THE CAPITAL, TALLAHASSEE, February 3, 2012 -

Jim Saunders, The News Service of Florida

The Senate's chief health-budget writer likely will propose $390 million in general-revenue cuts to health and human-services programs, though nursing homes and developmental-disability programs could be spared.

Sen. Joe Negron, R-Stuart, said Thursday the Senate's soon-to-be-released budget allocations --- big-picture numbers showing how money will be divided among different parts of the budget --- will not require as deep of health and human-services cuts as expected earlier. Negron had anticipated proposing $850 million in general-revenue cuts.

Negron, who is expected to release his budget plan next week, said he will not propose Medicaid rate reductions for nursing homes or cuts in Agency for Persons with Disabilities programs. He also said he wants cuts in hospital Medicaid rates to be a "last resort" --- after the rates were cut about $510 million last spring.

But other programs could face major changes. Negron said his proposal will include significant savings from moving many Medicaid beneficiaries enrolled in what is known as the "MediPass" program into HMOs or other managed-care plans.

The state considers MediPass as a form of managed care, at least in part because primary-care doctors provide case-management services to Medicaid beneficiaries. But unlike with HMOs, the state pays for treatment based on each service provided --- a fee-for-service system that Republican leaders blame for higher Medicaid costs.

Negron's proposal likely would eliminate MediPass in counties where there are at least two choices of Medicaid managed-care plans. Negron's Health and Human Services Appropriations Subcommittee received information in November that such a change could affect more than 400,000 beneficiaries in 31 counties and offers potential savings of $87 million a year.

The shift of MediPass beneficiaries also could be an interim step, as the state seeks federal approval to eventually move to a statewide Medicaid managed-care system. Nevertheless, such a shift likely would face opposition from advocacy groups who argue beneficiaries should not be forced into HMOs.

Negron's budget proposal also is expected to call for cuts in substance-abuse and mental-health treatment programs for adults. Negron has long questioned whether such programs are a spending priority when the state is making cuts elsewhere in health and human services.

The $390 million in general-revenue cuts would result in many programs losing federal matching money, so the actual effects of the cuts would be deeper.

The allocation, however, would bring the Senate closer to the House's overall level of proposed health- and human-services cuts, though it appears the chambers would need to resolve key differences. As examples, the House's budget proposal calls for a 7 percent rate reduction for hospitals and would avoid cuts in mental-health and substance-abuse programs.

The proposed cuts stem from a budget shortfall that, by some estimates, is as much as $2 billion for the upcoming 2012-13 fiscal year. Republican leaders have chosen to make cuts, as opposed to looking for additional tax dollars to close the shortfall.

Also, health and human services programs could get squeezed in the budget because Gov. Rick Scott and legislative leaders want to increase spending on public schools.

Three Democratic lawmakers, including Senate Minority Leader Nan Rich, appeared with members of health-care and teachers unions during a news conference Thursday to call on Republicans to close corporate tax loopholes to bring in additional money.

Rich, D-Weston, argues that Republicans are pitting education against health care and said they offer a "false choice."