Gov. Rick Scott, a Republican seeking $1 billion in tax cuts this year, portrayed state spending on services for disabled Floridians as solid during his 2016 State of the State address.
"With your help, we have invested Florida taxpayer dollars to make a lasting difference in the lives of Florida families," he said during the Jan. 12 speech. "For the first time ever, we completely funded the critical needs waiting list for persons with unique abilities so they can get the help they need."
Scott is technically right about a specific waiting list for people with disabilities, but he omits important context. Namely, the critical needs waiting list is one component within a bigger waiting list for services.
People with disabilities can apply through the state to get financial assistance through a Home and Community-Based Services Medicaid waiver, a joint state-federal program.
The program serves people with intellectual disabilities, autism, cerebral palsy or other disabilities. The goal is to provide them care in their homes or community instead of sending them to more costly institutions.
About 32,000 Floridians have this waiver now, but about 20,000 remain on a waiting list, according to a spokeswoman for the Agency for Persons with Disabilities. The state hasn’t provided enough money to fully empty out the waiting list for home- and community-based care.
Florida’s waiting list is the second-highest in the nation behind Texas as of 2014, according to the Henry J. Kaiser Family Foundation. That’s not surprising considering Florida’s large population, but some states do a better job at clearing off the waiting list than others.
It’s important to note that Florida’s "critical needs" waiting list is a classification devised during Scott’s administration. So when he says he completely funded this waiting list "for the first time ever," he is referring to something that has only existed for a few years.
In 2013, the state Agency for Persons with Disabilities had a work group that met to discuss how to reduce the waiting list.
"We decided to take those with the most critical needs first," said agency spokeswoman Melanie Etters. That’s when the agency came up with the idea for a specific "critical needs" waiting list.
The state assesses those on the waiting list and places them into different categories based on criteria set out in state law in July 2010, a few months before Scott took office. People who end up on this critical needs list face difficult circumstances, such as being a child in the welfare system or a person at risk of losing a caregiver.
The state received money to whittle the critical needs list starting in 2013 when it gave waivers to 1,600 Floridians. However, some still remained on the list that year. The next year, 2014, the state emptied out the list for the first time when it gave waivers to 1,200 people. Again in 2015, the agency received enough money to offer a waiver to everyone on the critical needs list, around 2,500 at that time.
Although the state has brought the list down to zero twice, it then starts to regrow again pretty much instantly as new babies are born or people with disabilities move to the state, sign up for the first time or move into categories deemed critical.
Scott’s budget request for the next year calls for enrolling more than 700 individuals from the critical needs list, which is projected to empty the list. We won’t know the outcome of his budget request until the Legislature concludes the session in March.
Advocates for people with disabilities said Scott has a point about working to reduce this specific waiting list, but he left out part of the story by not acknowledging the larger, non-"critical needs" list for services.
"The governor is correct that he has funded the critical needs waiting list, but that’s not to be confused with the overall waiting list," said Suzanne Sewell, president of the Florida Association of Rehabilitation Facilities. Other advocates we interviewed backed up her argument.
The last time the waiting list was fully funded was when Jeb Bush was governor, and that was as a result of a lawsuit, said Clint Bower, president of MACTown, or the Miami Achievement Center for the Developmentally Disabled.
The advocates noted that while some people on the waiting list are not receiving services, others are getting services through other programs, such as at school. And some sign up on the waiting list although they don’t need services now but anticipate they will in the future.
They had little hope for the wait list being completely cleared. It would be difficult to do because every year new babies are born with developmental disabilities, and they end up on the waiting list.
"There will always be more people coming on," Sewell said.
Scott said, "For the first time ever, we completely funded the critical needs waiting list" for people with disabilities.
Advocates said Scott has a point about working to help around 5,000 disabled Floridians get off a narrow waiting list, but he left out two pieces of important context.
First, the critical needs waiting list is a category that Scott’s administration came up with about three years ago, so it’s not as if he had any historical competition. The state offered services to everyone on the critical needs list in 2014 and 2015, and Scott wants to do it again this year.
However, Scott omits that those on the critical needs list are a subset of the overall waiting list of about 20,000 people.
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