Judge Upholds Rule On Disability Waivers

Judge Upholds Rule On Disability Waivers


TALLAHASSEE, FL---A judge has issued a final order in favor of new rules
concerning the delivery of services to Floridians with developmental
disabilities. Administrative Law Judge Eleanor Hunter ordered today that
the rules established by the state Agency for Persons with Disabilities
(APD) are "not invalid exercises of delegated legislative authority."

In 2007, the Florida Legislature required APD to establish four tiers for
the state's Medicaid developmental disability waivers. The tiers are based
on levels of need. Three of those levels will have annual caps on
spending. The Advocacy Center for Persons with Disabilities had brought a
lawsuit before the Division of Administrative Hearings to challenge APD's
rules for implementation of the tiers. Today's ruling permits APD to
proceed with implementation of the Legislature's requirements.

APD Interim Director Jim DeBeaugrine said, "Our agency works hard to comply
with the law, and today's ruling supports that. Although most of our
customers will not be affected by the tiers, we are sensitive to the fact
that our customers have anxiety about possible service reductions. We are
just as concerned as they are, and we are fully committed to assisting them
through this transition. This is a somber task for us to perform, and we
pledge to carry it out with fairness and caring for the people we serve."

APD will send letters to all of its customers notifying them of the
official start date for the waiver tiers, which has not yet been
determined. Customers who must reduce their services will be able to make
choices in order to do so. APD will provide guidance for readjusting
services and identifying community and nongovernmental supports.

In creating the four "waiver tiers" for individuals who are receiving
waiver services, the Legislature imposed annual limits on how much the
state can spend for people in three of the waivers. The four tiers and
their annual financial limits are:

Tier One – No cap
Tier Two – Cap of $55,000
Tier Three – Cap of $35,000
Tier Four – Cap of $14,792

In addition, the Legislature established criteria for each of the four
waiver tiers. The criteria cover the individual’s needed level of service,
along with other important characteristics and the person’s current living
situation. APD is currently determining which waiver tier is appropriate
for individuals receiving Medicaid Waiver services from APD based on how
their needs and characteristics match the established criteria. When the
waiver tiers are implemented, each person will be assigned to, and enrolled
in the tier that has been determined to be appropriate for them.

The services of most individuals will not be affected by their tier
assignment. The state, however, may not be able to pay as much for
services for some people, therefore requiring service reductions. The new
waiver system does allow individuals who have a significant change in
circumstance or condition that impacts their health, safety, or welfare to
migrate from one waiver to another.

APD currently serves about 35,000 Floridians with developmental
disabilities of mental retardation, autism, cerebral palsy, spina bifida,
and Prader-Willi syndrome. For more information on the agency, call
1-866-APD-CARES or visit www.apdcares.org