HOUSE BEGINS LOOK AT CUTS TO LOOK AT APD & HEALTH BUDGET

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HOUSE BEGINS LOOK AT CUTS TO HEALTH BUDGETBy JIM SAUNDERSTHE NEWS SERVICE OF FLORIDAPosting or forwarding this material without permission is prohibited.Contact news@....THE CAPITAL, TALLAHASSEE, January 24, 2012.....The House released aninitial health and human-services budget proposal Tuesday that would chophospital Medicaid rates by $291 million next year and trim a series ofbenefits for low-income Floridians.But the $29.8 billion proposal also would take steps such as increasingfunding for child-protection investigators, stabilizing the finances of thedeficit-plagued Agency for Persons with Disabilities and shielding fromcuts the Medically Needy program for people with debilitating illnesses."Our budget today reflected putting people over things,'' said House HealthCare Appropriations Chairman Matt Hudson, R-Naples, who released theproposal during a meeting of his subcommittee.The proposal is a first step as the House prepares to approve its versionof a 2012-13 budget and, ultimately, to negotiate a final spending planwith the Senate. Health and human-services programs play a critical role inthe budget, as lawmakers look to close an overall shortfall that has beenestimated as high as $2 billion.A key issue in the negotiations likely will be hospital Medicaid rates,which were cut by $510 million to help balance the current fiscal year'sbudget. The House proposal rejects a plan by Gov. Rick to overhaul--- and more deeply slash --- hospital funding, but it still calls for a 7percent rate reduction.Hudson said he thinks hospitals can handle the addition reduction, butSenate Health and Human Services Appropriations Chairman Joe Negron,R-Stuart, wants to avoid such blanket cuts."With the dramatic hospital reductions we had last session, we need to takea hard look at whether hospitals can sustain a 7 percent reduction,'' saidNegron, who is working on the Senate's initial health and human-servicesproposal this week.The House's overall proposal totals slightly less than the $30 billion thatlawmakers approved spending on health and human-services programs for thecurrent year. But it includes about $600 million in additional stategeneral revenue, which is critical to legislative budget writers.State analysts projected lawmakers needed to spend about $900 million inadditional general revenue to cover growing Medicaid costs and to replacetemporary federal funding. With the House proposal setting aside less thanthat, some cuts are needed to balance the budget.Members of Hudson's subcommittee were trying to sort through a spreadsheetshowing dozens of potential funding changes. At one point, Rep. ElaineSchwartz, D-Hollywood, said she had a "trillion questions" about theproposal.Along with hospitals, another major chunk of proposed cuts would involve a2.5 percent Medicaid rate reduction for nursing homes. That cut would totalabout $76 million and comes after $187 million in nursing-home reductionsduring the current year.Tony Marshall, senior director of reimbursement for the Florida Health CareAssociation, said his nursing-home industry group will try to get the 2.5percent cut lowered. But he said he thinks the House understands theeffects of last year's cuts on nursing homes."For some providers that (the proposed 2.5 percent cut) is still asignificant impact,'' Marshall said. "But we do recognize they (Houseleaders) have taken great steps to try to minimize the impact.''The proposal also would make a series of smaller cuts that would affectMedicaid beneficiaries. For example, the state would limit the number ofemergency-room visits that Medicaid would cover for non-pregnant adults to12 a year, which is estimated to save $16.3 million.Also, the proposal would end Medicaid-funded chiropractic and podiatricservices for adults, which would save about $4.3 million.In the proposal, however, House leaders reiterated priorities from earlierbudget fights. For instance, the proposal would keep intact the MedicallyNeedy program, which provides costly services to people who havedebilitating illnesses but don't qualify for Medicaid. Also, it would avoidcuts in community mental-health and substance-abuse programs.The proposal also would boost spending on some programs, includingfunneling an additional $9.9 million to the Department of Children andFamilies for child-protection services. The money would help increaseinvestigators' salaries and also is aimed at helping reduce turnover amonginvestigators.Hudson said the proposal also would set aside a total of $877 million foran Agency for Persons with Disabilities program that provides home andcommunity-based services to developmentally disabled people. He said thatamount is estimated to be enough to avoid further deficits in the program,which has repeatedly had financial problems in recent years.