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HB 0837 - Relating to Medicaid Buy-in for Persons with Disabilities by Homan
Florida Developmental Disabilities Council, Inc. 124 Marriott Drive, Suite 203, Tallahassee, FL 32301-2981 Phone: (850) 488-4180 / (800) 580-7801 ~ Fax: (850) 922-6702 ~ TDD (850) 488-0956 / (888) 488-8633 |
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| The Florida 2010 Legislative Session Begins
The Florida 2010 Legislative Session started
March 2 and the topic on everyone's mind is the budget. Florida is looking at a 3 billion dollar deficit, due to revenue
shortfalls, that will have to be addressed. Florida legislators are mandated to balance Florida's budget during each legislative
session. Education and Human Services represent the largest share of the budget and will have to be cut.
The Governor's 2010-2011 budget was called optimistic by
some and unrealistic by others. It is based on revenue sources that have not been approved and calls for leaving small reserves
in the existing budget. The Senate has written to the Federal Government asking for an extension of the increased federal
money that was provided in the economic stimulus package last year. This money, and revenue through a Seminole gambling compact,
will not be realized until after the regular session is over, if they are approved.
In the meantime, Senate and House appropriations committees are considering
cuts in health and human services programs that could result in as much as a 15% reduction in Home and Community Based Waiver
services. The initial decisions for cutting programs are expected by March 12, 2010.
The work being done by the House is somewhat encouraging because the
members of the Health Care Appropriations Committee have ranked services to people with developmental disabilities as one
of the five top services to be preserved. However, how this translates into cuts is not yet known and no program may end up
being exempt from reductions.
The
Senate is approaching the process of cutting differently. Like the House, they have asked state agencies to present their
recommendations on cuts. However, the process is moving more slowly and members have not been openly polled.
The Agency for Persons with Developmental Disabilities
(APD) has presented the following options: APD Recommended Cut
($ amount in millions) |
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1.
Cap services in Tier 1 to $120,000
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12.8 | 2. Eliminate behavior assistance services in standard &
behaviorally focused group homes
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4.0 |
3. Reduce Consumer
Directed Care Plus (CDC+) by 10%
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3.3 |
4. Eliminate ADT & other services & create a flexible
benefit service
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113.9 |
5. Consolidate durable & consumable medical equip.
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0.9
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6. Other reductions
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2.6 |
On February 17, Agency for Persons with Disabilities Director Jim DeBeaugrine was required to present a 15 percent budget
cutting exercise to a Senate committee. DeBeaugrine stated that he did not recommend any of the reductions to the agency's
budget. He was quoted in the media in a column by Jim Saunders with Health News Florida:
"Nevertheless, Jim DeBeaugrine,
director of the state Agency for Persons with Disabilities, made clear Wednesday that he didn't want to have to carry out
the cuts he proposed to the Senate committee. After a lawmaker asked about the effects of one proposed cut dealing with programs
that developmentally disabled people attend during the day," DeBeaugrine replied, 'In all honesty, it would be very drastic."
The elimination of Adult Day Training (ADT) and the other
services grouped with it (Item 4) represents a 62% cut for these services. The other services include respite care, supported
employment, supported living, and companion services. If enacted, this cut will affect 24,000 of the 29,000 people now being
served under the waiver. Despite the creation of a flexible benefit service that individuals, parents and guardians can use
to continue some of these services, the reality is that there will be only 38% of the money originally devoted to these services
left to pay for them.
This is troubling
because not only will there be more individuals idle during the day, but the two services that make up the very existence
of independent living, supported living and supported employment, will be dramatically reduced, possibly threatening the existence
of that living option. Also, while it is nice to have a flexible benefit, the reality is that the integrity of each of the
services that make up this benefit will be eliminated as a stand-alone service.
Putting a cap on Tier One will effectively force some individuals into residential services and the
elimination of behavioral assistance will affect some group homes dramatically, threatening their existence.
