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News Service Of Florida

The News Service of Florida provides journalists, lobbyists, government officials and other civic leaders with comprehensive, objective information about the activities of state government year-round.

Health plans line up to seek Medicaid contracts

More than 20 managed-care organizations are seeking state Medicaid contracts that could be worth up to $90 billion over a five-year period.

A review of state records shows that a total of 21 managed-care organizations are seeking to be part of Florida’s Medicaid program, which provides health coverage for the poor.

Southeast Florida, specifically Broward, Miami-Dade and Monroe counties, attracted the most interest, with 17 managed-care organizations submitting bids to the state Agency for Health Care Administration by a Nov. 1 deadline.

Conversely, a largely rural area of North Florida drew the least amount of interest from managed care plans, with 10 responding to the state’s invitation to negotiate.

Agency for Health Care Administration officials did not respond to a request for comment on the number of health plans seeking the contracts.

Trying to hold down costs and improve the quality of care, the Legislature in 2011 passed a sweeping rewrite of the state’s Medicaid program, requiring nearly all beneficiaries, from the cradle to the grave, to enroll in managed-care plans.

The state issued the latest invitation to negotiate, the second under the Medicaid managed-care program, this summer and expects to announce the winning bids in April 2018. It will transition from the current health plans under contract to new plans at the end of 2018, according to state documents.

Currently, 11 managed-care organizations participate in the Medicaid program. All of those plans submitted bids for the second invitation to negotiate, commonly known as an ITN.

Amerigroup, which is part of the Anthem group of health plans, responded to the ITN but not under that moniker. Company officials said they responded to the ITN under the Simply Healthcare brand and, if chosen, will participate in the program under that name, not Amerigroup.

The state has more than 4 million Medicaid beneficiaries, and 85 percent of them are enrolled in the state’s managed-care program, according to Medicaid Deputy Secretary Beth Kidder.

More than 3.1 million are enrolled in what’s considered the “managed medical assistance” portion of the system, and another 98,420 Medicaid beneficiaries — including many seniors — are enrolled in the “long term care” portion.

Florida’s Medicaid program is the fourth largest in the nation in terms of number of people. Expenditures in the program for fiscal year 2017-2018 are nearly $27 billion, according to Kidder.

For contracting purposes, the state is divided into 11 regions. State law establishes a minimum and maximum number of plans that can operate in each of the 11 regions.

Regions 1 and 2, which encompass the western Panhandle, must have at least two managed-care plans. Miami-Dade County, on the other hand, is authorized to have a minimum of five managed-care plans and as many as 10.

Moreover, the law makes clear that if a “provider sponsored network” is competing and submits a responsive bid, the state, must choose it as one of the plans. PSNs are provider owned and operated and don’t require an HMO license from the Florida Office of Insurance Regulation.

Of the health-care organizations that submitted responses to the ITN, 10 want to participate statewide.

The Northwest part of the state has traditionally struggled to attract managed-care plans. But 12 plans responded to the ITN in Region 1, which includes the far western Panhandle, and 12 plans responded in Region 2, which includes other parts of the Panhandle and the Big Bend area.

NRA lobbyist targets Barbara Pariente

National Rifle Association lobbyist Marion Hammer launched a campaign this week to purge Florida Supreme Court Justice Barbara Pariente from a case that could have far-reaching implications for the makeup of the court.

Hammer, long an influential figure in Tallahassee and a former president of the national gun-rights group, sent an email alert Wednesday morning to NRA and Unified Sportsmen of Florida “members and friends” urging them to tell Chief Justice Jorge Labarga and Pariente that “she must recuse or resign” from her post.

“Florida Supreme Court Justice Barbara Pariente has been caught in an act of what we believe is clear judicial misconduct and must recuse herself,” Hammer wrote, attaching an editorial penned by conservative political consultant Justin Sayfie.

In the email, Hammer wrote there “is no other appropriate option” for Pariente than recusal or resignation.

Gov. Rick Scott had asked Pariente to be removed from the case, which centers on whether the governor or his successor has the legal authority to appoint replacements for three justices — Pariente, R. Fred Lewis and Peggy Quince — whose terms end as Scott leaves office in January 2019.

