Legislative Update #2

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Developmental Disabilities

Legislative Session Report #2

By Kingsley Ross

k.ross@...

Summary: For people interested in developmental disabilities (DD), the second week of Session centered mainly on the House’s managed care Medicaid Reform bills. In addition, the revenue shortfall that Florida faces for next fiscal year was increased.

Action during week 2:

House and Senate Appropriations Subcommittees continued to take testimony but took no action this past week. The House Health Care Committee heard its manage care Medicaid reform bills and passed them out of committee. These bills will require that all services to people with DD, except those being provided in state institutions, be administered by a manage care organization (MCO) by 2016.

These bills are very similar to the versions passed by the House last year. They divide the state into seven regions and require a minimum of two MCOs in each region – a Health Maintenance Organization (HMO) and a Provider Service Network (PSN). People with DD would be the last group phased into a managed care system.

Finally, the Revenue Estimating Conference finished its work Friday and concluded that their prior estimate of state revenues was $135 million too high. This means that state funded programs will have larger cuts to achieve the constitutionally required balanced budget.

Anticipated Action in Week 3: The chairmen of both the House Health Care and the Senate HHS Appropriations Subcommittees will report on their recommendations. This will set the stage for Chairs of the House and Senate appropriation committees to act on their recommendations in the 4th week of the session.

A gathering of 700 or more people with DD as well as their families, and advocates is expected in Tallahassee on Wednesday, March 23rd to remind legislators that services to people with developmental disabilities should be a priority.

Finally, there are strong rumors that the Governor will make a decision on what to do about the Agency for Persons with Disabilities’ deficit.

Action Needed. None at this time.

Background Analysis:

While there was no official action on appropriations this week other than the Revenue Estimating Conference’s bleak projection, there was a great deal of behind the scenes activity. Most notably, a meeting by Florida Association for Rehabilitation Facilities (FARF) representatives with the Governor’s staff reinforced rumors of an imminent rate cut to waiver providers. (Services provided through Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) are not included.) The rumors indicate that the rate cut for the remaining three months of this fiscal year could be 15% or higher. In other words, providers would receive 15% less for each unit of services they provide from April through June of 2011. This would probably be achieved through an executive order or an emergency rule.

A cut of this magnitude would obviously be catastrophic. Currently, almost all service providers must raise funds in the community just to survive and most will tell you that increasing charitable donations in this environment has been extremely difficult. In addition, the precipitous nature of imposing such a cut with only a few days notice would make it virtually impossible to react in time to avoid fiscal melt downs, particularly since most providers have very small reserves.

Agencies will be faced with the need to cut expenses immediately. Since roughly 80% of cost of serving people with DD is tied to personnel, there will be few options providers can take that will not impact consumers and their families. With little time left to inform providers that a rate cut is coming, it is highly likely that an announcement may be made next week by the Governor’s office.

In addition, next week the appropriation subcommittees will report their chairmen’s recommendations. These recommendations will be a signal of what is to come next fiscal year in the way of more reductions and how the legislature is going to handle the APD’s deficit in FY 2011-12.

Regards,

Ven Sequenzia

President

Autism Society of America

State of Florida Chapter