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APD PROVIDERS / SUPPORT COORDINATORS JOINT MEETING
Thursday, November 17, 2011 9:30 A.M.
401 NW 2ND AVENUE, SUITE N-1011, MIAMI, FL 33128
ISSUE / DISCUSSION
ACTION / FOLLOW UP
Meeting began at 9:40 a.m. Area Administrator Ms. Evelyn Alvarez welcomed
I. CALL TO ORDER
everyone and requested that all phones be silenced to avoid interruptions.
: Hillary Jackson is on extended medical leave until
further notice. She is doing better and on was discharged from the hospital
yesterday is with her family and on the road to recovery. She has sent you
al a message through Tangy her Assistant that was emailed to you yesterday
thanking you for your prayers, love, support and well wishes. Please continue
to pray for Ms. Jackson as she gets stronger every day. You can send any
cards to our office and we will be sure to get them to her.
In the interim Ms. Gonzalez will be supervising the MW Area. All inquiries
Al Management staff and other staff at the front of the room
were asked to Introduce themselves: Ivonne Gonzalez, Kirk Ryon, Sharon
Powell, Maria Springer, Carolyn Eleby, Montrese Albury, Michael Cardello.
Friendly reminder: This room is the DCF District Administrator’s conf room
and we are very appreciative that it is made available to APD for our Provider
Meetings. However, the room is only available to until about 11:30am.
When we adjourn please be reminded to do so promptly, quietly and pickup
al of your belongings. If you need to meet with one of your col eagues we
ask that you do so in the 4th floor cafeteria. Thank you for your cooperation
New Staff Announcements
New Provider Announcements
: Amy Kay, ARNP- University of Miami Neurology Intrathecal
1. APD Announcements:
II. STATE / AREA
Provider Meeting Schedule for 2012 will be posted on the APD A11
AND APD UPDATE
web page at the end of the month. Reminder December meeting For more information about the
will be held on 12/15/11. We will start of the year with the first
Provider meeting date on January 12, 2012. Please pay special
attention to the dates since some meeting will be the second
Thursday of the month due to conference room availability.
2. APD Appointments:
• Director Hansen was appointed by the Governor to Commission on Jobs
for Floridians with Disabilities. Term began 10/21/11.
• Bryan Vaughn was appointed by the governor to the Transportation
2. Cost Containment Plan 2011-2012 Update –
The Director’s Weekly
Reports to the Legislature on Cost-Containment Plan Status Report may
-status of cost plan review initiative for A11: As of last night we had 1,431
completed reviews out of 4,228. Three HSPS and 5 QSI staff are working on
completing the reviews. Completion Due date is 12/31/11.
-Standardize payment rates for intensive behavior residential habilitation
-Agency will begin col ecting fees from APD customers who have income to
offset some of their cost of living in a group home effective 1/1/12.
-APD plans to reduce the rates it pays for the therapy assessments and all
nursing services to the standard rate paid by the Medicaid State Plan
-APD wil reduce the difference it pays between solo providers and agencies
CONTINUED STATE /
for the waiver services to no more than 20%. Effective 4/1/12.
AREA AND APD
3. ibudget Florida Update
- for updates please visit new website ibudet
florida.org. A Consulting company called North Highland Consultants,
Inc. wil be conducting interviews for the ibudget application program,
client central record, making assessment and recommendations on how
to proceed at this time. This will be ongoing though the end of this
week. ibudget implementation will continue in Area 1 & 2. The
assessment will yield a Functionality Business Report on Future needs,
agency integration best methods to future implementation.
4. Disability Mentoring Day
On Oct 4th Attorney General Pam Bondi
introduced a Cabinet resolution declaring October as Disability
Employment Awareness Month in Florida. Thank you for the referrals
that were made for DMD day on past October 19, 2011. Thank you to
provider and APD staff for volunteering to be mentors. Mike/ Montrese
will be speaking more in detail about this event.
5. Delmarva Quarterly Meeting
: Please let us know of any concerns
6. CDC+ Updates:
• AHCA has posted the CDC+ Draft Handbook on their internet site
at the following link:
• Notice of proposed rule for Developmental Disabilities CDC Plus as
it was submitted for publication in the Florida Administrative
weekly was published Nov 4th . The hearing is scheduled for
Monday November 28th, 10-12 noon APD Office in Tallahassee.
Ms. Alvarez on behalf of all APD staff wished all a very Happy Thanksgiving
Holiday, good health and many Blessings.
Mrs. Ivonne Gonzalez spoke on Medicaid Waiver updates and CDC+ Program:
Please continue to submit your Purchasing plans by the 10th of the month to
be approved for the fol owing month. The PP’s effective for December have
been processed already. Also remember to submit your QU, 8821 Forms, etc.