Scott’s lawyers argued that comments by Pariente caught on a “hot mic” after oral arguments in the case indicated she was biased against the governor.

Hammer’s Wednesday morning alert went out just as the court issued an order rejecting Scott’s request that Pariente be disqualified from the case. Presiding law in similar cases says that justices, not the entire court, get to decide whether to recuse themselves.

Hammer said the court’s decision Wednesday didn’t matter.

“She can recuse or resign at any time, and those are the only realistic options that are available,” she told The News Service of Florida on Thursday.

Pariente, Quince and Lewis are part of a liberal-leaning bloc that holds a slim 4-3 majority on the state’s high court. Whoever gets to choose the next three justices could shape court decisions for years, if not decades.

The court has thwarted efforts by Second Amendment supporters twice this year alone.

“The majority of our state’s highest court is not only liberal-leaning and biased against the Second Amendment of the U.S. Constitution but appears to be comfortable with Justice Pariente’s judicial misconduct,” Hammer said in the Thursday interview.

In September, a unanimous court drew a line in the sand in Florida’s “stand your ground” law, by saying the determination of immunity in a criminal case does not carry over to a civil case.

In a 4-2 ruling in March, the court upheld a long-standing ban on people openly carrying firearms in public.

The court could also hear an appeal in another case related to a change in the state’s “stand your ground” law. A Miami judge struck down the change, which supporters of the law called a “notable setback.”

Republished with permission of the News Service of Florida.

Rick Scott says Jack Latvala is ‘distraction’ amid investigation

Gov. Rick Scott on Thursday said Sen. Jack Latvala, under investigation after being accused of sexually harassing a legislative aide and others, is a “distraction” but stopped short of saying the veteran Republican lawmaker should resign.

Latvala, 66, has been accused by several women of groping and making unwelcome remarks about their bodies. Senate aide Rachel Perrin Rogers on Wednesday came forward and identified herself as the woman who lodged a formal complaint with the Senate Rules Committee and Senate President Joe Negron‘s office.

Scott previously called the allegations “disgusting” and said that Latvala, who is running for governor, should resign from the Senate if the accusations are true.

But, in a statement released Thursday, the governor went further.

“Any allegation of sexual harassment is absolutely disgusting and behavior like this is not acceptable. It is obvious that Senator Latvala remaining in the Senate is a distraction. It seems that everyone in Tallahassee is talking about this and not how to make Florida better. It is my understanding that there’s an investigation underway, and when that is complete, the Senate will have a decision to make,” Scott said. “As I have said all along, if these allegations are true, he must resign immediately. Last year, I championed a bill to protect state employees who were victims of sexual harassment at work, and my office is working on additional actions to continue to fight for victims.”

Latvala and his attorney, Steve Andrews, did not respond to requests for comment Thursday.

A special master is conducting an inquiry into the Rules Committee complaint, while the Office of Legislative Affairs hired an outside lawyer to lead a probe into accusations that were made by six unidentified women in a Politico Florida report that set off a firestorm in the Capitol early this month.

The allegations about Latvala, a Clearwater Republican, came as accusations of sexual misconduct topple powerful and well-known men in the movie industry, newsrooms and on television.

Latvala was the influential Senate budget chief until removed from the post by Negron after the allegations were made public. He has steadfastly denied making any unwanted physical contact with the women.

On Wednesday, Latvala’s attorney released more than 200 texts exchanged between the senator and the 35-year-old Perrin Rogers that showed the two had what appeared to be a cordial, if not friendly, relationship that went back several years.

Special master Ron Swanson, a former appellate judge, has been conducting interviews this week in Tallahassee, according to sources close to the investigation.

Swanson will make recommendations to the Rules Committee once his inquiry is complete. Potential sanctions for Latvala could include reprimand, censure or expulsion from the chamber, each of which would require a two-thirds vote of the Senate, which currently includes 39 members. One seat is vacant because former Sen. Jeff Clemens, a Lake Worth Democrat, stepped down last month after disclosures about an affair with a lobbyist.

