Florida Senate proposes sweeping overhaul of disabled care

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Senate proposes sweeping overhaul of disabled care

Pillow, 01/24/2012 - 03:29 PM

Sen. Joe Negron speaks during a committee meeting at the Capitol. Photo Credit: Ana Goni-Lessan

A Senate panel on Wednesday is slated to take up a sweeping set of changes proposed by the agency that provides care to the developmentally disabled.

The measure is intended to stem the persistent defecits that have dogged the Agency for Persons with Disabilities.

Among other things, SB 1516 would call for services beyond those essential to the health and safety of those who rely on the program to be provided first by community resources and other providers, with the Medicaid waiver administered by the agency serving as "the payor of last resort" for home and community-based services.

The bill's sponsor, Senate Health and Human Services Appropriations Subcommittee Chairman Joe Negron, R-Palm City, said the current measure is a "first draft," and that he is considering changes based on input from people who rely on the agency for services. Several are likely to be proposed Wednesday when the bill gets heard by the Senate Children Families and Elder Affairs Committee.

Concerns about what lawmakers will do to address the gap between the agency's appropriation and the amount of available funding have drawn people who receive services, such Alston of Apopka, to testify in front of Senate budget-writers as they prepare to find $850 million in savings on health and human services for the upcoming year.

Alston relies on the waiver to pay for transportation and adult day services that allow him to earn a wage. One provision in SB 1516 would eliminate statutory references to those services and require them to be provided "in the most cost-effective manner to the extent of the availability of agency resources as specified in the General Appropriations Act."

"If I get cut again, what am I supposed to do?" he asked Negron's committee on Tuesday.

Negron said he shares APD Director Mike Hansen's goal of bringing the agency's spending in line with its appropriation without jeoprodizing the health and safety of people who depend on it.

"Long-term, we can't have an agency of government spending 10 to 20 percent more than what they're budgeted," Negron said.

Hansen has emphasized that the iBudget will allow people to use the money provided under the waiver for services such as those received by Alston, which are intended to keep people out of institutions. The measure would also codify in statute the iBudget algorithm the agency has been working on, which Hansen said is intended to spread the agency's resources to as many people as as possible and give them control over how the money is used.

"You can't ever say we're going to spend whatever resources it takes when there are limited resources; you've got to do an evaluation of the benefit versus the cost," he said.

SB 1516 does not yet have a house companion, and the House Health Care Appropriations Subcommittee on Tuesday unveiled a budget that would provide an additional $27.5 million in general revenue to fund the waiver and help close the agency's shortfall.