Budget

House and Senate budgets finalized for budget conference. Last week, House and Senate budget committees voted out their respective General Appropriations Acts and related implementing and conforming bills. The implementing bill generally implements one-year changes to statutory law as a result of budgetary changes in the appropriations bill, while the various conforming bills make permanent changes to statutory law. For the upcoming fiscal year, the House has proposed a $66.5 billion budget, while the Senate has proposed a $69.8 billion budget. Both proposals eliminate more than 5,000 state positions, reduce per-student education funding by approximately six percent, and require state workers to contribute three percent of their pay to their retirement funds, among other changes. The difference between the chambers in the total budget amount is due primarily to the inclusion in the Senate budget of the budgets of the clerks of court and of the state's five water management districts. The budget cuts are a result of a loss of more than $2 billion in federal stimulus dollars as well as lower-than-expected tax revenues. Both chambers will take up and pass their respective proposals on the floor later this week. Once passed, procedural motions will be adopted to begin the budget conference process. Budget negotiations generally begin at the individual budget committee level. Issues that are not resolved at that level are then "bumped up" to the chairs of the appropriations committees and, if issues remain after the appropriations chairs have deliberated, these issues go to the House speaker and Senate president for a final resolution.

Legislature

Community-based care liability bill moves ahead in the House. Last Monday, H.B. 1019, by Rep. Scott Plakon, passed the Health Care Appropriations Subcommittee after significant pushback from children's advocates and trial attorneys. The bill would reduce the required liability coverage that community-based care providers must carry from $1 million per claim and $2 million per incident, to $500,000 per claim and $1.5 million per incident. In addition, the bill reduces the per-claim limit on economic damages in tort claims, from $1 million to $500,000, and imposes a per-incident cap of $1.5 million for economic damages and $500,000 for noneconomic damages. The bill also imposes an overall limit of $2 million for economic damages and $1 million for noneconomic damages for all claimants. Finally, the same provisions also are applied to subcontractors of community-based care providers. Opponents of the legislation claim that the bill will significantly limit the number of lawsuits to address harm to vulnerable children, while proponents claim that such lawsuits are extracting dollars out of the child welfare system that would otherwise go to the care of children. The companion in the Senate, S.B. 1500 by Sen. Jack Latvala, is next scheduled to be heard in its first committee of reference on Tuesday in the Banking and Insurance Committee.

House unveils $400-million economic development superfund while workshopping new Department of Economic Opportunity. On Friday, the House Select Committee on Government Reorganization approved two proposals that create a $400-million State Economic Enhancement and Development Trust Fund. The trust fund is created from the merger of various economic development trust funds, Florida housing trust funds, and the State Transportation Trust Fund. By the 2012 – 2013 fiscal year, the new trust fund will contain more than $400 million in tax revenues, although the vast majority of funds will not shift into the new trust fund until the 2012 – 2013 fiscal year. The trust fund will be used for five principal purposes:

  • Transportation facilities that meet a strategic and essential economic development state interest
  • Affordable housing programs and projects
  • Economic development incentives for job creation
  • Workforce training associated with locating a new business or expanding an existing business
  • Tourism promotion and marketing services and programs

The select committee also discussed a proposal to create a new Department of Economic Opportunity, headed by a commissioner appointed by the governor. The department would be created by merging the Office of Tourism, Trade, and Economic Development (OTTED), the Agency for Workforce Innovation, and the Department of Community Affairs. The department would contain four divisions: strategic business development, community planning and development, workforce services, and finance and administration. The broad goals of the department include promoting community revitalization and affordable housing, assisting with the coordination of community planning and development, and developing a strategic plan to recruit new businesses and expand and retain businesses in the state. The proposal also would create a single public-private partnership to promote economic development, merging the Florida Sports Foundation, VISIT Florida, and the Florida Black Business Investment Board into Enterprise Florida, Inc.

