Medicaid Archives - Page 2 of 39 - Florida Politics

Rick Scott treads carefully about Obamacare lawsuit

Despite being a fierce critic of the Affordable Care Act, Florida Gov. Rick Scott isn’t saying where he stands on the Donald Trump administration’s refusal to defend the federal law against the latest legal challenge brought by 20 Republican-led states, including Florida.

Scott on Wednesday avoided directly discussing the litigation, which, if successful, could dismantle changes to how insurance is bought and sold in the state, including eliminating protections for people with pre-existing conditions.

“I believe that if you have a pre-existing condition, you need to still be able to get health care. So it’s very important to me,” Scott, who is running for U.S. Senate, said when asked about the litigation. “I believe everybody ought to be able to get health care insurance.”

Scott, Florida Attorney General Pam Bondi and other Republican leaders have consistently opposed the sweeping health care law — often referred to as Obamacare — that has helped lower the percentage of uninsured citizens in the state and nation.

Florida’s uninsured rate in 2013, the year before Obamacare plans became available, was 20 percent and one of the highest in the nation. In 2016, the rate was 12.5 percent.

Florida also has consistently led the nation in the number of people who enroll in the federal health-insurance exchange under the law. Last year, more than 1.7 million Floridians entered the marketplace to buy a plan. The vast majority, more than 90 percent, received federal financial help to reduce their monthly premiums.

Longtime Florida Republican political consultant Mac Stipanovich said Scott is carefully choosing his positions so he doesn’t alienate Trump supporters while trying to defeat Democratic U.S. Sen. Bill Nelson in the fall.

“You have to be careful about criticizing Trump if you want to continue to enjoy the unreserved support from the Trump base,” Stipanovich told The News Service of Florida.

Bondi signed on this year to the lawsuit challenging the Affordable Care Act. The litigation gained new urgency last week after the Trump administration said it would not defend key portions of the law.

Whitney Ray, a spokesman for Bondi, said the attorney general believes people with pre-existing conditions should have access to coverage.

“But Congress must act in accordance with the U.S. Constitution when addressing the issue,” Ray said in a written statement.

If the suit is successful, it would do away with key parts of the law that require insurance companies to sell health policies to people regardless of pre-existing conditions and prevents charging more because of the conditions. The provisions benefit people who aren’t covered by employer-based plans or Medicaid.

Except for a brief period when Scott supported an expansion of Medicaid, Stipanovich said the governor “has been consistently opposed” to the Affordable Care Act or policies like it.

“I think that is something he cannot deny. And I’m not sure he would deny. Whether it turns out to be important in November or not as opposed to offshore drilling or gun control or immigration is a totally different issue,” Stipanovich said.

Florida Democrats are aggressively trying to make Scott’s opposition to the Affordable Care Act an issue. Democrats in the state’s congressional delegation sent a letter Wednesday to Scott calling on the state to immediately withdraw from the lawsuit, which is led by Texas.

“If successful, this dangerous lawsuit that you and Attorney General Bondi have joined will harm roughly 130 million Americans, including 7.8 million Floridians, who have a pre-existing condition,” the Democratic lawmakers wrote. “And it will take us back to a time when health insurers oftentimes outright rejected, or offered severely limited coverage to, Americans with such conditions.”

Democrats also have launched what they are calling “The Time is Now: Medicaid Expansion Tour” to promote Medicaid expansion in the state. The tour, which started in Gainesville, will highlight how Scott flipped his position on Medicaid.

Scott initially ran for governor in 2010 on an anti-Obamacare platform but said in 2013 he supported a three-year Medicaid expansion and described it as a “compassionate, common-sense step forward.”

During his campaign for re-election in 2014, Scott reiterated his support for the expansion, which was available to all states under the Affordable Care Act. After getting re-elected, though, Scott reversed his position and adamantly fought against efforts by the Florida Senate to expand Medicaid in 2015. The proposed expansion died in the Legislature.

A group called Floridians for a Fair Shake, held a press conference this week to highlight the litigation against the Affordable Care Act because of the potential impact it would have on people with pre-existing conditions. Stephen Gaskill, the group’s communications director, called pre-existing condition protections the most “compelling part of health care reform overall.”

