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Issue 6 | February 22, 2016 

Top News: Budget Conference May Start This Week
Florida House of Representatives debates the budget bill.

The House and Senate passed their proposed 2016-2017 state budgets last week. The Senate plan, at $80.9 billion, is nearly $1 billion larger than the $79.9 billion House plan, and both are larger than the Governor's proposed $79.3 billion budget. Differences between the proposals will be negotiated in the 'Joint Budget Conference' likely to begin this week, after House and Senate leaders work out the 'allocations', the overall amounts of money available in each budget area (education, health, human services, etc).  House Speaker Crisafulli and Senate President Gardiner will then appoint legislators to the conference committees.
See below for a look at some of the key health care budget and policy issues in the second half of the legislative session.
House and Senate Health Budget Plans
House Health Care Approps. Chair Matt Hudson.
Senate Health & Human Services Approps. Chair Rene Garcia.

The Senate health care budget is nearly $400 million larger than the House plan, mostly due to differences in 'Medicaid services to individuals' in the Agency for Health Care Administration budget.

House and Senate proposals both include: $1.2 billion to the Agency for Persons with Disabilities, $3 billion to the Department of Children and Families, $300 million to the Department of Elder Affairs, $2.8 billion to the Department of Health, and $105.6 million to the Department of Veterans' Affairs.

The Senate, but not the House, includes a $14 million grant program to increase access to primary care services and reduce and prevent unnecessary emergency room visits and hospitalizations; another $9.5 million supports free and charitable care clinics.

The Department of Elder Affairs budget reduces, but does not eliminate, the Home and Community Care waiting list and, according to Dave Bruns, communications director for AARP Florida, "Florida is falling further and further behind". State data show more than 6,000 poor, disabled, or elderly Floridians who qualified for home- and community-based health services died during a 12-month period while they were on waiting lists for those services.
Dental Care
Sen. Joe Negron (left) and Sen. Don Gaetz, sponsors of two dental services bills to increase statewide access.

Lack of affordable, accessible dental services is a problem for many low income Floridians. Several bills now ready for final votes in the House and Senate aim to improve access to dental services.
Dental Access Accounts: CS/CS/HB 139 and SB 234 require the Dept. of Health (DOH) to develop and implement dental care access accounts for dentists employed by a public health program or committed to opening a private practice capable of serving at least 1,200 patients in a dental health professional shortage or medically underserved area.
Dental Hygienist Services: CS/SB 580 and CS/HB 595 authorize the Agency for Health Care Administration to reimburse health care facilities under the Medicaid program for remedial dental services delivered by a dental hygienist when provided to a Medicaid recipient younger than 21 years of age.
Sunset Medicaid Dental Services: SB 994 and HB 819 
remove dental services as a required benefit from the Statewide Medicaid Managed Care program; require a comprehensive report on how effective Medicaid managed care plans have been in improving access, satisfaction, delivery, and value in dental services; and create an option for a separate dental program for children and adults.
Health Care Policy: Telehealth, Direct Primary Care and 'Scope of Practice' Bills
Long-time nurse advocates Barbara Lumpkin (left) and Sen. Denise Grimsley celebrate after SB 676 (the 'Barbara Lumpkin Act') passes its final committee and heads for a floor vote.

Several bills moving this session address access to health care by expanding availability, addressing physician shortages and/or lowering costs.
Telehealth technology increases access and reduces health care costs. The Senate bill (CS/SB 1686) establishes a taskforce charged with gathering data and issuing a report; the House bill (CS/CS/HB 7087) goes farther, defining the scope of practice and authorizing out of state physicians to practice telehealth. SB 1686 is in its final committee; HB 7087 is ready for a floor vote.
Direct primary care reduces the cost of health care by permitting patients to pay a monthly fee directly to a health care practitioner for a limited set of primary care services. CS/CS/SB 132 and CS/CS/HB 37 clarify that direct primary care agreements are not insurance and not subject to the Florida Insurance Code. Both bills are headed to full floor votes.
'Scope of Practice': A shortage of primary care physicians in Florida limits access and raises the cost of health care.  CS/CS/SB 676 Access to Health Care Services and related bills moving in the House and Senate expand the scope of practice of physician assistants (PAs) and advanced registered nurse practitioners (ARNPs) by allowing them to prescribe controlled substances, a first step towards relieving the physician shortage.
Bills to Watch This Week

CS/CS/SB 242 Infectious Disease Elimination (Braynon, D-Miami Gardens and Flores, R-Miami) Authorizes the University of Miami and its affiliates to establish a sterile needle and syringe exchange pilot program in Miami-Dade County; provides that the possession, distribution, or exchange of needles and syringes under the pilot program is not a violation of the Florida Comprehensive Drug Abuse Prevention and Control Act or any other law.
CS/SB 408 Juvenile Civil Citations and Similar Diversion Programs (Criminal Justice Committee) Requires the establishment of civil citation or similar diversion programs for juveniles.
CS/SB 1420 Eligibility for Employment as Child Care Personnel (Bean, R-Jacksonville) Prohibits the removal of or exemption from certain disqualifications from employment for child care personnel under certain circumstances; specifies certain offenses that disqualify a person from child care employment, notwithstanding any prior exemption.
CS/HB 7053 and SB 7058 Child Care and Development Block Grant (Education Committee/PreK-12 Subcommittee) Expand list of entities that have access to child abuse records for approving providers of school readiness services; require school readiness program providers to provide DCF & local licensing agencies with access for inspection purposes; require certain child care providers to submit affidavit of compliance with licensure requirements; provide criteria for exemption from disqualification for employment with school readiness program provider; revise duties of OEL; revise provisions relating to child and parent eligibility for school readiness programs.
Quick Links
Questions or Comments?
Contact Ted Granger, United Way of Florida, or Jess Scher, United Way of Miami-Dade.