Jun 10, 2011

Agency gets grilled over looming budget cuts

Agency gets grilled over looming budget cuts
Christine Jordan Sexton,

Protesters stand in the Governor's office in the Florida Capitol to protest cuts to the Medicaid waiver program on Wednesday, April 6, 2011. Photo Credit: Ana Goni-Lessan
Acting Secretary Bryan Vaughan and other top officials at the Agency for Persons with Disabilities were accused on Thursday of not advocating for the people they serve and not being creative when it comes to finding funding solutions to care for the state’s disabled populations.

Many of the 60 or so advocates who went to the Tallahassee meeting on Thursday complained that the agency is not in touch with the people it serves and does a bad job of communicating with the providers who care for the disabled.

The meeting was called to help APD prepare a plan to bring its “spending within appropriations.”

It is a big task. For the year ending June 30, APD was expected to spend $930 million on services related to its Medicaid waiver program for the developmentally disabled. For the upcoming fiscal year the agency was appropriated $810 million for the waiver program. About 30,000 Floridians receive services through the program, which has been hampered by ongoing budget deficits. Gov. Rick Scott briefly cut payments to providers earlier this year due to the deficit. State lawmakers covered the deficit but they have warned they expect the program to stay within its new budget.

The report, which is due to the Legislature on September 1, must be made with input from support coordinators and services providers. This is the only scheduled public meeting, said communications director Melanie Mowry-Etters.

The agency took testimony from every advocate who wanted to speak. There were many.

Longtime developmental disability advocate and lobbyist Kingsley Ross said he felt compelled to publicly comment about a new law with tough consequences if APD cannot eliminate its deficit problems by 2012-13.

HB 7109 -- one of the two sweeping Medicaid bills signed into law this year -- directs APD and the Agency for Health Care Administration to redesign the waiver program to limit it to a program that provides for client “health and safety.” The law directs the agencies to “recommend elimination of coverage for other services that are not affordable based on available resources.”

Ross said he started working in the developmentally disabled system when patients were institutionalized. He told a story about how babies were denied stimulation by having them lie in white cribs in white rooms. For staff convenience, Ross said, babies were swaddled in multiple diapers. He said by the time they were able to walk the children moved like crabs because their pelvises were disfigured. “They couldn’t straighten their legs,” he said.

“I want to make sure we know where we’re headed if we only focus on health and safety,” Kingsley said.

Aaron Nangle suggested the state centralize its support staff training and eliminate the requirements that support coordinators report to area APD offices. He also said APD should cut its employee salaries by four percent. The four percent figure equals the rate cut made to APD providers this session. Nangle runs an influential website for the developmentally disabled community, waiverprovider.com.

“If four percent cuts are good for providers and good for support coordinators, in APD’s opinion, then I believe a four percent across the board cut for all APD employees earning more than $28,000 a year should be done as well,” said Nangle.

Tre Littlefield also touted reductions to APD staff. His father, Carl Littlefield, was appointed APD Secretary by Gov. Rick Scott, but Carl Littefield resigned from the department days later amid a controversy over how he handled a group home that was under his supervision.

Tre Littlefield now works at PARC -- a St.Petersburg based advocacy group for the developmentally disabled.