Prior to the federal law, insurance companies could charge higher premiums based on pre-existing conditions or the use of health care services. The federal law also established adjusted community rating, which barred insurers from raising premiums based on health status, medical claims or gender, among other things.

While Scott did not directly address the Trump administration’s actions, he briefly outlined changes he thinks could lower health-insurance costs.

Scott said the changes should be incremental but said he supports “allowing more competition (among insurers), we gotta let people buy the insurance that fits for their family and we’ve got to reward people for taking care of themselves.”

Children lacking health insurance up slightly

While Florida has made strides in reducing the number of uninsured children, a national health-care expert warned Thursday that those gains are likely stalling, and she put part of the blame on increased scrutiny of immigration status.

Joan Alker, executive director of the Washington-based Center for Children and Families, said data released late last month by the National Center on Health Statistics shows that the number of uninsured children in Florida in 2017 rose slightly to 7.6 percent.

Alker said that while the small rise — from 7.4 percent the previous year — may be statistically insignificant, it could be “an early warning sign” that Florida’s seven-year trend of lowering uninsured rates for children is at risk.

She attributed the increase in part to attrition of what she called “mixed” families, or families where a parent is an immigrant and the child is either a citizen or legally residing in the state.

“Because of all the intimidation that is happening right now with immigrant families, we’ve heard lots of anecdotal evidence that they are very reluctant now to sign their kids up for coverage,” said Alker who has spent years observing Florida’s government-subsidized health insurance programs.

She suggested that other factors that could have played a factor in the slight hike include congressional efforts to repeal the Affordable Care Act and a push to restructure the Medicaid program and reduce funding.

State Agency for Health Care Administration spokeswoman Mallory McManus said she wasn’t aware of the new data and said that “ensuring that children have access to health care has always been a priority of our agency.”

Combined, the subsidized Children’s Health Insurance Program and Medicaid provide coverage to an estimated 44 percent of the children in the state.

The National Health Interview Survey data is collected through personal household interviews. Alker called the data an “early sign,” but said that the release in September of information from what is known as the American Community Survey will provide additional insight about health insurance. The American Community Survey is the largest household survey conducted by the Census Bureau.

While the 2017 percentage increase was small, Alker said it shows that Florida lost ground while states such as Texas and California continued to make progress. Those states lowered their uninsured rates by 1 percent and 1.4 percent, respectively.

Alker made the remarks during a webinar where she discussed a new report called, “The New Federal Children’s Health Insurance Law and What it Means for Florida’s Children.”

It is one of a series of reports that Alker has conducted about health insurance for Florida children and was funded by the Florida Blue Foundation, the Health Foundation of South Florida, the Space Coast Health Foundation and the Winter Park Health Foundation, among others, operating under the Florida Philanthropic Network.

The report examines the impact of two recently passed extensions of the Children’s Health Insurance Program and what they mean for the state. CHIP funding expired last year, and many states, such as Florida, were forced to operate the program on carry-over funds from previous years. Congress agreed to extend CHIP funding in January and again in February.

CHIP funds subsidized insurance coverage for more than 345,000 children in Florida.

Under the extensions, Alker said Florida cannot make any future changes to the CHIP program that would make it more cost- restrictive, including increasing co-payments.

Health plan to challenge Medicaid contracts

A decision last week to award Medicaid contracts to two additional managed-care plans could mean more legal challenges for the state Agency for Health Care Administration.

Attorneys for Molina Healthcare filed a notice with the state Tuesday announcing the HMO’s intention to challenge the agency’s decision last Thursday to award contracts to Miami Children’s Health Plan and Lighthouse Health Plan.

The HMO has 10 days to file a legal petition with the state.

The Agency for Health Care Administration has gone through a lengthy process to award new contracts in the Medicaid system, which requires most beneficiaries to enroll in managed-care plans. In April, the agency announced a decision to award five-year Medicaid contracts, which one official has estimated to be worth upwards of $90 billion in all, with nine HMOs.

That decision drew challenges from a dozen health plans that were not chosen for contracts, including Molina Healthcare.

