Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1516
       
       
       
       
       
       
                                Barcode 311224                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/09/2012           .                                
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       The Committee on Health Regulation (Gaetz) recommended the
       following:
       
    1         Senate Amendment 
    2  
    3         Delete lines 997 - 1042
    4  and insert:
    5         (a) During the transition, the agency shall determine an
    6  individual’s initial iBudget by comparing the individual’s
    7  algorithm allocation to the individual’s current annual cost
    8  plan and the individual’s extraordinary needs. The individual’s
    9  algorithm allocation shall be the amount determined by the
   10  algorithm, adjusted to the agency’s appropriation and any set
   11  asides determined necessary by the agency, including, but not
   12  limited to, funding for individuals who have extraordinary needs
   13  as delineated in paragraph (2)(b). The amount of funding needed
   14  to address the individual’s extraordinary needs shall be
   15  reviewed for each individual by the area office in order to
   16  determine medical necessity for each service in the amount,
   17  duration, frequency, intensity, and scope that meets the
   18  individual’s needs. The agency shall consider the individual’s
   19  characteristics based on a needs assessment as well as the
   20  individual’s living setting, availability of natural supports,
   21  family circumstances, and other factors that may affect the
   22  level of service needed.
   23         (b) The individual’s medical-necessity review must include
   24  a comparison of the following:
   25         1. If the individual’s algorithm allocation is greater than
   26  the individual cost plan, the individual’s initial iBudget shall
   27  be equal to the total cost plan amount.
   28         2. If the individual’s algorithm allocation is less than
   29  the individual’s cost plan but is greater than the amount for
   30  the individual’s extraordinary needs, the individual’s initial
   31  iBudget shall be equal to the algorithm allocation.
   32         3. If the individual’s algorithm allocation is less than
   33  the amount for the individual’s extraordinary needs, the
   34  individual’s initial iBudget shall be equal to the amount for
   35  the individual’s extraordinary needs.
   36  
   37  The individual’s initial annualized iBudget amount may not be
   38  less than 50 percent of that individual’s existing annualized
   39  cost plan. If the individual’s initial iBudget is less than the
   40  individual’s current cost plan, and is within $1,000 of the
   41  current cost plan, the agency may adjust the iBudget to equal
   42  the cost plan amount.
   43         (c) During the 2011-2012 and 2012-2013 fiscal years,
   44  increases to an individual’s initial iBudget amount may be
   45  granted only if a significant change in circumstances has
   46  occurred and if the criteria for extraordinary needs as
   47  described above are met.