Senate President McKay will review the sales tax exemptions to find more sources of revenue, however it is a difficult task in a shaken economy. The intangibles tax repeal was delayed which contributed about $130 million, however the state reserve fund for budget stabilization was not utilized.  There is almost $1 billion in that reserve but legislators fear that if the State economy does not improve there may be more potential shortfalls, possibly in the $2 to $3 billion range.

Although your calls, letters and faxes were very effective, the cuts were inevitable. The largest came from the Department of Education.  Autism CARD programs were cut by  $320,440 and overall FEFP was cut $250,264,821.  Another disappointing hit was $99,960 for the Centers for Independent Living.  In Health and Human Services, MediPass Services were cut $3,798,399, which is an option that many of our families utilize.  Also hit was Community Mental Health Services by $215,567.

A huge debt of gratitude is owed to Senate Health and Human Services Appropriations Chair, Senator Ron Silver! The Senate position was much more palatable in terms of minimizing cuts to direct services for persons with developmental disabilities. Senator Sanderson was also a very key legislator contributing her support to $2.2 million in direct intervention funding. Initially the House position was to cap waiver services.  If it cost more than $77,000 annually for care, that individual would be directed to an ICF. Senator Silver was crucial in removing that cap on cost plans and our friends at Florida ARF, Chairman, Dennis Haas and lobbyist Max Bosman, worked tirelessly to eliminate it.

Other cuts came for the implementation of the Personal Planning Guide, which had no significant impact and the Choice and Control Pilot Project that is funded out of general revenue.  The approximately 150 people on the plan will not be affected to a great degree as they will now be served in the Waiver, and no federal match is lost.  However, the Individual and Family Support Program suffered a cut so services will be lost as will federal dollars.

The Therapeutic Intervention Program remained intact, as did the Therapeutic Residential Autism Care program, thanks to the efforts of our friend and lobbyist Ron Book and his staff.  Unfortunately, the Inclusive Child Care Project lost it’s funding of $100,000 which was only half of last year’s amount.  This is an issue we must let the legislature know is an important one.  Without quality childcare, we cannot earn a living. 

As many of you have been advised directly by Delmarva Foundation, they and a company named Maximus have signed extended contracts with the Department of Children and Families.   Delmarva was hired for quality control and assurance and Maximus for rate utilization review and delivery consistency.  They offer, in my opinion, redundant services that the department does and should be responsible to provide. Each contract is valued at approximately $4 million over the term. These are dollars that should not be tapped from direct services and duplicate the function of the support coordinators, which are now costing $56.4 million annually.  Waiver support coordination helps consumers make informed choices about services and assure they are cost effective.  They also monitor the programs and certify that services have been received prior to payment to the provider. Each support coordinator must not service a caseload of more than 36 individuals.  In addition, each district reviews and approves all cost and support plans.  They also monitor the support coordinators for performance outcomes.  In addition, because of the budget crisis, many districts are reviewing each support plan for cost efficiency.  This seems to be quite sufficient as far as a ‘checks and balances’ system is concerned. 

Delmarva held several public meetings across the state, however many got the notice after meetings had occurred, or with only one days notice.  One parent, Holly Borfield, who did attend in Orlando, was very upset that these companies would have access to our children’s medical records and may override intervention prescribed by their regular physician.  Delmarva’s doctors may do this without ever having seen the child. Such statements along with the fear of cuts in program dollars created serious concern over these contracts statewide. The concern of a ‘managed care’ effect seems to be lurking in the shadows.

It appears to me that this is just another way to get around the ‘medical necessity’ or ‘meaningful day activity’ that is required by law.  The problem is that these interpretations are currently in litigation and still undecided.  It is my experience with the health care industry that their definition of “medical necessity” means: Is it a matter of life or death? This is the same argument the industry uses in committee when they try to gut our insurance bill every year. If you are ever the victim of this circumstance or experience a disregarding of vital services, remember that you have the right to a hearing and due process. We will need all our parents who are attorneys to step up to the plate and form a committee to address what could potentially become a significant and frequent issue.

These and other funding concerns prompted a teleconference call, which took place last Thursday that included a group of parents and providers, with Carl Littlefield, who is in charge of the DC&F, Mike Hanson from the Governor’s office, Shelly Brantly the Medicaid Bureau Chief and Susan Dickerson, Medicaid Budget Supervisor.  Carl Littlefield stated that the contracts were designated language by the legislature and specific proviso in SB 2000, special appropriation 377, Home and Community Based Waiver, referring to quality assurance. Their function, as he explained, is a ‘checks and balances’ system. Delmarva comes in up front and Maximus follows as a backup.   He also stated that it was a 25/75 match meaning that 75% of the dollars were federal, however, this was inconsistent with earlier reports I received. Susan Dickerson stated that quality assurance is required by ACHA contracts and it is ‘Medicaid protocol’ when federal dollars are drawn.

Suggestions given in the conference call were to bring stakeholders to the table before decisions are made that affect the lives of our children.  When budget cuts are eminent, preferably administrative redundancy is considered for a cut before the direct services to our precious children.  A better dissemination of information was also suggested and requested.  Mr. Littlefield said that a $90,000 grant from the Development Disabilities Council is in the works to fund an information liaison. I’d like to know how to apply for that job! Better yet, lets spend the $90,000 on those that need it and try e-mail or a web page.   This situation is far from being over; we will work hard to prevent additional cuts in services.  Remember, when an alert is sent, please respond promptly, it can make a big difference in the life of your children.  Happy Holidays and a better New Year!

Any questions, e-mail me at skgoldstein@hotmail.com.

2002 Pre-Session Alert...

The status of the Autism Insurance Bill is an important issue this 2002 session as many who are wait-listed for the waiver will not be receiving the services that Mr. Littlefield promised would come in March.  Representative Crow and Senator Geller have already filed and we must not give up this fight for insurance coverage.  Please contact your legislators and ask them to sign on as sponsors.  

Now more than ever the State must require the insurance industry to accept some of the financial burden they have abandoned and written off for so long.  Premium-paying policyholders with autistic children are discriminated against and we must not let it continue.  Insurance is a mutually beneficial concept.  Our premiums pay for treatments of other children, as theirs should pay for treatment of autism.  

Call you House member and Senator.  Go to your delegation and sign up to speak at the public hearings.  Take your child to their district offices and let them meet in person.   Tell them we must pass the insurance bill!  Let’s do it this year!  

SENATE Bill 110 and HOUSE Bill 43
(Click on above Bill number to view language)

 SPONSORED BY

Senator Steve Geller and Representative Larry Crow
(Click here for a complete list of all Senate co-sponsors already signed on)
(Click here for a complete list of all House co-sponsors already signed on)