Gov. Rick Scott's budget proposes a 17 percent cut to the budget for the Agency for Persons with Disabilities in the next year

Health agencies brace for cuts
Local care providers anxious about proposed state budget

ORMOND BEACH It's lunchtime but Stuart Roddy's lips are pursed shut to a
proffered mouthful of a white bread sandwich.

A bad sign, says his mother, as she pries open his lips with her fingers to
make a passageway for the food.

"Chew-chew-chew," Debbie Roddy says as she deposits bits of ham, bread,
lettuce and tomato into his mouth. Then she sighs and explains further: "On
a good day, he'll swallow a whole meatball sub."

Over 25 years of her son's life, Roddy has learned the signals that the day
likely will end with him screaming in pain -- his only way of showing he's
in distress

What's more troubling in the long term, though, is that the help that
allows her to handle her son's needs -- keeping his 90-pound frame clean,
fed and comfortable -- could be dramatically reduced.

Gov. Rick Scott's budget proposes a 17 percent cut to the budget for the
Agency for Persons with Disabilities in the next year, part of a plan to
cut $5 billion from the state budget over the next two years to make up for
a budget shortfall. Five agencies that deal with child welfare, health and
safety net services for the most vulnerable are looking at a combined $1.8
billion cut.

"The kinds of choices the governor is having to make are impossible to
fathom and comprehend," said Chet Bell, CEO of Stewart-Marchman-Act
Behavioral Healthcare based in Daytona Beach . "How do you prioritize one
needy population over another?"

Scott's press office did not return an inquiry asking for comment.

But Scott said in his budget address he had made hard decisions, "but the
right decisions for Florida's future . . . As long as 1.1 million
Floridians are out of work, we can't afford a government that runs wild
with taxes, regulations and excessive spending."

Roddy said the personal care assistants that work with her and her son have
told her to expect cuts in the 70 hours a week her son receives in personal
care assistance. That means she and her husband -- both with worn backs and
rotator cuffs from handling their son -- will be more on their own trying
to handle an adult-sized body that operates on the level of a 9-month-old
infant.

Legally blind, unable to walk, talk or use the toilet, Stuart Roddy
suffered a brain injury either before birth or shortly after resulting in
cerebral palsy that impairs even the bodily functions that occur
automatically. Both parents say they've never been more afraid that the
cuts will push their son into an institution.

"It seems like there's no way out," said Debbie Roddy, 55, "My whole life
is that I don't want my son institutionalized."

Her husband, Rick Roddy, 55, a retired Ormond Beach firefighter, nodded:
"This is the best quality of life for him."

MIXED BAG ON CUTS

Margaret Hooper, public policy coordinator at the federally funded Florida
Developmental Disability Council, said the Roddys have good reason to be
worried.

"This would be the biggest cuts they've seen since 2007," Hooper said.

Other agencies that provide services are not facing cuts quite so drastic.
At the Council on Aging of Volusia County, a 5 percent cut will mean memory
disorder clinics will be discontinued and the waiting list for in-home care
will likely grow.

"Given the rather tight budgetary conditions in Tallahassee, the aging did
relatively well," said Douglas Beach, executive director of the council.

Stewart-Marchman-Act Behavioral Healthcare based in Daytona Beach, which
contracts with state agencies to provide mental health and substance abuse
services, will be funded at current levels, according to its CEO Bell. But
the Senate budget would eliminate all community mental health services,
except crisis services, he said.

Scott's budget has called for the state Health Department to trim its
expenses by 6 percent -- which would mean cutting about 5 percent of the
17,367 positions. This week, the Health Department issued a 154-page report
that called for the local county Health Departments to get out of the
business of providing primary care to residents.

Volusia County Health Department stopped providing that in 2006, but it
would mean that Flagler County Health Department would lose about $113,000
the state pays it to administer primary health care to 2,752 Flagler
residents on Medicaid, the state's insurance for low-income Floridians.

Health Department Administrator Patrick Johnson said he's going to keep on
doing that, in spite of the cut, which the report allows for.

"As long as there's a need for it, we'll be providing it," Johnson said.
"Right now there aren't enough doctors in the area who take Medicaid, so
it's needed."

MEDICAID A PRIME TARGET

Hospitals are slated to take a cut in the Medicaid reimbursement they
receive from the state, according to Scott's plan.

At Halifax Health, for example, officials project that the Daytona
Beach-based hospital system would lose $4.4 million this year -- about 3
percent of what the public health system receives in Medicaid payments,
which account for 10 percent of the system's budget. For next year,
officials are projecting the hospital would lose about $12.7 million in
reimbursements it received through providing services to the medically
needy -- costs that would likely become bad debt. That would mean that
about 13 percent of its Medicaid revenues would disappear.

"We are hopeful as budget development continues that these reductions can
be mitigated," said Dee Schaeffer, Halifax's governmental affairs officer.

How those cuts would be absorbed has not been determined, she said

For Linda Merrell, an early proponent of Florida KidCare, an insurance
program for children of middle- to low-income Floridians, the cuts to the
severely disabled are the most unconscionable part of the Scott's budget.
Not only does it cut existing services, but it does nothing to address the
Agency for Persons with Disabilities 19,000-person waiting list for
services.

She agrees that Medicaid's spiraling costs -- the fastest-growing part of
the state budget -- need to be addressed in a cost-effective manner. But it
shouldn't be done in a way that threatens Floridians living with the most
complicated conditions, such as the Roddys.

"Families who have been relying on this lifeline for their child have every
right to be terribly anxious, nervous and uptight," she said,
characterizing this year's situation as a one-alarm fire that could grow
into a three-alarm blaze. "Restructuring of Medicaid right now could
unravel a good safety net system that has worked in the past."

Debbie Roddy says the most important thing is that her son can keep his
current caregivers, some of whom have been caring for him for the past
eight years. They understand his signals that can be as subtle as a
crinkled eyebrow or a funny face.

Through the years, "hundreds" of caregivers haven't been a fit for the
family, she said. But Mike Diggett, Stuart Roddy's personal caregiver for
the past seven years, doesn't know how much longer he can afford to stay in
this business. In the past three years, he's watched his pay drop from $21
per hour to $15 per hour. That doesn't come with health or retirement
benefits.

He said he's dedicated to it because of his sister, 30, who also has
cerebral palsy.

Daytona Beach News-Journal
By ANNE GEGGIS, Staff Writer
http://www.news-journalonline.com/news/local/east-volusia/2011/03/07/health-agencies-brace-for-cuts.html