Gov. Ron DeSantis’ proposed $96.6 billion budget unveiled Thursday got high marks from most, but not all, health care providers that treat poor, elderly and disabled Floridians.
The governor did not recommend Medicaid rate cuts for nursing homes or hospitals in his proposed spending plan for the 2021-22 fiscal year, drawing praise from associations that lobby for those facilities.
But other groups said the proposed budget falls short in funding for the care of people with intellectual and developmental disabilities.
Dubbed “Florida Leads,” the proposed budget recommends increasing by $15 million funding for the so-called Medicaid iBudget program, which helps people with disabilities live at home or in their communities. But the proposal does not contain Medicaid rate increases for providers that work directly with people with disabilities.
“It’s a source of great concern and unhappiness among most of our people,” said Jim DeBeaugrine, interim director of The ARC of Florida, which includes 40 facilities across the state.
DeSantis' proposed spending plan is a blueprint for lawmakers to consider when they convene in March for the 60-day legislative session. The Republican-led Legislature is in charge of crafting the general appropriations act, better known as the budget.
Facing an economic downturn caused by the COVID-19 pandemic, DeSantis in June vetoed $1 billion in spending from the current-year budget, with about $140 million coming in the health care portion of the budget.
DeSantis spared hospitals and nursing homes from rate cuts at the time, but he vetoed $58.4 million in rate increases meant for community-based providers who care for people with intellectual and developmental disabilities. He also wiped out $38.4 million in rate increases for institutional providers that treat disabled people with some of the most maladaptive behaviors.
DeSantis’ new proposal recommends $36 million in rate increases for the institutional care facilities. While that recommendation doesn’t mirror the amount he vetoed in June, lobbyists called the difference inconsequential.
But the proposed budget doesn’t recommend restoration of the $58.4 million for community-based providers, a top priority of former Senate President Bill Galvano, R-Bradenton.
In June, Sen. Aaron Bean, a Fernandina Beach Republican in charge of writing the Senate’s health care budget, said the $58.4 million veto “hurt the most.”
The funding is used to reimburse people who work directly with clients who have intellectual and developmental disabilities. On average, direct care workers earn $9.50 an hour, according to a state analysis.
Florida voters in November approved a constitutional amendment to gradually raise the state’s minimum wage, with the first step increasing it to $10 an hour in September. To meet that mandate, Florida Association of Rehabilitation Facilities President and CEO Suzanne Sewell said the Legislature needs to increase Medicaid rates by $83 million.
“I think we are at the point where the state needs to be looking at some additional revenues or new sources or in some way figuring out how to restore what was lost. Because I understand that Florida needs a balanced budget, but we’ve been through some very tough times,” Sewell said. ”There need to be some heroic efforts taken and some decisions made about how we can make sure Florida is taking care of the frail individuals who need it the most who truly cannot meet their own needs.”
DeSantis’ overall budget proposal is $4.3 billion higher than the current-year budget. But it came after legislative leaders have warned they will be forced to make hundreds of millions of dollars in spending cuts because of economic fallout from the pandemic.
Safety Net Hospital Alliance of Florida CEO Justin Senior told The News Service of Florida that DeSantis’ proposed budget shows that cuts - especially in the health care arena - aren’t necessary.
“I think that as this point, we now know it is not necessary to cut us,” said Senior, whose organization represents large teaching, public and children’s hospitals. “There is no need to cut health care and health care infrastructure in the middle of a pandemic. It is not required.”
The state’s largest nursing-home group, the Florida Health Care Association, also praised the governor for the proposal.
"With the state's increasingly growing aging population, our nursing centers need resources to invest in people, technologies and training, as well as infection prevention supplies, to ensure the health, safety and well-being of the residents entrusted to their care,” Florida Health Care Association CEO Emmett Reed said in a prepared statement.
