DOL’s presentation.  If you would like to submit a question(s) in advance, please email it at your earliest convenience.  During the webinar, we will respond to as many questions as possible.


Information about the Home Care Final Rule is available at

Information about the litigation related to the Home Care Final Rule is available at

Florida Medicaid Provider Self Audit Resources – Now Available

A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
July 2015

Provider Self Audit Resources are Now Available on the Agency’s Website

Medicaid providers are encouraged to voluntarily conduct self-audits and remedy any issues of non-compliance that are identified, including either voiding/adjusting improper claims or submitting to the Agency’s Bureau of Medicaid Program Integrity (MPI), the self-audit findings and repayment of the improper claims.

MPI recommended that providers review claims with dates of service as old as five years to the present.  MPI also encourages providers to engage in routine self-audits of more current claims (most recent twelve months).  This allows providers to have the opportunity to remedy the claims before an Agency-initiated audit.  When the Agency conducts an audit, it is entitled to recover the costs of the audit and is required to assess sanctions for the non-compliance.  A provider who conducts a self-audit, submits the results, and remits payment, may avoid sanctions for their voluntary disclosure and repayment of overpayments so long as the Agency determines that the disclosure is valid and so long as it is not discovered to be an attempt to alleviate liability for fraudulent practices.

Information about conducting self-audits is available on the Agency’s website, on the MPI landing page.  Please see the below screen-shot which demonstrates how to navigate from the Agency’s home page to the MPI landing page.

Medicaid providers are encouraged to voluntarily conduct self-audits and remedy any issues of non-compliance that are identified, including either voiding/adjusting improper claims or submitting to the Agency’s Bureau of Medicaid Program Integrity (MPI), the self-audit findings and repayment of the improper claims.

Questions regarding conducting a self-audit may be directed to Pam Fante via email at and please include the question in the email.

Florida Statewide Medicaid Managed Care Program – Webinar 1/21/14

The Agency for Health Care Administration invites you to participate as an attendee in the following online training session:

Topic: SMMC: Developmental Disabilities Webinar
Host: The Agency for Health Care Administration
Date: Tuesday, January 21, 2014
Time: 11:00 am, Eastern Standard Time (New York, GMT-05:00)
Session number: 643 551 021
Session password: This session does not require a password.

To join the training session

1. Go to
2. Enter your name and email address.
3. Enter the session password: This session does not require a password.
4. Click “Join Now”.
5. Follow the instructions that appear on your screen.

To view in other time zones or languages, please click the link…

Therap Services Receives CCHIT Federal Certification


Logo of CCHIT

Certification Facts™

Therap Services, LLC.
Therap Services EHR 2013.2.8

Long Term and Post Acute Care EHR

This product has been inspected against integrated functionality, interoperability and security criteria independently developed by CCHIT’s broadly representative, expert work groups. Using CCHIT’s testing methods, this product has been found in full compliance with the criteria in effect on the date of inspection.


©2012 Inspected and certified by the Certification Commission for Health Information Technology (CCHIT®).


