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Budget Questions Loom For Disabilities Programs

Gov. Ron DeSantis
The Florida Channel
DeSantis has warned that he will veto large amounts of money because economic fallout from the COVID-19 pandemic has dramatically reduced state tax revenues.

Gov. Ron DeSantis this week signed into law a pair of bills that will change how the state offers services to people with developmental and intellectual disabilities.

But the bigger question is whether DeSantis will veto $128 million in new funding that Senate President Bill Galvano, R-Bradenton, helped put in the state’s upcoming budget for disabilities programs. Advocates say the increased funding is necessary to implement one of the bills (SB 82), which makes changes in how the state’s Medicaid-funded “iBudget” program operates.

Valerie Breen, executive director of the Florida Developmental Disabilities Council, sent a letter in May asking DeSantis to spare the additional funds as he uses his line-item veto power to trim the budget. Her group, which includes state Agency for Persons with Disabilities Director Barbara Palmer, has not heard back from the administration.

Breen said she knows the governor supports the agency and programs for people with intellectual and developmental disabilities.

“But I think it’s just a matter of where he’s going to slash funding. We are hoping the most vulnerable citizens in Florida will not be impacted,” she said.

Lawmakers passed the proposed $93.2 billion budget in March, and DeSantis is required to act on it before the July 1 start of the 2020-2021 fiscal year. DeSantis has warned that he will veto large amounts of money because economic fallout from the COVID-19 pandemic has dramatically reduced state tax revenues.

One of the bills signed this week be DeSantis (SB 1344) will make it easier to build new institutions to house people with developmental and intellectual disabilities. South Florida-based institutional provider Sunrise Community was behind the legislation, which was opposed by the advocacy group Disability Rights Florida.

Meanwhile, in a prepared statement issued Wednesday, Galvano said the other disabilities bill signed by DeSantis, SB 82, makes changes that will ensure the long-term viability of the iBudget program.

The program provides Medicaid services designed to keep people with disabilities out of institutions. It is the only Medicaid program that state economists don’t review and agree on official cost estimates. Costs are unpredictable, and there is a long waiting list for services, with 22,828 people on the list as of Wednesday.

Galvano made improving the waiver program a top priority for the 2020 session and issued a statement thanking DeSantis and Senate bill sponsor Aaron Bean, R-Fernandina Beach, for what he called “important legislation.”

It “will help ensure the long-term viability of this program by taking a first step towards more predictability of costs, without a reduction in services,” Galvano said in the statement. “Coupled with increased funding in our budget, this legislation reinforces our strong and unwavering commitment to our fellow Floridians with unique abilities.”

Florida has in the past two decades made it a priority to keep people with developmental and intellectual disabilities out of institutions. But lawmakers this year agreed to temporarily waive certain regulatory requirements for the constructions of three new intermediate care facilities. Each facility would have 24 beds, 16 of which must be dedicated to treat people with the most severe maladaptive behaviors.

The changes, signed by DeSantis, came after Sunrise Community, a nonprofit organization headquartered in Miami, wanted to build a new facility in 2018 but was shot down by state regulators. On the eve of the 2020 legislative session, Sunrise Community President and CEO Zach Wray wrote checks to political committees led by the lawmakers who sponsored the changes. Attempts to contact the company Wednesday were unsuccessful.

Suzanne Sewell, president and CEO of Florida Association of Rehabilitation Facilities Inc., said new institutional beds are necessary. Her group, which includes Sunrise as a member, conducted a survey in 2018 that showed 59 people with severe maladaptive behaviors were denied placement in the institutions.

Olivia Babis, public policy analyst for Disability Rights Florida, opposed the bill throughout the session. She worries that the newly built institutions may become the only Medicaid option for people with developmental and intellectual disabilities who live in rural areas and don’t have access to many community-based alternatives such as behavioral group homes.

“And now when we add COVID to the mix, this is not a great environment to be in,” Babis said, noting that the deadly virus has spread through long-term care facilities, including intermediate care facilities for people with disabilities.

“We have organizations saying we need to get people out of the congregate care setting because this poses a public safety issue, and we have the state turning around saying, ‘Let’s build more of these,’” Babis said.

But Sewell said it takes time to have plans reviewed and approved by the state and that, “practically speaking,” she didn’t think a new facility would be operational for another two years.