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Capitol Update
Volume 7, Issue 4
April 7, 2008
Work Incentive Medicaid Coverage - HB 1311(Reed) / SB 2684(Crist)
Florida’s Return On Investment
This bill provides for Medicaid eligibility for certain persons with disabilities under a Medicaid buy-in program, subject to specific federal authorization. This program would allow people with disabilities to go back to work without fear of losing their Medicaid, as long as they share in paying for their Medicaid.
Florida’s Investment of $1.3 million for Work Incentive Medicaid Coverage in its first year is estimated to generate over $2 million that is returned to the state and federal government in taxes that the state uses to operate.
- A December 1999 study by the ABLE Trust reported that 23 percent of the earned income for an individual with a disability would be returned to the state and federal governments in taxes that the state uses to operate.
- $1.3 million is the estimated first year cost to have a Work Incentive Medicaid Coverage program in Florida. This cost is based on having 1,000 people enrolled in the first year. The cost would rise as more individuals were enrolled.
- Every individual who works would earn at least the minimum wage of $6.79 an hour (effective January 1, 2008). The earnings for a full year working 25 hours weekly would total $8,827 (Note: some individuals will earn much more than minimum wage and some individuals may work full time.)
- The 23 percent that each working individual would return to the government in taxes would total $2030.
- For the 1,000 individuals enrolled for the $1.3 million in state investment, a total of $2,030,210 would be returned to the state and federal governments in taxes that the state uses to operate.
Please contact Representative Aaron Bean, Chair, Healthcare Council and Representative Ray Sansom, Chair, Policy and Budget Council and ask them to agenda and pass this economic stimulus package!
In the Senate contact Senator Mandy Dawson, Chair, Health Policy Committee and ask her to agenda and pass this economic stimulus package!
APD Budget Update
In the Policy and Budget Council this week, the conforming bill to the House Budget HB 5087 passed with discussion regarding the roughly 1 million dollars that the House wants to save by putting APD Waiver Hearings under DCF. In 2006, these hearings were moved to the Department of Administrative Hearings (DOAH) where advocates have contended there is a neutral playing field.
The Advocacy Center representative noted in the committee meeting that the individuals with developmental disabilities were winning a higher percentage of cases(44%) than they had when the hearings were with DCF(7%). Representative Galvano referred to the staff analysis that indicated that the move aligned these hearings with other state Medicaid Hearings. The general sentiment from the Healthcare Council has been that this move is worth the savings because the agency is expecting more hearings as the Tiers System is implemented.
On the Senate side Senator Nan Rich offered an amendment to Senate Appropriations bill, SB 7084, during the Senate Health and Human Services Appropriations Committee meeting Wednesday, April 2, that requires the Agency for Persons with Disabilities to contract with independent waiver support coordinators to conduct needs assessments for individuals currently enrolled in the Developmental Disabilities Home and Community Based Waiver and those on the wait list, if funds are available.
Senator Rich emphasized that these support coordinators were not to conduct assessments on individuals they are already serving.
The amendment is not intended to replace the 75 employees that have been hired by the agency who are currently conducting assessments for individuals on the waiver. Independent support coordinators must meet the same inter-rater reliability standards and training requirements as the current assessors.
There were no further changes to the agency budget.
Medicaid Reform Expansion
Thursday evening the Policy and Budget Council passed the health care appropriation bill that delays Medicaid reform expansion to Miami-Dade, Monroe, Pasco, Pinellas, Hardee, Highlands, Hillsborough, Polk, and Manatee counties until 2010.
Additionally, the council passed the AARP Florida amendment which allows (not requires) the Governor, Senate President, and the House Speaker to appoint workgroups to propose cost effective alternatives to Health, Medicaid and Long Term Care reforms. The exact language is as follows:
The Governor, the President of the Senate, and the Speaker of the House of Representatives may convene workgroups to propose alternatives for cost-effective health and long-term care reforms, including, but not limited to, reforms for Medicaid.
Meanwhile other Health and Human Service advocates feel that Medicaid Reform has yet to deliver on its many promises, including but not limited to: more meaningful and informed choices, increased efficiency without reduced access, and improved health outcomes.
In its report on Medicaid Reform, the Agency for Health Care Administration (AHCA) determined that it does not have the data it needs in order to determine whether Reform is helping more than it is hurting, but has noted that the feedback it has received about Reform is mostly negative.
These advocates oppose expansion of Medicaid Reform until all of the problems encountered in the pilot counties have been accurately documented and fixed.
