Christine Jordan Sexton
Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.
— July 1 is around the corner —
Florida’s new fiscal year starts on July 1, and the Legislature passed many new health care laws that take effect.
While most health care bills have been signed at press time, Gov. Ron DeSantis still has not acted on SB 1600, which has some, including members of the Florida Board of Medicine, worried. It’s one of 18 bills that DeSantis hasn’t acted on.
Sen. Jay Collins’ office is on high alert waiting for the outcome of the heavily lobbied legislation.
Meanwhile, a key component of Senate President Kathleen Passidomo’s “Live Healthy” package is (SB 330), which takes effect on the 1st. The law sets aside $313 million for a program to establish new teaching hospitals specializing in behavioral health education and training programs.
The new law also establishes the Florida Center for Behavioral Health Workforce within the University of South Florida’s Louis de la Parte Florida Mental Health Institute (FMHI). The new center will analyze workforce supply and demand issues in behavioral health professions in the state, including recruitment, retention and other workforce issues.
Another new law (HB 415) kicking in sets aside nearly $500,000 for the Department of Health in concert with other state agencies to hire a company to set up a website that provides links and information about pregnancy and parenting. The new website must be functional by January 2025.
This measure was opposed by Democrats who tried unsuccessfully in the Legislature to amend the bill so that the new website would include information about abortion. Democrats are also concerned that the new site will direct Floridians to state-backed crisis pregnancy centers that steer women away from abortions.
Among the more than two dozen health care laws kicking in is a measure that establishes skin cancer screenings for state employees (HB 241), a new law designating rural emergency hospitals (SB 644), new rules for dentists (HB 855), and one that requires the state employee health insurance program and Medicaid to provide coverage for biomarker testing.
Two other notable laws taking effect: One (SB 1582) is an omnibus Department of Health bill with a range of issues, stemming from legal tussles over Black farmer medical marijuana licenses to creating the Andrew John Anderson Pediatric Rare Disease Grant Program to modifying the state’s sickle cell registry program. The other (SB 7072) modifies the framework in place for cancer research and the Casey DeSantis Cancer Research Program.
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— Medicaid dental contracts announced —
AHCA announced its intent to award Medicaid managed care dental contracts to DentaQuest of Florida and Liberty Dental Plan of Florida.
Both plans are currently contracted with the state to provide dental services. MCNA Dental, which is also under contract, is not included in the agency’s announcement.
The ITN established the goals of improving oral health outcomes by implementing a quality continuum, enabling personalized oral health care, particularly for people with special needs, strengthening the dental provider network, and integrating medical and dental care.
The ITN also required dental plans to cover authorized hospital outpatient and ambulatory surgery center (ASC) services, which has been a point of contention with contracted Medicaid plans in the Managed Medical Assistance and Long Term Care managed care programs.
— Back to work —
Florida economists will spend a chunk of their summer coming up with crucial estimates for programs such as Medicaid, Florida KidCare, and state employee health insurance.
The long line of estimating conferences will kick off in early July and reach its zenith on Aug. 14, when economists will draw up the always anticipated estimate for general revenue — which is how much money the state expects to take in over the coming year from sales taxes and other taxes charged by the state. General revenue is a big part of the overall state budget — about $48.6 billion in the 2024-25 budget.
The Office of Economic and Demographic Research late last week released its summer schedule, which includes roughly 40 meetings of conferences with EDR employees as well as top budget staff from the Legislature and the Governor’s office.
The Summer conferences produce important estimates that will be used to develop Florida’s three-year long-range financial outlook, which is presented to the Legislative Budget Commission in September. This outlook projects whether the state will run a budget surplus or a potential deficit over the next few years.
The top health care conferences include Medicaid caseload (July 10), state employees’ health insurance enrollment (July 24), Federal Medical Assistance Percentage (July 24), KidCare expenditures (July 24), Medicaid expenditures (July 25), and state employees’ health insurance expenditures (Aug. 7).
