Introducing The Florida Adult Day Care Association
Since its inception in 1983, the Florida Adult Day Care Association (FADCA) has provided leadership, education, planning and development of adult day services across Florida. Through the promotion of quality day services ranging from respite programs to adult day health centers, FADCA has established a reputation as a leader in education, training and advocacy within the long-term care industry.
Annual Membership Drive
FADCA is pleased to announce the kick off of our annual membership drive. Have we got a deal for you! This year, for one price, you can have both a membership with FADCA and a membership with the National Day Services Association (NADSA). We are able to offer this tremendous opportunity, becaue Florida was one of five states selected to participate in this membership pilot project with NADSA. Take a moment to review the membership brochure to learn about all of the benefits you will receive from this membership package which includes a subscription to the magazine "Future Age". Membership in both the state and national organizations will increase your availabilty to timely information, education and advocacy effirts affecting the Adult Day Services industry.
Registration is now easier! Register On-line! Pay by Credit Card!
Carol J. Neil, Executive Director, Hope Adult Day Services, Jacksonville
Two years ago, Carol Neil decided to follow her dream of starting a service that would help people to receive the extra care they needed during the day to allow then to remain living with their family. With her own personal experience dealing with her father's illness as well watching her patient's struggles with caregiving issues, Carol felt there had to be a better way to help. With the help of SCORE to develop and carry out her business plan, her dreams have developed into reality. Celebrating its 2 year anniversay, Hope Adult Day Services is thriving, profitable and most importantly, helping. Carol was recently highlingted in an article in The Florida Times Union newspaper detailing her experience with SCORE and how using their services enhanced her knowledge of how to start a new business. Read the article at:
Check out the updates on the Advocay and Legislative Page. It is important to watch impending legislation and contact your legislators with your opinions on the issues. - Click on the Advocay Tab for information
Advocacy
Legislative Wrap-up by the Associated Industries of Florida
The Associated Industries of Florida has written a summary of the legislative session with the emphasis on how it has impacted businesses. Click on the link to read the summary:
Wrap-Up
FADCA Position Paper opposing repeal of S430.50 F.S. relating to the Alheimer's Disease and related Disorders Population
See FADCA's Advocacy at work! Plase read the FADCA Position Paper opposing repeal of S430.50 F.S. relating to the Alheimer's Disease and related Disorders Population
FADCA's Position Paper
Legislative Update - Wrap-up of Session - 5/1/08
Budget
The House and Senate debated and passed out the budget for the state of Florida this week. The vote in the House was 75 Yeas to 44 Nays, mostly along party lines (in the House) and 33 yeas and 7 nays (in the Senate). The budget is the only bill that they are required to pass by the 60th day of regular session. The budget for the state of Florida this year totals $66.2 billion dollars. The current health care budget was cut by about half of a billion dollars (2.5%) and it would have been more sever had it not been for the last minute use of the Lawton Chiles Endowment Fund. The Endowment money was used to restore funding to the Medically Needy and Meds AD programs. Many of the cuts were to the service providers in the health care community. Hospitals, nursing homes and intermediate care facilities for the developmentally disabled all took substantial cuts. Albeit, the cuts were less than the 10% that was originally projected, however, they were still cuts. Proposed fee increases for dentists and physicians were not funded in the final budget, but they remain optimistic to provide the increases in the near future. Chairman Bean did acknowledge that the Agency for Persons with Disabilities took more than their share this year. Some of the cuts are detailed below: General Revenue $ 7,147,600,000 Trust Fund $16,225,090,008 Total Budget $23,372,690,008
AGENCY FOR HEALTH CARE ADMINISTRATION
