The Florida House wants to target $50 million toward opioid treatment and prevention in the upcoming year and spend about $1 million on a statewide prescription-drug database, the top House health-care budget writer said Tuesday.
Health Care Appropriations Chairman Jason Brodeur rolled out a proposed $36.9 billion spending plan for health and human-services programs in the 2018-2019 fiscal year, which starts July 1. The proposal would fund the state’s $28 billion Medicaid program and is 2.67 percent higher than current year spending.
Brodeur’s proposed budget, though, is based on Medicaid caseload and spending estimates made by economists in August. At a meeting of those same economists on Friday, Tom Wallace, bureau chief of the Medicaid finance program, said the latest projections show an increased need of $121 million, some of which is attributable to a change in the percentage rates used to determine the federal matching funds Florida receives for Medicaid.
Brodeur, R-Sanford, acknowledged that the latest estimates could increase the amount needed for Medicaid but downplayed the potential impact on his proposed spending plan saying, “if there turns out to be a higher need and we figure it out later we could always come back and do a budget amendment.”
The health-care proposal rolled out Tuesday is an initial step in the budget process, with the House Appropriations Committee next week slated to approve an overall state spending plan. The House will sign off on the overall plan the following week, setting the stage for negotiations with the Senate on a final budget.
The $50 million the House wants to spend on addressing the opioid epidemic includes $27 million in federal funds. Brodeur said the House wants to spend $17 million for direct services in local communities, with targeted outreach to pregnant women. Services that would be funded include outpatient care, residential and recovery support and medication-assisted treatment.
The House also wants to spend $1.1 million for upgrades to the prescription drug monitoring program, which is a statewide database aimed at preventing addicts from “doctor shopping” for drugs. The money would go toward providing real-time data uploads and data analysis and to integrate the database with electronic health records.
While seeking more money for opioid treatment, Brodeur also recommended a $1.5 million reduction in state spending on Vivitrol extended release, a shot that is given to help opioid addicts recover. Funding for Vivitrol was included in the current budget after closed-door negotiations between Senate President Joe Negron, R-Stuart, and House Speaker Richard Corcoran, R-Land O’Lakes.
It isn’t the only priority of Negron that is missing from the early House proposal. The House isn’t recommending funding increases for Florida nursing homes, which Negron said in December was a “very strong” priority of his.
For the first time in many years, the House has not recommended making cuts to hospital funding. While hospitals wouldn’t get cut under the proposal, they also wouldn’t get money they requested. Brodeur’s budget proposal does not include an additional $50 million in general revenue to help offset a reduction that is slated to be made to hospital reimbursements in the coming year.
Hospitals also want the Legislature to fund a $100,000 bonus for each primary-care residency program created by a hospital and asked for another $5 million to entice hospitals to retain graduate medical education slots in neurology, thoracic surgery, nephrology and ophthalmology. While Brodeur’s budget plan includes those programs, they would receive trust-fund dollars and not general revenue, which is the preferred source of money.
The House budget proposal also includes $1.5 billion in funding for the Low Income Pool program, which helps hospitals care for poor and uninsured patients. The Low Income Pool is funded through a combination of federal and local money. Hospitals have said it is difficult for them to raise enough local money to draw down the full federal amounts and reach $1.5 billion.
The proposed budget unveiled on Tuesday also includes $22 million to help fund an Agency for Persons with Disabilities “home and community-based services waiver” program, which serves people with intellectual disabilities, autism, cerebral palsy or other disabilities. Brodeur said the funding will provide care for upward of 900 people on a waiting list.
Agency for Persons with Disabilities Director Barbara Palmer said in December that the agency was in danger of going into a deficit. But Brodeur said his analysis of the agency shows there is no deficit.
“They are getting more money but … until they justify the shortfall, we are funding the waiver,” he said.
Brodeur included $41 million in the budget proposal to increase rates and ensure that the caregivers who work with the Agency for Persons with Disabilities clients are paid at least minimum wage.