Gov. Rick Scott said today he had to make an emergency 15 percent cut in state payments for services to people with developmental disabilities because past administrations had "kicked the can" while deficits grew at the Agency for Persons with Disabilities.


Parents, group home operators and other providers plan a protest at the Capitol today against the 90-day executive order Scott issued last Thursday to head off a $170 million budget shortage at APD. Although the order called for a 15 percent cut, providers said the impact is really 30 to 40 percent for many companies taking care of patients with severe mental or physical disabilities, because the state also cut out differential payments for administrative and business costs.


Scott, who ran a giant hospital group and operated a group of walk-in medical clinics before his election to the governor's office last year, said he walked in to a $174 million projected gap. The problem has been growing since 2005, when about 5,000 patients were added to Medicaid waiver program -- which now serves about 30,000 patients -- but the state did not fund the new services.

"It's tough, I mean, what we're going through is, that agency has not lived within its budget, as far as I can tell, I don't know if it ever did," Scott said at a news conference after the state Cabinet meeting. "Everybody has just kicked the can and never really held them accountable and looked at how they could spend that money better. We need to, we want to, take care of that group of individuals. We've got to come up with a way of doing it on a cost-effective basis where people are taken care of and we don't run out of money."

Organizations serving Florida's most severely handicapped citizens fear the 15-percent cut in state payments that Gov. Rick Scott ordered for care of the developmentally disabled will really add up to double that amount and force some providers out of business.
That's why advocates for people with disabilities are hastily arranging a rally at the Capitol on Wednesday. They even invited Scott and legislative presiding officers to speak to the patients, parents and caregivers who will assemble at 10:30 a.m. under the portico of the Senate Office Building.

Upstairs, legislators will be working on a state budget for the fiscal year that starts July 1. But Scott has already moved to close a $169-million shortage in the Agency for Persons with Disabilities with an emergency order last week reducing payments to providers by at least 15 percent through June 30.

"Hopefully, they'll realize the mistake they're making," said Aaron Nangle of Spring Hill, an organizer of the rally. "It's not just a 15-percent cut. Many of the providers could live with 15 percent. But when you put the agency providers down to solo pay, then you cut them 15 percent on top of that, they can't keep their doors open."

Melanie Mowry Etters, a spokeswoman for APD, said there have been two payment levels. One level is for individual providers and a higher one is for businesses that take care of patients with developmental disabilities. Because businesses have additional administrative and benefits costs, their reimbursement rate was higher.
No longer. All providers are now paid at the reduced individual level.
"For some providers and some services, this rate cut is not 15 percent, but actually 15 to 40 percent," said Sylvia Smith, director of legislative and public affairs for Disability Rights Florida.

She said her organization, formerly known as the Advocacy Center for Persons with Disabilities, has already heard from some providers that agencies are closing. If that happens, thousands of patients would be left looking for other services or would be forced into nursing homes or hospitals.
APD serves about 35,000 patients, including about 30,000 covered by the Medicaid waiver program. It provides care for patients with intellectual disabilities, autism, spina bifida, cerebral palsey and other afflictions, including disabling physical injuries.

"The system needs more money, not less money," said Smith. If agencies close and patients can't find other services, she said, they will be forced from their homes into large institutions. Nangle, who runs a website that helps families find services, said cost plans are frozen and people can't request new services except in emergencies. He said employees of many providing companies are paid little more than minimum wage.

The Arc of Florida, a statewide charity advocating for persons with developmental disabilities, posted notice on its website Monday, urging caregivers to contact Disability Rights Florida if the APD spending cuts caused their patients to lose services.

"We will not let the people we serve be returned to large state institutions and stand by and say nothing," the Arc proclaimed. "We will speak up for them."
By Bill Cotterell