These are the Senators that need to be e-mailed.
bean.aaron.web@flsenate.gov
harrell.gayle.web@flsenate.gov
book.lauren.web@flsenate.gov
diaz.manny.web@flsenate.gov
farmer.gary.web@flsenate.gov
flores.anitere.web@flsenate.gov
hooper.ed.web@flsenate.gov
passidomo.kathleen.web@flsenate.gov
rader.kevin.web@flsenate.gov
rouson.darryl.web@flsenate.gov
They should be given some information about SB82 and the potential impact of the poorly written bill in regards to the removal of Solo Waiver Support Coordination.
1. There is no Supporting statistical evidence that shows an Agency is any better at providing services to consumers. I bet that Qlarant Audits would show a Negative trend towards agencies and the service they provide versus Solo Waiver Support Coordinators.
2. Solo Waiver Support Coordinators and Agencies are required to complete the exact same requirements to provide services to consumers. The only difference is in the number of WSC's providing the support.
3. Two WSC's are not any different than Three, or Four or Ten. In actuality I would venture to predict that the larger the Agency the less control and less compliance to APD and State Regulations. Primarily because the Agency gets away from focusing solely on services to the Consumer and more on the management of the Employees in the Agency.
4. Additionally, what happens to an Agency of 4 WSCs when one of them is disqualified from providing services by Medicaid, or voluntarily leaves. Does the Agency have to Dissolve because it has less than the threshold? If this is the case this cold impact up to 172 Consumers if the Agency had a 4 WSCs and a FULL Caseload. What happens now? Because an Agency has to have at least 2 Employees, does APD intend to maintain the same criteria for letting an Agency continue to operate?
5. Waiver Support Coordinators are not a bunch of unqualified, uneducated individuals. It takes a 4 year degree, and 2 years of experience along with a Multitude of other things, like a Background check, Liability insurance and an actual PLAN for how they intend to adhere to APD and Medicaid Requirements. There is already a Critical Need for WSCs and forcing them to work for Minimum wage at an Agency will cause a decrease in the WSC field.
6. Medicaid Sets the Rates that are paid for Support Coordination Services. If an Agency were forced to have to compete by lowering their Rates they would further cause issues in the potential WSC hiring pool because the salary would be further depressed.
Friday, February 14, 2020
Florida Senate Bill 82 - Impact to Solo Waiver Support Coordinators
I have read a few articles and have found that there is a little bit of confusion around what things mean and the wording being thrown around to describe the section of Florida Senate Bill 82 that talks about "qualified organization".
This paper says "requiring the Agency for Persons with Disabilities to competitively procure qualified organizations to provide support coordination services".
The main flaw in this is that there is not a way to even have this as part of the bill since it does not stipulate these restrictions NOT on the Support Coordination aspect. It says that the Agency's need to adhere to the states "competitive cost Initiatives" which is still not very accurate since Medicaid sets the rates that can be charged, and until then everyone will charge the same amount. An Agency cannot set a lower Rate because they rely on the "PROFIT" to pay their Employees. So setting a Lower rate while it might get them more consumers would be cost prohibitive because they would then have to lower the pay of the WSC and the system would collapse.
This article https://www.news-press.com/story/news/newswire/2020/02/14/house-shies-away-overhauling-disabilities-program/4761396002/ states "The Senate proposal would require support coordinators, who help people with disabilities obtain services, to be employees of organizations. Currently they can be sole proprietors."
The main flaw in this article although accurate and is part of the bill is not supported by any statistical data that says the support coordination being provided is any better if provided by an agency or a sole proprietor (Solo Waiver Support Coordinator). Also lets say their was statistics and perhaps they said that an agency is better. The element of having to have 4 or more employees is also flawed because, it infers that the agency is required to have 4 employees and therefore Agencies will work hard to maintain at least that number regardless of performance, and if there is a vacancy of 1 Employee that would potentially cause the entire agency to be defunct, which means 1 person leaves ALL 4 are fired and the potential impact is to 172 consumers if the WSCs had full caseloads.
I know what you're thinking just hire another person. Well there is currently a CRITICAL NEED for Waiver Support Coordinators in Florida, that means they are not OUT THERE to be hired. The person has to have a 4 year Degree, with 2 years experience working with Special needs and to work for an agency the current avg Starting pay is between $30k and $40k depending on which part of the state you are in. SO it is not easy to become a Waiver Support Coordinator and if you do, they quickly realize that Agencies are taking in most cases at least 50% of the rate that the consumers are being billed for.
