Money Short For Hospitals, Poor
Published: Apr 21, 2007
TALLAHASSEE - Rep. Aaron Bean opened Friday's negotiations over the state health care budget with a warning for patients and families.
"We've come to the reality that there's going to be a lot of folks that are going to go away empty-handed," said Bean, R-Fernandina Beach, the House's main budget writer for health and human services.
It was an ominous beginning for the joint conference committee, which is negotiating hot-button funding issues such as services for the developmentally disabled. Conference meetings continue today.
Funding for the disabled has risen to the fore of the budget battles, given the $153 million projected deficit at the Agency for Persons With Disabilities and the waiting list of thousands seeking services. Talk of budget cuts prompted a rally Thursday at the Capitol of hundreds of disabled people and their families. The event drew appearances - but no promises - from Gov. Charlie Crist and several leading lawmakers.
A Reality Check
Stark reality set in quickly Friday when Bean began the conference meeting with a presentation about the Agency for Persons With Disabilities. The number of disabled people served by the agency over the years has not kept up with its rate of spending, he said.
"A lot of folks think the solution for APD is just to appropriate new money," he said. "We don't think that's a solution in itself. We think that's just treating the symptom."
Bean's initial budget offer to the Senate reduced the House's original $1.17 billion proposal for the disabilities agency by $21.9 million.
That brought the House closer to the Senate's $1 billion appropriation and the agency's current funding level of nearly $1.1 billion. It drew protest from House Minority Leader Dan Gelber, who said the state needs to spend more of its revenue to plug the troubled agency's deficit, which partly is attributed to increased demand for services.
Gelber's concern stems in part from the House and Senate plans to overhaul one of the state's programs for the disabled. More than 19,000 people are waiting to enroll in the Home and Community-Based Services program, which provides up to 33 services and therapies. The chambers have proposed differing strategies to trim spending on the program by up to $120 million.
Bean said after the conference that he was leaning toward restricting spending per person but not the kinds of services offered - a concept embodied more in the Senate's approach than the House's. The Senate proposal would affect more people.
Bean said he's not settling on either plan yet.
One big-ticket item skipped Friday was funding for hospital treatment of the poor and uninsured.
For the first time, money that local counties and hospital districts send to the state will fall short of what's needed to draw down the maximum federal match.
IfFlorida fails to pitch in $65 million in state dollars, hospitals will lose $86 million in federal funding for Medicaid reimbursements and charity care this year.
The House budget sufficiently fills the gap, hospital advocates said, but the Senate plan omits the state money.
Bean said House and Senate leaders intend to negotiate the issue.
Hospital care of residents on Medicaid or without insurance entails a complex intermingling of local, state and federal funding.
If the Senate refuses to provide state revenue, hospitals could lose $209 million, said Jill Chamberlin, spokeswoman for House Speaker Marco Rubio, R-Miami.
Bay Area Would Feel The Appeal
Tampa General Hospital could lose $10.67 million, and All Children's Hospital in St. Petersburg risks losing $5.38 million.
"To me it's a major priority," said Sen. Nan Rich, D-Weston. "We need to put our general revenue in; this would hurt our hospitals too badly."
Rich is a longtime supporter of reinstating KidCare coverage of legal immigrants excluded from the state's insurance program for low-income children.
Despite the governor's support, she said, things are looking bleak.
The House agreed this year to lift the state's freeze on enrolling children of state employees and certain categories of legal immigrants, but so far it has provided funding only for the employees' children.
Covering either group of children costs the state extra because they do not qualify for federal matching dollars.
A plan to cover both groups was progressing through the Senate but hit a wall this week when a committee removed the language from its KidCare plan. Crist said Thursday he supports enrolling immigrant children, but no funding has emerged in either chamber.
Advocates said they hope House and Senate leaders will find $5 million for the initiative somewhere in the $71 billion state budget.
House and Senate negotiators are expected to take up the proposed $5 million for state employees' children next week.
Reporter Catherine Dolinski can be reached at 
(850) 222-8382
or cdolinski@tampatrib.com.
posted by Unknown @ Saturday, April 21, 2007
