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Expanding Adult Day Training (ADT) Programs services with existing funds.
The Legislature and Governor have made historic efforts to expand services for individuals on the Agency for Persons with Disabilities (APD) Waiting List. This last year the budget increased the number of people served by the Home and Community Based Services (HCBS) waiver by $158.4 Million for 2,619 new waiver slots.
Adult Day Training programs are tailored to train individuals to gain competence in valued community routines that are age and culturally appropriate. The training, activities, and routines established by an ADT provider must be meaningful and foster the acquisition of skills such as positive social behavior and interpersonal competence, greater independence, and personal choice. ADT programs allow for the development of natural supports and moves individuals toward fuller community integration. Another benefit of ADT services is that they provide a safe environment for individuals during the day so that family members or caregivers can earn an income.
Individual choices regarding ADT programs vary in amount, duration, frequency, and intensity for any given service as well as selecting service providers. Based on these decisions, dollars are allocated in each individual’s iBudget and are committed to by APD. The choices made by individuals are translated into staffing patterns by their chosen providers. This step is critical to ensure that the level of supports meet licensing standards for staff ratios. A provider’s ability to maintain the required staffing pattern is dependent on predictability and stability of service delivery so that they, too, can manage within a given budget while meeting state licensing standards.
The current payment methodology was put into effect in July 2008 as a cost cutting measure when the country was experiencing a serious recession. This resulted in providers absorbing the costs of maintaining Direct Support Professional staffing ratios regardless of whether or not individual attended the program. Providers have experienced increasing budget shortfalls, causing many to consider capping or eliminating these programs at a time when the Legislature is expanding these services in response to unmet needs. This current methodology results in millions of State dollars going unspent each year.
The Legislature asked APD to look at monthly billing. This strategy that would allow providers to expand services to those on APD’s Waiting List and also for those on the HCBS waiver currently waiting for ADT services. Monthly and daily reimbursement rates for ADT and Prevocational services offer a stable, predictable framework that benefits everyone. Providers would gain steady revenue, improved operational efficiency, and the ability to expand programs, while individuals would enjoy cost predictability, convenience, and greater access to services. APD would have information to plan and project individual needs while the Legislature would receive reliable and timely financial data. The system of care for individuals with intellectual and developmental disabilities would grow in the manner envisioned by the Florida Legislature.
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