Stop HMO Takeover of Services for Developmentally Disabled in Florida

Dear Senators and Honorable State Representatives:

We are writing today because we are very concerned about the possibility of the Medicaid Waiver Program being put under an HMO.  We want you to  understand the consequences of this decision.

We are concerned with the fact that reduction in services, reduction in the number of providers, and the elimination of individualized case management would be the consequences of your decision.  The right to choices about much needed services for our most fragile citizens would be taken away.  Some issues to keep in mind if you allow an HMO to provide the services for the disabled are:

1. HMO's will save money by cutting services, cutting provider rates and reduce providers which will increase their bottom line at the expense of the disabled. They may say they will  save the state money, but they will turn around and make sure their profit is not reduced.


2. The only way to keep an HMO's profits up is to cut services and provider rates. This hurts the disabled person because the quality of care and the individual's quality of life suffers and so does their families. They in essence would not get the services and the choices about services that they actually need.


3. Representatives who know nothing about the disability and how the disability affects the individual will be making decisions about what or if specific services will be provided. 


4. These same representatives will be employed by or under the management of the HMO. This presents a true conflict of interest.


5. Because the representative is employed by or being managed by the HMO , there is no one who would truly serve the disabled person's needs adequately.  A representative employed by the HMO will not keep the disabled person's best interest in mind when making a decision about how to best address their needs.


6. The developmentally disabled have unique and varied needs that cannot be adequately served by a one-size fits all HMO.

Suppose you were disabled and the only way you could get the services you needed were through a representative who worked for the HMO that provides the funding for services. The representative has to stay within the guidelines set up by the HMO, you as the recipient will either end up being denied services that you actually needed,  get a very slimmed down version of the service you need, or possibly have to travel to another city to even get a service because there are no providers in your area.  Would you want to endure this added hardship if you were disabled or the caretaker of a disabled person?

I understand that tough decisions concerning the budget in Florida have to made.  I respectfully ask that you consider allowing the Medicaid Waiver program to exist as it is today and give the systems in place (iBudget) time to prove to you that the waiver budget can be managed effectively while still meeting the needs of many very fragile members of our community.

Thank you for seriously considering how to best support and provide much needed services for our disabled loved ones without  reducing  their quality of care and quality of life.