Under a 2011 law that called for the statewide use of Medicaid managed care, AHCA is awarding contracts in 11 different regions. The number of contracts varies by region.

Last week, AHCA announced that it was awarding additional contracts in Medicaid regions 9 and 11 to Miami Children’s Health Plan, which is affiliated with Nicklaus Children’s Hospital. Region 9 goes from Indian River County south to Palm Beach County and Okeechobee County, while Region 11 is made up of Miami-Dade and Monroe counties.

The state also announced that Lighthouse Health Plan would be given a contract in Medicaid Region 1, which includes the western counties of the Panhandle. Lighthouse is affiliated with Pensacola-based Baptist Health Care.

Molina’s notice filed Tuesday dealt with the additional contract awards.

Miami Children’s Health Plan and Lighthouse Health Plan are what are known as provider-sponsored networks because they are owned and operated by health-care providers. If the contract awards stand, they will provide “managed medical assistance” services, which involve the bulk of Medicaid beneficiaries and range from childhood checkups to surgeries.

Other health plans awarded contracts are expected to provide what AHCA describes as “comprehensive” services. In addition to managed medical assistance services, comprehensive plans would offer long-term care such as skilled nursing services.

Overall, Florida’s Medicaid program provides care for nearly 4 million poor, elderly and disabled people, with 85 percent of beneficiaries enrolled in managed-care plans. The new five-year contracts are slated to go into effect Jan. 1, which means the state would need to advise patients of the available new plans beginning in the fall.

Julio Fuentes: Florida lives depend on naloxone co-prescriptions

As the nationwide opioid epidemic continues to destroy families, communities and lives across the country, Congress is currently considering dozens of bills to address this public health crisis. Their action is critical, and time is of the essence.

In 2016, more than 4,000 Floridians fatally overdosed on opioids. Fortunately, in 2016 Florida also passed a law allowing health care practitioners to provide naloxone to patients, caregivers and first responders. This life-saving, overdose-reversing drug kept our death toll from being much higher.

As Congress deliberates legislation to combat the opioid epidemic, expanding access to naloxone through co-prescription should be a top priority. The Surgeon General has emphasized the importance of naloxone co-prescriptions for certain patients at an increased risk for opioid misuse, including certain Medicare and Medicaid patients. The Center for Disease Control (CDC) has also come to the same conclusion.

Opioids are incredibly unpredictable, and even when taking medication as prescribed, patients can still accidentally overdose. That’s where naloxone comes in.

Opioid addiction and misuse do not discriminate based on age, gender or skin color. We are all at risk. As the president and CEO of the Florida State Hispanic Chamber of Commerce, I am especially concerned about the impact on our Hispanic community.

Opioid-related fatalities among Hispanics increased by more than 50 percent between 2014 and 2016.

Older Americans are at risk, too. A recent Washington Post article discusses the opioid crisis’ impact on the elderly, and states: “One in three older Americans with Medicare drug coverage are prescribed opioid painkillers.” Here in Florida, that statistic is especially concerning, because we have such a high population of seniors.

It is extremely important to arm at-risk patients with the potentially life-saving tool they need to avoid fatal overdoses. The federal government must follow their own advice and help increase access to naloxone.

Despite its potentially life-saving ability, naloxone is still not readily available to all CDC-recommended patients. One main reason is cost, which is why federal funding is so important. And, co-prescriptions are cost-effective, and can actually save the government more money in the long run. A National Institute of Health (NIH) study found patients receiving naloxone co-prescriptions had 63 percent fewer emergency room visits in one year compared to patients without a co-prescription. Considering Medicaid and Medicare pay for more than 50 percent and 68 percent of opioid-related emergency room visits, this policy change is also a fiscal win.

Encouraging co-prescription for Medicare and Medicaid patients and those at-risk individuals identified by the Surgeon General is a powerful first step toward reversing accidental opioid overdoses.

It is up to us to urge lawmakers, such as Florida Reps. Gus Bilirakis and Kathy Castor, to mandate co-prescription in future legislation.

Our priority should be to preserve life at any cost.


Julio Fuentes is the president and CEO of the Florida State Hispanic Chamber of Commerce.