About Therap Services EHR
Therap Services was designed to help care providers record and maintain documentation for people with developmental disabilities. It is the needs of the Individuals and caregivers that together drive Therap’s product development. This has led to a comprehensive range of applications to document almost every aspect of Individual care. Over the years, Therap has become the recognized national leader in providing a web based, HIPAA compliant, Commercial-off-the-Shelf (COTS) Software as a Service (SaaS) application suite designed specifically for the intellectual and developmental disability community that address: – Electronic Health Records – Incident Reporting – Individual Profiles – Medicaid Billing – Medication Administration – Documentation and Reporting – Quality Assurance Everyday people are logging in from thousands of facilities, programs and community based locations to enter information on approximately 150,000 Individuals. Therap is programmed to be usable “out of the box” but also configurable to meet state regulations, requirements, and workflows. Using Therap’s Individual specific modules, agencies can create care plans and medication profiles for each Individual. Therap stores external documents including Referral Documents, Admission Orders, Authorization, Consultation Reports, Discharge Orders, Incident Reports, Progress Notes and Lab Results. Therap also works with Medicaid Waiver Provider Agencies operating community based programs and providers who operate ICF/DD programs and wish to track Service Authorizations and Electronic 837P/837I claims.Product URL:
About Therap Services, LLC.Therap Services, LLC. is a web-based service organization that provides an integrated solution for documentation, reporting and communication needs of agencies providing support to people with developmental disabilities. Therap applications, forms and modules are HIPAA compliant. Therap offers services to care providers in the ID/DD field which is an alternative solution to completing immense amounts of paperwork manually. Therap has expanded to over 47 states in the United States and provinces in Canada. In North Dakota, Nebraska, New Mexico, Delaware and Montana, all provider agencies are mandated to use Therap applications. Therap provides state specific functionality, support and training materials for users in different states. Therap’s patented technology (US Patent# 8,281,370) for managing secure sharing of private information across security domain guarantees that users can communicate effectively in a HIPAA compliant manner. The use of Therap Applications enables providers to efficiently share and communicate Protected Health Information (PHI) in real time. Therap maintains high-end, industrial-strength equipment and infrastructure software with redundancy of devices and system components and managed parallel communications access. Therap also conducts scheduled backups with offsite storage. Therap thrives to meet and exceed the need of the ID/DD community with their commitment to service availability and data security through a highly redundant set of hardware and software.
Vendor Phone: 203-568-1360

Non-Profit to Pay $50,000 for HIPAA Violation

Idaho Non-Profit Agrees to Pay $50,000 for HIPAA Violation

By Carlton Purvis

01/03/2013 –Picture of Security ManagementIn a first of its kind settlement, a non-profit medical facility in Idaho will pay the U.S. Department of Health and Human Services (HHS) $50,000 for HIPAA violations surrounding potential exposure of patient information.

The settlement is the first involving a breach of electronic protected health information affecting fewer than 500 individuals.

“This action sends a strong message to the health care industry that, regardless of size, covered entities must take action and will be held accountable for safeguarding their patients’ health information.” said OCR Director Leon Rodriguez in an HHS press release published Wednesday.

In February 2010, Hospice of North Idaho (HONI) reported to HHS that an unencrypted laptop containing information on 441 patients was stolen from inside an employee’s car.

An OCR investigation found that HONI had no policies or procedures in regard to mobile device security as required by HIPAA. Additionally, HONI had never done any type of electronic protected health information risk analysis.

The laptop was never recovered.

When a breach impacts more than 500 individuals, companies are required tonotify all major media outlets in their state, as well as the government. A notice is included on the Department of Health and Human Services Web site in accordance with the Health Information Technology for Economic and Clinical Health (HITECH) Act.

For breaches that affect fewer than 500 people, organizations keep a log that is turned in to the Secretary of Health and Human Services annually.

In addition to the fine, the December 28th agreement includes a two-year corrective action plan that mandates that the facility immediately report any future breaches to HHS.

“The theft of the laptop was out of our hands, but the measures we have taken since then to ensure the security and privacy of our patients’ information have been numerous,” Brenda Wild, Hospice of North Idaho Board President said in a written statement.

Since the incident, the facility has increased security on any equipment that contains patient information, including encryption and increased password protection, and scheduled security training.

HONI’s staff of more than 100 people is North Idaho’s only inpatient hospice facility. The organization serves members of the community regardless of their ability to pay.

Florida AHCA Alert: ADT Daily Billing


Better Health Care for All Floridians

A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
   September 2013

Provider Type(s): 67,  096,  098

Update to Billing Instruction Reminder

Developmental Disabilities iBudget Providers should bill according to the Individual Budgeting Waivers Provider Rate Tables.  For example, providers billing for services under procedure codes T2021UC or S5102UC must use hourly units of services, up to a maximum of 8 units per day.

Please disregard recent instructions regarding situations when the same number of units of service is provided daily on consecutive days, and completion of the date span using the “From—To Dates” dates of service.

A new claim line must be used for each day.

Please contact your local Medicaid Area Office for assistance with billing issues. Contact information for your local Medicaid Area Office may be found at

Therap Florida Regional Conference-West Palm Beach

Therap Conference in West Palm Beach, Florida October 22-23, 2013

Therap Services will be hosting a regional conference in West Palm Beach, Florida this October.

