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Florida Budget Cuts May Hit The Elderly Hard

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By CATHERINE DOLINSKI

cdolinski@tampatrib.com

Published: January 7, 2009

TALLAHASSEE - State budget pressures are bearing down hard on Florida's 4.3 million senior citizens.

Lawmakers are proposing to slash millions from health and related spending on seniors as part of the plan to close a $2.3-billion hole in the state budget. Cuts would affect everything from nursing homes to in-home services for seniors to a program helping caregivers to those with Alzheimer's.

Of greatest concern to AARP: deep cuts to Medicaid reimbursement rates for nursing homes.

"This will really force them to reduce staffing levels - that's our main concern," said Leslie Spencer, lobbyist for AARP Florida, representing people age 50 and older. "Studies show once you reduce staffing levels, it has a direct impact on the quality of care."

The Senate is proposing a 10 percent Medicaid rate cut, or $73.5 million, for what remains of the fiscal year ending June 30. House lawmakers are proposing a cut of 9.6 percent. Spencer said she fears such reductions will prevent some homes from complying with state nursing staff requirements.

Most areas of the state budget are receiving cuts of about 4 percent. If passed, the heavier cut to nursing homes would compound spring's $164 million rate reduction and the $75 million cut the previous fall.

Expect the rate cut to delay building maintenance and cut into activities, trips and other programs that enhance residents' quality of life, said Tony Marshall, a lobbyist who represents an association of nursing homes.

"I also think this funding reduction probably threatens the ability of many providers to comply with the nursing staff requirements," he said.

To offset some or all of this year's cuts, nursing homes are asking the state for a new program allowing them to pay assessments into a pool of money that federal Medicaid would match. The state would distribute the total amount back to nursing homes, based on their Medicaid caseloads.

The proposal has support in both chambers. House Health Appropriations Vice Chairman Jimmy Patronis, R-Panama City, said nursing homes would not be permitted to pass on the cost of the assessment to patients. The program would cushion the budget blow to nursing homes, at least temporarily, but probably would not cover their full losses, he said.

Lawmakers are also proposing to carve nearly $2 million from the Community Care for the Elderly program, which provides in-home services to seniors. The program provides in-home help with chores, meals and other needs to allow seniors to live at home as long as possible. It serves nearly 7,000 people and has a waiting list of more than 18,000.

Lawmakers also have targeted an assistance program for caregivers of Alzheimer's patients for a 4 percent cut of more than $280,000. A related Alzheimer's program, which funds memory-disorder clinics and day care programs, could lose about $236,000.

Senate health budget chief Durell Peaden, R-Crestview, bemoaned the heavy cuts his committee has been tasked with proposing, and called for consideration of a cigarette tax increase to generate health dollars. Lawmakers have already ruled out that idea during this special session but might take it up in March.

Democratic Sen. Nan Rich, vice-chairwoman of Peaden's panel, said the cuts are taking a particularly heavy toll on the elderly. "We have a very high population of seniors, and if you look at our budget, we spend a pittance on seniors in this state," said Rich, of Sunrise. "To reduce it further just compounds the lack of services that are already there."

But Patronis defended the Legislature's treatment of the elderly. He noted that no optional Medicaid services for poor seniors, such as podiatric care, are being cut.

"There are certain standards that the state is not going to waver from," he said.

Reporter Catherine Dolinski can be reached at (850) 222-8382.

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