Florida Senate - 2012 COMMITTEE AMENDMENT Bill No. CS for SB 1516 Barcode 311224 LEGISLATIVE ACTION Senate . House Comm: RCS . 02/09/2012 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— 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.