* KidCare Enrollment Increase - $28.7 million - Provides additional funding for increased enrollment in the Florida KidCare program. This is projected to fund an additional 38,400 children during the fiscal year. *Transfer Funding for Personal Care Services from Agency for Persons with Disabilities to Medicaid State Plan $26.6 million Transfers funding from APD to AHCA, to allow personal care services to be provided under the Medicaid state plan in lieu of the APD waiver. *Medicaid Aged and Disabled Eliminates recurring funds of $355.6 million for the optional MEDS AD program and provides $355.6 million in non-recurring funds to continue the program through June 30, 2009. The non-recurring state matching funds of $152.7 million is provided from tobacco settlement trust funds from the Lawton Chiles Endowment Fund. Approximately 24,200 individuals are covered under this program. *Medically Needy Eliminates recurring funds of $349.5 million for the optional Medically Needy Program except for pregnant women and children and provides $349.5 million in non-recurring funds to continue the program through June 30, 2009. The non-recurring state matching funds of $148.1 million is provided from tobacco settlement trust funds from the Lawton Chiles Endowment Fund. Approximately 16,000 adults and 3,900 pregnant women and children are covered under this program. *Reduce Nursing Home Reimbursement Rates ($163.6 million) Reduces the projected Medicaid nursing home expenditures by 6.5%. Suspended enforcement of CNA staffing above 2.6 level for a period of one year. * Impact to Hospice Rates from Reducing Nursing Home Rates ($15.2 million) Hospice reimbursement rates are calculated as a percentage of nursing home rates. Therefore as nursing home rates are reduced, hospice rates receive a correlating reduction. * Reduce Hospital Inpatient Reimbursement Rates ($154.3 million) Reduces the projected Medicaid hospital inpatient expenditures by 7.3%. * Reduce Hospital Outpatient Reimbursement Rates ($36.4 million) Reduces the projected Medicaid hospital outpatient expenditures by 7.3%. *Reduce Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) Reimbursement Rates ($6.2 million) Reduces the projected Medicaid ICF/DD expenditures by 2.5%. *Reduce Medicaid HMO Reimbursement Rates ($145.1 million) Reduces the projected Medicaid HMO expenditures by 6.5%. *Reduce County Health Department Reimbursement Rates ($9.3 million) Reduces the projected Medicaid County Health Department expenditures by 6.5%. *Pharmacy Ingredient Cost Adjustments ($9.7 million) - Lowers the Average Wholesale Price (AWP) component in the pharmacy reimbursement methodology from AWP minus 15.4% to AWP minus 16.4%; and lowers the Wholesale Acquisition Cost (WAC) pricing component in the pharmacy reimbursement methodology from WAC plus 5.75% to WAC plus 4.75%. *Expand Nursing Home Diversion ($26.7 million) Expands nursing home diversion by 4,000 slots. Savings are achieved by providing individuals eligible for nursing home care services in an alternative less costly setting. *Prior Authorization of Elective Cesarean Sections ($3.2 million) Establishes a prior authorization process for elective cesarean sections. Data indicates that over 40 percent of babies born in Miami-Dade County and Monroe are delivered by Cesarean Section. The primary growth in Cesarean Sections is in the "elective" category. * Freeze Florida Healthy Kids Capitation Rates ($15.5 million) Freezes the Florida Healthy Kids capitation reimbursement rates to their September 30, 2008 level. * Reduce Florida Healthy Kids Corporation Administration Expenditures ($1.5 million) Reduces the projected Florida Healthy Kids Corporation administration expenditures by 5%. * Reduce MediPass Case Management Fee ($6.7 million) Reduces the $3 per member per month fee to $2 per member per month for physicians participating in the MediPass program. *Increase Managed Care Enrollment ($5.7 million) Requires Medipass recipients in counties with two or more managed care plans to enroll in a managed care plan during their eligibility re-determination period. * Eliminate Payment for Preventable Hospital Errors ($215,647) - Eliminates payments to hospitals for preventable hospital errors based on the federal program established under Medicare. * Reduce Prepaid Mental Health Plan Reimbursement Rates ($9.5 million) Reduces the projected Medicaid prepaid mental health plan expenditures by 4%. *Reduce Medicaid Reimbursement for Non-Emergency Transportation ($2.9 million) Reduces the projected non- emergency transportation expenditures by 4%. * Reduce Freestanding Dialysis Center Reimbursement Rates ($1.9 million) Reduces the reimbursement rates for freestanding dialysis centers from $125 per visit to $95 per visit. *Increase Managed Care Enrollment ($5.7 million) Requires Medipass recipients in counties with two or more managed care plans to enroll in a managed care plan during their eligibility re-determination period. * Eliminate Contract with Teaching Nursing Home ($625,000 General Revenue) - Eliminates a contract that AHCA has with the Miami Jewish Home for the Aged. The facility was funded with recurring general revenue to supplement their comprehensive multidisciplinary program of geriatric education and research. * Eliminate Contract with Patient Safety Corporation ($750,000 General Revenue) Eliminates supplemental funding from AHCA to the Patient Safety Corporation. * Eliminate Expenditures for the Family Cafι ($200,000 General Revenue) - Eliminate AHCAs participation in this program. The Family Cafι is sponsored by a not-for-profit corporation. It is a meeting that is held each year (usually in Orlando) to present to the families of individuals with disabilities what services are available to them.