Assisted living facilities face $280 million tab for generators

Gov. Rick Scott‘s mandate that all assisted living facilities have generators and 96 hours of backup fuel will cost the industry about $280 million, according to estimates published Wednesday by the Florida Department of Elder Affairs.

Because the majority of residents in assisted living facilities are “self pay” and don’t rely on Medicaid, the providers won’t be able to recoup Medicaid funding to help offset the generator costs, said Susan Anderson, vice president of public policy for Florida Argentum, a statewide association that represents assisted living facilities.

The Department of Elder Affairs published a summary of the estimated regulatory costs on Wednesday after it received a three-page letter from the Joint Administrative Procedures Committee flagging potential problems with the proposed rule, initially published on Nov. 14. The estimated costs were published in the Florida Administrative Register.

Florida law requires the department to publish a summary of estimated costs to comply with the regulations and announce whether the rule would require legislative approval. Any rule that increases the costs of doing business by more than $200,000 in the aggregate requires legislative approval.

The rule proposed Nov. 14 is meant to replace an emergency rule that the Scott administration issued in September after the deaths of eight residents at The Rehabilitation Center of Hollywood Hills nursing home following Hurricane Irma. The Broward County facility lost its air-conditioning system Sept. 10 in the storm, and the residents died three days later.

According to the department’s estimates, there are 3,111 assisted living facilities licensed across the state, and more than half of them have fewer than seven beds. To abide by the mandate that they have a generator and enough fuel to keep the temperature at 81 degrees for four days, those small facilities will have to spend an average of $28,000. In the aggregate, the total cost for those providers is estimated at slightly more than $44.7 million.

The state has another 775 assisted living facilities with between seven and 49 beds, and compliance costs for those providers total an estimated $53.2 million. There are another 428 assisted living facilities with 50 to 100 beds, and they will pay a total of about $45.6 million to comply with the requirements.

About 10 percent of the assisted living facilities across the state have more than 100 beds. Those large facilities will be hit with upwards of $136.5 million in overall costs.

Florida Argentum’s Anderson said facilities will have to try to hold down their operating costs to help offset the increased regulatory expenses. The largest component of a facility’s operating costs, she said, is spent on employees.

Hurricane season ends — but issues will linger

Thursday is the last day of the highly active, deadly and destructive 2017 Atlantic hurricane season, but Floridians will feel its impact for years.

Politicians are still scrambling to determine how much of the next state budget will be dedicated to covering losses that may or may not be paid by the federal government.

The massive hit from Hurricane Irma caused direct physical and emotional impacts in Florida, and ripples continue to come ashore as thousands of people flee Hurricane Maria’s devastation in Puerto Rico and the U.S. Virgin Islands.

Lawmakers are also looking at regulatory changes for nursing homes and debris-removal companies, as well as changes dealing with issues such as evacuation lanes, shelters and a potential state fuel reserve.

Gov. Rick Scott, who was a constantly visible face before and after Irma struck, said Monday while in Tampa that he’d like to boost the availability of propane for generators before the 2018 storm season.

“You always learn something,” Scott said. “Everybody had generators. This last time we started running low on propane. I want to make sure that doesn’t happen again. But everyone did a good job. Highway safety, we kept the fuel going.”

Visit Florida spent $5 million to tell potential tourists that the state quickly reopened after Hurricane Irma, even as scars from the September storm remain etched across agricultural fields and the Florida Keys.

Meanwhile, 72 deaths in Florida are currently attributed to the Irma, according to reports supplied by county medical examiners to the state Division of Emergency Management.

The fatalities include 14 cases involving carbon monoxide, eight drownings, four electrocutions and 14 incidents involving blunt-force injuries. Deaths occurred statewide, with six in the Florida Keys, five in Duval County and even two in Leon County, which sustained relatively little damage from Irma compared to other parts of the state.

The numbers don’t include 14 deaths of residents of a Broward County nursing home — 12 were recently ruled homicides — that have caused Scott to push for new rules requiring nursing homes and assisted-living facilities to have emergency generators.

