Caregivers for severely disabled gird for long battle against budget cuts

That determination came out of Department of Children and Families Secretary Jerry Regier's testimony before a House Appropriations Committee panel on Thursday. Regier told legislators his agency would take at least 30 days to review internal policies it established July 1 -- policy changes he now believes will cause funding programs for the developmentally disabled to go $30 million over budget this year.

The DCF slashed the rates it pays to providers who care for the disabled on Nov. 1 after forecasting a new payment system it set up this summer would go $27.5 million over budget. Many providers questioned the data and charged the agency with penalizing them for its own internal policy shortcomings.

Scores of providers, parents and advocates spent three hours Thursday in often tearful testimony calling for lawmakers to stop the rollback in funding. But legislators warned them not to expect any changes until they review the information and obtain the results of another internal audit that won't begin until late December.

House Appropriations Chairman Bruce Kyle, R-Fort Myers, said his committee would not intervene until lawmakers returned in the spring to craft their budget for the next fiscal year.

"We're going to make sure that money allocated is the money spent," Kyle said.

Even more dispiriting to advocates for the disabled was what they described as the indifference of Gov. Jeb Bush. John Hall, executive director for the Association of Retarded Citizens of Florida, said Bush told a group of the disabled and their advocates in an informal exchange that the providers who cared for them were responsible for the budget cuts because they had charged the state too much money.

"He expressed anger towards providers gaming the system," said Hall. "He isn't fully sensitive of our value. ... Somehow, we've become the bad guys."

Alia Faraj, a spokeswoman for Bush, said that, "Right now, the governor is concerned about providers and the increases that we have seen."

Michelle Cooper, a social worker who cares for the developmentally disabled in Southwest Florida, said that the events showed "how the state manipulates and maneuvers around the lives of people with disabilities."

"What about people with cerebral palsy or who are mentally disabled? They're getting left behind," she said.

The week's legislative pronouncements seemed to wreck hopes of any quick solution that could mend the fractured relationship between the state and those it relies on to care for the disabled. After hundreds of people with severe disabilities rallied outside DCF offices across the state Nov. 12, many advocates said they felt state officials had become more willing to listen to their concerns and less likely to just place all of the blame for budget problems on them.

Regier even told providers at a meeting on the day of the mass rallies that he understood their problems and would ask an inspector general to examine internal DCF policies, not just the way providers were charging the state, according to advocates who attended the meeting.

Those concessions seem to matter much less than they did last week, when many felt that Regier had lessened his stance that providers alone were to blame.

Many local providers said they would have to scrimp by until any changes are made. None predicted an immediate disaster in care for those with severe disabilities like cerebral palsy, but said they could see unfortunate outlines on the horizon.

"After the new payments, we were barely making it," said Scott Kenyon, an instructor at Sunrise adult day training in Naples. "If you take 10 percent away from barely making it, that puts us between a rock and a hard place."

Roger Bradley, executive director of LARC, formerly known as Lee Association of Retarded Citizens, said he plans to still charge DCF at the rates it had promised before Nov. 1.

"I don't have a clue if they'll pay them or not," Bradley said. But he says he has little choice. He calculates the DCF's new payments for care would force him to shutter two group homes in Lee County, stop construction of another and eliminate a day treatment program that serves Lee and Collier residents, moves he says would jeopardize care for dozens of disabled people in the area.

"If they're going to do some true investigating, they'll find that this is as dire as we say it is," Bradley said.

The relationship between the DCF and caregivers for the disabled has long been tenuous and pockmarked with pleas for more funding. But providers had much room to negotiate with local DCF officials to adjust the rates they could charge the state.

That allowed for local leeway but routinely trashed state budgets. Over the summer, the DCF set a new standard by adopting the results of an 18-month Mercer Consulting study that set fixed rate payments to individual providers.

Some organizations had gotten $20.58 a day for a certain type of care while others received $72.82 for the same service. There would now be one set of fees.

But under the new plan, the DCF also lifted a limit on the number of days that caregivers for the disabled could charge them for care. They expected a slight increase. Instead, they got a 25 percent increase.

So just four months after implementing the plan, DCF officials learned they would exceed their budget by $27.5 million, and slashed the rates they paid providers to meet legislative requirements.

The financial impact of those cutbacks is still somewhat murky. Advocates for the disabled say it will cost $48 million. DCF officials maintain the new rates are still an average of 5 percent -- and $83 million -- more than last year.

What is clear is the fury of advocates for the disabled who say many caregivers were given just a week to adjust their annual budgets. They have held press conferences, implored legislators to intervene and even staged a massive statewide rally outside more than a dozen DCF offices. Now many say that only an extraordinary intervention by elected officials can offer any immediate help.

"This is absolutely just tragic," said Maxine Sonnenschein, director of external affairs and public policy for the Florida Association of Rehabilitation Facilities.

"Only one person can change what's going on, and that's the governor," she said. "We will continue to do everything in our power to plead with him to intervene."