APD BASE BUDGET OVERVIEW

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• APD BASE BUDGET OVERVIEW
• SENATE HEALTH HUMAN SERVICES APPROPRIATIONS
  COMMITTEE
• February 10, 2009

Charlie Crist, Governor Jim DeBeaugrine, Agency
Director
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What is the Agency for Persons with Disabilities
(APD)?

• The Legislature created APD in 2004 to address
  the unique and significant challenges faced by
  the developmental disabilities community
• Assists people who have developmental
  disabilities and their families
• Provides assistance to identify the needs of
  people with developmental disabilities and
  funding to purchase supports and services
• Seeks to support individuals in their communities
  and avoid unnecessary and costly
  institutionalization
• Fulfills an important role in serving as a
  central point of interagency coordination for
  developmental disabilities

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MISSION
The Agency supports persons with developmental
disabilities in living, learning, and working in
their community.
CHAPTER 20
Chapter 20.197 created the Agency for Persons
with Disabilities to provide services to persons
with developmental disabilities under Chapter
393, including the operation of state
institutional programs and programmatic
management of Medicaid waivers established to
fund services.
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Agency Organizational Structure

• Section 20.197 of the Florida Statutes creates
  the Division of Planning and Budgeting and the
  Division of Operations.
• Each Division is headed by a Deputy Director.
• The agency does not employ Division Directors.
• The restructuring of headquarters is an ongoing
  activity and has resulted in the elimination of 2
  Bureau Chief positions.
• The Legislature reduced headquarters by 598,187
  and area offices by 294,252 during the recent
  special session.

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Who Do We Serve?

• About 35,000 individuals with developmental
  disabilities such as
• Autism, 2,693
• Cerebral Palsy 3,662
• Mental Retardation 27,060
• Prader Willi Syndrome 73
• Spina Bifida 850
• High Risk 32

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What Services Do We Provide?

• Community-Based Services
• Support Coordination
• Residential Habilitation
• Intensive Behavior Homes
• Individual and Family Supports
• Personal Care
• Respite
• Adult Day Training
• Transportation
• Therapies
• Supported Living
• Environmental Adaptations
• Supported Employment
• Nursing, Dental, Etc.

• Intermediate Care / Developmentally Disabled
• Developmental Disabilities Centers
• Private Facilities (AHCA)
• Competency Restoration
• Mentally Retarded Defendant
• Community-Based Competency Services

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What Residential Services Are Available?

• Supported Living This service provides coaching
  services and supports to people who rent or own
  their own home. The service also provides
  financial assistance to individuals in the form
  of subsidies to assist with monthly living
  expenses. No more than three persons may reside
  in the same supported living setting (home,
  apartment, other).
• Group Home Facility A residential facility which
  provides a family living environment including
  supervision and care necessary to meet the
  physical, emotional, and social needs of its
  residents. The capacity of such a facility is at
  least 4 residents, but not more than 15 residents
• Foster Care Facility or Foster Home A
  residential facility which provides a family
  living environment including supervision and care
  necessary to meet the physical, emotional, and
  social needs of its residents. The capacity of
  such a facility is not more than three residents.

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What Residential Services Are Available?

• Intermediate Care Facility for the
  Developmentally Disabled (ICF/DD) These
  institutional facilities are licensed and
  certified by the Agency for Health Care
  Administration and are funded through Medicaid.
  The ICF/DD facilities are operated by public and
  private agencies. These facilities provide
  services to fulfill the needs identified in the
  individuals active treatment plan. The services
  may include behavior management, nursing, medical
  dental, work activities, personal care,
  transportation, recreation, adaptive equipment
  and other needs identified for the individual.
• Forensic Services Services are provided in 184
  unlicensed forensic system beds for people
  participating in the Mentally Retarded Defendant
  Program. This is a residential service provided
  in a secure setting for criminal defendants with
  a diagnosis of mental retardation or autism. In
  this program people receive competency training
  and other services in accordance with their needs.

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How Are Services Funded?

• Services provided by the Agency for Persons with
  Disabilities are funded mostly through the
  Medicaid program.
• The Medicaid program provides approximately 56
  federal match to 44 state general revenue
  dollars. This funding is in both the Medicaid
  waiver programs and the public and private
  institutional care programs.
• The Medicaid Home and Community Based Waiver-
  833,529,770 and serves 31,000 people.
• State General Revenue and Federal Block Grant
  funds for people in the community, the majority
  of whom are currently not enrolled in a
  waiver-21,836,771 and serves 7,100 people.
• Developmental Disability Centers (DDC)-
  118,227,904 and serves 1,010 people.
• Mentally Retarded Defendant Program (MRDP) -
  14,587,933 and serves 146 people.

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Agency for Persons with Disabilities FY 2008-09
Appropriations by Major Function(Total Budget
1,063,804,482)
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Recent Budget/Service Reductions to APD Waiver
Programs

• Impact of SB 1124 - 75 Million
• Cost plan rebasing - 20 Million
• Budget reductions during 2007 special session
  4.3 million
• Budget reductions during 2008 regular session
  55.9 million
• 9.4 million provided to partially replace 54
  million non-recurring appropriation from FY
  2007-08
• Budget reductions during 2009 special session
  7.3 million
• Total Reduction 207.1 million