House budget cuts hospitals by $259 million; redirects $100 million toward nursing training

The House budget didn't provide details as to how the funds would be spent.

Rep. Bryan Ávila rolled out a $47 billion health care spending plan Thursday that cuts hospital rates by nearly $252 million and redirects a portion of that money to help train future nurses in order to abate the state’s nursing shortage.

Ávila, the House Republican in charge of the Health Care Appropriations Subcommittee, said the chamber decided to remove $100 million in recurring revenue from hospitals and direct it toward training nurses after learning that the industry profited $6.3 billion in 2020. Additionally, Ávila said the Legislature approved two new supplemental payment programs that allowed hospitals to earn more than $1.5 billion in additional Medicaid funds in the current year budget.

“We have heard the call of the health care industry to partner with them to find solutions to this problem,” Ávila said, referring to a Florida Hospital Association report that projected Florida will have 59,100 less nurses than it needs by 2035. To address the problem, the report recommended expanding opportunities at schools and clinical training capacity, increasing the number of nurse faculty opportunities, and improving pass rates of the nurse licensing exams, which are some of the lowest in the country.

Given the industry’s strong financial performance, Ávila said, hospitals are in a “unique position to combine resources with the state to solve a problem that will uniquely benefit the same hospitals and the people they serve.”

Ávila said the $100 million in general revenue being removed from his proposed budget will be redirected to the House Education Appropriations Subcommittee to use. It’s not clear if the $100 million will continue to draw down the additional federal money once redirected to nurse training.

The Safety Net Hospital Alliance of Florida is reviewing how the House’s proposed spending plan would impact the industry and did not have immediate comment Thursday evening.

The House’s proposed hospital reduction is one of the starker differences that must be hammered out with the Florida Senate between now and the end of Session. But it’s not the only difference included in the health care budget rolled out a day earlier by the upper chamber.

Senate President Wilton Simpson has made it a priority to increase pay for state employees and state-contracted employees to $15 an hour. The Senate included $685.5 million to ensure nursing home staff and direct-care providers that care for people with intellectual and developmental disabilities get a pay bump. By contrast, Ávila‘s budget proposed spending $163 million to Medicaid providers to raise pay to $13 an hour.

The House budget didn’t provide details as to how the funds would be spent; Ávila said those details should be available Friday.

Ávila downplayed the differences between the hourly wage and whether it should be $13 or $15.

“These are both starting points,” he said. “Certainly, as we move through the process, we will continue to have these conversations.”

The House’s proposed budget plan spends less money on health care than the Senate’s proposed plan. Ávila’s proposed health care spending for state fiscal year 2022-2023 is $47.1 billion, of which $13.65 billion is from recurring and $134.7 million is from non-recurring general revenue, respectively. The Senate proposed spending for health care in the coming fiscal year is $47.8 billion. The Senate proposes spending $13.75 billion in recurring and $207.3 million in non-recurring general revenue, respectively, on providing health care and other social services to Florida residents.

Lawmakers meet annually in Tallahassee to consider bills on a wide variety of topics. But they only are required to pass one piece of legislation: the General Appropriations Act, which is the budget bill.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


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