Members of the House Select Committee on Hurricane Response and Preparedness will meet Monday and discuss potential storm-related recommendations for the 2018 Legislative Session, which starts in January. Among the possibilities are legislation about housing, agriculture tax relief, hardening for emergency-operations centers and management of shelters.

“Obviously, there will be short-term things that need to be taken care of in the immediate, upcoming Session,” committee Chairwoman Jeanette Nunez, a Miami Republican, said. “And then, as we saw back in (Hurricane) Andrew, or during the ’04-’05 season, Legislatures will deal with this issue for years to come.”

Hurricane Hermine in 2016 was Florida’s first direct hit from a hurricane in more than a decade. But Irma, which made landfall Sept. 10 in Monroe and Collier counties and traveled up the state, was far more destructive.

Mark Wool, the warning coordination meteorologist at the National Weather Service’s Tallahassee office, called 2017 the busiest for the Atlantic since 2005.

“We didn’t have any things working against tropical cyclone development like in recent years,” Wool said. “There was no El Nino in effect, which tends to suppress things. Didn’t see a lot of dust coming off Africa. We had a very warm ocean and the depth of the warm water was quite large. And all of those things tend to fuel development of a lot of storms.”

Emergency-management officials each year stress preparing for hurricanes. But Wool said the flatness of Florida requires additional vigilance by coastal communities against flooding, as the state is also experiencing a period of rising sea levels.

“Parts of South Beach are flooding now without any storms. Blue skies, tidal flooding, the king tides,” Wool said. “We’ve seen times in the historic record where we’ve had large fluctuations in sea level, and we’re certainly on the upswing.”

As of Nov. 13, more than 830,000 property owners across the state had filed claims for $5.88 billion in insured losses from Irma, which was one of four storms — Tropical Storm Emily, Irma, Hurricane Nate and Tropical Storm Philippe — that had a direct impact on the state during the six-month hurricane season that closes Thursday.

Emily in early August made landfall on Anna Maria Island and quickly was downgraded to a tropical depression. Nate brushed the western Panhandle on Oct. 8 as the center of the storm came ashore near Biloxi, Miss. Philippe brought rain and couple of tornadoes to the Southern part of the state as it made landfall Oct. 29 with 45 mph winds in Southwest Florida.

Overall, there were 17 named storms this year. The most devastation came from Harvey’s Aug. 26 landfall in Texas, Irma’s double landfall and run-up of Florida starting Sept. 10, and Maria’s destruction of utilities and other infrastructure across Puerto Rico on Sept. 20.

While spinning in the Atlantic, Irma reached maximum sustained winds of 185 mph, a pace it held for a record 37 consecutive-hours. Nate also set a record in October for the fastest forward motion recorded for a hurricane in the Gulf of Mexico.

“We certainly did establish some records,” Wool said. “Harvey’s rainfall established a new rainfall record for one system in the United States. I think some areas had 60 inches of rains, which was phenomenal.”

Irma also set new benchmarks for evacuees — an estimated 6.5 million people left their homes in advance of the storm — and power outages and restoration crews. Florida Power & Light, for example, reported 90 percent of its customers — about 10 million people — were without power on average 2.3 days.

The agriculture industry has put a preliminary estimate of $2.5 billion on its losses from the storm.

However, Florida leaders have yet to convince the White House and Congress to include an estimated $761 million in losses to the citrus industry in a series of disaster-relief packages this year.

State Agriculture Commissioner Adam Putnam again implored Florida’s congressional delegation on Tuesday to support U.S. Rep. Tom Rooney‘s proposal to add $1.5 billion for Florida’s agricultural industry to a $44 billion disaster-relief request sent to Congress on Nov. 17 by the White House Office of Management and Budget.

While awaiting federal assistance, Scott authorized a $25 million interest-free loan program for citrus farmers.

Visit Florida, meanwhile, directed $5 million from its tourism budget for a special post-Irma marketing campaign, and Scott has requested lawmakers boost Visit Florida’s marketing dollars from $75 million in the current year to $100 million because of the need to have post-disaster marketing money readily available.

Despite the state saying tourism numbers continue to climb, hotels remain closed in parts of the Keys, where housing issues have grown for workers after Irma devastated a number of areas outside of Key West.

