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Scott advisors recommend consolidating agencies into one, big health dept.

Gov. Rick Scott should reverse the work of Gov. Lawton Chiles 20 years ago, when he pushed for the separation of the state's social service agencies, and get back to a large Department of Health and Human Services, Scott's health care advisory team told him in a 68-page report on Monday.

The goal of the mega-agency would be to better coordinate overlapping functions now handled by the current Departments of Health, Elder Affairs, the Agency for Persons with Disabilities and Agency for Health Care Administration as the state attempts to reform the delivery of Medicaid services.

One proposal, submitted Monday Scott’s health care advisory team headed by Alan Levine, calls for sweeping changes in how the state delivers Medicaid and urges a continuation of many of the programs advanced by Levine when he was advising former Gov. Jeb Bush.

Levine, who is the former head of the North Broward Hospital District and formerly served as Health and Hospitals secretary under Louisiana Gov. Bobby Jindal, urged Scott to hire a “quarterback” in his office who could coordinate health policy and management and “be capable of working closely with the legislature.”

Levine predicted that consolidating so many agencies would take “at least a year to plan and implement” but was needed to improve policy coordination.

Among the recommendations:

• Merge the Agency for Persons with Disabilities with the Department of Elder Affairs and have it be a division within a larger health and human services agency
• Keep child welfare programs separate from  a larger health department.
• Continue to fight for repeal of the federal health care reform act because it is “very costly for Florida at the very time we cannot even afford to operate the Medicaid program in its current form.”
• Expand Medicaid reform from the pilot projects in Miami-Dade and Broward counties statewide.
• Adopt Medicaid reform that includes an “organized, coordinated network” of care for the elderly that uses the private sector to give people “services they need” and not necessarily “services they want.” The state would be responsible for providing “proper oversight to ensure needed services are not systemically denied.”