Rick Scott, Governor

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Geraud Moreland II, et al v. Palmer, Case No.
412-cv-00585-MW-CAS (N.D. Fla.)
Rick Scott, Governor Barbara Palmer, Director
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Geraud Moreland II, et al v. Palmer, Case No.
412-cv-00585-MW-CAS (N.D. Fla.)

• Class Action Lawsuit filed on November 7, 2012
• First Amended Class Action Complaint was filed on
  December 18, 2012
• Settlement reach on September 13, 2013 at
  mediation
• Settlement approved and Settlement Class
  certified November 27, 2013

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Geraud Moreland II, et al v. Palmer, Case No.
412-cv-00585-MW-CAS (N.D. Fla.)

• Moreland settling parties engaged in extensive
• litigation, including but not limited to
• Written discovery
• 12 depositions
• A motion for preliminary injunction
• A motion to dismiss
• A disputed motion for class certification
• Cross motions for summary judgment
• Oral arguments
• Evidentiary hearing

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Who is a Moreland Class Member?

• "Settlement Class" shall mean the collective
• group of "All individuals who receive services
• under Florida's DD waiver who have
• received notice of final agency action of a
• proposed reduction to the recipient's current
• annual budget due to transition to iBudget"

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Who is a Moreland Class Member?

• Class Member shall mean a person who is a
  member of the Settlement Class
• Class Member includes CDC individuals

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How Will I Know if I Am a Class Member?

• If you received a notice of reduction to your
  tier cost plan during your transition to iBudget
  you are part of the Settlement Class as a Class
  Member

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Timeline for Settlement

• November 27, 2013 - Settlement approved by Court
• December 20, 2013 (estimated) - Reinstatement
  notice mailed
• January 15, 2014 - budget restored
• Shortly after January 15, 2014 - Amended Notice
  of iBudget Allocation and Reduction of Annual
  Funding Amount ("Amended Notice") to be mailed

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Reinstatement Notice

• APD will reinstate all Class Members cost plans
  on a pro-rated basis to the level they were prior
  to transition to iBudget

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Reinstatement Notice

• If you are in the Consumer Directed Care Plus
  Program (CDC), and are a Moreland Class Member,
  please note that the CDC Monthly Budget for
  January 2014 will be increased to include the
  prorated reinstatement of funds
• Purchasing plans will not be required for the
  budget increase due to the reinstatement of funds

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Amended Notice

• Soon after January 15, 2014, APD will issue the
  Amended Notice to all Class Members and at the
  same time to their
• Parents
• Guardians
• Guardian advocates
• Authorized representatives

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Amended Notice

• Authorized representatives include
• Health care surrogates
• Durable powers of attorney
• Client advocates
• To the extent they are authorized to receive the
  notice

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Amended Notice

• If you previously requested a hearing, and did
  not withdraw the request, you will not need to
  request a new hearing. APD will honor that
  request unless you ask to have it withdrawn in
  writing
• If you do not request a hearing per the Amended
  Notice your iBudget amount will be reduced to the
  amount stated in the Amended Notice

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Amended Notice

• If you did not previously request a hearing you
  can request a hearing once you receive the
  Amended Notice
• If your hearing was postponed until this lawsuit
  was resolved, the hearing will be scheduled once
  you have received your Amended Notice

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Legal Representative Information andPrimary
Language

• APD agreed to modify the Agencys Allocation
  Budget and Contract system (ABC) to include
  fields for current information for
• any authorized representative and
• the primary language for the client

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Legal Representative Information andPrimary
Language

• Waiver support coordinators have been collecting
  all relevant addresses and primary language
  information for the "Settlement Class"
• Your waiver support coordinator is the person
  responsible for verifying your address and
  primary language and recording the information
  into the APD ABC computer system

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Legal Representative Information and Primary
Language

• Please confirm with your waiver support
  coordinator that she or he has done so
• Waiver support coordinators with APD staff will
  continue to collect primary language and legal
  representative information for the entire DD
  waiver and waiting list individuals

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Legal Representative Information andPrimary
Language

• If you have a primary language other than
  English, you and any identified legal
  representative authorized to receive a notice in
  the agency ABC computer system will receive two
  notices, one in English and the other in your
  primary language

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What does this mean for you?

• You will receive a NOTICE OF REINSTATEMENT OF
  MEDICAID WAIVER FUNDING before January 15, 2014
  (English Version Only)
• You will have your budget restored to it's
  previous tier amount on January 15,
  2014

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What does this mean for you?

• Soon after January 15, 2014, you will receive an
  Amended Notice (English and Primary Language)
• A Notice of Hearing Rights and a Hearing Request
  Form will be included in your Amended Notice

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What does this mean for you?

• You have up to 30 days from receipt of your
  Amended Notice to submit your Hearing Request
  Form and maintain your current budget level until
  a final hearing decision is reached
• Once 30 days have passed without a hearing
  request your budget will be changed to reflect
  the iBudget amount in your Amended Notice

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What does this mean for you?

