Diagnosis for 2.14.24: 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.

A bid to increase Florida’s sovereign immunity caps — a move being closely followed by those who run the state’s public hospitals — is now in doubt after a plan to tie the legislation to another controversial lawsuit measure encountered stiff resistance in a House panel.

Rep. Tommy Gregory announced at the start of the Wednesday meeting of the House Judiciary Committee that a revamped version of the sovereign immunity caps bill sponsored by Rep. Fiona McFarland would not be considered. It was a tacit acknowledgment that the bill (HB 569) lacked the votes to make it through.

Gregory had suggested merging McFarland’s proposal to double the amount of money that can be collected in lawsuits against state, local government and hospitals to his own bill that requires the disclosure of third-party groups who help bankroll civil lawsuits.

But this effort to link the two bills resulted in increasing opposition as supporters of raising the caps were unwilling to back the third-party litigation provision, a top priority of groups such as the Florida Justice Reform Institute.

One source told Diagnosis that only 4 legislators out of 23 on the panel were willing to vote for the bill.

Not surprisingly, Gregory deferred a vote on the bill.

“Today we are going to be considering 19 bills. Unfortunately, one we are not going to be hearing, so it’s a very poor Valentine’s gift for you, Rep. McFarland, we will not be hearing HB 569. “

After the meeting, Gregory would not say how many yes votes he had for the proposal, offering instead: “Politics makes strange bedfellows.”

Gregory also said that while the bill had an uphill battle, no bill is ever really dead until the Session is over.

But even proponents of a crackdown on third-party litigation financing acknowledge it would be “unprecedented” for a bill that had been deferred three times for lack of support to make it across the finish line.

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— Cancer funding changes —

Be prepared for another round of changes to how the state provides hundreds of millions of cancer funding dollars to health care providers.

While Gov Ron DeSantis and First Lady Casey DeSantis announced awards for cancer innovation programs across the state at the Governor’s Mansion Wednesday inside the walls of the Capitol the Governor’s staff is working on changes to how the Casey DeSantis Cancer Funding Research Program will operate going forward.

At press time, there was no proposed bill or amendment filed containing any of the changes sought by the Governor’s Office.

But a Feb. 23 2023 press release may perhaps be a harbinger of things to come. Casey DeSantis announced in the release preliminary members of the Cancer Connect Collaborative (CCC): Rep. Sam Garrison; Dr. Nicholas Panetta, a faculty member at the University of South Florida Health; Dr. Raj Bendre, a radiation oncologist at Tallahassee Memorial Cancer Center; Dr. Scot Ackerman, a radiation oncologist and Medical Director at the Ackerman Cancer Center in Jacksonville; Dr. Mehmet Hepgur, a Hematology/Oncology specialist at Broward Health; State Surgeon General Dr. Joseph Ladapo; and Agency for Health Care Administration Secretary Jason Weida.

Worth noting: there currently are no representatives on the CCC from the four National Cancer Institute (NCI) designated facilities: Moffitt Cancer Center, The University of Miami Sylvester Comprehensive Cancer, UF Health Cancer Center, or Mayo Clinic Comprehensive Cancer Center.

It’s not clear whether the Governor’s Office will include them as members.

The press release also notes that the CCC will be charged with developing a funding formula to spread the wealth when it comes to the providers that receive funds from the Casey DeSantis Cancer Funding Research Program.

Currently, those dollars are dedicated to the four NCI-designated centers. The financing changes wouldn’t take effect until the 2025-26 budget.

This is the second time in as many years that the Legislature has tackled cancer funding as part of budget negotiations.

— Garrison, Gayle on cancer —

Garrison, chair of the powerful House health care spending committee, told Florida Politics that the House’s cancer funding policies aren’t static.

“The House specifically and the Legislature in general has been very aggressive in our funding of cancer research. That’s not going to stop. I think one of the questions we are going to be looking at this year and in the years to come is what is the best utilization of those funds. How to get the best ROI (return on investment). And that’s an open conversation,” Garrison said.

“I don’t look at it as a negative or positive. It’s just, we want to have the best system of care for cancer patients in the southeastern United States. I’m very passionate about rural health care. We want to make sure nobody’s getting left behind as part of that process.”

