Diagnosis For 3.6.22: Checking The Pulse Of Florida Health Care News And Policy

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

All signs point to an on-time departure for the Florida Legislature this coming Friday as House and Senate budget negotiators worked over the weekend to put the finishing touches on a new spending plan. Yes, Lawmakers could be coming back soon in a Special Session to deal with congressional redistricting, but the door is closing for Legislators eager to enact health care policy for 2022.

This past week a sharply-divided Legislature sent Gov. Ron DeSantis a bill that would ban all abortions after 15 weeks — and he is expected to sign it.

And then there’s the Governor’s push for a bill that would prohibit medical boards from going after doctors for opinions they express, including through social media. DeSantis on Thursday reiterated his support for the bill, which has stalled in both chambers.

However, an ever-important rule for the final days is that nothing is truly dead until Sine Die is declared, and the white handkerchiefs are dropped in the middle of the Fourth Floor Rotunda in the Capitol.

While the window of opportunity is closing, several other substantive health care issues remain in play. Let’s take a look at them.

That’s a lot of cash

Will a top priority of Senate President Wilton Simpson — a plan to help Moffitt Cancer Center with a significant expansion in Simpson’s home county — make it across the finish line?

Moffitt — a well-known cancer treatment and research center named after former House Speaker H. Lee Moffitt — has been pushing ahead on its plans to move into Pasco County for several years now. The organization acquired land in 2020, and then a year ago, the Pasco County Commission approved $25 million to support road connections and infrastructure.

Moffitt serves more than 68,000 patients a year — but officials say they anticipate having more than 100,000 patients by 2026. They say their current hospital is at or near capacity and that the space crunch could hamper recruitment efforts.

The organization wants to create what it calls a “global destination to live, work and cure center” in Pasco. They project that eventually, there will be 16 million square feet for everything from research labs to light industrial and manufacturing to clinics.

The Senate has proposed helping Moffitt with a recurring $20 million a year budget item that would last for the next 30 years and ultimately cost $600 million. The first year’s funding is included in the proposed Senate budget, while a budget conforming bill (SB 2526) includes language pledging the money until 2052. None of this has been backed by House Republicans so far.

The expansion site is about 40 miles from Simpson’s home, and he said the money would help fast track the expansion.

“This facility will rival any cancer research center in the whole planet when Moffitt is finished with it,” Simpson told reporters on Thursday. “And so, when you think about the lives that will be saved 10 years from now, tens of thousands probably annually because of the research that would be done at Moffitt.”

Other appropriations are tied to roads and schools linked to the project, which connects to a large mixed-use master-planned community that will feature wellness trails and yoga.

Medicaid managed care

Florida’s existing Medicaid managed care contracts expire on Dec. 31, 2024, which means that the Agency for Health Care Administration will soon begin working on a new Medicaid procurement. Before that occurs, though, the DeSantis administration would like to update the law. Some of the changes the Governor’s Office would like to see include eliminating a requirement the state issue separate bids for each Medicaid region.

The Senate passed its version of the managed care bill SB 1950, and, according to top Republicans in the chamber, they aren’t in the mood to negotiate. The House’s version of the bill, HB 7047, is on the House’s Special-Order Calendar for Monday. And while there aren’t many differences between the chambers’ bills, the differences are significant. A deal-breaker for the Senate is the House’s push to include language in the bill that requires “essential providers” to sign contracts with Medicaid managed care plans on a regional or statewide basis, a move opposed by the Safety Net Hospital Alliance of Florida.

Nursing home staffing

Florida nursing homes appear poised to have a pretty good Session. Nursing homes already have been given extended COVID-19 liability protections, and the chambers are debating just how much additional revenue to provide the long-term care facilities that treat the state’s most vulnerable residents.

The Florida Senate could pass another nursing home priority, paring back the amount of “nursing” care they must provide as early as Monday.

Sponsored by Rep. Lauren Melo, HB 1239 requires facilities to conduct assessments to determine the staff needed to provide the type of care required for the facility’s resident population by considering the types of diseases, conditions, physical and cognitive disabilities, as required by federal rule.

The level of resident care required would be determined by the facility assessment and the resident’s direct care plan. At a minimum, the bill would maintain a minimum of two hours staffing by certified nursing assistants, a reduction from the current 2.5-hour requirement. Two statewide nursing home associations and the Florida Justice Association, which represents trial attorneys, are supporting the bill. But the bill is opposed by AARP Florida, which will call on DeSantis to veto the bill, according to AARP associate state director of advocacy Zayne Smith.

The nursing home associations say the bill is a “modernization” of statutes and is necessary due to a staffing shortfall. But the industry has tried to eliminate the staffing mandate for more than a decade.

However, Sen. Ben Albritton, the Senate sponsor, has already promised that this will not be the end of legislation that tackles the state’s nursing home industry. He promised this past week that there needed to be a “better way” to create a staffing model and that he would return in 2023 with additional changes.