Humana makes changes in Capitol, parting ways with Jon Bussey

After scoring a big victory in a statewide Medicaid managed-care procurement, Humana and Jon Bussey, who served as its regional director of corporate affairs, have parted ways.

Humana Director of Corporate Communications Mark Mathis confirmed the separation in an email to The News Service of Florida, saying the company made a decision last year to “restructure our Tallahassee government affairs team to align with new business strategies.”

According to his LinkedIn profile, Bussey was the health insurance company’s principal representative before state executive, legislative and regulatory bodies, including departments of insurance as well as state health and Medicaid agencies, in Florida, Louisiana, Mississippi, Texas, North Carolina and South Carolina. In the profile, he said he was responsible for providing strategic support on policy, political, public-sector procurement and regulatory matters, including commercial, long-term-care, Medicaid and Medicare and specialty insurance products.

The Florida Agency for Health Care Administration announced April 24 its decision to enter into five-year Medicaid contracts worth up to $90 billion with nine Medicaid managed care plans. If the decision stands, Humana will operate statewide.

Twelve managed care companies have filed petitions with the state notifying Medicaid officials of their intent to legally fight the decisions if changes aren’t made.

AHCA Secretary Justin Senior, Medicaid director Beth Kidder, and three other agency staff members have been meeting with the companies this week in hopes of avoiding litigation.

Bill Nelson, Democrats blast proposed Medicaid cuts

U.S. Sen. Bill Nelson and Democratic U.S. House members Thursday called for the federal Centers for Medicare & Medicaid Services to reject a move by Gov. Rick Scott’s administration to cut $98 million by trimming the length of time people have to apply for the Medicaid program.

“I rise here today because the state of Florida has again proposed to harm thousands of seniors and folks with disabilities who rely on Medicaid for their health care,” Nelson, a Democrat who faces an election challenge this year from Scott, said on the Senate floor.

Nelson, along with U.S. Rep. Kathy Castor and 10 other Democratic members of Florida’s congressional delegation sent a letter to CMS Director Seema Verma urging her to reject a proposed amendment to a state Medicaid “waiver” that would exempt Florida from a federal requirement that gives people up to 90 days following a health problem to apply for Medicaid coverage.

The Scott administration proposed — and the Republican-led Legislature agreed — to require people to apply for Medicaid during the same month of the health event.

“Retroactive eligibility is designed to protect Medicaid beneficiaries — including seniors, pregnant women, individuals with disabilities, and parents — and their families from the steep costs of medical services and long-term care. Importantly, this protection was also designed to minimize uncompensated care costs faced by hospitals and other health care providers who take care of our neighbors and are already challenged by the state’s low reimbursement rates,” the letter said.

The state Agency for Health Care Administration estimates that 39,000 people could be impacted by the change. Hospitals and nursing homes, though, say the numbers could be much higher.

The change has become a flashpoint between Democrats and Scott.

“It is our duty to ensure eligible individuals have access to care without going into debt to obtain it, which is why retroactive eligibility is so vital. This proposal would not only wipe out many families’ pocketbooks, but it would also place a financial burden on health care providers, the state and indeed all Florida taxpayers through increased uncompensated care costs,” the letter said. “We fail to see how this proposal will ‘enhance fiscal predictability’ as the state claims when it will increase costs across the board.”

But Mallory McManus, a spokeswoman for the Agency for Health Care Administration, issued a statement Thursday saying it is “categorically false to assert that this change impacts the care” provided to Medicaid beneficiaries.

“Florida continues to focus on quickly enrolling Florida’s most vulnerable people including children, frail elders, those with disabilities and pregnant women,” the statement said. “By enrolling individuals quickly, you ensure better-coordinated fully integrated care, as well as access to preventative services.”

Health plans mount challenges over Medicaid contracts

Twelve managed-care companies challenging the state’s award of tens of billions of dollars in Medicaid contracts have spelled out their arguments about why Florida officials were wrong in the handling of the coveted multi-year deals.

The filings allege a long list of errors by the Agency from Health Care Administration ranging from math mistakes, to not finishing reviews on time, to awarding a contract to a vendor that submitted the wrong bid.

In some cases, the petitions allege wrongdoing by rival health plans.

