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Proposal For 'IBudget' Disabilities Program Raises Concerns

brochure page from website
Agency for People With Disabilities
The Florida Channel
An online brochure for the Medicaid IBudget program, which keeps tens of thousands of people with disabilities at home or in their communities and out of institutions.

Advocates for people with disabilities worry that Florida might be trying to limit services under a proposed rule floated by the state Agency for Persons with Disabilities.

The proposal would require support coordinators, who help people with disabilities obtain home- and community-based services, to “certify” that their clients have exhausted all other avenues for care before applying for the Medicaid program known as the “iBudget.”

Under the proposed rule, people with disabilities could not get services until support coordinators complete a five-page document with questions about their clients’ health status and provide supporting documentation.

“I think it’s really freaked people out,” Nancy Wright, a Gainesville attorney who specializes in Medicaid law, told The News Service of Florida following a meeting Monday on the proposal.

The proposed form asks support coordinators whether clients are privately insured and, if so, for the names of insurance companies, the services and supports the clients have received and any services or supports that were requested and denied. Similarly, there are questions about whether clients are enrolled in the Medicaid managed-care system and, if so, the names of the plans and whether the clients are receiving physical, occupational, speech or respiratory services or applied behavioral analysis services.

Also, questions ask about Medicare, the amount of available community support resources and availability of “other governmental resources.”

Attending the meeting virtually, Wright told Agency for Persons with Disabilities staff members that the rule doesn’t define “available” or explain how to document  services that are unavailable because of lengthy waiting lists and denials of services because they aren’t covered benefits.

Wright also said the proposed rule would require support coordinators to become experts in what she called some of the most “complicated health care programs on the planet” and that the agency doesn’t help when asked to do so.

“And oftentimes not only is APD not helpful, they are actually acting kind of contrary by forcing people to do things that aren’t really possible under the system,” Wright said, adding that she’d like to see the agency “apply itself” and hire regional staff members to assist support coordinators.

The rule is being floated to help implement a law passed by the Legislature this spring to overhaul the IBudget program, which keeps tens of thousands of people with disabilities at home or in their communities and out of institutions.