Plan for tobacco windfall upsets advocates for elderly
For more than a year, advocates for the elderly have eagerly awaited lucrative new funding for their favorite programs. Now some are disappointed.
The money was to come from the Lawton Chiles Endowment Fund, a $2-billion pot of good fortune filled by the state's legal settlement with tobacco companies.
When Gov. Jeb Bush proposed the Chiles endowment last year, he said the money should go to Florida's neediest citizens -- half for children's programs, half for the elderly.
When the Legislature ironed out the details this month, however, programs for the elderly didn't fare as well.
Children's programs, vigorously promoted by Chiles' widow, emerged with a one-half share intact. Biomedical research, favored by an influential senator who lost both parents to cancer, got a one-third share. Elderly programs were left with one-sixth.
Though the governor's kids-elderly formula never was etched in stone, some advocates think the elderly have been pushed aside by biomedical research.
"If they want to fund medical research, fund it straight up, but don't steal it from elderly programs," Jim Towey, president of Aging With Dignity and a close friend of Lawton Chiles, said last week. "We need programs for caregivers, we need programs for adult day care, for Alzheimer's families, for people running out of money in assisted living facilities.
"We are at the center of an age wave. This was how Florida would have funded innovative programs for the elderly. And it was raided."
The Florida chapter of AARP, which first heard about the legislation last week, was debating whether to ask Bush to veto it.
"The last time I checked, the National Institutes of Health and the Institute on Aging did biomedical research," said state director Bentley Lipscomb. "Why should the state of Florida do biomedical research for the United States? Not at the expense of old people."
Sen. Jim King, a Jacksonville Republican who led the charge for medical research, has an answer.
For starters, King said, Florida sued the tobacco companies to recover the expense of treating Medicaid patients who suffered from smoking-related illnesses. So the tobacco money should go to fighting cancer, lung disease and heart disease.
The elderly will benefit from this research, he said, because "some of these diseases afflict the elderly far more than anyone else."
Research grants could go to places like Tampa's H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, Shands Hospital at the University of Florida and the Mayo Clinic in King's hometown, he said.
King was chairman of the House Appropriations Committee when the Chiles endowment was set up in 1999. Money from the tobacco settlement already was pouring into state coffers. Over 30 years, it was expected to total $17.4-billion. Worried that a feeding frenzy of pet legislation would consume the tobacco windfall, Bush, King and others wanted to set aside a healthy chunk for certain causes.
So they created the endowment and named it after the former governor, who had died suddenly a few months before.
By law, the endowment will receive tobacco money for four years until it reaches close to $2-billion. Spending from the fund, to begin slowly this July, would be capped at 6 percent as of the fourth year, or roughly $120-million a year in interest earned on the fund's investments.
Though the Bush spending formula -- half for kids, half for elderly -- was widely touted as the endowment's spending goal, that's not what the enabling legislation said. At King's urging, biomedical research also was included as a possible beneficiary. At first, there was no mention of how the three competing interests would divvy up the pot.
In this year's session, King shifted to the Senate. One of his first initiatives was a bill that designated half the Chiles endowment money for medical research. It passed the Senate's Fiscal Policy Committee, much to the dismay of Rhea Chiles, the former governor's widow, who carries considerable moral and emotional clout on endowment matters.
Children's programs were closest to her husband's heart, she said. She saw the Chiles endowment as his legacy. The King bill set no percentages for children or the elderly, leaving them to scrap for half the money at best.
She began to negotiate with King and Rep. Michael Fasano, a New Port Richey Republican who was sponsoring Chiles endowment legislation in the House. According to Fasano, Mrs. Chiles offered a new formula that he adopted in his bill: half for children, one-third for medical research, one-sixth for the elderly.
King then amended his Senate bill to match those numbers and the legislation passed both chambers unanimously.
"If you wanted my percentage, it would have been 100 percent for the children," Mrs. Chiles said last week. "But my husband well understood the art of compromise. If you don't get it all, try to get what you can."
Larry Polivka, director of the Florida Policy Exchange Center on Aging at the University of South Florida, said the legislation caught him and other elderly advocates by surprise.
"Biomedical research is fine, but we have a crisis in long-term care," he said. "We need that money to build a home- and community-based alternative" to nursing homes.
Two decades ago, 23 percent of Florida's long-term care money went for in-home programs. Today, only about 11 percent does. If that trend isn't reversed soon, Polivka said, Florida's rapidly aging population will swamp the long-term care system.
What would half the Chiles endowment represent? $60-million a year is $10-million more than the entire budget for Community Care for the Elderly, the state's biggest in-home care program. Often, the federal government will match what the state spends to divert people from nursing homes.
This session, the Legislature created a special commission to study the future of long-term care. Polivka, a member, hoped it would recommend a major shift toward in-home services.
"We have to get where we can spend another $40- to $60-million on assisted living, caregiver support and in-home services," he said. "We are way behind on that compared to many other states."
The Department of Elderly Affairs, which administers many of the in-home programs the advocates are worried about, was not about to look a gift horse in the mouth.
"We got 161/2 percent, the department of health got 331/2 percent for biomedical research and that research will greatly benefit elders," said spokesman Gary Gershowitz. "This was a win-win situation for everybody."
Fasano, whose father died of cancer, expressed surprise that AARP and others objected to the Chiles endowment formula. The only elderly advocates he saw during hearings, he said, came from the American Cancer Society, the American Lung Association and the American Heart Association, and they all favored the bill.
The spending formula doesn't kick in until fiscal year 2001-2002, he said. If enough people oppose the formula, it can be changed next session.
Elizabeth Hirst, spokeswoman for the governor, said Bush had not read the legislation's final language and is "not taking a formal position."
King, however, said he has been invited to a bill-signing ceremony next week.