The Children’s Movement of Florida, a group of prominent leaders across the state who care about the future of children, is gaining momentum.

The non-partisan, citizen-led organization is hosting a series of “Milk Party” rallies in various cities (click here to read more). Alliance members are encouraged to attend and invite patients and their families.

The top two priorities of the Children’s Movement are right in line with those of the Alliance: making sure children have access to health insurance; and screening, treatment and services for healthy child development.

Below is a schedule of the Milk Party rallies.

Monday, Sept. 6 (Labor Day) - Pensacola
Time: 10 to 11 a.m. - Doors open at 9:30 a.m.
Location: Pensacola High School
Contact: Audra Carter - audra.carter@childrensmovementflorida.org

Tuesday, Sept. 7 - Panama City
Time: 9 to 10 a.m. (Community Discussion)
Location: Bay District Schools Headquarters
Contact: Margaret Tidmore - tidmoma@bay.k12.fl.us

Tuesday, Sept. 7 - Tallahassee
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Tallahassee-Leon County Civic Center
Contact: David Abrams - david.abrams@childrensmovementflorida.org

Wednesday, Sept. 8 - Gainesville and Ocala
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Santa Fe College
Contact: David Abrams - david.abrams@childrensmovementflorida.org

Monday, Sept. 13 - Daytona Beach (Volusia and Flagler Counties)
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Mainland High School Performing Arts Center
Contact: Leah Shepherd - leah.shepherd@childrensmovementflorida.org

Tuesday, Sept. 14 - Orlando and Kissimmee
Time: 6:30 to 7:30 p.m. - Doors open at 6 p.m.
Location: Dr. Phillips High School
Contact: Leah Shepherd - leah.shepherd@childrensmovementflorida.org

Wednesday, Sept. 15 - Treasure Coast (St. Lucie, Martin and Indian River Counties)
Time: 6:30 to 7:30 p.m. - Doors open at 6 p.m.
Location: Fort Pierce Central High School
Contact: Kerline Boursiquot - kerline.boursiquot@childrensmovementflorida.org

Thursday, Sept. 16 - Tampa
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Tampa’s Lowry Park Zoo
Contact: Adam Brown - adam.brown@childrensmovementflorida.org

Friday, Sept. 17 - Lakeland
Time: 10 a.m. to noon - Doors open at 9:30 a.m. (Mini-rally)
Location: Common Ground Park
Contact: Shawna Butler - shawna.butler@uwcf.org

Monday, Sept. 20 - St. Petersburg
Time: 6:30 to 7:30 p.m. - Doors open at 6 p.m.
Location: Calvary Chapel St. Petersburg
Contact: Adam Brown - adam.brown@childrensmovementflorida.org

Tuesday, Sept. 21 - Sarasota and Bradenton
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Riverview High School
Contact: Cheray Keyes-Shima - cheray.shima@childrensmovementflorida.org
Seana Mincy - seana.mincy@childrensmovementflorida.org

Wednesday, Sept. 22 - Naples and Fort Myers
Time: 6:30 to 7:30 p.m. - Doors open at 6 p.m.
Location: Seacrest Country Day School
Contact: Becky Newell - becky.newell@childrensmovementflorida.org

Thursday, Sept. 23 - West Palm Beach
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: The Harriet Himmel Theater at CityPlace
Contact: Kerline Boursiquot - kerline.boursiquot@childrensmovementflorida.org

Monday, Sept. 27 - Jacksonville
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Ritz Theatre & La Villa Museum
Contact: Amy Rankin - arankin@smag.com

Tuesday, Sept. 28 - Ft. Lauderdale and Broward
Time: 7 to 8 p.m. - Doors open at 6:30 p.m.
Location: Bailey Concert Hall at Broward College (Central Campus)
Contact: Pam Gadinsky - pam.gadinsky@childrensmovementflorida.org

Wednesday, Sept. 29 - Miami-Dade County
Time: 6:30 to 7:30 p.m. - Doors open at 6 p.m.
Location: Miami-Dade County Auditorium
Contact: John Knight - john.knight@childrensmovementflorida.org

Thursday, Sept. 30 - Key West
Time: 6 to 7 p.m. - Doors open at 5:30 p.m.
Location: Key West High School
Contact: Kelli Brower - kelli.brower@childrensmovementflorida.org

Times-Union
Aug. 22

By Brandon Larrabee

TALLAHASSEE - With state budget-writers likely to face a shortfall of $6 billion or more in the next budget year, the incoming governor is likely to face the question of how to control Medicaid spending.

