Jan 20, 2012

health and human-services programs still likely face hundreds of millions of dollars in cuts during the upcoming 2012-13 fiscal year.

health and human-services programs still likely face hundreds of millions of dollars in cuts during the upcoming 2012-13 fiscal year. As an indication, Senate Health and Human Services Appropriations Chairman Joe Negron, R-Stuart, said Thursday he will release an initial budget proposal next week and expects about $850 million in cuts.

"To me, this is just a rerun every year,'' said Senate Minority Leader Nan Rich, D-Weston, lamenting a series of reductions that have hit hospitals, nursing homes and other providers.

In offering his budget plan last month, Scott proposed major changes in Medicaid rates for hospitals. The changes would seek to end wide differences in payments to hospitals, while also reducing funding by about $1.7 billion.

But Speaker Dean Cannon, R-Winter Park, on Thursday released what are known as budget allocations --- numbers that indicate how much the House wants to spend in each area of government --- and appeared to make clear the House does not plan to go along with Scott's proposed cuts to hospitals..

In a memo, Cannon pointed to a plan that lawmakers passed last year to transform Medicaid into a statewide managed-care system. Though Cannon did not specifically mention Scott's proposal, the memo said the House wants to use the managed-care plan to change Medicaid funding for hospitals.

"The House will continue to work toward a simplified hospital funding model, consistent with the Florida Medicaid reform enacted into law last year, recognizing that this effort will require more time-consuming, meticulous work and the investment of stakeholders,'' Cannon's memo said.

Negron said the Senate will continue to study Scott's proposal, which involves grouping hospitals into 10 categories based on similar characteristics. New, more-standardized rates would be used for hospitals in each category.

But during a meeting of Negron's subcommittee Thursday, senators blasted the proposal because it would lead to deep cuts at safety-net facilities such as Jackson Memorial Hospital in Miami and the Shands hospitals in Gainesville and Jacksonville.

"I, for one, cannot be quiet and sit here and take these cuts,'' said Senate Health Regulation Chairman Rene Garcia, R-Hialeah.

Part of Scott's proposal was designed to free up money to help pay for a $1 billion increase in public-school funding. The House allocations also included such a school-funding increase --- a decision that Scott praised in a prepared statement issued later Thursday.

"Today's budget allocations put forward in the Florida House are exactly what Florida's teachers and students need to keep our schools on a path to success,'' Scott said.

House Appropriations Chairwoman Denise Grimsley, R-Sebring, said "almost every policy area" in the state budget would take some reductions, as the House looks to put more money into education.

Lawmakers have repeatedly cut health- and human-services funding during the past few years as they grappled with billions of dollars in budget shortfalls. As an example, hospital Medicaid rates were cut about $510 million last spring, while nursing home rates were cut about $187 million.

More details will become available next week, but it appears the House allocations leave a roughly $300 million gap in general-revenue funding for health- and human-services programs. The House proposal would increase spending on the programs by about $600 million, but that is about $300 million short of the amount needed to keep up with Medicaid caseloads and other costs.

"That's the challenge we face every year with rising Medicaid rolls,'' Grimsley said.

The Senate has not released its allocations, but Negron was preparing Thursday to start making cuts. While he said he wants to continue studying Scott's proposal, he also said he wants to shield hospitals and nursing-homes from the types of across-the-board rate reductions they have faced in recent years.

But such an approach could lead to cuts in a wide range of other areas, such as substance-abuse and mental-health programs.

"I'm going to be very resistant to just doing the easy way out,'' Negron said.

Hospital and nursing-home industry officials said they hope lawmakers will take into consideration the deep cuts their facilities have sustained during the past few years. But they also were bracing for the possibility of more reductions.

"We hope they're minimal, but we certainly expect them,'' said Tony Marshall, a Florida Health Care Association official who closely follows Medicaid funding issues.