Floridians with disabilities will get chance to fight state cuts of services

From The Tampa Tribune:

TALLAHASSEE, Fla. - Thousands of Floridians with developmental disabilities will get another chance to fight state cuts to the services they rely on - even if the state denied their appeals last year.

That includes people like Peter Ciccarello, a 32-year-old Tampa resident who has spina bifida. Ciccarello, who lives with his mother and uses a wheelchair, lost dental care when the spending cuts took effect last year. The state denied his appeal of the cuts, and he now needs almost $7,000 worth of fillings and bridge work.

"This should be based upon the person's needs," he said.

It also includes Sean Mason, a 39-year-old Seffner resident diagnosed with autism, schizophrenia and intellectual disabilities. Yvonne Mason, his mother, has appealed a 42 percent cut in funding for services for her son, which she fears could cause him to wind up in an institution.

Ciccarello and Mason are among the 5,800 patients and families who protested their assignments last year to spending levels, or "tiers," which restrict how much the state will pay for services ranging from therapies to transportation.

In response to an order from the 1st District Court of Appeal, the state Agency for Persons with Disabilities is now tweaking its rules for assigning people to those tiers and re-evaluating the cases of everyone who appealed in 2009. If they wish, they will be able to appeal again when the state reassigns them to a spending tier later this year.

Unlike last year, everyone also will get to make their case - first in an informal hearing with APD staff, and if necessary, before an administrative law judge, APD director Jim DeBeaugrine said.

The agency denied hearings last year to the majority of people who appealed, finding their complaints "legally insufficient." That sparked protests from families, as well as a legal challenge from the Advocacy Center for Persons with Disabilities.

"We don't anticipate denying them this time," DeBeaugrine said.

Those may not be the only changes ahead.

Even as the Agency for Persons with Disabilities struggles to bring its current system into compliance with the court's order, it is also working on a new plan to change the way Florida serves people with developmental disabilities in the future.

"We're committed to getting this right," DeBeaugrine said.

The state Legislature designed the tier program in 2007, when APD had a budget deficit of about $155 million. Lawmakers responded by demanding that the agency cut spending on services and divide the 30,000 beneficiaries of the agency's Home and Community Based Services program into spending tiers.

That sent waves of fear and anger through families of the developmentally disabled, as well as the providers paid to care for them. From a purely cost-cutting perspective, the changes largely succeeded. As of last week, the agency had whittled its projected deficit for 2010 down to $26 million.

"I think it was the right decision at the time; there wasn't really any other decision to be made," said state Sen. Durell Peaden, who oversees health and human services spending in the Senate.

Because of the way the cuts were structured, their impacts varied widely. Many people experienced little or no change in services, but others lost as much as half when they were assigned to a tier.

That's one of the problems that DeBeaugrine said he hopes to solve, by moving to a system of "individualized budgeting."

The "iBudget" idea, he said, is to create a computerized algorithm to evaluate the needs of each person, based on a wide variety of factors ranging from their age to their ability to clean themselves.

The computer program would use the information to calculate a customized budget for each person. Families would have significantly more control over how they spend the dollars allotted to them for services than they have under the current system.

If lawmakers approve iBudget this spring, it could take effect statewide as early as 2011.

That sounds better, said Yvonne Mason, Sean's 70-year-old mother and caregiver, but only if the state gets its calculations right. She is concerned that the state will not take into account enough variables - for example, the age of parents who are caregivers for people with developmental disabilities. "That makes a big difference in the care of a person."

It will be up to lawmakers this spring to approve or reject the proposal, just as they will decide how much to spend on services for the disabled in a year when the state faces a budget deficit of more than $2.5 billion.

Peaden, of Crestview, said he hopes to minimize the budget cuts to APD, given the reductions it has already weathered. As for iBudget, "I'm willing to look at anything that maximizes the services they need and cap what they don't," Peaden said. "This is one of the toughest issues we face up here."