From the Harvard University Center on the Developing Child …..

Science shows that early exposure to circumstances that produce persistent fear and chronic anxiety can have lifelong consequences by disrupting the developing architecture of the brain. Unfortunately, many young children are exposed to such circumstances.

A report from the National Scientific Council on the Developing Child summarizes in clear language why, while some of these experiences are one-time events and others may reoccur or persist over time, all of them have the potential to affect how children learn, solve problems, and relate to others. 

Click here to access the report.

Established in 2003, the National Scientific Council is a multi-disciplinary collaboration of scientists and scholars from universities across the United States and Canada designed to bring the science of early childhood and early brain development to bear on public policy decision-making

This is from the Rehab License Network….

Some therapists may think that only travelers are eligible for tax deductions.  However there are certain tax deductions all therapists are eligible for, provided these expenses are not reimbursed to you by your employer. Information for travelers begins in the next section and additional tax information for all therapists follows.

Read the full article here…

Thanks to the Family Network on Disabilities of Florida for sharing this information…

Find educational consultants, psychologists, educational diagnosticians, health care providers, academic therapists, tutors, speech language therapists, occupational therapists, coaches, advocates, and attorneys for children with disabilities on the Yellow Pages for Kids for your state.

You will also find special education schools, learning centers, treatment programs, parent groups, respite care, community centers, grassroots organizations, and government programs for children with disabilities.

http://www.yellowpagesforkids.com/help/fl.htm

Despite continued problems with Medicaid reform, the Agency for Health Care Administration (AHCA) has identified 19 new counties as possible sites for expansion.

In a Feb. 17 presentation to the Senate Ways & Means Committee, AHCA Secretary Tom Arnold told lawmakers that 16 counties already have the infrastructure with two or more existing managed care plans  (read more here).

Those counties are: Miami-Dade, Orange, Hillsborough, Pinellas, Brevard, Citrus, Hernando, Jefferson, Lake, Madison, Manatee, Osceola, Pasco, Polk, Seminole and Wakulla. 

Another three counties — Gadsden, Liberty and Palm Beach — also have at least two managed-care plans but currently lack the capacity to accept additional enrollees, according to Arnold.

Currently, the Medicaid reform pilot project is underway in five counties: Broward, Duval, Baker, Clay and Nassau.

A University of Florida study commissioned by AHCA indicates that Medicaid reform has saved money, but the findings fail to take into account many factors, such as the cost of providing  ”choice counselors”  that are supposed to assist Medicaid recipients with choosing a health plan. But whether Medicaid reform has been a success or failure remains unanswered. The lead researcher of the UF study told legislative committees recently that Medicaid reform is “not the kind of panacea that would solve all of Medicaid’s problems in one fell swoop, nor is it the kind of train wreck that some people feared.”

Findings from Georgetown University’s Health Policy Institute indicate otherwise. According to their surveys, the pool of physicians and specialists has declined in the Medicaid reform health plans; excessive paperwork and service authorizations create barriers to medical care; reform plans have actually scaled back patient benefits including prescriptions (read their reports here; see more information at www.floridachain.org/medicaid).

For the past three years, Gov. Charlie Crist has stated his opposition to expanding Medicaid reform. But he recently reversed course and said he is “open” to the idea of Medicaid reform, so long as it’s not limited to managed care plans. Senate President Jeff Atwater told the Miami Herald that he supports expansion as well because it “has dealt with escalating prices and changed behaviors by setting up patients with a primary care doctor to prevent unnecessary emergency room visits.”

Industry groups including hospitals and community health centers have pitched lawmakers on ways to change the entire Medicaid program, irrespective of Medicaid reform. The hospital industry, for example, envisions an approach that involves more hospital-based provider service networks (Children’s Medical Service is an example of such a network).

The Florida Association of Health Plans has developed its own proposal for an overhaul. It calls for all Medicaid beneficiaries to be enrolled in managed care plans, which would include long-term care such as nursing homes. 

Meanwhile, several lawmakers and advocacy groups are pushing for a “medical home” model of care to replace Medicaid reform. (read more here).