The challenges by the managed-care companies reflect the high stakes surrounding Florida’s massive Medicaid program. If the initial contracting decisions stand, some companies will be shut out of the managed-care program for the next five years.

The 12 plans filed challenges in 11 regions across the state for decisions involving a variety of health care services, including comprehensive care and specialty care such as providing services to people with mental-health issues or HIV and AIDS. In all, the companies filed 88 petitions by a Monday deadline.

Chief among the companies protesting the state’s handling of the contracts is Molina Healthcare, which currently has a footprint in eight of the state’s 11 Medicaid regions. The health plan applied for openings — through a process formally known as an invitation to negotiate — in all 11 regions but wasn’t among the top-scoring plans chosen by AHCA for negotiations.

Lawyers for Molina argue, among other things, that agency staff made mathematical errors throughout the scoring process. They contend the state was required to average scores of three different evaluators to determine top-ranking health plans but, instead, used aggregate scores.

Tallahassee attorney Robert Vezina wrote that AHCA’s alleged failure to follow criteria about scoring and ranking was “clearly erroneous, contrary to competition, and arbitrary and capricious” and made the “entire procurement process fundamentally and fatally flawed.”

Molina is requesting that if the disputes cannot be amicably resolved that the state be required to start over with a new procurement process.

The Agency for Health Care Administration went through a lengthy process before it announced its April 24 decisions to award five-year contracts to nine managed care plans. For contracting purposes, the state is divided into 11 regions. State law establishes a minimum and maximum number of plans that can operate in each of the 11 areas.

This is the second such procurement since the Florida Legislature passed a law in 2011 mandating that most Medicaid patients enroll in managed-care plans. A top Medicaid official has said that the new contracts, in aggregate, could be worth up to $90 billion.

The new contracts also have the potential to upend parts of the existing Medicaid program because, in some instances, existing providers would be eliminated. Magellan, a long-standing Medicaid provider specializing in mental-health services, would be locked out of the managed-care program if the agency decisions remain intact.

Attorneys for Magellan allege in filings that numerous mistakes and errors were made during the procurement process. The plan argues that competitor Staywell was awarded a Medicaid contract to provide mental-health services to patients in Medicaid Region 2 despite not submitting a bid for the area, which stretches across 14 counties in Northwest Florida, including Leon County.

Magellan’s attorneys argue that Staywell erroneously responded to the invitation to negotiate in Region 2 by submitting its response to the so-called ITN for Region 5, which covers Pasco and Pinellas counties.

State evaluators “noted the discrepancies,” according to Magellan’s petition, but “there is no evidence that AHCA requested, or that Staywell submitted, a corrected Region 2 response.”

Magellan’s attorneys are asking that AHCA award a contract to Magellan or, alternatively, reject all specialty-plan submissions and conduct a new procurement.

Not all plans that filed petitions with the state would be locked out of the Medicaid program in the coming years. For instance, UnitedHealthcare was awarded contracts in Medicaid Regions 6 and 11 for comprehensive care, which includes long-term care services as well as traditional health care covered under Medicaid.

But United also wanted contracts statewide to provide services to people with serious mental illnesses and was shut out of that market. United filed 11 petitions — one in each region — challenging those decisions. United alleges in its petitions that AHCA agreed to extend an internal deadline for a trio of evaluators to complete their work but that time ran short before one of them — “evaluator No. 3” — could finish the review.

According to United’s petition, “evaluator No. 3” completed 20 percent of the task by the Dec. 29 extended deadline and executed what is known as an “independent evaluators certification.” The certification stated that any plan that scored a zero “was intended to score a zero”

But United attorney Seann Frazier argued that a score of zero should only be given if the vendor didn’t provide a response. Frazier said that “in reality,” a large number of the components in the ITN were scored by two, and not the required three, evaluators.

Not all of the allegations of wrongdoing were leveled against the state, though. In filings for Simply Healthcare, attorney Robert Hosay accused competing health plans of not following rules.

For instance, the ITN required health plans to disclose their largest out-of-state Medicaid contracts. But Hosay argued that Humana — which could operate statewide if the agency’s decisions stand — failed to disclose an out-of-state contract it has in Wisconsin or report on how the plan performed on certain quality-of-care measurements.

