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Lawmakers Seek More Funds For Disabled Care

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By CATHERINE DOLINSKI

cdolinski@tampatrib.com

Published: January 24, 2009

TALLAHASSEE - As families and advocates ask Gov. Charlie Crist to veto budget cuts affecting the developmentally disabled, lawmakers are trying to find a way to restore at least some of those dollars.

The $2.6 billion budget reduction package that lawmakers sent to Crist last week includes a 5 percent cut to reimbursement rates for most providers who serve people with Down syndrome, autism and other developmental disabilities.

The rate reduction, nearly $14 million, follows a cut of nearly $44 million that providers for the disabled took in spring 2008. And that's after lawmakers ordered an overhaul of services for the disabled in 2007 that slashed costs by more than $120 million. Those changes came in response to runaway expenses and a $150 million deficit looming at the state Agency for Persons with Disabilities.

"If they keep cutting and cutting, no one is going to be willing to do these jobs," said Carol Novak of Clearwater, whose 32-year-old son Jonathan has cerebral palsy and relies on round-the-clock assistance from three in-home aides.

Novak wrote for help this month to lawmakers and to Crist, who has until Thursday to decide which, if any, reductions he will veto.

Meanwhile, group homes for the disabled have started to notify ARC of Florida that they are downsizing or shutting down, said ARC director Deborah Linton.

"These cuts mean that people with developmental disabilities living in your community will not have their health and safety protected," Linton said.

Faced with a $2.4 billion budget shortfall, lawmakers had to decide whether to eliminate services or reduce pay rates, said Rep. Kevin Ambler, R-Lutz, who oversees the health care budget in the House. He hopes, he said, that providers will muddle through until the state can restore the money.

Ambler said he is working on a long-term fix for disabled services funding. But it hinges on one group of providers agreeing to bail out another.

Lawmakers cut provider rates for home and community-based care, the most expensive and in-demand area of services for the developmentally disabled. But the Legislature did not cut rates for facilities that care for the most severely disabled, many of whom are bed-ridden.

If those facilities agree to a cut, Ambler said, the Legislature can spend the savings on home and community-based care. The facilities that accepted the cut could make back the money by participating in a Medicaid matching program.

That program would allow those facilities to pay assessments into a statewide pool, which the federal government would match with Medicaid dollars for distribution back to the facilities. Lawmakers approved a similar plan for nursing homes this month.

The federal match would fill back the budget cut - for most facilities, anyway, Ambler said. "If, by going through all of these steps you are benefiting a group of patients as a whole, you're doing good public policy."

But the plan assumes that federal officials will approve it after lawmakers do. If the feds say no, facilities for the severely disabled might get stuck with a big budget cut.

Still, said Suzanne Sewell, head of the Florida Association of Rehabilitation Facilities, providers are receptive so far. "The industry has never been happy about robbing Peter to pay Paul. But if this can all be worked out to serve more people, it's a win-win situation."

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

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