FLORIDA INDEPENDENT LIVING COUNCIL, Inc. “Independence Worth Preserving” 1018 Thomasville Rd., Tallahassee, FL 32303-6271 Suite 100A Toll Free (877) 822-1993 (850) 488-5624 V/TDD (850) 488-5881 Fax Volume 1, Issue 1 January 2006 Medicaid Reform Legislation Signed by Governor Bush On January 11, 2005, Governor Bush released a Medicaid reform proposal for legislative consideration. The proposal was based on data indicating the Medicaid budget was growing at an unsustainable rate and that comprehensive overhaul of the system was necessary to improve care and provide predictability in Florida's Medicaid budget. The Governor's proposed Medicaid system redesign will move Medicaid recipients out of a fee-for service system to a managed care system which will include traditional Medicaid HMOs and new provider service networks. The proposal allows managed care plans to vary the amount, duration, and scope of services provided to Medicaid recipients enrolled in their plans within the parameters deemed actuarially equivalent and sufficient by the state. Actuarial equivalence assesses the value of the proposed plan compared to a target population's historical Medicaid expenditures. Sufficiency to meet medical needs is based on the plan's proposed service levels being sufficient to meet the needs of a target population. Advocates throughout Florida raised several concerns with the proposed reform plan including: (1) The Legislature approved a demonstration waiver for a few counties yet AHCA’s proposal sought approval for a statewide program based upon cost projections and expenditure caps that apply to the entire state; (2) Individuals with disabilities may be at a disadvantage or even harmed since their medical cost are higher and there is little incentive for private entities to compete for their business; (3) The waiver allows plans to limit the amount and duration of mandatory services that are medically necessary (caps) and eliminate optional services; and, (4) ensuring cost neutrality in the waiver is not linked to any discernable standard(s). On December 16, 2005, Governor Bush signed House Bill 3B, the Medicaid implementation bill. The first phase of the program will begin in July 2006 in Broward and Duval Counties. The Agency for Healthcare Administration (AHCA) is charged with expanding the program statewide over the next five years. Independent Living in Action (Contributed by Don Dawkins) On December 6, and 7th 2005 I testified as an individual activist in front of the Florida House of Representatives and Senate Committees relating to Fiscal, Ways and Means, and the Health and Human Services Committees regarding proposed Medicaid reform legislation. I described myself as a forty year survivor of a spinal cord injury and a Rehabilitation Counselor and Therapist of thirty years. I compared my personal journey to what a person with a spinal cord injury could expect in service delivery in the first decade of the 21st century. I spoke in opposition to the Medicaid Reform waiver. I spoke to a variety of issues. I presented the Medicaid reform waiver in a historical context. I made reference to the point that managed care has never reduced costs, has greatly affected the quality of outcomes in patient care and greatly contributed to the increase of inappropriate patients in skilled nursing facilitates. I made reference to the opportunities that were provided to me in the late 1960's compared to what a survivor of a catastrophic injury could expect today. I tried to keep my testimony in context. I mentioned many of the positive reforms like the ADA, Section eight housing and the increasingly opened society of the last few decades to the lack of seamless medical care in contemporary society. My intent overall was to highlight the inequities between what once was in place and what we are currently trying to work with. Any objective look at medical service delivery from 1990 to the present has to be struck by the loss of training opportunities, access to rehabilitation, DME, and preventative care. I summed up at the end of each five to ten minute testimony by asking for the pertinent legislators to allow us to move ahead to move ahead into the 21st century and allow every American the opportunities that I received forty years ago. CLOSED CAPTIONING REQUIREMENTS HAVE TELEVISION PROGRAMMERS RUSHING FOR FCC WAIVERS Did you know Closed Captioning provides 10% of the population a critical link to news and entertainment, which enables them to be part of the cultural mainstream of our society? In addition, it also helps those who want to learn English, by using English captions to improve comprehension and fluency. Studies