Passage of any kind of Medicaid Reform Expansion language means that AHCA will not have to come back for expansion approval if language that even delays expansion is passed. Given this idea it may be worth putting as many protections in statute as possible. Senator Lynn’s bill SB 1570 includes language that would put in specific recommendations that have been made by outside study groups including protections for individuals with Developmental Disabilities as follows:
Persons with developmental disabilities as defined by s.393.063 (9), children found to be dependent pursuant to s. 39.01(14), persons with severe and persistent mental illness, and recipients who meet the institutional or "ICP" level of care required for Medicaid nursing home care or enrollment in a Medicaid home-based or community-based waiver are excluded from mandatory enrollment in the pilot program until the service delivery systems described in the current statute have been developed and evaluated for a period of at least 1 year and until the Legislature expressly authorizes their mandatory enrollment.
The Senate has not indicated that they want to expand managed care Medicaid Reform Pilots, but now that it has passed in a conforming bill in the House it will be a conference issue.
SB 2684 - Relating to Optional Payments for Medical Assistance-Crist
Summary - Optional Payments for Medical Assistance; This bill provides for Medicaid eligibility for certain persons with disabilities under a Medicaid buy-in program, subject to specific federal authorization. This program would allow people with disabilities to go back to work without fear of losing their Medicaid, as long as they share in paying for their Medicaid services.
Actions
03/20/08 - SENATE - Referred to Health Policy; Children, Families and Elder Affairs and Health and Human Services Appropriations
Identical Bill
HB 1311 - Relating to Optional Payments for Medical Assistance -Reed
03/07/08 - HOUSE - Referred to Healthcare Council; Policy & Budget Council
03/13/08 - HOUSE - Referred to Committee on Health Innovation by Healthcare Council
SB 2654 - Relating to Autism Spectrum Disorder - Geller
Summary - General Autism Spectrum Disorder; The "Window of Opportunity Act" would require health insurance plans to provide coverage for screening, diagnosis, intervention, and treatment of autism spectrum disorder in certain children. The bill prohibits an insurer from denying or refusing coverage or refusing to renew or reissue or terminate coverage based on a diagnosis of autism spectrum disorder .The bill includes training provisions for child care personnel and procedures for early detection of Autism Spectrum Disorders. EFFECTIVE DATE: 01/01/2009.
Actions
03/13/08 - SENATE - Referred to Banking and Insurance; Health Policy; Health and Human Services Appropriations;
03/18/08 - SENATE - Favorable with CS by Banking and Insurance; 8 Yeas, 0 Nays
03/20/08 - SENATE - Committee Substitute (C1) Filed
04/01/08 - SENATE - Favorable with CS by Health Policy; 6 Yeas, 0 Nays
04/03/08 - SENATE - Committee Substitute (C1) Filed
Compare Bills
HB 1291 - Relating to Autism Spectrum Disorder - Porth
This bill includes additional language that requires training provisions for child care personnel and procedures for early detection of Autism Spectrum Disorders.
03/07/08 - HOUSE - Referred to Healthcare Council; Policy & Budget Council
03/18/08 - HOUSE - Favorable with 1 Amendment by Health Innovation; 4 Yeas, 3 Nays
HB 739 - Relating to Guardian Advocates for Persons with Developmental Disabilities-Ambler
Summary - Guardian Advocates for Persons with Developmental Disabilities: This bill provides a list of persons from which the court must select a guardian advocate and provides that the guardian advocate need not be represented by an attorney. It revises requirements for petition seeking appointment of a guardian advocate and modifies who may be appointed counsel to person with developmental disabilities. It also revises powers and duties of the guardian advocate with respect to financial accounting requirements.
Actions
02/06/08 - HOUSE - Referred to Healthcare Council; Policy & Budget Council
03/04/08 - HOUSE - Favorable with 1 Amendment by Healthy Families; 9 Yeas, 0 Nays
04/01/08 - HOUSE - Favorable with CS by Healthcare Council; 18 Yeas, 0 Nays
Similar
SB 688-Relating to Developmentally Disabled/Guardian Advocates - Crist
01/09/08 - SENATE - Referred to Children, Families, and Elder Affairs; Judiciary; Health and Human Services Appropriations
02/20/08 - SENATE - Favorable by Children, Families, and Elder Affairs; 7 Yeas, 0 Nays
03/25/08 - SENATE - Favorable with CS by Judiciary; 10 Yeas, 0 Nays
03/27/08 - SENATE - Committee Substitute (C1) Filed; Now in Health and Human Services Appropriations
SB 2028 - Relating to Disabled School Students/Discipline - Duetch
Summary - Disabled School Students/Discipline [SPCC]-This bill requires the training of school personnel concernning procedures for safely restraining students with disabilities in an emergency. Prohibits school personnel from restraining a student with disabilities for a behavioral intervention or when the student is prone. The bill also provides for parental notification of incidents of restraint and provides for an outside review committee.