The state-federal program, which provides health care for low-income Floridians, is consuming an ever higher share of state spending. Legislative figures show Medicaid spending growing from 18 percent of the state budget in the 1998-99 fiscal year to 26 percent in 2009-10. It’s projected to reach 36 percent in a decade.

Republican gubernatorial candidate Rick Scott has proposed creating a voucher system that would allow recipients to buy their own insurance. His opponent, Attorney General Bill McCollum, plans to create savings through better managed care.

Some efforts to rein in the cost in Florida are already under way. Former Gov. Jeb Bush pushed through a Medicaid reform pilot program based on managed care, implemented in 2006 for Duval and Broward counties and in 2007 for Baker, Clay and Nassau counties.

The Legislature will also have a say on the way forward, and lawmakers balked at expanding that program in 2011, when it was tentatively slated to go statewide. House leaders wanted a plan that would have eventually brought the entire state’s Medicaid population into a revamped version of the managed-care system; senators pushed an extension of Bush’s reform plan to 19 additional counties. Some advocates are nervous about expanding the plan.

The proposal from the Scott campaign would be a fundamental shift in how care is provided.

“Rick would like to seek a Medicaid waiver in order to allow Florida to create a voucher program in which Medicaid recipients would be able to shop for insurance in the private market and purchase an insurance option that fits their needs,” said Trey Stapleton, a campaign spokesman.

Senators approved, allowing the state’s Agency for Health Care Administration to seek a waiver in their budget for the current fiscal year, but it was ultimately left out of the compromise spending plan with the House.

“If we were not able get that waiver, Rick would seek to expand, statewide, the current Medicaid reform pilot program that was created by Gov. Bush in 2005,” Stapleton said.

The Scott campaign points to a study by researchers at the University of Florida that suggests the program cut costs and improved outcomes.

Combined with changes to health care for state employees, the Scott campaign estimates his plan will save taxpayers $1.8 billion.

Figures by legislative staff compiled in the run-up to the past legislative session seem to suggest that care coordinated either by doctors or managed-care providers can reduce costs. Patients with coordinated care cost the state an average of $3,479 in 2008, compared with an average of $13,320 for those outside of the programs.

Those results are at the heart of McCollum’s plan.

“Better coordination through a primary care physician not only prevents the duplication of services but also the use of unnecessary services,” the attorney general says in his health care blueprint.

McCollum also lays out a half-dozen “principles” for his plan, from providing choices to Medicaid patients to measuring medical results and rewarding patients who take steps to manage their health. He also pledges not to cut rates to medical providers and says cost savings for health care plans should be shared with doctors.

The Florida Medical Association, which endorsed McCollum, has praised his plan - particularly the attention paid to providers’ rates.

“The Attorney General’s health care plan addresses Florida’s low Medicaid reimbursement rates, which have limited physicians’ ability to participate in the program,” Tim Stapleton, the FMA’s executive vice president, said in a statement when McCollum’s plan was released.

McCollum also promises to crack down on Medicaid fraud.

brandon.larrabee@jacksonville.com, (678) 977-3709

From the Coalition of McKay Scholarship Schools:

Under a new law, private school students who have attended public school since 2005 — but have not received state funds — can qualify for McKay Scholarships.

Also, students who have a current IEP, have a disability and can be identified through Child Find are also eligible for the scholarships, regardless of whether they attended a public school last year.

To learn more about the new law, go the the Coalition’s website at www.mckaycoalition.com.