But does ensuring no one gets left behind mean less for the four facilities currently receiving the funds?

“It’s not a zero-sum game,” Garrison said. “But with that said, we can’t print our own money, so we have a fixed amount of funds we are able to deploy in any one given budget year, so you know, you just kind of do the best you can.”

Harrell told Florida Politics she was still digesting a Department of Health report but that cancer issues have “come to the forefront” in recent Sessions.

“I haven’t made up my mind as to what’s going on yet. I need to really get an in-depth understanding of what that report is saying, and certainly, the more research we have in the state of Florida, the better. “

— Headed to the House floor —

Rep. Randy Fine’s push to require independent hospital districts across the state to study whether they should sell off their assets to a private company or transition to a non-profit organization is now headed to the full House.

The House State Affairs Committee voted to advance the bill Wednesday along party lines. Several Democrats on the panel said they were concerned that the legislation did not require the studies of hospital operations to look at whether or not such services should be offered by publicly owned facilities.

“They are not run to make money. They are public hospitals,” said Rep. Anna Eskamani. “The proposal is step one to privatization.”

Rep. Felicia Robinson said the decision to evaluate whether or not hospital districts should no longer operate under public ownership should be left up to the local districts. There are 26 independent hospital districts in the state.

But Fine blasted the opponents of the bill, saying they were acting on behalf of top public hospital officials who don’t want to study whether to convert their operations. He argued that many top public hospital executives were making excessive salaries although he declined to provide a list of the salaries.

“Do we believe in knowledge or do we not?” Fine said. “If you fear the answer to the question, you should fear the entity in charge.”

Fine did make one change to his legislation before the final vote. Hospital districts that had conducted an evaluation of their financial operations in the last ten years would not have to follow the bill requirements.

— Walk, run or ruck —

The Florida Health Care Association is helping sponsor the “Race for Our Heroes 5K” with Lt. Governor Jeanette Nuñez.

The race is slated for 8 a.m. on Feb. 24 8 a.m. at Tom Brown Park.

“We’re thankful to have the Lt. Governor joining us to kick off the race, which is a run, walk or ruck event that will benefit the Florida Veterans Foundation and Florida veterans in need,” FHCA said in a statement provided to Florida Politics.

In addition to the race, the event will feature start and finish line activities at the Lake Leon Playground Pavilion at Tom Brown Park, which is located off Conner Boulevard.

“Bring the family and your four-legged friends to run, walk or ruck with us and help honor Florida’s military Veterans, first responders and their K-9s,” event organizers said.

Those wishing to compete in the 5K must register. The pre-registration cost is $25 and the first 100 people to register will receive a T-shirt. On-site registration costs $35.

Challenge Coins will be awarded to the top three male/female runners, walkers, ruckers and K-9s.

— 12 CON Applications —

AHCA approved seven CON applications for new nursing homes and intermediate care facilities for the developmentally disabled and denied another five applications. The following applications were approved:

—Marion Operations CON for a new 103-bed community nursing home;

—Sunrise Community’s CON for a new four-bed ICFDD in Hillsborough County and the de-licensure of four beds from Sunrise Community’s  120-bed ICF/DD in Maimi Dade County;

—Sunrise Community’s CON for a new four-bed ICFDD in Hillsborough County and the de-licensure of four beds from Sunrise Community’s  120-bed ICF/DD in Maimi Dade County;

—Sunrise Community’s CON for a new four-bed ICFDD in Hillsborough County and the de-licensure of four beds from Sunrise Community’s  120-bed ICF/DD in Maimi Dade Count;y

—Brevard Operations CON for new 90-bed community nursing home in Brevard County

—Mercy Center OPCO, CON for five community nursing home beds in Miami Dade through the transfer of five beds from North Dade Nursing and Rehabilitation Center; and

—Okeechobee SNF Operations D/b/a Okeechobee Health Care Facility CON to add community nursing home beds.