Attending the conference will be a good opportunity to learn about recent developments in Individual support documentation and reporting, electronic health records (EHR) and training management from technology leaders in the developmental disabilities field. The training intensive event will include beginner, intermediate, and advanced level sessions conducted by Therap experts on various Therap modules.

Conference highlights will include sessions on:

  • Therap’s health tracking modules for appointments, seizures, lab tests, vital signs, and medication histories
  • Therap Medication Administration Records (MAR)
  • Therap Individual Service Plans (ISP)
  • Hands on training on different other modules including Therap GERs (incident reports), Time Tracking, Secure Communications and Training Management
  • Therap electronic billingservice authorizations and claim tracking

Please check back on our website for updates.

We look forward to seeing you in Florida!

Future conferences

In the coming months, we will be hosting conferences in many other states including Colorado, New York, Texas and Iowa. Details regarding these events can be found here.


Therap’s HIPAA compliant documentation, reporting and communications solutions are widely used by organizations, working with people with developmental disabilities in home and community-based services (HCBS) and other settings. Direct Support Professionals, nurses, supervisors, executive directors and CEO’s in 1000+ agencies, in over 47 states, are using Therap’s paperless solutions to improve quality of care. To learn more about Therap please visit
Date & Time
October 22-23, 2013
8 am – 5 pm everyday
1301 Belvedere Road
West Palm Beach, Florida
Important Links
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CT 06708-2240, USA
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Florida IBudget Handbook – Change in “Service Logs”

The following is a response from Kristin Allen, Delmarva Regional Manager, regarding changes in the new IBudget Handbook for monitoring HCBS Waiver providers for Service Logs:

The iBudget Handbook deleted Service Logs as “required” for Life Skills 3 however providers will still be bound by whatever is identified in the IPs as the data collection method, which historically has included service logs.  It was a requirement, and “logical” in tracking progress. In terms of what should continue vs. what reviewers will be evaluating, the answer is more two-fold. Until the iBudget Handbook is promulgated as an organization continue to follow the November 2010 Handbook as per memo from Denise Arnold. However, our reviewers are using the new iBudget tools (but not citing providers for anything new) which means they will only be looking for a Daily Attendance Log which must include (for Life Skills 3) the name of the provider, name of the recipient, each date of service and the time period which means total time in attendance each day. It can be time in/out or just 4 hrs, 6 hrs, etc. For Residential Habilitation time in/out or time period is not required. One last note about service logs, although maybe not “required” they are useful in evaluating other standards.

The time period means total time in attendance each day. It can be time in/out or just 4 hrs, 6 hrs, etc. For Residential Habilitation time in/out or time period is not required.


IBudget: ADT Hourly Rate

Therap can accurately create the new Hourly Billing Unit for the I-Budget for ADT!

See the below: Sample set-up for the Service Description Code.  Please set the Automatic Unit Calculation to Hourly, Half Up and the smallest increment as 60 Minutes.

You will be able to use this auto calculation with:  Billing Data Input, Attendance Method or ISP Data Method and the Billing system will accurately calculate the Units per AHCA-Medicaid and APD Regulations.

Screenshot of Billing showing Hourly Billing Unit for the I-Budget for ADT

Florida APD will increase Planning and DD transition to Community Waiver Services

DD Waiver Waitlist Litigation Settled

Thursday, July 26, 2012

Dykes v. Dudek Settlement Agreement Summary

Disability Rights Florida filed the Dykes v. Dudek lawsuit in March of 2011 on behalf of individuals with intellectual and developmental disabilities who needed care, treatment, and habilitation and who were on the Waitlist for DD Medicaid Waiver services. Some of the plaintiffs resided in private ICF/DDs or nursing homes and some of the plaintiffs resided in their families’ homes. Many had been on the DD Waitlist for over five years.

The lawsuit sought to compel Florida to develop a reliable and accurate means of tracking and projecting service demand and associated trends in order to design and implement a comprehensive plan for the continued enrollment of over 21,000 persons waiting for DD Waiver services. In October of 2011, the court denied our motion to proceed as a class action and the case proceeded instead on the basis of our agency’s standing to sue and on behalf of the named plaintiffs.