— Death and dying —
Florida health care regulators this week announced they tentatively denied 21 Certificate of Need (CON) applications for new hospice programs and approved nine others.
Heavily populated Broward and Hillsborough counties drew the most interest, with seven providers wanting to establish new hospice programs in each area.
In Broward County regulators approved CON #10787 from Arc Hospice of Florida and CON #10791 from Moments Hospice of Broward. Regulators denied CON applications submitted by AMOR Hospice Care, Bonita Springs Healthcare Services, Bristol Hospice, South Florida, Charis Healthcare Holdings, and Parkside Hospice and Palliative Care, respectively.
In Hillsborough County, AHCA regulators approved applications submitted by Affinity Care Hospice of Hillsborough and Gulfside Hospice of Hillsborough. They denied applications by Arc Hospice of Florida, Bristol Hospice — West Florida, Charis Healthcare Holdings, Community Hospice of Northeast Florida, and VITAS Healthcare Corporation of Florida.
AHCA also denied CON applications by Big Bend Hospice and NHC/OP of Florida, which were hoping to establish new hospice programs in Bay County. AHCA approved CON #10765 submitted by Peoples Hospice and Palliative Care of NW Florida for a new Bay County program
A new hospice program in Franklin County, CON #10766, submitted by Heart’n Soul Hospice of Florida, was approved while health care regulators denied CON #10767 from NHC/OP of Florida.
Arc Hospice of Florida overcame three other competitors to build a new hospice program (CON #10769) in Alachua County. In contrast, VITAS Healthcare Corporation of Florida (CON #10773) edged out Suncoast Empath Hospice of Pasco for a new hospice in Pasco County.
One application for a new hospice program in Sarasota County — CON #10781 submitted by Hospice of Florida — was denied.
There were four applications for new hospice programs in Martin County. CON #10782 was approved by AccentCare Hospice & Palliative Care of the Treasure Coast. Regulators denied applications submitted by Affinity Care of the Treasure Coast, Charis Healthcare Holdings, and Trustbridge of the Treasure Coast, respectively.
The CON applications for hospice programs were submitted on March 27. The decisions are not final and can be appealed in state administrative court.
— Budget override? —
Saying his action “undermines the well-being of faculty who deserve access to affordable and effective health care,” the state’s largest higher education union blasted the Governor for vetoing $80 million to absorb the costs of allowing the staff at 28 state colleges to participate in the state of Florida group health insurance plan.
The United Faculty of Florida issued a statement this week calling on the Governor and the Legislature to “reconsider” the veto, saying the future of the state’s academic excellence “depends on it.”
“The signed budget provided the funding for the successful integration of the state college system into the state employee health system by 2025, a change that promises to reduce costs and improve coverage for FCS employees. However, by vetoing the necessary funding, Gov. DeSantis has once again prioritized his political agenda over the needs of higher education professionals,” the United Faculty of Florida said in a lengthy news release.
“Gov. DeSantis frequently touts Florida’s university and college system as a cornerstone of the state’s success in higher education. Yet, when it comes time to support our educators and staff, where it truly counts, his actions speak louder than his words. This veto not only jeopardizes the health and financial stability of our faculty and graduate assistants but also sends a clear message that their contributions are undervalued. At UFF, our commitment to enhancing Florida’s higher education system is unwavering. Unlike the Governor, we back our words with action, tirelessly advocating for the rights and well-being of our faculty, graduate assistants, and students. This veto is another in a series of attacks that seek to weaken the infrastructure and diminish the power of our higher education institutions.”
DeSantis signed legislation (HB 5101) allowing state college staff to enroll in the health insurance plan. But DeSantis vetoed the $80 million lawmakers agreed to put in the budget to offset the increased costs associated with potential new enrollment.
State workers — including the Gov., Cabinet members, legislators, legislative staff and employees at state agencies — have access to the state group health insurance plan. So do staff in the state university system.
Senate leadership pushed to let colleges join the state group health insurance program, even though economists project that the trust fund that pays for the program could run into a deficit in fiscal year 2024-25.