The Islamorada Resort Company, which hired more than 500 construction workers to repair storm damage at four locations on the islands, is reopening the first of the four on Dec. 15 and the second a month later.

“We are thrilled to welcome guests back to our slice of paradise,” said Eddie Sipple, the company’s area general manager.

House, Senate gear up for Session with budget, hurricane scrutiny

In their final series of meetings before the start of the 2018 Legislative Session, lawmakers will focus heavily on hurricane recommendations and Gov. Rick Scott‘s proposed record-breaking $87.4 billion budget.

On Dec. 6, Senate Appropriations Committee will receive a presentation about Scott’s proposal for the fiscal year that will start July 1.

Seven appropriations subcommittees – dealing with budget issues such as education, health and human services and criminal justice – will meet Dec. 7 to look at Scott’s recommendations for their spending areas. Scott’s proposal is a starting point for lawmakers, who will negotiate a final budget during the Legislative Session that starts Jan. 9. Lawmakers will hold four days of committee meetings next week, the final round of committee meetings before the Session.

In the House, receiving a series of presentations recently, a committee next week will discuss potential recommendations for responding to Hurricane Irma and preparing for future storms.

The House Select Committee on Hurricane Response and Preparedness is slated to meet Monday. Its recommendations likely will be considered during the 2018 Legislative Session, which starts in January.

Senate committees also have been looking at hurricane-related issues, though the Senate has not formed a special committee on the topic.

Among other issues going before legislative committees next week, the Senate Banking and Insurance Committee is scheduled Dec. 5 to take up a proposal (SB 150), filed by Republican Sen. Tom Lee of Thonotosassa, that would end the state’s no-fault auto insurance system.

A similar House bill (HB 19), filed by Vero Beach Republican Rep. Erin Grall is ready to go to the full House after the Session starts in January.

Republished with permission of the News Service of Florida.

Medical malpractice records battle brews

Florida voters next year could be asked to once again dive into a never-ending tug-of-war over medical malpractice lawsuits.

Voters more than a decade ago overwhelmingly agreed that what are known as “adverse medical-incident reports” should be made available to patients, but now there’s a move underway in Tallahassee to limit access to them.

Tim Cerio, a member of the state Constitution Revision Commission and former general counsel to Gov. Rick Scott, has filed a proposal that would amend the state Constitution to place limits on what types of records could be used in lawsuits filed against doctors, hospitals and other health-care providers.

The proposal crafted by Cerio, who works for the politically connected law firm of GrayRobinson, would make it clear that access to adverse medical-incident reports does not “abrogate attorney-client communications or work product privileges for patients, health care providers, or health care facilities.”

Moreover, the amendment would exclude from adverse incident reports documents that are “protected by federal laws or regulations relating to patient safety quality improvement.”

Cerio said he doesn’t want to thwart the public’s access to the records, which play a key role in medical malpractice cases, and said he is considering altering his proposal to narrow it.

Voters in 2004 approved a constitutional amendment, Amendment 7, that gave patients the right to have access to records of health-care providers’ adverse incidents.

The Constitution Revision Commission, which meets every 20 years, can put proposed constitutional changes directly on the 2018 ballot. Cerio’s proposal on adverse-incident reports is one of dozens the commission will consider during the coming months.

Cerio maintains recent Florida court rulings have broadened the initial intent of Amendment 7 to the point where it now interferes with hospitals’ abilities to prepare for litigation.

“There has been a stream of cases that have expanded basically the impact of Amendment 7 and created an ability for litigants to get at information that was not intended,” he said. “Attorney-client work product is sacrosanct, and for the courts to expand that, I think, is not a good reading of the original intent of Amendment 7.”

The Florida Supreme Court this year issued opinions in two cases related to the public’s right to the information.

In October, the Supreme Court overturned a decision by the 2nd District Court of Appeal that would have allowed Bartow Regional Medical Center to avoid turning over records that were prepared — at the request of the hospital’s counsel — outside of the ordinary peer-review process and in anticipation of litigation.