On July 3, 2012, the lawsuit was settled. Under the settlement agreement the Agency for Persons with Disabilities (APD) and the Agency for Health Care Administration (AHCA) will engage in the activities described below. The agreement addresses five key areas:

1.    Individuals Residing in ICF/DDs and Nursing Homes

During 2011-2012 and 2012-2013, after the lawsuit was filed, the Legislature enacted budget proviso language allowing APD and AHCA to utilize current appropriations in the ICF/DD budget to fund transitions of persons in ICF/DDs to the DD Waiver. Two named plaintiffs successfully transitioned to community services and APD began transitioning other individuals. The agreement requires that APD request another year of this key proviso language. Moreover, APD will complete the process of contacting everyone on the DD Waitlist who resides in an ICF/DD and providing transition support to those desiring to move. APD will also provide choice counseling at annual reviews and every 6 months after during the Continued Stay Reviews. Previously, the Continued Stay Review form only required a review of the level of care for the continuation of ICF/DD services. Thus, residents will be made aware of the available options more frequently and have a more meaningful option to view alternative placements and have their choice documented. APD and AHCA will provide Disability Rights Florida with monthly progress reports regarding ICF/DD transitions.

Additionally, the agreement requires that AHCA request a similar mechanism from the Legislature to transition people with DD who reside in nursing homes to the DD Waiver. The named plaintiff from the lawsuit who resided in a nursing home has successfully transitioned and is now thriving in a small group home setting in the community.

2.    Crisis

Individuals approved for Crisis enrollment will receive DD Waiver-funded services within no more than ninety days from the determination of crisis. General revenue funds may continue to be used during the crisis application process. The ninety-day period is important because it ensures prompt enrollment on the DD Waiver as required by Medicaid law and greater certainty in the provision of needed DD Waiver services.

3.    Individual Family Support (IFS) Funds

APD will notice the development of a rule to govern utilization of IFS funds and the rule will include a uniform application to be used statewide. APD will also track the IFS services requested, the IFS amounts requested, and whether each request was approved or denied. This data will be provided to Disability Rights Florida. These changes should make the statewide process more fair and equitable. Moreover, by tracking the services and amounts requested, APD will have a more reliable and accurate means of tracking and projecting service demand.

4.    Waitlist Strategic Planning Workgroup

Each of the past few years, only 500-600 people were enrolled onto the DD Waiver and only if they qualified for crisis. To address this problem, the agreement requires APD to invite certain stakeholders (Self-Advocates, Family Care Council, DD Council, Centers for Independent Living, ARC, Disability Rights Florida, and others) to their Waitlist workgroup. The agreement outlines that the Waitlist Workgroup will consider developing ways to meet the needs of those waiting when it comes to housing, transportation, choice and community activities, investing in training for self-advocates, establishing peer connections, new training for Waitlist support coordinators, and a means of tracking and projecting service demand and associated trends.

5.    Employment

Many people waiting for DD Waiver services need waiver services to access long-term employment supports to obtain and maintain a job. Disability Rights Florida will be added to APD’s Employment workgroup. This workgroup is charged with designing a system to support the employment objectives of people with DD who are waiting for DD Waiver services.

During the coming months, if you or someone you know is waiting for services, it is possible to request that APD provide notification about the Waitlist category assigned. This notice must be requested. It is also possible to request reconsideration. Additionally, if you or someone you know needs assistance transitioning out of an ICF/DD, the APD Area/Regional office can be reached to provide a contact person and more information about the transition process.

Disability Rights Florida will continue to provide free and confidential services to individuals and be actively involved in monitoring the performance of the settlement agreement. Special attention will be placed on the stakeholder-developed comprehensive plan. Florida needs such a plan to meet the needs of those waiting for services as well as to continue the process of diverting and deinstitutionalizing those waiting in ICF/DDs or nursing homes. Over 3000 of the 21,000 people on the DD Waiver Waitlist live in an institution or are expected to need care in the next 12 months because of caregiver or behavioral issues. Another 209 report their caregiver as being over the age of 70. Moreover, approximately 115 people with DD on the Waitlist currently reside in nursing homes. We consider these to be urgent problems requiring a comprehensive plan developed by Florida’s stakeholders and we know you do too.

For more information, please contact Sylvia W. Smith, Director of Legislative and Public Affairs at

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