A newly released report from Florida TaxWatch says there should be more “scrutiny” over the still-unfinished software system designed to help manage a Medicaid waiver program used to provide home and community-based services to people with disabilities.
The report from the business-backed government watchdog group notes the contract with the Agency for Persons with Disabilities (APD) to put the iConnect system into place has been extended three times and that several key elements of the program — including a consumer portal — have not been launched, or, jettisoned altogether.
APD did not immediately reply to Florida Politics’ request for comment.
The Florida TaxWatch report was released days after APD Director Barbara Palmer announced her resignation, which she said was submitted at the request of her boss, Gov. Ron DeSantis.
Palmer submitted a one-page resignation letter Dec. 2 that was accompanied by nine pages of highlights and accomplishments, including “implementing the iConnect software system.”
But the iConnect contract — which now has a cap of $9.6 million — remains incomplete. And the report shows there are ongoing problems with what’s operational today, findings that bolster the long-standing criticisms of the system from the entities that provide care to people with developmental and intellectual disabilities.
Bradenton businessman Aaron Nangle is well-connected in the developmental disabilities community in Florida and nationwide. Nangle, operates the Waiverprovider.com website and sells iConnect-compatible software that allows support coordinators and providers to document their efforts.
About 119,000 people have signed up for one of his newsletters. Nangle told Florida Politics Wednesday he wasn’t surprised with TaxWatch’s findings and that the watchdog group interviewed him for the report.
Nangle recalled that waiver support coordinators were the first to use iConnect.
“Most of the support coordinators are very smart people. They seemed to slowly get it but they still hated it. It didn’t work right for them,” he said.
But when APD later required providers to start using the software, it turned into a “colossal mess,” Nangle said.
“That’s when everything went really bad. That’s when we all decided that this would be the downfall of Barbara Palmer, the APD iConnect program.”
Florida created the Medicaid iBudget waiver program with the goal of keeping people with intellectual and developmental disabilities living outside of institutions. The waiver allows the state to provide people with disabilities access to home and community-based services that traditionally aren’t covered by Medicaid, such as assistance with bathing, eating and dressing.
Providing assistance with those activities costs the state less than institutional care and helps keep people with disabilities in communities where they can live, play and work.
In 2015 the state required iBudget providers to use the iConnect system and a contract was awarded to Harmony Information Systems, Inc. (which was later acquired by Mediware Information Systems and then by Wellsky, Inc.)
The TaxWatch report contends service providers and coordinators who help those with disabilities have had difficulties accessing their portal, uploading documents and maintaining records. The report adds that help desk support is “largely inaccessible and ineffective as personnel that staff the help desk often do not appear to possess the expertise necessary to effectively solve user problems.”
The report says in September 2022 the APD eliminated a claims module that was intended to process the billing of iBudget services. TaxWatch notes that while eliminating the module was “deemed in the best interest of the project,” state law requires vendors to use iConnect for billing.
“I don’t think the state has seen the value of iConnect yet,” Mark A. Swain, the CEO and President of ARC of Alachua County and Arc of Florida Board Chair, told Florida Politics prior to the release of the TaxWatch report.
December 22, 2022 at 10:27 am
Barbara Palmer was a great leader. She will be missed.
December 22, 2022 at 7:21 pm
All I know is that APD has gone downhill since Palmer came aboard. I addressed concerns with DeSantis from those at the forefront, like myself, in caring for the DD individuals over a year ago. (Waiver Support Coordinators, WSCs)
I read an article praising DeSantis for funding the APD Developmental Disabilities waitlist. After I read it, I asked myself, “what good is this going to do while there is a critical shortage of providers to serve these people.” At that time, I didn’t know of many WSCs in Florida who were accepting new clients since Senate bill 82 was signed into law.
Senate bill 82 has created considerable discord, and extremely low morale resulting in the resignation of many WSCs, due to constant threats of punitive actions by APD (losing their Med Waiver agreement), increased expenses for the WSCs, resulting in further reduction of pay with an increase in workload that is nearly double. Timelines and current reforms imposed on the WSCs are punitive, without merit, and unrealistic!
It is the opinion of many WSCs that Bill 82 was created to distract and cover up APDs’ inability to manage their finances. Support Coordinators became the scapegoats resulting in bill 82 being passed.
So, the crux of the bill is REFORMING WAIVER SUPPORT COORDINATION. The bill required all Waiver Support Coordinators (WSCs) to become qualified agencies. Without a doubt, this is the biggest mistake (next to the development and implementation of iConnect) that could have been made! This has given APD the opportunity to withhold assistance to the WSCs. Now APD redirects us to our QO (Agency Owner) for any problems, even though our agency owners have no more knowledge than those that make up their Agency. And yet, now they are expected to solve the problems that APD once was responsible for.
iConnect has been a nightmare for every person that uses it. Providers were struggling to learn and overcome the challenges iConnect presented prior to the B2 implementation. It is without a doubt the most cumbersome, faulty, laborious, redundant, and inaccurate data system ever created by APD. The norm while using the iConnect system is to be kicked off the system, at least hourly, and all the work that has been done is then lost. Nothing makes sense in iConnect, nor is anything you do in iConnect easy. There are far too many glitches in the entire system to even mention. I have a direct service provider (DSP) for one of my clients who has NEVER been able to access the system to enter notes the entire year she has been working with my client.
As a seasoned (12 years) WSC myself I can unequivocally state, this reform does not work! The state office, which is now managing requests for additional funds for needed client services, has no understanding of client needs. The goal of the State office is the reduction of services, i.e. reducing funds from client budgets. But it is the job of the WSC to advocate for our clients and ensure they have the services they need. The state office has made this impossible for us to accomplish. And now we have two diametrically opposed goals between APD and the WSCs who must work under the same roof.
The APD just isn’t working as it should. Now that Palmer is out, we all pray we can get back to the goal of assisting clients and ensuring their health and well-being are the priority and become the one and only goal of the Agency. We pray APD will recognize how important but difficult the role of the WSC is.
I will close by bringing up the fact that the B2 amendment now requires the WSC to secure mandatory insurance since we have become employees of an agency. WSC pay has decreased by approximately $1000 monthly. We have lost the ability to claim a home office tax deduction along with other deductions we no longer qualify for. And yet, our workload has doubled. How long do you think WSCs can sustain under these conditions?
December 22, 2022 at 5:19 pm
Meanwhile we have the same pay rates for services that we have had for 11 years, actually less because Rick Scott slashed our rates by 11% in 2012 and they have never been increased since.
And now the cost of everything has skyrocketed and the documentation and time spent in IConnect is not reimbursable which is downright CRIMINAL.
December 22, 2022 at 7:31 pm
This is so sad. The ones that have the hardest job and do the most good for those who have no voice are the ones that are not being compensated fairly.
Now that Barbara Palmer has been fired, her replacement might take a fresh look and realize the injustice. This needs to be fixed!!!
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