By James L. Dean, Freelance Writer
The 2011-12 budget that was passed by the Florida Legislature and just signed into law by Gov. Rick Scott failed to give the Agency for Health Care Administration (AHCA) budget authority to draw down and spend the money; an oversight or tactic that would cause overwhelming disappointment among Democratic lawmakers and Patient advocates since the money would have paid the cost of home-and community-care programs; allowing, among other things, disabled and elderly residents of nursing homes to move out, or avoid nursing homes altogether, as the MFP grant intended.
“It’s particularly appalling, considering the Legislature just cut funds to nursing homes,” said Jack McRay, AARP Florida lobbyist. And it won’t stop there. The health care 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, and questions sent to the Centers for Medicare and Medicaid Services Friday were not immediately answered.
Florida was one of 13 States that were awarded the grants from the Department of Health and Human Services (HHS) 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 changes its mind or whether HHS will give the grant to some other state.
According to Patient advocates, 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 Patient Protection and Affordable Care Act. Florida is leading a multi-State challenge of the health law in federal court, saying that it’s unconstitutional because it requires all Americans to obtain health coverage or pay a penalty.
“Money Follow the Person” is a part of The President’s New Freedom Initiatives—first authorized by Congress as part of the Deficit Reduction Act of 2005 and then extended by the 2010 Patient Protection and Affordable Care Act—is designed to shift Medicaid’s long-term care spending from institutional care to Home and Community Based Services (HCBS). With $4 billion (or 350 million dollars to states per year for five years for a total of 1.75 billion dollars) in federal funds authorized by Congress, the MFP supports a twofold effort by state Medicaid programs to transition people living in nursing homes and other long-term care institutions to homes, apartments, or group homes of four or fewer residents, and to change state policies so that Medicaid funds for long-term care services and support can “follow the person” to the setting of his or her choice. For additional information, visit
http://www.olmsteadva.com/mfp/downloads/rfp.pdf or http://www.mathematica-mpr.com/publications/PDFs/health/mfpfieldrpt5.pdf
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