Writing for the Supreme Court majority, Justice R. Fred Lewis said that “the result asserted by Bartow would provide a trap door through which hospitals could totally avoid their discovery obligations by outsourcing their adverse medical incident reporting to external, voluntary risk management committees separate from those required by the Florida statutory scheme.”

In January, the Supreme Court held in a separate case that a 2005 federal patient-safety law did not shield Baptist Health System in Jacksonville from turning over adverse medical-incident reports. The hospital appealed the ruling to the U.S. Supreme Court, which declined to take up the case.

Lobbyist Jan Gorrie, who represents hospitals, said patient safety transcends all other issues and given the U.S. Supreme Court’s refusal to hear the Baptist Health case, now is the time to reconsider the information that should be available to patients and prospective patients under Amendment 7.

“If your institution didn’t do something right, you want them to take a serious self-examination, which to some degree won’t happen if they don’t have these processes protected,” said Gorrie, with the Ballard Partners firm.

Medical malpractice has long been a highly contentious legal and political issue. On one side of the debate are medical providers and insurance companies, which have tried to limit the ability of injured patients to sue. On the other side are trial attorneys who oppose attempts to limit access to the courts.

At the behest of then-Gov. Jeb Bush who declared there was a medical-malpractice “crisis,” the Legislature in 2003 passed a number of changes meant to limit lawsuits that could be filed against providers.

Moreover, the legislation, which Bush signed into law, also placed limits on the amount of money injured patients could collect in malpractice cases for pain and suffering.

The law, though, fell short of what the medical community and insurance companies sought and was more restrictive than what trial attorneys wanted. Dissatisfied, both sides pushed proposed constitutional amendments in 2004.

The Florida Justice Association, made up of trial lawyers, backed two proposed constitutional amendments that year; Amendment 7, which gave patients a right to adverse medical-incident reports, and Amendment 8, which prohibited physicians who have been found to have committed three or more incidents of medical malpractice from being licensed to practice in Florida. Amendment 7 passed with 81 percent approval, while Amendment 8 was approved by 71 percent.

Amendment 3, supported by health-care providers, capped the amount of money attorneys could collect in medical malpractice cases. It passed with nearly 64 percent approval.

Jacksonville appellate attorney Bryan Gowdy called Cerio’s proposal a “pretty obvious attempt to diminish the right of patients to access adverse medical-incident reports.”

Gowdy agreed with Cerio that there’s been a “history of litigation” since Amendment 7. But unlike Cerio, Gowdy maintained that the Florida Supreme Court’s decisions have been accurate.

“Every effort has been made by the hospitals to resist and thwart implementation of Amendment 7,” said Gowdy, with the law firm, Creed and Gowdy. “Now they are trying to go back and rewrite it.”

Republished with permission of the News Service of Florida.

U.S. Supreme Court rejects challenge to open-carry ban

The U.S. Supreme Court on Monday refused to take up a challenge to a Florida law that bars people from openly carrying firearms in public, ending a case that started nearly six years ago when a man was arrested in St. Lucie County.

The U.S. Supreme Court, as is common, did not explain its reasons for declining to hear the case. But the move effectively let stand a Florida Supreme Court ruling in March that said the open-carry ban did not violate the constitutional right to bear arms.

The plaintiff in the case, Dale Norman, was arrested in February 2012 as he openly carried a gun in a holster. Norman, who had a concealed-weapons license, was found guilty of a second-degree misdemeanor, with a judge imposing a $300 fine and court costs, according to court documents.

Backed by the Second Amendment group Florida Carry, Norman challenged the constitutionality of the state’s long-standing ban on openly carrying weapons. But the state’s 4th District Court of Appeal and the Florida Supreme Court ruled against Norman, leading him to go to the U.S. Supreme Court.

In a petition filed with the U.S. Supreme Court, Norman’s attorneys pointed to major rulings in Second Amendment cases from Chicago and Washington, D.C. and argued that the right to openly bear arms exists outside homes.

“The Second Amendment provides in part that `the right of the people to keep and bear arms, shall not be infringed.’ This guarantees not only the right to `keep’ arms, such as in one’s house, but also to `bear arms,’ which simply means to carry arms without reference to a specific place. When the Framers intended that a provision of the Bill of Rights related to a house, they said so,” said the petition, filed in July and posted on the Florida Carry website.