From USA Today:

A federal government website that starts July 1 takes a step in that direction. The site, for the first time, will give consumers a list of all private and government health care plans for individuals and small businesses in their areas.

The nation’s new health care law requires the site (www.healthcare.gov). Initially, it will provide just basic facts, such as the names of companies, health plans and Web links. Beginning in October, it will list detailed cost and benefits information. Consumer groups and insurers already are clashing over exactly what information should be displayed.

To read the full article, click here.

Candidates seeking the governor’s office will face each other in an October debate that will be broadcast live statewide on public television and radio, according to News Service Florida.

The debate will be sponsored by the Florida Hospital Association, and will center on health care issues, according to sponsors. 

The event is scheduled for Oct. 14 in Orlando, and will be produced and broadcast by Florida Public Broadcasting Stations.

The Florida Interagency Coordinating Council for Infants and Toddlers (FICCIT) will have a quarterly meeting June 22-23 in Jacksonville.

The meeting will take place at Four Points by Sheraton, 8520 Baymeadows Road.

The role of FICCIT is to assist public and private agencies in implementing a statewide system of coordinated, comprehensive, multidisciplinary, interagency programs providing appropriate early intervention services to infants and toddlers with disabilities and risk conditions and their families, according to its website www.floridaicc.com.

For more information, contact the FICCIT liaison Tameka Davis at 850-245-4444 extension 2268.

The state Agency for Health Care Administration (AHCA) is holding several hearings across the state about the future of the five-county Medicaid Reform pilot program.

The first hearing was held in Tallahassee on May 14 (read about it here). The next one is scheduled for June 8 in Jacksonville. Click here to see the full schedule.

The Medicaid Reform pilot program has been underway since 2006 in Broward, Duval, Baker, Clay and Nassau counties. It was an initiative of former Gov. Jeb Bush and was approved by the federal Centers for Medicare and Medicaid Services (CMS) under the administration of his brother, President George Bush.

CMS gave Florida permission, in the form of a federal “waiver,” to move forward with its Medicaid Reform experiment through June 30, 2011.

Under the waiver, Florida must tell CMS by June 30 what it plans to do with the pilot program.

The Florida Legislature voted, in SB 1484, to ask the federal government to extend the waiver beyond 2011. In preparation, AHCA is seeking public comment on how the program has worked.

Results have been inconclusive as to whether it has saved money. Studies have certainly shown that the program has not improved access to health care.

Medicaid Reform is different than the traditional Medicaid program. It allows HMOs and provider service networks to enroll Medicaid-eligible Floridians and offer their own package of benefits. That means that the Reform health plans do not have to abide by state Medicaid guidelines in terms of the amount, duration and scope of services, including pediatric therapies.

THE CAPITAL, TALLAHASSEE, April 25, 2010…House and Senate leaders confirmed Sunday what had become increasingly obvious in recent days: The proposed Medicaid overhaul is dead for this year.

“I still believe it is good policy,” said Rep. Denise Grimsley, R-Lake Placid, chairman of the House Health Care budget committee, and an architect of the sweeping House proposal that would push the state’s 2.7 million Medicaid recipients into managed care over the next five years.

“We will just have to bring it back next year,” Grimsley said.

The ambitious Medicaid rewrite faded into history Sunday as budget-writers struggled to conclude budget negotiations. While not having much of an immediate impact on spending, the disputed Medicaid plan stood as an obstacle that needed to be cleared from the budget landscape, lawmakers conceded.

“It’s where we expected it to end,” said Senate budget chief J.D. Alexander, R-Lake Wales.

But even with Medicaid out of the picture, dozens of spending provisions separated House and Senate budget negotiators, with some issues that appeared settled remaining officially open to further talks. And the talks went on – with a 5 p.m. deadline between Alexander and his House counterpart, Rep. David Rivera, R-Miami, scrapped in favor of continued negotiations between the budget leaders.