Florida Senate Bill 82, SB82 SB 82 is not a well thought out or well written plan.
This paper says "requiring the Agency for Persons with Disabilities to competitively procure qualified organizations to provide support coordination services".
The main flaw in this is that there is not a way to even have this as part of the bill since it does not stipulate these restrictions NOT on the Support Coordination aspect. It says that the Agency's need to adhere to the states "competitive cost Initiatives" which is still not very accurate since Medicaid sets the rates that can be charged, and until then everyone will charge the same amount. An Agency cannot set a lower Rate because they rely on the "PROFIT" to pay their Employees. So setting a Lower rate while it might get them more consumers would be cost prohibitive because they would then have to lower the pay of the WSC and the system would collapse.
This article https://www.news-press.com/story/news/newswire/2020/02/14/house-shies-away-overhauling-disabilities-program/4761396002/ states "The Senate proposal would require support coordinators, who help people with disabilities obtain services, to be employees of organizations. Currently they can be sole proprietors."
The main flaw in this article although accurate and is part of the bill is not supported by any statistical data that says the support coordination being provided is any better if provided by an agency or a sole proprietor (Solo Waiver Support Coordinator). Also lets say their was statistics and perhaps they said that an agency is better. The element of having to have 4 or more employees is also flawed because, it infers that the agency is required to have 4 employees and therefore Agencies will work hard to maintain at least that number regardless of performance, and if there is a vacancy of 1 Employee that would potentially cause the entire agency to be defunct, which means 1 person leaves ALL 4 are fired and the potential impact is to 172 consumers if the WSCs had full caseloads.
I know what you're thinking just hire another person. Well there is currently a CRITICAL NEED for Waiver Support Coordinators in Florida, that means they are not OUT THERE to be hired. The person has to have a 4 year Degree, with 2 years experience working with Special needs and to work for an agency the current avg Starting pay is between $30k and $40k depending on which part of the state you are in. SO it is not easy to become a Waiver Support Coordinator and if you do, they quickly realize that Agencies are taking in most cases at least 50% of the rate that the consumers are being billed for.
Florida Senate Bill 82, SB82 SB 82 is not a well thought out or well written plan.
Thursday, February 13, 2020
Florida Senate Bill 82 - Solo Waiver Support Coordination
Has the state though through the impact of this?
- Solo Waiver Support Coordinators that don't want to go to Agencies that will take HALF their salary and provide NOTHING in return.
- Solo Waiver Support Coordinators KNOW what it takes to run their business and in many cases better than the owners of Agencies. Because the Agency is Managing employees. The Solo Waiver Support Coordinator is Managing the Consumers.
- Consumers will be forced to go with someone else. FORCED to be given to an AGENCY and the AGENCY taking away the Consumer's Rights and assigning them to a Waiver Support Coordinator just because they have capacity.
- Small Agencies, (3 or less) forced to hire someone just because....NO RATIONAL REASON to HIRE SOMEONE other than the State thinks the services are better when provided by a Larger company.
- Agencies that have 4 employees forced to HIDE poor performance, due to the threat of losing One Employee means the loss of the whole company.
- Influx of consumers from the lost Solo Waiver Support Coordinators and the lost smaller agencies. There is already a Critical Shortage of Waiver Support Coordinators and now with some SOLO's not wanting to go to an Agency because MOST Solos probably left an agency, Because they know what the Agencies are about. Agencies, manage employees, Solo WSCs Manage Consumers. EACH have the exact Same Regulations and Requirements and STANDARDS of service they are supposed to provide to Consumers and in Many cases the Agencies are just keeping any person they can around to keep caseloads.
- Solo Waiver Support Coordinators that don't want to go to Agencies that will take HALF their salary and provide NOTHING in return.
- Solo Waiver Support Coordinators KNOW what it takes to run their business and in many cases better than the owners of Agencies. Because the Agency is Managing employees. The Solo Waiver Support Coordinator is Managing the Consumers.
- Consumers will be forced to go with someone else. FORCED to be given to an AGENCY and the AGENCY taking away the Consumer's Rights and assigning them to a Waiver Support Coordinator just because they have capacity.