But attorneys for the state wrote in a brief that the ban does not violate Second Amendment rights, as people can carry concealed weapons if they have licenses.

“This (U.S. Supreme) Court has never held that the Second Amendment protects a right to openly carry firearms in public, and the reasoning set forth in pertinent case law supports the proposition that states fully accommodate the right to bear arms when they make available to responsible, law-abiding citizens some meaningful form of public carry,” the state’s brief said. “That is precisely what Florida has done here. Thus, Florida’s law is valid under any arguably applicable analytical framework.”

State lawmakers have proposed measures that would allow people with concealed-weapons licenses to openly carry firearms, but the proposals have not passed. Senate Judiciary Chairman Greg Steube, a Sarasota Republican and prominent gun-rights supporter, said this month he did not plan to file such a measure for the 2018 Legislative Session, which starts in January.

Member projects top $1 billion

House members are proposing to spend $1.12 billion through hundreds of projects they hope to take back home from the Legislative Session that starts Jan. 9.

Riding high atop the wish list is Rep. Bobby Payne, a Palatka Republican who offered 17 proposals on Tuesday totaling more than $105 million.

Last week, House members proposed 310 separate projects, worth more than a half-million dollars, while in Tallahassee for a pre-Session committee week.

Being away from the Capitol for the Thanksgiving holiday didn’t slow down the requests, even though most of the proposals won’t make it very far.

On Monday and Tuesday, 159 projects, collectively worth $267 million, were filed.

Payne’s proposals include what is now the single largest ask: $69.5 million (HB 3259) for drinking water infrastructure improvements in Palatka.

As of Wednesday morning, House members had created a 673-strong project list for the session. But the proposals will have to compete with diminishing revenue, rising health-care and education costs, and the need to cover Hurricane Irma repairs and an influx of Puerto Rican evacuees from Hurricane Maria.

House Speaker Richard Corcoran, a Land O’Lakes Republican, has made clear that the priority will be on relief related to Irma, which caused billions of dollars in damage to the state in early September.

Unlike the Senate, the House requires members to submit each spending proposal as an individual bill.

Overall, Republicans had filed 451 project bills collectively worth $819.8 million. Democrats have rolled out 221 bills worth $295.7 million. There is one bipartisan proposal (HB 2135) regarding a livestock pavilion in Marion County.

Orlando Republican Rep. Rene Plasencia had made the second-largest request. He’s seeking $34.4 million for a Lake Nona campus building for Valencia College (HB 2437).

Meanwhile, Republican Rep. Manny Diaz Jr. of Hialeah, is asking for $52 million through 23 projects, including $28 million for a STEM Center on the north campus of Broward College (HB 2423).

Across the political aisle, Democratic Rep. Roy Hardemon of Miami is pitching for $50.9 million in 25 projects, including a $25 million intermodal logistics center at Poinciana Industrial Park in Miami-Dade County (HB 2767).

Republished with permission of the News Service of Florida.

Panel eyes vaping restriction, patient rights

Vaping could be banned in workplaces, and nursing-home and assisted-living facility residents could be guaranteed certain rights – including the ability to sue without limitations – as part of a series of health care related proposals being considered by a Florida panel that has the power to place proposed constitutional amendments on the 2018 ballot.

Former state Sen. Lisa Carlton, the sponsor of the measure on vaping, said her goal is to amend the Florida Constitution to make clear that the state’s existing ban on smoking in workplaces also incorporates vaping, such as the use of electronic cigarettes.

“The goal is, if you cannot smoke there, you cannot vape there,” Carlton said, noting that electronic cigarettes weren’t available when the original ban was passed by Florida voters in 2002.

After e-cigarettes started to become available, she expected the Legislature to tackle the issue, but it didn’t.

In retrospect, Carlton said she thinks it’s better the Legislature didn’t address the issue because voters could get the opportunity to put a vaping ban in the Constitution. More than 70 percent of voters approved the original workplace smoking ban in 2002.