The following applications were denied:

—Sunrise Community CON to establish a new four-bed ICF/DD  in Hillsborough County by de-licensure and transfer of four beds from Sunrise Community, 120-bed Miami-Dade ICF/DD;

—Sunrise Community CON to establish a new four-bed ICF/DD in Hillsborough County by de-licensure and transfer of four beds from Sunrise Community, 120-bed Miami-Dade ICF/DD;

—Sunrise Community’s CON to establish a new four-bed ICF/DD in Hillsborough County by de-licensure and transfer of four beds from Sunrise Community, 120-bed Miami-Dade ICF/DD

—HSP Mid Florida’s CON for a new 111-bed community nursing home in 111-bed community nursing home in Martin County.

—Martin Coast Opco’s CON to add 22 community nursing home beds at Martin Coast Center for Rehabilitation and Healthcare 

— RULES —

The Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling has withdrawn Rules 64B4-3.001 4B4-3.0015 and 64B4-2.0025.

— LOBBYISTS —

Jon Hoffman:  American Kidney Fund

Travis Cummings, Oak Strategies: Precision Healthcare

Doug Holder,  The Legis Group: ARC Broward, Chapters Health Home Connect, LifeStream Behavioral Center, Love Serving Autism, Sarasota Memorial Health Care System, Suncoast Communities Blood Bank, Virtus Health

Nick Iarossi, Capital City Consulting: Precision Healthcare

Earl Jones Jr., The Fiorentino Group: Community Hospice of Northeast Florida

Anna Grace Lewis, Metz Husband & Daughton: National Association of Social Workers Florida Chapter

Marnie George, Johnson & Blanton: AdventHealth

— ETC —

—U.S. Reps. Gus Bilirakis and Darren Soto are working across the aisle to save lives. The Palm Harbor Republican and Kissimmee Democrat introduced the Congenital Heart Futures Reauthorization Act to direct funding through the Health and Human Services Department for research and awareness.

—AHCA approved the following expedited CON transfers his week: from  PruittHealth Citrus Hills to PruittHealth Citrus County; from PruittHealth Viera to PuittHealth Brevard County; and from PuittHealth Windermere to PruittHealth Orange County.

—The trauma center at HCA Florida Blake Hospital has been verified as a Level II Trauma Center by the American College of Surgeons Committee on Trauma (ACS COT), the highest possible designation.

— ROSTER —

Kelly Cullen, the academic health system’s executive vice president and chief operating officer for Tampa General Hospital (TGH) was named to Becker’s Hospital Review’s 2024 list of “Academic Medical Center Chief Operating Officers to Know.”

Christopher Senkowski, MD, FACS, has been named Director of the General Surgery Residency Program at Baptist Health.

— ICYMI —

In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.

“State employees could get free skin cancer screenings” via Christine Jourdan Sexton of Florida Politics — Employees covered by the state group health insurance plan will have free access to annual skin cancer screenings effective July 1 under bills that are moving through the Legislature. The Senate Appropriations Committee on Agriculture, Environment, and General Government unanimously approved SB 56. That sends the bill, filed by Sen. Gayle Harrell, to its last stop at the Senate Appropriations Committee. HB 241 is the companion measure and it’s identical to the Senate bill. The House measure has cleared two committees and next heads to the Health & Human Services Committee.

“Hemp rules keep moving through House. What substances could be banned?” via A.G. Cancarski of Florida Politics — New legislation that could put new restrictions on the state’s hemp market continues to move toward the finish line, but it may not be in its final form just yet. HB 1613, advanced by an 8-4 vote of the House Agriculture & Natural Resources Appropriations Subcommittee, would crack down on alternative cannabinoids that serve as functional alternatives to delta-9 THC, the euphoria-inducing compound commodified by the state’s medical marijuana program.

“Winning bid announced for Medicaid managed care developmental disability pilot program” via Christine Jordan Sexton of Florida Politics — Florida Medicaid officials have announced their intent to award a six-year contract to Florida Community Care as the state tests whether managed care can help integrate traditional health care with home- and community-based services. The decision is not final until Wednesday and can be challenged until then. The Agency for Health Care Administration (AHCA) announced the contracts for Medicaid Regions D and I. Region D comprises Hardee, Highlands, Hillsborough, Manatee and Polk counties. Medicaid Region I covers Miami-Dade and Monroe counties.

— FOR YOUR RADAR —

Aside from coverage by Florida Politics, these stories are worth your time.

