HEALTH BUDGET TALKS BUMPED TO NEXT LEVEL - APD mentioned near end of the article

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This goes along with the previous email I sent. You can read entire article or go to area I highlighted in yellow.

HEALTH BUDGET TALKS BUMPED TO NEXT LEVEL

By JIM SAUNDERS

THE NEWS SERVICE OF FLORIDA

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THE CAPITAL, TALLAHASSEE, April 28, 2011….. Pointing to “irreconcilable differences,†House and Senate negotiators abruptly ended talks Thursday on a health and human-services budget ---- leaving a raft of major issues for legislative leaders to decide.

Negotiators deadlocked on issues such as Medicaid payments to nursing homes, funding for the Medically Needy program, financial problems in the Agency for Persons with Disabilities and potential cuts in substance-abuse and mental-health treatment.

Now, House Appropriations Chairwoman Grimsley and Senate Budget Chairman JD --- and potentially House Speaker Dean Cannon and Senate President Mike Haridopolos --- will have to resolve the differences.

“There gets to a certain point in which you say, ‘OK, we have our line-in-the-sand items, and they have their line-in-the-sand items,’ ’’ said House Health Care Appropriations Chairman Matt Hudson, a Naples Republican who has been the House’s chief negotiator on the issues.

His Senate counterpart, Stuart Republican Joe Negron, said the two sides had different priorities.

“A case can be made for and against everything in this budget,’’ Negron said.

With lawmakers facing an overall budget shortfall of nearly $3.8 billion, dozens of health and human-services programs will get cut in the coming year. But the impasse centers on a handful of major issues that involve hundreds of millions of dollars.

As an example, Negron said the Senate wants to shield nursing homes from cuts in Medicaid funding. But the House proposed $245 million in cuts, an amount that the nursing-home industry argues would threaten the financial stability --- and quality of care --- at many facilities.

“It’s critical that we don’t end up at the levels they (the House) have right now,’’ said Tony Marshall, senior director of reimbursement at the Florida Health Care Association.

Illustrating the differing priorities, the House does not want to cut funding for the Medically Needy program, which serves people who have catastrophic illnesses but do not qualify for Medicaid. The Senate has proposed eliminating hospital care in the program, which would save $192 million.

House leaders and the hospital industry argue Medically Needy patients would still need expensive care, sticking hospitals with the costs. Compounding that, both the House and Senate propose hundreds of millions of dollars in cuts to hospital Medicaid rates.

Similarly, the Senate has proposed about $190 million in cuts to adult substance-abuse and mental-health treatment programs, according to an analysis by provider groups. The House would cut $16.1 million from adult mental health --- and nothing from substance abuse.

In drawing up the budget, Negron said his top priority was taking care of children, which is reflected in the mental-health and substance-abuse cuts only affecting adults.

“It’s a rule of civilization, it’s a rule of the sea: Take care of children first,’’ Negron said.

But Hudson said the House believes that cuts to adult mental-health and substance-abuse programs would have ripple effects, such as increasing costs in the criminal-justice system.

“One way or another, you’re going to pay,’’ Hudson said.

The chambers also differ in dealing with ongoing financial problems at the Agency for Persons with Disabilities. Negotiators agreed to spend about $166 million to cover an agency deficit during the current fiscal year, but they split on how to handle APD’s funding next year.

The House budget proposal includes $110 million to pay for an expected deficit in 2011-12, but the Senate does not set aside that money. Negron argues spending should be cut if programs for people with developmental disabilities appear to be going over budget.

“Even if you’re doing the Lord’s work, you still can’t bounce checks,’’ he said during a negotiating session Wednesday.

But Hudson said he doesn’t see “righting that ship†at the agency fast enough to avoid deficits next year. Among other things, cost-containment efforts are only gradually taking effect, and an acting director is running the agency.

The House and Senate negotiators were scheduled to continue hammering out their differences on the health and human-services budget until Friday. At that point, any differences would have gone to Grimsley and .

But with lobbyists crammed into a Senate meeting room Thursday, Negron and Hudson announced a halt to the meetings. That will force and Grimsley to grapple with dozens of issues of varying amounts.

As another example of a large unresolved issue, the Senate wants to spend $243.7 million on increased Medicaid payments to primary-care physicians, while the House does not propose an increase.

Similarly, the Senate wants to spend $50 million on cancer-research programs next year, while the House would eliminate the funding. Sen. Eleanor Sobel, D-Hollywood, said during a negotiating session Thursday morning the money is important for facilities such as the H. Lee Moffitt Cancer Center in Tampa.

“I believe we have a mandate to eradicate cancer in this state,’’ Sobel said.

But Hudson said the $50 million is needed to help cover the financial problems at the Agency for Persons with Disabilities.

“Given the choice between doing research or taking care of our most-vulnerable citizens, I decided to take care of our most-vulnerable citizens,’’ he said.

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04/28/2011

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Ven Sequenzia

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Autism Society of America

State of Florida Chapter