The pair set midnight Sunday for sending any remaining issues to Senate President Jeff Atwater, R-North Palm Beach, and House Speaker Larry Cretul, R-Ocala. But even that deadline looked fluid – with both budget chairmen conceding they could continue working through Monday.

Budgets will likely have to be on the desks of lawmakers sometime Tuesday to assure an on-time finish to the session Friday.

Meanwhile, budget negotiators Sunday settled a host of issues, including a 7 percent reduction in the state payment rate to hospitals treating indigent patients – a $96 million reduction that followed a $76.7 million cut in payments to nursing homes, and a $39.3 million general revenue reduction for HMOs.

An effort to exempt from the 7 percent cut rural hospitals and St. Petersburg’s All Children’s Hospital and Miami’s Children’s Hospital remained in play between the House and Senate going into Sunday night.

In education, state funding and terms for a revamped Bright Futures scholarship program was approved. The Legislature is moving to increase the SAT requirements for both the top and secondary awards, as lawmakers try to rein-in the cost of the scholarship program which covers tuition for about half of the state’s college students.

Budget negotiators haven’t settled public school financing, but are working to keep per-pupil spending close to its current, $6,866-level. That’s roughly a middle-ground between the House’s proposal to cut school dollars by $52-per-pupil and the Senate looking to boost spending by $38 for each child in a classroom.

The two sides Sunday also agreed to exclude from the budget revenue from the $7.50 saltwater fishing license fee approved just last spring. The fee was expected to be paid by some 120,000 anglers – but drew widespread criticism from Florida’s cane-pole fishing community, leaving lawmakers to push for repeal this year.

Even with some areas of agreement, the House and Senate continued to scrap over myriad details with dollars attached and proviso language that describes how money must be spent.

The Senate hasn’t surrendered in its effort to give school boards authority to increase property taxes by .25 mills without a voter referendum. The House rejects the idea and has already pushed back the Senate’s bid to build into school budget allocations money from these increased property taxes, which 42 of the state’s 67 counties approved last year.

Sometimes, the disputes took on a personal touch.

Rivera, a candidate for Congress, said the House will not retreat in its push to exclude human stem-cell research from such science carried out at state universities, sending the Senate back to effectively take it or leave it. He also is pushing to include a budget provision that would ban state-sanctioned travel to countries considered a “sponsor of terrorism,” a move similar to legislation he earlier sponsored aimed at banning university travel to Cuba.

While Rivera promoted those measures, Alexander said he was satisfied with budget language that puts the Department of Management Services under the authority of the governor and Cabinet – a heightened level of oversight for a state department he earlier wanted broken apart and scattered among other agencies.

Alexander has turned into a fierce DMS critic after the agency was unable to provide a list of state-owned property. Other budget bills now being advanced require DMS to provide such an inventory no later than Sept. 15 each year.

Alexander also endorsed a budget bill provision that gives the University of South Florida-Polytechnic priority to lease vacant land and buildings at the state’s former G. Pierce Wood mental hospital in DeSoto County. Alexander, a major advocate for USF-Poly in his home Polk County, denied Sunday he was positioning for a branch campus of the school, but instead is looking to help the school obtain new facilities at an underused site.

But the biggest move Sunday – the official end of the Medicaid rewrite — was in the makings for weeks.

Indeed, the Medicaid proposal was probably doomed when House leaders unveiled the plan with just a scheduled three weeks remaining in the legislative session. The Senate had already approved its own effort to overhaul Medicaid which, although dramatic, paled compared to the House approach.

Neither side worked toward a real consensus, but it wasn’t until Sunday that leaders took the idea off the table.

“You’ve got to start this type of thing early,” said Sen. Durell Peaden, the Senate’s Health and Human Services budget chief. “It’s going to take educating everybody up and down the state to work.”

From News Service Florida

Calls for a veto of a far-reaching Medicaid overhaul awaiting a Senate vote poured in Wednesday as Gov. Charlie Crist acknowledged he too has concerns about the proposal.