Alliance members: check the Members Only section for weekly legislative developments on these issues.

State Rep. Mia Jones will host a Medicaid Town Hall meeting in Jacksonville for members of the Florida Legislature to hear community concerns about the Medicaid program, including expansion of the reform pilot project.

The focus will be to discuss how the Medicaid program is working and to hear testimony on Medicaid reform. Duval County (Jacksonville) is one of five counties where the Medicaid Reform pilot project is in place. Lawmakers may consider expanding the program during their legislative session, which begins March 2.

The Medicaid Town Hall Meeting is scheduled for Monday, Feb. 22, at two times — 10 a.m. and again at 6 p.m. It will be held at Florida State College Jacksonville, Downtown Campus Auditorium.

A second day will be set aside for testimony from health care providers. It will take place 6 p.m., Tuesday, Feb. 23, at the same location.

This information is from the Family Network on Disabilities of Florida:

The Florida Department of Education is working with school districts to gather information from parents of children with disabilities on how well schools are facilitating their involvement in their children’s education.  The responses to the survey provide important information for planning and monitoring improvement activities.  The survey will be open until July 1, 2010. 

Parents with children receiving exceptional student education services in prekindergarten to grade 12 can access the online survey at www.ESEsurvey.com. 

 This survey is separate and distinct from the school district’s survey that parents complete after their child’s individual educational plan (IEP) meeting. 

If you prefer to complete the survey using a paper format, please call (239) 377-0108 to request a survey and provide your mailing address.

A statewide task force released report today recommends that Florida move toward a “medical home” model of care for Florida Medicaid recipients.

The Medicaid Medical Home Task Force developed the following recommendations based on months of examing other state’s programs, as well as input from members:  

• Every Medicaid recipient should have a primary care provider (physician, ARNP, or physician’s assistant) who is available on a 24/7 basis.
• Patient care should be coordinated - the PCP must ensure that services to which recipients are referred have been received and that appropriate follow-up is done. PCPs should address both physical and behavioral health care needs of recipients and develop strong referral relationships with local mental health providers.
• The Task Force suggested using the NCQA Patient-Centered Medical Home standards as a starting point for developing the requirements to qualify as a medical home.
• The Task Force is interested in pursuing a 3-tiered approach to levels of medical homes, similar to Oklahoma.
• The Task Force recommends that an Advisory Board be appointed to assist the Agency during the planning and implementation of the Florida Medicaid medical home pilot project.

• New payment methodologies and primary care practice operations will need to be instituted for the medical home pilot. In general, based on the models from the other states that presented to the Task Force as well as the studies provided to the Task Force, adequate physician participation in the pilot is dependent upon the reimbursement rates for physician fees as well as any case management fee and/or incentive payments. Agency staff reported to the Task Force that in general, Florida Medicaid FFS rates for physician services are approximately 58% of Medicare rates, so increasing physician fees may be necessary to attract providers to participate in the medical home project. While increasing physician fees may be necessary, the Task Force strongly recommends that any program design should investigate payment methodologies to ensure a return on investment.

The 16-page report doesn’t define which which group of Medicaid enrollees - children, aged and disabled, etc. - should be moved into this model, but instead leaves that to an advisory board for further discussion.

 The medical home concept is being seriously considered by state lawmakers faced with growing Medicaid costs. Many advocacy groups favor this approach, including pediatricians, hospitals and consumer groups. The American Academy of Pediatrics has long supported this role of health care delivery for children.

Florida already has a “medical home” model within Children’s Medical Service. Children enrolled in the CMS Network are assigned a primary care physician who serves as a case manager. Children are referred to specialists including therapists through the primary care physician.

Some other points raised in the report, which can be found here:

The Task Force recommends that at least one rural area and one urban area with an academic setting/medical school be included as pilot sites. Local providers’ level of interest in participating in the medical home pilot should be taken into account. Special consideration should be given to areas with high levels of uncoordinated care, as evidenced by frequency of emergency room visits and hospital admissions.

