Action Alert - Legislative Session Report #9

[Guest guest]

Please take the time to email or call Representatives Hudson and Grimsley and thank them for their support throughout the session. while the outcome was not what we had hoped, if not for their preserverence, we would have been in much worse shape. Their contact information is in the report below.

Developmental Disabilities

Legislative Session Report #9

By Kingsley Ross

k.ross (AT) associatedadvocates (DOT) com

Summary: For people interested in developmental disabilities (DD), the final week of this year’s legislative session focused on appropriations and Medicaid reform as the House and Senate finished the session early Saturday morning.

Action during week 9: House and Senate reconciled the differences in their budgets. The results are shown below for the Agency for Persons with Disabilities (APD). The conferees were unable to agree on whether to fund APD’s deficit for next fiscal year and bumped that issue up to the presiding officers. The budget passed on the final evening of the session.

Major Budget Issues

for the Agency for Persons with Disabilities (APD)

as of sine die

House

(in millions)

Senate

(in millions)

Budget Conference

Agreement (in millions)

· Across the board Waiver provider rate cut – Conference agreed to a 4% cut.

0

(42.8)

(38.4)

· Cut South FL geographic rate differential – by 50% for Palm Beach, Broward & Dade; Monroe by more than 80% - Conference agreed to take no cut

(2.9)

0

0

· Reduce service rates to “individual rates†vs. corporate rates. Affects companion & several other services - Conference agreed to take no cut

(34.0)

(34.0)

0

· Freeze cost plans – Conference agreed to freeze

0

(6.9)

(6.9)

· Cover Waiver deficit – Conference FY 2010-11 $169.2 mil and FY 2011-12: $54.5 million

279.6

0

224.7

· Reduce private Intermediate Care Facilities for the DD (ICF/DD) - Conference agreed to a 3% cut.

(6.3)

(10.5)

(6.3)

There was no change in how the conference ended up funding Healthy Families or the CARD centers. Healthy Families was funded at $18.9 million in the Appropriations Act (line item 301) and the CARD Centers were funded at $4.98 million (line item 80).

Medicaid reform also passed on the last day of the session. It does not require that APD services be administered through a managed care organization. Before it passed, the tort reform provisions that would have limited the liability for providers were removed the bills. Tort reform will have to wait until next spring to be considered again.

Action Needed. Thank Rep. Grimsley and Hudson for advocating for our programs. These two individuals carried the banner for our programs in conference and worked hard on behalf of programs for people with DD.

Rep. Grimsley

denise.grimsley@...

Rep. Matt Hudson

matt.hudson@...

Background Analysis: The struggle over the Health and Human Services (HHS) appropriations continued virtually to the last minute and was finally settled when the Senate agreed to fund several outstanding HHS issues including partially funding next year’s APD deficit. These issues were, in reality, a priority mainly for the House and in the end, the House had to use some of their reserves to pay for them.

As it relates to APD, key members of the Senate leadership felt that they were rewarding an agency for not living within its budget. In a way, you can understand the frustration that some legislators must feel about this issue. Legislators are the charged with appropriating funds and rightfully or wrongfully, they have been trying to reduce APD’s budget for several years. In the face of these reductions, APD has continued to over spend its budget which, from their point of a view, could be perceived as a statement of defiance. Much of the over spending can be tied to adding about 5,000 people to the waiver several years ago and not having the funds for those new consumers annualized in the following fiscal year. Federal regulations, giving consumers the right to appeal decisions about their cost plans, has also thwarted efforts to reduce costs. Unfortunately, there is no way to punish those who were responsible for the over annualization. Those leaders have left and the argument that reducing the amount available for services, only impacts consumers and providers has fallen on deaf ears.

Considering the events over the past nine weeks, the press and many others close to the process, feel we were one of the few winners of the session. The Governor rescinded his cuts when the legislature agreed to funded the current fiscal year’s deficit at a cost of $169 million. The legislature then added $54 million more to cope with next fiscal year’s deficit. Unfortunately, the amount appropriated in the Waiver for next year is $810 million - only $5 million more than this year. APD is currently purchasing Waiver services annually at a rate of between $930 and $975 million. As a result, the appropriation is short by as much $165 million compared to what APD is spending. The 4% provider rate cut is intended to cope with this short fall in part. It will only generate $38 million savings, however, and APD will have to either reduce rates more than the 4% currently mandated or reduce the services consumers are receiving to stay within its appropriation. Overall, the program must contract as much 17 percent to stay within the appropriation. Given this reality, many DD advocates feel far less than winners coming out of the session.

There are a number of proposals being examined about how to reduce services beyond the 4% provider rate cut. One of those proposals is to use the iBudget algorithm to achieve the reduction. Others consider that priority should be given to individuals who, for instance, are in residential care since many no longer have their parents to help out. Decisions will need to be reached rapidly in order to have the full 12 months of the fiscal year to absorb the cuts. Waiting will just mean the cuts will need to be larger since there will be less time for them to be applied.

Given this, next fiscal year is going to be difficult and we are very likely to be facing another year of cuts in 2012 session. We must begin now to change the perception that everything turned out ok and that you can punish an agency by cutting its services. To do this we must thank those who have helped us and show that we appreciate what they have done. We must also cultivate new champions by educating legislators on what we do and how people are affected as a result of the cuts.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter