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State wins $35.7M grant but can’t spend it

In March, Gov. Rick Scott’s staff said he would accept a $35.7-million federal health grant called the “Money Follows the Person.”

But apparently the Legislature decided otherwise. In the 2011-12 budget Scott just signed, lawmakers failed to give the Agency for Health Care Administration budget authority to draw down and spend the money.

Patient advocates were dismayed at the omission, since the money was to have been spent on home- and community-care programs that let disabled and elderly people move out of nursing homes or avoid them in the first place.

"It's particularly appalling, considering the Legislature just cut funds to nursing homes," said Jack McRay, AARP Florida lobbyist. The industry has said the Medicaid pay cuts will force staff cuts.

Neither the Legislature nor AHCA had publicized the decision. When Health News Florida inquired, AHCA spokeswoman Shelisha Coleman confirmed it in an e-mail: "The Florida Legislature did not include budget authority …for the administration of the Money Follows the Person grant award.”

No explanation was immediately available.

Florida was one of 13 states that were awarded the grants from the Department of Health and Human Services on Feb. 22. Since the grant covers five years, it is not clear whether Florida could get the money for later years if the Legislature changed its mind or whether HHS will give the grant to some other state.

Questions sent to the Centers for Medicare and Medicaid Services press office today drew an unusually cryptic response: "We continue working closely with states to ensure the benefits of more affordable, quality health care choices are available to all consumers."

Patient advocates say the grant money would have served the interests of both taxpayers and patients by keeping patients in the community and out of nursing homes – and letting some who are already in nursing homes be released to less-confining, less-expensive residential care.

“You end up spending a ton of money…in long-term care” that could be avoided, said Dave Bruns, communications manager for Florida AARP.

McRay and Bruns said they weren't sure whether the omission was an oversight or a deliberate cut for a program that was re-authorized under the 2010 health law, the Patient Protection and Affordable Care Act. Florida is leading a multistate challenge of the law in federal court, saying that it's unconstitutional because it requires all Americans to obtain health coverage or pay a penalty.
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