Randy Fine says he wants to tackle APD waitlist

TALLAHASSEE, FLA. 9/22/21-Rep. Randy Fine, R-Palm Bay, during the House Redistricting Committee, Wednesday at the Capitol in Tallahassee. COLIN HACKLEY PHOTO

A powerful House Republican said providing services to people with disabilities is one of his top priorities for the 2024 Session.

House Health & Human Services Committee Chairman Randy Fine told Florida Politics that he is concerned about the number of people on the waitlist for the Medicaid iBudget program, a waiver program that provides home- and community-based services to people with intellectual and developmental disabilities.

According to the Agency for Persons with Disabilities (APD), 21,587 people qualify for the Medicaid waiver services available in the iBudget program but are on a waiting list for services. More than half of them (51%) were between the ages of 23 and 59, APD documents show. Roughly 29% are between the ages of 15 and 22.

Fine stressed that not all people on the waitlist are equal and that he is particularly concerned for roughly 300 people on the waitlist who either have “intensive” needs, or whose primary caregivers are aged 70 or older.

“I focus on the 300 largely because it’s a pretty strong case (for the care). It doesn’t mean that we shouldn’t go further; I was focusing on the most obvious answers,” Fine said.

He estimates that it would take roughly $15 million in recurring funds to get those 300 people off the waiting list and into the Medicaid iBudget waiver program.

The iBudget program provides people with intellectual and developmental disabilities access to a variety of services that aren’t traditionally covered by Medicaid or health insurance, including assistance with bathing and dressing.

Because the iBudget is an optional Medicaid “waiver” program, the state isn’t required by the federal government to provide the benefits to all people who qualify. As a result, Florida has long had a lengthy waiting list that has often gone ignored.

“I’m trying to bring light to the issue and we’ll see what happens,” Fine said, adding that it was his idea to have APD make the presentation to the committee.

According to Fine, roughly 37% of the people on the iBudget waitlist have been waiting to be enrolled in the program for a decade or more.

‘I always think about the fact that we have $500 million to give people discounts on tolls and then we have folks like this who need our help,” he said.

Fine did not opine on whether the state should rely on Medicaid managed care plans to provide home- and community-based services to people with intellectual and developmental disabilities or keep the iBudget program intact.

The iBudget program is one of the few Medicaid programs that is not administered through managed care plans. Incoming Speaker Danny Perez helped secure passage of legislation during the 2023 Session that authorized the Agency for Health Care Administration to test pilot whether managed care would be successful for APD clients.