A high-priority issue for House Speaker Jose Oliva is in trouble in the Florida Senate.
The Senate Health Policy Committee on Monday delayed a vote on a bill that would eliminate the “certificate of need” regulatory program for hospitals beginning in July.
Committee Chairwoman Gayle Harrell, a Stuart Republican, tabled a vote on the measure (SB 1712) because it otherwise would have died on a 6-4 vote. Sen. Aaron Bean, a Fernandina Beach Republican, and Sen. Ed Hooper, a Clearwater Republican, joined the four Democrats on the committee in opposing the bill.
“I thought we had a very good compromise,” Harrell said after the meeting, adding, “I think this is the responsible approach to the repeal of CON.”
Harrell refused to say that the bill was in trouble or that the House and Senate were headed for a clash.
“I think that’s a topic for the speaker and the Senate president,” Harrell said, referring to Senate President Bill Galvano, a Bradenton Republican.
The House has fast-tracked broader legislation (HB 21) that would eliminate the so-called CON program for hospitals, nursing homes and hospices. The full House is slated to debate the proposal when it meets Wednesday.
Oliva, who has made eliminating certificate of need and other health-care regulations a priority, could not be immediately reached for comment Monday about the Senate bill getting tabled.
Florida is one of 35 states that have laws designed to require health-care providers to justify the need for certain types of new facilities and services. Oliva, a Miami Lakes Republican, and other lawmakers have argued that certificates of need unnecessarily drive up the cost of health care by artificially restricting the market and that the state should take more of a “free market” approach.
Molly McKinstry, a deputy secretary for the Florida Agency for Health Care Administration, testified in the House last month that in recent years most new hospitals have gone through the state’s current process without getting bogged down in regulatory fights. Those fights, which often include hearings before administrative law judges, can drag out for one to two years.
Harrell on Monday tacked on amendments to her bill to try to gain support.
One amendment, in part, would require that new hospitals, unless being built in rural areas, have at least 80 beds and offer intensive care and medical surgical beds. The amendment also would require hospitals to have onsite emergency departments that operate 24 hours a day seven days a week.
The changes were included in the bill to try to ensure that “boutique” hospitals that specialize in certain procedures wouldn’t be created to the detriment of larger so-called “safety net” facilities, which treat large numbers of poor and uninsured patients, usually in urban areas.
But the changes weren’t enough to gain the support of Bean and Hooper.
Hooper told The News Service of Florida after the meeting that Harrell’s amendments made the bill better, but he worries that if the state were to eliminate the CON program there would be a proliferation of new facilities in affluent neighborhoods.
“There’s just too many unanswered questions, and I don’t want it to turn into a Walgreens-CVS scenario where every corner has to have one of each,” he said.