Actions
02/27/08 - SENATE - Referred to Education Pre-K - 12; Children, Families, and Elder Affairs; Education Pre-K - 12 Appropriations
Identical Bills
HB 1139 - Relating to Discipline of Students with Disabilities by Bucher
03/02/08 - HOUSE - Referred to Schools & Learning Council
HB 1319 - Relating to Medicaid Utilization Management Program - Roberson
Summary - General Medicaid Utilization Management Program-The bill deletes the provision requiring the Agency for Health Care Administration to develop and implement utilization management programs for Medicaid-eligible recipients for management of occupational, physical, respiratory, & speech therapies. There currently are plans to put therapy services for children age 0-21 into for-profit managed care. This bill would terminate those plans.
Actions
03/07/08 - HOUSE - Referred to Healthcare Council; Policy & Budget Council
03/13/08 - HOUSE - Referred to Committee on Health Innovation by Healthcare Council
Identical Bills
SB 2238 - Relating to Medicaid Utilization Management Program by Garcia
03/07/08 - SENATE - Referred to Health Policy; Health Regulation; Children, Families, and Elder Affairs; Health and Human Services Appropriations
HB 91 - Relating to Disability History and Awareness –Richardson Cosponsors: Galvano, Kendrick, Kriseman, Sachs, Skidmore, Zapata
Summary - General Disability History and Awareness-This bill authorizes district school boards to designate "Disability History and Awareness Weeks" during the first 2 weeks in October each year. The bill provides for students in all K-12 public schools to be provided disability history and awareness instruction. Encourages state postsecondary institutions to conduct and promote activities related to disability history and awareness.
Actions
09/17/07 - HOUSE - Referred to Schools & Learning Council; Policy & Budget Council
01/24/08 - HOUSE - Referred to Committee on K-12 by Schools & Learning Council
03/18/08 - HOUSE - Favorable with 1 Amendment by K-12; 8 Yeas, 1 Nay
04/04/08 - HOUSE - On Council agenda - Schools & Learning Council, 04/08/08, 9:00 am, 212 K
Similar
SB 856 - Relating to Disability History and Awareness Pilot Project - Fasano CS Sponsors: Children, Families, and Elder Affairs
01/24/08 - SENATE - Referred to Education Pre-K - 12; Children, Families, and Elder Affairs; Education Pre-K - 12 Appropriations
02/20/08 - SENATE - Favorable by Education Pre-K - 12; 5 Yeas, 0 Nays
03/19/08 - SENATE - Favorable with CS by Children, Families, and Elder Affairs; 7 Yeas, 0 Nays
03/20/08 - SENATE - Committee Substitute (C1) Filed
03/21/08 - SENATE - Now in Education Pre-K - 12 Appropriations
SB 110 - Relating to Disability History and Awareness Weeks by Fasano Cosponsors: Bullard (L)
Summary - Resolution Disability History and Awareness Weeks; Recognizes October 1-15, 2008, as "Disability History and Awareness Weeks" and encourages public schools and universities to provide instruction on disability history, people with disabilities, and the disability rights movement, etc.
Actions
04/02/08 - SENATE - Read Second time; Adopted
SB 1570 - Relating to Medicaid Managed Care Pilot Program - Lynn
Summary - General Medicaid Managed Care Pilot Program. This bill provides exceptions to mandatory enrollment in the Medicaid managed care pilot program and provides for expiration of such exceptions. The bill requires the Agency for Health Care Administration (AHCA) to take on additional powers, duties, and responsibilities with respect to the pilot program. This bill requires that AHCA provide Medicaid recipients with certain information, such as, planned standards for granting services in excess of the plan's service caps. The language states that” Persons with developmental disabilities as defined by s.393.063 (9), children found to be dependent pursuant to s. 39.01(14), persons with severe and persistent mental illness, and recipients who meet the institutional or "ICP" level of care required for Medicaid nursing home care or enrollment in a Medicaid home-based or community-based waiver are excluded from mandatory enrollment in the pilot program until the service delivery systems described in the current statute have been developed and evaluated for a period of at least 1 year and until the Legislature expressly authorizes their mandatory enrollment.
Actions
02/21/08 - SENATE - Referred to Health Policy; Health Regulation; Children, Families, and Elder Affairs; Health and Human Services Appropriations
03/19/08 - SENATE - Favorable with 4 Amendments by Health Policy; 7 Yeas, 0 Nays
03/20/08 - SENATE - Now in Health Regulation
SB 366 - Relating to Elderly Persons and Disabled Adults/Abuse & Neglect - Margolis Cosponsors: Fasano, Bullard (L)
Summary - General Elderly Persons and Disabled Adults/Abuse and Neglect This bill reclassifies the offense of aggravated abuse of an elderly person or disabled adult from a second-degree felony to a first-degree felony. This bill also requires certified law enforcement officers to complete training in identifying and investigating elder abuse and neglect before June 30, 2011.