“It’s the perfect opportunity because it should be alongside smoking,” she said, adding, “I feel like this (vaping) has put a cloud over our clean air, and it’s time for us to recognize it and update it.”

Carlton’s proposal would amend a section of the Constitution currently titled “Workplaces without Tobacco Smoke” to read “Workplaces without Tobacco Smoke or Vapor.”

Carlton is part of the 37-member Florida Constitution Revision Commission which meets every 20 years to evaluate possible changes to the Constitution. The panel can put issues before voters without having to gather petition signatures or get proposals approved by the Legislature.

Commission members proposed 103 amendments, and the panel is expected to whittle that number in the coming months. The commission’s General Provisions Committee could take up Carlton’s proposal Tuesday.

In all, the commission is expected to consider seven health care related proposals, including a controversial proposal about nursing homes and assisted living facilities.

Commissioner Brecht Heuchan has offered a proposal that would establish a “bill of rights” for residents of nursing homes and assisted living facilities. Heuchan’s proposal, in part, would require nursing homes to carry liability insurance – which is not a requirement today – and includes a right of access to courts and legal remedies, “without limitations,” in cases involving issues such as abuse, negligence or exploitation.

Emmett Reed, executive director of the Florida Health Care Association, the state’s largest nursing-home group, issued a scathing news release attacking Heuchan for the proposed amendment. Reed accused Heuchan, who is a lobbyist for the Florida Justice Association trial-lawyers group, of ignoring “his broader obligations in order to serve the narrow interest of his clients.”

Reed called the state constitution the “core document” that sets out the structure of Florida’s government and said that “some things simply do not belong in the Florida Constitution.” He also said that the proposal would “add nothing to the quality of life for our state’s frailest elders, nor would it solve the real issues of keeping nursing home residents safe during disasters. It would only serve the interests of greedy trial attorneys who continually attempt to cash in by suing nursing homes.”

But Heuchan fired back at the nursing home organization. In a letter he sent to The News Service of Florida, Heuchan said the Constitution is “a place where rights of the individual are protected, especially when it comes to the rights of the vulnerable.”

“I cannot count the number of times I have been told one issue or another does not belong in the Constitution,” he wrote in the letter, adding that when the argument comes from special-interest groups, it’s “code” for something else.

“What they really mean,” the letter said, is “they think they have other forums wired in their favor, (or) … they know if voters have a chance to consider the proposal, it would pass.”

Heuchan disputed the allegation that his amendment would help his clients or is a potential conflict of interest. Before filing the amendment he reviewed the rules, which make clear that he cannot file an amendment that would result in a special gain for him or a principal of his.

“What they are saying is speculative at best,” he said adding that if a lawyer successfully sues a nursing home on behalf of a resident, the attorney is paid from the damages the resident is awarded. “It’s not a gain to me personally, and it’s not a special gain to anyone I work for,” he said.

“This is just part of their campaign to discredit me personally because they don’t have a good answer to the proposal,” he said.

Meanwhile, Heuchan isn’t the only member of the Constitution Revision Commission wanting to create a patient’s bill of rights.

Commissioner Frank Kruppenbacher has proposed an amendment that, if approved by voters, would require the Legislature to guarantee patients “transparency in health care.” That transparency would apply to such things as medical costs and information needed to help patients make informed decisions about treatment.

Health care transparency has been a priority for Gov. Rick Scott, who appointed Kruppenbacher to the commission.

Kruppenbacher also has offered another health care proposal that aligns with Scott’s priorities.

That proposal would eliminate “certificate of need” laws, which the state can use to restrict the addition of new hospitals and nursing homes. Certificates of need are licenses that Florida requires before new health care facilities can be built.

Proponents of so-called CONs argue that they help keep health care costs lower by preventing facilities from being overbuilt. Critics, such as Scott and House Speaker Richard Corcoran, maintain that CONs are artificial barriers to the marketplace that prevent competition and provide monopolies for companies that already have the licenses.

Scott and the House have tried unsuccessfully to eliminate certificate of need laws but have faced opposition from hospitals and nursing homes that don’t want to see the restrictions lifted.

Republished with permission of the News Service of Florida.

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