Gov. Scott’s Proposed Budget Includes Increases and Cuts for Medicaid Home Care Services

a4s_scottbudget0201_257965cGov. Rick Scott yesterday announced his budget recommendations for the 2013-14 fiscal year, which includes a combination of increases and spending cuts for the home care industry. Gov. Scott’s $74.2 billion budget package – a $4 billion increase over last year – would be the largest budget in state history, and includes a one-time $1,200 bonus for state employees and a $2,500 raise for public school teachers. The budget recommendation marks the first time in five years that the state won’t have to make deep cuts since the state is not facing a shortage of revenue.

To balance the increased spending, Scott proposed cutting Medicaid services and payments to hospitals, squeezing $9 million in savings from county health clinics, spending no more money for mental health or substance abuse prevention, and eliminating 3,600 state jobs while freezing state workers’ salaries for the seventh straight year.

By law, Gov. Scott must submit a proposed budget to the legislature before the annual legislative session session, which runs from March through May. However, the legislature is responsible for crafting state budget during the session and, while it generally includes some of the governor’s proposals, it’s up to legislators to decide what’s included and what isn’t. HCAF is seeking a 50% rate increase for Medicaid home health services delivered by an RN and LPN, as well as a rate increase for Medicaid private duty nursing services. Neither increase was included in Gov. Scott’s recommendation, but HCAF lobbyists will be pursuing these budget increases when session kicks off next month.

As it relates to home care, Gov. Scott calls for reduced spending for home health services to the tune of $9.5 million and in private duty nursing in the amount of $26.7 million. The reduction in home health services is three-fold: the three-visit limitation of home health visits for non-pregnant adults; savings associated with the expansion of both the Sandata telephony project and the Comprehensive Care Management Pilot Program; and funding for the Medicaid program due to projected enrollment based on estimates from the Social Services Estimating Conference.

The difference in the private duty nursing is due to savings associated with expansion of the Sandata telephony project and Comprehensive Care Management Pilot Program, as well as funding for the Medicaid program based on the Social Services Estimating Conference.

Gov. Scott proposed increases for Medicaid home and community based waivers, including the Nursing Home Diversion Waiver and Aged and Disabled Adult waiver, by $24.1 million, which should amount to about 2,000 slots. The budget points out that the Department of Elderly Affairs’ and the Department of Children and Families’ Medicaid waivers are all transferring to the Agency for Health Care Administration this year for the implementation of Medicaid Managed Care, and any funding increases are realized in AHCA’s budget instead of DOEA or DCF. The long-term care managed care component must be implemented by October 1, 2013.

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