- Small Agencies, (3 or less) forced to hire someone just because....NO RATIONAL REASON to HIRE SOMEONE other than the State thinks the services are better when provided by a Larger company.
- Agencies that have 4 employees forced to HIDE poor performance, due to the threat of losing One Employee means the loss of the whole company.
- Influx of consumers from the lost Solo Waiver Support Coordinators and the lost smaller agencies. There is already a Critical Shortage of Waiver Support Coordinators and now with some SOLO's not wanting to go to an Agency because MOST Solos probably left an agency, Because they know what the Agencies are about. Agencies, manage employees, Solo WSCs Manage Consumers. EACH have the exact Same Regulations and Requirements and STANDARDS of service they are supposed to provide to Consumers and in Many cases the Agencies are just keeping any person they can around to keep caseloads.
Florida Senate Bill 82 - Waiver Support Coordination Impact
This bill is flawed and the reason I say it is flawed is because of the following issues.
1. An Agency is not suited to provide the best services to a Consumer!
WHY? Because the Agencies that currently exist are threatened by Solo Waiver Support Coordination Providers. They are threatened because SOLO Providers will go out on their own and take consumers.....which only constitute PROFIT to the Agency.
WHY? Because Agencies are ran by WSCs who may have started as a SOLO and realize it is HARD to do. However they didn't want to work as hard so they hire Support Coordinators at very reduced rates to do the work that they themselves used to do. Take a Look at any JOB posting for a WSC online and you will see the rate is around $30k to $40k starting pay. At $30k the Agency will make profit of about $43k or possibly more on a full 43 caseload.
SO! So to protect themselves they HIDE their Policies and Procedures documents, hoard and steal their employees training files and tell their employees how to operate and many times it is ONLY their opinion or interpretation of the regulations....and many times it is outdated and the Agency does not always keep up to date with the newest regulations.
2. The legislative intent of the Bill is do do exactly what is already spelled out in the iBudget Waiver handbook.
To enable the state to provide a systematic approach to service oversight for persons providing care to individuals with developmental disabilities, it is the intent of the Legislature that the agency work in collaboration with relevant stakeholders to ensure that waiver support coordinators have the knowledge, skills, and abilities necessary Florida Senate - 2020 COMMITTEE AMENDMENT Bill No. SB 82 Ì610520bÎ610520 Page 13 of 21 1/27/2020 10:57:27 AM 603-02573A-20 330 to competently provide services to individuals with developmental disabilities by requiring all support coordinators to be employees of a qualified organization.
SAME? Yes the intent is the same as what is in the iBudget Waiver handbook. The handbook spells out all the things required of the Waiver Support Coordinator and if the Senate is saying this is not CURRENTLY working then why isn't it? and if it Isn't working then Where is the Qlarant Audit statistics that support the premise that AGENCIES are better than SOLO Waiver Support Coordinators.
3. The enrollment process is EXACTLY the Same for an Agency or a Solo Waiver Support Coordinator. In actuality all AGENCIES had to start out as a WSC in order to "expand their services" the only difference is in the fact that the CURRENT regulation defines an Agency as having 2 employees and that is the ONLY difference and it is not unique to Waiver Support Coordinators it is for all Medicaid Providers.
4. Why is it only SOLO Waiver Support Coordinators being affected? Is the State of Florida Saying they have statistics that show that other SOLO medicaid providers are doing a great job? Is it driven by the Agencies PROFITS being impacted? There has been provided NO PROOF that an Agency provides better Service yet in the wording of the BILL they require 4 employees as the only delineating factor in better service. "by requiring all support coordinators to be employees of a qualified organization. "
5. Small agencies of 4 employees will be forced to HIDE poor performance, and bad employees, in order to maintain their Agency or be forced to stop providing services and the remaining 3 employees will no longer be able to work because they don't meet the 4 person Threshold.
This is the worst part of the BILL! Lets say I have an agency and through no fault of my own, one of the employees leaves/quits/resigns. Now My Agency is at risk of being shut down and I am at risk of having to stop providing services because of a threshold that is flawed in its implementation.
This Bills is bad for the CONSUMER and only a good thing for the Agencies, and for those that currently have agencies and are making a profit. The consumer will suffer.....see my next post on what the IMPACT is.