The contract is with a company called iCare, which is a joint venture between Humana and the Centers for Independence, a Milwaukee-based non-profit rehabilitation provider.

Hosay also alleged in the petitions that Staywell was not truthful when it disclosed that its Medicaid contract had been terminated in Iowa in December 2015. Staywell attributed the termination to bid protest proceedings, but Hosay argued the disclosure was misleading.

“In reality, WellCare’s Iowa contract was terminated as a result of unfair bidding practices on WellCare’s part being discovered, including a violation of bidding rules and an attempt to acquire an unfair advantage over competing bidders,” wrote Hosay, referring to Staywell’s parent company.

Democrats say Medicaid cut information wrong

Incoming Florida Senate Minority Leader Audrey Gibson sent a letter Monday to the federal government accusing Gov. Rick Scott’s administration of falsifying the record to show support for a $98 million Medicaid reduction and asked for a “thorough review” of the proposed cut, which would impact an estimated 39,000 people.

“I felt compelled to ensure (the federal Centers for Medicare & Medicaid Services) has no misunderstanding as to opposition on this ill-advised move targeting seniors and families facing catastrophic health care emergencies,” Gibson, a Jacksonville Democrat , wrote to CMS Administrator Seema Verma.

Florida is asking the federal government to approve limiting the length of time people have to qualify for the Medicaid program. The issue is known as Medicaid retroactive eligibility. Federal law has long required states to give people 90 days to apply for the program following a health issue.

At the behest of the Scott administration, the Legislature during the 2018 Session approved requiring adults who aren’t pregnant to apply for the Medicaid program the month they required the health services. Florida submitted the request to the federal government last month.

State Medicaid Director Beth Kidder sent a letter to CMS Project Officer Vanessa Khoo last month accompanying the request, saying she was not “not aware of any concern or opposition raised by any member of either party regarding this provision during extensive budget debate.”

Kidder also went on to say that the $98 million reduction “cannot accurately be described as a cut.”

In her letter Monday to Veema, though, Gibson noted that several Democrats flagged the $98 million cut while raising questions on the Senate floor about who would be impacted and what would happen to them.

“AHCA’s proposal to cut off an entire population of powerless citizens and their families in the midst of a catastrophic medical emergency lacks innovation for improving outcomes and ultimately may push more costs to largely safety net hospitals who already bear a tremendous cost burden, particularly in light of rejection of Medicaid expansion in Florida,” Gibson wrote in her letter.

This is not the first time the agency’s correspondence regarding the change has come under fire.

In a March 2017 letter to the federal government, state Agency for Health Care Administration Secretary Justin Senior said reducing Medicaid retroactive eligibility could save as much as $500 million annually. But that figure was reduced to $98 million months later.

AHCA said the $500 million estimate included health care costs for pregnant women and children and that the $98 million figure was only for non-pregnant adults.

Joan Alker, executive director of the Georgetown University Center for Children and Families who has extensively studied Florida’s Medicaid program said the explanation can’t be right. That’s because children account for only 20 percent of total spending in the program.

Report targets AHCA over nursing home verifications

The state Agency for Health Care Administration failed to verify that nursing homes properly corrected deficiencies cited by agency staff in 2015, according to a report issued Friday by the U.S. Department of Health and Human Services inspector general’s office.

Federal officials are recommending that the state improve practices for verifying that deficiencies have been corrected.

The Agency for Health Care Administration did not agree with the Office of Inspector General’s findings and asked that federal officials change the name of the audit titled, “Florida Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid.”

The inspector general reviewed 100 deficiencies at nursing homes across Florida that were flagged by regulators in 2015 and found that the agency verified the correction of 82 deficiencies.

According to the report, the state agency did not obtain evidence of correction — or sufficient evidence of correction — for the remaining 18 deficiencies. Based on those findings, the Office of Inspector General estimated that the state agency failed to obtain evidence of corrections for 455 of 2,381 deficiencies cited at facilities that participated in Medicare and Medicaid.

Moreover, the report estimated that the state didn’t provide sufficient evidence that corrections had been properly made for another 130 deficiencies.

