TALLAHASSEE -- With billions in new Medicaid money available in federal stimulus dollars, this looked like the year that the poor, sick and elderly might get more services.

But before the federal cash has started flowing to state coffers, legislative leaders have all but decided to divert about $790 million to other areas of next year's deficit-ridden budget. They also plan to cut some healthcare services.

The results: 646 nursing homes will face up to 3 percent in rate cuts. About $18 million to help foster kids could go away. And about 18,000 Floridians with developmental disabilities will remain on an ever-growing waiting list for services.

Dakotah Hughes was assigned number 11,000 on the waiting list shortly after she was born in Tampa. Unable to feed herself or go to the toilet unassisted, she has had no state services for the 11 years of her life.

''It's just infuriating,'' said her mother, Jennifer Hughes, a special-education teacher who now lives in Orange City. ``The state used to say they were going to try to clear the waiting list. Yet the money never comes. It's so frustrating.''

It's not just parents and advocates who are frustrated with what many call the ''shell game'' of plugging new federal money into programs -- and then diverting state money from those same programs to other parts of the budget.

The chairman of the Senate's health budget committee, Durell Peaden of Crestview, blasted his fellow Republicans Monday for moving forward with a cigarette tax to be used for healthcare only to subtract the same amount of money -- about $1 billion -- from the health budget.

Add in the $790 million in stimulus money, and that means the Senate is diverting almost $1.8 billion in health money for non-health purposes, such as schools or prisons.

Peaden said he was the victim of a ''bait and switch'' for his support of the cigarette tax.

''I was told it would go into helping people who are sick, dying and underserved,'' Peaden said, calling that a ``deception.''

TOBACCO TAX

The Senate's budget chief, Republican J.D. Alexander of Lake Wales, denied he gave anyone assurances about the use of the tobacco tax, which senators call a ``surcharge.''

Echoing other legislative leaders, Alexander says the health budget would be much worse were it not for the federal stimulus money that largely spared Medicaid and other health services from deep cuts.

Under the federal stimulus legislation, Florida could receive upward of $13.4 billion over three budget years, including the current one that ends June 30. Of that money, about $4.3 billion is available for Medicaid, a state-federal program serving 2.5 million Floridians.

The proposed House and Senate budgets both use about the same amount of stimulus cash and both transfer about the same amount of Medicaid money out.

The two chambers' budgets have some significant differences that must be reconciled before the session ends May 1:

• Revenues: The Senate's budget has a total of $2.1 billion in new fees, taxes and gambling money. The House, which is balking at a cigarette tax, proposes less than $1 billion from fees levied on everything from trash haulers to drivers.

• Bottom line: The chambers' budgets differ by $546 million. The House proposes $65.1 billion in spending. The Senate, $65.6 billion. The current-year budget is $65.4 billion.

• Trust Funds: The Senate scoops up about $62 million from specially dedicated accounts called trust funds. The House takes $926 million, gutting some.

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