In an effort to bolster the state’s home- and community-based services network, the Gov. Ron DeSantis administration late last summer agreed to tap into $1.2 billion in additional federal Medicaid funds.
More than six months later, the state hasn’t distributed any of the supplemental funds and providers don’t know when to expect the payments. They also don’t know how much to expect because the state did not finalize the distribution formula it was going to use to disburse the funds.
Attain Inc. has taken out two small business loans since September when the state announced it received approval from the federal government to use the funds, said Craig Cook, executive director of the not-for-profit agency that has been providing residential services to people with disabilities in central Florida since 1988.
The loan money, Cook said, is being used to cover deficit spending, the result of years of stagnant Medicaid reimbursement rates and a tight long-term care labor market that was made worse by the COVID-19 pandemic.
“We were given hope,” Cook said of the supplemental Medicaid payments. “But now, it’s like there’s no help at this point, because nothing is being realized.”
Cook, and many other providers like him, thought that the state would have distributed the supplemental payments by now. And according to documents submitted to the federal government, the state intended to have the payments distributed by winter 2022.
Agency for Health Care Administration Communications Director Brock Suarez did not comment on why the funds were delayed.
Cook’s application for funds was one of more than 2,400 received by the agency before the Feb. 14 deadline.
The agency announced late last year it would award the supplemental payments in two rounds. More than $680 million was made available during the first round of funding and the state would accept applications between Dec. 17, 2021 and Feb. 14, 2022.
The money was divided into three silos: $405 million in grants for provider stipends, $266.6 million for retaining employees and recruiting new ones, and $12 million for delayed egresses.
Providers could apply for funds from more than one silo.
And they did.
Of the more than 2,400 applications received, 89% of them were for one-time stipends and 82% of the applications were for retention funds. That’s according to Kristin Sokoloski, a Medicaid program coordination administrator.
Sokoloski told members of a Medicaid medical advisory committee that assisted living facilities, home- and community-based service providers, home health agencies and case management agencies qualified for supplemental Medicaid funds during the first round of funding.
The majority of the applications received, 70%, were submitted by home- and community-based providers. Of those providers, 70% worked with people enrolled in the Medicaid iBudget Waiver program, according to Sokoloski’s presentation to the committee.
Jim DeBeaugrine is the former director of the state Agency for Persons with Disabilities and currently is a lobbyist for a spate of clients that provide services to people with intellectual and developmental disabilities. That includes The ARC of Florida.
“They are definitely very interested in these funds and a lot of these guys are barely hanging on,” DeBeaugrine said. “The quicker this can get out there, the better.”
The DeSantis administration moved last summer to take advantage of a 10% bump in federal Medicaid dollars available under the American Rescue Plan Act.
Most Florida Medicaid patients who receive home- and community-based services are either enrolled in the Medicaid managed long-term care program or the Medicaid iBudget program.
The former is for frail and elderly individuals who qualify for nursing home placement but choose to receive assistance with daily living activities, such as eating and dressing, that enable them to continue to live in their homes or another non-institutional setting.
Similarly, the Medicaid iBudget Waiver program allows adults with intellectual and developmental disabilities to tap into the home- and community-based services they require to continue living outside of an institution and in their family home or a group home.
Tyler Sununu is the president and CEO of the Florida Association of Rehabilitation Facilities, an association that represents facilities that treat people with intellectual and developmental disabilities.
“Providers are asking me every day for an update,” Sununu said about the additional payments. “The bottom line is providers really need the money and I’m very hopeful that if not this week, next week we’ll see some of that.”
The agency is supposed to announce a second round of funding opportunities sometime this month.