Changes ahead for developmental disabilities program

The head of the Florida agency that helps people with disabilities told a large crowd of people Wednesday not to worry about an impending redesign of the state’s Medicaid home and community-based waiver program.

“I know that some of you think that doom and gloom is here because of this, but it’s not,” Agency for Persons with Disabilities Director Barbara Palmer said at a public meeting. “It’s a great opportunity for us to make a difference in the people’s lives.”

Palmer said her agency has been working with the state Agency for Health Care administration on the redesign of the program and that the two agencies have held 12 meetings on the issue. Palmer said that AHCA, which has an expertise in Medicaid waivers, is reviewing other states’ Medicaid waiver programs to see how they administer services necessary to keep people with developmental disabilities out of institutions and living in the community. Palmer kept her remarks brief and spent most of the three-hour meeting taking notes.

Public testimony centered on three main themes: stakeholder involvement in the redesign, increased funding, and opposition to managed care. APD has garnered a lot of legislative attention of late, mostly due to budget deficits in the home- and community-based Medicaid waiver program known as the "iBudget."

Over the last two years, the agency’s deficits have totaled $154 million, according to a corrective action report issued in January. The agency attributed the deficits to a variety of factors, such as the aging population of clients receiving services.

The state is spending approximately $33,600 per to keep people with disabilities living in the community, compared to $120,000 for individuals who are in an institutional setting. Suzanne Sewell, president of the Florida Association of Rehabilitation Facilities, suggested that the state find a dedicated revenue source to continue to fund the needs of people with developmental disabilities as they age.

“Any system, properly funded, can basically work, “ she said.

During the legislative session that ended in May, lawmakers ordered the two state agencies to identify core services that are essential for client health and safety and to recommend elimination of other services that are too expensive.

While a new plan cannot be implemented without approval from the Legislature, it is being closely tracked by stakeholders. Florida Developmental Disabilities Council Executive Director Valerie Breen, for example, sent an email to 3,000 individuals with disabilities, family members and advocates on Friday, advising them to contact legislative leaders regarding the program redesign.