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  • Jason Hahr

FSACentral Candidate Q & A: Philip Levine

Florida Self-Advocacy Central has reached out to all gubernatorial and U.S. Senate candidates with specific questions about their positions on issues affecting people with disabilities.

We used a sampling of questions designed by REV UP, an American Association of People with Disabilities (AAPD) initiative, created to increase voter registration and encourage people with disabilities to vote.

Democratic candidate for governor, former Miami Beach Mayor Philip Levine, the only candidate to respond so far, sent us the following answers to our questions.

What do you think Florida should do to assist families and caregivers of people with disabilities?

The first duty of the governor is to protect Medicaid, which is a program that helps the disabled community. With all the focus on how we pay for healthcare, we have overlooked the gaps in services. Non-hospital and rehabilitation services are unavailable to many, and home health care is also difficult to find. We need to use cost-savings in health care, generally, and Medicaid in particular, to expand services for the disabled.

Florida has to do a better job at housing for the disabled. It should undoubtedly protect the Affordable Housing trust fund.

The state must improve its compliance with the ADA as it builds new facilities and retrofits old ones, for instance, in community colleges and university.

I will task APD with compiling best practices and then doing outreach to school boards, local governments, mental health and group home providers, and others. We should not have to wait for a civil rights suit to do the right thing. Simply providing up-to-date information to all parties could help them comply and do more.

Do you support or oppose proposals to block grant Medicaid spending or convert funding to a per capita cap system in Florida? What Medicaid services in Florida, if any, would you seek to eliminate under a block grant or per capita spending system?

I oppose proposals to shift Medicaid funding to a block grants system. The plan is insidious for the entire United States, but it would be especially damaging to Florida.

Block grants would punish Florida for its innovation in implementing an efficient way of managing Medicaid by using our lower costs as a baseline for determining how much funding the federal government would provide. The block grant proposal is a time bomb: the negative impact would not be massive right away, but eventually, it would blow Medicaid up.

  • Block grants would set in stone the current differences in Medicaid programs, in which poor states do less and wealthier states do more for their citizens. Since the state has already shifted its Medicaid program to a capitated risk-adjusted model, Florida's baseline would be lower than less efficient states. Florida would be punished for its efficiency.

  • The block grant approach would not allow expenditures to readjust during recessions when caseloads for Medicaid climb, meaning states would be forced to reduce services when they are needed most.

  • Block grants would also not adjust for demographic changes. Almost two-thirds of the patients in nursing homes pay for their services with Medicaid, and a fixed baseline block grant would not take this into account as the population ages. Again, elders would receive reduced services.

  • Block grants on their own would not control cost inflation in health care services, which is higher than other sectors of the economy. The combined impact of an aging population and cost inflation would result in health care services subject to rationing. People’s real needs would go unmet. If a recession hit with these caps in place, even more, people would lose health care. The certainty of a slowdown poses a significant danger to the elderly and the disabled, many of whom end up on Medicaid.

The Kaiser Foundation also suggests that this block grant scheme could be the thin entering wedge for renouncing the federal government commitment to Medicare and Social Security. By committing to a rigid cap now, future politicians can claim they have no choice in the matter when they reduce access and further privatize the Medicaid system. The same approach appears to be on the table for Social Security and Medicare—undermine its fiscal viability, and then declare it a failure and privatize them, leaving those with the highest risk exposure—the poor, the disabled and the elderly—on their own.

Governor Scott and others argue that we need spending caps to salvage the long-term viability of Medicaid. Ironically, the Florida waiver experience proves the opposite. We have increased services but shifted them in a cost savings direction resulting in superior outcomes and improved patient satisfaction. I have other health care policy proposals that would control costs while improving health care services.

As governor, how would you address the shortage of consumer-directed, as opposed to agency-directed, supports for adults with developmental disabilities?

APD should make consumer-directed support services the first option for referrals and those seeking assistance. If consumer-directed plans are the default path for designing services, people with disabilities will be empowered to advocate for themselves. Other states have better-developed consumer-directed support programs with higher visibility than we have in Florida. We should adopt the best practices. Disabled people and those close to them are the key resources in the team effort to meet disability induced needs.

The disabled population is under-represented in the electorate. In the 2016 election, disabled people voted 6% less than their non-disabled peers. What steps will you take to reach these voters to engage them in the democratic process?

My approach to voting is that we should make it easy for every eligible voter to participate. We know many of the barriers to disabled people voting are mobility-related. First, we need to remove the state law that requires voters renew their preference for vote-by-mail. Anyone with a disability should be able to make vote by mail a permanent choice.

We should direct supervisors of election to have filed plans for outreach to persons with disabilities. These plans should include efforts to make registration easier by reaching out to affected voters to enable them to register and vote. Voter registration should be made automatic upon receiving a state identification card.

How do you plan to build an infrastructure that addresses the underemployment and wage gaps experienced by people with disabilities?

When I think about governing, I see investing in infrastructure as the highest priority—but the first kind of investment we need is in people. We need to invest in people to give them the opportunity to chart their life plan and pursue it. Persons with disabilities have the same rights to have life chances and make equal contributions to society that anyone else has. So, what can we do?

  • First, we have to fund our schools fully so they can take their mandate seriously to provide opportunities for disabled people.

  • As we build our capacity to provide better workforce training, we will prioritize the full inclusion of people with disabilities. One of the mandates of this training effort is to make sure disabled persons can get appropriate training to excel in the workforce.

  • We plan to expand community health centers and mental health care throughout Florida.

As we build our physical infrastructure, we should make a goal that Florida’s public buildings and transportation projects will be state-of-the-art in facilitating people with disabilities.

How will you ensure students with disabilities have the same access to ambitious educational opportunities as their peers?

I will make this mission a priority and build the right to full accommodation into everything we do. We can do better at communication and collaboration with advocates and disabled persons. As mentioned above, I will fully fund schools, and expand workforce training. These efforts will include enabling disabled citizens to pursue whatever dreams they might have. I also intend to support education facilities, and these projects will improve our capacity to be inclusive of students with disabilities. I will get to work on better public transportation that fully accommodates people with different abilities and will enhance mobility for all.

Florida Self-Advocacy Central would like to thank Mr. Levine for participating in our interview and sharing his insights with us.

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Special note: Democrat Jeff Greene had not yet joined the governor's race at the time the initial questionnaires were sent out. We have sent him a questionnaire and will post his responses if we receive them.

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