Agency for Health Care Administration spokeswoman Mallory McManus downplayed the findings, saying the report involves a small number of “isolated incidents in 2015 at nursing facilities that did not involve patient harm” and said the agency has since changed its operations.

Federal regulations require nursing homes that participate in Medicare and Medicaid to submit correction plans to the federal Centers for Medicare & Medicaid Services or to the proper state agency. State agencies must verify the correction of deficiencies by obtaining evidence or through onsite reviews.

But according to the report released Friday, a state official told a federal auditor that AHCA’s practice for less-serious deficiencies was to accept the nursing homes’ correction plans as confirmation of substantial compliance. The report noted that an AHCA official cited a section of a federal manual that allowed for the practice.

But the inspector-general report said the cited section of the manual “is not applicable to nursing homes. …  Without verification of evidence of correction, the state agency cannot ensure CMS that nursing homes have complied with federal participation requirements and that residents are adequately protected.”

AHCA Secretary Justin Senior wrote a three-page letter in February on the findings and recommendations. In it, Senior said the “18 deficiencies in question were isolated incidents (not patterns or widespread), and none of them involved patient harm or immediate jeopardy. We are therefore concerned that the title significantly misrepresents the findings for Florida.”

A copy of the report is here.

Child care, health insurance and housing are ‘fiscal cliffs’ for Florida families

State and federal programs aimed at helping low-income Florida families aren’t working, according to a new report from the Florida Children’s Council.

“Positive child and youth outcomes, financial stability for families, and economic vitality for businesses are interrelated goals. There is clear need to rethink social service policy and align work-based solutions with child and family supports,” said Dr. Brittany Birken, CEO of the Florida Children’s Council. “These two-generational strategies provide a framework for developing systems that support strong child and youth outcomes within the context of family.”

The report, released Monday, studied the impact of Temporary Assistance for Needy Families, Supplemental Nutrition Assistance Program, block grants for school readiness, the Earned Income Tax Credit, Medicaid/Florida CHIP, and Section 8 housing vouchers on household budgets.

The combination of social programs were found to be lacking in the report, which concluded that if “children from low-income homes are to reach their full potential, there is a significant need to eliminate the current silos addressing adult-oriented and child-oriented programs separately.”

The Council report demonstrated the financial “break even” points for single adults without children and compared them to a household with a single working parent who has two children. Both models assumed the households were in Miami-Dade County.

The report found a household where a single parent earns $11,000 a year could “break even” through the use of social program, and the same was true as the parent’s income increased to about $40,000 a year.

Once past that mark however, net resources plummet – a single parent earning between $40,000 a year and $53,000 is likely to see negative income between $3,200 and $8,000 each year.

Single adults start to break even at about $15,000 a year in earnings, with incomes over $25,000 a year generally allowing them to have cash left over once their expenses are paid.

Such losses as a parent’s income rises were attributed to three “fiscal cliffs” –  children’s health insurance, child care, and housing. Each of those cost categories contributes to what the report calls “parking,” where a working parent is disincentivized from earning more money due tin order to maintain eligibility for social programs.

“Florida is a vibrant and growing state that has its share of opportunities and challenges.  To ensure that we secure paths to prosperity for all Floridians, especially the nearly one million kids living in poverty, we must focus on bold and broad strategies that consider two-generation approaches,” said Tony Carvajal, Executive Vice President of the Florida Chamber Foundation.  “Targeting policies that trap families in fiscal cliffs or create hurdles to self-sufficiency should be job one.”

Of the three cliffs, quality child care stood out as “perhaps the singularly most important social service in recognition of its impact on the entire family while providing clear economic benefit to employers and communities.”

“There are systemic barriers that hinder a family’s ability to become economically self-sufficient,” said Cindy Arenberg Seltzer, chair of the Florida Children’s Council and Executive Director of the Children’s Services Council of Broward County. “By strategically aligning systems of care, we can ensure that all children live in stable and nurturing environments.”

The Council’s findings will be addressed during the upcoming Florida Business Leaders’ Summit on Prosperity And Economic Opportunity being put on by the Florida Chamber. The event will be held in Orlando on Wednesday and Thursday.

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