The Task Force recognizes that successful medical home projects in other states have been predicated on a higher general reimbursement rate to physicians and other providers of health care services. To be successful in Florida, the Task Force finds that a medical home pilot project must address core funding issues for those who agree to provide health care services through this program. Strong consideration should be given to reimbursement models that include, but are not limited to: enhanced fees for services rendered, care management fees, and pay for performance/incentive payments.

Florida leaders are working on ways to bring relief to businesses facing significant increases in their unemployment taxes.

According to www.businessjacksonville.com:

Gov. Charlie Crist, who’s running for the U.S. Senate, has pledged to soften the tax increase’s impact on Florida businesses. Bills are working through the House and Senate, and backers say they hope the Legislature will vote for passage.

House Speaker Larry Cretul has announced a proposal that would delay the increases for two years while reducing penalties and interest payments.

A Jan. 22 press release from the Associated Industries of Florida outlines some of the discussions underway:

Over the past several weeks and as recently as this morning, Associated Industries of Florida (AIF) has been in discussions with the Governor’s Office, Senate and House to identify a solution for the significantly increased unemployment compensation payments every business in Florida must remit to the state by the end of the first quarter. Several proposed solutions which AIF and our members can support for reducing employers’ tax rates in 2010 and 2011 have risen out of these discussions, including:

• A quarterly payment plan that lets employers spread out their unemployment compensation payments over the whole year without penalties or interest.
• A reduction in the amount of each employee’s taxable wages - from $8,500 back down to $7,000 for 2010 and 2011.
• The elimination of all provisions in last year’s legislation that would have allowed the state to replenish the Unemployment Compensation Trust Fund balance more quickly.

“In these very trying times, many small and medium-sized businesses are just trying to hold on and survive. A down economy coupled with a growing lack of access to capital has hamstrung businesses’ ability to make these payments in full over such a short period of time,” said Barney Bishop III, president and CEO of AIF. “AIF and our members around the state appreciate the commitment by Gov. Charlie Crist, Senate President Jeff Atwater and House Speaker Larry Cretul to finding a resolution that brings businesses relief and protects jobs. We applaud their attention to this critical fiscal issue, which could easily exacerbate our weakened economy and rising unemployment rate.”

 

Children’s Medical Services has made some recent changes to its website, making it easier for providers and families to learn more about Early Steps and other services.

The website is available at www.cms-kids.org

Therpy providers — click here to be taken directly to your page.

Funding for the state’s Early Steps program is a growing concern among many advocates in Tallahassee and throughout the state.

At a Jan. 27 meeting of the Florida Interagency Coordinating Council for Infants and Toddlers, state officials discussed the possibility of withdrawing from the IDEA Part C grant program that funds Early Steps. 

The chief concern is the future of the program once federal stimulus money runs out. According to the Florida Developmental Disabilities Council: 

Funding per child is at a critical level that has forced many providers to withdraw participation or offer services that are inadequate in scope and frequency, therefore minimizing the impact that these services can provide. Without help from the Federal Economic Stimulus Package, Early Steps would not have been able to meet their Federal Match requirement (22%) and would not have been able to continue helping children during their critically important first three years (click here for full document)

Early Steps program administrators remain hopeful that Florida will see an increased share of federal funding.

However, if the state choses to give up the grant funding for Early Steps, literally thousands of children will no longer receive the medically-based therapies needed to improve their developmental functioning.

As it is, commercial health plans and Florida Medicaid HMOs routinely deny therapy services for thousands of children. The state cannot afford to let these toddlers — many of whom have been diagnosed with autism spectrum disorder — go without therapies at a key time in their development. In their denial letters to parents, Medicaid HMOS instruct them to seek services through Early Steps instead.

This is a critical issue for pediatric therapy providers enrolled in the program. The Alliance has made it a top 2010 legislative priority, and we encourage providers to join us in our lobbying efforts.

Early Steps is the state’s early intervention program for children ages birth through 3. Occupational, physical and speech therapies are among the services provided.

For more information about the Early Steps program, click here.