Actions
11/28/07 - SENATE - Referred to Criminal Justice; Children, Families, and Elder Affairs; Criminal and Civil Justice Appropriations
02/06/08 - SENATE - Favorable by Criminal Justice; 9 Yeas, 0 Nays
03/19/08 - SENATE - Favorable by Children, Families, and Elder Affairs; 7 Yeas, 0 Nays
04/03/08 - SENATE - Withdrawn from Criminal and Civil Justice Appropriations; Placed on Calendar, on second reading
Identical Bill
HB 233 - Relating to Elderly Persons and Disabled Adults - Anderson Cosponsors: Ambler, Heller, Holder, Porth, Sachs
12/12/07 - HOUSE - Referred to Safety & Security Council; Policy & Budget Council
02/06/08 - HOUSE - Favorable by Homeland Security & Public Safety; 7 Yeas, 0 Nays
02/20/08 - HOUSE - Favorable by Safety & Security Council; 12 Yeas, 0 Nays; Now in Policy & Budget Council
03/18/08 - HOUSE - Favorable by Policy & Budget Council; 32 Yeas, 0 Nays
03/19/08 - HOUSE - Placed on Calendar, on second reading.
SB 788 - Relating to Transportation Disadvantaged/Services - by Fasano
Summary - General Transportation Disadvantaged/Services –This bill revises the number of members required for a quorum at a meeting of the Commission for the Transportation Disadvantaged and revises responsibilities for the commission. The bill requires the commission to incur expenses for the purchase of advertisements, marketing services, and promotional items. The bill revises and creates duties and responsibilities for agencies that purchase transportation services for the transportation disadvantaged.
Actions
01/24/08 - SENATE - Referred to Transportation; Community Affairs; Transportation and Economic Development Appropriations
03/04/08 - SENATE - Favorable by Transportation; 7 Yeas, 0 Nays
03/13/08 - SENATE - Favorable by Community Affairs; 9 Yeas, 0 Nays; Now in Transportation and Economic Development Appropriations
03/24/08 - SENATE - Transportation and Economic Development Appropriations Meeting canceled, 03/24/08, 4:30 pm; On Committee agenda - Transportation and Economic Development Appropriations, 03/25/08, 3:00 pm, 309 C
03/25/08 - SENATE - Temporarily postponed by Transportation and Economic Development Appropriations
03/28/08 - SENATE - On Committee agenda - Transportation and Economic Development Appropriations, 04/02/08, 8:30 am, 309 C
04/02/08 - SENATE - Favorable with CS by Transportation and Economic Development Appropriations; 5 Yeas, 0 Nays
04/03/08 - SENATE - Committee Substitute (C1) Filed
Similar Bill
HB 1175 - Relating to Transportation Disadvantaged Services - by Robaina
03/05/08 - HOUSE - Referred to Healthcare Council; Policy & Budget Council
03/13/08 - HOUSE - Referred to Committee on Health Innovation by Healthcare
04/04/08 - HOUSE - Referral revoked from Committee on Health Innovation by Healthcare Council; Now in Healthcare Council; On Council agenda - Healthcare Council, 04/08/08, 8:30 am, Morris Hall
SB 1954 - Relating to Developmental Disabilities by Rich CS Sponsors: Children, Families, and Elder Affairs
Summary - Agency for Persons with Disabilities 2008 legislative package.
This bill revises the term "developmental disabilities institution" to be known as a "developmental disabilities center." It revises provisions regarding background screening of direct service providers. It also provides additional grounds for denying, suspending, or revoking a license, and imposing a fine against a provider serving clients of the Agency for Persons with Disabilities if the licensure applicant or licensee has been verified by the caregiver responsible for abuse, neglect, or abandonment of a child; abuse, neglect or exploitation of an adult; or previously had a license revoked by APD, the Agency for Health Care Administration, or DCF.
Actions
02/27/08 - SENATE - Referred to Children, Families, and Elder Affairs; Health Regulation; Health and Human Services Appropriations
03/26/08 - SENATE - Favorable with CS by Children, Families, and Elder Affairs; 6 Yeas, 0 Nays
03/28/08 - SENATE - Committee Substitute (C1) Filed
04/03/08 SENATE On Committee agenda - Health Regulation, 04/08/08, 3:15 pm, 401 S