Christine Jordan Sexton
A telehealth program to improve maternal outcomes among ethnic and minority populations in Orange and Duval counties could be expanded if state Surgeon General Joseph Ladapo has his way.
So could school-based health programs.
The Florida Department of Health released the Fiscal Year 2023-24 legislative budget request (LBR) this week which increases public health spending by tens of millions of dollars.
The budget includes a $12.6 million infusion to expand to another 18 counties a program aiming to eliminate racial and ethnic disparities in maternal morbidity and other maternal outcomes. Those counties are Brevard, Broward, Collier, Escambia, Hillsborough, Lake, Lee, Leon, Manatee, Marion, Miami-Dade, Palm Beach, Pasco, Pinellas, Polk, Sarasota, Seminole and Volusia.
Lawmakers in 2021 passed legislation that required the state to develop telehealth pilot projects in Duval and Orange counties where women were provided evidence-based health literacy about pregnancy, childbirth and parenting. The women are also provided with medical devices such as blood pressure cuffs that allow perinatal professionals to check their wellness.
Initially, lawmakers required that the telehealth projects be funded with $4.85 million in recurring funds that were earmarked for “Closing the Gap” grants. Lawmakers agreed to earmark an additional $5.4 million for the program in the FY 2022-23 budget, but the money was non-recurring.
Ladapo’s budget request also doubles the amount of money for school health programs, adding an additional $29 million for school health programs.
During the 2020-21 school year, 1,321 registered nurses provided services to more than 2.81 million students in 3,769 Florida public schools. One registered nurse supports three schools or upward of 2,100 students, according to the budget documents.
About $3 million in funds are currently being targeted for school health services to draw matching federal administrative funds. Ladapo’s budget wouldn’t earmark any added state funding to the school health program but would triple the amount of existing funds the state identifies as administrative. In doing so, the state has an additional $29.3 million it can use to fund its programs under the School Services Act.
It requires no additional state dollars and “will increase the program’s financial resources to implement innovative staffing models to meet future program needs statewide,” the budget narrative reads.
According to the LBR, the plan is for the School Health Services Program to ink regional and statewide contracts with medical staffing agencies and hospital systems for the county health programs statewide.
“Rather than rely on ‘a one-size-fits-all’ staffing allocations, each school health program can make a request to the office based on what they need to meet their local programmatic goals,” the budget notes.
It’s not clear, though, what the budget proposes is allowable under the law. Currently, the school services plan is developed jointly by the county health department and the district School Board and the local school health advisory committee.
The LBR also earmarks an additional $5.9 million for school dental health and sealant programs. According to the budget narrative, the money will be used to open or expand 25 school-based sealant programs and to hire 25 additional hygienists.
The goal is to treat an additional 97,250 children. According to the DOH, in Fiscal Year 2021-22, 46,296 children through age 20 received 195,281 services through the county health department’s school-based sealant program.
LBRs signify the beginning of the annual appropriations process. State agencies are asked to prepare LBRs in advance of Regular Legislative Sessions. The proposals are wish lists only, but they are also considered by Governors as they prepare their own proposed spending plans for legislative consideration.
In addition to requesting additional funds for those programs Ladapo’s budget also requests tens of millions for information technology (IT).
The use of newer technology, an increase in telework, the use of high-resolution imaging, and other data streaming services have put a demand on the DOH network capacity. The DOH is asking for $6.65 million to contract with a network services provider to fund the development of a modern network, which would include the replacement of the old network equipment and outsourcing the maintenance and management of the network.
The DOH would be the first agency in Florida to outsource its network requirements, the department contends. The department also is asking for about $1.95 million to hire 11 full-time IT positions and five support positions.
The DOH budget also includes funding for new fleet vehicles for different divisions. The Correctional Medical Authority (CMA) is housed in the department and is responsible for monitoring the Florida Department of Corrections health care delivery system at its 58+ facilities across the state.
In FY 2021-22, the CMA spent $19,160 in rental car costs and staff mileage. The LBR notes that the CMA needs money to buy two vehicles and requests $70,736 in nonrecurring funds to buy two 2023 Ford Transit Connect Wagons.
The Division of Medical Quality Assurance, which investigates rogue providers and inspects office-based surgery centers, has to replace four vehicles due to high mileage and is requesting $104,106 in order to do so.
Meanwhile, the county health departments (CHDs) are requesting a reduced increase of $1,321,143 for vehicle acquisition. “This increase would provide CHDs adequate authority to procure needed vehicles for the foreseeable future, based on patterns of the past four years,” the budget notes.