1. An Agency is not suited to provide the best services to a Consumer!
WHY? Because the Agencies that currently exist are threatened by Solo Waiver Support Coordination Providers. They are threatened because SOLO Providers will go out on their own and take consumers.....which only constitute PROFIT to the Agency.
WHY? Because Agencies are ran by WSCs who may have started as a SOLO and realize it is HARD to do. However they didn't want to work as hard so they hire Support Coordinators at very reduced rates to do the work that they themselves used to do. Take a Look at any JOB posting for a WSC online and you will see the rate is around $30k to $40k starting pay. At $30k the Agency will make profit of about $43k or possibly more on a full 43 caseload.
SO! So to protect themselves they HIDE their Policies and Procedures documents, hoard and steal their employees training files and tell their employees how to operate and many times it is ONLY their opinion or interpretation of the regulations....and many times it is outdated and the Agency does not always keep up to date with the newest regulations.
2. The legislative intent of the Bill is do do exactly what is already spelled out in the iBudget Waiver handbook.
To enable the state to provide a systematic approach to service oversight for persons providing care to individuals with developmental disabilities, it is the intent of the Legislature that the agency work in collaboration with relevant stakeholders to ensure that waiver support coordinators have the knowledge, skills, and abilities necessary Florida Senate - 2020 COMMITTEE AMENDMENT Bill No. SB 82 Ì610520bÎ610520 Page 13 of 21 1/27/2020 10:57:27 AM 603-02573A-20 330 to competently provide services to individuals with developmental disabilities by requiring all support coordinators to be employees of a qualified organization.
SAME? Yes the intent is the same as what is in the iBudget Waiver handbook. The handbook spells out all the things required of the Waiver Support Coordinator and if the Senate is saying this is not CURRENTLY working then why isn't it? and if it Isn't working then Where is the Qlarant Audit statistics that support the premise that AGENCIES are better than SOLO Waiver Support Coordinators.
3. The enrollment process is EXACTLY the Same for an Agency or a Solo Waiver Support Coordinator. In actuality all AGENCIES had to start out as a WSC in order to "expand their services" the only difference is in the fact that the CURRENT regulation defines an Agency as having 2 employees and that is the ONLY difference and it is not unique to Waiver Support Coordinators it is for all Medicaid Providers.
4. Why is it only SOLO Waiver Support Coordinators being affected? Is the State of Florida Saying they have statistics that show that other SOLO medicaid providers are doing a great job? Is it driven by the Agencies PROFITS being impacted? There has been provided NO PROOF that an Agency provides better Service yet in the wording of the BILL they require 4 employees as the only delineating factor in better service. "by requiring all support coordinators to be employees of a qualified organization. "
5. Small agencies of 4 employees will be forced to HIDE poor performance, and bad employees, in order to maintain their Agency or be forced to stop providing services and the remaining 3 employees will no longer be able to work because they don't meet the 4 person Threshold.
This is the worst part of the BILL! Lets say I have an agency and through no fault of my own, one of the employees leaves/quits/resigns. Now My Agency is at risk of being shut down and I am at risk of having to stop providing services because of a threshold that is flawed in its implementation.
This Bills is bad for the CONSUMER and only a good thing for the Agencies, and for those that currently have agencies and are making a profit. The consumer will suffer.....see my next post on what the IMPACT is.
Wednesday, February 12, 2020
TOOK A YEAR
After multiple back and forth and an ungodly amount of waiting finally got fully approved as a SOLO Waiver Support Coordinator.....THEN this happens.
Senate Bill 82
http://www.flsenate.gov/Session/Bill/2020/82/BillText/Filed/PDF
(Removes the SOLO Waiver Support Coordinator) requires them to be part of an Agency with 4 or more employees.
http://www.flsenate.gov/Session/Bill/2020/82/Amendment/610520/PDF
NOW What?
Well looking into forming an agency and working through that process.
Senate Bill 82
http://www.flsenate.gov/Session/Bill/2020/82/BillText/Filed/PDF
(Removes the SOLO Waiver Support Coordinator) requires them to be part of an Agency with 4 or more employees.
http://www.flsenate.gov/Session/Bill/2020/82/Amendment/610520/PDF
NOW What?
Well looking into forming an agency and working through that process.
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