Budget negotiators agreed to add $550 million to the trust fund to keep it solvent and not increase the monthly insurance premiums paid by state employees, including lawmakers. According to data obtained by Florida Politics, most lawmakers take advantage of the state group health insurance.
Ninety-seven members of the House are enrolled in the state group health insurance plan, according to Jenna Box Sarkissian, the Director of Open Government & Special Projects for House Speaker Paul Renner.
Thirty-four Senators tap into the state group health insurance plan, according to Katherine Betta, a spokesperson for Passidomo.
— RULES —
— The Board of Dentistry is proposing changes to Rule 64B5-13.001 to remove a restriction limiting current and former dental hygiene members to probable cause determinations solely for dental hygienists. More here.
— The Board of Dentistry is proposing changes to Rule 64B5-14.003 to allow any dentist with an unencumbered license or on the faculty of a dental school who is fully trained in the administration of nitrous oxide to teach the administration of nitrous oxide to dental hygienists. More here.
— LOBBYISTS —
— Michael Corcoran, Matt Blair, Will Rodriguez, Corcoran Partners: Sidecar Health
— Steve Crisafulli, Crisafulli Consulting: American Kratom Association
— David Daniel, Jeff Hartley, Lisa Hurley, Jonathan Rees, Smith Bryan & Myers: Rural Urgent Care
— Jose Diaz, Robert M. Levy & Associates: Home Care Plus
— ETC —
—The Tampa Bay Sun Football Club, the new USL Super League first-division franchise, announced its Front-of-Kit partnership and Official Health Care Provider before its inaugural season. Tampa General Hospital (TGH) and the USF Health Morsani College of Medicine at USF have teamed up with the new club. TGH will be the prominent Front-of-Kit partner and Exclusive Academic Health System for the region’s first professional women’s soccer team. The TGH logo will take center stage on both the home and away kits for the Tampa Bay Sun Football Club, and Tampa General will serve as the Official Presenting Partner for the 2024-25 season.
— ROSTER —
—Reema Narang is the new Chief Strategy and Innovation Officer at Lee Health. Narang joins Lee Health from Advocate Health in Chicago, where she was the Senior Vice President for Strategic Growth and Transformation. Narang also served as the administrative officer for value-based care at the Cleveland Clinic in Cleveland, Ohio. Narang earned a bachelor’s degree in electrical engineering from Delhi University in New Delhi, India, and an MBA from the University of Connecticut. She also holds an executive certificate in Health Care Value from the Harvard Business School.
— The Governor appointed Michael Caschette, registered nurse and founder of KIDS 1st Urgent Care to the Broward College District Board of Trustees.
— Walter Long has been named the Chief Operating Officer for HCA Florida Lake City Hospital. Long has been with HCA Healthcare since 2016 and recently served as the Vice President of operations at HCA Florida West Hospital, a 515-bed acute care facility in Pensacola. The appointment was announced last week though he has served in the post since Dec. 4, 2023.
— ICYMI —
In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.
“Nikki Fried says abortion makes health care an issue at the polls” via Christine Jordan Sexton of Florida Politics — On the second anniversary of the U.S. Supreme Court ruling that overturned Roe v. Wade, Florida Democratic Party Chair Nikki Fried is confident that this will be the year that health care will be a driving factor in the state’s elections. Shortly after the Dobbs decision in 2022, Fried herself tried to use access to abortion as a talking point in her Democratic Primary campaign against Charlie Crist. But Crist easily defeated Fried for the gubernatorial nomination before he was trounced by Gov. Ron DeSantis that November.
“Smart & Safe Florida loses some spark with less than $1,500 raised in the first half of June” via Christine Jordan Sexton of Florida Politics — The main committee pushing the proposed amendment to allow recreational marijuana had its smallest fundraising period in the past year, according to newly filed campaign finance reports. Smart & Safe Florida raised less than $1,500 for the first half of June, the lowest amount the organization has brought in since June of 2023. However, the group, which has received the bulk of its money from medical marijuana company Trulieve, has more than $13.2 million in the bank even though it has already dropped several million on ads encouraging voters to back the initiative. The group’s latest campaign report shows that Smart & Safe Florida has spent nearly $400,000 this month on printing, media production and professional services from several different political consulting and communications firms.