AGENCY FOR PERSONS WITH DISABILITIES
* Serving Persons with Disabilities - $9.6 million Provides $4.3 million of non-recurring general revenue funds and $5.3 million of non-recurring operations and maintenance trust funds to provide additional services through the Home and Community Based Services Waiver.
* Transition Clients from the Institutions to Community Settings - $5.1 million - Provides funding to transition 60 clients from the Gulf Coast institution to community settings.
* Complete Client Assessments - $3.1 million Provides funds to complete assessments on home and community services waiver clients by June 30, 2009.
* Staff Augmentation $844,842 Provides for information technology infrastructure.
* Provider Rate Reduction - ($43.5 million) Reduces provider rates except those for personal care assistance by approximately 6.5%.
* Transfer Personal Care Assistance (PCA) for Children to ACHA - ($20.4 million) Transfers funds from APD to AHCA so that children will receive personal care assistance services through the Medicaid state plan.
* Savings from Personal Care Assistance Transfer - ($12.4 million) - Savings resulting from reducing the Personal Care Assistance hourly rate to $15.
* Administrative Reductions - ($0.4 million) - Reduces, contracts, group home management, and community development programs.
Bills
Amidst final work on the budget,and farewell speaches by various members of the House and Senate who are reaching their term limits,this week the Legislators rushed to have their bills reach the final stages. Listed below are the bills which passed the Legislature and are now on their way to the Governor.
The most important bills dealing with health care this year are as follows:
SB 2534,a compromise between the House and Governors health care plans, creates the "Cover Florida Health Access Program Act", which implements the Governor's plan to provide affordable health care options to uninsured residents ages 19- 64 and creates the "Florida Health Choices Program". The bill was unanimously passed on the Senate floor.
SB 2654, which was Senator Gellar's priority bill this semester, requires large group health insurance plans to provide coverage for diagnostic screening, intervention and treatment of autism spectrum disorder in children. If this bill passes,health insurance plans cannot deny, refuse to issue or reissue coverage,terminate, or restrict coverage because the individual is diagnosed with autism spectrum disorder .The bill was finally passed as the last bill this session on the House floor. Speaker Rubio gave a speech before the final passage, asking every single member to promise to keep at work in the following sessions to make sure this bill goes above just covering children with autism but with all disabilities.He also expressed how much this bill meant to every member, a bill bringing both parties together.
SB 2326, which is the Governor's plan to revise the certificate of need process (CON) process for hospitals. The bill modifies the application and review process that applicants must go through to receive a CON hearing.The bill was unanimously passed on the House floor.
Other bills of interest:
SB 370, amends the existing personal care attendant program for individuals who are disabled as the result of a traumatic spinal cord injury and expands participant eligibility to persons who have severe and chronic disabilities of all kinds. The bill was passed unanimously on the House floor.
HB 461, relates to Health Flex Plans . The hope with health flex is to provide a "cafeteria-like" plan for health insurance, it is not something that will try to be a full blown insurance. It will hopefully provide a choice to companies to provide a lower cost insurance option for their employees or individuals to purchase. This bill passed on the Senate floor unanimously.
HB 535,is an additional health insurance mandate requiring insurance providers to cover nonablative therapy and transplants in relation to bone marrow transplants.The bill also requires providers to provide policyholders with an identification card that can be used to identify the insured individual and type of plan, obtain authorization for services, and estimate the covered persons financial responsibility. The bill was unanimously passed on the Senate floor.
