Florida applies for $1.1 billion in further Medicaid funds

TALLAHASSEE – Governor Ron DeSantis’ administration is demanding an additional $ 1.1 billion in federal Medicaid dollars from the federal government over the next two years to improve access to home and community programs and hundreds of millions of dollars for the poor, elderly and disabled Floridians from buying technology and doing home improvement that will enable them to age on the spot.

Florida tabled a proposal to the Centers for Medicare and Medicaid Services late Monday evening that, if approved, would also instruct $ 191 million to enroll more people in the state Medicaid suspension program – called the “iBudget” program – for people with intellectual and mental health developmental disability.

The additional federal Medicaid funding is available under a provision in the American Rescue Plan Act, a stimulus package signed by President Joe Biden in March that allows the state to draw a 10 percentage point increase in federal funding to support both domestic and life community-based services in government Medicaid programs.

Florida’s decision to seek such a large inflow of federal funds for health programs contradicts previous years when Republican leaders were skeptical about tapping additional federal funds for health care.

According to Senator Aaron Bean, R-Fernandina Beach, if the Biden administration signs the plan, no money could be spent without approval from the Budget Legislative Commission.

The 14-member body, consisting of seven state officials and seven state senators, has the authority to make spending decisions on behalf of the Florida legislature.

Advocates for the poor, the elderly and the disabled, who have been urging the DeSantis administration to mobilize the additional funds since the spring, welcomed the plan.

“Oh my god. This is absolutely fantastic news,” Valerie Breen, executive director of the Developmental Disabilities Council of Florida, told The News Service of Florida on Monday evening. “We’re excited about the governor’s decision to work with the home and community-based We know our families and individuals will be very pleased with this decision. “

Jim DeBeaugrine, a former secretary for the state agency for people with disabilities, said he was “thrilled” with the proposal.

“It definitely looks good,” said DeBeaugrine. “I’m pretty excited to see this and look forward to learning more.”

The state’s proposal states that more than 108,000 Floridians will receive home and community-based services in various Medicaid waiver programs.

Some of these people have intellectual and developmental disabilities and are enrolled in the iBudget program or are on a waiting list for the program. Around 20,000 people are on the waiting list for the program, which is administered by the State Office for People with Disabilities.

Other people who are frail enough to qualify for nursing home placement, who choose to live at home with the support of home and community-based services, will be enrolled in or on the government’s long-term care exemption program Waiting list set. Approximately 60,000 people are on the waiting list for the Waiver program administered by the Florida Department of Elder Affairs.

While the proposal presented to the Biden government this week includes $ 191 million to reduce the iBudget waiting list, the plan does not include money to reduce the waiting list for the Long-Term Care Exemption Program.

According to the proposal, the state is calling for nearly $ 128 million in federal funding to provide one-time scholarships for people aged 60 and older under the Long-Term Care Exemption Program. The scholarships can be used to purchase anything from air conditioning to technology.

The state’s plan also shows that the DeSantis government plans to provide an additional $ 127 million in scholarships for other Medicaid members who receive home and community-based services. Half of the funding – $ 63,584,500 – would go towards technology grants and the other half would go towards grants for home improvement or other purchases that promote aging.

The lion’s share of the state proposal would go to $ 623,030,996 in one-time payments to companies providing services to Medicaid customers in the home and community.

However, the plan does not contain details on how the money is to be distributed among the various providers.

“That’s one of the $ 64 questions. What is the split between the Developmental Disability (DD) population and the elderly receiving home and community-based services and other adults with disabilities who are not covered by the Agency for People with Disabilities? said DeBeauigrine. “How is that divided? Many people in our world will be very interested to know these details. “

Miriam Harmatz, the director and founder of the Florida Health Justice Project, also said the document does not distinguish how provider payments are distributed between waiver programs. Harmatz, whose association is committed to universal health care, said providers in both waiver programs would need pay increases.

“These are heroes who we need to pay a living wage and perform and make this a career path for people who are called to care. And there are some angels among us. It’s a very tough job, ”said Harmatz.

And while the potential for a $ 1.1 billion infusion looks promising, Harmatz stressed the need for an ongoing commitment to allocate additional funding for home and community services.

Harmatz helped lead a letter to the Florida Congressional Delegation urging lawmakers to continue the increased funding for home and community services. The letter has been signed by more than 400 individuals and organizations who are supporting the additional funding.

Posted by Christine Sexton, Florida Intelligence Agency

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