Lawsuit
Settlement Strengthens HCBS Waiver
By Peter Nimkoff, Advocacy Center Chief Counsel
A major developmental disabilities lawsuit filed by the Center has been
settled by the State of Florida and the Advocacy Center. The three year
old lawsuit was filed on behalf of individuals with developmental disabilities
and their family members contending that Florida's Home and Community
Based Waiver program was inadequately funded, poorly administered and
inconsistently delivered throughout the State.
While both the Center and the State aggressively prepared for a trial
that was scheduled to be heard this past July before Judge Wilkie Ferguson,
Jr., separate negotiations continued to avert a long drawn out trial.
On June 30th, 2000, the parties in Prado-Steiman v. Bush reached an agreement,
and on July 31st they formally moved the Court to schedule the required
Public Hearing at which the agreement might be considered and approved.
That hearing date (expected for early October) has not yet been specified.
In the agreement Governor Jeb Bush, Secretary Katherine Kearney, and other
State officials have agreed to major systemic reforms to improve the Home
and Community-Based Waiver programs including:
New Appropriations: For the fiscal year 2000-2001, the legislature has
appropriated an additional $131 million to continue services initiated
in this fiscal year (1999-2000) and to provide services to the remaining
individuals on the waiting lists in existence as of July 1, 1999.
Reduction of Waiting Lists and Unmet Needs: As of May 4, 2000, Developmental
Services had added 6,034 individuals to the Waiver and had arranged for
services to fulfill additional or unmet needs for 8,946 persons already
enrolled on the Waiver.
Expanded Efforts to Develop Providers: Too often individuals have been
unable to receive needed and approved services because of the lack of
providers. Developmental Services has agreed to focus on provider development.
By August 31, 2000, the districts will complete a district needs assessment.
Each district will develop a written plan to increase provider capacity
in those areas where there is a need for increased capacity. Among other
things, the Department is to sponsor a statewide provider fair.
Statewide Waiver Certification: Effective July 1, 2000, all Waiver providers
will be certified on a statewide basis, without the necessity of certification
by district.
Training for Waiver Providers: The Department will develop a training
program for Waiver providers. The Department will develop a protocol for
medication handling and administration.
Revised and Strengthened Training for Waiver Support Coordinators: The
Department will revise and strengthen orientation training for support
coordinators by March 1, 2001, and include training in IDEA, Medicaid
State Plan services, and Vocational Rehabilitation services.
Personal Planning Guide: The Department will implement a tool to identify
needs and plan effectively to meet those needs.
Quality Assurance System: The Agency for Health Care Administration will
contract with an outside agency to provide client-based quality assurance
monitoring.
Group Home Placements: The Department will work to provide a meaningful
choice of alternative residential placement to individuals residing in
rehabilitation centers (where more than 15 persons reside and receive
services).
Reasonable Promptness: The Department will make reasonable efforts to
provide Waiver services for which a determination of medical necessity
has been made within 90 days of the date of an individual's enrollment
on the Waiver. The Department will enroll eligible individuals who are
Medicaid recipients by June 30, 2001.
Due Process: The Department will comply with the due process policy with
regard to individuals requesting enrollment on the Waiver and individuals
on the Waiver requesting Waiver services.
Statewide Uniformity: On June 30, 2001, the Defendants will publish a
Waiver handbook which will establish statewide policies regarding administration
of the Waiver.
Translation of Florida Status Tracking Survey into Spanish and Creole:
The Department will translate the FSTS into Spanish and Creole no later
than November 1, 2000.
Federal Court Jurisdiction: The federal district court will retain jurisdiction
until December 31, 2001, at which time the case will be dismissed with
prejudice, unless the Plaintiffs can show material breach as evidenced
by systemic deficiencies in the Defendants' Implementation of the Plan
of Compliance.
Mr. Nimkoff may be reached at p.nimkoff@advocacycenter.org