Lawmakers want state economists to examine costs, need for Medicaid developmental disability programs

Carlos Guillermo Smith presses for the bottom line of legal costs.

Florida’s top economists could be taking a closer look at the number of people with developmental and intellectual disabilities in Florida who require home- and community-based services.

Those services can help those with disabilities live in the community and outside of institutions. A pair of lawmakers have filed bills that require state economists from the Florida Legislature, the Governor’s Office and the state’s Medicaid program to provide lawmakers with information about projected enrollment and costs.

The economists, who meet quarterly at the Social Services Estimating Conference Committee, delve into the minutia impacting Florida’s Medicaid program and develop enrollment projections as well as Medicaid cost estimates.

Lawmakers rely on the Medicaid projections as they build state budgets. However, the Social Services Estimating Conference does not provide lawmakers with enrollment and cost projections for the Medicaid iBudget.

Rep. Carlos Guillermo Smith, an Orlando Democrat, told Florida Politics last week the exclusion from the Social Services review is purposeful.

“They don’t want to shine the light on what they are most embarrassed by, which is that we have left so many Floridians with disabilities behind,” Smith said. “But that’s my goal. My goal is to shine the light on this tremendous need that exists. Many lawmakers do not even know that the APD waitlist is 22,000 persons long and that 40% of people on that list have been on it for more than 10 years. They are shocked to find out. They should be shocked. They should be appalled. And I hope that that brings them into action in joining us trying to make this investment.”

To that end, Guillermo Smith on Tuesday filed HB 1569. In addition to requiring the Social Services Estimating Conference to develop iBudget enrollment and cost projections, the bill also requires conference members to provide projections on the number of people on the waitlist for iBudget services.

iBudget, a Medicaid waiver program, serves people with intellectual and developmental disabilities. Administered by the state Agency for Persons with Disabilities, the program enables people to access several home- and community-based services that can help people with daily living activities such as bathing, grooming and eating. Medicaid doesn’t traditionally cover home- and-community based services, so Florida offers them through the iBudget waiver program.

Because the home- and-community based services are not a Medicaid “entitlement,” the state can maintain a waiting list for iBudget services. More costly institutional care, though, is a Medicaid entitlement.