SB 686, reduces paperwork for nursing homes. The bill eliminates the letter requesting permission from AHCA to use nurses for CNA positions as well as eliminating the 24 hour adverse incident report. The bill also authorizes certain licensed nursing facilities to develop a plan to provide training for nursing assistants.The bill was unanimously passed on the Senate floor.
SB 736, relating to the certification of clinical nurse specialists, was unanimously passed on the House floor. The bill authorizes the Florida Board of Nursing to grant a waiver of the specialty area certification requirement if the applicant is academically prepared as a clinical nurse specialist in a specialty area where no certification exam is available.
SB 989, which deletes antipsychotics and parenteral preparations from the formulary of drugs that a physician assistant prohibited from prescribing, was unanimously passed on the Senate floor.
SB 1092, which continues the Alzheimer's Disease Medicaid Waiver Program, was unanimously passed on the House floor. The bill extends the program through 2010, rather then current law which sunsets it later this year.
HB 7075, authorizes APD to suspend, revoke, or fine a residential facility if that facility has been found responsible for abuse of a child or vulnerable adult, as well as to deny application for licensure for such acts. The bill also amends the background screening requirements for direct service providers. The bill was passed on the House floor.
HB 7083, which creates extensive new regulatory standards for medical home health and durable medical equipment providers, was passed unanimously on the House floor
HB 7041 which expands the Florida Self Directed Care Program state wide was unanimously passed on the Senate floor.
SB 1854 authorizes AHCA to transfer fees used to repay nursing home Medicaid overpayments to the Grants and Donations Trust Fund within AHCA. The bill was highly controversial due to the discontinuation of optional Medicaid payments to individuals 65 years or older who are blind are disabled.The bill passed the Senate with 21 yeas and 14 nays.
SB 1360 revises the requirements for pharmacy licensure by endorsement,deleting the requirement that an applicant must have passed the licensure examination not more than 12 years prior to the application.The bill also requires pharmacy technicians to register with the Board of Pharmacy as well as be 18 years of age and have received a High School diploma or G.E.D. The bill was unanimously passed on the House floor.
Any bill not contained in the above report died in the final weeks of this Session.
Understanding the Legislative Budget Process
Read about the legislative budget process and how you can influence the process. Understanding the process helps to promote advocacy efforts.
Understanding the Legislative Budget Process
2008 Legislative Session: List of Priorities Supported by Florida Adult Day Care Association (FADCA), Florida Association of Service Providers (FASP), the Alzheimer's Association, Florida AARP and the Florida Dietetic Association.
There are many issues facing the legislature this session that may affect the provision of services for the elderly and disabled. To see the list of issues that are important and that are supported by FADCA, click on the following link. Issues supported by the Alzheimer's Association, FASP, AARP and the Florida Dietetic Association are also included as our industries often support the same issues.
2008 Legislative Issues
HR 1032 (Federal) Alzheimer's Treatment and Caregiver Support Act
The intent of the Alzheimer's Treatment and Caregiver Support Act is to provide grants to public and non-profit organizations to improve treatment for individuals with Alzheimer's disease and expand training and support services for caregivers. Click the link to read the bill.
HR 1032
HB 279 and SB116 (Florida) Electrobic Monitoring for Lost Persons
This is and act relating to the establishment of an electronic monitoring program for tracking at risk persons who become lost. A grant program will encourage counties to implement county lifesaver programs. Click on the link for more information. FADCA spoke in support of this bill in the Senate committee.
HB 279
2007 Legislative Victory
Legislation to allow Licensed Adult Day Centers to operate in a separate premises if the center becomes unusable due to disaster.
Our lobbyist and the FADCA board are working hard to attach legislation allowing adult day care centers to continue operation in an alternate location if damaged during a natural disaster or other emergency. We currently have agreement from Senator Margolis and Representative Gelber to allow us to ammend their companion bills that create a grant program for nursing homes to purchase generators. Both Senate and House bills have cleared at least one committee and each have one more committee stop before the floor. We will amend both bills with our ammendment in the last committee stops. Once we get that done, we will need FADCA members to e-mail their legislators and ask that they support the bill. Click to read the proposed ammendment and wait for word to act upon this important legislation!
