Lawmakers want state economists to examine costs, need for Medicaid developmental disability programs
Carlos Guillermo Smith presses for the bottom line of legal costs.

Could this be the year that Lawmakers require economists to provide Medicaid iBudget cost and need projections?

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.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


  • Alex

    January 11, 2022 at 3:00 pm

    “40% have been waiting 10 years to get on the program”

    But DeFascist wants to spend millions on his little private army, and his voter fraud task force to chase Dem fraudsters that only exist in his little mind.

  • Sandy Adams

    January 12, 2022 at 7:09 pm

    Thank you Rep. Guillermo Smith for prioritizing this issue.The disable and their long suffering families need help NOW! They’re hurting and they deserve to live with dignity!

  • May Navarro

    January 19, 2022 at 1:47 pm

    I’m hurting right now, my son is 21 yrs old born DS/autism/adhd.. and I’m a single mother wrkn partime n when my son is sick got to stay with him and means no work no pay. Why people who really needs help can’t get services My Son is in a crisis, despite with all the documents by the doctors, psychologists,schools still can’t have services… this is Sad! They deserve to live dignity…

  • Padrica Davis

    January 23, 2022 at 10:42 am

    I have been providing services for 10+ years. It’s a shame how the program has changed with wanting the provider to pay money back if the timesheets are not in the iconnect. We don’t live in a perfect world so as a provider my main concern daily is to make sure none of the clients that I serve ever go without their services. To me that’s mandatory!!!! That’s my agency’s constant. They only pay 2.92 per unit for life skills1. They only pay 3.86 per unit for personal support and 3.81 per unit for respite. That’s a shame and expect us to get the job done. There is not one policy maker that could walk an hour in a provider shoes on any given day. Like I said WE do not live in a perfect world that’s why the policies are not working. Listen to the ppl that are out here doing the job to find better positive solutions for a very broken system. I thank God for Governor Smith he’s doing an amazing job.

Comments are closed.


Florida Politics is a statewide, new media platform covering campaigns, elections, government, policy, and lobbying in Florida. This platform and all of its content are owned by Extensive Enterprises Media.

Publisher: Peter Schorsch @PeterSchorschFL

Contributors & reporters: Phil Ammann, Drew Dixon, Roseanne Dunkelberger, A.G. Gancarski, Anne Geggis, Ryan Nicol, Jacob Ogles, Cole Pepper, Gray Rohrer, Jesse Scheckner, Christine Sexton, Drew Wilson, and Mike Wright.

Email: [email protected]
Twitter: @PeterSchorschFL
Phone: (727) 642-3162
Address: 204 37th Avenue North #182
St. Petersburg, Florida 33704