The Florida Developmental Disabilities Council has taken
a position to avoid further cuts in waiver dollars and services (Link to
FDDC position). Please call your Senators and Representatives (Link
to Legislature) and members of the House and Senate Appropriations Committees and let them know your opinion. (Link
to committees) |
| Protect
Early Steps, Florida's Part C Program Early Steps is administered by Children's Medical Services
(CMS) in accordance with the Individuals with Disabilities Education Act (IDEA), Part C. Early Steps, which serves children
from birth to 36 months who have a developmental delay, or a condition that places them at risk for developmental delays,
provides Florida's infants and toddlers early-intervention services and supports intended to improve children's chances to
develop to their full potential by achieving specific developmental milestones. These milestones are essential to the development
of a child's ability to learn, speak, and move at critical periods that research shows lead to optimal abilities in later
life. In 2008-09, Florida provided these critical early-intervention services to 41,940 children. For
the 2010-11 fiscal year, a projected shortfall of about $4.5 million dollars could jeopardize the federal government's ability
to provide a grant to Florida. The shortfall would result in a loss of funding from the state to continue a meaningful
program, and the state could lose this $54 million early- intervention program. Research has proven that the biggest impact
on a child's health and functioning is in the child's early years. Longitudinal studies have documented the savings to society
in the long run by taking care of our youngest citizens now. The Council encourages lawmakers to adequately fund
the Part C Early Steps program to effectively serve all children with a developmental delay. We will be contacting
members of the Health and Human Services Appropriations Committee in the Senate and the Health Care Appropriations Committee
in the House (Link
to committees)and we will let them know that the state needs 4.5 million dollars to maintain Early Steps at the current level
or risk losing our federal grant to provide services critical to the health and functioning of all children ages 0-36 months
who have a developmental delay. Intentional Communities Senator Altman and Representative Stargel have filed identical bills,
SB 1166 and HB 645, that would do the following: eliminate the 1,000 foot rule for group homes within a planned residential
community for individuals with developmental disabilities; allow the local government to consider certain criteria, such as
land use, zoning and building codes, in determining approval of the community; prohibit local government from considering
the proximity of the group homes in the community; and requires that rulemaking for the Agency for Persons with Disability
not limit the number of group homes that can be located in the planned residential community. The Senate
bill was heard and passed in the Senate Community Affairs Committee on Tuesday, February 16th.
The Florida
Developmental Disabilities Council invested a considerable amount of effort this past summer learning about this issue, including
listening to families who want planned residential communities (also referred to as intentional communities), learning about
intentional communities, visiting an intentional community in Florida, and gaining an understanding of the implication of
state and federal requirements on intentional communities. We recognize that the current living arrangements
for adults with developmental disabilities who wish or need to live outside of their families' homes often do not adequately
provide for safety, social connections, full belonging in the community, affordable housing, ability to move about their neighborhood
freely, continuity, and life- long sustainability. The Council adopted a position (Link
to FDDC position) that included its acknowledgement that intentional communities, designed to meet the unique needs of individuals
with developmental disabilities, can offer a framework for creating greater choice of living arrangements; for bringing together
the community supports and services to address many of the current issues; for enhancing choice, control, and responsibility
in all aspects of life; and for maintaining full inclusion in the community.
While acknowledging the potential benefits intentional communities
can offer, the Council also strongly supports the values that have been inherent in the intent of the federal Home and Community
Based Waiver funds. The Council therefore believes that Waiver funds should be used for Intentional Communities when
the following characteristics are present:
· Provides for housing
options only - no workshops, day training, or common dining is provided on-site; · Ensures easy access to
the broader community; · Encourages the broader community to come into the Intentional
Community; ·
Ensures that individuals with developmental disabilities create their own daily schedules and activities; ·
Ensures that individuals with developmental disabilities choose their own supports and providers; ·
Offers housing that is affordable; · Provides special safety
features; and ·
Includes residents who are both individuals with disabilities (i.e., developmental disabilities and other disabilities)
and individuals without disabilities in a sufficient mix so as not to create a segregated community. The Florida Developmental Disabilities Council
is working with other organizations to amend the House and Senate bills to require through rulemaking the presence of these
characteristics when wavier funds are used in Planned (or intentional) communities. The Council is concerned that
community integration, independence, choice in daily living, and full access to community services as intended with Waiver
funds will be jeopardized without such requirements.
SB 1166 - Relating to Community Residential Homes by Altman Co-Sponsors: Storms Summary This bill prohibits rules adopted by the Agency for Persons
with Disabilities from restricting the number of facilities designated as community residential homes located within a planned
residential community. The bill also defines the term "planned residential community" and provides that community
residential homes located within a planned residential community may be contiguous to one another and exempt from the 1000
foot rule. The 1000 foot rule states that group homes that have six beds or less may not be within 1000 feet of each other.
