New law brings managed care to people with intellectual disabilities
Gov. Ron DeSantis on Tuesday signed into law priority legislation for House Speaker Daniel Perez that addresses how people with intellectual and developmental disabilities (IDD) receive health care.
There were fears in the IDD advocacy community that DeSantis was going to veto the bill but he signed HB 1103 into law without any ceremony or a press conference. He acted three days after receiving it and while the House and Senate met in an extended session to craft the next state budget.
Jim DeBeaugrine, a former Agency for Persons with Disabilities (APD) director and now a lobbyist, praised language that requires the agency to make public information about the number of people served in the Medicaid waiver program known as iBudget, plus the number of individuals on the waiting list, broken down by the counties in which they live.
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Federal Medicaid law provides coverage for health care services to cure or ameliorate diseases but generally doesn't cover services that won't. Specific to IDD, Medicaid covers the costs of institutional care but not of home- and community-based services that, if provided, can help people with IDD live outside of institutions.
Former Gov. Jeb Bush applied for a Medicaid waiver to provide these services to people with IDD. Eligible diagnoses include disorders or syndromes attributable to intellectual disability, cerebral palsy, autism, spina bifida, Down syndrome, Phelan-McDermid syndrome, or Prader-Willi syndrome so long as the disorder manifested itself before the age 18.
But the program is underfunded and has had lengthy waiting lists on which sometimes people have lingered for more than a decade. The Legislature has required APD to provide it with information about the program but while the information was once easily publicly available, the DeSantis administration stopped posting it online.
The bill requires the information to be made public again.
'You know, APD has gotten hundreds and hundreds of millions of dollars over the last several years. And I think it'll help to hold the agency accountable. And it's good for the public, particularly the advocacy community, to understand what happens with those dollars, how many people we're funding, whether the dollars are being spent for services,' DeBeaugrine told the Florida Phoenix Tuesday.
'You know, the rub on all of this is that the agency used to publish that data without the law telling them to. But since they stopped, I believe this is a positive step towards re-establishing accountability and transparency.'
The law also involves a Medicaid managed-care pilot program launched at the behest of then-House Speaker-Designate, now speaker, Perez in 2023. The pilot was designed to care for up to 600 individuals and was approved for Medicaid regions D and I, which serve Hillsborough, Polk, Manatee, Hardee, Highlands, Miami-Dade, and Monroe counties.
The state received federal approval for the pilot in February 2024. The Agency for Health Care Administration (AHCA) issued a competitive procurement for the pilot with two vendors, Florida Community Care and Simply Healthcare Plans Inc., vying for the contract. AHCA eventually awarded the contract to Florida Community Care.
Three hundred and fifty eight people were enrolled in the pilot program as of May 5. During testimony before the House Health and Human Services Committee in February, Carol Gormley, vice president for government affairs for Independent Living Systems, attributed the slow start-up to administrative barriers on APD's part. Independent Living Systems is the parent company of Florida Community Care.
The new law lifts the 600-person cap on the pilot program on Oct. 1, expanding enrollment statewide for qualifying disabled people on the Medicaid iBudget wait list. There are 21,000 plus people on the waitlist, according to a legislative analysis.
In a statement to the Florida Phoenix Tuesday, Gormley lauded DeSantis and the Legislature for their 'commitment to expanding and improving services for persons with disabilities.
'We look forward to the opportunity to extend the comprehensive benefits offered through the pilot program to families who choose to participate,' she said.
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