Agency deficit illusion or real?

Disabled funds cut despite surplus?

State officials decided two years ago to cut the amount of money paid to centers providing residential and day training services to developmentally disabled adults. Their reason: a projected $27.5-million deficit.

The cuts, according to the centers, forced them to close group homes and watch some of the state's most vulnerable residents go without services.

Now, a state senator and advocates are questioning whether a deficit ever existed. In fact, they contend the Agency for Persons with Disabilities could be $90-million in the black.

With 14,600 people on a waiting list for services and providers struggling to stay afloat, two state senators have asked for a legislative review of the agency's finances.

"If the agency is not spending the money on the services we have asked them to spend it on, then obviously we have a problem," said Sen. Burt Saunders, a Naples Republican who joined Sen. Walter "Skip" Campbell, D-Tamarac, in seeking a review by the Legislature's Office of Program Policy Analysis and Government Accountability.

A spokesman for the state's developmental disabilities agency disputes the surplus claim, saying it was based on incomplete Medicaid claims data from the first three months of the fiscal year.

"Such methodology grossly underestimates outstanding liability," spokesman Scottie Howell said in an e-mail. "Data from the first three months of the year reflect the least complete and least accurate information on which to base a (12-month) projection."

It's an explanation that falls short for many advocates of the developmentally disabled.

The problems began in late 2003.

To stay within its budget, the state's developmental disabilities program said it needed to reduce rates for two of the services provided to the developmentally disabled.

The cuts took effect Nov. 1, 2003. They reduced reimbursement rates to group home providers by 14 percent and adult day training programs by 9.5 percent.

Some providers learned about the changes only a week before; others didn't get their notification letters until a week after the adjustment was put in place.

Providers rallied with their clients outside Florida Department of Children and Families district offices across the state, urging the department to reconsider.

Gov. Jeb Bush responded by asking the inspector general to audit the new rate structure. But providers became even more perplexed last year when the review concluded that the developmental disabilities program had set aside $30.5-million from its budget before claiming the projected deficit.

The inspector general's report questioned the deficit amount and rate adjustment. Program officials said the money eventually was spent to cover a previous budget shortfall and 2003-04 expenses.

But providers now think the money was left out of spending projections to create the illusion of a deficit and validate a cut in service payments.

"We said there was going to be a surplus and there is a surplus," Tallahassee attorney Frank Rainer told a group of providers gathered in Tampa last week for the annual Association for Retarded Citizens of Florida convention.

Rainer represents 60 providers who sued the state last year, seeking damages for the money lost since officials changed the reimbursement rates. The case is set for trial in October.

Providers say they are frustrated that they had to file a lawsuit. While the budget of the developmental disabilities agency has grown, providers say they have had a hard time breaking even under the scaled back payment structure.

"During that time, people have suffered," said Jim Freyvogel, president of the MacDonald Training Center in Tampa. "Some people have died because of having their critical and vital services cut, and other people have lingered on the waiting list needlessly."

David Barzelay, director of development for New Port Richey's Center for Independence in Pasco County, tells a similar story.

He said the center has lost $430,000 and closed three of its seven group homes in the last two years. The cuts, he said, have been "catastrophic."

Lost in the bureaucratic shuffle, advocates say, are people with Down's syndrome, cerebral palsy, autism, spina bifida and mental retardation.

People such as Ellen Neubauer, who lives in a group home and attends adult day training classes at the Center for Independence. She is 53 and severely mentally retarded. She wears Velcro shoes and loves baby dolls.

Neubauer has become more aggressive with age, her sister and caretakers say. Her changing behavior prompted the center's staff to seek state approval for more individualized supervision.

The state's developmentally disabled program not only denied the extra funding, it decreased Neubauer's level of supervision. The request, officials told Neubauer's sister, exceeded what was medically necessary.

Howell, the agency spokesman, emphasized that all decisions to authorize services are "based on medical necessity, never on monetary considerations."

And current agency projections indicate a potential surplus of only 3 percent, or about $20-million, above the agency's $1.1-billion budget, he said.

"...The Agency for Persons with Disabilities stands to gain nothing by finishing a year with a surplus," Howell added. "It is our desire and goal to spend all funds available to provide services for persons with developmental disabilities."

Saunders said he is just looking for clear answers.

In April, agency officials told Senate Health and Human Services Appropriations Committee members that rumors of a $30-million to $90-million surplus were untrue.

But Saunders, the committee chairman, finds recent evidence to the contrary "very, very troubling.

"We will get to the bottom of it over the next several months."

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