EFFECTIVE DATE: 07/01/2010. Committees of Reference Community Affairs and Children, Families, and Elder Affairs Actions 01/21/10 SENATE Referred to Community Affairs; Children, Families, and Elder Affairs 02/16/10 SENATE
Favorable by Community Affairs; 10 Yeas, 0 Nays Identical Bills HB 0645 - Relating to Community Residential Homes by Stargel Actions 01/28/10 HOUSE Referred to Military & Local Affairs Policy Committee; Health Care Services Policy
Committee; Economic Development & Community Affairs Policy Council SB1388 - Relating to Intellectual Disabilities by Haridopolos
Summary This bill amends provisions in statute
by substituting the term "intellectual disability" for the term "mental retardation." The bill revises
definitions relating to intermediate care facilities for the developmentally disabled to delete unused terms. The bill also
provides that the name Arc of Florida is substituted for the Association for Retarded Citizens. This bill is a "reviser
bill". It provides a directive to theDivision of
Statutory Revision. EFFECTIVE DATE: 07/01/2010. Committees of Reference Children, Families, and Elder Affairs, Criminal Justice, Judiciary,
Health and Human Services Appropriations Actions 01/26/10 SENATE Filed
HB 81 - Relating to Use, Prevention, and Reduction of Seclusion and
Restraint on Students with Disabilities in Public Schools Sponsor(s) by Hukill Cosponsors: Anderson, Brandenburg, Burgin, Flores, Fresen, Glorioso, Gonzalez,
Heller, Hudson, Jenne, Kiar, Llorente, McBurney, Nehr, Pafford, Planas, Porth, Precourt, Sachs, Schenck, Schultz, Schwartz,
Skidmore, Soto, Stargel, Steinberg, Tobia, Williams (T), Zapata Summary This bill provides that manual physical restraint shall be used only in an emergency when there is
imminent risk of serious injury or death to the student or others; it provides restrictions on the use of manual physical
restraint and prohibits the use of manual physical restraint by school personnel who are not trained and certified to use
district-approved methods for applying restraint techniques. The bill prohibits school personnel from placing a student in
seclusion and provides requirements for use of time-out. It requires schools to prepare an incident report after an occasion
of student restraint and also requires development and revision of school district policies and procedures. The Council has
taken a position supporting this legislation(Link to FDDC Position) Effective Date: July 1, 2010 Committees of Reference PreK-12 Policy Committee, Health Care Services Policy Committee, PreK-12
Appropriations Committee, Education Policy Council Actions 08/20/09 HOUSE Filed 10/01/09 HOUSE
Referred to PreK-12 Policy Committee; Health Care Services Policy Committee; PreK-12 Appropriations Committee; Education Policy
Council HOUSE Now in PreK-12 Policy Committee Similar Bills SB 2118 - Relating to Students with Disabilities/Seclusion/Restraint by Gardiner 03/01/10 SENATE
Referred to Education Pre-K - 12; Children, Families, and Elder Affairs; Education Pre-K - 12 Appropriations
SB 2038 - Relating to Medicaid Buy-in Program/Persons with Disabilities
by Crist Summary: The bill provides for Medicaid eligibility for certain persons
with disabilities under a Medicaid buy-in program, subject to specific federal authorization. The proposed Work Incentive
Medicaid Coverage program would continue to offer Medicaid coverage to people with disabilities who are working. Once they
enrolled in the program they would have the opportunity to earn more and save more than the allowable limits for regular Medicaid
and still retain their health care coverage through the State's Medicaid Program. The bill requires the Department of Children
and Family Services to adopt rules for determining eligibility. The bill also directs the Department of Health to perform
all disability determinations. Finally, the bill requires the Agency for Healthcare Administration to seek amendments to specified
Medicaid waivers for certain persons with disabilities. The Council supports this legislation (Link to FDDC Position) EFFECTIVE DATE: 07/01/2010. | Committees
of Reference Health Regulation, Children, Families, and Elder Affairs, Health
and Human Services Appropriations; Policy and Steering Committee on Ways and Means Actions
02/16/10 SENATE Filed 03/01/10 SENATE Referred to Health Regulation; Children,
Families, and Elder Affairs; Health and Human Services Appropriations; Policy & Steering Committee on Ways and Means
Similar Bills HB 0837 - Relating to Medicaid Buy-in for Persons with Disabilities
by Homan 02/10/10 HOUSE Referred to Health Care Regulation Policy Committee; Health Care Appropriations Committee;
Health & Family Services Policy Council
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