2. Crisis requests:
Remember to submit your Crisis packets to my attention. We review them
here local y and request for additional documentations. The procedure again
is to have a QSI assessment and either the Medical Case Management Team
needs to do a face to face visit or if the consumer has Behavioral concerns,
Dr. Molina goes out and does a face to face visit and report his findings.
The Crisis team reviews all the documents and sends it up to Central Office
for final review. If the consumer comes in through the Waiting List as a
Crisis, the area office can approve 3 months of their needed service.
Al change of provider requests, cost plan adjustments, or Respite request
will go directly to Beverley Alexander. Please submit your requests 10 days
Cost plan adjustment service requests require the determination of medical
necessity being made by our office. Support coordinators, you are still
required to provide us with supporting documentation to justify the service
4. Cost Plan Reviews:
Staff members are finishing up the cost plan reviews for more than 1200+
waiver consumers that receive residential habilitation. The next service to
review is In Home Support about over 1800, and then fol owed by consumers
having other services, which is about another 1800 reviews. We are asking
for the support plans and supporting documentation for the services on the
cost plan which are to be in the consumer's central record file. We need to
complete this assignment by December 31, 2011. We have taken staff from
the QSI department to assist us with these reviews so if you receive a phone
cal from one of them, please submit your support plans within 3 business
days via zixmail or bring the documents in to our office. If you receive a due
process letter, the consumer guardian must reply within 10 calendar days
according to 65-2.048 (Action to Reduce or Discontinue Assistance or
Service). A copy of the due process request will be faxed to the Waiver
Support Coordinator. ABC will be updated after 20 days of no receipt of
hearing request. If the consumer accepts the reduction, please send me a
document signed by the guardian/consumer accepting the reduction and we
can update ABC. A due process letter wil be sent out to the consumer also
giving them due process rights for the voluntary reductions that were made
Please note that we are looking to fil 3 more QSI positions, so if you know
someone that meets the Bachelor’s degree & 2 years in the developmental
disabilities field, please email me their resume.
Thank you so much for your continued cooperation and support.
• Ms.Carolyn Eleby advised that Austin Dean, provider enrol ment
specialist, has returned from Medical Leave. However, due to his 8
week absence we now have somewhat of a backlog in the provider
enrol ment area. She asked that providers continue to send all there
requests for updates to Carolyn Eleby and Yugoslavia Marte. Ms. Eleby
also asked that to assist in completing the requests timely that
providers send all documentation and information timely to avoid
• Carolyn Eleby also reported that Area 11 will continue to post a
quarterly classroom training calendar and registration is on-line through
• Ms. Eleby advised additionally that there is a proposed Supported Living
Quarterly meeting scheduled for Dec 12, 2011 at 1:00 PM. She strongly
suggested that waiver support coordinators, in home support providers
and all other providers who serve supported living consumers should
attend this meeting in order to be familiar with all the requirements that
each provider must adhere to in assuring the appropriate services are
provided to our consumers as members of their circle of support.
American Association Heart Walk:
Thanks to al providers who participated in the American Heart
association walk on October 29th. The walk was a successful we were able to
contribute $700+ to the association through your generous donations, and for
the providers and family members who joined our team and came out and
Medication Error Report:
Medication error reports, please to remember to complete all medication
error reports in its entirety, as soon as you identify the error, whether it was
a documentation error, family error, wrong medication, wrong dosage and or
medication not given. Also, we would like you to include on the form the
name of the medication trainer and validator. We are planning to address
these topics in more detail in the coming year with providers who are having
difficulties with medication compliance.
This month the focus is on Diabetes with greater emphasis on
prediabetes. In 2010 25.8 million people in the US were diabetic and an
estimated 79 mil ion people were considered pre-diabetic. Diabetes is the
seventh leading cause of death in the US. Diabetes is a chronic degenerative
condition, is a leading cause of renal failure, can lead to blindness, heart
For persons who are told that they are prediabetic, they can prevent
diabetes through increasing physical activity and healthy eating. It is
important to have complex carbohydrates which wil not peak your blood
sugar resulting in increase work on the pancreas. Education is key to curtail
Most common symptoms are:
• Wounds that take longer to heal especially on the feet.
Types of diabetes:
• Type 1 known as juvenile diabetes or insulin-dependent normal y affects
• Type 2 also known as adult onset-diabetes, occurs when the body
creates a resistance to insulin. This is the most common form of
diabetes and affects 1 in every 10 adults.
