Florida Governor DeSantis Budget Boosts Disabilities Spending

TALLAHASSEE (CBSMiami/NSF) -- Gov. Ron DeSantis on Monday called for legislators to pump hundreds of millions of dollars into programs for people with intellectual and developmental disabilities, as well as $20 million into the state's prescription-drug importation effort --- or about $5 million less than what a top state health official sought.

The DeSantis budget proposal recommends $94.8 million in new Medicaid funding for people with disabilities and another $239 million to offset deficits that have accumulated in past years in the Agency for Persons with Disabilities.

The funding comes at a time when the Legislature is considering revamping the state's Medicaid waiver program for people with disabilities, commonly called the individual budget, or iBudget, program.

Valerie Breen, executive director of the Florida Developmental Disabilities Council, was pleased with DeSantis' recommendations but remained cautiously optimistic. Lawmakers will consider the recommendations during the legislative session that starts Jan. 14.

"The key will be to sustain this commitment throughout the 2020 session, with still much work to be done," Breen told The News Service of Florida.

Part of the money will be used to enroll 1,200 people who currently are on a waiting list into the iBudget program, which provides home- and community-based services to people instead of institutional care.

Health and human services, spread across six state agencies, makes up the biggest portion of DeSantis' proposed budget. Those agencies total $38.7 billion, with much of the money going to Medicaid services.

DeSantis included money in the proposal to hire a contractor to help implement a law passed this spring that is designed to lead to importing cheaper prescription drugs from Canada. Agency for Health Care Administration Secretary Mary Mayhew, who is helping oversee the effort, asked for $25 million, but the governor's budget recommendation was for $20.4 million.

DeSantis included the funding in his proposal even though the federal government hasn't moved ahead on rules necessary to make Florida's drug-importation program a reality. Florida maintains that the program can save upward of $150 million annually.

But DeSantis downplayed the lack of movement in Washington at a news conference Monday to roll out his budget proposal.

"I wish I could say that this will happen tomorrow, but I just know how Washington works and I know specifically when you get into something that is dealing with probably the most powerful industry in Washington --- -certainly one of the top two or three --- it just is never easy," he told reporters, referring to the pharmaceutical industry..

In a prepared statement, meanwhile, Mayhew said the funding would pay dividends.

"Making key investments in the Canadian Prescription Drug Importation Program will bolster the governor's efforts to improve access to safe, affordable prescription drugs and identify real cost savings within taxpayer funded programs," she said.

DeSantis's proposed spending plan does not include reductions in Medicaid spending for hospitals or nursing homes that care for poor, elderly and disabled people.

Also, DeSantis didn't propose redirecting hundreds of millions of dollars in Medicaid funds away from 29 hospitals with large Medicaid caseloads and toward Medicaid rates paid to all hospitals --- an issue that has drawn heavy debate in the past.

The Safety Net Hospital Alliance of Florida, which represents facilities that provide the most Medicaid care in the state, lauded DeSantis for keeping what it calls the "critical care fund" intact.

"This funding goes to ensure the poorest in our communities, mostly children, receive the very best care when they suffer from complex medical conditions like pediatric cancers or burns," alliance Chief Executive Officer Justin Senior said in a prepared statement. "The governor's protection of this funding means state dollars are truly following the patient because only certain hospitals in our state are able to handle a high volume of complex pediatric care and still have the very best outcomes."

On the public health front, DeSantis told reporters that he wants to continue using about $54.8 million in federal dollars to address opioid abuse in the state.

Moreover, DeSantis' proposed budget would give the Florida Department of Health the authority to spend $15.2 million in federal grants to help stop the spread of HIV and AIDS.

But the governor proposed eliminating 97 positions from the health department, making up most of the 141 positions he recommended for elimination across state government. The governor stressed that all positions he recommended for elimination are currently vacant.

While DeSantis stayed away from recommending cuts, the House already is reviewing health care spending for possible "reprioritization."

House Health Care Appropriations Chairwoman MaryLynn Magar, R-Tequesta, said last month that her spending panel will target $624 million in reductions across the six agencies that fall under her watch.

The $624 million "reprioritization" would equal about 5 percent of the state's general revenue going to health and human services. General revenue is the main building block of the state budget and comes primarily from sales taxes. It also draws billions of dollars in federal matching money.

While there aren't any across-the-board reductions to hospitals or nursing homes in the governor's recommendations, it would continue a controversial policy of eliminating a 90-day retroactive eligibility window for people to apply for Medicaid.

The policy, first implemented by former Gov. Rick Scott, reduces Medicaid spending. When it was approved by the federal government in December 2018, Florida was ordered to conduct an analysis to determine whether the change resulted in people enrolling in the Medicaid program quicker. The analysis has not been completed, according to the governor's office.

(©2019 CBS Local Media. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. The News Service of Florida's Christine Sexton contributed to this report.)