“Abortion rights activists highlight Florida fight on anniversary of Roe v. Wade” via Gabrielle Rousson of Florida Politics — On the two-year anniversary of the U.S. Supreme Court overturning Roe v. Wade, Florida abortion rights activists are spotlighting their push to enshrine abortion rights in the state constitution this November. The Supreme Court’s Dobbs v. Jackson decision reversed the landmark case on abortion that stood for nearly 50 years. Since then, the Republican-controlled Legislature banned abortion after 15 weeks, then enacted a six-week ban that took effect in May. The six-week ban includes exceptions, such as in cases of rape, incest and human trafficking, until 15 weeks of pregnancy.
“Multiple Catholic dioceses donate to anti-abortion committee” via Robert Haughn of Florida Politics — Multiple Catholic dioceses have contributed money to Florida Voters Against Extremism, a committee advocating against the pro-abortion rights Amendment 4. From June 1 to June 14, the anti-Amendment 4 committee raised $107,560. A significant portion of that came from multiple Catholic dioceses. The Diocese of St. Augustine contributed $55,000 to the committee, over half of what the committee raised in that period. The Diocese of Pensacola-Tallahassee also contributed $25,000 to the committee. The committee currently has around $190,000 cash on hand.
— FOR YOUR RADAR —
Aside from coverage by Florida Politics, these stories are worth your time.
“Supreme Court will take up state bans on gender-affirming care for minors” via The Associated Press — The Supreme Court on Monday jumped into the fight over transgender rights, agreeing to hear an appeal from the Biden administration seeking to block state bans on gender-affirming care. The Justices’ action comes as Republican-led states have enacted a variety of restrictions on health care for transgender people, school sports participation, bathroom usage and drag shows. The administration and Democratic-led states have extended protections for transgender people, including a new federal regulation that seeks to protect transgender students. The case before the high court involves a law in Tennessee that restricts puberty blockers and hormone therapy for transgender minors. The federal appeals court in Cincinnati allowed laws in Tennessee and Kentucky to take effect after lower courts had blocked them.
“Florida Medicaid spending on undocumented immigrants plummets after new law “ via Arek Sarkissian of POLITICO — The amount of money that Florida’s Medicaid program spends to provide emergency health care to undocumented migrants has dropped significantly after DeSantis launched a multipronged crackdown on illegal immigration amid his unsuccessful Primary bid for President. DeSantis signed a law last year directing hospitals that accept Medicaid to ask patients about their immigration status when they seek treatment. While the law does not force patients to provide hospitals with an answer, immigrant rights groups feared the mandate would scare migrants away from seeking urgent medical attention. The DeSantis administration and other Florida Republicans say any marked decreases in spending are signs his immigration crackdown is working.
“FSU Trustees Chair talks ‘transformative’ health care, student housing projects” via Tarah Jean of the Tallahassee Democrat — Florida State University’s Board of Trustees Chair Peter Collins brought a group of local business leaders up to speed Monday about FSU’s changing landscape and its 2020-2030 Campus Master Plan initiatives on the horizon. While a good chunk of Collins’ talking points referred to the ongoing FSU versus ACC litigation, he also touched on some of the university’s major projects — such as FSU Health and the future of student housing — as he spoke to a group of about 60 Capital Tiger Bay Club members at the Tucker Civic Center during a luncheon.
— PENCIL IT IN —
Thursday
Happy birthday to Sen. Lori Berman!
Friday
Happy birthday to Agriculture Commissioner Wilton Simpson!
Sunday
Happy birthday to Sen. Erin Grall!
Monday
State fiscal year 2024-25 begins.
Diagnosis is written by Christine Jordan Sexton and edited by Drew Wilson.
