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State Needs Better System To Fund Needs Of Disabled

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The Tampa Tribune

Published: January 2, 2009

The Florida Agency for Persons with Disabilities, under the leadership of Director Jim DeBeaugrine, has shown clients admirable compassion by suspending a controversial cost-reduction program. The agency is considering revamping how it funds services.

Now the agency needs to convince state lawmakers to take the next logical step: to develop an equitable system that allows the disabled and developmentally delayed to obtain the help they need.

The special session that begins Jan. 5 is a perfect time to at least begin working on a new system since lawmakers will convene to address the state's financial crisis.

There is no question APD, which had a $150 million deficit in 2007, must do a better job of budgeting. This has been a problem since the agency's inception four years ago. Its failure prompted the Legislature to mandate better accounting. Every agency - no matter its duties - must be able to set a budget and live within it.

Unfortunately, the Legislature has made things worse.

Thousands of people qualified for state assistance are being penalized for not spending money that had been set aside for individual needs, which are identified in "cost plans." But in some areas of the state, services are difficult to come by or not available. The clients may not be able to utilize the money one year, but that doesn't mean they don't need it when the service becomes available. The state's decision to reduce rates it pays for services also has been a deterrent to providers, making services even tougher to come by in some areas.

Under the "rebasing" initiative the state correctly suspended a few weeks ago, a client also stood to lose funds for services if they weren't completely spent the prior year. The effects would be devastating for many families who want to keep their loved ones at home instead of placing them in group homes or other tightly controlled environments - at higher costs to the state.

This flawed system also forces a painful dilemma on families whose loved ones are in residential facilities: Do they continue taking their children home for weekends and holidays and risk losing services for the next year? Taking the child home on weekends means the families don't completely use the state's allocation for the individual's care. With the loopy state formula, this would mean the family would risk losing residential funding altogether.

It's a horrible position to put loving families in, and it doesn't make sense since facilities don't get paid when clients are visiting their families.

Clients' needs and circumstances often change. Rebasing fails to take this into account because, under the rules, it will be extremely difficult for clients to make the case to keep previous funding levels or increase them if needs arise. The Legislature lost sight of this crucial fact.

Also complicating matters is that Florida no longer allows clients' support coordinators - the vital link between the individual, services and the state - to track costs on a state computer system. They need immediate access to the computer system.

The state's system that assigns tiers to clients based upon the severity of their disabilities also needs to be scrapped. The system is unfair, because funding for clients on the highest level is not capped, while those in lower tiers face strict limits.

Funding limits do need to be set, but they need to be fair and reflect clients' needs as determined by able-bodied clients, support coordinators, families and providers. Clients and their families should not be penalized for failing to spend all the money approved the previous year or when their needs increase. And they should not be forced to sacrifice services because they want to spend time with their loved ones.

Flexibility is needed. That, and better budgeting overall, can be provided through the cost plan process that occurs every year, not through arbitrary tiers and service reductions.

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