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Tampa Tribune: New budget format hurts the disabled and organizations

Tuesday, April 23, 2013


Imagine you have a developmental disability, a reality for thousands of Floridians.

Imagine, at 6 months old, your parents place you in an institution in Tennessee, never to see you again.

Imagine spending the next 50 years of your life in a sterile environment, seldom visiting the community and never knowing any of your family.

Imagine, finally, a distant relative finding you and bringing you to an organization in Tampa dedicated to helping you achieve the life you dreamed of.

If this were you, your name would be Mary, and you would now be sharing a home you love with two friends as part of the MacDonald Training Center family.

Mary came to MTC 23 years ago. Yet, to this day, she still deals with the pain and trauma typical of individuals who have spent decades being overly overmedicated and isolated from society. Mary has an intense fear of being placed in another institutional-like setting, such as a nursing home. This fear compels her to refuse the use of a wheelchair; instead, she uses only her walker, despite the immense extra effort it requires on her part.

Mary had been receiving $58,578 in state funding — $20,310 less than her actual cost of care. Thanks to donations from our friends and business enterprises, we at MTC have been able to provide the additional funds necessary to ensure Mary receives the care she needs to remain in her own home with her friends.

But as of Jan. 1, 2013, with the implementation of the iBudget, the state’s new Medicaid waiver funding methodology for those with developmental disabilities, Mary received a drastic cut of $6,346 in service funding. This comes at a time when Mary’s needs are increasing due to continued challenges resulting from her institutionalization.

Mary’s case is only one of thousands throughout the state. It is anticipated more than 12,000 individuals with developmental disabilities — 40 percent of those receiving funding — will be similarly affected once the full implementation of iBudget has been completed. Ironically, the very services that are now being denied through iBudget were deemed medically necessary by the Agency for Persons with Disabilities just a few short months ago.

In addition to the devastating effect this will have on the individuals we serve, these unwarranted cuts jeopardize the tens of millions of dollars in savings to Florida taxpayers that organizations such as MTC generate to supplement the actual cost of care. Mary’s case is a perfect example. The average annual cost of a Medicaid nursing home bed in Florida is $77,599, nearly $20,000 more than Mary was receiving from the state before iBudget slashed her funding. Now, MTC must find the additional resources necessary to fund both the $6,346 Mary lost, as well as the cost of her increased needs.

As an organization that empowers people with disabilities to lead the lives theychoose, we are dedicated to providing Mary with the care she needs to age with dignity and to not be prematurely placed into a nursing home. However, with the overwhelming iBudget cuts, our ability to continue supplementing the cost of care for Mary, and the many other people we serve who have also received cuts, is increasingly imperiled.

If you take Mary’s story and multiply it by the 12,000 other individuals whose services are also being profoundly affected by iBudget cuts, you will begin to grasp the enormity of the challenges facing our fellow citizens with developmental disabilities, as well as the hundreds of dedicated organizations from which they receive services.

In its current form, iBudget is endangering the cost savings that organizations such as MTC are able to pass on to taxpayers by supplementing the actual cost of services — services that are essential to providing the people we serve with the care they need and the quality of life they deserve.

If changes are not immediately made, the service system for Floridians with developmental disabilities will continue to deteriorate, ultimately costing taxpayers more to correct when organizations such as MTC are no longer capable of providing services.

The time for action is now.

The Florida Legislature must understand that the iBudget methodology has to be dramatically changed or the state must move to a more viable alternative.

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