have shown that captions help children learn to read, and have improved literacy skills. Technology has changed the lives of the hearing impaired and deaf through the use of TTY, "Teletype", and TDD devices, “Telecommunications Device for the Deaf" and closed captioning. In 1993, the Federal Communications Commission, (FCC) required all analog television sets sold in the United States to contain built-in decoder circuitry to display closed captions for the hearing impaired. In 2002, the FCC added the new technology of digital television receivers to include closed caption display. Beginning January 2006, the FCC has ordered all broadcast and cable programmers to include closed captioning. The recent change has many small and large producers running frantically to meet the new-year deadline, or file a waiver for exemption with the FCC demonstrating that compliance with the closed captioning requirements would cause an undue burden. For the deaf and hard-of-hearing, captioning is a lifeline to everyday information and entertainment for millions of Americans. Captioning gives viewers access to a world of programming that otherwise would not be possible. Hearing loss is one of the most common disabilities touching the lives of 28 million people in the United States. When they turn the television on, many select the closed caption function to get informed. The Florida Independent Living Council wishes to express gratitude to Rose Lee Archer and all of the independent television producers who are ringing in the New Year by offering the true meaning of reality television… not by scrambling for a waiver but by adding closed captioning to achieve all-inclusive programming. For more information about how to comply with FCC requirements, please contact Rose Lee Archer at (561) 241-7987 or www.roseleearchershow.com. (Information provided by Rose Lee Archer) SILC Congress 2006 Florida's Independent Living Council is proud to have been chosen to host the 9th Annual SILC Congress being held January 10-12, 2006 at the Radisson Parkway Hotel in Orlando, Florida. SILC Congress is a national conference where all the State Independent Living Councils come together to further the independent living movement for individuals with disabilities through development of public policy and programs reflecting this culture. FILC provides technical assistance to the Centers for Independent Living throughout the state. Centers scheduled for technical assistance visits this year include: Suncoast Center for Independent Living,Sarasota Coalition for Independent Living Options,W. Palm Beach Center for Independent Living of Broward,Tamarac Disability Resource Center,Panama City Center for Independent Living of the Florida Keys,Key Largo Center for Independent Living of North Central Florida,Gainesville Self Reliance, Inc., Tampa Center for Independent Living of South Florida,Miami Independent Living Resource Center of northeast Florida,Jacksonville Center for Independent Living of Southwest Florida,Ft. Myers Center for Independent Living of Northwest Florida,Pensacola Caring and Sharing Center for Independent Living, Largo January Calendar January 2, 2006 Closed for Holiday January 4, 2006 Planning Committee Teleconference 2:00 p.m. January 4, 2006 Evaluation Committee Teleconference 3:00 p.m. January 6, 2006 Executive Committee Teleconference 1:30 p.m. January 10-12, 2006 SILC Congress Orlando, Florida January 13, 2006 Standards Committee Orlando, Florida 9:00 a.m. January 20, 2006 Advocacy/Outreach Committee Teleconference 2:00 p.m. January 27, 2006 Consumer Survey Teleconference 9:00 a.m. Activities initiated/hosted by the Florida Independent Living Council are open to the public. For information about these or any other FILC events please contact the FILC office @ (850)488-5624. Officers Chip Wilson President Don Dawkins 1st Vice President Peter Sachs, Esq. 2nd Vice President Wendy Herzman Treasurer Kristi Chapman Secretary Elizabeth Howe Network of Centers Board Members Rose Lee Archer William Gordon Doug Hall Darlene Maynard Carol Novak Jeff Oatley, Ph.D. Roberta Van Sickle Nancy Wilbur Staff Molly Gosline, Executive Director Debbie Richards, Advocacy Coordinator Jenny Bopp, Office/Fiscal Manager Please submit information you would like to contribute to this publication to Debbie Richards at dlr@polaris.net It is the mission of the Florida Independent Living Council to assist and advocate for people with disabilities in achieving equal opportunities. Our vision is to foster change via leadership, collaboration and visibility. Please feel free to distribute this letter to any other persons/organizations that may be interested.