Agency for Persons withDisabilities OverviewHouse Healthy Families SubcommitteeJanuary 16, 2013
Barbara Palmer
Director
Rick ScottGovernor
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S. 393.062, F.S.: “…the greatest priority shall be given tothe development and implementation of community-basedservices that will enable individuals with developmentaldisabilities to achieve their greatest potential forindependent and productive living, enable them to live intheir own homes or in residences located in their owncommunities, and permit them to be diverted or removedfrom unnecessary institutional placements….”
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Legislative Authority
APD Mission
The agency supports persons withdevelopmental disabilities in living,learning, and working in their communities.
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Regions
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![APD RegionalFL Map without legend [Converted].png](data/images/img3.png)
![APD Regional legend onlyFINAL [Converted].png](data/images/img4.png)
Customers by Primary Disability
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Includes HCBS Waiver and Waiting List
Agency Appropriations – FY 2012-13
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Expenditures History
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Medicaid Home andCommunity BasedServices (HCBS)Waiver
•Provides services in thecommunity in lieu ofmore restrictive andexpensive institutionalprograms
•State matches thefederal Medicaid dollarsout of General Revenuedollars
- 42.27% state dollars to57.73% federal dollars
Individual and FamilySupports (IFS)
•Primary funding sourcefor individuals who arenot enrolled in the waiver
•Primarily 100% FederalSocial Services BlockGrant dollars
•Includes a small portionof 100% State FundedGeneral Revenue
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•State-operated IntermediateCare Facilities for theDevelopmentally Disabled
•Funded by the Medicaidprogram
Intermediate CareFacility/DevelopmentalDisability
•Privately operated and fundedby Medicaid program, andlicensed and administered byAHCA.
•APD authorizes admissions,determines the level of care ofeach resident, and performscontinued stay reviews everysix months.
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Developmental DisabilityCenters (DDCs)
Forensic
•Mentally Retarded DefendantProgram (MRDP)
•Forensic programs at Sunlandand Tacachale
iBudgetSimplicity, Equity, Self-Direction, Sustainability
•Approved by both the Legislature and the federal government
•Customers have better access to a wide range of services within theirindividual annual budget amount
•Customers will have flexibility to use the funding for necessary services aslong as their health and safety needs are covered
•Provides for financial predictability within the HCBS Medicaid waiver whilemaking the funding process fair and equitable for all waiver customers
•APD worked with a diverse group of stakeholders: individuals withdevelopmental disabilities, family, waiver support coordinators, andproviders
•Total enrolled as of January 14, 2013 is 19,866 customers
•Of the total enrolled, 2,081 (10.5%) iBudget customers have appealed
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iBudget Implementation Schedule
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•Northwest Region– 3,007 customers
–Areas 1 and 2 from Pensacola to Tallahassee on April 1, 2012
•Northeast Region and Central Region– 4,794 customers
–Northeast (Areas 4 (Jacksonville), 12 (Daytona Beach)) and Central (Area13 (Ocala)) on July 1, 2012
•Northeast Region and Central Region – 5,747 customers
–Northeast (Areas 3 (Gainesville)) and Central (Area 7 (Orlando), 14(Lakeland), and 15 (Fort Pierce)) on October 1, 2012
•Suncoast Region – 6,318 customers
–Areas 23 and 8 from Tampa to Fort Myers on January 1, 2013
•Southeast Region – 3,879 customers
–Areas 9 and 10 from West Palm Beach to Fort Lauderdale on April 1, 2013
•Southern Region – 5,766 customers
–(Area 11, Miami-Dade) on July 1, 2013
Agency Priorities
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Agency Initiatives
Community Initiatives
Fiscal Accountability
Employment
APD operates within the limits setforth in the General AppropriationsAct.
People with developmental disabilitieswho desire work are competitivelyemployed.
Quality Services
Waitlist
Ability to measure and trackperformance to ensure the highestquality care.
APD adopts national and local bestpractices to serve people on thewaitlist efficiently and effectively.
Agency Priorities
•Fiscal Accountability/Cost-Containment
–The Home and Community Based Services (HCBS) waiverprogram currently has a $39.9 million ($17.02 million GR) carry-forward deficit (from prior years)
–However, APD projects expenditures to be within appropriationsfor Fiscal Year 2012 – 13 in the HCBS waiver program
–As a result of cost-containment efforts between the Legislature,the Governor’s Office, and APD, the Agency’s waiverexpenditures were reduced by more than $70 million duringFiscal Year 2011 – 12 while still ensuring customer health,safety, and community living
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Agency Priorities
•Employment
–Approximately 3,100 APD customers arecompetitively employed and are making an averageof $8.49 per hour
–Over 9,000 APD Customers would like to becompetitively employed and APD is working diligentlywith public and private partners to assist theseindividuals
–A specific focus will be placed on assisting those thatare in transition from the school system to post highschool employment (age16-24)
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Source: APD Agency Allocation, Budget, and Contract Control (ABC) System as ofNovember 1, 2012
Total Waitlist by Category
Total = 22,009
Waitlist by Category
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Agency Priorities –Quality Services
Regionalization
•Reorganized from 14Areas to 6 Regions toalign with Department ofChildren and Families
•Gained efficiencies bystreamlining processes
Sunland and MentallyRetarded DefendantsProgram (MRDP) Merger
•Consolidatedadministrative supervisionof two residential programareas
•Improves efficiency andcollaboration between thetwo program area
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Agency Priorities – Quality Services
Cost-Sharing Agreement
•Created an Interagency agreementwith DCF and other agencies thatwas signed by agency heads at theGovernor’s Children’s Cabinetmeeting in December 2012
•Costs will be shared when a child canbe served by more than one agency
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Thank you
Director Barbara Palmer
(850) 488-1558
Barbara_Palmer@apd.state.fl.us
apdcares.org