UPDATE: 5/18/07 Bob Asztalos reported that the disaster amendment for ADC attached to the assisted living training bill is going well. Senate bill 1916 has passed the first round and will be up for a third reading on Monday, April 30th. Once passed in the Senate, the bill will go to the House (HB1019) and is expected to be voted on next Wednesday or Thursday. Each chamber has to approve the bill twice before going to the governor for signature. The Senate will convene on Monday, April 30 at 10am. Bob stated that the board members would be able to watch the bill being passed in the Senate. The House convenes at 2pm.
Good News!
The Bill has been approved by the legislature and has been signed into law by the Governor! Your association dollars and membership at work!
New CMS Medicaid Proposal Opens Door for Increased Adult Day Services
Under a new rule change, the Centetrs for Medicare and Medicaid Services (CMS) will now give states the option of providing Home and Community Based Services to Medicaid clients without the need for a waiver or a demonstration project. This should open the way for the availability of more services that will allow people to receive services in their own home instead of an institution. Adult Day Services are a part of this package. Please read the article to learn more.
Find out if the Nursing Home Diversion Pilot Program was a success. Read the 2007 report to the Legislature evaluating the new program.
Report
The Veteran's Administration Shows Support for Adult Day Care!
It is with great excitement that NADSA announces tremendous progress in support from the Veterans Administration for attendance of veterans at adult day services. As a result of advocacy efforts, the VA has allocated additional funds for Community Based service for Veteran's. This funding includes funds for Adult Day Services. See the attached letter for more information regarding NADSA's efforts.
VA letter from NADSA
Board of Director Meetings
Minutes of the meetings of the Board of Director's and of the General Membership Meetings will be posted on the web. See the newest minutes. Click on the Minutes Tab to find them.
Minutes
Each conference call board meeting will be held on the 3rd Thursday of each month at 1:30pm. The telephone number to access these monthly conference calls is (605) 990-0300 and the access code is 132109#. Eveyone is welcome to listen in and participate in these calls.
Upcoming Events
2008 Florida Conference on Aging "Better Together. Celebrating Change"
Co-sponsored by Florida Council on Aging (FCOA), Florida Association of Service Providers (FASP) and Florida Department of Elder Affairs (DOEA)
August 11 to 14, 2004 Renaisance Orlando Resort at Seaworld
For More Information call (850) 222-8877 or go to:
www.fcoa.org
For Hotel Reservation call 1-800-836-7610. Hotel reservations due by July 19, 2008.
Conference on Effective Programs to Treat Depression in Older Adults: Implementation Strategies for Community Agencies.
Sponsored by the Carter Center in Atlanta, Georgia along with the Centers for Disease Control and Prevention and the Health and Aging Research Network
May 19 - 20, 2008
The conference is intended for mental health, public health and aging service providers interested in implementing community- and evidence-based programs for older adults with depression.
The Florida Association of Aging Services Providers, through funding from the Florida Department of Elder Affairs, is conducting three Aging Policy Forums for aging network leaders. The purpose of each Forum is to identify key topics and share insights, expertise and experiences on emerging aging-related issues. Strategies for communication and collaboration on advocacy on behalf of older Floridians will also be discussed. These are intended to be small, working sessions, not large public hearing-type meetings.
May 22, 2008, 10:00 AM 2:00 PM, Renaissance Center, 435 N. Macomb Street, Tallahassee ($15 Luncheon fee)
May 28, 2008, 9:00 AM 12:30 PM, Margate City Hall, 5790 Margate Boulevard, Margate
June 10, 2008, 10:30 AM 2:00PM, Renaissance on 9th, 1816 9th Street W, Bradenton ($15 Luncheon fee)
You can register by sending your name, organization, address, phone number and which meeting you would like to attend to moreinfo@fasp.net. If you are registering for more than one person, please include the contact information for all people that will be in attendance.
Lunch will be provided at the May 22nd and June 10th Forums. A $15 luncheon fee will be requested by all persons attending on May 22nd in Tallahassee and June 10th in Bradenton. Cash and checks will be accepted on site or you can mail payment to:
FASP 1018 Thomasville Rd, Suite 110 Tallahassee, FL 32303
Members are welcome to list their upcoming events here. E-mail information for the listing to the webmaster at
FADCA Webmaster