House sends Medicaid reform legislation to the Senate largely unchanged, while Senate continues debate in committee. On Wednesday and Thursday, the House passed H.B. 7107 and H.B. 7109, bills which transition the delivery system for Florida's Medicaid program to statewide managed care. The bills passed largely unchanged from their final form as voted out in committee, and debate proceeded along partisan lines. Democrats decried a perceived reduction in patient choice and services under managed care, while Republicans emphasized the need to provide better health outcomes for patients and achieve predictable growth for the program. The Senate proposal, S.B. 1972 by Sen. Joe Negron, passed the Health Regulation committee on a unanimous vote after the committee discussed 34 amendments. The adopted amendments were offered by a number of Senators to address a variety of details in the implementation of the bill, such as extending the medical loss ratio requirement to managed care subcontractors, and requiring managed care plans to adhere to a single, statewide drug formulary. Sen. Negron argued successfully against a handful of "carveout" amendments by Sen. Mike Fasano, which would have either removed services from managed care (i.e., transportation) or given preferential treatment to certain providers (i.e., community care for the elderly, or CCE, providers). The Senate bill is next scheduled to be heard in the Health and Human Services Budget Subcommittee on Wednesday.

Bill prohibiting physicians from queries about gun ownership voted out of Senate committee after compromise reached. A proposal to prohibit physicians from querying their patients about the presence of guns in their homes passed last Monday after a compromise was reached between physician and gun lobbyists. Sen. Greg Evers, the sponsor of the proposal, S.B. 432, offered the amendment in the Health Regulation Committee. The amendment prohibits health care providers and facilities from entering information regarding firearm ownership into a patient's medical record when the provider knows that the information is not relevant to the patient's medical care or safety. Further, the amendment prohibits a health care provider or facility from inquiring about firearm ownership, unless the provider in good faith believes that such information is relevant to the patient's medical care or safety. The bill next goes to the Judiciary Committee for a hearing this afternoon, its second-to-last committee of reference. The companion in the House, H.B. 155 by Rep. Jason Brodeur, will be heard on Tuesday in the Health and Human Services Committee.

Senate rejects repeal of drug database and Gov. Rick Scott creates a pill mill strike force, while House dispensing ban bill advances. On Monday, the Senate Health Regulation Committee rejected an attempt by Chairman Rene Garcia to amend a repeal of the drug database onto S.B. 818 by Sen. Fasano. S.B. 818 strengthens a number of provisions related to controlled substances, but does not repeal the drug database. Supporters of the database rejected privacy concerns and pointed to the more than 30 states that operate similar systems. Meanwhile, on the same day, Gov. Scott launched a strike force to combat the state's pill mill epidemic, made up of squads in each of Florida Department of Law Enforcement's seven regions throughout the state. Gov. Scott also appeared to endorse the dispensing ban favored by the House, albeit with certain exceptions. In the House on Wednesday, the Judiciary Committee voted out an amended H.B. 7095, which substantially revises the regulation of controlled substances. The original bill, among other provisions, repealed pain clinic regulations, prohibited physicians from dispensing controlled substances in their offices, and banned wholesale drug distributors from distributing such drugs to physicians and dentists. The bill also required wholesale distributors to buy back undispensed drugs held by physicians and dentists. A strike all amendment offered by Rep. Charles McBurney and adopted by the committee deleted the restrictions on wholesale distributors and narrowed the dispensing ban to Schedule II and III drugs, the controlled substances that are most susceptible to abuse. The amendment also bans community pharmacies from dispensing these drugs unless the pharmacy is owned by a publicly traded corporation, is owned by a corporation that has at least $100 million in taxable assets in the state, or has been continuously licensed for the past 10 years. Finally, the amendment requires wholesale distributors to credential physicians, dentists, and pharmacies that purchase Schedule II or III drugs from the distributor. The amended bill still repeals the regulation of pain clinics, as in the original bill. The companion to H.B. 7095, H.B. 7097, which repeals the Office of Drug Control and the drug database, has not yet been referred to any committees.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.