A legislative proposal to overhaul a program that helps Floridians with developmental and intellectual disabilities was released Thursday --- and is quickly sparking fears among people who work with the thousands of residents who rely on assistance from the state.
The measure, filed by a top Senate budget writer, would require state officials to competitively bid certain components of the program and set rates that service providers can charge.
For several years, Florida officials have struggled to figure out how much should be spent on the “iBudget” program, which offers services to roughly 34,000 people with disabilities.
The bill (SB 82), filed by Senate Health and Human Services Appropriations Chairman Aaron Bean, R-Fernandina Beach, would require the state in October to begin a competitive bidding process to contract with two organizations to provide support-coordination services.
The bill also would require the state to hire an outside organization to determine whether people’s iBudgets should be increased because of “significant additional needs.” Currently, the Agency for Persons with Disabilities, which administers the iBudget program, makes those determinations.
Already, the proposal has raised concerns among advocates for people with disabilities.
Bean is promising to redirect any savings derived by the changes back into the program. But that isn’t enough to assuage the concerns of Kirk Hall, chief executive officer of The ARC of Florida.
“Anytime you change a system, even if it’s a good change, there’s going to be a period of time where people are playing catch up,” Hall said.
Valerie Breen, executive director of the Florida Developmental Disabilities Council, said support coordinators and reviews of iBudget allocations are “critical functions” and expressed concerns that they were potentially being “privatized.”
“The council hopes to be the thought leader for all parties involved should this initiative move forward,” Breen said.
Bean told The News Service of Florida that the bill was the first iteration of a proposal that he predicted would be altered throughout the 60-day legislative session, set to begin Tuesday.
He also said any savings resulting from those changes and others contained in the bill would be pumped back into the Agency for Persons with Disabilities to provide services.
“No one cares more about this population,” Bean said.
The Senate bill also would delete from current law circumstances that qualify people with disabilities to receive bumps in their iBudget allotments. Current law makes clear that extraordinary needs include those that would “place the health and safety of the client, the client’s caregiver or the public in immediate, serious jeopardy unless the increase is approved.”
The bill also would direct the state to seek federal approval to amend its Medicaid “waivers” and contracts to cap the amounts of certain services that can be provided to iBudget enrollees, including 180 hours a month for personal-care assistance services and eight hours a day for residential habilitation services.
Moreover, Bean’s bill would allow the state to establish rates for providers to be paid. The rates could be based on an analysis of historical expenditures along with prospective costs or “any other methodology” developed by the Agency for Health Care Administration, according to the bill.
The iBudget program is designed, in part, to help people live as independently as possible in their homes or in their communities. Each person has an individual budget to spend on services they require. A person’s budget is determined using a complex algorithm.
The Agency for Persons with Disabilities has spent more money providing services to the 34,000 people in the iBudget program than what the state has agreed to spend, which has spurred lawmakers to take a closer look at how the program operates. Also, the program has a long waiting list of people seeking services.
Bean said he routinely receives emails from people who are enrolled in the program and don’t want to see changes. He also receives emails from people on the waiting list who are pressing him to make changes.
“If you’re receiving services, you’re scared there are going to be big changes,” Bean said. “If you’re on a waiting list, you’re scared we aren’t going to make any changes.”