“Florida’s immigration crackdown is scaring patients away from seeking care” via Arek Sarkissian of POLITICO — One of DeSantis’ most controversial immigration moves has led to women shunning mammograms and prenatal care out of fear that they’ll be forced to reveal their immigration status. At issue is a new Florida law requiring hospitals that receive Medicaid dollars to ask patients about their immigration status. Undocumented migrants in Florida are now steering clear of hospitals and clinics, worried that they’ll be arrested or deported, according to 10 immigration advocates, lawmakers and health care officials.

“Medicated without consent? Collier leaders halt fluoride being added in drinking water” via Liz Freeman of the Naples Daily News — After three hours of public testimony on the merits and harms of fluoride being added to the county’s drinking water, the Collier County Commission voted unanimously to end the practice. The decision was largely based on the county’s Health Freedom Bill of Rights ordinance adopted last year to safeguard the health care freedoms of residents and not impose medical treatment without their consent. Commissioner Dan Kowal put the issue on the agenda after some people brought it to his attention and what he found in his own research. “So, in reality, as we sit here today, we are in violation of our own law,” Kowal said.

“NCH gets approval for new 87-foot tall heart center at Baker Hospital campus” via Liz Freeman of the Naples Daily News — The Naples City Council has approved rezoning NCH’s Baker Hospital campus for a new heart and stroke center at 87 feet in height and a new 30-foot parking garage. The rezoning of 13.72 acres that encompasses the main block of the hospital campus from “medical” to the city’s “public services” zoning passed 4 to 1 with Vice Mayor Terry Hutchison casting the lone “no” vote. A companion conditional use application to allow for the five-story heart center at 87 feet and other conditions passed 3 to 2 with Hutchison and Councilwoman Beth Petrunoff dissenting. A site development plan passed 4 to 1 with Hutchison voting against it.

— PENCIL IT IN —

Thursday

It’s Apprenticeship Day at the Capitol.

9 a.m. — The House Health & Human Services Committee meets. It will consider bills related to skin cancer screening coverage (HB 241), and HIV prevention drugs (HB 159). Room 17, House Office Building.

9 a.m. — The Senate will hold a floor session. Senate chambers.

Noon — The Senate Appropriations Committee meets. It will take up legislation (HB 5301) regarding Medicaid supplemental payment programs. Room 110, Senate Office Building.

Noon — The Senate Fiscal Policy Committee meets. It will consider more than 20 bills, including measures (SB 1512) replated to controlled substances and civil liability for the wrongful death of an unborn child (SB 476). Room 412, Knott Building.

2 p.m. — The House will hold a floor session. House chambers.

Friday

Happy birthday to Rep. Dan Daley!

10 a.m. — The House will hold a floor session. House chambers.

Sunday

Happy birthday to Rep. Doug Bankson!

Happy birthday to Rep. Jenna Persons-Mulicka!

Tuesday

Happy birthday to Rep. Cyndi Stevenson!

Happy birthday to Rep. Joe Cassello!

It’s Day One of ‘Suits for Session.’ Volunteer Florida will be collecting gently worn professional attire. 2nd Floor Rotunda, the Capitol.

10 a.m. — The FX Executive Steering Committee (ESC)  meets. the Agency for Health Care Administration (AHCA), 2727 Mahan Drive, Building 3, Tallahassee,32308-5407, in Conference Rooms A, B, and C. A virtual option will be available via Microsoft Teams Webinar. Wednesday

1:30 p.m. — The Senate Appropriations Committee on Health and Human Services meets. Room 412, Knott Building.

Wednesday

Happy birthday to Sen. Jay Trumbull!

It’s Lilly Pulitzer Day at the Capitol.

It’s Day One of Safety Net Hospital Alliance of Florida 2024 Hospital Days at the Capitol.

It’s FAMU ”Boldly Striking” Day at the Capitol.

It’s Day Two of ‘Suits for Session.’ Volunteer Florida will be collecting gently worn professional attire. 2nd Floor Rotunda, the Capitol.

2 p.m. — The House will hold a floor session. House chambers.

2 p.m. — The Senate will hold a floor session. House chambers.

Diagnosis is written by Christine Jordan Sexton and edited by Drew Wilson.