• If you have already requested a hearing and your
  budget was restored to your previous amount, your
  budget will remain at that restored amount until
  the conclusion of your hearing and a final order
  is issued

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Reinstatement of Funds

• On January 15, 2014, Class Members will have
  their budgets restored. The restored amount will
  be your tier amount prior to the transition onto
  the iBudget waiver
• The restored money will be prorated for six
  months and will be added to your current budget
  in the iBudget technology system

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What Will I See In My Amended Notice?

• This is the Amended Notice of your individual
  yearly (12 month) funding amount (iBudget
  Allocation) for your transition into the iBudget
  Florida Program
• In addition to setting out your iBudget
  Allocation, it will describe the reasons for the
  Agencys decision on your funding, as well as the
  information relied upon in reaching that decision
• The Amended Notice will also include a Notice of
  Hearing Rights and a Hearing Request Form

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What Will I See In My Notice?

• Your iBudget Allocation Amount
• Your annual cost plan amount prior to iBudget was
  ______
• Your annual iBudget Allocation for July 1, 2013
  June 30, 2014, is ___________. This is the
  amount of funding you have available to spend in
  each fiscal year (which runs July 1, - June 30)
  absent a change in your circumstances
• This represents a reduction of ________from you
  annual cost plan prior to your transition to
  iBudget

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What Will I See In My Notice?

• The annual amount will continue until 30 days
  have passed without a hearing request, upon
  issuance of a final order after your hearing, or
  upon entering into a written settlement between
  you and the Agency

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What Will I See In My Notice?

• Your iBudget Amended Notice amount would continue
  into next fiscal year 2014 -2015 if no final
  order or hearing settlement has occurred

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What Will I See In My Notice?

• iBudget Allocation Process
• Determining the Base Amount
• The base amount was adjusted to the amount of
  funds appropriated for the iBudget program by the
  Florida Legislature. The base dollar amount is
  determined by the following factors

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What Will I See In My Notice?

1. Your age (under 21)
2. Your living setting (family home, supported
   living, group home, residential treatment center)
3. The answers to QSI (Questionnaire for Situational
   Information) 18, 20 23, the total functional
   raw score on the QSI (questions 14-24), and the
   total behavioral raw score on the QSI (questions
   25-30)

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What Will I See In My Notice?

• Your age, living setting, and your score on your
  QSI
• The weighted factor for each of these elements
  (same for everyone)
• How your funding was adjusted to fit the
  appropriation
• Your adjusted base amount (iB810 Amount) was
  _______________

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What Will I See In My Notice?

• 2. Target Allocation APD calculated the amount
  of your currently approved services in your cost
  plan at the time of iBudget implementation as
  reflected in your sum of services included in
  your notice. The total for these services was
  _______________

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What Will I See In My Notice?

• The services included were adult day training,
  behavior services, consumable medical supplies,
  durable medical equipment, in-home-supports,
  nursing services, occupational therapy, personal
  care assistance, physical therapy, residential
  habilitation, respiratory therapy, special
  medical home care, supported employment,
  supported living coaching, and support
  coordination
• Target Allocation is the greater of this amount
  or your iB810 amount

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What Will I See In My Notice?

• The Allocation Implementation Meeting
  Extraordinary needs review
• APD directed your support coordinator to meet
  with you and/or your legal representative to
  discuss your extraordinary needs to determine
  whether they could be met by the Target
  Allocation

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What Will I See In My Notice?

• Together, you were to fill out an Allocation
  Implementation Meeting (AIM) form that was to be
  turned in to APD with a Recommended Cost Plan
  budget if you believed that an increase in the
  Target Allocation was necessary to meet your
  extraordinary needs
• Extraordinary needs is defined in iBudget Rule
  65G-4-0210(7)
• https//www.flrules.org/gateway/ruleno.asp?id65G-
  4.0210

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What Will I See In My Notice?

• Your notice will indicate whether APD received or
  did not receive an AIM form from your waiver
  support coordinator
• APD will also indicate whether other information
  was used to make a decision on your request for
  an increase in your Target Allocation

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What Will I See In My Notice?

• Other Information that APD could have used to
  determine your budget included
• AIM Form
• Documents submitted with AIM Form (list)
• Support Plan
• QSI
• Behavioral Plan
• Other

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What Will I See In My Notice?

• Based upon the information just listed, APD
  decided that
• You DO NOT have extraordinary needs that would
  require an increase in your Target Allocation
  amount. Thus, your iBudget Allocation is
  ______________
• OR
• b. You DO have extraordinary needs that require
  an increase of ________in annual funds, thus
  your iBudget Allocation is ___________

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What Will I See In My Notice?

• You will see the reason(s) why APD increased or
  did not increase your budget based after review
  of any extraordinary needs
• Included in your notice will be
• Your EZ iBudget Calculator
• List of Services and Annualized Amounts
• AIM Worksheet (attachment)
• Notice of Hearing Rights
• Hearing Request Form
• AIM form-if one was completed as part of the
  decision process for your iBudget

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Additional Information

• Your waiver support coordinator can amend your
  current service
• You may request additional (new) services to be
  approved at your local Regional APD office
• New services will need to be considered medically
  necessary and must be supported by all required
  documentation

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Thank You

• Please direct your questions to your local
  Regional APD Office