• Gestational diabetes also known as pregnancy diabetes, this condition
Information taken from Miami Herald Sunday, November 13, 2011 and
• As far as our waitlist consumers I am happy to report that thanks to the
partnerships that have been built by our Community Relations
Coordinator Mrs. Rosa Llaguno, and the generous donations of
Centrocampesion Farmworker Center and Construction Catering ,this
year we will be able to provide over a dozen families with Thanksgiving
• Ms.Springer also mentiones Also via these partnerships we have placed
on the table Discount Prescription Drug Cards that can be used by the
• We are continuing our effort to enplane our community partnerships,
and by doing so assist our waitlist families with the local resources. Our
General Revenue Units have been successful in assisting families when
they phone by providing them with information on useful community
resources as wel as guiding them in obtaining State Medicaid Benefits.
• Kirk Ryon, POA for Quality Assurance/Licensing and Monitoring
discussed current issues with the Delmarva Foundation reviews. Mr.
Ryon noted that there have not been any specific complaints concerning
the Delmarva review process during the past several months. Mr. Ryon
noted that most of the reviews in Area 11 have been completed for the
2011 calendar year. All Area 11 Plans of Remediation and Plans of
Corrective Action must be submitted no later than December 31, 2011.
• Kirk Ryon re-distributed all previously issued memorandums concerning
Incident Reporting. There have been some issues with non-reporting,
late reporting or hand written reports that are illegible. Mr. Ryon
reminded all present that a writable template of the State Wide Incident
Reporting form is available on the APD web site. Reporting deadlines
and categories of reports are clearly written on the Incident Reporting
• Kirk Ryon distributed guidelines for incident reports for customers who
have been Baker Acted. It was noted that a study conducted by
Enrique Molina, Ph.D., revealed that between 100 and 200 Area 11
customers are Baker Acted every month. Providers of residential
services were directed to the Baker Act Manual available on line for
prevention techniques for avoiding using the Baker Act for customers
with mental illness. This topic will be revisited in upcoming meetings as
the study of Baker Acts for APD customers in Area 11 is refined to
include specific residential settings and customers.
Jorge Villalon , Mariana Abraham, Betty Seltzer, Milagros Aniceto, Claudia Perez, Argeo Rodriguez, Mayan Wiltz, Christine
McAnrt,Roberto Pire,Yirlank Rivero, Maurren Winter,Olimpi Omir, Lillian Rangelm Wilma Johnson, Arnold Coats, Maria
Garcia,Tatiana Cortez, Gloria Fortune ,Cristina Schwarz, Dora Guzman, Mable Burger, Janice Thurston, Carmen C Roberts,
Luz Ortiz,Muriel Cuadro, Aileen Phelan, Nse Essiet, Mario Valdes, Rene Gomez, Carlos Rocha, Pascale Maneette,Veronica
Oliver, Mathew Zosnick, Rosaire Olivier, Aglyam Olivier, Kathlyn Morman, Diane Gelpi, Viveen Brooks,Reynold Stewart,
Manuel Achong,Chanelle Alavarez, Jooly Cox , Luis Rodirguez, Natalia Laver, Velma Fulger,Dianne Barton,Monica Cruz,Isis
Espino, Ray Bell, Xiomara Margothes,Jason Mendoza, Elsbeth Arce, Steven Kuster, Cherie O’Geen, Marianela Wata Wara,
Estrella Granda, Laura Vinent, Eddie Danta, Monica Martinez, Eduardo Martin, Jerome Silverberg.
*Kathleen Mulkey*Portia Jame*Penny Schueneman*Josephine Livingstone*Neftali Pernas*Martine Ossaghae*Lixon
Nelson*Jacqueline Coats*Nadege Arinad *Edna Arroyo*Derick Toro
* Denotes tardiness of more than 15 minutes
T. M. Glaus, G. Wess, Band 152, Heft 3, März 2010, xxx – xxx © 2010 by Verlag Hans Huber, Hogrefe AG, Bern Originalarbeiten 1 Linksherzhypertrophie bei der Katze – „wenn eine hypertrophe Kardiomyopathie keine hypertrophe Kardiomyopathie ist“ T. M. Glaus1, G. Wess2 1Abteilung für Kardiologie, Klinik für Kleintiermedizin, Universität Zürich, 2Abteilung für Kardiologie,
MINISTERO DELLA DIFESA DIREZIONE GENERALE PER IL PERSONALE CIVILE 3° REPARTO 8^ DIVISIONE 1^SEZIONE Viale dell’Università 4 - 00185 Roma Tel. – fax. 06.49862475 email@example.com M_DGCIV Prot. Nr68 Del 20/02/2009 PARTENZA A U.D.G. – U.R.P. OGGETTO : candidature di dipendenti civili a posti a “status internazionale”. Legge 27 lug