Crist met Wednesday with two representatives of AARP, who told the governor the senior lobby is strongly against the legislation. “

“It’s such a huge reform proposed in the waning days of the Legislature,” said Leslie Spencer, one of two AARP officials who met with Crist. The group’s main concern is a House bill’s shifting of nursing home patients into managed care programs. “”It’s a big change,” said Spencer, who added that Crist didn’t give any indication of his thoughts on two companion bills, which have passed the House, but are awaiting Senate approval (HB 7223, HB 7225).

Crist did weigh in a bit, however, earlier in the day, acknowledging that he also is concerned. “I have some concerns about it,” Crist said. “I want to make sure whatever is passed doesn’t unfairly treat the most vulnerable in our society as well as our senior citizens.”

Meanwhile, more than 100 nurses planned to come to the Capitol on Thursday to urge Crist to veto the legislation, even as it awaits a Senate vote. “

“Low income children, the developmentally disabled, pregnant women and seniors would face delays and denials in care if they are forced into for-profit, managed-care Medicaid,” the Service Employees International Union, which represents many nurses, said in a statement announcing its opposition to the proposal.

Negotiations are underway today between leaders in the Florida House and Senate regarding the future of the state’s $19 billion Medicaid program.

Health News Florida reports that Sen. Don Gaetz, chairman of the Senate Health Regulation Committee, and Sens. Durell Peaden and Joe Negron met with House Rep. Dean Cannon and staff members who wrote a pair of bills that passed the full House yesterday (read story here).

The House bills (HB 7223 and HB 7225) would, in part:

• expand the Medicaid Reform experiment from five counties to a sixth one, Miami-Dade, in 2012;
• split the state into six Medicaid service regions;
• allow HMOs and provider service networks to run the Medicaid program in those regions;
• require ALL Medicaid-eligible Floridians (including seniors and the developmentally disabled) to enroll in health plans, phased in over the next four years.

The Alliance for Pediatric Therapies helped negotiate language that would require health plans to have a process for electronic submission of claims and require them to follow current Medicaid guidelines for paying providers. This has been a big problem in Broward County, where at least one health plan still processes claims by paper and doesn’t pay claims in a timely fashion.

Thanks to Rep. Mia Jones (D-Jacksonville) for sponsoring these very important amendments. 

Despite these and many other fixes to the bill, key members of the Senate largely disagree with the approach taken by the House. Senators are especially concerned that the developmentally disabled will be required to enroll in Medicaid managed care plans.  

Furthermore, a news article today states that the House ignored its own analysts, who found that putting seniors into Medicaid HMOs won’t save money (read story here).

The Senate’s proposal to “reform” Medicaid isn’t much better.

Their plan calls for expanding Medicaid reform to 19 counties, ignoring many of the fixes that need to be made to the program (click here to read more).

It’s unclear at this point — Day 50 of the 60-day session of the Florida Legislature — what will emerge from the competing Medicaid proposals.

Either way, health plans will have more flexibility to deviate from current Medicaid guidelines for therapies — just as Amerigroup is doing through their therapy management subcontractor, TRS.

The wild card in the Medicaid legislation is Gov. Crist, who already vetoed a bill regarding teacher merit pay.

In his veto message of SB 6, Gov. Crist said that key stakeholders had no input into the bill that sped through committees. The governor futher notes that during the House floor debate and final passage of SB 6, supporters acknowledged its imperfections while largely ignoring concerns raised about the measure.

House Democrats were clearly teeing up the governor for a veto of Medicaid legislation.

In floor debate Monday, they noted the speed and timing of the bills that arrived on the House floor. The bills were made available to the public on April 6, just hours before the House Select Council on Strategic and Economic Planning had a workshop for members.

Fourteen days later, the bills sailed through the council, bypassing all health care and budget committees, and landed on the House floor for a vote on final passage.

There is increasing attention on who’s really behind the bills - the HMO industry. An editorial in the Palm Beach Post notes that consultants hired by the House actually work for the managed care industry (read more here).

To learn more about Medicaid Reform and how to best prepare your therapy practice for changes, join the Alliance for Pediatric Therapies.